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Alfuth M. Pain improvement after three weeks of daily self-executed cross-friction massage using a fascia ball in a patient with recent-onset plantar heel pain: a case report. J Man Manip Ther 2024:1-9. [PMID: 38448397 DOI: 10.1080/10669817.2024.2325186] [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: 08/21/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Plantar heel pain is described as sharp pain at the medial plantar aspect of the calcaneus and medial longitudinal arch of the foot. There are various treatment options that usually need a clinician or a therapist for application. The present case report aimed to describe the outcomes of self-executed cross-friction massage using a fascia ball in a patient with recent-onset plantar heel pain. CASE DESCRIPTION The patient was a 42-year-old man who reported plantar heel pain during the first steps in the morning along with decreased function of the foot and ankle lasting about three months. He was instructed to self-execute cross-friction massage using a fascia ball daily in the evening at home for six weeks. OUTCOMES Pain during treatment decreased from a Numeric Pain Rating Scale (NPRS)-score of 8/10 and from a Short-Form McGill Pain Questionnaire (SF-MPQ)-score of 34/60 at initial treatment to NPRS- and SF-MPQ-scores of 0/10 and 0/60, respectively, after about three weeks. The patient reported no pain and restored function after six weeks of treatment, and in the follow-up measurements. DISCUSSION Daily self-executed cross-friction massage using a fascia ball may be a useful alternative intervention for treating recent-onset plantar heel pain.
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Affiliation(s)
- Martin Alfuth
- Faculty of Health Care, Therapeutic Sciences, Niederrhein University of Applied Sciences, Krefeld, Germany
- Department of Further Education, Sport Physiotherapy, German Sport University Cologne, Cologne, Germany
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Azhdari N, Kamali F, Vosooghi O, Petramfar P, Rahimijaberi A. The effect of manual therapies on tension-type headache in patients who do not respond to drug therapy: a randomized clinical trial. J Man Manip Ther 2023; 31:246-252. [PMID: 36052499 PMCID: PMC10324431 DOI: 10.1080/10669817.2022.2107446] [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] [Indexed: 10/14/2022] Open
Abstract
BACKGROUNDS Tension-Type Headache (TTH) is one of the most common types of headache. In patients with TTH, manual therapy can be used to treat myofascial pain. OBJECTIVES This study aimed to evaluate the effect of manual therapy on TTH in patients who did not respond to drug therapy. METHODS A total of 24 patients with TTH were randomly enrolled into this prospective trial. The participants were divided into an intervention and a control group. The intervention group received the common medication and manual therapy, while the control group only received the common medication. Headache pain intensity, frequency, and duration, tablet count, and Neck Disability Index (NDI) were measured in both groups before, after, and one week after the intervention. RESULTS There were significant differences between the two groups (treatment, control) regarding pain intensity (3.04, 6.75, P = 0.0001; effect size (ES) = 1.85), headache frequency (2.33, 5, P = 0.004; ES = 1.48) and duration (91.29, 284.74, P = 0.002; ES = 1.48), tablet count (1.83, 4.91, P = 0.01; ES = 1.04), and NDI (7.33, 20.16, P = 0.003; ES = 1.37). Within group differences were recorded in intervention group only for all dependent variables immediately after intervention and one week after the intervention (p < 0.05). CONCLUSION Manual therapy reduced headache pain intensity, frequency and duration, tablet count, and NDI score in patients with TTH.
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Affiliation(s)
- Negar Azhdari
- PhD Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fahimeh Kamali
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Vosooghi
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Payman Petramfar
- Department of Neurology, School of Medicine Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rahimijaberi
- Department of Neurology, School of Medicine Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Cabanillas-Barea S, Pérez-Guillén S, López-de-Celis C, Rodríguez-Sanz J, Fanlo-Mazas P, Carrasco-Uribarren A. Effects of diacutaneous fibrolysis in patients with tension-type headache: A randomized controlled trial. PLoS One 2023; 18:e0273877. [PMID: 36972231 PMCID: PMC10042356 DOI: 10.1371/journal.pone.0273877] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 02/17/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Manual therapy appears to be effective for the relief of tension-type headache (TTH), just as diacutaneous fibrolysis (DF) has shown to be a beneficial technique for the relief of symptoms in other dysfunctions. However, no studies have evaluated the potential beneficial effect of DF in TTH. The aim of this study is to analyze the effect of three sessions of DF in patients with TTH. METHODS Randomized controlled trial in 86 subjects (43 intervention/ 43 control group). The headache frequency, the headache intensity, the pressure pain thresholds (PPTs) at trapeziometacarpal joint, upper trapezius, suboccipital, frontal and temporal muscles, parietal sutures and the cervical mobility were measured at baseline, at the end of the third intervention and one-month after the last intervention. RESULTS Statistically significant differences with p values <0.05 were observed between groups in favor of the intervention group in the one-month follow-up in the following variables: headache frequency, headache intensity, flexion, extension, right and left side-bending, right and left rotation, PPTs in left trapeziometacarpal joint, right suboccipital muscle, right and left temporal muscle, left frontal muscle and right and left parietal. CONCLUSIONS DF provides a beneficial effect in reducing headache frequency, relieving pain, and improving cervical mobility in patients with TTH.
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Affiliation(s)
- Sara Cabanillas-Barea
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Silvia Pérez-Guillén
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Carlos López-de-Celis
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Jacobo Rodríguez-Sanz
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Pablo Fanlo-Mazas
- Department of Physiatry and Nursery, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Andoni Carrasco-Uribarren
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
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Effect of soft tissue manipulation of popliteus muscle on quadriceps muscle activity and torque production in athletes with anterior knee pain. BIOMEDICAL HUMAN KINETICS 2022. [DOI: 10.2478/bhk-2022-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Study aim: Popliteus is majorly associated with posterior knee pain; however, this muscle can also have an impact on anterior knee pain. The purpose of this study was to determine the effect of soft tissue manipulation of popliteus muscle on non-traumatic anterior knee pain in athletes; as the relationship between popliteus and Quadriceps muscle has not been studied/explored much.
