PAST ISSUES OF THE JOURNAL OF MANUAL AND MANIPULATIVE THERAPY

Editorial: So Close and Yet so Far—Growth and Progress in the Accessory Motion Testing Literature

DANIEL L. RIDDLE, PT, PhD, FAPTA

[no abstract available]
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The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2009), 132-133

Manual Therapy Awards 2009

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The Journal of Manual & Manipulative Therapy Vol. 17 No. 1 (2008), 134

The Reliability of Maitland's Irritability Judgments in Patients with Low Back Pain

EDWARD T. BARAKATT, PT, PhD; PATRICK S. ROMANO, MD, MPh; DANIEL L. RIDDLE, PT, PhD; LAUREL A. BECKETT, PhD

Abstract: Maitland's construct of musculoskeletal pain irritability is widely used by physical therapists but has not been defined to the extent that its measurement properties can be tested. The purpose of this study was to examine the inter-rater reliability of physical therapists' irritability judgments during application to patients with low back pain (LBP). Eighty patients with LBP received two consecutive examinations at their initial clinic visit by two physical therapists. Patients reported pain location and intensity prior to each evaluation. Therapists judged subjects’ LBP as irritable or non-irritable. Inter-rater agreement of physical therapist irritability judgments was moderate (kappa = 0.44, prevalence-adjusted kappa = 0.50). This level of reliability of therapists' LBP irritability judgments may be improved upon by development of an operational definition of pain irritability. Further research is needed to identify measures appropriate for inclusion in an operational definition of pain irritability and to assess the value of making pain irritability judgments in evidence- based physical therapy practice.

The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2009), 135-140

Clinimetrics Corner: Publishing a Scientific Manuscript on Manual Therapy

CHAD COOK, PT, PhD, MBA, OCS, FAAOMPT; JEAN-MICHEL BRISMÉE, PT, ScD, OCS, FAAOMPT; CAROL COURTNEY, PT, PhD, FAAOMPT; MARK HANCOCK, PT, PhD; STEPHEN MAY, PT, FCSP, Dip MDT, MSc, PhD

Abstract: Publication in peer-reviewed journals is the way to introduce new information that has clinical implications. however, clinicians may be reluctant to embark on the publication process because of lack of confidence or uncertainty about the process. The aim of this paper is to summarize the requirements of that process and to provide tips for successful publication to encourage potential clinical authors of manual therapy articles. In general, articles should contribute knowledge, corroborate or contradict previous knowledge, or summarize existing knowledge. Articles should be clearly structured, with abstract, introduction, methods, discussion, conclusion, and references; and often include tables and figures. The content of each of these sections is described. The use of standardized checklists is encouraged and the format should adhere to each journal’s author guidelines. Submission is electronic and typically first the editor or deputy editor reviews for suitability, adherence to journal format, and quality of writing. If deemed suitable, the article is then sent out for blinded review by two reviewers with expertise in that area. Review typically takes 6–8 weeks, and all communication is via the editor. A decision is made then to either accept, accept with amendments to be made, reject but with advice to resubmit, or reject outright. In any re-submissions, the review teams' comments should be diligently addressed, either making the recommended changes or justifying why they have not been adopted. Common reasons for rejection of articles are given. Finally, the authors provide some tips for publication to help readers with successful submission of articles.
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The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2009), 141-147

Correlation of Magnetic Resonance Imaging Findings and Reported Symptoms in Patients with Chronic Cervical Dysfunction

ROGELIO CORONADO, PT; BEVERLY HUDSON, PT, DPT; CHARLES SHEETS, PT, Dip MDT; MATTHEW ROMAN, PT, FAAOMPT; ROBERT ISAACS, MD; JESSIE MATHERS, PT, OCS, FAAOMPT; CHAD COOK, PT, PhD, MBA, OCS, FAAOMPT

Abstract: Information gathered from the patient history, physical examination, and advanced testing augments the decision-making process and is proposed to improve the probability of diagnostic and prognostic accuracy. However, these findings may provide inconsistent results and can lead to errors in decision-making. The purpose of this study was to examine the relationship between common clinical complaints and specific findings on magnetic resonance imaging (MRI) in patients with chronic neck dysfunction. Fortyfive English-speaking participants (25 female), with mean age of 52 (SD = 13.4), were evaluated by a neurosurgeon for complaints of symptoms related to the cervical spine. All participants answered a subjective questionnaire and received an MRI of the cervical spine. Cramer’s V nominal correlation was performed to explore the relationship between the targeted variables. The correlation matrix calculations captured three significant findings. Evidence of spinal cord compression was significantly correlated to 1) anteroposterior canal diameter of less than or equal to 9 mm (r = .31; p<0.05) and 2) diminished subarachnoid fluid around the cord (r = .48; p<0.01). Report of loss of dexterity was significantly correlated with 3) report of lower extremity clumsiness (r = .33; p<0.05). In this study, no definitive relationships were found between the clinical complaints of neck pain, hand function, or clumsiness and specific MRI findings of spinal cord compression. Further research is needed to investigate the diagnostic utility of subjective complaints and their association with advanced testing.

