Stephen May

Medizinische Hochschule Brandenburg Theodor Fontane

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Chris Littlewood

Edge Hill University

Stephen J. Walters

University of Sheffield

Hiroshi Takasaki

Saitama Prefectural University

Sue Mawson

University of Sheffield

Alessandro Aina

Vrije Universiteit Brussel

Sionnadh McLean

Sheffield Hallam University

Richard Rosedale

Canadian Physiotherapy Association

Peter Malliaras

Monash University

Eric Gardiner

Livingstone Hospital

Audrey Long

Johns Hopkins University

Cooperative Institutions

Museum of Heilongjiang Province

130

New York Proton Center

Communities In Schools of Orange County

Oregon Medical Research Center

University of Pittsburgh

Lindsay Unified School District

Sheffield Hallam University

Manhattan Institute for Policy Research

University of Hull

University of Sydney

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Nucleus pulposus deformation following application of mechanical diagnosis and therapy: a single case report with magnetic resonance imaging

Journal of Manual & Manipulative Therapy (2010)

Hiroshi Takasaki Stephen May Peter J. Fazey Toby Hall

The McKenzie management strategy of mechanical diagnosis and therapy (MDT) is commonly used for the assessment and management of spinal problems. Within this system, 'derangement syndrome' is the most common classification, for which the conceptual model is an intra-discal displacement. However, the reduction of an intra-discal displacement by MDT has never been documented. The purpose of this study was to compare, using magnetic resonance imaging (MRI), the nucleus pulposus (NP) profiles before and after the use of this approach.The patient was a 34-year-old female with a long history of right sided low back and buttock pain classified with 'derangement syndrome'.T2-weighted images of the L4-5 disc at initial assessment were compared with that at final assessment 1 month later. Initially, the MRI showed a portion of the NP displaced right and posteriorly towards the side of pain, and an overall NP position in the coronal plane shifted to the left.The patient was managed with a 1-month course of the McKenzie management strategy treatment.One month later, the displaced portion of the NP was no longer present and the left-shifted NP was centrally located.These intervertebral disc changes coincided with centralization and abolition of symptoms. This case may support the conceptual model of MDT.

Derangement

Intervertebral Disc

Manual therapy

Conservative Management

10.1179/106698110x12640740712455

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Citations (9)

Bret Harte: Opening the American Literary West

Western Historical Quarterly (2001)

Joseph M. Flora Gary Scharnhorst Stephen May

Journal Article Bret Harte: Opening the American Literary West and Maverick Heart: The Further Adventures of Zane Grey Get access Bret Harte: Opening the American Literary West. By Scharnhorst Gary. (Norman: University of Oklahoma Press, 2000. xvi + 256 pp. Illustrations, bibliography, index. $29.95.)Maverick Heart: The Further Adventures of Zane Grey. By May Stephen J.. (Athens: Ohio University Press, 2000. xxv + 267 pp. Illustrations, appendix, notes. $29.95, cloth; $16.95, paper.) Joseph M. Flora Joseph M. Flora University of North Carolina at Chapel Hill Search for other works by this author on: Oxford Academic Google Scholar Western Historical Quarterly, Volume 32, Issue 3, Autumn 2001, Pages 385–387, https://doi.org/10.2307/3650762 Published: 01 August 2001

Chapel

American west

Flora

10.2307/3650762

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COMPARISON OF ‘MCKENZIE’ PHYSICAL THERAPY TREATMENT VS. A BRIEF PHYSIOTHERAPY INTERVENTION; WITH A SECONDARY ANALYSIS

Orthopaedic Proceedings (2009)

J Klaber Moffett D M. Jackson ED Gardiner David Torgerson Stephen Coulter

Background: The main aim of this study was to compare the effectiveness of a brief intervention based on cognitive-behavioural principles (Solution Finding Approach – SFA) with the McKenzie approach (McK). A secondary aim was to determine if there were any clinical characteristics that distinguished patients who responded best to the McKenzie method. Methods: Eligible patients who were referred by GPs to physiotherapy departments in the UK with neck or back pain were randomly allocated to McK (n= 161) or to SFA (n=154) and their outcome compared at 6 weeks, 6 and 12 months. In addition, putative predictors within the McKenzie group were compared using univariate analysis to examine the relationship between variables and outcomes. Significant variables were assessed using multiple logistic regression analyses. Results: Both groups demonstrated modest improvements in outcomes. There were no statistically significant differences in outcomes, except 2 small but significant differences at 6 weeks. At 6 weeks, patient satisfaction was greater for McK (median 90% compared with 70% for SFA). The number of treatment successes in the McK group depended upon the definition used, but were limited. Less chronic back pain (rather than neck pain) in patients demonstrating centralisation responded best. Conclusion: In the original RCT there were few differences between McK and SFA though modest improvements in both. In a secondary analysis of the results for the McK group there were few treatment successes according to our definition of success; these were most likely to occur in back pain patients with shorter duration symptom who demonstrated centralisation response.

