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Liu Z, Li Z, Duan C. Effects of Maitland mobilization technique on upper extremity function in stroke survivors with spasticity: An experimental study. Medicine (Baltimore) 2024; 103:e38184. [PMID: 38758885 PMCID: PMC11098168 DOI: 10.1097/md.0000000000038184] [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: 12/14/2023] [Accepted: 04/18/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND The recovery of upper limb function is of great significance for stroke patients to regain their self-care ability, yet it is still a difficult point in clinical practice of neurological rehabilitation. This study aimed to investigate the effect of Maitland joint mobilization technique on the recovery of upper extremity function in patients with spasticity after stroke. METHODS From August to December 2023, 71 patients with upper extremity flexor spasm after stroke were recruited and randomly divided into experimental group (n = 35) and control group (n = 36). The control group was given conventional rehabilitation treatment, while the experimental group was treated with Maitland mobilization technique treatment of upper extremity joints on the basis of the control group. The experiment lasted for 8 weeks. Participants of the 2 groups were observed for Fugl-Meyer motor assessment-upper extremity (FMA-UE), box and block test (BBT) and Brunnstrom stage, modified Ashworth scale (MAS), and functional independence measure (FIM) at pre- and post-8 weeks study. RESULTS There was no significant difference in gender distribution, hemiplegic side, diagnosis, past history, age, duration, body mass index, and mini-mental state examination between the 2 groups (P > .05). After 8 weeks of intervention, both groups showed significant improvement in FMA-UE, Brunnstrom stage, BBT, FIM, and MAS of the shoulder (P < .05); however, there was no significant change in MAS of the elbow, wrist, and finger joints (P > .05). The posttreatment values showed a significant improvement in FMA-UE, BBT, and FIM in the experimental group compared to the control group. Comparing the changes in pretreatment and posttreatment, FMA-UE, BBT, and FIM in the experimental group were significantly improved compared with those in the control group (P < .05). CONCLUSION Maitland joint mobilization can improve the motor function of upper extremity and the spasticity of shoulder joint complex in patients with stroke.
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Affiliation(s)
- Ziqing Liu
- Department of Rehabilitation, Shanghai Yangpu Hospital of TCM, Shanghai, China
| | - Zhangjie Li
- Department of Rehabilitation, Yangpu Hospital, Tongji University, Shanghai, China
| | - Chaoyang Duan
- Department of Rehabilitation, Shanghai Yangpu Hospital of TCM, Shanghai, China
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Bae S, Jung J, Moon D. Impact of Movement Control Training Using a Laser Device on the Neck Pain and Movement of Patients with Cervicogenic Headache: A Pilot Study. Healthcare (Basel) 2023; 11:healthcare11101439. [PMID: 37239725 DOI: 10.3390/healthcare11101439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/03/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
This study verified the effect of movement control training using a laser device on the neck pain and movement of patients with cervicogenic headache. A total of twenty outpatients recruited from two Busan hospitals were equally divided into two groups. The experimental group underwent movement control training with visual biofeedback, while the control group performed self-stretching. Both groups received therapeutic massage and upper cervical spine mobilization. A four-week intervention program was also conducted. Measurement tools including the cervical flexion-rotation test, visual analog scale, Headache Impact Test-6, pressure pain threshold, range of motion, sensory discrimination, and Neck Disability Index helped assess the participating patients before and after the intervention. Additionally, the Wilcoxon signed-rank test and the Mann-Whitney U test helped determine inter and intra-group variations, respectively, before and after the intervention. Most of the measurement regions revealed significant changes post-intervention within the experimental group, while only the cervical flexion-rotation test, visual analog scale, Headache Impact Test-6, and Neck Disability Index indicated significant changes post-intervention within the control group. There were also considerable inter-group differences. Thus, movement control training using a laser device more effectively improves neck pain and movement of patients with cervicogenic headache.
