Physiotherapy Group Research Articles

The Effects of Photobiomodulation on Shoulder Pain, Muscle Thickness, and Function in Subjects With Adhesive Capsulitis

Background: Adhesive capsulitis or frozen shoulder is among the most prevalent causes of pain and disability in individuals. Objectives: We aimed to evaluate the effect of Photobiomodulation (PBM) on pain, range of motion, and thickness and function of supraspinatus muscle in patients with adhesive capsulitis. Materials & Methods: Overall, 52 subjects (n=26/group) with adhesive capsulitis referring to Poorsina Hospital, physiotherapy ward, Rasht City, Iran, in 2019 participated in this study. They were randomly assigned to 2 groups of control or routine physical therapy and PBM group. The variables were pain (Visual Analogue Scale, VAS), range of motion (goniometer), the supraspinatus muscle thickness in rest and contraction, and muscle function (ultrasonography). The outcomes were examined before, after 5 and 10 sessions, and at a 1-month follow-up. Results: There were no significant differences between the two groups regarding the demographic characteristics and studied variables. The interaction of group and time (2×4) was significant for pain (P=0.02). Finally, the Bonferroni post hoc test data indicated the pain reduction in the PBM group was higher than the control group at the follow-up (P=0.03). The mixed two-factor analysis of variance indicated that the interaction of the group and time of shoulder abduction (P=0.6), shoulder external rotation (P=0.46), supraspinatus muscle thickness, rest (P=0.31), supraspinatus muscle thickness, contraction (P=0.11), and rest-contraction (P=0.66) were not significant. Conclusion: The PBM revealed greater analgesic effects than routine physical therapy in the short term and one-month follow-up. However, the effects on a range of motion and muscle thickness and function were insignificant.

Effects of Early Physical Therapy and Follow-Up in Acute Severe Coronavirus Disease 2019 Pneumonia: A Retrospective Observational Study.

BackgroundRehabilitation in subjects with severe coronavirus disease 2019 (COVID-19) pneumonia has been widely recommended. However, data regarding the starting time of rehabilitation, subjects and healthcare workers’ safety, as well as rehabilitation program features are limited. We aimed to assess the safety and characterize the effect of early and non-early physiotherapy on severe COVID-19 pneumonia subjects.MethodsA retrospective cohort study, including a consecutive sample of surviving subjects admitted to an acute care hospital due to severe COVID-19 pneumonia from March 13th to May 15th of 2020, is made. Subjects were separated into three groups: non-physical therapy, early physiotherapy (onset <7 days of admission), and non-early physiotherapy. Subject and therapist safety and length of hospital stay were the main evaluated outcomes.ResultsA total of 159 subjects were included (72% men; median age 62 years). Rehabilitation was performed on 108 subjects (32 early and 76 non-early physiotherapies). The length of hospital stay was 19 [interquartile range (IQR) 36.25] and 34 days (IQR 27.25) (p = 0.001) for early and non-early physiotherapy groups, respectively. No physiotherapist was infected and no subject adverse effect was identified. Multivariate analysis of subjects receiving physiotherapy during admission identified obesity [odds ratio (OR) 3.21; p-value 0.028], invasive mechanical ventilation (OR 6.25; p-value <0.001), and non-early physiotherapy (OR 3.54; p-value 0.017) as independent factors associated with a higher risk of prolonged hospital stay. Survivors’ follow-up after hospital discharge at 8 weeks was completed by 54% of subjects.ConclusionRehabilitation in acute severe COVID-19 pneumonia is safe for subjects and healthcare workers and could reduce the length of hospitalization stay, especially in those that may start early.

A Pilot Randomized Trial of Different Weekly Applications of Kinesthesia, Balance and Agility Exercise Program for Individuals with Knee Osteoarthritis

