Intrasound therapy: an effective alternative to sodium diclofenac phonophoresis in the management of mechanical chronic cervical spine pain

The efficacy of Sodium Diclofenac Phonophoresis (SDP) as an effective adjunct in the management of inflammation and pain has been established though its application entails complicated choices of treatment parameters. Intrasound Therapy (IST), acclaimed for its simplicity of operation has been reported to promote healing though no studies have been done on its effect in Chronic cervical spine pain (CCSP). The aim of this study was to determine if IST could be an effective therapeutic option to SDP as an adjunct in the management of CCSP. Forty seven (47) participants with CCSP that had definite diagnoses were randomly assigned into 3 groups. All participants had exercises and massage while in addition, group 1 had SDP and group 2 IST for 10 minutes each. Participants were treated for 40 minutes twice a week for 4 weeks and were evaluated for pain, Quality of life (QoL), disability and range of motion (ROM) of the cervical spine. Paired sample t-test was used to compare the outcome parameters in each group and data presented as Mean ± SEM with significance at p<0.05. IST and SDP significantly (p˂0.05) improved the clinical parametres compared with the control group and there were no significant (p ˃0.05) differences in clinical outcome between the IST and SDP groups. IST was as effective as SDP and considering its relative simplicity of operation could be an alternative therapeutic adjunct in the management of chronic cervical pain

Sport participation and injuries among undergraduate students of a Nigerian University.

Backgroud: Sports participation is a healthy behaviour but it is not without the risk of injuries. Information on the extent of sport participation and sport injuries among Nigerian Unversity students is sparse. Objeclive: To determine the prevalence and types of sport participation and injuries among university.students in Nigeria. Factors associated with sport participation among students were also examined. METHODS: A cross-sectional survey was conducted using a self-administered questionnaire to collect information on the frequcncy and types of sport participation and sport-related injuries among a representative sample of undergraduate students of the University of Lagos, Nigeria. Resuts: A sport participation prevalence of 64.2% (95%CI: 59.5 - 68.7) was recorded among students. Football (soccer) (53.2%) had the highest participation rate. Male students (78.4% vs.41.2%) participated more frequently in sports (p <0.001). Overall injury rate was 52.5 injuries/100 students/ year (95%CI: 46.5 - 58.5). The prevalence of injury was 45.7% in male and 12.7% in female students. About half (49.3%) of reported injuries resulted in time loss. The leg and ankle were the most frequently injured body parts for all injuries and most serious injuries. Football recorded the highest prevalence of injury (73.8%). CONCLUSION: Sport participation among students was fair and injury rate was considerably high, mostly affecting the lower extremity and most injuries resulting from football participation. This study suggests the need for improved sport participation support among students and the need for the initiation of injury prevention initiatives by stakeholders.

Physical activity profile of senior civil servants in Lagos, Nigeria: need for effective strategies for improvement.

AIMS AND OBJECTIVES: To investigate the profile of physical activity (PA) among Lagos State senior civil servants (LSCSs). SUBJECTS AND METHODS: A cross-sectional survey in which 305 LSCSs (163 men, 142 women) with age range 25 65 years, in five ministries of the LSCS was carried out in May of 2011. The Global Physical Activity Questionnaire (GPAQ) was used to assess respondents' PA at work, for transport, and during leisure time during the last 7 days. RESULTS: Overall, 56.7% of the respondents (58.3% men and 54.9% women) were active; equivalent to 43.3% inactive respondents (41.7% men and 54.9% women). In spite of the high prevalence of physical inactivity in the women, gender was not significantly associated with PA levels (p = 0.718). However, the educational status and cadre of respondents were significantly associated with PA levels (p < 0.05). CONCLUSION: The findings of this study showed that close to half of LSCSs were physically inactive. There was no significant difference between the PA levels of men and women but educational status and cadre were associated with the PA levels of respondents. The results provided by this study suggests the need for the Lagos State government and stakeholders to formulate polices, plan programmes and interventions for LSCSs to get more physically active.

Effects of dance movement therapy on selected cardiovascular parameters and estimated maximum oxygen consumption in hypertensive patients.

