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Kaif Physiotherapy & X-Ray Clinik, maluka rod kotha guru ka (bathinda), Bathinda (2026)

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Maluka Rod Kotha Guru Ka (bathinda)

17/07/2020

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28/06/2013

Pain by Kristy Themelis MSc:

A link to the free full text of the article described in the summary below can be found at our Twitter ().

A 5% lidocaine patch is a patch containing 5% lidocaine, which is applied to the affected area. It is used in conditions such as neuropathic pain, CRPS, diabetic neuropathy and chronic back pain (CBP). Except for its minimal side effects, the mechanism and potential efficacy of the patches in reducing pain are not clearly understood.

In this study, the effectiveness of the 5% lidocaine patch was compared with a placebo (patch with no pharmacological components) in reducing pain of CBP in a total of 30 CBP patients.

Results show that there was no significant difference between the two groups in either pain intensity (measured by numerical and visual pain scales), sensory and affective qualities of pain (measured by questionnaires) or pain in related activated brain areas (measured by fMRI).

These results suggest that 5% lidocaine wasn’t more effective than placebo in CBP. However, results indicate a significant reduction in clinical pain after treatment in both groups compared to an untreated group receiving no treatment. Application of the patch two times a day for two weeks may have acted as a potent placebo analgesic by expectation of pain relief. > From: Hashmi et al., Mol Pain 8 (2012) 29. All rights reserved to BioMed Central Ltd.

27/04/2013

Nutrition by Lesley Wassef-Birosik, PhD:

Osteoporosis is a common disease affecting the older population and is associated with an increased risk of hip fractures. Hip fractures have different severities (Garden I-IV and Kyle I-IV) and different sites of fracture (intracapsular and extracapsular). Vitamin D is an important nutrient involved in bone physiology.

The current study analysed 324 patients with osteoporotic hip fractures over the age of 65 and examine blood levels for vitamin D, calcium, potassium and parathyroid. There was no difference in blood vitamin D levels between the two sites of fractures.

Hypovitaminosis D was seen in 67% of patients. In addition, patients with a more severe hip fracture had hypervitaminosis D and hyperparathyroidism compared to those with less severe hip fractures. Interestingly, those that were treated with vitamin D had less severe fractures.

Calcium levels were similar suggesting that changes in bone remodeling are occurring to ensure calcium levels are constant. Therefore, when treated patients with osteoporotic hip fractures, vitamin D supplementation needs to be considered. > From: Larrosa et al., Osteoporosis Int 23 (2012) 607-614. All Rights reserved to the International Osteoporosis Foundation and the National Osteoporosis Foundation.

26/04/2013

Pain by Kristy Themelis, MSc:

The natural course of a disease helps to provide a baseline against which treatments effects can be measured. This study aimed to describe the natural course over one year of the general Norwegian population with a new episode of Neck pain (NP) or Low back pain (LBP).

Only 219 out of 9065 subjects matched the inclusion criteria and were included for analysis. Data were collected by questionnaires at 1,2,3,6 and 12 months after the pain presented. It is possible that few subjects had specific pathology that went undetected or that people with more severe complaints do not participate in general population studies.

Overall mean current pain at baseline was 3.64 (NRS). Current pain was reduced by 95% at one month after a new NP or LBP episode. Only 1 out of 5 sought treatment at one point during follow up. Complete resolution of pain at 12 month follow up was reported by 43% in the NP, 36% in the LBP groups and 20% in people with both NP and LBP.

Contrary, results indicate that pain in people with equal intensity in NP and LBP and people reporting pain in 4 or more pain sites, remained (hardly) unchanged over the follow-up year, and therefore may require more health care consideration. > From: Vasseljen et al., Pain (2013) (Accepted manuscript in press). All rights reserved to Elsevier.

22/04/2013

Musculoskeletal Monday by Romain Hayem, MSc:

Low-back pain (LBP) affects up to 70% of people in their lifetime. In 85% of these LBP, no specific pathology can be identified (“non-specific LBP”). However, in 1-5% of LBP, a serious pathology can identified, such as spinal malignancy, fracture, infection, cauda equina, etc. “Red flags” are clinical features thought to be associated with a higher risk of serious pathology.

This Cochrane review assessed the performance of 20 “red flags” used in isolation to screen for spinal malignancy in LBP patients. The main findings are:
- The prevalence of spinal malignancy in primary care settings is up to 0.66%.
- When carried out in isolation, the diagnostic performance of most “red flags” is poor.
- “Previous history of cancer” and “unexplained weight loss” are the only two “red flags” that increase the probability of spinal malignancy (to 4.6% and 1.2% respectively).
- Anecdotally, only one study (Deyo 1988) described a combination of “red flags”: age >50y, previous history of cancer, and unexplained weight loss, or failure to improve (sensitivity 100%, for spinal malignancy).

