PAST ISSUES OF THE JOURNAL OF MANUAL AND MANIPULATIVE THERAPY

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2005 - Vol. 13, No. 4

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Abstracts:

Systematic Review of Effects of Manual Therapy in Infants with Kinetic Imbalance due to Suboccipital Strain (KISS) Syndrome

Paul L.P. Brand, MD, PhD, Raoul H.H. Engelbert, PT, PhD, Paul J.M. Helders, PT, PhD, Martin Offringa, MD, PhD

Abstract: The goal of this systematic literature review was to establish the effects of manual therapy, chiropractic, or osteopathic treatment of the kinetic imbalance due to suboccipital strain (KISS) syndrome in infants with positional preference, plagiocephaly, and colic. We searched PubMed, Embase, and the Cochrane Library for articles on the effects of manual therapy, chiropractic, and osteopathy for the KISS syndrome. In addition, experts in the field of manual medicine and osteopathy were asked to provide relevant articles, and the bibliography in a textbook of manual therapy for children was hand-searched for additional references to the syndrome. This search strategy located no clinical trials that evaluated the effects of manual therapy or osteopathy on either the KISS syndrome or its symptoms. However, pooled analysis of two randomized clinical trials on the effects of chiropractic in infantile colic showed no statistically significant difference between active and control treatments. In addition, we found that 22% of infants showed short episodes of apnea during manual therapy of the cervical spine and that one case has been described in which apnea after Vojta therapy resulted in death. Given the absence of evidence of beneficial effects of spinal manipulation in infants and in view of its potential risks, we conclude that manual therapy, chiropractic, and osteopathy should not be used in infants with the KISS-syndrome outside the context of randomized double-blind controlled trials.


The Journal of Manual & Manipulative Therapy Vol. 13 No. 4 (2005), 210 - 215

Interrater Reliability of Palpation of Three-Dimensional Segmental Motion of the Lumbar Spine

Jean-Michel Brismée, PT, ScD, OCS, FAAOMPT, Kacey Atwood, BS, MPT, Matthew Fain, BS, MPT, Jake Hodges, MPT, Anna Sperle, MPT, Marie Swaney, BS, MPT, Valerie Phelps, PT, OCS, FAAOMPT, Didi Van Paridon, PT, MOMT, Omer Matthijs, PT, MOMT, Phillip Sizer, PT, PhD, OCS, FAAOMPT

Abstract: The purpose of this study was to evaluate interrater reliability of a specific palpatory test to assess the three-dimensional (3-D) mobility of L4-L5. Subjects included 17 men and 37 women with a mean age of 24 years (range 20-39 years) who were tested independently by three manual physical therapists with a mean of 15 years of experience. Testers performed 3-D motion testing of the L4-L5 spinal segment in a non-weight-bearing position. Interrater reliability was assessed with Cohen's Kappa statistics, using three pair-wise comparisons for determination of the direction (right or left) of lateral flexion leading to the greatest amount of segmental rotation. Percent agreement ranges were 46.3% to 62.9%, with Kappa scores ranging from -0.16 to 0.04, respectively. The palpatory test demonstrated poor to slight strength of interrater reliability. Further examination of a symptomatic population and/or other age categories is recommended. This study suggests that quantitative manual palpatory assessment of rotation at L4-L5 in combination with ipsilateral or contralateral lateral flexion is not reliable between testers. Such testing is not recommended for clinical use.


The Journal of Manual & Manipulative Therapy Vol. 13 No. 4 (2005), 216 - 221

Dizziness in Orthopaedic Physical Therapy Practice: History and Physical Examination

Paul Vidal, PT, MHSc, DPT, OCS, MTC, Peter Huijbregts, PT, MSc, MHSc, DPT, OCS, MTC, FAAOMPT, FCAMT

Abstract: Physical therapy (PT) differential diagnosis of patients complaining of dizziness centers on distinguishing those patients who might benefit from sole management by the physical therapist from those patients who require referral for medical-surgical differential diagnosis and (co) management. There is emerging evidence that PT management may suffice for patients with benign paroxysmal positional vertigo, cervicogenic dizziness, and musculoskeletal impairments leading to dysequilibrium. This article provides information on the history taking and physical examination relevant to patients with a main complaint of dizziness. The intention of the article is to enable the therapist to distinguish between patients complaining of dizziness due to these three conditions amenable to sole PT management and those patients who likely require referral. Where available, we have provided data on reliability and validity of the history items and physical tests described to help the clinician establish a level of research-based confidence with which to interpret history and physical examination findings. The decision to refer the patient for a medical-surgical evaluation is based on our findings, the interpretation of such findings in light of data on reliability and validity of history items and physical tests, an analysis of the risk of harm to the patient, and the response to seemingly appropriate intervention.


The Journal of Manual & Manipulative Therapy Vol. 13 No. 4 (2005), 222 - 251

* this issue only available in PDF format