scholarly journals Effectiveness of acromioclavicular joint mobilization and physical therapy vs physical therapy alone in patients with frozen shoulder: A randomized clinical trial

2021 ◽  
pp. 026921552110704
Author(s):  
Mohammad Rahbar ◽  
Sepideh Ranjbar Kiyakalayeh ◽  
Reza Mirzajani ◽  
Bina Eftekharsadat ◽  
Neda Dolatkhah
Keyword(s):  
Clinical Trial ◽  
Physical Therapy ◽  
Visual Analogue Scale ◽  
Range Of Motion ◽  
Analogue Scale ◽  
Acromioclavicular Joint ◽  
Therapy Group ◽  
Frozen Shoulder ◽  
Joint Mobilization ◽  
Active Abduction

Objectives The objective of this trial was to compare the efficacy of acromioclavicular joint mobilization and standard physical-therapy versus physical-therapy alone in the treatment of the frozen shoulder. Design Single-blind randomized clinical trial. Setting Outpatient setting. Subjects Patients with frozen shoulder. Intervention Participants were randomly allocated into mobilization + physical-therapy (n = 28), and physical-therapy alone (n = 28) groups for one month. Main Measures The primary outcomes were the shoulder pain and disability index and the shoulder range of motion. The secondary outcome was the visual analogue scale. Measures were performed at the baseline, immediately and one month after the beginning of the treatment. Results Visual analogue scale and the shoulder pain and disability index improved more significantly in the mobilization group compared to the physical-therapy group immediately [−4.63 (−5.58–−3.67) vs. −2.22 (−2.96–−1.47), P < 0.001 and −23.08 (−28.63–−17.53) vs. −13.04 (−17.93–−8.16), P = 0.008, respectively] and one month after the beginning of the treatment [−5.58 (−6.45–−4.72) vs. −3.61 (−4.60–−2.62), P < 0.001 and −33.43 (−40.85–−26.01) vs. −20.03 (−26.00–−14.07), P = 0.001, respectively]. Active abduction range of motion was also improved more significantly immediately after the treatment in the mobilization group compared to the physical-therapy group [25.83 (11.45–40.13) vs. 10.17 (1.02–19.15), P = 0.025], however there were no significant differences between two groups concerning other measured range of motions. Conclusions Adding acromioclavicular mobilization to standard physical-therapy was more efficient in decreasing pain and disability and improving active abduction range of motion compared to standard physical-therapy in frozen shoulder patients.

scholarly journals Effectiveness of Acromioclavicular Joint Mobilization and Physical Therapy vs Physical Therapy Alone in Patients with Frozen Shoulder: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Mohammad Rahbar ◽  
Sepideh Ranjbar Kiyakalayeh ◽  
Bina Eftekharsadat ◽  
Behzad Izadseresht ◽  
Neda Dolatkhah
Keyword(s):  
Clinical Trial ◽  
Physical Therapy ◽  
Randomized Clinical Trial ◽  
Shoulder Pain ◽  
Acromioclavicular Joint ◽  
Frozen Shoulder ◽  
Secondary Outcome ◽  
Control Group ◽  
Joint Mobilization ◽  
Active Abduction

