scholarly journals Two manual therapy techniques for management of lumbar radiculopathy: a randomized clinical trial

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Musa S. Danazumi ◽  
Bashir Bello ◽  
Abdulsalam M. Yakasai ◽  
Bashir Kaka
Keyword(s):  
Manual Therapy ◽  
Repeated Measures ◽  
Treatment Protocol ◽  
Leg Pain ◽  
Lumbar Radiculopathy ◽  
Pain Disability ◽  
Short Term Study ◽  
The Individual ◽  
Reported Data

Abstract Context Evidence has shown that spinal mobilization with leg movement (SMWLM) and progressive inhibition of neuromuscular structures (PINS) are individually effective in the management of lumbar radiculopathy. However, previous evidence reported data for only a short-term study period and did not investigate the effect of the combined manual therapy techniques. Objectives To compare the combined effects of two manual therapy techniques (SMWLM and PINS) with the individual techniques alone (SMWLM or PINS) in the management of individuals with lumbar radiculopathy. Methods A total of 60 patients diagnosed with unilateral lumbar radiculopathy secondary to disc herniation were randomly allocated into three groups: 20 participants each in the SMWLM, PINS, and combined SMWLM + PINS groups. Each group attended two treatments per week for 30 min each, for three months. Participants were assessed at baseline, immediately posttreatment, and then at three, six, and nine months follow-up using the Visual Analog Scale (VAS), Rolland-Morris Disability Questionnaire (RMDQ), and Sciatica Bothersomeness Index (SBI). Results Between-groups analyses using a two-way repeated-measures analysis of variance indicated significant interactions between groups and follow-up times for all outcomes (p=0.001). Participants receiving combined SMWLM + PINS treatment experienced greater improvement in leg pain, back pain, disability, and sciatica at all timelines (immediately posttreatment, and three, six, and nine months follow-up) than the participants receiving SMWLM or PINS alone (p<0.05). However, participants receiving SMWLM alone showed better improvement than the participants receiving PINS alone at all timelines (p<0.05). Conclusions A combined SMWLM + PINS treatment protocol showed greater improvement than the individual techniques alone in the management of individuals with LR in this study.

scholarly journals Patient-Reported Outcomes After Complex Adult Spinal Deformity Surgery: 5-Year Results of the Scoli-Risk-1 Study

2021 ◽  
pp. 219256822098827
Author(s):  
Scott L. Zuckerman ◽  
Meghan Cerpa ◽  
Lawrence G. Lenke ◽  
Christopher I. Shaffrey ◽  
Leah Y. Carreon ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Adult Spinal Deformity ◽  
Corrective Osteotomy ◽  
Leg Pain ◽  
Major Surgery ◽  
Mean Values ◽  
Self Image ◽  
Patient Reported ◽  
Spinal Deformity Surgery

Study Design: Prospective cohort. Objective: To prospectively evaluate PROs up to 5-years after complex ASD surgery. Methods: The Scoli-RISK-1 study enrolled 272 ASD patients undergoing surgery from 15 centers. Inclusion criteria was Cobb angle of >80°, corrective osteotomy for congenital or revision deformity, and/or 3-column osteotomy. The following PROs were measured prospectively at intervals up to 5-years postoperative: ODI, SF36-PCS/MCS, SRS-22, NRS back/leg. Among patients with 5-year follow-up, comparisons were made from both baseline and 2-years postoperative to 5-years postoperative. PROs were analyzed using mixed models for repeated measures. Results: Seventy-seven patients (28.3%) had 5-year follow-up data. Comparing baseline to 5-year data among these 77 patients, significant improvement was seen in all PROs: ODI (45.2 vs. 29.3, P < 0.001), SF36-PCS (31.5 vs. 38.8, P < 0.001), SF36-MCS (44.9 vs. 49.1, P = 0.009), SRS-22-total (2.78 vs. 3.61, P < 0.001), NRS-back pain (5.70 vs. 2.95, P < 0.001) and NRS leg pain (3.64 vs. 2.62, P = 0.017). In the 2 to 5-year follow-up period, no significant changes were seen in any PROs. The percentage of patients achieving MCID from baseline to 5-years were: ODI (62.0%) and the SRS-22r domains of function (70.4%), pain (63.0%), mental health (37.5%), self-image (60.3%), and total (60.3%). Surprisingly, mean values ( P > 0.05) and proportion achieving MCID did not differ significantly in patients with major surgery-related complications compared to those without. Conclusions: After complex ASD surgery, significant improvement in PROs were seen at 5-years postoperative in ODI, SF36-PCS/MCS, SRS-22r, and NRS-back/leg pain. No significant changes in PROs occurred during the 2 to 5-year postoperative period. Those with major surgery-related complications had similar PROs and proportion of patients achieving MCID as those without these complications.