BACKGROUND: Objective:Arterial hypertension is a medical condition associated with increased risks of of death, cardiovascular mortality and cardiovascular morbidity including stroke, coronary heart disease, atrial fibrillation and renal insufficiency. Regular physical exercise is considered to be an important part of the non-pharmacologictreatment of hypertension. OBJECTIVE: The purpose of this study was to investigate the effects of dance movement therapy (DMT) on selected cardiovascular parameters and estimated maximum oxygen consumption in hypertensive patients. METHODS: Fifty (50) subjects with hypertension participated in the study. They were randomly assigned to 2 equal groups; A (DMT group) and B (Control group). Group A carried out dance movement therapy 2 times a week for 4 weeks while group B underwent some educational sessions 2 times a week for the same duration. All the subjects were on anti-hypertensive drugs. 38 subjects completed the study with the DMTgroup having a total of 23 subjects (10 males and 13 females) and the control group 15 subjects (6 males and 9 females). Descriptive statistics of mean, standard deviation and inferential statistics of paired and independentt-testwere used for data analysis. RESULTS: Following four weeks of dance movement therapy, paired t-test analysis showed that there was a statistically significant difference in the Resting systolic blood pressure (RSBP) (p < 0.001*), Resting diastolic blood pressure (RDBP) (p < 0.001*), Resting heart rate (RHR) (p = 0.024*), Maximum heart rate (MHR) (p=0.002*) and Estimated oxygen consumption (VO2max) (p = 0.023*) in subjects in group A (p < 0.05) while there was no significant difference observed in outcome variables of subjects in group B (p > 0.05). Independent t-test analysis between the differences in the pre and post intervention scores of groups A and B also showed statistically significant differences in all the outcome variables (p <0.05). CONCLUSION: DMT was effective in improving cardiovascular parameters and estimated maximum oxygen consumption in hypertensive patients.

Incidence and characteristics of injuries during the 2011 West Africa Football Union (WAFU) Nations' Cup.

BACKGROUND: Prospective studies on football injuries and their risk factors in the African setting are sparse. Such studies are needed to understand the peculiarities of injuries and hence proffer appropriate intervention for injury prevention in the region. OBJECTIVE: To evaluate the incidence and characteristics of match injuries during the 2011 West Africa Football Union (WAFU) cup. METHODS: Team physiotherapists from the participating teams documented all newly incurred injuries on standardised injury report forms using the Federation of International Football Association's (FIFA) Medical Assessment and Research Centre protocols. RESULTS: An overall of 89 injuries were sustained during the tournament, resulting in 9.9 injuries per match or 289 injuries per 1000 player hours. Seventeen (19.1%) of these injuries resulted in loss of competition activity (time-loss), equivalent to 1.9 injuries per match or 55.2 injuries per 1000 player hours. Over three quarters (73; 82%) of injuries were incurred through contact with another player. The lower leg accounted for almost a quarter of all injuries (21; 23.6%) while the knee recorded the highest number of time-loss injuries (5; 29.4%). The most frequent types of injury were contusion (61; 68.5%) and strain (13; 14.6%). CONCLUSION: The overall incidence of injuries during the WAFU cup was much higher than those of other tournaments ever documented but the characteristics of injuries were similar. In order to fully define the nature of injuries and more reliably identify the risk of injury for the establishment of injury prevention strategies that will be appropriate for this region of the world, it is imperative that further systematic injury recording and analysis in African players are carried out.

Physiotherapy in the management of total knee arthroplasty: a review.

BACKGROUND: Although total knee arthroplasty (TKA) is considered the treatment of choice for patients with intractable pain and substantial functional disabilities who have not had acceptable relief and functional improvement after conservative treatment. It was found out that patients with total knee arthroplasty need physiotherapy intervention for pre-operative and post-operative management. OBJECTIVES: To take a critical look at the importance of TKA following destruction of the knee joint, its indications and contraindications and to ascertain the current trend involved in the physiotherapy management of TKA. METHODS: The current literature materials on physiotherapy management of TKA was reviewed. RESULTS: The aim of treatment is to maximize functionality and independence and to minimize complication such as deep vein thrombosis and pulmonary embolism by relieving pain using cryotherapy, improving range of motion with mobilization techniques, muscle strengthening, therapeutic exercise, transfer training, gait training and training of activities of daily living. These are administered as home programme or in organized groups led by a physiotherapist and has been shown to improve outcome related to physical activity after knee joint arthroplasty. CONCLUSION: It was concluded that interventions, including physiotherapy and functional exercises after discharge, is still beneficial after TKA.

