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1.
Olga Velasco-Roldán Inmaculada Riquelme Alejandro Ferragut-Garcías Alberto Marcos Heredia-Rizo Cleofás Rodríguez-Blanco Ángel Oliva-Pascual-Vaca 《PM & R》2018,10(1):28-35
Background
There is controversy regarding the best technique for applying Kinesio Taping (KT), and the theory supporting that skin convolutions may explain its efficacy has recently been challenged.Objective
To compare the immediate and short-term effectiveness of KT tightness on mechanosensitivity and spinal mobility in nonspecific low back pain (LBP), and to observe the influence of gender in the outcome measures.Design
Double-blind, randomized, controlled trial.Setting
University-based clinical research center.Participants
A total of 75 individuals with a mean age of 33 years (±7.4 years), 60% female and 40% male, with nonspecific LBP were recruited and randomly assigned to 1 of the following study groups: standard KT tension (n = 26), increased KT tension (n = 25), and no KT tension (n = 24).Interventions
All participants received a two I-strip taping over the paravertebral muscles for 24 hours. Paper-off tension (15%-25% of the available stretch) was used in the standard KT group, which was increased to 40% in the increased KT tension group. The rest of participants received a taping procedure with no KT tension. Measurements were taken at baseline, immediately after the taping, 24 hours after the taping, and after KT removal.Main Outcome Measures
The primary outcome included pressure pain thresholds over the erector spinae and gluteus medius muscles. The secondary outcome was lumbar mobility (assessed with a digital inclinometer, and back-saver sit-and-reach, finger-to-floor, and sit-and-reach tests).Results
In the between-groups analysis of the mean score changes after baseline assessment, no significant differences were found for any of the outcome measures (P > .05) except the left back-saver sit-and-reach test (P = .03). A statistically significant interaction group × gender × time was observed only for mechanosensitivity values (P = .02 for the gluteus and P = .01 for the erector spinae).Conclusion
KT tightness does not seem to influence pain sensitivity and lumbar mobility in chronic LBP in either the immediate or short term.Level of Evidence
II 相似文献2.
Objective
Postural control of patients with chronic low back pain (CLBP) is usually impaired. Effects of treatment applications on postural stability have not been well investigated. The aim of this study was to investigate the immediate effects of kinesio taping on pain and postural stability in patients with CLBP.Methods
One hundred and one patients with CLBP (age: 53.00 (10.69) years, body mass index (BMI): 31.52 (5.57) kg/m2) were included in this study. Kinesio taping was applied on paravertebral muscles and sacrum with muscle and ligament techniques. Postural stability was assessed with Biodex Balance System® (USA) both at static and dynamic mode in bilateral standing position. The base was set “static” for static mode, and set between“12-1” for dynamic mode. Pain intensity was evaluated with the pain section (0–5 points) of Oswestry Disability Index, including ten items (pain, personal care, lifting, walking, sitting, standing, sleeping, sex life, social life, travelling), pre- and post-application.Results
The static overall (pre: 1.49 (1.15), post: 1.25 (1.11)) and antero-posterior (pre: 0.96 (0.86), post: 0.74 (0.59)), dynamic overall (pre: 3.12 (2.26), post: 2.73 (2.44)) and medio-lateral postural sway scores (pre: 1.62 (1.12), post: 1.24 (0.75)), and pain (pre: 2.00 (0.00–5.00), post: 1.00 (0.00–4.00)) decreased after the application (p?<?.05). However, no differences were observed in static medio-lateral (pre: 0.84 (0.78), post: 0.82 (1.01)) and dynamic antero-posterior postural sway scores (pre: 2.33 (1.99), post: 2.12 (2.33)), (p?>?.05).Conclusions
Kinesio taping may immediately improve postural stability and decrease pain of patients with CLBP. 相似文献3.
