Dynamic Chiropractic – December 2, 2012, Vol. 30, Issue 25

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Journal of Manipulative and Physiological Therapeutics

Sept 2012 Abstracts Volume 35, Issue 7

The JMPT is the premier scientific journal of the chiropractic profession, dedicated to the advancement of chiropractic health care. The National University of Health Sciences, owner of the journal, upholds the journal's compliance with the highest publication standards, which expressly support editorial freedom and best publication practices.

The JMPT is an independent publication that strives to provide the best scientific information that improves health care practice and future research.

Musculoskeletal Symptoms and Risk Factors Due to High Workload Computer Use

Chiung-Yu Cho, PT, PhD, et al.

Objective: Although the prevalence of reported discomfort by computer workers is high, the impact of high computer workload on musculoskeletal symptoms remains unclear. The purpose of this study was to investigate the prevalence of musculoskeletal symptoms for office workers with high computer workload. The association between risk factors and musculoskeletal symptoms was also assessed.

Methods: Two questionnaires were posted on the Web sites of three companies and one university to recruit computer users in Tainan, Taiwan, during May to July 2009. The 12-item Chinese Health Questionnaire and Musculoskeletal Symptom Questionnaire were chosen as the evaluation tools for musculoskeletal symptoms and its associated risk factors. Chinese Health Questionnaire greater than five and computer usage greater than seven h/d were used to as the cutoff line to divide groups. Descriptive statistics were computed for mean values and frequencies. X2 Analysis was used to determine significant differences between groups. A 0.05 level of significance of was used for statistical comparisons.

Results: A total of 254 subjects returned the questionnaire, of which 203 met the inclusion criteria. The three leading regions of musculoskeletal symptoms among the computer users were the shoulder (73%), neck (71%), and upper back (60%) areas. Similarly, the three leading regions of musculoskeletal symptoms among the computer users with high workload were shoulder (77.3%), neck (75.6%), and upper back (63.9%) regions. High psychologic distress was significantly associated with shoulder and upper back complaints (odds ratio [OR], 3.46; OR, 2.24), whereas a high workload was significantly associated with lower back complaints (OR, 1.89). Females were more likely to report shoulder complaints (OR, 2.25).

Conclusions: This study found that high psychologic distress was significantly associated with shoulder and upper back pain, whereas high workload was associated with lower back pain. Women tended to have a greater risk of shoulder complaints than men. Developing an intervention that addresses both physical and psychologic problems is important for future studies.

Effects of Grade III Talocrural Joint Mobilization on Balance in Elderly Women

Adriana Pertille, PT, PhD, et al.

Objective: The purpose of this study was to evaluate the immediate effects of a single treatment session of bilateral grade III mobilization of the talocrural joint on the balance of elderly women.

Methods: Thirty-two elderly women (age, 65-80 years) with low physical activity levels completed balance evaluation using baropodometry, the Functional Reach Test and the Timed Up and Go Test, and plantar flexion and dorsiflexion range of motion (ROM), before and immediately after the mobilization (n = 16) or sham (n = 16). Each subject was submitted to a total of twelve 30-second grade III mobilizations, six for each ankle, in a single treatment session.

Results: No significant difference was found for intragroup and intergroup comparisons in the balance of elderly women during the following evaluations: Functional Reach Test (P = .851), Timed Up and Go Test (P = .653), anteroposterior oscillation with eyes opened (P = .333) and with eyes closed (P = .652), and mediolateral oscillation with eyes opened (P = .486) and with eyes closed (P = .602). In addition, no significant difference was observed in right (P = .881) and left (P = .060) plantar flexion ROM and in right (P = .540) and left (P = .341) dorsiflexion ROM.

Conclusion: The results of this study suggest that a single session of bilateral grade III mobilization of the talocrural joint does not immediately improve balance and ROM in elderly women with low physical activity levels.

Chiropractic Use, Costs and Health Outcomes for Arthritis: Rural vs. Nonrural

Ekele I. Enyinnaya, DC, MS, et al.

Objective: Arthritis is considered the leading cause of disability among adults in the United States today and contributes substantially to the rising cost of health care. Residents of rural areas are especially affected. The purposes of this article are to describe chiropractic use by rural and nonrural individuals with arthritis and to identify differences in other health care use and health status by those using chiropractic care plus conventional care or conventional care alone.

Methods: A longitudinal cohort from panel 12 (N = 12,440) of the Medical Expenditure Panel Survey spanning 2007 to 2008 was selected for this study to represent changes in health care expenditures and use and outcomes throughout this period. The population was stratified by self-reported physician-diagnosed arthritis and rural status and compared across demographics, health status, and health care use and expenditures, including use of chiropractic services plus conventional care or conventional care alone.

Results: Twice as many rural people with arthritis had one or more visits with a doctor of chiropractic compared with nonrural persons with arthritis. More rural chiropractic users with arthritis reported their perceived health status as excellent, very good, or good compared with nonrural chiropractic users with arthritis and to rural people with arthritis who reported no chiropractic visits. Health care expenditures for other physician services were higher among rural chiropractic users with arthritis than nonrural users with arthritis.

Conclusions: Differences in chiropractic use were observed between rural and nonrural individuals with arthritis. More studies are needed to investigate these differences and the impact on health care use and expenditures and outcomes of individuals with arthritis.

