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Boostani R, Olfati N, Shamshiri H, Salimi Z, Fatehi F, Hedjazi SA, Fakharian A, Ghasemi M, Okhovat AA, Basiri K, Haghi Ashtiani B, Ansari B, Raissi GR, Khatoonabadi SA, Sarraf P, Movahed S, Panahi A, Ziaadini B, Yazdchi M, Bakhtiyari J, Nafissi S. Iranian clinical practice guideline for amyotrophic lateral sclerosis. Front Neurol 2023; 14:1154579. [PMID: 37333000 PMCID: PMC10272856 DOI: 10.3389/fneur.2023.1154579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/09/2023] [Indexed: 06/20/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegeneration involving motor neurons. The 3-5 years that patients have to live is marked by day-to-day loss of motor and sometimes cognitive abilities. Enormous amounts of healthcare services and resources are necessary to support patients and their caregivers during this relatively short but burdensome journey. Organization and management of these resources need to best meet patients' expectations and health system efficiency mandates. This can only occur in the setting of multidisciplinary ALS clinics which are known as the gold standard of ALS care worldwide. To introduce this standard to the care of Iranian ALS patients, which is an inevitable quality milestone, a national ALS clinical practice guideline is the necessary first step. The National ALS guideline will serve as the knowledge base for the development of local clinical pathways to guide patient journeys in multidisciplinary ALS clinics. To this end, we gathered a team of national neuromuscular experts as well as experts in related specialties necessary for delivering multidisciplinary care to ALS patients to develop the Iranian ALS clinical practice guideline. Clinical questions were prepared in the Patient, Intervention, Comparison, and Outcome (PICO) format to serve as a guide for the literature search. Considering the lack of adequate national/local studies at this time, a consensus-based approach was taken to evaluate the quality of the retrieved evidence and summarize recommendations.
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Affiliation(s)
- Reza Boostani
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nahid Olfati
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hosein Shamshiri
- Department of Neurology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zanireh Salimi
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzad Fatehi
- Department of Neurology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Arya Hedjazi
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Atefeh Fakharian
- Pulmonary Rehabilitation Research Center (PRRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
- National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Internal Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Ghasemi
- Department of Neurology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Asghar Okhovat
- Department of Neurology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Keivan Basiri
- Department of Neurology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Haghi Ashtiani
- Department of Neurology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Behnaz Ansari
- Department of Neurology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- AL Zahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholam Reza Raissi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Payam Sarraf
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Movahed
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Akram Panahi
- Department of Neurology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bentolhoda Ziaadini
- Department of Neurology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Yazdchi
- Department of Neurology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jalal Bakhtiyari
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahriar Nafissi
- Department of Neurology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Alemrajabi M, Raissi GR, Sajadi S, Ahadi T, Madani SP, Mansoori K, Tirandazi B. Effects of weight loss after bariatric surgery on the median and ulnar nerves conduction studies. Am J Surg 2023; 225:753-757. [PMID: 36462960 DOI: 10.1016/j.amjsurg.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/17/2022] [Accepted: 11/17/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of the present study was to compare the nerve conduction study (NCS) of median and ulnar nerves before and after bariatric surgery. METHODS This prospective cross-sectional study included 32 patients with BMI≥35 who were candidate for Sleeve gastrectomy. NCS of median and ulnar nerves were evaluated before and 3 months after surgery. In CTS cases, Boston Carpal Tunnel Questionnaire (BCTQ) was completed. RESULTS Eligible participants were 32 patients aged between 19 and 64 years. 20 patients including 34 hands had CTS. Severity of CTS and BCTQ scores were significantly different after surgery. Moreover, sensory amplitude, and motor NCV for both median and ulnar nerves in hands without CTS as well as sensory amplitude of ulnar nerve in hands with CTS were significantly different after bariatric surgery (P value < 0.05). CONCLUSIONS The results of this study suggest that three months after the bariatric surgery, the clinical and electrophysiological severity of CTS shows a significant improvement. ETHICAL CODE OF STUDY IR.IUMS.FMD.REC.1396.15008.
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Affiliation(s)
- Mahdi Alemrajabi
- Clinical Research Development Center (CRDC), Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Raissi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Simin Sajadi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Tannaz Ahadi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Pezhman Madani
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Korosh Mansoori
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Behnaz Tirandazi
- Department of Physical Medicine and Rehabilitation, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Ahadi T, Cham MB, Mirmoghtadaei M, Raissi GR, Janbazi L, Zoghi G. The effect of dextrose prolotherapy versus placebo/other non-surgical treatments on pain in chronic plantar fasciitis: a systematic review and meta-analysis of clinical trials. J Foot Ankle Res 2023; 16:5. [PMID: 36759882 PMCID: PMC9912486 DOI: 10.1186/s13047-023-00605-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Prolotherapy is the injection of a small volume of sclerosing or irritant solutions into an injured tissue. We aimed to investigate the effect of dextrose prolotherapy (DPT) versus placebo/other non-surgical treatments on pain in chronic plantar fasciitis. METHODS We searched seven electronic databases (PubMed/MEDLINE, Web of Science, EMBASE, Scopus, ProQuest, CENTRAL, PEDro) from inception to December 31, 2021 with no language restriction for publications comparing the effect of DPT with placebo/other non-surgical treatments in patients with chronic plantar fasciitis. Our primary outcome was pain and the secondary outcomes were foot function and plantar fascia thickness. The risk of bias was assessed using the Cochrane Collaboration's tool. RESULTS Overall, eight studies with a total of 449 patients were included in the meta-analysis. All the included studies reported short-term pain. A large effect size (dppc2 = -0.97, 95% confidence interval [CI] -1.84 to -0.10) was observed favoring the use of DPT to reduce pain in patients with chronic plantar fasciitis in the short-term. The results for foot function improvement (dppc2 = -1.28, 95% CI -2.49 to -0.07) and plantar fascia thickness reduction (dppc2 = -1.02, 95% CI -1.99 to -0.05) in the short-term were also in favor of DPT. CONCLUSIONS Since almost all the included studies had high risk of bias and multiple trials lacked long-term follow-ups, further high-quality research is required to determine the long-term effects of DPT vs placebo/other non-surgical interventions.