Relationship between selected anthropometric variables and prevalence of flatfoot among urban and rural school children in south west Nigeria.

BACKGROUND: Flat foot is a common reason for attendance at children's orthopaedic clinics. Its prevalence which varies from one population to the other has been reported to be influenced by various factors. OBJECTIVE: This study investigated the effect of nutritional status as indicated by factors such as height, weight and BMI on the prevalence of flatfoot in school age children in urban and rural areas in south-western Nigeria. MATERIALS AND METHODS: This study involved 560 children with age range 6 to 12 years. They were divided into two groups; rural and urban. The demographic and anthropometric data of all the subjects was taken. Each subject's static footprint was taken on a white duplicating paper after which the instep was measured and the footprint classified into high arch, normal, flat or severe flat. The body mass index and nutritional status of each subject was calculated from the anthropometric data. Epi Info statistical package programme version 3.5.1 (2008) was used to analyse the data. RESULTS: There was a statistically significant (p < 0.05) prevalence of flatfoot between the rural dwelling (18.2%) and the urban dwelling (32.9%) children. Anthropometric measurements were significantly higher in urban than in rural children. Nutritional status of urban children was also significantly higher than that of the rural children. CONCLUSION: Flatfoot is more prevalent in school age children in urban area than in the rural area; age and body mass index being the primary predictors for flatfoot.

Physical activity level, nutritional intake, functional status and quality of life of geriatric individuals in Lagos, South-West, Nigeria: a cross sectional survey.

BACKGROUND: Participation in physical activity (PA) and healthy nutrition are important factors that affects muscle and bone strength and the resultant functioning in the activities of daily living (ADL) skills including the overall quality of life (QoL) of geriatric individuals. However, the relationships between all these parameters are yet to be fully documented and studies from developing countries are lacking. OBJECTIVE: This study was designed to investigate the relationships between PA level, frequency of nutritional intake of food rich in calcium, magnesium, phosphorus, vitamin D and the basic ADL, instrumental ADL and QoL of geriatric individuals in Lagos, Nigeria. METHODS: A cross-sectional study involving 394 geriatric individuals. A combination of standardized questionnaires which assessed the socio-demographic parameters, PA level, frequency of intake of food rich in calcium, magnesium, phosphorus, vitamin D, ADL skills, and QoL of the geriatric individuals was used. Data was analyzed using descriptive statistics and Pearson's chi-square. RESULTS: The highest proportion (35.5%) of participating geriatric individuals was at the active PA level. PA level was statistically associated with QoL, basic and instrumental ADL, (X2 = 199.57, p = 0.001; X2 = 87.07, p = 0.000; and X2 = 164.53, p = 0.001 respectively). There was also an association between frequency of intake of food rich in calcium, magnesium, phosphorus, vitamin D and the basic ADL (X2 = 97.43, p = 0.001), instrumental ADL (X2 = 151.56, p = 0.001) and QoL (X2 = 250.21, p = 0.001) of the studied geriatric individuals. CONCLUSION: The study demonstrated that an increase in PA level and regular intake of food rich in calcium, magnesium, phosphorus, vitamin D were associated with optimal functional status and better QoL in geriatric individuals. Educational programmes on the importance of participation in regular PA and healthy nutrition are imperative and recommended for geriatric individuals.

Prevalence of hallux valgus among youth population in Lagos, Nigeria.

AIMS AND OBJECTIVE: This study was aimed at evaluating the prevalence of Hallux Valgus (HV) and related foot problems among the youth population in Lagos, Nigeria. SUBJECTS AND METHODS: A structured questionnaire was administered to 1, 200 subjects from 10 secondary schools and undergraduate students of the College of Medicine University of Lagos, Lagos, Nigeria. The participants were requested to provide information on demographic data, severity of HV, and the functional limitation imposed on the participants by HV. Nine hundred and seventy (970) of the 979 returned questionnaires were analyzed using descriptive statistics. RESULTS: The prevalence of HV in this study was 15.4% of which 43.6% and 56.4% were male and female respectively. 36 (3.7%) out of total number of participants had bilateral HV (both feet), 57 (5.9%) and 56 (5.8%) had HV on left and right foot only respectively. Eighty four (25.2%) of the 333 (34.3%) subjects that complained of pain at the first metatarsophalangeal joint had HV. Inability to stand for long periods due to pain at the first metatarsophalangeal joint was reported by 90 (9.3%) participants, while 136 (14.0%) reported inability to walk long distances. CONCLUSION: Prevalence of HV among youths in Lagos, Nigeria is low. HV is more common among females and its prevalence increases with age. More attention should be focused on foot pain and deformities. Preventive measures and education on the HV deformity is advocated.

