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Tang F, Yin S, Gao P, Chen L. The effect of joint mobilization of Maitland on chronic ankle instability: A randomized trial. Medicine (Baltimore) 2024; 103:e39100. [PMID: 39121319 PMCID: PMC11315491 DOI: 10.1097/md.0000000000039100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND The aim of study was to observe the therapeutic effect of joint mobilization of Maitland on subjects with chronic ankle instability (CAI). METHODS 76 subjects with CAI were recruited for this randomized, single-blinded trial and randomized divided into experimental group (EG) and control group (CG). The CG was received conventional rehabilitation, and the EG added 8-weeks treatment of Maitland technology based on the CG. The visual analogue scale, ankle range of motion, Y-balance test, and Foot and Ankle Ability Measure scores (the daily living part of Foot and Ankle Ability Measure scores and the sport part of Foot and Ankle Ability Measure scores) were measured before and 8 weeks after the intervention respectively. RESULTS There was no significant difference on outcomes between the 2 groups before treatment (P > .05). After 8 weeks of intervention, the visual analogue scale, ankle range of motion (dorsiflexion, plantar flexion, and varus), the value of Y-balance test (forward extension distance, inner extension distance, and posterior extension distance), the daily living part of Foot and Ankle Ability Measure scores, and the sport part of Foot and Ankle Ability Measure scores of the 2 groups were significantly improved (P < .01), and the improvement of the EG showed remarkable than CG (P < .01). CONCLUSION Maitland therapy is effective in the treatment of CAI. Conventional rehabilitation assisted by Maitland therapy were beneficial to improve pain and functional state in patients with CAI than only routine rehabilitation.
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Affiliation(s)
- Fang Tang
- College of Physical Education, Anqing Normal University, Anqing, China
- Department of Rehabilitation and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Shanshan Yin
- Public Physical Education Department, Taizhou University, Taizhou, China
| | - Pincao Gao
- College of Physical Education, Anqing Normal University, Anqing, China
- Department of Rehabilitation and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Lin Chen
- Guilin Vocational College of life and health, Guilin, China
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Ferguson J, Fritsch A, Rhon DI, Young JL. Adverse Events Reported in Trials Assessing Manual Therapy to the Extremities: A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:507-517. [PMID: 38452161 DOI: 10.1089/jicm.2023.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Objective: This review aimed to describe the quality and comprehensiveness of adverse event (AE) reporting in clinical trials incorporating manual therapy (MT) as an intervention for extremity conditions using the Consolidated Standards of Reporting Trials (CONSORT)-Harms extension as the benchmark. The secondary aim was to determine whether the quality of AE reporting improved after the availability of the CONSORT reporting checklist. Design: Systematic review. Methods: A literature search was conducted using multiple databases to identify trials where MT was used to treat extremity conditions. Studies that reported AEs were identified and evaluated using the CONSORT-Harms extension. The frequency of trials reporting study AEs before and after the publication of the updated 2010 CONSORT statement was calculated, along with the categorization of how study AEs were reported. Results: Of the 55,539 studies initially identified, 220 trials met all inclusion criteria. Eighty trials (36.4%) reported AE occurrence. None of the studies that reported AEs adhered to all 10 criteria proposed by the 2010 CONSORT-Harms extension. The most commonly reported criterion was number four, which clarified how AE-related information was collected (30% of trials). The least reported criterion was number six, which describes the participant withdrawals for each arm due to AEs and the experience with the allocated treatment (1.3% of trials). The nomenclature used to describe AEs varied substantially. Fifty-nine of 76 trials (33.3%) were published after the updated CONSORT Harms-checklist was available, compared to 21 of 44 trials (46.7%) published before it was available. Conclusion: Reporting of AEs in trials investigating MT for extremity conditions is poor. Every included trial lacked adherence to all 10 criteria proposed by the CONSORT-Harms Extension. The quality and comprehensiveness of AE reporting did not improve after the most recent CONSORT update recommending AE reporting. Clinicians must obtain informed consent before performing any intervention, including MT, which requires disclosing potential risks, which could be better known with improved tracking, analyzing, and reporting of AEs. The authors recommend improved adherence to best practices for adequately tracking and reporting AEs in future MT trials.