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Affiliation(s)
- Tannaz Ahadi
- grid.411746.10000 0004 4911 7066Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Masumeh Bagherzadeh Cham
- Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Mahtab Mirmoghtadaei
- Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Gholam Reza Raissi
- grid.411746.10000 0004 4911 7066Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Lobaneh Janbazi
- grid.411746.10000 0004 4911 7066Department of Physical Medicine and Rehabilitation, School of Medicine, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ghazal Zoghi
- grid.412237.10000 0004 0385 452XEndocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Madani SP, Abdolmaleki K, Ahadi T, Mansoori K, Raissi GR. Neuropathic Pain Symptom Inventory (NPSI) Questionnaire-Persian Version Can Differentiate Neuropathic from Non-Neuropathic Pain. Pain Manag Nurs 2023; 24:96-101. [PMID: 35985908 DOI: 10.1016/j.pmn.2022.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/14/2022] [Accepted: 07/07/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Neuropathic pain (NP) is a common condition that impacts life negatively. This type of pain responds poorly to treatment. Neuropathic Pain Symptom Inventory (NPSI) is a common instrument used for the assessment of NP response to the treatment. AIM The current study aims to validate the Persian version of NPSI (PV-NPSI). METHODS The current study has been conducted on 162 patients experiencing pain from neuropathic ornon-neuropathic origin. The Persian version of NPSI was proposed through standard protocol and responded to by patients twice: at baseline within an interval of 3 hours and then again within 1 month. Its correlation with the patient global impression of change (PGIC) and the clinical global impression of change (CGIC) was assessed. In addition, the validity and reliability of the PV-NPSI was evaluated. RESULTS The reliability Cronbach's alpha of PV-NPSI was 0.834 and test-retest intraclass-coefficient was calculated as 0.983 (95% confidence interval [CI]: 0.977-0.988; p < .001). In addition, the measured coefficient sensitivity to change based on PGIC and CGIC was 0.859 for both. Receiver operating characteristic (ROC) curve for the diagnosis of NP revealed area under curve (AUC) of 0.936 (p < .001; 95%CI: 0.894-0.978). CONCLUSIONS Based on the current study's findings, the PV-NPSI is a reliable and valid means for the differentiation of NP from the other types of pain in patients with several musculoskeletal pain complaints, but we cannot determine a cutoff point for it. Also, this questionnaire can be efficiently used for the assessment of response to NP treatment.
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Affiliation(s)
- Seyed Pezhman Madani
- From the Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Khatereh Abdolmaleki
- From the Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Tannaz Ahadi
- From the Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Kourosh Mansoori
- From the Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Raissi
- From the Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
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Ahadi T, Asilian M, Raissi GR, Khalifeh Soltani S, Soleymanzadeh H, Sajadi S. Ultrasound-Guided vs. Blind Coccygeal Corticosteroid Injections for Chronic Coccydynia: A Randomized, Clinical Trial. Arch Bone Jt Surg 2022; 10:877-884. [PMID: 36452413 PMCID: PMC9702026 DOI: 10.22038/abjs.2022.58507.2895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 03/09/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Corticosteroid injection is frequently used for chronic coccydynia management. Ultrasonography can be used to improve the accuracy of the injection. This study aims to assess the clinical outcome of ultrasound-guided compared to blind coccygeal injection in chronic coccydynia. METHODS Thirty patients with chronic coccydynia were randomized into two groups and received a coccygeal corticosteroid injection at maximum tenderness point: 15 patients with and 15 patients without ultrasound guidance. The patient's pain was evaluated with the visual analog scale (VAS) at 1-, 4-, 8-, and 24-week postinjection. Furthermore, the Dallas Pain Questionnaire was assessed before injection; also, four and eight weeks after treatment. The quality of life of patients was evaluated before an assessment and four weeks after the intervention by the SF-36 questionnaire. RESULTS The VAS score decreased significantly 24-week after the intervention in both ultrasound-guided and blinded groups (P < .001), without any significant difference between the groups (P = .964). Similarly, the Dallas pain scale had a significant decrease at eight weeks after intervention in both groups (P < .001) with no significant difference between the groups (P = .972). Although there was a significant improvement in the patient's quality of life in each group eight weeks after the intervention, it was not significantly different between the two groups. Neither of the treatment groups had any adverse effects associated with the injection. CONCLUSION There were no significant differences in the clinical outcome of coccygeal ultrasound-guided vs. blind steroid injection for chronic coccydynia.
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Affiliation(s)
- Tannaz Ahadi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdiye Asilian
- Department of Geriatric, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Raissi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Hosnieh Soleymanzadeh
- Department of Geriatric, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Simin Sajadi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Mansoori K, Raissi GR, Madani SP, Ameri M, ZoghAli M, Sajadi S. A Three months Electrodiagnostic Follow-Up of Patients Suspected of having Ulnar Nerve Involvement at Elbow Level with Normal Conventional Electrodiagnostic Study at First Evaluation. Neurol India 2022; 70:1920-1924. [PMID: 36352588 DOI: 10.4103/0028-3886.359279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Compression of ulnar nerve at the elbow is the second most common peripheral neuropathy of the upper extremity. OBJECTIVE Due to the lack of the gold diagnostic standard for ulnar nerve involvement at elbow level (UNE) and the lack of sufficient study in this field, we decided to evaluate patients with symptoms of this disease who have normal conventional electrodiagnostic study (EDX) in first evaluation. MATERIALS AND METHODS In this cross-sectional study, 18 persons were selected from patients who were referred to the clinic of Physical Medicine and Rehabilitation. If conventional EDX was normal, compound nerve action potential (CNAP) test (peak latency and amplitude) was carried out. Patients with normal conventional EDX but abnormal ulnar CNAP included to our study. After 3 months, if they had not been treated for ulnar neuropathy, they were reexamined by conventional EDX plus ulnar CNAP measurement. RESULTS In total, 18 patients (11 females, 7 males) aged 28-58 years old (mean = 40.11) were analyzed in this study. After 3 months, 14 patients (77.8%) demonstrated parameter changes consistent with UNE in conventional EDX. CONCLUSION Based on the results of this study, ulnar CNAP has diagnostic value in patients with symptoms of UNE who have normal routine EDX. Therefore, ulnar CNAP should be taken into account for early diagnosis of ulnar neuropathy when routine electrodiagnostic tests are normal.