Intrasound therapy in tendon healing: is intensity a factor?

OBJECTIVE: This study investigated the effects of low- and high-intensity intrasound therapy (LITR and HITR, respectively) given once daily and twice daily on the morphology and oxidative stress in healing tendon tissue following an acute injury. METHODS: Eighty-five male rats, randomized into six groups were further subdivided into groups A, B, and C, except for Group 1 which was subdivided into A and B only. Groups 2-6 underwent an induced crush injury. The six groups were allocated to: serve as controls (Group 1), receive no treatment (Group 2), HITR twice daily (Group 3), HITR once daily (Group 4), LITR twice daily (Group 5), and LITR once daily (Group 6). Intrasound therapy (ITR) was commenced 24 hours postinjury and was given once daily or twice daily over the first 14 days postinjury. The animals in subgroups A and B were sacrificed on day 15 postinjury, and those in subgroup C were sacrificed on day 31 postinjury. The tendons were excised, and processed for histology and malondialdehyde (MDA) assay. RESULTS: There was no significant difference in the tenocyte population between the HITR- and LITR-treated groups. However, twice-daily treatment in either the low- or high-intensity mode resulted in significant tenocyte proliferation compared with the once-daily treated groups, and also had the highest percentage of tenoblasts compared with the population of tenocytes in the proliferative phase of healing. All treatment protocols marginally lowered the MDA level. CONCLUSION: The role of IRT in tendon healing is influenced more by the frequency of treatment rather than the intensity of the delivered dosage.

The effects of varied intensities of intrasound therapy with indomethacin on the morphology of the healing tendon.

BACKGROUND: Patients undergoing intrasound therapy are often concurrently on NSAIDs. The effect of varied intensities of intrasound therapy with NSAIDs on tendon healing is yet to be determined. OBJECTIVE: The study investigated the effects of a concurrent admistration of low and high intensity intrasound therapy (LIRT&HIRT) with indomethacin (Indocid) on the morphology of the tendon in the early stage of healing. METHODS: Thirty five male rats were divided randomly into seven groups; groups 2-6 underwent an induced crush injury. Group 1, nil injury and nil treatment. Group 2: injury but nil treatment. Group 3: Indomethacin only. Group 4: LIRT only, Group 5: Indocidand LIRT, Group 6: HIRT, Group 7: Indocid and HIRT. Intrasound therapy (IRT) commenced 24 hours post-injury and was given alternate days for the first 10 days post injury. Indocid was given at a dosage of 0.4 mg/kg body weight daily. On the 11 day post injury, the animals were sacrificed and the tendons excised and processed for histological study. RESULTS: Indocid significantly (p < 0.05) reduced the tenocyte population when combined with LIRT but marginally increased it when combined with HIRT (p > 0.05). There was significant difference in the tenocyte population between the combined Indocid and LIRT and the combined Indocid and HIRT groups (p < 0.05). CONCLUSION: High intensity intrasound given concurrently with oral indomethacin resulted in tenoblast proliferation and promoted healing in the injured tendon.

The Effects of Varied Intensities of Intrasound Therapy with Indomethacin on the Morphology of the Healing Tendon

BACKGROUND: Patients undergoing intrasound therapy are often concurrently on NSAIDs. The effect of varied intensities of intrasound therapy with NSAIDs on tendon healing is yet to be determined. OBJECTIVE: The study investigated the effects of a concurrent admistration of low and high intensity intrasound therapy (LIRTetHIRT) with indomethacin (Indocid) on the morphology of the tendon in the early stage of healing. METHODS: Thirty five male rats were divided randomly into seven groups; groups 2-6 underwent an induced crush injury. Group 1; nil injury and nil treatment. Group 2: injury but nil treatment. Group 3: Indomethacin only. Group 4: LIRT only; Group 5: Indocidand LIRT; Group 6: HIRT; Group 7: Indocid and HIRT. Intrasound therapy (IRT) commenced 24 hours post-injury and was given alternate days for the first 10 days post injury. Indocid was given at a dosage of 0.4 mg/kg body weight daily. On the 11 day post injury; the animals were sacrificed and the tendons excised and processed for histological study. RESULTS: Indocid significantly (p 0.05) reduced the tenocyte population when combined with LIRT but marginally increased it when combined with HIRT (p 0.05). There was significant difference in the tenocyte population between the combined Indocid and LIRT and the combined Indocid and HIRT groups (p 0.05). CONCLUSION: High intensity intrasound given concurrently with oral indomethacin resulted in tenoblast proliferation and promoted healing in the injured tendon

Risk factors of post-stroke depression among stroke survivors in Lagos, Nigeria.

