PAST ISSUES OF THE JOURNAL OF MANUAL AND MANIPULATIVE THERAPY
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2005 - Vol. 13, No. 2
* this issue only available in PDF format
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Abstracts:
Differential Diagnosis and Treatment of Chronic Neck and Upper Trapezius Pain and Upper Extremity Paresthesia: A Case Study Involving the Management of an Elevated First Rib and Uncovertebral Joint Dysfunction
Jean-Michel Brismée, PT, ScD, OCS, FAAOMPT, Valerie Phelps, PT, OCS, FAAOMPT, Phillip Sizer, PT, PhD, OCS, FAAOMPT
Abstract: Diagnosis and effective treatment of patients presenting with cervicobrachial symptoms are often challenging due to the large number of potential pain sources and the high degree of convergence of sensory afference in the cervical region. A 42-year-old female presented in the clinic with a six-month history of neck pain, upper trapezius pain, and upper extremity paresthesia. A careful history, specific functional examination, and selected special tests led to diagnosis-specific orthopedic manual therapy management of this patient. The patient fully recovered within 6 physical therapy treatment sessions, which included management of an elevated first rib, double-crush phenomenon, uncovertebral joint dysfunction, and careful ergonomic intervention with home instructions. Although controlled trials are needed to evaluate the effectiveness of these techniques and allow generalizability of such interventions, the recovery of this patient suggests the efficacy of manual techniques and ergonomic intervention in the management of uncovertebral joint dysfunction and thoracic outlet syndrome associated with a double-crush phenomenon.
The Journal of Manual & Manipulative Therapy Vol. 13 No. 2 (2005), 79 - 90
A Pilot Study to Investigate the Validity of the Rule of Threes of the Thoracic Spine
Michael A. Geelhoed, PT, DPT, OCS, MTC, James A. Viti, DPT, OCS, FAAOMPT, Patricia A. Brewer, PhD
Abstract: This report describes a pilot study conducted to determine the location of the transverse processes (TPs) of the thoracic spine relative to the location of their corresponding spinous processes (SPs). There are clinicians who recommend utilizing the "rule of threes" to locate the TPs of the thoracic spine. This rule was proposed by Mitchell in 1979 and adopted in many orthopedic and manual therapy texts, but it has not been validated with research. In this pilot study, five cadavers were dissected and measurements were taken between the TPs of one thoracic vertebra and the SP of the superior vertebra. Based on the results of this pilot study, the rule of threes was determined to not be an accurate predictor of the location of the TPs of the thoracic spine.
The Journal of Manual & Manipulative Therapy Vol. 13 No. 2 (2005), 91 - 93
The Effects of Manual Physical Therapy and Therapeutic Exercise on Peripartum Posterior Pelvic Pain: Two Case Reports
James Hall, PTA, BS, SPT, Joshua A. Cleland, DPT, OCS, Jessica A. Palmer, MPT
Abstract: Peripartum posterior pelvic pain is a clinical enigma commonly encountered by physical therapists. It is hypothesized that the release of relaxin hormone during pregnancy may result in ligament laxity, which could lead to sacroiliac instability resulting in pain and decreased function. The purpose of these case reports was to describe the effects of manual physical therapy and therapeutic exercise on a peripartum patient with reports of posterior pelvic pain. Two patients referred to physical therapy by their obstetrician during their pregnancy were recruited for these case reports. During the initial examination, both patients completed a number of self-report measures including the Oswestry Disability Index, a body diagram, and the Numeric Pain Rating Scale. Both patients were treated with muscle energy techniques directed at pelvic and sacral positional faults and therapeutic exercise consisting of transverse abdominis and multifidus neuromuscular re-education; isometric hip abduction and external rotation; and a force closure sacroiliac stabilization program directed at neuromuscular re-education of the anterior and posterior oblique sling systems (hip adductors-contralateral obliques and gluteus maximus-contralateral latissimus dorsi combinations). At the time of discharge, both patients again completed the self-report outcome measures as well as a global rating of change. Both patients demonstrated a clinically meaningful improvement in their pain levels as well as perceived disability. In addition, both rated their global rating of change as "a great deal better." These case reports provide preliminary evidence suggesting that manual physical therapy and therapeutic exercise may be an effective intervention strategy for peripartum patients reporting posterior pelvic pain.
The Journal of Manual & Manipulative Therapy Vol. 13 No. 2 (2005), 94 - 102
A Comparison of the McKenzie Approach to a Specific Spine Stabilization Program for Chronic Low Back Pain
Eric R. Miller, PT, DSc, OCS, Ronald J. Schenk, PT, PhD, OCS, FAAOMPT, James L. Karnes, PT, PhD, John G. Rousselle, PT, EdD
Abstract: The purpose of this randomized pragmatic controlled trial was to compare the effectiveness of two specific treatment approaches for patients with chronic low back pain. Thirty subjects with chronic low back pain were randomly assigned to either a McKenzie group or a specific stabilization group. The Functional Status Questionnaire, short-form McGill Pain Questionnaire (SF-MPQ), and passive straight leg raising (SLR) were administered at the initial examination and following a 6-week treatment program. Wilcoxon Signed-Ranks tests, and Mann-Whitney U-tests were used to analyze the data. The stabilization group demonstrated a statistically significant improvement in pain scores and in SLR range of the involved lower extremity (p<0.05). The McKenzie group improved in the present pain index of the SF-MPQ only (p<0.05). Between-group comparisons of changes in the dependent variable scores revealed no statistical differences between the groups.
The Journal of Manual & Manipulative Therapy Vol. 13 No. 2 (2005), 103 - 112
Physical Therapy and Manual Physical Therapy: Differences in Patient Characteristics
C. D. Dorine van Ravensberg, PhD, Rob A. B. Oostendorp, PhD, PT, MT, Lonneke M. van Berkel, MSc, PT, Gwendolijne G. M. Scholten-Peeters, PhD, PT, MT, Jan J.M. Pool, BSc, PT, MT, Raymond A. H. M. Swinkels, MSc, PT, MT, Peter A. Huijbregts, DPT, FAAOMPT, FCAMT
Abstract: This study compared socio-demographic characteristics, health problem characteristics, and primary process data between database samples of patients referred to physical therapy (PT) versus a sample of patients referred to manual physical therapy (MPT) in the Netherlands. Statistical analysis indicated that that the MPT sample was significantly (P<0.01) different from the PT samples with regards to the socio-demographic data in that the patients in the MPT sample were younger, had attended post-secondary education to a greater degree, and were more often gainfully employed. The MPT sample was significantly (P< or = 0.01) different from the PT samples in that health problem data in the MPT sample indicated mainly acute, non-surgical orthopaedic or neurological, spine-related complaints of recent occurrence. Recurrence was significantly (P<0.01) more common and complaints were significantly (P=0.01) more often non-traumatic in the MPT sample. MPT referrals were significantly (P<0.01) different from PT referrals in that the MPT referral originated more frequently with a general practitioner but not with a medical specialist and that referral occurred within three months of occurrence. Primary treatment goals and interventions are discussed, as are study limitations, suggestions for future research, and relevance to the international situation.
The Journal of Manual & Manipulative Therapy Vol. 13 No. 2 (2005), 113 - 124
* this issue only available in PDF format
