Journal of Manual & Manipulative Therapy最新文献

{"title":"Prevalence of positive neural findings in patients attending outpatient physical therapy: an exploratory study.","authors":"Kevin Farrell, Adriaan Louw, Candi Gardner, Collin Besch, Jacob Braun, Kyle Sellers, Paul Mintken","doi":"10.1080/10669817.2025.2509558","DOIUrl":"https://doi.org/10.1080/10669817.2025.2509558","url":null,"abstract":"<p><strong>Introduction: </strong>Neurological testing is commonly used in outpatient physical therapy (PT) for patients with suspected neurological involvement. However, limited data exist on the prevalence of abnormal neurological findings in patients without a peripheral neuropathic pain (PNP) diagnosis. Understanding the frequency of these findings may help refine screening practices and improve patient care. This study aimed to determine the prevalence of abnormal neurological findings in patients attending PT without a clinical PNP diagnosis.</p><p><strong>Methods: </strong>This observational study included 104 adult patients attending PT for upper or lower quadrant pain. Each patient underwent a series of clinical neurologic tests (strength, sensation, and reflexes) and neurodynamic (ND) tests. Patients were categorized as having either a clinical PNP diagnosis or a non-PNP diagnosis based on physician and/or physical therapist assessment.</p><p><strong>Results: </strong>Of the participants, 22% had a clinical PNP diagnosis. Among those without a PNP diagnosis, clinical neurologic test abnormalities were common, with 50.6% exhibiting abnormal reflexes, 48.1% showing strength deficits, and 21% having sensory impairments. ND test abnormalities were less frequent in this group, with 18.5% experiencing symptom reproduction during testing.</p><p><strong>Discussion: </strong>These findings suggest that abnormal neurological test results are not exclusive to patients with a clinical PNP diagnosis. The high prevalence of clinical neurologic test abnormalities in patients without a PNP diagnosis raises questions about the sensitivity of current screening approaches.</p><p><strong>Conclusion: </strong>Neurological abnormalities may be overlooked when screening is based solely on clinical diagnosis or reported symptoms. Expanding neurological testing to a broader patient population may enhance diagnostic accuracy and treatment planning. Further research is needed to determine the clinical significance of these findings and the potential benefits of routine neurological screening in outpatient PT.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143836","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":"Consensus-based dosage recommendations for sensorimotor training in the management of neck pain: a Delphi study.","authors":"Kevin Hablützel, Heike Kubat","doi":"10.1080/10669817.2025.2509549","DOIUrl":"https://doi.org/10.1080/10669817.2025.2509549","url":null,"abstract":"<p><strong>Introduction: </strong>Neck pain is a common condition associated with high treatment costs, reduced productivity, and work limitations. It represents the second-largest group requiring physiotherapy services. Given its high prevalence, it is crucial to evaluate intervention effectiveness and ensure optimal implementation in practice. Literature highlights sensorimotor training (SMT) as an important approach in managing neck pain, though dosage recommendations for clinical application are only partially defined. This study aims to develop practical dosage guidelines for SMT in neck pain to support its implementation in daily physiotherapy.</p><p><strong>Methods: </strong>A Delphi study was conducted. Based on literature and the expertise of 12 specialists from Switzerland and Germany, dosage recommendations were developed. Two questionnaire rounds were required to reach consensus (≥ 80%).</p><p><strong>Results: </strong>After the second round, 92-100% consensus was achieved on key aspects: targeted abilities, training cycle, frequency, training duration, number of exercises, sets per exercise, repetitions, time per exercise, and rest time. Additional background questions and comments contributed to a factsheet designed as a practical clinical guide. Recommended parameters include: training cycle of 4-12 weeks, 3-21 sessions/week, 10-20 minutes/session, 2-6 exercises/session, 2-5 sets/exercise, 7-15 repetitions or 20-60 seconds/exercise, and 20-40 seconds rest between sets. Further guidance is provided on targeted abilities, clinical indicators of positive effects, criteria for progression, and required adjustments for effective SMT.    .</p><p><strong>Conclusion: </strong>This study closes a knowledge gap regarding SMT dosage. The resulting factsheet aims to simplify SMT implementation for neck pain and promote its integration in daily physiotherapy practice.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129226","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 considerations for adhesive capsulitis in the breast cancer population: a clinical perspective.","authors":"Diana Garrett, Gary Kearns, Steve Karas","doi":"10.1080/10669817.2025.2506721","DOIUrl":"https://doi.org/10.1080/10669817.2025.2506721","url":null,"abstract":"<p><p>Adhesive capsulitis (AC) is common in women aged 40-60, overlapping with the population at higher risk for breast cancer. Many breast cancer survivors develop shoulder dysfunction, including AC, due to cancer treatments such as surgery, chemotherapy, and radiation, leading to pain, limited mobility, altered biomechanics, and soft tissue contracture. Despite the prevalence of AC in this population, clinical guidelines for its management remain underexplored. Manual therapy can play a key role in improving quality of life for these individuals.Understanding the pain mechanisms - nociceptive, neuropathic, and nociplastic - can inform appropriate treatment strategies for breast cancer survivors with AC. This clinical perspective integrates manual therapy principles into the evaluation and management of AC in this population. As breast cancer cases continue to rise, clinicians must recognize the impact of cancer treatment sequelae on orthopedic conditions to optimize patient care.