Journal of Manipulative and Physiological Therapeutics最新文献

{"title":"Predictors of Utilization Frequency of and Expenditure Amount for Chiropractic Care in U.S. Adults: A Retrospective Cohort Study","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.2024.08.004","DOIUrl":"10.1016/j.jmpt.2024.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the prospective associations of baseline personal characteristics with utilization frequency and expenditure of chiropractic care in US adults (≥18 years).</div></div><div><h3>Methods</h3><div>Data are from the 1358 respondents to the 2014 to 2016 Medical Expenditure Panel Survey who utilized chiropractic care. Individual, familial, health-related, and behavioral factors were included as covariates in the multivariate analytic model. Poisson and multinominal logistic regressions were modeled to examine the associations between the predictors and chiropractic utilization and expenditure.</div></div><div><h3>Results</h3><div>The mean annual number of visits was 8.2 visits (95% confidence interval [CI]: 7.9, 8.5), with annual expenditure of $677.43 U.S. dollars (95% CI: $595.47-$759.39) and $84.84 (95% CI: $77.89-$91.78) per visit. Female sex was associated with a 19% higher number of visits (rate ratio [RR] = 1.19, 95% CI: 1.01, 1.41) than males. Publicly insured and uninsured were associated with a 44% higher (RR = 1.44, 95% CI: 1.14, 1.82) and 36% lower (RR = 0.64, 95% CI: 0.48, 0.86) visit frequency, respectively, than those privately insured. Rheumatoid arthritis was associated with 7.38 times the risk of high expenditure (95% CI: 2.61, 24.67) than medium expenditure, compared to no arthritis. Relative to physically active individuals, physical inactivity was associated with a 27% higher visit frequency (RR = 1.27, 95% CI: 1.09, 1.49) and an 82% higher risk (relative risk ratio = 1.82, 95% CI: 1.05, 3.14) of high expenditure than low expenditure.</div></div><div><h3>Conclusion</h3><div>This analysis found distinct usage and expenditure patterns that vary according to specific baseline predictors. Female sex, being publicly insured, having rheumatoid arthritis, and physically inactive were associated with variance in expenditure. Results from this study may help identify chiropractic patients with tendencies for higher utilization or spending and may indirectly assist in predicting patients with slower response to care.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 10-26"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348180","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":"Angular Kinematic Analysis of Supine Cervical Thrusts Performed by Chiropractors and Chiropractic Students on Mannequins","authors":"Mackenzie A. Keller DC ,&nbsp;Brent S. Russell MS, DC ,&nbsp;Ronald S. Hosek PhD, DC, MPH ,&nbsp;Edward F. Owens Jr MS, DC","doi":"10.1016/j.jmpt.2025.10.033","DOIUrl":"10.1016/j.jmpt.2025.10.033","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to examine characteristics of cervical axial rotation and other motion components during cervical spine manipulation.</div></div><div><h3>Methods</h3><div>Eleven doctors of chiropractic (DCs), 10 chiropractic students with patient experience, and 16 inexperienced students from our institution each performed 4 thrusts on a mannequin. The thrust measured is an essential component of chiropractic cervical spine manipulation, also known as a chiropractic adjustment. The mannequin was designed for chiropractic education and outfitted with inertial measurement units for motion capture. Data were analyzed in Excel for rotation, lateral bending, and flexion-extension at thrust onsets and peaks. Differences between groups were analyzed in R (R Foundation) using Kruskal-Wallis tests, followed by Dunn tests for pairwise comparisons.</div></div><div><h3>Results</h3><div>Mean rotation for DCs was 19.3° at thrust onset and 33.9° at peak; mean peak lateral bending and cervical extension were 32.0° and 10.4°, respectively. On average, 14.6° of rotation occurred in 144 milliseconds between onset and peak, with rotational velocity and acceleration maximum values of 192.9°/s and 4427°/s², respectively. Most student characteristics were similar, but DCs’ acceleration means were significantly higher (Kruskal-Wallis <em>P</em> = .019), and experienced students used significantly greater lateral bending at onset (Kruskal-Wallis <em>P</em> = .049) and peak (<em>P</em> = .023).</div></div><div><h3>Conclusion</h3><div>Mean axial rotation for DCs during chiropractic cervical spinal adjustments was less than 34° at peak; most other measures were similar to previously reported findings.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 490-501"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471214","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 Standing Back Extension Exercise on Lumbar Erector Spinae Hemodynamics and Muscle Activity After Prolonged Lumbar Flexion","authors":"Hiroshi Ishida PhD ,&nbsp;Tadanobu Suehiro PhD ,&nbsp;Chiharu Kurozumi PhD","doi":"10.1016/j.jmpt.2025.10.012","DOIUrl":"10.1016/j.jmpt.2025.10.012","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the hemodynamic effects of standing back extension exercise (SBEE) on the lumbar erector spinae (LES) after adoption of the lumbar flexion position.