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Thesis Review

Developing a clinical prediction level for identifying patients with neck pain, probably benefiting from the thorax spine manipulation and a series of exercise exercise.
Yes Cleland.
Doctoral thesis.
2006. Nova Southeasters University: Fort Lauderdale, FL-E-mail: ude.cpf@jdnalelc

The prevalence of neck pain in the general population is considerable. The National Center of the United States for Health Statistics reported that in 2004, 14.8% of the acquired adults were experienced at the age of 18 and older neck pain in the last 3 months. Previous studies have reported that 54% of the population has experienced neck pain over the past 6 months, leading to disability in 5% 2.

The first goal of this work was the development of a clinical prediction level (CPR) that would identify neck pain patients who would probably benefit from the thoracic spine manipulation (TSTM). The second goal of this work was to compare the treatment effect of TSTM to all patients who obtained TSTM, regardless of the clinical presentation, against the patients who received the CPR criteria. This dissertation project has already produced a landmark peer review article recently published in physical therapy 3.

Chapter 1 offers an introduction to the thesis and outlines the goals of the study. The incidence of neck pain is checked with the relevance for the practice of physiotherapy. The author discusses the problems in classifying patients with neck pain due to the difficulty of identifying the underlying pathology and offers an argument to develop treatment with treatment offered classifications.

Chapter 2 presents a very interesting and extensive review of the literature. Detection for the use of cervical manipulation in the treatment of patients with mechanical neck pain are checked as well as the justification for the integration of TSTM. The theoretical basis for the association of thoracic hypomobility with neck and shoulder pain is presented with references and body diagrams, which reflect the transfer patterns of the thoracic Zygapophysenfugen. The thesis cites the incidence of serious complications from neck manipulation to 5-10 per 10 million and suggests that TSTM can offer advantages without the inherent risks of cervical manipulation. Theoretical mechanisms relating to the positive effects of TSTM are investigated, including neurophysiological effects and neuromuscular effects of muscle inhibition, relief and reduced arthrogenic inhibition. The author also offers evidence to challenge the importance of manipulation technology specificity. The rational for including the active range of movement exercises in the study is included.

Chapter 3 Sketches the methodology of the study and describes the training of the clinicians shared in the study. The subject recruitment method and authorization and exclusion criteria are described. A detailed manual of standard operations and procedures is included in Appendix B.. The questionnaire of anxiety avoidance and the questionnaire (FABQ) and the Tampa scale of kinesiophobia. All self-reported questionnaires are included in appendices as well as in the standardized examination and treatment forms. The thoracic spine, the manipulations and general mobility exercises and general mobility exercises are described and presented. All topics received a standardized treatment regime: two seated thoracic distraction manipulations, two upper thorax / cervicothoracic manipulations and two back member rupture manipulations as well as a general range of movement with advice to maintain the usual activity within the pain limits. The GROC was used in the following sessions to classify the treatment effect: the descriptions "A much better", "a great business better" and "a little better," showed successful results.At the meeting 2, patients who experienced a successful result apologized from further participation in the study, while those who had no successful answer was treated in the first session. In the third and final treatment session, those who had assessed their improvement in the above descriptions were classified as success, while the remaining patients were considered unsuccessful. At this time, the participation of patients at the study was complete, and further treatment was made available per discretion of the thermiter. Differences between the groups were analyzed with independent sample T tests for permanent variables and П‡ 2 tests for categorical variables. Variables with a significance level of P and it is part of an ongoing research effort of the author in the field of mechanical neck pain and thorax function disorders th Cleland, who is undoubtedly one of the most productive authors of high-quality publications in the field of orthopedic manual physiotherapy, is recommended for a valuable contribution to the research base of this area.

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