Shelley D Sargent, Geoffrey M Gelley, Steven R Passmore
{"title":"Self-reported Measures of Function Compared to Lower Limb Motor Performance in People With and Without Imaging Evidence of Unilateral Lumbar Nerve Root Compression: A Cross-sectional Study.","authors":"Shelley D Sargent, Geoffrey M Gelley, Steven R Passmore","doi":"10.1016/j.jmpt.2024.02.002","DOIUrl":"10.1016/j.jmpt.2024.02.002","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of the present study was to determine if imaging findings of unilateral lumbar nerve root compression (ULNRC) impact performance on a coordinated motor performance task and to determine if there were correlations between motor performance and self-reported clinical measures.</p><p><strong>Methods: </strong>People with back pain (N = 45) were stratified into 3 groups based on combinations of: lumbar imaging; and clinical presentation for ULNRC. Group 1 included people with imaging of lumbar nerve root compression, who presented with neurological deficit. Group 2 people demonstrated imaging evidence of nerve compression, without motor, sensory or reflex change. Group 3 participants possessed only degenerative changes on lumbar imaging films, and were neurologically intact. Performance measures included behavioral and kinematic variables from an established lower limb Fitts' Task requiring movements to targets of different difficulties. Self-reported measures of disability, function and pain were collected. Analysis of variance for between and within group variables were conducted, and Pearson correlation compared performance with self-reported measures.</p><p><strong>Results: </strong>All groups yielded main effects for movement time with increasing task difficulty as predicted by Fitts' Law. A main effect revealed Group 1 participants performed less accurately than Group 3 participants. Positive correlations were predominantly found between self-report measures and motor performance for Group 2 and Group 3.</p><p><strong>Conclusion: </strong>Imaging, and self-reported measures alone did not predict function, however, Fitts' task performance accuracy effectively differentiated groups.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119797","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}
Brian S Budgell, H Stephen Injeyan, Julita Teodorczyk-Injeyan
{"title":"Effect of Seated Cervical Spinal Manipulation on Autonomic Nervous System Activity as Measured by Heart Rate Variability and Plasma Norepinephrine Levels: A randomized Pre- and Poststudy.","authors":"Brian S Budgell, H Stephen Injeyan, Julita Teodorczyk-Injeyan","doi":"10.1016/j.jmpt.2024.02.003","DOIUrl":"10.1016/j.jmpt.2024.02.003","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to determine whether seated cervical manipulation produced changes in autonomic nervous system activity, as measured by heart rate variability and plasma norepinephrine levels.</p><p><strong>Methods: </strong>Ninety-five healthy young adults (ages 20-48 years) were recruited into a single-blinded physiological study, with 47 randomized to a seated cervical manipulation and 44 randomized to a sham procedure. Heart rate variability in the frequency domain, and plasma norepinephrine levels were measured prior to, immediately following, and 5 minutes following the intervention.</p><p><strong>Results: </strong>Electrocardiograms were obtained from 39 subjects in the sham group and 43 subjects in the manipulation group. No statistically significant changes were found in measures of heart rate variability in the frequency domain in either the manipulation or sham groups. Blood samples were obtained from 22 subjects in the sham group and 27 subjects in the manipulation group. Plasma norepinephrine levels, as measured by spectrophotometry, declined in both groups from pre- to immediately postintervention, and they remained at decreased levels 5 minutes after the interventions. There were no statistically significant differences between groups in pre- or postintervention norepinephrine levels.</p><p><strong>Conclusions: </strong>Measures of heart rate variability and plasma norepinephrine levels did not show that seated cervical manipulation produced short-term changes in autonomic nervous system activity compared to a sham procedure in healthy young adults.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119796","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}
Hatice Cetin, Nezire Kose, Emre Gurses, Ceyhun Turkmen, Songül Aksoy, Halil Kamil Oge
