511 - evidence

General References

Electrotherapy Modalities :

www.Electrotherapy.org Watson’s Website.

Watson (2008) Electrotherapy evidence based practice, churchill 2008

Peripheral and Vertebral Mobilisations :

Maitland’s vertebral mobilazation (2005) 7th edition , Butterworth Heineman

Maitland’s Peripheral mobilization (2005) 4th edition, Butterworth Heineman

Deep tissue friction massage:

Pioneered by Cyriax (1984) in his textbook of orthodox medicine 1984

Reviewed by goats (1994) in Br J Sports Med 1994 28: 153-156 Part 2. Massage--the scientific basis of an ancient art

• Maintains & improves mobility of ligaments and muscles - prevents scarring-

Enables breakdown & realignment of fibres - promotes healing

Trigger point therapy

Pioneered by travel and simons. More recent textbook : concise book of trigger points Simeon Niel Asher 2nd edition ( 2008)

Case Specific References

Case 2 Hamstring

Journal 2-Garrett,CL , Draper, D, Knight, K (2000) Heat Distribution in pulsed short wave diathermy (PSWD) compared to ultrasound(US),Journal of Athletic Training, 35(1)

• pulse shortwave performs better than ultrasound for large muscle mass

Ttreatment of chronic hamstring/posterior thigh pain[Soft Break]Best Practice & Research Clinical Rheumatology, Volume 21, Issue 2, Pages 261-277[Soft Break]D. Hunter, C. Speed

• biceps femoris most commonly injured

Case 3 Frozen Shoulder

The Journal of Bone and Joint Surgery 82:1398 (2000) Idiopathic Adhesive Capsulitis . A Prospective Functional Outcome Study of Nonoperative Treatment*

Sean M. Griggs, M.D.[Picture], Anthony Ahn, M.D.[Picture] and Andrew Green, M.D.

• 4 way stretch effective in rehabilitation

Case 4 Ligament Damage

Zammit, E., Harrigton,L.( 2005) “Ultrasound therapy in the management of acute lateral ligament sprains of the ankle joint”, Physical Therapy in Sport, 6(3), pp.116-121

• Ultrasound has no significant effect

Jorge, S., Parada, C. A., Ferreira, S. H. & Tambeli, C. H. (2006) “Interferential Therapy Produces Antinociception During Application in Various Models of Inflammatory Pain”. Physical Therapy, 86, (6), pp. 800-808.

• Interferential effective reduces inflammatory pain although is short term

Case 5 Iliopsoas Injury

M Mozes, M Z Papa, A Zweig, et al.(1985) Iliopsoas injury in soccer players.Br J Sports Med 1985 19: 168-170 => confirms pain disappears at rest reappears on flexion

Case 6 Achilles Tendinopathy

Bruckner, Kahn (2006) clinical sports medicidne 3rd edition

• Achilles tendinopathy characterised by collagen fibre disarray

Available online http://www.clinicalsportsmedicine.com

Case Study 7 Impingement

Giombini et al (2006) “supraspinatus tendiopathy” American journal of sports medicine

• Ultrasound effective treatment of shoulder impingement

Senbursa (2007) shoulder impingement

• Mobilization more effective than just exercise

case study 8 postural pain

kendall (1993) postural types = kyphosis- lordosis ?

fascial theory : http://www.fascialrelease.com/tag/postural-alignment

www.somatics.de – website of Robert Schliep => trigger point release promote lower back activity and lower back activity reduce postural strain within trapezius

case study 9 whiplash

Arch Phys Med Rehabil. 2002 Oct;83(10):1406-14. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Hou CR, Tsai LC, Cheng KF, Chung KC, Hong CZ. => trigger point appropriate intervention when manually palpable pain present in trapezius

case study 10 Low back pain

Lewis, J. S., Hewitt, J. S., Billington, L., Cole, S., Byng, J. & Karayiannis, S. (2005) “A randomized clinical trial comparing two physiotherapy interventions for chronic low back pain”. Spine, 30, (7), pp. 711-721.

