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García-Rueda L, Cabanas-Valdés R, Salgueiro C, Pérez-Bellmunt A, Rodríguez-Sanz J, López-de-Celis C. Immediate effects of TECAR therapy on lower limb to decrease hypertonia in chronic stroke survivors: a randomized controlled trial. Disabil Rehabil 2024:1-10. [PMID: 38958103 DOI: 10.1080/09638288.2024.2365992] [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: 11/21/2023] [Accepted: 06/05/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE To analyze immediate effects of TECAR therapy (TT) to reduce lower limb hypertonia and improve functionality in chronic post-stroke. MATERIALS AND METHODS It is a single-blind randomized controlled clinical trial. A total of 36 chronic stroke survivors were divided into two groups. The experimental group received a single 30-minute session of TT with functional massage (FM) on lower limb. The control group received a single 30-minute session sham treatment of TT plus FM. The primary outcome measure was hypertonia (Modified Ashworth Scale, MAS). Secondary outcomes were gait speed (4-Meter Walk-Test), standing knee-flexion (Fugl-Meyer Assessment Scale IV-item), change in weight bearing ankle dorsiflexion (Ankle Lunge Test, ALT), and functional lower limb strength (5-Times Sit-to-Stand Test). All measurements were performed at baseline, immediately and 30-minutes after treatment. RESULTS There was a group-time interaction in MAS-knee (p = 0.044), MAS-ankle (p = 0.018) and ALT (p = 0.016) between T1 and T0 (p<.0001) and T2 and T0 (p<.0001) for the experimental group. There was a significant increase in ALT between T1 and T0 (p = 0.003) in the control group. CONCLUSIONS A single session of TT performed at the same time as FM immediately reduces plantar-flexors and knee-extensor muscle hypertonia and increases change in weight bearing ankle dorsiflexion in chronic stroke survivors.
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Affiliation(s)
| | - Rosa Cabanas-Valdés
- Physiotherapy Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Carina Salgueiro
- Physiotherapy Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
- Clínica de Neurorehabilitación, Barcelona, Spain
| | - Albert Pérez-Bellmunt
- Basic Sciences Department, Actium Functional Anatomy Research Group, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jacobo Rodríguez-Sanz
- Basic Sciences Department, Actium Functional Anatomy Research Group, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Carlos López-de-Celis
- Physiotherapy Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
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McDevitt AW, Young JL, Cleland JA, Hiefield P, Snodgrass SJ. Physical therapy interventions used to treat individuals with biceps tendinopathy: a scoping review. Braz J Phys Ther 2024; 28:100586. [PMID: 38219522 PMCID: PMC10825607 DOI: 10.1016/j.bjpt.2023.100586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/23/2023] [Accepted: 12/17/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Shoulder pain related to pathology of the long head of the biceps tendon (LHBT) can be debilitating. Chronic LHBT tendinopathy is a common condition that is difficult to treat. Little consensus exists regarding the optimal approach to treating individuals with LHBT tendinopathy. OBJECTIVE To systematically scope the literature to identify and present the available information regarding physical therapist interventions used for the management of individuals with LHBT tendinopathy including types of interventions used or recommended. METHODS A scoping review of physical therapist interventions used to treat LHBT was conducted of the CINAHL, Embase, Medline, and SportDiscus databases. Full text records reporting physical therapist-based interventions in individuals with proximal LHBT pathology were included. Articles not written in English were excluded. RESULTS Of the 4059 records identified, 14 articles met the inclusion criteria. Interventions used to treat LHBT tendinopathy identified in quantitative studies included: extracorporeal shock wave therapy, polarized light, ultrasound, low-level laser, iontophoresis, general exercise, eccentric training, stretching, dry needling, and joint mobilization. Interventions described in literature reviews, clinical commentaries, and a Delphi study included: therapeutic modalities, manual therapy, exercise, dry needling, and patient education. CONCLUSION This scoping review reported interventions primarily based on therapeutic modalities in quantitative studies while literature reviews, clinical commentaries, and a Delphi study described the addition of manual therapy, patient education, exercise, and dry needling. Overall, there is a dearth of evidence detailing the conservative management of LHBT tendinopathy.
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Affiliation(s)
- Amy W McDevitt
- University of Colorado Anschutz Medical Campus, Department of Physical Medicine and Rehabilitation, Physical Therapy Program, Aurora, CO, United States of America; Discipline of Physiotherapy, The University of Newcastle, Callaghan, Australia.
| | - Jodi L Young
- Bellin College, Doctor of Science in Physical Therapy Program, Green Bay, WI, United States of America
| | - Joshua A Cleland
- Tufts University School of Medicine, Department of Public Health and Community Medicine, Doctor of Physical Therapy Program, Boston, MA, United States of America
| | - Paisley Hiefield
- University of Colorado Anschutz Medical Campus, Department of Physical Medicine and Rehabilitation, Physical Therapy Program, Aurora, CO, United States of America
| | - Suzanne J Snodgrass
- Discipline of Physiotherapy, The University of Newcastle, Callaghan, Australia
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Irsay L, Ungur RA, Borda IM, Tica I, Iliescu MG, Ciubean AD, Popa T, Cinteza D, Popa FL, Bondor CI, Ciortea VM. Safety of Electrotherapy Treatment in Patients with Knee Osteoarthritis and Cardiac Diseases. Life (Basel) 2022; 12:life12111690. [PMID: 36362845 PMCID: PMC9699242 DOI: 10.3390/life12111690] [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: 10/11/2022] [Revised: 10/16/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE: To assess the safety of electrotherapy applied in the knee area in patients with known atrial arrhythmias or ischemic heart disease, as it is not known whether this treatment induces or aggravates arrhythmias during or immediately after therapy. MATERIAL AND METHODS: The analytical and transversal study involved 46 patients with degenerative knee osteoarthritis (OA), with or without cardiac diseases, from the Clinical Rehabilitation Hospital inpatient center, Cluj-Napoca, Romania. All patients underwent a 10-day physical therapy program for knee OA (electrotherapy, massage and kinesiotherapy). Heart rate and the total number of ventricular and supraventricular extrasystoles were evaluated before and after treatment, by 24 h Holter ECG monitoring. RESULTS: There was no significant increase in heart rate or in the number of ventricular or supraventricular extrasystoles before or after electrotherapy treatment, regardless of the positive or negative history of arrhythmia or ischemic heart disease (all p > 0.05). Mean values during day 1 were: 35.15 (95% CI [9.60−60.75]) for ventricular ones extrasystoles and 91.7 (95% CI [51.69−131.7]) for supraventricular ones, which during day 2 were 38.09 (95% CI [3.68−72.50]), 110.48 (95% CI [48.59−172.36]), respectively. CONCLUSION: One of the most important things to consider when dealing with an OA patient is that they are most likely older than 65 years, which increases the chance of having a cardiac disease. This raises the need for viable interventions regarding the management of this disease in patients that probably have multiple comorbidities, and where pharmacological and surgical management are not possible, limited or have multiple side effects. Electrotherapy used for treating knee OA did not cause a significant increase in heart rate or number of ventricular and supraventricular extrasystoles in this category of patients.
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Affiliation(s)
- Laszlo Irsay
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Rodica Ana Ungur
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Ileana Monica Borda
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Irina Tica
- Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus—Corp B, 900470 Constanta, Romania
| | - Mădălina Gabriela Iliescu
- Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus—Corp B, 900470 Constanta, Romania
- Correspondence: (M.G.I.); (A.D.C.)
| | - Alina Deniza Ciubean
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
- Correspondence: (M.G.I.); (A.D.C.)
| | - Theodor Popa
- Department of Rehabilitation Medicine, Clinical Rehabilitation Hospital, 46-50 Viilor Street, 400337 Cluj-Napoca, Romania
| | - Delia Cinteza
- 9th Department—Physical Medicine and Rehabilitation, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Florina Ligia Popa
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, Victoriei Blvd., 550024 Sibiu, Romania
- Academic Emergency Hospital of Sibiu, Coposu Blvd., 550245 Sibiu, Romania
| | - Cosmina Ioana Bondor
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 6 Pasteur Street, 400349 Cluj-Napoca, Romania
| | - Viorela Mihaela Ciortea
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
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Kalemba M, Ekiert-Radecka M, Wajdzik M, Mlyniec A. An in-House System for the Precise Measurement of Electrical Potentials and Mechanical Properties of Soft Tissues: Design and Validation Using Adult Mammalian Tendon Fascicle Bundles. MATERIALS 2022; 15:ma15134444. [PMID: 35806569 PMCID: PMC9267749 DOI: 10.3390/ma15134444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/03/2022] [Accepted: 06/17/2022] [Indexed: 02/04/2023]
Abstract
Tissues, such as skin, bones, and tendons, exhibit a piezoelectric effect, which may be an important phenomenon in terms of tissue renewal and regeneration as well as the possibility of modifying their mechanical behavior. In this article, we present the design and development of an in-house system for the precise measurement of electrical potentials and mechanical properties of tendons. The system was validated using tendon fascicle bundles derived from positional as well as energy-storing tendons from various adult mammals (porcine, bovine, and deer samples). The presented system is able to capture changes in elastic and viscoelastic properties of tissue as well as its time–voltage response and, thus, may be used in a broad spectrum of future studies to uncover factors influencing piezoelectric phenomena in tendons. This, in turn, will help to optimize current methods used in physiotherapy and postoperative treatment for effective tendon recovery.
