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Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 36128

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Special Issue Editors

Prof. Dr. César Fernández De Las Peñas

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Guest Editor

Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Madrid, Spain
Interests: chronic pain; pain neuroscience education, manual therapy; central nervous system sensitization
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Francisco Alburquerque-Sendín

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Guest Editor

Physiotherapy Section, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain
Interests: research methodology; physical therapy; manual therapy; kinematics; musculoskeletal pain
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Proper diagnosis in physical therapy is a challenging step before the application of any clinical procedure. The evidence-based physical therapy paradigm has established the patterns of a well-grounded practice, and the diagnosis and monitoring of the status and the evaluation of the patients are also subject to the strictest standardized rules.

Currently, the broad spectrum of pathologies and syndromes requiring physical therapy attention has increased. Nevertheless, adequate support of proper and valuable diagnostic procedures is not always available.

Recently, technological and non-technological tools have been developed with promising approaches in healthcare and, specifically, in physiotherapy. Some examples include movement analyses throughout portable or non-portable devices, such as inertial measurement units, cameras, or smartphones; and the evaluation of normal tissue mechanical properties determined by elastography, ultrasound, or myotonometry. Examples of non-technological tools include the identification of clinical features (clinical prediction rules) for anticipating the results of defined treatments; specific questionnaires designed to address pathological features of chronic pain syndromes; or patient classification systems for a better definition of the most disabling syndromes, such as low back pain or fibromyalgia.

In summary, this Special Issue targets any innovative solution for a better detection, quantification, or control of any relevant biopsychosocial dimensions for physical therapy in the clinical setting application.

Prof. Dr. César Fernández De Las Peñas
Prof. Dr. Francisco Alburquerque-Sendín
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

innovative diagnostic tools
physical therapy diagnosis
diagnosis in clinical settings
biopsychosocial model evaluation tools

Published Papers (14 papers)

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Research

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9 pages, 1073 KiB

Open AccessArticle

Ultrasonography Comparison of Pelvic Floor and Abdominal Wall Muscles in Women with and without Dyspareunia: A Cross-Sectional Study

by Elena Castellanos-López, Camila Castillo-Merino, Vanesa Abuín-Porras, Daniel López-López and Carlos Romero-Morales

Diagnostics 2022, 12(8), 1827; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12081827 - 29 Jul 2022

Cited by 4 | Viewed by 1456

Abstract

Pelvic floor hypertonicity and narrowing of the levator ani hiatus is traditionally assumed in women with dyspareunia and considered a therapeutical target by physical therapists. However, accurate pre-treatment assessment of pelvic floor muscles is difficult to perform in clinical sites. In addition, the abdominal musculature has not been evaluated in this population, despite its relationship with pelvic floor disfunctions. The purpose of this study was to determine the existence of differences in the length of the anteroposterior diameter of the levator ani hiatus (APDH), the thickness of the abdominal wall musculature and the interrecti distance (IRD) in subjects with dyspareunia compared to a control group. A cross-sectional observational study was designed using ultrasound imaging to measure the APH, the thickness of the abdominal musculature—rectus abdominis (RA), transverse abdominis (TrAb), internal oblique (IO), external oblique (EO)—and IRD at rest and during contraction. Thirty-two women were recruited through advertising and social webs and divided into two groups: dyspareunia (n = 16) and no dyspareunia (n = 16). There were no statistically significant differences (p < 0.05) in RA, TrAb, OI and OE muscle thickness. No differences in APH or in supraumbilical and infraumbilical IRD were found. The findings of this study suggest that the relationship between the abdominal structure/levator ani hypertonia and dyspareunia remains uncertain. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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11 pages, 2062 KiB

Open AccessArticle

Fast Functional Rehabilitation Protocol versus Plaster Cast Immobilization Protocol after Achilles Tendon Tenorrhaphy: Is It Different? Clinical, Ultrasonographic, and Elastographic Comparison

by Mario Mosconi, Gianluigi Pasta, Salvatore Annunziata, Viviana Guerrieri, Matteo Ghiara, Simone Perelli, Camilla Torriani, Federico Alberto Grassi and Eugenio Jannelli

Diagnostics 2022, 12(8), 1824; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12081824 - 29 Jul 2022

