A Comparison of 2 Exercise Protocols in Athletes With Primary Subacromial Impingement Syndrome: A Randomized Clinical Trial.

CONTEXT: To stabilize the humeral head within the glenoid fossa during arm elevation, the rotator cuff muscles may contribute through internal and external rotation. The main purpose of the current study was to compare the acromiohumeral distance between athletes with primary subacromial impingement syndrome who received progressive resistance exercises consisting of either shoulder internal or external rotation. DESIGN: A randomized and controlled clinical study. METHODS: Thirty athletes with primary subacromial impingement syndrome were enrolled and randomly divided into 2 experimental groups. The progressive resistance exercise protocol in experimental group I comprised shoulder internal rotation, while in experimental group II consisted of shoulder external rotation. The experimental groups worked out 3 days a week for 6 weeks. The experimental groups were compared with the control group consisting of 15 healthy athletes. The acromiohumeral distance was measured before and after the intervention using an ultrasound machine under the passive and active across no arm elevation and 45°of arm elevation. RESULTS: The acromiohumeral distance significantly increased in both experimental groups under the passive and active arm positions following the intervention (P < .001), with no significant differences detected between the experimental groups (P > .665). The paired comparisons of the acromiohumeral distance discrepancy indicated a significant difference between the control group and each experimental group under the active and passive arm positions (P < .001), while no significant difference was observed between the experimental groups (P > .999). CONCLUSIONS: The present study revealed, for the first time, that both progressive resistance exercise protocols involving either the shoulder internal or the external rotation increased the acromiohumeral distance in individuals with primary subacromial impingement syndrome and improved associated pain and disabilities.

The linear intra-articular motions of the temporomandibular joint in individuals with severe forward head posture: A cross-sectional study.

BACKGROUND: The cervical vertebrae and the temporomandibular joint (TMJ) may be linked through their common muscles. OBJECTIVES: The aim of the present study was to compare the linear intra-articular motions of the TMJ between individuals with the normal craniocervical posture (CCP) and severe forward head posture (FHP). DESIGN: Cross-sectional study. METHODS: Volunteers (N = 38) were equally assigned to either the severe FHP group or the normal CCP group according to their craniovertebral angle (CVA). The CVA angles greater than 49° were considered as the normal CCP while angles between 44 and 40° were regarded as the severe FHP. The TMJ was imaged at the closed, median, and maximum open positions of the mouth using an ultrasound machine with a 7.5 MHz linear transducer in the sitting position. The best-fitting curve in the contour registration method was employed to measure displacement of the mandibular condyle on the transverse and vertical axes. RESULTS: The forward displacement of the mandibular condyle in the severe FHP group was significantly (p-value = 0.037) reduced compared to the normal CCP group at maximum open position of the mouth, while no significant difference was revealed at closed (p-value = 0.937) or median open (p-value = 0.699) positions. The perpendicular displacement of the mandibular condyle exhibited no significant (p-value>0.107) difference between groups at any mouth position. DISCUSSION: The current study demonstrated, for the first time, that severe FHP may impact the intra-articular motion of the TMJ. This study presumed that individuals with severe FHP may encounter a force imbalance in the anterior-posterior direction.

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.

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.

The immediate effect of whole body vibration training on the electromyographic activity of contralateral hand muscles; a randomized controlled trial.

Whole Body Vibration (WBV) has been used as a useful adjunct to improve the neuromuscular function of the upper limb. Cross-transfer of strength plays an important role in rehabilitation of unilateral injuries. The present research intended to evaluate the acute effect of low frequency WBV training on cross-transfer of electromyographic activity and hand muscles strength when the measurement was performed on the contralateral limb. This was a randomized crossover trial conducted in a clinical biomechanics laboratory. Twenty-eight healthy participants aging between 20 and 35 years were included who were involved in two sessions with two weeks of rest. The participants were randomly assigned in two groups as follows: 1) active WBV/sham WBV; 2) sham WBV/active WBV. The participants were asked to stand on the vibrating plate and pull its belt in a vibrating mode using their dominant hand. Then, after a two-week rest, they performed the same task in the vibrating mode (35 Hz). Grip strength and electromyography (root mean square) in flexor digitorum profundus (FDP), flexor digitorum superficialis (FDS), extensor carpi radialis (ECR), and extensor carpi ulnaris (ECU) muscles of the contralateral limb were measured before and after exercise in both phases. No significant change was observed in the electrical activity of FDP, FDS, ECR, ECU muscles, and hands' grip strength of the contralateral limb (P > 0.05). WBV (35 Hz) was not able to augment cross-transfer in electromyographic activity and neuromuscular performance of the upper limb. Further studies would help to explore these results for several sessions of WBV on cross-transfer of training.

Dynamic comparison of segmentary scapulohumeral rhythm between athletes with and without impingement syndrome.

BACKGROUND: Patients who have shoulder pain usually have compensatory or contributory deviation of shoulder motion during arm elevation. In the traditional scapulohumeral rhythm, the share of the acromioclavicular (AC) and the sternoclavicular (SC) joint movements and also the role of AC internal rotation angle are unknown. OBJECTIVES: The main purpose of this study was to measure and compare the segmentary scapulohumeral rhythm (SSHR) during scapular arm elevation at a steady rotational speed in athletes with and without impingement syndrome. PATIENTS AND METHODS: Using a speedometer, the maximum speed of arm elevation was measured in 21 men in each of the involved and uninvolved groups. Using fluoroscopy on the dominant side, SSHR during scapular arm elevation at a rotational speed equal to 1/30 of maximum speed was compared between the two groups. The ratio of glenohumeral (GH) elevation angle to AC rotation angle in the scapular plane was considered as SSHR. RESULTS: The maximum speed of arm elevation between the two groups was significantly different (P < 0.001). The rhythm of the involved group significantly exceeded the rhythm of the uninvolved group in a part of the first quarter range of the arm elevation. SSHR during arm elevation in the uninvolved group did not change significantly (P = 0.845); however, it decreased significantly in the involved group (P = 0.024). CONCLUSIONS: Speed differences between the two groups were probably due to the pain in some ranges of arm elevation. SSHR in the involved group probably changed in order to compensate downward rotation of the scapula in the resting position. Study of the AC upward rotation range can be misleading; therefore, the study of scapulohumeral rhythm is recommended.