THE ROLE OF MANUAL THERAPY IN THE TREATMENT OF CHRONIC CERVICAL PAINS

2020 ◽  
pp. 1-4
Author(s):  
George-Sebastian Iacob ◽  
Constantin Munteanu
Keyword(s):  
Manual Therapy ◽  
Therapy Group ◽  
Neck Disability Index ◽  
Initial Assessment ◽  
Visual Analogue Pain Scale ◽  
Rehabilitation Protocol ◽  
Visual Analogue Pain ◽  
Therapeutic Exercises ◽  
Group A ◽  
Group B

Cervical back pain is one of the most important and common musculoskeletal disorders in medical recovery clinics and clinics. The main objective of the study was to highlight the effectiveness of an individualized therapeutic program adapted to the particularities of 22 subjects, which combines physical exercise with manual therapy. Subjects were randomly assigned to two equal groups. Group A - rehabilitation protocol consisting of therapeutic exercises (specific to the head, neck and upper limbs). Group B - rehabilitation protocol that included both therapeutic exercises and manual therapy (specific maneuvers of vertebral mobilization, massage, myofascial techniques, stretching and manipulations). The Visual Analogue Pain Scale (VAS) and the Neck Disability Index (NDI) were used to monitor the evolution of the research subjects, both of which have a specific applicability character to chronic pain. According to VAS (p <0.001), Group B showed mean values reduced to 2.2 ± 0.9 at week 12, compared to 7.3 ± 0.92, following the initial assessment. NDI values indicate better functional status after 12 weeks of treatment for both groups of subjects. NDI showed a beneficial decrease for Group B (13.2 ± 2.2 after 12 weeks, compared to 25.8 ± 2.3 in the first week). The mean results of VAS and NDI indicated a better evolution of symptoms in the case of the protocol that combined exercise and manual therapy (group B), but there were no statistically significant differences (compared to group A).

scholarly journals ADHESIVE CAPSULITIS; MANAGEMENT BY PHYSIOTHERAPY VERSUS INTRA-ARTICULAR CORTICOSTEROID INJECTION

2021 ◽  
Vol 71 (5) ◽  
pp. 1824-27
Author(s):  
Muhammad Umair Hashmi ◽  
Babar Bakht Chughtai ◽  
Muhammad Nadeem Ahsan
Keyword(s):  
Pain Score ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Sampling Technique ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Group A ◽  
Group B

Objective: To determine outcomes of intra-articular corticosteroids injection versus physiotherapy for the treatment of adhesive capsulitis using mean pain score on the visual analogue scale. Study Design: Comparative prospective study. Place and Duration of Study: Orthopedic outpatient department, Bahawal Victoria Hospital Bahawalpur from Jan to Jun 2021. Methodology: A total of 120 cases having adhesive capsulitis (frozen shoulder) were included in the study according to inclusion criteria. Non-probability consecutive sampling technique was used for the selection of cases. Patients were divided into two groups, group-A and group B, each containing 60 cases. Patients in group-A were given intra-articular steroid injection (2ml triamcinolone 40mg ± 2ml of bupivacaine). Patients in group B received ten sessions of physiotherapy by a welltrained physiotherapist under the supervision of an orthopaedic surgeon on alternate days. After six weeks, outcomes were measured in terms of pain score using a visual analogue pain scale. Results: Significant improvement was seen among patients in group-A with mean pain score from 7.32 ± 0.89 measured initially to 5.44 ± 1.37 measured after six weeks (p<0.001). No significant improvement was found among patients in group B with a mean pain score of 7.58 ± 0.94 measured initially to 7.12 ± 0.88 measured after six weeks (p>0.05). Conclusion: Significant improvement in pain relief can be achieved using intra-articular steroid injection administered in the shoulder as compared to supervised sessions of physiotherapy among patients with adhesive capsulitis.

scholarly journals Safety & Efficacy of Propranolol and Amitriptyline Combination Therapy in Migraine Prophylaxis: A Randomized Control Trial

