Mar
10
2010
The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain
Chiropractic & Osteopathy 2010, 18:1doi:10.1186/1746-1340-18-1
Background
Shortening of the iliotibial band (ITB) has been considered to be associated with low back pain (LBP). It is theorized that ITB tightness in individuals with LBP is a compensatory mechanism following hip abductor muscle weakness. However, no study has clinically examined this theory. The purpose of this study was to investigate the muscle imbalance of hip abductor muscle weakness and ITB tightness in subjects with LBP.
Methods
A total of 300 subjects with and without LBP between the ages of 20 and 60 participated in this cross-sectional study. Subjects were categorized in three groups: LBP with ITB tightness (n = 100), LBP without ITB tightness (n = 100) and no LBP (n = 100). Hip abductor muscle strength was measured in all subjects.
Results
Analysis of Covariance (ANCOVA) with the body mass index (BMI) as the covariate revealed significant difference in hip abductor strength between three groups (P < 0.001). Post hoc analysis showed no significant difference in hip abductor muscle strength between the LBP subjects with and without ITB tightness (P = 0.59). However, subjects with no LBP had significantly stronger hip abductor muscle strength compared to subjects with LBP with ITB tightness (P < 0.001) and those with LBP without ITB tightness (P < 0.001).
Conclusion
The relationship between ITB tightness and hip abductor weakness in patients with LBP is not supported as assumed in theory. More clinical studies are needed to assess the theory of muscle imbalance of hip abductor weakness and ITB tightness in LBP.
In conclusion, the results of this study, in contrast with presented theory, revealed no significant difference in hip abductor strength between subjects with LBP with and without ITB tightness. However, our data indicated that both LBP subjects with ITB tightness and those without ITB tightness have significantly lower hip abductor muscle strength compared with subjects without LBP. It seems that in clinical evidence, ITB tightness might not be due to a compensatory mechanism following hip abductor weakness in subjects with LBP. More clinical studies are needed to assess the stated hypothesis regarding the theory of muscle imbalance between hip abductor muscle weakness and ITB tightness in patients with LBP.
Clinical implications
The results of this study could be beneficial to clinicians when prescribing therapeutic exercises for patients with ITB tightness, particularly those with LBP.
http://www.chiroandosteo.com/content/18/1/1
Mar
10
2010
Effectiveness of manual therapies: the UK evidence report
Chiropractic & Osteopathy 2010, 18:3doi:10.1186/1746-1340-18-3
Published: 25 February 2010
Background
The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions.
Methods
The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs.
Results
By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines. Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments.
Conclusions
Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1 hypertension when added to an antihypertensive diet. In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation.
Massage is effective in adults for chronic low back pain and chronic neck pain. The evidence is inconclusive for knee osteoarthritis, fibromyalgia, myofascial pain syndrome, migraine headache, and premenstrual syndrome. In children, the evidence is inconclusive for asthma and infantile colic.
http://www.chiroandosteo.com/content/18/1/3
Mar
10
2010
A new randomized trial shows that on average, three months after receiving a series of 10 massage sessions, patients had half the symptoms of anxiety. This improvement resembles that previously reported with psychotherapy, medications, or both. But the trial, published in the journal Depression and Anxiety, also found massage to be no more effective than simple relaxation in a room alone with soft, soothing music.
“We were surprised to find that the benefits of massage were no greater than those of the same number of sessions of ‘thermotherapy’ or listening to relaxing music,” said Karen J. Sherman, PhD, MPH, a senior investigator at Group Health Research Institute. “This suggests that the benefits of massage may be due to a generalized relaxation response.”
Massage therapy is among the most popular complementary and alternative medical (CAM) treatments for anxiety, she added. But this is the first rigorous trial to assess how effective massage is for patients with generalized anxiety disorder.
The trial randomly assigned 68 Group Health patients with generalized anxiety disorder to 10 one-hour sessions in pleasant, relaxing environments, each presided over by a licensed massage therapists who delivered either massage or one of two control treatments:
* Relaxation therapy: breathing deeply while lying down
* Thermotherapy: having arms and legs wrapped intermittently with heating pads and warm towels
All three treatments were provided while lying down on a massage table in a softly lighted room with quiet music. All participants received a handout on practicing deep breathing daily at home. Unlike the two control treatments, massage was specifically designed to enhance the function of the parasympathetic nervous system and relieve symptoms of anxiety including muscle tension.
