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You are viewing the most viewed ACE Reports by Physiotherapists over the last 30 days in all specialties.
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7%
①
Synopsis:
Sixty adults with clinically diagnosed frozen shoulder were randomized to receive intra-articular lidocaine plus active manual therapy (scapular mobilization and posterior capsular stretching; n = 30) or intra-articular lidocaine plus sham manual therapy (light touch/simulated mobilization; n = 30), in addition to a standardized physiotherapy and progressive resistance exercise program delivered four times per week for four weeks.The primary outcome was shoulder pain intensity measured on a 10-cm visual analogue scale (VAS).Secondary outcomes included shoulder range of motion (abduction and lateral rotation), functional disability (QuickDASH), coracohumeral ligament (CHL) thickness on MRI, kinesiophobia (TSK-AV), depression (HADS), and health-related quality of life (EQ-5D), assessed at baseline, 4 weeks, 8 weeks, and 6 months.Overall, the results of the study revealed that the active manual therapy group had significantly greater reductions in pain (between-group VAS differences 2.4–3.0 points), larger improvements in CHL thickness, disability, kinesiophobia, depression, and quality of life across all follow-up points (all p ≤ 0.001, large effect sizes) compared with the sham group. These findings suggest...
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Level 1 RCT
7%
①
Synopsis:
Forty adults with unilateral functional ankle instability (FAI) were randomized to receive isokinetic eccentric training (n = 20) or isokinetic concentric training (n = 20) targeting ankle dorsiflexor and evertor muscles using a Biodex dynamometer, three times per week for twelve weeks.The primary outcome of interest was postural control of the affected limb (static sway area and length; dynamic total offset index) assessed on the Pro-Kin 254P platform.Secondary outcomes included ankle dorsiflexion and eversion relative peak torque (RPT) and dorsiflexion/plantarflexion (D/P) and eversion/inversion (E/I) torque ratios at 60°/s and 180°/s.Outcomes were assessed at baseline and after 12 weeks.Overall, the results of the study revealed that eccentric training produced larger improvements in dynamic postural control (notably a 23.8% reduction in total offset index), static sway area, dorsiflexion and eversion strength, and D/P and E/I torque ratios than concentric training, whereas sway length did not differ significantly between groups. These findings suggest...
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Level 1 RCT
5%
①
Synopsis:
12 randomized controlled trials (788 patients) comparing the use of a minimally invasive medial midvastus approach (MMV-TKA) versus the standard medial parapatellar total knee arthroplasty (MP-TKA) were included in this systematic review and meta-analysis.Outcomes of interest included the Knee Society Score (KSS), knee pain on a Visual Analog Scale (VAS), knee function on a Normalized Function Scale, knee range of motion (ROM), time to straight leg activity, incidence of loose outboard support belt use, operative time, length of stay, blood loss, and incidence of postoperative complications.KSS scores, VAS pain scores, and knee joint flexural activity at 3 months, and days of straight leg raises were significantly better in the MMV-TKA group.Operative time was significantly shorter in the MP-TKA group. All other outcomes...
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Level 1 Meta Analysis
4%
①
Synopsis:
One hundred and sixteen patients with displaced femoral neck fractures were randomized to receive hemiarthroplasty via the anterior approach (AA) (n=58) or the lateral approach (LA) (n=58).The primary outcome was function at 6 weeks on the Barthel-20 Index.Secondary outcomes included EQ-5D, pain (VAS; plus 5-day opioid use), length of stay (acute and to rehab discharge), complications (medical and implant-related), readmissions/ED visits, and mortality.Outcomes were assessed at 2, 6, 12, and 24 weeks.Overall, the results revealed no between-group differences for the primary outcome (both groups mean 15.8 at 6 weeks; P=0.98) or for secondary patient-reported outcomes, resource use, complications, readmissions, or mortality; operative time was modestly longer with AA and cement mantle quality was worse. In short, AA...
