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ERSİN A, KAYA M. Effect of thoracic mobilization exercises on hamstring flexibility: a randomized controlled trial. Turk J Med Sci 2023; 53:1293-1300. [PMID: 38813012 PMCID: PMC10763815 DOI: 10.55730/1300-0144.5695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 10/26/2023] [Accepted: 06/12/2023] [Indexed: 05/31/2024] Open
Abstract
Background and aim The aim was to investigate the effect of thoracic mobilization exercises on hamstring flexibility. Materials and methods One hundred twenty individuals with hamstring tightness were included in the study. The participants were randomized into two groups: the experimental group (EG) (n = 60) or the control group (CG) (n = 60). The EG performed a home-based thoracic mobilization exercise program comprising 2 sets with 10 repetitions, once a day, 3 days a week, for 4 weeks. The CG performed active-assisted stretching of the hamstring comprising 3 sets with 10 repetitions for 15 seconds. The active knee extension (AKE) test was used to measure hamstring flexibility, and self-reported hamstring pain intensity was evaluated with a visual analog scale (VAS). All evaluations were conducted at the beginning and end of the intervention. Results Both groups showed significant improvement in AKE (p<0.05). Pain intensity during the stretching exercises was significantly decreased only in the EG. The improvements in AKE and VAS score were greater in the EG than in the CG (p < 0.05). Between-group effect sizes were large for AKE (d = 1.075) and VAS score (d = 1.077). Conclusion The current study showed that thoracic mobilization exercises may increase hamstring flexibility and reduce pain intensity during hamstring stretch exercises.
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Affiliation(s)
- Aybüke ERSİN
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İstanbul Atlas University, İstanbul,
Turkiye
| | - Meltem KAYA
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İstanbul Atlas University, İstanbul,
Turkiye
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Ruiz JJB, Perez-Cruzado D, Llanes RP. Immediate effects of lumbar fascia stretching on hamstring flexibility: A randomized clinical trial. J Back Musculoskelet Rehabil 2023; 36:619-627. [PMID: 36872764 DOI: 10.3233/bmr-210274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
BACKGROUND The hamstring muscles have a great tendency to decrease their extensibility, a phenomenon that presents a distinct clinical entity called short hamstring syndrome (SHS), in addition to problems with adjacent structures. OBJECTIVE The objective of this study was to evaluate the immediate effect of lumbar fascia stretching on the flexibility of the hamstring musculature. METHODS A randomized controlled trial was carried out. Forty-one women between 18 and 39 years old were divided into two groups: the experimental group received a technique of fascial stretching in the lumbar area while the control group participated in a magnetotherapy machine that was turned off. Hamstring flexibility in both lower limbs was measured by the straight leg raising test (SLR) and the passive knee extension test (PKE). RESULTS The results showed statistically significant improvements (p< 0.05) in the SLR and the PKE for both groups. There was a large effect size (Cohen's d) for both tests. There was a statistically significant correlation between the International Physical Activity Questionnaire (IPAQ) and the SLR. CONCLUSION The inclusion of lumbar fascia stretching might be an effective part of a treatment protocol to increase the flexibility of the hamstring muscle observing an immediate result in healthy participants.
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Affiliation(s)
- Juan Javier Bru Ruiz
- Department of Physiotherapy, San Antonio Catholic University of Murcia, Murcia, Spain
| | - David Perez-Cruzado
- Department of Occupational Therapy, San Antonio Catholic University of Murcia, Murcia, Spain
| | - Raúl Pérez Llanes
- Department of Physiotherapy, San Antonio Catholic University of Murcia, Murcia, Spain
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Jiang WB, Samuel OC, Li Z, Chen W, Sui HJ. Effectiveness of craniosacral therapy in the human suboccipital region on hamstring muscle: A meta-analysis based on current evidence. Medicine (Baltimore) 2023; 102:e32744. [PMID: 36749266 PMCID: PMC9901966 DOI: 10.1097/md.0000000000032744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Craniosacral therapy (CST) has remained controversial in the treatment of musculoskeletal disorders. To our knowledge, there is no larger sample size of research to demonstrate the effectiveness of craniosacral therapy in the human suboccipital region on hamstring muscle. METHODS To study whether the CST in the human suboccipital region could have a remote effect on the flexibility of the hamstring muscles, the Cochrane Library, Medline/Pubmed, CNKI, Embase, and Google Scholar were searched. Clinical trials assessing the effects of CST in short hamstring syndrome patients were eligible. Mean differences (MD) and 95% confidence intervals (CI) were calculated for the straight leg raise test (primary outcomes). The quality of the included studies was assessed using the Newcastle-Ottawa Scale. RevMan 5.3 software was used for data analysis. RESULTS Five controlled trials with a total of 238 participants were included. CST could effectively relieve the symptoms of short hamstring syndrome patients [the overall MD -9.47, 95% confidence interval (CI) -15.82 to -3.12, P < .000001]. The CST was better than the proprioceptive neuromuscular facilitation technique (MD 3.09, 95% CI 1.48-4.70, P = .0002). Sensitivity analysis shows that the frequency of treatment and who did the experiment might be the main sources of impact results. CONCLUSION CST could change the flexibility of the hamstring muscles. CST had a better curative effect when compared to proprioceptive neuromuscular facilitation technique on the hamstring muscles.
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Affiliation(s)
- Wen-Bin Jiang
- Department of Anatomy, Dalian Medical University, Dalian, China
| | | | - Zhe Li
- Department of Anatomy, Guang Dong Medical University, Dong Guan, China
| | - Wei Chen
- Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hong-Jin Sui
- Department of Anatomy, Dalian Medical University, Dalian, China
- * Correspondence: Hong-Jin Sui, Department of Anatomy, Dalian Medical University, Dalian 116044, China (e-mail: )
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Kaczmarek T, Truszczyńska-Baszak A. The Impact of Suboccipital Muscle Release on Pain and Range of Motion in the Cervical Spine of Young Adults. REHABILITACJA MEDYCZNA 2022. [DOI: 10.5604/01.3001.0016.0619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Introduction: Limited mobility and pain in the cervical spine affect 50% of the population, leading to disability and a reduction in quality of life. It is important to use effective forms of therapy. One of them, enjoying growing popularity, is deep tissue massage, the stability of which requires confirmation in scientific research.
Research objective: The aim of the study was to investigate how a single deep tissue massage therapy aimed at suboccipital muscles reduces pain and improves the range of motion in the cervical spine and how long the improvement lasts.
Research materials and methods: The study participants included 41 people aged 20-34. The respondents were randomly divided into 2 groups: study (21 people) and control (20 people). The subjects completed a questionnaire consisting of 14 questions and were subjected to 2 tests for evaluating cervical spine stability: the covering membrane test and the anterior occipital membrane test. Then, the measurements of pain on the VAS scale (0-10) and the range of cervical mobility were collected. Measurements were taken before, immediately after, as well as 2 and 4 weeks following the therapeutic intervention. The therapy in the study group consisted of a single, 10-minute relaxation session of the sub-occipital muscles. In the control group, cervical spine traction, lasting 30 seconds, was performed 3 times.
Results: In the study group, the pain decreased statistically significantly (p<0.05), before the therapy it totalled 4.33 ± 1.49, while after the therapy, its value decreased to 2.05 ± 0.86 and lasted up to 2 weeks after the massage – 2.67 ± 1.49. In the control group, the pain level before the therapy was 4.25 ± 0.76, and following the therapy, it decreased to 3 ± 0.95 and then increased to the mean value of 4 ± 1 (after 2 weeks). On average, the level equalled 4.25 ± 0.76 (after 4 weeks). In the study group, the range of flexion motion was, on average, 3.24 ± 1.00 cm, extension, mean 6.90 ± 1.14 cm, lateral flexion to the left, on avg. 4.76 ± 0.62, to the right on avg. 4.90 ± 1.04 cm, left rotation on avg. 8.43 ± 0.81, and right rotation on avg., 8.19 ± 1.08 cm. After deep tissue massage therapy, the results differed from the range of motion results obtained in the control group: flexion totalled 5.67 ± 0.48 cm immediately after therapy and 4.90 ± 1.34 cm 2 weeks post-intervention, extension 8.57 ± 0.87 cm immediately after therapy and 7.62 ± 1.47 cm 2 weeks after therapy, and finally, left lateral flexion 5.52 ± 0.81 directly following the therapy and 5.43 ± 0.93 cm 2 weeks after therapy.
