Showing papers in "American Journal of Physical Medicine & Rehabilitation in 2015"
TL;DR: In this paper, the effects of ischemic compression and dry needling on trigger points in the upper trapezius muscle in patients with neck pain and compare these two interventions with other therapeutic interventions aiming to inactivate trigger points.
Abstract: The aim of this review was to describe the effects of ischemic compression and dry needling on trigger points in the upper trapezius muscle in patients with neck pain and compare these two interventions with other therapeutic interventions aiming to inactivate trigger points. Both PubMed and Web of Science were searched for randomized controlled trials using different key word combinations related to myofascial neck pain and therapeutic interventions. Four main outcome parameters were evaluated on short and medium term: pain, range of motion, functionality, and quality-of-life, including depression. Fifteen randomized controlled trials were included in this systematic review. There is moderate evidence for ischemic compression and strong evidence for dry needling to have a positive effect on pain intensity. This pain decrease is greater compared with active range of motion exercises (ischemic compression) and no or placebo intervention (ischemic compression and dry needling) but similar to other therapeutic approaches. There is moderate evidence that both ischemic compression and dry needling increase side-bending range of motion, with similar effects compared with lidocaine injection. There is weak evidence regarding its effects on functionality and quality-of-life. On the basis of this systematic review, ischemic compression and dry needling can both be recommended in the treatment of neck pain patients with trigger points in the upper trapezius muscle. Additional research with high-quality study designs are needed to develop more conclusive evidence.
123 citations
TL;DR: This novel survey identified important barriers to mobilizing medical inpatients that were similar across two hospital settings and can assist with the implementation of quality improvement projects for increasing early hospital-based patient mobility.
Abstract: Objective
Functional status decline commonly accompanies hospitalization making patients vulnerable to complications. Such decline can be mitigated through hospital-based early mobility programs. Success in implementing patient mobility quality improvement processes requires evaluating providers’ knowledge, attitudes, and behaviors.
113 citations
TL;DR: It is demonstrated that KT application with proper tension to the quadriceps effectively attenuates various types of pain and improves AROM and proprioception in osteoarthritis patients.
Abstract: ObjectiveThis study investigated the short-term effects of Kinesio taping (KT) on various types of pain, active range of motion (AROM), and proprioception in patients with knee osteoarthritis.DesignForty-six older participants (mean [SD], 57.9 [4.4] yrs) with osteoarthritis were randomly all
112 citations
TL;DR: Nineteen important reasons have been highlighted to consolidate the scenario of how/why the probe of ultrasound needs to become the stethoscope, the extended hand, and the pen of physiatrists.
Abstract: This article is an eventual consensus of experts from the European Musculoskeletal Ultrasound Study Group (EURO-MUSCULUS) and the Ultrasound Study Group in Physical and Rehabilitation Medicine (USPRM) pertaining to the use of musculoskeletal ultrasound in physical and rehabilitation medicine. Nineteen important reasons (as regards general advantages, specific conditions in physical and rehabilitation medicine, as well as comparisons with other imaging tools) have been highlighted to consolidate the scenario of how/why the probe of ultrasound needs to become the stethoscope, the extended hand, and the pen of physiatrists.
84 citations
TL;DR: The smartphone app is both reliable and valid, provides a low-cost method of measuring range of motion, and can be easily incorporated into clinical practice.
Abstract: In clinical and research settings, objective range of motion measurement is an essential component of lower limb assessment and treatment evaluation. One reliable tool is the digital inclinometer; however, availability and cost preclude its widespread use. Smartphone apps are now widely available, allowing smartphones to be used as an inclinometer. Reliability and validity studies of new technologies are scarce. Intrarater and interrater reliability of the iHandy Level app installed on a smartphone and an inclinometer were assessed in 20 participants for ankle dorsiflexion using a weight-bearing lunge test. Criterion validity was assessed between a Fastrak and the app, and construct validity was assessed between the inclinometer and the app. Intraclass correlation coefficients2,1 demonstrated excellent intrarater and interrater reliability (intraclass correlation coefficient, 0.97 and 0.76, respectively). Tests of validity demonstrated excellent correlation between all three methods (r > 0.99). The smartphone app is both reliable and valid, provides a low-cost method of measuring range of motion, and can be easily incorporated into clinical practice.
