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Young I, Dunning J, Butts R, Bliton P, Zacharko N, Garcia J, Mourad F, Charlebois C, Gorby P, Fernández-de-Las-Peñas C. Spinal manipulation and electrical dry needling as an adjunct to conventional physical therapy in patients with lumbar spinal stenosis: a multi-center randomized clinical trial. Spine J 2024; 24:590-600. [PMID: 38103739 DOI: 10.1016/j.spinee.2023.12.002] [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: 06/26/2023] [Revised: 11/10/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND CONTEXT Nonoperative management of lumbar spinal stenosis (LSS) includes activity modification, medication, injections, and physical therapy. Conventional physical therapy includes a multimodal approach of exercise, manual therapy, and electro-thermal modalities. There is a paucity of evidence supporting the use of spinal manipulation and dry needling as an adjunct to conventional physical therapy in patients with LSS. PURPOSE This study aimed to determine the effects of adding thrust spinal manipulation and electrical dry needling to conventional physical therapy in patients with LSS. STUDY DESIGN/SETTING Randomized, single-blinded, multi-center, parallel-group clinical trial. PATIENT SAMPLE One hundred twenty-eight (n=128) patients with LSS from 12 outpatient clinics in 8 states were recruited over a 34-month period. OUTCOME MEASURES The primary outcomes included the Numeric Pain Rating Scale (NPRS) and the Oswestry Disability Index (ODI). Secondary outcomes included the Roland Morris Disability Index (RMDI), Global Rating of Change (GROC), and medication intake. Follow-up assessments were taken at 2 weeks, 6 weeks, and 3 months. METHODS Patients were randomized to receive either spinal manipulation, electrical dry needling, and conventional physical therapy (MEDNCPT group, n=65) or conventional physical therapy alone (CPT group, n=63). RESULTS At 3 months, the MEDNCPT group experienced greater reductions in overall low back, buttock, and leg pain (NPRS: F=5.658; p=.002) and related-disability (ODI: F=9.921; p<.001; RMDI: F=7.263; p<.001) compared to the CPT group. Effect sizes were small at 2 and 6 weeks, and medium at 3 months for the NPRS, ODI, and RMDI. At 3 months, significantly (p=.003) more patients in the MEDNCPT group reported a successful outcome (GROC≥+5) than the CPT group. CONCLUSION Patients with LSS who received electrical dry needling and spinal manipulation in addition to impairment-based exercise, manual therapy and electro-thermal modalities experienced greater improvements in low back, buttock and leg pain and related-disability than those receiving exercise, manual therapy, and electro-thermal modalities alone at 3 months, but not at the 2 or 6 week follow-up.
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Affiliation(s)
- Ian Young
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA; Tybee Wellness & Osteopractic, Tybee Island, GA, USA.
| | - James Dunning
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA; Montgomery Osteopractic Physical Therapy & Acupuncture Clinic, Montgomery, AL, USA
| | | | - Paul Bliton
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA; William S. Middleton Veterans Memorial Hospital, Madison, WI, USA
| | - Noah Zacharko
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA; Osteopractic Physical Therapy of the Carolinas, Fort Mill, SC, USA
| | - Jodan Garcia
- Department of Physical Therapy, Georgia State University, Atlanta, GA, USA
| | - Firas Mourad
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
| | - Casey Charlebois
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA
| | - Patrick Gorby
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA; Gorby Osteopractic Physiotherapy, Colorado Springs, CO, USA
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; Cátedra de Clínica, Investigación y Docencia en Fisioterapia: Terapia Manual, Punción Secay Ejercicio, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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Zuo C, Zheng Z, Ma X, Wei F, Wang Y, Yin Y, Liu S, Cui X, Ye C. Efficacy of Core Muscle Exercise Combined with Interferential Therapy in Alleviating Chronic Low Back Pain in High-Performance Fighter Pilots: A Randomized Controlled Trial. BMC Public Health 2024; 24:700. [PMID: 38443845 PMCID: PMC10913547 DOI: 10.1186/s12889-024-18177-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Chronic low back pain (LBP) related to flight is a prevalent health issue in military aviation, impacting pilots. The objective of this investigation was to ascertain if the application of core muscle training in conjunction with interferential current (IFC) therapy results in a reduction in pain severity and associated disability, consequently enhancing core muscle functionality in Chinese Air Force high-performance fighter pilots experiencing chronic LBP. METHODS Fifty-three fighter pilots with chronic LBP were randomized into 3 groups: a core muscle exercise combined with IFC group (CG, n = 19), a core muscle exercise group (EG, n = 19), and an IFC group (IG, n = 15). The three groups underwent therapeutic intervention 5 times a week for 12 weeks. The primary outcomes were pain intensity, Oswestry Disability Index (ODI) score and SF-12 health-related quality of life (PCS and MCS) score. Secondary outcomes included evaluations of trunk muscle strength, endurance, and range of motion (ROM) during medial/lateral rotation to assess muscle functionality. Measurements were obtained both before and after the implementation of the intervention therapy. RESULTS After 12 weeks of intervention therapy, all the health condition parameters significantly improved among the three groups. However, the CG had a significant improvement in pain intensity compared to the EG (MD = - 0.84 scores; 95% CI = - 1.54 to - 0.15; p = 0.013) and the IG (MD = - 1.22 scores; 95% CI = - 1.96 to - 0.48; p = 0.000). Additionally, the CG led to greater conservation of ODI and improved SF-12 PCS scores than did the IG (p < 0.05). Finally, compared with those at baseline, the core muscle function parameters in the CG and EG improved significantly at the end of the study, but no statistically significant differences were observed between the two groups (p > 0.05). CONCLUSION Among participants with chronic LBP, three intervention therapies appear effective in reducing pain, diminishing disability, and enhancing quality of life. Also, combined therapy significantly improved pain and disability compared to the other two monotherapies; moreover, combined therapy and core muscle exercise provided similar benefits in terms of core muscle function after 12 weeks of intervention therapy.
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Affiliation(s)
- Chongwen Zuo
- Department of Rehabilitation Medicine, Air Force Medicine Centre of Chinese PLA, 100142, Beijing, China
| | - Zhiyang Zheng
- Department of Rehabilitation Medicine, Air Force Medicine Centre of Chinese PLA, 100142, Beijing, China
- Beijing Sports University, 100091, Beijing, China
| | - Xiaoyan Ma
- Tianjin University, 300072, Tianjin, China
| | - Fen Wei
- Department of Rehabilitation Medicine, Air Force Medicine Centre of Chinese PLA, 100142, Beijing, China
| | - Yushui Wang
- Department of Rehabilitation Medicine, Air Force Medicine Centre of Chinese PLA, 100142, Beijing, China
| | - Yi Yin
- Department of Rehabilitation Medicine, Air Force Medicine Centre of Chinese PLA, 100142, Beijing, China
| | - Shuai Liu
- Department of Rehabilitation Medicine, Air Force Medicine Centre of Chinese PLA, 100142, Beijing, China
| | - Xiaosong Cui
- Department of Rehabilitation Medicine, Air Force Medicine Centre of Chinese PLA, 100142, Beijing, China
| | - Chaoqun Ye
- Department of Rehabilitation Medicine, Air Force Medicine Centre of Chinese PLA, 100142, Beijing, China.
