The Effect of Contralateral Exercise on Patient Pain and Range of Motion

2018 ◽  
Vol 27 (2) ◽  
pp. 185-188 ◽  
Author(s):  
Smokey Fermin ◽  
Lindsay Larkins ◽  
Sarah Beene ◽  
David Wetzel
Keyword(s):  
Range Of Motion ◽  
Muscle Activation ◽  
Current Evidence ◽  
Viable Option ◽  
Bottom Line ◽  
Contralateral Limb ◽  
Limited Mobility ◽  
Patient Pain ◽  
Feasible Option ◽  
Based Medicine

Clinical Scenario: Pain and range of motion (ROM) deficits are 2 issues that are commonly treated by clinicians. In certain instances, clinicians are tasked with treating patients who report with both pain and limited mobility. Currently, clinicians utilize a variety of different methods to combat pain and ROM limitations, but in singularity. However, contralateral exercises (CEs) may be a viable option that can have an effect on pain, ROM, or simultaneous effect on both. Clinical Question: For patients with pain and/or ROM deficits, will CE decrease pain and increase ROM? Summary of Findings: CE can have a significant effect on ipsilateral muscle activation, strength, as well as available motion on the contralateral limb. However, there is limited research on CE that explores effects on pain. Clinical Bottom Line: According to current evidence, CE can be a feasible option for clinicians trying to increase a patient’s ROM. Furthermore, there can be enhanced effects on stability, muscle strength, and muscle activation due to CE. Strength of Recommendation: Studies that have been included are a level of 4 or higher based on Center for Evidence Based Medicine. However, future studies both of higher levels and variability should be conducted.

scholarly journals The Effect of Kinesio Tape on Factors for Neuromuscular Control of the Lower-Extremity: A Critically Appraised Topic

2020 ◽  
Vol 29 (6) ◽  
pp. 841-846
Author(s):  
Nickolai Martonick ◽  
Kimber Kober ◽  
Abigail Watkins ◽  
Amanda DiEnno ◽  
Carmen Perez ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Muscle Activation ◽  
Knee Kinematics ◽  
Neuromuscular Control ◽  
Current Evidence ◽  
Healthy Population ◽  
Bottom Line ◽  
Athletic Population ◽  
Randomized Controlled Studies ◽  
Kinesiology Tape

Clinical Scenario: Joint instability is a common condition that often stems from inadequate muscle activation and results in precarious movement patterns. When clinicians attempt to mechanically treat the unstable joint rather than attending to the underlying cause of the instability, patient outcomes may suffer. The use of kinesiology tape (KT) on an unstable joint has been proposed to aid in improving lower-extremity neuromuscular control. Clinical Question: Does KT improve factors of neuromuscular control in an athletic population when compared with no-tape or nonelastic taping techniques? Summary of Key Findings: The current literature was searched, and 5 randomized controlled studies were selected comparing the effects of KT with no-tape or nonelastic taping techniques on lower-extremity neuromuscular control in an athletic population. Primary findings suggest KT is not more effective than no-tape or nonelastic tape conditions at improving lower-extremity neuromuscular control in a healthy population. Clinical Bottom Line: The current evidence suggests that KT is ineffective for improving neuromuscular control at the ankle compared with nonelastic tape or no-tape conditions. KT was also found to be ineffective at improving hip and knee kinematics in healthy runners and cyclists. However, preliminary research has demonstrated improved neuromuscular control in a population displaying excessive knee valgus during a drop jump landing, after the application of KT. Clinicians should be cautious of these conflicting results and apply the best available evidence to their evaluation of the patient’s status. Strength of Recommendation: There is grade B evidence that the use of KT on an athletic population does not improve biomechanical measures of ankle stability. There is inconclusive, grade B evidence that KT improves neuromuscular control at the knee in symptomatic populations.

