This study examined the intertester reliability of using James Cyriax's system for assessing patients with shoulder pain. Two experienced physical therapists independently evaluated 21 cases of painful shoulders using Cyriax's evaluation method. They classified the cases into specific shoulder lesions or indicated that the case did not fit the Cyriax model. The therapists agreed on the classification for 19 of the 21 cases, showing 90.5% agreement. Statistical analysis found "almost perfect" agreement between the therapists. Both therapists also agreed on the same 4 cases that did not fit the Cyriax model. The results demonstrate that Cyriax's evaluation can be a highly reliable method for assessing patients with shoulder pain.
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
Case study on lowback pain using Physioball, yoga And Dietry Measures.iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Recent advances in Manipulative MedicineSoniya Lohana
What new techniques are been used in manipulative medicine and physical therapy that help the patients to recover better and address their condition by various approaches where surgery is not required.
Crimson Publishers - Efficacy of Core Strengthening Exercise on a Geriatric S...CrimsonpublishersMedical
Efficacy of Core Strengthening Exercise on a Geriatric Subject with Lumbar Spine Degeneration-Evidence Based Study by Subramanian ss* in Research in Medical & Engineering Sciences
Case study on lowback pain using Physioball, yoga And Dietry Measures.iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Recent advances in Manipulative MedicineSoniya Lohana
What new techniques are been used in manipulative medicine and physical therapy that help the patients to recover better and address their condition by various approaches where surgery is not required.
Crimson Publishers - Efficacy of Core Strengthening Exercise on a Geriatric S...CrimsonpublishersMedical
Efficacy of Core Strengthening Exercise on a Geriatric Subject with Lumbar Spine Degeneration-Evidence Based Study by Subramanian ss* in Research in Medical & Engineering Sciences
Running head: NECK PAIN 1
NECK PAIN 2
NECK PAIN
Bamgbola Abitogun
Grand Canyon University
NRS 433V
April 2nd, 2017
Dosage impacts of spinal manipulative treatment for endless neck torment Comment by Denise Foti: APA: The first line of your paper needs to be your paper title not bold-faced
Neck pain is second most common spinal pain to low back torment among musculoskeletal grievances revealed in the all inclusive community and among those exhibiting to manual treatment suppliers. Ceaseless neck torment (i.e. neck torment enduring longer than 90 days) is a typical purpose behind introducing to a chiropractor's office, and such patients frequently get spinal control or activation. Comment by Denise Foti: Indent
Research question: In adults with chronic neck pain, what is the base measurements of control important to create a clinically vital change in neck pain contrasted with directed practice in 2 months Comment by Denise Foti: You need to revise this. Look at the example I provided the first day of class.
(P)-Population: Adults 18 to 60 years old, with a clinical conclusion of endless mechanical neck pain who have not gotten cervical spinal manipulative therapy in the previous year. Patients with non-mechanical neck agony or contraindications to cervical control will be rejected.
(I)-Intervention: Subjects randomized to have control would get standard rotational or sidelong break enhanced method once, twice, or three times each week over a time of 2, 4, or a month and a half. These subjects would likewise get a similar practice regimen given to the control gathering to take out practice as a moment variable influencing results.
(C)-Comparison-An institutionalized administered practice regimen would be utilized as a dynamic control bunch. All subjects, paying little heed to gathering task, would play out an institutionalized practice administration at every session over a time of a month and a half. Utilizing this methodology, we will have the capacity to limit the non-particular impacts because of going to a facility.
(O)-Outcome- Changes in neck pain, measured utilizing the 100mm VAS for agony.
(T)-Time-The result would be measured week by week for two months
Reference
Vernon, H., & Mior, S. (January 01, 1991). The Neck Disability Index: a study of reliability and validity. Journal of Manipulative and Physiological Therapeutics, 14, 7, 409-15.
Injuries to the cervical spine, particularly those including the delicate tissues, speak to a huge wellspring of unending handicap. Techniques for appraisal for such inability, particularly those focused at exercises of day by day living which are most influenced by neck agony, are very few. An alteration of the Oswestry Low Back Pain Index was led ...
Assessing the Relationship between Body Composition and Spinal Curvatures in ...peertechzpublication
Introduction: Although it is thought that abdominal adiposity is one of the risk factor for postural deviation, such as increased lumbar lordosis, the studies in the literature only explored the effects of body mass index on spinal alignment and postural changes. The aim of this study was to investigate the correlation with detailed body composition and spine alignment in healthy young adults.
Objective: To assess the effect of a kinesitherapeutic
program of special exercises for treatment of pain intensity and
endurance of the extensor trunk muscles in patients with
chronic lumbalgy.
Methods: The study included 110 patients with chronic
lumbalgy, equally distributed in two treatment groups.
Participants in the experimental group performed the
recommended special exercises 3 times a week at home, while
those in the control group only followed the guidelines of a
physician. At the beginning of the study and 12 months later,
the pain intensity of all the participants was assessed by means
of Visual Analog Scale.
Results: In contrast to the participants in the control
group, those in the experimental group at the end of observation
were reported to experience a significant reduction in pain
intensity.
