Manual therapy
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This study had two purposes: to compare head repositioning accuracy (HRA) using the cervical range of motion (CROM) device between individuals with cervical radiculopathy caused by disc disease (CDD; n = 71) and neck- healthy individuals (n = 173); and to evaluate the test-retest reliability of the CROM device in individuals with CDD, and criterion validity between the CROM device and a laser in neck-healthy individuals, with quantification of measurement errors. Parameters of reliability and validity were expressed with intra- class- correlation coefficients (ICCs), and measurement errors with standard error of measurement (SEM) and Bland Altman limits of agreement. HRA (Mdn, IQR) differed significantly between individuals with CDD and neck- healthy individuals after rotation right 2.7° (6.0), 1.7° (2.7); and rotation left 2.7° (3.3), 1.3° (2.7) (p < = 0.021); 31% of individuals with CDD were classified as having impairment in HRA. ⋯ The criterion validity between the CROM device and the laser in neck-healthy individuals showed ICCs of 0.43- 0.91 and SEMs of 0.8°- 1.3°. The results support the use of the CROM device for quantifying HRA impairment in individuals with CDD in clinical practice; however, criterion validity between the CROM device and a laser in neck-healthy individuals was questionable. HRA impairment in individuals with CDD may be important to consider during rehabilitation and evaluated with the criterion established with the CROM device in neck-healthy individuals.
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The Örebro Musculoskeletal Screening Questionnaire (ÖMSQ) is a recently validated, 21-item instrument. It modified the original Örebro Musculoskeletal Pain Questionnaire (ÖMPainQ) providing broader focus and also improved development and practicality for identifying work-injured patients at-risk of persistent musculoskeletal problems. These instruments are critiqued for practicality and a shortened-version recommended. ⋯ The ÖMSQ-12 content-retention version is recommended. It demonstrated suitable internal consistency, a three-factor structure and high correlation with recovery time (r = 0.73). The ÖMSQ-12 will facilitate early identification and management of at-risk individuals and enable targeted intervention strategies through psychosocial informed management principles.
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Randomized Controlled Trial Multicenter Study
Effectiveness of Diacutaneous Fibrolysis for the treatment of subacromial impingement syndrome: a randomised controlled trial.
Our objective was to assess the effectiveness of Diacutaneous Fibrolysis on pain intensity, range of motion and functional status in patients suffering from Subacromial Impingement Syndrome. A randomised controlled trial was conducted in two Spanish National Health Service Primary Health Care Centres. Participants (n = 120) were randomly assigned to one of three groups (intervention, placebo or control groups). ⋯ At the 3 month follow-up assessment, between-groups differences were not statistically significant and clinical relevance was achieved only for external rotation movement between intervention and control groups. At the post-treatment assessment 89% of the participants in the intervention group, 76% of the participants in the placebo group and 67% of the participants in the control group reported subjective improvement (p < 0.01). In conclusion, adding Diacutaneous Fibrolysis to the conservative treatment of Subacromial Impingement Syndrome improves function and external rotation movements and also gives significantly higher patient satisfaction.
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To identify differences in repositioning error in adolescents with and without non-specific chronic low back pain (NSCLBP), sub-groups of NSCLBP and in different spinal regions. ⋯ Differences in spinal repositioning errors were noted between adolescents with and without NSCLBP and sub-groups of NSCLBP. Those with flexion-pattern NSCLBP had the lowest levels of spinal repositioning ability. Individuals with no-LBP (low-back pain) or extension-pattern NSCLBP displayed greater variability in the upper lumbar spine.
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Cervical radiculopathy is the result of cervical nerve root pathology that may lead to chronic pain and disability. Although manual therapy interventions including cervical traction and neural mobilization have been advocated to decrease pain and disability caused by cervical radiculopathy, their analgesic effect has been questioned due to the low quality of research evidence. The purpose of this paper is to present the effect of cervical traction combined with neural mobilization on pain and disability in a patient experiencing cervical radiculopathy. ⋯ Improvements in all outcome measures were noted over a period of four weeks. Scores in all outcome measures revealed that the patient's pain had almost disappeared and that she was able to perform her household chores and job tasks without difficulties and limitations. In conclusion, the findings of this study support that the application of cervical traction combined with neural mobilization can produce significant improvements in terms of pain and disability in cervical radiculopathy.