Journal of Manual & Manipulative Therapy最新文献

{"title":"Characteristics of high-performing physical therapists managing cervical and lumbar conditions: a mixed methods review.","authors":"John Morris, Patricia Crane, Evan Bohan, Brooke Tripp, Michael Parlatore, Maria Flach","doi":"10.1080/10669817.2025.2554213","DOIUrl":"https://doi.org/10.1080/10669817.2025.2554213","url":null,"abstract":"<p><strong>Objective: </strong>To identify self-reported characteristics of physical therapists who consistently achieve superior outcomes in the management of cervical and lumbar conditions.</p><p><strong>Methods: </strong>Mixed-methods study combining quantitative analysis of risk-adjusted patient-reported outcome data with qualitative surveys and structured interviews. Clinicians from Jefferson Moss-Magee Rehab were included if their Focus on Therapeutic Outcomes (FOTO) scores for cervical or lumbar patients met or exceeded risk-adjusted national benchmarks from 2021-2023. High-performing therapists were surveyed regarding demographics, clinical experience, post-professional education, and treatment approaches. A subset participated in structured interviews, and thematic analysis was used to identify common characteristics contributing to success.</p><p><strong>Results: </strong>For the lumbar cohort, 32 therapists met criteria; for the cervical cohort, 11 met criteria. Surveys were completed by 20 lumbar and 6 cervical cohort members; 18 participated in interviews. Thematic analysis revealed four key characteristics among high performers: (1) use of evidence-informed practice, (2) commitment to lifelong learning via post-professional training, (3) strong therapeutic alliance, and (4) clinical experience with spinal conditions.</p><p><strong>Discussion/conclusion: </strong>Effective management of cervical and lumbar conditions is linked not only to clinical expertise but also to key clinician attributes, such as ongoing professional growth and strong interpersonal skills. These findings may guide professional development and quality improvement efforts in musculoskeletal physical therapy practice.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative short-term effects of oscillatory mobilization and mulligan MWM on pain, disability, and range of motion among De Quervain's tenosynovitis patients- a randomized clinical trial.","authors":"Waqas Qadir, Aleena Waheed, Rehana Niazi, Tahir Mahmood, Ifra Zulqarnain Awan","doi":"10.1080/10669817.2025.2557951","DOIUrl":"https://doi.org/10.1080/10669817.2025.2557951","url":null,"abstract":"<p><strong>Background: </strong>De Quervain's tenosynovitis is characterized by thickening and swelling of the extensor retinaculum. The most reported symptoms are pain, swelling, and discomfort over the radial styloid.</p><p><strong>Objective: </strong>To determine the short-term effects of oscillatory Mobilization and Mobilization with movement on pain, Range of Motion and Disability among De-Quervain's tenosynovitis.</p><p><strong>Methods: </strong>This single-blinded randomized clinical trial with parallel assignment was conducted at Arif Memorial Teaching Hospital on 28 patients from August 2023 to October 2023. The subjects were allocated to groups A and B, with 14 patients in each group. Group A received mobilization with movement, and Group B received oscillatory mobilization for two weeks with three sessions per week. Data were taken of each patient before and after treatment through a numeric pain rating scale for pain, a goniometer for a range of motion, and patient-related wrist evaluation for Disability. The data were analyzed using SPSS V. 22, and appropriate statistical tests were used based on data distribution and taking <i>p</i> < 0.05 as significant.</p><p><strong>Results: </strong>The study comprised 28(100%) participants, with 14 (50%) in each group. There were 08 males (57.1%) and 6 (42.9%) female participants in group A, whereas there were seven male (50.0%) and 7 (50.0%) female participants in group B. The mean age of patients in group A was 32.857 ± 5.815, and in group B was 31.642 ± 5.838. The pain pretreatment in Group A was 8.28 ± 1.49, while in Group B was 8.50 ± 1.22, whereas the post-treatment in Group A was 3.50 ± 0.94 while in Group B was 4.28 ± 1.14. The paired t-test showed a significant difference between the pre-and post-treatment pain scores, disability index, and range of motion with a p-value < 0.05. The Patient Rated Wrist Evaluation score value at pretreatment in Group A was 78.71 ± 4.16; in Group B, it was 76.86 ± 3.09, whereas the post-treatment in Group A was 33.39 ± 5.48, while in Group B was 38.96 ± 3.66. The independent t-test showed a significant difference between both groups for pain disability index and range of motion with a p-value < 0.05.</p><p><strong>Conclusion: </strong>The study concluded that both treatments have short-term effects, but Mobilization with movement was more effective than Oscillatory movements for pain, ROM, and Disability in patients with De Quervain's tenosynovitis.