ABSTRACT
Objetivo: Comparar la eficacia en la disminución del dolor y la discapacidad cervical del tratamiento fisioterapéutico individualizado frente al colectivo en las cervicalgias mecánicas agudas y subagudas. Diseño: Ensayo clínico aleatorizado. Emplazamiento: Área sanitaria del Hospital Universitario Virgen del Rocío, Sevilla. Participantes: Noventa sujetos diagnosticados de cervicalgia mecánica de menos de un mes de evolución distribuidos aleatoriamente en 2 grupos: a) tratamiento individualizado, y b) tratamiento colectivo. Intervención: Se realizaron 15 sesiones de aproximadamente 60 min en ambos grupos. El tratamiento individual consistió en 15 min de termoterapia infrarroja, 17 de masaje, y estiramientos analíticos pasivos de los músculos trapecio y angular de la escápula. El colectivo constó de un programa de movilizaciones activas, contracciones isométricas, autoestiramientos y recomendaciones posturales. Mediciones principales: Al inicio y al final del tratamiento se midió el dolor mediante la escala visual analógica y el algómetro aplicado sobre los músculos trapecio y angular de la escápula, así como la discapacidad cervical mediante el índice de discapacidad cervical. Resultados: Ambos tratamientos se mostraron estadísticamente significativos (p < 0,001) en la mejora de todas las variables. Se observaron diferencias estadísticamente significativas (p < 0,001) para todas ellas a favor del tratamiento individualizado frente al colectivo. Conclusiones: Los pacientes con cervicalgia mecánica en estado agudo o subagudo experimentan una mejora estadísticamente significativa del dolor y de la discapacidad cervical tras recibir ambas modalidades de tratamiento de fisioterapia empleadas en nuestro estudio, mostrándose la modalidad de tratamiento individual más eficaz que la colectiva (AU)
Objective: To compare the efficacy in reducing neck pain and disability in an individualised physiotherapy treatment with group treatment in acute and subacute mechanical neck pain. Design: Randomised clinical trial. Location: Health Area of University Hospital Virgen del Rocío, Seville, Spain. Participants: A total of 90 patients diagnosed with mechanical neck pain of up to one month onset, distributed randomly into two groups: (I) individualised treatment; (II) group treatment. Intervention: The treatment consisted of 15 sessions of about 60 minutes for both groups. Individual treatment consisted of 15 minutes of infrared heat therapy, 17 minutes of massage, and analytical passive stretching of the trapezius muscles and angle of the scapula. The group treatment consisted of a program of active mobilisation, isometric contractions, self-stretching, and postural recommendations. Main measures: Pain was measured at the beginning and end of treatment pain using a Visual Analogue Scale (VAS) and an algometer applied on the trapezius muscles and angle of the scapula, and neck disability using the Neck Disability Index. Results: Both treatments were statistically significant (P < .001) in improving all variables. Statistically significant differences (P < .001) were found for all of them in favour of individualised treatment compared to group treatment. Conclusions: Patients with acute or subacute mechanical neck pain experienced an improvement in pain and neck disability after receiving either of the physiotherapy treatments used in our study, with the individual treatment being more effective than collective (AU)
Subject(s)
Humans , Neck Pain/rehabilitation , Physical Therapy Modalities , Pain Management/methods , Risk Factors , Primary Health Care/methods , Acute Disease , Treatment Outcome , Disability Evaluation , Pain MeasurementABSTRACT
OBJECTIVE: To compare the efficacy in reducing neck pain and disability in an individualised physiotherapy treatment with group treatment in acute and subacute mechanical neck pain. DESIGN: Randomised clinical trial. LOCATION: Health Area of University Hospital Virgen del Rocío, Seville, Spain. PARTICIPANTS: A total of 90 patients diagnosed with mechanical neck pain of up to one month onset, distributed randomly into two groups: (i)individualised treatment; (ii)group treatment. INTERVENTION: The treatment consisted of 15 sessions of about 60minutes for both groups. Individual treatment consisted of 15minutes of infrared heat therapy, 17minutes of massage, and analytical passive stretching of the trapezius muscles and angle of the scapula. The group treatment consisted of a program of active mobilisation, isometric contractions, self-stretching, and postural recommendations. MAIN MEASURES: Pain was measured at the beginning and end of treatment pain using a Visual Analogue Scale (VAS) and an algometer applied on the trapezius muscles and angle of the scapula, and neck disability using the Neck Disability Index. RESULTS: Both treatments were statistically significant (P<.001) in improving all variables. Statistically significant differences (P<.001) were found for all of them in favour of individualised treatment compared to group treatment. CONCLUSIONS: Patients with acute or subacute mechanical neck pain experienced an improvement in pain and neck disability after receiving either of the physiotherapy treatments used in our study, with the individual treatment being more effective than collective.
