Priming Effects of Anodal Transcranial Direct Current Stimulation on the Effects of Conventional Physiotherapy on Balance and Muscle Performance in Athletes With Anterior Cruciate Ligament Injury.

CONTEXT: In athletes, postural control impairment and knee muscle dysfunction are the most common disorders following anterior cruciate ligament (ACL) injury. Because of functional changes in the motor cortex following ACL injury, physiotherapy (PT) is not enough for treatment and using neuromodulators, such as trans-cranial direct current stimulation (tDCS) may be necessary. The present study focused on the effects of anodal tDCS (a-tDCS) over the primary motor cortex (M1) concurrent with PT on postural control and muscular performance in the athletes with ACL injury. DESIGN: In this study, 34 athletes with ACL injury were randomly assigned in 2 groups of intervention group (active M1 a-tDCS concurrent with PT, n = 16) and control group (sham M1 a-tDCS concurrent with PT, n = 16). METHODS: The participants of all groups received 20-minute 2 mA M1 a-tDCS with PT during 10 sessions, while tDCS was turned off after 30 seconds in the sham group. Before, immediately following, and 1 month after the interventions, the center of pressure and the average of power of flexor and extensor muscles at 2 velocities of 30°/s and 60°/s were measured by force plate and isokinetic devices, respectively. RESULTS: One month after treatment, the displacement of center of pressure was decreased in the intervention group (P < .05), while there were no changes in the control group. Y-axis of center of pressure decreased in the intervention group relative to the control group, although average of power of flexor and extensor muscles increased immediately in both groups, but the rise in the intervention group was larger than that in the control group (P < .05). CONCLUSION: The findings indicated that M1 a-tDCS can induce the efficacy of PT, which has a lasting effect on the improvement of the postural control in athletes with ACL injury.

The Effects of Acute and Long-Term Whole-Body Vibration Training on the Postural Control During Cognitive Task in Patients With Chronic Ankle Instability.

CONTEXT: Chronic ankle instability (CAI) is a common problem associated with impaired postural stability. Whole-body vibration (WBV) has been developed to improve muscle function and reportedly improves postural stability. The aim of this study was to evaluate the effect of 12 sessions of WBV on postural control during standing postural task in participants with CAI. DESIGN: A controlled clinical trial study. METHODS: Sixteen participants with CAI and 16 healthy participants aged between 20 and 40 years included in this study. They received WBV (30-Hz frequency, 3 series of four 45-s exercises with a 45-s rest) for a total of 12 sessions, 2 session per week for 6 weeks. Postural control was assessed by center of pressure (COP) parameters, including mean and SD in the anterior-posterior and medial-lateral displacement during single-leg standing. Assessments were done before and immediately after the first session and after the 12th session of WBV, with opened and closed eyes associated with easy and difficult cognitive tasks. RESULTS: The results showed that the SD of COP displacement in the x-axis was significant in eyes opened and SD of COP displacement in the x- and y-axes were significant between groups in the eyes-opened, and eyes-closed conditions (P < .05). Analysis of variance indicated that the effect of WBV training was significant for the mean of COP displacement in the y-axis. Post hoc indicated that the effect of 12 sessions of WBV on the mean of COP displacement was significant in the CAI group (P < .05). However, the acute effect of WBV was not significant on the COP displacement in all axes (P > .05). CONCLUSION: Higher postural sway associated with postural cognitive interactions might be considered in the rehabilitation of CAI. Twelve sessions of WBV might induce some improvement in postural control with the method of WBV used in this study.

Comparison of Ultrasonic Thickness of Masseter Muscle Between Individuals With and Without Severe Forward Head Posture: A Cross-Sectional Study.

