Respiratory Dysfunction in Individuals With Thoracic Outlet Syndrome.

OBJECTIVE: The purpose of this study was to compare pulmonary function and respiratory muscle strength and endurance in individuals with thoracic outlet syndrome (TOS) and healthy participants. METHODS: Sixty-two individuals with TOS (mean age 30.81 ± 10.69 years; 10 male, 52 female) and 47 healthy individuals (mean age 30.64 ± 9.16 years; 14 male, 33 female) participated in this study. Pulmonary function testing was performed using a spirometer. Respiratory muscle strength (maximal inspiratory pressure [MIP] and maximal expiratory pressure [MEP]) were measured using a mouth pressure device. Respiratory muscle endurance was tested at 35% MIP and measured as the time in seconds from the start of the test to voluntary exhaustion. RESULTS: Age distribution and physical characteristics were similar between the groups (P > .05). All pulmonary function parameters except for peak expiratory flow rate were similar in patients with TOS and healthy controls (P > .05). Patients with TOS had significantly lower peak expiratory flow rate, MIP, MIP%, MEP, MEP%, and respiratory muscle endurance compared with controls (P < .05). Forty-six patients with TOS (74.2%) had MIP values below the lower limit of the 95% CI of the control group (97.05-113.88 cmH2O), and 53 patients with TOS (85.2%) had MEP values below the lower limit of the 95% CI of the control group (124.74-146.49 cmH2O). CONCLUSION: Expiratory flow rate and respiratory muscle strength and endurance may be adversely affected in TOS. Trunk muscles perform both postural and breathing functions. Therefore, disruption in one function may negatively affect the other.

Effects of different frequencies of conventional transcutaneous electrical nerve stimulation on pressure pain threshold and tolerance.

BACKGROUND: Pulse frequency is one of the key determinants of analgesic outcomes by transcutaneous electrical nerve stimulation (TENS). However, optimal settings remain unclear. OBJECTIVE: To compare the effects of different frequencies of TENS, on pressure pain threshold and tolerance. METHODS: Currents with pulse duration of 110 µs, and pulse frequencies of 60 pps or 150 pps were applied on the volar aspects of the dominant forearms of 20 healthy volunteers, on two consecutive days, in a randomized order. Threshold and tolerance were measured at the beginning, after the 15th and 30th minutes of the applications, and 30 minutes after the applications. RESULTS: Pressure pain threshold and tolerance values were higher at the 150 pps frequency, at all measurement times (p< 0.05). However, no frequencyXtime interaction and time-dependent changes were found for the outcome measures (p> 0.05). CONCLUSIONS: These findings established that, at 150 pps conventional TENS, threshold and tolerance values were consistently higher. These results are presented to inform future research regarding optimal conventional TENS parameters and to provide support for clinical applications.

Neurodynamic mobilization in the conservative treatment of cubital tunnel syndrome: long-term follow-up of 7 cases.

OBJECTIVE: The aim of this case series is to describe the effect of nerve mobilization techniques in the standard conservative management of cubital tunnel syndrome (CTS). METHODS: Seven patients with CTS participated in this study. Inclusion criteria were having grade 1 and grade 2 entrapment neuropathy according to the McGowan grading system and no other neuropathies. In the evaluation, gripping with grip dynamometer; palmar gripping with a pinchmeter; pain level and Tinel sign with visual analog scale; sensibility with Semmes-Weinstein monofilaments; and functional status of the patients with the Turkish version of the Disability of Arm, Shoulder, and Hand Index were performed before starting a rehabilitation program, at the end of the 8-week rehabilitation program, and at 12-month follow-up. The physiotherapy program consisted of cold application, pulsed ultrasound, nerve mobilization techniques, strengthening exercises, postural adaptations, patient education, and ergonomic modifications. RESULTS: Pain; Tinel sign; and Disability of Arm, Shoulder, and Hand Index scores were decreased, whereas grip and pinch strength increased in the observation period for these 7 patients. CONCLUSION: This case series demonstrated that conservative treatment of CTS may be beneficial for selected patients with mild to moderate symptoms. The treatment included neurodynamic mobilizations, including sliding techniques and tensioning techniques, which are thought to enhance ulnar nerve gliding and restore neural tissue mobility. Conservative treatment using neurodynamic mobilization with patient education and activity modification demonstrated some long-term positive results.