Conclusions: Treatment with specific exercises proved
more effective in terms of pain complaints in patients with
chronic lumbalgy.
1. Intertester Reliability of the Cyriax Evaluation in
Assessing Patients With Shoulder Pain
Authors: Geraldine L. Pellecchia, MA, PT1 Julie Paolino, PT, ATC2 Jeanne Connell,
PT3
AFFILIATIONS:
1 Assistant Professor, University of Hartford, Physical Therapy Program, 200 Bloomfield
Avenue, West Hartford, CT 06117; Research Coordinator, Physical Therapy and Sports
Medicine Associates, Farmington, CT
2 Site Director, Physical Therapy and Sports Medicine Associates, East Hartford, CT
3 Ms. Connell was Regional Director of Physical Therapy and Sports Medicine
Associates at the time of this study.
Published: Journal of Orthopaedic & Sports Physical Therapy, 1996, Volume: 23
Issue: 1 Pages: 34-38 doi:10.2519/jospt.1996.23.1.34
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Abstract
James Cyriax's approach to diagnosis and treatment of soft tissue disorders is
frequently used by orthopaedic and sport physical therapists. The reliability of using
Cyriax' s system to determine diagnostic categories, however, has not been
established. The purpose of this study was to examine the intertherapist reliability of
assessments made using Cyriax's shoulder evaluation. Twenty-one cases of painful
shoulder were evaluated independently by two experienced physical therapists.
Therapists used a checklist to indicate their assessment of each case by selecting a
specific shoulder lesion or by indicating that the case did not fit the Cyriax model.
Cohen's kappa statistic was used to measure intertherapist agreement. Therapists
classified 19 of the 21 cases into the same diagnostic category for a percent agreement
of 90.5%. The kappa value was .875, indicating “almost period” agreement. Both
therapists classified the same four cases of painful shoulder as not fitting the Cyriax
model of soft issue examination. The results of this study show that the Cyriax
evaluation can be a highly reliable schema for assessing patients with shoulder pain.
Read More: http://www.jospt.org/doi/abs/10.2519/jospt.1996.23.1.34
2. Diagnosisof ShoulderPain by History and
Selective Tissue Tension: Agreement
Between Assessors
Nigel C. A. Hanchard, MSc1
Tracey E. Howe, PhD2
Meg M. Gilbert, BSc(Hons)3
Study Design: Evaluation of agreement between assessors.
Objective: To evaluate agreement between an expert in selective tissue tension (STT) and 3
other
trained assessors, all using STT in conjunction with a preliminary clinical history, on their
diagnostic labeling of painful shoulders.
Background: Consensus on diagnostic labeling for shoulder pain is poor, hampering
interpretation
of the evidence for interventions. STT, a systematic approach to physical examination and
diagnosis, offers potential for standardization, but its reliability is contentious.
Methods and Measures: Four trained assessors, 1 of whom was considered an expert,
separately
assessed 56 painful shoulders in 53 subjects (32 male [mean ± SD age, 51 ± 13 years], 21
female
[mean ± SD age, 57 ± 12 years]), using STT in conjunction with a preliminary clinical history.
Assessors labeled each painful shoulder as ‘‘rotator cuff lesion,’’ ‘‘bursitis,’’ ‘‘capsulitis,’’ ‘‘other
diagnosis,’’ or ‘‘no diagnosis.’’ Combinations of diagnoses were allowed.
Results: A diagnosis was made in every case, with less than 7% of the diagnoses being
combined.
With the diagnostic categories pooled, agreement (kappa and 95% confidence interval [CI])
between the expert assessor and each of the other assessors was good, ranging from 0.61
(0.44-0.78) to 0.75 (0.60-0.90). For single diagnostic categories, agreement between the expert
and each of the others (dichotomized data) ranged from 0.35 (–0.03-0.73) to 0.58 (0.29-0.87)
for
bursitis; 0.63 (0.40-0.86) to 0.82 (0.65-0.99) for capsulitis; 0.71 (0.49-0.93) to 0.79 (0.61-0.96)
for
rotator cuff lesions; and from 0.69 (0.35-1.00) to 0.78 (0.48-1.00) for other diagnoses.
Conclusions: Overall, STT in conjunction with a preliminary clinical history enables good
agreement between trained assessors. Future work is required to evaluate its criterion validity.
J Orthop Sports Phys Ther 2005;35:147-153.
Key Words: orthopedics, physical therapy, tests
3. Reliability of Classifications Derived From Cyriax's Resisted Testing in Subjects
With Painful Shoulders and Knees
Authors: Karen W. Hayes , PT, PhD1 Cheryl M. Petersen , PT, MS2
AFFILIATIONS:
1Associate Professor, Physical Therapy and Human Movement Sciences, Director, Professional
Education, Department of Physical Therapy and Human Movement Sciences, Feinberg School of
Medicine, Northwestern University, Chicago, IL.
2Assistant Professor, Department of Physical Therapy, Concordia University Wisconsin, Mequon, WI.
