Optimal Duration of Cold and Heat Compression for Forearm Muscle Biomechanics in Mixed Martial Arts Athletes: A Comparative Study.

BACKGROUND Cold and heat therapies for recovery in sports are commonly used, including in the mixed martial arts (MMA). The Game Ready (GR) device can be used for local monotherapy with either heat or cold and for contrast therapy. This study aimed to compare the effects of duration of cold and heat compression on biomechanical changes in the forearm muscles of 20 healthy mixed martial arts athletes. MATERIAL AND METHODS Twenty MMA volunteers (26.5±4.5 years old) underwent 3 different phases of the GR: (1) stimulation time 10 min (eGR-10, GR experimental group), (2) 10 min (cGR-10, sham control group) and (3) 20 min (eGR-20, GR experimental group). The following outcomes were assessed: muscle tone (T), stiffness (S), flexibility (E), pressure pain threshold (PPT), microvascular response (PU), and maximum isometric strength (Fmax). All measurements were performed before GR (rest) and after GR stimulation (post). RESULTS Both eGR-10 and eGR-20 significantly improved outcomes T (p<0.001), S (p<0.001), E (p=0.001, and p<0.001, respectively), PPT (p<0.001), PU (p<0.001), and Fmax (p<0.001). Notably, eGR-20 exhibited superior improvements in PU, Fmax, and PPT, with larger effect sizes (p<0.001). While eGR-10 demonstrated more pronounced reductions in T and S (p<0.001), these results underscore the potential for tailored GR therapy durations to optimize specific recovery goals for MMA athletes. CONCLUSIONS GR stimulation affects muscle biomechanical changes, pain threshold, muscle strength, and tissue perfusion. The study results suggest that 10 min of GR stimulation is sufficient to achieve changes that can be used to optimize recovery for MMA athletes.

The effects of one-time soft tissue therapy on pelvic floor muscle electromyographic signals in women with urinary incontinence: A randomized intervention trial.

AIMS: To investigate the effects of one-time soft tissue therapy (STT) on pelvic floor muscle (PFM) electromyographic signals in women with stress and/or mixed urinary incontinence. METHODS: An intervention study conducted with 63 women with stress and/or mixed urinary incontinence. Participants were randomly assigned to either the one-time STT group (experimental group) or the control group. The same teaching model for voluntary contraction and relaxation of the PFM was used for all participants. Electromyographic signals from the PFM during functional tasks were the primary clinical outcome measures at baseline and immediately after the intervention. Electromyographic signals were analyzed using root mean square amplitude. RESULTS: There was no significant difference between groups in electromyographic PFM signals in prebaseline rest (mean difference: -0.146 [95% confidence interval (CI): -0.44 to 0.148; p = 0.470]), phasic contractions (mean difference: 0.807 [95% CI: 0.123-1.491; p = 0.459]), tonic contractions (mean difference: 1.06 [95% CI: 0.255-1.865; p = 0.302]), endurance contractions (mean difference: 0.896 [95% CI: 0.057-1.735; p = 0.352]) and postbaseline rest (mean difference: -0.123 [95% CI: -0.406 to 0.16; p = 0.591]) immediately after the one-time STT intervention. CONCLUSION: A one-time STT intervention does not appear to effectively alter electromyographic signal of the PFM in women with urinary incontinence. Due to the limitations of the study, further research is needed to confirm these results.

Vibrating Exercise Equipment in Middle-Age and Older Women with Chronic Low Back Pain and Effects on Bioelectrical Activity, Range of Motion and Pain Intensity: A Randomized, Single-Blinded Sham Intervention Study.

