Osteopathic Manual Treatment Compared to Kaltenborn-Evjenth Orthopedic Manual Therapy for Chronic Low Back Pain: A Randomized Study.

Context: Low back pain (LBP) is a painful pathology causing pain and disability despite treatment with the best evidence-based therapies. Osteopathic manual therapy (OMT) and Kaltenborn-Evjenth orthopedic manual therapy (KEOMT) are alternative treatments for LBP. Objective: The study intended to evaluate the efficacy of OMT compared to that of KEOMT for patients with chronic LBP. Design: The research team designed a randomized study. Setting: The study was held at the Medita Health Center in Warsaw, Poland. Participants: The study included 68 participants of both genders, aged 30 to 60, with chronic LBP. Intervention: Participants were randomly assigned to one of two parallel groups, each with 34 members. The OMT group received, as a direct technique, a high-velocity/low-amplitude (HVLA) impulse, and as indirect techniques, strain counterstrain (SCS), myofascial release (MFR), and visceral mobilization therapy (VMT). The KEOMT group received lumbar segmental traction and lumbar segmental mobilization-flexion and gliding therapy grade 3. The participants in both groups received 10 treatments, two per week for five weeks. Outcome Measures: The primary outcome was pain severity, using a numeric pain rating scale (NPRS). The secondary outcome was measurement of functional disability, using the Oswestry Disability Index (ODI). Results: The OMT and KEOMT both decreased pain and disability; however, the changes on the NPRS and ODI postintervention were statistically greater for the OMT group compared to the KEOMT group (P < .05). Conclusions: OMT was better at reducing pain and improving quality of life. It reduced functional disability more than KEOMT in patients with chronic LBP.

Cryotherapy With Mobilization Versus Cryotherapy With Mobilization Reinforced With Home Stretching Exercises in Treatment of Chronic Neck Pain: A Randomized Trial.

OBJECTIVES: The purpose of this study was to compare the effectiveness of cryotherapy with mobilization (CM) vs cryotherapy with mobilization reinforced with home stretching exercises (CMS) on pain and disability. METHOD: A randomized clinical trial with 2-arm parallel design, concealed allocation, assessor blinding, and intention to-treat analysis. Sixty participants were in 2 groups. Group 1 included cryotherapy with mobilization twice per week for 5 weeks. Group 2 included cryotherapy with mobilization plus home stretching exercises 5 times per week for 5 weeks. The evaluations were at baseline and 2 days posttreatment for the numeric pain rating scale, neck disability index, patient-specific functional scale, and global rating of change. RESULTS: The CM and CMS decreased neck pain and disability (P = .000). The statistical significance between the groups' differences favored the CM in the numeric pain rating scale, patient-specific functional scale, global rating of change (P = .000), and neck disability index (P = .004). CONCLUSION: Cryotherapy with mobilization for subjects in this study was more effective in decreasing disability and neck pain than CMS.

Manual Therapy With Cryotherapy Versus Kinesiotherapy With Cryotherapy for Knee Osteoarthritis: A Randomized Controlled Trial.

CONTEXT: Manual therapy and kinesiotherapy are used for knee osteoarthritis (OA). Yet, a clear evidence of the effects of manual therapy versus kinesiotherapy on knee OA is limited. The addition of cryotherapy to manual therapy or to kinesiotherapy may enhance the health benefits in patients with knee OA. OBJECTIVE: The study intended to evaluate the efficacy of manual therapy combined with cryotherapy versus kinesiotherapy combined with cryotherapy for patients with knee OA. DESIGN: The research team designed a randomized, controlled trial. SETTING: The study occurred in the Physiotherapy Outpatient Department of the Regional Hospital (Sandomierz, Poland). PARTICIPANTS: The participants were 128 females and males with knee OA, aged 40 to 80 y, who were patients in the department at the hospital. INTERVENTION: The participants were randomly assigned to an intervention group that received manual therapy combined with cryotherapy, the MT-C group (n = 64), or to a control group, which received kinesiotherapy combined with cryotherapy, the KIN-C group (n = 64). The participants in both groups received 10 treatments, 2 per wk for 5 wk. OUTCOME MEASURES: The primary outcome was measured using a visual analog scale pain ratings. The secondary outcome measured the quality of life using the Western Ontario and McMaster Universities questionnaire, knee extension, and flexion range of motion using the goniometer, and functional capacity using the 6-min walk test. RESULTS: After the treatments, the intervention group had significantly lower scores than the control group for pain, as well as significantly higher scores for quality of life, range of motion of the affected knee, and functional capacity. CONCLUSION: The patients achieved better health benefits from manual therapy when it was combined with cryotherapy.

