785 research outputs found
Manual Therapy vs. Surgery: Which Is Best for Carpal Tunnel Syndrome Relief?
No full textBackground: Carpal Tunnel Syndrome (CTS) is a common condition characterized by compression of the median nerve, leading to pain, numbness, and hand dysfunction. Both manual therapy and surgical decompression are widely used interventions, but their comparative effectiveness remains uncertain. Methods: A systematic review and a meta-analysis were conducted to compare the short- and long-term efficacy of manual therapy versus surgery for CTS. Studies were selected based on randomized controlled trials (RCTs) that met the inclusion criteria, focusing on outcomes such as pain intensity, hand function, symptom severity, and quality of life. Data were extracted and analyzed by using standardized tools to assess treatment effects. Results: Five RCTs with a total of 533 participants were included. Manual therapy was more effective for short-term pain relief, with significant improvements at 1 and 3 months compared with surgery. However, at 6 to 12 months, surgical intervention provided greater improvements in hand function and symptom severity. Quality-of-life improvements were similar in both groups. Risk of bias was moderate to low across the studies, with limitations in blinding due to the nature of the interventions. Conclusions: Manual therapy offers effective short-term relief for CTS, making it a viable option for patients with mild to moderate symptoms. Surgery provides more durable, long-term outcomes, particularly for severe cases. The choice of treatment should be individualized, considering patient preferences and symptom severity
Towards a new frontier in wrist rehabilitation: The traction-free posture orthosis
No full textThis study presents the novel Traction-Free Posture Orthosis, designed to address wrist stiffness without the use of traditional traction methods. The orthosis employs a velcro system to stabilize the position of the wrist in flexion or extension, thereby avoiding the compression and rotational disadvantages associated with non-perpendicular traction forces. Triangular-shaped cuts in the brace allow for plastic material flexibility, ensuring movement and comfort. Significant is the absence of a traction strap, which traditionally reduces the support surface and could create pressure points leading to patient discomfort or treatment rejection. The design facilitates a wide contact surface with the hand, optimal load distribution, and the capacity to adjust dual traction straps independently, adapting to the natural wrist movement. This single-piece base orthosis offers a stable, cost-effective, and patient-friendly alternative to conventional splints. However, patients with stiffness in both flexion and extension may require two separate orthoses, potentially increasing costs and patient inconvenience. Overall, the Traction-Free Posture Orthosis represents an innovative step in wrist rehabilitation, providing a quick-to-construct, easy-to-wear solution with the promise of enhanced patient compliance and comfort
Progression and clinical implications of boutonniere deformity
No full textThe Boutonniere Deformity, characterized by PIP flexion and DIP hyperextension, results from central slip damage. Initial central slip lesion progresses to involve other structures, causing volar migration of lateral bands. Elson's test aids diagnosis by isolating central slip function. Conservative treatment involves immobilization followed by mobilization. Understanding the complex mechanics is crucial for accurate diagnosis and effective management
Breaking stiffness: a non-invasive solution for proximal interphalangeal joint rigidity
No full textA non-invasive thermoplastic orthosis combined with targeted exercise effectively addresses proximal interphalangeal joint (PIPj) stiffness. Stabilizing the metacarpophalangeal joint at 60 ° enables optimal torque transfer, improving flexion and correcting compensatory patterns. Posture maintenance prevents elastic recoil,enhancing tissue elongation. Preliminary results show improved kinematic control and functional recovery
Cueing Interventions for Gait and Balance in Parkinson’s Disease: A Scoping Review of Current Evidence
