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        <title>Article Comments - 'Spinal Manipulative Therapy versus Graston Technique in the treatment of Non-specific Thoracic Spine Pain: Design of a randomised controlled trial'</title>
        <link>http://www.chiroandosteo.com/content/16/1/12/comments</link>
        <description>The latest comments on the article 'Spinal Manipulative Therapy versus Graston Technique in the treatment of Non-specific Thoracic Spine Pain: Design of a randomised controlled trial'</description>
        <dc:date>2008-12-15T00:00:00Z</dc:date>
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        <item rdf:about="http://www.chiroandosteo.com/content/16/1/12/comments#311643">
        <title>SMT to Thoracic Spine</title>
        <link>http://www.chiroandosteo.com/content/16/1/12/comments#311643</link>
        <description>&lt;p&gt;I have a difficult time with the concept of having students delivering a thoracic spinal adjustment and that being equated to a practitioner in practice over 5 years or more.  If I was attempting to devalue SMT for the thoracic spine one way would be to have students do the adjustment, under the guidance of a registered doctor or not.&lt;/p&gt;&lt;p&gt;The use of static or motion palpation of the thoracic spine as a rational to deliver a thrust is also might devalue the SMT since the assumption is that that joint is fixated and a thrust will reduce the fixation.  In a subset of patients with this condition it may well lead to a positive outcome.&lt;/p&gt;&lt;p&gt;Other methods of diagnosis such as determining if the vertebra or costovertebral region has a directional preference based on pain or even adjacent muscle strength weakness or improvement with pressure to the joint could lend itself to better outcomes to SMT.&lt;/p&gt;&lt;p&gt;This could be a valuable time, for instance, to investigate sacro occipital technique&apos;s trapezius fibre analysis which relates to the thoracic spine and could help locate a segment warranting focused attention.  Following the SMT thrust the trapezius fibre&amp;#8217;s sensitivity would purportedly subside, offering a valuable pre and post assessment tool.&lt;/p&gt;&lt;p&gt;All in all I applaud the investigation of chiropractic techniques and think this study takes a good step in attempting to look at methods of treating non-specific thoracic spine pain.&lt;/p&gt;&lt;p&gt;Thank you,&lt;/p&gt;&lt;p&gt;Charles Blum, DC&lt;/p&gt;</description>
                <dc:creator>Charles Blum</dc:creator>
                <dc:date>2008-12-15T00:00:00Z</dc:date>
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