</p><p><strong>Clinical trial registry: </strong>IRCT20220604055072N2.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manual therapy reduces pain, disability and oxidative stress in patients with chronic non-specific neck pain; a double-blind, randomized pilot study.","authors":"Betsos Theodoros, Zemadanis Konstantinos, Papadea Polyxeni, Skipitari Marianna, Kalaitzopoulou Electra, Varemmenou Athina, Michail Effimia, Philippou Anastasios, Georgiou Christos D","doi":"10.1080/10669817.2025.2555453","DOIUrl":"https://doi.org/10.1080/10669817.2025.2555453","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic nonspecific neck pain (CNNP) affects millions of people; nonetheless, several mechanistic details remain unknown. Oxidative stress (OS) is believed to be a contributing factor; however, its connection with manual therapy (MT), the current CNNP treatment, remains poorly investigated. Herein, the effects of low-velocity low-amplitude (LVLA) and high-velocity high-amplitude (HVLA) MT on pain relief, disability, and OS levels of CNNP patients are investigated.</p><p><strong>Methods: </strong>The study follows a double-blind randomized pilot study design. OS is assessed using blood serum lipid hydroperoxides (LOOH). MT is assessed by using the Numeric Pain Rating Scale (NPRS) and the Neck Disability Index (NDI). Finally, the results are compared with those of patients receiving a sham intervention.</p><p><strong>Results: </strong>Mixed ANOVA revealed that MT affects blood serum LOOH levels in CNNP patients. Pre-intervention, mean LOOH levels of CNNP patients (<i>n</i> = 11) were 3.3-fold higher compared to those of healthy individuals (<i>n</i> = 10; p-value < 0.001); whereas, following nine treatment sessions, a regression to healthy levels was documented. On the contrary, LOOH levels of patients following a sham intervention (<i>n</i> = 11), decreased by 0.7-fold during the first treatment session (p-value < 0.001), and remained unchanged even after the nine sessions (p-value > 0.99). Regarding NPRS, the MT group had a pre-intervention mean score of 4.91, which decreased to 1.36 after nine sessions (p-value < 0.001), whereas the sham group had a pre-intervention mean score of 5.27, which regressed to 4.64 post-intervention (p-value = 0.2208). Regarding NDI, the MT group had a pre-intervention mean score of 21.82, which decreased to 6.36 after nine sessions (p-value = 0.007). Conversely, the sham group had a pre-intervention mean score of 21.45, which increased to 25.09 post-intervention (p-value = 0.4392).</p><p><strong>Discussion/conclusion: </strong>The results indicate that HVLA-LVLA MT causes significant decreases in pain and OS levels and improves function. Therefore, OS assessment in patients with CNNP could assist the evaluation of MT effectiveness in pain relief.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of cervicogenic headache in patients with chronic neck pain: a prospective study of 6-month follow-up.","authors":"Osama N Alshana, Mosab M Aldabbas, Abed El Hamed Qaradaya, Tarushi Tanwar, Hasan Taha, Mohammed Matar","doi":"10.1080/10669817.2025.2553040","DOIUrl":"https://doi.org/10.1080/10669817.2025.2553040","url":null,"abstract":"<p><strong>Background: </strong>Cervicogenic headache is a common condition frequently associated with cervical spine disorders. It significantly impairs physical and psychological well-being. To date, no study has prospectively investigated the predictors of Cervicogenic headache. Identifying these predictors is essential for early intervention and the development of targeted management strategies.</p><p><strong>Purpose: </strong>To examine the predictors of cervicogenic headache in patients with chronic neck pain at the 6-month follow-up period.</p><p><strong>Methods: </strong>A prospective study was conducted. A total of 321 patients with chronic neck pain were selected for this study. Data were collected at baseline and at the 6-month follow-up. Cervical X-rays were taken to assess the Cervical Cobb angle, and self-reported questionnaires were used to assess sleep quality, pain intensity, depression, anxiety, fatigue, and disability in patients with chronic neck pain. Binary logistic regression and Mann-Whitney U test were employed for the analysis.</p><p><strong>Results: </strong>The study found that cervical Cobb angle 95% CI (.85, .96), <i>p</i> = .001, sleep quality 95% CI (1.32, 1.81), <i>p</i> < .001, depression 95% CI (1.09, 1.55), <i>p</i> = .003 and anxiety 95% CI (1.15, 1.59), <i>p</i> < .001 were significant predictors of cervicogenic headache in patients with chronic neck pain at 6-month follow-up period.</p><p><strong>Conclusion: </strong>Our results suggest that altered cervical Cobb angle, poor sleep quality, and psychological status may serve as potential predictors of cervicogenic headache in patients with chronic neck pain. These findings highlight the importance of a comprehensive approach to managing cervicogenic headache and neck pain that addresses both physical and psychological factors. By targeting these comorbidities, health-care providers may be able to improve outcomes and prevent the development of cervicogenic headache in patients with chronic neck pain.