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Somatosensory and psychosocial profile of migraine patients: A cross-sectional study. Musculoskelet Sci Pract 2024; 70:102924. [PMID: 38422705 DOI: 10.1016/j.msksp.2024.102924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/25/2024] [Accepted: 02/21/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Migraine is a chronic neurological disorder that involves the brain, characterized by a series of abnormal neuronal networks interacting at different levels of the central and peripheral nervous system. Furthermore, it is known that psychosocial features contribute to the exacerbation and chronicity of symptoms. OBJECTIVE To compare the somatosensory and psychosocial profiles of migraine patients with a control group. METHODS We conducted a cross-sectional study comparing the somatosensory and psychosocial profiles of patients with migraine and healthy volunteers. A total of 52 women were included. For the somatosensory profile, Mechanical Detection Threshold (MDT), Pressure Pain Threshold (PPT), Temporal Summation (TS), and Conditioned Pain Modulation (CPM) in the trigeminal and extra-trigeminal areas were evaluated. Psychosocial profiles were assessed using questionnaires, the Central Sensitization Inventory, the Generalized Anxiety Disorders, the Pain Catastrophizing Scale, and the Tampa Scale of Kinesiophobia. Mann-Whitney U test was used to compare differences in the profiles between groups. The significance level was set at 5%. RESULTS Migraine patients showed a loss of somatosensory function in the trigeminal area for MDT (p = 0.019, r = 0.34 and p = 0.011, r = 0.37 for the ophthalmic nerve and masseter muscle respectively), lower PPT in trigeminal and extra-trigeminal areas (p < 0.001, r=>0.60) and less efficient CPM (p < 0.001, r=>0.60). No statistically significant differences were found in the TS (p=>0.05). Statistically significant differences were found in all psychosocial variables (p = <0.001 r=>0.60). CONCLUSION Migraine patients showed loss of somatosensory function, lower pressure pain threshold, and an inhibitory pro-nociceptive profile with high scores on central sensitization and fear of movement compared to the control group.
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Reliability of two devices for shoulder strength assessment: Wii Fit Balance Board and hand-held dynamometer. Shoulder Elbow 2024; 16:110-118. [PMID: 38425742 PMCID: PMC10901178 DOI: 10.1177/17585732221145558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 03/02/2024]
Abstract
Background The aim of this study was to compare the reliability and agreement between two devices - Wii Fit Balance Board (WBB) versus Hand-Held Dynamometer (HHD) to measure isometric strength during the athletic shoulder (ASH) test in healthy amateur rugby players. Methods Fifteen males (23.73 ± 2.8 years) completed two testing sessions. Maximal isometric contractions using the dominant arm (D) and non-dominant arm (ND) against a WBB and HHD were assessed at three angles of abduction (180°, 'I'; 135°, 'Y' and 90°, 'T'), in a prone lying position. Results The results indicate a very large correlation between the HHD and the WBB. WBB provides acceptable reliability at I-Test D (CV = 9.97%, ICC = 0.88) and HHD in the I-Test D (CV = 8.90%, ICC = 0.94), I-Test ND (CV = 8.60%, ICC = 0.95) in peak strength values. The HHD is most reliable in D ASH I-Y-T (CV = 10.94%) and WBB (CV = 11.05%). In the ND ASH I-Y-T test, the HHD is the most reliable (CV = 12.5%) compared to the WBB (CV = 14.43%). Conclusions These results suggest that WBB is a reliable device to assess strength in the ASH test with a very large correlation with the HHD. WBB and HHD are two affordable devices to assess isometric shoulder strength.
