The Role of Physical Therapy in Pain Management and Pain Relief

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Pain Management".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 38807

Special Issue Editor


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Guest Editor
Laboratory of Advanced Physiotherapy (LAdPhys), Physiotherapy Department, School of Health and Care Sciences, University of West Attica (UNIWA), 122 43 Athens, Greece
Interests: neuromusculoskeletal conditions; movement impairment syndromes; manual therapy; sports rehabilitation; functional rehabilitation
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Special Issue Information

Dear Colleagues,

Pain management and pain relief are among the key determinants of successful physical therapy care of many neuromusculoskeletal conditions. However, several interactions seem to exist between the pain experience magnitude and duration, the associated self-reported and functional disability recorded, and patients' psychosocial state. Therefore, several issues arise in the rehabilitation of pain-related conditions from the diagnostic point of view to the management strategies available. Acute and chronic pain conditions may require different management strategies. This Special Issue focuses on delineating recent research findings in physical therapy as a conservative method available in the assessment and management of several pain conditions. Within the remit of this Special Issue, different exercise approaches, manual therapy techniques, electrophysical modalities, soft tissue techniques, motor and mental imagery strategies, psychologically based approaches, ergonomic and load management programs can be included.

The latest research developments and findings in the above areas are welcome. Therefore, we invite you to contribute original research articles and reviews of the literature in this Special Issue of Healthcare (PubMed indexed ISSN 2227-9032), aiming to attract high-quality research papers on the etiology, assessment, treatment, and prevention in a variety of pain-related syndromes. 

Dr. Koumantakis George
Guest Editor

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Keywords

  • injury
  • musculoskeletal pain
  • pain classification
  • acute pain
  • chronic pain
  • neuropathic pain
  • pain assessment
  • motor control
  • proprioception
  • manual therapy
  • exercise
  • fascia
  • blood-flow restriction
  • mirror therapy
  • mental imagery
  • graded exposure
  • electrophysical modalities

Published Papers (16 papers)

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Research

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16 pages, 1315 KiB  
Article
Impact of Movement Control Training Using a Laser Device on the Neck Pain and Movement of Patients with Cervicogenic Headache: A Pilot Study
by Songui Bae, Juhyeon Jung and Dongchul Moon
Healthcare 2023, 11(10), 1439; https://doi.org/10.3390/healthcare11101439 - 15 May 2023
Cited by 1 | Viewed by 1732
Abstract
This study verified the effect of movement control training using a laser device on the neck pain and movement of patients with cervicogenic headache. A total of twenty outpatients recruited from two Busan hospitals were equally divided into two groups. The experimental group [...] Read more.
This study verified the effect of movement control training using a laser device on the neck pain and movement of patients with cervicogenic headache. A total of twenty outpatients recruited from two Busan hospitals were equally divided into two groups. The experimental group underwent movement control training with visual biofeedback, while the control group performed self-stretching. Both groups received therapeutic massage and upper cervical spine mobilization. A four-week intervention program was also conducted. Measurement tools including the cervical flexion–rotation test, visual analog scale, Headache Impact Test-6, pressure pain threshold, range of motion, sensory discrimination, and Neck Disability Index helped assess the participating patients before and after the intervention. Additionally, the Wilcoxon signed-rank test and the Mann–Whitney U test helped determine inter and intra-group variations, respectively, before and after the intervention. Most of the measurement regions revealed significant changes post-intervention within the experimental group, while only the cervical flexion–rotation test, visual analog scale, Headache Impact Test-6, and Neck Disability Index indicated significant changes post-intervention within the control group. There were also considerable inter-group differences. Thus, movement control training using a laser device more effectively improves neck pain and movement of patients with cervicogenic headache. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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19 pages, 19587 KiB  
Article
Investigation of Real-Time Diagnostic Ultrasound as a Means of Biofeedback Training in Transversus Abdominus Re-Education of Patients with Non-Specific Low Back Pain: A Prospective Randomized Controlled Pilot Study
by Nikolaos Taxiarchopoulos, Elena Drakonaki, Maria Gianniotis, Charalampos Matzaroglou, Elias Tsepis and Evdokia Billis
Healthcare 2023, 11(10), 1396; https://doi.org/10.3390/healthcare11101396 - 11 May 2023
Viewed by 1592
Abstract
Background: It is believed that ultrasound-guided imaging of activation/contraction of the deep abdominal muscles (such as transervsus abdominis) is useful for assisting deep muscle re-education, which is often dysfunctional in non-specific low back pain (NSLBP). Thus, this pilot study aimed to evaluate the [...] Read more.