</p><p><strong>Registration number (phrc/hc/1339/23): </strong>The study was registered in August 2023.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanosensitivity during straight leg raise and slump neurodynamic tests in people with type 1 diabetes mellitus and diabetic peripheral neuropathy.","authors":"Georgia Koutsoflini, Antonios Lepouras, Colette Ridehalgh","doi":"10.1080/10669817.2025.2544285","DOIUrl":"10.1080/10669817.2025.2544285","url":null,"abstract":"<p><strong>Objectives: </strong>Neurodynamic tests are clinical tests used to identify heightened nerve mechanosensitivity but may be negative in the presence of severe neuropathy, as seen in people with carpal tunnel syndrome and type 2 diabetes. It is not known if this also occurs in people with diabetic peripheral neuropathy (DPN) from type 1 diabetes mellitus (T1DM). The primary aim of this study is to determine the proportion of positive neurodynamic tests in people with T1DM and DPN. The secondary aim is to assess whether the severity of DPN influences the presence of a positive neurodynamic test.</p><p><strong>Methods: </strong>This is a cross-sectional study. Forty-three participants with T1DM and DPN were assessed using straight leg raise (SLR) and slump neurodynamic tests to determine a positive and negative test. DPN severity was graded according to Toronto Clinical Scoring System (TCSS).</p><p><strong>Results: </strong>Forty-six percent and 56% of participants had positive SLR and slump tests, respectively, indicating heightened nerve mechanosensitivity. There was a statistically significant association between negative neurodynamic tests and DPN severity (<i>p</i> < 0.0001). In addition, participants with negative neurodynamic tests had significantly higher TCSS scores compared to participants with positive neurodynamic tests (<i>p</i> < 0.0001).</p><p><strong>Discussion/conclusion: </strong>People with T1DM and severe DPN, as graded by TCSS, are more likely to demonstrate negative neurodynamic tests than those with mild DPN. Future studies should investigate the relationship between neurodynamic tests and nerve function in other conditions. This supports previous research on negative neurodynamic tests in severe neuropathy, suggesting that neurodynamic tests should not be used alone to determine nerve involvement.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of two mobilization approaches on the acromiohumeral distance in overhead athletes with primary subacromial impingement syndrome: a randomized clinical study.","authors":"Ali Khandaloo, Cyrus Taghizadeh Delkhoush, Fatemeh Paknazar, Fatemeh Ehsani, Zohreh Shokrian","doi":"10.1080/10669817.2025.2544288","DOIUrl":"https://doi.org/10.1080/10669817.2025.2544288","url":null,"abstract":"<p><strong>Objectives: </strong>Shoulder mobilization techniques, with and without movement, may restore the range of intra-articular glenohumeral motions and expand the subacromial space during arm abduction. The primary purpose of this study was to measure and compare the acromiohumeral distance at three static angles of passive scapular arm abduction (no arm abduction, 45° of arm abduction, and 60° of arm abduction) in overhead athletes diagnosed with primary subacromial impingement syndrome, before and after shoulder mobilization techniques with and without movement, combined with contemporary physical therapy.</p><p><strong>Methods: </strong>Fifty-one overhead athletes diagnosed with primary subacromial impingement syndrome were randomly assigned to three parallel groups. One intervention group received the Mulligan shoulder mobilization techniques, whereas the other intervention group received the Maitland shoulder mobilization techniques. Both mobilization approaches were accompanied by contemporary physical therapy and were administered every other day for two weeks. The control group received no specific intervention for two weeks. Using an ultrasound device, the acromiohumeral distance was assessed in the intervention groups one day before and one day after treatment with manual therapy and in the control group at two-week intervals.</p><p><strong>Results: </strong>Both the Mulligan and Maitland approaches significantly increased the acromiohumeral distance at all three static angles of passive scapular arm abduction (p-values < 0.001). In contrast, no significant changes were observed in the control group (p-values > 0.317).The Mulligan approach, compared to the Maitland approach, exhibited significantly greater increases in the acromiohumeral distance at all three static angles of passive scapular arm abduction (p-values < 0.001).</p><p><strong>Conclusions: </strong>Both the Mulligan and Maitland shoulder mobilization techniques, combined with contemporary physical therapy, significantly increased the acromiohumeral distance at static angles of passive scapular arm abduction in individuals suffering from primary subacromial impingement syndrome. Moreover, the Mulligan approach provided significantly greater improvements in the acromiohumeral distance compared to the Maitland approach.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary perspectives in teaching and assessment of thrust joint manipulation of the spine or pelvis in entry-level Doctor of Physical Therapy programs.","authors":"C Howland, K Huhn","doi":"10.1080/10669817.2025.2541738","DOIUrl":"https://doi.org/10.1080/10669817.2025.2541738","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the current status of spinal and pelvic thrust joint manipulation (TJM) educationin entry-level Doctor of Physical Therapy (DPT) programs within the United States.</p><p><strong>Methods: </strong>Accredited DPT programs were recruited through electronic communications to take part in an anonymous survey and optional follow up interview. The study evaluated TJMJ curriculum design, faculty qualifications, and perceived barriers to teaching and learning TJM.</p><p><strong>Results: </strong>Seventy-eight programs met the study's inclusion criteria (response rate: 28%). All participating programs taught TJM of the spine or pelvis, with 96% believing it to be an achievable entry-level skill. However, variability was noted in the specific spinal regions covered within TJM curricula. Faculty credentials primarily included orthopedic certified specialist (80%). Didactic hours devoted to TJM were commonly 1-10 hours for lecture (65%) and 10-20 hours for laboratory instruction (42%), with a typical faculty-to-student ratio of 1:10 (65%). Competency assessments most often consisted of practical exams (87%) and skills checks (82.1%). Faculty cited multiple barriers to TJM education and emphasized the need for post-professional instructor training, greater opportunities for experiential learning, and more consistent integration of TJM across the core curriculum.</p><p><strong>Discussion/conclusion: </strong>Contemporary TJM curricula appear generally consistent to those reported a decade ago, although a larger proportion of programs now use competency-based assessments. Despite this progress, educators identified persistent barriers to TJM education and advocated for enhancements in faculty development and curriculum integration.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An overview of systematic reviews investigating clinical features for diagnosing neck pain and its associated disorders.","authors":"Brandon C Williams, Scott W Lowe, Ryan C McConnell, Joshua A Subialka","doi":"10.1080/10669817.2024.2436403","DOIUrl":"10.1080/10669817.2024.2436403","url":null,"abstract":"<p><strong>Background: </strong>Neck pain is a common condition that is often difficult to diagnose. Previous literature has investigated diagnostic accuracy of examination measures, but the strength and clinical applicability are limited. This overview of systematic reviews aimed to investigate clinical features for diagnosing neck pain and its associated disorders.</p><p><strong>Methods: </strong>An overview of systematic reviews was conducted searching four electronic databases for systematic reviews evaluating diagnostic criteria for neck pain. Quality and risk of bias were assessed using the AMSTAR 2 and ROBIS. Clinical features for neck pain were investigated for diagnostic utility.</p><p><strong>Results: </strong>Twenty-seven systematic reviews were included. Hand radiculopathy and numbness have good specificities (0.89-0.92) for facet and uncinate joint hypertrophy. For facet-related dysfunction, the extension rotation test (ERT) and manual assessment have good sensitivities and moderate-good specificities. Positive ERT combined with positive manual assessment findings (+LR = 4.71; Sp = 0.83) improves diagnostic accuracy compared to positive ERT alone (+LR = 2.01; Sp = 0.59). Canadian C-spine Rules and Nexus criteria have excellent validity in screening for cervical fracture or instability. Imaging appears to have validity in diagnosing ligamentous disruption or fractures but lacks clarity on predicting future neck pain. Increased fatty infiltrates have been found with whiplash-associated disorders and mechanical neck pain.</p><p><strong>Conclusions: </strong>This review found limited indicators providing strong diagnostic utility for diagnosing neck pain. Strength of recommendations are limited by heterogeneous outcomes, methodology, and classification systems. Future research should investigate new differential diagnostic criteria for specific structures contributing to neck pain.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"286-298"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819772","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":"Evaluation of exploration time, accuracy, and task difficulty perception in three tactile tests among physiotherapy students.","authors":"Nataša Mlakar, Sonja Hlebš","doi":"10.1080/10669817.2025.2465729","DOIUrl":"10.1080/10669817.2025.2465729","url":null,"abstract":"<p><strong>Objectives: </strong>Tactile sensitivity is one of the most important skills for developing competence in manual palpation. There is a lack of studies aimed at analyzing the development of tactile sensitivity during different levels of physiotherapy education. The present study aims to compare manual tactile sensitivity in two groups of physiotherapy students.</p><p><strong>Methods: </strong>Twenty first-year physiotherapy students (mean age 19.4 yrs ± 0.6) and twenty final-year physiotherapy students (mean age 23.7 yrs ± 3.7) participated in the study. For the tactile sensitivity test, 3 wooden tables were used, in which different geometric structures were engraved. Subjects were instructed to perform a tactile examination of the geometric structures and then reproduce them by drawing on a sheet of paper. The tactile time, drawing time, accuracy, and difficulty of the geometric structures were scored. A two-sample t-test was used for the between-groups comparison if more time in an educational program should result in differences in tactile time, drawing time, accuracy, and difficulty. Linear regression was used to compare the difficulty with the accuracy of all geometric structures. Wilcoxon test was used to test the intra-rater agreement.</p><p><strong>Results: </strong>The accuracy of the reproduction of geometric structures 1, 2 and 3 were 77.5%, 27.5% and 45%, for all physiotherapy students respectively. Final-year physiotherapy students spent more time exploring geometric structure 2 (<i>p</i> = 0.014) and geometric structure 3 (<i>p</i> = 0.0018) compared to first-year physiotherapy students. No statistically significant differences were found between groups in drawing time, accuracy, and difficulty of geometric structures. The examiner showed a high intra-rater agreement in the assessment (over 96%).</p><p><strong>Discussion/conclusion: </strong>The study showed that the level of education and gained experience during laboratory teaching may be important in improving the palpation skills of physiotherapy students. Tactile sensitivity exercises should be included in physiotherapy education programs.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"365-372"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426434","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":"Evaluation of lumbar segmental motion using ultrasound imaging following common joint mobilization techniques.","authors":"Nathan J Savage, Katelyn George, Evante Gibson, Kayleigh Taylor","doi":"10.1080/10669817.2025.2470464","DOIUrl":"10.1080/10669817.2025.2470464","url":null,"abstract":"<p><strong>Objectives: </strong>Spinal mobility is clinically important in managing mechanical low back pain. Manual methods are commonly used for diagnosis and treatment in orthopedic practice. This study quantified changes in sagittal plane lumbar segmental motion using ultrasound imaging (USI) following common joint mobilization techniques in asymptomatic individuals. Additionally, tibial H-reflexes and sagittal plane trunk motion in standing were evaluated for association with lumbar segmental motion.Participants aged ≤ 30 or ≥ 50 years were recruited from among students, faculty, and affiliates of the Department of Physical Therapy at Winston-Salem State University and randomized to receive L4 central posterior-to-anterior (CPA) mobilization or left lumbar rotation mobilization interventions. Joint laxity was assessed using the Beighton score, and standing sagittal plane trunk motion was measured using the fingertip-to-floor method. Lumbar segmental motion was evaluated using USI in neutral, extension, and flexion positions at baseline, immediately following joint mobilization, and following 5 minutes of prone resting. Tibial H-reflexes were measured at baseline, immediately following joint mobilization, and in real-time during CPA mobilization. The primary outcome was lumbar segmental motion analyzed by position, mobilization group, sex, age category, and Beighton risk.</p><p><strong>Results: </strong>Repeated measures ANOVA revealed significant increases in L4/5 flexion (<i>p</i> = .01, ƞ²=.21) and combined flexion and extension (<i>p</i> = .03, ƞ²=.15). These changes persisted following 5 minutes of prone resting, regardless of mobilization technique. Significant interactions between segmental motion, sex, and/or Beighton risk were observed.</p><p><strong>Discussion/conclusion: </strong>Significant increases were observed in L4/5 flexion immediately following joint mobilization regardless of mobilization group, with significant statistical interactions observed between segmental motion, sex, and/or Beighton risk. This is the first investigation to demonstrate the value of USI for quantifying lumbar segmental motion following joint mobilization. Quantifying lumbar segmental motion helps clarify the underlying mechanisms of manual therapy. Future studies should include patients with low back pain.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"343-355"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606531","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}