The Rehabilitation Journal

Sacroiliac joint manipulation helps to improve pain pressure threshold in chronic piriformis syndrome: a 6-week randomized controlled trial

2023-02-27T18:06:36+00:00

Background: Piriformis syndrome (PS) has negative impact on the daily activities of the patients and lead to disability. There is an anatomical association of piriformis muscle with sacroiliac joint (SIJ). So manual therapy including manipulation of SI joint may be the option for relieving the symptoms of PS

Objective: To investigate the effectiveness of Sacroiliac joint manipulation in improving pain pressure threshold in patients with chronic piriformis syndrome.

Materials and Methods: A randomized clinical trial (NCT04603703) was conducted at Max Rehab and Physical Therapy Centre G8-Markaz, Islamabad, Pakistan. A total of n=30 patients were randomly divided into Experimental group (n=15) and control group (n=15). Both groups received conventional physical therapy including therapeutic ultrasound, moist hot pack, piriformis muscle stretching, myofascial release of paraspinal muscles, gluteal strengthening, sciatic neurodynamics. The experimental group additionally received sacroiliac joint manipulation. The outcome measures were pain, straight leg raise (SLR), pain pressure threshold and piriformis muscle length. The total time frame of the treatment was 3 days per week for 6 weeks and pre and post intervention assessment was done.

Result: The mean age of participants was 40.46 ±10.513 years. Pain, SLR, pain pressure threshold and piriformis length was significantly improved (p<0.001) in both the experimental and control group after 6th week intervention. Between group comparison there was no significant difference between the groups after 6-week intervention regarding the pain, SLR and piriformis muscle length, except pain pressure threshold which was significantly improved in experimental group as compared to control group (67.7±18.42 vs 52.51±15.26, p=0.020) .

Conclusion: Addition of the sacroiliac joint thrust manipulation technique and conventional physical therapy alone were equally effective in decreasing pain intensity and normalizing length of Piriformis and Straight leg raise. But SIJ manipulation showed promising results on pain pressure threshold.

Keywords: Articular, physical therapy modalities, piriformis muscle syndrome, pain threshold, range of motion, sacroiliac joint.

Correlation of kinesiophobia with postpartum depression in females with lumbo-pelvic pain

2023-02-28T15:15:53+00:00

Background:Lumbopelvic pain (LPP) is common during pregnancy associated with postpartum depressive symptoms. These negatively affect maternal health and behavior, such as exercise and physical activity ultimately leads to kinesiophobia.

Objective: To determine the association of kinesiophobia with postpartum depression in females with lumbo-pelvic pain.

Methods: A cross-sectional study was conducted on 89 postpartum women with lumbo-pelvic pain within six months of delivery in Jinnah Hospital, Lahore. Nonprobability convenience sampling was used to collect the data. Females presenting with lumbo-pelvic pain were selected on the basis of inclusion and exclusion criteria. Lumbo-pelvic pain severity, kinesiophobia and depression were measured by Visual Analogue Scale, Tampa Scale and Zung Self Rating Depression Scale, respectively. Pearson correlation was used to determine the correlation between kinesiophobia and depression.

Results: The mean age of participants was 29.14 + 3.28 years. The mean pain score of lumbosacral pain was 1.989, Kinesiophobia was 47.5169 and depression was 60.2247. There was significant strong positive correlation (r=0.786, p<0.001) between Kinesiophobia and postpartum depression among female having lumbosacral pain.

Conclusion: There was strong association of kinesiophobia with postpartum depression in females with lumbo-pelvic pain

Key words: Depression, kinesiophobia, lumbo-pelvic pain, pregnancy

Knowledge, attitude and practice behavior regarding blood pressure among physical therapists of twin cities

2022-12-27T06:56:57+00:00

Background: Blood pressure (BP) monitoring has a very crucial role in physical therapy for accurate evaluation and re-evaluation of the patient, otherwise it can lead to inaccurate clinical decision making and the patient may be falsely diagnosed. It is an important cardinal sign that cannot be neglected in making clinical decision, may put the individual to a greater risk of cardiovascular and other health problems.

Objective: to explore the knowledge, attitude, and practice behavior regarding BP among physical therapists (PT) of twin cities.

Methods: A cross sectional study was conducted in 6 months, from January 2019 to June 2019 in different hospitals of Islamabad and Rawalpindi. The data was collected from n=296 PT of twin cities after obtaining the written consent. The data of knowledge, attitude and practice behaviors towards BP was collected by semi structured questionnaire. The results were presented in table and graph while description was given as Mean ± SD and f (%).

Results: The mean age of study participants was 28.4±3.71 years. The overall mean score of knowledge (4.27±3.05) showed that n=159(53.72%) participants in the study have poor knowledge about the information related to BP. While attitude score (19.74±.2.29) showed that majority of the sample n=179(60.47%) have positive attitude towards the importance of BP evaluation during assessment, management and educating the patient. While observing the behaviour, mean score (14.55±4.78) showed that physical therapist has acceptable behaviour towards the BP measurement. But frequency distribution showed that n=160(54.05%) physical therapist has poor behaviour towards BP measurement during their practice.