</div></div><div><h3>Methods</h3><div>Hemodynamics and activities of the LES were measured in 16 asymptomatic adults (8 men and 8 women; mean age, 20.3 ± 0.5 years) using near-infrared spectroscopy of oxygenated hemoglobin and myoglobin (Hb + Mb) levels and surface electromyography in resting prone and Biering-Sørensen test positions to evaluate both resting and contraction states of the LES before and after 5 minutes of adopting the lumbar flexion position. After adopting the lumbar flexion position, all participants randomly performed two 3-second repetitions of SBEE and maintained a relaxed sitting position (control [CON]) separated by at least a 1-day interval.</div></div><div><h3>Results</h3><div>After participants had assumed the lumbar flexion position, compared with SBEE, CON was significantly associated with more positive changes in the deoxygenated[Hb + Mb] levels in the prone position (<em>P</em> = .028, <em>w</em> = 0.76, power = 0.99). Deoxygenated[Hb + Mb] levels in the prone (<em>P</em> = .026, d = 0.71, power = 0.73) and Biering-Sørensen test positions (<em>P</em> = .036, d = 0.32, power = 0.22) were significantly lower for SBEE than for CON.</div></div><div><h3>Conclusion</h3><div>Compared with CON, SBEE resulted in lower deoxygenated[Hb + Mb] levels in the LES at rest and during sustained muscle contraction after participants adopted the lumbar flexion position. These results suggest that the physiological effects of using SBEE on low back pain are caused by partial ischemia of the LES due to maintaining a flexed trunk posture.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 319-327"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145438039","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":"Reliability and Validity of Telehealth Spinal Examination Components: A Systematic Review","authors":"Frank M. Bucki DC,&nbsp;Victoria A. Bensel DC, MS,&nbsp;Clarice H. Wallert DC, MS,&nbsp;Brittney N. Walters DC, MS","doi":"10.1016/j.jmpt.2025.08.008","DOIUrl":"10.1016/j.jmpt.2025.08.008","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to systematically review the literature on the reliability or validity of telehealth spine examination components.</div></div><div><h3>Methods</h3><div>MEDLINE database from inception to May 17, 2022. Subject headings include virtual, telerehabilitation, telehealth, telemedicine, spine, spinal, neurologic, cervical, thoracic, lumbar, back, and examination. Studies not done synchronously, lacked comparisons to in-person, involved non-spine pathologies, or lacked reliability/validity were excluded. Reliability and validity data were captured using Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. Quality and risk of bias were assessed with Quality Appraisal Tool for Studies of Diagnostic Reliability and the Scottish Intercollegiate Guidelines Network diagnostic accuracy checklist.</div></div><div><h3>Results</h3><div>Six studies, with sample sizes of 11 to 100, were included. In 2 studies, Quality Appraisal Tool for Studies of Diagnostic Reliability was low, and the remaining were moderate to high. Two validity studies had high Scottish Intercollegiate Guidelines Network methodologic quality. Two studies suggested high validity and/or reliability for inspection, cranial nerve testing, pain localization, range of motion, deep neck flexion endurance, Lhermitte sign, and cervical spine neuroforaminal compression. Five studies suggested reliability for inspection, lower extremity muscle testing, pain localization, straight leg raise, Sorensen test, 5 repetitive sit-to-stand test, Lasègue test, reverse Lasègue test, Adams test, and pain on heel strike and poor postural inspection reliability.</div></div><div><h3>Conclusion</h3><div>This review found that components of telehealth spine examinations, such as those done in physical therapy or chiropractic clinical settings, were valid or reliable and provided support for clinical use.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 86-98"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124933","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":"Cross-sectional Survey of the Evidence Implementation Environment of the Australian Chiropractic and Osteopathic Professions","authors":"Matthew J. Leach BN, BN[Hons], ND, DipClinNutr, PhD","doi":"10.1016/j.jmpt.2025.10.006","DOIUrl":"10.1016/j.jmpt.2025.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to explore the complex environment of the Australian chiropractic and osteopathic medicine (COM) professions to ascertain their preparedness for evidence implementation (EI).</div></div><div><h3>Methods</h3><div>This cross-sectional study, conducted between July and November 2024, used nonprobability sampling and a comprehensive recruitment strategy to engage students, academics, clinicians, managers, directors and administrators in COM to complete the 44-item online Global Assessment of the Evidence Implementation Environment (GENIE) questionnaire.</div></div><div><h3>Results</h3><div>The survey was completed by 157 respondents (59.2% chiropractors; 40.8% osteopaths). Overall, more than one-half of respondents believed the 34 indicators of EI preparedness in COM had been meet, although the strength of respondents’ convictions was mostly low. Respondents perceived the COM academic environment to be somewhat better prepared for EI (with 72.6% agreeing/strongly agreeing that the sector was ready for EI) relative to the clinical (70.7%) and regulatory sectors (68.1%). Notable challenges to EI were insufficient research funding, champions of evidence-based practice, evidence-based decision-support, and practitioner engagement in research and information literacy.