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Affiliation(s)
- Jeffrey Ferguson
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Adam Fritsch
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Daniel I Rhon
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
- Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Jodi L Young
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
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Swanson BT, Hagenbruch M, Lapaan B, Skipalskiy K. Combined Effects of Glenohumeral Mobilization, Stretching, and Thoracic Manipulation on Shoulder Internal Rotation Range of Motion. Int J Sports Phys Ther 2024; 19:394-409. [PMID: 38699673 PMCID: PMC11065457 DOI: 10.26603/001c.95040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/07/2024] [Indexed: 05/05/2024] Open
Abstract
Background/purpose Interventions including posterior glenohumeral mobilizations (PGM), sleeper stretches, and thoracic manipulation are commonly used to address posterior shoulder tightness. The purpose of this study was to assess the effects of adding thoracic manipulation to PGM and sleeper stretches on passive range of motion (PROM), joint mobility, and infraspinatus electromyographic (EMG) activity in shoulders with decreased internal rotation (IR) PROM. Design Randomized Sequential Intervention Laboratory Study. Methods Forty individuals with clinically significant IR loss attended two study sessions. Participants were randomized to receive five 30 seconds bouts of either grade III PGM or sleeper stretching. Following a seven-day washout period, all participants attended a second session and received a prescriptive supine HVLA manipulation targeting the T3-4 segment, followed by the previously randomized intervention. Outcome measures included internal rotation PROM, horizontal adduction PROM, posterior glenohumeral joint translation assessed via ultrasound imaging, and EMG activity of the infraspinatus during a PGM. All outcome measures were assessed pre- and immediately post-intervention and compared statistically. Results There were significant within-group, but not between-group, differences for IR and horizontal adduction PROM following a single session of PGM or sleeper stretch. When combined with thoracic manipulation, significantly smaller within session changes of IR PROM were observed for both PGM (mean difference 4.4, p=0.017) and sleeper stretches (mean difference 6.4, p=0.0005). There were no significant between group differences for horizontal adduction PROM, humeral head translation, or EMG activity across all time points. Discussion Both GH posterior mobilizations and sleeper stretches improved IR and horizontal adduction PROM in a single session. The addition of thoracic manipulation prior to local shoulder interventions resulted in smaller gains of both IR and horizontal adduction ROM. Level of evidence Level 2.
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Yin Y, Yu Z, Wang J, Sun J. Effectiveness of the Rehabilitation Training Combined with Maitland Mobilization for the Treatment of Chronic Ankle Instability: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15328. [PMID: 36430049 PMCID: PMC9690276 DOI: 10.3390/ijerph192215328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
The study aims to determine whether routine rehabilitation training combined with the Maitland mobilization is more effective than routine rehabilitation training alone in patients with chronic ankle instability, intending to provide a novel rehabilitation strategy for chronic ankle instability. A total of 48 subjects were divided into three groups: EG (Maitland mobilization and routine rehabilitation), CG (routine rehabilitation), and SG (sham mobilization and routine rehabilitation). The intervention was performed three times each week for 4 weeks, for a total of 12 sessions. Before and after the intervention, the muscle strength, star excursion balance test (SEBT), weight-bearing dorsiflexion range of motion (WB-DFROM), ankle range of movement, Cumberland ankle instability tool (CAIT), self-comfort visual analog scale (SCS-VAS), and self-induced stability scale (SISS-VAS) were assessed. The results showed that the improvement of SEBT, WB-DFROM, and active ankle range of movement without the pain in EG was more obvious than CG and SG, but the improvement of the self-report of ankle severity and muscle strength was not. Compared with routine rehabilitation training alone, routine rehabilitation training combined with Maitland mobilization for patients with chronic ankle instability may provide more benefit in terms of balance and ankle range of movement than routine rehabilitation alone, but the improvement in muscle strength was not evident enough.