The Provision of an EMDR-Based Multicomponent Trauma Treatment With Child Victims of Severe Interpersonal Trauma

2013 ◽  
Vol 7 (1) ◽  
pp. 17-28 ◽  
Author(s):  
Ignacio Jarero ◽  
Susana Roque-López ◽  
Julio Gomez
Keyword(s):  
Group Treatment ◽  
Treatment Approach ◽  
Treatment Protocol ◽  
Interpersonal Trauma ◽  
Trauma Treatment ◽  
Child Victims ◽  
Traumatic Memories ◽  
The One ◽  
The Individual

This study evaluated a multicomponent phase–based trauma treatment approach for 34 children who were victims of severe interpersonal trauma (e.g., rape, sexual abuse, physical and emotional violence, neglect, abandonment). The children attended a week-long residential psychological recovery camp, which provided resource building experiences, the Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP), and one-on-one EMDR intervention for the resolution of traumatic memories. The individual EMDR sessions were provided for 26 children who still had some distress about their targeted memory following the EMDR-IGTP. Results showed significant improvement for all the participants on the Child’s Reaction to Traumatic Events Scale (CRTES) and the Short PTSD Rating Interview (SPRINT), with treatment results maintained at follow-up. More research is needed to assess the EMDR-IGTP and the one-on-one EMDR intervention effects as part of a multimodal approach with children who have suffered severe interpersonal trauma.

scholarly journals Ironic or Overcompensation Effects of Motor Behaviour: An Examination of a Tennis Serving Task Under Pressure

2019 ◽  
Vol 9 (2) ◽  
pp. 21 ◽  
Author(s):  
Recep Gorgulu
Keyword(s):  
Repeated Measures ◽  
Motor Behaviour ◽  
Mental Control ◽  
Tennis Players ◽  
Self Confidence ◽  
Paired Samples ◽  
Specific Direction ◽  
Ironic Processes ◽  
The Individual

With specific regard to the hypothesized effects of anxiety on performance in motor behaviour, the rival predictions emanating from the Wegner’s “ironic processes theory” and the “implicit overcompensation hypothesis” are largely indiscriminate. Specifically, Wegner’s theory predicts that self-instructions not to perform in a certain manner would lead to the very behaviour the individual seeks to avoid under pressure. On the other hand, the implicit overcompensation hypothesis predicts that avoidant instructions would produce the opposite outcome to that intended by the performer under pressure. The present novel study directly compared these predictions using a tennis serving task under manipulated instructions. The sample comprised 32 (20 men, 12 women; Mage = 20.81, SD = 2.20) experienced tennis players who performed a tennis serving task. Participants’ levels of cognitive anxiety, somatic anxiety and self-confidence were measured by using Mental Readiness Form-3. A 2 (anxiety: low, high) × 3 (serving zone: target zone, non-target ironic error zone, non-target non-ironic error zone) repeated measures of ANOVA revealed a significant anxiety × serving zone interaction F(2, 62) = 32.27, p < 0.001 which provides specific support for the Wegner’s ironic processes of mental control theory rather than implicit overcompensation hypothesis. More specifically, Bonferroni-corrected follow-up paired samples t-tests revealed that when instructed not to serve in a specific direction, anxious performers did so a significantly greater number of times (t31 = −5.15, p < 0.001). The present research demonstrates that ironic performance errors are a meaningful and robust potential concern for performers who are required to perform under pressure.

scholarly journals Reaching Out to Problem Anger: Assessing the Effectiveness of One-Day Cognitive Behavioural Workshops in a Community Setting in the UK

2016 ◽  
Vol 44 (5) ◽  
pp. 615-619 ◽  
Author(s):  
Nathan A. Illman ◽  
June S. L. Brown
Keyword(s):  
Repeated Measures ◽  
Depressive Symptomatology ◽  
Community Sample ◽  
Community Setting ◽  
Depression And Anxiety ◽  
Small Community ◽  
Client Group ◽  
Cognitive Behavioural ◽  
The Individual

