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Tudini F, Jordon M, Levine D, Healy M, Cathey S, Chui K. Evaluating the effects of two different kinesiology taping techniques on shoulder range of motion and proprioception in patients with hypermobile Ehlers-Danlos syndrome: a randomized controlled trial. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1383551. [PMID: 38836006 PMCID: PMC11148207 DOI: 10.3389/fresc.2024.1383551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 05/02/2024] [Indexed: 06/06/2024]
Abstract
Background Ehlers-Danlos syndrome (EDS) is a common group of inherited connective tissue disorders with a prevalence as high as 0.75%-2% of the population. Physical manifestations include pain and decreased proprioception, especially in more mobile joints, such as the shoulder. The kinesiology tape (K-Tape) is often used to treat patients with shoulder dysfunction. The effectiveness of the K-Tape is uncertain, and there is a lack of studies specifically studying the K-Tape in an EDS population. Purpose The purpose of this study was to compare the short-term effects of two different K-Tape procedures on shoulder active joint reposition (AJR) and active range of motion (AROM) in patients with hypermobile EDS (hEDS) and shoulder pain. Methods All participants were recruited from the EDS support groups and presented with shoulder pain. Baseline demographic information was obtained for each participant, after which AROM and AJR were assessed. The participants were randomized to receive one of two K-Tape procedures. Testing was repeated immediately post-taping and 48 h post-taping. Results Significant improvements in shoulder external (F = 10.917, p < 0.001) and internal (F = 11.736, p < 0.001) rotations were seen from baseline to immediately post-taping and baseline to 48 h post-taping in the experimental K-Tape group. There were no significant differences in the shoulder rotation in the control K-Tape group and no significant differences in either group for shoulder flexion or AJR at any time point (p > 0.05). Conclusion K-Tape may offer short-term improvements in shoulder rotation AROM in patients with hEDS and shoulder pain.
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Affiliation(s)
- Frank Tudini
- Department of Physical Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Max Jordon
- Department of Physical Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - David Levine
- Department of Physical Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Michael Healy
- Healy Physical Therapy and Sports Medicine, East Providence, RI, United States
| | - Sarah Cathey
- Department of Physical Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Kevin Chui
- Department of Physical Therapy, Radford University, Roanoke, VA, United States
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Mi H, Oh C, Towheed T. Systematic Review of Non-surgical Therapies for Osteoarthritis of the Hand: An Update. Eur J Rheumatol 2023; 11. [PMID: 36744772 PMCID: PMC11184966 DOI: 10.5152/eurjrheum.2023.21197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/27/2022] [Indexed: 02/05/2023] Open
Abstract
Hand osteoarthritis is a common disease with significant morbidity. This review aimed to update our earlier systematic reviews which included all published randomized controlled trials evaluating pharmacological and non-pharmacological therapies in patients with hand osteoarthritis. A total of 133 randomized controlled trials evaluating pharmacological and nonpharmacological therapies in hand osteoarthritis were reviewed. Overall, the methodological quality of randomized controlled trials has improved since the last update. Almost all new studies described their methods for randomization, blinding, and allocation concealment. However, studies continued to underreport features specific to hand osteoarthritis, such as pattern of joint involvement and number of affected joints. Standardized outcome assessments for pain and function were commonly presented, but measures of other hand osteoarthritis specific outcomes, such as health-related quality of life and patient global assessments, continued to be underreported. Future trials should consistently report on hand osteo arthritis specific features and outcome assessments in order to make clinically relevant conclusions about the efficacy of the diverse treatment options available.
