Functional outcomes of accelerated rehabilitation protocol for anterior cruciate ligament reconstruction in amateur athletes: a randomized clinical trial.

BACKGROUND: Anterior cruciate ligament (ACL) rupture is the most common knee injury among athletes, and can result in long-term complications and career-ending conditions for sportspeople. There is no consensus in the literature on the effectiveness of rehabilitation after ACL reconstruction, or the best protocol to follow for functional outcome improvement. OBJECTIVE: To determine the impact of an accelerated rehabilitation protocol on knee functional outcomes in amateur athletes with anterior cruciate ligament reconstruction (ACLR). DESIGN: Two-arm, parallel-group randomized comparative design. PATIENTS: A total of 100 amateur male athletes (mean age 22.01 ± 1.79 years) with ACLR were randomly divided into experimental and control groups (n = 50/group). METHODS: An accelerated rehabilitation protocol and a conventional rehabilitation protocol were used for the experimental group. In contrast, only the conventional rehabilitation protocol was used for the control group. The rehabilitation was delivered in 5 weekly sessions for 22 weeks. The primary outcome measure, knee pain, was measured using a visual analogue scale (VAS). Extensive test batteries, for hop tests, Knee Injury and Osteoarthritis Outcome Score (KOOS), and knee effusion, were measured, aiming to add more objective criteria to determine functional performance. RESULTS: Both groups (n = 50/group) were well-matched (p = 0.816), with insignificant differences in their demographic characteristics (p > 0.05). A multivariate analysis of variance (MANOVA) test showed no significant difference between the 2 groups (p = 0.781) at baseline. A 2-way MANOVA (2 × 2 MANOVA) of within- and between-group variations indicated overall significant treatment, time, and treatment × time interaction effects (p < 0.001) in favour of the accelerated rehabilitation group. CONCLUSION: The accelerated rehabilitation protocol was more effective in improving functional outcomes than a conventional rehabilitation protocol in amateur athletes with ACLR.

Effect of blood flow restriction as a stand-alone treatment on muscle strength, dynamic balance, and physical function in female patients with chronic ankle instability.

BACKGROUND: Blood Flow Restriction (BFR) training has gained popularity as a novel training strategy in athletes and rehabilitation settings in recent years. OBJECTIVE: To investigate whether BFR as a stand-alone treatment would affect muscle strength, dynamic balance, and physical function in female patients with chronic ankle instability (CAI). METHODS: Thirty-nine patients with CAI were randomly allocated into 1 of 3 groups: BFR as a stand-alone (BFR) group, BFR with rehabilitation (BFR+R) group, and rehabilitation (R) group. All groups trained 3 times per week for 4 weeks. One week before and after the intervention, strength of muscles around ankle joint, 3 dynamic balance indices: Overall Stability Index, Anterior-Posterior Stability Index, and Medial-Lateral Stability Index, and physical function were assessed via an isokinetic dynamometer, the Biodex Balance System, and the Foot and Ankle Disability Index, respectively. RESULTS: The strength of muscles around ankle and dynamic balance indices improved significantly in BFR + R and R groups (P < .006), but not in BFR group (P > .006). All dynamic balance indices showed improvement in BFR + R and R groups except the Medial-Lateral Stability Index (P > .006). Foot and Ankle Disability Index increased significantly in BFR + R and R groups (P < .006), however; no improvement occurred in BFR group (P > .006). CONCLUSIONS: The BFR as a stand-alone treatment hasn't the ability to improve the strength of muscles around the ankle, dynamic balance, and physical function in females with CAI compared to the BFR + R or the R program. In addition, the strength of muscles around the ankle correlated significantly with both dynamic balance and physical function in BFR + R and R groups.

The Efficacy of Manual Therapy and Pressure Biofeedback-Guided Deep Cervical Flexor Muscle Strength Training on Pain and Functional Limitations in Individuals with Cervicogenic Headaches: A Randomized Comparative Study.

Objective: This study aimed to compare the efficacy of manual therapy and pressure biofeedback-guided DCFM strength training on pain intensity and functional limitations in individuals with CGH. Trial Design. A double-blinded, two-arm parallel group randomized comparative design. Methods: After applying the eligibility criteria, sixty out of eighty-nine CGH patients were recruited from King Saud University Medical Center in Riyadh and randomly allocated to intervention groups using simple random sampling. Group 1 underwent pressure biofeedback-guided DCFM strength training and conventional treatment, while Group 2 received manual therapy and conventional treatment for three consecutive weeks. The main outcome measures were scores on the visual analog scale (VAS) and the headache disability index (HDI). One assessor and two physical therapists were blinded to group allocation. Results: Sixty out of eighty participants aged 29-40 years were randomized into intervention groups (n = 30/group; age (mean ± standard deviation): group 1 = 35.0 ± 2.82; group 2 = 34.87 ± 2.60), and their data were analyzed. A significant improvement (95% CI, p < 0.05) was observed within each group when comparing the VAS and HDI scores between baseline and postintervention. In contrast, between-group comparisons for the outcome score of VAS and HDI revealed nonsignificant differences in the first, second, and third weeks after intervention, except for the VAS score, which showed a significant difference in weeks 2 and 3 after intervention. Cohen's d-value indicated that the intervention effect size for reducing pain was larger in group 1 than in group 2 at weeks 2 and 3. Conclusion: Compared with manual therapy, pressure biofeedback-guided DCFM strength training showed a greater reduction in pain intensity (assessed using the VAS) at weeks two and three. However, both treatments were equally effective in lowering headache-related functional limitations in patients with CGH. This trial is registered with ClinicalTrial.gov PRS (Identifier ID: NCT05692232).

