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Medical Science Monitor : International... May 2024BACKGROUND Shoulder subluxation in patients with stroke impairs recovery and quality of life. Kinesiology tape is elastic and water-resistant, is commonly used to... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND Shoulder subluxation in patients with stroke impairs recovery and quality of life. Kinesiology tape is elastic and water-resistant, is commonly used to prevent musculoskeletal injury, and is increasing in use for rehabilitation of patients requiring neurological or physical rehabilitation. This study included 35 patients with shoulder subluxation following stroke and aimed to compare outcomes from standard physical therapy with and without shoulder kinesiology taping. MATERIAL AND METHODS This randomized controlled study involved 35 participants. The patients were randomized into a shoulder kinesiology taping group (n=18) or sham taping group (n=17). All patients underwent a conventional rehabilitation exercise program 5 days a week for 6 weeks. Half of the patients underwent shoulder kinesiology taping, and the other half underwent sham taping. Pre- and post-assessment scores were recorded for all participants for shoulder subluxation distance (SSD), active range of motion (AROM), visual analog scale (VAS), shoulder pain and disability index (SPADI), and modified Barthel index (MBI). RESULTS After the intervention, SSD, AROM, VAS, SPADI, and MBI improved significantly in the shoulder kinesiology taping and sham taping groups (P<0.05). Also, the shoulder kinesiology taping group showed more effective changes in SSD, AROM, VAS, SPADI, and MBI than the sham taping group (P<0.05). CONCLUSIONS These results suggest that the shoulder kinesiology taping is effective in improving SSD, AROM, VAS, SPADI, and MBI in patients with hemiplegic shoulder subluxation.
Topics: Humans; Male; Female; Middle Aged; Athletic Tape; Hemiplegia; Shoulder Dislocation; Range of Motion, Articular; Treatment Outcome; Stroke Rehabilitation; Aged; Shoulder; Adult; Stroke; Quality of Life; Exercise Therapy; Shoulder Joint
PubMed: 38820090
DOI: 10.12659/MSM.944222 -
Journal of Orthopaedic Surgery (Hong... 2024A fundamental understanding of plantar pressure distribution is important for prescribing an appropriate orthosis and applying nonoperative methods, such as stretching...
PURPOSE
A fundamental understanding of plantar pressure distribution is important for prescribing an appropriate orthosis and applying nonoperative methods, such as stretching exercises, for the treatment of plantar fasciitis. Despite existing research on plantar pressure distribution, discrepancies between affected and unaffected sides in unilateral plantar fasciitis patients warrant further investigation. This study aimed to evaluate the plantar pressure distribution in patients with unilateral plantar fasciitis by comparing it with that on the contralateral unaffected side.
METHODS
We retrospectively reviewed records from 20 consecutive patients diagnosed with unilateral plantar fasciitis, using the unaffected side as the control. The emed pedobarographic system was used to measure the plantar pressure distribution during gait. The analysis was performed using a 4-mask configuration (toes, forefoot, midfoot, and hindfoot).
RESULTS
Both sides showed no significant differences in radiographic parameters. The affected side showed a significantly higher contact area, maximum force, and force-time integrals in the midfoot. However, the unaffected side demonstrated significantly higher maximum force and force-time integrals in the hindfoot. There was no difference in the distribution of the peak pressure and pressure-time integrals between the two sides in all mask regions. The increased contact area and maximum force in the midfoot on the side with plantar fasciitis may result from heel pain-induced weight transfer from the hindfoot.
CONCLUSION
The findings of this study provide a basic understanding of plantar pressure distribution in the treatment of plantar fasciitis and highlight the importance of considering inter-side differences when designing treatment interventions or orthotic devices.
Topics: Humans; Fasciitis, Plantar; Retrospective Studies; Female; Pressure; Male; Middle Aged; Adult; Foot; Aged; Gait
PubMed: 38814119
DOI: 10.1177/10225536241258331 -
CoDAS 2024To analyze the sensation of pain and the range of mandibular movements of adult individuals with temporomandibular disorder, before and after the application of the... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To analyze the sensation of pain and the range of mandibular movements of adult individuals with temporomandibular disorder, before and after the application of the athletic tape.
