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Dolbec A, Doucet C, Pohlman KA, Sobczak S, Pagé I. Assessing adverse events associated with chiropractic care in preschool pediatric population: a feasibility study. Chiropr Man Therap 2024; 32:9. [PMID: 38481318 PMCID: PMC10938841 DOI: 10.1186/s12998-024-00529-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/23/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Manual therapies are commonly used by healthcare professionals when caring for children. However, few prospective studies have evaluated their adverse events (AEs). This study aims to assess the feasibility of a pragmatic prospective study aiming to report the immediate and delayed (48-hours post-treatment) AEs associated with manual therapies in children aged 5 or younger. Preliminary data on AEs frequency are also reported. METHODS Between July 2021 and March 2022, chiropractors were recruited through purposive sampling and via a dedicated Facebook group for Quebec chiropractors interested in pediatrics. Legal guardians of patients aged 5 or younger were invited to fill out an online information and consent form. AEs were collected using the SafetyNET reporting system, which had been previously translated by the research team. Immediate AEs were collected through a questionnaire filled out by the legal guardian immediately after the treatment, while delayed AEs were collected through a questionnaire sent by email to the legal guardian 48 h after the treatment. Feasibility was assessed qualitatively through feedback from chiropractors and quantitatively through recruitment data. RESULTS Overall, a total of 28 chiropractors expressed interest following the Facebook publication, and 5 participated. An additional two chiropractors were enrolled through purposive sampling. In total, 80 legal guardians consented to their child's participation, and data from 73 children were included for the analysis of AEs. At least one AE was reported in 30% of children (22/73), and AEs were mainly observed immediately following the treatment (16/22). The most common AEs were irritability/crying (11 children) or fatigue/tiredness (11 children). Feasibility analysis demonstrated that regular communication between the research team and clinicians, as well as targeting clinicians who showed great interest in pediatrics, were key factors for successful research. CONCLUSION Results suggest that it is feasible to conduct a prospective pragmatic study evaluating AEs associated with manual therapies in private practices. Direct communication with the clinicians, a strategic clinicians' recruitment plan, and the resulting administrative burden should be considered in future studies. A larger study is required to confirm the frequency of AEs reported in the current study. TRIAL REGISTRATION ClinicalTrials.gov., NCT05409859, Registered on June 3 2022. https://clinicaltrials.gov/study/NCT05409859 .
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Affiliation(s)
- Anne Dolbec
- Département d'anatomie, Université du Québec à Trois-Rivières, 3351 Boul. des Forges, G8Z 4M3, Trois-Rivières, Québec, Canada
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Boul. des Forges, G8Z 4M3, Trois-Rivières, Québec, Canada
| | - Chantale Doucet
- Département de chiropratique, Université du Québec à Trois-Rivières, 3351 Boul. des Forges, G8Z 4M3, Trois-Rivières, Québec, Canada
| | - Katherine A Pohlman
- Research Center, Parker University, 2540 Walnut Hill Lane, 75229, Dallas, TX, USA
| | - Stéphane Sobczak
- Département d'anatomie, Université du Québec à Trois-Rivières, 3351 Boul. des Forges, G8Z 4M3, Trois-Rivières, Québec, Canada
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Boul. des Forges, G8Z 4M3, Trois-Rivières, Québec, Canada
- Chaire de recherche en anatomie fonctionnelle, Université du Québec à Trois-Rivières, 3351 Boul. des Forges, G8Z 4M3, Trois-Rivières, Québec, Canada
| | - Isabelle Pagé
- Département de chiropratique, Université du Québec à Trois-Rivières, 3351 Boul. des Forges, G8Z 4M3, Trois-Rivières, Québec, Canada.
- Centre Interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSS-CN), 525 Boul. Wilfrid-Hamel, G1M 2S8, Québec, Québec, Canada.
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Boul. des Forges, G8Z 4M3, Trois-Rivières, Québec, Canada.
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Alptug B, Tüzün EH, Keçeci B, Eker L. Effects of perceptive rehabilitation and mobilization methods on symptoms and disability in patients with fibromyalgia: A preliminary randomized control trial. Ir J Med Sci 2023; 192:2937-2947. [PMID: 36897535 DOI: 10.1007/s11845-023-03333-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Currently, there is no definitive cure for fibromyalgia. Instead, treatments focus of reducing symptoms and disability. AIMS This randomized controlled study aimed to evaluate the effectiveness of perceptive rehabilitation and soft tissue and joint mobilization on the severity of symptoms and disability in fibromyalgia compared with a control group. METHODS A total of 55 fibromyalgia patients were randomized into three groups: perceptive rehabilitation, mobilization, and control. The impact of fibromyalgia was evaluated using the Revised Fibromyalgia Impact Questionnaire (FIQR; primary outcome). Pain intensity, fatigue severity, depression, and sleep quality were secondary outcome measures. Data were collected at baseline (T0), the end of treatment (8 weeks; T1), and the end of 3 months (T2). RESULTS Statistically significant differences were found in between-groups comparisons at T1 for primary and secondary outcome measurements (p < .05), except for sleep quality. Both the perceptive rehabilitation and mobilization groups had statistically significant differences at T1 over the control group (p < .05). Between-group pairwise comparisons showed statistically significant differences between the perceptive and control groups for all outcome measures at T1 (p < .05). Similarly, statistically significant differences existed between the mobilization and control groups for all outcome measures at T1 (p < .05), except the FIQR overall impact scores. All other variables except depression were statistically similar between groups at T2. CONCLUSION This study shows that perceptive rehabilitation and mobilization therapy are similarly effective in improving fibromyalgia symptoms and disability, but the effects disappear within 3 months. Further research is needed to understand how the improvements could be maintained longer. TRIAL REGISTRATION Clinical Trial Registration number, ClinicalTrials.gov Identifier: NCT03705910.
