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Zeng D, Feng R, Xia Y, Hu C, Liu Y. Effectiveness of trigger point manual therapy for rotator cuff related shoulder pain: a systematic review and meta-analysis. Disabil Rehabil 2024:1-17. [PMID: 39189423 DOI: 10.1080/09638288.2024.2393797] [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: 11/13/2023] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 08/28/2024]
Abstract
PURPOSE To evaluate the effectiveness of trigger point manual therapy (TPMT) in treating rotator cuff related shoulder pain (RCRSP). METHODS Randomized controlled trials that compared the effects of TPMT with no or other conservative treatments in patients with RCRSP were included. Primary outcomes were shoulder pain intensity and function. Secondary outcomes were pressure pain threshold (PPT) and number of myofascial trigger points (MTrPs). The Cochrane Risk of Bias 2.0 tool, PEDro scale and GRADE approach were employed. RESULTS Ten studies were included in this systematic review and seven in the meta-analysis. Very low to low quality of evidence showed no statistically significant difference between TPMT and other conservative treatments in rest and activity pain reduction in the short term (3 days to 12 weeks), and the difference in shoulder function was statistically significant in favor of TPMT. Furthermore, TPMT was found to be effective in the improvement of PPT and the inactivation of active MTrPs in the short term. CONCLUSION TPMT may be equally effective as other passive treatments for the pain reduction in patients with RCRSP in the short term, and slightly more effective for functional improvement. TPMT seems to be effective to treat the active MTrPs in RCRSP. REGISTRATION NUMBER CRD42023409101.
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Affiliation(s)
- Dongye Zeng
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Renzhi Feng
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Yunpeng Xia
- China Institute of Exercise and Health, Beijing Sport University, Beijing, China
| | - Chenxi Hu
- Institute of Artificial Intelligence in Sports, Capital University of Physical Education and Sports, Beijing, China
| | - Yang Liu
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
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Aguilar García M, González Muñoz A, Pérez Montilla JJ, Aguilar Nuñez D, Hamed Hamed D, Pruimboom L, Navarro Ledesma S. Which Multimodal Physiotherapy Treatment Is the Most Effective in People with Shoulder Pain? A Systematic Review and Meta-Analyses. Healthcare (Basel) 2024; 12:1234. [PMID: 38921347 PMCID: PMC11203989 DOI: 10.3390/healthcare12121234] [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: 04/17/2024] [Revised: 06/09/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024] Open
Abstract
The study aimed to determine if combined physiotherapy treatments offer additional benefits over exercise-only programs for shoulder pain and to identify the most effective combined treatment. A systematic review, registered in PROSPERO (CRD42023417709), and meta-analyses were conducted. Quality analysis was performed using the PEDro scale on randomized clinical trials published from 2018 to 2023. Twenty articles met the inclusion criteria. The most commonly used combination was exercise plus manual therapy, without being statistically superior to exercise alone. The meta-analysis indicated that combining exercise with low-level laser therapy (mean difference of -1.06, 95% CI: -1.51 to -0.60) and high-intensity laser therapy (mean difference of -0.53, 95% CI: -1.12 to 0.06) resulted in the greatest reduction in SPADI scores. Adding manual therapy provided limited additional benefit (mean difference of -0.24, 95% CI: -0.74 to 0.27). Progressive exercise with advice or telerehabilitation yielded modest improvements. The multimodal meta-analysis for DASH scores showed significant improvement (mean difference of -1.06, 95% CI: -1.51 to -0.60). In conclusion, therapeutic exercise is the cornerstone of shoulder pain treatment, with the addition of laser therapy showing substantial benefits. Manual therapy and educational interventions offer some benefits but are not consistently superior. More rigorous studies are needed.