OBJECTIVE: In this cross-sectional descriptive-analytical study, we sought to compare the ultrasonic thickness of the masseter muscle in people with severe forward head posture vs people without forward head posture, and to determine sex differences in muscle thickness. METHODS: Thirty-eight volunteers (19 with normal head postures and 19 with severe forward head postures), aged 18 to 35 years, entered the study. The severity of the forward head posture was measured by a plumb line and the craniovertebral angle drawn on the recorded images. Based on the recorded images, the masseter muscle thickness was also measured by a 7.5-MHz linear transducer using an ultrasound device in the seated position with 3 mouth positions (closed, half open, and fully open). RESULTS: The results showed that the head posture affects masseter thickness significantly (P = .01), with masseter thickness significantly lower in the participants without severe forward head postures compared to those with severe forward head postures in the closed, half-open, and fully open mouth positions (P < .05). Comparing the mean masseter thickness across sexes showed that the masseter muscle is significantly thicker in men compared to women (P = .01). CONCLUSION: Head posture and thickness of the masseter muscle are linked, as the masseter muscle was thicker in all 3 positions in the participants with severe forward head postures.

Cognitive Behavioral Therapy With Stabilization Exercises Affects Transverse Abdominis Muscle Thickness in Patients With Chronic Low Back Pain: A Double-Blinded Randomized Trial Study.

OBJECTIVE: Nonspecific chronic low back pain (NCLBP) is a major public health and global socioeconomic burden with a variety of symptoms, such as fear-avoidance behaviors. This study aimed to evaluate the effect of cognitive behavioral therapy (CBT) associated with stabilization exercise (SE) on thickness of transverse abdominis (TrA) muscle in patients with NCLBP. METHODS: Forty patients with NCLBP were randomly assigned into experimental CBT associated with SE (n = 20) and control groups without SE (n = 20). Transverse abdominis muscle thickness was assessed during abdominal drawing in maneuver (ADIM) and active straight leg raise (ASLR) of the right lower limb using ultrasound imaging. Fear-avoidance belief and disability were evaluated using a fear-avoidance belief questionnaire (FABQ) and a Roland-Morris disability questionnaire (RMDQ) before and after intervention. RESULTS: Mixed-model analysis of variance indicated that the effect of time was significant for the right and left TrA contraction thickness during ADIM and left TrA contraction thickness during ASLR (P < .05). However, the experimental group exhibited higher right and left TrA muscle thickness compared with the control group during ADIM (P = .001). Moreover, there were no significant differences between groups in the thickness of TrA muscle during ASLR (P > .05). The effect of time was significant for FABQ (P = .02) and RMDQ (P = .01); however, the effect of group was significant for the FABQ after intervention (P = .04). CONCLUSIONS: Stabilization exercise associated with CBT is more effective than SE alone in improving fear avoidance belief and in increasing the thickness of the TrA muscle during ADIM task.

Effect of Chronic Low Back Pain on Lumbar Spine Lordosis During Sit-to-Stand and Stand-to-Sit.

OBJECTIVE: This study aimed to evaluate lumbar lordosis during sit-to-stand (STS) and stand-to-sit (SIT) in individuals with and without chronic nonspecific low back pain (CNLBP). The second objective was to investigate sex-related differences in lumbar lordosis. METHODS: Twenty-six patients with CNLBP and 26 controls were recruited. Controls were matched with cases using a frequency matching method. Reflective markers were placed over the spinous process of T12, L3, S2, and the anterior and posterior superior iliac spines. The participants were instructed to stand up at a self-selected pace and maintain their normal upright standing posture for 3 seconds, and then sit down. Kinematic data were recorded at a sampling frequency of 100 Hz using a motion capture system. Lumbar lordosis angle was calculated from the intersection between the line joining T12 and L3, and the line joining L3 to S2. RESULTS: Lumbar lordosis was decreased in patients with CNLBP during STS and SIT compared with the asymptomatic group (mean difference = 2.68°-9.32°; P ≤ .005). Furthermore, no differences were seen in lumbar lordosis at starting position between CNLBP and asymptomatic groups during STS and SIT (mean difference = 2.68°-3.75°; P ≥ .099). Interestingly, the magnitude of the effect size suggested that the difference in lumbar lordosis values between female and male participants was relatively large (Cohen's d = -1.81 to 0.20). CONCLUSION: Decreased lumbar lordosis in patients with CNLBP during STS and SIT could be considered as an important point during rehabilitation. Moreover, the present study showed that there is a sex-related difference among women and men in lumbar lordosis during STS and SIT tasks.