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Affiliation(s)
- Marek Kalemba
- Faculty of Mechanical Engineering and Robotics, AGH University of Science and Technology, Al. Mickiewicza 30, 30-059 Krakow, Poland; (M.K.); (M.E.-R.)
| | - Martyna Ekiert-Radecka
- Faculty of Mechanical Engineering and Robotics, AGH University of Science and Technology, Al. Mickiewicza 30, 30-059 Krakow, Poland; (M.K.); (M.E.-R.)
| | - Marek Wajdzik
- Faculty of Forestry, University of Agriculture, Al. 29-listopada 46, 31-425 Krakow, Poland;
| | - Andrzej Mlyniec
- Faculty of Mechanical Engineering and Robotics, AGH University of Science and Technology, Al. Mickiewicza 30, 30-059 Krakow, Poland; (M.K.); (M.E.-R.)
- Correspondence:
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Sui M, Jiang N, Yan L, Liu J, Luo B, Zhang C, Yan T, Xiang Y, Li G. Effect of Electroacupuncture on Shoulder Subluxation in Poststroke Patients with Hemiplegic Shoulder Pain: A Sham-Controlled Study Using Multidimensional Musculoskeletal Ultrasound Assessment. Pain Res Manag 2021; 2021:5329881. [PMID: 34840636 PMCID: PMC8626186 DOI: 10.1155/2021/5329881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/22/2021] [Accepted: 11/03/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study aimed to use multidimensional musculoskeletal ultrasound imaging technique to investigate the effect of electroacupuncture (EA) on shoulder subluxation in poststroke patients with hemiplegic shoulder pain. METHODS In this prospective single-blind, randomized, sham-controlled study, thirty-four patients with shoulder subluxation and hemiplegic shoulder pain were recruited and randomly assigned into the EA group or the sham EA (SEA) group. In the EA group, EA was applied to the Jian yu (LI15), Bi nao (LI14), Jian zhen (SI9), and Jian liao (TE14) acupoints. In the SEA group, the EA was applied 15 mm away from the Lou gu (SP7), Di ji (SP8), Jiao xin (KI8), and Zhu bin (KI9) acupoints. Both groups underwent treatment 30 minutes/day, five days a week, for two weeks using dense waves with a frequency of 2/100 Hz. A Visual Analogue Scale (VAS) was used to evaluate the effectiveness of treatment in reducing shoulder pain. Musculoskeletal ultrasound was used to evaluate the changes of measures of shoulder subluxation in multidimensions (i.e., the acromiohumeral distance, AHD; acromion-greater tuberosity, AGT; and acromion-lesser tuberosity, ALT). Both the within- and between-groups treatment effects were assessed. RESULTS The pain intensity measured by VAS and shoulder subluxation measured by musculoskeletal ultrasound (i.e., AHD, AGT, and ALT) showed significant (p < 0.05) within-group difference in both groups. The between-group difference appeared in the pain intensity (p < 0.05), while it disappeared in the three measures of shoulder subluxation (p > 0.05). CONCLUSIONS Using VAS for measuring pain intensity and multidimensional musculoskeletal ultrasound imaging technique for measuring shoulder subluxation, this study finds that the hemiplegic shoulder pain can be improved significantly by the EA while the shoulder subluxation cannot be. Our findings further reveal the analgesic mechanism of EA on hemiplegic shoulder pain following stroke.
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Affiliation(s)
- Minghong Sui
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS) and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen 518055, China
| | - Naifu Jiang
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS) and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen 518055, China
- Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen 518055, China
| | - Luhui Yan
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
| | - Jiaqing Liu
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
| | - Bin Luo
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
| | - Chenxi Zhang
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
| | - Tiebin Yan
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Yun Xiang
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
- Department of Sports Rehabilitation, School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Guanglin Li
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS) and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen 518055, China
- Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen 518055, China
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Abe Y. Changes in availability and usage of electrophysical agents by physical therapists: a 5 year longitudinal follow-up study. J Phys Ther Sci 2021; 33:870-875. [PMID: 34776625 PMCID: PMC8575475 DOI: 10.1589/jpts.33.870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/23/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] There have been concerns that the availability and usage of electrophysical
agents have decreased, based on data from cross-sectional surveys. The aim of this study
was to conduct the first five-year follow-up longitudinal survey to determine the changes
in the availability and usage of electrophysical agents in Nagano Prefecture, Japan.
[Participants and Methods] This longitudinal observational study employed the same postal
questionnaire survey of practicing clinicians in 2014 and 2019. A total of 22 modalities
had been selected for inclusion in the questionnaire based on what is used in clinical
facilities and hospitals. [Results] The response rate was 71% and 63% for 2014 and 2019,
respectively. The modalities that were high in availability and usage for both 2014 and
2019 were hot packs, ultrasound, cryotherapy and low frequency. While most modalities
demonstrated a decreased trend in usage, electrical stimulation devices increased from
2014 to 2019. The results also demonstrated that usage was affected by gender (males
greater than females), years of experience (older greater than younger), qualifications
(diplomas greater than degrees), and confidence (confident greater than non-confident).
[Conclusion] Our results may assist educators with designing educational curricula that is
consistent with the needs of clinicians.
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Affiliation(s)
- Yuichi Abe
- Faculty of Health Sciences, Iryo Sosei University: 5-5-1 Chuodai Iino, Iwaki-shi, Fukushima 970-8551, Japan
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Qing W, Shi X, Zhang Q, Peng L, He C, Wei Q. Effect of Therapeutic Ultrasound for Neck Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2021; 102:2219-2230. [PMID: 33722564 DOI: 10.1016/j.apmr.2021.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/18/2020] [Accepted: 02/02/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate the effects and safety of therapeutic ultrasound in patients with neck pain. DATA SOURCES The PubMed, EMBASE, CENTRAL, and Physiotherapy Evidence databases were searched for articles published before December 1, 2020. STUDY SELECTION Randomized controlled trials that compared the effects of therapeutic ultrasound on neck pain were included in this review. The included studies compared therapeutic ultrasound plus other treatments with the other treatments alone or compared therapeutic ultrasound with sham or no treatment. Outcome measures involved the effects on pain, disability, and quality of life. Other treatments included all nonultrasonic therapies (eg, various exercises, massage, electrotherapy). DATA EXTRACTION Data on the study population, therapeutic ultrasound intervention, combined intervention, outcome measures, and follow-up were extracted. DATA SYNTHESIS Twelve randomized controlled trials (705 patients) fulfilled the inclusion criteria. Seven studies compared therapeutic ultrasound plus other treatments vs the other treatments alone (449 patients). Therapeutic ultrasound yielded additional benefits for pain, but there was high heterogeneity and we could not draw a clear conclusion. Ultrasound did not have a better effect on disability or quality of life when it was combined with other treatments. Five studies compared therapeutic ultrasound with sham or no treatment (256 patients), and the pooled data showed that therapeutic ultrasound significantly reduced pain intensity. No adverse events of therapeutic ultrasound were reported in the included studies. CONCLUSIONS Therapeutic ultrasound may reduce the intensity of pain more than sham or no treatment, and it is a safe treatment. Whether therapeutic ultrasound in combination with other conventional treatments produced additional benefits on pain intensity, disability, or quality of life is not clear. The randomized trials included in this review had different levels of quality and high heterogeneity. A large trial using a valid methodology is warranted.
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Affiliation(s)
- Wanyi Qing
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Xian Shi
- School of Medicine, Guilin Medical University, Guilin, Guangxi, PR China
| | - Qing Zhang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Lihong Peng
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Chengqi He
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Quan Wei
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China.
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Adhikari SP, Shrestha N, Shakya R, Phuyal R, Gyawali M, Dev R. A structured workshop enhanced Physiotherapists' skills in clinical decision-making: A pre-post study. J Family Med Prim Care 2021; 9:5658-5664. [PMID: 33532410 PMCID: PMC7842476 DOI: 10.4103/jfmpc.jfmpc_1048_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/19/2020] [Accepted: 09/28/2020] [Indexed: 11/04/2022] Open
Abstract
Context Effective clinical decision-making skills enhance the quality of patient care. Clinical reasoning and decision-making are fundamental aspects of best physiotherapy clinical practice. Aims To evaluate the effectiveness of an evidence-based structured educational workshop in enhancing physiotherapists' clinical decision-making skills. Settings and Designs A pre-post design conducted in a medical college. Methods and Materials A workshop protocol was developed based on the existing evidence and clinical practice guidelines. The workshop was advertised on the social media page of Nepal Physiotherapy association. On the first come first serve method; physiotherapists were selected. Those who met eligibility criteria were recruited for one of two workshops. Discussion was made on clinical scenarios aimed at enhancing clinical decision-making skills. Data were collected before and after the workshop using a self-administered clinical decision-making skills assessment tool to evaluate effectiveness of the workshop. Paired and unpaired t-tests were used to analyze within and between groups respectively. Results Significant improvement in clinical decision-making skills was found for all individual items (P < 0.001 in all items, effect size: 0.6 - 0.9), total EP score (P < 0.001, effect size: 0.8) and total clinical decision-making score (P < 0.001, effect size: 0.9). A significant difference was found between Bachelor and Master level education (P < 0.05). Conclusions An evidence-based structured educational workshop enhanced physiotherapists' clinical decision-making skills. The findings of this study could be relevant to all health care professionals working in clinical practice. Larger studies with a control group are recommended to strengthen the findings of this study.
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Affiliation(s)
- Shambhu P Adhikari
- Department of Physiotherapy, School of Medical Sciences, Kathmandu University, Nepal
| | - Nistha Shrestha
- Department of Physiotherapy, School of Medical Sciences, Kathmandu University, Nepal
| | - Rishita Shakya
- Department of Physiotherapy, School of Medical Sciences, Kathmandu University, Nepal
| | - Rajani Phuyal
- Department of Physiotherapy, School of Medical Sciences, Kathmandu University, Nepal
| | - Manju Gyawali
- Department of Physiotherapy and Rehabilitation, Nepal Mediciti Hospital, Nepal
| | - Rubee Dev
- Sun Yat-sen University Global Health Institute, Sun Yat-sen University, Guangzhou, China
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Mohammed J, Kabir R, Bakhsh HR, Greenfield D, Georgievna VA, Bulińska A, Rai J, Gonzales A, Hashmi SK. Should healthcare organisations offer ongoing rehabilitation services for patients undergoing haematopoietic cell transplant? A narrative review. INTERNATIONAL JOURNAL OF HEALTH GOVERNANCE 2021. [DOI: 10.1108/ijhg-05-2020-0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PurposeHematopoietic stem cell transplant (HSCT) patients can suffer from long-term transplant-related complications that affect their quality of life and daily activities. This study, a narrative review, aims to report the impact of HCT complications, the benefits of rehabilitation intervention, the need for long-term care and highlights the research gap in clinical trials involving rehabilitation.Design/methodology/approachA comprehensive search strategy was performed on several databases to look for relevant articles published from 1998 to 2018. Articles published in English with the following terms were used: hematopoietic stem cell transplant, chronic graft-versus-host disease, rehabilitation, exercise, physical therapy, occupational therapy. A patient/population, intervention, comparison, and outcomes (PICO) framework was employed to ensure that the search strategies were structured and precise. Study year, design, outcome, intervention, sample demographics, setting and study results were extracted.FindingsOf the 1,411 records identified, 51 studies underwent title/abstract screening for appropriateness, 30 were reviewed in full, and 19 studies were included in the review. The review found that, for the majority of patients who underwent HSCT and developed treatment-related complications, rehabilitation exercises had a positive impact on their overall quality of life. However, exercise prescription in this patient group has not always reflected the scientific approach; there is a lack of high-quality clinical trials in general. The review also highlights the need to educate healthcare policymakers and insurance companies responsible for rationing services to recognise the importance of offering long-term follow-up care for this patient group, including rehabilitation services.Practical implicationsA large number of HSCT patients require long-term follow-up from a multidisciplinary team, including rehabilitation specialists. It is important for healthcare policymakers and insurance companies to recognise this need and take the necessary steps to ensure that HSCT patients receive adequate long-term care. This paper also highlights the urgent need for high-quality rehabilitation trials to demonstrate the feasibility and importance of rehabilitation teams.Originality/valueHealthcare policymakers and insurance companies need to recognise that transplant patients need ongoing physiotherapy for early identification of any functional impairments and appropriate timely intervention.
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Silva FPD, Severo-Silveira L, Plentz RDM, Durigan JLQ, Baroni BM. Electrophysical agents in clinical practice of orthopedic and sports physical therapists in Brazil. FISIOTERAPIA E PESQUISA 2020. [DOI: 10.1590/1809-2950/19019727022020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Studies have described the use of electrophysical agents (EPA) by physical therapists worldwide. However, the use of EPA by Brazilian physical therapists remains undetermined. This study aims to describe the availability, use, and perception about EPA by orthopedic and sports physical therapists in Brazil. Professionals of the area were invited to answer an online questionnaire. Demographic data and information regarding the availability, use and perception about EPA in their current clinical practice were asked. Out of 376 physical therapists included in this study, 89% declared to use EPA in clinical practice. Sensory electrotherapy with pulsed current (TENS), therapeutic ultrasound, excitomotor electrotherapy with pulsed current (FES/NMES), and cryotherapy are available for more than 3/4 of interviewees. Scientific articles and clinical experience, respectively, are the most influential factors for the choice of EPA. Ultrasound is the most frequently used EPA, followed by TENS, cryotherapy, photobiomodulation, hot packs, and FES/NMES. The top-five most useful EPA in clinical practice chosen by physical therapists are: (1) ultrasound; (2) photobiomodulation; (3) TENS; (4) cryotherapy; and (5) FES/NMES. In conclusion, EPA are widely used by orthopedic and sports physical therapists in Brazil. Therapeutic ultrasound, TENS, FES/NMES, photobiomodulation, cryotherapy, and hot packs are the most used EPA in clinical practice of these physiotherapists.
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Tan Y, Liu Y, Ye R, Xu H, Nie W, Lu J, Zhang B, Wang C, He B. Change of bio-electric interferential currents of acute fatigue and recovery in male sprinters. SPORTS MEDICINE AND HEALTH SCIENCE 2020; 2:25-32. [PMID: 35783337 PMCID: PMC9219318 DOI: 10.1016/j.smhs.2020.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 11/27/2022] Open
Abstract
We studied the muscle fatigue and recovery of thirty male sprinters (aged 18–22 years) using the Frequency Analysis Method (FAM). The interferential currents (ICs) with different thresholds for sensory, motor and pain responses, the maximal voluntary contraction (MVC), and the amplitude of the surface EMG (aEMG, sEMG) were assessed prior to and immediately after an acute explosive fatigue training session, and during one-week recovery. We found that IC increased on average from 32.3 ± 8.9 mA to 37.5 ± 7.5 mA in sensory response at 10 Hz immediately post training (p = 0.004) but decreased at 24-hr post training (p = 0.008) and returned to pre-levels thereafter. Motor and pain response patterns at 10 Hz were similar (motor: p = 0.033 and 0.040; pain: p = 0.022 and 0.019, respectively). The change patterns of ICs were similar to but prior to the changes of sEMG. The agreement between IC assessment and amplitude of sEMG (aEMG)/MVC ratio was good (>95%). The present study suggested that the changes in ICs were prior to the changes in both the aEMG and force during fatigue. These changes may reflect the physiological sensory change due to peripheral fatigue. FAM may be useful as an effective early detection and simple tool for monitoring muscle fatigue during training and recovery in athletes.
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Papadopoulos DV, Koulouvaris P, Aggelidakis G, Tsantes AG, Mavrodontidis A, Papadopoulos G. Electroacupuncture for the treatment of supraspinatus calcific tendonitis. J Clin Orthop Trauma 2019; 10:624-628. [PMID: 31061602 PMCID: PMC6491911 DOI: 10.1016/j.jcot.2019.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 01/06/2019] [Accepted: 02/07/2019] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Conservative treatment of calcific tendonitis includes rest, medications, and physical therapy. Several physiotherapy interventions such as shockwave therapy are commonly used. The aim of this study was to investigate the efficacy of an electrotherapy method called electroacupuncture, in the treatment of calcific tendonitis. METHODS 40 patients with calcific tendonitis were randomly divided to receive either a combination of medications and electroacupuncture, or just a course of medications. Evaluated outcomes included pain using the visual analog scale, shoulder range of motion with the use of goniometer, and quality of life along with functional status using the Instrumental Activities of Daily Living Scale (IAOLDS) and the Beck Depression Inventory (BDI). Radiological evaluation for the progression of the calcific deposits was also performed. All these evaluations were performed before and at the end of treatment. A final interview with the patients regarding any recurrent episodes was performed 18-24 months after the end of treatment. RESULTS The intervention group showed greater improvement in pain intensity (2.8 points), range of motion (forward flexion, +30; abduction +29) when compared with the control group (for all, P < .05) while there was no statistically significant difference regarding the quality of life (IOLDS +0.2; BDI 0). Radiological evaluation demonstrated total or nearly total absorption of calcific deposits in 15 patients of the intervention group and in 8 patients of the control group. CONCLUSION The successful clinical results of electroacupuncture and the regression of calcific depositions after treatment showed that electroacupuncture may have a role as a treatment modality in calcific tendonitis.
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Affiliation(s)
- Dimitrios V. Papadopoulos
- Department of Ïrthopedics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45500, Ioannina, Greece,Corresponding author. Êaraoli kai Dimitriou 5, Ioannina, Epirus, 45332, Greece
| | - Panagiotis Koulouvaris
- Department of Orthopedics, University Hospital “Attikon”, 12462, Haidari, Athens, Greece
| | - Georgios Aggelidakis
- Department of Ïrthopedics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45500, Ioannina, Greece
| | - Andreas G. Tsantes
- Department of Ïrthopedics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45500, Ioannina, Greece
| | - Alexandros Mavrodontidis
- Department of Ïrthopedics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45500, Ioannina, Greece
| | - Georgios Papadopoulos
- Department of Anesthesiology, University Hospital of Ioannina, Stavros Niarchos Avenue, 45500, Ioannina, Greece
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Boonhong J, Suntornpiyapan P, Piriyajarukul A. Ultrasound combined transcutaneous electrical nerve stimulation (UltraTENS) versus phonophoresis of piroxicam (PhP) in symptomatic knee osteoarthritis: A randomized double-blind, controlled trial. J Back Musculoskelet Rehabil 2018; 31:507-513. [PMID: 29439307 DOI: 10.3233/bmr-150492] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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 Ultrasound combined with transcutaneous electrical nerve stimulation (UltraTENS) and phonophoresis of piroxicam (PhP) are combined modality therapy that frequently used in musculoskeletal pain including knee osteoarthritis (OA). But it is lack of a good clinical trial to prove and compare their effects. OBJECTIVE To compare the effects of UltraTENS with PhP on mild to moderate degree of symptomatic knee OA. METHODS Sixty-one patients (55 women), mean age of 63.4 ± 8.1 y, 50-90 mm VAS of knee pain and Kellgren-Lawrence score of grade I-III were randomly allocated into UltraTENS and PhP (N = 31 and 30, respectively). The UltraTENS group received a combined ultrasound with TENS program and a non-drug gel, whereas the PhP group got an ultrasound program with piroxicam gel and sham TENS. All patients were treated for a total of 10 sessions, consisting of five times per week and 10 min per session. Before and after treatment, patients were evaluated knee pain by using the 100-mm VAS and functional performance by Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index. RESULTS The UltraTENS and PhP groups experienced considerable improvement in both VAS and total WOMAC scores post-treatment (P< 0.001). The PhP had better VAS of pain and WOMAC scores but no statistical significance. CONCLUSIONS Results show that UltraTENS and PhP were effective for relieving pain and improve functionality knee OA without significant differences between their effects.
