Journal of Manipulative and Physiological Therapeutics最新文献

{"title":"TOC","authors":"","doi":"10.1016/S0161-4754(25)00130-7","DOIUrl":"10.1016/S0161-4754(25)00130-7","url":null,"abstract":"","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages A1-A3"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrarater and Interrater Reliability of Scapulothoracic and Glenohumeral Strength Measurements by the Belt-Stabilized Handheld Dynamometer in Individuals With Subacromial Pain Syndrome","authors":"Guilherme A.P. Custódio PT ,&nbsp;Camila F. Gobatto PT ,&nbsp;Jaqueline Martins PT, MSc ,&nbsp;Érik C. Terroni PT ,&nbsp;Anamaria S. de Oliveira PT, PhD","doi":"10.1016/j.jmpt.2025.10.004","DOIUrl":"10.1016/j.jmpt.2025.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the intrarater and interrater reliability of glenohumeral and scapulothoracic muscle strength measured in individuals with chronic, unilateral subacromial pain syndrome.</div></div><div><h3>Methods</h3><div>Fifty individuals with shoulder pain were evaluated in 2 sessions using a belt-stabilized handheld dynamometer (HHD) for maximum isometric strength of the glenohumeral flexion, extension, abduction, lateral and medial rotation, and elevation, protraction, retraction, and retraction with scapular depression. Reliability was determined using the intraclass correlation coefficient (ICC_2,3) with the standard error of measurement (SEM), the minimal detectable change (MDC), and a percentage of average strength (%SEM and %MDC).</div></div><div><h3>Results</h3><div>The values of intraclass correlation coefficient, SEM, and %SEM for glenohumeral muscles ranged from 0.93 to 0.98, 1 kg, and 7% to 14%, respectively, and for scapulothoracic muscles from 0.90 to 0.98, 2 to 4 kg, and 10% to 17%, respectively. The MDC and %MDC values ranged from 2 to 4 kg and 19% to 38% for glenohumeral muscles and 4 to 11 kg and 27% to 47% for scapulothoracic muscles, respectively.</div></div><div><h3>Conclusion</h3><div>Belt-stabilized handheld dynamometer demonstrated excellent reliability to measure scapulothoracic and glenohumeral muscle strength in patients with chronic, unilateral subacromial pain syndrome. Guidelines for correct positioning and measurement of the strength of the shoulder complex along with their clinical viability are presented.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 357-364"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145438010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Neck Pain Influence on Oculomotor Performance During Near Point Convergence and Fitts’s Tasks: a cross-sectional study","authors":"Michayla M. Esteves MSc ,&nbsp;Brian MacNeil PhD ,&nbsp;Ganesh Tailor MSc ,&nbsp;Cheryl M. Glazebrook PhD ,&nbsp;Michael G. Johnson MD, FRCSC ,&nbsp;Steven R. Passmore DC, PhD","doi":"10.1016/j.jmpt.2025.08.005","DOIUrl":"10.1016/j.jmpt.2025.08.005","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to quantify the influence of musculoskeletal dysfunction on oculomotor performance by evaluating oculomotor convergence and volitional gaze performance in participants with chronic neck pain compared with controls.</div></div><div><h3>Methods</h3><div>Twelve participants with chronic neck pain were age/sex matched to 12 asymptomatic participants. All participants completed a series of tests in neutral, trunk rotated right, and trunk rotated left positions. A Royal Air Force ruler was used to measure near point convergence (NPC), a convergence insufficiency (CI) measurement. Oculomotor performance was assessed using an oculomotor Fitts’s Law task. Questionnaire data included the neck disability index (NDI) and CI symptom survey (CISS).</div></div><div><h3>Results</h3><div>A significant reduction in NPC was found in participants with neck pain for the neutral and rotated left positions. Movement time increased for targets at farther amplitudes for both groups. Reaction time increased for targets at shorter amplitudes for the symptomatic group, indicating motor planning challenges. Significant correlations were found between CISS and NPC scores, as well as between CISS and NDI scores, indicating CISS scores are associated with convergence performance deficits. Greater NDI scores related to larger CISS scores, correlating to increased CI symptoms.