Effects of a supervised exercise program in addition to electrical stimulation or kinesio taping in low back pain: a randomized controlled trial.

Chronic low back pain it is one of the most common health problems worldwide. Usually is accompanied by a complex set of symptoms and generates significant direct and indirect socioeconomic and health costs. From a therapeutic point of view, there are a wide variety of methods to address the treatment of this pathology, however, these therapies have not been shown definitive efficacy. To investigate the effect of a mixed treatment with exercise and electrical stimulation versus exercise and kinesio taping in patients with non-specific chronic low back pain. A total of 58 patients participated in this single-blinded randomised clinical trial. Participants were assigned to the exercises- kinesio taping group, or exercises- analgesic current group, both received 12 treatment sessions. Disability, fear of movement, anxiety, depression, sleeps quality, pain, lower limb mechanosensitivity and pressure-pain thresholds were recorded at baseline and after 4 weeks of treatment. The 2 × 2 mixed analysis of covariance test showed statistically significant differences between groups for pain (P = 0.046). Pair-wise comparisons with baseline demonstrated significant differences for both groups in pain (P ≤ 0.001), disability (P ≤ 0.001), pressure-pain thresholds (P ≤ 0.044), lower limb mechanosensitivity, (P ≤ 0.047), anxiety (P ≤ 0.001), depression (P ≤ 0.001) and sleep quality (P ≤ 0.010). Patients with chronic low back pain who received a combined treatment of exercises and kinesio taping or analgesic current showed an improvement in pain, disability, anxiety, depression and sleep pattern. Moreover, exercises combined with electrotherapy produces greater improvements over these variables.Trial registration: NCT02812459.

Manipulative therapy of sacral torsion versus myofascial release in patients clinically diagnosed posterior pelvic pain: a consort compliant randomized controlled trial.

BACKGROUND CONTEXT: Chronic low back pain represents a health care problem with substantial costs. It is generally accepted that approximately 10% to 25% of patients with persistent chronic low back pain may have pain arising from the sacroiliac joints. PURPOSE: This study aimed to analyze the effects of manipulative therapy of sacral torsion versus myofascial release on disability, pain intensity, and mobility in patients with chronic low back pain and sacroiliac joints. STUDY DESIGN/SETTING: A prospective, single-blinded randomized clinical trial. PATIENT SAMPLE: Sixty-four patients (mean±SD age: 51±9; 60% female) with chronic low back pain and sacroiliac joints comprised the patient sample. No participant withdrew because of adverse effects. OUTCOME MEASURES: Self-reported disability (primary), pain intensity, scale of kinesiophobia, quality of life, isometric endurance of trunk flexor muscles, and lumbar mobility in flexion were assessed at baseline, pos-treatment, and one month follow-up. METHODS: Participants were randomly assigned to a sacral torsion manipulation group or myofascial release group, receiving a total of 12 sessions (once weekly). RESULTS: ANCOVA did not showed a statistically significant difference between groups for disability (95% CI -2.40-1.90, p=.177). Effect sizes were large in both groups at both follow-up periods. Similar results were achieved for all secondary outcomes (p˂. 05). The linear model longitudinal analyses showed significant improvements in both groups over time for all outcomes with the exception of fear of movement (manipulative: Minimum within-groups change score 1.91, p˂.001; myofascial: 1.66, p˂.001). CONCLUSION: Manipulative and myofascial release therapy in patients with clinically diagnosed sacroiliac joints syndrome resulted in a similar short-term benefits on patient reported disability. Both groups experienced similar decrease in the intensity of pain over time, although no clinically meaningful effects were demonstrated in either group.

The complementary effects of galvanic current electrical stimulation associated with conservative treatment to increase vasodilation in patients with Raynaud's phenomenon: a randomized trial.

