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Iqbal, Amir
- Efficacy of Electromyography Biofeedback Training on Trunk Stability in Chronic Low Back Pain
Authors
1 Department of Physiotherapy, Taneja Hospital, Preet Vihar, Delhi, IN
2 Faculty of Applied Medical Sciences, Jazan
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 7, No 3 (2013), Pagination: 81-86Abstract
Objectives: The purpose of this study was to investigate the effect of trunk stabilization exercise using a gym ball with or without electromyography biofeedback for people with chronic low back pain.Design: Pretest-posttest Experimental - control group design.
Method: 30 subjects were randomly assigned into two groups. Experimental group received trunk stabilization exercise along with the electromyography biofeedback whereas control group received trunk stabilization exercise without electromyography biofeedback. Endurance and Pain was measured at 0 week, 2nd week, 4th week and 6th week.
Results: Trunk stabilization exercise along with Electromyography biofeedback significantly improves the endurance and reduces pain. /
Conclusion: from the result we may conclude that trunk stabilization exercise along with the electromyography biofeedback is more effective than trunk stabilization exercise without electromyography biofeedback in rehabilitation of patient with chronic low back pain.
Keywords
Trunk Stabilization Exercise, Electromyography Biofeedback, Endurance, Pain
References
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- Middaugh SJ, Kee WG. Advances in electromyographic monitoring and biofeedback in the treatment of chronic cervical and low back pain. Adv Clin Rehabil. 1987; 1:137-172.
- Neblett R, Gatchel RJ, Mayer TG. A clinical guide to surface-EMG-assisted stretching as an adjunct to chronic musculoskeletal pain rehabilitation. Appl Psychophysiol Biofeedback. 2003; 28(2):147-610.
- Arokoski JP, Valta T, Airaksinen O et al (2001) Back and abdominal muscle function during stabilization exercises. Arch Phys Med Rehabil 82:1089–1098
- Silfies SP, Maurer P et al (2005) Trunk muscle recruitment patterns in specific chronic low back pain populations. Clin Biomech 20:465–473
- Moffroid MT. Endurance of trunk muscles in persons with chronic low back pain: assessment, performance, and training. Journal of Rehab. Research and Development 2006: vol.34, no.4, oct- 1997, page 440-52.
- Greiwe J S, Holloszy JO et al Exercise induced lipoprotein lipase and GLUT-4 protein in muscle, independent of adrenergic receptor signalling. Journal of applied physiology 2000; 89:1:176-181
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- Efficacy of Muscle Energy Technique in Combination with Strain-counterstrain Technique on Deactivation of Trigger Point Pain
Authors
1 Department of Physiotherapy, Taneja Hospital, Preet Vihar, Delhi, IN
2 Department of Physiotherapy, Shreya Hospital, Shalimar Garden Extension, Ghaziabad, U.P, IN
3 Faculty of Applied Medical Sciences, Jazan University, KSA, AE
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 7, No 3 (2013), Pagination: 118-123Abstract
Objective: To establish the best possible long term effective choice of treatment program for deactivating MTrP's by using the combination of muscle energy technique with strain-counterstrain techniqueDesign: Pretest-Posttest control group design Setting: Outpatient physiotherapy department, Taneja Hospital, Preet Vihar New Delhi.
Patients: Fourty five subjects (only male) with Myofascial Trigger Points Pain. Subjects were randomly placed into three groups: Experimental group A (n=15), Experimental group B (n=15) and a Control group C (n=15).
Intervention: The experimental group A received muscle energy technique in combination with straincounterstrain technique and experimental group B received muscle energy technique alone whereas control group received conventional treatment only.
Main Outcome Measures: Pain pressure threshold was assessed with the pressure threshold meter (PTM). Pain and functional status of the patients were measured by a visual analogue scale (VAS) and the Neck Disability Index scores respectively.
Results: Within group analysis revealed significant improvement in pain pressure threshold, functional status and reduction in pain intensity in all groups. Between group analysis revealed significant difference between group A, group B and group C. Further post hoc analysis revealed significant difference between group A and B, group A and C and group B and C for all variables even after one week of follow up after the termination of intervention.
Conclusion: The combination of muscle energy technique with strain-counterstrain has been shown to produce greater improvement in pain pressure threshold on pressure threshold meter, function status on neck disability index scores and reduction in pain intensity on visual analogue scores even after one week of the termination of intervention. This shows the long term effectiveness of combination of two manual techniques deactivating the myofascial trigger point's pain.
Keywords
Myofascial Trigger Points Pain, Pain Pressure Threshold, Pressure Threshold Meter, Muscle Energy Technique, Strain-Counterstrain TechniqueReferences
- Imamura ST, Fischer AA, Imamura M, Teixeira MJ, et al. Pain management using myofascial approach when other treatment failed. Phys Med Rehabil Clin North Am 1997; 8:179-96.
