Effect of Therapeutic Sequence of Hot Pack and Ultrasound on Physiological Response Over Trigger Point of Upper Trapezius

Parasympathetic Dominance Decreases the Choroidal Blood Flow Velocity Measured Using Laser Speckle Flowgraphy

BACKGROUND

This study aimed to examine the changes to choroidal blood flow velocity using laser speckle flowgraphy (LSFG) in healthy eyes after warm water immersion at 40°C.

METHODS

Data regarding the right eyes of 23 healthy volunteers were included. The mean blur rate (MBR) of the macula, which represents the choroidal blood flow velocity, was evaluated using LSFG. Intraocular pressure (IOP), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), ocular perfusion pressure (OPP), and MBR were assessed at baseline, immediately after immersion (0 minutes), and 10, 20, and 30 minutes later.

RESULTS

At 0 minutes, SBP, DBP, MBP, and OPP values were lower than those at baseline. The MBR significantly declined immediately after immersion to -6.0 ± 5.2%. However, there were no changes in these parameters after 10, 20, or 30 minutes. A significant positive correlation was observed between the MBR, SBP, DBP, MBP, and OPP values. In healthy individuals, the dominant parasympathetic activity induced by warm stimulation reduced the choroidal hemodynamic rate in the macula and decreased systemic circulatory dynamics, which normalized after 10 minutes.

CONCLUSIONS

These findings suggest that the dominant parasympathetic activity induced by warm water immersion at 40°C may lead to a reduction in the systemic circulation rate and choroidal blood flow rate in the macula. These findings may help prevent and treat various retinal choroidal diseases, in which sympathetic hyperactivity is involved in the pathogenesis of the disease.

Otago Home Exercise Program along with other physiotherapy interventions for the management of prolapsed intervertebral disc and its associated symptoms in an elderly: a case report

Prolapsed intervertebral disc or herniated disc (PIVD) is a common cause of back pain between the ages of 30 and 50 years. But, in the elderly PIVD is associated with associated symptoms whose management is often ignored. We reported a case of an 85 years old male patient with existing symptoms of PIVD for the last 5 years. However, the patient has never gone for physiotherapy treatment for the past 5 years due to unawareness and ignorance of the same. Since it was a geriatric case, the patient presented with associated symptoms along with PIVD. We tried to focus on the associated symptoms of the patient as well along with PIVD like fall risk and balance. The intervention program constituted 3 weeks of physiotherapy intervention focusing on pain management, strength conditioning, and balance training followed by an Otago Home Exercise Program.

The efficacy of intramuscular electrical stimulation in the management of patients with myofascial pain syndrome: a systematic review

Introduction

Myofascial pain syndrome (MPS) is one of the most common disorders causing chronic muscle pain. Almost one-third of patients with musculoskeletal complaints meet the MPS criteria. The aim of this study is to evaluate the effectiveness of intramuscular electrical stimulation (IMES) in patients with MPS through a systematic review method.

Methods

PubMed, Scopus, Embase, ProQuest, PEDro, Web of Science, and CINAHL were systematically searched to find out the eligible articles without language limitations from 1990 to December 30, 2020. All relevant randomized controlled trials that compared the effectiveness of IMES with sham-IMES, dry needling, or exercise therapy in patients with MPS were included. Full texts of the selected studies were critically appraised using Revised Cochrane risk-of-bias tool for randomized trials (RoB2).

Results

Six studies (out of 397) had met our inclusion criteria (involving 158 patients) and were entered to the systematic review. Outcome measures examined in these studies included pain, range of motion, pressure pain threshold, biochemical factors, disability, and amount of analgesic use. In the most studies, it has been shown that IMES is more effective than the control group in improving some outcome measurements such as pain.

Conclusion

There is preliminary evidence from a few small trials suggesting the efficacy of IMES for the care of myofascial pain syndrome. The data support the conduct of larger trials investigating the efficacy of IMES.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12998-021-00396-z.

The effectiveness of routine physiotherapy with and without neuromobilization on pain and functional disability in patients with shoulder impingement syndrome; a randomized control clinical trial

Background

The objective of the study was to compare the effects of neuromobilization (NM) techniques and routine physiotherapy on pain and functional disability in patients having shoulder impingement syndrome (SIS). Present study was aimed to discover evidence based conservative and cost effective remedy on pain and functional disability.

Study design

Single blinded randomized control clinical trial.

Methods

A total of 80 patients with SIS were randomly assigned into care and experimental groups (40 in each group). After the baseline assessment routine physiotherapy was executed on both groups, while NM was applied additionally to experimental group. Pain and functional disability score were evaluated by Visual Analogue Scale and University of California at Los Angeles rating score at baseline, 5th and 11th week. Differences in outcome between groups were evaluated with clinical improvement.

Results

The experimental group compared with care group at 11th week had lower mean pain score 2.15(1.66–2.64) vs 4.90(4.41–5.40); between group difference, 1.82; 95% (CI), − 2.38 to − 1.25; P < 0.001 and Partial ƞ² = 0.33, similarly functional disability score 28.58(27.32–29.83) vs 20.10(18.84–21.36); between group difference,5.62; 95%CI, (4.32–6.92); P< 0.001 and Partial ƞ² = 0.49 respectively. In experimental group NM was a more effective technique to reduce the pain severity and disability in SIS patients as compare to care group.

