Chiropractic and CAM Utilization: A Descriptive Reviewhome
Studies looking at chiropractic utilization demonstrate that the rates vary, but
generally fall into a range from around 6% to 12% of the population, most of whom seek
chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself
used by people suffering from a variety of conditions, though it is often used not as a primary
intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs
for comparable results compared to conventional medicine
Acupuncture and/or moxibustion for the treatment of lumbar disc herniation: q...LucyPi1
Abstract Objective: In the current systematic review on acupuncture and/or moxibustion for lumbar disc herniation (LDH), we evaluated the methodology and quality of evidence and reports to provide necessary information for accurate clinical decision-making regarding acupuncture and/or moxibustion for LDH. Methods: From databases such as CBM (Chinese biomedical literature database), VIP (China science and technology journal database), CNKI (China national knowledge infrastructure), WF (Wanfang database), Web of Science, Embase, Medline, and Cochrane Library, systematic reviews on acupuncture and/or moxibustion for LDH were retrieved, and the methodological quality of the literature was evaluated according to the assessment of multiple systematic reviews (AMSTAR) list. Furthermore, the grading of recommendations assessment, development and evaluation (GRADE) system was used to grade the quality of evidence and the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement to evaluate the quality of the report. Results: A total of 18 systematic reviews were included, and the conclusion is that acupuncture and/or moxibustion have some advantages in terms of efficacy and safety with regard to LDH treatment. According to the AMSTAR score, there were 4 high-quality studies, 13 moderate-quality studies, and 1 low-quality study. GRADE showed that quality of evidence such as total effective rate of LDH and VAS was low and that of other forms of evidence was lower. The PRISMA statement showed that 8 articles were in line with 20 or more of the 27 items, and 10 articles were in line with 10-19 of the 27 items. Conclusion: At present, acupuncture and/or moxibustion for LDH has a good curative effect. More importantly, its methodological quality was of moderate level and the report quality was generally good and relatively complete. However, the poor quality of the original research results was reflected in the quality of evidence. More studies are needed to make sure whether acupuncture is more effective than other treatment methods
Arthroplasty: Present practices by DR. D. P. SWAMI DR. D. P. SWAMI
COMPARISON OF DIFFERENT APPROACHES FOR HIP REPLACEMENT, DIFFERENT ASPECTS OF OVERLAPPING SURGERIES IN TKR AND TEST FOR CONTAMINATION IN OPERATION THEATER
Chiropractic and CAM Utilization: A Descriptive Reviewhome
Studies looking at chiropractic utilization demonstrate that the rates vary, but
generally fall into a range from around 6% to 12% of the population, most of whom seek
chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself
used by people suffering from a variety of conditions, though it is often used not as a primary
intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs
for comparable results compared to conventional medicine
Acupuncture and/or moxibustion for the treatment of lumbar disc herniation: q...LucyPi1
Abstract Objective: In the current systematic review on acupuncture and/or moxibustion for lumbar disc herniation (LDH), we evaluated the methodology and quality of evidence and reports to provide necessary information for accurate clinical decision-making regarding acupuncture and/or moxibustion for LDH. Methods: From databases such as CBM (Chinese biomedical literature database), VIP (China science and technology journal database), CNKI (China national knowledge infrastructure), WF (Wanfang database), Web of Science, Embase, Medline, and Cochrane Library, systematic reviews on acupuncture and/or moxibustion for LDH were retrieved, and the methodological quality of the literature was evaluated according to the assessment of multiple systematic reviews (AMSTAR) list. Furthermore, the grading of recommendations assessment, development and evaluation (GRADE) system was used to grade the quality of evidence and the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement to evaluate the quality of the report. Results: A total of 18 systematic reviews were included, and the conclusion is that acupuncture and/or moxibustion have some advantages in terms of efficacy and safety with regard to LDH treatment. According to the AMSTAR score, there were 4 high-quality studies, 13 moderate-quality studies, and 1 low-quality study. GRADE showed that quality of evidence such as total effective rate of LDH and VAS was low and that of other forms of evidence was lower. The PRISMA statement showed that 8 articles were in line with 20 or more of the 27 items, and 10 articles were in line with 10-19 of the 27 items. Conclusion: At present, acupuncture and/or moxibustion for LDH has a good curative effect. More importantly, its methodological quality was of moderate level and the report quality was generally good and relatively complete. However, the poor quality of the original research results was reflected in the quality of evidence. More studies are needed to make sure whether acupuncture is more effective than other treatment methods
Arthroplasty: Present practices by DR. D. P. SWAMI DR. D. P. SWAMI
COMPARISON OF DIFFERENT APPROACHES FOR HIP REPLACEMENT, DIFFERENT ASPECTS OF OVERLAPPING SURGERIES IN TKR AND TEST FOR CONTAMINATION IN OPERATION THEATER
Effectiveness of Passive Range of Motion Exercises on Hemodynamic parameters ...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Recent advances in Manipulative MedicineSoniya Lohana
What new techniques are been used in manipulative medicine and physical therapy that help the patients to recover better and address their condition by various approaches where surgery is not required.