Current Evidence Regarding the Treatment of Pediatric Lumbar Spondylolisthesis: A Report From the Scoliosis Research Society Evidence Based Medicine Committee

2017 ◽  
Vol 5 (5) ◽  
pp. 284-302 ◽  
Author(s):  
Charles H. Crawford ◽  
A. Noelle Larson ◽  
Marilyn Gates ◽  
R. Shay Bess ◽  
Tenner J. Guillaume ◽  
...  
Keyword(s):  
Evidence Based Medicine ◽  
Research Society ◽  
Current Evidence ◽  
Evidence Based ◽  
Scoliosis Research Society ◽  
Lumbar Spondylolisthesis ◽  
Based Medicine

scholarly journals Exercise-Based Rehabilitation and Manual Therapy Compared With Exercise-Based Rehabilitation Alone in the Treatment of Chronic Ankle Instability: A Critically Appraised Topic

2020 ◽  
Vol 29 (5) ◽  
pp. 684-688 ◽  
Author(s):  
Bridget M. Walsh ◽  
Katherine A. Bain ◽  
Phillip A. Gribble ◽  
Matthew C. Hoch
Keyword(s):  
Manual Therapy ◽  
Ankle Instability ◽  
Patient Reported Outcome ◽  
Chronic Ankle Instability ◽  
Current Evidence ◽  
Bottom Line ◽  
Patient Reported ◽  
Outcome Scores ◽  
The Difference ◽  
Improve Patient

Clinical Scenario: Patients with chronic ankle instability (CAI) commonly display lower levels of self-reported function and health-related quality of life. Several rehabilitation interventions, including manual therapy, have been investigated to help CAI patients overcome these deficits. However, it is unclear if the addition of manual therapy to exercise-based rehabilitation is more effective than exercise-based rehabilitation alone. Clinical Question: Does incorporating manual therapy with exercise-based rehabilitation improve patient-reported outcomes when compared with exercise-based rehabilitation alone? Summary of Key Findings: The literature was searched for articles that examined the difference in outcomes for patients with CAI between manual therapy with exercise-based rehabilitation and exercise-based rehabilitation alone. A total of 3 peer-reviewed randomized controlled trials were identified. Two articles demonstrated improved patient-reported outcome scores following the incorporation of manual therapy with exercise-based rehabilitation, whereas one study found no statistically significant differences between interventions. Clinical Bottom Line: The current evidence suggests that incorporating manual therapy in addition to exercised-based rehabilitation may improve patient-reported outcome scores in patients with CAI. Strength of Recommendation: In accordance with the Strength of Recommendation Taxonomy, the grade of A is recommended due to consistent evidence from high-quality studies.

scholarly journals Mechanisms of Hamstring Strain Injury: Interactions between Fatigue, Muscle Activation and Function

Sports ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. 65 ◽  
Author(s):  
Shaun Huygaerts ◽  
Francesc Cos ◽  
Daniel D. Cohen ◽  
Julio Calleja-González ◽  
Marc Guitart ◽  
...  
Keyword(s):  
High Intensity ◽  
Injury Risk ◽  
Muscle Activation ◽  
Injury Mechanism ◽  
Hamstring Injury ◽  
Current Evidence ◽  
Hamstring Muscle ◽  
Hamstring Strain ◽  
And Function

Isolated injury to the long head of biceps femoris is the most common type of acute hamstring strain injury (HSI). However, the precise hamstring injury mechanism (i.e., sprint-type) is still not well understood, and research is inconclusive as to which phase in the running cycle HSI risk is the greatest. Since detailed information relating to hamstring muscle function during sprint running cannot be obtained in vivo in humans, the findings of studies investigating HSI mechanisms are based on modeling that requires assumptions to be made based on extrapolations from anatomical and biomechanical investigations. As it is extremely difficult to account for all aspects of muscle-tendon tissues that influence function during high-intensity running actions, much of this complexity is not included in these models. Furthermore, the majority of analyses do not consider the influence of prior activity or muscular fatigue on kinematics, kinetics and muscle activation during sprinting. Yet, it has been shown that fatigue can lead to alterations in neuromuscular coordination patterns that could potentially increase injury risk. The present critical review will evaluate the current evidence on hamstring injury mechanism(s) during high-intensity running and discuss the interactions between fatigue and hamstring muscle activation and function.