Background: It is believed that ultrasound-guided imaging of activation/contraction of the deep abdominal muscles (such as transervsus abdominis) is useful for assisting deep muscle re-education, which is often dysfunctional in non-specific low back pain (NSLBP). Thus, this pilot study aimed to evaluate the use of real-time ultrasound (US) as a feedback device for transverse abdominis (TrA) activation/contraction during an exercise program in chronic NSLBP patients. Methods: Twenty-three chronic NSLBP patients were recruited and randomly assigned to a US-guided (n = 12, 8 women, 47.6 ± 2.55 years) or control group (n = 11, 9 women, 46.9 ± 4.29 years). The same motor control-based exercise program was applied to both groups. All patients received physiotherapy twice per week for seven weeks. Outcome measures, tested at baseline and post-intervention, included Numeric Pain Rating Scale, TrA activation level (measured through a pressure biofeedback unit-based developed protocol), seven established motor control tests, Roland-Morris Disability Questionnaire and Hospital Anxiety and Depression Scale. Results: For each group, all outcome variables yielded statistical differences post-intervention (p < 0.05), indicating significant improvements. However, there were no significant group x time interactions for any of the outcomes (p > 0.05), thus, indicating no superiority of the US-guided group over the control. Conclusions: The addition of US as a visual feedback device for TrA re-education during a motor control exercise program was not proven superior to traditional physiotherapy. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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13 pages, 1180 KiB  
Article
Manual Therapy versus Localisation (Tactile, Sensory Training) in Patients with Non-Specific Neck Pain: A Randomised Clinical Pilot Trial
by Eleftheria Thomaidou, Christopher James McCarthy, Elias Tsepis, Konstantinos Fousekis and Evdokia Billis
Healthcare 2023, 11(10), 1385; https://doi.org/10.3390/healthcare11101385 - 11 May 2023
Viewed by 2382
Abstract
Manual therapy (MT) techniques typically incorporate localised touch on the skin with the application of specific kinetic forces. The contribution of localised touch to the effectiveness of MT techniques has not been evaluated. This study investigated the immediate effects of MT versus localisation [...] Read more.
Manual therapy (MT) techniques typically incorporate localised touch on the skin with the application of specific kinetic forces. The contribution of localised touch to the effectiveness of MT techniques has not been evaluated. This study investigated the immediate effects of MT versus localisation training (LT) on pain intensity and range of movement (ROM) for neck pain. In this single-blind randomised controlled trial thirty eligible neck pain volunteers (23 females and 7 males), aged 28.63 ± 12.49 years, were randomly allocated to MT or to a motionless (LT) group. A single three-minute treatment session was delivered to each group’s cervico-thoracic area. The LT involved tactile sensory stimulation applied randomly to one out of a nine-block grid. Subjects were asked to identify the number of the square being touched, reflecting a different location on the region of skin. MT involved three-minute anteroposterior (AP) glides and sustained natural apophyseal glides (SNAG) techniques. Pre- and post-intervention pain intensity were assessed using a pressure pain threshold (PPT) algometer and the numeric pain rating scale (NPRS). Neck ROM was recorded with a bubble inclinometer. Improvements in ROM and self-reported pain were recorded in both groups (p < 0.001) without differences in NPRS, ROM or PPT scores between groups (p > 0.05). Tactile sensory training (localisation) was as effective as MT in reducing neck pain, suggesting a component of MT’s analgesic effect to be related with the element of localised touch rather than the forces induced during passive movements. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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14 pages, 3708 KiB  
Article
Instrument-Assisted Soft Tissue Mobilization Technique versus Static Stretching in Patients with Pronated Dominant Foot: A Comparison in Effectiveness on Flexibility, Foot Posture, Foot Function Index, and Dynamic Balance
by Ujjwal Gupta, Ankita Sharma, Moattar R. Rizvi, Mazen M. Alqahtani, Fuzail Ahmad, Faizan Z. Kashoo, Mohammad Miraj, Mohammad R. Asad, Shadab Uddin, Waseem M. Ahamed, Saravanakumar Nanjan, Sayed A. Hussain and Irshad Ahmad
Healthcare 2023, 11(6), 785; https://doi.org/10.3390/healthcare11060785 - 7 Mar 2023
Cited by 4 | Viewed by 2723
Abstract
Background: Pronated foot is a deformity with various degrees of physical impact. Patients with a pronated foot experience issues such as foot pain, ankle pain, heel pain, shin splints, impaired balance, plantar fasciitis, etc. Objective: The study intended to compare the effectiveness of [...] Read more.