Background: This pilot study was conducted to determine the feasibility of a large-scale randomized controlled trial to examine the effectiveness of different weekly applications of kinesthesia, balance and agility (KBA) exercises for knee osteoarthritis (OA). Methods: Eighteen knee OA patients were randomly assigned to three groups of six patients: Twice-weekly KBA, thrice-weekly KBA, and control (conventional physical therapy) for six weeks. Feasibility outcomes included recruitment rate, retention/dropout rate, report of adverse events, pain (Visual Analog Scale for pain), and physical function (Ibadan Knee and Hip Osteoarthritis Outcome Measure). Descriptive statistics and a 3 × 2 (treatment group × time) mixed-model ANOVA were applied to analyze the data. Results: The recruitment rate was 66.6%. Retention rates for the three groups ranged from 90 – 100%. No serious adverse events were reported throughout the study. Pain and physical function significantly improved (P &lt; 0.05) in all the groups post-intervention, except for the conventional physical therapy group, which showed no significant improvement in the physical function (P &gt; 0.05). However, inter-group difference was not significant in all the clinical outcomes evaluated (all P &gt; 0.05). Conclusions: This study suggests the feasibility of a large-scale randomized controlled trial to examine the effectiveness of different weekly applications of KBA exercises among knee OA individuals, with minor amendments.

Effect of Salat Activity on Knee Pain, Range of Motion and Muscle Strength After Total Knee Arthroplasty: A Single-Blinded Randomized Controlled Trial.

Objectives: The aim of this study was to investigate the effect of salat activity on knee pain, muscle strength and range of motion after posterior stabilized total knee arthroplasty.&#x0D; Material and Methods: This prospective randomized study was conducted in KTO Karatay University and Medova Hospital, Konya, Turkey, between March 2019 and June 2019. Thirty volunteers between the ages of 55 and 75 who had undergone total knee arthroplasty participated in this study. Participants were randomly divided into two groups as physical therapy group and physical therapy + salat group. The participants in the physical therapy group were provided hot-cold application, transcutenous electrical nerve stimulation (TENS), active-assisted range of motion, stretching and strengthening exercises during four weeks. Physical therapy+salat group performed salat activity in addition to the treatment. The knee joint patency was measured using a digital goniometer, muscle strength using a manual muscle tester, knee pain with the visual analogue scale (VAS).&#x0D; Results: There was no difference in knee flexion and extension muscle strength between the groups before and after treatment (p ˃ 0.05). There was no difference in VAS values between the groups before and after treatment (p ˃ 0.05). Knee flexion angle increased significantly in the physical therapy+prayer group compared to the post-treatment physical therapy group (p˂0.003). There was no significant difference between the groups in knee extension angle before and after treatment (p˃0.05).&#x0D; Conclusion: In this study, it was found that Salat activity after knee arthroplasty improved knee joint range of motion.

Effectiveness of graded motor imagery in subjects with frozen shoulder: a pilot randomized controlled trial.

BackgroundSubjects with frozen shoulder (FS) might not be comfortable with vigorous physical therapy. Clinical trials assessing the effect of graded motor imagery (GMI) in FS are lacking. The aim of this study was to determine the effect of GMI as an adjunct to conventional physiotherapy in individuals with painful FS.MethodsTwenty subjects aged 40–65 years having stage I and II of FS were randomly divided into two study groups. The conventional physiotherapy group (n = 10) received electrotherapy and exercises while the GMI group (n = 10) received GMI along with the conventional physiotherapy thrice a week for 3 weeks. Pre- (Session 1) and post- (Session 9) intervention analysis for flexion, abduction, and external rotation range of motion (ROM) using a universal goniometer, fear of movement using the fear avoidance belief questionnaire (FABQ), pain with the visual analogue scale, and functional disability using the shoulder pain and disability index (SPADI) was done by a blinded assessor.ResultsStatistically significant difference was seen within both the groups for all the outcomes. In terms of increasing abduction ROM as well as reducing fear of movement, pain, and functional disability, the GMI group was significantly better than control group. However, both groups were equally effective for improving flexion and external rotation ROM.ConclusionsAddition of GMI to the conventional physiotherapy proved to be superior to conventional physiotherapy alone in terms of reducing pain, kinesiophobia, and improving shoulder function for stage I and II of FS.

COMPARISON OF DRY NEEDLING WITH CONVENTIONAL PHYSIOTHERAPY IN PATIENTS WITH KNEE OSTEOARTHRITIS FOR PAIN AND FUNCTIONAL IMPROVEMENTS