Background: Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders. Physical activity (PA) is often recommended as part of the management of CLBP, but to date, no one particular exercise has been shown to be superior. Vibrating exercise equipment (VEE) is widely available and used despite little scientific evidence to support its effectiveness in the prevention and treatment of musculoskeletal problems. The aim of this study was to evaluate the efficiency of using VEE compared with sham-VEE in women with CLBP. Methods: A randomized (1:1 randomization scheme) single-blinded sham-controlled intervention study was conducted. Through simple randomization, 92 women aged 49-80 years were assigned to one of two groups: VEE (the experimental group) and sham-VEE (the control group). The VEE and sham-VEE intervention consisted of aerobic exercises with specific handheld equipment. Both groups performed physical activity twice weekly for 10 weeks. The erector spinae muscles' bioelectrical activity (using an eight-channel electromyograph MyoSystem 1400L), lumbar range of motion (Schober's test) and pain intensity (visual analog scale) were measured in all participants at baseline and after 10 weeks. Results: There was a significant decrease in the bioelectrical activity of the erector spinae muscles during flexion movement (left: Me = 18.2 before; Me = 14.1 after; p = 0.045; right: Me = 15.4 before; Me = 12.6 after; p = 0.010), rest at maximum flexion (left: Me = 18.1 before; Me = 12.5 after; p = 0.038), extension movement (right: Me = 21.8 before; Me = 20.2 after; p = 0.031) and rest in a prone position (right: Me = 3.5 before; Me = 3.2 after; 0.049); an increase in lumbar range of motion (Me = 17.0 before; Me = 18.0 after; p = 0.0017) and a decrease in pain intensity (Me = 4.0 before; Me = 1.0 after; p = 0.001) following a program of PA in the VEE group. Conclusions: No significant changes were found in intergroup comparisons. The beneficial changes regarding decreased subjective pain sensation in the VEE and sham-VEE groups may be due to participation in systematic physical activity. However, PA with vibrating exercise equipment could be a prospective strategy for increasing lumbar range of motion and for decreasing pain and erector spinae muscle activity in people with CLBP.

Effect of Whole-Body Cryotherapy on Morphological, Rheological and Biochemical Indices of Blood in People with Multiple Sclerosis.

The aim of this study was to examine and assess the impact of a series of 20 whole-body cryotherapy (WBC) treatments on the biochemical and rheological indices of blood in people with multiple sclerosis. In this prospective controlled study, the experimental group consisted of 15 women aged 34-55 (mean age, 41.53 ± 6.98 years) with diagnosed multiple sclerosis who underwent a series of whole-body cryotherapy treatments. The first control group consisted of 20 women with diagnosed multiple sclerosis. This group had no intervention in the form of whole-body cryotherapy. The second control group consisted of 15 women aged 30-49 years (mean age, 38.47 ± 6.0 years) without neurological diseases and other chronic diseases who also underwent the whole-body cryotherapy treatment. For the analysis of the blood indices, venous blood was taken twice (first, on the day of initiation of whole-body cryotherapy treatments and, second, after a series of 20 cryotherapy treatments). The blood counts were determined using an ABX MICROS 60 hematological analyzer (USA). The LORCA analyzer (Laser-Optical Rotational Cell Analyzer, RR Mechatronics, the Netherlands) was used to study the aggregation and deformability of erythrocytes. The total protein serum measurement was performed using a Cobas 6000 analyzer, Roche and a Proteinogram-Minicap Sebia analyzer. Fibrinogen determinations were made using a Bio-Ksel, Chrom-7 camera. Statistically significant differences and changes after WBC in the levels of red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), elongation index, total extend of aggregation (AMP), and proteins (including fibrinogen) were observed. However, there was no significant effect of a series of 20 WBC treatments on changes in blood counts, rheology, and biochemistry in women with multiple sclerosis. Our results show that the use of WBC has a positive effect on the rheological properties of the blood of healthy women.

The Rolf Method of Structural Integration and Pelvic Floor Muscle Facilitation: Preliminary Results of a Randomized, Interventional Study.