{"title":"Effects of Virtual Reality for Postural Control in Chronic Neck Pain: A Single-Blind, Randomized Controlled Study.","authors":"Hatice Cetin, Nezire Kose, Emre Gurses, Ceyhun Turkmen, Songül Aksoy, Halil Kamil Oge","doi":"10.1016/j.jmpt.2024.02.006","DOIUrl":"10.1016/j.jmpt.2024.02.006","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to investigate the effects of virtual reality (VR) on postural control, posture, and kinesiophobia in patients with chronic neck pain (CNP).</p><p><strong>Methods: </strong>Forty-one participants with CNP were randomly allocated to the VR and control groups. The VR group experienced VR with glasses for 20 minutes and then performed motor control (MC) exercises for 20 minutes. The control group received only MC exercises for 40 minutes. Both groups received 18 sessions over 6 weeks. Computerized dynamic posturography outcomes, including sensory organization test (SOT), limits of stability, and unilateral stance tests, gait speed, forward head posture (FHP), shoulder protraction (SP), cervical lordosis angle, kinesiophobia, and exercise compliance were recorded.</p><p><strong>Results: </strong>The VR group had more effects regarding composite equilibrium (Cohen's d = 1.20) of SOT and kinesiophobia (Cohen's d = -0.96), P < .05). Also, the VR group was more effective in exercise compliance (P < .05). Contrary to these results, the control group was more effective in correcting FHP and SP (Cohen's d > 0.7, P < .05).</p><p><strong>Conclusion: </strong>Virtual reality seemed to have an effect on postural control, posture, and kinesiophobia in patients with chronic neck pain.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468565","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}
Nahid Pirayeh, Zahra Heidary, Mohammad Mehravar, Mohammad Jafar Shaterzadeh Yazdi, Neda Mostafaee
{"title":"Sensory Organization and Postural Control Strategies in Individuals With Mild and Moderate-to-Severe Forward Head Posture: A Comparative Study.","authors":"Nahid Pirayeh, Zahra Heidary, Mohammad Mehravar, Mohammad Jafar Shaterzadeh Yazdi, Neda Mostafaee","doi":"10.1016/j.jmpt.2024.02.004","DOIUrl":"10.1016/j.jmpt.2024.02.004","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare sensory organization test and postural control strategies between individuals with mild and moderate-to-severe forward head posture (FHP).</p><p><strong>Methods: </strong>A sensory organization test (SOT) was performed in 6 conditions using computerized dynamic posturography, to assess postural control. Equilibrium scores representing overall balance, strategy analysis to assess ankle vs hip strategy dominance, and sensory analysis (Somatosensory, visual, vestibular, visual preference ratio) as an indicator of the use of sensory systems were obtained.</p><p><strong>Results: </strong>Our results revealed a significant difference between the 2 groups in terms of equilibrium score (P < .05) and strategy scores (P < .05) in conditions of 4 to 6 of the SOT. The results of sensory analysis of SOT showed visual and vestibular ratios were significantly different between the 2 study groups (P < .05), but somatosensory and visual preference ratios were not significantly different between these 2 groups (P > .05).</p><p><strong>Conclusion: </strong>Individuals with moderate-to-severe FHP swayed more in comparison with mild FHP ones in conditions with the Sway-referenced platform of the SOT. They tended to rely on the hip strategy more than the ankle strategy excessively when sensory difficulty increased. Overall, it can be concluded that individuals with moderate-to-severe FHP are more likely to have postural deficits.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293756","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}
Carol Ann Weis, Kathy Padkapayeva, Peter Smith, Jon Barrett, Victoria Landsman
{"title":"Relationship Between Location of Pregnancy-Related and Postpartum-Related Back Pain and Limitations of Daily Activities and Work Participation.","authors":"Carol Ann Weis, Kathy Padkapayeva, Peter Smith, Jon Barrett, Victoria Landsman","doi":"10.1016/j.jmpt.2024.02.001","DOIUrl":"10.1016/j.jmpt.2024.02.001","url":null,"abstract":"<p><strong>Objective: </strong>The aims of this study were to (1) examine if the location of pregnancy-related back pain impacts activities of daily living and absence from work and (2) determine which types of pain were more likely to persist postpartum.</p><p><strong>Methods: </strong>This was a secondary analysis of data from an observational cohort study. Data were collected in Ontario between 2013 and 2014. Four pain location groups were identified, including low back pain (LBP), pelvic girdle pain (PGP), combined pain, and mixed pain. Logistic regression models were used to examine the impact of pain location on activity and absence from work. Descriptive analyses explored the association between pregnancy pain location and postpartum pain patterns.</p><p><strong>Results: </strong>We surveyed 305 pregnant participants and followed up with 80 of these participants up to 6 months postpartum. Data analysis showed approximately a 2-fold increase in interference with employment (outside the home) and self-grooming for those with combined pain compared to those only experiencing LBP. Respondents with PGP and combined PGP and LBP had approximately a 5-fold increased likelihood of absence from work compared to respondents with only LBP; those with a mixture of LBP and PGP had a 13-fold increase in likelihood. Approximately 50% of respondents reported being pain-free, 16% experienced lingering pain, and 38% experienced persistent pain within 6 months postpartum. Those with combined pain during pregnancy continued to have persistent pain up to 6 months postpartum.