Therapeutic Exercise In Patients Research Articles

Evaluation of the efficacy of manual soft tissue therapy and therapeutic exercises in patients with pain and limited mobility TMJ: a randomized control trial (RCT)

SummaryThe limited number of randomized controlled trials (RCTs) comparing the efficacy of soft tissue manual therapy and self-therapy interventions prompted the authors to focus on the analgesic and myorelaxant use of massage, post-isometric muscle relaxation (PIR) and therapeutic exercise in TMD patients.ObjectivesTo evaluate the effectiveness of soft tissue therapy and therapeutic exercises in female patients with pain, increased masseter muscle tension and limited mandibular mobility.Material and methodsThe study was conducted on a group of 82 women (G1) with the Ib disorder diagnosed in DC/TMD (Ib—myofascial pain with restricted mobility). The control group (G2) consisted of 104 women without diagnosed TMDs (normal reference values for TMJ ROM and masseter muscle sEMG bioelectric activity). Diagnostic procedures were performed in both groups (sEMG of the masseter muscles at baseline and during exercise, measurement of TMJ mobility, assessment of pain intensity—NRS scale). The G1 group was randomly divided into 3 therapeutic groups in which the therapy was carried out for 10 days: therapeutic exercises (TE), manual therapy – massage and therapeutic exercises (MTM_TE), manual therapy – PIR and therapeutic exercises (MTPIR_TE). Each time after therapy, the intensity of pain and TMJ mobility were assessed. Sealed, opaque envelopes were used for randomization. After 5 and 10 days of therapy, bilateral sEMG signals of the masseter muscles were acquired.ResultsMassage, PIR and self-therapy led to a decrease in sEMG at rest as well as in exercise. After day 6 of therapy, the groups obtained a significant difference (p = 0.0001). Each of the proposed forms of therapy showed a minimal clinically significant difference (MID) in the sEMG parameter at the endpoint, with the most considerable difference in the MTM_TE group. The forms of MT used were effective in reducing the patients’ pain intensity; however, a significant difference between therapies occurred after 4 treatments (p = 0.0001). Analyzing the MID between methods, it was observed that self-therapy had an analgesic effect only after 8 treatments, while PIR after 3 and massage after 1 treatment. After day 7, the mean pain score in the MTM_TE group was 0.889 and in the TMPIR_TE group was 3.44 on the NRS scale. In terms of MMO, a significant difference was obtained between monotherapy and each form of TM, i.e. massage (p = 0.0001) and PIR (p = 0.0001). Analyzing mandibular lateral movements, the authors got a significant difference in the proposed MT forms, of which massage treatments exceeded the effectiveness of PIR.ConclusionsSoft tissue manual therapy and therapeutic exercise are simple and safe interventions that can potentially benefit patients with myogenic TMDs, with massage showing better analgesic effects than PIR.

EVALUATION OF THE THERAPEUTIC EFFECTS OF TRANSCUTANEOUS INTERFERENTIAL CURRENT THERAPY AND THERAPEUTIC EXERCISES ON MUSCULOSKELETAL SYMPTOMS IN PATIENTS WITH POST COVID-19

