Journal of chiropractic medicine最新文献

{"title":"Factors Associated With Compliance With Self-Management Home Therapies for Spine Pain: A Survey of Participants Attending a Chiropractic Teaching Clinic in South Africa","authors":"Devereaux Muller MTechChiro ,&nbsp;Yasmeen Thandar PhD ,&nbsp;Firoza Haffejee PhD","doi":"10.1016/j.jcm.2022.09.001","DOIUrl":"10.1016/j.jcm.2022.09.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to determine factors that affect compliance with various prescribed home therapies based on reported feedback from participants with spine pain.</p></div><div><h3>Methods</h3><p>This was a descriptive, quantitative, cross-sectional survey. A purposive sampling method was used to recruit 121 participants with neck and back pain<span> attending the Durban University of Technology Chiropractic<span> Day Clinic located in KwaZulu-Natal, South Africa. Data were collected using a self-administered questionnaire. Descriptive statistics, including frequencies and percentages, were used to summarize the data, and odds ratios (ORs) were calculated.</span></span></p></div><div><h3>Results</h3><p>Most participants presented with chronic pain, reporting an average severity of 6 out of 10 and little disability from the pain. Home therapy included stretches (92.2%), heat therapy (49.1%), and ice therapy (38.8%). Almost two-thirds (62.1%) of participants reported being fully compliant with the prescribed home therapy, while 32.8% reported partial compliance. The main factors that potentially affected compliance were laziness and forgetfulness. Participants who reported having depression were less compliant (OR, 0.181), while those with chronic pain were more compliant (OR, 3.74). Those who believed that home therapy would alleviate their pain were also more compliant (OR, 3.83).</p></div><div><h3>Conclusion</h3><p>The study found that a majority of participants with spine pain were compliant with prescribed chiropractic home treatment. Key factors that potentially influenced compliance were identified.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"22 2","pages":"Pages 96-102"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10280084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9714115","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":"Coenzyme Q10 Supplementation in Reducing Inflammation: An Umbrella Review","authors":"Marc P. McRae DC","doi":"10.1016/j.jcm.2022.07.001","DOIUrl":"10.1016/j.jcm.2022.07.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to review meta-analyses on the effectiveness of coenzyme Q10<span> supplementation in reducing inflammation through changes in the inflammatory biomarkers C-reactive protein, interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α).</span></p></div><div><h3>Methods</h3><p>An umbrella review of all published meta-analyses was performed. A PubMed search from January 1, 1980, to December 31, 2021, was conducted using the following search strategy: “(coenzyme q10 OR CoQ10 OR ubiquinone OR ubiquinol) AND (meta-analysis OR systematic review)”. Only English language publications that provided quantitative statistical analysis on coenzyme Q10 supplementation and markers of inflammation were retrieved.</p></div><div><h3>Results</h3><p>Seven meta-analyses were retrieved for inclusion in this umbrella review, and for all 3 inflammatory biomarker marker groups, the median intake of supplemental coenzyme Q10 was 200 mg/d for a median duration of 12 weeks. For C-reactive protein, only 3 of the 7 meta-analyses presented with statistically significant reductions, while statistically significant reductions in IL-6 and TNF-α for were observed in 4 of the 5 meta-analyses and 3 of the 4 meta-analyses, respectively. However, statistically significant heterogeneity was observed in the majority of these meta-analyses.</p></div><div><h3>Conclusion</h3><p>The majority of included meta-analyses showed that coenzyme Q10 supplementation significantly decreased the proinflammatory cytokines IL-6 and TNF-α. However, heterogeneity was observed in the majority of these meta-analyses, and therefore the results should be interpreted with caution.