No description available.

Student Number : 0216607K - MSc research report - School of Physiotherapy - Faculty of Health Sciences / Thoracic mobilisation is a popular modality employed by physiotherapists as part of the management of neck pain, despite the lack of evidence as to its benefits. A randomised control trial was conducted to compare manual physiotherapy to the cervical and thoracic regions and manual therapy to the cervical spine alone for the treatment of neck pain. The Spielberger State Anxiety Inventory (STAI) was used to assess anxiety change due to the intervention. The Memorial Pain Assessment Card (MPAC) was used to assess pain change through the intervention. A treatment effects questionnaire (TAQ) was constructed to assess other effects of the treatment protocols. Results showed no difference between the groups for anxiety reduction, although within the groups there was a highly significant reduction in anxiety (p<0.0001). Pain reduction was marginally significantly reduced in the experimental group in comparison to the control group (p=0.08) although the CI was very broad. Within group tests for the MPAC showed a highly significant reduction in pain from either intervention (p<0.0001).

A disfunção temporomandibular (DTM) é uma doença complexa e multifatorial. Diversas modalidades terapêuticas prometem aliviar os sintomas, melhorar a função e reduzir o impacto da doença na qualidade de vida do paciente. O objetivo desse estudo foi investigar o efeito da fotobiomodulação (PBM) e da terapia manual (MT) isoladas ou combinadas no controle da dor, no restabelecimento dos movimentos mandibulares, nos aspectos psicossociais e dos níveis de ansiedade nos pacientes com DTM mista. Cinqüenta e um pacientes com DTM foram alocados randomicamente em três grupos: grupo PBM (808 nm, 100mW, 13,3J / cm2, 4J por ponto), grupo MT (sessões de 21 minutos, nos músculos mastigatórios e ATM) e grupo de Terapia Combinada (CT). Todos os tratamentos foram realizados três vezes por semana durante quatro semanas consecutivas. As avaliações foram realizadas no início, durante o tratamento (dias 7, 14, 21 e 28) e no follow up(dia 60 e dia 90). A escala analógica visual (VAS), o Research Diagnostic Criteria (RDC / TMD) e o inventário de ansiedade Beck (BAI) foram utilizados em diferentes momentos do estudo. Todos os grupos demonstraram redução da dor ao longo do tratamento e follow up(<0,001). Todos os tratamentos promoveram melhora em alguns movimentos mandibulares durante o período de tratamento e follow up. A avaliação dos aspectos psicossociais da DTM, comparando o início e o follow up, não revelou modificação na intensidade da dor crônica (D1) em nenhum dos grupos de tratamento. No entanto, a avaliação de D2 (depressão) mostrou redução nos grupos PBM e CT. Todos os tratamentos promoveram redução dos sintomas físicos com e sem dor (D3a e D3b). Além disso, todos promoveram melhora funcional mandibular. A MT promoveu a melhora em 5 funções, PBM em 2 e CT em 1. A análise de BAI revelou que todos os tratamentos reduziram a ansiedade. Os resultados indicam que PBM, MT e CT são capazes de promover alívio da dor, melhorar a função mandibular e reduzir os efeitos dos aspectos psicossociais em pacientes com DTM. / Temporomandibular disorders (TMD) is a complex and multifactorial disease. Therapeutic modalities expected to relief symptoms, improve function and reduce the impact of the disease in patient’s quality of life. The aim of the present study was to investigate the effect of photobiomodulation (PBM) and manual therapy (MT) isolated or combined in the treatment of TMD. Fifty-one TMD patients were randomly allocated to three groups: PBM (808 nm, 100mW, 13.3J /cm2, 4 J per point), MT group (21 minutes sessions of MT of the masticatory muscles and TMJ)and Combined Therapy group (CT). All treatments were done three times a week for four consecutive weeks. Evaluations were performed at baseline, during the treatment (Days 7, 14, 21, and 28) and follow up (Day 60 and Day 90).Visual analogue scale(VAS),Research Diagnostic Criteria(RDC / TMD),Beck anxiety inventory (BAI)were used in different moments of evaluation time. All groups demonstrated reductions in pain throughout treatment and maintained low pain value in follow up period (<0.001). All treatments promoted improvement in some jaw movements during the treatment and follow up period.The assessment of psychosocial aspects of TMD comparing baseline and follow up in all treatment groups revealed that treatment do not promote modification in intensity of chronic pain (D1). However, D2 (depression) evaluation showed reduction in PBM and CT groups. All treatments promoted reduction in physical symptoms with and without pain (D3a and D3b). Also, all the treatments results in enhancement of jaw disabilities. MT promotes improvement in 5 functions, PBM in 2 and CT in 1.BAI analysis revealed that all treatments lead to a reduction in anxiety. The present findings indicate that PBM, MT and CT are able to promote pain relief, improve mandibularfunction and reduce the psychosocial negative aspects in TMD patients.

