Journal of Manipulative and Physiological Therapeutics最新文献

{"title":"Attitudes, Beliefs, and Values of Italian Osteopaths Toward the Management of Patients With Tension-Type Headache: A Categorical Content Analysis","authors":"Alessio Iacopini MSc ,&nbsp;Jorge E. Esteves PhD ,&nbsp;Giacomo Consorti MSc, DO ,&nbsp;Christian Lunghi BSc ,&nbsp;Francesco Cerritelli PhD","doi":"10.1016/j.jmpt.2025.08.009","DOIUrl":"10.1016/j.jmpt.2025.08.009","url":null,"abstract":"<div><h3>Objective</h3><div>Tension-type headache (TTH) is among the 20 leading causes of disability worldwide. Due to the difficulty in diagnosis and the variable association of other symptoms, the management of this clinical condition is often unsatisfactory. Osteopathic manipulative treatment combined with exercise, diet, and general relaxation therapies may be valid for TTH. This study investigated osteopaths’ common attitudes, beliefs, and values when treating and managing individuals experiencing TTH.</div></div><div><h3>Methods</h3><div>This is a qualitative study using thematic analysis with elements of grounded theory. Osteopaths with expertise in treating patients with primary headache conditions were recruited through purposive sampling methods. Data were gathered from individual, semistructured interviews and transcribed verbatim and then analyzed through thematic analysis. Ten osteopaths who met the inclusion criteria were recruited.</div></div><div><h3>Results</h3><div>Four main themes were generated from data analysis: (1) osteopathy and its alternative perspective on patients’ perception of osteopathic intervention; (2) osteopaths’ clinical decision making regarding the selection of treatment approaches; (3) the person’s management through an individualized case treatment model; (4) a person-centered approach, setting the treatment in a particular environment to achieve the fulfillment of an individual’s potential.</div></div><div><h3>Conclusion</h3><div>The present study highlights that this sample of osteopaths endorse a person-centered renewed approach. The participants regularly assess the clinical conditions and disabilities associated with TTH to tailor their treatment approach. These osteopaths consider that these tailored treatment approaches directed at improving and promoting the individual’s wellbeing alongside a reduction of their symptoms should be the main aim of osteopathic treatment.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 99-111"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137733","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":"Analysis of Nociceptive Pain and Related Psychosocial Factors in Women With Endometriosis: A Cross-sectional Study","authors":"Anna Arnal-Gómez PhD ,&nbsp;Beatriz Arranz-Martín PhD ,&nbsp;Lucas Monzani PhD ,&nbsp;Celia Martínez-Alexandre MSc ,&nbsp;Adriana Hortelano-Molina MSc ,&nbsp;Laura Fuentes-Aparicio PhD","doi":"10.1016/j.jmpt.2025.10.057","DOIUrl":"10.1016/j.jmpt.2025.10.057","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to explore the associations and compare differences in abdominal and lumbar pain pressure thresholds, pelvic floor state, and pain- and movement-related psychosocial factors in women with and without endometriosis.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted on women (18-50 years). Participants with endometriosis (EG) were compared to age-matched counterparts without endometriosis (CG). Clinical symptoms were recorded, and pain pressure thresholds (PPT) and pelvic floor muscles (PFM) tone and strength were measured. Psychosocial factors such as catastrophizing, kinesiophobia, sexual function, and health-related quality of life were assessed. Univariate and multivariate analyses of covariance were conducted.</div></div><div><h3>Results</h3><div>In total, 46 participants were analyzed (EG: 22; CG: 24). After isolating the effect of the participants’ psychosocial factors, statistically significant differences between the groups regarding pain were still observed (<em>P</em> &lt; .05; η2 &gt; 0.14). EG participants had lower PPT in all abdominal and lumbar measurements (<em>P</em> &lt; .05; d &gt; 0.8). Sexual function and quality of life were significantly lower (<em>P</em> &lt; .05; d &gt; 0.8), while catastrophizing and kinesiophobia were significantly higher (<em>P</em> &lt; .05; d ≥ 0.8) in the EG compared to CG.</div></div><div><h3>Conclusions</h3><div>After isolating the effect of the psychological factors, pain remained a specific symptom of endometriosis. Woman with endometriosis had lower PPT in the lumbar and abdominal muscles, engaged more frequently in catastrophizing, kinesiophobia, and reported significantly lower quality of life. These findings underscore the need for a multidimensional approach that addresses both the physical and psychological aspects of women with endometriosis.