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Affiliation(s)
- Yikun Yin
- College of Physical and Health Education, Guangxi Normal University, Guilin 541006, China
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Zhengze Yu
- College of Physical and Health Education, Guangxi Normal University, Guilin 541006, China
| | - Jialin Wang
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Junzhi Sun
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
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Immediate Effects of Long-Axis Talocrural Thrust Manipulation on the Length of the Anterior Talofibular and Calcaneofibular Ligaments Measured With Musculoskeletal Ultrasound Imaging. J Manipulative Physiol Ther 2022; 45:153-162. [PMID: 35753871 DOI: 10.1016/j.jmpt.2022.03.020] [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: 08/05/2020] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of the present study was to measure the immediate effect of a thrust manipulation on the length of the anterior talofibular and calcaneofibular ligaments in healthy patients. METHODS A convenience sample of 47 healthy patients were recruited for this quasi-experimental study. The patients had an age range from 22 to 54 years, with a mean age of 30.36 years. There were 23 female patients and 24 male patients. Musculoskeletal ultrasound imaging was used to measure the length of the anterior talofibular and calcaneofibular ligaments before and immediately after a high-velocity long-axis thrust manipulation of the talocrural joint during various validated test positions. RESULTS A single long-axis thrust manipulation did not result in a significant change in the length of the anterior talofibular ligament (P = .325). Additionally, there was no significant difference in calcaneofibular length after a long-axis thrust manipulation (P = .26). CONCLUSION The results indicate that the length of the anterior talofibular and calcaneofibular ligament did not significantly change after a single long-axis thrust manipulation of the talocrural joint in healthy patients. It appears that the joint capsule of the talocrural joint reached end-range during the manipulation before the ligament undergoes plastic length changes; thus, the increase in joint range of motion after a thrust manipulation was probably not due to increased plastic length changes of the anterior talofibular and calcaneofibular ligaments.
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Kosik KB, Terada M, McCann RS, Drinkard CP, Gribble PA. Association between corticospinal inhibition and active dorsiflexion range of motion in patients with chronic ankle instability. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kyle B. Kosik
- Department of Athletic Training & Clinical Nutrition University of Kentucky Lexington KY USA
| | - Masafumi Terada
- Department of Sport and Health Science Ritsumeikan University Kyoto Japan
| | - Ryan S. McCann
- School of Physical Therapy & Athletic Training Old Dominion University Norfolk VA USA
| | | | - Phillip A. Gribble
- Department of Athletic Training & Clinical Nutrition University of Kentucky Lexington KY USA
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Bechert RE. Treatment of Posttraumatic Osteoarthritis Secondary to a Chronic Plafond Fracture: A Case Report. J Chiropr Med 2020; 18:219-224. [PMID: 32874162 DOI: 10.1016/j.jcm.2019.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 01/26/2019] [Accepted: 02/05/2019] [Indexed: 12/30/2022] Open
Abstract
Objective The purpose of this case report is to describe the treatment of a 3-year-old plafond fracture that developed posttraumatic osteoarthritis in a patient with chronic left ankle pain. Clinical Features A 65-year-old woman presented with daily anterior, posterior, medial, and lateral left ankle pain. Her initial pain level was 7 of 10 on weight bearing. She had trouble working and walking. She was previously treated with a walking boot, crutches, exercises, nonsteroidal anti-inflammatory drugs, and a steroid injection. She consulted our office approximately 3 years post-injury, at which point her initial disability score was 55 of 104 on the Foot and Ankle Disability Index. Interventions and Outcome The patient was subsequently treated with low-level laser, kinesio taping, exercise, and toggle board manipulation of the ankle. After a total of 6 visits, she was able to return to work and was walking with marked reduction of pain. Her pain level was 1 of 10 on weight bearing 1.5 years after her last treatment. Conclusion In this case report, a patient presented with 3-year-old ankle pain with an original etiology of plafond fracture. Her pain and disability resolved with a combination of low-level laser, exercises, kinesio taping, and toggle board manipulation. Her disability score after 6 visits was 18 of 104 on the Foot and Ankle Disability Index. This is a possible treatment option for posttraumatic osteoarthritis secondary to plafond fractures.
