scholarly journals Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Musa S. Danazumi ◽  
Abdulsalam M. Yakasai ◽  
Aminu A. Ibrahim ◽  
Usman T. Shehu ◽  
Shehu U. Ibrahim
Keyword(s):  
Repeated Measures ◽  
Trigger Point ◽  
Treatment Session ◽  
Tender Point ◽  
Functional Mobility ◽  
Piriformis Syndrome ◽  
Light Pressure ◽  
Release Technique ◽  
Inhibition Technique ◽  
Stretching Exercises

Abstract Context Studies have indicated that the muscle energy technique (MET) and the positional release technique (PRT) are effective in the management of piriformis syndrome (PS); however, evidence is scarce regarding the combination of these techniques in the form of an integrated neuromuscular inhibition technique (INIT) in the management of individuals with PS. Although a previous trial investigated the effect of INIT for PS, that study did not integrate Ruddy’s reciprocal antagonist facilitation (RRAF) method into the INIT protocol, nor did the authors diagnose PS according to established criteria. Objectives To examine the effects of INIT with integrated RRAF compared with PRT in the management of patients diagnosed with PS. Methods This study was designed as a single blind randomized clinical trial in which participants diagnosed with PS were randomly allocated into INIT and PRT groups. Each group attended two treatment sessions per week for 8 weeks. Patients in the INIT group received a protocol in which the patient’s tender point or trigger point was palpated in the belly of the piriformis approximately halfway between the inferior lateral angle of the sacrum and the greater trochanter, at which point the therapist applied an intermittent or sustained pressure and maintained the pressure for 20–60 seconds (depending on the participant’s response to pain reduction). For INIT patients, that protocol was also followed by RRAF, a method in which a patient introduces a series of tiny/miniature contractions or efforts (20 times per 10 seconds) against a therapist’s resistance. Patients in the PRT group were treated by palpating the same trigger point described in the INIT group, followed by application of light pressure at the location of the trigger point, which was maintained the pressure for 2 minutes or until the pain subsided (determined by asking the participant to report a pain score using a visual analog scale at 30 second intervals). For both groups, three repetitions of the INIT or PRT treatment were performed over 10 minutes at each clinical visit. Additionally, each group also received stretching exercises immediately after the INIT or PRT treatment session. Each participant was assessed at baseline, immediately posttreatment, and at 4 months posttreatment for pain, sciatica, functional mobility, quality of life, hip abduction, and internal rotation. A repeated measures analysis of variance (ANOVA) of within-between group interactions was used to analyze the treatment effect. Results Forty eight participants (age range, 25–47 years; mean age ± standard deviation, 32.81 ± 3.27 years) were randomized into the INIT and PRT groups, with 24 participants in each group. No significant between-group differences (p>0.05) were observed in the baseline demographic and clinical variables of the participants. A repeated-measures ANOVA indicated that there was a significant time effect for all outcomes, with a significant interaction between time and intervention (p<0.001). The Bonferroni post hoc analyses of time and intervention effects indicated that the INIT group improved significantly compared with the PRT group in all outcomes (p<0.05) immediately posttreatment and at the 4 months follow up period. Conclusions INIT was more effective than PRT in the management of individuals with PS. It should be noted the significant improvement achieved in both the groups may have also been contributed to by the stretching exercises that were used as adjunct therapies by both groups.

Changes in Muscle Tone, Function, and Pain in the Chronic Hemiparetic Shoulder after Dry Needling Within or Outside Trigger Points in Stroke Patients: A Crossover Randomized Clinical Trial

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 2939-2947 ◽  
Author(s):  
Alma R Hernández-Ortíz ◽  
Raquel Ponce-Luceño ◽  
Carlos Sáez-Sánchez ◽  
Olga García-Sánchez ◽  
César Fernández-de-las-Peñas ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Shoulder Pain ◽  
Repeated Measures ◽  
Muscle Tone ◽  
Trigger Point ◽  
Treatment Session ◽  
Dry Needling ◽  
Extremity Function ◽  
Upper Extremity Function