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Affiliation(s)
- Beraat Alptug
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, European University of Lefke, Mersin 10, Lefke, Northern Cyprus, Turkey.
| | - Emine Handan Tüzün
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Mersin 10, Famagusta, Northern Cyprus, Turkey
| | - Barış Keçeci
- Sorgun Municipality Sports Club Association, Sorgun Municipality, Sorgun, Yozgat, Turkey
| | - Levent Eker
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Mersin 10, Famagusta, Northern Cyprus, Turkey
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Vielsmeier V, van der Loo J, Marcrum SC. [Somatosensory tinnitus]. HNO 2023; 71:731-738. [PMID: 37782343 DOI: 10.1007/s00106-023-01372-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Somatosensory tinnitus represents a clinically significant subgroup of chronic tinnitus. Although not completely understood, increasing evidence suggests interactivity between the somatosensory and auditory systems is responsible for both the development and maintenance of tinnitus. OBJECTIVES The aim of this study is to provide an overview of the evaluation of somatosensory tinnitus and to propose an examination protocol to support the diagnosis and treatment of this patient group. MATERIALS AND METHODS In addition to patient history, various clinical examination maneuvers are presented to establish the diagnosis of somatosensory tinnitus. RESULTS The maneuvers can be divided into examinations of the cervical spine, temporomandibular joint, and soft tissue near the jaw. The maneuvers should be performed in a quiet environment and usually in comparison between sides. CONCLUSION Accurate and efficient diagnosis of somatosensory tinnitus is essential to initiate appropriate treatment. The clinical maneuvers presented here are well suited for this purpose.
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Affiliation(s)
- Veronika Vielsmeier
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
| | - Joachim van der Loo
- Abteilung für Physio- und Ergotherapie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Steven C Marcrum
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
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Kweon M, Kim J. Comparison of immediate effects of myofascial release and fascial distortion model on the range of motion, pain pressure threshold, and balance in healthy adults. J Bodyw Mov Ther 2023; 35:33-37. [PMID: 37330789 DOI: 10.1016/j.jbmt.2023.04.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 03/15/2023] [Accepted: 04/15/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Many fascial therapies have been demonstrated to positively affect the range of motion, pain sensitivity, balance, daily functioning, and participation in social activities. Among these therapies, myofascial release has been extensively studied and widely used in clinical trials. The fascial distortion model was recently introduced, and it has received much attention due to its rapid onset of action and ease of application. OBJECTIVE This study aims to compare the effects of myofascial release and the fascial distortion model on range of motion, pain sensitivity, and balance, with the goal of helping therapists select the most appropriate treatment. METHODS Sixteen healthy adults were included in a prospective, randomized, single-blind study. The subjects were randomly assigned to either the myofascial release or fascial distortion model groups. The outcome measures were functional reach test, pain pressure threshold, straight leg-raising test angle, and finger floor distance. RESULTS The myofascial release and fascial distortion model groups showed significantly increased straight leg-raising angle and finger floor distance, but no between-group differences were observed (p > .05). The fascial distortion model group demonstrated significantly better pain control (p < .05), which was also better than in the myofascial release group (p < .05). The myofascial release group showed significantly improved balance control (p < .05); however, there was no difference between the two groups (p > .05). CONCLUSIONS Either myofascial release or fascial distortion model can be chosen to improve the range of motion. However, if pain sensitivity is the goal, it is expected that the fascial distortion model will be more effective.
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Affiliation(s)
- Migyoung Kweon
- Department of Physical Therapy, Daegu University, Republic of Korea
| | - JiYoung Kim
- Department of Physical Therapy, Masan University, Republic of Korea.
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5
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Nafees K, Baig AAM, Ali SS, Ishaque F. Dynamic soft tissue mobilization versus proprioceptive neuromuscular facilitation in reducing hamstring muscle tightness in patients with knee osteoarthritis: a randomized control trial. BMC Musculoskelet Disord 2023; 24:447. [PMID: 37268961 DOI: 10.1186/s12891-023-06571-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 05/25/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) considered as one of the most common degenerative diseases of synovial joint. KOA is mostly managed by physical therapy, focused on pain management, the range of motion and muscle strengthening but muscle flexibility is usually neglected. A study was conducted to evaluate the effectiveness of dynamic soft tissue mobilization (DSTM) in comparison with the proprioceptive neuromuscular facilitation (PNF) stretching in the management of hamstring tightness, reduction of pain intensity and improvement of physical functionality in KOA. METHODS Forty eight patients with KOA were randomly allocated to group A receiving DTSM and group B receiving PNF stretching. The cryotherapy and isometric strengthening exercises were also given to both groups. Total treatment duration consisted of 4 weeks, 3 sessions per week and total 12 sessions per patient. Each treatment session comprised of 30 min. At baseline and post treatment, Active knee extension test(AKET), Visual analogue scale (VAS), and Knee Injury and Osteoarthritis Outcome Score (KOOS) were used to assess hamstring flexibility, pain intensity level and physical functional capability respectively. The continuous variables were shown as mean and standard deviations. For the comparison of outcome within and between groups, paired sample and independent t-test was applied. Considerable p value was less than 0.05. RESULTS The between group analysis of VAS, right AKE test, and left AKE test showed non-significant (p > 0.05) mean difference as 0.2 (95% CI= -0.29, 0.70), 1.79 (95% CI= -1.84, 4.59), 1.78 (95% CI= -1.6, 5.19) respectively. KOOS domains of symptom, pain, ADLs, sports and recreational, and quality of life had also non-significant (p > 0.05) mean difference as 1.12 (95% CI= -4.05, 6.3), -5.12 (95% CI= -12.71, 2.46), -2.55 (95% CI= -7.47, 2.38), -2.7 (95% CI= -9.72, 4.3), and - 0.68 (95% CI= -7.69, 6.36) respectively. Significant (p < 0.001) improvement was shown in both groups for all outcome measures after 12 sessions. CONCLUSION DSTM and PNF stretching, both treatments are equally beneficial in KOA for hamstring flexibility, pain reduction and functional mobility in terms of AKET, VAS, and KOOS respectively. TRIAL REGISTRATION ClincalTrials.Gov with ID: NCT04925895, 14/06/2021, retrospectively registered.
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Affiliation(s)
- Khadija Nafees
- Department of physiotherapy, Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi, Pakistan.
| | - Aftab Ahmed Mirza Baig
- Department of physiotherapy, Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan
| | - Syed Shahzad Ali
- Department of physiotherapy, Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan
| | - Farhan Ishaque
- Department of physiotherapy, Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi, Pakistan
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Sposato Sinderholm N, Bjerså K. Manual therapies in cystic fibrosis care: a scoping review. Chiropr Man Therap 2023; 31:7. [PMID: 36747207 PMCID: PMC9903555 DOI: 10.1186/s12998-023-00478-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/22/2023] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES To review the use of manual therapies (MT) for pain, respiratory muscle strength and pulmonary function in cystic fibrosis (CF) care. METHODS A search with a systematic approach was conducted by two independent reviewers, using the databases Medline, PubMed, Scopus and Cinahl from their respective inception dates to March 2021. RESULTS A total of 199 publications were initially screened by title and abstract, after which 190 were excluded. Following a full-text review of the remaining articles, six studies with a total of 234 participants were included. Decreased pain levels following MT were observed in two studies and, in three studies, patient reports on improvement in ease of breathing and peak airflow were presented. No significant effects on spirometry measures were observed and none of the included studies investigated respiratory muscle strength. CONCLUSION Current research on MT in CF care indicates positive trends based on subjective measures. However, research in this context is sparse and disparate in terms of both interventions and methodology. Further investigations including MT as part of multimodal interventions are therefore suggested before any specific recommendations for clinical implementation of MT in CF can be provided.
