Physiotherapy research international : the journal for researchers and clinicians in physical therapy
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Randomized Controlled Trial
Ultrasound and laser as stand-alone therapies for myofascial trigger points: a randomized, double-blind, placebo-controlled study.
Ultrasound (US) and low-level laser therapy (LLLT) are commonly employed for myofascial trigger points (MTP) despite lack of evidence for usage as stand-alone treatments. The aim of the study was to determine, on MTP of the upper trapezius muscle (uTM), the effects of US and LLLT per se, as delivered in accordance with the procedures reported by surveys about their usage among physiotherapists. ⋯ Ultrasound and LLLT provided significant improvements in pain and muscle extensibility, which were superior to no therapy but not to placebos, thus raising concerns about the suitability, both economically and ethically, of administering such common physical modalities as stand-alone treatments in active MTP of the uTM.
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Randomized Controlled Trial Multicenter Study
Characterizing the protocol for early modified constraint-induced movement therapy in the EXPLICIT-stroke trial.
Constraint-induced movement therapy (CIMT) is a commonly used rehabilitation intervention to improve upper limb function after stroke. CIMT was originally developed for patients with a chronic upper limb paresis. Although there are indications that exercise interventions should start as early as possible after stroke, only a few randomized controlled trials have been published on either CIMT or modified forms of CIMT (mCIMT) during the acute phase after stroke. ⋯ The intervention starts within 2 weeks after stroke onset. The protocol retains two of the three key elements of the original CIMT protocol, that is, repetitive training and the constraining element. Repetitive task training is applied for 1 hour per working day, and the patients wear a mitt for at least 3 hours per day for three consecutive weeks.
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Randomized Controlled Trial
Microcurrent therapy in the management of chronic tennis elbow: pilot studies to optimize parameters.
In microcurrent therapy (MCT), low-intensity electric current is applied to promote tissue healing and relieve symptoms. MCT is used with recalcitrant skin and bone lesions, but little is known about its effects on tendinopathy, and optimal treatment parameters are uncertain. Two studies were conducted to ascertain whether varying (i) current intensity and (ii) waveform and treatment duration affect outcomes of MCT for chronic tennis elbow. ⋯ Monophasic MCT of peak current intensity 50 μA applied for tens of hours may be effective in reducing symptoms and promoting tendon normalization in chronic tennis elbow. Hyperaemia may help predict treatment outcome. A full-scale trial of the therapy is warranted.
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Randomized Controlled Trial Multicenter Study
Effectiveness of a home exercise programme in low back pain: a randomized five-year follow-up study.
Therapeutic exercise has been shown to be beneficial in decreasing pain and in increasing functioning in patients with chronic low back pain. However, longitudinal follow-up studies are small in number, and often limited in the numbers of subjects due to drop-outs. In addition there is a shortage of real control groups in most cases. The purpose of the present study was to describe long-term changes in intensity of low back pain and in functioning for two study groups five years after undertaking a home exercise programme. ⋯ The present randomized study indicates that supervised, controlled home exercises lead to reduced low back pain, and that positive effects were preserved over five years.
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Randomized Controlled Trial
Is mechanical pain threshold after transcutaneous electrical nerve stimulation (TENS) increased locally and unilaterally? A randomized placebo-controlled trial in healthy subjects.
It is not fully understood how transcutaneous electrical nerve stimulation (TENS) intensity affects mechanical pain threshold. ⋯ TENS administered at a strong but comfortable non-painful stimulation intensity increases mechanical pain threshold ipsi-laterally in healthy subjects, whereas TENS administered at sensory threshold intensity does not. TENS may be ineffective if electrodes are placed contralaterally or distant to the pain site and if stimulation intensity levels are not titrated to subjective strong levels. Further clinical trials are needed to clarify if these findings may also be generalized to populations of chronic pain sufferers.