Vicente Hennemann, Patrícia K Ziegelmann, Miriam A Z Marcolino, Bruce B Duncan
{"title":"The McKenzie Method delivered by credentialed therapists for chronic low back pain with directional preference: systematic review with meta-analysis.","authors":"Vicente Hennemann, Patrícia K Ziegelmann, Miriam A Z Marcolino, Bruce B Duncan","doi":"10.1080/10669817.2024.2408084","DOIUrl":"10.1080/10669817.2024.2408084","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effectiveness of the McKenzie Method compared to any conservative interventions on pain and disability in patients with chronic low back pain (LBP) with directional preference (DP).</p><p><strong>Methods: </strong>We searched six electronic databases up to September 2022. Eligible randomized controlled trials were those assessing the McKenzie Method delivered by credentialed therapists for chronic LBP with DP. Two reviewers independently selected studies, extracted data, assessed risk of bias with the revised Cochrane Risk of Bias 2.0 tool and certainty of evidence with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.</p><p><strong>Results: </strong>Five trials (<i>n</i> = 743) were included. There was low-certainty evidence that the McKenzie Method, compared to all other interventions combined, produced clinically important reductions in short-term pain (mean difference [MD] -1.11 points on a 10-point scale; 95% CI -1.83 to -0.40) and in intermediate-term disability (standardized mean difference [SMD] -0.53; 95% CI -0.97 to -0.09). Low-to-moderate certainty evidence showed that the McKenzie Method also resulted in clinically important improvements in short-term pain (MD -1.53; 95% CI -2.51 to -0.54) and disability (SMD -0.50; 95% CI -0.74 to -0.25) when compared specifically to other exercise approaches, and in intermediate-term pain (MD -2.10; 95% CI -2.94 to -1.26) and disability (SMD -1.01; 95% CI -1.58 to -0.43) as well as long-term disability (SMD -0,59; 95% CI -1.14 to -0.03) when compared to minimal intervention. Low-certainty evidence showed usually small, clinically unimportant effects in comparison to manual therapy.</p><p><strong>Conclusion: </strong>We found low-to-moderate certainty evidence that the McKenzie Method was superior to all other interventions combined for up to 6 months for pain and up to 12 months for disability, with clinically important differences versus exercise in the short term and versus minimal interventions in the intermediate term. The only clinically important long-term effect was on disability compared to minimal intervention.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"96-111"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cameron W MacDonald, Robert Parkes, Peter G Osmotherly
{"title":"Part I: examining the broken history of manual therapy across professions. A survey-based analysis.","authors":"Cameron W MacDonald, Robert Parkes, Peter G Osmotherly","doi":"10.1080/10669817.2024.2426750","DOIUrl":"10.1080/10669817.2024.2426750","url":null,"abstract":"<p><p>The historical development of manual therapy is an area of ongoing debate impacting clinical practice, education, and practice regulations. Primary professions utilizing manual therapy include chiropractic, manual medicine, osteopathy, and physiotherapy. A survey was developed to explore perceptions, experiences, and opinions across professions, and was disseminated globally. It was completed by 194 individuals. Results demonstrated this topic is of significance with over 80% reporting that knowledge of historical development informs professional identity. Of the respondents, 64% had over 20 years professional experience. Student participation was low (<1%). Over 95% acknowledged an ancient basis for manual therapy, with 67% emphasizing bonesetter contributions. North America was reported as the primary area for the development of modern manual therapies by all except physiotherapy, which identified Northern Europe. Osteopathy's impact on current practice was recognized, though each profession ranked its own impact highest. Of respondents, 85% agreed there was conflict between professions over history. Thematic elements identified a shift for respondents from their initial education to a more nuanced understanding of the history over time, and an appreciation that there is not one profession that owns or developed manual therapy. Practice limitations were identified, as 19% of respondents reported limitations due to inaccurate historical understanding. This study highlights a lack of historical knowledge and its potential benefits for practice, education, regulation and interprofessional relations if recaptured. (<i>the abstract was rewritten per reviewer comments to reformat)</i>.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"75-81"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brian T Swanson, Kenneth E Learman, Shannon M Petersen, Bryan O'Halloran
