Effectiveness of manual therapy or pulsed shortwave diathermy in addition to advice and exercise for neck disorders: a pragmatic randomized controlled trial in physical therapy clinics.
OBJECTIVE: To determine whether manual therapy or pulsed shortwave diathermy, in addition to advice and exercise, provide better clinical outcome at 6 months than advice and exercise alone in primary care patients with nonspecific neck disorders. METHODS: This was a multicenter, 3-arm randomized controlled trial in 15 physical therapy departments. Of the 735 screened patients, 350 were recruited to the study (mean age 51 years) from July 2000 to June 2002. Participants were randomized to advice and exercise plus manual therapy, advice and exercise plus pulsed shortwave, or advice and exercise alone. Assessments were undertaken at baseline, 6 weeks, and 6 months. The primary outcome was the Northwick Park Neck Pain Questionnaire. Analysis was by intention to treat. RESULTS: Of the participants, 115 were allocated to advice and exercise, 114 to advice and exercise plus manual therapy, and 121 to advice and exercise plus pulsed shortwave; 98% received the allocated treatment. There was 93% followup at 6 months. The mean +/- SD fall in Northwick Park score at 6 months was 11.5 +/- 15.7 for advice and exercise alone, 10.2 +/- 14.1 for advice and exercise plus manual therapy, and 10.3 +/- 15.0 for advice and exercise plus pulsed shortwave. There were no statistically significant differences in mean changes between groups. CONCLUSION: The addition of pulsed shortwave or manual therapy to advice and exercise did not provide any additional benefits in the physical therapy treatment of neck disorders. (+info)
Effects of repetitive shortwave diathermy for reducing synovitis in patients with knee osteoarthritis: an ultrasonographic study.
BACKGROUND AND PURPOSE: Shortwave (SW) diathermy can be used to improve vascular circulation and reduce inflammation and pain for patients with osteoarthritis. However, reduction in synovial inflammation has never been explored. The purpose of this study was to investigate whether repetitive SW diathermy, using ultrasonographic examination, could reduce synovitis in patients with knee osteoarthritis. SUBJECTS AND METHODS: Thirty subjects with 44 osteoarthritic knees participated in this study. Eleven subjects received SW, and 10 subjects received SW and nonsteroidal anti-inflammatory drugs. Nine subjects received no treatment and served as a control group. Synovial sac thickness superior, medial, and lateral to the patella was measured using ultrasonography. The sum of these 3 measurements was taken as the total synovial sac thickness. Subjects in the treatment groups underwent ultrasonographic examination before and after 10, 20, and 30 treatments, whereas control subjects underwent ultrasonographic examination before the experiment and then once every 2 or 3 weeks for a total of 3 follow-up measurements. RESULTS: After 10 SW diathermy treatments, the total synovial sac thickness in both treatment groups was significantly less than the initial thickness, and the synovial sac continued to become significantly thinner with 20 sessions of treatment. These observations were not made in the control subjects. DISCUSSION AND CONCLUSION: The results indicate that SW diathermy in patients with knee osteoarthritis can significantly reduce both synovial thickness and knee pain. Such reductions of synovial sac thickness and pain index continue over treatment sessions. (+info)
No additional benefit of shortwave diathermy over exercise program for knee osteoarthritis in peri-/post-menopausal women: an equivalence trial.
Does short-wave diathermy increase the effectiveness of isokinetic exercise on pain, function, knee muscle strength, quality of life, and depression in the patients with knee osteoarthritis? A randomized controlled clinical study.
