PAST ISSUES OF THE JOURNAL OF MANUAL AND MANIPULATIVE THERAPY
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2000 - Vol. 8, No. 2
* this issue only available in PDF format
Validity and lntertester Reliability of Cervical Range of Motion ~ Using Inclinometer Measurements
Kenneth W. Bush, PT, PhD Nora Collins, MSPT Laurie Portman, MSPT Nancy Tillett, MSPT
Abstract: Several procedures have been developed for using inclinometers to measure cervical range of motion. The purpose of this study was to evaluate the validity and reliability of three such methods. The subjects were thirty-four practicing physical therapists. Three individuals, who served as models, had their cervical range of motion measured by the thirty-four physical therapists using a single, double, and stabilization inclinometer method. X-ray films were then taken of the models in flexion, extension, and right and left lateral flexion. A computerized axial tomography scan was used for measuring cervical spine rotation. Results indicate that the single and double methods in flexion and single and stabilization methods in flexion were valid. Inclinometer measurements of cervical flexion, extension, lateral flexion, and rotation were found to be reliable for all three methods with ICCs ranging from .89 to .94. Although inclinometry yields consistent results, there validly is questionable. Sources of error were identified and suggestions given for improving validity and reliability of cervical range of motion while using inclinometers.
The Journal of Manual & Manipulative Therapy Vol. 8 No. 2 (2000), 52 - 61
Service, Science and Self-regulation: Refining the Values to Carry Forward
Donald M McKenzie OBE MCSP(Lon), Dip MT
Abstract: This paper was reprinted with the permission from the New Zealand Journal of Physiotherapy, December 1999.
The Journal of Manual & Manipulative Therapy Vol. 8 No. 2 (2000), 62 - 65
A History of Manipulative Therapy Through the Ages and Up to the Current Controversy in the United States
Stanley V Paris PhD, PT
Abstract: Joint manipulation is an ancient art and science that can trace its origins to the earliest medical and lay practitioners. Today, it is practiced principally by physical therapists and chiropractors and to a lesser degree, by osteopathic and medical physicians. Self-manipulation of both joint and soft tissues is also a common practice in those who "crack" their own knuckles and spines. This article traces the history and development of manipulation from its origins to the present with a special emphasis on developments in the United States as a background for under- standing current licensure and practice issues. Since the beginning of this century, physical therapy has enjoyed a close relationship with medicine and has developed its knowledge base and practice in spinal and extremity manipulation from the medical profession. Manipulation in physical therapy has become a significant part of its rehabilitation practice, often encompassed in the terms therapeutic exercise, active and passive movement, or manual therapy. Instruction in manipulation begins with pre-professional education; for those who wish to specialize in this field, instruction continues at the post-professional level, following the medical model of specialization. Since the 1960's, physical therapists have developed their own body of knowledge in manipulation, emphasizing pain relief and enhanced physical function. By contrast, since its independent origins in the late 19th century, chiropractic has practiced manipulation for most of its history as a primary therapeutic tool to correct spinal subluxation. It provides spinal adjustments to facilitate the free flow of nerve energy, which, in turn, relieves many human ailments. Unlike physical therapy, chiropractic has not been practiced in cooperation with medicine but has existed as an alternative during most of its history. In recent years, the chiropractic profession has divided along philosophical lines: those who strongly defend the subluxation theory (straights) to those who do not (mixers), with the later group now holding sway. This change in chiropractic philosophy and practice has brought practitioners into a practice model more closely aligned with the comprehensive model of rehabilitation therapy modeled by physical therapists. Consequently, many chiropractors now use physical therapy procedures even though they are prohibited from calling themselves physical therapists. As a result, competition in the market place has heightened, with concomitant licensure and political challenges. This article discusses the history and evolution of the practice of manipulation against a background of other key developments in health care; as such, it should provide under- standing for today's current practice scene.
The Journal of Manual & Manipulative Therapy Vol. 8 No. 2 (2000), 66 - 77
Characteristics of a Mechanical Assessment for Chronic Lumbar Facet Joint Pain
Sharon Young, PT, Cert. MDT Charles Aprill, MD
Abstract: Study design, A prospective descriptive study. Objectives. To identify components of a mechanical assessment that are characteristic of symptomatic lumbar discs, facets, and sacroiliac joints (SIJ). Background. Recent studies have demonstrated the utility of McKenzie's mechanical assessment augmented by SIJ provocation tests in identifying the presence of symptomatic lumbar discs and SIJ. No previous study has revealed a means of diagnosing painful lumbar facets by physical examination. Method. Chronic low-back pain patients underwent blind examinations by physical therapists and received diagnostic injections as a criterion standard. Comparisons were made of the mechanical assessments for those patients who had symptomatic discs, facets, or SIJ. Results. Unique sets of characteristics were identified for each of the three groups. Conclusions. Features were found in the mechanical assessment that appear characteristic of painful lumbar facets. Further research is required to determine the diagnostic utility of these characteristics.
The Journal of Manual & Manipulative Therapy Vol. 8 No. 2 (2000), 78 - 84
* this issue only available in PDF format
