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November, 2018 - VOL. 24, NO. 6 | |
November, 2018 |
| The Association of Manual Muscle Tests and Treatment Outcomes With Headache and Cranial Dysfunctions: A Retrospective Case Series Report |
| Charles Blum, DC, CSCP; Scott Cuthbert, DC; Anthony Rosner, PhD, LLD (Hon), LLC |
| Background • This study examine whether there is an interrelationship between cranio-sacral dysfunctions and the muscle inhibitions found in the muscles attaching to the skull in patients with headaches.
Primary Study Objective • To present a retrospective case series report assessing the prevalence of positive manual muscle tests (MMTs) in the assessment and management of adults with headache and cervico-cranial dysfunctions and to present patient outcomes pre- and posttreatment.
Methods/Design • Fifty-two patient files with headache (HA) (48 females, 4 males) were retrospectively examined. These patients had either primary (tension-type, migraine, or cervicogenic) or secondary HAs (that result from other medical conditions), according to the International Classification of Headache Disorders. A standardized MMT assessment of the major cervical muscles attaching to the skull was performed on every patient pre- and posttreatment, and a pre- and posttreatment numeric pain scale of neck and associated head pain was recorded.
Setting • The setting was an in-office clinical chiropractic trial.
Primary Outcome Measures • MMT and numeric pain scale of neck and associated head pain evaluation pre- and posttreatment.
Results • Muscle dysfunctions (inhibition) were found to be associated with HA in these patients as follows: sternocleidomastoid, 42 patients; deep neck flexors, 33 patients; anterior scalenes, 24 patients; and upper trapezius, 24 patients. Three patients with HA had no muscle inhibition. Cranial and upper cervical articular dysfunctions were found in 49 and 52 patients, respectively. In this group of 52 patients with HA, 49 patients had cranial dysfunctions that when treated with applied kinesiology improved all or a portion of the muscle inhibitions, whereas the initial numeric pain scale of neck and associated head pain simultaneously fell from an average of 6.75 to an average of 0.49. Odds ratios were calculated to be >1, meaning there was a positive correlation between positive MMT of these muscles (as well as upper cervical and cranial dysfunctions) and HAs in this cohort.
Conclusion • A symptomatic group of patients with HA and cranial dysfunctions demonstrated MMT findings in the form of muscle inhibition. Cranial treatments to improve muscle strength were found to correlate with improvements in HA for these patients. This evidence may suggest that the MMT is a potentially useful test for evaluating pericranial muscular impairments in patients with cranial dysfunctions and HA. |
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November, 2018 - VOL. 24, NO. 6 | |
November, 2018 |
| Randomized, Controlled, Crossover Study of Self-administered Jacobson Relaxation in Chronic, Nonspecific, Low-back Pain |
| Raquel Ajo, PhD; Olga Alda, PhD; Maria-del-Mar Inda, PhD; Cesar Margarit, PhD, MD; Margarita Mateu, MSS; Domingo Morales, PhD; Ana M Peiro, PhD, MD; Carlos J van-der Hofstadt, PhD |
| Context • Opioids decrease pain and improve functional capacity and quality of life; however, they are not always effective and are associated with harmful side effects. Few studies have shown that relaxation-based therapies, in comparison with usual care, can decrease pain.
Objective • The objective of the study was to investigate whether a controlled relaxation treatment, Jacobson progressive muscular relaxation (PMR), was effective in relieving chronic low-back pain (CLBP) and reducing pain comorbidities. The research team hypothesized that PMR-controlled relaxation could be more effective in reducing CLBP than music.
Design • The research team designed a randomized, controlled, crossover study.
Setting • The study took place in the pain unit, a clinic, in the Department of Health at Alicante-General Hospital (Alicante, Spain).
Participants • Participants in this study were 58 adults with nononcological CLBP, secondary to lumbar canal stenosis, who had been treated with opioids without any changes in the 3 mo prior to the study.
Intervention • Participants were randomly assigned to
1 of 2 groups, each of which received 2 treatments, but in a different order (ie, either AB or BA where A was the
standardized PMR, the intervention, and B was relaxing music, the control. For both groups, the 2 treatment periods were 8 wk in length, with a 1-mo washout period between them.
Outcome Measures • The primary outcome measures included (1) a visual analogue scale—pain and relief intensity; (2) the 12-item short form health survey—quality of life; (3) the hospital anxiety and depression scale—anxiety and depression; and (4) the medical outcomes study sleep scale—sleep disturbances. Secondary outcome measures included a self-efficacy scale and a measure of satisfaction with treatment and compliance.
Results • Pain was mostly mild to moderate. Greater decreases in pain between baseline and postintervention were observed for the PMR vs the control treatment in the mild pain category, with a VAS difference of 1.8 cm and
P = .018. Significant differences were also found in anxiety, depression, quality of life, and sleep between participants in the 3 pain categories. Self-rated adherence was high.
Conclusions • Findings support the efficacy and acceptability of a self-guided PMR intervention for reducing CLBP with minimal time with a therapist. |
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November, 2018 - VOL. 24, NO. 6 | |
November, 2018 |
| Attributes of Videos on YouTube Related to Cupping Therapy |
| Md Mohiuddin Adnin, MS; Corey H Basch, EdD, MPH; M Dottington Fullwood, MS; Isaac Chun-Hai Fung, PhD; Anthony Menafro, BS; Jingjing Yin, PhD |
| Context • Cupping is a complementary and alternative therapy that attracts much attention on social media.