Sequencing of superficial trunk muscle activation during range-of-motion tasks

2015 ◽  
Vol 43 ◽  
pp. 67-77 ◽  
Author(s):  
Alison Schinkel-Ivy ◽  
Janessa D.M. Drake
Keyword(s):  
Range Of Motion ◽  
Muscle Activation ◽  
Trunk Muscle

Triceps Tenotomy and Double Plate Stabilization of “Y-T” Fracture of the Humeral Condyle in Three Dogs

2000 ◽  
Vol 13 (01) ◽  
pp. 34-38 ◽  
Author(s):  
C. Sturgeon ◽  
A. M. Wilson ◽  
P. McGuigan ◽  
T. J. Lawes ◽  
P. Muir
Keyword(s):  
Range Of Motion ◽  
Open Reduction ◽  
Bone Plates ◽  
Implant Loosening ◽  
Contralateral Limb ◽  
Articular Fracture ◽  
Bone Screw ◽  
Lag Effect ◽  
Humeral Condyle

SummaryCaudal elbow arthrotomy by use of triceps tenotomy was performed for open reduction of “Y-T” fractures of the humeral condyle in three dogs. Stabilization of the fracture was achieved by use of a bone screw inserted with a lag effect to compress the articular fracture and placement of bone plates on the caudolateral surface of the lateral epicondylar crest and the caudomedial surface of the medial epicondylar crest. This construct successfully maintained reduction in all three dogs without implant loosening or breakage. All three of the fractures healed satisfactorily without any evidence of progressive osteoarthritis. Long-term (median - 20 months) function of the affected limb was comparable to the contralateral limb, with little loss of elbow range-of-motion and minimal to an absence of lameness.Triceps tenotomy was used for open reduction of “Y-T” fractures of the humeral condyle in three dogs. Stabilization of the fracture with a bone screw inserted for lag effect and use of a bone plate on each epicondylar crest resulted in satisfactory healing of the fracture and good limb function in all of the patients.

Evidence-based medicine in anaesthesia

2017 ◽  
Author(s):  
Ann Merete Møller
Keyword(s):  
Evidence Based Medicine ◽  
Meta Analysis ◽  
Consort Statement ◽  
Current Evidence ◽  
Evidence Based ◽  
Clinical Question ◽  
Clinical Expertise ◽  
Clinical Databases ◽  
Patient Values ◽  
Based Medicine

Evidence-based medicine (EBM) is defined as ‘The judicious use of the best current evidence in making decisions about the care of individual patients’. Evidence-based medicine (EBM) is meant to integrate clinical expertise with the best available research evidence and patient values. The purpose of EBM is to assist clinicians in making the best decisions. Practising EBM includes asking an answerable, well-defined clinical question, searching for information, critically appraising information retrieved, extracting data, synthesizing data, and making conclusions about the overall effect. The clinical question includes information of the following elements: the population, the intervention, and the clinically relevant outcomes in focus. The clinical question is a tool to make the focus of the question clearer, and an aid to build the following search strategy. A comprehensive and reproducible literature search is essential for conducting a high-quality and up-to-date search. The search should include all relevant clinical databases. Papers retrieved after the search must be critically appraised and evaluated for the risk of bias. Evidence-based methods are used in the production of systematic reviews, and the development of clinical guidelines. Whether a meta-analysis should be performed depends on the quality and nature of the extracted data. Practising EBM may be challenged by a lack of well-performed trials, various types of bias (including publication bias), and heterogeneity between existing trials. Several tools have been constructed to help the process; examples are the CONSORT statement, the PRISMA statement, and the AGREE instrument.