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Does the Position of the Ankle Matter During the Single Gluteal Bridge in Futsal Players? An Electromyographic Analysis. J Sport Rehabil 2024; 33:73-78. [PMID: 37917981 DOI: 10.1123/jsr.2022-0425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 07/18/2023] [Accepted: 08/29/2023] [Indexed: 11/04/2023]
Abstract
CONTEXT The aim of this study was to analyze the muscle activity of the hamstring muscles and the lateral gastrocnemius during different variants of the single-leg bridge (SLB) in futsal players. DESIGN Cross-sectional study. METHODS Twenty-two futsal players (age = 24.8 [3.9] y) volunteered to participate in this study. The participants performed 3 variations of the SLB with the knee flexed at 45°. The first position was performed with the ankle in plantar position with flat support, the second with the ankle in dorsiflexion (DF) with heel support, and the third with the ankle in DF and external rotation (ER) with heel support. The Wilcoxon rank-sum test assessed the difference between variables for samples with the rank-biserial correlation effect size. Spearman correlation coefficients were used to examine the associations of the percentage maximal voluntary isometric contraction for each muscle with peak force and rate of force development with 3 different variances of the SLB. RESULTS The variation of ankle DF and ER with heel support generated higher muscle activity in BF in concentric (P < .01, effect size [ES] = -0.613); isometric (P < .042, ES = -0.494); and eccentric (P < .005, ES = -0.668) contraction than ankle DF with heel support. In contrast, the variation of ankle DF and ER with heel support generated fewer muscle activity in lateral gastrocnemius in concentric (P < .001, ES = 0.779); isometric (P < .003, ES = 0.708); and eccentric (P < .014, ES = 0.589) contraction than ankle DF with heel support. CONCLUSIONS The position of DF and ER was the best position in SLB to train the BF. It could be convenient to start rehabilitation of the BF with flat foot postition or ankle in DF with heel support and progress with the position of the ankle in DF and ER with heel support.
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No Evidence of Short-term Changes in Muscle Activity Elicited by Dry Needling in Chronic Unilateral Shoulder Pain Patients. Clin J Pain 2023; 39:595-603. [PMID: 37440340 DOI: 10.1097/ajp.0000000000001151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE The aim of the study was to assess short-term changes in shoulder muscle activity elicited by dry needling in chronic unilateral shoulder pain (USP) patients. METHODS A randomized, double-blind, placebo-controlled clinical trial was conducted, in which 30 volunteers with USP were recruited and randomly assigned to either real or sham dry needling conditions. Pain intensity scores, pressure pain threshold, glenohumeral internal rotation angles, and electromyographic activity during isotonic shoulder tasks (shoulder flexion and extension) were assessed before, immediately, and 72 hours after the intervention in the infraspinatus and deltoid muscles. RESULTS A single application of real dry needling resulted in lower pain intensity scores and a larger range in glenohumeral internal rotation 72 hours after the intervention in comparison with sham dry needling. No differences in pressure pain threshold or muscle activity were observed due to the intervention. DISCUSSION A single application of real dry needling resulted in clinically significant changes in the short term. No differences were detected in muscle activation in the infraspinatus or deltoid muscles. Complementary interventions and longer follow-up times may be required to observe changes in muscle activity.
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Assessing muscle strength of persons with transfemoral amputation with and without a prosthesis: A cross-sectional study. Prosthet Orthot Int 2023; 47:532-536. [PMID: 36996310 DOI: 10.1097/pxr.0000000000000228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 01/18/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND There is a gap in the research about the influence of wearing or not wearing a prosthesis for muscle strength assessment in transfemoral amputees (TFA) and how it is associated with functional mobility. OBJECTIVES The aim of this study was to compare the muscle isometric strength of the residual limb with and without the prosthesis in people with TFA and to analyze associations between muscle strength and functional mobility. STUDY DESIGN Cross-sectional study. METHODS 20 subjects with TFA were included. A handheld dynamometer was used for the assessment of residual limb muscle strength. Functional mobility was assessed with the Timed Up and Go test. The Wilcoxon rank sum test with the rank biserial correlation effect size were used. RESULTS There were statistically significant differences when testing isometric strength of the residual limb with and without the prosthesis (flexion [ p = 0.007], extension [ p < 0.001], and abduction [ p = 0.003]). There was association between functional mobility and flexion and abduction strength with the prosthesis ( p = 0.005, p = 0.01). CONCLUSIONS Measurements of muscle strength of the residual limb were different when assessed with and without the prosthesis. Isometric strength of the residual limb in abduction and flexion using the prosthesis were correlated with functional mobility.
