scholarly journals Effectiveness of Standardized Physical Therapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome: Randomized Controlled Trial

2016 ◽  
Vol 96 (6) ◽  
pp. 787-796 ◽  
Author(s):  
David Høyrup Christiansen ◽  
Poul Frost ◽  
Deborah Falla ◽  
Jens Peder Haahr ◽  
Lars Henrik Frich ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Outcome Measures ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Exercise Group ◽  
Subacromial Impingement Syndrome ◽  
Decompression Surgery ◽  
Subacromial Decompression ◽  
Randomized Controlled

Background Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function. Objective The purpose of this study was to evaluate the effectiveness at 3 and 12 months of a standardized physical therapy exercise intervention compared with usual care in patients with difficulty returning to usual activities after subacromial decompression surgery. Design A multicenter randomized controlled trial was conducted. Setting The study was conducted in 6 public departments of orthopedic surgery, 2 departments of occupational medicine, and 2 physical therapy training centers in Central Denmark Region. Patients One hundred twenty-six patients reporting difficulty returning to usual activities at the postoperative clinical follow-up 8 to 12 weeks after subacromial decompression surgery participated. Intervention A standardized exercise program consisting of physical therapist–supervised individual training sessions and home training was used. Outcome Measures The primary outcome measure was the Oxford Shoulder Score. Secondary outcome measures were the Constant Score and the Fear-Avoidance Beliefs Questionnaire. Results At 3 and 12 months, follow-up data were obtained for 92% and 83% of the patients, respectively. Intention-to-treat analyses suggested a between-group difference on the Oxford Shoulder Score favoring the exercise group at 3 months, with an adjusted mean difference of 2.0 (95% confidence interval=−0.5, 4.6), and at 12 months, with an adjusted mean difference of 5.8 (95% confidence interval=2.8, 8.9). Significantly larger improvements for the exercise group were observed for most secondary and supplementary outcome measures. Limitations The nature of the exercise intervention did not allow blinding of patients and care providers. Conclusion The standardized physical therapy exercise intervention resulted in statistically significant and clinically relevant improvement in shoulder pain and function at 12 months compared with usual care.

Effects of Calisthenics and Pilates Exercises on Coordination and Proprioception in Adult Women: A Randomized Controlled Trial

2012 ◽  
Vol 21 (3) ◽  
pp. 235-243 ◽  
Author(s):  
Derya Ozer Kaya ◽  
Irem Duzgun ◽  
Gul Baltaci ◽  
Selma Karacan ◽  
Filiz Colakoglu
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Exercise Group ◽  
Lower Limbs ◽  
Control Group ◽  
Adult Women ◽  
Kinetic Chain ◽  
Randomized Controlled ◽  
Closed Kinetic Chain

Objective:To assess and compare the effects of 6 mo of Pilates and calisthenics on multijoint coordination and proprioception of the lower limbs at the 3rd and 6th mo of training.Design:Randomized, controlled, assessor-blinded, repeated-measures.Setting:University research laboratory.Participants and Intervention:Healthy, sedentary, female participants age 25–50 y were recruited and randomly divided into 3 groups: a calisthenic exercise group (n = 34, mean age ± SD 40 ± 8 y, body-mass index [BMI] 31.04 ± 4.83 kg/m2), a Pilates exercise group (n = 32, mean age ± SD 37 ± 8 y, BMI 31.04 ± 4.83 kg/m2), and a control group (n = 41, mean age ± SD 41 ± 7 y, BMI 27.09 ± 4.77 kg/m2). The calisthenics and Pilates groups underwent related training programs for 6 mo, while the controls had no specific training.Main Outcome Measures:Coordination and proprioception of the lower extremities with concentric and eccentric performances in the closed kinetic chain assessed with the monitored rehab functional squat system at baseline and at the 3rd and 6th mo of training.Results:For the within-group comparison, coordinative concentric and eccentric deviation values were significantly decreased for both dominant and nondominant lower limbs at pretraining and at the 3rd and 6th mo posttraining in the calisthenics group (P < .05). In contrast, there was no improvement in the Pilates group throughout the training. However, for comparisons between groups, the baseline values of coordinative concentric and eccentric deviations were different in the calisthenics group than in Pilates and the controls (P < .05). There were no differences in the proprioception values of either visible or nonvisible movement in any group throughout the training (P > .05).Conclusions:It seems that calisthenic exercises are more likely to improve coordination of the lower extremity after 3 and 6 mo of training than Pilates exercises. Calisthenic exercises may be useful for individuals who require improved coordination.

