April 2017
Manual therapy in joint and nerve structures combined with exercises in the treatment of recurrent ankle sprains: A randomized, controlled trial
07.04.17-17:03 // Catégories : Neurodynamique
Recurrent ankle sprains often involve residual symptoms for which subjects often perform proprioceptive or/and strengthening exercises. However, the effectiveness of mobilization to influence important nerve structures due to its anatomical distribution like tibial and peroneal nerves is unclear. To analyze the effects of proprioceptive/strengthening exercises versus the same exercises and manual therapy including mobilizations to influence joint and nerve structures in the management of recurrent ankle sprains. A randomized single-blind controlled clinical trial. Fifty-six patients with recurrent ankle sprains and regular sports practice were randomly assigned to experimental or control group. The control group performed 4 weeks of proprioceptive/strengthening exercises; the experimental group performed 4 weeks of the same exercises combined with manual therapy (mobilizations to influence joint and nerve structures). Pain, self-reported functional ankle instability, pressure pain threshold (PPT), ankle muscle strength, and active range of motion (ROM) were evaluated in the ankle joint before, just after and one month after the interventions. The within-group differences revealed improvements in all of the variables in both groups throughout the time. Between-group differences revealed that the experimental group exhibited lower pain levels and self-reported functional ankle instability and higher PPT, ankle muscle strength and ROM values compared to the control group immediately after the interventions and one month later.
A protocol involving proprioceptive and strengthening exercises and manual therapy (mobilizations to influence joint and nerve structures) resulted in greater improvements in pain, self-reported functional joint stability, strength and ROM compared to exercises alone.
...Afficher la suiteComparison of cranio-cervical flexion training versus cervical proprioception training in patients with chronic neck pain: A randomized controlled clinical trial
07.04.17-16:53 // Catégories : TMO
To compare the effects of cranio-cervical flexion vs cervical proprioception training on neuromuscular control, pressure pain sensitivity and perceived pain and disability in patients with chronic neck pain. Twenty-eight volunteers with chronic non-specific neck pain were randomly assigned to 1 of 2 interventions and undertook 6 physiotherapist-supervised sessions over a period of 2 months. Both groups performed daily home exercise. Performance on the cranio-cervical flexion test, pressure pain thresholds and reported levels of pain and disability were measured before and immediately after the first treatment session, 1 month after starting treatment and 2 months after starting treatment (at completion of the intervention). At 2 months, both groups improved their performance on the cranio-cervical flexion test (p < 0.05), but this did not differ between groups (p > 0.05). Both groups showed a reduction in their pain at rest and disability at 2 months, but this was also not different between groups (p > 0.05). Pressure pain sensitivity did not change for either group.
Both specific cranio-cervical flexion training and proprioception training had a comparable effect on performance on the cranio-cervical flexion test, a test of the neuromuscular control of the deep cervical flexors. These results indicate that proprioception training may have positive effects on the function of the deep cervical flexors.
...Afficher la suiteEffectiveness of Nerve Gliding Exercises on Carpal Tunnel Syndrome: A Systematic Review
07.04.17-16:44 // Catégories : Neurodynamique
The objective of this study was to review the literature regarding the effectiveness of neural gliding exercises for the management of carpal tunnel syndrome (CTS). A computer-based search was completed through May 2014 in PubMed, Physiotherapy Evidence Database (PEDro), Web of Knowledge, Cochrane Plus, and CINAHL. The following key words were included: nerve tissue, gliding, exercises, carpal tunnel syndrome, neural mobilization, and neurodynamic mobilization. Thirteen clinical trials met the inclusion/exclusion criteria, which were: nerve gliding exercise management of participants aged 18 years or older; clinical or electrophysiological diagnostics of CTS; no prior surgical treatment; and absence of systemic diseases, degenerative joint diseases, musculoskeletal affectations in upper limbs or spine, or pregnancy. All studies were independently appraised using the PEDro scale. The majority of studies reported improvements in pain, pressure pain threshold, and function of CTS patients after nerve gliding, combined or not with additional therapies. When comparing nerve gliding with other therapies, 2 studies reported better results from standard care and 1 from use of a wrist splint, whereas 3 studies reported greater and earlier pain relief and function after nerve gliding in comparison with conservative techniques, such as ultrasound and wrist splint. However, 6 of the 13 studies had a quality of 5 of 11 or less according to the PEDro scale.
