This study supports a rehabilitation program of moderate-intensity aerobic exercise and progressive resisted exercise being safe and effective for reducing neuropathic pain and is beneficial with analgesics for HIV-induced distal symmetrical polyneuropathy.

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Objectives: The aim of this study is to examine the effect of spinal manipulation (SMT) compared with spinal mobilization (MOB) on pain, disability, quality of life, sciatica and general perception of recovery in individuals with lumbar disk herniation with radiculopathy (LDHR). Methods: A total of 40 individuals with LDHR will be randomly allocated into 2 groups; 20 participants each in SMT and MOB groups. Each participant will be assessed at baseline, 6 and 12 weeks of intervention. Outcomes will also be assessed at 6th and 12th months of follow-up. Outcomes to be assessed will include pain (VAS), functional disability (RMDQ-Rolland Morris disability questionnaire), sciatica bothersomeness index (SBI), sciatica frequency index (SFI), quality of life (SF-36), general perception of recovery (GROC) and objective functional impairment (TUG-timed up and go test). Discussion: This trial will determine the difference in outcomes between spinal manipulative therapy and spinal mobilization groups in individuals with LDHR.

Context Evidence has shown that spinal mobilization with leg movement (SMWLM) and progressive inhibition of neuromuscular structures (PINS) are individually effective in the management of lumbar radiculopathy. However, previous evidence reported data for only a short-term study period and did not investigate the effect of the combined manual therapy techniques. Objectives To compare the combined effects of two manual therapy techniques (SMWLM and PINS) with the individual techniques alone (SMWLM or PINS) in the management of individuals with lumbar radiculopathy. Methods A total of 60 patients diagnosed with unilateral lumbar radiculopathy secondary to disc herniation were randomly allocated into three groups: 20 participants each in the SMWLM, PINS, and combined SMWLM + PINS groups. Each group attended two treatments per week for 30 min each, for three months. Participants were assessed at baseline, immediately posttreatment, and then at three, six, and nine months follow-up using the Visual Analog Scale (VAS), Rolland-Morris Disability Questionnaire (RMDQ), and Sciatica Bothersomeness Index (SBI). Results Between-groups analyses using a two-way repeated-measures analysis of variance indicated significant interactions between groups and follow-up times for all outcomes (p=0.001). Participants receiving combined SMWLM + PINS treatment experienced greater improvement in leg pain, back pain, disability, and sciatica at all timelines (immediately posttreatment, and three, six, and nine months follow-up) than the participants receiving SMWLM or PINS alone (p<0.05). However, participants receiving SMWLM alone showed better improvement than the participants receiving PINS alone at all timelines (p<0.05). Conclusions A combined SMWLM + PINS treatment protocol showed greater improvement than the individual techniques alone in the management of individuals with LR in this study.

Objective: This study aimed to examine the effect of Kinesio taping as an adjunct to combined chain exercises compared with combined chain exercises alone in the management of individuals with knee osteoarthritis. Methods: A total of 60 (27 male, 33 female) individuals (age range = 50-71 yrs and mean age = 54.26 ± 8.83 yrs) diagnosed as having mild to moderate knee osteoarthritis (based on the Kellgren and Lawrence grade I-III classification) were randomly allocated into two groups with 30 participants each in the Kinesio taping + combined chain exercises and combined chain exercises groups. Participants in the Kinesio taping + combined chain exercises group received Kinesio taping plus combined chain exercises and those in the combined chain exercises group received only combined chain exercises. Each participant was assessed for pain, range of motion, functional mobility, and quality of life at baseline and after 8 wks of intervention. A mixed-design multivariate analysis of variance was used to analyze the treatment effect. Results: No significant differences were observed in the baseline characteristics of participants in both groups. The result indicated that there was a significant time effect for all outcomes, with a significant interaction between time and intervention (P < 0.001). The Bonferroni post hoc analyses of time and intervention effects indicated that the Kinesio taping + combined chain exercises group improved significantly better than the combined chain exercises group in all outcomes, pain (mean = 2.01 [0.64] vs. 3.94 [1.12], F[df] = 5.466[1,58], P = 0.011), flexion range of motion (mean = 121.15 [2.07] vs. 104.28 [3.24], F[df] = 26.722 [1,58], P < 0.001), functional mobility (mean = 19.47 [1.95] vs. 31.01 [2.39], F[df] = 29.436 [1,58], P < 0.001), and quality of life (mean = 68.76 [3.19] vs. 45.62 [2.87], F[df] = 71.984[1,58], P < 0.001), after 8 wks of intervention. Conclusions: The findings of this study concluded that Kinesio taping + combined chain exercises and combined chain exercises were both effective but Kinesio taping plus combined chain exercises was more effective in the management of individuals with knee osteoarthritis.

Introduction: Piriformis syndrome (PS) is one of the most commonly misdiagnosed neuromuscular conditions characterized by buttock pain which radiates down the ipsilateral lower extremity. This case report describes the use of integrated neuromuscular inhibition technique (INIT) in the management of a patient with piriformis syndrome (PS). Case Presentation: A 40-year-old man presented with a complaint of right buttock pain which radiated to the ipsilateral lower limb. The patient was diagnosed as having PS. The treatment of the patient included INIT followed by stretching exercises for 6-weeks. Outcome measurements included visual analogue scale (VAS), Rolland-Morris disability questionnaire (RMDQ), Sciatica bothersome index (SBI), Sciatica frequency index (SFI), and global rating of change scale (GROC) and were assessed at baseline (T0), at 3 (T1) and 6-weeks (T2) of intervention, and then at 12-weeks (T3) follow-up. Conclusions: At 12-weeks follow-up (T3), the outcomes indicated improvement in all symptoms (VAS = 0, RMDQ = 0, SBI = 0, SFI = 0, and GROC = +7). Integrated neuromuscular inhibition technique is effective in the management of a patient with piriformis syndrome.

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