Materials and methods: In this experimental study, 15 subjects presenting with non-traumatic anterior knee pain were selected. Quadriceps muscle activity, torque production and knee pain were assessed. Followed by a single session of popliteus manipulation all the above parameters were re-assessed immediately and at 24 hours after intervention.
Results: Significant reduction in pain (P < 0.005) at 24 hours was observed. There was a significant increase in muscle activity of Vastus Medialis (P < 0.05) and Vastus Lateralis (P < 0.005) immediately after the intervention but not after 24 hours. No significant change was found in the activity of Rectus femoris and Peak torque of Quadriceps immediately after the intervention and at 24 hours.
Conclusion: Soft tissue manipulation decreased knee pain and improved muscle activity. Therefore, incorporating popliteus manipulation can be effective in treatment of anterior knee pain.
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Gur Kabul E, Basakci Calik B, Oztop M, Cobankara V. The efficacy of manual soft-tissue mobilization in ankylosing spondylitis: A randomized controlled study. Int J Rheum Dis 2021; 24:445-455. [PMID: 33644986 DOI: 10.1111/1756-185x.14072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/19/2020] [Accepted: 01/05/2021] [Indexed: 12/14/2022]
Abstract
AIM The aim of this randomized controlled study was to investigate the effect of soft-tissue mobilization in patients with ankylosing spondylitis (AS). METHOD Twenty-one patients (mean age 44.57 ± 10.40 years) were randomly divided into two groups. There were 13 patients (11 females, 2 males, age 43.69 ± 9.94 years) in the intervention group and 8 patients (5 females, 3 males, age 46.00 ± 11.67 years) in the control group. In the intervention group, soft-tissue mobilization therapy and 20 spinal mobility exercises were applied. The control group received only 20 spinal mobility exercises. The Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Bath AS Metrology Index (BASMI) were used for assessment of disease activity, functional level, and mobility, respectively. Nottingham Health Profile (NHP) for quality of life and Roland Morris Disability Questionnaire (RMDQ) were used to determine disability levels. RESULTS We found significant differences between pretreatment and post-treatment scores of BASDAI (P = 0.049); BASFI (P = 0.009; lateral lumbar flexion (P = 0.005), maximal intermalleolar distance (P = 0.001) and total score (P = 0.001) of BASMI; pain subtest (P = 0.036) and total score (P = 0.036) of NHP; and RMDQ score (P = 0.004) in the intervention group. However, in the control group the BASMI score (P = 0.049) was observed to worsen significantly. Delta values were compared and differences in BASFI (P = 0.039), and in lateral lumbar flexion (P = 0.027), maximal intermalleolar distance (P = 0.045) and total score (P = 0.001) of BASMI were significant in favor of intervention group. Only tragus-to-wall distance (P = 0.039) of BASMI was observed to worsen significantly in the control group. CONCLUSION We recommend the use of soft-tissue mobilization in addition to the exercises to treat AS patients.
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Affiliation(s)
- Elif Gur Kabul
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Bilge Basakci Calik
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Mucahit Oztop
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Veli Cobankara
- Department of Rheumatology, Medical Faculty of Pamukkale University, Denizli, Turkey
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Gui-Demase MS, Silva KCD, Teixeira GDS. Manual therapy associated with topical heat reduces pain and self-medication in patients with tension-type headache. FISIOTERAPIA E PESQUISA 2021. [DOI: 10.1590/1809-2950/17019328032021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Tension-type headache (TTH) is a significant public health problem. The myofascial trigger points in the masticatory and cervical muscles are related to pain located in the temporomandibular joint, face, and cranium according to specific patterns. Thus, therapeutic procedures should be directed to myofascial trigger points rather than to the area of referred pain. For this purpose, the massage therapy combined with the topical heat can provide effective results due to the increase of the local microcirculation, improving tissue perfusion and promoting muscle relaxation. In this study we investigated the effects of manual therapy associated with topical heat therapy in TTH pain. This is a single-arm study composed of 13 participants with TTH (females), which were submitted to a three-month research protocol. In the first month , they filled out a pain diary and then they were evaluated. In the following month, the treatment protocol was applied (8 sessions of 45 minutes, twice a week, involving massage for skin desensitization, myofascial trigger point deactivation and stretching (friction massage) on masticatory and trapezius muscles after the topical heat). Then, in the third month (follow-up period), the participants were instructed to fill out the pain diary once again. We observed a significant decrease in pain intensity in TTH episodes, and medication intake after treatment and it keeps decreasing in follow-up. We conclude that the combination of manual therapy protocol and topical heat reduced pain and episodes related to TTH, and self-medication use in our sample.
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Roth TM. Non-invasive massage technique to aid in removal of a tined sacral neuromodulation lead. Int Urogynecol J 2020; 32:661-663. [PMID: 33026467 DOI: 10.1007/s00192-020-04539-3] [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: 06/12/2020] [Accepted: 09/14/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Describe a novel technique for retrieval of the Interstim lead in part based on techniques used in massage therapy. METHODS Retrospective review of patients (single surgeon) identified by CPT code 64585 over 10 years. Exclusion criteria included patients who (1) had explantation for active infection or (2) did not proceed with a stage 2 implant (in the event of a staged procedure). To effect removal, the surgeon applies a focused massage with firm deliberate pressure in deep circular motions to the insertion site and surrounding tissue. At the same time, gentle steady traction is applied to the lead (from the IPG pocket) by the surgeon. RESULTS Sixty women were identified. Mean implant duration was 24 (6-60) months. There were three lead fractures at retrieval (5%). In all three occurrences, the inner conductor wire was removed despite leaving the tined fragment in place. The author did not perform a cutdown to retrieve the retained fragment. There were no peri- or postoperative complications. CONCLUSIONS Lead removal is safely accomplished in a matter of a few minutes with the presented technique without the need for a cutdown. Lead breakage was 5% and similar to more invasive techniques.
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Affiliation(s)
- Ted M Roth
- Beacon Memorial Hospital, 621 Memorial Drive. Suite 302, South Bend, IN, 46601, USA.