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Affiliation(s)
- Korosh Mansoori
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Raissi
- Department of Physical Medicine and Rehabilitation, Neuromusculoskeletal Research Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Pezhman Madani
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran; ALS Clinical and Research Fellow, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Milad Ameri
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Masoume ZoghAli
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Simin Sajadi
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
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Ahadi T, Nik SS, Forogh B, Madani SP, Raissi GR. Comparison of the Effect of Ultrasound-Guided Injection of Botulinum Toxin Type A and Corticosteroid in the Treatment of Chronic Plantar Fasciitis: A Randomized Controlled Trial. Am J Phys Med Rehabil 2022; 101:733-737. [PMID: 34620739 DOI: 10.1097/phm.0000000000001900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to compare the efficacy of ultrasound-guided injection of botulinum toxin type A with corticosteroid in patients with chronic plantar fasciitis (PF). DESIGN This randomized controlled trial was conducted on 35 patients with chronic plantar fasciitis. Participants were randomly allocated into two groups: one group received methylprednisolone in to the plantar fascia ( n = 18) and the other group received botulinum toxin type A injection into the flexor digitorum brevis and quadratus plantae ( n = 17). All injections were performed under ultrasound guidance. Patients were evaluated using the Visual Analog Scale, Foot and Ankle Ability Measures, and plantar fascia thickness before the intervention, 3 wks, 12 wks, and 6 mos after the treatment. RESULTS In both groups, patients' pain and function improved significantly up to 3 wks after injection. In the botulinum toxin type A group, morning Visual Analog Scale improved significantly at 12 wks after intervention and the improvement was sustained for another 3 mos. In the botulinum toxin type A group, Foot and Ankle Ability Measures-sports subscale improved in all evaluated points, whereas in the corticosteroid group, the improvement was significant only when comparing follow-ups values to baseline. CONCLUSIONS Both ultrasound-guided botulinum toxin type A and corticosteroid injection were effective in the treatment of plantar fasciitis. Our study showed that the effects of botulinum toxin type A injection last longer than those of steroid injection.
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Affiliation(s)
- Tannaz Ahadi
- From the Neuromusculoskeletal Research Center, Physical Medicine and Rehabilitation Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Janbazi L, Morovati H, Raissi GR, Forogh B, Bagherzadeh Cham M. Validity and reliability of the Persian version of self-administered foot evaluation questionnaire (SAFE-Q) in people with foot orthopedic problems. J Orthop Sci 2022:S0949-2658(22)00129-4. [PMID: 35691878 DOI: 10.1016/j.jos.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 04/03/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Foot problems are one of the main causes of seeing a doctor. According to the World Health Organization's definition of health, the healthcare system must consider patients' quality of life as an important entity. In this regard, many tools have been developed to evaluate patients' opinions about their health status. The purpose of the present study is to evaluate the validity and reliability of the Persian version of the Foot Self-Assessment Questionnaire (SAFE-Q) in patients with foot orthopedic problems. METHOD 215 people aged 17-60 years with orthopedic foot problems were included in this cross-sectional study. The Spearman correlation coefficient of SAFE-Q questionnaires versus Foot Function Index (FFI) questionnaire was evaluated for the convergent validity. Forty-three people randomly completed SAFE-Q again one week later. Intraclass correlation coefficient (ICC) and Cronbach's alpha was calculated to evaluate the test-retest reliability and internal consistency of the SAFE-Q, respectively. RESULTS A strong relationship was found between the SAFE-Q total score and other scales with FFI questionnaire (r = 0.52 to 0.87). ICC test-retest reliability and Cronbach's alpha were 0.981 and 0.98 for SAFE-Q, respectively. CONCLUSION The results indicate that the Persian version of the SAFE-Q questionnaire has acceptable validity and reliability and can be used to assess the health status and quality of life of Persian speakers with orthopedic foot problems.
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Affiliation(s)
- Lobaneh Janbazi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Hazrat Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hawre Morovati
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Raissi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Bijan Forogh
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Masumeh Bagherzadeh Cham
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran; Department of Orthotics & Prosthetics, Iran University of Medical Sciences, Tehran, Iran.
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Ebadi S, Alishahi V, Ahadi T, Raissi GR, Khodabandeh M, Haqiqatshenas H, Sajadi S. Acupuncture-like versus conventional transcutaneous electrical nerve stimulation in the management of active myofascial trigger points: A randomized controlled trial. J Bodyw Mov Ther 2021; 28:483-488. [PMID: 34776182 DOI: 10.1016/j.jbmt.2021.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/13/2021] [Accepted: 06/09/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Myofascial pain syndrome (MPS) is one of the most common causes of chronic musculoskeletal pain. The transcutaneous electrical nerve stimulation (TENS) is a non-expensive, safe, feasible modality, used recently for the treatment of MPS with promising but limited results. The purpose of this study was to determine the efficacy of acupuncture-like TENS (AL-TENS) vs conventional TENS (C-TENS) in the treatment of active myofascial trigger points. METHODS This randomized controlled trial study was carried out with 60 consecutive patients with active trapezius trigger points referred to Physical Medicine and Rehabilitation Clinic. Participants randomly assigned to receive AL-TENS, C-TENS or sham TENS (S-TENS). The Visual Analogue Scale (VAS), Pressure Pain Thresholds (PPTs), and neck range of motion (ROM) were measured at baseline, after the first treatment sessions, after the final treatment session, and 3 months after the end of the last treatment session. Patients function was evaluated by Disabilities of the Arm, Shoulder, and Hand (DASH) at baseline, after the final treatment sessions, and 3 months after the end of intervention. RESULTS The interaction effect of time and group was significantly different when evaluating VAS (df = 4.65, F = 2.50, p = 0.038) and DASH (df = 2.63, F = 7.25, p < 0.001) in favor of active groups, as well as neck total lateral bending in favor of AL-TENS group compared other two groups (df = 4.16, F = 5.23, p = 0.001). Both VAS and DASH improved significantly at all follow-ups in AL-TENS and C-TENS groups. Of note, significant immediate improvement in all outcomes was observed only with AL-TENS. CONCLUSIONS According to the present study, both AL-TENS and C-TENS were superior to placebo in pain reduction and functional improvement. Although both TENS techniques have similar efficiency on pain reduction, functional and pain perception improvement, the AL-TENS was the superior approach when evaluating neck lateral bending ROM.
