Comparing the effectiveness of mulligan mobilization versus cyriax approach in the management of patients with subacute lateral epicondylitis

2020 ◽  
pp. 1-11
Author(s):  
Aqeel Ahmed ◽  
Muhammad Ibrar ◽  
Aatik Arsh ◽  
Sonia Wali ◽  
Shoukat Hayat ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Functional Disability ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Evaluation Index ◽  
Pain Subscale ◽  
Significant Difference ◽  
Group A ◽  
Physical Tests ◽  
Group B

Abstract Objective: To determine the effectiveness of Mulligan mobilisation versus Cyriax approach in the management of patients with subacute lateral epicondylitis. Methods: The clinical trial was conducted at the District Headquarter Hospital, Bahawalnagar, Pakistan, from September to December 2018, and comprised lateral epicondylitis patients having symptoms for >2 weeks. The diagnosis was confirmed on the basis of physical tests and musculoskeletal ultrasound. The subjects were randomly allocated to two equal groups A and B. Group A received deep transverse friction and Mill’s manipulation according to Cyriax approach, while group B received Mulligan mobilisation with movement techniques. Patient-related tennis elbow evaluation index was used to collect data which was analysed using SPSS 20. Results: Of the 60 patients, there were 30(50%) in each of the two groups. The overall mean age was 35.27±7.30 years, and 38(63.3%) participants were male.  After 4 weeks of treatment sessions, both groups showed significant improvements (p<0.05) in pain and functional disability scores. Group A showed significantly more improvement (p<0.05) in pain subscale scores compared to group B, while group B showed significant improvement (p<0.05) in functional disability subscale scores compared to group A. There was no significant difference (p>0.05) between the groups on total the patient-related tennis elbow evaluation index score. Conclusion: Both Mulligan mobilisation with movement and Cyriax approach decreased pain and improved functional status in lateral epicondylitis patients. Key Words: Elbow, Lateral epicondylitis, Massage, Mobilisation, Physiotherapy. Continuous..,

scholarly journals Effect of Post Isometric Relaxation with Deep Neck Flexor Exercise in Subacute Mechanical Neck Pain

2021 ◽  
Vol 11 (10) ◽  
pp. 46-59
Author(s):  
Priyanka Chauhan ◽  
Pooja Attrey ◽  
Anand Kumar Singh
Keyword(s):  
General Population ◽  
Neck Pain ◽  
Functional Disability ◽  
Rating Scale ◽  
Lateral Epicondylitis ◽  
Posterior Aspect ◽  
Significant Difference ◽  
Group A ◽  
Numeric Pain Rating Scale ◽  
Group B

Background: Mechanical neck pain (MNP) is the most common type of pain confined in the posterior aspect of neck, also known as nonspecific or simple neck pain affecting two thirds of the general population at some time in their lives. Prevalence: Neck pain is most common muscular skeletal condition affecting up to 70% of individual and 5% to 10% of adults having a disabling neck pain problem. Neck pain is more common in women than men. The prevalence of neck pain in the general population has been reported to be 15% for men and 23% for women. Objectives of the Study: To find out the effect of Post Isometric Relaxation (PIR) along with Deep Neck Flexor (DNF) exercises in reducing pain and disability and improving ROM in patient with sub-acute mechanical neck pain. To find out the effect of Deep Neck Flexor exercise alone in reducing pain and disability and improving ROM in patient with sub-acute mechanical neck pain. To compare whether Post Isometric Relaxation (PIR) along with Deep Neck Flexor exercises or Deep Neck Flexor exercises alone are effective in reducing pain and disability and improving ROM in patient with sub-acute mechanical neck pain Methods: Study included 30 patients with lateral epicondylitis between ages 30-50 years. The subjects were randomly divided into 2 groups: Group-A and Group-B. Group A (n = 15) was treated using Cyriax physiotherapy, group B (n = 15) was treated with movement with mobilization. Patients were treated for 3 times a week for 4 weeks. Outcome measures are NPRS (Numeric Pain Rating Scale) and DASH (The Disabilities of the Arm, Shoulder and Hand). Results: The results of the study indicate that there were highly statistically significant improvement in functional disability on NDI, cervical lateral flexion(Right & Left), rotation (Right & Left) ROM and reduction in pain on VAS in Group-A as compared to Group-B. There was no significant difference observed when the groups were compared for cervical flexion and extension ROM. Conclusion: From the result it is concluded that Post isometric relaxation with DNF exercise is effective in mechanical neck pain. Key words: Mechanical neck pain (MNP), Post Isometric Relaxation (PIR), Deep Neck Flexor (DNF) exercise.