Abstract Objectives To investigate the effects of applying dry needling into a trigger point (TrP) or non-TrP area in people who have suffered a stroke and to investigate if the effects of dry needling are maintained at six-week follow-up. Methods A controlled, repeated-measures, crossover, double-blinded randomized trial was conducted. Nineteen patients with hemiparetic shoulder pain after a stroke event were randomly assigned to receive a single multimodal treatment session combined with TrP dry needling or non-TrP dry needling. The neuro-rehabilitation session included modulatory interventions targeting the central nervous system. Spasticity (Modified Ashworth Scale), shoulder pain intensity (numerical pain rate scale, 0–10), and upper extremity function (Motor Evaluation Scale for Upper Extremity in Stroke [MESUPES], Reaching Performance Scale [RPS]) were assessed before (baseline) and one, two, three, four, five, and six weeks after the treatment session by a blinded assessor. All participants received both sessions in a randomized order where they were followed up for six weeks before receiving the opposite treatment and then followed up for another six weeks. Results Changes in muscle tone (all P &gt; 0.266) and upper extremity function (MESUPES: F = 0.544, P  = 0.465; RPS close task: F = 0.820, P = 0.371; RPS far task: 0.830, P  = 0.368) were similar after both interventions at all follow-up periods. The decrease in shoulder pain was higher within the TrP dry needling group as compared with the non-TrP dry needling group, particularly at two and four weeks (P  = 0.01). Conclusions The effect of dry needling on muscle tone (spasticity) and upper extremity function is not related to its application in or outside of a TrP area. The effect of dry needling on shoulder pain was slightly superior when applied over a TrP in poststroke people. These effects were maintained six weeks after treatment.

Static and Dynamic Acute Stretching Effect on Gymnasts’ Speed in Vaulting

2003 ◽  
Vol 15 (4) ◽  
pp. 383-391 ◽  
Author(s):  
Theophanis Siatras ◽  
Georgios Papadopoulos ◽  
Dimitra Mameletzi ◽  
Vasilios Gerodimos ◽  
Spiros Kellis
Keyword(s):  
Repeated Measures ◽  
Acute Effect ◽  
Static Stretching ◽  
Warm Up ◽  
Dynamic Stretching ◽  
Significant Difference ◽  
Post Hoc ◽  
Stretching Effect ◽  
Stretching Exercises

Although warm-up and stretching exercises are routinely performed by gymnasts, it is suggested that stretching immediately prior to an activity might affect negatively the athletic performance. The focus of this investigation was on the acute effect of a protocol, including warm-up and static and dynamic stretching exercises, on speed during vaulting in gymnastics. Eleven boys were asked to perform three different protocols consisting of warm-up, warm-up and static stretching and warm-up and dynamic stretching, on three nonconsecutive days. Each protocol was followed by a “handspring” vault. One-way analysis of variance for repeated-measures showed a significant difference in gymnasts’ speed, following the different protocols. Tukey’s post hoc analysis revealed that gymnasts mean speed during the run of vault was significantly decreased after the application of the static stretching protocol. The findings of the present study indicate the inhibitory role of an acute static stretching in running speed in young gymnasts.

scholarly journals Topical Intrapocket Anesthesia During Scaling and Root Planing: a Randomized Clinical Trial

2015 ◽  
Vol 26 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Raquel Pippi Antoniazzi ◽  
Bruna Cargnelutti ◽  
Daniela Napoleão Freitas ◽  
Magáli Beck Guimarães ◽  
Fabricio Batistin Zanatta ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Repeated Measures ◽  
Pain Control ◽  
Eutectic Mixture ◽  
Treatment Session ◽  
Scaling And Root Planing ◽  
Root Planing ◽  
Verbal Scale ◽  
Probing Depth ◽  
Equivalent Effect

