Herpes simplex encephalitis and its neurosurgical implications: report of five cases.
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Adolescent↗
Biomedical subjects
D Peterson
Publications and source records attributed to D Peterson.
Muscle testing response to provocative vertebral challenge and spinal manipulation: a randomized controlled trial of construct validity.
OBJECTIVE: To evaluate the relationship of muscle strength response to a provocative vertebral challenge and to spinal manipulation. DESIGN: Prospective double-blind randomized controlled trial: crossover and between subjects designs. SETTING: Laboratory: Center for Technique Research. PARTICIPANTS: Sixty-eight naive volunteers from the student body, staff and faculty of the college. INTERVENTIONS: Provocative vertebral challenge: standardized 4-5 kg force applied with a pressure algometer to the lateral aspects of the T3-12 spinous processes. INTERVENTION: manual high velocity low amplitude adjustment or switched-off activator sham. MAIN OUTCOME MEASURES: Piriformis muscle response was defined in two ways: reactivity (a decrease in muscle resistance, yes or nor, following a vertebral challenge); responsiveness (the cessation of reactivity following spinal manipulation). Relative response attributable to the maneuver (RRAM): the percent of an outcome attributable to the challenge or adjustment itself. RESULTS: Average RRAM = 16% reactivity to vertebral challenge; average RRAM = 0% responsiveness to spinal manipulation. Six to 10% of muscle tests were positive regardless of examiner, previous finding or intervention. CONCLUSIONS: For the population under investigation, muscle response appeared to be a random phenomenon unrelated to manipulable subluxation. In and of itself, muscle testing appears to be of questionable use for spinal screening and post-adjustive evaluation. Further research is indicated in more symptomatic populations, different regions of the spine, and using different indicator muscles.
Adult↗
Short-term responsiveness of manual thoracic end-play assessment to spinal manipulation: a randomized controlled trial of construct validity.
OBJECTIVE: To evaluate the short-term responsiveness of rotatory thoracic end-play assessment to spinal manipulation and, thereby, motion palpation construct validity. DESIGN: Prospective, single-blind, randomized, controlled trial (randomized blocks design). SETTING: Laboratory, Center for Technique Research. PARTICIPANTS: Sixty first-year chiropractic college student volunteers; seventy-three possible candidates were screened. INTERVENTIONS: The treatment group received manual high-velocity, low-amplitude rotatory manipulation. The control group received no intervention to minimize nonspecific effects of sham treatment. MAIN OUTCOME MEASURES: End-play response, defined as the change from restricted to normal end play immediately after intervention. Responsiveness, defined as the percentage of the end-play response attributable to spinal manipulation: relative response attributable to the maneuver, RRAM = (treatment group response--control group response)/treatment group response. RESULTS: Ten percent of the tests were positive for restriction of end play in left or right rotation from T3-T4 to T12-L1; the average rate was 2.1 restrictions per subject (SD = 1.4). End-play response was 60% in the treatment group, in contrast to the 37% response in the control group (z = 1.86, p = .04). More than a third of the response in the treatment group was attributable to spinal manipulation (RRAM = 39%). For one examiner, RRAM = 51%. Mild symptomatology did not affect responsiveness. CONCLUSIONS: The data suggest a moderate short-term responsiveness of rotatory thoracic end-play restriction to spinal manipulation, hence it has utility as a posttreatment evaluative test. This study was the first to use an external standard (manipulation) to demonstrate that segmental end-play restriction changes, hence end-play restriction itself, are detectable in human subjects with manual palpation by chiropractors. Further research is required to determine the generalizability of the study findings.
Adult↗