</div></div><div><h3>Conclusion</h3><div>Significant differences between groups were found for NPC suggesting that symptomatic participants have difficulties controlling convergent eye movements compared with asymptomatic participants. Reaction time was found to be longer for index of difficulty at a shorter amplitude for the symptomatic group. Correlations between CISS scores with NPC and NDI scores respectively were found, providing evidence of a relationship between CI and neck disability.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 119-128"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupuncture as Adjuvant Therapy for Hypertension in the Elderly: A Network Meta-Analysis","authors":"Huiqi Lv MD ,&nbsp;Ming Li MD ,&nbsp;Hong Liu MD ,&nbsp;Yucheng Zhong MD ,&nbsp;Hao Wen MD ,&nbsp;Xiang Wang MD","doi":"10.1016/j.jmpt.2025.10.061","DOIUrl":"10.1016/j.jmpt.2025.10.061","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the effectiveness and safety of acupuncture as adjuvant therapy for hypertension in elderly patients.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and network meta-analysis to assess the effects of acupuncture as adjuvant therapy for hypertension in the elderly. Databases searched included the Cochrane Library, PubMed, Embase, Web of Science, and the China National Knowledge Infrastructure database from their inception to March 1, 2025. The primary outcome was the mean change in blood pressure, while the secondary outcome was safety, evaluated by the incidence of adverse reactions.</div></div><div><h3>Results</h3><div>A total of 24 studies (3044 participants) were included. For systolic blood pressure (SBP), acupuncture combined with calcium antagonists demonstrated significantly greater efficacy compared to calcium antagonists alone, auricular acupressure plus calcium antagonists, auricular acupressure alone, acupuncture plus ACE inhibitors, auricular acupressure plus ACE inhibitors, ACE inhibitors alone, acupuncture alone, electroacupuncture, and angiotensin II (mean difference [MD]: 10.71; 17.86; 13.48; 16.47; 19.84; 25.8; 28.25; 36.34; and 27.23, respectively). For diastolic blood pressure (DBP), acupuncture combined with calcium antagonists was significantly more effective than auricular acupressure alone, calcium antagonists alone, electroacupuncture, acupuncture alone, angiotensin II, acupuncture plus ACE inhibitors (MD: 26.32; 17.48; 32.43; 29.56; 22.66; 29.18; 31.75; 24.27; and 25.61, respectively). Based on ranking probabilities, acupuncture combined with calcium antagonists may be the most effective and safe treatment for hypertension in the elderly.</div></div><div><h3>Conclusions</h3><div>Current evidence suggests that acupuncture as adjuvant therapy could be effective and safe for elderly patients with hypertension, with the combination of acupuncture and calcium antagonists potentially being the optimal choice. However, due to potential biases, results should be interpreted cautiously.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 473-482"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Costs and Utilization Between Provider Types for Back and Neck Pain: A Cross-Sectional Study","authors":"Forest S. Kim PhD ,&nbsp;David J. Kahle PhD ,&nbsp;Neil S. Fleming PhD ,&nbsp;Michael Gallaugher PhD ,&nbsp;Tanner Houston MBA ,&nbsp;Sonish Lamsal MS ,&nbsp;Rodney X. Sturdivant PhD","doi":"10.1016/j.jmpt.2024.09.013","DOIUrl":"10.1016/j.jmpt.2024.09.013","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to compare treatment expenditures and utilization of licensed doctors of chiropractic or doctors of physical therapy working for Airrosti (AP) compared with non-AP providers (NAP) comprising 5 different provider types.</div></div><div><h3>Methods</h3><div>This study was a retrospective, claims-based, cross-sectional study using 5 years of claims and enrollment data from the state of Texas. We compared licensed doctors of chiropractic or doctors of physical therapy working for Airrosti to NAP. Episodes of care for back and neck pain were formed using 90-day clean periods. We utilized propensity scores using inverse probability weighting to control for selection bias. We examined the association of provider type with total costs per episode and 5 different measures of utilization: numbers of visits, length of episode, hospitalization, use of advanced diagnostic imaging, and use of surgery.