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Affiliation(s)
- Safoora Ebadi
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Vajiheh Alishahi
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Tannaz Ahadi
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Gholam Reza Raissi
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Mehrdad Khodabandeh
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Hosnieh Haqiqatshenas
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Simin Sajadi
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Shamili A, Hassani Mehraban A, Azad A, Raissi GR, Shati M, Farajzadeh A. Effectiveness of Self-Action Observation Therapy as a Novel Method on Paretic Upper Limb and Cortical Excitability Post-Stroke: A Single-Subject Study. Med J Islam Repub Iran 2021; 35:193. [PMID: 36042823 PMCID: PMC9391775 DOI: 10.47176/mjiri.35.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Indexed: 11/25/2022] Open
Abstract
Background:
Action Observation Therapy (AOT) is a top-down approach that has been recently introduced in the rehabilitation of neurological disorders mainly after stroke. The main goal of this study was to investigate the effects and feasibility of a new technique in AOT procedure (called self-AOT) following periods of no treatment and routine AOT intervention on upper limb motor function, occupational performance and neurophysiological changes in a stroke patient.
Methods:
A single-subject A-B-A-C design was used and a 58-year-old woman with a 3-year history of left hemiplegia poststroke participated in this study. In the baseline (A1, A2) phases, the patient received no treatment. In the first intervention (B phase), she received a 4-week AOT, and in the second intervention (C phase), a 4 week of Self-AOT was practiced. In all phases, upper limb motor recovery as a target outcome was evaluated on 4 occasions using the Fugl-Meyer assessment. Upper limb function, dexterity and spasticity were assessed using Action Research Arm Test, Box-Block Test and Modified Modified Ashworth Scale respectively. Occupational Performance/Satisfaction was assessed with Canadian Occupational Performance Measure and to assess neuroplasticity, Motor Evoked Potential was recorded by Transcranial Magnetic Stimulation. Visual analysis, slope, and percentage of non-overlapping data were used for assessing the changes between phases.
Results:
Percentage of non-overlapping data and slopes indicated that motor recovery had clinically relevant improvements after both interventions compared to baselines. Other outcomes also showed improvements except for spasticity of wrist/elbow flexors and Motor Evoked Potential of opponens indicis.
Conclusion:
Self-AOT may be as effective as other procedures of AOT for improving upper limb motor function, occupational performance/satisfaction, and cortical excitability post-stroke.
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Affiliation(s)
- Aryan Shamili
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Afsoon Hassani Mehraban
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Akram Azad
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
- Corresponding author:Akram Azad,Dr Akram Azad,
| | - Gholam Reza Raissi
- Neuromusculoskeletal research center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Shati
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Farajzadeh
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
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11
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Ahadi T, Raissi GR, Hosseini M, Sajadi S, Ebadi S, Mansoori K. A Randomized Clinical Trial on the Effect of Biofeedback on Pain and Quality of Life of Patients With Chronic Coccydynia. Basic Clin Neurosci 2020; 11:753-763. [PMID: 33850612 PMCID: PMC8019848 DOI: 10.32598/bcn.11.6.1553.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/10/2018] [Accepted: 10/02/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction Pelvic floor muscles dysfunction is one of the most important etiologies of coccydynia; therefore, manual therapies have been proposed as the first line of treatment. The purpose of this study was to investigate the effect of biofeedback as a new approach in the treatment of coccydynia. Methods Thirty women were randomized into two groups. Both groups were injected with the corticosteroid. One group received pelvic floor muscle exercises plus biofeedback while the other group only performed exercises. The patient's pain was measured using the Visual Analog Scale (VAS) in the first visit and after 1, 2, and 6 months of follow-up as well as Dallas pain and SF-36 quality of life questionnaires before and 2 months after the treatment. Results Pain had improved significantly after 1, 2, and 6 months in both groups compared to the baseline. However, the amount of change was not different between the groups at any time interval. The results were the same for the Dallas pain scale and SF-36 quality of life questionnaire. Conclusion Adding biofeedback to pelvic floor muscle exercises did not lead to any further improvement in the management of chronic coccydynia. Further studies with larger sample sizes may reveal the effect of biofeedback more clearly.
