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1.
Ana Paula A. Ferreira Luciana C. Póvoa José F.C. Zanier Arthur S. Ferreira 《Journal of manipulative and physiological therapeutics》2017,40(2):98-105
Objectives
The aim of this study was to assess the thorax-rib static method (TRSM), a palpation method for locating the seventh cervical spinous process (C7SP), and to report clinical data on the accuracy of this method and that of the neck flexion-extension method (FEM), using radiography as the gold standard.Methods
A single-blinded, cross-sectional diagnostic accuracy study was conducted. One hundred and one participants from a primary-to-tertiary health care center (63 men, 56 ± 17 years of age) had their neck palpated using the FEM and the TRSM. A single examiner performed both the FEM and TRSM in a random sequence. Radiopaque markers were placed at each location with the aid of an ultraviolet lamp. Participants underwent chest radiography for assessment of the superimposed inner body structure, which was located by using either the FEM or the TRSM.Results
Accuracy in identifying the C7SP was 18% and 33% (P = .013) with use of the FEM and the TRSM, respectively. The cumulative accuracy considering both caudal and cephalic directions (C7SP ± 1SP) increased to 58% and 81% (P = .001) with use of the FEM and the TRSM, respectively. Age had a significant effect on the accuracy of FEM (P = .027) but not on the accuracy of TRSM (P = .939). Sex, body mass, body height, and body mass index had no significant effects on the accuracy of both the FEM (P = .209 or higher) and the TRSM (P = .265 or higher).Conclusions
The TRMS located the C7SP more accurately compared with the FEM at any given level of anatomic detail, although both still underperformed in terms of acceptable accuracy for a clinical setting. 相似文献2.
Monique Silva Rezende Ana Luiza Marsengo Amanda Apolinário Vânia Tie Koga Ferreira Elaine Caldeira de Oliveira Guirro 《Journal of manipulative and physiological therapeutics》2017,40(4):241-245
Objective
The purpose of this study was to correlate upper limb volume and arterial and venous blood flow velocity in breast cancer survivors.Methods
A cross-sectional study was conducted on 30 women with lymphedema and a mean age of 55.60 years (standard deviation = 8.12). For the assessment of upper limb volume, perimetry was performed with measures at 6 points on the limb, which were mathematically calculated as volume. The blood flow velocity of the axillary and brachial arteries and veins were assessed by Doppler ultrasound with a probe at 4 MHz. In the statistical analysis, a Shapiro-Wilk test determined a non-normal data distribution. Spearman correlation coefficients (ρ) were calculated to determine the association between the variables blood flow velocity and lymphedema volume.Results
We identified significant and positive associations between all variables correlated with limb volume: blood flow velocity of the axillary artery (ρ = 0.381, P = .041), axillary vein (ρ = 0.383, P = .039), brachial artery (ρ = 0.375, P = .044), and the brachial vein (ρ = 0.373, P = .045).Conclusion
There is a positive association between limb volume and blood flow velocity in the upper limbs of women with lymphedema secondary to breast cancer treatment. 相似文献3.
Johanna Wibault Birgitta Öberg Åsa Dedering Håkan Löfgren Peter Zsigmond Liselott Persson Maria Andell Margareta R. Jonsson Anneli Peolsson 《Journal of manipulative and physiological therapeutics》2017,40(5):330-339
Objective
The purpose of this study was to compare postoperative rehabilitation with structured physiotherapy to the standard approach in patients with cervical radiculopathy (CR) in a prospective randomized study at 6 months follow-up based on measures of neck-related physical function, self-efficacy, and coping strategies.Methods
Patients with persistent CR and scheduled for surgery (N = 202) were randomly assigned to structured postoperative physiotherapy or a standard postoperative approach. Structured postoperative physiotherapy combined neck-specific exercises with a behavioral approach. Baseline, 3-month, and 6-month evaluations included questionnaires and clinical examinations. Neck muscle endurance, active cervical range of motion, self-efficacy, pain catastrophizing (CSQ-CAT), perceived control over pain, and ability to decrease pain were analyzed for between-group differences using complete case and per-protocol approaches.Results
No between-group difference was reported at the 6-month follow-up (P = .05-.99), but all outcomes had improved from baseline (P < .001). Patients undergoing structured postoperative physiotherapy with ≥50% attendance at treatment sessions had larger improvements in CSQ-CAT (P = .04) during the rehabilitation period from 3 to 6 months after surgery compared with the patients who received standard postoperative approach.Conclusions
No between-group difference was found at 6 months after surgery based on measures of neck-related physical function, self-efficacy, and coping strategies. However, the results confirm that neck-specific exercises are tolerated by patients with CR after surgery and may suggest a benefit from combining surgery with structured postoperative physiotherapy for patients with CR. 相似文献4.
S. Jun Son Hyunsoo Kim Matthew K. Seeley J. Ty Hopkins 《Archives of physical medicine and rehabilitation》2017,98(1):25-35
Objectives
To examine the effect of experimental knee pain on perceived knee pain and gait patterns and to examine the efficacy of transcutaneous electrical nerve stimulation (TENS) on perceived knee pain and pain-induced knee gait mechanics.Design
Crossover trial.Setting
Biomechanics laboratory.Participants
Recreationally active, individuals without musculoskeletal pain aged 18 to 35 years (N=30).Interventions
Thirty able-bodied individuals were assigned to either a TENS (n=15) or a placebo (n=15) group. All participants completed 3 experimental sessions in a counterbalanced order separated by 2 days: (1) hypertonic saline infusion (5% NaCl); (2) isotonic saline infusion (0.9% NaCl); and (3) control. Each group received sensory electrical stimulation or placebo treatment for 20 minutes, respectively.Main Outcome Measures
Perceived pain was collected every 2 minutes using a 10-cm visual analog scale (VAS) for 50 minutes and analyzed using a mixed model analysis of covariance with repeated measures. Gait analyses were performed at baseline, infusion, and treatment. Sagittal and frontal knee angles and internal net joint torque across the entire stance were analyzed using a functional data analysis approach.Results
Hypertonic saline infusion increased perceived pain (4/10cm on a VAS; P<.05) and altered right knee angle (more flexion and less abduction; P<.05) and internal net joint torque (less extension and greater abduction; P<.05) across various stance phases. TENS treatment reduced perceived pain and improved right sagittal gait abnormalities as compared with placebo treatment (P<.05).Conclusions
This pain model increases perceived pain and induces compensatory gait patterns in a way that indicates potential quadriceps weakness. However, TENS treatment effectively reduces perceived pain and restores pain-induced gait abnormalities in sagittal knee mechanics. 相似文献5.
Leonardo Shigaki Edgar Ramos Vieira André Wilson de Oliveira Gil Cynthia Gobbi Alves Araújo Mariana Zingari Carmargo Leandro Amaral Sturion Marcio Roǵerio de Oliveira Rubens A. da Silva 《Journal of manipulative and physiological therapeutics》2017,40(4):284-292
Objective
The purpose of this study was to assess the effect of holding an external load on the standing balance of younger and older adults with and without chronic low back pain (CLBP).Methods
Twenty participants with and 20 without CLBP participated in the study. Each group contained 10 younger (50% men) and 10 older adults (50% men). Participants were instructed to look straight ahead while standing on a force platform during two 120-second trials with and without holding an external load (10% of body mass). The center of pressure area, mean velocity, and mean frequency in the anteroposterior and mediolateral directions were measured.Results
Older adults had worse standing balance than younger adults did (P < .001, d = 0.20). There were no significant balance differences between participants with and without CLBP within age groups during standing balance condition. However, holding the external load significantly increased postural instability for both age groups and CLBP status, with mean effect size across center of pressure variables of d = 0.82 for older participants without CLBP and d = 2.65 for younger participants without CLBP. These effects for people with CLBP were d = 1.65 for subgroup of older and d = 1.60 for subgroup of younger participants.Conclusion
Holding an external load of 10% of body mass increased postural instability of both younger and older adults with and without CLBP. 相似文献6.
Kelvin J. Murray Tom Molyneux Michael R. Le Grande Aurora Castro Mendez Franz K. Fuss Michael F. Azari 《Journal of manipulative and physiological therapeutics》2017,40(5):320-329
Objective
The purpose of this study was to evaluate the correlation between mild leg length discrepancy (LLD) and degenerative joint disease (DJD) or osteoarthritis.Methods
We evaluated standard postural lumbopelvic radiographs from 255 adults (121 women and 134 men) who had presented with spinal pain for chiropractic care. Symmetry of femoral head diameters was used to exclude magnification errors. Pearson’s partial correlation was used to control for age and derive effect sizes for LLD on DJD in the hip and lower lumbar motion segments. Krippendorff’s α was used for intraobserver and interobserver reliability.Results
A strong correlation was found between LLD and hip DJD in men (r = 0.532) and women (r = 0.246). We also found a strong correlation between LLD and DJD at the L5-S1 motion segment in men (r = 0.395) and women (r = 0.246). At the L4-5 spinal level this correlation was much attenuated in men (r = 0.229) and women (r = 0.166).Conclusions
These findings suggest an association between LLD and hip and lumbar DJD. Cause–effect relationships between mild LLD and DJD deserve to be properly evaluated in future longitudinal cohort studies. 相似文献7.
Isabelle Pagé Éric Biner Martin Descarreaux 《Journal of manipulative and physiological therapeutics》2018,41(9):753-761
Objective
The purpose of this study was to compare vertebral displacements (absolute and relative) and muscle responses induced by spinal manipulative therapy of short (spinal manipulation) and long (spinal mobilization) impulse duration.Methods
Twenty-five healthy adults (without thoracic pain) were recruited for this crossover study. Six spinal manipulative therapies (255 N peak force) of different impulse durations (100, 125, 200, 500, 1000, and 1500 ms) were delivered to each participant’s T7 transverse process using a mechanical device. Impulse duration effect on the vertebral displacement (absolute displacement of T6, T7, and T8 and relative displacement between T7 and T6 and between T7 and T8) and the thoracic muscle response (surface electromyography) were assessed using mixed-model analyses of variance and predefined linear trend analyses.Results
Results showed a linear increase in the absolute vertebral displacement for T8 (P = .002) and a linear decrease in the T7/T6 and T7/T8 relative displacement (P < .0001) when impulse duration was increased. The data of 24 participants were available for electromyography analysis. A significant main effect of impulse duration on surface electromyography response was observed (P < .0001, ?p2=0.43). Planned comparisons for a linear trend between these variables revealed a negative relationship (P < .0001). Only 13 of the 24 participants with available data presented a muscle response at every impulse duration.Conclusion
These results support the assumption that spinal manipulation and spinal mobilization might operate under distinct mechanisms. 相似文献8.
Kyoung Min You Chiwon Lee Woon Yong Kwon Jung Chan Lee Gil Joon Suh Kyung Su Kim Min Ji Park Sungwan Kim 《The American journal of emergency medicine》2017,35(2):292-298
Purpose
We performed this study to investigate whether real-time tidal volume feedback increases optimal ventilation and decreases hyperventilation during manikin-simulated cardiopulmonary resuscitation (CPR).Basic procedures
We developed a new real-time tidal volume monitoring device (TVD) which estimated tidal volume in real time using a magnetic flowmeter. The TVD was validated with a volume-controlled mechanical ventilator with various tidal volumes. We conducted a randomized, crossover, manikin-simulation study in which 14 participants were randomly divided into a control (without tidal volume feedback, n = 7) and a TVD group (with real-time tidal volume feedback, n = 7) and underwent manikin simulation. The optimal ventilation was defined as 420-490 mL of tidal volumes for a 70-kg adult manikin. After 2 weeks of the washout period, the simulation was repeated via the participants' crossover.Main findings
In the validation study, 97.6% and 100% of the difference ratios in tidal volumes between the mechanical ventilator and TVD were within ±1.5% and ±2.5%, respectively. During manikin-simulated CPR, TVD use increased the proportion of optimal ventilation per person. Its median values (range) of the control group and the TVD group were 37.5% (0.0-65.0) and 87.5% (65.0-100.0), respectively, P < .001). TVD use also decreased hyperventilation. The proportions of hyperventilation in the control group and the TVD group were 25.0% vs 8.9%, respectively (P < .001).Principal conclusions
Real-time tidal volume feedback using the new TVD guided the rescuers to provide optimal ventilation and to avoid hyperventilation during manikin-simulated CPR. 相似文献9.
Casey S. Okamoto Andrew S. Dunn Bart N. Green Lance R. Formolo David Chicoine 《Journal of manipulative and physiological therapeutics》2017,40(5):358-364
Objective
Back pain is more prevalent in the obese, but whether back pain severity is directly correlated to obesity in veterans is unknown. We sought to determine if there was a correlation between body composition and low back pain severity in a sample of veterans. The hypothesis was that veterans with higher body mass index values would report higher low back pain severity scores.Methods
This study was a retrospective chart review of 1768 veterans presenting to a Veterans Affairs chiropractic clinic with a chief complaint of low back pain between January 1, 2009 and December 31, 2014. Spearman’s rho was used to test for correlation between body composition as measured by body mass index and low back pain severity as measured by the Back Bournemouth Questionnaire.Results
On average, the sample was predominantly male (91%), older than 50, and overweight (36.5%) or obese (48.9%). There was no correlation between body mass index and Back Bournemouth Questionnaire scores, r = .088, p < .001.Conclusions
The majority of veterans with low back pain in this sample were either overweight or obese. There was no correlation between body composition and low back pain severity in this sample of veterans. 相似文献10.
Sean P. Wilson Taher Vohra McKenna Knych Jared Goldberg Christopher Price Sean Calo Meredith Mahan Joseph Miller 《The American journal of emergency medicine》2017,35(5):701-703
Introduction
Delay in current nucleic acid amplification testing for Neisseria gonorrhoeae and Chlamydia trachomatis has led to recommendations for presumptive treatment in patients with concern for infection and unreliable follow-up. In the urban setting, it is assumed that many patients have unreliable follow-up, therefore presumptive therapy is thought to be used frequently. We sought to measure the frequency of disease and accuracy of presumptive treatment for these infections.Methods
This was an observational cohort study performed at an urban academic Level 1 trauma center ED with an annual census of 95,000 visits per year. Testing was performed using the APTIMA Unisex swab assay (Gen-Probe Incorporated, San Diego, CA). Presumptive therapy was defined as receiving treatment for both infections during the initial encounter without confirmation of diagnosis.Results
A total of 1162 patients enrolled. Infection was present in 26% of men, 14% of all women and 11% of pregnant women. Despite high frequency of presumptive treatment, > 4% of infected patients in each category went untreated.Conclusion
Inaccuracy of presumptive treatment was common for these sexually transmitted infections. There is an opportunity to improve diagnostic accuracy for treatment. 相似文献11.
Rodrigo Miguel Ruivo Pedro Pezarat-Correia Ana Isabel Carita 《Journal of manipulative and physiological therapeutics》2017,40(1):1-10
Objective
The purpose of this study was to evaluate the effects of a 16-week resistance and stretching training program applied in physical education (PE) classes on forward head posture and protracted shoulder posture in Portuguese adolescents.Methods
This prospective, randomized, controlled study was conducted in 2 secondary schools. One hundred and thirty adolescents (aged 15-17 years) with forward head and protracted shoulder posture were randomly assigned to a control or experimental group. Sagittal head, cervical, and shoulder angles were measured with photogrammetry and Postural Assessment Software. The American Shoulder and Elbow Surgeons Shoulder Assessment was used to assess shoulder pain, and neck pain during the last month was self-reported with a single question. These variables were assessed before and after a 16-week intervention period. The control group (n = 46) attended the PE classes, whereas the exercise group (n = 84) received a posture corrective exercise program in addition to PE classes.Results
A significant increase in cervical and shoulder angles was observed in the intervention group from pretest to posttest (P < .05). For the shoulder pain scores in both groups, there were no significant changes after the 16 weeks.Conclusions
A 16-week resistance and stretching training program decreased forward head and protracted shoulder postures in adolescents. 相似文献12.
Mehmet Ali Aslaner Mustafa Boz Ali Çelik Asliddin Ahmedali Sercan Eroğlu Nalan Metin Aksu Serkan Emre Eroğlu 《The American journal of emergency medicine》2017,35(1):71-76
Objectives
Altered mental status (AMS) is a challenging diagnosis in older patients and has a large range of etiologies. The aim of this study was to investigate the nature of such etiologies for physicians to be better aware of AMS backgrounds and hence improve outcomes and mortality rates.Methods
This prospective observational study was conducted at 4 emergency departments. Patients 65 years and older who presented to the emergency department with acute AMS (≤1 week), with symptoms ranging from comas and combativeness, were eligible for inclusion in this study. The outcomes, etiologies, Richmond Agitation and Sedation Scale scores, and the presence of delirium were recorded.Results
Among 822 older patients with AMS, infection (39.5%) and neurological diseases (36.5%) were the most common etiologies. The hospital admission and mortality rates were 73.7% (n = 606) and 24.7% (n = 203), respectively. The mortality rate rose if AMS persisted for more than 3 days. Delirium was observed in 55.7% of the patients; these individuals had higher durations of AMS than those without delirium (median, 24 hours; interquartile range, 3-48 hours; median 6 hours, interquartile range, 3-48 hours, respectively; P = .010). Notably, delirium was observed in more than two-thirds of neurological patients.Conclusions
The most common causes of AMS were infection and neurological diseases. Delirium was associated with AMS in nearly half the patients. Moreover, the rates of hospitalization and mortality remained high. 相似文献13.
Zhuomao Mo Renwen Zhang Jinfeng Chen Xinnong Shu Tang Shujie 《Journal of manipulative and physiological therapeutics》2018,41(9):771-779
Objective
The purpose of this review was to compare oblique pulling spinal manipulation with other treatments for lumbar disc herniation.Methods
Randomized controlled trials of oblique pulling manipulation versus other treatment for lumbar disc herniation were identified using the following databases: China National Knowledge Infrastructure, Wanfang Data, Chinese Science and Technology Periodical Database, PubMed, the Cochrane Library, Embase, Chinese Biological Medicine, and Web of Science. Data extraction was carried out based on inclusion and exclusion criteria, and meta-analysis were performed using RevMan 5.3 software.Results
Nine relevant randomized controlled trials with a total of 887 patients were included. Meta-analysis revealed that oblique pulling manipulation was superior in effective rate to lumbar traction (risk ratio = 1.12; 95% confidence interval [CI]: 1.06-1.19; P < .01) and acupuncture (risk ratio = 1.22; 95% CI: 1.06-1.39; P < .01) and more effective in Visual Analog Scale score (mean difference = - 1.03, 95% CI: -1.32 to -0.74; P < .01) when compared to lumbar traction. It also demonstrated a favorable effect of modified oblique pulling manipulation in Japanese Orthopedic Association scores when compared with lumbar traction (mean difference = 1.66, 95% CI: 0.89 to 2.43; P < .01).Conclusion
In the treatment of lumbar disc herniation, oblique pulling spinal manipulation presented with a higher effective rate than acupuncture and lumbar traction. Manipulation had a favorable effect in alleviating pain, and modified oblique pulling manipulation had significant superiority in improving lumbar function when compared with lumbar traction. However, considering the low methodological quality of included studies, more rigorously designed trials should be performed in the future. 相似文献14.
Sayuri Matsunami Nobuyasu Komasawa Yuki Konishi Toshiaki Minami 《The American journal of emergency medicine》2017,35(11):1709-1712
Purpose
We performed two prospective randomized crossover trials to evaluate the effect of head elevation or lateral head rotation to facemask ventilation volume.Methods
In the first trial, facemask ventilation was performed with a 12-cm high pillow (HP) and 4-cm low pillow (LP) in 20 female patients who were scheduled to undergo general anesthesia. In the second trial, facemask ventilation was performed with and without lateral head rotation in another 20 female patients. Ventilation volume was measured in a pressure-controlled ventilation (PCV) manner at 10, 15, and 20 cmH2O inspiratory pressures.Results
In the first trial evaluating head elevation effect, facemask ventilation volume was significantly higher with a HP than with a LP at 15 and 20 cmH2O inspiratory pressure (15 cmH2O: HP median540 [IQR480–605] mL, LP 460 [400–520] mL, P = 0.006, 20 cmH2O: HP 705 [650–800] mL, LP 560 [520–677] mL, P < 0.001). In the second trial, lateral head rotation did not significantly increase facemask ventilation volume at all inspiratory pressure.Conclusion
Head elevation increased facemask ventilation volume in normal airway patients, while lateral head rotation did not. 相似文献15.
Troy Madsen Cameron Smyres Talmage Wood Tamara Moores Matthew Fuller Virgil Davis Kurt Bernhisel 《The American journal of emergency medicine》2017,35(1):25-28
Background
In evaluating patients with chest pain, emergency department observation units (EDOUs) may use a staffing model in which emergency physicians determine patient testing (EP model) or a model similar to a chest pain unit (CPU) in which cardiologists determine provocative testing (CPU model).Methods
We performed a prospective study with 30-day telephone follow-up for all chest pain patients placed in our EDOU. Halfway through the study period, our EDOU transitioned from an EP model to a CPU model. We compared provocative testing rates and outcomes between the 2 models.Results
Over the 34-month study period, our EDOU evaluated 1190 patients for chest pain. Patients placed in the EDOU during the 17-month CPU model were more likely to be moderate risk (Thrombolysis in Myocardial Infarction score 3-5) than those during the 17-month EP model: 24.9% vs 18.8%, P = .011. Despite this difference, rates of provocative testing (stress testing or coronary computed tomography) were lower during the CPU model: 47.1% vs 56.5%, P = .001. This reduction was particularly evident among low-risk patients (Thrombolysis in Myocardial Infarction score 0-2): 49.8% vs 58.1%, P = .011. Rates of myocardial infarction, percutaneous coronary intervention, or coronary artery bypass graft were similar between the 2 groups (2.8% vs 3.2%, P = .140). We noted no significant events or missed diagnoses in either group during the 30-day follow-up.Conclusion
An EDOU model that used mandatory cardiology consultation resulted in decreased provocative testing, particularly among low-risk chest pain patients. Future research should explore the cost-effectiveness of this model. 相似文献16.
Yi-Ping Chang Kao-Shang Shih Hongsen Chiang Hsiao-Li Ma Leou-Chyr Lin Wei-Chen Peng Che-Sheng Wen Hsing-Kuo Wang 《PM & R》2017,9(1):32-39
Background
Early microcirculatory responses after experimental tenotomy are critical to the healing of tendons and their ultimate tensile strength. The effects of changes in microcirculation on the outcomes of tendon healing, however, have not been determined.Objectives
To assess microcirculation values in injured Achilles tendons in the first 3 months after surgical repair and to correlate the inter-limb microcirculatory changes with functional outcomes at 3 and 6 months after surgery.Design
Case-control study.Setting
A university sports physiotherapy laboratory.Participants
Thirteen subjects (median age: 45 years; range: 34.8-51.9 years) with a repaired Achilles tendon were recruited.Methods or Intervention
Surgical repair.Main Outcome Measurements
Measurements were obtained at 1, 2, 3, and 6 months after surgery. Bilateral measurements of tendon microcirculation (total hemoglobin [THb] and oxygen saturation [StO2]) were recorded at the first 3 time points, whereas outcome measures of a Taiwan Chinese version of the Victorian Institute of Sport Assessment Scale-Achilles questionnaire, one-leg hopping distance, the star excursion balance test, and the heel raise index were conducted at the third and fourth time points. Correlations between the inter-limb microcirculatory changes, eg, between the measurements at 2 months and 1 month (2-1) after surgery, at 3 months and 2 months (3-2) after surgery, and at 3 months and 1 month (3-1) after surgery, and the outcome measures were investigated.Results
Compared with the noninjured tendons, the repaired Achilles demonstrated greater THb (at 1, 2, and 3 months; P = .017, .008, and .012 respectively) and StO2 (at 3 months; P = .017). Furthermore, the THb2-1 and THb3-2, StO2 2-1, and StO2 3-2 showed correlations with the heel raise index, differences in the star excursion balance test and one-leg hopping distance between the noninjured leg and injured leg, and Taiwan Chinese version of the Victorian Institute of Sport Assessment Scale-Achilles questionnaire scores (rho ?0.921 to 0.855).Conclusions
Changes in the inter-limb microcirculation shortly after Achilles repair were correlated with subsequent symptoms and functional symmetry.Level of Evidence
III 相似文献17.
Tomasz Wolny Edward Saulicz Paweł Linek Michael Shacklock Andrzej Myśliwiec 《Journal of manipulative and physiological therapeutics》2017,40(4):263-272
Objective
The purpose of this randomized trial was to compare the efficacy of manual therapy, including the use of neurodynamic techniques, with electrophysical modalities on patients with mild and moderate carpal tunnel syndrome (CTS).Methods
The study included 140 CTS patients who were randomly assigned to the manual therapy (MT) group, which included the use of neurodynamic techniques, functional massage, and carpal bone mobilizations techniques, or to the electrophysical modalities (EM) group, which included laser and ultrasound therapy. Nerve conduction, pain severity, symptom severity, and functional status measured by the Boston Carpal Tunnel Questionnaire were assessed before and after treatment. Therapy was conducted twice weekly and both groups received 20 therapy sessions.Results
A baseline assessment revealed group differences in sensory conduction of the median nerve (P < .01) but not in motor conduction (P = .82). Four weeks after the last treatment procedure, nerve conduction was examined again. In the MT group, median nerve sensory conduction velocity increased by 34% and motor conduction velocity by 6% (in both cases, P < .01). There was no change in median nerve sensory and motor conduction velocities in the EM. Distal motor latency was decreased (P < .01) in both groups. A baseline assessment revealed no group differences in pain severity, symptom severity, or functional status. Immediately after therapy, analysis of variance revealed group differences in pain severity (P < .01), with a reduction in pain in both groups (MT: 290%, P < .01; EM: 47%, P < .01). There were group differences in symptom severity (P < .01) and function (P < .01) on the Boston Carpal Tunnel Questionnaire. Both groups had an improvement in functional status (MT: 47%, P < .01; EM: 9%, P < .01) and a reduction in subjective CTS symptoms (MT: 67%, P < .01; EM: 15%, P < .01).Conclusion
Both therapies had a positive effect on nerve conduction, pain reduction, functional status, and subjective symptoms in individuals with CTS. However, the results regarding pain reduction, subjective symptoms, and functional status were better in the MT group. 相似文献18.
Nathan F. Jarman Toby Brooks C. Roger James Troy Hooper Mark Wilhelm Jean-Michel Brismée Manuel A. Domenech Stanley J. Kotara Phillip S. Sizer 《PM & R》2017,9(10):969-975
Background
Deep neck flexor (DNF) muscles stabilize the neck and contribute to head acceleration control. The function of DNF in cervical spine dynamic stabilization has not been examined in athletes of any age group, including adolescents. This investigation was necessary prior to studying the DNF muscles’ role in cervical spine injury patterns.Objectives
The objectives of this study were (1) to determine average Deep Neck Flexor Endurance Test (DNFET) time scores in high school?aged and university-aged subjects (aged 14-22 years); and (2) to establish the relationship between gender and age for adolescent DNFET time scores.Design
Cross-sectional design.Setting
Public high school and private university.Participants
A total of 81 (40 male, 41 female) healthy high school and collegiate athletes.Intervention
DNFET time scores (in seconds) were collected and means values were calculated. Interrater reliability was established using the first 15 university-aged subjects enrolled in the study.Main Outcomes
Mean DNFET time (seconds) scores.Results
The DNF muscle endurance interrater reliability coefficient of reproducibility for 4 allied health clinicians was intraclass correlation coefficient (2,4) 0.712 (confidence interval, 0.24-0.85). The mean (± standard deviation) DNFET time score for females was 31.86 (±8.53) seconds versus 35.57 (±10.43) seconds for males. The DNFET performance demonstrated a significant but fair correlation with age (r = 0.401, P = .0001). No significant performance differences were found between male and female subjects in the 14- to 17-year-old group (U = 187.0, P = .285), the 18- to 22-year-old group (U = 145.0, P = .215), or the total male versus female subject groups (U = 653.0, P = .083).Conclusion
Our study establishes a normative data set available for the DNFET in the adolescent population. The fair correlation between DNFET time scores and age is consistent with other studies. These findings serve as a basis for clinician testing, objectifying, and monitoring DNF dysfunction in an adolescent athletic population.Level of Evidence
II 相似文献19.
20.
Tadashi Ashida Shigemasa Tani Ken Nagao Tsukasa Yagi Naoya Matsumoto Atsushi Hirayama 《The American journal of emergency medicine》2017,35(3):448-457