An evaluation of the rehabilitation for patients recovering from knee joint trauma surgically treated by internal osteosynthesis

Paweł Ryngier, Edward Saulicz, Rafał Gnat, Tomasz Wolny

Paweł Ryngier, Edward Saulicz, Rafał Gnat, Tomasz Wolny – An evaluation of the rehabilitation for patients recovering from knee joint trauma surgically treated by internal osteosynthesis. Fizjoterapia Polska 2001; 1(4); 369-375

Abstract
Background. When the knee joint is immobilized, the sliding of joint surfaces is quickly reduced, primarily as a result of the periartricular contraction of the soft tissues (especially the articular capsule). This kind of mechanical imbalance between gliding and rolling is additionally strengthened by the disturbance of muscle equilibrium, both between different muscle groups (the femoral quadriceps and the ischio-crural muscles) and within the thigh muscle itself (between the vastus medialis and the rectus femoris). In the latter case, this status may also lead to the physiological route of knee-cap slide. In view of the complex arthromechanics of the knee joint and the proper distribution of muscle strength for its functioning, the purpose of our research was to study the impact of selected techniques of manual therapy and some of the motion patterns of the PNF method on improving the activity of the knee joint patients with injuries in the vicinity of this joint surgically treated by internal osteosynthesis. Material and methods. The study involved two groups of 17 people who were treated surgically for injuries to the vicinity of the knee joint. After a period of immobility the active mobility of this joint was assessed in all patients, along with the strength of the muscles functionally connected with the knee joint and subjective pain complaints. The studied patients from both groups underwent routine rehabilitation. Selected traction and mobilization techniques for the knee joint were additionally introduced for the patients from the main group, with exercises based on the notion of post-isometric relaxation and some motion patterns taken from PNF models. Results. The statistical analysis of the quantitative data we acquired pointed to a larger range of improvement in the mobility of the knee joint, associated with a somewhat larger simultaneous increase in the strength of the evaluated muscle groups among the patients from the main group.

Key words:
Immobilization, kinesitherapy, manual therapy

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Evaluating the effectiveness of mechanical methods on the basis of published reports

Mirosław Kokosz, Edward Saulicz, Janusz Kubacki

Mirosław Kokosz, Edward Saulicz, Janusz Kubacki – Evaluating the effectiveness of mechanical methods on the basis of published reports. Fizjoterapia Polska 2003; 3(4); 347-356

Abstract

Background. Movement based-therapy is becoming increasing popular. In fact, it can be said to be dominant modality in contemporary kinesitherapy. One of the most important criteria justifying the use of a particular therapeutic method is its clinical suitability. In this article, we attempted to establish the effectiveness of mechanical methods on the basis of a literature search. For this purpose we used our own system of evaluating the quality of published reports.Material and methods. We analyzed 20 articles from the literature devoted to the problem of evaluated the effectiveness of mechanical methods. The research reports were then ranked on the basis of the authors’ own method of evaluating their quality.Results. The results of our meta-analysis suggest that kinesitherapeutic methods are more effective than individual treatment methods used in isolation. Conclusions. A literature search in the available data bases produces numerous works discussing therapeutic techniques or diagnostic methods. There are relatively few articles, however, that evaluate the effectiveness of movement-based therapy. There are no unified criteria for the evaluation of effectivenessm which means that in the analysis of outcomes achieved from using one and the same kinesitherapeutic method there are major discrepancies in the results obtained by different authors.

Key words:
kinesithearpy, meta-analysis, manual therapy
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Analysis of therapy results in patients with cervical spine pain according to PNF concept and elements of manual therapy

Tomasz Maicki, Rafał Trąbka, Wojciech Szwarczyk, Magdalena Wilk-Frańczuk, Bogusław Figura

Tomasz Maicki, Rafał Trąbka, Wojciech Szwarczyk, Magdalena Wilk-Frańczuk, Bogusław Figura – Analysis of therapy results in patients with cervical spine pain according to PNF concept and elements of manual therapy. Fizjoterapia Polska 2012; 12(3); 263-273

