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Objective To observe the clinical efficacy of thumb-tack needling for subcutaeous embedding combined with joint mobilization in the treatment of post-stroke shoulder-hand syndrome.Methods A total of 80 patients with post-stroke shoulder-hand syndrome were randomly divided into a treatment group and a control group,with 40 patients in each group.Both groups were given arthrocentesis,the control group was given ordinary acupuncture on the basis of arthrocentesis,and the treatment group was combined with thumb-tack needling for subcutaeous embedding.One course of treatment was 4 weeks and a total of 4 weeks of treatment was given.After 1 month of treatment,the clinical efficacy of the two groups was evaluated.The changes of Visual Analogue Scale(VAS)of pain scores and simplified Fugl-Meyer Assessment(FMA)scores,as well as the pain-free passive forward flexion and abduction of the shoulder joint of the affected limb were observed before and after treatment.The Simple Quality of Life Scale(SF-36)scores of the patients in the two groups were compared after treatment.The safety and the occurrence of adverse reactions in the two groups were also evaluated.Results(1)The total effective rate was 95.00%(38/40)in the treatment group and 80.00%(32/40)in the control group.The efficacy of the treatment group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the VAS scores and upper extremity FMA scores of the patients in the two groups were significantly improved(P＜0.05),and the treatment group was significantly superior to the control group in improving the VAS scores and upper extremity FMA scores,and the differences were statistically significant(P＜0.05).(3)After treatment,the joint mobility of patients in the two groups were significantly improved(P＜0.05),and the improvement of shoulder joint movement in the treatment group was superior to that in the control group,and the difference was statistically significant(P＜0.05).(4)After treatment,the SF-36 Quality of Life Scale scores of the treatment group were significantly superior to those of the control group in terms of physical function,psychological function,emotional health,and social function levels,and the difference was statistically significant(P＜0.05).(5)There was no significant difference in the incidence of adverse reactions between the treatment group and the control group(P＞0.05).Conclusion Thumb-tack needling for subcutaeous embedding combined with joint mobilization exert certain effect in the treatment of post-stroke shoulder-hand syndrome.It can significantly improve the pain symptoms of patients,thus improving their quality of life,and the clinical effect is remarkable.
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Background: Lumbar Spondylitis (LS) is a common term that denotes degenerative changes that develop in trauma-center patients, specific age groups, and head injury patients. A study done on Indian population reported 60% to 90% of radiological changes of L4 at L5-S1 levels in asymptomatic individuals. These degenerative changes in the lumbar spine may remain asymptomatic or can present as pure axial lumbar pain, lumbar radiculopathy, lumbar myelopathy, or lumbar myeloradiculopathy. So, the aim of the study was to check the effectiveness of hip flexor muscle strengthening, femoral nerve muscle stretching with facet joint mobilization for lumbar spondylitis. Materials and methods: 60 patients were included in the study which was divided into two groups; Group A and Group B, 30 patients in each group. Subjects were randomly selected and assigned to each group. Pre-test measurements of the patient were done with the help of two measures - RolandMorris Low Back Pain and Disability Questionnaire for disability and Visual Analog Scale (VAS). Goniometer was used for range motion of lumbar spine movements done in each group. The Subjects in Group-A were given hip flexor muscles strengthening with femoral nerve stretching for lumbar region for 45 minutes for 4 days in a week for four weeks where the subject were sitting. The Subjects in Group-B were given femoral nerve stretching with facet joint mobilization for 45 minutes for 4 days in a week for four weeks where the subjects were in supine and prone position and remain Sreenivasu Kotagiri, Neeti Mathur, Ashwin Kumar. Comparative Efficacy of Hip Flexor Muscle Strengthening with Femoral Nerve Stretching and Facet Joint Mobilization for Lumbar Spondylitis. IAIM, 2019; 6(9): 49-57. Page 50 relaxed with the feet uncrossed. Result analysis was done by Wilcoxon Sum Rank Test (Mann Whitney U Test). Results: On comparing Group A and Group B for post-treatment VAS score and RMQ score, results showed a significant difference (p=0.001) in improvement in terms of VAS and RMQ. The overall study proved that hip flexor muscle strengthening, femoral nerve stretching with facet joint mobilization for lumbar spondylitis in improving Pain and decreasing the disability level in lumbar radiculopathy and reduce tightness subjects. Conclusion: The analysis obtained indicated that Group B (femoral nerve stretching with facet joint mobilization) showed more significant improvement when compared to Group A ( hip flexor muscles strengthening with femoral nerve stretching).
