Cupping Therapy Does Not Influence Healthy Adult's Hamstring Range of Motion Compared to Control or Sham Conditions.

Cupping therapy, a form of traditional Chinese medicine, has recently gained popularity as a therapeutic modality among sports medicine clinicians. While the use of cupping therapy to decrease musculoskeletal pain is supported by recent research findings, evaluations on the use of cupping therapy to influence range of motion (ROM) are limited. The purpose of the study was to identify if cupping therapy applied passively for 10 minutes increases flexibility compared to sham treatment or control conditions. Twenty-five participants with hamstring ROM less than 80° and no previous cupping therapy experience completed the study. Participants reported to the laboratory on three occasions for one of three randomly assigned treatment conditions (cupping, sham, or control) for 10 minutes while prone. Hamstring flexibility was evaluated three times (pre-treatment, post-treatment, and 10-minutes post-treatment) via ROM measured during an active straight leg raise. Participants returned on two other occasions to receive the remaining treatment conditions. A 3 (treatment condition) × 3 (time) repeated measures analysis of variance was utilized for statistical analysis. There was no interaction between condition and time (p = 0.78). Within-subjects effects for time (p = 0.76) was not significant. Post hoc pairwise comparison of treatment conditions found no differences between control and cupping (p = 0.36), cupping and sham (p = 0.35), or control and sham (p=0.98) conditions. Cupping therapy applied statically for 10 minutes does not increase hamstring flexibility compared to a sham treatment or control condition.

THE USE OF POSTURAL RESTORATION FOR TREATMENT OF CHRONIC ROTATOR CUFF PATHOLOGY: A CASE REPORT.

BACKGROUND AND PURPOSE: Postural Restoration Institute® (PRI) theories and rehabilitation techniques focus on restoring balance to anatomical systems. Common postural asymmetries can present in athletes as dysfunctions and limitations. The purpose of this case report was to examine the use of PRI exercises and theories to address pelvic alignment, along with core stabilization, during treatment of shoulder dysfunction in a collegiate volleyball player. CASE DESCRIPTION: A 22-year-old female volleyball athlete reported unresolved right rotator cuff tendinopathy. She presented with bilateral rib cage flare, anterior pelvic tilt, and bilateral ROM differences in hip and shoulder internal and external rotation. PRI® special test findings included a positive left and right Adduction Drop Test (ADT), positive left Extension Drop, and Hruska Adduction Lift test (left=2, right=3) indicating posterior exterior chain (PEC) pattern of dysfunction. The traditional shoulder rehabilitation program from the previous season was eliminated and a PRI based intervention was performed. Intervention exercises included the 90/90 dead bug diaphragmatic breathing, 90/90 hamstring hip lift, and right sidelying respiratory left adductor pull back. Exercises were performed as three sets of ten diaphragmatic breathing repetitions, a minimum of three times weekly prior to activity. OUTCOMES: Likert scale ratings of pain decreased from a six pre-intervention to two. The left hip gained 10° of internal rotation and the right hip gained 14° of external rotation. Right shoulder internal rotation increased 15°. Hruska Adduction Lift improved to a four bilaterally (right by day 24, and left by day 31). Left extension drop test was negative following day 17. DISCUSSION: PRI® exercises focusing on core and pelvic stability translated to improved hip and shoulder ROM, and decreased shoulder pain associated with rotator cuff tendinopathy. By treating pelvic alignment with the PRI® exercises, the ROM imbalance and pain at the shoulder joint were addressed. CONCLUSION: Incorporating PRI exercises and theories into the rehabilitation program of a volleyball player was useful in addressing underlying imbalances throughout the kinetic chain. LEVEL OF EVIDENCE: 3b.

Duloxetine for the treatment of stress urinary incontinence in women: an integrated analysis of safety.

OBJECTIVE: The objective was to characterize the safety of duloxetine for treatment of stress urinary incontinence (SUI) in women, using an integrated database generated from four published placebo-controlled clinical trials. METHODS: The database included 1913 women randomized to duloxetine (N=958) or placebo (N=955), examining adverse events (AEs), serious adverse events (SAEs), vital signs, electrocardiograms, and laboratory analytes. AEs occurring initially or worsening during the double-blind treatment period were considered treatment-emergent (TEAE). Differences between duloxetine-treated and placebo-treated groups were compared statistically. RESULTS: Common TEAEs included: nausea (23.2%), dry mouth (13.4%), fatigue (12.7%), insomnia (12.6%), constipation (11.0%), headache (9.7%), dizziness (9.5%), somnolence (6.8%), and diarrhea (5.1%). Most TEAEs that emerged early were mild to moderate, rarely worsened, and resolved quickly. Overall AE discontinuation rates were 20.5% for duloxetine and 3.9% for placebo (P<.001). Most discontinuations (83%) occurred within the first month of treatment. SAEs were uncommon and did not differ between treatments. Statistically significant, but clinically unimportant mean increases in heart rate (2.4 bpm) and systolic and diastolic blood pressure (