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OBJECTIVE: The purpose of this study was to determine the effect of functional scapular stabilization training compared with the standard physical therapy on function and pain in people with frozen shoulder syndrome (FSS). METHODS: In a single-blind randomized controlled trial, 86 people with FSS were randomly allocated into the intervention group (functional stabilization training [n = 43]) and control group (standard physical therapy [n = 43]) using block randomization for 12 weeks. The primary outcome measures were the Shoulder Pain and Disability Index and the numeric pain rating scale. The secondary outcome measures were range of motion (ROM), range of passive abduction, and coracoid pain test. All the outcome measures were carried out by an independent blind outcome assessor at baseline and at the end of 12 weeks. RESULTS: A significant group × time interaction effect was observed for the Shoulder Pain and Disability Index (95% CI, 2.95-16.74; P < .01) and the numeric pain rating scale (95% CI, 0.67-2.07; P < .01) at the end of 12 weeks. The external rotation ROM showed a statistical significance with a mean change of 7.8° and P value of <.01. CONCLUSION: The present findings show that scapular functional stabilization training resulted in improvement of function, reduction in pain, and greater improvement in external rotation ROM in patients with FSS. Also, our study findings suggest the involvement of rotator interval and inferior soft-tissue structures as indicated by the coracoid pain test and range of passive abduction.
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Background: Sleep disturbance is one of the key symptoms of fibromyalgia syndrome (FMS), which negatively affects the participants' quality of life. Craniosacral therapy (CST) is a gentle manual technique found to have significant effects on pain and function in chronic pain participants. However, limited evidence exists on its effectiveness on sleep quality in FMS participants. Purpose: To evaluate the feasibility and effectiveness of CST on sleep quality in FMS participants. Setting: Outpatient physiotherapy department of a hospital in Bangalore. Participants: Participants diagnosed with FMS. Research Design: A pre/post pilot trial. Intervention: Once weekly, 45-minute sessions of CST for 12 weeks. The participants continued the standard medical care prescribed by the physician. Main Outcome Measure: The sleep quality was evaluated using Pittsburgh Sleep Quality Index (PSQI) at baseline and 12 weeks. The data analysis was carried out using paired t test. Results: 9 out of 10 included participants completed the treatment and were included for analysis. The results of the paired t test showed significant improvement in the global PSQI score (p = .001, mean difference = 5.44±3.28, 95% CI = 2.92-7.97), as well as the 5 components of PSQI (p < .05). Conclusion: CST was feasible to deliver with high retention, acceptability, and minimal adverse events. It significantly improved sleep quality in FMS participants along with standard medical care. However, future studies with larger sample sizes and appropriate control groups are required to confirm the findings.
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BACKGROUND AND PURPOSE: There is limited evidence on the effects of myofascial release on fibromyalgia symptoms. This review aims to update the evidence on the effectiveness of myofascial release on pain, sleep, and quality of life in patients with fibromyalgia syndrome. METHODS: The review was prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Scopus, Cochrane Library, Physiotherapy Evidence Database, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature Complete, and ProQuest Medical library were searched from their inception to April 1, 2021 for randomized or nonrandomized clinical trials published in English. Studies consisting of myofascial release alone or in combination with exercise as the intervention were included. The quality of the studies was evaluated using Cochrane Risk of Bias 2.0. RESULTS: Six studies, including a total of 279 participants, were included in the review. The meta-analysis showed a large significant effect of myofascial release on pain posttreatment (-0.81[95% CI = -1.15 to -0.47], p < 0.00001) and a moderate effect at 6 months post-treatment (-0.61, 95% CI = -0.95 to -0.28, p = 0.0003). CONCLUSION: The review demonstrated moderate evidence for the effect of therapist administered and self-myofascial release in improving pain, sleep subscales, and quality of life against sham and no treatment, respectively, in fibromyalgia syndrome patients. However, more high-quality randomized controlled trials with manual control group are required to be conducted at different geographical locations to generalize the findings.
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Fibromialgia , Osteopatia , Fibromialgia/terapia , Humanos , Dor , Qualidade de Vida , SonoRESUMO
BACKGROUND: Inspiratory muscle training is used to specifically strengthen the respiratory muscles. Controversy exists regarding the use of inspiratory muscle training as a method of facilitating airways clearance. Acapella is already known to be effective in airway clearance. OBJECTIVE: The objective of the study was to compare the effects of the Acapella and a threshold inspiratory muscle trainer as a method of airway clearance in subjects with bronchiectasis and to determine patient preference between the two techniques. METHODS: Thirty patients (10 males, 20 females) mean age of 50.67+/-6.37 (mean+/-SD) with a history of expectoration of more than 30 ml sputum per day were recruited. The sequence of therapy was allocated by block randomization. Assessment and familiarization session was performed on day 1. Treatments employing the Acapella and inspiratory muscle trainer were done on days 2 and 3. Treatment order and allocation was determined by block randomization. Sputum volume was measured during and 2 hours after the treatment and patient treatment preference was recorded. RESULTS: A statistically significant difference was found in the sputum volume expectorated after treatment with the Acapella (7.16+/-1.12 ml) compared with the threshold inspiratory muscle trainer (6.46+/-1.08 ml). Patients preferred Acapella in terms of usefulness of clearing secretions. CONCLUSION: The present study demonstrated increased sputum clearance following the use of the Acapella when compared to the threshold inspiratory muscle trainer. In addition, the Acapella was preferred by patients who judged that it was more useful in clearing secretions.