scholarly journals Clinical Trial of Exercise for Shoulder Pain in Chronic Spinal Injury

2006 ◽  
Vol 86 (12) ◽  
pp. 1604-1618 ◽  
Author(s):  
Deborah A Nawoczenski ◽  
Jordan M Ritter-Soronen ◽  
Christine M Wilson ◽  
Benjamin A Howe ◽  
Paula M Ludewig

AbstractBackground and Purpose. The high prevalence of shoulder pain in wheelchair users may be related to the repetitive use of the upper limbs during self-care and wheelchair-related activities. The purpose of this study was to determine the effects of a controlled 8-week, scapula-focused exercise intervention on pain and functional disability in people with spinal cord injury (SCI) and shoulder impingement symptoms. Subjects. Forty-one manual wheelchair users (with SCI and spina bifida), both with (n=21) and without (n=20) shoulder impingement symptoms, participated. Methods. The study design was a clini\\cal trial with an asymptomatic control group. Subjects completed the Wheelchair User’s Shoulder Pain Index (WUSPI) and the Shoulder Rating Questionnaire (SRQ) and provided patient satisfaction scores at initial and 8-week visits. Subjects in the intervention group were instructed in a home exercise program consisting of stretching and strengthening exercises. Subjects in the asymptomatic control group received no intervention. An analysis of variance model was used to test for group and time effects for the WUSPI, SRQ, and satisfaction scores. Results. Subjects in the intervention group showed significant improvements in all measures as a result of the intervention, whereas asymptomatic control group subjects remained stable. Discussion and Conclusion. A selective 8-week home exercise program is effective in reducing pain and improving function and satisfaction in this population of wheelchair users.

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Einas Al-Eisa ◽  
Asma Al-Rushud ◽  
Ahmad Alghadir ◽  
Shahnawaz Anwer ◽  
Bashayer Al-Harbi ◽  
...  

Objective.To investigate the efficacy of using “Instagram application” with a “home-exercise program” as a motivational stimulus in improving physical activity (PA) adherence levels among female college students.Methods.Fifty-eight female undergraduate students with the mean age20.3±0.96years participated. Participants were divided into two groups: intervention and the control group; both the groups received an exercise program and the intervention group was additionally motivated by “Instagram.” Adherence to PA was measured by using an adherence sheet. The Exercise Motivation Inventory (EMI-2) was used to assess the motivational factors.Results.The most frequent motivational factors were extrinsic as assessed using the EMI-2. “Positive health” was the most frequent factor mentioned of the two types with 47% of the sample. The intervention group adhered with 17% more to the activity program compared to the control group. Moreover, 72% of the participants in the intervention and control groups found the activity program flexible enough to be performed at home; they agreed about its effectiveness on adherence (53%).Conclusions.The use of Instagram with the home exercise program as a motivational modality could be attractive and effective to reinforce adherence and maintain an appropriate PA level.


2012 ◽  
Vol 92 (1) ◽  
pp. 24-37 ◽  
Author(s):  
Xiao Jing Yang ◽  
Keith Hill ◽  
Kirsten Moore ◽  
Susan Williams ◽  
Leslie Dowson ◽  
...  

