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Erol K, Akyildiz Tezcan E, Akgöl S. Exploring hand function in newly diagnosed primary Sjögren's syndrome: Clinical, radiographic, and ultrasonographic insights. J Hand Ther 2025:S0894-1130(25)00033-X. [PMID: 40090771 DOI: 10.1016/j.jht.2025.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 02/12/2025] [Accepted: 02/17/2025] [Indexed: 03/18/2025]
Abstract
BACKGROUND Primary Sjögren's syndrome (pSS) is a chronic, systemic autoimmune disease. Musculoskeletal and neurological system involvement occurs in patients with pSS, which may lead to impairment in hand function. Hand dysfunction and its underlying causes remain an underexplored area in pSS. PURPOSE This study aims to evaluate hand function in patients with newly diagnosed pSS, exploring the associations with disease activity, clinical parameters, and radiographic and ultrasonographic findings. STUDY DESIGN Cross-sectional. METHODS Fifty patients with newly diagnosed pSS and 50 healthy controls were recruited in this study. Hand functions were evaluated using the Duruöz Hand Index (DHI) and hand grip strength measurements. Detailed hand physical examination was made. Carpal tunnel syndrome (CTS) was assessed with the CTS -6 questionnaire and electrodiagnostic methods. Hands A-P radiography was evaluated for joint erosion, joint space narrowing. Ultrasonographic assessment of hand was made for intercarpal and metacarpophalangeal joint synovitis and extensor tenosynovitis. Additional evaluations included the Hospital Anxiety and Depression Scale (HADS), Short Form-36 (SF-36), Fatigue severity scale (FSS) and the European League Against Rheumatism (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI). RESULTS Patients with pSS exhibited significantly higher DHI scores compared to controls (p = 0.027, r = 0.22) and lower non-dominant hand grip strength (p = 0.016, r = 0.30), while dominant hand grip strength did not differ significantly (p = 0.520, r = 0.08). Higher HADS anxiety (p < 0.001, r = 0.63) and depression scores (p < 0.001, r = 0.55) were noted in pSS patients. Additionally, these patients had reduced SF-36 scores (p < 0.001, r = 0.53). DHI scores were significantly correlated with ESSDAI (ρ = 0.413, p = 0.003), SF-36 (ρ = -0.605, p < 0.001), HADS (**ρ = 0.307 for anxiety, p = 0.030; ρ = 0.286 for depression, p = 0.044), hand grip strength (ρ = -0.298 for dominant hand, p = 0.036; ρ = -0.280 for non-dominant hand, p = 0.049), Health Assessment Questionnaire (HAQ) (ρ = 0.893, p < 0.001), and FSS (ρ = 0.378, p = 0.007). Ultrasonographic evaluations revealed synovitis and/or tenosynovitis in 18% of patients, while CTS was detected in 32%. CONCLUSIONS This study highlights significant hand function impairments in newly diagnosed pSS patients, with DHI scores correlating with disease activity, psychological well-being, and general health. These findings underscore the importance of early and comprehensive hand assessments using advanced diagnostic tools to improve patient outcomes.
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Affiliation(s)
- Kemal Erol
- Selcuk University Medical Faculty, Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Konya, Turkey.