Introduction: The purpose of this study was to determine the effect of spinal manipulation therapy (SMT) duration and amplitude on spinal stiffness. Methods: Simulated SMTs were performed at the L6 spinous process in twenty-two felines. SMTs ranging from 25 to 250 ms duration were performed. Groups 1 and 2 received maximal displacements of 1.0mm to 3.0mm. Groups 3 and 4 received maximal loads of 25% to 85% body weight. Local stiffness was quantified by applying an indentation to the vertebra. Results: Repeated SMTs caused minimal changes in stiffness. The interaction effect of duration X displacement in Groups 1 and 2, and the effect of duration in Group 3 were significant. Conclusion: Repeated SMTs cause minimal changes in stiffness thought to be due to a viscoelastic response. Some of the changes following select SMT conditions may be the result of an interaction effect between SMT duration and amplitude. No specific threshold condition was identified as causing a greater stiffness change. / Physical Therapy

Aims: The primary physiotherapeutic aims of the study were to validate a manual physiotherapy evaluation technique in the assessment of cervical biomechanical dysfunction, and to test the effectiveness of a manual physiotherapy treatment technique in the correction of cervical biomechanical dysfunction. The primary educational aims were to test the effectiveness and safety of a therapeutic exercise programme for the correction of biomechanical dysfunction as well as the effectiveness of a neck rehabilitation programme for improving neck muscle strength. Design: A four group experimental design with three pre-test - post-test groups and a control group was used for the investigation. Sample: The subjects were South African schoolboy rugby players between the ages of 15 and 18 years. Groups I and 2 presented with biomechanical dysfunction of their cervical spines, Group 3 had no biomechanical dysfunction of their cervical spines and the players of Group 4, the control group, presented with or without biomechanical dysfunction of their cervical spines. Each group consisted of 25 players. Method: Group I received manual physiotherapy with x-rays before and after treatment. Groups 2 and 3 performed a therapeutic exercise programme, with before and after x-rays, and Group 4 received no intervention between their sets of x-rays. Following the second set of x-rays all the players from Groups I, 2 and 3 performed the neck rehabilitation programme after which a third set of x-rays were taken. Results: The results validated the manual physiotherapy evaluation technique. The manual therapy treatment technique used in the treatment of Group I showed highly significant improvements in cervical biomechanical function. Results for Group 2 following the therapeutic exercise programme showed moderate practically significant improvements in cervical biomechanical dysfunction. The therapeutic exercise programme for the correction of biomechanical dysfunction was found to be very safe with only small significant changes in x-ray measurements (Group 3). The results of the control group showed a negative trend of small statistical significance. A highly significant improvement in cervical circumference as moderate significant improvement in biomechanical function was found following the neck rehabilitation programme. Conclusion: It could therefore be concluded that the manual physiotherapy evaluation technique for motion segment analysis was indeed valid in determining biomechanical dysfunction of the cervical spine. The manual physiotherapy treatment technique as well as the therapeutic exercise programme for the correction of biomechanical dysfunction was found to be effective in the correction of cervical biomechanical dysfunction. It could further be concluded that the therapeutic exercise programme was safe to be performed by players without biomechanical dysfunction. The neck rehabilitation programme was effective in improving cervical circumference as well as cervical biomechanical function. / Thesis (Ph.D. (Education))--North-West University, Potchefstroom Campus, 2005.

No description available.