Abstract
This study shows an analysis of two rehabilitation methods in order to determine the differences between groups and changes after the therapy in terms of reducing pain, restoration of mobility and proper function of the cervical spine. The study was conducted on a group of 80 patients referred to rehabilitation due to restricted mobility and pain in the cervical spine, which resulted in impairment in everyday life. Patients were divided into two groups: group 1 consisted of 40 patients treated with PNF concept, and group 2 consisted of 40 patients treated with manual therapy elements. The study used a survey: Functional Index Scale and Oswestry scale for cervical and McGill pain Questionnaire. Additionally range of motion in certain planes was measured by the CROM device. Statistically significant differences were obtained in both groups of patients according to their individual rehabilitation program based on PNF concept and elements of manual therapy. However, patients who received PNF treatment showed greater improvement in mobility, function and pain relief. Results based analysis shows that therapy in group 1 and 2 was efficient, however PNF method proved to be more effective in comparison to treatment with manual therapy elements.
Key words:
Deep neck muscles, PNF, manual therapy, functional rehabilitation
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Effectiveness of manual therapy in pain syndromes originating from the cervical spine

Mariana Szczepaniuk, Zbigniew Śliwiński, Kamil Markowski, Grzegorz Śliwiński

 

M. Szczepaniuk, Z. Śliwiński, K. Markowski, G. Śliwiński – Effectiveness of manual therapy in pain syndromes originating from the cervical spine. Fizjoterapia Polska 2020; 20(1); 170-179

Abstract
Introduction. Cervical pain is a common problem worldwide and is increasingly prevalent. The structure of the cervical segment, as well as its biomechanics, contributes to this. The highest number of cases has been observed among professionally active people, however, the most vulnerable are people practicing a profession involving long-term sitting in one position for several hours. The spine is often overloaded due to long periods of remaining in unnatural and uncomfortable static positions. Pain is most often the result of changes in the paravertebral tissues occurring on a structural background. This problem affects 60–90% of the population and occurs in people aged 25–65. The main methods of treating pain syndromes include: kinesitherapy, i.e. movement therapy, physical procedures and various special methods, including the McKenzie method, PNF or manual therapy.
Objective The objective of the study was to assess the effectiveness of treating people with pain syndromes originating from the cervical spine with various physiotherapy methods.
Material and methods. The PubMed database was searched electronically using keywords such as ‘manual therapy’, ‘PNF’, ‘McKenzie method’, ‘pain syndromes’, ‘cervical spine pain syndrome’, ‘cervical spine’, ‘neck pain’, ‘neck pain therapy’ and the relevant studies were examined. Twenty-two publications were found, containing treatment of cervical spine pain syndromes using various methods, which were further analyzed. These articles were published between 2006 and 2019. Based on the analysis of titles and abstracts, five studies were excluded. Then another three studies were excluded based on the analysis of full texts. In total, 8 studies were excluded. Finally, the analysis of data contained in 14 studies was performed.
Results. It has been observed that pain is one of the most common symptoms of cervical spine disorders. Most often it is assessed using the VAS visual-analog scale. Based on the analysis of 14 studies, it is found that after the application of special physiotherapy techniques, pain is reduced.
Conclusions. Based on the analysis performed, it is concluded that the most commonly used method of measuring pain in patients before and after therapy is the VAS visual-analogue scale. After analyzing the results of selected studies, it can be clearly stated that special methods have a beneficial effect on reducing pain in patients with cervical pain syndrome, based on the average values before and after therapy.

Key words:
cervical spine pain syndrome, McKenzie method, PNF method, manual therapy

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Changes in Rotator Cuff Strength Ratio, Shoulder Pain and Disability after Cervicothoracic Mobilization in Subjects with shoulder impingement syndrome

Ahmed M Elmelhat, Salwa F Abdelmagid, Ebtessam F Gomaa, Ahmed M Gad

Ahmed M Elmelhat, Salwa F Abdelmagid, Ebtessam F Gomaa, Ahmed M Gad – Changes in Rotator Cuff Strength Ratio, Shoulder Pain and Disability after Cervicothoracic Mobilization in Subjects with shoulder impingement syndrome. Fizjoterapia Polska 2020; 20(1); 36-42