{"title":"The diagnostic validity of the cervical side bend-rotation test for C 1/2 dysfunction.","authors":"Brian T Swanson, Kenneth E Learman, Shannon M Petersen, Bryan O'Halloran","doi":"10.1080/10669817.2024.2430506","DOIUrl":"10.1080/10669817.2024.2430506","url":null,"abstract":"<p><strong>Introduction: </strong>Neck pain and headaches are common, with a reported lifetime prevalence of up to 66%. Upper cervical segmental dysfunction has been implicated as meaningful in neck pain and multiple headache types. Several tests have been described to assess upper cervical joint dysfunction, including the flexion-rotation test (FRT), the side bend-rotation test (SBRT), and joint play assessment (PA). The purpose of this study was to determine the diagnostic validity of the SBRT to detect C1-2 dysfunction in a sample of people with medically diagnosed sinus headaches and controls.</p><p><strong>Methods: </strong>Design: prospective diagnostic accuracy study, occurring during an observational case-control study in a sample of individuals with medically diagnosed sinus headaches. All participants were assessed using the SBRT, FRT, and C1-2 joint play assessments. The diagnostic accuracy of the SBRT was assessed using a reference standard of concurrent positive FRT (a loss of at least 10° from expected ROM (≤34°)) and restriction of C1-2 joint play. Cut-off scores for the SBRT were determined using ROC curve analysis, and tests of diagnostic accuracy were calculated using 2 × 2contingency tables.</p><p><strong>Results: </strong>A total of 80 individuals (40 headache, 64 female, mean age 32.9 ± 13.8 yrs.) were included in the study. Mean ROM for the tests was: SBRT 31.4 ± 9.4°, FRT 44.9 ± 9.5°, and C1-2 mobility 22 hypomobile/58 normal. An SBRT cutoff score of <25° was confirmed using ROC curves. Using this cutoff score, the SBRT demonstrated 100% sensitivity and 62% specificity to detect C1-2 hypomobility.</p><p><strong>Discussion/conclusion: </strong>The SBRT, using a cutoff score of ≤25°, appears to be a sensitive test to detect C1-2 dysfunction. Based on the strong sensitivity and negative predictive values, scores greater than 25° may effectively rule-out C1-2 dysfunction. The SBRT should be considered as part of a sequential clinical decision-making process when screening for C1-2 dysfunction, although further research is required to improve generalizability of these findings.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"133-141"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shannon Petersen, Bryan O'Halloran, Brian T Swanson, Andra M Luth, Kenneth E Learman
{"title":"Neck pain associated with headache attributed to rhinosinusitis: an observational study.","authors":"Shannon Petersen, Bryan O'Halloran, Brian T Swanson, Andra M Luth, Kenneth E Learman","doi":"10.1080/10669817.2024.2448568","DOIUrl":"10.1080/10669817.2024.2448568","url":null,"abstract":"<p><strong>Background: </strong>Neck pain is common among people with headache, including migraines, tension headache, and cervicogenic headache. Neck pain has also been associated with self-reported sinus headache in individuals who were not formally diagnosed with headache attributed to rhinosinusitis (HAR). Neck pain, in individuals diagnosed with HAR according to the International Classification of Headache Disorders, has not been investigated.</p><p><strong>Objective: </strong>The primary objective of this study was to compare the report of neck pain in people with and without HAR. A secondary purpose was to compare measures of cervical musculoskeletal dysfunction between groups.</p><p><strong>Methods: </strong>This was an observational study. There were 80 total participants, age and sex-matched with 40 per group. HAR group participants completed the Headache Impact Test, Sino-Nasal Outcome Test-22, Neck Disability Index (NDI), and Visual Analog Scale Score (VASS) to rate headache. All participants underwent examination of neck range of motion, neck muscle endurance, and segmental examination.</p><p><strong>Results: </strong>There were significant between-group differences for reported neck pain (82.5% in HAR group; 22.5% in control group, <i>p</i> < .001) and NDI score (mean difference [95% CI] = 15.7 [11.1, 20.2], <i>p</i> < .001). There was a moderate and significant positive correlation between HAR and segmental dysfunction in the upper cervical spine (O-C3) (0.425, <i>p</i> < .001) but not the lower cervical spine.</p><p><strong>Conclusion: </strong>Neck pain may be associated with HAR, and patients perceive this neck pain as impacting their quality of life. Upper cervical segmental dysfunction was common and significantly different in the HAR group. Causation of both the subjective and objective findings remains unclear.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"158-166"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kesava Kovanur Sampath, Tevin Smith, Suzie Belcher, Gerard Farrell, Gary Fryer, Brett Vaughan, Rob Moran
