Effects of glucosamine and chondroitin sulfate supplementation in addition to resistance exercise training and manual therapy in patients with knee osteoarthritis: A randomized controlled trial.

OBJECTIVE: To determine the added benefits of short-term glucosamine and chondroitin sulfate supplementation in combination with manual therapy and resistance exercise training in the management of knee osteoarthritis. METHODS: A parallel-design, double-blind randomised controlled trial was conducted from January to September 2020 at the Foundation University Institute of Rehabilitation Sciences and Fauji Foundation Hospital, Rawalpindi, Pakistan, and comprised of knee osteoarthritis patients of either gender having radiological evidence of grade III or less on Kellgren classification. The subjects were randomly allocated to active comparator group A and experimental group B. Both the groups received manual therapy and resistance exercise training, while group B additionally received glucosamine and chondroitin sulfate supplementation for 4 weeks. Study outcomes included pain, function, quality of life, range of motion, strength, fall risk, skeletal muscle mass, visceral fat area, body fat, intracellular water ratio, and segmental lean and fat mass. Data was analysed using SPSS 21. RESULTS: Of the 24 subjects, there were 12(50%) in each of the two groups. Each groups had 9(75%) males and 3(25%) females. In terms knee osteoarthritis grade, there was no significant difference between the groups (p=1.00). No significant differences were observed in any of the outcome measures neither at 2 weeks, nor at 4 weeks post-intervention between the groups (p>0.05) except for percentage change in segmental lean mass of the right leg at 2nd week and of the left leg at 4th week (p<0.05). CONCLUSIONS: Manual therapy and resistance exercise training are effective in the management of knee osteoarthritis, however, glucosamine and chondroitin sulfate supplementation for 4 weeks showed no additional benefits. Clinical Trial Number: NCT04654871. https://www.clinicaltrials.gov/ct2/show/NCT04654871.

Comparative effectiveness of proprioceptive neuromuscular facilitation and passive vertebral mobilization for neck disability in patients with mechanical neck pain: A randomized controlled trial.

OBJECTIVE: To compare the effectiveness of Proprioceptive Neuromuscular Facilitation (PNF) and Passive Vertebral Mobilization (PVM), both when given in adjunct to routine physical therapy (RPT), on neck disability in patients with mechanical neck pain (MNP). METHODS: A single-blinded randomized controlled trial was conducted on 90 patients with MNP at the National Institute of Rehabilitation Medicine, Islamabad, Pakistan, from September 2015 to March 2018. The participants aged between 18 and 65 years were recruited through a simple random sampling technique and randomly divided into three groups i.e. PNF + RPT, PVM + RPT, and RPT. Each participant was evaluated pre and post-intervention (after four weeks) through neck disability index (NDI). The data were analyzed by using SPSS version 21. RESULTS: The MANOVA was run on the pre-post mean differences of the variables to determine the changes within the groups which showed that the participants improved significantly in all the groups in terms of the NDI components and overall NDI score (p < 0.05). Univariate analysis with the post-hoc comparison and Tuckey HSD correction was used to determine the differences between the groups which showed that there was a significant difference between the interventional groups in the overall pain intensity, as well as pain experienced while performing personal care activities, reading, doing work, driving, sleeping, recreation and in the total NDI score (p < 0.05). CONCLUSION: PVM (in adjunct to RPT) was more effective than PNF (in adjunct to RPT) for the patients with MNP to manage themselves in daily activities. CLINICAL TRIAL REGISTRATION: NCT03813680 (at clinicaltrials.gov) (https://clinicaltrials.gov/ct2/show/NCT03813680).

The effects of traditional massage on spasticity of children with cerebral palsy: a randomized controlled trial.

OBJECTIVE: To examine the effects of traditional massage on spasticity of children with cerebral palsy. METHODS: The randomised control trial was conducted at the National Institute of Rehabilitation Medicine, Islamabad, Pakistan, from September 2016 to August 2018, and comprised children with spastic cerebral palsy aged 2-10 years who were randomly allocated to control and intervention groups. Both the groups received routine physical therapy once daily, five times a week for three months. The intervention group additionally received traditional massage. Spasticity was evaluated using the Modified Ashworth Scale at baseline, and after 6th and 12th weeks of intervention. Data analysed using SPSS 20.. RESULTS: Of the 86 subjects enrolled, 75(87.2%) completed the study; 37(49.3%) in the control group with a mean age of 6.81±2.31 years, and 38(50.6%) in the intervention group with a mean age of 7.05±2.47 years. There were 25(68%) boys among the controls and 22(58%) in the intervention group. There was no statistically significant difference in baseline scores between the groups (p>0.05). At 6th week, reduction in scores was statistically significant in the right upper limb (p<0.05), and in the right lower limb (p<0.05) after the 12th week. CONCLUSIONS: Traditional massage was found to have significant effect on the right side compared to the routine physical therapy for reduction of spasticity in children with cerebral palsy.