Conclusions: 1. Single-session deep tissue massage therapy significantly reduces pain and increases range of motion in the cervical spine. 2. The effects last up to 2 weeks following the therapy.
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Affiliation(s)
- Tymoteusz Kaczmarek
- Józef Piłsudski University of Physical Education in Warsaw, Faculty of Rehabilitation, Warsaw, Poland
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Jeong ED, Kim CY, Kim NH, Kim HD. Immediate effects of static and proprioceptive neuromuscular facilitation stretching of hamstring muscles on straight leg raise, craniovertebral angle, and cervical spine range of motion in neck pain patients with hamstring tightness: A prospective randomized controlled trial. J Back Musculoskelet Rehabil 2022; 35:429-438. [PMID: 34151831 DOI: 10.3233/bmr-201840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The cranio-cervical flexion exercise and sub-occipital muscle inhibition technique have been used to improve a forward head posture among neck pain patients with straight leg raise (SLR) limitation. However, little is known about the cranio-vertebral angle (CVA) and cervical spine range of motion (CROM) after applying stretching methods to the hamstring muscle. OBJECTIVE To compare the immediate effects of static stretching and proprioceptive neuromuscular facilitation stretching on SLR, CVA, and CROM in neck pain patients with hamstring tightness. METHODS 64 subjects were randomly allocated to the static stretching (n1= 32) or proprioceptive neuromuscular facilitation (n2= 32) stretching group. The SLR test was performed to measure the hamstring muscle's flexibility and tightness between the two groups, with CROM and CVA also being measured. The paired t-test was used to compare all the variables within each group before and after the intervention. The independent t-test was used to compare the two groups before and after the stretching exercise. RESULTS There were no between-group effects for any outcome variables (P> 0.05). However, all SLR, CVA, and CROM outcome variables were significantly improved within-group (P< 0.05). CONCLUSIONS There were no between-group effects for any outcome variable; however, SLR, CVA, and CROM significantly improved within-group after the one-session intervention in neck pain patients with hamstring tightness.
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Affiliation(s)
- Eun-Dong Jeong
- Department of Physical Therapy, College of Health Sciences, Korea University, Seoul, Korea
| | - Chang-Yong Kim
- Pharma and Bio Pharma Industry Team, Department of Pharmaceutical and Bio-Pharmaceutical Industry, Korea Health Industry Development Institute, Cheongju-si, Korea
| | - Nack-Hwan Kim
- Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea
| | - Hyeong-Dong Kim
- Department of Physical Therapy, School of Health and Environmental Science, College of Health Science, Korea University, Seoul, Korea
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The Effect of Hamstring Relaxation Program on Headache, Pressure Pain Threshold, and Range of Motion in Patients with Tension Headache: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910137. [PMID: 34639438 PMCID: PMC8508316 DOI: 10.3390/ijerph181910137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to determine if the severity of headache is reduced by decreasing hamstring tension in patients with tension headache. Thirty patients participated in this study. The participants were randomly allocated to two groups: hamstring relaxation program (HR) group (n = 15) and control group (n = 15). The participants in the HR group participated in a HR program for 25 min per day, three times per week, for a period of 4 weeks, and the control group participated in an electrotherapy for 25 min per day, three times per week, for a period of 4 weeks. Both groups participated in a self-myofacial release for 5 min per day, three times per week, for a period of 4 weeks. Headache was evaluated using the headache impact test (HIT-6) and visual analog scale (VAS). The pain pressure threshold (PPT) was evaluated using a digital pressure algometer. The range of motion (ROM) was evaluated using a goniometer and two special tests: straight leg raise test (SLRT) and popliteal angle test (PAT). The two groups showed no significant differences in terms of age, sex, height, and weight. The VAS and HIT-6 scores (p < 0.05) and neck and hamstring PPT showed significant improvements (p < 0.05). Neck flexion ROM and SLRT and PAT scores showed significant improvements (p < 0.05) in both groups, and the HR group showed significantly more improvements than the control group. This study confirmed that the HR program has positive effects on tension headache and is a good intervention for alleviating headaches in patients with tension headache.
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Wah SW, Puntumetakul R, Boucaut R. Effects of Proprioceptive and Craniocervical Flexor Training on Static Balance in University Student Smartphone Users with Balance Impairment: A Randomized Controlled Trial. J Pain Res 2021; 14:1935-1947. [PMID: 34234540 PMCID: PMC8242145 DOI: 10.2147/jpr.s312202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/02/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose University student smartphone users adopt flexed neck postures during smartphone use, creating an increased compressive load on their neck structures. This study was conducted to compare the effects of proprioceptive and craniocervical flexor training with a control group on static balance in a group of university student smartphone users with balance impairment. Methods A double-blinded, randomized controlled trial was conducted involving 42 university students (19.67±1.68 years old) with balance impairment. Participants were randomized into a proprioceptive training (ProT) group (n=14), a craniocervical flexor training (CCFT) group (n=14), and a control group (CG; n=14) for a 6-week intervention. The balance error scoring system (BESS), cervical joint position sense (CJPS), craniocervical flexion (CCF) test, and visual analog scale (VAS) for neck pain were evaluated using univariate analysis of covariance (ANCOVA). Results After 6 weeks of intervention, the ProT group showed significantly greater improvement of CJPS than the CG (p=0.000) and the CCFT group significantly improved of CCF test than CG (p=0.002). Findings, at 4 weeks after intervention, were (i) the ProT group had significantly more improvement in BESS than the CCFT group (p=0.014) and CG (p=0.003), (ii) the ProT group had significantly more improvement of CJPS than the CG (right and left rotate) (p=0.001, p=0.016, respectively) and CCFT group (right rotate) (p=0.004), (iii) the CCFT group had significantly more improvement of craniocervical flexor strength than CG (p=0.004), and (iv) the ProT group and CCFT group had significantly more decreased pain than CG (p=0.015, p=0.033, respectively). No adverse effects occurred during or after training in any group. Conclusion ProT is important for regaining static balance and CJPS, while CCFT improved craniocervical flexor strength. Moreover, both ProT and CCFT can reduce neck pain. We recommend performing ProT to improve static balance, CJPS and to reduce neck pain in smartphone users with static balance impairment. Clinical Trail Registration Number TCTR20190909003.
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Affiliation(s)
- Saw Wah Wah
- Human Movement Sciences, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand.,Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Rungthip Puntumetakul
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, 40002, Thailand.,School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Rose Boucaut
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, 5001, Australia.,University of South Australia: Allied Health and Human Performance, Adelaide, SA, 5001, Australia
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Kang HS, Kwon HW, Kim DG, Park KR, Hahm SC, Park JH. Effects of the Suboccipital Muscle Inhibition Technique on the Range of Motion of the Ankle Joint and Balance According to Its Application Duration: A Randomized Controlled Trial. Healthcare (Basel) 2021; 9:healthcare9060646. [PMID: 34072454 PMCID: PMC8227022 DOI: 10.3390/healthcare9060646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/12/2021] [Accepted: 05/26/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the effects of suboccipital muscle inhibition technique (SMIT) on active range of motion (AROM) of the ankle joint, lunge angle (LA), and balance in healthy adults, according to the duration of its application. A total of 80 participants were randomly allocated to the 4-min suboccipital muscle inhibition (SMI) group (SMI_4M, n = 20), 8-min SMI group (n = 20), 4-min sham-SMI (SSMI) group (n = 20), and 8-min SSMI group (n = 20). Accordingly, the SMIT and sham SMIT were applied for 4 min or 8 min in the respective groups. AROM of dorsiflexion and LA were assessed, and a single leg balance test (SLBT) was performed before and after the intervention. AROM (4 min, p < 0.001; 8 min, p < 0.001), LA (4 min, p < 0.001; 8 min, p < 0.001), and SLBT (4 min, p < 0.001; 8 min, p < 0.001) significantly improved after SMI application. Compared with the SSMI group, the SMI group showed a significant increase in AROM (p < 0.001), LA (p < 0.001), and SLBT (p < 0.001). Except for SLBT (p = 0.016), there were no significant interactions between intervention and application duration. The results suggest that the SMIT, at durations of both 4 and 8 min, could be effective tools for improving AROM, LA, and balance.
