Effect of cold and heat therapies on pain relief in patients with delayed onset muscle soreness: A network meta-analysis

Objective: To comprehensively compare the effectiveness of cold and heat therapies for delayed onset muscle soreness using network meta-analysis. Methods: Eight Chinese and English databases were searched from date of establishment of the database to 31 May 2021. Cochrane risk-of-bias tool was used to analyse the included randomized controlled trials. Potential papers were screened for eligibility, and data were extracted by 2 independent researchers. Results: A total of 59 studies involving 1,367 patients were eligible for this study. Ten interventions were examined: contrast water therapy, phase change material, the novel modality of cryotherapy, cold-water immersion, hot/warm-water immersion, cold pack, hot pack, ice massage, ultrasound, and passive recovery. Network meta-analysis results showed that: (i) within 24 h after exercise, hot pack was the most effective for pain relief, followed by contrast water therapy; (ii) within 48 h, the ranking was hot pack, followed by the novel modality of cryotherapy; and (iii) over 48 h post-exercise, the effect of the novel modality of cryotherapy ranked first. Conclusion: Due to the limited quality of the included studies, further well-designed research is needed to draw firm conclusions about the effectiveness of cold and heat therapies for delayed onset muscle soreness. Lay Abstract The effects of different methods of cold and heat therapy on pain in patients with delayed onset muscle soreness are debated, and there is uncertainty regarding the most effective of these therapies. The aim of this study was to evaluate the effects of different cold and heat treatments on pain in patients with delayed onset muscle soreness. Using network meta-analysis and ranking, it was found that, within 48 h post-exercise, use of hot-pack was superior to other interventions, whereas, over 48 h post-exercise, cryotherapy was the optimal intervention for pain relief in patients with delayed onset muscle soreness.

Effects of hot pack application before high-intensity stretching on the quadriceps muscle

Background/aims High-intensity static stretching is assumed to increase the range of motion and/or decrease muscle stiffness; however, the effects of high-intensity static stretching on the quadriceps muscle have been debated. Hot pack application before high-intensity static stretching was assumed to decrease stretching pain, which is the main problem in high-intensity static stretching, and decrease quadriceps muscle stiffness. This study aimed to examine hot pack application before high-intensity static stretching on stretching pain, knee flexion range of motion, and quadriceps muscle stiffness. Methods In total, 21 healthy sedentary male participants randomly performed two interventions: high-intensity static stretching and hot pack application before stretching. Static stretching was performed at three 60-second stretching interventions with a 30-second interval. Then, a 20-minute hot pack was applied before high-intensity static stretching. The knee flexion range of motion and shear elastic modulus of the quadriceps muscle were measured by ultrasonic shear-wave elastography before and after the static stretching intervention. Results Stretching pain after hot pack application before stretching was lower than high-intensity static stretching alone. Significant increases were also found in knee flexion range of motion after both stretching interventions, but no significant difference was noted in the increase in the knee flexion range of motion with or without hot pack application. No significant change was found in quadriceps muscle stiffness in either intervention. Conclusions The results suggest that hot pack application before high-intensity static stretching could decrease stretching pain, but no significant difference in knee flexion range of motion increase was found.

Modified-Active Release Therapy in Patients with Scapulocostal Syndrome and Masticatory Myofascial Pain: A Stratified-Randomized Controlled Trial

Modified-active release therapy (mART) was developed to treat patients experiencing upper quarter pain. The objective of the study was to determine the effectiveness of the mART in treating pain, promoting function, and measuring emotions in patients with scapulocostal syndrome (SCS) and masticatory myofascial pain (MMP). A stratified-randomized controlled trial was employed in 38 participants separated into two groups. All participants underwent the same series visual analog scale (VAS), pressure pain threshold (PPT), mouth opening (MO), maximum mouth opening (MMO), craniovertebral angle (CV-angle), and pain catastrophizing scale Thai version (PCS-Thai-version) at the baseline. The mART group underwent the mART program three times a week for 4 weeks with a hot pack and an educational briefing while the control group received only a hot pack and the educational briefing. After treatment, both groups showed significant improvement (p < 0.05) in all parameters except MO, MMO, and CV-angle. When comparing outcomes between the groups, the mART group showed a statistically significant greater number of improvements than did the control group. In conclusion, the mART program can improve pain experienced by patients with SCS and MMP and it can be used as an adjuvant technique with conservative treatment.