Although the use of injectable anesthesia prior to subgingival scaling and root planing (SRP) reduces pain, many patients report fear and prolonged numbness of adjacent tissues. The aim of the present study was to compare the effects of a eutectic mixture containing 25 mg/g of lidocaine and 25 mg/g of prilocaine, injectable 2% lidocaine, topical 2% benzocaine and a placebo substance on reducing pain during SRP. In this randomized, split-mouth, masked clinical trial, thirty-two patients presenting more than two teeth with probing depth and clinical attachment level ≥5 mm in at least 4 sextants were randomly allocated to four groups: EMLA(r); injectable 2% lidocaine; topical 2% benzocaine and placebo. Pain and discomfort were measured using a visual analogue scale (VAS) and verbal scale (VS). Repeated-measures analysis of variance and Poisson regression were used for analysis. Patient satisfaction with the anesthesia was determined at the end of each treatment session. VAS and VS scores did not differ between injectable 2% lidocaine and EMLA (p>0.05) and both substances showed significantly better pain control compared to 2% benzocaine and placebo (p<0.05). 93.7% and 81.2% of the individuals were satisfied with the injectable anesthetic and EMLA, respectively (p=0.158). Dissatisfaction with benzocaine and placebo was approximately 10 times greater than injectable anesthesia (p=0.001). In conclusion, EMLA showed an equivalent effect on pain control when compared to the injectable anesthesia and performed better than 2% benzocaine in SRP. Thus, EMLA is a viable anesthetic option during scaling and root planning, despite the frequent need for second application.

scholarly journals Acute Effects Of Different Stretching Durations on Vertical Jump Performance in Rhythmic Gymnasts

2018 ◽  
Vol 3 (82) ◽  
Author(s):  
Nuriye Özengin ◽  
Necmiye Ün Yıldırım ◽  
Gül Baltacı ◽  
Nerijus Masiulis
Keyword(s):  
Repeated Measures ◽  
Vertical Jump ◽  
Effective Means ◽  
Anaerobic Power ◽  
Static Stretching ◽  
Jump Performance ◽  
Warm Up ◽  
Rhythmic Gymnastics ◽  
Rhythmic Gymnasts ◽  
Stretching Exercises

Research background. Stretching is believed to enhance performance, reduce injury, and be an effective means of developing flexibility and alleviating muscular soreness (Shellock, Prentice, 1985; Brandy et al., 1997). A review of the current literature shows that the results of many studies conflict with others; some report that static stretching diminishes vertical jum (VJ) performance (Cornwell et al., 2001; McNeal, Sands, 2003; Wallmann et al., 2005), whereas others report that static stretching has no effect at all on VJ (Church et al., 2001; Power et al., 2004; Unick et al., 2005). Research aim, was to examine the effects of different durations of stretching on performance and to find the stretching durations that affect the performance negatively or positively. Research methods. The subjects of the study were 27 rhythmic gymnasts with the mean age of 10.00 ± 1.2 years. The subjects as a whole group participated in two different stretching programs on nonconsecutive days to eliminate the effect of individual differences on the performance. On the first day, athletes were asked to warm up by 5 minute jogging after the pretest was administered. The posttest measured the vertical jump performance after athletes stayed inactive for 20 minutes. They rested for a day and on the third day, their performance was measured again. After the 5 minute warm-up period, 10 repetitions of 15 seconds static stretching exercises for hip flexor, hamstring and gastrocnemius muscle groups were followed by the posttest. Moreover, on the fifth day 30-second exercises were repeated five times on the same type of muscles. The participants in this investigation were tested in individual vertical jump performances following warm-up only, warm-up plus 15 seconds static stretching, and warm-up plus 30 seconds. Research results. Results of a one-way repeated-measures ANOVA indicated a nonsignificant difference for vertical jump performance (F = 2.052; p > 0.05). Discussion and conclusions. Stretching exercises are referred in rhythmic gymnastics more intensively than other sports. Relevant literature displays fewer stretching repetitions and durations. These durations and repetitions may not be realistic and practical for rhythmic gymnasts. Therefore, the durations and repetitions utilized in this study are considered more appropriate for rhythmic gymnastics trainings. Rhythmic gymnasts may make use of duration and repetitions determined in this study that will not affect their performance.Keywords: anaerobic power, gymnastics, exercise.

scholarly journals Examination of basic motoric characteristics with different stretching exercises in football playersFutbolcularda farklı germe egzersizleri ile temel motorik özelliklerinin incelenmesi

