A Comparison Between People With and Without Subacromial Impingement Syndrome and a New Method for Measuring Thoracolumbar Fascia Flexibility.

OBJECTIVE: The purpose of this study was to compare the flexibility of the thoracolumbar fascia (TLF) in individuals with and without subacromial impingement syndrome (SAIS). A secondary purpose was to demonstrate a new method for measuring TLF flexibility. METHODS: A total of 60 participants-30 diagnosed with SAIS and 30 asymptomatic-were included. In both groups, trunk flexibility was assessed by the modified Schober test, TLF flexibility by rotational measurement on a goniometric platform, and shoulder posterior capsule tightness by tape measurement. The data obtained were compared using t tests for independent variables. RESULTS: No statistically significant difference was observed for any parameter between participants with SAIS and healthy controls (P > .05). CONCLUSION: For the participants we studied, the flexibility of the TLF was not associated with SAIS. The goniometric evaluation method used in this study was affordable and feasible. The validity and reliability of this measurement method should be assessed further in future studies.

Comparison of Physiotherapy Approaches in Low Back Pain: A Randomized Controlled Trial.

BACKGROUND: The purpose of this study was to compare the effectiveness of rehabilitation approaches in individuals with low back pain (LBP) on pain, spinal mobility, disability, and muscular strength. METHODS: Ninety volunteers were included and divided into four groups depending on the rehabilitation approach: group 1, soft tissue mobilization techniques and stabilization exercises (n=24; 11 females [F], 13 males [M]); group 2, Kinesio Taping and stabilization exercises (n=24; 12F, 12M); group 3, stabilization exercises (n=22; 11F, 11M); and group 4, reflex therapy and stabilization exercises (n=20; 10F, 10M). Visual Analog Scale for pain intensity, an isokinetic evaluation for strength at 60°/s and a side-plank position test for trunk stabilization were measured before and assessed at the beginning, after a 4-week treatment and during 4 weeks of follow-up. The functional status was evaluated with the Oswestry Disability Index. RESULTS: Individuals in all groups showed similar decrease in pain after the treatment and at 1-month follow-up, but there were no significant differences in pain levels between the groups (P<0.05). CONCLUSION: All therapeutic approaches were found to be effective in diminishing pain and thus helpful in increasing strength and stabilization in patients with LBP.

Comparison of virtual reality exergaming and home exercise programs in patients with subacromial impingement syndrome and scapular dyskinesis: Short term effect.

OBJECTIVE: The aim of this study was to compare the short term effects of home exercise program and virtual reality exergaming in patients with subacromial impingement syndrome (SAIS). METHODS: A total of 30 patients with SAIS were randomized into two groups which are Home Exercise Program (EX Group) (mean age: 40.6 ± 11.7 years) and Virtual Reality Exergaming Program (WII Group) (mean age: 40.33 ± 13.2 years). Subjects were assessed at the first session, at the end of the treatment (6 weeks) and at 1 month follow-up. The groups were assessed and compared with Visual Analogue Scale (based on rest, activity and night pain), Neer and Hawkins Tests, Scapular Retraction Test (SRT), Scapular Assistance Test (SAT), Lateral Scapular Slide Test (LSST) and shoulder disability (Shoulder Pain and Disability Index (SPADI)). RESULTS: Intensity of pain was significantly decreased in both groups with the treatment (p < 0.05). The WII Group had significantly better results for all Neer test, SRT and SAT than the EX Group (p < 0.05). CONCLUSION: Virtual reality exergaming programs with these programs were found more effective than home exercise programs at short term in subjects with SAIS. LEVEL OF EVIDENCE: Level I, Therapeutic study.

Short-term effects of high-intensity laser therapy, manual therapy, and Kinesio taping in patients with subacromial impingement syndrome.

Subacromial impingement syndrome (SAIS) is a major contributing factor of shoulder pain; and treatment approaches (Kinesio® taping [KT], Exercise [EX], manual therapy [MT], and high-intensity laser therapy [HILT]) have been developed to treat the pain. The key objective of this study was to compare the effects of KT, MT, and HILT on the pain, the range of motion (ROM), and the functioning in patients with SAIS. Seventy patients with SAIS were randomly divided into four groups based on the treatment(s) each group received [EX (n = 15), KT + EX (n = 20), MT + KT + EX (n = 16), and MT + KT + HILT + EX (n = 19)]. All the patients were assessed before and at the end of the treatment (15th day). The main outcome assessments included the evaluation of severity of pain by visual analogue scale (VAS) and shoulder flexion, abduction, and external rotation ROM measurements by a universal goniometry. Shoulder pain and disability index (SPADI) was used to measure pain and disability associated with shoulder pathology. Statistically significant differences were found in the treatment results of all parameters in MT + KT + EX and HILT + MT + KT + EX groups (p < 0.05). When the means of ROM and SPADI results of three groups were compared, statistically significant differences were found between all the groups (p < 0.05). These differences were significant especially between the groups MT + KT + EX and KT + EX (p < 0.05) and HILT + MT + KT + EX and KT + EX (p < 0.05). HILT and MT were found to be more effective in minimizing pain and disability and increasing ROM in patients with SAIS. Further studies with follow-up periods are required to determine the advantages of these treatments conclusively.