Effectiveness of Passive Range of Motion Exercises on Hemodynamic parameters ...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Recent advances in Manipulative MedicineSoniya Lohana
What new techniques are been used in manipulative medicine and physical therapy that help the patients to recover better and address their condition by various approaches where surgery is not required.
At CAGR of 9%, Global Shale Gas Market Set for Rapid Growth, To Reach Around ...Steven Schulz
Global demand for shale gas market was valued at USD 63 billion in 2014 is anticipatedto reach around USD 105 billion in 2020, growing at a CAGR of around 9% between 2015 and 2020.
Charity marketing specialist Lucy Conlan steps us through the trends across web, mobile, email and social media marketing to engage their audiences into 2016.
Introduces the essential technical concepts and Domino environment required for the administration. Also outlines the responsibilities of the System Administrator.
Reference: Lotus Domino Admin Help
Startups Celebrate - Build Your Own Movement To Promote Local StartupsPenelope Liot
Startups Celebrate is an initiative to encourage people from around the world to promote local startups to the general public through a collaborative movement.
The official Startups Celebrate playbook gives you all the tools to start your own movement.
Physical Therapy Practice Guidelines: Thoracic manipulation is both safe and effective in treating mechanical neck pain (neck pain with mobility deficits).
Long-Term Effect of Exercise Therapyand Patient Education on.docxwkyra78
Long-Term Effect of Exercise Therapy
and Patient Education on Impairments
and Activity Limitations in People
With Hip Osteoarthritis: Secondary
Outcome Analysis of a Randomized
Clinical Trial
Ida Svege, Linda Fernandes, Lars Nordsletten, Inger Holm, May Arna Risberg
Background. The effect of exercise on specific impairments and activity limitations in
people with hip osteoarthritis (OA) is limited.
Objective. The study objective was to evaluate the long-term effect of exercise therapy and
patient education on range of motion (ROM), muscle strength, physical fitness, walking
capacity, and pain during walking in people with hip OA.
Design. This was a secondary outcome analysis of a randomized clinical trial.
Setting. The setting was a university hospital.
Participants. One hundred nine people with clinically and radiographically evident hip
OA were randomly allocated to receive both exercise therapy and patient education (exercise
group) or patient education only (control group).
Intervention. All participants attended a patient education program consisting of 3 group
meetings led by 2 physical therapists. Two other physical therapists were responsible for
providing the exercise therapy program, consisting of 2 or 3 weekly sessions of strengthening,
functional, and stretching exercises over 12 weeks. Both interventions were conducted at a
sports medicine clinic.
Measurements. Outcome measures included ROM, isokinetic muscle strength, predicted
maximal oxygen consumption determined with the Astrand bicycle ergometer test, and
distance and pain during the Six-Minute Walk Test (6MWT). Follow-up assessments were
conducted 4, 10, and 29 months after enrollment by 5 physical therapists who were unaware
of group allocations.
