Comparison of the efficacy of manual treatment according to fascial distortion model versus joint mobilization in patients with shoulder impingement: A randomized clinical trial.

BACKGROUND: The Fascial Distortion Model (FDM) is a relatively new manual therapy approach in the field of musculoskeletal physical therapy, but to date no study has been conducted to compare its' effect in comparison with joint mobilization on patients with shoulder impingement syndrome. OBJECTIVE: The present study aims to compare the efficacy of the FDM versus joint mobilization in pain intensity, pain-free abduction range of motion and function of patients with shoulder impingement syndrome. DESIGN: single-blind, parallel-arm randomized controlled trial. METHODS: 26 patients diagnosed with shoulder impingement syndrome were equally randomized into 2 groups: manual treatment according to the FDM, and joint mobilization of the shoulder complex. All patients received 3 intervention sessions every other day. Pain intensity (by visual analogue scale), pain-free abduction range of motion (by goniometry) and function (by Persian version of shoulder pain and disability index) were measured before and after every session and at follow-up 2 weeks later. Patients' satisfaction with treatment was also measured (by a 4-point Likert scale) at follow-up. RESULTS: FDM therapy group showed statistically significant greater pain reduction (P = 0.014) and range of motion increment (P = 0.044) than joint mobilization group after intervention, while only range of motion maintained the difference at follow-up (P = 0.034). Function improvement was not statistically different after the intervention (P = 0.582) and at follow-up (P = 0.094). There was no difference in patients' satisfaction with treatment between groups (P > 0.05). CONCLUSION: The FDM is a safe and effective treatment approach with comparable results to joint mobilization in patients with shoulder impingement syndrome.

The Effect of Combined Auditory Training on Concurrent Sound Segregation in Young old: A Single-Blinded Randomized Clinical Trial.

This study aimed to investigate the behavioral results of perceptual learning in young old using double-vowel discrimination tasks in combined auditory training programs. In a single-blind randomized clinical trial, 35 participants were randomly divided into three groups and received different auditory training programs for six sessions using the software. To compare the double-vowel discrimination score, CV in noise test, and reaction time to the first and second vowels pre- and post-intervention, an analysis of variance was conducted. The discrimination score in the double vowel task and CV in noise test improved after training with no significant difference between the groups. After auditory training, the lowest RT1 was observed in the first intervention group, whereas RT2 decreased only in the second intervention. The present study showed that combined auditory training programs are as effective as conventional auditory training programs in improving speech perception in the elderly. Modifications in the sensory cortex could be investigated using electrophysiological recordings, but this was not conducted because of the pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03923-x.

Effectiveness of ultrasound and median nerve gliding with and without shock-wave therapy in patients with moderate carpal tunnel syndrome.

[Purpose] The aim of this research was to see how ultrasound and nerve gliding with and without shock wave therapy effects on clinical and sonographic data of patients with carpal tunnel syndrome (CTS). [Participants and Methods] Forty four patients with moderate carpal tunnel syndrome participated in this research. One group got shock-wave therapy in addition to median nerve glide exercises and ultrasound, whereas the other group received median nerve glide exercises and ultrasound alone. Hand grip strength (HGS), pinch grip strength (PGS), Visual Analogue Scale (VAS)-pain, Boston Questionnaire (BQ), and Cross-sectional area (CSA) of median nerve were examined before and after 10 sessions of treatment. [Results] HGS, PGS, VAS, BQ and CSA of median nerve improved considerably after therapy. [Conclusion] Patients with moderate CTS who received ultrasound and median nerve glide exercises with and without shock-wave therapy improved considerably without preference of adding shock-wave therapy to other treatment.

Factors Influencing Verbal Intelligence and Spoken Language in Children with Phenylketonuria.

OBJECTIVE: To determine verbal intelligence and spoken language of children with phenylketonuria and to study the effect of age at diagnosis and phenylalanine plasma level on these abilities. DESIGN: Cross-sectional. SETTING: Children with phenylketonuria were recruited from pediatric hospitals in 2012. Normal control subjects were recruited from kindergartens in Tehran. PARTICIPANTS: 30 phenylketonuria and 42 control subjects aged 4-6.5 years. Skills were compared between 3 phenylketonuria groups categorized by age at diagnosis/treatment, and between the phenylketonuria and control groups. MAIN OUTCOME MEASURES: Scores on Wechsler Preschool and Primary Scale of Intelligence for verbal and total intelligence, and Test of Language Development-Primary, third edition for spoken language, listening, speaking, semantics, syntax, and organization. RESULTS: The performance of control subjects was significantly better than that of early-treated subjects for all composite quotients from Test of Language Development and verbal intelligence (P<0.001). Early-treated subjects scored significantly higher than the two groups of late-treated subjects for spoken language (P=0.01), speaking (P=0.04), syntax (P=0.02), and verbal intelligence (P=0.019). There was a negative correlation between phenylalanine level and verbal intelligence (r=-0.79) in early-treated subjects and between phenylalanine level and spoken language (r=-0.71), organization (r=-0.82) and semantics (r=-0.82) for late-treated subjects diagnosed before the age one year. CONCLUSION: The study confirmed that diagnosis of newborns and control of blood phenylalanine concentration improves verbal intelligence and spoken language scores in phenylketonuria subjects.

