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Reichardt A, Passmore SR, Toth A, Olin G. Utilization of chiropractic services in patients with osteoarthritis and spine pain at a publicly funded healthcare facility in Canada: A retrospective study. J Back Musculoskelet Rehabil 2022; 35:1075-1084. [PMID: 35253731 DOI: 10.3233/bmr-210192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Osteoarthritis (OA) is one of the most prevalent and disabling musculoskeletal diseases worldwide. There is preliminary evidence from experimental studies and consensus documents that chiropractic management may alleviate spine and/or extremity OA related pain in the short term. OBJECTIVE This research explores the potential relationship of a pragmatic course of care, including soft tissue therapy, spinal manipulation, and other treatments commonly delivered by chiropractors, to spine and extremity pain in patients with OA. METHODS A retrospective analysis of prospectively collected data from the chiropractic program at a publicly funded healthcare facility was conducted. The primary outcome measures for patients diagnosed with spine and/or extremity OA (n= 76) were numeric pain scores of each spinal and extremity region at baseline and discharge, and a change score was determined. RESULTS Statistically significant improvements that exceed a clinically meaningful difference in pain numeric rating scale scores were demonstrated by point change reductions from baseline to discharge visits. Change scores exceeding a minimally clinically important difference of "2-points" were present in the sacroiliac (-2.91), extremity (-2.84), cervical (-2.73), thoracic (-2.61), and lumbar (-2.59) regions. CONCLUSION Patients diagnosed with OA in a socioeconomically disadvantaged community demonstrated reductions in mean pain scores in both a clinically meaningful and statistically significant manner concurrent with a course of chiropractic care.
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Affiliation(s)
- Amber Reichardt
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | - Steven R Passmore
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada.,Research Department, New York Chiropractic College, Seneca Falls, NY, USA
| | - Audrey Toth
- Chiropractic Program, Mount Carmel Clinic, Winnipeg, MB, Canada
| | - Gerald Olin
- Manitoba Chiropractors Association, Winnipeg, MB, Canada
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Estébanez-de-Miguel E, Caudevilla-Polo S, González-Rueda V, Bueno-Gracia E, Pérez-Bellmunt A, López-de-Celis C. Ultrasound measurement of the effects of high, medium and low hip long-axis distraction mobilization forces on the joint space width and its correlation with the joint strain. Musculoskelet Sci Pract 2020; 50:102225. [PMID: 32858316 DOI: 10.1016/j.msksp.2020.102225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/17/2020] [Accepted: 07/19/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND No study has evaluated the mechanical effect of different magnitudes of long axis-distraction mobilization (LADM) force on hip joint space width (JSW) or the association between the separation of joint surfaces and the strain on hip capsular ligaments. OBJECTIVE To compare the joint separation when applying three different magnitudes of LADM forces (low, medium and high) and to analyse the correlation between joint separation, strain on the inferior ilio-femoral ligament and magnitude of applied force. DESIGN Repeated measures controlled laboratory cadaveric study. METHODS Three magnitudes of force were applied to 11 cadaveric hip joints (mean age 73 years). Ultrasound images were used to measure joint separation, and strain gauges recorded inferior ilio-femoral ligament strain during each condition. RESULTS The magnitude of joint separation was significantly different between low (0.23 ± 0.19 mm), medium (0.72 ± 0.22 mm) and high (2.62 ± 0.43 mm) forces (p < 0.001). There were significant associations between magnitude of force, joint separation and the strain on the inferior ilio-femoral ligament during LADM (r > 0.723; p < 0.001). CONCLUSION Hip joint separation and ligament strain during LADM are associated with the magnitude of the applied force.
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Affiliation(s)
- Elena Estébanez-de-Miguel
- Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain.
