No abstract

Background Given the prevalence of chronic nonspecific neck pain (CNSNP) internationally, attention has increasingly been paid in recent years to evaluating the efficacy of therapeutic exercise (TE) in the management of this condition. Purpose The purpose of this study was to conduct a current review of randomized controlled trials concerning the effect of TE on pain and disability among people with CNSNP, perform a meta-analysis, and summarize current understanding. Data Sources Data were obtained from MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Physiotherapy Evidence Database (PEDro), and Cochrane Central Register of Controlled Trials (CENTRAL) databases from their inception to August 2012. Reference lists of relevant literature reviews also were tracked. Study Selection All published randomized trials without any restriction regarding time of publication or language were considered for inclusion. Study participants had to be symptomatic adults with only CNSNP. Data Extraction Two reviewers independently selected the studies, conducted the quality assessment, and extracted the results. Data were pooled in a meta-analysis using a random-effects model. Data Synthesis Seven studies met the inclusion criteria. Therapeutic exercise proved to have medium and significant short-term and intermediate-term effects on pain (g=−0.53, 95% confidence interval [CI]=−0.86 to −0.20, and g=−0.45, 95% CI=−0.82 to −0.07, respectively) and medium but not significant short-term and intermediate-term effects on disability (g=−0.39, 95% CI=−0.86 to 0.07, and g=−0.46, 95% CI=−1.00 to −0.08, respectively). Limitations Only one study investigated the effect of TE on pain and disability at follow-up longer than 6 months after intervention. Conclusions Consistent with other reviews, the results support the use of TE in the management of CNSNP. In particular, a significant overall effect size was found supporting TE for its effect on pain in both the short and intermediate terms.

Manual therapy and exercise are an effective means of improving pain and function at short-term follow-up by patients with thumb CMC OA. Magneto therapy, manual therapy, manual therapy and exercise and Orthoses (splints) were found to have clinically significant results. Very few of the included studies showed a clinically significant effect size in favor of treatment.

adding action observation training to conventional inpatient physiotherapy is associated with a greater degree of recovery in patients who have undergone a primary total knee replacement.

Robot gait training has the potential to increase the effectiveness of walking therapy. Clinical outcomes after robotic training are often not superior to conventional therapy. We evaluated the effectiveness of a robot training compared with a usual gait training physiotherapy during a standardized rehabilitation protocol in inpatient participants with poststroke hemiparesis. This was a randomized double-blind clinical trial in a postacute physical and rehabilitation medicine hospital. Twenty-eight patients, 39.3% women (72±6 years), with hemiparesis (<6 months after stroke) receiving a conventional treatment according to the Bobath approach were assigned randomly to an experimental or a control intervention of robot gait training to improve walking (five sessions a week for 5 weeks). Outcome measures included the 6-min walk test, the 10 m walk test, Functional Independence Measure, SF-36 physical functioning and the Tinetti scale. Outcomes were collected at baseline, immediately following the intervention period and 3 months following the end of the intervention. The experimental group showed a significant increase in functional independence and gait speed (10 m walk test) at the end of the treatment and follow-up, higher than the minimal detectable change. The control group showed a significant increase in the gait endurance (6-min walk test) at the follow-up, higher than the minimal detectable change. Both treatments were effective in the improvement of gait performances, although the statistical analysis of functional independence showed a significant improvement in the experimental group, indicating possible advantages during generic activities of daily living compared with overground treatment.