PAST ISSUES OF THE JOURNAL OF MANUAL AND MANIPULATIVE THERAPY
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2001 - Vol. 9, No. 2
* this issue only available in Hardcopy format
SLAP Lesions: Structure, Function, and Physical Therapy Diagnosis and Treatment
Peter A. Huijbregts, DPT, OCS, FAAOMPT
Abstract: This article describes the structure and function of the labral-bicipital complex. It also it discusses incidence, classification, injury mechanisms, subjective and physical examination findings, and conservative treatment options for lesions to the labral-bicipital complex, also known as SLAP-lesions.
The Journal of Manual & Manipulative Therapy Vol. 9, No. 2 (2001), 71 - 83
Effects of Physical Therapist Training on Outcomes of Patients With Chronic Low Back Pain or Chronic Shoulder Pain
Mark J. Levsen, PT MA, OCS, SCS, FAAOMPT Melissa L. Hansen, SPT April Dawn Kent, SPT Jennifer J. Sieren, SPT Jon P Thoreson SPT Kevin P Farrell, PT PHD, OCS, FAAOMPT
Abstract: No studies to date were found investigating the impact of clinical reasoning on physical therapy outcomes. Previous research has focused on specific physical therapy interventions versus the entire scope of physical therapy practice. The purpose was to investigate whether a long-term post graduate course with emphasis in clinical reasoning enhances physical therapy outcomes in patients with chronic low back pain and chronic shoulder pain. In two outpatient clinics, patients with chronic low back pain and chronic shoulder pain were assigned to participating physical therapists. Therapists who had attended a long-term course with an emphasis on development of clinical reasoning skills (Group 1) were compared to therapists who had not attended the long-term course (Group 2). Patients completed the Revised Disability Pain Questionnaire (Oswestry) or the Shoulder Rating Questionnaire on the initial and final visits. Data collected on subjects included: age, initial questionnaire score, discharge questionnaire score, and number of visits. A critical alpha level of 0.05 was set for all statistics. This study used a prospective, mixed design. The independent variables were therapist training and time of measurement. The dependent variables were functional tool scores, number of visits, and efficiency ratio (change in functional tool score/number of visits). The mean ± SE number of visits for patients with chronic low back pain in therapists in Group 1 (5.3 +/- 0.4) was statistically fewer than for therapists in Group 2 (7.6 +/- 0.4); (p<0.001). Likewise there was a greater efficiency ratio (p<0.001) for therapists in Group 1 (5.6 +/- 0.6) compared to therapists in groups 2 (1.8 +/- 0.3) 'An interaction existed between therapist training and time of measurement (p<0.001) with a greater effect for therapists in group 1 (26.2 ± 2.3) versus group 2 (13.4 +/- 2. 1). For patients with chronic shoulder pain, therapists in groups I again demonstrated significantly fewer number of visits (6.3 +/- 1.2) versus group 2 (10.8 +/- 1.2); p=0.026. Therapists in Group I also demonstrated a greater efficiency ratio (3.9 + 0.7) vs. therapists in group 2 (1.9 = 0.3); p=0.026. No significant interaction was found between therapist group and measurement in patients with chronic shoulder pain (p=0.834). The results suggest therapists completing the long-term course emphasizing clinical reasoning have better effectiveness (change in functional tool scores) for patients with chronic low back pain and better efficiency for patients with chronic low back pain and chronic shoulder pain than therapists who have not completed the long-term course. For both diagnoses and therapist groups, a significant improvement was evident in patients' functional tool scores, indicating the overall positive effect of physical therapy.
The Journal of Manual & Manipulative Therapy Vol. 9 No. 2 (2001), 84 - 91
The Use of Strain-Counterstrain in the Treatment of Patients with Low Back Pain
Cynan Lewis, MSCPT, MTC, MAPA 77mothy W. Flynn, PT, PhD, OCS, FAAOMPT
Abstract: Strain-Counterstrain (S-CS) is a manipulative technique routinely used by manual practitioners to treat somatic dysfunction. However, no peer-reviewed literature to support or refute its use has been reported. In the four clinical cases reported, S-CS was initially provided as the sole treatment for low back pain. The S-CS intervention phase for each case took approximately one week and consisted of 2 to 3 treatment sessions to resolve perceived "aberrant neuromuscular activity." Outcome measures were derived from the McGill Pain Questionnaire and the Oswestry Low Back Pain Disability Questionnaire. All patients registered reductions in pain and disability following S-CS intervention. No experimental evidence for the effectiveness of S-CS is offered, although outcomes do suggest that a controlled study is war- ranted to examine the effectiveness of S-CS for the treatment of low back pain.
The Journal of Manual & Manipulative Therapy Vol. 9 No. 2 (2001), 92 - 98
Accuracy of Feedback During Training of Passive Accessory Intervertebral Movements
Nicola J. Petty, MSc PostGradManipTher MCSP MMACP MMPA Timothy M. Bach, MSc PhD Liz Cheek, MSc
Abstract: The purpose of this study was to determine the accuracy of verbal feedback given by manipulative physiotherapy students after a fellow student had applied Passive Accessory Intervertebral Movements (PAIVMs). Twelve students working in pairs acted in turn as model and therapist. Student therapist performance in producing a Grade-III movement was com- pared subjectively by student models to that of an experienced therapist. Their performance was also objectively compared using a force platform measurement system. Performances were assessed in terms of peak force and the frequency and amplitude of force oscillations. The feedback provided by student models was found to be inconsistent and unreliable. Alternate teaching methods seem necessary in order to provide student therapists with feedback appropriate for learning.
The Journal of Manual & Manipulative Therapy Vol. 9 No. 2 (2001), 99 - 108
Reliability of Inferior Glide Mobility Testing of the Glenohumeral Joint
Arie J. van Duijn, MSc, PT, OCS, MTC Richard H Jewen, PhD, PT
Abstract: The purpose of this study was to investigate intratester and intertester reliability for inferior glide mobility testing of the glenohumeral joint, a frequently used accessory motion test. Eighteen volunteers (21-55 years) were studied; 10 subjects had a history of shoulder dysfunction. Three experienced orthopedic physical therapists performed three blinded ratings and one non-blinded rating of inferior glide mobility for each subject's right glenohumeral joint using a 7 point rating scale. Intraclass correlation coefficients (ICCs) were calculated to evaluate intratester reliability using the blinded ratings and the intertester reliability using the non-blinded ratings. The ICCs (3,l) expressing intratester reliability were .88,.56, and .53. The ICC (2,I) expressing intertester reliability was .52. Intratester reliability of inferior glide mobility testing of the glenohumeral joint was moderate to good. Intertester reliability was moderate. Clinicians need to exercise caution when making treatment decisions based on inferior glide mobility testing.
The Journal of Manual & Manipulative Therapy Vol. 9 No. 2 (2001), 109 - 114
* this issue only available in Hardcopy format