Background: Knee Osteoarthritis is a degenerative disease that affects many individuals in their forties or later and can lead towards impairment of physical functions and poor quality of life. Our study aimed to compare the effectiveness of dry needling with conventional physical therapy in patients with knee osteoarthritis (OA). Methods: It was a non-randomized clinical study conducted after ethical approval at Syed Medical Complex and Amin Welfare and Teaching Hospital Sialkot in 6 months. Sample size was calculated to be 58 using WHO calculator. Purposive sampling technique was used to enrol the participants according to predetermined eligibility criteria. They were allocated into two groups. Group A received conventional physical therapy treatment and group B received dry needling for 3 weeks, 2 sessions per week. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale and Numeric Pain Rating Scale (NPRS) were used to measure the outcomes before 1st treatment session and after last session. Paired sample t-test and independent sample t-test were applied to compare the results, and p?0.05 was considered significant. Results: Pre-treatment WOMAC score in group A was 50.07±11.835 and in group B it was 45.87±12.512. Post-treatment WOMAC score in group A was 38.87±13.731 and in group B it was 24.33±8.926. The scores improved in both groups, but group B showed significant improvement. Conclusion: Both conventional physical therapy and dry needling are effective to manage pain and functional limitation in patients with knee OA. Dry needling proved more effective compare to conventional physical therapy. Pak J Physiol 2022;18(1):48–52

The investigation of acute effects of fascial release technique in patients with arthroscopic rotator cuff repair: A randomized controlled trial

BackgroundFascial release technique is used for releasing fascial tissue to decrease pain, to increase range of motion, and to improve functional level. ObjectiveTo investigate the acute effects of fascial release technique on pain, range of motion, upper extremity functional level, and fear of movement in individuals with arthroscopic rotator cuff repair. MethodsThirty volunteers with an arthroscopic rotator cuff repair were included in the study. The individuals were randomly divided into two groups. One group received only conventional physiotherapy including hot pack, interferential current, and exercise program, while the fascial release technique was applied to the other group in addition to the conventional physiotherapy program for 2 weeks with 2 sessions per week. Individuals were assessed for pain intensity, range of motion, functional level, fear of movement before and after treatment, and satisfaction level after treatment. ResultsDemographic and clinical characteristics of the groups were similar (p > 0.05). Both groups showed improvement in pain, range of motion, and upper extremity functions (p < 0.05). Improvements in the treatment group were better than the conventional physiotherapy group (p < 0.05). Fear of movement was significantly decreased in the treatment group (p < 0.05). Both groups were similar in terms of satisfaction level (p > 0.05). ConclusionFascial release technique is acutely effective on the pain, joint range of motion and upper extremity functions in the treatment of individuals with arthroscopic rotator cuff repair and more successful results can be obtained by including it in the early rehabilitation program after arthroscopic rotator cuff surgery.

A randomized clinical trial of burst vs. spaced physical therapy for Parkinsons disease

IntroductionThe optimal timing for physical therapy (PT) delivery in Parkinson's disease (PD) is unknown. Our objective was to determine whether spacing physical therapy visits over a longer period of time is beneficial for maintenance of physical function in PD. MethodsA single center, single-blinded, randomized controlled trial of PD participants. Participants (n = 30) were randomized to either burst (two PT sessions weekly for 6 weeks) or spaced (one PT session every 2 weeks for 6 months) PT. 11 participants in each arm completed the study and were analyzed. The primary outcome measure was the Timed Up and Go (TUG) test at baseline and 6 months. The burst group had an additional outcome measure timepoint at the completion of PT at 6 weeks. ResultsNeither group achieved a minimal clinically significant benefit in the TUG score (3.5s) at 6 months. The spaced PT TUG scores were maintained when comparing baseline (7.8 ± 1.5s) and 6 month timepoints (7.8 ± 2.6s, p = 0.594). The burst group TUG scores comparing baseline (9.8 ± 3.8s) to 6 weeks (9.1 ± 3.0s) also was maintained (p = 0.365). The burst group worsened, however, when measuring the period from 6 weeks to 6 months (12.1 ± 7.6s, p = 0.034). ConclusionsThe spaced PT group had stability of the TUG mobility measure at 6 months, while the burst group had a significant worsening once PT was discontinued after 6 weeks. It is feasible to test these approaches in a future larger comparative effectiveness study.