scholarly journals Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition

Neurosurgery ◽  
2016 ◽  
Vol 80 (1) ◽  
pp. 6-15 ◽  
Author(s):  
Nancy Carney ◽  
Annette M. Totten ◽  
Cindy O'Reilly ◽  
Jamie S. Ullman ◽  
Gregory W.J. Hawryluk ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Clinical Judgment ◽  
Current Evidence ◽  
Evidence Based ◽  
Clinical Use ◽  
Fourth Edition ◽  
Treatment Protocols ◽  
Guideline Document ◽  
Evidence Based Treatments ◽  
Based Medicine

AbstractThe scope and purpose of this work is 2-fold: to synthesize the available evidence and to translate it into recommendations. This document provides recommendations only when there is evidence to support them. As such, they do not constitute a complete protocol for clinical use. Our intention is that these recommendations be used by others to develop treatment protocols, which necessarily need to incorporate consensus and clinical judgment in areas where current evidence is lacking or insufficient. We think it is important to have evidence-based recommendations to clarify what aspects of practice currently can and cannot be supported by evidence, to encourage use of evidence-based treatments that exist, and to encourage creativity in treatment and research in areas where evidence does not exist. The communities of neurosurgery and neuro-intensive care have been early pioneers and supporters of evidence-based medicine and plan to continue in this endeavor. The complete guideline document, which summarizes and evaluates the literature for each topic, and supplemental appendices (A-I) are available online at https://www.braintrauma.org/coma/guidelines.

scholarly journals Current Status of Cell-Based Therapy in Patients with Critical Limb Ischemia

2020 ◽  
Vol 21 (23) ◽  
pp. 8999
Author(s):  
Frantisek Jaluvka ◽  
Peter Ihnat ◽  
Juraj Madaric ◽  
Adela Vrtkova ◽  
Jaroslav Janosek ◽  
...  
Keyword(s):  
Cell Therapy ◽  
Critical Limb Ischemia ◽  
Evidence Based Medicine ◽  
Odds Ratio ◽  
Limb Ischemia ◽  
Current Evidence ◽  
Evidence Based ◽  
Cell Based Therapy ◽  
Meta Analyses ◽  
Based Medicine

(1) Background: The treatment of peripheral arterial disease (PAD) is focused on improving perfusion and oxygenation in the affected limb. Standard revascularization methods include bypass surgery, endovascular interventional procedures, or hybrid revascularization. Cell-based therapy can be an alternative strategy for patients with no-option critical limb ischemia who are not eligible for endovascular or surgical procedures. (2) Aims: The aim of this narrative review was to provide an up-to-date critical overview of the knowledge and evidence-based medicine data on the position of cell therapy in the treatment of PAD. The current evidence on the cell-based therapy is summarized and future perspectives outlined, emphasizing the potential of exosomal cell-free approaches in patients with critical limb ischemia. (3) Methods: Cochrane and PubMed databases were searched for keywords “critical limb ischemia and cell therapy”. In total, 589 papers were identified, 11 of which were reviews and 11 were meta-analyses. These were used as the primary source of information, using cross-referencing for identification of additional papers. (4) Results: Meta-analyses focusing on cell therapy in PAD treatment confirm significantly greater odds of limb salvage in the first year after the cell therapy administration. Reported odds ratio estimates of preventing amputation being mostly in the region 1.6–3, although with a prolonged observation period, it seems that the odds ratio can grow even further. The odds of wound healing were at least two times higher when compared with the standard conservative therapy. Secondary endpoints of the available meta-analyses are also included in this review. Improvement of perfusion and oxygenation parameters in the affected limb, pain regression, and claudication interval prolongation are discussed. (5) Conclusions: The available evidence-based medicine data show that this technique is safe, associated with minimum complications or adverse events, and effective.

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