Sannasi Rajasekar Ajay Kumar Jignesh Patel Muthukrishnan Ramprasad Asir John Samuel 《Journal of bodywork and movement therapies》2018,22(3):727-732
Background
Deficiency in hip girdle neuromuscular control can cause exaggerated Dynamic Knee Valgus (DKV) which afflicts the knee joint and lead to knee injuries especially ACL injury in sports. Though Kinesio taping (KT) is known to improve function, stability and proprioception, the evidence is inconclusive on its effectiveness in athletes. We hypothesized that kinesio taping could enhance neuromuscular control of the hip girdle there by causing a reduction in DKV.Aim/Objective
To determine whether KT on Gluteus medius can correct exaggerated dynamic knee valgus and improves hip abductor strength when compared to sham KT.Method
40 collegiate level athletes, aged between 18 and 28 years, of both genders with presence of dynamic knee valgus (>8° for men and >13° for women) were recruited in the study. Athletes were excluded if they had history of lower back pain, history of any injury or surgery to the lower extremities during the past year. Subjects who met the inclusion criteria were randomized into kinesio taping (KT) group and sham taping (ST) group. The Drop Jump test and the Donnatelli Drop Leg Test (DDT) were performed before, and on the third day, immediately after the application of KT on them and documented.Results
There was a significant reduction in DKV among male [4.0° (95% CI 3.5–4.5); p < 0.001] and female [4.3° (95% CI 3.5–5.2); p < 0.002] immediately after application of taping but not on the third day after application of KT. There was a significant rise in DDT immediately and on the third day after application of KT between KT group and SC group.Conclusion
There was a reduction in DKV immediately after the application of KT. However, there was no significant difference between KT group and SC group on the third day. Meanwhile, gluteus medius strength also showed significant improvement immediately after taping and it was maintained even on the third day. 相似文献4.
Leonid Kalichman Inbar Levin Itzhak Bachar Elisha Vered 《Journal of bodywork and movement therapies》2018,22(3):700-706
Background
Kinesio taping is a possible therapeutic modality for myofascial pain, nevertheless, very scarce research has been performed on this subject.Objective
To evaluate the immediate and short-term effect of kinesio taping application on myofascial trigger points (MTrPs) and pressure pain thresholds (PPTs) in the upper trapezius and gastrocnemius muscles.Methods
Two randomized, single-blinded, controlled trials were simultaneously executed on the upper trapezius and gastrocnemius muscles. Different participants in each study were randomly assigned to an active intervention (N = 15) or control (N = 15) group. Kinesio taping was applied on the gastrocnemius or upper trapezius muscles by positioning three “I” strips in a star shape (tension on base) directly above the MTrPs in the active intervention group and a few centimeters away from the MTrPs in the controls.Results
The second evaluation on both sides showed lower PPT values than the first evaluation in the control group, denoting that the spots were more sensitive. The third evaluation showed even lower values. The active intervention group showed a contralateral side pattern similar to the controls. However, on the side of the kinesio taping application, the PPT values of the second evaluation were higher (the spots were less sensitive) and after 24 h returned to the original values. The difference between the PPT measurements on the MTrPs’ side of the active intervention group vs. the controls (time-group interaction) was significant (F (2,56) = 3.24, p = 0.047).Conclusions
We demonstrated that a kinesio taping application positioned directly above the MTrPs may prevent an increase in sensitivity (decrease in PPT) immediately after application and prevent further sensitization up to 24 h later. The fact that two different muscles were similarly affected by the kinesio taping application, confirmed that the results were not in error. Further studies are needed to directly test the effect of a kinesio taping application on post-treatment soreness. 相似文献5.
