Effects of kinesiotaping and exercise program on patients with obesity-induced coccydynia: a randomized, double-blinded, sham-controlled clinical trial

OBJECTIVE

To investigate the effect of kinesiotaping and a designed exercise program versus sham kinesiotaping and the same exercise program on pain, range of motion, and activities of daily living in obese patients suffering from coccydynia.

DESIGN

A double-blinded, randomized, sham-controlled trial.

SETTING

Outpatient, Cairo University hospitals.

PARTICIPANTS

Sixty patients with coccydynia randomized equally into kinesiotape plus exercise and sham kinesiotape plus exercise groups.

INTERVENTION

The kinesiotape was worn for three days and replaced for three weeks. Each patient practiced exercises for three weeks.

OUTCOME MEASURES

All patients were examined by visual analogue scale (VAS) for rating pain, Modified Modified Schober Test (MMST), and Oswestry Disability Index (ODI). All outcomes were measured at baseline, three weeks postintervention, and four weeks follow-up.

RESULTS

There were no statistically significant differences between groups at baseline (P < 0.05), but there were statistically significant differences between groups for pain score, MMST, and ODI at post and follow-up data in favor of the kinesiotape group (P < 0.001). For the three weeks postintervention, mean (SD) for pain score, MMST, and ODI was 33.07 ± 3.8, 6.6 ± 0.7, and 8.7 ± 2.1 in the study group and 39.9 ± 4.7, 5.8 ± 1.4, and 14.4 ± 2.7 in the control group, respectively. For the four weeks follow-up, mean (SD) for pain score, MMST, and ODI was 32.2 ± 3.4, 7.13 ± 0.6, and 7.2 ± 1.8 in the study group and 40.9 ± 4.4, 6.6 ± 0.75, and 13 ± 2 in the control group, respectively.

CONCLUSION

Experimental kinesiotape intervention and exercise program provided significant improvements in pain, range of motion, and disability. It is suggested as an adjunctive therapy in treating obese patients with coccydynia.

Effects of Ultrasound, Laser and Exercises on Temporomandibular Joint Pain and Trismus Following Head and Neck Cancer

OBJECTIVE

To compare the effects of low intensity ultrasound (LIUS), traditional exercise therapy (TET), low level laser therapy (LLLT) and TET on temporomandibular joint (TMJ) pain and trismus following recovery from head and neck cancer (HNC).

METHODS

Sixty participants following, who had experienced HNC, were randomly allocated to three groups of 20 people each. Each group received different therapy. Group A received LIUS and TET; group B received LLLT and TET; while group C received TET. All 60 participants were evaluated under the visual analog scale (VAS), the University of Washington Quality of Life questionnaire (UW-QOL) and the Vernier caliper scale (VCS) at the beginning of the therapies and after 4 weeks.

RESULTS

ANOVA test revealed significant improvements across all three groups with outcomes of p<0.05. The results of the UW-QOL questionnaire showed a significant difference between groups A, B and C in favor of group A (p<0.05). The VAS results showed a more improvement in group A as compared to group B (p<0.05), while there was no statistical difference between groups B and C (p>0.05). The VCS results showed more improvement for the individuals in group B as compared to those in group C (p<0.05), while there was minimal difference between groups A and B (p>0.05).

CONCLUSION

The LIUS and TET are more effective than LLLT and/or TET in reducing TMJ pain and trismus following HNC.

The effect of a short term conservative physiotherapy versus occlusive splinting on pain and range of motion in cases of myogenic temporomandibular joint dysfunction: a randomized controlled trial

[Purpose] This study compared the effects of a short-term conservative physiotherapy program versus those of occlusive splinting on pain and range of motion in cases of Temporomandibular Joint Dysfunction. [Participants and Methods] This study included 112 male and female participants with ages ranging from 15–27 years. Outcome measures were pain assessed by the visual analogue scale and Temporomandibular Joint Range of Motion measured with the Temporomandibular joint opening index. Patients were randomly assigned to one of two groups. Conservative physiotherapy was provided to one group 3 days weekly while the other group received standard occlusive splinting. Splinting was used daily for the total period of treatment. Any adjustments for splints were done by the treating dentist. Both groups were treated for a total period of 6 weeks. [Results] Between group statistical analysis revealed a significant reduction in pain intensity and Temporomandibular joint opening index in favor of the conservative physiotherapy group. [Conclusion] Over a treatment period of 6 consecutive weeks, conservative physiotherapy could be a better initial treatment than occlusive splint in relieving pain and improving range of motion in cases of myogenic temporomandibular dysfunction.