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Affiliation(s)
- Tannaz Ahadi
- Neuromusculoskeletal Research Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Raissi
- Neuromusculoskeletal Research Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Hosseini
- Department of Physical Medicine and Rehabilitation, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Simin Sajadi
- Neuromusculoskeletal Research Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Safoora Ebadi
- Neuromusculoskeletal Research Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Korosh Mansoori
- Neuromusculoskeletal Research Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
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12
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Babaei-Ghazani A, Forogh B, Raissi GR, Ahadi T, Eftekharsadat B, Yousefi N, Rahimi-Dehgolan S, Moradi K. Ultrasound-Guided Corticosteroid Injection in Carpal Tunnel Syndrome: Comparison Between Radial and Ulnar Approaches. J Pain Res 2020; 13:1569-1578. [PMID: 32617017 PMCID: PMC7326201 DOI: 10.2147/jpr.s248600] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/08/2020] [Indexed: 01/07/2023] Open
Abstract
Purpose To compare two common approaches for ultrasonography (US)-guided injection. Patients and Methods Sixty patients with mild-to-moderate CTS were included in this double-blind randomized controlled trial (RCT). They received a single shot of corticosteroid injection through either the US-guided in-plane approach: radial or ulnar side. Participants were evaluated using Boston Carpal Tunnel Questionnaire (BCTQ) and visual analogue scale (VAS) for pain, as well as electrodiagnosis (EDX) and US parameters before the intervention, and within 12 weeks of follow-up. Results In both groups, all outcomes, except for the electrodiagnostic measures, significantly improved within the follow-up. Pain-VAS and both subscales of BCTQ questionnaire, as our main subjective outcomes, revealed dramatic improvement, with the largest amount of changes in VAS (70%; comparing to baseline value), and about 37% for both of BQSS and BQFS scales, all indicating superiority of radial to ulnar in-plane approach. During the first follow-up, we did not detect any remarkable preference between the groups in either subjective or electrodiagnostic variables. However, there was a significant difference at next follow-up time-points in terms of VAS for pain and BQFS favoring radial approach (Table 3). Furthermore, US-measured parameters including nerve-circumference and CSA improved only in the radial in-plane group. Conclusion The current data proved that radial in-plane approach for CTS injection could be at least as effective as the more common ulnar in-plane method. Even the pain-relief effect was longer for the radial in-plane approach. Also, patients’ functional status and objective variables all revealed better outcomes via the new approach.
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Affiliation(s)
- Arash Babaei-Ghazani
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Bijan Forogh
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Gholam Reza Raissi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Tannaz Ahadi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Bina Eftekharsadat
- Physical Medicine and Rehabilitation Research Center, Department of Physical Medicine and Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naseh Yousefi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Shahram Rahimi-Dehgolan
- Physical Medicine and Rehabilitation Department, IKHC Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Katayoun Moradi
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences (IUMS), Tehran, Iran
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13
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Ahadi T, Esmaeili Jamkarani M, Raissi GR, Mansoori K, Emami Razavi SZ, Sajadi S. Prolotherapy vs Radial Extracorporeal Shock Wave Therapy in the Short-term Treatment of Lateral Epicondylosis: A Randomized Clinical Trial. Pain Med 2019; 20:1745-1749. [PMID: 30698771 DOI: 10.1093/pm/pny303] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The aim of this study was to compare the efficacy of prolotherapy with hypertonic dextrose and radial shock wave therapy in chronic lateral epicondilosis. DESIGN Prospective single-blind randomized clinical trial. SETTING Physical medicine and rehabilitation clinic. SUBJECTS Thirty-three patients with at least three months of signs and symptoms of lateral epicondilosis, as well as failure of at least one of the conservative treatments, randomly allocated into two groups. METHODS Sixteen patients received three sessions of shock wave therapy, and 17 received one session prolotherapy. Severity of pain via visual analog scale (VAS), grip strength via Baseline Pneumatic Dynamometer, pressure pain threshold (PPT) by algometer and Disabilities of Arm, Shoulder, and Hand quick questionnaire (Quick DASH) were assessed at baseline, four weeks, and eight weeks after the intervention. RESULTS Within-group analysis showed that in both groups, differences between all of the outcome measures were significant after four and also eight weeks. Between-group analysis after four and eight weeks showed that the VAS and Quick DASH had significantly more improvement in the shock wave group. However, the two groups were similar regarding grip strength and PPT. No complication was observed in the two groups. CONCLUSIONS Based on the results of this study, a regiment of three sessions (weekly) of radial extracorporeal shock wave therapy is significantly more effective than one session of prolotherapy with 20% dextrose regarding pain and function in the management of chronic lateral epicondylosis in short-term follow-up.
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Affiliation(s)
- Tannaz Ahadi
- Neuromusculoskeletal Research Centre, Firoozgar Hospital
| | | | | | - Korosh Mansoori
- Neuromusculoskeletal Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Seyede Zahra Emami Razavi
- Physical medicine and rehabilitation department, Tehran University of Medical Sciences, Tehran, Iran
| | - Simin Sajadi
- Neuromusculoskeletal Research Centre, Iran University of Medical Sciences, Tehran, Iran
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14
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Ahadi T, Taghvadoost N, Aminimoghaddam S, Forogh B, Bazazbehbahani R, Raissi GR. Efficacy of biofeedback on quality of life in stages I and II pelvic organ prolapse: A Pilot study. Eur J Obstet Gynecol Reprod Biol 2017; 215:241-246. [PMID: 28686982 DOI: 10.1016/j.ejogrb.2017.06.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 05/06/2017] [Accepted: 06/14/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Pelvic organ prolapse (POP) is a prevalent disorder which seriously affects the sufferer's quality of life. The main goal of this study was to evaluate biofeedback impact on quality of life in women with mild to moderate POP. STUDY DESIGN 40 females in stages I and II POP were allocated into 2 groups. One group received pelvic floor muscle exercise and lifestyle advice in addition to biofeedback twice a week for 4 weeks, while the other received a lifestyle advice sheet and pelvic floor muscle exercise without biofeedback. A valid Persian version of P-QOL questionnaire was applied to assess the patients̕ quality of life at baseline, 4 weeks and 12 weeks follow up. Pressure biofeedback and Physical examination were also performed in order to determine pelvic floor muscle strength and staging of the prolapse, respectively. Collected data were analyzed by mixed ANOVA test using SPSS 22. RESULTS Biofeedback improved the quality of life in seven of nine P-QOL domains. However, it had no significant impact either on pelvic floor muscle strength or on the stage of the prolapse. CONCLUSION Biofeedback could be considered as a non-invasive treatment leading to quality of life promotion in women with stages I and II POP.