{"title":"Diagnosing and treating upper back pain: insights from New Zealand's manipulative physiotherapists and osteopaths.","authors":"Kesava Kovanur Sampath, Tevin Smith, Suzie Belcher, Gerard Farrell, Gary Fryer, Brett Vaughan, Rob Moran","doi":"10.1080/10669817.2024.2438196","DOIUrl":"10.1080/10669817.2024.2438196","url":null,"abstract":"<p><strong>Background: </strong>Manual therapy is routinely used in the management of upper back pain (UBP), a disabling condition. However, the approach to diagnosis and treatment techniques used by manipulative physiotherapists and osteopaths is largely unknown.</p><p><strong>Objectives: </strong>To explore knowledge about UBP, including diagnosis and treatment, by New Zealand (NZ) osteopaths and manipulative physiotherapists and to investigate differences (if any) in the self-reported approaches to diagnosis and management of UBP between the professions.</p><p><strong>Design: </strong>A cross-sectional survey administered through an online platform (Qualtrics) between September 2023 and January 2024.</p><p><strong>Participants: </strong>One hundred and ten NZ osteopaths and manipulative physiotherapists completed the survey.</p><p><strong>Results: </strong>Forty-eight percent (<i>n</i> = 53) of respondents identified their profession as physiotherapists and 52% (<i>n</i> = 57) as osteopaths. Over three-quarters of respondents (77%) 'strongly agreed' that a multimodal approach is essential for effective UBP management. Osteopaths were significantly more likely to <i>often</i> proffer 'wear and tear/degeneration' (<i>p</i> < 0.01) and 'visceral referred pain' (<i>p</i> = 0.02) as the cause of a patient's UBP. In terms of management, osteopaths were significantly more likely to use soft tissue techniques (<i>p</i> < 0.01), spinal manipulations (<i>p</i> < 0.01), rib manipulations (<i>p</i> < 0.01), rib mobilizations (<i>p</i> < 0.01), and visceral techniques (<i>p</i> < 0.01), compared to physiotherapists.</p><p><strong>Conclusions: </strong>The survey highlights a strong consensus among respondents that a multimodal approach is essential for effective UBP management. The survey also identified profession-specific approaches to the diagnosis and management of UBP. Future research using qualitative methods is required to further explore these profession-specific differences and explore outcomes of care.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"149-157"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A physical therapy specialist interest group in the International Headache Society be in on its creation!","authors":"Gwendolen Jull, Kerstin Luedtke, Debora Bevilaqua-Grossi, Zhiqi Liang","doi":"10.1080/10669817.2025.2470501","DOIUrl":"10.1080/10669817.2025.2470501","url":null,"abstract":"","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"73-74"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Part II: Beyond Broken Histories: Reframing Professional Identity and the Historical Genesis of Manual Therapy. Interviews across professions.","authors":"C W MacDonald, R Parkes, P G Osmotherly","doi":"10.1080/10669817.2024.2426051","DOIUrl":"10.1080/10669817.2024.2426051","url":null,"abstract":"<p><strong>Background: </strong>Perspectives on the historical genesis of manual therapy for chiropractic, manual medicine, osteopathy, and physiotherapy are limited.</p><p><strong>Objective: </strong>This study sought to identify themes and narratives related to the genesis of manual therapy; the potential of a common root for manual therapy in 19<sup>th</sup> century Northern Europe; and the potential impact of a current 'broken history' for manual therapy.</p><p><strong>Methods: </strong>An exploratory phenomenological approach was utilized, based upon structured one-hour interviews of 21 professionals across four professions who had previously completed a survey on the historical genesis of manual therapy.</p><p><strong>Results: </strong>Descriptive and hermeneutic themes were developed based upon the lived experience of individuals relating to interview questions and a presented historical narrative. Support for a common genesis in Northern Europe was present within physiotherapists, but for all other professions North America was primary. Multiple themes and quotes of significance were developed from the study, including the importance of history within professional identity. An archetypal analysis was completed to answer specific assumptions related to the historical genesis of manual therapy including points of genesis for manual therapy and scientific necessity within manual therapy.</p><p><strong>Conclusion: </strong>The findings of this study provide new perspectives to consider on the value, criticality, and impact of manual therapy, and its history's for the four professions in practice, education, and regulations.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"82-94"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lawrence S Ramiscal, Lori A Bolgla, Chad E Cook, John S Magel, Stephen A Parada, Raymond Chong