83 citations
TL;DR: The authors aim to demonstrate the relevant nerve tracking techniques as regards the upper extremity by incorporating a series of ultrasound images and videos to demonstrate how to scan the suprascapular, axillary, musculocutaneous, median, ulnar, and radial nerves.
Abstract: Compared with the upper limbs, sonographic tracking of peripheral nerves in the lower limbs is more challenging. The overlying muscles are larger, hindering visualization of the deeply embedded nerves by using a linear transducer. The use of a curvilinear transducer-providing an extended view with better penetration for the field of interest-may be useful for scanning the nerves in the hip and thigh. Application of the Doppler mode helps localization of the target nerve by identifying the accompanying vessels. Aiming to demonstrate the relevant tracking techniques, the present article comprises a series of ultrasound images and videos showing how to scan the nerves in the lower limb, that is, femoral, obturator, pudendal, lateral femoral cutaneous, sciatic, saphenous, sural, tibial, and peroneal nerves.
76 citations
TL;DR: A multimodal treatment is a good method for reducing disability in patients with nonspecific chronic neck pain in the short and medium term.
Abstract: ObjectiveThe aim of this study was to determine the effectiveness of a multimodal treatment in the short and medium term for disability in nonspecific chronic neck pain.DesignThe design of this study is a single-blinded randomized controlled trial carried out in a university research laborat
69 citations
TL;DR: A meta-analysis of relevant cohort studies showed that aerobic exercise had no effects on heart rate, sit-and-reach test, and maximum oxygen consumption of CLBP patients, and aerobic exercise may be a good choice in the treatment for CLBP.
Abstract: OBJECTIVE A meta-analysis of relevant cohort studies was performed to investigate the efficacy of aerobic exercise for the treatment of patients with chronic low back pain (CLBP). METHOD A range of electronic databases were searched: MEDLINE (1966-2013), the Cochrane Library Database (issue 12, 2013), EMBASE (1980-2013), CINAHL (1982-2013), Web of Science (1945~2013), and the Chinese Biomedical Database (1982-2013), without language restrictions. The Roland-Morris Disability Questionnaire, the Oswestry Disability Questionnaire, the McGill Pain Questionnaire, visual analog scale, and heart rate, sit-and-reach test, and maximum oxygen consumption were used to evaluate the efficacy of aerobic exercise. Meta-analysis was performed with the use of the STATA statistical software. The standardized mean difference (SMD) with its corresponding 95% confidence interval (CI) was calculated. Eight clinical cohort studies with a total of 310 CLBP patients were included in the meta-analysis. RESULTS The results of this meta-analysis indicated that CLBP patients exhibited positive decreases in scores on the Roland-Morris Disability Questionnaire (SMD, 0.44; 95% CI, 0.20-0.68; P 0.05). CONCLUSION The current meta-analysis provides reliable evidence that aerobic exercise could effectively diminish pain intensity and improve the physical and psychologic functioning of CLBP patients. Thus, aerobic exercise may be a good choice in the treatment for CLBP.
55 citations
TL;DR: In this article, a critique of these reviews was undertaken to summarize efficacy findings, and the quality of the reviews was evaluated, and gaps in the research were identified to better guide clinical practice.