OBJECTIVE: To analyze the effectiveness of an electrotherapy intervention with galvanic current on symptoms associated with Raynaud's phenomenon. DESIGN: Single-blind randomized controlled trial, parallel design (1:1 ratio) and intention-to-treat analysis. SETTING: Virgen de las Nieves Hospital, Granada, Spain. SUBJECTS: Thirty-four participants with Raynaud's phenomenon, with a mean (SD) age of 43.43 (17.62) years. INTERVENTIONS: The patients were randomly assigned to a control group with conservative treatment (anti-inflammatory, vasodilatory and analgesic drugs) or an intervention group that received conservative treatment and vasodilatory electrical stimulation during seven weeks, three times/week for a total of 20 sessions. MAIN MEASURES: The primary outcome was the number of attacks. Secondary outcomes were pain, peripheral blow flow, oxygen saturation, upper limb disability, central sensitization, pain catastrophizing and temperature recovery. All outcomes were assessed at baseline, posttreatment and at two months of follow-up. RESULTS: The galvanic current electrotherapy group showed significantly greater improvements in the number of attacks (mean difference = 26.3, 95% confidence interval (CI) = 14.4 to 38.3), pre-cold stress pain (95% CI = 0.6 to 2.4), radial artery blood flow (95% CI = -7.8 ⩾ x ⩽ 1.3), ulnar artery blood flow (95% CI = -8.63 to 0.60), oxygen saturation (95% CI = -1.7 ⩾ x ⩽ -0.29), upper limb disability (95% CI = 1.1 to 22.3), central sensitization (95% CI = 6.7 to 18.2) and temperature recovery (95% CI = -5.7 ⩾ x ⩽ -0.32) than the conservative treatment group. CONCLUSION: This study suggests that a complementary treatment with galvanic current in combination to conservative approach is superior to conservative applied as isolate, in reducing the clinical manifestations and disability in Raynaud's phenomenon.

Benefits of dry needling of myofascial trigger points on autonomic function and photoelectric plethysmography in patients with fibromyalgia syndrome.

BACKGROUND: Fibromyalgia syndrome (FMS) is a condition characterised by the presence of chronic, widespread musculoskeletal pain, low pain threshold and hyperalgesia. Myofascial trigger points (MTrPs) may worsen symptoms in patients with FMS. OBJECTIVE: The purpose of this randomised controlled trial was to compare the effects of dry needling and transcutaneous electrical nerve stimulation (TENS) on pain intensity, heart rate variability, galvanic response and oxygen saturation (SpO2). METHODS: 74 subjects with FMS were recruited and randomly assigned to either the dry needling group or the TENS group. Outcomes measures (pain intensity, heart rate variability, galvanic skin response, SpO2 and photoplethysmography) were evaluated at baseline and after 6 weeks of treatment. 2×2 mixed-model analyses of variance (ANOVAs) were performed. RESULTS: The mixed-model ANOVAs showed significant differences between groups for the sensory dimension of pain, affective dimension of pain, total dimension of pain, visual analogue scale (VAS) and present pain intensity (PPI) (P=0.001). ANOVAs also showed that significant differences between groups were achieved for very low frequency power of heart rate variability (P=0.008) and low frequency power (P=0.033). There were no significant differences in dry needling versus TENS groups on the spectral analysis of the photoplethysmography and SpO2. CONCLUSIONS: This trial showed that application of dry needling therapy and TENS reduced pain attributable to MTrPs in patients with FMS, with greater improvements reported in the dry needling group across all dimensions of pain. Additionally, there were between-intervention differences for several parameters of heart rate variability and galvanic skin responses. TRIAL REGISTRATION NUMBER: NCT02393352.

Improvement in clinical outcomes after dry needling versus myofascial release on pain pressure thresholds, quality of life, fatigue, pain intensity, quality of sleep, anxiety, and depression in patients with fibromyalgia syndrome.

