Research Flashcards
Cook, et. al, 2010
Journal of Manual & Manipulative Therapy
Clustered clinical findings for diagnosis of cervical spine myelopathy (1) gait deviation (2) + Hoffmann's test (3) inverted supinator sign (4) + Babinski test (5) age >45 years 1/5 = 94% sensitivity, rule out 2/5 = 88% specificity, rule in 3/5 = 99% specificity, rule in 4/5 = 98% - 100% specificity, rule in Patients with 3/5 or 4/5 tests showed post-test probability of the condition 94-99%.
Beattie, 2008
Journal of Orthopaedic & Sports PT
Current Understanding of Lumbar Intervertebral Disc Degeneration
- Strongly linked to genetics
- Loss of hydration in the nucleus is caused by an impairment of the diffusion of O2, H2O, nutrients and metabolites
- Hydrostatic properties can be maintained with degeneration as long as the annulus provides adequate support
- inadequate findings for PT intervention, future research needed
Sterling, 2014
Journal of Physiotherapy
Physiotherapy management of WAD
Learman, et. al, 2014
Physiotherapy Canada
No differences in outcomes (pain/disability) in people with LBP who met the clinical prediction rule for lumbar spine manipulation when a pragmatic non-thrust manipulation was used as the comparator
- found that non-thrust manipulation is just as effective as thrust manipulation for patients who met the CPR for manipulation
Nyberg, Smith, 2013
Journal of Manual & Manipulative Therapy
SMP clinical considerations to improve accuracy/reliability:
Use of a lighter, more passive receptive palpation technique increasing tactile discrimination of spinal movement behavior.
Anderson, et al, 2005
Spine Journal
Cervical Multifidus
- Originates from the facet capsules of lower cervical verterbrae & tranverse processes of upper thoracic vertebrae, and inserts on the SP and laminae of superior cervical vertebrae -> therefore, forces in the multifidus can alter load distribution in the facet capsular ligaments and be a source of neck pain/injury
- multifidus can be used to maintain spinal stability
Laslett, 2008
The Journal of Manual & Manipulative Therapy
SIJ CPR
- 3 or more provocation tests provoke the usual pain: distraction, compression, thigh thrust, Gaeslen’s, sacral thrust
- centralization of pain is not achieved during McKenzie evaluation of repeated movements/sustained positions
- treatments most likely to be effective include specific lumbopelvic stabilization
Rabin, et al 2014
Journal of Orthopaedic & Sports Physical Therapy
Unable to validate previous CPR rules to determine if patients with LBP would benefit from lumbar stabilization exercise. Modified CPR containing presence of aberrant movement and a positive prone instability test had better predictive validity in identifying those who would benefit from LSE.
Rivett, et al 2006
Australian Physiotherapy Association
Most common presenting symptom of vertebrobasilar insufficiency is dizziness
other related symptoms: visual disturbances, dysarthria, dysphagia, drop attacks, nausea/vomiting, lightheadedness/fainting, disorientation/anxiety, tinnitus, facial paresthesia, pallor/tremors/sweating
- exam end-range cervical movements and obtain informed consent before performing cervical manipulation
Rushton, et al 2014
Journal of Manual Therapy
High risk for cervical arterial dysfunction = low predicted benefit of MT = avoid tx
Moderate risk for CAD = moderate predicted benefit = avoid/delay tx and monitor and reassess
Low risk for CAD = low/mod/high predicted benefit of MT = treat with care/continue to monitor for change/new s/s
Thomas, 2003
Physical Medicine and Rehab Clinics of North America
History and physical exam are essential for assessment of patients with lumbar spinal stenosis. Common differential diagnoses include peripheral neuropathy, arteriovascular disease and hip arthrosis.