2018 ◽  
Vol 4 (1) ◽  
pp. 3-7
Author(s):  
Mohammad Ariful Islam ◽  
Abdul Kader Shaikh ◽  
Sk Mahbub Alam ◽  
Dahlia Sultana ◽  
Md Saiful Islam ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Side Effects ◽  
Combination Therapy ◽  
Randomized Control Trial ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Combination of propranolol and amitriptyline drugs an be effective for migraine prophylaxis.Objective: The purpose of the present study was to see the safety and efficacy of propranolol and amitriptyline combination therapy in migraine prophylaxis.Methodology: This study randomized control trial was conducted in headache clinic at Banghabandhu Sheikh Medical University (BSMMU), Dhaka, Bangladesh from July 2012 to June 2014 for a period of two (02) years. Migraine patients with or without aura of 16 to 50 years of age, patients not on any prophylactic medication and patients willing to take part in the study were included for this study. Patients meeting all the criteria was randomized for two (02) treatment groups designated as the group A who were treated with Amitriptyline and the group B who were treated with the combination of amitriptyline and propranolol. Patients was followed for a three months period during which they were instructed to maintain a headache diary. The primary outcome evaluated was the proportion of patients in each group that achieved a 50% reduction in the number of days with headache. Secondary outcomes was reduction of visual analogue pain scale score, the number of days with headache per month, frequency of side effects and the proportion of patients abandoning the study before the end of medication. The causes of noncompliance and side effects was individually registered.Result: A total number of 8 0patietns were recruited for this study. During 1st visit among the patients in group A, duration of pain 1-4 hours 1 (2.5.0%), 5-8 hours 16(13.3%) and 9-12 hours 14(35.0%). In group B, duration of pain 1-4 hours 0(0.0%), 5-8 hours 18(15.0%) 9-12 were 21(52.5%), above 13 hours pain duration were 1(2.5%) (p>0.05). Duration of pain was recorded in final follow up among the patients. In group A, duration of pain 1-4 hours 24(60.0%), 5-8 hours 14(35.0%), 9-12 hours 2(5.0%). In group B, duration of pain 1-4 hours 28(70.0%), 5-8 hours 12(30.0%), 9-12 hours were not found (p>0.05). In group A, no adverse effect was found 26(65.0%), drowsiness 6(15.0%), dryness of mouth 6(15.0%), constipation 2(5.0%), fatigue and bradycardia were not found. In group B, no adverse effect was found 29(72.5%), drowsiness, dryness of mouth and constipation were not found, fatigue and bradycardia were 7(17.5%) and 4(10.0%). Number of attack and headache before treatment and subsequent follow up with medication it was found that number of attach and headache gradually decrease (p<0.05).Conclusion: In conclusion there is a significant changes of number of headache and attach in the amitriptyline and combine group.Journal of National Institute of Neurosciences Bangladesh, 2018;4(1): 3-7

A study to observe the effects of physiotherapy with and without manual therapy in the management postural neck pain: a randomized control trial

2020 ◽  
pp. 1-12
Author(s):  
Rubab Jawed ◽  
Muhammad Fareed Nasir ◽  
Nabeel Naeem Baig ◽  
Maryam Younus ◽  
Ayesha Arshad ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Neck Pain ◽  
Pain Intensity ◽  
Manual Therapy ◽  
Analogue Scale ◽  
Neck Disability Index ◽  
City Hospital ◽  
Group A ◽  
Group B ◽  
Neck Disability

Abstract Objective: To compare the effects of physiotherapy with and without manual therapy in the management of postural neck pain. Method: The randomised controlled trial was conducted at the Physiotherapy Department of South City Hospital, Karachi, from September 2017 to July 2018, and comprised subjects with >6 months of neck pain with no related medical dysfunction. The patients were enrolled by non-probability consecutive sampling technique and   randomly divided into Group A and Group B using computer-generated numbers. Group A received physiotherapy along with manual therapy, while Group B only had physiotherapy. Group A was also taught a home exercise programme. A printed exercise sheet was provided with frequency and repetition details. Visual analogue scale for pain intensity level and neck disability index were used to measure outcome at 3rd and 12th week. Data was analysed using SPSS 22. Results: Of the 60 subjects, there were 30(50%) in each of the two groups. The mean age in Group A was 32.77±7.44 years and it was 32.53±7.9 years in Group B. Overall, there were 21(35%) males and 39(65%) females. Significant reduction in pain intensity and neck disability levels at 3 and 12 weeks was noted compared to baseline (p<0.05). Inter-group comparison at final follow-up showed better Group A results compared to Group B (p<0.05). Conclusion: Physiotherapy with manual therapy was found to be better compared to physiotherapy alone. Key Words: Neck pain, Visual analogue scale, Neck disability index, Manual therapy, Exercise. Continuous...