Cited by 2 | Viewed by 1891

Abstract

Background: the incidence of Achilles tendon (AT) rupture is rising; however, there is no clear consensus regarding the optimal treatment. The aim of this retrospective study was to compare instrumental and patient-reported outcome scores after fast functional rehabilitation (group A) versus plaster cast immobilization (group B) programs in patients who underwent AT tenorrhaphy. Methods: 33 patients, with similar clinical and demographic features, underwent open AT tenorrhaphy between January and July 2018. Of these, 15 patients were treated with fast functional rehabilitation program (group A), and 18 patients were treated with plaster cast immobilization protocol (group B). Sural triceps hypotrophy and functional scores (American Orthopaedic Foot and Ankle Society (AOFAS) Ankle–Hindfoot Score, and Achilles tendon Total Rupture Score (ATRS)) were recorded at a 12-month follow-up. Ultrasonography (US) and elastosonography (ES) were used to compare the characteristics of the tendons after surgery. Results: At 12 months, no significant differences in any of the patient-reported outcomes or the instrumental measurement tests were seen between the two groups. Conclusions: fast functional rehabilitation after AT surgical repair is safe, effective, and may be the first choice of treatment, especially in young, collaborative, and active patients. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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11 pages, 868 KiB

Open AccessArticle

Interexaminer Reliability and Validity of Quantity of Cervical Mobility during Online Dynamic Inspection

by Leire Leonet-Tijero, Jaime Corral-de-Toro, Jacobo Rodríguez-Sanz, Mar Hernández-Secorún, Hugo Abenia-Benedí, María Orosia Lucha-López, Sofía Monti-Ballano, Julián Müller-Thyssen-Uriarte, Héctor Tricás-Vidal, César Hidalgo-García and José Miguel Tricás-Moreno

Diagnostics 2022, 12(2), 546; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12020546 - 21 Feb 2022

Viewed by 2852

Abstract

Background: Physical therapists routinely measure range of motion (ROM) of cervical spine. The reliability of the cervical range of motion (CROM) device has been demonstrated in several studies, but current evidence on the validity and reliability of the visual inspection is contradictory. The aim is to assess the validity and interexaminer reliability of the online visual inspection of active cervical ROM in physiotherapy students. Methods: Flexion, extension, both lateral flexions and rotations of a single participant were measured using CROM. Online visual inspection of 18 physiotherapy students against CROM was registered. Results: The validity, against CROM, of the online visual inspection of the active ROM ranged from good to excellent (Intraclass Correlation Coefficient (ICC) 0.83–0.97). Interexaminer reliability of the online visual inspection had favorable outcomes in all cervical movements in the three physiotherapy courses (ICC 0.70–0.96), with the visual inspection of the rotations being the most reliable (ICC 0.93–0.97). Interexaminer reliability of the classification of mobility was poor to good (Kappa 0.03–0.90). Conclusions: The interexaminer reliability and validity of the quantification of active cervical movement during online visual inspection was shown to be good to excellent for flexion-extension and lateral flexions and excellent for rotations. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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14 pages, 1277 KiB

Open AccessArticle

Assessment from a Biopsychosocial Approach of Flight-Related Neck Pain in Fighter Pilots of Spanish Air Force. An Observational Study

by Luis Espejo-Antúnez, Carlos Fernández-Morales, Juan Manuel Moreno-Vázquez, Fernando Blas Tabla-Hinojosa, María de los Ángeles Cardero-Durán and Manuel Albornoz-Cabello

Diagnostics 2022, 12(2), 233; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12020233 - 19 Jan 2022