Abstract Background: Frozen shoulder (FS) is a prevalent musculoskeletal condition characterized by an often prolonged pain, disability and limited active and passive range of motion (ROM), however its management remains challenging yet. The objective of this trial was to compare the efficacy of acromioclavicular joint mobilization and physical therapy versus physical therapy in treatment of FS.Methods: In this single-blind randomized clinical trial, patients with diagnosis of FS were randomly allocated into mobilization + physical therapy (n=28) as experiment group, and physical therapy (n=28) as control group in two outpatient clinics of Tabriz University of Medical Sciences, Iran. The primary outcomes were self-reported shoulder pain-related disability measured by the Shoulder Pain and Disability Index (SPADI) questionnaire and goniometric assessment of shoulder ROM. The secondary outcome was the Visual Analogue Scale (VAS). Measures were performed at the baseline, immediately and one month after beginning the treatments.Results: Totally 51 patients with 25.73 ± 6.88 years old of age completed the study and their data were analyzed. VAS, SPADI, pain and disability improved more significantly in experiment group compared to control group immediately [-4.63 (-5.58- -3.67) vs. -2.22 (-2.96- -1.47), p<0.001; -23.08 (-28.63- -17.53) vs. -13.04 (-17.93- -8.16), p=0.008; -26.00 (-31.71- -20.29) vs. -16.35 (-23.39- -9.31), p=0.034 and -21.25 (-29.11- -13.39) vs. -10.98 (-17.53- -4.43), p=0.042, respectively] and one month after beginning of treatment [-5.58 (-6.45- -4.72) vs. -3.61 (-4.60- -2.62), p<0.001; -33.43 (-40.85- -26.01) vs. -20.03 (-26.00- -14.07), p=0.001; --42.83 (-49.09- -36.57) vs. -25.57 (-33.92- -17.21), p<0.001 and -27.55 (-36.19- -15.94) vs. -16.58 (-24.48- -8.67), p=0.041, respectively]. Active abduction ROM was also improved more significantly immediately after treatment in experiment group compared to control group [25.83 (11.45- 40.13) vs. 10.17 (1.02- 19.15), p=0.025], however there were no significant differences between two groups concerning other measured ROMs immediately and one month after treatment (all p>0.05). Conclusions: Acromioclavicular mobilization along with conventional physical therapy was more efficient in decreasing pain and disability and improving active abduction ROM compared to physical therapy in patients with FS. These findings would suggest a new therapeutic method for shoulder disorders with pain and disability.Trial registrationwww.irct.ir, IRCT20100605004104N7, registered 06.01.2019 (https://www.irct.ir/trial/35900)

Joint mobilization and therapeutic exercises in the hands of patients with systemic sclerosis: A preliminary randomized controlled trial

2021 ◽  
pp. 026921552110387
Author(s):  
Letticia Cristina Santos Cardozo Roque ◽  
Angélica da Silva Tenório ◽  
Lígia Tomaz de Aquino ◽  
Renata dos Santos Ferreira ◽  
Angela Luzia Branco Pinto Duarte ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Physical Therapy ◽  
Range Of Motion ◽  
Therapy Group ◽  
Controlled Trial ◽  
Control Group ◽  
Joint Mobilization ◽  
Randomized Controlled ◽  
Therapeutic Exercises

Objective: To investigate the effectiveness of Maitland’s joint mobilization and therapeutic exercises on the functionality of the hands in patients with systemic sclerosis. Design: Randomized controlled trial. Setting: Tertiary university hospital. Subjects: Twenty-four patients diagnosed with systemic sclerosis according to ACR/EULAR 2013 criteria; age ⩾18 years and Cochin Hand Functional Scale (COCHIN) score ⩾10. They were randomized to physical therapy group ( n = 12) or control group ( n = 12). Interventions: The physical therapy group received joint mobilization and undertook therapeutic exercises, twice a week, for 12 weeks, and received a booklet with information about the disease. The control group only received the booklet about the disease. Main measures: The primary outcome measure was functionality of the hands (COCHIN). The secondary outcomes measures were disability (SHAQ), pain (visual analogic scale), range of motion (HAMIS and Delta finger-to-palm), grip strength (JAMAR dynamometer), and quality of life (SF12). Results: Twenty-two patients were female, with a mean age of 47.4 ± 11.1 years and 18 had limited cutaneous form. The physical therapy group showed a decrease of 11.33 points in the COCHIN in comparison with the control group ( P = 0.09). There was a significant increase in range of motion by HAMIS (3.00 ± 1.48 vs 5.42 ± 2.64, P = 0.008), reduction in pain VAS (3.42 ± 2.78 vs 7.75 ± 2.53, P < 0.001), and increase in the physical component of SF12 (38.51 ± 9.60 vs 32.65 ± 9.10, P = 0.038). Conclusion: Maitland’s joint mobilization and therapeutic exercises improved the functionality of the hands, reduced pain in the hands and wrists, increased range of motion, and improved quality of life in patients with systemic sclerosis.

scholarly journals Short-term Clinical Results of Manipulation Under Ultrasound-Guided Brachial Plexus Block in Patients with Idiopathic Frozen Shoulder and Diabetic Secondary Frozen Shoulder

