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Pontes-Silva A, Dibai-Filho AV, de Melo TS, Santos LM, de Souza MC, DeSantana JM, Avila MA. Effects of progressive intensity resistance training on the impact of fibromyalgia: protocol for a blinded randomized controlled trial. BMC Musculoskelet Disord 2023; 24:816. [PMID: 37838712 PMCID: PMC10576880 DOI: 10.1186/s12891-023-06952-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/10/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Fibromyalgia guidelines indicate that exercise is critical in the management of fibromyalgia, and there is evidence that patients with fibromyalgia can perform resistance training at moderate and high intensities. However, despite the biological plausibility that progression of intensity provides greater benefit to individuals, no studies have compared different intensities (progressive versus constant intensities) of the same exercise in this population. OBJECTIVE To compare the effect of 24 sessions of resistance training (progressive vs. constant intensity) on impact of fibromyalgia, sleep quality, anxiety, depression, pain, walking ability, and musculoskeletal capacity. METHODS A protocol for a blinded randomized controlled trial. The sample will be randomized into three groups: group 1 (progressive intensity, experimental), group 2 (constant intensity, control A), and group 3 (walking, control B). Group 1 will perform resistance training at moderate intensity (50% of maximum dynamic strength), previously determined by the 1 repetition maximum (1-RM) test in the proposed exercises. The strength of each individual will be reassessed every 4 weeks (by 1-RM) and the intensity of each exercise will be positively adjusted by 20% of the value observed in kg (i.e., first month 50%; second month 70%; third month 90% of the maximum dynamic strength). Group 2 will perform the same procedure, but the intensity will be maintained at 50% of the maximum dynamic strength throughout the treatment (i.e., constant intensity from the first to the third month). Group 3 will perform a 40-minute treadmill walk at low intensity, defined by a walking speed corresponding to 60-70% of the maximum heart rate, which we will control with a heart rate monitor. All groups will receive a 45-minute pain education session prior to the exercise program, covering the pathophysiologic mechanisms of chronic pain, strategies for coping with pain, avoiding hypervigilance, and deconstructing beliefs and myths about chronic pain. DISCUSSION The results of the present study may help health care professionals adjust the intensity of resistance training and thus plan the most effective intervention (progressive or constant intensity) to reduce the impact of fibromyalgia on patients' lives. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (ReBEC) ID: RBR-9pbq9fg, date of registration: October 06, 2022.
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Affiliation(s)
- André Pontes-Silva
- Physical Therapy Postgraduate Program, Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Almir Vieira Dibai-Filho
- Physical Education Postgraduate Program, Physical Education Department, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Thayná Soares de Melo
- Physical Therapy Postgraduate Program, Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
- Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Marcelo Cardoso de Souza
- Postgraduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Josimari Melo DeSantana
- Laboratory of Research on Neuroscience (LAPENE), Physical Therapy Department, Graduate Program in Health Science, Graduate Program in Physiological Science, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil
| | - Mariana Arias Avila
- Physical Therapy Postgraduate Program, Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
- Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, Brazil.
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Martins-de-Sousa PH, Fidelis-de-Paula-Gomes CA, Pontes-Silva A, Henrique MFP, Araujo GGC, Kalatakis-Dos-Santos AE, Damasceno KLB, Dibai-Filho AV. Additional effect of transcutaneous electrical nerve stimulation in a therapeutic exercise program for sedentary with chronic neck pain: A double-blind randomized controlled trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e1978. [PMID: 36252091 DOI: 10.1002/pri.1978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/02/2022] [Accepted: 10/09/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE To evaluate the additional effect of high frequency (HF) or low frequency (LF) transcutaneous electrical nerve stimulation (TENS) in a specific therapeutic exercise program for the treatment of patients with chronic neck pain. METHODS A randomized controlled trial. Sixty participants of both sexes and with chronic neck pain were randomized into three groups: therapeutic exercise group + placebo TENS (n = 20), therapeutic exercise group + HF TENS (n = 20) and therapeutic exercise group + low TENS frequency (n = 20). The following assessment instruments were used: Numerical Pain Rating Scale, Neck Disability Index, Pain-Related Catastrophizing Thoughts Scale and Tampa Scale for Kinesiophobia. Participants were evaluated before the interventions, after eight treatment sessions and 1 month after the end of treatment. Primary outcome was disability measured after the eight treatment sessions. Secondary outcomes were pain intensity, catastrophizing, and kinesiophobia after eight treatment sessions and pain intensity 4 weeks after the end of the treatment sessions. RESULTS The three groups were similar at baseline for personal and clinical characteristics. Regarding the main study analyses, there were no significant (p > 0.05) or clinical (d < 0.80) differences between the groups for the main variable (disability), nor for the secondary variables (pain intensity, catastrophizing and kinesiophobia). CONCLUSION HF or LF TENS, compared to placebo TENS, does not provide additional clinical benefits to an exercise program for patients with chronic neck pain.
