scholarly journals Sciatica: Treatment with a Blend of Maitland Mobilization, McKenzie Exercises along with NMES - A Case Study

2021 ◽  
Vol 8 (6) ◽  
pp. 59-66
Author(s):  
Mitisha Shah ◽  
Suraj Mathew
Keyword(s):  
Lower Extremity ◽  
Rating Scale ◽  
Exercise Program ◽  
Radicular Pain ◽  
Acute Stage ◽  
Home Exercise ◽  
Post Intervention ◽  
Conservative Care ◽  
Interferential Current ◽  
The Individual

Sciatica is referred to radiculopathy involving any of the lower extremity, caused by either inflammation or compression of the nerve roots L1-S1. It can be diagnosed majorly through an appropriate history taking and physical examinations to not be misdiagnosed with other chronic low back pain conditions. A conservative management is preferred when in an acute stage of 6-8 weeks after which a surgical approached is advised. Although various studies has shown evidences that a prolonged conservative care is most fitting than a short term surgical approach (discectomy). The prevalence of sciatic symptoms ranging from 1.6% to 43%, maximum noted in the working population, has drawn attention for the need of an effective and early conservative care to downsize the symptoms causing discomfort and pain. Thus, the aim of the case report was to present with an early and effective conservative care with a blend of Maitland Mobilization, McKenzie exercises along with Neuro-Muscular Electrical Stimulation (Interferential Current) to minimize the discomfort thus easing and bolstering the individual in activities of daily living followed by an uncomplicated returning back to recreational activities. The patient was managed with a blend of Maitland Mobilization, McKenzie exercises and Interferential current for 7 days consecutively along with an individually tailored Home exercise program according the patient tolerance. Outcomes measures namely numerical pain rating scale, lower extremity functional scale and Roland Morris Disability Questionnaire were evaluated before and after the 7 day intervention period to assess prognosis in pain and pain related disability. Thus the changes in pre and post intervention results stated positive outcomes in reducing pain and improving the functional activity and participation in social and recreational ventures. Keywords: Sciatica, Maitland Mobilization, Mckenzie exercise, Interferential Therapy, radicular pain.

Efficacy of Instrument Assisted Soft-Tissue Mobilization in patients with heel pain: An Experimental study.

2021 ◽  
Author(s):  
Shivani Bhurchandi ◽  
Rakesh K Sinha ◽  
Pratik Phansopkar
Keyword(s):  
Soft Tissue ◽  
Rating Scale ◽  
Exercise Program ◽  
Heel Pain ◽  
Home Exercise ◽  
Long Term Effects ◽  
Home Exercise Program ◽  
Group B ◽  
The Impact ◽  
Soft Tissue Mobilization

Abstract Background: ‘Heel pain’ is one of the commonest ailments of foot affecting 10% of population and having visible effects on lifestyle of these patients , affecting both younger and elder population. This study’s purpose is to determine the efficacy of Instrument Assisted Soft Tissue Mobilization in people affected with heel pain and the resultant effect on their lifestyle.Method: Seventy participants(n=70) with heel pain (lasting from 6 weeks to 1 year) will be selected and divided in 2 groups . Each group receiving 8 treatment sessions. Group A will receive IASTM + Home exercise program and Group B will receive Therapeutic Ultrasound + Home exercise program . Outcome measures will be recorded i.e. Pre-test and Post-test , by using Numerical Pain Rating Scale and Foot & Ankle Ability Measure scale.The study’s purpose is to assess the impact (i.e. immediate and long term effects) of IASTM on heel pain. The Central Trial Registry of India (CTRI) registration number for this trial is CTRI/2021/06/044018.

scholarly journals Efficacy of Instrument Assisted Soft-Tissue Mobilization in Patients with Heel Pain: An Experimental Study

2021 ◽  
pp. 292-301
Author(s):  
Shivani Bhurchandi ◽  
Pratik Phansopkar
Keyword(s):  
Rating Scale ◽  
Exercise Program ◽  
Heel Pain ◽  
Home Exercise ◽  
Pain Rating ◽  
Foot And Ankle ◽  
Home Exercise Program ◽  
Numerical Pain Rating Scale ◽  
Ability Measure ◽  
Pain Rating Scale