METHOD
This is a double-blind randomized clinical trial, in which 22 adults with temporomandibular disorder participated, randomly allocated into two groups, with group A comprising 10 women and one man (mean age 28.2±8.3 years) and group B comprising nine women and two men (mean age 26.2±3.9 years). Group A was submitted to the application of the athletic tape on the masseter with 40% stretch and the group B to the application of the athletic tape on the masseter without stretching. All participants underwent the application of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Pain threshold assessment was performed using an algometer to apply pressure to measurement points. The measurement of mandibular movements was performed using a caliper. The athletic tape was glued using the I technique, with a fixed point over the insertion and a movable point over the origin of the masseter muscle. Participants remained with the athletic tape for 24 hours and were re-evaluated.
RESULTS
There was pain relief in the group A in the temporomandibular joint on the right and at the origin of the masseter on the left. The group B showed a reduction in pain in the left anterior temporal region. No differences were found in mandibular movements after intervention, as well as no difference was found in the comparison by groups.
CONCLUSION
The use of the athletic tape over the masseter muscle, with stretching, for 24 hours produced relief from the sensation of pain, on the origin of the right masseter and in the right temporomandibular joint, and, without stretching, in the left anterior temporal muscle. There was no difference in the range of mandibular movements.
Topics: Humans; Female; Adult; Double-Blind Method; Male; Facial Pain; Temporomandibular Joint Disorders; Masseter Muscle; Athletic Tape; Young Adult; Range of Motion, Articular; Pain Measurement; Pain Threshold; Mandible
PubMed: 38808856
DOI: 10.1590/2317-1782/20242023066pt -
Gait & Posture Jul 2024Persons with diabetic peripheral neuropathy (DPN) may face challenges such as balance issues due to reduced somatosensory feedback and an increased risk of developing...
BACKGROUND
Persons with diabetic peripheral neuropathy (DPN) may face challenges such as balance issues due to reduced somatosensory feedback and an increased risk of developing diabetic foot ulcers (DFUs) due to increased plantar pressure. Pressure reducing footwear is thought to further impair balance. We introduced 3D-printed rocker midsoles and self-adjusting insoles that are able to reduce elevated plantar pressure values and aimed to prevent balance deterioration. However, their effect on the balance during walking (dynamic stability) is not analyzed yet.
RESEARCH QUESTION
Is dynamic stability of persons with DPN impaired compared to healthy individuals and what is the effect of the 3D-printed rocker midsoles and self-adjusting insoles on the dynamic stability in this population?
METHODS
Dynamic stability, specifically the margins of stability (MOS) in the anterior-posterior (AP) and medio-lateral (ML) direction, was measured in ten healthy and nineteen persons with DPN. Independent-samples t-test was applied to analyze the difference in the MOS between groups. One-way repeated measures analyses of variance (ANOVA) was conducted to test the difference between the therapeutic footwear combinations within the DPN group.
RESULTS
There is no significant difference between the healthy and DPN group in MOS-AP. MOS-ML is significantly larger in DPN compared to the healthy participants. Using the self-adjusting insole shows a significantly lower (negative) MOS-AP compared to when using a rocker shoe within the DPN group.
SIGNIFICANCE
This study provides valuable information on whether DPN and our therapeutic footwear have a negative effect on the dynamic stability. DPN does not have a negative effect on dynamic stability in the AP direction. For the ML direction, DPN seems to cause larger MOS-ML by likely using a compensation strategy (e.g., wider steps) while our experimental footwear does not further impair the MOS-ML.
Topics: Humans; Shoes; Male; Postural Balance; Foot Orthoses; Middle Aged; Female; Diabetic Neuropathies; Adult; Aged; Diabetic Foot; Equipment Design; Printing, Three-Dimensional; Walking; Pressure; Case-Control Studies
PubMed: 38795476
DOI: 10.1016/j.gaitpost.2024.05.011 -
Sensors (Basel, Switzerland) May 2024Sensory peripheral neuropathy is a common complication of diabetes mellitus and the biggest risk factor for diabetic foot ulcers. There is currently no available...
Retention of Improved Plantar Sensation in Patients with Type II Diabetes Mellitus and Sensory Peripheral Neuropathy after One Month of Vibrating Insole Therapy: A Pilot Study.
Sensory peripheral neuropathy is a common complication of diabetes mellitus and the biggest risk factor for diabetic foot ulcers. There is currently no available treatment that can reverse sensory loss in the diabetic population. The application of mechanical noise has been shown to improve vibration perception threshold or plantar sensation (through stochastic resonance) in the short term, but the therapeutic use, and longer-term effects have not been explored. In this study, vibrating insoles were therapeutically used by 22 participants, for 30 min per day, on a daily basis, for a month by persons with diabetic sensory peripheral neuropathy. The therapeutic application of vibrating insoles in this cohort significantly improved VPT by an average of 8.5 V ( = 0.001) post-intervention and 8.2 V ( < 0.001) post-washout. This statistically and clinically relevant improvement can play a role in protection against diabetic foot ulcers and the delay of subsequent lower-extremity amputation.
Topics: Humans; Pilot Projects; Vibration; Male; Diabetes Mellitus, Type 2; Female; Middle Aged; Diabetic Foot; Aged; Diabetic Neuropathies; Foot; Peripheral Nervous System Diseases; Shoes; Sensation; Foot Orthoses
PubMed: 38793985
DOI: 10.3390/s24103131 -
Trials May 2024Mid-portion Achilles tendinopathy is a common condition, characterised by localised Achilles tendon load-related pain and dysfunction. Numerous non-surgical treatments...
BACKGROUND
Mid-portion Achilles tendinopathy is a common condition, characterised by localised Achilles tendon load-related pain and dysfunction. Numerous non-surgical treatments have been proposed for the treatment of this condition, but many of these treatments have a poor or non-existent evidence base. Heel lifts have also been advocated as a treatment for Achilles tendinopathy, but the efficacy and mechanism of action of this intervention is unclear. This proposal describes a randomised controlled trial comparing the effectiveness of heel lifts versus sham heel lifts for reducing pain associated with mid-portion Achilles tendinopathy, with an embedded biomechanical analysis.
METHODS
One hundred and eight men and women aged 18 to 65 years with mid-portion Achilles tendinopathy (who satisfy the inclusion and exclusion criteria) will be recruited. Participants will be randomised, using the website Sealed Envelope, to either a control group (sham heel lifts) or an experimental group (heel lifts). Both groups will be provided with education regarding acceptable pain levels to ensure all participants receive some form of treatment. The participants will be instructed to use their allocated intervention for at least 8 h every day for 12 weeks. The primary outcome measure will be pain intensity (numerical rating scale) at its worst over the previous week. The secondary outcome measures will be additional measures of Achilles tendon pain and disability, participant-perceived global ratings of change, function, level of physical activity and health-related quality of life. Data will be collected at baseline and the primary endpoint (week 12). Data will be analysed using the intention-to-treat principle. In addition, the acute kinetic and kinematic effects of the interventions will be examined at baseline in a subpopulation of the participants (n = 40) while walking and running using three-dimensional motion analysis.
DISCUSSION
The LIFT trial (efficacy of heeL lIfts For mid-portion Achilles Tendinopathy) will be the first randomised trial to compare the efficacy of heel lifts to a sham intervention in reducing pain and disability in people with Achilles tendinopathy. The biomechanical analysis will provide useful insights into the mechanism of action of heel lifts.
TRIAL REGISTRATION
Australian New Zealand Clinical Trials Registry, ACTRN12623000627651 . Registered 7 June 2023.
