Effectiveness of Dry Needling in Improving Pain and Function in Comparison with Other Techniques in Patients with Chronic Neck Pain: A Systematic Review and Meta-Analysis.

The purpose of this systematic review and meta-analysis was to assess the short-, mid-, and long-term effectiveness of dry needling in improving pain and functional capacity of patients with chronic neck pain. Search strategy was performed on PubMed, Web of Science, Scopus, PEDro, and Cochrane Library Plus biomedical databases. The risk of bias was assessed using the RoB2 tool. Randomised controlled clinical trials in which at least 1 of the groups received dry needling were included. 662 studies were found; 14 clinical trials were selected for qualitative analysis and 13 for quantitative analysis. The quality of most of the studies included was "high." All the studies reported improvements in cervical pain and/or disability, regardless of the protocol followed and the muscles targeted. No serious adverse effects were reported. Dry needling showed to be more effective when compared with other therapies in both women and men, without differences by sex. When the analysis was carried out by age, patients over 40 years old benefitted more than those below 40 years old. Our meta-analysis supports the use of dry needling to improve pain and functional capacity in patients with chronic neck pain at short- and mid-term intervals.

Association between age, sex and cervical and upper cervical rotation tests. Descriptive and correlational study in healthy volunteers.

Background: Active cervical spine rotation (ACROM Rot) shows cervical rotation and flexion rotation test (FRT); side-bending rotation test (SBRT) and upper cervical axial rotation test (C0-C2ART) are described to measure upper cervical rotation. The objectives of this study are (1) to describe the normal range of motion (ROM) of ACROM Rot, and the ROM in FRT, SBRT and C0-C2ART tests; (2) to explore the correlation among the four tests and (3) to investigate the influence of age and sex in their ROM. Methods: A cross-sectional study was carried out with healthy volunteers from 18 to 75 years of age. Tests were measured using a CROM device and a bubble inclinometer. Descriptive analysis was performed to establish normative data for the ROM tests. Correlation analysis was conducted to understand the relation between upper and global cervical rotation ROM and among the three upper cervical rotation tests. Linear regression models were developed to understand the influence of age and sex in the ROM of all tests. Results: Normative values were obtained from 122 healthy volunteers (50% male), by sex and age strata. The degree of correlation ranged between 0.582 (p < 0.01) for FRT and ACROM Rot left and 0.217 (p < 0.05) for SBRT and C0-C2ART left. Linear regression models showed the influence of sex for ACROM Rot right (men -4.64° less than women), SBRT (men -4.1° less than women) left and C0-C2ART right and left (men -2.24° and -1.78° less than women). The age influenced rotation ROM with a decrease for every 10 years of -2.11° and -1.96° for ACROM Rot right and left, of -1.72° and -1.26° for FRT right and left and -0.58° and -0.41° for C0-C2ART right and left in the linear regression models. No association was found between age and SBRT (p = 0.63 for right SBRT and p = 0.49 for left SBRT). Conclusion: Weak-to-moderate correlation was found between the upper cervical spine rotation tests and with the ACROM. Women had a larger ROM in ACROM Rot right, SBRT left and C0-C2ART. Decreases in ROM related with age were observed for ACROM Rot, FRT and C0-C2ART but not for SBRT.

Association between Age, Sex and Cervical Spine Sagittal Plane Motion: A Descriptive and Correlational Study in Healthy Volunteers.

Active motion examination of patients with cervical spine-related pathologies is necessary to establish baseline function, set physical therapy goals, and choose interventions. This study investigated the sagittal plane active range of motion (ROM) of the global (GCS) and upper cervical spine (UCS) in relation to age and sex in healthy volunteers. One hundred twenty-two volunteers aged 18 to 75 years participated. Volunteers were excluded if they displayed any characteristic that could affect cervical spine ROM. GCS and UCS flexion and extension were each measured three times using a CROM device. Linear regression models (LRMs) were developed to explore the relationships between age and sex and GCS and UCS ROM. The LRM for age showed a decrease in GCS flexion (-2.01°), GCS extension (-3.33°), and UCS extension (-1.87°) for every decade of increasing age. The LRM for sex showed that men displayed less ROM than women in GCS extension (-6.52°) and UCS extension (-2.43°). These results suggest an age-related loss of sagittal plane GCS ROM and UCS extension ROM, and sex-related differences in GCS and UCS extension with women having greater motion than men.