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095314","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":"Response to letter to the editor regarding: 'does online clinical mentoring for physical therapists enhance clinical practice and patient outcomes? A randomized controlled trial.'","authors":"Edmund Leahy, Lucy Chipchase, Rocco Cavaleri, Felicity C Blackstock","doi":"10.1080/10669817.2025.2506718","DOIUrl":"https://doi.org/10.1080/10669817.2025.2506718","url":null,"abstract":"","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-3"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081360","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":"Beyond the lungs: patients' experiences of musculoskeletal symptoms and manual therapy in cystic fibrosis care - A qualitative interview study.","authors":"Niklas Sinderholm Sposato, Jenny Danielsbacka, Marita Gilljam, Louise Lannefors, Kristofer Bjerså, Monika Fagevik Olsén","doi":"10.1080/10669817.2025.2505096","DOIUrl":"10.1080/10669817.2025.2505096","url":null,"abstract":"<p><strong>Background: </strong>Cystic fibrosis (CF) is a severe hereditary disease that affects multiple organ systems. Among these, the musculoskeletal system is an under-explored area. This interview study aimed to explore experiences of musculoskeletal symptoms and of manual therapies as complementary care in this context.</p><p><strong>Methods: </strong>Semi-structured interviews were used to collect data from ten respondents. The data were subsequently analyzed through content analysis with an inductive approach in accordance with the method of Elo and Kyngäs.</p><p><strong>Results: </strong>The analysis resulted in three main categories; 1) Living with CF involves musculoskeletal health challenges, 2) Manual therapies impact daily life for people with CF, and 3) People with CF aspire for broader and more collaborative respiratory care.</p><p><strong>Conclusion: </strong>The respondents described musculoskeletal symptoms in and around the thoracic cage. They experienced symptom relief and increased body awareness following manual therapy interventions (MTI) and recommended that these methods be offered as complementary care to enhance quality of life.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015761","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 utilization of dry needling - a survey of contemporary clinical practice within the USA.","authors":"Emilio J Puentedura, Keri Maywhort, Stephanie Pascoe, Bradford Tracy, Adam Weaver, Millicent Weber, Dominic Severino, Shane Koppenhaver","doi":"10.1080/10669817.2025.2503999","DOIUrl":"https://doi.org/10.1080/10669817.2025.2503999","url":null,"abstract":"<p><strong>Background: </strong>Dry needling (DN) is a skilled intervention commonly used for pain relief and the management of movement disorders in neuromusculoskeletal conditions. Although systematic reviews indicate its effectiveness, variations in treatment parameters exist. This study surveyed U.S. healthcare professionals who utilize DN, examining their clinical techniques, rationale, and use of electrostimulation.</p><p><strong>Methods: </strong>An electronic survey was created and distributed via Qualtrics™ to healthcare providers performing DN. The survey link was shared through social media and e-mail, and data were analyzed using non-parametric statistical methods (Mann-Whitney U, Spearman's rho) to identify significant patterns in DN practices.</p><p><strong>Results: </strong>A total of 1,399 healthcare providers completed the survey, predominantly physical therapists (93.3%) with an average of 13.5 years of clinical experience and 5.2 years in DN. Most worked in outpatient orthopedics (90.3%). Common DN techniques included trigger point needling (95.8%) and deep needling (82.0%), with 44.5% using periosteal pecking. The majority of practitioners used up to 4 needles per session (68.1%), while 63.8% used more than 4. Electro-stimulation (e-stim) was commonly applied, with 62.5% using it after needle insertion and 55.6% combining it with needle manipulation. Differences in techniques were noted between physical and nonphysical therapists, particularly in the practice of leaving needles in place without manipulation.</p><p><strong>Conclusion: </strong>This study highlights the widespread use and evolving methodologies of DN practices in the U.S. noting the integration of electrostimulation and multimodal approaches. It also highlights inconsistencies in treatment parameters, underscoring the need for standardized protocols to enhance clinical effectiveness and research validity. Future research should focus on the long-term efficacy of various DN techniques and their applications in neurological rehabilitation.