Abstract
Background. Shoulder impingement syndrome (SIS) is the most common cause of shoulder pain. Recently, attention has been given to the use of spinal manual therapy to treat shoulder pain. Methods. This study is a Randomized controlled trial. Overall, 35 patients with mean age (32 ± 6.47) years were participated in this study as SIS (stage I and II Neer’s classification) were randomized into 2 equal groups. The control group received only a treatment based on the most evidence-based treatment for SIS (Stretching of the posterior capsule, rotator cuff exercises, and scapular muscle training) while experimental group received Maitland’s rhythmic oscillatory central posteroanterior (PA) and transverse mobilization of cervico-thoracic spine (C7-T4 vertebra) with addition same physiotherapy program received by control group for 4 weeks. All patients in both groups were evaluated pre- and post-treatment with isometric rotator-strength ratio measured by Hand Held Dynamometer (HHD) Device. pain level and shoulder disability were measured by Shoulder Pain and Disability Index (SPADI). Results. Statistical analysis using pre and post treatment design indicated that there’s no significant difference between groups in the isometric rotator-strength ratio. However, a significant difference was found in pain level and shoulder disability index between groups. Conclusions. Cervicothoracic mobilization may be an effective intervention to treat pain and disability associated with shoulder impingement; however, the improvements associated with mobilization are not likely explained by changes in shoulder muscle strength.

Key words:
Manual Therapy, Shoulder Pain, Cervicothoracic, SPADI

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Evaluation of the effectiveness of manual techniques and dynamic taping in the reduction of postoperative complications after surgical treatment of orthognathic defects

Szymon Tyszkiewicz, Marcin Kozakiewicz, Marta Tyndorf, Dorota Kościelniak

S. Tyszkiewicz, M. Kozakiewicz, M. Tyndorf, D. Kościelniak – Evaluation of the effectiveness of manual techniques and dynamic taping in the reduction of postoperative complications after surgical treatment of orthognathic defects. Fizjoterapia Polska 2019; 19(3); 146-157

Abstract
Aim of the study. Evaluation of the effectiveness of manual techniques and dynamic taping in the reduction of postoperative complications after surgical treatment of orthognathic defects.
Material and methods.50 people were qualified for the tests. These people were between the ages of 16 and 39. They were rehabilitated as a result of the surgical treatment of orthognathic defects. These patients were hospitalized due to postoperative complications such as tissue contractures, adhesions and scars, disturbances in joint mobility of the temporomandibular region and the cervical spine, lymphatic edema and nerve conduction disorders in the facial area. In a few people, additional blood bruising was found.
Dynamic taping was performed for two weeks postoperatively, treatments with massage and manual therapy twice a week (45-60 min. – time of a particular visit) for a period of 3 months, starting from the first week after surgery. The results of the therapy were supported by patients performing the recommended exercises. The rate and amount of edema reduction were assessed. Changes in the movement of temporomandibular joints and complex movement of the cervical spine were measured. The rate and extent of reinnervation and the level of pain were controlled. The Pietruski’s, House and Brackmann’s scales, VAS and linear measurements were used for the assessment.
Results.The average range of mobility in the field of temporomandibular joints and the cervical spine was improved in all examined spatial axes. The edema was significantly reduced, remaining after 3 months of therapy only at the averaged value of 8% of the baseline value.Sensory as well as motor fibers in the reinnervation process regained their functions. Their average state described by Pietruski’s scale results is about 26 points, which in the descriptive assessment corresponds to a small paresis.Post-operative haematomas were absorbed within two weeks of the operation.Pain in patients decreased from 7 points at the beginning of therapy, to 3 points after three weeks (average values). The total reduction occurred on average after 5 weeks.
Conclusions. The therapeutic process carried out had a significant influence on the results achieved. These data are comparable with the results presented in the scientific literature, describing similar issues. The results achieved are statistically significant (p <0.05), referring them to the results of people in the comparative group. As a result of the implemented comprehensive therapy, biomechanics and mobility in temporomandibular joints and spine joints were restored to physiological conditions. The performance of the lymphatic system has increased. The pain sensations have been reduced. There were no significant disturbances in the area of facial expressions and the work of sensory branches on the face. Fascial adhesions and scars have been released, to a condition that does not hinder the return to normal daily activity.