scholarly journals The Effects of Therapeutic Exercise With and Without Mobilization in Participants With Chronic Ankle Instability: A Randomized Controlled Trial

2020 ◽  
pp. 1-8
Author(s):  
Cameron Bolton ◽  
Sheri Hale ◽  
Todd Telemeco
Keyword(s):  
Randomized Controlled Trial ◽  
Outcome Measures ◽  
Ankle Instability ◽  
Controlled Trial ◽  
Chronic Ankle Instability ◽  
Therapeutic Exercise ◽  
Convenience Sample ◽  
Randomized Controlled ◽  
Hop Test

Context: Manual therapy (MT) is reported to increase range of motion (ROM), improve balance, and decrease pain in individuals with chronic ankle instability (CAI). Additional literature is needed to examine the effectiveness of the addition of MT to a therapeutic exercise regimen in individuals with CAI. Objective: To examine the combined effects of thrust joint manipulation (TJM) and exercise on function in participants reporting CAI. Design: Randomized controlled trial. Setting: Research laboratory. Participants: A convenience sample of 30 participants (mean age 23.7 [3.65] y; mean height 169.50 [9.50] cm; mean mass 66.48 [10.64] kg). Intervention: Participants were randomly allocated to the exercise (n = 15) or exercise + TJM group (n = 20) and completed an exercise program. The exercise + TJM group also received MT at the talocrural, proximal, and distal tibiofibular joints in the first 3 sessions. Main Outcome Measures: Self-reported outcomes were recorded at baseline and follow-up using the Foot and Ankle Ability Measure (FAAM), the FAAM-Sport (FAAM-S) subscale, and the Ankle Joint Functional Assessment Tool (AJFAT). The side-hop test, figure-of-8 hop test, 3 directions of the Star Excursion Balance Test, and dorsiflexion ROM were also assessed at baseline and follow-up. Results: Only the exercise + TJM group demonstrated an improvement in weight-bearing dorsiflexion with the knee flexed following treatment (P = .02). For all outcome measures, except ROM, subjects improved significantly at follow-up regardless of group assignment (P ≤ .01). Conclusions: Our data suggest that rehabilitation of patients with CAI is related to improved ROM, function, and self-reported outcomes. This provides evidence that the addition of MT to exercise may enhance improvements in ROM as compared with exercise alone. Additional research is needed to identify optimal parameters to maximize therapeutic benefit.

scholarly journals The Effect of a Multicomponent Dual-Task Exercise on Cortical Thickness in Older Adults with Cognitive Decline: A Randomized Controlled Trial

2020 ◽  
Vol 9 (5) ◽  
pp. 1312
Author(s):  
Seongryu Bae ◽  
Kenji Harada ◽  
Sangyoon Lee ◽  
Kazuhiro Harada ◽  
Keitaro Makino ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Cognitive Decline ◽  
Cognitive Training ◽  
Cortical Thickness ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Exercise Group ◽  
Control Group ◽  
Randomized Controlled