Please send correspondence to Karen W. Hayes, 645 N. Michigan Avenue, Suite 1100, Chicago, IL
60611. E-mail: k-hayes@northwestern.edu
Published: Journal of Orthopaedic & Sports Physical Therapy, 2003, Volume: 33
Issue: 5 Pages: 235-246 doi:10.2519/jospt.2003.33.5.235
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Abstract
Study Design Intrarater and interrater reliability.
Objectives Examine intrarater and interrater reliability of the resisted-testing component
of Cyriax's selective tension testing for patients with painful shoulders and knees.
Background Clinicians make diagnostic and intervention decisions about lesions in
contractile tissues based on resisted testing. Diagnostic and intervention decisions
require reliable data gathering, especially when more than 1 physical therapist manages
a patient. No studies have examined agreement of the results of the resisted tests used
in selective tension testing, either within or between physical therapists, in subjects
having pathology.
Methods and Measures Subjects with pain in 1 knee (18 male, 22 female; mean age ±
SD = 31.8 ± 9.5 years) or shoulder (21 male, 25 female; mean age ± SD = 34.3 ± 12.9
years) were examined twice. Referring diagnoses included ligament injuries, overuse
syndromes, joint instability, and postsurgical symptoms, with some subjects seeking
initial diagnosis. Two physical therapists used standardized positions to evaluate 2 knee
motions or 6 shoulder and elbow motions. Evaluators applied maximal isometric manual
resistance and rated the contraction as strong or weak while subjects identified the
presence or absence of pain during the contraction. Evaluators did not interview the
subjects and were masked to previous test results. Analyses included percentage of
agreement, kappa coefficients, confidence intervals, and maximum kappa coefficients.
Results Intrarater kappa coefficients ranged from 0.44 to 0.82 and interrater coefficients
ranged from 0.00 to 0.46. The small number of subjects who were classified as weak
affected the kappa coefficients. In the intrarater condition, evaluators averaged 91% of
maximum kappa for the knee and 66.5% for the shoulder. In the interrater condition,
they averaged 60.4% of the maximum kappa for both the knee and the shoulder.
4. Conclusions Based on 2 physical therapist evaluators with previous education in the
selective tension system and an additional 6 hours of formal training on the methods,
intrarater reliability of resisted tests was generally acceptable for the knee but not for the
shoulder. Interrater reliability of these tests, however, was generally not acceptable.
Results were limited by subjects who were younger and had mostly chronic conditions
that were mildly to moderately severe and by the small subject samples in the analyses.
Reliability might be improved by more intensive training of the evaluators and by
standardizing the magnitude of the applied resistance and stabilization of the subjects.
Read More: http://www.jospt.org/doi/abs/10.2519/jospt.2003.33.5.235
5. Article about END-FEEL
Construct Validity of Cyriax's Selective Tension Examination: Association of End-
Feels With Pain at the Knee and Shoulder
Authors: Cheryl M. Petersen, PT, MS1Karen W. Hayes, PT, PhD1
AFFILIATION:
1 Department of Physical Therapy and Human Movement Sciences, Northwestern University Medical
School, Chicago, Ill.
Send correspondence to: Cheryl M. Petersen, 645 N. Michigan Avenue, Suite 1100, Chicago, IL 60611.
E-mail: c-petersen@nwu.edu
Published: Journal of Orthopaedic & Sports Physical Therapy, 2000, Volume: 30 Issue: 9
Pages: 512-527 doi:10.2519/jospt.2000.30.9.512
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Abstract
Study Design Descriptive.
Objectives To examine the relationship between pain and normal and abnormal-pathologic end-
feels during passive physiologic motion assessment at the knee and shoulder. We theorized
that abnormal-pathologic end-feels would be more painful than normal end-feels.
Background End-feel testing and pain intensity information are part of physical therapy
musculoskeletal patient examinations. End-feels are categorized as normal or abnormal-
pathologic. No previous studies have examined the relationship between pain during end-feel
testing and the type of end-feel.
Methods and Measures Two physical therapists examined subjects with unilateral knee or
shoulder pain. Each subject was examined twice. Passive physiologic motions, 2 at the knee
and 5 at the shoulder, were tested by applying an overpressure at the end of range of motion
using standardized positions. Subjects reported the amount of pain (0–10) immediately after the
evaluator recorded the end-feel. Analyses included one-way ANOVAs and post-hoc Tukey's
Honestly Significant Difference tests.
Results Some abnormal-pathologic end-feels were significantly more painful than the normal
end-feels at both the knee and the shoulder for all physiologic motions. Among the abnormal-
pathologic end-feel categories there were no statistical differences in pain intensity, although
small samples in some categories may be responsible for this finding.
Conclusion Abnormal-pathologic end-feels are associated with more pain than normal end-feels
during passive physiologic motion testing at the knee or shoulder. Dysfunction should be
suspected when abnormal-pathologic end-feels are present. J Orthop Sports Phys Ther
2000;30:512–527.
Read More: http://www.jospt.org/doi/abs/10.2519/jospt.2000.30.9.512