Immediate Effect of Hot Pack versus Kinesiotape and Hot Pack on Pain in Primary Dysmenorrhea

Background: Primary dysmenorrhea is one where there is no identifiable pelvic pathology. It is mostly confined to adolescents and young adult female. The pain begins a few hours before or just with the onset of menstruation. The severity of pain usually lasts for few hours and may extend beyond 48 hours. The pain is spasmodic and confined to lower abdomen and may radiate to back. Systemic discomforts like nausea, vomiting, fatigue, headache, stress, nervousness, fainting may be associated. Purpose: To study the immediate effect of Hot Pack versus Kinesiotape and Hot Pack on pain in primary dysmenorrhea. Methods: The study consists of fifty participants with primary dysmenorrhea. Sampling Method: Simple Random sampling by tossing the coin and allocation of the participants to the two groups: Group A and Group B Selection Criteria -Inclusion Criteria: Age Group 18-25 yrs., Females suffering from symptoms of primary dysmenorrhea, females having 5 and above score on NPRS. Exclusion Criteria: Females having underlying conditions related in gynaecological origin, musculoskeletal dysfunction, irregular menstrual cycle. Results: The results of the study showed that there was a significant reduction in the pain intensity (p<0.05) in both the groups. Based on statistical analysis, there was no significant adjunct effect of kinesiotape seen as compared to only hot pack. Conclusion: Study concludes that clinically Hot Pack as well as Kinesiotape both are effective in alleviating pain in primary dysmenorrhea. Kinesiotape showed no significant adjunct effect as compared to only hot pack. Key words: Primary dysmenorrhea, Hot Pack, Kinesiotape.

Effectiveness of Selected Exercise Programme on Cervical Range of Motion in Patients with Thoracic Kyphosis & Forward Head Posture

Background: Altered postural behaviours result in Forward head posture and thoracic kyphosis making it amenable to correction. The biomechanical strain, in presence of reduced strength of the core stabilizing musculature, in particular, if it is repeated or prolonged, is the predominant explanation for symptoms associated with forward head posture and thoracic kyphosis i.e., neck pain and reduced cervical range of motion. Objective: The aim of the present study was to investigate and compare the effect of postural awareness and conventional exercises on the cervical range of motion in patients with thoracic kyphosis and forward head posture. Methodology: This experimental study was conducted on 60 subjects both male and female of age group 20-35yrs. Subjects were randomly divided into two groups consisting of 30 subjects each. Group A received hot pack and postural advice and Group B received hot pack and stretching and strengthening exercises. All the subjects received a total intervention of 4 days (alternate days) per week for 4 weeks. Results: Intra-group significant differences were obtained between pre- and post-treatment for all evaluated variables (p˂0.01) in both groups. The inter-group comparison showed significant differences (p˂0.01) between post-treatment variables of Group A and Group B where, Group B showed greater improvement than Group A. Conclusion: The treatment given to both the groups together can be used to improve cervical range of motion, thoracic kyphosis, and forward head posture. This study may serve as a guideline for physiotherapists when making decisions regarding possible interventions. KEY WORDS: Cervical range of motion, Craniovertebral angle, Forward head posture, Kyphosis index, Neck disability index, Thoracic kyphosis.

