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Luxey X, Lemoine A, Dewinter G, Joshi GP, Le Ray C, Raeder J, Van de Velde M, Bonnet MP. Acute pain management after vaginal delivery with perineal tears or episiotomy. Reg Anesth Pain Med 2024:rapm-2024-105478. [PMID: 38772634 DOI: 10.1136/rapm-2024-105478] [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: 03/14/2024] [Accepted: 04/27/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND A vaginal delivery may be associated with acute postpartum pain, particularly after perineal trauma. However, pain management in this setting remains poorly explored. OBJECTIVE The aim of this systematic review was to evaluate the literature and to develop recommendations for pain management after a vaginal delivery with perineal trauma. EVIDENCE REVIEW MEDLINE, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) and systematic reviews assessing pain after a vaginal delivery with perineal tears or episiotomy until March 2023. Cochrane Covidence quality assessment generic tool and the RoB Vis 2 tool were used to grade the quality of evidence. FINDINGS Overall, 79 studies (69 RCTs and 10 systematic reviews and meta-analyses) of good quality of evidence were included. Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line treatment. Epidural morphine (≤2 mg) is recommended among women with labor epidural analgesia and severe perineal tears, with adequate respiratory monitoring. Local anesthetic infiltration, topical local anesthetic, ointment application, and pudendal nerve block are not recommended due to insufficient or lack of evidence. Ice or chemical cold packs are recommended for postpartum pain first-line treatment due to their simplicity of use. Transcutaneous nerve stimulation and acupuncture are recommended as adjuvants. When a perineal suture is indicated, a continuous suture compared with an interrupted suture for the repair of episiotomy or second-degree perineal tears is recommended for the outcome of pain. For women with first-degree or second-degree perineal tears, no suturing or glue compared with suturing is recommended for the outcome of pain. CONCLUSIONS Postpartum pain management after a vaginal delivery with perineal trauma should include acetaminophen, NSAIDs, and ice or chemical cold packs. Epidural morphine should be reserved for severe perineal tears. A surgical repair technique should depend on perineal tear severity.
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Affiliation(s)
- Xavier Luxey
- Anesthesiology and Intensive Care Medicine, Hôpital Armand-Trousseau, DMU DREAM, AP-HP, Paris, Île-de-France, France
- Hôpital de la Timone service d'anesthésie réanimation 1, Marseille, Provence-Alpes-Côte d'Azur, France
| | - Adrien Lemoine
- Anesthesia, Intensive Care and Perioperative Medicine, Tenon Hospital, DMU DREAM, AP-HP, Paris, France
| | - Geertrui Dewinter
- Biomedical Sciences Group, Department of Cardiovascular Sciences, Department of Anesthesiology, University Hospitals of Leuven, Leuven, Belgium
| | - Girish P Joshi
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - Camille Le Ray
- Port Royal Maternity Unit, Cochin Hospital, Université Paris Cité, APHP, Paris, Île-de-France, France
- Centre for Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, INSERM, Paris, Île-de-France, France
| | - Johan Raeder
- Institute of Clinical Medicine, department of Anesthesiology, Oslo University Hospital, Oslo, Norway
| | - Marc Van de Velde
- Biomedical Sciences Group, department of cardiovascular sciences, Department of anesthesiolgy, University Hospitals Leuven, Leuven, Vlaams-Brabant, Belgium
| | - Marie-Pierre Bonnet
- Centre for Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, INSERM, Paris, Île-de-France, France
- Department of Anesthesiology and Intensive Care Medicine, Armand Trousseau Hospital, DMU DREAM, GRC29, Sorbonne University, APHP, Paris, Île-de-France, France
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Dinçer Ş, Devran S, Savaş EÇ, Pasin Ö, Bayraktar B. Efficacy of capacitive-resistive therapy on the treatment of myofascial pain - A randomized control trial. J Bodyw Mov Ther 2024; 38:86-91. [PMID: 38763621 DOI: 10.1016/j.jbmt.2023.09.010] [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: 04/11/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 05/21/2024]
Abstract
BACKGROUND Myofascial pain syndrome is a painful musculoskeletal condition with muscle spasm, referred pain, stiffness, restricted range of motion. Capacitive-resistive diathermy heats deep tissues by transferring energy through radiofrequency waves. Although this modality is used to treat various musculoskeletal disorders, there is no specific data on myofascial trigger points. Thus, we aimed to evaluate the effectiveness of capacitive-resistive diathermy on the myofascial trigger points. METHODS Thirty-six volunteers with active myofascial trigger points were included. Patients were randomly and equally allocated into two groups. Group-1 is the capacitive-resistive diathermy treatment group; Group-2 is the placebo capacitive-resistive diathermy (PG). Visual analog scale (VAS), pain pressure threshold (PPT), neck disability index (NDI), neck range of motion (nROM), Short form-36 (SF-36) were used as outcomes before and after the intervention. RESULTS In both groups, VAS, PPT, NDI score significantly improved within the groups (p < 0.05). The CRG showed a statistically significant improvement in nROM for flexion, extension, and rotation (p < 0.05). However, ROM increase in CRG is not superior to PG (p > 0.05). CONCLUSIONS There was no significant difference between the two groups. We thought positive results in the PG might attributed to doing exercise. As a result, capacitive-resistive diathermy is not superior to exercise, but can be used as an adjuvant modality in myofascial trigger points treatment.
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Affiliation(s)
- Şensu Dinçer
- Istanbul University, Faculty of Medicine, Sports Medicine Department, Istanbul, Topkapı, 34093, Fatih, Turkey.
| | - Sergen Devran
- Istanbul University, Faculty of Medicine, Sports Medicine Department, Istanbul, Topkapı, 34093, Fatih, Turkey.
| | - Emre Çağrı Savaş
- Istanbul University, Faculty of Medicine, Sports Medicine Department, Istanbul, Topkapı, 34093, Fatih, Turkey.
| | - Özge Pasin
- Bezmialem University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Istanbul, 34093, Fatih, Turkey.
| | - Bülent Bayraktar
- Istanbul University, Faculty of Medicine, Sports Medicine Department, Istanbul, Topkapı, 34093, Fatih, Turkey.
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Siereńska J, Sotomska Z, Madej-Łukasiak D, Wąż P, Grzybowska ME. The Use of Capacitive and Resistive Energy Transfer in Postpartum Pain Management in Women after Perineal Trauma. J Clin Med 2023; 12:6077. [PMID: 37763017 PMCID: PMC10532265 DOI: 10.3390/jcm12186077] [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: 08/22/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Perineal pain occurs in 97% of women with episiotomy or first- and second-degree perineal tears on the first day after delivery. The study aimed to assess the impact of capacitive and resistive energy transfer (TECAR) on perineal pain and discomfort in the first two postpartum days. The prospective randomized double-blind study was performed with the pain and discomfort assessment using the Visual Analogue Scale at baseline and after both TECAR interventions. Characteristics data, delivery information, and the number of painkillers taken were collected. The assumed significance level was α < 0.05. The study included 121 women with a mean age of 30.7 ± 4.2 years and a median BMI of 26.1 kg/m2 (24.1; 28.9). Pain reduction at rest, when walking, and discomfort reduction when walking were significantly higher in the TECAR group compared to the sham group (p < 0.05). After the first TECAR intervention, significant reduction in all measured parameters was observed in the study group (p < 0.03), whereas in the control group, it was observed in pain and discomfort while sitting (p < 0.04). The amount of ibuprofen taken on the second day was significantly reduced in the study group compared to the first day (p = 0.004). TECAR has been shown to provide more immediate and significant reduction in perineal pain and discomfort.
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Affiliation(s)
- Joanna Siereńska
- Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland;
| | - Zofia Sotomska
- Independent Team of Physiotherapists, University Clinical Center, Al. Zwycięstwa 30, 80-219 Gdańsk, Poland;
| | - Dorota Madej-Łukasiak
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, University Clinical Center, Smoluchowskiego 17, 80-214 Gdańsk, Poland;
| | - Piotr Wąż
- Department of Nuclear Medicine, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland;
| | - Magdalena Emilia Grzybowska
- Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland;
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Brusciano L, Brillantino A, Flagiello L, Pennacchio M, Gambardella C, Lucido FS, Pizza A, Tolone S, Del Genio G, Docimo L. EFFECTIVENESS OF PERINEAL PELVIS REHABILITATION COMBINED WITH BIOFEEDBACK AND RADIOFREQUENCY DIATHERMY (RDF) IN ANORECTAL FUNCTIONAL PAIN SYNDROMES ASSOCIATED WITH PARADOXICAL CONTRACTION OF THE LEVATOR ANI MUSCLES. A PROSPECTIVE STUDY. ARQUIVOS DE GASTROENTEROLOGIA 2023; 60:201-207. [PMID: 37556746 DOI: 10.1590/s0004-2803.20230222-150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/24/2023] [Indexed: 08/11/2023]
Abstract
•Anorectal functional pain syndrome is a very often disabling disease with a consequent significant negative impact on the patient's quality of life. Chronic proctalgia, in many patients, is secondary to the paradoxical contraction of the pelvic floor and associated with a dissynergy between the thorax-abdomen and the pelvic floor. •The use of radiofrequency diathermy with a system of static electrodes associated with biofeedback represents a valid rehabilitation option for those patients suffering from anorectal functional pain syndrome because it reduces pain and paradoxical contraction of the levator ani and improves quality of life of the patient. Background - Anorectal functional pain syndrome, also called chronic proctalgia, represents a neglected clinical entity and often confused with other syndromes such as vulvodynia or acute proctalgia. It is a very often disabling disease with a consequent significant negative impact on the patient's quality of life. Chronic proctalgia, in many patients, is secondary to the paradoxical contraction of the pelvic floor and associated with a dissynergy between the thorax-abdomen and the pelvic floor. To improve symptoms in functional anorectal pain syndromes, various rehabilitation techniques are used with the aim of promoting relaxation of the pelvic floor; however, to improve defecatory dynamics in patients with levator ani syndrome, only biofeedback has shown efficacy in a randomized study. The aim of this work is to evaluate whether a rehabilitation protocol with manometric biofeedback and radiofrequency diathermy (mt100 Fremslife emotion Tecar) reduces pain and paradoxical contraction of the levator ani and improves the quality of life in patients with anorectal pain syndromes. functional. Methods - This was a prospective study on 30 patients (20 women and 10 men) with anorectal functional pain syndrome and paradoxical contraction of the pelvic floor enrolled at the UOC of General, Minimally Invasive, Oncological and Obesity Surgery of the AOU "Luigi Vanvitelli" of Naples, Italy, from September 2021 to May 2022. All patients were evaluated with a coloproctological specialist visit followed by anorectal manometry and evaluation of altered clinical physiatric parameters (Brusciano Score). The protocol consisted of 10 rehabilitation sessions of the pelvic floor once a week and lasting approximately 45 minutes. During the sessions the patients were subjected to diathermy / radiofrequency treatment (10 minutes) with a static resistive electrode on the diaphragm, during which they were required to breathe diaphragmatically and to become aware of the perineal muscles, under the supervision of a physiotherapist; followed by application of diathermy with static capacitive (5 minutes) and resistive (10 minutes) electrode at the lumbar level. This was followed by the use of manometric biofeedback (15 minutes of tonic / phasic exercises) in order to instruct the patient on the reflex mechanism to obtain a voluntary relaxation of the external anal sphincter. The variables evaluated were Pain (VAS 0-10) and the questionnaire on the impact of colorectal and anal pathologies on the quality of life (CRAIQ-7) at the beginning, after 3 months and at the end of the treatment. Results - After 10 weeks, the rehabilitation treatment combined with diathermy and manometric biofeedback proved effective in the short term with a reduction in the scores of the Vas scale and CRAIQ-7 questionnaire and an increase in the percentage of release of the anal muscles on anorectal manometry. Conclusion - The use of radiofrequency diathermy with a system of static electrodes associated with biofeedback represents a valid rehabilitation option for those patients suffering from anorectal functional pain syndrome because it reduces pain and paradoxical contraction of the levator ani and improves quality of life of the patient.