The Effects of Photobiomodulation on Shoulder Pain, Muscle Thickness, and Function in Subjects With Adhesive Capsulitis

Background: Adhesive capsulitis or frozen shoulder is among the most prevalent causes of pain and disability in individuals. We aimed to evaluate the effect of Photobiomodulation (PBM) on pain, range of motion, and thickness and function of supraspinatus muscle in patients with adhesive capsulitis. Materials &amp; Methods: Overall, 52 subjects (n=26/group) with adhesive capsulitis referring to Poorsina Hospital, physiotherapy ward, Rasht City, Iran, in 2019 participated in this study. They were randomly assigned to 2 groups of control or routine physical therapy and PBM group. The variables were pain (VAS), range of motion (goniometer), the supraspinatus muscle thickness in rest and contraction, and muscle function (ultrasonography). The outcomes were examined before, after 5 and 10 sessions, and at a 1-month follow-up. Results: There were no significant differences between the two groups regarding the demographic characteristics and studied variables. The interaction of group and time (2×4) was significant for pain (P=0.02). Finally, the Bonferroni post hoc test data indicated the pain reduction in the PBM group was higher than the control group at the follow-up (P=0.03). The mixed two-factor analysis of variance indicated that the interaction of the group and time of shoulder abduction (P=0.6), shoulder external rotation (0.46), supraspinatus muscle thickness, rest (0.31), supraspinatus muscle thickness, contraction (0.11), and rest-contraction (0.66) were not significant. Conclusions: The PBM revealed greater analgesic effects than routine physical therapy in the short term and one-month follow-up. However, the effects on a range of motion and muscle thickness and function were insignificant.

Prospective Randomized Trial of Continuous Passive Motion Versus Physical Therapy After Arthroscopic Release of Elbow Contracture.

Continuous passive motion (CPM) has been used for decades, but we are not aware of any randomized controlled trials (RCTs) in which CPM has been compared with physical therapy (PT) for rehabilitation following release of elbow contracture. In this single-blinded, single-center RCT, we randomly assigned patients undergoing arthroscopic release of elbow contracture to a rehabilitation protocol involving either CPM or PT. The primary outcomes were the rate of recovery and the arc of elbow motion (range of motion) at 1 year. The rate of recovery was evaluated by measuring range of motion at 6 weeks and 3 months. The secondary outcomes included other range-of-motion-related outcomes, patient-reported outcome measures (PROMs), flexion strength and endurance, grip strength, and forearm circumference at multiple time points. A total of 24 patients were assigned to receive CPM, and 27 were assigned to receive PT. At 1 year, CPM was superior to PT with regard to the range of motion, with an estimated treatment difference of 9° (95% confidence interval [CI], 3° to 16°; p = 0.007). Similarly, the use of CPM led to a greater range of motion at 6 weeks and 3 months than PT. The percentage of lost motion recovered at 1 year was higher in the CPM group (51%) than in the PT group (36%) (p = 0.01). The probability of restoring a functional range of motion at 1 year was 62% higher in the CPM group than in the PT group (risk ratio for functional range of motion, 1.62; 95% CI, 1.01 to 2.61; p = 0.04). PROM scores were similar in the 2 groups at all time points, except for a difference in the American Shoulder and Elbow Surgeons (ASES) elbow function subscale, in favor of CPM, at 6 weeks. The use of CPM decreased swelling and reduced the loss of flexion strength, flexion endurance, and grip strength on day 3, with no between-group differences thereafter. Among patients undergoing arthroscopic release of elbow contracture, those who received CPM obtained a faster recovery and a greater range of motion at 1 year, with a higher chance of restoration of functional elbow motion than those who underwent routine PT. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Treatment Analysis of Patients Followed up With Postherpetic Neuralgia in Nothern Cyprus.

Background:Postherpetic neuralgia (PHN) is a frequent complication of herpes zoster (HZ). Treatment of this chronic pain syndrome and results are often not clear. Tricyclic antidepressants, gabapentinoids and potent opioids are first-line treatments and are highly effective, but their use is limited due to adverse effects that may occur in elderly patients with significant medical comorbidities or interaction due to multiple drug use. There are no head-to-head comparisons of non medical treatments. Dry needling appears comparable to conventional physical therapy for treating PHN.Objective:Our aim is to determine the incidence of PHN in our population and to compare the treatments in patients with postherpetic neuralgia.Methods:A search for HZ and PHN was conducted in a general practice research database, comprising 2 general practices (dermatologist and physiatrist) and representing 5600 people. We analyzed a retrospective 37 case with PNH of 170 herpes zoster patient admmited to the dermatology and physical therapy and rehabilitation outpatient clinic between October 2018 and October 2020. Dry needling and physical therapy methods applied in addition to medical treatment in PHN treatment were compared.Results:In patients with postherpetic neuralgia, both dry needling therapy group and physical therapy group LANSS scores decreased significantly in the first week and in the third week compared to baseline. Dry needling therapy group has also similar results in VAS scores in the first and third week. But in physical therapy group, the VAS score did not show a significant decrease in the first week compared to the baseline, but it decreased significantly in the third week.Conclusion:PHN is a complex, difficult to treat and severe neuropathic pain that affects patients’ daily function and quality of life. Various agents and methods are available to relieve the symptoms of PHN. This study shows as both physical therapy and dry needling therapy are effective treatment for postherpetic nevralgia..

