Research and News
Posts tagged rehabilitation
Cervicogenic Headache Treatment: What’s the Evidence?
Oct 11th
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Janda's Upper Crossed Syndrome
How many of your patients with neck pain suffer from headaches as well, or vice-versa? Cervicogenic headaches are characterized by unilateral headache radiating from the posterior to anterior head, unilateral upper cervical pain and facet “locking,” which is often aggravated by sustained neck positions. Cervicogenic headaches are thought to result from a convergence of sensory input from the upper cervical spine into the trigeminal nucleus. Interestingly, these patients often exhibit Janda’s Upper Crossed Syndrome.
I recently published a review article on the assessment and management of cervicogenic headaches in the International Journal of Sports Physical Therapy. The article describes the assessment of posture, range of motion, muscle length, muscle strength, joint mobility, breathing patterns, and trigger points. A special test, the Cervical Flexion-Rotation test, can help confirm the diagnosis with ~90% accuracy.
Based on my review of the literature, I recommend a multi-modal layered approach to cervicogenic headaches (or any chronic musculoskeletal pain syndrome for that matter): modalities, manual therapy, and therapeutic exercise. For cervicogenic headache patients, modalities such as TENS, cryotherapy, or low-level laser therapy can be helpful. Spinal manipulative More >
A successful treatment of chronic plantar fasciitis
May 19th
Plantar fasciitis is a painful condition caused by an inflammation of the plantar fascia, affecting nearly 2 million in the US annually (Martin et al. 2001). While most cases of plantar fasciitis are resolved with conservative treatment within a year, severe cases usually result in a surgical intervention.
A recent case report in the Journal of Geriatric Physical Therapy describes a successful intervention in a 61 year old patient with a 10-year history of chronic plantar fasciitis who used night splints. Plantar fasciitis can increase the risk of falls in older adults, although the condition is not as prevalent as in younger adults.
In the case report, physical therapists Stephanie Peplinski and Kent Irwin described their 4-week intervention. The patient received 8 sessions of individualized physical therapy, twice a week for 4 weeks. She received soft tissue mobilization and iontophoresis with dexamethasone, and performed 4-direction ankle Thera-Band resistance band exercises for 10 repetitions in the clinic and at home. She also used a balance board and foam pad for balance training in the clinic.
At discharge, she reported decreased pain and improved activities of daily living (ADL). This case report demonstrated that an individualized physical therapy program with targeted interventions can improve the symptoms in chronic More >
Elastic resistance training can be effective for treating anterior knee pain
Apr 19th
Elastic resistance is often prescribed as part of a rehabilitation program for anterior knee pain (patellofemoral pain syndrome), but its overall efficacy remains unclear. I recently published a systematic review of the topic in the journal, Sports Health. Eight studies using elastic resistance training met the criteria for the review. The exercises typically involved strengthening the hip muscles with 4-direction Thera-Band® kicks, but each study used a different exercise program with elastic resistance. Download an anterior knee pain exercise program with Thera-Band® elastic resistance here.
While each study found significant improvements in pain, due to the study designs (lack of true control), it’s difficult to determine if the elastic resistance was the primary factor for the reduction in pain. However, we can conclude that exercise programs utilizing Thera-Band elastic resistance products can help reduce pain and increase function and strength in patients with patellofemoral pain syndrome.
REFERENCE: Page P. Effectiveness of elastic resistance in rehabilitation of patients with patellofemoral syndrome: What is the evidence? Sports Health. 2011. 3(2):190-94.
Visit the Thera-Band Academy Anterior Knee Pain Resource Center Here
Intensive two-week exercise program benefits stroke survivors
Mar 28th
Patients suffering a stroke are often left with residual deficits in strength and gait. Depending on the severity of the stroke, patients are left with a wide range of disabilities. It was once thought that stroke survivors would never regain use of their paretic extremities; however, research continues to demonstrate the benefit of exercise after a stroke. Researchers in Norway were interested to see if a two-week, intensive exercise program for stroke survivors at least six months post stroke was effective and feasible. 12 hemiparetic patients (27-62 years old, average 46.5 years old) completed two weeks of group exercise for six hours a day at an inpatient rehabilitation hospital. The patients exercised in groups of three or four patients supervised by one or two therapists (physical and/or occupational therapists). Their exercises consisted of transfers, weight-bearing on the paretic limb, and stepping exercises for 90 minutes. Balance activities including rocker board and foam balance exercise were performed for 60 minutes. Gait training and strength training exercises were performed for 75 minutes each. Strengthening activities included functional tasks and exercises for the ankle, knee, hip and trunk. Patients were pre-tested 16 days and three days prior to the intervention, and post-tested three More >
Thera-Band exercise protocol for chronic neck pain improves quality of life
Dec 15th
Dr. Jari Ylinen of Finland has published several studies using Thera-Band resistance bands for chronic neck pain, including articles in the Journal of the American Medical Association. Females with chronic neck pain have shown significant decreases in pain and significant increases in neck strength up to 2 years after his program. The exercises include dynamic-isometric cervical flexion, extension, and sidebending against black Thera-Band resistance bands. Patients also perform upper body dumbbell exercises. The program is initially performed for 12 days in a rehabilitation clinic, then at home for one year. Download the Thera-Band Chronic Neck Pain exercise protocol here.
In his most recent publication documenting the outcomes of his program, Dr. Ylinen and his colleagues investigated the effects of high-intensity Thera-Band resistance exercises on health-related quality of life in patients with chronic neck pain after one year of exercise. 180 female office workers with neck pain were randomly assigned to a strengthening exercise group, endurance training group, or control group. The strength training group performed the exercise described above, while the endurance group performed a 20-repetition head-lifting task and dumbbell exercises. Both groups also performed squats, back extension, sit-ups, and stretching.
After one year, both the Thera-Band exercise and endurance exercise groups significantly More >
