Time to evolve: the applicability of pain phenotyping in manual therapy

Damian, Keter; Cook, Chad; Learman, Kenneth; Griswold, David

doi:10.1080/10669817.2022.2052560

Cited by 12 publications

(10 citation statements)

References 82 publications

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“…Wenn die Patientin oder der Patient ein Responder auf manuelle Therapie ist 68 , dann sollte auch diese Maßnahme in Kombination mit aktiver Therapie zur Schmerzmodulation ausgeschöpft werden 24 . Eine Variation manualtherapeutischer Techniken kann hier am unteren Rücken zum Einsatz kommen 20 , 69 , 70 , 71 . Zur Reduktion einer gesteigerten Mechanosensitivität des neuralen Gewebes können neurodynamische Mobilisationen appliziert werden.…”

Section: Postoperative Physiotherapie In Der Spätphase Der Rehabilita...unclassified

Ein „Best-Practice-Modell“ für die Rehabilitation nach lumbaler Nukleotomie

Thalhamer¹

2022

MSK – Muskuloskelettale Physiotherapie

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Section: Postoperative Physiotherapie In Der Spätphase Der Rehabilita...unclassified

Ein „Best-Practice-Modell“ für die Rehabilitation nach lumbaler Nukleotomie

Thalhamer¹

2022

MSK – Muskuloskelettale Physiotherapie

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“…This framework aligns with evidence-based propositions that effectiveness and efficiency in assessment, diagnosis, and outcomes are not reliant on the therapist’s skill set of specialised elements of TMT, but rather other factors—for example variations in pain phenotypes [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…MT has been described as the deliberate application of externally generated force upon body tissue, typically via the hands, with therapeutic intent [ 4 ]. It includes touch-based interventions such as thrust manipulation, joint mobilisation, soft-tissue mobilisation, and neurodynamic movements [ 5 ]. For people with MSK conditions, this therapeutic intent is usually to reduce pain and improve movement, thus facilitating a return to function and improved quality of life [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

A modern way to teach and practice manual therapy

Kerry,

Young,

Evans

et al. 2024

Chiropr Man Therap

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Background Musculoskeletal conditions are the leading contributor to global disability and health burden. Manual therapy (MT) interventions are commonly recommended in clinical guidelines and used in the management of musculoskeletal conditions. Traditional systems of manual therapy (TMT), including physiotherapy, osteopathy, chiropractic, and soft tissue therapy have been built on principles such as clinician-centred assessment, patho-anatomical reasoning, and technique specificity. These historical principles are not supported by current evidence. However, data from clinical trials support the clinical and cost effectiveness of manual therapy as an intervention for musculoskeletal conditions, when used as part of a package of care. Purpose The purpose of this paper is to propose a modern evidence-guided framework for the teaching and practice of MT which avoids reference to and reliance on the outdated principles of TMT. This framework is based on three fundamental humanistic dimensions common in all aspects of healthcare: safety, comfort, and efficiency. These practical elements are contextualised by positive communication, a collaborative context, and person-centred care. The framework facilitates best-practice, reasoning, and communication and is exemplified here with two case studies. Methods A literature review stimulated by a new method of teaching manual therapy, reflecting contemporary evidence, being trialled at a United Kingdom education institute. A group of experienced, internationally-based academics, clinicians, and researchers from across the spectrum of manual therapy was convened. Perspectives were elicited through reviews of contemporary literature and discussions in an iterative process. Public presentations were made to multidisciplinary groups and feedback was incorporated. Consensus was achieved through repeated discussion of relevant elements. Conclusions Manual therapy interventions should include both passive and active, person-empowering interventions such as exercise, education, and lifestyle adaptations. These should be delivered in a contextualised healing environment with a well-developed person-practitioner therapeutic alliance. Teaching manual therapy should follow this model.

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“… 9 65 Although CS may influence changes in pain sensitivity induced by SMT, 32 pain phenotyping has been scarcely applied to manual therapy research. 66 Therefore, the response of this subgroup of patients to SMT has yet to be assessed. The aim of this clinical trial is to investigate whether variables associated with a CS phenotype may help predict the response to SMT.…”

Section: Introductionmentioning

confidence: 99%

“…The classification of mechanism-based pain phenotypes is a complex and controversial task,35 63 64 for which a variety of clinical, inflammatory, psychological and psychophysical constructs must be considered 9 65. Although CS may influence changes in pain sensitivity induced by SMT,32 pain phenotyping has been scarcely applied to manual therapy research 66. Therefore, the response of this subgroup of patients to SMT has yet to be assessed.…”

Section: Introductionmentioning

confidence: 99%

Mechanisms of chiropractic spinal manipulative therapy for patients with chronic primary low back pain: protocol for a mechanistic randomised placebo-controlled trial

2023

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IntroductionChronic low back pain (CLBP) is a highly prevalent and disabling condition. Identifying subgroups of patients afflicted with CLBP is a current research priority, for which a classification system based on pain mechanisms was proposed. Spinal manipulative therapy (SMT) is recommended for the management of CLBP. Yet, little data are available regarding its mechanisms of action, making it difficult to match this intervention to the patients who may benefit the most. It was suggested that SMT may influence mechanisms associated with central sensitisation. Therefore, classifying patients with CLBP according to central sensitisation mechanisms may help predict their response to SMT.Methods and analysisThis protocol describes a randomised placebo-controlled trial aiming to examine which variables linked to central sensitisation may help predict the clinical response to SMT in a cohort of patients with CLBP. One hundred patients with chronic primary low back pain will be randomised to receive 12 sessions of SMT or placebo SMT over a 4-week period. Pain intensity and disability will be assessed as primary outcomes after completing the 4-week treatment (primary endpoint), and at 4-week and 12-week follow-ups. Baseline values of two pain questionnaires, lumbar pressure pain thresholds, concentrations of an inflammatory cytokine and expectations of pain relief will be entered as predictors of the response to SMT in a multiple regression model. Changes in these variables after treatment will be used in a second multiple regression model. The reference values of these predictors will be measured from 50 age and sex-matched healthy controls to allow interpretation of values in patients. Mixed analyses of variance will also be conducted to compare the primary outcomes and the predictors between groups (SMT vs placebo) over time (baseline vs post-treatment).Ethics and disseminationEthical approval was granted by the Fundación Jiménez Díaz Clinical Research Ethics Committee.Trial registration numberNCT05162924.

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Time to evolve: the applicability of pain phenotyping in manual therapy

Cited by 12 publications

References 82 publications

Ein „Best-Practice-Modell“ für die Rehabilitation nach lumbaler Nukleotomie

Ein „Best-Practice-Modell“ für die Rehabilitation nach lumbaler Nukleotomie

A modern way to teach and practice manual therapy

Mechanisms of chiropractic spinal manipulative therapy for patients with chronic primary low back pain: protocol for a mechanistic randomised placebo-controlled trial

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