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Background Thoracic myofascial pain syndrome is a clinical problem arising from the muscles and soft tissues of thoracic region, which include the mid and upper back area. Risk factors associated with myofascial pain syndrome are muscle overuse and repetitive strain, poor posture, trauma or injury, emotional and psychological stresses. The management of myofascial pain syndrome (MPS) typically involves a multidimensional approach that focuses on relieving pain, reducing muscle tension, and improving muscle function. Bowen therapy and tennis ball technique are also recommended for treating myofascial pain syndrome. Objective The objective of this study was to compare the effects of Bowen therapy and tennis ball technique on pain and functional disability in patients with thoracic myofascial pain syndrome. Methods It was a randomized clinical trial conducted on thirty patients. It was carried out in physiotherapy outpatient department of D.H.Q Hospital, Kasur. Non-probability convenience sampling technique was used. Data collection was done from the patients of thoracic myofascial pain syndrome by using Numeric Pain Rating Scale (NPRS) for pain and Pain Disability Questionnaire (PDQ) for functional disability. Participants were randomly allocated into two groups using computer generated random number method. Group A received Bowen therapy, and group B received tennis ball technique. Outcome measures were measured at baseline, after second week treatment session and after fourth week with three sessions in a week on alternate days. Data analysis was done by using Statistical Package for the Social Sciences (SPSS) version 26. Results There was significant difference between the mean values of NPRS and PDQ in both groups at baseline, second week and fourth week with p value < 0.05. The results indicated that both treatments were significant but Bowen therapy is more effective treatment than tennis ball technique. Within-group difference calculated with repeated-measure ANOVA indicated that there was significant difference from pre- to post-values of both groups. Conclusion This study concluded that Bowen therapy produced statistically significant and clinically relavant results for all the outcome measures. Trial registration. (IRCT20190717044238N7).
Background Thoracic myofascial pain syndrome is a clinical problem arising from the muscles and soft tissues of thoracic region, which include the mid and upper back area. Risk factors associated with myofascial pain syndrome are muscle overuse and repetitive strain, poor posture, trauma or injury, emotional and psychological stresses. The management of myofascial pain syndrome (MPS) typically involves a multidimensional approach that focuses on relieving pain, reducing muscle tension, and improving muscle function. Bowen therapy and tennis ball technique are also recommended for treating myofascial pain syndrome. Objective The objective of this study was to compare the effects of Bowen therapy and tennis ball technique on pain and functional disability in patients with thoracic myofascial pain syndrome. Methods It was a randomized clinical trial conducted on thirty patients. It was carried out in physiotherapy outpatient department of D.H.Q Hospital, Kasur. Non-probability convenience sampling technique was used. Data collection was done from the patients of thoracic myofascial pain syndrome by using Numeric Pain Rating Scale (NPRS) for pain and Pain Disability Questionnaire (PDQ) for functional disability. Participants were randomly allocated into two groups using computer generated random number method. Group A received Bowen therapy, and group B received tennis ball technique. Outcome measures were measured at baseline, after second week treatment session and after fourth week with three sessions in a week on alternate days. Data analysis was done by using Statistical Package for the Social Sciences (SPSS) version 26. Results There was significant difference between the mean values of NPRS and PDQ in both groups at baseline, second week and fourth week with p value < 0.05. The results indicated that both treatments were significant but Bowen therapy is more effective treatment than tennis ball technique. Within-group difference calculated with repeated-measure ANOVA indicated that there was significant difference from pre- to post-values of both groups. Conclusion This study concluded that Bowen therapy produced statistically significant and clinically relavant results for all the outcome measures. Trial registration. (IRCT20190717044238N7).
Introduction. Pain perception varies due to many factors. Quantitative sensory testing is a panel of diagnostic tests used to assess somatosensory function. The aim of the study was to determine how psychophysical variables are related to the perceived pain intensity in patients with chronic pain. Material and Methods. The cross-sectional study included 88 subjects (average age 51.3 ? 9.4 years, 76 (86.4%) women) diagnosed with chronic pain syndrome and fibromyalgia or chronic neuropathic pain associated with lumbosacral radiculopathy. Current and average pain intensities in the past 4 weeks were rated on a numerical rating scale. Quantitative sensory testing included pressure pain thresholds, heat pain thresholds, and cold pain thresholds. Patients filled out the Fear Avoidance Component Scale, a questionnaire that examines the fear avoidance phenomenon. Results. The highest correlations were found between the Fear Avoidance Component Scale scores and current and average pain intensity (r = 0.438 and r = 0.253, respectively); between pain duration and current and average pain intensity in the past 4 weeks (r = 0.340 and r = 0.308, respectively). Moderate and negative correlations were found between pressure pain thresholds and current and average pain intensity (r = - 0.233 and r = -0.300, respectively). Conclusion. Low to moderate, significant positive correlations were found between fear-avoidance and pain intensity. Significant but low negative correlations were found between pressure pain threshold and current pain intensity, as well as between pressure pain threshold and average pain intensity.
Introduction. Osteoarthritis is the most common form of arthritis which affects millions of people worldwide and represents the leading cause of disability among the elderly. There is a substantial number of guidelines available for the treatment of knee osteoarthritis. The primary aim of this paper is to explore the distinctions and similarities between knee osteoarthritis treatment guidelines. The treatment is divided into core treatment and additional steps. Core treatment of knee osteoarthritis involves education of the patient, weight loss in the case of overweight patients and establishing an exercise program. First step of additional treatment of knee osteoarthritis consists of non-pharmacological (application of orthoses, lateral wedge insoles, assistive walking devices, therapeutic modalities, manual therapy, aquatic exercise, Tai chi) and pharmacological therapy (topical nonsteroidal anti-inflammatory drugs, topical capsaicin, paracetamol). Second step of additional treatment of knee osteoarthritis - pharmacological therapy should be considered if the first step didn?t show any significant results. It involves the use of oral nonsteroidal antiinflammatory drugs, intra-articular corticosteroid injections and viscosupplementation. Third step of additional treatment of knee osteoarthritis - last resort pharmacological therapy Pain occurring in knee osteoarthritis. can be partially caused by central sensitization. Because of that, use of duloxetine and tramadol may be considered. Fourth step of additional treatment of knee osteoarthritis-end stage treatment of knee osteoarthritis is reserved for the most severe patients. It includes total knee replacement surgery, and if it is not possible, treatment with strong opioids could be considered. Conclusion There are many possibilities in treatment of knee osteoarthritis. Unfortunately, there is often a lack of concordance between different guidelines. In these circumstances, treatment plans should be personalized, while comprehending potential risks and benefits.
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