The Comparison of The Effectiveness of Physical And Electrotherapy Modalities Versus Home Exercises

Program on Frozen Shoulder

Aim

In addition to exercise, physical and electrotherapy modalities such as hotpack, ultrasound and TENS is
often applied on frozen shoulder rehabilitation in clinics. The aim of this study was to compare the
effectiveness of electrotherapy modalities versus home exercises program in addition to standard
physical therapy in both groups on frozen shoulder rehabilitation.

Methods

24 patients diagnosed with frozen shoulder were included in this study. Patients were randomly
assigned to Group I (Standard program + electrotherapy, n = 12) and Group II (standard program + home
exercise program, n = 12). Standard program consisted of shoulder joint mobilization and shoulder
muscles.stretching and strengthening exercises (30 minutes). In addition to this program, Group 1
received Hotpack, ultrasound and TENS for 30 minutes. Group II was given a 30-minute home program
including Wand exercises, isometric strengthening and self stretching exercises in addition to standart
program. Treatment was applied five day a week for 3 weeks. Patients level of pain, functional state,
level of depression and sleep quality evaluated before and after treatment by the Visual Analogue Scale
(VAS), the Disabilities of the Arm, Shoulder and Hand (DASH), the Beck Depression Inventory (BDI) and
the Pittsburgh Sleep Quality Index (PSQI) respectively. The data were analyzed using the SPSS 20.0
software. The intra-group variations were analyzed using Wilcoxon's signed-rank test, while inter-group
comparisons were drawn using the Mann-Whitney U-test.

Result

Study was completed total 22 patients (mean age: 55.2 ± 10.4 years; BMI = 27.7 ± 3.9 kg / m2, 15
women) Group I (n = 12) and Group II (n = 10). VAS-resting (p = 0.011; p = 0.015), VAS-activity (p = 0.005;
p = 0.002), BDI (p = 0.012; p = 0.004) and the DASH (p = 0.005 and p = 0004) found a statistically
significant improvement in both intra-group change. VAS-night (p = 0.039) and sleep quality (p = 0.047)
was found a significant improvement only in Group I. But there was no statistically significant difference
between the groups in any parameter (p> 0.05).

Conclusion

However VAS-night and sleep quality improved in electrotherapy in terms of intra group change, there
was no significant difference between the groups in any parameter. Therefore, we believe that the
choice of home exercise program applied in addition to the exercise programwould be more
advantageous in terms of cost-effectiveness and time instead of electrotherapy modalities.
Effect of Physiotherapy Treatment on Frozen Shoulder: a Case Study2

ABSTRACT

Objective: To determine the effectiveness of physiotherapy management in patients with frozen

shoulder.

Materials and Method: A rehabilitation protocol was followed to treat diagnosed frozen shoulder
patient.

Result: In this study, Reduction in pain, improvement in range of motion and able to do activities of daily
living after giving physiotherapy management.

Conclusion: this study concluded that Various therapeutic techniques like hot packs, ultrasound,
capsular stretches, strengthening exercises and home regime have a significant effect in reducing pain,
increasing range of motion and stiffness of joints in frozen shoulder.2

Effect of a physiotherapy rehabilitation program on knee osteoarthritis in patients with different pain
intensities2

Abstract. [Purpose] To examine the effect of physiotherapy rehabilitation program on moderate knee
osteoarthritis in patients with different pain intensities. [Subjects and Methods] Sixty subjects (37 men
and 23 women) with moderate knee osteoarthritis participated in the current study. Randomization
software was used to select the participating subjects’ numbers from the clinic records. They were
classified into three groups according to pain intensity: mild, moderate, and severe pain groups. All
groups underwent a standard set of pulsed electromagnetic field, ultrasound, stretching exercises, and
strengthening exercises. Pain intensity, knee range of motion, knee function, and isometric quadriceps
strength were evaluated using the visual analogue scale, universal goniometer, Western Ontario and
McMaster Universities osteoarthritis index, and Jamar hydraulic dynamometer, respectively. The
evaluation was performed before and after a 4-week rehabilitation program. [Results] All groups
showed significant differences in pain intensity, knee range of motion, isometric quadriceps strength,
and knee function. The score change in moderate pain group was significantly greater than those in mild
and severe pain groups. [Conclusion] Pain intensity is one of the prominent factors that are responsible
for the improvement of knee osteoarthritis. Consequently, pain intensity should be considered during
rehabilitation of knee osteoarthritis.2

The effect of exercise therapy on knee osteoarthritis: a randomized clinical trial2

Abstract

Background: Knee osteoarthritis (OA) is the most common musculoskeletal disease among old
individuals which affects ability for sitting on the chair, standing, walking and climbing stairs. Our
objective was to investigate the short and long-term effects of the most simple and the least expensive
exercise protocols in combination to conventional conservative therapy for knee OA.