Background: Pronated foot is a deformity with various degrees of physical impact. Patients with a pronated foot experience issues such as foot pain, ankle pain, heel pain, shin splints, impaired balance, plantar fasciitis, etc. Objective: The study intended to compare the effectiveness of IASTM (instrument-assisted soft tissue mobilization) and static stretching on ankle flexibility, foot posture, foot function, and balance in patients with a flexible pronated foot. Methods: Seventy-two participants between the ages of 18–25 years with a flexible pronated foot were included and allocated into three groups: Control, stretching, and IASTM group using single-blinded randomization. Range of motion (ROM) measuring ankle flexibility, foot posture index (FPI), foot function index (FFI), and dynamic balance was measured at baseline and after 4 weeks of intervention. Soft tissue mobilization was applied on to the IASTM group, while the stretching group was directed in static stretching of the gastrocnemius-soleus complex, tibialis anterior, and Achilles tendon in addition to the foot exercises. The control group received only foot exercises for 4 weeks. Results: The result shows the significant improvement of the right dominant foot in ROM plantar flexion, (F = 3.94, p = 0.03), dorsiflexion (F = 3.15, p = 0.05), inversion (F = 8.54, p = 0.001) and eversion (F = 5.93, p = 0.005), FFI (control vs. IASTM, mean difference (MD) = 5.9, p < 0.001), FPI (right foot, control vs. IASTM MD = 0.88, p = 0.004), and in dynamic balance of the right-leg stance (anterior, pre vs. post = 88.55 ± 2.28 vs. 94.65 ± 2.28; anteromedial, pre vs. post = 80.65 ± 2.3 vs. 85.55 ± 2.93; posterior, pre vs. post = 83 ± 3.52 vs. 87 ± 2.99 and lateral, pre vs. post = 73.2 ± 5.02 vs. 78.05 ± 4.29) in the IASTM group. The FFI was increased remarkably in the stretching group as compared to the control group. Conclusions: Myofascial release technique, i.e., IASTM with foot exercises, significantly improves flexibility, foot posture, foot function, and dynamic balance as compared to stretching, making it a choice of treatment for patients with a flexible pronated foot. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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7 pages, 1001 KiB  
Communication
Pain-Pressure Threshold Changes throughout Repeated Assessments with No Sex Related Differences
by Andreas Konrad, Kazuki Kasahara, Riku Yoshida, Yuta Murakami, Ryoma Koizumi and Masatoshi Nakamura
Healthcare 2023, 11(4), 475; https://doi.org/10.3390/healthcare11040475 - 7 Feb 2023
Cited by 1 | Viewed by 1443
Abstract
Algometers are commonly used to measure the pain-pressure threshold (PPT) in various tissues, such as muscle, tendons, or fascia. However, to date, it is not clear if the repeated application of a PPT assessment can adjust the pain thresholds of the various muscles. [...] Read more.
Algometers are commonly used to measure the pain-pressure threshold (PPT) in various tissues, such as muscle, tendons, or fascia. However, to date, it is not clear if the repeated application of a PPT assessment can adjust the pain thresholds of the various muscles. Therefore, the purpose of this study was to investigate the repeated application of PPT tests (20 times) in the elbow flexor, knee extensor, and ankle plantar flexor muscles in both sexes. In total, 30 volunteers (15 females, 15 males) were tested for their PPT using an algometer on the respective muscles in random order. We found no significant difference in the PPT between the sexes. Moreover, there was an increase in the PPT in the elbow flexors and knee extensors, starting with the eighth and ninth assessments (out of 20), respectively, compared to the second assessment. Additionally, there was a tendency to change between the first assessment and all the other assessments. In addition, there was no clinically relevant change for the ankle plantar flexor muscles. Consequently, we can recommend that between two and a maximum of seven PPT assessments should be applied so as not to overestimate the PPT. This is important information for further studies, as well as for clinical applications. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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14 pages, 1066 KiB  
Article
Comparative Effects of Mulligan’s Mobilization, Spinal Manipulation, and Conventional Massage Therapy in Cervicogenic Headache—A Prospective, Randomized, Controlled Trial
by Gopal Nambi, Mshari Alghadier, Elturabi Elsayed Ebrahim, Arul Vellaiyan, Jaya Shanker Tedla, Ravi Shankar Reddy, Venkata Nagaraj Kakaraparthi, Osama R. Aldhafian, Naif N. Alshahrani and Ayman K. Saleh
Healthcare 2023, 11(1), 107; https://doi.org/10.3390/healthcare11010107 - 29 Dec 2022
Cited by 4 | Viewed by 2714
Abstract
Background: There is ample evidence supporting the use of manual therapy techniques for the treatment of cervicogenic headache (CGH). Objective: The objective of this study was to find and compare the effects of different manual therapy approaches to cervicogenic headache. Methods: A randomized, [...] Read more.