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Affiliation(s)
- Tannaz Ahadi
- Physical Medicine & Rehabilitation, Iran University of Medical Sciences, Firoozgar Hospital, Neuromuscular Research Center, Tehran, Iran
| | - Neda Taghvadoost
- Physical Medicine & Rehabilitation, Iran University of Medical Sciences, Firoozgar Hospital, Tehran, Iran
| | - Soheila Aminimoghaddam
- Gynecology-Oncology, Iran University of Medical Sciences, Firoozgar Hospital, Tehran, Iran
| | - Bijan Forogh
- Physical Medicine & Rehabilitation, Iran University of Medical Sciences, Firoozgar Hospital, Neuromuscular Research Center, Tehran, Iran
| | | | - Gholam Reza Raissi
- Physical Medicine & Rehabilitation, Iran University of Medical Sciences, Firoozgar Hospital, Neuromuscular Research Center, Tehran, Iran.
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15
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Raissi GR, Ghazaei F, Forogh B, Madani SP, Daghaghzadeh A, Ahadi T. The Effectiveness of Radial Extracorporeal Shock Waves for Treatment of Carpal Tunnel Syndrome: A Randomized Clinical Trial. Ultrasound Med Biol 2017; 43:453-460. [PMID: 27814933 DOI: 10.1016/j.ultrasmedbio.2016.08.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 08/11/2016] [Accepted: 08/16/2016] [Indexed: 06/06/2023]
Abstract
This study examined the effectiveness of radial extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome (CTS). Forty patients with mild to moderate CTS were allocated to two groups: (i) shock wave + wrist splint and (ii) wrist splint. Patients used wrist splints followed by three sessions of low-energy shock wave therapy in the intervention group and wrist splints alone in the other group. The QuickDASH Questionnaire, visual analogue scale and nerve conduction studies were used to evaluate the patients before the study and at 3, 8 and 12 wk after the start of the treatment. At the end of the study, both groups saw the same clinical benefits. However, a significantly greater improvement in the median nerve distal sensory latency was noted in the shock wave group compared with the control group. We suggest that application of shock wave with alternative protocols may be effective in the treatment of CTS in future studies.
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Affiliation(s)
- Gholam Reza Raissi
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ghazaei
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bijan Forogh
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Pezhman Madani
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Daghaghzadeh
- Department of Physical Medicine and Rehabilitation, Arak University of Medical Sciences, Arak, Iran
| | - Tannaz Ahadi
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
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16
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Ahadi T, Raissi GR, Yavari M, Majidi L. Prevalence of ulnar-to-median nerve motor fiber anastomosis (Riché-Cannieu communicating branch) in hand: An electrophysiological study. Med J Islam Repub Iran 2016; 30:324. [PMID: 27390694 PMCID: PMC4898834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 08/22/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Two main muscles studied in the hand for evaluation of median nerve injuries are opponens pollicis (OP) and abductor pollicis brevis (APB). However, Riché-Cannieu communicating branch (RCCB) may limit the use of these muscles in electrodiagnosis. This condition is confusing in the case of median nerve injuries. This study was conducted to evaluate the prevalence of RCCB. METHODS Twenty-three consecutive cases of complete median nerve injury were studied. Evoked responses via stimulation of median and ulnar nerves in the wrist and recording with needle in the thenar area were studied. RESULTS Of the patients, 82.6% exhibited RCCB. In 14 (60.8%) cases the OP and in 19(82.6%) cases APB was supplied by the ulnar nerve. CONCLUSION RCCB was detected to be 60.8% in OP and 82.6% in APB, so OP is preferable to APB in the study of median nerve.
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Affiliation(s)
- Tannaz Ahadi
- 1 MD, Assistant Professor of Physical Medicine and Rehabilitation, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Gholam Reza Raissi
- 2 MD, Associate Professor of Physical Medicine and Rehabilitation, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran. ,(Corresponding author) MD, Associate Professor of Physical Medicine and Rehabilitation, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Masood Yavari
- 3 MD, Associate Professor of Hand and Plastic Surgery, Panzdah Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Lobat Majidi
- 4 MD, Physical Medicine and Rehabilitation Specialist, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
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17
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Forogh B, Mirshaki Z, Raissi GR, Shirazi A, Mansoori K, Ahadi T. Repeated sessions of transcranial direct current stimulation for treatment of chronic subjective tinnitus: a pilot randomized controlled trial. Neurol Sci 2015; 37:253-9. [PMID: 26498289 DOI: 10.1007/s10072-015-2393-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 10/05/2015] [Indexed: 10/22/2022]
Abstract
Subjective tinnitus is an auditory phantom sensation characterized by the perception of sound in the absence of an identifiable external source. This distressing audiological symptom can severely affect the quality of life. Transcranial direct current stimulation (tDCS) is a noninvasive technique that can induce short-term relief in tinnitus in some patients. The purpose of this pilot double-blind randomized controlled trial was to investigate whether repeated application of anodal tDCS over left temporoparietal area could induce long-lasting relief in patients with chronic tinnitus. Twenty-two patients with chronic tinnitus for at least 6 months were randomly allocated into two groups and received five sessions of anodal (N = 11) or sham (N = 11) stimulation in five consecutive days. A current intensity of 2 mA for 20 min was used for anodal stimulation. Outcomes were assessed using Persian version of tinnitus handicap inventory (THI), loudness and distress visual analog scale (VAS) scores and clinical global impression (CGI) scale. The trial is registered at the Iranian Registry of Clinical Trials (IRCT) with the reference ID of IRCT2014082018871N1. No statistically significant difference was found between anodal and sham stimulation regarding either immediate or long-lasting effects over the 2 weeks follow-up period. Deterioration of symptoms and alteration in tinnitus characteristics were reported by a few patients. There were no significant long-term beneficial effects following tDCS of the left temporoparietal area.