Univariate analysis

Neck pain

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Printed "National Testimonial to William Lloyd Garrison," and Note Sent to Prince S. Crowell

Stephen May

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McKenzie Method

Elsevier eBooks (2011)

Stephen May Ronald Donelson

10.1016/b978-0-323-07293-9.00010-6

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Do musculoskeletal physiotherapists believe the NICE guidelines for the management of non-specific LBP are practical and relevant to their practice? A cross sectional survey

Physiotherapy (2013)

Sarah Parr Stephen May

Nice

Excellence

Thematic Analysis

Clinical Practice

Evidence-Based Practice

Cross-sectional study

Musculoskeletal pain

Guideline

10.1016/j.physio.2013.09.004

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Citations (19)

General Practitioners' Views About an Orthopaedic Clinical Assessment Service

Physiotherapy Research International (2014)

Damon Burn Stephen May Lindsay L. Edwards

Abstract Background General practitioners' (GP) views about orthopaedic clinical assessment services (OCAS) managed by physiotherapists in the NHS have seldom been sought, yet GPs are likely to be key referrers to such a service. Aim This study aims to review GP views about an OCAS and how they believed the service could be improved. Design of the Study Fifteen consenting GPs were interviewed utilizing semi‐structured interviews and a standardized topic guide. Method Interviews were recorded, transcribed and analysed for emergent themes. Interviews were analysed sequentially by date performed until saturation. Themes were discussed, and disagreements evaluated until agreement was found between the two main authors. The third author then analysed randomly selected interview transcripts and found no additional themes. Results The study found GPs refer to specialist services, including this OCAS, because of wait times, locality, patient experience, GP experience and knowledge of available services. No GP identified they knew all possible orthopaedic referral routes. Conclusion GPs saw OCAS as another referral choice for patients suffering orthopaedic pathologies. GPs identified some difficulty in understanding the different services including the various professional roles involved. To assist with their understanding, they described requesting advertising of the different services and the clinicians involved or streamlining of services by provider services. Further detailed research addressing the limitations in this research design is indicated to investigate GP's thoughts and behaviours in relation to referral patterns especially as GPs in the UK took on commissioning for services from April 2013. Copyright © 2014 John Wiley & Sons, Ltd.

10.1002/pri.1581

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THE COMPARATIVE PROGNOSTIC VALUE OF DIRECTIONAL PREFERENCE AND CENTRALIZATION: A USEFUL TOOL FOR FRONT LINE CLINICIANS?

Orthopaedic Proceedings (2010)

Audrey Long Stephen May Tung Fung

A large number of prognostic factors have been associated with recovery from an episode of back pain. The literature has placed much emphasis on psychosocial prognostic factors. The large number of prognostic factors and the lack of comparative analysis of different factors make their use difficult in clinical practice. The aim of this study was to evaluate the comparative usefulness of a range of factors to predict outcome using data from a randomized controlled trial. 312 patients with sub-acute to chronic back pain received a mechanical evaluation and were sub-grouped based on the presence or absence of directional preference (DP). Patients were then randomized to treatment that was matched or unmatched to that DP. Patients with a minimal reduction of 30% in RMDQ score were defined as the ‘good outcome’ group. 17 baseline variables were entered into a step-wise logistic regression analysis for their ability to predict a good outcome. 84 patients met the good outcome criteria and had a mean RMDQ decrease of 58.2% (9.8 points) in 4 visits. Leg pain, work status, depression, pain location, chronicity, and treatment assignment were significant predictors of outcome in univariate analysis. Only leg bothersomeness rating and treatment assignment survived multivariate analysis. Subjects with DP/centralization who received matched treatment had a 7.8 times greater likelihood of a good outcome. Matching patients to their DP is a stronger predictor of outcome than a range of other biopsychosocial factors.

Univariate analysis

Univariate

Biopsychosocial model

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Self-managed loaded exercise versus usual physiotherapy treatment for rotator cuff tendinopathy: a pilot randomised controlled trial

Physiotherapy (2013)

Chris Littlewood Peter Malliaras Sue Mawson Stephen May Stephen J. Walters

Rotator cuff injury

Pilot trial

10.1016/j.physio.2013.06.001