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Personalized pain management: The relationship between clinical relevance and reliability of measurements. Eur J Pain 2023; 27:1056-1064. [PMID: 36951044 DOI: 10.1002/ejp.2110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 03/24/2023]
Abstract
Reliability is a topic in health science in which a critical appraisal of the magnitudes of the measurements is often left aside to favour a formulaic analysis. Furthermore, the relationship between clinical relevance and reliability of measurements is often overlooked. In this context, the aim of the present article is to provide an overview of the design and analysis of reliability studies, the interpretation of the reliability of measurements and its relationship to clinical significance in the context of pain research and management. The article is divided in two sections: the first section contains a step-by-step guide with simple and straightforward recommendations for the design and analysis of a reliability study, with a relevant example involving a commonly used assessment measure in pain research. The second section provides deeper insight about the interpretation of the results of a reliability study and the association between the reliability of measurements and their experimental and clinical relevance. SIGNIFICANCE: Reliability studies quantify the measurement error in experimental or clinical setups and should be interpreted as a continuous outcome. The assessment of measurement error is useful to design and interpret future experimental studies and clinical interventions. Reliability and clinical relevance are inextricably linked, as measurement error should be considered in the interpretation of minimal detectable change and minimal clinically important differences.
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Evidence-based practice in physiotherapy in Argentina: Barriers, perceptions and behaviors. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e2034. [PMID: 37417546 DOI: 10.1002/pri.2034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/30/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND AND PURPOSE Evidence-based practice (EBP) has been widely implemented in different areas of biomedical sciences. However, no precedents in Argentina have investigated the data regarding the knowledge and difficulties related to EBP in physiotherapists. The purpose was to describe the self-reported behavior, knowledge, skills, opinion, and barriers related to the EBP of Argentinian physiotherapists. METHODS A customized descriptive survey was conducted among 289 physical therapists in Argentina. The data were analyzed descriptively. RESULTS The response rate was 56% (163/289). Argentinian physiotherapists update themselves through scientific articles, meetings, congresses, and courses. They reported having sufficient knowledge to use EBP, informing patients about treatment options, and considering their choices in the decision-making process. However, there were inconsistencies in responses regarding experience with EBP during undergraduate or postgraduate studies. The most frequently reported barriers were lack of time, difficulty in understanding statistics, and difficulties with the English language of scientific articles. DISCUSSION EBP in Argentine physiotherapists is still poorly understood. Time, language, and difficulties in understanding statistics are the most important barriers to the implementation of EBP. Undergraduate and postgraduate courses are warranted to improve the clinical decision-making process.
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Muscle responses during radial nerve-biased upper limb neurodynamic test in asymptomatic individuals: a cross-sectional study. J Man Manip Ther 2023; 31:105-112. [PMID: 35708965 PMCID: PMC10013554 DOI: 10.1080/10669817.2022.2085849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
This laboratory cross-sectional study aimed at explore the muscle response (MR) of the upper trapezius, infraspinatus, biceps brachii and extensor carpi radialis brevis (ECRB) during the radial nerve-biased upper limb neurodynamic test (RN-ULNT) in healthy participants. Myoelectric activity was stage-by-stage recorded during two sequencing variants of the RN-ULNT: S1, in which elbow extension was the last movement; and S2, in which wrist flexion was the last movement. Final elbow and wrist joint angle and sensory response (SR) in five zones (Z1-Z5) were also registered. MR was qualitatively categorized as 'absent' (No-MR), 'true' (TMR) or 'uneven' (UMR). In both sequences, significant increases in muscle activity occurred mostly during shoulder abduction and elbow extension (p ≤ 0.009). Also, elbow extension but not wrist flexion increased the activity of the ECRB muscle (p ≤ 0.009). S2 showed significantly higher upper trapezius (p = 0.04) and biceps brachii (p = 0.036) muscle activity during wrist flexion, and higher report of SR in Z1 and Z4 (p < 0.001) compared to S1. Only the ECRB muscle showed significant differences in the MR type between S1 and S2 (TMR, p = 0.016; UMR, = 0,012). Our results may be useful in the assessment of upper limb musculoskeletal disorders.