Background: Problem anger is frequently experienced by the general population and is known to cause significant problems for the individual and those around them. Whilst psychological treatments for problem anger are becoming increasingly established, this is still an under-researched area of mental health. We present an evaluation of a series of one-day anger management workshops for the public, targeting problem anger with a cognitive-behavioural approach. Aims: The main aim was to evaluate the effectiveness of a brief group-based anger intervention in terms of subjectively reported anger provocation levels and of depression and anxiety. Method: Workshop participants completed a number of questionnaire measures at baseline before the intervention and at 1 month follow-up. The key questionnaires measured self-reported anger provocation levels (Novaco Anger Scale-Provocation Inventory), depressive symptomatology (PHQ-9) and symptoms of generalized anxiety (GAD-7). Change scores were analysed using repeated measures analyses. Results: We found a significant reduction in anger provocation among workshop participants at 1 month follow-up (p = .03). Reductions in depression and anxiety were not statistically significant. Conclusions: We conclude that this brief psychoeducational anger intervention was effective in a small community sample and suggest future work should assess the effectiveness on similar brief interventions using a larger client group and examine outcomes on a broader range of anger measures.

scholarly journals The need for a patient-tailored Helicobacter pylori eradication protocol prior to bariatric surgery

2018 ◽  
Vol 46 (7) ◽  
pp. 2696-2707 ◽  
Author(s):  
Tadeja Pintar ◽  
Niko Kaliterna ◽  
Tanja Carli
Keyword(s):  
Bariatric Surgery ◽  
Helicobacter Pylori ◽  
Treatment Protocol ◽  
Infectious Complications ◽  
Quality Data ◽  
Morbidly Obese ◽  
First Year ◽  
H Pylori ◽  
The Individual

Objective High-quality data indicating the advantages of preoperative Helicobacter pylori screening and eradication as well the clinical outcomes of patients with and without H. pylori after bariatric surgery are lacking. Methods In total, 96 morbidly obese patients with H. pylori preparing for bariatric surgery were retrospectively reviewed. Results Of 96 biopsy specimens, 73 (76%) were positive for H. pylori on initial Giemsa staining. These patients were treated with the standard 7-day antibiotic treatment protocol corrected by the individual patient’s creatinine clearance rate and body mass index and received a 30% higher dose because of their H. pylori positivity. A linear correlation was found between the effective antibiotic dose and the BMI with a recurrence rate of only 2.1% (2/96 patients). The preoperative percent estimated weight loss before surgery (17%) and in the first year of follow-up (68%–88%) was statistically equal between H. pylori-positive and -negative patients. Two early postoperative infectious complications and two postoperative surgical complications occurred in the preoperatively H. pylori-positive patients. Conclusions A patient-tailored H. pylori eradication protocol prior to bariatric surgery is mandatory to improve the eradication rate and reduce the incidence of postoperative complications in mostly asymptomatic H. pylori-positive bariatric candidates.

scholarly journals A Comparison Between the Effects of Manual Therapy Plus Sexual Advice With Manual Therapy Alone in Patients With Low Back Pain: A Study Protocol

2020 ◽  
Author(s):  
Musa Sani Danazumi ◽  
Abdulsalam Mohammed Yakasai ◽  
Shehu Usman Ibrahim ◽  
Usman Tijjani Shehu ◽  
Mubarak Falke Abubakar ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Manual Therapy ◽  
Repeated Measures ◽  
Self Report ◽  
Low Back ◽  
Clinical Trial Registry ◽  
Lumbar Disk Herniation ◽  
Pain Disability ◽  
Objective Outcomes

Abstract Objective: The aim of this study is to compare the effects of manual therapy plus sexual advice (MT+SA) with manual therapy alone (MTA) in the management of individuals with low back pain (LBP). Methods: A total of 208 individuals diagnosed with LBP secondary to lumbar disk herniation with radiculopathy (LDHR) will be randomly (computer-generated block randomization) assigned into 2 treatment groups; 104 participants each in (MT+SA) and (MTA) groups. Each participant will be assessed at baseline, 4, 8 and 12 weeks of intervention and then at 6, 9, and 12 months of follow-up. Outcomes to be assessed will include both self-report (pain, disability, sciatica bothersomeness and sciatica frequency), and objective outcomes (gait speed and dynamic isometric abdominal strength). Repeated measures ANOVA with intervention (MT+SA and MTA) as the between-subject variable and time (weeks 4, 8 and 12, months 6, 9 and 12) as the within-subject variable will be used to analyze treatment effects. Discussion: This study will determine if the addition of sexual advice to manual therapy will yield better outcomes than when manual therapy alone is administered to individuals with LBP secondary to LDHR. Trial Registration: Pan African Clinical Trial Registry: PACTR202002785212512.

