Enhanced Therapeutic Alliance Modulates Pain Intensity and Muscle Pain Sensitivity in Patients With Chronic Low Back Pain: An Experimental Controlled Study

Fuentes, Jorge; Armijo‐Olivo, Susan; Funabashi, Martha; Miciak, Maxi; Dick, Bruce; Warren, Sharon; Rashiq, Saifee; Magee, David J.; Gross, Douglas P.

doi:10.2522/ptj.20130118

Cited by 214 publications

(213 citation statements)

References 64 publications

Supporting

Mentioning

205

Contrasting

Unclassified

Order By: Relevance

“…The mechanical stimulus and resultant neurophysiological effects are modified by nonspecific factors such as expectation of the patient [58,59], equipoise of the practitioner [60,61], placebo effects [62], contextual factors such as the setting and therapeutic alliance between provider and patient [63]. All of these factors can be decisive in treatment outcomes.…”

Section: Moderating For Effectiveness Of Mtmentioning

confidence: 99%

What effect can manual therapy have on a patient's pain experience?

et al. 2015

View full text Add to dashboard Cite

Manual therapy (MT) is a passive, skilled movement applied by clinicians that directly or indirectly targets a variety of anatomical structures or systems, which is utilized with the intent to create beneficial changes in some aspect of the patient pain experience. Collectively, the process of MT is grounded on clinical reasoning to enhance patient management for musculoskeletal pain by influencing factors from a multidimensional perspective that have potential to positively impact clinical outcomes. The influence of biomechanical, neurophysiological, psychological and nonspecific patient factors as treatment mediators and/or moderators provides additional information related to the process and potential mechanisms by which MT may be effective. As healthcare delivery advances toward personalized approaches there is a crucial need to advance our understanding of the underlying mechanisms associated with MT effectiveness.

show abstract

Section: Moderating For Effectiveness Of Mtmentioning

confidence: 99%

What effect can manual therapy have on a patient's pain experience?

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Interferential current therapy has been used in a variety of settings including low back pain 11 and neurological disorders such as carpal tunnel syndrome. 12 More recently, interferential current therapy has been found to be effective in small studies in managing conditions such as fecal incontinence and constipation.…”

Section: The Nature Of Interferential Current Therapymentioning

confidence: 99%

“…The strongly positive response to active therapy with enhanced interaction was encouraging however the greater benefit of sham interferential current therapy with enhanced interaction over the real interferential current therapy and limited interaction was also enlightening. Certainly, a powerful influence of the therapeutic alliance was demonstrated 11 and future studies of this technique must consider the role of placebo. For instance, in a randomised controlled study of children with juvenile arthritis, half of the study group had combined interferential current therapy and resistive underwater exercises where the other half, as the control group, received traditional physical therapy alone and no underwater therapy.…”

Section: Potential Actions Of Interferential Current Therapy On Variomentioning

confidence: 99%

Neuromodulation via Interferential Electrical Stimulation as a Novel Therapy in Gastrointestinal Motility Disorders

Moore

Burgell

2018

J Neurogastroenterol Motil

View full text Add to dashboard Cite

The concept of therapeutic percutaneous neuromodulation has, until recently, been limited by the ability to penetrate deeply enough to stimulate internal organs. By utilizing 2 medium frequency, slightly out of phase electrical currents passing diagonally through the abdomen, a third, low frequency current is created at the point of bisection. This interferential current appears to stimulate nerve fibers in the target organs and may have a therapeutic action. The aim of the study is to review the use of transcutaneous interferential electrical stimulation with a focus on its application in gastroenterology, particularly in motility disorders. Studies involving use of interferential current therapy were searched from Medline, PubMed, and Scopus databases, and articles pertaining to history, its application and all those treating abdominal and gastrointestinal disorders were retrieved. Seventeen studies were identified, 13 involved children only. Eleven of these were randomised controlled trials (3 in adults). Four trials were from the one center, where each paper reported on different outcomes such as soiling, defecation frequency, quality of life, and colon transit studies from the one pool of children. All studies found statistically significant improvement in symptom reduction. However, weaknesses in study design were apparent in some. In particular, finding an adequate placebo to interferential current therapy has been difficult. Interferential current therapy shows potential as a novel, non-pharmacological and economical means of treating gastrointestinal dysfunction such as constipation. More studies are needed particularly in the adult population. However, the design of a suitable placebo is challenging. Search MethodA search of Medline, PubMed, and Scopus databases for information on electrical interferential current and its application using search words such as "electrical interferential current," "transcutaneous," "therapeutics or uses," "mechanisms of action," and "gastrointestinal" was performed. Articles that were available in English were included. This review focuses on the use of transcutaneous interferential current therapy in the treatment of gastrointestinal symptoms. The Nature of Interferential Current TherapyInterferential current therapy has been used in a variety of settings including low back pain 11 and neurological disorders such as carpal tunnel syndrome. 12 More recently, interferential current therapy has been found to be effective in small studies in managing conditions such as fecal incontinence and constipation. It has the benefit of being completely non-invasive, cost effective and convenient, as it can be self-administered at home. 13Despite increased convenience to the patient, doctor and payer, the use of transcutaneously-delivered current can be problematic. To stimulate the nerve of interest, the current has to pass through the skin and surrounding muscle to reach its target. This causes resistance to flow, requiring the use of a higher current to achieve the desired resu...

show abstract

“…Recently, a rapid review was published on the results of group-based physiotherapy-led exercise and education interventions to promote self-management for people with osteoarthritis and chronic low back pain. 24 Within the rapid review, TF was assessed for adherence. The results showed the overall use of fidelity to be low, with training of providers (10%) being the least adhered to TF component.…”

Section: Documentation Of Tf In Health Care Literaturementioning

confidence: 99%

“…2 • Interactions with participants are standardized to neutralize therapeutic alliance influence. 29 Therapeutic alliance is a positive social connection between the participants and the PT 24 that provides the participants with a sense of collaboration and support. 24,31 In research, therapeutic alliance is shown to improve treatment adherence and outcomes.…”

Section: Delivery Of Treatmentmentioning

confidence: 99%

Consideration of treatment fidelity to improve manual therapy research

Karas

Plankis

2016

Journal of Manual & Manipulative Therapy

View full text Add to dashboard Cite

Objectives: The purpose of this paper was to define treatment fidelity, review its use in health care research and suggest how it may be utilized in manual therapy research to improve the reliability and validity of the literature. Results: We offer an outline and a table of how manual therapy research may benefit from the concept of treatment fidelity. Discussion: While treatment fidelity is a newer concept, and has not been integrated into Physical Therapy or Manual Therapy research, when utilized, it can have positive effects on the reliability and validity of the techniques we evaluate.

show abstract

Enhanced Therapeutic Alliance Modulates Pain Intensity and Muscle Pain Sensitivity in Patients With Chronic Low Back Pain: An Experimental Controlled Study

Abstract: The context in which physical therapy interventions are offered has the potential to dramatically improve therapeutic effects. Enhanced TA combined with active IFC appears to lead to clinically meaningful improvements in outcomes when treating patients with CLBP.

Cited by 214 publications

References 64 publications

What effect can manual therapy have on a patient's pain experience?

What effect can manual therapy have on a patient's pain experience?

Neuromodulation via Interferential Electrical Stimulation as a Novel Therapy in Gastrointestinal Motility Disorders

Consideration of treatment fidelity to improve manual therapy research

Contact Info

Product

Resources

About