Background Previous research has mainly targeted older people with high risk of falling. The effectiveness of exercise interventions in older people with mild levels of balance dysfunction remains unexplored. Objective This study evaluated the effectiveness of a home balance and strength exercise intervention in older people systematically screened as having mild balance dysfunction. Design This was a community-based, randomized controlled trial with assessors blinded to group allocation. Participants Study participants were older people who reported concerns about their balance but remained community ambulant (n=225). After a comprehensive balance assessment, those classified as having mild balance dysfunction (n=165) were randomized into the trial. Intervention Participants in the intervention group (n=83) received a 6-month physical therapist–prescribed balance and strength home exercise program, based on the Otago Exercise Program and the Visual Health Information Balance and Vestibular Exercise Kit. Participants in the control group (n=82) continued with their usual activities. Outcome Measures Laboratory and clinical measures of balance, mobility, and strength were assessed at baseline and at a 6-month reassessment. Results After 6 months, the intervention group (n=59) significantly improved relative to the control group (n=62) for: the Functional Reach Test (mean difference=2.95 cm, 95% confidence interval [CI]=1.75 to 4.15), the Step Test (2.10 steps/15 seconds, 95% CI=1.17 to 3.02), hip abductor strength (0.02, 95% CI=0.01 to 0.03), and gait step width (2.17 cm, 95% CI=1.23 to 3.11). There were nonsignificant trends for improvement on most other measures. Fourteen participants in the intervention group (23.7%) achieved balance performance within the normative range following the exercise program, compared with 3 participants (4.8%) in the control group. Limitations Loss to follow-up (26.6%) was slightly higher than in some similar studies but was unlikely to have biased the results. Conclusions A physical therapist–prescribed home exercise program targeting balance and strength was effective in improving a number of balance and related outcomes in older people with mild balance impairment.


2017 ◽  
Vol 16 (2) ◽  
pp. 85-93 ◽  
Author(s):  
Sergio Vinuesa-Montoya ◽  
María Encarnación Aguilar-Ferrándiz ◽  
Guillermo A. Matarán-Peñarrocha ◽  
Manuel Fernández-Sánchez ◽  
Elena María Fernández-Espinar ◽  
...  

2019 ◽  
Vol 13 (3) ◽  
pp. 263-269
Author(s):  
Djunizar Djamaludin ◽  
Setiawati Setiawati ◽  
Rika Yulendasari

The effect of range motion (ROM) ankle exercise on prevention of neuropathy and angiopathy in patient with diabetes mellitusBackground: Based on data from Basic Health Research (2013) conducted by the Indonesian Ministry of Health in a way to obtain the proportion of DM at the age of 15 years and over, confirmed / checked whether or not they suffer from DM or not.It was found that Lampung Province was ranked as the 8th largest DM person from 33 provinces throughout Indonesia, with DM patients with 38,923 lives and 5,560 people. One complication that needs attention is diabetes foot injury and it can cause amputation. The most common cause of diabetes foot injury is peripheral neuropathy which includes damage to sensory, autonomic and motor nerves.Purpose: The purpose of this study was to determine the effect of Range of Motion (ROM) ankle exercise on prevention of neuropathy and angiopathy on diabetes patients.Methods: A quasi experimental pre and post- test with control group study design was employed. The purposive sampling with 26 participants (13 respondents intervention group and 13 respondents control group) were recruited. The interventions groups performed ROM ankle exercise in their own respective training programs for 4 weeks, whereas no training was done in the control group. Both groups intervention and control, before and after the exercise program were measured with monofilament test for neuropathy and Venous Doppler for angiopathy. The data analysis was using t-test.Results: In the intervention group there were a significant improvements after ROM ankle exercise on prevention of neuropathy with p Value 0.000 and for angiopathy with p Value 0.000. There were significant different between intervention group and control group for neuropathy (p: .004) and angiopathy (p: .031).Conclusion: To prevent neuropathy and angiopathy on diabetes patients a home exercise program with Range of Motion (ROM) ankle could be implementedKeywords: Range of Motion; Neuropathy; Angiopathy; Diabetes MellitusPendahuluan: Berdasarkan Riskesdas tahun 2013 oleh Kemenkes RI dengan melakukan wawan cara untuk mendapatkan proporsi DM pada usia 15 tahun keatas yaitu proporsi penduduk yang terdiagnosis menderita DM dan penduduk yang belum pernah didiagnosis menderita DM. Provinsi Lampung menduduki peringkat ke – 8 penyandang DM terbesar dari 33 Provinsi diseluruh Indonesia, 38.923 jiwa dan 5.560 jiwa . Salah satu komplikasi yang harus mendapat perhatian yaitu luka kaki diabetes karena dapat mengakibarkan amputasi. Penyebab terbanyak dari luka kaki diabetes yaitu neuropati perifer yang meliputi kerusakan syaraf sensorik, otonom dan motorik.Tujuan: Diketahui pengaruh Range Of Motion (ROM) Ankle terhadap pencegahan terjadinya Neuropati dan Angiopati pada pasien Diabetes Melitus.Metode: Penelitian ini mengunakan desain quasi eksperimen pre post test dengan kelompok control dan intervensi..Sampel diambil dengan menggunakan tehnik Purposive Sampling dengan jumlah sampel yaitu 26 responden. Instrument penelitian ini  menggunakan 10 gr semmens weinstein monofilament untuk  mendeteksi  Neuropati dan  Venous Doppler  Ultrasound untuk  mendeteksi angiopati. Hasil: Menunjukkan adanya pengaruh latihan Range of Motion (ROM) Ankle terhadap pencegahan neuropati dengan p Value 0.000 dan angiopati dengan p Value 0.000. Terdapat perbedaan bermakna antara kelompok intervensi dan control untuk neuropati (p: .004) dan  angiopati  (p: .031).Simpulan: Untuk mencegah terjadinya neuropati dan angiopati pada penderita DM untuk dapat melakukan latihan Range of Motion (ROM) Ankle  dirumah