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Affiliation(s)
- Luigi Brusciano
- Division of General, Oncologic, Mininvasive and Bariatric Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Luigi Flagiello
- Division of General, Oncologic, Mininvasive and Bariatric Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Marianna Pennacchio
- Division of General, Oncologic, Mininvasive and Bariatric Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Claudio Gambardella
- Division of General, Oncologic, Mininvasive and Bariatric Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Saverio Lucido
- Division of General, Oncologic, Mininvasive and Bariatric Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alessandra Pizza
- Division of General, Oncologic, Mininvasive and Bariatric Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Salvatore Tolone
- Division of General, Oncologic, Mininvasive and Bariatric Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gianmattia Del Genio
- Division of General, Oncologic, Mininvasive and Bariatric Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ludovico Docimo
- Division of General, Oncologic, Mininvasive and Bariatric Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
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Albornoz-Cabello M, Ibáñez-Vera AJ, Barrios-Quinta CJ, Lara-Palomo IC, Cardero-Durán MDLÁ, Espejo-Antúnez L. Effects of Radiofrequency Diathermy Plus Therapeutic Exercises on Pain and Functionality of Patients with Patellofemoral Pain Syndrome: A Randomized Controlled Trial. J Clin Med 2023; 12:jcm12062348. [PMID: 36983348 PMCID: PMC10051503 DOI: 10.3390/jcm12062348] [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: 01/24/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Although consensus has been reached about the use of therapeutic exercise in patellofemoral pain syndrome, several techniques used worldwide such as radiofrequency diathermy could be useful as complementary therapy. The objective of this randomized controlled trial was to compare the effects of adding radiofrequency diathermy to therapeutic exercises in patients with patellofemoral pain syndrome. Fifty-six participants were randomly assigned either to radiofrequency diathermy plus therapeutic exercises group (n = 29) or therapeutic exercises group (n = 27). Both groups received the same therapeutic exercises, and the diathermy group additionally received monopolar dielectric diathermy for three weeks (5-3-2 weekly sessions). Data related to intensity of pain, probability of neuropathic pain, functionality, and range of movement of the knee were measured at baseline and three weeks after the intervention. Comparing pre-treatment and values obtained at the third week, significant improvements were found in intensity of pain, neuropathic pain, functionality, and range of motion in both groups (p < 0.05). The diathermy plus exercises group had significantly better intensity of pain than the control group at the end of the three weeks (p < 0.01). The addition of diathermy by emission of radiofrequency to the therapeutic knee exercise protocol is more effective than a therapeutic exercise protocol alone in the relief of intensity of pain in patients with patellofemoral pain in the immediate post-treatment follow-up compared with baseline scores.
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Affiliation(s)
| | | | | | | | | | - Luis Espejo-Antúnez
- Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, University of Extremadura, 06006 Badajoz, Spain
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Elhosary EA, Ahmed Hamada H, Ali AlMubali F, López Sánchez GF, Ahmed SM. Effect of monopolar capacitive resistive radiofrequency in treating stress urinary incontinence: A pilot randomized control trial. Front Psychol 2023; 13:1062363. [PMID: 36687887 PMCID: PMC9851078 DOI: 10.3389/fpsyg.2022.1062363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/06/2022] [Indexed: 01/07/2023] Open
Abstract
Objective To assess the effectiveness of 448 kHz monopolar capacitive resistive radiofrequency (MCRR) in the treatment of females with stress urinary incontinence (SUI). Materials and methods Forty females with SUI complaints were separated randomly into two equal groups. Group A with 20 females received the MCRR therapy for 20 min and performed pelvic floor exercises for 20 min. Group B with 20 females received placebo treatment by applying the same application as in Group A without emitting any waves for 20 min, three times a week, for 4 weeks. The patients in both groups were instructed to pause the treatment during their menstruation; the patients were instructed to maintain home pelvic floor exercises. Both groups were assessed by a perineometer that was used to assess the strength of the pelvic floor muscles (PFM), the visual analogue scale (VAS), and the Incontinence Symptom Severity Index to assess the frequency of urinary incontinence symptoms as described by each patient before treatment and after 4 weeks of treatment. Results There was a significant reduction (p < 0.05) in VAS and the Incontinence Symptom Severity Index and a significant increase in the strength of the PFM in both groups post-treatment compared with the pre-treatment. Regarding between-subject effects, there was a significant difference in VAS, the Incontinence Symptom Severity Index, and the perineometer between both groups (p < 0.05), and this significant improvement favored Group A. Conclusion MCRR and pelvic floor exercises are more effective methods for the treatment of SUI than just pelvic floor exercises of females with SUI. Clinical Trial Registration ClinicalTrials.gov. Identifier: NCT04612205.