2017 ◽  
Vol 14 (2) ◽  
pp. 1255 ◽  
Author(s):  
Öznur Akyüz
Keyword(s):  
Repeated Measures ◽  
Dynamic Balance ◽  
Football Players ◽  
Balance Test ◽  
Significant Difference ◽  
Package Program ◽  
Explosive Force ◽  
Bonferroni Test ◽  
And Performance ◽  
Stretching Exercises

To investigate acutely the effects of different stretching exercises on football players on the basic motoric properties (strength, flexibility, speed, balance and explosive force). 10 volunteer football players with an average age of 17 participated in the study. Three different measurements protocols were used in the study. The first measurement was performed without stretching exercise, the second measurement was performed after the static stretching exercise and the third measurement was performed after the dynamic stretching exercise. All measurements were carried out at Manisa Tarık Almış sports facilities. To determine the performances of volunteers; back strength, leg strength, hand grip strength, flexibility, 20 m. sprint and flamingo balance test. The Repeated Measures ANOVA test and the Bonferroni Test were used using the SPSS 23.0 package program to analyze the relationship between the performance of the study group and performance tests on different days and different protocols. When the three different methods applied to participants were compared; there is a statistically significant difference between sit and reach, speed and balance tests. As a result, there is a positive effect of stretching exercises on flexibility, sprint and dynamic balance skills. ÖzetFutbolcularda farklı germe egzersizlerinin temel motorik özellikler (kuvvet, esneklik, sürat, denge ve patlayıcı kuvvet) üzerine etkilerini akut olarak incelemektir. Çalışmaya yaş ortalamaları 17 olan 10 gönüllü futbolcu katılmıştır. Çalışmada 3 farklı ölçüm protokolü kullanılmıştır. Birinci ölçüm germe egzersizi yapmadan, ikinci ölçüm statik germe egzersizinden sonra ve üçüncü ölçüm dinamik germe egzersizinden sonra gerçekleştirildi. Tüm ölçümler Manisa Tarık Almış Spor Tesislerinde yapılmıştır. Katılımcıların performanslarını belirlemek için sırt kuvveti, bacak kuvveti, el kavrama kuvveti, esneklik, 20 m. sprint, flamingo denge testi uygulanmıştır. Araştırma grubunun farklı günlerde ve farklı germe egzersizlerini takiben uygulanan performans testlerinin aralarındaki ilişkiyi analiz etmek için SPSS 23.0 paket programından, Repeated Measures Testi ve Bonferroni Testi kullanılmıştır. Katılımcılara uygulanan three farklı ölçüm metodu karşılaştırıldığında; otur-eriş, sürat ve denge testleri arasında istatistiksel olarak anlamlı farklılık vardır (p<0.05). Sonuç olarak, germe egzersizlerinin esneklik, sürat ve denge üzerinde olumlu etkisi vardır.

scholarly journals Comparison of the Effect of Bicarbonate, Hyaluronidase, and Lidocaine Injection on Myofascial Pain Syndrome

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Mahshid Ghasemi ◽  
Faramarz Mosaffa ◽  
Behnam Hoseini ◽  
Faranak Behnaz
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Trapezius Muscle ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
The Body ◽  
Lidocaine Injection ◽  
Permanent Effect

Background: Myofascial pain syndrome is a chronic syndrome that occurred in a local or focal part of the body. The basis for myofascial pain syndrome is the presence of myofascial trigger point or points, producing pain in clinical examinations. Objectives: This study aimed to compare the effect of injection of bicarbonate, hyaluronidase, and lidocaine on myofascial pain syndrome. Methods: The patients were randomly allocated to three groups of bicarbonate, hyaluronidase, and lidocaine. The injection was done at two painful regions of trapezius muscle with a sonography guide for each patient. The values of visual analogue scale (VAS), pre-injection range of motion (ROM), immediately after injection, second and fourth week were measured. Results: The analysis showed that there were no significant differences between the three groups for age, gender, BMI, and height (P > 0.05). Repeated measures one-way ANOVA (week * group) 4 * 3 was used to compare the effect of bicarbonate, hyaluronidase, and lidocaine on VAS and range of motion (ROM) before injection, immediately after injection, second and fourth week. The results showed that the main effect of group and week is significant for VAS (P < 0.05). This study showed that the values of VAS were significantly different between the three groups during the fourth weeks of the study. Moreover, the patients experienced more pain decline in the hyaluronidase group during weeks before injection, after injection, second and fourth week, which indicated the permanent effect of this medication on pain decline. Conclusions: Injection of lidocaine leads to a significant reduction in pain immediately after injection; however, the decline was not permanent and disappeared in the following four weeks. But VAS reduction in hyaluronidase group more than bicarbonate and lidocaine groups.

