PAST ISSUES OF THE JOURNAL OF MANUAL AND MANIPULATIVE THERAPY
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2001 - Vol. 9, No. 4
* this issue only available in PDF format
The Use of Lumbar Harness Traction to Treat a Patient with Lumbar Radicular Pain: A Case Report
Marie Corkery PT, MHS, FAAOMPT
Abstract: The purpose of this case study is to describe an intervention using standing lumbar harness traction to treat a patient with lumbar radicular pain. A 60-year-old male presented with a 3 month history of right buttock and posterior thigh pain. The patient had positive unilateral straight leg raise and slump tests, and ankle evertor weakness. He exhibited symptom alleviation with lumbar deloading tests. His main functional limitation was difficulty sitting. The patient was seen for five visits. Initial intervention included standing harness traction. The patient’s status, including neurological signs and symptoms, was monitored. Passive psoas stretching and instruction in self-stretch for psoas, gastrocnemius, and soleus was later included. Functional instruction and training in body mechanics and back care was carried out prior to discharge. Harness traction reduced neurological signs and radicular pain in this patient. He exhibited good functional recovery after five visits. Harness traction intervention should be considered in patients with complaints of low back and leg pain who exhibit symptom alleviation with lumbar deloading tests.
The Journal of Manual & Manipulative Therapy Vol. 9, No. 4 (2001), 191 - 197
Diagnostic Tests for Mechanical Dysfunction of the Sacroiliac Joints
Elizabeth Grieve PhD, MCSP, MMACP
Abstract: Despite almost a century of management of mechanical dysfunction of the sacroiliac joints, no testing procedures have been satisfactorily validated for diagnosis. This paper presents tests that proved to be the most reliable for the management of 57 patients referred by their GPs for treatment of back and leg pain. The patients all regained normal pain-free function after manipulation of the sacroiliac joint(s) followed by a program of modified living and progressively increased walking. The tests include a version of Gillet’s test (alternate hip and knee flexion in support standing) revised by the author, passive hip rotations in supine with 90 degrees of hip and knee flexion, and palpation of the superior ligament of the symphysis pubis. This paper proposes that when performed as described, these four tests are worth validating for the diagnosis of sacroiliac joint dysfunction.
The Journal of Manual & Manipulative Therapy Vol. 9 No. 4 (2001), 198 - 206
The Effect of Thoracic Spine Mobilization On Lower Trapezius Strength Testing
Ethan John Liebler, PT, MS, Lisa Tufano-Coors, PT, MS, Peter Douris, PT, EdD, Howard W. Makofsky, PT, DHSc, OCS, Raymond McKenna, PT, PhD, Christopher Michels, PT, MS, Shawlyn Rattray, PT, MS
Abstract: Evidence has shown that muscle strength and function become altered due to motion restrictions. Strengthening muscles with traditional therapeutic exercise will not be completely successful unless inhibition is removed by restoring normal joint mechanics. This study investigated the effect of Grade-IV thoracic spine mobilizations on lower trapezius strength testing in normal subjects. The mobilization for the treatment group (n=20) consisted of posterior-anterior (P-A) oscillations performed from T6-T12 at each segment’s end range (Grade-IV). This technique is aimed at restoring normal joint play. The control group (n=20) received a Grade-I mobilization consisting of P-A oscillations performed at the beginning of the joint’s range, which is not expected to have articular reflexogenic effects. Before and after the mobilizations, isometric muscle strength of the lower trapezius was measured using a Nicholas Manual Muscle Tester. An independent group t-test comparing the groups demonstrated a statistically significant effect of thoracic spine mobilization on lower trapezius strength testing (P<.05).
The Journal of Manual & Manipulative Therapy Vol. 9 No. 4 (2001), 207 - 212
The Short-Term Effect of Lumbar Positional Distraction
Ulrike H. Mitchell, MScPT, MTC, Michael J. Wooden, MSPT, OCS, D. Michael McKeough, PT, EdD
Abstract: The purpose of this study was to test the hypothesis that positional distraction provides immediate relief of unilateral leg pain suspected to be caused by lumbar-nerve root irritation. Thirty subjects with true neurological signs were randomly assigned to a treatment group or control group. The treatment group received positional distraction for five minutes and the control group lay in side-lying for the same amount of time. Pain intensity, pain location, and SLR test height data was taken pre- and post-test. Statistical analysis was completed with the Wilcoxinsigned rank test for the data of pain intensity and with the paired sample t-test for the SLR height. The treatment group was found to have significantly less pain, more centralization of pain, and an increase in SLR test height (p-values of 0.001, 0.006, and 0.005 respectively). The control group showed no significant change (p-values of 0.506, 0.480, 0.884).
The Journal of Manual & Manipulative Therapy Vol. 9 No. 4 (2001), 213 - 221
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 PDF format