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 606-616"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471153","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 Connective Tissue Manipulation on Clinical Symptoms and Pelvic Floor Muscles in Children With Lower Urinary Tract Dysfunction: a Randomized Clinical Trial","authors":"Melis Ünal MSc ,&nbsp;Elif Develi PhD ,&nbsp;Halil Tuğtepe","doi":"10.1016/j.jmpt.2025.10.037","DOIUrl":"10.1016/j.jmpt.2025.10.037","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of the study was to examine the impact of a combined approach involving connective tissue manipulation (CTM) and pelvic floor muscle (PFM) exercises on symptoms, uroflowmetry parameters, and PFM activation in children with lower urinary tract disorders.</div></div><div><h3>Methods</h3><div>Forty children with lower urinary tract disorder were randomized into 2 groups: (1) PFM group and (2) CTM+PFM exercise group (CTG). The treatment was performed 3 times a week for 8 weeks. Children were evaluated with electromyography-uroflowmetry, bladder ultrasonography, bladder diary, electromyography-PFM activation, and the Dysfunctional Voiding and Incontinence Scoring System at baseline and 8 weeks after interventions.</div></div><div><h3>Results</h3><div>A comparison of the 2 groups revealed that the CTG group demonstrated greater improvement in mean flow rate (Q-Ave), maximum voiding volume, incontinence frequency, PFM contraction activation (work average), and Dysfunctional Voiding and Incontinence Scoring System scores (<em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>Connective tissue manipulation applied in addition to pelvic floor muscle exercises was more effective on certain uroflow and bladder diary parameters, symptom severity score, and certain PFM activation parameters. Connective tissue manipulation applied together with PFM exercises may be a novel approach in children with lower urinary tract disorders, a noninvasive and accessible manual therapy method.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 531-540"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471302","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":"Observational Study of the Safety of Chiropractic vs Medical Care Among Older Adults With Neck Pain","authors":"James M. Whedon DC, MS ,&nbsp;Brian Anderson DC, PhD ,&nbsp;Todd A. Mackenzie PhD ,&nbsp;Leah Grout PhD ,&nbsp;Steffany Moonaz PhD ,&nbsp;Jon D. Lurie MD, MS ,&nbsp;Scott Haldeman DC, MD, PhD","doi":"10.1016/j.jmpt.2025.07.002","DOIUrl":"10.1016/j.jmpt.2025.07.002","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the risk of selected adverse outcomes for older adults with a new episode of neck pain (NP) receiving chiropractic care compared to those receiving primary medical care with Prescription Drug Therapy (PDT) or primary care without medication.</div></div><div><h3>Methods</h3><div>Through analysis of Medicare claims data, we designed a retrospective cohort study including 291 604 patients with a new office visit for NP in 2019. We developed 3 mutually exclusive exposure groups: the <em>Chiropractic Manipulative Therapy (CMT)</em> group received spinal manipulative therapy from a chiropractor with no primary care visits; the <em>PDT</em> group visited primary care and filled an analgesic prescription within 7 days without chiropractic care, and the <em>Primary Care Only (PCO)</em> group visited primary care without chiropractic care or analgesic prescriptions. We analyzed possible complications, including adverse drug events, vertebrobasilar insufficiency, and other selected adverse outcomes, calculating incidence rate ratios over 24 months using Poisson regression with robust standard errors and inverse propensity weighing to balance the exposure groups regarding patient characteristics.</div></div><div><h3>Results</h3><div>Among 291 604 patients, 182 596 (63%) received chiropractic care. For <em>CMT</em> vs <em>PDT</em>, the rate for any measured adverse outcome was 20% lower; for <em>CMT</em> vs <em>PCO</em>, the rate was 14% lower, and for <em>PDT</em> vs <em>PCO</em>, the rate was 6% higher. <em>PDT</em> had the highest risk of any measured adverse outcome.</div></div><div><h3>Conclusion</h3><div>For Medicare Part B beneficiaries with new onset NP, management with <em>chiropractic care</em> was associated with lower rates of adverse events than primary medical care. The PDT group had the highest risk of any measured adverse outcome.