Aim: The purpose of this study was to evaluate and compare the effects of Instrument-Assisted Soft-Tissue Mobilisation (IASTM) and Therapeutic Ultrasound in patients with heel pain in terms of Numerical Pain Rating Scale and Foot and Ankle Ability Measure scale. This was undertaken as even though Ultrasound is regularly used, heel pain still remains resistant to treatment in some patients. Hence, the need to compare a relatively newer technique with it. Study Design : Experimental study Place and Duration: Department of Musculoskeletal Physiotherapy Sciences, Ravi Nair Physiotherapy College, Sawangi (Meghe) , Wardha , duration of 12 months. Methods: Seventy people (n=70) with heel discomfort (lasting 6 weeks to 1 year) were chosen at random and placed into two groups, each getting eight therapy sessions. IASTM and Home Exercise Program was given to Group A, whereas Therapeutic Ultrasound and Home Exercise Program was given to Group Calf muscle stretches and Plantar fascia stretches were incorporated in the Home Exercise Programme. Outcome measures were recorded both at the beginning of treatment and after final treatment. The patients were assessed for Numerical Pain Rating Scale with first step in morning and at the beginning of first session and after end of last session and for Foot and Ankle Ability Measure scale at the beginning of first session and after end of last session. A follow up period of 90 days (after last session) was taken, the measurements of Numerical Pain Rating Scale and Foot and Ankle Ability Measure scale were taken again to see the long-term effects. Results: Group A which received IASTM + Home exercises showed great improvements than Ultrasound and Home exercise group, from baseline to week 4 after the pain intensity and foot function were assessed using Numerical Pain Rating Scale and Foot and Ankle Ability Measure scale. Statistically significant differences were found in both the groups. i.e. P=0.0001. But 7 people in Ultrasound group complained of pain and functional ability at follow-up session. Conclusion: In this study, it can be concluded that combining both the IASTM and Home Exercise Program have got beneficial effects in decreasing the pain intensity thus improving the foot and ankle function in patients with heel pain.

scholarly journals Effect of Exercise on Motor and Nonmotor Symptoms of Parkinson’s Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Khashayar Dashtipour ◽  
Eric Johnson ◽  
Camellia Kani ◽  
Kayvan Kani ◽  
Ehsan Hadi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Statistical Significance ◽  
Exercise Program ◽  
Motor Symptoms ◽  
Post Intervention ◽  
Positive Effects ◽  
General Exercise ◽  
Non Motor Symptoms

Background. Novel rehabilitation strategies have demonstrated potential benefits for motor and non-motor symptoms of Parkinson’s disease (PD).Objective. To compare the effects of Lee Silverman Voice Therapy BIG (LSVT BIG therapy) versus a general exercise program (combined treadmill plus seated trunk and limb exercises) on motor and non-motor symptoms of PD.Methods. Eleven patients with early-mid stage PD participated in the prospective, double-blinded, randomized clinical trial. Both groups received 16 one-hour supervised training sessions over 4 weeks. Outcome measures included the Unified Parkinson’s Disease Rating Scale (UPDRS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Modified Fatigue Impact Scale (MFIS). Five patients performed general exercise and six patients performed LSVT BIG therapy. Post-intervention evaluations were conducted at weeks 4, 12 and 24.Results. The combined cohort made improvements at all follow-up evaluations with statistical significance for UPDRS total and motor, BDI, and MFIS (P<0.05).Conclusion. This study demonstrated positive effects of general exercise and LSVT BIG therapy on motor and non-motor symptoms of patients with PD. Our results suggest that general exercise may be as effective as LSVT BIG therapy on symptoms of PD for patients not able to readily access outpatient LSVT BIG therapy.

scholarly journals A Survey of Practice Patterns for Rehabilitation Post Elbow Fracture

