颞下颌关节与髋关节之间的功能性联系

Kamil Lenczewski, Małgorzata Wójcik

Kamil Lenczewski, Małgorzata Wójcik – Functional connections between the temporomandibular joint and the hip joint –  Fizjoterapia Polska 2024; 24(1); 122-125

DOI: https://doi.org/10.56984/8ZG2EF8R1m

摘要
引言。形成颞下颌关节紊乱的一些因素是中枢和外周神经系统的变化。在创建两个关节之间的联系的背景下,筋膜和生物张力整合的概念是重要的。在组织中创建的张力沿整个身体线性分布。在一个结构内创建过度的张力可以导致在一个远处的结构中创建相同的张力。
研究目的。研究假设是,对颞下颌关节进行持续7分钟的软组织手法治疗,将会影响髋关节在外展运动中的活动度增加。
结果。右侧和左侧髋关节获得的值显示出强烈且正向的相关性。这证明了所进行的治疗对增加运动范围有影响。
结论。颞下颌关节组织的肌筋膜释放对增加髋外展运动范围有正面效果。
关键词
手法治疗,髋关节,运动范围,颞下颌关节,肌筋膜链
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Terapia manualna dla bólu miednicy o podłożu miofascjalnym: opis przypadku i przegląd narracyjny

Amira N. Abdellatif, Amel M. Youssef, Hamada A. Hamada, Karima A. Hassan


Amira N. Abdellatif, Amel M. Youssef, Hamada A. Hamada, Karima A. Hassan – Manual therapy formyofascial pelvic pain: A case report and narrative review. Fizjoterapia Polska 2023; 23(3); 126-137

DOI: https://doi.org/10.56984/8ZG1435AD

Streszczenie
Wstęp. Ból miednicy o podłożu miofascjalnym (MFPP) charakteryzuje się obecnością wrażliwych punktów spustowych mięśniowo-powięziowych (MTrPs) w mięśniach i powięzi dna miednicy. Terapia manualna dna miednicy jest często proponowana jako pierwsza linia leczenia MFPP.
Istniejąca literatura potwierdza korzystne wyniki terapii manualnej w leczeniu MFPP i oferuje zwięzłe podsumowanie, jak te techniki są stosowane u pacjentów z MFPP. Literatura zawiera dziesięć technik; (1) uwalnianie punktów spustowych miofascjalnych, (2) masaż Thiele, (3) wewnętrzny samomasaż, (4) masaż krocza, (5) łączone techniki manualne, (6) mobilizacja miofascjalna miednicy, (7) manualna terapia narządów wewnętrznych, (8) manipulacja tkanki łącznej, (9) uwalnianie blizny, oraz (10) wewnętrzna manipulacja kości guzicznej.
Metody. Przeprowadzono przegląd narracyjny w celu podsumowania dostępnych dowodów na temat technik terapii manualnej dna miednicy dla MFPP.
Kluczowe treści i wyniki. Po przeglądzie aktualnych badań, dwadzieścia pięć badań spełniło kryteria włączenia. Dostępne dowody sugerują, że terapia manualna dna miednicy jest skuteczna w leczeniu MFPP.
Wnioski. Chociaż obecnie dostępne badania są ograniczone pod względem liczby i mają pewne ograniczenia w projekcie badania, terapia manualna jest uważana za obiecującą, skuteczną i bezpieczną opcję leczenia MFPP.

Słowa kluczowe:
ból miednicy o podłożu miofascjalnym, przewlekły ból miednicy, punkty spustowe miofascjalne, terapia manualna, manipulacja

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Multimodal programmes in the treatment of myofascial pain syndrome (MPS) – a two-step review

Krzysztof Konior, Aleksandra Bitenc-Jasiejko, Danuta Lietz-Kijak, Piotr Skomro, Małgorzata Kowacka, Konrad Kijak, Zbigniew Śliwiński


Krzysztof Konior, Aleksandra Bitenc-Jasiejko, Danuta Lietz-Kijak, Piotr Skomro, Małgorzata Kowacka, Konrad Kijak, Zbigniew Śliwiński – Multimodal programmes in the treatment of myofascial pain syndrome (MPS) – a two-step review. Fizjoterapia Polska 2023; 23(1); 188-202