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ABSTRACT BACKGROUND AND OBJECTIVES: A possibility to treat chronic low back pain is joint mobilization. There is moderate literature evidence of the effects of mobilization on chronic low back pain; however, few studies have used sham mobilization as comparison group. This study aimed at evaluating the effects of back joint mobilization on the following outcomes: pain intensity and incapacity in chronic low back pain patients. METHODS: Participated in the study 60 individuals of both genders with the following eligibility criteria: aged between 18 and 55 years with chronic nonspecific low back pain for at least three months. Selected volunteers were randomly distributed in three groups of 20 individuals: joint mobilization group MG: 39.15±11.45 years, sham mobilization group SG: 37.10±12.57 years, and control group CG: 30.60±8.97. All groups were evaluated by the same blind investigator and have answered to the following tools pre-and immediately after the ten intervention sessions: pain numeric scale to evaluate pain intensity, Oswestry Disability Index to evaluate low back pain-related incapacity and Catastrophic Thoughts Scale to evaluate pain-related catastrophizing. RESULTS: There were significant pre-and post-treatment differences in pain intensity for MG (p<0.001) and SG (p<0.001). There has been significant difference in mean pain intensity value in MG as compared to CG (-2.55). CONCLUSION: Our results suggest sham effect related to the application of mobilization in chronic low back pain patients.
RESUMO JUSTIFICATIVA E OBJETIVOS: Uma das possibilidades de tratamento da dor lombar crônica são as mobilizações articulares. Há evidência moderada na literatura sobre os efeitos de mobilizações para dor lombar crônica, entretanto, poucos estudos têm utilizado mobilizações-sham como grupo de comparação. O objetivo deste estudo foi avaliar os efeitos da mobilização articular lombar sobre os seguintes desfechos: intensidade da dor e incapacidade em pacientes com dor lombar crônica. MÉTODOS: Foram selecionados 60 indivíduos de ambos os sexos com os seguintes critérios de elegibilidade: idade entre 18 e 55 anos, que apresentassem dor lombar crônica não específica há pelo menos três meses. Os voluntários selecionados foram distribuídos aleatoriamente em três grupos de 20 indivíduos: grupo mobilização articular GM: 39,15±11,45 anos, grupo mobilização sham GS: 37,10±12,57 anos e grupo controle GC: 30,60±8,97 anos. Todos os grupos foram avaliados por um mesmo pesquisador encoberto e responderam os seguintes instrumentos pré e imediatamente após as 10 sessões de intervenção: escala numérica de dor para avaliação da intensidade da dor, Oswestry Disability Index para avaliação da incapacidade relacionada à dor lombar e Escala de Pensamentos Catastróficos para avaliação da catastrofização relacionada à dor. RESULTADOS: Foram observadas diferenças significativas pré e pós-tratamento para a variável de intensidade de dor nos GM (p<0,001) e GS (p<0,001). Na comparação entre os grupos de intervenção, foi verificada diferença significativa no valor médio de intensidade de dor entre GM versus GC (-2,55). CONCLUSÃO: Os presentes resultados sugerem efeito sham relacionado à aplicação de mobilizações em pacientes com dor lombar crônica.