Topics: Humans; Achilles Tendon; Tendinopathy; Middle Aged; Adult; Male; Randomized Controlled Trials as Topic; Female; Aged; Heel; Young Adult; Treatment Outcome; Pain Measurement; Adolescent; Biomechanical Phenomena; Time Factors; Exercise Therapy
PubMed: 38790025
DOI: 10.1186/s13063-024-08185-8 -
BMC Pulmonary Medicine May 2024Knowledge concerning pulmonary function in adult patients with onset of idiopathic scoliosis before age 10 is sparse. A long-term follow-up (FU, mean 26 years, > 12... (Comparative Study)
Comparative Study
Do middle-aged patients with onset of idiopathic scoliosis before the age of 10 years who have reduced pulmonary function have a risk for rapid decline - a comparative study.
BACK GROUND
Knowledge concerning pulmonary function in adult patients with onset of idiopathic scoliosis before age 10 is sparse. A long-term follow-up (FU, mean 26 years, > 12 years after treatment) of pulmonary function (PF) in patients treated with brace or surgery due to idiopathic scoliosis with onset before the age of 10 was earlier performed. To evaluate whether a more severe reduction in pulmonary function leads to more rapid deterioration within a four-year period, this study was performed.
METHODS
Twenty patients with the most reduced pulmonary function and 19 out of those with normal PF found at the long-term FU were reexamined 4 years later to evaluate further changes in pulmonary function. Patients underwent spirometry and arterial blood gas analysis and answered pulmonary symptom questionnaires.
RESULTS
70% of the reduced pulmonary function group had undergone surgery vs. 26% of the normal group. The mean age (47 vs. 43 years) at this FU and curve size (37° vs. 35°) at the 26-year FU were similar. The decline in forced vital capacity (FVC) % of predicted was similar in both groups over the four-year period, from 67 to 65% in the reduced PF group vs. 96 to 94% in the normal PF group. The total lung capacity (TLC) % of predicted did not change over time in either group. No patient reported worsening dyspnea symptoms. Only one patient in the reduced PF group showed low arterial oxygen tension, 8.4 kPa, not signifying respiratory insufficiency.
CONCLUSION
The age-related decline in FVC and TLC % of predicted did not differ between those with reduced and those with normal pulmonary function at the 26-year follow-up. Thus, these data do not infer increased rate of decline in the most deteriorated patients.
Topics: Humans; Scoliosis; Female; Male; Adult; Vital Capacity; Middle Aged; Lung; Spirometry; Disease Progression; Follow-Up Studies; Child; Total Lung Capacity; Respiratory Function Tests; Blood Gas Analysis; Braces; Surveys and Questionnaires; Age of Onset
PubMed: 38789978
DOI: 10.1186/s12890-024-03053-2 -
Medical Engineering & Physics Jun 2024Scleroderma is a chronic and progressive autoimmune disorder of connective tissues often causing lesions and deformities of the hands. Individuals affected by this...
Scleroderma is a chronic and progressive autoimmune disorder of connective tissues often causing lesions and deformities of the hands. Individuals affected by this condition experience daily life limitations and are typically unable to take part in sport activities that involve impacts on the hands. In this article we describe the design and manufacturing of custom-made hand orthoses to play sitting volleyball, for an elite paralympic athlete affected by scleroderma. The devices consist of a carbon fibre shell with an internal silicone padding and an external polymeric multilayer cover. The manufacturing of the orthoses involves digital modelling, 3D printing, composite lamination and an innovative method to create a strong and durable chemical bonding between silicone and carbon fibre. The internal silicone padding proved to be effective in hosting and protecting the hands, whereas the external shell with polymeric multilayer cover allowed to dampen the ball shocks while effectively hitting the ball. Indeed, these devices allowed the athlete to take part in the 2020 Tokyo Paralympic games and were used for two years without showing any damage.
