Research Articles

Intramuscular Stimulation (IMS) Research Articles

Intramuscular Stimulation (IMS) of Motor Muscle Points in the Treatment of Chronic Low Back Pain: A Randomized Clinical Trial

Torticollis: A Graphic Presentation of Intramuscular Stimulation (IMS) Treatment Course

Treating Whiplash and Whiplash Associated Disorders (WAD) with Intramuscular Stimulation (IMS)

What is IMS Acupuncture? Intramuscular Stimulation vs. Traditional Acupuncture

Why Things Hurt: Explain Pain with IMS

Evidence for the Use of Ischemic Compression and Dry Needling in the Management of Trigger Points of the Upper Trapezius in Patients with Neck Pain: A Systematic Review

Vestibular,Dizziness, Vertigo Research Articles

Vestibular system anatomy, vascularization, and physiology with clinical implications

Chronic Pain Articles

Alternative Treatment may Tame Chronic Pain

A Neural Model for Chronic Pain and Pain Relief by Extracorporeal Shock Wave Treatment

Physical Therapy Treatment Effectiveness for Osteoarthritis of the Knee: A Randomized Comparison of Supervised Clinical Exercise and Manual Therapy Versus a Home exercise Program

Manual Therapy, Exercise Therapy, or both, in Addition to Usual Care for osteoarthritis of the hip or knee: a Randomised Controlled Trial

Role of Physical Therapy in the Management of Knee Osteoarthritis

Predictors of Response to Physiotherapy Intervention in Patients with Primary Hip Osteoarthritis

Comparison of Manual Therapy and Exercise Therapy in Osteoarthritis of the Hip

Women’s Health Research Article Abstracts

Pelvic Floor muscle training versus no treatment for urinary incontinence in women

Dumoulin C, Hay-Smith J. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD005654. DOI: 10.1002/14651858.CD005654.pub2. Published Online: January 20, 2010. Stress incontinence is the involuntary leakage of urine with a physical activity such as coughing or sneezing and can happen if the pelvic floor muscles are weak. Urge leakage occurs with a strong need to urinate, but the person cannot make it to the toilet in time and is caused by an involuntary contraction of the bladder muscle. A combination of stress and urge leakage is called mixed incontinence. The review of trials found that pelvic floor muscle training (muscle-clenching exercises) helps women with all types of incontinence although women with stress incontinence who exercise for three months or more benefit most. Background: Pelvic floor muscle training is the most commonly used physical therapy treatment for women with stress urinary incontinence. It is sometimes recommended for mixed and less commonly urge urinary incontinence. Objectives: To determine the effects of pelvic floor muscle training for women with urinary incontinence in comparison to no treatment, placebo or sham treatments, or other inactive control treatments. Search strategy: The Cochrane Incontinence Group Specialised Trials Register (searched 18 February 2009) and the reference lists of relevant articles were searched. Selection criteria: Randomised or quasi-randomised trials in women with stress, urge or mixed urinary incontinence (based on symptoms, signs, or urodynamics). One arm of the trial included pelvic floor muscle training (PFMT). Another arm was a no treatment, placebo, sham, or other inactive control treatment arm. Data collection and analysis: Trials were independently assessed for eligibility and methodological quality. Data were extracted then cross-checked. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook (Higgins 2008). Trials were subgrouped by diagnosis. Formal meta-analysis was not undertaken because of study heterogeneity. Main results: Fourteen trials involving 836 women (435 PFMT, 401 controls) met the inclusion criteria; twelve trials (672) contributed data to the analysis. Many studies were at moderate to high risk of bias, based on the trial reports. There was considerable variation in interventions used, study populations, and outcome measures. Women who did PFMT were more likely to report they were cured or improved than women who did not. Women who did PFMT also reported better continence specific quality of life than women who did not. PFMT women also experienced fewer incontinence episodes per day and less leakage on short office-based pad test. Of the few adverse effects reported, none were serious. The trials in stress urinary incontinent women which suggested greater benefit recommended a longer training period than the one trial in women with detrusor overactivity (urge) incontinence. Authors’ conclusions: The review provides support for the widespread recommendation that PFMT be included in first-line conservative management programmes for women with stress, urge, or mixed, urinary incontinence. Statistical heterogeneity reflecting variation in incontinence type, training, and outcome measurement made interpretation difficult. The treatment effect seems greater in women with stress urinary incontinence alone, who participate in a supervised PFMT programme for at least three months, but these and other uncertainties require testing in further trials.

Randomized multicenter clinical trial of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome and pelvic floor tenderness.

