Rustem Mustafaoglu

FRI0690 Comparison of effectiveness of different stretching exercises combined with pressure release technique on latent trigger points in the pectoralis minor muscle

Background: A myofascial trigger point (MTrP) is a hyperirritabl spot located in a palpable taut band of skeletal muscle which are painful upon compression, stretching, or overload of the muscle. It is well known that latent triggerpoint (LTrPs), highly prevalent in healthy subjects, are usually silent even though they can easily develop into ATrPs under the influence of perpetuating factors; therefore LTrPs need to be treated. Objectives: To investigate which type of stretching exercise using after a single-session ischemic compression is more effective for muscle length, pressure pain threshold (PPT), pulmonary function, and respiratory muscle strength in subjects with latent trigger point in the pectoralis minor (PM) muscle. Methods: Two-hundred-six individuals were screened for possible inclusion criteria. Fourty subjects were randomized to the Group-1 (ischemic compression with modified contract-relax PNF stretching), Group-2 (ischemic compression with static stretching), Group-3 (ischemic compression with myofascial release) or Group-4 (no intervention). The assessments were performed at baseline, immediatley after the intervention, and at 24-hours later. The pectoralis minor length (PML) was measured using a standard tape measure. Then, pectoralis minor index (PMI) was calculated. Rounded shoulder posture (RSP) was assessed by the measuring the distance between the posterior border of the acromion and the table 1. Digital algometer was used to evaluate the PPT; spirometer and respiratory pressure meter were used to assess pulmonary function and maximal respiratory pressure, respectively. Results: Improvements were found for PML and PMI between baseline and immediately after intervention in Group-1 and Group-3 (p<0.05). RSP showed a significant improvement only in Group-3 (p=0.03), whereas there was a statistically significant improvement for PPT value in Group-1 immediately after intervention (p=0.005). Significant difference were found in the PEMax at baseline to 24-hours later in Group-1 (p<0.05). There was a statistically significant difference in the PIMax and PEMax in Group-3 (p<0.05). Conclusions: For effective trigger point therapy, ischemic compression should be followed by myofascial release or contract-relax PNF stretching exercises. References 1. Simons DG. Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction. Journal of electromyography and kinesiology2004;14(1):95–107. 2. Ge H-Y, Arendt-Nielsen L. Latent myofascial trigger points. Current pain and headache reports2011;15(5):386–392. 3. Mutlu EK, et al. Latent Trigger Points: What Are the Underlying Predictors?Archives of physical medicine and rehabilitation2016;97(9):1533–1541. Acknowledgements: The present work was supported by the Research Fund of Istanbul University (Project No: TYD-2017–24415). Disclosure of Interest: None declared

The Comparison of The Effectiveness of Physical And Electrotherapy Modalities Versus Home Exercises Program on Frozen Shoulder

Aim: In addition to exercise, physical and electrotherapy modalities such as hotpack, ultrasound and TENS is often applied on frozen shoulder rehabilitation in clinics. The aim of this study was to compare the effectiveness of electrotherapy modalities versus home exercises program in addition to standard physical therapy in both groups on frozen shoulder rehabilitation. Methods: 24 patients diagnosed with frozen shoulder were included in this study. Patients were randomly assigned to Group I (Standard program + electrotherapy, n = 12) and Group II (standard program + home exercise program, n = 12). Standard program consisted of shoulder joint mobilization and shoulder muscles.stretching and strengthening exercises (30 minutes). In addition to this program, Group 1 received Hotpack, ultrasound and TENS for 30 minutes. Group II was given a 30-minute home program including Wand exercises, isometric strengthening and self stretching exercises in addition to standart program. Treatment was applied five day a week for 3 weeks. Patients level of pain, functional state, level of depression and sleep quality evaluated before and after treatment by the Visual Analogue Scale (VAS), the Disabilities of the Arm, Shoulder and Hand (DASH), the Beck Depression Inventory (BDI) and the Pittsburgh Sleep Quality Index (PSQI) respectively. The data were analyzed using the SPSS 20.0 software. The intra-group variations were analyzed using Wilcoxon’s signed-rank test, while inter-group comparisons were drawn using the Mann-Whitney U-test. Result: Study was completed total 22 patients (mean age: 55.2 ± 10.4 years; BMI = 27.7 ± 3.9 kg / m2, 15 women) Group I (n = 12) and Group II (n = 10). VAS-resting (p = 0.011; p = 0.015), VAS-activity (p = 0.005; p = 0.002), BDI (p = 0.012; p = 0.004) and the DASH (p = 0.005 and p = 0004) found a statistically significant improvement in both intra-group change. VAS-night (p = 0.039) and sleep quality (p = 0.047) was found a significant improvement only in Group I. But there was no statistically significant difference between the groups in any parameter (p> 0.05). Conclusion: However VAS-night and sleep quality improved in electrotherapy in terms of intra group change, there was no significant difference between the groups in any parameter. Therefore, we believe that the choice of home exercise program applied in addition to the exercise programwould be more advantageous in terms of cost-effectiveness and time instead of electrotherapy modalities.

