The purpose of this study was to compare visual analogue scale (VAS), pain threshold (PT), $%RMS_{RVC}$, and EMG gaps before and after applying transcutaneous electrical nerve stimulation (TENS) on the upper trapezius muscle at the patients with myofascial pain syndrome (MPS). The subjects were 4 men and 10 women composed of both the inpatients and outpatients who were diagnosed as MPS at Wonju Medical Center. VAS and PT measurements were performed to assess the subjective pain level. The reference voluntary contraction (RVC) test was performed for 15 seconds for normalization on the bilateral trapezius muscle using surface electromyography (sEMG). After 3-minute resting time, the EMG signal was recorded while performing a typing activity for 2 minutes and then TENS was applicated with a comfortable intensity for 10 minutes. The EMG activity of the upper trapezius muscle was recorded during typing for 2 minutes. The results of study were as follows: 1) VAS score was significantly decreased on the more painful side after treatment, however, it was not significantly different on the less painful side. 2) PT was increased after treatment on both sides, however, it was not significantly different between before and after the TENS application. 3) The EMG activity during typing was significantly decreased after treatment, and 4) The EMG gaps were significantly increased after TENS treatment compared to before it. Consequently, the study showed that TENS was effective in decreasing VAS, $%RMS_{RVC}$, and in increasing EMG gaps. The EMG gap analysis could be a useful method to measure pain in patients with MPS in the upper trapezius.
This study was to investigate the effects of joint mobilization with two different electrotherapy methods on shoulder external rotation range of motion and pain in mastectomy patients. Thirty mastectomy patients were divided into STMG (joint mobilization+pain scrambler therapy, n=15) and TENMG (joint mobilization+transcutaneous electrical nerve stimulation, n=15). The measurements were performed shoulder external rotation range of motion (ROM), pain (VAS). In both groups, there was a significant difference in the shoulder external rotation ROM, pain after intervention (p <.05). STMG was more decrease in VAS score than TENMG (p <.05). There was no significant difference in shoulder external rotation ROM between the two groups. In order to decrease the pain of mastectomy patients, it was confirmed that STMG was more effective than TENMG.. It is thought that a control group is added to confirm various differences, and more subjects are needed.
Objective : Kuesu point is a newly discovered point, it is located in 3-cun from the centre of sacrum laterally, paralleled to the 4th foramen on the sacrum. This controlled trial was to evaluate the superior effect of Kuesu point on back pain which radiated to lower extremities. Methods : Randomized Controlled Trial (RCT) and Single Blind in patient was designed. Patients (n=31) were randomized to two groups, Kuesu-point acupuncture group (Group A, n=16) and non Kuesu point acupuncture group (Group B, n=15). Group A was acupunctured on B25 (大腸兪), B26 (關元兪) and B60 (崑崙) with Kuesu point. Group B was acupunctured on the same points without Kuesu point. The clinical subjects were female patients. Beside acupuncture, the other therapies were excluded. Clinical period was three weeks total. Each group was treated 4-5 times per week for 3 weeks. The outcome measurements were The Estimation Index of Backache (quality of life), Pain Rating Scale (pain intensity) and other physical examinations (ROM, SLR, etc.). Results : 31 patients (Group A: n=16, Group B: n=15) were Randomized, 6 of them dropped out. Eventually 25 patients (Group A: n=15, Group B: n=10) were included in the analysis. Group A acupunctured on Kuesu point scored more significant Estimation Index of Backache and lower PRS (Pain Rating Scale) than Group B acupunctured without Kuesu point (p=0.003/2). It turned out that the group acupunctured on Kuesu point show meaningful high improvement index. And other examination's results showed that the treatment effects of Group A are twice as better as Group B. Conclusion : These results suggest that Kuesu point acupuncture was more effective on lower back pain and improved the life quality of patients, being compared with non Kuesu point acupuncture.
Journal of the Korean Society of Physical Medicine
/
v.2
no.2
/
pp.113-124
/
2007
Purpose : The purpose of this study was to investigate the effects of joint mobilization on the rang of motion and pain of patient with chronic low back pain. Methods : The subjects were consisted of thirty patients with chronic low back pain(19 females, 11 males ; mean aged 59.93) from 50 to 71. All subjects randomly assigned to the modalities treatment group, joint mobilization group. Modalities treatment group received hot pack used thermal therapy for 20minutes and ICT used electrical therapy for 15minutes, joint mobilization group received modalities treatment with sustained natural apophyseal glides(SNAGS) techniques of Mulligan for 10minutes per day and three times a week during 2 weeks period. Visual Analogue Scale(VAS) was used to measure subjective pain level. Remodified Schober test(RST) was used to measure range of motion of lumbar spine. All measurements of each patients were measured at pre-treatment and 2 weeks post-treatment. Results : The results of this study were summarized as follows : 1. VAS was joint mobilization group showed significantly decreased more than modalities treatment group (p<.05). 2. The lumbar flexion range of motion was joint mobilization group showed significantly decreased more than modalities treatment group(p<.05). 3. The lumbar extension range of motion was joint mobilization group showed significantly decreased more than modalities treatment group(p<.05). 4. The lumbar left lateral flexion range of motion was joint mobilization group showed significantly decreased more than modalities treatment group(p<.05). 5. The lumbar right lateral flexion range of motion was joint mobilization group showed significantly decreased more than modalities treatment group(p<.05). Conclusion : These data suggests that SNAGS of Mulligan is beneficial treatment for chronic low back pain.