Interaural difference values of vestibular evoked myogenic.

Migraine is a neurologic disease, which often is associated with a unilateral headache. Vestibular abnormalities are common in migraine. Vestibular evoked myogenic potentials (VEMPs) assess otolith function in particular functional integrity of the saccule and the inferior vestibular nerve. We used VEMP to evaluate if the migraine headache can affect VEMP asymmetry parameters. A total of 25 patients with migraine (22 females and 3 males) who were diagnosed according to the criteria of IHS-1988 were enrolled in this cross-sectional study. Control group consisted of 26 healthy participants (18 female and 8 male), without neurotological symptoms and history of migraine. The short tone burst (95 dB nHL, 500 Hz) was presented to ears. VEMP was recorded with surface electromyography over the contracted ipsilateral sternocleidomastoid (SCM) muscle. Although current results showed that the amplitude ratio is greater in migraine patients than normal group, there was no statistical difference between two groups in mean asymmetry parameters of VEMP. Asymmetry measurements in vestibular evoked myogenic potentials probably are not indicators of unilateral deficient in saccular pathways of migraine patients.

A study of therapeutic ultrasound and exercise treatment for muscle fatigue in patients with chronic non specific low back pain: a preliminary report.

AIM: The aim of this study was to investigate the effect of continuous ultrasound (US) plus exercise on the endurance of paravertebral muscles of patients with chronic non specific low back pain (CNSLBP). METHODS AND MATERIALS: In this pilot, pretest-posttest study, 22 patients with CNSLBP participated. Patients received 10 sessions of treatment, including continuous US plus exercise therapy, over a period of four consecutive weeks. Median frequency slopes of Iliocostalis and Multifidus muscles as well as holding time during Biering-Sorensen test were measured using surface electromyography. In addition, function and pain were measured using Functional Rating Index (FRI) questionnaire and VAS. RESULTS: Five females and 15 males with a mean age of 31.7 years completed the treatment. Descriptive data showed a decrease of 0.01 and 0.02 mean in median frequency slope of right and left Iliocostalis respectively and a mean of 0.08 decrease for both right and left Multifidus muscles. Endurance time increased 1.8 seconds mean. Both function (17%) and pain (24%) improved post treatment. CONCLUSION: Larger population studies in the context of high quality, randomized clinical trial are needed to validate the results.

The effect of continuous ultrasound on chronic non-specific low back pain: a single blind placebo-controlled randomized trial.

BACKGROUND: Non-specific chronic low back pain (NSCLBP) is one of the most common musculoskeletal disorders around the world including Iran. One of the most widely used modalities in the field of physiotherapy is therapeutic ultrasound (US). Despite its common use, there is still inconclusive evidence to support its effectiveness in patients with NSCLBP. The objective of this study was to evaluate the effect of continuous US compared with placebo US additional to exercise therapy for patients with NSCLBP. METHODS: In this single blind placebo controlled study, 50 patients with NSCLBP were randomized into two treatment groups: 1) continuous US (1 MHz &1.5 W/cm2) plus exercise 2) placebo US plus exercise. Patients received treatments for 4 weeks, 10 treatment sessions, 3 times per week, every other day. Treatment effects were assessed in terms of primary outcome measures: 1) functional disability, measured by Functional Rating Index, and 2) global pain, measured by a visual analog scale. Secondary outcome measures were lumbar flexion and extension range of motion (ROM), endurance time and rate of decline in median frequency of electromyography spectrum during a Biering Sorensen test. All outcome variables were measured before, after treatment, and after one-month follow-up. An intention to treat analysis was performed. Main effects of Time and Group as well as their interaction effect on outcome measures were investigated using repeated measure ANOVA. RESULTS: Analysis showed that both groups had improved regarding function (FRI) and global pain (VAS) (P < .001). Lumbar ROM as well as holding time during the Sorensen test and median frequency slope of all measured paravertebral muscles did not change significantly in either group (P > .05). Improvement in function and lumbar ROM as well as endurance time were significantly greater in the group receiving continuous US (P < .05). CONCLUSIONS: The study showed that adding continuous US to a semi supervised exercise program significantly improved function, lumbar ROM and endurance time. Further studies including a third group of only exercise and no US can establish the possible effects of placebo US. TRIAL REGISTRATION: NTR2251.