Randomized trial of medical compression stockings versus two-layer short-stretch bandaging in the management of venous leg ulcers

Phlebologie ◽  
2009 ◽  
Vol 38 (04) ◽  
pp. 157-163 ◽  
Author(s):  
A. Franek ◽  
L. Brzezinska-Wcislo ◽  
E. Blaszczak ◽  
A. Polak ◽  
J. Taradaj
Keyword(s):  
Drug Therapy ◽  
Randomized Clinical Trials ◽  
Therapy Group ◽  
Long Term Results ◽  
Leg Ulcers ◽  
Compression Stockings ◽  
Venous Leg Ulcers ◽  
Group A ◽  
Group B ◽  
Medical Compression Stockings

SummaryA prospective randomized clinical trial was undertaken to compare a medical compression stockings with two-layer short-stretch bandaging in the management of venous leg ulcers. Study endpoints were number of completely healed wounds and the clinical parameters predicting the outcome. Patients, methods: Eighty patients with venous leg ulcers were included in this study, and ultimately allocated into two comparative groups. Group A consisted of 40 patients (25 women, 15 men). They were treated with the compression stockings (25–32 mmHg) and drug therapy. Group B consisted of 40 patients (22 women, 18 men). They were treated with the short-stretch bandages (30–40 mmHg) and drug therapy, administered identically as in group A. Results: Within two months the 15/40 (37.50%) patients in group A and 5/40 (12.50%) in group B were healed completely (p = 0.01). For patients with isolated superficial reflux, the healing rates at two months were 45.45% (10/22 healed) in group A and 18.18% (4/22 healed) in group B (p = 0.01). For patients with superficial plus deep reflux, the healing rates were 27.77% (5/18 healed) in group A and 5.55% (1/18 healed) in group B (p = 0.002). Comparison of relative change of the total surface area (61.55% in group A vs. 23.66% in group B), length (41.67% in group A vs. 27.99% in group B), width (46.16% in group A vs. 29.33% in group B), and volume (82.03% in group A vs. 40.01% in group B) demonstrated difference (p = 0.002 in all comparisons) in favour of group A. Conclusion: The medical compression stockings are extremely useful therapy in enhancement of venous leg ulcer healing (both for patients with superficial and for patients who had superficial plus deep reflux). Bandages are less effective (especially for patients with superficial plus deep reflux, where the efficiency compared to the stockings of applied compression appeared dramatically low). These findings require confirmation in other randomized clinical trials with long term results.

An Efficacy and Safety Study of Remogliflozin in Obese Indian Type 2 Diabetes Mellitus Patients Who Were Inadequately Controlled on Insulin glargine plus other oral hypoglycemic agents

2020 ◽  
Vol 17 ◽  
Author(s):  
Anand Shankar
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Glargine ◽  
Therapy Group ◽  
Insulin Dose ◽  
Blood Glucose Control ◽  
Hypoglycemic Agents ◽  
Oral Drug ◽  
Group A ◽  
Group B

Aim & Objective: The objective of this retrospective study was to investigate the efficacy of adding remogliflozin to current insulin glargine plus two oral drug i.e. metformin and teneligliptin therapy in poorly controlled Indian type 2 diabetes. Material and Methods: 173 study participants were initially selected from patient database who continued on their insulin glargine or received an increased dose of insulin glargine along with other OHA based therapy (Group A) and 187 were selected who had received remogliflozin (100 mg BD) (Group B) in addition to insulin glargine along with other OHA based therapy. Glycated haemoglobin (HbA1c), total daily insulin dose, body weight, and the number of hypoglycemic events were recorded at weeks 0, 12 and 24. Result: During the study, mean values of HbA1c, FBG and P2BG were significantly reduced in both groups. Insulin requirements decreased from 45.8 ± 16.7 IU/day to 38.5 ± 13.5 IU/day (P < 0.001) and at week 24 even further decreased to 29.5 ± 14.5 IU/Day . Twenty three patients in group B were able to cease insulin treatment altogether after 24 week treatment. It has been observed to attain tight blood glucose control we need to increase insulin dose in group A from 45.5 ± 16.5 IU/Day to 51.5 ± 14.5 at week 12 (P<0.01) and which further increased to 53.8 ± 12.8 IU/Day at week 24 (P<0.01). Adding remogliflozin showed significant effect on blood pressure (P < 0.001) and weight reduction (P < 0.001). It has been observed that 38% patients has achieves targeted HbA1c (≤7%) in group B where it was 22% in group A. Conclusion: Results demonstrate that in uncontrolled T2DM patients remogliflozin 100 mg BD can successfully lay a foundation for prolonged good glycemic control. Early addition of remogliflozin with insulin glargine plus OHAs may be an alternative compare to intensive up titration of insulin daily dose in people with uncontrolled T2DM. Clinical Trial Registration Number: A 2358

Moxifloxacin Based Triple Therapy as Alternative to Standard Therapy in Helicobacter Pylori Eradication.