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Impact of Extremity Manipulation on Postural Sway Characteristics: A Preliminary, Randomized Crossover Study. J Manipulative Physiol Ther 2020; 43:457-468. [PMID: 32800642 DOI: 10.1016/j.jmpt.2019.02.014] [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: 10/16/2018] [Revised: 01/02/2019] [Accepted: 02/25/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Evaluate multisegmental postural sway after upper- vs lower-extremity manipulation. METHODS Participants were healthy volunteers (aged 21-40 years). Upper- or lower-extremity manipulations were delivered in a randomized crossover design. Postural assessments were made pre-post manipulation, in floor and rocker board conditions. Analysis included traditional balance measures of pathlength and range and sample entropy (SampEn) to examine the temporal structure of sway of the head, trunk, and surface. RESULTS No statistical changes in pathlength or sway range on the ground surface condition were observed. No increases in the amount of sway occurred in any condition. Chiropractic manipulation of either upper or lower extremities led to reductions in traditional measures of postural control on the rocker board. In the anteroposterior direction (sagittal plane), lower-extremity manipulation led to increased trunk SampEn while on the ground, and conversely a decreased SampEn while on the rocker board. In the mediolateral rocker board condition (frontal plane), manipulation elicited a change in SampEn that differed according to site of manipulation; upper-extremity manipulation increased SampEn, whereas lower-extremity manipulation reduced SampEn. CONCLUSION Both upper- and lower-extremity manipulation influenced several measures of postural sway on both the ground and the rocker board. Lower-extremity manipulation improved the organization of sway at the trunk (anteroposterior direction) and the board (mediolateral direction). Given the reduction and reorganization of sway metrics seen in this study, we propose extending this line of research to the elderly who are at greatest risk of increased sway and falls.
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Lee YY, Li MH, Tai CH, Luh JJ. Corticomotor Excitability Changes Associated With Freezing of Gait in People With Parkinson Disease. Front Hum Neurosci 2020; 14:190. [PMID: 32508609 PMCID: PMC7253638 DOI: 10.3389/fnhum.2020.00190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/28/2020] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose Freezing of gait (FOG) is a debilitating gait disorder in people with Parkinson’s disease (PD). While various neuroimaging techniques have been used to investigate the pathophysiology of FOG, changes in corticomotor excitability associated with FOG have yet to be determined. Research to date has not concluded if changes in corticomotor excitability are associated with gait disturbances in this patient population. This study aimed to use transcranial magnetic stimulation (TMS) to investigate corticomotor excitability changes associated with FOG. Furthermore, the relationship between corticomotor excitability and gait performances would be determined. Methods Eighteen participants with PD and FOG (PD + FOG), 15 without FOG (PD − FOG), and 15 non-disabled adults (Control) were recruited for this study. Single and paired-pulse TMS paradigms were used to assess corticospinal and intracortical excitability, respectively. Gait performance was measured by the 10-Meter-Walk test. Correlation analysis was performed to evaluate relationships between TMS outcomes and gait parameters. Results Compared with the Control group, the PD + FOG group showed a significantly lower resting motor threshold and reduced short intracortical inhibition (SICI). Correlation analysis revealed a relationship between resting motor evoked potential and step length, and between SICI and walking velocity in the Control group. While the silent period correlated with step length in the PD − FOG group, no significant relationship was observed in the PD + FOG group. Discussion and Conclusion Compared to the Control group, the PD + FOG group exhibited reduced corticomotor inhibition. Distinct correlations observed among the three groups suggest that the function of the corticomotor system plays an important role in mediating walking ability in non-disabled adults and people with PD − FOG, while people with PD + FOG may rely on neural networks other than the corticomotor system to control gait.
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Affiliation(s)
- Ya-Yun Lee
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Min-Hao Li
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Hwei Tai
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jer-Junn Luh
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,College of Education, Fu-Jen Catholic University, Taipei, Taiwan
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Silva Neto JB, Ismania C, de Freitas DG, Cazarini C, Martin RL, Fukuda TY. The effect of a single high velocity low amplitude hip mobilization on strength in subjects with knee injuries. Musculoskelet Sci Pract 2019; 44:102051. [PMID: 31472415 DOI: 10.1016/j.msksp.2019.102051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 07/23/2019] [Accepted: 08/19/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Manual therapy have been used as a disinhibitory intervention to increase muscle activation before performing functional tasks that are limited by weakness. Knee injuries are commonly associated with weakness in quadriceps and gluteus. Currently, there is no evidence to support anecdotal experience that a hip distraction mobilization improves muscle performance in subjects with knee injuries and lower extremity weakness. OBJECTIVES To determine if a hip distraction mobilization would result in an immediate change of maximal force output of the quadriceps and gluteus. DESIGN Non-controlled observational pre-post design. METHODS Forty individuals with knee pathology were included. Subjects underwent quadriceps, gluteus maximus, and gluteus medius muscle strength assessment before a single hip distraction of the symptomatic side. An immediate re-assessment of muscle strength of both symptomatic and asymptomatic sides followed the mobilization. RESULTS /findings: Comparing pre-to post-mobilization strength on the symptomatic side, a significant increase was found with the gluteus maximus (average change = 2.0 kg [95%CI 0.6-3.4]; p < 0.01) but not gluteus medius (0.2 kg [-0.7-1.0]; p = 0.71) or quadriceps (0.1 kg [-1.4-1.7]; p = 0.86). When comparing the strength on the symptomatic side in subjects with weakness greater than the MDD95 (0.7-2.9 kg), a significant increase was again found for gluteus maximus (4.7 kg [2.6-6.8]; p < 0.01) but not for gluteus medius (0.2 kg [-1.0-1.4]; p = 0.71) or quadriceps (1.6 kg [-0.7-3.9]; p = 0.15). CONCLUSION A single hip distraction resulted in a significant increase in gluteus maximus strength but did not produce a change in gluteus medius or quadriceps strength in subjects with knee injuries.
