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Ang DC, Davuluri S, Kaplan S, Keefe F, Rini C, Miles C, Chen H. Duloxetine and cognitive behavioral therapy with phone-based support for the treatment of chronic musculoskeletal pain: study protocol of the PRECICE randomized control trial. Trials 2024; 25:330. [PMID: 38762720 PMCID: PMC11102257 DOI: 10.1186/s13063-024-08158-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/07/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Chronic musculoskeletal pain (CMP) is the most common, disabling, and costly of all pain conditions. While evidence exists for the efficacy of both duloxetine and web-based cognitive behavioral therapy (CBT) as monotherapy, there is a clear need to consider study of treatment components that may complement each other. In addition, given the reported association between patient's adherence and treatment outcomes, strategies are needed to enhance participant's motivation to adopt and maintain continued use of newly learned pain coping skills from CBT. METHODS Two hundred eighty participants will be recruited from the primary care clinics of a large academic health care system in North Carolina. Participants with CMP will be randomized to one of three treatment arms: (1) combination treatment (duloxetine + web-based self-guided CBT) with phone-based motivational interviewing (MI), (2) combination treatment without phone-based MI, and (3) duloxetine monotherapy. Participants will be in the study for 24 weeks and will be assessed at baseline, week 13, and week 25. The primary outcome is the Brief Pain Inventory (BPI)-Global Pain Severity score, which combines BPI pain severity and BPI pain interference. Secondary measures include between-group comparisons in mean BPI pain severity and BPI pain interference scores. Data collection and outcome assessment will be blinded to treatment group assignment. DISCUSSION This randomized controlled trial (RCT) will determine if combination treatment with duloxetine and web-based CBT is superior to duloxetine monotherapy for the management of CMP. Furthermore, this RCT will determine the effectiveness of phone-based motivational interviewing in promoting the continued practice of pain coping skills, thereby enhancing treatment outcomes. TRIAL REGISTRATION NCT04395001 ClinicalTrials.gov. Registered on May 15, 2020.
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Affiliation(s)
- Dennis C Ang
- Department of Medicine/Rheumatology, Wake Forest University School of Medicine, Winston Salem, NC, 27157, USA.
| | - Swetha Davuluri
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Sebastian Kaplan
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Francis Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Christine Rini
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Christopher Miles
- Department of Family Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Haiying Chen
- Department of Biostatistical Sciences, Wake Forest University, Winston Salem, NC, USA
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Hotfiel T, Fanlo-Mazas P, Malo-Urries M, Paulino E, Sequeira de Medeiros L, Blondett M, Vetrano M, Freiwald J. Importance of heat therapy in the treatment of pain in the daily clinical practice. J Bodyw Mov Ther 2024; 38:263-268. [PMID: 38763568 DOI: 10.1016/j.jbmt.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/18/2023] [Accepted: 01/13/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Musculoskeletal (MSK) pain includes a wide variety of causes and conditions. Despite the heterogeneity of MSK pain, it is possible to identify some common clinical features and treatments. Heat therapy (HT) is one of the most common and could be a suitable non-pharmacological approach. OBJECTIVE To obtain a European overview on the use of non-pharmacological approaches and the role of heat therapy in the treatment of MSK pain. METHODS Through a two-cycle Delphi-like method, an international board of experts reached a consensus on 13 questions for a survey to healthcare professionals who provide direct patient care. Between November 2021 and January 2022, the resulting web survey was distributed to professionals with the collaboration of ten European scientific societies and associations. Univariate and bivariate analyses were performed on collected data. RESULTS Two hundred eighty-two answers were validated. Most of the respondents had extensive professional experience. Participants were widely distributed throughout Europe. HT is administered to about 50% of patients, with a higher percentage administered to those affected by low back pain (92%) and neck pain (84%). The choice of exogenous HT is based on both personal clinical experience and scientific evidence. HT is primarily chosen due to its relaxation effect, high safety profile and enhancement of tissue perfusion. The use of HT is recommended by 86.5% of respondents. CONCLUSION Experts indicate that exogenous HT represents a valid therapeutic choice and is widely used in Europe. Patients should be informed about the use of heat therapy as a valuable self-management therapy option.
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Affiliation(s)
- Thilo Hotfiel
- Friedrich-Alexander University Erlangen-Nuremberg, Department of Orthopaedic and Trauma Surgery, Erlangen, DE, 91054, Germany.
| | - Pablo Fanlo-Mazas
- University of Zaragoza, Department of Physiatry and Nursing, Zaragoza University, Aragón, ES, 50009, Spain
| | - Miguel Malo-Urries
- University of Zaragoza, Department of Physiatry and Nursing, Zaragoza University, Aragón, ES, 50009, Spain
| | | | | | | | - Mario Vetrano
- Sant'Andrea Hospital, Department of Medical and Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, Roma, Lazio, IT, 00189, Italy
| | - Juergen Freiwald
- BergischeUniversität Wuppertal, Research Center for Performance Diagnostics and Training Advice (FLT), Gaußstrasse 10, Wuppertal, Nordrhein-Westfalen, DE, 42119, Germany
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Alfuth M. Pain improvement after three weeks of daily self-executed cross-friction massage using a fascia ball in a patient with recent-onset plantar heel pain: a case report. J Man Manip Ther 2024:1-9. [PMID: 38448397 DOI: 10.1080/10669817.2024.2325186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Plantar heel pain is described as sharp pain at the medial plantar aspect of the calcaneus and medial longitudinal arch of the foot. There are various treatment options that usually need a clinician or a therapist for application. The present case report aimed to describe the outcomes of self-executed cross-friction massage using a fascia ball in a patient with recent-onset plantar heel pain. CASE DESCRIPTION The patient was a 42-year-old man who reported plantar heel pain during the first steps in the morning along with decreased function of the foot and ankle lasting about three months. He was instructed to self-execute cross-friction massage using a fascia ball daily in the evening at home for six weeks. OUTCOMES Pain during treatment decreased from a Numeric Pain Rating Scale (NPRS)-score of 8/10 and from a Short-Form McGill Pain Questionnaire (SF-MPQ)-score of 34/60 at initial treatment to NPRS- and SF-MPQ-scores of 0/10 and 0/60, respectively, after about three weeks. The patient reported no pain and restored function after six weeks of treatment, and in the follow-up measurements. DISCUSSION Daily self-executed cross-friction massage using a fascia ball may be a useful alternative intervention for treating recent-onset plantar heel pain.
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Affiliation(s)
- Martin Alfuth
- Faculty of Health Care, Therapeutic Sciences, Niederrhein University of Applied Sciences, Krefeld, Germany
- Department of Further Education, Sport Physiotherapy, German Sport University Cologne, Cologne, Germany
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Verville L, Hincapié CA, Southerst D, Yu H, Bussières A, Gross DP, Pereira P, Mior S, Tricco AC, Cedraschi C, Brunton G, Nordin M, Connell G, Shearer HM, Wong JJ, Hofstetter L, Romanelli A, Guist B, To D, Stuber K, da Silva-Oolup S, Stupar M, Myrtos D, Lee JGB, DeSouza A, Muñoz Laguna J, Murnaghan K, Cancelliere C. Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Primary Low Back Pain in Adults. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:651-660. [PMID: 37991646 PMCID: PMC10684422 DOI: 10.1007/s10926-023-10121-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE To evaluate benefits and harms of transcutaneous electrical nerve stimulation (TENS) for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline. METHODS We searched for randomized controlled trials (RCTs) from various electronic databases from July 1, 2007 to March 9, 2022. Eligible RCTs targeted TENS compared to placebo/sham, usual care, no intervention, or interventions with isolated TENS effects (i.e., combined TENS with treatment B versus treatment B alone) in adults with CPLBP. We extracted outcomes requested by the WHO Guideline Development Group, appraised the risk of bias, conducted meta-analyses where appropriate, and graded the certainty of evidence using GRADE. RESULTS Seventeen RCTs (adults, n = 1027; adults ≥ 60 years, n = 28) out of 2010 records and 89 full text RCTs screened were included. The evidence suggested that TENS resulted in a marginal reduction in pain compared to sham (9 RCTs) in the immediate term (2 weeks) (mean difference (MD) = -0.90, 95% confidence interval -1.54 to -0.26), and a reduction in pain catastrophizing in the short term (3 months) with TENS versus no intervention or interventions with TENS specific effects (1 RCT) (MD = -11.20, 95% CI -17.88 to -3.52). For other outcomes, little or no difference was found between TENS and the comparison interventions. The certainty of the evidence for all outcomes was very low. CONCLUSIONS Based on very low certainty evidence, TENS resulted in brief and marginal reductions in pain (not deemed clinically important) and a short-term reduction in pain catastrophizing in adults with CPLBP, while little to no differences were found for other outcomes.