Jon J. Ford Matt C. Richards Luke D. Surkitt Alexander Y.P. Chan Sarah L. Slater Nicholas F. Taylor Andrew J. Hahne 《Archives of physical medicine and rehabilitation》2018,99(12):2504-2512.e12
Objective
To identify predictors for back pain, leg pain, and activity limitation in patients with early persistent low back disorders (LBDs).Design
Prospective inception cohort study.Setting
Primary care private physiotherapy clinics in Melbourne, Australia.Participants
Individuals (N=300) aged 18-65 years with low back and/or referred leg pain of ≥6 weeks and ≤6 months duration.Interventions
Not applicable.Main Outcome Measures
Numeric rating scales for back pain and leg pain as well as the Oswestry Disability Scale.Results
Prognostic factors included sociodemographics, treatment related factors, subjective/physical examination, subgrouping factors, and standardized questionnaires. Univariate analysis followed by generalized estimating equations were used to develop a multivariate prognostic model for back pain, leg pain, and activity limitation. Fifty-eight prognostic factors progressed to the multivariate stage where 15 showed significant (P<.05) associations with at least 1 of the 3 outcomes. There were 5 indicators of positive outcome (2 types of LBD subgroups, paresthesia below waist, walking as an easing factor, and low transversus abdominis tone) and 10 indicators of negative outcome (both parents born overseas, deep leg symptoms, longer sick leave duration, high multifidus tone, clinically determined inflammation, higher back and leg pain severity, lower lifting capacity, lower work capacity, and higher pain drawing percentage coverage). The preliminary model identifying predictors of LBDs explained up to 37% of the variance in outcome.Conclusions
This study evaluated a comprehensive range of prognostic factors reflective of both the biomedical and psychosocial domains of LBDs. The preliminary multivariate model requires further validation before being considered for clinical use. 相似文献6.
7.
Krista Beth Highland Audrey Schoomaker Winifred Rojas Josh Suen Ambareen Ahmed Zhiwei Zhang Sarah Fink Carlin Christian E. Calilung Michael Kent Christin McDonough Chester C. Buckenmaier 《Archives of physical medicine and rehabilitation》2018,99(1):91-98
Objective
To examine the feasibility and preliminary effectiveness of an individualized yoga program.Design
Pilot randomized controlled trial.Setting
Military medical center.Participants
Patients (N=68) with chronic low back pain.Interventions
Restorative Exercise and Strength Training for Operational Resilience and Excellence (RESTORE) program (9–12 individual yoga sessions) or treatment as usual (control) for an 8-week period.Main Outcome Measures
The primary outcome was past 24-hour pain (Defense & Veterans Pain Rating Scale 2.0). Secondary outcomes included disability (Roland-Morris Disability Questionnaire) and physical functioning and symptom burden (Patient-Reported Outcomes Measurement Information System-29 subscales). Assessment occurred at baseline, week 4, week 8, 3-month follow-up, and 6-month follow-up. Exploratory outcomes included the proportion of participants in each group reporting clinically meaningful changes at 3- and 6-month follow-ups.Results
Generalized linear mixed models with sequential Bonferroni-adjusted pairwise significance tests and chi-square analyses examined longitudinal outcomes. Secondary outcome significance tests were Bonferroni adjusted for multiple outcomes. The RESTORE group reported improved pain compared with the control group. Secondary outcomes did not retain significance after Bonferroni adjustments for multiple outcomes, although a higher proportion of RESTORE participants reported clinically meaningfully changes in all outcomes at 3-month follow-up and in symptom burden at 6-month follow-up.Conclusions
RESTORE may be a viable nonpharmacological treatment for low back pain with minimal side effects, and research efforts are needed to compare the effectiveness of RESTORE delivery formats (eg, group vs individual) with that of other treatment modalities. 相似文献8.