Purpose: To compare the effectiveness of dry needling versus myofascial release on myofascial trigger points pain in cervical muscles, quality of life, impact of symptoms pain, quality of sleep, anxiety, depression, and fatigue in patients with fibromyalgia syndrome. Method: A single-blind randomized controlled trial was conducted. Sixty-four subjects with fibromyalgia were randomly assigned to a dry needling group or a myofascial release group. Pain pressure thresholds of myofascial trigger points were evaluated in the cervical muscles. In addition, quality of life, impact of fibromyalgia symptoms, quality of sleep, intensity of pain, anxiety and depression symptoms, impact of fatigue at baseline and post treatment after four weeks of intervention were evaluated. Results: Significant improvement was found in most pain pressure thresholds of the myofascial trigger points in cervical muscles in the dry needling group compared to myofascial release (p < 0.05). Similarly, these differences between groups were found for the components of quality of life of physical function (F = 12.74, p = 0.001), physical role (F = 11.24, p = 0.001), body pain (F =30.26, p < 0.001), general health (F = 15.83, p < 0.001), vitality (F = 13.51, p = 0.001), social function (F = 4.73, p = 0.034), emotional role (F = 8.01, p = 0.006), and mental health (F = 4.95, p = 0.030). Similar results were achieved for total impact of FMS symptoms (F = 42.91, p < 0.001), quality of sleep (F = 11.96, p = 0.001), state anxiety (F = 7.40, p = 0.009), and trait anxiety (F = -14.63, p < 0.001), hospital anxiety and depression (F = 20.60, p < 0.001), general pain intensity (F = 29.59, p < 0.001), and fatigue (F = -25.73, p < 0.001). Conclusion: The dry needling therapy showed higher improvements in comparison with myofascial release therapy for pain pressure thresholds, the components of quality of life of physical role, body pain, vitality and social function, as well as the total impact of FMS symptoms, quality of sleep, state and trait anxiety, hospital anxiety-depression, general pain intensity and fatigue. Implications for rehabilitation Dry needling therapy reduces myofascial trigger point pain in the short term in patients with fibromyalgia syndrome. This therapeutic approach improves anxiety, depression, fatigue symptoms, quality of life, and sleep after treatment. Dry needling and myofascial release therapies decrease intensity of pain, and the impact of fibromyalgia symptoms in this population. These intervention approaches should be considered in an independent manner as complementary therapies within a multidisciplinary setting.

Effectiveness of Transcutaneous Electrical Nerve Stimulation Energy in Older Adults: A Pilot Clinical Trial.

OBJECTIVE: To evaluate the effectiveness of a transcutaneous electric nerve stimulation (TENS) device typically used for pain suppression (analgesia) during pressure injury (PI) healing, peripheral vascularization, and secondary pain in older adults with chronic PIs and cognitive impairment. DESIGN AND SETTING: This pilot clinical trial followed patients from 6 nursing homes. PATIENTS AND INTERVENTION: Twenty-two patients with PIs in the distal third of their lower limbs (7 men, 15 women) were included in this study. The control group completed standard wound care (SWC), whereas the experimental group received SWC and TENS. A total of 20 sessions were conducted for each group over 2 months, 3 times a week. MAIN OUTCOME MEASURE: PI area, PI healing rate, blood flow, skin temperature, oxygen saturation, and level of pain at baseline and posttreatment. MAIN RESULTS: Significant improvements were achieved in PI area (mean difference, 0.92; 95% confidence interval [CI], 0.15-1.67; P =.024), healing rate (3; 95% CI, 1-4.99; P =.009), skin temperature (1.82; 95% CI, 0.35-3.28; P =.021), and pain (1.44; 95% CI, 0.49-2.39; P =.008) in the experimental group, whereas none of the variables revealed a significant change in the control group. CONCLUSIONS: The effect of local and spinal TENS combined with the SWC for PI produced a significant improvement in size, healing, skin temperature, and pain levels.

Effectiveness of mirror therapy, motor imagery, and virtual feedback on phantom limb pain following amputation: A systematic review.