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<p><b>OBJECTIVE</b>To investigate the effect of joint mobilization on postoperative wrist joint function, pain and grip strength for elderly patients with distal radius fracture.</p><p><b>METHODS</b>From January 2015 to June 2016, a total of 67 elderly patients with distal radius fracture were randomly divided into routine exercise group and joint mobilization group. Among them, 37 patients in the routine exercise group underwent conventional distal radius fracture postoperative joint function exercise regimen, including 16 males and 21 females with a mean age of (67.8±3.2) years old ranging from 60 to 72 years old;the injured side was dominant in 23 cases and non-dominant in 14 cases;injury mechanism was fall in 26 cases, traffic accident in 11 cases; for AO type, 6 cases were type B3, 18 cases were type C1, 7 cases were type C2, 6 cases was type C3. Other 30 patients in the joint mobilization group underwent joint mobilization on the basis of the routine exercise group including 14 males and 16 females with a mean age of (67.1±4.0) years old ranging from 61 to 74 years old; the injured side was dominant in 21 cases and non-dominant in 9 cases;injury mechanism was fall in 25 cases, traffic accident in 5 cases;for AO type, 8 cases were type B3, 13 cases were type C1, 6 cases were type C2, 9 cases were type C3. The wrist joint activity, Gartland-Werley wrist joint function score, VAS pain score and grip strength were observed at 3 months afrer treatment.</p><p><b>RESULTS</b>After 3 months' treatment, the VAS in the routine exercise group was higher than that of the joint mobilization group (<0.05). The grip strength of affected side in both groups were lower than that of contralateral side, but the average grip strength of affected side in joint mobilization group was higher than that in routine exercise group(<0.05). In routine exercise group, the average angle of flexion, extension, radial deviation were significantly higher than those of joint mobilization group(<0.05). But ulnar deviation angle in routine exercise group compared with joint mobilization group had no significant difference (>0.05). In the comparison of each item of Gartland-Werley, there was no significant difference between two groups in residual deformity and complication(>0.05); the average score of subjective score, objective score and total score in routine exercise group were significantly higher than those of the joint mobilization group (<0.05). The wrist function Gartland-Werley score in routine exercise group after treatment was excellent in 21 cases, good in 10, 6 in fair, while in joint mobilization group, excellent in 23, good in 6, fair in 1(<0.05).</p><p><b>CONCLUSIONS</b>The application of joint mobilization in the treatment of elderly patients with distal radius fracture can improve the joint activity and obtain better wrist function after surgery.</p>
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Objective To observe the clinical effect of Wangbi tablet oral therapy combined with joint mobilization in the treatment of periarthritis of shoulder, to provide reference for the treatment of periarthritis of shoulder.Methods A total of 136 patients with scapulohumeral periarthritis in our hospital from January 2015 to June 2016 were selected as the research object, according to the order of hospitalized patients were randomly divided into observation group and control group,with 68 cases in each group, the observation group was treated with Wangbi tablet combined with joint mobilization,the control group was treated with single joint mobilization.After treatment, the clinical curative effect,complications or adverse reactions were comparedbetween the two groups, visual analogue scale(VAS)was used to compare the degree of pain of shoulder joint of patients before and after treatment, the shoulder joint function score were compared by the Japanese Orthopedic Association(JOA)'s shoulder disease score, the patients were followed up for a half a year and the Barthel index score was used to compare the daily life ability score of dynamic contrast.Results (1)The total effective rate of the observation group was(64/68), the control group was 82.35%(56/68), the observation group was significantly better than the control group(P<0.05).(2)The incidence of adverse reactions in the observation group was(8/68), the control group was 7.35%(5/68), and the safety of the two groups was good.(3)the VAS score of the observation group was(3.09±0.98), the control group was(4.53±1.02), and the pain of the observation group was significantly lower than that of the control group(P<0.05).(4)After treatment, the JOA score of the observation group was(16.54±2.36), and the control group was(12.97±2.71).The observation group was significantly higher than the control group(P<0.05).(5)The observation group treatment and follow-up of the Barthel index score was(73.11±6.21),(83.89±7.95)points, the control group was(68.41±5.65),(73.88±6.80), the activities of daily living of the observation group were higher than that of the control group(P<0.05).Conclusion There is a significant effect of Wangbi tablet therapy combined with joint mobilization for the treatment of patients with periarthritis of shoulder, the safety of the treatment is high, can reduce the pain of patients, improve the activity of shoulder joint function and activity of daily living, the comprehensive curative effect, with a high clinical value to promote.