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Affiliation(s)
- Songui Bae
- Department of Physical Therapy, Graduate School, Dong-Eui University, Busan 47340, Republic of Korea
| | - Juhyeon Jung
- Department of Physical Therapy, College of Nursing, Healthcare Sciences and Human Ecology, Dong-Eui University, Busan 47340, Republic of Korea
| | - Dongchul Moon
- Department of Physical Therapy, Gimhae College, Gimhae-si 50811, Republic of Korea
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James CM, Brismée JM, St-Pierre MO, Descarreaux M, Hooper TL, Nougarou F, Bélanger EM, Sobczak S. Variability of Intradiscal Pressure During Cervical Spine Posterior-Anterior Mobilization: A Cadaveric Investigation. J Manipulative Physiol Ther 2022; 45:522-530. [PMID: 36529553 DOI: 10.1016/j.jmpt.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate in cadaveric specimens the reliability of measuring cervical intradiscal pressure (CIDP) and if posterior-anterior (PA) mobilizations targeting the cervical spine were associated with CIDP changes. METHODS Cervical PA mobilizations were performed on the spinous processes of 7 (3 men, 4 women) cadaveric specimens using a servo-controlled linear actuator to provide 25N and 45N forces. CIDP measurements were performed at C4-5, C5-6, C6-7, and C7-T1 intervertebral discs (IVDs) using a fiberoptic catheter system that recorded CIDP for each IVD cervical segment. To assess CIDP measurement reliability, the intraclass correlation coefficient (ICC [3,k]) was calculated. Repeated measures Friedman analysis of variance assessed effect of cervical mobilizations on CIDP for before, during, and immediately after mobilization at 25N and 45N forces for each cervical IVD segment. RESULTS All CIDP measurements demonstrated excellent reliability (ICC >0.98). During the 25N mobilizations, the median CIDP varied from -0.12 to 0.91 (interquartile range, 5.22-5.36), while for 45N mobilizations the median ranged from -0.94 to 1.21 (interquartile range, -7.74 to 43.49). These changes were not statistically significant (P > .40) during 25N and 45N PA mobilizations, with the exception of C5-6 CIDP at 25N and 45N (P = .05 and .018, respectively). CONCLUSION There was high CIDP variability between cadavers during and after mobilization. Mobilizations of 1 cervical vertebra resulted in both CIDP increase or decrease at adjacent and remote cervical IVD segments that were not consistent. Cervical PA mobilizations produced variable CIDP changes at adjacent and remote cervical segments in cadavers.
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Affiliation(s)
- Carla M James
- Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas; Department of Anatomy, University of Québec at Trois-Rivières, Clinical and Functional Anatomy Research Unit (URACEF), Trois-Rivières, Québec, Canada
| | - Jean-Michel Brismée
- Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas.
| | - Marc-Olivier St-Pierre
- Department of Anatomy, University of Québec at Trois-Rivières, Clinical and Functional Anatomy Research Unit (URACEF), Trois-Rivières, Québec, Canada
| | - Martin Descarreaux
- Department of Sciences of Physical Activity, University of Québec at Trois-Rivières, Québec, Canada
| | - Troy L Hooper
- Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - François Nougarou
- Department of Electrical Engineering and Computer Engineering, University of Québec at Trois-Rivières, Québec, Canada
| | - Emile Marineau Bélanger
- Department of Sciences of Physical Activity, University of Québec at Trois-Rivières, Québec, Canada
| | - Stéphane Sobczak
- Department of Anatomy, University of Québec at Trois-Rivières, Clinical and Functional Anatomy Research Unit (URACEF), Trois-Rivières, Québec, Canada
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Shah R, Sadhu S. Role of physiotherapy interventions in treating varicose veins. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_605_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sensorimotor performance in acute-subacute non-specific neck pain: a non-randomized prospective clinical trial with intervention. BMC Musculoskelet Disord 2021; 22:1017. [PMID: 34863120 PMCID: PMC8645120 DOI: 10.1186/s12891-021-04876-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 11/15/2021] [Indexed: 01/01/2023] Open
Abstract
Background The assessment of cervical spine kinematic axial rotation performance is of great importance in the context of the study of neck sensorimotor control. However, studies addressing the influence of the level of provocation of spinal pain and the potential benefit of passive manual therapy mobilizations in patients with acute-subacute non-specific neck pain are lacking. Methods A non-randomized prospective clinical trial with an intervention design was conducted. We investigated: (1) the test-retest reliability of kinematic variables during a fast axial head rotation task standardized with the DidRen laser test device in 42 Healthy pain-free Control Participants (HCP) (24.3 years ±6.8); (2) the differences in kinematic variables between HCP and 38 patients with Acute-subacute Non-Specific neck Pain (ANSP) assigned to two different groups according to whether their pain was localized in the upper or lower spine (46.2 years ±16.3); and (3) the effect of passive manual therapy mobilizations on kinematic variables of the neck during fast axial head rotation. Results (1) Intra-class correlation coefficients ranged from moderate (0.57 (0.06-0.80)) to excellent (0.96 (0.91-0.98)). (2) Kinematic performance during fast axial rotations of the head was significantly altered in ANSP compared to HCP (age-adjusted) for one variable: the time between peaks of acceleration and deceleration (p<0.019). No significant difference was observed between ANSP with upper vs lower spinal pain localization. (3) After the intervention, there was a significant effect on several kinematic variables, e.g., ANSP improved peak speed (p<0.007) and performance of the DidRen laser test (p<0.001), with effect sizes ranging from small to medium. Conclusion (1) The DidRen laser test is reliable. (2) A significant reduction in time between acceleration and deceleration peaks was observed in ANSP compared to HCP, but with no significant effect of spinal pain location on kinematic variables was found. (3) We found that neck pain decreased after passive manual therapy mobilizations with improvements of several kinematic variables. Trial registration Registration Number: NCT 04407637 Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04876-4.