BACKGROUND: Phantom limb pain is reported in 50%-85% of people with amputation. Clinical interventions in treating central pain, such as mirror therapy, motor imagery, or virtual visual feedback, could redound in benefits to amputee patients with phantom limb pain. OBJECTIVES: To provide an overview of the effectiveness of different techniques for treating phantom limb pain in amputee patients. STUDY DESIGN: Systematic review. METHODS: A computerized literature search up to April 2017 was performed using the following databases: PubMed, Scopus, CINAHL, MEDLINE, ProQuest, PEDro, EBSCOhost, and Cochrane Plus. Methodological quality and internal validity score of each study were assessed using PEDro scale. For data synthesis, qualitative methods from the Cochrane Back Review Group were applied. RESULTS: In all, 12 studies met our inclusion criteria, where 9 were rated as low methodological quality and 3 rated moderate quality. All studies showed a significant reduction in pain, but there was heterogeneity among subjects and methodologies and any high-quality clinical trial (PEDro score ≤8; internal validity score ≤5) was not found. CONCLUSION: Mirror therapy, motor imaginary, and virtual visual feedback reduce phantom limb pain; however, there is limited scientific evidence supporting their effectiveness. Future studies should include designs with more solid research methods, exploring short- and long-term benefits of these therapies. Clinical relevance This systematic review investigates the effectiveness of mirror therapy, motor imagery, and virtual visual feedback on phantom limb pain, summarizing the currently published trials and evaluating the research quality. Although these interventions have positive benefits in phantom limb pain, there is still a lack of evidence for supporting their effectiveness.

Effects of Dry Needling on Spinal Mobility and Trigger Points in Patients with Fibromyalgia Syndrome.

BACKGROUND: The etiology of fibromyalgia syndrome (FMS) is inconclusive, but central mechanisms are well accepted for this pain condition. Myofascial pain syndrome (MPS) is one of the most common musculoskeletal pain diseases and is characterized by myofascial trigger points (MTrPs). It has been suggest that MTrPs have an important factor in the genesis of FMS. OBJECTIVE: The purpose of the current randomized clinical trial was to compare the effectiveness of dry needling versus cross tape on spinal mobility and MTrPs in spinal muscles in patients with FMS. STUDY DESIGN: A single-blind randomized controlled trial was conducted on patients with FMS. SETTING: Clinical setting. METHODS: Sixty-four patients with FMS were randomly assigned to an experimental group receiving dry needling therapy or to a control group for cross tape therapy in the MTrPs in the latissimus dorsi, iliocostalis, multifidus, and quadratus lumbourum muscles. Spinal mobility measures and MTrPs algometry were recorded at baseline and after 5 weeks of treatment. RESULTS: The repeated measures analysis of variance (ANOVA) demonstrated that significant differences between groups were achieved for the MTrPs in latissimus dorsi muscle (right axillary portion: F = 9.80, P = 0.003); multifidus muscle (right L2 level: F = 11.80, P = 0.001); quadratus lumborum (right lateral superficial upper: F = 6.67, P = 0.012; and right lateral superficial lower: F = 5.38, P = 0.024). In addition, the ANOVA repeated measures test showed significant differences between groups for the segmental amplitude thoracic spine in the standing erect position (F = 7.33, P = 0.009), and segmental amplitude of lumbar spine (F = 11.60, P = 0.001) in the sitting erect position. LIMITATIONS: The outcomes were not collected from a long-term follow-up period. Dry needling therapy or cross tape were used alone when in reality physical therapists usually treat patients with FMS using a multi-modal approach. A non-treatment control group was not included. CONCLUSIONS: This study has demonstrated that dry needling therapy reduces myofacial trigger points algometry on thoracic and lumbar muscles. Dry needling and cross tape approaches reported a similar effect size for spinal mobility measures in patients with FMS.Key words: Fibromyalgia, trigger points, physical therapy modalities, musculoskeletalequilibrium, myofascial pain syndromes.

Laser Therapy and Occlusal Stabilization Splint for Temporomandibular Disorders in Patients With Fibromyalgia Syndrome: A Randomized, Clinical Trial.