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Canela VC, Crivelaro CN, Ferla LZ, Pelozo GM, Azevedo J, Liebano RE, Nogueira C, Guidi RM, Grecco C, Sant’Ana E. Synergistic effects of Combined Therapy: nonfocused ultrasound plus Aussie current for noninvasive body contouring. Clin Cosmet Investig Dermatol 2018; 11:203-212. [PMID: 29731654 PMCID: PMC5927144 DOI: 10.2147/ccid.s157782] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Nowadays, there are several noninvasive technologies being used for improving of body contouring. The objectives of this pilot study were to verify the effectiveness of the Heccus® device, emphasizing the synergism between nonfocused ultrasound plus Aussie current in the improvement of body contour, and to determine if the association of this therapy with whole-body vibration exercises can have additional positive effects in the results of the treatments. SUBJECTS AND METHODS Twenty healthy women aged 20-40 years participated in the study. Ten patients received Combined Therapy treatment (G1) and the other 10 participants received Combined Therapy with additional vibratory platform treatment (G2). Anthropometric and standardized photography analysis, ultrasonography, cutometry and self-adminestered questionnaires of tolerance and satisfaction levels with the treatment were used. RESULTS Compared with baseline values, reduction of fat thickness was observed by ultrasonography in the posterior thigh area in the G1 group (P<0.05) and in the buttocks (P<0.05) and the posterior thigh areas (P<0.05) in the G2. All the treated areas in both groups showed reduction in cellulite degree in the buttocks, G1 (P<0.05) and G2 (P<0.05), and in posterior thigh areas, G1 (P<0.05) and G2 (P<0.05). Optimal improvement of skin firmness (G1, P<0.0001; G2, P=0.0034) in the treated areas was observed in both groups. CONCLUSION We conclude that the synergistic effects of the Combined Therapy (nonfocused ultrasound plus Aussie current) might be a good option with noninvasive body contouring treatment for improving the aspect of the cellulite, skin firmness and localized fat. If used in association with the whole-body vibratory platform, the results can be better, especially in the treatment of localized fat. Further studies with larger sample size should be performed to confirm these results.
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Affiliation(s)
| | | | | | | | - Juliana Azevedo
- CDE Medical Imaging Department, Brazilian College of Radiology (CBR), Amparo, SP, Brazil
| | - Richard Eloin Liebano
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Caroline Nogueira
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
- Biomedical Engineering Department, Faculty of Electrical Engineering and Computing, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Renata Michelini Guidi
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
- Biomedical Engineering Department, Faculty of Electrical Engineering and Computing, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Clóvis Grecco
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
| | - Estela Sant’Ana
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
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Tan AY, Sourial M, Hutson JM, Southwell BR. Short-Term Interferential Transabdominal Electrical Stimulation Did Not Change Oral-Rectal Transit Time in Piglets. Neuromodulation 2018; 21:669-675. [DOI: 10.1111/ner.12761] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/10/2017] [Accepted: 12/20/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Andre Y.F. Tan
- Surgical Research Group, Murdoch Children's Research Institute; Parkville VIC Australia
- Department of Paediatrics; University of Melbourne; Melbourne VIC Australia
| | - Magdy Sourial
- Surgical Research Group, Murdoch Children's Research Institute; Parkville VIC Australia
- Large Animal House Facility, Royal Children's Hospital; Melbourne VIC Australia
| | - John M. Hutson
- Surgical Research Group, Murdoch Children's Research Institute; Parkville VIC Australia
- Department of Paediatrics; University of Melbourne; Melbourne VIC Australia
- Department of Urology; Royal Children's Hospital; Melbourne VIC Australia
| | - Bridget R. Southwell
- Surgical Research Group, Murdoch Children's Research Institute; Parkville VIC Australia
- Department of Paediatrics; University of Melbourne; Melbourne VIC Australia
- Department of Urology; Royal Children's Hospital; Melbourne VIC Australia
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Almeida CCD, Silva VZMD, Júnior GC, Liebano RE, Durigan JLQ. Transcutaneous electrical nerve stimulation and interferential current demonstrate similar effects in relieving acute and chronic pain: a systematic review with meta-analysis. Braz J Phys Ther 2018; 22:347-354. [PMID: 29426587 DOI: 10.1016/j.bjpt.2017.12.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 12/12/2017] [Accepted: 12/20/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Transcutaneous electrical nerve stimulation and interferential current have been widely used in clinical practice. However, a systematic review comparing their effects on pain relief has not yet been performed. OBJECTIVES To investigate the effects of transcutaneous electrical nerve stimulation and interferential current on acute and chronic pain. METHODS We use Pubmed, Embase, LILACS, PEDro and Cochrane Central Register of Controlled Trials as data sources. Two independent reviewers that selected studies according to inclusion criteria, extracted information of interest and verified the methodological quality of the studies made study selection. The studies were selected if transcutaneous electrical nerve stimulation and interferential current were used as treatment and they had pain as the main outcome, as evaluated by a visual analog scale. Secondary outcomes were the Western Ontario Macmaster and Rolland Morris Disability questionnaires, which were added after data extraction. RESULTS Eight studies with a pooled sample of 825 patients were included. The methodological quality of the selected studies was moderate, with an average of six on a 0-10 scale (PEDro). In general, both transcutaneous electrical nerve stimulation and interferential current improved pain and functional outcomes without a statistical difference between them. CONCLUSION Transcutaneous electrical nerve stimulation and interferential current have similar effects on pain outcome The low number of studies included in this meta-analysis indicates that new clinical trials are needed.
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Affiliation(s)
| | - Vinicius Z Maldaner da Silva
- Physical Therapy Division, Instituto Hospital de Base do Distrito federal e Escola Superior de Ciências da Saúde (ESCS), Brasilia, DF, Brazil
| | - Gerson Cipriano Júnior
- Rehabilitation Sciences Program, Physical Therapy Division, Universdade de Brasilia UnB, Brasília, DF, Brazil
| | - Richard Eloin Liebano
- Department of Physical Therapy, Universidade Federal de São Carlos UFSCar, São Carlos, SP, Brazil
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The immediate effects of lidocaine iontophoresis using interferential current on pressure sense threshold and tactile sensation. Ther Deliv 2016; 7:163-9. [PMID: 26893248 DOI: 10.4155/tde.16.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Iontophoresis is the noninvasive delivery of ions using direct current. The direct current has some disadvantages such as skin burning. Interferential current is a kind of alternating current without limitations of direct current; so the purpose of this study is to investigate and compare the effects of lidocaine, interferential current and lidocaine iontophoresis using interferential current. 30 healthy women aged 20-24 years participated in this randomized clinical trial study. Pressure, tactile and pain thresholds were evaluated before and after the application of treatment methods. Pressure, tactile and pain sensitivity increased significantly after the application of lidocaine alone (p < 0.005) and lidocaine iontophoresis using interferential current (p < 0.0001). Lidocaine iontophoresis using interferential current can increase perception threshold of pain, tactile stimulus and pressure sense more significantly than lidocaine and interferential current alone.
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Kumaran B, Watson T. Radiofrequency-based treatment in therapy-related clinical practice – a narrative review. Part II: chronic conditions. PHYSICAL THERAPY REVIEWS 2016. [DOI: 10.1080/10833196.2015.1133034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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LLLT for the management of patients with ankylosing spondylitis. Lasers Med Sci 2016; 31:459-69. [PMID: 26796709 DOI: 10.1007/s10103-016-1874-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 01/12/2016] [Indexed: 10/22/2022]
Abstract
This study aimed to compare the effectiveness of the combined low-level laser therapy (LLLT) and passive stretching with combined placebo LLLT laser and the same passive stretching exercises in patients suffering from Αnkylosing spondylitis. Forty-eight patients suffering from Αnkylosing spondylitis participated in the study and were randomized into two groups. Group A (n = 24) was treated with a λ = 820 Ga-Al-As laser CW, with power intensity = 60 mW/cm(2), energy per point in each session = 4.5 J, total energy per session = 27.0 J, in contact with specific points technique, plus passive stretching exercises. Group B (n = 24), received placebo laser plus the same passive stretching exercises. Both groups received 12 sessions of laser or placebo within 8 weeks; two sessions per week (weeks 1-4) and one session per week (weeks 5-8). Pain and function scales were completed before the treatment, at the end of the fourth and eighth week of treatment, and 8 weeks after the end of treatment (follow-up). Group A revealed a significant improvement after 8 weeks of treatment in all pain and function scales. At 8-week follow-up, the improvement remained only for the pain, while for all other function outcomes the differences were not statistically significant. The results suggested that after an 8-week treatment and after a follow-up, the combination of LLLT and passive stretching exercises decreased pain more effectively than placebo LLLT along with the same passive stretching exercises in patients with Αnkylosing spondylitis. Future studies are needed to establish the relative and absolute effectiveness of the above protocol.