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Dynamometric Strength Profile of Hip Muscles in Youth Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1291. [PMID: 36674053 PMCID: PMC9859035 DOI: 10.3390/ijerph20021291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Soccer is the most widely practiced sport in the world, demanding high-speed activities such as jumps, sprints and changes of direction. Therefore, having optimal levels of muscle strength improves performance and reduces the injury rate. OBJECTIVES The objectives of our study were (i) to determine the dynamometric profile of hip muscle strength in young soccer players by position, evaluated at different isokinetic speeds, (ii) to describe the conventional and functional unilateral muscle strength ratios, (iii) to analyze the bilateral balance. METHODS Thirty-seven male soccer players (age 17.02 ± 0.92 years) participated in the study. Strength assessment was performed with a functional electromechanical dynamometer, and concentric and eccentric strength of abductors, adductors, extensors and hip flexors were measured bilaterally at 0.5 m/s and 1 m/s. RESULTS For eccentric right hip abduction at 0.5 m/s, defenders are significantly stronger than midfielders (p = 0.013) and stronger than forwards (p = 0.140). For eccentric right hip adduction at 0.5 m/s, defenders are significantly stronger than midfielders (p = 0.005) and stronger than forwards (p = 0.253), as for eccentric right hip adduction at 1 m/s, defenders are significantly stronger than midfielders (p = 0.014) and stronger than forwards (p = 0.084). There is a significant effect for the conventional strength ratio of left abduction/adduction at 1 m/s. The conventional strength ratio of forwards is significantly higher than that of defenders (p = 0.045) and higher than that of midfielders (p = 0.152). CONCLUSIONS Concentric and eccentric hip strength values differ according to playing position.
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Effects of an exercise program plus manual therapy in a patient with failed neck surgery syndrome: A case report. J Bodyw Mov Ther 2023; 33:216-222. [PMID: 36775521 DOI: 10.1016/j.jbmt.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 04/18/2022] [Accepted: 09/17/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Patients who have undergone cervical surgery may present pain and dysfunction in the upper limb, which is often referred to as failed neck surgery syndrome. Little is known about the effects of an exercise program plus manual therapy in the treatment of prolonged neuropathic pain of the upper quadrant in a patient with failed neck surgery. CASE DESCRIPTION A 66-year-old woman consulted for neuropathic pain and dysfunction during grasping activities, as a result of failed neck surgery after 12 months. Clinical, functional, and electromyographic measurements were recorded at baseline and after treatment. The patient underwent a treatment for six weeks based on manual therapy for the upper limb and cervical spine and an exercise program for the scapular muscles, rotator cuff and wrist extensor muscles. OUTCOMES Positive clinically significant changes were observed in the Neuropathic Pain Questionnaire (DN4) (baseline = 7 points; post-treatment = 4 points), Neck Disability Index (NDI) (baseline = 36; post-treatment = 18 points), QuickDASH (baseline = 78; post- treatment = 32 points), Upper Limb Neurodynamic Test 1 (ULNT-1) (baseline = 75°; post- treatment = 42°) and grip strength (GS) (baseline = 23 kgf; post-treatment = to 32 kgf). Improvements in the surface electromyographic (sEMG) activity of the upper trapezius (UT), infraspinatus (IS) and radial wrist extensors (RWE) muscles also seemed to occur after treatment. CONCLUSION Treatment helped relieve neuropathic pain, decrease neck disability, and improve general upper limb function.