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Deep Friction Massage in the Management of Patellar Tendinopathy in Athletes: Short-Term Clinical Outcomes. J Sport Rehabil 2020; 29:860-865. [PMID: 31575823 DOI: 10.1123/jsr.2019-0046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/06/2019] [Accepted: 08/03/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Deep friction massage (DFM) is often used in the treatment of tendinopathies; however, the pressure applied may vary and interfere with the obtained results. OBJECTIVE To assess whether the immediate effects of DFM on pain (pain intensity and time to onset of analgesia) and muscle strength are dependent on the pressure applied during the DFM application in athletes with patellar tendinopathy. DESIGN Randomized, controlled, cross-over trial. SETTING University research laboratory (institutional). PARTICIPANTS Ten athletes with diagnosis of unilateral patellar tendinopathy (age 27.90 [5.24] y). INTERVENTIONS All participants attended 4 sessions, 3 treatment sessions with DFM applied with different pressures (the mean pressure-previously determined for each participant-and the mean pressure ± 25%) and a control session, each of which was separated by 48 hours. MAIN OUTCOME MEASURES Pain (intensity upon palpation and time to onset of analgesia), and muscle strength of knee extensors were assessed before and immediately after each session. RESULTS Pain intensity changed significantly over time (F1,9 = 52.364; P < .001; ηp2=.853) and among sessions (F3,27 = 82.588; P < .001; ηp2=.902), with a significant interaction for group × time (F3,27 = 19.841; P < .001; ηp2=.688). The knee extensors strength did not change significantly over time (F1,9 = 2.240; P = .17; ηp2=.199), nor a significant interaction for session × time was observed (F3,27 = 3.276; P = .07; ηp2=.267). Regardless of the pressure applied, the time to onset of analgesia was not significantly different (F2,18 = 1.026; P > .05; ηp2=.102). CONCLUSION It was shown that DFM induces an immediate reduction in pain intensity upon palpation, regardless of the pressure performed. Notwithstanding, the reader should take into account the small sample size and the caution needed in the results' interpretation.
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The Beliefs and Attitudes of Cypriot Physical Therapists Regarding the Use of Deep Friction Massage. ACTA ACUST UNITED AC 2019; 55:medicina55080472. [PMID: 31409027 PMCID: PMC6723561 DOI: 10.3390/medicina55080472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/07/2019] [Accepted: 08/07/2019] [Indexed: 12/03/2022]
Abstract
Background: Deep friction massage (DFM) is a widely used technique by physical therapists worldwide for chronic pain management. According to Dr. James Cyriax, compliance with the proposed guidelines is vital to obtain the desired therapeutic results. Objectives: This study explored the beliefs and attitudes of Cypriot physical therapists to DFM and their compliance with the suggested guidelines to identify any empirical-based application patterns and compare them to the suggestions of Cyriax. In addition, the prevalence of DFM use in clinical practice in Cyprus was investigated. Methods: Questionnaires, consisting of 18 multiple choice questions and a table of six sub-questions, were distributed to 90 local physical therapists. Results: A total of 70% of respondents declared that they perform DFM in their daily practice. The respondents answered 11 out of the 19 technical questions in compliance with the guidelines. Conclusion: The study revealed the DFM application pattern of Cypriot physical therapists. The compliance percentage of this pattern to Cyriax guidelines was 58% in general and 62.5% for patients with chronic conditions.
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Pitsillides A, Stasinopoulos D. Cyriax Friction Massage-Suggestions for Improvements. ACTA ACUST UNITED AC 2019; 55:medicina55050185. [PMID: 31117314 PMCID: PMC6572216 DOI: 10.3390/medicina55050185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/19/2019] [Accepted: 05/17/2019] [Indexed: 11/16/2022]
Abstract
Background and objectives: Cyriax friction massage is a widely known and used technique in the field of chronic pain management. Despite its frequent use in daily clinical practice, the technique lacks evidence to support its therapeutic value. While this might be due to various factors, the authors of this paper suggest that the technique might need to be improved and/or modernized according to the recent literature. The purpose of this letter is to further analyze our point of view. Materials and Methods: Using the most relevant methods to the subject literature, the authors intended to point out a few technical details that might need reconsideration and/or modernization. Results: An appropriate terminology is suggested in the text. Further, suggestions are made regarding the technique’s interval time, a possible addition of self-treatment, a discussion of the combination with Mill’s manipulation, tendon positioning and other parameters. Conclusions: As a therapeutic value has not yet been clearly documented, and since the modernization and/or improvement of the technique might be needed, we suggest that this technique should not be used as a first-line treatment for the management of chronic pain.
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Affiliation(s)
- Alexios Pitsillides
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 1516, Cyprus.
| | - Dimitrios Stasinopoulos
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 1516, Cyprus.
- Director of Cyprus Musculoskeletal and Sports Trauma Research Centre (CYMUSTREC), Nicosia 1516, Cyprus.
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Kim JH, Hwang UJ, Jung SH, Gwak GT, Kwon OY. Immediate improvements of supination range of motion and strength following pronator teres muscle friction massage: a clinical trial comparing people with and without supination limited motion. J Man Manip Ther 2019; 27:109-114. [PMID: 30935339 DOI: 10.1080/10669817.2018.1542559] [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: 10/27/2022] Open
Abstract
OBJECTIVES To investigate the effects of friction massage techniques on the pronator teres muscle on supination range of motion (ROM) and supinator strength in individuals with and without limited supination ROM. METHODS In total, 26 subjects (13 with limited supination ROM and 13 healthy subjects) volunteered to participate in this study. We used a customized wrist cuff. Supination ROM and supinator strength were measured with a 9-axis inertial motion sensor and load cell. The friction massage protocol was executed with the pronator teres muscle in a relaxed position. Then supination ROM and supinator strength were measured again. RESULTS There was no significant interaction effect on supination ROM, which was significantly greater in the limited supination and control groups. A post hoc t-test revealed that the limited supination group achieved a significantly increased post-test supination ROM (51.7 ± 7.8°) compared to the pre-test value (43.6 ± 5.2°). In addition, the control group achieved a significant increase in post-test supination ROM (67.7 ± 10.0°) compared to the pre-test value (61.4 ± 7.7°). There was no significant interaction effect on supinator strength. Supinator strength was significantly greater in the limited supination and control groups. A post hoc t-test revealed a significant difference in supinator strength between the pre- and post-test values in the limited supination group. DISCUSSION Friction massage helps restore a limited ROM of the forearm supination motion and immediately increases supinator muscle strength. This technique can be used as an intervention method to improve muscle strength in patients with limited supination ROM.
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Affiliation(s)
- Jun-Hee Kim
- a Department of Physical Therapy, Graduate School , Yonsei University , Wonju , Korea
| | - Ui-Jae Hwang
- a Department of Physical Therapy, Graduate School , Yonsei University , Wonju , Korea
| | - Sung-Hoon Jung
- a Department of Physical Therapy, Graduate School , Yonsei University , Wonju , Korea
| | - Gyeong-Tae Gwak
- a Department of Physical Therapy, Graduate School , Yonsei University , Wonju , Korea
| | - Oh-Yun Kwon
- b Department of Rehabilitation Medicine, Wonju Christian Hospital, Wonju College of Medicine , Yonsei University , Wonju , Korea.,c Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis , Yonsei University , Wonju , Korea
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Chaves P, Simões D, Paço M, Pinho F, Duarte JA, Ribeiro F. Deep Friction Massage and the Minimum Skin Pressure Required to Promote a Macroscopic Deformation of the Patellar Tendon. J Chiropr Med 2019; 17:226-230. [PMID: 30846914 DOI: 10.1016/j.jcm.2018.04.007] [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: 11/23/2017] [Revised: 03/29/2018] [Accepted: 04/02/2018] [Indexed: 11/17/2022] Open
Abstract
Objective The purpose of this study was to determine the skin pressure needed to promote the macroscopic deformation of the asymptomatic patellar tendon and to verify if the pressure is associated with the individual's characteristics. Methods A descriptive laboratory study was performed with a convenience sample of 18 young, voluntary, and asymptomatic individuals of both sexes. A progressively increasing pressure was applied on the skin over the patellar tendon, through an instrument designed to perform and control the pressure upon an ultrasound probe; data were recorded and analyzed by 2 blind investigators. All statistical analyses were conducted considering α = 0.05. Results The average pressure needed to promote a macroscopic deformation of the patellar tendon was 1.12 ± 0.37 kg/cm2. Female sex and age were inversely but not significantly associated with the pressure performed. Sports practice, weight, height, body mass index, muscle mass, and subcutaneous thickness were positively but not significantly associated with the pressure executed. Conclusion The average pressure needed to promote the macroscopic deformation of the patellar tendon was 1.12 ± 0.37 kg/cm2, which was not influenced by the characteristics of the participants.
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Affiliation(s)
- Paula Chaves
- Department of Physiotherapy, CESPU, North Polytechnic Institute of Health, Gandra PRD, Portugal
| | - Daniela Simões
- Department of Physiotherapy, Santa Maria Health School, Porto, Portugal
| | - Maria Paço
- Department of Physiotherapy, CESPU, North Polytechnic Institute of Health, Gandra PRD, Portugal
| | - Francisco Pinho
- Department of Physiotherapy, CESPU, North Polytechnic Institute of Health, Gandra PRD, Portugal
| | - José A Duarte
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport of University of Porto, Porto, Portugal
| | - Fernando Ribeiro
- Institute for Research in Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
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Okada-Ogawa A, Sekine N, Watanabe K, Kohashi R, Asano S, Iwata K, Imamura Y. Change in muscle hardness after trigger point injection and physiotherapy for myofascial pain syndrome. J Oral Sci 2018; 61:36-44. [PMID: 30568046 DOI: 10.2334/josnusd.17-0453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Assessment and treatment of masticatory myofascial pain syndrome (MPS) are not standardized and remain controversial. We examined whether muscle hardness was useful for evaluating masticatory MPS and analyzed the effectiveness of treatments such as stretching and massage (SM) and trigger point injection (TPI). Twenty healthy volunteers and 20 MPS patients were enrolled. MPS patients were divided into TPI and SM treatment groups. Hardness of masticatory muscle with a taut band (TB) and change in hardness were evaluated after SM and TPI treatments. Hardness values were significantly higher in muscle including a TB (TB point) than in the muscle of healthy controls. Visual analogue scale scores were significantly lower after SM and TPI treatments, and hardness of the TB point was significantly lower after SM but not after TPI. These results suggest that measurement of muscle hardness, including the TB, is useful for evaluating masticatory MPS. However, TPI analgesia might not be caused by change in muscle hardness. The mechanisms underlying the effects of SM and TPI on reducing pain in MPS may differ and thus warrant further research.
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Affiliation(s)
- Akiko Okada-Ogawa
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry.,Division of Orofacial Pain Clinic, Nihon University Dental Hospital.,Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
| | - Naohiko Sekine
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry
| | - Kosuke Watanabe
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry
| | - Ryutaro Kohashi
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry
| | - Sayaka Asano
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry
| | - Koich Iwata
- Department of Physiology, Nihon University School of Dentistry.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry
| | - Yoshiki Imamura
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry.,Division of Orofacial Pain Clinic, Nihon University Dental Hospital.,Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
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Chuna manual therapy combined with acupuncture and cupping for frozen shoulder (adhesive capsulitis): Study protocol for a multicenter, randomized, patient-assessor blind, clinical trial. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Chaves P, Simões D, Paço M, Pinho F, Duarte JA, Ribeiro F. Cyriax's deep friction massage application parameters: Evidence from a cross-sectional study with physiotherapists. Musculoskelet Sci Pract 2017; 32:92-97. [PMID: 28934644 DOI: 10.1016/j.msksp.2017.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 07/20/2017] [Accepted: 09/11/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Deep friction massage is one of several physiotherapy interventions suggested for the management of tendinopathy. OBJECTIVES To determine the prevalence of deep friction massage use in clinical practice, to characterize the application parameters used by physiotherapists, and to identify empirical model-based patterns of deep friction massage application in degenerative tendinopathy. DESIGN observational, analytical, cross-sectional and national web-based survey. METHODS 478 physiotherapists were selected through snow-ball sampling method. The participants completed an online questionnaire about personal and professional characteristics as well as specific questions regarding the use of deep friction massage. Characterization of deep friction massage parameters used by physiotherapists were presented as counts and proportions. Latent class analysis was used to identify the empirical model-based patterns. Crude and adjusted odds ratios and 95% confidence intervals were computed. RESULTS The use of deep friction massage was reported by 88.1% of the participants; tendinopathy was the clinical condition where it was most frequently used (84.9%) and, from these, 55.9% reported its use in degenerative tendinopathy. The "duration of application" parameters in chronic phase and "frequency of application" in acute and chronic phases are those that diverge most from those recommended by the author of deep friction massage. CONCLUSION We found a high prevalence of deep friction massage use, namely in degenerative tendinopathy. Our results have shown that the application parameters are heterogeneous and diverse. This is reflected by the identification of two application patterns, although none is in complete agreement with Cyriax's description.