Distinct effects of trampoline-based stretch-shortening cycle exercises on muscle strength and postural control in children with Down syndrome: a randomized controlled study.

The aim of the study was to investigate the effect of a 3-month, trampoline-based stretch-shortening cycle (SSC) exercises on muscle strength and postural control in children with Down's syndrome (DS). Thirty-two children with DS aged between 7-9 years were enrolled and randomly assigned into the control group (n = 16); received standard physical therapy (sPT) or SSC group (n = 16); received sPT in addition to a 15-minute, trampoline-based SSC training program twice per week for 12 successive weeks. Lower limb muscle strength and postural stability [anterior/posterior stability index (A/P-SI), medial/lateral stability index (M/L-SI)], and overall stability index (O-SI) were assessed pre- and post-treatment. Strength of hip extensor (p=0.034) and adductor (p=0.015), knee extensor (p=0.028) and flexor (p=0.01), and ankle dorsi (p=0.033) and plantar flexor (p=0.007) muscles increased significantly in the SSC group when compared with the control group. Also, the A/P-SI (p=0.019), M/L-SI (p=0.002), and O-SI (p=0.021) decreased significantly in the SSC group when compared with the control group, suggesting better postural control. Twelve weeks of trampoline-based SSC exercises are likely effective for enhancing muscle strength and postural control in children with DS and should consequently be included in the rehabilitation programs for these children.

Effects of Paraplegia Fitness Integrated Training on Physical Function and Exercise Self-Efficacy and Adherence Among Individuals With Spinal Cord Injury.

ObjectiveTo determine the effects of the Paraplegia Fitness Integrated Training (PARAFiT) program, which is an integrated graded physical exercise and health education program for individuals with spinal cord injury (SCI).MethodsThis nonrandomized single-blind study included 44 participants, who were assigned to either an intervention (PARAFiT) group or an active control (conventional physiotherapy) group. The intervention group underwent the PARAFiT program (8 weeks), which consisted of circuit-based interval training, progressive upper limb resistance training, and health education sessions. During the unsupervised period, the intervention group continuously underwent health education program once a month for 2 months (8 weeks). Repeated-measures analysis of variance was used for the analysis.ResultsThe intervention group presented with a higher level of physical activity than did the control group; however, the difference was not significant (p=0.36). Additionally, the intervention group presented with better exercise self-efficacy and cardiorespiratory fitness and stronger bilateral shoulder muscle and handgrip than did the control group (all p<0.05). Exercise adherence was higher in the intervention group than in the control group during both the supervised (80% vs. 75%) and unsupervised (40% vs. 20%) periods.ConclusionThe PARAFiT program enhanced the level of physical activity, exercise self-efficacy, physical fitness, and exercise adherence among the patients with SCI. Future studies should incorporate guidelines for home-based exercises and regular monitoring to promote long-term adherence to exercise and physical activity among individuals with SCI.

The 3-Month Effectiveness of a Stratified Blended Physiotherapy Intervention in Patients With Nonspecific Low Back Pain: Cluster Randomized Controlled Trial.