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Affiliation(s)
- Eman A. Elhosary
- Department of Physical Therapy for Women Health, Faculty of Physical Therapy, Kafr Elshiekh University, Kafr Elshiekh, Egypt
| | - Hamada Ahmed Hamada
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt,*Correspondence: Hamada Ahmed Hamada,
| | - Fatimah Ali AlMubali
- Department of Physical Therapy, Sharurah Armed Forces Hospital, Sharurah, Saudi Arabia
| | - Guillermo F. López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain,Guillermo F. López Sánchez,
| | - Sara M. Ahmed
- Department of Physical Therapy for Women’s Health, Cairo University, Giza, Egypt
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González-Gutiérrez MD, López-Garrido Á, Cortés-Pérez I, Obrero-Gaitán E, León-Morillas F, Ibáñez-Vera AJ. Effects of Non-Invasive Radiofrequency Diathermy in Pelvic Floor Disorders: A Systematic Review. Medicina (B Aires) 2022; 58:medicina58030437. [PMID: 35334613 PMCID: PMC8951766 DOI: 10.3390/medicina58030437] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/01/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: In recent years, the use of radiofrequency diathermy in pelvic floor disorders has grown proportionally to the interest in this specialty. Despite the common use of this therapy among pelvic floor physiotherapists, little is known about its effects and effectiveness in pelvic floor disorders. For this reason, the aim of the present review is to assess the effects of non-invasive 300 kHz–1 MHz radiofrequency diathermy in the treatment of pelvic floor disorders. Materials and Methods: A literature search was performed in PubMed, Scopus and Web of Science, searching for any type of study that included pelvic floor disorder participants and an experimental group treated with non-invasive nor ablative radiofrequency diathermy. Results: There were a total of 578 studies after removing duplicates. The inclusion and exclusion criteria were applied, resulting in a total of 15 studies, which were methodologically assessed with PEDro and the Newcastle and Ottawa scale. Conclusions: Despite the low quality of most of them, the studies showed improvements in urinary incontinence, pelvic pain conditions, pelvic floor muscles strength and sexual function. These findings must be considered with caution until more randomized clinical trials are performed to solve the biases detected.
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Affiliation(s)
| | | | - Irene Cortés-Pérez
- Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaén, Spain; (I.C.-P.); (A.J.I.-V.)
- Poniente de Almería Northeast Health District, Andalusian Health Service, 04740 Roquetas de Mar, Spain
| | - Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaén, Spain; (I.C.-P.); (A.J.I.-V.)
- Correspondence: ; Tel.: +34-953-212-918
| | - Felipe León-Morillas
- Department of Physiotherapy, Catholic University of Murcia UCAM, Avenida de los Jerónimos, 30107 Murcia, Spain;
| | - Alfonso Javier Ibáñez-Vera
- Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaén, Spain; (I.C.-P.); (A.J.I.-V.)
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Carralero-Martínez A, Muñoz Pérez MA, Kauffmann S, Blanco-Ratto L, Ramírez-García I. Efficacy of capacitive resistive monopolar radiofrequency in the physiotherapeutic treatment of chronic pelvic pain syndrome: A randomized controlled trial. Neurourol Urodyn 2022; 41:962-972. [PMID: 35266184 DOI: 10.1002/nau.24903] [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: 08/01/2021] [Revised: 12/26/2021] [Accepted: 02/14/2022] [Indexed: 11/11/2022]
Abstract
AIM To evaluate the efficacy of adjuvant, capacitive resistive monopolar radiofrequency (CRMRF, INDIBA) treatment at 448 kHz together with physiotherapeutic techniques compared to a sham treatment with the same techniques, for pain reduction and quality of life (QoL) improvements in patients with chronic pelvic pain syndrome (CPPS). METHODS A triple-blind, randomized controlled trial (RCT) including patients with CPPS randomly allocated (1:1) to a CRMRF-activated group (intervention) or a CRMRF-deactivated one (control). Both groups received physiotherapeutic techniques and pain education weekly for 10 consecutive weeks. Data from a visual analogical scale and the SF-12 questionnaire were collected at trial commencement and repeated at the 5th and 10th sessions. Pain intensity was considered the main outcome. For the comparisons between variables, the χ2 and Student's t test were used. Superiority was analyzed by estimating the mean change (95% confidence interval). Analysis was performed for the per-protocol and the intention-to-treat populations. The statistical significance level was set at p < 0.05. RESULTS Eighty-one patients were included (67.9% women) with a mean age of 43.6 years (SD 12.9). CRMRF lessened pain scores by more than 2 points and improved QoL by 5 points. There were no relevant side effects and overall adherence to the treatment was 86.4%. CONCLUSIONS This is the first RCT that evaluates the efficacy of CRMRF (INDIBA) compared to a sham treatment, and demonstrates its superiority in decreasing pain and improving QoL. Such results may lead to greater prescribing of CRMRF when treating CPPS patients.