• Mobilisations and spinal exercises are an effective intervention

case study 11 Colles Fracture

www.Electrotherapy.org Watson – “Numerous recent papers have identified the benefits of using therapeutic ultrasound for both normally healing (fresh) fractures and those that demonstrate either a delayed union or non union (e.g. Mayr et al 2000, Busse et al 2002, Warden et al 1999)”

Peripheral and Vertebral Mobilisations :

Maitland’s vertebral mobilazation (2005) 7th edition , Butterworth Heineman

Maitland’s Peripheral mobilization (2005) 4th edition, Butterworth Heineman

Deep tissue friction massage:

Pioneered by Cyriax (1984) in his textbook of orthodox medicine 1984

Reviewed by goats (1994) in Br J Sports Med 1994 28: 153-156 Part 2. Massage--the scientific basis of an ancient art

• Maintains & improves mobility of ligaments and muscles - prevents scarring-

Enables breakdown & realignment of fibres - promotes healing

Trigger point therapy

Pioneered by travel and simons. More recent textbook : concise book of trigger points Simeon Niel Asher 2nd edition ( 2008)

Case Specific References

Case 2 Hamstring

Journal 2-Garrett,CL , Draper, D, Knight, K (2000) Heat Distribution in pulsed short wave diathermy (PSWD) compared to ultrasound(US),Journal of Athletic Training, 35(1)

• pulse shortwave performs better than ultrasound for large muscle mass

Ttreatment of chronic hamstring/posterior thigh pain[Soft Break]Best Practice & Research Clinical Rheumatology, Volume 21, Issue 2, Pages 261-277[Soft Break]D. Hunter, C. Speed

• biceps femoris most commonly injured

Case 3 Frozen Shoulder

The Journal of Bone and Joint Surgery 82:1398 (2000) Idiopathic Adhesive Capsulitis . A Prospective Functional Outcome Study of Nonoperative Treatment*

Sean M. Griggs, M.D.[Picture], Anthony Ahn, M.D.[Picture] and Andrew Green, M.D.

• 4 way stretch effective in rehabilitation

Case 4 Ligament Damage

Zammit, E., Harrigton,L.( 2005) “Ultrasound therapy in the management of acute lateral ligament sprains of the ankle joint”, Physical Therapy in Sport, 6(3), pp.116-121

• Ultrasound has no significant effect

Jorge, S., Parada, C. A., Ferreira, S. H. & Tambeli, C. H. (2006) “Interferential Therapy Produces Antinociception During Application in Various Models of Inflammatory Pain”. Physical Therapy, 86, (6), pp. 800-808.

• Interferential effective reduces inflammatory pain although is short term

Case 5 Iliopsoas Injury

M Mozes, M Z Papa, A Zweig, et al.(1985) Iliopsoas injury in soccer players.Br J Sports Med 1985 19: 168-170 => confirms pain disappears at rest reappears on flexion

Case 6 Achilles Tendinopathy

Bruckner, Kahn (2006) clinical sports medicidne 3rd edition

• Achilles tendinopathy characterised by collagen fibre disarray

Available online http://www.clinicalsportsmedicine.com

Case Study 7 Impingement

Giombini et al (2006) “supraspinatus tendiopathy” American journal of sports medicine

• Ultrasound effective treatment of shoulder impingement

Senbursa (2007) shoulder impingement

• Mobilization more effective than just exercise

case study 8 postural pain

kendall (1993) postural types = kyphosis- lordosis ?

fascial theory : http://www.fascialrelease.com/tag/postural-alignment

www.somatics.de – website of Robert Schliep => trigger point release promote lower back activity and lower back activity reduce postural strain within trapezius

case study 9 whiplash

Arch Phys Med Rehabil. 2002 Oct;83(10):1406-14. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Hou CR, Tsai LC, Cheng KF, Chung KC, Hong CZ. => trigger point appropriate intervention when manually palpable pain present in trapezius

case study 10 Low back pain

Lewis, J. S., Hewitt, J. S., Billington, L., Cole, S., Byng, J. & Karayiannis, S. (2005) “A randomized clinical trial comparing two physiotherapy interventions for chronic low back pain”. Spine, 30, (7), pp. 711-721.

• Mobilisations and spinal exercises are an effective intervention

case study 11 Colles Fracture

www.Electrotherapy.org Watson – “Numerous recent papers have identified the benefits of using therapeutic ultrasound for both normally healing (fresh) fractures and those that demonstrate either a delayed union or non union (e.g. Mayr et al 2000, Busse et al 2002, Warden et al 1999)”

Mobes Contraindications Malignancy, infections, osteoporosis, osteitis deformans, rheumatoid arthritis, ankylosing spondylitis, recent #, vertebral artery involvement, cauda equine, inflammation, bone disease of spine, spinal cord involvement >1nerve root, steroid therapy, mechanical bony defects, extra care w/ hyper mobility, neurotic pt, presence of neurological signs, undiagnosed pain, spinal mobs w/ pregnancy, irritable Jts w/ protective spasm.