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Affiliation(s)
| | | | - André Pontes-Silva
- Postgraduate Program in Adult Health, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
| | | | | | | | | | - Almir Vieira Dibai-Filho
- Postgraduate Program in Adult Health, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil.,Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
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Karaarslan F, Yılmaz H, Akkurt HE, Kaya FM, Şafak Yılmaz E. Comparison of the efficacy of mud-pack and hot-pack treatments in chronic non-specific neck pain: A single-blind, randomized-controlled study. Turk J Phys Med Rehabil 2022; 68:381-390. [PMID: 36475098 PMCID: PMC9706788 DOI: 10.5606/tftrd.2022.8575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 10/27/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives This study aims to compare the short-term efficacy of mud-pack (MP) and hot-pack (HP) treatments with the same temperature and duration on sleep, function, depression, and quality of life for chronic non-specific neck pain (CNNP) patients. Patients and methods Between December 2018 and September 2019, a total of 70 patients with CNNP diagnosis (12 males, 58 females; mean age: 50.2±9.4 years; range, 24 to 65 years) were included. The patients were divided into two groups. The MP group (n=35) had a total of 15 sessions of MP for 20 min + transcutaneous electrical nerve stimulation (TENS) for 20 min + home exercise (HE) on five days per week for three weeks. The HP group (n=35) had 15 similar sessions of HP for 20 min + TENS for 20 min + HE. The patients were assessed with the Visual Analog Scale (VAS-pain), VAS physician's and patient's global assessments, modified Neck Disability Index (mNDI), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and Short Form-36 (SF-36) measures before treatment, at the end of post-treatment third week and one month later. Results In the MP group, there were statistically significant improvements in all parameters at the end of treatment three-week and one-month follow-up (p<0.05), apart from SF-36 Vitality/Energy (SF-36V/E) at the end of treatment and SF-36 General Health (SF-36GH) at one month. In the HP group, there were statistically significant improvements observed for all parameters (p<0.05), apart from the SF-36 Physical Role and SF-36GH at the end of treatment third week and SF-36V/E at the first-month assessment. The VAS-pain(p<0.001), mNDI (p=0.019), BDI (p=0.002), SF-36GH (p<0.001), SF-36V/E (p<0.001) and SF-36 mental health (p<0.001) showed statistically significantly superior improvements in the MP group (p<0.05). Conclusion In CNNP patients, both MP and HP treatments are effective. However, MP therapy has more positive effects on pain, function, depression, and quality of life parameters. The MP treatment may be used in addition to TENS treatment for CNNP patients.
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Affiliation(s)
- Fatih Karaarslan
- Department of Medical Ecology and Hydroclimatology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| | - Halim Yılmaz
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Konya Training and Research Hospital, Konya, Türkiye
| | - Halil Ekrem Akkurt
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Konya Training and Research Hospital, Konya, Türkiye
| | - Fatih Muhammed Kaya
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Konya Training and Research Hospital, Konya, Türkiye
| | - Esra Şafak Yılmaz
- Department of Medical Informatic, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
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Clinical Efficacy of Epidural Injections of Local Anesthetic Alone or Combined with Steroid for Neck Pain: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8952220. [PMID: 35663039 PMCID: PMC9162875 DOI: 10.1155/2022/8952220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022]
Abstract
Aims To compare the effectiveness of cervical epidural injections of local anesthetic with vs. without a steroid. Methods Three databases (PubMed, Embase, and Cochrane library) were used to search and assess all clinical randomized controlled trials regarding the clinical efficacy of epidural injections from January 01, 2009, to October 31, 2020. Cochrane review criteria and the Interventional Pain Management Techniques-Quality Appraisal of Reliability and Risk of Bias Assessment instrument were used to evaluate the methodologic quality of the included studies. Qualitative and quantitative analyses were performed according to best evidence synthesis principles and by single-arm meta-analysis, respectively. Results Based on the search criteria, 4 RCTs were qualitatively and quantitatively analyzed in the single-arm meta-analysis. Treatment with lidocaine alone or with the steroid resulted in decreases of 4.46 and 4.29 points, respectively, in pain scores and of 15.8 and 14.46 points, respectively, in functional scores at 6 months. Similar trends were observed at the 1-year follow-up: pain scores decreased by 4.27 and 4.14 points, while functional scores decreased by 15.94 and 14.44 points in patients with neck pain who received lidocaine without or with the steroid, respectively. In the 3 studies that reported 2-year follow-up data, patients with neck pain treated with lidocaine or lidocaine + steroid showed 4.2- and 4.14-point decreases, in pain score and 15.92- and 14.89-point decreases, respectively, in functional scores. Conclusions The studies showed level I (strong) evidence for short- and long-term improvements in pain relief and functionality with cervical epidural injections of local anesthetic alone or with a steroid in the management of neck pain.