BACKGROUND: Knee osteoarthritis (OA) is a painful condition causing disability and muscle weakness. Shortwave diathermy (SWD) is one of several physical therapy modalities and used predominantly as a pain reduction modality in the clinical practice. However, the efficacy of SWD in knee OA is still inconclusive. AIM: The aim of this study was to determine if SWD increase the effectiveness of isokinetic exercise on pain, function, muscle strength, quality of life and depression in patients with OA. DESIGN: This was a randomised, controlled clinical trial. SETTING: Inpatient Physiotherapy Department. POPULATION: Forty women aged between 42 and 74 years, with a diagnosis of bilateral primary knee OA. METHODS: Patients were sequentially randomized into two groups. Group 1 (N.=20) received SWD and isokinetic muscular strengthening exercises. Group 2 (N.=20) served as control group and they received isokinetic exercises only. Both of the programs were performed three days a week, for a duration of four weeks, and a total of 12 sessions. Patients were assessed before treatment (BT), after treatment (AT), and at a three-month follow-up (F). Outcome measures included visual analogue scale, Western Ontario and McMaster University Osteoarthritis Index, six minute walking distance, isokinetic muscle testing, Short Form 36 and Beck depression index. RESULTS: The patients with OA in each group had significant improvements in pain, disability, depression, walking distance, muscle strength, and quality of life AT and F when compared with their initial status (P<0.05). There was no statistically significant difference between the groups according to all the parameters regarding the change scores between AT-BT test and F-BT test (P>0.05) except some isokinetic peak torque measurements (F-BT scores of extension right 60 degrees , 120 degrees and flexion right 60 degrees ). CONCLUSION: Use of SWD in addition to isokinetic exercise program seems to have no further significant effect in terms of pain, disability, walking distance, muscle strength, quality of life and depression in patients with knee OA. CLINICAL REHABILITATION IMPACT: Considering the time and cost of combination therapy is now, the isokinetic exercise program, as it is efficient, may be preferable for the treatment of knee OA, alone. (+info)
Rehabilitation procedures in the management of spasticity.
Spasticity is a major disabling symptom in many patients with spinal and/or cerebral lesions. During functional movements, spasticity manifests itself within the complex condition of the "spastic movement disorder". The pathophysiology of the spastic movement disorder relies on multiple factors including abnormal supraspinal drive, abnormal control of reflex activities, and changes in muscle mechanical properties. The most widely used procedures for management of spasticity are represented by pharmacological treatment aimed at inhibiting reflex hyperexcitability. In the last decades, several non pharmacological procedures for treating spasticity have been put forward, including muscle stretching, muscle reinforcement, physical agents and pain management. These procedures may have both neurophysiological and biomechanical effects on the spastic movement disorder. In the present paper, the literature concerning non-pharmacological procedures in the treatment of spasticity was reviewed and discussed, taking into account the multifaceted pathophysiology of the spastic movement disorder. Although further research in this field is recommended, existing evidence supports the potential role of rehabilitation interventions as a therapeutic tool, which could be integrated with traditional pharmacological procedures in the management of the spastic movement disorder. (+info)
Pulsed shortwave treatment in women with knee osteoarthritis: a multicenter, randomized, placebo-controlled clinical trial.
Effects of ultrasound, shortwaves, and physical exertion on pregnancy outcome in physiotherapists.
STUDY OBJECTIVE: The aim of the study was to investigate whether occupational exposure among physiotherapists is associated with spontaneous abortion or congenital malformation in the offspring. DESIGN: The study was a retrospective nested case-control study, where the pregnancy outcome data were based on the medical registers. SETTING: All registered physiotherapists in Finland who had become pregnant during the study period were included in the study. SUBJECTS: Cases were defined as women who had been treated for spontaneous abortion during 1973-1983 or had delivered a malformed child during 1973-1982. One pregnancy per woman was randomly selected for the study. Three age matched (+/- 18 months) controls were selected for each abortion case and five for each malformation case. The final study population was 204 cases and 483 controls in the spontaneous abortion study, and 46 cases and 187 controls in the congenital malformation study. MEASUREMENTS AND MAIN RESULTS: Exposure information was collected by mailed questionnaires from 1329 women. The response rate was 92% in the spontaneous abortion study, and 89% in the congenital malformation study. Heavy lifting (including patient transfers) was associated significantly with spontaneous abortion. Exposure to ultrasound and shortwaves showed about threefold odds ratios for spontaneous abortions occurring after the 10th week of gestation but in analysis where potential confounding variables were controlled, neither reached statistical significance. Deep heat therapies together, and shortwaves alone, were associated significantly with congenital malformations, but the increase was found in the lower exposure category only. From the potential confounding variables, previous abortion (spontaneous or induced) was associated significantly with spontaneous abortion, and febrile disease in early pregnancy was associated with congenital malformation. CONCLUSION: Physical exertion during early pregnancy seems to be a risk factor for spontaneous abortion. The findings raise suspicion of the potential harmful effect of shortwaves and ultrasound on the pregnancy, but no firm conclusion can be drawn on the bases of these results alone. (+info)
An assessment of hazards caused by electromagnetic interaction on humans present near short-wave physiotherapeutic devices of various types including hazards for users of electronic active implantable medical devices (AIMD).