The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2009), 148-153

Repeated Applications of Thoracic Spine Thrust Manipulation do not Lead to Tolerance in Patients Presenting with Acute Mechanical Neck Pain: A Secondary Analysis

CESAR FERNANDEZ-DE-LAS-PENAS, PT, PhD; JOSHUA A. CLELAND, PT, PhD; PETER HUIJBREGTS, PT, DPT, OCS, FAAOMPT, FCAMT; LUIS PALOMEQUE-DEL-CERRO, PT; JAVIER GONZALEZ-IGLESIAS, PT, PhD

Abstract: It has been demonstrated that patients receiving mobilization techniques do not exhibit tolerance to repeated applications. However, this phenomenon has not been investigated for thoracic manipulation. Our aim was to determine if patients receiving thoracic thrust manipulation exhibit tolerance to repeated applications in acute mechanical neck pain. Forty-five patients were randomly assigned to two groups. The control group received electro- and thermotherapy for 5 sessions, and the experimental group received the same program and also received a thoracic thrust manipulation once a week for 3 consecutive weeks. Outcome measures included neck pain and cervical mobility. Within-session change scores for pain and mobility during treatment sessions #1, 3, and 5 were examined with a one-way repeated measured ANOVA. A 2-way ANOVA with session as within-subject variable and group as between-subject variable was used to compare change scores for each visit between groups to ascertain if there were significant between-group differences in within-session changes for the experimental versus the control group. The ANOVA showed that for either group the 3 within-session change scores were not significantly different (P > 0.1). The 2-way ANOVA revealed significant differences between groups for both pain and neck mobility in within-session change scores (all, P < 0.001). Change scores in each session were superior in the experimental group as compared to those in the control group. The results suggest that patients receiving thoracic manipulation do not exhibit tolerance to repeated applications with regard to pain and mobility measures in acute mechanical neck pain. Further studies should investigate the dose-response relationship of thoracic thrust manipulation in this population.

The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2009), 154-162

Global Rating of Change Scales: A Review of Strengths and Weaknesses and Considerations for Design

STEVEN J KAMPER, PT, BAppSc; CHRISTOPHER G MAHER, PT, PhD; GRANT MACKAY, PT, BAppSc

Abstract: Most clinicians ask their patients to rate whether their health condition has improved or deteriorated over time and then use this information to guide management decisions. Many studies also use patient-rated change as an outcome measure to determine the efficacy of a particular treatment. Global rating of change (GRC) scales provide a method of obtaining this information in a manner that is quick, flexible, and efficient. As with any outcome measure, however, meaningful interpretation of results can only be undertaken with due consideration of the clinimetric properties, strengths, and weaknesses of the instrument. The purpose of this article is to summarize this information to assist appropriate interpretation of the GRC results and to provide evidence-informed advice to guide design and administration of GRC scales. These considerations are relevant and applicable to the use of GRC scales both in the clinic and in research.

The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2009), 163-170

Cyriax Physiotherapy Versus Phonophoresis with Supervised Exercise in Subjects with Lateral Epicondylalgia: A Randomized Clinical Trial

AMIT V. NAGRALE, MPhT; CHRISTOPHER R. HERD, PT, DPT, CSCS; SHYAM GANVIR, MPhT; GOPICHAND RAMTEKE, MPhT

Abstract: Cyriax and Cyriax advocated the use of deep transverse friction massage in combination with Mill’s manipulation in treating lateral epicondylalgia. Evidence comparing this approach with other physical therapies is lacking. The purpose of this randomized clinical trial was to compare the effectiveness of deep transverse friction massage with Mill’s manipulation versus phonophoresis with supervised exercise in managing lateral epicondylalgia. Sixty patients age 30-60, presenting with the teno-periosteal variety of lateral epicondylalgia with symptom duration greater than one month, were randomized into two groups. The control group received phonophoresis with diclofenac gel over the area of the lateral epicondyle for 5 minutes combined with supervised exercise. The experimental group received 10 minutes of deep transverse friction massage followed by a single application of Mill’s manipulation. Both groups received treatment 3 times per week for 4 weeks. Outcomes of interest included pain via visual analog scale (VAS), pain-free grip strength, and functional status measured with the Tennis Elbow Function Scale. Data were analyzed using a one-way ANOVA. Whereas both groups improved significantly from the initiation of treatment, a between-group comparison revealed significantly greater (p<0.05) improvements regarding pain, pain-free grip, and functional status for the experimental group compared to the control group. The results of this study demonstrate that Cyriax physiotherapy is a superior treatment approach compared to phonophoresis and exercise in managing lateral epicondylalgia.