There is poor evidence to support the use “red flags”, which have high false-positive rates. More research is required to develop clusters of “red flags”, rather than individual tests. > From: Henschke et al., Cochrane Database of Systematic Reviews 2013. All rights reserved to The Cochrane Collaboration.

16/04/2013

Aging and Chronic Diseases by Andrew Cuff BSc (Hons):

It is commonly assumed that patients with CLBP are less active than healthy individuals. The aim of this systematic review was to determine, based on the current body of evidence, if patients with chronic low back pain have a lower level and/or altered pattern of physical activity compared with asymptomatic, healthy individuals.

Studies which compared the level and/or pattern of physical activity of patients with chronic low back pain and healthy controls were included. The quality of the included studies was assessed using an assessment tool based on the Newcastle-Ottawa Scale. The scale was modified for the purposes of this study.

Seven studies were included in the final review. Four studies recruited adult patients (18–65 years), two studies examined older adults (≥65 years) and one study recruited adolescents ( From: Griffin et al., Physiotherapy 98 (2012) 98 13-23 . All rights reserved to the Chartered Society of Physiotherapy.

16/04/2013

Musculoskeletal Monday by Gökmen Yapali, MSc:

A link to the free full text of the article described in the summary below can be found at our Twitter ().

The aim of the present study was to investigate the effect of warm-up and cool-down exercise on delayed onset of muscle soreness at the distal and central parts of re**us femoris following leg resistance exercise. Thirty-six volunteers were randomly assigned to the warm-up, cool-down (20 min ergometer cycling prior to and after the resistance exercise), or control group performing resistance exercise only, which consisted of front lunges (10×5 reps/sets) with external loading of 40-50% of body mass. Primary outcomes were pressure pain threshold along re**us femoris and maximal isometric knee extension force.

Pressure pain threshold at the central muscle belly was significantly reduced for the control group on both day 2 and 3 but not for the warm-up group. For the cool-down group, pressure pain threshold at the central muscle belly was significantly reduced on day 2 and was also lower compared to the warm-up group. Force was significantly reduced on day 2 and 3 for all groups. This study indicates that aerobic warm-up exercise performed prior to resistance exercise may prevent muscle soreness at the central but not distal muscle regions, but it does not prevent loss of muscle force. > From: Olsen et al., J Hum Kinet 35 (2012) 59-68. All rights reserved to Versita Ltd.

11/04/2013

Neurosciences by Juncal Roman, MSc:

We routinely use dermatomes to diagnose the location of neurological injury but do we truly know the location of the dermatomes? The problem of inconsistency in the use of dermatome maps can affect clinician communication and students learning their distribution. This paper discussed the history of dermatome maps and examined those found in textbooks.

Dermatome maps currently in use were developed in the late nineteenth and early twentieth centuries using diverse techniques. Overal those maps are disimilar and contradictory. For example L4 dermatome would be placed entirely distal to the knee by some authors (Foester,1930; Head & Campbell, 1900), while others have it swirling from the lower lumbar region around the thigh to end at the great toe (Keegan & Garet 1948). Lee et al.(2008) created a new map superposing all the other ones, however data used for its creation came from experiments that used different methods to identify dermatomes.

Dermatome maps appearing in textbooks are inconsistent; some books show a version of the early maps, some show the Keegan and Garrett map or something completely different. Often they are unreferenced or consistent with any described map. In conclusion dermatome maps should be re-evaluated using current technology in order to provide a more precise define map. > From: Downs & Laporte, J Orthop Sports Phys Ther 41 (2011) 427-434. All rights reserved to The Journal of Sports & Orthopaedic Physical Therapy.

10/04/2013

Musculoskeletal Wednesday by Michel van Exsel, MSc:

Quadriceps muscle injuries often occur in sports with kicking and sprinting movements (all different forms of football). The Re**us Femoris (RF) is the most commonly injured muscle of the quadriceps muscle. The article reviewed the available literature on RF injuries.

The RF is the only bi-articulate muscle of the quadriceps and involved in extending the knee, flexing the hip and stabilizing the pelvis. The percentage of type II fibers is high (approximately 65%). The distal myotendinous junction is the most common site of injury. Risk factors for RF injury can be divided in intrinsic and extrinsic. Intrinsic factors include previous injury (both quadriceps and hamstring injury), height (shorter means increased risk), leg dominance (dominant leg more involved), and probably lower eccentric strength (more studies required). A dry playing field is an extrinsic factor.