2012 ◽  
Vol 6 (1) ◽  
pp. 429-439 ◽  
Author(s):  
Joy C MacDermid ◽  
Joshua I Vincent ◽  
Leah Kieffer ◽  
Ashley Kieffer ◽  
Jennifer Demaiter ◽  
...  
Keyword(s):  
Practice Patterns ◽  
Exercise Program ◽  
Acute Stage ◽  
Prognostic Indicators ◽  
Home Exercise ◽  
Future Research ◽  
Optimal Dosage ◽  
Elbow Fracture ◽  
Elbow Fractures ◽  
Patient Reported

Background and Purpose:Elbow fractures amount to 4.3% of all the fractures. The elbow is prone to stiffness after injury and fractures can often lead to significant functional impairment. Rehabilitation is commonly used to restore range of motion (ROM) and function. Practice patterns in elbow fracture rehabilitation have not been defined. The purpose of this study was to describe current elbow fracture rehabilitation practices; and compare those to the existing evidence base.Methods:Hand therapists (n=315) from the USA (92%) and Canada (8%) completed a web-based survey on their practice patterns and beliefs related to the acute (0-6 weeks) and functional (6-12 weeks) phases of elbow fracture rehabilitation.Results:More than 99% of respondents agreed that fracture severity, co-morbidities, time since fracture, compliance with an exercise program, psychological factors, and occupational demands are important prognostic indicators for optimal function. Strong agreement was found with the use of patient education (95%) and active ROM (86%) in the acute stage while, home exercise programs (99%), active ROM (99%), stretching (97%), strengthening (97%), functional activities (ADLs and routine tasks) (97%), passive ROM (95%), and active assisted ROM (95%) were generally used in the functional stage. The most commonly used impairment measures were goniometry (99%), Jamar dynamometry (97%), and hand held dynamometry (97%). Agreement on the use of patient-reported outcome measures was very minimal (1.3%- 35.6%).Conclusions:Exercise, education, and functional activity have high consensus as components of elbo fracture rehabilitation. Future research should focus on defining the optimal dosage and type of exercise/activity, and establish core measures to monitor outcomes of these interventions.

scholarly journals Behavior Change Text Messages for Home Exercise Adherence in Knee Osteoarthritis: Randomized Trial

10.2196/21749 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e21749 ◽  
Author(s):  
Kim Bennell ◽  
Rachel K Nelligan ◽  
Sarah Schwartz ◽  
Jessica Kasza ◽  
Alexander Kimp ◽  
...  
Keyword(s):  
Behavior Change ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Exercise Program ◽  
Exercise Adherence ◽  
Home Exercise ◽  
Knee Oa ◽  
The Past ◽  
Sms Intervention ◽  
Secondary Outcomes

Background Exercise is a core recommended treatment for knee osteoarthritis (OA), yet adherence declines, particularly following cessation of clinician supervision. Objective This study aims to evaluate whether a 24-week SMS intervention improves adherence to unsupervised home exercise in people with knee OA and obesity compared with no SMS. Methods A two-group superiority randomized controlled trial was performed in a community setting. Participants were people aged 50 years with knee OA and BMI ≥30 kg/m2 who had undertaken a 12-week physiotherapist-supervised exercise program as part of a preceding clinical trial. Both groups were asked to continue their home exercise program unsupervised three times per week for 24 weeks and were randomly allocated to a behavior change theory–informed, automated, semi-interactive SMS intervention addressing exercise barriers and facilitators or to control (no SMS). Primary outcomes were self-reported home exercise adherence at 24 weeks measured by the Exercise Adherence Rating Scale (EARS) Section B (0-24, higher number indicating greater adherence) and the number of days exercised in the past week (0-3). Secondary outcomes included self-rated adherence (numeric rating scale), knee pain, physical function, quality of life, global change, physical activity, self-efficacy, pain catastrophizing, and kinesiophobia. Results A total of 110 participants (56 SMS group and 54 no SMS) were enrolled and 99 (90.0%) completed both primary outcomes (48/56, 86% SMS group and 51/54, 94% no SMS). At 24 weeks, the SMS group reported higher EARS scores (mean 16.5, SD 6.5 vs mean 13.3, SD 7.0; mean difference 3.1, 95% CI 0.8-5.5; P=.01) and more days exercised in the past week (mean 1.8, SD 1.2 vs mean 1.3, SD 1.2; mean difference 0.6, 95% CI 0.2-1.0; P=.01) than the control group. There was no evidence of between-group differences in secondary outcomes. Conclusions An SMS program increased self-reported adherence to unsupervised home exercise in people with knee OA and obesity, although this did not translate into improved clinical outcomes. Trial Registration Australian New Zealand Clinical Trials Registry 12617001243303; https://tinyurl.com/y2ud7on5 International Registered Report Identifier (IRRID) RR2-10.1186/s12891-019-2801-z