The management of pelvic floor dysfunctions might need to be based on a comprehensive neuro-musculoskeletal therapy such as The Rolf Method of Structural Integration (SI). The aim of the study was to evaluate the pelvic floor muscle (PFM) after the tenth session of SI by using surface electromyography (sEMG). This was a randomized, interventional study. Thirty-three healthy women were randomly assigned to the experimental (SI) or control group. The outcome measures included PFM bioelectrical activity, assessed using sEMG and endovaginal probes. An intervention in the SI group included 60 min of SI once a week, and teaching on how to contract and relax PFMs; in the control group, only the teaching was carried out. In the SI group, a significant difference was found between the PFM sEMG activity during "pre-baseline rest" (p < 0.014) and that during "rest after tonic contraction" (p = 0.021) in the supine position, as were significant increases in "phasic contraction" in the standing position (p = 0.014). In the intergroup comparison, higher PFM sEMG activity after the intervention "phasic contraction" (p = 0.037) and "pre-baseline rest" (p = 0.028) was observed in the SI group. The SI intervention significantly changes some functional bioelectrical activity of PFMs, providing a basis for further research on a new approach to PFM facilitation, particularly in clinical populations.

The Rolf Method of Structural Integration on Fascial Tissue Stiffness, Elasticity, and Superficial Blood Perfusion in Healthy Individuals: The Prospective, Interventional Study.

Introduction: There are multiple theories surrounding the physiological impact of structural integration (SI) with little evidence or research corroborating any of these. The aim of the study was to assess the effectiveness of 10 sessions of SI on fascial tissue (FT) superficial blood perfusion, stiffness, and elasticity in 13 healthy women. Methods: This was a prospective, interventional study. The primary outcome measures were FTs' superficial blood perfusion, stiffness, and elasticity of bilateral selected FT points on the body. Data were collected before and after 10 sessions of SI intervention. Statistical analysis was performed using the non-parametric Wilcoxon test (intragroup comparison). Results: The superficial blood perfusion increased significantly in the most selected FT points on the body (p < 0.05). SI interventions produced significant decreases in selected points (brachioradialis, biceps brachii, and trapezius; p < 0.05) of FT stiffness and significant increases in elasticity (brachioradialis, biceps brachii, triceps surae, and trapezius; p < 0.05), especially in the FT of the right (dominant) upper limb. Conclusion: A 10-session of SI demonstrated positive effects on increasing superficial blood perfusion contributed to a decrease in FT stiffness and an increase in elasticity properties in the dominant upper limb. Data collection for this study is currently underway, and the trial is registered at ISRCTN.com with the identifier: ISRCTN46707309.

Immediate effects of the respiratory stimulation on ventilation parameters in ischemic stroke survivors: A randomized interventional study (CONSORT).

BACKGROUND: Post-stroke brain damage, which affects the central control of respiration, leads to various respiratory disorders. They can be caused by the weakening of the respiratory muscles and chest movements, which can indirectly contribute to an impairment of the ventilation function. The aim of the study is an objective assessment of the effect of a single-session intervention of respiratory stimulation through Proprioceptive Neuromuscular Facilitation (PNF) on chosen respiratory parameters and the following comparison of these changes with a group in which positioning was used (intra- and intergroup comparison). METHODS: This was a randomized interventional study evaluating the respiratory parameters depending on the applied respiratory stimulation in patients after ischemic stroke. The patients qualified to participate in the study were randomly assigned to 1 of 2 groups: PNF-treated group - in which respiratory stimulation through PNF was used, PNF untreated group - in which positioning was used. The research procedure consisted of several stages. First, an interview was conducted with each participant and basic data was collected. Then, spirometry was conducted, after which each patient underwent a single-session intervention according to their assigned group. Finally, the patients were given another spirometry examination. The main outcomes will be to compare the results of a spirometry test (FVC, FEV1, FEV1/ FVC%, PEF) before and after single-session intervention and between groups. RESULTS: Based on the inclusion and exclusion criteria for the study, 60 patients took part in the measurement. The values of FEV1/FVC% were higher in PNF-treated group than in PNF-untreated group, if the post-intervention measures (P = .04) are considered. The difference between the pre- and post-intervention results of the FEV1/FVC% values in PNF-untreated group was substantially lower than in PNF-treated group (P = .001). CONCLUSION: A single application of respiratory stimulation through PNF positively affect air flow in the respiratory tract. Application of PNF stimulation contributed to an increase in the FEV1/FVC% parameter. However, no positive changes were noted in the other parameters, which would provide proof of the beneficial effect of facilitation on the respiratory system function.