Conclusion: The knowledge and practice behavior regarding the BP assessment and evaluation among the physical therapist is very poor, while their attitude is positive towards the importance of BP evaluation during assessment, management and educating the patients.

Keywords: Blood pressure, inpatient clinic, outpatient clinic, physical therapy.

Correlation of mobile phone usage on grip strength, disabilities and posture in young adults

2023-03-08T18:56:38+00:00

Background: The musculoskeletal issues are now common in excessive use of mobile phone for communication, gamming and socialization on internet. The excessive use of mobile phone may decrease the muscle strength and lead to poor posture ultimately functional impairment related to upper extremity.

Objective: to determine correlation among duration of mobile phone usage, neck posture, disabilities and hand grip strength.

Methods: A correlational cross sectional study was done at Riphah International University Lahore from March 2020 to February 2021. The target population was male and female young students of 18 to 24 years, used mobile phone more than 6 hours in a day. A total of n=400 subjectsarticipated in the study in which n=235 were females and n=165 were males. The information was gathered using the DASH Questionnaire to identify upper limb problems, the photogrammetry method to determine the cervical angle, and a dynamometer to determine the strength of each hand's grasp. The pearson product-moment correlation coefficient was done by using SPSS version 21.

Result: The mean age of the study participant was 20.99±2.34 years. A total of n=165(41.25%) were male and remaining n=235 were female participated in the study. Increase use of mobile had negative significant small correlation with degree of cervical angle (p=0.04), right hand grip strength (p=0.01) and positive significant small correlation with DASH score (0.01). While no significant correlation between daily use of mobile phone and left hand grip strength

Conclusion: The study concluded that as the duration of mobile phone usage increased, the forward head posture and disabilities of the upper limb also increased. But the grip strength of right hand decreased as the mobile phone duration is increased.

Key words: Correlation, disabilities, female, grip strength, mobile phone, male, posture.

Effect of Kegel exercises on distress symptom and quality of life in elderly Pakistani female with urinary incontinence

2023-03-06T11:13:11+00:00

Background: The stress urinary incontinence was the reason the affected women experienced anxiety and depression. the more severe the symptoms of stress urinary incontinence were, the more negative impact to aspects of quality of life was seen. Objective: To determine the effects of Kegel exercises on distress symptom and quality of life in elderly Pakistani female patients with stress urinary incontinence. Methodology: A single-blinded, randomized control trial was conducted on n=50 female patients having stress urinary incontinence at department of physiotherapy, Haleema Siraj Hospital Rawalpindi from January 2021 to June 2022. The participants with the age above 55 years were recruited through non-probability convenient sampling technique and divided into experimental and control group; n=25 participants in each group. The experimental group received Kegel exercise as an intervention for three months and 3-4 time/day. While control groups didn’t received any intervention but continue the regular medicines. Both groups was evaluated pre and post interventionally (after 3-months) by using urinary distress inventory (UDI) for distress symptoms and incontinence impact questionnaire (IIQ) for quality of life. SPSS version 21 was used for data analysis. Independent t-test was used for between group comparisons of mean differences. Results: The mean age of the study participants was 65.00±8.90 years. Between group analysis, showed that symptom distress {MD=16.21, 95%CI (3.10 to 14.55) on urinary distress inventory (short Form), and life quality {MD=8.83, 95%CI (3.10 to 14.55) on incontinence impact questionnaire significantly greater in experimental group as compared to the control group. Conclusion: Kegel exercises significantly improved distress symptoms and quality of life in females with stress incontinence.

Keywords: elderly, incontinence, Kegel exercises, stress incontinence.

Effects of footwear modification along with physiotherapy on activity of daily living (ADLS) in patients with medial knee osteoarthritis

2023-03-17T20:42:04+00:00

Background: the management of osteoarthritis (OA) of the knee with biomechanical therapies claimed that application of orthotic devices is another crucial component of a rehabilitation program. Several footwear modifications are used to lessen medial knee loading (MKL), which helps to reduce pain and other symptoms.

Objective: to compare the effects of lateral heel wedge insole alone and in combination with medial arch support on ADLs in patient with medial knee OA.

Methodology: A randomized clinical trial was conducted on n=60 patients with medial knee OA were randomly allocated in to group A, received lateral heel wedge insole (LHWI) along with medial arch support (MAS) and group B only adjusted with LHWI. Nonprobability convenient sampling technique was used to collect the data on the knee injury and osteoarthritis outcomes score (KOOS) was used as outcome measures. The outcome measures were assessed at the baseline, and after 8 and 16 weeks.

Results: The results of independent t-test showed that group A which received LHWI along with MAS showed more significant improvement (p<0.05) in pain, ADLs, sports activity on KOOS questionnaire at each level of assessment than group B which only received the LHWI. But KOOS quality of life scores only showed significant improvement after 8 weeks of intervention in group A while after 16^th weeks no significant difference (p=0.09) was observed.

Conclusion: the lateral wedge insoles with medial arch support combined with conventional physical therapy protocol is more effective to improve activities of daily living (ADLS) in patients having medial knee osteoarthritis.

Keywords: Footwear, osteoarthritis, lateral heel wedge insoles, KOOS, ADLs.