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Fan M, Liu A, Lu T, Zhou X, Tian C, Liu B, Xie Q, Cai J, Yin L, Ge L, Wu D. Quality appraisal of clinical practice guidelines addressing massage interventions using the AGREE II instrument. Syst Rev 2024; 13:83. [PMID: 38459534 PMCID: PMC10921609 DOI: 10.1186/s13643-024-02503-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/23/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVE The purpose of this study was to systematically evaluate the methodological quality of massage-related clinical practice guidelines (CPGs)/consensus on massage using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument and to summarize the current status of recommendations in the CPGs. METHODS The Chinese National Knowledge Infrastructure (CNKI), WanFang Data, China Science and Technology Journal Database (VIP), China Biology Medicine disc (CBM), PubMed, Embase, and guideline websites (such as the Chinese Medical Ace Base, the China Association of Chinese Medicine, the World Health Organization, Guideline International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network) were searched from inception to October 31, 2022. In addition, the reference lists of relevant studies were reviewed to identify domestic and overseas massage CPGs/consensus. The search terms adopted a combination of subject words and free words, mainly including traditional Chinese medicine, complementary therapies, Tuina, massage, manipulation, chiropractic/osteopathic, spinal, acupressure, guideline, and consensus. Two researchers independently completed the eligible records and extracted the data. Before the formal research, calibrations were performed twice on AGREE II, and all reviewers completed the pilot test three times until they understood and reached an agreement on the assessment items. Three researchers appraised the methodological quality of the included guidelines using the AGREE II instrument and calculated the overall intraclass correlation coefficient (ICC) of agreement. RESULTS The evaluation results showed that among the 49 eligible CPGs/consensus, 4 (8.2%) CPGs/consensus were considered "recommended", 15 (30.6%) CPGs/consensus were considered "recommended with modifications", and 30 (61.2%) CPGs/consensus were considered "not recommended", while the consensus was considered "not recommended". Generally, the scores in the six domains of the guidelines were all higher than the consensus. Evaluation results for the overall quality of 36 CPGs showed that 4 (11%) were "good quality", 15 (42%) were "sufficient quality" and 17 (47%) were "lower quality". The AGREE II quality scores of domains ranged from 0.30 to 0.75 ([ICC = 0.993, 95% CI (0.992, 0.995)]). The domain of scope and purpose (domain 1), with a median score of 0.75 (0.52~0.91), performed best in the guidelines with AGREE II, and stakeholder involvement (domain 2) [median 0.39 (0.31~0.56)] and application (domain 5) [median 0.30 (0.17~0.47] obtained lower scores. The consensus score of domain 1 was better at 26.0 (21.6~44.8), followed by rigor of development (domain 3) with a score of 18.0 (10.0~28.9). A total of 119 massage-related recommendations were extracted from 49 guidelines/consensuses, including "in favor" (102, 85.7%), "against" (9, 7.6%), and "did not make recommendations" (8, 6.7%). CONCLUSION The overall quality of the included guidelines was low, and most of the guidelines were not "recommended". In future guideline updates, the existing evidence should be used, the professional composition of members of the expert group should be enriched, and patients' values and preferences should be fully considered. It is necessary to clearly propose recognizable recommendations and strengthen the rigor and standardization of guideline formulation. Thus, clear standard guidelines can be formulated to better guide clinical practice.
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Affiliation(s)
- Mingyue Fan
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Aolin Liu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Taoying Lu
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
| | - Xiaowen Zhou
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Chen Tian
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Bingqing Liu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Qianwen Xie
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
| | - Jianxiong Cai
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
| | - Lingjia Yin
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
- Karolinska Institutet, Stockholm, Sweden
| | - Long Ge
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, People's Republic of China
| | - Darong Wu
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
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Stewart-Richardson JL, Hopf SC, Crockett J, Southwell P. What is Effective in Massage Therapy? Well, "It Depends…": a Qualitative Study of Experienced Orthopaedic Massage Therapists. Int J Ther Massage Bodywork 2024; 17:4-18. [PMID: 38486839 PMCID: PMC10911828 DOI: 10.3822/ijtmb.v17i1.935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Background Massage has been used as a treatment for musculoskeletal pain throughout history and across cultures, and yet most meta-analyses have only shown weak support for the efficacy of massage. There is a recognised need for more research in foundational questions including: how massage treatments are constructed; what therapists actually do within a treatment, including their clinical reasoning; and what role therapists play in determining the effectiveness of a massage treatment. Purpose The aim of this study was to explore what experienced orthopaedic massage therapists consider to be the aspects of their work that contribute to effectiveness. Setting and Participants Semi-structured interviews were conducted via Zoom with six experienced orthopaedic massage therapists in Australia. Research Design The interviews were analysed using inductive thematic analysis, seeking insights that might be practically applied, rather than theory-driven interpretations. Results The participants focused on the underlying differences between clients, between therapists, and between treatments, and clearly indicated that this concept of "difference" was foundational to their view of their work and was the underlying context for the comments they made. Within that frame of "difference", three key themes were interpreted from the data: (1) "Everyone is different so every treatment is different": how they individualised treatment based on these differences; (2) "How therapists cope with difference": how they managed the challenges of working in this context; and (3) "What makes a difference": the problem-solving processes they used to target each treatment to meeting the client's needs. Conclusions Participants did not identify specific techniques or modalities as "effective" or not. Rather, a therapist's ability to provide effective treatment was based on an iterative process of treatment and assessment that allowed them to focus on the individual needs of the client. In this case "effectiveness" could be considered a process rather than a specific massage technique.
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Affiliation(s)
- Jennifer L. Stewart-Richardson
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury
- Canberra Myotherapy (private practice), Canberra
| | - Suzanne C. Hopf
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury
| | - Judith Crockett
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury
| | - Phillipa Southwell
- Western NSW Regional Training Hub, The University of Sydney, Sydney, Australia
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Kovanur Sampath K, Treffel L, P.Thomson O, Rodi JD, Fleischmann M, Tumilty S. Changes in biochemical markers following a spinal manipulation - a systematic review update. J Man Manip Ther 2024; 32:28-50. [PMID: 37671460 PMCID: PMC10795611 DOI: 10.1080/10669817.2023.2252187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/18/2023] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVE The aim of this systematic review was to update the current level of evidence for spinal manipulation in influencing various biochemical markers in healthy and/or symptomatic population. METHODS This is a systematic review update. Various databases were searched (inception till May 2023) and fifteen trials (737 participants) that met the inclusion criteria were included in the review. Two authors independently screened, extracted and assessed the risk of bias in included studies. Outcome measure data were synthesized using standard mean differences and meta-analysis for the primary outcome (biochemical markers). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for assessing the quality of the body of evidence for each outcome of interest. RESULTS There was low-quality evidence that spinal manipulation influenced various biochemical markers (not pooled). There was low-quality evidence of significant difference that spinal manipulation is better (SMD -0.42, 95% CI - 0.74 to -0.1) than control in eliciting changes in cortisol levels immediately after intervention. Low-quality evidence further indicated (not pooled) that spinal manipulation can influence inflammatory markers such as interleukins levels post-intervention. There was also very low-quality evidence that spinal manipulation does not influence substance-P, neurotensin, oxytocin, orexin-A, testosterone and epinephrine/nor-epinephrine. CONCLUSION Spinal manipulation may influence inflammatory and cortisol post-intervention. However, the wider prediction intervals in most outcome measures point to the need for future research to clarify and establish the clinical relevance of these changes.
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Affiliation(s)
- Kesava Kovanur Sampath
- Centre for Health and Social Practice, Waikato Institute of Technology, Te Pukenga, Hamilton, New Zealand
- School of Public Health, University of Technology, ARCCIM, Sydney, Australia
| | - Loïc Treffel
- School of Public Health, University of Technology, ARCCIM, Sydney, Australia
- Institut Toulousain d’Ostéopathie, IRF’O, Toulouse, France
- INMG-PGNM, Univ Lyon1, Lyon, France
| | - Oliver P.Thomson
- School of Public Health, University of Technology, ARCCIM, Sydney, Australia
- Research Department, University College of Osteopathy, London, UK
| | - Jerry Draper Rodi
- School of Public Health, University of Technology, ARCCIM, Sydney, Australia
- Research Department, University College of Osteopathy, London, UK
- National Council for Osteopathic Research, London, UK
| | - Michael Fleischmann
- School of Public Health, University of Technology, ARCCIM, Sydney, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Steve Tumilty
- Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Zaina F, Côté P, Cancelliere C, Di Felice F, Donzelli S, Rauch A, Verville L, Negrini S, Nordin M. A Systematic Review of Clinical Practice Guidelines for Persons With Non-specific Low Back Pain With and Without Radiculopathy: Identification of Best Evidence for Rehabilitation to Develop the WHO's Package of Interventions for Rehabilitation. Arch Phys Med Rehabil 2023; 104:1913-1927. [PMID: 36963709 DOI: 10.1016/j.apmr.2023.02.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/13/2023] [Accepted: 02/28/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE To Identify evidence-based rehabilitation interventions for persons with non-specific low back pain (LBP) with and without radiculopathy and to develop recommendations from high-quality clinical practice guidelines (CPGs) to inform the World Health Organization's (WHO) Package of Interventions for Rehabilitation (PIR). DATA SOURCE We searched MEDLINE, EMBASE, CINAHL, PsycINFO, National Health Services Economic Evaluation Database, Health Technology Assessment Database, PEDro, the Trip Database, the Index to Chiropractic Literature and the gray literature. STUDY SELECTION Eligible guidelines were (1) published between 2009 and 2019 in English, French, Italian, or Swedish; (2) included adults or children with non-specific LBP with or without radiculopathy; and (3) assessed the benefits of rehabilitation interventions on functioning. Pairs of independent reviewers assessed the quality of the CPGs using AGREE II. DATA SYNTHESIS We identified 4 high-quality CPGs. Recommended interventions included (1) education about recovery expectations, self-management strategies, and maintenance of usual activities; (2) multimodal approaches incorporating education, exercise, and spinal manipulation; (3) nonsteroidal anti-inflammatory drugs combined with education in the acute stage; and (4) intensive interdisciplinary rehabilitation that includes exercise and cognitive/behavioral interventions for persistent pain. We did not identify high-quality CPGs for people younger than 16 years of age. CONCLUSION We developed evidence-based recommendations from high-quality CPGs to inform the WHO PIR for people with LBP with and without radiculopathy. These recommendations emphasize the potential benefits of education, exercise, manual therapy, and cognitive/behavioral interventions.