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Affiliation(s)
- Haonan Mi
- Department of Medicine, Queen's University, Kingston, Canada
| | - Christopher Oh
- Department of Medicine, Queen's University, Kingston, Canada
| | - Tanveer Towheed
- Department of Medicine, Queen's University, Kingston, Canada
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Tudini F, Levine D, Healy M, Jordon M, Chui K. Evaluating the effects of two different kinesiology taping techniques on shoulder pain and function in patients with hypermobile Ehlers-Danlos syndrome. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2023; 4:1089748. [PMID: 36726531 PMCID: PMC9885497 DOI: 10.3389/fpain.2023.1089748] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/03/2023] [Indexed: 01/18/2023]
Abstract
Background Ehlers-Danlos Syndrome (EDS) is a group of inherited connective tissue disorders which predominantly affects women and has a prevalence as high as 1 in 5,000 individuals. Hypermobile EDS (hEDS) is the most common subtype of EDS and is characterized by multi-joint pain, particularly in large joints such as the shoulder. Physical therapy is often utilized to address the pain, physical impairments, and functional loss in patients with EDS. Kinesiology Tape (KT) is an intervention commonly used by physical therapists for treating shoulder pain and dysfunction. Studies related to the effectiveness of KT in patients with shoulder pain is equivocal and there are a lack of studies specifically studying the effects of KT in an EDS population. Purpose The purpose of this study was to assess the efficacy and short-term effects of two different KT techniques on shoulder pain and function in individuals with hEDS and shoulder pain. Methods Participants were recruited from EDS support groups in the New England area of the United States; were diagnosed with hEDS by their physician; and had shoulder pain. Baseline demographic information was obtained for each participant followed by completion of 4 patient reported outcome (PRO) measures: the Upper Extremity Functional Index, QuickDASH (Disabilities of the Arm, Shoulder, & Hand), Shoulder Pain and Disability Index, and the Western Ontario Shoulder Instability Index. Current pain level, average pain over the past 24 h, and worst pain over the past 24 h were recorded using the numeric pain rating scale (NPRS). Subjects were randomly assigned to receive either an experimental shoulder KT procedure or a control shoulder taping. Immediately after taping, the NPRS was reassessed. Subjects then returned 48 h later to repeat the NPRS and PRO measures. Results There was no significant difference between the experimental and control tape groups for any outcome measure. There was a significant improvement from pre-taping to 48-hours post taping for each of the 4 PRO measures with large effect sizes (p < 0.001; ƞ p 2 = .517-.719). Likewise, average, and worst pain over the last 24 h significantly improved with large effect sizes over the same period (p = 0.005; ƞ p 2 = .225 and p < 0.001; ƞ p 2 = .382, respectively). Current NPRS levels significantly improved from pre-tape to immediately post-tape (p = .023, ƞ p 2 = .131) and was maintained through the 48-hour follow up, although no further improvement was seen. Conclusion KT is an inexpensive and relatively safe intervention that is easy to apply and can offer temporary improvements in pain and function for patients with EDS and shoulder pain.
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Affiliation(s)
- Frank Tudini
- Department of Physical Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, United States,Correspondence: Frank Tudini
| | - David Levine
- Department of Physical Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Michael Healy
- Healy Physical Therapy and Sports Medicine, East Providence, RI, United States
| | - Max Jordon
- Department of Physical Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Kevin Chui
- Department of Physical Therapy, Radford University, Roanoke, VA, United States
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Nakagawa Y, Tatebe M, Yamamoto M, Kurimoto S, Iwatsuki K, Hirata H. Choice of control group treatments in hand osteoarthritis trials: A systematic review and meta-analysis. Semin Arthritis Rheum 2021; 51:775-785. [PMID: 34146952 DOI: 10.1016/j.semarthrit.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/08/2021] [Accepted: 04/15/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To assess how patient characteristics and study design influence the effectiveness of control interventions in hand OA trials. METHODS The study protocol was registered in PROSPERO (CRD42020163473). Two authors independently searched four electronic databases from their inception to December 31, 2019. Randomized and non-randomized controlled hand OA trials were included if pain intensity was assessed using a validated scale. We allocated control groups into one of the following: placebo, add-on treatment, no treatment, or active treatment. The standardized mean differences (d) of pain, as well as subjective function and hand strength, were pooled with 95% confidence intervals (CI) and 90% prediction intervals using random-effects models. Meta-regression and post-hoc subgroup analyses were performed to investigate which factors potentially impacted placebo analgesia and between-study heterogeneity. RESULTS Thirty-one placebo, 11 add-on, 12 no-treatment, and 10 active-treatment controls were included in meta-analyses. Effective pain relief was observed in placebo (d = -0.50, 95% CI -0.63 to -0.37), add-on (d = -0.35, 95% CI -0.59 to -0.12), and active-treatment (d = -0.92, 95% CI -1.35 to -0.48) groups. In subjective function, these treatments had smaller but beneficial effects; hand strength, contrastingly, was not improved. Placebo effects were larger when flare designs were used (d = -0.96) and more homogeneous when minimum pain thresholds were set (d = -0.46, 90% prediction intervals -0.79 to -0.14). CONCLUSION Placebo, add-on, and active control treatments were more effective than the no treatment control in relieving hand pain and improving subjective function. By choosing minimum pain thresholds and flare requirements at patient enrollment, moderate pain relief may be replicated among control participants in future randomized placebo-controlled trials.