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Affiliation(s)
- Leslie Verville
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Cesar A Hincapié
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland.
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.
- University Spine Centre Zurich (UWZH), Balgrist University Hospital and University of Zurich, Zurich, Switzerland.
| | - Danielle Southerst
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Hainan Yu
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - André Bussières
- Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières (Québec), Québec, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Québec, Canada
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - Paulo Pereira
- Department of Neurosurgery, Centro Hospitalar Universitário São João, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Silvano Mior
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Andrea C Tricco
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
- Epidemiology Division and Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Geneva University and University Hospitals, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Ginny Brunton
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- EPPI-Centre, UCL Institute of Education, University College London, England, United Kingdom
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, NYU Grossman School of Medicine, New York University, New York, United States
| | - Gaelan Connell
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Heather M Shearer
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Jessica J Wong
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Léonie Hofstetter
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
- University Spine Centre Zurich (UWZH), Balgrist University Hospital and University of Zurich, Zurich, Switzerland
| | - Andrew Romanelli
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Brett Guist
- Department of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Daphne To
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Kent Stuber
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
- Parker University Research Center, Dallas, United States
| | - Sophia da Silva-Oolup
- Department of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, Canada
- Department of Graduate Education, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Maja Stupar
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Danny Myrtos
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Joyce G B Lee
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Astrid DeSouza
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Javier Muñoz Laguna
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
- University Spine Centre Zurich (UWZH), Balgrist University Hospital and University of Zurich, Zurich, Switzerland
| | - Kent Murnaghan
- Library and Information Services, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Carol Cancelliere
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.
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Zielińska P, Śniegucka K, Kiełbowicz Z. A Case Series of 11 Horses Diagnosed with Bone Spavin Treated with High Intensity Laser Therapy (HILT). J Equine Vet Sci 2023; 120:104188. [PMID: 36470513 DOI: 10.1016/j.jevs.2022.104188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
The aim of this work was to characterize and describe the effect of High Intensity Laser Therapy (HILT) used in the treatment of chronic osteoarthritis in horses. Over a 2 year period, 11 horses with diagnosed bone spavin were treated with HILT as a monotherapy. The horses chosen for this report presented hind limb lameness, were positive in a spavin flexion test and showed improvement after intra-articular anesthesia of the tarsometatarsal joint. Additionally, all the horses presented radiological signs of tarsus osteoarthritis and had not been treated for bone spavin for a minimum of 6 months. Each horse received 10 HILT therapies over 14 days' treatment time with the same laser protocol. At post-treatment orthopedic examination, 4 horses (36%) had improved 2 lameness grades (in the 5 grade American Association of Equine practitioners lameness scale), 4 horses (36%) had improved 1 lameness grade and 3 horses (28%) did not improve. Additionally, 3 horses were totally sound after HILT. Post-treatment spavin test result improvement was observed in 5 horses (45%), and 6 horses (55%) showed the same spavin test grade as before treatment. There were no horses that were sound in the spavin test performed after HILT. Therefore, it seems probable that the application of HILT in horses suffering from bone spavin may decrease joint pain, which influences visual lameness reduction.
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Affiliation(s)
- Paulina Zielińska
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland.
| | - Karolina Śniegucka
- Institute of Animal Breeding, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Zdzisław Kiełbowicz
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
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Cuenca-Martínez F, Sempere-Rubio N, Varangot-Reille C, Fernández-Carnero J, Suso-Martí L, Alba-Quesada P, Touche RL. Effects of High-Intensity Interval Training (HIIT) on Patients with Musculoskeletal Disorders: A Systematic Review and Meta-Analysis with a Meta-Regression and Mapping Report. Diagnostics (Basel) 2022; 12:diagnostics12102532. [PMID: 36292221 PMCID: PMC9601160 DOI: 10.3390/diagnostics12102532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 11/23/2022] Open
Abstract
The aim was to assess the impact of high-intensity interval training (HIIT) on patients with musculoskeletal disorders. We conducted a search of Medline, Embase, PEDro, and Google Scholar. We conducted a meta-analysis to determine the effectiveness of HIIT on pain intensity, maximal oxygen consumption (VO2 max), disability, and quality of life (QoL). We employed the GRADE and PEDro scales to rate the quality, certainty, and applicability of the evidence. Results showed significant differences in pain intensity, with a moderate clinical-effect (SMD = −0.73; 95% CI: −1.40–−0.06), and in VO2 max, with a moderate clinical-effect (SMD = 0.69; 95% CI: 0.42–0.97). However, the meta-analysis showed no statistically significant results for disability (SMD = −0.34; 95% CI: −0.92–0.24) and QoL (SMD = 0.40; 95% CI: −0.80–1.60). We compared HIIT against other exercise models for reducing pain intensity and increasing VO2 max. The meta-analysis showed no significant differences in favour of HIIT. Meta-regression analysis revealed that pain intensity scores were negatively associated with VO2 max (R2 = 82.99%, p = 0.003). There is low-moderate evidence that the HIIT intervention for patients with musculoskeletal disorders can reduce pain intensity and increase VO2 max but has no effect on disability and QoL. Results also showed that HIIT was not superior to other exercise models in reducing pain intensity and increasing VO2 max.
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Affiliation(s)
- Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46022 Valencia, Spain
| | - Núria Sempere-Rubio
- UBIC, Department of Physiotherapy, Faculty of Physiotherapy, Universitat de València, 46010 Valencia, Spain
| | - Clovis Varangot-Reille
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46022 Valencia, Spain
| | - Josué Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28933 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Correspondence: (J.F.-C.); (L.S.-M.); Tel.: +34-914-88-88-00 (J.F.-C.); +34-963-98-38-55 (L.S.-M.)
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46022 Valencia, Spain
- Correspondence: (J.F.-C.); (L.S.-M.); Tel.: +34-914-88-88-00 (J.F.-C.); +34-963-98-38-55 (L.S.-M.)
| | - Patricio Alba-Quesada
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46022 Valencia, Spain
| | - Roy La Touche
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28003 Madrid, Spain
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Ultra deformable vesicles for boosting transdermal delivery of 2-arylpropionic acid class drug for management of musculoskeletal pain. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2022. [DOI: 10.1007/s40005-021-00555-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kwak H, Oh H, Cha B, Kim JM. The assessment of usability of pain medical device by physiatrists and physiotherapists: A Delphi survey. Medicine (Baltimore) 2021; 100:e27245. [PMID: 34559126 PMCID: PMC8462558 DOI: 10.1097/md.0000000000027245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 08/26/2021] [Indexed: 01/05/2023] Open
Abstract
When developing a new medical device, it is essential to assess the usability of such a device through various stakeholders.This study assessed the usability of pain medical devices through a Delphi survey administered to physiatrists and physiotherapists.A Delphi survey was conducted on the problems and improvements in hardware and software for a panel consisting of 10 physiatrists and 10 physiotherapists. A total of 3 rounds of surveys were conducted, and the third round of survey was confirmed through a Likert scale (1 = strongly agree to 5 = strongly disagree).The 2 groups generally had a common perception of the problems and improvements in pain medical devices. However, the physiatrist group mostly identified problems such as linking patient information, whereas the physiotherapist group deemed hardware problems such as device weight or connection cables as being more important (mean [standard deviation]; physiatrist, hardware 2.90 [0.93], software 2.28 [0.91] / physiotherapist, hardware 3.04 [0.84], software 3.03 [1.13]).To date, analysis has not been conducted by dividing the focus of various stakeholders using pain medical devices. The difference in view of the usability of these 2 stakeholder groups should be considered when improving the hardware or software of pain medical devices in the future. Further research is warranted to investigate other stakeholders such as patients and device developers to improve the devices.