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Affiliation(s)
- Maria Aguilar García
- Biomedicine PhD Program, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
| | - Ana González Muñoz
- Clinical Medicine and Public Health PhD Program, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (A.G.M.); (J.J.P.M.); (D.H.H.)
| | - José Javier Pérez Montilla
- Clinical Medicine and Public Health PhD Program, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (A.G.M.); (J.J.P.M.); (D.H.H.)
| | - Daniel Aguilar Nuñez
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain;
| | - Dina Hamed Hamed
- Clinical Medicine and Public Health PhD Program, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (A.G.M.); (J.J.P.M.); (D.H.H.)
| | - Leo Pruimboom
- University Chair in Clinical Psychoneuroimmunology, University of Granada and PNI Europe, 52004 Melilla, Spain;
| | - Santiago Navarro Ledesma
- University Chair in Clinical Psychoneuroimmunology, University of Granada and PNI Europe, 52004 Melilla, Spain;
- Department of Physical Therapy, Faculty of Health Sciences of Melilla, University of Granada, 52004 Melilla, Spain
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Conte da Silva A, Aily JB, Mattiello SM. Ischemic compression associated with joint mobilization does not promote additional clinical effects in individuals with rotator cuff related shoulder pain: A randomized clinical trial. J Bodyw Mov Ther 2023; 36:335-342. [PMID: 37949581 DOI: 10.1016/j.jbmt.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/09/2023] [Accepted: 08/08/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE The objective of this study was to verify which are the additional effects of the ischemic compression (IC) technique associated with joint mobilization techniques on pain, morphological aspects of myofascial trigger points (MTrPs), function, and psychological aspects in individuals with rotator cuff-related shoulder pain (RCRSP). METHODS Sixty individuals with RCRSP were randomly allocated intervention sessions the Mobilization Group (MG, n = 20), only joint mobilizations of the shoulder complex; intervention sessions Compression Group (CG, n = 20), with the same mobilizations associated with the IC over MTrPs; and Placebo Group (PG, n = 20), with the same mobilizations associated with placebo of IC. All interventions performed 2 per week, for 6-weeks. Pain was assessed by Visual Analogue Scale and function by the Disabilities of the Arm, Shoulder and Hand questionnaire. The kinesiophobia, pain catastrophizing, perception of improvement, mobility, pain threshold and area the MTrPs were also evaluated at baseline (week-0), after 6-weeks and after 10-weeks. RESULTS There were no between-group difference in pain: CG-MG 0.8 (95% CI 0.4 to 1.2), CG-PG 0.5 (95% CI 0.0 to 0.9), MG-PG -0.3 (95% CI -0.8 to 0.1) after 6-weeks and CG-MG 0.1 (95% CI -0.2 to 0.5), CG-PG -0.7 (95% CI -0.9 to -0,4), MG-PG -0,8 (95% CI -1.07 to 0.5) at 10-weeks. Similar effects were observed on function, characteristics of MTrPs and psychological aspects. CONCLUSION The IC technique on the MTrPs of the upper trapezius muscle associated with joint mobilization techniques has no additional effect on pain in individuals with RCRSP. TRIAL REGISTRATION RBR-44v8y7.
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Affiliation(s)
| | - Jéssica Bianca Aily
- Physiotherapy Department, Federal University of São Carlos, São Carlos, SP, Brazil.