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Menezes MA, Mendonça Araújo F, Lima LV, Souza TAS, Carvalho EAN, Melo DeSantana J. Interferential current intensity influences the hypoalgesic response in healthy subjects under mechanically-induced pain: A randomized controlled trial. Physiother Theory Pract 2023; 39:2087-2098. [PMID: 35505631 DOI: 10.1080/09593985.2022.2068095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Interferential current (IFC) is a non-pharmacological therapy often used to reduce pain intensity. However, there is no scientific evidence of the biological effects of the adjustment of IFC intensity of stimulation. OBJECTIVE To investigate whether the adjustment of IFC intensity influences pain on cutaneous sensory threshold (CST), pressure pain threshold (PPT) and pain intensity in healthy subjects under mechanically induced pain. METHODS This is a placebo-controlled randomized trial. One hundred and two healthy university students blinded to intervention were randomized using opaque sealed envelopes to the following groups: 1) sensory IFC (n = 24); 2) fixed motor IFC (n = 26); 3) adjusted motor IFC (n = 27); and 4) placebo IFC (n = 25). After 40 minutes of stimulation or placebo, subjects were evaluated by an investigator blinded to group allocation. CST (von Frey filaments), PPT (algometry), and pain intensity (11-point numerical scale) were measured. RESULTS Adjusted motor IFC promoted a significant reduction of CST (hand: mean difference (MD) = 2.39, confidence intervals (CI) = 1.39-3.38; and forearm: MD = 3.01, CI = 2.87-3.14) compared to placebo. Adjusted motor IFC increased PPT significantly (hand: MD = 27.59, CI = 26.80-28.37; and forearm: MD = 34, CI = 25.74-42.25) when compared to placebo. Adjusted motor IFC reduced pain intensity by 4.01 points (CI = 3.64-4.55) when compared to placebo. No adverse events were observed. CONCLUSIONS Adjusted motor IFC intensity increased PPT and CST and also reduced pain intensity in healthy subjects under mechanically induced pain.
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Affiliation(s)
- Mayara Alves Menezes
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Fernanda Mendonça Araújo
- Physiological Sciences Graduate Program, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Lucas Vasconcelos Lima
- Department of Psychology, McGill University, 2001 Avenue McGill College, Montreal, QC, Canada
| | | | - Elyson Adan Nunes Carvalho
- Department of Electrical Engineering, Graduate Program in Electrical Engineering, Federal University of Sergipe, São Cristóvão, Brazil
| | - Josimari Melo DeSantana
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil
- Physiological Sciences Graduate Program, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Department of Physical Therapy, Federal University of Sergipe, Brazil
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Rampazo ÉP, Júnior MAL, Corrêa JB, de Oliveira NTB, Santos ID, Liebano RE, Costa LOP. Effectiveness of interferential current in patients with chronic non-specific low back pain: a systematic review with meta-analysis. Braz J Phys Ther 2023; 27:100549. [PMID: 37801776 PMCID: PMC10562668 DOI: 10.1016/j.bjpt.2023.100549] [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: 05/10/2022] [Revised: 07/06/2023] [Accepted: 09/11/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND There is no systematic review assessing the effectiveness of interferential current (IC) in patients with low back pain. OBJECTIVE To investigate the effectiveness of IC in patients with chronic non-specific low back pain. METHODS The databases PUBMED, EMBASE, PEDro, Cochrane Library, CINAHL, and SCIELO were searched. Randomized controlled trials reporting pain intensity and disability in patients with chronic non-specific low back pain, in which IC was applied were included. Methodological quality was assessed using the PEDro scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of evidence. RESULTS Thirteen RCTs were considered eligible for this systematic review (pooled n = 1367). Main results showed moderate-quality evidence and moderate effect sizes that IC probably reduces pain intensity and disability compared to placebo immediately post-treatment (Pain: MD = -1.57 points; 95% CI -2.17, -0.98; Disability: MD = -1.51 points; 95% CI -2.57, -0.46), but not at intermediate-term follow-up. Low-quality evidence with small effect size showed that IC may reduce pain intensity (SMD = -0.32; 95% CI -0.61, -0.03, p = 0.03) compared to TENS immediately post-treatment, but not for disability. There is very low-quality evidence that IC combined with other interventions (massage or exercises) may not further reduce pain intensity and disability compared to the other interventions provided in isolation immediately post-treatment. CONCLUSION Moderate-quality evidence shows that IC is probably better than placebo for reducing pain intensity and disability immediately post-treatment in patients with chronic non-specific low back pain.
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Affiliation(s)
- Érika P Rampazo
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Maurício A Luz Júnior
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo SP, Brazil
| | - Juliana B Corrêa
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo SP, Brazil
| | - Naiane T B de Oliveira
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo SP, Brazil
| | - Irlei Dos Santos
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo SP, Brazil
| | - Richard E Liebano
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil; Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
| | - Leonardo O P Costa
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo SP, Brazil
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Effect of premodulated interferential current versus diadynamic current on the management of lateral elbow tendinopathy. BIOMEDICAL HUMAN KINETICS 2023. [DOI: 10.2478/bhk-2023-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Abstract
Study aim: To compare the effect of premodulated interferential current (PREMOD IFC) and diadynamic current (DD) with exercise training on the management of lateral elbow tendinopathy (LET).
Material and methods: One hundred and four patients with unilateral LET from both genders (55 females and 49 males) were randomly allocated into two groups. Group A received PREMOD IFC in addition to the exercises, and group B received DD with the same exercises. The outcomes were maximum grip strength assessed by the hand dynamometer, the pinch strength assessed by the pinch gauge dynamometer, and pain and functional disability of the forearm assessed by a patient-rated tennis elbow evaluation (PRTEE) questionnaire. All participants received electrical stimulation, consisting of three sessions per week for six weeks.
Results: The mean PRTEE score, and grip strength were significantly improved after six weeks in favour of group A, while there was no significant difference between the two groups in pinch strength. (p < 0.05).
Conclusion: The results revealed that the combination of PREMOD IFC with exercises could improve pain, functional disability, and grip strength compared to DD with exercises in LET patients without a significant difference between the two groups in pinch strength.
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Espejo-Antúnez L, Fernández-Morales C, Hernández-Sánchez S, Cardero-Durán MDLÁ, Toledo-Marhuenda JV, Albornoz-Cabello M. The Impact on the Stress-Associated Autonomic Response of Physiotherapy Students Receiving Interferential Current in an Electrotherapy Training Session. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13348. [PMID: 36293928 PMCID: PMC9603673 DOI: 10.3390/ijerph192013348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Electrical currents are didactic contents widely applied in the training of physiotherapy students, but the treatment is considered a stressful situation for both the patient who receives it and the student who applies it. The aim of this study was to evaluate the stress-associated autonomic response of physiotherapy students receiving interferential current by measuring and analysing heart rate variability. An observational case-control study was conducted. Ninety healthy male volunteers, all physiotherapy degree students, were enrolled while attending laboratory practice during the 2020-2021 academic year. Participants were randomly allocated to a sham electrotherapy group (44 subjects), in which heart rate variability was recorded for 10 min, both at rest and during the application of sham technique on the lower back (10 min), and an electrotherapy group (46 subjects), applying the same procedure with the electrical current flowing. Outcome measures included baseline (seated position) and postintervention (prone position) time domain parameter, diameters of the Poincaré plot 1 and 2, stress score, and sympathetic/parasympathetic ratio. The sham electrotherapy group exhibited significant increases in time domain parameter (p = 0.027) and diameters of the Poincaré plot 1 (p = 0.032), with a small effect size (d ≤ 0.5). The electrotherapy group exhibited significant increases in time domain parameter and diameters of the Poincaré plot 1 and 2 (p < 0.001) and decreases in the stress score and sympathetic/parasympathetic ratio (p < 0.001), with a large effect size (d > 0.8) other than for the time domain parameter (d = 0.42), indicating increased parasympathetic and decreased sympathetic activity. After interventions, there were significant differences between groups in diameters of the Poincaré plot 2 (p < 0.001), stress score (p = 0.01) and sympathetic/parasympathetic ratio (p = 0.003), with moderate effect size (d > 0.5). The application of the interferential current technique produces stress-associated autonomic response characterized by greater parasympathetic activity and decreased sympathetic activity. Further studies are needed to determine possible adverse effects.
