Comparison of the efficacy of manual treatment according to fascial distortion model versus joint mobilization in patients with shoulder impingement: A randomized clinical trial.

BACKGROUND: The Fascial Distortion Model (FDM) is a relatively new manual therapy approach in the field of musculoskeletal physical therapy, but to date no study has been conducted to compare its' effect in comparison with joint mobilization on patients with shoulder impingement syndrome. OBJECTIVE: The present study aims to compare the efficacy of the FDM versus joint mobilization in pain intensity, pain-free abduction range of motion and function of patients with shoulder impingement syndrome. DESIGN: single-blind, parallel-arm randomized controlled trial. METHODS: 26 patients diagnosed with shoulder impingement syndrome were equally randomized into 2 groups: manual treatment according to the FDM, and joint mobilization of the shoulder complex. All patients received 3 intervention sessions every other day. Pain intensity (by visual analogue scale), pain-free abduction range of motion (by goniometry) and function (by Persian version of shoulder pain and disability index) were measured before and after every session and at follow-up 2 weeks later. Patients' satisfaction with treatment was also measured (by a 4-point Likert scale) at follow-up. RESULTS: FDM therapy group showed statistically significant greater pain reduction (P = 0.014) and range of motion increment (P = 0.044) than joint mobilization group after intervention, while only range of motion maintained the difference at follow-up (P = 0.034). Function improvement was not statistically different after the intervention (P = 0.582) and at follow-up (P = 0.094). There was no difference in patients' satisfaction with treatment between groups (P > 0.05). CONCLUSION: The FDM is a safe and effective treatment approach with comparable results to joint mobilization in patients with shoulder impingement syndrome.

Efficacy of low-level laser therapy on management of Bell's palsy: a systematic review.

The aim of this study is to evaluate the efficacy of low-level laser therapy (LLLT) in patients with Bell's palsy (BP) through a systematic review method. We systematically searched international databases including PubMed, Scopus, and Web of Science to find eligible articles without language limitation. All relevant randomized controlled trials (RCTs) that compared the efficacy of the LLLT with placebo laser, exercise, massage, or no intervention on BP patients were included. Four studies (out of 259) had met our inclusion criteria involving 171 patients and were entered to the systematic review. Full texts of the selected studies were retrieved and critically appraised using Physiotherapy Evidence Database (PEDro) scale. The patients of all trials were in sub-acute (less than 1 week) stage. Both of LLLT and control groups showed significant improvement after trials. Two authors reported significant differences between the groups after 6 weeks of laser application (830 nm, 100 mW). In converse, two other authors did not identify any effectiveness following 4 weeks and 15 days of LLLT application with 670 and 830 nm wavelength, sequentially. There is clear lack of information lead to get and evidence-based suggestion for the LLLT application on Bells' palsy; however, the LLLT irradiation with 830 nm and 100 mW power for a period of 6 weeks might be beneficial on recovery for the patients with sub-acute Bell's palsy. There were no reported adverse effects during treatment and/or follow-up sessions.