Effect of Transfer Energy Capacitive and Resistive Therapy on Shoulder Pain, Disability, and Range of Motion in Patients With Adhesive Capsulitis: A Study Protocol for a Randomized Controlled Trial.

Objective: We describe a protocol to evaluate the effectiveness of transfer energy capacitive and resistive (TECAR) therapy on shoulder passive range of motion, shoulder pain, and disability index in patients with adhesive capsulitis. Methods: This study will be a double-blinded randomized clinical trial with a 1-month follow-up. For the purpose of this research, 30 patients with a 3-month history of shoulder pain and disability diagnosed as adhesive capsulitis will be selected and then randomized into 2 groups, including conventional physiotherapy consisting of electrophysical modalities and therapeutic exercises, which will be given to the control group. In the intervention group, after conventional physiotherapy, 10 minutes of TECAR therapy in resistive mode will be applied on both the anterior and inferior aspects of the shoulder joint. Outcome measures will be related to shoulder passive range of abduction, flexion, and external rotation that will be measured using a digital inclinometer, as well as shoulder pain and disability index that will be assessed by the validated questionnaire. Assessment will be done at baseline, 1 day after the intervention, and by passing 1 month. Results: The statistical analysis will describe within-group and between-group comparisons; the findings will be illustrated in tables and charts. Conclusion: Given the reason that the effectiveness of TECAR therapy has not been widely evaluated in adhesive capsulitis, the findings of this pilot study would provide baseline information on the effectiveness and complications of this treatment method and possibly propose a more appropriate protocol for patients with adhesive capsulitis.

The effects of passive stretching on the blood glucose levels of patients with type 2 diabetes.

BACKGROUND: Type 2 diabetes is characterized by poor glycemic control due to decreased insulin sensitivity. Physical activity plays an important role in the management of diabetes and reduces blood glucose level. The aim of this study was to evaluate the effectiveness of passive stretching (PS) on the blood glucose level (BGL) of diabetic patients. MATERIALS AND METHODS: In this randomized clinical trial, fifty patients with type 2 diabetes and mean age of 50.7 ±â€¯4.8 years were randomly and equally allocated into control and intervention groups. Patients in the intervention and control groups underwent 20 min of passive stretching (PS) and passive movement (PM), respectively. BGL was measured before and immediately after, 20 min after and 1 h after PS/PM in the two study groups. BGL at the mentioned times was compared between and within the groups. RESULTS: The findings showed that when compared with before the PS (195.7 ±â€¯30.1), BGL significantly reduced (p < 0.001) immediately after (178.9 ±â€¯29.7), 20 min after (183.2 ±â€¯29.1), and 1 h after (187.8 ±â€¯29.6) the PS. However, BGL after PM (immediately, 20 min and 1 h after PM) did not significantly change (p > 0.05). CONCLUSION: The findings of this study indicated that PS has a significant effect on the reduction of the immediate BGL in type 2 diabetic patients. The trend reduced even though the effect remained for 1 h after PS. It is therefore suggested that the effectiveness of these types of activities should be evaluated over a longer duration of study.

Determining the effect of laser acupuncture in treating stutterers in comparison with speech therapy.

BACKGROUND: Investigation of strategies and methods of therapy in stutterers regarding to its characteristics, length of treatment, and relapse of stuttering is very important. Acupuncture has been introduced as a therapeutic method for the treatment of stuttering. The aim of the present research was the identification of the results of intervention of laser acupuncture in comparison with speech therapy in stutterers. MATERIALS AND METHODS: This clinical - trial and case control research was conducted on 20 stutterers and 20 non-stutterers. In the present study, speech therapy and laser acupuncture were used on 10 persons who had developmental stuttering from childhood. RESULTS: The results were compared with the data of speech therapy and placebo laser in 10 control subjects. All of the subjects were followed up for 12 weeks after the intervention. The obtained data showed that accompanying of speech therapy with laser acupuncture resulted the increasing of maintenance and therapeutic effects of stuttering treatment and decreasing of relapsing. The speech rate and percent of stuttered words before and after the intervention in both groups (A and B) were decreased. Following the results after 12 weeks showed that the results were stable in laser group more than the other group and there was a significant difference between the two groups. CONCLUSION: The results of the present study showed that using of laser acupuncture therapy accompanying by speech therapy has many effects on the treatment of stuttering and prevents the relapsing of stuttering that is very common.

