Titel Deelnemers "Korte inhoud" "Thoracic manual therapy is not more effective than placebo thoracic manual therapy in patients with shoulder dysfunctions: A systematic review with meta-analysis." "Paolo Bizzarri, Luca Buzzatti, Erik Cattrysse, Aldo Scafoglieri" "Background Manual treatments targeting different regions (shoulder, cervical spine, thoracic spine, ribs) have been studied to deal with patients complaining of shoulder pain. Thoracic manual treatments seem able to produce beneficial effects on this group of patients. However, it is not clear whether the patient improvement is a consequence of thoracic manual therapy or a placebo effect. Objectives To compare the efficacy of thoracic manual therapy and placebo thoracic manual treatment for patients with shoulder dysfunction. Methods Electronic databases (MEDLINE, CENTRAL, PEDro, CINAHL, WoS, EMBASE, ERIC) were searched through November 2016. Randomized Controlled Trials assessing pain, mobility and function were selected. The Cochrane bias estimation tool was applied. Outcome results were either extracted or computed from raw data. Meta-analysis was performed for outcomes with low heterogeneity. Results Four studies were included in the review. The methodology of the included studies was generally good except for one study that was rated as high risk of bias. Meta-analysis showed no significant effect for “pain at present” (SMD -0.02; 95% CI: −0.35, 0.32) and “pain during movement” (SMD -0.12; 95% CI: −0.45, 0.21). Conclusion There is very low to low quality of evidence that a single session of thoracic manual therapy is not more effective than a single session of placebo thoracic manual therapy in patients with shoulder dysfunction at immediate post-treatment." "Thoraci Manual therapy is not more effective than placebo thoracic manual therapy in patients with shoulder dysfcuntions: A systematic review with meta-analysis" "Paulo Bizzarri" "Background: Manual treatments targeting different regions (shoulder, cervical spine, thoracic spine, ribs) have been studied to deal with patients complaining of shoulder pain. Thoracic manual treatments seem able to produce beneficial effects on this group of patients. However, it is not clear whether the patient improvement is a consequence of thoracic manual therapy or a placebo effect.Objectives: To compare the efficacy of thoracic manual therapy and placebo thoracic manual treatment for patients with shoulder dysfunction.Methods: Electronic databases (MEDLINE, CENTRAL, PEDro, CINAHL, WoS, EMBASE, ERIC) were searched through November 2016. Randomized Controlled Trials assessing pain, mobility and function were selected. The Cochrane bias estimation tool was applied. Outcome results were either extracted or computed from raw data. Meta-analysis was performed for outcomes with low heterogeneity.Results: Four studies were included in the review. The methodology of the included studies was generally good except for one study that was rated as high risk of bias. Meta-analysis showed no significant effect for ""pain at present"" (SMD -0.02; 95% CI: -0.35, 0.32) and ""pain during movement"" (SMD -0.12; 95% CI: -0.45, 0.21).Conclusion: There is very low to low quality of evidence that a single session of thoracic manual therapy is not more effective than a single session of placebo thoracic manual therapy in patients with shoulder dysfunction at immediate post-treatment." "Cognitive functional therapy compared with core exercise and manual therapy in patients with chronic low back pain" "Julia Castro, Luis Correia, Bruno de Sousa Donato, Bruno Arruda, Felipe Agulhari, Marina J Pellegrini, Fabiana T C Belache, Cíntia P de Souza, Jessica Fernandez, Leandro Alberto Calazans Nogueira, Felipe Reis, Arthur de Sá Ferreira, Ney Meziat-Filho" "Cognitive functional therapy (CFT) is a physiotherapy-led intervention that has evolved from an integration of foundational behavioral psychology and neuroscience within the physiotherapist practice directed at the multidimensional nature of chronic low back pain (CLBP). The current evidence about the comparative effectiveness of CFT for CLBP is still scarce. We aimed to investigate whether CFT is more effective than core training exercise and manual therapy (CORE-MT) in pain and disability in patients with CLBP. A total of 148 adults with CLBP were randomly assigned to receive 5 one-hour individualized sessions of either CFT (n = 74) or CORE-MT (n = 74) within a period of 8 weeks. Primary outcomes were pain intensity (numeric pain rating scale, 0-10) and disability (Oswestry Disability Index, 0-100) at 8 weeks. Patients were assessed preintervention, at 8 weeks and 6 and 12 months