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An Economic Evaluation of TENS in Addition to Usual Primary Care Management for the Treatment of Tennis Elbow: Results from the TATE Randomized Controlled Trial. PLoS One 2015; 10:e0135460. [PMID: 26317528 PMCID: PMC4552676 DOI: 10.1371/journal.pone.0135460] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 07/23/2015] [Indexed: 11/21/2022] Open
Abstract
Background The TATE trial was a multicentre pragmatic randomized controlled trial of supplementing primary care management (PCM)–consisting of a GP consultation followed by information and advice on exercises–with transcutaneous electrical nerve stimulation (TENS), to reduce pain intensity in patients with tennis elbow. This paper reports the health economic evaluation. Methods and Findings Adults with new diagnosis of tennis elbow were recruited from 38 general practices in the UK, and randomly allocated to PCM (n = 120) or PCM plus TENS (n = 121). Outcomes included reduction in pain intensity and quality-adjusted-life-years (QALYs) based on the EQ5D and SF6D. Two economic perspectives were evaluated: (i) healthcare–inclusive of NHS and private health costs for the tennis elbow; (ii) societal–healthcare costs plus productivity losses through work absenteeism. Mean outcome and cost differences between the groups were evaluated using a multiple imputed dataset as the base case evaluation, with uncertainty represented in cost-effectiveness planes and through probabilistic cost-effectiveness acceptability curves). Incremental healthcare cost was £33 (95%CI -40, 106) and societal cost £65 (95%CI -307, 176) for PCM plus TENS. Mean differences in outcome were: 0.11 (95%CI -0.13, 0.35) for change in pain (0–10 pain scale); -0.015 (95%CI -0.058, 0.029) for QALYEQ5D; 0.007 (95%CI -0.022, 0.035) for QALYSF6D (higher score differences denote greater benefit for PCM plus TENS). The ICER (incremental cost effectiveness ratio) for the main evaluation of mean difference in societal cost (£) relative to mean difference in pain outcome was -582 (95%CI -8666, 8113). However, incremental ICERs show differences in cost–effectiveness of additional TENS, according to the outcome being evaluated. Conclusion Our findings do not provide evidence for or against the cost-effectiveness of TENS as an adjunct to primary care management of tennis elbow.
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LASER versus electromagnetic field in treatment of hemarthrosis in children with hemophilia. Lasers Med Sci 2015; 30:2179-87. [PMID: 26306883 DOI: 10.1007/s10103-015-1794-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 08/10/2015] [Indexed: 12/13/2022]
Abstract
Children with hemophilia usually have recurrent joint bleeding that leads to joint damage, loss of range of motion, and restriction of mobility, therefore affecting the quality of life in these children. The purpose of this study was to compare the effects of low-level laser therapy (LLLT) to that of pulsed electromagnetic field (PEMF) in treatment of hemarthrosis in children with hemophilia. Thirty boys with hemophilia A with ages ranging from 9 to 13 years were selected and assigned randomly, using sealed envelopes, into two equal intervention groups. The study group I received the traditional physical therapy program in addition to LLLT, whereas the study group II received the same physical therapy program given to the study group I in addition to PEMF. Both groups received the treatment sessions three times per week for three successive months. Pain, laboratory investigations, swelling, and range of motion (ROM) of the affected knee joint, in addition to physical fitness were evaluated before, at the end of the sixth week and at 12 weeks of the treatment program. Laser group showed significant improvement in all measured variables after the sixth week of treatment when compared with PEMF. By 12 weeks of treatment, there was a significant improvement in pain, ROM, ESR and leucocytes levels in laser group compared with PEMF, while there was no significant difference in knee circumferences and the 6-min walk test (6MWT) between both groups. Both groups showed significant improvement at 12 weeks of treatment compared with that at 6 weeks. Both LLLT and PEMF are effective modalities in reducing pain, swelling, increasing ROM and improving physical fitness. Twelve weeks of treatment of both modalities demonstrated significant improvement than 6 weeks of treatment. Laser therapy induced significant improvement than electromagnetic therapy in treatment of hemarthrosis-related problems in children with hemophilia.
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Dimitrios S. There is lack of evidence to support the effectiveness of therapeutic ultrasound in the management of patellar tendinopathy. PHYSICAL THERAPY REVIEWS 2015. [DOI: 10.1179/1743288x15y.0000000015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Springer S, Laufer Y, Elboim-Gabyzon M. Clinical decision making for using electro-physical agents by physiotherapists, an Israeli survey. Isr J Health Policy Res 2015; 4:14. [PMID: 26078848 PMCID: PMC4466804 DOI: 10.1186/s13584-015-0015-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 03/09/2015] [Indexed: 12/04/2022] Open
Abstract
Background Electro-physical agents (EPAs) are fundamental components in the management arsenal of physiotherapy. The objective of this study was to provide a comprehensive understanding of the factors affecting the decisions made by Physiotherapists (PTs) when choosing to apply EPAs as a treatment modality. Methods A purpose-designed questionnaire was developed to investigate the contribution of 13 factors on the decision to use EPAs. Two hundred questionnaires were randomly distributed to PTs attending the annual conference of the Israeli Physiotherapy Society, 2014. The factors were grouped into six categories and Wilcoxon Sign Rank tests were applied to compare their impact on decision making. Results In total, 144 (72%) questionnaires were completed. Good internal consistency was found for the 13 component of the decisions factors (Cronbach’s coefficient alpha = 0.77) with unequal distribution of answers in each question (p < 0.01). Eighty-one percent of the participants reported past experience, and 55 % mentioned research evidence as strong or very strong factors which influence their decision to use of EPAs. However, only 38% of the participants reported patients’ preferences as a strong or very strong factor. Comparisons between the six categories of the decision factors determined three levels of impact (rank scores) which were significantly different from each other (p < 0.01). Availability of equipment ranked the highest. The lowest level of impact included two categories, technology related issues and patients’ and physicians’ preferences. Conclusion The participating PTs were likely to make decisions which were strongly impacted by availability of equipment and operational factors. This research can be used to provide practicing PTs with a basis for a critical appraisal of their decision making regarding the application of EAPs. In addition, due to the strong impact of availability of equipment, health policy makers should verify that the available equipment is up to date with the best research evidence.
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Affiliation(s)
- Shmuel Springer
- Physical Therapy Department, Faculty of Health Sciences, Ariel University, Ariel, 40700 Israel
| | - Yocheved Laufer
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Michal Elboim-Gabyzon
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Samuel SR, Maiya GA. Application of low frequency and medium frequency currents in the management of acute and chronic pain-a narrative review. Indian J Palliat Care 2015; 21:116-20. [PMID: 25709199 PMCID: PMC4332116 DOI: 10.4103/0973-1075.150203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Trancutaneous electrical nerve stimulation (TENS) and interferential therapy (IFT) have been a regular line of treatment for various types of acute and chronic pain. This review aims to compile the latest literature in pain management using these modalities which use low-frequency and medium-frequency currents. The Cochrane Library, Scopus, PubMed, MEDLINE, and CINAHL were searched and studies were examined from their inception till October 2013. After title and abstract screening the relevant studies were included for this review. We found through this review that even though TENS and IFT are used in management of pain, there is limited amount of high quality research available in this area. Most of the studies lack methodological quality and have a low sample size.
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Affiliation(s)
- Stephen Rajan Samuel
- Department of Physiotherapy, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
| | - G Arun Maiya
- Department of Physiotherapy, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
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Bae YH, Lee SM. Analgesic effects of transcutaneous electrical nerve stimulation and interferential current on experimental ischemic pain models: frequencies of 50 hz and 100 hz. J Phys Ther Sci 2014; 26:1945-8. [PMID: 25540504 PMCID: PMC4273064 DOI: 10.1589/jpts.26.1945] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 06/23/2014] [Indexed: 12/02/2022] Open
Abstract
[Purpose] This study compared the analgesic effects of transcutaneous electrical nerve
stimulation (TENS) and interferential currents (IFC) on induced ischemic pain in healthy
volunteers. [Subjects] The subjects were 36 volunteers (18 male, 18 female) without known
pathology that could cause pain. Their mean age was 24.5±2.2 years. [Methods] A
single-blind and parallel-group method was used. Subjects were randomly allocated to
receive each 50 Hz TENS, 50 Hz IFC, 100 Hz TENS, and 100 Hz IFC. This study experimentally
induced ischemic pain in otherwise pain-free subjects using a modified version of the
submaximal effort tourniquet technique. Subjects completed twelve cycles of the
ischemic-induced pain test. The primary outcome measure was the change in self-reported of
pain intensity during one of four possible treatments. [Results] There were significant
effects for Time, which were attributed to a significant reduction in pain intensity for
all groups. There were no significant effects for groups or group-time interaction. The
50 Hz IFC treatment was more comfortable than the other treatments in the present study,
and it is likely to be better accepted and tolerated by patients. [Conclusion] We conclude
that there were no differences in the analgesic effects of the four treatments under the
present experimental conditions. The 50 Hz IFC treatment is more comfortable than the
other treatments.
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Affiliation(s)
- Young-Hyeon Bae
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea ; Doctor of Physical Therapy Program, Department of Nursing and Rehabilitation Science, Angelo State University, USA
| | - Suk Min Lee
- Department of Physical Therapy, Sahmyook University, Republic of Korea
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Abstract
It is accepted that the optimal management of spondyloarthritis requires a combination of non-pharmacological and pharmacological interventions. Non-pharmacologic therapy in spondyloarthritis has generally focused on the exercise regimens whose purpose is to maintain mobility and strength, relieve symptoms, prevent or decrease spinal deformity, contribute to long-term cardiopulmonary health, and improve overall function and quality of life. Exercise programs such as home exercise, group exercise, inpatient programs, and spa exercise have all been the subject of multiple reports that are reviewed here. Studies reviewed support the use of exercise, spa therapy, manual therapy, and electrotherapeutic modalities. Additional topics that are finding relevance in spondyloarthritis are the behavioral interventions that maximize knowledge, motivation for compliance, and healthy lifestyle choices including smoking cessation, weight management, diet, and probiotics. However, the quality and generalizability of the studies are limited.
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Affiliation(s)
- Andreas M Reimold
- Dallas VA Medical Center and University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Vinod Chandran
- Division of Rheumatology, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
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Microwave diathermy for treating nonspecific chronic neck pain: a randomized controlled trial. Spine J 2014; 14:1712-21. [PMID: 24184641 DOI: 10.1016/j.spinee.2013.10.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Revised: 09/12/2013] [Accepted: 10/17/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Although the use of deep heat therapy is widespread, there is scant literature available on its effectiveness in treating back or neck pain. PURPOSE The purpose of this study was to determine the efficacy of microwave diathermy to treat nonspecific chronic neck pain. DESIGN The study was designed as a double-blind, randomized controlled trial. PATIENT SAMPLE The patient sample consisted of 149 patients with nonspecific chronic neck pain in a hospital of the Andalusian Public Health Care System, Spain OUTCOME MEASURES The study outcome measures are as follows: at baseline, pain intensity (using a visual analogue scale), disability (Neck Disability Index), and health-related quality of life (36-item short form health survey [SF-36]); at 3 weeks, baseline measures and patients' perceived overall outcome and satisfaction with the treatment; and at 6 months, 3-week measures, therapeutic co-interventions, and adherence to exercises. METHODS Patients were allocated randomly to three groups. The first group received continuous microwave diathermy, the second group was administered pulsed microwaves, and the third group (the control group) received unplugged microwaves. All three groups received the same general treatment: range of motion, isometric exercises, and transcutaneous electrical nerve stimulation. RESULTS The three groups had reduced pain and disability, and improvement was seen in some dimensions of the SF-36. However, there were no differences found in any of the parameters measured among the three therapeutic groups. CONCLUSIONS Microwave diathermy does not provide additional benefit to a treatment regimen of chronic neck pain that already involves other treatment approaches.
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Abtahi NS, Eimani H, Vosough A, Shahverdi A, Fathi R, Hayati N, Nasiri N. Effect of therapeutic ultrasound on folliculogenesis, angiogenesis and apoptosis after heterotopic mouse ovarian transplantation. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:1535-1544. [PMID: 24785439 DOI: 10.1016/j.ultrasmedbio.2014.02.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 01/14/2014] [Accepted: 02/01/2014] [Indexed: 06/03/2023]
Abstract
One of the challenges in ovarian transplantation is ischemia-reperfusion damage. When transitional tissue faces an acute and critical condition in terms of blood supply (immediately after organ transplantation), treatment with low-intensity pulsed ultrasound (LIPUS) seems to be very beneficial. The aim of this study was to evaluate the effects of ultrasound therapy on heterotopic transplanted mouse ovarian tissue. Adult female Naval Medical Research Institute mice were divided into three groups. In the experimental groups, the transplanted ovary was exposed 5 min daily to ultrasound with an intensity of 0.3 W/cm(2), frequency of 3 MHz and pulse mode of 1:4. The grafted ovaries were assessed with the usual histology and immunohistochemistry techniques. Results indicate that more CD31 angiogenic factor was expressed in irradiated animals than in control animals, and ultrasound therapy resulted in better follicular preservation, especially after 14 d. In conclusion, therapeutic ultrasound may accelerate and increase re-angiogenesis and can help to promote ovarian follicular growth.
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Affiliation(s)
- N S Abtahi
- Department of Embryology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - H Eimani
- Department of Embryology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Anatomy, Faculty of Medicine, Baqiyatallah University of Medical Science, Tehran, Iran.
| | - A Vosough
- Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Ab Shahverdi
- Department of Embryology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - R Fathi
- Department of Embryology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - N Hayati
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - N Nasiri
- Department of Embryology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Shaik SS, MacDermid JC, Birmingham T, Grewal R, Farooq B. Short-term sensory and cutaneous vascular responses to therapeutic ultrasound in the forearms of healthy volunteers. J Ther Ultrasound 2014; 2:10. [PMID: 24936304 PMCID: PMC4040486 DOI: 10.1186/2050-5736-2-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 04/16/2014] [Indexed: 12/05/2022] Open
Abstract
Background Therapeutic ultrasound (US) is used for a variety of clinical pathologies and is thought to accelerate tissue repair and help with pain reduction via its thermal and nonthermal effects. The evidence on physiological effects of US on both sensory and vascular functions in humans is incomplete. Hence, the purpose of this study was to determine the short-term impact of two doses of US (3 MHz, 1:4, 0.25 W/cm2, 5 min; 1 MHz, continuous, 0.8 W/cm2, 3 min), on sensory and vascular responses in the healthy forearms. Methods Twenty healthy subjects were recruited (mean age, 29.6 ± 8.8 years) for the study. Superficial blood flow (SBF) in the distal forearms was determined using the tissue viability imaging system. Sensory perception thresholds (SPT) were determined from ring finger (C7, C8) to assess A-beta (at 2,000 Hz) and C fiber function (at 5 Hz), using a Neurometer CPT/C device. Subject’s two hands were randomly allocated to group order (AB/BA). Scores were obtained before and immediately after the application of US and control. Differences in these were analyzed using repeated measures. Results Both 3 MHz pulsed US and 1 MHz continuous US showed small to moderate (effect size = 0.12 to 0.68), statistically significant reductions in SBF (3 MHz, mean change = 2.8 AU and 1 MHz, mean change = 3.9 AU, p < 0.05 respectively), skin temperature (2.5°C and 1.1°C, p < 0.05), and SPT at 5 Hz (1.3 and 1 mA, p < 0.05) across time. SPT at 2,000 Hz remained unaltered by all three conditions (p > 0.05). Age and gender also had no effect on all outcome measures (p > 0.05). Conclusion This study demonstrated minor reductions in skin blood flow, skin temperatures, and C fiber perception thresholds immediately after 3 MHz, and 1 MHz US. The responses observed may have been due to a thermo-cooling effect of the gel or due to the direct effect of US on C fibers of median and ulnar nerves. US had a negligible effect on A-beta fibres. This would suggest that future studies looking at physiological effects of US should move towards investigating larger dosages and study the effects in patient populations.
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Affiliation(s)
- Shaguftha Sultana Shaik
- Faculty of Health Sciences, Department of Health and Rehabilitation Sciences, Physical Therapy Field, Western University, London, ON N6G 1H1, Canada
| | - Joy C MacDermid
- Faculty of Health Sciences, Department of Health and Rehabilitation Sciences, Physical Therapy Field, Western University, London, ON N6G 1H1, Canada ; Hand and Upper Limb Centre, Clinical Research Laboratory, St. Joseph's Health Centre, London, ON N6A 4 V2, Canada ; School of Rehabilitation Science, McMaster University, Hamilton, ON L8S4L8, Canada
| | - Trevor Birmingham
- Tier 2 Canada Research Chair in Musculoskeletal Rehabilitation, Faculty of Health Sciences, Department of Health and Rehabilitation Sciences, School of Physical Therapy, Western University, London, ON N6G 1H1, Canada
| | - Ruby Grewal
- Hand and Upper Limb Centre, St. Joseph's Health Care, Division of Orthopedics, Western University, London, ON N6A 4 L6, Canada
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Palmer S, Domaille M, Cramp F, Walsh N, Pollock J, Kirwan J, Johnson MI. Transcutaneous electrical nerve stimulation as an adjunct to education and exercise for knee osteoarthritis: a randomized controlled trial. Arthritis Care Res (Hoboken) 2014; 66:387-94. [PMID: 23983090 DOI: 10.1002/acr.22147] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 08/20/2013] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To determine the additional effects of transcutaneous electrical nerve stimulation (TENS) for knee osteoarthritis (OA) when combined with a group education and exercise program (knee group). METHODS The study was a randomized, sham-controlled clinical trial. Patients referred for physiotherapy with suspected knee OA (confirmed using the American College of Rheumatology clinical criteria) were invited. Exclusion criteria included comorbidities preventing exercise, previous TENS experience, and TENS contraindications. Prospective sample size calculations required 67 participants in each trial arm. A total of 224 participants (mean age 61 years, 37% men) were randomized to 3 arms: TENS and knee group (n = 73), sham TENS and knee group (n = 74), and knee group (n = 77). All patients entered an evidence-based 6-week group education and exercise program (knee group). Active TENS produced a "strong but comfortable" paraesthesia within the painful area and was used as much as needed during the 6-week period. Sham TENS used dummy devices with no electrical output. Blinded assessment took place at baseline and 3, 6, 12, and 24 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function subscale at 6 weeks. Secondary outcomes included WOMAC pain, stiffness, and total scores; extensor muscle torque; global assessment of change; exercise adherence; and exercise self-efficacy. Data analysis was by intent to treat. RESULTS All outcomes improved over time (P < 0.05), but there were no differences between trial arms (P > 0.05). All improvements were maintained at 24-week followup. CONCLUSION There were no additional benefits of TENS, failing to support its use as a treatment adjunct within this context.