Trunk-Pelvis Kinematics Variability During Gait and Its Association With Trunk Muscle Endurance in Patients With Chronic Low Back Pain.

The first purpose was to investigate the trunk muscle endurance, the second aim was to evaluate the trunk-pelvis kinematics during gait, and the third was to evaluate the relationship between trunk-pelvis kinematics and the trunk muscle endurance. Thirty participants (15 nonspecific chronic low back pain [NCLBP] and 15 healthy) were included. The authors first assessed trunk muscle endurance on endurance testing protocols. The authors next measured the trunk-pelvis kinematics during gait using a 3-dimensional motion capture system. Angular displacement, waveform pattern (CVp), and offset variability (CVo) were also examined. Statistical analysis revealed a significant difference in (1) the trunk muscle endurance and (2) sagittal, frontal, and transverse planes CVp between groups (P < .05). A significant moderate correlation was found between supine double straight-leg raise and frontal CVp (r = .521, P = .03) and transverse planes CVp (r = .442, P = .05). However, a significant moderate correlation was observed between prone double straight-leg raise and sagittal plane CVp (r = .528, P = .03) and transverse plane CVp (r = .678, P = .001). The relationship between (1) lower trunk extensor endurance with transverse and sagittal planes CVp and (2) lower abdominal muscle endurance with transverse and frontal planes CVp suggests that gait variability in these planes may result because of trunk muscle deconditioning accompanying NCLBP.

The Effects of Stabilization Exercise on the Thickness of Lateral Abdominal Muscles During Standing Tasks in Women With Chronic Low Back Pain: A Randomized Triple-Blinded Clinical Trial Study.

CONTEXT: Chronic low back pain (CLBP) often presents with a dysfunction in deep abdominal muscles activity during standing tasks. Although some studies indicated that deep abdominal muscle activity improved during some functional tasks following stabilization exercise (SE), there is no study to evaluate the effect of SE on lateral abdominal muscles thickness during standing postural tasks. OBJECTIVE: The purpose of this study was (1) to evaluate the lateral abdominal muscles thickness in the participants with CLBP while standing on a balance board and (2) to compare the effects of SE and a general exercise (GE) program on the lateral muscles thickness changes. METHODS: This was a between-groups, triple-blinded randomized controlled trial design. In total, 40 females with CLBP were randomly assigned into 2 groups:  GE (control group) and supervised progressive SE (experimental group). Diagnostic ultrasound imaging was used before and after the intervention to measure lateral abdominal muscles thickness during standing on 2 different levels of platform in the Biodex Balance System. Visual analog scale and Roland-Morris Disability Questionnaire were used to evaluate changes in pain intensity and disability. RESULTS: The results indicated significant increases in transverse abdominis muscle thickness during all standing tasks (P = .02) and significant decreases in pain intensity and disability following SE intervention (P < .001). However, the lateral abdominal muscle thicknesses were not changed after GE intervention while standing postural tasks (P > .05). The GE group revealed only significant decreases in pain intensity after intervention (P = .03). CONCLUSION: Supervised progressive SE improved the activity of deep abdominal muscles in standing postural tasks in the patients with CLBP.

Effectiveness of Slump Stretching on Low Back Pain: A Systematic Review and Meta-analysis.

BACKGROUND: The slump test is a type of neurodynamic test that is believed to evaluate the mechanosensitivity of the neuromeningeal structures within the vertebral canal. The objective of this review was to investigate the effectiveness of slump stretching on back pain and disability in patients with low back pain (LBP). METHODS: We searched eight electronic databases (PubMed/Medline, Scopus, Ovid, CINAHL, Embase, PEDro, Google Scholar, CENTRAL). The publication language was restricted to English, and we searched the full time period available for each database, up to October 2017. Our primary outcomes were pain and disability, and the secondary outcome was range of motion (ROM). RESULTS: We identified 12 eligible studies with 515 LBP patients. All included studies reported short-term follow-up. A large effect size (standardized mean difference [SMD] = -2.15, 95% confidence interval [CI] = -3.35 to -0.95) and significant effect were determined, favoring the use of slump stretching to decrease pain in patients with LBP. In addition, large effect sizes and significant results were also found for the effect of slump stretching on disability improvement (SMD = -8.03, 95% CI = -11.59 to -4.47) in the LBP population. A qualitative synthesis of results showed that slump stretching can significantly increase straight leg raise and active knee extension ROM. CONCLUSIONS: There is very low to moderate quality of evidence that slump stretching may have positive effects on pain in people with LBP. However, the quality of evidence for the benefits of slump stretching on disability was very low. Finally, it appears that patients with nonradicular LBP may benefit most from slump stretching compared with other types of LBP.