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Affiliation(s)
- Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | - Pierre Côté
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada; Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | - Carolina Cancelliere
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada; Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | | | | | - Alexandra Rauch
- Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Leslie Verville
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada; Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, NYU Grossman School of Medicine, Occupational and Industrial Orthopedic Center (OIOC), NYU Hospital for Joint Diseases, NYU Langone Health, New York University, New York, NY
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Tefner IK, Bender T, Kleiber J, Hodosi K, Gáti T. The effects of immersion in 42℃ radon, natrium, calcium, bicarbonate content thermal-mineral water on chronic low back pain. Controlled, follow-up study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:527-537. [PMID: 36708381 DOI: 10.1007/s00484-023-02433-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
In our minimized follow-up trial with 137 participants with chronic low back pain, one group of participants received regular outpatient care, and the other group received balneotherapy by immersion in 42℃ thermal-mineral water in addition to regular outpatient care on 15 occasions for 3 weeks. Pain on movement and at rest on the 0-100 mm visual analogue scale (VAS), Oswestry index, the number of participants evaluating the symptoms clinically acceptable (Patient Acceptable Symptom State, PASS) and the EuroQol-5D-5L (EQ-5D-5L) quality of life questionnaire were assessed at basal time (at week 0) and after balneotherapy (at weeks 3 and 12). The VAS pain scores, the Oswestry index, the EQ-5D-5L index and the EQ-VAS significantly improved in the balneotherapy group after treatment at week 3 (p < 0.001) and week 12 (p < 0.001) compared to baseline, with a significant between group difference at week 3 (p < 0.001) and week 12 (p < 0.001). The pain VAS score on movement was 66.82 ± 11.48, 26.69 ± 21.49, and 20.09 ± 23.29 in the balneotherapy group, and 63.67 ± 14.77, 67.35 ± 15.44, and 70.23 ± 18.26 in the control group at the consecutive visits. The PASS increased in both groups at week 3 and week 12 compared to the baseline, with a significant between-group difference at week 3 and week 12 for the balneotherapy group. Our results suggest the therapeutic efficacy of immersion in 42℃ thermal mineral water on chronic low back pain.ClinicalTrials.gov Identifier: NCT05342051.
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Affiliation(s)
- Ildikó Katalin Tefner
- Department of Rheumatology, Saint Cosmas Health Center of Joseph Town, Budapest, Hungary.
| | - Tamás Bender
- Department of Rheumatology, Polyclinic of The Hospitaller Brothers of St John of God, Budapest, Hungary
| | - Judit Kleiber
- Department of Rheumatology, Saint Cosmas Health Center of Joseph Town, Budapest, Hungary
| | - Katalin Hodosi
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tamás Gáti
- Department of Rheumatology, Saint Cosmas Health Center of Joseph Town, Budapest, Hungary
- Department of Rheumatology, Polyclinic of The Hospitaller Brothers of St John of God, Budapest, Hungary
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Fiat F, Merghes PE, Scurtu AD, Almajan Guta B, Dehelean CA, Varan N, Bernad E. The Main Changes in Pregnancy—Therapeutic Approach to Musculoskeletal Pain. Medicina (B Aires) 2022; 58:medicina58081115. [PMID: 36013582 PMCID: PMC9414568 DOI: 10.3390/medicina58081115] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/27/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background and Objectives: During pregnancy, women undergo various physiological and anatomical changes that are accentuated as the pregnancy progresses, but return to their previous state a few weeks/months after the pregnancy. However, a targeted therapeutic approach is needed. Most of the time, during this period, these changes precipitate the appearance of pain, musculoskeletal pain being the most common. Pregnant women should avoid treating musculoskeletal pain with medication and should choose alternative and complementary methods. Exercise along with rest is the basis for treating chronic musculoskeletal pain. Side effects of physical therapy are rare and, in addition, it is not contraindicated in pregnant women. The benefits of this type of treatment in combating pain far outweigh the risks, being an easy way to improve quality of life. The objective of this article is to discuss the management of musculoskeletal pain during pregnancy, to identify the main musculoskeletal pain encountered in pregnant women along with drug treatment, and to expose the beneficial effects of alternative and complementary methods in combating pain. Materials and Methods: A literature search was conducted using medical databases, including PubMed, Google Scholar, and ScienceDirect, using the keywords “changes of pregnancy”, “musculoskeletal pain”, “pregnancy pain”, “pain management”, “pharmacological approach”, “alternative and complementary treatment” and specific sites. Information was collected from studies whose target population included pregnant women who complained of musculoskeletal pain during the 9 months of pregnancy; pregnant women with other pathologies that could increase their pain were not included in this review. Results: The articles related to the most common non-obstetric musculoskeletal pain in pregnancy along with pharmacological treatment options and alternative and complementary methods for musculoskeletal pain management during pregnancy were selected. Conclusions: The results were used to guide information towards the safest methods of therapy but also to raise awareness of the treatment criteria in order to compare the effectiveness of existing methods. Treatment must consider the implications for the mother and fetus, optimizing non-pharmacological therapeutic options.
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Affiliation(s)
- Felicia Fiat
- Department of Obstetrics-Gynecology II, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Petru Eugen Merghes
- Department of Physical Education and Sport, Banat’s University of Agricultural Sciences and Veterinary Medicine “King Mihai I of Romania” from Timisoara, Calea Aradului 119, 300645 Timisoara, Romania
| | - Alexandra Denisa Scurtu
- Department of Toxicology and Drug Industry, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Research Centre for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Correspondence: (A.D.S.); (B.A.G.)
| | - Bogdan Almajan Guta
- Department of Physical Therapy and Special Motor Skills, Faculty of Physical Education and Sport, West University of Timisoara, Vasile Parvan Boulevard, No. 4, 300223 Timisoara, Romania
- Correspondence: (A.D.S.); (B.A.G.)
| | - Cristina Adriana Dehelean
- Department of Toxicology and Drug Industry, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Research Centre for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Narcis Varan
- Department of Physical Education and Sport, Banat’s University of Agricultural Sciences and Veterinary Medicine “King Mihai I of Romania” from Timisoara, Calea Aradului 119, 300645 Timisoara, Romania
| | - Elena Bernad
- Department of Obstetrics-Gynecology II, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
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Gianola S, Bargeri S, Cinquini M, Iannicelli V, Meroni R, Castellini G. More than one third of clinical practice guidelines on low back pain overlap in AGREE II appraisals. Research wasted? BMC Med Res Methodol 2022; 22:184. [PMID: 35790902 PMCID: PMC9254584 DOI: 10.1186/s12874-022-01621-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 04/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background Systematic reviews can apply the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool to critically appraise clinical practice guidelines (CPGs) for treating low back pain (LBP); however, when appraisals differ in CPG quality rating, stakeholders, clinicians, and policy-makers will find it difficult to discern a unique judgement of CPG quality. We wanted to determine the proportion of overlapping CPGs for LBP in appraisals that applied AGREE II. We also compared inter-rater reliability and variability across appraisals. Methods For this meta-epidemiological study we searched six databases for appraisals of CPGs for LBP. The general characteristics of the appraisals were collected; the unit of analysis was the CPG evaluated in each appraisal. The inter-rater reliability and the variability of AGREE II domain scores for overall assessment were measured using the intraclass correlation coefficient and descriptive statistics. Results Overall, 43 CPGs out of 106 (40.6%) overlapped in seventeen appraisals. Half of the appraisals (53%) reported a protocol registration. Reporting of AGREE II assessment was heterogeneous and generally of poor quality: overall assessment 1 (overall CPG quality) was rated in 11 appraisals (64.7%) and overall assessment 2 (recommendation for use) in four (23.5%). Inter-rater reliability was substantial/perfect in 78.3% of overlapping CPGs. The domains with most variability were Domain 6 (mean interquartile range [IQR] 38.6), Domain 5 (mean IQR 28.9), and Domain 2 (mean IQR 27.7). Conclusions More than one third of CPGs for LBP have been re-appraised in the last six years with CPGs quality confirmed in most assessments. Our findings suggest that before conducting a new appraisal, researchers should check systematic review registers for existing appraisals. Clinicians need to rely on updated CPGs of high quality and confirmed by perfect agreement in multiple appraisals. Trial Registration Protocol Registration OSF: https://osf.io/rz7nh/ Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01621-w.
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Infrared Thermography as a Non-Invasive Tool in Musculoskeletal Disease Rehabilitation—The Control Variables in Applicability—A Systematic Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In recent years, the usefulness of infrared thermography (IRT) as a valuable supplementary imaging method in medical diagnostics, as well as for assessing the effects of the treatment of musculoskeletal injuries, has been increasingly confirmed. At the same time, great importance is attached to the standards of thermographic research, the fulfillment of which determines the correct methodology and interpretation of the results. This article discusses the medical applications of infrared thermography in musculoskeletal system diseases, with particular emphasis on its usefulness in assessing the therapeutic effects of physical treatments used in rehabilitation. The literature from the last decade that is available in the Medline and Web of Science databases has been reviewed. Among the physiotherapeutic methods used, the following were selected that directly affect the musculoskeletal system: cryotherapy, laser therapy, electrotherapy, diathermy, and massage. The article summarizes all the guidelines and recommendations for IR imaging in medicine and rehabilitation.
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Shirado O, Arai Y, Iguchi T, Imagama S, Kawakami M, Nikaido T, Ogata T, Orita S, Sakai D, Sato K, Takahata M, Takeshita K, Tsuji T. Formulation of Japanese Orthopaedic Association (JOA) clinical practice guideline for the management of low back pain- the revised 2019 edition. J Orthop Sci 2022; 27:3-30. [PMID: 34836746 DOI: 10.1016/j.jos.2021.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/12/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The latest clinical guidelines are mandatory for physicians to follow when practicing evidence-based medicine in the treatment of low back pain. Those guidelines should target not only Japanese board-certified orthopaedic surgeons, but also primary physicians, and they should be prepared based entirely on evidence-based medicine. The Japanese Orthopaedic Association Low Back Pain guideline committee decided to update the guideline and launched the formulation committee. The purpose of this study was to describe the formulation we implemented for the revision of the guideline with the latest data of evidence-based medicine. METHODS The Japanese Orthopaedic Association Low Back Pain guideline formulation committee revised the previous guideline based on a method for preparing clinical guidelines in Japan proposed by Medical Information Network Distribution Service Handbook for Clinical Practice Guideline Development 2014. Two key phrases, "body of evidence" and "benefit and harm balance" were focused on in the revised version. Background and clinical questions were determined, followed by literature search related to each question. Appropriate articles were selected from all the searched literature. Structured abstracts were prepared, and then meta-analyses were performed. The strength of both the body of evidence and the recommendation was decided by the committee members. RESULTS Nine background and nine clinical qvuestions were determined. For each clinical question, outcomes from the literature were collected and meta-analysis was performed. Answers and explanations were described for each clinical question, and the strength of the recommendation was decided. For background questions, the recommendations were described based on previous literature. CONCLUSIONS The 2019 clinical practice guideline for the management of low back pain was completed according to the latest evidence-based medicine. We strongly hope that this guideline serves as a benchmark for all physicians, as well as patients, in the management of low back pain.
