PAST ISSUES OF THE JOURNAL OF MANUAL AND MANIPULATIVE THERAPY
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1995 - Vol. 3, No. 4
* this issue only available in Hardcopy format
The Rotated Segment in Acute Low Back Pain
Kate Haswell, PGDIP(MPT), BS, PT
Abstract: A clinically relevant asymmetric rotation may be detected in acute low back pain patients who present with a lateral lumbar shift. It is suggested, that an examination category of asymmetric rotation could be used to guide treatment choices in the management of acute low back pain. Because of rotational coupling in the lumbar spine both rotation and sideflexion movements are considered relevant to the examination and treatment of asymmetric rotation. In this paper, five different tests are described that can be used for detecting the presence and direction of a clinically relevant asymmetric rotation. Further to this, it is recommended that a cluster of tests, rather than a single test is used in this clinical decision. Treatment for asymmetric, rotation may include the use of rotation, sideflexion and sidegliding techniques. Rotational techniques for patients presenting with a clinically relevant asymmetric rotation is described and critically analyzed.
The Journal of Manual & Manipulative Therapy Vol. 3 No.4 (1995 ), 127 - 134
Reliability in Evaluating Passive Intervertebral Motion of the Lumbar Spine
E. Lynette Inscoe, MS, PT, MTC, Philip L. Witt, Ph.D., PT, Michael T. Gross, PH.D., PT, Ruth U. Mitchell, PH.D., PT
Abstract: Passive intervertebral motion (PIVM) of the lumbar spine during forward bending was assessed independently during two grading trials by two physical therapists. The therapists each had a minimum of two years clinical experience with similar orthopaedic manual therapy skills, including the sidelying double leg technique utilized in this study. Six segments of the lumbar spine were graded as normal, hypomobile, or hypermobile. Subjects were six volunteers who had a history of low back pain (LBP) and were currently experiencing LBP symptoms. Each therapist graded the segmental mobility during two different trials to investigate both intra- and inter-examiner reliability. Data were analyzed by percent agreement, and scott's pi () which is an indicater of reliability greater than that expected to occur by chance with nominal data. Results demonstrated inter-examiner reliability of 66.67% and 75.00%, with agreement greater than chance of 41.89% and 61.29% respectively. Inter-examiner reliability was 48.61% and agreement greater than chance was 18.35%.
The Journal of Manual & Manipulative Therapy Vol. 3 No.4 (1995 ), 135 - 143
Neurovascular Compromise Complicating Cervical Spine Manipulation: What is the Risk?
Darren A. Rivett MappSc (Manip Phty), Grad Dip Manip Ther, BappSc (Phty)
Abstract: Complications of cervical spine manipulation (CSM) have been documented in the literature for over half a century. Most incidents involve Neurovascular compromise resulting from trauma for the vertebral artery or less frequently the internal carotid artery. The determination of the incidence rate or degree of risk of this complication is of crucial importance in clinical decision making regarding CSM. To this end a critical review of published case reports and studies investigating the event rate of stroke associated with CSM is undertaken. It is concluded that the case repots in the literature are not representative of the frequency of Neurovascular complications. Methodological limitations of past research on this topic are discussed, as is the need for a prospective study. Despite these considerations it is found that marked neurological sequelae to CSM are an uncommon event for which the level of risk may be further reduced by prudent practice.
The Journal of Manual & Manipulative Therapy Vol. 3 No.4 (1995 ), 144 - 151
Neural Plasticity, Muscle Spasm and Tissue Manipulation: A review of the Literature
Andrea L. Vujnovich MSc (Hons), ADP (OMT), Dip MT, Dip Phys.
Abstract: It is recognized that the sensation of pain may be associated with changes in parts of the central nervous system responsible for processing nociceptive information. Some of these changes reflect long term, possibly permanent increases in the excitability of neurons within the ventral and dorsal horns of the spinal cord. Experimental evidence supports a relationship between neural plasticity, muscle spasms and voluntary recruitment of motor units. Passive muscle stretch, join manipulations and muscle message all result in a significant decrease in the excitability of neurons within the lower motoneuron pool. These therapeutic interventions may be appropriate to reduce or prevent high levels of neural activity caused by noxious stimulation.
The Journal of Manual & Manipulative Therapy Vol. 3 No.4 (1995 ), 152 - 156
* this issue only available in Hardcopy format
