Effectiveness of Spinal Manipulation in the Treatment of Non-Musculoskeletal Disorders: A Systematic Review

Purpose: Perform a systematic review to determine if spinal manipulation (SM) is an effective treatment for non-musculoskeletal disorders. Subjects: Four studies from peer-reviewed journals that met inclusion/exclusion criteria were reviewed. Materials & Methods: Pubmed, PEDro, Chiropractic Literature, CINAHL, Cochrane were searched between March and April 2014. In order to assess methodological quality, three raters applied the PEDro scale to included studies. Results: The initial search yielded 2,324 articles covering 45 non-musculoskeletal conditions. Four randomized control trials (RCTs), met inclusion criteria. The conditions covered included: inner ear infection, infantile colic, asthma, and chronic obstructive pulmonary disease. Pedro scores ranged from 6-8, with a mean score of 7.25±.957, indicating fair to good methodological quality. Two studies reported significant improvement between groups for forced vital capacity, 6MWT and dyspnea scores for individuals with COPD and self-reported quality of life and symptom severity for individuals with asthma. Two studies found no statistically significant changes in physiologic or self-reported outcomes. Conclusions: Although, there were significant improvements in some outcome measures, the applicability of these results is limited by the poor methodological design of the studies, making it impossible to attribute these improvements to SM, alone. Therefore, there is no conclusive evidence that supports the use of SM as a treatment for non-musculoskeletal disorders. Clinical Relevance: It is imperative to investigate the possible benefits of SM in order to provide evidence based treatment to individuals with non-musculoskeletal conditions. This reviews illuminates the need for higher quality research when examining the effect of SM on non-musculoskeletal disorders

The Short-Term Effects of Thoracic Transverse Mobilization in Patients with Subacromial Shoulder Pain

Background: There is evidence that thoracic manipulation is effective for treating subacromial shoulder pain (SSP). However, evidence is limited for thoracic mobilization. Manipulation is not safe for all patients; therefore, effects of thoracic mobilization on SSP needs to be researched further. Purpose: To measure the effects of thoracic spine transverse mobilization (TSTM) and a home exercise in patients with SSP immediately after treatment, and 48 hours later. Shoulder range of motion (ROM), shoulder pain, and patient perception of treatment effects were assessed. Methods: This is a single treatment pretest/posttest design consisting of eight patients (five females, three males; mean age 26.75 +8.14 years) with shoulder pain. Participants completed a standardized examination, and then treatment using TSTM and a home exercise. Outcome measures were taken at baseline, immediately following treatment, and 48 hours later. Results:The improvements in Shoulder Pain and Disability Index (SPADI) and Numerical Pain Rating Scale (NPRS) scores were statistically significant (p Conclusion: In conclusion, a single treatment of TSTM and one exercise provided a statistically significant decrease in self-reported shoulder pain and disability measures at 48-hour follow-up. The SPADI and NPRS did not reach the minimum clinically important difference (MCID), however, the SPADI Pain subscale did. Future studies should focus on the long-term effects of TSTM, multiple treatments, and in comparison with a control group

Resiliency, Anxiety and Depression Amongst DPT Students - A Survey During the COVID-19 Pandemic

Resiliency, Anxiety and Depression Amongst DPT Students–A Survey of Three Cohorts During the COVID-19 Pandemic Michaela Corbitt, SPT; Amber Odo, SPT Mentor: Robert Boyles, PT, DSc Background: Doctor of Physical Therapy (DPT) programs are challenging due to the academic rigor, fast-paced learning environment, tuition cost, and feelings of inadequacy. Resiliency involves the ability to cope with stressors presented in daily life. Higher levels of resiliency has been associated with lower levels of depression, stress, and anxiety. This negative correlation may be key for preventing burnout, increasing life satisfaction, and prolonging careers for DPT graduates. Purpose: To assess resiliency, anxiety and depression across three DPT cohorts at a single time point during the COVID-19 Pandemic. Methods: This study utilized an anonymous, voluntary online survey on demographics, Connor Davidson Resilience Scale (CD-RISC 25) and Hospital Anxiety and Depression Scale (HADS). Means and standard deviations (SD) were performed on demographic information, HADS, and CD-RISC scores. One-way ANOVAs compared between cohorts for scores of HADS Anxiety, HADS Depression, and CD RISC. T-test compared CD-RISC means of study population with the general population. Results: 56.5% students responded to the survey; 7% were positive for depression symptoms and 51% were either borderline or positive for symptoms of anxiety. There were no significant score differences between cohorts for depression, anxiety, or resiliency (p=0.8, p=0.15, p= 0.99). There was a statistically significant difference in mean resilience scores between DPT students and the general US population (p=0.001). Conclusion: DPT students appear to be less resilient than the general population, which is a concern, as resilience may be a buffer against work-place stress and burnout