2018 ◽  
Vol 12 (1) ◽  
pp. 99-104 ◽  
Author(s):  
Akira Ando ◽  
Junichiro Hamada ◽  
Yoshihiro Hagiwara ◽  
Takuya Sekiguchi ◽  
Masashi Koide ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Brachial Plexus ◽  
Range Of Motion ◽  
Analogue Scale ◽  
Brachial Plexus Block ◽  
Frozen Shoulder ◽  
Clinical Results ◽  
Ultrasound Guided ◽  
Scale Range ◽  
Plexus Block

Purpose: This study examined the effectiveness of manipulation under ultrasound-guided brachial plexus block in patients with recalcitrant idiopathic frozen shoulder and diabetic secondary frozen shoulder (diabetic frozen shoulder). Methods: Forty-four idiopathic frozen shoulders and 10 diabetic frozen shoulders with failed conservative treatment for at least 3 months were included in this study. The manipulation was performed under ultrasound-guided brachial plexus block and visual analogue scale, range of motion, and Constant scores were measured before manipulation and at the last follow-up examination. Results: No major complications were observed during the procedure. Sufficient improvement was not obtained in two patients during the procedure and to avoid complications, the procedure was discontinued and subsequently arthroscopic capsular release was performed. Visual analogue scale, range of motion towards all directions, and Constant scores were significantly improved after the manipulation in both the idiopathic frozen shoulder and diabetic frozen shoulder groups, however the diabetic group showed inferior results compared with those of the idiopathic group. Conclusion: This manipulation was effective and shortened the duration of symptoms in most of the idiopathic and diabetic frozen shoulders without major complications during the procedure. Diabetic frozen shoulder showed inferior clinical results and difficulty in recovery in range of motion, which indicated that diabetic frozen shoulder should be discussed as a different entity.

scholarly journals A Comparative Study of Patients with Periarthritis Shoulder on Treatment with Analgesics Only and Analgesics Plus Exercises

2021 ◽  
pp. 795-799
Author(s):  
Nikita Rajgadia ◽  
R. Kalanithi ◽  
Damodharan Vasudevan
Keyword(s):  
Pain Relief ◽  
Visual Analogue Scale ◽  
Range Of Motion ◽  
Shoulder Joint ◽  
Analogue Scale ◽  
Frozen Shoulder ◽  
Significant Loss ◽  
Pain Severity ◽  
Painful Condition ◽  
Medical College

Background: Frozen Shoulder is known to be a painful condition affecting the shoulder joint that results in significant loss of range of motion. A number of published comprehensive studies have suggested the different modalities of treatment. In this study, we focussed on the effect of exercise on enhancing the restricted motion and reducing the severity of pain. Objective: The objective is to study the influence of exercise on range of motion and pain severity in Frozen shoulder patients. Materials and Methods: Thirty patients diagnosed with Periarthritis Shoulder were selected from orthopaedic outpatient in Saveetha Medical College, Chennai. These patients were randomly divided in two groups, receiving analgesics as well as exercises and another receiving only analgesic. They were assessed using the Visual Analogue Scale for the severity of their pain and range of motion with a Goniometer and results noted. Results: The group receiving exercise in addition to analgesics showed greater reduction in pain severity and range of motion. Conclusion: Physical exercise of the Shoulder joint helps in restoring the mobility and relieves stiffening of the muscles and hence should be added as the mainstay of treatment with pain relief.

scholarly journals Physical therapy evaluation and treatment in distal radius fracture: a case report.

2016 ◽  
Vol 14 ◽  
pp. 359
Author(s):  
Maylli Daiani Graciosa ◽  
Tamiris Beppler Martins ◽  
Camila Fadel Da Silva ◽  
Larissa Sinhorim ◽  
Gilmar Moraes Santos
Keyword(s):  
Case Report ◽  
Physical Therapy ◽  
Visual Analogue Scale ◽  
Range Of Motion ◽  
Analogue Scale ◽  
Treatment Protocol ◽  
Functional Deficit ◽  
Active Range Of Motion ◽  
Therapy Intervention ◽  
Physical Therapy Intervention

Background: subjects who have suffered DRF submitted imobilization may have a loss in active range of motion and functional deficit. Objectives: evaluate changes in the wrist and verify the effectiveness of physical therapy intervention used in the treatment of DRF. Methods: a physiotherapy evaluation form, goniometry and Visual Analogue Scale were used to assess the patient. A treatment protocol was applied for seven sessions. Results: the results showed reduced pain and increased range of motion of the wrist. Conclusion: there were changes as pain and reduced range of motion of the wrist. The treatment protocol was effective for these changes.