Fahimeh Kamali Ehsan Sinaei Elham Taherkhani 《Journal of bodywork and movement therapies》2018,22(2):540-545
Objectives
Chronic non-specific low back pain (CNLBP) is a prevalent problem among athletes that can cause long-lasting disability and time lost from sporting activities. Thus far, a variety of methods have been suggested to address this problem, including spinal manipulation (SM) and Kinesio Tape® (KT). The aim of this study was to investigate whether adding KT to SM can provide any extra effect in athletes with CNLBP or not.Method
Forty-two athletes (21males, 21females) with CNLBP were randomized into two groups of SM (n = 21) and SM plus KT (n = 21). Pain intensity, functional disability level and trunk flexor-extensor muscles endurance were assessed by Numerical Rating Scale (NRS), Oswestry pain and disability index (ODI), McQuade test, and unsupported trunk holding test, respectively. The tests were done before and immediately, one day, one week, and one month after the interventions and compared between the two groups.Results
After treatments, pain intensity and disability level decreased and endurance of trunk flexor-extensor muscles increased significantly in both groups. Repeated measures analysis, however, showed that there was no significant difference between the groups in any of the evaluations.Conclusions
The findings of the present study showed that adding KT to SM does not appear to have a significant extra effect on pain, disability and muscle endurance in athletes with CNLBP. However, more studies are needed to examine the therapeutic effects of KT in treating these patients.Clinical trial registry number (irct.ir)
IRCT2016020624149N5. 相似文献9.
Pradeep Suri Kristin Delaney Sean D. Rundell Daniel C. Cherkin 《Archives of physical medicine and rehabilitation》2018,99(8):1533-1539.e2
Objective
To examine the predictive validity of the Subgrouping for Targeted Treatment (STarT Back) tool for classifying people with back pain into categories of low, medium, and high risk of persistent disabling back pain in U.S. primary care.Design
Secondary analysis of data from participants receiving usual care in a randomized clinical trial.Setting
Primary care clinics.Participants
Adults (N = 1109) ≥18 years of age with back pain. Those with specific causes of back pain (pregnancy, disc herniation, vertebral fracture, spinal stenosis) and work-related injuries were not included.Interventions
Not applicable.Main Outcome Measures
The original 9-item version of the STarT Back tool, administered at baseline, stratified patients by their risk (low, medium, high) of persistent disabling back pain (STarT Back risk group). Persistent disabling back pain was defined as Roland-Morris Disability Questionnaire scores of ≥7 at 6-month follow-up.Results
The STarT Back risk group was a significant predictor of persistent disabling back pain (P<.0001) at 6-month follow-up. The proportion of individuals with persistent disabling back pain at follow-up was 22% (95% confidence interval [CI] 18-25) in the low-risk group, 62% (95% CI 57-67) in the medium-risk group, and 80% (95% CI 75-85) in the high-risk group. The relative risk of persistent disabling back pain was 2.9 (95% CI 2.4-3.5) in the medium-risk group compared to the low-risk group, and 3.7 (95% CI 3.1-4.4) in the high-risk group.Conclusions
The STarT Back risk groups successfully separated people with back pain into distinct categories of risk for persistent disabling back pain at 6-month follow-up in U.S. primary care. These results were very similar to those in the original STarT Back validation study. This validation study is a necessary first step toward identifying whether the entire STarT Back approach, including matched/targeted treatment, can be effectively used for primary care in the United States. 相似文献10.
Arsalan Ghourbanpour Ghadam Ali Talebi Somayeh Hosseinzadeh Naser Janmohammadi Mohammad Taghipour 《Journal of bodywork and movement therapies》2018,22(2):493-497
Question
What are the effects of patellar taping on pain, functional disability and patellar alignments in Patellofemoral Pain Syndrome (PFPS)?Design
Double-blind randomized clinical trial.Participants
Thirty PFPS Patients were randomly divided into two groups, intervention and control.Intervention: Patients in control group received only the routine physiotherapy. In addition to routine physiotherapy, patellar taping was used in the intervention group. Each patient was treated for 12 sessions over a period of 4 weeks.Outcome measures
The KOOS and VAS questionnaires were used to assess the quality of life (QOL) and pain intensity, respectively. Three components of patellar alignment including Patellofemoral Congruence Angle (PFCA), Lateral Patellofemoral Angle (LPFA) and Lateral Patellar Displacement (LPD) were evaluated using the skyline radiography method.Results
The results indicated that there was no significant difference between the control and intervention groups for LPD (P = 0.586), PFCA (P = 0.704) and LPFA (P = 0.176) variables. No significant difference was found between the two groups in all items of the KOOS questionnaire. The knee pain intensity was significantly reduced in both the intervention (P < 0.001) and control (P = 0.001) groups at the end of the 4th week.Conclusion
The results of the present study indicated that patellar taping compared to routine physiotherapy treatments had no beneficial effects on pain reduction, QOL improvement and correction of patellar alignment in PSPS patients.Trial registration
IRCT201111012851N2. 相似文献11.