Effects of Different Frequencies of Whole Body Vibration on Repositioning Error in Patients With Chronic Low Back Pain in Different Angles of Lumbar Flexion.

OBJECTIVE: This study aimed to evaluate the effect of high and low frequency of whole body vibration (WBV) on repositioning error in 3 different angles of lumbar flexion in patients with chronic low back pain. METHODS: Twenty-four participants with chronic low back pain, aged between 20 and 35 years, were included in this randomized crossover trial study. Participants were randomly assigned into 2 groups as follows: (1) low frequency/high frequency, and (2) high frequency/low frequency. Participants received high-frequency (50 Hz) and low-frequency (30 Hz) WBV in a semi-squat position for 5 minutes in 2 sessions, with 2 weeks of rest. Before and after the WBV, lumbar repositioning error in 30% and 60% of lumbar full flexion and neutral position with eyes closed when standing was evaluated using an electrogoniometer. RESULTS: The repositioning error was decreased in neutral, 30%, and 60% of lumbar flexion after the low-frequency and high-frequency WBV. Post hoc testing revealed that the effect of angle was not significant in repositioning error changes between high-frequency and low-frequency WBV (P > .05). However, the effect of low-frequency WBV on the repositioning error was significantly higher compared with high-frequency WBV (P < .05). CONCLUSION: Low-frequency WBV might induce more improvement in the accuracy of lumbopelvic repositioning compared with high-frequency WBV with the method of WBV used in this study.

Kinematics of the Spine During Sit-to-Stand Movement Using Motion Analysis Systems: A Systematic Review of Literature.

CONTEXT: Clinical evaluation of the spine is commonplace in musculoskeletal therapies, such as physiotherapy, physical medicine/rehabilitation, osteopathic, and chiropractic clinics. Sit-to-stand (STS) is one of the most mechanically demanding daily activities and crucial to independence. Difficulty or inability to perform STS is common in individuals with a variety of motor disabilities, such as low back pain (LBP). OBJECTIVE: The purpose of this systematic review was to evaluate available evidence in literature to determine 2-dimensional and 3-dimensional kinematics of the spine during STS in patients with LBP and healthy young adult participants using motion analysis systems (electromagnetic and marker based). METHODS: Electronic databases (PubMed/MEDLINE [National Library of Medicine], Scopus, ScienceDirect, and Google Scholar) were searched between January 2002 and February 2017. Additionally, the reference lists of the articles that met the inclusion criteria were also searched. Prospective studies published in peer-reviewed journals, with full text available in English, investigating the kinematics of the spine during STS in healthy subjects (mean age between 18 and 50 y) or in patients with LBP using motion analysis systems, were included. Sixteen studies fulfilled the eligibility criteria. All information relating to methodology and kinematic modeling of the spine segments along with the outcome measures was extracted from the studies identified for synthesis. RESULTS: The results indicated that the kinematics of the spine are greatly changed in patients with LBP. In order to develop a better understanding of spine kinematics, studies recommended that the trunk should be analyzed as a multisegment. It has been shown that there is no difference between the kinematics of patients with LBP and healthy population when the spine is analyzed as a single segment. Furthermore, between-gender differences are present during STS movement. CONCLUSION: This review provided a valuable summary of the research to date examining the kinematics of the spine during STS.

Effect of Elastic Therapeutic Taping on Abdominal Muscle Endurance in Patients With Chronic Nonspecific Low Back Pain: A Randomized, Controlled, Single-Blind, Crossover Trial.