DOI: https://doi.org/10.56984/8ZG07B914

Abstract
Myofascial pain syndrome (MPS) is one of the most common ailments associated with the human musculoskeletal system, characterised by the presence of the so-called trigger points (TrP – trigger point; MTrPs – myofascial trigger points). The International Association for the Study of Pain indicates that MPS may affect approximately one-third of people with chronic musculoskeletal pain, and that there is a lack of appropriate classification which can be attributed to a misunderstanding and/or misinterpretation of the pathophysiology. Given the diverse causes of pain syndromes in myofascial structures, it is vital to properly select and integrate therapeutic methods. The scientific literature indicates that treatment programmes should include a variety of manual therapy methods and rehabilitation exercises. Trigger point therapies, such as dry needling or dry cupping, are also widely used. At the heart of the success of rehabilitation programmes, in the opinion of the authors of this publication, is their multimodality, i.e. selection of therapeutic methods based on the cause of the pain, providing for measurable, reproducible diagnostic methods in therapy.
Aim of the study. The aim of this study is to analyse and infer conclusions on multimodal myofascial pain therapy programmes.
Material and methods. Given the complex research problem set as the aim, the study was carried out through a literature review in terms of two criteria:
Criterion I (C I): analysis of the literature on the etiology and pathogenesis of myofascial pain (i.e. causes and triggers, symptoms, social and environmental factors determining the onset of MPS), diagnostic procedures (initial diagnosis and ongoing monitoring of treatment outcomes), and therapeutic methods used in the course of MPS.
Criterion II (C II): a literature study of research publications addressing multimodal programmes for myofascial pain therapy, with their qualitative evaluation using the modified PEDro scale, and empirical testing of hypotheses based on the literature study and the analysis made in Part I.
Data sources: PubMed, SCOPUS, Science Direct, MEDLINE, PEDro, Cochrane, Embase, Web of Science Core Collection, Google Scholar electronic databases were searched systematically, restricting the languages to English and German only.
Results. The analysis of the literature showed that the causes, symptoms and associations of myofascial pain have been described in detail. There are also numerous reports on a variety of therapeutic methods, together with a precisely described methodology for their implementation. It is not uncommon to recommend combining methods into multimodal programmes, which unfortunately does not mean that there are many such programmes or that studies on MPS are consistent. The literature study on multimodal treatment programmes for MPS revealed that there is no correlation between its pathogenesis and a purposeful selection of specific therapeutic methods. In a small number of cases, a complex etiopathogenesis led to the formation of multidisciplinary teams. This may be associated with the absence of strict recommendations on the diagnostic methods applicable to the assessment of MPS.
Conclusions. 1. Multimodal programmes for the treatment of musculoskeletal pain, notably MPS and MTrPs, should include a detailed and comprehensive diagnosis (structural, biochemical, psycho-emotional) which should serve as the basis for the formation of interdisciplinary rehabilitation teams. 2. Musculoskeletal diagnosis, in addition to radiological assessment, should include measurable techniques of postural and functional assessment (such as pedobarography, wearable sensors, assisted anthropometry, i.e. photogrammetry, videogrammetry, etc.), aimed primarily at the ongoing assessment of posture. 3. The choice of therapeutic methods and patient education should be based on the causes of the patient’s pain, taking into account systemic diseases, postural defects, lifestyle and psycho-emotional state. 4. Scientific research in multimodal treatment programmes should be carried out in randomised groups, with due attention to the methodologies of diagnostic and therapeutic procedures and group selection.
Keywords
chronic pain, myofascial pain, manual therapy, exercise, multimodal programmes
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Fractures of the condylarprocess of the mandible – the use of comprehensive manual therapy in the reduction of postoperative complications

Szymon Tyszkiewicz, Dominik Szczeciński, Anna Lichnowska, Marta Tyndorf, Marcin Kozakiewicz


Szymon Tyszkiewicz, Dominik Szczeciński, Anna Lichnowska, Marta Tyndorf, Marcin Kozakiewicz – Fractures of the condylarprocess of the mandible – the use of comprehensive manual therapy in the reduction of postoperative complications. Fizjoterapia Polska 2022; 22(3); 80-87

Abstract
Condyloid process fractures are a serious injury to the temporomandibular joints, and the surgical supply of tissues intensifies the occurrence of certain disorders.
These Rehabilitation performed was proposed as a result of complications following surgical reconstruction of broken condyloid process of the mandible. 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.
Mobility of joints and functional abilities of the surrounding systems have significantly improved. The function of the facial nerve has been restored to a small sensory-motor disorder.

Key words:
condyloid process, facial nerve, manual therapy, dental physiotherapy, postoperative disorders

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Strategies of procedure in manual therapy

Tadeusz Kasperczyk, Robert Walaszek

Tadeusz Kasperczyk, Robert Walaszek – Strategies of procedure in manual therapy. Fizjoterapia Polska 2001; 1(2); 173-178

Abstract
Orthopedic manual therapy is involved with treatable joint and bone disorders, i.e. dysfunctions characterized by blocking. Its scope encompasses all diagnostic, preventive, and treatment techniques involving the spine, the limbs, and all other joints.The purpose of this article is to discuss the principles and course of treatment in manual therapy, understood as particular strategies of procedure. This includes the techniques of therapeutic procedure within the framework of three periods: Period I, which involves procedures prior to mobilization or manipulation, in order to create the best possible conditions for this operation; Period II, which pertains to the actual operation (techniques) of removing the block; and Period III, which includes procedures subsequent to manipulation, both immediately after the operation and in a later period of time. The article discusses in detail the proper tasks for each of these periods. Contraindications for manual therapy are also listed.

Key words:
manual therapy, Diagnosis, manual techniques

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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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