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This pilot clinical study evaluates the effects of manipulative treatment on surgical scars. Forty patients were evaluated, 20 of whom had surgical scars on the spine, 20 with surgical scars on the abdomen. The scars were evaluated with a thermal imaging camera and Adheremeter. All patients received two treatments and completed a VAS (Visual Analogic Scale). The scar area may have a local temperature difference due to decreased vascularisation of the fibrotic tissue, with an alteration of locoregional tissue sensitivity and a nociceptive reflex. The aim of the study is to assess the extent to which manipulative treatment can alter the local tissue texture of the scar. [ABSTRACT FROM AUTHOR]

The dataset presented in this article was used in a pilot randomized and controlled trial that evaluated the effectiveness of manual physical therapy (MPT) compared to conventional pharmacologic treatment (CPT) for treating chronic pediatric functional constipation (CPC). The pilot trial was carried out at the Central University Hospital of Asturias in Oviedo, Spain, with 47 children between 2 and 12 years old being evaluated by a Pediatric Gastroenterologist. Participants received 9 sessions of MPT which were spaced out weekly for the first two months and bi-weekly for the third month. The Pediatric Quality of Life questionnaire (PedsQLTM) scores were assessed at the start of the trial (Time 1), its end (Time 2), and 5 years later (Time 3). The dataset contains the collected raw data, including participant demographics data and PedsQLTM scores categorized by question group, as well as total scores for each participant at each time point. This dataset can be used to further analyze the results and the study can be potentially replicated.

Background Occipito-mastoid structure normalization (OMSN) is an osteopathy manipulative treatment aiming at reducing tensions around the jugular foramen, where cranial nerves IX, X and XI come out of the skull. Tensions in this area may induce compressions of those nerves, which might imply symptoms related to those nerves dysfunctions (e.g., dysphagia, gastrointestinal issues, cardiac issues, upper body muscle pain, fatigue). Vagus nerve X is the main parasympathetic nerves of this area. Heart rate variability (HRV) is a surrogate for vagal modulation, and purpose of this study was to observe how HRV variables evolved before and after an OMSN. Methods Pre- and post- intervention HRV was analyzed in two randomly distributed groups of 15 participants. One received the OMSN and the other a SHAM technique. HRV was collected supine 5 min before and 5 min after a10-minute application of either OMSN or SHAM. HRV was analyzed on the last 4 minutes of the 5 minutes sample in time- and frequency-domain. Results HR significantly decreased in both groups (change in mean (CIM) -2.6 (4.3), and -2.3 (2.1) bpm, for NSOM and SHAM, respectively) but without difference between groups (p = 0.245). Vagally-related HRV variable root mean square of successive differences (RMSSD) increased in both groups, but in a significantly higher proportion in OMSN group (CIM 8.1 ±6.4 and 2.8 ±6.2 ms, p = 0.030 for NSOM and SHAM, respectively). No differences between groups were observed on frequency-domain analysis. Conclusion Compared to a SHAM technique, OMSN had a significant effect on HRV vagally-related metric RMSSD. This effect was measured in the very short term and thus, OMSN may be used to imply a short-term influence on parasympathetic ANS modulations. Further research are needed to investigate medium and long-term influences of this manipulation.