BackgroundPatient education, home-based exercise therapy, and advice on returning to normal activities are established physiotherapeutic treatment options for patients with nonspecific low back pain (LBP). However, the effectiveness of physiotherapy interventions on health-related outcomes largely depends on patient self-management and adherence to exercise and physical activity recommendations. e-Exercise LBP is a recently developed stratified blended care intervention comprising a smartphone app integrated with face-to-face physiotherapy treatment. Following the promising effects of web-based applications on patients’ self-management skills and adherence to exercise and physical activity recommendations, it is hypothesized that e-Exercise LBP will improve patients’ physical functioning.ObjectiveThis study aims to investigate the short-term (3 months) effectiveness of stratified blended physiotherapy (e-Exercise LBP) on physical functioning in comparison with face-to-face physiotherapy in patients with nonspecific LBP.MethodsThe study design was a multicenter cluster randomized controlled trial with intention-to-treat analysis. Patients with nonspecific LBP aged ≥18 years were asked to participate in the study. The patients were treated with either stratified blended physiotherapy or face-to-face physiotherapy. Both interventions were conducted according to the Dutch physiotherapy guidelines for nonspecific LBP. Blended physiotherapy was stratified according to the patients’ risk of developing persistent LBP using the Keele STarT Back Screening Tool. The primary outcome was physical functioning (Oswestry Disability Index, range 0-100). Secondary outcomes included pain intensity, fear-avoidance beliefs, and self-reported adherence. Measurements were taken at baseline and at the 3-month follow-up.ResultsBoth the stratified blended physiotherapy group (104/208, 50%) and the face-to-face physiotherapy group (104/208, 50%) had improved clinically relevant and statistically significant physical functioning; however, there was no statistically significant or clinically relevant between-group difference (mean difference −1.96, 95% CI −4.47 to 0.55). For the secondary outcomes, stratified blended physiotherapy showed statistically significant between-group differences in fear-avoidance beliefs and self-reported adherence. In patients with a high risk of developing persistent LBP (13/208, 6.3%), stratified blended physiotherapy showed statistically significant between-group differences in physical functioning (mean difference −16.39, 95% CI −27.98 to −4.79) and several secondary outcomes.ConclusionsThe stratified blended physiotherapy intervention e-Exercise LBP is not more effective than face-to-face physiotherapy in patients with nonspecific LBP in improving physical functioning in the short term. For both stratified blended physiotherapy and face-to-face physiotherapy, within-group improvements were clinically relevant. To be able to decide whether e-Exercise LBP should be implemented in daily physiotherapy practice, future research should focus on the long-term cost-effectiveness and determine which patients benefit most from stratified blended physiotherapy.Trial RegistrationISRCTN Registry 94074203; https://doi.org/10.1186/ISRCTN94074203International Registered Report Identifier (IRRID)RR2-https://doi.org/10.1186/s12891-020-3174-z

The effect of video-assisted discharge education after total hip replacement surgery: a randomized controlled study

This study aimed to investigate the effect of a video-assisted discharge education program on activities of daily living, functionality, and patient satisfaction following total hip replacement (THR) surgery. This study included 31 patients who were randomly divided into the physiotherapy group (n = 18), and the video-assisted discharge education (VADE) group (n = 13). Both groups received a physiotherapy program. The VADE group was also received the VADE program. Face-to-face instruction was used in all of the educational programs. There was a significant difference in favor of the VADE group in Harris Hip Score, Nottingham Extended Activities of Daily Living Scale’s movement score, Tampa Scale of Kinesiophobia, Patient Satisfaction Questionnaire (p < 0.05). There was a significant difference between groups on resting pain levels in the first week and on resting and activity pain levels in the third month in favor of the VADE group (p < 0.05). The results of this study demonstrated that VADE can be effective in improving patient satisfaction and functionality, reducing pain and kinesiophobia following THR.

A Retrospective Cohort Study Comparing the Outcomes of Conservative Versus Operative Fixation of Distal Radius Fractures in Children.