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Affiliation(s)
- Bijan Forogh
- Department of Physical Medicine and Rehabilitation, Firoozgar Hospital, Iran University of Medical Sciences, Valiasr Square, Tehran, Iran
| | - Zohre Mirshaki
- Physical Medicine and Rehabilitation Specialist at Iran University of Medical Sciences, Firoozgar Hospital, Valiasr Square, Tehran, Iran
| | - Gholam Reza Raissi
- Department of Physical Medicine and Rehabilitation, Firoozgar Hospital, Iran University of Medical Sciences, Valiasr Square, Tehran, Iran
| | - Ali Shirazi
- Department of Otolaryngology, Firoozgar Hospital, Valiasr square, Tehran, Iran
| | - Korosh Mansoori
- Department of Physical Medicine and Rehabilitation, Firoozgar Hospital, Iran University of Medical Sciences, Valiasr Square, Tehran, Iran
| | - Tannaz Ahadi
- Department of Physical Medicine and Rehabilitation, Firoozgar Hospital, Iran University of Medical Sciences, Valiasr Square, Tehran, Iran.
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18
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Eftekharsadat B, Ahadi T, Raissi GR, Shakoory SK, Fereshtehnejad SM. Validity of current electrodiagnostic techniques in the diagnosis of carpal tunnel syndrome. Med J Islam Repub Iran 2014; 28:45. [PMID: 25405111 PMCID: PMC4219876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 10/26/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Determining the validity of current median sensory nerve conduction techniques for diagnosis of carpal tunnel syndrome (CTS). METHODS Eighty five patients with clinical diagnosis of CTS were compared with the same number of healthy people. The validity of electrodiagnostic tests were compared in a case-control manner. These electrodiagnostic techniques included long-segment, short-segment, 2-segment and relative slowing studies; as well as distoproximal ratio. Receiver Operating Characteristic (ROC) curve employed for comparison, determining the optimal cut-off points for each test. Validity was evaluated with likelihood ratio. RESULTS Likelihood ratio (LHR) for Radial-median sensory latency difference was ∞, while LHR for ulnarmedian sensory latency difference was 16.9. Sensitivity of Two-segment method was 98.8% and mixed palmwrist median Nerve Conduction Velocity (NCV) study showed a sensitivity and specificity of 97.6%, 83.5% respectively. CONCLUSIONS Radial-median latency difference study (optimal cut-off point ≥0.5) and study of wrist-segment NCV (optimal cut-off point <50.45) were the most valuable techniques in diagnosis of CTS, respectively. Median-ulnar latency difference study and disto-proximal ratio study had more diagnostic implication than long and short (mixed) segment technique in this regard.
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Affiliation(s)
- Bina Eftekharsadat
- 1. MD, Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Tannaz Ahadi
- 2. MD, Physical Medicine and Rehabilitation Department, Iran University of Medical Sciences, Tehran, Iran.
| | - Gholam Reza Raissi
- 3. MD, Physical Medicine and Rehabilitation Department, Iran University of Medical Sciences, Tehran, Iran.
| | - Saied Kazem Shakoory
- 4. MD, Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Seyed Mohammad Fereshtehnejad
- 5. MD, MP, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran.
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19
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Madani SP, Fateh HR, Forogh B, Fereshtehnejad SM, Ahadi T, Ghaboussi P, Bouhassira D, Raissi GR. Validity and Reliability of the Persian (Farsi) Version of the DN4 (Douleur Neuropathique 4 Questions) Questionnaire for Differential Diagnosis of Neuropathic from Non-Neuropathic Pains. Pain Pract 2013; 14:427-36. [DOI: 10.1111/papr.12088] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 04/22/2013] [Indexed: 12/28/2022]
Affiliation(s)
- Seyed Pezhman Madani
- Physical Medicine and Rehabilitation Department; Tehran University of Medical Sciences (TUMS); Tehran Iran
| | - Hamid R. Fateh
- Physical Medicine and Rehabilitation Department; Tehran University of Medical Sciences (TUMS); Tehran Iran
| | - Bijan Forogh
- Physical Medicine and Rehabilitation Department; Tehran University of Medical Sciences (TUMS); Tehran Iran
- Brain and Spinal Cord Injury Repair Research Center; Tehran University of Medical Sciences (TUMS); Tehran Iran
| | - Seyed-Mohammad Fereshtehnejad
- Firoozgar Clinical Research Development Center (FCRDC); Firoozgar Hospital; Tehran University of Medical Sciences (TUMS); Tehran Iran
- Division of Clinical Geriatrics; Department of Neurobiology Care Sciences and Society (NVS); Karolinska Institutet; Stockholm Sweden
| | - Tannaz Ahadi
- Physical Medicine and Rehabilitation Department; Tehran University of Medical Sciences (TUMS); Tehran Iran
| | - Pouya Ghaboussi
- Physical Medicine and Rehabilitation Department; Tehran University of Medical Sciences (TUMS); Tehran Iran
| | - Didier Bouhassira
- INSERM U-792; Centre d'Evaluation et de Traitement de la Douleur; Boulogne-Billancourt France
| | - Gholam Reza Raissi
- Physical Medicine and Rehabilitation Department; Tehran University of Medical Sciences (TUMS); Tehran Iran
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20
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Adelmanesh F, Jalali A, Attarian H, Farahani B, Ketabchi SM, Arvantaj A, Raissi GR. Reliability, Validity, and Sensitivity Measures of Expanded and Revised Version of the Short-Form McGill Pain Questionnaire (SF-MPQ-2) in Iranian Patients with Neuropathic and Non-Neuropathic Pain. Pain Med 2012; 13:1631-6. [DOI: 10.1111/j.1526-4637.2012.01517.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Saphenous nerve, a pure sensory nerve, may compromise as a result or complication of a surgical procedure or secondary to trauma or insidiously. We present a male patient with low back pain concomitant with pain in medial portion of left thigh in addition to pain and numbness in medial part of leg and inferior part of patella after a strenuous activity. Preliminary diagnosis suggested that the patient had radiculopathy but electrodiagnostic tests revealed the absence of left saphenous response both in medial leg and infrapatellar region, while normal findings were recorded from right side. Needle electromyography in L4 innervated muscles were normal. The patient had saphenous nerve entrapment in left thigh. Two months later symptoms relieved with conservative therapy.
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Affiliation(s)
- Tannaz Ahadi
- Physical Medicine and Rehabilitation Department, Iran University of Medical Sciences, Firoozgar hospital, Tehran, Iran.