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Affiliation(s)
- Luis Espejo-Antúnez
- Department of Medical-Surgical Therapeutics, Faculty of Medicine and Health Sciences, University of Extremadura, 06006 Badajoz, Spain
| | - Carlos Fernández-Morales
- Department of Medical-Surgical Therapeutics, Faculty of Medicine and Health Sciences, University of Extremadura, 06006 Badajoz, Spain
| | - Sergio Hernández-Sánchez
- Department of Pathology and Surgery (Area of Physiotherapy), Faculty of Medicine, Miguel Hernández University, 03550 Alicante, Spain
| | | | - José Vicente Toledo-Marhuenda
- Department of Pathology and Surgery (Area of Physiotherapy), Faculty of Medicine, Miguel Hernández University, 03550 Alicante, Spain
| | - Manuel Albornoz-Cabello
- Department of Physical Therapy, Faculty of Nursing, Physical Therapy and Podiatry, University of Seville, 41009 Seville, Spain
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Chitale N, Patil DS, Phansopkar P. Integrated Neuromuscular Inhibition Technique Versus Mulligan Mobilization on Functional Disability in Subjects With Nonspecific Low Back Pain: A Comparative Study. Cureus 2022; 14:e30253. [DOI: 10.7759/cureus.30253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
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Graham A, Ryan CG, MacSween A, Alexanders J, Livadas N, Oatway S, Atkinson G, Martin DJ. Sensory discrimination training for adults with chronic musculoskeletal pain: a systematic review. Physiother Theory Pract 2022; 38:1107-1125. [PMID: 33078667 DOI: 10.1080/09593985.2020.1830455] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Sensory discrimination training (SDT) is a form of feedback guided sensory training used in the treatment of chronic musculoskeletal pain (CMP). OBJECTIVE This systematic review aimed to investigate the efficacy and safety of SDT for CMP. METHODS MEDLINE, CINAHL, EMBASE, AMED, CENTRAL, PsycINFO, Scopus, OT Seeker, PEDro, ETHOS, Web of Science, and Open Grey were searched for appropriate randomized controlled trials (RCTs). Included papers were assessed for risk of bias, and evidence was graded using the GRADE approach. The protocol was published on PROSPERO (anonymized). RESULTS Ten RCTs met the inclusion/exclusion criteria. There was conflicting evidence from seven RCTs for the efficacy of SDT for chronic low back pain (CLBP). There was very low-quality evidence from two studies supporting the efficacy of SDT for phantom limb pain (PLP). There was very low-quality evidence from one RCT for the efficacy of SDT for Fibromyalgia. No adverse effects of SDT were identified. CONCLUSIONS SDT has been delivered in multiple forms in the literature. SDT does not appear to be associated with any adverse effects and shows potential regarding its clinical efficacy. However, there is a lack of high-quality evidence upon which to make any firm clinical recommendations.
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Affiliation(s)
- Andrew Graham
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Cormac G Ryan
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Alasdair MacSween
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Jenny Alexanders
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Nick Livadas
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Sarah Oatway
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Greg Atkinson
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Denis J Martin
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
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Rezende LFD, Da Silva Costa EC, Lenzi J, Carvalho RL, Vilas Boas VF. Transcutaneous Electrical Stimulation, Interferential Current and Photobiomodulation May Lead to the Recurrence of Breast Cancer in Rats? REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n3.2383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Introduction: Transcutaneous electrical nerve stimulation (TENS), interferential current therapy (IFC) and photobiomodulation therapy (PBMT) have been used in the management of cancer-related pain in adults. However, there are still some controversy regarding the effects of this therapy on tumor cells that may remain after cancer treatment. Objective: To evaluate the risk of recurrence of breast cancer in rats when using TENS, IFC or PBMT. Method: An experimental, randomized, controlled and cross-sectional study. With 90 days of age, 7,12-dimetylbenz(a)anthracene (7,12-DMBA) was administered to rats by gastric gavage to induce mammary cancer. After 120 days the mammary glands of the rats belonging to the group with mammary cancer were removed. Results: 39 female Sprague-Dawley rats were studied: 9 rats without induction of mammary carcinoma; 9 rats with induction of mammary carcinoma and without surgery; 9 rats with induction of mammary carcinoma with surgery and placebo application of TENS, IFC, PBMT; 9 rats with induction of mammary carcinoma, surgery and the application of TENS, IFC and PBMT. Conclusion: This study demonstrated that there was local recurrence of tumors in rats that were stimulated with TENS or IFC, however no evidence of local recurrence with PBMT.
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Hussein HM, Alshammari RS, Al-Barak SS, Alshammari ND, Alajlan SN, Althomali OW. A Systematic Review and Meta-analysis Investigating the Pain-Relieving Effect of Interferential Current on Musculoskeletal Pain. Am J Phys Med Rehabil 2022; 101:624-633. [PMID: 34469914 DOI: 10.1097/phm.0000000000001870] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Interferential current is one of the most common electrotherapeutic modalities used in the treatment of painful conditions. Patients seeking medical help to reduce their musculoskeletal pain can be treated using interferential current. OBJECTIVE The current review aimed to analyze the recently available information regarding the efficacy of interferential current in alleviating the pain of musculoskeletal origin. METHODS This study used Scopus, CINAHL, Cochrane Library, Web of Science, MEDLINE, Embase, and EBSCOas as data sources. The initial selection of the studies, thorough assessment of the full articles, and extraction of the necessary study characteristics were carried out by two independent reviewers. Another two independent reviewers assessed the methodological quality of each included trial against 39 criteria. These criteria were integrated from several popular scales. Pain intensity-measured using the visual analog scale, numeric pain rating scale, or McGill Pain Questionnaire-was the outcome of interest. RESULTS This review included 35 trials of variable methodological quality from which 19 trials were selected for the meta-analysis. In general, interferential current alone versus placebo demonstrated a significant pain-relieving effect. On the other hand, interferential current showed no significant difference when added to standard treatment compared with placebo plus standard treatment or standard treatment alone. Similarly, interferential current showed no significant difference when compared with other single interventions (laser, transcutaneous electrical nerve stimulation, cryotherapy). CONCLUSIONS Interferential current alone is better than placebo at discharge. However, the low number of studies raises suspicions about this conclusion. Interferential current alone or added to other interventions is not more effective than comparative treatments in relieving musculoskeletal pain.