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"22 2","pages":"Pages 131-137"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10280088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9702572","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 of Remote Myofascial Release on Lumbar Elasticity and Pain in Patients With Chronic Nonspecific Low Back Pain: A Randomized Clinical Trial","authors":"Hassan Tamartash PhD ,&nbsp;Farid Bahrpeyma PhD ,&nbsp;Manijhe Mokhtari Dizaji PhD","doi":"10.1016/j.jcm.2022.04.002","DOIUrl":"10.1016/j.jcm.2022.04.002","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to evaluate the effects of myofascial release<span> technique of a remote area on lumbar elasticity and low back pain (LBP) in patients with chronic nonspecific LBP.</span></p></div><div><h3>Methods</h3><p>For this clinical trial<span><span><span>, 32 participants with nonspecific LBP were assigned to a myofascial release group (n = 16) or a remote release group (n = 16). Participants in the myofascial release group received 4 sessions of myofascial release to the lumbar region. The remote release group received 4 myofascial release sessions to the crural and hamstring </span>fascia of the lower limbs. Low back </span>pain severity<span> and elastic modulus<span> of the lumbar myofascial tissue were assessed before and after treatment<span> by the Numeric Pain Scale and ultrasonography examinations.</span></span></span></span></p></div><div><h3>Results</h3><p>The mean pain and elastic coefficient in each group before and after myofascial release interventions were significantly different (<em>P</em> ≤ .0005). The results showed that the changes in mean pain and elastic coefficient of the 2 groups after myofascial release interventions were not significantly different from each other (<em>F</em> <span>1</span>, <span>2</span>, <span>3</span>, <span>4</span>, <span>5</span>, <span>6</span>, <span>7</span>, <span>8</span>, <span>9</span>, <span>10</span>, <span>11</span>, <span>12</span>, <span>13</span>, <span>14</span>, <span>15</span>, <span>16</span>, <span>17</span>, <span>18</span>, <span>19</span>, <span>20</span>, <span>21</span>, <span>22</span> = 1.48, <em>P</em> = .230, 95% confidence interval) (effect size = 0.22).</p></div><div><h3>Conclusion</h3><p>The improvements in the outcome measures for both groups suggest that remote myofascial release was effective in patients with chronic nonspecific LBP. The remote myofascial release of the lower limbs reduced the elastic modulus of the lumbar fascia and LBP.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"22 1","pages":"Pages 52-59"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947999/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10190535","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":"Ergonomic Risk Factors of Fourth- and Fifth-Year International Medical University Dental Students","authors":"Ni Ting Chong BS(Hons)Chiro,&nbsp;Valerie Ying Chin BS(Hons)Chiro,&nbsp;Michael Thomas Haneline MPH,&nbsp;Yi Kai Wong BS(Hons)Chiro, MSPH","doi":"10.1016/j.jcm.2022.05.001","DOIUrl":"10.1016/j.jcm.2022.05.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to identify and compare the ergonomic risk factors of year 4 and year 5 dental students attending International Medical University.</p></div><div><h3>Methods</h3><p>This was an exploratory, observational study evaluating ergonomic risk factors among year 4 and year 5 dental students, with a total of 89 participants. The students’ ergonomic risk components were evaluated using the Rapid Upper Limb Assessment (RULA) worksheet. Descriptive statistics were used to analyze the RULA scores, and the Mann-Whitney <em>U</em> test served to determine the difference of ergonomic risk between year 4 and year 5 dental students.</p></div><div><h3>Results</h3><p>The descriptive analysis showed that the participants’ (N = 89) median final RULA score was 6.00 (standard deviation = 0.716). One-year difference in the years of clinical practice did not produce a significant difference in the final RULA score (<em>U</em> = 913.0, <em>P</em> = 0.49). The final RULA scores showed year 4 dental students had a higher mean ranking (year 4 = 46.65, year 5 = 43.23). Furthermore, the Mann-Whitney <em>U</em> test indicated that this was not statistically significant (<em>U</em> = 913.0, <em>P</em> = 0.49).</p></div><div><h3>Conclusion</h3><p>The descriptive analysis showed that the final RULA score of the participants indicated that the participants were in a high-risk category for experiencing work-related musculoskeletal disorders<span> due to poor ergonomics. Contributing physical factors included working in asymmetric, awkward, and static positions in a confined workspace, infrequent use of dental loupes, and utilization of dental chairs that were not ergonomically appropriate.