The aim of this research was to investigate the therapeutic effectiveness of a multi-component rehabilitation program including: transcutaneous interferential current therapy and therapeutic exercises in patients with musculoskeletal symptoms in post COVID-19 syndrome. Materials and Methods: 62 patients, mean age 55.9(13.99), aged 21 to 79 years, with persistent musculoskeletal symptoms in the recovery phase after experiencing COVID-19 were included in this study. All patients underwent a ten-day treatment course in an outpatient setting, including transcutaneous application of interferential current with four electrodes. The therapeutic parameters were selected with analgesic, trophic and stimulating effects (90-100 Hz, 5min and 0-100 Hz, 15min). Immediately after electrotherapy, kinesitherapy was performed including: breathing exercises, aerobic training, active and resistance exercises for the limbs, postural control exercises and exercises to improve the mobility of the peripheral joints and the axial skeleton. Results were evaluated by: Visual Analogue Scale (VAS) for assessment of back pain, Numerical Rating Scale (NRS) for arthralgia and myalgia assessment, Brief Fatigue Inventory (BFI) – fatigue assessment, functional tests of mobility, Goniometry in the spine, Ott Sign- for measuring the range of motion (ROM) of the thoracic spine, Schober’s test to determine a lumbar spine range of motion (flexion), Tom Meyer’s test for total hip joint and spine flexion mobility. The results were reported before and after the rehabilitation. The statistical significance level was specified as (p<0.05). Results: Musculoskeletal symptoms in the observed patients persisted for an average of 12 weeks, ranging from 7 to 20 weeks, and included: myalgia in 46.8% (29), arthralgia 29.0% (18), pain in various back departments 79.0% (49), fatigue 66.1% (41). Inpatient treatment for acute COVID-19 was performed in 35.5% (22) of patients, and home and outpatient treatment in 64.5% (40). There was a statistically significant reduction (Mean (SD)) after therapy in back pain (VAS) from 4.88(1.5) to 1.93(1.1), myalgia (NRS) from 3.66(1.2) to 1.29(1.1), arthralgia (NRS) from 3.27(1.2) to 0.89 (0.8), and fatigue index (BFI) showed a reduction from 5.73(1.4) to 3.22(1.4). There was an increase in mobility in Ott’s symptom from 2.24(1.2) to 2.86(0.9) cm, Schober’s test 1.41(1.2) to 2.38(0.9) cm, Tom Meyer’s test from - 8.23(6.5) to - 2.46(3.7) cm. Conclusion: In the recovery phase post COVID-19, some of the patients had long-time persistent musculoskeletal symptoms (fatigue, myalgia, arthralgia, back pain). These are a common reason for these patients to be referred for outpatient rehabilitation. In order to design a multi-component rehabilitation programme, it is necessary to take into account individual characteristics and comorbidities. The inclusion of physical modalities such as electrotherapy requires an accurate assessment of the rehabilitation potential and the presence of any counterindications. Therapeutic exercises have been proven to be effective in post COVID-19 patients. The results of this study show that the combination of interferential current therapy and therapeutic exercise can effectively reduce back pain, myalgia, arthralgia, and perception of fatigue. On the other hand, this multicomponent program resulted in improvement in functional tests in the studied patients. Due to the small sample size, it is advisable to continue the study in the future, covering a larger number of patients with long-standing musculoskeletal symptoms as part of post-COVID-19 syndrome, in order to design an effective strategy that can efficiently reduce negative health consequences and improve functional activity in these patients.

Effects of Radiofrequency Diathermy Plus Therapeutic Exercises on Pain and Functionality of Patients with Patellofemoral Pain Syndrome: A Randomized Controlled Trial

Although consensus has been reached about the use of therapeutic exercise in patellofemoral pain syndrome, several techniques used worldwide such as radiofrequency diathermy could be useful as complementary therapy. The objective of this randomized controlled trial was to compare the effects of adding radiofrequency diathermy to therapeutic exercises in patients with patellofemoral pain syndrome. Fifty-six participants were randomly assigned either to radiofrequency diathermy plus therapeutic exercises group (n = 29) or therapeutic exercises group (n = 27). Both groups received the same therapeutic exercises, and the diathermy group additionally received monopolar dielectric diathermy for three weeks (5-3-2 weekly sessions). Data related to intensity of pain, probability of neuropathic pain, functionality, and range of movement of the knee were measured at baseline and three weeks after the intervention. Comparing pre-treatment and values obtained at the third week, significant improvements were found in intensity of pain, neuropathic pain, functionality, and range of motion in both groups (p < 0.05). The diathermy plus exercises group had significantly better intensity of pain than the control group at the end of the three weeks (p < 0.01). The addition of diathermy by emission of radiofrequency to the therapeutic knee exercise protocol is more effective than a therapeutic exercise protocol alone in the relief of intensity of pain in patients with patellofemoral pain in the immediate post-treatment follow-up compared with baseline scores.

The use of electrotherapy in complex treatment programs for patients after total arthroplasty

BACKGROUND: Total knee arthroplasty is one of the most common surgical interventions in the world and the Russian Federation. Endoprosthetics of the knee joint occupies a leading place in the structure of surgical methods for the treatment osteoarthritis.&#x0D; AIM: of the study was to scientifically substantiate the feasibility of the complex use of electrical stimulation and therapeutic exercises in patients after total knee arthroplasty.&#x0D; MATERIALS AND METHODS: We examined 60 patients who were admitted 3 months after TCS and were randomized into 2 groups. In the first group, 30 subjects received electrical stimulation of the quadriceps muscles and underwent therapeutic exercises, for a course of 10 procedures. The subjects of the second group, 30 people, had only physiotherapy exercises.&#x0D; RESULTS: The use of electrotherapy and physiotherapy exercises, in the complex treatment of patients after total knee arthroplasty, improves the function of joint mobility. This is confirmed by the improvement in the functional activity of the operated joint according to the KSS scale (Кnee Society Scores), the improvement in the state of microcirculation and the positive dynamics of the pain syndrome according to the VAS (Visual Analog Scale). The obtained data of the HAQ (Health Assessment Questionnaire) questionnaire testify to the expansion of the possibilities for performing most of the activities in everyday life. However, more statistically significant results were obtained in patients after a course of quadriceps electrical stimulation and therapeutic exercises compared with the use of therapeutic exercises alone.&#x0D; CONCLUSION: The complex of rehabilitation of patients after total knee arthroplasty presented by us, including electrostimulation and therapeutic gymnastics, is scientifically sound, effective and can be implemented into the basic scheme of outpatient and sanatorium treatment of this category of patients.

Use of QR Codes for Promoting a Home-Based Therapeutic Exercise in Patients with Lumbar Disc Herniation and Lumbar Spinal Stenosis: A Prospective Randomized Study.

In the current study, we investigated the usefulness of the quick response (QR) code linked to the source of a video of home-based therapeutic exercise to promote home-based therapeutic exercise in patients with LDH and LSS. Forty patients with LDH and LSS were included in this study. The patients were randomly assigned to one of two groups: QR codes or control groups (20 patients per group). The QR code group received QR code stickers linked with a video that includes a demonstration on how to exercise for the back muscles. We instructed the patients to perform home-based therapeutic exercises three or more days a week. Patients in the control group were asked to perform the therapeutic exercise without providing a QR code to them. The primary outcome was the number of exercises per week. The scores of the numeric rating scale (NRS) and Oswestry disability index (ODI) were investigated as secondary outcomes. The patients in the QR code group exercised for the lower back muscles on average about two times a week, and 40% of the patients in the QR code group performed the exercise three or more days a week. However, almost no patients in the control group performed therapeutic exercises. Patients in the QR code group showed significantly lower ODI scores at the 1-month and 2-month follow-ups compared with the control group. In addition, the patients who exercised ≥3 times per week showed more improvement in the disability than those who exercised <3 times per week. The NRS scores for lower back pain and radicular leg pain were not significantly different between the QR code and control groups. We found that QR codes can be useful for encouraging patients with LDH or LSS to perform home-based therapeutic exercises.

Telehealth Delivery Of Therapeutic Exercise For Musculoskeletal Disorders During A Global Pandemic

The COVID-19 pandemic has globally disrupted the delivery of healthcare services, particularly for interventions that traditionally require face-to-face interactions, such as manual techniques and therapeutic exercise. Telehealth provides a potential alternative to in-clinic care. However, it has not been well-studied for delivering therapeutic exercise in patients with musculoskeletal (MSK) disorders and little guidance is available on implementation. PURPOSE: The purpose of this paper was to describe the implementation process of a telehealth program for delivering therapeutic exercise in patients with MSK disorders during a global pandemic. METHODS: A quality project was conducted to implement a telehealth program in an outpatient physical therapy organization in the United States. Various implementation outcomes were assessed, such as adoption, adherence, barriers and facilitators, safety, and satisfaction. Representative cases of patients with MSK disorders were also reviewed to illustrate challenges and solutions when administering a telehealth plan of care including exercises. RESULTS: A telehealth program to deliver therapeutic exercise was successfully implemented for patients with MSK disorders presenting for outpatient physical therapy. Barriers, such as limited exercise equipment, technology difficulties, and fall risk safety, were addressed through creative approaches in the home setting. Adherence was high and no adverse events were reported. At its peak, approximately 900 patient visits per month were conducted via telehealth, representing approximately 7% of the total volume. Review of cases suggested good functional outcomes and high satisfaction. CONCLUSION: This project provided insight about implementing a telehealth program focusing on therapeutic exercise for the management of patients with MSK disorders. The findings of this project indicate that telehealth delivery in a physical therapy plan of care is safe, enhances patient access, and allows for continuity of care, which may result in improved functional outcomes. Research is needed to determine the effectiveness of telehealth and updated regulations are needed to clarify roles of providers who are qualified to deliver therapeutic exercises via telehealth.

Comparison of the Effects of Isokinetic, Isometric, and Isotonic Exercises on Knee Osteoarthritis Using Ultrasound.

Introduction: This study aims to investigate the effects of different types of exercise on pain, functional capacity, muscle strength measured by an isokinetic dynamometer, and femoral cartilage (FC) thickness measured using ultrasound in patients with knee osteoarthritis (KOA).Methods: Sixty patients were randomized to isokinetic, isometric, and isotonic exercise groups, and exercise programs were completed five days a week over three weeks. The FC thickness for each knee was evaluated in medial, intercondylar, and lateral areas using ultrasound, and muscle strength was assessed by an isokinetic dynamometer. Activity levels were also measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). At three weeks from baseline, follow-up clinical measurements of knee muscle strength and FC thickness were performed.Results: A significant decrease was observed in all three groups in post-treatment visual analog scale (VAS) pain scores. In terms of evaluation of WOMAC scores, no significant difference was observed between the groups. In the isokinetic group, a significant increase was detected in extensor and flexor muscle strength measurements at the angular velocities of 60º/s and 180º/s. In the isotonic group, a statistically significant increase was detected in peak torque values of extensor and flexor muscles at 60º/s in the left knee only. Regarding FC thickness, a significant increase was found in the intercondylar area and the lateral condyle measurements of the left knee in the isokinetic group and the intercondylar area measurements of the right knee in the isometric group. In the isokinetic group, a statistically significant decrease was detected in the medial condyle of the right knee. It was observed that isokinetic exercise ended up with a significant increase in FC thickness in the intercondylar area and the lateral condyle of the left knee and a significant decrease in the medial condyle of the right knee.Conclusion: Isokinetic exercise is functionally superior to isometric and isotonic exercise, providing more significant improvements in muscle strength measurements and FC thickness. Further research is needed to determine the interactions among therapeutic exercises in patients with KOA that impact knee cartilage quantities.

The Effect of Manual Therapy Plus Exercise in Patients with Lateral Ankle Sprains: A Critically Appraised Topic with a Meta-Analysis.

A high percentage of patients with lateral ankle sprains report poor outcomes and persistent neuromuscular impairment leading to chronic ankle instability and re-injury. Several interventions have been proposed and investigated, but the evidence on manual therapy combined with therapeutic exercise for pain reduction and functional improvement is still uncertain. The purpose was to study the effectiveness of adding manual therapy to therapeutic exercise in patients with lateral ankle sprains through a critically appraised topic. The literature search was performed in PubMed, PEDro, EMBASE and CINAHL databases, and only randomized clinical trials were included according to following criteria: (1) subjects with acute episodes of lateral ankle sprains, (2) administered manual therapy plus therapeutic exercise, (3) comparisons with therapeutic exercise alone and (4) reported outcomes for pain and function. Three randomized clinical trials (for a total of 180 patients) were included in the research. Meta-analyses revealed that manual therapy plus exercise was more effective than only exercises in improving dorsal (MD = 8.79, 95% CI: 6.81, 10.77) and plantar flexion (MD = 8.85, 95% CI 7.07, 10.63), lower limb function (MD = 1.20, 95% CI 0.63, 1.77) and pain (MD = −1.23; 95% IC −1.73, −0.72). Manual therapy can be used with therapeutic exercise to improve clinical outcome in patients with lateral ankle sprains.

Well-described exercises for chronic low back pain in Life Science Literature: A systematic review.

Therapeutic exercise (TE) is recommended in multimodal treatment for patients with non-specific chronic back pain (cLBP). The aim of this study is to identify an exercise or a spectrum of exercises, well described and reproducible by the clinician, for cLBP patients. Systematic review by researching in the databases MEDLINE, EMBASE, PEDro, CINAHL, and Scopus. Evidence from Randomized Controlled Trials (RCTs) supported the TE in patients with non-specific cLBP, provided that it was well described and could be repeated by another therapist. Methodological evaluation was performed using the PEDro scale and only studies with a score of ⩾ 6 were included. The assessment of the intervention description was carried out with the TIDieR checklist. The risk of bias was examined. Twenty-one articles were included in this systematic review. The defective description and the poorly reporting of the intervention makes it more difficult for the clinician to include the TE into clinical practice. The findings of this study showed that the reporting of the intervention in high quality RCT on chronic low back pain is low, threatening the external validity of the results.

Visually Induced Kinaesthetic Illusion Combined with Therapeutic Exercise for Patients with Chronic Stroke: A Pilot Study.

ObjectiveKinaesthetic perceptional illusion by visual stimulation (KINVIS) combined with neuromuscular electrical stimulation (NMES) and conventional therapeutic exercise (TherEX) has been shown previously to enhance motor function in stroke patients with chronic hemiparesis. The aim of this preliminary study is to assess the effects of a repetitive KINVIS intervention combined with TherEX, but without NMES, on upper limb motor function of patients with stroke-induced hemiparesis.DesignA quasi-experimental study, with pretest–posttest for 1 groupPatientsTen patients with stroke-induced, chronic, severe upper limb hemiparesis.MethodsPatients were evaluated before and after a 10-day intervention, during which KINVIS and TherEX were applied for 20 and 60 min, respectively, for 5 days per week (Monday to Friday). Upper limb motor function was assessed using Fugl-Meyer Assessment (FMA) and Action Research Arm Test (ARAT), and resistance to passive movement in flexor muscles was assessed using the Modified Ashworth Scale (MAS). In addition, the amount of use and quality of movement of the affected upper limb in daily life were assessed using Motor Activity Log (MAL).ResultsClinical assessments with FMA, ARAT, MAS, and MAL significantly improved after the intervention period.ConclusionA repetitive KINVIS intervention combined with TherEX may improve upper limb motor function in patients with chronic stroke and severe hemiparesis.LAY ABSTRACTKinaesthetic perceptional illusion by visual stimulation (KINVIS) combined with neuromuscular electrical stimulation (NMES) and a conventional therapeutic exercise (TherEX) enhance muscle use in stroke patients with chronic paralysis. This preliminary study assessed the effects of a repetitive KINVIS intervention with added TherEX, but without NMES, on the use of the arm in Ten patients with stroke-induced paralysis. Ten patients with stroke-induced chronic paralysis were evaluated before and after a 10-day intervention, during which KINVIS and TherEX were applied for 20 and 60 min, respectively, for 5 days per week (Monday to Friday). The use of the paralysed arm improved significantly after the intervention. The repetitive KINVIS intervention combined with TherEX may improve the use of the arm in patients with chronic paralysis due to stroke.

Effects of therapeutic exercises in patients with lung cancer. A scoping review

IntroductionLung cancer is one of the most common malignancies worldwide and the leading cause of cancer-related death. Smoking is one of the main risk factors associated with this cancer. Treatment will depend on the form of cancer and its stage, existing many therapeutic possibilities. In this regard, therapeutic exercise plays an important role in lung cancer care, as well as the pulmonary rehabilitation and respiratory physical therapy. PurposeTo review the current scientific literature about the effects of therapeutic exercise in lung cancer. MethodA search was carried out in CINAHL, MEDLINE, PubMed, Scopus y Web of Science using de terms “Exercise Therapy” and “Lung Neoplasms”. 141 studies were obtained, but only 19 were selected by adjusting to the inclusion and exclusion criteria. 10 of them were randomized controlled trials with a Jadad score between 2 and 3. ResultsThese works performed a large variety of interventions based on therapeutic exercise, classified in preoperative, postoperative, during treatment, post treatment and combination. Most focused on aerobic exercise, muscle strength and respiratory exercises. Conclusion: therapeutic exercise seems to be positive and obtain significant improvements in patients with lung cancer, regardless the moment of intervention and the type of exercise performed.

MUSCULOSKELETAL SYMPTOMS IN PATIENTS WITH POST COVID-19 SYNDROME AND OPPORTUNITIES FOR INCREASED FUNCTIONAL ACTIVITY

There is an increasing number of patients surviving SARS-CoV-2 infection who have no evidence of acute infection but who continue to have symptoms that persist and shape the post COVID-19 symptoms (PCS). Musculoskeletal symptoms (MSK), as part of the PCS, lead to reduced functional activity and cause prolonged suffering. The purpose of this review is to identify the main MSK symptoms in PCS and to review physical interventions that may have a beneficial effect in reducing MSK complaints and increasing functional activity in PCS. Materials and methods: A review of the literature was performed, including articles about MSK symptoms in patients with PCS and the possible physical interventions used in rehabilitation of these patients, with impact on symptoms, functional capacity, and functional activity. The scientific articles research took place in the bibliographic database of PubMed. The search results were found for: post-COVID-19 (PCS) syndrome, long COVID, post-acute sequelae of SARS-CoV-2 infection (PASC), chronic COVID syndrome (CCS), Musculoskeletal symptom, Pain post-COVID, physical function, Rehabilitation post-COVID, exercise, physical activity, functional capacity, traditional Chinese medicine. Results: The review found evidence of prolonged persistence of MSK symptoms as part of PCS syndrome. Fatigue, myalgia, back, waist and neck pain and arthralgia (pain in the peripheral joints) are the most reported symptoms. Data showing the need for rehabilitation and the positive effect of physical therapy and therapeutic exercises in patients with PCS to reduce pain and increase functional activity was found. Conclusion: Increasing physical activity in patients with PCS is likely to have a beneficial effect on general conditioning, physical function, and functional recovery, helping to overcome the effects of infection, reducing pain, and reducing emotional stress. Individually targeted physical interventions are recommended, including multimodal programs, exercises for overall muscle strengthening, increasing joint stability, cycling training, Individually targeted physical interventions are recommended, including multimodal programs, exercises for overall muscle strengthening, increasing joint stability, cycling training, electrical modalities -Transcutaneous electrical nerve stimulation (TENS) for pain symptoms. Rehabilitation should be applied after detailed functional assessment and shaped be carried out with the participation of a multidisciplinary rehabilitation team. The development of appropriate rehabilitation strategies will allow the achievement of optimal functional recovery and increased functional activity, satisfactory to the patient and will reduce the economic burden of prolonged reduced work capacity.

The effect of therapeutic exercise and vegan diet on pain and quality of life in young female patients with chronic non-specific neck pain

Background and purposeIn recent years, dietary practices have begun to be used in painful conditions. This study aimed to investigate the effect of a vegan diet and therapeutic exercise in patients with chronic non-specific neck pain.Materials and methodsA total of 45 young female patients with chronic non-specific neck pain, aged 18–25 years, participated in the study. Body mass index and body fat percentage were measured with bioelectrical impedance analysis. Pain severity was assessed using the Visual Analogue Scale, quality of life with the short form-36 scale, kinesiophobia with the Tampa scale of kinesiophobia and neck disability with the Neck Disability Index.ResultsThe pain severity reduced in the diet group and exercise group after treatment (p = 0.001). After treatment, Neck Disability Index score decreased in the diet group and exercise group (p = 0.001). Tampa scale of kinesiophobia score decreased in the diet group and exercise group (p = 0.001). The eight domains of the short form-36 scale score increased in the diet group and exercise group (p < 0.05). No difference was found in the body mass index and fat percentage in all groups before and after treatment (p˃ 0.05).ConclusionA vegan diet and therapeutic exercise are beneficial to patients with chronic non-specific neck pain in terms of pain severity and quality of life.

Factors for Individualization of Therapeutic Exercises for the Design of Health-Enabling Technologies.

Designing health-enabling technologies (HETs) to support individualized physiotherapeutic exercises requires comprehensive knowledge of bio-psycho-social factors to be considered. Therefore, this review identified factors for individualization of therapeutic exercises in patients with musculoskeletal shoulder disorders in peer-reviewed articles searched in MEDLINE. The final full-text analysis included 16 of 335 search results and extracted nineteen main categories of individualization factors. The most frequently identified main categories include progression of exercises, exercise framework, and assessment. An iterative approach with constant reassessments represents the key principle for the process of individualization. Categories that are difficult to standardize were rarely mentioned, but should also be considered. The identified factors can improve the design-process of HETs by sensitizing developers, enable further formal modelling, and support communication between developers, physiotherapists, and patients.