Abstract: Lymphedema treatment aims to alleviate symptoms, prevent progression, and reduce risk for skin infection. Mainstream treatment options have been investigated in more than 160 studies. Findings from these studies have been included in at least 1 of more than 20 literature reviews. A critique of these reviews was undertaken to summarize efficacy findings. The quality of the reviews was evaluated, and gaps in the research were identified to better guide clinical practice. Overall, there was wide variation in review methods. The quality of studies included in reviews, in study design and reporting overall, has been poor. Reviews consistently concluded that complex physical therapy is effective at reducing limb volume. Volume reductions were also reported after the use of compression garments, pumps, and manual lymphatic drainage. However, greatest improvements were reported when these treatments formed a combined treatment program. Large, well-designed, evaluated, and reported randomised, controlled trials are needed to evaluate and compare treatments. Consistent outcome measures will allow better quality reviews and meta-analysis in the future.
54 citations
TL;DR: Analysis of a subset of National Spina Bifida Patient Registry data from 380 individuals accompanied by data from a specialized spina bifida electronic medical record revealed that those with no history of a shunt, lower motor level, andno history of hip or knee contracture release surgery were more likely to be ambulatory at the community level than at the household or wheelchair level.
Abstract: ObjectiveTo provide descriptive data on ambulatory ability and muscle strength in a large cohort of individuals with spina bifida enrolled in a National Spina Bifida Patient Registry and to investigate factors associated with ambulatory status.DesignCross-sectional analysis of data from a mu
54 citations
TL;DR: In summary, foot drop stimulation and ankle foot orthoses seem effective and “equivalent” for increasing gait speed, and physical therapy may facilitate improvement in both foot drop stimulated groups.
Abstract: The purpose of this systematic review was to summarize the effect of daily use of single-channel foot drop stimulation among persons with stroke. Randomized controlled trials were searched using electronic databases through May 2014. Six randomized controlled trials were included, involving 820 participants. Gait speed was the most common outcome measured. Other common outcomes included Timed Up and Go, modified Emory Functional Ambulation Profile, Berg Balance Scale, Physiologic Cost Index, Six-Minute Walk Test, quality-of-life, and lower extremity Fugl-Meyer. In summary, foot drop stimulation and ankle foot orthoses seem effective and "equivalent" for increasing gait speed. Other outcomes that consistently improved in both groups were the Timed Up and Go and Six-Minute Walk Test. Foot drop stimulation was more effective compared with ankle foot orthosis for decreasing Physiologic Cost Index and seemed to be preferred by participants. Physical therapy may facilitate improvement in both foot drop stimulation and ankle foot orthosis groups.
TL;DR: Continuous ultrasound therapy is more efficient in reducing pain at rest for myofascial pain syndrome patients than is sham or pulsed ultrasound therapy, and certain subparameters of the quality of life scale.
Abstract: ObjectivesThis study aimed to compare continuous and pulsed ultrasound therapy with sham ultrasound in terms of pain, severity of muscle spasm, function, depression, and quality of life in patients with myofascial pain syndrome.DesignPatients were randomly divided into three groups, includin
TL;DR: A 12-wk supervised exercise therapy program yielded clinically relevant and statistically significant improvement in isokinetic quadriceps strength immediately after completion of the program, as compared with treatment with arthroscopic partial meniscectomy.
Abstract: ObjectiveThe aim of this study was to compare the effect of a 12-wk exercise therapy program and arthroscopic partial meniscectomy on knee strength and functional performance in middle-aged patients with degenerative meniscus tears.DesignA total of 82 patients (mean age, 49 yrs; 35% women) w
TL;DR: Both moderate-intensity CAE and IAE programs significantly reduced serum markers of adhesion molecules and prevented the change in VO2 in patients with chronic heart failure.
Abstract: ObjectiveAbnormal expression of cellular adhesion molecules may be related to endothelial dysfunction, a key feature in chronic heart failure. This study compares the effects of 10-wk supervised moderate-intensity continuous aerobic exercise (CAE) and intermittent aerobic exercise (IAE) prog
TL;DR: Compared with usual care, individualized gait training resulted in immediate improvements in mobility disability knee symptoms in adults with symptomatic knee osteoarthritis, but these effects were not sustained.