</span></p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"22 1","pages":"Pages 20-26"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947964/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10488827","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":"Effects of Manual Versus Instrumental Spinal Manipulation on Blood Flow of the Vertebral and Internal Carotid Arteries in Participants With Chronic Nonspecific Neck Pain: A Single-Blind, Randomized Study","authors":"Burcu Kocabey ,&nbsp;Dilber Karagözoğlu Coşkunsu PhD ,&nbsp;Koray Güven ,&nbsp;Mustafa H. Ağaoğlu DC ,&nbsp;Selvi Yüce","doi":"10.1016/j.jcm.2022.05.006","DOIUrl":"10.1016/j.jcm.2022.05.006","url":null,"abstract":"<div><h3>Objective</h3><p><span>The aim of this study was to compare the hemodynamic effects of manual </span>spinal manipulation<span> (MSM) and instrumental spinal manipulation (ISM) on the vertebral artery<span> (VA) and internal carotid artery (ICA) in participants with chronic nonspecific neck pain (NNP).</span></span></p></div><div><h3>Methods</h3><p>Thirty volunteers aged 20 to 40 years old with NNP over 3 months duration were included. Participants were randomly divided into the following 2 groups: (1) MSM group (n = 15) and (2) ISM group (n = 15). Ipsilateral (intervention side) and contralateral<span><span> (opposite side of intervention) VAs and ICAs were evaluated using spectral color Doppler ultrasound before and immediately after manipulation. Measurements were recorded by visualizing the ICA </span>carotid sinus<span> (C4 level) and the VA at the V3 segment (C1-C2 level). The blood flow parameters<span> of peak systolic velocity<span> (PSV), end-diastolic velocity, resistive index<span>, and volume flow (only for VA) were evaluated. The spinal segment, in which biomechanical aberrant movement was detected by palpation in the upper cervical spine, was manually manipulated in the MSM group. The same methodology was performed for the ISM group using an Activator V instrument (Activator Methods).</span></span></span></span></span></p></div><div><h3>Results</h3><p>Intragroup analysis exhibited no statistically significant difference between the MSM and ISM groups in terms of PSV, end-diastolic velocity, resistive index of ipsilateral and contralateral ICA and VA, in addition to volume flow of both VAs preintervention and postintervention (<em>P</em> &gt; .05). Within the intergroup analysis, there was a significant difference in ipsilateral ICA PSV (<em>P</em> = .031) (preintervention vs postintervention difference was –7.9 ± 17.2 cm/s [95% confidence interval, –17.4 to 1.6] in the ISM group and 8.7 ± 22.5 cm/s [95% confidence interval, –3.6 to 21.2]) in the MSM group (<em>P</em> &lt; .05). Other parameters did not show any significant difference (<em>P</em> &gt; .05).</p></div><div><h3>Conclusion</h3><p>Manual and instrumental spinal manipulations applied to the upper cervical spine in participants with chronic NNP did not appear to alter blood flow parameters of the VAs and ICAs.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"22 1","pages":"Pages 1-10"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947994/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10190538","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":"Association Between Isokinetic Knee Strength Characteristics and Single-Leg Hop Performance In Healthy Young Participants","authors":"Konstantinos Vassis PT, MSc ,&nbsp;Asimakis Kanellopoulos PT, PhD ,&nbsp;Savvas Spanos PT, PhD ,&nbsp;Dimitra Kakolyri PT, BSc ,&nbsp;Aggeliki Loukopoulou PT, BSc ,&nbsp;Vasiliki Papanikolakou PT, BSc ,&nbsp;Dimitrios Aivaliotis PT, BSc ,&nbsp;Ioannis Poulis PT, PhD","doi":"10.1016/j.jcm.2022.05.003","DOIUrl":"10.1016/j.jcm.2022.05.003","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to determine the extent to which the mean peak moment (MPM) of knee flexors and extensors could predict performance in a group of healthy individuals.</p></div><div><h3>Methods</h3><p>Eighty-four healthy individuals—32 men and 52 women (mean age, 22.1 ± 3 years; range, 18-35 years)—participated in this study. Isokinetic unilateral concentric knee flexor and extensor MPM was assessed isokinetically at angular velocities of 60°/s and 180°/s. Functional performance was assessed using the single hop of distance (SHD).</p></div><div><h3>Results</h3><p>Positive moderate to good statistically significant correlations (<em>r</em> = .636 to <em>r</em> = .673) were found between knee flexor and extensor MPM at 60°/s and 180°/s for the SHD test. Knee flexor and extensor MPMs are strong predictors for the SHD test at 60°/s and 180°/s (R² = .40 to R² = .45).