2020 ◽  
Vol 18 ◽  
Author(s):  
Mohammed Hussien Ahmed ◽  
Sherief Abd-Elsalam ◽  
Aya Mohammed Mahrous
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Therapy Group ◽  
Low Cost ◽  
High Rate ◽  
Helicobacter Pylori Eradication ◽  
Treatment Regimens ◽  
Group A ◽  
H Pylori ◽  
Group B

Introduction: Helicobacter pylori eradication remains a problematic issue. We are in an urgent need for finding a treatment regimen that achieves eradication at a low cost and less side effect. Recent published results showing a high rate of resistance and with clarithromycin-based treatment regimens. The aim of the study was to compare moxifloxacin therapy and classic clarithromycin triple therapy in H. pylori eradication. Methods: This was a pilot study that enrolled 60 patients with helicobacter pylori associated gastritis. Diagnosis was done by assessment of H. pylori Ag in the stool. The patients were randomly assigned to receive either moxifloxacin based therapy (Group A), or clarithromycin based therapy (Group B) for two weeks. We stopped the treatment for another two weeks then reevaluation for cure was done. Results: 90 % of patients had negative H. pylori Ag in the stool after 2 weeks of stoppage of the treatment in group A versus 66.7 % in Group B. None of the patients in both groups had major side effects. Conclusion: Moxifloxacin-based therapy showed higher eradication power and less resistance when compared to clarithromycin triple therapy.

Effectiveness of Laser Therapy and Ultrasound Therapy along with Muscle Energy Technique in subjects with Trapezitis

2021 ◽  
pp. 116-120
Author(s):  
K. Kotteeswaran ◽  
Syed Gaffar ◽  
Krishna. R ◽  
Keerthana Priya. R.
Keyword(s):  
Laser Therapy ◽  
Functional Disability ◽  
Neck Disability Index ◽  
Ultrasound Therapy ◽  
Muscle Energy Technique ◽  
Significant Difference ◽  
Group A ◽  
Muscle Energy ◽  
Group B ◽  
Neck Disability

Aim: To find the effectiveness of laser therapy and ultrasound therapy along with muscle energy technique in treatment of Trapezitis. Materials and Methods: Non-equivalent quasi experimental study design was used in this study. Total of 30 subjects with trapezitis were selected using non probability convenient sampling technique.30 Subjects was divided into two groups by lot system. Group A received laser therapy and Group B received ultrasound therapy and for both the group muscle energy technique was given. The outcome measures are Neck Disability Index (NDI) for measuring Functional Disability. Data collected and tabulated was statistically analyzed. Result: Statistical analysis of post-test, Neck Disability Index (NDI) revealed that there is statistically significant difference seen between Group A and Group B. Conclusion: From the result, it has been concluded that Laser therapy with muscle energy technique (Group A) was more effective than Ultrasound therapy with muscle energy technique (Group B) on improving functional ability in subjects with Trapezitis.

Management of fresh odontoid fractures using posterior C1–2 fixation without fusion: a long-term clinical follow-up study

2021 ◽  
pp. 1-11
Keyword(s):  
Scale Score ◽  
Neck Disability Index ◽  
Implant Removal ◽  
Odontoid Fractures ◽  
Significant Difference ◽  
Flexion Extension ◽  
Group A ◽  
Group B

OBJECTIVE Posterior C1–2 fixation without fusion makes it possible to restore atlantoaxial motion after removing the implant, and it has been used as an alternative technique for odontoid fractures; however, the long-term efficacy of this technique remains uncertain. The purpose of the present study was to explore the long-term follow-up outcomes of patients with odontoid fractures who underwent posterior C1–2 fixation without fusion. METHODS A retrospective study was performed on 62 patients with type II/III fresh odontoid fractures who underwent posterior C1–2 fixation without fusion and were followed up for more than 5 years. The patients were divided into group A (23 patients with implant removal) and group B (39 patients without implant removal) based on whether they underwent a second surgery to remove the implant. The clinical outcomes were recorded and compared between the two groups. In group A, the range of motion (ROM) of C1–2 was calculated, and correlation analysis was performed to explore the factors that influence the ROM of C1–2. RESULTS A solid fracture fusion was found in all patients. At the final follow-up, no significant difference was found in visual analog scale score or American Spinal Injury Association Impairment Scale score between the two groups (p > 0.05), but patients in group A had a lower Neck Disability Index score and milder neck stiffness than did patients in group B (p < 0.05). In group A, 87.0% (20/23) of the patients had atlantoodontoid joint osteoarthritis at the final follow-up. In group A, the C1–2 ROM in rotation was 6.1° ± 4.5° at the final follow-up, whereas the C1–2 ROM in flexion-extension was 1.8° ± 1.2°. A negative correlation was found between the C1–2 ROM in rotation and the severity of tissue injury in the atlantoaxial region (r = –0.403, p = 0.024) and the degeneration of the atlantoodontoid joint (r = –0.586, p = 0.001). CONCLUSIONS Posterior C1–2 fixation without fusion can be used effectively for the management of fresh odontoid fractures. The removal of the implant can further improve the clinical efficacy, but satisfactory atlantoaxial motion cannot be maintained for a long time after implant removal. A surgeon should reconsider the contribution of posterior C1–2 fixation without fusion and secondary implant removal in preserving atlantoaxial mobility for patients with fresh odontoid fractures.