scholarly journals Effectiveness of Autologous Blood and Steroid Injection in Tennis Elbow Based on Visual Analog Score Pain Score and Nirschl Stage

2020 ◽  
Vol 18 (1) ◽  
pp. 15-17
Author(s):  
Gopal Sagar DC
Keyword(s):  
Pain Score ◽  
Steroid Injection ◽  
Tennis Elbow ◽  
Corticosteroid Injection ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Significant Difference ◽  
Group A ◽  
Group B

Introduction: Lateral epicondylitis or Tennis elbow is one of the most common causes of lateral elbow pain. Local steroid injection is a time tested treatment for providing symptomatic relief. Local injection of autologous blood in a case of lateral epicondylitis provides pain relief due to its cellular and humoral factor and triggers a healing cascade. Aims: This study aims to compare the outcomes of the autologous blood injection and local corticosteroid injection in the treatment of tennis elbow. Methods: This is a Hospital based study on conducted in the Department of Orthopedics at Nepalgunj Medical College from July 2018 to June 2019. 42 patients with unilateral tennis elbow were divided into two groups-Group A-21 patients (Autologous Blood Injection) and Group B-21 patients (Steroid Injection). Group A received 2 ml of autologous venous blood and mixed with 1 ml of 2% lignocaine solution; Group B patients received 80 mg (in 2 ml) of methyl Prednisolone acetate and 1ml of 2% lignocaine solution. Visual Analogue Scale pain score and Nirschl stage of patients were evaluated before injection and at 2, 6, and 12 weeks of injection were noted and analyzed. Results: Preinjection mean VAS pain score was - 7.48±0.75, 7.52±0.68 in Group A, and Group B respectively while the Nirschl stage was 5.62±0.59 and 5.6±0.5 in group A and B, these scores among two group was not statistically significant. At 2 weeks follow up both groups showed improvement without any significant difference between two groups (p=0.84 and 0.549), while group A had better improvement in VAS pain score at 6 weeks (p=0.001). At 12 weeks follow-up within each group, there was significant VAS pain and Nirschl stage improvement (p=0.001) but there was no significant difference between the two groups. Conclusion: Injection of autologous blood and corticosteroid injection is equally effective in the treatment of Tennis elbow at 12 weeks final follow-up.

Effectiveness of Laser Therapy and Ultrasound Therapy along with Muscle Energy Technique in subjects with Trapezitis

2021 ◽  
pp. 116-120
Author(s):  
K. Kotteeswaran ◽  
Syed Gaffar ◽  
Krishna. R ◽  
Keerthana Priya. R.
Keyword(s):  
Laser Therapy ◽  
Functional Disability ◽  
Neck Disability Index ◽  
Ultrasound Therapy ◽  
Muscle Energy Technique ◽  
Significant Difference ◽  
Group A ◽  
Muscle Energy ◽  
Group B ◽  
Neck Disability

Aim: To find the effectiveness of laser therapy and ultrasound therapy along with muscle energy technique in treatment of Trapezitis. Materials and Methods: Non-equivalent quasi experimental study design was used in this study. Total of 30 subjects with trapezitis were selected using non probability convenient sampling technique.30 Subjects was divided into two groups by lot system. Group A received laser therapy and Group B received ultrasound therapy and for both the group muscle energy technique was given. The outcome measures are Neck Disability Index (NDI) for measuring Functional Disability. Data collected and tabulated was statistically analyzed. Result: Statistical analysis of post-test, Neck Disability Index (NDI) revealed that there is statistically significant difference seen between Group A and Group B. Conclusion: From the result, it has been concluded that Laser therapy with muscle energy technique (Group A) was more effective than Ultrasound therapy with muscle energy technique (Group B) on improving functional ability in subjects with Trapezitis.