Using a standard rating scale in interviews, the researchers asked the patients about the psychological and physical effects of their anxiety right after the 12-week treatment period ended and three months later, Dr. Sherman said.
All three of the groups reported that their symptoms of anxiety had decreased by about 40 percent by the end of treatment—and by about 50 percent three months later. In addition to the decline in anxiety, the patients also reported fewer symptoms of depression and less worry and disability. The research team detected no differences among the three groups; but the trial did not include a control group that got no treatment at all.
“Treatment in a relaxing room is much less expensive than the other treatments (massage or thermotherapy), so it might be the most cost-effective option for people with generalized anxiety disorder who want to try a relaxation-oriented complementary medicine therapy,” Dr. Sherman said.
Mar
4
2010
Soft Tissue Release by Jane Johnson
Soft Tissue Release is a clear, concise, and practical book that guides you in understanding and applying the three types of soft tissue release (STR): passive (clients do not help), active assisted (clients and therapists work together), and active (clients do it on their own). Rather than focus on the specific purposes of soft tissue release, this text provides basic information about the therapy and prepares readers to perform the techniques. The result is a text that professionals and students in massage therapy, physiotherapy, and osteopathy will find invaluable.
Soft Tissue Release thoroughly explains the differences between the three types of STR by providing step-by-step descriptions on performing each type along with the key holds, moves, and stances for various muscles. The descriptions are accompanied by handy reference charts indicating the types of clients and situations in which each technique is particularly useful. Complete instructions explain how to apply STR to various parts of the body—the trunk, the lower limbs, and the upper limbs—and detail the advantages and disadvantages of each technique. Numerous full-color photos depict the locks and stretches.
This book is available from: http://www.terrarosa.com.au/book/soft_tissue_release.htm
Mar
4
2010
Soft-tissue practitioners have been asking Whitney for a DVD on his Orthopedic Massage system for a long time. Well, we are happy to say they are finally within site. It is now available from: http://www.terrarosa.com.au/dvd/orthopedic_massage_dvd.htm
This DVD series demonstrates Lowe’s assessment and treatment methods for soft-tissue conditions. Designed to complement Lowe’s texts, these DVDs show exactly how to perform evaluation procedures that illuminate the nature of your client’s condition. They then offer you detailed demonstrations of the most effective treatment methods for both common and complex soft-tissue complaints.
Whitney applied his highly developed teaching skills to these DVDs, making them easy to follow and understand, and easy to navigate with detailed menus. Also, while Whitney has packed these DVDs full of information, they are filmed with efficiency and time considerations in mind so that practitioners may utilize their time effectively.
Use these great informational gems along with Whitney’s texts for additional visuals and active demonstration.
This DVD is now available from: http://www.terrarosa.com.au/dvd/orthopedic_massage_dvd.htm
Mar
4
2010
Assessment Through Touch, by Leon Chaitow, Now in the 3rd edition, fully revised and published in February 2010 with CD-ROM.
This useful guide to palpation for musculoskeletal diagnosis and assessment describes and illustrates the skills needed to increase sophistication of palpatory assessment skills and practice. A companion CD-ROM supports the skills with video clips, and each technique is reinforced with practical exercises and self-assessment questions.
This book is available from: http://www.terrarosa.com.au/book/palpate.htm
By combining a workbook approach with the use of video demonstrations and audio explanations on a CD-Rom, Palpation Skills provides the student and developing practitioner with a portable workshop which they can access at any time. The book helps to extend the range of skills by bringing together suggested approaches from a variety of disciplines.
* Covers the palpation and assessment of all tissues and systems, including the skin, muscle structure, and the spine and pelvis
* Gives practical guidance and instruction on a broad variety of palpation techniques
* All the palpation techniques covered are clearly described and illustrated in the text and supported by video film on the CD-Rom
* Each technique is supported by practical exercises and self assessment questions.
* Further questions relating to the video clips are included in the CD-Rom
* Directs the beginner in the correct way to carry out the techniques and provides additional techniques for the practitioner to add to his basic library of skills
* Provides outcome expectations against which progress can be measured.
* The video support can help to identify how to improve these skills.
* Written by a highly respected practitioner and teacher – brings his workshops to the individual at home and in the clinic
* 2 colour printing throughout the text helps to clarify the structure of the content and the details of the movements being shown in the diagrams
* The CD-Rom (featuring video clips) supports and supplements the written text.