scholarly journals Pulsed Radiofrequency Dorsal Root Ganglion-Fluoroscopy Guide for Lumbar Radicular Pain

2021 ◽  
Vol 2 (2) ◽  
pp. 82-88
Author(s):  
Nugroho Wicaksono ◽  
Keyword(s):  
Neuropathic Pain ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Rating Scale ◽  
Positive Outcome ◽  
Radicular Pain ◽  
Pulsed Radiofrequency ◽  
Post Intervention ◽  
Disc Protrusion ◽  
Lumbar Radicular Pain

Background: Lumbosacral radicular pain is the most common neuropathic pain. Pulsed Radio Frequency (PRF) is a method that believes to be safe and effective for reducing pain. Case: A 43-year-old woman experiences chronic right lumbar radiculopathy due to Herniated nucleus pulposus (HNP) L4-5. Anamnesis and physical examination show a sign of neuropathic pain. The MRI examination shows a paracentral disc protrusion L4-5 that compresses the transversing nerve L5. The conservative management did not produce a satisfying result indicated by the patient still experience pain with the Numeric Rating Scale (NRS) 4-5. Patient unable to do activity properly. We perform pain management using the dorsal root ganglion L5 pulsed radiofrequency-fluoroscopy (PRF) and producing a positive outcome. Patients experience a decrease in pain intensity with NRS 1. The examination on one and two months post-intervention show an improvement. Patient able to do the daily activity with NRS 1-2. Conclusion: Pulsed radiofrequency dorsal root ganglion-fluoroscopy guide that relatively safe, minimum complications, and minimal side effects, making it the preferred treatment for chronic lumbar radicular pain.

scholarly journals Behavior Change Text Messages for Home Exercise Adherence in Knee Osteoarthritis: Randomized Trial (Preprint)

2020 ◽  
Author(s):  
Kim Bennell ◽  
Rachel K Nelligan ◽  
Sarah Schwartz ◽  
Jessica Kasza ◽  
Alexander Kimp ◽  
...  
Keyword(s):  
Behavior Change ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Exercise Program ◽  
Exercise Adherence ◽  
Home Exercise ◽  
Knee Oa ◽  
The Past ◽  
Sms Intervention ◽  
Secondary Outcomes