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Azin Z, Kamali F, Salehi Dehno N, Abolahrari-Shirazi S. Comparison of Manual Therapy Technique to Therapeutic Exercise in the Treatment of Patients With Subacromial Impingement Syndrome: A Randomized Clinical Trial. J Manipulative Physiol Ther 2023; 46:98-108. [PMID: 37777940 DOI: 10.1016/j.jmpt.2023.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/22/2023] [Accepted: 06/26/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE The purpose of this study was to compare the effects of manual therapy to therapeutic exercise on shoulder pain, disability, and range of motion (ROM) in patients with subacromial impingement syndrome (SAIS). METHODS Sixty patients with SAIS were randomly assigned into the manual therapy (MT) and therapeutic exercise (TE) groups. Patients in the MT group were treated with joint mobilization, which was applied to the glenohumeral, acromioclavicular, sternoclavicular and scapulothoracic joints, and trigger point (TrP) inactivation using ischemic compression. Patients in the TE group performed therapeutic exercises. Shoulder pain, disability and active ROM (elevation, external rotation, and internal rotation) were assessed by the visual analog scale, the Shoulder Pain and Disability Index, and a goniometer, respectively. The outcomes were measured at baseline, after the intervention, and 1 month after the intervention. RESULTS After the treatment, both groups had significant improvements in shoulder pain, disability, and ROM (P < .05). The MT group experienced a greater reduction in shoulder pain than the TE group (P < .001). However, in disability and ROM, both groups exhibited similar improvements in post-treatment and follow-up periods. CONCLUSION Both MT and TE were effective in improving shoulder pain, disability, and ROM in patients with SAIS. Greater improvement in shoulder pain was observed in the MT group.
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Affiliation(s)
- Zeynab Azin
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fahimeh Kamali
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Salehi Dehno
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Abolahrari-Shirazi
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Lavoie-Gagne O, Farah G, Lu Y, Mehta N, Parvaresh KC, Forsythe B. Physical Therapy Combined With Subacromial Cortisone Injection Is a First-Line Treatment Whereas Acromioplasty With Physical Therapy Is Best if Nonoperative Interventions Fail for the Management of Subacromial Impingement: A Systematic Review and Network Meta-Analysis. Arthroscopy 2022; 38:2511-2524. [PMID: 35189304 DOI: 10.1016/j.arthro.2022.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE To construct an algorithm to optimize clinical outcomes in subacromial impingement based on current, high-level evidence. METHODS A systematic review of all clinical trials on subacromial impingement published from 1999 to 2020 was performed. Demographic, clinical, range of motion (ROM), and patient-reported outcome measure (PROM) data were collected. Interventions were compared via arm-based Bayesian network meta-analysis in a random-effects model and treatments ranked via surface under the cumulative ranking curves with respect to 3 domains: pain, PROMs, and ROM. RESULTS A total of 35 studies comprising 3,643 shoulders (42% female, age 50 ± 5 years) were included. Arthroscopic decompression with acromioplasty ranked much greater than arthroscopic decompression alone for pain relief and PROM improvement, but the difference in absolute PROMs was not statistically significant. Corticosteroid injection (CSI) alone demonstrated inferior outcomes across all 3 domains (pain, PROMs, and ROM) with low cumulative rankings. Physical therapy (PT) with CSI demonstrated moderate-to-excellent clinical improvement across all 3 domains whereas PT alone demonstrated excellent ROM and low-moderate outcomes in pain and PROM domains. PT with nonsteroidal anti-inflammatory drugs or alternative therapies ranked highly for PROM outcomes and moderate for pain and ROM domains. Finally, platelet-rich plasma injections demonstrated moderate outcomes for pain, forward flexion, and abduction with very low-ranking outcomes for PROMs and external rotation. CONCLUSIONS Arthroscopic decompression with acromioplasty and PT demonstrated superior outcomes whereas CSI demonstrated poor outcomes in all 3 domains (pain, PROMs, and ROM). For patients with significant symptoms, the authors recommend PT with CSI as a first-line treatment, followed by acromioplasty and PT if conservative treatment fails. For patients with symptoms limited to 1 to 2 domains, the authors recommend a shared decision-making approach focusing on treatment rankings within domains pertinent to individual patient symptomatology. LEVEL OF EVIDENCE I, systematic review and network meta-analysis of Level I studies.
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Affiliation(s)
- Ophelie Lavoie-Gagne
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Ghassan Farah
- Department of Orthopaedics, University of California San Diego, San Diego, California, U.S.A
| | - Yining Lu
- Department of Orthopaedics, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Nabil Mehta
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Kevin C Parvaresh
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Brian Forsythe
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A..