</div></div><div><h3>Conclusions</h3><div>The majority of Australian COM professionals in this sample believed that key indicators of EI have been met. However, uncertainty remains about each profession’s overall readiness, with academic environments perceived to be better prepared than clinical and regulatory sectors.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 596-605"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471186","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":"Evaluation of Cervical Proprioception in Type 2 Diabetes Individuals in Comparison to Healthy Individuals","authors":"Maryam Homafar MSc ,&nbsp;Leila Abbasi PhD ,&nbsp;Iman Rezaei PhD ,&nbsp;Marzieh Mohamadi PhD ,&nbsp;Fatemeh Jabari Fard MSc","doi":"10.1016/j.jmpt.2025.10.042","DOIUrl":"10.1016/j.jmpt.2025.10.042","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess cervical proprioception and Kinesthesia in individuals with Type 2 diabetes (T2D) compared to healthy subjects.</div></div><div><h3>Methods</h3><div>This observational-descriptive study was conducted using a cross-sectional approach. The study comprised 20 individuals with type 2 diabetes (10 females, 10 males, aged 40 to 65, diabetes duration ≥5 years, no prior neck issues) and 20 age- and sex-matched healthy individuals Participants underwent 3 sensorimotor tests: (1) the JPET to assess joint position sense, (2) the CCFT to evaluate the activation and endurance of deep cervical flexors, and (3) the Cervical Movement Sense Test to measure movement accuracy using a computer-based laser tracking system.</div></div><div><h3>Results</h3><div>The T2DM group demonstrated significantly greater joint position errors in flexion (mean ± SD: 5.01° ± 0.66), extension (6.92° ± 4.39), right rotation (6.70° ± 1.05), and left rotation (6.14° ± 2.41) compared to controls (all <em>P</em> &lt; .05). In the CCFT, diabetic participants had a significantly lower cumulative performance index (58.50 ± 5.88) than healthy individuals (107.80 ± 9.07, <em>P</em> &lt; .0001). The Movement Sense Test revealed significantly worse error scores in both zigzag and figure-8 patterns (eg, Zigzag/Right: −3.12 ± 2.43 in T2D vs −1.12 ± 0.76 in controls, <em>P</em> = .001).</div></div><div><h3>Conclusion</h3><div>Individuals with T2DM exhibited substantial impairments in cervical proprioception and kinesthesia, including deficits in joint position sense, deep cervical muscle activation, and movement accuracy. These impairments may contribute to balance dysfunction and increased fall risk, suggesting that early identification and targeted rehabilitation strategies may be implicated for improving postural stability in this population. While our findings support the presence of cervical sensorimotor impairments in T2DM, we acknowledge that causation cannot be established due to the cross-sectional nature of this study.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 435-447"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458514","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(25)00121-6","DOIUrl":"10.1016/S0161-4754(25)00121-6","url":null,"abstract":"","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Page A5"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719049","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 Muscle Energy Technique on Pain and Disability in People With Sacroiliac Joint Dysfunction: A Systematic Review and Meta-Analysis","authors":"Aleyna Senol MSc ,&nbsp;Nishadi N.H. Gamage MSc ,&nbsp;Berzan Cetinkaya PhD ,&nbsp;Ahmet Begde PhD ,&nbsp;Joseph Agu MSc","doi":"10.1016/j.jmpt.2025.10.026","DOIUrl":"10.1016/j.jmpt.2025.10.026","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to compare the effects of Muscle Energy Technique (MET) with other treatments on pain and disability levels in individuals with sacroiliac joint dysfunction.</div></div><div><h3>Methods</h3><div>This study systematically searched 11 databases to identify relevant trials (March 2023). The Cochrane risk of bias tool was used to assess the methodological quality of studies. The quality of the evidence for comparisons was evaluated with the Grades of Recommendation, Assessment, Development, and Evaluation approach. MET was compared with other treatments regarding reducing pain as a primary outcome and disability as a secondary outcome.</div></div><div><h3>Results</h3><div>Seventeen randomised controlled trials involving 665 people with sacroiliac joint dysfunction were included. The results showed that MET was not statistically more effective than other treatments in reducing pain (standard mean difference [SMD]: 0.63, 95% confidence interval [CI] –0.06 to 1.31, <em>I</em>²: 87%, <em>P</em> = .07). Likewise, a meta-analysis of studies comparing MET plus any intervention with other therapies found a statistically nonsignificant difference between the 2 treatments (SMD: –0.91, 95% CI –1.83 to 0.01; <em>I</em>²: 87%, <em>P</em> = .05). Pooled data from 2 studies reported that MET was more effective than other treatments in reducing disability (SMD: 1.56, 95% CI 0.59-2.53; <em>I</em>²: 93%, <em>P</em> = .002). Nevertheless, the combination of MET with any treatment was not found to be more effective in reducing disability than the combination of other treatments with any treatment (SMD: –0.24, 95% CI –1.18 to 0.71; <em>I</em>²: 89%, <em>P</em> = .62).