BACKGROUND Exercise is a core recommended treatment for knee osteoarthritis (OA), yet adherence declines, particularly following cessation of clinician supervision. OBJECTIVE This study aims to evaluate whether a 24-week SMS intervention improves adherence to unsupervised home exercise in people with knee OA and obesity compared with no SMS. METHODS A two-group superiority randomized controlled trial was performed in a community setting. Participants were people aged 50 years with knee OA and BMI ≥30 kg/m<sup>2</sup> who had undertaken a 12-week physiotherapist-supervised exercise program as part of a preceding clinical trial. Both groups were asked to continue their home exercise program unsupervised three times per week for 24 weeks and were randomly allocated to a behavior change theory–informed, automated, semi-interactive SMS intervention addressing exercise barriers and facilitators or to control (no SMS). Primary outcomes were self-reported home exercise adherence at 24 weeks measured by the Exercise Adherence Rating Scale (EARS) Section B (0-24, higher number indicating greater adherence) and the number of days exercised in the past week (0-3). Secondary outcomes included self-rated adherence (numeric rating scale), knee pain, physical function, quality of life, global change, physical activity, self-efficacy, pain catastrophizing, and kinesiophobia. RESULTS A total of 110 participants (56 SMS group and 54 no SMS) were enrolled and 99 (90.0%) completed both primary outcomes (48/56, 86% SMS group and 51/54, 94% no SMS). At 24 weeks, the SMS group reported higher EARS scores (mean 16.5, SD 6.5 vs mean 13.3, SD 7.0; mean difference 3.1, 95% CI 0.8-5.5; <i>P</i>=.01) and more days exercised in the past week (mean 1.8, SD 1.2 vs mean 1.3, SD 1.2; mean difference 0.6, 95% CI 0.2-1.0; <i>P</i>=.01) than the control group. There was no evidence of between-group differences in secondary outcomes. CONCLUSIONS An SMS program increased self-reported adherence to unsupervised home exercise in people with knee OA and obesity, although this did not translate into improved clinical outcomes. CLINICALTRIAL Australian New Zealand Clinical Trials Registry 12617001243303; https://tinyurl.com/y2ud7on5 INTERNATIONAL REGISTERED REPORT RR2-10.1186/s12891-019-2801-z

Combining Values

2002 ◽  
Vol 7 (2) ◽  
pp. 1-4, 12 ◽  
Author(s):  
Christopher R. Brigham
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Evaluation Method ◽  
Proximal Phalanx ◽  
Common Error ◽  
The Third ◽  
Whole Person ◽  
Impairment Ratings ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract To account for the effects of multiple impairments, evaluating physicians must provide a summary value that combines multiple impairments so the whole person impairment is equal to or less than the sum of all the individual impairment values. A common error is to add values that should be combined and typically results in an inflated rating. The Combined Values Chart in the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, includes instructions that guide physicians about combining impairment ratings. For example, impairment values within a region generally are combined and converted to a whole person permanent impairment before combination with the results from other regions (exceptions include certain impairments of the spine and extremities). When they combine three or more values, physicians should select and combine the two lowest values; this value is combined with the third value to yield the total value. Upper extremity impairment ratings are combined based on the principle that a second and each succeeding impairment applies not to the whole unit (eg, whole finger) but only to the part that remains (eg, proximal phalanx). Physicians who combine lower extremity impairments usually use only one evaluation method, but, if more than one method is used, the physician should use the Combined Values Chart.

Impairment Tutorial: Functionally Limiting Upper Extremity Pain: Controversies in Impairment Rating

2003 ◽  
Vol 8 (5) ◽  
pp. 4-12
Author(s):  
Lorne Direnfeld ◽  
James Talmage ◽  
Christopher Brigham
Keyword(s):  
Upper Extremity ◽  
Radicular Pain ◽  
Illness Behavior ◽  
Orthopedic Surgeon ◽  
First Case ◽  
Clinical Presentations ◽  
Whole Person ◽  
Physical Examinations ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract This article was prompted by the submission of two challenging cases that exemplify the decision processes involved in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). In both cases, the physical examinations were normal with no evidence of illness behavior, but, based on their histories and clinical presentations, the patients reported credible symptoms attributable to specific significant injuries. The dilemma for evaluators was whether to adhere to the AMA Guides, as written, or to attempt to rate impairment in these rare cases. In the first case, the evaluating neurologist used alternative approaches to define impairment based on the presence of thoracic outlet syndrome and upper extremity pain, as if there were a nerve injury. An orthopedic surgeon who evaluated the case did not base impairment on pain and used the upper extremity chapters in the AMA Guides. The impairment ratings determined using either the nervous system or upper extremity chapters of the AMA Guides resulted in almost the same rating (9% vs 8% upper extremity impairment), and either value converted to 5% whole person permanent impairment. In the second case, the neurologist evaluated the individual for neuropathic pain (9% WPI), and the orthopedic surgeon rated the patient as Diagnosis-related estimates Cervical Category II for nonverifiable radicular pain (5% to 8% WPI).

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