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Affiliation(s)
- Han-Sol Kang
- Graduate School of Integrative Medicine, CHA University, Seongnam 13488, Korea;
- Department of Anatomy & Cell Biology, Graduate School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (H.-W.K.); (D.-g.K.); (K.-R.P.)
| | - Hyung-Wook Kwon
- Department of Anatomy & Cell Biology, Graduate School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (H.-W.K.); (D.-g.K.); (K.-R.P.)
| | - Di-gud Kim
- Department of Anatomy & Cell Biology, Graduate School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (H.-W.K.); (D.-g.K.); (K.-R.P.)
| | - Kwang-Rak Park
- Department of Anatomy & Cell Biology, Graduate School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (H.-W.K.); (D.-g.K.); (K.-R.P.)
| | - Suk-Chan Hahm
- Graduate School of Integrative Medicine, CHA University, Seongnam 13488, Korea;
- Correspondence: (S.-C.H.); (J.-H.P.); Tel.: +82-31-881-7101 (S.-C.H.); +82-33-250-8814 (J.-H.P.); Fax: +82-31-881-7069 (S.-C.H.); ++82-33-259-5635 (J.-H.P.)
| | - Jeong-Hyun Park
- Department of Anatomy & Cell Biology, Graduate School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (H.-W.K.); (D.-g.K.); (K.-R.P.)
- Correspondence: (S.-C.H.); (J.-H.P.); Tel.: +82-31-881-7101 (S.-C.H.); +82-33-250-8814 (J.-H.P.); Fax: +82-31-881-7069 (S.-C.H.); ++82-33-259-5635 (J.-H.P.)
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Martínez-Lema D, Guede-Rojas F, González-Fernández K, Soto-Martínez A, Lagos-Hausheer L, Vergara-Ríos C, Márquez-Mayorga H, Mancilla CS. Immediate effects of a direct myofascial release technique on hip and cervical flexibility in inactive females with hamstring shortening: A randomized controlled trial. J Bodyw Mov Ther 2020; 26:57-63. [PMID: 33992297 DOI: 10.1016/j.jbmt.2020.12.013] [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: 05/22/2020] [Revised: 12/01/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Currently, greater background is required about the effectiveness of myofascial release (MFR) on muscle flexibility. OBJECTIVE Our goal was to determine the immediate effect of a direct MFR technique on hip and cervical flexibility in inactive females with hamstring shortening. METHOD The sample group included 68 female university students, randomly divided into a control group (n = 34) and an experimental group (n = 34). A placebo technique was used with the control group, and direct MFR on the posterior thigh region was used with the experimental group. RESULTS The mixed factorial ANOVA did not show significant intergroup differences (p > 0.05). In the experimental group, Bonferroni post hoc test showed significant intragroup differences between pre-test and post-test 1, as well as between pre-test and post-test 2 for the three ischiotibial muscle flexibility tests (p < 0.001). Cervical flexion range of motion showed significant differences between pre-test and post-test 1 (p < 0.001). CONCLUSIONS We conclude that the protocol based on a single direct MFR intervention was no more effective than the placebo in improving flexibility both locally at the hamstring level and remotely at the level of the cervical extensor muscles. Future research should consider different MFR techniques on the immediate increase in muscle flexibility and the long-term effect of MFR, as well as consider different intervention groups.
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Affiliation(s)
- Daniel Martínez-Lema
- Kinesiology, Faculty of Health Sciences, GICAV, Universidad Arturo Prat, Victoria, Chile.
| | - Francisco Guede-Rojas
- Kinesiology, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Concepción, Chile.
| | | | - Adolfo Soto-Martínez
- Kinesiology, Faculty of Health Sciences, Universidad de Las Américas, Concepción, Chile.
| | | | - César Vergara-Ríos
- Kinesiology, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Concepción, Chile.
| | - Héctor Márquez-Mayorga
- Kinesiology, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Concepción, Chile.
| | - Carlos S Mancilla
- Kinesiology, Faculty of Health Sciences, GICAV, Universidad Arturo Prat, Victoria, Chile.
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Li L, Stoop R, Clijsen R, Hohenauer E, Fernández-de-Las-Peñas C, Huang Q, Barbero M. Criteria Used for the Diagnosis of Myofascial Trigger Points in Clinical Trials on Physical Therapy: Updated Systematic Review. Clin J Pain 2020; 36:955-967. [PMID: 32841969 DOI: 10.1097/ajp.0000000000000875] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The objective of this study was to conduct an updated systematic review of diagnostic criteria for myofascial trigger points (MTrPs) used in clinical trials of physical therapy interventions from 2007 to 2019. METHODS MEDLINE and Physiotherapy Evidence Database (PEDro) were searched using the following MeSH keywords: "trigger points," "trigger point," "myofascial trigger point," "myofascial trigger points," "myofascial pain," and "myofascial pain syndrome." The MeSH keywords were combined by using Boolean operators "OR"/"AND." All physiotherapy clinical trials including patients with musculoskeletal conditions characterized by at least 1 active MTrP or latent MTrP in any body area were selected. We pooled data from an individual criterion and criteria combinations used to diagnose MTrPs. The protocol was developed in accordance with the PRISMA-P guidelines. RESULTS Of 478 possibly relevant publications, 198 met the inclusion criteria. Of these 198 studies, 129 studies (65.1%) stated specifically the diagnostic criteria used for MTrPs in the main text, 56 studies (28.3%) failed to report any method whereby MTrP was diagnosed, and 13 studies (6.6%) adopted expert-based definitions for MTrPs without specification. Of 129 studies, the 6 criteria applied most commonly were: "spot tenderness" (n=125, 96.9%), "referred pain" (95, 73.6%), "local twitch response" (63, 48.8%), pain recognition (59, 45.7%), limited range of motion" (29, 22.5%), and "jump sign" (10, 7.8%). Twenty-three combinations of diagnostic criteria were identified. The most frequently used combination was "spot tenderness," "referred pain," and "local twitch response" (n=28 studies, 22%). CONCLUSIONS A number of the included studies failed in properly reporting the MTrP diagnostic criteria. Moreover, high variability in the use of MTrP diagnostic was also observed. Spot tenderness, referred pain, and local twitch response were the 3 most popular criteria (and the most frequently used combination). A lack of transparency in the reporting of MTrP diagnostic criteria is present in the literature. REGISTRY This systematic review was registered under the Centre for Reviews and Dissemination, PROSPERO number: CRD42018087420.
