Physiotherapy clinic in Tambaram Are you Looking f...

Physiotherapy clinic in Tambaram Are you Looking for Physiotherapy Treatment in Tambaram, Sunshine Super Speciality Physiotherapy Clinic, We Provide Electrotherapy, Exercise and Manual Therapy, Orthopedic, Neuro, Cardio, Pediatric, Sports and Geriatric Rehabilitation, Post Operative Physiotherapy Treatment, Fracture Rehabilitation, pain free movement. Just published in JOSPT 🔥 Spinal Manipulative Therapy for Non-Specific Low Back Pain - Does Targeting a Specific Vertebral Level Make a Difference? https://pubmed.ncbi.nlm.nih.gov/37506306/ 👉 The two most common types of SMT for non-specific LBP are joint mobilization and manipulation. https://pubmed.ncbi.nlm.nih.gov/29034802/. The difference between the two is the force required to obtain “cavitation of the joint” resulting in an audible crack. 👉 All major professions practicing manual therapy are taught and apply principles of the importance of specific SMT, and a prerequisite for providing this specificity requires the ability to locate specifically which vertebral level to target. As a consequence, clinicians feel comfortable to perform targeted treatment at the dysfunctional vertebral level. However, it is not clear whether targeting a specific spinal level is necessary to achieve a clinical effect. In a brand-new systematic review with meta-analysis Sørensen and colleagues examined the effect of a targeted vs. a non-targeted spinal manipulation or mobilization in non-specific low back pain patients. https://pubmed.ncbi.nlm.nih.gov/37506306/ 👉 A candidate site was defined as either: i) the most painful vertebral level(s), ii) clinically relevant as determined by clinician(s), or ii) clinically relevant as determined by the study protocol. 👉 The comparator was passive, non-targeted SMT, not administered at a candidate site in the spine; for instance, SMT of a non-candidate site in the lumbar spine, generic SMT of the lumbar spine, or of any other body region than the lumbar spne (e.g., thoracic spine or sacroiliac joint(s)). 📔 📔 Ten RCTs (n = 931 patients) were included. 📊 There was moderate certainty evidence of no difference between targeted SMT and a non-targeted approach for pain intensity at post-intervention: weighted mean difference (WMD) = -0.20 (95% CI: -0.51; and at follow-up: WMD = 0.05 (95% CI: -0.26; 0.36). 📊 For patient-reported disability, there was moderate certainty evidence of no difference at post-intervention: standardized mean difference (SMD) = -0.04 (95% CI: -0.36; 0.29) and at follow-up: SMD = -0.05 (95% CI: -0.24; 0.13). Adverse events were reported in four trials, and were minor and evenly distributed between groups. ☑ The overall evidence of moderate certainty showed NO DIFFERENCE IN EFFECT BETWEEN TARGETED AND NON-TARGETED SMT for either pain intensity or disability, and adverse events were minor and transient in both groups. ❓ What could be the reason for this lack of difference? ▶ The lumbar spine does not function biomechanically as vertebrae with independent motion patterns when providing anterior pressure (palpation, oscillatory mobilization, or thrust). Therefore, any force will be distributed throughout the lumbar spine and not just at the vertebra in question, and a potential cavitation with a therapeutic effect from SMT could happen throughout a number of levels. https://pubmed.ncbi.nlm.nih.gov/14970817/, https://pubmed.ncbi.nlm.nih.gov/15029938/ ▶ The clinical effects of SMT are also driven by neurophysiological responses in the central nervous system caused by the mechanical stimulus, resulting in local and remote hypoalgesia at the targeted treatment site. https://pubmed.ncbi.nlm.nih.gov/30719281/, https://pubmed.ncbi.nlm.nih.gov/30935324/, https://pubmed.ncbi.nlm.nih.gov/26751060/ ▶ The pain reduction following SMT may be due to contextual factors or natural history. https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-021-05454-8 , https://pubmed.ncbi.nlm.nih.gov/28459190/ , https://pubmed.ncbi.nlm.nih.gov/35449074/ SUNSHINE ® SUPER SPECIALITY PHYSIOTHERAPY CLINIC - #DrParthiban #Sunshinephysioclinic.in #Physiotherapyclinicintambaram DR.M.P. PARTHIBAN.M.P.T (Ortho), Chief Orthopedic Physiotherapist, Call for Appointments: - 9345122177 East Tambaram, CHENNAI