Transdermal iontophoretic delivery of celecoxib from gel formulation.

Celecoxib is used in the treatment of osteoarthritis, rheumatoid arthritis, acute pain, joint inflammation and sport injuries. Long term administration of the drug results in such complications as gastrointestinaland renal disturbances and cardio-vascular complications. The main objective of the present study was to investigate the feasibility of delivering celecoxib incorporated in gel formulations by iontophoresis. Sodium alginate, sodium carboxymethyl cellulose, hydroxypropyl methylcellulose (HPMC) and carbopol 934P were used to develop topical gel formulations of celecoxib. The gel formulations were evaluated for macroscopic and microscopic properties, pH determination, spreadability, rheological behaviour, and drug release characteristics both in vitro and ex vivo. Drug release was evaluated in the presence of iontophoresis field (0.1 to 0.5 mA/cm(2)) or without electrical current (passive diffusion) and celecoxib was measured spectrophotometrically at 252 nm. Most gel formulations showed acceptable physicochemical properties. Amongst formulations, gel formulation containing HPMC K4M which indicated greater performance in drug release behaviour was selected for further in vivo studies. The cumulative percent of drug released in vitro at the end of each experiment was 36%, 63%, and 89.7% for passive diffusion, direct electric current (DC) current density of 0.3 mA/cm(2), and 0.5 mA/cm(2), respectively. The findings of ex vivo drug transport across rat skin also showed a significantly higher release of celecoxib compared to passive flux for both AC and DC currents. A 0.5 mA/cm(2) of DC current increased drug flux to 73% compared to 41.5% of passive diffusion. It can be concluded from the results of this study that the application of iontophoresis enhances the flux of celecoxib, as compared to the passive diffusion.

Comparison of the effect of baclofen and transcutaneous electrical nerve stimulation for the treatment of spasticity in multiple sclerosis.

OBJECTIVE: The aim of this study was to compare the relative efficacy of baclofen and self-applied transcutaneous electrical nerve stimulation (TENS) for the treatment of spasticity in the lower extremities in multiple sclerosis (MS). METHODS: A randomized controlled clinical trial was conducted from September 2010 to June 2011. Fifty-two patients with MS presenting muscle spasm in the leg at 20-50 years of age were randomly allocated to receive a four-week treatment course of either baclofen (10 mg twice daily, increasing over three weeks to 25 mg) or self-applied TENS. Response to treatment was assessed at four weeks after commencement of the intervention by modified Ashworth scale (MAS). RESULTS: Spasticity decreased in both groups. Of the 26 people treated with TENS, the mean (standard deviation (SD)) MAS decreased from 1.77 (0.29) at baseline to 0.73 (0.70) at the four-week follow-up (P < 0.001). Correspondingly, in the 26 people treated with baclofen, the mean (SD) MAS decreased from 1.73 (0.38) to 1.15 (0.63) (P < 0.001). The mean difference in MAS score at the four-week follow-up was significantly lower in the TENS group than the baclofen group (mean difference -0.42; 95% CI, -0.79, -0.05; P < 0.05). DISCUSSION: This study demonstrates that both baclofen and TENS can be effective in reducing MS-related spasticity. The mean MAS score was significantly lower in the TENS group. However given the side-effect profile of baclofen, TENS may have some benefits over baclofen.

The angular profile of the knee in Iranian children: A clinical evaluation.