- Ballantyne, F., Fryer, G., McLaughlin, P., The Effect of Muscle Energy Technique on Hamstring Extensibility: The Mechanism of Altered Flexibility. Journal of Osteopathic Medicine, April 6 (1), 37; 2003.
- Hong CZ, Hsueh TC. Difference in pain relief after trigger point injections in myofascial pain patients with and without fibromyalgia. Arch Phys Med Rehabil 1996; 77:1161-6.
- Simons DG, Travell JG, Simons LS. Travell & Simons' Myofascial pain and dysfunction: the trigger point manual. 2d ed. Baltimore: Williams & Wilkins, 1999:
- Han SC, Harrison P. Myofascial pain syndrome and trigger-point management. Reg Anesth 1997;22:89-101.
- Ling FW, Slocumb JC. Use of trigger point injections in chronic pelvic pain. Obstet Gynecol Clin North Am 1993;20:809-15.
- Mense S, Schmit RF. Muscle pain: which receptors are responsible for the transmission of noxious stimuli? In: Rose FC, ed. Physiological aspects of clinical neurology. Oxford: Blackwell Scientific Publications, 1977:265-78.
- Hopwood MB, Abram SE. Factors associated with failure of trigger point injections. Clin J Pain 1994; 10:227-34.
- Fricton JR, Kroening R, Haley D, Siegert R. Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients. Oral Surg Oral Med Oral Pathol 1985;60:615-23.
- Simons DG, Travell JG, Simons LS. Travell & Simons' Myofascial pain and dysfunction: the trigger point manual. 2d ed. Baltimore: Williams & Wilkins, 1999:94-173.
- Rachlin ES. Trigger points. In: Rachlin ES, ed. Myofascial pain and fibromyalgia: trigger point management. St. Louis: Mosby, 1994:145-57.
- Simons DG, Travell JG, Simons LS. Travell & Simons' Myofascial pain and dysfunction: the trigger point manual. 2d ed. Baltimore: Williams & Wilkins, 1999:11-93.
- Sola A E, Bonica JJ, Myofascial pain syndrome: the management of pain. 2 ed, Philadelphia: Lea and Febiger,1990,352-57.
- Hou, C.R., Tsai, L.C., Cheng, K.F., Chung, K.C., Hong, C.Z., 2002. Immediate effects of various therapeutic modalities on cervical myofascial and trigger point pain sensitivity; Archives of Physical Medicine and Rehabilitation 1982,1406-14.
- Meseguer A.A, Ferna´ndez-de-las-Pen˜as C, Navarro-Poza J L,. Immediate effects of the strain/counterstrain technique in local pain evoked by tender points in the upper trapezius muscle; Clinical Chiropractic: 2006 vol. 9, 112-118.
- Jensen, M.P., Turbner, J.A., Romano, J.M., Fisher, L.D., 1999. Comparative reliability and validity of chronic pain intensity measures. Pain 83, 157-162.
- Fischer, A., pressure algometry over normal muscle, standard values, validity and reproducibility of pressure threshold, pain 1987, 30; 115-126.
- Simons, D., Hong, C.-Z., 2002. Endplate potentials are common to mid fiber myofascial trigger points. American Journal of Physical Medicine and Rehabilitation 81, 212-222.
- Jaeger, B., Reeves, J.L., 1986. Quantification of changes in myofascial trigger point sensitivity with the pressure algometer following passive stretch. Pain 27, 203-210.
- Hou, C.R., Tsai, L.C.,2002. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Archives of Physical and Medical Rehabilitation 82, 1406-1414.
- Efficacy of Ischaemic Compression Technique in Combination with Strain Counterstrain Technique in Managing Upper Trapezius Myofascial Trigger Point Pain
Authors
1 Hamdard University, IN
2 Institute of Health and Management Studies, New Delhi, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 4, No 2 (2010), Pagination: 10-15Abstract
Objective
To establish the best possible long term effective choice of treatment program for deactivating MTrPs by using the combination of ischaemic compression technique with strain-counterstrain technique.
Design
Pretest-Posttest control group design.
Setting
Outpatient physiotherapy department, Northern Railway Central Hospital, New Delhi.
Patients
Fourty five subjects (only male) with Myofascial Trigger Points Pain. Subjects were randomly placed into three groups: Experimental group A (n=15), Experimental group B (n=15) and a control group C (n=15).
Intervention
The experimental group A received ischaemic compression technique in combination with straincounterstrain technique and experimental group B received ischaemic compression technique alone whereas control group received conventional treatment only. Main Outcome Measures: Pain pressure threshold was assessed with the pressure threshold meter (PTM). Pain and functional status of the patients were measured by a visual analogue scale (VAS) and the Neck Disability Index scores respectively.