Context • Patients with fibromyalgia syndrome (FMS) report frequent and severe symptoms from temporomandibular disorders (TMDs). The appropriate treatment of TMDs remains controversial. No studies have occurred on the efficacy of therapy with a laser or an occlusal stabilization splint in the treatment of TMDs in patients with FMS. Objective • The study intended to investigate the therapeutic effects of laser therapy and of an occlusal stabilization splint for reducing pain and dysfunction and improving the quality of sleep in patients with TMDs and FMS. Design • The research team designed a single-blinded, randomized clinical trial. Setting • The study took place in the research laboratory at the University of Granada (Granada, Spain). Participants • Participants were 58 women and men who had been diagnosed with FMS and TMDs and who were referred from the clinical setting. Intervention • Participants were randomly assigned to the occlusal-splint or the laser group. The laser group received a treatment protocol in which laser therapy was applied to the participant's tender points, and the occlusal-splint group underwent a treatment protocol in which an occlusal stabilization splint was used. Both groups underwent treatment for 12 wk. Outcomes Measures • Pain intensity, widespread pain, quality of sleep, severity of symptoms, active and passive mouth opening, and joint sounds were assessed in both groups at baseline and after the last intervention. The measurements used were (1) a visual analogue scale (VAS), (2) the Widespread Pain Index (WPI), (3) the Symptom Severity Scale (SSS), (4) the Patient's Global Impression of Change (PGIC), (5) the Pittsburgh Quality of Sleep Questionnaire Index (PSQI), (6) an assessment of the number of tender points, (7) a measurement of the active mouth opening, (8) a measurement of the vertical overlap of the incisors, and (9) the measurement of joint sounds during mouth opening and closing. Results • The group X time interaction for the 2 × 2 mixed analysis of variance found no statistically significant differences between the 2 treatment groups: (1) VAS, P = .591; (2) WPI, P = .112; (3) SSS, P = .227; (4) PGIC, P = .329; (5) number of tender points, P = .107; (6) right and left clicking sounds in the jaw joint during palpation at mouth opening, P = .723 and P = .121, respectively; and (7) right and left clicking sounds in the jaw joint during palpation at mouth closing, P = .743 and P = .698, respectively. Compared with baseline, the laser treatment showed significant improvements on several outcomes, including the VAS, P < .001; WPI, P = .003; and SSS, P = .001. Overall, the study found an average improvement in symptoms from baseline of 21% , P < .001, based on the PGIC. Conclusions • Laser therapy or an occlusal stabilization splint can be an alternative therapeutic treatment for reducing pain symptoms and the clicking sound for TMDs in patients with FMS.

Effectiveness of a flamenco and sevillanas program to enhance mobility, balance, physical activity, blood pressure, body mass, and quality of life in postmenopausal women living in the community in Spain: a randomized clinical trial.

OBJECTIVE: This study aimed to test the effectiveness of a dance therapy program in improving mobility, balance, physical activity, blood pressure (BP), body mass, and quality of life in postmenopausal women in Spain. METHODS: Fifty-two sedentary postmenopausal women (mean age 69.27 ±â€Š3.85 y) were randomly assigned to receive either dance therapy (n = 27) or self-care treatment advice (n = 25). The intervention group participated in 2 months of dance therapy, three sessions weekly, based on Spanish folk dance (flamenco and sevillanas). The control group was provided a booklet containing physical activity recommendations. Mobility, balance, physical activity, BP, body mass, and quality of life were assessed at baseline and posttreatment in both groups. Statistical analysis was performed using a 2 × 2 analysis of variance (ANOVA). RESULTS: Women in the intervention group showed significant improvements in mobility and balance (timed up-and-go test [P = 0.022], cognitive timed up-and-go [P = 0.029], and one-leg stance test results [P = 0.001]), physical activity (total time index [P = 0.045], energy expenditure [P = 0.007], vigorous physical activity [P = 0.001], leisure activity [P = 0.001], moving [P < 0.001], and activity dimension summary [P = 0.001]), and fitness (overall fitness [P = 0.039], cardiorespiratory fitness [P < 0.001], speed-agility [P = 0.001], and flexibility [P = 0.007]) compared with those in the control group. No differences were observed in BP, body mass, or quality of life. CONCLUSIONS: Spanish dance therapy may be effective to improve mobility, balance, and levels of physical activity and fitness in sedentary postmenopausal women.