EFFICACY OF TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION AND THERAPEUTIC ULTRASOUND IN PATIENTS SUFFERING FROM CHRONIC CERVICAL PAIN

The purpose of the present study was to search to search the efficacy of transcutaneous electrical nerve stimulation and therapeutic ultrasound in patients suffering from chronic cervical pain. To fulfill the purpose, A total of randomly selected 30 patients with chronic cervical pain aged 20-70 years were selected from the Physiotherapy Center of Guru Nanak Dev University, Amritsar for the present study. The patients were further randomly divided into two groups, in Group-A, patients were treated with Transcutaneous Electrical Nerve Stimulation (TENS), Therapeutic Ultrasound (TUS), followed by hot pack, massage, therapeutic exercises (shoulder circumduction, pectoral stretching), cervical stretching, cervical isometrics with the recommendation for daily living activities, whereas, in Group-B, the patient s were treated only with hot pack, massage, therapeutic exercises (shoulder circumduction, pectoral stretching), cervical stretching and cervical isometrics with the recommendation for daily living activities. The outcome measures were Visual Analogue Scale (VAS) for pain, Neck Pain Visual Disability Index (NDI) for disability. The results revealed statistically significant decrease (p<0.001) both in NDI and VAS in patients with cervical pain between pre- and post-intervention in the Group-A and B, but Group-A showed significantly superior effects both in NDI (82.88% decrement) and VAS (71.62% decrement) than Group-B. In conclusion, it might be stated that transcutaneous electrical nerve stimulation and therapeutic ultrasound were found more effective than conventional physiotherapeutic techniques in relieving pain intensity and disability in patients with chronic cervical pain. Keywords: Transcutaneous Electrical Nerve Stimulation, Therapeutic Ultrasound, Patients with Chronic Cervical Pain.

Stretching Exercise Versus Tissue Mobilization Technique in Piriformis Syndrome

Objective: The study was aimed to compare the effectiveness of stretching exercise and tissue mobilization techniques with piriformis syndrome patients. Methods: Thirty-two participants were included in this study and they were classified into two groups. Group A, stretching exercise, hot pack, and group B, tissue mobilization technique, hot pack. Every group obtained two sessions in a week, for four weeks. The participants were assessed by (VAS), (RMQ), and (HAM-A). Results: The comparison revealed that for RMQ there was a significant difference between groups in terms of the stretching exercise group (P >0.05). For HAM-A and VAS, there were no statically significant differences between groups (P <0.05), but the impact of both exercises indicates that stretching exercises have a higher positive effect comparing to tissue mobilization on pain. Conclusion: The study proved which the stretching exercise was more efficient than the tissue mobilization technique on the pain outcome measures. It’s reported that stretching exercise improves low back function more than tissue mobilization technique. In the end, the study indicated that significantly there was no difference between both groups on the anxiety outcome measure.

The effects of rice grain and Thai herbal hot pack on pain and back extensibility in persons with low back pain

Objectives Low back pain (LBP) is the most prevalent musculoskeletal condition. Superficial heat has been utilized for decades to alleviate the symptoms; however, there has been no study of the effect of rice grain and Thai herbal hot packs using a microwave method in persons with low back pain. The purpose of this study was to compare pain scale scores and back extensibility with rice grain and Thai herbal hot packs with standard hot packs in individuals with LBP. Methods Forty participants with LBP were stratified using a random sampling method into two groups: a rice grain and Thai herbal hot pack group (n=20) and a standard hot pack group (n=20). Twenty-minute duration treatments were given. Each patient was followed-up 6 times (3 times per week for 2 weeks). Pressure pain threshold (PPT) and back extensibility were measured using a visual analogue scale (VAS) and the Thai Oswestry low back pain disability index. Results VAS scores and the Thai Oswestry low back pain disability index in both groups were reduced significantly (p < 0.05). PPT and back extensibility were significantly increased after rice grain and Thai herbal hot pack and hot pack treatment (p < 0.05). After treatments, PPT with rice grain and Thai herbal hot pack was significantly higher than the standard hot pack group. (p < 0.05). Conclusions Rice grain and Thai herbal hot pack may be considered as an alternative method for relieving pain and improving pressure pain threshold and back extensibility in persons with LBP. Chiang Mai Medical Journal 2021;60(1):75-86. doi 10.12982/CMUMEDJ.2021.07