Isokinetic peak torque and flexibility changes of the hamstring muscles after eccentric training: Trained versus untrained subjects

Objective

The aim of this study was to examine the effect of eccentric isotonic training on hamstring flexibility and eccentric and concentric isokinetic peak torque in trained and untrained subjects.

Methods

Sixty healthy subjects (mean age: 21.66 ± 2.64) were divided into three equal groups, each with 20 voluntary participants. Two experimental groups (untrained and trained groups) participated in a hamstring eccentric isotonic strengthening program (five days/week) for a six-week period and one control group that was not involved in the training program. The passive knee extension range of motion and hamstring eccentric and concentric isokinetic peak torque were measured at angular velocities 60° and 120°/s for all groups before and after the training period.

Results

Two-way analysis of variance showed that there was a significant increase in the hamstring flexibility of the untrained and trained groups (25.65 ± 6.32°, 26.55 ± 5.99°, respectively), (p < 0.05) without a significant increase in the control group (31.55 ± 5.84°), (p > 0.05). Moreover, there was a significant increase in eccentric isokinetic peak torque of both the untrained and trained groups (127.25 ± 22.60Nm, 139.65 ± 19.15Nm, 125.40 ± 21.61Nm, 130.90 ± 18.71Nm, respectively), (p < 0.05) without a significant increase in the control group (109.15 ± 20.89Nm, 105.70 ± 21.31Nm, respectively), (p > 0.05) at both angular velocities. On the other hand, there was no significant increase in the concentric isokinetic peak torque of the three groups (92.50 ± 20.50Nm, 79.05 ± 18.95Nm, 92.20 ± 21.96Nm, 79.85 ± 18.97Nm, 100.45 ± 25.78Nm, 83.40 ± 23.73Nm, respectively), (p > 0.05) at both angular velocities. The change scores in the hamstring flexibility (06.25 ± 1.86°) and eccentric peak torque of the untrained group (16.60 ± 4.81Nm, 17.45 ± 5.40Nm, respectively) were significantly higher (p < 0.05) than those of the trained group (03.40 ± 1.14°, 9.90 ± 5.14Nm, 9.80 ± 7.57Nm, respectively), and the control group (00.90 ± 2.10°, 0.60 ± 2.93Nm, 1.40 ± 3.53Nm, respectively), at both angular velocities. Meanwhile, the change scores of the concentric peak torques of the three groups (1.15 ± 1.50Nm, −0.15 ± 2.16Nm, 1.35 ± 1.63Nm, 0.20 ± 2.95Nm, 0.60 ± 2.28Nm, −0.30 ± 2.25Nm) were statistically insignificant (p > 0.05).

Conclusion

After a six-week period of eccentric isotonic training, the hamstring eccentric peak torque and flexibility of trained and untrained groups improved without changes in the concentric peak torque. Moreover, the improvement of untrained subjects was higher than trained subjects. These findings may be helpful in designing the hamstring rehabilitation program.

