scholarly journals Successful management of a professional viola player with a complex playing related musculoskeletal disorder

2021 ◽  
Vol 72 (1) ◽  
pp. 59-65
Author(s):  
Florina Georgeta Popescu ◽  
Monica Adriana Vaida ◽  
Grant JK Mackay ◽  
Claudia Borza ◽  
Elena-Ana Păuncu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Pain ◽  
Manual Therapy ◽  
Conservative Management ◽  
Neck Disability Index ◽  
Treatment Techniques ◽  
Therapy Program ◽  
Shoulder Range Of Motion ◽  
Mulligan Concept ◽  
Neck Disability

Abstract Objective: This paper presents the case of a 53-year-old female professional violist with chronic disabling neck and shoulder pain who had failed standard conservative management. A multimodal approach including Mulligan Concept manual therapy techniques resulted in a successful return to the workplace. Methods: Mobilization with Movements and Sustained Natural Apophyseal Glides as part of Mulligan Concept manual therapy approach, were the main treatment techniques utilized. Neuro-dynamic exercises, strengthening exercises, ergonomic interventions, alterations in playing load, and posture training were also implemented. Pain, range of motion and disability levels were monitored throughout treatment. Results: Significant improvements were seen in both neck and shoulder range of motion alongside considerable pain reduction in both regions. Clinically meaningful improvements were also noted in Neck Disability Index and Shoulder Pain and Disability Index scores. Discussion: Ergonomic intervention with postural correction and replacement with a lighter viola also contributed to patient recovery and return to the workplace. The Mulligan approach has proved to be effective in a wide variety of conditions. Still, it has not previously been considered in managing complex neck and upper limb disfunctions in string players. Conclusion: This paper highlights how an intensive manual therapy program had better results compared with standard conservative management. Multimodal intervention with occupational, ergonomic, and physiotherapy approaches was effective, leading to progressive re-integration into the workplace. Mulligan Concept manual therapy techniques should be considered in the management of playing related musculoskeletal disorders.

Effectiveness of Neural Mobilization on Pain, Range of motion, and Disability in Cervical Radiculopathy: a Randomized Controlled Trial

2021 ◽  
Author(s):  
Shazia Rafiq ◽  
Hamayun Zafar ◽  
Prof. Dr. Syed Amir Gillani ◽  
Muhammad Sharif Waqas ◽  
Amna Zia ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Conventional Treatment ◽  
Rating Scale ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Sampling Technique ◽  
Cervical Radiculopathy ◽  
Neck Disability

Abstract Background: Cervical Radiculopathy (CR) is a disorder of the spinal nerve roots that is largely caused by space occupying lesion which can lead to nerve root inflammation and patient usually presents with radiating pain in his/her upper extremity known as cervical radiculopathy. The objective of the study was to compare the effectiveness of neural mobilization technique with conservative treatment on pain intensity, range of motion and disability.Methods: It was a double blinded randomized clinical trial; data was collected from Mayo Hospital, Lahore through convenience sampling technique. After taking consent from the patients, the patients fulfilling the inclusion and exclusion criteria were selected and randomized blindly and assigned through computer generated random number into two groups i.e. group 1 (neural mobilization), group 2 (conventional treatment). Pain intensity was measured on Numeric pain rating scale, range of motion measured with inclinometer and functional status with neck disability index (NDI). Data was analyzed using SPSS and difference in improvement before, after 02 and 04 weeks was noted and compared. Results: There was significant improvement in pain relief, neck disability and cervical ranges after the treatment in both groups compared to the pre-treatment status (p < 0.00) and when neural mobilization was compared , it was more effective technique than conventional treatment in reducing pain and neck disability (p < 0.00). But there was not statistical difference in mean score of cervical range of motion (p>0.05)Conclusions: The present study concluded that both neural mobilization and conservative treatment were effective as an exercise program for patient with cervical radiculopathy, however neural mobilization was more effective in reducing pain and neck disability in cervical radiculopathy.Trial registration: RCT20190325043109N1

scholarly journals Effect of neck range of motion exercises on neck disability and pain among patients undergoing thyroidectomy

2020 ◽  
Vol 8 (4) ◽  
pp. 1
Author(s):  
Om Elhana Kamel Abo Shehata ◽  
Omima Said M.H. Shehata ◽  
Seham Mohamed Abd elalem
Keyword(s):  
Neck Pain ◽  
Range Of Motion ◽  
Neck Disability Index ◽  
Pain Scale ◽  
Control Group ◽  
Surgical Performance ◽  
Surgical Department ◽  
Significant Difference ◽  
Neck Disability ◽  
And Control