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Affiliation(s)
- Hyunseok Kwak
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hyunjung Oh
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Byoungwoo Cha
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jong Moon Kim
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
- Rehabilitation and Regeneration Research Center, CHA University, Seongnam, Korea
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Zielińska P, Soroko M, Howell K, Godlewska M, Hildebrand W, Dudek K. Comparison of the Effect of High-Intensity Laser Therapy (HILT) on Skin Surface Temperature and Vein Diameter in Pigmented and Non-Pigmented Skin in Healthy Racehorses. Animals (Basel) 2021; 11:ani11071965. [PMID: 34209183 PMCID: PMC8300361 DOI: 10.3390/ani11071965] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/24/2021] [Accepted: 06/27/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary High-intensity laser therapy (HILT) is used in the treatment of horses, but little is known about the differences in the impact of HILT performed on pigmented and non-pigmented skin. The aim of this study was to assess differences in the influence of HILT on skin surface temperature and vein diameter in a group of healthy racehorses with pigmented and non-pigmented skin in the treatment area. The hypothesis was that HILT would cause a greater increase in skin surface temperature and vein diameter in horses with pigmented skin compared to non-pigmented skin. Ten Thoroughbreds with pigmented skin and ten Thoroughbreds with non-pigmented skin in the treatment area received HILT. Changes in the vein diameter and skin surface temperature of the irradiated area were measured before and after HILT. The HILT treatment caused an increase in the pigmented skin surface temperature and a decrease in the non-pigmented skin surface temperature, while the vein diameter increased in both groups. In conclusion, melanin content in the epidermis plays an important role in light energy absorption and photothermal effects. Determining the physiological and clinical effects of HILT performed on pigmented and non-pigmented skin will help clinicians choose appropriate HILT parameters. Abstract The aim of the study was to assess differences in the influence of high-intensity laser therapy (HILT) on the skin surface temperature and vein diameter of the lateral fetlock joint region in a group of racehorses with pigmented and non-pigmented skin in the treatment area. Twenty Thoroughbreds were divided into two equal groups: pigmented and non-pigmented skin groups. Each horse received the same HILT treatment. Just before and immediately after HILT, thermographic examination was performed to measure the skin surface temperature and ultrasonographic examination assessed the lateral digital palmar vein diameter. After HILT, the pigmented skin surface temperature increased, while the non-pigmented skin surface temperature decreased, and the difference between both groups was significant (p < 0.001). The vein diameter increased after HILT in horses with pigmented and non-pigmented skin, but the difference between both groups was not significant (p = 0.14). In conclusion, melanin content in the epidermis plays an important role in light energy absorption and photothermal effects. The vein diameter changes after HILT application indicated that the increase in vessel diameter may partly depend on photothermal mechanisms occurring in irradiated tissue. Further research is necessary to describe the physiological and clinical effects of HILT performed on pigmented and non-pigmented skin.
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Affiliation(s)
- Paulina Zielińska
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Plac Grunwaldzki 51, 50-366 Wroclaw, Poland; (M.G.); (W.H.)
- Correspondence: ; Tel.: +48-536-267-722
| | - Maria Soroko
- Institute of Animal Breeding, Wroclaw University of Environmental and Life Sciences, Chelmonskiego 38C, 51-630 Wroclaw, Poland;
| | - Kevin Howell
- Microvascular Diagnostics, Institute of Immunity and Transplantation, Royal Free Hospital, Pond Street, London NW3 2QG, UK;
| | - Maria Godlewska
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Plac Grunwaldzki 51, 50-366 Wroclaw, Poland; (M.G.); (W.H.)
| | - Weronika Hildebrand
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Plac Grunwaldzki 51, 50-366 Wroclaw, Poland; (M.G.); (W.H.)
| | - Krzysztof Dudek
- Faculty of Mechanical Engineering, Wroclaw University of Technology, Lukasiewicza 7/9, 50-231 Wroclaw, Poland;
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Sterke S, Nascimento da Cunha AP, Oomen H, Voogt L, Goumans M. Physiotherapy in nursing homes. A qualitative study of physiotherapists' views and experiences. BMC Geriatr 2021; 21:150. [PMID: 33648440 PMCID: PMC7923506 DOI: 10.1186/s12877-021-02080-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/03/2021] [Indexed: 11/18/2022] Open
Abstract
Background There are distinct differences in the implementation of physiotherapeutic care in nursing homes. Both nationally and internationally staffing levels of physiotherapy differ significantly between and within nursing homes. Since legislation or guidelines that specify the parameters of physiotherapy required in nursing homes are lacking, it is unknown how physiotherapists currently estimate the usefulness and necessity of physiotherapy in individual situations in long-term care. The purpose of this study was to describe how physiotherapists actually work, and how they want to work, in daily practice in Dutch nursing homes. Methods We performed a qualitative study with an online questionnaire. We asked 72 physiotherapists working in Dutch nursing homes to describe as accurately as possible usual care in nine different cases in long-term care. Furthermore we asked them to describe their role in the prevention and treatment of a number of indicators that measure the quality of care in nursing homes. Two reviewers thematically analysed the answers to the questionnaires. Results Forty-six physiotherapists returned the questionnaire. Physiotherapy services include active exercise therapy aimed to improve mobility and movement dysfunctions, advising on prevention and management of falls, pressure ulcers, incontinence, malnutrition and sarcopenia, overweight, physical restraints, intertrigo, chronic wounds, behavioural and psychological symptoms in dementia, and physical inactivity, and ergonomic and behavioural training. The way and extent in which physiotherapists are involved in the various care- and functional problems differs and depends on organisational and personal factors such as, organisation’s policy, type of ward, time pressure, staffing level, collaboration with other members of the multidisciplinary team, or lack of knowledge. Conclusion Physiotherapists in nursing homes are involved in the prevention and management of different care situations and functional problems. The way in which they are involved differs between physiotherapist. Aiming for more uniformity seems necessary. A shared vision can help physiotherapists to work more consistently and will strengthen their position in nursing homes.
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Affiliation(s)
- Shanty Sterke
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands. .,Department of Physiotherapy, Aafje Nursing Homes, Rotterdam, The Netherlands. .,Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | | | - Hanneke Oomen
- Department of Physiotherapy, Swinhovegroep, Zwijndrecht, The Netherlands
| | - Lennard Voogt
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Marleen Goumans
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
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Madeira F, Brito RND, Emer AA, Batisti AP, Turnes BL, Salgado ASI, Cidral-Filho FJ, Mazzardo-Martins L, Martins DF. The role of spinal inhibitory neuroreceptors in the antihyperalgesic effect of warm water immersion therapy. Braz J Phys Ther 2020; 25:56-61. [PMID: 32070652 DOI: 10.1016/j.bjpt.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 11/21/2019] [Accepted: 02/04/2020] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE Warm water immersion therapy (WWIT) has been widely used in the treatment of various clinical conditions, with analgesic and anti-inflammatory effects. However, its mechanism of action has not been fully investigated. The present study analyzed the role of spinal inhibitory neuroreceptors in the antihyperalgesic effect of WWIT in an experimental model of inflammatory pain. METHODS Mice were injected with complete Freund's adjuvant (CFA; intraplantar [i.pl.]). Paw withdrawal frequency to mechanical stimuli (von Frey test) was used to determine: (1) the effect of intrathecal (i.t.) preadministration of naloxone (a non-selective opioid receptor antagonist; 5 µg/5 µl), (2); AM281 (a selective cannabinoid receptor type 1 [CB1] antagonist; 2 µg/5 µl), (3); and 1,3-dipropyl-8-cyclopentylxanthine (DPCPX; a selective adenosine A1 receptor antagonist; 10 nmol/5 µl), on the antihyperalgesic (pain-relieving) effect of WWIT against CFA-induced hyperalgesia. RESULTS Intrathecal naloxone, AM281, and DPCPX significantly prevented the antihyperalgesic effect of WWIT. This study suggests the involvement of spinal (central) receptors in the antihyperalgesic effect of WWIT in a model of inflammatory pain. CONCLUSIONS Taken together, these results suggest that opioid, CB1, and A1 spinal receptors might contribute to the pain-relieving effect of WWIT.
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Affiliation(s)
- Fernanda Madeira
- Experimental Neuroscience Laboratory (LaNEx), Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil; Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil
| | - Rômulo Nolasco de Brito
- Experimental Neuroscience Laboratory (LaNEx), Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil; Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil
| | - Aline A Emer
- Experimental Neuroscience Laboratory (LaNEx), Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil; Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil
| | - Ana Paula Batisti
- Experimental Neuroscience Laboratory (LaNEx), Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil; Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil
| | - Bruna Lenfers Turnes
- Experimental Neuroscience Laboratory (LaNEx), Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil; Laboratory of Bioenergetics and Oxidative Stress (LABOX), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Afonso Shiguemi Inoue Salgado
- Experimental Neuroscience Laboratory (LaNEx), Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil; Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil; Coordinator of Integrative Physical Therapy Residency, Centro Universitário Filadélfia, Londrina, PR, Brazil
| | - Francisco José Cidral-Filho
- Experimental Neuroscience Laboratory (LaNEx), Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil; Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil
| | - Leidiane Mazzardo-Martins
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Daniel Fernandes Martins
- Experimental Neuroscience Laboratory (LaNEx), Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil; Postgraduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil.