Expression Profile of VEGF-C, VEGF-D, and VEGFR-3 in Different Grades of Endometrial Cancer.

BACKGROUND: Vascular endothelial growth factor (VEGF)-C, -D, and VEGF receptor-3 are proteins characterized as crucial for tumor lymphangiogenesis. It is accompanied by angiogenesis during wound healing, but also in the neoplastic process. The research studies have shown that the lymphatic system plays a key role in the progression of carcinogenesis. OBJECTIVE: The aim of this study was to evaluate changes in the expression of VEGF-C, VEGF-D and VEGFR-3 in different grades of endometrial cancer (G1-G3). METHODS: The study included 45 patients diagnosed with endometrial cancer (G1=17; G2=15; G3=13) and 15 patients without neoplastic changes. The expression of VEGF-C, VEGF-D, and VEGFR-3 was assessed using microarray technique and immunohistochemistry. Statistical analysis was performed using the one-way ANOVA and Tukey's post-hoc test. RESULTS: Statistically significant changes in the expression at the transcriptome level were found only in the case of VEGF-C (G1 vs. C, fold change - FC = -1.15; G2 vs. C, FC = -2.33; G3 vs. C, FC = - 1.68). However, VEGF-D and VEGFR-3 were expressed at the protein level. Analysis of VEGF-D expression showed that the optical density of the reaction product in G1 reached 101.7, while the values in G2 and G3 were 142.7 and 184.4, respectively. For VEGF-R3, the optical density of the reaction product reached the following levels: 72 in control, 118.77 in G1, 145.8 in G2, and 170.9 in G3. CONCLUSION: An increase in VEGF-D and VEGFR-3 levels may indicate that VEGF-D-dependent processes are intensified along with the dedifferentiation of tumor cells. The lack of VEGF-C expression in endometrial cancer samples may suggest that this tumor is characterized by a different mechanism of metastasis than EMT. Our study emphasizes that when analyzing the metastatic potential of cancer, the expression of more than one factor should be taken into account.

Changes in the Expression Profile of VEGF-A, VEGF-B, VEGFR-1, VEGFR-2 in Different Grades of Endometrial Cancer.

BACKGROUND: VEGF-A, VEGF-B, VEGFR-1 and VEGFR-2 are important proteins involved in the induction and development of a new blood vessel network through which the tumor is properly nourished and oxygenated. OBJECTIVES: The aim of the study was to evaluate changes in VEGF-A, VEGF-B, VEGFR-1 and VEGFR-2 expression in endometrial cancer depending on its grade and to determine the VEGFR-1 to VEGFR-2 concentration ratio. METHODS: The study group consisted of 45 patients diagnosed with endometrial cancer (G1, 17; G2, 15; G3, 13). The control group included 15 patients. VEGF-A, VEGF-B, VEGF-R1, VEGFR-2 expression was assessed using the immunohistochemical method. Statistical analysis was carried out using the Statistica 12 PL program (StatSoft, Cracow, Poland). It included the one-way ANOVA and Tukey's post-hoc test (p<0.05). RESULTS: Statistically significant differences in the level of VEGF-A, VEGF-B, VEGF-R1, VEGFR-2 were observed between the majority of analyzed groups (except for VEGF-B; G3 vs. G1, p=0.997700). The expression pattern of VEGF-A, VEGF-R1, VEGFR-2 was as follows: G3>G2>G1>C; VEGF-B: G2> G3> G1>C. A lower concentration of VEGFR-1 than VEGFR-2 was found regardless of the cancer grade. CONCLUSION: VEGF-A, VEGF-B, VEGF-R1, VEGFR-2 are key proteins involved in tumor angiogenesis. The analysis of the entire panel of proteins participating in a given process is an important element of modern diagnostics. The concentration ratio of VEGFR-1 to VEGFR-2 appears to be a determining factor in the patients' survival prognosis.