Objective • The study intended to examine the types of user-generated content found on YouTube on the practice of cupping therapy as a form of pain management.
Design • The current research team searched YouTube for videos on cupping therapy on August 14, 2016.
Setting • The Internet was accessed from Wayne, NJ, USA.
Outcome Measures • The research team manually coded the 100 most widely viewed, cupping videos for content and sources. Logistic regression was applied to obtain the association of video source—consumer, news, or professional—to each of the 21 content categories.
Results • In total, the 100 videos were viewed more than 36.80 million times. Among them, 52 were consumer videos; 16 were professional videos; and 32 were news videos. Compared to news videos, (1) the odds of consumer videos mentioning what cupping is were 85.90% lower-odds ratio (OR) = 0.14, 95% confidence interval (CI) (0.04 to 0.52), P < .01; (2) the odds of consumer videos and professional videos mentioning an increase in blood flow as a benefit were 93.50% lower—OR = 0.07, 95% CI (0.02 to 0.24), P < .01—and 82.80% lower—OR = 0.17, 95% CI (0.04 to 0.82), P = .03, respectively; and (3) the odds of consumer videos mentioning a decrease in inflammation as a benefit were 92.9% lower—OR = 0.07, 95% CI
(0.02 to 0.21), P < .01.
Conclusions • The current study found that, despite the large presence of consumer-based videos in YouTube regarding cupping therapy, news sources were more widely viewed. Health professionals could engage more with YouTube by providing clear and authentic information about a popular alternative therapy. |
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November, 2018 - VOL. 24, NO. 6 | |
November, 2018 |
| Specific Immunoglobulin G4 and Immunoglobulin E Titers to Common Food Antigens in Sera of Children With Allergic Rhinitis |
| En-Chih Liao, PhD; Po-Jen Liu, MD; Kai-Li Liu, PhD |
| Context • Allergic rhinitis is a chronic disease that usually affects children. Its etiology has been investigated for years.
Objective • The aim of the study was to evaluate the diagnostic value of immunoglobulin G4 (IgG4) against common food allergens, to determine the correlation between it and immunoglobulin E (IgE), and to evaluate the role of IgG4 (ie, whether its presence should be considered to be a significant factor that induces hypersensitivity or whether an effector role in allergic rhinitis could be attributed to it).
Design • This research was conducted as a randomized controlled trial.
Setting • The research team performed the study in the Department of Otolaryngology and Sleep Center, Cheng Ching General Hospital-Chung Kang Branch (Taichung, Taiwan).
Participants • The participants were 46 patients—29 boys and 17 girls—with an average age of 8.02 ± 2.92 y—who had been diagnosed with allergic rhinitis.
Outcome Measures • Blood samples were collected from the participants. The total IgE, food-specific IgE, and food-specific IgG4 in their sera were measured using the proprietary BioIC system, which is based on the principles of the enzyme-linked immunosorbent assay (ELISA).
Results • In terms of total IgE, 20 patients (43.5%) had a concentration of <100 IU/mL, and 7 patients (15.2%) had levels between 100 and 199 IU/ml; 6 participants (13.0%) had levels between 200 and 299 IU/mL, 3 participants (6.5%) had levels between 300 and 399 IU/mL,
2 participants (4.3%) had levels between 400 and 499 IU/mL, 4 participants (8.7%) had a concentration from 500 to 1000 IU/mL, and 4 participants (8.7%) had a concentration of >1000 IU/mL. Regarding specific IgG4, 89.1% of patients were highly reactive to egg white IgG4, whereas >50% were highly reactive to egg yolk, milk, peanuts, almonds, wheat, and soybeans. Regression analysis to test the correlation between specific IgE and specific IgG4 revealed that egg whites, milk, peanuts, and almonds had significant correlations (P < .05). Cod, shrimp, and crab showed very significant correlations (P < .001).
Conclusion • Total IgE varies widely in children with allergic rhinitis but remains one of the references for diagnosis. The main inhalational allergens are dust mites, followed by grass pollen, molds, German cockroach, and animal dander. Food allergy generates highly concentrated IgG4 and may play a role in children with allergic rhinitis. |
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November, 2018 - VOL. 24, NO. 6 | |
November, 2018 |
| Grounding Patients With Hypertension Improves Blood Pressure: A Case History Series Study |
| Howard K Elkin, MD, FACC; Angela Winter, RN, BSN |
| Background • Research conducted during the last 15 y has demonstrated that grounding (Earthing) the human body to Earth’s surface charge generates multiple beneficial physiological effects. Anecdotal reports include lowering of high blood pressure (BP).
Objective • To test such reports, a pilot case history series was undertaken with hypertensive patients in a single physician cardiology practice.
Intervention • Patients grounded themselves at home for at least 10 h/d for several mo.
Outcome Measure • BP was measured at baseline in the clinic, and then, after starting grounding, 3 subsequent times in the clinic again at approximately monthly intervals. Patients were also given a BP monitor and were asked to measure their BP on Mondays, Thursdays, and Saturdays at 8:00 AM and 8:00 PM for 12 wk.
Results • All 10 patient measurements were found to be significantly improved at the end of the trial period, and some, well before the end. Systolic levels decreased during this time, ranging individually from 8.6% to 22.7%, with an average decrease of 14.3%.
Conclusion • This is the first known study measuring the influence of grounding the body on hypertension. The results indicate that grounding appears to be a safe BP-reducing therapy warranting further research. |
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