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13 pages, 1168 KiB

Open AccessArticle

Change in the Order of Activation of Lower Limb Muscles Relative to Spinal Extensors During the Janda Test and Change in Postural Balance in Patients with LBP After Muscle Energy Techniques

by Katarzyna Wegner-Czerniak, Jacek Mączyński, Anna Błaszczyk and Małgorzata B. Ogurkowska

J. Clin. Med. 2025, 14(5), 1448; https://doi.org/10.3390/jcm14051448 - 21 Feb 2025

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Abstract

Background: The aim of this study was to investigate change in the order activation of leg muscles in relation to the spinal extensors during the Janda test and change postural balance in patients with low back pain (LBP) after muscle energy techniques (METs). [...] Read more.

Background: The aim of this study was to investigate change in the order activation of leg muscles in relation to the spinal extensors during the Janda test and change postural balance in patients with low back pain (LBP) after muscle energy techniques (METs). Methods: The study included fifteen men (mean age 41.9 years) working on an assembly line. The activity and recruitment of the following muscles: biceps femoris (BF), gluteus maximus (GM) and erector spinae (ES) were measured with the use of surface electromyography (sEMG) during the prone hip extension (PHE) test. Pain levels and postural balance were analysed. Results: MET translated into a reduction in muscle activation time in both the left and right side of the body (p < 0.001). The change was observed in the following muscles: BF (p = 0.003) and GM (p = 0.004). A reduction in pain was obtained post application of the MET therapy (p < 0.001). It was observed that after the therapy, along with the later activation time of the GM muscle, the range of motion of the COP along the x-axis increased (p = 0.0368). Increased activation time of the RES (p = 0.0411) and the LES (p = 0.0350) muscles influenced a decrease in the COP range of motion along the x-axis. Conclusions: The use of MET in people with LBP improves the sequence of activation of the ES, GM and BF muscles, affects postural balance, allows for the restoration of muscle balance in the lumbar spine and lower limbs, and reduces pain. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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12 pages, 426 KiB

Open AccessArticle

The Impact of Autonomic Nervous System Modulation on Heart Rate Variability and Musculoskeletal Manifestations in Chronic Neck Pain: A Double-Blind Randomized Clinical Trial

by Hani A. Alkhawajah, Ali M. Y. Alshami and Ali M. Albarrati

J. Clin. Med. 2025, 14(1), 153; https://doi.org/10.3390/jcm14010153 - 30 Dec 2024

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Abstract

Background: The role of autonomic nervous system (ANS) modulation in chronic neck pain remains elusive. Transcutaneous vagus nerve stimulation (t-VNS) provides a novel, non-invasive means of potentially mitigating chronic neck pain. This study aimed to assess the effects of ANS modulation on heart [...] Read more.

Background: The role of autonomic nervous system (ANS) modulation in chronic neck pain remains elusive. Transcutaneous vagus nerve stimulation (t-VNS) provides a novel, non-invasive means of potentially mitigating chronic neck pain. This study aimed to assess the effects of ANS modulation on heart rate variability (HRV), pain perception, and neck disability. Methods: In this double-blind randomized clinical trial, 102 participants with chronic neck pain were randomly allocated to one of three groups: t-VNS plus standard-care physiotherapy (SC-PT), heart rate variability biofeedback (HRV-BF) with SC-PT, or SC-PT alone. Interventions were administered three times weekly for 6 weeks. The following outcome measures were assessed at baseline and after 6 weeks: HRV, the visual analog scale (VAS), the pressure pain threshold (PPT), and the neck disability index (NDI). Results: The t-VNS group exhibited significant improvements compared to the HRV-BF and SC-PT groups. Specifically, t-VNS increased the RR interval (mean difference [MD] = 35.0 ms; p = 0.037) and decreased the average heart rate (MD = −5.4 bpm; p = 0.039). Additionally, t-VNS reduced the VAS scores (versus HRV-BF: MD = −0.8 cm, p = 0.044; SC-PT: MD = −0.9 cm, p = 0.018), increased the PPT (versus HRV-BF: MD = 94.4 kPa, p < 0.001; SC-PT (MD = 56.2 kPa, p = 0.001)), and lowered the NDI scores (versus HRV-BF: MD = −4.0, p = 0.015; SC-PT: MD = −5.9, p < 0.001). Conclusions: t-VNS demonstrated superior effectiveness compared to HRV-BF and SC-PT in regulating HRV, alleviating pain, and enhancing functional capabilities in individuals with chronic neck pain. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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17 pages, 1458 KiB

Open AccessArticle

Efficacy of Transcutaneous Pulsed Radiofrequency Treatment in Subacromial Impingement Syndrome: A Randomized Controlled Study

by Ayça Utkan Karasu, Ayza Kılıç and Belgin Karaoğlan

J. Clin. Med. 2024, 13(23), 7462; https://doi.org/10.3390/jcm13237462 - 7 Dec 2024

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Abstract

Background: This study assessed Transcutaneous Pulse Radiofrequency Therapy’s (TCPRF) effectiveness in reducing shoulder pain and improving shoulder function. Methods: A double-blind randomized controlled trial involved 50 SAIS patients with chronic shoulder pain. Participants were randomized into two groups: the study group (n = [...] Read more.

Background: This study assessed Transcutaneous Pulse Radiofrequency Therapy’s (TCPRF) effectiveness in reducing shoulder pain and improving shoulder function. Methods: A double-blind randomized controlled trial involved 50 SAIS patients with chronic shoulder pain. Participants were randomized into two groups: the study group (n = 27) received TCPRF, while the control (n = 23) received sham treatment. The primary outcome was shoulder pain, secondary outcomes, including shoulder function, quality of life, and range of motion, were assessed at baseline, and at 1, 4, and 12 weeks using the Visual Analog Scale (VAS), Shoulder Pain and Disability Index (SPADI), and the SF-36 questionnaire. Supraspinatus tendon thickness (SSPT) and acromiohumeral distance (AHD) were measured by ultrasound. Results: Both groups showed reductions in activity and resting pain over 12 weeks. In the control, activity pain dropped from a median (IQR) of 8 (7–8) to 6 (3–7), and in TCPRF from 8 (7–10) to 3.5 (2–6.3), with no significant difference at 12 weeks (p = 0.192). Resting pain decreased from 3 (1–6) to 1 (1–3) in the control, and from 3 (2–4) to 0 (0–2) in TCPRF, showing a lower resting pain at 12 weeks (p = 0.041). SPADI-Total scores decreased from 87 (54–105) to 50 (29–82) in the control and from 84 (69–107) to 21 (9–66.3) in TCPRF, favoring TCPRF at 12 weeks (p = 0.017). SPADI–Disability scores reduced from 49 (30–63) to 30 (15–30) in control and from 47 (35–62) to 11 (5.8–38.8) in TCPRF, also favoring TCPRF (p = 0.008). Both groups showed similar improvements in other outcomes. Conclusions: TCPRF reduced resting pain and shoulder disability in SAIS over 12 weeks, though other outcomes showed similar improvement in both groups. Further studies are needed to determine long-term effects. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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10 pages, 911 KiB

Open AccessArticle

Association between Hip/Groin Pain and Hip ROM and Strength in Elite Female Soccer Players

by Eloy Jaenada-Carrilero, Luis Baraja-Vegas, Paula Blanco-Giménez, Raul Gallego-Estevez, Iker J. Bautista and Juan Vicente-Mampel

J. Clin. Med. 2024, 13(18), 5648; https://doi.org/10.3390/jcm13185648 - 23 Sep 2024

Cited by 1 | Viewed by 1685

Abstract

Background/Objectives: Hip strength and range of motion have been compared in soccer players with and without hip and groin pain but only in male footballers or gender-combined samples. In female soccer players, the biomechanics contributing to this injury remain poorly understood compared [...] Read more.

Background/Objectives: Hip strength and range of motion have been compared in soccer players with and without hip and groin pain but only in male footballers or gender-combined samples. In female soccer players, the biomechanics contributing to this injury remain poorly understood compared to other sporting injuries. The aim of the present study is to investigate whether differences exist in adductor and abductor isometric test values and hip joint range of motion between elite female soccer players with longstanding groin pain and injury-free controls. Methods: Ten female elite soccer players with current longstanding hip and groin pain and twenty-five injury-free controls from the same teams were included in the study. Hip adductor and abductor isometric strength were evaluated with a hand-held dynamometer. A bent knee fall-out test was also utilized to examine the hip joint range of motion. Results: A significant difference in abductor isometric test values was observed between the control group (2.29 ± 0.53 N/Kg) and the hip and groin pain group (2.77 ± 0.48 N/Kg; p = 0.018). Furthermore, the injured group showed a decreased adductor/abductor ratio compared to the control group (1.00 ± 0.33 vs. 1.27 ± 0.26; p = 0.013). No differences were observed in the bent knee fall-out test (p = 0.285). Conclusions: Female elite soccer players with current longstanding hip and groin pain exhibited higher abductor isometric strength and lower adductor/abductor ratio compared to non-injured women players. There were no differences in the BKFO test between groups. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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11 pages, 1055 KiB

Open AccessArticle

Influence of Sagittal Cervical and Thoracic Range of Motion on Neck Pain Severity in Young White-Collar Workers: A Cross-Sectional Study

by Tomasz Kuligowski, Anna Skrzek and Błażej Cieślik

J. Clin. Med. 2024, 13(18), 5412; https://doi.org/10.3390/jcm13185412 - 12 Sep 2024

Viewed by 1388

Abstract

Background: Neck pain (NP) is a prevalent musculoskeletal disorder, especially among individuals with sedentary occupations. The interplay between cervical and thoracic spine mobility is hypothesized to contribute significantly to NP severity, yet this relationship requires further exploration. Methods: This cross-sectional study [...] Read more.

Background: Neck pain (NP) is a prevalent musculoskeletal disorder, especially among individuals with sedentary occupations. The interplay between cervical and thoracic spine mobility is hypothesized to contribute significantly to NP severity, yet this relationship requires further exploration. Methods: This cross-sectional study involved 179 young white-collar workers with NP lasting for at least six weeks. Participants were stratified into mild (n = 78) and moderate (n = 101) pain groups based on their scores on the Northwick Park Neck Pain Questionnaire (NPQ). Cervical and thoracic range of motion (ROM) in the sagittal plane was measured using inclinometers. NP severity was further assessed using the NPQ and the Neck Disability Index (NDI). Correlation, regression, and mediation analyses were conducted to investigate the relationship between cervical and thoracic ROM and NP severity. Results: Thoracic ROM was higher in the mild pain group (median: 47.35, IQR: 10.13) than in the moderate pain group (median: 42.10, IQR: 13.60; p < 0.001). The NDI had a negative correlation with thoracic ROM (r = −0.65; p < 0.05) and a positive correlation with cervical ROM (r = 0.84; p < 0.01). Additionally, thoracic ROM mediated the effect of cervical ROM on NP, particularly influencing NDI scores (p < 0.01). Conclusions: This study found a significant association between reduced thoracic ROM and increased NP severity, highlighting the role of thoracic spine mobility in NP among young white-collar workers. Targeted interventions for thoracic dysfunction may reduce compensatory cervical strain and improve NP management, suggesting that thoracic spine assessments should be integrated into routine clinical evaluations. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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11 pages, 372 KiB

Open AccessArticle

Preliminary Studies on Changes in Static Plantar Pressure and Stabilometry in Patients with Ankylosing Spondylitis Undergoing an Exercise Program

by Ioana Gabriela Seres, Andrei Daniel Bolovan, Daniela Dragomir, Adina Octavia Duse, Daniel Popa, Georgeta Mioara Sinmarghitan and Elena Amaricai

J. Clin. Med. 2024, 13(16), 4673; https://doi.org/10.3390/jcm13164673 - 9 Aug 2024

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Abstract

Background/Objectives: Studies have reported that patients suffering from ankylosing spondylitis (AS) have decreased postural stability in comparison to healthy subjects. Our study aims to compare static plantar pressure and stabilometry parameters in AS patients who performed an 8-week exercise program (spine motion [...] Read more.

Background/Objectives: Studies have reported that patients suffering from ankylosing spondylitis (AS) have decreased postural stability in comparison to healthy subjects. Our study aims to compare static plantar pressure and stabilometry parameters in AS patients who performed an 8-week exercise program (spine motion and flexibility exercises; stretching of hamstring, erector spine, and shoulder muscles; control abdominal and diaphragm breathing exercises and chest expansion exercises), in three different testing conditions (eyes open, eyes closed, and head retroflexed). Methods: Plantar pressure (the loading of the first and fifth metatarsal heads (MT1, MT5) and calcaneus) and stabilometry (CoP path length, 90% confidence ellipse area, and maximum CoP speed) were recorded in 28 AS patients (age 56.64 ± 10.3 years; body mass index 29.4 ± 4.9 kg/m²) at the beginning of rehabilitation and after 8 weeks. At first evaluation, there were significant differences (p < 0.05) for the foot loading sites (MT1, MT5, and calcaneus), both for the right and left feet, when comparing eyes open with the other two testing situations. Results: After rehabilitation, significant differences were recorded between eyes-open and head-retroflexed conditions for MT1 (p = 0.03 for right; p = 0.004 for left) and calcaneus (p = 0.014 for right; p = 0.011 for left). A significantly higher CoP path length was registered in both initial and final assessments when tested with eyes closed. The maximum CoP speed had increased values at both evaluations when tested with head retroflexed. Conclusions: The CoP path length decreased after the physical exercise program, with a better postural stability after rehabilitation. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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16 pages, 2070 KiB

Open AccessArticle

Postural and Lumbopelvic Control: Crucial Factors in the Functionality of Patients with Low Back Pain—A Descriptive Cross-Sectional Study

by Katherine Stöwhas, Guillermo Droppelmann, Carlos Jorquera and Felipe Feijoo

J. Clin. Med. 2024, 13(13), 3836; https://doi.org/10.3390/jcm13133836 - 29 Jun 2024

Viewed by 1621

Abstract

Background: Low back pain (LBP) is one of the most prevalent musculoskeletal disorders in adults worldwide. Alterations in postural and lumbopelvic control and functionality appear to be determining factors in its resolution. Methods: A cross-sectional study was performed. Patients with LBP were enrolled. [...] Read more.

Background: Low back pain (LBP) is one of the most prevalent musculoskeletal disorders in adults worldwide. Alterations in postural and lumbopelvic control and functionality appear to be determining factors in its resolution. Methods: A cross-sectional study was performed. Patients with LBP were enrolled. Lumbar pain; postural control (PC), total area of the center of pressure (TACOP), and the velocity of the center of pressure (VCOP); lumbopelvic control (LPC); and functionality were evaluated. Statistical tests were implemented to determine differences between sex and age and correlation models among the variables. Results: Thirty adult patients with LBP were analyzed. A strong relationship was found between pain and functionality [r = 0.64; p < 0.001]. A moderate relationship was found between pain and TACOP [r = 0.395; p = 0.031]. A moderate relationship was observed between TACOP and functionality [0.413; p = 0.023] and between LPC and TACOP [r = 0.416; p = 0.001]. Conclusions: This study demonstrates the significant impact of LBP on postural control, lumbopelvic control, and functionality. These results highlight the importance of addressing postural and lumbopelvic control in LBP treatment. No significant differences based on gender and age were found, but all clinical variables differed significantly between the LBP and control groups, underscoring the unique impairments associated with LBP. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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17 pages, 2332 KiB

Open AccessArticle

by Alberto Arribas-Romano, Josué Fernández-Carnero, Leonardo Rodríguez-Lagos, Miguel Molina-Álvarez, Jesús Zabala-Zambrano, Lucas Lezaun-Hernández, Lucía Contreras-Padilla and Francisco Mercado

J. Clin. Med. 2024, 13(13), 3648; https://doi.org/10.3390/jcm13133648 - 22 Jun 2024

Cited by 1 | Viewed by 1227

Abstract

Objective: The aim of this study is to assess whether pain-inducing manual pressure (PIMP) leads to effects on pressure pain threshold (PPT) mediated by conditioned pain modulation (CPM) and whether these effects are influenced by the intensity and repetition of the stimulus. [...] Read more.

