I send out a monthly newsletter to physicians in the area to highlight some relevant research in regards to Physical Therapy and patients that might benefit from a referral to Physical Therapy for certain conditions, so I thought I would share some of them here as well.


Immediate effects of a high-velocity spine manipulation in paraspinal muscles activity of nonspecific chronic low-back pain subjects. Manual therapy. 2010; 15(5): 469-475.

High-velocity spinal manipulation is commonly adopted for treating chronic low-back pain (CLBP) and has been associated with changes in muscle activity, but the evidence is controversial. The aim of this study was to analyze the immediate effects of high-velocity spine manipulation on paraspinal activity during flexion–extension trunk movements. EMG activity during the static relaxation phase was significantly reduced following intervention for the manipulation group but not for the control group. The extension-phase EMG activity was also reduced after manipulation, but the flexion-phase EMG levels remained unchanged. Accordingly, the percent changes in FRR and ERR were significantly larger for the manipulation group compared to the control.

The results suggest that a high-velocity spinal manipulation is able to acutely reduce abnormal EMG activity during the full-flexion static phase and activation during the extension phase.

Treatment of Chronic Low Back Pain: A Randomized, Clinical Trial Comparing Group-Based Multidisciplinary Biopsychosocial Rehabilitation and Intensive Individual Therapist-Assisted Back Muscle Strengthening Exercises Spine; 1 March 2010 - Volume 35 - Issue 5 - pp 469-476

Both a multidisciplinary biopsychosocial rehabilitation program and an intensive individual therapist-assisted back muscle strengthening exercise program used in Denmark have been reported to be effective for the treatment of CLBP.

Results: Of the 286 patients, 14 patients did not start treatment. Of the remaining patients, 25 (9%) dropped out of therapy. The 2 groups were comparable regarding baseline characteristic. After treatment, significant improvements were observed with regard to pain, disability, and most of the quality of life dimensions. These effects were sustained over the 24-month follow-up period. There were some statistically significant differences between the 2 groups relating to secondary end points, Roland-Morris disability questionnaire, and in the MOS 36-Item Short-Form Health Survey the “physical functioning” dimension and the “physical component summary.”

Conclusion: Both groups showed long-term improvements in pain and disability scores, with only minor statistically significant differences between the 2 groups. The minor outcome difference in favor of the group-based multidisciplinary rehabilitation program is hardly of clinical interest for individual patients.

Trying to get to the simple side of complexity with health.

The body is an amazingly wonderfully complex living organism. As we study and research the body looking for ways to improve the health of it, we can very quickly get confused with the complexity of all the different systems interacting with each other to maximize the efficiency of the body as it lives.

I like that phrase, "Simplicity lies on the far side of complexity." It means you must strive to make your way through the difficult, uncertain and often confusing part before things become clear enough to be considered simple. Let’s apply this thought to a few basic health principles:

• Exercise – We can easily get confused with magazine articles from supposed experts and antidotal information from family or friends on how often, how long, what types of exercises are best for weight loss or muscle production, what pace or exertion, high intensity versus lower intensity and debates can go on and on over many of these. But the simple side for most us is we need move more.

• Nutrition – What percent of each macro-nutrient (fat, carbohydrate, and protein) does each of us need? How many calories should I eat? Are some calories better then other calories? How many times a day do I need to eat? Do I need supplements, if so which ones? And the question list goes on and on. But the simple side is most of us need to control portion sizes and be a more balanced, nutritious eater.

• Stress – There are lots of books you can buy to help you reduce your stress, probably enough that trying to decide which one you need stresses you out!!! But the simple side is most of us need to laugh more and worry less. Also take action to walk the delicate line of hoping for the best and let positive thoughts and feelings dominate most of our emotions, but at the same time be realistic and let a small piece of us prepare for the worst.

• Overall health – How do you get healthy? This is the magic question for most of us. With so many different answers to the same question, how do you know what to believe? Everyday there is another guru or fad that we hear works for them or others to get healthier. But the simple side is most of us need to: exercise more, eat better and stress less in a way that works for us and keep working to get better at all of them.