Results
Within group analysis revealed significant improvement in pain pressure threshold, functional status and reduction in pain intensity in all groups. Between group analysis revealed significant difference between group A, group B and group C. Further post hoc analysis revealed significant difference between group A and B, group A and C and group B and C for all variables even after one week of follow up after the termination of intervention.
Conclusion
The combination of ischaemic compression technique with strain-counterstrain has been shown to produce greater improvement in pain pressure threshold on pressure threshold meter, function status on neck disability index scores and reduction in pain intensity on visual analogue scores even after one week of the termination of intervention. This shows the long term effectiveness of combination of two manual techniques. This study may provide a rationale for the clinical use of these two manual techniques in deactivating the myofascial trigger points pain.
References
- Imamura ST, Fischer AA, Imamura M, Teixeira MJ, Tchia Yeng Lin, Kaziyama HS, et al. Pain management using myofascial approach when other treatment failed. Phys Med Rehabil Clin North Am 1997; 8:179-96.
- Cole TM, Edgerton VR. Musculoskeletal disorders.In: Cole TM, Edgerton VR, eds. Report of the Task Force on Medical Rehabilitation Research: June 28-29, 1990, Hunt Valley Inn, Hunt Valley, Md.Bethesda: National Institutes of Health, 1990:61-70.
- Hong CZ, Hsueh TC. Difference in pain relief after trigger point injections in myofascial pain patients with and without fibromyalgia. Arch Phys Med Rehabil 1996; 77:1161-6.
- Simons DG, Travell JG, Simons LS. Travell & Simons’ Myofascial pain and dysfunction: the trigger point manual. 2d ed. Baltimore: Williams & Wilkins, 1999:5.
- Han SC, Harrison P. Myofascial pain syndrome and trigger-point management. Reg Anesth 1997;22:89-101.
- Ling FW, Slocumb JC. Use of trigger point injections in chronic pelvic pain. Obstet Gynecol Clin North Am 1993;20:809-15.
- Mense S, Schmit RF. Muscle pain: which receptors are responsible for the transmission of noxious stimuli? In: Rose FC, ed. Physiological aspects of clinical neurology. Oxford: Blackwell Scientific Publications, 1977:265-78.
- Hopwood MB, Abram SE. Factors associated with failure of trigger point injections. Clin J Pain 1994; 10:227-34.
- Fricton JR, Kroening R, Haley D, Siegert R. Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients. Oral Surg Oral Med Oral Pathol 1985;60:615-23.
- Simons DG, Travell JG, Simons LS. Travell & Simons’ Myofascial pain and dysfunction: the trigger point manual. 2d ed. Baltimore: Williams & Wilkins, 1999:94-173.
- Rachlin ES. Trigger points. In: Rachlin ES, ed. Myofascial pain and fibromyalgia: trigger point management. St. Louis: Mosby, 1994:145-57.
- Simons DG, Travell JG, Simons LS. Travell & Simons’ Myofascial pain and dysfunction: the trigger point manual. 2d ed. Baltimore: Williams & Wilkins, 1999:11-93.
- Sola AE, Bonica JJ. Myofascial pain syndromes. In:Bonica JJ, ed. The management of pain. 2d ed. Philadelphia: Lea & Febiger, 1990:352-67.
- Hou, C.R., Tsai, L.C., Cheng, K.F., Chung, K.C., Hong, C.Z., 2002. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Archives of Physical and Medical Rehabilitation 82, 1406– 414.
- Meseguer A.A, Ferna´ndez-de-las-Pen˜as C, Navarro- Poza J L, Rodri´guez-Blanco C, Bosca´ Gandia J.J. Immediate effects of the strain/counterstrain technique in local pain evoked by tender points in the upper trapezius muscle; Clinical Chiropractic: 2006 vol. 9, 112—118.
- Jensen, M.P., Turbner, J.A., Romano, J.M., Fisher, L.D., 1999. Comparative reliability and validity of chronic pain intensity measures. Pain 83, 157–162.
- Fischer, A., pressure algometry over normal muscle, standard values, validity and reproducibility of pressure threshold, pain 1987, 30; 115-126.
- Simons, D., Hong, C.-Z., Simons, L., 2002. Endplate potentials are common to mid fiber myofascial trigger points. American Journal of Physical Medicine and Rehabilitation 81, 212–222.
- Jaeger, B., Reeves, J.L., 1986. Quantification of changes in myofascial trigger point sensitivity with the pressure algometer following passive stretch. Pain 27, 203–210.
- Hou, C.R., Tsai, L.C., Cheng, K.F., Chung, K.C., Hong, C.Z., 2002. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Archives of Physical and Medical Rehabilitation 82, 1406–1414.
- Lewit, K., 1991. Manipulative Therapy in Rehabilitation of the Locomotor System, second ed. Butterworth Heinemann, Oxford.
- Lewit D, Simons DG. Myofascial pain: relief by postisometric relaxation. Arch Phys Med Rehabil. 1984; 65:452– 456.