Comparing Targeted Thrust Manipulation With General Thrust Manipulation In Patients With Low Back Pain. A General Approach Is As Effective As A Specific One. A Randomised Controlled Trial

ABSTRACT Background: Spinal manipulation is commonly used to treat back pain. The application of spinal manipulation has traditionally involved an element of targeting the technique to a level of the spine where the proposed movement dysfunction is sited. We evaluated the effects of a targeted manipulative thrust versus a thrust applied generally to the lumbar region. Methods: A randomised controlled clinical trial in patients with low back pain following CONSORT guidelines. Sixty subjects were randomly allocated to two groups—one group received a targeted manipulative thrust (TT) (n=29) and the other a general manipulation thrust (GT) (n=31) to the lumbar spine. Thrust was either localised to a clinician-defined symptomatic spinal level or an equal force was applied through the whole lumbo-sacral region. We measured pressure-pain thresholds (PPT) using algometry and muscle activity (magnitude of stretch reflex) via surface electromyography (EMG). Numeric ratings of pain and Oswestry disability index scores were collected. Results: Repeated measures of analysis of covariance (ANCOVA), revealed no between group differences in self-reported pain or pressure-pain threshold for any of the muscles studied. Summary: A general thrust procedure--applied without any specific targeting--was as effective in reducing participants’ pain scores as targeted approaches

Rounding and uncertainties in parameters determined from fits to experimental data, or a failure to round data-analysis fit parameters properly may make them useless

Almost no physically interesting physico/chemical parameter is determined directly from a measurement. Rather, they are determined by performing a least-squares fit of some model to a set of data. Unfortunately, there seems to be no commonly accepted set of `best practices' for determining how to round off such fitted parameter values to a minimum number of significant digits while ensuring that they retain the ability to reproduce the experimental data within their uncertainties. This sometimes results in lists of fitted parameters with no quoted uncertainties that have 2--3 times as many significant digits as the data being fitted, or to the results of an analysis being defined by parameters that are (unnecessarily?) quoted to more digits than normal computer double precision, which makes those results difficult or impossible to apply. Alternatively, it may also lead to fitted parameters being `over-rounded' so that the model no longer accurately represents the experimental data. This presentation describes a `best practice' to address these problems, offers a general-purpose least-squares fitting program that applies it, and provides an illustrative application of this approach in a study of the A\,^1\Sigma_u^+ - X\,^1\Sigma_g^+ system of Mg$_2$.Ope

Pulsed electromagnetic energy treatment offers no clinical benefit in reducing the pain of knee osteoarthritis: a systematic review

Background The rehabilitation of knee osteoarthritis often includes electrotherapeutic modalities as well as advice and exercise. One commonly used modality is pulsed electromagnetic field therapy (PEMF). PEMF uses electro magnetically generated fields to promote tissue repair and healing rates. Its equivocal benefit over placebo treatment has been previously suggested however recently a number of randomised controlled trials have been published that have allowed a systematic review to be conducted. Methods A systematic review of the literature from 1966 to 2005 was undertaken. Relevant computerised bibliographic databases were searched and papers reviewed independently by two reviewers for quality using validated criteria for assessment. The key outcomes of pain and functional disability were analysed with weighted and standardised mean differences being calculated. Results Five randomised controlled trials comparing PEMF with placebo were identified. The weighted mean differences of the five papers for improvement in pain and function, were small and their 95% confidence intervals included the null. Conclusion This systematic review provides further evidence that PEMF has little value in the management of knee osteoarthritis. There appears to be clear evidence for the recommendation that PEMF does not significantly reduce the pain of knee osteoarthritis

The importance of subject knowledge for mathematics teaching: An analysis of feedback from Subject Knowledge Enhancement Courses

Over the last ten years, Subject Knowledge Enhancement (SKE)programmes have become an established part of the Initial Teacher Education (ITE) landscape in England, providing the opportunity for those who do not have sufficient degree level mathematics for direct entry to Post Graduate ITE programmes the opportunity to develop their mathematics knowledge prior to undertaking teacher preparation. More recently, SKE programmes have become more diverse in terms of mode of delivery with a growth in popularity of on-line provision. This session will present an analysis of feedback and evaluations from students on face-to-face mathematics SKE programmes at several institutions through consideration of Ball, Thames & Phelps’ (2008) domains of mathematical knowledge for teaching. Evaluations are also considered in terms of the outcomes and benefits, in terms of both subject knowledge and other outcomes, fo these programmes