Esthetic and Clinical Performance of Implant-Supported All-Ceramic Crowns Made with Prefabricated or CAD/CAM Zirconia Abutments: A Randomized, Multicenter Clinical Trial

2016 ◽  
Vol 96 (2) ◽  
pp. 163-170 ◽  
Author(s):  
J.G. Wittneben ◽  
J. Gavric ◽  
U.C. Belser ◽  
M.M. Bornstein ◽  
T. Joda ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Performance ◽  
Multicenter Clinical Trial ◽  
Anterior Maxilla ◽  
Single Crown ◽  
Significant Difference ◽  
All Ceramic ◽  
Cad Cam ◽  
Group A ◽  
Group B

Patients’ esthetic expectations are increasing, and the options of the prosthetic pathways are currently evolving. The objective of this randomized multicenter clinical trial was to assess and compare the esthetic outcome and clinical performance of anterior maxillary all-ceramic implant crowns (ICs) based either on prefabricated zirconia abutments veneered with pressed ceramics or on CAD/CAM zirconia abutments veneered with hand buildup technique. The null hypothesis was that there is no statistically significant difference between the 2 groups. Forty implants were inserted in sites 14 to 24 (FDI) in 40 patients in 2 centers, the Universities of Bern and Geneva, Switzerland. After final impression, 20 patients were randomized into group A, restored with a 1-piece screw-retained single crown made of a prefabricated zirconia abutment with pressed ceramic as the veneering material using the cut-back technique, or group B using an individualized CAD/CAM zirconia abutment (CARES abutment; Institut Straumann AG) with a hand buildup technique. At baseline, 6 mo, and 1 y clinical, esthetic and radiographic parameters were assessed. Group A exhibited 1 dropout patient and 1 failure, resulting in a survival rate of 94.7% after 1 y, in comparison to 100% for group B. No other complications occurred. Clinical parameters presented stable and healthy peri-implant soft tissues. Overall, no or only minimal crestal bone changes were observed with a mean DIB (distance from the implant shoulder to the first bone-to-implant contact) of −0.15 mm (group A) and 0.12 mm (group B) at 1 y. There were no significant differences at baseline, 6 mo, and 1 y for DIB values between the 2 groups. Pink esthetic score (PES) and white esthetic score (WES) values at all 3 examinations indicated stability over time for both groups and pleasing esthetic outcomes. Both implant-supported prosthetic pathways represent a valuable treatment option for the restoration of single ICs in the anterior maxilla ( ClinicalTrials.gov NCT02905838).

scholarly journals LAND BASED EXERCISES VERSUS POOL BASED EXERCISES FOR SWIMMER’S SHOULDER IN COMPETITIVE SWIMMERS: RANDOMIZED CLINICAL TRIAL

2021 ◽  
Vol 10 (4) ◽  
pp. 3296-3299
Author(s):  
Waqar M. Naqvi
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Shoulder Pain ◽  
Pain Disability Index ◽  
Pain Disability ◽  
Significant Difference ◽  
Shoulder Strength ◽  
Group A ◽  
Group B ◽  
Competitive Swimmers

To compare the effect of Land based exercises and Pool based exercises for shoulder strength to reduce shoulder pain in competitive swimmers using Shoulder Pain Disability Index (SPADI) score, Hand-Held dynamometer (HHD), Randomized Clinical trial.29 competitive swimmers with age group between 8 to 18 years were evaluated for shoulder pain using Shoulder Pain Disability Index Score [SPADI] and shoulder strength was evaluated using Hand Held Dynamometer [HHD] before and after the study. Then all the subjects were divided into 2 groups, for Group A Pool based exercises were given and for Group B Land based exercises were given. Statistically there is significant difference in values of outcome measures after the study in both groups but there is more significant difference in Group A than Group B. Pool based exercises showed more significant effect on shoulder pain than land based exercises in swimmer’s shoulder.

scholarly journals Effects of posterior capsule stretch on adhesive capsulitis.