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Affiliation(s)
- Paula Chaves
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Gandra, Paredes, Portugal.
| | - Daniela Simões
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Gandra, Paredes, Portugal; Santa Maria Health School, Porto, Portugal
| | - Maria Paço
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Gandra, Paredes, Portugal
| | - Francisco Pinho
- CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Gandra, Paredes, Portugal; Algoritmi - Universidade do Minho, Guimarães, Portugal; School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - José Alberto Duarte
- University of Porto, Faculty of Sport, Research Centre in Physical Activity, Health and Leisure, Porto, Portugal
| | - Fernando Ribeiro
- School of Health Sciences, University of Aveiro, Aveiro, Portugal; Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
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Ariji Y, Nakayama M, Nishiyama W, Ogi N, Sakuma S, Katsumata A, Kurita K, Ariji E. Potential clinical application of masseter and temporal muscle massage treatment using an oral rehabilitation robot in temporomandibular disorder patients with myofascial pain. Cranio 2016. [DOI: 10.1179/2151090314y.0000000030] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Terry Loghmani M, Bayliss AJ, Clayton G, Gundeck E. Successful treatment of a guitarist with a finger joint injury using instrument-assisted soft tissue mobilization: a case report. J Man Manip Ther 2016; 23:246-53. [PMID: 26952165 DOI: 10.1179/2042618614y.0000000089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Finger injuries are common and can greatly affect a musician's quality of life. A 55-year-old man, who had injured the proximal interphalangeal joint of the left index finger 6 months prior to any intervention, was treated with a manual therapy approach incorporating instrument-assisted soft tissue mobilization (IASTM). Initial examination findings included self-reported pain and functional limitations and physical impairments that significantly impeded his ability to play the acoustic guitar. He was treated once a week for 6 weeks with IASTM, joint mobilization, therapeutic exercise, and ice massage. Additionally, a home exercise program and self-care instructions were provided. The patient gained positive outcomes with improvements in pain (Numerical Pain Rating Scale while playing the guitar: initial 5/10, discharge 1/10) and function (Disability Arm Shoulder Hand Sports-Performing Arts Optional Module: initial 75; discharge 6·25), each reaching a minimum clinically important difference. Importantly, he was able to play the guitar with minimal to no pain as desired. Physical measures also improved, including an immediate gain in finger range of motion with IASTM alone. Manual therapy approaches integrating IASTM may provide an effective conservative treatment strategy for patients with finger/hand conditions in the performing arts and other patient populations.
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Affiliation(s)
- M Terry Loghmani
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, Indiana
| | - Amy J Bayliss
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, Indiana
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Ariji Y, Nakayama M, Nishiyama W, Ogi N, Sakuma S, Katsumata A, Kurita K, Ariji E. Can sonographic features be efficacy predictors of robotic massage treatment for masseter and temporal muscle in patients with temporomandibular disorder with myofascial pain? Cranio 2014; 34:13-9. [PMID: 25399824 DOI: 10.1179/2151090314y.0000000037] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The aim of this study was to detect sonographic predictors for the efficacy of massage treatment of masseter and temporal muscle in temporomandibular disorders (TMDs) patients with myofascial pain. METHODS Thirty-seven TMD patients with myofascial pain (6 men and 31 women, a median age of 45 years) were enrolled. An oral rehabilitation robot massaged the patient's masseter and temporal muscles with a standard massage pressure of 10 N for 16 min. The standard treatment protocol was set five sessions every 2 weeks. The median total duration of treatment was 9.5 weeks. Efficacy of treatment was evaluated based on maximum mouth opening and visual analog scale scores of muscle pain and daily life impediments. The intramuscular echogenic bands and elasticity index ratios of the masseter muscles were evaluated on sonographic or sonoelastographic images obtained before treatment and after the third and last treatment sessions. RESULTS The sonographic features detected different changes after the third treatment session between the therapy-effective and therapy-ineffective groups: in the therapy-effective group, the frequency of visibility of the distinct echogenic bands increased, and the elasticity index ratio decreased. CONCLUSION Sonographic features after the third treatment session may be useful as predictors of therapeutic efficacy.
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Affiliation(s)
- Yoshiko Ariji
- a Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry , Nagoya, Japan
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Hiraiwa Y, Ariji Y, Kise Y, Sakuma S, Kurita K, Ariji E. Efficacy of massage treatment technique in masseter muscle hardness: robotic experimental approach. Cranio 2014; 31:291-9. [PMID: 24308103 DOI: 10.1179/crn.2013.31.4.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The study aimed to clarify the masseter muscle hardness in patients with myofascial pain, to examine their changes after massage, and to analyze whether the hardness can be an index for massage treatment. Sixteen patients with myofascial pain (12 with unilateral and 4 with bilateral masseter muscle pain) and 24 healthy volunteers were enrolled in this study. The masseter hardness between patients and the healthy volunteers was compared. The changes in the hardness in patients after massage were examined. The relation of the hardness with massage regimens and efficacies was analyzed. There was a significant right-and-left difference of the hardness in patients, although there was no difference in the healthy volunteers. The hardness decreased after massage. The pretreatment asymmetry index of the hardness showed a significant correlation with the massage pressure. It was concluded that there was a significant difference between the right and left masseter hardness in patients with myofascial pain. After massage treatment, the masseter hardness and right-and-left difference decreased. The hardness may be an index for determining the massage pressure.