Abstract: OBJECTIVE: The objective of this study was to determine whether individualized gait training is more effective than usual care for reducing mobility disability and pain in individuals with symptomatic knee osteoarthritis. DESIGN: Adults aged 60 yrs or older with symptomatic knee osteoarthritis and mobility limitations were randomized to physical therapist-directed gait training on an instrumented treadmill, with biofeedback individualized to optimize knee movements, biweekly for 3 mos or usual care (control). Mobility disability was defined using Late Life Function and Disability Index Basic Lower Limb Function score (primary); mobility limitations, using timed 400-m walk, chair-stand, and stair-climb tests; and symptoms, using the Knee Injury/Osteoarthritis Outcome Score at baseline, as well as at 3, 6, and 12 mos. The analyses used longitudinal mixed models. RESULTS: There were no significant intergroup differences between the 35 gait-training (74.3% women; age, 69.7 ± 8.2 yrs) and 21 control (57.1% women; age, 68.9 ± 6.5 yrs) participants at baseline. At 3 mos, the gait-training participants had greater improvement in mobility disability (4.3 ± 1.7; P = 0.0162) and symptoms (8.6 ± 4.1; P = 0.0420). However, there were no intergroup differences detected for pain, 400-m walk, chair-stand, or stair-climb times at 3 mos or for any outcomes at 6 or 12 mos. CONCLUSIONS: Compared with usual care, individualized gait training resulted in immediate improvements in mobility disability knee symptoms in adults with symptomatic knee osteoarthritis, but these effects were not sustained. Language: en
TL;DR: The addition of 3 wks of daily electrical stimulation shortly after facial palsy onset, improved functional facial movements and electrophysiologic outcome measures at the 3-mo follow-up in patients with Bell palsy is warranted.
Abstract: ObjectiveThe aim of this study was to determine the efficacy of electrical stimulation when added to conventional physical therapy with regard to clinical and neurophysiologic changes in patients with Bell palsy.DesignThis was a randomized controlled trial. Sixty patients diagnosed with Bell
TL;DR: HIT is more effective than MCT for improving VO2peak in acute myocardial infarction patients with drug-eluting stent and these findings may have important implications for more effective exercise training in cardiac rehabilitation program.
Abstract: ObjectivePeak oxygen uptake (VO2peak) is a strong predictor of survival in cardiac patients. The aims of this study were to compare the effects of high interval training (HIT) to moderate continuous training (MCT) on VO2peak and to identify the safety of HIT in acute myocardial infarction pa
TL;DR: Segmental measures are highly repeatable and thus may be used on their own to monitor growth and when an accurate measure of height is needed to monitor nutritional status, caution is warranted because there is only fair-to-poor agreement between actual height and estimated height.
Abstract: Objective
The purpose of this study was to determine the agreement between actual height or segmental length, and estimated height from segmental measures among individuals cerebral palsy (CP).
TL;DR: It is demonstrated that exercise treatment significantly improves musculoskeletal symptoms in patients with juvenile idiopathic arthritis and balance-proprioceptive exercises prove to be effective more than strengthening exercises for improving lower extremity function such as walking, climbing stairs, and balance.
Abstract: ObjectiveThe aim of this study was to investigate the effects of two exercise programs on lower extremity function in patients with juvenile idiopathic arthritis.DesignThirty patients with juvenile idiopathic arthritis participated in this study. Pain, passive range of motion, muscle strengt
TL;DR: This multimodal exercise training could improve motion function and benefit balance function in patients with Parkinson disease and the questionnaire results after training showed that the multimodAL exercise training is easy to learn and adhere to.
Abstract: ObjectiveThe primary aim of this study was to investigate the effects of two different patterns of rehabilitation training on movement and balance function in patients with idiopathic Parkinson disease.DesignForty patients with Parkinson disease were randomized into the tai chi group (n = 20
TL;DR: PT was found to be effective in reducing pain severity and functional disability, and the addition of suprascapular nerve block to PT improved functional status and pain levels in patients with adhesive capsulitis.
