Biomedical subjects

Suzanne J Snodgrass

Publications and source records attributed to Suzanne J Snodgrass.

3 recordsLinked to original sources

PubMed2007

Manual forces applied during cervical mobilization.

OBJECTIVE: Manual therapists routinely use passive accessory mobilization techniques to treat patients with mechanical neck disorders, but little is known about the manual forces applied. The aim of this study was to quantify the manual forces applied to the cervical spine during joint mobilization. METHODS: Ten physiotherapists performed posterior-to-anterior mobilizations to C2 and C7 (both centrally and unilaterally, 1 right and 1 left, grades I-IV) on a single asymptomatic male subject. Manual forces were measured in 3 planes using an instrumented treatment table. RESULTS: The instrumented table showed excellent reliability (intraclass correlation coefficient [2,1], 0.99; 95% confidence interval, 0.97-1.00) and accuracy (mean absolute error; vertical force, 1.1 N; SD, 1.5). There were considerable differences between therapists for mean peak force, force amplitude, and oscillation frequency for each technique and grade. Mean peak forces (grade I, 21.8 N; SD, 15.0; grade II, 34.9 N; SD, 20.9; grade III, 58.2 N; SD, 27.5; grade IV, 61.0 N; SD, 29.9) were considerably lower than previously reported lumbar mobilization forces. Intratherapist repeatability for all mobilization parameters was high. Force amplitude and oscillation frequency measures indicated that therapists generally adhered to the published definitions of the grades of mobilization when applying force, but when asked, provided quite different definitions of the grades. CONCLUSIONS: This study provides preliminary evidence that cervical mobilization forces vary considerably between therapists, but intratherapist repeatability is high.

Adult↗

PubMed2006

Manual forces applied during posterior-to-anterior spinal mobilization: a review of the evidence.

OBJECTIVE: The objective of this review was to evaluate the evidence for the consistency of force application by manual therapists when carrying out posterior-to-anterior (PA) mobilization techniques, including the factors that influence the application and measurement of mobilization forces. METHODS: Studies were identified by searching 6 electronic databases up to April 2005, screening the reference lists of retrieved articles, and contacting experts by e-mail. Relevant articles were defined as those that described the measurement of forces applied during spinal mobilization or discussed the reliability of measurement of manual forces. RESULTS: Twenty studies described the quantitative measurement of applied force during a PA mobilization technique, with most focusing on the lumbar spine. When defined by magnitude, frequency, amplitude, and displacement, PA mobilization forces are extremely variable among clinicians applying the same manual technique. Variability may be attributed to differences in techniques, measurement or reporting procedures, or variations between therapists or between patients. CONCLUSIONS: The inconsistency in manual force application during PA spinal mobilization in existing studies suggests that further studies are needed to improve the clinical standardization of manual force application. Future research on mobilization should include forces applied to the cervical and thoracic spines in addition to the lumbar spine while thoroughly describing force parameters and measurement methods to facilitate comparison between studies.

Evidence-Based Medicine↗

PubMed2003

Factors related to thumb pain in physiotherapists.

The aim of this study was to determine whether differences exist between physiotherapists with work-related thumb pain and physiotherapists without thumb pain. Twenty-four physiotherapists with work-related thumb pain (Pain Group) and 20 physiotherapists without thumb or wrist pain (Non-pain Group), who were working at least 20 hours per week in an outpatient musculoskeletal setting, were compared on a number of attributes: generalised joint laxity, hand and thumb strength, height, weight, working environment, hand position and force applied during mobilisation, mobility at individual thumb joints, extent of osteoarthritis at the thumb and radial-sided wrist joints, and demographic data including age, gender and years of experience. All physiotherapists in the Pain Group reported their thumb pain was related to and initially caused by the performance of manual techniques, and 88% had altered their manual techniques because of pain in the thumb. There was extreme variability in hand position and force applied during mobilisation, and a slightly high prevalence of osteoarthritis (22.7%) considering the mean age of the total sample (38.6 years). Statistically significant differences between groups included increased right carpometacarpal joint laxity (6.4%, 95% CI 0.19 to 12.6), decreased right tip pinch strength (0.84 kg, 95% CI 0.01 to 1.68), and lower body mass index (2.0, 95% CI 0.11 to 3.9) for the Pain Group. Other factors were not statistically different between groups. These results indicate that work-related thumb pain affects physiotherapists ability to administer manual treatments, and suggest that decreased stability and strength of the thumb may be associated with work-related thumb pain.

Adult↗