</div></div><div><h3>Results</h3><div>Included were 645 799 unique patient episodes of care. Orthopedic specialists, physiatrists, and physical therapists had higher costs and utilization than AP, except for lower visits for orthopedic specialists. Primary care providers had lower costs and utilization than AP, except for hospitalizations, in which no difference was found. AP were most similar to chiropractors in terms of costs and utilization; however, AP had higher use of advanced diagnostic imaging compared with chiropractors. Chiropractors had more visits and longer episodes than AP. Standard deviations for average episode cost, episode length, and number of visits were greater for all provider types compared with AP, except for primary care providers.</div></div><div><h3>Conclusion</h3><div>In the sample studied, providers using standardized treatment pathways had reduced variation and costs for patients with spinal pain. We hypothesize that adherence to treatment pathways that align with recommended clinical practice guidelines that discourage the use of diagnostic imaging and surgery as a first step for treating lower back and neck pain may have resulted in the significant cost and utilization differences found between AP and NAP.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 69-78"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of 2 Training Protocols on Aspects of Pain in Older Women With Chronic Low Back Pain: A Randomized Clinical Trial","authors":"Poliana de Jesus Santos MSc ,&nbsp;José Carlos Aragão-Santos MSc ,&nbsp;Thainá Souza Santos BSc ,&nbsp;Marcos Raphael Pereira-Monteiro MSc ,&nbsp;Josimari Melo DeSantana PhD ,&nbsp;Elyson Ádan Nunes Carvalho PhD ,&nbsp;Marzo Edir Da Silva-Grigoletto PhD","doi":"10.1016/j.jmpt.2024.09.012","DOIUrl":"10.1016/j.jmpt.2024.09.012","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to compare the effects of 16 weeks of functional versus dual-task training on aspects of pain in older women with chronic nonspecific low back pain.</div></div><div><h3>Methods</h3><div>This randomized clinical trial included 38 participants aged 60 to 79 years divided into 2 groups: functional training (FT) and dual-task training (DT). We assessed pressure pain threshold (PPT), temporal summation of pain, conditioned pain modulation (CPM), trunk instability, isometric strength, and endurance of trunk muscles before and 16 weeks after training. Generalized mixed models were used to compare the groups over time, adopting <em>P</em> ≤ .05. Additionally, the effect size (Cohen's d) was calculated.</div></div><div><h3>Results</h3><div>Functional training and DT promoted statistically significant increases in PPT (d = 1.82 and 1.10, respectively) and CPM (d = 1.60 and 1.13, respectively). Only FT promoted a statistically significant increase in PPT (d = 1.23). Functional training was superior to DT in PPT and CPM (<em>P</em> &lt; .05). Functional training and DT increased the maximum isometric strength of trunk extensors (d = 2.14 and 2.12, respectively; <em>P</em> &lt; .05), without statistically significant differences between groups. Only DT showed a statistically significant improvement in the endurance of extensors and lateral flexors of the trunk (d = 0.77; d = 0.69).</div></div><div><h3>Conclusion</h3><div>Both FT and DT were effective in promoting increased pain pressure threshold, improvement of CPM, and trunk function in older women with chronic nonspecific low back pain, however, without effects on temporal summation of pain and trunk stability. These indicators show that the proposed training may promote pain attenuation and increased trunk function.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 47-56"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Obesity on Outcomes of Traction Therapy for Women With Chronic Low Back Pain: An Observational Study","authors":"Marzena Ratajczak PhD ,&nbsp;Michał Wendt PhD ,&nbsp;Damian Skrypnik PhD ,&nbsp;Krzysztof Kusy PhD ,&nbsp;Małgorzata Waszak PhD","doi":"10.1016/j.jmpt.2025.10.036","DOIUrl":"10.1016/j.jmpt.2025.10.036","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine whether obesity influences the effects of traction therapy on pain, disability, lumbar mobility, and the biomechanical and viscoelastic properties (BVPs) of tissues in the lumbar region in women with low back pain (LBP).