Gema Bodes Pardo Enrique Lluch Girbés Nathalie A. Roussel Tomás Gallego Izquierdo Virginia Jiménez Penick Daniel Pecos Martín 《Archives of physical medicine and rehabilitation》2018,99(2):338-347
Objective
To assess the effect of a pain neurophysiology education (PNE) program plus therapeutic exercise (TE) for patients with chronic low back pain (CLBP).Design
Single-blind randomized controlled trial.Setting
Private clinic and university.Participants
Patients with CLBP for ≥6 months (N=56).Interventions
Participants were randomized to receive either a TE program consisting of motor control, stretching, and aerobic exercises (n=28) or the same TE program in addition to a PNE program (n=28), conducted in two 30- to 50-minute sessions in groups of 4 to 6 participants.Main Outcomes Measures
The primary outcome was pain intensity rated on the numerical pain rating scale which was completed immediately after treatment and at 1- and 3-month follow-up. Secondary outcome measures were pressure pain threshold, finger-to-floor distance, Roland-Morris Disability Questionnaire, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Patient Global Impression of Change.Results
At 3-month follow-up, a large change in pain intensity (numerical pain rating scale: ?2.2; ?2.93 to ?1.28; P<.001; d=1.37) was observed for the PNE plus TE group, and a moderate effect size was observed for the secondary outcome measures.Conclusions
Combining PNE with TE resulted in significantly better results for participants with CLBP, with a large effect size, compared with TE alone. 相似文献12.
Background
Low back pain (LBP) is commonly associated with paraspinal muscle dysfunctions. A method to study deep lumbar paraspinal (ie, multifidus) muscle function and neuromuscular activation pattern is intramuscular electromyography (EMG). Previous studies have shown that the procedure does not significantly impact muscle function during activities involving low-level muscle contractions. However, it is currently unknown how muscular function and activation are affected during high-exertion contractions.Objective
To examine the effects of insertion and presence of fine-wire EMG electrodes in the lumbar multifidus on muscle strength, endurance, and activation profiles during high-exertion spinal extension muscle contractions.Design
Single-blinded, repeated measures intervention trial.Setting
University clinical research laboratoryParticipants
Twenty individuals between the ages of 18-40 free of recent and current back pain.Methods
Muscle performance was assessed during 3 conditions (with [WI] and without [WO] presence of intramuscular electrodes, and insertion followed by removal [IO]). Isometric spinal extension strength was assessed with a motorized dynamometer. Muscle endurance was assessed using the Sorensen test with neuromuscular activation profiles analyzed during the endurance test.Main Outcome Measurements
Spinal extensor muscle strength, endurance, and activation.Results
Our data showed no significant difference in isometric strength (P = .20) between the 3 conditions. A significant difference in muscle endurance was found (P = .03). Post hoc analysis showed that the muscle endurance in the IO condition was significantly higher than the WO condition (161.3 ± 58.3 versus 142.1 ± 48.2 seconds, P = .04), likely due to a learning effect. All 3 conditions elicited minimal pain (range 0-4/10) and comparable muscle activation profiles.Conclusion
Our findings suggested the sonographically guided insertion and presence of fine-wire intramuscular EMG electrodes in the lumbar multifidus muscles had no significant impact on spinal extension muscle function. This study provides evidence that implementing intramuscular EMG does not affect muscle performance during high-exertion contractions in individuals with no current back pain.Level of Evidence
II 相似文献13.