Key words:
orthognathic defects, dental physiotherapy, manual therapy, dynamic taping

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Effect of Manual therapy over conventional treatment among chronic degenerative joint disease of the knee – A Prospective Comparative study

A D Gopalswami, S.Senthil Kumar, S. Venkatesan

A D Gopalswami, S.Senthil Kumar, S. Venkatesan – Effect of Manual therapy over conventional treatment among chronic degenerative joint disease of the knee – A Prospective Comparative study. Fizjoterapia Polska 2019; 19(3); 82-90

Abstract
Background. Degenerative Joint Disease (DJD) of knee is a musculoskeletal disorder that affects about 22% to 39% of population in India. The physical impairments among DJD patients poses a significant challenge to clinicians in order to manage and restore their functional capabilities. The disease has been well managed with conventional physiotherapy and exercises. The potential benefits of such physiotherapy lasted for short term.
Aim. Thus, the primary aim was to find the efficacy of less explored methods of treating muscular deficits such as Muscle Energy Techniques (MET) and structured exercise program. The primary objectives of the study were to analyze the effectiveness of MET and joint mobilization in relieving pain severity, improving knee joint ROM and muscle strength.
Material and methods. One hundred patients diagnosed to have tibiofemoral joint degeneration with a grade 2 or 3 on Kellgren and Lawrence scale, were allocated in to Experimental Group (EG) and Comparative Group (CG). EG had received manual therapy in the form of joint mobilization, MET, strengthening exercises and patient education whereas CG had received the referred treatment program (Interferential therapy) along with strengthening exercises and patient education for a period of two weeks.
Results. The analyses of outcome variables for Pain (VAS), knee joint Range of Motion (ROM), Muscle Power and Isometric muscle strength of Quadriceps and Hamstrings was done. Choice of statistical tests (Wilcoxon signed rank test and Mann Whitney U test) was used based on the type of variables.
Conclusions. In a disease specific program, inclusion of manual therapy as a part of treatment regimen would be an effective management for knee osteoarthritis patients. Such an intervention may possibly delay or reduce the need for joint replacement.

Key words:
Degenerative Joint Disease, Manual therapy, Muscle energy technique, Exercise program

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Application of manual therapy in the elimination of myogenic pain in stomatognathic system disorders

Magdalena Gębska, Danuta Lietz-Kijak, Krystyna Opalko,
Ewelina Żyżniewska-Banaszak, Zbigniew Śliwiński, Marek Kiljański

M. Gębska, D. Lietz-Kijak, K. Opalko, E. Żyżniewska-Banaszak, Z. Śliwiński, M. Kiljański – Application of manual therapy in the elimination of myogenic pain in stomatognathic system disorders. FP 2015; 15(2); 60-67

Abstract

Introduction. In last years there has been considerable development of physiotherapy methods used in dentistry. Among them is the manual therapy as a_form of treatment of functional disorders of the stomatognathic system muscular origin. This method is still very popular among dentists. This is because a_small number of literature, and a_small amount of physiotherapists involved in manual therapy in order to eliminate the symptom of pain.
Aim of the study. determined the effect of relaxing and analgesic masseter muscles under the influence of the use of manual therapy.
Material and methods. study was performed in 20 females, aged from 40 to 45  pain diagnosed as a_disorder of the stomatognathic system. In patients conducted physical examination and clinical examination, electromyographic study of masseter muscles and pain assessment using the VAS scale. Then, the test group received manual therapy treatments.
Results. After completion of therapy and analysis of the results showed a_decrease in the electrical potentials studied muscle and decrease of the VAS scale

Key words:
stomatognathic system, manual therapy, electromyography, pain, VAS scale

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Block coincidence of sacroiliac joints in lateral curvature of the spine as well as the effect of the therapy on the size of scoliosis

Daniel Olędzki, Tomasz Sajko, Andrzej Sadowski, Marek Kiljański

D. Olędzki, T. Sajko, A. Sadowski, M. Kiljański – Block coincidence of sacroiliac joints in lateral curvature of the spine as well as the effect of the therapy on the size of scoliosis. FP 2015; 15(2); 22-38