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 37-46"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023444","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":"Quality of Descriptions of Pelvic Floor Muscle Training Prescribed to Women With Dyspareunia: A Systematic Review","authors":"Isabela R.S. Cavalcanti MSc ,&nbsp;Adriana C. Lunardi PhD ,&nbsp;Daniela F. Carro MSc ,&nbsp;Leda T.Y. da Silveira PhD ,&nbsp;Elizabeth A. Ferreira PhD","doi":"10.1016/j.jmpt.2025.10.039","DOIUrl":"10.1016/j.jmpt.2025.10.039","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to analyze the description quality of interventions with pelvic floor muscle training (PFMT) for dyspareunia treatment and to describe treatment modalities and protocols.</div></div><div><h3>Methods</h3><div>This was a systematic review of randomized clinical trials, longitudinal studies, and before–after studies. We searched MEDLINE/PubMed, Web of Knowledge, Scopus, Cochrane, LILACS, PEDro, and Embase, last updated June 2024. The Consensus on Exercise Reporting Template recommendations and Consensus on Therapeutic Exercise Training document were used to analyze the description of PFMT protocols.</div></div><div><h3>Results</h3><div>Among 769 retrieved articles, 17 were included, involving 963 women 20 to 70 years of age with dyspareunia, vulvodynia, pelvic pain, and/or sexual dysfunction. Dyspareunia was assessed with tools such as numeric or subjective pain scales and questionnaires like the Female Sexual Function Index. The mean Consensus on Exercise Reporting Template score was 7.3 ± 2.7 (40% of items accomplished). The mean Consensus on Therapeutic Exercise Training score was 5.4 ± 1.3 (61% of items accomplished). Most protocols applied supervised exercises at outpatient clinics and prescribed nonsupervised home exercises. PFMT encompassed muscle contraction with varied duration (3-60 seconds) and intensity (phasic and tonic), followed by muscle relaxation. Most associated therapy was biofeedback, followed by manual therapy and electrical stimulation.</div></div><div><h3>Conclusion</h3><div>Most descriptions of PFMT protocols for dyspareunia treatment did not follow recommended consensus tools, making it difficult to compare data and transpose to clinical practice. Protocols of PFMT are heterogeneous among studies.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 550-559"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471384","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":"Factors Influencing Initial Trial Planning for Low Back Pain Among Veterans Health Administration Chiropractors: A Descriptive Observational Survey","authors":"Victoria A. Bensel DC, MPH, MS ,&nbsp;Paul E. Dougherty DC ,&nbsp;Brenda T. Fenton PhD ,&nbsp;Anthony J. Lisi DC","doi":"10.1016/j.jmpt.2025.08.007","DOIUrl":"10.1016/j.jmpt.2025.08.007","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to assess how chiropractors within the Veterans Health Administration (VHA) determine their perceived-optimal dosage (number of visits and trial duration) when planning initial trials of care for patients with low back pain, and to describe factors perceived to influence these decisions, as well as barriers and facilitators to implementation.</div></div><div><h3>Methods</h3><div>A cross-sectional electronic survey was distributed to all chiropractors with an active VHA appointment as of July 1, 2024 (N = 384). The survey, based on prior qualitative interviews and pilot testing, included a clinical vignette and questions related to perceived-optimal visit number and duration, modifying factors, and implementation. Descriptive and inferential statistics (Pearson’s chi-squares) were used to analyze responses in SAS 9.4.</div></div><div><h3>Results</h3><div>A total of 181 VHA chiropractors completed the survey (47.1% response rate). The most frequently reported perceived-optimal initial trial was 6 visits over 6 weeks (21.5%). Respondents reported that increasing patient age, higher pain intensity, greater functional impairment, and shorter duration of symptoms would increase the planned visit dosage. There was considerable variation in chiropractors’ perceptions of the ideal initial treatment trial. Most clinicians (62%) reported they were able to implement their preferred initial trial less than half of the time. The same barriers (including number of available chiropractic clinicians and treatment rooms) and facilitators (including the ability to collaborate with non-DC clinicians and the presence of clinical support staff) were reported by both the &lt;25% and ≥75% optimal implementation groups. However, more chiropractors in the &lt;25% optimal implementation group reported barriers than did those in the ≥75% optimal implementation group for the number of DC Clinicians (74% vs 39%, <em>p</em> = .0002), and clinical access parameters (67% vs 36%, <em>p</em> = .0002).