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Affiliation(s)
- Lihui Li
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- School of Medicine, Southern University of Science and Technology, Shenzhen
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Rahel Stoop
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
| | - Ron Clijsen
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Erich Hohenauer
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Qiangmin Huang
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
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Calixtre LB, Oliveira AB, Alburquerque-Sendín F, Armijo-Olivo S. What is the minimal important difference of pain intensity, mandibular function, and headache impact in patients with temporomandibular disorders? Clinical significance analysis of a randomized controlled trial. Musculoskelet Sci Pract 2020; 46:102108. [PMID: 31999615 DOI: 10.1016/j.msksp.2020.102108] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 12/09/2019] [Accepted: 01/10/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND There are insufficient studies providing Minimal Clinically Important Difference (MCID) for outcomes related to temporomandibular disorders (TMD). OBJECTIVES (1) To provide the MCID of outcomes related to TMD using the Global Rating of Change Scale (GRCS) as an anchor. (2) To verify which outcomes can predict a moderate or large response to the treatment. STUDY DESIGN Secondary analysis of a randomized controlled trial in subjects with TMD. METHODS Sixty-one women with TMD were divided into intervention and control groups. Visual Analogue Scale (VAS), Headache Impact Test (HIT-6), pressure pain thresholds (PPTs) of masticatory muscles, Mandibular Function Impairment Questionnaire (MFIQ), and Craniocervical Flexion Test (CCFT) were collected at baseline and 5-weeks follow-up. RESULTS Participants were divided based on their response to the treatment, according to the GRCS. MCID values were provided for subjects that moderately or largely improved to the treatment. MCID was between 0 and 1.90 for orofacial pain, around 2 points for the MFIQ, between 3 and 6.26 points for the HIT-6, around 0.2 kg/cm2 for the PPTs on masticatory muscles, around 2.5 mm for MMO and between 60 and 68 points for CCFT. Orofacial pain and HIT-6 were the most discriminative variables at determining whether patients would largely/moderately improve or would not improve after treatment. CONCLUSIONS The values of MCID could be used as guidance for both clinical practice and research. Pain intensity and headache impact were the most predictive outcomes for improvement of the general health status of women with TMD.
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Affiliation(s)
- Letícia Bojikian Calixtre
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Ana Beatriz Oliveira
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Francisco Alburquerque-Sendín
- Department of Sociosanitary Sciences, Radiology and Physical Medicine, University of Córdoba, GC05 Systemic and Chronic Inflammatory Autoimmune Diseases of the Locomotor System and Connective Tissue, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Susan Armijo-Olivo
- University of Applied Sciences, Faculty of Business and Social Sciences, Osnabrück, Germany; Faculty of Rehabilitation Medicine/Faculty of Medicine and Dentistry, Department of Physical Therapy, University of Alberta, Edmonton, Canada
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12
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Can Myofascial Interventions Have a Remote Effect on ROM? A Systematic Review and Meta-Analysis. J Sport Rehabil 2019; 29:650-656. [PMID: 31629335 DOI: 10.1123/jsr.2019-0074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/12/2019] [Accepted: 05/27/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Anatomical and in vivo studies suggest that muscles function synergistically as part of a myofascial chain. A related theory is that certain myofascial techniques have a remote and clinically important effect on range of motion (ROM). OBJECTIVE To determine if remote myofascial techniques can effectively increase the range of motion at a distant body segment. EVIDENCE ACQUISITION In November 2018, the authors searched 3 electronic databases (CENTRAL, MEDLINE, and PEDro) and hand-searched journals and conference proceedings. Inclusion criteria were randomized controlled trials comparing remote myofascial techniques with passive intervention (rest/sham) or local treatment intervention. The primary outcome of interest was ROM. Quality assessment was performed using the PEDro Scale. Three authors independently evaluated study quality and extracted data. RevMan software was used to pool data using a fixed-effect model. EVIDENCE SYNTHESIS Eight randomized controlled trials, comprising N = 354 participants were included (mean age range 22-36 y; 50% female). Study quality was low with PEDro scores ranging from 2 to 7 (median scores 4.5/10). None of the studies incorporated adequate allocation concealment and just 2 used blinded assessment of outcomes. In all studies, treatments and outcomes were developed around the same myofascial chain (superficial back line). Five studies included comparisons between remote interventions to sham or inactive controls; pooled results for ROM showed trends in favor of remote interventions (standard mean difference 0.23; 95% confidence intervals; -0.09 to 0.55; 4 studies) at immediate follow-ups. Effects sizes were small, corresponding to mean differences of 9% or 5° in cervical spine ROM, and 1 to 3 cm in sit and reach distance. Four studies compared remote interventions to local treatments, but there were few differences between groups. CONCLUSIONS Remote exercise interventions may increase ROM at distant body segments. However, effect sizes are small and the current evidence base is limited by selection and measurement bias.
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13
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González-Rueda V, López-de-Celis C, García-Barrull A, Cid-Quintas M, Bonnet A, Carrasco-Uribarren A, Barra-López ME. Comparative study of the effects of two inhibitory suboccipital techniques in non-symptomatic subjects with limited cervical mobility. J Back Musculoskelet Rehabil 2019; 31:1193-1200. [PMID: 30056410 DOI: 10.3233/bmr-160756] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hypomobility on a cervical segment is a frequent finding which is sometimes asymptomatic. The effects of inhibitory suboccipital techniques on cervical mobility have not been evaluated. OBJECTIVE To compare the effect on cervical mobility, of pressure maintained suboccipital inhibition manual technique versus a self-treatment using an Occipivot cushion, in asymptomatic subjects with limited mobility assessed by the flexion-rotation test. METHODS Before-after randomized uncontrolled trial. Thirty-two subjects were recruited and randomized into two groups: Manual Group and Instrumental Group, receiving a single session of the assigned technique. Upper and overall cervical spine mobility was measured. Subjective sensation during technique application and post-treatment, and number and intensity of headache episodes during the following 15 days after treatment were also registered. RESULTS Comparing with the Instrumental Group, the Manual Group showed statistically significant improvements on flexion-rotation test (p< 0.01 to p< 0.03), upper cervical extension (p< 0.01), overall right rotation (p< 0.05) and overall right (p< 0.01) and left (p< 0.01) side-bending. CONCLUSION In asymptomatic subjects with limited cervical mobility, pressure maintained suboccipital inhibition manual technique achieves further improvement on cervical range of motion than the technique using the Occipivot cushion.
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Affiliation(s)
- Vanessa González-Rueda
- Baix Llobregat Centre Rehabilitation Service, DAP Costa de Ponent, Catalan Institute of Health, Barcelona, Spain.,Jordi Gol Institute of Research on Primary Health Care, Barcelona, Spain.,OMT, Spain
| | - Carlos López-de-Celis
- Baix Llobregat Centre Rehabilitation Service, DAP Costa de Ponent, Catalan Institute of Health, Barcelona, Spain.,Jordi Gol Institute of Research on Primary Health Care, Barcelona, Spain.,Faculty of Medicine and Health Sciences, International University of Catalonia, Barcelona, Spain.,OMT, Spain
| | | | | | | | | | - Martín Eusebio Barra-López
- Jordi Gol Institute of Research on Primary Health Care, Barcelona, Spain.,Faculty of Medicine and Health Sciences, International University of Catalonia, Barcelona, Spain.,OMT, Spain
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Jeong ED, Kim CY, Kim SM, Lee SJ, Kim HD. Short-term effects of the suboccipital muscle inhibition technique and cranio-cervical flexion exercise on hamstring flexibility, cranio-vertebral angle, and range of motion of the cervical spine in subjects with neck pain: A randomized controlled trial. J Back Musculoskelet Rehabil 2019; 31:1025-1034. [PMID: 30248030 DOI: 10.3233/bmr-171016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cervical spinal instability often leads to neck pain and forward head posture (FHP). To improve neck pain and FHP, both the suboccipital muscle inhibition (SMI) technique and cranio-cervical flexion exercise (CCFE) have been used. However, little is known regarding the validity of hamstring flexibility in neck pain subjects after CCFE as a treatment index, and comparison between the SMI technique and CCFE for neck pain treatment. OBJECTIVE This study aimed to determine the short-term effects of SMI technique and CCFE, which represent passive and active exercise programs, respectively, and whether these improve the straight leg raise (SLR) test results, popliteal angle (PA), cranio-vertebral angle (CVA), and cervical range of motion (CROM) and are equally effective in immediate enhancement of such measures in neck pain subjects. METHODS Twenty subjects with neck pain were randomly allocated to the SMI and CCFE groups (n= 10 each). The outcomes were evaluated via clinical evaluation and SLR, PA, CVA, and CROM measurement before and after intervention. RESULTS SLR test results, PA, CVA (sitting and standing), and CROM (flexion, extension, lateral flexion, and right and left rotations) after both interventions were significantly higher than those before the interventions (P< 0.05). The SLR test results (left), PA, and CVA (standing) after the SMI technique improved to levels similar to those observed after CCFE. CONCLUSIONS Both the SMI technique and CCFE improve SLR test results, PA, CVA, and CROM and are equally effective in immediate enhancement of the hamstring flexibility, CVA, and CROM in subjects with neck pain.