Limited evidence is available on the effectiveness of neural gliding. Standard conservative care seems to be the most appropriate option for pain relief, although neural gliding might be a complementary option to accelerate recovery of function. More high-quality research is still necessary to determine its effectiveness and the subgroups of patients who may respond better to this treatment.
...Afficher la suiteEffectiveness of Different Deep Dry Needling Dosages in the Treatment of Patients With Cervical Myofascial Pain: A Pilot RCT
07.04.17-04:59 // Catégories : Dry Needling/Points Trigger
To assess the effectiveness of different dosages of local twitch responses (LTRs) elicited by deep dry needling (DDN) in relation to pain intensity, pressure pain threshold (PPT), cervical range of movement (CROM), and disability degree in cervical myofascial pain patients. A randomized, double-blind clinical trial. Eighty-four patients (21 males, 63 females; 27.18 ± 10.91 yrs) with cervical pain. DDN in active myofascial trigger points (MTrPs) in the upper trapezius. Patients were randomly divided into four groups: (a) no LTRs elicited, (b) four LTRs elicited, (c) six LTRs elicited, and (d) needling until no more LTRs were elicited. Pain intensity, PPT, CROM, and disability degree were assessed before treatment, post-immediate, 48 hrs, 72 hrs, and 1 wk after treatment. Significant differences were found in the time factor for all the variables (P < 0.005), but no significant changes were found in the group-time interaction (P > 0.05).
DDN in the upper trapezius MTrP improved pain at a 1-wk follow-up, but improvements were not significantly different among DDN dosages. A higher number of patients with neck pain improvements superior to the moderate clinically important differences were observed when eliciting 6 LTRs and LTRs until exhaustion compared with not eliciting LTRs.
...Afficher la suiteExperienced versus Inexperienced Interexaminer Reliability on Location and Classification of Myofascial Trigger Point Palpation to Diagnose Lateral Epicondylalgia: An Observational Cross-Sectional Study
07.04.17-04:59 // Catégories : Points Trigger
The purpose was to evaluate the interexaminer reliability of experienced and inexperienced examiners on location and classification of myofascial trigger points (MTrPs) in two epicondylar muscles and the association between the MTrP found and the diagnosis of lateral epicondylalgia (LE). Fifty-two pianists (some suffered LE) voluntarily participated in the study. Three physiotherapists (one inexperienced in myofascial pain) examined, located, and marked MTrPs in the extensor carpi radialis brevis (ECRB) and extensor digitorum communis (EDC) muscles. Forearms were photographed and analyzed to establish the degree of agreement on MTrPs diagnosis. Data showed 81.73% and 77.88% of agreement on MTrP classification and 85.58% and 72.12% on MTrP location between the expert evaluators for ECRB and EDC, respectively. The agreement on MTrP classification between experienced and inexperienced examiners was 54.81% and 51.92% for ECRB and 50.00% and 55.77% for EDC. Also, agreement on MTrP location was 54.81% and 60.58% for ECRB and 48.08% and 48.08% for EDC.
A strong association was found between presence of relevant MTrPs, LE diagnosis, and forearm pain when the examiners were experts. The analysis of location and classification of MTrPs in the epicondylar muscles through physical examination by experienced evaluators is reliable, reproducible, and suitable for diagnosing LE.
...Afficher la suiteEffectiveness of a Treatment Involving Soft Tissue Techniques and/or Neural Mobilization Techniques in the Management of Tension-Type Headache: A Randomized Controlled Trial
07.04.17-04:59 // Catégories : Neurodynamique