OBJECTIVE: Stroke is an important neurological problem and a leading cause of death in clinical practice. Among survivors, over half have significant disabilities; and/ or psychiatric complications most especially Post-stroke depression (PSD). The study aimed to establish prevalence and risk factors for post stroke depression. METHOD: A prospective study carried out among selected stroke survivors in Lagos University Teaching Hospital (LUTH). Subjects included those who satisfied the WHO definition of stroke. The necessary socio-demographic data was obtained from each subject; the Depression Anxiety Stress Scale-21 (DASS-21) and Modified Motor Assessment Scale (MMAS) were administered. Risk factors of PSD studied were gender, laterality of stroke, post stroke functional impairment and post stroke duration before clinical presentation. RESULTS: A total of 51 stroke survivors were studied, made up of 31 (60.8%) males and 20 (39.2% ) females. The mean age was 52.5+/-5.9 years; and age range of 40-64 years. From assessment with the depression subscale of DASS-21, 38 (74.5% ) of the subjects were normal and the rest 13 (25.5% ) had depression. Risk factors found to be statistically significant for PSD in the study included: gender (X(2)=10.3 at p=0.001) and stroke laterality ( X (2)=6.1 at p = 0.013). However, there were no statistically significant differences for mean post-stroke duration before clinical presentation and PSD ( "t" =3.5 and p= 0.073) ; and post-stroke disability as shown by mean MMAS scores and PSD ( "t" =7.6 and p= 0.084). CONCLUSION: Depression was found to be an important complication among stroke survivors in our study. Important risk factors found for PSD included gender and laterality. The findings emphasized a need for appropriate health facilities and for stroke survivors to present early for treatment to attenuate stroke complications.

Factors contributing to possession of walking aids among persons with osteoarthritis of the knee.

OBJECTIVES: To investigate the possession and use of walking aids among patients with knee osteoarthritis (OA), and to identify factors contributing to possession and actual use of these aids METHODS: A random sample of 90 patients with OA was derived from a database of 3,500 registered patients. A total of 80 (88.8%) patients with OA completed a questionnaire on possession and use of walking aids. Demographics, disease-related characteristics, and information about possession and use were assessed. Logistic regression analyses were used to determine which factors are associated with the possession and use of walking aids. RESULTS: Sixty (75%) of the OA patients owned a walking aid. Canes, forearm crutches and walkers were most frequently possessed. Age, frequency of pain, and disability were associated with possessing a walking aid. Of the sixty patients that possess walking aid 25 (41.7%) of them are active walking aid users while the remaining 58.3% are non users. Factors associated with the actual use of an aid included higher age, a high intensity of pain, more disability, decrease in morning stiffness by the aid, and a positive evaluation of the aid CONCLUSION: More than half of the patients with OA possess a walking aid. Disability, pain, and age-related impairments seem to determine the need for a walking aid. Nonuse is associated with less need, negative outcome, and negative evaluation of the walking

Characteristics of back pain among commercial drivers and motorcyclists in Lagos, Nigeria.

