Manual medicine
Harald Breivik, William I Campbell, Michael K Nicholas in Clinical Pain Management, 2008
In view of current evidence which includes observed changes both in the structure and function of the CNS of people with pain,24 it seems apparent that manual therapy used in isolation is at best only likely to produce shortterm improvements, particularly for those with persistent/chronic pain.40,47,46,51 Conversely, if manual therapy is used as part of a multidimensional approach and is administered alongside an understanding of normal tissue healing, recovery, and natural history, while supported by other key factors including skilled examination, reassurance, pain education, and graded rehabilitation, it can occupy a valuable place in preventing chronic pain and disability.23,53,54
Physical Therapy and Pain Management
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
The evaluation process determines the tissue lesion or what structure needs treatment. Manual therapy techniques including massage, mobilization, and manipulation are highly effective in reducing pain, muscle guarding, and producing increased range of motion. The evaluation will determine whether there is a hypermobility or a hypomobility of a joint and the amount of tension in the muscles surrounding the joint. Hypermobilities, or excessive motion, in a spinal or extremity joint are effectively treated with stabilization exercises and are addressed later in this chapter. Hypomobility, or restricted motion, at a spinal or extremity joint is effectively treated with manual therapy. Manual therapy philosophies include Mennell’s — there is a pathological condition or joint disease; osteopathic structure governs function according to Cyriax — all pain has an anatomical source and with correct diagnosis and treatment directed at the cause a positive outcome will occur. The majority of information covered is a combination of osteopathic and Cyriax philosophies.
Low Back Pain and Sciatica: Pathogenesis, Diagnosis and Nonoperative Treatment
Gary W. Jay in Practical Guide to Chronic Pain Syndromes, 2016
Manual therapy includes passive stretching, soft-tissue mobilization, myofascial release, manual traction, muscle energy techniques, joint mobilization, and manipulation. Joint mobilization is a low-velocity passive stretch applied to a joint within or at the limit of its range. Manipulation uses a high-velocity thrust maneuver beyond a joint’s restricted range of motion (71, 72). More controlled trials have been carried out to evaluate manipulation than any other nonoperative treatment measures (73). However, it is difficult to interpret these studies because of a variety of methodological issues. Manipulative therapy may vary due to the variable skill levels and techniques among different practitioners, that is, physiotherapists, osteopaths, physicians, and chiropractors. A recent systematic review showed evidence of a modest beneficial effect of spinal manipulation on cLBP when compared to sham interventions judged to have no efficacy; however, this effect was not greater than other usually applied therapies (74). Spinal manipulation is probably most beneficial for the treatment of acute axial spinal pain, without radiculopathy or neurological impairment (73).
The fidelity of comparison intervention in manual therapy trial for patients with low back pain: a systematic review
Published in Physical Therapy Reviews, 2019
Mackenzie Snow, Sean Trexler, Christine Gates, Kathryn Pudoka, Mark Wilhelm
One aspect of physical therapy treatment that the CPG presents as beneficial is manual therapy. In this systematic review, manual therapy was chosen as the intervention to compare to the comparison group. According to the American Academy of Orthopedic Manual Physical Therapists (AAOMPT), manual therapy is defined as ‘a specialized area of physical therapy for the management of musculoskeletal conditions, based on clinical reasoning, using highly specific manual techniques and therapeutic exercises’ [5]. Manual therapy techniques may consist of, but are not limited to, mobilizations and/or manipulations of soft tissue and joints. In a systematic review and meta-analysis conducted by Coulter et al., manual therapy was shown to be a safe and effective treatment strategy used to significantly reduce pain as well as disability, demonstrating its value in physical therapy care in patients with low back pain [6].
Effect of dynamic stabilisation exercise therapy enhanced with muscles energy technique on some selected patients outcomes and trunk muscles function in patients with chronic non-specific low back pain: a study protocol
Published in European Journal of Physiotherapy, 2021
Usman Abba Ahmed, Thaya Nadasan, Jessica Van Oosterwijck, Sonill Sooknunan Maharaj
A review of some randomised controlled trials reported that manual therapy seems more effective on pain relief, physical function and physical disability when compared to the general form of exercises [27–30]. However, a meta-analysis did not confirm the benefit of manual therapy over exercises on long term pain and disability [28]. Additionally, a recent RCTs result favoured combining treatment effect of strengthening and spinal manipulation exercises over isolated treatment alone in chronic NSLBP population [21,31,32]. They further argued that it is uncertain if isolated strengthening or isolated mobilisation would have the same effect. Therefore, the focus of this study is to determine if stabilisation exercises (strengthening exercise) enriched with Muscles Energy Techniques (manual therapy) will provide long-term therapeutic benefits on the biopsychosocial variables when compared with isolated stabilisation exercises or standard physiotherapy in chronic NSLBP.
Manual therapy and early return to sport in football players with adductor-related groin pain: A prospective case series
Published in Physiotherapy Theory and Practice, 2020
Igor Tak, Rob Langhout, Bas Bertrand, Maarten Barendrecht, Janine Stubbe, Gino Kerkhoffs, Adam Weir
Adductor-related groin pain (ARGP) is the most common groin injury in football players (Hölmich 2007; Serner et al, 2015a). The term ARGP and the clinical characteristics of pain on palpation and resistance testing have been described previously (Hölmich 2007; Nevin and Delahunt 2014; Weir et al. 2011). The recent Doha agreement confirmed ARGP to be the preferred term (Weir et al. 2015). A recent systematic review on the treatment of groin pain in athletes found that there was moderate evidence that multimodal treatment including manual therapy may shorten the time to return to sport (RTS) (Serner et al, 2015b). This finding was based upon a previous randomized study in which manual therapy, combined with a return to running program (Weir et al. 2011), was compared to the well-established use of active exercises (Hölmich et al. 1999). The manually applied stretch of the adductor muscles used in this randomized study was followed by two weeks of active stretching and a gradual return to running program. Manual therapy offered a significantly quicker recovery (12 weeks) compared to active exercises (18 weeks) with comparable but equally low success rates regarding RTS of 50% versus 55% (Weir et al. 2011).
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