Results. No significant group differences were found for ROM, muscle strength, predicted
maximal oxygen consumption, or distance during the 6MWT over the follow-up period, but
the exercise group had less pain during the 6MWT than the control group at 10 months (mean
difference��8.5 mm; 95% confidence interval��16.1, �0.9) and 29 months (mean differ-
ence��9.3 mm; 95% confidence interval��18.1, �0.6).
Limitations. Limitations of the study were reduced statistical power and 53% rate of
adherence to the exercise therapy program.
Conclusions. The previously described effect of exercise on self-reported function was
not reflected by beneficial results for ROM, muscle strength, physical fitness, and walking
capacity, but exercise in addition to patient education resulted in less pain during walking in
the long term.
I. Svege, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
Kirkeveien 166, 0450 Oslo, Nor-
way. Address all correspondence
to Dr Svege at: [email protected]
ous-hf.no.
L. Fernandes, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
and Department of Orthopaedic
Surgery and T.
Long-Term Effect of Exercise Therapyand Patient Education on.docxcroysierkathey
Long-Term Effect of Exercise Therapy
and Patient Education on Impairments
and Activity Limitations in People
With Hip Osteoarthritis: Secondary
Outcome Analysis of a Randomized
Clinical Trial
Ida Svege, Linda Fernandes, Lars Nordsletten, Inger Holm, May Arna Risberg
Background. The effect of exercise on specific impairments and activity limitations in
people with hip osteoarthritis (OA) is limited.
Objective. The study objective was to evaluate the long-term effect of exercise therapy and
patient education on range of motion (ROM), muscle strength, physical fitness, walking
capacity, and pain during walking in people with hip OA.
Design. This was a secondary outcome analysis of a randomized clinical trial.
Setting. The setting was a university hospital.
Participants. One hundred nine people with clinically and radiographically evident hip
OA were randomly allocated to receive both exercise therapy and patient education (exercise
group) or patient education only (control group).
Intervention. All participants attended a patient education program consisting of 3 group
meetings led by 2 physical therapists. Two other physical therapists were responsible for
providing the exercise therapy program, consisting of 2 or 3 weekly sessions of strengthening,
functional, and stretching exercises over 12 weeks. Both interventions were conducted at a
sports medicine clinic.
Measurements. Outcome measures included ROM, isokinetic muscle strength, predicted
maximal oxygen consumption determined with the Astrand bicycle ergometer test, and
distance and pain during the Six-Minute Walk Test (6MWT). Follow-up assessments were
conducted 4, 10, and 29 months after enrollment by 5 physical therapists who were unaware
of group allocations.
Results. No significant group differences were found for ROM, muscle strength, predicted
maximal oxygen consumption, or distance during the 6MWT over the follow-up period, but
the exercise group had less pain during the 6MWT than the control group at 10 months (mean
difference��8.5 mm; 95% confidence interval��16.1, �0.9) and 29 months (mean differ-
ence��9.3 mm; 95% confidence interval��18.1, �0.6).
Limitations. Limitations of the study were reduced statistical power and 53% rate of
adherence to the exercise therapy program.
Conclusions. The previously described effect of exercise on self-reported function was
not reflected by beneficial results for ROM, muscle strength, physical fitness, and walking
capacity, but exercise in addition to patient education resulted in less pain during walking in
the long term.
I. Svege, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
Kirkeveien 166, 0450 Oslo, Nor-
way. Address all correspondence
to Dr Svege at: [email protected]
ous-hf.no.
L. Fernandes, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
and Department of Orthopaedic
Surgery and T ...