Aims: The primary physiotherapeutic aims of the study were to validate a manual physiotherapy evaluation technique in the assessment of cervical biomechanical dysfunction, and to test the effectiveness of a manual physiotherapy treatment technique in the correction of cervical biomechanical dysfunction. The primary educational aims were to test the effectiveness and safety of a therapeutic exercise programme for the correction of biomechanical dysfunction as well as the effectiveness of a neck rehabilitation programme for improving neck muscle strength. Design: A four group experimental design with three pre-test - post-test groups and a control group was used for the investigation. Sample: The subjects were South African schoolboy rugby players between the ages of 15 and 18 years. Groups I and 2 presented with biomechanical dysfunction of their cervical spines, Group 3 had no biomechanical dysfunction of their cervical spines and the players of Group 4, the control group, presented with or without biomechanical dysfunction of their cervical spines. Each group consisted of 25 players. Method: Group I received manual physiotherapy with x-rays before and after treatment. Groups 2 and 3 performed a therapeutic exercise programme, with before and after x-rays, and Group 4 received no intervention between their sets of x-rays. Following the second set of x-rays all the players from Groups I, 2 and 3 performed the neck rehabilitation programme after which a third set of x-rays were taken. Results: The results validated the manual physiotherapy evaluation technique. The manual therapy treatment technique used in the treatment of Group I showed highly significant improvements in cervical biomechanical function. Results for Group 2 following the therapeutic exercise programme showed moderate practically significant improvements in cervical biomechanical dysfunction. The therapeutic exercise programme for the correction of biomechanical dysfunction was found to be very safe with only small significant changes in x-ray measurements (Group 3). The results of the control group showed a negative trend of small statistical significance. A highly significant improvement in cervical circumference as moderate significant improvement in biomechanical function was found following the neck rehabilitation programme. Conclusion: It could therefore be concluded that the manual physiotherapy evaluation technique for motion segment analysis was indeed valid in determining biomechanical dysfunction of the cervical spine. The manual physiotherapy treatment technique as well as the therapeutic exercise programme for the correction of biomechanical dysfunction was found to be effective in the correction of cervical biomechanical dysfunction. It could further be concluded that the therapeutic exercise programme was safe to be performed by players without biomechanical dysfunction. The neck rehabilitation programme was effective in improving cervical circumference as well as cervical biomechanical function. / Thesis (Ph.D. (Education))--North-West University, Potchefstroom Campus, 2005.

A disfunção temporomandibular (DTM) é uma doença complexa e multifatorial. Diversas modalidades terapêuticas prometem aliviar os sintomas, melhorar a função e reduzir o impacto da doença na qualidade de vida do paciente. O objetivo desse estudo foi investigar o efeito da fotobiomodulação (PBM) e da terapia manual (MT) isoladas ou combinadas no controle da dor, no restabelecimento dos movimentos mandibulares, nos aspectos psicossociais e dos níveis de ansiedade nos pacientes com DTM mista. Cinqüenta e um pacientes com DTM foram alocados randomicamente em três grupos: grupo PBM (808 nm, 100mW, 13,3J / cm2, 4J por ponto), grupo MT (sessões de 21 minutos, nos músculos mastigatórios e ATM) e grupo de Terapia Combinada (CT). Todos os tratamentos foram realizados três vezes por semana durante quatro semanas consecutivas. As avaliações foram realizadas no início, durante o tratamento (dias 7, 14, 21 e 28) e no follow up(dia 60 e dia 90). A escala analógica visual (VAS), o Research Diagnostic Criteria (RDC / TMD) e o inventário de ansiedade Beck (BAI) foram utilizados em diferentes momentos do estudo. Todos os grupos demonstraram redução da dor ao longo do tratamento e follow up(<0,001). Todos os tratamentos promoveram melhora em alguns movimentos mandibulares durante o período de tratamento e follow up. A avaliação dos aspectos psicossociais da DTM, comparando o início e o follow up, não revelou modificação na intensidade da dor crônica (D1) em nenhum dos grupos de tratamento. No entanto, a avaliação de D2 (depressão) mostrou redução nos grupos PBM e CT. Todos os tratamentos promoveram redução dos sintomas físicos com e sem dor (D3a e D3b). Além disso, todos promoveram melhora funcional mandibular. A MT promoveu a melhora em 5 funções, PBM em 2 e CT em 1. A análise de BAI revelou que todos os tratamentos reduziram a ansiedade. Os resultados indicam que PBM, MT e CT são capazes de promover alívio da dor, melhorar a função mandibular e reduzir os efeitos dos aspectos psicossociais em pacientes com DTM. / Temporomandibular disorders (TMD) is a complex and multifactorial disease. Therapeutic modalities expected to relief symptoms, improve function and reduce the impact of the disease in patient’s quality of life. The aim of the present study was to investigate the effect of photobiomodulation (PBM) and manual therapy (MT) isolated or combined in the treatment of TMD. Fifty-one TMD patients were randomly allocated to three groups: PBM (808 nm, 100mW, 13.3J /cm2, 4 J per point), MT group (21 minutes sessions of MT of the masticatory muscles and TMJ)and Combined Therapy group (CT). All treatments were done three times a week for four consecutive weeks. Evaluations were performed at baseline, during the treatment (Days 7, 14, 21, and 28) and follow up (Day 60 and Day 90).Visual analogue scale(VAS),Research Diagnostic Criteria(RDC / TMD),Beck anxiety inventory (BAI)were used in different moments of evaluation time. All groups demonstrated reductions in pain throughout treatment and maintained low pain value in follow up period (<0.001). All treatments promoted improvement in some jaw movements during the treatment and follow up period.The assessment of psychosocial aspects of TMD comparing baseline and follow up in all treatment groups revealed that treatment do not promote modification in intensity of chronic pain (D1). However, D2 (depression) evaluation showed reduction in PBM and CT groups. All treatments promoted reduction in physical symptoms with and without pain (D3a and D3b). Also, all the treatments results in enhancement of jaw disabilities. MT promotes improvement in 5 functions, PBM in 2 and CT in 1.BAI analysis revealed that all treatments lead to a reduction in anxiety. The present findings indicate that PBM, MT and CT are able to promote pain relief, improve mandibularfunction and reduce the psychosocial negative aspects in TMD patients.