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Affiliation(s)
- Hisham M Hussein
- From the Department of Physical Therapy, College of Applied Medical Sciences, University of Hail, Ha'il, Saudi Arabia (HMH, RSA, SSA-B, NDA, SNA, OWA); and Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt (HMH)
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Tarcău E, Ianc D, Sirbu E, Ciobanu D, Boca IC, Marcu F. Effects of Complex Rehabilitation Program on Reducing Pain and Disability in Patients with Lumbar Disc Protrusion—Is Early Intervention the Best Recommendation? J Pers Med 2022; 12:jpm12050741. [PMID: 35629163 PMCID: PMC9144614 DOI: 10.3390/jpm12050741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/13/2022] [Accepted: 04/29/2022] [Indexed: 11/30/2022] Open
Abstract
(1) Background: Due to its frequency and possible complications, low back pain (LBP) has a high social impact, it is a common problem of the active population and the second reason for visiting a physician. In patients with lumbar disc protrusion (LDP), one of the most common causes of LBP, the nucleus pulposus bulges against the disc and then protrudes into the spinal cord, but the annulus fibrosus remains intact; (2) Objectives: The primary objective of this study was to determine the efficacy of a rehabilitation treatment (RT) comprising electrotherapy (ET), hydrotherapy (HT) and individualized physical therapy (PT) versus ET alone in patients with LDP. The second objective was to investigate whether there is a correlation between early RT and the symptomatology of patients with LDP; (3) Methods: The research was conducted between July 2021 and January 2022 at the Ceres Hotel Treatment Centre from Baile 1 Mai, Romania, and all the study subjects signed an informed consent form. For this study, the block randomization method was used to randomize subjects into groups that resulted in equal sample size, in order to maintain a reasonably good balance among groups. Therefore, the two groups had the same number of subjects (30 subjects) and the randomization was made taking into account the patient’s motivation or the subject’s willingness to receive not only electrotherapy treatment, but also the physical exercises and hydrotherapy. The eligibility criteria were: low back pain for more than three months, an MRI confirmed diagnosis of LDP (without dural compression), and ability to perform a PT program. The control group received only a classical ET program. In addition, the patients in the experimental group received a complex individualized PT program associated with HT and ET. To achieve these objectives, the study subjects were monitored for spinal mobility (lateral lumbar flexion—LLF, index fingers-ground—IFG, lumbar Schober tests for flexion—LS, Inverted Schober test for extension—ILS), trunk flexor and extensor muscle strength (LF strength, LE strength), level of pain (Short Form McGill Pain Questionnaire—SF-MPQ, Visual Analogue Scale—VAS), and the degree of limitation in activities of daily living (Oswestry Disability Index—ODI); (4) Results: Comparing the evolution of the subjects, using the One-Way ANOVA between groups, we observed a significant improvement in all variables [SF-MPQ (95% CI, 7.996/11.671), VAS (95% CI, 1.965/3.169), mobility FTF (95% CI, −7.687/−3.940), LS (95% CI, 2.272/2.963), LE strength (95% CI, −5.676/−3.324), LF strength (95% CI, −5.970/−3.630), disability (95% CI, 8.026/10.441) after six months of treatment for the experimental group subjects. A clear correlation was found, using the Bravis–Pearson test, between the earliest possible initiation of RT and improvement of patients’ symptoms; (5) Conclusion: The current study proves the importance of combining ET with HT and PT. The earlier the RT is implemented, the lower the pain perception and level of disability associated with the lumbar disease.
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Affiliation(s)
- Emilian Tarcău
- Department of Physical Education, Sport and Physiotherapy, University of Oradea, 410087 Oradea, Romania; (E.T.); (D.I.); (D.C.); (I.C.B.)
- Human Performance Research Center, University of Oradea, 410087 Oradea, Romania
| | - Dorina Ianc
- Department of Physical Education, Sport and Physiotherapy, University of Oradea, 410087 Oradea, Romania; (E.T.); (D.I.); (D.C.); (I.C.B.)
- Human Performance Research Center, University of Oradea, 410087 Oradea, Romania
| | - Elena Sirbu
- Department of Physical Therapy and Special Motricity, Faculty of Physical Education and Sport, West University of Timisoara, 300223 Timisoara, Romania
- Correspondence:
| | - Doriana Ciobanu
- Department of Physical Education, Sport and Physiotherapy, University of Oradea, 410087 Oradea, Romania; (E.T.); (D.I.); (D.C.); (I.C.B.)
- Human Performance Research Center, University of Oradea, 410087 Oradea, Romania
| | - Ioan Cosmin Boca
- Department of Physical Education, Sport and Physiotherapy, University of Oradea, 410087 Oradea, Romania; (E.T.); (D.I.); (D.C.); (I.C.B.)
- Human Performance Research Center, University of Oradea, 410087 Oradea, Romania
| | - Florin Marcu
- Department of Psychoneuroscience and Rehabilitation, University of Oradea, 410087 Oradea, Romania;
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Rampazo ÉP, Liebano RE. Analgesic Effects of Interferential Current Therapy: A Narrative Review. Medicina (B Aires) 2022; 58:medicina58010141. [PMID: 35056448 PMCID: PMC8779694 DOI: 10.3390/medicina58010141] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 12/26/2022] Open
Abstract
Background and Objectives: Transcutaneous electrical stimulation of low- and medium-frequency currents is commonly used in pain management. Interferential current (IFC) therapy, a medium frequency alternating current therapy that reportedly reduces skin impedance, can reach deeper tissues. IFC therapy can provide several different treatment possibilities by adjusting its parameters (carrier frequency, amplitudemodulated frequency, sweep frequency, sweep mode or swing pattern, type of application (bipolar or quadripolar), time of application and intensity). The objective of this review article is to discuss the literature findings on the analgesic efficacy of IFC therapy. Conclusions: According to the literature, IFC therapy shows significant analgesic effects in patients with neck pain, low back pain, knee osteoarthritis and post-operative knee pain. Most of the IFC parameters seem not to influence its analgesic effects. We encourage further studies to investigate the mechanism of action of IFC therapy.
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ALMEIDA NICOLE, PALADINI LUISHENRIQUE, DIAS LUCASVINICIUS, SALES RAMONSCHMIDTDE, MACEDO ANACAROLINABRANDTDE. IMMEDIATE ANALGESIC EFFECT OF 4KHZ AMFS INTERFERENTIAL CURRENT ON CHRONIC LOW BACK PAIN. COLUNA/COLUMNA 2022. [DOI: 10.1590/s1808-185120222102253908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To analyze the immediate effect of amplitude modulation frequencies (AMFs) of 4kHz interferential current (IFC) on chronic low back pain (CLBP). Method: This is a randomized controlled clinical trial. Sixty-three subjects with CLBP were recruited. The subjects were randomized into 3 groups: the placebo group (PG, n=21) and 2 intervention groups (IG), IG4kHz/2Hz (n=21) and IG4kHz/100Hz (n=21). All groups were submitted to a single session of 30 minutes. Pain was evaluated using a numerical rating scale (NRS), the McGill Pain Questionnaire (MPQ), and pressure algometry. Flexibility was evaluated using the Modified Schober Test (MST), the Sit-and-Reach Test (SRT), the Fingertip-to-Floor Test (FTF), and the Passive Straight-Leg Raise Test (PSLR). Results: Comparing IG4kHz/100Hz with PG, we found a significant difference (p<0.05) in NRS in the total and in the MPQ categories, whereas in the comparison between IG4kHz/2Hz and PG, we found a significant difference only in the sensory and evaluative categories of MPQ. Regarding the flexibility tests, we observed a significant difference of both IG4kHz/100Hz and IG4kHz/2Hz in comparison to PG in MST and PSLR, and of IG4kHz/2Hz in comparison to PG in SRT. The 4kHz IFC was effective in immediately reducing CLBP and, consequently, in increasing the flexibility of the lumbar spine and lower limbs. Conclusion: Conclusion: There was a greater number of significant positive outcomes when the 100Hz AMF was adopted. Level of Evidence I; High quality randomized clinical trial with or without statistically significant differences, but with narrow confidence intervals.