Checkmate 577:Health-related quality of life (HRQoL) in a randomized, double-blind phase III study of nivolumab (NIVO) versus placebo (PBO) as adjuvant treatment in patients (pts) with resected esophageal or gastroesophageal junction cancer (EC/GEJC).

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 167-167
Author(s):  
Eric Van Cutsem ◽  
Prianka Singh ◽  
James M. Cleary ◽  
Ronan Joseph Kelly ◽  
Markus H. Moehler ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Visual Analogue Scale ◽  
Repeated Measures ◽  
Analogue Scale ◽  
Gastroesophageal Junction ◽  
Neoadjuvant Chemoradiotherapy ◽  
Phase Iii ◽  
Meaningful Improvement ◽  
Utility Index ◽  
Patient Reported

167 Background: NIVO is the first adjuvant therapy to provide a statistically significant and clinically meaningful improvement in disease-free survival (DFS) versus PBO in resected EC/GEJC following neoadjuvant chemoradiotherapy as demonstrated by CheckMate 577. NIVO was well tolerated with an acceptable safety profile. This analysis provides additional information on the exploratory HRQoL endpoints in this clinical trial. Methods: The effect of NIVO versus PBO on HRQoL, including general and disease-related symptoms, functioning, disease burden, and overall QoL, was assessed using FACT-E and EQ-5D-3L patient-reported outcome (PRO) questionnaires administered at baseline (BL), every 4 weeks during the 12-month treatment period, and at post-treatment follow-up visits (up to 2 years after last dose). Longitudinal change from BL in PRO scores over 12 months was assessed using descriptive statistics. Additionally, mixed model for repeated measures and time to deterioration analyses evaluated the difference between treatment with NIVO and PBO (data not shown). Results: 794 pts with EC/GEJC were randomized 2:1 to NIVO (n = 532) or PBO (n = 262). PRO completion rates were ≥ 95% at BL and ~ 90% at 12 months on treatment. Mean (SD) BL HRQoL scores were similar between treatment arms for the FACT-E total score (NIVO: 133.40 [20.97]; PBO: 134.03 [20.40]); esophageal cancer subscale (ECS; NIVO: 50.2 [9.3]; PBO: 50.1 [8.9]); EQ-5D Visual Analogue Scale (NIVO: 70.4 [22.3]; PBO: 69.1 [24.1]); and EQ-5D Utility Index (NIVO: 0.820 [0.179]; PBO: 0.831 [0.163]) based on the UK value set. Descriptive analyses showed a trend for increases from baseline at most time points through week 49 for both NIVO and PBO treatment groups for FACT-E total score, ECS, and EQ-5D Visual Analogue Scale and Utility Index. Conclusions: Preliminary results from CheckMate 577 demonstrated that pts on NIVO treatment showed trends of improvement in both esophageal-specific and general HRQoL. Similar trends were also observed in pts treated with PBO over 1 year. Pts treated with NIVO did not experience a reduction in HRQoL, further supporting clinical data to demonstrate treatment benefit and tolerability for adjuvant NIVO in pts with resected EC/GEJC. Clinical trial information: NCT02743494.

scholarly journals Effect of nicotine 6 mg gum on urges to smoke, a randomized clinical trial

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Hansson ◽  
Thomas Rasmussen ◽  
Roland Perfekt ◽  
Elin Hall ◽  
Holger Kraiczi
Keyword(s):  
Clinical Trial ◽  
Smoking Cessation ◽  
Clinical Study ◽  
Visual Analogue Scale ◽  
Replacement Therapy ◽  
Success Rate ◽  
Analogue Scale ◽  
Healthy Adult ◽  
Nicotine Gum ◽  
Search Query

