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Category: Physio

Elevate Physical TherapyPhysio
By elevateah 0 Comments Physio

Frozen Shoulder? New Research Indicates Dry Needling is Effective!

Here is the abstract from a recent journal article highlighting the results of the study.  Take home message: Frozen shoulder aka adhesive capsulitis is classically considered a “joint issue”.  Dry Needling aims to influence mainly “muscle dysfunction”.  What “joint issues” do you have that needling can help???

Trigger Point Dry Needling as an Adjunct Treatment for a Patient With Adhesive Capsulitis of the Shoulder

Authors: Derek Clewley, PT, DPT, OCS, FAAOMPT, Timothy W. Flynn, PT, PhD, OCS, FAAOMPT, Shane Koppenhaver, PT, PhD, OCS, FAAOMPT

Published: Journal of Orthopaedic & Sports Physical Therapy, 0, Volume: Early Access Issue: Early Access Pages: 1-32 doi:10.2519/jospt.2014.4915

Background: Prognosis for adhesive capsulitis has been described as self-limiting and can persist for 1-3 years. Conservative treatment including physical therapy is commonly advised.

Case Description: The patient was a 54 year old female with primary symptoms of shoulder pain and loss of motion consistent with adhesive capsulitis. Manual physical therapy intervention initially consisted of joint mobilizations of the shoulder region and thrust manipulation of the cervicothoracic region. Although manual techniques seemed to cause some early functional improvement, continued progression was limited by pain. Subsequent examination identified trigger points in the upper trapezius, levator scapula, deltoid and infraspinatus muscles that were treated with dry needling to decrease pain and allow for higher grades of manual intervention.

Outcomes: The patient was treated for a total of 13 visits over a 6 weeks period. After trigger point dry needling was introduced on the third visit, improvements in pain-free shoulder range of motion and functional outcome measures, including SPADI and QuickDASH, exceeded the minimal clinically important difference after 2 treatment sessions. At discharge the patient had achieved significant improvements in shoulder range of motion in all planes and outcome measures were significantly improved.

Discussion:This case report describes the clinical reasoning behind the use of trigger point dry needling in the treatment of a patient with adhesive capsulitis. The rapid improvement seen in this patient following the initiation of dry needling to the upper trapezius, levator scapula, deltoid and infraspinatus muscles suggests that surrounding muscles may be a significant source of pain in this condition.

By elevateah 0 Comments Physio, shock wave

Shock-wave therapy improved outcome with plantar fasciitis: a meta-analysis of randomized controlled trials

Abstract

Background: Shock-wave therapy (SWT) has been widely applied and proven to be an effective treatment in ameliorating symptoms of plantar fasciitis (PF). Ultrasound therapy (UT) is another common treatment of PF, and several researches have documented its advantages when compared to corticosteroid injection. Despite this, few studies have focused on comparing the use of SWT and UT in the treatment of PF. The purpose of our meta-analysis is to evaluate whether SWT is better than UT in managing PF, both in terms of ameliorating pain and improving functionality.

Methods: A systematic search of the literature was conducted to identify relevant articles that were published in Pubmed, Medline, Embase, the Cochrane Library, SpringerLink, Clinical Trials.gov and OVID from the databases’ inception to October 2018. All studies comparing the efficacy of SWT and UT in terms of pain levels and functionality improvement were included. Data on the two primary outcomes were collected and analyzed using the Review Manager 5.3.

Results: Five studies were included in the current meta-analysis. A significant difference in VAS score (MD = – 13.14, Cl – 14.07 to – 12.75 P < 0.00001, I2 = 100%) was noted between the SWT group and the UT group. No significant difference was seen in the AOFAS (MD = 3.19, Cl – 1.72 to 8.10 P = 0.20, I2 = 100%); FFI or PFPS score was not found significant difference either (SMD = – 1.17, Cl – 4.45 to 2.10 P = 0.48, I2 = 96%).

Conclusions: The results from this meta-analysis highlight the effectiveness of both SWT and UT in the treatment of PF. Although inter-group differences were not significant, the VAS score was better improved in the SWT group, suggesting that SWT may be a superior alternative for the treatment of PF.

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