Manual therapy associated with topical heat reduces pain and self-medication in patients with tension-type headache

2021 ◽  
Vol 28 (3) ◽  
pp. 244-251
Author(s):  
Maisa Soares Gui-Demase ◽  
Kelly Cristina da Silva ◽  
Gisely dos Santos Teixeira
Keyword(s):  
Manual Therapy ◽  
Treatment Protocol ◽  
Public Health Problem ◽  
Trigger Points ◽  
Tension Type Headache ◽  
Self Medication ◽  
Myofascial Trigger Points ◽  
Pain Diary ◽  
Type Headache

ABSTRACT Tension-type headache (TTH) is a significant public health problem. The myofascial trigger points in the masticatory and cervical muscles are related to pain located in the temporomandibular joint, face, and cranium according to specific patterns. Thus, therapeutic procedures should be directed to myofascial trigger points rather than to the area of referred pain. For this purpose, the massage therapy combined with the topical heat can provide effective results due to the increase of the local microcirculation, improving tissue perfusion and promoting muscle relaxation. In this study we investigated the effects of manual therapy associated with topical heat therapy in TTH pain. This is a single-arm study composed of 13 participants with TTH (females), which were submitted to a three-month research protocol. In the first month , they filled out a pain diary and then they were evaluated. In the following month, the treatment protocol was applied (8 sessions of 45 minutes, twice a week, involving massage for skin desensitization, myofascial trigger point deactivation and stretching (friction massage) on masticatory and trapezius muscles after the topical heat). Then, in the third month (follow-up period), the participants were instructed to fill out the pain diary once again. We observed a significant decrease in pain intensity in TTH episodes, and medication intake after treatment and it keeps decreasing in follow-up. We conclude that the combination of manual therapy protocol and topical heat reduced pain and episodes related to TTH, and self-medication use in our sample.

AAC Supports for Individuals With Rett Syndrome Across the Lifespan

2015 ◽  
Vol 24 (3) ◽  
pp. 74-85
Author(s):  
Sandra M. Grether
Keyword(s):  
Rett Syndrome ◽  
Communication Skills ◽  
Preliminary Analysis ◽  
Multidisciplinary Approach ◽  
Motor Deficits ◽  
Complex Profile ◽  
Communication Behaviors ◽  
The Individual

Individuals with Rett syndrome (RS) present with a complex profile. They benefit from a multidisciplinary approach for diagnosis, treatment, and follow-up. In our clinic, the Communication Matrix © (Rowland, 1990/1996/2004) is used to collect data about the communication skills and modalities used by those with RS across the lifespan. Preliminary analysis of this data supports the expected changes in communication behaviors as the individual with RS ages and motor deficits have a greater impact.

Muenke syndrome: long-term outcome of a syndrome-specific treatment protocol

2019 ◽  
Vol 24 (4) ◽  
pp. 415-422 ◽  
Author(s):  
Bianca K. den Ottelander ◽  
Robbin de Goederen ◽  
Marie-Lise C. van Veelen ◽  
Stephanie D. C. van de Beeten ◽  
Maarten H. Lequin ◽  
...  
Keyword(s):  
Treatment Protocol ◽  
First Year ◽  
Ventricular Size ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Skull Growth ◽  
Muenke Syndrome ◽  
First Year Of Life