Prevention programs focusing on quadriceps injuries are spare. Therefore this article presents mainly recommendations based on expert opinions. Quadriceps muscle flexibility should be incorporated in any prevention program. Thereby also hip extension should be optimal to prevent extra loading of the RF and mechanically irritation of the femoral nerve. Besides that exercises focuses on improving strength should be performed. Areas of attention are increasing hip flexor strength, knee extension strength at long muscle length (eccentric exercises) and core stability. > From: Mendiguchia et al., Br J Sports Med 47 (2013) 359-66. All rights reserved to BMJ Publishing Group Ltd. & British Association of Sport and Exercise Medicine.

10/04/2013

Musculoskeletal Wednesday by Willem-Paul Wiertz, MSc:

Both the empty can (EC) and full can (FC) maneuvers are used as diagnostic tests and therapeutic exercises in patients presenting with subacromial impingement syndrome (SIS). Differences in characteristics between positions may affect the clinical decision to use one, the other or both.

This study compared 3D scapular position, acromiohumeral distance (AHD) and shoulder pain during maximum isometric contractions in the EC and FC maneuver and sought to determine whether scapular position and AHD differed between asymptomatic subjects and those with SIS.

Although there were differences in scapular position between the EC and FC position, no significant differences in AHD between tests or between asymptomatic and symptomatic subjects were found. Subjects with SIS however did have greater pain in the EC position which, based on current findings, cannot be attributed to a decrease in AHD.

In asymptomatic subjects, coupling of scapular upward rotation, internal rotation and posterior tilting was observed; this was not the case for those with SIS. It is speculated that these associated movements help to reduce compression of tissues in the subacromial space. Dissociation of posterior tilting and internal rotation on the other hand, may contribute to pain during evaluative maneuvers. > From: Timmons et al., Clin Biomech (2013) (Epub ahead of print). All rights reserved to Elsevier Ltd.

10/04/2013

Aging and Chronic Diseases by Lesley Wassef-Birosik, PhD:

Rheumatoid Arthritis (RA) is an inflammatory chronic and progressive disease, which leads to deformities of the joints. Many RA patients have severe pain in their hands. This current study evaluated the effects of an exercise program aimed at improving the force of hand muscles in RA patients and to assess the impact of these exercises on hand functionality.

Twenty women with RA and deformities in at least one of their fingers were included in the study. Group 1 (n=13 women) took part in a rehabilitation program, which aimed to increase hand muscle force, while Group 2 (n=7 women) did not receive any type of treatment. Handgrip and pinch strength were evaluated initially for all women. Exercises were conducted twice a week for 2 months, totaling 20 sessions under supervision and 3 days a week at home.

The rehabilitation program consisted of 12 exercises to strengthen the intrinsic and extrinsic muscles of the hand. Patients were re-evaluated after 10 and 20 physiotherapy sessions. After 20 sessions, Group 1 showed a significant improvement in functionality when comparing their HAQ scores with their initial scores. Handgrip strength was similar between the two groups at the initial evaluation, however, after 20 sessions, Group 1 showed an increase in handgrip strength. Similarly, the pinch strength test involving the index finger and thumb was significantly greater in Group 1 after 20 sessions of physiotherapy.

In conclusion, this study shows that a recommended exercise program for the treatment of RA hands is efficient in improving handgrip and pinch strengths, which in turn can improve the daily life. > From: Robinson Cima et al. Rheumatol Int 33 (2013) 725-732. All rights reserved Springer-Verlag.

05/04/2013

Random Friday by Lewis Ingram, BSc:

Active elevation of the upper extremity is a key clinical test utilised by physiotherapists to facilitate the differential diagnosis of subacromial impingement (SAI). Dynamic humeral centring (DHC) is a modality that aims to prevent SAI of the rotator cuff tendons during elevation of the arm, with recent studies demonstrating significant symptom reduction amongst patients with SAIS at 3 months. The objective of the current study was to investigate the specific mechanism(s) that facilitated such improvements.

The authors conducted a secondary analysis of data originally collated from their previous study investigating the actual effectiveness of DHC. 69 patients were randomised into an experimental group - who underwent DHC; or a control group who received non-specific mobilisation. Both interventions consisted of 15 individual supervised sessions performed over a 6-week period. Outcome measures included pain-free ROM and the presence of a painful arc during flexion and abduction.

At 3 months, the DHC group exhibited greater pain-free ROM, whilst the control group continued to demonstrate a painful arc during flexion. These findings suggest that DHC improves pain and upper extremity elevation via its specific effect on SAI of the rotator cuff tendons, and subsequently could be considered an effective adjunct to current treatment amongst those with SAI. > From: Beaudeuil et al., Br J Sports Med (2013) (Epub ahead of print). All rights reserved to BMJ Publishing Group Ltd.

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