Chiropractic Research RoundUp: February
ChiroUp reviewed over 1,000 new abstracts last month. Check out the top 18 summaries that will impact your management from head-to-toe…
Review the latest news:
✔ Top undiagnosed causes of hip pain
✔ High false-positive carpal tunnel rate for NCV’s
✔ Therapeutic tape for tennis elbow and shoulder dysfunction
✔ Low vitamin D may contribute to scoliosis
✔ Surprise: ultrasound works for ______ but not _______
Head & Spine
1. A small study of 31 patients with forward head posture found “The combination of upper cervical and upper thoracic spine mobilization indicated better overall short-term outcomes in craniovertebral angle, numeric pain rating scale, and respiratory function, compared with deep cervical flexion exercises.”
2. Manual Therapy Wins Again! A new JAMA randomized clinical trial of 259 lumbar spine stenosis (LSS) patients compared the effectiveness of three non-surgical options and concluded ”Manual therapy/individualized exercise had a greater proportion of responders in symptoms and physical function (20%) and walking capacity (65.3%) at 2 months compared with medical care (7.6% and 48.7%, respectively) or group exercise (3.0% and 46.2%, respectively). Although LSS is a chronic degenerative condition, patients with LSS can show improvement in walking capacity with nonsurgical approaches.”Schneider MJ, Ammendolia C, Murphy DR, et al. Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis: A Randomized Clinical Trial. JAMA Netw Open.2019;2(1):e186828. doi:10.1001/jamanetworkopen.2018.6828
Shoulder
3. Short-term rigid and Kinesio taping may help improve scapular dyskinesis and pectoralis minor length in overhead athletes.”
4. Another study of 30 overhead athletes confirmed positive effects of therapeutic taping on scapular joint position sense and movement control.
5. A study of 23 minor league baseball players found: “Stretching the contralateral SI joint improved Glenohumeral Rotation Deficits (GIRD) more than the sleeper's stretch.”
Left SI stretch for Right-sided GIRD - While lying supine, grab your left knee with your right hand and forcefully pull your knee toward your right shoulder while fully abducting your left arm and shoulder in the opposite direction. Hold this position for 30 seconds and repeat three times.
6. A study of 46 participants with shoulder impingement concluded: “The effect of high-intensity laser therapy plus exercise is not higher than exercise alone to reduce pain and improve functionality in patients with subacromial syndrome.”
Elbow
7. A study of 30 lateral epicondylopathy patients found: “Therapeutic taping in addition to exercises is more effective than sham taping and exercises only in improving pain in daily activities and arm disability.”
8. In patients with acute tennis elbow symptoms: “A counterforce brace provides significant reduction in the frequency and severity of pain in the short term as well as overall elbow function.”
9. A study of 50 patients found that “extracorporeal shock wave therapy (ESWT) and therapeutic ultrasound are equally effective in the treatment of lateral epicondylosis.”
Hand/Wrist
10. A study of 40 asymptomatic hands found that nerve conduction studies had a high false-positive rate (43%) for carpal tunnel syndrome; while the false positive rate for diagnostic ultrasound was lower (23%).
11. In patients with mild carpal tunnel syndrome, use of a splint is an appropriate and sufficient treatment.
SI & Hip
12. In patients younger than 50, greater than 85% of hip pain that is undiagnosed or misdiagnosed by primary physicians falls into one of the four following diagnoses:
Femoroacetabular impingement (FAI) (55.3%)
Hip dysplasia (13.3%)
Lumbar spine referral (9.3%),
Inflammatory spondyloarthritis (SpA) (7.3%)
Knee
13. The A study of 36 patients with patellofemoral pain found “altered gluteus medius, vastus medialis oblique (VMO), and vastus lateralis (VL) muscle activity during single leg stance and single leg squat compared to healthy subjects.”
Foot/Ankle
14. “The addition of therapeutic ultrasound did not improve the efficacy of conservative treatment for plantar fasciitis. Therefore, the authors recommend excluding therapeutic ultrasound from the treatment of plantar fasciitis and agree with results of previous studies that stretching may be an effective treatment for healing plantar fasciitis.”
15. A systematic review found that “low-level laser therapy (LLLT) in patients with plantar fasciitis significantly relieves the heel pain and the excellent efficacy lasts for 3 months after treatment.”
General
16. Consider testing scoliosis patients for vitamin D deficiency: “We postulate that vitamin D deficiency and/or insufficiency (negatively) affects Adolescent Idiopathic Scoliosis development by its effect on the regulation of fibrosis, postural control, and bone mineral density.”
The liver converts vitamin D to 25-hydroxyvitamin D [25(OH)D] which can be measured in the blood.
17. A systematic review of 22 studies found: “strength training is beneficial and can be used to treat fibromyalgia. The main results included reduction in pain, fatigue, number of tender points, depression, and anxiety, with increased functional capacity and quality of life.”
18. “A single session of chiropractic manipulative therapy was shown to have an immediate effect of reducing the time required for asymptomatic special operations forces personnel to complete a complex whole-body motor response task.”
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