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Structural validity of the Brazilian version of the Shoulder Pain and Disability Index in patients with chronic shoulder pain. J Hand Ther 2021; 35:501-506. [PMID: 33820709 DOI: 10.1016/j.jht.2021.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/30/2020] [Accepted: 01/07/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND The Shoulder Pain and Disability Index (SPADI) is a measuring instrument for pain and disability in patients with shoulder dysfunction. However, its structure is controversial (ie, 1 or 2 domains). PURPOSE To investigate the structural validity of the Brazilian version of the SPADI in patients with chronic shoulder pain. STUDY DESIGN Cross-sectional study. METHODS Brazilian Portuguese speakers of both genders aged 18 years or older with shoulder pain for at least 90 days (chronic) were included in this study. The structure of the SPADI was assessed by means of exploratory factor analysis with the implementation of parallel analysis and by confirmatory factor analysis. For the latter, the following goodness-of-fit indices were considered: root mean square error of approximation with 90% confidence interval, comparative fit index, Tucker-Lewis index, standardized root mean square residual, and chi-square/degrees of freedom. RESULTS A total of 103 participants were included in the study. The original version of the SPADI with 2 domains and 13 items showed high covariance between domains (0.98), suggesting one-dimensionality. After exploratory factor analysis with the implementation of parallel analysis, one-dimensionality was found in the SPADI. Comparing models with 1 and 2 domains by means of confirmatory factor analysis, both presented adequate values (chi-square/degrees of freedom < 3; comparative fit index and Tucker-Lewis index > 0.90; root mean square error of approximation and standardized root mean square residual < 0.08). However, the model with one domain is more suitable for presenting lower values of Akaike information criterion (3308.713) and Bayesian information criterion (3377.216). CONCLUSION The Brazilian version of the SPADI has a one-dimensional structure with 13 items ("shoulder impairment" construct), in contrast to the version with 2 domains.
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de Paula Gomes CAF, Dibai-Filho AV, Politti F, de Oliveira AR, de Souza Bacelar Pereira C, da Silva ACB, Biasotto-Gonzalez DA. Photobiomodulation therapy and the clinical reality in Brazil: response to the letter to the editor. BMC Musculoskelet Disord 2021; 22:59. [PMID: 33423658 PMCID: PMC7798227 DOI: 10.1186/s12891-020-03906-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/22/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Cid André Fidelis de Paula Gomes
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Rua Vergueiro, 235/249, 2° Subsolo, Liberdade, São Paulo, SP, CEP 01504-001, Brazil.
| | - Almir Vieira Dibai-Filho
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Fabiano Politti
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Rua Vergueiro, 235/249, 2° Subsolo, Liberdade, São Paulo, SP, CEP 01504-001, Brazil
| | - Adriano Rodrigues de Oliveira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Rua Vergueiro, 235/249, 2° Subsolo, Liberdade, São Paulo, SP, CEP 01504-001, Brazil
| | - Cheila de Souza Bacelar Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Rua Vergueiro, 235/249, 2° Subsolo, Liberdade, São Paulo, SP, CEP 01504-001, Brazil
| | - Aron Charles Barbosa da Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Rua Vergueiro, 235/249, 2° Subsolo, Liberdade, São Paulo, SP, CEP 01504-001, Brazil
| | - Daniela Aparecida Biasotto-Gonzalez
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Rua Vergueiro, 235/249, 2° Subsolo, Liberdade, São Paulo, SP, CEP 01504-001, Brazil