</p></div><div><h3>Conclusion</h3><p>Knee flexor and extensor strength was substantially correlated with SHD.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"22 1","pages":"Pages 27-34"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9948001/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10488826","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":"Radiographic Measures for the Assessment of Frontal and Sagittal Knee Alignments and the Associated Normality Values: A Meta-Analysis","authors":"Bruna Nichele da Rosa MS,&nbsp;Eduardo Nunes Camargo MS,&nbsp;Cláudia Tarragô Candotti PhD","doi":"10.1016/j.jcm.2022.03.005","DOIUrl":"10.1016/j.jcm.2022.03.005","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this literature review was to identify knee alignment assessment methods using radiography in the sagittal and frontal planes and to identify normality values for classifying knee alignment using these methods.</p></div><div><h3>Methods</h3><p>A systematic review<span><span> with a meta-analysis was conducted. The eligibility criterion was studies that performed radiographic examinations to assess the knee alignment of adults without a history of hip or </span>knee prosthesis surgery. The methodological qualities of the included studies were assessed using the QUADAS-2 tool. A meta-analysis was performed to measure the normality values of knee alignment in the frontal plane.</span></p></div><div><h3>Results</h3><p>The hip-knee-ankle (HKA) angle was the measure most frequently used to assess knee alignment. Only a meta-analysis of HKA normality values was possible. Thereby, we found normality values of the HKA angle for the overall population, men, and women. The normality values of knee alignment for healthy adults that were found in this study were as follows: overall sample (male and female patients) HKA angle = –0.2° (–2.8° to 2.41°), male patient HKA angle = 0.77° (–2.91° to 7.94°), and female patient HKA angle = –0.67° (–5.32° to 3.98°).</p></div><div><h3>Conclusion</h3><p>This review identified the most common methods and expected values for knee alignment assessment methods using radiography in the sagittal and frontal planes. We suggest HKA angles ranging from –3° to 3° as the cutoff for classifying knee alignment in the frontal plane, in accordance with the normality limits found in the meta-analysis.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"22 1","pages":"Pages 72-84"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947998/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10190533","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":"Chiropractic Management of Chronic Ankle Pain and Limited Mobility in a Pediatric Athlete: A Case Report","authors":"Randy L. Hewitt DC,&nbsp;Jennifer L. Brocker DC","doi":"10.1016/j.jcm.2022.10.001","DOIUrl":"10.1016/j.jcm.2022.10.001","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this case study was to report the chiropractic management of a teenage athlete who had chronic pain after a lateral ankle </span>sprain.</p></div><div><h3>Clinical Features</h3><p>A 15-year-old male patient presented with persistent ankle pain due to an inversion sprain while playing soccer approximately 8.5 months prior. Emergency department<span><span> records noted a left lateral ankle sprain, including the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament. The examination revealed ankle tenderness upon palpation, limited active and passive dorsiflexion range of motion, restricted talocrural joint posterior glide, and moderate lateral compartment muscular </span>hypertonicity.</span></p></div><div><h3>Intervention and Outcome</h3><p>Chiropractic management included high-velocity, low-amplitude chiropractic ankle manipulation and education on home-based ankle dorsiflexion stretching. After 4 treatments, the athlete returned to unencumbered athletic participation. Follow-up evaluation at 5 months revealed no pain or functional complaints.</p></div><div><h3>Conclusion</h3><p>This teen athlete's chronic pain from a lateral ankle sprain resolved with a short course of chiropractic manipulation coupled with home-based stretching.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"22 1","pages":"Pages 85-88"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947970/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10488824","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":"Footwork Pro System Reproducibility of Static and Dynamic Plantar Pressure Indicators","authors":"Fernando Raphael Rogério PhD,&nbsp;Dartagnan Pinto Guedes PhD","doi":"10.1016/j.jcm.2022.08.001","DOIUrl":"10.1016/j.jcm.2022.08.