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Youssef ASA, Xia N, Emara STE, Moustafa IM, Huang X. Addition of a new three-dimensional adjustable cervical thoracic orthosis to a multi-modal program in the treatment of nonspecific neck pain: study protocol for a randomised pilot trial. Trials 2019; 20:248. [PMID: 31036033 PMCID: PMC6489278 DOI: 10.1186/s13063-019-3337-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 03/30/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Nonspecific neck pain (NSNP) is one of the most common musculoskeletal problems treated by orthopaedic physicians and physiotherapists. Posture has emerged as one of the major risk factors associated with NSNP, but most previous studies ignored correct posturing as an effective treatment. Therefore, one of the major challenges faced by clinicians is how to incorporate 3D posture findings into the treatment plane. The present study will evaluate the feasibility of conducting a larger randomized trial. This pilot study is designed to investigate the hypothesis that a multimodal programme supplemented with the addition of a 3D adjustable cervico thoracic posture corrective orthotic (CTPCO) will yield short- and long-term improvement on NSNP management outcomes. METHODS/DESIGN This pilot, single-blind, randomized controlled trial will divide 24 patients into two groups (study and control) using block randomization. Both groups will receive conventional treatment consisting of a moist hot pack, soft tissue mobilization, manual therapy and therapeutic exercise. The study group will undergo ambulatory mirror-image functional re-training wearing a 3D adjustable CTPCO. The primary outcome is feasibility, including recruitment (e.g., time to complete enrolment, recruitment rate), patient retention and adherence to treatment allocation (e.g., session attendance, home practice, use of non-study treatments). The secondary outcomes used to assess the effectiveness of the treatment will include neck pain (measures using the visual analogue scale (VAS)) and neck disability (measures using the neck disability index (NDI)), among other outcome measures, compared between the experimental and control groups. Three-dimensional posture parameters of head measurements will be provided by a Global Posture System (GPS). The outcome measures for determining the treatment effect will be assessed at three intervals: pre-treatment, after 10 weeks of intervention and after 3 months at follow-up. DISCUSSION This randomized controlled pilot trial will inform the design of a future full-scale trial. The outcomes will provide some resources for the incorporation of ambulatory mirror-image functional re-training intervention compared to a control group intervention for neck pain, disability and 3D posture parameters. TRIAL REGISTRATION Prospectively registered at ClinicalTrials.gov, NCT03331120 . Registered on 22 October 2017.
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Affiliation(s)
- Ahmed S A Youssef
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jiefang Avenue, Wuhan, 430030, Hubei, China
- Basic science department, Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt
| | - Nan Xia
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | | | - Ibrahim M Moustafa
- Basic science department, Faculty of Physical Therapy, Cairo University, 7-Mohamed Hassan El-Gamel st, Naser City, Cairo, 002, Egypt.
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE.
| | - Xiaolin Huang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jiefang Avenue, Wuhan, 430030, Hubei, China.
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Dorsey SG, Resnick BM, Renn CL. Precision Health: Use of Omics to Optimize Self-Management of Chronic Pain in Aging. Res Gerontol Nurs 2018; 11:7-13. [PMID: 29370441 DOI: 10.3928/19404921-20171128-01] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Chronic pain has become a public health epidemic based on the number of Americans affected and its associated health care costs. Unfortunately, there are few efficacious treatments to manage chronic pain and as the population of older adults and centenarians who are at high risk for chronic pain continues to grow, the chronic pain epidemic will continue to worsen unless new therapeutic strategies are discovered. In the current era of precision medicine, there is a major emphasis being placed on the use of self-management and omics to discover new therapeutic targets and design treatment strategies that are tailored to the individual patient. This commentary discusses the current state of the science related to omics and self-management of chronic pain in older adults, the role of gerontological nurses in this process, and future directions. [Res Gerontol Nurs. 2018; 11(1):7-13.].
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Takla MKN. Low-frequency high-intensity versus medium-frequency low-intensity combined therapy in the management of active myofascial trigger points: A randomized controlled trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018; 23:e1737. [DOI: 10.1002/pri.1737] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 05/07/2018] [Accepted: 07/11/2018] [Indexed: 11/09/2022]
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Pompilio da Silva M, Tamaoki MJS, Blumetti FC, Belloti JC, Smidt N, Buchbinder R. Electrotherapy modalities for lateral elbow pain. Hippokratia 2018. [DOI: 10.1002/14651858.cd013041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Milla Pompilio da Silva
- Universidade Federal de São Paulo; Department of Orthopaedics and Traumatology; R. Borges Lagoa, 783 - 5º Andar ? Vila Clementino São Paulo Brazil 04032-038
| | - Marcel JS Tamaoki
- Universidade Federal de São Paulo; Department of Orthopaedics and Traumatology; R. Borges Lagoa, 783 - 5º Andar ? Vila Clementino São Paulo Brazil 04032-038
| | - Francesco C Blumetti
- Universidade Federal de São Paulo; Department of Orthopaedics and Traumatology; R. Borges Lagoa, 783 - 5º Andar ? Vila Clementino São Paulo Brazil 04032-038
| | - João Carlos Belloti
- Universidade Federal de São Paulo; Department of Orthopaedics and Traumatology; R. Borges Lagoa, 783 - 5º Andar ? Vila Clementino São Paulo Brazil 04032-038
- Escola Paulista de Medicina; São Paulo Brazil
| | - Nynke Smidt
- University Medical Center Groningen, University of Groningen; Department of Epidemiology; Hanzeplein (Entrance 24) Groningen Groningen Netherlands PO Box 30.001, 9700 RB
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; 4 Drysdale Street Malvern Victoria Australia 3144
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16
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Marchand LR. Palliative and End-of-Life Care. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00082-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pullen S. Physical therapy as non-pharmacological chronic pain management of adults living with HIV: self-reported pain scores and analgesic use. HIV AIDS (Auckl) 2017; 9:177-182. [PMID: 29075140 PMCID: PMC5609779 DOI: 10.2147/hiv.s141903] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND HIV-related chronic pain has emerged as a major symptom burden among people living with HIV (PLHIV). Physical therapy (PT) has been shown to be effective as a non-pharmacological method of chronic pain management in the general population; however, there is a gap in research examining the role of PT for chronic pain among PLHIV. MATERIALS AND METHODS This study examined the effect of PT on self-reported pain scores and pain medication usage in PLHIV enrolled in a multidisciplinary HIV clinic. Data were collected via reviews of patient medical records within a certain timeframe. Data were gathered from patient charts for two points: initial PT encounter (Time 1) and PT discharge or visit ≤4 months after initial visit (Time 2). RESULTS Subjects who received PT during this timeframe reported decreased pain (65.2%), elimination of pain (28.3%), no change in pain (15.2%), and increased pain (6.5%). Three-quarters of the subjects reported a minimal clinically important difference (MCID) in pain score, and more than half reported a decrease in pain score over the MCID. Subjects showed a trend of decreasing pain medication prescription and usage during the study period. CONCLUSION Results of the current study indicate that in this sample, PT intervention appears to be an effective, cost-effective, non-pharmacological method to decrease chronic pain in PLHIV.
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Affiliation(s)
- Sara Pullen
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA
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18
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Dureja GP, Iyer RN, Das G, Ahdal J, Narang P. Evidence and consensus recommendations for the pharmacological management of pain in India. J Pain Res 2017; 10:709-736. [PMID: 28435313 PMCID: PMC5386610 DOI: 10.2147/jpr.s128655] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Despite enormous progress in the field of pain management over the recent years, pain continues to be a highly prevalent medical condition worldwide. In the developing countries, pain is often an undertreated and neglected aspect of treatment. Awareness issues and several misconceptions associated with the use of analgesics, fear of adverse events - particularly with opioids and surgical methods of analgesia - are major factors contributing to suboptimal treatment of pain. Untreated pain, as a consequence, is associated with disability, loss of income, unemployment and considerable mortality; besides contributing majorly to the economic burden on the society and the health care system in general. Available guidelines suggest that a strategic treatment approach may be helpful for physicians in managing pain in real-world settings. The aim of this manuscript is to propose treatment recommendations for the management of different types of pain, based on the available evidence. Evidence search was performed by using MEDLINE (by PubMed) and Cochrane databases. The types of articles included in this review were based on randomized control studies, case-control or cohort studies, prospective and retrospective studies, systematic reviews, meta-analyses, clinical practice guidelines and evidence-based consensus recommendations. Articles were reviewed by a multidisciplinary expert panel and recommendations were developed. A stepwise treatment algorithm-based approach based on a careful diagnosis and evaluation of the underlying disease, associated comorbidities and type/duration of pain is proposed to assist general practitioners, physicians and pain specialists in clinical decision making.
