The effect of increasing sets (within one treatment session) and different set durations (between treatment sessions) of lumbar spine posteroanterior mobilisations on pressure pain thresholds

Spinal mobilisations are a common form of treatment intervention applied by physiotherapists in clinical practice to manage musculoskeletal pain and/or dysfunction. Previous research has demonstrated that mobilisations cause a hypoalgesic effect. However, there is very little research investigating the optimal treatment dose inducing this effect.AimTo investigate the effect of the number of sets (up to 5) and different durations (30 vs. 60 s) on pressure pain thresholds (PPTs) at different sites.MethodsThis single-blinded, randomised, same subject repeated measures crossover design included 19 asymptomatic healthy volunteers. The participants received 5 sets of either 30 or 60 s of postero-anterior mobilisations to L4 on different days. PPTs were measured immediately before, between and after the intervention at 4 different standardised sites.ResultsA 4-way ANOVA analysis revealed that there was no statistically significant difference between 30 versus 60 s of mobilisations. However, there was a tendency for PPT values to be higher for the 60 s intervention. All PPT measurements after the interventions were significantly higher than the baseline. Only the measurement after the 4th set of mobilisations was significantly higher than the measurement after the 1st set (p = 0.035).ConclusionsThe results suggest that in order to induce the greatest local hypoalgesia, at least 4 sets of mobilisations are required. The different durations of 30 versus 60 s of mobilisation may not change the extent of the hypoalgesic effect.     

An uncommon cause of dyspnea in the emergency department

Chest pain and shortness of breath are chief complaints frequently evaluated in the emergency department. ACS, pulmonary embolism, and disorders involving the lung parenchyma are some of the disease processes commonly screened for. Occasionally, patients presenting with histories and clinical exams consistent with these common illnesses may end up having more rare pathology. We present the case of a young patient who presented with chest pain and dyspnea with ECG changes and history concerning for pulmonary embolism who was ultimately diagnosed with idiopathic primary pulmonary hypertension. The importance of a prompt diagnosis of this condition along with emergency department management of complications related to the disease is discussed in this report.     

The Relationship Between Parent’s Subjective Well-Being and the Life Satisfaction of Their Children in Britain

This paper uses longitudinal data from the British Household Panel Survey to investigate the relationship between the subjective well-being of parents, in terms of life satisfaction and affective well-being, and the life satisfaction of their children. Literature, primarily from psychology, suggests that such a relationship exists due to the shared family environment, common stressors and the heritability of subjective well-being. Linear and logit regression showed a significant positive relationship between parent??s life satisfaction and the life satisfaction of their children, which differed between mothers and fathers. High life satisfaction in mothers was found to be more influential on children whose life satisfaction was not low, while the influence of father??s life satisfaction was not found to vary; having a consistent influence on children regardless of their level of life satisfaction. Parent??s affective well-being was not significantly related to the life satisfaction of their children. Parent??s subjective well-being was compared with parent?Cchild relationship quality in terms of influence on child life satisfaction. Parental life satisfaction measures were found to maintain their significant influence but relationship quality was found to explain a far higher amount of the variance in child life satisfaction. As with the findings for parent??s life satisfaction, quality of relationship with their mother was found to vary according to the level life satisfaction of the child while quality of relationship with father had a consistent influence.