The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2009), 171-178

Abstracts: Accepted Platform Presentations AAOMPT 2009

[no abstract available]
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The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2009), 179-184

Book and Multimedia Reviews

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The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2008), 185

Information For Authors

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The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2008), 186

Correlation of Digital Palpation and Transabdominal Ultrasound for Assessment of Pelvic Floor Muscle Contraction

AMIR MASSOUD ARAB, PT, PhD; ROXANA BAZAZ BEHBAHANI, PT, BSc; LEILA LORESTANI, PT, BSc; AFSANEH AZARI, PT, MSc

Abstract: Pelvic floor muscle (PFM) dysfunction has been commonly associated with urinary disorders and lumbo-pelvic pain. Transabdominal (TA) ultrasound is currently used by physical therapists to assess PFM function. Controversy exists regarding the correlation between TA ultrasound measurement and vaginal palpation for assessment of PFM contraction, and this relationship has not yet been examined concurrently during the same contraction. The purpose of this study was to determine the correlation of digital palpation and TA ultrasound to assess PFM contraction when recorded 1) simultaneous to digital palpation during one contraction and 2) following digital palpation testing in another con- traction. A descriptive correlational design was used to describe the relationship between variables. A total of 19 women (both asymptomatic women and those with incontinence or lumbo-pelvic pain) participated in the study. The modified Oxford scale was used to grade PFM contraction in digital palpation testing. The amount of bladder base movement on ultrasound was measured and considered as an indicator of PFM activity. Two trials were performed for TA ultrasound measurement: 1) simultaneous to digital palpation during one contraction, and 2) following digital palpation testing in another contraction. Spearman’s correlation coefficient was used for analysis. There was a significant correlation between digital palpation and TA ultrasound for PFM assessment when measured simultaneously in one contraction (rho=0.62, p=0.01) and separately in a different contraction (rho=0.52, p=0.02), with a stronger correlation found in simultaneous testing. In conclusion, digital palpation and TA ultrasound measurement are significantly correlated and measure comparable parameters in evaluation of PFM contraction.
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The Journal of Manual & Manipulative Therapy Vol. 17 No. (2009), E75-E79

Systematic Review of Efficacy for Manual Lymphatic Drainage Techniques in Sports Medicine and Rehabilitation: An Evidence-Based Practice Approach

GIAMPIETRO L VAIRO, MS, ATC, ACI; SAYERS JOHN MILLER, PhD, PT, ATC; NICOLE M MCBRIER, PhD, ATC; WILLIAM E BUCKLEY, PhD, MBA, ATC

Abstract: Manual therapists question integrating manual lymphatic drainage techniques (MLDTs) into conventional treatments for athletic injuries due to the scarcity of literature concerning musculoskeletal applications and established orthopaedic clinical practice guidelines. The purpose of this systematic review is to provide manual therapy clinicians with pertinent information regarding progression of MLDTs as well as to critique the evidence for efficacy of this method in sports medicine. We surveyed English-language publications from 1998 to 2008 by searching PubMed, PEDro, CINAHL, the Cochrane Library, and SPORTDiscus databases using the terms lymphatic system, lymph drainage, lym- phatic therapy, manual lymph drainage, and lymphatic pump techniques. We selected articles investigating the effects of MLDTs on orthopaedic and athletic injury outcomes. Nine articles met inclusion criteria, of which 3 were randomized controlled trials (RCTs). We evaluated the 3 RCTs using a validity score (PEDro scale). Due to differences in experimental design, data could not be collapsed for meta-analysis. Animal model experiments reinforce theoretical principles for application of MLDTs. When combined with concomitant musculoskeletal therapy, pilot and case studies demonstrate MLDT effectiveness. The best evidence suggests that efficacy of MLDT in sports medicine and rehabilitation is specific to resolution of enzyme serum levels associated with acute skeletal muscle cell damage as well as reduction of edema following acute ankle joint sprain and radial wrist fracture. Currently, there is limited high-ranking evidence available. Well-designed RCTs assessing outcome variables following implementation of MLDTs in treating athletic injuries may provide conclusive evidence for establishing applicable clinical practice guidelines in sports medicine and rehabilitation.
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The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2009), E80-E89

Abstracts: Accepted Abstracts Poster Presentations AAOMPT 2009

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The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2009), E90-E103

Letter to the Editor with Author Response: "Upper Limb Neural Tension and Seated Slump Tests: The False Positive Rate Among Healthy Young Adults without Cervical or Lumbar Symptoms"

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The Journal of Manual & Manipulative Therapy Vol. 17 No. 3 (2009), E104-106