PAST ISSUES OF THE JOURNAL OF MANUAL AND MANIPULATIVE THERAPY
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2004 - Vol. 12, No. 4
Thumb Pain in Physiotherapists: Biomechanical Causes of Pain and Alternate Methods of Preventing Distress in Treatment
B.W. Atkinson, HonDHSt Csturt, MAPA, MAAOMT, Timothay Maher, BSc, Grad Dip Phty, MHlthSc (OrthoManipT)
Abstract: Many therapists have been burdened with the danger of developing trauma of the thumb following continuous mobilizing with the thumb. This paper discusses the anatomical and arthrokinematic implications of using longitudinal pressure through the thumbs in manual therapy. Alternative methods performed not using the thumb in this manner may be of more benefit to the therapist. The use of arthrokinematic principles may assist the therapist to minimize strength of force required to achieve the same results.
The Journal of Manual & Manipulative Therapy Vol. 12 No. 4 (2004), 187 - 191
Inter-Rater Reliability of Coupling Pattern Observations of the Pathological Lumbar Spine: A Pilot Study
Chad Cook, PhD, PT, MBA, OCS, Lois Stickley, PhD, PT, Nabeel Akram, MPT, Yvonne Benavides, MPT, Christine Renz, MPT, Kevin Ramey, MS, PT
Abstract: The orthopedic assessment of low back pain by some clinicians is based to some extent, on observational detection of directional lumbar coupling analysis. This assessment process is controversial, specifically in the presence of pathology. The purpose of this study was to investigate the inter-rater reliability among physical therapists when visually determining coupling patterns of the lumbar spine and to examine the relationship between the visual coupling determination and prior attitudinal perceptions of coupling behavior. This pilot study was a single-intervention descriptive study. Twenty physical therapists were asked to record their preconceptions of "standard" lumbar coupling directional patterns. Upon completion, each therapist then assessed the coupling pattern of three patients diagnosed with pathologies of the low back pain. These analyses of L1-2 and L4-5 coupling movements were standardized through the use of videotaping. Each patient actively performed 12 different motions using both sidebending initiation and rotation initiation, in a neutral, flexed, and extended position. The results demonstrated poor observation agreement between physical therapists for sidebending initiation and rotation initiation at segments L1-2 and L4-5 indicating significance greater than chance (p < 0.05). Significant differences between prior coupling perception and the observed findings were established for rotation initiation at segment L4-5. The relationship between prior coupling perception and observation findings was not strong. It appears that physical therapists do not agree on visual coupling assessment but do not rely on preconceptions of coupling behavior to determine coupling direction.
The Journal of Manual & Manipulative Therapy Vol. 12 No. 4 (2004), 192 - 198
Dizziness in Orthopaedic Physical Therapy Practice: Classification and Pathophysiology
Peter Huijbregts, PT, MSc, MHSc, DPT, OCS, MTC, FAAOMPT, FCAMT, Paul Vidal, PT, MHSc, DPT, OCS, MTC
Abstract: Dizziness is a frequent complaint in patients presenting to orthopaedic physical therapists. Differential diagnosis of dizziness is complex but essential and requires knowledge of musculoskeletal, vestibular, cardiovascular, neurological, metabolic, and psychiatric conditions, thus transcending the musculoskeletal boundaries of orthopaedic physical therapy clinical practice. Physical therapy intervention is not indicated for many causes of dizziness. Some types of dizziness present contra-indications to certain orthopaedic physical therapy interventions. This article presents a diagnostic classification system and relevant pathophysiology that may facilitate orthopaedic physical therapy diagnosis, screening, and subsequent appropriate physical therapy management or medical referral.
The Journal of Manual & Manipulative Therapy Vol. 12 No. 4 (2004), 199 - 214
Effect of Strain Counterstrain on Pain and Strength in Hip Musculature
Christopher Kevin Wong, MS, PT, OCS, Carrie Schauer-Alvarez, MS, PT
Abstract: This randomized, controlled study assessed the effect of Strain Counterstrain (SCS) on tender points (TP) and strength of hip musculature. The convenience sample included 49 volunteers (15 men, 34 women; 98 limbs), aged 19-38 years, with hip weakness and corresponding TPs. A visual analog scale was used to assess pain; a digital handheld dynamometer was used to assess strength. Participants were randomly assigned to three intervention groups: SCS, Exercise (EX), and SCS+EX. All interventions were performed twice over two weeks; pain and strength were measured three times, both before and after intervention began. The SCS and SCS+EX groups demonstrated increased strength (p<.001, 2-tailed t-tests), which when analyzed with one-way ANOVA and Scheffé post-hoc tests was significantly greater than in the EX group (p<.001). All groups reported reduced pain and increased strength 2-4 weeks after intervention (p<.001). The results supported the hypothesis that SCS reduces TP pain and demonstrated that SCS positively affects strength.
The Journal of Manual & Manipulative Therapy Vol. 12 No. 4 (2004), 215 - 223