scholarly journals Blood asymmetric dimethylarginine and nitrite/nitrate concentrations in short-stature children born small for gestational age with and without growth hormone therapy

2017 ◽  
Vol 46 (2) ◽  
pp. 761-772 ◽  
Author(s):  
Hironori Nagasaka ◽  
Ichiro Morioka ◽  
Mayuko Takuwa ◽  
Mariko Nakacho ◽  
Mayumi Yoshida ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Growth Hormone ◽  
Asymmetric Dimethylarginine ◽  
Therapy Group ◽  
Adma Level ◽  
Gh Therapy ◽  
Normal Children ◽  
Group A ◽  
Group B ◽  
Nitrite Nitrate

Objective To investigate the basal amino acid metabolism and impact of growth hormone (GH) therapy in short-stature children born small for gestational age (short SGA children). Methods In this age-matched case-control study, the basal blood levels of amino acids, asymmetric dimethylarginine (ADMA), and nitrite/nitrate (NOx) were compared between 24 short SGA children and 25 age-matched normal children. Changes in these parameters were assessed for 12 months in 12 short SGA children initiating GH therapy (Group A) and 12 age-matched short SGA children without GH therapy (Group B). Results The arginine levels were significantly lower in the short SGA than in normal children. The ADMA levels were significantly higher and NOx levels were significantly lower in the short SGA than normal children. In Group A, the ADMA level was significantly lower and NOx level was significantly higher at 6 months than at baseline. At 12 months, the ADMA level in Group A began to increase, but the NOx level remained the same. Group B showed no significant changes. Conclusions This study is the first to show that ADMA is promoted and nitric oxide is suppressed in short SGA children and that GH therapy affects the production of ADMA and nitric oxide.

scholarly journals EFFECTIVENESS OF C1-C2 SUSTAINED NATURAL APOPHYSEAL GLIDE COMBINED WITH DRY NEEDLING ON PRESSURE POINT THRESHOLD AND HEADACHE DISABILITY IN CERVICOGENIC HEADACHE.

2018 ◽  
Vol 11 (1) ◽  
pp. 171 ◽  
Author(s):  
Ramesh Chandra Patra ◽  
Patitapaban Mohanty ◽  
Ajay P Gautam
Keyword(s):  
Therapy Group ◽  
Combined Treatment ◽  
Cervicogenic Headache ◽  
Dry Needling ◽  
Pressure Point ◽  
Cervicogenic Headaches ◽  
Group A ◽  
The Mean ◽  
Headache Disability ◽  
Group B

 Objective: The main objective of this study was to evaluate the effectiveness of dry needling and mulligan C1-C2 sustained natural apophyseal glides (SNAGs) in increasing pressure point threshold and reducing headache disability in patients with CGH.Methods: This study was conducted on 150 patients. They were divided into three groups for the purpose of the study. Group A was referred to as the dry needling group. They were subjected to dry needling for treating the pain. Group B was the manual therapy group. The patients in this group were subjected to C1-C2 SNAGs. Group C was the combined group. Patients belonging to this group were given C1-C2 SNAGs along with dry needling.Results: Statistical analysis paired t-test was used for comparison of the mean within every group where it showed significant improvement in all the parameter (p<0.05).Conclusion: There was a consistent reduction in tenderness and improvement in disability of the patients belonging to all groups. However, Group C, where the patients were subjected to combined treatment, showed better results. Results of this study indicate that dry needling along with mulligan C1-C2 SNAGs is more beneficial in patients suffering from cervicogenic headaches.

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