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Affiliation(s)
- Shea Palmer
- University of the West of England, Bristol, UK
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Morelle M, Cardon F, Beuscart JB, Campagne JB, Wiel E, Boulanger E, Assez N. Intérêt de la neurocryostimulation dans la prise en charge de la douleur post-traumatique en médecine d’urgence. ANNALES FRANCAISES DE MEDECINE D URGENCE 2014. [DOI: 10.1007/s13341-013-0400-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bartley J, Ansari NN, Naghdi S. Therapeutic ultrasound as a treatment modality for chronic rhinosinusitis. Curr Infect Dis Rep 2014; 16:398. [PMID: 24570383 DOI: 10.1007/s11908-014-0398-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Chronic rhinosinusitis (CRS) is a chronic infective, inflammatory upper respiratory disease. While the current medical treatment of CRS focuses on the systemic and topical use of steroids and/or antibiotics, many bacteria residing on mucosal surfaces of patients with CRS exist in a biofilm state, making them resistant to most systemic antibiotics. Alternative therapeutic strategies that include blocking bacterial molecular communication, inhibiting biofilm matrix production and breaking down bacterial biofilms are all being explored. Physical therapies such as therapeutic ultrasound (US) have been advocated and utilized as a treatment modality for CRS for many years. US may have antiinflammatory actions and can also be used for the local delivery of drugs through the skin. Therapeutic US, which has been shown in clinical studies to be an effective treatment for both acute rhinosinusitis and CRS, offers significant potential in CRS management.
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Affiliation(s)
- Jim Bartley
- Department of Surgery, University of Auckland, 10 Owens Road, Auckland, 1023, New Zealand,
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Shah SGS, Farrow A. Trends in the availability and usage of electrophysical agents in physiotherapy practices from 1990 to 2010: a review. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x12y.0000000007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Saban B, Deutscher D, Ziv T. Deep massage to posterior calf muscles in combination with neural mobilization exercises as a treatment for heel pain: a pilot randomized clinical trial. ACTA ACUST UNITED AC 2013; 19:102-8. [PMID: 24090993 DOI: 10.1016/j.math.2013.08.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Revised: 08/12/2013] [Accepted: 08/22/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Plantar heel pain syndrome (PHPS) is a common foot disorder; however, there is limited clinical evidence on which to base treatment. Repeated clinical observations indicating heel pain during heel rise and minisquat on the affected leg, involving activation of posterior calf muscles, formed the basis of this study. OBJECTIVE To compare deep massage therapy to posterior calf muscles and neural mobilization with a self-stretch exercise program (DMS) to a common treatment protocol of ultrasound therapy to the painful heel area with the same self-stretch exercises (USS). METHODS Patients with PHPS were assigned to a program of 8 treatments over a period of 4-6 weeks in a single-blind randomized clinical trial. Functional status (FS) at admission and discharge from therapy as measured by the Foot & Ankle Computerized Adaptive Test was the main outcome measure. RESULTS Sixty-nine patients were included in the trial (mean age 53, standard deviation (SD) 13, range 25-86, 57% women), 36 received DMS treatment and 33 with USS. The overall group-by-time interaction for the mixed-model analysis of variance (ANOVA) was found statistically significant (p=0.034), with a change of (mean (confidence interval, CI)) 15 (9-21) and 6 (1-11) FS points for the DMS and USS groups, respectively. CONCLUSIONS Data indicated that both treatment protocols resulted in an overall short-term improvement, however, DMS treatment was significantly more effective in treating PHPS than USS treatment.
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Affiliation(s)
- Bernice Saban
- Physical Therapy Service, Maccabi Healthcare Services, Shpeigel 3, Petach Tikva, Israel.
| | - Daniel Deutscher
- Physical Therapy Service, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Tomer Ziv
- Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Chesterton LS, Lewis AM, Sim J, Mallen CD, Mason EE, Hay EM, van der Windt DA. Transcutaneous electrical nerve stimulation as adjunct to primary care management for tennis elbow: pragmatic randomised controlled trial (TATE trial). BMJ 2013; 347:f5160. [PMID: 23999980 PMCID: PMC3759476 DOI: 10.1136/bmj.f5160] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2013] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To investigate the effectiveness of supplementing information and advice on analgesia and exercise from a general practitioner with transcutaneous electrical nerve stimulation (TENS) as a non-drug form of analgesia to reduce pain intensity in patients with tennis elbow. DESIGN Pragmatic randomised controlled trial in primary care. SETTING AND 38 general practices in the West Midlands, UK. PARTICIPANTS 241 adults consulting with a first or new (no consultation in previous six months) clinical diagnosis of tennis elbow. INTERVENTIONS Participants were randomly allocated to either primary care management alone, consisting of a consultation with a general practitioner followed by information and advice on exercises, or primary care management plus TENS to be used once a day for 45 minutes over six weeks (or until symptom resolution) for pain relief. OUTCOME MEASURES The primary outcome was self reported intensity of elbow pain (0-10 rating scale) at six weeks. Primary and secondary outcomes were measured at baseline and at six weeks, six months, and 12 months by postal questionnaire. Analysis was by intention to treat. RESULTS 121 participants were randomised to primary care management plus TENS and 120 to primary care management only (first episode, n=197 (82%); duration <1-3 months, n=138 (57%)). Adherence to exercise and TENS recommendations reported at six weeks was low; only 42 participants in the primary care management plus TENS group met a priori defined adherence criteria. Both intervention groups showed large improvements in pain and secondary outcomes, especially during the first six weeks of follow-up. However, no clinically or statistically significant differences were seen between groups at any follow-up timepoint. At the primary endpoint (six weeks), the between group difference in improvement of pain was -0.33 (95% confidence interval -0.96 to 0.31; P=0.31) in favour of the primary care management only group, with adjustment for age, sex, and baseline pain score. CONCLUSIONS This trial does not provide evidence for additional benefit of TENS as an adjunct to primary care management of tennis elbow. Poor adherence to interventions is evidence of the challenges of implementing self management treatment strategies in primary care. TRIAL REGISTRATION Current Controlled Trials ISRCTN87141084.
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Affiliation(s)
- Linda S Chesterton
- Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire ST5 5BG, UK.
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Chipchase LS, Williams MT, Robertson VJ. A framework for determining curricular content of entry level physiotherapy programmes: electrophysical agents as a case study. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/174328808x309269] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Kwan RLC, Cheing GLY, Vong SKS, Lo SK. Electrophysical therapy for managing diabetic foot ulcers: a systematic review. Int Wound J 2012; 10:121-31. [PMID: 22958779 DOI: 10.1111/j.1742-481x.2012.01085.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
To systematically assess published reports on the efficacy of electrophysical therapy in the treatment of diabetic foot ulcers, including electrical stimulation, low-level laser therapy, therapeutic ultrasound and electromagnetic therapy. Databases searched included MEDLINE, CINAHL, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) from 1966 to 2011. Studies reviewed included only randomised controlled trials (RCTs) on treatment with electrophysical modalities compared with sham, conventional treatment or other electrophysical modalities. Information extracted were objective measures of healing and data useful for the calculation of effect size. Eight RCTs were eventually included in the critical appraisal, with a combined total of 325 participants. Five studies were conducted on electrical stimulation, two on phototherapy and one on ultrasound. All studies reported that the experimental group was significantly more favourable than the control or sham group. The pooled estimate of the number of healed ulcers of the three studies on electrical stimulation compared to the control or sham electrical stimulation showed statistical significance [mean difference of 2·8 (95% CI = 1·5-5·5, P = 0·002] in favour of electrical stimulation. The results indicated potential benefit of using electrophysical therapy for managing diabetic foot ulcers. However, due to the small number of trials ever conducted, the possibility of any harmful effects cannot be ruled out, and high-quality trials with larger sample sizes are warranted.
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Affiliation(s)
- Rachel L-C Kwan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Abstract
Practical relevance: Physiotherapy is highly valued within human medicine and relatively well established for canine patients. Despite a popular misconception that feline patients will not cooperate with such treatment, physiotherapy is now increasingly being performed with cats. With cat ownership increasing in many countries, and an emergence of specialist physiotherapy practitioners, there is demand for effective postoperative and post-injury rehabilitation for any cat with compromised physical function due to injury, surgery or disease. Clinical challenges: While physiotherapy and rehabilitation are potentially beneficial for cats, due to their independent nature feline patients certainly present a greater challenge in the pursuit of effective therapy than their canine counterparts. Audience: This two-part review article is directed at the primary care veterinary team. The benefits of physiotherapy and the various treatment modalities available to the qualified veterinary physiotherapist, as well as the non-specialist veterinarian and veterinary nurse or technician, are examined in this first part. Evidence base: The benefits of human physiotherapeutic intervention are well documented, and there is good evidence for the effectiveness of most treatment modalities. Animal studies are still in their infancy, although some preliminary studies in dogs have shown good results.
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Affiliation(s)
- Brian Sharp
- The Queen Mother Hospital for Animals, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
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de Brito Vieira WH, Aguiar KA, da Silva KM, Canela PM, da Silva FS, Abreu BJ. Overview of ultrasound usage trends in orthopedic and sports physiotherapy. Crit Ultrasound J 2012; 4:11. [PMID: 22871050 PMCID: PMC3439362 DOI: 10.1186/2036-7902-4-11] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 05/03/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study is to examine current beliefs about the use, the clinical importance, the theoretical fundamentals and the utilization criteria of therapeutic ultrasound (TUS) among physical therapists on the clinical practice in orthopedic and sports physiotherapy in Brazil. METHODS A brief survey was developed based on previous studies and was sent to 55 physical therapists with advanced competency in orthopedics and sports physiotherapy. The questions addressed general topics about the professional profile and ultrasound usage and dosage. RESULTS Our data show the wide availability and frequent use of TUS in this sample of physical therapists. TUS is used in distinct musculoskeletal injuries and/or disorders in both acute and chronic conditions. Muscles, tendons and ligaments represented the major structures where TUS is used. Questions on the basic theory of TUS demonstrated a lack of knowledge of the ultrasound physiological effects as well as its interaction with biological tissues and TUS absolute contraindication. CONCLUSION A Brazilian profile about the US usage and dosage in orthopedic and sports physiotherapy is presented and highlights the need for a continuous upgrading process and further research into its effects.