2020 ◽  
Vol 22 (5) ◽  
pp. 208-214
Author(s):  
Sarah J. Donkers ◽  
Darren Nickel ◽  
Lorna Paul ◽  
Shyane R. Wiegers ◽  
Katherine B. Knox

Abstract Background: Options to support adherence to physical activity in moderate-to-severe multiple sclerosis (MS) are needed. The primary aim was to evaluate adherence to a Web-based, individualized exercise program in moderate-to-severe MS. Secondary aims explored changes in 29-item Multiple Sclerosis Impact Scale, Hospital Anxiety and Depression Scale (HADS), grip strength, Timed 25-Foot Walk test, and Timed Up and Go (TUG) results. Methods: Participants were randomized (2:1) to a physiotherapist-guided Web-based home exercise program or a physiotherapist-prescribed written home exercise program. The primary outcome was adherence (number of exercise sessions over 26 weeks). Secondary outcomes were described in terms of means and effect sizes. Results: There were 48 participants: mean ± SD age, 54.3 ± 11.9 years; disease duration, 19.5 ± 11.0 years; and Patient-Determined Disease Steps scale score, 4.4 ± 1.6. There was no significant difference in mean ± SD adherence in the Web-based group (38.9 ± 28.1) versus the comparator group (34.6 ± 40.8; U = 198.5, P = .208, Hedges’ g = 0.13). Nearly 50% of participants (23 of 48) exercised at least twice per week for at least 13 of the 26 weeks. Adherence was highest in the Web-based subgroup of wheelchair users. Medium effect sizes were found for the HADS anxiety subscale and in ambulatory participants for TUG. There were no adverse events. Conclusions: There was no difference in exercise adherence between the Web-based and active comparator groups. There was no worsening of secondary outcomes or adverse events, supporting the safety of Web-based physiotherapy. More research is needed to determine whether wheelchair users might be most likely to benefit from Web-based physiotherapy.


2018 ◽  
Vol 8 (1) ◽  
pp. 35-41
Author(s):  
Amila Kapetanović ◽  
Adila Horić ◽  
Dijana Avdic ◽  
Amila Jaganjac ◽  
Emina Softić