Abstract Background Chiropractic care is commonly used to treat infantile colic. However large trials with parental blinding are missing. Therefore, the purpose of this study is to evaluate the effect of chiropractic care on infantile colic. Method This is a multicenter, single-blind randomized controlled trial conducted in four Danish chiropractic clinics, 2015–2019. Information was distributed in the maternity wards and by maternal and child health nurses. Children aged 2–14 weeks with unexplained excessive crying were recruited through home visits and randomized (1:1) to either chiropractic care or control group. Both groups attended the chiropractic clinic twice a week for 2 weeks. The intervention group received chiropractic care, while the control group was not treated. The parents were not present in the treatment room and unaware of their child’s allocation. The primary outcome was change in daily hours of crying before and after treatment. Secondary outcomes were changes in hours of sleep, hours being awake and content, gastrointestinal symptoms, colic status and satisfaction. All outcomes were based on parental diaries and a final questionnaire. Results Of 200 recruited children, 185 completed the trial (treatment group n = 96; control group n = 89). Duration of crying in the treatment group was reduced by 1.5 h compared with 1 h in the control group (mean difference − 0.6, 95% CI − 1.1 to − 0.1; P = 0.026), but when adjusted for baseline hours of crying, age and chiropractic clinic, the difference was not significant (P = 0.066). The proportion obtaining a clinically important reduction of 1 h of crying was 63% in the treatment group and 47% in the control group (p = 0.037), and NNT was 6.5. We found no effect on any of the secondary outcomes. Conclusion Excessive crying was reduced by half an hour in favor of the group receiving chiropractic care compared with the control group, but not at a statistically significant level after adjustments. From a clinical perspective, the mean difference between the groups was small, but there were large individual differences, which emphasizes the need to investigate if subgroups of children, e.g. those with musculoskeletal problems, benefit more than others from chiropractic care. Trial registration Clinical Trials NCT02595515 , registered 2 November 2015

Abstract Background A recent trial identified large variation in effect of chiropractic care for infantile colic. Thus, identification of possible effect modifiers could potentially enhance the clinical reasoning to select infants with excessive crying for chiropractic care. Therefore, the aim of this study is to identify potential treatment effect modifiers which might influence the effect of chiropractic care for excessive crying in infancy. Methods Design: Prespecified secondary analyses of data from a randomised controlled trial. The analyses are partly confirmative and partly exploratory. Setting: Four chiropractic clinics in Denmark. Participants: Infants aged 2–14 weeks with unexplained excessive crying. Of the 200 infants randomised (1:1), 103 were assigned to a chiropractic care group and 97 to a control group. Intervention: Infants in the intervention group received chiropractic care for 2 weeks, while the control group was not treated. Main analyses: The outcome was change in daily hours of crying. Fifteen baseline variables and 6 general variables were selected as potential effect modifiers, and indices based on these were constructed. Factor analyses, latent class analyses and prognosis were used to construct other potentially modifying variables. Finally, an attempt at defining a new index aiming at optimal prediction of the treatment effect was made. The predictive value for all resulting variables were examined by considering the difference in mean change in crying time between the two treatment groups, stratified by the values of the candidate variables, i.e. interaction analyses. Results None of the predefined items or indices were shown to be useful in identifying colicky infants with potentially larger gain from manual therapy. However, more baseline hours of crying (p = 0.029), short duration of symptoms (p = 0.061) and young age (p = 0.089) were all associated with an increased effect on the outcome of hours of crying. Conclusion Musculoskeletal indicators were not shown to be predictive of an increased benefit for colicky infants from chiropractic treatment. However, increased benefit was associated with early treatment and a high level of baseline crying, suggesting that the most severely affected infants have the greatest potential of benefiting from manual therapy. This finding requires validation by future studies. Trial registration Clinical Trials NCT02595515 , registered 2 November 2015.

Background: A recent trial identified large variation in effect of chiropractic care for infantile colic. Thus, identification of possible effect modifiers could potentially enhance the clinical reasoning to select infants with excessive crying for chiropractic care. Therefore, the aim of this study is to identify potential treatment effect modifiers which might influence the effect of chiropractic care for excessive crying in infancy. Methods: Design: Prespecified secondary analyses of data from a randomised controlled trial. The analyses are partly confirmative and partly exploratory. Setting: Four chiropractic clinics in Denmark. Participants: Infants aged 2–14 weeks with unexplained excessive crying. Of the 200 infants randomised (1:1), 103 were assigned to a chiropractic care group and 97 to a control group. Intervention: Infants in the intervention group received chiropractic care for 2 weeks, while the control group was not treated. Main analyses: The outcome was change in daily hours of crying. Fifteen baseline variables and 6 general variables were selected as potential effect modifiers, and indices based on these were constructed. Factor analyses, latent class analyses and prognosis were used to construct other potentially modifying variables. Finally, an attempt at defining a new index aiming at optimal prediction of the treatment effect was made. The predictive value for all resulting variables were examined by considering the difference in mean change in crying time between the two treatment groups, stratified by the values of the candidate variables, i.e. interaction analyses. Results: None of the predefined items or indices were shown to be useful in identifying colicky infants with potentially larger gain from manual therapy. However, more baseline hours of crying (p = 0.029), short duration of symptoms (p = 0.061) and young age (p = 0.089) were all associated with an increased effect on the outcome of hours of crying. Conclusion: Musculoskeletal indicators were not shown to be predictive of an increased benefit for colicky infants from chiropractic treatment. However, increased benefit was associated with early treatment and a high level of baseline crying, suggesting that the most severely affected infants have the greatest potential of benefiting from manual therapy. This finding requires validation by future studies. Trial registration: Clinical Trials NCT02595515, registered 2 November 2015. [ABSTRACT FROM AUTHOR]