Abstract: OBJECTIVE The aim of this study was to compare the efficacy of suprascapular nerve block plus physical therapy (PT) with PT alone for the treatment of adhesive capsulitis of the shoulder. DESIGN Forty-one patients with adhesive capsulitis were randomly assigned to the injection group (n = 19) or PT-alone control group (n = 22). All patients received PT consisting of electrotherapy, range of motion, stretching, and strengthening exercises. The patients in the injection group received suprascapular nerve block before PT. Pain was assessed using the Brief Pain Inventory-Short Form, and functional status was assessed with the total Constant score. RESULTS In both groups, significant differences were found in all parameters of the Brief Pain Inventory-Short Form compared with baseline levels apart from walking ability in the last 24 hrs (P = not applicable). However, the differences of mean pain severity in the last 24 hrs at first to second and first to third assessments, pain severity at that time at first to second assessments, percentage improvement at second to third assessments, general activity in the last 24 hrs at first to second and first to third assessments, and enjoyment of life in the last 24 hrs at first to second and first to third assessments were statistically significant in favor of the injection group (P < 0.05). CONCLUSIONS The current study supports that suprascapular nerve block is a safe and well-tolerated method. PT was found to be effective in reducing pain severity and functional disability, and the addition of suprascapular nerve block to PT improved functional status and pain levels in patients with adhesive capsulitis.
TL;DR: The similarity in fatigue between the CP and AB groups indicates that elite athletes with CP may have a different exercise response to others with CP, which has rehabilitative implications, as it indicates near-maximal adaptation of the CP body toward normal levels.
Abstract: ObjectiveThis study investigated the sprint cycling performance and neuromuscular characteristics of Paralympic athletes with cerebral palsy (CP) during a fatiguing maximal cycling trial compared with those of able-bodied (AB) athletes.DesignFive elite athletes with CP and 16 AB age- and per
TL;DR: A strong evidence base exists for the use of ABO to reduce ULS caused by stroke as well as other clinical trial efficacy, safety, and dosing practices, and most adverse events reported were considered unrelated to treatment.
Abstract: Objective
The aim of this study was to elucidate clinical trial efficacy, safety, and dosing practices of abobotulinumtoxinA (ABO) treatment in adult patients with upper limb spasticity (ULS).
TL;DR: Recovered lower portion of the ascending reticular activating system (ARAS) between the pontine reticular formation and the thalamus in a patient with traumatic brain injury is demonstrated.
Abstract: The authors report on a patient with traumatic brain injury who showed recovery of an injured lower portion of the ascending reticular activating system (ARAS) between the pontine reticular formation and the thalamus. A 57-yr-old male patient experienced head trauma. After 4 mos from onset, he exhibited impaired alertness, with a score of 7 on the Glasgow Coma Scale. At 40 mos after onset, the patient had a full Glasgow Coma Scale score of 15. The lower portion of the ARAS was reconstructed using the probabilistic tractography method. On 4-mo diffusion tensor tractography, the fractional anisotropy and the tract volume of the lower portion of the right ARAS were lower by more than 2 SDs of those of control subjects. By contrast, on 40-mo diffusion tensor tractography, the fractional anisotropy and the tract volume values of the lower portion of the right ARAS were within 2 SDs of those of the control subjects. The increment fractional anisotropy and the FV value of the lower portion of the right ARAS on 40-mo diffusion tensor tractography indicated recovery of the injured lower ARAS. As a result, recovery of an injured lower portion of the ARAS in a patient with traumatic brain injury was demonstrated.
TL;DR: Noninvasive management permits cost-effective living at home but is disincentivized by fixed hospital diagnosis-related groups compensation that encourages rapid tracheotomy as well as expensive institutionalization and nursing care.