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Pressure pain threshold mappings of the infraspinatus muscle in chronic unilateral shoulder pain patients do not reflect generalized hypersensitivity. Musculoskelet Sci Pract 2022; 58:102495. [PMID: 35114503 DOI: 10.1016/j.msksp.2021.102495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/25/2021] [Accepted: 12/14/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Increased mechanical sensitivity has been observed on the unaffected side in chronic pain conditions, suggesting generalized or widespread hypersensitivity. However, this cannot be considered as a universal response since this hypersensitivity is inconsistent across muscle pain pathologies. The aim of this study was to assess generalized hypersensitivity in chronic unilateral shoulder pain, using pressure pain threshold (PPT) mappings of the infraspinatus muscle. The proposed evaluation is based on the assessment of PPT on a limited subset of sites, reducing potential habituation or sensitization effects. METHODS Twenty-nine patients with unilateral shoulder pain (USP) and twenty-seven healthy volunteers were recruited. PPT was assessed using a manual pressure algometer. Six sites distributed over the infraspinatus muscle were assessed, and three repetitions were performed at each site. Mappings were derived using two-dimensional interpolation. RESULTS Lower PPT values were found in the symptomatic side in comparison with the asymptomatic side at all assessment sites (estimated difference: 1.42 ± 0.10 kgf/cm2, p < 0.001), but there were no differences among the asymptomatic side of USP patients and any of the sides in healthy volunteers (largest estimated difference: 0.17 ± 0.28 kgf/cm2, p = 0.927). Furthermore, the medial region of the infraspinatus muscle showed higher mechanical sensitivity in both healthy volunteers and USP patients. CONCLUSIONS These results suggest that USP does not induce generalized hypersensitivity, in contrast with previously reported findings. Physiotherapists could take these results into account for the assessment and treatment of patients with USP.
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Supine scapular punch: An exercise for early phases of shoulder rehabilitation? Clin Biomech (Bristol, Avon) 2022; 92:105583. [PMID: 35124534 DOI: 10.1016/j.clinbiomech.2022.105583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/09/2021] [Accepted: 01/17/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Serratus anterior strengthening generally appears in shoulder rehabilitation protocols. This study's aim was to measure electromyographic activity of the serratus anterior, upper trapezius, and infraspinatus muscles during the Supine Scapular Punch exercise in healthy volunteers and those with unilateral shoulder pain. METHODS Fifty-four participants were included and grouped as without (n = 34, age = 25.8 years) or with unilateral shoulder pain (n = 20, age = 26.3 years, visual analogue scale = 4.15 cm). Electromyographic activity of the serratus anterior, upper trapezius, and infraspinatus muscles was assessed during Supine Scapular Punch (four phases: P1 = press up concentric, P2 = Supine Scapular Punch concentric, P3 = Supine Scapular Punch eccentric, P4 = press up eccentric) performed under two conditions, with and without additional load. FINDINGS Overall muscle activity during P1 and P4 was negligible (< 10% maximal voluntary isometric contractions). During P2 and P3, no statistically significant differences in serratus anterior and upper trapezius muscle activity were found between groups, with moderate to high serratus anterior activity (28.94% to 44.3%) and very low upper trapezius activity (< 6%). Upper trapezius/serratus anterior activity ratios ranged from 0.09 to 0.18. Overall infraspinatus muscle activity was always very low (< 10%). INTERPRETATION The Supine Scapular Punch induces moderate to high serratus anterior muscle activity with very low upper trapezius and infraspinatus activation. Based on these results, the Supine Scapular Punch is a safe exercise that can be used in the early phases of shoulder rehabilitation.
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Immediate effects of rhythmic joint mobilization of the temporomandibular joint on pain, mouth opening and electromyographic activity in patients with temporomandibular disorders. J Bodyw Mov Ther 2021; 28:563-569. [PMID: 34776197 DOI: 10.1016/j.jbmt.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 07/05/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Rhythmic joint mobilizations (RJM) of the temporomandibular joint (TMJ) are employed to relieve pain and improve function in patients with temporomandibular disorders (TMD). However, the evidence on the immediate effects of RJM in patients with TMD is scarce. The aim of this study was to assess the immediate clinical and functional effects of RJM in patients with TMD. MATERIALS AND METHODS This was a one-group quasi-experimental before and after study. Thirty-eight patients with TMD were assessed by means of pain intensity (visual analogue score, VAS), pressure pain threshold (PPT, measured through pressure algometry on the masseter and temporal muscles), mouth opening (MO, measured with a ruler), and surface electromyographic activity of the masseter and temporal muscles (asymmetry index, AI). Measurements were performed before and after a single, 1-min session of RJM of each TMJ. All statistical analyses were performed using the SPSS version 20.0 statistical package. RESULTS A statistical significant difference was found in pain intensity, PPT and MO after the intervention (p < 0.05). No difference was found in the AI. A large effect size was observed for pain intensity, PPT of the left and right masseter muscles and MO (d = 0.85-1.13), whereas for the left and right temporal muscles the effect size was moderate (d = 0.62) and small, respectively (d = 0.49). CONCLUSION In this sample of patients with TMD, a single session of RJM of the TMJ seemed to be effective in reducing pain intensity, increasing PPT and improving MO immediately after the intervention, without differences in the AI.