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Objective To explore the effect of static progressive stretching combined with joint mobilization on dysfunction after total knee arthroplasty.Methods Fifty-six patients with knee joint dysfunction after total knee arthroplasty were randomly divided into a treatment group and a control group,each of 28.Both groups were treated with joint mobilization,while the treatment group was additionally provided with static progressive stretching for 8 weeks.Before and after the treatment,both groups' pain and knee function were evaluated using visual analogue scale (VAS) scores,the range of motion and the hospital for special surgery knee score (HSS).Results Before the treatment there were no significant differences between the two groups in any of the measurements.After the treatment,all of the measurements had improved in both groups,on average.Compared with the control group,the treatment group's average range of motion of the knee and HSS score were significantly better.Conclusion Static progressive stretches combined with joint mobilization can effectively relieve pain,expand the range of motion and improve the function of a knee joint after total knee arthroplasty.
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PURPOSE: The purpose of this study was to confirm the immediate effect of wrist joint mobilization with taping on the range of motion, grip strength, and spasticity. METHODS: Thirty stroke patients were randomly divided into two groups: the joint mobilization with taping group (n=15) and a taping group (n=15). For measurement of spasticity and joint range of motion, the modified Tardieu scale, active and passive range of motion of wrist flexion, as well as extension were measured by the Rapael smart glove, and for grip strength measurement, grip dynamometer was performed. RESULTS: The experimental group showed a significant improvement in the range of motion, grip strength, and spasticity after 10 minutes of taping (p0.05). However, there was no significant difference between the two groups (p>0.05). CONCLUSION: The study found that wrist joint mobilization with taping has an immediate effect on wrist range of motion, grip strength, and spasticity in stroke patients, whereas it was not effective in the control group with just taping. The long-term change still needs to be evaluated, when taking into consideration of the carryover effect.
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Humans , Hand Strength , Joints , Muscle Spasticity , Range of Motion, Articular , Stroke , Wrist Joint , WristABSTRACT
Objective To study the clinical efficacy of acupuncture combined with medication plus joint mobilization in the treatment of lumbar intervertebral disc protrusion accompanied with secondary lumbar spinal stenosis.MethodsTotally 66 cases of lumbar intervertebral disc protrusion accompanied with secondary lumbar spinal stenosis were collected randomly and divided into treatment group (34 cases) and control group (32 cases). The control group was given treatment of simple acupuncture and TCM medication, while the treatment group was given joint mobilization treatment besides acupuncture and TCM medication. Functions of lumbar vertebra were evaluated by ODI scale and the degrees of pain were evaluated by VAS. The clinical efficacy in the two groups was compared. Results ODI in both groups were significantly improved after treatment compared with that before treatment. However, the changing range of the ODI of the treatment group was more significant than that in control group (P<0.01). After treatment, VAS scores were relieved (P<0.05) in both groups, and treatment group was more significant than that in control group (P<0.05). The total clinical efficacy was 97.06% (33/34) in the treatment group, and 84.38% (27/32) in the control group, with statistical significance (P<0.05).Conclusion Acupuncture combined with medication plus joint mobilization in the treatment of lumbar intervertebral disc protrusion accompanied with secondary lumbar spinal stenosis has good efficacy.
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Objective To observe the curative effect of joint mobilization technique in the treatment of shoulder peri-arthritis and its effect on the recovery of shoulder joint functions. Methods Patients with shoulder periarthritis who were admitted to our hospital from March 2013 to June 2014 were sampled. 80 patients were selected and randomly as-signed to two groups. The control group was given the treatment of electroacupuncture and functional training, and the experiment group was given joint mobilization technique on the basis of the control group. Effect of clinical treatment was observed in the two groups. Results Total effective rate in the experiment group was 92.50%, significantly higher than that of 77.50% in the control group. Score of shoulder joint functions was (78.87±20.64) in the experiment group, significantly higher than that of (62.53±18.76) in the control group. All the differences were statistically significant (P<0.05). Conclusion Joint mobilization technique in the treatment of shoulder periarthritis has an exact clinical effect, and is able to promote early recovery of shoulder joint functions.
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ObjectiveTo investigate the efficacy of superficial needling plus Joint mobilization training in treatingsupraspinatus tendonitis.MethodForty-one patients with supraspinatus tendonitis were randomly allocated to a treatment group of 21 cases and a control group of 20 cases. The treatment group received one session of superficial needling plus shoulder Joint mobilization training and the control group, one session of pain point injection of 2% lidocaine hydrochloride plus triamcinolone acetonide acetate. The therapeutic effects were compared between the two groups.ResultThe total efficacyrate was significantly higher in the treatment group (100%) and in the control group (65%); there was a statistically significant difference between the two groups (P<0.05). ConclusionSuperficial needling plus Joint mobilization training has a positive therapeutic effect on supraspinatus tendonitis.