Scapular resting position, shoulder pain and function in disabled athletes.

BACKGROUND: Despite the fact that the number of disabled individuals participating in sports is increasing, there are only sparse reports in the literature concerning overuse injuries. OBJECTIVES: The purpose of this study was to compare scapular resting position, shoulder pain, and function in wheelchair basketball, amputee soccer, and disabled table tennis players. STUDY DESIGN: Descriptive study. METHODS: A total of 63 disabled players from amputee soccer, wheelchair basketball, and disabled table tennis participated in our study. Scapular resting position was taken as primary outcome; pain and function were taken as secondary outcome measurements. Scapular resting position was evaluated with Lateral Scapular Slide Test. Visual Analog Scale was used for evaluating shoulder pain intensity. Quick disabilities of the arm, shoulder, and hand questionnaire were used to assess upper extremity function. RESULTS: There was a significant difference in shoulder pain, function, and scapular resting position in all groups (p < 0.05). Paired comparisons between amputee soccer and wheelchair basketball players and also amputee soccer and disabled table tennis showed difference for all measurement parameters (p < 0.05). CONCLUSION: When the results are evaluated, it may be stated that amputee soccer players have better scapular resting position than other sports. Crutch usage may not negatively affect scapular resting position and perceived function as much as wheelchair usage. Exercise techniques for shoulder and resting position could be included in training programs of disabled athletes. CLINICAL RELEVANCE: Wheelchair/crutch usage is a risk, and special exercise techniques for shoulder and dyskinesis could be included in training programs to prevent injury. However, it may not just be important for wheelchair athletes, it may also be important for amputee soccer players. In particular, total upper extremity evaluations and exercises could be added within exercise programs.

Complex decongestive therapy and taping for patients with postmastectomy lymphedema: a randomized controlled study.

PURPOSE: The purpose of our study was to investigate the effects of Kinesio Taping(®) Application with Complex Decongestive Therapy (CDT) in patients with lymphedema. MATERIALS AND METHODS: 45 patients were randomly divided into 3 groups (CDT including Bandage, CDT including Bandage + Kinesio Tape(®), CDT including Kinesio Tape(®) without bandage). Assessments included the severity of the symptoms such as pain, discomfort, heaviness, tension, stiffness and weakness. Bilateral circumference measurements were done for evaluation of the edema. RESULTS: Symptoms were decreased in all three groups (p < 0.05). CDT was found effective only during treatment in arm volume (p < 0.05). Kinesio Taping(®) applied with CDT had effect of decreasing edema after 10 days of treatment period (p < 0.05) and for control period (p < 0.05). Only the application of Kinesio Taping(®) group also had significant decrease at edema (p < 0.05). CONCLUSION: Kinesio Taping(®) Application along with CDT may have a better effect on decreasing lymphedema which can stimulate the reduction of edema for long term effects.

Is there a relationship between core stability, balance and strength in amputee soccer players? A pilot study.

BACKGROUND: The body is a kinetic chain and all the systems and muscle groups play important roles in this chain. Core stability, strength and balance are important components of performance within many sports, and in particular soccer. However, the relationship between these components is not fully understood. OBJECTIVES: To investigate the relationship between core stability, balance and strength in amputee soccer players. STUDY DESIGN: Clinical pilot trial. METHODS: Eleven amputee soccer players (mean age = 24.63 ± 6.48 years) participated in our study. A Kinesthetic Ability Trainer device was used to assess balance. Trunk strength was evaluated by isokinetic dynamometer. Gillet test was used to evaluate the sacroiliac joint movement. Modified plank test was used to determined dynamic core stability. Disability was evaluated using the Oswestry Disability Index. RESULTS: The results showed that there was a correlation between flexor isokinetic trunk muscle strength at the velocity of 60°/sec and modified plank test (r = 0.630, p = 0.038). There was a negative correlation between flexor isokinetic trunk muscle strength at the velocity of 180°/sec and Oswestry Disability Index score (r = -0.649, p = 0.031). CONCLUSIONS: Amputee soccer is a sport which is generally performed with one limb balance with crutches. It is therefore perceived that a relationship between balance and sacroiliac mobility, and should be considered for evaluation process and performance analysis in amputee soccer. However, in future studies, we recommend that such evaluations on amputee soccer players should be carried out with increased numbers.