Extracorporeal shockwave therapy vs. kinesiotherapy for osteoarthritis of the knee: A pilot randomized controlled trial.

BACKGROUND: Osteoarthritis (OA) of the knee is a degenerative, painful pathology, needing conservative treatment for symptoms' relief. OBJECTIVE: Comparing the effects of Extracorporeal shockwave therapy (ESWT) and Kinesiotherapy (KIN) on perceived health and range of motion (ROM) of the affected knee. METHOD: A pilot randomized controlled trial with concealed allocation, assessor blinding, intention-to-treat analysis. Forty participants, aged 40-75 with OA of the knee were randomized to an ESWT and a KIN groups. The ESWT group completed 5 interventions for 5 weeks, the KIN group completed the same number of interventions. All evaluations were performed at baseline and after the treatment for: perceived health (Western Ontario and McMaster Universities questionnaire - WOMAC), range of motion (ROM). RESULTS: After the intervention the statistical significant between groups differences favoring the ESWT were found in the WOMAC with regard to pain (p< 0.000), stiffness (p= 0.018), physical function (p< 0.000), total score (p< 0.000), extension and flexion of the affected knee (p= 0.015, p< 0.000) respectively. CONCLUSIONS: ESWT improves WOMAC and ROM better then KIN on the affected knee in patients with OA of the knee.

Manual Therapy With Cryotherapy Versus Manual Therapy With Kinesio Taping for Males With Lumbar Discopathy: A Pilot Randomized Trial.

Context • Numerous modalities of therapeutic interventions exist for lumbar discopathy. Manual therapy is one option, although its effectiveness remains controversial. The addition of cryotherapy to manual therapy may enhance the health benefits in patients with lumbar discopathy.  Objective • The study intended to evaluate the efficacy of manual therapy combined with cryotherapy vs manual therapy combined with Kinesio taping for males with lumbar discopathy. Design • The research team designed a pilot randomized trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Setting • The study occurred in the Physiotherapy Outpatient Department of the Regional Hospital (Zywiec, Poland). Participants • The participants were 40 males with lumbar discopathy, aged 30-75 y, who were patients in the department at the hospital. Intervention • The participants were randomly assigned to an intervention group that received Kaltenborn-Evjenth orthopedic manual therapy (KEOMT) combined with cryotherapy, the KEOMT-C group (n = 20), or to a control group that received KEOMT combined with Kinesio taping, the KEOMT-K group (n = 20). The participants in both groups received 10 treatments, 2 per wk for 5 wk. Outcome Measures • The primary outcome was measured using a visual analog scale and the Laitinen scale pain ratings. The secondary outcome measured the quality of life using the short form-36 questionnaire. The participants completed the tests at baseline and postintervention. Results • After the treatments, the intervention group had significantly lower scores than the control group for pain as well as significantly higher scores for quality of life. Conclusions • Patients achieved better health benefits from manual therapy when it was combined with cryotherapy.

Evaluation of the effects of a physiotherapy program on quality of life in females after unilateral total knee arthroplasty: a prospective study.

[Purpose] Osteoarthritis is a chronic and degenerative joint disease and is considered to be one of the most common musculoskeletal disorders. This study evaluated the differences in the quality of life of females treated with supervised physiotherapy and a standardized home program after unilateral total knee arthroplasty. [Subjects and Methods] From January 2012 to May 2015, a total of 40 females were examined at the Central Military Hospital in Ruzomberk, Slovakia. Quality of life was assessed with the Short Form-36. Quality of life and intensity of pain after normal daily activity, according to the visual analog scale, were assessed before total knee arthroplasty, immediately after physiotherapy, 3 months after total knee arthroplasty, and 6 months after total knee arthroplasty. [Results] We found statistically significant improvement of the quality of life results and a decreased intensity of pain at each time point compared with before total knee arthroplasty. [Conclusions] The results of this study provide further evidence indicating that patients who undergo total knee arthroplasty for primary osteoarthritis of the knee can achieve a significant improvement in the quality of life by using supervised physiotherapy compared with a standardized home program.

