Immediate effects of hip mobilization with movement in patients with hip osteoarthritis: A randomised controlled trial
Carlos Beselga, Francisco Neto, Francisco Alburquerque-Sendín, Toby Hall, Natália Oliveira-Campelo
Mobilization with movement (MWM) has been shown to reduce pain, increase range of motion (ROM) and physical function in a range of different musculoskeletal disorders. Despite this evidence, there is a lack of studies evaluating the effects of MWM for hip osteoarthritis (OA).
To determine the immediate effects of MWM on pain, ROM and functional performance in patients with hip OA.
DesignRandomized controlled trial with immediate follow-up.
Forty consenting patients (mean age 78 ± 6 years; 54% female) satisfied the eligibility criteria. All participants completed the study. Two forms of MWM techniques (n = 20) or a simulated MWM (sham) (n = 20) were applied. Primary outcomes: pain recorded by numerical rating scale (NRS). Secondary outcomes: hip flexion and internal rotation ROM, and physical performance (timed up and go, sit to stand, and 40 m self placed walk test) were assessed before and after the intervention.
For the MWM group, pain decreased by 2 points on the NRS, hip flexion increased by 12.2°, internal rotation by 4.4°, and functional tests were also improved with clinically relevant effects following the MWM. There were no significant changes in the sham group for any outcome variable.
Pain, hip flexion ROM and physical performance immediately improved after the application of MWM in elderly patients suffering hip OA. The observed immediate changes were of clinical relevance. Future studies are required to determine the long-term effects of this intervention.
Systematic review of the literature of low-level laser therapy (LLLT) in the management of neck pain
Low-level laser therapy (LLLT) is widely used in the treatment of musculoskeletal pain. However, there is controversy over its true efficacy. We aimed to determine the efficacy of LLLT in the treatment of neck pain through systematically reviewing the literature.
Study Design/Materials and Methods
A search of computerized bibliographic databases covering medicine, physiotherapy, allied health, complementary medicine, and biological sciences was undertaken undertaken from date of inception until February 2004 for randomized controlled trials of LLLT for neck pain. A comprehensive list of search terms was applied and explicit inclusion criteria were developed a priori. Twenty studies were identified, five of which met the inclusion criteria.
Significant positive effects were reported in four of five trials in which infrared wavelengths (λ = 780, 810–830, 904, 1,064 nm) were used. Heterogeneity in outcome measures, results reporting, doses, and laser parameters precluded formal meta-analysis. Effect sizes could be calculated for only two of the studies.
This review provides limited evidence from one RCT for the use of infrared laser for the treatment of acute neck pain (n = 71) and chronic neck pain from four RCTs (n = 202). Larger studies are required to confirm the positive findings and determine the most effective laser parameters, sites and modes of application. © 2005 Wiley-Liss, Inc.
Effects of taping on pain and function in patellofemoral pain syndrome: a randomized controlled trial
Whittingham M, Palmer S, Macmillan F
The Journal of Orthopaedic and Sports Physical Therapy 2004 Sep;34(9):504-510
OBJECTIVES: To investigate the effectiveness of daily patella taping and exercise on pain and function in individuals with patellofemoral pain syndrome.
BACKGROUND: Patella taping and muscle-strengthening programs are commonly used to treat patellofemoral pain syndrome. There is, however, little evidence for the effectiveness of these approaches.
METHODS AND MEASURES: Twenty-four men and 6 women aged 17 to 25 years (mean +/- SD, 18.7 +/- 1.2 years) participated in the study. Subjects were randomly and exclusively assigned to 1 of 3 treatment groups: patella taping combined with a standardized exercise program, placebo patella taping and exercise program, or exercise program alone (n = 10 in each group). Taping was applied and exercises performed on a daily basis for 4 weeks. Outcome measures were visual analog scales for pain and the functional index questionnaire, recorded at weekly intervals by a therapist who was blinded to group allocation.
RESULTS: Separate mixed-model ANOVAs, with repeated measures on time, indicated statistically significant improvements in pain and function over time for all groups (p < 0.01) and also significant differences between groups for all measures (p < 0.01). Separate independent samples t tests showed that the group receiving taping and exercises had better pain and function scores following treatment than the placebo taping-and-exercise group and the exercise-alone group. There were no significant differences between the placebo taping-and-exercise group and exercise-alone group at any time point.
CONCLUSIONS: These findings indicate that over a period of 4 weeks a combination of daily patella taping and exercises was successful in improving pain and function in individuals with patellofemoral pain syndrome. The combination of patella taping and exercise was superior to the use of exercise alone
Activity- versus structural-oriented treatment approach for frozen shoulder: a randomized controlled trial [with consumer summary]
Horst R, Maicki T, Trabka R, Albrecht S, Schmidt K, Metel S, von Piekartz H
Clinical Rehabilitation 2017 May;31(5):686-695
OBJECTIVE: To compare the short- and long-term effects of a structural-oriented (convential) with an activity-oriented physiotherapeutic treatment in patients with frozen shoulder.
SUBJECTS: We included patients diagnosed with a limited range of motion and pain in the shoulder region, who had received a prescription for physiotherapy treatment, without additional symptoms of dizziness, a case history of headaches, pain and/or limited range of motion in the cervical spine and/or temporomandibular joint.
INTERVENTIONS: The study group received treatment during the performance of activities. The comparison group was treated with manual therapy and proprioceptive neuromuscular facilitation (conventional therapy). Both groups received 10days of therapy, 30minutes each day.
MAIN MEASURES: Range of motion, muscle function tests, McGill pain questionnaire and modified Upper Extremity Motor Activity Log were measured at baseline, after two weeks of intervention and after a three-month follow-up period without therapy.
RESULTS: A total of 66 patients were randomized into two groups: The activity-oriented group (n = 33, mean 44years, SD 16years) including 20 male (61%) and the structural-oriented group (n = 33, mean 47years, SD 17years) including 21 male (64%). The activity-oriented group revealed significantly greater improvements in the performance of daily life activities and functional and structural tests compared with the group treated with conventional therapy after 10days of therapy and at the three-month follow-up (p < 0.05).
CONCLUSIONS: Therapy based on performing activities seems to be more effective for pain reduction and the ability to perform daily life activities than conventional treatment methods.