Cited by 4 | Viewed by 2300

Abstract

Flying on fighter aircraft is the only human activity that exposes the body to acceleration levels for long periods of time. In this sense, the regular exposure to G forces has been related to a high incidence of flight-related neck pain. The aim is to evaluate flight pilots of the Spanish Air Force (instructors vs. students) diagnosed with flight-related neck pain from a biopsychosocial perspective. Eighteen fighter pilots with flight-related neck pain were divided into two groups: instructor fighter pilots (n = 7) and student fighter pilots (n = 11). The Neck Disability Index (NDI), Cervical Range of Motion (CRoM), Pain Pressure Threshold (PPT), cervical repositioning error, and myoelectric activity were evaluated. Cervical flexion, extension and left and right rotation showed a reduced range of motion in both groups with respect to the normative values of the healthy population. There were no statistically significant differences between the groups (p ≥ 05). The correlational analysis showed a strong association between the NDI and CRoM of the left rotation (β =−0.880, p = 0.002). The NDI also had a positive association with the pilot’s age (β = 1.353, p < 0.01) and the number of flight hours (β = 0.805, p = 0.003). In conclusion, the Cervical Range of Motion at the left rotation seems to determine the perceived degree of disability in both the instructors and students. This factor could be influenced by the number of flight hours and accumulated experience as an F-5 fighter pilot. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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12 pages, 7238 KiB

Open AccessArticle

Study on the Reliability and Accuracy of Scolioscope, a New Digital Scoliometer

by Georgios Krekoukias, George A. Koumantakis, Vasileios S. Nikolaou and Konstantinos Soultanis

Diagnostics 2022, 12(1), 142; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12010142 - 07 Jan 2022

Cited by 1 | Viewed by 2167

Abstract

Early detection of scoliosis with school screening and quick, easy, and reliable assessment of its progress are of paramount importance in the management of patients. There have been several tools described, with the most common being the analog scoliometer. Most recently, smartphone applications have entered this area with and without the use of sleeves for the device. There is no research that has evaluated the accuracy of measurements both left and right in either digital or analog devices. In this study, we evaluated the reliability and validity of a new digital scoliometer called the Scolioscope. Thirty subjects were included for the intra-rater reliability study. ICC values >0.9 were calculated both for same-day and between-day measurements. The device was highly accurate with an average difference from the ones set on the sine bar of 0.03° for right-side measurements and 0.18° for the left. These measurements suggest a highly accurate and reliable tool. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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13 pages, 985 KiB

Open AccessArticle

Absolute and Relative Reliability of the Assessment of the Muscle Mechanical Properties of Pelvic Floor Muscles in Women with and without Urinary Incontinence

by Daiana Priscila Rodrigues-de-Souza, Sandra Alcaraz-Clariana, Lourdes García-Luque, Cristina Carmona-Pérez, Juan Luis Garrido-Castro, Inés Cruz-Medel, Paula R. Camargo and Francisco Alburquerque-Sendín

Diagnostics 2021, 11(12), 2315; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11122315 - 09 Dec 2021

Cited by 6 | Viewed by 2368

Abstract

An analysis of the muscle mechanical properties (MMPs) of the pelvic floor muscles (PFMs) is relevant for understanding the physiopathology of urinary incontinence (UI). However, there is no objective and reliable methodology currently available for quantifying the MMPs of PFMs. Thus, the objective was to determine the intra-rater and inter-rater reliability of the MMPs of PFM assessment with a hand-held tonometer device, called the MyotonPRO, in young women with and without UI. Sociodemographic and pelvic floor questionnaires, plus MMPs of PFMs were assessed in 38 nulliparous women with UI and 40 matched healthy women by two trained physiotherapists on two different occasions, 48–72 h apart. Good to excellent absolute reliability was found for tone, stiffness, and decrement of both intra- and inter-rater analyses in both study groups (Intraclass Correlation Coefficient ranged from 0.75 to 0.92), with a trend of lower values for relaxation and creep. The standard error of measurement (SEM) did not achieve 10% of the mean values for any MMPs. The minimum detectable change (MDC) values were also provided for clinical applications. In conclusion, the relative reliability of tone, stiffness, and the assessment of the decrement of PFMs with MyotonPRO is good to excellent for UI and healthy women. The SEM and MDC values were acceptable for their application in clinical settings. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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13 pages, 8011 KiB

Open AccessArticle

Detection of Changes on Parameters Related to Heart Rate Variability after Applying Current Interferential Therapy in Subjects with Non-Specific Low Back Pain

by Luis Espejo-Antúnez, Carlos Fernández-Morales, María de los Ángeles Cardero-Durán, José Vicente Toledo-Marhuenda, Juan Antonio Díaz-Mancha and Manuel Albornoz-Cabello