ObjectivesDistal radius fractures are common pediatric orthopedic injuries accounting for 25% of all fractures with a significant incidence in the age group 10-14 years. This study aims to evaluate the operative and non-operative methods of treating distal radius fractures in children.MethodsThis is a retrospective cohort study conducted on 176 children with distal radius fracture. We studied the operative and non-operative treatments of all children presented with distal radius fracture to the emergency department of the Bahrain Defense Force (BDF) Hospital from January 1, 2015, to February 1, 2022. The inclusion criteria were as follows: age of 17 years or younger, distal radius fracture with or without complete displacement and skeletal immaturity managed as of non-operative or operative groups. Patients who did not have follow-up data after the date of surgery were excluded. The statistical analysis was performed using the software SPSS version 23.0 (IBM Corp., Armonk, NY). Continuous data expressed as mean, standard deviation and discrete variables were expressed as frequency and percentages. One-way Analysis of Variance (ANOVA) was used to compare the continuous variables between groups. The Student’s t-test was used for the two-group comparison. For the comparison of discrete variables, a Chi-Square test or Fisher’s exact test was used.ResultsSeventy-seven patients were conservatively managed with cast immobilization (“non-operative” group) in comparison to 99 patients who were surgically managed (“operative” group) with either percutaneous pinning (n=56) or flexinail (n=43). Fewer patients underwent physiotherapy in the operative group with 14 (25.0%) patients for percutaneous pinning and seven (16.3%) patients for flexinail versus 31 (40.3%) patients in the non-operative group (p<0.015). There were statistically significant differences in radial inclination (p<0.001) between conservative and percutaneous pinning (22.22±2.86 vs 18.76±3.33 degrees) and percutaneous pinning and flexinail (18.76±3.33 vs 22.37±3.44 degrees). Likewise, there was a significant difference found in ulnar variance between conservative and percutaneous pinning (-0.45±2.14 mm vs -1.47±1.93 mm, p=0.012) and conservative and flexinail (-0.45±2.14 mm vs -1.59±1.90 mm, p=0.009). There were a total of 25 documented complications. Nineteen (19.8%) complications occurred in the non-operative group versus five (7.2%) and one (2.3%) complications in percutaneous pinning and flexinail groups, respectively (p=0.003). The most common complication in the non-operative group was loss of reduction while in cast and subsequent need for surgical intervention. Ten of these patients underwent percutaneous pinning whereas nine were fixed by flexinail.ConclusionThis study illustrated an overall similar success between the surgical and the conservative treatments of distal radius fractures in children. Due to the higher complication rate reported in the conservative group, the conservative treatment cannot be considered safer than the surgical treatment.

Ultrasound-guided genicular nerve block versus physical therapy for chronic knee osteoarthritis: a prospective randomised study.

To compare the effectiveness of ultrasound-guided genicular nerve block (GNB) and physical therapy (PT) in patients with chronic knee osteoarthritis. A prospective randomised study with 102 patients (45–70 years) was performed wherein the patients received ultrasound-guided GNB (n = 51) and PT (n = 51) along with a standard home exercise programme. Scores for pain on a Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and 6-min walking test (6MWT) were assessed pre-treatment and at 2- and 12-weeks post-treatment. Both groups were comparable for sociodemographic characteristics. VAS scores (in mm) in the ultrasound-guided GNB group at 0, 2 and 12 weeks were 7.01 ± 1.36; 3.71 ± 2.18; 5.08 ± 2.22 (p < 0.001) and 6.64 ± 1.99; 4.35 ± 1.09; 5.25 ± 1.33, (p < 0.001) in the PT group. While the increase in the 6MWT test in the 2nd week was similar for both groups (p = 0.073), the increase in walking distance was greater in the ultrasound-guided GNB group at 12 weeks (p = 0.046). As compared to PT, ultrasound-guided GNB is beneficial in reducing pain and increasing functional and physical capacity, with greater retention of effects on the physical capacity seen at 12 weeks. Trial registration number: ClinicalTrials.gov (NCT04782401).

Effect of tetraataxiometric posturography programs (TETRAX) on stroke patients with impaired standing balance

ABSTRACT Patients are suffering from stroke experience balance dysfunction leading to poor weight shifts and reduced weight bearing on the affected lower limb. The Tetrax biofeedback system is a Centre of Pressure-controlled, video game-based exercise system designed for patients with balance dysfunction. Objective: This study aimed to investigate the effects of using Tetrax balance games and conventional rehabilitation on the balance and mobility of subjects with impaired standing balance due to stroke. Design: Pretest-posttest Randomized Clinical Trial Method: A total of thirty patients (including male and female) who have suffered a stroke at least six months back, diagnosed with hemiplegia within the age group of 35-65 years with MMSE Score = 24 were recruited. Six subjects did not give their consent. Subjects were assigned to Group 1 (test group) and Group 2 (control group), using Convenience sampling. Group 1 (test group) consisted of 12 subjects (both male and female) and received conventional therapy and tetrax sessions. Group 2 (control group) consisted of 12 subjects (both male and female) and received only conventional therapy. All participants received conventional outpatient rehabilitation therapy (which accounted for an average of 60 minutes of physiotherapy for the control group and 40 minutes for the test group per day) three days a week in an outpatient setting. The test group received additional Tetrax biofeedback balance training three days per week (20 minutes per day) for four weeks in the same outpatient setting. The Tetrax system was equipped with four independent force plates under the toes and heels. The outcome measures of the study were BBs and FIMS. All outcome measures were evaluated pretest and posttest. Result: The means standard deviations of Improvement in BBS in test and control groups are 3.83 4.64 and 1.25 1.28, respectively. On applying the t-Test, we found the mean difference of 0.077 of Improvement in BBS in the test and control group is not significant. The means standard deviations of Improvement in FIMS in test and control groups are 2.83 2.24 and 1.75 1.21, respectively. On applying the t-Test, we found the mean difference of 0.156 of Improvement in FIMS in the test and control group is not significant. Conclusion: The current study found that both groups—those receiving only conventional therapy and those receiving a combination of tetrax and conventional therapy—improved their balance significantly, although there was no significant difference between them. Keywords: Stroke, Tetrax, Balance, Weight shift in lower limbs, Postural Balance.