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Affiliation(s)
- Osamu Shirado
- Department of Orthopaedic and Spinal Surgery, Aizu Medical Center (AMEC) at Fukushima Medical University, Japan.
| | - Yoshiyasu Arai
- Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, Japan
| | - Tetsuhiro Iguchi
- Department of Orthopaedic Surgery, Saiseikai Hyogo Prefectural Hospital, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Japan
| | | | - Takuya Nikaido
- Department of Orthopaedic Surgery, Fukushima Medical University, Japan
| | | | - Sumihisa Orita
- Center for Frontier Medical Engineering (CFME), Department of Orthopaedic Surgery, Chiba University, Japan
| | - Daisuke Sakai
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Japan
| | - Kimiaki Sato
- Department of Orthopaedic Surgery, Kurume University, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | | | - Takashi Tsuji
- Department of Orthopaedic Surgery, National Hospital Organization Tokyo Medical Center, Japan
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Wu Q, Zhao J, Guo W. Efficacy of massage therapy in improving outcomes in knee osteoarthritis: A systematic review and meta-analysis. Complement Ther Clin Pract 2021; 46:101522. [PMID: 34890892 DOI: 10.1016/j.ctcp.2021.101522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 08/14/2021] [Accepted: 11/30/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND and purpose: Massage therapy is being used for knee osteoarthritis. However, level-1 evidence is lacking. This systematic review and meta-analysis aimed to synthesize evidence on the effect of massage therapy on knee osteoarthritis. METHODS PubMed, Embase, Ovid, Springer, and Google Scholar databases were searched up to May 8, 2021 for randomized controlled trials comparing massage with controls for knee osteoarthritis. Review manager was used for a random-effect meta-analysis. Risk of bias was assessed using the Cochrane collaboration risk assessment tool and certainty of evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS Twelve studies with 737 participants were included. After 1-4 weeks of therapy, there was a significant reduction in pain and stiffness scores in the massage group and after 6-8 weeks of therapy, there was a significant reduction in stiffness and functionality scores. There was no significant difference in outcomes with long-term therapy. A statistically significant reduction in stiffness scores was seen with aromatherapy massage. Aromatherapy massage was not superior to standard massage. The overall quality of evidence according to GRADE was low to moderate for standard massage therapy and very low for aromatherapy. CONCLUSION Massage therapy may lead to some improvement in pain, stiffness, and functionality scores in the short term but not in long term. Aromatherapy massage was not found to be any better than standard massage therapy. Current evidence is limited by methodological heterogeneity amongst trials and small sample size of the studies.
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Affiliation(s)
- Qiling Wu
- Department of Nursing, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Jie Zhao
- Department of Nursing, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Weili Guo
- Department of Nursing, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing, China.
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Maghalian M, Mirghafourvand M, Ghaderi F, Abbasalizadeh S, Pak S, Kamalifard M. Comparison the effect of Swedish massage and interferential electrical stimulation on labor pain and childbirth experience in primiparous women: a randomized controlled clinical trial. Arch Gynecol Obstet 2021; 306:37-47. [PMID: 34716820 DOI: 10.1007/s00404-021-06220-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Since mothers are more inclined toward non-pharmacological labor pain management methods, this study aimed to compare the effect of interferential electrical stimulation (IES) and Swedish massage (SM) on labor pain and childbirth experience (primary outcomes) and childbirth satisfaction, duration of active phase and side effects (secondary outcomes) in primiparous women. METHODS This randomized controlled trial was performed on 90 primiparous women. Participants were randomly assigned into three groups through the block randomization method. The SM group received two massage techniques of effleurage and petrissage, on T10-L1 and S2-S4 at cervical dilatation of 4 and 8-10 cm. The IES group received electrical stimulation in a similar way to SM group, with a base frequency of 4000 Hz and a pulse frequency of 80-120 Hz by a physiotherapist. Control group received only routine care. RESULTS The mean pain was significantly lower in the SM group (adjusted mean difference (AMD) - 0.86; 95% confidence interval (95% CI) - 1.60 to - 0.11) and the IES group (AMD - 0.95; 95% CI - 1.70 to - 0.21) compared to the control group. The mean score of childbirth experience was significantly higher in the SM (MD 5.63; 95% CI 2.15-9.11) and IES (MD 3.66; 95% CI 0.18-7.14) group compared to the control group. The mean childbirth satisfaction in the SM (p = 0.003) and IES (p = 0.046) groups was significantly higher than the control group; and duration of the active phase of labor was significantly lower (p < 0.001) than the control group. No serious side effects were occurred in none of the groups. CONCLUSION SM and IES are safe methods that can significantly reduce pain and duration of active phase and improve the experience and satisfaction of childbirth.
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Affiliation(s)
- Mahsa Maghalian
- Student Research Committee, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Centre, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Ghaderi
- Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shamsi Abbasalizadeh
- Department of Obstetrics and Gynecology, Women's Reproductive Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahar Pak
- Student Research Committee, Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahin Kamalifard
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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12
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William J Nahm, Waite K, Recidoro T, Lowell L, Harris ZC, Mendoza N, Vega C, Harris E, Hizon G. Treatment of chronic musculoskeletal pain with electron modulation procedure. Pain Manag 2021; 11:369-378. [PMID: 33593098 DOI: 10.2217/pmt-2020-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To assess the efficacy of the electron modulation procedure (EMP) in reducing chronic musculoskeletal pain acutely over distinct anatomical areas. Materials & methods: We performed a retrospective analysis of 223 patients who received a single EMP treatment for various chronic musculoskeletal pain issues. Pain levels, recorded before and after receiving EMP, were analyzed at distinct anatomical musculoskeletal areas. Results & conclusion: The effect of the EMP treatments in reducing musculoskeletal pain was statistically significant at the 5% level. Those with hip/gluteal and ankle pain had the highest (92%) and lowest (58%) pain elimination rate, respectively. Statistical evidence supported the idea that EMP treatment can quickly reduce musculoskeletal pain. Distinct anatomical musculoskeletal areas responded differently to EMP treatment.
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Affiliation(s)
- William J Nahm
- New York University Grossman School of Medicine; New York, NY 10016, USA.,Department of Family Medicine, University of California Riverside School of Medicine, Riverside, CA 92507, USA
| | - Kelsey Waite
- Texas Christian University, Fort Worth, TX 76129, USA
| | - Therese Recidoro
- Department of Family Medicine, University of California Riverside School of Medicine, Riverside, CA 92507, USA.,University of California Santa Cruz, Santa Cruz, CA 95064, USA
| | - Luke Lowell
- Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | | | | | - Carlos Vega
- University Clinical Trials, San Diego, CA 92123, USA
| | - Elan Harris
- Department of Diagnostic Radiology, City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Gerardo Hizon
- Department of Family Medicine, University of California Riverside School of Medicine, Riverside, CA 92507, USA
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13
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Bellido-Fernández L, Jiménez-Rejano JJ, Chillón-Martínez R, Lorenzo-Muñoz A, Pinero-Pinto E, Rebollo-Salas M. Clinical relevance of massage therapy and abdominal hypopressive gymnastics on chronic nonspecific low back pain: a randomized controlled trial. Disabil Rehabil 2021; 44:4233-4240. [PMID: 33587856 DOI: 10.1080/09638288.2021.1884903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To determine the clinical relevance of the effects that Massage-Therapy (MT) and Abdominal-Hypopressive-Gymnastics (AHG) and the combination of both procedures have on the disability, pain intensity, quality of life, and lumbar mobility of patients with chronic nonspecific low back pain (CNSLBP). METHODS A randomized controlled-trial with parallel-groups, concealed allocation, assessor blinding, and intention-to-treat analysis was carried out. The sample included 60 adults with CNSLBP. The participants received MT (n = 20), AHG (n = 20), or MT + AHG (n = 20). Each group received 8 interventions. RESULTS The ODI change scores were significantly higher (p < 0.05) in the MT + AHG group than in the other two groups. Significant differences were found in the results of NRS, Schober's test, and SF-12 PCS (p < 0.05) in each group. There were significant differences (p < 0.05) between the values of SF-12 MCS in AHG and MT + AHG groups. CONCLUSIONS Massage Therapy and Abdominal Hypopressive Gymnastics reduce pain levels, increase the mobility of the lumbar spine, and improve disability and quality of life (PCS) in patients with CNSLBP in the short term. Likewise, AHG and MT + AHG improve quality of life (MCS). The combination of both therapies provides more benefits in terms of lumbar disability in patients with CNSLBP in the short term. This improvement is clinically relevant. TRIAL REGISTRATION ClinicalTrials.gov (NCT02721914). IMPLICATIONS FOR REHABILITATIONMassage Therapy (MT) and Abdominal Hypopressive Gymnastics (AHG), reduce pain, improve mobility and quality of life, and reduce disability in the short term.These results are clinically relevant.The combination of manual and active therapy (MT + AHG) seems to be more effective and produces clinically relevant changes.
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14
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Ng JY, Mohiuddin U, Azizudin AM. Clinical practice guidelines for the treatment and management of low back pain: A systematic review of quantity and quality. Musculoskelet Sci Pract 2021; 51:102295. [PMID: 33444892 DOI: 10.1016/j.msksp.2020.102295] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Low back pain (LBP) is highly prevalent in the general population and is responsible for increased health-care costs, pain, impairment of activity, and if chronic, is associated with a range of comorbidities. OBJECTIVES The purpose of this review was to identify the quantity and assess the quality of evidence-based clinical practice guidelines (CPGs) for the treatment and/or management of LBP in adults. METHODS MEDLINE, EMBASE, CINAHL, and the Guidelines International Network were systematically searched from 2008 to 2018 to identify LBP CPGs. Eligible CPGs were assessed in duplicate using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument across 6 domains: scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence. RESULTS Of 181 unique search results, 22 CPGs for the treatment and/or management of LBP were eligible. Scaled domain percentages from highest to lowest were: scope and purpose (90.0%), clarity of presentation (84.0%), stakeholder involvement (54.0%), rigour of development (51.2%), editorial independence (39.6%) and applicability (28.5%). Quality varied within and across CPGs. CONCLUSIONS CPGs varied in quality, with most scoring the highest in the scope and purpose and clarity of presentation domains. CPGs achieved variable and lower scores in the stakeholder involvement, rigour of development, applicability, and editorial independence domains. CPGs with higher AGREE II scores can serve as suitable evidence-based resources for clinicians involved in LBP care; CPGs with lower scores could be improved in future updates using the AGREE II instrument, among other guideline development resources, as a guide.
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Affiliation(s)
- Jeremy Y Ng
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| | - Uzair Mohiuddin
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| | - Ashlee M Azizudin
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
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15
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Rathbone T, Truong C, Haldenby H, Riazi S, Kendall M, Cimek T, Macedo LG. Sex and gender considerations in low back pain clinical practice guidelines: a scoping review. BMJ Open Sport Exerc Med 2020; 6:e000972. [PMID: 33437498 PMCID: PMC7780542 DOI: 10.1136/bmjsem-2020-000972] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 12/26/2022] Open
Abstract
Objective The purpose of this scoping review is to determine if and how sex and gender have been incorporated into low back pain (LBP) clinical practice guidelines (CPG), and if sex and gender terms have been used properly. Methods CPGs were searched on MEDLINE, Embase, NICE, TRIP and PEDro from 2010 to 2020. The inclusion criteria were English language, CGPs within physiotherapy scope of practice and for adult population with LBP of any type or duration. Three pairs of independent reviewers screened titles, abstracts and full texts. Guidelines were searched for sex/gender-related terms and recommendations were extracted. The AGREE II (Appraisal of Guidelines for Research and Evaluation II) was used to evaluate the quality of the CPGs. Results Thirty-six CPGs were included, of which 15 were test-positive for sex or gender terms. Only 33% (n=5) of CPGs incorporated sex or gender into diagnostic or management recommendations. Sixty percent of guidelines (n=9) only referenced sex or gender in relation to epidemiology, risk factors or prognostic data, and made no specific recommendations. Overall, there was no observable relationship between guideline quality and likeliness of integrating sex or gender terms. The majority of guidelines used sex and gender terms interchangeably, and no guidelines defined sex or gender. Conclusion CPGs did not consistently consider sex and gender differences in assessment, diagnosis or treatment of LBP. When it was considered, sex and gender terms were used interchangeably, and considerations were primarily regarding pregnancy. Researchers should consider the importance of including sex-based and/or gender-based recommendations into future LBP CPGs.
