Objectives: This research aimed to investigate the usefulness of low-level laser therapy (LLLT) combined with myofascial release (MFR) technique for Temporomandibular myofascial pain (TMP) during pregnancy. Methods: A randomized, controlled experiment with a prospective, double-blind design was conducted on 30 pregnant women, with a mean age of 28.2±3.4 years, at 24 weeks of pregnancy, seeking treatment for chronic TMP (lasting more than 3 months). The patients were randomly assigned into either control group (CG) who received standard treatment alone in the form of therapeutic ultrasound, hot pack and exercise program or experimental group (EG) who received the standard treatment combined with LLLT and MFR. Pain intensity and temporomandibular joint (TMJ) function as a primary outcome and pain pressure threshold (PPT) as a secondary outcome were assessed pre and post the treatment (four weeks program). Results: Participants from both groups improved all outcomes after the treatment (p < .001). The EG showed better improvement in the primary outcome function compared to the CG with (MD) = -2.07 (95%CI = -3.66 to -1.59). In addition, both groups significantly increased PPT at the TMJ, Masseter and Temporal anterior muscles in both sides (p < .001). Although the combined treatment resulted in clinically important changes in pain intensity, this change was more prominent in participants from the control group (MD = 2.6, 95%CI = 0.3 to 1.91). Conclusion: LLLT combined with MFR and standard treatment is superior to standard treatment alone to reduce PPT and increase TMJ function in pregnant women with TMP.
Abstract Study aim : To evaluate the effectiveness of extracorporeal shockwave therapy (ESWT) for frozen shoulder in perimenopausal diabetic women. Materials and methods : A single blind randomized controlled trial was conducted on sixty-two perimenopausal women diagnosed with diabetic frozen shoulder. They were divided randomly into two groups. Group (A) received physiotherapy program in the form of maitland joint mobilization for shoulder joint, self-stretching exercises, range of motion exercises (ROM) and strengthening exercises. Sessions were held 3 times per week, for 4 weeks. Group (B) study group: received the same physiotherapy program in addition to ESWT, once per week, for 4 weeks. Visual analogue scale was used to measure pain intensity, shoulder pain and disability index (SPADI) was used to evaluate disability level, while an electrogoniometer was used to measure shoulder flexion, abduction and external rotation range of motion. All measurements were recorded pretreatment and posttreatment program. Results : For intragroup comparison, significant improvement in all treatment outcomes was noted in both groups (P < 0.05). However, no significant differences were found between both groups regarding all outcome measures in case of intergroup comparison in the study (P > 0.05). Conclusion : The use of ESWT have a positive effect in reducing pain and improving shoulder range of motion in perimenopausal women suffering from frozen.
Abstract Background Corticosteroid (CS) can be injected in a blind fashion (landmark-guided) or with ultrasound (US) guidance, and this may contribute to varying clinical results. We conducted this systematic review and meta-analysis to assess the effectiveness of US-guided versus landmark CS injections in the treatment of adult patients with shoulder pain. Methods We searched MEDLINE (via PubMed), Scopus, Web of Science, EBSCO, and Cochrane Library for randomized controlled trials (RCTs) comparing US-guided versus landmark CS injection regarding visual analogue scale (VAS), functional scores, disability scores, abduction degree, and side effects. The data were pooled as mean difference (MD), standardized mean difference (SMD), or risk ratios (RRs), with 95% confidence intervals (CIs), using R software (meta package 4.9-0) for windows. Subgroup analysis and leave-one-out analysis were conducted. Results Eighteen RCTs, with a total of 1010 patients, were included in this meta-analysis. The pooled estimate favored the US-guided over landmark CS injection in terms of the mean change of VAS between 6 weeks and baseline (SMD = − 0.48, 95% CI [− 0.79, − 0.17]), the shoulder functional scores (SMD = 0.35, 95% CI [0.05, 0.65]) and shoulder abduction degree (MD = 8.78, 95% CI [3.11, 14.46]). Whilst no significant difference was found between the compared group regarding the overall shoulder disability scores (SMD = − 0.51, 95% CI (− 1.25, 0.22]) and side effects (RR = 0.45, 95% CI [0.15, 1.34]). None of the eligible study analyzed the cost-effectiveness of the US-guided method compared with the landmark method for CS injection. Conclusion Our analysis showed that US-guided CS injection was effective in the treatment of various shoulder diseases. Further research on the cost-effectiveness of US-guided CS methods is needed.
Recently, high-intensity laser therapy has been used in the therapeutic protocols for pain management. We aimed to evaluate the clinical efficacy of high-intensity laser therapy versus other different modalities for improving lateral epicondylitis symptoms.We conducted a systematic review and meta-analysis on prospective randomized controlled trials from PubMed, Embase, Scopus, Web of Science, and Science Direct until June 2021 using relevant key words. We analyzed the data using Review Manager software (RevMan 5.4).Six randomized controlled trials with 344 patients were included. There is low-quality evidence that high-intensity laser therapy generates a small reduction on pain intensity compared with a control group either during activity (mean difference = -0.98, 95% confidence interval = -1.6 to -0.35, P = 0.002) or during rest (mean difference = -0.98, 95% confidence interval = -1.68 to -0.09, P = 0.03). In addition, there is low-quality evidence that high-intensity laser therapy provides small improvements in quality of life (physical component) compared with control (mean difference = 9.76, 95% confidence interval = 2.69 to 16.83, P < 0.0001).High-intensity laser therapy is an effective therapeutic modality to reduce pain and improve quality of life (36-item short form health survey physical component) in patients experiencing persistent symptoms of lateral epicondylitis. However, grip strength, hand function, and quality of life (36-item short form health survey) did not show significant differences between high-intensity laser therapy and other therapies.
Purpose. COVID-19 is an extremely infectious, life-threatening viral illness that has constituted a global public health emergency. Rehabilitation programs of children with cerebral palsy were interrupted during the COVID-19 pandemic. The aim of the study was to assess the effects of COVID-19 restrictions on gross motor function of children with cerebral palsy.
Material and Methods. In this study, a survey of fifty eight cerebral palsied children of both genders who received physical therapy recruited from three hospitals in Cairo, Egypt (October 6 university hospital -6th of October general hospital- El Hosary hospital- Zaid general hospital- Zaid specialled hospital- Private physical therapy centers). It was done through paediatrics Quality of life inventory (cerebral therapy module) to compare between the level of the children’s quality of life before and after frequent stopping of physical therapy sessions due to covid-19 pandemic.
Results. The result of this study shows that there was a significant difference in movement and balance before and after the lockdown (p <0.001). The mean value was decreased from 54.1% to 33.3%. Also, there was a significant decrease in Pain and hurt (p<0.001) from 68.2% to 37.1% and in fatigue (p<0.001) from 58.8% to 37.8%. Regarding age there was a significant difference between different age groups regarding daily activities (p<0.001), pain (p<0.010) and fatigue (p<0.030), while after lockdown, there was a significant difference between different age groups regarding daily activities (p<0.001) and fatigue (p<0.001).
Conclusion. Children with cerebral palsy were protected from COVID-19 exposure by staying at home, but their rehabilitation activities were disrupted. Therefore, during pandemics, caregivers must develop effective homecare therapy procedures, and healthcare professionals must routinely reassess the state of the child and caregiver. Additionally, caregivers of children with CP should experience less stress and anxiety. Children with CP can get multidisciplinary support, effective communication, and contact between medical professionals and families.