Objective: The aim of this study is to assess whether pain-inducing manual pressure (PIMP) leads to effects on pressure pain threshold (PPT) mediated by conditioned pain modulation (CPM) and whether these effects are influenced by the intensity and repetition of the stimulus. Additionally, the influence of psychological factors and physical activity on the response to PIMP was explored. Methods: A total of 72 pain-free students were randomly assigned to three crossover trials. Trial 1 compared the effects of PIMP with the cold pressor task and pain-inducing electrostimulation. Trial 2 compared the effects of manual pressure that elicited moderate pain, mild pain, and no pain. Trial 3 compared a single PIMP stimulation with four stimuli applied at the same site or at different sites. Results: PIMP produced a lower increase in PPT than cold pressor task and no difference with electrostimulation. Manual pressure that caused moderate pain led to a greater increase in PPT compared to mild pain and pain-free application. Repetition of PIMP stimulus, whether at the same or different sites, did not significantly increase PPT compared to a single stimulation. No association with psychological factors or physical activity was found. Conclusions: PIMP produces an increase in PPT, suggesting the involvement of CPM-related mechanisms. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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14 pages, 990 KiB

Open AccessArticle

Remote Delivery of Partial Meal Replacement for Weight Loss in People Awaiting Arthroplasty

by Ritesh Chimoriya, Justine Naylor, Kimberly Mitlehner, Sam Adie, Ian Harris, Anna Bell-Higgs, Naomi Brosnahan and Milan K. Piya

J. Clin. Med. 2024, 13(11), 3227; https://doi.org/10.3390/jcm13113227 - 30 May 2024

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Abstract

Background: Obesity is linked to higher rates of complications; lower absolute recovery of mobility, pain, and function; and increased costs of care following total knee or hip arthroplasty (TKA, THA). The aim of this prospective cohort study was to evaluate the effectiveness [...] Read more.

Background: Obesity is linked to higher rates of complications; lower absolute recovery of mobility, pain, and function; and increased costs of care following total knee or hip arthroplasty (TKA, THA). The aim of this prospective cohort study was to evaluate the effectiveness of a 12-week partial meal replacement (PMR) weight loss program for people awaiting TKA or THA and living with obesity (body mass index (BMI) ≥ 30 kg/m²). Methods: The intervention was delivered remotely and included a 12-week PMR plan of 1200 calories/day, incorporating two meal replacement shakes/soups and a third suitable simple meal option. The intervention support was provided through online group education sessions, one-to-one teleconsultation with a dietitian, and access to a structured PMR App with functions for goal setting and providing educational content on diet, physical activity, and behaviour changes. Results: Of the 182 patients approached, 29 provided consent to participate, 26 participants commenced the program, and 22 participants completed the 12-week PMR plan. Completers exhibited statistically significant weight loss from baseline to 12 weeks, with a paired difference of 6.3 kg (95% CI: 4.8, 7.7; p < 0.001), with 15 out of 22 (68.2%) participants achieving at least 5% weight loss. Statistically significant reductions in HbA1c and low density lipoprotein (LDL) were observed at 12 weeks compared to baseline. Moreover, a significant increase in the proportion of participants in the action and maintenance phases of the readiness to change diet, physical activity, and weight were observed at 12 weeks. The majority of program completers (18 out of 22) expressed willingness to pay for the service if offered on a long-term basis following the arthroplasty. Conclusions: This study’s findings demonstrated that significant weight loss is achievable for people living with obesity awaiting arthroplasty following a 12-week PMR weight loss program. The remote delivery of the intervention was feasible and well accepted by people awaiting TKA or THA. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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14 pages, 2202 KiB

