PAST ISSUES OF THE JOURNAL OF MANUAL AND MANIPULATIVE THERAPY
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2004 - Vol. 12, No. 2
* this issue only available in PDF format
Rate of False Positive Using the Cyriax Release Test for Thoracic Outlet Syndrome in an Asymptomatic Population
Jean-Michel Brismée, ScD, PT, OCS, FAAOMPT, Kerry Gilbert, ScD, PT, COMT, Krista Isom, BS, MPT, Rachel Hall, MPT, Bret Leathers, BS, MPT, Nathan Sheppard, BS, MPT, Steven Sawyer, PhD, PT, Phillip Sizer, PhD, PT, OCS, FAAOMPT
Abstract: The purpose of this study was to determine the rate of false positive findings during the Cyriax Release Test for Thoracic Outlet Syndrome (TOS) in an asymptomatic population. The 119 subjects (238 shoulder girdles) with a mean age of 36.3 years included in the study were asked to report any symptoms noted at 1, 3, 5, 10 and 15 minutes of holding the Cyriax Release Test position, which consisted of passive shoulder girdle elevation. Specificity was calculated for each time interval and was highest at 1 minute (97.4%), with a progressive decrease to 77.4% at 15 minutes. Correlation and chi-square analyses were run between demographic data/medical history and positive test results. Neck pain was the only statistically significant variable (p < 0.001). The high specificity of the Cyriax Release Test at 1 and 3 minutes justifies its continued use in clinical setting for the diagnosis of Thoracic Outlet Syndrome.
The Journal of Manual & Manipulative Therapy Vol. 12 No. 2 (2004), 73 - 81
Short-Term Effects of Thoracic Manipulation on Lower Trapezius Muscle Strength
Joshua Cleland, DPT, OCS, Ben Selleck, BS, Thomas Stowell, PT, DC, Lindsey Browne, SPT, Steve Alberini, SPT, Heather St. Cyr, SPT, Thomas Caron, SPT
Abstract: Lower trapezius muscle-strength deficits are a common clinical finding in patients presenting with poor postural habits. It has been speculated that zygapophyseal extension restrictions in the middle to lower thoracic spine are associated with these muscle-strength deficits. This may be a direct result of muscle inhibition related to reflexogenic influences from dysfunctional joints. The purpose of this study was to investigate the effects of manipulation applied to the lower thoracic spine (T6-T12) of asymptomatic individuals on lower trapezius muscle strength. A convenience sample of 40 subjects was randomly split into control and experimental groups of equal size. Pre-test and post-test measurements of isometric lower trapezius muscle strength were collected using a Nicholas Manual Muscle Tester. Both groups received identical assessment procedures. The experimental group received thoracic manipulations while the control group received a placebo technique. An independent group t-test was used to compare the mean change in lower trapezius muscle strength between the groups. Results revealed a significantly greater (p < 0.025) percentage increase in lower trapezius strength in the manipulation group (14%) as compared to the controls (3%). The results suggest that lower thoracic manipulation techniques may be beneficial in reducing the lower trapezius muscle inhibition commonly associated with many postural syndromes.
The Journal of Manual & Manipulative Therapy Vol. 12 No. 2 (2004), 82 - 90
Rehabilitation for Clinical Lumbar Instability in a Female Adolescent Competitive Diver with Spondylolisthesis
Chad Cook, PT, MBA, PhD, OCS, COMT, Amy Cook, MS, PT, Robert Fleming, PT, MS, OCS, COMT
Abstract: Few studies have investigated conservative lumbar stabilization approaches with adolescent athletes, specifically those with radiographic evidence of a unilateral pars interarticularis fracture. The purpose of this case study was to describe a lumbar stabilization strengthening intervention for an adolescent competitive diver. A 12-year-old female was diagnosed with a grade-I, traumatic, unilateral, dysplastic spondylolisthesis, accompanied by ensuing symptoms of lumbar spine instability. Symptom provocation occurred during extension and torsion motions as well as long-term sitting and standing. A comprehensive lumbar stabilization program was associated with a reduction of symptoms, improvement in trunk stabilization, and a quick return to competitive diving. Because the case report involved one highly motivated subject, the results are not generalizable to all adolescent divers. Future studies should investigate the treatment of spine instability on a sample of adolescent athletes.
The Journal of Manual & Manipulative Therapy Vol. 12 No. 2 (2004), 91 - 99
Effects of Glucosamine in the Treatment of Osteoarthritis
Kenneth A. Olson, PT, DHSc, OCS, FAAOMPT
Abstract: This paper describes the effects and efficacy of glucosamine sulfate for the treatment of osteoarthritis. In vitro evidence is presented that supports the beneficial effects of glucosamine sulphate in treating osteoarthritis in both human and animal models. The mechanisms of glucosamine action are described including stimulation of the production of glycoaminoglycans, which are important building blocks of the structure of articular cartilage, inhibition of interleukin-1, and enhancement of the components of synovial fluid, such as increased quality and quantity of hylunonic acid. Glucosamine sulfate has demonstrated in clinical trials to be a relatively safe, effective treatment for the pain associated with mild to moderate osteoarthritis of the human knee joint. However, many of the clinical trials have had short-term follow-up and relatively small sample sizes. No research has been reported regarding the prevention of osteoarthritis in healthy joints with the use of glucosamine, and further research is needed to determine if joints other than the knee can be successfully treated with glucosamine sulfate.
The Journal of Manual & Manipulative Therapy Vol. 12 No. 2 (2004), 100 - 106
Reliability, Validity and Effectiveness of Strain Counterstrain Techniques
Christopher Kevin Wong, MS, PT, OCS, Carrie Schauer, MS, PT
Abstract: This study examined the reliability and validity of a tender-point palpation scale (TPPS) and the effect of Strain Counterstrain (SCS) on painful tender-points (TP). The experimental design employed a convenience sample of 49 volunteers with bilateral hip TPs, randomly assigned to three groups each receiving SCS, Exercise (EX), or SCS and EX. Pain before and after intervention was assessed with the TPPS and visual analog scale (VAS). Pre-intervention reliability of the TPPS was poor for the hip abductors (kappa = .327) and adductors (kappa = .228). TPPS concurrent validity as compared to VAS was weak (Spearman r=.233 to .709). Even weaker reliability and validity estimates can be assumed for a sample not limited to those with TPs, such as a general clinical population. Interventions were performed twice over two weeks. By study end, all groups demonstrated significant pain decreases in both muscle groups demonstrated with the VAS and TTPS (Wilcoxon: SCS and SCS+EX p<.001; EX p<.01). The SCS groups tended toward greater pain reductions than the EX group for hip abductors and adductors (Kruskal Wallis: VAS p<.05 and p=.06; TPPS p=.09 and p<.001 respectively). However, low TPPS reliability and validity preclude any conclusions based on this assessment method.
The Journal of Manual & Manipulative Therapy Vol. 12 No. 2 (2004), 107 - 112
* this issue only available in PDF format
