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Dynamic Chiropractic Canada – May 1, 2010, Vol. 03, Issue 03
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JMPT Research Abstracts

March/April 2010, Vol. 33, Issue 3

Spinal Manipulation: Effect on Rehab Protocol for Patients With Chronic Neck Pain

Bernadette Murphy, PhD, DC, Heidi Haavik Taylor, PhD, BSc (Chiro), Paul Marshall, PhD

Objective: This pilot study sought to (1) determine whether a four-week period of chiropractic care improved the ability of chronic neck pain patients to respond to an eight-week period of exercise rehabilitation; and (2) determine effect sizes to use in sample size calculations for future studies.

Methods: Twenty male and female participants (age 43 ± 12 years; body mass index 27 ± 4.5 [mean ± SD]) with chronic nonspecific neck pain were randomized into either a chiropractic care combined with exercise or an exercise-only group. Group 1 received four weeks of chiropractic care, and group 2 waited four weeks before both groups participated in an eight-week exercise intervention. The following outcome measures were assessed in week 1 (baseline), week 4, and at week 12: Neck Disability Index (NDI); Visual Analogue Scale (VAS), both now and worst; neck flexion-relaxation response; and feed-forward activation (FFA) times. A repeated-measures analysis of variance was used to evaluate the changes in the NDI and VAS over time. Effect sizes were calculated for changes in neuromuscular parameters.

Results: There were significant decreases in the NDI score (P < .001) and VAS in (P < .005) in both groups with no significant differences between the groups. Effect sizes (ESs) were as follows: NDI (.293); VAS now (.175); VAS worst (.392); flexion-relaxation (.636); FFA times: sternocleidomastoid (.1321), anterior scalene (.195). This led to sample size estimates as follows: flexion-relaxation response, 64 subjects per group; NDI, 145 subjects per group; VAS, 166 subjects per group.

Conclusions: Chiropractic care combined with exercise and exercise alone are both effective at reducing functional disability and pain in chronic nonspecific neck pain patients. Future studies will need at least 64 subjects per group to determine if there are differences between the groups and if these differences are attributable to changes in neuromuscular measures.


Effects of Ice Massage on Pressure Pain Thresholds and Electromyography Activity Postexercise

Laura Anaya-Terroba, PT, Manuel Arroyo-Morales, MD, PT, PhD, et al.

Objective: The purpose of this study was to investigate the effects of ice massage postexercise on pressure pain thresholds (PPTs) over the quadriceps muscle and the electromyography (EMG) root mean square (RMS).

Methods: Fifteen athletes (eight females, seven males; average age 19 ± 2 years) participated. Subjects were required to visit the laboratory on two separate occasions with a one-week interval between sessions. Participants performed five isokinetic concentric dominant knee extension contractions at 60°, 120°, 180°, and 240°/s. After exercise, they were randomly assigned to receive either an ice massage or detuned ultrasound for 15 minutes, one on each session. The PPT and RMS during maximal voluntary contraction were measured over the vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) muscles at baseline, postexercise, and five minutes postintervention. The hypothesis of interest was the intervention x time interaction.

Results: The analysis of covariance found a significant intervention x time interaction for PPT over the VM (F = 17.3, P < .001) and VL (F = 5.4, P = .03) muscles but not over the RF (F = 1.2, P = .3), indicating an increase in PPT after the ice massage. An intervention x time interaction was found for RMS of the VL (F = 5.8, P = .01) but not of the VM (F = 0.5, P = .5) or RF (F = 0.01, P = .9) muscles, indicating an increase in RMS after the ice massage. A significant positive correlation between PPT and RMS for the VL muscle was identified (r = 0.6, P = .03).

Conclusion: Ice massage after isokinetic exercise produced an immediate increase of PPT over the VL and VM and EMG activity over the VL muscle in recreational athletes, suggesting that ice massage may result in a hypoalgesic effect and improvements in EMG activity.


JMPT abstracts are reprinted with permission from the journal. Due to space restrictions, we cannot always print all abstracts from a given issue. Visit www.mosby.com/jmpt for access to the complete March/April 2010 issue of JMPT.

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