The aim of this study was to examine cortical thickness changes associated with a multicomponent exercise intervention combining physical exercise and cognitive training in older adults with cognitive decline. This study involved a secondary analysis of neuroimaging data from a randomized controlled trial with 280 older adults having cognitive decline who were randomly assigned to either a multicomponent exercise group (n = 140) that attended weekly 90-minute exercise and cognitive training sessions or a health education control group (n = 140). The cortical thickness and cognitive performance were assessed at the baseline and at trial completion (10 months). The cortical thickness in the frontal and temporal regions was determined using FreeSurfer software. Cognitive performance was evaluated using the Gerontology-Functional Assessment Tool (NCGG-FAT). The cortical thickness significantly increased in the middle temporal (p < 0.001) and temporal pole (p < 0.001) in the multicomponent exercise group compared with the control group. Cortical thickness changes were significantly associated with change in trail making test (TMT)-A, TMT-B, and story memory after a 10-month multicomponent exercise intervention. This study suggests that multicomponent exercise programs combining physical exercise and cognitive training have important implications for brain health, especially in providing protection from age-related cortical thinning.

scholarly journals Aerobic and Resistance Exercise Improves Shoulder Function in Women Who Are Overweight or Obese and Have Breast Cancer: A Randomized Controlled Trial

2019 ◽  
Vol 99 (10) ◽  
pp. 1334-1345 ◽  
Author(s):  
Frank C Sweeney ◽  
Wendy Demark-Wahnefried ◽  
Kerry S Courneya ◽  
Nathalie Sami ◽  
Kyuwan Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Exercise Intervention ◽  
External Rotation ◽  
Controlled Trial ◽  
Shoulder Function ◽  
Exercise Group ◽  
Randomized Controlled ◽  
Active Range Of Motion ◽  
The Mean

Abtract Background Adverse upper limb musculoskeletal effects occur after surgical procedures and radiotherapy for breast cancer and can interfere with activities of daily living. Objective The objective of this study was to examine the effects of a 16-week exercise intervention on shoulder function in women who are overweight or obese and have breast cancer. Design This study was a randomized controlled trial. Setting The study was performed at the Division of Biokinesiology and Physical Therapy at the University of Southern California. Participants One hundred women with breast cancer were randomly allocated to exercise or usual-care groups. The mean (SD) age of the women was 53.5 (10.4) years, 55% were Hispanic white, and their mean (SD) body mass index was 33.5 (5.5) kg/m2. Intervention The 16-week exercise intervention consisted of supervised, progressive, moderate to vigorous aerobic and resistance exercise 3 times per week. Measurements Shoulder active range of motion, isometric muscular strength, and patient-reported outcome measures (including Disabilities of the Arm, Shoulder, and Hand and the Penn Shoulder Scale) were assessed at baseline, after the intervention, and at the 3-month follow-up (exercise group only). Differences in mean changes for outcomes were evaluated using mixed-model repeated-measures analysis. Results Compared with the usual-care group, the exercise group experienced significant increases in shoulder active range of motion (the mean between-group differences and 95% confidence intervals (CIs) were as follows: shoulder flexion = 36.6° [95% CI = 55.2–20.7°], external rotation at 0° = 23.4° [95% CI = 31.1–12.5°], and external rotation at 90° = 34.3° [95% CI = 45.9–26.2°]), improved upper extremity isometric strength, and improved Disabilities of the Arm, Shoulder, and Hand and Penn Shoulder Scale scores. Limitations Limitations include a lack of masking of assessors after the intervention, an attention control group, and statistical robustness (shoulder function was a secondary end point). Conclusions A 16-week exercise intervention effectively improved shoulder function following breast cancer treatment in women who were overweight or obese, who were ethnically diverse, and who had breast cancer.

The effect of Tai Chi training on the dual-tasking performance of stroke survivors: a randomized controlled trial

2018 ◽  
Vol 32 (8) ◽  
pp. 1076-1085 ◽  
Author(s):  
Wing Nga Chan ◽  
William Wai-Nam Tsang
Keyword(s):  
Randomized Controlled Trial ◽  
Tai Chi ◽  
Controlled Trial ◽  
Exercise Group ◽  
Stroke Survivors ◽  
Dual Tasking ◽  
Walking Test ◽  
Randomized Controlled ◽  
Post Assessment