BACKGROUND: Intercondylar (IC) and intermalleolar (IM) distance measurements are appropriate modalities for screening angular deformities but the values are not the same in all ethnics. This study was conducted to assess the mean values and normal limits of IC and IM distances in Iranian children. METHODS: A total of 2268 children aged eight to eleven years were recruited in this research project. The IC and IM distances were measured and recorded according to a special procedure in standing and supine positions. RESULTS: The mean values of IC distance were 2.4 ± 6.05 and 3.83 ± 8.1 mm in supine and standing positions, respectively, while the corresponding IM distances were 5.63 ± 10.74 and 7.51 ± 11.22 mm. There was no significant difference among the age groups. Moreover, the mean values of these parameters did not differ significantly between two genders. CONCLUSIONS: With respect to reported values, IC and IM measurements, especially when selected according to age, can be used for screening angular deformities of lower limbs.

Sensory complaints of the upper extremities in multiple sclerosis: relative efficacy of nortriptyline and transcutaneous electrical nerve stimulation.

OBJECTIVE: The aim of this study was to evaluate the relative efficacy of nortriptyline and self-applied transcutaneous electrical nerve stimulation (TENS) in the treatment of pain and/or sensory complaints of the upper extremities in people with multiple sclerosis (MS). METHODS: A randomized clinical trial conducted from September 2005 to September 2006. Fifty-nine people with clinically definite MS aged 15 to 50 years were randomly allocated to receive an 8-week treatment course of either nortriptyline (10 mg daily increment over 1 week to 50 mg) or self-applied TENS. Response to treatment was assessed at 2, 4, and 8 weeks after commencement of the intervention. RESULTS: TENS seemed to be equivalent in efficacy to nortriptyline. A significant decrease in visual analog scale scores of pain and/or sensory complaints of the upper extremities occurred in both groups. Of the 29 people treated with TENS, the mean (SD) intensity of pain and/or sensory complaints decreased from 5.3 (1.6) at baseline to 2.8 (1.5) at 8 weeks follow-up (P < 0.001). Correspondingly in the 30 people treated with nortriptyline, the mean (SD) intensity of pain and/or sensory complaints decreased from 4.9 (1.9) to 3.3 (2.1) (P < 0.001). The mean difference in visual analog scale score at 8 weeks follow-up was not significant between the 2 groups (mean difference -0.5; 95% confidence interval, -1.5-0.5). DISCUSSION: This study demonstrates that both nortriptyline and TENS can be effective in reducing the intensity of pain and/or sensory complaints in the upper extremities of people with MS. However given the side-effect profile of nortriptyline, TENS may have some benefits over nortriptyline. This modest reduction in the intensity of pain and/or sensory complaints suggests that physicians should carefully weigh the risk and benefits of nortriptyline and TENS in people with MS with pain and/or sensory complaints.

The effects of laser acupuncture on chronic tension headache--a randomised controlled trial.

OBJECTIVE: Headache affects the quality of life for many people throughout the world. Tension headache is among the commonest forms. Acupuncture is the most widely practised non-medicinal treatment for headaches. The purpose of this study was to explore the effects of laser acupuncture in this type of headache. METHODS: Fifty patients with chronic tension-type headache were randomly allocated to treatment or placebo groups. Patients in the treatment group received low energy laser acupuncture to LU7, LI4, GB14, and GB20 bilaterally. Points were irradiated for 43 seconds, and the intensity was 1.3J (approximately 13J/cm2). Ten sessions were given, three per week. The placebo group was treated in a similar way except that the output power of the equipment was set to zero. The outcome variables were headache intensity (VAS), duration of attacks, and number of days with a headache per month, by daily diary, assessed monthly to three months after treatment. RESULTS: There were significant differences between groups (P<0.001) in changes from baseline in months one, two and three, in median score for headache intensity (treatment group -5, -3 and -2, placebo group -1, 0 and 0), median duration of attacks (treatment group -6, -4 and -4, placebo group -1, 0 and 0 hours), and median number of days with headache per month (treatment group -15, -10 and -8, placebo group -2, 0 and 0). CONCLUSION: This study suggests that laser acupuncture may be an effective treatment for chronic tension-type headache, but the results should be confirmed in larger and more rigorous trials.