</div></div><div><h3>Conclusions</h3><div>This study revealed that VHA chiropractors reported variable perceived-optimal initial trial dosages and endorsed several clinical and system-level factors that influence trial planning. Reported barriers to implementation were common, particularly those related to staffing and space limitations, with more chiropractors in the low implementation group reporting barriers.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 155-165"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206682","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":"Immediate Effects of Manual Therapy Techniques on Ankle Dorsiflexion: A Randomized Clinical Trial","authors":"Matheus de Castro Silva PT, MSc ,&nbsp;Arthur de Sá Ferreira PT, PhD ,&nbsp;Rodrigo de Marche Baldon PT, PhD ,&nbsp;Carolina Lins PT, PhD ,&nbsp;Gustavo Martins de Andrade ,&nbsp;Gustavo Barros Braga de Castro Pereira ,&nbsp;Natalia Camin Silva PT, MSc ,&nbsp;Lilian Ramiro Felício PhD","doi":"10.1016/j.jmpt.2025.09.002","DOIUrl":"10.1016/j.jmpt.2025.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the effects of combined techniques on ROM, performance, and dynamic postural balance in young adults.</div></div><div><h3>Methods</h3><div>Sixty participants were recruited, with a mean age of 25.35 (±8.00) years and ankle dorsiflexion ROM below 40° in closed kinetic chain (CKC). The participants were randomly divided into 2 groups: Joint mobilization based on the Mulligan Concept (Group 1); Joint mobilization based on the Mulligan Concept, together with the Maitland Method (Group 2). The participants were evaluated preintervention (A0), immediately after the intervention (A1), and 3 to 4 days after the intervention (A2). Primary outcome: DF ROM in CKC. Secondary outcomes: ROM in open kinetic chain, performance, and balance.</div></div><div><h3>Results</h3><div>Group 2 presented superior performance in the Triple Hop Test in evaluations A1 (Cohen’s d = 1.45) and A2 (Cohen’s d = 1.21), and after the intervention (A2) showed greater displacement (Cohen’s d = 3.22) in the Y Balance Test. Both groups showed increases of DF ROM in CKC and performance.</div></div><div><h3>Conclusions</h3><div>The combination of joint mobilization techniques can provide additional benefits in functional performance. Both techniques are effective for increasing ankle DF ROM.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 166-176"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206631","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":"Traction Loading Human Coracohumeral Ligaments With 20 and 40 Newton Forces and Sustained Creep Deformation: A Preliminary Cadaveric Investigation","authors":"John F. Hoops ScD ,&nbsp;Carla M. James ScD ,&nbsp;Charles Nichols ScD ,&nbsp;Jean-Michel Brismee ScD ,&nbsp;Peter J. Rundquist PhD ,&nbsp;Lee Atkins PhD ,&nbsp;Stéphane Sobczak PhD","doi":"10.1016/j.jmpt.2025.10.030","DOIUrl":"10.1016/j.jmpt.2025.10.030","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to determine if different force magnitudes, loading cycle repetitions, and loading speeds alter creep deformation (CD) during cyclical traction loading of human cadaveric coracohumeral ligaments (CHL).</div></div><div><h3>Methods</h3><div>Fifteen unembalmed human cadaveric CHL specimens were assigned to 3 groups based on maximal force and loading speed: (1) 40Nslow: 40N; 0.83 mm/s; (2) 20Nslow: 20N; 0.83 mm/s; (3) 20Nfast: 20N; 2.5 mm/s. All specimens underwent 360 cycles of traction loading in a material testing system. The material testing system collected CD during loading at 60-cycle intervals. Micrometer measurements determined CD 60 minutes after loading. Friedman’s ANOVA was used to compare within-group CD changes, and Kruskal-Wallis ANOVA was used to compare between-group CD differences.</div></div><div><h3>Results</h3><div>All groups demonstrated increased CD during 360 cycles (<em>P</em> &lt; .003) without differences between groups at any 60-cycle interval (<em>P</em> &gt; .05). Sixty minutes after loading, CD was 7% (±5) in the 20Nslow, 15% (±12) in the 40Nslow, and 13% (±7) in the 20Nfast groups without between-group differences (<em>P</em> = .353).</div></div><div><h3>Conclusion</h3><div>Cyclical traction loading cadaveric CHL specimens with 20N and 40N forces increased CD without a difference between groups. Creep deformation was partially retained 60 minutes after loading. No CD differences were found using 20N loads at 2 different loading speeds.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 483-489"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458635","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 Swimming and Running Exercise-Induced Changes in Muscle Fibers, Bone Structure, and Oxidative Stress in Aging Rats","authors":"Mahmut Sürmeli PhD ,&nbsp;Fikret Gevrek PhD ,&nbsp;Elif Azize Özşahin Delibaş PhD ,&nbsp;Funda Demirtürk PhD ,&nbsp;Eylem Tütün Yümin PhD","doi":"10.1016/j.jmpt.2025.10.048","DOIUrl":"10.1016/j.jmpt.2025.10.048","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to investigate the effects of weight-bearing and nonweight-bearing aerobic exercises on bone morphometry, muscle fiber types, and oxidative stress markers.