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Affiliation(s)
- Eun-Dong Jeong
- Department of Physical Therapy, College of Health Sciences, Korea University, Seoul 02841, Korea
| | - Chang-Yong Kim
- Scientific Instruments Reliability Assessment Center, Korea Basic Science Institute, Daejeon 34133, Korea
| | - Seung-Min Kim
- Department of Physical Therapy, College of Health Sciences, Korea University, Seoul 02841, Korea
| | - Seok-Jun Lee
- Department of Physical Medicine and Rehabilitation, College of Medicine, Korea University, Seoul 02841, Korea
| | - Hyeong-Dong Kim
- Department of Physical Therapy, College of Health Sciences, Korea University, Seoul 02841, Korea
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15
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Raţă BC, Raţă M, Antohe B. Morpho-functional implications of myofascial stretching applied to muscle chains: A case study. J Back Musculoskelet Rehabil 2018; 31:749-758. [PMID: 29578477 DOI: 10.3233/bmr-170998] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Most lesions of the soft tissues, especially those at the muscle level, are due to the lack of elasticity of the connective tissue and fascia. Stretching is one of the most commonly used methods of treatment for such musculoskeletal issues. OBJECTIVE This study tracks the effects of stretching on the electromyographic activity of muscle chains, applied to a 24-year-old athlete diagnosed with the Haglund's disease. METHOD For the evaluation, we used visual examination and surface electromyography (maximum volumetric isometric contraction). The therapeutic intervention consisted in the application of the static stretching positions, which intended the elongation of the shortened muscle chains. The treatment program had a duration of 2 months, with a frequency of 2 sessions per week and an average duration of 60 minutes. RESULTS The posterior muscle chains recorded an increase in the EMG activity, while the anterior muscle chains tended to diminish their EMG activity. As a result of the applied treatment, all the evaluated muscle chains recorded a rebalancing of the electromyographic activity, demonstrating the efficiency of stretching as a method of global treatment of muscle chains. CONCLUSIONS By analysing all the data, we have come to the conclusion that static stretching is an effective treatment method for shortened muscle chains.
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16
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Shih HS, Chen SS, Cheng SC, Chang HW, Wu PR, Yang JS, Lee YS, Tsou JY. Effects of Kinesio taping and exercise on forward head posture. J Back Musculoskelet Rehabil 2018; 30:725-733. [PMID: 28282792 DOI: 10.3233/bmr-150346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Little is known about the effects of Kinesio taping and therapeutic exercise on correcting forward head posture. OBJECTIVE To compare Kinesio taping versus therapeutic exercise for forward head posture on static posture, dynamic mobility and functional outcomes. METHODS Sixty subjects (31 women, 29 men) with forward head postures participated in this study. They were randomly assigned to either one of the three groups: (1) exercise group (n = 20), (2) taping group (n = 20), and (3) control groups (n = 20). The horizontal forward displacement (HFD) between ear lobe and acromion process, upper cervical and lower cervical angle (UCA, LCA), active range of motion (AROM) of cervical spine, and neck disability index (NDI) were measured before and after a 5-week intervention, and a 2-week follow-up. Data were analyzed by means of a mixed design repeated-measures ANOVA. RESULTS Both taping and exercise groups showed significant improvements in HFD compared with the control group at post-treatment and follow-up. Compared with the control group, the exercise group exhibited significant improvements in the LCA and the side bending AROM at post-treatment. CONCLUSIONS Both Kinesio taping and therapeutic exercise improve forward head posture after intervention and a 2-week follow-up. The effectiveness of therapeutic exercise is better than taping.
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Affiliation(s)
- Hsu-Sheng Shih
- Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan
| | - Shu-Shi Chen
- Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan
| | - Su-Chun Cheng
- Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan
| | - Hsun-Wen Chang
- Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan
| | - Pei-Rong Wu
- Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan
| | - Jin-Shiou Yang
- Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan
| | - Yi-Shuang Lee
- Department of Rehabilitation, Dajia Lees General Hospital Lees Medical Corporation, Taichung, Taiwan
| | - Jui-Yi Tsou
- Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan
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17
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Jung J, Choi W, Lee Y, Kim J, Kim H, Lee K, Lee J, Lee S. Immediate effect of self-myofascial release on hamstring flexibility. ACTA ACUST UNITED AC 2017. [DOI: 10.14474/ptrs.2017.6.1.45] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Jihye Jung
- Physical Therapy Team, Hangeoleum Rehabilitation Hospital, Seoul, Republic of Korea
| | - Wonjae Choi
- Department of Physical Therapy, Health and Welfare Graduate School, Seoul, Republic of Korea
| | - Yonghyuk Lee
- Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, Seoul, Republic of Korea
| | - Jiwoo Kim
- Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, Seoul, Republic of Korea
| | - Hyunju Kim
- Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, Seoul, Republic of Korea
| | - Kyoungho Lee
- Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, Seoul, Republic of Korea
| | - Jaewoo Lee
- Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, Seoul, Republic of Korea
| | - Seungwon Lee
- Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, Seoul, Republic of Korea
- Institute of Rehabilitation Science, Sahmyook University, Seoul, Republic of Korea
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18
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Cruz-Montecinos C, Godoy-Olave D, Contreras-Briceño FA, Gutiérrez P, Torres-Castro R, Miret-Venegas L, Engel RM. The immediate effect of soft tissue manual therapy intervention on lung function in severe chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2017; 12:691-696. [PMID: 28260875 PMCID: PMC5327901 DOI: 10.2147/copd.s127742] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVE In chronic obstructive pulmonary disease (COPD), accessory respiratory muscles are recruited as a compensatory adaptation to changes in respiratory mechanics. This results in shortening and overactivation of these and other muscles. Manual therapy is increasingly being investigated as a way to alleviate these changes. The aim of this study was to measure the immediate effect on lung function of a soft tissue manual therapy protocol (STMTP) designed to address changes in the accessory respiratory muscles and their associated structures in patients with severe COPD. METHODS Twelve medically stable patients (n=12) with an existing diagnosis of severe COPD (ten: GOLD Stage III and two: GOLD Stage IV) were included. Residual volume, inspiratory capacity and oxygen saturation (SpO2) were recorded immediately before and after administration of the STMTP. A Student's t-test was used to determine the effect of the manual therapy intervention (P<0.05). RESULTS The mean age of the patients was 62.4 years (range 46-77). Nine were male. Residual volume decreased from 4.5 to 3.9 L (P=0.002), inspiratory capacity increased from 2.0 to 2.1 L (P=0.039) and SpO2 increased from 93% to 96% (P=0.001). CONCLUSION A single application of an STMTP appears to have the potential to produce immediate clinically meaningful improvements in lung function in patients with severe and very severe COPD.
