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Purpose: To assess the feasibility and clinical impact of brain-targeted treatment (BT; aiming to target sensorimotor processing) in knee osteoarthritis patients attending tertiary care. Methods: Randomized replicated case series. The study involved three phases, each of 2 weeks duration: (1) no-treatment phase; (2) BT phase (left/right judgments and touch discrimination training); and (3) usual care (education, strengthening, and stretching training). Primary outcomes were: timely recruitment; number of participants completing the interventions; treatment compliance and barriers; follow-up rates; and treatment impact on pain and function. Fear-avoidance beliefs and clinical measures of cortical body representation (tactile acuity and left/right judgment performance) were secondary outcomes. Results: A total of 5% (19/355) of all assessed patients were eligible to participate and of these, 58% (11/19) agreed to participate. Ten patients completed the study, and 9 were successfully followed up, with treatment compliance varying between interventions. Compliance was poor for the touch discrimination component of BT. No significant effects were observed for pain relief or knee function after any treatment. A positive impact of treatment was found for fear-avoidance beliefs (usual care vs. washout, p = 0.007; BT vs. washout, p = 0.029) and left/right judgment accuracy (usual care vs. washout; p = 0.006). Conclusions: Clear barriers were identified to implementing BT in tertiary care for knee osteoarthritis. Access to all available services (especially the use of interpreters), and treatment options that do not require additional assistance to perform (e.g., touch discrimination training) represent the main lessons learned. [ABSTRACT FROM AUTHOR]

This study aimed to characterize movement-evoked pain during tendon loading and stretching tasks in individuals with Achilles tendinopathy, and to examine the association between movement-evoked pain with the Achilles tendinopathy type (insertional and midportion), biomechanical, and psychological variables. In this laboratory-based, cross-sectional study, 37 individuals with chronic Achilles tendinopathy participated. Movement-evoked pain intensity (Numeric Rating Scale: 0 to 10) and sagittal-plane ankle biomechanics were collected simultaneously during standing, fast walking, single-leg heel raises, and weight-bearing calf stretch. Description of symptoms, including location of Achilles tendon pain and duration of tendon morning stiffness, as well as pain-related psychological measures, including the Tampa Scale of Kinesiophobia were collected. Linear mixed effects models were built around two paradigms of movement-evoked pain (tendon loading and stretching tasks) with each model anchored with pain at rest. Movement-evoked pain intensity increased as task demand increased in both models. Lower peak dorsiflexion with walking (β = −0.187, 95% CI: −0.305, −0.069), higher fear of movement (β = 0.082, 95% CI: 0.018, 0.145), and longer duration of tendon morning stiffness (β = 0.183, 95% CI: 0.07, 0.296) were associated with greater pain across tendon loading tasks (R2 = 0.47). Lower peak dorsiflexion with walking (β = −0.27, 95% CI: −0.41, −0.14), higher dorsiflexion with the calf stretch (β = 0.095, 95% CI: 0.02, 0.16), and insertional Achilles tendinopathy (β = −0.93, 95% CI: −1.65, −0.21) were associated with higher pain across tendon stretching tasks (R2 = 0.53). In addition to exercise, the ideal management of Achilles tendinopathy may require adjunct treatments to address the multifactorial aspects of movement-evoked pain. • Limited use of ankle dorsiflexion is associated with more severe pain in Achilles tendinopathy. • No association was found between movement-evoked pain and ankle power during fast walking. • Achilles tendinopathy type seems to influence movement-evoked pain and ankle biomechanics. [ABSTRACT FROM AUTHOR]