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Affiliation(s)
- Andrea Carralero-Martínez
- RAPbarcelona Physiotherapy Clinical Center, Barcelona, Spain.,Gynecology, Obstetrics and Neonatology Institute, Barcelona Clinical Hospital, Barcelona, Spain.,Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine. PhD program in Methodology of Biomedical Research and Public Health, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Miguel A Muñoz Pérez
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine. PhD program in Methodology of Biomedical Research and Public Health, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain.,Foundation University Institute for Primary Health Care Research, Jordi Gol i Gurina (IDIAP JGol), Barcelona, Spain.,Institut Català de la Salut (ICS), Barcelona, Spain
| | | | | | - Inés Ramírez-García
- RAPbarcelona Physiotherapy Clinical Center, Barcelona, Spain.,Blanquerna School of Health Science, Ramon Llull University, Barcelona, Spain.,GHenderS (Global Health, Gender and Society) Research Group, Barcelona, Spain
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De Sousa-De Sousa L, Tebar Sanchez C, Maté-Muñoz JL, Hernández-Lougedo J, Barba M, Lozano-Estevan MDC, Garnacho-Castaño MV, García-Fernández P. Application of Capacitive-Resistive Electric Transfer in Physiotherapeutic Clinical Practice and Sports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312446. [PMID: 34886180 PMCID: PMC8657372 DOI: 10.3390/ijerph182312446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022]
Abstract
Diathermy techniques embody an oscillating electrical current passaging through the body tissues generating therapeutic heat; use of this technique in the physiotherapy field has been introduced recently, and because there is scarce information, the following review is proposed, aiming to explore the available evidence on applying CRET in physiotherapy clinical practice and sports. A systematic search was led through a keyword search on PubMed, MedLine, DialNet, Scopus, PEDro, Web of Science and Clinicaltrials databases. Including randomised controlled trials and quasi-experimental studies, which applied radiofrequency diathermy in sports and physiotherapy fields, without any restrictions on dates, published in Spanish, English, Portuguese or Italian. Data extraction was conducted through the Cochrane data extraction form and presented in tabular format; 30 articles were included for analysis, and assessment of methodological quality was made through the PEDro scale with a "Good/Fair" general quality score. The nature of existing articles does not allow a quantitative analysis. Conclusion: identified fields of applications were musculoskeletal physiotherapy, treatment of pelvic floor and sexual dysfunctions, as well as dermato-functional physiotherapy and sports, evidencing an increase of skin temperature, enhanced skin and muscle blood perfusion, as well as reporting an increase in oxyhaemoglobin. Further research is needed. Prospero registration number: CRD42020215592.
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Affiliation(s)
- Luis De Sousa-De Sousa
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain; (L.D.S.-D.S.); (J.L.M.-M.); (P.G.-F.)
| | - Cristina Tebar Sanchez
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain; (L.D.S.-D.S.); (J.L.M.-M.); (P.G.-F.)
- Correspondence: ; Tel.: +34-649-358-347
| | - José Luis Maté-Muñoz
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain; (L.D.S.-D.S.); (J.L.M.-M.); (P.G.-F.)
| | - Juan Hernández-Lougedo
- Department of Physical Activity and Sports, Faculty of Health Sciences, Alfonso X University, Villanueva de la Cañada, 28691 Madrid, Spain; (J.H.-L.); (M.B.)
| | - Manuel Barba
- Department of Physical Activity and Sports, Faculty of Health Sciences, Alfonso X University, Villanueva de la Cañada, 28691 Madrid, Spain; (J.H.-L.); (M.B.)
| | | | | | - Pablo García-Fernández
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain; (L.D.S.-D.S.); (J.L.M.-M.); (P.G.-F.)
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