Motor Imagery and Mental Practice in the Subacute and Chronic Phases in Upper Limb Rehabilitation after Stroke: A Systematic Review.

Introduction: Motor imagery and mental practice can be defined as a continuous mechanism in which the subject tries to emulate a movement using cognitive processes, without actually performing the motor action. The objective of this review was to analyse and check the efficacy of motor imagery and/or mental practice as a method of rehabilitating motor function in patients that have suffered a stroke, in both subacute and chronic phases. Material and Methods. We performed a bibliographic search from 2009 to 2021 in the following databases, Medline (PubMed), Scopus, WOS, Cochrane, and OTSeeker. The search focused on randomized clinical trials in which the main subject was rehabilitating motor function of the upper limb in individuals that had suffered a stroke in subacute or chronic phases. Results: We analysed a total of 11 randomized clinical trials, with moderate and high methodological quality according to the PEDro scale. Most of the studies on subacute and chronic stages obtained statistically significant short-term results, between pre- and postintervention, in recovering function of the upper limb. Conclusions: Motor imagery and/or mental practice, combined with conventional therapy and/or with other techniques, can be effective in the short term in recovering upper limb motor function in patients that have suffered a stroke. More studies are needed to analyse the efficacy of this intervention during medium- and long-term follow-up.

Effects of Contralateral Hip Flexion Angle on the Ober Test.

The Ober test is an orthopedic evaluation procedure used to assess for tightness of the tensor fascia latae (TFL) and iliotibial band (ITB). Multiple versions of this test have been described using different degrees of contralateral hip joint flexion to stabilize the pelvis. The aim of this study was to analyze the hip range of motion (ROM) in the frontal plane and perceived tension produced during the Ober test using four different angles of contralateral hip flexion prepositioning. The secondary objective was to analyze the differences in the Ober test with different contralateral hip flexion angles according to limb dominance. This cross-sectional study included healthy individuals aged 18 years or older. The Ober test was performed on the right and left leg of each participant with the contralateral hip joint stabilized at 0° flexion, 45° flexion, 90° flexion, and maximal flexion. Hip range of motion in the frontal plane (abduction or adduction) was measured using a digital inclinometer. Three measurements were performed on each limb for every angle of contralateral prepositioning, using the average of the three measurements for statistical analysis. Participants were asked to report the location of any perceived tension and the intensity of tension using a Numeric Rating Scale during the test. Twenty-eight participants (17 men and 11 women) were examined. Significant differences in the Ober test hip ROM in the frontal plane (p < 0.01) were observed when comparing different angles of contralateral hip flexion prepositioning. Significant differences between tests were also present for intensity of perceived tension (p ≤ 0.001), except for the intensity of perceived tension between 0° and 45°. No statistically significant differences were observed related to limb dominance (p > 0.05) or gender (p > 0.05), except for the Ober test at 0° (p < 0.001) which was higher in men (9.61° ± 5.01°) than in women (5.05° ± 2.87°). Greater contralateral hip flexion prepositioning during the Ober test results in decreased hip adduction ROM in the tested limb and greater perceived tension in the region of tensor fascia latae-iliotibial band.

Interexaminer Reliability and Validity of Quantity of Cervical Mobility during Online Dynamic Inspection.

BACKGROUND: Physical therapists routinely measure range of motion (ROM) of cervical spine. The reliability of the cervical range of motion (CROM) device has been demonstrated in several studies, but current evidence on the validity and reliability of the visual inspection is contradictory. The aim is to assess the validity and interexaminer reliability of the online visual inspection of active cervical ROM in physiotherapy students. METHODS: Flexion, extension, both lateral flexions and rotations of a single participant were measured using CROM. Online visual inspection of 18 physiotherapy students against CROM was registered. RESULTS: The validity, against CROM, of the online visual inspection of the active ROM ranged from good to excellent (Intraclass Correlation Coefficient (ICC) 0.83-0.97). Interexaminer reliability of the online visual inspection had favorable outcomes in all cervical movements in the three physiotherapy courses (ICC 0.70-0.96), with the visual inspection of the rotations being the most reliable (ICC 0.93-0.97). Interexaminer reliability of the classification of mobility was poor to good (Kappa 0.03-0.90). CONCLUSIONS: The interexaminer reliability and validity of the quantification of active cervical movement during online visual inspection was shown to be good to excellent for flexion-extension and lateral flexions and excellent for rotations.