Diagnostics 2021, 11(12), 2175; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11122175 - 23 Nov 2021

Cited by 3 | Viewed by 2270

Abstract

Interferential current therapy (ICT) is an electrotherapeutic intervention that combines the advantages of high permeability from middle frequency currents and efficient tissue stimulation from low frequency currents, delivering the maximum current with high tissue permeability. The aim was to evaluate the effects of ICT on heart rate variability (HRV) and on pain perception in patients with non-specific chronic low back pain (NSCLBP). In the study, 49 patients with NSCLBP were randomly divided into an experimental (EG) and a sham group (SG). All participants received a single intervention, ICT, or simulated intervention. Outcome measures including baseline (sit-down position) and postintervention (prone position) pain, heart rate (HR), time domain parameter (rMSSD), diameters of the Poincaré plot (SD1, SD2), stress score (SS), and sympathetic/parasympathetic (S/PS) ratio were investigated. In both groups, significant statistical differences were found in perceived pain and in all HRV parameters except in HRmax. Between-group comparisons showed statistically significant differences in all variables except for HRmin and HRmean in favor of the experimental group. These changes reported an increase in parasympathetic activity (rMSSD) (p < 0.05) and a decrease in sympathetic activity (increase in SD2 and decrease in SS) (p < 0.001) and perceived pain (p < 0.001), with a greater size effect (η2 = 0.44) in favor of the experimental group. In conclusion, a single session of ICT can shift the autonomic balance towards increase parasympathetic dominance and decrease the sympathetic dominance and intensity of pain perceived by patients with NSCLBP. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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9 pages, 1871 KiB

Open AccessArticle

Muscular Echovariation as a New Biomarker for the Classification of Soleus Muscle Pathology: A Cross-Sectional Study

by Blanca De-la-Cruz-Torres and Carlos Romero-Morales

Diagnostics 2021, 11(10), 1884; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101884 - 12 Oct 2021

Cited by 3 | Viewed by 1927

Abstract

Background: Soleus injury is one of the most common soft tissue tears during sport activities. Current classifications of muscle tears are based on symptoms and tear size and they do not contribute suitable evidence-based treatment protocols. The objective of this study was to analyze the most frequent echotexture findings of patients with soleus muscle injury, located in the central intramuscular tendon (IMT), and healthy people to determine whether they behave differently and to propose an ultrasound (US)-based classification. Methods: eighty-four athletes, who played in sport activities comprising lower limbs. Echotexture characteristics of soleus muscle were reviewed for 84 subjects. They were divided based on the muscle echogenicity in three groups (Injury Type 1 group, Injury type 2 group and healthy group). Echointensity (EI) and Echovariation (EV) were taken in all groups like quantitative US variable. Results. The Injury Type 1 group was identified by a hypoechoic area and characterized by a higher EV; and Injury Type 2 group was identified by a fibrotic area and characterized by a lower EV. The echogenic pattern of healthy people obtained an intermediate value of EV between both injured soleus types. Conclusions. EV may be useful to classify different types of soleus muscle pathology according to the echogenicity pattern. An innovative proposed US-based classification system for soleus tears may be used to guide treatment decisions for patients with central tendon injury of soleus muscle. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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10 pages, 698 KiB

Open AccessArticle

Psychometric Evaluation of the Krogh-Poulsen Test for the Diagnosis of the Temporomandibular Disorders

by Alfonso Javier Ibáñez-Vera, Roger Alonso-Royo, Carmen María Sánchez-Torrelo, Noelia Zagalaz-Anula, Jesús López-Collantes and Rafael Lomas-Vega

Diagnostics 2021, 11(10), 1876; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101876 - 12 Oct 2021