| | - Ezgi Akyildiz Tezcan
- Selcuk University Medical Faculty, Department of Physical Medicine and Rehabilitation, Konya, Turkey
| | - Süleyman Akgöl
- Pamukkale University Medical Faculty, Department of Internal Medicine, Division of Rheumatology, Denizli, Turkey
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Menek B, Menek MY. The efficacy of Mulligan mobilization and corticosteroid injection on pain, functionality, and proprioception in rotator cuff tears: A randomized controlled trial. J Hand Ther 2025:S0894-1130(24)00184-4. [PMID: 39919923 DOI: 10.1016/j.jht.2024.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 12/30/2024] [Accepted: 12/30/2024] [Indexed: 02/09/2025]
Abstract
BACKGROUND Treatment of rotator cuff (RTC) tears commonly involves manual therapy, exercise, and injection methods. These treatments are typically administered together as components of a physical therapy intervention. However, it is not known which intervention is more effective. PURPOSE The objective of this study was to examine the impact of mobilization with movement (MWM) mobilization, a technique from Mulligan approaches, and corticosteroid (CS) injection on pain, functionality, and proprioception in cases of RTC tears. STUDY DESIGN This was a single-blinded randomized clinical trial. METHODS Participants with RTC tears (n = 60) were divided into Mulligan mobilization (MM) and CS groups. The participants in the MM group performed mobilization with movement and a conventional exercise program; the CS group received a CS injection in addition to conventional exercises. The Visual Analog Scale, The Disabilities of the Arm, Shoulder, and Hand questionnaire, active range of motion (AROM), and joint position sense (JPS) were evaluated. The outcomes were analyzed using effect size, minimum clinically important difference, minimal detectable change, Wilcoxon test, and Mann-Whitney U test. RESULTS Both groups significantly improved in all measured outcomes at 3 weeks. The MM group showed significantly better (p < 0.05, Cohen d range 0.82-3.2) results in pain, AROM (Flexion, abduction, extension, external rotation, internal rotation), and proprioception (30° and 60° of flexion and abduction). Between-group differences in AROM were also clinically meaningful as they exceeded their MDC90 and minimum clinically important difference values. CONCLUSIONS Although both of these treatment methods may be successful in the short-term management of chronic RTC, the MM approach combined with conventional exercises seems to be a more effective approach for improving shoulder pain, function, and proprioception in this patient population. CLINICAL TRIAL NUMBER NCT05933382.
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Affiliation(s)
- Burak Menek
- Department of Physiotherapy and Rehabilitation, Istanbul Medipol University, Istanbul, Turkey
| | - Merve Yilmaz Menek
- Department of Physiotherapy and Rehabilitation, Istanbul Medipol University, Istanbul, Turkey.
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Li J, Zhang J, Wang B, Huang K, Yang X, Song Y, Liu H, Rong X. Comparison of Titanium Mesh Cage, Nano-Hydroxyapatite/Polyamide Cage, and Three-Dimensional-Printed Vertebral Body for Anterior Cervical Corpectomy and Fusion. Spine (Phila Pa 1976) 2025; 50:88-95. [PMID: 39175433 DOI: 10.1097/brs.0000000000005126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 08/06/2024] [Indexed: 08/24/2024]
Abstract
STUDY DESIGN A prospective nonrandomized controlled study. OBJECTIVE To compare the clinical and radiographic outcomes of anterior cervical corpectomy and fusion (ACCF) using titanium mesh cages (TMCs), nano-hydroxyapatite/polyamide 66 (n-HA/PA66) cages, and three-dimensional-printed vertebral bodies (3d-VBs). BACKGROUND Postoperative subsidence of TMCs in ACCF has been widely reported. Newer implants such as n-HA/PA66 cages and 3d-VBs using biocompatible titanium alloy powder (Ti6Al4V) have been introduced to address this issue, but their outcomes remain controversial. PATIENTS AND METHODS We enrolled 60 patients undergoing ACCF using TMCs, n-HA/PA66 cages, or 3d-VBs from January 2020 to November 2021. For each group, there were 20 patients. Follow-up was conducted for a minimum of 2 years. Clinical outcomes, including Japanese Orthopedic Association (JOA) scores, Neck Disability Index, and Visual Analog Scale scores, and radiographic outcomes, including function of spinal unit (FSU) height, fusion rate, and cervical alignment, were collected preoperatively and at each follow-up. A loss of FSU height ≥3mm was deemed implant subsidence. One-way analysis of