Purpose: The aim of this study was to examine the effects of abdominal muscle contraction thickness using real-time ultrasound imaging while applying an abdominal draw-in maneuver (ADIM) and pelvic floor muscle contraction (PFC) to low back pain patients and healthy subjects. Methods: The subjects were 21 young adults; a group of 10 low back pain patients and a control group of 11 healthy subjects. Measurements were made with the subjects on a pillow in a supine position, with the knee joints flexed at 60 degrees. While the two groups conducted ADIM and PFC, their transverse abdominal muscle (TrA), internal abdominal oblique muscle (IO), and external abdominal oblique muscle (EO) thicknesses were measured using an ultrasound imaging system. Result: The TrA muscle contraction thickness ratio during PFC and ADIM was significantly lower in the low back pain group than in the healthy group (p<0.05). The EO muscle contraction thickness ratio during ADIM was also significantly lower in the low back pain group than in the healthy group. The healthy group's muscle contraction thickness ratio was significantly lower during PFC than during ADIM in the TrA, IO, and EO (p<0.05). The low back pain group's muscle contraction thickness ratio was lower during PFC than during ADIM in the TrA, IO, and EO, but the difference was not statistically significant. Conclusion: The results of this study indicate that oral direction during ADIM induced an appropriate contraction of the TrA. Therefore, the procedure reported here may be applied during rehabilitation for appropriate contraction of the TrA.
Purpose: The study aimed to determine the effect of the proprioceptive neuromuscular facilitation (PNF) lower trapezius muscle strengthening exercise on pain, shoulder range of motion, and shoulder pain and disability index (SPADI) in patients with frozen shoulder. Methods: Following baseline measurements, 30 subjects (n=30) with frozen shoulder were randomized into two groups: the PNF group (n=15), which received PNF strength training of the lower trapezius muscles, and the control group (n=15), which received gentle palpation of the skin. Each group participated in the intervention for 30 minutes, three times per week, for six weeks. The visual analogue scales for pain, range of motion, and SPADI of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention period compared with pre-intervention, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the six-week intervention, both groups experienced significantly decreased pain and SPADI (p < 0.05) and significantly increased shoulder flexion, abduction, internal rotation, and external rotation range of motion (p < 0.05). The PNF group that received the PNF strength exercise of the lower trapezius muscles showed greater improvements in pain and range of motion than those of the control group (p < 0.05). Conclusion: These results suggest that the PNF lower trapezius strengthening exercise reduces shoulder pain and disability levels and enhances shoulder range of motion in patients with frozen shoulder.
Journal of International Academy of Physical Therapy Research
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v.12
no.1
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pp.2279-2285
/
2021
Background: The spinal nerves, which start at the lumbar level, are connected to the nerve innervation in the knees. Currently, there is a lack of research on the treatment of knee pain through lumbar mobilization. Objectives: To investigate the effects of lumbar joint mobilization (LJM) and transcutaneous electronic nerve stimulation (TENS) on proprioception and muscular strength in volleyball players with chronic knee pain. Design: Two group pre-posttest. Methods: A total of 26 professional volleyball players with chronic knee pain were allocated to the LJM (n=13) and TENS (n=13) groups. In the LJM group, grade III - IV amplitude was applied 3 times for 1 minute (80 times per minute) at the affected lumbar (L2-3) facet joint in the prone position. In the TENS group, the TENS treatment device was used to directly apply or 15 minutes to the area of chronic knee pain (100 Hz, 150 ㎲). Proprioception was measured by knee flexion and extension angles, and muscle strength was evaluated using an isokinetic test. Measurements were taken before and after interventions. Results: In the eye opened conditiond, proprioception significantly increased during both knee extension and flexion after LJM, while only knee extension was significantly increased in the TENS group. There was also a significant difference in knee extension between the two groups. In the eye close conditiond, proprioception was significantly improved only during knee extension in the LJM group, and the difference in knee extension between the groups was also significant (P<.05). The maximum torque of the affected knee joint was significantly improved at 60°/sec in both groups (P<.05); however, there was no difference between the two groups. There was no significant difference in the maximum flexion torque within or between the groups. Conclusion: This study suggests that LJM improved proprioception and muscular strength in volleyball players with chronic knee pain.