J Urol. 2012 Jun;187(6):2113-8. doi: 10.1016/j.juro.2012.01.123. Epub 2012 Apr 12. FitzGerald MP, Payne CK, Lukacz ES, Yang CC, Peters KM, Chai TC, Nickel JC, Hanno PM, Kreder KJ, Burks DA, Mayer R, Kotarinos R, Fortman C, Allen TM, Fraser L, Mason-Cover M, Furey C, Odabachian L, Sanfield A, Chu J, Huestis K, Tata GE, Dugan N, Sheth H, Bewyer K, Anaeme A, Newton K, Featherstone W, Halle-Podell R, Cen L, Landis JR, Propert KJ, Foster HE Jr, Kusek JW, Nyberg LM; Interstitial Cystitis Collaborative Research Network. Source Loyola University Medical Center, Maywood, Illinois, USA. mary.fitzgerald6@va.gov Abstract PURPOSE: We determined the efficacy and safety of pelvic floor myofascial physical therapy compared to global therapeutic massage in women with newly symptomatic interstitial cystitis/painful bladder syndrome. MATERIALS AND METHODS: A randomized controlled trial of 10 scheduled treatments of myofascial physical therapy vs global therapeutic massage was performed at 11 clinical centers in North America. We recruited women with interstitial cystitis/painful bladder syndrome with demonstrable pelvic floor tenderness on physical examination and a limitation of no more than 3 years’ symptom duration. The primary outcome was the proportion of responders defined as moderately improved or markedly improved in overall symptoms compared to baseline on a 7-point global response assessment scale. Secondary outcomes included ratings for pain, urgency and frequency, the O’Leary-Sant IC Symptom and Problem Index, and reports of adverse events. We compared response rates between treatment arms using the exact conditional version of the Mantel-Haenszel test to control for clustering by clinical center. For secondary efficacy outcomes cross-sectional descriptive statistics and changes from baseline were calculated. RESULTS: A total of 81 women randomized to the 2 treatment groups had similar symptoms at baseline. The global response assessment response rate was 26% in the global therapeutic massage group and 59% in the myofascial physical therapy group (p=0.0012). Pain, urgency and frequency ratings, and O’Leary-Sant IC Symptom and Problem Index decreased in both groups during followup, and were not significantly different between the groups. Pain was the most common adverse event, occurring at similar rates in both groups. No serious adverse events were reported. CONCLUSIONS: A significantly higher proportion of women with interstitial cystitis/painful bladder syndrome responded to treatment with myofascial physical therapy than to global therapeutic massage. Myofascial physical therapy may be a beneficial therapy in women with this syndrome. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved. PMID: 22503015 [PubMed – in process] PMCID: PMC3351550 Free PMC Article   J Orthop Sports Phys Ther. 2006 Dec;36(12):920-5.

The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects.

Author information:Van K1, Hides JA, Richardson CA. Abstract STUDY DESIGN: Randomized controlled trial. OBJECTIVE: To determine if the provision of visual biofeedback using real-time ultrasound imaging enhances the ability to activate the multifidus muscle. BACKGROUND: Increasingly clinicians are using real-time ultrasound as a form of biofeedback when re-educating muscle activation. The effectiveness of this form of biofeedback for the multifidus muscle has not been reported. METHODS AND MEASURES: Healthy subjects were randomly divided into groups that received different forms of biofeedback. All subjects received clinical instruction on how to activate the multifidus muscle isometrically prior to testing and verbal feedback regarding the amount of multifidus contraction, which occurred during 10 repetitions (acquisition phase). In addition, 1 group received visual biofeedback (watched the multifidus muscle contract) using real-time ultrasound imaging. All subjects were reassessed a week later (retention phase). RESULTS: Subjects from both groups improved their voluntary contraction of the multifidus muscle in the acquisition phase (P<.001) and the ability to recruit the multifidus muscle differed between groups (P<.05), with subjects in the group that received visual ultrasound biofeedback achieving greater improvements. In addition, the group that received visual ultrasound biofeedback retained their improvement in performance from week 1 to week 2 (P>.90), whereas the performance of the other group decreased (P<.05). CONCLUSION: Real-time ultrasound imaging can be used to provide visual biofeedback and improve performance and retention in the ability to activate the multifidus muscle in healthy subjects. Short-Term Physical Therapy Treatment for Female Urinary Incontinence: a quality of Life Evaluation

The effects of pilates mat exercise on the balance ability of elderly females.

Author information: Hyun J1, Hwangbo K2, Lee CW1.   J Phys Ther Sci. 2014 Feb;26(2):291-3. doi: 10.1589/jpts.26.291. Epub 2014 Feb 28., Department of Rehabilitation Science, Graduate School, Daegu University, Republic of Korea., Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea. Abstract Purpose: The purpose of this study was to examine the effects of Pilates exercise on a mat and balance exercise on an unstable base of support for trunk stability on the balance ability of elderly females. Subjects and Methods: Forty elderly women aged 65 or older were equally assigned to a Pilates mat exercise (PME) group and an unstable support surface exercise (USSE) group. They conducted exercise three times per week for 12 weeks for 40 minutes each time. In order to examine balance, sway length and the speed of the center of foot pressure were measured for one minute, and in order to examine dynamic balance, the Timed Up and Go (TUG) test was conducted. [Results] After the intervention, sway length, sway speed, and TUG significantly decreased in both groups. A comparison of sway speed after the intervention between the two groups revealed that the PME group showed larger decreases than the USSE group. Conclusion: PME and USSE elicited significant effects on the static and dynamic balance of elderly female subjects, suggesting that those exercises are effective at enhancing the balance ability of this group of subjects. However, the Pilates mat exercise is regarded as being safer than exercise on an unstable base of support. KEYWORDS: Elderly females; Pilates mat exercise; Unstable support surface exercise. Free PMC Article

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