OBJECTIVE: The purpose of this study was to determine the immediate effect of elastic therapeutic taping and sham taping of the abdominal musculature on maximum hold time of endurance tests in patients with chronic nonspecific low back pain (CNLBP). METHODS: Twenty-six people with CNLBP and 26 asymptomatic individuals were included in this study. The CNLBP participants were allocated to an elastic therapeutic tape group or a sham tape group. Standard adhesive elastic therapeutic tape was utilized for facilitatory application in the elastic therapeutic tape group. The elastic therapeutic tape group received real elastic therapeutic taping on the transversus abdominis and internal obliques, and the sham tape group received sham elastic therapeutic taping application. For the sham group, the elastic therapeutic tape was positioned horizontally above the navel and applied without tension. After a wash-out period, each CNLBP participant was switched to the other group. Outcome measures included maximum hold time of supine isometric chest raise, supine double straight-leg raise, and abdominal drawing in maneuver. RESULTS: The CNLBP participants had lower maximum hold time compared to the asymptomatic individuals (P ≤ .01). Following taping, both groups showed an increase in the maximum hold time (mean difference = 4.43 - 50.69 seconds; P ≤ .02). Although there was no difference between the results of both groups (P ≥ .12), effect sizes were large for the elastic therapeutic tape group (Cohen's d = -1.93 to -1.00). CONCLUSIONS: The results suggest that the maximum hold time of endurance tests was decreased in CNLBP patients compared to healthy participants. The application of both elastic therapeutic tape and sham tape to the transversus abdominis and internal obliques produced short-term improvement in abdominal endurance. There was no statistically significant difference between the results of elastic therapeutic tape and sham tape.

Effects of Photobiomodulation Therapy on Lung Function and Inflammatory Factors in Patients with COVID-19 During Acute Stage.

Objective: We aimed to evaluate the effects of photobiomodulation therapy on the respiratory function and laboratory parameters in COVID-19 participants with respiratory involvement. Methods: A randomized, double-blind controlled design was used. This study was conducted at Koosar Hospital. Thirty participants with COVID-19 who were hospitalized met the inclusion criteria and were randomly assigned to two groups. Patients were treated with a program of five sessions of high-power photobiomodulation (intervention group) and placebo photobiomodulation (control group). Both groups received standard treatment. Outcomes were assessed before and after the intervention (two sessions), according to the immune system function and laboratory tests for the respiratory rate (RR), oxygen saturation, and inflammatory factors, including C-reactive protein (CRP), white blood cells, and interleukin-6 (IL-6), as well as complete blood count (CBC), hematocrit, hemoglobin, and ferritin. Results: Findings indicated that the values of ferritin, erythrocyte sedimentation ratio, CRP, IL-6, O2 saturation, and RR were significantly improved after the intervention in both groups (p < 0.05). Independent T-test analyses also indicated significant differences in the CRP, IL-6, and O2 saturation in the photobiomodulation group compared with the control group after the five-session intervention (p < 0.05). Conclusions: Application of photobiomodulation is recommended for treatment of respiratory problems in patients with COVID-19 to improve clinical signs and control inflammatory factors. Clinical Trial Registration: IRCT2017070934969N1.

Relationship of Impaired Lumbar Spine-Hip Coordination During Sit To Stand and Stand To Sit with Functional Disability in Chronic Nonspecific Low Back Pain Patients.