To Determine Preference of Shoulder Pain Management by General Physicians in ...suppubs1pubs1
Rotator cuff muscles are functionally active and provide stability to the shoulder joint and also thereby allow the full Range of Motion (ROM) by moving the head of humerus in the glenoid cavity. Any tear or fragility of the rotator cuff muscles can cause the dislocation or instability and hence damaging other muscles specially the long head of biceps muscle. The diseases related to the supraspinatus tendon are frequently linked with the long head of the biceps tendon. Other cause of chronic shoulder pain is the adhesive capsulitis with large prevalence rates of more than 5.3% in the general target population [3].
Ingredient in MS, Psoriasis Drugs Linked to Two Deadly Brain Infections
Physical Therapy's Effects Equal to Surgery for Spinal Stenosis Symptoms
1. Physical Therapy's Effects Equal to Surgery for Spinal
Stenosis Symptoms
Physical therapy for spinal stenosis is as effective as surgery and should be fully considered as a
first-choice treatment option, according to a new study that is the first to directly compare a single,
evidence-based physical therapy regimen with decompression surgery among patients who agreed
to be randomly assigned to either approach.
The study focused on self-reported physical function among 169 participants diagnosed with lumbar
spinal stenosis (LSS) after 2 years, but it also tracked function measurements along the way--at
baseline, 10 weeks, 6 months, and 12 months. Researchers found that not only were 2-year effects
similar for the 2 groups (87 who began with surgery and 82 who started with physical therapy), the
increase in function followed similar trajectories from baseline on.
Research was conducted between 2000 to 2007, and limited to patients 50 years and older who had
no previous LSS surgery and had no additional conditions including dementia, vascular disease,
metastatic cancer, or a recent history of heart attack.
The study, which appears in the Annals of Internal Medicine (abstract only available for free), was
led by Anthony Delitto, PT, PhD, FAPTA, with coauthors including Sara R. Pilva, PT, PhD, FAAOMP,
OCS, Julie M. Fritz, PT, PhD, FAPTA, and Deborah A. Josbeno, PT, PhD, NCS. The findings have been
reported in Reuters, the Pittsburgh Post-Gazette, Medpage Today, and other outlets.
According to an editorial that accompanies the article (sample available for free), what makes this
research important is that it restricted the nonsurgical approach to a single physical therapy
regimen, and that participants--all of whom were prequalified for surgery--consented to a
randomized treatment approach. Previous studies focused on surgical vs (mostly unspecified)
"nonsurgical" approaches, and some allowed patients to self-select their treatment groups.
Editorial author Jeffrey N. Katz, MD, MSc, writes that the current study more accurately represents
practice, in which "clinicians and patients must choose between surgery and a particular
nonoperative regimen, rather than an amalgam of regimens."
Those particular nonoperative physical therapy treatments administered to the participants included
"instruction on lumbar flexion exercises including posterior pelvic tilts and supine knee-to-chest and
quadruped flexion exercises; general conditioning exercises, including stationary cycling or
treadmill walking; lower extremity strengthening exercises ... ; lower-extremity flexibility exercises
2. deemed appropriate ... ; and patient education to avoid postures involving hyperextension of the
lumbar spine," authors write.
Most participants in the physical therapy group attended at least 1 of the 12 prescribed sessions,
with two-thirds participating in at least 6 sessions. However, over half (57%) of the physical therapy
group elected to have surgery at some point within the 2-year study window. While authors write
that this crossover presents "a challenge in interpretation," additional analysis revealed that even
with this shift, "any differences between the groups were not significant."
"From a clinical standpoint, Delitto and colleagues' trial suggests that a strategy of starting with an
active, standardized [physical therapy] regimen results in similar outcomes to immediate
decompressive surgery over the first several years," writes Katz in his editorial. "Taken together,
these data suggest that patients with LSS should be offered a rigorous, standardized [physical
therapy] regimen. Those who do not improve and ultimately consider surgery should be informed
that the benefits are likely to diminish over time."
Both the study's authors and Katz agree that health provider-patient communication is key.
"Patients and health care providers should engage in shared decision-making conversations that
include full disclosure of evidence involving surgical and nonsurgical treatments for LSS," authors
write, with Katz's editorial arguing that "because long-term outcomes are similar for both treatments
yet short-term risks may differ, patient preferences should weigh heavily in the decision of whether
to have surgery for LSS."
