Clinical Research Directory

Effect of Dry Needling Plus Vibration on Myofascial Trigger Points in Individuals With Nonspecific Low Back Pain

Low back pain is one of the most common health issues worldwide, and in most cases, this pain is nonspecific low back pain (NSLBP). NSLBP is characterized by the inability to determine the real source of the pain and commonly presents with myofascial trigger points (MTrPs) in the muscles related to the lumbar region. One of the most widely used techniques for treating NSLBP by targeting MTrPs is dry needling (DN), a technique that involves inserting a needle to produce a mechanical effect capable of "deactivating" the MTrP and thereby alleviating its symptoms. However, some studies have concluded that other techniques are more effective than DN, such as percutaneous electrolysis (PE). When using the PE technique, it appears that adding a galvanic current enhances the effects of DN. Nonetheless, this poses a greater risk to the patient, as the galvanic current could damage nervous tissue if it comes into contact. For this reason, it is proposed to investigate whether other physical agents that are not electrical could enhance the effect of DN without increasing its risk. This is the case for vibration, a stimulus that has already been used successfully for the treatment of MTrPs, allowing us to investigate whether adding vibration to DN introduces therapeutic capabilities that: * Maintain or increase the effectiveness of DN in terms of pain and functional capacity. * Do not add risks for the patient, unlike PE. * Are less painful than DN and cause less post-needling pain than that generated after successive needle insertions with DN. Emphasizing these adverse effects is necessary since most clinical trials do not report these variables, which is fundamental for describing the safety of invasive techniques. Following this idea, the present project will analyze a new invasive therapy for the treatment of MTrPs: dry needling with vibratory stimulus (DN+V), for which the following hypotheses are proposed: * DN+V, instead of using an electrical stimulus like PE that could cause damage to some tissues, will apply vibration to the DN needles to increase the mechanical stimulus exerted on the MTrP, expecting greater benefits in terms of pain, functional capacity, muscle strength, and other variables of interest in individuals with NSLBP, and possibly requiring less treatment time than DN. * In DN, the repeated insertions and withdrawals of the needle in the MTrP provoke a hemorrhagic and inflammatory reaction that translates into hypersensitivity and microscopic tissue injury in the muscle, causing pain during treatment and post-needling pain for the following 24-32 hours. Another study showed that PE caused less post-needling pain than DN, which may be due to the fact that, unlike DN, it is common in PE to only perform a single puncture with each needle and not mobilize them. * The methodology for DN+V will be the same as for PE, with a single puncture and no needle manipulation, so it is expected that DN+V, being less invasive than DN, will reduce pain during treatment and post-needling pain compared to that generated by DN. There are studies that support this hypothesis, concluding that needle manipulation in DN produces greater post-needling pain than DN without needle manipulation.

The Course of Acute Respiratory Failure in Geriatric Patients With Hip Fracture Using Different Modes of a Vibroacoustic Device for the Lungs

A medical professional trained in the procedure and use of the device will conduct the vibroacoustic therapy session. He will also take blood samples. In the control group, patients will undergo vibroacoustic pulmonary therapy in the "Pneumonia" mode, and in the control group, in the "Prevention" mode. Vibroacoustic pulmonary therapy will be conducted over a period of 5 days. A similar algorithm of actions is planned for both groups. VALT sessions will be conducted 4-6 times a day for 5 minutes in combination with treatment according to the protocol for the use of "Vibroacoustic Therapy" of the lungs of the Ministry of Health of the Republic of Kazakhstan. The device's emitters will be applied to the affected areas of the lungs. Since the device has long cords for the emitters and is portable, it is not difficult to change the patient's position and does not require their active participation, which is important for patients on ventilators and with limited mobility.

IASTM and Vibration Effects on Pain, Functionality, and Kinesiophobia in Lumbar Disc Herniation

The aim of this study is to investigate the effects of Instrument-Assisted Soft Tissue Mobilization and vibration massage therapy on pain, functionality, and kinesiophobia in individuals with lumbar disc herniation.