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Affiliation(s)
- Yasunobu Nakagawa
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
| | - Masahiro Tatebe
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Michiro Yamamoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Shigeru Kurimoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Katsuyuki Iwatsuki
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Hitoshi Hirata
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
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Cupler ZA, Alrwaily M, Polakowski E, Mathers KS, Schneider MJ. Taping for conditions of the musculoskeletal system: an evidence map review. Chiropr Man Therap 2020; 28:52. [PMID: 32928244 PMCID: PMC7491123 DOI: 10.1186/s12998-020-00337-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/12/2020] [Indexed: 12/14/2022] Open
Abstract
Background Taping is a common treatment modality used by many rehabilitation providers. Several types of tapes and taping methods are used in the treatment of musculoskeletal dysfunction and pain. Purpose To summarize and map the evidence related to taping methods used for various joints and conditions of the musculoskeletal system, and to provide clinicians and researchers with a user-friendly reference with organized evidence tables. Data sources The PEDro, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register for Controlled Trials, PubMed, and PROSPERO databases were searched from inception through October 31, 2019. Study selection Eligible studies were selected by two independent reviewers and included either systematic reviews (SRs) or randomized controlled trials (RCTs) and included a musculoskeletal complaint using a clinical outcome measure. Data extraction Data was extracted by two investigators independently. Risk of bias and quality were assessed using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) for SRs or the Physiotherapy Evidence Database (PEDro) scale for RCTs. The protocol was registered with PROSPERO (CRD42019122857). Data synthesis Twenty-five musculoskeletal conditions were summarized from forty-one SRs and 127 RCTs. There were 6 SRs and 49 RCTs for spinal conditions. Kinesio tape was the most common type of tape considered. Four evidence tables representing the synthesized SRs and RCTs were produced and organized by body region per condition. Limitations Inclusion of only English language studies. Also, the heterogeneous nature of the included studies prevented a meta-analysis. Conclusions There is mixed quality evidence of effectiveness for the different types of taping methods for different body regions and conditions. All of the SRs and RCTs found during our search of the taping literature have been organized into a series of appendices. A synthesis of the results have been placed in evidence tables that may serve as a useful guide to clinicians and researchers.
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Affiliation(s)
- Zachary A Cupler
- Physical Medicine & Rehabilitation Services, Butler VA Healthcare System, 353 N. Duffy Road, Butler, Pennsylvania, USA.
| | - Muhammad Alrwaily
- Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, West Virginia, USA.,Department of Physical Therapy, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Emily Polakowski
- Private Practice, Independence Physical Therapy, Mystic, Connecticut, USA
| | - Kevin S Mathers
- VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Michael J Schneider
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management. Nat Rev Rheumatol 2019; 14:641-656. [PMID: 30305701 DOI: 10.1038/s41584-018-0095-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Osteoarthritis (OA) is a highly prevalent condition, and the hand is the most commonly affected site. Patients with hand OA frequently report symptoms of pain, functional limitations and frustration in undertaking everyday activities. The condition presents clinically with changes to the bone, ligaments, cartilage and synovial tissue, which can be observed using radiography, ultrasonography or MRI. Hand OA is a heterogeneous disorder and is considered to be multifactorial in aetiology. This Review provides an overview of the epidemiology, presentation and burden of hand OA, including an update on hand OA imaging (including the development of novel techniques), disease mechanisms and management. In particular, areas for which new evidence has substantially changed the way we understand, consider and treat hand OA are highlighted. For example, genetic studies, clinical trials and careful prospective imaging studies from the past 5 years are beginning to provide insights into the pathogenesis of hand OA that might uncover new therapeutic targets in the disease.
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