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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: 26] [Impact Index Per Article: 6.5] [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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Effectiveness of Hydrogalvanic Bath on Improving Pain, Disability, and Quality of Life in Individuals with Chronic Nonspecific Neck Pain: A Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:7974816. [PMID: 33082830 PMCID: PMC7559532 DOI: 10.1155/2020/7974816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/14/2020] [Accepted: 09/22/2020] [Indexed: 12/02/2022]
Abstract
Background Neck pain is one of the world's leading factors in years lived with disability. Ambiguity in the effect of electrotherapy modalities for the treatment of chronic nonspecific neck pains (CNSNP) needs to be examined further. This study sought to elucidate the effectiveness of hydrogalvanic bath on improving pain, disability, and quality of life among individuals with CNSNP. Methods Thirty-four individuals with a diagnosis of CNSNP were selected through convenient sampling and randomly divided into two groups by block randomization. The control group treatment underwent low Transcutaneous Electrical Nerve Stimulation (TENS) and exercise, and the experimental group was subjected to hydrogalvanic bath therapy (HGBT) and exercise. Individuals were evaluated for pain using a visual analog scale (VAS), disability with the Neck Disability Index (NDI), and quality of life with Short Form-36 (SF-36). These measures were applied at baseline and after 12 weeks of treatment. Results The pretreatment and posttreatment results for VAS, NDI, and SF-36 were compared for both control and experimental groups. We found that all the three variables showed significant differences between the two time points with p < 0.05 in both the groups but the experimental group improvements were more significant than the control group with p < 0.05. Conclusion Twelve weeks of low TENS or HGBT along with exercises can decrease pain and neck disability and increase the quality of life in individuals with CNSNP. However, HGBT along with exercise has superior effects relative to low TENS along with exercise. This randomized controlled trial was registered in the International Standard Randomized Controlled Trials Number-ISRCTN29695190 and registered on 05/02/2020. This study is a retrospective registration.
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Pinheiro JS, Monteiro OLS, Pinheiro CAB, Penha LMB, Almeida MQG, Bassi-Dibai D, Pires FDO, Cabido CET, Fidelis-de-Paula-Gomes CA, Dibai-Filho AV. Seated Single-Arm Shot-Put Test to Measure the Functional Performance of the Upper Limbs in Exercise Practitioners With Chronic Shoulder Pain: A Reliability Study. J Chiropr Med 2020; 19:153-158. [PMID: 33362437 PMCID: PMC7750822 DOI: 10.1016/j.jcm.2020.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/17/2019] [Accepted: 01/29/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To measure the intra- and interrater reliability of the seated single-arm shot-put test (SSPT) in the functional performance of the upper limbs of regular physical exercise practitioners with shoulder pain. METHODS This is a reliability study. Thirty individuals regularly practicing any sports modality that uses the upper limb effectively for at least 6 months, both sexes, ages between 18 and 30 years, with chronic shoulder pain were included. Chronic shoulder pain was measured by means of the shoulder pain and disability index, numerical rating scale, and catastrophic thoughts about pain scale. Functional performance of the upper limbs was measured by means of SSPT. RESULTS Excellent intrarater reliability was found, with intraclass correlation coefficient ≥0.93, standard error of the measurement values ≤4.63%, and minimum detectable change values for absolute and normalized score of 45.11 cm and 9.97, respectively. Excellent interrater reliability was found, with intraclass correlation coefficient ≥0.96, standard error of the measurement values ≤3.55%, and minimum detectable change values for absolute and normalized score of 32.29 cm and 7.70, respectively. CONCLUSION SSPT is a reliable tool for measuring the functional performance of the upper limbs in regular exercise practitioners with chronic shoulder pain.