variance was used for comparisons of mean values at different time points within the same group, with pairwise comparisons performed using the least significance difference method. The Mann-Whitney test was used for comparisons between groups. Categorical data such as sex, smoking status, implant subsidence, and pathology level were analyzed using the χ 2 test. RESULTS Postoperative FSU height loss at 2 years differed significantly among the TMC, n-HA/PA66, and 3d-VB groups, measuring 3.07 ± 1.25mm, 2.11 ± 0.73mm, and 1.46 ± 0.71mm, respectively ( P < 0.001). The rates of implant subsidence were 45%, 20%, and 10%, respectively ( P = 0.031). All patients obtained solid fusion at a 2-year follow-up. We observed statistically significant differences in Visual Analog Scale and JOA scores at 3 months postoperatively, and JOA scores at 2 years postoperatively among the 3 groups. At a 2-year follow-up, the n-HA/PA66 and the 3d-VBs groups exhibited less FSU height loss, lower subsidence rates, and demonstrated better cervical lordosis than the TMC group. No severe postoperative complications were observed in any of the patients, and no patient required reoperation. CONCLUSION At a 2-year follow-up after ACCF, the n-HA/PA66 and the 3d-VBs groups exhibited less FSU height loss, lower subsidence rates, and demonstrated better cervical lordosis than the TMC group. Longer-term observation of implant subsidence in ACCF using TMC, n-HA/PA66, and 3d-VB is necessary. LEVEL OF EVIDENCE Level III-therapeutic.
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Affiliation(s)
- Jing Li
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
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Du C, Gu NM, Guo TC, Liu AF. Efficacy of virtual reality balance training on rehabilitation outcomes following anterior cruciate ligament reconstruction: A systematic review and meta-analysis. PLoS One 2025; 20:e0316400. [PMID: 39808622 PMCID: PMC11731729 DOI: 10.1371/journal.pone.0316400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 12/10/2024] [Indexed: 01/16/2025] Open
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis is to clarify the rehabilitation efficacy of virtual reality (VR) balance training after anterior cruciate ligament reconstruction (ACLR). METHODS This meta-analysis was registered in PROSPERO with the registration number CRD42024520383. The electronic databases PubMed, Web of Science, Cochrane Library, MEDLINE, Embase, China National Knowledge Infrastructure, Chinese Biomedical Literature, China Science and Technology Journal Database, and Wanfang Digital Periodical database were systematically searched to identify eligible studies from their inception up to January 2024. The investigated outcomes included International Knee Documentation Committee (IKDC) score, visual analogue scale (VAS), Holden grading, Extensor peak torque (EPT), Flexor peak torque (FPT), knee reaction time, knee reproduction angle difference. The pooled mean difference (MD) and 95% confidence intervals (CIs) were calculated using the random-effects model. RESULTS Six RCTs with a total of 464 patients after unilateral ACLR were included for 8-12 weeks of VR balance training intervention. Analysis of the results showed that compared with the conventional rehabilitation control group, the VR balance training group significantly improved the International Knee Documentation Committee (IKDC) score (MD = 3.88, 95%CI: 0.95~6.81), Holden grading (MD = 0.42, 95%CI: 0.33~0.51), Extensor peak torque (EPT) (MD = 12.03, 95%CI: 3.28~20.78)and Flexor peak torque (FPT) (MD = 14.57, 95%CI: 9.52~19.63) in postoperative ACLR patients, and significantly reduced knee reaction time (MD = -0.30, 95%CI: -0.35~-0.25), knee angle reproduction difference at 30° (MD = -0.88, 95%CI: -1.16~-0.61), knee angle reproduction difference at 60° (MD = -0.80, 95%CI: -1.09~-0.50), and VAS score (MD = -0.52, 95%CI: -0.65~-0.39). CONCLUSION Since many of the included results are based on low-or very-low-quality evidence, although the results show a certain trend, the conclusion has great uncertainty. In the rehabilitation training following ACLR and lower-limb balance training, the application of VR might be advantageous for the recovery of patients' knee joint function, lower-limb muscle strength, proprioception, and pain management. The level of immersion may influence the rehabilitation outcome. Because of the limitations in data quality and heterogeneity as well as the small sample size, the strength of the conclusions is weakened. These findings should be verified in further large-scale prospective studies.
