Physiotherapy and Occupational Therapy Journal

Purpose: To assess the efficacy of impairment-based manual physical therapy compared to sham conservative treatment for painful stiff shoulder in diabetic subjects. Relevance: Adhesive capsulitis or painful stiff shoulder is a common condition among diabetes mellitus (DM) subjects. Effects of manual therapy techniques have been widely studied in the literature but not as integrated impairment-based manual therapy techniques. Participants: Ninety patients of age (54.14 ± 12.85 years), both gender (41 male, 49 female) were selected on convenient sampling. Subjects were selected based on following: Physician diagnosed type-II DM of at-least two years duration; complaint of shoulder pain and stiffness (> 3 months duration); ability to understand and cooperate for instructions of tester. Methods: The subjects then were randomized to receive either of two interventions- sham intervention + standard care and experimental intervention + standard care. The sham control group received drugs for glycemic control, analgesics for shoulder pain, active mobilization exercises to shoulder girdle and shoulder joint. The experimental group received in addition, impairment-based manual therapy comprising of joint mobilization, neurodynamic mobilization, myofascial release and trigger point therapy. The treatment session was of 45 min duration on five sessions (one session per week) for total study duration of five weeks. Patients were instructed to perform home programme once daily and were given patient log to ensure compliance. Data was collected twice- pre and post intervention by an independent blinded observer. Analysis: The two outcome measures (range of motion- ROM, shoulder functional tests battery- SFTB) were analyzed using students´ t-test at 95% confidence interval by SPSS 11.5 for Windows. Results: The experimental group showed statistically significant improvements post treatment in all the four outcomes. The pre-post mean differences for shoulder abduction ROM (26.64 ± 7.36 degrees), shoulder external rotation ROM (15.11 ± 3.75 degrees), SFTB score (2.35 ± 1.41 points), was significant (p<.05) in favor of experimental group. Conclusions: Impairment-based manual physical therapy in addition to standard physical therapy care was better than standard physical therapy care combined with sham intervention to improve range of motion and shoulder function in type-2 diabetes mellitus patients with painful stiff shoulders. Keywords : Shoulder dysfunction, rehabilitation, physical therap

Aims and Objectives: The aim of research is to compare the effectiveness of thoracic versus cervical mobilization on physiological parameter in prehypertensive subjects. Methodology: A sample of 30 prehypertensive subjects were recruited for the study. The subject were randomly divided in to 2 groups Group A (Cervical Mobilization) and Group B (Thoracic mobilization group). Grade III posterior anterior vertebral mobilization, single sitting was given for both the group for 60 sec at each level of spinous process from C2-C7 and T1 to T5. Data collected for pre, post immediate and post 30 min for Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heaert Rate (HR). Results: Comparing of SBP of thoracic and cervical group at pre mobilization, post immediate mobilization and post 30 min mobilization is significance. Discussion: Results of our study explained that when we compare the systolic blood pressure (SBP) variable for cervical group and thoracic mobilization showed the significant lowering effect. Diastolic blood pressure variable, Heart rate variable did not achieve significant level of mean change between the both groups. Conclusions: So it is concluded that thoracic mobilization is much more impressive in decreasing systolic blood pressure (SBP) with significant change as compare to cervical mobilization. Keywords: SBP,DBP,HR ,Thoracic Mobilization and Cervical mobilization.

Aims and Objectives: The aim of research is to compare the  effectiveness of aerobic exercise tranning on treadmill and bicycle ergometer on physiological parameter in hypertensive post menopausal womens. Methodology: A sample of 30 hypertensive post menopausal subjects were recruited for this experimental study. The subjects were
randomly divided in to 2 groups Group A (Treadmill exercise) and Group B (Bicycle ergometer). The exercise session of 30 minutes with intensity set at 60%-65% of the reserve heart rate according to the Karvonen method for 4 week5 training session/week. Data collected in the form of Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) every pre & post exercise session. Results: Comparing of SBP of Group A and Group B at 4 weeks of aerobic training is significance. Comparison of SBP variable has significance difference between the two groups. Discussion: Results of our study explained that aerobic exercise training on treadmill and bicycle ergometer showed the significant lowering effect SBP & DBP but not on HR variable for both group. Treadmill exercise is much more impressive in decreasing systolic blood pressure (SBP) with significant change as compare
to bicycle ergometer. Conclusions: Aerobic physical activity should be considered an important component of lifestyle modification for prevention and treatment of high blood pressure in post menopausal females.
Keywords: SBP; DBP; HR; Treadmill exercise; Bicycle ergometer.
 

Purpose: To assess the efficacy of impairment-based manual physical therapy compared to sham conservative treatment for painful stiff shoulder in diabetic subjects. Relevance: Adhesive capsulitis or painful stiff shoulder is a common condition among diabetes mellitus (DM) subjects. Effects of manual therapy techniques have been widely studied in the literature but not as integrated impairment-based manual therapy techniques. Participants: Ninety patients of age (54.14 ± 12.85 years), both gender (41 male, 49 female) were selected on convenient sampling. Subjects were selected based on following: Physician diagnosed type-II DM of at-least two years duration; complaint of shoulder pain and stiffness (> 3 months duration); ability to understand and cooperate for instructions of tester. Methods: The subjects then were randomized to receive either of two interventions- sham intervention + standard care and experimental intervention + standard care. The sham control group received drugs for glycemic control, analgesics for shoulder pain, active mobilization exercises to shoulder girdle and shoulder joint. The experimental group received in addition, impairment-based manual therapy comprising of joint mobilization, neurodynamic mobilization, myofascial release and trigger point therapy. The treatment session was of one hour duration on five sessions (one session per week) for total study duration of five weeks. Patients were instructed to perform home programme once daily and were given patient log to ensure compliance. Data was collected twice- pre and post intervention by an independent blinded observer. Analysis: The two outcome measures (shoulder pain and disability index- SPADI, and pain intensity on visual analogue scale- VAS) were analyzed using students´ t-test at 95% confidence interval by SPSS 11.5 for Windows. Results: The experimental group showed statistically significant improvements post treatment in both the outcomes. The pre-post mean differences for SPADI (17.28 ± 3.18), and pain on VAS (3.29 ± 1.4) was significant (p<.05) in favor of experimental group. Conclusions: Impairment-based manual physical therapy in addition to standard physical therapy care was better than standard physical therapy care combined with sham intervention to relieve pain and disability in type-2 diabetes mellitus patients with painful stiff shoulders. Implications: Inclusion of impairment-based manual physical therapy should be considered based on clinical examination findings of articular, myofascial and neural tissue impairments through their contribution to shoulder pain and dysfunction in patients with type-2 diabetes mellitus. Further studies are warranted with large, population-based, multicenter, multinational trials on patients with idiopathic shoulder pain and dysfunction or in other clinical states following trauma, rupture, dislocation or surgery. Keywords: Shoulder Dysfunction; Rehabilitation; Physical Therapy.