scholarly journals Cervicothoracic Manual Therapy Plus Exercise Therapy Versus Exercise Therapy Alone in the Management of Individuals With Shoulder Pain: A Multicenter Randomized Controlled Trial

2016 ◽  
Vol 46 (8) ◽  
pp. 617-628 ◽  
Author(s):  
Paul E. Mintken ◽  
Amy W. McDevitt ◽  
Joshua A. Cleland ◽  
Robert E. Boyles ◽  
Amber R. Beardslee ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Shoulder Pain ◽  
Manual Therapy ◽  
Exercise Therapy ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial

scholarly journals Study on Efficacy and Safety of Shi’s Manual Therapy Treatment for Lumbar Disc Herniation with Radiculopathy: Study Protocol for A Multicenter Randomized Controlled Trial

2021 ◽  
Author(s):  
Huihao Wang ◽  
Yuan Weian ◽  
Yu Zhongxiang ◽  
Wang Xiang ◽  
Zhao Xinxin ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Lumbar Disc Herniation ◽  
Manual Therapy ◽  
Controlled Trial ◽  
Lumbar Disc ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial ◽  
Straight Leg Raising ◽  
Post Operation

Abstract Background Lumbar disc herniation (LDH) is a common chronic musculoskeletal disorder that seriously affects quality of life. Percutaneous endoscopic lumbar diskectomy (PELD) technique was developed to address spine nerve root compression by direct visualization of pathological findings while minimizing tissue destruction upon exposure. It is an effective and safe treatment for LDH. However, recurrent LDH is a major concern after lumbar discectomy for primary LDH. A considerable number of clinical studies reported that patients will benefit from manual therapy practice for LDH with radiculopathy patients. Shi's manual therapy (SMT) is established based on the Traditional Chinese medicine (TCM) theory, which has been shown to have a superior effect in alleviating muscle tension and loosen joints to improve lumbar and leg pain, radiculopathy, stiffness, activity discomfort, and related disorders. But there is a lack of high-quality clinical evidences to support the conclusion. The purpose of this study will be to evaluate the efficacy and safety of the combination of Shi’ manual therapy (SMT) for reducing the recurrent rate of LDH with radiculopathy. Methods/design: A multicenter randomized controlled trial (RCT) with a 1years’ follow-up period will be performed. A total of 510 participants with LDH with radiculopathy will be recruited in four clinical centers. Sample size estimation was calculated and statistical analysis will be performed calculated and supervised by biostatisticians from the independent third-party research institution. Two hundred and fifty-five subjects will be randomly allocated to each group. The subject in the control group will undergo the PELD. Participants in the intervention group will be treated with SMT, and the straight leg raising angle will be evaluated. If the patients’ straight leg raising the angle of the affected side is close to the healthy side, and the treatment is finished, if not, the PELD procedure will proceed. The primary outcome will be the recurrence rate of LDH with radiculopathy and the ODI score. The secondary outcome measures will be the VAS score for the pain of lumbar and lower limbs, the straight leg raising angle, the stability of the operated lumbar segment, and SF-36 scores. Assessments will occur at baseline, post-operation, and at 1week, 4 weeks, 13 weeks, 26 weeks and 1year post-operation. In addition, adverse events related to clinical symptoms and signs and results of laboratory tests will be documented during the clinical trials. Discussion This study will provide reliable evidence of the effectiveness and safety of the combination of SMT and PELD for LDH with radiculopathy. If the results are favorable, it is expected that the patients with LDH with radiculopathy will benefit from this study, many patients may have a good alternative treatment for LDH with radiculopathy. Trial registration: ChiCTR, ChiCTR2000036515. Registered on 13 November 2020.