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Affiliation(s)
| | | | | | | | | | - Daniela Bassi-Dibai
- Postgraduate Program in Programs Management and Health Services, Ceuma University, São Luís, MA, Brazil
| | | | | | | | - Almir Vieira Dibai-Filho
- Postgraduate Program in Physical Education, Federal University of Maranhão, São Luís, MA, Brazil
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Petterson S, Plancher K, Klyve D, Draper D, Ortiz R. Low-Intensity Continuous Ultrasound for the Symptomatic Treatment of Upper Shoulder and Neck Pain: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. J Pain Res 2020; 13:1277-1287. [PMID: 32606899 PMCID: PMC7287226 DOI: 10.2147/jpr.s247463] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 05/05/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose Low-intensity continuous ultrasound (LICUS) is an emerging high-dosimetry ultrasound-based therapy for accelerated tissue healing and the treatment of myofascial pain. In this study, LICUS treatment is clinically evaluated for chronic upper neck and shoulder pain in a randomized, multi-site, double-blind, placebo-controlled study. Patients and Methods CONSORT guidelines were followed in conducting and reporting the clinical trial. Thirty-three participants with upper trapezius myofascial pain were randomized for treatment with active (n=25) or placebo (n=8) devices. Investigators and subjects were blinded to treatment groups. Participants self-reported pain daily, rating from 0–10 on the numeric rating scale. If pain rating was more significant than or equal to 3, the LICUS (3MHz, 0.132W/cm2, 1.3W, 4 hours) was self-applied for total energy dosimetry of 18,720 Joules per treatment. During the 4-week study, daily pain rating was recorded. If LICUS treatment was delivered, pain before, during, and after treatment were recorded as well as the global rate of change (GROC). Independent t-tests were used to assess change from baseline and differences between treatment groups. ClinicalTrials.gov: NCT02135094. Results There was a 100% completion rate for participants enrolled in the study and no significant differences between the groups regarding demographic variables or baseline outcome measures. Participants treated with active therapy observed a significant mean pain reduction from baseline of 2.61 points for active (p<0.001), compared to 1.58 points decrease from baseline for placebo (p=0.087), resulting in a 1.03 points significant decrease in the active group over placebo (p=0.003). The total GROC was significantly higher in the active group at 2.84 points compared to the placebo group at 0.46 points (p<0.001). Conclusion Low-intensity continuous ultrasound treatment significantly reduced pain in patients with upper trapezius myofascial pain of the neck and shoulder. LICUS treatment showed a clinically meaningful improvement in the GROC scores for patients. The results from this clinical trial indicate that the LICUS treatment of 18,720 Joules can effectively be used to treat clinical pain related to upper trapezius myofascial pain. Further research could investigate varying dosimetry to improve efficacy and/or reduce the dose.
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Affiliation(s)
| | - Kevin Plancher
- Plancher Orthopaedics & Sports Medicine, New York, NY 10128, USA
| | - Dominic Klyve
- Department of Mathematics, Central Washington University, Ellensburg, WI, USA
| | - David Draper
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
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Seven Key Themes in Physical Therapy Advice for Patients Living With Subacromial Shoulder Pain: A Scoping Review. J Orthop Sports Phys Ther 2020; 50:285-a12. [PMID: 32476583 DOI: 10.2519/jospt.2020.9152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To systematically scope the reported advice and education in physical therapy management of patients with subacromial shoulder pain, and to define key themes of the advice and education. DESIGN Scoping review. LITERATURE SEARCH We searched MEDLINE, Scopus, Web of Science, and CINAHL, with publication dates from 2007 to September 2019. STUDY SELECTION CRITERIA We included quantitative and qualitative research that reported on physical therapy interventions for subacromial shoulder pain. DATA SYNTHESIS We performed a qualitative synthesis that identified items included in patient advice and education. RESULTS Of 89 original studies included, there were 61 randomized controlled trials; 5 prospective studies; 16 nonrandomized observational intervention studies or case series; and 7 surveys, audits of physical therapy patient records, and focus groups with physical therapists. We identified 7 key themes for advice and education: exercise intensity and pain response, activity modification advice, posture advice, pain self-management advice, pathoanatomical and diagnosis information, behavioral approaches, and pain biology advice. CONCLUSION While advice focused predominantly on the local tissue pathology model, 10% of studies included information about pain neuroscience education, psychosocial factors, motor imagery, or behavior change. J Orthop Sports Phys Ther 2020;50(6):285-293. doi:10.2519/jospt.2020.9152.
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