Article

OBJECTIVE: To describe the development of a sham manual medicine protocol.
SETTING: An academic physical medicine and rehabilitation clinic. PARTICIPANTS:
Twenty-six persons with cervical tender points were included in the pilot study.
Exclusion criteria entailed cervical disk herniations or diskitis, cancer,
current incarceration, or any condition that prevented small-range passive neck
movements. Subjects were also excluded if, in the past 3 months, they had
received cervical or thoracic spine surgery, osteopathic manipulation, or
workers' compensation benefits. INTERVENTIONS: The subjects were sequentially
assigned to receive either sham or strain-counterstrain treatment. The subjects
filled out pre- and posttreatment questionnaires. Fifteen subjects were in the
sham group, and 11 were in the treatment group. MAIN OUTCOME MEASURES: Outcome measures included subject tolerance of manual medicine, change in pain level, and
ability to accurately determine receipt of strain-counterstrain or sham
technique. Statistical significance was set at P < .05. RESULTS: There were no
adverse effects of the sham or treatment protocols. There was no statistically
significant change in pain as a result of the sham manual medicine protocol (P =
.222) in contrast to the strain-counterstrain group, which did have decreased
pain (P = .014). The subjects were unable to determine whether they had received
sham or strain-counterstrain technique (P = .850). CONCLUSION: The sham protocol
developed for this study was well tolerated. The small study size and design
limitations do not yet allow the sham protocol developed in this pilot study to
be definitively validated as a manual medicine tool, but there are early
indications that it may be useful. Larger studies that validate this sham
protocol by addressing inter- and intra-rater reliability are needed, followed by
studies that evaluate strain-counterstrain as a treatment modality.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS