Effect of Dry Needling on Spasticity, Shoulder Range of Motion, and Pressure Pain Sensitivity in Patients With Stroke: A Crossover Study

This study aimed to evaluate changes in neuromuscular function and pain perception in latent trigger points (TrPs) in the gastrocnemius muscle after a single session of dry needling. A randomized within-participant clinical trial was conducted. Fifty volunteers with latent TrPs in the gastrocnemius muscles were explored. Each extremity was randomly assigned to a control or experimental (dry needling) group. Viscoelastic parameters and contractile properties were analyzed by tensiomyography. Ankle dorsiflexion range of motion was assessed with the lunge test. Pressure pain thresholds (PPT) and pain perceived were also analyzed. The results observed that three viscoelastic proprieties (myotonometry) showed significant differences in favor of the experimental extremity in the lateral gastrocnemius: stiffness (p = 0.02), relaxation (p = 0.045), and creep (p = 0.03), but not in the medial gastrocnemius. No changes in tensiomyography outcomes were found. The control extremity showed a higher increase in PPTs (i.e., decrease in pressure pain sensitivity) than the experimental extremity (p = 0.03). No significant effects for range of motion or strength were observed. In general, gender did not influence the effects of dry needling over latent TrPs in the gastrocnemius muscle. In conclusion, a single session of dry needling was able to change some parameters of neuromuscular function, such as muscle tone, relaxation, pressure pain sensitivity, and creep in the lateral (but not medial) gastrocnemius but did not improve strength or range of motion.

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Electronic Moxibustion for Breast Cancer-Related Lymphedema: A Pilot Clinical Trial

Integrative Cancer Therapies ◽

10.1177/1534735420962854 ◽

2020 ◽

Vol 19 ◽

pp. 153473542096285

Author(s):

Kyungsun Han ◽

Ojin Kwon ◽

Hyo-Ju Park ◽

Ae-Ran Kim ◽

Boram Lee ◽

...

Keyword(s):

Breast Cancer ◽

Clinical Trial ◽

Range Of Motion ◽

Upper Limb ◽

Life Questionnaire ◽

Breast Cancer Patients ◽

Shoulder Range Of Motion ◽

Breast Cancer Related Lymphedema ◽

Shoulder Range

This is a preliminary study to investigate the feasibility of electronic moxibustion in breast cancer patients with upper limb lymphedema. As current treatment options for lymphedema are unsatisfactory and time consuming, there have been attempts to manage symptoms using integrative treatments. Electronic moxibustion was developed to compensate for the shortcomings of conventional moxibustion and is widely used in clinical practice. However, there have been no studies on using electronic moxibustion in breast cancer-related lymphedema. To investigate the feasibility of electronic moxibustion in treating breast cancer-related lymphedema, this study included subjects who completed primary cancer treatment at least 6 months ago and had more than 10 mm difference in arm circumference of upper limbs. All subjects were assigned to the treatment group. Subjects were treated with 16 sessions (30 minutes/session) of electronic moxibustion for 8 weeks followed by 4 weeks of follow-up. For outcome measures, upper limb circumferences, shoulder range of motion, bioimpedance analysis, and quality of life questionnaire were assessed. All 10 subjects completed the study. The effective index showed 38.21% reduction after treatment ( P = .0098) and 29.35% ( P = .0039) after 4 weeks of follow-up compared to the baseline. The reduction of lymphedema was most prominent at 10 cm above the elbow crease, where the mean reduction of circumference difference was 7.5 mm ( P = .0430) and continued to improve after treatment (mean reduction of 8.3 mm, P = .0156). There was significant improvement in shoulder range of motion only in flexion and internal rotation at week 9. There were 7 adverse events, and most were irrelevant to the treatment. Only 1 participant had a mild burn on the acupuncture point. Here, we demonstrate for the first time that electronic moxibustion treatment is a feasible treatment for breast cancer-related lymphedema. Electronic moxibustion may reduce differences in upper limb circumference and improve shoulder range of motion. A future comparative clinical trial is needed to confirm the clinical efficacy of this treatment.

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Effectiveness of arthroscopic management of idiopathic shoulder stiffness: A meta-analysis

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200267 ◽

2021 ◽

pp. 1-8

Author(s):

Ya-Dong Wang ◽

Yu-Xiang Ming ◽

Yong-Hua Pang ◽

Wei-Nan Chen ◽

Xu-Hua Zong ◽

...

Keyword(s):

Range Of Motion ◽

External Rotation ◽

Meta Analysis ◽

Eligibility Criteria ◽

Shoulder Stiffness ◽

Capsular Release ◽

Shoulder Range Of Motion ◽

Arthroscopic Capsular Release ◽

Shoulder Range

BACKGROUND: Persisting shoulder stiffness adversely affects quality of life by causing pain and motion restrictions especially in patients with diabetes. OBJECTIVE: The aim of this study was to evaluate the outcomes of arthroscopic capsular release in patients with idiopathic shoulder stiffness. METHOD: A literature search was conducted in electronic databases and studies were selected by following precise eligibility criteria. Random-effects meta-analyses were performed to estimate the changes at latest follow-up in scores of the Constant, American Shoulder and Elbow Surgeons (ASES), and University of California at Los Angelis (UCLA) scales, Visual Analogue Scale (VAS), and shoulder range of motion. RESULTS: Nineteen studies were included. The follow-up duration was 42 months [95% confidence interval (CI): 32, 51]. Improvements in scores of the Constant, ASES, UCLA scales, and VAS were 48.3 [95% CI: 38.0, 58.6], 44.6 [95% CI: 24.6, 64.6], 19.3 [95% CI: 16.6, 22.0], and -6.1 [95% CI: -6.9, -5.4] respectively (P< 0.05 all). Improvements in the shoulder range of motion were: abduction 82.0 [95% CI: 65.0, 98.9]; forward flexion 75.9 [95% CI: 59.7, 92.1]; external rotation 43.2 [95% CI: 37.5, 49.0]; and internal rotation 25.4 [95% CI: 15.2, 35.5] degrees; P< 0.05 all). CONCLUSION: Arthroscopic capsular release effectively improves shoulder function in patients with idiopathic shoulder stiffness.

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The tolerance to stretch is linked with endogenous modulation of pain

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0010 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Morten Pallisgaard Støve ◽

Rogerio Pessoto Hirata ◽

Thorvaldur Skuli Palsson

Keyword(s):

Range Of Motion ◽

Pain Sensitivity ◽

Cold Pressor Test ◽

Cold Pressor ◽

Static Stretch ◽

Pain Thresholds ◽

Pressure Pain ◽

Pressor Test ◽

Pressure Pain Thresholds ◽

Exercise Induced

Abstract Objectives The effect of stretching on joint range of motion is well documented, and although sensory perception has significance for changes in the tolerance to stretch following stretching the underlining mechanisms responsible for these changes is insufficiently understood. The aim of this study was to examine the influence of endogenous pain inhibitory mechanisms on stretch tolerance and to investigate the relationship between range of motion and changes in pain sensitivity. Methods Nineteen healthy males participated in this randomized, repeated-measures crossover study, conducted on 2 separate days. Knee extension range of motion, passive resistive torque, and pressure pain thresholds were recorded before, after, and 10 min after each of four experimental conditions; (i) Exercise-induced hypoalgesia, (ii) two bouts of static stretching, (iii) resting, and (iv) a remote, painful stimulus induced by the cold pressor test. Results Exercise-induced hypoalgesia and cold pressor test caused an increase in range of motion (p<0.034) and pressure pain thresholds (p<0.027). Moderate correlations in pressure pain thresholds were found between exercise-induced hypoalgesia and static stretch (Rho>0.507, p=0.01) and exercise-induced hypoalgesia and the cold pressor test (Rho=0.562, p=0.01). A weak correlation in pressure pain thresholds and changes in range of motion were found following the cold pressor test (Rho=0.460, p=0.047). However, a potential carryover hypoalgesic effect may have affected the results of the static stretch. Conclusions These results suggest that stretch tolerance may be linked with endogenous modulation of pain. Present results suggest, that stretch tolerance may merely be a marker for pain sensitivity which may have clinical significance given that stretching is often prescribed in the rehabilitation of different musculoskeletal pain conditions where reduced endogenous pain inhibition is frequently seen.

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The Effects of Body Mass Index on Softball Pitchers’ Hip and Shoulder Range of Motion

Sports Medicine International Open ◽

10.1055/a-1244-1621 ◽

2020 ◽

Vol 05 (01) ◽

pp. E8-E13

Author(s):

Kenzie B. Friesen ◽

Adam W. Anz ◽

Jeffrey R. Dugas ◽

James R. Andrews ◽

Gretchen D. Oliver

Keyword(s):

Body Mass Index ◽

Body Composition ◽

Range Of Motion ◽

Body Mass ◽

Mean Difference ◽

Additional Stress ◽

Maximal Velocity ◽

Strength And Conditioning ◽

Shoulder Range Of Motion ◽

Shoulder Range

AbstractCurrently it is hypothesized that increased body mass index may contribute to overuse injuries. Thus, if hip or shoulder range of motion is affected by body mass index, pitchers may be placing additional stress on joints as they seek to pitch at maximal velocity. The purpose of this study was to examine if range of motion at the hips and shoulders were related to body mass index classification. A sample of 147 female softball pitchers (17.0±4.2 years; 167.6±11.8 cm; 70.6±17.5 kg; body mass index=24.8±4.7 kg/m2) participated. Bilateral hip and shoulder range of motion were assessed. Multivariate analysis of variance results indicated body mass index [Wilks’ Λ=0.742, F=1.722, p=0.014, η2=0.095] significantly affected range of motion of the shoulder and hip. Post hoc results indicated the underweight group had significantly more range of motion than the obese group in hip internal range of motion on both the throwing side (mean difference=12.39, p=0.005) and glove side (mean difference=11.98, p=0.004). Although body composition is not overly emphasized among softball pitchers, the current study reveals excess weight may inhibit proper mechanics. Coaches, athletic trainers, strength and conditioning personnel, and athletes should acknowledge the role that body composition can play in affecting pitch outcomes.

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