Preface to the first edition

Ombregt, Ludwig; Bisschop, Pierre; Veer, Herman J. ter; Velde, Tony Van de

doi:10.1016/b978-0-7020-3145-8.00104-6

Cited by 9 publications

(11 citation statements)

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“…1–7 While the mechanisms of action remain uncertain, current evidence suggests that the procedures may be associated with altered sensorimotor integration, 8 motor control, 9–11 and localized tissue stress. 12–15 Kawchuk et al 16 using an ex vivo porcine model, have shown that the intervertebral disc experiences the greatest loading arising from manipulation procedures.…”

Section: Introductionmentioning

confidence: 99%

“…12–15 Kawchuk et al 16 using an ex vivo porcine model, have shown that the intervertebral disc experiences the greatest loading arising from manipulation procedures. A common manipulation procedure consists of techniques positioning patients in varying degrees of axial rotation of the torso 7, 17–19 up to end voluntary range. Indeed, recent clinical studies report the use of manipulation incorporating rotational positioning as a therapeutic measure for patients with confirmed disc herniation.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Axial Torsion on Disc Height Distribution: An In Vivo Study

Orías

Mammoser

Triano

et al. 2016

Journal of Manipulative and Physiological Therapeutics

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Objectives Axial rotation of the torso is commonly used during manipulation treatment of low back pain. Little is known about the effect of these positons on disc morphology. Rotation is a three-dimensional event that is inadequately represented with planar images in the clinic. True quantification of the intervertebral gap can be achieved with a disc height distribution. The objective of this study was to analyze disc height distribution patterns during torsion relevant to manipulation in vivo. Methods Eighty-one volunteers were CT-scanned both in supine and in right 50° rotation positions. Virtual models of each intervertebral gap representing the disc were created with the inferior endplate of each ‘disc’ set as the reference surface and separated into five anatomical zones: four peripheral and one central, corresponding to the footprint of the annulus fibrosus and nucleus pulposus, respectively. Whole-disc and individual anatomical zone disc height distributions were calculated in both positions, and were compared against each other with ANOVA, with significance set at p < 0.05. Results Mean neutral disc height was 7.32 (1.59) mm. With 50° rotation, a small but significant increase to 7.44 (1.52) mm (p < 0.0002) was observed. The right side showed larger separation in most levels, except at L5/S1. The posterior and right zones increased in height upon axial rotation of the spine (p < 0.0001), while the left, anterior and central decreased. Conclusions This study quantified important tensile/compressive changes disc height during torsion. The implications of these mutually opposing changes on spinal manipulation are still unknown.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Axial Torsion on Disc Height Distribution: An In Vivo Study

Orías

Mammoser

Triano

et al. 2016

Journal of Manipulative and Physiological Therapeutics

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“…A passive external rotation deficit of ≥30 degrees compared with the unaffected side was used as the cut-point for the external rotation deficit variable. This value is consistently used to classify capsular restriction of glenohumeral joint range of motion associated with frozen shoulder and glenohumeral arthritis [47, 48]. The clinical examination was conducted by an experienced musculoskeletal clinician with 22 years of experience.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic Accuracy of Clinical Examination and Imaging Findings for Identifying Subacromial Pain