Proprioceptive Neuromuscular Facilitation for Accessory Respiratory Muscles Training in Patients After Ischemic Stroke.

This study focused on how pulmonary function is affected by proprioceptive neuromuscular facilitation (PNF) of accessory respiratory muscles in the chronic post-stroke phase. The study involved patients who had had ischemic stroke 6 months or more before the PNF treatment investigated. The objective was to define the effect of PNF on bioelectrical resting and maximum activity of the accessory muscles. Patients were randomly assigned to PNF treatment and just positioning treatment as a reference for comparison; 30 patients each. Electromyography of accessory muscles was investigated before and after physiotherapeutic treatments. We found that there was a greater reduction in EMG activity in all muscles investigated after PNF compared to positioning treatment alone. A reduction of muscle activity due to PNF concerned both affected and unaffected body side, but it was greater on the affected side. We conclude that a reduction of the accessory respiratory muscle activity due to PNF treatment could be of benefit in chronic stoke patients in that it would help normalize breathing pattern and thereby prevent the development of hypoxia.

Effects of massage on the expression of proangiogenic markers in rat skin.

INTRODUCTION: Massage is a physiotherapeutic treatment, commonly used in both therapy and restoration of normal body functions. The aim of this work was to determine the effects of skin massage on stimulating the expression of angiogenesis-initiating factors, i.e. VEGF-A, FGF-2 (bFGF) and CD34 and on skin regeneration processes. MATERIAL AND METHODS: The study was conducted on 48 Buffalo strain rats, randomly divided into two groups. In the first group (M, the massaged group), massage was applied five times a week for 7 weeks. In the second study group (C, the control group), the massage was omitted. Massage consisted of spiral movements at the plantar surface of skin for 5 min on each rear extremity. The gene expression of proangiogenic factors, including VEGF-A, FGF-2, CD34 at the mRNA level was determined using real-time PCR. Immunohistochemistry was performed on paraffin sections of rat skin to determine VEGF-A, FGF-2 CD34 and Ki-67expression. RESULTS: An increase in mRNA expression in the skin of the rat's rear extremity for VEGF-A and FGF-2 in the first week of the experiment was shown in the M group compared with the control rats. The upregulation of CD34 mRNA expression was also observed in the M group. We observed positive correlations between VEGF-A mRNA expression and the expression of mRNA for FGF-2 and CD34, as well as correlation between the expression of mRNA for FGF-2 and CD34. The immunohistochemical expression of VEGF-A, FGF-2 and CD34 was at a much lower level in the skin of control rats relative to the skin of massaged animals. Moreover, significantly higher immunoreactivity was shown for nuclear protein Ki-67 in epidermal cells in the M group compared with the C group. CONCLUSIONS: Rat skin massage increased the expression of the main angiogenesis-stimulating factors and the proliferative activity of epidermal cells, which can stimulate skin regeneration and tissue repairing processes.

[Post-stroke spasticity management including a chosen physiotherapeutic methods and improvements in motor control - review of the current scientific evidence.]