Introduction: The aim of this study was to assess effects of strength, stretching and balance home exercise program (moderate intensity, performed once a day, five times a week) on quality of life of people with knee osteoarthritis. Methods: Participants with knee osteoarthritis performed physical therapy for a period of two weeks at the Department for Physical Medicine and Rehabilitation. The study group (n=30) continued to perform exercise program at home while the control group (n=30) did not continue the exercise program. The participants in the study group performed strength, stretching and balance exercises of moderate intensity, once a day, five times a week, for a total of eight weeks. The Short Form-36 Health Questionnaire (SF-36) was used to examine the effects of exercise program. Results: There was no the difference between the average value of quality of life in all examined areas (physical functioning, role limitations due to physical problems, role limitations due to emotional problems, vitality/energy, mental health, social functioning, physical pain, perception of general health) at the beginning of the study between the study group and control group (p>0.05 in all eight areas). The difference between the average value of quality of life at the beginning and end of the study was statistically significantly higher in the study group compared to the control group (physical functioning p=0.0001; role limitations due to physical problems p=0.0001; role limitations due to emotional problems p=0.0001; vitality/energy p=0.0001; mental health p=0.0001; social functioning p=0.0001; bodily pain p=0.0001; perception of general health p=0.0001). Conclusion: Home exercise program consisting of strength, stretching and balance exercises, of moderate intensity, performed once a day, five times a week is effective in improving quality of life of people with knee osteoarthritis.


2020 ◽  
Author(s):  
Limin Wang ◽  
Hongbo Chen ◽  
Han Lu ◽  
Yunlin Wang ◽  
Congying Liu ◽  
...  

Abstract Background: Knee osteoarthritis (KOA) is a common joint disease in people over 60 years old. Exercise therapy is one of the most effective non-pharmacological treatments for KOA, but low exercise adherence needs to be improved. The present study aimed to evaluate the effect of the Transtheoretical Model-lead home exercise intervention (TTM-HEI) program on exercise adherence, KOA symptoms, and knee function in older adults with KOA. Methods: A two-arm, superiority, assessor-blinded, cluster randomized trial was conducted. Community-dwelling older adults with KOA were recruited from 14 community centers in Beijing, China, via print and social media advertisements from April to October 2018. The present study lasted 48 weeks, with an intervention duration of 0–24 weeks and follow-up time of 24–48 weeks. The intervention was a two-stage and 24-week TTM-based exercise program, and the control group underwent a same-length exercise program guidance without any exercise-adherence interventions. The primary outcome was exercise adherence to the prescribed home exercise program and was measured using an 11-point numerical (0=not at all through and 10=completely as instructed) self-rating scale at week 4, 12, 24, 36, and 48 after the program started. KOA symptoms (pain intensity and joint stiffness) were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and knee function (lower limb muscle strength and balance) was measured using the Five-Times-Sit-to-Stand Test (FTSST) and the Timed Up and Go Test (TUG) at baseline, week 24 and week 48. Latent growth model (GLM), repeated measures ANOVA, and independent t-test were the main statistical tests used.Results: A total of 189 older adults (intervention group: n = 103, control group: n = 86) were enrolled. Differences of any outcome measures at baseline were not significant between groups. The growth rate of exercise adherence in the intervention group increased 2.175 units compared with the control group (unstandardized coefficient of slope on group B2 = 2.175, p < 0.001), and the intervention program maintained participants’ exercise adherence with 5.56 (SD = 1.00) compared with 3.16 (SD = 1.31) in the control group at week 48. In addition, TTM-HEI program showed significant effects on relieving KOA symptoms and improving knee function.Conclusion: Over time, TTM-HEI could improve participants’ exercise adherence, KOA symptoms, and knee function.Trial registration: This study was approved by the ethics committee (IRB00001052-17066) in July 2017 and was registered at Chinese Clinical Trails Registry (website: www.chictr.org.cn, registry number: ChiCTR1800015458).