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Objective To observe the therapeutic effects of muscle energy technique combined with joint mobilization on frozen shoulder.Methods Thirty-six patients with frozen shoulder were randomly assigned to:group A (treated with muscle energy technique plus joint mobilization),group B (treated with passive stretching with joint mobilization),and group C (treated with joint mobilization merely),and each had 12 patients.All the patients were treated accordingly for 3 times a week,totally for 4 weeks.The American Shoulder and Elbow Surgeons evaluation system (ASES) was adopted to evaluate clinical effects before and at the end of treatment.Results After 4 weeks of treatment,all patients' ASES scores were improved significantly (P ＜ 0.05).The improvement in the shoulder score index and shoulder range of motion were to a significantly better extent in group A than in the other two groups.Conclusion Muscle energy technique plus joint mobilization could effectively relieve pain increase the shoulder ROM and improve performance in activities of daily living in patients suffering from frozen shoulder.
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@#Objective To investigate the efficacy and analgesia of moxibustion with warming needles combined with joint mobilizationon scapulohumeral periarthritis. Methods 126 subjects were randomly divided into 2 groups, the observation group received moxibustionwith warming needles combined with joint mobilization; the control group received moxibustion with warming needles only. Short-form ofMcGill pain questionnaire and effect were assessed. Results The effective rate was 98.4% and 95.2% for the 2 groups respectively(P>0.05);but there was significant differences between the 2 groups in the visual analogue scale (VAS), present pain intensity (PPI) and pain rating index(PRI) (P<0.05). Conclusion The moxibustion with warming needles combined with joint mobilization is a good effective therapy forscapulohumeral periarthritis.
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@#ObjectiveTo evaluate the significance of flexion priority strategy and the principle of joint mobilization technique in the rehabilitation of posttraumatic stiffness of the elbow. Methods24 patients with posttraumatic stiffness of the elbow were divided into 2 groups, 12 patients in each group. The treatment group was treated with flexion priority strategy of joint mobilization technique only in the treatment of flexion contracture. In order to decrease the pain caused by joint mobilization training of extension and achieve the restoration of flexion as early as possible, the rehabilitation of extension was altered to self-exercise under the consultation of doctors combined with gentle passive traction by the therapist. The control group was treated with joint mobilization technique of both flexion and extension once a day. All the patients were measured the flexion range, extension range, and flexion-extension arc after 6 weeks of rehabilitation. Results6 weeks after rehabilitation, the treatment group got 124° of flexion (range 95°～135°), much better than the control group of 95° (range 80°～110°) （P<0.01）. There was no significant difference of extension degrees between the treatment group (15°, range 10°～35°) and the control group (16°, range 10°～30°) （P＞0.05）. The final arc of flexion and extension in the treatment group had an increase of 53°, significantly greater than 30° in the control group（P<0.01）. ConclusionFlexion priority strategy of elbow rehabilitation can significantly restore the flexion function of posttraumatic elbow stiffness.
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@# Objective To explore the effect of joint mobilization and quadriceps setting on nitric oxide(NO) and tumor necrosis factor(TNF) of the experimental knee osteoarthritis in rabbits. Methods Rabbits model of knee osteoarthritis was induced by papain. 32 rabbits were divided into 4 groups randomly, 8 in each group. The changes of contents of NO and TNF in synovia were detected.Results Expression of NO and TNF in synovia of all treatment groups decreased compared to the control group(P<0.01).Conclusion Joint mobilization and quadriceps setting can decrease the level of NO and TNF in synovia.
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@#Objective To study Joint Mobilization on shoulder pain after stroke. Methods Hemiplegic patients with shoulder pain after stroke were treated with joint mobilization. The effects were determined by the simple McGill Questionnaires and Fugal-Meyer upper extremity functional score before and 30 days after treatment.Results The pain scores of the treatment group were significantly lower than that of the control group (P<0.01), the upper extremity functional scores of the treatment group were significantly higher than that of the control group (P<0.01).Conclusion Joint mobilization for hemiplegic patients with shoulder pain after stroke can significantly reduce shoulder pain and effectively improve upper extremity function.
