Effectiveness of Shock Wave Therapy versus Intra-Articular Corticosteroid Injection in Diabetic Frozen Shoulder Patients’ Management: Randomized Controlled Trial

Frozen shoulder is a major musculoskeletal illness in diabetic patients. This study aimed to compare the effectiveness of shock wave and corticosteroid injection in the management of diabetic frozen shoulder patients. Fifty subjects with diabetic frozen shoulder were divided randomly into group A (the intra-articular corticosteroid injection group) and group B that received 12 sessions of shock wave therapy, while each patient in both groups received the traditional physiotherapy program. The level of pain and disability, the range of motion, as well as the glucose triad were evaluated before patient assignment to each group, during the study and at the end of the study. Compared to the pretreatment evaluations there were significant improvements of shoulder pain and disability and in shoulder flexion and abduction range of motion in both groups (p < 0.05). The shock wave group revealed a more significant improvement the intra-articular corticosteroid injection group, where p was 0.001 for shoulder pain and disability and shoulder flexion and abduction. Regarding the effect of both interventions on the glucose triad, there were significant improvements in glucose control with group B, where p was 0.001. Shock waves provide a more effective and safer treatment modality for diabetic frozen shoulder treatment than corticosteroid intra-articular injection

Efficacy of Vitamin D Supplementation in Addition to Aerobic Exercise Training in Obese Women with Perceived Myalgia: A Single-Blinded Randomized Controlled Clinical Trial

Obese women were more susceptible to myalgia because of their significantly lower vitamin D concentrations; the present study investigated the efficacy of vitamin D in addition to an aerobic interval training in the management of obese women with myalgia. Forty-five obese women with vitamin D deficiency and myalgia (30 to 40 years old) were assigned randomly into three equal groups. Group A received an aerobic interval training with vitamin D supplementation, Group B received vitamin D supplementation only, and Group C received aerobic interval training only; participants in all groups were on calorie deficient diets. The study outcomes were the Visual Analog Scale (VAS) for Pain Evaluation, serum vitamin D level, and Cooper 12-Minute Walk Test for Functional Capacity Evaluation, while the Short-Form Health Survey (SF) was used for assessment of quality of life. We detected a significant improvement in pain intensity level, serum vitamin D level, and quality of life in all groups with significant difference between Group A and groups B and C. We also detected a significant improvement in functional capacity in groups A and C, with no significant change in Group B. Aerobic interval training with vitamin D supplementation was more effective for the management of obese women with perceived myalgia

A RANDOMIZED CONTROLLED PLACEBO STUDY OF DEXTROSE IONTOPHORESIS VERSUS DEXTROSE PROLOTHERAPY IN CASE OF KNEE OSTEOARTHRITIS

Background: Osteoarthritis is the most common cause of musculoskeletal pain and disability in the knee joint. This study investigated the efficacy of Dextrose iontophoresis versus Dextrose prolotherapy in case of knee osteoarthritis in a randomized, placebo-controlled, double-blinded study. Methods: sixty patients diagnosed mild to moderate osteoarthritis were included in the study. Their age's were45:65 years with mean age 51 ± 3.5 years. Patients were divided randomly into three equal groups, group (A)received 50 % dextrose iontophoresis, group (B) Each patient received three intra-articular injections of dextrose at 1-month intervals in weeks 0, 4, and 8 and group (C ) received sham iontophoresis. The outcome measurements were Western Ontario and McMaster Universities arthritis index (WOMAC) values, knee ROM, and pain severity at rest (seated) and in activity (after walking 6 m) using the visual analogue scale (VAS) were recorded. The patients were evaluated for these parameters before allocated in their groups then after 4, 8, and 24 weeks later. Results: compared to sham group (placebo) there were significant improvement of VAS and ROM of iontophoresis group than sham (placebo) group (p<0.000). Also there were significant improvement of prolotherapy group than placebo (p<0.006, and 0.02) respectively. Furthermore there was significant improve of iontophoresis group than prolotherapy where p was <0.000 for VAS, ROM and (WOMAC). Conclusion: The results of this study suggested that both dextrose iontophoresis and dextrose prolotherapy may be as useful modalities in treatment of osteoarthritis with better effects of dextrose iontophoresis than prolotherapy

¿La adición de la terapia de ondas de choque extracorpóreas a los ejercicios de corrección postural mejora el dolor y la diversidad funcional en el dolor de la articulación sacroilíaca posparto? Un ensayo controlado aleatorizado

Examining the outcome of the extracorporeal shock wave therapy (ESWT) on females with postpartum sacroiliac joint pain was the aim of this study.Forty primigravida (six weeks postpartum) females with sacroiliac pain was the sample in this study. The subjects equally randomly allocated in group A and B. Group A was treated by ESWT in addition to postural correction and posterior pelvic tiltingexercises. Group B was treated by the same exercise program only. Two sessions every week for four weeks were received by both groups. The measurement variables were sacroiliac pain and function level that were measured by visual analogue scale (VAS) and the back pain functional scale (BPFS), respectively. All measurements were evaluated pre and post four weeks of intervention.The within groups analysis showed a significant improvement in VAS and a significant increase in BPFS in both groups after treatment compared with baseline. Regarding between groups analyses there was a significant improvement in VAS and a significant increase in BPFS in group A compared with group B. In conclusion, bothESWT and exercise program are effective in decreasing the pain and improving the function in females with postpartum sacroiliac pain. However, byaddingESWT to exercises in the treatment program the results are better, so this combination is recommended in treatment of females with postpartum sacroiliac pain.El objetivo de este estudio fue examinar el resultado de la terapia de ondas de choque extracorpóreas (TOCH) en mujeres con dolor en la articulación sacroilíaca posparto. Cuarenta mujeres primigrávidas (seis semanas después del parto) con dolor sacroilíaco participaron en este estudio. Fueron asignadas al azar a los grupos A y B. El grupo A fue tratado mediante TOCH, además de ejercicios de corrección postural y ejercicios de inclinación pélvica posterior. El grupo B fue tratado únicamente con el mismo programa de ejercicios. Ambos grupos recibieron dos sesiones por semana durante cuatro semanas. Las variables estudiadas fueron el dolor sacroilíaco y el nivel de función, las cuales se midieron mediante la escala visual analógica (EVA) y la escala funcional de dolor de espalda (EFDE), respectivamente. Todas las mediciones se evaluaron antes y después de las cuatro semanas de intervención. El análisis dentro de los grupos mostró una mejora significativa en la EVA y un aumento significativo en la EFDE en ambos grupos después del tratamiento en comparación con el valor inicial. Con respecto a los análisis entre grupos, hubo una mejora significativa en la EVA y un aumento significativo en la EFDE en el grupo A en comparación al grupo B. En conclusión, tanto la TOCH como el programa de ejercicios son efectivos para disminuir el dolor y mejorar la función en mujeres con dolor sacroilíaco posparto. Sin embargo, al agregar TOCH a los ejercicios en el programa de tratamiento, los resultados son mejores, por lo que esta combinación se recomienda en el tratamiento de mujeres con dolor sacroilíaco posparto