Journal of Manual & Manipulative Therapy最新文献

{"title":"Manual physical therapy for neck disorders: an umbrella review.","authors":"Breanna Reynolds, Amy McDevitt, Joseph Kelly, Paul Mintken, Derek Clewley","doi":"10.1080/10669817.2024.2425788","DOIUrl":"10.1080/10669817.2024.2425788","url":null,"abstract":"<p><strong>Introduction: </strong>Neck pain is a common musculoskeletal disorder, with a prevalence rate (age-standardized) of 27.0 per 1000 in 2019. Approximately 50-85% of individuals with acute neck pain do not experience complete resolution of symptoms, experiencing chronic pain. Manual therapy is a widely employed treatment approach for nonspecific neck pain (NSNP), cervical radiculopathy (CR) and cervicogenic headaches (CGH). This umbrella review synthesized systematic reviews examining manual physical therapy for individuals with cervical disorders.</p><p><strong>Methods: </strong>Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed with Prospero registration (CRD42022327434). Four databases were searched from January 2016 to May 2023 for systematic reviews with or without meta-analysis examining manual therapy for individuals with neck pain of any stage. Interventions included any manual physical therapy of the cervical or thoracic spine as well as neuromobilization of the upper quarter. Primary outcomes included pain and disability. Two reviewers screened for eligibility and completed data extraction. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR 2) tool.</p><p><strong>Results: </strong>A total of 35 SRs were included: 15 NSNP, 7 cervical radiculopathy, 9 CGH and 4 samples with combined diagnoses. AMSTAR 2 ratings of the SRs support high confidence in results for 10 reviews, moderate confidence in 12 reviews and low to critically low confidence in 13 reviews. For NSNP, there was high confidence in the results showing manual therapy combined with exercise was superior to either treatment in isolation. In cervical radiculopathy, neural mobilization, distraction, soft tissue treatment and mobilization/manipulation to cervical and thoracic spine were supported with moderate confidence in results. For CGH, there was high confidence in the results supporting the use of cervical spine mobilization/manipulation, soft tissue mobilization, and manual therapy combined with exercise. Original authors of SRs reported varying quality of primary studies with lack of consistent high quality/low risk of bias designs.</p><p><strong>Conclusion: </strong>Manual therapy plus exercise, cervical or thoracic mobilization and manipulation, neuromobilization, and other types of manual therapy were supported as effective interventions in the management of pain and disability for individuals with NSNP, CGH, or CR in the short-term.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"18-35"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740836","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":"Authors response to 'Tendential and unscientific opinion' letter-to-the-editor by Dr. Marc Wuttke MD, PhD.","authors":"Kenneth A Olson, Derek Clewley, Nikki Milne, Jean-Michel Brismee, Jan Pool, Annalie Basson, Jenifer L Dice, Anita R Gross","doi":"10.1080/10669817.2024.2425003","DOIUrl":"10.1080/10669817.2024.2425003","url":null,"abstract":"","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"13-15"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648696","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":"Effect duration of a self-applied talocrural joint mobilization on restricted dorsiflexion: a repeated measures design.","authors":"Camryn A Yacks, Ceili M Y Kacmarcik, Carly A Archambeau, Joaquin A Barrios","doi":"10.1080/10669817.2024.2424545","DOIUrl":"10.1080/10669817.2024.2424545","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to determine the effect duration of a talocrural mobilization on individuals with restricted dorsiflexion during a static weight bearing lunge test (WBLT) and dynamic 3D motion capture-based peak ankle dorsiflexion during a forward step down (FSD) task. Secondarily, we aimed to correlate any immediate changes in ankle mobility with concurrent changes in proximal joint kinematics during the FSD post-mobilization.</p><p><strong>Methods: </strong>Seventy-six individuals were screened for dorsiflexion restriction, of which 26 (15 females, 22.3 ± 2.2 years old, body mass index 25.2 ± 2.9 kg/m2) qualified with a WBLT of ≤ 35° on at least one limb. A baseline WBLT measure and 3D motion capture of 5 consecutive FSD repetitions on a 6-inch box were obtained. Participants then viewed an instructional video of a talocrural joint self-mobilization using a resistance band. WBLT and FSD were collected again immediately post-mobilization and at 5-min intervals for 60 min or until the WBLT returned to baseline for 2 consecutive measures.</p><p><strong>Results: </strong>WBLT dorsiflexion showed a mean increase of 6.5 degrees (<i>p</i> < 0.001) post-mobilization. The effect faded over time and no longer differed from baseline 25 min post-mobilization (<i>p</i> = 0.964). Dynamic peak ankle dorsiflexion did not change post-mobilization at any time point (<i>p</i> ≥ 0.546). No 3D kinematic time-course changes were observed at the hip or knee. However, immediate raw alterations in dorsiflexion correlated with alterations for hip and knee flexion.</p><p><strong>Discussion/conclusion: </strong>A talocrural joint mobilization increased static dorsiflexion per the WBLT for a 20-25-min period with regression to baseline. However, increased dynamic ankle dorsiflexion was not observed during the FSD task. Improved mobility alone does not appear to change movement patterns. Clinicians should be aware of both effect duration and the potential need for task-specific training to better facilitate dynamic utilization of increased mobility.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"54-62"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605579","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":"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":"https://doi.org/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":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014112","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":"Adherence to neck and low back pain clinical practice guidelines based on clinical specialization: a survey of physical therapists.","authors":"Kaitlin Kirker, Michael Masaracchio, Birendra Dewan, Melanie O'Connell, Brian Young","doi":"10.1080/10669817.2025.2449977","DOIUrl":"https://doi.org/10.1080/10669817.2025.2449977","url":null,"abstract":"<p><strong>Objective: </strong>To investigate physical therapist adherence to the Academy of Orthopaedic Physical Therapy's (AOPT) clinical practice guidelines (CPGs) for the management of neck and low back pain (LBP) and to compare adherence among varying clinical specializations.</p><p><strong>Design: </strong>Electronic cross-sectional survey.</p><p><strong>Methods: </strong>The survey was sent to 17,348 AOPT members and 7,000 American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) members. Participants selected the best diagnosis and intervention(s) for six case vignettes based on the current AOPT CPGs for neck and LBP. Diagnostic and intervention adherence rates were reported as total percentages and delineated by the highest level of clinical specialization - fellowship training (PTFs), orthopedic residency training (PTRs), Board Certified Clinical Specialist in Orthopaedic Physical Therapy (PTSs), orthopedic background without clinical specialization (PTOs). Binary logistic regression analyses were performed to determine the effects of clinical specialization (PTFs, PTRs, or PTSs) compared to PTOs on the likelihood of guideline adherence for all six cases.</p><p><strong>Results: </strong>Of the 159 participants who responded to the survey, 152 were eligible and 145 completed demographic data. Participant responses declined as the survey progressed from 125 completing case one to 106 completing case six. The odds ratio from binary logistic regression analyses were not significant for any specialization in all six cases (OR = 0.16; 95% CI: 0.02, 1.11; <i>p</i> = 0.064).</p><p><strong>Conclusions: </strong>The results of this manuscript demonstrated variable adherence rates across subgroups of patients with neck and LBP with no significant association between clinical specialization and adherence. Adherence to CPGs is dependent on the clinical presentation of various patient cohorts.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956569","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":"Exploring the personal and professional outcomes of pursuing fellowship training in orthopedic manual physical therapy: a mixed-methods analysis.","authors":"Matthew R Schumacher, Joshua A Clark, Andrew J King, Corbin J Olson, Maddy L Steckler","doi":"10.1080/10669817.2024.2448203","DOIUrl":"https://doi.org/10.1080/10669817.2024.2448203","url":null,"abstract":"<p><strong>Objective: </strong>Post-professional education in orthopedic manual physical therapy (OMPT) provides a unique pathway for clinicians to refine clinical skills and reasoning in pursuit of professional excellence. Despite these benefits, fellowship training demands significant personal and financial investment. Therefore, understanding whether fellowship education promotes professional growth, job satisfaction, and return on investment is essential. The aim of this study was to explore fellowship-trained OMPTs' self-reported perceptions of pursuing fellowship education in the United States (US), while identifying predictors that may be associated with career success following fellowship education.</p><p><strong>Methods: </strong>A convergent parallel mixed-methods design via online survey and one-on-one semi-structured interviews was used. A thematic coding process was implemented for qualitative analysis. Descriptive statistics were calculated for demographic data. Binary logistic regression models assessed relationships between demographic variables and the personal and professional impact of fellowship training.</p><p><strong>Results: </strong>One hundred and nine participants completed the survey, and 23 underwent focused interviews, meeting data saturation. Merging of analyses revealed five themes related to personal and professional impacts of fellowship including clinical outcomes, job satisfaction, barriers, clinical excellence, and professional opportunities. Board-certified clinicians had greater odds (OR = 4.47, 95% CI 1.17-15.93, <i>p</i> = .03) of reporting fellowship training enhancing their application of current research. Those with a doctorate degree reported greater odds (OR = 9.18, 95% CI 2.31-36.56, <i>p</i> = .002) of establishing impactful mentors through fellowship. PTs with < 10 years of practice were more likely to report fellowship training positively affecting their salary (OR = 4.28, 95% CI 1.50-12.24, <i>p</i> = .01) and self-perception as expert clinicians (OR = 7.29, 95% CI 1.65-32.22, <i>p</i> = .01).</p><p><strong>Discussion/conclusion: </strong>This study is the first to examine personal and professional outcomes among US fellowship-trained clinicians, highlighting the positive impact on clinical reasoning, mentorship, and compensation - especially among novice clinicians. Fellowship enhances job satisfaction, career growth, and clinical excellence, offering insights for prospective fellows and future research directions.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933043","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":"The prevalence of subclassification-based diagnoses when considering cervical contribution in shoulder pain patients: a secondary analysis from a previous research.","authors":"Alberto Roldán-Ruiz, Javier Bailón-Cerezo, María Torres-Lacomba","doi":"10.1080/10669817.2024.2443134","DOIUrl":"https://doi.org/10.1080/10669817.2024.2443134","url":null,"abstract":"<p><strong>Objectives: </strong>Determining the prevalence of different shoulder subclassification-based diagnoses using a defined exclusion-type diagnostic algorithm. Analyzing the relationships between cervical contribution and other shoulder diagnoses.</p><p><strong>Methods: </strong>A proposal of a shoulder pain diagnosis based on functional subclassification was carried out in all subjects. The included diagnoses were cervical contribution, acromioclavicular joint pain, stiff shoulder, atraumatic unstable shoulder, rotator cuff-related shoulder pain, and 'Others'. Each diagnosis was based on a defined exclusion-type diagnostic algorithm. Cervical contribution was considered if a > 30% shoulder symptom modification in pain intensity was recorded after a cervical spine screening. Since a > 30% change in symptoms does not definitively indicate a categorical diagnosis, cervical contribution was presumed to potentially coexist with other diagnostic labels in these cases. If there was a complete (100%) resolution of shoulder symptoms after the cervical spine screening, cervical contribution was deemed the sole diagnosis.</p><p><strong>Results: </strong>Sixty subjects were analyzed. Rotator cuff-related shoulder pain was the most prevalent diagnosis (36.7%, <i>n</i> = 22), followed by stiff shoulder, being present in 30% (<i>n</i> = 18) of subjects. Cervical contribution (13.3%, <i>n</i> = 8), atraumatic unstable shoulder (11.7%, <i>n</i> = 7), others (6.7%, <i>n</i> = 4) and acromioclavicular joint pain (1,7%, <i>n</i> = 1) completed the results. In patients diagnosed with rotator cuff-related shoulder pain, cervical contribution coexisted in 71,4% of them. Thus, a statistically significant association between cervical contribution and rotator cuff-related shoulder pain was found (<i>p</i> = 0,002). This association was not observed in any of the other diagnoses.</p><p><strong>Discussions/conclusions: </strong>Rotator cuff-related shoulder pain was the most prevalent diagnosis, followed by stiff shoulder and cervical contribution. Cervical contribution may coexist with other diagnoses or even be considered as a unique diagnosis itself. Patients diagnosed with rotator cuff-related shoulder pain are more likely to have cervical contribution.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873258","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":"https://doi.org/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":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819772","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":"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":"https://doi.org/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":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819816","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":"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":"https://doi.org/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":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802881","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}