Efficacy Of Manual Therapy Research Articles

Efficacy of Manual Therapy as a Treatment for Fibromyalgia Patients An Evaluation of the Evidence

Efficacy of Manual Therapy as a Treatment for Fibromyalgia Patients An Evaluation of the Evidence

Manual therapies for pain relief in patients with headache

Objective. This systematic review aimed to assess the efficacy of manual therapies for headache relief. Method. A systematic search in MEDLINE, LILACS, Cochrane, CINAHL, Scopus and Web of Sci­ence databases was conducted for randomized and quasi-randomized trials, with no restrictions for language or year of publication. The de­scriptors were ‘Headache’, ‘Headache disorders’ and ‘Musculoskeletal manipulations’, in addition to the keyword ‘Manual therapy’ and its equivalents in Portuguese. We included studies that compared mas­sage, chiropractic manipulation, osteopathic manipulation and other spinal manipulation to groups with no intervention, other physiother­apeutic modalities or to a sham group. Results. Seven of the 567 ar­ticles initially screened were selected, including patients with tension type headache, cervicogenic headache or migraine. It was not possible to assess the magnitude of the treatment effect on the findings of this review. The main limitations were the absence of randomization and adequate allocation concealment, the lack of blinded evaluators and intention-to-treat analysis and inadequate statistical analysis. Conclu­sions. We were unable to determine the size of the treatment effect due to the selective description of findings. Owing to the high risk of bias in the articles included, the available evidence regarding the ef­ficacy of manual therapies for headache relief is insufficient.

The efficacy of manual therapy for rotator cuff tendinopathy: a systematic review and meta-analysis.

Systematic review and meta-analysis. To evaluate the efficacy of manual therapy (MT) for patients with rotator cuff (RC) tendinopathy. Rotator cuff tendinopathy is a highly prevalent musculoskeletal disorder, for which MT is a common intervention used by physical therapists. However, evidence regarding the efficacy of MT is inconclusive. A literature search using terms related to shoulder, RC tendinopathy, and MT was conducted in 4 databases to identify randomized controlled trials that compared MT to any other type of intervention to treat RC tendinopathy. Randomized controlled trials were assessed with the Cochrane risk-of-bias tool. Meta-analyses or qualitative syntheses of evidence were performed. Twenty-one studies were included. The majority had a high risk of bias. Only 5 studies had a score of 69% or greater, indicating a moderate to low risk of bias. A small but statistically significant overall effect for pain reduction of MT compared with a placebo or in addition to another intervention was observed (n = 406), which may or may not be clinically important, given a mean difference of 1.1 (95% confidence interval: 0.6, 1.6) on a 10-cm visual analog scale. Adding MT to an exercise program (n = 226) significantly decreased pain (mean difference, 1.0; 95% confidence interval: 0.7, 1.4), as reported on a 10-cm visual analog scale, which may or may not be clinically important. Based on qualitative analyses, it is unclear whether MT used alone or added to an exercise program improves function. For patients with RC tendinopathy, based on low- to moderate-quality evidence, MT may decrease pain; however, it is unclear whether it can improve function. More methodologically sound studies are needed to make definitive conclusions. Therapy, level 1a-.

A Study on the Efficacy of Manual Therapy as an Intervention to Supervised Exercise Therapy in Patients with Anterior Knee Pain: a Randomised Controlled Trial

A study on the efficacy of manual therapy as an intervention to supervised exercise therapy in patients with anterior knee pain. Design: Randomized controlled trial.

An Experimental Study to See the Efficacy of Manual Therapy and Conventional Therapy in Low Back Pain

Low back pain is a significant problem in today's society. Low back pain (LBP) is usually defined as pain, muscle tension, or stiffness. Few cases of back pain are due to specific causes: most cases are non-specific. This research work is done to see the efficacy of McKenzie technique and IFT in patients suffering from low back pain.