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Torlak MS, Gonulalan G, Tufekci O, Nazli MS, Atici E. The effect of therapeutic exercise and vegan diet on pain and quality of life in young female patients with chronic non-specific neck pain. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2022. [DOI: 10.1186/s43161-021-00061-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Abstract
Background and purpose
In recent years, dietary practices have begun to be used in painful conditions. This study aimed to investigate the effect of a vegan diet and therapeutic exercise in patients with chronic non-specific neck pain.
Materials and methods
A total of 45 young female patients with chronic non-specific neck pain, aged 18–25 years, participated in the study. Body mass index and body fat percentage were measured with bioelectrical impedance analysis. Pain severity was assessed using the Visual Analogue Scale, quality of life with the short form-36 scale, kinesiophobia with the Tampa scale of kinesiophobia and neck disability with the Neck Disability Index.
Results
The pain severity reduced in the diet group and exercise group after treatment (p = 0.001). After treatment, Neck Disability Index score decreased in the diet group and exercise group (p = 0.001). Tampa scale of kinesiophobia score decreased in the diet group and exercise group (p = 0.001). The eight domains of the short form-36 scale score increased in the diet group and exercise group (p < 0.05). No difference was found in the body mass index and fat percentage in all groups before and after treatment (p˃ 0.05).
Conclusion
A vegan diet and therapeutic exercise are beneficial to patients with chronic non-specific neck pain in terms of pain severity and quality of life.
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The effects of combined sternocleidomastoid muscle stretching and massage on pain, disability, endurance, kinesiophobia, and range of motion in individuals with chronic neck pain: A randomized, single-blind study. Musculoskelet Sci Pract 2021; 55:102417. [PMID: 34147954 DOI: 10.1016/j.msksp.2021.102417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The effect of interventions to the Sternocleidomastoid (SCM)-muscle, as an important element of neck movement which is overactive in individuals with chronic neck pain (CNP), are unknown. OBJECTIVE The aim of the current study is to investigate the effects of SCM stretching and massage on pain, range of motion (ROM), endurance, disability, and kinesiophobia in individuals with CNP. METHODS In this study, individuals with CNP were randomized 1:1 to parallel SCM-Group (n = 30) or control group (CG) (n = 30). Conventional physiotherapy was applied to CG. In addition to the same interventions applied to the CG, classical massage and stretching exercises were applied to the SCM-muscle in the SCM-Group. Treatment sessions were administered three times each week for a total of 5 weeks. Pain, endurance, ROM, disability, and kinesiophobia were evaluated. Both prior to and immediately following the treatments. Mixed-model repeated measured ANOVAs were then employed to determine if a group*time interaction existed on the effects of the treatment on each outcome variable for each group as the between-subjects variable and time as the within-subjects variables. RESULTS Improvements in pain, disability, ROM(extension, left-lateral flexion, and right/left-rotation), and endurance were found to be greater in the SCM-Group compared to the CG (p < 0.05). Changes in flexion and right-lateral flexion ROM and kinesiophobia did not significantly differ between the groups (p > 0.05). CONCLUSION Stretching exercises and massage applied to the SCM-muscle, together with conventional physiotherapy, can reduce pain and disability, and increase ROM and endurance in individuals with CNP. This treatment may therefore be considered for use as an alternative method in treating CNP. The study was registered in ClinicalTrials.gov (NCT04345042).
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