Michael S Crowell1, Nancy H Wofford. 1. US Army-Baylor University Doctoral Fellowship in Orthopedic Manual Physical Therapy, Brooke Army Medical Center, Fort Sam Houston, TX, USA ; Tuttle Army Health Clinic, Hunter Army Airfield, Savannah, GA, USA.
Abstract
OBJECTIVES: A recent clinical prediction rule (CPR) identified characteristics that may predict an immediate reduction in pain following lumbopelvic manipulation in patients with patellofemoral pain syndrome. The purpose of this single-arm cohort study was to replicate the proposed CPR in a different population and investigate changes in self-reported pain, hip range of motion, strength, and function immediately following lumbopelvic manipulation. METHODS: Forty-four subjects (63·6% female; mean age 27·4 years) met inclusion criteria. Hip internal rotation range of motion, lower extremity strength using a handheld dynamometer, and single/triple hop tests were assessed prior to and immediately following a spinal manipulation. A global rating of change questionnaire was administered after testing and telephonically at 1 week. Paired t-tests compared pre- and post-manipulation range of motion, strength, and hop test limb symmetry indices (α = 0·05). RESULTS: Fifty-seven percent of subjects had a successful outcome measured by the numerical pain rating scale immediately following manipulation. Twenty-five of subjects experienced a successful outcome as measured by the global rating of change questionnaire at 1 week. No single individual or combination of predictor variables predicted a positive outcome immediately following the lumbopelvic manipulation (+likelihood ratio 0·7 with three of five predictor variables present). Statistically significant differences (P<0·05) were found in hip extension and abduction strength and hip internal rotation symmetry post-manipulation, but do not appear to be clinically meaningful. DISCUSSION: The previously identified CPR was not able to be replicated and no clinically meaningful changes in range of motion, strength, or function were apparent. Future research should focus on a comprehensive impairment-based treatment approach in patients with patellofemoral pain syndrome.
OBJECTIVES: A recent clinical prediction rule (CPR) identified characteristics that may predict an immediate reduction in pain following lumbopelvic manipulation in patients with patellofemoral pain syndrome. The purpose of this single-arm cohort study was to replicate the proposed CPR in a different population and investigate changes in self-reported pain, hip range of motion, strength, and function immediately following lumbopelvic manipulation. METHODS: Forty-four subjects (63·6% female; mean age 27·4 years) met inclusion criteria. Hip internal rotation range of motion, lower extremity strength using a handheld dynamometer, and single/triple hop tests were assessed prior to and immediately following a spinal manipulation. A global rating of change questionnaire was administered after testing and telephonically at 1 week. Paired t-tests compared pre- and post-manipulation range of motion, strength, and hop test limb symmetry indices (α = 0·05). RESULTS: Fifty-seven percent of subjects had a successful outcome measured by the numerical pain rating scale immediately following manipulation. Twenty-five of subjects experienced a successful outcome as measured by the global rating of change questionnaire at 1 week. No single individual or combination of predictor variables predicted a positive outcome immediately following the lumbopelvic manipulation (+likelihood ratio 0·7 with three of five predictor variables present). Statistically significant differences (P<0·05) were found in hip extension and abduction strength and hip internal rotation symmetry post-manipulation, but do not appear to be clinically meaningful. DISCUSSION: The previously identified CPR was not able to be replicated and no clinically meaningful changes in range of motion, strength, or function were apparent. Future research should focus on a comprehensive impairment-based treatment approach in patients with patellofemoral pain syndrome.
Authors: Sallie M Cowan; Kim L Bennell; Kay M Crossley; Paul W Hodges; Jenny McConnell Journal: Med Sci Sports Exerc Date: 2002-12 Impact factor: 5.411
Authors: Shane L Koppenhaver; Julie M Fritz; Jeffrey J Hebert; Greg N Kawchuk; John D Childs; Eric C Parent; Norman W Gill; Deydre S Teyhen Journal: J Orthop Sports Phys Ther Date: 2011-04-06 Impact factor: 4.751
Authors: Jennifer E Earl-Boehm; Lori A Bolgla; Carolyn Emory; Karrie L Hamstra-Wright; Sergey Tarima; Reed Ferber Journal: J Athl Train Date: 2018-06-12 Impact factor: 2.860
Authors: Thomas G Sutlive; Andrew Golden; Kristin King; William B Morris; John E Morrison; Josef H Moore; Shane Koppenhaver Journal: Int J Sports Phys Ther Date: 2018-06
Authors: Aldo Scafoglieri; Jona Van den Broeck; Stijn Willems; Rob Tamminga; Henk van der Hoeven; Yde Engelsma; Stijn Haverkamp Journal: BMC Musculoskelet Disord Date: 2021-05-15 Impact factor: 2.362
Authors: Douglas P Gross; Susan Armijo-Olivo; William S Shaw; Kelly Williams-Whitt; Nicola T Shaw; Jan Hartvigsen; Ziling Qin; Christine Ha; Linda J Woodhouse; Ivan A Steenstra Journal: J Occup Rehabil Date: 2016-09