June Research Update
This blog covers 12 practical research studies from the past few weeks. We reviewed hundreds and highlighted only those papers that can enrich our practice. We changed up this week’s blog to include both the research, as well as the associated ChiroUp resource.
Review the latest news:
✔ Water and Melatonin for Migraines
✔ Cutaneous Clues to Carpal Tunnel
✔ Top Test to Rule Out FAI
✔ Throwing Injuries May Start at the Hip
✔ Obesity Increases Tendinopathy Risk
Carpal Tunnel Syndrome
“Up to 20% of carpal tunnel syndrome CTS patients demonstrate cutaneous findings involving the affected digits.”
Longitudinal fissuring
Beau's lines
Onychomadesis (shedding)
Melanonychia
Nail thickening
Hyperkeratosis
Egger A, Tosti A. Carpal Tunnel Syndrome and Associated Nail Changes: Review and Examples from the Author’s Practice. Journal of the American Academy of Dermatology. 2020 Mar 19.
Carpal Tunnel Syndrome
“Myofascial stretching of the carpal ligament showed statistically significant improvements…in numbness, tingling, pinch strength, and symptom severity.”
Shem K, Wong J, Dirlikov B. Effective self-stretching of carpal ligament for the treatment of carpal tunnel syndrome: A double-blinded randomized controlled study. Journal of Hand Therapy. 2020 May 1.
ChiroUp subscribers can access the carpal ligament stretch tutorial from the exercise library, and then incorporate the exercise when building your Lay Condition Reports for Carpal Tunnel Syndrome.
Migraine
"The present study found a significant negative correlation between daily water intake and migraine headache characteristics but further clinical trials are needed to interpret the causal relationship (in 256 participants)."
Khorsha F, Mirzababaei A, Togha M, Mirzaei K. Association of drinking water and migraine headache severity. Journal of Clinical Neuroscience. 2020 May 20.
ChiroUp subscribers can download the new ChiroUp Hydration Infographic in the Forms Library to share with your patients in-office and on social media.
Migraine
“Melatonin may be of potential benefit in the treatment-prevention of migraine in adults.”
Liampas I, Siokas V, Brotis A, Vikelis M, Dardiotis E. Endogenous Melatonin Levels and Therapeutic Use of Exogenous Melatonin in Migraine: Systematic Review and Meta-Analysis. Headache: The Journal of Head and Face Pain. 2020 Apr 30.
Subscribers can view the ChiroUp condition reference for Migraine Headache, which now includes melatonin as a supplemental consideration, plus five other research-supported options.
Femoroacetabular Impingement
“The Anterior Impingement test and FADIR test can only be used to rule out patients with FAI syndrome, while evaluation of ROM in internal rotation with neutral position may be more suitable to rule in patients with FAI syndrome.”
Pålsson A, Kostogiannis I, Ageberg E. Combining results from hip impingement and range of motion tests can increase diagnostic accuracy in patients with FAI syndrome. Age (years). 2020 Apr 25;36:9.
Editor’s note: The author’s description of the Anterior Impingement and FADIR tests are nearly identical, with the former entailing 90 degrees of hip flexion, and the latter performed with “maximal” hip flexion.
ChiroUp subscribers can instantly review the Anterior Impingement and FADIR test tutorial from the clinical evaluations library.
Lateral Epicondylopathy
“A treatment program using eccentric strengthening of adequate intensity and duration seemed to be most effective for treating lateral elbow tendinopathy.”
Chen Z, Baker NA. Effectiveness of eccentric strengthening in the treatment of lateral elbow tendinopathy: A systematic review with meta-analysis. Journal of Hand Therapy. 2020 Apr 11.
The ChiroUp lay condition report for Lateral Epicondylopathy includes eccentric rehabilitation exercises.
Tendinopathy
“Obesity is associated with a higher risk of tendinopathy, tendon tear and rupture, and complications after tendon surgery than non-obesity.”
Medial epicondylitis: odds ratio (OR) 1.9
Achilles tendinopathy: OR 3.81
Patellar tendinopathy: OR 1.10
Plantar fasciitis: OR 2.97
Rotator cuff tendinopathy: OR 1.25
Rotator cuff tear: OR 2.35
Rotator cuff rupture leading to tendon surgery OR 3.13 – 3.51
Macchi M, Spezia M, Elli S, Schiaffini G, Chisari E. Obesity Increases the Risk of Tendinopathy, Tendon Tear and Rupture, and Postoperative Complications: A Systematic Review of Clinical Studies. A Publication of The Association of Bone and Joint Surgeons®| CORR®. 2020 Apr 14.
ChiroUp subscribers can incorporate weight management and proper nutrition ADL advice into any lay condition report with the click of a mouse.
Knee Osteoarthritis
“The addition of resistance hip exercises resulted in greater improvements in patient-reported pain and function."
Hislop AC, Collins NJ, Tucker K, Deasy M, Semciw AI. Does adding hip exercises to quadriceps exercises result in superior outcomes in pain, function and quality of life for people with knee osteoarthritis? A systematic review and meta-analysis. British Journal of Sports Medicine. 2020 Mar 1;54(5):263-71.
The ChiroUp lay condition reports and exercise plans for Patellofemoral Pain Syndrome, Chondromalacia Patella, and Knee Osteoarthritis have a strong focus on hip stability exercises.
Chronic LBP
“This qualitative analysis demonstrates the multifaceted benefits of tai chi for older adults living with chronic LBP.”
Lee TL, Sherman KJ, Hawkes RJ, Phelan EA, Turner JA. The Benefits of T'ai Chi for Older Adults with Chronic Back Pain: A Qualitative Study. The Journal of Alternative and Complementary Medicine. 2020 May 5.
Subscribers can download the Mind-Body Infographic in the Forms Library provides additional practical advice and can be attached to any condition report with one click.
Throwing Injuries
“Decreased hip internal rotation range of motion of the stride leg was significantly associated with elbow and shoulder pain incidence. Players, coaches, and clinicians should consider the physical function of the trunk and lower extremities for the prevention of elbow and shoulder pain.”
Sekiguchi T, Hagiwara Y, Yabe Y, Tsuchiya M, Itaya N, Yoshida S, Yano T, Sogi Y, Suzuki K, Itoi E. Restriction in the hip internal rotation of the stride leg is associated with elbow and shoulder pain in elite young baseball players. Journal of shoulder and elbow surgery. 2020 Jan 1;29(1):139-45.
ChiroUp subscribers can visit the newest protocol on Little League Elbow for a more detailed description of how lower body mechanics affect upper extremity injuries.
Whiplash
“There was a consistent positive association between motor vehicle collision-related neck injury and future neck pain. (2.3-fold elevated risk)”
Nolet PS, Emary PC, Kristman VL, Murnaghan K, Zeegers MP, Freeman MD. Exposure to a Motor Vehicle Collision and the Risk of Future Neck Pain: A Systematic Review and Meta-Analysis. PM&R. 2019 Nov;11(11):1228-39.
Post-MVC Back Pain
“Persistent low back pain is a relatively common complaint after acute injury in a motor vehicle collision, with a reported 1 year post-crash prevalence of at least 31% of exposed individuals. For the patient with chronic low back pain who was initially injured in a motor vehicle collision, more often than not (63 % of the time) the condition was caused by the [accident].”
Nolet PS, Emary PC, Kristman VL, Murnaghan K, Zeegers MP, Freeman MD. Exposure to a motor vehicle collision and the risk of future back pain: A systematic review and meta-analysis. Accident Analysis & Prevention. 2020 Jul 1;142:105546.
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