Nobushige Takahashi Hidetoshi Takahashi Osamu Takahashi Ryosuke Ushijima Rie Umebayashi Junji Nishikawa Yasutomo Okajima 《PM & R》2018,10(2):168-174
Background
Spasticity is a common sequela of upper motor neuron pathology, such as cerebrovascular diseases and cerebral palsy. Intervention for spasticity of the ankle plantarflexors in physical therapy may include tone-inhibiting casting and/or orthoses for the ankle and foot. However, the physiological mechanism of tone reduction by such orthoses remains unclarified.Objective
To investigate the electrophysiologic effects of tone-inhibiting insoles in stroke subjects with hemiparesis by measuring changes in reciprocal Ia inhibition (RI) in the ankle plantarflexor.Design
An interventional before–after study.Setting
Acute stroke unit or ambulatory rehabilitation clinic of a university hospital in Japan.Participants
Ten subjects (47-84 years) with hemiparesis and 10 healthy male control subjects (31-59 years) were recruited.Methods
RI of the spastic soleus in response to the electrical stimulation of the deep peroneal nerve was evaluated by stimulus-locked averaging of rectified electromyography (EMG) of the soleus while subjects were standing.Main Outcome Measurements
The magnitude of RI, defined as the ratio of the lowest to the baseline amplitude of the rectified EMG at approximately 40 milliseconds after stimulation, was measured while subjects were standing with and without the tone-inhibiting insole on the hemiparesis side.Results
Enhancement of EMG reduction with the tone-inhibiting insole was significant (P < .05) in the subjects with hemiparesis, whereas no significant changes were found in controls.Conclusion
Tone-inhibiting insoles enhanced RI of the soleus in subjects after stroke, which might enhance standing stability by reducing unfavorable ankle plantarflexion tone.Level of Evidence
III 相似文献14.
Sergey Motov Reuben Strayer Bryan D. Hayes Mark Reiter Steven Rosenbaum Melanie Richman Zachary Repanshek Scott Taylor Benjamin Friedman Gary Vilke Daniel Lasoff 《The Journal of emergency medicine》2018,54(5):731-736
Background
Pain is one of the most common reasons patients present to the emergency department (ED). Emergency physicians should be aware of the numerous opioid and nonopioid alternatives available for the treatment of pain.Objectives
To provide expert consensus guidelines for the safe and effective treatment of acute pain in the ED.Methods
Multiple independent literature searches using PubMed were performed regarding treatment of acute pain. A multidisciplinary panel of experts in Pharmacology and Emergency Medicine reviewed and discussed the literature to develop consensus guidelines.Recommendations
The guidelines provide resources for the safe use of opioids in the ED as well as pharmacological and nonpharmacological alternatives to opioid analgesia. Care should be tailored to the patient based on their specific acute painful condition and underlying risk factors and comorbidities.Conclusions
Analgesia in the ED should be provided in the most safe and judicious manner, with the goals of relieving acute pain while decreasing the risk of complications and opioid dependence. 相似文献15.