Open AccessArticle

Effect of Mirror Therapy on Post-Needling Pain Following Deep Dry Needling of Myofascial Trigger Point in Lateral Elbow Pain: Prospective Controlled Pilot Trial

by Sebastián Eustaquio Martín Pérez, Jhoselyn Delgado Rodríguez, Alejandro Kalitovics, Pablo de Miguel Rodríguez, Daniela Sabrina Bortolussi Cegarra, Iremar Rodríguez Villanueva, Álvaro García Molina, Iván Ruiz Rodríguez, Juan Montaño Ocaña, Isidro Miguel Martín Pérez, María Dolores Sosa Reina, Jorge Hugo Villafañe and José Luis Alonso Pérez

J. Clin. Med. 2024, 13(5), 1490; https://doi.org/10.3390/jcm13051490 - 5 Mar 2024

Viewed by 1782

Abstract

Background: This prospective randomized, controlled pilot trial to explore the immediate effect of adding Mirror Visual Feedback Therapy on pain sensitivity and motor performance among subjects suffering from post-needling pain diagnosed as Lateral Elbow Pain. Methods: A total of 49 participants [...] Read more.

Background: This prospective randomized, controlled pilot trial to explore the immediate effect of adding Mirror Visual Feedback Therapy on pain sensitivity and motor performance among subjects suffering from post-needling pain diagnosed as Lateral Elbow Pain. Methods: A total of 49 participants (23 female, 26 male) were enrolled and randomly allocated to either the experimental group, which received Deep Dry Needling in the m. Brachioradialis, Ischemic Compression, Cold Spray, Stretching, and Mirror Visual Feedback Therapy (n = 25), or a control group without Mirror Visual Feedback Therapy (n = 24). Pre- and post-treatment evaluations included assessments of post-needling pain intensity, pressure pain threshold, two-point discrimination threshold, and maximum hand grip strength. Results: Intergroup analysis revealed a statistically significant reduction in post-needling pain intensity favoring the experimental group (U = 188.00, p = 0.034). Additionally, intragroup analysis showed significant improvements in post-needling pain intensity (MD = 0.400, SEM = 0.271, W = 137.00, p = 0.047) and pressure pain threshold (MD = 0.148 Kg/cm², SEM = 0.038, W = 262.00, p < 0.001) within the experimental group following the intervention. Conclusions: These findings suggest a potential benefit of integrating Mirror Visual Feedback Therapy into treatment protocols for individuals with Lateral Elbow Pain experiencing post-needling discomfort. Further research is necessary to fully elucidate the clinical implications of these findings. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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12 pages, 1368 KiB

Open AccessArticle

Impact of the Order of Movement on the Median Nerve Root Function: A Neurophysiological Study with Implications for Neurodynamic Exercise Sequencing

by Dalia Ibrahim, Amal Ahbouch, Raneen Mohammed Qadah, Meeyoung Kim, Saud M. Alrawaili and Ibrahim M. Moustafa

J. Clin. Med. 2024, 13(3), 913; https://doi.org/10.3390/jcm13030913 - 5 Feb 2024

Cited by 2 | Viewed by 2136

Abstract

Background: Neurodynamic exercise is a common clinical practice used to restore neural dynamic balance. The order in which movements are performed during these exercises is believed to play a crucial role in their effectiveness. This study aimed to investigate the impact of different [...] Read more.

