Journal of Manipulative and Physiological Therapeutics

Dynamic Chiropractic,  Jun 4, 2007  

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Abstracts for March/April 2007 * Volume 30 - No. 3

Editor's note: Due to space constraints, we are unable to reprint all of the abstracts from the March/April 2007 issue of JMPT. To review the complete table of contents for the March/April issue, visit www.mosby.com/jmpt.

Chiropracticcare of musculoskeletal disorders in a unique population within Canadian community health centers.

Michael J. Garner, MSc, Peter Aker, MSc, DC, Jeff Balon, DC, MD, Michael Birmingham, PhD, David Moher, PhD, Dirk Keenan, DC, Pran Manga, PhD

Objective: This study was part of a larger demonstration project integrating chiropractic care into publicly funded Canadian community health centers. This pre/ post study investigated the effectiveness of chiropractic care in reducing pain and disability as well as improving general health status in a unique population of urban, low-income, and multiethnic patients with musculoskeletal (MSK) complaints.

Methods: All patients who presented to one of two community health center-based chiropractic clinics with MSK complaints between August 2004 and December 2005 were recruited to participate in this study. Outcomes were assessed by a general health measure (Short Form-12), a pain scale (VAS), and site-specific disability indexes (Roland-Morris Questionnaire and Neck Disability Index), which were administered before and after a 12-week treatment period.

Results: Three hundred twentyfour patients with MSK conditions were recruited into the study, and 259 (80.0%) of them were followed to the study's conclusion. Clinically important and statistically significant positive changes were observed for all outcomes (Short Form-12: physical composite score mean change = 4.9, 95% confidence interval [CI] = 3.8-6.0; VAS: current pain mean change = 2.3, 95% CI = 1.92.6; Neck Disability Index: mean change = 6.8, 95% CI = 5.4-8.1; Roland-Morris Questionnaire: mean change = 4.3, 95% CI = 3.6-5.1). No adverse events were reported.

Conclusions: Patients of low socioeconomic status face barriers to accessing chiropractic services. This study suggests that chiropractic care reduces pain and disability as well as improves general health status in patients with MSK conditions. Further studies using a more robust methodology are needed to investigate the efficacy and cost-effectiveness of introducing chiropractic care into publicly funded health care facilities.

Age- and sex-specific reference values of a test of neck muscle endurance.

Anneli Peolsson, RPT, PhD, Cecilia Almkvist, Camilla Dahlberg, Sara Lindqvist, Susanne Pettersson

Objective: This study evaluates age- and sex-specific reference values for neck muscle endurance (NME).

Methods: In this cross-sectional study, 116 randomly selected, healthy volunteers (ages 25-64 years) stratified according to age and gender participated. Dorsal and ventral NME was measured in seconds until exhaustion in a laying-down position. A weight of 4 kg for men or 2 kg for women was used in the dorsal procedure. The ventral procedure was performed without external load. Background and physical activity data were obtained and used in the analysis of NME performance.

Results: Mean values for dorsal and ventral NME were about 7 and 2.5 minutes for men and 8.5 and 0.5 minutes for women, respectively. The cutoff values for subnormal dorsal and ventral NME were 157 and 56 seconds for men and 173 and 23 seconds for women, respectively. Women's NME was 122% of men's NME in the dorsal (P = .17) and 24% of men's NME in the ventral (P

Conclusion: The reference values and the cutoff points obtained could be used in clinical practice to identify patients with a subnormal NME. Sex is an important consideration when using both the test procedure and the reference values.

Flexion mobilizations with movement techniques: the immediate effects on range of movement and pain in subjects with low back pain.

Kika Konstantinou, PhD, MSc, Nadine Foster, DPhil, PGCE, Alison Rushton, EdD, MSc, David Baxter, DPhil, Christine Wright, C. Math, Alan Breen, PhD, DC

Objective: This study investigates the immediate effects of flexion mobilizations with movement techniques (MWMs) on spinal range of movement in individuals with low back pain and also their impact on pain. A preliminary attempt has been made to describe the clinical profiles of subjects who were thought to benefit from MWMs.

Method: A small-scale explanatory study was conducted using a crossover design, placebo-controlled, with subjects and assessors blinded. After assessment by physiotherapists, 26 subjects with low back pain with pain on lumbar flexion, thought to be appropriate for treatment with MWMs, participated. Subjects received an MWM intervention and a placebo intervention in a randomized order. Lumbar spinal flexion and extension and pain during flexion were recorded immediately before and after each intervention, using double inclinometry and visual analogue scales.

Results: Mean spinal range of movement increased significantly with the MWM intervention, as compared with the placebo (true flexion: MWMs 49.2° [SD 16.4], placebo 45.3° [SD 14.1], P = .005; total flexion: MWMs 76.7° [SD 22.4], placebo 69.7° [SD 21.5], P = .005). Mean pain scores did not change.