ABSTRACT
BACKGROUND: Some motor impairments, such as decreased reaction of peroneal muscles, altered kinematics, or poor postural control, have been described in people with functional ankle instability. Evidence shows a possible relationship between fibular nerve impairments and functional ankle instability. OBJECTIVE: To investigate the electrophysiologic excitability of the common fibular nerve, as measured by strength-duration curves, in subjects with functional ankle instability compared with a control group without ankle impairment. DESIGN: A cross-sectional study. SETTING: University Research laboratory. PARTICIPANTS: Fifty subjects with functional ankle instability (35 men, 15 women; ages 24.36 ± 5.01 years) and 63 uninjured control patients (44 men, 19 women; ages 22.67 ± 4.85 years) were recruited by convenience sampling. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Strength-duration curves of the common fibular nerve were made in all participants. Rheobase, chronaxie, Bawen index, accommodation index, galvano-tetanic threshold, and intensity thresholds for different pulse durations were obtained and compared between the 2 groups. RESULTS: Subjects with functional ankle instability show increased values of chronaxie (0.58 ± 0.24 ms versus 0.47 ± 0.16 ms; P = .004), Bawen index (1.53 ± 0.24 versus 1.39 ± 0.21; P = .002), and intensity thresholds for pulse durations ≤2 ms both for rectangular and triangular pulse wave forms. The accommodation index was smaller in subjects with functional ankle instability than controls (3.7 ± 0.72 versus 4.05 ± 0.98; P = .036). The remaining parameters did not show significant differences between groups. CONCLUSIONS: These findings suggest that subjects with functional ankle instability show a decreased excitability in their common fibular nerve when compared with subjects without ankle injuries.
Subject(s)
Peroneal Nerve , Adult , Ankle , Ankle Injuries , Ankle Joint , Cross-Sectional Studies , Female , Humans , Joint Instability , Male , Young AdultABSTRACT
PURPOSE: To estimate the psychometric properties of the Spanish version of the Cumberland Ankle Instability Tool (CAIT-Sv). METHOD: One hundred and seventy-one subjects participated. The psychometric properties tested for CAIT-Sv were internal consistency with Cronbach's α (n = 171) in the first measurement; test-retest reliability using the intraclass correlation coefficient (ICC2,1) (n = 171) in two measurements separated by one week; criterion validity by ICC2,1 between the original CAIT and CAIT-Sv in two measurements separated by two weeks for a subgroup of 54 bilingual subjects; ceiling and floor effects (n = 78 subjects with a history of at least one ankle sprain), and responsiveness using Cohen's d in a subgroup of 25 subjects with a history of at least one ankle sprain and a score ≤24 points on the CAIT-Sv and treated with a rehabilitation program during four weeks. RESULTS: Internal consistency was excellent (Cronbach's α: 0.8-0.84). Test-retest reliability was high (ICC2,1: 0.95). Criterion validity was high (ICC2,1: 0.91; 95% CI: 0.84-0.94; p < 0.001 for dominant ankle). There were no ceiling (9%) and floor (0%) effects. Responsiveness was moderate (Cohen's d: 0.6995; CI: 0.11-1.27). CONCLUSIONS: CAIT-Sv is a reliable instrument with high criterion validity to measure the presence and severity of chronic ankle instability (CAI) in the Spanish population. Implications for Rehabilitation Chronic ankle instability is the most prevalent complication after ankle injuries. CAIT is a widely used tool for clinical detection of subjects with chronic ankle instability (CAI). In this study, CAIT-Sv has shown good phsychometric properties for using with Spanish speaking individuals.
Subject(s)
Ankle Injuries/complications , Cross-Cultural Comparison , Joint Instability/rehabilitation , Severity of Illness Index , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Language , Male , Psychometrics , Reproducibility of Results , Spain , Surveys and Questionnaires , Young AdultABSTRACT
To determine if ultrasound (US) is effective in reducing pain and mobility limitation in the treatment of traumatic cervical sprain, we performed an experimental study. The sample comprised 54 diagnosed subjects with a mean age of 36.54 y (standard deviation = 12.245), assigned by simple random selection to an experimental group with ultrasound treatment and a control group with placebo ultrasound. Treatment consisted of 10 sessions of an ultrasound treatment protocol, followed by 15 sessions of a protocol identical for both groups without ultrasound. The variables assessed were pain and joint mobility. There was no significant difference (p > 0.05) between groups in the first 10 sessions of treatment. However, there was a statistically significant difference (p < 0.05) between groups on the pain variable, 20 days after completion of the US. High-active ultrasound treatment is more effective than placebo in reducing pain.