Effect of a physiotherapy rehabilitation program on knee osteoarthritis in patients with different pain intensities

[Purpose] To examine the effect of physiotherapy rehabilitation program on moderate knee osteoarthritis in patients with different pain intensities. [Subjects and Methods] Sixty subjects (37 men and 23 women) with moderate knee osteoarthritis participated in the current study. Randomization software was used to select the participating subjects' numbers from the clinic records. They were classified into three groups according to pain intensity: mild, moderate, and severe pain groups. All groups underwent a standard set of pulsed electromagnetic field, ultrasound, stretching exercises, and strengthening exercises. Pain intensity, knee range of motion, knee function, and isometric quadriceps strength were evaluated using the visual analogue scale, universal goniometer, Western Ontario and McMaster Universities osteoarthritis index, and Jamar hydraulic dynamometer, respectively. The evaluation was performed before and after a 4-week rehabilitation program. [Results] All groups showed significant differences in pain intensity, knee range of motion, isometric quadriceps strength, and knee function. The score change in moderate pain group was significantly greater than those in mild and severe pain groups. [Conclusion] Pain intensity is one of the prominent factors that are responsible for the improvement of knee osteoarthritis. Consequently, pain intensity should be considered during rehabilitation of knee osteoarthritis.

The effect of pain severity on postural stability and dynamic limits of stability in chronic low back pain

BACKGROUND

Deficits of dynamic balance in chronic low back pain patients have been reported by different studies in terms of impaired postural control. However, they excluded the degree of pain as a determinant affecting dynamic balance.

OBJECTIVE

To evaluate the effect of pain intensity on dynamic balance control in terms of postural stability indices (PSIs) and limits of stability (LOS) in chronic LBP patients.

METHODS

Sixty subjects (38 men, 22 women) participated in the current study, 45 patients with chronic LBP were selected randomly and served as the chronic LBP group while 15 healthy subjects served as the asymptomatic group (AS). The chronic LBP group was further classified in terms of pain intensity into 3 subgroups; low pain (LP), moderate pain (MP) and severe pain (SP) subgroups. The Biodex Balance System was used to measure the dynamic balance control (PSIs and LOS).

RESULTS

Statistical significant differences were found among AS group and chronic LBP subgroups in PSIs and LOS.

CONCLUSIONS

The intensity of pain has shown to be one of the determinants affecting dynamic balance in chronic LBP patients who showed differences in the impairment of PSIs and LOS with different degrees of pain.

The correlation between radiographic and surface topography assessments in three plane pelvic parameters

BACKGROUND

Noninvasive rasterstereography has been reported as a helpful tool for assessing pelvic parameters. However, the validation and reproducibility of this tool are still questionable.

OBJECTIVE

To investigate the correlation between video rasterstereography device (VRD) and X-ray photography in terms of validity and reproducibility (inter- and intra-examiner reliability) in pelvic parameters.

METHODS

Thirty male and female healthy subjects with a mean age (26.9 ± 4.9 years) participated in this study. Subjects were examined by VRD for three pelvic parameters (pelvic torsion, pelvic tilt, and pelvic inclination). Measurements were conducted by three different examiners. Subjects were examined by X-ray radiography for the same pelvic parameters as well. Pearson correlation coefficient (r) was used to examine the validity and Intra-class correlation coefficient (ICC) was used to check intra- and inter-examiner reliability.

RESULTS

For pelvic torsion, tilt, and inclination the validity levels of VRD were 0.867, 0.996, and 0.930 (P < 0.05), respectively; while the intra- and inter-examiner reliability coefficients were 0.999, 0.999, and 0.998 and 0.990, 0.997, and 0.989, respectively.

CONCLUSION

The results of this study revealed that the VRD has both high validity and reliability in assessing the selected three pelvic parameters that reflect the three fundamental planes of movement in healthy subjects. Further studies using VRD are recommended to assess low back pain-associated pelvic parameters.

Radical cystectomy for carcinoma of bilharzial bladder. Technique and results

One hundred and sixty-two patients with carcinoma of the bilharzial bladder were treated by radical cystectomy. The postoperative mortality was 12.9 per cent and the five-year survival rate was 38.9 per cent. Correlations of the survival figures relative to the various pathologic features of the tumor revealed that squamous and transitional tumors have essentially the same prognosis, and that the most important prognostic index was the tumor grade. In most cases treatment failures were due to local recurrences which developed within one year after operation.