USE OF NON-DRUG METHODS IN THE TREATMENT OF PATIENTS WITH ARTERIAL HYPERTENSION

The aim of the study is to optimize the comprehensive treatment of patients with severe arterial hypertension, through the use of multicomponent rational antihypertensive pharmacotherapy, followed by the use of unloading therapeutic exercises. 32 men with severe arterial hypertension were examined. Initially, a clinical, instrumental and laboratory examination, registration of blood pressure and its 24-hour monitoring were carried out. The average daily systolic (ADBPsyst.) and average daily diastolic (ADBPdiast.) blood pressure were determined. A multicomponent rational antihypertensive pharmacotherapy, according to the clinical recommendations for the treatment of arterial hypertension was selected for all the patients. In at least 3 months after the selection of pharmacotherapy, the patients were divided into two groups, comparable in gender, age, severity of the condition, features of the disease course and medicamentous therapy. Patients of the 1st group (active treatment group) against the background of pharmacotherapy were prescribed unloading therapeutic exercises according to a patented technique. The 2nd group of patients continued to take pharmacotherapy and it was used as a baseline group. The average age in the 1st and 2nd groups was 46,3±6,8 and 43,6±7,2 years, respectively. Patients of the 1st group were prescribed unloading therapeutic exercises and in 3 months in both groups the ADBPsyst. and ADBPdiast. were compared. Initially, there was a significant increase in ADBPsyst. and ADBPdiast. compared to the normal range in both groups. These indicators in both groups differed insignificantly. In 3 months after pharmacotherapy, there was a significant decrease in ADsyst. and ADdiast. in both groups, but these indicators remained elevated and did not reach the target level. Then, in the 1st group, unloading therapeutic exercises were included in the comprehensive treatment. Patients of the 2nd group continued to receive pharmacotherapy. In 3 months after including unloading therapeutic exercises in the 1st group, there was a significant decrease in ADBP (syst. and diast.) not only in comparison with the initial data, but also with the data in 3 months after pharmacotherapy. In the 2nd group, these indicators did not change significantly compared to the three-month data. In 6 months, ADBPsyst. and ADBPdiast. in the 1st group were significantly lower compared to similar indicators in the 2nd group, which proves significant clinical effectiveness of unloading therapeutic exercises in patients of the 1st group. The results obtained confirm that patients with severe arterial hypertension have such types of disorders at the cellular-tissue and microcirculatory level that are not eliminated only by drug therapy. For their high-grade correction, along with multicomponent pharmacotherapy, it is necessary to include unloading therapeutic exercises. To optimize the treatment of severe arterial hypertension against the background of receiving multicomponent antihypertensive pharmacotherapy, it is recommended to include unloading therapeutic exercises in the therapeutic complex.

The effect of therapeutic exercise on depressive symptoms in people with multiple sclerosis

Introduction: Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system. It involvesa wide range of symptoms, with depression being one of the main sources of disability for patients living with MS. Aim: The aim of this study was to perform a review of the literature on the effects of exercise on depressive symptoms in patients with MS, with the main focus on the benefits of physiotherapy, therapeutic exercise, and telerehabilitation. Methods: The review was performed using the databases of Medline, PubMed, and other sources, such as Google Scholar and Elsevier. The keywords used for the conduction were therapeutic exercise, physiotherapy, physical therapy, rehabilitation, telerehabilitation, depression, and multiple sclerosis. The inclusion criteria consisted of studies: a) published between 2010-2021, b) looking into the effects of depression and/or therapeutic exercise in patients living with MS, and c) written in English. The exclusion criteria used were:a) patients not diagnosed with MS, b) pilot studies, c) case studies, and d) studies published prior to 2010. Results:Of the 211 potentially relevant studies detected,33 were included for qualitative synthesis. The full texts of these articles were carefully evaluated by four different examiners in different timeframes. Conclusion:Utilizing physical therapy through therapeutic exercise and/orwith telerehabilitation protocols can help improve depressive symptoms in MS patients. However, further research should be conducted regarding the parameters of different forms of intervention in order to create clinical guidelines for therapists and patients to follow.

Influences of Kinesio Taping with Therapeutic Exercise in Patients with Low Back Pain.

The aim of this study was to evaluate the effect of core stability exercise combined with Kinesio taping on pain, endurance, and balance in patients with lower back pain (LBP). 46 patients with LBP were recruited and randomly allocated into the core stability exercise with taping (CSET) group and the core stability exercise (CSE) group. All participants performed core stability exercises for 40 min/day, 5 times/week for 8 weeks, and additional Kinesio taping was applied to the lower backs in the CSET group. The primary outcome measure was the pain intensity using the visual analog scale, and secondary outcome measures were trunk endurance and balance using the Biering-Sorensen test and force plate, respectively. After the intervention, the CSET group showed significant improvements in pain and postural balance compared to the CSE group (p < 0.05). However, there was no significant difference in trunk endurance between two groups (p > 0.05). This study found that core stability exercise was effective in reducing pain and enhancing balance in patients with LBP, and demonstrated that the application of additional Kinesio taping further increased these effects. Therefore, we recommend that core exercise combined with Kinesio taping may be used to improve the pain and postural balance of patients with LBP in clinics.

