Mechanical diagnosis and therapy in musculoskeletal pain of individuals with spinal cord injury

The Journal of Spinal Cord Medicine, 2024 · DOI: 10.1080/10790268.2023.2197818 · Published: May 1, 2024

Spinal Cord Injury Orthopedics Rehabilitation

Simple Explanation

This study investigates the use of Mechanical Diagnosis and Therapy (MDT) for musculoskeletal pain (MSKP) in individuals with spinal cord injury (SCI). MDT is a method that aims to identify the source of pain in the musculoskeletal system. The study found that MDT can reduce pain and improve independence in daily activities in individuals with SCI and MSKP. Participants experienced significant decreases in pain levels and disability, along with increased functional abilities after MDT treatment. MDT involves assessing a patient’s history and symptoms, followed by a physical examination where movements are performed to explore symptomatic and mechanical responses. Based on these responses, participants are classified into different syndromes, and a tailored exercise program is prescribed.

Study Duration

6 Months

Participants

24 individuals with SCI who presented MSKP

Evidence Level

Single-arm trial

Key Findings

1
Significant median decreases were found for NRS (from 7 to 2) and PDI (from 27 to 8) after MDT treatment, indicating reduced pain and disability.
2
The PSFS score presented a significant mean increase (from 3.2 to 7.7) after MDT treatment, showing improved functional abilities.
3
The average decrease in pain after MDT treatment was 70.9% (5.36 on the NRS), demonstrating a substantial reduction in pain intensity.

Research Summary

This study evaluated the applicability and outcomes of Mechanical Diagnosis and Therapy (MDT) in pain relief and independence improvement in daily activities of individuals with spinal cord injury (SCI) presenting musculoskeletal pain (MSKP). The study found that MDT treatment led to a significant reduction in pain and disability, as well as an improvement in functional abilities in individuals with SCI and MSKP. The findings suggest that MDT can be a valuable approach for managing MSKP in the SCI population, potentially improving their quality of life and participation in daily activities.

Practical Implications

Clinical Practice

MDT can be considered as a treatment option for individuals with SCI experiencing MSKP, potentially reducing pain and improving functional independence.

Rehabilitation Programs

Integrating MDT into rehabilitation programs for SCI patients may enhance pain management strategies and improve patient outcomes.

Future Research

Further randomized controlled trials are needed to compare the effectiveness of MDT with other interventions for pain relief in the SCI population.

Study Limitations

1
The study included participants with pain complaints in different body areas and different levels of neurological impairment, which somewhat precludes reproducibility.
2
Individuals in inpatient rehabilitation programs performed other exercises and daily activity training, which may have influenced the findings.
3
The study did not compare MDT to usual care or another intervention to demonstrate the efficiency of the MDT for pain relief in SCI.

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