Abstract Background Ability to manage urges to smoke is fundamental to maximizing the chances of success in smoking cessation. Previous studies have linked a higher dose of nicotine in nicotine replacement therapy to a higher success rate for smoking cessation. Thus, this study was performed to compare relief of urges to smoke, up until 5 h following treatment with a new 6 mg nicotine gum versus currently marketed 4 mg nicotine gum. Methods This was a randomized crossover clinical study. Following 12 h of abstinence from smoking, either one 6 mg or one 4 mg nicotine gum was given to 240 healthy adult smokers. Thereafter, urges to smoke were scored on a 100 mm Visual Analogue Scale repeatedly over 5 h. Results The reductions in urges to smoke over the first 1 and 3 h after administration were statistically significantly greater with 6 mg than 4 mg gum, (p < 0.005). A 50% reduction in perceived urges to smoke was reached in 9.4 min with 6 mg gum compared to 16.2 min with 4 mg gum (median values). The median duration of a 50% or more reduction in VAS urges to smoke score was 111 min with the 6 mg gum, versus 74 min for the 4 mg gum. Conclusion This study provides evidence that the 6 mg nicotine gum provided a greater reduction, faster and longer relief of urges to smoke than the 4 mg nicotine gum. Trial registration EudraCT Number: 2010–023268-42. Study was first entered in EudraCT 2011-02-23.

scholarly journals Effect of Oculus Guided Physical Therapy in Adjunct to Conventional Therapy in Frozen Shoulder Patients- A Research Protocol

2021 ◽  
pp. 218-223
Author(s):  
Shrutika Wankhade ◽  
Pratik Phansopkar ◽  
Neha Chitale
Keyword(s):  
Virtual Reality ◽  
Physical Therapy ◽  
Range Of Motion ◽  
Conventional Therapy ◽  
Rating Scale ◽  
Frozen Shoulder ◽  
Rehabilitation Programs ◽  
Group A ◽  
Group B ◽  
Post Assessment

Background: Frozen shoulder is a musculoskeletal ailment that causes pain and limits the range of motion of the shoulder joint. Traditional therapy, which includes mobilization, has traditionally been utilized to treat and rehab frozen shoulder patients. But, nowadays, virtual reality is also playing important role in rehabilitation programs. This study focuses on effectiveness of oculus guided physical therapy in adjunct to conventional therapy in frozen shoulder patients. Methods: 50 participants of age more than 40 years having frozen shoulder will be randomly selected and categorized in two groups: Group A (n=25) and Group B (n=25). The duration of study will be 6 months. The pre and post assessment form will be taken from both groups and data will be analysed with the help of outcome measures which includes Numerical Pain Rating Scale (NPRS), Range of motion, Shoulder Pain and Disability Index (SPADI). Discussion: According to a previous study on maternal brachial plexus injury, virtual reality treatment is more successful than traditional physiotherapy in rehabilitating childrens upper extremity functions.

scholarly journals Effect of intraarticular steroid injection in addition to physical modalities in osteoarthritis knee

2015 ◽  
Vol 23 (1) ◽  
pp. 48-54
Author(s):  
Md Jahidul Islam ◽  
MM Jalal Uddin ◽  
Md Shahadat Hossain ◽  
Md Ruhul Amin ◽  
Md Moshiur Rahman ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Range Of Motion ◽  
Analogue Scale ◽  
Small Sample ◽  
Therapeutic Exercise ◽  
Womac Index ◽  
Group A ◽  
Pre Treatment ◽  
Group B ◽  
Physical Modalities