Comparative assessment of calcitonin stimulation test using calcium gluconate and pentagastrin and the usefulness of procalcitonin basic and post-stimulation concentrations in the diagnosis of patients after surgery for medullary.

OBJECTIVES: The aim of the study was to compare the calcitonin (CT) stimulation tests with tests of calcium gluconate (CaG) and pentagastrin (PG), their tolerance and usefulness of PCT in the patients' diagnosis with active Medullary thyroid cancer (MCT) after thyroidectomy. METHODS: CT was marked in serum by the immunosorbent sandwich test. PCT was marked by the immunosorbent sandwich test, with the final reading of fluorenscence. PG was given intravenously at a dose of 0.5 mg/kg body weight for 10 seconds. CaG was also given by intravenous injection at a dose of 2.5 mg of elemental Ca/kg body weight at a rate of 5ml/min, for minimum 3 minutes. Blood was taken at the 0 minute, the 3 and 5 minute after getting the stimulating substances. RESULTS: The post-stimulation CT concentration in the 3 and 5 minute of the CaG test vs PG is significantly higher compared to the baseline. The maximal stimulation of the CT is in the 3 minute, but higher concentrations occurred using the CaG. CONCLUSION: The results of the study suggest a similar diagnostic value of the tests with CaG compared to the PG as stimulants. In the present study we noticed a trend of basic and post-stimulation concentrations of PCT to increase in the tests with PG and CaG which correspond with the elevated concentrations of CT.

Analgesic effect of extracorporeal shock wave therapy versus ultrasound therapy in chronic tennis elbow.

[Purpose] This study compared the analgesic effects of extracorporeal shock wave therapy with those of ultrasound therapy in patients with chronic tennis elbow. [Subjects] Fifty patients with tennis elbow were randomized to receive extracorporeal shock wave therapy or ultrasound therapy. [Methods] The extracorporeal shock wave therapy group received 5 treatments once per week. Meanwhile, the ultrasound group received 10 treatments 3 times per week. Pain was assessed using the visual analogue scale during grip strength evaluation, palpation of the lateral epicondyle, Thomsen test, and chair test. Resting pain was also recorded. The scores were recorded and compared within and between groups pre-treatment, immediately post-treatment, and 3 months post-treatment. [Results] Intra- and intergroup comparisons immediately and 3 months post-treatment showed extracorporeal shock wave therapy decreased pain to a significantly greater extent than ultrasound therapy. [Conclusion] Extracorporeal shock wave therapy can significantly reduce pain in patients with chronic tennis elbow.

Evaluation of relations between body posture parameters with somatic features and motor abilities of boys aged 14 years.

INTRODUCTION: Body posture is an individual characteristic for everyone, it shows great differentiation - especially in people during their progressive development. As a result, the variability of the development and lack of physical activity impose body posture defects in children and youth. In the literature there is a great lack of measureable data on the relations between correct body posture with somatic features, especially motor features in children at the developing age. The aim of this study was to evaluate the relations between correct body posture parameters, measured with the photogrammetric method, with some of the somatic features and motor abilities of boys at the age of 14. MATERIAL AND METHODS: The study included 133 boys aged 14 attending junior secondary schools in the Kraków area of Poland. Only boys with the correct body posture were examined. Posture was examined by the Moire method, through which six parameters were obtained in the sagittal plane, seven in the frontal plane, and one in the transverse plane. The somatic measurements included basic parameters, such as body weight and body height. The measurements of motor features included: marching balance test, speed movement test of the arms and their functional strength. To evaluate the relationships between correct body posture with the characteristics of somatic and motor abilities, the Spearman rank correlation was used. The lowest level of statistical significance was accepted at p≤0,05. RESULTS: No correlations were noted between some of the correct body posture features and the somatic features, and some of the motor abilities of the examined boys at the level of p≤0.05 and p≤0.01. CONCLUSIONS: The irregular correlation between the correct body posture and somatic and motor features probably results from the rather big development variability of the boys during puberty.

Effect of spa physiotherapy on the range of motion and muscle strength in women with gonarthrosis.