BACKGROUND: Studies have shown that there is a relationship between back pain and long hours of driving among commercial motor drivers (CMDs). It has also been reported that a high number of CMDs suffer from low back pain (LBP) with loss of working hours. However, little is known about the prevalence of back pain among the motorcyclists particularly the commercial motorcyclists (CMCs). OBJECTIVE: To determine and compare the prevalence of back pain among CMDs and CMCs in Lagos state. METHODS: A structured questionnaire was administered to 400 each of CMDs and CMCs. The questionnaire contained four sections of30 items. The respondents were requested to provide information on age, sex, working hour/day, associated back pain and location, pain severity and knowledge of preventive measures. Five hundred and ninety nine returned copies of the questionnaire were analyzed using descriptive statistics. RESULTS: The prevalence of back pain was 193 (64.5%) and 180 (60%) among the CMDs and CMCs respectively. One hundred and seventy eight (59.3%) and 129 (43%) of those who reported back pain among the CMDs and CMCs, complained of LBP. The occurrence of upper back/neck pain was higher in the CMCs {41 (13.7%)} than the CMDs {5 (1.7%)}. Very few respondents {21 (7%) CMDs, and 4 (1.3%) CMCs} were aware of backpain preventive measures and none of the CMCs had formal ergonomics instructions at workplace. CONCLUSION: Back pain was a common phenomenon among CMDs and CMCs; while LBP was more prevalent among CMDs, upper back/neck pain was more prevalent among CMCs. Practically, the result of this study can help in preventing occupational injury associated with driving/riding with emphases on good sitting posture.

Comparison of electrical stimulation and conventional physiotherapy in functional rehabilitation in Erb's palsy.

BACKGROUND AND PURPOSE: Erb's Duchenne paralysis constitutes the single commonest form of brachial plexus injury. Treatment intervention is mainly by physical therapy and surgery. Popular or conventional physiotherapy approaches include exercise therapy, tactile stimulation, soft tissue manipulation techniques and functional splinting. The role of electrical stimulation has been reported in literature but not without differing opinions on its efficacy in early resolution of infantile Erbs palsy. OBJECTIVES: The purpose of this study is to compare the effects of electrical stimulation and conventional physiotherapy in the early resolution of function in infantile brachial plexus lesion. METHODS: Sixteen subjects who were diagnosed to have Erb's palsy were assigned randomly into two groups; A (n = 8) and B (n = 8). While group A was treated with electrical stimulation, group B had conventional physiotherapy treatment. Both groups were seen three times weekly and the study lasted 6 weeks. Four functional variables measured include (a) Shoulder Abduction, (b) Elbow flexion, (c) Wrist extension and (d) Arm circumference (6cm distal to the acromion process). These were evaluated at the baseline (pre-study), 3 weeks into the study and 6 weeks (end of study) periods. RESULTS: Functional variables did not differ significantly among the groups at the baseline (p > 0.05), shoulder range of motion showed significantly higher increase in group A. At the end of the 6-week intervention, statistically significant differences, with higher increase in group A than group B, were found in all the variables. CONCLUSION: The outcome of this study suggests that functional electrical stimulation may be preferred to conventional approach in the course of rehabilitation for an early resolution of function in Erbs paralysis.

Comparison of the therapeutic efficacy of phonophoresis and iontophoresis using dexamethasone sodium phosphate in the management of patients with knee osteoarthritis.

BACKGROUND AND OBJECTIVE: Many treatment options, including non-pharmacological and pharmacological measures, have been recommended in the management of osteoarthritis (OA). Among the non-pharmacological approach is physiotherapy, which involves the use of physical modalities like, heat therapy, exercise therapy, electrical stimulation, therapeutic ultrasound, iontophoresis, and phonophoresis. This study was therefore designed to compare the effectiveness of 0.4% Dexamethasone sodium phosphate (DEX-P) phonophoresis (PH) with 0.4% DEX-P iontophoresis (ION) therapy in the management of patients with knee joint OA. METHODS: Fifty patients (19 males and 31 females) with a mean age of 53.6 +/- 8.9 years were randomly assigned to PH or ION groups with 25 patients in each group. Ultrasound waves of 1 MHz frequency was applied for 5 minutes to the target knee, so also was the direct current for 10 minutes for 10 sessions treatment period. Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores, 20 meters ambulatory time, and knee range of motion (ROM) were evaluated before and after therapy as the outcome measures. RESULTS: At the end of two weeks, significant improvement in total WOMAC scores was observed in 15 (60%) and 16 (64%) patients in the PH and ION groups respectively, indicating no significant difference in the improvement rate. Twenty (20) metres ambulatory time and knee range of motion also improved significantly in both groups, yet these variables showed no significant difference between the two groups. CONCLUSION: Both therapeutic modalities were found to be effective and generally well tolerated after 10 treatment sessions. DEX-P phonophoresis was not superior to DEX-P iontophoresis in the treatment of patients with OA of the knee.