after the first treatment session. Altogether, 97.3% (n = 72) of patients in each intervention group completed the 8 weeks of the trial. Cognitive functional therapy was more effective than CORE-MT in disability at 8 weeks (MD = -4.75; 95% CI -8.38 to -1.11; P = 0.011, effect size= 0.55) but not in pain intensity (MD = -0.04; 95% CI -0.79 to 0.71; P = 0.916). Treatment with CFT reduced disability, but the difference was not clinically important compared with CORE-MT postintervention (short term) in patients with CLBP. There was no difference in pain intensity between interventions, and the treatment effect was not maintained in the mid-term and long-term follow-ups." "The benefits of adding manual therapy to exercise therapy for improving pain and function in patients with knee or hip osteoarthritis - a systematic review with meta-analysis" "Nils Runge, Alessandro Aina, Stephen May" "Objective To evaluate if there was an additional benefit of combining manual therapy (MT) and exercise therapy over exercise therapy alone on pain and function in patients with hip or knee osteoarthritis Design Intervention systematic review Literature search We (i) searched 4 databases from inception to 20 June, 2021, (ii) hand searched reference list of included trials and relevant systematic reviews and (iii) contacted two researchers in the field. Study selection criteria We included randomized controlled trials that compared MT plus exercise therapy to similar exercise therapy programs alone in patients with hip or knee osteoarthritis. Data synthesis The data were combined using random-effects meta-analyses where appropriate. The certainty of evidence for each outcome was judged using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. Results We included 19 trials. There was very low to moderate certainty evidence that MT added benefit in the short-term for pain, and combined pain, function and stiffness (WOMAC global scale), but not for performance-based function and self-reported function. In the medium-term, there was low to very low certainty evidence that MT added benefit for performance-based function and WOMAC global score, but not for pain. There was high certainty evidence that MT provided no added benefit in the long-term for pain and function. Conclusion There was very low to moderate certainty evidence supporting MT as an adjunct to exercise therapy for pain and WOMAC global scale but not function in patients with knee or hip osteoarthritis in the short-term. There was high certainty evidence of no benefit for additional MT over exercise therapy alone in the long-term." "Integration of subclassification strategies in randomised controlled clinical trials evaluating manual therapy treatment and exercise therapy for non-specific chronic low back pain: a systematic review" "Wim Dankaerts" "Abstract Background: There is lack of evidence for specific treatment interventions for patients with non-specific chronic low back pain (NSCLBP) despite the substantial amount of Randomised Controlled clinical Trials (RCTs) evaluating treatment outcome for this disorder. Hypothesis: It has been hypothesised that this vacuum of evidence is caused by the lack of sub-classifying the heterogeneous population of patients with CLBP for outcome research. Study design: A systematic review (SR). Methods: A systematic review with a meta-analysis (MA) was undertaken to determine the integration of sub-classification strategies with matched interventions in RCTs evaluating manual therapy treatment and exercise therapy for NSCLBP. A structured search for relevant studies in Embase, Cinahl, Medline, PEDro and the Cochrane Trials Register database, followed by hand searching all relevant studies in English up till December 2008. Results: Only 5 out of 68 studies (7.4%) sub-classified patients beyond applying general in- and exclusion criteria. In the few studies where classification and matched interventions have been utilised, our meta-analysis showed a statistical difference in favour of the classification based intervention for reductions in pain (p= 0.004) and disability (p= 0.0005), both for short and long-term reduction in pain (p= 0.001). Effect sizes ranged from moderate (0.43) short term, to minimal (0.14) for long-term. Conclusion: A better integration of sub-classification strategies in NSCLBP outcome research is needed. We propose the development of explicit recommendations for the use of sub-classification strategies and evaluation of targeted interventions in future research evaluating NSCLBP." "Strength training alone, exercise therapy alone, and exercise therapy with passive manual mobilisation each reduce pain and disability