No full textBackground: Cueing interventions, which utilize external auditory, visual, or somatosensory stimuli, are increasingly used to improve motor performance in individuals with Parkinson’s disease (PD). This review explores the effectiveness of cueing on gait, balance, and quality of life outcomes in PD. Methods: A scoping review of six studies was conducted, focusing on the impact of cueing interventions on gait parameters, balance stability, and functional outcomes in PD patients. Studies were evaluated for methodological quality using the PEDro scale, and risk of bias was assessed with RoB 2. Results: Cueing interventions consistently improved gait parameters, with five studies showing significant increases in step length. The results for walking speed were more varied, with some studies reporting statistically significant gains while others found non-significant or mixed outcomes. Balance improvements were noted in dynamic balance measures, though static balance effects were less consistent. Two studies observed long-term benefits at follow-up, particularly when interventions were structured and supervised. The quality of life improvements were limited, with only one study measuring this outcome and showing no significant changes. Conclusions: Cueing interventions demonstrate potential for enhancing gait and dynamic balance in PD, though effects on quality of life remain uncertain. Early and structured implementation of cueing, especially with auditory stimuli, may support functional gains in PD management. Further research is required to establish optimal cueing protocols and long-term benefits
Footwear and Foot Health: Unveiling the Role of Proper Shoe Fit in Preventing Podiatric Issues and Enhancing Well-Being
No full textBackground: The appropriate choice of footwear is crucial for foot health, yet its impact on different populations and medical conditions remains understudied. This review explores the effect of shoe fit on the prevention of podiatric disorders and overall well-being. Methods: The research included major academic databases such as MEDLINE, Cochrane Central, Scopus, and PEDro, using specific keywords. A scoping review was conducted following the Joanna Briggs Institute methodology, encompassing studies on shoe fit across diverse populations and conditions. Medical databases and grey literature were also included. Results: Five studies were included, covering topics such as footwear advice for women over 50, the effect of shoes in preventing calluses under the metatarsals, the effectiveness of a shoe-related intervention for gout patients, and the impact of custom-fitted shoes on physical activity in children with Down syndrome. Results showed that well-fitting shoes can prevent callus formation, but the efficacy of custom-fitted shoes for increasing physical activity requires further research. Conclusions: The choice of appropriate footwear should not be solely based on aesthetic considerations but rather on the specific needs of each individual. Physicians should consider providing advice on appropriate shoe characteristics as a primary interventio
Harnessing the Power of Water: A Scoping Review of Hydrokinesiotherapy as a Game-Changer in Knee Osteoarthritis Management
No full textBackground: Knee osteoarthritis (OA) is a prevalent condition that significantly impairs pain, mobility, and quality of life. Hydrokinesiotherapy, a water-based exercise therapy, is gaining traction as a potential alternative to traditional land-based rehabilitation for managing knee OA symptoms. Methods: This scoping review aimed to evaluate the effectiveness of hydrokinesiotherapy compared to standard land-based physical therapy and self-administered exercise regimens in improving pain, joint mobility, quality of life, and physical function in patients with knee OA. Five randomized controlled trials (RCTs) were included, assessing outcomes using measures such as the WOMAC score, Visual Analog Scale (VAS), and SF-12. The studies were critically appraised using the PEDro scale and the RoB-2 tool to determine the quality and risk of bias. Results: Hydrokinesiotherapy consistently demonstrated superior outcomes in pain reduction, joint mobility, and physical function across all studies. Patients in the hydrokinesiotherapy groups reported significant improvements in pain and mobility, which were strongly associated with enhanced quality of life. The review also highlighted the potential for hydrokinesiotherapy to serve as an effective alternative or complement to land-based exercises, particularly in populations experiencing severe symptoms. Conlusions: Hydrokinesiotherapy is an effective intervention for managing knee OA, offering significant improvements in key clinical outcomes. Given its benefits, hydrokinesiotherapy should be considered a valuable addition to knee OA treatment protocols. However, further research is needed to confirm long-term effects and to explore ways to improve accessibility to this therapeutic option
Beyond the smile: a systematic review of diagnostic tools for peripheral facial paralysis
No full textBackground
Effective rehabilitation of peripheral facial paralysis (PFP) requires reliable assessment tools. This systematic review aimed to identify and validate instruments used in PFP rehabilitation, categorizing them according to the ICF framework.
Methods
A comprehensive search was conducted across PubMed, Cinahl, Web of Science, and Scopus up to April 2024. Observational analytical studies and one non-randomized controlled trial that validated tools for assessing PFP were included.