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Affiliation(s)
- Carlos Cruz-Montecinos
- Laboratory of Biomechanics and Kinesiology, San José Hospital, Santiago, Chile; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Unit of Kinesiology and Physical Therapy, San José Hospital, Santiago, Chile
| | - Diego Godoy-Olave
- Departamento de Kinesiología, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile
| | | | - Paulina Gutiérrez
- Departamento de Kinesiología, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile
| | - Rodrigo Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Roger M Engel
- Department of Chiropractic, Macquarie University, Sydney, Australia
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Ozmen T, Yagmur Gunes G, Dogan H, Ucar I, Willems M. The effect of kinesio taping versus stretching techniques on muscle soreness, and flexibility during recovery from nordic hamstring exercise. J Bodyw Mov Ther 2017; 21:41-47. [DOI: 10.1016/j.jbmt.2016.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 03/16/2016] [Accepted: 03/21/2016] [Indexed: 12/14/2022]
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20
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Cruz-Montecinos C, Cerda M, Sanzana-Cuche R, Martín-Martín J, Cuesta-Vargas A. Ultrasound assessment of fascial connectivity in the lower limb during maximal cervical flexion: technical aspects and practical application of automatic tracking. BMC Sports Sci Med Rehabil 2016; 8:18. [PMID: 27403319 PMCID: PMC4939606 DOI: 10.1186/s13102-016-0043-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 06/15/2016] [Indexed: 01/14/2023]
Abstract
Background The fascia provides and transmits forces for connective tissues, thereby regulating human posture and movement. One way to assess the myofascial interaction is a fascia ultrasound recording. Ultrasound can follow fascial displacement either manually or automatically through two-dimensional (2D) method. One possible method is the iterated Lucas-Kanade Pyramid (LKP) algorithm, which is based on automatic pixel tracking during passive movements in 2D fascial displacement assessments. Until now, the accumulated error over time has not been considered, even though it could be crucial for detecting fascial displacement in low amplitude movements. The aim of this study was to assess displacement of the medial gastrocnemius fascia during cervical spine flexion in a kyphotic posture with the knees extended and ankles at 90°. Methods The ultrasound transducer was placed on the extreme dominant belly of the medial gastrocnemius. Displacement was calculated from nine automatically selected tracking points. To determine cervical flexion, an established 2D marker protocol was implemented. Offline pressure sensors were used to synchronize the 2D kinematic data from cervical flexion and deep fascia displacement of the medial gastrocnemius. Results Fifteen participants performed the cervical flexion task. The basal tracking error was 0.0211 mm. In 66 % of the subjects, a proximal fascial tissue displacement of the fascia above the basal error (0.076 mm ± 0.006 mm) was measured. Fascia displacement onset during cervical spine flexion was detected over 70 % of the cycle; however, only when detected for more than 80 % of the cycle was displacement considered statistically significant as compared to the first 10 % of the cycle (ANOVA, p < 0.05). Conclusion By using an automated tracking method, the present analyses suggest statistically significant displacement of deep fascia. Further studies are needed to corroborate and fully understand the mechanisms associated with these results.
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Affiliation(s)
- Carlos Cruz-Montecinos
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile ; Laboratory of Biomechanics, San José Hospital, Santiago, Chile
| | - Mauricio Cerda
- SCIAN-Lab, Programa de Anatomía y Biología del Desarrollo, ICBM, University of Chile, Santiago, Chile
| | - Rodolfo Sanzana-Cuche
- Departamento de Ciencias Morfológicas, Facultad de Ciencia, Universidad San Sebastián, Santiago, Chile
| | - Jaime Martín-Martín
- Escuela de Terapia Ocupacional, Facultad de Salud, Deporte y Recreación, Universidad Bernardo O Higgins, Santiago, Chile ; Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Instituto Investigacion Biomedica de Málaga (IBIMA), Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y DiscapacidadGrupo de Clinimetria (FE-14), Málaga, Spain
| | - Antonio Cuesta-Vargas
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Instituto Investigacion Biomedica de Málaga (IBIMA), Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y DiscapacidadGrupo de Clinimetria (FE-14), Málaga, Spain ; School of Clinical Science, Faculty of Health Sciences at Queensland University Technology, Brisbane, Australia ; Facultad de Ciencias de la Salud, Universidad de Málaga, Av. Arquitecto Peñalosa s/n (Teatinos Campus Expansion), 29009 Málaga, Spain
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Espejo-Antúnez L, Castro-Valenzuela E, Ribeiro F, Albornoz-Cabello M, Silva A, Rodríguez-Mansilla J. Immediate effects of hamstring stretching alone or combined with ischemic compression of the masseter muscle on hamstrings extensibility, active mouth opening and pain in athletes with temporomandibular dysfunction. J Bodyw Mov Ther 2016; 20:579-87. [DOI: 10.1016/j.jbmt.2015.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 11/16/2015] [Accepted: 12/14/2015] [Indexed: 12/28/2022]
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22
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Espejo-Antúnez L, López-Miñarro P, Albornoz-Cabello M, Garrido-Ardila E. Acute effect of electrical muscle elongation and static stretching in hamstring muscle extensibility. Sci Sports 2016. [DOI: 10.1016/j.scispo.2015.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Demoulin C, Wolfs S, Chevalier M, Granado C, Grosdent S, Depas Y, Roussel N, Hage R, Vanderthommen M. A comparison of two stretching programs for hamstring muscles: A randomized controlled assessor-blinded study. Physiother Theory Pract 2016; 32:53-62. [DOI: 10.3109/09593985.2015.1091533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Piper S, Shearer HM, Côté P, Wong JJ, Yu H, Varatharajan S, Southerst D, Randhawa KA, Sutton DA, Stupar M, Nordin MC, Mior SA, van der Velde GM, Taylor-Vaisey AL. The effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities: A systematic review by the Ontario Protocol for Traffic Injury management (OPTIMa) collaboration. ACTA ACUST UNITED AC 2015; 21:18-34. [PMID: 26386912 DOI: 10.1016/j.math.2015.08.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 04/29/2015] [Accepted: 08/21/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Soft-tissue therapy is commonly used to manage musculoskeletal injuries. OBJECTIVE To determine the effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities. DESIGN Systematic Review. METHODS We searched six databases from 1990 to 2015 and critically appraised eligible articles using Scottish Intercollegiate Guidelines Network (SIGN) criteria. Evidence from studies with low risk of bias was synthesized using best-evidence synthesis methodology. RESULTS We screened 9869 articles and critically appraised seven; six had low risk of bias. Localized relaxation massage provides added benefits to multimodal care immediately post-intervention for carpal tunnel syndrome. Movement re-education (contraction/passive stretching) provides better long-term benefit than one corticosteroid injection for lateral epicondylitis. Myofascial release improves outcomes compared to sham ultrasound for lateral epicondylitis. Diacutaneous fibrolysis (DF) or sham DF leads to similar outcomes in pain intensity for subacromial impingement syndrome. Trigger point therapy may provide limited or no additional benefit when combined with self-stretching for plantar fasciitis; however, myofascial release to the gastrocnemius, soleus and plantar fascia is effective. CONCLUSION Our review clarifies the role of soft-tissue therapy for the management of upper and lower extremity musculoskeletal disorders and injuries. Myofascial release therapy was effective for treating lateral epicondylitis and plantar fasciitis. Movement re-education was also effective for managing lateral epicondylitis. Localized relaxation massage combined with multimodal care may provide short-term benefit for treating carpal tunnel syndrome. More high quality research is needed to study the appropriateness and comparative effectiveness of this widely utilized form of treatment.
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Affiliation(s)
- Steven Piper
- Department of Graduate Studies, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1
| | - Heather M Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1.