Physiotherapeutic Reduction of Orofacial Pain Using Extremely Low-Frequency Electromagnetic Field and Light-Emitting Diode Therapy-A Pilot Study.

Introduction Pain is a natural response of the body to injury and one of the symptoms defining an inflammatory reaction. It is almost always present after orthognathic surgeries (OGS), but its severity is subjective in each patient. Postoperative care of the patient is aimed at minimizing of postoperative pain relief orofacial region. Options of physiotherapy include extremely low-frequency electromagnetic field (ELF EMF) and high-energy light-emitting diode (LED). Aim of the Study. The aim of this study was to evaluate the effects of physiotherapy combining ELF EMF and LED to reduce pain of the orofacial region in patients after OGS. Material and Methods. The study was conducted in thirty-two patients who underwent OGS to treat morphological defects. The participants were randomly divided into two groups: Physiotherapy group (PT) and Control group (CG). In both groups, patients were prescribed Paracetamol and nonsteroidal analgesics (NSAID—ibuprofen). Patients from the PT group additionally received postoperative physiotherapy immediately after leaving the surgical clinic in the form of ELF EMF and LED therapy. Physiotherapeutic treatments were performed for 10 days, three applications a day, at no cost to the patient. Pain intensity was assessed using the visual analogue scale (VAS), which is a reliable instrument for the measurement of pain intensity self-reported by the patient. Results Faster reduction of pain was the major observation made in patients who received physiotherapy treatments. In all subjects, after 5 days of therapy, the pain intensity was reduced by about 50% or resolved completely. Effects of therapy were measured with the relative changes in the pain intensity score, showing what fraction of the initial pain was eliminated at the first stage and throughout the whole therapy. The analysis of relative changes instead of absolute changes allowed us, among other things, to eliminate the bias of the higher initial pain intensity in the CG group compared to the PT group. Conclusions The conducted research revealed that the combined use of ELF EMF and LED is beneficial in the reduction of pain of patients after OGS. The analgesic effects of physiotherapy in the treatment after OGS are necessary to continue research in this area and analyze the possibility of extending the indications for its use in other surgically treated maxillofacial diseases.

A systematic review and meta-analysis of neostigmine for urinary retention after surgeries.

BackgroundThe aim of this research is to analyze the efficacy of neostigmine in the treatment of postoperative urinary retention (POUR).MethodsIn this research, we screened multiple databases including PubMed, EMBASE, Web of Science, and Chinese National Knowledge Infrastructure (CNKI). After a systematic search process, data extraction was conducted. Review Manager 5.2 was adopted for meta-analysis, sensitivity analysis, and bias analysis.ResultsAfter searching for articles, 20 eligible trials including 1,850 patients after surgery were extracted. Our results suggested that the neostigmine group had a higher effective rate for urinary retention than the Chinese traditional and physical therapy group (OR =7.47, 95% CI: 4.10–13.59, overall effect P<0.001). Further subgroup analysis showed that neostigmine acupoint injection was better than neostigmine intramuscular injection. Time to first voiding in the neostigmine acupoint injection group was shorter than that in the neostigmine intramuscular injection group (MD =–81.92, 95% CI: –130.13 to –33.70, overall P<0.001, I2=99% with random effects model). Furthermore, neostigmine acupoint injection improved urine excretion (MD =243.40, 95% CI: 201.62–285.18, overall P<0.0001) and reduced the residual urine volume (MD =–41.31, 95% CI: –58.05 to –24.58, overall P<0.001, I2=75% with random effects model). The results of the sensitivity analysis and publication bias showed that this research was robust and had little publication bias.DiscussionOur meta-analysis results suggest that neostigmine can effectively improve the symptoms of POUR and neostigmine acupoint injection may achieve a better therapeutic effect.