Background
Spondylolysis with and without anterolisthesis is the most common cause of structural back pain in children and adolescents, but few predictive factors have been confirmed. An association between abnormal sacropelvic orientation and both spondylolysis and spondylolisthesis has been supported in the literature. Sacral slope and other sacropelvic measurements are easily accessible variables that could aid clinicians in assessing active adolescents with low back pain, particularly when the diagnosis of spondylolysis is suspected.Objective
To examine the relationship between sacral slope and symptomatic spondylolysis in a cohort of active adolescents.Design
Case-control retrospective study.Setting
Academic outpatient physiatry practice.Patients
Seventy-four patients of primarily adolescent age (between 12 and 22 years old) with a chief complaint of low back pain and presence of lateral radiographs of the lumbar spine were enrolled. Cases (n = 37) were defined as subjects with evidence of spondylolysis on both radiograph and magnetic resonance imaging of the lumbar spine. Controls (n = 37) were defined as subjects without spondylolysis.Methods
Using a single sagittal radiograph, taken with the patient standing, a fellowship-trained interventional spine physiatrist measured the sacral slope of each subject (angle between the superior plate of S1 and a horizontal reference on sagittal imaging of the lumbosacral spine). Ages and genders were collected from medical records.Main Outcome Measurements
The primary outcome was mean sacral slope. Mean sacral slope of cases was compared with mean sacral slope of controls with the Student t-test.Results
Ages ranged from 12 to 22 for both groups, with no significant differences in age between the groups (cases: 16.8 ± 2.3 years; controls: 17.7 ± 2.7 years). The patients with spondylolysis (cases) consisted of 29 male and 8 female patients, whereas those without spondylolysis (controls) consisted of 15 male and 21 female patients (gender details for 1 patient were not available). The mean sacral slope among cases was 42.4°, whereas the mean sacral slope among controls was 37.4°. The difference achieved significance (P = .014).Conclusions
The interdependence of positional parameters, such as sacral slope, with anatomic parameters, such as pelvic incidence, can affect lumbar lordosis and therefore upright positioning and loading of the spine. Sacral slope may be an important variable for clinicians to consider when caring for young athletes with low back pain, particularly when the index of suspicion for spondylolysis is high.Level of Evidence
IV 相似文献16.
Safoora Ebadi Noureddin Nakhostin Ansari Tannaz Ahadi Ehsan Fallah Bijan Forogh 《Journal of bodywork and movement therapies》2018,22(3):693-699
Background and design
Chronic nonspecific low back pain (CNSLBP) has major socioeconomic as well as personal impact in many industrialized and developing countries. Physiotherapy is a common intervention for this group of patients and using anti-pain physical modalities is a common part of the physical therapy. In a randomized controlled trial we investigated the immediate effect of the Diadynamic current in comparison to TENS on reducing the pain in patients suffering from non specific chronic low back pain.Methods
Thirty patients were randomized into the Diadynamic current and TENS groups. Electrical stimulation was applied for 10 min in the Diadynamic group and for 15 min in the TENS group for one session. Pain, on a 100 mm Visual Analog Scale, and Pressure Pain Threshold (PPT), using an Algometer, was measured before the treatment, after the current application, 20 min later and after 48 h.Results
Pain was decreased significantly after 20 min following the current application only in the TENS group, with no improvement at all measurement points in the group receiving Diadynamic current. PPT was increased immediately after current application in both groups but did not last until later measurements.Conclusion
Diadynamic current had no positive effect on prompt relief of pain in patients suffering from recurrent CNSLBP. 相似文献17.
Cleveland T. Barnett Natalie Vanicek David F. Rusaw 《Archives of physical medicine and rehabilitation》2018,99(11):2271-2278
Objective
To assess whether variables from a postural control test relate to and predict falls efficacy in prosthesis users.Design
Twelve-month within- and between-participants repeated measures design. Participants performed the limits of stability (LOS) test protocol at study baseline and at 6-month follow-up. Participants also completed the Falls Efficacy Scale-International (FES-I) questionnaire, reflecting the fear of falling, and reported the number of falls monthly between study baseline and 6-month follow-up, and additionally at 9- and 12-month follow-ups.Setting
University biomechanics laboratories.Participants
Participants (N=24) included a group of active unilateral transtibial prosthesis users of primarily traumatic etiology (n=12) with at least 1 year of prosthetic experience and age- and sex-matched control participants (n=12).Interventions
Not applicable.Main Outcome Measures
Postural control variables derived from center of pressure data obtained during the LOS test, which was performed on and reported by the Neurocom Pro Balance Master, namely reaction time, movement velocity (MVL), endpoint excursion (EPE), maximum excursion (MXE), and directional control (DCL). Number of falls and total FES-I scores.Results
During the study period, the prosthesis users group had higher FES-I scores (U=33.5, P=.02), but experienced a similar number of falls, compared to the control group. Increased FES-I scores were associated with decreased EPE (r= ?0.73, P=.02), MXE (r= ?0.83, P<.01) and MVL (r= ?0.7, P=.03) in the prosthesis users group, and DCL (r= ?0.82, P<.01) in the control group, all in the backward direction.Conclusions
Study baseline measures of postural control, in the backward direction only, are related to and potentially predictive of subsequent 6-month FES-I scores in relatively mobile and experienced prosthesis users. 相似文献18.