Made available in DSpace on 2014-06-11T19:28:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-10-15Bitstream added on 2014-06-13T20:37:38Z : No. of bitstreams: 1 giovanetti_col_me_guara.pdf: 518381 bytes, checksum: ddfdeaa86ef27663b67237c1b7d951da (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O presente estudo teve por objetivo estimar a pressão plantar em indivíduos com e sem dor temporomandibular, antes e após a intervenção fisioterapêutica manual na porção cervical. Na metodologia, utilizou-se uma plataforma de força para aquisição da distribuição das pressões plantares dos pés em duas etapas: antes e após a intervenção. Foram comparadas as forças plantares das porções ântero-medial, ânterolateral, postero-medial e postero-lateral dos pés, as quais foram quantificadas e comparadas entre os pés direito e esquerdo dos indivíduos com e sem dor antes e após a manobra fisioterapêutica. Nas comparações entre as médias dos ensaios anteriores e posteriores à intervenção fisioterapêutica para as situações com e sem sintomatologia dolorosa foi utilizado o teste não paramétrico Mann-Whitney Wilcoxon, através do programa SSPS 15.0. As comparações dos valores médios do grupo com e sem sintomatologia dolorosa foram feitas comparando a força em cada sensor antes e depois do pé direito e esquerdo e para sensores de mesma localização antes e depois de pés diferentes. O nível de significância estatística adotado foi = 10%. Participaram 20 indivíduos de ambos os sexos, sendo 8 com dor e 12 sem dor, com idade entre 16 e 60 anos, sem qualquer queixa ou indício de outras doenças ortopédicas e/ou neurológicas. Nas comparações entre as médias de mesma posição em pés diferentes para os sujeitos com e sem dor houve maior significância estatística em detrimento das comparações entre as médias antes e depois da intervenção, isto é, dos mesmos pés. Além disso, houve um aumento na pressão plantar no retropé, o que leva a uma hipótese de menor carga distribuída nas demais porções dos pés, mesmo que não se saiba se a compensação se deu em porção dos mesopés ou do antepés. / The present study has the aim of making a research into the plantar pressure, by investigating those ones with or without temporomandibular pain, before and after a manual physicaltherapy intervention in cervical portion. In the methodology, it was used a force plataform for the acquisition of the plantar pressure distribution in two times: just before and just after the intervention. It was compared the plantar strength of the front-medial, front-lateral, back-medial e back-lateral portions of the feet. They were quantified and compared between the right and left feet of those with and without pain just before just after the manual therapy. It was used the non-parametric test Mann-Whitney Wilcoxon, using the SSPS 15.0 program to compare the medias of the essays. In the comparision of the medium values of the group with and without pain, it was compared each of the sensor stenght of the right and the left feet before and after and between them before and after in different feet. The statistic significance level was = 10%. Twenty people participated of both sexes, 8 with pain and 12 without it, between 18 e 60 years old, without any claim or symptom of orthopedic or neurological deseases. In the comparision of the medias of same position in different feet, for those with and without pain, there was more satistical significance than the comparision between the medias before and after the intervention of the same feet. More over, there was an increase of the plantar pressure of the back portions of the feet that could be compensed by the medium or front portion of one foot or the feet.