The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews

Objective:to review and update the evidence for different forms of manual therapy (MT) for patients with different stages of non-specific low back pain (LBP).Data sources:MEDLINE, Cochrane-Register-of-Controlled-Trials, PEDro, EMBASE.Method:A systematic review of MT with a literature search covering the period of January 2000 to April 2013 was conducted by two independent reviewers according to Cochrane and PRISMA guidelines. A total of 360 studies were evaluated using qualitative criteria. Two stages of LBP were categorized; combined acute–subacute and chronic. Further sub-classification was made according to MT intervention: MT1 (manipulation); MT2 (mobilization and soft-tissue-techniques); and MT3 (MT1 combined with MT2). In each sub-category, MT could be combined or not with exercise or usual medical care (UMC). Consequently, quantitative evaluation criteria were applied to 56 eligible randomized controlled trials (RCTs), and hence 23 low-risk of bias RCTs were identified for review. Only studies providing new updated information (11/23 RCTs) are presented here.Results:Acute–subacute LBP: STRONG-evidence in favour of MT1 when compared to sham for pain, function and health improvements in the short-term (1–3 months). MODERATE-evidence to support MT1 and MT3 combined with UMC in comparison to UMC alone for pain, function and health improvements in the short-term.Chronic LBP:MODERATE to STRONG-evidence in favour of MT1 in comparison to sham for pain, function and overall-health in the short-term. MODERATE-evidence in favour of MT3 combined with exercise or UMC in comparison to exercise and back-school was established for pain, function and quality-of-life in the short and long-term. LIMITED-evidence in favour of MT2 combined with exercise and UMC in comparison to UMC alone for pain and function from short to long-term. LIMITED-evidence of no effect for MT1 with extension-exercise compared to extension-exercise alone for pain in the short to long-term.Conclusion:This systematic review updates the evidence for MT with exercise or UMC for different stages of LBP and provides recommendations for future studies.

The biology of manual therapies.

Each year, more than 18 million adults in the United States receive manual therapies, at a total annual out-of-pocket cost of $3.9 billion. Although there is growing evidence supporting the efficacy of manual therapies, little is known about the mechanisms underlying these treatments. This lack of basic knowledge significantly limits the development of rational strategies for the use of these treatments and potentially hinders their acceptance by the wider scientific and health care communities. Many authors have hypothesized that manual therapies act by disrupting the pain-spasm-pain cycle, but relatively little experimental evidence has supported this hypothesis. The authors have tested this hypothesis and summarize their work on the biology of manual therapies.

Efficacy of manual therapy in infant colic: a pragmatic single-blind randomised controlled trial

<h3>Aims</h3> Excessive crying in otherwise healthy infants, often termed infant colic, continues to be an enigmatic condition to treat. Manual therapy is an option, yet the evidence remains controversial not least because of the role of the parent in reporting the child9s symptoms. The aim of this study was to compare a short course of manual therapy with no treatment, and to consider any biasing effect by the parent on the report of crying. <h3>Methods</h3> Infants below the age of 8 weeks were randomised to one of three groups: i) infant treated, parent aware; ii) infant treated, parent unaware; iii) infant not treated, parent unaware. The primary outcome was a daily crying time diary completed by parents over a period of 10 days during which the infant was treated on a needs basis. <h3>Results</h3> In parents blinded to treatment allocation, using conservative cut-off values to determine a clinically significant improvement in crying time, the increased odds of improvement in treated infants compared to those not receiving treatment were statistically significant at day 8 (adjusted OR 8.1 (95% CI 1.4 to 45.0)) and at day 10 (adjusted OR 11.8 (2.1 to 68.3)). The number needed to treat was 3. In contrast, the odds of improvement in treated infants were not significantly different in blinded compared to non-blinded parents (adjusted ORs 0.7 (0.2 to 2.0) and 0.5 (0.1 to 1.6) at days 8 and 10 respectively). <h3>Conclusion</h3> These findings support a short-term effect of manual therapy that does not appear to be influenced significantly by parental reporting bias.

A Dutch View of the ‘‘Science’’ of CAM 1986—2003

Between 1986 and 2003, research efforts on complementary and alternative medicine (CAM) were subsidized by the Dutch government. This led to 12 academic theses and a considerable number of papers in medical journals. In our review, we have summarized the results of this research, grouped by therapeutic category (that is, acupuncture, paranormal therapies, naturopathy, manual therapies, homeopathy and anthroposophical medicine.) Of the 12 theses, four were written in Dutch, three of which were not subsequently published in peer-reviewed journals, while the fourth, on enzyme therapy, led to a number of papers in Dutch medical journals. In three instances, mildly positive findings were reported: on the efficacy of manual therapies, the use of acupuncture analgesia in surgery, and an elimination diet against migraine and tension headaches. These positive conclusions can easily be explained by methodological shortcomings (e.g., not using credible placebo-control groups); in the other nine theses, the researchers themselves had drawn negative conclusions. The Dutch government ended its financial support for CAM research in 2006.

Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review

BackgroundThe treatment of adolescent idiopathic scoliosis is contingent upon many variables. Simple observation is enough for less serious curvatures, but for very serious cases surgical intervention could be proposed. Between these there is a wide range of different treatments. Manual therapy is commonly used: the aim of this paper is to verify the data existing in the literature on the efficacy of this approach.MethodsA systematic review of the scientific literature published internationally has been performed. We have included in the term manual therapy all the manipulative and generally passive techniques performed by an external operator. In a more specific meaning, osteopathic, chiropractic and massage techniques have been considered as manipulative therapeutic methods. We performed our systematic research in Medline, Embase, Cinhal, Cochrane Library, Pedro with the following terms: idiopathic scoliosis combined with chiropractic; manipulation; mobilization; manual therapy; massage; osteopathy; and therapeutic manipulation. The criteria for inclusion were as follows: Any kind of research; diagnosis of adolescent idiopathic scoliosis; patients treated exclusively by one of the procedures established as a standard for this review (chiropractic manipulation, osteopathic techniques, massage); and outcome in Cobb degrees.ResultsWe founded 145 texts, but only three papers were relevant to our study. However, no one of the three satisfied all the required inclusion criteria because they were characterized by a combination of manual techniques and other therapeutic approaches.ConclusionThe lack of any kind of serious scientific data does not allow us to draw any conclusion on the efficacy of manual therapy as an efficacious technique for the treatment of Adolescent idiopathic scoliosis.

Nichtmedikament�se Therapie myofaszialer Schmerzen

In a prospective study, the efficacy of manual therapy and dry needling was examined in 84 patients with chronic low back pain (mean duration of pain 4.4 years). The initial value of pain on the visual analogue scale was about 6.6, the follow up value was reduced to 3.67 (p=0.0033). Manual trigger point therapy of myofascial trigger points in the low back is effective.

The Role of Therapeutic Exercise in the Conflicting and Unstable Shoulder

Context: The use of therapeutic exercise and manual therapy in rehabilitation of the unstable and conflicting shoulder (UCS) is widespread. In the literature, there are several electromyographical studies that have analysed the effect of specific physical exercises and clinical trials on the effectiveness of specific rehabilitative protocols. However, it has not been established yet what is the best intervention for these disorders.Objective: In order to establish general recommendations for the treatment of UCS, we have reviewed the results of some electromyographical studies to identify the best exercises to recruit specifically the shoulder girdle muscles and some clinical trials that have proposed the utilisation of therapeutic exercise and manual therapy for UCS.Methods: Review of the literature of the last 10 years. We have searched Pedro, Medline and the Cochrane Library for randomised clinical trials, systematic reviews and electromyographical studies on rehabilitative protocols based on therapeutic exercise and manual therapy.Outcomes: It is common practice for clinicians to consider the involvement of patients with shoulder instability or impingement in a programme of exercises, before proceeding to a surgical intervention. Our analysis of the literature provides evidence of the efficacy of manual therapy associated with therapeutic exercises for decrease in pain, recovery of patient's strength and restoration of abilities.Conclusions: While the analysed studies are inconclusive, on the basis of the available data, we suggest some general rehabilitative principles for the treatment of the unstable and conflicting shoulder.

Efficacy of manual therapy.

The use of manual therapy to treat somatic pain syndromes and associated disabilities is widespread. Yet, the efficacy of manual therapy has not been previously established because equivocal findings in the literature prevent definitive conclusions. The purposes of this article are (1) to establish objective criteria for judging the validity of manual therapy research, (2) to identify and discuss the results of those trials that were determined to be valid demonstrations of treatment efficacy or valid demonstrations of nonuseful therapy, and (3) to determine whether patients who benefit from manual therapy have common characteristics. The abstracts or full reports of 146 titles with appropriate key words were reviewed. Of these, 105 studies were not primary studies of manual therapy and were thus eliminated from review. In the 41 remaining studies, 18 did not utilize statistical comparisons or report blinded assessment of outcome measures. Nine controlled studies yielded negative results, but the statistical power or minimum sample size required to detect potential differences between manual therapy and control groups was not described. The 14 studies that met the efficacy criteria were categorized by the following factors: (1) the anatomical region of intervention, (2) pragmatic versus explanatory goals, and (3) primary intervention (manipulation, mobilization, combination). There was a paucity of valid explanatory research in all areas and a particular absence of controlled trials involving manual therapy applied to the peripheral joints. Manual therapy for low back pain, however, was studied extensively. The analysis of valid trials provided clear evidence that manual therapy, particularly manipulation, can be an effective modality when used to treat patients who have low back pain. A preliminary "profile" of the patient with low back pain who would likely benefit from manual therapy included acute symptom onset with less than a 1-month duration of symptoms, central or paravertebral pain distribution, no previous exposure to spinal manipulation, and no pending litigation or workers' compensation. Suggestions for future manual therapy research are discussed.