Background: There is ample evidence supporting the use of manual therapy techniques for the treatment of cervicogenic headache (CGH). Objective: The objective of this study was to find and compare the effects of different manual therapy approaches to cervicogenic headache. Methods: A randomized, controlled study was conducted on 84 CGH participants at the university hospital. The participants were divided into a Mulligan mobilization therapy group (MMT; n = 28), a spinal manipulation therapy group (SMT; n = 28), and a control group (Control; n = 28); they received the respective treatments for four weeks. The primary outcome (CGH frequency) and secondary outcomes (CGH pain intensity, CGH disability, neck pain frequency, pain intensity, pain threshold, flexion rotation (right and left), neck disability index, and quality of life scores) were measured at baseline, after 4 weeks, after 8 weeks, and at a 6-month follow-up. The one-way ANOVA test and repeated measures analysis of variance (rANOVA) test were performed to find the difference between the inter- and intra-treatment group effects. Results: Four weeks following training, the MMT group showed a statistically significant difference in the primary (CGH frequency) and secondary (CGH pain intensity, CGH disability, neck pain frequency, neck pain intensity, flexion rotation test, neck disability index, and quality of life) scores than those of the SMT and control groups (p < 0.001). The same difference was seen in the above variables at 8 weeks and at the 6-month follow-up. At the same time, the neck pain threshold level did not show any difference at the 4-week and the 8-week follow-up (p ≥ 0.05) but showed statistical difference at the 6-month follow-up. Conclusion: The study concluded that Mulligan’s mobilization therapy provided better outcomes in cervicogenic headache than those of spinal manipulation therapy and conventional massage therapy. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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11 pages, 21503 KiB  
Article
Reliability and Validity of the Double Inclinometer Method for Assessing Thoracolumbar Joint Position Sense and Range of Movement in Patients with a Recent History of Low Back Pain
by Zacharias Dimitriadis, Ioannis Parintas, Georgios Karamitanis, Kiven Abdelmesseh, George A. Koumantakis and Alexandros Kastrinis
Healthcare 2023, 11(1), 105; https://doi.org/10.3390/healthcare11010105 - 29 Dec 2022
Cited by 2 | Viewed by 1896
Abstract
The study was aimed at examining the reliability of the Double Inclinometer (DI) method for the assessment of thoracolumbar Range of Movement (ROM) and Joint Position Sense (JPS) in patients with a recent history of Low Back Pain (LBP). Twenty patients with a [...] Read more.
The study was aimed at examining the reliability of the Double Inclinometer (DI) method for the assessment of thoracolumbar Range of Movement (ROM) and Joint Position Sense (JPS) in patients with a recent history of Low Back Pain (LBP). Twenty patients with a history of LBP in the last three months participated. The thoracolumbar ROM and JPS were examined from a standing position by using both the DI and the tape measure method. The DI method was found to have moderate to good intra-rater (ICC = 0.68–0.79, SEM = 2.20–2.77°, SDD = 6.09–7.67°), moderate inter-rater (ICC = 0.59–0.62, SEM = 2.96–3.35°, SDD = 8.19–9.27°) and poor test-retest reliability (ICC = 0.13–0.17, SEM = 3.98–4.32°, SDD = 11.02–11.96°) for the assessment of thoracolumbar JPS. For the assessment of thoracolumbar ROM, the DI method was found to have good to excellent intra-rater (ICC = 0.88–0.94, SEM = 4.25–6.20°, SDD = 11.77–17.17°), excellent inter-rater (ICC = 0.90–0.91, SEM = 7.26–7.74°, SDD = 20.11–21.43°) and excellent test-retest reliability (ICC = 0.91–0.93, SEM = 6.03–6.87°, SDD = 16.70–19.02°). The concurrent validity of the DI method with the tape measure method was found to be very weak for the assessment of thoracolumbar JPS (r = 0.02, p = 0.93) and strong for the assessment of thoracolumbar ROM (r = 0.66, p = 0.001). The DI method seems to be a very reliable method for the assessment of thoracolumbar ROM in individuals with a recent history of LBP. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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12 pages, 3149 KiB  
Article
Exercised-Induced Hypoalgesia following An Elbow Flexion Low-Load Resistance Exercise with Blood Flow Restriction: A Sham-Controlled Randomized Trial in Healthy Adults
by Stefanos Karanasios, Alexia Sozeri, George A. Koumantakis and George Gioftsos
Healthcare 2022, 10(12), 2557; https://doi.org/10.3390/healthcare10122557 - 16 Dec 2022
Cited by 5 | Viewed by 1800
Abstract
We aimed to evaluate the hypoalgesic effect of an elbow flexion low-load resistance exercise with blood flow restriction (LLRE–BFR) when compared to high-load resistance exercise (HLRE) with sham-BFR in healthy individuals. Forty healthy young adults (17 women), with a mean age ± SD: [...] Read more.