Background: This study aimed to investigate the relationships of lumbar spine-hip discoordination during sit-to-stand (STD) and stand-to-sit (SIT) with pain and functional disability in chronic nonspecific low back pain (CNLBP) patients. Methods: A cross-sectional observational study was conducted in a biomechanics laboratory of the physical therapy department located at the School of Rehabilitation Sciences, Iran University of Medical Sciences (Tehran-Iran). A total of 16 CNLBP patients (men 9, female 7) aged 18-40 years (mean 31.48) were selected according to our eligibility criteria. Furthermore, ten reflective markers were placed on the spinous processes of T12 and S2, posterior and anterior superior iliac spines, greater trochanters, and lateral epicondyles. The patients were instructed to perform STD and SIT tasks at a preferred speed without using their hands. Relative phase angle was used as an indicator of coordination and was identified as the inverse tangent of angular displacement/angular velocity. Moreover, the relative phase angle between the lumbar spine and right and left hip joints was measured by subtracting the phase angle of the hip joint from the lumbar spine joint. The ratios of the total movements of the lumbar spine to the total movements of the right and left hip joints were also calculated in the sagittal plane. Finally, Pearson correlation coefficients (r) were utilized to assess the association between variables. Results: The results of this study indicated that kinematic parameters of the pain had statistically significant direct relationships with functional disability in CNLBP participants during STD and SIT with r values ranging from 0.57 (Pvalue = 0.021) to 0.85 (Pvalue<0.001) and 0.54 (Pvalue=0.053) to 0.82 (Pvalue<0.001), respectively. Conclusion: Out of the results of this study, it could be stated that pain and functional disability play a major role in lumber spine-hip discoordination, and it altered the movement ratio in CNLBP patients during STD and SIT. In clinical practice, clinicians should improve lumber spine-hip discoordination in patients with CNLBP since there is a linear relationship between kinematic parameters of the pain and functional disability in patients with CNLBP.

Development and psychometric evaluation of a scale to measure telepractice among speech and language pathologists during COVID-19 pandemic.

PURPOSE: With the outbreak of the COVID-19 and the need for physical distancing, the provision of Speech-Language Pathology (SLP) services via telepractice has been essential. One of the first steps in this field is the need to study telepractice among Speech and Language Pathologists (SLPs). However, there is currently no specific instrument to measure telepractice in SLP to achieve this aim. The present study was conducted to develop and evaluate the psychometric properties of a questionnaire to investigate telepractice among SLPs during the COVID-19 pandemic. MATERIALS AND METHODS: The study comprised of two stages: (1) development of the questionnaire according to an in-depth literature review and (2) evaluation of the validity and reliability of the questionnaire. The content validity of the instrument was determined by 10 experts in the field of SLP. To check the face validity of the questionnaire, 10 SLPs were interviewed and their opinions were incorporated in the questionnaire. A total of 221 SLPs completed the questionnaire to determine the construct validity and the internal consistency. To evaluate the test-retest reliability, 30 SLPs completed the questionnaire twice with two weeks of interval. RESULTS: The final version of the questionnaire comprised of three sections and 31 items. The Cronbach's alpha coefficients for different sections of the questionnaire ranged between 0.902 and 0.92 and the Intra-class Correlation coefficients of the sections were found to be between 0.9 and 0.96 in the test-retest reliability. CONCLUSIONS: The questionnaire developed in the study is a valid and reliable scale to measure telepractice among SLPs for educational or research purposes.

Immediate Effects of Combining Kinesio Tape with Voice Therapy in Patients with Muscle Tension Dysphonia.

INTRODUCTION: The present study investigated the immediate effect of adding Kinesio taping along with voice therapy for the treatment of muscle tension dysphonia patients. MATERIALS AND METHODS: Twenty patients with primary muscle tension dysphonia (MTD) (12 males and 8 females) with a mean age of 36.95 ± 9.58 years participated in the study. Participants were assigned to two groups: one group (6 males and 4 females) received only traditional voice therapy (VT) and the other group (6 males and 4 females) received Kinesio taping (KT) and voice therapy (VT). The VT group received laryngeal manual therapy (LMT) (for 15 minutes) and voice therapy techniques including humming, chewing, and yawn-sigh (for 15 minutes). The VT + KT group received both KT and the same VT as the first group. KT was applied to the sternocleidomastoid, infralaryngeal, and supralaryngeal muscles of the neck. Auditory-perceptual assessments using CAPE-V, acoustic voice analysis, and assessments of vocal tract discomfort and pain were used to evaluate the effects of a single treatment session. The Wilcoxon and Mann-Whitney U tests were used for data analysis. RESULTS: The results of within-group comparison of the auditory-perceptual assessment (overall severity, roughness, breathiness, and strain) in both sustained vowels and connected speech tasks showed a significant reduction in all mentioned items in both groups (P < 0.05). Acoustic voice analysis showed significant improvement of HNR in the KT + VT group for both sustained vowels and connected speech tasks, and significant improvement of jitter in the VT group for sustained vowels (P < 0.05). Regarding vocal tract discomfort, the symptom of tightness in the KT + VT group, irritability and pain in the VT group, and the overall score of vocal tract discomfort in both groups, significantly decreased (P < 0.05). A significant decrease in pain severity in the front of the neck, throat, and larynx was reported by MTD patients in both groups (P < 0.05). Between-group comparisons indicated a significant difference only in the pain item of the VTD scale (P < 0.05) with greater pain decrease for the VT group. Comparison of the mean of differences showed that the VT group reduced irritability more than the KT + VT group (P < 0.05). CONCLUSION: The present study showed that voice therapy with and without Kinesio taping can improve patients' voice quality (auditory-perceptual and acoustic voice analysis) and reduce vocal tract discomfort and pain in MTD patients after one therapy session. Moreover, MTD patients treated with KT + VT did not experience more significant improvements compared to those treated with VT alone. More studies in this area are recommended to better determine the effects of KT in MTD patients especially for long term effects of KT.

