Effect of Dry Needling Injection and Kinesiotaping on Pain and Quality of Life in Patients with Mechanical Neck Pain.

BACKGROUND: Dry needling (DN) is a commonly used technique by clinicians for the treatment of mechanical neck pain (MNP) by targeting trigger points and nontrigger point structures. It is a skilled intervention that uses a thin ?liform needle to penetrate the skin and stimulate underlying trigger points, muscular and connective tissues without the use of injectate. Another popular treatment technique used in the management of musculoskeletal pathologies is kinesiotaping (KT). Although its popular, there is minimal scientific evidence supporting KT for neck pain. Although there are a few studies regarding KT for neck pain in literature, there is a lack of randomized, controlled studies evaluating KT for neck pain. OBJECTIVES: To evaluate the effect of KT on posterior cervical spine and DN into a posterior paracervical muscle of patients with MNP. STUDY DESIGN: Randomized clinical study. SETTING: Physical medicine and rehabilitation center. METHODS: Seventy-two patients (17 men, 55 women) were randomly assigned to DN or KT treatment groups. Numeric Rating Scale (NPS-11), Neck Disability Index (NDI), range of motion (ROM), Short Form-36 Quality of Life Scale, and Beck Depression Inventory (BDI) were assessed before the intervention and one month postintervention. RESULTS: Before treatment, there was no difference between groups in NPS-11, NDI, and BDI scores; however, ROM of the DN group was greater than ROM of the KT group (P < 0.05). After treatment, significant improvement was observed in all variables for both of the groups, except ROM in the DN group (P < 0.05). The KT group showed greater ROM compared with the DN group (P < 0.05). The pre- and posttreatment results showed that the KT group was significantly superior for the differences on ROM and NDI (P < 0.05); however, each group showed better results after treatment (P < 0.05). LIMITATIONS: First, we did not include a control or placebo group. Second, patients were followed up for only 4 weeks. Third, we used a sample of convenience from one clinic, which may not be representative of the entire population of individuals with MNP. CONCLUSIONS: In this study, both methods were found to be effective on pain, mood, and quality of life, and KT was found to be superior to DN in MNP in terms of increasing ROM and decreasing disability. KEY WORDS: Dry needling, kinesiotaping, mechanical neck pain, quality of life.

The Effectiveness of Fluidotherapy in Poststroke Complex Regional Pain Syndrome: A Randomized Controlled Study.

OBJECTIVE: To evaluate whether combining fluidotherapy to conventional rehabilitation program provides additional improvements on pain severity, upper extremity functions, and edema volume in patients with poststroke complex regional pain syndrome (CRPS). DESIGN: Randomized controlled trial. SETTING: Training and research hospital. PARTICIPANTS: Thirty hemiplegic patients with subacute stage CRPS type-1 of the upper extremity. INTERVENTIONS: The patients randomly divided into 2 groups. Both groups received a 3 week conventional rehabilitation program (5 days/week, 2-4 hours/day). Experimental group received 15 sessions additional fluidotherapy application to the affected upper extremity (40 °C, 20 minutes in continuous mode, 5 sessions/week). MAIN OUTCOME MEASURES: We evaluated the distal upper arm edema with a volumeter. Other used clinical assessment scales were Brunnstrom recovery stages of the arm and hand for motor recovery, motor items of the functional independence measure for functional status, visual analog scale for pain severity, and the painDETECT questionnaire for presence and the severity of neuropathic pain. RESULTS: The mean age of the participants was 64.3 ± 11.66 (28-84). At the post-treatment evaluation, significant improvements were revealed regarding to the edema volume, pain visual analog scale, painDETECT and functional independence measure scores, and the Brunnstrom stages of upper extremity and hand in both groups (P < .05). But among the parameters mentioned above, only the decrease in edema volume and the painDETECT scores were greater in fluidotherapy group than the control group (P < .05). CONCLUSIONS: Addition of the fluidotherapy to the conventional rehabilitation program provides better improvements on neuropathic pain and edema volume in subacute stage poststroke CRPS.

Complex Decongestive Therapy Enhances Upper Limb Functions in Patients with Breast Cancer-Related Lymphedema.

BACKGROUND: We aimed to evaluate the effects of complex decongestive therapy (CDT) on upper extremity functions, the severity of pain, and quality of life. We also searched the impact of the sociodemographic and clinical characteristics on the improvement in upper extremity functions. METHODS: A total of 37 women with breast cancer-related lymphedema (BCRL) [age, 53.6 ± 11.2 (28-72)] were included in this study. All patients underwent CDT-phase 1 program, including meticulous skin care, manual lymphatic drainage, remedial exercises, and compression bandages. Arm volume was calculated by a formula for truncated cone using circumferential measurements. A baseline questionnaire, including sociodemographic and clinical properties, was used for each patient. Short Form-36 (SF-36), Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and Visual Analog Scale (VAS) for pain and heaviness were used as clinical assessment scales. RESULTS: The mean of the posttreatment volume of the affected limb was lower compared to pretreatment volume (2741.81 ± 696.85 and 2990.67 ± 745.49, respectively), and the mean percentage change in edema volume was 38.1% ± 26.5%. We observed a statistically significant reduction in pain and heaviness VAS scores and improvement of shoulder mobility among upper extremities with lymphedema (p < 0.001) after CDT. The mean of posttreatment DASH score was lower compared to pretreatment score (37.19 ± 16.01, 49.81 ± 18.84, respectively, p < 0.001). All subgroups of the SF-36 parameters were increased after the CDT application (p < 0.01). Besides being under 65 years old, having a body mass index above 30 and short duration of lymphedema were found to be related to greater improvement in upper extremity functions. CONCLUSIONS: CDT provides enhancement of upper extremity functions and quality of life in patients with BCRL. The reduction in lymphedema volume, pain, and heaviness and the improvement in shoulder mobility may be the contributed factors.

Can kinesio tape be used as an ankle training method in the rehabilitation of the stroke patients?

OBJECTIVE: To investigate the effects of the kinesio tape application to the tibialis anterior on rehabilitation outcomes of the stroke patients. DESIGN AND SETTING: Twenty patients with stroke were allocated into two groups: the first group of ten patients was assigned to receive kinesio tape in addition to the conventional rehabilitation program while a second group of 10 patients was assigned to receive a conventional rehabilitation program only. MAIN OUTCOME MEASURES: The clinical variables and health-related quality of life (HRQoL) were evaluated at baseline and at the end of the forth week. RESULTS: The present study showed that kinesio tape application to the tibialis anterior has significant effects on motor recovery of the lower extremity, spasticity, ambulation capacity, HRQoL and gait compared to the control group and baseline. CONCLUSIONS: The results of this study suggest that kinesio tape can be used as an ankle training method.