Abstract

In the presentation the authors try to estimate dependencies between lateral curvature of the spine occurrence and the dysfunction of sacroiliac joints as blocks. It was pointed out that scoliosis as a phenomenon can be widely observed in a human body.  The position itself as well as the course of the delivery may lead to different types of muscle tone disorders and positional asymmetry in effect of fascia continuity damaging of the neonate during the delivery or perinatal period.
It may be assumed that the pathology of embryonic development and later in neonatal period can be the origin of the spine statics disorder, and consequently cause overloads of sacroiliac joints manifested in blocks. The secondary effect of the dysfunction of sacroiliac joints may be an asymmetric arrangement of hip bones, and this could lead to asymmetric position of the sacrum and compensatory scoliosis (the term coined by the authors).
Authors underline the important role of the dysfunction of the sacroiliac joint – the strongest proprioreceptor in the joint system – in causing other joints to disfunction, even those which are distant to the pelvis as well as causing muscle tone disorders.
The authors described the following phenomena:
1) how occurrence of sacroiliac joints blocks correlate with the asymmetry of the pelvis position,
2) the relation of lateral curvature of the spine size with the rotation of the spine with a sacroiliac joint block.
In the group of tested children with the scoliosis of a little degree (up to 5 degrees of the rotation) it was noticed that there was a high percentage of the sacroiliac joint dysfunction going with the asymmetric pelvis position. After the therapy of sacroiliac joints blocks there was a statistically substantial improvement in the position of the pelvis as well as the decrease in the scoliosis degree (with connected to it vertebra rotation) was observed.

Key words:
sacroiliac joint, manual therapy, scoliosis, block

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Evaluation of the therapeutic effects in the patients with the glenohumeral joint dysfunction treated according to Brian Mulligan concept and with the pectoral girdle muscle tapping as well as circumarticular injections

Mateusz Curyło, Katarzyna Cienkosz, Jan W. Sosnowski, Andrzej Szczygieł, Irena Szczepańska, Piotr Wróbel, Magdalena Wilk-Frańczuk,  Jan W. Raczkowski

M. Curyło, K. Cienkosz, J. W. Sosnowski, A. Szczygieł, I. Szczepańska, P. Wróbel, M. Wilk-Frańczuk,  J. W. Raczkowski – Evaluation of the therapeutic effects in the patients with the glenohumeral joint dysfunction treated according to Brian Mulligan concept and with the pectoral girdle muscle tapping as well as circumarticular injections. FP 2017; 17(1); 116-124

DOI: https://doi.org/10.56984/8ZG075474

Abstract

Introduction. Sedentary lifestyle connected with the civilizational development and the work in sitting position cause glenohumeral joints dysfunction, most often in the form of overload-pain ailments.
Purpose of this study. The purpose of this study was to compare the physiotherapeutic effects with the application of mobilization with motion according to Brian Mulligan and the pectoral girdle muscle tapping, and the used circumarticular injections.
Material and Methods. The research included 27 patients. The first group (16 persons) was treated with the circumarticular injections of medicines of the corticosteroids group. In the second group (11 persons) the manual therapy according to Brian Mulligan’s concept and the muscle tapping were used. The examinations were performed before the therapy and after three weeks. The used measurements included the shoulder pain and disability index SPADI, provocative tests HIN, HIB, POP, Job, “painful arc” (70°-120°), “belly–press”, goniometric measurement and the subjective pain feeling at the night time. In order to check if the used therapy type had any effect on the upper limb function improvement, the statistical analysis was made in the variance with a_mixed scheme, where the inter-group factor was the type of therapy, and the intra-group factor was the measurement moment: before and after completion of the therapy. Data were processed using Microsoft Excel and Statistica software.
Results. The applied therapy methods influenced improvement of the glenohumeral joint movement range in both groups. The group 2 had better results in reduction of periodic pain ailments and sleep disturbances.
Conclusions. Both used therapeutic programs improves functioning and reduce pain ailments in the investigated group, however the use of 2 therapeutic techniques in the group 2, according to Mulligan’s concept and the muscle tapping, brought significantly greater improvement in the clinical condition evaluation and in the patients’ subjective assessment.

Key words:
painful shoulder syndrome, manual therapy, physiotherapy

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