Comparison of Dry Needling and Inhibitory Kinesio Taping in Treatment of Myofascial Pain Syndrome of the Upper Trapezius Muscle: A Randomized Controlled Trial.

Objective: The purpose of this study was to compare the effects of dry needling and inhibitory Kinesio taping on the pressure pain threshold and muscle thickness in women with myofascial pain syndrome in the upper trapezius muscle. Methods: The present study was a single-blind randomized controlled clinical trial. Seventy-five women with active trigger points in the upper trapezius muscle were included and randomly divided into 3 groups of equal sizes. Groups 1 and 2 were treated in 2 sessions with a 3-day interval by dry needling and inhibitory Kinesio taping, respectively. Group 3 did not receive treatment (ie, the control group). Pressure pain threshold and muscle thickness were measured using a pressure algometer and an ultrasound device, respectively, and this was done before, 3 days after, and 10 days after the treatment. Results: Pressure pain threshold increased significantly in groups 1 and 2 (P < .001) after the intervention. Muscle thickness reduced significantly in group 1 (P = .015) and group 2 (P = .010) after the intervention. No significant differences were observed between these 2 intervention groups in terms of these variables. Meanwhile, the changes in the control group in muscle thickness (P = .430) and pressure pain threshold (P = .230) were not significant. Conclusion: Both dry needling and inhibitory Kinesio taping increased pressure pain threshold and reduced muscle thickness in participants with active trigger points in the upper trapezius muscle. These 2 therapeutic techniques appear to cause similar positive changes in pain and muscle function but may do so through different mechanisms.

Development and Preliminary Validation of a Pain Scale Specific to Patients With Voice Disorders: The Voice-Related Pain Scale (VRPS).

INTRODUCTION: Although pain is one of the complaints reported by voice patients, still there is no valid and reliable scale to evaluate pain in Patients with Voice Disorders (PWVDs). Therefore, the aim of the present study was to develop and validate the Voice-Related Pain Scale (VRPS). METHODS: The present study was conducted in two stages: (1) development of the VRPS based on semistructured interviews with PWVDs and experts in the field of voice disorders and an in-depth literature review, and (2) Evaluation of the psychometric properties of the VRPS. Determining the validity and reliability of the VRPS was performed using qualitative and quantitative content validity, the qualitative face validity, and the test-retest reliability. Content validity of the VRPS was assessed by Speech and Language Pathologists who are experts in the assessment and treatment of voice patients and laryngologist. The reliability of the scale was determined using test-retest reliability. RESULTS: Based on the interviews with PWVDs and experts, and a thorough review of the related literature, a self-reported scale with 11 items and three sections was developed. The three items included ear, temporomandibular joint, and shoulder all of which were divided into right and left pairs based on the experts' suggestion. One item was eliminated because it had a content validity ratio less than 0.62. The content validity index (CVIs) for all the remaining items were higher than 0.79 and the scale content validity index was equal to 0.93. The test-retest reliability was satisfactory with weighted kappa ranging from 0.64 to 1 for VRPS items. The final version of the VRPS comprised of 13 items related to the pain location in the human body. Each of these items has three sections: frequency of pain, severity of pain, and time of pain occurrence. CONCLUSION: The present study indicated that VRPS is a valid and reliable tool to evaluate pain in PWVDs. The VRPS is a useful tool for clinical and research purposes. However, more studies are needed in this regard for further evaluation of the VRPS.