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Detection of Changes on Parameters Related to Heart Rate Variability after Applying Current Interferential Therapy in Subjects with Non-Specific Low Back Pain. Diagnostics (Basel) 2021; 11:diagnostics11122175. [PMID: 34943411 PMCID: PMC8700138 DOI: 10.3390/diagnostics11122175] [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: 10/25/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 02/06/2023] Open
Abstract
Interferential current therapy (ICT) is an electrotherapeutic intervention that combines the advantages of high permeability from middle frequency currents and efficient tissue stimulation from low frequency currents, delivering the maximum current with high tissue permeability. The aim was to evaluate the effects of ICT on heart rate variability (HRV) and on pain perception in patients with non-specific chronic low back pain (NSCLBP). In the study, 49 patients with NSCLBP were randomly divided into an experimental (EG) and a sham group (SG). All participants received a single intervention, ICT, or simulated intervention. Outcome measures including baseline (sit-down position) and postintervention (prone position) pain, heart rate (HR), time domain parameter (rMSSD), diameters of the Poincaré plot (SD1, SD2), stress score (SS), and sympathetic/parasympathetic (S/PS) ratio were investigated. In both groups, significant statistical differences were found in perceived pain and in all HRV parameters except in HRmax. Between-group comparisons showed statistically significant differences in all variables except for HRmin and HRmean in favor of the experimental group. These changes reported an increase in parasympathetic activity (rMSSD) (p < 0.05) and a decrease in sympathetic activity (increase in SD2 and decrease in SS) (p < 0.001) and perceived pain (p < 0.001), with a greater size effect (η2 = 0.44) in favor of the experimental group. In conclusion, a single session of ICT can shift the autonomic balance towards increase parasympathetic dominance and decrease the sympathetic dominance and intensity of pain perceived by patients with NSCLBP.
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George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG60. [PMID: 34719942 PMCID: PMC10508241 DOI: 10.2519/jospt.2021.0304] [Citation(s) in RCA: 183] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Low back pain (LBP) remains a musculoskeletal condition with an adverse societal impact. Globally, LBP is highly prevalent and a leading cause of disability. This is an update to the 2012 Academy of Orthopaedic Physical Therapy (AOPT), formerly the Orthopaedic Section of the American Physical Therapy Association (APTA), clinical practice guideline (CPG) for LBP. The overall objective of this update was to provide recommendations on interventions delivered by physical therapists or studied in care settings that included physical therapy providers. It also focused on synthesizing new evidence, with the purpose of making recommendations for specific nonpharmacologic treatments. J Orthop Sports Phys Ther 2021;51(11):CPG1-CPG60. doi:10.2519/jospt.2021.0304.
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Maghalian M, Mirghafourvand M, Ghaderi F, Abbasalizadeh S, Pak S, Kamalifard M. Comparison the effect of Swedish massage and interferential electrical stimulation on labor pain and childbirth experience in primiparous women: a randomized controlled clinical trial. Arch Gynecol Obstet 2021; 306:37-47. [PMID: 34716820 DOI: 10.1007/s00404-021-06220-6] [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: 01/07/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Since mothers are more inclined toward non-pharmacological labor pain management methods, this study aimed to compare the effect of interferential electrical stimulation (IES) and Swedish massage (SM) on labor pain and childbirth experience (primary outcomes) and childbirth satisfaction, duration of active phase and side effects (secondary outcomes) in primiparous women. METHODS This randomized controlled trial was performed on 90 primiparous women. Participants were randomly assigned into three groups through the block randomization method. The SM group received two massage techniques of effleurage and petrissage, on T10-L1 and S2-S4 at cervical dilatation of 4 and 8-10 cm. The IES group received electrical stimulation in a similar way to SM group, with a base frequency of 4000 Hz and a pulse frequency of 80-120 Hz by a physiotherapist. Control group received only routine care. RESULTS The mean pain was significantly lower in the SM group (adjusted mean difference (AMD) - 0.86; 95% confidence interval (95% CI) - 1.60 to - 0.11) and the IES group (AMD - 0.95; 95% CI - 1.70 to - 0.21) compared to the control group. The mean score of childbirth experience was significantly higher in the SM (MD 5.63; 95% CI 2.15-9.11) and IES (MD 3.66; 95% CI 0.18-7.14) group compared to the control group. The mean childbirth satisfaction in the SM (p = 0.003) and IES (p = 0.046) groups was significantly higher than the control group; and duration of the active phase of labor was significantly lower (p < 0.001) than the control group. No serious side effects were occurred in none of the groups. CONCLUSION SM and IES are safe methods that can significantly reduce pain and duration of active phase and improve the experience and satisfaction of childbirth.
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Affiliation(s)
- Mahsa Maghalian
- Student Research Committee, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Centre, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Ghaderi
- Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shamsi Abbasalizadeh
- Department of Obstetrics and Gynecology, Women's Reproductive Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahar Pak
- Student Research Committee, Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahin Kamalifard
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Lai WY, Cui H, Hu Y. Correlation between change in pain, disability, and surface electromyography topographic parameters after interferential current treatment in patients with chronic low back pain. J Phys Ther Sci 2021; 33:772-778. [PMID: 34658523 PMCID: PMC8516599 DOI: 10.1589/jpts.33.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Surface electromyography (SEMG) topography is used to objectively assess
patients with low back pain (LBP). This study aimed to investigate the correlation between
SEMG topographic variables, pain, and disability in patients with chronic LBP (CLBP) after
interferential current (IFC) treatment, and to evaluate IFC treatment efficacy using SEMG
topography. [Participants and Methods] Twenty nine patients with CLBP were recruited for a
6-week IFC treatment. Pain and disability scores, and the root-mean-square difference
(RMSD) of SEMG topographic variables (relative areas [RAs] at flexion and extension) were
compared before and after the intervention by repeated measures ANOVA; the correlation
between variables was also explored and p-value was set at 0.001. [Results] Significant
positive correlations between changes in pain score and the RMSD of RA at flexion
(r(29)=0.593), and between changes in pain and disability scores (r(29)=0.426) were
observed. All participants showed statistically significant improvements in the RMSD of RA
at flexion, pain score, and disability score after IFC treatment. [Conclusion] SEMG
topographic variables are closely associated with changes in pain score in patients with
CLBP after IFC treatment. The RMSD of RA at flexion can be used as an objective marker in
IFC treatment efficacy evaluation.