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Affiliation(s)
- João B Silva Neto
- Physical Therapy Department, Santa Casa of São Paulo, São Paulo, Brazil; Trata Institute, Knee and Hip Rehabilitation, São Paulo, Brazil
| | - Caio Ismania
- Physical Therapy Department, Santa Casa of São Paulo, São Paulo, Brazil; Trata Institute, Knee and Hip Rehabilitation, São Paulo, Brazil
| | | | - Claudio Cazarini
- Physical Therapy Department, Santa Casa of São Paulo, São Paulo, Brazil
| | | | - Thiago Y Fukuda
- Trata Institute, Knee and Hip Rehabilitation, São Paulo, Brazil.
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Decreased supraspinal control and neuromuscular function controlling the ankle joint in athletes with chronic ankle instability. Eur J Appl Physiol 2019; 119:2041-2052. [DOI: 10.1007/s00421-019-04191-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 07/13/2019] [Indexed: 12/26/2022]
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Shi X, Han J, Witchalls J, Waddington G, Adams R. Does treatment duration of manual therapy influence functional outcomes for individuals with chronic ankle instability: A systematic review with meta-analysis? Musculoskelet Sci Pract 2019; 40:87-95. [PMID: 30753998 DOI: 10.1016/j.msksp.2019.01.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 01/04/2019] [Accepted: 01/30/2019] [Indexed: 12/26/2022]
Abstract
QUESTION Can manual therapy improve functional outcomes for individuals with chronic ankle instability? DESIGN Systematic review with meta-analysis of randomized controlled trials. PARTICIPANTS Individuals with chronic ankle instability. INTERVENTION Manual therapy is defined as an intervention that involves joint mobilization, and mobilization with movement. OUTCOME MEASURE The primary outcome is patient reported function (PRF) questionnaires scores, the secondary outcomes are ankle dorsiflexion range of motion (DFROM) and balance control. RESULTS Four studies were included (n = 208, mean age = 24.4) in the meta-analysis, with moderate to high quality on the PEDro scale (range 6-8). For patient reported function (PRF) questionnaires, two studies reported significant improvement after six-session manual therapy measured by foot and ankle ability measures sport subscale (FAAMS) and Cumberland ankle instability tool (CAIT), respectively. For DFROM, one session manual therapy had no significant effect on the weight-bearing lunge test (WBLT) (3 studies, n = 147, SMD = 1.24 (95%CI -0.87 to 3.36), I2 = 96%) or non-weight-bearing inclinometer test (2 studies, n = 47, MD = 3.41° (95%CI -0.26 to 7.09),I2 = 43%), while six-sessions manual therapy showed, a significantly positive effect on WBLT(2 studies, n = 80, SMD = 2.39, (95% CI 0.55, to 4.23), I2 = 93%). For the SEBT, one-session manual therapy had no significant effect on overall star excursion balance test (SEBT) score (3 studies, n = 137,MD = 2.05,95%CI (-0.96,5.05), I2 = 75%), while qualitative analysis of 2 included studies showed significant improvement both on the SEBT score and single limb balance test (SLBT). CONCLUSIONS Six sessions rather than one session of manual therapy improves ankle functional performance for individuals with CAI. TRIAL REGISTRATION NUMBER PROSPERO CRD42017054715.