We aimed to evaluate the hypoalgesic effect of an elbow flexion low-load resistance exercise with blood flow restriction (LLRE–BFR) when compared to high-load resistance exercise (HLRE) with sham-BFR in healthy individuals. Forty healthy young adults (17 women), with a mean age ± SD: 26.6 ± 6.8 years, and mean body mass index ± SD: 23.6 ± 2.7 were randomly assigned to either an LLRE–BFR (30% 1 repetition maximum, RM) or an HLRE with sham-BFR group (70% of 1 RM). Blood pressure and pressure pain thresholds (PPTs) were measured pre- and post-exercise intervention. The rating of perceived exertion (RPE) was recorded after each set. There were non-significant between-group changes in PPT at the dominant biceps (−0.61, 95%CI: −1.92 to 0.68) with statistically significant reductions between pre- and post-exercise in LLRE–BFR (effect size, d = 0.88) and HLRE-BFR (effect size, d = 0.52). No within- or between-group differences were recorded in PPT at non-exercising sites of measurement. No mediating effects of changes in blood pressure or RPE on the changes in pressure pain threshold were observed. LLRE–BFR produced a similar hypoalgesic effect locally compared to HLRE and can be used as an alternative intervention to decrease pain sensitivity when HLRE is contraindicated or should be avoided. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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10 pages, 429 KiB  
Article
Cold-Water Immersion and Sports Massage Can Improve Pain Sensation but Not Functionality in Athletes with Delayed Onset Muscle Soreness
by Pavlos Angelopoulos, Anastasios Diakoronas, Dimitrios Panagiotopoulos, Maria Tsekoura, Panagiota Xaplanteri, Dimitra Koumoundourou, Farzaneh Saki, Evdokia Billis, Elias Tsepis and Konstantinos Fousekis
Healthcare 2022, 10(12), 2449; https://doi.org/10.3390/healthcare10122449 - 5 Dec 2022
Cited by 1 | Viewed by 3464
Abstract
This study aimed to investigate the effects of cold-water immersion (CWI) and sports massage on delayed-onset muscle soreness (DOMS) in amateur athletes. Sixty male amateur athletes were randomised into four equal groups (n = 15) receiving either CWI, sports massage, their combination, [...] Read more.
This study aimed to investigate the effects of cold-water immersion (CWI) and sports massage on delayed-onset muscle soreness (DOMS) in amateur athletes. Sixty male amateur athletes were randomised into four equal groups (n = 15) receiving either CWI, sports massage, their combination, or served as controls after applying plyometric training to their lower extremities. The main outcomes measures were pain, exertion, rectus femoris perimeter, knee flexion range of motion, knee extensors isometric strength and serum creatine phosphokinase (CPK) levels examined before the plyometric training, immediately after the treatment, and 24, 48 and 72 h post exercise. We observed no significant differences between study groups in the most tested variables. CWI improved pain compared to the combined application of CWI and sports massage, and the control group both on the second and third day post exercise. Sports massage combined with CWI also led to a significant reduction in pain sensation compared to the control group. In conclusion the treatment interventions used were effective in reducing pain but were unable to affect other important adaptations of DOMS. Based on the above, sports scientists should reconsider the wide use of these interventions as a recovery strategy for athletes with DOMS. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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9 pages, 820 KiB  
Article
Can Exercise Affect the Pain Characteristics in Patients with Fibromyalgia? A Randomized Controlled Trial
by Sotiria Vrouva, Varvara Sopidou, Evangelia Koutsioumpa, Konstantinos Chanopoulos, Alexandra Nikolopoulou, Vasileios Papatsimpas and George A. Koumantakis
Healthcare 2022, 10(12), 2426; https://doi.org/10.3390/healthcare10122426 - 30 Nov 2022
Cited by 3 | Viewed by 1499
Abstract
Exercise is often recommended for fibromyalgia. The aim of this study was to investigate the possible influence and change in the pain characteristics of fibromyalgia patients when breathing exercises were added to their exercise program. A total of 106 patients were included and [...] Read more.