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Affiliation(s)
| | - Rajagopalan N Iyer
- Department of Orthopaedics, Raja Rajeswari Medical College and Hospital, Bengaluru, Karnataka
| | - Gautam Das
- Daradia Pain Clinic, Kolkata, West Bengal
| | - Jaishid Ahdal
- Department of Medical Affairs, Janssen India, Johnson & Johnson Pvt Ltd, Mumbai, Maharashtra, India
| | - Prashant Narang
- Department of Medical Affairs, Janssen India, Johnson & Johnson Pvt Ltd, Mumbai, Maharashtra, India
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Kumar S, Rampp T, Kessler C, Jeitler M, Dobos GJ, Lüdtke R, Meier L, Michalsen A. Effectiveness of Ayurvedic Massage (Sahacharadi Taila) in Patients with Chronic Low Back Pain: A Randomized Controlled Trial. J Altern Complement Med 2017; 23:109-115. [DOI: 10.1089/acm.2015.0272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Syal Kumar
- Department of Integrative Medicine, University Hospital Essen, Essen, Germany
| | - Thomas Rampp
- Department of Integrative Medicine, University Hospital Essen, Essen, Germany
| | - Christian Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre and Immanuel Hospital Berlin, Berlin, Germany
- Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre and Immanuel Hospital Berlin, Berlin, Germany
- Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany
| | - Gustav J. Dobos
- Department of Integrative Medicine, University Hospital Essen, Essen, Germany
| | - Rainer Lüdtke
- Karl and Veronica Carstens Foundation, Essen, Germany
| | - Larissa Meier
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre and Immanuel Hospital Berlin, Berlin, Germany
- Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre and Immanuel Hospital Berlin, Berlin, Germany
- Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany
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Panta P. The Possible Role of Meditation in Myofascial Pain Syndrome: A New Hypothesis. Indian J Palliat Care 2017; 23:180-187. [PMID: 28503039 PMCID: PMC5412127 DOI: 10.4103/0973-1075.204239] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND OF HYPOTHESIS Myofascial pain syndrome (MPS) is the most common musculoskeletal pain disorder of the head and neck area. In the past, several theories were put forth to explain its origin and nature, but none proved complete. Myofascial pain responds to changing psychological states and stress, anxiety, lack of sleep, anger, depression and chronic pain are direct contributional factors. Myofascial pain syndrome may be considered as a psychosomatic disorder. There are numerous accepted palliative approaches, but of all, relaxation techniques stand out and initiate healing at the base level. In this article, the connection between mental factors, MPS and meditation are highlighted. Recent literature has shed light on the fundamental role of free radicals in the emergence of myofascial pain. The accumulating free radicals disrupt mitochondrial integrity and function, leading to sustenance and progression of MPS. Meditation on the other hand was shown to reduce free radical load and can result in clinical improvement. 'Mindfulness' is the working principle behind the effect of all meditations, and I emphasize that it can serve as a potential tool to reverse the neuro-architectural, neurobiological and cellular changes that occur in MPS. CONCLUSIONS The findings described in this paper were drawn from studies on myofascial pain, fibromyalgia, similar chronic pain models and most importantly from self experience (experimentation). Till date, no hypothesis is available connecting MPS and meditation. Mechanisms linking MPS and meditation were identified, and this paper can ignite novel research in this direction.
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Affiliation(s)
- Prashanth Panta
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy, Telangana, India
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ÜNAL M, Durmus D. Diz Osteoartritinde Kapsaisin Fonoforezin Etkisi ve Birinci Basamakta Erken Kullanılabilirliği: Randomize Kontrollü Bir Çalısma. KONURALP TIP DERGISI 2016. [DOI: 10.18521/ktd.284442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Does Evidence Support the Use of Neural Tissue Management to Reduce Pain and Disability in Nerve-related Chronic Musculoskeletal Pain? Clin J Pain 2016; 32:991-1004. [DOI: 10.1097/ajp.0000000000000340] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Abstract
Both clinical and animal studies suggest that exercise may be an effective way to manage inflammatory and neuropathic pain conditions. However, existing animal studies commonly use forced exercise paradigms that incorporate varying degrees of stress, which itself can elicit analgesia, and thus may complicate the interpretation of the effects of exercise on pain. We investigated the analgesic potential of voluntary wheel running in the formalin model of acute inflammatory pain and the spared nerve injury model of neuropathic pain in mice. In uninjured, adult C57BL/6J mice, 1 to 4 weeks of exercise training did not alter nociceptive thresholds, lumbar dorsal root ganglia neuronal excitability, or hindpaw intraepidermal innervation. Further, exercise training failed to attenuate formalin-induced spontaneous pain. Lastly, 2 weeks of exercise training was ineffective in reversing spared nerve injury-induced mechanical hypersensitivity or in improving muscle wasting or hindpaw denervation. These findings indicate that in contrast to rodent forced exercise paradigms, short durations of voluntary wheel running do not improve pain-like symptoms in mouse models of acute inflammation and peripheral nerve injury.
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Malcolm C. Acute pain management in the older person. J Perioper Pract 2015; 25:134-139. [PMID: 26309959 DOI: 10.1177/1750458915025007-804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The proportion of older people in society is growing steadily. This particular group is more likely to be admitted to hospital and a number of papers have highlighted the inadequate or inappropriate assessment and management of their pain, particularly in the perioperative period. Pain relief is possible for the majority of people. This paper aims to give an overview of the assessment and management of pain in older people.
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McArthur C, Hirdes J, Berg K, Giangregorio L. Who receives rehabilitation in canadian long-term care facilities? A cross-sectional study. Physiother Can 2015; 67:113-21. [PMID: 25931661 DOI: 10.3138/ptc.2014-27] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe the proportion of residents receiving occupational therapy (OT) and physical therapy (PT) and the factors associated with receiving PT in long-term care (LTC) facilities across five provinces and one territory in Canada. METHODS Using a population-based, retrospective analysis of cross-sectional data, the proportion of LTC facility residents in each province or territory receiving three different amounts (time and frequency) of PT, OT, or both before July 1, 2013, was calculated according to the Resource Utilization Groups-III rehabilitation classifications. Twenty-three variables from the Resident Assessment Instrument 2.0, such as age and cognition, were examined as correlates; those significant at p<0.01 were included in a multivariate logistic regression. RESULTS Between 63.7% and 88.6% of residents did not receive any PT or OT; 0.8%-12.6% received both PT and OT; 5.8%-29.5% received an unspecified amount of PT; 1.9%-7.0% received 45 minutes or more of PT 3 days or more per week; and fewer than 1% received 150 minutes or more of PT on 5 or more days per week. Province, age, cognitive status, depression, clinical status, fracture, multiple sclerosis, and self-rated potential for improvement were associated with PT irrespective of time intensity. CONCLUSIONS The proportion of LTC residents receiving rehabilitation services varies across Canada and appears to be associated with physical impairments and the potential for improvement; older residents with cognitive impairment or mood disorders are less likely to receive rehabilitation services. Future recommendations should consider what is driving the patterns of service use, determine whether the resources available are appropriate, and address the most appropriate goals for residents in LTC.
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Affiliation(s)
| | - John Hirdes
- Department of Health Studies and Gerontology, University of Waterloo, Waterloo
| | - Katherine Berg
- Department of Physical Therapy, University of Toronto, Ont
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Berg AT, Stafne SN, Hiller A, Slørdahl SA, Aamot IL. Physical therapy intervention in patients with non-cardiac chest pain following a recent cardiac event: A randomized controlled trial. SAGE Open Med 2015; 3:2050312115580799. [PMID: 26770781 PMCID: PMC4679239 DOI: 10.1177/2050312115580799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 03/03/2015] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To assess the effect of two different physical therapy interventions in patients with stable coronary heart disease and non-cardiac chest pain. METHODS A randomized controlled trial was carried out at a university hospital in Norway. A total of 30 patients with known and stable coronary heart disease and self-reported persistent chest pain reproduced by palpation of intercostal trigger points were participating in the study. The intervention was deep friction massage and heat pack versus heat pack only. The primary outcome was pain intensity after the intervention period and 3 months after the last treatment session, measured by Visual Analogue Scale, 0 to 100. Secondary outcome was health-related quality of life. RESULTS Treatment with deep friction massage and heat pack gave significant pain reduction compared to heat pack only (-17.6, 95% confidence interval: -30.5, -4.7; p < 0.01), and the reduction was persistent at 3 months' follow-up (-15.2, 95% confidence interval: -28.5, -1.8; p = 0.03). Health-related quality of life improved in all three domains in patients with no significant difference between groups. CONCLUSION Deep friction massage combined with heat pack is an efficient treatment of musculoskeletal chest pain in patients with stable coronary heart disease.