Shelby Baez Matthew C. Hoch Johanna M. Hoch 《Archives of physical medicine and rehabilitation》2018,99(11):2287-2298
Objectives
To systematically locate, critically appraise, and synthesize the available evidence regarding the effectiveness of cognitive behavioral therapies (CBTs) and psychoeducation that can be implemented by rehabilitation specialists to treat fear-avoidance beliefs in patients with acute, subacute, and chronic low back pain (LBP).Data Sources
Electronic databases (CINAHL, PubMed, Psychology and Behavior Sciences Collection, SPORTDiscus, PsycINFO) were searched from inception to September 2017.Study Selection
Assessment of methodological quality was completed using the Physiotherapy Evidence Database (PEDro) scale. The Strength of Recommendation Taxonomy was used to evaluate the quality of evidence.Data Extraction
Study sample, subject demographics, CBT and/or psychoeducation intervention details, data collection time points, outcome assessments, statistical analysis, results, and conclusions were extracted from each study. In addition, effect sizes were calculated.Data Synthesis
Five high-quality studies (PEDro ≥6) were included. All included studies evaluated fear-avoidance beliefs. CBTs and psychoeducation strategies designed to target patient-specific fears demonstrated clinically meaningful results, while psychoeducation methodologies were not as effective.Conclusions
There is inconsistent, patient-oriented evidence (grade B) to support the use of CBTs and/or psychoeducation strategies by rehabilitation specialists to treat fear-avoidance beliefs. Patient-centered and personalized CBTs were most effective to treat these psychosocial factors in patients with LBP when compared with a control treatment. 相似文献19.
Amanda Costa Araujo Patrícia do Carmo Silva Parreira Luiz Carlos Hespanhol Junior Tatiane Mota da Silva Maurício Antônio da Luz Junior Lucíola da Cunha Menezes Costa Leonardo Oliveira Pena Costa 《Physiotherapy》2018,104(1):149-151
Background
Kinesio taping is a commonly used intervention for patients with chronic low back pain. However, the medium term effects of kinesio taping in these patients are unknown.Objective
To investigate the effectiveness of kinesio taping in patients with chronic low back pain after 6 months from randomization.Methods
This was a randomized controlled trial with a 6 months follow up. One hundred and forty eight participants were randomly assigned to the experimental (kinesio taping with skin convolutions) or control (kinesio taping without convolutions—Sham Taping) group. Participants from both groups had the tape reapplied twice a week for four weeks. The outcomes were pain, disability and global impression of recovery after 6 months.Results
One participant was lost to follow up in the experimental group (n = 73, response rate 99%) and two in the control group (n = 72, response rate 97%). After 6 months there were no statistically significant between-group differences in pain intensity (between-group difference ?0.8 points, 95% CI ?1.7 to 0.2), global impression of recovery (0.4, ?0.7 to 1.5), or disability (?1.1, ?3.0 to 0.7).Conclusion
Four weeks of kinesio taping treatment was no better than sham taping for patients with chronic low back pain, at 6 months follow-up.Trial Registration Number (http://www.ensaiosclinicos.gov.br/): RBR-7ggfkv (Brazilian Registry of Clinical Trials). 相似文献20.
Lin Liu Qiang-Min Huang Qing-Guang Liu Nguyen Thitham Li-Hui Li Yan-Tao Ma Jia-Min Zhao 《Archives of physical medicine and rehabilitation》2018,99(1):144-152.e2