2019 ◽  
Vol 26 (08) ◽  
pp. 1272-1277
Author(s):  
Madiha Maryam ◽  
Muhammad Kashif ◽  
Abdul Ghafoor Sajjad ◽  
Razia Rizwan ◽  
Sehrish Ali ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Manual Therapy ◽  
Functional Disability ◽  
Adhesive Capsulitis ◽  
Mean Value ◽  
Control Group ◽  
P Value ◽  
Significant Difference ◽  
Group A ◽  
Group B

To compare the effect of posterior capsular stretch on pain, ROM and functional disability in Adhesive Capsulitis. Study Design: Experimental, Randomized Control Trail. Setting: Department of Physiotherapy, Capital Development Authority Hospital Islamabad. Period: October 2015 to March 2016. Materials and Methods: Forty female patients having aged between 40 to 70 years with freezing and frozen stage of adhesive capsulitis were screened out. Adhesive capsulitis secondary to cervical Spondylosis, osteoporosis, direct trauma and any inflammation were excluded from the study. Subjects were randomly placed into two groups lottery method, the experimental group having 19 subjects received posterior capsular stretch along with conventional manual therapy and electrotherapy  whereas the control group had 21 subjects and they were given manual therapy and electrotherapy alone. The Numeric Pain Rating Scale, Shoulder Pain and Disability Index, and Range of Motion of shoulder joint were used as outcome measures. All the patients were assessed at baseline before intervention and at the completion of 6 weeks of treatment. Data was analyzed using SPSS version 20. Results: Abduction, Internal Rotation and disability show significant result. The abduction mean value of Group A was 115.00±22.023and of the Group B was 81.74±20.653 with p value was P<05. The internal rotation mean value of Group A was 70.71±12.776 and for the Group B was 60.32±8.699 and having p value P<05. The SPADI mean value of Group A was 51.76±22.043 and for the Group B was 24.24±7.287 having p value P<05. The NPRS and external rotation showed non-significant difference. Conclusion: It is concluded that posterior capsular stretch along with mobilization is more effective in treating ROM and functional disability.

scholarly journals Effectiveness of Pilates exercises on non-specific low back pain to determine pain and disability

Biomedicine ◽  
2021 ◽  
Vol 41 (4) ◽  
pp. 825-829
Author(s):  
P Manikandan ◽  
G Mohan Kumar ◽  
V Rajalaxmi ◽  
C Priya ◽  
G Yuvarani ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Functional Disability ◽  
Conventional Group ◽  
Patient Specific ◽  
Low Back ◽  
Mean Values ◽  
Significant Difference ◽  
Group A ◽  
Group B

Introduction and Aim: Low back discomfort is one of the commonest musculoskeletal problems. The Pilates exercises are an approach to stretching and strengthening techniques and specifically train all the core muscles. The intend of the current study was to verify the influences of the Pilates exercises among pain and disability among patients with Non-specific Low Back Pain (NSLBP).     Materials and Methods: A 100 non-specific low back pain subjects were randomly selected for this experimental study. The study includes of non-specific LBP age group between 25 to 40 years, both male and female patients with pain and disability and this study excludes spinal fractures and Pregnant Women. The estimations were taken utilizing Visual Analogue scale (VAS), Patient Specific Functional Scale (PSFS) and Modified Oswestry Low Back Pain Disability Questionnaire (MODQ). Subjects are allotted in two groups, Group A (Pilates group) receives Pilate’s exercise and Group B (conventional group) receives conventional exercise. Exercises were given for 3 times a week for 12 weeks and a regular follow up was done for every 4 weeks.   Results: Group A (Pilates group) were found to be more effective than Group B (conventional group). It shows a highly significant difference in mean values at P ? 0.001. This implies that Pilates exercise is more beneficial in decreasing pain and functional disability.   Conclusion: On comparing the mean values, Group A (Pilates group) showed significant improvement at the end of the study when compared with Group B (conventional group).

scholarly journals Efficacy of Locally Administered 1.2% Rosuvastatin Gel in Patients with Periodontitis: A Randomized Placebo Controlled Clinical Trial