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Shabbir M, Arshad N, Naz A, Saleem N. Clinical outcomes of maitland mobilization in patients with Myofascial Chronic Neck Pain: A randomized controlled trial. Pak J Med Sci 2021; 37:1172-1178. [PMID: 34290803 PMCID: PMC8281150 DOI: 10.12669/pjms.37.4.4220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/23/2021] [Accepted: 03/05/2021] [Indexed: 11/15/2022] Open
Abstract
Background and Objective Myofascial neck pain is a common musculoskeletal problem caused by presence of trigger points and local and referred pain patterns. Chronic neck pain is responsible for the involvement of joints, ligaments, fascia and connective tissue as well. The objective of this study was to assess the effect of Maitland mobilization in patients with myofascial chronic neck pain. Methods In this randomized, placebo treatment-controlled trial, 30 patients consecutively aged 25-45 years meeting inclusion criteria were isolated into two groups. The study group was treated with Maitland mobilization consistently for eight weeks while the control group got placebo treatment for a similar timeframe. Visual analog Scale (VAS), Neck disability index (NDI) and cervical range of motion (ROM) questionnaire was filled by patients before, intermediate and after the intervention to evaluate the severity of pain, functional ability and range of motion. Results Following eight weeks of treatment, when compared the post treatment effects of both groups, the significance value for VAS was 0.008, for NDI p=0.030, for Flexion p=0.573, for extension p=0.001, for right rotation p<0.001, for left rotation p=0.002, for right and left side bending p<0.001. Conclusion The study concluded that Maitland mobilization grades (I-IV) are effective in reducing pain and improving functional level of NDI scale and the ranges of cervical spine in patients with myofascial chronic neck pain.
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Affiliation(s)
- Maryam Shabbir
- Dr. Maryam Shabbir, Ph.D. (Rehab) scholar, Associate Professor, Riphah International University, Lahore Pakistan
| | - Naveed Arshad
- Dr. Naveed Arshad, M.Phil. (Rehab), Assistant Professor, Islamabad Medical and Dental College, Islamabad Pakistan
| | - Anam Naz
- Dr. Anam Naz, MS (Rehab), Senior Lecturer, The University of Lahore, Lahore Pakistan
| | - Nadia Saleem
- Dr. Nadia Saleem, MS (Rehab), Assistant Professor, Bakhtawar Amin College of Rehabilitation Sciences, Multan Pakistan
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An HJ, Park SJ. Effects of Cervical Spine Mobilization on Respiratory Function and Cervical Angles of Stroke Patients: A Pilot Study. Healthcare (Basel) 2021; 9:healthcare9040377. [PMID: 33805494 PMCID: PMC8066151 DOI: 10.3390/healthcare9040377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 11/16/2022] Open
Abstract
The forward head posture (FHP) of stroke patients has a negative impact on respiratory function. Cervical spine mobilization is a manual therapy technique that used to prevent and treat FHP and respiratory function. This pilot study investigated whether cervical spine mobilization can effectively improve outcomes following FHP and respiratory function of stroke patients. Twenty-four patients participated in our assessor-blinded randomized controlled trial. All the participants received neurodevelopmental treatments (gait training and trunk rehabilitation). The experimental group additionally received 15-min sessions of cervical spine mobilization three times per week for 4 weeks. The control group received cervical spine sham mobilization during the same period. For the cervical angles, the cranial vertebral angle (CVA) and cranial rotation angle (CRA) were measured. A respiratory function test was performed to measure the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and chest circumferences (upper and lower chest sizes). Except for MIP, there was no significant difference between the experimental group and the control group. The CVA and CRA were significantly increased in the experimental group only. Cervical spine mobilization improved cervical angles and inspiratory function of the stroke patients in this study. However, a comparative study with a larger number of patients is needed to confirm this finding from our pilot study, which had a small sample size.
