RESUMO
Idiopathic adhesive capsulitis is a complex pathology that combines inflammation and tightness of the ligamentous and capsular structures in the shoulder joint. Using methods like mobilization, strengthening exercises, and stretching modalities, physiotherapy is still the mainstay in treating adhesive capsulitis. However, novel treatment modalities are being used in various musculoskeletal conditions. This case study investigates the effectiveness of matrix rhythm therapy (MRT) in treating a 42-year-old female patient with idiopathic adhesive capsulitis by examining the elasticity of the coracohumeral ligament (CHL). The patient received six sessions of MRT over two weeks, in addition to stretching exercises for the CHL and capsular tissues. The modality's effectiveness was recorded using a universal goniometer for measuring the range of motion, the Numeric Pain Rating Scale (NPRS) to measure pain, and elastography to measure CHL thickness. Significant improvement in pain and range of motion was noted. Additionally, ultrasonographic evaluations revealed a substantial reduction in thickness from 1.9 mm to 0.9 mm and in CHL shear ratio from 2.94 to 0.40. MRT has shown a beneficial effect on CHL elasticity, which helped in the case of idiopathic adhesive capsulitis, showing a possibility as a viable technique for addressing deeper tissue involvement in shoulder disorders.
RESUMO
BACKGROUND: Dry needling (DN) is commonly used to treat various neuromuscular syndromes. It is effective in reducing spasticity in stroke and other neurological conditions. The current study explores the immediate effect of ultrasound-guided dry needling on soleus muscle spasticity and thickness in individuals with stroke. METHODS: Approval was obtained from the Institutional Sub-ethics Committee of Dr. D. Y. Patil College of Physiotherapy, Pune. The trial was registered with the Clinical Trials Registry of India. Thirty stroke survivors having soleus muscle spasticity ranging from grade 1 to 4 on the Modified Modified Ashworth Scale (MMAS) were selected. Spasticity was also assessed using the Modified Tardeau Scale (MTS) and H-reflex. Soleus muscle architecture was assessed by using ultrasonography (USG). Participants received a single session of DN for the spastic soleus muscle. Pre and immediate post-DN outcome measures were assessed. RESULTS: Based on USG findings, the thickness of the soleus muscle significantly increased by 2.67 mm (p<0.001) after dry needling treatment. The MMAS showed decreased spasticity by 1.47 (p<0.001) for ankle plantar flexors. A significant reduction of H-reflex values by 1.4 mV (p<0.001) was noted. The MTS also showed a significant increase in the range of ankle motion by 2.7 (p<0.001). All these indicate an immediate reduction of spasticity following DN. CONCLUSION: Based on the findings of the current study, we can conclude that a single session of USG-guided DN has an immediate beneficial effect on reducing soleus muscle spasticity and increased muscle thickness in individuals with stroke.