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Does postural sway change in association with manual therapeutic interventions A review of the literature.doc

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Does postural sway change in association with manual therapeutic interventions A review of the literature

Ruheetal.ChiropracticManualTherapies2013,21:9 /content/21/1/9 CHIROPRACTIC MANUAL THERAPIES REVIEW OpenAccess Doesposturalswaychangeinassociationwith manualtherapeuticinterventions?Areviewof theliterature AlexanderRuhe1,2*,RenéFejer3andBruceWalker1 Abstract Studydesign:LiteratureReview Objectives:Theobjectiveofthisliteraturereviewwastodetermineifposturalswaychangesinassociationwith manualtherapeuticinterventionsandtoinvestigatewhetheranychangesoccurinhealthyindividualsorin associationwithpainintensity. SummaryofBackgrounddata:Improvingposturalstabilityhasbeenproposedasagoalofmanualtherapeutic interventions.Sofar,noliteraturereviewhasaddressedwhetherthereissupportiveevidenceforthisandifso, whatfactorsmaybeassociatedorcausativeforobservedswayalterations. Searchmethods:Sevenonlinedatabases(PubMed,MEDLINE,EMBASE,CINAHL,WebofScience,ScienceDirectand theCochranelibrary)weresystematicallysearchedfollowedbyamanualsearchoftheretrievedpapers. Selectioncriteria:Studiescomparingposturalswayderivedfrombipedalforceplatemeasurementsinassociation withamanualtherapeuticintervention,ideallycomparedtoacontrolgroup. Datacollectionandanalysis:Tworeviewersindependentlyscreenedtitlesandabstractsforrelevance,conducted thedataextractionandtheriskofbiasassessmentwhichwasconductedusingtheRTIitembank.Adescriptive analysiswasconductedastheheterogeneousstudydesignspreventedpoolingofdata. Results:Ninestudiesofvaryingmethodologicalqualitymettheinclusioncriteria.Nodirectcomparisonofdata acrossthestudieswaspossible.Therewasnoevidencethatmanualinterventionsleadtoachangeinpostural swayinhealthyindividualsregardlessofthebodyregionsaddressedbytheintervention.Therewassome indicationthatposturalswaymaychangeatfollow-upmeasurementsinpainsufferers;however,thismaybedue tovariationsinpainintensityratherthanresultingfromtheinterventionitself. Conclusions:Thereisnoconclusivescientificevidencethatmanualtherapeuticinterventionsmayexhibitany immediateorlong-termeffectonCOPexcursions.Anychangesinswaymaybeattrib