Cerebrovascular diseases based on stroke etiology concern millions of people worldwide, and annual rates of disease are still increasing. In the era of an aging society and suffering from a number of risk factors, in particular those modifiable, strokes and muscles' spastic paresis, subsequently resulting in damage of upper motor neuron structures will become a serious problem for the entire health care system. Effective management and physiotherapy treatment for post-stroke spasticity persisted, both in the acute and chronic, is still a significant medical problem in the interdisciplinary aspect. Care procedures for this type of patient becomes a kind of challenge for specialists in neurology, internal medicine, cardiology, dermatology or neurosurgery, but also for physiotherapists in their everyday clinical practice. The aim of this paper is to present the issues of cerebral stroke and resulting spastic hypertonia in terms of current pharmacological treatment and surgery, and primarily through the use of effective physiotherapy methods, the use of which was confirmed in the way of reliable scientific research in accordance with the principles of Evidence Based Medicine and Physiotherapy (EBMP).

[Extracorporeal shock waves (ESW) as an alternative treatment method for improving the limb muscles' spasticity after cerebral stroke - a systematic review of the literature].

Extracorporeal shock wave (ESW) is a physical factor, of which the clinical use is observed in a wide range of disorders, particularly musculoskeletal dysfunctions. Recently, one can observe that the list of indications for ESW treatment is continuously growing and adapting the increasingly different systemic diseases in terms of etiology and pathomechanism. Nevertheless, it should be remembered that the potential biological mechanisms of ESW stimulation conditioning advantageous and desirable therapeutic effects are not clearly explained. In the world of science is the lack of irrefutable evidence, supported by advanced research in the field of observation and recording biophysical mechanisms under the influence of ESW stimulation in a number of neurological disorders, especially in patients after stroke suffer from the damage of upper motor neuron (UMN). The aim of this paper is to provide an overview of current research reports evaluating the efficacy and safety of ESW in reducing a post-stroke spasticity of limbs and recover a motor finctions in stroke patients. A number of 8 research articles were qualified into review, only in English, which appeared in the years 2005 - 2015. The following summary includes a total group of 83 patients with spasticity of the lower limbs and 79 in the upper limbs. Review of scientific reports were based on international medical databases. All classified papers were characterized in detail, taking into account the methodology of research, patient characteristics, establish treatment parameters, as well as the results obtained on the basis of subjective and objective indicators. Despite a promising effectiveness of ESW therapy, the results of which have been described so far in several pilot studies, there is a legitimate need for further verification of this subject of research in terms of clinical application.

Assessment of bioelectrical activity of pelvic floor muscles depending on the orientation of the pelvis in menopausal women with symptoms of stress urinary incontinence: continued observational study.

BACKGROUND: Menopausal women often experience the prolapse of the uterus, bladder and rectum resulting from the failure and weakening of the pelvic floor muscles (PFM). Strengthening of the PFM through the standard exercises is recognized as an effective way of preventive measures and conservative treatment of the symptoms listed above, but still need to be improved. AIM: The goal was the objective assessment of resting and functional bioelectrical activity of PFM in women during menopause and its comparison in three different positions of the pelvis: anterior pelvic tilt - position 1 (P1), posterior pelvic tilt - position 2 (P2), and neutral pelvic tilt - position 3 (P3). DESIGN: Prospective, cross-sectional observational study. SETTING: Department and Clinic of Urology of a University Hospital. POPULATION: The target group of this study included women in the menopausal period (inpatient and outpatient). METHODS: The study evaluating resting and functional activity of the PFM depending on the orientation of pelvis. Bioelectric activity was assessed with an electromyographic instrument (sEMG) and endovaginal electrodes. The inclination angle was measured with an inclinometer. The comparisons of results between the values obtained in P1, P2, and P3 were performed using one-way Analysis of Variance (ANOVA). RESULTS: One hundred thirty-one registered for the study were screened for inclusion and exclusion criteria and on the basis of the results 82 participants were enrolled for analysis. The highest mean resting activity of sEMG PFM (µV) was observed in P2 and it amounted to 11.6 µV (SD=5.5 µV) in P1 the value equaled 9.8 µV (SD=4.8 µV) and P3-9.0 µV (SD=4.2 µV). The results revealed a significant statistical difference (main effect: P=0.0007). Considering the functional sEMG activity of PFM (µV), the highest mean value was recorded in P2. CONCLUSIONS: Posterior pelvic tilt position determines higher resting and functional bioelectric activity of PFM. Additionally, electromyographic activity of PFM increases during the pelvic movement backwards. CLINICAL REHABILITATION IMPACT: These positions should be implemented in therapy in order to improve the effectiveness of the effect on the pelvic floor.