Objective: Thyroidectomy is a surgery in which head and neck became extended during operation to facilitate surgical performance. Patients experience neck pain and limitation to the range of motion following surgery. The study’s aim was to assess the effect of neck range of motion exercises on neck disability and pain among patients undergoing thyroidectomy.Methods: A quasi-experimental research design was utilized, the research was carried out at the surgical department in Shebin Emergency Hospital, at Shebin El-Kom District, Menoufia Governorate, Egypt. Sample; 90 adult subjects undergoing thyroidectomy and are welcoming to participate in the current research. Four Instruments for data collection: Instrument (1): Interview questionnaire sheet consists of two parts to assess subjects’ socio-demographic and medical data. Instrument (2): Visual analog pain scale to rate the patients’ level of pain intensity. Instrument (3): Neck disability index to assess neck pain and its effect on patients’ ability to perform daily activities. Instrument (4): Compliance assessment sheet to follow the patient’s adherence with neck range of motion exercise.Results: There was no statistically significant difference found between study and control group socio-demographic characteristics and medical history while there was a statistically significant difference between study and control group concerning neck disability and pain after one week and four weeks post-operative thyroidectomy.Conclusions: Patient compliance with a range of motion exercises significantly improves neck movement in order to be able to carry out daily life activities and reducing pain for the study group in comparison with the control group.Recommendation: Nurses who work in the general surgery department should include a neck range of motion exercises in providing the care and follow up protocol for the patients undergoing thyroidectomy.

scholarly journals Electrical interferential current stimulation versus electrical acupuncture in management of hemiplegic shoulder pain and disability following ischemic stroke-a randomized clinical trial

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Fariba Eslamian ◽  
Mehdi Farhoudi ◽  
Fatemeh Jahanjoo ◽  
Elyar Sadeghi-Hokmabadi ◽  
Parvin Darabi
Keyword(s):  
Clinical Trial ◽  
Ischemic Stroke ◽  
Range Of Motion ◽  
Randomized Clinical Trial ◽  
Shoulder Pain ◽  
Pain Severity ◽  
Shoulder Range Of Motion ◽  
Significant Difference ◽  
Electrical Acupuncture ◽  
Interferential Current

Abstract Background Hemiplegic Shoulder Pain (HSP) is among common complications occurring after stroke leading to disability. This study was conducted to compare the effects of electrical Interferential Current stimulation (IFC) and Electrical Acupuncture (EAC) on pain intensity, range of motion, and functional ability in patients with HSP and also comparing the two modalities regarding improvement of above indices. Methods In this randomized clinical trial, 46 patients with HSP caused by ischemic stroke were recruited and assigned into 2 groups. Conventional exercise trainings were applied for both groups. Group A received additional IFC with medium frequency of 4000 HZ, and Group B received additional EAC two times a week for a total of 10 sessions. Pain severity, daily function, and shoulder Range of Motion (ROM) were evaluated using Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), and goniometry, respectively before and 5 weeks after the treatment. Results Both groups showed relative improvement in pain severity, SPADI score, and its subscales, and also active and passive shoulder ROM after the treatment. However, IFC group compared to EAC group had higher mean changes of active ROM in abduction (28.00 ± 3.81 vs. 12.25 ± 2.39) and functional subscale of SPADI (11.45 ± 1.88 vs. 5.80 ± 1.66) after the treatment. On the contrary, EAC group showed higher percentage of VAS changes (46.14 ± 6.88 vs. 34.28 ± 5.52), indicating better pain improvement compared to IFC group. Other parameters did not show significant difference between two groups. Conclusion Both IFC and EAC caused short term improvement in functional state, increased motion, and decreased pain in patients with HSP. Although pain control was more evident in acupuncture group, IFC resulted in better effects on function and active ROM of abduction, and seems to have higher efficacy. Trial registration This clinical trial was registered in the Iranian Registry of Clinical Trials at 2016-07-16 with a registry number of IRCT201602153217N10.

scholarly journals Neuromodulation of the Suprascapular Nerve

2014 ◽  
Vol 6;17 (6;12) ◽  
pp. E769-E773
Author(s):  
Foad Elahi
Keyword(s):  
Peripheral Nerve ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
Nerve Stimulation ◽  
Shoulder Joint ◽  
Adhesive Capsulitis ◽  
Suprascapular Nerve ◽  
Shoulder Range Of Motion ◽  
Shoulder Range ◽  
Chronic Shoulder Pain

The shoulder joint is an enarthrodial or ball-and-socket joint. A complex network of anatomic structures endows the human shoulder with tremendous mobility, greater than any other joint in the body. Many pathologies can been found in those patients with chronic shoulder pain. The painful limitation of shoulder motion affects hand and arm motion as well; therefore, it significantly influences work performance and everyday activities as well as the quality of life. Therefore, the treatment of patients with chronic shoulder pain has major social and health economic implications. In this article we present a patient with a complex history of shoulder pathology including 7 surgeries that left the patient with chronic debilitating shoulder pain. She was suffering from chronic pain and limited mobility of the shoulder joint due to adhesive shoulder capsulitis. She was treated with a multimodality approach with the goals of increasing shoulder range of motion and decreasing her pain. This did not provide significant improvement. The suprascapular nerve supplies motor and sensory innervation to the shoulder, and can be easily accessible in the supraspinatus fossa. A suprascapular nerve block dramatically decreased her pain. This clinical observation along with confirmatory nerve block play an important role during the decision-making process for a trial period of electrical neuromodulation. She was followed for 3 months after the permanent implantation of a suprascapular nerve stimulator. Her pain and shoulder range of motion in all planes improved dramatically. Peripheral nerve stimulation (PNS) of the suprascapular nerve, in addition to multimodality pain management, is one approach to the difficult task of treating adhesive capsulitis with accompanying pain and the inability to move the shoulder. We conducted a literature review on PubMed and found no case describing a similar patient to our knowledge. Key words: Suprascapular nerve, neuromodulation, peripheral nerve stimulation, adhesive capsulitis, chronic shoulder pain