Background: Chiropractic care is commonly used to treat infantile colic. However large trials with parental blinding are missing. Therefore, the purpose of this study is to evaluate the effect of chiropractic care on infantile colic. Method: This is a multicenter, single-blind randomized controlled trial conducted in four Danish chiropractic clinics, 2015–2019. Information was distributed in the maternity wards and by maternal and child health nurses. Children aged 2–14 weeks with unexplained excessive crying were recruited through home visits and randomized (1:1) to either chiropractic care or control group. Both groups attended the chiropractic clinic twice a week for 2 weeks. The intervention group received chiropractic care, while the control group was not treated. The parents were not present in the treatment room and unaware of their child's allocation. The primary outcome was change in daily hours of crying before and after treatment. Secondary outcomes were changes in hours of sleep, hours being awake and content, gastrointestinal symptoms, colic status and satisfaction. All outcomes were based on parental diaries and a final questionnaire. Results: Of 200 recruited children, 185 completed the trial (treatment group n = 96; control group n = 89). Duration of crying in the treatment group was reduced by 1.5 h compared with 1 h in the control group (mean difference − 0.6, 95% CI − 1.1 to − 0.1; P = 0.026), but when adjusted for baseline hours of crying, age and chiropractic clinic, the difference was not significant (P = 0.066). The proportion obtaining a clinically important reduction of 1 h of crying was 63% in the treatment group and 47% in the control group (p = 0.037), and NNT was 6.5. We found no effect on any of the secondary outcomes. Conclusion: Excessive crying was reduced by half an hour in favor of the group receiving chiropractic care compared with the control group, but not at a statistically significant level after adjustments. From a clinical perspective, the mean difference between the groups was small, but there were large individual differences, which emphasizes the need to investigate if subgroups of children, e.g. those with musculoskeletal problems, benefit more than others from chiropractic care. Trial registration: Clinical Trials NCT02595515, registered 2 November 2015 [ABSTRACT FROM AUTHOR]

Objective/Subjects To determine the autonomic effects of suboccipital release (SOR) during experimentally induced pain, 16 healthy subjects (eight women, eight men) experienced ischemic (forearm postexercise muscle ischemia [PEMI]) and cold (cold pressor test [CPT]) pain. Design Beat-to-beat heart rate (electrocardiogram), mean arterial blood pressure (finger photoplethysmography), baroreflex sensitivity (transfer function analysis), and pain perception were measured. SOR or a sham (modified yaw; 30 cycles/min) was performed in minute 2 of pain. Results PEMI increased blood pressure by 23 ± 2 and 20 ± 2 mmHg; no differences occurred between SOR or yaw. PEMI modestly elevated heart rate during ischemia, followed by significant reduction from baseline with SOR (–3 ± 2 bpm) and yaw (−4 ± 2 bpm); no differences were observed between treatments. CPT increased blood pressure (SOR = 11 ± 1, yaw = 9 ± 2 mmHg) and heart rate (SOR = 10 ± 2, yaw = 8 ± 3 bpm) before SOR and yaw. Neither treatment nor sham blunted blood pressure increases (SOR = 25 ± 2, yaw = 22 ± 2 mmHg) during CPT; both decreased heart rate (SOR = −3 ± 2, yaw = −2 ± 2 bpm) from baseline. PEMI and CPT caused increased pain without treatment modulation. Following pain and manual intervention, SOR increased baroreflex sensitivity in the 0.15–0.35 Hz range and decreased R-R interval power spectral density in the 0.03–0.5 Hz range compared with yaw. To probe potential mechanisms and interactions between manual treatment and a prototypic analgesic, oral aspirin (967 mg) was given 60 minutes before testing to reduce prostaglandin synthesis. Aspirin slightly attenuated pain but neither altered cardiovascular changes to PEMI nor interacted with SOR or yaw. Conclusions SOR has the capacity to modulate pain-induced autonomic control and regulation. [ABSTRACT FROM AUTHOR]