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Affiliation(s)
- Wai Ying Lai
- Department of Orthopedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong: 12 Sandy Bay Road, Pokfulam, Hong Kong.,Physiotherapy Department, Queen Elizabeth Hospital, Hong Kong
| | - Hongyan Cui
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, China
| | - Yong Hu
- Department of Orthopedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong: 12 Sandy Bay Road, Pokfulam, Hong Kong.,Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, China
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Kurt V, Aras O, Buker N. Comparison of conservative treatment with and without neural mobilization for patients with low back pain: A prospective, randomized clinical trial. J Back Musculoskelet Rehabil 2021; 33:969-975. [PMID: 32144973 DOI: 10.3233/bmr-181241] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low back pain (LBP) is a common problem that causes pain, disability, and gait and balance problems. Neurodynamic techniques are used in the treatment of LBP. OBJECTIVE The aim of this study was to compare the effects of electrotherapy and neural mobilization on pain, functionality, gait, and balance in patients with LBP. MATERIALS AND METHODS A total of 41 patients were randomly assigned to either the neural mobilization group (NMG, n= 20) or electrotherapy group (ETG, n= 21). Assessment tools used were Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI) for functionality, straight leg raise test (SLRT) for neural involvement, and baropedographic platform (Zebris FDM-2TM) for gait and static balance measurements. RESULTS Both groups showed a significant decrease in pain and functional disability, while only the NMG group showed a significant increase in SLRT scores (p< 0.05). However, there were no statistically significant pre- to post-treatment changes in gait or static balance parameters in either group (p< 0.05). CONCLUSION Neural mobilization was effective in reducing pain and improving functionality and SLRT performance in patients with LBP, but induced no change in gait and static balance parameters. Neural mobilization may be used as self-practice to supplement standard treatment programs.
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Affiliation(s)
- Vedat Kurt
- Deparment of Physiotherapy and Rehabilitation, Faculty of Health Science, Kutahya Health Science University, Kutahya, Turkey
| | - Ozgen Aras
- Deparment of Physiotherapy and Rehabilitation, Faculty of Health Science, Kutahya Health Science University, Kutahya, Turkey
| | - Nihal Buker
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
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Albornoz-Cabello M, Barrios-Quinta CJ, Escobio-Prieto I, Sobrino-Sánchez R, Ibáñez-Vera AJ, Espejo-Antúnez L. Treatment of Patellofemoral Pain Syndrome with Dielectric Radiofrequency Diathermy: A Preliminary Single-Group Study with Six-Month Follow-Up. ACTA ACUST UNITED AC 2021; 57:medicina57050429. [PMID: 33925211 PMCID: PMC8145052 DOI: 10.3390/medicina57050429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Notwithstanding patellofemoral pain syndrome (PFPS) being one of the most common causes of pain in the front of the knee in outpatients, few studies have shown the effects of radiofrequency on knee pain and function in this population. The aim of the present study was to determine whether outpatients diagnosed with PFPS obtained improvement in pain and function after treatment by dynamic application of monopolar dielectric diathermy by emission of radiofrequency (MDR). Materials and Methods: An experimental study was conducted with 27 subjects with PFPS. Subjects were treated with 10 sessions of MDR in dynamic application. The visual analogue scale (VAS), the Kujala scale, the DN4 questionnaire, the lower extremity function scale (LEFS), the range of movement (ROM) in knee flexion and extension and the daily drug intake were measured pre- and post-intervention and at the time of the follow-up (six months). Results: Statistically significant differences were found in pain perception (VAS: F1,26 = 92.43, p < 0.000, ŋ2 = 0.78 and DN4: F1.26 = 124.15, p < 0.000, ŋ2 = 0.82), as well as improvements in functionality (LEFS: F1.26 = 72.42, p < 0.000, ŋ2 = 0.74 and Kujala: F1.26 = 40.37, p < 0.000, ŋ2 = 0.61]) and in ROM (Flexion: F1.26 = 63.15, p < 0.000, ŋ2 = 0.71). No statistically significant changes in drug intake were found. Conclusions: The present study shows that the dynamic application of MDR seems effective in reducing pain and increasing functionality and knee flexion in patients with PFPS, after a follow-up of six months.
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Affiliation(s)
- Manuel Albornoz-Cabello
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain;
| | | | - Isabel Escobio-Prieto
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain;
- Correspondence:
| | | | | | - Luis Espejo-Antúnez
- Department of Medical-Surgical Therapy, Medicine Faculty, University of Extremadura, 06071 Badajoz, Spain;
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Morlion B, Finco G, Aldington D, Überall M, Karra R. Severe chronic low back pain: patient journey from onset of symptoms to strong opioid treatments in Europe. Pain Manag 2021; 11:595-602. [PMID: 33847146 DOI: 10.2217/pmt-2021-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We report the first patient roadmap in severe chronic low back pain (cLBP) in Europe, assessing the views of cLBP patients and general practitioners (GPs) who treat cLBP with regard to current cLBP management. Methodology: Patient journey mapping was conducted in four European countries to assess the views of cLBP patients (n = 20) and GPs (n = 40). Results: Four broad phases of cLBP, subdivided into eight individual steps, were identified as part of the patient journey, showing a disconnect between patients' and physicians' treatment goals, and expectations regarding pain relief levels for some patients. Conclusion: Improved communication, with greater involvement of patients in multimodal management decisions, might benefit the GP-patient relationship and overall outcomes for cLBP patients.
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Affiliation(s)
- Bart Morlion
- Leuven Centre for Algology & Pain Management, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Gabriele Finco
- Department of Medical Science & Public Health, University of Cagliari, Cagliari, Italy
| | | | - Michael Überall
- IFNAP - Private Institute of Neurological Sciences, Nürnberg, Germany
| | - Ravi Karra
- Grünenthal GmbH, Zieglerstr. 6, 52058 Aachen 4, 90411, Nürnberg, Germany
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21
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Albornoz-Cabello M, Barrios-Quinta CJ, Espejo-Antúnez L, Escobio-Prieto I, Casuso-Holgado MJ, Heredia-Rizo AM. Immediate clinical benefits of combining therapeutic exercise and interferential therapy in adults with chronic neck pain: a randomized controlled trial. Eur J Phys Rehabil Med 2021; 57:767-774. [PMID: 33759439 DOI: 10.23736/s1973-9087.21.06688-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Therapeutic exercise is highly recommended for the management of non-specific neck pain and has shown promising results combined with interferential current therapy. Yet, the clinical relevance of the pooled effect of these approaches remains uncertain. AIM To investigate the immediate clinical effect size of combining therapeutic exercise and interferential therapy, compared with the isolated use of therapeutic exercise, in adults with chronic non-specific neck pain. DESIGN Randomized, single-blinded, controlled, superiority trial. SETTING Outpatients, primary care center. POPULATION Forty-nine adults with chronic non-specific neck pain. METHODS Participants with neck pain (grades I or II) lasting for more than 12 weeks were allocated to a therapeutic exercise plus interferential currents group (n = 25) or to a therapeutic exercise only group (n = 24). All individuals underwent treatment 5 times a week for 2 weeks. The primary outcome was current neck pain intensity (11-point numeric pain rating scale). Secondary outcomes included neck disability (Neck Disability Index) and active cervical range-of-movement (CROM device). Measurements were taken at baseline and immediately after treatment. An intention-to-treat analysis was carried out. To quantify the effect size of the interventions, the relative risk, the absolute and relative risk reduction, and the number needed to treat were calculated. RESULTS A significant time*group effect was found for pain intensity, disability, and neck flexion and right rotation (all, p < 0.05). In the analysis for treatment benefit, the number needed to treat was 2 (95% CI: 2 to 4, p < 0.001) for neck pain and disability, and 3 (95% CI: 2 to 11, p = 0.029) for neck flexion. CONCLUSIONS Adding interferential therapy to therapeutic exercise is clinically more effective than therapeutic exercise alone to immediately improve neck pain and disability, but not active cervical range-of-movement, in adults with persistent neck pain. CLINICAL REHABILITATION IMPACT Our results suggest that this multimodal intervention can be a useful strategy for rehabilitation of patients with non-specific neck pain. This is the first study on this topic reporting findings in terms of clinical relevance, which is key to transfer research evidence into practice.