</p><p><strong>Conclusion: </strong>The results suggest that the location of pregnancy-related back pain is associated with interference in daily activities, an increase in absence from work, and the persistence of postpartum pain. For this cohort, back pain did not always resolve after delivery, and those experiencing pregnancy-related combined pain continued to experience symptoms postpartum.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293755","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":"Effectiveness of Glenohumeral Joint Mobilization on Range of Motion and Pain in Patients With Rotator Cuff Disorders: A Systematic Review and Meta-Analysis","authors":"Héctor Gutiérrez-Espinoza PT, PhD , Iván Cuyul-Vásquez PT, MSc , Cristian Olguin-Huerta PT, MSc , Marcelo Baldeón-Villavicencio PT, MSc , Felipe Araya-Quintanilla PT, PhD","doi":"10.1016/j.jmpt.2023.05.009","DOIUrl":"10.1016/j.jmpt.2023.05.009","url":null,"abstract":"<div><h3>Objective</h3><p><span><span>The purpose of this study was to determine the effectiveness of glenohumeral joint mobilization (JM) on range of motion and pain intensity </span>in patients with </span>rotator cuff (RC) disorders.</p></div><div><h3>Methods</h3><p><span>An electronic search was performed in the MEDLINE, CENTRAL, Embase, </span>PEDro<span><span>, LILACS, CINAHL, SPORTDiscus, and Web of Science databases. The eligibility criteria for selecting studies included </span>randomized clinical trials that investigated the effect of glenohumeral JM techniques with or without other therapeutic interventions on range of motion, pain intensity, and shoulder function in patients older than 18 years with RC disorders. Two authors independently performed the search, study selection, and data extraction, and assessed risk of bias. Grades of Recommendation Assessment, Development and Evaluation ratings were used to evaluate the quality of evidence in this study.</span></p></div><div><h3>Results</h3><p><span>Twenty-four trials met the eligibility criteria, and 15 studies were included in the quantitative synthesis. At 4 to 6 weeks, for glenohumeral JM with other manual therapy techniques vs other treatments, the mean difference (MD) for shoulder flexion was −3.42° (</span><em>P</em> = .006), abduction 1.54° (<em>P</em> = .76), external rotation 0.65° (<em>P</em><span> = .85), and Shoulder and Pain Disability Index score 5.19 points (</span><em>P</em> = .5), and standard MD for pain intensity was 0.16 (<em>P</em><span> = .5). At 4 to 5 weeks, for the addition of glenohumeral JM to an exercise program vs exercise program alone, the MD for the visual analog scale was 0.13 cm (</span><em>P</em> = .51) and the Shoulder and Pain Disability Index score was −4.04 points (<em>P</em> = .01).</p></div><div><h3>Conclusion</h3><p>Compared with other treatments or an exercise program alone, the addition of glenohumeral JM with or without other manual therapy techniques does not provide significant clinical benefit with respect to shoulder function, range of motion, or pain intensity in patients with RC disorders. The quality of evidence was very low to high according to Grades of Recommendation Assessment, Development and Evaluation ratings.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10120623","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}
Martijn S. Stenneberg PhD , Herman ten Berge MSc , Bart de Leeuw MSc , Erik Cattrysse PhD , Rob de Bie PhD , Henrica de Vet PhD , Gwendolijne G.M. Scholten-Peeters PhD
{"title":"Variability of Active Cervical Range of Motion Within and Between Days in Healthy Participants: A Prospective Observational Study","authors":"Martijn S. Stenneberg PhD , Herman ten Berge MSc , Bart de Leeuw MSc , Erik Cattrysse PhD , Rob de Bie PhD , Henrica de Vet PhD , Gwendolijne G.M. Scholten-Peeters PhD","doi":"10.1016/j.jmpt.2023.06.001","DOIUrl":"10.1016/j.jmpt.2023.06.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to determine the intraday and interday variability and systematic change over the day of active cervical range of motion (aCROM) measurements in asymptomatic persons using a clinically applicable measurement device.</p></div><div><h3>Methods</h3><p>A prospective observational study was performed. Sixteen adults (8 men and 8 women, median age 51 years) without neck pain in the last 3 months were recruited in 2 physiotherapy practices. Active cervical range of motion was estimated using the Apple iPhone application “3D Range of Motion.” Measurements were performed 3 times a day for 7 days and spread over a period of 3 weeks. Mean values of aCROM were calculated. Intraday and interday variability was estimated by calculating limits of agreement.</p></div><div><h3>Results</h3><p>The limits of agreement for intraday variability ranged from ±12.1° for left rotation to ±15.5° for total rotation. For interday variability, the limits of agreement ranged from ±14.2° for right rotation to ±20.1° for total rotation. No systematic change over the day was found.</p></div><div><h3>Conclusion</h3><p>This study showed substantial intraday and interday variability of aCROM measurements in asymptomatic people. No trend toward an increased or decreased aCROM was observed during the course of the day. When interpreting aCROM values, clinicians should consider the degree of variation in aCROM measurements over time.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10503032","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}