Non-invasive Vibratory Stimulation of the Knee Muscles for the Improvement of the Somatosensory Input and Motor Performance

The goal of this interventional cross-sectional study is to evaluate motor responses to non-invasive vibratory stimulation applied to the hamstring muscle tendons in healthy individuals. Knee flexion and extension efforts, in both isometric and concentric contractions, will be tested. The investigators hypothesize that vibratory stimulation causes an increase in activity in the flexor muscles (hamstrings) and a decrease in the extensor muscles (quadriceps) of the knee in all motor tasks. It follows that during knee flexion (both concentric and isometric), vibratory stimulation should cause an increase in the distance between the angular trajectories of the knee obtained with and without vibratory stimulation (with a positive sign). The increased activity of the hamstring muscles would, in fact, contribute to increasing the velocity of the flexor movement. Conversely, during extensor movements (both concentric and isometric), vibratory stimulation should reduce the instantaneous velocity of the movement, therefore causing an increase in distance (with a negative sign) between the trajectories obtained with and without stimulation. Participants will be tested using an isokinetic dynamometer and they will be asked to perform the following motor tasks in a random order: concentric knee flexion, concentric knee extension, isometric knee flexion, and isometric knee extension. The dominant limb will be tested, only. The assessment will be performed one time.

Sensory Mechanisms of Manual Dexterity Recovery After Stroke: a Prospective Cohort Study of Prediction and Cerebral Correlates

In the proposed research, we will assess motor and sensory functions of the hand using clinical tests and a tool designed to measure manual dexterity combined with vibrotactile stimulation. We will also evaluate the integrity of brain structure and function using MRI.

The Effect of Home-Based Walking on Symptoms and Health Profile of Hemodialysis Patients

This study aims to evaluate the effect of 8 weeks of home-based moderate-speed walking on hemodialysis symptoms and health profile while patients are receiving hemodialysis treatment. Due to permanent deterioration in kidney function, patients need hemodialysis treatment, which is the most commonly used treatment method among renal replacement therapies. Hemodialysis treatment causes a series of physical and psychological problems. Problems such as hypotension, headache, nausea, muscle cramps, itching and pain are physical problems, while depression, anxiety, cognitive disorders and stress are psychological problems. In addition, it has been reported that long-term hemodialysis treatment and all the resulting problems increase the tendency to a sedentary lifestyle in this patient group, leading to a decrease in physical function and activity, and indirectly to a low quality of life and low survival rates. For this reason, hemodialysis patients have difficulty meeting their daily activities and needs, and their dependency and healthcare burden increase. Adopting a sedentary lifestyle by these patients prevents them from managing both the physical and psychological problems of hemodialysis and their conditions such as hypertension and diabetes mellitus, and causes the disease to progress. Physical exercises, which are considered among the useful therapeutic suggestions in addition to pharmacological treatments in the management of the negative situations that arise, are considered as an easy, useful and effective intervention method. Kidney Disease: Improving Global Outcomes (KDIGO) recommends 30 minutes of moderate-intensity physical exercise at least 5 days a week. Additionally, it should not be overlooked that whether patients have places to do physical activity and what their facilities are are a detail that should be questioned by health professionals. Patients without suitable accommodations should be encouraged to engage in physical activity, especially in indoor spaces like home. Home-based walking exercise is known to be easy, inexpensive, and safe, and is also advantageous when the weather is not favorable. When we examined the studies in which home-based walking exercise was performed, it was determined that its effect on functional capacity was generally investigated, but its effect on the health outcomes and symptoms of patients receiving hemodialysis treatment was not evaluated. There was no evidence that home-based walking exercise had any effect on symptoms in patients receiving HD treatment. Therefore, it was planned to conduct a study to evaluate whether home-based walking exercise has an effect on patient health outcomes.