Poststroke shoulder pain in subacute patients and its correlation with upper limb recovery after robotic or conventional treatment: A secondary analysis of a multicenter randomized controlled trial

2020 ◽  
pp. 174749302093719
Author(s):  
I Aprile ◽  
M Germanotta ◽  
A Cruciani ◽  
C Pecchioli ◽  
S Loreti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Shoulder Pain ◽  
Motor Function ◽  
Upper Limb ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial

Background and aims Poststroke shoulder pain is a common complication. We aimed to investigate the prevalence of poststroke shoulder pain, with attention to the neuropathic component, and the relationship between poststroke shoulder pain and upper limb improvement in motor function, strength, disability, and quality of life after upper limb rehabilitation. Methods This is a secondary analysis of a multicenter randomized controlled trial to compare upper limb conventional or robotic rehabilitation on 224 patients enrolled in eight rehabilitation centers. We assessed poststroke shoulder pain (using the Numerical Rating Scale and the Douleur Neuropathique 4), and upper limb motor function, strength, disability, and quality of life at baseline (T0), after 30 rehabilitation sessions (T1), and three months after the end of rehabilitation (T2). Results A moderate/severe poststroke shoulder pain was reported by 28.9% of patients, while 19.6% of them showed a neuropathic component. At T0, the intensity of pain was higher in women and in patients with neglect syndrome, positively correlated with the time since stroke and disability and negatively correlated with motor function, strength, and the physical aspects of the quality of life. Moderate/severe pain and neuropathic component significantly reduced after both treatments and this reduction was maintained at T2. Finally, the intensity of pain at baseline was negatively correlated with the improvement of upper limb motor function. Conclusions Poststroke shoulder pain negatively impact on motor performance, strength, disability, and physical aspects of the quality of life as well as on upper limb motor recovery; however, it can be reduced after a robotic or a conventional rehabilitation. Therefore, we suggest considering poststroke shoulder pain when planning the rehabilitation intervention.

scholarly journals Exercise, Manual Therapy, and Booster Sessions in Knee Osteoarthritis: Cost-Effectiveness Analysis From a Multicenter Randomized Controlled Trial

2017 ◽  
Vol 98 (1) ◽  
pp. 16-27 ◽  
Author(s):  
Allyn M Bove ◽  
Kenneth J Smith ◽  
Christopher G Bise ◽  
Julie M Fritz ◽  
John D Childs ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cost Effectiveness ◽  
Manual Therapy ◽  
Controlled Trial ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial ◽  
Booster Sessions ◽  
The Cost ◽  
Care Costs

Abstract Background Limited information exists regarding the cost-effectiveness of rehabilitation strategies for individuals with knee osteoarthritis (OA). Objective The study objective was to compare the cost-effectiveness of 4 different combinations of exercise, manual therapy, and booster sessions for individuals with knee OA. Design This economic evaluation involved a cost-effectiveness analysis performed alongside a multicenter randomized controlled trial. Setting The study took place in Pittsburgh, Pennsylvania; Salt Lake City, Utah; and San Antonio, Texas. Participants The study participants were 300 individuals taking part in a randomized controlled trial investigating various physical therapy strategies for knee OA. Intervention Participants were randomized into 4 treatment groups: exercise only (EX), exercise plus booster sessions (EX+B), exercise plus manual therapy (EX+MT), and exercise plus manual therapy and booster sessions (EX+MT+B). Measurements For the 2-year base case scenario, a Markov model was constructed using the United States societal perspective and a 3% discount rate for costs and quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios were calculated to compare differences in cost per QALY gained among the 4 treatment strategies. Results In the 2-year analysis, booster strategies (EX+MT+B and EX+B) dominated no-booster strategies, with both lower health care costs and greater effectiveness. EX+MT+B had the lowest total health care costs. EX+B cost${\$}$1061 more and gained 0.082 more QALYs than EX+MT+B, for an incremental cost-effectiveness ratio of${\$}$12,900/QALY gained. Limitations The small number of total knee arthroplasty surgeries received by individuals in this study made the assessment of whether any particular strategy was more successful at delaying or preventing surgery in individuals with knee OA difficult. Conclusions Spacing exercise-based physical therapy sessions over 12 months using periodic booster sessions was less costly and more effective over 2 years than strategies not containing booster sessions for individuals with knee OA.

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