STUDY DESIGN: Prospective, repeated measures obtained under treatment and control conditions. OBJECTIVES: The purposes of this study were to provide preliminary evidence regarding the immediate change in the diffusion of water in the nuclear region of normal and degenerative lumbar intervertebral discs (IVDs) following a single session of lumbar joint mobilization, and to compare these findings to the immediate change in the diffusion of water following a 10-minute session of prone lying. BACKGROUND: There is conflicting evidence regarding the effectiveness and efficacy of lumbar joint mobilization. Increased knowledge of the physiologic effects of lumbar joint mobilization can lead to refinement of its clinical application. METHODS AND MEASURES: A total of 24 people (15 males and 9 females), ranging in age from 22 to 58 years, participated in this study. All subjects had a history of activity-limiting low back pain. Diffusion-weighted magnetic resonance images (DW-MRIs) were obtained immediately before and after a 10-minute session of lumbar joint mobilization. At least 1 month later, a second session was performed in which DW-MRIs were obtained immediately before and after a 10-minute session of prone lying. RESULTS: Following lumbar joint mobilization, a significant increase (P = .002) in the mean values for diffusion of water was observed within degenerative IVDs at L5-S1 (22.2% increase; effect size, 0.97). Degenerative IVDs at L1-2 to L4-5 and normal IVDs at L1-2 to L5-S1 did not demonstrate a change in diffusion following joint mobilization. Prone lying was not associated with a change in diffusion for normal or degenerative IVDs. CONCLUSIONS: The stimulus provided by lumbar joint mobilization may influence the diffusion of water in degenerative IVDs at L5-S1; however, these are preliminary findings and the relationship of these findings to pain and function needs further investigation. LEVEL OF EVIDENCE: Therapy, level 5.

J Orthop Sports Phys Ther 2009;39(1):4-11, Epub 24 October 2008. doi:10.2519/jospt.2009.2994

KEY WORDS: back pain, lumbar disc disease, lumbar spine, manual therapy, physical therapy

STUDY DESIGN: Randomized clinical trial. OBJECTIVES: To investigate if patients with mechanical neck pain receiving thoracic spine thrust manipulation would experience superior outcomes compared to a group not receiving thrust manipulation. BACKGROUND: Evidence has begun to emerge in support of thoracic thrust manipulation as an intervention in the management of mechanical neck pain. However, to make a strong recommendation for a clinical technique it is necessary to have multiple studies with convergent findings. METHODS AND MEASURES: Forty-five patients (21 females) were randomly assigned to 1 of 2 groups: a control group, which received electro/thermal therapy for 5 treatment sessions, and the experimental group, which received the same electro/thermal therapy program in addition to a thoracic spine thrust manipulation once a week for 3 consecutive weeks. Mixed-model analyses of variance (ANOVAs) were used to examine the effects of treatment on pain (100-mm visual analogue scale), disability (100-point disability scale), and cervical range of motion, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction for pain. RESULTS: The group-by-time interaction effects for the ANOVA models were statistically significant for pain, mobility, and disability (P<.05), indicating greater improvements in the manipulation group for all the outcome measures. Patients receiving thoracic manipulation experienced greater improvements in pain at the fifth (final) treatment session and at the 2-week and 4-week follow-up periods (P<.001), with pain improvement scores in the manipulation group of 16.8 mm and 26.5 mm greater than those in the comparison group at the 2- and 4-week follow-up periods, respectively. The experimental group also experienced significantly greater improvements in disability with a between-group difference of 8.8 points (95% confidence interval [CI]: 7.5, 10.1; P<.001) at the fifth visit and 8.0 points (95% CI: 5.8, 10.2; P<.001) at the 2-week follow-up. CONCLUSIONS: The results of our study suggest that thoracic spine thrust manipulation results in superior clinical benefits that persist beyond the 1-month follow-up period for patients with acute neck pain. Future studies should continue to investigate the effects of thoracic spine thrust manipulation, as compared to other physical therapy interventions, in a population with mechanical neck pain. LEVEL OF EVIDENCE: Therapy, level 1b.

J Orthop Sports Phys Ther 2009;39(1):20-27, Epub 19 September 2008. doi:10.2519/jospt.2009.2914

KEY WORDS: cervical spine, clinical trial, manual therapy, mobilization, thrust manipulation

A summary of the schedule of platform and poster research presentations made by the Orthopaedic Section and Sports Physical Therapy Section of the American Physical Therapy Association during APTA's Combined Sections Meeting, February 9-12, 2008, in Las Vegas, NV.

On February 5, 2009, a corrected version of the CSM schedule was uploaded and is now available for download. Please note the change in date for the Orthopaedic Section poster presentations, as well as a change in poster viewing and presentation times for both sections.

J Orthop Sports Phys Ther 2009;39(1):A1-A12

KEY WORDS: Combined Sections Meeting, CSM

The abstracts are presented here as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors. In the identification number above each abstract, OPO designates an Orthopaedic poster presentation.

J Orthop Sports Phys Ther 2009;39(1):A39-A100

KEY WORDS: Combined Sections Meeting, CSM, Orthopaedic Section posters

The abstracts are presented here as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors. In the identification number above each abstract, SPO designates a Sports poster presentation.

J Orthop Sports Phys Ther 2009;39(1):A113-A120

KEY WORDS: Combined Sections Meeting, CSM, Sports posters