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Level 1 RCT
4%
①
Synopsis:
Forty patients older than 50 years with chronic Achilles tendinopathy following Haglund deformity, who did not respond to conservative treatment, were randomized to receive either debridement and ostectomy alone (control group, n=20) or debridement and ostectomy with flexor hallucis longus (FHL) tendon transfer (FHL group, n=20).The primary outcome of interest was improvement in American Orthopaedic Foot & Ankle Society (AOFAS) ankle hindfoot scores and Victorian Institute of Sports Assessment Achilles (VISA-A) scores.Secondary outcomes included surgical complications and hallux function.Outcomes were assessed preoperatively and at one-year follow-up.Overall, the results indicated that while both groups showed significant improvements in AOFAS and VISA-A scores, the FHL group demonstrated greater improvements (P < .001), though the differences did not reach the minimal clinically important difference.There were no significant differences in surgical complications or hallux function between groups. These findings suggest...
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Level 1 RCT
4%
①
Synopsis:
One hundred fifty six adults with chronic plantar fasciitis were randomized to receive ultrasound-guided corticosteroid injection (n=76) or radial extracorporeal shock wave therapy (rESWT; n=80).The corticosteroid group received 2 mL methylprednisolone acetate (40 mg/mL) + 2 mL 2% lidocaine delivered under ultrasound guidance, while the rESWT group received 2000 impulses at 2.5 bars and 15 Hz weekly for three consecutive weeks.The primary outcome of interest was pain, assessed using the Visual Analogue Scale (VAS) at the first step in the morning, at rest, and during ADLs.Secondary outcomes included the FAAM-ADL and FAAM-Sports subscales and ultrasound-measured plantar fascia thickness.Outcomes were measured at baseline, 4 weeks, and 8 weeks.Overall, the results revealed that corticosteroid injection produced greater reductions in pain, better functional improvement, and greater reduction in plantar fascia thickness at both 4 and 8 weeks compared with rESWT. In conclusion, early...
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Level 1 RCT
3%
①
Synopsis:
Forty-two sport-active patients with chronic insertional Achilles tendinopathy were randomized to low tendon compression rehabilitation (LTCR; n=20) or high tendon compression rehabilitation (HTCR; n=22).The primary outcome was VISA-A at 12 and 24 weeks.Secondary outcomes included patient satisfaction, return-to-sport, pain on hopping (VAS-HOP) and during ADLs (VAS-ADL), single-leg heel-raise repetitions, and ultrasound tendon thickness; outcomes were assessed at baseline, 12, and 24 weeks.Overall, the results of the study revealed larger VISA-A gains with LTCR at both 12 weeks and 24 weeks, alongside higher satisfaction and better pain metrics. In short, limiting...
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Level 1 RCT
3%
①
Synopsis:
Five randomized controlled trials (189 patients) comparing platelet-rich plasma (PRP) against conservative treatment for chronic Achilles tendinopathy were included in this systematic review and meta-analysis.Outcomes of interest included the Victorian Insitute of Sport Assessment (VISA-A) score, pain during activity on a Visual Analog Scale (VAS), and Achilles tendon thickness.VISA-A scores at 6 weeks favored the PRP group.Tendon thickness also favored the PRP group. All other outcomes...
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Level 1 Meta Analysis
3%
①
Synopsis:
Forty patients with medial meniscus posterior root tears were randomized to undergo arthroscopic transtibial pullout repair (n = 20) or all-inside repair (n = 20).Clinical outcomes were assessed using IKDC, Tegner activity, Lysholm scores, and active range of motion (AROM) of knee flexion, along with operative time, time to ambulation, hospital stay, and complications.Outcomes were evaluated preoperatively and at final postoperative follow-up (timepoint not clearly specified).Overall, the results of the study revealed that both procedures significantly improved knee function, but the transtibial pullout technique produced higher postoperative IKDC (52.82 vs 46.43), Tegner (7.69 vs 5.96), and Lysholm (84.41 vs 79.32) scores (all p < 0.01), albeit with a slightly longer operative time and more wound-related complications. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Sixty patients undergoing elective posterior-approach total hip arthroplasty (THA) were randomized to receive either an ultrasound-guided supra-inguinal fascia iliaca block (SFIB) (n=30) or a pericapsular nerve group (PENG) block (n=30).The primary outcome was 24-hour cumulative intravenous fentanyl consumption.Secondary outcomes included perioperative fentanyl use, pain scores at rest and with movement across hip regions, cutaneous sensory loss, quadriceps strength, functional measures (TUG, QMS), and adverse events. Outcomes were assessed...
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Level 1 RCT