Exercise is often recommended for fibromyalgia. The aim of this study was to investigate the possible influence and change in the pain characteristics of fibromyalgia patients when breathing exercises were added to their exercise program. A total of 106 patients were included and randomly divided into two groups. Τhe first group of patients followed a program of active exercises up to the limits of pain, lasting 30 min with a repetition of two times a week. Patients of the second group followed the same program with the addition of diaphragmatic breaths when they reached the pain limit. The patients completed three questionnaires: the Fibromyalgia Rapid Screening Tool (FiRST), the Brief Pain Inventory (BPI), and the Pain Quality Assessment Scale (PQAS)—once at the beginning, once again after three weeks of exercise, and again 3 months since the beginning of the program. Independent t-tests for the mean total change scores in pain scales demonstrated that for the second group there was a greater improvement in all pain scales, except for the PQAS Deep Pain subscale (p = 0.38). In conclusion, both groups showed significant improvement in all characteristics of the pain scales; however, the improvement of the second group was significantly higher. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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14 pages, 326 KiB  
Article
In the Shoulder or in the Brain? Behavioral, Psychosocial and Cognitive Characteristics of Unilateral Chronic Shoulder Pain with Symptoms of Central Sensitization
by Paraskevi Bilika, Jo Nijs, Emmanouil Fandridis, Zacharias Dimitriadis, Nikolaos Strimpakos and Eleni Kapreli
Healthcare 2022, 10(9), 1658; https://doi.org/10.3390/healthcare10091658 - 30 Aug 2022
Cited by 6 | Viewed by 2937
Abstract
The recognition of central sensitization (CS) is crucial, as it determines the results of rehabilitation. The aim of this study was to examine associations between CS and catastrophizing, functionality, disability, illness perceptions, kinesiophobia, anxiety, and depression in people with chronic shoulder pain (SP). [...] Read more.
The recognition of central sensitization (CS) is crucial, as it determines the results of rehabilitation. The aim of this study was to examine associations between CS and catastrophizing, functionality, disability, illness perceptions, kinesiophobia, anxiety, and depression in people with chronic shoulder pain (SP). In this cross-sectional study, 64 patients with unilateral chronic SP completed a few questionnaires including the Central Sensitization Inventory, the Oxford Shoulder Score, the Tampa Scale for Kinesiophobia, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale, the Brief Illness Perception Questionnaire and the “arm endurance” test. On the basis of three constructed linear regression models, it was found that pain catastrophizing and depression (model 1: p < 0.001, R = 0.57, R2 = 0.33), functionality (model 2: p < 0.001, R = 0.50, R2 = 0.25), and helplessness (model 3: p < 0.001, R = 0.53, R2 = 0.28) were significant predictors for CS symptoms in chronic SP. Two additional logistic regression models also showed that depression (model 4: p < 0.001, Nagelkerke R2 = 0.43, overall correct prediction 87.5%) and functionality (model 5: p < 0.001, Nagelkerke R2 = 0.26, overall correct prediction 84.4%) can significantly predict the classification of chronic SP as centrally sensitized. Patients who were classified as centrally sensitized (n = 10) were found to have significantly worse functionality, psychological factors (anxiety, depression, kinesiophobia, catastrophizing), and pain intensity (p < 0.05). Catastrophizing, depression, and functionality are predictive factors of CS symptoms in patients with chronic shoulder pain. Health care providers should adopt a precision medicine approach during assessment and a holistic rehabilitation of patients with unilateral chronic SP. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
10 pages, 1795 KiB  
Article
Immediate Effects of Stabilization Exercises on Trunk Muscle Activity during Jump Header Shooting: A Pilot Study
by Chie Sekine, Kazusa Saisu, Ryo Hirabayashi, Hirotake Yokota, Haruna Hayashi, Tomoya Takabayashi and Mutsuaki Edama
Healthcare 2022, 10(7), 1272; https://doi.org/10.3390/healthcare10071272 - 9 Jul 2022
Viewed by 1294
Abstract
This study aimed to clarify trunk muscle activity during jump header shooting and examine the immediate effects of trunk stabilization exercises on trunk muscle activity. Nineteen males who had played soccer for over 5 years were assigned to either the trunk stabilization exercise [...] Read more.