Objectives: Make a preliminary assessment of the efficacy of manual physical therapy (MPT) compared to conventional pharmacologic treatment (CPT) in chronic pediatric functional constipation (CPC). Design: A pilot randomized and controlled trial was conducted. Settings/Location: Subjects were recruited in a tertiary university hospital in the north of Spain. Subjects: Forty-seven children (2–14 years) were included. Participants were assessed by Pediatric Gastroenterologist. They were recruited in a tertiary university hospital. Subjects were randomly allocated. MPT was performed in a private clinic. Interventions: Control group (CG) received CPT and intervention group (IG) received MPT, consisting in nine sessions of MPT with a 45-min initial session and 30 min for the rest of sessions distributed weekly during the first and second months and biweekly in the third month. Outcome Measures: At times 0-1-3 months and 5 years, results obtained were checked and compared, according to the defecatory pattern ("Symptom Severity Score" SSS), quality of life (Pediatric Quality of Life Inventory Scale), Bristol Stool Form Scale (BSFS), and the defecation frequency (DF). Results: Results from SSS, BSFS, and DF revealed no statistically significant differences between groups in median values at any follow-up. However, there were significant changes over time. The full sample median for SSS was reduced from baseline 24 (interquartile range 20–27) to 11 (6–13) at month 1, 7 (3–13) at month 3, (8 CG; 5 IG), and 5 (1–12) at year 5. The BSFS scale increased from 2 (1–3) at baseline to 4 (3–4) at month 1 and year 5. DF increases progressively from 1 per week to 5 in the fifth year. Higher rates of quality of life were observed at month 3 in IG for the total, physical, and emotional functioning scores and at fifth year for total, emotional, social, and school functioning scores. Conclusions: This study gives preliminary evidence of no difference between MPT and CPT for improvement in measures of CPC, although there was some advantage for MPT in quality of life. Study results justify the conduct of a full-scale efficacy trial of MPT, as well as a noninferiority trial comparing MPT and CPT. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the effect of chiropractic manipulative treatment on sacroiliac joint dysfunction (SIJD) and its relationship to oxidative stress (OXS) parameters. Patients and methods: Thirty-three patients diagnosed with SIJD (20 males, 13 females; mean age 36.3±9.7 years; range, 18 to 60 years) and 30 healthy volunteers (20 males, 10 females; mean age 36.4±12.2 years; range, 20 to 57 years) were included in this cross-sectional, case-control study conducted between February 2017 and September 2017. Manipulation was applied to the patients once a week for a duration of four weeks. The patients were evaluated at pre-treatment and one month after treatment with visual analog scale, SIJD test, and total thiol, native thiol, disulphide, and ischemia-modified albumin (IMA) as OXS indicators. Results: Prior to treatment, we demonstrated that serum native thiol (µmol/L) and total thiol (µmol/L) levels in the patient group were lower compared to control subjects (p=0.03 and p=0.02, respectively). Serum IMA levels were higher in the patient group (p=0.01). There was no change in OXS parameters after manipulative treatment in the patient group. Conclusion: Manipulation is useful in SIJD. Thiol/disulphide homeostasis and serum IMA levels may be used to measure the OXS in patients with SIJD. [ABSTRACT FROM AUTHOR]

The article examines the feasibility of utilizing early individualized manipulative rehabilitation to address early post-operative functional disability following lumbar discectomy. Topics discussed include the effectiveness of lumbar open laser microdiscectomy for lumbar disc prolapse and sporadic reports of post-operative physical disability affecting daily activities. The results showed that post-operative physical disability was improved with rehabilitation compared to control care.