Auto-Targeted Neurostimulation Is Not Superior to Placebo in Chronic Low Back Pain: A Fourfold Blind Randomized Clinical Trial.

BACKGROUND: Myofascial trigger points (MTrPs) are common in people with musculoskeletal pain and may play a role in chronic nonspecific low back pain (CLBP). One of the potential treatments of MTrPs is the Nervomatrix Soleve® auto-targeted neurostimulation device, providing targeted transcutaneous electrical nerve stimulation (TENS) to MTrPs in the lower back muscles. To date, no controlled studies have evaluated the effectiveness of this device for the pain management of this population. OBJECTIVE: To examine whether the Nervomatrix Soleve® auto-targeted neurostimulation device is superior over placebo for the treatment of CLBP. STUDY DESIGN: A fourfold-blind randomized controlled trial was conducted. SETTING: Brussels University Hospital, health care centers and pharmacies around Belgium. METHODS: Participants with CLBP for at least 3 months were randomly assigned to the experimental (the Nervomatrix Soleve® auto-targeted neurostimulation device providing TENS-stimulation and mechanical pressure) or placebo group (the Nervomatrix Soleve® auto-targeted neurostimulation device providing mechanical pressure alone without current). The treatment protocol in both groups consisted of 6 treatment sessions per patient. Participants were evaluated at baseline prior to the intervention, immediately following treatment, and at one month follow-up. Pain and pain behavior (steps climbed) were assessed as primary outcome measures. Secondary outcome measures were pain functioning, health beliefs, symptoms of central sensitization, pain catastrophizing, and kinesiophobia. RESULTS: In total, 39 participants were included in the study. Participants in both groups improved significantly for pain and functioning, but no significant differences were observed between groups. These improvements were not clinically meaningful for any of the reported measures. The health beliefs changed significantly in both groups (P < 0.05), with superior results at follow-up in the placebo group. LIMITATIONS: The follow-up period is limited to one month. CONCLUSIONS: Treatment of MTrPs with the Nervomatrix Soleve® auto-targeted neurostimulation device in patients with CLBP does not result in a better outcome than placebo-treatment in terms of pain, pain behavior, functioning, central sensitization, pain catastrophizing, and health beliefs.

Benefits of Craniosacral Therapy in Patients with Chronic Low Back Pain: A Randomized Controlled Trial.

OBJECTIVES: To evaluate the effects of craniosacral therapy on disability, pain intensity, quality of life, and mobility in patients with low back pain. DESIGN: A single-blinded randomized controlled trial. PATIENTS: Sixty-four patients with chronic nonspecific low back pain (mean age ± SD, 50 ± 12 years; 66% female) who were referred for physical therapy at a clinical unit of the Health Science School of the University of Almeria (Spain). INTERVENTIONS: Participants were randomly assigned to an experimental group (10 sessions of craniosacral therapy) or a control group (10 sessions of classic massage). OUTCOME MEASURES: Disability (Roland Morris Disability Questionnaire [RMQ, primary outcome] and Oswestry Disability Index), pain intensity (10-point numeric pain rating scale), kinesiophobia (Tampa Scale of Kinesiophobia), isometric endurance of trunk flexor muscles (McQuade test), lumbar mobility in flexion, hemoglobin oxygen saturation, systolic blood pressure, diastolic blood pressure, hemodynamic measures (cardiac index), and biochemical estimation of interstitial fluid. These outcomes were registered at baseline, after treatment, and 1-month follow-up. RESULTS: No statistically significant differences were seen between groups for the main outcome of the study, the RMQ (p = 0.060). However, patients receiving craniosacral therapy experienced greater improvement in pain intensity (p ≤ 0.008), hemoglobin oxygen saturation (p ≤ 0.028), and systolic blood pressure (p ≤ 0.029) at immediate- and medium-term and serum potassium (p = 0.023) level and magnesium (p = 0.012) at short-term than those receiving classic massage. CONCLUSIONS: Ten sessions of craniosacral therapy resulted in a statistically greater improvement in pain intensity, hemoglobin oxygen saturation, systolic blood pressure, serum potassium, and magnesium level than did 10 sessions of classic massage in patients with low back pain.

