Chiropractic & manual therapies
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For diagnostic procedures to be clinically useful, they must be reliable. The interpretation of lumbar spine MRI scans is subject to variability and there is a lack of studies where reliability of multiple degenerative pathologies are rated simultaneously. The objective of our study was to determine the inter-rater reliability of three independent raters evaluating degenerative pathologies seen with lumbar spine MRI. ⋯ Inter-rater reliability for 3 raters, evaluating 177 disc levels, was found to be overall acceptable for 6 out of 8 degenerative MRI-findings in the lumbar spine. Ratings of facet joint degeneration and disc contour achieved moderate reliability and was considered unacceptable.
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Randomized Controlled Trial
What is the effect of spinal manipulation on the pressure pain threshold in young, asymptomatic subjects? A randomized placebo-controlled trial, with a cross-over design.
Spinal manipulation (SM) has been shown to have an effect on the pressure pain threshold (PPT) in asymptomatic subjects, but SM has never been compared in studies on this topic to a validated sham procedure. We investigated the effect of SM on the PPT when measured i) in the area of intervention and ii) in an area remote from the intervention. In addition, we measured the size and duration of the effect. ⋯ When compared to a valid sham procedure and with successfully blinded subjects, there is no regional or remote effect of spinal manipulation of the thoracic spine on the pressure pain threshold in a young pain-free population.