in people with knee osteoarthritis: a systematic review" "Wolfgang Viechtbauer" "What are the effects of strength training alone, exercise therapy alone, and exercise with additional passive manual mobilisation on pain and function in people with knee osteoarthritis compared to control? What are the effects of these interventions relative to each other?" "A clinical perspective on a pain neuroscience education approach to manual therapy" "Jo Nijs, Emilio J Puentedura" "In recent years, there has been an increased interest in pain neuroscience education (PNE) in physical therapy. There is growing evidence for the efficacy of PNE to decrease pain, disability, fear-avoidance, pain catastrophization, limited movement, and health care utilization in people struggling with pain. PNE teaches people in pain more about the biology and physiology of their pain experience including processes such as central sensitization, peripheral sensitization, allodynia, inhibition, facilitation, neuroplasticity and more. PNE's neurobiological model often finds itself at odds with traditional biomedical models used in physical therapy. Traditional biomedical models, focusing on anatomy, pathoanatomy, and biomechanics have been shown to have limited efficacy in helping people understand their pain, especially chronic pain, and may in fact even increase a person's pain experience by increasing fear-avoidance and pain catastrophization. An area of physical therapy where the biomedical model is used a lot is manual therapy. This contrast between PNE and manual therapy has seemingly polarized followers from each approach to see PNE as a 'hands-off' approach even having clinicians categorize patients as either in need of receiving PNE (with no hands-on), or hands-on with no PNE. In this paper, we explore the notion of PNE and manual therapy co-existing. PNE research has shown to have immediate effects of various clinical signs and symptoms associated with central sensitization. Using a model of sensitization (innocuous, noxious, and allodynia), we argue that PNE can be used in a manual therapy model, especially treating someone where the nervous system has become increasingly hypervigilant. Level of Evidence: VII." "Identifying patient characteristics associated with the occurrence of post treatment non-serious adverse events after cervical spine manual therapy treatment in patients with neck pain" "Renske Peters R, Maarten Schmitt, Bert Mutsaers, Ronald Buyl, Arianne Verhagen, Annelies Pool-Goudzwaard, Bart W Koes" "Objectives: To compare prevalence rates of serious and non-serious adverse events after manipulation and mobilization and to identify risk factors of serious and non-serious adverse events following 4 types of manual therapy treatment in patients with neck pain. Design: A prospective cohort study in primary care manual therapy practice. Participants: Patients with neck pain (N=686) provided data on adverse events after 1014 manipulation treatments, 829 mobilization treatments, 437 combined manipulation and mobilization treatments, and 891 treatments consisting of “other treatment modality”. Interventions: Usual care manual therapy. Main Outcome Measures: A chi-square test was performed to explore differences in prevalence rates. Logistic regression analysis was performed within the 4 treatment groups. A priori we defined associations between patient-characteristics and adverse events of odds ratio (OR)>2 or OR" "The effectiveness of manual circumlaryngeal therapy in future elite vocal performers: a pilot study" "Sofie Claeys" "What effect can manual therapy have on a patient's pain experience?" "Mark D Bishop, Rafael Torres Cueco, Charles W Gay, Enrique Lluch Girbes, Jason M Beneciuk, Joel E Bialosky" "Manual therapy (MT) is a passive, skilled movement applied by clinicians that directly or indirectly targets a variety of anatomical structures or systems, which is utilized with the intent to create beneficial changes in some aspect of the patient pain experience. Collectively, the process of MT is grounded on clinical reasoning to enhance patient management for musculoskeletal pain by influencing factors from a multidimensional perspective that have potential to positively impact clinical outcomes. The influence of biomechanical, neurophysiological, psychological and nonspecific patient factors as treatment mediators and/or moderators provides additional information related to the process and potential mechanisms by which MT may be effective. As healthcare delivery advances toward personalized approaches there is a crucial need to advance our understanding of the underlying mechanisms associated with MT effectiveness."