Effectiveness of an individualized comprehensive rehabilitation program in women with chronic knee osteoarthritis: a randomized controlled trial.

OBJECTIVE: To evaluate the short- and medium-term effects of an 8-week individualized comprehensive rehabilitation program in women with chronic knee osteoarthritis as regards functionality, physical performance, and perceived health status. METHODS: Women with chronic knee osteoarthritis were randomly assigned to the aquatic training group or to the individualized comprehensive rehabilitation (ICR) group. The main outcomes were functionality assessed with the Western Ontario and McMaster Universities Osteoarthritis Index, physical performance assessed with the Timed Up and Go test and the Stair Climbing Test, and perceived health status evaluated with the European Quality of Life- 5 Dimensions questionnaire. Participants were assessed after the treatment and at 3-month follow-up. RESULTS: Forty participants were included in the study. After the treatment, there were no significant between- group differences. At 3-month follow-up, there were significant between-group differences in functionality (stiffness P = 0.049, function P = 0.005, and total subscores P = 0.048) and physical performance (Timed Up and Go P = 0.031 and Stair Climbing Test P = 0.046) in favor of the ICR group. CONCLUSION: An 8-week ICR program improved functionality, physical performance, and perceived health status compared with an aquatic training program in women with chronic knee osteoarthritis.

Effects of neurodynamic treatment on hamstrings flexibility: A systematic review and meta-analysis.

OBJECTIVE: To provide detailed information on the effectiveness of neurodynamic treatment on hamstrings flexibility. METHODS: Systematic review in the following databases: PubMed, Google Scholar, and ScienceDirect. Articles were included if the intervention followed a neurodynamic treatment and the study was a randomized clinical trial including at least one measurement related to hamstrings flexibility. Articles were independently screened for inclusion and data were extracted by two researchers. It was registered in the PROSPERO database (CRD42015020707). RESULTS: Finally, 6 articles (n = 294 participants) were included. Neurodynamic treatment was compared with no treatment, placebo, and with other manual therapy techniques such as active and passive stretching, muscle inhibition and proprioceptive neuromuscular facilitation. Meta-analysis shows benefits of neurodynamic treatment for knee-extension range of motion (1 trials compared with no intervention, MD = -2.23, 95% CI = -3.02 to -1.44, and 4 trials compared to other techniques, MD = -0.40, 95% CI = -1.09 to 0.29, I2 = 81.55%) and passive straight leg raise test measures (2 trials compared with no intervention, MD = 2.26, 95% CI = 1.78 to 2.74, I2 = 0%, and 3 trials compared with other techniques MD = 2.26, 95% CI = 1.78 to 2.74, I2 = 0%). CONCLUSIONS: This review and meta-analysis shows the effectiveness of neurodynamic treatment on hamstrings flexibility compared with no intervention and other techniques.

Results of an Active Neurodynamic Mobilization Program in Patients With Fibromyalgia Syndrome: A Randomized Controlled Trial.

OBJECTIVE: To examine the effects of an active neurodynamic mobilization program on pain, neurodynamics, perceived health state, and fatigue in patients with fibromyalgia syndrome (FMS). DESIGN: Randomized controlled trial. SETTING: Local fibromyalgia association. PARTICIPANTS: Patients with FMS (N=48). INTERVENTIONS: Patients were randomly allocated to an active neurodynamic mobilization program or a control group. The intervention was performed twice a week. MAIN OUTCOME MEASURES: Pain was assessed with the Brief Pain Inventory and Pain Catastrophizing Scale; neurodynamics were evaluated using neurodynamic tests for upper and lower limbs. The functional state was evaluated with the Health Assessment Questionnaire Disability Index, and perceived fatigue was evaluated with the Fatigue Severity Scale. RESULTS: Significant (P<.05) between-groups differences were found in the values of pain, upper and lower limb neurodynamics, functional state, and fatigue. Also, significant pre- to postintervention within-group differences were found in the intervention group, whereas no significant changes were found in the control group. CONCLUSIONS: A neurodynamic mobilization program is effective in improving pain, neurodynamics, functional status, and fatigue in patients with FMS.