This study aimed to clarify trunk muscle activity during jump header shooting and examine the immediate effects of trunk stabilization exercises on trunk muscle activity. Nineteen males who had played soccer for over 5 years were assigned to either the trunk stabilization exercise group or the control group. Muscle activity during jump header shooting was measured before and after intervention. The intervention in the trunk stabilization exercise group was trunk muscle training, whereas that in the control group was sitting. The phases of jump header shooting and the effects of the interventions were compared. In pre-intervention measurements, the internal oblique activity during the push-off phase and early floating phase was significantly greater than that during the late floating phase (p < 0.01667). In pre-intervention measurements, the muscle activity of the internal oblique increased from the push-off phase, prior to the increase in muscle activity of the rectus abdominis and external oblique, whereas the muscle activity of all abdominal muscles increased immediately after take-off. The trunk stabilization exercise intervention decreased the muscle activity of the erector spinae (p < 0.05). There seems to be a certain activation sequence in the abdominals during jump header shooting, and a single application of stabilization exercises could possibly reduce the activation of the back muscles. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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Review

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11 pages, 546 KiB  
Review
The Effect of Physiotherapy Interventions in the Workplace through Active Micro-Break Activities for Employees with Standing and Sedentary Work
by Stergios Vitoulas, Vasileios Konstantis, Irene Drizi, Sotiria Vrouva, George A. Koumantakis and Vasiliki Sakellari
Healthcare 2022, 10(10), 2073; https://doi.org/10.3390/healthcare10102073 - 18 Oct 2022
Cited by 2 | Viewed by 5094
Abstract
Workers worldwide experience a range of occupational musculoskeletal disorders that affect both the functionality of many parts of their body and their overall performance. Physiotherapists provide counseling and treatment programs during work. Recently, physiotherapy interventions have been introduced during work breaks. This study [...] Read more.
Workers worldwide experience a range of occupational musculoskeletal disorders that affect both the functionality of many parts of their body and their overall performance. Physiotherapists provide counseling and treatment programs during work. Recently, physiotherapy interventions have been introduced during work breaks. This study aimed to investigate the value of different types of workplace-based exercise programs administered during work breaks and compare them with counseling methods. Electronic searches were performed in relevant databases by keywords such as: workplace, musculoskeletal disorders, sedentary, standing, employees, micro-breaks, exercise interventions, and ergonomics. Initially, 706 articles were identified. An article sorting procedure was employed by two independent researchers, based on the inclusion and exclusion criteria set for this study, and after the removal of non-relevant articles (n = 391) or duplicates (n = 300), 15 randomized controlled trials (RCTs) remained for qualitative analysis. The methodological quality of the 13 RCTs was performed using the PEDro scale. No risk of bias evaluation was made. The findings suggested that active micro-breaks that contained various exercise programs including stretching, strengthening, torso stabilization, and ergonomic interventions were more beneficial than passive micro-breaks, reducing pain and the feeling of fatigue and increasing employees’ mood. It is concluded that micro-breaks are beneficial to employees with either orthostatic or sedentary work. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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13 pages, 417 KiB  
Systematic Review
A Systematic Review of the Aerobic Exercise Program Variables for Patients with Non-Specific Neck Pain: Effectiveness and Clinical Applications
by Eleftherios Paraskevopoulos, George A. Koumantakis and Maria Papandreou
Healthcare 2023, 11(3), 339; https://doi.org/10.3390/healthcare11030339 - 24 Jan 2023
Cited by 2 | Viewed by 2059
Abstract
Studies have shown that aerobic exercise (AE) may improve symptoms related to non-specific neck pain (NNP); however, the variables of the exercise programs and the overall effectiveness of AE have not been evaluated in a systematic review. Therefore, this review aimed to describe [...] Read more.