INTRODUCTION: Degeneration arthritis is a chronic disease of undetermined progressiveness and unknown pathogenesis. It can affect one or more joints. It reveals itself most frequently between 40 - 60 years of age, and affects the lives of professionally active individuals. The aim of the presented study was to assess the impact of a 21-day stay at a rehabilitation facility on the range of motion and muscle strength of the knee in women with gonarthrosis. MATERIALS AND METHODS: The study group consisted of 30 women aged 50-74 years diagnosed with degeneration of the knee joint. The average age of the study group was 65.9 ± 7.2 years. Patients remained in the 21-day rehabilitation facility of Rehabilitational Hospital No. 21 in Busko Zdrój SP ZOZ, Poland. We measured with the help of protractor in SFTR range the motion bending and straightening of the knee with an accuracy of 1°. The Lovett strength test was assessed of the ischio-tibial muscles, quadriceps, sartorius--acting on the knee joint of the patient. The study was carried out on the first and the last day of the stay in the rehabilitation facility. RESULTS: There was improvement in the range of flexion and strength of muscles acting on the knee joint of the afflicted women. CONCLUSION: The study showed that 21-day rehabilitation holiday improved the range and strength of the muscles acting on the knee joint of the afflicted women. This proved that comprehensive rehabilitation improves the function of the knee joint with gonarthrosis, prevents disease progression and is an alternative to drug therapy.

Pilates for low back pain: a systematic review.

OBJECTIVE: The aim of this paper is to systematically review all controlled clinical trials of Pilates to treat low back pain. DATA SOURCES: A systematic review of nine databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, Pedro, Rehadat, Rehab Trials) was conducted and the reference lists of all the papers were checked for further relevant publications until May 2010. STUDY SELECTION: A first selection was performed by means of title and abstract. A second selection was made by means of predefined inclusion criteria: randomized controlled clinical trials testing Pilates in patients of any age or sex with low back pain. DATA EXTRACTION: Data relating to changes in body function, quality of life and pain from the included studies were independently extracted by the reviewers on a standardized form. Study quality was assessed using the Oxford scale. DATA SYNTHESIS: Four eligible randomized controlled clinical trials (n = 4) involving Pilates for the management of low back pain were included. The methodological quality of the RCTs was relatively low, varying from 1-4 on the Oxford scale. All studies were heterogeneous in terms of population of patients, control groups, inclusion and exclusion criteria, and outcome measures making a meta-analysis not feasible. Although there is some evidence supporting the effectiveness of Pilates in the management of low back pain, no definite conclusions can be drawn except that further research is needed with larger samples and using clearer definitions of the standard care and comparable outcome measures. CONCLUSIONS: There is a wide diversity in research investigating the clinical and cost-effectiveness of Pilates in patients with low back pain.

Relationship between explosive muscle strength and medial longitudinal arch of the foot.

BACKGROUND: There has been a suggested link between muscle strength and arch type of the foot. However, a distinct cause and effect dependence has yet to be established. The purpose of this study was to compare the outcomes from selected explosive strength tests with different arch heights. MATERIAL AND METHODS: The medial longitudinal arch (MLA) was measured using a Clarke's angle method. Five hundred seventy-four subjects (n = 574) participated in this study and were divided into three arch height groups and three muscle strength groups, respectively. To evaluate the association between longitudinal arch of the foot with the explosive power of lower limb muscles, Chi-square (χ²) test was used. RESULTS: Arch heights were not significantly related to explosive muscle strength. CONCLUSIONS: Arch measurement was ineffective in accounting for the observed variability in the explosive strength among young adults. CLINICAL RELEVANCE: This data may be useful in evaluating patients with painful flat feet and any strength deficits they may have.

Lomi Lomi as a massage with movements: a conceptual synthesis?

This article narratively reviews the evidence of 2 therapeutic modalities, massage and passive movement. The authors suggest that these 2 treatment techniques may be combined as 1 treatment to be used in a variety of clinical settings. We present the rationale through which the concept of massage with movement (MWM) has been developed and constructed from the principles of passive movements with gentle massage during Lomi Lomi massage. It is hypothesized that through further investigation and empirical studies, this concept may allow bodywork and movement therapists, nurses, physiotherapists, and occupational therapists to combine the positive effects of passive movements with those of massage for patients' health benefits, most notably through enhanced relaxation.