The dataset presented in this article was used in a pilot randomized and controlled trial that evaluated the effectiveness of manual physical therapy (MPT) compared to conventional pharmacologic treatment (CPT) for treating chronic pediatric functional constipation (CPC). The pilot trial was carried out at the Central University Hospital of Asturias in Oviedo, Spain, with 47 children between 2 and 12 years old being evaluated by a Pediatric Gastroenterologist. Participants received 9 sessions of MPT which were spaced out weekly for the first two months and bi-weekly for the third month. The Pediatric Quality of Life questionnaire (PedsQL TM ) scores were assessed at the start of the trial (Time 1), its end (Time 2), and 5 years later (Time 3). The dataset contains the collected raw data, including participant demographics data and PedsQL TM scores categorized by question group, as well as total scores for each participant at each time point. This dataset can be used to further analyze the results and the study can be potentially replicated., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Introduction. The aim of this clinical trial is to compare the results obtained with a manipulative protocol developed by our investigation group with the results obtained with a conventional physiotherapy treatment in patients suffering from whiplash injury. No controlled experimental trials have been published documenting the effects of this manipulative protocol. Design. A randomized controlled trial. Material and methods. 380 volunteers subjects, 300 men and 80 women, participated in this trial. All patients were diagnosed with acute whiplash injury of less than 3 months duration, and classified in grades II and III according to the Quebec Task Force (QTF). Patients were divided randomly in 2 groups, using a table of random numbers: Group A (experimental group) and group B (control group). Group A was treated with a manipulative protocol which includes “high velocity-low amplitude techniques”, soft tissues manipulation and mobilization techniques. Group B was treated with a conventional physiotherapy treatment which includes active exercises, electrotherapy, ultrasound therapy and diathermy (best evidence). Patients in group A have received weekly manipulative treatment, whereas group B received daily physiotherapy treatment. All subjects signed the required consent sheet before becoming part of the research. The outcome measures were the visual analogue scale (VAS), the cervical range of motion (CROM) in flexion and rotation, and number of sessions needed to complete the treatment. Data were collected pre-treatment, after each 4 sessions in group A and after each 10 sessions in group B. Results. Patients of manipulative group needed an average of 9 sessions to complete the treatment, whereas physiotherapy group needed an average of 23 sessions (P = 0.002). Results showed that the manipulative group had more benefits than the physiotherapy group in the VAS and CROM, specifically after the first 4 sessions with a decrease of 40%in the VAS (P = 0.003) and an improvement of 20 degrees in cervical rotation (P = 0.02). Conclusions. Patients who had received manipulative treatment needed fewer sessions to complete the treatment than patients who had received physiotherapy treatment. The improvement in the manipulative group was achieved with fewer treatment sessions and was greater than the improvement in physiotherapy group. In the future, we plan to analyze if this improvement will be maintained over time by assessing and checking the patients after 6 months and 1 year. [ABSTRACT FROM PUBLISHER]

Background: Lumbar open laser microdiscectomy has been shown to be an effective intervention and safe approach for lumbar disc prolapse. However early post-operative physical disability affecting daily activities have been sporadically reported., Objective: To evaluate the feasibility of using early individualised manipulative rehabilitation to improve early post-operative functional disability following lumbar discectomy., Methods: Randomised controlled pilot trial. Setting at a major metropolitan spine surgery hospital. Twenty-one patients aged 25-69 years who underwent lumbar microdiscectomy were randomised to either the manipulative rehabilitation treatment group or the active control group. Rehabilitation was initiated 2-3 weeks after surgery, twice a week for 4 weeks. Each session was for 30 minutes. Primary outcomes were the Roland-Morris disability questionnaire and the visual analogue pain scale. Outcome measures were assessed at baseline and post-intervention., Results: Early post-operative physical disability was improved with a 55% reduction by early individualised manipulative rehabilitation, compared to that of control care with a 5% increase. Early post-operative residual leg pain decreased with rehabilitation (55%) and control care (9%)., Conclusion: This pilot study supports the feasibility of a future definitive randomised control trial and indicates this type of rehabilitation may be an important option for post-operative management after spinal surgery.