Research-related stories featured in PT in Motion News are intended to highlight a topic of interest
only and do not constitute an endorsement by APTA. For synthesized research and evidence-based
practice information, visit the association's PTNow website.
I was most pleased to hear of the re-discovery of the posterior pelvic tilt. I have found it most helpful
also, especially in the correction of the subluxation of the sacral axis. DonTigny, RL: Evaluation,
manipulation and management of anterior dysfunction of the sacroiliac joint. The D.O. 14:215-226,
1973 DonTigny, RL: Letter to Editor: Sciatica and the Sacroiliac Joint. PT March 1977, p 143
DonTigny, RL: Dysfunction of the sacroiliac joint and its treatment. JOSPT 1:13-25, 1979 DonTigny,
RL: Function and pathomechanics of the sacroiliac joint. Phys Ther 65:35-44, 1985 DonTigny, RL:
Anterior dysfunction of the sacroiliac joint as a major factor in the etiology of idiopathic low back
pain syndrome. Phys Ther 70:250-265, 1990 DonTigny, RL: Measuring PSIS movement. Clinical
Management 10:43-44, 1990 DonTigny, RL: Sacroiliac joint as a major source of low back pain. Back
Pain Monitor, April 1991, pp 55-58 DonTigny, RL: Sacroiliac joint dysfunction responds well to
manual therapy. Back Pain Monitor, May 1991 DonTigny, RL: Mechanics and treatment of the
sacroiliac joint. Journal of Manual Manipulative Therapy, 1:3-12, 1993 DonTigny, RL: Function of the
lumbosacroiliac complex as a self-compensating force couple with a variable, force-dependent
transverse axis: A theoretical analysis. JMMT, 2:87-93, 1994 DonTigny, RL: The DonTigny low back
pain management program. JMMT, 2:163-168, 1994 DonTigny, RL: Functional Biomechanics and
Management of the Pathomechanics of the Sacroiliac Joint. In Dorman TA (ed): SPINE: State of the
Art Reviews. Philadelphia, PA, Hanley Belfus, Inc. 1995, Chpt 14 DonTigny, RL: Critical analysis of
the sequence and extent of the result of the pathological release of self- bracing of the sacroiliac
joint. Concurrently in JMMT 7:173-181, 1999 and J of Ortho Med (UK) 22:16-23,2000 DonTigny, RL:
Critical analysis of the functional dynamics of the sacroiliac joints as they pertain to normal gait. J of
Orthopaedic Medicine (UK) 27:3-10, 2005 . DonTigny, RL: Pathology of the sacroiliac joint, its effect
3. on normal gait and its correction. J of Orthopaedic Medicine (UK) 27:61-69, 2005 DonTigny, RL: A
detailed and critical biomechanical analysis of the sacroiliac joints and relevant kinesiology: the
implications for lumbopelvic function and dysfunction. In Vleeming A, Mooney V, Stoeckart R (eds):
Movement, Stability Lumbopelvic Pain: Integration of research and therapy. Churchill Livingstone
(Elsevier). Edinburgh, 2007, pp 265-279 DonTigny, RL: Sacroiliac 101; Form and Function; A
biomechanical study. Journal of Prolotherapy 3:561-567, 2011 Available in full text from
https://www.researchgate.net DonTigny, RL: Sacroiliac 201; Dysfunction and Management: A
biomechanical solution. Journal of Prolotherapy 3:644-652, 2011 Available in full text from
https://www.researchgate.net http://www.thelowback.com. How it works, why it hurts and how to fix
it. http://www.greatseminarsonline.com Immediate relief of low back pain
Posted by Richard DonTigny, PT on 4/8/2015 5:22 PM
http://www.apta.org/PTinMotion/News/2015/4/7/StenosisPTvsSurgery/?blogid=10737418615