Adherence to prescriptions of therapeutic exercises in patients with traumatic spinal cord injury.

Spinal cord injury (SCI), which disrupts motor, sensory and autonomic functions, causes significant changes in the functioning of an individual. It is believed that most of the conditions secondary to SCI, i.e. osteoporosis, spasticity or cardiopulmonary diseases, are associated with immobility. The aim of the study is to assess the adherence to prescriptions of therapeutic exercises (APTE) in patients with SCI after acute phases of rehabilitation. The criterionfor APTE recognition was the performance at least twice a week for a minimum of 30 minutes of active exercises with resistance, and exercises maintaining the range of movement of the joints The research tools were own questionnaire and the WHOQOL-BREF scale. 46 subjects (63.9%) met the APTE criteria. The most frequent place for performing the exercises was the subject's home with 43 subjects (93.5%) with APTE performed the exercises in their homes. 17 subjects (36.9%) with APTE performed exercises during stays at various rehabilitation centres. The main cause for the lack of APTE was the limited availability of facilities considered necessary by the respondents to adhere to the instructions. In statistical analysis, the level of neurological injury correlated with meeting the APTE criteria. It was discovered that a subjective assessment of the exercise dose correlated with the place where the exercises were performed, but did not correlate with meeting the APTE criteria. The basic place for performing exercises (as instructed in hospital) was the subject's home. Limited access to reimbursed environmental therapy resulted in an increased cost of exercises supervised by commercially-employed physiotherapists. The current gaps in the system of supervision and counselling of subjects post-SCI necessitate changes in the Polish health care system.

The role of therapeutic exercise as a means of intervention for the treatment of amyotrophic lateral sclerosis

Background: Amyotrophic lateral sclerosis (ALS) leads to paralysis and premature death within an average of 3-5 years from the onset of symptoms. Therapeutic exercise helps to slow down the onset of muscle weakness. The aim of this review is to describe recent research data on the applications of therapeutic exercise in patients with ALS. The Google Scholar and PubMed databases were searched with the following keywords: motor neurone disease, amyotrophic lateral sclerosis, exercises, rehabilitation. Both clinical trials and reviews were included in the review. In conclusion, the application of therapeutic exercise helps to better compensate the deficits and to minimize the muscle weakness and atrophy caused by the disease. Exercises such as aerobics and flexibility and mobility exercises help maintain work ability and endurance and prevent lack of use in the upper and lower limbs.

Intramuscular Electrical Stimulation Combined with Therapeutic Exercises in Patients with Shoulder Adhesive Capsulitis: A Randomised Controlled Trial.

Background:Myofascial trigger points (MTrPs) precipitate the shoulder pain severity and disability in patients with shoulder adhesive capsulitis (SAC). This study aims to compare the effectiveness of intramuscular electrical stimulation (IMES) combined with therapeutic exercises versus dry needling (DN) combined with therapeutic exercises in improving the clinical outcomes in patients with SAC.Methods and Materials:In this randomized controlled trial, IMES (n = 45) and DN (43) groups had received respectively IMES, and DN twice weekly for three consecutive weeks. Both groups received therapeutic exercises 1520 minutes, five days in a week during the second and third week. Pain, disability, kinesiophobia, number of active and latent MTrPs, shoulder abduction and external rotation range of motion were assessed at baseline, week-1, week-2, week-3 and follow-up at 3 months. A repeated measures ANOVA performed to find out the significant differences in the clinical outcomes between the groups.Results:The results of repeated measures of ANOVA shows that the post intervention timelines assessment scores of VAS, DASH, shoulder abduction and external rotation ROM, number of active and latent MTrPs and kinesiophobia were significantly (p. < 0.05) improved in both groups. However, IMES group had achieved a greater improvement over DN group (p. < 0.05) on the shoulder pain severity and disability, shoulder range of motion, number of active and latent MTrPs and kinesiophobia. Despite the significant statistical differences between the groups, IMES group did not achieve the minimal clinically important differences of 1.5cm and 11-points respectively for the VAS and DASH scores. No serious adverse effects occurred during the three weeks of treatment.Conclusion:IMES combined with therapeutic exercises is an effective treatment to reduce the shoulder pain severity and upper limb disability by deactivating the active and latent MTrPs and improving the shoulder abduction and external rotation range of motion in patients with SAC.