Studies have shown that aerobic exercise (AE) may improve symptoms related to non-specific neck pain (NNP); however, the variables of the exercise programs and the overall effectiveness of AE have not been evaluated in a systematic review. Therefore, this review aimed to describe and discuss the variables of the AE programs used in clinical trials for patients with NNP. Included studies were analyzed for the selected AE variables such as intensity, frequency, duration, delivery, supervision, and adherence. The PEDro scale was used to assess the methodological quality of the studies. From the literature search, six studies met the inclusion criteria and were evaluated. After reviewing all the included studies, it was found that a range of AE interventions were used such as cycling, brisk walking, aerobics, stationary bike, treadmill running, circuit training, and swimming. Further, the duration was between 30 and 45 min for each session, with or without progressive increases from week to week. The intervention periods ranged from 1 month to 6 months in duration. Most studies used AE three times per week. Furthermore, exercise intensity was measured with either subjective (BORG) or objective measures (heartrate reserve). Justification for the specified intensity and reporting of adverse events was reported only in two studies and differed between studies. Exercise interventions were poorly reported. This review showed that moderate-intensity AE undertaken three times per week, in patients with NNP, may be beneficial for pain and function; however, the development of reporting standards is essential for the successful replication of studies. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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11 pages, 578 KiB  
Systematic Review
The Effects of Motor Imagery on Pain in Lower Limb Sports Injuries: A Systematic Review and Meta-Analysis
by George Plakoutsis, Eleftherios Paraskevopoulos, Athanasios Zavvos and Maria Papandreou
Healthcare 2022, 10(12), 2545; https://doi.org/10.3390/healthcare10122545 - 15 Dec 2022
Cited by 1 | Viewed by 1823
Abstract
This review evaluated the efficacy of Motor Imagery intervention in athletes with lower limb sports injuries that could affect their pain levels during rehabilitation. We carried out a thorough research of the scientific literature for RCT studies in athletes with lower limb musculoskeletal [...] Read more.
This review evaluated the efficacy of Motor Imagery intervention in athletes with lower limb sports injuries that could affect their pain levels during rehabilitation. We carried out a thorough research of the scientific literature for RCT studies in athletes with lower limb musculoskeletal sports injuries including search terms Motor Imagery AND pain, Motor Imagery AND sport injuries, Motor Imagery AND lower limb. We searched 3 major databases, PubMed, Scopus, and ScienceDirect, with the search period ranging from their inception until May 2022. We assessed the quality of the studies using the PEDro Scale and the data was recorded and extracted with the use of Mendeley software. The search criteria resulted in a pool of 10.107 possible articles. Upon completion of the selection procedure, only 3 RCT studies met the inclusion criteria with a total of 60 injured athletes (n = 18 with ankle sprain and n = 42 with ACL injuries). The meta-analysis showed no statistically significant positive effects of MI intervention on pain intensity after lower limb sports injuries (n = 60; MD = −1.57; 95% CI: −3.60 to 0.46; I2 = 50%; p = 0.13). The limited number of studies could justify the statistically insignificant effect of MI, but although the methodological quality of the studies was moderate to high, the heterogeneity of them was also relatively high. More RCT’s are required to explore the effect of MI on pain in athletes with lower limb injuries in order to address psychophysiological processes during rehabilitation. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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12 pages, 1302 KiB  
Case Report
Ultrasound-Guided Injections and Proprioceptive Neuromuscular Facilitation as Shoulder Rehabilitation for Multiple Sclerosis and Neuropathic Pain
by Alessandro de Sire, Lucrezia Moggio, Nicola Marotta, Francesco Fortunato, Renata Spalek, Maria Teresa Inzitari, Teresa Paolucci and Antonio Ammendolia
Healthcare 2022, 10(10), 1869; https://doi.org/10.3390/healthcare10101869 - 25 Sep 2022
Cited by 3 | Viewed by 2682
Abstract
Multiple sclerosis (MS) represents a major cause of chronic neurological disability in young adults and can result in upper limb sensorimotor impairment with a huge impact on manual dexterity and activities of daily living. Moreover, pain is common in MS and a large [...] Read more.
Multiple sclerosis (MS) represents a major cause of chronic neurological disability in young adults and can result in upper limb sensorimotor impairment with a huge impact on manual dexterity and activities of daily living. Moreover, pain is common in MS and a large proportion of patients suffer from central neuropathic pain. To date, no rehabilitative treatment has been described as useful for these patients. A 46-year-old woman, affected by relapsing-remittent MS, described a one-year history of right shoulder pain (Visual Analogue Scale = 8) that started gradually and without trauma. The patient also presented balance and gait impairments, upper limb strength deficit, and fatigue (Expanded Disability Status Scale = 5.5). A multidisciplinary treatment was proposed, including three intra-articular corticosteroid injections and one month of manual therapy, three sessions/week, based on proprioceptive neuromuscular facilitation for the upper limb. At the end of the rehabilitative treatment, pain relief and an improvement in the range of motion of the affected shoulder, upper limb muscle strength, and hand dexterity were observed. The present paradigmatic case report with literature review demonstrated that a multidisciplinary approach seems to be effective in pain relief in a patient with central neuropathic shoulder pain and relapsing-remitting MS. Full article
(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)
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