Predicting Improvement in LBP Patients Receiving Chiropractic Care

Cynthia Peterson, DC, MMedEd, et al.

Objectives: The purpose of this study was to investigate outcomes and prognostic factors in patients with acute or chronic low back pain (LBP) undergoing chiropractic treatment.

Methods: This was a prognostic cohort study with medium-term outcomes. Adult patients with LBP of any duration who had not received chiropractic or manual therapy in the prior three months were recruited from multiple chiropractic practices in Switzerland. Participating doctors of chiropractic were allowed to use their typical treatment methods (such as chiropractic manipulation, soft-tissue mobilization, or other methods) because the purpose of the study was to evaluate outcomes from routine chiropractic practice. Patients completed a numerical pain rating scale and Oswestry disability questionnaire immediately before treatment and at one week, one month, and three months after the start of treatment, together with self-reported improvement using the Patient Global Impression of Change.

Results: Patients with acute (<4 weeks; n = 523) and chronic (>3 months; n = 293) LBP were included. Baseline mean pain and disability scores were significantly (P < .001) higher in patients with acute LBP. In both groups of patients, there were significant (P < .0001) improvements in mean scores of pain and disability at one week, one month, and three months, although these change scores were significantly greater in the acute group. Similarly, a greater proportion of patients in the acute group reported improvement at each follow-up. The most consistent predictor was self-reported improvement at one week, which was independently associated with improvement at one month (adjusted odds ratio [OR], 2.4 [95% confidence interval, 1.3-4.5] and 5.0 [2.4-10.6]) and at three months (2.9 [1.3-6.6] and 3.3 [1.3-8.7]) in patients with acute and chronic pain, respectively. The presence of radiculopathy at baseline was not a predictor of outcome.

Conclusions: Patients with chronic and acute pain reporting that they were "much better" or "better" on the Patient Global Impression of Change scale at one week after the first chiropractic visit were four to five times more likely to be improved at both one and three months compared with patients who were not improved at one week. Patients with acute pain reported more severe pain and disability initially but recovered faster. Patients with chronic and acute back pain both reported good outcomes, and most patients with radiculopathy also improved.

Risk Factors for Nonspecific LBP in Office Workers: Literature Review

Prawit Janwantanakul, PhD, et al.

Objective: The purpose of this study was to systematically review prospective cohort studies to identify risk factors for the onset of low back pain (LBP) in office workers.

Methods: Online searches were conducted on PubMed, CINAHL Plus with full text, ScienceDirect, PEDro, ProQuest, and Scopus databases from 1980 to November 2011 using the following keywords: low back pain paired with risk or prognostic factors and office or computer or visual display unit (VDU) or visual display terminal (VDT). The methodological quality of each study was assessed using a 21-item checklist, which was divided into two parts: the internal validity (11 items) and descriptive quality (10 items) of studies. Strength of evidence for risk factors associated with the development of nonspecific LBP was assessed by defining five levels of evidence based on the number of studies and the quality score of studies.

Results: Eighteen full-text articles were identified, and 15 were excluded. A total of three articles were judged to meet the selection criteria and were included in the methodological quality assessment. Risk factors were divided into three groups: individual, work-related physical, and work-related psychosocial risk factors. There was strong evidence that history of LBP is a predictor of the onset of LBP. Limited evidence was found that the combination of postural risk factors and job strain is associated with the onset of LBP.

Conclusion: After review of three high-quality prospective studies on the association between risk factors and the onset of nonspecific LBP in office workers, few risk factors were found to predict the onset of LBP in office workers.

Shoulder Pain in Elite Athletes: Prevalence and Risk Factors

Mohammad Mohseni-Bandpei, PT, PhD, et al.

Objective: Shoulder sports injuries are relatively common in athletes who perform highly repetitive motions. The purposes of this study were to determine the prevalence of and risk factors for shoulder injuries and to analyze how individual and other sport characteristics contribute to the risk of shoulder injuries among six overhead sports, those being swimming, rowing, wrestling, basketball, volleyball, and handball.

Methods: A cross-sectional study was carried out on 613 Iranian overhead sports athletes in different collegiate sport fields. Data were collected using different questionnaires. A structured questionnaire including demographics, sport characteristics, and also prevalence and risk factors of shoulder pain was used. Visual analogue scale and Disability of the Arm, Shoulder, and Hand questionnaires were used to determine the pain intensity and functional disability, respectively.

Results: Point, last six-months, last year, and lifetime prevalences of shoulder pain were 21.4%, 29%, 38.8%, and 41.6%, respectively. The highest point prevalence was related to the rowing athletes with 31.9% and the lowest for swimming athletes (12.3%). Sex, body mass index, sport level, days of practice per week, and satisfaction with income were found to be significantly correlated with the prevalence of shoulder pain (P < .05 in all instances). For those with shoulder pain, the mean pain intensity and functional disability were 53.8 mm and 15.46%, respectively.

Conclusions: The prevalence of shoulder pain in athletes with highly repetitive overhead motions seems to be high.

JMPT abstracts appear in DC with permission from the journal. Due to space restrictions, we cannot always print all abstracts from a given issue. Visit www.journals.elsevierhealth.com/periodicals/ymmt for access to the complete September 2012 issue of JMPT.


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