Placebo, Nocebo, and Expectations: Leveraging Positive Outcomes

Benz, Laurence N.; Flynn, Timothy W.

doi:10.2519/jospt.2013.0105

Cited by 23 publications

(16 citation statements)

References 13 publications

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“…We are not able to rule out positive effects from factors such as repeated shoulder motion during testing, interaction with a health care professional, passage of time, placebo effects, or the positive contributions that could be associated with manual contact (touch), which could contribute to the positive effects of manual therapy. 2,7 The magnitude of the changes in function observed in the present study, indicated by the improvements in Penn Shoulder Score values and the GROC, was similar to that reported in previous studies. 8,21 Across both groups, there was an increase in Penn Shoulder Score values from pretreatment to 24-to 48-hour follow-up of 9.1 points (95% CI: 6.5, 11.7), which is slightly larger than the difference reported by Muth et al 21 of 7.6 points (95% CI: 4.1, 11.1).…”

Section: Limitationssupporting

confidence: 79%

Thoracic Spine Manipulation in Individuals With Subacromial Impingement Syndrome Does Not Immediately Alter Thoracic Spine Kinematics, Thoracic Excursion, or Scapular Kinematics: A Randomized Controlled Trial

Kardouni

Pidcoe²,

Shaffer³

et al. 2015

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Randomized controlled trial. Objectives To determine if thoracic spinal manipulative therapy (SMT) alters thoracic kinematics, thoracic excursion, and scapular kinematics compared to a sham SMT in individuals with subacromial impingement syndrome, and also to compare changes in patient-reported outcomes between treatment groups. Background Prior studies indicate that thoracic SMT can improve pain and disability in individuals with subacromial impingment syndrome. However, the mechanisms underlying these benefits are not well understood. Methods Participants with shoulder impingement symptoms (n = 52) were randomly assigned to receive a single session of thoracic SMT or sham SMT. Thoracic and scapular kinematics during active arm elevation and overall thoracic excursion were measured before and after the intervention. Patient-reported outcomes measured were pain (numeric pain-rating scale), function (Penn Shoulder Score), and global rating of change. Results Following the intervention, there were no significant differences in changes between groups for thoracic kinematics or excursion, scapular kinematics, and patient-reported outcomes (P>.05). Both groups showed an increase in scapular internal rotation during arm raising (mean, 0.9°; 95% confidence interval [CI]: 0.3°, 1.6°; P = .003) and lowering (0.8°; 95% CI: 0.0°, 1.5°; P = .041), as well as improved pain reported on the numeric pain-rating scale (1.2 points; 95% CI: 0.3, 1.8; P<.001) and function on the Penn Shoulder Score (9.1 points; 95% CI: 6.5, 11.7; P<.001). Conclusion Thoracic spine extension and excursion did not change significantly following thoracic SMT. There were small but likely not clinically meaningful changes in scapular internal rotation in both groups. Patient-reported pain and function improved in both groups; however, there were no significant differences in the changes between the SMT and the sham SMT groups. Overall, patient-reported outcomes improved in both groups without meaningful changes to thoracic or scapular motion. Level of Evidence Therapy, level 1b-. J Orthop Sports Phys Ther 2015;45(7):527–538. Epub 21 May 2015. doi:10.2519/jospt.2015.5647

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Section: Limitationssupporting

confidence: 79%

Thoracic Spine Manipulation in Individuals With Subacromial Impingement Syndrome Does Not Immediately Alter Thoracic Spine Kinematics, Thoracic Excursion, or Scapular Kinematics: A Randomized Controlled Trial

Kardouni

Pidcoe²,

Shaffer³

et al. 2015

Journal of Orthopaedic & Sports Physical Therapy

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“…The mechanism of SMT could be related to factors of manual contact, positioning of the subject and moving them through the range of motion, interaction with a healthcare provider, or placebo effects (Bialosky et al, 2008;Benz and Flynn, 2013;Bishop et al, 2013). Since only immediate effects were assessed in this study, it is also possible that greater benefits and mechanistic changes with SMT would be seen with multiple treatments or over a greater time period following treatment.…”

Section: Discussionmentioning

confidence: 93%

“…Our study and that of Boyles et al used a standardized treatment approach, whereas Strunce et al used a pragmatic approach in applying thoracic SMT based on joint restrictions noted during examination. It is possible that the use of a pragmatic approach could improve outcomes, especially if the therapist engaged the patient with the treatment rationale and leveraged expectations prior to the application of particular techniques (Benz and Flynn, 2013).…”

Section: Discussionmentioning

confidence: 99%

Immediate changes in pressure pain sensitivity after thoracic spinal manipulative therapy in patients with subacromial impingement syndrome: A randomized controlled study

et al. 2015

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“…It is perhaps more important for the clinician to internalize the benefits that can be achieved through patient expectations than the benefits that can be achieved through individual modalities. 29 Finally, further research on the effect …”

Section: Resultsmentioning

confidence: 99%

Effect of Kinesiology Taping on Pain in Individuals With Musculoskeletal Injuries: Systematic Review and Meta-Analysis

Montalvo

Cara²,

Myer

2014

The Physician and Sportsmedicine

104

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Kinesiology tape, an elastic tape used by sports medicine clinicians to enhance sports performance in athletes, is purported to facilitate a reduction in pain during physical activity in individuals with orthopedic injuries, but high-quality literature on this topic remains scarce. The purpose of this meta-analysis is to critically examine and review the existing literature to evaluate the effect of kinesiology tape application on pain in individuals with musculoskeletal injury. English-language publications from 2003 to 2013 were surveyed by searching SPORTDiscus, Scopus, ScienceDirect, CINAHL, Cochrane Library, PubMed, and PEDro databases using the terms kinesio tap*, kinesiology tap*, kinesiotap*, and pain. Thirteen articles investigating the effects of kinesiology tape application on pain with at least level II evidence were selected. The combined results of this meta-analysis indicate that kinesiology tape may have limited potential to reduce pain in individuals with musculoskeletal injury; however, depending on the conditions, the reduction in pain may not be clinically meaningful. Kinesiology tape application did not reduce specific pain measures related to musculoskeletal injury above and beyond other modalities compared in the context of included articles. We suggest that kinesiology tape may be used in conjunction with or in place of more traditional therapies, and further research that employs controlled measures compared with kinesiology tape is needed to evaluate efficacy.

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Placebo, Nocebo, and Expectations: Leveraging Positive Outcomes

Cited by 23 publications

References 13 publications

Thoracic Spine Manipulation in Individuals With Subacromial Impingement Syndrome Does Not Immediately Alter Thoracic Spine Kinematics, Thoracic Excursion, or Scapular Kinematics: A Randomized Controlled Trial

Thoracic Spine Manipulation in Individuals With Subacromial Impingement Syndrome Does Not Immediately Alter Thoracic Spine Kinematics, Thoracic Excursion, or Scapular Kinematics: A Randomized Controlled Trial

Immediate changes in pressure pain sensitivity after thoracic spinal manipulative therapy in patients with subacromial impingement syndrome: A randomized controlled study

Effect of Kinesiology Taping on Pain in Individuals With Musculoskeletal Injuries: Systematic Review and Meta-Analysis

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