Contributions of myofascial pain in diagnosis and treatment of shoulder pain. A randomized control trial

<p>Abstract</p> <p>Background</p> <p>Rotator cuff tendinopathy and subacromial impingement syndrome present complex patomechanical situations, frequent difficulties in clinical diagnosis and lack of effectiveness in treatment. Based on clinical experience, we have therefore considered the existence of another pathological entity as the possible origin of pain and dysfunction. The hypothesis of this study is to relate subacromial impingement syndrome (SIS) with myofascial pain syndrome (MPS), since myofascial trigger points (MTrPs) cause pain, functional limitation, lack of coordination and alterations in quality of movement, even prior to a tendinopathy. MTrPs can coexist with any degenerative subacromial condition. If they are not taken into consideration, they could perpetuate and aggravate the problem, hindering diagnosis and making the applied treatments ineffective.</p> <p>The aims and methods of this study are related with providing evidence of the relationship that may exist between this condition and MPS in the diagnosis and treatment of rotator cuff tendonitis and/or SIS.</p> <p>Method/design</p> <p>A descriptive transversal study will be made to find the correlation between the diagnosis of SIS and rotator cuff tendonitis, positive provocation test responses, the existence of active MTrPs and the results obtained with ultrasonography (US) and Magnetic Renonance Imaging (MRI). A randomized double blinded clinical trial will be carried out in experimental conditions: A Protocolized treatment based on active and passive joint repositioning, stabilization exercises, stretching of the periarticular shoulder muscles and postural reeducation. B. The previously described protocolized treatment, with the addition of dry needling applied to active MTrPs with the purpose of isolating the efficacy of dry needling in treatment.</p> <p>Discussion</p> <p>This study aims to provide a new vision of shoulder pain, from the perspective of MPS. This syndrome can, by itself, account for shoulder pain and dysfunction, although it can coexist with real conditions involving the tendons.</p> <p>Trail Registration</p> <p>ISRCTN Number: 30907460</p

Contribution of dry needling to individualized physical therapy treatment of shoulder pain: A randomized clinical trial

STUDY DESIGN: Multicenter, parallel randomized clinical trial. BACKGROUND: Myofascial trigger points (MTrPs) are implicated in shoulder pain and functional limitations. An intervention intended to treat MTrPs is dry needling. OBJECTIVES: To investigate the effectiveness of dry needling in addition to evidence-based personalized physical therapy treatment in the treatment of shoulder pain. METHODS: One hundred twenty patients with nonspecific shoulder pain were randomly allocated into 2 parallel groups: (1) personalized, evidencebased physical therapy treatment; and (2) trigger point dry needling in addition to personalized, evidence-based physical therapy treatment. Patients were assessed at baseline, posttreatment, and 3-month follow-up. The primary outcome measure was pain assessed by a visual analog scale at 3 months, and secondary variables were joint range-of-motion limitations, Constant-Murley score for pain and function, and number of active MTrPs. Clinical efficacy was assessed using intention-to-treat analysis. RESULTS: Of the 120 enrolled patients, 63 were randomly assigned to the control group and 57 to the intervention group. There were no significant differences in outcome between the 2 treatment groups. Both groups showed improvement over time. CONCLUSION: Dry needling did not offer benefits in addition to personalized, evidencebased physical therapy treatment for patients with nonspecific shoulder pain. Copyrigh

Proyecto curricular para graduado escolar

Se desarrolla un nuevo currículo escolar con la ampliación de los contenidos de tipo formal, buscando adecuarse mejor a la realidad del actual trabajador adulto. También se realizan talleres de ocio y creatividad. Pretende desarrollar la capacidad crítica, adquirir una formación básica a través de técnicas de estudio y trabajo, desarrollar la creatividad, favorecer el espíritu de tolerancia y solidaridad, y promover una educación democrática que favorezca la participación social. La metodología es globalizadora, interdisciplinar, activa y participativa, e individualizada. Se evalúa la metodología y contenidos, la inserción de los talleres en el currículo, y los conocimientos y actitudes conseguidos por el alumnado..Madrid (Comunidad Autónoma). Consejería de EducaciónMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

La imagen como desencadenante del proyecto de lectoescritura

Se elaboran materiales para la Educación de Adultos partiendo de los intereses del alumnado y de su entorno socio-cultural. Algunos de los objetivos son la comprensión de la imagen como uno de los lenguajes fundamentales de nuestra sociedad, entender los distintos códigos del lenguaje, ampliar el mundo cultural, desarrollar la capacidad de expresión oral, conseguir el manejo y el dominio de la lecto-escritura, desarrollar la capacidad de crítica ante la realidad que les rodea, desarrollar la capacidad de escucha y comprensión, dominar las operaciones de cálculo utilizadas en la vida cotidiana, desarrollar los lazos afectivos y de solidaridad dentro del grupo, adquirir seguridad en sí mismos y desarrollar la independencia y la autonomía. La metodología es globalizadora, individualizada, y participativa..Madrid (Comunidad Autónoma). Consejería de EducaciónMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES