A Randomized Controlled Trial Comparing Manipulation With Mobilization for Recent Onset Neck Pain
Leaver et al

Leaver and colleagues conducted a randomized controlled trial to compare the effectiveness of manipulation and mobilization in the treatment of nonspecific neck pain. Analysis of 182 patients with recent onset neck pain revealed that participants treated with neck manipulation did not undergo a more rapid recovery than those treated with mobilization. Statistical analysis revealed no statistical significance between those receiving manipulation and those mobilization in terms of pain, disability, function, global perceived effect, or health-related quality of life. The authors conclude that manipulation is not appreciably more effective than mobilization and that the choice to use one over the other cannot be justified on the basis of superior effectiveness.

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Forgoing Physician Visits Because of Cost: A Source of Health Disparities for Elderly People With Disabilities?
Lee et al

Lee and Heinemann conducted a cross-sectional analysis of 93,933 community-dwelling adults aged 65 or older to assess the disparities in having a usual source of medical care and forgoing medical treatment due to cost between elderly people with and without disabilities. After controlling for predisposing, enabling, and perceived and evaluated health needs, these researchers found that elderly persons with disabilities were more likely to have a usual source of care compared to those without disabilities. In addition, people with disabilities were more likely to forgo physician visits due to cost even after controlling for all behavioral factors. Perceived health care needs contributed most significantly to the disparity in physician visits, while enabling factors such as income, health insurance, and support played the second largest role. The investigators conclude that these results have national health care implications as the majority of these persons are covered by Medicare.

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Comparison of Trunk Proprioception Between Patients With Low Back Pain and Healthy Controls
Lee et al

A number of studies have been published on the relationship of proprioception and the presence of low back pain (LBP); however, conclusions about their interactions have not been consistent. As a result, Lee and colleagues examined proprioception in the sagittal, coronal, and transverse planes in 24 people with LBP and in an equal number of healthy control subjects. The patients with LBP exhibited a lower acuity for detection of changes in trunk position during motion perception threshold testing, while repositioning tasks resulted in no apparent differences between the 2 groups. The authors conclude that impairments in proprioception may be detected in patients with LBP when assessed with a motion perception threshold measure.

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Preparation for Compensatory Forward Stepping in Parkinson's Disease
King et al

Studies have suggested that 50% of people with Parkinson's disease (PD) fall during a 3-month period and that they exhibit inadequate postural responses. In an assessment of the compensatory stepping strategies of 19 subjects with severe PD (while on as well as off their l-dopa regimen) and 17 age-matched controls, King and colleagues demonstrated that subjects with PD in either their medicated or nonmedicated states were 4 to 5 times more likely to exhibit 1 or more lateral anticipatory postural adjustments (APAs) in response to a backward surface translation perturbation than their control counterparts. Poor axial balance and reports of freezing were associated with an increased use of APAs. The investigators conclude that lateral postural preparation prior to compensatory stepping in subjects with PD is associated with inefficient balance recovery from external perturbations.

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This international journal has distinguished itself through its coverage of the specialty of physical medicine and rehabilitation and of the more interdisciplinary field of rehabilitation. The journal publishes original articles that report on important trends and developments in these fields. Archives of Physical Medicine and Rehabilitation brings readers authoritative information on the therapeutic utilization of physical and pharmaceutical agents in providing comprehensive care for persons with disabilities and chronically ill individuals. The journal is recommended for initial purchase in the Brandon-Hill study, Selected List of Books and Journals for the Small Medical Library.