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Scapular Retraction under Adduction Load: An Alternative to Overhead Exercises to Activate Infraspinatus, Upper, and Lower Trapezius in Subjects with and without Shoulder Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179251. [PMID: 34501840 PMCID: PMC8430934 DOI: 10.3390/ijerph18179251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 01/07/2023]
Abstract
Exercises for lower trapezius (LT) often use overhead positions, causing compressive forces to the subacromial space. Scapular retraction would be an alternative to activate LT muscle. The present study aimed to assess the excitation levels of infraspinatus, upper trapezius, and lower trapezius muscles during a scapular retraction exercise under progressive adduction loads in subjects with and without painful shoulder. Electromyography of infraspinatus (IS), upper trapezius (UT), and LT was recorded during scapular retraction under progressive adduction loads of 42 participants, divided into two groups: with (SP, n = 26) and without shoulder pain (nSP, n = 16). The adduction loads of 20%, 30%, 40%, and 50% of the maximal voluntary contraction (MVC) were applied using a load cell. Normalized electromyography and the ratio between UT and LT (UT:LT) were used for statistical analysis. No differences were observed between groups, but a condition effect occurred for all muscles: UT showed higher values at 50% vs. 20% of MVC (p = 0.004); LT showed higher values on 40% and 50% of MVC (p = 0.001; 0.006). Higher values for IS were noted at 40% of MVC (vs. 20% of MVC; p = 0.04) and at 50% of MVC (vs. 20% of MVC; p = 0.001, vs. 30% of MVC, p = 0.001; vs. 40% of MVC; p = 0.001). UT:LT showed lower values at 50% of MVC (vs. 20% of MVC; p = 0.001 and vs. 30% of MVC; p = 0.016). Scapular retraction with adduction loads at 40-50% is an alternative to overhead exercises aiming to activate the LT and the IS muscles. The exercise ensures higher levels of LT and IS excitation without increasing UT excitation.
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Abstract
Objective To determine whether non-hospitalized adults post COVID-19 have impaired exercise capacity. Design Retrospective analysis. Setting Cardiovascular outpatients unit in Instituto Cardiovascular de Rosario, Argentina. Patients Eighty non-hospitalized patients post-infection by COVID-19. Interventions Participants completed an ergometry pre and post COVID-19 infection. Main outcome measures The study's main variables were the metabolic equivalents of task (METs) and the indirect peak oxygen consumption (VO2 peak). Results The median of METs was 11.7 (9.4-14.8) and 11.7 (11-11.7) in pre and post ergometry, respectively, (p = 0.022). The median VO2 (mL/Kg/min) was 21857 (16938-32761) and 21699 (17004-26467) in pre and post ergometry, respectively, without significant differences. Conclusions We found slight differences in maximal physical capacity evaluated through exercise testing in non-hospitalized patients by COVID-19.