The Effects of Lateral Wedge Insole in the Management of Patients with Varus Osteoarthritis of the Knee

Although insufficient evidence supports the application of lateral wedge insole (LWI) as a non-operative treatment for medial/varus osteoarthritis of the knee joint; objective evaluation of its effects on pain; stiffness and functional disability is limited. The purpose of the study therefore was to determine the effect of LWI on the functional disability and symptoms resulting from the medial/varus osteoarthritis of the knee.Fifty (50) out of 76 patients referred for physiotherapy with diagnosis of varus osteoarthritis of the knee joint participated in this study. The 50 subjects were randomly assigned into 2 groups of 25 patients each. Group A (Experimental); were treated with thermal therapy; massage and LWI. Group B (Control); were treated with thermal therapy and massage only. The outcome measures included knee pain; knee stiffness and functional disability. These parameters were statistically analysed pre and post treatment.Results established a significant difference (p0.05) post treatment between the 2 groups for the outcome measures except knee stiffness. It can be inferred from the results that the therapeutic reduction in pain intensity and enhanced physical activities in group A compared with group B was induced by the LWI.These results provide some insight into the functional effects of the LWI on pain; knee stiffness and functional disability of patients with medial osteoarthritis of the knee. This makes the LWI a useful treatment modality in the management of varus osteoarthritis/varum gonarthrosis

Effects of different cervical traction weights on neck pain and mobility.

AIMS AND OBJECTIVES: This study investigated the effects of 3 different traction weights on neck pain and range of motion/mobility. MATERIALS AND METHODS: Ninety subjects, 42 men and 48 women, with neck pain due to cervical spondylosis participated in the study. They were assigned into three groups, each of which was subjected to a different cervical traction(CT) weight namely: group A = 7.5% total body weight(TBW), group B = 10%TBW, and group C =15%TBW CT respectively. Pain intensity and neck mobility, pre-treatment and post-treatment, were assessed using visual analogue scale(VAS) and universal goniometer respectively. RESULTS: There was no significant difference(p < 0.05) pre-treatment, but existed post-treatment (p < 0.05) between the groups for neck pain and mobility. Nineteen subjects had reactions due to the CT application: 3,5 and 11 in groups A,B and C respectively. The least reactions were recorded with the use of 7.5% TBW traction and the highest with the 15% TBW traction. The 10%TBW CT recorded the most significant pain relief and neck flexibility/mobility compared with the 7.5% TBW and 15% TBW CT therapy. CONCLUSION: This study established the 10% TBW CT as the ideal weight with minimal side effects and with highest therapeutic efficacy. Therefore clinicians could adopt this weight in managing neck disorders requiring traction.

Effect of cervical traction on cardiovascular and selected ECG variables of cervical spondylosis patients using various weights.

BACKGROUND: There is currently no consensus among the clinicians regarding the tractive force to be employed during cervical traction (CT) that will correlate precisely with the percentage body weight of the patient and reduce the side effects associated with CT therapy. OBJECTIVE: This study therefore aimed to investigate the response of cervical spondylosis (CS) patients to different CT weights and to establish the effect of CT on the cardiovascular system of patients with cervical spondylosis (CS). METHODS: Sixty out of 78 subjects participated in the study. They were randomly assigned into three experimental groups A, B and C. Their systolic and diastolic blood pressures (SBP and DBP) and heart rates (HR) were measured. Rate pressure product (RPP) was calculated using standard equation18 and ECG recorded using the KENZ, 201 machine. Subjects' cardiovascular and ECG responses were monitored in a supine resting position (baseline) and under three experimental conditions using the subjects' 7.5% kg total body weights (TBW), 10% kg TBW and 15% TBW at different time intervals (5, 10 and 15 minutes respectively). RESULTS: Compared with the baseline values, there was a drop in SBP, DBP and RPP for all subjects in the three groups. The SBP, DBP and RPP alteration were not significant for the 7.5% TBW CT, but significant (p <0.05) for the 10% and 15% TBW tractions. The HR and ECG variables revealed no significant difference in all the groups, these results signified that the cardiac muscles were not adversely affected by any of the traction weights during application. Twenty subjects had side-effects including 5 subjects that terminated the treatment due to pain during the CT application. CONCLUSIONS: Cardiovascular alterations do occur during the application of cervical traction weights resulting in untoward patient's reactions. Efforts should be made to monitor the cardiovascular variables during and immediately after CT especially in "high risk" patients, that is, elderly patients and patients with unstable cardiovascular systems.