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Affiliation(s)
- Tori Rathbone
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Catherine Truong
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Haley Haldenby
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Sara Riazi
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Mara Kendall
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Tayler Cimek
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Luciana G Macedo
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Withdrawn: Influence of instrument assisted soft tissue techniques versus active soft tissue therapies on latent trigger point of upper trapezius muscle: Randomized clinical study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 28:e1859. [PMID: 32808409 DOI: 10.1002/pri.1859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/28/2020] [Accepted: 05/23/2020] [Indexed: 11/11/2022]
Abstract
Withdrawal: Noha Elserty & Dina Othman Shokri Morsi Galal, Influence of instrument assisted soft tissue techniques versus active soft tissue therapies on latent trigger point of upper trapezius muscle: Randomized clinical study, 2020, e1859 (https://onlinelibrary.wiley.com/doi/10.1002/pri.1859). The above article, published online on 18 August 2020 in Wiley Online Library (wileyonlinelibrary.com), has been withdrawn by agreement between the authors, the journal Editor in Chief Dr. Geert Verheyden, and John Wiley & Sons Ltd. The withdrawal has been agreed due to inappropriate and unlicensed use of a registered trademark technique and tool. This article was first retracted on 22 January 2021 but has now been withdrawn to protect the trademark.
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17
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Ng JY, Mohiuddin U. Quality of complementary and alternative medicine recommendations in low back pain guidelines: a systematic review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:1833-1844. [DOI: 10.1007/s00586-020-06393-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/23/2020] [Accepted: 03/22/2020] [Indexed: 11/24/2022]
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19
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Effects of Massage and Acupressure on Relieving Labor Pain, Reducing Labor Time, and Increasing Delivery Satisfaction. J Nurs Res 2019; 28:e68. [DOI: 10.1097/jnr.0000000000000344] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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Herman PM, Hurwitz EL, Shekelle PG, Whitley MD, Coulter ID. Clinical Scenarios for Which Spinal Mobilization and Manipulation Are Considered by an Expert Panel to be Inappropriate (and Appropriate) for Patients With Chronic Low Back Pain. Med Care 2019; 57:391-398. [PMID: 30870390 PMCID: PMC6459705 DOI: 10.1097/mlr.0000000000001108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Spinal mobilization and manipulation are 2 therapies found to be generally safe and effective for chronic low back pain (CLBP). However, the question remains whether they are appropriate for all CLBP patients. RESEARCH DESIGN An expert panel used a well-validated approach, including an evidence synthesis and clinical acumen, to develop and then rate the appropriateness of the use of spinal mobilization and manipulation across an exhaustive list of clinical scenarios which could present for CLBP. Decision tree analysis (DTA) was used to identify the key patient characteristics that affected the ratings. RESULTS Nine hundred clinical scenarios were defined and then rated by a 9-member expert panel as to the appropriateness of spinal mobilization and manipulation. Across clinical scenarios more were rated appropriate than inappropriate. However, the number patients presenting with each scenario is not yet known. Nevertheless, DTA indicates that all clinical scenarios that included major neurological findings, and some others involving imaging findings of central herniated nucleus pulposus, spinal stenosis, or free fragments, were rated as inappropriate for both spinal mobilization and manipulation. DTA also identified the absence of these imaging findings and no previous laminectomy as the most important patient characteristics in predicting ratings of appropriate. CONCLUSIONS A well-validated expert panel-based approach was used to develop and then rate the appropriateness of the use of spinal mobilization and manipulation across the clinical scenarios which could present for CLBP. Information on the clinical scenarios for which these therapies are inappropriate should be added to clinical guidelines for CLBP.
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Affiliation(s)
- Patricia M Herman
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90403
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawaii, 1960 East-West Road, Honolulu, HI 96822; Ph: 808-956-7425; Fax: 808-956-3368;
| | - Paul G Shekelle
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90403; Ph: 310-393-0411 ×6669; Fax: 310-260-8161;
| | - Margaret D Whitley
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90403; Ph: 310-393-0411 ×7225; Fax: 310-260-8161;
| | - Ian D Coulter
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90403; Ph: 310-393-0411 ×7455; Fax: 310-260-8161;
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21
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Eaves ER, Hsu CW, DeBar LL, Livingston CJ, Ocker LE, McDonald SJ, Dillon-Sumner L, Ritenbaugh C. Whole Systems Within Whole Systems: The Oregon Health Plan's Expansion of Services for Back and Neck Pain. J Altern Complement Med 2019; 25:S61-S68. [PMID: 30870022 DOI: 10.1089/acm.2018.0431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The authors employ a Whole Systems framework to explore implementation of new guidelines for back and neck pain in Oregon's Medicaid system. Whole Systems research is useful for understanding the relationship between complementary and integrative health care (CIH) and conventional health care systems in real-world clinical and practice settings. DESIGN Preliminary results are from an observational study designed to evaluate state-wide implementation of CIH and other non-pharmacological treatments for neck and back pain among Oregon Medicaid patients. This natural experiment, even in early stages, provides insight into the challenges of integrating Whole Systems oriented therapies into Medicaid billing and treatment. METHODS Qualitative data are drawn from: (1) semi-structured interviews with representatives of each of the 16 coordinated care organizations (CCOs) responsible for administering the Oregon's Medicaid insurance through the Oregon Health Plan (OHP); and (2) open-ended survey responses from acupuncturists in all 16 CCO areas. RESULTS Implementation of the new policy guidelines poses logistical and epistemological challenges. Differences in worldview, inadequate reimbursement, and simple lack of awareness of CIH among medical providers are some of the factors that pose barriers to merging CIH therapies into conventional frameworks. CONCLUSIONS In this article, we explore the potential for a Whole Systems perspective to better explain the complexity of integrating CIH and other non-pharmacological services into a state financed health care system. Oregon's expansion of services for back and neck pain presents an opportunity to explore challenges and successes in melding multiple approaches to health and pain management into a managed system such as the OHP.
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Affiliation(s)
- Emery R Eaves
- 1 Department of Anthropology, Northern Arizona University, Flagstaff, AZ
| | - Clarissa W Hsu
- 2 Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Lynn L DeBar
- 2 Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | | | | | - Sarah J McDonald
- 2 Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | | | - Cheryl Ritenbaugh
- 5 Department of Family and Community Medicine, University of Arizona, Tucson, AZ
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Miake-Lye IM, Mak S, Lee J, Luger T, Taylor SL, Shanman R, Beroes-Severin JM, Shekelle PG. Massage for Pain: An Evidence Map. J Altern Complement Med 2019; 25:475-502. [PMID: 30892910 PMCID: PMC6533778 DOI: 10.1089/acm.2018.0282] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives: Massage therapy has been proposed for painful conditions, but it can be difficult to understand the breadth and depth of evidence, as various painful conditions may respond differently to massage. The authors conducted an evidence mapping process and generated an "evidence map" to visually depict the distribution of evidence available for massage and various pain indications to identify gaps in evidence and to inform future research priorities. Design: The authors searched PubMed, Embase, and Cochrane for systematic reviews reporting pain outcomes for massage therapy. The authors assessed the quality of each review using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) criteria. The authors used a bubble plot to depict the number of included articles, pain indication, effect of massage for pain, and strength of findings for each included systematic review. Results: The authors identified 49 systematic reviews, of which 32 were considered high quality. Types of pain frequently included in systematic reviews were cancer pain, low back pain, and neck pain. High quality reviews concluded that there was low strength of evidence of potential benefits of massage for labor, shoulder, neck, low back, cancer, arthritis, postoperative, delayed onset muscle soreness, and musculoskeletal pain. Reported attributes of massage interventions include style of massage, provider, co-interventions, duration, and comparators, with 14 high-quality reviews reporting all these attributes in their review. Conclusion: Prior reviews have conclusions of low strength of evidence because few primary studies of large samples with rigorous methods had been conducted, leaving evidence gaps about specific massage type for specific pain. Primary studies often do not provide adequate details of massage therapy provided, limiting the extent to which reviews are able to draw conclusions about characteristics such as provider type.
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Affiliation(s)
- Isomi M Miake-Lye
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Selene Mak
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | | | - Tana Luger
- 2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Stephanie L Taylor
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Roberta Shanman
- 4 Southern California Evidence-Based Practice Center, RAND Corporation, Santa Monica, CA
| | | | - Paul G Shekelle
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA
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Joseph LH, Hancharoenkul B, Sitilertpisan P, Pirunsan U, Paungmali A. Effects of Massage as a Combination Therapy with Lumbopelvic Stability Exercises as Compared to Standard Massage Therapy in Low Back Pain: a Randomized Cross-Over Study. Int J Ther Massage Bodywork 2018; 11:16-22. [PMID: 30524633 PMCID: PMC6279433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Little is known about the effects of providing massage as a combination therapy (CT) with lumbopelvic stability training (LPST) in management of chronic nonspecific low back pain (CLBP) among elite female weight lifters. It is unclear whether massage therapy (MT) together with LPST has any additional clinical benefits for individuals with CLBP. PURPOSE The current study compares the therapeutic effects of CT against MT as a stand-alone intervention on pain intensity (PI), pain pressure threshold (PPT), tissue blood flow (TBF), and lumbopelvic stability (LPS) among elite weight lifters with CLBP. SETTING The study was conducted at the campus for National Olympic weight lifting training camp. PARTICIPANTS A total of 16 professional female elite weight lifting athletes who were training for Olympic weight lifting competition participated in the study. RESEARCH DESIGN A within-subject, repeated measures, crossover, single-blinded, randomized allocation study. INTERVENTION The athletes were randomized into three sessions of CT and MT with a time interval of 24 hrs within sessions and a wash out period of four weeks between the sessions. MAIN OUTCOME MEASURES The PI, PPT, TBF, and LPS were measured before and after each session repeatedly in both groups of intervention. The changes in the PI, PPT, TBF, and LPS were analyzed using repeated measures analysis of variance (ANOVA). RESULTS The results showed that the CT significantly demonstrated greater effects in reducing pain perception (45%-51%), improving pain pressure threshold (15% up to 25%), and increasing tissue blood flow (131%-152%) than MT (p < .001). CONCLUSION The combination therapy of massage therapy and LPST is likely to provide more clinical benefits in terms of PI, PPT, and TBF when compared to massage as a stand-alone therapy among individuals with chronic nonspecific low back pain.