Less TV and just a little exercise for a longer life

Just wanted to pass on a couple of studies done if you want to live a little longer:

One shows watching TV up to 6 hours a day can reduce your life span by about 5 years!!!  See this link for more info: http://www.medicalnewstoday.com/articles/232902.php

The other shows just 15 minutes of exercise a day can increase your life span by about 3 years as compared to sedentary people!!!  See this link for more info: http://www.medicalnewstoday.com/articles/232899.php

Here is a link that sums up both articles: http://www.medicalnewstoday.com/articles/232783.php

Follow the simple rule of 5 to get the day started off right

It’s amazing the different marketing we can fall victim too when we walk down the cereal aisle. More money is spent on marketing breakfest foods than any other food item as stated by research done by USDA/Economic Research Service.  We will find a huge variety of flakes, nugget, clusters, squares, and O’s fortified with various vitamins, minerals and such; all in the name of getting our day off to a healthy start. In the attempt to compete in the very profitable market of breakfast foods they add all sorts of fancy ingredients and health claims – lower cholesterol, promote weight loss, improve health. Don’t be so impressed. Most of these nutrients and benefits can be obtained from less processed and many times less expensive foods. The biggest concern with many of these is the added sugar.

Follow the Simple Rule of Five: Look at the Nutrition Facts label; ideally, it should have less than 5 grams of sugar and 5 grams or more of fiber per serving. This is not an absolute rule; some breakfast foods may fall short in the fiber category but have 0 grams of sugar, so not a bad choice. Also some cereals have dried fruit in them so will be higher in the sugar category. If sugar or corn syrup is one of the first few ingredients pass it on and look for a better choice.

Info taken from Nurtition Diva's: Secrets for a Healthy Diet

Get in the Zone for proper exercise intensity

Finding the right intensity to exercise at is important to maximize the safety and effectiveness of your workout.
One of the best ways to monitor the intensity of your workout is with your heart rate. Find the appropriate “zone” for your exercise to meet your goals, try to keep your heart rate during the workout in this zone. Consult your physician if you have any risk factors for cardiovascular problems or if you are unsure if you might have some. Next calculate your submax heart rate; your physician can help you with this if you have any risk factors. If not, then this can be found by walking or running at a sustainable pace at near maximum effort for 15-20 minutes after warming up and then check your heart rate at the end. This is your submax heart rate.
Healthy Heart Zone (Warm up 60-70% submax rate) --- The easiest zone and probably the best zone for people just starting a fitness program. It can also be used as a warm up for more serious exercisers. This zone has been shown to help decrease body fat, blood pressure and cholesterol. It also decreases the risk of degenerative diseases and has a low risk of injury.
Fitness Zone (Fat Burning 70-80% submax rate) --- This zone provides the same benefits as the healthy heart zone, but is more intense and burns more total calories.
Aerobic Zone (Endurance Training 80-90% submax rate) --- The aerobic zone will improve your cardiovascular and respiratory system AND increase the size and strength of your heart. This is the best zone to progress toward with your exercise program for long term health benefits.
Anaerobic Zone (Performance Training 90-100% submax rate) --- Benefits of this zone include an improved VO2 maximum (the highest amount of oxygen one can consume during exercise) and thus an improved cardiorespiratory system, and a higher lactate tolerance ability which means your endurance will improve and you'll be able to fight fatigue better. If you are training for a competition of some sort you need to get into this zone to improve your performance.
High Intensity Interval Training (Maximum Effort 100-110% submax rate) --- Although this zone burns the highest number of calories, it is very intense. Most people can only stay in this zone for short periods. You should only train in this zone if you are in very good shape and have been cleared by a physician to do so. Implementing short bursts (1-2 minutes, 5-6 times) of this intensity with easy rest periods in between can have significant health and fat burning effects, but care needs to be taken.