Effects of oscillatory mobilization as compared to sustained stretch mobilization in the management of cervical radiculopathy: A randomized controlled trial.

BACKGROUND: Cervical radiculopathy is a relatively common musculoskeletal disorder resulting in a significant social and occupational impact. Manual therapy is thought to provide relief in cervical radiculopathy; however, evidence is lacking regarding the comparison of different manual therapy concepts. OBJECTIVE: To determine the effects of Maitland's oscillatory mobilization as compared to Kaltenborn's sustained stretch mobilization in the management of cervical radiculopathy. METHODS: A randomized controlled trial was conducted at Fauji Foundation Hospital comprising of 46 patients randomized into oscillatory and sustained stretch mobilization groups. Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI) and cervical range of motion (ROM) were used as outcome variables. RESULTS: No significant differences were observed at base line between the two groups (P> 0.05) except for ROM in extension and left side bending (P< 0.05). In terms of pre and post treatment comparison, P value of less than 0.05 was observed for both groups, indicating both treatments to be effective in isolation. However, post treatment comparison between both groups showed oscillatory mobilization to be superior to sustained stretch mobilization (P< 0.05) in the management of cervical radiculopathy except for the outcomes of pain and side bending. CONCLUSION: Both oscillatory and sustained stretch mobilization techniques are found to be effective in the management of cervical radiculopathy in terms of pain, range and disability. However, oscillatory mobilization is found to be superior in terms of functional ability and range of motion.

Observations on the Efficacy of Electrothermal Acupuncture plus Joint Mobilization in Treating Knee Osteoarthritis / 上海针灸杂志

Objective To investigate the clinical efficacy of electrothermal acupuncture plus joint mobilization in treating knee osteoarthritis.Methods One hundred patients with knee osteoarthritis were randomized to treatment and control groups, 50 cases each. The control group received Maitland's technique and the treatment group, electrothermal acupuncture in addition. The Osteoarthritis Index score was recorded and cytokines (IL-1, IL-6 and TNF-α) contents were measured in the two groups before and after four weeks of treatment. The clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 91.5％ in the treatment group and 80.0％ in the control group; there was a statistically significant difference between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in the WOMAC score and cytokines in the two groups (P<0.01,P<0.05). There were statistically significant post-treatment differences in the WOMAC score and cytokines between the treatment and control groups (P<0.05).Conclusion Electrothermal acupuncture plus joint mobilization is an effective way to treat knee osteoarthritis.

Effect of stretching of piriformis and iliopsoas in coccydynia.

Pain in the coccyx is referred as coccydynia. The pain aggravates in weight bearing i.e. sitting. Total 48 persons with coccydynia diagnosed clinically were recruited and randomly assigned into one of the 3 groups. Experimental group I were treated by stretching of piriformis and iliopsoas muscles, experimental group II were treated by stretching of piriformis and iliopsoas muscles and Maitland's rhythmic oscillatory thoracic mobilization over the hypomobile segments and the conventional group were treated by seat cushioning + Sitz bath + Phonophorosis. All participants underwent an initial baseline assessment for Pressure Pain Threshold (PPT) by using modified syringe algometer and pain free sitting duration. All the subjects were advised to minimise sitting posture and use a seat cushion. Treatment was given for 3 weeks, 5 sessions per week and post-treatment evaluation was done after completion of 3 weeks. Follow up evaluation was done after 1 month. DATA ANALYSIS: The data was analyzed by using 3 × 3 ANOVA. Tukey's HSD post-Hoc analysis was used for all pair wise comparison. RESULTS: The overall results of the study showed that there was significant improvement in pain pressure threshold and pain free sitting in both the experimental groups with treatment and improvement continued after cessation of therapy, whereas the conventional group did not improve significantly.

Mobilisation of the thoracic spine in the management of spondylolisthesis.

INTRODUCTION: Segmental instability due to lumbar spondylolisthesis is a potential cause of chronic low back pain. Hypomobility of the spine results in compensatory segmental hypermobility of the segment above or below restricted segments. Therefore, the aim of the study is to determine the effects of mobilisation of the hypomobile upper thoracic spine along with conventional flexion exercises and stretching of short hip flexors on the degree of slippage and the functions of the persons with lumbar spondylolisthesis. METHODOLOGY: All patients with spondylolisthesis were randomly assigned into two groups: Group I - Experimental group, treated with mobilisation of the thoracic spine along with the conventional physiotherapy and Group II - Conventional group, treated with conventional stretching, strengthening, and lumbar flexion exercise programme. RESULTS: The experimental group treated with mobilisation of the thoracic spine shows a significant reduction in the percentage of vertebral slip from pre-treatment to post-treatment measurements. CONCLUSION: Low back pain due to spondylolisthesis may be benefited by mobilisation of the thoracic spine along with stretching of short hip flexors, piriformis, lumbar flexion range of motion exercises, core strengthening exercises, etc.