Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · Jun 2004
ReviewCentral neuronal plasticity, low back pain and spinal manipulative therapy.
Recent experimental evidence demonstrating neuronal/synaptic plasticity and, in particular, long-term potentiation (LTP) and long-term depression (LTD) in spinal neurons is reviewed. The implications of these studies for possible mechanistic explanations of low back pain and its remediation by spinal manipulative therapy (SMT) are explored. Brief descriptions of LTP and LTD and elaboration of the key roles of calcium, glutamate, and glutamate receptors in LTP/LTD are provided as separate appendices. ⋯ The potential involvement of LTP in low back pain is discussed and a role for LTD in spinal manipulative therapy is proposed. The need for future studies is identified in the areas of spatial and temporal changes in symptomatology post-SMT of the low back; combining, sequencing, and comparing several therapeutic approaches; and demonstrating LTD in spinal cord neurons post-SMT-like stimulation.
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J Manipulative Physiol Ther · May 2004
Low back pain in Australian adults: prevalence and associated disability.
To determine the prevalence ranges of low back pain (LBP) together with any related disability in Australian adults. ⋯ LBP is a common problem in the Australian adult population, yet most of this is low-intensity and low-disability pain. Nevertheless, over 10% had been significantly disabled by LBP in the past 6 months. Data from this study will provide a better understanding of the magnitude of the LBP problem in Australia, the need for access to health care resources, and also strategic research directions.
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J Manipulative Physiol Ther · May 2004
ReviewParaspinal muscles and intervertebral dysfunction: part one.
One of the diagnostic characteristics of the manipulable spinal lesion--a musculoskeletal disturbance detected by manual palpation and corrected with manipulation--is said to be altered segmental tissue texture. Various manual therapy authors have speculated on the possible nature of this tissue change, with some authors hypothesizing that it represents deep segmental muscle overactivity. ⋯ Although little direct evidence exists of the nature of clinically detected paraspinal tissue texture change, the concept of reactive muscle contraction appears plausible. Increased paraspinal EMG activity associated with LBP does not appear to be mediated by a simple protective reflex.
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J Manipulative Physiol Ther · Mar 2004
A practice-based study of patients with acute and chronic low back pain attending primary care and chiropractic physicians: two-week to 48-month follow-up.
This study reports pain and disability outcomes up to 4 years for chiropractic and medical patients with low back pain (LBP) and assesses the influence of doctor type and pain duration on clinical outcomes. ⋯ Study findings were consistent with systematic reviews of the efficacy of spinal manipulation for pain and disability in acute and chronic LBP. Patient choice and interdisciplinary referral should be prime considerations by physicians, policymakers, and third-party payers in identifying health services for patients with LBP.
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J Manipulative Physiol Ther · Feb 2004
The impact of non-injury-related factors on disability secondary to whiplash associated disorder type II: a retrospective file review.
There is evidence to suggest that Whiplash Associated Disorders (WADs) are influenced by physical trauma and psychosocial factors, as well as by medicolegal and compensation systems. ⋯ Our analysis of WAD type II patients in receipt of compensation found that higher self-reported disability on initial assessment was associated with female sex and in particular by retaining a lawyer. Large prospective studies are needed to establish the validity of these findings.