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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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8%
①
Synopsis:
One hundred eight patients with tricompartmental knee osteoarthritis (OA) were randomized to gel cold pack (n=36), cryo-cuff (n=36), or mobile cold compression device (MCCD) (n=36) applied immediately post-TKA and refreshed every 6 hours until discharge.The primary outcome was pain intensity at prespecified intervals through 72 hours and again at 2 weeks.Secondary outcomes included morphine consumption (24/48/72 h), knee ROM (flexion, extension lag), knee swelling (girth change), length of stay, and patient satisfaction (SAPS-based).Outcomes were assessed up to 72 hours and at 2 weeks.Overall, the results showed lower pain at 8 hours with MCCD versus gel cold pack and versus cryo-cuff, while cryo-cuff produced less swelling at 72 hours than gel cold pack and MCCD. In conclusion, MCCD...
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Level 1 RCT
6%
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:
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
5%
①
Synopsis:
One hundred twenty patients with symptomatic tibiofemoral knee osteoarthritis (Kellgren–Lawrence grade 2–3) were randomised to receive a single intra-articular injection of autologous micro-fragmented adipose tissue (n=60) or placebo isotonic saline (n=60) following abdominal liposuction.The primary outcome of interest was KOOS4 at 6 months.Secondary outcomes included KOOS subscales (Pain, Symptoms, ADL, Sports/Recreation, QoL), Tegner activity score, proportion achieving the KOOS4 MCID, treatment failure, return to work and sport, adverse events, and treatment-related discomfort, assessed at 3, 6, 12, and 24 months.Overall, the results of the study revealed no statistically significant or clinically important between-group differences in KOOS4 at any time point (6-month between-group difference in change 1.7, 95% CI −3.6 to 7.1; p=0.52), nor in Tegner scores or other secondary outcomes, although both groups showed substantial and sustained improvements from baseline over 2 years. These findings suggest...
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Level 1 RCT
4%
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
4%
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
3%
①
Synopsis:
Ninety-eight patients with for anterior cruciate ligament (ACL) rupture were randomized to receive a quadrupled semitendinosus (ST-only) graft (n=49) or a doubled semitendinosus–gracilis (ST/G) graft (n=49); one ST-only patient was converted intra-op and excluded.The primary outcome was IKDC-Subjective score.Secondary outcomes included KOOS subscales, Tegner Activity Score (TAS), KT-1000 side-to-side laxity, Lachman and pivot-shift grades, sports/activity participation, and need for secondary surgery (including revision).Outcomes were assessed pre-op, 2 years, and again at a median of 8 years (range 5–10).Overall, the results of the study revealed no between-group differences at long-term follow-up for IKDC (ST 81.7 vs ST/G 82.1; p=0.93), instrumented or clinical stability, KOOS subscales, or revision rates; however, cyclops removal was more frequent with ST/G (p=0.014).Both groups showed large, durable improvements from baseline. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Thirty-six patients with chronic rotator cuff–related shoulder pain (C-RCRSP) were randomized to receive comprehensive physiotherapy (CP; n=18) or CP plus graded motor imagery (CP+GMI; n=18).The primary outcomes were pain (NPRS) and function (SPADI).Secondary outcomes included pressure pain threshold (PPT), range of motion (ROM), left/right judgment task (LRJT) accuracy and response time, motor imagery ability (VMIQ-2), central sensitization symptoms (CSI), fear-avoidance and catastrophizing (FABQ, PCS), two-point discrimination, and global rating of change (GRC).Pain and PPT were repeatedly assessed at baseline, weeks 1–2, and week 6; other measures were assessed at baseline and 6 weeks.Overall, the results of the study revealed clinically important within-group improvements in both arms for pain, ROM, SPADI, and pain-related fear at 6 weeks, with earlier pain reductions and superior mechanosensory/neurocognitive gains in CP+GMI. In conclusion, adding...
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Level 1 RCT
3%
①
Synopsis:
Two hundred thirty-one patients with chronic lateral epicondylosis were randomized to physiotherapy (n=58), extracorporeal shockwave therapy (ESWT) (n=62), prolotherapy (n=56), or platelet-rich plasma (PRP)(n=55).The primary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH); the secondary outcome was a 6-point Subjective Satisfaction Score (SSS).Outcomes were assessed at baseline, 3, 6, 18, and 24 months, with 24 months pre-specified as primary.Overall, the results of the study revealed that PRP achieved the largest DASH improvement at 24 months (−31.18) and the highest SSS (4.60±0.90), with prolotherapy also outperforming physiotherapy and ESWT on both outcomes; all groups exceeded the DASH MCID. These findings suggest...
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Level 1 RCT
3%
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