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Affiliation(s)
- Xiaojian Shi
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China.
| | - Jia Han
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China; Research Institute for Sport and Exercise, University of Canberra, ACT, 2601, Australia.
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, ACT, 2601, Australia.
| | - Gordon Waddington
- Research Institute for Sport and Exercise, University of Canberra, ACT, 2601, Australia.
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, ACT, 2601, Australia.
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Griffin K, O'Hearn M, Franck CC, Courtney CA. Passive accessory joint mobilization in the multimodal management of chronic dysesthesia following thalamic stroke. Disabil Rehabil 2018; 41:1981-1986. [PMID: 29557687 DOI: 10.1080/09638288.2018.1450453] [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: 10/17/2022]
Abstract
Study design: Case Report. Purpose: Stroke is the most common cause of long-term disability. Dysesthesia, an unpleasant sensory disturbance, is common following thalamic stroke and evidence-based interventions for this impairment are limited. The purpose of this case report was to describe a decrease in dysesthesia following manual therapy intervention in a patient with history of right lacunar thalamic stroke. Case description: A 66-year-old female presented with tingling and dysesthesia in left hemisensory distribution including left trunk and upper/lower extremities, limiting function. Decreased left shoulder active range of motion, positive sensory symptoms but no sensory loss in light touch was found. She denied pain and moderate shoulder muscular weakness was demonstrated. Laterality testing revealed right/left limb discrimination deficits and neglect-like symptoms were reported. Passive accessory joint motion assessment of glenohumeral and thoracic spine revealed hypomobility and provoked dysesthesia. Interventions included passive oscillatory joint mobilization of glenohumeral joint, thoracic spine, ribs and shoulder strengthening. Results: After six sessions, shoulder function, active range of motion, strength improved and dysesthesia decreased. Global Rating of Change Scale was +5 and QuickDASH score decreased from 45% to 22% disability. Laterality testing was unchanged. Conclusion: Manual therapy may be a beneficial intervention in management of thalamic stroke-related dysesthesia. Implications for Rehabilitation While pain is common following thalamic stroke, patients may present with chronic paresthesia or dysesthesia, often in a hemisensory distribution. Passive movement may promote inhibition of hyperexcitable cortical pathways, which may diminish aberrant sensations. Passive oscillatory manual therapy may be an effective way to treat sensory disturbances such as paresthesias or dysesthesia.
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Affiliation(s)
- Kristina Griffin
- a Outpatient Orthopedics , Shirley Ryan Ability Lab , Chicago , IL , USA.,b Department of Physical Therapy , University of Illinois at Chicago , Chicago , IL , USA
| | - Michael O'Hearn
- b Department of Physical Therapy , University of Illinois at Chicago , Chicago , IL , USA.,c Outpatient Orthopedics , Lakeland Health , St. Joseph , MI , USA
| | - Carla C Franck
- b Department of Physical Therapy , University of Illinois at Chicago , Chicago , IL , USA
| | - Carol A Courtney
- b Department of Physical Therapy , University of Illinois at Chicago , Chicago , IL , USA
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The effect of additional joint mobilization on neuromuscular performance in individuals with functional ankle instability. Phys Ther Sport 2017; 30:22-28. [PMID: 29310055 DOI: 10.1016/j.ptsp.2017.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 10/23/2017] [Accepted: 12/17/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To examine the effects of joint mobilization and exercise training on neuromuscular performance in individuals with functional ankle instability (FAI). DESIGN A cross-sectional study. PARTICIPANTS Forty five subjects with FAI were randomized into three groups: control (CG, n = 15, 27.9 ± 6.6yr), training (TG, n = 15, 26.9 ± 5.8yr) and mobilization with training group (MTG, n = 15, 26.5 ± 4.8yr). INTERVENTION Four weeks of neuromuscular training for TG; neuromuscular training and joint mobilization for MTG. MAIN OUTCOME MEASURES Electromyography of the peroneus longus (PL), tibialis anterior (TA), and soleus (SOL) and the reaching distance of the Y balance test (YBT), dorsiflexion range of motion (DFROM), Cumberland ankle instability tool (CAIT), and global rating scale (GRS). Two-way repeated measures MANOVA were used with the significance level p < .05. RESULTS MANOVA found significant group by time interactions on posterolateral reaching distance (p = .032), PL activation (p = .006-.03), DFROM (p < .001), CAIT (p < .001) and GRS (p < .001). The post hoc tests indicated significantly improved PL muscle activity and posterolateral reaching distance for MTG compared to TG (p = .004) and CG (p = .006). CONCLUSION Joint mobilization resulted in additional benefits on self-reported ankle instability severity, dorsiflexion mobility, and posterolateral balance performance in individuals with FAI, but its effects on general improvement, muscle activation, and other balance tasks remained uncertain.