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Affiliation(s)
- Astrid T Berg
- Department of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Signe N Stafne
- Department of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Aud Hiller
- Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Stig A Slørdahl
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Inger-Lise Aamot
- Department of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
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Keeratitanont K, Jensen MP, Chatchawan U, Auvichayapat P. The efficacy of traditional Thai massage for the treatment of chronic pain: A systematic review. Complement Ther Clin Pract 2015; 21:26-32. [DOI: 10.1016/j.ctcp.2015.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/20/2015] [Indexed: 01/19/2023]
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Moshkani Farahani D, Tavallaie SA, Ahmadi K, Fathi Ashtiani A. Comparison of neurofeedback and transcutaneous electrical nerve stimulation efficacy on treatment of primary headaches: a randomized controlled clinical trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e17799. [PMID: 25389484 PMCID: PMC4222010 DOI: 10.5812/ircmj.17799] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 05/07/2014] [Accepted: 06/25/2014] [Indexed: 11/21/2022]
Abstract
Background: Headache is one of the most prevalent investigated complaints in the neurology clinics and is the most common pain-related complaint worldwide. Stress is a significant factor that causes and triggers headaches. Since healthcare practitioners experience a lot of stress in their careers, they are more prone to headaches. Objectives: This study was designed to evaluate and compares the efficacy of neurofeedback behavioural therapy (NFB) and transcutaneous electrical nerve stimulation (TENS) in the treatment of primary headaches in healthcare providers. Patients and Methods: The current study was a clinical trial, performed in Teheran, IR Iran, with two experimental groups and a control group. Convenient sampling method was used to recruit patients. Independent variables were NFB and TENS and dependent variables were frequency, severity, and duration of headache. Blanchard headache diary was used for assessment. Hence, 45 healthcare providers with primary headache were selected and randomly allocated to one of the NFB, TENS, and control groups by block random assignment method. All three groups completed the headache diary during one week before and after the treatment period as pretest and posttests, respectively. The NFB group was treated in the period between pretest and posttest with fifteen 30-minute treatment sessions three times a week and the TENS group was treated with fifteen 20-minute daily sessions. The control group received none of these treatments. Results: The results from the analysis of covariance showed that treatment with NFB and TENS had caused significant decrease in the frequency, severity, and duration of headache in experimental groups. The results of the LSD post-hoc test indicated that there were significant differences in the frequency, severity, and duration of pain among experimental groups and the control group. Moreover, there were significant differences between pain frequencies in experimental groups. Conclusions: According to the results and given the significant reductions in the frequency, severity, and duration of headaches, it seems that NFB and TENS might have an effective role in reducing primary headaches of healthcare providers. In addition, comparing the two methods, treatment with NFB was more effective in reducing headache frequency and severity.
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Affiliation(s)
- Davood Moshkani Farahani
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran
- Corresponding Author: Davood Moshkani Farahani, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran. Tel: +98-2144813175, Fax: +98-2144813175, E-mail:
| | - Seyed Abbas Tavallaie
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran
| | - Ali Fathi Ashtiani
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran
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Martins DF, Brito RN, Stramosk J, Batisti AP, Madeira F, Turnes BL, Mazzardo-Martins L, Santos AR, Piovezan AP. Peripheral neurobiologic mechanisms of antiallodynic effect of warm water immersion therapy on persistent inflammatory pain. J Neurosci Res 2014; 93:157-66. [DOI: 10.1002/jnr.23461] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/26/2014] [Accepted: 07/07/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Daniel F. Martins
- Laboratório de Neurociência Experimental (LaNEx), Universidade do Sul de Santa Catarina; Campus Grande Florianópolis-Palhoça SC Brazil
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade do Sul de Santa Catarina; Campus Grande Florianópolis-Palhoça SC Brazil
- Curso de Fisioterapia, Universidade do Sul de Santa Catarina; Campus Grande Florianópolis-Palhoça SC Brazil
| | - Rômulo N. Brito
- Laboratório de Neurociência Experimental (LaNEx), Universidade do Sul de Santa Catarina; Campus Grande Florianópolis-Palhoça SC Brazil
- Curso de Fisioterapia, Universidade do Sul de Santa Catarina; Campus Grande Florianópolis-Palhoça SC Brazil
| | - Juliana Stramosk
- Curso de Fisioterapia, Universidade do Sul de Santa Catarina; Campus Grande Florianópolis-Palhoça SC Brazil
| | - Ana P. Batisti
- Curso de Naturologia, Universidade do Sul de Santa Catarina; Campus Grande Florianópolis-Palhoça SC Brazil
| | - Fernanda Madeira
- Curso de Fisioterapia, Universidade do Sul de Santa Catarina; Campus Grande Florianópolis-Palhoça SC Brazil
| | - Bruna L. Turnes
- Laboratório de Neurobiologia da Dor e Inflamação, Departamento de Ciências Fisiológicas, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Universitário; Trindade Florianópolis SC Brazil
| | - Leidiane Mazzardo-Martins
- Laboratório de Neurobiologia da Dor e Inflamação, Departamento de Ciências Fisiológicas, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Universitário; Trindade Florianópolis SC Brazil
| | - Adair R.S. Santos
- Laboratório de Neurobiologia da Dor e Inflamação, Departamento de Ciências Fisiológicas, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Universitário; Trindade Florianópolis SC Brazil
| | - Anna P. Piovezan
- Laboratório de Neurociência Experimental (LaNEx), Universidade do Sul de Santa Catarina; Campus Grande Florianópolis-Palhoça SC Brazil
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade do Sul de Santa Catarina; Campus Grande Florianópolis-Palhoça SC Brazil
- Curso de Fisioterapia, Universidade do Sul de Santa Catarina; Campus Grande Florianópolis-Palhoça SC Brazil
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Distal traditional acupuncture points of the large intestinal meridian and the stomach meridian differently affect heart rate variability and oxygenation of the trapezius muscle. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:283010. [PMID: 24696701 PMCID: PMC3950417 DOI: 10.1155/2014/283010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/27/2013] [Accepted: 01/13/2014] [Indexed: 11/18/2022]
Abstract
Physicians in traditional Chinese medicine have found that acupoints and meridians have effects on specific parts of the body. The aim of this study was to see how acupressure at distal acupuncture points of a specific meridian affects heart rate variability (HRV) and oxygenation of the trapezius muscle. Forty-one female participants were randomly allocated to three groups. Subjects in the Stomach Meridian acupuncture point (ST) group received acupressure at ST 34, ST 36, and ST 41, subjects in the Large Intestinal Meridian acupuncture point (LI) group received acupressure at LI 4, LI 10, and LI 11, and subjects in the control group did not receive any stimuli. HRV and oxygenation of the trapezius muscles were measured. The high frequency components of HRV in the control and LI groups tended to be higher than those in the ST group. Total hemoglobin in the control and LI groups eventually reached significantly higher levels than in the ST group. While oxyhemoglobin (ΔO2Hb) in the control and LI groups did not change, ΔO2Hb in the ST significantly decreased temporarily.
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MacFarlane PD, Tute AS, Alderson B. Therapeutic options for the treatment of chronic pain in dogs. J Small Anim Pract 2014; 55:127-34. [PMID: 24467556 DOI: 10.1111/jsap.12176] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Chronic pain is a widely recognised problem in humans and is being increasingly recognised as a significant problem in dogs. Whilst a large number of therapies are described and utilised to treat chronic pain in dogs, there is a severe shortage of evidence to guide practitioners in selection of treatments. Until more evidence becomes available, practitioners should adopt a cautious approach, utilising licensed treatments first when possible. Non-pharmacological therapies should be incorporated into the chronic pain management plan whenever possible. Given the probable prevalence of chronic pain in dogs there is an urgent need for research to identify effective treatments.
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Affiliation(s)
- P D MacFarlane
- Langford Veterinary Services, The University of Bristol, Langford, BS40 5DU
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Brosseau L, Robinson V, Léonard G, Casimiro L, Pelland L, Wells G, Tugwell P. Efficacy Of Balneotherapy For Rheumatoid Arthritis: A Meta-analysis. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/108331902125001879] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Effectiveness of manual therapy and home physical therapy in patients with temporomandibular disorders: A randomized controlled trial. J Bodyw Mov Ther 2013; 17:302-8. [DOI: 10.1016/j.jbmt.2012.10.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 09/20/2012] [Accepted: 10/01/2012] [Indexed: 11/21/2022]
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Taspinar F, Aslan UB, Sabir N, Cavlak U. Implementation of matrix rhythm therapy and conventional massage in young females and comparison of their acute effects on circulation. J Altern Complement Med 2013; 19:826-32. [PMID: 23621388 DOI: 10.1089/acm.2012.0932] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To examine and compare the effects of massage and matrix rhythm therapy in young women on the peripheral blood circulation. DESIGN Randomized, double-blind, controlled trial. SETTING Pamukkale University in Denizli, Turkey. PATIENTS Fifteen healthy women age 19-23 years. INTERVENTION Matrix rhythm therapy was applied to the left lower extremity for a single 30-minute session. At least 1 week later, massage was applied to the left lower extremity for 30 minutes in a single session. The same physiotherapist applied both sessions. OUTCOME MEASURES The blood velocity (cm/s), artery diameter (mm), and blood flow (ml/min) of the popliteal and the posterior tibial arteries were measured with color Doppler ultrasonography. All images were evaluated by the same radiologist. RESULTS After matrix rhythm therapy and massage application, blood velocity, artery diameter, and blood flow in arteries increased. However, matrix rhythm therapy caused a more prominent increase in the amount of blood flow in the popliteal and in the posterior tibial artery than did massage. After matrix rhythm therapy application, the average increases in the blood flow rates in the popliteal and the posterior tibial arteries were 25.29%±16.55% and 34.33%±15.66%, respectively; after the massage, the increases were 17.84%±17.23% and 16.07%±10.28%, respectively. CONCLUSION Matrix rhythm therapy and massage increased peripheral blood flow in young women. Matrix rhythm therapy method resulted in more prominent increases.