et al. 2016

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BackgroundThe diagnosis of subacromial pathology is limited by the poor accuracy of clinical tests for specific pathologies. The aim of this study was to estimate the diagnostic accuracy of clinical examination and imaging features for identifying subacromial pain (SAP) defined by a positive response to diagnostic injection, and to evaluate the influence of imaging findings on the clinical diagnosis of SAP.Methods and FindingsIn a prospective, diagnostic accuracy design, 208 consecutive patients presenting to their primary healthcare practitioner for the first time with a new episode of shoulder pain were recruited. All participants underwent a standardized clinical examination, shoulder x-ray series and diagnostic ultrasound scan. Results were compared with the response to a diagnostic block of xylocaineTM injected into the SAB under ultrasound guidance using ≥80% post-injection reduction in pain intensity as the positive anaesthetic response (PAR) criterion. Diagnostic accuracy statistics were calculated for combinations of clinical and imaging variables demonstrating the highest likelihood of a PAR. A PAR was reported by 34% of participants. In participants with no loss of passive external rotation, combinations of three clinical variables (anterior shoulder pain, strain injury, absence of symptoms at end-range external rotation (in abduction)) demonstrated 100% specificity for a PAR when all three were positive (LR+ infinity; 95%CI 2.9, infinity). A full-thickness supraspinatus tear on ultrasound increased the likelihood of a PAR irrespective of age (specificity 98% (95%CI 94, 100); LR+ 6.2; 95% CI 1.5, 25.7)). Imaging did not improve the ability to rule-out a PAR.ConclusionCombinations of clinical examination findings and a full-thickness supraspinatus tear on ultrasound scan can help confirm, but not exclude, the presence of subacromial pain. Other imaging findings were of limited value for diagnosing SAP.

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“…The patients also had severe shoulder pain with an intensity of five or higher on a Numeric Rating Scale (NRS; scored from 0-10). Patients were required to have stage II or greater shoulder adhesive capsulitis, defined as symptoms meeting one or more of the following criteria [26]: 1) pain at rest; 2) pain below the elbow; 3) disturbed sleep on the painful side at night; and 4) hard end-feel on lateral rotation. All patients were required to have a significant limitation of passive movements in the glenohumeral joint (more than 30 degrees for at least two of the following three movements: forward flexion, abduction or external rotation) compared with the unaffected side [27].…”

Section: Methodsmentioning

confidence: 99%

A Comparison of the Short-Term Effects of a Botulinum Toxin Type A and Triamcinolone Acetate Injection on Adhesive Capsulitis of the Shoulder

Joo

Yoon

Kim³

et al. 2013

Ann Rehabil Med

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ObjectiveTo evaluate the short-term clinical effects of the intra-articular injection of botulinum toxin type A (BoNT-A) for the treatment of adhesive capsulitis.MethodsA prospective, controlled trial compared the effects of intra-articular BoNT-A (Dysport; 200 IU, n=15) with the steroid triamcinolone acetate (TA; 20 mg, n=13) in patients suffering from adhesive capsulitis of the shoulder. All patients were evaluated using a Numeric Rating Scale (NRS) of the pain intensity and a measurement of the range of motion (ROM) at baseline (before treatment) and at 2, 4, and 8 weeks post-treatment.ResultsThe NRS at 2 weeks (BoNT-A vs. TA; 5.0 vs. 5.2), 4 weeks (4.1 vs. 4.9) and 8 weeks (3.8 vs. 4.6) of both treatment groups were significantly lower than that measured at baseline (7.4 vs. 7.6). The ROM of patients' shoulders increased significantly from baseline in both treatment groups. There was no significant difference in the NRS of pain intensity or the ROM between the two groups. Reduction in the pain intensity score was maintained for 8 weeks post-injection in both groups. There were no significant adverse events in either treatment group.ConclusionThe results suggest that there are no significant short-term differences between the intra-articular injections of BoNT-A and TA. Although BoNT-A has a high cost, it may be used as a safe alternative of TA to avoid the steroid-induced side effects or as a second-line agent, for patients who have failed to respond to the current treatments.

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Preface to the first edition

Cited by 9 publications

References 0 publications

Effects of Axial Torsion on Disc Height Distribution: An In Vivo Study

Effects of Axial Torsion on Disc Height Distribution: An In Vivo Study

Diagnostic Accuracy of Clinical Examination and Imaging Findings for Identifying Subacromial Pain

A Comparison of the Short-Term Effects of a Botulinum Toxin Type A and Triamcinolone Acetate Injection on Adhesive Capsulitis of the Shoulder

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