Context: Osteoarthritis (OA) is the most common form of arthritis accounting for about 30% of general physician visits. Intrarticular (IA) corticosteroid injections have been used for decades in clinical practice for pain relief and control of local inflammation in OA. In the present study a combined therapy of long acting intra-articular injection in addition to physical modalities of OA knee was given to find out the functional improvement and clinical outcome of the patient. Methods: It was a prospective interventional non-randomized clinical study conducted in the Department of Physical Medicine & Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from October, 2011 to March, 2012. Fifty four patients between 35 and 75 years without consideration of gender with a history of not less than three months knee pain with radiographic confirmation of primary osteoarthritis were selected purposefully. Then they were divided randomly in group A and B, having 27 patients in each group. Group A received NSAID (non steroidal anti-inflammatory drugs) i.e. aceclofenac 100mg twice daily for 10 days + omeprazol 20mg twice daily for 10 days + MWD (micro wave diathermy 20 minutes for 14 days. + therapeutic exercise + ADL (activities of daily living), while Group B received 80mg intraarticular triamcinolon acetonide injection once followed by NSAID i.e. aceclofenac 100mg twice daily for 10 days + omeprazol 20mg twice daily for 10 days + MWD 20 minutes for 14 days. + therapeutic exercise + ADL. In both groups the patients were observed for six weeks. Results: The mean of age of patients in group A and B were 52.33±9.62 years and 52.29±9.67 years respectively. In group A, 9 (33.3%) were male and 18 (66.7%) were female. In group B, 10 (37.0%) were male and 18 (63.0%) were female. Mean visual analogue scale (VAS) during pre treatment in group A and group B were 6.22±1.60 and 7.15±1.56 respectively. Mean range of motion (ROM) during pre treatment in group A and group B were 117.33±13.05 and 112.37±19.01 respectively. Mean time taken to walk 50 feet during pre treatment in group A and group B were 18.22±2.39 and 18.81±2.13 minutes respectively. Mean Western Ontario and Mc Master Universities (WOMAC) index in group A and group B were 60.85±15.86 and 67.33±16.33 minutes respectively. After treatment in both groups visual analogue scale (VAS), range of motion (ROM), time taken to walk 50 feet and Western Ontario and Mc Master Universities (WOMAC) index gradually decreased and range of motion (ROM) gradually increased, which were statistically significant. However, the study conducted with small sample size in a single centre in Dhaka city, which may not be representative for the whole country. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22694 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 48-54

scholarly journals Effects of Cervico-Mandibular Manual Therapy in Patients with Temporomandibular Pain Disorders and Associated Somatic Tinnitus: A Randomized Clinical Trial

Pain Medicine ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 613-624 ◽  
Author(s):  
Pablo Delgado de la Serna ◽  
Gustavo Plaza-Manzano ◽  
Joshua Cleland ◽  
César Fernández-de-las-Peñas ◽  
Patricia Martín-Casas ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Range Of Motion ◽  
Randomized Clinical Trial ◽  
Manual Therapy ◽  
Short Form ◽  
Therapy Group ◽  
Masticatory Muscles ◽  
Manual Therapies ◽  
Tinnitus Severity ◽  
Pressure Pain Thresholds

Abstract Objective This randomized clinical trial investigated the effects of adding cervico-mandibular manual therapies into an exercise and educational program on clinical outcomes in individuals with tinnitus associated with temporomandibular disorders (TMDs). Methods Sixty-one patients with tinnitus attributed to TMD were randomized into the physiotherapy and manual therapy group or physiotherapy alone group. All patients received six sessions of physiotherapy treatment including cranio-cervical and temporomandibular joint (TMJ) exercises, self-massage, and patient education for a period of one month. Patients allocated to the manual therapy group also received cervico-mandibular manual therapies targeting the TMJ and cervical and masticatory muscles. Primary outcomes included TMD pain intensity and tinnitus severity. Secondary outcomes included tinnitus-related handicap (Tinnitus Handicap Inventory [THI]), TMD-related disability (Craniofacial Pain and Disability Inventory [CF-PDI]), self-rated quality of life (12-item Short Form Health Survey [SF-12]), depressive symptoms (Beck Depression Inventory [BDI-II]), pressure pain thresholds (PPTs), and mandibular range of motion. Patients were assessed at baseline, one week, three months, and six months after intervention by a blinded assessor. Results The adjusted analyses showed better outcomes (all, P &lt; 0.001) in the exercise/education plus manual therapy group (large effect sizes) for TMD pain (η 2 P = 0.153), tinnitus severity (η 2 P = 0.233), THI (η 2 P = 0.501), CF-PDI (η 2 P = 0.395), BDI-II (η 2 P = 0.194), PPTs (0.363 &lt; η 2 P &lt; 0.415), and range of motion (η 2 P = 0.350), but similar changes for the SF-12 (P = 0.622, η 2 P = 0.01) as the exercise/education alone group. Conclusions This clinical trial found that application of cervico-mandibular manual therapies in combination with exercise and education resulted in better outcomes than application of exercise/education alone in individuals with tinnitus attributed to TMD.

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