The immediate effects of soft tissue mobilization versus therapeutic ultrasound for patients with neck and arm pain with evidence of neural mechanosensitivity: a randomized clinical trial

Abstract

Study design: Randomized clinical trial. Objectives: To investigate the immediate effects of soft tissue mobilization (STM) versus therapeutic ultrasound (US) in patients with neck and arm pain who demonstrate neural mechanical sensitivity. Background: While experts have suggested that individuals with neck and arm pain associated with neural tissue mechanical sensitivity may benefit from STM, there has been little research to investigate this hypothesis. Methods: Twenty-three patients with neck and arm pain and a positive upper limb neurodynamic test (ULNT) were randomly assigned to receive STM or therapeutic US during a single session. Outcome measures were collected immediately before and after treatment, and at 2-4 day follow-up. Primary outcomes were the Global Rating of Change (GROC), range of motion (ROM) during the ULNT, and pain rating during the ULNT. Secondary measures included the Neck Disability Index (NDI), Patient-Specific Functional Scale (PSFS), Numeric Pain Rating Scale (NPRS), and active range of shoulder abduction motion combined with the wrist neutral or wrist extension. Results: A greater proportion of patients in the STM group reported a significant improvement on the GROC immediately after treatment (P50.003, STM575%, US59%), and at 2-4 day follow-up (P50.027, STM558%, US59%). Patients who received STM demonstrated greater improvements in ROM during ULNT (P50.026), PSFS (P50.007), and shoulder active ROM combined with wrist extension (P50.028). Improvements in Numeric Pain Rating Scale and pain during the ULNT were observed only in the STM group. There was no difference between groups for the NDI or shoulder abduction ROM with wrist neutral. Conclusion: Patients with neck and arm pain demonstrated greater improvements in ULNT ROM, GROC, and PSFS, and pain following STM than after receiving therapeutic US. Level of evidence: Therapy, level 1b.

Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature

“…Cervical radiculopathy, thought to be mechanical, spatial dysfunction, also needs treatment, including movement, both proximally and distally. It has to be mentioned that a small number of papers used clinical tests for assessing functional outcomes [ 38 , 43 , 49 , 54 ]. This is because local pain is not the primary CR and LR problem, but distal dysfunction (e.g., muscle weakness, motor and sensory deficits due to neural malfunction), causing disability, which should always be assessed.…”

Manejo fisioterápico de dolor neuropático sin correlación anatómica nerviosa: informe de caso

“…Por ello, se debe complementar el diagnóstico con TCS y cuestionarios, siendo utilizados en este caso el S-LANSS (Bennett et al, 2005) y bastoncillo con algodón (3mNw) para alodinia mecánica (Schmid et al, 2009). Con respecto al tratamiento, la propuesta y realización de deslizamiento neural sobre patología de miembro superior ha mostrado efectos sobre la disminución de dolor (Basson et al, 2017), reduciendo la mecanosensibilidad y edema nervioso (Costello et al, 2016). Además de forma más específica se han documentado en la literatura la eficacia sobre el deslizamiento del nervio radial para las epicondilalgias laterales, obteniendo mejores resultados a corto plazo que con una intervención de ejercicio (Dabholkar et al, 2006).…”

“…El dolor neuropático periférico es definido como una de las principales manifestaciones provocadas por una lesión en el sistema nervioso somatosensorial, periférico o central (Colloca et al, 2017), como respuesta maladaptativa a un proceso de daño tisular nervioso (Costigan et al, 2009). Suele ir acompañado de perdida de la función, manifestaciones de dolor espontáneas y aumento de la sensibilidad ante estímulos, normalmente de etiología desconocida.…”

The Rolf Method of Structural Integration on Fascial Tissue Stiffness, Elasticity, and Superficial Blood Perfusion in Healthy Individuals: The Prospective, Interventional Study

“…It contains smooth muscle-like cells with a myofibroblast cellular structure, which can change its shape in response to mechanical stimuli (Horton, 2015) and is also richly vascularized (Behm and Wilke, 2019). Fascial therapy, apart from relieving pain and improving the range of joint mobility, can have a direct effect on molecular pathways, cellular response, and the structure and function of tissues as well as their healing, repair, and regeneration (Best et al, 2013;Costello et al, 2016;Kojidi et al, 2016). There is also some evidence that when performed on musculoskeletal and myofascial chains, therapy can induce long-lasting effects on tissues, which can manifest as changes in their strength and range of motion (Dischiavi et al, 2018).…”