Methods: It was a single blind RCT study with a 12-months follow-up. Totally, 56 patients with knee OA
were assigned into 2 random groups. The patients in exercise group received exercise for knee muscles
in combination with non-steroid anti-inflammatory drugs (NSAIDs) and 10 sessions acupuncture and
physiotherapy modalities. Non-exercise group received similar treatments except exercise program. The
changes in patients’ pain and functional status were evaluated by visual analog scale (VAS), knee and
osteoarthritis outcome score (KOOS) questionnaire and functional tests (4 steps, 5 sit up, and 6 min walk
test) before and after treatment (1 and 3 months after intervention), and 1 year later at the follow-up.

Results: The results showed that the patients with knee OA in exercise group had significant
improvement in pain, disability, walking, stair climbing, and sit up speed after treatment at first and
second follow-up when compared with their initial status and when compared with non-exercise group.
At third follow up (1 year later) there was significant difference between groups in VAS and in three
items of KOOS questionnaire in functional status.

Conclusion: Non aerobic exercises for muscles around knee can augment the effect of other therapeutic
interventions like medical therapy, acupuncture, and modalities for knee OA.

Effectiveness of physical therapy interventions for low back pain targeting the low back only or low
back plus hips: a randomized controlled trial protocol3

Abstract

Background: Recent evidence suggests that physical therapy interventions targeting the hips may
improve outcomes, including pain and disability, for patients with low back pain (LBP). Currently, there is
conflicting data in regard to whether an individual with LBP needs to have a concurrent hip impairment
in order to respond to this approach. The purpose of this clinical trial will be to determine the short and
long-term effectiveness of physical therapy interventions directed at the lumbar spine only, versus
lumbar spine and hip(s), in individuals with a primary complaint of LBP with a concurrent hip
impairment.

Methods: A multi-center, randomized controlled trial of 76 adult individuals with a primary complaint of
LBP, who also have at least one concurrent hip impairment. Participants will be randomized into the
‘LBP only’ or ‘LBP + Hip’ group. Treatment to the low back in both groups will be a pragmatic approach
consisting of interventions targeting the low back withouttargeting the hip(s). Participants randomized
to the LBP + Hip group will also receive a semi-prescriptive set of manual therapy and exercise
techniques that target the hips. The primary outcome measures will be the modified Oswestry Disability
Index and the Numeric Pain Rating Scale at discharge.3

Chronic low back pain and postural rehabilitation exercise: a literature review3
Abstract: Chronic low back represents one of the major causes of disability worldwide. Our narrative
review has the purpose of highlighting the evidence supporting the different rehabilitative techniques
described for its management. In total, 26 studies were found suitable to be included in the review (14
articles about pilates, six about McKenzie (MK), one article about Feldenkrais, three about Global
Postural Rehabilitation (GPR) and two about Proprioceptive Neuromuscular Facilitation). The effect of
exercise therapy was examined for each single study through changes in the main clinical outcomes
(pain, disability,) quality of life (QoL) and psychological aspects and the targeted aspects of physical
function (muscle strength, mobility, muscular activity and flexibility). All the techniques are effective for
the study groups with respect to the control groups in reducing pain and disability and improving the
QoL and maintaining benefits at follow-up; pilates, Back School, MK and Feldenkrais methods reduce
pain and are more efficient than a pharmacological or instrumental approach in reducing disability and
improving all psychological aspects also. GPR shows long lasting results for the last outcome. To date, it
is difficult to affirm the superiority of one approach over another. Further high quality research is
needed to confirm the effect of these techniques, together with the use of more appropriate evaluation
measures.4