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Affiliation(s)
- Manuel Albornoz-Cabello
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | | | - Luis Espejo-Antúnez
- Department of Medical-Surgical Therapeutics, Faculty of Medicine, Extremadura University, Badajoz, Spain
| | - Isabel Escobio-Prieto
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | - María J Casuso-Holgado
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain -
| | - Alberto M Heredia-Rizo
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
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Dias LV, Cordeiro MA, Schmidt de Sales R, Dos Santos MMBR, Korelo RIG, Vojciechowski AS, de Mace do ACB. Immediate analgesic effect of transcutaneous electrical nerve stimulation (TENS) and interferential current (IFC) on chronic low back pain: Randomised placebo-controlled trial. J Bodyw Mov Ther 2021; 27:181-190. [PMID: 34391232 DOI: 10.1016/j.jbmt.2021.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 01/27/2021] [Accepted: 03/13/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To compare the immediate analgesic effect of transcutaneous nerve stimulation (TENS) and interferential current (IFC), with different combinations of parameters, in individuals with chronic low back pain (CLBP). METHODOLOGY 280 individuals with CLBP were included in the study, both genders, randomized in 8 groups: GI2KHz/100Hz, GI2KHz/2Hz, GI4KHz/100Hz, GI4KHz/2Hz, placebo interferential group (GIP), GT100Hz, GT2Hz, and placebo TENS group (GTP). All individuals underwent a single application of TENS or IFC for 30min. The assessments were carried out prior to the intervention, as well as immediately after, with the following outcomes: pain intensity (Numeric Pain Rating Scale-NPRS), qualitative pain characteristics (McGill Pain Questionnaire-MPQ), and pressure pain threshold (PPT) by pressure algometry (PA) in 4 points of the low back region. RESULTS In the intergroup comparison of NPRS, all intervention groups showed greater pain reduction compared to GTP (p < 0.05). In the total MPQ score, the groups that obtained significant results (p < 0.05) when compared to GTP were GT100Hz and GT2Hz, while the groups GT100Hz and GI4KHz/100Hz were significant when compared to GIP. In the PA, GI4KHz/100Hz showed an increase in the PPT in all points compared to GTP and GI2KHz/100Hz. CONCLUSION Both TENS and IFC presented immediate analgesic effect in CLBP, with emphasis on the interferential current of 4 KHz modulated at 100Hz.
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Affiliation(s)
| | | | | | | | - Raciele I G Korelo
- Department of Prevention and Rehabilitation in Physical Therapy at UFPR, Brazil
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Silveira AM, Santos LT, Rodrigues AYBM, Brum FDO, Yamada EF, Silva MDD. A eletroterapia pode aprimorar o efeito de exercícios cinesiofuncionais no tratamento da dor lombar inespecífica crônica? FISIOTERAPIA E PESQUISA 2021. [DOI: 10.1590/1809-2950/20022028032021] [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
RESUMO O presente estudo teve como objetivo comparar o efeito de um protocolo de exercícios cinesiofuncionais (ECF) isolados ou associados a corrente interferencial (CI) ou corrente aussie (CA), sobre a intensidade da dor, a mobilidade/flexibilidade, a funcionalidade e a qualidade de vida (QV) de indivíduos com dor lombar inespecífica crônica. Trata-se de um ensaio clínico não randomizado, em que foram selecionados 42 sujeitos aleatorizados em três grupos: GI (treinamentos cinesiofuncional; n=14), GII (treinamentos cinesiofuncional + CI; n=14) e GIII (treinamento cinesiofuncional + CA; n=14). Os indivíduos foram submetidos a dez sessões de tratamento ao longo de 5 semanas e foram avaliados pré e pós-intervenção, usando escala visual analógica de dor (EVA); avaliação da QV pelo questionário SF-36; avaliação da mobilidade/flexibilidade lombar pelo teste de Schober modificado e o teste de sentar e alcançar com o banco de Wells; avaliação da incapacidade funcional através do índice Oswestry; e, para os aspectos depressivos, inventário de depressão de Beck (IDB). Na reavaliação, percebeu-se que houve melhora significativa em todos os grupos experimentais na intensidade da dor (p<0,0001) e na mobilidade/flexibilidade. No SF-36, verificamos que apenas os indivíduos tratados com exercícios associados à corrente elétrica apresentaram melhora dos domínios capacidade física, aspectos físicos e dor. A avaliação do IDB não apresentou modificações pré e pós-intervenção. Conclui-se que a associação das técnicas terapêuticas apresentou maior benefício aos indivíduos da amostra, uma vez que produziu melhora sobre as variáveis avaliadas, como dor, mobilidade/flexibilidade e qualidade de vida.
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Albornoz-Cabello M, Ibáñez-Vera AJ, Aguilar-Ferrándiz ME, Espejo-Antúnez L. Monopolar dielectric diathermy by emission of radiofrequency in Patellofemoral pain. A single-blind-randomized clinical trial. Electromagn Biol Med 2020; 39:282-289. [PMID: 32683992 DOI: 10.1080/15368378.2020.1793169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Despite the high incidence of patellofemoral pain syndrome (PFPS), few studies show the effects of radiofrequency on pain and functionality in these patients. For this reason, the aim of this study was to determine the efficacy of monopolar dielectric diathermy by emission of radiofrequency (MDR) in dynamic applications aimed at treating pain and improving function in patients with PFPS. For this purpose, a single-blind randomized clinical trial was conducted. Eighty-four participants with PFPS were evenly divided into an experimental group (EG) and a control group (CG). All subjects receive 10 min of daily home exercises along 3 weeks, and in addition, the subjects of the EG received 10 sessions based on the dynamic application of MDR. Variables measured included Visual Analogue Scale (VAS), DN4 questionnaire, Lower Extremity Functionality Scale (LEFS), Kujala scale, Range of Movement (ROM) in knee flexion and extension and drug intake. The EG showed a statistically significant reduction in pain (VAS = 4.8 [5.5-4.1] [p < .001]; DN4 = 3.8 [4.4-3.2] [p < .001]), and an increase in functionality (LEFS = 16 [19-13] [p < .001]; Kujala = 19 [23-14] [p < .001]) and in ROM (flexion 18º [21º-16º] [p < .001]). No statistically significant changes in drug intake were found. Based on this data, the dynamic application of MDR seems effective in reducing pain and increasing functionality and flexion in patients with PFPS. Diathermy by emission of radiofrequency could be recommended as complement or main therapy in the treatment of PFPS.