</div></div><div><h3>Conclusion</h3><div>This review found that MET reduced pain and disability, similar to other therapies.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 460-472"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452269","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":"Impact of Acupressure on Pain, Functional Status, and Quality of Life in Individuals With Knee Osteoarthritis","authors":"Tugba Aydemir RN, PhD ,&nbsp;Rabiye Çirpan RN, PhD ,&nbsp;Pınar Tekinsoy Kartin RN, PhD","doi":"10.1016/j.jmpt.2025.09.001","DOIUrl":"10.1016/j.jmpt.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to ascertain the impact of acupressure on pain perception, functional status, and overall quality of life in individuals afflicted with knee OA.</div></div><div><h3>Methods</h3><div>The research was executed as an experimental study employing both pre- and post-test assessments, featuring a control group. Ninety participants were divided into 2 groups: acupressure and control. The acupressure intervention was administered twice weekly, once daily, for a duration of 4 weeks, totaling eight sessions. It adhered to the guidelines for acupuncture application as outlined by the researcher, targeting 6 specific acupuncture points. Data were collected both before and after the acupressure sessions, utilizing assessment tools such as the Visual Analogue Scale (VAS), the 36-Item Short-Form Health Survey (SF-36), and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC).</div></div><div><h3>Results</h3><div>The study was conducted with a total of 90 participants, comprising 45 individuals in the acupressure group (comprising 88.9% females, with a mean age of 62.88 ± 9.55 years) and 45 individuals in the control group (also comprising 88.9% females, with a mean age of 58.93 ± 10.19 years). Before the acupressure intervention, the acupressure group exhibited higher scores in pain, stiffness, and physical function compared to the control group. Nevertheless, after the interventions, a noteworthy enhancement was detected in the VAS scores, WOMAC scores, and SF-36 scores within the acupressure group (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>In conclusion, acupressure was found to reduce pain severity and enhance the functional status and quality of life in patients diagnosed with knee OA.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov, ID: NCT05238350.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 204-213"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238750","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":"Association of Cognitive Impairment and Spinal Pain in the Older Adult Population in the United States: A Cross-Sectional Study","authors":"Haiou Yang PhD ,&nbsp;Scott Haldeman DC, MD, PhD ,&nbsp;Eric L. Hurwitz DC, PhD ,&nbsp;Patricia A. Tavares DC ,&nbsp;Bart N. Green DC, MSEd, PhD ,&nbsp;Hannah Dale MChiro ,&nbsp;Katie de Luca MChiro, PhD","doi":"10.1016/j.jmpt.2025.07.001","DOIUrl":"10.1016/j.jmpt.2025.07.001","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to explore the association between cognitive impairment and spinal pain in the older population in the United States.</div></div><div><h3>Methods</h3><div>We undertook a secondary analysis of cross-sectional data from the 1999 to 2000 and 2001 to 2002 National Health and Nutrition Examination Survey. The pooled data included a representative sample (<em>n</em> = 2975) of older adults (aged 60-85 years) in the United States. Cognitive impairment was assessed through the Digit Symbol Substitution Test. Spinal pain was defined with a multisite definition, including both nonspecific low back pain and neck pain present in the past 3 months. To account for the complex sampling design, logistic regression was performed using Taylor linearized variance estimation to compute weighted measures of associations.</div></div><div><h3>Results</h3><div>For older adults with spinal pain, the proportion of cognitive impairment increased with age, from 32.64% in the 60 to 64 age group to 93.83% in the 80 to 84 age group, which was also statistically significantly higher than the general population group and the group without spinal pain (<em>P</em> &lt; .001). After controlling for demographic characteristics, socioeconomic status, and general health status, older adults with spinal pain had significantly increased odds of cognitive impairment (odds ratio 1.76, 95% confidence interval: 1.12, 2.79). Vulnerable subgroups (older, female, and less education) were identified.</div></div><div><h3>Conclusion</h3><div>There was a significant association between cognitive impairment and spinal pain in the older adult population in the United States. Within this population, there were vulnerable subgroups for which spinal pain and cognitive impairment had a greater impact, namely people who are older, female, and those with less education.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 57-68"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033599","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}