Selections From This Month in the Archives

Article Outline

• The Immediate Effects of Mobilization Technique on Pain and Range of Motion in Patients Presenting With Unilateral Neck Pain: A Randomized Controlled Trial
• Predictors of Cardiopulmonary Hospitalization in Chronic Spinal Cord Injury
• A Prospective Outcome Study on the Effects of Facet Joint Radiofrequency Denervation on Pain, Analgesic Intake, Disability, Satisfaction, Cost, and Employment
• Rehabilitation Consumers' Use and Understanding of Quality Information: A Health Literacy Perspective

Rotsalai Kanlayanaphotporn, PhD

Adit Chiradejnant, PhD

Roongtiwa Vachalathiti, PhD

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The Immediate Effects of Mobilization Technique on Pain and Range of Motion in Patients Presenting With Unilateral Neck Pain: A Randomized Controlled Trial 

The benefits of differing spinal mobilization and manipulation techniques for neck and back pain remain controversial. Kanlayanaphotporn and colleagues examine one aspect of this issue in a randomized controlled trial of 60 subjects with unilateral mechanical neck pain. Participants were randomized into 2 groups: one underwent a spinal mobilization program that took into account the location of their pain while the other received a similar but more generalized program that was administered without knowledge of the nature of the pain's location. Pain intensity, cervical ROM, and perceived effects were measured before and after a single treatment. The investigators found that while each group improved relative to their baseline in terms of pain and range of motion (ROM) that inter-group differences could not be detected. The authors conclude that their finding do not support the use of specialized mobilization programs but note the need for studies with longer courses of treatment and post-treatment follow-up. • SEE PAGE 187

Anthony C. Waddimba, MD, MS

Nitin B. Jain, MD, MSPH

Kelly Stolzmann, MS

David R. Gagnon, MD, MPH, PhD

James F. Burgess, Jr., PhD

Lewis E. Kazis, ScD

Eric Garshick, MD, MOH

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Predictors of Cardiopulmonary Hospitalization in Chronic Spinal Cord Injury 

Spinal cord injury (SCI) is associated with an increased risk of hospitalization but the reasons for this increase are poorly understood. Waddimba and colleagues explored one aspect of this question in a prospective study that investigated cardiopulmonary associated hospital admissions in a cohort of 309 veterans with SCI. The investigators found that the veterans of the cohort experienced 1,478 admissions over the 8-year period of the study with 10% (143) having a cardiopulmonary cause. Independent predictors for cardiopulmonary admissions were determined to be age, hypertension, and low body mass index. A larger than predicted forced expiratory volume in one second (FEV₁) was associated with a reduced risk of admission while injury level and severity were not statistically significant factors. The investigators observed that these predictors mirror those of the general population and that some are potentially modifiable. • SEE PAGE 193

Robert S. Burnham, MSc, MD, FRCPC

Shelley Holitski, BScPT

Irina Dinu, PhD

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A Prospective Outcome Study on the Effects of Facet Joint Radiofrequency Denervation on Pain, Analgesic Intake, Disability, Satisfaction, Cost, and Employment 

Radiofrequency denervation (RFD) is a relatively common but invasive treatment for facet-related low back pain. Burnham and colleagues examined the benefits of this approach in 44 consecutive subjects (101 facet joints) with chronic refractory mechanical low back pain of facet origin (as established by local anesthetic blocks). Subjects were evaluated at a baseline prior to treatment and at 1, 3, 6, 9 and 12 months post-procedure. Significant improvements in pain, analgesic usage, disability status and direct costs were found following treatment which peaked at 3 to 6 months and subsequently gradually declined. No complications were noted. The authors conclude that RFD appears to be safe and beneficial but that further research utilizing randomized controlled trials, strict selection criteria, and optimized techniques/assessment is needed. • SEE PAGE 201

Susan Magasi, PhD

Elizabeth Durkin, PhD

Michael S. Wolf, PhD, MPH

Anne Deutsch, PhD, RN, CRRN

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Rehabilitation Consumers' Use and Understanding of Quality Information: A Health Literacy Perspective 

Although state and federal governments are increasingly requiring health care providers to provide the public with quality and outcome information, the public's ability to effectively use this information is questionable. Magasi and colleagues utilized a semi-structured interview format with 17 adults undergoing inpatient rehabilitations to examine how they might select a rehabilitation facility, interpret health care quality information, and understand the relationship between that information and the overall quality of care provided by a facility. Subjects were found to have a limited ability to obtain and assess quality information and to rely on informal sources of information (eg, family members) to make decision. The investigators concluded consumers can not effectively use the information available and that rehabilitation providers have a responsibility to present quality information in a way that the public can use and understand. • SEE PAGE 206