Extremities

Effect of manual physiotherapy in homogeneous individuals with subacromial shoulder impingement: A randomized controlled trial. Land H, Gordon S, Watt K. Physiother Res Int. 2019 Jan 25:e1768. [Epub ahead of print]

Key Findings: Manual therapy to address mobility restrictions of the thoracic spine and posterior glenohumeral capsule reduce signs and symptoms of shoulder impingement.

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Effects of neurodynamic treatment on hamstrings flexibility: A systematic review and meta-analysis. López López L, Torres JR, Rubio AO, Torres Sánchez I, Cabrera Martos I, Valenza MC. Phys Ther Sport. 2019 Nov;40:244-250. Epub 2019 Oct 15. Review

Key Findings: Neurodynamic treatment seems to be the most appropriate option to improve the passive knee extension ROM and the extensibility on hamstring musculature, proving to be more effective than other methods such as stretching.

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Spine

Impact of McKenzie Method Therapy Enriched by Muscular Energy Techniques on Subjective and Objective Parameters Related to Spine Function in Patients with Chronic Low Back Pain.

Szulc P, Wendt M, Waszak M, Tomczak M, Cieślik K, Trzaska T. Med Sci Monit. 2015 Sep 29;21:2918-32

Key Findings: Muscle Energy Techniques used in conjunction with MeKenzie exercise is effective in improving ROM, pain and disc herniation size in patients with back pain. However, this study does apply McKenzie prior to MET and we would advocate that being done in reverse order.

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No Differences in Outcomes in People with Low Back Pain Who Met the Clinical Prediction Rule for Lumbar Spine Manipulation When a Pragmatic Non-thrust Manipulation Was Used as the Comparator. Learman K et al. Physiother Can. (2014).

Key Findings: Despite the emphasis on manipulation, patients who satisfy the manipulation clinical prediction rule will benefit equally from joint mobilizations. We believe this also applies to MET.

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Lumbar muscle stiffness is different in individuals with low back pain than asymptomatic controls and is associated with pain and disability, but not common physical examination findings. Koppenhaver S, et al. Musculoskelet Sci Pract. 2019 Nov 1;45:102078.

Key Findings: Resting multifidi and erector spinae stiffness as measured by Shear-wave elastography is associated with pain and disability in the back pain population.

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Mobilisation of the thoracic spine in the management of spondylolisthesis. Mohanty PP, Pattnaik M. J Bodyw Mov Ther. 2016 Jul;20(3):598-603

Key Findings: Addressing extension loss in the lower thoracic spine in addition to standard lower quarter flexibility exercise can reduce slippage of lumbar spondylolisthesis.

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Origin, Branching, and Communications of the Intercostobrachial Nerve: a Meta-Analysis with Implications for Mastectomy and Axillary Lymph Node Dissection in Breast Cancer. Henry BM, Graves MJ, Pękala JR, et al. Cureus. 2017;9(3):e1101. Published 2017 Mar 17.

Key Findings: The intercostal brachial nerve is the anatomic connection between the upper thoracic spine and brachial plexus. This study shows as low as T3 can have a direct connection to the medial cord of the brachial plexus. We have found addressing upper thoracic vertebral and rib mechanics is very beneficial to QU neurodynamics.

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Effect of Sacroiliac Joint Manipulation on Selected Gait Parameters in Healthy Subjects. Wójtowicz S, Sajko I, Hadamus A, et al. Ortop Traumatol Rehabil. 2017 Aug 31;19(4):323-331

Key Findings: "1. Subclinical dysfunctions of the sacroiliac joints may cause functional gait disturbance. 2. Manipulation of the iliosacral joint exerts a significant effect on gait parameters, which may lead to improved gait economy and effec-tiveness. 3. Following manipulation of one iliosacral joint, altered gait parameters are noted on both the manipulated side and the contralateral side, which may translate into improved quality of locomotion."

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·Sub-classification based specific movement control exercises are superior to general exercise in sub-acute low back pain when both are combined with manual therapy: a randomized controlled study. Lehtola V, Luomajoki H, Leinonen V, et al. BMC Musculoskeletal Disorders. 2016; 17: 1-9.

Key Findings: Using directional specific exercise in conjunction with manual therapy is superior to manual therapy with general exercise. Our curriculum will show how to integrate specific exercise with FRS or ERS dysfunction.

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Motor Control

Ultrasonographic analysis of the neck flexor muscles in patients with chronic neck pain and changes after cervical spine mobilization. Jesus-Moraleida FR, et al.  J Manipulative Physiol Ther. 2011 Oct;34(8):514-24.

Key Findings: Improving joint mobility in patients with chronic neck pain can improve longus colli recruitment.

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Headaches

Evaluation of neurodynamic responses in women with frequent episodic tension type headache.

Caamaño-Barrios LH, Galán-Del-Río F, Fernández-de-Las-Peñas C, Cleland JA, Plaza-Manzano G, Ortega-Santiago R. Musculoskelet Sci Pract. 2019 Dec;44:1

Key Findings: Those suffering from tension type headaches demonstrate system wide dural restrictions suggesting evaluation of the whole person is necessary in these challenging patients.

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Non-pharmacological Management of Persistent Headaches Associated with Neck Pain: A Clinical Practice Guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Côté P, et al. Eur J Pain. 2019 Feb 1. Review.

Key Findings: Physical therapy management of cervicogenic and tension type headaches should include specific exercise and manual therapy

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