[Purpose] The aim of this study was to evaluate the effects of soft tissue mobilization and PNF on pain level, and shoulder ROM in patients with shoulder impingement syndrome. [Subjects and Methods] Thirty patients with painful and limited glenohumeral ROM activities were selected. The subjects were randomly assigned to an experimental group (n=15), which received treatment consisting of soft tissues mobilization and the PNF technique. The control group received an ultrasound treatment. Pain level, glenohumeral external rotation and overhead reach were measured before and after the intervention in groups. [Results] The experimental group showed a significant reduction in pain level in comparison with the control group. The values for Shoulder external rotation showed a significant improvement. The mean value for overhead reach in the experimental group significantly increased. [Conclusion] The combination of soft tissue mobilization for the subscapularis for 7 minutes and 5 repetitions of the contract-relax PNF technique for the shoulder internal rotator muscles followed by 5 repetitions of a PNF facilitated abduction and external rotation diagonal pattern was found to be effective in reducing pain and improving glenohumeral external rotation and overhead reach during a single intervention session.

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Objective: The aim of this paper is to review literature systematically and quantify the effects of leg spasticity on gait parameters in PwMS. Methods and Materials:This study is a systematic review and meta-analysis of observational studies. Articles were included if they met the following inclusion criteria: They were original, observational studies, participants were PwMS, study the effects of leg spasticity on gait in MS patients compared with MS patients without spasticity. The included articles were assessed by modified Downs and Black checklist. The difference between the groups using standardized mean differences and 95% confidence intervals were calculated for meta-analyses. Results:The review included 3 studies with a total of 156 participants; 78 participants were with spasticity, and 78 without spasticity. The lower limb spasticity was detected by modified Ashworth scale self-rating spasticity. The gait was assessed by clinical scales, spatial and temporal gait analyses, free-living walking for a 7 days, O2 consumption during gait, kinematic parameters within the gait, and lower limb muscles range of motion and activity. The included studies and meta-analyses show that the spasticity affected negatively gait with significant differences in comparison with non-spasticity PwMS.Conclusion: Spasticity affects negatively on gait and walking mobility. Those walking impairments lead to increase level of disability, and risk of fall. Gait training is required in MS rehabilitation protocols especially for PwMS with spasticity

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