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Affiliation(s)
- Wouber Herickson de Brito Vieira
- Departamento de Morfologia, Universidade Federal do Rio Grande do Norte, Av, Lagoa Nova S/N, Natal, Rio Grande do Norte, 1524-59072-970, Brazil.
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Chipchase L. Is there a future for electrophysical agents in musculoskeletal physiotherapy? MANUAL THERAPY 2012; 17:265-6. [PMID: 22542161 DOI: 10.1016/j.math.2012.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 03/28/2012] [Indexed: 11/18/2022]
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Low-frequency electrotherapy for female patients with detrusor underactivity due to neuromuscular deficiency. Int Urogynecol J 2012; 23:1007-15. [PMID: 22441580 PMCID: PMC3396337 DOI: 10.1007/s00192-012-1714-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 02/09/2012] [Indexed: 02/06/2023]
Abstract
Introduction and hypothesis The aim of the study was to assess the efficacy of low-frequency electrotherapy (LFE) for female patients with early-stage detrusor underactivity (DUA) due to neuromuscular deficiency. Methods A total of 102 female patients were divided randomly into four groups: LFE-NC (normal compliance), LFE-LC (low compliance), CON (control)-NC and CON-LC. Patients in the LFE-NC and LFE-LC groups received LFE, and those in the CON-NC and CON-LC groups received conservative treatment. Urodynamic evaluation was performed before and after treatment. Results After treatment, 82 % of the LFE-NC regained detrusor contractility, whereas only 2 (8 %) of the CON-NC had normal detrusor contraction. None of LFE-LC or CON-LC regained detrusor contractility (p < 0.01). The per cent of LFE-NC who relied on catheterization for bladder emptying decreased by 43 % (p < 0.01). Those in the LFE-LC, CON-NC and CON-LC groups decreased by only 4, 12 or 0 % (p > 0.05). Conclusions LFE was more effective for DUA patients with normal compliance; these patients benefited from LFE, but DUA patients with low compliance did not.
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Gobbo M, Gaffurini P, Bissolotti L, Esposito F, Orizio C. Transcutaneous neuromuscular electrical stimulation: influence of electrode positioning and stimulus amplitude settings on muscle response. Eur J Appl Physiol 2011; 111:2451-9. [PMID: 21717122 DOI: 10.1007/s00421-011-2047-4] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 06/08/2011] [Indexed: 11/29/2022]
Abstract
The aim of the study was to investigate the influence of two different transcutaneous neuromuscular electrical stimulation procedures on evoked muscle torque and local tissue oxygenation. In the first one (MP mode), the cathode was facing the muscle main motor point and stimulus amplitude was set to the level eliciting the maximal myoelectrical activation according to the amplitude of the evoked electromyogram (EMG); in the second one (RC mode), the electrodes were positioned following common reference charts for electrode placement while stimulus amplitude was set according to subject tolerance. Tibialis Anterior (TA) and Vastus Lateralis (VL) muscles of 10 subjects (28.4 ± 8.2 years) were tested in specific dynamometers to measure the evoked isometric torque. The EMG and near-infrared spectroscopy probes were placed on muscle belly to detect the electrical activity and local metabolic modifications of the stimulated muscle, respectively. The stimulation protocol consisted of a gradually increasing frequency ramp from 2 to 50 Hz in 7.5 s. Compared to RC mode, in MP mode the contractile parameters (peak twitch, tetanic torque, area under the torque build-up) and the metabolic solicitation (oxygen consumption and hyperemia due to metabolites accumulation) resulted significantly higher for both TA and VL muscles. MP mode resulted also to be more comfortable for the subjects. Based on the assumption that proper mechanical and metabolic stimuli are necessary to induce muscle strengthening, our results witness the importance of an optimized, i.e., comfortable and effective, stimulation to promote the aforementioned muscle adaptive modifications.
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Affiliation(s)
- M Gobbo
- Department of Biomedical Sciences and Biotechnologies, University of Brescia, Brescia, Italy.
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Abstract
PURPOSE OF REVIEW Ankylosing spondylitis (AS) is a disease that tends to affect younger individuals, many of whom are in the prime of their lives; therefore, incorporating the most up-to-date evidence into physiotherapy practice is critical. The purpose of this review is to update the most recent evidence related to physiotherapy intervention for AS and highlight the application of the findings to current physiotherapy research and clinical practice. RECENT FINDINGS The results of this review add to the evidence supporting physiotherapy as an intervention for AS. The emphasis continues to be on exercise as the most studied physiotherapy modality, with very few studies examining other physiotherapy modalities. Results of the studies reviewed support the use of exercise, spa therapy, manual therapy and electrotherapeutic modalities. In addition, the results of this review help to understand who might benefit from certain interventions, as well as barriers to management. SUMMARY A review of recently published articles has resulted in a number of studies that support the body of literature describing physiotherapy as an effective form of intervention for AS. In order to continue to build on the existing research, further examination into physiotherapy modalities, beyond exercise-based intervention, needs to be explored.
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Shanks P, Curran M, Fletcher P, Thompson R. The effectiveness of therapeutic ultrasound for musculoskeletal conditions of the lower limb: A literature review. Foot (Edinb) 2010; 20:133-9. [PMID: 20961748 DOI: 10.1016/j.foot.2010.09.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Revised: 09/19/2010] [Accepted: 09/20/2010] [Indexed: 02/04/2023]
Abstract
BACKGROUND Ultrasound is suggested as one of the treatment options available for soft tissue musculoskeletal conditions of the lower limb and to this end, the objective was to review the literature and evaluate the effectiveness of therapeutic ultrasound for musculoskeletal conditions of the lower limb. METHODS A search of the literature published between 1975 and February 2009 was carried out. All studies that fulfilled the inclusion criteria were quality assessed and scored using the Critical Appraisal Skills Programme (CASP) appraisal tool [1] for randomised controlled trials. RESULTS Ten studies out of a possible fifteen were included in the review. Only one trial was considered to be high quality (score 16+), three medium quality trials (score 11-15) were identified and six trials were considered to be low or poor quality (score≤10). None of the six placebo-controlled trials found any statistically significant differences between true and sham ultrasound therapy. CONCLUSION This literature review found that there is currently no high quality evidence available to suggest that therapeutic ultrasound is effective for musculoskeletal conditions of the lower limb.
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Effectiveness of interferential current therapy in the management of musculoskeletal pain: a systematic review and meta-analysis. Phys Ther 2010; 90:1219-38. [PMID: 20651012 DOI: 10.2522/ptj.20090335] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Interferential current (IFC) is a common electrotherapeutic modality used to treat pain. Although IFC is widely used, the available information regarding its clinical efficacy is debatable. PURPOSE The aim of this systematic review and meta-analysis was to analyze the available information regarding the efficacy of IFC in the management of musculoskeletal pain. DATA SOURCES Randomized controlled trials were obtained through a computerized search of bibliographic databases (ie, CINAHL, Cochrane Library, EMBASE, MEDLINE, PEDro, Scopus, and Web of Science) from 1950 to February 8, 2010. DATA EXTRACTION Two independent reviewers screened the abstracts found in the databases. Methodological quality was assessed using a compilation of items included in different scales related to rehabilitation research. The mean difference, with 95% confidence interval, was used to quantify the pooled effect. A chi-square test for heterogeneity was performed. DATA SYNTHESIS A total of 2,235 articles were found. Twenty studies fulfilled the inclusion criteria. Seven articles assessed the use of IFC on joint pain; 9 articles evaluated the use of IFC on muscle pain; 3 articles evaluated its use on soft tissue shoulder pain; and 1 article examined its use on postoperative pain. Three of the 20 studies were considered to be of high methodological quality, 14 studies were considered to be of moderate methodological quality, and 3 studies were considered to be of poor methodological quality. Fourteen studies were included in the meta-analysis. CONCLUSION Interferential current as a supplement to another intervention seems to be more effective for reducing pain than a control treatment at discharge and more effective than a placebo treatment at the 3-month follow-up. However, it is unknown whether the analgesic effect of IFC is superior to that of the concomitant interventions. Interferential current alone was not significantly better than placebo or other therapy at discharge or follow-up. Results must be considered with caution due to the low number of studies that used IFC alone. In addition, the heterogeneity across studies and methodological limitations prevent conclusive statements regarding analgesic efficacy.
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Concurrent Oral 11 - Osteoarthritis [OP73-OP78]: OP73. Mechanical Load Drives Inflammatory Gene Expression and Disease in Murine OA. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fuentes C J, Armijo-Olivo S, Magee DJ, Gross D. Does amplitude-modulated frequency have a role in the hypoalgesic response of interferential current on pressure pain sensitivity in healthy subjects? A randomised crossover study. Physiotherapy 2010; 96:22-9. [DOI: 10.1016/j.physio.2009.06.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2008] [Accepted: 06/22/2009] [Indexed: 01/22/2023]
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Bearne LM, Hurley MV. Physical therapies. Rheumatology (Oxford) 2010. [DOI: 10.1016/b978-0-443-06934-5.00008-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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