Cited by 4 | Viewed by 1639

Abstract

The Krogh-Poulsen Test is a classic instrument to measure dysfunction of the stomatognathic system whose psychometric properties are unknown. This study aimed to evaluate the psychometric properties of the Krogh-Poulsen Test for the diagnosis of temporomandibular disorders (TMDs). A cross-sectional study was designed, including 119 patients (63 patients with TMD and 56 healthy controls). Factorial validity, inter-rater reliability, error of measurement, diagnostic validity of the Krogh-Poulsen Test, and concurrent validity were analyzed. The Krogh-Poulsen Test showed a three-factor structure. The inter-rater agreement could be considered very good with a kappa index of 0.87 (95% CI 0.83–0.90) and Standard Error of Measurement of 0.79. Correlations were strong with other orofacial instruments, moderate with instruments measuring TMD-related disorders such as neck pain, headache, or dizziness, and poor with generic quality of life instruments. The Area Under the Curve ROC was 0.928 showing, for a cut-off point >1, a sensitivity of 90.48 (95% CI 80.4–96.4) and a specificity of 85.71 (95% CI 73.8–93.6) for the diagnosis of TMD disorders. The Krogh-Poulsen Test showed a three-factor structure, very good inter-rater reliability, a strong correlation with other orofacial instruments, and an excellent capacity to discriminate between patients with or without TMD. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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Other

Jump to: Research

14 pages, 919 KiB

Open AccessProtocol

The Effectiveness of Manual Therapy in the Cervical Spine and Diaphragm, in Combination with Breathing Reeducation Exercises, in Patients with Non-Specific Chronic Neck Pain: Protocol for Development of Outcome Measures and a Randomized Controlled Trial

by Petros I. Tatsios, Eirini Grammatopoulou, Zacharias Dimitriadis and George A. Koumantakis

Diagnostics 2022, 12(11), 2690; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12112690 - 04 Nov 2022

Cited by 2 | Viewed by 2637

Abstract

Until now, non-specific chronic neck pain has mainly been considered as a musculoskeletal system dysfunction, with associated psychological involvement due to its prolonged or recurrent nature. However, patients with non-specific chronic neck pain frequently additionally exhibit respiratory dysfunction. Emerging evidence suggests that addressing the respiratory dysfunction in these patients will provide additional therapeutic benefits in musculoskeletal and respiratory-related outcomes for several reasons (biomechanical, biochemical, and psychological). Motor control dysfunction of the muscles surrounding the spine (diaphragm included) negatively affects the mechanics and biochemistry of breathing (pH-homeostasis). An impaired and ineffective breathing pattern has been recognized as the primary source of many unexplained symptoms (anxiety, depression, confusion, chest pain, hypocapnia, and breathlessness) in patients with non-specific chronic neck pain. The proposed protocol’s purpose is dual: to assess the relative effectiveness of manual therapy in the cervical spine and the diaphragm, in combination with breathing reeducation exercises, along with cervical spine manual therapy or usual physical therapy care on the underlying dysfunctions in patients with non-specific chronic neck pain via a randomized controlled clinical trial, and to validate part of the outcome measures. Several musculoskeletal and respiratory dysfunction outcomes will be employed to delimit the initial extent and level of dysfunction and its resolution with the treatments under study. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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5 pages, 412 KiB

Open AccessReply

Trigger Points and Contracture/Contraction Knots: What’s in a Name? Reply to Dommerholt, J.; Gerwin, R.D. Contracture Knots vs. Trigger Points. Comment on “Ball et al. Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response. Diagnostics 2022, 12, 321”

by Andrew Ball, Thomas Perreault, César Fernández-de-las-Peñas, Michael Agnone and Jordan Spennato

Diagnostics 2022, 12(10), 2366; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12102366 - 29 Sep 2022

Cited by 1 | Viewed by 1200

Abstract

We are responding to the comment by Dommerholt and Gerwin that we have reverse-defined “myofascial trigger point” (MTrP) and “contracture/contraction knot.” In attempting to maintain philosophical agreement with specific and implied aspects of their integrated hypothesis of trigger-point formation (namely a MTrP being ischemic and hypoxic), we referred to the MTrP as the small hyperechoic signal rather than the larger hypoechoic (and therefore hyperperfused) structure surrounding it. It was never our intent to re-define nor contribute to confusion. In making this concession with respect to Dommerholt and Gerwin’s preferred nomenclature, however, we must instead now reconcile what we image as a hypoechoic (and therefore hyperperfused) MTrP with it being concurrently hypoxic. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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5 pages, 236 KiB