</div></div><div><h3>Methods</h3><div>Women aged 34 to 50 years with chronic LBP and obesity (<em>n</em> = 26) or normal body weight (bw; <em>n</em> = 17) underwent 20 traction therapy sessions. LBP (on a visual analog scale), Oswestry Disability Index, BVPs, lumbar spine mobility, and trunk tissue fat were assessed before and then 3 days and 3 months after therapy. Two-way repeated measures ANOVAs were used.</div></div><div><h3>Results</h3><div>Pain and disability were significantly decreased (<em>P</em> &lt; .01) and anterior lumbar flexion was increased (<em>P</em> &lt; .05) after treatment and maintained at this level for 3 months in both women with obesity and normal body mass index (BMI). However, while stiffness was only reduced in women with normal BMI after treatment (<em>P</em> &lt; .05), this effect was not maintained at follow-up. The mobility in posterior and lateral flexions and rotations did not change. All BVPs correlated with trunk tissue fat content (<em>P</em> &lt; .01).</div></div><div><h3>Conclusion</h3><div>The outcomes of traction therapy with continuous mode at a force of 25% to 30% of the patient’s bw were not different for women with BMI ≥ 30 and &lt;25 kg/m². Only the effect on muscle stiffness seems to be more beneficial for women without obesity. However, myotonometric results are strongly related to trunk fat content, subject to a potential measurement error in women with obesity.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 502-512"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Base of Support and Foot Positioning on Posture Evaluated Using the Postural Analysis Software: An Exploratory Study","authors":"Elizabeth A. Ferreira PhD ,&nbsp;Daniel V. Kolisch BPT ,&nbsp;Daniela F. Carro MSc ,&nbsp;Leda T.Y. Da Silveira PhD ,&nbsp;João Simão De Melo-Neto PhD ,&nbsp;Patrícia Driusso PhD ,&nbsp;Adriana C. Lunardi PhD","doi":"10.1016/j.jmpt.2025.10.005","DOIUrl":"10.1016/j.jmpt.2025.10.005","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to evaluate the changes in posture with 2 different bases of support for static posture.</div></div><div><h3>Methods</h3><div>In this exploratory study, participants were photographed in a standing position from anterior, posterior, and lateral views, in both spontaneous standing base of support (SBoS) (feet in a freely adopted position) and closed feet base of support (CBoS) (feet held together). Styrofoam markers were attached to 32 anatomical reference points, and posture assessment was conducted using software (PAS/SAPO). The area of each base of support (BoS) and the deviation of the center of gravity (CG) from the reference point within the BoS were measured. Comparisons between CBoS and SBoS postures were performed using paired t-tests.</div></div><div><h3>Results</h3><div>One hundred and seven participants (81 women) and 856 photographs were evaluated. Average age was 25.65 ± 2.83 years and body mass index was 22.4 ± 2.8 kg/m². Alignment of the right and left lower limbs showed a difference in the frontal view; however, no differences were found in the posterior view. In the left lateral view, differences were noted in the hip angle (trunk and thigh), horizontal alignment of the pelvis, and knee angle. In the SBoS, the BoS area was greater, with a smaller deviation from the CG compared to the CBoS.</div></div><div><h3>Conclusion</h3><div>This study found that foot positioning can influence the alignment of lower limbs, pelvis, base of support, and balance, without affecting trunk postural assessment.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 587-595"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise-Induced Modulation of Inflammatory Biomarkers After Stroke: A Systematic Review and Meta-Analysis","authors":"Ana C.S. Bitencourt MS ,&nbsp;Maria Eduarda S. Aveiro BS ,&nbsp;Rodolfo P. Timóteo PhD ,&nbsp;Rodrigo Bazan PhD ,&nbsp;Eduardo E.V. Carvalho PhD ,&nbsp;Gustavo J. Luvizutto PhD","doi":"10.1016/j.jmpt.2025.10.002","DOIUrl":"10.1016/j.jmpt.2025.