Purpose: The study aimed to determine the effect of extra thoracic mobilization exercises on shoulder pain and function in patients who had undergone rotator cuff repair. Methods: Following the recording of baseline measurements, 20 subjects who had undergone rotator cuff repair were randomized into two groups: the experimental group (n = 10), which did thoracic mobilization exercises, and the control group (n = 10), which received traditional physical therapy. Each group participated in the intervention five times per week for two weeks. The pain (using the visual analogue scales [VAS]), the flexion and abduction range of motion (ROM), and the shoulder pain and disability index (SPADI) scores of both groups were recorded pre- and post-intervention. Paired t-tests were used to determine whether post-intervention scores were significantly different from pre-intervention scores, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the two-week intervention, both groups experienced significantly decreased VAS and SPADI scores (p < 0.05) and significantly increased flexion and abduction ROM (p < 0.05). The experimental group that undertook the thoracic mobilization exercises showed greater improvements in pain, flexion and abduction ROM, and the SPADI than the control group (p < 0.05). Conclusion: These results suggest that thoracic mobilization exercises reduce shoulder pain and disability and enhance function in patients who have undergone rotator cuff repair.
Journal of The Korean Society of Integrative Medicine
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v.12
no.3
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pp.143-153
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2024
Purpose : Forward head posture (FHP), characterized by the anterior positioning of the head relative to the spine, is a common postural deviation that can lead to neck pain, reduced mobility, and muscle imbalances. Recently, high-frequency deep heat therapy (HFDT) has been gaining attention for the intervention of FHP. This research aims to investigate the efficacy of HFDT in comparison to instrument assisted soft-tissue mobilization (IASTM) for treating FHP among 30 young adults. Methods : Participants were randomly assigned to either the HFDT or IASTM group. The study focused on examining changes in neck joint mobility, pain thresholds, rounded shoulder distance, lower trapezius muscle strength, and neck dysfunction. Measurements were taken before and after the interventions. Paired t-tests were used for within-group analyses, and independent t-tests were employed for between-group comparisons. The statistical significance level α was set to .05. Results : Statistically significant improvements were observed across all measured parameters in both groups (p<.05). The HFDT group showed significantly greater enhancements in neck joint mobility, pain thresholds, rounded shoulder distance, lower trapezius muscle strength, and neck dysfunction parameters. Specifically, HFDT was more effective than IASTM in improving neck joint mobility, right upper trapezius pain threshold, left rounded shoulder distance, and right lower trapezius strength. The only exceptions were neck flexion range of motion, left upper trapezius pain threshold, right rounded shoulder distance, and left lower trapezius strength, where no significant differences were found between the groups. Conclusion : The findings suggest that HFDT, by combining the benefits of high-frequency therapy and manual therapy, effectively alleviates upper trapezius muscle pain and tension, enhances neck mobility, and strengthens lower trapezius muscles. Thus, HFDT could be considered a valuable intervention for clinicians aiming to address FHP and associated musculoskeletal problems.
Journal of Physiology & Pathology in Korean Medicine
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v.27
no.1
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pp.118-123
/
2013
This study was performed from April, 2007 to August, 2012 with female patients who were being treated for and suffering from chronic lumbar pain for periods of 6 months and over. The 53 female patients were diagnosed with osteoporosis by having a T-Score of <-2.5 in a bone mineral density(BMD), as well as showing signs of metabolic syndrome. This was deduced by taking measurements of blood pressure, carrying out blood-chemical examinations and physical measurements such as weight, height, waist measurement and body mass index(BMI). After 5 minutes rest, the patient's blood pressure, height and weight were measured. BMI was calculated using the equation BMI = weight (Kg)/height ($m^2$). The patients had their blood taken in a fasted state(more than 12hours), the fasting blood sugar, total cholesterol, triglyceride, HDL-cholesterol were measured. The average BMD and T-score were calculated by measuring BMD(mg/cc) of L1-L3 using QCT. In a correlation analysis of the physical examinations, clinical character of metabolic syndrome and T-score, the result showed that age and T-score had a negative correlation(r=-0.699, p<0.01) as did triglyceride and T-score (r=-0.047, p<0.01), where as weight(r=0.239, p<0.05) and height(r-=0.329, p<0.01) and T-score had a positive correlation. There was no significant correlation with total cholesterol, HDL cholesterol, blood sugar, blood pressure and T-score. This study showed that there are significant correlations with age, weight, height and T-score. But there are no significant correlations with total cholesterol, HDL cholesterol, blood sugar, blood pressure and T-score and that these did not influence bone density. Further research with more subjects is required to determine whether there is a correlation of clinical character of metabolic syndrome and T-score.
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