scholarly journals Relationship Between Clusters of Chronic Conditions and Disability Trajectories

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 881-881
Author(s):  
Tara Klinedinst ◽  
Lauren Terhorst ◽  
Juleen Rodakowski
Keyword(s):  
Repeated Measures ◽  
Chronic Conditions ◽  
Latent Class ◽  
Functional Mobility ◽  
Multiple Chronic Conditions ◽  
Class Time ◽  
Time Interaction ◽  
Minimal Disease ◽  
Best Fit ◽  
Over Time

Abstract Recent evidence shows that more complex clusters of chronic conditions are associated with poorer health outcomes. Less clear is the extent to which these clusters are associated with different types of disability (basic and instrumental activities of daily living (ADL, IADL) and functional mobility (FM)) over time. This was a longitudinal analysis using the National Health and Aging Trends Study (NHATS) (n = 6,179). Using latent class analysis, we determined the optimal clusters of chronic conditions, then assigned each person to a best-fit class. Next, we used mixed-effects models with repeated measures to examine the effects of group (best-fit class), time (years from baseline), and the group by time interaction on each of the outcomes in separate models over 4 years. We identified 5 chronic condition clusters: “multisystem morbidity” (13.9% of the sample), “diabetes” (39.5%), “osteoporosis” (24.9%), “cardio/stroke/cancer” (4.5%), and “minimal disease” (17.3%). Group by time interaction was not significant for any outcome. For ADL outcome, only time was significant (F3,16249 = 224.72, p &lt; .001). For IADL, both group (F4,5403 = 6.62, p &lt; .001) and time (F3,22622 = 3.87, p = .009) were significant. For FM, both group (F4,5920 = 2.96, p = .02) and time were significant (F3,16381 = 213.41, p &lt; .001). We did not find evidence that any cluster experienced greater increases in disability over time, but all clusters containing multiple chronic conditions had risk of IADL and FM disability. Increased screening for IADL and FM disability could identify early disability and prevent decline.

scholarly journals Efficacy of Self Myofascial Release Technique to Reduce Frequency and Severity of Noctural Leg Cramp in Older Adults

2021 ◽  
pp. 193-197
Author(s):  
Samiksha V. Sonone ◽  
Deepali Patil ◽  
Om C. Wadhokar
Keyword(s):  
Older Persons ◽  
Trigger Point ◽  
Low Cost ◽  
Night Time ◽  
Prolonged Standing ◽  
Myofascial Release ◽  
Release Technique ◽  
Wide Range ◽  
Proprioceptive Neuromuscular Facilitation

