Hong Kong Physiotherapy Journal最新文献

Background: The International Study of Wheezing in Infants defines recurrent wheezing as the presence of three or more medically documented episodes of wheezing within one year. To date, there is no evidence on the use of hypertonic saline (HS) combined with airway clearance techniques (ACT) for children with recurrent wheezing treated in an outpatient setting. Therefore, this is the first study to explore the use of such interventions in infants with recurrent wheezing.

Objectives: To evaluate the effects and safety of a three-month protocol including HS and ACT for non-hospitalized infants with recurrent wheezing.

Methods: Randomized, double-blind, controlled trial, including outpatient infants with recurrent wheezing. Children were randomized to either 3% HS or 0.9% saline groups and were treated with bronchodilator and nebulized with the respective solutions before ACT. The primary outcome was the Wang score. Secondary outcomes included the number of hospitalizations and respiratory crisis, need for rescue medication, and school absences. All variables were measured during the three previous months from inclusion and during intervention period. The study protocol was registered at ClinicalTrials.gov (NCT04331496) on March, 31, 2020.

Results: Forty children were included. Regarding immediate effects, significant differences ($p<0.001$) were found for time, but not for group or interaction (group × time), in all outcome variables (increase in SpO₂, decrease in heart and respiratory rate, wheezing episodes, retraction, and Wang score). Comparing the previous three months with the study period, there were significant differences in both groups for the severity of crisis ($p<0.001$) and medication steps ($p=0.002$).

Conclusion: A three-month protocol including HS and ACT for outpatient infants with recurrent wheezing was safe and reduced morbidity. No differences were found between the use of HS and 0.9% saline.

Background: Pain is the most common symptom for seeking therapeutic alternative to conventional medicine. Trigger points (TrP) being the most debilitating cause of nonspecific neck pain, are found to be more prevalent in trapezius muscle. Various instrument-based and other manual therapy techniques are effective in the treatment of TrP.

Objective: To compare the effect of Myofascial Cupping (MFC) and Integrated Neuromuscular Inhibition Technique (INIT) on the upper trapezius latent TrP on pain intensity, pressure pain threshold (PPT) & cervical range.

Method: A randomized trial controlled on 40 individuals aged 20-40 years, both gender with latent TrPs in upper trapezius excluding ones who have taken treatment for upper trapezius TrPs within 6 months. Participants were randomly allocated into 2 groups by chit method, one group received MFC and other INIT. Pre- and post-intervention assessment was done using NPRS, pressure algometer and goniometer.

Result: Within group, pain has significantly reduced after MFC and INIT with mean difference of $6.05\pm 0.8$ and $4.95\pm 0.7$, respectively ($p<0.001$). PPT increased in both groups ($p<0.001$) with mean difference of $0.63\pm 0.3$ and $0.28\pm 0.11$, respectively. Comparison between the groups showed significant difference in pain intensity ($p=0.003$) suggesting MFC was more effective in reducing pain. However, a PPT (p=0.606) and neck lateral flexion to the contralateral side of TrP ($p=0.74$) were not significant.

Conclusion: MFC was more effective than INITs in improving pain, however both interventions showed similar effect on PPT and neck lateral flexion on latent TrP in trapezius.

Background: Low-back pain (LBP) continues to be one of the main problems for which sufferers seek treatment in primary care. It can be treated with different physiotherapy mechanisms.

Objective: The purpose of the study is to compare the effect of isotonic and isometric exercise on the reported pain of patients with low back pain.

Methods: Thirty participants, 16 males and 14 females aged between 22 and 50 years suffering from nonspecific low back pain were included. The sample was divided randomly into two groups, group A isometric exercises and group B isotonic exercises, both groups received conservative therapy of TENS and infrared (IR) therapy. The following outcome measures were used: Visual analogue scale, modified Oswestry disability index (MODI) and Endurance Test Measurement were administered pre-treatment and at the end of four weeks of treatment.

Results: Both groups were comparable in terms of demographic data, except for weight. Inter group analysis was done using the Mann-Whitney test. When comparing pre- and post-treatments using VAS scores, there were no significant differences between group A and group B (pre-test: $P=0.285$; Post-test: $P=0.838$). Mann-Whitney test was used to calculate the P-value test between pre-treatment and post- treatment for MODI and there was no significant difference between group A and group B, where the pre-test P-value was 0.061, and post-treatment was 0.077. Comparing between groups, pre- and post-abdominal endurance scores were done using the Mann-Whitney test. The pre-treatment scores revealed P value of 0.345, and the post-treatment scores revealed P value of 0.305. Therefore, there is no statistically significant difference between group A and group B in endurance scores.

Conclusion: There was no difference between the use isotonic and isometric exercises on LBP patients.

Background: Lower Back Pain (LBP) with radiculopathy is a potentially more serious form of mechanical low back pain. A paucity of literature exists about the effect of the gross myofascial release (MFR) technique on the management of LBP.

Objective: The study aimed to evaluate the effect of gross MFR when given as an adjunct to conventional physical therapy in subjects with low back pain with radiculopathy.

Methods: Forty subjects ($n=40$) clinically diagnosed with LBP with radiculopathy were enrolled and randomly allocated to either the control group ($n=20$) or the experimental group ($n=20$). Both study groups received 5 sessions of intervention. The control group received conventional physical therapy while the experimental group received gross MFR of the trunk and lower limb along with conventional physical therapy. The outcome measures included were pressure pain threshold for the lower back and lower extremity, lumbar flexion and extension range of motion (ROM), percentage disability, and patient satisfaction towards the treatment which were measured pre-intervention (day 1) and post-treatment (day 5). The interaction between group and time was analysed using two-way mixed ANOVA.

Results: The results suggested that the experimental group was statistically significant over the control group in terms of pressure pain threshold in the lower back ($p<0.001$) and lower limb ($p=0.003$), disability ($p<0.001$), and patient satisfaction ($p=0.034$) and lumbar flexion ($p=0.002$) except lumbar extension ROM ($p=0.973$).

Conclusion: When given as an adjuvant to conventional physical therapy, gross myofascial release proved to provide a significant and faster short-term improvement over conventional treatment alone in subjects diagnosed with low back pain with radiculopathy.