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Created with Fabric.js 1.4.5 OBJECTS drag and drop icons,shapes, text or upload your own from our extensive library of artwork your artboard start from scratch[clears the canvas] double click on textto edit or change TEXT A COMPARATIVE STUDY BETWEEN ULTRASOUND AND TENS VERSUS ULTRASOUND AND LASER IN ANTERIOR TALOFIBULAR LIGAMENT INJURED PATIENTS By Nasr Alkali Tripoli University for Medical Sciences Faculty of Medical Technology, Physiotherapy Department, Libya Research aim: To compare the effectiveness of ultrasound & TENS with laser &ultrasound in (ATFL) patient.To check the effectiveness of ultrasound , TENS with laser in (ATFL) injury patient.To check the effectiveness of exercise in (ATFL) in injured patients. Reseach method: The total number of 14 patient were grouped as Group 1 (7 patients), Group 2 (7 patients) both groups were under gone pre & post tests ofPain, ROM, Muscle strength,The measurements were taken and recorded.The patients of group 1 Were received US + TENS with exercise.The patients of group 2 were received US + laser with exercise on alternate days for 2 weeks.The study was conducted in Sport Medicine Center Tripoli / Libya. double click to change this title text! Criteria selection: Inclusion criteria:1-The age group between 16 to 35 year were included in the study.2-Only male patients were included.3-Patient with grade 1 & 2 injuries only were included.4-Injury either on left or right sides were included.5-Injury occur due to all kind of sports. Exclusion criteria: 1-Patient in grade 3 injury were excluded from the study.2-Patient underwent surgical procedure were excluded from the study.3-Patient associated fracture for lower limb were not included.4-Patient with cardio-respiratory problems were excluded.5-patients with any neurological involvement were excluded. Variables of the study: Pain, ROM, Muscle strength. Material used in the study: US machine, TENS machine, LASER machine, Goniometer,Bed, PARALELL bar & DISC balance.Procedure:This study is comparative in design. The total number of 14 patients were grouped in to two groups as 7 patients in each group.Both groups underwent the pre & post tests for Pain, ROM & MS.The VAS for pain, Goniometer & MMS tests were used to take Measurements respectively. 1-Visual analog scale (VAS): The scale of 10 centimeters marked from [0-10] was drawn and 'shown to the patient. The 0 was printed as no pain, 10 as the maximum pain felt in life time. 2-Range of motion (ROM):To determine the amount of ankle & subtalar movements we used Goniometer. 3-Manual muscle strength (MMS) tests: Planterflexors test, Dorsiflexors test, Inversion stress test, Eversion stress test. Reseach results: The variables of both groups were analyzed to reveal the difference in improvement between the groups.1_Visual analog scale (VAS): The pre test of VAS for pain in group Ι is 6.28 & group ΙΙ is 7.42 The post test of VAS for pain in group I is 1.71 and group ΙΙ is 1.85.2_ROM of ankle joint:Dorsiflextion: The pre test of ROM for ankle joint (dorsiflextion) in group Ι is 15.71 & group ΙΙ is 15.42, & the post test of ROM in group Ι is 20 and group ΙΙ is 20.2.1_ROM of ankle joint:Planterflextion: The pre test of ROM for ankle joint (planterflextion) in group Ι is 45 & group ΙΙ is 41.17 and the post test of ROM in group Ι is 50 & group ΙΙ is 50.2.2_ROM of subtalar joint: Inversion: The pre test of ROM for subtalar joint (inversion) in group Ι is 24.2 & group ΙΙ is 24.57 and the post test of ROM in group Ι is 30 and group ΙΙ is 30.2.3_ROM of subtalar joint: Eversion: The pre test of ROM for subtalar joint (eversion) in group Ι is 10.85 & group ΙΙ is 8.42 and the post test of ROM in group Ι is 15 & group ΙΙ is 15.3_Muscle strength (MS) results:Dorsi flexors: The pre test of muscle strength for Dorsi flexors in group Ι is 3 & in group ΙΙ is 3.42, the post test of muscle strength in group Ι is 5 & in group ΙΙ is 4.7.Planter flexors: The pre test of muscle strength for planter flexors in group Ι is 4.7 and in group ΙΙ is 3.9, the post test of muscle strength in group Ι is 5 & in group ΙΙ is 4.44. Results: The study shows decrease of the pain after treatment in group1 as well as in group 2 shows better results in all variables.It shows the increase of ROM after treatment in group 1 as well as group 2 Both groups are the same.It shows the increase of the muscle strength after treatment in group 1 as well as group 2 shows better result in all variables. Conclusion: The observation and results of this study shows a significant Improvement in pain, ROM and muscle strength in patients with ankle sprain, it is concluded that the electrotherapy (US + TENS + Laser therapy) and exercises, ice therapy has improved the function of the patient in both groups. The group received US and TENS with exercises shows better results than group ΙI which received ultrasound and Laser. So patient of ATFL can be treated by both groups but laser was better improvement than US. References: 1-The Cochrane Library Issue (2004).Therapeutic ultrasound for acute ankle sprains Ultrasound (the use of high frequency sound pulses).2-Fredericia Sygehus, kirurgisk afdeling (1993). The effect of low-power laser therapy on acute ankle sprains was evaluated in a double-blind randomisedclinical study consisting of 40 patients from the casualty ward.3-Jonathan cluett (1999).Transcutaneous electrical nerve stimulation (TENS) is a method of providing pain relief. In his studyit was proved that the (TENS) treatment was effective in ATFL injuried patient.4_Jonathan cluett (1999).TENS relieves pain mainly by stimulating the pain gate mechanism.5_ Bryant J, Milne R, Stein K, (1999). Primary and secondary studies on the use of therapeutic ultrasound are problemic and lack of evidence is not evidence of lack of effect. The committee's decision was unproven and highlighted the need for well conducted trials to establish the clinical and economic benefits of therapeutic ultrasound in combination with other modalities in prognostically similar groups.6_ David O. Draper,(1998). Immediate effects were that exercise and stretch increased range of motion and muscle power in all patients significantly and Residual effects were that range of motion and muscle power increased in both groups after six treatment sessions.Methods,7_Hamilton WG (1994). Current concepts in the treatment of acute and chronic lateral ankle instability. SportsMed Arthrosc Rev;2:264266.8_Brostrom L (1965). Sprained ankles: III Clinical observations in recent ligament ruptures. Acta Chir Scand; 130:560-569.9_Publication Year: (2004) Publisher: McGraw-Hill, Medical Publishing Division Date osted: 2/15/2007 8:41:14 AM PST (GMT -08:00) Book Title: Orthopaedic Examination, Evaluation, & Intervention (2004) Date Accessed: 3/30/2007 4:45:30 PM PST (GMT -08:00) Electronic Address: http://online.statref.com/document.aspx?fxid=116&docid=66310_ Ottoson L (1978). Lateral instability of the ankle treated by a modified Evans procedure. Acta Orthop Scand; 49:302-305. Observation and analysis:A questionnaire was prepared for observing and recording the dat, and every patient hasa separate questionnaire in which pre and post tests assessment for pain, MS & ROM were entered in corresponding tables.
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