| | - Santos Caudevilla-Polo
- Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain
| | - Vanessa González-Rueda
- Faculty of Medicine and Health Sciences, Universitat International de Catalunya, Barcelona, Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Elena Bueno-Gracia
- Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain
| | - Albert Pérez-Bellmunt
- Faculty of Medicine and Health Sciences, Universitat International de Catalunya, Barcelona, Spain
| | - Carlos López-de-Celis
- Faculty of Medicine and Health Sciences, Universitat International de Catalunya, Barcelona, Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
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The effect of high, medium and low mobilization forces applied during a hip long-axis distraction mobilization on the strain on the inferior ilio-femoral ligament and psoas muscle: A cadaveric study. Musculoskelet Sci Pract 2020; 47:102148. [PMID: 32174546 DOI: 10.1016/j.msksp.2020.102148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/15/2020] [Accepted: 03/03/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Several studies have suggested that the changes in elasticity of the joint capsule and surrounding muscles during a hip long-axis distraction mobilization (LADM) could explain the pain-relieving and mobility-improving effects of the technique. OBJECTIVE To compare the strain on the inferior ilio-femoral ligament and psoas muscle when applying three different magnitudes of force during LADM. DESIGN Repeated measures controlled laboratory cadaveric study. METHODS Eleven hip joints were mobilized from six fresh-frozen cadavers (mean age, 73.4 ± 5.7 years). Three magnitudes of force (low, medium and high) were applied during a hip LADM in open-packed position according to grades of joint mobilization. Strain on the inferior ilio-femoral ligament and psoas muscle were measured with strain gauges. The magnitude of the force applied during LADM was recorded. RESULTS Strain on the inferior ilio-femoral ligament during a high-force LADM was significantly higher than strain on the inferior ilio-femoral ligament during low (p < 0.001) and medium-force LADM (p < 0.001). The strain on the inferior ilio-femoral ligament during a medium-force LADM was significantly higher than during a low-force LADM (p = 0.004). No changes in strain on psoas muscle were observed. The magnitude of force applied during LADM showed a significant progressive increase from low to high-force LADM. CONCLUSION The different magnitudes of forces applied during LADM produce different strains on the inferior ilio-femoral ligament but not on the psoas muscle. The strain on the inferior ilio-femoral ligament during LADM depends on the magnitude of the mobilization force.
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Estébanez-de-Miguel E, Jimenez-Del-Barrio S, Fortún-Agud M, Bueno-Gracia E, Caudevilla-Polo S, Malo-Urriés M, Ceballos-Laita L. Comparison of high, medium and low mobilization forces for reducing pain and improving physical function in patients with hip osteoarthritis: Secondary analysis of a randomized controlled trial. Musculoskelet Sci Pract 2019; 41:43-48. [PMID: 30909110 DOI: 10.1016/j.msksp.2019.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/16/2019] [Accepted: 03/18/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Long-axis distraction mobilization (LADM) of the hip has been shown to reduce pain and improve physical function in hip osteoarthritis (OA). The optimal intensity of mobilization force necessary to reduce pain and improve physical function is unknown. OBJECTIVE To compare the effects on pain and physical function of three different intensities of LADM mobilization force in hip OA patients. DESIGN Randomized controlled trial. METHODS Sixty patients with unilateral hip OA were randomized to three groups: low, medium or high force mobilization group. Participants received three treatment sessions of LADM. Pressure pain thresholds (PPT) at hip, knee and heel, physical function (Western Ontario and McMaster Universities physical function subscale, timed up and go and 40 m self-placed walk test) and pain after the physical function tests (visual analogic scale) were assessed before and after the intervention. RESULTS The three treatment groups showed significant improvements in pain and in physical function (p < 0.05). The low-force group showed the largest effects size for pain (d = 2.0) and the greatest mean percentage increase in PPTs (hip = 30.3%, knee = 34.6%, heel = 25.6%). The high-force group showed the largest effects size for physical function (d = 0.5-0.7). CONCLUSION A low-force LADM produced the largest reduction in pain and a high-force LADM the largest improvement in physical function in hip OA patients. The improvements in pain and physical function after LADM in hip OA patients appear to be modulated by the intensity of the mobilization force.
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Affiliation(s)
- Elena Estébanez-de-Miguel
- Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain.
| | | | | | - Elena Bueno-Gracia
- Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain
| | - Santos Caudevilla-Polo
- Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain
| | - Miguel Malo-Urriés
- Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain
| | - Luis Ceballos-Laita
- Department of Surgery, Ophthalmology and Physiotherapy, University of Valladolid, Valladolid, Spain
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Sato T, Sato N, Masui K, Hirano Y. Immediate effects of manual traction on radiographically determined joint space width in the hip joint. J Manipulative Physiol Ther 2014; 37:580-5. [PMID: 25200270 DOI: 10.1016/j.jmpt.2014.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 07/11/2014] [Accepted: 08/04/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the immediate effects of manual traction of the hip joint on joint space width (JSW) on asymptomatic subjects. METHODS Asymptomatic, healthy male volunteers (n = 15), aged 25 to 34 years were included in this study. Three radiographs were obtained with the subjects in the supine position, before and after loading with 10% of his body weight, and after manual traction on only the right hip joint. Joint space width was measured by a radiologist at the point described by Jacobson and Sonne-Holm. RESULTS There were significant changes in JSW on the right hip joint and left hip joint between the baseline (before loading) and immediately after loading. We also observed a significantly increased JSW on only the right hip joint between periods that followed loading and manual traction on the right hip joint. There was no significant change in JSW on the left hip joint between periods that followed loading and manual traction on the right hip joint. CONCLUSIONS The results of this study suggest that a significant increase in JSW in young, healthy male patients can occur immediately after manual traction of the hip joint.