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As causas mais comuns de dor no ombro estão relacionadas às degenerações dos tendões da musculatura do manguito rotador. OBJETIVO: Verificar a influência da mobilização articular por meio dos movimentos acessórios do ombro na recuperação inicial de 14 pacientes com tendinopatia crônica dos mm. supra-espinal e/ou bíceps braquial. MÉTODOS: Foram comparados dois protocolos de tratamento, compostos da aplicação de ultra-som terapêutico na área do tendão afetado e de treinamento excêntrico na musculatura envolvida, acompanhados ou não de manobras de mobilização articular. Como métodos de avaliação foram utilizados os questionários de Constant e Disabilities of the Arm, Shoulder and Hand (DASH), no início e ao final do tratamento. RESULTADOS: Os resultados encontrados demonstraram que ambos os protocolos de tratamento foram eficazes na reabilitação dos pacientes, pois se obtiveram melhores resultados funcionais na aplicação dos questionários quando comparados o final com o início do tratamento para os pacientes (p<0,001). Os pacientes que foram submetidos à mobilização articular associada ao ultra-som terapêutico e o treinamento excêntrico obtiveram em média melhores escores para os questionários, ocorrendo diferença estatística significante entre os escores finais nos dois grupos para os dois questionários (p<0,05). CONCLUSÕES: Assim ambos os protocolos de tratamento foram eficazes no tratamento da tendinopatia crônica do ombro, sendo que, o uso associado da mobilização articular parece oferecer melhores resultados funcionais.
The most common causes of shoulder pain are related to degeneration of the tendons of the rotator cuff muscles. OBJECTIVE: To investigate the influence of joint mobilization by means of accessory movements of the shoulder during the early rehabilitation of 14 patients with chronic tendinopathy of the supraspinatus and/or biceps brachii muscles. METHODS: Two treatment protocols were compared: application of therapeutic ultrasound over the affected tendon area and eccentric training of the musculature involved, with or without joint mobilization maneuvers. The Constant and DASH (Disabilities of the Arm, Shoulder and Hand) questionnaires were used as the assessment method, before and after the treatment. RESULTS: The results showed that both treatment protocols were effective for patient rehabilitation, since better functional results were obtained at the end of the treatment, in comparison with the beginning (p<0.001). The patients who underwent joint mobilization in association with therapeutic ultrasound and eccentric training achieved better mean scores in the questionnaires. There was a statistically significant difference in the final scores between the two groups, for both questionnaires (p<0.05). CONCLUSIONS: Thus, both treatment protocols were effective for treating chronic tendinopathy of the shoulder, although their use in association with joint mobilization seems to provide better functional results.
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@#Objective To observe the efficacy and safety of joint mobilization therapy for osteoarthritis of knee joint.Methods 120 patients with osteoarthritis of knee joint were randomly divided into the treatment group and control group with 60 cases in each group. The treatment group were treated with joint mobilization and synthesis rehabilitation therapy, and control group only with synthesis rehabilitation therapy.Results The total effective rate was 90.00% in the treatment group and 76.67% in the control group according to analysis of intention-to-treat, and 92.73% in the treatment group and 80.77% in the control group based on analysis of per-protocol population. There was a significant difference between the two groups ( P<0.05). No adverse effect was found in the treatment group.Conclusion The joint mobilization therapy is efficacy and safety for osteoarthritis of knee joint.
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Objective To observe and compare the effects of extracorporeal shock wave therapy(ESWT) and that of joint mobilization technique on periarthritis of shoulder. Methods Eighty-two patients were divided into two groups randomly, a treatment group (n=42) treated with extracorporeal shock wave therapy, and a control group (n=40) treated with joint mobilization technique. All the patients were evaluated with Visual Analogue Scale (VAS) and Constant-Murley Scale(C-M scale) before and half a month after the treatment. Results After treatment the results obtained with the use of VAS Scale and C-M Scale (only ADL and ROM) were significantly different in two groups when compared with those before the treatment (P