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041385","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":"Letter to the editor regarding 'Does online clinical mentoring for physical therapists improve clinical practice and patient outcomes? A randomized controlled trial'.","authors":"Özge Tezen","doi":"10.1080/10669817.2025.2501058","DOIUrl":"https://doi.org/10.1080/10669817.2025.2501058","url":null,"abstract":"","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034704","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":"Mobilization with movement on reducing pain and disability for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.","authors":"Long-Huei Lin, Min Lin, Guo-Jia Hsieh, Hsin-I Chen, Shu-Fen Sun, Ren Jei Tsai","doi":"10.1080/10669817.2025.2495576","DOIUrl":"https://doi.org/10.1080/10669817.2025.2495576","url":null,"abstract":"<p><strong>Introduction: </strong>Knee osteoarthritis (OA), affecting both tibiofemoral and patellofemoral compartments, causes pain and reduced quality of life. The Mulligan Concept of mobilization with movement (MWM) may relieve symptoms by modifying sensory input, enhancing central inhibition, and improving motor activation. This study conducted a systematic review and meta-analysis with subgroup analysis to evaluate MWM's efficacy in improving pain and disability in knee OA.</p><p><strong>Methods: </strong>Electronic databases were searched from inception to January 2025 for randomized controlled trials (RCTs) on the effects of MWM on knee OA. Pain intensity and disability improvement, standardized using Hedges' g, were the primary and secondary outcomes. Two reviewers independently assessed study quality, extracted data, and performed a meta-analysis using a random-effects model. Subgroup analyses considered intervention regimens, technique including weight-bearing or not, Kellgren-Lawrence (K-L) classification grades, and control group comparisons.</p><p><strong>Results: </strong>From 2<i>3</i> RCTs (<i>996</i> participants; mean age 37-61 years), MWM significantly reduced pain (Hedges' g = -0.984, 95% CI = -1.375 to -0.593) and improved disability (Hedges' g = -1.041, 95% CI = -1.477 to - 0.606).. Greater effect sizes were observed when MWM was combined with other therapies, including weight-bearing positions, and among participants without advanced K-L grades. MWM also demonstrated significant effects in comparison with active controls.</p><p><strong>Conclusion: </strong>This meta-analysis showed that MWM reduces pain and disability in individuals with knee osteoarthritis, especially when incorporated into treatment protocols featuring weight-bearing positions and combined physical therapies. Clinically, MWM could be incorporated into rehabilitation programs to enhance pain relief and functional recovery. Future studies should extend follow-ups and address bias.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-16"},"PeriodicalIF":1.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053073","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":"Effects of mobilization or manipulation of the thoracic spine on autonomic nervous system markers in symptomatic and asymptomatic participants - a systematic review and meta-analysis.","authors":"Lars Hansen, Hartmut Goebel, Larissa Pagels, Kerstin Luedtke","doi":"10.1080/10669817.2025.2478611","DOIUrl":"https://doi.org/10.1080/10669817.2025.2478611","url":null,"abstract":"<p><strong>Objectives: </strong>To identify the effects of thoracic mobilization/manipulation on autonomic nervous system responses.</p><p><strong>Methods: </strong>Four electronic databases were searched for controlled trials published before February 2024. Studies on mobilization/manipulation of the thoracic spine were included evaluating effects on the autonomic nervous system (ANS). Risk of bias was assessed by two independent assessors using the Cochrane risk-of-bias tool 2, the RoB-2 tool for crossover studies or the ROBINS-I tool. Meta-analyses using random-effects models present the overall combined mean effects.</p><p><strong>Results: </strong>2139 articles were identified, 20 studies (863 participants) were included in the qualitative data analysis and 15 in meta-analyses. Four studies had a high risk of bias in one or more domains. Meta-analyses indicated no statistically significant effect of mobilization or manipulation on markers of the ANS. The ratio of low-frequency-to-high-frequency power did not significantly decrease after thoracic mobilization/manipulation compared to any type of control intervention (-0.28; 95% CI -0.59 to 0.04; p=0.09). Skin conductance and root mean square of successive RR interval differences as well as LFab (ms^2; absolute power of the low-frequency band) did not significantly increase after thoracic mobilization/manipulation. Subgroup and sensitivity-analyses indicated no significant effects.</p><p><strong>Discussion: </strong>Methodological limitations and heterogeneity (<i>I</i>²=0-94%) in reported outcomes, reduce the level of evidence. Future studies with a rigorous methodological approach and studies on symptomatic participants with longer follow-ups are warranted.</p><p><strong>Conclusion: </strong>No significant effects of mobilization/manipulation of the thoracic spine on ANS markers were found. The direction of changes towards increased or decreased sympathetic or parasympathetic nervous system activity was ambiguous.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"1-24"},"PeriodicalIF":1.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062776","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":"Reevaluating clinical significance in lumbar disc herniation treatment: insights from Cohen's d analysis.","authors":"Umesh Kumar Maurya, Adarsh Kumar Srivastav, Digvijay Sharma","doi":"10.1080/10669817.2024.2432520","DOIUrl":"10.1080/10669817.2024.2432520","url":null,"abstract":"","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"95"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711448","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}