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Affiliation(s)
- Niklas Sposato Sinderholm
- grid.8761.80000 0000 9919 9582Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Kristofer Bjerså
- Department of Surgery, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden.
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Giandomenico D, Nuria R, Alessandro A, Matteo G, Mattia I, Marco T, Francesco C. Differences between experimental and placebo arms in manual therapy trials: a methodological review. BMC Med Res Methodol 2022; 22:219. [PMID: 35941533 PMCID: PMC9358888 DOI: 10.1186/s12874-022-01704-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/04/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND To measure the specific effectiveness of a given treatment in a randomised controlled trial, the intervention and control groups have to be similar in all factors not distinctive to the experimental treatment. The similarity of these non-specific factors can be defined as an equality assumption. The purpose of this review was to evaluate the equality assumptions in manual therapy trials. METHODS Relevant studies were identified through the following databases: EMBASE, MEDLINE, SCOPUS, WEB OF SCIENCE, Scholar Google, clinicaltrial.gov, the Cochrane Library, chiloras/MANTIS, PubMed Europe, Allied and Complementary Medicine (AMED), Physiotherapy Evidence Database (PEDro) and Sciencedirect. Studies investigating the effect of any manual intervention compared to at least one type of manual control were included. Data extraction and qualitative assessment were carried out independently by four reviewers, and the summary of results was reported following the PRISMA statement. RESULT Out of 108,903 retrieved studies, 311, enrolling a total of 17,308 patients, were included and divided into eight manual therapy trials categories. Equality assumption elements were grouped in three macro areas: patient-related, context-related and practitioner-related items. Results showed good quality in the reporting of context-related equality assumption items, potentially because largely included in pre-existent guidelines. There was a general lack of attention to the patient- and practitioner-related equality assumption items. CONCLUSION Our results showed that the similarity between experimental and sham interventions is limited, affecting, therefore, the strength of the evidence. Based on the results, methodological aspects for planning future trials were discussed and recommendations to control for equality assumption were provided.
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Affiliation(s)
- D.’Alessandro Giandomenico
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,Centre Pour L’Etude, La Recherche Et La Diffusion Ostéopathiques “C.E.R.D.O”, 00199 Rome, Italy
| | - Ruffini Nuria
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,Foundation C.O.ME. Collaboration, National Centre Germany, 10825 Berlin, Germany
| | - Aquino Alessandro
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,grid.4708.b0000 0004 1757 2822Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Galli Matteo
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Innocenti Mattia
- Centre Pour L’Etude, La Recherche Et La Diffusion Ostéopathiques “C.E.R.D.O”, 00199 Rome, Italy
| | - Tramontano Marco
- grid.417778.a0000 0001 0692 3437Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Cerritelli Francesco
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy
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Toloui-Wallace J, Forbes R, Thomson OP, Setchell J. When worlds collide: Experiences of physiotherapists, chiropractors, and osteopaths working together. Musculoskelet Sci Pract 2022; 60:102564. [PMID: 35462317 DOI: 10.1016/j.msksp.2022.102564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND In Australia, people with musculoskeletal conditions frequently seek care from chiropractors, osteopaths, and physiotherapists. Intertwined histories, distinct philosophies and practical tensions characterise relationships between these three professions, yet little is known about contact or collaboration between individual clinicians. OBJECTIVES To explore the experiences of osteopaths, physiotherapists and chiropractors who work together in the same clinic location and explore their attitudes towards each other. METHODS Utilising a predominantly inductive qualitative research design, semi-structured interviews were undertaken with a total of 13 clinicians (physiotherapists [n=6], chiropractors [n=2], osteopaths [n=4], dual-qualified chiropractor and physiotherapist [n=1]) who work with at least one clinician from the other two professions. Interviews were analysed using reflexive thematic analysis. RESULTS Data analysis produced two main themes and five sub-themes that characterised clinicians' experiences and attitudes: collaboration (collaborative practices; benefits of collaboration) and resisting tension (accepting similarities and differences to work towards shared goals; clinic culture; alignment with evidence-based practice). These findings can be understood in the context of the concepts of professional boundary-work and intergroup contact theory. CONCLUSIONS The findings from this study suggest that physiotherapists, chiropractors and osteopaths that work together in the same clinic may collaborate while simultaneously navigating blurred professional lines. These results suggest that working together in the same clinic is a meaningful form of contact, which in turn allows for collaborative practices that may reduce intergroup tension between professions.
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Affiliation(s)
- Joshua Toloui-Wallace
- School of Health & Rehabilitation Sciences, The University of Queensland, 84a Services Rd, St Lucia, QLD, 4072, Australia.
| | - Roma Forbes
- School of Health & Rehabilitation Sciences, The University of Queensland, 84a Services Rd, St Lucia, QLD, 4072, Australia.
| | - Oliver P Thomson
- University College of Osteopathy, 275 Borough High Street, London, SE1 1JE, United Kingdom.
| | - Jenny Setchell
- School of Health & Rehabilitation Sciences, The University of Queensland, 84a Services Rd, St Lucia, QLD, 4072, Australia.