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Xu J, Zhang J, Wang XQ, Wang XL, Wu Y, Chen CC, Zhang HY, Zhang ZW, Fan KY, Zhu Q, Deng ZW. Effect of joint mobilization techniques for primary total knee arthroplasty: Study protocol for a randomized controlled trial. Medicine (Baltimore) 2017; 96:e8827. [PMID: 29245244 PMCID: PMC5728859 DOI: 10.1097/md.0000000000008827] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Total knee arthroplasty (TKA) has become the most preferred procedure by patients for the relief of pain caused by knee osteoarthritis. TKA patients aim a speedy recovery after the surgery. Joint mobilization techniques for rehabilitation have been widely used to relieve pain and improve joint mobility. However, relevant randomized controlled trials showing the curative effect of these techniques remain lacking to date. Accordingly, this study aims to investigate whether joint mobilization techniques are valid for primary TKA. METHODS/DESIGN We will manage a single-blind, prospective, randomized, controlled trial of 120 patients with unilateral TKA. Patients will be randomized into an intervention group, a physical modality therapy group, and a usual care group. The intervention group will undergo joint mobilization manipulation treatment once a day and regular training twice a day for a month. The physical modality therapy group will undergo physical therapy once a day and regular training twice a day for a month. The usual care group will perform regular training twice a day for a month. Primary outcome measures will be based on the visual analog scale, the knee joint Hospital for Special Surgery score, range of motion, surrounded degree, and adverse effect. Secondary indicators will include manual muscle testing, 36-Item Short Form Health Survey, Berg Balance Scale function evaluation, Pittsburgh Sleep Quality Index, proprioception, and muscle morphology. We will direct intention-to-treat analysis if a subject withdraws from the trial. DISCUSSION The important features of this trial for joint mobilization techniques in primary TKA are randomization procedures, single-blind, large sample size, and standardized protocol. This study aims to investigate whether joint mobilization techniques are effective for early TKA patients. The result of this study may serve as a guide for TKA patients, medical personnel, and healthcare decision makers. TRIAL REGISTRATION It has been registered at http://www.chictr.org.cn/showproj.aspx?proj=15262 (Identifier:ChiCTR-IOR-16009192), Registered 11 September 2016. We also could provide the correct URL of the online registry in the WHO Trial Registration. http://apps.who.int/trialsearch/Trial2.aspx?TrialID=ChiCTR-IOR-16009192.
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MESH Headings
- Aged
- Aged, 80 and over
- Arthroplasty, Replacement, Knee/adverse effects
- Arthroplasty, Replacement, Knee/rehabilitation
- Clinical Protocols
- Female
- Humans
- Intention to Treat Analysis
- Knee Joint/physiopathology
- Knee Joint/surgery
- Male
- Middle Aged
- Osteoarthritis, Knee/physiopathology
- Osteoarthritis, Knee/surgery
- Pain Measurement/methods
- Pain, Postoperative/etiology
- Pain, Postoperative/rehabilitation
- Physical Therapy Modalities
- Prospective Studies
- Range of Motion, Articular
- Recovery of Function
- Single-Blind Method
- Treatment Outcome
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Affiliation(s)
- Jiao Xu
- Sport Medicine and Rehabilitation Center, Shanghai University of Sport
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, China
| | - Juan Zhang
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, China
| | - Xue-Qiang Wang
- Sport Medicine and Rehabilitation Center, Shanghai University of Sport
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, China
| | - Xuan-Lin Wang
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, China
| | - Ya Wu
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, China
| | - Chan-Cheng Chen
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, China
| | - Han-Yu Zhang
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, China
| | - Zhi-Wan Zhang
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, China
| | - Kai-Yi Fan
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, China
| | - Qiang Zhu
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, China
| | - Zhi-Wei Deng
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedics Hospital, Shanghai, China
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