scholarly journals A Cross-Sectional Study Examining Shoulder Pain and Disability in Division I Female Swimmers

2014 ◽  
Vol 23 (1) ◽  
pp. 65-75 ◽  
Author(s):  
Shana Harrington ◽  
Corinne Meisel ◽  
Angela Tate
Keyword(s):  
Range Of Motion ◽  
Shoulder Pain ◽  
Ncaa Division I ◽  
Muscle Length ◽  
Injury Rate ◽  
Division I ◽  
Competitive Swimming ◽  
Shoulder Range Of Motion ◽  
Pectoralis Minor ◽  
Pain Subscale

Context:The prevalence of shoulder pain in the competitive swimming population has been reported to be as high as 91%. Female collegiate swimmers have a reported shoulder-injury rate 3 times greater than their male counterparts. There has been little information on how to best prevent shoulder pain in this population. The purpose of this study was to examine if differences exist in shoulder range of motion, upper-extremity strength, core endurance, and pectoralis minor length in NCAA Division I female swimmers with and without shoulder pain and disability.Methods:NCAA Division I females (N = 37) currently swimming completed a brief survey that included the pain subscale of the Penn Shoulder Score (PSS) and the sports/performing arts module of the Disabilities of the Arm, Shoulder, and Hand (DASH) Outcome Measure. Passive range of motion for shoulder internal rotation (IR) and external rotation (ER) at 90° abduction was measured using a digital inclinometer. Strength was measured using a handheld dynamometer for scapular depression and adduction, scapular adduction, IR, and ER. Core endurance was assessed using the side-bridge and prone-bridge tests. Pectoralis minor muscle length was assessed in both a resting and a stretched position using the PALM palpation meter. All measures were taken on the dominant and nondominant arms.Results:Participants were classified as positive for pain and disability if the following 2 criteria were met: The DASH sports module score was >6/20 points and the PSS strenuous pain score was ≥4/10. If these criteria were not met, participants were classified as negative for pain and disability. Significant differences were found between the 2 groups on the dominant side for pectoralis muscle length at rest (P = .003) and stretch (P = .029).Conclusions:The results provide preliminary evidence regarding an association between a decrease in pectoralis minor length and shoulder pain and disability in Division I female swimmers.

scholarly journals Scapular Dyskinesis in Elite Boxers with Neck Disability and Shoulder Malfunction

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1347
Author(s):  
Jae Woo Jung ◽  
Young Kyun Kim
Keyword(s):  
Range Of Motion ◽  
Neck Disability Index ◽  
Isometric Strength ◽  
Scapular Dyskinesis ◽  
Shoulder Injuries ◽  
Pectoralis Minor ◽  
Neck Disability ◽  
The Relationship

Background and Objectives: Neck and shoulder injuries commonly occur during boxing, and scapular dyskinesis is related to those injuries. This study investigated scapular dyskinesis with neck disability and shoulder malfunction in elite boxers. Materials and Methods: Seventy-two elite boxers participated in this study. Scapular dyskinesis was evaluated as normal, subtle, and obvious. Neck disability index (NDI), shoulder internal (IR), and external (ER) range of motion (ROM), isometric strength of IR and ER, and pectoralis minor length were measured and compared with the severity of scapular dyskinesis. Results: Thirty-eight boxers (52.7%) showed scapular dyskinesis. NDI score was significantly different (normal = 3.89 ± 3.08, obvious = 7.36 ± 4.95, p = 0.025). Isometric IR strength was significantly different (normal = 10.48 ± 2.86, obvious = 8.46 ± 1.74, p = 0.01). The length of the pectoralis minor was significantly different (normal = 10.17 ± 0.67, subtle = 9.87 ± 0.79, obvious = 9.47 ± 0.85; p = 0.001), and the dominant and non-dominant arm IR ROM was significantly different (dominant = 57.43 ± 11.98, non-dominant = 64.62 ± 10.3, p = 0.001). Conclusions: The prevalence of scapular dyskinesis is high among elite boxers. Boxers with scapular dyskinesis presented shoulder malfunction as well as neck disability. Further investigation is necessary to examine the relationship between scapular dyskinesis and neck disability in boxers.

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