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Affiliation(s)
- Leonard H. Joseph
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
- School of Health Science, University of Brighton, Eastbourne, East Sussex, UK
| | | | - Patraporn Sitilertpisan
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Ubon Pirunsan
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Aatit Paungmali
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
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Zolfaghari M, Mirhosseini SJ, Baghbeheshti M, Afshani A, Moazzam S, Golabchi A. Effect of physiotherapy on quality of life after coronary artery bypass graft surgery: A randomized study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:56. [PMID: 30057640 PMCID: PMC6040150 DOI: 10.4103/jrms.jrms_96_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 08/26/2017] [Accepted: 03/22/2018] [Indexed: 11/18/2022]
Abstract
Background: This study aims to assess the impact that physiotherapy (PT) has on the quality of life (QoL) of patients who have undergone coronary artery bypass grafting (CABG) surgery. The objective of this study was to assess the effect of PT on physical and mental aspects of patients’ QoL. Materials and Methods: The study population consisted of 50 patients who aged between 60 and 70 years and who had previously undergone CABG surgery. The patients were randomly allocated to two groups: a PT group (n = 25) and a control group (n = 25). The physical characteristics of the participants were recorded at the outset of the study. The patients who were allocated to the PT group completed 16 sessions of classic PT. QoL assessments of all participants were performed before and after the program in the form of a short form-36 health survey. An independent sample t-test and an ANCOVA were performed for the purpose of statistical analyses. Results: The QoL scores of the patients (mean age = 62.08 years) who underwent PT significantly improved after the intervention (P < 0.001). A significant difference between groups was observed (P < 0.001) in both the mental component summary and physical component summary variables. Conclusion: PT can help relieve pain, reduce depression, help patients more effectively perform the tasks of everyday living, and help ease the symptoms of other disabilities associated with cardiac surgery. In the current study, the implementation of a PT program improved the patient's mental health and increased their QoL.
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Affiliation(s)
- Mohammad Zolfaghari
- Student Research Committee, Faculty of Medicine, Shahid Sadoughi University of Medical Science, Yazd, Iran
| | | | - Maryam Baghbeheshti
- Student Research Committee, Faculty of Medicine, Shahid Sadoughi University of Medical Science, Yazd, Iran
| | | | - Shadrooz Moazzam
- Student Research Committee, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Allahyar Golabchi
- Department of Cardiology, Cardiac Electrophysiology Center, Kashan University of Medical Sciences, Kashan, Iran
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Prevalence, patterns, and predictors of massage practitioner utilization: Results of a US nationally representative survey. Musculoskelet Sci Pract 2017; 32:31-37. [PMID: 28802839 DOI: 10.1016/j.msksp.2017.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/05/2017] [Accepted: 07/12/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND The use of massage therapy is common, especially in patients with musculoskeletal pain. The purpose of this study was to examine the prevalence, utilization, socio-demographic and health-related predictors of massage practitioner consultations in the US population. METHODS Cross-sectional data from the 2012 National Health Interview Survey for adults (n = 34,525). RESULTS Prevalence of massage practitioner utilization were 12.8% (lifetime) and 6.8% (last 12 months). Compared to non-users, those who used massage in the last year were more likely: female, at least high school educated, annual income ≥ US$ 15,000, diagnosed with spinal pain or arthritis, report moderate physical activity level as compared to low level, and consume alcohol as compared to being abstinent. Massage was mainly used for general wellness or disease prevention (56.3%), but also for specific, typically musculoskeletal, health problems (41.9%) for which 85.2% reported massage helped to some or a great deal. Most (59.1%) did not disclose massage use to their health care provider, despite 69.4% reporting massage therapy combined with medical treatment would be helpful. CONCLUSIONS Approximately 7% (15.4 million) of US adults used massage therapy in the past year, mainly for general disease prevention, wellness or musculoskeletal pain. The majority of respondents reported positive outcomes of massage on specific health problems and overall well-being. Massage utilization was rarely covered by health insurance. Despite the majority of massage users considered massage therapy combined with medical care helpful, most did not disclose massage therapy use to their health care provider.
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Tüzün EH, Gıldır S, Angın E, Tecer BH, Dana KÖ, Malkoç M. Effectiveness of dry needling versus a classical physiotherapy program in patients with chronic low-back pain: a single-blind, randomized, controlled trial. J Phys Ther Sci 2017; 29:1502-1509. [PMID: 28931976 PMCID: PMC5599809 DOI: 10.1589/jpts.29.1502] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/02/2017] [Indexed: 02/07/2023] Open
Abstract
[Purpose] We compared the effectiveness of dry needling with a classical physiotherapy
program in patients with chronic low-back pain caused by lumbar disc hernia (LHNP).
[Subjects and Methods] In total, 34 subjects were allocated randomly to the study (n=18)
and control groups (n=16). In the study group, dry needling was applied using acupuncture
needles. The control group performed a home exercise program in addition to hot pack,
TENS, and ultrasound applications. Pain was assessed with the short form of the McGill
Pain Questionnaire. The number of trigger points and their pressure sensitivity were
evaluated with a physical examination (palpation). The Beck Depression Inventory was used
to assess depression. The Tampa Kinesiophobia Scale was used to assess fear of movement.
[Results] In the study group, the calculated Cohen’s effect sizes were bigger than those
in the control group in terms of pain, trigger point-related variables, and fear of
movement. Effect sizes for reducing depressive symptoms were similar in both groups.
[Conclusion] These results suggest that dry needling can be an effective treatment for
reducing pain, number of trigger points, sensitivity, and kinesiophobia in patients with
chronic low-back pain caused by lumbar disc hernia.
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Affiliation(s)
- Emİne Handan Tüzün
- Physiotherapy and Rehabilitation, Health Sciences Faculty, Eastern Mediterranean University: Famagusta, Northern Cyprus
| | - Sıla Gıldır
- Physiotherapy and Rehabilitation, Health Sciences Faculty, Eastern Mediterranean University: Famagusta, Northern Cyprus
| | - Ender Angın
- Physiotherapy and Rehabilitation, Health Sciences Faculty, Eastern Mediterranean University: Famagusta, Northern Cyprus
| | - Büşra Hande Tecer
- Physiotherapy and Rehabilitation, Health Sciences Faculty, Eastern Mediterranean University: Famagusta, Northern Cyprus
| | - Kezban Öztürk Dana
- Physiotherapy and Rehabilitation Department, Famagusta State Hospital, Northern Cyprus
| | - Mehtap Malkoç
- Physiotherapy and Rehabilitation, Health Sciences Faculty, Eastern Mediterranean University: Famagusta, Northern Cyprus
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Comparison of Deep Tissue Massage and Therapeutic Massage for Lower Back Pain, Disease Activity, and Functional Capacity of Ankylosing Spondylitis Patients: A Randomized Clinical Pilot Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:9894128. [PMID: 28845185 PMCID: PMC5563410 DOI: 10.1155/2017/9894128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/14/2017] [Accepted: 07/02/2017] [Indexed: 01/12/2023]
Abstract
Objectives This study aims to compare the effectiveness of deep tissue massage (DTM) and therapeutic massage (TM) in the management of ankylosing spondylitis (AS) patients. Materials and Methods This was a small, randomized clinical pilot study. Subjects were 27 men with diagnosed AS, randomly assigned to DTM group or TM group. Subjects in each group had 10 sessions of massage. Outcomes included the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Modified Schober Test, Finger to Floor Test, chest expansion, and pain intensity of lower back. Results There are no statistical significant differences between groups, except for BASDAI and pain intensity of lower back. Conclusions This study suggests that massage may have clinical benefits for treating ankylosing spondylitis patients. Additional scientific research in this area is warranted.
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Babatunde OO, Jordan JL, Van der Windt DA, Hill JC, Foster NE, Protheroe J. Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PLoS One 2017; 12:e0178621. [PMID: 28640822 PMCID: PMC5480856 DOI: 10.1371/journal.pone.0178621] [Citation(s) in RCA: 200] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 05/16/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND & AIMS Musculoskeletal pain, the most common cause of disability globally, is most frequently managed in primary care. People with musculoskeletal pain in different body regions share similar characteristics, prognosis, and may respond to similar treatments. This overview aims to summarise current best evidence on currently available treatment options for the five most common musculoskeletal pain presentations (back, neck, shoulder, knee and multi-site pain) in primary care. METHODS A systematic search was conducted. Initial searches identified clinical guidelines, clinical pathways and systematic reviews. Additional searches found recently published trials and those addressing gaps in the evidence base. Data on study populations, interventions, and outcomes of intervention on pain and function were extracted. Quality of systematic reviews was assessed using AMSTAR, and strength of evidence rated using a modified GRADE approach. RESULTS Moderate to strong evidence suggests that exercise therapy and psychosocial interventions are effective for relieving pain and improving function for musculoskeletal pain. NSAIDs and opioids reduce pain in the short-term, but the effect size is modest and the potential for adverse effects need careful consideration. Corticosteroid injections were found to be beneficial for short-term pain relief among patients with knee and shoulder pain. However, current evidence remains equivocal on optimal dose, intensity and frequency, or mode of application for most treatment options. CONCLUSION This review presents a comprehensive summary and critical assessment of current evidence for the treatment of pain presentations in primary care. The evidence synthesis of interventions for common musculoskeletal pain presentations shows moderate-strong evidence for exercise therapy and psychosocial interventions, with short-term benefits only from pharmacological treatments. Future research into optimal dose and application of the most promising treatments is needed.
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Affiliation(s)
- Opeyemi O. Babatunde
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, United Kingdom
| | - Joanne L. Jordan
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, United Kingdom
| | - Danielle A. Van der Windt
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, United Kingdom
| | - Jonathan C. Hill
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, United Kingdom
| | - Nadine E. Foster
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, United Kingdom
| | - Joanne Protheroe
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, United Kingdom
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Cavallo S, Brosseau L, Toupin-April K, Wells GA, Smith CA, Pugh AG, Stinson J, Thomas R, Ahmed S, Duffy CM, Rahman P, Àlvarez-Gallardo IC, Loew L, De Angelis G, Feldman DE, Majnemer A, Gagnon IJ, Maltais D, Mathieu MÈ, Kenny GP, Tupper S, Whitney-Mahoney K, Bigford S. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Structured Physical Activity in the Management of Juvenile Idiopathic Arthritis. Arch Phys Med Rehabil 2017; 98:1018-1041. [DOI: 10.1016/j.apmr.2016.09.135] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 08/15/2016] [Accepted: 09/27/2016] [Indexed: 12/31/2022]
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30
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Zangrando F, Piccinini G, Tagliolini C, Marsilli G, Iosa M, Vulpiani MC, Paolucci T. The efficacy of a preparatory phase of a touch-based approach in treating chronic low back pain: a randomized controlled trial. J Pain Res 2017; 10:941-949. [PMID: 28461765 PMCID: PMC5404807 DOI: 10.2147/jpr.s129313] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Massage therapy is an important element of rehabilitation in the treatment of chronic low back pain (CLBP). The objective of this study was to determine the relative efficacy of massage therapy between traditional massage and a new massage approach for CLBP. We also examined whether any reduction in pain was linked to interoceptive awareness and parasympathetic activation. Methods A single-blind, randomized, controlled trial of 51 patients who were allocated into a traditional massage therapy group (TMG; N=24, mean age: 50.54±9.13 years) or experimental massage therapy group (SMG; N=27, mean age: 50.77±6.80 years). The primary outcome was the reduction in pain per the visual analog scale (VAS); the secondary outcome measures were multidimensional pain intensity on the McGill Pain Questionnaire, pain-related disability per the Waddel Disability Index, interoceptive awareness per the Multidimensional Assessment of Interoceptive Awareness Questionnaire, quality of life per the Short Form - 12 Health Survey, and heart rate variability, expressed as the coherence ratio (CR) by photoplethysmography. The following outcome measures were assessed at baseline, at the end of the treatment program, and at the 3-month follow-up. The mean and standard deviation were calculated for continuous data. Mann–Whitney U test was used to perform between-group comparisons, Friedman’s analysis was used for data on the 3 assessment times in each group, and Spearman’s R coefficient was used to analyze correlations. Results Both approaches had a positive result on pain, an effect that was more acute in the SMG versus TMG for all pain scales, with better maintenance at the 3-month follow-up (VAS p=0.005 and p=0.098; Waddell Index p=0.034 and 0.044; McGill total p=0.000 and 0.003). In the SMG, CR scores were significant at baseline and at the end of the treatment program (p=0.000 and 0.002). Conclusion The new massage approach with a preparatory phase that is pleasant to the touch was more effective than the traditional approach for CLBP.
