To evaluate and compare the effects of stretching and combined therapy (stretching and massage) on postural balance in people aged 50 to 65 years.
Twenty-three subjects participated in this nonrandomized clinical trial study. Each participant randomly received plantar flexor muscle stretching (3 cycles of 45 seconds with a 30-second recovery period between cycles) alone and in combination with deep stroking massage (an interval of at least 30 minutes separated the two interventions). The data were recorded with a force platform immediately after each condition with eyes open and closed. The center of pressure displacement and velocity along the mediolateral and anteroposterior axes were calculated under each condition. The data were analyzed with multiple-pair t-tests.
The center of pressure displacement and velocity along the mediolateral axis increased after both stretching and the combined intervention. There were significant differences in both values between participants in the stretching and combined interventions (p<0.05).
Plantar flexor muscle stretching (for 45 seconds) combined with deep stroking massage may have more detrimental effects on postural balance than stretching alone because each intervention can intensify the effects of the other.
Citations
Massage is generally accepted as a safe and a widely used modality for various conditions, such as pain, lymphedema, and facial palsy. However, several complications, some with devastating results, have been reported. We introduce a case of a 43-year-old man who suffered from tetraplegia after a neck massage. Imaging studies revealed compressive myelopathy at the C6 level, ossification of the posterior longitudinal ligament (OPLL), and a herniated nucleus pulposus (HNP) at the C5-6 level. After 3 years of rehabilitation, his motor power improved, and he is able to walk and drive with adaptation. OPLL is a well-known predisposing factor for myelopathy in minor trauma, and it increases the risk of HNP, when it is associated with the degenerative disc. Our case emphasizes the need for additional caution in applying manipulation, including massage, in patients with OPLL; patients who are relatively young (i.e., in the fifth decade of life) are not immune to minor trauma.
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To introduce a newly designed massage instrument, the Hand Grip T-bar (HT-bar) and use it to relieve chronic non-specific low back pain (nLBP) through deep cross-friction massage (roptrotherapy).
22 subjects (9 males and 13 females, aged 51.6±6.7) with chronic nLBP were allocated randomly to a Roptrotherapy group (n=12) and a Transcutaneous Electrical Nerve Stimulation (TENS) group (n=10). The Roptrotherapy group received deep cross-friction massage with the HT-bar, which was made of metal and had a cylinder for increasing weight and grooves for an easy grip. It was applied across the middle and lower back for 20 minutes a day, 3 days a week for 2 weeks. The TENS group received TENS for 20 minutes a day, 5 days a week for 2 weeks. The outcome was measured on the pain numeric rating scale (PNRS), by the Oswestry disability index (ODI), and by the Roland & Morris Disability Questionnaire (RMDQ) at pre-treatment, at immediate post-treatment and 2 weeks later. The application of the HT-bar was assessed by a questionnaire to 19 therapists.
At post-treatment, immediately and 2 weeks later, both groups showed significant improvement in PNRS, ODI and RMDQ. During the two weeks after post-treatment, however, the Roptrotherapy group improved in PNRS, ODI and RMDQ, but the TENS group did not. Over 80% of the therapists responded that the HT-bar was useful and comfortable.
This study suggests that deep cross-friction massage can be a beneficial therapeutic technique and that the HT-bar can be a useful instrument in deep cross-friction massage for chronic nLBP patients.
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Objective: Shoulder pain in hemiplegia is common and serious problem, but is not completely understood and somewhat controversial. This preliminary study attempt to evaluate the effect and usefulness of subacromial massage in the management of hemiplegic shoulder.
Method: In this ramdomized controlled trial, twenty nine hemiplegic patients with shoulder pain and limitation of motion were treated with either subacromial massage (treatment group) or massage on the supra-acromial area (control group). Outcome measurement of pain intensity, and range of motion were obtained by blinded assessment.
Results: After massage, in treatment group, mean active range of shoulder motion was increased by 14.3o in abduction, 9.0o in flexion, 10.3o in external rotation and 13o in internal rotation versus 3.9o in abduction, 7.5o in flexion, 4.3o in external rotation and 6.4o in internal rotation in control group. The mean pain intensity decreased from VAS 5.47 to 3.8 in treatment group and from VAS 4.57 to 3.71 in control group. This result was statistically significant, except in increment of active range of motion of flexion and external rotation of shoulder joint.
Conclusion: Subacromial massage was used in an effort to increase shoulder motion and to reduce shoulder pain in hemiplegic patients. There were increase in shoulder motion especially abduction, and decrease shoulder pain in study group compared with control group. Further investigation in the form of long term follow up studies is needed. (J Korean Acad Rehab Med 2002; 26: 385-390)
Objective: The purpose of this study is to document the prevalence and patterns of use of alternative therapies and effectiveness in a rehabilitation medicine outpatient practice.
Method: This study was performed that a random sample of 200 patients of rehabilitation outpatient were given a questionnaire addressing their use of alternative therapies.
Results: One or more alternative therapies had been used by 51.3% of subjects for their presenting problem. The most common therapies were acupuncture, oriental medicine, chiropractic and massage. Musculoskeletal pain syndrome involving the low back and shoulder were the most common problems of use of alternative therapies. Of the patients who used alternative treatments, 40.2% reported some degree of efficacy.
Conclusion: A significant proportion of rehabilitation outpatients use alternative therapies and frequently perceived a benefit from them. Incorporating alternative therapies into physiatric practice is a desirable future direction for the speciality.
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