Anthropometric Measurements, Metabolic Profile and Physical Fitness in a Sample of Spanish Women with Type 2 Diabetes.

BACKGROUND: Exercise training has proven to be effective for treatment of metabolic diseases, such as type 2 diabetes mellitus. The aims of this study were to compare anthropometric measurements, metabolic profile and physical fitness between active and sedentary women with type 2 diabetes, and to analyse relationships between anthropometry and metabolic profile and components of physical fitness (balance, flexibility, strength and endurance). METHODS: Cross-sectional research on 28 women with type 2 diabetes. Amount of daily physical activity, BMI, waist circumference, HbA1c, fibrinogen, hs-CRP, tiptoe dynamic balance, static balance, finger floor distance, abdominal, upper and lower limb strength and walking cardiovascular endurance were recorded. RESULTS: Age: 58.5 ± 7.8. Overall, 16 subjects were physically active and 12 were sedentary. Active subjects had lower BMI (p = 0.033) and better cardiovascular endurance (p = 0.025). BMI and waist circumference were not influenced by any physical fitness component. HbA1c, fibrinogen and hs-CRP were related with worse dynamic balance (p = 0.036, 0.006 and 0.031, respectively). CONCLUSIONS: Active women had lower BMI and showed a better performance in cardiovascular endurance. Tiptoe dynamic balance impairments were related to worse glycaemic control, hypercoagulation and inflammatory state.

Manual Therapy as a Management of Cervical Radiculopathy: A Systematic Review.

BACKGROUND: Cervical radiculopathy is defined as a disorder involving dysfunction of the cervical nerve roots characterised by pain radiating and/or loss of motor and sensory function towards the root affected. There is no consensus on a good definition of the term. In addition, the evidence regarding the effectiveness of manual therapy in radiculopathy is contradictory. OBJECTIVE: To assess the effectiveness of manual therapy in improving pain, functional capacity, and range of motion in treating cervical radiculopathy with and without confirmation of altered nerve conduction. METHODS: Systematic review of randomised clinical trials on cervical radiculopathy and manual therapy, in PubMed, Web of Science, Scopus, PEDro, and Cochrane Library Plus databases. The PRISMA checklist was followed. Methodological quality was evaluated using the PEDro scale and RoB 2.0. tool. RESULTS: 17 clinical trials published in the past 10 years were selected. Manual therapy was effective in the treatment of symptoms related to cervical radiculopathy in all studies, regardless of the type of technique and dose applied. CONCLUSIONS: This systematic review did not establish which manual therapy techniques are the most effective for cervical radiculopathy with electrophysiological confirmation of altered nerve conduction. Without this confirmation, the application of manual therapy, regardless of the protocol applied and the manual therapy technique selected, appears to be effective in reducing chronic cervical pain and decreasing the index of cervical disability in cervical radiculopathy in the short term. However, it would be necessary to agree on a definition and diagnostic criteria of radiculopathy, as well as the definition and standardisation of manual techniques, to analyse the effectiveness of manual therapy in cervical radiculopathy in depth.

Effectiveness of Conservative Treatment According to Severity and Systemic Disease in Carpal Tunnel Syndrome: A Systematic Review.

(1) Background: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy in the upper extremity. Conservative treatment has been effective for mild and moderate idiopathic CTS. However, severe CTS and systemic conditions were an exclusion criterion from the studies. The aim of this study is to review the effectiveness of conservative treatment in patients with CTS regardless of the level of severity and the presence or not of systemic diseases in the last ten years. (2) Methods: Randomized controlled clinical trials that compared the effect of conservative treatment on the Boston questionnaire and pain were selected. PubMed, PEDro, Scopus, Cochrane, and Web of Science databases were used. PRISMA statement checklist was performed. (3) Results: 876 studies were recorded, 29 were selected. Pharmacology, Electrotherapy and Manual Therapy had benefits for CTS. Electrotherapy and manual therapy could be effective for severe CTS patients with a systemic condition in the short term, but there was a low percentage of these patients included in the studies. (4) Conclusion: Some pharmacological treatments, manual therapy and electrotherapy have shown benefits for handling CTS, although the most effective combination of techniques is unknown. It would be necessary to include patients with systemic conditions in the selection criteria for future studies.