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Affiliation(s)
- Federico Zangrando
- Complex Unit of Physical Medicine and Rehabilitation, Policlinico Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Giulia Piccinini
- Unit of Physical Medicine and Rehabilitation, Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Clara Tagliolini
- Complex Unit of Physical Medicine and Rehabilitation, Policlinico Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Gabriella Marsilli
- Unit of Physical Medicine and Rehabilitation, Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Marco Iosa
- Clinical Laboratory of Experimental Neurorehabilitation, Santa Lucia Foundation, Rome, Italy
| | - Maria Chiara Vulpiani
- Unit of Physical Medicine and Rehabilitation, Sant'Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Teresa Paolucci
- Complex Unit of Physical Medicine and Rehabilitation, Policlinico Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy
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Meryanos CJ. Utilizing Chair Massage to Address One Woman's Health in Rural Ghana West Africa: a Case Report. Int J Ther Massage Bodywork 2016; 9:22-29. [PMID: 27974948 PMCID: PMC5142710 DOI: 10.3822/ijtmb.v9i4.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives There is limited access to health care in rural Ghana and virtually no rehabilitative services available. This situation presents a unique opportunity to utilize chair massage in addressing women’s health in rural Ghana, particularly when it comes to muscle pain and fatigue from heavy labor. The objective of this case report is to determine the results of chair massage as a strategy to reduce neck, shoulder, and back pain, while increasing range of motion. Case Presentation The patient is a 63-year-old Ghanaian female, who was struck by a public transport van while carrying a 30–50 pound load on her head, two years prior. The accident resulted in a broken right humerus and soft tissue pain. A traditional medicine practitioner set the bone, however there was no post-accident rehabilitation available. At the time of referral, she presented complaints of shoulder, elbow, and wrist pain. In addition, she was unable to raise her right hand to her mouth for food intake. Results The results of this case report include an increase in range of motion, as well as elimination of pain in the right shoulder, elbow, and hand. Visual assessments showed an approximate increase of ROM within the ranges of 45–65 degrees in the right arm, as well as 10–15 degrees in 4th and 5th fingers. There was also a decrease in muscle hypertonicity in the thoracic and cervical areas, and a profound increase in quality of life for the patient. Discussion This case report illustrates how therapeutic chair massage was utilized to address a common health concern for one woman in rural Ghana. It also demonstrates that pre-existing musculoskeletal disorders and pain may be eliminated with massage intervention. Massage therapy may be important to ameliorating certain types of health problems in remote rural villages in low income countries.
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Frawley J, Peng W, Sibbritt D, Ward L, Lauche R, Zhang Y, Adams J. Is there an association between women's consultations with a massage therapist and health-related quality of life? Analyses of 1800 women aged 56-61 years. J Bodyw Mov Ther 2016; 20:734-739. [PMID: 27814852 DOI: 10.1016/j.jbmt.2016.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 03/19/2016] [Accepted: 03/25/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) is commonplace in Australia with massage being a popular CAM modality. METHODS This is a sub-study from the Australian Longitudinal Study on Women's Health (ALSWH). A total of 2120 mid-age (56-61 year old) women who consulted a CAM practitioner were invited to participate in this study. The Short-Form (SF-36) questionnaire was used to measure women's health-related quality of life. RESULTS A total of 1800 women returned the questionnaire generating a response rate of 85.0%. Overall, 912 (50.7%) women visited a massage therapist in the previous 12 months. Women with lower quality of life scores in terms of bodily pain (p = 0.012) and/or emotional health (p = 0.029) were more likely to consult a massage therapist than those with higher scores. CONCLUSION The implications of these associations are important for informing healthcare providers in providing effective and coordinated care for patients with pain and mood symptoms.
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Affiliation(s)
- Jane Frawley
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Wenbo Peng
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Lesley Ward
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276, Essen, Germany
| | - Yan Zhang
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia; Department of Family Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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Wong JJ, Côté P, Sutton DA, Randhawa K, Yu H, Varatharajan S, Goldgrub R, Nordin M, Gross DP, Shearer HM, Carroll LJ, Stern PJ, Ameis A, Southerst D, Mior S, Stupar M, Varatharajan T, Taylor-Vaisey A. Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur J Pain 2016; 21:201-216. [PMID: 27712027 DOI: 10.1002/ejp.931] [Citation(s) in RCA: 217] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2016] [Indexed: 12/13/2022]
Abstract
We conducted a systematic review of guidelines on the management of low back pain (LBP) to assess their methodological quality and guide care. We synthesized guidelines on the management of LBP published from 2005 to 2014 following best evidence synthesis principles. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, DARE, National Health Services Economic Evaluation Database, Health Technology Assessment Database, Index to Chiropractic Literature and grey literature. Independent reviewers critically appraised eligible guidelines using AGREE II criteria. We screened 2504 citations; 13 guidelines were eligible for critical appraisal, and 10 had a low risk of bias. According to high-quality guidelines: (1) all patients with acute or chronic LBP should receive education, reassurance and instruction on self-management options; (2) patients with acute LBP should be encouraged to return to activity and may benefit from paracetamol, nonsteroidal anti-inflammatory drugs (NSAIDs), or spinal manipulation; (3) the management of chronic LBP may include exercise, paracetamol or NSAIDs, manual therapy, acupuncture, and multimodal rehabilitation (combined physical and psychological treatment); and (4) patients with lumbar disc herniation with radiculopathy may benefit from spinal manipulation. Ten guidelines were of high methodological quality, but updating and some methodological improvements are needed. Overall, most guidelines target nonspecific LBP and recommend education, staying active/exercise, manual therapy, and paracetamol or NSAIDs as first-line treatments. The recommendation to use paracetamol for acute LBP is challenged by recent evidence and needs to be revisited. SIGNIFICANCE Most high-quality guidelines recommend education, staying active/exercise, manual therapy and paracetamol/NSAIDs as first-line treatments for LBP. Recommendation of paracetamol for acute LBP is challenged by recent evidence and needs updating.
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Affiliation(s)
- J J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - P Côté
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada.,Canada Research Chair in Disability Prevention and Rehabilitation, University of Ontario Institute of Technology, Oshawa, ON, Canada.,Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - D A Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - K Randhawa
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada.,Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - H Yu
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada.,Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - S Varatharajan
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada.,Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - R Goldgrub
- Masters Program, Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - M Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, Occupational and Industrial Orthopedic Center, NYU School of Medicine, New York University, USA
| | - D P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada.,Rehabilitation Research Centre, University of Alberta, Edmonton, AB, Canada
| | - H M Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada.,Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - L J Carroll
- Injury Prevention Centre and School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - P J Stern
- Department of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - A Ameis
- Certification Program in Insurance Medicine and Medico-legal Expertise, Faculty of Medicine, University of Montreal, QC, Canada
| | - D Southerst
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada.,Rebecca MacDonald Centre for Arthritis and Autoimmune Disease, Mount Sinai Hospital, Toronto, ON, Canada
| | - S Mior
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada.,Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - M Stupar
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada
| | - T Varatharajan
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada.,Masters Program, University of Saskatchewan, Saskatoon, SK, Canada
| | - A Taylor-Vaisey
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Oshawa, ON, Canada
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Toosi M, Akbarzadeh M. The Effect of Aerobic Exercises on Maternal Outcomes: A Randomized Controlled Clinical Trial. WOMEN’S HEALTH BULLETIN 2016. [DOI: 10.17795/whb-31337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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35
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Complementary and alternative medicine therapies for chronic pain. Chin J Integr Med 2016; 22:403-11. [DOI: 10.1007/s11655-016-2258-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Indexed: 01/30/2023]
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36
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Kennedy AB, Cambron JA, Sharpe PA, Travillian RS, Saunders RP. Process for massage therapy practice and essential assessment. J Bodyw Mov Ther 2016; 20:484-96. [PMID: 27634069 DOI: 10.1016/j.jbmt.2016.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/14/2015] [Accepted: 01/23/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Little evidence exists about processes in massage therapy practice. Investigating current frameworks is warranted. This qualitative study is a secondary data analysis using grounded theory to understand how massage therapy experts describe massage therapy practice. METHODS 31 massage therapy experts were invited to a 2-day symposium to discuss best practices for the profession. Through qualitative analysis, memoing, and discussion, the data were summarized into themes. RESULTS Three themes were identified around massage therapy practice: 1) client centered, 2) structure for practice, and 3) influencing factors. Each theme is clarified and expanded. DISCUSSION Conceptual models were developed for research and clinical practice and a definition for massage therapy practice was identified. Challenges and limitations are discussed. CONCLUSION The goal of providing these models is to give massage therapists tools to deliver the best possible care. The models need testing to see if they help advance the profession.