Objective: To compare the effect of Tai Chi training with conventional exercise on dual-tasking performance among stroke survivors. Design: An assessor-blinded, randomized controlled trial. Subjects: Community-dwelling stroke survivors. Setting: Community centers and university. Interventions: Subjects in the Tai Chi group and the conventional exercise group were trained with the corresponding exercises for 12 weeks (1 hour/session, 2/week). No training was given to the controls. Main measures: An auditory Stroop test, a turning-while-walking test, and a dual-tasking condition that combined the two tests were conducted at baseline, after the intervention, and one month later. Results: Forty-seven subjects were randomized into Tai Chi group ( n = 15), conventional exercise group ( n = 17), or control group ( n = 15). There was no significant difference in the outcome measures among the three groups after the intervention and at the one month follow-up assessment. Within-group comparisons showed improvements in dual-tasking performance after Tai Chi training and further improvement during the follow-up period (composite score on the auditory Stroop test: pre-assessment: 73.1 ± 27.6, post-assessment: 89.9 ± 23.4, follow-up assessment: 91.7 ± 26.9; completion time of the turning-while-walking test: pre-assessment: 17.7 ± 6.9 seconds, post-assessment: 15.6 ± 5.2 seconds, follow-up assessment: 14.9 ± 4.9 seconds). Conclusion: Tai Chi training does not have superior effect on dual-tasking performance compared with conventional exercise among stroke survivors. Further studies with larger sample size, longer training, and follow-up periods are needed.

Cost analysis of telerehabilitation after arthroscopic subacromial decompression

2017 ◽  
Vol 24 (8) ◽  
pp. 553-559 ◽  
Author(s):  
Jose Manuel Pastora-Bernal ◽  
Rocío Martín-Valero ◽  
Francisco Javier Barón-López
Keyword(s):  
Cost Analysis ◽  
Controlled Trial ◽  
Health Sector ◽  
Healthcare Services ◽  
Subacromial Impingement Syndrome ◽  
Decompression Surgery ◽  
Subacromial Decompression ◽  
Real Cost ◽  
Cost Differential ◽  
Study Protocols

Background Subacromial impingement syndrome poses a substantial socioeconomic burden, leading to significant consumption of healthcare. Health systems are calling for greater evidence of economic impacts of particular healthcare services. Telerehabilitation programmes have the potential to reduce costs and improve patient access as an alternative to traditional care. Cost analysis has been traditionally included in study protocols and results, although the reliability and research methodology have frequently been under debate. The aim of this study was to compare costs related to a telerehabilitation programme versus conventional physiotherapy following subacromial decompression surgery (ASD). Methods The study was embedded in a randomised controlled trial. The economic analysis was based on the perspective of the health sector and the human capital method. Only the costs associated with the provision of physiotherapy services were taken into account. Costs were measured during the intervention period between baseline and 12 weeks for both groups. Student’s t-test was used to compare independent variables between the two groups, with a 95% confidence interval for the estimates and real costs. Results The estimated total cost analysis shows a preliminary cost differential in favour of the telerehabilitation group, meaning that for each participant’s total intervention, telerehabilitation saves 29.8% of the costs. Real cost analysis, only for received treatments, shows a cost differential in favour of telerehabilitation, meaning that for each participant’s total intervention, telerehabilitation saves 22.15% of the costs incurred for conventional rehabilitation. Conclusions Our study provides direct and meaningful information about telerehabilitation opportunities and can be an essential component in further cost evaluations for different strategies after surgical procedures. This study demonstrates that there was a trend towards lower healthcare costs after ASD. Managers now have the responsibility to decide whether to implement telerehabilitation based on clinical and economic data.

scholarly journals Motor Control Exercises, Sling Exercises, and General Exercises for Patients With Chronic Low Back Pain: A Randomized Controlled Trial With 1-Year Follow-up

2010 ◽  
Vol 90 (10) ◽  
pp. 1426-1440 ◽  
Author(s):  
Monica Unsgaard-Tøndel ◽  
Anne Margrethe Fladmark ◽  
Øyvind Salvesen ◽  
Ottar Vasseljen
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
Controlled Trial ◽  
Low Back ◽  
Randomized Controlled