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Affiliation(s)
| | - A J Ibáñez-Vera
- Health Sciences Department, University of Jaen , Jaen, Spain
| | | | - L Espejo-Antúnez
- Department of Medical-Surgical Therapy, University of Extremadura , Badajoz, Spain
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Almeida N, Paladini LH, Korelo RG, Liebano RE, de Macedo ACB. Immediate Effects of the Combination of Interferential Therapy Parameters on Chronic Low Back Pain: A Randomized Controlled Trial. Pain Pract 2020; 20:615-625. [PMID: 32219973 DOI: 10.1111/papr.12888] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/12/2020] [Accepted: 03/17/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To compare the immediate analgesic effects of 2 kHz or 4 kHz interferential current (IFC) with different amplitude-modulated frequencies (AMFs) (2 Hz or 100 Hz) on chronic low back pain (CLBP). DESIGN Three-arm double-blinded randomized controlled trial. SETTING Primary care. PARTICIPANTS 175 patients (19 to 60 years of age, 105 female) with CLBP. INTERVENTIONS One session of IFC: Interferential group (GI): GI2 kHz/100 Hz, GI2 kHz/2 Hz, GI4 kHz/100 Hz, GI4 kHz/2 Hz, or placebo. MAIN OUTCOMES MEASURES Pain intensity by numerical rating scale of pain (NRS), McGill Pain Questionnaire (MPQ), and algometry. RESULTS There was a significant difference in NRS scores (P < 0.05) in the GI2 kHz/2 Hz, GI4 kHz/2 Hz, and GI4 kHz/100 Hz groups compared with those of the placebo group (PG), and a significant difference in MPQ scores in the GI4 kHz/2 Hz and GI4 kHz/100 Hz groups compared with those of the PG. In algometry, only the GI4 kHz/100 Hz group showed a significant difference (by 2 points in the lumbar region) compared with the PG. Of the carrier frequencies, an IFC of 4 kHz showed more effective results, although no significant difference was noted between the AMFs. CONCLUSION An IFC with a carrier frequency of 4 kHz and an AMF of 100 Hz provide immediate analgesic effects in individuals with CLBP. CLINICAL TRIAL REGISTRATION NUMBER RBR-59YGRB.
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Affiliation(s)
- Nicole Almeida
- Department of Prevention and Rehabilitation in Physiotherapy, Universidade Federal do Paraná, Curitiba, Brazil
| | - Luis Henrique Paladini
- Department of Prevention and Rehabilitation in Physiotherapy, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Richard E Liebano
- Physiotherapy Department, Universidade Federal de São Carlos, São Carlos, Brazil
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Al-Ruwaili B, Khalil T. Prevalence and Associated Factors of Low Back Pain Among Physicians Working at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia. Open Access Maced J Med Sci 2019; 7:2807-2813. [PMID: 31844441 PMCID: PMC6901851 DOI: 10.3889/oamjms.2019.787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/07/2019] [Accepted: 07/08/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Low back pain is a common presenting symptom among workers in primary health care facilities, including physicians. AIM This study aimed to identify the magnitude, determinants and sequence of the problem of low back pain among physicians working at the King Salman Armed Forces hospital, Tabuk, Saudi Arabia. METHODS A cross-sectional study was carried out among physicians who are working at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia. A previously validated self-administered questionnaire was utilised for data collection including demographic information and data related to low back pain and its characteristics and outcome. RESULTS The study included 254 physicians. Their age ranged between 23 and 66 with a mean ± SD of 36.0 ± 9.3 years. Almost two-thirds (66.9%) were males. Most of the physicians (76.4%) ever had LBP whereas 70.5% had LBP in the last 12 months. The only significant factor associated with LBP in the past 12 months was physicians` speciality as all ophthalmologists and majority of emergency physicians and anaesthesia/intensive care physicians (88.9%) compared to only 14.3% of nephrologists and neurologists expressed LBP in the last 12 months. Overall, the association between physicians' speciality and a history of LBP in the last 12 months was statistically significant, p = 0.014. Absence from work because of LBP in the last 3 months was mentioned by 15% of physicians. CONCLUSION Low back pain is a very common health problem among physicians working at the King Salman Armed Forces hospital, Saudi Arabia. A considerable proportion of them was absent from work because of LBP.
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Affiliation(s)
- Bashayr Al-Ruwaili
- Family Medicine Department, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
| | - Tahani Khalil
- Family Medicine Department, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
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Effects of Adding Interferential Therapy Electro-Massage to Usual Care after Surgery in Subacromial Pain Syndrome: A Randomized Clinical Trial. J Clin Med 2019; 8:jcm8020175. [PMID: 30717426 PMCID: PMC6406802 DOI: 10.3390/jcm8020175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 01/27/2019] [Accepted: 01/30/2019] [Indexed: 11/17/2022] Open
Abstract
Subacromial pain syndrome (SAPS) is a prevalent condition that results in loss of function. Surgery is indicated when pain and functional limitations persist after conservative measures, with scarce evidence about the most-appropriate post-operative approach. Interferential therapy (IFT), as a supplement to other interventions, has shown to relieve musculoskeletal pain. The study aim was to investigate the effects of adding IFT electro-massage to usual care after surgery in adults with SAPS. A randomized, single-blinded, controlled trial was carried out. Fifty-six adults with SAPS, who underwent acromioplasty in the previous 12 weeks, were equally distributed into an IFT electro-massage group or a control group. All participants underwent a two-week intervention (three times per week). The control group received usual care (thermotherapy, therapeutic exercise, manual therapy, and ultrasound). For participants in the IFT electro-massage group, a 15-min IFT electro-massage was added to usual care in every session. Shoulder pain intensity was assessed with a 100-mm visual analogue scale. Secondary measures included upper limb functionality (Constant-Murley score), and pain-free passive range of movement. A blinded evaluator collected outcomes at baseline and after the last treatment session. The ANOVA revealed a significant group effect, for those who received IFT electro-massage, for improvements in pain intensity, upper limb function, and shoulder flexion, abduction, internal and external rotation (all, p < 0.01). There were no between-group differences for shoulder extension (p = 0.531) and adduction (p = 0.340). Adding IFT electro-massage to usual care, including manual therapy and exercises, revealed greater positive effects on pain, upper limb function, and mobility in adults with SAPS after acromioplasty.
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Hartl F. Physikalische Therapie bei chronischen Beschwerden im Lenden-Becken-Hüft-Bereich. MANUELLE MEDIZIN 2018. [DOI: 10.1007/s00337-017-0354-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Park YH, Lee JH. The effects of abdominal interferential current therapy on waist circumference and visceral fat distance in obese women. J Phys Ther Sci 2017; 29:1680-1683. [PMID: 28932012 PMCID: PMC5599845 DOI: 10.1589/jpts.29.1680] [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: 05/22/2017] [Accepted: 06/20/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the effects of interferential current therapy on the waist circumference and visceral fat length in obese women. [Subjects and Methods] In this study, we selected 30 patients whose body mass index was over 25 kg/m2. The subjects were randomly assigned to receive interferential current therapy three times a week for four weeks (n=15) and transcutaneous electrical nerve stimulation three times a week for four weeks (n=15). Waist circumference was measured in cm using a tape measure with the participant in an upright posture, and the length of visceral fat was measured using a high-resolution, B-mode ultrasound machine. [Results] There was a statistically significant difference between the group of waist circumference and visceral fat length. The change of waist circumference and visceral fat length was larger the experimental group than the control group. [Conclusion] These results can be used as a basis for reducing the risk factors that increase mortality due to diseases and can prevent cardiovascular and other adult diseases caused by obesity.
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Affiliation(s)
- Young-Han Park
- Department of Physical Therapy, Korea National University of Transportation, Republic of Korea
| | - Jung-Ho Lee
- Department of Physical Therapy, Kyungdong University: Bongpo-ri, Toseong-myeon, Goseong-gun, Gangwon-do, Republic of Korea
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