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to identify the reproducibility of the Footwork Pro plate in the measurement of static and dynamic plantar pressure in healthy adults.</p></div><div><h3>Methods</h3><p>We performed a reliability study using a test-retest design. The sample consisted of 49 healthy adults of both sexes, aged 18 to 64. Participants were assessed on the following 2 different occasions: the initial moment and 7 days later. Measurements for the static and dynamic plantar pressure were performed. We used the Student <em>t</em><span> test for paired data, the concordance correlation coefficient, and bias to estimate reliability.</span></p></div><div><h3>Results</h3><p>Plantar pressure values for the static condition (peak plantar pressure, plantar surface contact area, and body mass distribution) and dynamic condition (peak plantar pressure, plantar surface contact area, and contact time) between the first and second measurements did not present statistically significant differences. The concordance correlation coefficients were ≤0.90, and the biases were of low magnitude.</p></div><div><h3>Conclusion</h3><p>The findings showed that the Footwork Pro system offered clinically acceptable reproducibility to identify static and dynamic plantar pressure and thus may be a reliable tool for this purpose.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"22 1","pages":"Pages 45-51"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947969/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10488829","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":"Mediation Analysis in Manual Therapy Research","authors":"Thiago da Silva Rocha Paz PhD ,&nbsp;Pedro Teixeira Vidinha Rodrigues MSc ,&nbsp;Bruno Moreira Silva PhD ,&nbsp;Arthur de Sá Ferreira DSc ,&nbsp;Leandro Alberto Calazans Nogueira PhD","doi":"10.1016/j.jcm.2022.04.007","DOIUrl":"10.1016/j.jcm.2022.04.007","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this study was to illustrate the applicability of mediation analysis in the manual therapy field by assessing whether pain intensity, duration of pain, or the change in systolic blood pressure<span> mediated the heart rate variability (HRV) of patients with </span></span>musculoskeletal pain who received manual therapy.</p></div><div><h3>Methods</h3><p><span>A secondary data analysis from a 3-arm, parallel, randomized, placebo-controlled, assessor-blinded, superiority trial was performed. Participants were randomized into spinal manipulation, myofascial manipulation, or </span>placebo groups. Cardiovascular autonomic control was inferred from resting HRV variables (low-high frequency power ratio; LF/HF) and blood pressure responsiveness to a sympathoexcitatory stimulus (cold pressor test). Pain intensity and duration were assessed. Mediation models analyzed whether pain intensity, duration, or blood pressure independently affected the improvement of the cardiovascular autonomic control of patients with musculoskeletal pain after intervention.</p></div><div><h3>Results</h3><p>The first assumption of mediation was met for LF/HF with statistical evidence of a total effect of spinal manipulation, as compared with placebo on HRV outcomes (<em>β</em> = 0.77 [0.17-1.30]); second and third assumptions showed no statistical evidence of a relationship between the intervention and pain intensity (<em>β</em> = –5.30 [–39.48 to 28.87]), pain intensity, and LF/HF (<em>β</em> = 0.00 [–0.01 to 0.01]).</p></div><div><h3>Conclusion</h3><p>In this study of causal mediation analysis, the baseline pain intensity, duration of pain, and responsiveness of the systolic blood pressure to a sympathoexcitatory stimulus did not mediate the effects of the spinal manipulation on the cardiovascular autonomic control of patients with musculoskeletal pain. Accordingly, the immediate effect of spinal manipulation on the cardiac vagal modulation of patients with musculoskeletal pain may more likely be related to the intervention rather than the mediators investigated.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"22 1","pages":"Pages 35-44"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947974/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10488830","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}