Background: Neurodynamic exercise is a common clinical practice used to restore neural dynamic balance. The order in which movements are performed during these exercises is believed to play a crucial role in their effectiveness. This study aimed to investigate the impact of different sequences of neurodynamic exercise on nerve root function, with a specific focus on the median nerve. Methods: Participants were assigned randomly to three experimental groups, each undergoing a different test sequence: standard, proximal-to-distal, and distal-to-proximal. Dermatomal somatosensory evoked potentials (DSSEPs) were recorded at key levels (C6, C7, C8, and T1). Results: The findings revealed a significant influence of the movement sequence on DSSEP amplitudes. The execution of neurodynamic exercise in the proximal-to-distal sequence was associated with a notable reduction in amplitudes (p < 0.05). Conversely, the distal-to-proximal sequence resulted in increased amplitudes compared to the standard sequence (p < 0.05). Conclusions: This study underscores the importance of carefully considering the order of movements during neurodynamic exercising, particularly when evaluating nerve roots that lack the protective perineurium. The choice of sequence appears to have a substantial impact on nerve function, with implications for optimizing clinical neurodynamic exercise techniques. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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18 pages, 2084 KiB

Open AccessArticle

Clinical Evidence Regarding the Dynamic of Baker Cyst Dimensions after Intermittent Vacuum Therapy as Rehabilitation Treatment in Patients with Knee Osteoarthritis

by Elena-Valentina Ionescu, Liliana-Elena Stanciu, Andreea Bujduveanu, Mihaela Minea, Doinita Oprea, Adina Petcu, Madalina-Gabriela Iliescu, Viorela-Mihaela Ciortea, Florina-Ligia Popa, Emma Gheorghe, Bogdan Obada and Carmen Oprea

J. Clin. Med. 2023, 12(20), 6605; https://doi.org/10.3390/jcm12206605 - 18 Oct 2023

Cited by 1 | Viewed by 2625

Abstract

The Baker cyst (BC), also known as the popliteal cyst or parameniscal cyst, is a fluid-filled sac that normally develops in the back of the knee, between the semimembranosus and medial head of the gastrocnemius. We aimed to evaluate the effectiveness of physiotherapy [...] Read more.

The Baker cyst (BC), also known as the popliteal cyst or parameniscal cyst, is a fluid-filled sac that normally develops in the back of the knee, between the semimembranosus and medial head of the gastrocnemius. We aimed to evaluate the effectiveness of physiotherapy (10 days of treatment) that associates intermittent vacuum therapy (IVT) on the lower limbs in the treatment of the BC, respectively, in its size reduction. Sixty-five patients with knee osteoarthritis using Kellgren–Lawrence criteria and the presence of BC (ultrasonography evaluation), were divided into the Control and Vacuum groups. We collected the following features: sex, age, level of education, occupation, environment, body mass index, Knee Injury and Osteoarthritis Outcome Score, Western Ontario, and McMaster Universities Osteoarthritis Index, the Functional Independence Measurement, the Fall Risk Score, and the Visual Analog Scale were recorded at baseline and after 10 days. Both groups are similar in terms of demographic features. Regarding the clinical functional parameters, the results elicit a statistically significant change in all parameters between admission and discharge, including the echo volume at BC. Physical medicine and rehabilitation increase the autonomy of patients with BC. Clinical-functional improvement begins in the first 10 days of complex rehabilitation treatment; it is statistically significant and is not different between the two groups, which brings an additional argument for the effectiveness of conservative therapy in the treatment of BC. Although IVT has not demonstrated its superiority over classical balneo-physical therapy, additional research, and long-term monitoring are needed to provide additional arguments regarding this aspect. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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35 pages, 61213 KiB

Open AccessSystematic Review

Hip Flexor Muscle Activation During Common Rehabilitation and Strength Exercises

by Jessica Juan, Gretchen Leff, Kate Kevorken and Michael Jeanfavre

J. Clin. Med. 2024, 13(21), 6617; https://doi.org/10.3390/jcm13216617 - 4 Nov 2024

Cited by 3 | Viewed by 4768

Abstract

Background/Objectives: The iliopsoas muscle plays an essential role in lumbopelvic and hip anterior stability, which is particularly important in the presence of limited osseous acetabular coverage anteriorly as in hip dysplasia and/or hip micro-instability. The purpose of this systematic review is to (1) [...] Read more.