Examining the Use of Kinesiology Tape During Weight Bearing Exercises on Proprioception in Participants With Functional Ankle Instability.

The aim of this study was to examine the effect of tape worn during weight bearing exercises on proprioception (i.e., ankle angle repositioning error) in participants with functional ankle instability. We employed a randomized, controlled clinical study in a laboratory setting, with 56 participants with functional ankle instability. Participants were randomly assigned to three groups: (a) weight bearing exercises without tape (n = 18), (b) weight bearing exercises with tape (n = 19) and controls not engaged in weight bearing exercises (n = 19). Weight bearing exercises included six weeks of bilateral squats in partial form with up to 45 degrees of knee flexion, and unilateral partial squats with full heel raise, and with full toe raise. In the taped condition, participants wore tape for six weeks with up to three tape replacements per week. Proprioception was measured as ankle repositioning error. Results showed that the mean angle repositioning error among participants in the active weight bearing groups was decreased by the taping intervention, relative to the control group's performance (p = 0.042). There were no significant differences between weight bearing exercise groups and control groups. The addition of kinesiology tape in weight bearing exercises can improve proprioception in active conditions.

A comparison of mobilization and mobilization with movement on pain and range of motion in people with lateral ankle sprain: A randomized clinical trial.

BACKGROUND: Maitland and Mulligan mobilization techniques are two manual therapy methods to increase the range of motion following immobility treatment. The present study was conducted to compare two therapeutic methods, namely mobilization and mobilization with movement (MWM), on the pain and range of motion in people with lateral ankle sprain. METHODS: A total of 40 individuals with grade two lateral ankle sprain were randomly divided into two groups, including the Maitland's mobilization intervention group, and the Mulligan's mobilization intervention group. Both groups underwent treatment every other day for two consecutive weeks. The pain intensity was measured using the Visual Analogue Scale (VAS), and the ankle dorsiflexion movement range using the Weight Bearing Lunge Test (WBLT) before and one day after the intervention. RESULTS: There were no significant differences between the two groups in terms of pain (P = 0.297) and range of motion (P = 0.294) before the intervention. Meanwhile, after the intervention, a significant change was observed in both groups in terms of these variables, which indicates the effectiveness of both interventions (P < 0.001) and the greater effect of the mobilization with movement in reducing pain (P = 0.037) and increasing the range of motion (P = 0.021). CONCLUSIONS: Both techniques significantly improved the range of motion and reduced pain in people with lateral ankle sprain, but Mulligan's technique was significantly more effective among the two, perhaps due to joining active and passive mobilizing tensile forces as well as interaction of afferents and efferents in the reflex arc.

Determining pain in patients with voice disorders: a qualitative study.

AIM: The present study aimed to determine pain in patients with voice disorders (PWVDs). PATIENTS AND METHODS: A total number of 28 patients with a range of voice disorders and without any other diseases participated in the study. To gain maximum variation, purposive sampling method was used. Moreover, semi-structured interviews were employed for data collection. The interviews were then continued until data saturation was reached, and the data were subsequently recorded and transcribed verbatim. Qualitative content analysis was utilized for data analysis. RESULTS: Data analysis of the interviews emerged three themes about pain experienced by PWVDs. The emerged themes included location of pain, type of pain, and time of pain occurrence. In this respect, PWVDs reported pain in different locations on their body including head, ears, anterior neck, posterior neck, larynx, temporomandibular joint, submandibular area, shoulders, and upper back. Furthermore, chronic, acute, severe, and mild were the most common types of pain reported by PWVDs. The PWVDs also stated that they had experienced pain at different times, i.e. during speaking, after long-time speaking, after voice use, during swallowing, during palpation, and all the time (even at rest). CONCLUSIONS: One of the physical discomforts experienced by PWVDs is pain. According to the results of the present study, pain should properly be considered in the assessment and treatment of PWVDs in clinical practices. Also, our study suggested that a specific scale is needed to measure pain in voice disorders.