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Affiliation(s)
- Ho Jung An
- Department of Physical Therapy, Dongnam Health University, 50, Cheoncheon-ro 74beon-gil, Jangan-gu, Suwon-si, Gyeonggi-do 16328, Korea;
| | - Shin Jun Park
- Department of Physical Therapy, Suwon Women’s University, 1098, Juseok-ro, Bongdam-eup, Hwaseong-si, Gyeonggi-do 18333, Korea
- Correspondence: ; Tel.: +82-31-290-8998; Fax: 82-31-290-8959
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Park SJ, Kim SH, Kim SH. Effects of Thoracic Mobilization and Extension Exercise on Thoracic Alignment and Shoulder Function in Patients with Subacromial Impingement Syndrome: A Randomized Controlled Pilot Study. Healthcare (Basel) 2020; 8:healthcare8030316. [PMID: 32887287 PMCID: PMC7551755 DOI: 10.3390/healthcare8030316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/25/2020] [Accepted: 08/30/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction: Thoracic kyphosis commonly occurs in subacromial impingement syndrome. This pilot study investigated the effect of thoracic joint mobilization and extension exercise on improving thoracic alignment and shoulder function. Methods: In total, 30 patients with subacromial impingement syndrome were recruited and randomly assigned to three groups, the joint mobilization group (n = 10), exercise group (n = 10), and combination group (n = 10). After four weeks of treatment, the measured outcomes included thoracic kyphosis using a manual inclinometer; pectoralis major (PM) and upper trapezius (UT) muscle tone and stiffness using the MyotonPRO®; affected side passive range of motion (ROM) using the goniometer (flexion, abduction, medial rotation, and lateral rotation); and shoulder pain and disability index (SPADI). Results: All three groups had significant improvements in all variables (p < 0.05). Thoracic kyphosis; UT muscle tone; and flexion, medial rotation, and lateral rotation ROM and SPADI were all significantly improved in the combination group compared to the mobilization and exercise groups (p < 0.05). Conclusions: The combination therapy of thoracic mobilization and extension exercise can be regarded as a promising method to improve thoracic alignment and shoulder function in patients with subacromial impingement syndrome.
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Affiliation(s)
- Shin Jun Park
- Department of Physical Therapy, Gangdong University, 278, Daehak-gil, Gamgok-myeon, Eumseong-gun, Chungcheongbuk-do 27600, Korea;
| | - Seok Hyeon Kim
- Department of Physical Therapy, General Graduate School, Yongin University, 134, Yongindaehak-ro, Cheoin-gu, Yongin-si, Gyeonggi-do 17092, Korea;
| | - Soon Hee Kim
- Department of Physical Therapy, Yongin University, 134, Yongindaehak-ro, Cheoin-gu, Yongin-si, Gyeonggi-do 17092, Korea
- Correspondence: ; Tel.: +82-31-8020-2774; Fax: +82-31-8020-3075
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Kendall JC, Vindigni D, Polus BI, Azari MF, Harman SC. Effects of manual therapies on stability in people with musculoskeletal pain: a systematic review. Chiropr Man Therap 2020; 28:13. [PMID: 32070377 PMCID: PMC7027250 DOI: 10.1186/s12998-020-0300-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 01/21/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction Chronic musculoskeletal pain is associated with reduced balance performance and falls risk. Manual therapies are commonly used interventions for musculoskeletal pain. There is emerging evidence that manual therapies may improve balance. The aim of this systematic review was to examine the effectiveness of manual therapies for musculoskeletal pain on measures of static and dynamic stability. Methods Six electronic databases were searched using pre-defined eligibility criteria and two independent reviewers assessed all identified records. Risk of bias was assessed using the 12-item Cochrane Risk of Bias assessment by two authors independently and any discrepancies resolved through consensus. Meta-analysis was conducted when three or more studies used the same outcome measures including gait speed, timed up and go test, step test and sit-to-stand test. Results Twenty-six studies were included in the analysis. Both spinal and extremity musculoskeletal pain conditions were represented. Manual therapies included manipulation, mobilisation and massage. The most common intervention compared to manual therapy was exercise. Outcome measures included both clinical and objective measures of stability. Overall the risk of bias was reported as generally low or unclear. Conclusion Improvement in stability measures were reported in studies comparing manual therapy in the short term, but not long-term follow-up. There was no clear association between significant pain reduction and measures of stability. Further prospective studies are recommended to investigate whether manual therapies should be part of an integrative healthcare plan for risk of falls management and when a transition from manual therapy to more active interventions should occur for long term management.
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Affiliation(s)
- Julie C Kendall
- Chiropractic, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.
| | - Dein Vindigni
- Chiropractic, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Barbara I Polus
- School of Engineering, RMIT University, Bundoora, VIC, 3083, Australia
| | - Michael F Azari
- Chiropractic, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.,Private practice, Melbourne, Australia
| | - Samantha C Harman
- Chiropractic, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
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