This book is available from: http://www.terrarosa.com.au/book/palpate.htm
Mar
4
2010
Ortho-Bionomy, A Path to Self-Care
by Luann Overmyer
Ortho-Bionomy is based on the premise that the body inherently knows how to heal and self-correct, given the opportunity. This user-friendly self-help guide by one of the pioneers of the approach presents positions, postures, and movements designed to release tension and ease pain. Not only are the techniques simple to perform, but they can be done on one’s own, without the use of special equipment. Positions for each part of the body are clearly described in lay terms and illustrated with photos and drawings. Selected topics include low back, hip and knee pain, neck, shoulder, and rib releases, repetitive strain injuries, and arthritic pain in the hands. Quick fixes for sciatica, suggestions for dealing with menstrual cramps, and gentle movement exercises to address posture, scoliosis, and flexibility of the spine are just a few among 150 techniques described. The book also includes simple movements and exercises to increase ease, function, strength, and flexibility once the pain has subsided. Rounded out with human-interest stories and client examples, this accessible work can be used quickly and effectively by anyone with pain.
This new book is now available from: http://www.terrarosa.com.au/book/ortho_bionomy.htm
Mar
4
2010
Using real-time classroom video and photos, this 2-DVD set presents an unfolding firsthand voyage of discovery in the field of manual and movement therapies – a unique 21st century view of fascial anatomy in manual and movement therapy unexplored from the first dissections in the Renaissance until now.
This DVD is now available at: http://www.terrarosa.com.au/dvd/anatomy_trains.htm
Thomas Myers, author of Anatomy Trains, takes you on this journey with the help of master prosector Todd Garcia in his Laboratories of Anatomical Enlightenment. Together, they reveal a new understanding of clinically relevant myofascial links to your eye and hand. This DVD set uses video and photography to capture a firsthand discovery of the body’s myofascial meridians in the Anatomy Trains map- the whole-body fascial net that functionally links muscles in an integrative system.
Exploring and explaining new dissections of both traditional preserved and “fresh tissue” cadavers. See new video footage of the fascial tissues surrounding the brain & organs. A narrated slide show with labelled graphics is also included.
Mar
2
2010
Preterm infant massage therapy research: A review
Field, T., Diego, M., Hernandez-Reif, M. 2010 Infant Behavior and Development
In this paper, preterm infant massage therapy studies are reviewed. Massage therapy has led to weight gain in preterm infants when moderate pressure massage was provided. In studies on passive movement of the limbs, preterm infants also gained significantly more weight, and their bone density also increased. Research on ways of delivering the massage is also explored including using mothers versus therapists and the added effects of using oils. The use of mothers as therapists was effective in at least one study. The use of oils including coconut oil and safflower oil enhanced the average weight gain, and the transcutaneous absorption of oil also increased triglycerides. In addition, the use of synthetic oil increased vagal activity, which may indirectly contribute to weight gain. The weight gain was associated with shorter hospital stays and, thereby, significant hospital cost savings. Despite these benefits, preterm infant massage is only practiced in 38% of neonatal intensive care units. This may relate to the underlying mechanisms not being well understood. The increases noted in vagal activity, gastric motility, insulin and IGF-1 levels following moderate pressure massage are potential underlying mechanisms. However, those variables combined do not explain all of the variance in weight gain, highlighting the need for additional mechanism studies.
Mar
2
2010
The experience and management of neck pain in general practice: the patients’ perspective
Scherer, M., Schaefer, H., Blozik, E., Chenot, J.-F., Himmel, W. 2010 European Spine Journal , pp. 1-9
The objective of this study is to investigate the perspective and expectation of patients presenting with neck pain in general practice. The study design is a qualitative analysis of patient interviews and was conducted in a primary care setting in Germany. Twenty patients aged 20-78, according to theoretical sampling were included in the study. Patients tried to cope autonomously with the situation and consulted GPs only if their self-help had failed. When patients asked for external help, they usually focused on somatic treatment options such as massage, physiotherapy or injections. Most patients reported to have experiences with somatic therapies; however, they felt that some or all of these treatments were inefficient or led only to short-time improvements. Patients often avoided psychosocial themes when talking to doctors for fear of being branded as ‘neurotic’. Although neck pain is difficult to manage and a burden for patients, they have obviously found a way of both living with their pain and a pragmatic approach of talking about their symptoms with their doctor. According to the patients’ statements, the interaction between doctor and patient seems to be rather distant, ensuring that both sides avoid any issues that might touch upon psychological aspects of neck pain.