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Santos TS, Oliveira KKB, Martins LV, Vidal APC. Effects of manual therapy on body posture: Systematic review and meta-analysis. Gait Posture 2022; 96:280-294. [PMID: 35738063 DOI: 10.1016/j.gaitpost.2022.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/11/2022] [Accepted: 06/16/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Several clinical trials investigated the effectiveness of MT on body posture, but a systematic review grouping the results of these studies was not found in the literature. RESEARCH QUESTION Does manual therapy (MT) cause postural changes? METHODS Inclusion criteria were: randomized controlled trials in any population; studies in which the primary intervention was the use of any MT technique; studies that evaluated the immediate, short, medium, or long-term effects of interventions on body posture; and studies published in peer-reviewed scientific journals in any year and language. In March 2022, we conducted a search in the PUBMED, Cinahl, Embase, PEDro, and Cochrane Central databases that yielded 6627 articles, of which 38 including 1597 participants were eligible; of these, 35 could be grouped into 12 meta-analyses. The risk of bias was assessed using the PEDro scale and the certainty in the scientific evidence rated through the GRADE system. RESULTS The results allowed us to conclude with moderate certainty in the evidence that, when compared to no intervention or sham, in the short and medium term, MT reduced the forward head posture (14 studies, 584 individuals, 95%CI 0.38, 1.06), reduced thoracic kyphosis (5 studies, 217 individuals, 95%CI 0.37, 0.94), improved lateral pelvic tilt (5 studies, 211 individuals, 95%CI 0.11, 0.67) and pelvic torsion (2 studies, 120 individuals, 95%CI 0.44, 1.19) and increased plantar area (3 studies, 134 individuals, 95%CI 0.04, 0.74). With moderate certainty, there was no significant effect on shoulder protrusion (5 studies, 176 individuals, 95%CI -0.11, 0.61), shoulder alignment in the frontal plane (3 studies, 160 individuals, 95%CI -0.15, 0.52), scoliosis (2 studies, 26 individuals, 95%CI -1.57, 2.19), and pelvic anteversion (5 studies, 233 individuals, 95%CI -0.02, 0.51). With low certainty, MT had no effect on scapular upward rotation (2 studies, 74 individuals, 95%CI -0.76, 2.17). With low to very low certainty, it is possible to conclude that MT was not superior to other interventions in the short or medium term regarding the improvement of forward head posture (5 studies, 170 individuals, 95%CI -1.39, 0.67) and shoulder protrusion (3 studies, 94 individuals, 95%CI -4.04, 0.97). SIGNIFICANCE MT can be recommended to improve forward head posture, thoracic kyphosis and pelvic alignment in the short and medium term, but not shoulder posture and scoliosis. MT reduces the height of the plantar arch and this must be taken into account in physical therapy planning. PROSPERO registration number: CRD42021244423.
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Affiliation(s)
- T S Santos
- Federal University of Espírito Santo, Brazil
| | | | - L V Martins
- Federal University of Espírito Santo, Brazil
| | - A P C Vidal
- Federal University of Espírito Santo, Brazil.
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Norouzi A, Delkhoush CT, Mirmohammadkhani M, Bagheri R. A comparison of mobilization and mobilization with movement on pain and range of motion in people with lateral ankle sprain: A randomized clinical trial. J Bodyw Mov Ther 2021; 27:654-660. [PMID: 34391302 DOI: 10.1016/j.jbmt.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 03/18/2021] [Accepted: 05/07/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Maitland and Mulligan mobilization techniques are two manual therapy methods to increase the range of motion following immobility treatment. The present study was conducted to compare two therapeutic methods, namely mobilization and mobilization with movement (MWM), on the pain and range of motion in people with lateral ankle sprain. METHODS A total of 40 individuals with grade two lateral ankle sprain were randomly divided into two groups, including the Maitland's mobilization intervention group, and the Mulligan's mobilization intervention group. Both groups underwent treatment every other day for two consecutive weeks. The pain intensity was measured using the Visual Analogue Scale (VAS), and the ankle dorsiflexion movement range using the Weight Bearing Lunge Test (WBLT) before and one day after the intervention. RESULTS There were no significant differences between the two groups in terms of pain (P = 0.297) and range of motion (P = 0.294) before the intervention. Meanwhile, after the intervention, a significant change was observed in both groups in terms of these variables, which indicates the effectiveness of both interventions (P < 0.001) and the greater effect of the mobilization with movement in reducing pain (P = 0.037) and increasing the range of motion (P = 0.021). CONCLUSIONS Both techniques significantly improved the range of motion and reduced pain in people with lateral ankle sprain, but Mulligan's technique was significantly more effective among the two, perhaps due to joining active and passive mobilizing tensile forces as well as interaction of afferents and efferents in the reflex arc.
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Affiliation(s)
- Adeleh Norouzi
- Department of Physiotherapy, Rehabilitation Faculty, Semnan University of Medical Sciences, Semnan, Iran.
| | | | - Majid Mirmohammadkhani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Rasool Bagheri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
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Corts M. [Cause-effect chains after distal radius fracture from an osteopathic perspective]. Unfallchirurg 2021; 124:446-455. [PMID: 33929551 DOI: 10.1007/s00113-021-00998-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 11/28/2022]
Abstract
Osteopathy as a manual procedure is an important therapeutic tool in postoperative care. The essence of diagnostic and manual medical procedures in osteopathy is explained. The clinical procedure of osteopathic work is presented on the basis of a case study of a distal radius fracture and cause-effect chains are dealt with in depth. Pain can have its origin in another region of the body than where it occurs. The functional significance of the fasciae and myofascial chains is examined in more detail. Finally, the range of applications and effects of osteopathy in postoperative care are presented.
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Affiliation(s)
- M Corts
- , Elisenstr. 1, 50667, Köln, Deutschland.
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12
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Martínez-Lema D, Guede-Rojas F, González-Fernández K, Soto-Martínez A, Lagos-Hausheer L, Vergara-Ríos C, Márquez-Mayorga H, Mancilla CS. Immediate effects of a direct myofascial release technique on hip and cervical flexibility in inactive females with hamstring shortening: A randomized controlled trial. J Bodyw Mov Ther 2020; 26:57-63. [PMID: 33992297 DOI: 10.1016/j.jbmt.2020.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 12/01/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Currently, greater background is required about the effectiveness of myofascial release (MFR) on muscle flexibility. OBJECTIVE Our goal was to determine the immediate effect of a direct MFR technique on hip and cervical flexibility in inactive females with hamstring shortening. METHOD The sample group included 68 female university students, randomly divided into a control group (n = 34) and an experimental group (n = 34). A placebo technique was used with the control group, and direct MFR on the posterior thigh region was used with the experimental group. RESULTS The mixed factorial ANOVA did not show significant intergroup differences (p > 0.05). In the experimental group, Bonferroni post hoc test showed significant intragroup differences between pre-test and post-test 1, as well as between pre-test and post-test 2 for the three ischiotibial muscle flexibility tests (p < 0.001). Cervical flexion range of motion showed significant differences between pre-test and post-test 1 (p < 0.001). CONCLUSIONS We conclude that the protocol based on a single direct MFR intervention was no more effective than the placebo in improving flexibility both locally at the hamstring level and remotely at the level of the cervical extensor muscles. Future research should consider different MFR techniques on the immediate increase in muscle flexibility and the long-term effect of MFR, as well as consider different intervention groups.