Objective This study aimed to assess the immediate and short-term effects of cervical spinal manipulation (SM), compared with a placebo, on the magnitude of near and distance exophoria in adults with asymptomatic exophoria. Methods In this single-blind, randomized controlled trial, individuals with a clinical diagnosis of horizontal exophoria confirmed with the prism alternating cover test (PACT) were allocated to a single intervention session using a high-velocity, low-amplitude cervical SM technique or a sham intervention (manual contact under the head). Outcomes were the magnitude of horizontal heterophoria, as a measure of binocular vision efficiency at near (40 cm) or distance (4 m) fixation, using the PACT. Evaluations were made at baseline, immediately after intervention, and at a 1-week follow-up. Results From May to September 2021, 44 volunteers (23 women), with a mean age of 35 (SD = 9.5) years, were recruited and equally distributed into the study groups. All participants completed follow-up assessments, and no adverse events were reported. There was a significant time × group interaction for exophoria at near vision, but not at distance fixation. The SM group showed a significant decrease of near exophoria compared with the control group at the 1-week follow-up (mean difference = −1.09 prism diopters; 95% CI = −0.20 to −1.98 prism diopters). Conclusion The use of cervical SM therapy resulted in a significant reduction of the magnitude of horizontal exophoria at near vision (medium effect size), compared with the placebo, in young adults who are asymptomatic. However, these effects were not observed at distance fixation and should be considered cautiously due to the pre–post design with a single intervention session and the short-term follow-up. Impact The findings suggest short-term benefits of SM therapy can manage undiagnosed ocular convergence disorders, although changes were not clinically relevant. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare the short and medium-term effectiveness of combining Kinesio Tape (KT) or neuromuscular electrical stimulation (NMES) with a conventional approach to prevent shoulder pain after stroke. METHODS: Thirty-one first-time stroke survivors (58.06% females) were recruited and randomly assigned to one group; Control (n = 10), KT (n = 11), or NMES (n = 10). Ten of all participants were lost during follow-up because of death or a second stroke. The control group underwent conventional treatment (careful shoulder handling and daily mobilizations). This approach was combined with KT or NMES over deltoid muscles in the KT and NMES groups respectively. Measurements were taken at baseline, and at weeks 1, 2, 3, 4, 12, and 24 post-stroke. Data collected included self-perceived shoulder pain (Visual Analogue Scale), disability (Barthel Index and Berg scale), and upper limb function (Action Research Arm test). RESULTS: In all groups, shoulder pain did not appear during the first month (p < 0.001), but increased afterwards. In the between-groups analysis, all groups similarly improved disability and function, and no significant differences were observed for any measure (p > 0.05). CONCLUSION: The combination of KT or NMES with conventional treatment is no superior to conventional treatment alone to prevent hemiplegic shoulder pain. [ABSTRACT FROM AUTHOR]

Objective This study aims to evaluate the immediate effect of a global pelvic manipulation ( GPM) technique, bilaterally applied, on low back pelvic pain in women with primary dysmenorrhea ( PD). Design A prospective, randomized, double-blind, controlled trial. Setting Faculty of Nursing, Physiotherapy and Podiatry. University of Sevilla, Spain. Methods The sample group included 40 women (30 ± 6.10 years) that were divided into an experimental group ( EG) (N = 20) who underwent a bilateral GPM technique and a control group ( CG) (N = 20) who underwent a sham (placebo) intervention. Evaluations were made of self-reported low back pelvic pain (visual analog scale), pressure pain threshold ( PPT) in sacroiliac joints ( SIJs), and the endogenous response of the organism to pain following catecholamines and serotonin release in blood levels. Results The intragroup comparison showed a significant improvement in the EG in the self-perceived low back pelvic pain ( P = 0.003) and in the mechanosensitivity in both SIJs ( P = 0.001). In the between-group comparison, there was a decrease in pain perception ( P = 0.004; F(1,38) = 9.62; R2 = 0.20) and an increase in the PPT of both SIJs, in the right side ( P = 0.001; F(1,38) = 21.29; R2 = 0.35) and in the left side ( P = 0.001; F(1,38) = 20.63; R2 = 0.35). There were no intergroup differences for catecholamines plasma levels (adrenaline P = 0.123; noradrenaline P = 0.281; dopamine P = 0.173), but there were for serotonin levels ( P = 0.045; F(1,38) = 4.296; R2 = 0.10). Conclusion The bilateral GPM technique improves in a short term the self-perceived low back pelvic pain, the PPT in both SIJs, and the serotonin levels in women with PD. It shows no significant differences with a sham intervention in catecholamines plasma levels. [ABSTRACT FROM AUTHOR]