Two physically active patients presented with low back pain (LBP) and were previously diagnosed with a herniated disc. A unique treatment combination of a muscle energy technique (MET) and MyoKinesthetic (MYK) treatments were used to decrease pain and improve function. The treatment combination displayed clinically significant short-term improvements in four treatments or less and both patients reported no recurrence of pain at their 1-year follow-up. It is questionable if the presence of an anatomical abnormality, such as a herniated disc, is truly the source or unrelated to those experiencing LBP; utilizing a MET and MYK treatment may be beneficial for other patients reporting similar symptoms.
Jena A. Hansen-Honeycutt, Alan M. Nasypany and Russell T. Baker
Kimberly D. Johnston, Russell T. Baker and Jayme G. Baker
Christy L. Hancock, Russell T. Baker and Eric A. Sorenson
Erica S. Albertin, Emilie N. Miley, James May, Russell T. Baker and Don Reordan
Clinical Scenario: Hip osteoarthritis currently affects up to 28% of the population, and the number of affected Americans is expected to rise as the American population increases and ages. Limited hip range of motion (ROM) has been identified as a predisposing factor to hip osteoarthritis and limited patient function. Clinicians often apply therapy techniques, such as stretching and strengthening exercises, to improve hip ROM. Although traditional therapy has been recommended to improve hip ROM, the efficiency of the treatments within the literature is questionable due to lack of high-quality studies. More recently, clinicians have begun to utilize joint mobilization and the Mulligan Concept mobilization with movement techniques to increase ROM at the hip; however, there is a paucity of research on the lasting effects of mobilizations. Given the difficulties in improving ROM immediately (within a single treatment) and with long-lasting results (over the course of months), it is imperative to examine the evidence for the effectiveness of traditional therapy techniques and more novel manual therapy techniques. Focused Clinical Question: Is there evidence to suggest manual mobilizations techniques at the hip are effective at treating hip ROM limitations? Summary of Clinical Findings: 5 Randomized Controlled Studies, improved patient function and ROM with the Mulligan concept, high velocity low amplitude improved. Clinical Bottom Line: We found moderate evidence to suggest favorable outcomes following the use of hip mobilizations aimed at improving hip ROM and patient function. Strength of Recommendation: Strength of the studies identified are 1B.
Robert W. Cox, Rodrigo E. Martinez, Russell T. Baker and Lindsay Warren
Context: Range of motion is a component of a physical examination used in the diagnostic and rehabilitative processes. Following ankle injury and/or during research, it is common to measure plantar flexion with a universal goniometer. The ease and availability of digital inclinometers created as applications for smartphones have led to an increase in using this method of range of motion assessment. Smartphone applications have been validated as alternatives to inclinometer measurements in the knee; however, this application has not been validated for plantar flexion in the ankle. Objectives: The purpose of this study was (1) to assess the validity of the Clinometer Smartphone Application™ produced by Plaincode App Development for use in the ankle (ie, plantar flexion) and (2) to assess the validity of the inclinometer procedures used to measure ankle dorsiflexion for measuring ankle plantar flexion. Design: Blinded repeated measures correlational design. Setting: University-based outpatient rehabilitative clinic. Participants: A convenience sample (N = 50) of participants (27 females and 23 males) who reported to the clinic (mean age = 30.48 y). Intervention: Patients were long seated on a plinth, with the knee in terminal extension. Three plantar flexion measurements were taken with a goniometer on each foot by the primary researcher. The primary researcher then conducted 3 blinded measurements with The Clinometer Smartphone Application™ following the same procedure. A second researcher, who was blinded to the goniometer measurements, recorded the inclinometer measurements. After data were collected, a Pearson’s correlation was calculated to determine the validity of the clinometer app compared with goniometry. Main Outcome Measure: Degrees of motion for ankle plantar flexion. Results: Measurements produced using the Clinometer Smartphone Application™ were highly correlated for right foot (r = .92, P < .001), left foot (r = .92, P < .001), and combined (r = .92, P < .001) with goniometer measurements using a plastic universal goniometer. Conclusion: The Clinometer Smartphone Application™ is a valid instrument for measuring plantar flexion of the ankle.