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Affiliation(s)
- Daniel Martínez-Lema
- Kinesiology, Faculty of Health Sciences, GICAV, Universidad Arturo Prat, Victoria, Chile.
| | - Francisco Guede-Rojas
- Kinesiology, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Concepción, Chile.
| | | | - Adolfo Soto-Martínez
- Kinesiology, Faculty of Health Sciences, Universidad de Las Américas, Concepción, Chile.
| | | | - César Vergara-Ríos
- Kinesiology, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Concepción, Chile.
| | - Héctor Márquez-Mayorga
- Kinesiology, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Concepción, Chile.
| | - Carlos S Mancilla
- Kinesiology, Faculty of Health Sciences, GICAV, Universidad Arturo Prat, Victoria, Chile.
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13
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Marin T, Maxel X, Robin A, Stubbe L. Evidence-based assessment of potential therapeutic effects of adjunct osteopathic medicine for multidisciplinary care of acute and convalescent COVID-19 patients. Explore (NY) 2020; 17:141-147. [PMID: 33158784 PMCID: PMC7516474 DOI: 10.1016/j.explore.2020.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/12/2020] [Accepted: 09/13/2020] [Indexed: 12/28/2022]
Abstract
Although the COVID-19 pandemic affects predominantly the respiratory function, epidemiological studies show that multiple systems can be affected. The severe complications of SARS-CoV-2 infection seem to be induced by an inflammatory dysregulation (“cytokine storm”), which can also induce an immunodepression. Several studies highlight beneficial effects of osteopathic medicine on inflammation and immune regulation. A careful review of evidence-based literature brings to the fore significant improvements of osteopathic manipulative treatment (OMT) in adjunction to conventional care. OMT can improve the condition of infected patients by decreasing symptoms and boosting the efficiency of conventional care. OMT might also benefit surviving patients by reducing the long-lasting consequences of the infection as well as improving their quality of life during convalescence. This review should constitute an argument in favor of multidisciplinary care, although further biological and clinical research is essential to better assess the potential beneficial contributions of adjunct osteopathic medicine to conventional care in the fight against pandemics such as COVID-19.
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Affiliation(s)
- Thibault Marin
- ESO Paris Recherche, Ecole Supérieure d'Ostéopathie, Cité Descartes, 77420 Champs sur Marne, France; Laboratoire Performance, Santé, Métrologie, Société (PSMS, EA 7507), UFR STAPS, Campus Moulin de la Housse, Université de Reims Champagne-Ardenne, Chemin des Rouliers, 51100 Reims, France
| | - Xuan Maxel
- ESO Paris Recherche, Ecole Supérieure d'Ostéopathie, Cité Descartes, 77420 Champs sur Marne, France.
| | - Alexandra Robin
- ESO Paris Recherche, Ecole Supérieure d'Ostéopathie, Cité Descartes, 77420 Champs sur Marne, France
| | - Laurent Stubbe
- ESO Paris Recherche, Ecole Supérieure d'Ostéopathie, Cité Descartes, 77420 Champs sur Marne, France
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14
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Skillgate E, Pico-Espinosa OJ, Côté P, Jensen I, Viklund P, Bottai M, Holm LW. Effectiveness of deep tissue massage therapy, and supervised strengthening and stretching exercises for subacute or persistent disabling neck pain. The Stockholm Neck (STONE) randomized controlled trial. Musculoskelet Sci Pract 2020; 45:102070. [PMID: 31655314 DOI: 10.1016/j.msksp.2019.102070] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/25/2019] [Accepted: 10/08/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the effectiveness of deep tissue massage, supervised strengthening and stretching exercises, and a combined therapy (exercise followed by massage) (index groups), with advice to stay active (control group). METHODS Randomized controlled trial of 619 adults with subacute or persistent neck pain allocated to massage (n = 145), exercise (n = 160), combined therapy (n = 169) or advice (n = 147). Primary outcomes were minimal clinically important improvements in neck pain intensity and pain-related disability based on adapted questions from the Chronic Pain Questionnaire. Secondary outcomes were perceived recovery and sickness absence. Outcomes were measured at seven, 12, 26 and 52 weeks. RESULTS We found improvement in pain intensity favouring massage and combined therapy compared to advice; at seven weeks (RR = 1.36; 95%CI:1.04-1.77) and 26 weeks (RR = 1.23; 95%CI:0.97-1.56); and seven (RR = 1.39; 95%CI:1.08-1.81) and 12 weeks (RR = 1.28; 95%CI:1.02-1.60) respectively, but not at later follow-ups. Exercise showed higher improvement of pain intensity at 26 weeks (RR = 1.31; 95%CI:1.04-1.65). Perceived recovery was higher in the index groups than in the advice group at all follow-ups. We found no consistent differences in pain related disability or sickness absence. CONCLUSIONS In this study, at 12-months follow-up, none of the index therapies were more effective than advice in terms of pain intensity in the long term or in terms of pain-related disability in the short or long term. However, the index therapies led to higher incidence of improvement in pain intensity in the short term, and higher incidence of favorable perceived recovery in the short and in the long term than advice. TRIAL REGISTRATION ISRCTN01453590. Registered 3 July 2014.
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Affiliation(s)
- Eva Skillgate
- Musculoskeletal and Sports Injury Epidemiology Center, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Naprapathögskolan - Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
| | - Oscar Javier Pico-Espinosa
- Musculoskeletal and Sports Injury Epidemiology Center, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Pierre Côté
- Faculty of Health Sciences and UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology, Toronto, Canada
| | - Irene Jensen
- Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Peter Viklund
- Musculoskeletal and Sports Injury Epidemiology Center, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Naprapathögskolan - Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
| | - Matteo Bottai
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lena W Holm
- Musculoskeletal and Sports Injury Epidemiology Center, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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15
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Abbott JH, Wilson R, Pinto D, Chapple CM, Wright AA. Incremental clinical effectiveness and cost effectiveness of providing supervised physiotherapy in addition to usual medical care in patients with osteoarthritis of the hip or knee: 2-year results of the MOA randomised controlled trial. Osteoarthritis Cartilage 2019; 27:424-434. [PMID: 30553932 DOI: 10.1016/j.joca.2018.12.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 12/02/2018] [Accepted: 12/06/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the clinical- and cost-effectiveness at 2-year follow-up of providing individual, supervised exercise physiotherapy and/or manual physiotherapy in addition to usual medical care. METHOD People with hip or knee osteoarthritis meeting the American College of Rheumatology clinical diagnostic criteria were randomised (1:1, concealed, assessor-blinded) to four groups: usual medical care; supervised exercise physiotherapy; manual physiotherapy; or combined exercise and manual physiotherapy. Physiotherapy group participants were provided 10 50-min treatment sessions including booster sessions at 4 and 13 months, in addition to usual care. The primary outcome at 2-year follow-up was incremental cost-utility ratio (ICUR) of each physiotherapy intervention in addition to usual care, compared with usual care alone, from the health system and societal perspectives. To allow interpretation of negative ICURs, we report incremental net benefit (INB). The primary clinical outcome was the Western Ontario and McMaster Osteoarthritis Index (WOMAC). RESULTS Of 206 patients, 186 (90·3%) were retained at 2-year follow-up. Exercise physiotherapy and manual physiotherapy dominated usual care, demonstrating cost savings; combined therapy did not. Exercise therapy had the highest incremental net benefits (INBs), statistically significant at all willingness-to-pay (base-case: societal New Zealand (NZ)$6,312, 95%CI 334 to 12,279; health system NZ$8,065, 95%CI 136 to 15,994). Clinical improvements were superior to usual care only in the exercise physiotherapy group (-28.2 WOMAC points, 95%CI -49.2 to -7.1). No serious adverse events were recorded. CONCLUSION Individually supervised exercise therapy is cost-effective and clinically effective in addition to usual medical care at 2-year follow-up, and leads to cost savings for the health system and society. TRIAL REGISTRATION Prospectively registered with the Australian NZ Clinical Trials Registry, reference ACTRN12608000130369.
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Affiliation(s)
- J H Abbott
- Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, 9054, New Zealand.
| | - R Wilson
- Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, 9054, New Zealand.
| | - D Pinto
- College of Health Sciences, Program in Physical Therapy, Marquette University, Milwaukee, WI, USA.
| | - C M Chapple
- Centre for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, 9054, New Zealand.
| | - A A Wright
- Department of Physical Therapy, High Point University, High Point, NC, USA.
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16
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Crockett KL, Bourassa R, Friesen T. Anterior disc derangement with reduction of the temporomandibular joint: a case report. J Med Case Rep 2018; 12:148. [PMID: 29803229 PMCID: PMC5971088 DOI: 10.1186/s13256-018-1637-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 03/04/2018] [Indexed: 11/10/2022] Open
Abstract
Background Temporomandibular dysfunction involving anterior disc derangement with or without reduction, secondary to posterior ligament insufficiency is typically managed conservatively with success in a majority of patients. When conservative management fails, the next step in the continuum of care is unclear. Platelet-rich plasma injection combined with a 3-week immobilization period may be effective in treating posterior ligament insufficiency following a period of physical therapy. The result of this case was exceptionally successful, with the patient reporting 100% improvement 6 months post-injection. Prior to this case, we predicted a 20% success rate based on her inability to maintain the effects of conservative management over the long term. Case presentation A 33-year-old white woman presented with temporomandibular dysfunction, which responded to an initial course of physical therapy aimed at restoring the mechanics of her temporomandibular joint, exercise management, and education on self-management strategies. She returned 20 months later and responded well to another course of physical therapy. Despite improvement in pain, range of motion, and mechanics, she continued to present with a reduction click at the end range of opening. The crisp and loud nature of the reduction click indicated a viable posterior ligament and reduction of the anteriorly displaced disc. She opted for platelet-rich plasma injection, provided by a chronic pain specialist with the assistance of a physical therapist. She was immobilized for 3 weeks, followed by a weaning period with reduced posterior support for an additional 5 weeks. Follow-up appointments with a physical therapist occurred at 3 weeks, 8 weeks, and 6 months post-injection. Conclusions At 6 months, she reported 100% improvement. Objectively, there was no indication that the disc condyle relationship was disrupted. At 6 months post-platelet-rich plasma injection, preceded by a period of conservative physical therapy management, and followed with appropriate physical therapy follow-up, this individual had complete resolution of her anterior disc derangement with reduction. Electronic supplementary material The online version of this article (10.1186/s13256-018-1637-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katie L Crockett
- Bourassa and Associates Rehabilitation Centre, 109-294 Venture Cres, Saskatoon, SK, S7K 6M1, Canada. .,School of Physical Therapy, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Richard Bourassa
- Bourassa and Associates Rehabilitation Centre, 109-294 Venture Cres, Saskatoon, SK, S7K 6M1, Canada.,School of Physical Therapy, University of Saskatchewan, Saskatoon, SK, Canada
| | - Tyler Friesen
- Bourassa and Associates Rehabilitation Centre, 109-294 Venture Cres, Saskatoon, SK, S7K 6M1, Canada
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17
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Clark BC, Russ DW, Nakazawa M, France CR, Walkowski S, Law TD, Applegate M, Mahato N, Lietkam S, Odenthal J, Corcos D, Hain S, Sindelar B, Ploutz-Snyder RJ, Thomas JS. A randomized control trial to determine the effectiveness and physiological effects of spinal manipulation and spinal mobilization compared to each other and a sham condition in patients with chronic low back pain: Study protocol for The RELIEF Study. Contemp Clin Trials 2018; 70:41-52. [PMID: 29792940 DOI: 10.1016/j.cct.2018.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 05/08/2018] [Accepted: 05/18/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Low back pain (LBP) is one of the most common reasons for seeking medical care. Manipulative therapies are a common treatment for LBP. Few studies have compared the effectiveness of different types of manipulative therapies. Moreover, the physiologic mechanisms underlying these treatments are not fully understood. Herein, we present the study protocol for The Researching the Effectiveness of Lumbar Interventions for Enhancing Function Study (The RELIEF Study). METHODS AND STUDY DESIGN The RELIEF Study is a Phase II RCT with a nested mechanistic design. It is a single-blinded, sham-controlled study to test the mechanisms and effectiveness of two manual therapy techniques applied to individuals (n = 162; 18-45 years of age) with chronic LBP. The clinical outcome data from the mechanistic component will be pooled across experiments to permit an exploratory Phase II RCT investigating the effectiveness. Participants will be randomized into one of three separate experiments that constitute the mechanistic component to determine the muscular, spinal, and cortical effects of manual therapies. Within each of these experimental groups study participants will be randomly assigned to one of the three treatment arms: 1) spinal manipulation, 2) spinal mobilization, or 3) sham laser therapy. Treatments will be delivered twice per week for 3-weeks. DISCUSSION This data from this will shed light on the mechanisms underlying popular treatments for LBP. Additionally, the coupling of this basic science work in the context of a clinical trial will also permit examination of the clinical efficacy of two different types of manipulative therapies.