| | - Pierre Côté
- Canada Research Chair in Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Oshawa, Ontario, Canada L1H 7K4; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Oshawa, Ontario, Canada L1H 7K4; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1
| | - Jessica J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1; Division of Undergraduate Education, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1
| | - Hainan Yu
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1
| | - Sharanya Varatharajan
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1; Division of Undergraduate Education, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1
| | - Danielle Southerst
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1; Division of Undergraduate Education, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1
| | - Kristi A Randhawa
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1; Division of Undergraduate Education, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1
| | - Deborah A Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1
| | - Maja Stupar
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1
| | - Margareta C Nordin
- Department of Orthopedic Surgery, Occupational and Industrial Orthopedic Center, NYU School of Medicine, New York University, 63 Downing Street, New York, NY 10014, USA; Department of Environmental Medicine, Occupational and Industrial Orthopedic Center, NYU School of Medicine, New York University, 63 Downing Street, New York, NY 10014, USA
| | - Silvano A Mior
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Oshawa, Ontario, Canada L1H 7K4
| | - Gabrielle M van der Velde
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, Leslie Dan Pharmacy Building, University of Toronto, 6th Floor, Room 658, 144 College Street, Toronto, Ontario, Canada M5S 3M2; Faculty of Pharmacy, University of Toronto, Leslie Dan Pharmacy Building, University of Toronto, 144 College Street, Toronto, Ontario, Canada M5S 3M2; Institute for Work and Health, 481 University Ave., Toronto, Ontario, Canada M5G 2E9
| | - Anne L Taylor-Vaisey
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St., Toronto, Ontario, Canada M2H 3J1
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Rodriguez-Blanco C, Cocera-Morata FM, Heredia-Rizo AM, Ricard F, Almazán-Campos G, Oliva-Pascual-Vaca Á. Immediate Effects of Combining Local Techniques in the Craniomandibular Area and Hamstring Muscle Stretching in Subjects with Temporomandibular Disorders: A Randomized Controlled Study. J Altern Complement Med 2015. [PMID: 26218883 DOI: 10.1089/acm.2014.0332] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To assess the immediate effects on vertical mouth opening, orofacial mechanosensitivity, and lumbar and suboccipital mobility after adding a myofascial induction technique to a multimodal protocol in subjects with temporomandibular disorders (TMD). DESIGN A randomized and double-blind controlled trial was carried out. SETTINGS/LOCATION University-based physical therapy research clinic. SUBJECTS Sixty subjects (35±11.22 years) with TMD, and restricted mobility of the mandibular condyles and the first cervical vertebrae, were recruited and randomized to either a control group (CG) (n=30) or an experimental group (EG) (n=30). INTERVENTIONS The CG underwent a neuromuscular technique over the masseter muscles and passive hamstring muscle stretching. A suboccipital muscle inhibition technique was added to this protocol in the EG. OUTCOME MEASURES Primary measurements were made of vertical mouth opening and pressure pain threshold of the masseter muscles. Secondary outcome measures included pressure algometry of the trigeminal nerve, suboccipital range of motion, and lumbar spine mobility, assessed with the sit-and-reach (SAR) test and lumbar forward bending. All evaluations were collected at baseline and immediately after intervention. RESULTS In the intragroup comparison, the EG observed an increase in suboccipital flexion (p<0.001; F1,29=14.47; R(2)=0.33) and the SAR test (p=0.009; F1,29=7.89; R(2)=0.21). No significant differences were found in the between-group comparison for any variable (p>0.05). CONCLUSION The inclusion of a myofascial induction maneuver in a protocol combining local (neuromuscular treatment) and distal techniques (hamstring stretching) in subjects with TMD has no impact on improving mouth opening, suboccipital and lumbar mobility, and orofacial sensitivity to mechanical pressure.
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Affiliation(s)
- Cleofás Rodriguez-Blanco
- 1 Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla , Sevilla, Spain
| | | | - Alberto Marcos Heredia-Rizo
- 1 Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla , Sevilla, Spain
| | | | | | - Ángel Oliva-Pascual-Vaca
- 1 Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla , Sevilla, Spain
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Cho SH, Kim SH, Park DJ. The comparison of the immediate effects of application of the suboccipital muscle inhibition and self-myofascial release techniques in the suboccipital region on short hamstring. J Phys Ther Sci 2015; 27:195-7. [PMID: 25642072 PMCID: PMC4305561 DOI: 10.1589/jpts.27.195] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 08/03/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to research the effect of performing the suboccipital muscle inhibition (SMI) and self-myofascial release (SMFR) techniques in the suboccipital area on the flexibility of the hamstring. [Subjects] Fifty persons with short hamstrings participated in this research. According to the results of the finger-floor distance (FFD) test, the subjects were allocated to SMI and SMFR groups of 25 subjects each. [Methods] The SMI and SMFR techniques were applied to the groups. For the analysis, we used the FFD test and the straight leg raise (SLR) test for the flexibility of hamstring. The evaluator was blindfolded. [Results] In the SMI group, FFD, SLR, and PA were significantly changed after the intervention, and in the SMFR group, there was a significant change in SLR after the intervention. In a comparison between the groups, FED was found to be significantly increased in the SMI group. [Conclusion] Application of the SMI and SMFR to persons with short hamstrings resulted in immediate increases in flexibility of the hamstring. However, we could see that the SMI technique was more effective.
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Affiliation(s)
- Sung-Hak Cho
- Department of Physical Therapy, Graduate School, Catholic University of Pusan, Republic of Korea
| | - Soo-Han Kim
- Department of Physical Therapy, College of Health Medicine, Kaya University, Republic of Korea
| | - Du-Jin Park
- Department of Physical Therapy, College of Health Medicine, Kaya University, Republic of Korea
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Antolinos-Campillo P, Oliva-Pascual-Vaca Á, Rodríguez-Blanco C, Heredia-Rizo A, Espí-López G, Ricard F. Short-term changes in median nerve neural tension after a suboccipital muscle inhibition technique in subjects with cervical whiplash: a randomised controlled trial. Physiotherapy 2014; 100:249-55. [DOI: 10.1016/j.physio.2013.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 09/25/2013] [Indexed: 12/22/2022]
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Immediate Effects of Neurodynamic Sliding versus Muscle Stretching on Hamstring Flexibility in Subjects with Short Hamstring Syndrome. JOURNAL OF SPORTS MEDICINE 2014; 2014:127471. [PMID: 26464889 PMCID: PMC4590905 DOI: 10.1155/2014/127471] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 03/24/2014] [Accepted: 03/25/2014] [Indexed: 11/25/2022]
Abstract
Background. Hamstring injuries continue to affect active individuals and although inadequate muscle extensibility remains a commonly accepted factor, little is known about the most effective method to improve flexibility. Purpose. To determine if an isolated neurodynamic sciatic sliding technique would improve hamstring flexibility to a greater degree than stretching or a placebo intervention in asymptomatic subjects with short hamstring syndrome (SHS). Study Design. Randomized double-blinded controlled trial. Methods. One hundred and twenty subjects with SHS were randomized to 1 of 3 groups: neurodynamic sliding, hamstring stretching, and placebo control. Each subject's dominant leg was measured for straight leg raise (SLR) range of motion (ROM) before and after interventions. Data were analyzed with a 3 × 2 mixed model ANOVA followed by simple main effects analyses. Results. At the end of the study, more ROM was observed in the Neurodynamic and Stretching groups compared to the Control group and more ROM in the Neurodynamic group compared to Stretching group. Conclusion. Findings suggest that a neurodynamic sliding technique will increase hamstring flexibility to a greater degree than static hamstring stretching in healthy subjects with SHS. Clinical Relevance. The use of neurodynamic sliding techniques to improve hamstring flexibility in sports may lead to a decreased incidence in injuries; however, this needs to be formally tested.