BackgroundExercise benefits patients with chronic nonspecific low back pain; however, the most effective type of exercise remains unknown.ObjectiveThis study compared outcomes after motor control exercises, sling exercises, and general exercises for low back pain.DesignThis was a randomized controlled trial with a 1-year follow-up.SettingThe study was conducted in a primary care setting in Norway.PatientsThe participants were patients with chronic nonspecific low back pain (n=109).InterventionsThe interventions in this study were low-load motor control exercises, high-load sling exercises, or general exercises, all delivered by experienced physical therapists, once a week for 8 weeks.MeasurementsThe primary outcome measure was pain reported on the Numeric Pain Rating Scale after treatment and at a 1-year follow-up. Secondary outcome measures were self-reported activity limitation (assessed with the Oswestry Disability Index), clinically examined function (assessed with the Fingertip-to-Floor Test), and fear-avoidance beliefs after intervention.ResultsThe postintervention assessment showed no significant differences among groups with respect to pain (overall group difference) or any of the outcome measures. Mean (95% confidence interval) group differences for pain reduction after treatment and after 1 year were 0.3 (−0.7 to 1.3) and 0.4 (−0.7 to 1.4) for motor control exercises versus sling exercises, 0.7 (−0.6 to 2.0) and 0.3 (−0.8 to 1.4) for sling exercises versus general exercises, and 1.0 (−0.1 to 2.0) and 0.7 (−0.3 to 1.7) for motor control exercises versus general exercises.LimitationsThe nature of the interventions made blinding impossible.ConclusionsThis study gave no evidence that 8 treatments with individually instructed motor control exercises or sling exercises were superior to general exercises for chronic low back pain.

scholarly journals Detraining Effects on Musculoskeletal Parameters in Early Postmenopausal Osteopenic Women: 3-Month Follow-Up of the Randomized Controlled ACTLIFE Study

2021 ◽  
Author(s):  
Wolfgang Kemmler ◽  
Michael Hettchen ◽  
Matthias Kohl ◽  
Marie Murphy ◽  
Laura Bragonzoni ◽  
...  
Keyword(s):  
Exercise Intervention ◽  
Exercise Program ◽  
Exercise Group ◽  
Frequent Pattern ◽  
Control Group ◽  
Group Exercise ◽  
Mineral Density ◽  
Leg Extension ◽  
Randomized Controlled

AbstractPeriods of absence from supervised group exercise while maintaining physical activity might be a frequent pattern in adults' exercise habits. The aim of the present study was to determine detraining effects on musculoskeletal outcomes after a 3-month detraining period in early post-menopausal, osteopenic women. Due to the COVID-19 pandemic, we terminated the 18-month randomized controlled ACTLIFE exercise intervention immediately after the 13-month follow-up assessment. This put an abrupt stop to the high-intensity aerobic and resistance group exercise sessions undertaken three times per week by the exercise group (EG: n = 27) and the gentle exercise program performed once per week for the attention control group (CG: n = 27); but both groups were permitted to conduct individual outdoor activity for the 3-month lock-down period. Study endpoints were lean body mass (LBM), bone mineral density (BMD) at the lumbar spine (LS), maximum hip-/leg extension strength and power. Detraining-induced reductions of LBM, hip/leg strength and power (but not BMD-LS) were significantly greater (p < 0.001 to p = 0.044) compared with the CG. Significant exercise effects, i.e. differences between EG and CG, present after 13 months of exercise, were lost after 3 months of detraining for LBM (p = 0.157) and BMD-LS (p = 0.065), but not for strength (p < 0.001) and power (p < 0.001). Of note, self-reported individual outdoor activities and exercise increased by about 40% in both groups during the lock-down period. Three months' absence from a supervised group exercise protocol resulted in considerable detraining effects for musculoskeletal parameters. Thus, exercise programs for adults should be continuous rather than intermittent.Trial registration number: ClinicalTrials.gov: NCT04420806, 06.05.2020.

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