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Affiliation(s)
| | | | | | | | - Ruth P Saunders
- University of South Carolina, Department of Health Promotion, Education, and Behavior, USA
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Brosseau L, Toupin-April K, Wells G, Smith CA, Pugh AG, Stinson JN, Duffy CM, Gifford W, Moher D, Sherrington C, Cavallo S, De Angelis G, Loew L, Rahman P, Marcotte R, Taki J, Bisaillon J, King J, Coda A, Hendry GJ, Gauvreau J, Hayles M, Hayles K, Feldman B, Kenny GP, Li JX, Briggs AM, Martini R, Feldman DE, Maltais DB, Tupper S, Bigford S, Bisch M. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Foot Care in the Management of Juvenile Idiopathic Arthritis. Arch Phys Med Rehabil 2015; 97:1163-1181.e14. [PMID: 26707409 DOI: 10.1016/j.apmr.2015.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/15/2015] [Accepted: 11/09/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To create evidence-based guidelines evaluating foot care interventions for the management of juvenile idiopathic arthritis (JIA). DATA SOURCES An electronic literature search of the following databases from database inception to May 2015 was conducted: MEDLINE (Ovid), EMBASE (Ovid), Cochrane CENTRAL, and clinicaltrials.gov. STUDY SELECTION The Ottawa Panel selection criteria targeted studies that assessed foot care or foot orthotic interventions for the management of JIA in those aged 0 to ≤18 years. The Physiotherapy Evidence Database scale was used to evaluate study quality, of which only high-quality studies were included (score, ≥5). A total of 362 records were screened, resulting in 3 full-text articles and 1 additional citation containing supplementary information included for the analysis. DATA EXTRACTION Two reviewers independently extracted study data (intervention, comparator, outcome, time period, study design) from the included studies by using standardized data extraction forms. Directed by Cochrane Collaboration methodology, the statistical analysis produced figures and graphs representing the strength of intervention outcomes and their corresponding grades (A, B, C+, C, C-, D+, D, D-). Clinical significance was achieved when an improvement of ≥30% between the intervention and control groups was present, whereas P>.05 indicated statistical significance. An expert panel Delphi consensus (≥80%) was required for the endorsement of recommendations. DATA SYNTHESIS All included studies were of high quality and analyzed the effects of multidisciplinary foot care, customized foot orthotics, and shoe inserts for the management of JIA. Custom-made foot orthotics and prefabricated shoe inserts displayed the greatest improvement in pain intensity, activity limitation, foot pain, and disability reduction (grades A, C+). CONCLUSIONS The use of customized foot orthotics and prefabricated shoe inserts seems to be a good choice for managing foot pain and function in JIA.
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Affiliation(s)
- Lucie Brosseau
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
| | - Karine Toupin-April
- Department of Pediatrics, Faculty of Medicine, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - George Wells
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada; Cardiovascular Research Methods Center, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Christine A Smith
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Arlanna G Pugh
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Jennifer N Stinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Ciarán M Duffy
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Wendy Gifford
- Faculty of Health Sciences, School of Nursing Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - David Moher
- Clinical Epidemiology Program, Ottawa Methods Center, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Catherine Sherrington
- Musculoskeletal Division, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Sabrina Cavallo
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Gino De Angelis
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Laurianne Loew
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Prinon Rahman
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rachel Marcotte
- Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada
| | - Jade Taki
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, Ottawa, Ontario, Canada
| | - Jacinthe Bisaillon
- Faculty of Health Sciences, School of Nursing Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Judy King
- Physiotherapy Program, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrea Coda
- Faculty of Health and Medicine - Health Precinct, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Gordon J Hendry
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Lanarkshire, United Kingdom
| | - Julie Gauvreau
- Podiatry Clinic of Outaouais, Hospital Boulevard, Gatineau, Québec, Canada
| | - Martin Hayles
- Hayles Foot and Ankle Clinic, Ottawa, Ontario, Canada
| | - Kay Hayles
- Hayles Foot and Ankle Clinic, Ottawa, Ontario, Canada
| | - Brian Feldman
- Department of Pediatrics and Medicine, University of Toronto, Toronto, Ontario, Canada; The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Glen P Kenny
- Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada
| | - Jing Xian Li
- Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada
| | - Andrew M Briggs
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Rose Martini
- Occupational Therapy Program, Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Debbie Ehrmann Feldman
- School of Public Health, Option Epidemiology, University of Montreal, Montreal, Quebec, Canada
| | - Désirée B Maltais
- Physiotherapy Program, Department of Rehabilitation, Pavillon Ferdinand-Vandry, Université Laval, Québec, Quebec, Canada
| | - Susan Tupper
- School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sarah Bigford
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Marg Bisch
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Gambito EDV, Gonzalez-Suarez CB, Grimmer KA, Valdecañas CM, Dizon JMR, Beredo MEJ, Zamora MTG. Updating contextualized clinical practice guidelines on stroke rehabilitation and low back pain management using a novel assessment framework that standardizes decisions. BMC Res Notes 2015; 8:643. [PMID: 26537008 PMCID: PMC4632672 DOI: 10.1186/s13104-015-1588-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/14/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Clinical practice guidelines need to be regularly updated with current literature in order to remain relevant. This paper reports on the approach taken by the Philippine Academy of Rehabilitation Medicine (PARM). This dovetails with its writing guide, which underpinned its foundational work in contextualizing guidelines for stroke and low back pain (LBP) in 2011. METHODS Working groups of Filipino rehabilitation physicians and allied health practitioners met to reconsider and modify, where indicated, the 'typical' Filipino patient care pathways established in the foundation guidelines. New clinical guidelines on stroke and low back pain which had been published internationally in the last 3 years were identified using a search of electronic databases. The methodological quality of each guideline was assessed using the iCAHE Guideline Quality Checklist, and only those guidelines which provided full text references, evidence hierarchy and quality appraisal of the included literature, were included in the PARM update. Each of the PARM-endorsed recommendations was then reviewed, in light of new literature presented in the included clinical guidelines. A novel standard updating approach was developed based on the criteria reported by Johnston et al. (Int J Technol Assess Health Care 19(4):646-655, 2003) and then modified to incorporate wording from the foundational PARM writing guide. The new updating tool was debated, pilot-tested and agreed upon by the PARM working groups, before being applied to the guideline updating process. RESULTS Ten new guidelines on stroke and eleven for low back pain were identified. Guideline quality scores were moderate to good, however not all guidelines comprehensively linked the evidence body underpinning recommendations with the literature. Consequently only five stroke and four low back pain guidelines were included. The modified PARM updating guide was applied by all working groups to ensure standardization of the wording of updated recommendations and the underpinning evidence bases. CONCLUSIONS The updating tool provides a simple, standard and novel approach that incorporates evidence hierarchy and quality, and wordings of recommendations. It could be used efficiently by other guideline updaters particularly in developing countries, where resources for guideline development and updates are limited. When many people are involved in guideline writing, there is always the possibility of 'slippage' in use of wording and interpretation of evidence. The PARM updating tool provides a mechanism for maintaining a standard process for guideline updating processes that can be followed by clinicians with basic training in evidence-based practice principles.
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Affiliation(s)
- Ephraim D V Gambito
- Department of Physical Medicine and Rehabilitation, University of Santo Tomas Hospital, Manila, Philippines. .,Philippine Academy of Rehabilitation Medicine (PARM), Quezon City, Philippines.
| | - Consuelo B Gonzalez-Suarez
- Department of Physical Medicine and Rehabilitation, University of Santo Tomas Hospital, Manila, Philippines. .,Philippine Academy of Rehabilitation Medicine (PARM), Quezon City, Philippines.
| | - Karen A Grimmer
- International Center for Allied Health Evidence (iCAHE), University of South Australia, Adelaide, Australia.
| | - Carolina M Valdecañas
- Department of Rehabilitation Medicine, St. Luke's Medical Center, Quezon City, Philippines. .,Philippine Academy of Rehabilitation Medicine (PARM), Quezon City, Philippines.
| | - Janine Margarita R Dizon
- College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines. .,Philippine Academy of Rehabilitation Medicine (PARM), Quezon City, Philippines.
| | - Ma Eulalia J Beredo
- Department of Rehabilitation Medicine, Philippine Orthopedic Center, Quezon City, Philippines. .,Philippine Academy of Rehabilitation Medicine (PARM), Quezon City, Philippines.
| | - Marcelle Theresa G Zamora
- Department of Physical Medicine and Rehabilitation, University of Santo Tomas Hospital, Manila, Philippines. .,Philippine Academy of Rehabilitation Medicine (PARM), Quezon City, Philippines.
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Perlman A, Dreusicke M, Keever T, Ali A. Perceptions of Massage Therapists Participating in a Randomized Controlled Trial. Int J Ther Massage Bodywork 2015; 8:10-5. [PMID: 26388961 PMCID: PMC4560530 DOI: 10.3822/ijtmb.v8i3.278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background Clinical practice and randomized trials often have disparate aims, despite involving similar interventions. Attitudes and expectancies of practitioners influence patient outcomes, and there is growing emphasis on optimizing provider–patient relationships. In this study, we evaluated the experiences of licensed massage therapists involved in a randomized controlled clinical trial using qualitative methodology. Methods Seven massage therapists who were interventionists in a randomized controlled trial participated in structured interviews approximately 30 minutes in length. Interviews focused on their experiences and perceptions regarding aspects of the clinical trial, as well as recommendations for future trials. Transcribed interviews were analyzed for emergent topics and themes using standard qualitative methods. Results Six themes emerged. Therapists discussed 1) promoting the profession of massage therapy through research, 2) mixed views on using standardized protocols, 3) challenges of sham interventions, 4) participant response to the sham intervention, 5) views on scheduling and compensation, and 6) unanticipated benefits of participating in research. Conclusions Therapists largely appreciated the opportunity to promote massage through research. They demonstrated insight and understanding of the rationale for a clinical trial adhering to a standardized protocol. Evaluating the experiences and ideas of complementary and alternative medicine practitioners provides valuable insight that is relevant for the implementation and design of randomized trials.
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Affiliation(s)
- Adam Perlman
- Duke Integrative Medicine, Duke University, Durham, NC, USA
| | - Mark Dreusicke
- Duke Integrative Medicine, Duke University, Durham, NC, USA
| | - Teresa Keever
- Duke Integrative Medicine, Duke University, Durham, NC, USA
| | - Ather Ali
- Department of Pediatrics, Yale University, New Haven, CT, USA
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Bervoets DC, Luijsterburg PAJ, Alessie JJN, Buijs MJ, Verhagen AP. Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review. J Physiother 2015; 61:106-16. [PMID: 26093806 DOI: 10.1016/j.jphys.2015.05.018] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 05/04/2015] [Accepted: 05/20/2015] [Indexed: 11/25/2022] Open
Abstract
QUESTION Is massage therapy effective for people with musculoskeletal disorders compared to any other treatment or no treatment? DESIGN Systematic review of randomised clinical trials. PARTICIPANTS People with musculoskeletal disorders. INTERVENTIONS Massage therapy (manual manipulation of the soft tissues) as a stand-alone intervention. OUTCOME The primary outcomes were pain and function. RESULTS The 26 eligible randomised trials involved 2565 participants. The mean sample size was 95 participants (range 16 to 579) per study; 10 studies were considered to be at low risk of bias. Overall, low-to-moderate-level evidence indicated that massage reduces pain in the short term compared to no treatment in people with shoulder pain and osteoarthritis of the knee, but not in those with low back pain or neck pain. Furthermore, low-to-moderate-level evidence indicated that massage improves function in the short term compared to no treatment in people with low back pain, knee arthritis or shoulder pain. Low-to-very-low-level evidence from single studies indicated no clear benefits of massage over acupuncture, joint mobilisation, manipulation or relaxation therapy in people with fibromyalgia, low back pain and general musculoskeletal pain. CONCLUSIONS Massage therapy, as a stand-alone treatment, reduces pain and improves function compared to no treatment in some musculoskeletal conditions. When massage is compared to another active treatment, no clear benefit was evident.