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Effect of pain neuroscience education and transcutaneous electrical nerve stimulation on trigeminal postherpetic neuralgia. A case report. Physiother Theory Pract 2021; 38:1813-1822. [PMID: 33541188 DOI: 10.1080/09593985.2021.1878567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Postherpetic neuralgia (PHN) is a complex neuropathic painful condition in which pain is a direct consequence of the response to peripheral nerve damage experienced during herpes zoster attack. PHN is the most common chronic complication of herpes zoster and it causes considerable suffering, affecting the physical functioning and psychological well-being of patients. Objective: To describe the effect of a conservative treatment using pain neuroscience education (PNE) and transcutaneous electrical nerve stimulation (TENS) in a patient with trigeminal PHN. Case Description: A 67-year-old woman sought care for pain, dysfunction, and sensory loss in the left jaw. The assessment included: 1) pain, using the numerical pain rating scale (NPRS), pressure pain threshold (PPT), Douleur Neuropathique 4 (DN4), McGill Pain Questionnaire (MPQ), Graded Chronic Pain Scale (GCPS), and classic body charts of the cranial region; 2) somatosensory function, by means of mechanical detection threshold (MDT) and pressure pain threshold (PPT); 3) jaw function, using the Jaw Functional Limitation Scale-20 (JFLS-20); and 4) psychosocial features, by means of the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorders Questionnaire-7 (GAD-7). Treatment consisted of 12 sessions of PNE and TENS. Outcomes: After treatment, a clinically significant improvement in NPRS, DN4, MDT, GCPS, and PHQ-9 was observed. Conclusion: In this case report, a treatment based on the combination of PNE and TENS seemed to have contributed to improving pain, sensory abnormalities, and jaw function. Psychosocial factors also showed a trend to improve after the treatment.
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Instrumental validity and intra/inter-rater reliability of a novel low-cost digital pressure algometer. PeerJ 2020; 8:e10162. [PMID: 33083153 PMCID: PMC7560318 DOI: 10.7717/peerj.10162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/21/2020] [Indexed: 12/30/2022] Open
Abstract
Background Pain assessment is a key measure that accompanies treatments in a wide range of clinical settings. A low-cost valid and reliable pressure algometer would allow objective assessment of pressure pain to assist a variety of health professionals. However, the pressure algometer is often expensive, which limits its daily use in both clinical and research settings. Objectives This study aimed to assess the instrumental validity, and the intra- and inter-rater reliability of an inexpensive digital adapted pressure algometer. Methods A single rater applied 60 random compressions on a force platform. The pressure pain thresholds of 20 volunteers were collected twice (3 days apart) by two raters. The main outcome measurements were as follows: the maximal peak force (in kPa) and the pressure pain threshold (adapted pressure algometer vs. force platform). Cronbach’s α test was used to assess internal consistency. The standard error of measurement provided estimates of measurement error, and the measurement bias was estimated with the Bland–Altman method, with lower and upper limits of agreement. Results No differences were observed when comparing the compression results (P = 0.51). The validity and internal intra-rater consistencies ranged from 0.84 to 0.99, and the standard error of measurement from 0.005 to 0.04 kPa. Very strong (r = 0.73–0.74) to near-perfect (r = 0.99) correlations were found, with a low risk of bias for all measurements. The results demonstrated the validity and intra-rater reliability of the digitally adapted pressure algometer. Inter-rater reliability results were moderate (r = 0.55–0.60; Cronbach’s α = 0.71–0.75). Conclusion The adapted pressure algometer provide valid and reliable measurements of pressure pain threshold. The results support more widespread use of the pressure pain threshold method among clinicians.
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Behavior of the muscle quality index and isometric strength in elderly women. Physiol Behav 2020; 227:113145. [PMID: 32822709 DOI: 10.1016/j.physbeh.2020.113145] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/07/2020] [Accepted: 08/09/2020] [Indexed: 10/23/2022]
Abstract
This study aimed (I) to compare the muscle quality index (MQI) and the isometric hip strength between younger and older women, and (II) to determine the relationship of the MQI with the sit-to-stand test (STS) and isometric hip strength in younger and older women. Twenty-eight elderly women (age= 66.2 ± 5.6 years) and twenty younger women (21.2 ± 2.2 years) participated in the study. The following dependent variables were measured: MQI, STS, body composition, and the peak isometric strength of the hip (PF) which was also normalized using three different methods (PF/Body Mass, PF/Fat-Free Mass, and PF/Body Mass0,335). Older women presented a lower PF in hip flexion, extension and external rotation regardless of the method of normalization (p < 0.001), but the PF of hip abductors and internal rotators was higher for older women (p < 0.05). No significant differences were found in the MQI between older and younger women (p = 0.443). The MQI was negatively correlated with the time in the STS in older women (r = -0.706, p < 0.001) and younger women (r = -0.729, p < 0.001), while the correlations of MQI with isometric hip strength were weaker in older women (r range: -0.082 - 0.556) and younger women (r range: -0.020 - 0.309). MQI is a clinical and practical tool to assess the muscular power of the lower extremities.