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18
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Ribeiro DC, Sole G, Venkat R, Shemmell J. Differences between clinician- and self-administered shoulder sustained mobilization on scapular and shoulder muscle activity during shoulder abduction: A repeated-measures study on asymptomatic individuals. Musculoskelet Sci Pract 2017; 30:25-33. [PMID: 28499143 DOI: 10.1016/j.msksp.2017.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 04/10/2017] [Accepted: 04/29/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Sustained glenohumeral postero-lateral glide administered by a clinician is commonly used in the management of patients with shoulder pain. This technique reduced shoulder muscle activity in asymptomatic individuals, but it is unknown whether a self-administered version of the mobilization leads to similar neuromuscular response. This study compared the effect of sustained shoulder mobilizations (performed by a physiotherapist) with self-administered mobilization (with a belt) on activity levels of scapular and glenohumeral shoulder muscles. METHODS Twenty-two individuals participated in this study, which had a cross-over, repeated measures design. Seven shoulder muscles (upper and lower trapezius, supraspinatus, infraspinatus, posterior deltoid, middle deltoid, and serratus anterior) were monitored using surface electromyography (SEMG) during shoulder abduction performed with a clinician-administered sustained mobilization, and with self-administered sustained mobilization. Muscle activity levels were measured prior, during and after the sustained glide was applied to the shoulder. Mixed-effect models for repeated measures were used for within- and between-condition comparisons. RESULTS There was no carry-over effect. Within-condition comparisons suggest that both interventions lead to changes in scapular and shoulder muscle activity levels. No differences between clinician-administered and self-administered mobilizations at intervention and follow-up were found for the monitored muscles, with the exception of upper trapezius. CONCLUSIONS In young, asymptomatic individuals, self- or clinician-administered sustained mobilizations reduced activity levels of most scapular and shoulder muscles during shoulder abduction. This effect was observed only while the sustained glides were applied to the shoulder. At the immediate follow-up, muscle activity levels were similar to baseline measurements.
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Affiliation(s)
- Daniel Cury Ribeiro
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, Otago, New Zealand.
| | - Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, Otago, New Zealand
| | - Ramu Venkat
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, Otago, New Zealand
| | - Jonathan Shemmell
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, Otago, New Zealand
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19
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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20
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Kayser R, Harke G. [Manual medicine and osteopathic methods on the growing spine]. Orthopade 2016; 45:527-33. [PMID: 27255905 DOI: 10.1007/s00132-016-3276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The application of various techniques in manual medicine on infants, toddlers and adolescents enjoys widespread acknowledgement not only in the musculoskeletal field but also beyond that. For a long time, the seminars of the DGMM have been trying to structure the advanced training of doctors and the vocational training of physiotherapists and to adjust it according to the latest clinical and scientific findings (in this subject matter). Considering the controversial debates, this seems particularly necessary and meaningful. This article aims to identify the current state of discussion and the consensus between medical associations but it also means to provide assistance in daily routine.
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Affiliation(s)
- R Kayser
- Abt. Orthopädie, MEDIAN-Klinik Wismar, Ernst-Scheel-Str. 28, 23986, Wismar, Deutschland. .,Universitätsmedizin Greifswald, Fleischmannstr. 8, 17489, Greifswald, Deutschland. .,Ärztevereinigung für Manuelle Medizin, Ärzteseminar Berlin (ÄMM), Deutsche Gesellschaft für Manuelle Medizin (DGMM), Köpenicker Str. 48/49, 10179, Berlin, Deutschland.
| | - G Harke
- Manuelle Medizin und Osteopathie, Praxis für Physikalische und Rehabilitative Medizin, Schlossstr. 26, 12163, Berlin, Deutschland.,Ärztevereinigung für Manuelle Medizin, Ärzteseminar Berlin (ÄMM), Deutsche Gesellschaft für Manuelle Medizin (DGMM), Köpenicker Str. 48/49, 10179, Berlin, Deutschland
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Abstract
Pseudo-radicular leg pain as initially described by Bruegger more than 55 years ago was at that time a genius explanation for so many non-radicular pain syndromes that needed not any kind of surgical intervention but in first line a manual treatment or a treatment by therapeutic local anesthetics. Today we describe this pain as a "referred pain" originating from other anatomic structures that may occur during the development of chronic pain. Nevertheless this pain is found in many patients and it still seems to be a big problem for many physicians and surgeons. Imaging does not help either. The history and the clinical symptoms, the examinations, the chain reactions in the motor system as well as the treatment options from the point of view of manual medicine are described.
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Affiliation(s)
- W von Heymann
- Orthopädische Praxis, Mendestr. 7, 28203, Bremen, Deutschland.
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22
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Twist E, Lawrence DJ, Salsbury SA, Hawk C. Do informed consent documents for chiropractic clinical research studies meet readability level recommendations and contain required elements: a descriptive study. Chiropr Man Therap 2014; 22:40. [PMID: 25505516 PMCID: PMC4261587 DOI: 10.1186/s12998-014-0040-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 10/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Informed consent documents (ICD) in research are designed to educate research participants about the nature of the research project in which he or she may participate. United States (US) law requires the documents to contain specific elements present and be written in a way that is understandable to research participants. The purpose of this research is to determine if ICDs from randomized controlled trials conducted at chiropractic colleges meet recommended readability standards and contain the 13 content items required by US law. METHODS This study was approved by Palmer College of Chiropractic's IRB #2012-12-3-T and was conducted between December 3, 2012 and February 14, 2013. We contacted the research directors of five chiropractic colleges that have received federal funding supporting their clinical research. A total of 13 informed consent documents from four chiropractic colleges were analyzed using the Flesch-Kincaid measurement. We assigned a grade-level readability score to the document based on the average of three separate grade level scores conducted on the three largest uninterrupted blocks of text. Content of the 13 ICDs was assessed using a 13-element checklist. A point was given for every element present in the document, giving a score range of "0, no elements are present", to "13, all elements are present." RESULTS The mean Flesch-Kincaid grade level readability was 10.8 (range 7.2 -14.0). Our sample had a mean readability score 2.8 grade levels above the generally-accepted US average reading level. Content varied among the 13 informed consent forms, ranging from only nine elements present in one document to all 13 required in five documents. Additionally, we collated the risks presented in each document. CONCLUSION These results strongly suggest that chiropractic clinical researchers are not developing ICDs at a readability level congruent with the national average acceptable level. The low number of elements in some of the informed consent documents raises concern that not all research participants were fully informed when given the informed consent, and it may suggest that some documents may not be in compliance with federal requirements. Risk varies among institutions and even within institutions for the same intervention.
