PAST ISSUES OF THE JOURNAL OF MANUAL AND MANIPULATIVE THERAPY
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2000 - Vol. 8, No. 4
* this issue only available in Hardcopy format
A Study to Investigate Whether Golfers with a History of Low Back Pain Show a Reduced Endurance of Transversus Abdominis
Caroline Evans, BSc, MCSP, SRP Williarn Oldreive, MSc, BA, MCSP, Dip PT
Abstract: Recently published evidence has shown an increasing number of golfers reporting the presence of low back pain (LBP). Research has shown the occurrence and recurrence of LBP to be associated with the dysfunction of the deep abdominal muscle, transversus abdominis (TrA). To investigate the reduction in its stabilizing role, the pressure biofeedback unit (PBU) was developed as an objective assessment and monitoring tool. This instrument is also used in the rehabilitation of TrA. Twenty male golfers, age 20-44, were recruited by newsletter article and direct approach to see whether golfers with a history of LBP showed a reduced muscle endurance time of TrA compared with golfers with no such history. Subjects were taught TrA contraction in prone kneeling and in prone lying using the PBU. Using a cycle of 10 seconds contraction followed by 20 seconds rest, the total time each subject could maintain a TrA contraction was measured. The results showed that golfers with a history of LBP had a statistically significant reduction (P<0.025) in the endurance of the static contraction time of TrA compared to golfers without a history of LBP. The results are discussed in relation to previous research, and the implications for clinicians for the rehabilitation of golfers with LBP are identified.
The Journal of Manual & Manipulative Therapy Vol. 8 No. 4 (2000), 162 - 174
Osteonecrosis of the Humeral Head: A Literature Review and Two Case Studies
Peter A. Huijbregts, PT, OCS, FAAOMPT
Abstract: Osteonecrosis of the humeral head may be idiopathic, but it is also associated with a number of known medical conditions. In these patient groups, it is a differential diagnostic possibility that the physical therapist needs to consider. This article discusses histopathology, classification, etiology, history and examination findings, and treatment of humeral head osteonecrosis. It also presents two case studies of patients with undiagnosed osteonecrosis who were referred to physical therapy to illustrate the difficulties and possibilities for correct identification of such patients.
The Journal of Manual & Manipulative Therapy Vol. 8 No. 4 (2000), 175 - 182
Reliability of a New Instrument to Measure Scapular Position
Dean M. Plafcan, MS, ATC, PT Paul K. Canavan, MA, PT, ATC, CSCS Wayne J. Sebastianelli, MD K. Michael Swope, RT (R)
Abstract: The purpose of this study was to develop an objective method to measure scapulae position as it relates to the frontal, sagittal and transverse reference planes of the human body. Contemporary shoulder rehabilitation programs place great emphasis on the role of the scapula in the treatment of shoulder pathology. While clinicians employ many treatment techniques aimed at improving scapular function, a literature review reveals that clinicians lack objective measurement techniques to measure scapular position. A Scapular Measurement Instrument (SMI) was used to objectify scapular position. Eleven subjects, who reported no current history of shoulder pain or pathology, were included in the study. Testers obtained measurements of scapulae position with respect to the frontal, sagittal, and transverse planes of the body. Inferior angle scapular measurements (LAM) and spine of the scapula measurements (SM) were taken. Two test positions were used. Position I was termed the "rest position" and involved subjects sitting with their arms resting at their side; position 2 involved subjects placing their arms in a "reach position" touching their opposite shoulder blade. Statistical analysis was carried out in an attempt to estimate reliability. Intratester and intertester correlation coefficients (ICC), and Standard Error of Measurement (SEM) values were calculated for all measurements. In an attempt to validate the frontal and sagittal plane referenced measurements, subjects' scapulae positions were quantified via radio- graphic (x-ray) analysis. Pearson Moment Correlation Coefficients were used to assess the measurement relationships between x- ray and (SMI) obtained values. lntratester ICC values for the rest condition ranged from .68 to .88 (LAM) and .68 to .86 (SM). Intratester ICC values for the reach condition ranged from .51 to .91 (LAM) and .60 to .95 (SM). Intertester ICC values for the rest condition ranged from .68 to .80 (LAM) and .80 to .95 (SM), and intertester ICC for the reach condition ranged from .48 to .66 (LAM) and .30 to .86 (SM). These values indicate better reliability for the rest condition. Intratester reliability values were generally greater than intertester values. SEM was I cm or less for all measurements. In regard to the validation of testers' measurements via x-ray, Pearson Moment Correlation Coefficients revealed a general trend of greater validity for rest versus reach conditions. Restcondition correlation data ranged from .87 to .96, while reach-condition correlation data ranged from .23 to .93. The large range in correlation data was believed to be representative of random error of measurement. The authors feel that this technique is a viable option for objective measurement of at- rest scapular position. Further research is suggested, including refinement of the SMI and investigation into alternative radiographic and measurement procedures.
The Journal of Manual & Manipulative Therapy Vol. 8 No. 4 (2000), 183 - 192
The Use of Manual Therapy and Exercise in the Treatment of Chronic Cervicogenic Headaches: A Series of Case Studies
R. Lance Whorton, MS, PT, MTC Sam Kegerreis, MS, PT, ATC
Abstract: Six individuals suffering from chronic cervicogenic headache were the subjects of a series of case studies involving manual therapy, exercise, and a home-exercise program. Headache duration ranged from three months to twenty years. During the course of treatment, the subjects maintained a journal tracking duration, frequency, and intensity of their headaches as well as any relieving factors. The purpose of this series of studies was to describe the use of manual therapy and exercise in the treatment of chronic cervicogenic headaches. Subjects were treated using a custom home-exercise protocol; manual therapy involving soft tissue and non-thrust joint manipulation, aerobic conditioning, and resistance exercise. The Pain Disability Index (PDI) was used as the functional improvement scale. The PDI was administered pre-, post- and six months post-treatment. Five of the six subjects reported improvement. These five subjects were seen for an average of 5.9 sessions over an average of 3.8 weeks. The average improvement on the PDI was 29.5% at discharge and 28.8% at 6- month follow-up. The five subjects each reported the need to continue their home exercise program in order to control their headaches at 6-month follow-up. A voluntary decrease in medication intake was also reported by five of the six subjects at discharge. Six-month follow-up showed that these five patients were still taking less medication than reported at time of the initial examination. No follow- up data was available for the patient which reported no improvement. The results of these case studies seem to indicate that a treatment regimen of exercise and manual therapy can be beneficial in the treatment of chronic cervicogenic headaches.
The Journal of Manual & Manipulative Therapy Vol. 8 No. 4 (2000), 193 - 203
* this issue only available in Hardcopy format