Short-term effects of interferential current electro-massage in adults with chronic non-specific low back pain: a randomized controlled trial.

OBJECTIVES: To analyse the effectiveness of a combined procedure of massage and electrotherapy with interferential current in individuals with chronic non-specific low back pain of mechanical aetiology. DESIGN: A single blinded randomized controlled trial. SETTING: Clinical setting. PARTICIPANTS: Sixty-two individuals with chronic non-specific low back pain were randomly assigned to an experimental or control group. For 10 weeks the experimental group underwent treatment comprising 20 sessions (twice a week) of massage with interferential current in the lumbar and dorsal-lumbar area, and the control group received superficial lower back massage (effleurage, superficial pressure and skin rolling). MAIN OUTCOME VARIABLES: Oswestry Disability Index, pain visual analogue scale, Tampa Scale for Kinesiophobia, Roland Morris Disability Questionnaire, McQuade Test, Side Bridge Test, quality of life scores and the range of trunk anteflexion motion, which were all assessed before the treatment and immediately after the last treatment session. RESULTS: The 2 × 2 mixed model ANOVA with repeated measurements showed statistically significant group * time interactions for the visual analogue scale (F = 12.839; P = 0.001), Oswestry Disability Index (F = 5.850; P = 0.019), Roland Morris Disability Questionnaire (F = 8.237; P = 0.006) and quality of life (physical function (F = 16.792; P = 0.001), physical role (F = 14.839; P = 0.001) and body pain (F = 11.247; P = 0.001)). CONCLUSIONS: In individuals with chronic non-specific low back pain, interferential current electro-massage achieved a significantly greater improvement in disability, pain and quality of life in comparison to superficial massage after 20 treatment sessions.

Comparative study on the effectiveness of myofascial release manual therapy and physical therapy for venous insufficiency in postmenopausal women.

OBJECTIVES: Venous insufficiency is present in a large number of postmenopausal women, increasing their risk of disability. The objective of this study was to determine the effects of myofascial release therapy and conventional kinesiotherapy on venous blood circulation, pain and quality of life in postmenopausal patients with venous insufficiency. METHODS: A randomised controlled trial was undertaken. We enrolled 65 postmenopausal women with stage I or II venous insufficiency on the clinical, aetiological, anatomical and physiopathological (CEAP) scale of venous disorders, randomly assigning them to a control (n=32) or experimental (n=33) group. The control and experimental group patients underwent physical venous return therapy (kinesiotherapy) for a 10-week period, during which the experimental group patients also received 20 sessions of myofascial release therapy. Main outcome measures determined pre- and post-intervention were blood pressure, cell mass, intracellular water, basal metabolism, venous velocity, skin temperature, pain and quality of life. RESULTS: Basal metabolism (P<0.047), intracellular water (P<0.041), diastolic blood pressure (P<0.046), venous blood flow velocity (P<0.048), pain (P<0.039) and emotional role (P<0.047) were significantly higher in the experimental group than in the control group after the 10-week treatment programme. CONCLUSION: The combination of myofascial release therapy and kinesiotherapy improves the venous return blood flow, pain and quality of life in postmenopausal women with venous insufficiency.

Problem based learning approaches to the technology education of physical therapy students.

BACKGROUND: Problem-Based Learning (PBL) is a whole-curriculum concept. AIM: This study aimed to compare learning preferences and strategies between physical therapy students taught by PBL and those receiving conventional lectures on massage therapy, trauma physical therapy, and electrotherapy, hydrotherapy, and thermotherapy. METHODS: This quasi-experimental study included 182 male and female students on physical therapy diploma courses at three universities in Andalusia (Spain). The Canfield Learning Skills Inventory (CLSI) was used to assess learning strategies and the Approaches to Study Skills Inventory for Students (ASSIST) to analyze study preferences. RESULTS: At the end of the academic year 2009/10, physical therapy students taught by PBL considered the most important learning strategies to be group work, study organization, relationship of ideas, and academic results. In comparison to conventionally taught counterparts, they considered that PBL reduced lack of purpose, memorizing without relating, the law of minimum effort, and fear of failure. Among these PBL students, the most highly rated study preferences were: organization of course tasks, cordial interaction with the teacher, learning by reading and images, and direct hands-on experience. CONCLUSION: For these physical therapy students, PBL facilitates learning strategies and study preferences in comparison to conventional teaching.