Ischemic Pressure vs Postisometric Relaxation for Treatment of Rhomboid Latent Myofascial Trigger Points: A Randomized, Blinded Clinical Trial.

OBJECTIVE: The purpose of this study was to investigate the effects of ischemic pressure (IP) vs postisometric relaxation (PIR) on rhomboid-muscle latent trigger points (LTrPs). METHODS: Forty-five participants with rhomboid-muscle LTrPs were randomly assigned into 3 groups and received 3 weeks of treatment-group A: IP and traditional treatment (infrared radiation, ultrasonic therapy, and transcutaneous electrical nerve stimulation); group B: PIR and traditional treatment; and group C: traditional treatment. Shoulder pain and disability, neck pain and disability, and pressure pain threshold (PPT) of 3 points on each side were measured before and after treatment. RESULTS: Multivariate analysis of variance indicated a statistically significant Group × Time interaction (P = .005). The PPT for the right lower point was increased in group A more than in groups B or C. Neck pain was reduced in group B more than in group C. Moreover, shoulder and neck disability were reduced in both groups A and B more than in group C. The PPTs of the left lower and middle points were increased in group B compared with groups A and C. The PPT of the left upper point was increased in group A more than in group C. There were significant changes in all outcomes in the 2 experimental groups (P < .05). No changes were found in the control group except in pain intensity, shoulder disability, and PPT of the left lower point. CONCLUSION: This study found that IP may be more effective than PIR regarding PPT, but both techniques showed changes in the treatment of rhomboid-muscle LTrPs.

Efficacy of Kinesio Taping and Postural Correction Exercises on Levator Scapula Electromyographic Activities in Mechanical Cervical Dysfunction: A Randomized Blinded Clinical Trial.

OBJECTIVE: Mechanical neck dysfunction (MND) is a major health burden. Although postural correction exercises (PCEs) are commonly used for its treatment, efficacy of Kinesio Taping (KT) has received considerable attention. This study was conducted to determine the effect of KT and PCEs on levator scapula (LS) electromyography. METHODS: Ninety-one patients with MND were randomly assigned into 1 of 3 groups that received 4 weeks' treatment: group A, KT; group B, PCE; and group C, both interventions. Neck pain, LS root mean square (RMS), and median frequency (MDF) were measured pretreatment and post-treatment with the Numerical Pain Rating Scale and surface electromyography, respectively, by an assessor blinded to the patients' allocation. RESULTS: Multivariate analysis of variance indicates a statistically significant group-by-time interaction (P = .000). Pain intensity was significantly reduced in group C more than in group B (P = .001). Mean values of RMS were significantly reduced in group C compared to both group A (P = .001) and group B (P = .022), whereas MDF was significantly increased in group C compared to either group A (P = .00) or group B (P = .026), and in group B compared to group A (P = 0.26). A paired t test revealed that there was a significant decrease in pain and RMS, and a significant increase in MDF in all groups (P < .01). CONCLUSION: Application of both KT and PCE combined can significantly reduce neck pain and normalize LS activities in patients with MND more than the application of either intervention.

Efficacy of kinesiology tape versus postural correction exercises on neck disability and axioscapular muscles fatigue in mechanical neck dysfunction: A randomized blinded clinical trial.

BACKGROUND: Mechanical neck dysfunction (MND), with axioscapular muscles fatigue, is highly prevalent worldwide. While postural correction is commonly used for its treatment, efficacy of kinesiology tape (KT) has received considerable attention. OBJECTIVES: To determine the effectiveness of KT versus correction exercises on neck disability, and axioscapular muscles fatigue in MND patients. METHODS: 46 MND patients were randomly assigned into 1 of 2 groups receiving 4 weeks treatment of either KT or correction exercises. Neck disability and axioscapular muscles fatigue as median frequency of electromyography (EMG-MF) were measured pre and post treatment. RESULTS: Group-by-time interaction was not significant in the multivariable test. Post hoc tests revealed that KT produced more disability reduction than the postural exercises. However, there was no significant interaction for EMG-MF. CONCLUSIONS: KT has been found to be more effective than postural exercises to reduce neck disability. However, both modalities have similar effects to reduce axioscapular muscles fatigue.

Efficacy of kinesio taping versus postural correction exercises on pain intensity and axioscapular muscles activation in mechanical neck dysfunction: a randomized blinded clinical trial.

BACKGROUND: While postural correction is commonly used for mechanical neck dysfunction (MND), efficacy of KT has received considerable attention. This study was conducted to determine the effectiveness of kinesio taping (KT) versus postural correction exercises on pain intensity and axioscapular muscles activation in patients with MND. METHODS: Randomized clinical trial for which forty six patients with MND were randomly assigned in to 1 of 2 groups received 4 weeks treatment; KT group: received kinesio taping, PCE group: performed postural correction exercises. Neck pain and axioscapular muscles activation in form of normalized root mean square of dominant upper trapezius and levator scapula muscles were measured pre- and post-treatment by visual analogue scale and electromyography. Two ways MANOVA was used to examine the effects of treatment on outcome measures. The variable of interest was the group-by-time interaction at an a priori alpha level of 0.05. Intragroup comparisons were performed using paired t-tests. RESULTS: Group by time interaction was statistically significant in multivariate test (F=3.114, P=0.031). KT produced more pain reduction than postural exercises (P<0.05). There was no significant interaction for either UT RMS (P=0.274) or LS RMS (P=0.59). In both groups, Paired t tests revealed that there was significant reduction in pain and muscle activation of both measured muscles (P<0.01). CONCLUSIONS: KT has been found to be more effective than postural exercises to reduce neck pain. However, both modalities have similar effects to reduce axioscapular muscles activation.