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Affiliation(s)
- Yuichiro Hiraiwa
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
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Bayliss AJ, Klene FJ, Gundeck EL, Loghmani MT. Treatment of a patient with post-natal chronic calf pain utilizing instrument-assisted soft tissue mobilization: a case study. J Man Manip Ther 2012; 19:127-34. [PMID: 22851875 DOI: 10.1179/2042618611y.0000000006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Musculoskeletal pain is commonly reported by pre- and postnatal women, with the most common complaint being low back pain. However, lower leg pain is also frequently reported by women particularly in the third trimester. The purpose of the case study is to illustrate how instrument-assisted soft tissue mobilization (ISTM) can be used to treat a patient with a 2-year history of chronic calf pain. The subject was a 35-year-old female who developed calf pain during the last trimester of her pregnancy following severe lower leg edema. The calf pain was present for the 2 years following delivery and was described as a dull ache, typically aggravated by direct pressure on the calf, prolonged standing, and stairs. An X-ray, magnetic resonance imaging (MRI) with contrast, and ultrasound Doppler study prior to referral ruled out tumors, vascular, lymphatic, or skeletal bone abnormalities. However, her MRI did show a dense superficial venous tissue asymmetry in the same location of her symptoms. Impairments were minimal; the only asymmetrical objective findings were calf length, strength, and soft tissue restrictions detected on palpation. After nine treatments incorporating an ISTM approach, soft tissue mobility, pain, calf strength, and lower extremity functional scale score all improved and her symptoms were abolished.
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Affiliation(s)
- Amy J Bayliss
- Department of Physical Therapy, Indiana University, Indianapolis, IN, USA
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Fedorczyk JM. Tendinopathies of the elbow, wrist, and hand: histopathology and clinical considerations. J Hand Ther 2012; 25:191-200; quiz 201. [PMID: 22507213 DOI: 10.1016/j.jht.2011.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 12/02/2011] [Accepted: 12/05/2011] [Indexed: 02/03/2023]
Abstract
This article reviews the current opinion of the histopathological findings of common elbow, wrist, and hand tendinopathies. Implications for client management including examination, diagnosis, prognosis, intervention, and outcomes are addressed. Concepts for further research regarding common therapeutic interventions are discussed.
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Affiliation(s)
- Jane M Fedorczyk
- Department of Physical Therapy & Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania 19102, USA.
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22
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Anandkumar S. Physical therapy management of entrapment of the superficial peroneal nerve in the lower leg: A case report. Physiother Theory Pract 2012; 28:552-61. [DOI: 10.3109/09593985.2011.653709] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sudarshan Anandkumar
- Coventry University – International School of Physiotherapy, Gokula Education Foundation, M.S.R Nagar, MSRIT Post, Bangalore, Karnataka 54, India.
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Ariji Y, Katsumata A, Hiraiwa Y, Izumi M, Sakuma S, Shimizu M, Kurita K, Ariji E. Masseter muscle sonographic features as indices for evaluating efficacy of massage treatment. ACTA ACUST UNITED AC 2011; 110:517-26. [PMID: 20868996 DOI: 10.1016/j.tripleo.2010.05.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 03/12/2010] [Accepted: 05/07/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this study was to clarify the sonographic features of the masseter muscle as indices for judging the efficacy of massage treatment. STUDY DESIGN Fifteen patients with temporomandibular disorder (10 with unilateral and 5 with bilateral muscle pain) underwent massage treatment alternately on the bilateral masseter and temporal muscles with an oral rehabilitation robot. Sonography was performed before and after treatment, and the masseter thickness and existence of anechoic areas were evaluated. RESULTS The thickness on the symptomatic side in the unilateral group significantly decreased after treatment. Anechoic areas were shown in 20 muscles (66.7%) before treatment, and disappeared or were reduced in size in 17 muscles (85.0%) after treatment. The pretreatment thickness was significantly related to visual analog scale (VAS) scores regarding posttreatment muscle pain and massage impression. The existence of anechoic areas was relevant to VAS scores regarding muscle pain. CONCLUSION Masseter thickness and existence of anechoic areas might be related to the therapeutic efficacy regarding muscle pain.
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Affiliation(s)
- Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology,Aichi-Gakuin University School of Dentistry, Nagoya, Japan.
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Cacchio A, Rompe JD, Furia JP, Susi P, Santilli V, De Paulis F. Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes. Am J Sports Med 2011; 39:146-53. [PMID: 20855554 DOI: 10.1177/0363546510379324] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Chronic proximal hamstring tendinopathy is an overuse syndrome that is usually managed by nonoperative methods. Shockwave therapy has proved to be effective in many tendinopathies. HYPOTHESIS Shockwave therapy may be more effective than other nonoperative treatments for chronic proximal hamstring tendinopathy. STUDY DESIGN Randomized controlled clinical study; Level of evidence, 1. METHODS Forty professional athletes with chronic proximal hamstring tendinopathy were enrolled between February 1, 2004, and September 30, 2006. Patients were randomly assigned to receive either shockwave therapy, consisting of 2500 impulses per session at a 0.18 mJ/mm² energy flux density without anesthesia, for 4 weeks (SWT group, n = 20), or traditional conservative treatment consisting of nonsteroidal anti-inflammatory drugs, physiotherapy, and an exercise program for hamstring muscles (TCT group, n = 20). Patients were evaluated before treatment, and 1 week and 3, 6, and 12 months after the end of treatment. The visual analog scale (VAS) score for pain and Nirschl phase rating scale (NPRS) were used as primary outcome measures. RESULTS The patients were observed for a mean of 10.7 months (range, 1-12 months). Six patients were lost to follow-up because they underwent a surgical intervention: 3 (all in TCT group) were lost at 3 months; 2 (1 in each group), at 6 months; and 1 (in the TCT group), at 12 months. Primary follow-up was at 3 months after the beginning of treatment. The VAS scores in the SWT and TCT groups were 7 points before treatment (P = .84), and 2 points and 5 points, respectively, 3 months after treatment (P < .001). The NPRS scores in the SWT and TCT groups were 5 points in either group before treatment (P = .48), and 2 points and 6 points, respectively, 3 months after treatment (P < .001). At 3 months after treatment, 17 of the 20 patients (85%) in the SWT group and 2 of the 20 patients (10%) in the TCT group achieved a reduction of at least 50% in pain (P < .001). There were no serious complications in the SWT group. CONCLUSION Shockwave therapy is a safe and effective treatment for patients with chronic proximal hamstring tendinopathy.
