Abstract:
OBJECTIVES:To assess the feasibility of patient recruitment, the ability of patients and clinicians to comply with study protocols, and the use of data collection instruments to collect cost-effectiveness data, and to obtain variability estimates for sample-size calculations for a full-scale trial. STUDY DESIGN:Prospective, observer-blinded, pilot randomized clinical trial. SETTING:Primary contact chiropractic and medical clinics. PATIENTS:Ages 20 to 65 years, with low back-related radiating leg pain (sciatica). OUTCOME MEASURES:Self-report questionnaires were administered at baseline and 3 and 12 weeks after randomization. The measures included leg and back pain severity, frequency and bothersomeness of symptoms, leg/back disability, medication use, global improvement, satisfaction, and health care utilization. INTERVENTIONS:Medical care, chiropractic care, and epidural steroid injections. RESULTS:A total of 706 persons were screened by phone to determine initial eligibility. Of these, over 90% of those persons contacted did not meet the entrance criteria. The most common reason for disqualification was that the duration of the complaint was longer than 3 months. Twenty patients were randomized into the study. All 3 groups showed substantial improvements in the main patient-rated outcomes at the end of the 12-week intervention phase. For leg pain, back pain, frequency and bothersomeness of leg symptoms, and Roland-Morris disability score, the percent improvement varied from 50% to 84%, and the corresponding effect sizes ranged from 0.8 to 2.2. Bothersomeness of leg symptoms was the most responsive outcome associated with the largest magnitude of effect size. All within-group changes from baseline were statistically significant (P <.01). No between-group comparisons were planned or performed because of the insufficient sample size and high risk of committing type I and type II errors. CONCLUSIONS:Pilot studies such as these are important for the determination of the feasibility of conducting costly, larger scale trials. Recruitment for a full-scale study of sciatica of 2 to 12 weeks duration is not feasible, given the methods used in this pilot study. Our results do indicate, however, that there are substantial numbers of patients with sciatica more chronic in nature who would be interested in participating in a similar study. In addition, collaboration with a local health maintenance organization would likely facilitate clinician referrals and optimize the recruitment process. Patient and provider compliance was high in the pilot study, which indicates that most study protocols are feasible. Additionally, we were able to collect complete outcomes data, including those regarding health care use. A suggested modification by investigators and outside consultants has resulted in the replacement of the medication group with a minimal intervention control group (ie, self-care advice). As a result, a second pilot study of patients with sciatica of more than 4 weeks duration has been planned before a full-scale trial is attempted.
journal_name
J Manipulative Physiol Therjournal_title
Journal of manipulative and physiological therapeuticsauthors
Bronfort G,Evans RL,Anderson AV,Schellhas KP,Garvey TA,Marks RA,Bittell Sdoi
10.1067/mmt.2000.109678subject
Has Abstractpub_date
2000-10-01 00:00:00pages
536-44issue
8eissn
0161-4754issn
1532-6586pii
S0161-4754(00)52930-3journal_volume
23pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:To describe the chiropractic management of a patient suffering from a right lateral meniscus tear concurrent with calcium pyrophosphate dihydrate (CPPD) deposition disease. CLINICAL FEATURES:A 51-yr-old bus driver suffered from right knee pain (7 on a 1-10 pain scale). The onset of the pain was gradual and i...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between the right and left foot posture in terms of body mass index (BMI), sex, and age in adolescents aged 10 to 14. METHODS:A total of 1400 adolescents were included. For assessment, the Foot Posture Index (FPI-6) was used. Each foot was assessed and ranked as supinated, nor...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2018.11.035
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:To present the clinical and neurological features of a patient suffering from cervical spondylotic myelopathy. CLINICAL FEATURES:Cervical spondylotic myelopathy (CSM) is a condition in which the vascular and neural structures are compressed by bony spurring and soft tissue hypertrophy, causing ischemic damag...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to compare clinical and ultrasound findings of thumb joints in young adults with and without thumb pain associated with text messaging. METHODS:In this case-control study, 117 students with thumb pain associated with text messaging were evaluated clinically and with ultrasound analy...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2017.11.001
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to propose a quantitative evaluation for mandibular opening-closing movement asymmetries and to verify the intraexaminer and interexaminer reliability using photogrammetry in individuals with and without myogenic temporomandibular disorders. METHODS:Forty-nine female participant...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2018.11.008
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this preliminary study was to demonstrate the feasibility of a study that measures the short-term effects of a course of manual therapy (MT) and exercise (Ex) in people with moderate chronic obstructive pulmonary disease (COPD). METHODS:Fifteen participants (9 males; mean age, 56.1 years), wit...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmpt.2013.05.028
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the changes in passive ankle dorsiflexion range of motion (ROM), maximum plantar force, force-time integral, and time to heel off during walking between pre- and postapplication of modified mobilization with movement (MWM) using talus glide taping in people with li...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2014.01.007
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:The purpose of this project was to review the literature for the use of spinal manipulation for low back pain (LBP). METHODS:A search strategy modified from the Cochrane Collaboration review for LBP was conducted through the following databases: PubMed, Mantis, and the Cochrane Database. Invitations to subm...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,评审
doi:10.1016/j.jmpt.2008.10.007
更新日期:2008-11-01 00:00:00
abstract::The interaction of the body and mind in stress syndromes; the input from the mind which influences the neurological functions regulating physiological responses; and the metabolic changes that result are discussed. Treatment direction is based on clinical experience and previously published theories. The synergistic e...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1984-12-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate survey data from a national cross-sectional sample of 1427 urban and nonurban Australian women focusing on the relationship between the use of specific complementary and alternative medicine (CAM) practitioner types and the levels of CAM use across urban and nonurban...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2012.12.010
更新日期:2013-01-01 00:00:00
abstract::In the first 50 years of the chiropractic profession, a variety of unorthodox meanings for the terms "research," "science" and related words were in evidence. In harmony with popular conceptions of the day, science was constructed as a relatively static body of knowledge and was thought to reflect the will of God. Res...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 历史文章,杂志文章
doi:
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:To present an overview of possible effects of Arnold-Chiari malformation (ACM) and to offer chiropractic approaches and theories for treatment of a patient with severe visual dysfunction complicated by ACM. CLINICAL FEATURES:A young woman had complex optic nerve neuritis exacerbated by an ACM type I of the b...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2005.03.001
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To describe the clinical management with spinal manipulation of a male patient with risk factors for lumbar disk herniation initially suffering from what appeared to be mechanical low back pain that evolved into radiculopathy; also to review issues pertinent to chiropractic/manipulative management of disk her...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,评审
doi:10.1016/s0161-4754(99)70050-3
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:To describe the components of the Alberta Registered Massage Therapists Society (ARMTS) examination and their psychometric properties. METHODS:All 3 components of the ARMTS examination (knowledge, clinical judgement, and clinical skills) were administered to 112 candidates. The examination consisted of 2 wri...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1067/mmt.2002.121413
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:The aim of the current study was to investigate changes in the intrinsic inhibitory interactions within the somatosensory system subsequent to a session of spinal manipulation of dysfunctional cervical joints. METHOD:Dual peripheral nerve stimulation somatosensory evoked potential (SEP) ratio technique was u...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2010.01.005
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:Transfer capability represents the changes in performance in one task that result from practice or experience in other related tasks. Increased transfer capability has been associated with expertise in several motor tasks. The purpose of this study was to investigate if expertise in spinal manipulation therap...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2015.02.001
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To determine the reproducibility of patient positioning on radiographically evaluated static configurations of the human pelvis. DESIGN:Repeat anteroposterior radiography of the human pelvis was performed in vivo. Comparative examinations were performed after 1 hr in one subject pool. A second sample underwe...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:There has been much discussion about the role of chiropractic care in the evaluation, management, and treatment of pediatric patients. To date, no specific guidelines have been adopted that address this issue from an evidence based perspective. Previous systematic reviews of the chiropractic literature conclu...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2009.08.018
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to identify differences in the diagnosis and treatment of nonspecific low back pain among 3 professional groups in the Netherlands: orthomanual physicians, manual therapists, and chiropractors. METHODS:Information was obtained from training materials from professional groups, literat...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2005.01.008
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:A widely accepted theoretical model suggests that vertebral hypomobility can cause pain and abnormal spinal mechanics because of changes in sensory input from spinal and paraspinal tissues. The purpose of this pilot study was 3-fold: (1) to make a preliminary determination if chronic vertebral hypomobility at...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2007.04.007
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:To present the diagnosis and differential diagnosis of diabetic polyneuropathy and report a case in which a patient with this disorder was successfully managed utilizing chiropractic procedures. CLINICAL FEATURES:An 80-year-old man with a history of diabetes mellitus complained of low back pain along with bu...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:A managed care organization (MCO) examined differences in allowed cost for managing low back pain by medical providers vs chiropractors in an integrated care environment. The purpose of this study is to provide a retrospective cost analysis of administrative data of chiropractic vs medical management of low b...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2009.10.001
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:To present a case study of infantile Erb's palsy that responded to conservative chiropractic care. CLINICAL FEATURES:A 5-wk-old infant boy suffered from a limp left arm. A clinical diagnosis of Erb-Duchenne palsy was made. Birth records were obtained to further substantiate the diagnosis. INTERVENTION AND O...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1993-07-01 00:00:00
abstract::Radiation dosages to sensitive organs in full spine radiography have in recent years been a concern of physicians as well as the general public. The spine is the prime target for exposure in scoliosis radiography, though the exposure usually necessitates irradiation of several radio-sensitive organs. In recent studies...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVE:The objectives of this study were to investigate whether elbow joint position sense (JPS) accuracy differs between participants with a history of subclinical neck pain (SCNP) and those with no neck complaints and to determine whether adjusting dysfunctional cervical segments in the SCNP group improves their J...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2010.12.009
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Lumbar pathologies may cause the perception of leg pain, but the character of this pain has not been described. Diagnosis is often based on dermatomal charts, but observations reveal that the pain is not typically perceived on the skin. OBJECTIVE:To document the incidence of superficial versus deep pain loc...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2004.12.011
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:Traumatic injuries are common and may promote disruption of neuromuscular communication, triggering phenomena that lead to nerve degeneration and affect muscle function. A laser accelerates tissue recovery; however, the parameters used are varied, making it difficult to compare studies. The purpose of this st...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2019.05.012
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to systematically review the literature evaluating the reliability and validity of all available methods for measuring active and passive cervical range of motion (CROM). METHODS:Electronic databases (PubMed, MEDLINE, CINAHL, EMBASE, and AMED) were searched through OVID from the...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,评审
doi:10.1016/j.jmpt.2009.12.009
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this preliminary study was to determine feasibility of a clinical trial to measure the effects of manual therapy on sternocleidomastoid active trigger points (TrPs) in patients with cervicogenic headache (CeH). METHODS:Twenty patients, 7 males and 13 females (mean ± SD age, 39 ± 13 years), wit...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmpt.2013.05.022
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To investigate the recovery pattern in chiropractic patients being treated for long-lasting or recurrent low back pain; in particular, to identify the minimum number of required treatments and the minimum number of days from the beginning of treatment to the occurrence of improvement. DESIGN:Prospective, unc...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1067/mmt.2001.114362
更新日期:2001-05-01 00:00:00