Results
Thirty-three studies were included, covering twenty different tools. Seventeen tools were related to the "Structure and Function" domain, while three addressed "Activity and Participation." The Sunnybrook and House-Brackmann scales were the most extensively studied. The Sunnybrook scale exhibited excellent intra- and inter-rater reproducibility and internal validity, making it suitable for clinical use. The House-Brackmann scale was user-friendly but had limitations in reproducibility and sensitivity to subtle differences, which newer versions like the FNGS 2.0 aimed to address. The FAME scale showed promise by reducing subjective scoring. Computerized tools, such as eFACE and A-FPG, and instruments for lip asymmetry and ocular involvement demonstrated potential but require further validation. The Facial Disability Index and the FaCE Scale were validated for assessing disability and participation restrictions.
Conclusion
This review identified several validated tools for PFP assessment, with the Sunnybrook and House-Brackmann scales being the most reliable. While emerging tools and computerized programs show promise, they need further validation for routine clinical use. Integrating validated tools into clinical practice is essential for comprehensive assessment and effective rehabilitation of PFP
Harnessing Foot Mechanics: The Role of Lacing Techniques in Enhancing Comfort and Reducing Injury Risk
No full textBackground: Lacing techniques are often viewed as a functional necessity, but recent research has highlighted their role as a customization tool for foot health and comfort. This review synthesizes findings from studies examining the biomechanical effects of different lacing patterns on pressure distribution, tendon loading, and foot mechanics. Methods: We analyzed studies that investigated various lacing techniques, including tightness and patterns. Objective measurements, such as pressure insoles and cadaveric models, were used to quantify the effects. Diverse study populations, including individuals with foot health concerns and athletes, were considered. This study was conducted as a scoping review following the JBI methodology, adhering to the PRISMA-ScR guidelines. Results: The studies collectively reveal that lacing patterns significantly influence dorsal pressure distribution during activities like running. Customized lacing can optimize foot biomechanics, reducing the risk of injuries related to abnormal pressure distribution. A total of 27 records were identified from the initial search. After removing duplicates and screening, four articles were included in the final review. Additionally, certain lacing configurations were found to reduce peak Achilles tendon tension, a crucial finding for injury-prone individuals. Conclusions: Proper lacing techniques are not just a functional aspect but a means to enhance foot health and prevent injuries. Healthcare professionals can provide personalized lacing recommendations to patients, with implications for those with specific foot conditions, athletes, and individuals at risk of injuries. The importance of patient education on the significance of lacing techniques cannot be overstated, emphasizing the need for informed choices when lacing shoes. These findings underscore the multifaceted role of lacing techniques in promoting foot health and well-being
Effectiveness of manual thoracic therapy in treating impingement syndrome: a systematic review
No full textBackground
Impingement syndrome, a common cause of shoulder pain, often leads to functional limitations. Manual thoracic therapy is frequently employed as a non-surgical intervention, but its efficacy remains debated. This review assesses the impact of manual thoracic therapy on pain reduction and functional improvement in impingement syndrome.
Methods
A systematic review of randomized clinical trials was conducted, focusing on studies that applied manual thoracic therapy to patients with impingement syndrome. The primary outcomes were pain reduction and functional improvement. Studies were evaluated for methodological quality using the PEDro scale, with scores ≥ 6 indicating high quality.
Results
Nine studies met the inclusion criteria. All studies demonstrated high methodological quality (PEDro score ≥ 6). Pain reduction was consistent across studies, with an NPRS score reduction of 0.6 to 1.5 points immediately after treatment and up to 3.2 points at follow-up. Functionality improvements were statistically significant in some studies. However, the results showed limited homogeneity, and the majority of studies did not report substantial differences between intervention and placebo groups.
Conclusion
This review suggests that manual thoracic therapy may lead to pain reduction in impingement syndrome, with some evidence of functional improvement. However, the variability in manual therapy techniques and the limitations in research methodologies indicate a need for further controlled studies. These findings underscore the potential of manual therapy as a supplementary treatment but also highlight the necessity for more robust clinical trials to fully ascertain its effectiveness in clinical practice
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