ABSTRACT
Background: Low back pain (LBP) is one of the most prevalent musculoskeletal disorders, affecting up to 90% of people at some point in their lifetime. Up to 50% will have more than one episode of back pain. Previous studies have highlighted the benefits of fascial manipulation for chronic low back pain over manual therapy alone. But early detection of densification of specific points in the lateral thigh region in low back pain subjects in an acute phase itself will be of benefit in resolving the back pain as the deep friction on these points aims at restoring the physiological gliding properties of the fascia and lead to immediate pain relief in the low back, increased range of motion and improved functions. Methods: Sixty individuals were enrolled for the study and were randomly allotted to two groups using a simple random method, were samples were randomly allocated by the primary investigator before baseline assessment. Control group subjects in Group A received conventional exercises, including core stability exercises. Experimental group subjects in Group B received Fascial manipulation to the lateral aspect of the thigh region in the lower limb. Both the groups received interferential therapy for 20 minutes as a part of conventional treatment for low back pain for 15 days. The subjects were assessed for their pain level, using NPRS score, and range of motion (ROM) was assessed to find any restriction in the lumbar region due to fascial densification. The functional activities of daily life were assessed using the ODI scale. The above scores were recorded before and after the interventions for both the groups. Results: The pre-test and post-test results were analyzed using a Paired and Unpaired t-test. The outcome measures of the Numeric Pain Rating Scale, Modified Schober's test, the Oswestry Disability Index were used for the study. A comparison of post-test values between Group A and Group B using unpaired t-test revealed a significant difference of p<0.001 in terms of pain relief, improved Range of motion, and functional ability of subjects in Group B than subjects in Group A. Conclusion: Fascial manipulation technique on lateral thigh region proved to be effective than conventional exercises as it showed a clinical and significant effect in decreasing pain and disability and improving the range of motion and functional activities of daily living in subjects with mechanical low back pain.
ABSTRACT
Background: A normal Finger Flexion Cascade (FFC) is formed by the fingers of the hand when the hand in a relaxed position. Usually, the fingers of the hand assume a flexed position; gender may influence the normative values of the resting hand due to differences in the anatomical structure of hand and frequency of usage of joints of hand in their respective occupation and habitual activities of daily living. Hence the study aims to find the difference in the FFC between men and women in power grip and nonpower grip occupational activities. Methods: A cross-sectional study was conducted in a mixed population of five hundred active individuals aged between 25 and 40 years belonging to various occupations of industrial work and individuals working with software companies. Individuals who fulfilled the inclusion criteria participated in the study. After completing a questionnaire based on occupation, the subjects were grouped into power grip users and nonpower grip users. The range of motion of the joints of all the fingers, namely, metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints of both dominant hand and nondominant hand was measured using universal finger goniometer, and the composite finger flexion was recorded using a geometric ruler. The results were analyzed, and Un-paired T-test was used to compare the FFC between the power grip and the nonpower grip group. Results: The FFC variations in both the hands of male and female subjects in power grip users (PGU) and nonpower grip users(NPGU) were recorded. In the dominant hand, it was found that the DIP joint of 5th digit in female subjects had a greater ROM values than male subjects, but greater ROM values in MCP joints of the hand in males were found. The comparison between the range of values of both groups revealed that the values in the PGU group were more than the NPGU group with a statistical significance of p<0.001. Conclusion: The finger flexion cascade was found to be more closed in female subjects than males in both the dominant and nondominant hands of in the power grip users than in the nonpower grip users.