Mona Ramezani MS , Fatemeh Ehsani PT, PhD , Ali Gohari MD
{"title":"Effect of Functional Electrical Stimulation on Muscle Mass, Fatigue, and Quality of Life in Older Patients With COVID-19: A Randomized Clinical Trial Study","authors":"Mona Ramezani MS , Fatemeh Ehsani PT, PhD , Ali Gohari MD","doi":"10.1016/j.jmpt.2023.06.004","DOIUrl":"10.1016/j.jmpt.2023.06.004","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to evaluate the effects of functional electrical stimulation (FES) on muscle strength, fatigue, muscle mass, and quality of life (QoL) in older patients with COVID-19.</p></div><div><h3>Methods</h3><p>Older patients with COVID-19 were randomly divided into the following 2 groups: real FES (intervention group, n = 20) and sham FES (control group, n = 20). These patients received FES concurrent with the voluntary contraction of muscles for 10 consecutive sessions. Ultrasound imaging, pressure biofeedback, Chalder fatigue scale, and QoL were utilized to measure muscle mass, muscle strength, chronic fatigue, and QoL, respectively. Evaluations were performed at the beginning, immediately, and 1 month after the end of intervention.</p></div><div><h3>Results</h3><p>All variables showed statistically significant improvement immediately and 1 month after the intervention in the real FES group (<em>P</em> < .05). However, the tibialis anterior muscle mass and fatigue significantly improved immediately after the intervention in the sham FES group. However, the tibialis anterior and rectus femoris muscles strength and rectus femoris muscle mass were not significantly changed immediately and 1 month after the intervention (<em>P</em> > .05). There were significant differences in muscle mass, physical fatigue, muscle strength, and QoL between groups with more efficacy of real FES (<em>P</em> < .05).</p></div><div><h3>Conclusion</h3><p>For this sample of patients, FES improved fatigue, muscle strength, muscle mass, and QoL in older adults with COVID-19.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41134988","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":"Information for Readers","authors":"","doi":"10.1016/S0161-4754(23)00070-2","DOIUrl":"https://doi.org/10.1016/S0161-4754(23)00070-2","url":null,"abstract":"","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50187920","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}
Jennifer F. Mullins PhD, DPT , Matthew C. Hoch PhD, ATC , Phillip Gribble PhD, ATC , Nicholas Heebner PhD, ATC , Kyle Kosik PhD, ATC , Philip Westgate PhD , Arthur J. Nitz PhD
{"title":"Examination of Dry Needling Dose and Effect Duration for Individuals With Chronic Ankle Instability","authors":"Jennifer F. Mullins PhD, DPT , Matthew C. Hoch PhD, ATC , Phillip Gribble PhD, ATC , Nicholas Heebner PhD, ATC , Kyle Kosik PhD, ATC , Philip Westgate PhD , Arthur J. Nitz PhD","doi":"10.1016/j.jmpt.2023.05.007","DOIUrl":"10.1016/j.jmpt.2023.05.007","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this study was to evaluate the effect of a single treatment vs serial </span>dry needling (DN) treatments of the fibularis longus on individuals with chronic ankle instability and to determine the longevity of any effect found.</p></div><div><h3>Methods</h3><p>Thirty-five adults with chronic ankle instability (24.17 ± 7.01 years, 167.67 ± 9.15 cm, 74.90 ± 13.23 kg) volunteered for a university laboratory repeated-measures study. All participants completed patient-reported outcomes and were objectively tested using the Star Excursion Balance Test (SEBT), threshold to detect passive motion (TTDPM) measurements, and single limb time-to-boundary measurements. Participants received DN treatment to the fibularis longus once weekly for 4 weeks on the affected lower extremity by a single physical therapist. Data were collected 5 times: baseline 1 week before initial treatment (T0), pre-treatment (T1A), immediately after the first treatment (T1B), after 4 weekly treatments (T2), and 4 weeks after the cessation of treatment (T3).</p></div><div><h3>Results</h3><p>Significant improvements were found for clinician-oriented (SEBT-Composite <em>P</em> < .001; SEBT-Posteromedial <em>P</em> = .024; SEBT-Posterolateral <em>P</em> < .001; TTDPM-Inversion <em>P</em> = .042) and patient-oriented outcome measures (Foot and Ankle Ability Measure–Activities of Daily Living <em>P</em> < .001; Foot and Ankle Ability Measure–Sport <em>P</em> = .001; Fear Avoidance Belief Questionnaire <em>P</em> = .021) following a single DN treatment. Compounding effects from additional treatments exhibited improvement of TTDPM (T1B to T2). No significant losses were noted 4 weeks after cessation of treatment (T2 to T3).</p></div><div><h3>Conclusion</h3><p>For the participants in this study, outcomes improved immediately following the first DN treatment. This improvement was sustained but not further improved with subsequent treatments.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9818066","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}