Document Detail

Full kinetic chain manual and manipulative therapy plus exercise compared with targeted manual and manipulative therapy plus exercise for symptomatic osteoarthritis of the hip: a randomized controlled trial.
MedLine Citation:
PMID:  22289235     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: To determine the short-term effectiveness of full kinematic chain manual and manipulative therapy (MMT) plus exercise compared with targeted hip MMT plus exercise for symptomatic mild to moderate hip osteoarthritis (OA).
DESIGN: Parallel-group randomized trial with 3-month follow-up.
SETTING: Two chiropractic outpatient teaching clinics.
PARTICIPANTS: Convenience sample of eligible participants (N=111) with symptomatic hip OA were consented and randomly allocated to receive either the experimental or comparison treatment, respectively.
INTERVENTIONS: Participants in the experimental group received full kinematic chain MMT plus exercise while those in the comparison group received targeted hip MMT plus exercise. Participants in both groups received 9 treatments over a 5-week period.
MAIN OUTCOME MEASURES: Western Ontario and McMasters Osteoarthritis Index (WOMAC), Harris hip score (HHS), and Overall Therapy Effectiveness, alongside estimation of clinically meaningful outcomes.
RESULTS: Total dropout was 9% (n=10) with 7% of total data missing, replaced using a multiple imputation method. No statistically significant differences were found between the 2 groups for any of the outcome measures (analysis of covariance, P=.45 and P=.79 for the WOMAC and HHS, respectively).
CONCLUSIONS: There were no statistically significant differences in the primary or secondary outcome scores when comparing full kinematic chain MMT plus exercise with targeted hip MMT plus exercise for mild to moderate symptomatic hip OA. Consequently, the nonsignificant findings suggest that there would also be no clinically meaningful difference between the 2 groups. The results of this study provides guidance to musculoskeletal practitioners who regularly use MMT that the full kinematic chain approach does not appear to have any benefit over targeted treatment.
James W Brantingham; Gregory Parkin-Smith; Tammy Kay Cassa; Gary A Globe; Denise Globe; Henry Pollard; Katie Deluca; Muffit Jensen; Stephan Mayer; Charmaine Korporaal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  93     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  259-67     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Department of Research, Cleveland Chiropractic College, Los Angeles, CA; School of Chiropractic & Sports Science, Murdoch University, Perth, WA, Australia; Department of Chiropractic and Somatology, Durban University of Technology, Durban, South Africa.
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