Topics: Humans; Equipment Design; Hand; Orthotic Devices; Volleyball; Athletes; Scleroderma, Systemic; Printing, Three-Dimensional
PubMed: 38789218
DOI: 10.1016/j.medengphy.2024.104174 -
Medicine May 2024A dysphagia rehabilitation method using kinesiology taping (KT) was recently introduced, and its potential for clinical efficacy was demonstrated by evaluating muscle... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
A dysphagia rehabilitation method using kinesiology taping (KT) was recently introduced, and its potential for clinical efficacy was demonstrated by evaluating muscle activity and thickness. However, its effect on the swallowing function in patients with dysphagia remains unclear. This study aimed to investigate the effects of effortful swallowing against KT resistance on the swallowing function in patients with post stroke dysphagia.
METHODS
Thirty patients with poststroke dysphagia were recruited and randomly assigned to the experimental and placebo groups. In the experimental group, the KT was attached to the front of the neck (the hyoid bone between the sternum) with a tension of approximately 70% to 80%, and effortful swallowing was performed against the KT tension. In contrast, the placebo group performed effortful swallowing with KT applied at the same location without tension. The intervention was performed 30 times/day, 5 days/week for 6 weeks. The videofluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) based on a videofluoroscopic swallowing study were used to analyze oropharyngeal swallowing function.
RESULTS
The experimental group showed statistically significant improvements in the oral and pharyngeal phases of the VDS (P = .029 and .007, respectively) and PAS (P = .034) compared with the placebo group. Effect sizes were observed for the oral (0.3) and pharyngeal phases (0.5) of the VDS and PAS (1.1).
CONCLUSION
This study demonstrated that effortful swallowing against resistance to KT is an effective therapeutic exercise for improving the swallowing function in patients with poststroke dysphagia.
Topics: Humans; Deglutition Disorders; Male; Female; Middle Aged; Aged; Stroke; Stroke Rehabilitation; Deglutition; Athletic Tape; Treatment Outcome
PubMed: 38788044
DOI: 10.1097/MD.0000000000038344 -
Frontiers in Neurology 2024A knee-ankle-foot orthosis (KAFO) prevents knee buckling during walking and enables gait training for acute hemiplegic stroke patients with severe gait disturbances....
Quadriceps muscle activity during walking with a knee ankle foot orthosis is associated with improved gait ability in acute hemiplegic stroke patients with severe gait disturbance.
INTRODUCTION
A knee-ankle-foot orthosis (KAFO) prevents knee buckling during walking and enables gait training for acute hemiplegic stroke patients with severe gait disturbances. Although the goal of gait training with a KAFO is to improve gait ability, that is, to acquire walking with an ankle-foot orthosis (AFO), it is not clear how gait training with a KAFO contributes to improving gait ability. Therefore, this study aimed to investigate the relationship between muscle activities during walking with a KAFO and the improvement of gait ability in hemiplegic stroke patients with severe gait disturbance.
METHODS
A prospective cohort study was conducted. Fifty acute hemiplegic stroke patients who could not walk with an AFO participated. Muscle activities of the paretic rectus femoris, biceps femoris, tibialis anterior, and soleus were assessed with surface electromyogram during walking with a KAFO. Electromyograms were assessed at the beginning of gait training and at the time the Ambulation Independence Measure score improved by 3 or higher, or discharge.
RESULTS
Even in patients with complete hemiplegia, paretic rectus femoris, biceps femoris, and soleus showed periodic muscle activity during walking with a KAFO. Twenty-three patients improved to an Ambulation Independence Measure score of 3 or higher and were able to walk with an AFO (good recovery group). At the beginning of gait training, paretic rectus femoris muscle activity during the first double-limb support phase was significantly higher in the good recovery group than in the poor recovery group. The rectus femoris muscle activity significantly increased from before to after acute rehabilitation, which consisted mainly of gait training with a KAFO.
DISCUSSION
For acute hemiplegic stroke patients with severe disturbance, the induction and enhancement of paretic quadriceps muscle activity during walking with a KAFO play an important role in acquiring walking with an AFO.
PubMed: 38774057
DOI: 10.3389/fneur.2024.1387607