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Affiliation(s)
- Ferruh Taspinar
- 1 Dumlupinar University , School of Health Science, Department of Physiotherapy and Rehabilitation, Kutahya, Turkey
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Rastogi R, Meek BD. Management of chronic pain in elderly, frail patients: finding a suitable, personalized method of control. Clin Interv Aging 2013; 8:37-46. [PMID: 23355774 PMCID: PMC3552607 DOI: 10.2147/cia.s30165] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The elderly population is projected to make up 20% of the total United States population by the year 2030. In addition, epidemiological data suggests increasing prevalence of chronic pain and frailty with advancing age. Pain, being a subjective symptom, is challenging to manage effectively. This is more so in elderly populations with age-specific physiological changes that affect drug action and metabolism. Elderly patients are also more likely to have multiple chronic health pathologies, declining function, and frailty. The barriers present for patients, providers, and health systems also negatively impact efficient and effective pain control. These factors result in disproportionate utilization of health resources by the older population group. The scientific literature is lagging behind in age-specific studies for the elderly population. As a result, there is a lack of age-specific standardized management guidelines for various health problems, including chronic pain. Increasing efforts are now being directed to studies on pain control in the elderly. However, pain management remains inconsistent and suboptimal. This article is an attempt to suggest an informed, comprehensive guide to achieve effective pain control in the presence of these limitations.
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Affiliation(s)
- Rahul Rastogi
- Department of Anesthesiology, Washington University School of Medicine, Saint Louis, USA.
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Martins DF, Bobinski F, Mazzardo-Martins L, Cidral-Filho FJ, Nascimento FP, Gadotti VM, Santos ARS. Ankle Joint Mobilization Decreases Hypersensitivity by Activation of Peripheral Opioid Receptors in a Mouse Model of Postoperative Pain. PAIN MEDICINE 2012; 13:1049-58. [DOI: 10.1111/j.1526-4637.2012.01438.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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39
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Ulus Y, Tander B, Akyol Y, Durmus D, Buyukakıncak O, Gul U, Canturk F, Bilgici A, Kuru O. Therapeutic ultrasound versus sham ultrasound for the management of patients with knee osteoarthritis: a randomized double-blind controlled clinical study. Int J Rheum Dis 2012; 15:197-206. [PMID: 22462424 DOI: 10.1111/j.1756-185x.2012.01709.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AIM The aim of this trial was to evaluate the short-term effectiveness of ultrasound (US) therapy on pain, physical function, ambulation activity, disability and psychological status in patients with knee OA. METHODS Forty-two inpatients with bilateral knee OA were randomized by an independent researcher not involved in the data assessment, to receive either therapeutic continuous US (group 1) or sham US (group 2). A 1-MHz US head was used, set to an intensity of 1 W/cm(2) for 10 min. All patients received 20 min of hot packs, 10 min of interferential current, and 15 min of quadriceps isometric exercise of both knees. Patients in each group received treatments five times weekly for 3 weeks. Patients were evaluated at baseline and at the end of the treatment sessions. Outcome measures included visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), 50-m walking speed, Lequesne index, Hospital Anxiety and Depression Scale (HADS). RESULTS The patients with knee OA had significant improvements in pain, stiffness, functional activity, walking time, disability, depression and anxiety scores with therapeutic US and sham US (P < 0.05). The improvement in pain VAS scores, WOMAC scores, Lequesne index and HADS scores were not significantly different in patients treated with US and sham US (P > 0.05). No side-effects were reported during or after the US treatment periods. CONCLUSION US therapy is safe but use of US in addition to conventional physical therapy programs seems to have no further significant effect in people with knee OA.
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Affiliation(s)
- Yasemin Ulus
- Department of Physical Medicine and Rehabilitation, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
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Park J, Hughes AK. Nonpharmacological Approaches to the Management of Chronic Pain in Community‐Dwelling Older Adults: A Review of Empirical Evidence. J Am Geriatr Soc 2012; 60:555-68. [DOI: 10.1111/j.1532-5415.2011.03846.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Juyoung Park
- School of Social Work Florida Atlantic University Boca Raton Florida
| | - Anne K. Hughes
- School of Social Work Michigan State University East Lansing Michigan
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41
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Marchand LR. End-of-Life Care. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00064-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kasturi G, Adler RA. Mechanical means to improve bone strength: ultrasound and vibration. Curr Rheumatol Rep 2011; 13:251-6. [PMID: 21484337 DOI: 10.1007/s11926-011-0177-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Not all fractures heal well. One method that has been used to improve fracture healing is low-intensity pulsed ultrasound (LIPUS). LIPUS has been US Food and Drug Administration approved for several years, and some preclinical and clinical evidence indicates that fracture healing can be improved by this technique, which appears to be generally safe. There are several suggested mechanisms of action of LIPUS. Clinical studies generally support its usefulness in accelerating fracture healing. A less-established modality is whole body vibration (WBV), which appears to stimulate bone and muscle growth while suppressing adipogenesis in animal studies. Early studies in humans, including some in children with disabilities, suggest that WBV holds promise as a technique for reducing fracture risk. The exact place of WBV in preventing fracture remains to be established.
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Affiliation(s)
- Gopi Kasturi
- Physical Medicine and Rehabilitation, VA Central California Health Care System, Fresno, CA, USA.
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Comparing biofeedback with active exercise and passive treatment for the management of work-related neck and shoulder pain: a randomized controlled trial. Arch Phys Med Rehabil 2011; 92:849-58. [PMID: 21621660 DOI: 10.1016/j.apmr.2010.12.037] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 12/21/2010] [Accepted: 12/21/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To compare the effects of biofeedback with those of active exercise and passive treatment in treating work-related neck and shoulder pain. DESIGN A randomized controlled trial with 3 intervention groups and a control group. SETTING Participants were recruited from outpatient physiotherapy clinics and a local hospital. PARTICIPANTS All participants reported consistent neck and shoulder pain related to computer use for more than 3 months in the past year and no severe trauma or serious pathology. A total of 72 potential participants were recruited initially, of whom a smaller group of individuals (n=60) completed the randomized controlled trial. INTERVENTIONS The 3 interventions were applied for 6 weeks. In the biofeedback group, participants were instructed to use a biofeedback machine on the bilateral upper trapezius (UT) muscles daily while performing computer work. Participants in the exercise group performed a standardized exercise program daily on their own. In the passive treatment group, interferential therapy and hot packs were applied to the participants' necks and shoulders. The control group was given an education booklet on office ergonomics. MAIN OUTCOME MEASURES Pain (visual analog scale), neck disability index (NDI), and surface electromyography were assessed preintervention and postintervention. Pain and NDI were reassessed after 6 months. RESULTS Postintervention, average pain and NDI scores were reduced significantly more in the biofeedback group than in the other 3 groups, and this was maintained at 6 months. Cervical erector spinae muscle activity showed significant reductions postintervention in the biofeedback group, and there were consistent trends of reductions in the UT muscle activity. CONCLUSIONS Six weeks of biofeedback training produced more favorable outcomes in reducing pain and improving muscle activation of neck muscles in patients with work-related neck and shoulder pain.
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Kumar SP, Saha S. Mechanism-based Classification of Pain for Physical Therapy Management in Palliative care: A Clinical Commentary. Indian J Palliat Care 2011; 17:80-6. [PMID: 21633629 PMCID: PMC3098553 DOI: 10.4103/0973-1075.78458] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Pain relief is a major goal for palliative care in India so much that most palliative care interventions necessarily begin first with pain relief. Physical therapists play an important role in palliative care and they are regarded as highly proficient members of a multidisciplinary healthcare team towards management of chronic pain. Pain necessarily involves three different levels of classification–based upon pain symptoms, pain mechanisms and pain syndromes. Mechanism-based treatments are most likely to succeed compared to symptomatic treatments or diagnosis-based treatments. The objective of this clinical commentary is to update the physical therapists working in palliative care, on the mechanism-based classification of pain and its interpretation, with available therapeutic evidence for providing optimal patient care using physical therapy. The paper describes the evolution of mechanism-based classification of pain, the five mechanisms (central sensitization, peripheral neuropathic, nociceptive, sympathetically maintained pain and cognitive-affective) are explained with recent evidence for physical therapy treatments for each of the mechanisms.