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Affiliation(s)
- Angelo Cacchio
- Department of Physical Medicine and Rehabilitation, University of Rome "La Sapienza," Italy.
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25
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Hammer WI. The effect of mechanical load on degenerated soft tissue. J Bodyw Mov Ther 2008; 12:246-56. [DOI: 10.1016/j.jbmt.2008.03.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Revised: 03/16/2008] [Accepted: 03/31/2008] [Indexed: 11/25/2022]
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Stasinopoulos D, Johnson MI. It may be time to modify the Cyriax treatment of lateral epicondylitis. J Bodyw Mov Ther 2007. [DOI: 10.1016/j.jbmt.2006.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Post-operative care of the surgical patient significantly contributes to the success of the surgical procedure. Post-operative physical therapy is directed at reducing pain and inflammation, preventing or minimizing scar tissue, and returning the patient to full function. An individualized and well-planned therapeutic exercise program is an integral part of the post-operative care. Manual therapy techniques are utilized to break up scar tissue and reduce joint stiffness. Pain and inflammation can be addressed by modalities such as ultrasound, laser, and electrical stimulation in addition to cryotherapy.
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Affiliation(s)
- Tamara J Bond
- Foot and Ankle Institute of Santa Monica, 2121 Wilshire Blvd, Suite 101, CA 90403, USA.
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28
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Gregory MA, Deane MN, Mars M. Ultrastructural Changes in Untraumatised Rabbit Skeletal Muscle Treated with Deep Transverse Friction. Physiotherapy 2003. [DOI: 10.1016/s0031-9406(05)60074-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pringle RK, Richardson DL, Shiel RS. Case report: Myofascial pain syndrome: a double crush-like appearance. J Chiropr Med 2003; 2:66-74. [PMID: 19674598 PMCID: PMC2646961 DOI: 10.1016/s0899-3467(07)60045-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2002] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To discuss the case of a patient with myofascial pain syndrome that appeared similar to double crush syndrome. CLINICAL FEATURES This is a case report of a 45-year old female who presents to the private practice clinic with the same signs and symptoms of carpal tunnel syndrome, 1 year post-carpaltunnel surgery. The history is consistent with injuries that result in double crush syndrome and thoracic outlet syndrome. The patient history includes a motor vehicle accident (MVA) in 1963 that resulted in a prolonged hospital stay and fracture of a cervical vertebral (C4) body. She fractured the olecranon process of the right elbow during a fall in 1970's. She has smoked approximately 1 pack a day for 20 years. Her job involves long periods of sitting at a keyboard and in a car. All of these portions of the patient history are possible factors in the clinical signs and symptoms of double crush syndrome. INTERVENTION AND OUTCOME Treatment involved chiropractic manipulation and physical therapy modalities for the elimination of pain and returning the patient's full range of motion in the wrist, elbow, shoulder and cervical spine. After range of motion was restored, a home exercise program was initiated. The home exercise program included a return to past sporting activity and active, resistive (Theraciser band) activities for the elbow and cervical spine. Also a reduction in smoking was initiated as part of the patient's treatment plan. CONCLUSION It is our contention that patients who have electromyographic (EMG) demonstrable carpal tunnel syndrome need a cervical spine workup and a period of conservative care to include skilled manipulation, physical therapy and home exercises before surgery is recommended.
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Backstrom KM. Mobilization with movement as an adjunct intervention in a patient with complicated de Quervain's tenosynovitis: a case report. J Orthop Sports Phys Ther 2002; 32:86-94; discussion 94-7. [PMID: 12168742 DOI: 10.2519/jospt.2002.32.3.86] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Case study. OBJECTIVES To describe the use of conventional physical therapy interventions together with Mobilization With Movement (MWM) techniques in the treatment of an individual with a complicated scenario of de Quervain's tenosynovitis. BACKGROUND The patient was a 61-year-old woman who presented with signs and symptoms consistent with de Quervain's tenosynovitis of the right hand. Range limitations in all motions of the right wrist and first carpometacarpal joint complicated her presentation. METHODS AND MEASURES Physical therapy included conventional intervention with superficial heat, ice, iontophoresis, and transverse friction massage directed to the first dorsal tunnel. Conventional joint mobilization techniques addressed the motion limitations of the first carpometacarpal, radiocarpal, and midcarpal joints. In addition, MWM techniques were utilized to promote pain-free wrist and thumb mobility. The specific MWM techniques used with this patient involved active movements of the thumb and wrist superimposed on a passive radial glide of the proximal row of carpal bones. RESULTS The described treatment regime, which involved conventional physical therapy interventions, along with MWM, aided in the complete resolution of this patient's impairments and functional limitations. CONCLUSION The combination of conventional physical agents, exercise, and manual therapy, and the less conventional MWM techniques, proved successful with this patient. MWM involving the correction of minutejoint malalignments, coupled with active motion of the wrist and first carpometacarpal joints, was an effective and efficient adjunct physical therapy intervention. Because subtle changes injoint alignment may contribute to painful syndromes in the tendon complexes that cross a malaligned joint, use of MWM as a treatment technique warrants continued research.