2018 ◽  
Vol 32 (12) ◽  
pp. 1656-1665 ◽  
Author(s):  
Marianne Roos ◽  
Jean-Sébastien Roy

Objective: To explore the feasibility of a rehabilitation program and its effect on the performance-related musculoskeletal symptoms and functional limitations of orchestral musicians. Design: Single-blind pilot randomized controlled trial with exercise group and control group. Setting: Workplace of professional symphony orchestra and tertiary-level conservatory orchestral musicians. Participants: Professional and student orchestral musicians with or without performance-related musculoskeletal disorders. Interventions: A rehabilitation program including an educational presentation, an 11-week home exercise program and three supervised exercise sessions, versus no intervention. Measures: Feasibility measures included adherence and drop-out rate. The Musculoskeletal Pain Intensity and Interference Questionnaire for professional orchestra Musicians (MPIIQM) measured symptom intensity and functional limitations, while the Nordic Musculoskeletal Questionnaire (NMQ) measured symptom prevalence and frequency. Results: A total of 30 participants were recruited ( n = 15 per group). Exercise group adherence was 97.7% for the supervised sessions and 89% for the home exercise program. There were no drop-outs. Significant group-time interactions were obtained for both the pain intensity (partial η2 = 0.166; P = 0.025) and pain interference (partial η2 = 0.186; P = 0.017) sections of the MPIIQM. Mean (standard deviation) pain intensity score changes from baseline to 11 weeks were control group: 0.40 (5.04); P = 0.763; partial η2 = 0.007; and exercise group: –4.07 (5.31); P = 0.010; partial η2 = 0.386. For pain interference, mean score changes were control group: 0.20 (9.10); P = 0.933; partial η2 = 0.001; and exercise group: –9.00 (10.73); P = 0.006; partial η2 = 0.430. NMQ analyses revealed no significant interaction ( P > 0.05). Conclusion: Results suggest that the studied program is feasible and effective in decreasing the intensity and functional impact of musicians’ symptoms. However, no significant medium-term effect on the prevalence and frequency of symptoms was shown.


2019 ◽  
Vol 4 (1) ◽  
pp. 611-615
Author(s):  
Shambhu Sah ◽  
Shivam Karn ◽  
Deepak Sigdel ◽  
Mukunda Dahal ◽  
Ragin Kathet ◽  
...  

Introduction: Idiopathic frozen shoulder (IFS) is a common chronic and disabling condition of shoulder pain characterized by progressive loss of active and passive range of motion (ROM) with unclear pathogenesis. The ideal treatment protocol is still controversial but commonly used treatment includes single agent or combination of oral non-steroid anti- inflammatory drugs (NSAIDS), oral steroids, intra-articular steroid injection and physiotherapy. Objective: The objective of this study was to evaluate the effectiveness of intra-articular methylprednisolone injection for pain and ROM in patients suffering from idiopathic frozen shoulder who did not respond to oral NSAIDS with or without oral steroid. Methodology: A total of 70 patients suffering from IFS were enrolled in this cross sectional study from May 2017–October 2018 from outpatient department of orthopaedic and physiotherapy of Koshi Zonal Hospital. All the patients underwent treatment protocol that comprised of Intra-articular steroid injection followed by five days of oral NSAIDS along with five days regime of physical therapy at the physiotherapy centre, followed by home exercise program. Each patient was followed up at every two weeks interval from intra-articular injection till 6th week. Each patient was evaluated for range of motion (ROM), Numerical Pain Rating Scale (NPRS) and Shoulder Pain and Disability Index (SPADI) before the treatment protocol and at every follow up visit. Data was analyzed using Microsoft Excel Program. Results: All patients enrolled for the study had satisfactory response. The mean age of the patient was 51.8 years (range 40-65 years). The mean age of the 26 male patients was 54 years (range 45-65), whereas the mean age of 44 female patients was 50.5 years (range 45-60). Mean duration of illness was 26.5 weeks (range 18-32 weeks), SPADI before medication was 83.14, at 2nd week was 50.92, at 4th week was 38.63 and at 6th week was 27.22. Conclusion: Combination of intra-articular methylprednisolone injection, physiotherapy and home exercise program is effective in IFS for rapid improvement in pain and ROM.


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