AB1245-HPR The Acute Effects of Kinesio Taping on Pain and Aggregated Locomotor Function Score in Knee Osteoarthritis: Pilot Study

Background The European League Against Rheumatism recommended taping on the osteoarthritic knees recently.1 However there is still insufficient evidence about which taping intervention is effective. Kinesio tape, an alternative taping technique, has been theorized to improve a variety of physiological problems, including pain, based on the functions of the tape.2 The acute effect of Kinesio taping on pain has been well identified by previous studies3,4, however effects on physical function in knee osteoarthritis has not been reported yet. Objectives The purpose of the pilot study was to investigate the acute effect of Kinesio Taping on pain and Aggregated Locomotor Function (ALF) score in knee osteoarthritis Methods Fourteen patients (17 knees) with knee osteoarthritis according to Kellegrence Lawrence scale grade 2 or 3 (11 female, 3 male) with a mean age of 53,1±6,1 years included to the study. Patients received written and verbal explanations of the purpose of the study and of the procedures to be applied. They signed informed consent forms. The pain level was evaluated with a Visual Analogue Scale (VAS) in resting and activity time and ALF score was used to assess physical function before and after Kinesio Taping application. The ALF score is a sum of the mean time (seconds) taken to complete three physical function tasks: walking eight meters, ascending and descending seven stairs, and transferring two meters from a sitting to standing position. Each task was carried out separately with a break in between. Taping intervention were applied by certificated physical therapist on knee, quadriceps and hamstring muscles with 25% and without tension. Results The mean body mass index and disease duration was found 30.1±4.4 kg/m2 3.9±2.1 years respectively. The VAS values and ALF scores (walking, ascending and descending stairs, transfering time) significantly reduced after Kinesio Taping application in knee osteoarthritis (p=0.04, p=0.01, p=0.005, p=0,01, p=0,001 and p=0.02; respectively). Conclusions The acute results indicated that patients with osteoarthritis of knee gain clinical benefits from Kinesio Taping application on pain and physical function. However, the long term effects of Kinezio Taping application on pain and physical function is unknown. Further investigation including different kinesio taping application methods with larger sample size are required to reveal short and long term effects. References Fernandes L, Hagen KB, Bijlsma JW, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis. 2013 Jul;72(7):1125-35. Mostafavifar M, Wertz J, Borchers J. A systematic review of the effectiveness of kinesio taping for musculoskeletal injury. The Physician and Sportsmedicine 2012, 40(4):33-40. Hinman RS, Crossley KM, McConnell J, Bennell KL. Efficacy of knee tape in the management of osteoarthritis of the knee: blinded randomised controlled trial. BMJ. 2003 Jul 19;327(7407):135. Anandkumar S, Sudarshan S, Nagpal P. Efficacy of kinesio taping on isokinetic quadriceps torque in knee osteoarthritis: a double blinded randomized controlled study. Physiother Theory Pract. 2014 Aug;30(6):375-83. Disclosure of Interest None declared