Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialA pilot randomized clinical trial on the relative effect of instrumental (MFMA) versus manual (HVLA) manipulation in the treatment of cervical spine dysfunction.
To determine the relative effect of instrument-delivered thrust cervical manipulations in comparison with traditional manual-delivered thrust cervical manipulations in the treatment of cervical spine dysfunction. ⋯ The results of this clinical trial indicate that both instrumental (MFMA) manipulation and manual (HVLA) manipulation have beneficial effects associated with reducing pain and disability and improving cervical range of motion in this patient population. A randomized, controlled clinical trial in a similar patient base with a larger sample size is necessary to verify the clinical relevance of these findings.
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J Manipulative Physiol Ther · Oct 2000
Randomized Controlled Trial Clinical TrialNonoperative treatments for sciatica: a pilot study for a randomized clinical trial.
To assess the feasibility of patient recruitment, the ability of patients and clinicians to comply with study protocols, and the use of data collection instruments to collect cost-effectiveness data, and to obtain variability estimates for sample-size calculations for a full-scale trial. ⋯ Pilot studies such as these are important for the determination of the feasibility of conducting costly, larger scale trials. Recruitment for a full-scale study of sciatica of 2 to 12 weeks duration is not feasible, given the methods used in this pilot study. Our results do indicate, however, that there are substantial numbers of patients with sciatica more chronic in nature who would be interested in participating in a similar study. In addition, collaboration with a local health maintenance organization would likely facilitate clinician referrals and optimize the recruitment process. Patient and provider compliance was high in the pilot study, which indicates that most study protocols are feasible. Additionally, we were able to collect complete outcomes data, including those regarding health care use. A suggested modification by investigators and outside consultants has resulted in the replacement of the medication group with a minimal intervention control group (ie, self-care advice). As a result, a second pilot study of patients with sciatica of more than 4 weeks duration has been planned before a full-scale trial is attempted.
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J Manipulative Physiol Ther · Jul 2000
Randomized Controlled Trial Comparative Study Clinical TrialEffects of side-posture positioning and side-posture adjusting on the lumbar zygapophysial joints as evaluated by magnetic resonance imaging: a before and after study with randomization.
To test the a priori hypothesis that one of the positive mechanisms of action of chiropractic side-posture manipulation (adjusting) of the lumbar spine is to separate, or gap, the zygapophysial (Z) joints. ⋯ Lumbar side-posture spinal adjusting produced increased separation (gapping) of the zygapophysial joints. Side-posture positioning also produced gapping, but less than that seen with lumbar side-posture adjusting. A larger clinical trial should be performed to further define the results of this study.
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J Manipulative Physiol Ther · Jul 1999
Randomized Controlled Trial Comparative Study Clinical TrialChronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a nonsteroidal anti-inflammatory drug, and spinal manipulation.
To compare needle acupuncture, medication (tenoxicam with ranitidine), and spinal manipulation for managing chronic (>13 weeks duration) spinal pain syndromes. ⋯ The consistency of the results provides, in spite of several discussed shortcomings of this pilot study, evidence that in patients with chronic spinal pain syndromes spinal manipulation, if not contraindicated, results in greater improvement than acupuncture and medicine.
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J Manipulative Physiol Ther · Feb 1999
Randomized Controlled Trial Clinical TrialChanges and implications of blood flow velocity of the vertebral artery during rotation and extension of the head.
To study the effects of extension and extension-rotation of the head on the blood flow velocity of the vertebral artery experimentally and clinically. ⋯ Extreme rotation and extension are dangerous to patients who have abnormal vertebral arteries when extreme rotatory and extension manipulations are applied. Doctors should be very careful when rotating the patient's head to the right side.