Background: Nocturnal leg cramps (NLC) are involuntary muscle contractions of the calf muscles, hamstrings, or foot muscles that occur unexpectedly, episodically, and are unpleasant. Night time cramping affects about one-third of adults. Leg cramps can strike anyone at any age, although they are more widespread and often more severe as grow older. The majority of cramps are idiopathic, and the physiological cause behind them is unknown. Muscle cramps appear to be triggered by neuromuscular structures in muscle, tendons, and nerve fibres, according to some writers. Musculoskeletal issues linked to a sedentary lifestyle, as well as job postures, prolonged standing, and the western habit of sitting rather than squatting, have been implicated of generating cramps, particularly NLC. Patients with cramps have a higher risk of peripheral vascular disease than individuals without cramps. Stretching before bedtime can help older persons lessen the frequency and severity of nocturnal leg cramps. Stretching treatments, like as Myofacial Release, can help relieve NLC. Self-Myofacial release (SMFR) is a sort of Myofacial release (MFR) that is accomplished by the person rather than a therapist, and it is usually done with the help of a tool. Self-MFR is a low-cost, easily accessible approach for people to relieve muscle and fascia pain while also maintaining flexibility. Foam rollers and roller massage are two of the most used devices for self-MFR. MFR is used to treat a wide range of musculoskeletal disorders; it is used to treat a wide range of problems, and many types of treatment, such as trigger-point therapy and proprioceptive neuromuscular facilitation, fall under the myofascial umbrella. Aim and Objectives: To study the main impact of Self Myofascial Release (SMFR) to decreasing the duration of pain and improving Quality of Life in patients with NLC. Methodology: In this study total 30 patient with nocturnal leg cramps will receive Self Myofascial Release technique (SMFR), it will be including exercise which will be performed for 4 weeks twice a day and each for 5-10 mins. Discussion: This study is done to find out the effectiveness of Self Myofacial release in individual with nocturnal leg cramps (NLC). Conclusion: Conclusion of the study can be made based on the effect of Self Myofascial Release technique on patient with nocturnal leg cramps. 

scholarly journals PENAMBAHAN INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUE LEBIH MENURUNKAN DISABILITAS LEHER DARIPADA CONTRACT RELAX STRETCHING PADA INTERVENSI ULTRASOUND DALAM KASUS SINDROM MYOFASCIAL OTOT UPPER TRAPEZIUS

2018 ◽  
Author(s):  
Putu Ayu Sita Saraswati ◽  
I Putu Gede Adiatmika ◽  
Syahmirza Indra Lesmana ◽  
I Wayan Weta ◽  
I Made Jawi ◽  
...  
Keyword(s):  
Trigger Point ◽  
Neck Disability Index ◽  
Test Group ◽  
Myofascial Trigger Point ◽  
Group Design ◽  
Upper Trapezius ◽  
Post Test ◽  
Neck Disability ◽  
Inhibition Technique

Sindrom myofascial pada otot upper trapezius merupakan nyeri otot yang ditandai oleh satu atau beberapa myofascial trigger point pada otot upper trapezius. Posisi kerja statis dalam jangka waktu lama memicu timbulnya masalah tersebutdan mengakibatkan nyeri dan keterbatasan gerak pada leher sehingga akan menimbulkan disabilitas leher. Penanganan fisioterapi berupa integrated neuromuscular inhibition technique (INIT) dan contract relax stretching yang dikombinasikan dengan modalitas ultrasound berdampak pada penurunan disabilitas leher. Tujuan: mengetahui metode yang lebih efektif dalam menurunkan disabilitas leher pada sindrom myofascial otot upper trapezius.Metode: Jenis penelitian eksperimental dengan rancangan randomizedpre test and post test group design. Sampel sebanyak 24 orang dibagi menjadi dua kelompok masing-masing 12 orang secara random. Kelompok perlakuan 1 dengan kombinasi INIT dengan ultrasound, sedangkan perlakuan 2 dengan contract relax stretching dengan ultrasound. Data diperoleh dengan mengukur disabilitas leher menggunakan Neck Disability Index(NDI), lingkup gerak sendi leher (LGS) dengan goniometerpada saat sebelum dan setelah perlakuan. Hasil:Diperoleh penurunan NDI22,50±2,43%(p<0,001) dan peningkatan LGS 5,083±1,0840 (p<0,001) pada Kelompok 1.Kelompok 2 juga terdapat penurunan NDI 17,33±3,05%(p<0,001) dan peningkatan LGS3,333±0,7780 (p<0,001). Hal ini berarti bahwa dalam setiap kelompok terjadi penurunan disabilitas leher secara bermakna. Hasil uji antar kelompok menunjukkan terdapat perbedaan yang bermakna pada penurunan NDI (p<0,001) dan peningkatan LGS (p<0,001). Simpulan: penambahan INIT lebih menurunkan disabilitas leher daripada contract relax stretching pada intervensi ultrasound dalam kasus sindrom myofascial otot upper trapeziusKata kunci : myofascial, trapezius, INIT, ultrasound, stretching, disabilitas leher

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