OBJECTIVEThe authors evaluated the long-term outcome of their treatment protocol for Muenke syndrome, which includes a single craniofacial procedure.METHODSThis was a prospective observational cohort study of Muenke syndrome patients who underwent surgery for craniosynostosis within the first year of life. Symptoms and determinants of intracranial hypertension were evaluated by longitudinal monitoring of the presence of papilledema (fundoscopy), obstructive sleep apnea (OSA; with polysomnography), cerebellar tonsillar herniation (MRI studies), ventricular size (MRI and CT studies), and skull growth (occipital frontal head circumference [OFC]). Other evaluated factors included hearing, speech, and ophthalmological outcomes.RESULTSThe study included 38 patients; 36 patients underwent fronto-supraorbital advancement. The median age at last follow-up was 13.2 years (range 1.3–24.4 years). Three patients had papilledema, which was related to ophthalmological disorders in 2 patients. Three patients had mild OSA. Three patients had a Chiari I malformation, and tonsillar descent < 5 mm was present in 6 patients. Tonsillar position was unrelated to papilledema, ventricular size, or restricted skull growth. Ten patients had ventriculomegaly, and the OFC growth curve deflected in 3 patients. Twenty-two patients had hearing loss. Refraction anomalies were diagnosed in 14/15 patients measured at ≥ 8 years of age.CONCLUSIONSPatients with Muenke syndrome treated with a single fronto-supraorbital advancement in their first year of life rarely develop signs of intracranial hypertension, in accordance with the very low prevalence of its causative factors (OSA, hydrocephalus, and restricted skull growth). This illustrates that there is no need for a routine second craniofacial procedure. Patient follow-up should focus on visual assessment and speech and hearing outcomes.

Long-term seizure outcomes after pediatric temporal lobectomy: does brain MRI lesion matter?

2019 ◽  
Vol 24 (2) ◽  
pp. 200-208
Author(s):  
Ravindra Arya ◽  
Francesco T. Mangano ◽  
Paul S. Horn ◽  
Sabrina K. Kaul ◽  
Serena K. Kaul ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Hippocampal Sclerosis ◽  
Brain Mri ◽  
Temporal Lobectomy ◽  
Seizure Freedom ◽  
Seizure Onset

OBJECTIVEThere is emerging data that adults with temporal lobe epilepsy (TLE) without a discrete lesion on brain MRI have surgical outcomes comparable to those with hippocampal sclerosis (HS). However, pediatric TLE is different from its adult counterpart. In this study, the authors investigated if the presence of a potentially epileptogenic lesion on presurgical brain MRI influences the long-term seizure outcomes after pediatric temporal lobectomy.METHODSChildren who underwent temporal lobectomy between 2007 and 2015 and had at least 1 year of seizure outcomes data were identified. These were classified into lesional and MRI-negative groups based on whether an epilepsy-protocol brain MRI showed a lesion sufficiently specific to guide surgical decisions. These patients were also categorized into pure TLE and temporal plus epilepsies based on the neurophysiological localization of the seizure-onset zone. Seizure outcomes at each follow-up visit were incorporated into a repeated-measures generalized linear mixed model (GLMM) with MRI status as a grouping variable. Clinical variables were incorporated into GLMM as covariates.RESULTSOne hundred nine patients (44 females) were included, aged 5 to 21 years, and were classified as lesional (73%), MRI negative (27%), pure TLE (56%), and temporal plus (44%). After a mean follow-up of 3.2 years (range 1.2–8.8 years), 66% of the patients were seizure free for ≥ 1 year at last follow-up. GLMM analysis revealed that lesional patients were more likely to be seizure free over the long term compared to MRI-negative patients for the overall cohort (OR 2.58, p < 0.0001) and for temporal plus epilepsies (OR 1.85, p = 0.0052). The effect of MRI lesion was not significant for pure TLE (OR 2.64, p = 0.0635). Concordance of ictal electroencephalography (OR 3.46, p < 0.0001), magnetoencephalography (OR 4.26, p < 0.0001), and later age of seizure onset (OR 1.05, p = 0.0091) were associated with a higher likelihood of seizure freedom. The most common histological findings included cortical dysplasia types 1B and 2A, HS (40% with dual pathology), and tuberous sclerosis.CONCLUSIONSA lesion on presurgical brain MRI is an important determinant of long-term seizure freedom after pediatric temporal lobectomy. Pediatric TLE is heterogeneous regarding etiologies and organization of seizure-onset zones with many patients qualifying for temporal plus nosology. The presence of an MRI lesion determined seizure outcomes in patients with temporal plus epilepsies. However, pure TLE had comparable surgical seizure outcomes for lesional and MRI-negative groups.

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