</div></div><div><h3>Methods</h3><div>Eighteen 15-month-old male rats were divided into control, swimming, and running groups (n = 6 each). After a 2-week adaptation period, the exercise groups underwent 8 weeks of moderate-intensity swimming or running. Blood, gastrocnemius muscle, and femur bone samples were collected postexercise. Parameters analyzed included total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) in blood, muscle fiber types by immunohistochemistry, and bone characteristics by histostereology.</div></div><div><h3>Results</h3><div>OSI values were similar across groups (<em>P</em> &gt; .05), but oxidative stress was elevated in the exercise groups. The ratio of type I fibers was higher in the exercise groups compared to controls (<em>P</em> &lt; .05) and similar between swimming and running groups (<em>P</em> &gt; .05). Type IIa fiber ratio was highest in the control group and lowest in the running group (<em>P</em> &lt; .05). Bone surface area, trabecular thickness, and cortical thickness were greater in the running group than in controls (<em>P</em> &lt; .05). The swimming group had a higher distal femur bone area and trabecular width than controls (<em>P</em> &lt; .05), but no significant differences were found between the exercise groups (<em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>Weight-bearing and nonweight-bearing exercises had a significant effect on muscle fiber composition, bone structure, and oxidative stress in elderly rats. Running particularly enhanced bone surface area and thickness, while swimming also benefited bone health. Both exercises increased oxidative stress and antioxidant capacity.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 617-630"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471460","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":"National Trends in the Utilization and Expenditure of Chiropractic Care in U.S. Adults: Analysis of the 2007-2016 Medical Expenditure Panel Survey","authors":"Baojiang Chen PhD ,&nbsp;Henry S. Brown PhD ,&nbsp;David Douphrate PhD ,&nbsp;Jud Janak PhD ,&nbsp;Kelley Pettee Gabriel MS, PhD ,&nbsp;Trent Peng PhD, DC, MS","doi":"10.1016/j.jmpt.2024.08.005","DOIUrl":"10.1016/j.jmpt.2024.08.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to examine the trends in the utilization and expenditure of chiropractic care in a representative sample of US adults, aged ≥18 years.</div></div><div><h3>Methods</h3><div>Serial cross-sectional data (2007-2016) from the Medical Expenditure Panel Survey (MEPS) were examined. Weighted descriptive statistics were analyzed to obtain national estimates of chiropractic utilization and expenditure, and time-series linear regression was used to assess trends over time. Socio-demographic characteristics and musculoskeletal diagnoses associated with chiropractic use were also reported.</div></div><div><h3>Results</h3><div>A statistically significantly increasing trend was observed for the number of adults receiving chiropractic care (<em>p</em> &lt; .05), number of visits (<em>p</em> &lt; .05) and utilization rate (<em>P</em> &lt; .05) from 2007 to 2016. A similar trend was not found for chiropractic expenditure during this period (<em>P</em> &gt; .05). The mean number of visits was 8.3 visits per year, with a mean expenditure of $86.94 USD per visit and $721.43 USD per person per year. Mean age of adult chiropractic users each year ranged between 48.6 and 51.2 years old, and users were primarily female (56.3%-60.4%), White persons (90.1%-93.5%), and privately insured (77.3%-82.8%). The most prevalent musculoskeletal diagnoses associated with chiropractic use were low back conditions (45.4%-58.1%), inflammatory/degenerative disc or joint conditions (21.2%-26.8%) and head and neck complaints (9.8%-13.7%).</div></div><div><h3>Conclusion</h3><div>The findings showed statistically significant increasing trends for the number of adult chiropractic users, the number of visits, and percent utilization of chiropractic care from 2007 to 2016. Conversely, we found a statistically null trend for the total annual expenditure on chiropractic care during the same time period. Findings from this analysis imply that, while chiropractic care appears to be growing, it may still be under-utilized, and more efforts should be devoted to ensuring sustained growth and a larger role in the management of musculoskeletal health.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 1-9"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348179","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}