Prevención del linfedema tras cirugía de cáncer de mama mediante ortesis elástica de contención y drenaje linfático manual: ensayo clínico aleatorizado / Preventing lymphoedema after breast cancer surgery by elastic restraint orthotic and manual lymphatic drainage: A randomized clinical trial

Fundamento y objetivo: El linfedema secundario es una de las complicaciones más comunes tras cirugía de cáncer de mama. El objetivo del presente trabajo fue analizar la eficacia de la ortesis elástica de contención y drenaje linfático manual en la prevención del linfedema de miembro superior secundario a mastectomía. Pacientes y método: Se realizó un estudio experimental con grupo control. Se asignaron de forma aleatoria 48 pacientes a grupo experimental (ortesis elástica de contención y drenaje linfático manual) y grupo control (medidas posturales). Las dimensiones de estudio fueron la calidad de vida, composición corporal, temperatura, valoración funcional de hombro, dolor y volumen del miembro. Las evaluaciones se realizaron en el momento basal y al finalizar los 8 meses de intervención. Resultados: Finalizado el período de intervención, en el grupo experimental se encontraron diferencias significativas (p<0,05) en la calidad de vida, agua extracelular, valoración funcional y volumen del miembro del lado mastectomizado. Conclusiones: La aplicación de la ortesis elástica de contención y el drenaje linfático manual contribuye a prevenir el linfedema secundario tras cirugía de cáncer de mama, mejorando la calidad de vida de estas pacientes (AU)

Background and objective: Secondary lymphoedema is considered one of the most common complications after breast cancer surgery. The aim of the present study was to analyze the effectiveness of containment elastic orthosis and manual lymphatic drainage in the prevention of lymphoedema secondary to mastectomy. Patients and method: An experimental study was performed with a control group. Forty-eight patients were randomly assigned to experimental (containment elastic orthosis and manual lymphatic drainage) and control (postural measures) groups. Outcomes measures were quality of life, body composition, temperature, functional assessment of the shoulder, pain and limb volume. Measures were performed at baseline and after 8-months intervention. Results: After the intervention period, the experimental group showed significant differences (P<.05) in the quality of life, extracellular water, and functional assessment of the volume of the limb of the mastectomized side. Conclusions: The application of containment elastic orthosis and manual lymphatic drainage contribute to prevent secondary lymphoedema after breast cancer surgery, improving the quality of life in these patients (AU)

[Preventing lymphoedema after breast cancer surgery by elastic restraint orthotic and manual lymphatic drainage: a randomized clinical trial]. / Prevención del linfedema tras cirugía de cáncer de mama mediante ortesis elástica de contención y drenaje linfático manual: ensayo clínico aleatorizado.

BACKGROUND AND OBJECTIVE: Secondary lymphoedema is considered one of the most common complications after breast cancer surgery. The aim of the present study was to analyze the effectiveness of containment elastic orthosis and manual lymphatic drainage in the prevention of lymphoedema secondary to mastectomy. PATIENTS AND METHOD: An experimental study was performed with a control group. Forty-eight patients were randomly assigned to experimental (containment elastic orthosis and manual lymphatic drainage) and control (postural measures) groups. Outcomes measures were quality of life, body composition, temperature, functional assessment of the shoulder, pain and limb volume. Measures were performed at baseline and after 8-months intervention. RESULTS: After the intervention period, the experimental group showed significant differences (P<.05) in the quality of life, extracellular water, and functional assessment of the volume of the limb of the mastectomized side. CONCLUSIONS: The application of containment elastic orthosis and manual lymphatic drainage contribute to prevent secondary lymphoedema after breast cancer surgery, improving the quality of life in these patients.