Chiropractic Research RoundUp: March

Staying at the top of your clinical “A” game means staying on top of the latest research. In this week’s blog, our team has summarized 11 of the most relevant studies pulled from the most recent research, with best practices that you can apply today. 

Review the latest news:

✔ Magnesium relieves migraines

✔ Exercise vs. manipulation for SI dysfunction

✔ Cupping carpal tunnel syndrome

✔ Glucosamine & chondroitin for TMD

✔ Exercise rivals shoulder surgery

1. An umbrella review of 2048 papers found strong evidence that magnesium supplementation reduced the intensity and frequency of migraine. 

What dose? The abstract doesn’t tell us, but ChiroUp subscribers can reference their ChiroUp Migraine protocol for specific recommendations on magnesium dosage and every other detail for the current best practice assessment and management of this common condition.

P.S. It’s typically 400-600 mg/ day

Veronese N et al. Magnesium and health outcomes: an umbrella review of systematic reviews and meta-analyses of observational and intervention studies. Eur J Nutr. 2019 Jan 25. doi: 10.1007/s00394-019-01905-w. [Epub ahead of print]

Subscribers - this recommendation has automatically been added to your patient education reports for Migraine headache

2. “Upper limb nerve tension (ULNT) tests are useful for ruling out cervical radiculopathy. The combined use of all four tests shows a sensitivity of 0.97. “

Koulidis K et al. Diagnostic accuracy of upper limb neurodynamic tests for the assessment of peripheral neuropathic pain: A systematic review. Musculoskelet Sci Pract. 2019 Jan 12;40:21-33. doi: 10.1016/j.msksp.2019.01.001. [Epub ahead of print]

3. A double-blind trial of 44 patients found that for treating cervical radiculopathy, both active (self-flossing) and passive (in-office) neural mobilization are equally effective.

Ayub A et al. Effects of active versus passive upper extremity neural mobilization combined with mechanical traction and mobilization in females with cervical radiculopathy: A randomized controlled trial. J Back Musculoskelet Rehabil. 2019 Jan 11. doi: 10

4. A study of patients with chronic lateral epicondylalgia found that scapular muscle strengthening improves pain, pain-free grip strength, functional outcome, muscle strength, scapular position, and muscle activity.

 Click here to watch the ChiroUp 15 Minutes to Clinical Excellence video for a quick synopsis of scapular muscle assessment and management. 

Sethi K et al. Scapular muscles strengthening on pain, functional outcome and muscle activity in chronic lateral epicondylalgia. J Orthop Sci. 2018 Sep;23(5):777-782. doi: 10.1016/j.jos.2018.05.003. Epub 2018 Jun 28.

5. “Exercise and manipulation therapy appear to be effective in reducing pain and disability in patients with sacroiliac joint dysfunction  (with manipulation showing earlier results). However, the combination of these 2 therapies does not seem to bring about significantly better therapeutic results than either approach implemented separately.”

Nejati P, Safarcherati A, Karimi F. Effectiveness of Exercise Therapy and Manipulation on Sacroiliac Joint Dysfunction: A Randomized Controlled Trial. Pain Physician. 2019 Jan;22(1):53-61.

6. Twenty minutes of daily “early subthreshold aerobic exercise appears to be an effective treatment for adolescents after sport-related concussion.”

Leddy JJ, Haider MN, Ellis MJ, et al. Early Subthreshold Aerobic Exercise for Sport-Related Concussion: A Randomized Clinical Trial. JAMA Pediatr. Published online February 04, 2019. doi:10.1001/jamapediatrics.2018.4397

7. A study of 56 hands with CTS found: “Incorporation of cupping can reduce the severity of symptoms and improve the distal sensory disturbance of the median nerve.” 

Want to learn more about cupping? Consider a course from our friends at FAKTR. 

Mohammadi S et al.  The effects of cupping therapy as a new approach in the physiotherapeutic management of carpal tunnel syndrome. Physiother Res Int. 2019 Jan 29:e1770. doi: 10.1002/pri.1770. [Epub ahead of print]

8. “Open-chain hip abduction and single-limb support exercises appear to be effective options for recruiting the individual gluteus medius segments.”

Moore D et al. Rehabilitation Exercises for the Gluteus Medius Muscle Segments - An Electromyography Study. J Sport Rehabil. 2019 Feb 12:1-14. [Epub ahead of print]

9. Glucosamine and chondroitin sulfate are effective in treating TMJ disorders. (The typical dose is 1500mg Glucosamine and 1200mg Chondroitin/ day)

Ganti S, Shriram P, Ansari AS, Kapadia JM, Azad A, Dubey A. Evaluation of Effect of Glucosamine-Chondroitin Sulfate, Tramadol, and Sodium Hyaluronic Acid on Expression of Cytokine Levels in Internal Derangement of Temporomandibular Joint. J Contemp Dent Pract. 2018 Dec 1;19(12):1501-1505. PubMed PMID: 30713180.

10. Despite being one of the most common orthopedic surgeries performed, subacromial decompression is not significantly better than exercise therapy to treat patients with pain and limited function caused by shoulder impingement.

Shaughnessy AF. Decompression Surgery No More Effective Than Exercise for Shoulder Impingement Syndrome. Am Fam Physician. 2019 Feb 1;99(3):190.

11. HVLA Beats Exercise for Chronic Neck Pain: “Although both interventions were associated with immediately improved ROM and pain after treatment, HVLA manipulation was more effective than craniocervical flexion exercise in improving ROM and VAS (for chronic neck pain patients)”.

Galindez-Ibarbengoetxea X, Setuain I, Ramírez-Velez R, Andersen LL, González-Izal M, Jauregi A, Izquierdo M. Immediate Effects of Osteopathic Treatment Versus Therapeutic Exercise on Patients With Chronic Cervical Pain. Altern Ther Health Med. 2018 May;24(3):24-32.

Bonus - Re-thinking Group Think 

A 2019 JAMA study concluded that group diagnostic intelligence outperforms individuals:

“Across a broad range of medical cases and common presenting symptoms, differential diagnoses of multiple physicians significantly outperformed diagnoses of individual physicians.”

It’s no surprise that collective knowledge is superior!

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