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Affiliation(s)
- Senthil P Kumar
- Department of Physiotherapy, Kasturba Medical College, Manipal University, Mangalore, India
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Fouladbakhsh JM, Szczesny S, Jenuwine ES, Vallerand AH. Nondrug Therapies for Pain Management Among Rural Older Adults. Pain Manag Nurs 2011; 12:70-81. [DOI: 10.1016/j.pmn.2010.08.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Revised: 08/12/2010] [Accepted: 08/18/2010] [Indexed: 11/30/2022]
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Beatti A, Rayner A, Chipchase L, Souvlis T. Penetration and spread of interferential current in cutaneous, subcutaneous and muscle tissues. Physiotherapy 2011; 97:319-26. [PMID: 22051589 DOI: 10.1016/j.physio.2011.01.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2010] [Accepted: 01/09/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate the penetration depth of interferential current (IFC) through soft tissue and the area over which it spreads during clinical application. DESIGN A laboratory-based study of healthy participants. SETTING A university research laboratory. PARTICIPANTS Twelve healthy subjects. INTERVENTIONS Premodulated IFC at 90 Hz and 'true' IFC at frequencies of 4, 40 and 90 Hz were applied via four electrodes, in a quadrant setting, to the distal medial thigh of each participant on separate occasions. MAIN OUTCOME MEASURE Voltage induced by tested currents was measured at three locations (middle of the four electrodes, in line with one circuit and outside the four electrodes) and three depths (skin, subcutaneous and muscle tissues) using three Teflon-coated needle electrodes connected to a Cambridge Electronic Design data acquisition system. RESULTS All voltages were greater at all depths and locations compared with baseline (P<0.001): premodulated IFC [mean difference 0.112, 95% confidence interval (CI) 0.065 to 0.160], 4 Hz (mean difference 0.168, 95% CI 0.106 to 0.229), 40 Hz (mean difference 0.165, 95% CI 0.107 to 0.223) and 90 Hz (mean difference 0.162, 95% CI 0.102 to 0.221). Voltages decreased with depth. Lower voltages of all currents were recorded in the middle of the four electrodes, with the highest voltage for 'true' IFC being recorded outside the four electrodes (mean difference 0.04, 95% CI 0.01 to 0.029; P=0.011). The premodulated IFC had the highest voltage in line with one circuit. CONCLUSIONS IFC passed through soft tissues, with the highest voltages recorded in superficial tissue and the lowest voltages recorded in muscle. For 'true' IFC, the current spread outside the electrodes at higher voltages compared with the intersection of the four electrodes. The premodulated IFC had the highest voltage in line with one circuit. In terms of higher recorded voltages, 'true' IFCs were more efficient than the premodulated IFC when targeting deeper tissues. However, further studies with larger samples are required to confirm the results of this study.
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Affiliation(s)
- Abulkhair Beatti
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland 4072, Australia
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47
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Braun M, Schwickert M, Nielsen A, Brunnhuber S, Dobos G, Musial F, Lüdtke R, Michalsen A. Effectiveness of Traditional Chinese “Gua Sha” Therapy in Patients with Chronic Neck Pain: A Randomized Controlled Trial. PAIN MEDICINE 2011; 12:362-9. [DOI: 10.1111/j.1526-4637.2011.01053.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kim MY, Kim JH, Lee JU, Kim YM, Lee JA, Yoon NM, Hwang BY, Kim KJ, Lee HM, Kim B, Kim J. Temporal Changes in Pain and Sensory Threshold of Geriatric Patients after Moist Heat Treatment. J Phys Ther Sci 2011. [DOI: 10.1589/jpts.23.797] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mee-Young Kim
- Graduate School of Rehabilitation & Health Science, Doctoral Course, Yongin University
| | - Ju-Hyun Kim
- Graduate School of Rehabilitation & Health Science, Doctoral Course, Yongin University
| | - Jeong-Uk Lee
- Graduate School of Rehabilitation & Health Science, Doctoral Course, Yongin University
| | - Young-Mi Kim
- Graduate School of Rehabilitation & Health Science, Doctoral Course, Yongin University
| | - Jeong-A Lee
- Graduate School of Rehabilitation & Health Science, Doctoral Course, Yongin University
| | - Na-Mi Yoon
- Graduate School of Rehabilitation & Health Science, Doctoral Course, Yongin University
| | - Byong-Yong Hwang
- Department of Physical Therapy, College of Public Health & Welfare Yongin University
| | - Keun-Jo Kim
- Department of Physical Therapy, Gimcheon University
| | - Hyun-Min Lee
- Department of Physical Therapy, Honam University
| | - Bokyung Kim
- Department of Physiology, Institute of Functional Genomics, School of Medicine, Konkuk University
| | - Junghwan Kim
- Department of Physical Therapy, College of Public Health & Welfare Yongin University
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Bosy D, Etlin D, Corey D, Lee JW. An interdisciplinary pain rehabilitation programme: description and evaluation of outcomes. Physiother Can 2010; 62:316-26. [PMID: 21886371 PMCID: PMC2958070 DOI: 10.3138/physio.62.4.316] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose of this archival report is to describe the essential elements of an intensive 8-week interdisciplinary pain rehabilitation programme (IPRP) with a cognitive-behavioural emphasis and the results that can be expected in treating patients with chronic pain conditions. METHOD This report describes a private outpatient program providing treatment services to patients with long-term disabling pain arising from work- or accident-related musculoskeletal injuries. The cohort consists of 338 consecutive patients who completed the program over a 3-year period (patients discharged between January 1, 2005, and December 31, 2007). RESULTS Improvements in vocational status were noted in 75% of patients with chronic pain. Patients were also able to reduce their pain levels by approximately 16% and to reduce their levels of anxiety and depression by 13% and 17% respectively. At the same time, 61% of patients were able to reduce or eliminate their pain medications. CONCLUSIONS Outcomes are consistent with evidence-based clinical practice guidelines for the management of chronic pain conditions. The published literature supports the efficacy of this interdisciplinary approach in highly disabled patients for whom effective treatment has been delayed. Early intervention in the subacute phase is recommended for prevention of long-term disability in patients with chronic pain.
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Affiliation(s)
- Dan Bosy
- Dan Bosy, BScH, BSc (PT), FCAMPT: Physiotherapist, Health Recovery Clinic, Mississauga, Ontario
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Yildirim N, Filiz Ulusoy M, Bodur H. The effect of heat application on pain, stiffness, physical function and quality of life in patients with knee osteoarthritis. J Clin Nurs 2010; 19:1113-20. [PMID: 20492056 DOI: 10.1111/j.1365-2702.2009.03070.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The aim in this study was to evaluate the effect of local heat application on pain, stiffness, physical function and quality of life in patients with knee osteoarthritis. BACKGROUND Local heat application is used as a non-pharmacological practice for the treatment of knee osteoarthritis. On the other hand, literature reveals limited information on the effects of heat application. DESIGN The study was a comparative study. METHODS The patients with knee osteoarthritis were divided into two groups (23 patients in each) as intervention and control groups, and patients in the control group were applied with the routine medication of the physician. The intervention group received 20-minute heat application every other day for four weeks in addition to the routine medication. The data were collected using data collection form, Western Ontario and McMaster Universities Index and SF-36. RESULTS The Western Ontario and McMaster Universities pain and Western Ontario and McMaster Universities disability scores of the patients with knee osteoarthritis in control and intervention groups before and after the intervention were compared, and the differences for both scores in the change were found to be statistically significant (p < 0.05). Moreover, statistically significant differences were found between the control and intervention group patients in terms of changes in the scores for physical function, pain and general health perception (p < 0.05). CONCLUSIONS It was found that heat application every other day decreased pain and disability of the patients with knee osteoarthritis. Also, heat application was found to improve the subdimensions of quality of life scores of physical function, pain and general health perception of patients. RELEVANCE TO CLINICAL PRACTICE The data obtained in this study on the efficiency of heat application on pain, stiffness, physical function and general health perception of patients with knee osteoarthritis may offer an insight into decision-making process for appropriate intervention.
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Affiliation(s)
- Nurcan Yildirim
- Faculty of Health Sciences, Midwifery Department, Cumhuriyet University, 58140, Sivas, Turkey.
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