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Affiliation(s)
- Tomonori Sato
- Associate Professor, Department of Physical Therapy, Tokoha University, Shizuoka, Japan.
| | - Naomi Sato
- Professor, Department of Nursing, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kenji Masui
- Chief Physical Therapist, Department of Physical Therapy, Osaka Kaisei Hospital, Osaka, Japan
| | - Yukinobu Hirano
- Professor, Department of Physical Therapy, Tokoha University, Shizuoka, Japan
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Prevalence of Hip Osteoarthritis in Chiropractic Practice in Denmark: A Descriptive Cross-Sectional and Prospective Study. J Manipulative Physiol Ther 2012; 35:263-71. [DOI: 10.1016/j.jmpt.2012.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 10/19/2011] [Accepted: 10/27/2011] [Indexed: 11/20/2022]
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Brantingham JW, Parkin-Smith G, Cassa TK, Globe GA, Globe D, Pollard H, deLuca K, Jensen M, Mayer S, Korporaal C. Full Kinetic Chain Manual and Manipulative Therapy Plus Exercise Compared With Targeted Manual and Manipulative Therapy Plus Exercise for Symptomatic Osteoarthritis of the Hip: A Randomized Controlled Trial. Arch Phys Med Rehabil 2012; 93:259-67. [DOI: 10.1016/j.apmr.2011.08.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 08/24/2011] [Accepted: 08/31/2011] [Indexed: 01/22/2023]
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Brantingham JW, Bonnefin D, Perle SM, Cassa TK, Globe G, Pribicevic M, Hicks M, Korporaal C. Manipulative Therapy for Lower Extremity Conditions: Update of a Literature Review. J Manipulative Physiol Ther 2012; 35:127-66. [DOI: 10.1016/j.jmpt.2012.01.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 11/18/2011] [Accepted: 11/18/2011] [Indexed: 12/26/2022]
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Poulsen E, Christensen HW, Roos EM, Vach W, Overgaard S, Hartvigsen J. Non-surgical treatment of hip osteoarthritis. Hip school, with or without the addition of manual therapy, in comparison to a minimal control intervention: protocol for a three-armed randomized clinical trial. BMC Musculoskelet Disord 2011; 12:88. [PMID: 21542914 PMCID: PMC3112433 DOI: 10.1186/1471-2474-12-88] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 05/04/2011] [Indexed: 11/10/2022] Open
Abstract
Background Hip osteoarthritis is a common and chronic condition resulting in pain, functional disability and reduced quality of life. In the early stages of the disease, a combination of non-pharmacological and pharmacological treatment is recommended. There is evidence from several trials that exercise therapy is effective. In addition, single trials suggest that patient education in the form of a hip school is a promising intervention and that manual therapy is superior to exercise. Methods/Design This is a randomized clinical trial. Patients with clinical and radiological hip osteoarthritis, 40-80 years of age, and without indication for hip surgery were randomized into 3 groups. The active intervention groups A and B received six weeks of hip school, taught by a physiotherapist, for a total of 5 sessions. In addition, group B received manual therapy consisting of joint manipulation and soft-tissue therapy twice a week for six weeks. Group C received a self-care information leaflet containing advice on "live as usual" and stretching exercises from the hip school. The primary time point for assessing relative effectiveness is at the end of the six weeks intervention period with follow-ups after three and 12 months. Primary outcome measure is pain measured on an eleven-point numeric rating scale. Secondary outcome measures are the hip dysfunction and osteoarthritis outcome score, patient's global perceived effect, patient specific functional scale, general quality of life and hip range of motion. Discussion To our knowledge this is the first randomized clinical trial comparing a patient education program with or without the addition of manual therapy to a minimal intervention for patients with hip osteoarthritis. Trial registration ClinicalTrials NCT01039337
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Affiliation(s)
- Erik Poulsen
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark.
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