ABSTRACT
OBJECTIVE: To systematically review the literature on the efficacy of addressing glenohumeral internal rotation deficit (GIRD) and risk of upper-extremity injury in overhead athletes. DATA SOURCES: A search was conducted for relevant studies published in PubMed, Medline, CINAHL, Cochrane, Embase, Ovid, Google Scholar, and Web of Science. STUDY SELECTION: The review focused on randomized controlled trials (RCTSs) and quasi-experiments conducted in English language that assessed the effectiveness of GIRD and the risk of upper-extremity injury in athletes performing overhead movements. The review included 7 RCTs and 2 quasi-experiments out of 5403, which involved a total of 360 participants. DATA EXTRACTION: Two reviewers independently screened the articles, assessed methodological quality, and extracted data for analysis. The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews. All studies were assessed in duplicate for risk of bias using the Physiotherapy Evidence Database Scale for RCTs. DATA SYNTHESIS: The efficacy of different types of techniques was evaluated, including joint mobilization, sleeper stretch, cross-body stretch, myofascial release, kinesio taping, and rigid taping. These techniques showed improvement in pain score and range of motion. Furthermore, self-myofascial release tends to improve internal rotation; sleeper stretch and cross-body stretch tend to improve internal rotation with 40 percent decline in pain. However, kinesio taping and rigid taping showed positive results for internal rotation. Acute results determined that the metabolic equivalent (MET) group had significantly more horizontal adduction range of motion posttreatment compared with the control group (P=.04). No significant differences existed between MET and joint mobilizations or between joint mobilizations and the control group for horizontal adduction (P>.16). No significant between-group differences existed acutely for internal rotation (P>.28). There were no significant between-group differences for either horizontal adduction or internal rotation at the 15-minute posttests (P>.70). CONCLUSIONS: The study evaluated the efficacy of various techniques in improving pain score and range of motion in individuals with GIRD. Joint mobilization, sleeper stretch, cross-body stretch, myofascial release, kinesio taping, and rigid taping all showed improvements in pain score and range of motion. However, no significant between-group differences were found for horizontal adduction or internal rotation at the 15-minute posttests. These findings suggest that a combination of these techniques may be effective in treating individuals with GIRD.
ABSTRACT
Parkinson's disease (PD) is the second most common neurological illness after Alzheimer's disease. According to research, medication alone can give palliative alleviation; however, freezing of gait (FOG) and balance can be treated with physical therapy. This meta-analysis aims to bridge gaps about exercise-based therapy's impact on balance and FOG in patients with PD. Google Scholar, CINHAL, Medline, PubMed, and PEDro were searched for 2016-2021 citations using the PIOD paradigm. Pooled effect size mean and SD were analysed using a fixed and random effects model. A total of 21 trials were included in this review, with SMD=0.60 and p=0.0007 utilising BBS. The pooled analysis revealed statistically significant impacts on exercise-based management in the experimental group. With SMD=0.87 and p<0.00001 using Mini-BESTest, the pooled analysis revealed that exercise-based management was also effective on balance in the experimental group. The fixed effect model of FOG in terms of SMD was used to draw the pooled effects of FOG in terms of SMD and FOG in terms of SMD (0.21; 95 percent CI -0.01 to 0.44; p=0.06). According to this research, several physiotherapy approaches such as exergaming, gamepad systems, virtual reality, gait exercises, and core training, help Parkinson's patients regain balance and FOG. Key Words: Parkinson's disease, Physical therapy techniques, Neurological rehabilitation, Balance, Freezing of gait, Motor symptoms.