Effect of Contractubex phonophoresis on postsurgical scar of carpal tunnel release: A case report.

Key Clinical Message: Contractubex phonophoresis can be used in clinical setting to manage postsurgical scar after carpal tunnel release. Contractubex phonophoresis can improve pliability, height, and tenderness of the scar. Abstract: Scar is one of the most common complications after open release of carpal tunnel. Scars are mentally and physically disturbing, and they can result into itching and pain. Scar after release of carpal tunnel can lead to compression of median nerve and failure of surgery. Various treatments are suggested for scar management. topical drugs are one of these treatments. Phonophoresis of topical drugs can enhance delivery of topical drugs. In present case, author report the effect of phonophoresis of Contractubex on postsurgical scar after carpal tunnel release. Result indicated that phonophoresis of Contractubex can be effective in scar management.

The Efficacy of Trunk Bracing With an Instrumented Corrective Exercise on Spinal Deformity, Pulmonary Function, Trunk Muscle Endurance, and Quality of Life in Adolescent Idiopathic Scoliosis: Protocol for a Parallel Groups Clinical Study.

BACKGROUND: Adolescent idiopathic scoliosis is a 3D spine distortion with an unidentified etiology. It results in noticeable trunk deformity, decreased muscle strength and endurance at the trunk, changes in chest volume, breathing issues, and ultimately a decline in the quality of life. Trunk bracing and corrective exercises make up most of the treatment of patients with scoliosis when their deformity is between 20° and 45°, and they have not yet attained skeletal maturity. Evidence suggests that spinal deformity in people with scoliosis may result from improper motor control. Automatic response training is an exercise therapy technique that can modify the pattern of trunk muscle control for supporting the spinal column in normal alignment. An apparatus called a cantilever device is required for this type of exercise, which facilitates training at home. In spite of research showing the benefit of braces and therapeutic exercise in adolescents with scoliosis, less emphasis has been given to the impact of home-based training, especially when this intervention is paired with braces. OBJECTIVE: We aim to compare the efficacy of bracing and a conventional exercise program to a combination treatment that includes trunk bracing and exercises with a cantilever device performed at home on the degree of spine curvature, pulmonary function, trunk muscular endurance, and quality of life. METHODS: This study was a 2-arms parallel-group clinical study. A total of 16 adolescents with idiopathic scoliosis and single lumbar and thoracolumbar curves of 20°-45° were recruited and randomly assigned into 2 groups. Group A received a combination of trunk bracing and exercise using an instrument known as a "cantilever." Group B (controls) received trunk bracing and a conventional exercise program (without a tool). The study outcomes were the Cobb angle of the scoliotic curve, pulmonary function, the endurance of the trunk muscles, and quality of life. The study outcomes were measured at 2 time points: before the intervention (T1) and 12 weeks following the start of the intervention (T2; at this time, the intervention period has been completed). Multivariate analysis of variance was used to test between- and within-group differences. RESULTS: Recruitment for this study began in fall 2022 and is expected to be completed by the end of summer 2023. CONCLUSIONS: We studied the efficacy of a combined trunk bracing program and postural response exercises using a cantilever device in treating adolescent idiopathic scoliosis and compared it with trunk bracing and conventional home exercises. Exercises performed at home using a cantilever device are anticipated to raise the endurance of trunk muscles, which will help reduce trunk deformity, enhance pulmonary function, and improve the quality of life of participants. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20220330054371N1; https://www.irct.ir/trial/62811. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/43265.

Ultrasound echo intensity of cervical muscles in women with and without forward head posture.

Objective: Forward head posture (FHP) is a common abnormal posture in neck disorders. FHP causes an alteration of the strength in the cervical muscles. Since both muscle quantity and quality impress the muscle strength, this study aimed to compare the echo intensity of cervical muscles (index of muscle quality) between women with and without FHP.Method: Echo intensity of cervical muscles was measured by Adobe Photoshop software and compared between two groups.Results: The findings of the current study indicate the insignificant difference between two groups regarding the echo intensity of cervical muscles.Conclusion: Evaluation of echo intensity of cervical muscles may expand knowledge about the muscle quality and function.

Comparison of cervical muscle thickness between asymptomatic women with and without forward head posture.

BACKGROUND: Forward head posture (FHP) is a forward positioning of the head relative to the trunk in the sagittal plane. This posture is one of the most prevalent poor postures in patients with head and neck pain. Rehabilitative Ultrasound Imaging (RUSI) is a reliable method to objectively evaluate muscle thickness and function. OBJECTIVE: To compare thickness of cervical muscles that control both head and neck posture between asymptomatic women with and without FHP. METHODS: Seventy asymptomatic women aged between 20 and 40 years, with and without FHP (35 in each group), participated in the study. The thickness of the cervical muscles (rectus capitis posterior - RCP, oblique capitis superior - OCS, semispinalis capitis - SSC, sternocleidomastoid - SCM, and longus coli - LCo) was measured using RUSI and the data was compared between the two groups. RESULTS: The comparison of cervical muscle thickness between women with and without FHP revealed significant difference only with regard to the muscle thickness of the SCM muscle (mean difference: 0.7mm, 95% confidence interval of the difference: 0.14, 1.26mm, p value: 0.014). The thickness of this muscle was greater in women with FHP. CONCLUSION: Tonic contraction of the SCM muscle can lead to greater thickness of this muscle in subjects with FHP.

A new device for measuring isometric force of the craniocervical flexor and extensor muscles and its reliability.

OBJECTIVE: Craniocervical (CC) muscles control posture of the CC area. Muscle imbalance at this area induces musculoskeletal disorders. The purpose of this study was to develop a device for measuring isometric force of CC flexor and extensor muscles and to evaluate its intra-rater reliability. METHOD: Isometric force of CC flexor and extensor muscles was measured in 20 women by one examiner on two days with a custom-made device. The intra-class correlation coefficient (ICC), standard error of measurements (SEM), smallest detectable difference (SDD), and Pearson correlation coefficient were computed. RESULTS: The results of this study revealed that this device had excellent reliability (ICC: 0.98, SEM: 2.29 N, SDD: 6.36 N, Pearson correlation coefficient: 0.97 for CC flexor muscles and ICC: 0.97, SEM: 2.13 N, SDD: 5.91 N, Pearson correlation coefficient: 0.94 for CC extensor muscles). DISCUSSION: This new device can improve knowledge about the CC muscle and efficacy of treatments in patients with poor posture.

Comparison of isometric force of the craniocervical flexor and extensor muscles between women with and without forward head posture.

OBJECTIVE: The stability of the craniocervical (CC) area is provided by CC muscles. Muscle imbalance between forces of these muscles may lead to forward head posture (FHP). FHP is one of the most prevalent abnormal postures in patients with neck pain. The aim of the present study was to compare isometric force of the CC flexor and extensor muscles between women with and without FHP. METHOD: Isometric force of the CC flexor and extensor muscles was measured by a custom-made device and compared between 70 women with and without FHP (35 in each group). RESULTS: No significant difference was observed between the two groups regarding isometric force of the CC flexor and extensor muscles, but the ratio of the isometric force of the CC muscles (flexor to extensor) revealed significant difference between the two groups, and it was greater in the control group compared with that in the FHP group. DISCUSSION: The ratio of isometric force of the CC muscles (flexor to extensor) may be a good indicator for assessment of patients with FHP. This ratio may also be valuable to follow the results of therapeutic intervention for these patients.