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Effects of 8 weeks of masticatory muscles focused endurance exercises on women with oro‐facial pain and temporomandibular disorders: A placebo randomised controlled trial. J Oral Rehabil 2019; 46:885-894. [DOI: 10.1111/joor.12823] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/09/2019] [Accepted: 05/13/2019] [Indexed: 01/06/2023]
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Activity of Lower Limb Muscles During Squat With and Without Abdominal Drawing-in and Pilates Breathing. J Strength Cond Res 2017; 31:3018-3023. [PMID: 29068863 DOI: 10.1519/jsc.0000000000001877] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Barbosa, AC, Martins, FM, Silva, AF, Coelho, AC, Intelangelo, L, and Vieira, ER. Activity of lower limb muscles during squat with and without abdominal drawing-in and Pilates breathing. J Strength Cond Res 31(11): 3018-3023, 2017-The purpose of this study was to assess the effects of abdominal drawing-in and Pilates breathing on the activity of lower limb muscles during squats. Adults (n = 13, 22 ± 3 years old) with some Pilates experience performed three 60° squats under each of the following conditions in a random order: (I) normal breathing, (II) drawing-in maneuver with normal breathing, and (III) drawing-in maneuver with Pilates breathing. Peak-normalized surface electromyography of the rectus femoris, biceps femoris, gastrocnemius medialis, and tibialis anterior during the knee flexion and extension phases of squat exercises was analyzed. There were significant differences among the conditions during the knee flexion phase for the rectus femoris (p = 0.001), biceps femoris (p = 0.038), and tibialis anterior (p = 0.001), with increasing activation from conditions I to III. For the gastrocnemius medialis, there were significant differences among the conditions during the knee extension phase (p = 0.023), with increased activity under condition I. The rectus and biceps femoris activity was higher during the extension vs. flexion phase under conditions I and II. The tibialis anterior activity was higher during the flexion compared with the extension phase under all conditions, and the medial gastrocnemius activity was higher during the extension phase under condition I. Doing squats with abdominal drawing-in and Pilates breathing resulted in increased rectus, biceps femoris, and tibialis anterior activity during the flexion phase, increasing movement stability during squat exercises.
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Effects of scapular taping in young adults with shoulder pain and scapular dyskinesis. J Bodyw Mov Ther 2016; 20:525-32. [PMID: 27634074 DOI: 10.1016/j.jbmt.2015.11.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 10/16/2015] [Accepted: 11/16/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the immediate effects of scapular taping on pain, isometric force, and the level of activation of several scapular girdle muscles in individuals with shoulder pain and scapular dyskinesis. MATERIALS AND METHODS Ten individuals with shoulder pain during arm elevation and scapular dyskinesis were included and evaluated by using a visual analogue scale (VAS), pressure algometry, dynamometry, and surface electromyography. All assessments were performed before and immediately after the application of scapular taping. RESULTS Scapular taping did not change the electromyographic activity of the upper trapezius muscle (p = 0.041, IC95%: -0.8256 to 10.8752). The positive effects of taping application were related to pain reduction (p = 0.025) and improvement in pressure algometry in the middle deltoid muscle (p = 0.020, IC95%:-1.8910 to -0.0490). Maximal isometric force did not change after the application of taping (flexo-abduction p = 0.4136, external rotation p = 0.4261). Significant correlations were noted between the VAS and pressure pain threshold (PPT) for the upper trapezius muscle (r = -0.6643, p = 0.0361) as well as for the PPT measures of the middle deltoid and infraspinatus muscles before (r = 0.9491, p = 0.0001) and after (r = 0.9006, p = 0.0004) the application of taping. CONCLUSION Scapular taping was not effective for inducing changes in the electromyographic activity of the upper trapezius, lower trapezius, and serratus anterior muscles, nor in altering the isometric force of shoulder flexo-abduction and external rotation. However, taping was effective at improving the pressure algometry values of the middle deltoid. Significant correlations between the pressure algometry of the middle deltoid and infraspinatus muscles, both before and after the application of scapular taping, were noted.
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