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to perform a systematic review of the literature on the effectiveness of physical exercise on cytokine levels after stroke.</div></div><div><h3>Methods</h3><div>The PubMed, LILACS, ScienceDirect, Web of Science, Scopus, and Embase databases were searched without language or date restriction through September 2025 using the terms “stroke” and “exercise” and “cytokines” and related terms. Eligible studies included patients with stroke (P), investigated aerobic or multimodal exercise interventions (I), compared them with a control group (C), and reported outcomes on cytokines or other systemic inflammatory biomarkers (O). To assess the risk of bias in each study, we used the criteria described in the Cochrane Handbook for Systematic Review of Interventions. Fixed-effect meta-analysis were performed for homogeneous outcomes.</div></div><div><h3>Results</h3><div>In total, 8 randomized clinical trials were included for qualitative analysis, and in the meta-analysis. The meta-analysis showed that aerobic training significantly reduced IL-6 (SMD −0.51; 95% CI −0.86 to −0.15; <em>P = .</em>006) and hs-CRP (SMD −1.46; 95% CI −2.18 to −0.75; <em>P &lt; .</em>001), while no significant effect was observed for TNF-α (SMD −0.11; 95% CI −0.53 to 0.31; <em>P = .</em>60). Heterogeneity was high across studies.</div></div><div><h3>Conclusions</h3><div>Exercise interventions were associated with reductions in cytokine levels, particularly IL-6 and hs-CRP. These effects were mainly observed after aerobic training. Given the limited number of trials and the substantial heterogeneity, these findings should be interpreted with caution.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 373-384"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter- and Intra-Tester Reliability of Postural Stability Tests in Patients With Whiplash-Associated Disorder","authors":"Niklas Särkilahti MHc ,&nbsp;Airi Oksanen PhD ,&nbsp;Eliisa Löyttyniemi MSc ,&nbsp;Jenny Mäkelä BHc ,&nbsp;Janette Kaukonen BHc ,&nbsp;Jani Takatalo PhD, MD ,&nbsp;Olli Tenovuo PhD, MD","doi":"10.1016/j.jmpt.2025.10.046","DOIUrl":"10.1016/j.jmpt.2025.10.046","url":null,"abstract":"<div><h3>Objective</h3><div>Our study aimed to examine the inter- and intra-tester reliability of postural balance tests in patients with whiplash-associated disorder (WAD).</div></div><div><h3>Methods</h3><div>Fifteen adults with chronic WAD performed 7 different postural balance tests using a static force platform: in the neutral head position (neutral test), gaze rotated 20° (left and right), head rotated 20° (left and right), and neck torsioned 20° (left and right) positions. Inter- and intra-tester reliability were assessed for both individual tests and the differences between the neutral test and each test variant in sway velocity (mm/s) and velocity moment (mm²/s) parameters. This assessment utilized intra- and interclass correlation, mean differences of 2 measurements (paired t-test or Wilcoxon signed-rank test), the coefficient of within-subject variance, and the 95% percentile.</div></div><div><h3>Results</h3><div>Overall results showed at least a strong (≥0.70) correlation between the 2 testers and the tester’s 2 test sessions in the individual tests. Furthermore, the average results did not mainly differ between testers and test sessions, and no wide variability of results was noticeable, indicating that the results can be considered clinically meaningful. However, the correlations of the between-test differences primarily ranged from negligible to moderate, leaving the results clinically insignificant.</div></div><div><h3>Conclusions</h3><div>The results of this study suggest that individual postural balance tests yield clinically reliable results for patients with WAD. However, caution is warranted when assessing the difference between balance test variations. It is not yet known whether these tests can distinguish between different study groups and whether they are reliable in assessing different sensory systems.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 404-421"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}