Abstract: BackgroundContinuous tracheostomy mechanical ventilation users with Duchenne muscular dystrophy are institutionalized or have home nursing services (licensed practical nurse/registered nurse), whereas patients dependent on continuous noninvasive ventilatory support (CNVS) can avoid hospitali
TL;DR: The authors examine special features of the adolescent pitcher as compared with skeletally mature pitchers and characteristics of pitch mechanics, type, velocity, fatigue, and overuse.
Abstract: The baseball and medical communities have recognized injuries of the upper extremity associated with the overhead throwing motion and have examined manners in which to reduce risk. The authors examine special features of the adolescent pitcher as compared with skeletally mature pitchers and characteristics of pitch mechanics, type, velocity, fatigue, and overuse. A summary is presented on previously identified risk factors as they relate to pitching injuries. Development, use, and compliance with the most current pitching guidelines in youth baseball, based on the available evidence, will be presented and examined. In an increasingly competitive environment, identifying known risk factors and potential signs of pathology as well as implementing the current best evidence in a consistent manner are important steps in decreasing injury risk of youth baseball pitchers. More research is needed to evaluate the effectiveness of pitching guidelines in the short and long term and to focus on manners in which to increase compliance with best practice procedures throughout youth baseball organizations.
TL;DR: Strength training was able to intensify the upper-limb rehabilitation, as demonstrated by the superior scores achieved by the TOT_ST group in most of the evaluated parameters.
Abstract: Objective The aim of this study was to verify the effects of loaded exercises associated with a task-oriented training (TOT) program in the recovery of upper-limb function in individuals with chronic hemiparesis after stroke. Design This study used a single-blinded, randomized controlled trial. Patients were included into two TOT groups: one that performed the task-oriented therapy without load (TOT group, n = 10) and another one that performed task-oriented therapy with personalized resistance (TOT_ST group, n = 10) for 6 wks, for a total of 12 sessions. Main measures included The Upper Extremity Performance Test, shoulder flexor and handgrip strength, shoulder active range of motion, motor impairment (Fugl-Meyer Scale), and muscle tone. Results The TOT_ST group demonstrated better scores relating to unilateral tasks and in the quality aspects of bilateral movements (The Upper Extremity Performance Test, P = 0.04) at the end of rehabilitation protocol. The highest muscle force gain was reached by the TOT_ST group for the shoulder flexors (P = 0.001). Similarly, the active range of motion (P = 0.01) and Fugl-Meyer scores (P = 0.001) were higher in the TOT_ST group compared with the TOT group. Both groups showed improvement after training. Conclusions Strength training was able to intensify the upper-limb rehabilitation, as demonstrated by the superior scores achieved by the TOT_ST group in most of the evaluated parameters. Muscle strength training might be a pivotal element of the task-oriented rehabilitation program of chronic patients with mild impairment after stroke.
TL;DR: Whole-body vibration may be a useful intervention modality to improve balance and muscle strength in children with Down syndrome.
Abstract: ObjectiveThe purpose of this study was to determine whether whole-body vibration training could improve standing balance and muscle strength in children with Down syndrome.DesignThis study was a randomized controlled trial studying 30 children (8–10 yrs old) with Down syndrome. They were ass
TL;DR: The WAI could support the assessment of need for rehabilitation by occupational health services in return-to-work strategies, which include the opportunity to access multiprofessional rehabilitation.
Abstract: ObjectiveThe purpose of this study was to assess associations of self-reported work ability as measured by the Work Ability Index (WAI) with modifiable behavioral and occupational health risks, health service utilization, and intended rehabilitation and pension requests.DesignThis is a cross
TL;DR: People with peripheral artery disease and transfemoral amputations had fewer falls and improved balance confidence and walking performance when using prostheses with MK.
Abstract: ObjectiveApproximately 50% of people with leg amputation fall annually. Evidence suggests that microprocessor knees (MK) may decrease falls and improve prosthetic function in people with traumatic amputations. This study explored whether adults with transfemoral amputations and peripheral ar