Background/Objectives: The iliopsoas muscle plays an essential role in lumbopelvic and hip anterior stability, which is particularly important in the presence of limited osseous acetabular coverage anteriorly as in hip dysplasia and/or hip micro-instability. The purpose of this systematic review is to (1) describe iliopsoas activation levels during common rehabilitation exercises and (2) provide an evidence-based exercise progression for strengthening the iliopsoas based on electromyography (EMG) studies. Methods: In total, 109 healthy adult participants ranging from ages 20 to 40 were included in nine studies. PubMed, CINAHL, and Embase databases were systematically searched for EMG studies of the psoas, iliacus, or combined iliopsoas during specific exercise. The Modified Downs and Black Checklist was used to perform a risk of bias assessment. PROSPERO guidelines were followed. Results: Nine studies were included. Findings suggest that the iliopsoas is increasingly activated in ranges of hip flexion of 30–60°, particularly with leg lowering/raising exercises. Briefly, >60% MVIC activity of the iliopsoas was reported in the active straight leg raise (ASLR) in ranges around 60° of hip flexion, as well as with supine hip flexion and leg lifts. In total, 40–60% MVIC was found in exercises including the mid-range of the ASLR around 45° of hip flexion and lifting a straight trunk while in a hip flexed position. Conclusions: The findings suggest that exercises in increased hip flexion provide greater activation of the iliopsoas compared to exercises where the trunk is moving on the lower extremity. Iliopsoas activation can be incrementally progressed from closed to open kinetic chain exercises, and eventually to the addition of external loads. The proposed exercise program interprets the results and offers immediate translation into clinical practice. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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19 pages, 8560 KiB

Open AccessSystematic Review

Effects of Extracorporeal Shock Wave Therapy in Patients with Mild-to-Moderate Carpal Tunnel Syndrome: An Updated Systematic Review with Meta-Analysis

by Lei Zhang, Ting Yang, Long Pang, Yinghao Li, Tao Li, Chunsen Zhang, Lei Yao, Ran Li and Xin Tang

J. Clin. Med. 2023, 12(23), 7363; https://doi.org/10.3390/jcm12237363 - 28 Nov 2023

Cited by 3 | Viewed by 3030

Abstract

Background: Carpal tunnel syndrome (CTS) is the most common entrapment syndrome, primarily affecting women between the ages of 40 and 70, and conservative treatments are the first option for mild-to-moderate CTS. However, the comparisons between extracorporeal shock wave therapy (ESWT) and other non-surgical [...] Read more.

Background: Carpal tunnel syndrome (CTS) is the most common entrapment syndrome, primarily affecting women between the ages of 40 and 70, and conservative treatments are the first option for mild-to-moderate CTS. However, the comparisons between extracorporeal shock wave therapy (ESWT) and other non-surgical methods in the treatment of mild-to-moderate CTS remain controversial, and an updated systematic review is needed. Methods: An electronic search was performed, and all available articles until August 2023 were included in the analysis. The overall quality of evidence was assessed by the GRADE approach. Meta-analyses were conducted using Manager V.5.3.3. Pooled effect sizes were expressed as the weighted mean difference (WMD) with 95% confidence intervals (CIs). Results: A total of 19 RCTs were included. Low-level quality evidence showed that ESWT outperformed the control intervention in terms of functional improvements, pain relief, electrodiagnostic parameters, and cross-sectional area of the median nerve at any time point of follow-up. Compared to local corticosteroid injection (LCI), there were statistically better improvements in functional improvements, pain relief, and electrodiagnostic parameters at 3 and 6 months of follow-up. Conclusions: There is low-level quality evidence to show that both fESWT and rESWT are more clinically effective than controls in symptom relief, functional enhancement, and electrophysiologic parameters’ improvement for patients with mild-to-moderate CTS at any time point of follow-up. Compared with LCI, ESWT yielded similar short-term (<1 month) but better medium- (1–6 months) and long-term (>6 months) improvements in pain relief and functional recovery with fewer potential complications. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders: Clinical Rehabilitation and Physiotherapy)

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