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Effects of a neurodynamic sliding technique on hamstring flexibility in healthy male soccer players. A pilot study. Phys Ther Sport 2013; 14:156-62. [DOI: 10.1016/j.ptsp.2012.07.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 07/01/2012] [Accepted: 07/11/2012] [Indexed: 11/24/2022]
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Heredia-Rizo AM, Oliva-Pascual-Vaca Á, Rodríguez-Blanco C, Piña-Pozo F, Luque-Carrasco A, Herrera-Monge P. Immediate Changes in Masticatory Mechanosensitivity, Mouth Opening, and Head Posture After Myofascial Techniques in Pain-Free Healthy Participants: A Randomized Controlled Trial. J Manipulative Physiol Ther 2013; 36:310-8. [DOI: 10.1016/j.jmpt.2013.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 01/27/2013] [Accepted: 02/20/2013] [Indexed: 12/25/2022]
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Gay CW, Alappattu MJ, Coronado RA, Horn ME, Bishop MD. Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials. J Pain Res 2013; 6:7-22. [PMID: 23403507 PMCID: PMC3569047 DOI: 10.2147/jpr.s37272] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Muscle-biased therapies (MBT) are commonly used to treat pain, yet several reviews suggest evidence for the clinical effectiveness of these therapies is lacking. Inadequate treatment parameters have been suggested to account for inconsistent effects across studies. Pain sensitivity may serve as an intermediate physiologic endpoint helping to establish optimal MBT treatment parameters. The purpose of this review was to summarize the current literature investigating the short-term effect of a single dose of MBT on pain sensitivity in both healthy and clinical populations, with particular attention to specific MBT parameters of intensity and duration. METHODS A systematic search for articles meeting our prespecified criteria was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE from the inception of each database until July 2012, in accordance with guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analysis. Relevant characteristics from studies included type, intensity, and duration of MBT and whether short-term changes in pain sensitivity and clinical pain were noted with MBT application. Study results were pooled using a random-effects model to estimate the overall effect size of a single dose of MBT on pain sensitivity as well as the effect of MBT, dependent on comparison group and population type. RESULTS Reports from 24 randomized controlled trials (23 articles) were included, representing 36 MBT treatment arms and 29 comparative groups, where 10 groups received active agents, 11 received sham/inert treatments, and eight received no treatment. MBT demonstrated a favorable and consistent ability to modulate pain sensitivity. Short-term modulation of pain sensitivity was associated with short-term beneficial effects on clinical pain. Intensity of MBT, but not duration, was linked with change in pain sensitivity. A meta-analysis was conducted on 17 studies that assessed the effect of MBT on pressure pain thresholds. The results suggest that MBT had a favorable effect on pressure pain thresholds when compared with no-treatment and sham/inert groups, and effects comparable with those of other active treatments. CONCLUSION The evidence supports the use of pain sensitivity measures by future research to help elucidate optimal therapeutic parameters for MBT as an intermediate physiologic marker.
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Affiliation(s)
- Charles W Gay
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Meryl J Alappattu
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Rogelio A Coronado
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Maggie E Horn
- Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, Gainesville, FL
| | - Mark D Bishop
- Department of Physical Therapy, University of Florida, Gainesville, FL
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Affiliation(s)
- Chad Cook
- Walsh University, North Canton, OH, USA
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Immediate effects of the suboccipital muscle inhibition technique in craniocervical posture and greater occipital nerve mechanosensitivity in subjects with a history of orthodontia use: a randomized trial. J Manipulative Physiol Ther 2012; 35:446-53. [PMID: 22902193 DOI: 10.1016/j.jmpt.2012.06.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 05/26/2012] [Accepted: 06/07/2012] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The purpose of this study was to measure the immediate differences in craniocervical posture and pressure pain threshold of the greater occipital (GO) nerve in asymptomatic subjects with a history of having used orthodontics, after intervention by a suboccipital muscle inhibition (SMI) technique. METHODS This was a randomized, single-blind, clinical study with a sample of 24 subjects (21±1.78 years) that were divided into an experimental group (n=12) who underwent the SMI technique and a sham group (n=12) who underwent a sham (placebo) intervention. The sitting and standing craniovertebral angle and the pressure pain threshold of the GO nerve in both hemispheres were measured. RESULTS The between-group comparison of the sample indicated that individuals subjected to the SMI technique showed a statistically significant increase in the craniovertebral angle in both the sitting (P<.001, F1,22=102.09, R2=0.82) and the standing (P<.001, F1,22=21.42, R2=0.56) positions and in the GO nerve pressure pain threshold in the nondominant hemisphere (P=.014, F1,22=7.06, R2=0.24). There were no statistically significant differences observed for the GO nerve mechanosensitivity in the dominant side (P=.202). CONCLUSION Suboccipital muscle inhibition technique immediately improved the position of the head with the subject seated and standing, the clinical effect size being large in the former case. It also immediately decreased the mechanosensitivity of the GO nerve in the nondominant hemisphere, although the effect size was small.
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The immediate effects of atlanto-occipital joint manipulation and suboccipital muscle inhibition technique on active mouth opening and pressure pain sensitivity over latent myofascial trigger points in the masticatory muscles. J Orthop Sports Phys Ther 2010; 40:310-7. [PMID: 20436241 DOI: 10.2519/jospt.2010.3257] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
DESIGN A randomized controlled trial. OBJECTIVE To investigate the immediate effects on pressure pain thresholds over latent trigger points (TrPs) in the masseter and temporalis muscles and active mouth opening following atlanto-occipital joint thrust manipulation or a soft tissue manual intervention targeted to the suboccipital muscles. BACKGROUND Previous studies have described hypoalgesic effects of neck manipulative interventions over TrPs in the cervical musculature. There is a lack of studies analyzing these mechanisms over TrPs of muscles innervated by the trigeminal nerve. METHODS One hundred twenty-two volunteers, 31 men and 91 women, between the ages of 18 and 30 years, with latent TrPs in the masseter muscle, were randomly divided into 3 groups: a manipulative group who received an atlanto-occipital joint thrust, a soft tissue group who received an inhibition technique over the suboccipital muscles, and a control group who did not receive an intervention. Pressure pain thresholds over latent TrPs in the masseter and temporalis muscles, and active mouth opening were assessed pretreatment and 2 minutes posttreatment by a blinded assessor. Mixed-model analyses of variance (ANOVA) were used to examine the effects of interventions on each outcome, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction. RESULTS The 2-by-3 mixed-model ANOVA revealed a significant group-by-time interaction for changes in pressure pain thresholds over masseter (P<.01) and temporalis (P = .003) muscle latent TrPs and also for active mouth opening (P<.001) in favor of the manipulative and soft tissue groups. Between-group effect sizes were small. CONCLUSIONS The application of an atlanto-occipital thrust manipulation or soft tissue technique targeted to the suboccipital muscles led to an immediate increase in pressure pain thresholds over latent TrPs in the masseter and temporalis muscles and an increase in maximum active mouth opening. Nevertheless, the effects of both interventions were small and future studies are required to elucidate the clinical relevance of these changes. LEVEL OF EVIDENCE Therapy, level 1b.J Orthop Sports Phys Ther 2010;40(5):310-317, Epub 12 April 2010. doi:10.2519/jospt.2010.3257.
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Bretischwerdt C, Rivas-Cano L, Palomeque-del-Cerro L, Fernández-de-las-Peñas C, Alburquerque-Sendín F. Immediate effects of hamstring muscle stretching on pressure pain sensitivity and active mouth opening in healthy subjects. J Manipulative Physiol Ther 2010; 33:42-7. [PMID: 20114099 DOI: 10.1016/j.jmpt.2009.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2009] [Revised: 07/02/2009] [Accepted: 07/21/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study analyzed the immediate effect of hamstring muscle stretching on pressure pain sensitivity over the masseter and the upper trapezius muscles and maximum active mouth opening in healthy subjects. METHODS One hundred twenty volunteers, 70 males and 50 females, between the ages of 22 and 47, were randomly divided into 3 groups: group 1 (control group) that did not receive any intervention, group 2 where a unilateral hamstring muscle stretching was applied, and group 3 where a bilateral stretching was applied. Pressure pain thresholds (PPTs) were bilaterally assessed over the masseter and upper trapezius muscles pre- and 5 minutes posttreatment by an assessor blinded to group assignment. Maximum mouth opening was also assessed pre- and 5 minutes posttreatment. Mixed-model analyses of variance (ANOVAs) were used to examine the effects of the intervention. The primary analysis was the group x time interaction. RESULTS The ANOVA revealed significant group x time interaction for changes in PPTs over the upper trapezius (F = 4.5; P = .01) and masseter (F = 6.3; P = .002) muscles. Pre-post effect sizes were moderate (0.5 >d > 0.7) for both stretching groups and negative (d < -0.2) for the control group. A significant group x time interaction (F = 8.15; P < .001) for maximum mouth opening was also found; both experimental groups showed greater improvement when compared to the control group (P < .001). Pre-post effect sizes were large (d > 0.7) for both stretching groups and negative (d < -0.2) for the control group. CONCLUSIONS The application of a stretching of the hamstring musculature produced an immediate increase in PPTs over both masseter and upper trapezius muscles in healthy subjects.
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