Relationship between lower limb position and pelvic floor muscle surface electromyography activity in menopausal women: a prospective observational study.

OBJECTIVES: In physiotherapeutic practice, special attention is being given to the reciprocal anatomical, physiological, and biomechanical relationship of the pelvis and the structures connected to it. However, the scientific literature shows mainly the theoretical information about their mutual connections. The lack of information about these relations from a practical aspect coupled with the paucity of scientific papers on the impact of posture changes on the pelvic floor led the authors to conduct this study. The primary aim of this study was to compare the resting and functional bioelectrical activities of pelvic floor muscles (PFMs) depending on three different positions of the lower limbs (positions A, B, and C) in the supine position. MATERIALS AND METHODS: This was a prospective observational study evaluating resting and functional activities of the PFM depending on the position of the lower limbs. The study was carried out at the Department and Clinic of Urology, University Hospital in Wroclaw, Poland and the target group were women in the menopausal period. Bioelectrical activity of PFM was recorded using a surface electromyographic instrument in the supine position. Results of the values obtained in A, B, and C positions were compared using a one-way analysis of variance. RESULTS: In position A, the average resting surface electromyography (sEMG) activity of PFM was 6.9±2.6 µV; in position B, the result was 6.9±2.5 µV and in position C, the resting sEMG activity was 5.7±1.8 µV (P=0.0102). The results of the functional bioelectrical activity of PFM were as follows: position A - 20.3±11.8 µV, position B - 19.9±10.6 µV, and position C - 25.3±10.9 µV (P=0.0104). CONCLUSION: The results showed that in the supine position, the PFM achieved the lowest resting activity and the highest functional activity. Therefore, the supine position can be recommended for the diagnosis and therapy of weakened PFM.

Efficacy of Selected Electrical Therapies on Chronic Low Back Pain: A Comparative Clinical Pilot Study.

BACKGROUND In the currently available research publications on electrical therapy of low back pain, generally no control groups or detailed randomization were used, and such studies were often conducted with relatively small groups of patients, based solely on subjective questionnaires and pain assessment scales (lacking measurement methods to objectify the therapeutic progress). The available literature also lacks a comprehensive and large-scale clinical study. The purpose of this study was to assess the effects of treating low back pain using selected electrotherapy methods. The study assesses the influence of individual electrotherapeutic treatments on reduction of pain, improvement of the range of movement in lower section of the spine, and improvement of motor functions and mobility. MATERIAL AND METHODS The 127 patients qualified for the therapy (ultimately, 123 patients completed the study) and assigned to 6 comparison groups: A - conventional TENS, B - acupuncture-like TENS, C - high-voltage electrical stimulation, D - interferential current stimulation, E - diadynamic current, and F - control group. RESULTS The research showed that using electrical stimulation with interferential current penetrating deeper into the tissues results in a significant and more efficient elimination of pain, and an improvement of functional ability of patients suffering from low back pain on the basis of an analysis of both subjective and objective parameters. The TENS currents and high voltage were helpful, but not as effective. The use of diadynamic currents appears to be useless. CONCLUSIONS Selected electrical therapies (interferential current, TENS, and high voltage) appear to be effective in treating chronic low back pain.

Effects of extracorporeal shock wave on upper and lower limb spasticity in post-stroke patients: A narrative review.