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22
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Vahdatpour B, Raissi GR, Hollisaz MT. Study of the ulnar nerve compromise at the wrist of patients with carpal tunnel syndrome. Electromyogr Clin Neurophysiol 2007; 47:183-6. [PMID: 17557651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
INTRODUCTION That the ulnar nerve compromise occurs concomitant with the carpal tunnel syndrome (CTS) has been cited by previous studies. It seems that the previously mentioned incidence is much higher than what we observe in our electrodiagnosis studies. MATERIAL AND METHOD A prospective study was designed to evaluate the incidence of ulnar nerve compromise in patients with electrodiagnostic evidence of CTS according to age and sex, and also to determine the site of ulnar nerve involvement. RESULTS One hundred and sixty five limbs with standard elestrodiagnostic criteria of CTS were evaluated In 9.7% of the tested limbs, the ulnar nerve was involved. The site of the involvement was the wrist area in 43.75%. The elbow region was involved in 43.75%, and in 12.5%, the forearm region was involved. The most prevalent age range of concomitant involvement was 45-54 years old. In patents who had sensory symptoms in the 4th and 5th fingers, the incidence of concomitant ulnar nerve compromise was significantly higher (p < 0.001) than the patients without these symptoms. DISCUSSION In patients with CTS, concomitant ulnar nerve compromise is much lower than the incidence mentioned in previous researches. Apparently the rate of involvement in wrist and elbow are equal. It is recommended that in evaluation of patients for CTS especially when the patient has sensory symptoms in the hand, special attention is paid to ulnar nerve involvement and two nerve comparison tests are interpreted with caution.
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Abstract
BACKGROUND In December 2003, a devastating earthquake destroyed Bam and surrounding areas in Iran, leaving many people with residual deficits and disabilities, of which approximately 240 patients had spinal cord injury (SCI). METHODS As an independent volunteer working in outpatient clinics, I visited the patients as part of a mobile team and set up a short educational course in spinal cord medicine. RESULTS I visited 34 patients with SCI in the first 3 months. Eight months after the disaster, I visited 54 patients with SCI, 29 female (53.7%) and 25 male (46.3%). Postdisaster problems were identified, including need for accurate data collection, identification of patients' conditions, attention paid to psychosocial issues, ethical dilemmas, and research needs. CONCLUSION Disaster preparedness for earthquakes should include first aid and injury prevention, coordination of relief efforts, basic education and medical care, and short-and long-term rehabilitation needs. The major focus of rehabilitation medicine specialists' should be education of the general and professional population toward integrating the concept of rehabilitation.
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Affiliation(s)
- Gholam Reza Raissi
- Physical Medicine & Rehabilitation Department, Iran University of Medical Sciences, Tehran, Iran.
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Abstract
This study reports the attitudes of general practitioners towards physical medicine and rehabilitation after participating in a continued medical education course in this field. Given the high prevalence of musculoskeletal disorders and number of disabled persons in the country, along with the role of general practitioners in the primary and long-term management of such patients, basic competency in rehabilitation medicine must be considered in the educational curriculum of medical students. Nevertheless, rehabilitation medicine is not taught in most universities. This study was performed to evaluate the attitude of general practitioners towards physical medicine and rehabilitation as a baseline for developing educational programs in this field. In a simple descriptive study, at the end of a continued medical education program in low back pain management, 217 questionnaires, focusing on the field of physical medicine and rehabilitation, were distributed between participants. One-hundred-and-forty-three questionnaires were analyzed. Statistical analyses were performed with descriptive and Student's t-test. The results showed that of the participants, 69 (48.3%) were female and that they graduated from 24 medical schools. Most respondents (92.2%) believed that musculoskeletal education had not been sufficient in general practitioner training courses. Of the respondents, 56.8% had visited at least one disabled patient during the previous month, while 11% had visited more than 10 in the same period, but 84.3% had not studied disabilities. Musculoskeletal physical examination was the most needed educational field cited by general practitioners. In conclusion, this study clearly documents the inadequacy of basic rehabilitation training in medical schools. The findings reveal the most needed and preferred rehabilitation areas for general practitioners, and these should be considered in the establishment of rehabilitation training programs for Iranian medical students.
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Affiliation(s)
- Gholam Reza Raissi
- Physical Medicine and Rehabilitation Department, Iran University of Medical Science, Tehran, Iran.
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25
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Emad MR, Raissi GR. Congenital insensitivity to pain with anhidrosis: a case report. Electromyogr Clin Neurophysiol 2003; 43:409-11. [PMID: 14626720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Congenital insensitivity to pain with anhidrosis is an extremely rare autosomal recessive disorder characterized by inexplicable episodes of hyperpyrexia, anhidrosis, insensitivity to pain and self-mutilation. Described is a 6-year-old girl with symptoms signs and electrodiagnostic finding compatible with this disease.
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Affiliation(s)
- M R Emad
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences.
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26
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Jazayeri M, Ghavanini MR, Rahimi HR, Raissi GR. A study of the sympathetic skin response and sensory nerve action potential after median and ulnar nerve repair. Electromyogr Clin Neurophysiol 2003; 43:277-9. [PMID: 12964255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
The purpose of this study was to compare SSR with sensory nerve action potential (SNAP) responses in regeneration of injured peripheral nerves after nerve repair. We studied 10 male patients with a mean age of 26.7 years. All the patients had complete laceration of median or ulnar nerves. The patients were followed up at least for six months. SSR and SNAP assessment were performed every one to two months. Normal hands were used as controls. SSR was positive after 15.8 +/- 9.4 weeks (mean +/- 2 SD) and SNAP after 27.8 +/- 12.9 weeks (mean +/- 2 SD). The difference was statistically significant (P value < 0.001). This can be due to more rapid growth of sympathetic unmyelinated fibers relative to sensory myelinated fibers. This study also shows that recovery of the sudomotor activity following nerve repair is satisfactory in general and SSR can be used as a useful and sensitive method in the evaluation of sudomotor nerve regeneration.
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Affiliation(s)
- M Jazayeri
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences and Health Services, Fars
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