2019 ◽  
Vol 13 (01) ◽  
pp. 029-035 ◽  
Author(s):  
Debopriya Chatterjee ◽  
Anjali Kapoor ◽  
Sharmistha Vijay ◽  
Geetika Sobti ◽  
Dheeraj Kara ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Phase 1 ◽  
Colony Count ◽  
Controlled Clinical Trial ◽  
Clinical Parameters ◽  
Pharmacological Agents ◽  
Intergroup Comparison ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Objective Periodontitis initiation and progression are a result of host immune inflammatory response to oral pathogens. Several pharmacological agents are being delivered locally, to improve periodontal health. Hence, the present randomized placebo controlled clinical trial is designed to check the clinical and antimicrobial efficacy of locally delivered 1.2% rosuvastatin (RSV) in intrabony defects (IBD) in periodontitis patients. Materials and Methods One-hundred patients were randomly allotted into two treatment groups: group A received 1. 2% RSV gel, scaling and root debridement and group B received placebo gel, scaling and root debridement. Clinical parameters, including modified sulcus bleeding index (mSBI), probing depth (PD), clinical attachment level (CAL), and plaque index (PI), were recorded at baseline before phase 1 and after 6 months. Radiographic assessment of IBD was done by cone beam computed tomography at baseline and after 6 months. Anaerobic colony count was done at baseline and after 180 days. Results On intragroup comparison, there is a significant improvement in periodontal parameters in both the groups. On intergroup comparison, there is significant gain in CAL in group A than group B (p = 0.04). There is significant decrease in PD in group A, compared to group B. There is significant bone fill in group A (p = 0.034), compared to group B. With respect to mSBI, PI, and anaerobic colony count, there is no significant difference between the two groups after 6 months. No adverse effect was noticed in any subjects. Conclusion The author concludes that 1.2% RSV gel when delivered locally into IBD improved periodontal clinical parameters such as PD and CAL and showed significant bone fill.

Clinical trial to assess role of ketamine in post operative analgesia after laparoscopic cholecystectomy

2021 ◽  
Vol 23 (05) ◽  
pp. 421-432
Author(s):  
Dr. Mohammad Kheiri Mahmod ◽  
◽  
Dr. Bashar Naser Hussein ◽  
Dr. Ammar Hamid Hanoosh ◽  
◽  
...  
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Analgesic Requirement ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.

Image-guided versus palpation-guided injections for the treatment of chronic lateral epicondylopathy: a randomized controlled clinical trial

2018 ◽  
Vol 50 (05) ◽  
pp. 348-352 ◽  
Author(s):  
Michael-Alexander Malahias ◽  
Maria-Kyriaki Kaseta ◽  
Sotirios-Tsambikos Kazas ◽  
Panayiotis D Megaloikonomos ◽  
Andreas F Mavrogenis ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Statistical Difference ◽  
Lateral Epicondylitis ◽  
T Test ◽  
Controlled Clinical Trial ◽  
Ultrasound Guided ◽  
Chi Square ◽  
Before And After ◽  
Group A ◽  
Group B

Abstract Background There have been several studies published comparing the ultrasound-guided with the “blind” infiltrations in the shoulder’s area. On the contrary, there is only very limited data regarding the necessity of ultrasound guidance in lateral epicondylitis. Materials and Methods A prospective, randomized, blinded at initial and follow-up evaluation, comparative clinical trial was conducted, involving 44 patients with a history of chronic persistent epicondylopathy. The patients were randomly divided into 2 groups of 22 people each. Group A patients underwent three ultrasound-guided betamethazone injections, while group B included those who underwent three “blind” injections, centered at the palpable point of maximum pain. The evaluation was done before and after (4 and 12 weeks) the injections using the Visual Analogue Scale for pain (VAS, 0–10) and the Roles & Maudsley score. Results There was not any significant statistical difference between the two groups as for mean VAS at 4 weeks (p = 0.150, t-test) and mean VAS at 12 weeks (p = 0.286, t-test). Furthermore, the final success rate, as measured by the Roles & Maudsley score, was slightly superior in group B (67 % of the patients with excellent or good results) when compared with group A (46 % of the patients), but without any statistical difference (p = 0.161, chi-square). Conclusion Our trial proved that an ultrasound-guided injection is not superior than a palpation-guided injection of corticosteroids in the treatment of lateral epicondylopathy.

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