Open AccessComment

Contracture Knots vs. Trigger Points. Comment on Ball et al. Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response. Diagnostics 2022, 12, 321

by Jan Dommerholt and Robert D. Gerwin

Diagnostics 2022, 12(10), 2365; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12102365 - 29 Sep 2022

Cited by 4 | Viewed by 1470

Abstract

A recent study published in Diagnostics attempted to visualize trigger points and contracture knots with high-definition ultrasound. Based on their findings, the authors reversed the commonly understood meaning of the two terms. However, they did so without providing any convincing evidence. The authors maintained that their sonography images represented trigger points within contracture knots, supporting the multiple loci hypothesis. On review of the paper, both conclusions seem premature and rather speculative. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

16 pages, 1577 KiB

Open AccessSystematic Review

The Effectiveness of Spinal, Diaphragmatic, and Specific Stabilization Exercise Manual Therapy and Respiratory-Related Interventions in Patients with Chronic Nonspecific Neck Pain: Systematic Review and Meta-Analysis

by Petros I. Tatsios, Eirini Grammatopoulou, Zacharias Dimitriadis, Maria Papandreou, Eleftherios Paraskevopoulos, Savvas Spanos, Palina Karakasidou and George A. Koumantakis

Diagnostics 2022, 12(7), 1598; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12071598 - 30 Jun 2022

Cited by 6 | Viewed by 2952

Abstract

Patients with nonspecific chronic neck pain (NSCNP) exhibit respiratory dysfunction. This systematic review aimed to analyze randomized controlled trials (RCTs) investigating the effect of spinal and/or diaphragmatic and/or specific stabilization exercise manual therapy and/or respiratory exercises on musculoskeletal and respiratory diagnostic outcomes in patients with NSCNP. A systematic search and selection of RCTs was performed in three scientific databases (Pubmed, Scopus, and Physiotherapy Evidence Database (PEDro)) and one search engine (Google Scholar) from inception to April 2022. Relevant studies published in the English language were extracted, evaluated, and independently rated for methodological quality (PEDro scale). The quality of the evidence was assessed with the GRADE approach. Out of 1089 studies collected in total, 1073 were excluded (i.e., did not meet the inclusion criteria or were duplicates). Sixteen RCTs were finally included, rated on 5.62/10 (PEDro score) on average for methodological quality. Overall, there was sparse evidence that spinal and/or diaphragmatic manual therapy and/or trunk stabilization exercises and/or respiratory exercises significantly improved pain, disability, and respiratory outcomes in patients with NSCNP immediately post-treatment. However, the clinical heterogeneity between studies was significant, and the level of certainty of the evidence was low to very low. More, high-quality RCTs are required, contributing to the holistic diagnostic monitoring and management of patients with NSCNP. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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8 pages, 2736 KiB

Open AccessCase Report

Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response

by Andrew Ball, Thomas Perreault, César Fernández-de-las-Peñas, Michael Agnone and Jordan Spennato

Diagnostics 2022, 12(2), 321; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12020321 - 27 Jan 2022

Cited by 6 | Viewed by 7134

Abstract

The literature has hypothesized that a trigger point (TrP) area consists of a hyperperfused contracture knot with smaller hypoperfused TrPs within the contracture knot. By contrast, the only published ultrasound image of a TrP has it labeled hypoechoic (i.e., hyperperfused) with no commentary regarding smaller speckles of hypoperfusion within. Furthermore, the lack of clarity in objective definition of the terms associated with the TrP (namely, the palpable “contracture knot” and smaller nonpalpable “trigger point”) has led to unnecessary communication difficulties between and among clinicians and researchers. In this case series of three muscles across two patients, by using high-definition musculoskeletal ultrasound imaging technology, we present what we believe to be the first reliable capture of palpable hypoechoic (e.g., hypoperfused) contracture knots (previously mislabeled as a hypoechoic TrP), and a visual support of the multiple loci hypothesis first proposed by Hong and Simons—the first reliable confirmation of the hyperechoic (i.e., hypoperfused) TrP within. Initially proposed by a histological study and supported by microdialysis study, this case series lends further support for the multiple loci hypothesis through visual confirmation of palpable hypoechoic contracture knots, with smaller hypoechoic TrPs “speckles” within. Full article

(This article belongs to the Special Issue Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting 2.0)

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