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Gehlsen GM, Ganion LR, Helfst R. Fibroblast responses to variation in soft tissue mobilization pressure. Med Sci Sports Exerc 1999; 31:531-5. [PMID: 10211847 DOI: 10.1097/00005768-199904000-00006] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED Augmented soft tissue mobilization therapy (ASTM), a newly developed massage therapy, has been successfully used in the treatment of chronic tendinitis patients. We theorized that the ASTM technique promotes healing through a controlled application of microtrauma. PURPOSE The purpose of this study was to determine morphologic changes in the rat Achilles tendon after enzyme-induced injury with collagenase and subsequent pressure variations in ASTM therapy. METHODS Thirty male white rats were randomly assigned to one of five groups with six animals per group: tendinitis (A), tendinitis plus light ASTM (B), tendinitis plus medium ASTM (C), tendinitis plus extreme ASTM (D), and control with surgery only (E). ASTM was performed for 3 min, for a total of six treatment sessions. The Achilles tendons of each group were harvested 1 wk after the last ASTM treatment. Fibroblast numbers were assessed by light microscopy. An electron microscope was used to observe enlargement of fibroblasts. RESULTS Statistical analysis of the number of fibroblasts present indicated a significant difference (P<0.00) between group D and all other groups. CONCLUSION The morphological evidence indicated that the application of heavy pressure promoted the healing process to a greater degree than light or moderate pressure.
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Affiliation(s)
- G M Gehlsen
- Department of Health and Physiology, Ball State University, Muncie, IN 47306, USA.
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Davidson CJ, Ganion LR, Gehlsen GM, Verhoestra B, Roepke JE, Sevier TL. Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Med Sci Sports Exerc 1997; 29:313-9. [PMID: 9139169 DOI: 10.1097/00005768-199703000-00005] [Citation(s) in RCA: 100] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Augmented Soft Tissue Mobilization (ASTM) is a new non-invasive soft tissue mobilization technique which has been used successfully to treat a variety of musculoskeletal disorders. The purpose of this study was to determine the effects of ASTM therapy on the morphological and functional characteristics of enzyme induced injured rat Achilles tendons. Four groups of five rats were allocated as follows: (A) control, (B) tendinitis, (C) tendinitis plus ASTM, and (D) ASTM alone. Collagenase injury was induced, and the surgical site was allowed to heal for 3 wk. ASTM was performed on the Achilles tendon of groups C and D for 3 min on postoperative days 21, 25, 29, and 33 for a total of four treatments. Gait data were gathered prior to each treatment. The Achilles tendons of each group were harvested 1 wk after the last treatment. Specimens were prepared for light and electron microscopy, and immunostaining for type I and type III collagen and fibronectin was performed. Light microscopy showed increased fibroblast proliferation in the tendinitis plus ASTM treatment group. Although healing in rats may not translate directly to healing in humans, the findings of this study suggest that ASTM may promote healing via increased fibroblast recruitment.
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Goats GC. Massage--the scientific basis of an ancient art: Part 2. Physiological and therapeutic effects. Br J Sports Med 1994; 28:153-6. [PMID: 8000810 PMCID: PMC1332056 DOI: 10.1136/bjsm.28.3.153] [Citation(s) in RCA: 145] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The physiological and therapeutic effects of massage are frequently questioned. This article reviews previous research into the effects of massage on blood flow and composition, oedema, connective tissue, muscle and the nervous system. Although further investigations are clearly required in certain areas, the discussion demonstrates that the use of massage in sports medicine can be justified according to orthodox scientific criteria.
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Affiliation(s)
- G C Goats
- School of Occupational Therapy and Physiotherapy, University of East Anglia, Norwich, UK
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Treatment of infrapatellar Tendinitis: A Combination of Modalities and Transverse Friction Massage versus Iontophoresis. J Sport Rehabil 1994. [DOI: 10.1123/jsr.3.2.135] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to compare an established protocol of modalities and transverse friction massage (MOD & TFM) with iontophoresis of dexamethasone and lidocaine (IONTO) in the treatment of patients with infrapatellar tendinitis. Thirty cases with infrapatellar tendinitis were randomly assigned to either the MOD & TFM or the IONTO intervention. Subjects still symptomatic after six sessions of intervention received the alternate treatment protocol. Four measures were used to assess patient status: a functional index questionnaire, a visual analog pain scale, a rating of tenderness with palpation of the involved tendon, and the number of step-ups needed to elicit pain. In response to the MOD & TFM intervention, only the number of step-ups performed to elicit pain showed significant improvement. All status measures improved significantly with the IONTO intervention. The results suggest that iontophoresis may be more effective and efficient in decreasing pain, reducing inflammation, and promoting healing in patients with infrapatellar tendinitis.
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Schwellnus MP, Mackintosh L, Mee J. Deep Transverse Frictions in the Treatment of lliotibial Band Friction Syndrome in Athletes: A clinical trial. Physiotherapy 1992. [DOI: 10.1016/s0031-9406(10)61197-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Flexor hallucis longus tendinitis-a case of mistaken identity and posterior impingement syndrome in dancers: evaluation and management. J Orthop Sports Phys Ther 1984; 5:204-6. [PMID: 18806415 DOI: 10.2519/jospt.1984.5.4.204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Flexor hallucis longus tendinitis and posterior impingement syndrome, two problems commonly encountered by dancers, but sometimes misdiagnosed, are presented and discussed in terms of anatomy, evaluation, and management.J Orthop Sports Phys Ther 1984;5(4):204-206.
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Abstract
The purpose of this study was to examine the effect of deep transverse frictions on the healing of a minor sprain of the knee medial collateral ligament, in rabbits, using histological observations. Right knees of 18 animals were manually sprained; left knees served as controls. Deep transverse frictions were given five times to six animals; ten times to six animals. It was not possible on stained tissue sections to distinguish (P > 0.05) either between sprained or unsprained ligaments, or between treated and untreated sprained ligaments. The hypothesis that deep transverse frictions promote repair of sprained ligaments is not supported by the results of this study.J Orthop Sports Phys 1984;6(2):89-94.
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