A disfunção temporomandibular (DTM) é uma doença complexa e multifatorial. Diversas modalidades terapêuticas prometem aliviar os sintomas, melhorar a função e reduzir o impacto da doença na qualidade de vida do paciente. O objetivo desse estudo foi investigar o efeito da fotobiomodulação (PBM) e da terapia manual (MT) isoladas ou combinadas no controle da dor, no restabelecimento dos movimentos mandibulares, nos aspectos psicossociais e dos níveis de ansiedade nos pacientes com DTM mista. Cinqüenta e um pacientes com DTM foram alocados randomicamente em três grupos: grupo PBM (808 nm, 100mW, 13,3J / cm2, 4J por ponto), grupo MT (sessões de 21 minutos, nos músculos mastigatórios e ATM) e grupo de Terapia Combinada (CT). Todos os tratamentos foram realizados três vezes por semana durante quatro semanas consecutivas. As avaliações foram realizadas no início, durante o tratamento (dias 7, 14, 21 e 28) e no follow up(dia 60 e dia 90). A escala analógica visual (VAS), o Research Diagnostic Criteria (RDC / TMD) e o inventário de ansiedade Beck (BAI) foram utilizados em diferentes momentos do estudo. Todos os grupos demonstraram redução da dor ao longo do tratamento e follow up(<0,001). Todos os tratamentos promoveram melhora em alguns movimentos mandibulares durante o período de tratamento e follow up. A avaliação dos aspectos psicossociais da DTM, comparando o início e o follow up, não revelou modificação na intensidade da dor crônica (D1) em nenhum dos grupos de tratamento. No entanto, a avaliação de D2 (depressão) mostrou redução nos grupos PBM e CT. Todos os tratamentos promoveram redução dos sintomas físicos com e sem dor (D3a e D3b). Além disso, todos promoveram melhora funcional mandibular. A MT promoveu a melhora em 5 funções, PBM em 2 e CT em 1. A análise de BAI revelou que todos os tratamentos reduziram a ansiedade. Os resultados indicam que PBM, MT e CT são capazes de promover alívio da dor, melhorar a função mandibular e reduzir os efeitos dos aspectos psicossociais em pacientes com DTM. / Temporomandibular disorders (TMD) is a complex and multifactorial disease. Therapeutic modalities expected to relief symptoms, improve function and reduce the impact of the disease in patient’s quality of life. The aim of the present study was to investigate the effect of photobiomodulation (PBM) and manual therapy (MT) isolated or combined in the treatment of TMD. Fifty-one TMD patients were randomly allocated to three groups: PBM (808 nm, 100mW, 13.3J /cm2, 4 J per point), MT group (21 minutes sessions of MT of the masticatory muscles and TMJ)and Combined Therapy group (CT). All treatments were done three times a week for four consecutive weeks. Evaluations were performed at baseline, during the treatment (Days 7, 14, 21, and 28) and follow up (Day 60 and Day 90).Visual analogue scale(VAS),Research Diagnostic Criteria(RDC / TMD),Beck anxiety inventory (BAI)were used in different moments of evaluation time. All groups demonstrated reductions in pain throughout treatment and maintained low pain value in follow up period (<0.001). All treatments promoted improvement in some jaw movements during the treatment and follow up period.The assessment of psychosocial aspects of TMD comparing baseline and follow up in all treatment groups revealed that treatment do not promote modification in intensity of chronic pain (D1). However, D2 (depression) evaluation showed reduction in PBM and CT groups. All treatments promoted reduction in physical symptoms with and without pain (D3a and D3b). Also, all the treatments results in enhancement of jaw disabilities. MT promotes improvement in 5 functions, PBM in 2 and CT in 1.BAI analysis revealed that all treatments lead to a reduction in anxiety. The present findings indicate that PBM, MT and CT are able to promote pain relief, improve mandibularfunction and reduce the psychosocial negative aspects in TMD patients.