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Affiliation(s)
- Diederik C Bervoets
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam
| | - Pim A J Luijsterburg
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam
| | | | | | - Arianne P Verhagen
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam
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Téllez-García M, de-la-Llave-Rincón AI, Salom-Moreno J, Palacios-Ceña M, Ortega-Santiago R, Fernández-de-las-Peñas C. Neuroscience education in addition to trigger point dry needling for the management of patients with mechanical chronic low back pain: A preliminary clinical trial. J Bodyw Mov Ther 2015; 19:464-72. [DOI: 10.1016/j.jbmt.2014.11.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 11/12/2014] [Accepted: 11/14/2014] [Indexed: 02/07/2023]
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Larson ER. Massage therapy effects in a long-term prosthetic user with fibular hemimelia. J Bodyw Mov Ther 2015; 19:261-7. [PMID: 25892381 DOI: 10.1016/j.jbmt.2014.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 03/02/2014] [Accepted: 04/09/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND Individuals with lower limb amputation (LLA) commonly experience low back pain (LBP). Although massage effects on LBP are well-documented, research regarding massage for individuals with LLA is scarce. OBJECTIVES This study evaluated the effectiveness of massage therapy to promote activity level, decrease LBP, and improve health-related quality of life (HRQOL) in a long-term prosthetic user. METHODS The 50-day study consisted of two baseline sessions, seven treatment sessions that included a 50-min massage applied to major gait muscles, and two follow-up sessions. Pedometer-measured ambulatory activity level, visual analog scale-measured pain level, and RAND-36 Health Survey 1.0-determined HRQOL were assessed. RESULTS Pain level decreased, HRQOL increased, and no change occurred in ambulatory activity level. CONCLUSION For the participant, therapeutic massage intervention lead to successful LBP symptom management.
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Keeratitanont K, Jensen MP, Chatchawan U, Auvichayapat P. The efficacy of traditional Thai massage for the treatment of chronic pain: A systematic review. Complement Ther Clin Pract 2015; 21:26-32. [DOI: 10.1016/j.ctcp.2015.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/20/2015] [Indexed: 01/19/2023]
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Wong JJ, Côté P, Shearer HM, Carroll LJ, Yu H, Varatharajan S, Southerst D, van der Velde G, Jacobs C, Taylor-Vaisey A. Clinical practice guidelines for the management of conditions related to traffic collisions: a systematic review by the OPTIMa Collaboration. Disabil Rehabil 2014; 37:471-89. [PMID: 24963833 DOI: 10.3109/09638288.2014.932448] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the methodological quality and synthesize recommendations of evidence-based guidelines for the management of common traffic injuries. STUDY DESIGN We conducted a systematic review and best evidence synthesis of guidelines on musculoskeletal injuries, psychological disorders and mild traumatic brain injuries (MTBI) from 1995 to 2012. Independent reviewers critically appraised eligible guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) criteria. RESULTS We retrieved 9863 citations. Of those, 16 guidelines were eligible for critical appraisal and eight were scientifically admissible (four targeting whiplash-associated disorders (WAD), one addressing anxiety and three addressing MTBI). The inadmissible guidelines had inadequate literature searches, inexplicit links between evidence and recommendations, and ambiguous recommendations. The literature used to develop most of the admissible guidelines was outdated. Major recommendations included: (1) Advice, education and reassurance for all conditions; (2) Exercise, return-to-activity, mobilization/manipulation, analgesics and avoiding collars for WAD; (3) Psychological first aid, pharmacotherapy and cognitive behavioral therapy as first-line interventions for anxiety; and (4) Monitoring for complications, discharge criteria, advice upon discharge from the emergency room and post-discharge care for MTBI. CONCLUSION Fifty percent of appraised guidelines were scientifically admissible, but most need updating. Most guidelines focus on WAD and MTBI. Few guidelines make comprehensive recommendations on a wide range of consequences from traffic collisions. IMPLICATIONS FOR REHABILITATION The core components of a program of care designed to manage common traffic injuries (whiplash-associated disorders - WAD, anxiety and mild traumatic brain injuries) should include advice, education and reassurance. Depending on the condition, the following specific interventions should be considered: (1) WAD: exercise, early return to activity, mobilization/manipulation, analgesics and avoidance of collars; (2) Anxiety: psychological first aid, pharmacotherapy and cognitive behavioral therapy; and (3) Mild traumatic brain injuries: use of specific discharge criteria (including no factors warranting hospital admission and support structures for subsequent care), education upon discharge from emergency room and post-discharge care (e.g. monitoring for complications, gradual return to normal activity based on tolerance of individual). The methodological quality of guidelines varies greatly; therefore, guideline developers need to adhere to established methodological standards and conform to the evaluation criteria outlined in the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.
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Affiliation(s)
- Jessica J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC) , Toronto , Canada
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Cheville AL, Basford JR. Role of rehabilitation medicine and physical agents in the treatment of cancer-associated pain. J Clin Oncol 2014; 32:1691-702. [PMID: 24799472 PMCID: PMC5569680 DOI: 10.1200/jco.2013.53.6680] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To provide an overview of rehabilitation medicine- and physical modality-based approaches to cancer pain management, and to highlight the fact that these approaches are generally used in conjunction and that a majority are focused on minimizing pain during periods of mobility and the performance of activities of daily living. METHODS We performed a nonsystematic literature review and provide a description of the current standard of care. RESULTS Rehabilitative and physical modalities used to manage pain can be grouped into four categories: those that modulate nociception, stabilize or unload painful structures, influence physiological processes that indirectly influence nociception, or alleviate pain arising from the overloading of muscles and connective tissues that often occurs after surgery or with sarcopenia in late-stage cancer. Most modalities have been pragmatically refined over the years, and many have an evidence base, although few have been explicitly validated in the oncologic setting. With few exceptions, they are patient controlled and free of adverse effects. CONCLUSION Physical modalities and rehabilitation medicine offer a range of pain management approaches that may serve as beneficial adjuncts to the conventional systemic and interventional analgesic strategies used to control cancer-related pain. These approaches may be particularly beneficial to patients with movement-associated pain and those who are ambivalent regarding pharmacoanalgesia.
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Snider KT, Johnson JC, Degenhardt BF, Snider EJ. The persistence of lumbar somatic dysfunction and its association with bone mineral density. J Osteopath Med 2014; 114:8-20. [PMID: 24384969 DOI: 10.7556/jaoa.2014.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
CONTEXT Clinically meaningful somatic dysfunction, if left untreated, should persist over time and be associated with objective measurable findings. OBJECTIVE To investigate the persistence of lumbar somatic dysfunction over 8 weeks and the association of that persistence with lumbar bone mineral density (BMD) T scores. METHODS Individuals were assessed at 0, 4, and 8 weeks for the presence and severity of paraspinal tissue texture abnormalities (TTA), vertebral rotational asymmetry, anterior motion restriction, and tenderness from L1 to L4. Participants underwent dual-energy x-ray absorptiometry of the lumbar spine at 0 and 8 weeks. Persistent somatic dysfunction findings from all 3 examinations were compared with BMD T scores obtained at 8 weeks and to changes in the BMD T scores from 0 to 8 weeks. RESULTS Forty-eight individuals (38 women [79%] and 10 men [21%]) participated in the study. The mean (standard deviation [SD]) age was 30.1 (6.4) years (range, 20.0-40.8 years), and the mean (SD) body mass index was 26.3 (5.2). The percentage of vertebrae with persistent somatic dysfunction varied by vertebral level and ranged from 44% to 83% for TTA, 63% to 79% for rotational asymmetry, 10% to 56% for motion restriction, and 2% to 10% for tenderness. Vertebral segments with persistent motion restriction had higher mean BMD T scores (95% confidence interval [CI]) than those without persistent motion restriction (0.6 [0.4 to 0.8] vs 0.2 [0.1 to 0.4], respectively; P=.02). There was a significant increase in the vertebral BMD T scores for those vertebrae that demonstrated persistent TTA (P=.02) and for those vertebrae that demonstrated persistent moderate/severe TTA (P=.02). A significant difference was found in the initial to final vertebral BMD T-score change between vertebrae that demonstrated persistent tenderness and those that did not (mean [95% CI] change, -0.2 [-0.4 to 0.1] vs 0.1 [0.0 to 0.1], respectively; P=.04). CONCLUSION A persistence of predominantly left lumbar rotation was observed. Persistent vertebral motion restriction was shown to have an association with final lumbar BMD T scores, and persistent TTA and tenderness were associated with changes in the BMD T scores over 8 weeks.
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Affiliation(s)
- Karen T Snider
- Department of Osteopathic Manipulative Medicine, A.T. Still University-Kirksville College of Osteopathic Medicine, 800 W Jefferson St, Kirksville, MO 63501-1443.
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Kumar S, Beaton K, Hughes T. The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews. Int J Gen Med 2013; 6:733-41. [PMID: 24043951 PMCID: PMC3772691 DOI: 10.2147/ijgm.s50243] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction The last decade has seen a growth in the utilization of complementary and alternative medicine therapies, and one of the most popular and sought-after complementary and alternative medicine therapies for nonspecific low back pain is massage. Massage may often be perceived as a safe therapeutic modality without any significant risks or side effects. However, despite its popularity, there continues to be ongoing debate on the effectiveness of massage in treating nonspecific low back pain. With a rapidly evolving research evidence base and access to innovative means of synthesizing evidence, it is time to reinvestigate this issue. Methods A systematic, step-by-step approach, underpinned by best practice in reviewing the literature, was utilized as part of the methodology of this umbrella review. A systematic search was conducted in the following databases: Embase, MEDLINE, AMED, ICONDA, Academic Search Premier, Australia/New Zealand Reference Centre, CINAHL, HealthSource, SPORTDiscus, PubMed, The Cochrane Library, Scopus, Web of Knowledge/Web of Science, PsycINFO, and ProQuest Nursing and Allied Health Source, investigating systematic reviews and meta-analyses from January 2000 to December 2012, and restricted to English-language documents. Methodological quality of included reviews was undertaken using the Centre for Evidence Based Medicine critical appraisal tool. Results Nine systematic reviews were found. The methodological quality of the systematic reviews varied (from poor to excellent) although, overall, the primary research informing these systematic reviews was generally considered to be weak quality. The findings indicate that massage may be an effective treatment option when compared to placebo and some active treatment options (such as relaxation), especially in the short term. There is conflicting and contradictory findings for the effectiveness of massage therapy for the treatment of nonspecific low back pain when compared against other manual therapies (such as mobilization), standard medical care, and acupuncture. Conclusion There is an emerging body of evidence, albeit small, that supports the effectiveness of massage therapy for the treatment of non-specific low back pain in the short term. Due to common methodological flaws in the primary research, which informed the systematic reviews, recommendations arising from this evidence base should be interpreted with caution.
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Affiliation(s)
- Saravana Kumar
- International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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McNeill W, Gee J. Accessing intuition in Massage and Bodywork Therapies using mindfulness, knowledge, empathy and flow. J Bodyw Mov Ther 2013; 17:116-20. [PMID: 23294692 DOI: 10.1016/j.jbmt.2012.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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