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Affiliation(s)
- Elissa Twist
- Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA 52803 USA
| | - Dana J Lawrence
- Palmer College of Chiropractic, 1000 Brady St., Davenport, IA 52803 USA
| | - Stacie A Salsbury
- Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA 52803 USA
| | - Cheryl Hawk
- Logan University, 1851 Schoettler Rd., Chesterfield, MO 63017 USA
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Pinto D, Robertson MC, Abbott JH, Hansen P, Campbell AJ. Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee. 2: economic evaluation alongside a randomized controlled trial. Osteoarthritis Cartilage 2013; 21:1504-13. [PMID: 23811491 DOI: 10.1016/j.joca.2013.06.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 04/28/2013] [Accepted: 06/13/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the cost effectiveness of manual physiotherapy, exercise physiotherapy, and a combination of these therapies for patients with osteoarthritis of the hip or knee. METHODS 206 Adults who met the American College of Rheumatology criteria for hip or knee osteoarthritis were included in an economic evaluation from the perspectives of the New Zealand health system and society alongside a randomized controlled trial. Resource use was collected using the Osteoarthritis Costs and Consequences Questionnaire. Quality-adjusted life years (QALYs) were calculated using the Short Form 6D. Willingness-to-pay threshold values were based on one to three times New Zealand's gross domestic product (GDP) per capita of NZ$ 29,149 (in 2009). RESULTS All three treatment programmes resulted in incremental QALY gains relative to usual care. From the perspective of the New Zealand health system, exercise therapy was the only treatment to result in an incremental cost utility ratio under one time GDP per capita at NZ$ 26,400 (-$34,081 to $103,899). From the societal perspective manual therapy was cost saving relative to usual care for most scenarios studied. Exercise therapy resulted in incremental cost utility ratios regarded as cost effective but was not cost saving. For most scenarios combined therapy was not as cost effective as the two therapies alone. CONCLUSIONS In this study, exercise therapy and manual therapy were more cost effective than usual care at policy relevant values of willingness-to-pay from both the perspective of the health system and society. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12608000130369.
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Affiliation(s)
- D Pinto
- Department of Physical Therapy and Human Movement Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Teys P, Bisset L, Collins N, Coombes B, Vicenzino B. One-week time course of the effects of Mulligan's Mobilisation with Movement and taping in painful shoulders. ACTA ACUST UNITED AC 2013; 18:372-7. [PMID: 23391760 DOI: 10.1016/j.math.2013.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 12/29/2012] [Accepted: 01/04/2013] [Indexed: 11/20/2022]
Abstract
Previous research suggests that Mulligan's Mobilisation-with-Movement (MWM) technique for the shoulder produces an immediate improvement in movement and pain. The aims of this study were to investigate the time course of the effects of a single MWM technique and to ascertain the effects of adding tape following MWM in people with shoulder pain. Twenty-five participants (15 males, 10 females), who responded positively to an initial application of MWM, were randomly assigned to MWM or MWM-with-Tape. Range of movement (ROM), pressure pain threshold (PPT) and current pain severity (PVAS) were measured pre- and post-intervention, 30-min, 24-h and one week follow-up. Following a one-week washout period, participants were crossed over to receive a single session of the opposite intervention with follow-up measures repeated. ROM significantly improved with MWM-with-Tape and was sustained over one week follow-up (p < 0.001; 18.8°, 95% confidence intervals (CI) 7.3-30.4), and in PVAS up to 30-min follow-up (38.4 mm, 95% CI 20.6-56.1 mm). MWM demonstrated an improvement in ROM (11.8°, 95% CI 1.9-21.7) and PVAS (40.4 mm, 95% CI 27.8-53.0 mm), but only up to 30-min follow-up. There was no significant improvement in PPT for either intervention at any time point. MWM-with-Tape significantly improved ROM over the one-week follow-up compared to MWM alone (15.9°, 95% CI 7.4-24.4). Both MWM and MWM-with-Tape provide a short-lasting improvement in pain and ROM, and MWM-with-Tape also provides a sustained improvement in ROM to one-week follow-up, which is superior to MWM alone.
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Sánchez-Rebull MV, Terceño Gómez A, Travé Bautista A. [Cost of therapy for neurodegenerative diseases. Applying an activity-based costing system]. Gac Sanit 2013; 27:406-10. [PMID: 23333030 DOI: 10.1016/j.gaceta.2012.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 11/28/2012] [Accepted: 12/04/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To apply the activity based costing (ABC) model to calculate the cost of therapy for neurodegenerative disorders in order to improve hospital management and allocate resources more efficiently. METHOD We used the case study method in the Francolí long-term care day center. We applied all phases of an ABC system to quantify the cost of the activities developed in the center. We identified 60 activities; the information was collected in June 2009. RESULTS The ABC system allowed us to calculate the average cost per patient with respect to the therapies received. The most costly and commonly applied technique was psycho-stimulation therapy. Focusing on this therapy and on others related to the admissions process could lead to significant cost savings. CONCLUSIONS ABC costing is a viable method for costing activities and therapies in long-term day care centers because it can be adapted to their structure and standard practice. This type of costing allows the costs of each activity and therapy, or combination of therapies, to be determined and aids measures to improve management.
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Affiliation(s)
- María-Victoria Sánchez-Rebull
- Departamento de Gestión de Empresas, Facultad de Economía y Empresa, Universitat Rovira i Virgili, Reus (Tarragona), España.
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Takasaki H, May S, Fazey PJ, Hall T. Nucleus pulposus deformation following application of mechanical diagnosis and therapy: a single case report with magnetic resonance imaging. J Man Manip Ther 2011; 18:153-8. [PMID: 21886426 DOI: 10.1179/106698110x12640740712455] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND The McKenzie management strategy of mechanical diagnosis and therapy (MDT) is commonly used for the assessment and management of spinal problems. Within this system, 'derangement syndrome' is the most common classification, for which the conceptual model is an intra-discal displacement. However, the reduction of an intra-discal displacement by MDT has never been documented. The purpose of this study was to compare, using magnetic resonance imaging (MRI), the nucleus pulposus (NP) profiles before and after the use of this approach. PATIENT CHARACTERISTICS The patient was a 34-year-old female with a long history of right sided low back and buttock pain classified with 'derangement syndrome'. EXAMINATION T2-weighted images of the L4-5 disc at initial assessment were compared with that at final assessment 1 month later. Initially, the MRI showed a portion of the NP displaced right and posteriorly towards the side of pain, and an overall NP position in the coronal plane shifted to the left. INTERVENTION The patient was managed with a 1-month course of the McKenzie management strategy treatment. OUTCOMES One month later, the displaced portion of the NP was no longer present and the left-shifted NP was centrally located. DISCUSSION These intervertebral disc changes coincided with centralization and abolition of symptoms. This case may support the conceptual model of MDT.
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Affiliation(s)
- Hiroshi Takasaki
- Division of Physiotherapy, School of Health and Rehabilitation Science, The University of Queensland, Australia
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