{"title":"Is the YES/NO classification accurate in screening scapular dyskinesis in asymptomatic individuals? - A novel validation study utilizing surface electromyography as a surrogate measure in identifying movement asymmetries.","authors":"Lawrence S Ramiscal, Lori A Bolgla, Chad E Cook, John S Magel, Stephen A Parada, Raymond Chong","doi":"10.1080/10669817.2024.2436402","DOIUrl":"10.1080/10669817.2024.2436402","url":null,"abstract":"<p><strong>Background: </strong>Scapular dyskinesis is a known risk factor for shoulder pain, making it important to screen for prevention. Physical therapists screen scapular dyskinesis by visually comparing asymmetries in scapular movement during overhead reach using the Scapular Dyskinesis Test Yes/No classification (Y/N). Although scapular kinematics has been used to quantify scapular dyskinesis, current measurement techniques are inaccurate. Optimal scapular muscle activity is crucial for normal shoulder function and is measured using surface electromyography (sEMG). Research suggests that impaired scapular muscles can lead to scapular dyskinesis. Despite kinematics being a poor reference standard, there is currently no validated method to identify movement asymmetries using muscle activity as an alternative. We utilized sEMG to establish Y/N's validity. We hypothesized that Y/N is a valid tool using sEMG as a viable surrogate measure for identifying scapular dyskinesis.</p><p><strong>Methods: </strong>We employed a known-groups (symmetrical vs. asymmetrical shoulders) validity design following the Standards for Reporting Diagnostic Accuracy Studies. Seventy-two asymptomatic subjects were evaluated using Y/N as the index test and sEMG as the reference standard. We created a criterion to assign the sEMG as the reference standard to establish the known groups. We calculated the sensitivity (Sn), specificity (Sp), positive and negative predictive values (PPV, NPV), likelihood ratios (LR+, LR-), and diagnostic odds ratio (DOR) using a 2 × 2 table analysis.</p><p><strong>Results: </strong>The diagnostic accuracy values were Sn = 0.56 (0.37-0.74), Sp = 0.36 (0.08-0.65), PPV = 0.68 (0.49-0.88), NPV = 0.25 (0.04-0.46), LR+ = 0.87 (0.50-1.53), and LR- = 1.22 (0.50-2.97).</p><p><strong>Conclusion: </strong>The Y/N's diagnostic accuracy was poor against the sEMG, suggesting clinicians should rely less on Y/N to screen scapular dyskinesis in the asymptomatic population. Our study demonstrated that sEMG might be a suitable alternative as a reference standard in validating methods designed to screen movement asymmetries.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"122-132"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What do patients with lumbar spinal stenosis think is physical therapy's best card? A survey of perceived message strength.","authors":"Seth Peterson, Brett Halpert, John D Heick","doi":"10.1080/10669817.2024.2438182","DOIUrl":"10.1080/10669817.2024.2438182","url":null,"abstract":"<p><strong>Objectives: </strong>Rising surgical rates for lumbar spinal stenosis (LSS) and underutilization of physical therapist services for this condition may increase patient risks and healthcare costs. Patient beliefs may also contribute to this problem. Therefore, our objective was to determine which messages about physical therapy were perceived as strongest by patients with LSS and whether those messages were influenced by patient factors.</p><p><strong>Methods: </strong>The study used a cross-sectional survey design, and participants were patients of outpatient physical therapy clinics with imaging or clinical evidence of LSS. Participants completed an electronic survey containing different messages about physical therapist services for LSS. Messages were designed using the health belief model. Perceived message strength was scored using the perceived argument strength scale (PASS). Pain catastrophizing and pain self-efficacy were measured to determine whether they influenced participant perceptions. Occurrence of magnetic resonance imaging and surgical consultations were also measured.</p><p><strong>Results: </strong>Of 189 potential participants, 101 were included in the study. The message perceived as strongest emphasized physical therapists as listeners who would customize a plan (PASS 36.1 [5.0]) Similar scores were seen for messages that emphasized benefits of education and self-management and de-emphasized severity. The message that emphasized research findings was rated the least strong. Participants who had high levels of pain catastrophizing were more likely to have had imaging and perceived arguments as less strong.</p><p><strong>Discussion/conclusion: </strong>Results of the current study suggested patients with LSS preferred a message that emphasized physical therapists as listeners who would customize a plan. The message about research outcomes was perceived as the least strong. Therefore, awareness campaigns intended to influence the beliefs or behavior of patients with LSS should emphasize the individualized nature of physical therapy more than research evidence.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"142-148"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}