Conclusion

Neuromobilization techniques in addition to routine physiotherapy were significantly effective for the treatment of SIS.

Trial registration

IRCT20190121042445N1, Registered 19 February 2019.

Associations Between Skin Surface Temperature and Pressure Pain Tolerance Thresholds of Asymptomatic Individuals Exposed to Cryotherapy and Thermotherapy

Objective

The purpose of this study was to evaluate associations between skin surface temperature and pressure pain tolerance thresholds (PPTs) of asymptomatic individuals exposed to cryotherapy and thermotherapy.

Methods

Twenty-two asymptomatic female university students aged between 18 and 35 years underwent thermography and algometry assessments at 6 points in both knees before, immediately after, and 20 minutes after the application of frozen (cryotherapy) or heated (thermotherapy) gel bags in the right knee for 20 minutes. Data were analyzed by 1-way analysis of variance, Student t test, and Pearson or Spearman correlation tests.

Results

There was a significant change in skin surface temperature after cryotherapy and thermotherapy, which was maintained after 20 minutes of withdrawal (P < .001). After the intervention, no significant differences were observed regarding PPT compared with the baseline measurements, nor between the experimental and control knees.

Conclusion

Cryotherapy and thermotherapy produced significant changes in the temperature of the evaluated points after their application. No differences in pain tolerance were observed in these asymptomatic participants. There was little association between skin surface temperature and PPT in the knees of healthy women after application of the resources.

Pain Tolerance: The Influence of Cold or Heat Therapy

Objectives

Resources of heat or cold therapies have been widely used for their low cost, analgesic action and for assisting the rehabilitation of acute or chronic injuries. The objective of this study was to search for associations between skin surface temperature and pressure pain tolerance thresholds (PPTs) of healthy individuals undergoing cryotherapy and thermotherapy.

Methods

This is an experimental clinical trial with 22 healthy university students aged between 18 and 35 years. Volunteers underwent thermography and algometry assessments at 6 points in both knees before, immediately after, and 20 minutes after the application of frozen (cryotherapy) or heated (thermotherapy) gel bags in the right knee for 20 minutes. Data were analyzed by 1-way analysis of variance, Student's t test, and Pearson or Spearman correlation tests.

Results

There was a significant change in skin surface temperature after cryotherapy and thermotherapy, which was maintained after 20 minutes of withdrawal (P < .001). After the intervention, no significant differences were observed regarding the PPT compared to the baseline measurements, nor between the experimental and control knees.

Conclusion

Cryotherapy and thermotherapy produced significant changes in the temperature of the evaluated points after their application. Despite this, no differences in pain tolerance were observed, and there was little association between skin surface temperature and PPT in the knees of healthy women after application of the resources.

Effects of routine physiotherapy with and without neuromobilization in the management of internal shoulder impingement syndrome: A randomized controlled trial

Background & Objective:

Routine physiotherapy has been advocated was an effective treatment for internal shoulder impingement syndrome. However, there is lack of best exercise treatment and lots of studies are under consideration. The objective of the study was to compare the effects of Neuromobilization and routine physiotherapy on pain in patients having shoulder internal impingement syndrome.

Methods:

This is a single blinded randomized control clinical trial that was conducted at Social Security Hospital Gujranwala in which 80 patients with SIS were participated. The duration of study was from September 2016 to March 2018. Patients were recruited after giving an informed consent and were randomly assigned to either control or experimental group which was treated with routine physiotherapy and routine physiotherapy plus neuromobilization respectively; pain was assessed by Numeric Rating Scale at base line, 5^th and 11^th week.

Results:

The experimental group compared with control group at 11^th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% (CI), -2.38 to -1.25; P < 0.001 and Partial Ŋ²=0.33. These results show that pain score is much improved in experimental group.

Conclusion:

Neuromobilization along with physical therapy is more effective as compared to physiotherapy alone.

Effects of combination therapy and infrared radiation on pain, physical function, and quality of life in subjects with knee osteoarthritis: A randomized controlled study

Background:

Knee osteoarthritis (KOA) is a common degenerative articular disease that causes disability and poor quality of life (QoL) of the individuals. Electrotherapeutic agents such as therapeutic ultrasound (US), interferential current (IFC), and infrared radiation are used in the treatment. It is not clear which of these agents is the best in improving these variables.

Objective:

The study aimed to compare the effects of the combined application of US and IFC therapies and infrared radiation on pain, functional activities, and QoL in people with KOA.

Methods:

In a randomized controlled study, 60 participants were randomized into two groups, the combination therapy group (CTG) and the infrared radiation group (IRG). Each group received 15-min treatment three times per week for 12 weeks. The visual analog scale (VAS) was used to assess the pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functional activities and the Short Form Health Survey questionnaire for QoL.

Results:

Participants in the CTG had a significant (p<0.05) reduction in pain and significant (p<0.05) improvement in functional activities and QoL compared to the IRG.

Conclusion:

The results of this study support the use of the combination of IFC and US therapies to reduce pain and improve function and QoL for KOA patients.