BACKGROUND: Effective treatment strategies for post-stroke muscle spasticity are still a significant interdisciplinary issue and challenge for neurologists, neurosurgeons, physiatrists nurses and physiotherapists. Extracorporeal shock wave (ESW) treatment is a well-supported physical modality used in a wide range of musculoskeletal disorders. The list of justified indications for ESW treatment and scientific areas of investigations is continuously evolving and adapting to different pathologies, including spasticity after stroke. OBJECTIVES: To analyze the relevant available research and clinical studies demonstrated that the treatment potentials and effectiveness of ESW procedure including mechanisms of the anti-spastic action within hypertonic muscles after stroke. LITERATURE SEARCH: A computer research was performed using MEDLINE, PubMed, PEDro, CINAHL, and EMBASE databases. Assessment of eligibility of papers was determined by two independent reviewers. The inclusion criteria comprised: publication in peer-reviewed journals, studies published in the last 10 years, involving clinical trials, full-version available and written in English only. DISCUSSION: A total of 91 articles were collected, 83 of which were non relevant. Ultimately, 8 clinical studies within a total of 195 patients met inclusion criteria for this review. Only one randomized controlled trial was found and then scored using the Cochrane-based assessment. The other studies involving were analyzed separately according to their methodological quality in a descriptive manner. CONCLUSIONS: ESW was found to be safe and effective. The mechanism of ESW action is still under investigation.

Comparison of efficacy of the intermittent pneumatic compression with a high- and low-pressure application in reducing the lower limbs phlebolymphedema.

INTRODUCTION: The primary lymphedema and chronic venous insufficiency present an important medical problem, and effective physical therapeutic methods to treat this problem are still at the search phase. The aim of this study was to compare the efficacy of intermittent pneumatic compression (IPC) of a high- or low-pressure level in the treatment of primary phlebolymphedema of the lower limbs. METHODS: The study included 81 patients with chronic venous insufficiency and primary lymphedema of the lower limbs. Group A consisted of 28 patients who underwent a monthly antiedematous therapy including a manual lymphatic drainage, multilayer bandaging, and IPC with the output pressure of 120 mmHg. Group B consisted of 27 patients who underwent the same basic treatment as group A and IPC with the output pressure of 60 mmHg. Group C (control) consisted of 26 patients who underwent only a basic treatment - without IPC. RESULTS: After completion of the study, it was found that the greatest reduction of edema occurred in patients who underwent treatment with a pressure of 120 mmHg. The comparison of percentage reduction of edema showed a statistically significant advantage of the group A over groups B and C, both for the changes in the right (P=0.01) and the left limb (P=0.01). Results in patients undergoing intermittent compression of the lower pressure (60 mmHg) were similar to those obtained in the control group. CONCLUSION: The IPC with the pressure of 120 mmHg inside the chambers effectively helps to reduce a phlebolymphedema. Furthermore, it appears that the treatments with a pressure of 60 mmHg are ineffective and their application becomes useless only in the antiedematous therapy.

Short-Term Effects of Kinesio Taping and Cross Taping Application in the Treatment of Latent Upper Trapezius Trigger Points: A Prospective, Single-Blind, Randomized, Sham-Controlled Trial.

Kinesio taping (KT) may be a new treatment in patients with myofascial trigger points (MTrPs). A new method available for taping practitioners is cross taping (CT). The main objective was to determine how CT, KT, and medical adhesive tape (sham group) affect the subjective assessment of resting bioelectrical activity and pain of the upper trapezius muscle (UT) in patients with MTrPs. 105 volunteers were recruited to participate. The primary outcome was resting bioelectrical activity of UT muscle as assessed by surface electromyography (sEMG) in each group and pain intensity on a visual analog scale (VAS). Assessments were collected before and after intervention and after the 24-hours follow-up. No significant differences were observed in bioelectrical activity of UT between pre-, post-, and follow-up results. In three groups patients had significantly lower pain VAS score after the intervention (CT-p < 0.001, KT-p < 0.001, and sham-p < 0.01). The Kruskal-Wallis ANOVA showed no significant differences in almost all measurements between groups. The application of all three types of tapes does not influence the resting bioelectrical activity of UT muscle and may not lead to a reduction in muscle tone in the case of MTrPs.