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Affiliation(s)
- Chao Du
- Orthopedics Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Traditional Chinese Medicine and Acupuncture, Tianjin, China
| | - Nei-Meng Gu
- Orthopedics Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Traditional Chinese Medicine and Acupuncture, Tianjin, China
| | - Tian-Ci Guo
- Orthopedics Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Traditional Chinese Medicine and Acupuncture, Tianjin, China
| | - Ai-Feng Liu
- Orthopedics Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Traditional Chinese Medicine and Acupuncture, Tianjin, China
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Sanzo P, Agostino M, Fidler W, Lawrence-Dewar J, Pearson E, Zerpa C, Niccoli S, Lees SJ. Shockwave therapy and fibromyalgia and its effect on pain, blood markers, imaging, and participant experience - a multidisciplinary randomized controlled trial. Physiother Theory Pract 2025; 41:99-114. [PMID: 38384123 DOI: 10.1080/09593985.2024.2321503] [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: 11/15/2023] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Patients with fibromyalgia experience chronic, widespread pain. It remains a misunderstood disorder with multimodal treatments providing mixed results. OBJECTIVES To examine the effects of radial shockwave therapy (RSWT) compared to placebo on pain, pain catastrophizing, psychological indices, blood markers, and neuroimaging. Study-related experiences were also explored qualitatively. METHODS Quantitative sensory testing (QST), Visual Analog Scale (VAS), Beighton Scoring Screen (BSS), Pain Catastrophizing Scale (PCS), blood biomarker (Interleukin (IL)-6 and IL-10), and brain fMRI were measured pre- and post-treatment along with a post-treatment survey. The RSWT group received five treatments (one week apart over five-week period) to the three most painful areas (500 shocks at 1.5 bar and 15 Hz, then 1000 shocks at 2 bar and 8 Hz, and finally 500 shocks at 1.5 bar and 15 Hz) versus sham treatment for the placebo group. RESULTS There were no statistically significant differences in the BSS for hypermobility (p = .21; d = .74), PCS (p = .70; d = .22), VAS (p = .17-.61; d = .20-.83) scores, QST for skin temperature and stimuli (p = .14-.65; d = .25-.88), and for the pressure pain threshold (p = .71-.93; d = .05-.21). The VAS scores had clinically significant changes (MCID greater than 13.90) with improved pain scores in the RSWT group. Neuroimaging scans revealed no cortical thickness changes. Post-treatment surveys revealed pain and symptom improvements and offered hope to individuals. CONCLUSION RSWT was implemented safely, without any negative treatment effects reported, and acted as a pain modulator to reduce sensitivity. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov identification number NCT02760212.
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Affiliation(s)
- Paolo Sanzo
- Faculty of Health and the Behavioral Sciences, Kinesiology Department, Lakehead University, Thunder Bay, Canada
- Medical Sciences, NOSM University - Thunder Bay Campus, Thunder Bay, Canada
| | - Martina Agostino
- Faculty of Health and the Behavioral Sciences, Kinesiology Department, Lakehead University, Thunder Bay, Canada
| | - Wesley Fidler
- Medical Sciences, NOSM University - Thunder Bay Campus, Thunder Bay, Canada
| | - Jane Lawrence-Dewar
- Faculty of Health and the Behavioral Sciences, Kinesiology Department, Lakehead University, Thunder Bay, Canada
| | - Erin Pearson
- Faculty of Health and the Behavioral Sciences, Kinesiology Department, Lakehead University, Thunder Bay, Canada
| | - Carlos Zerpa
- Faculty of Health and the Behavioral Sciences, Kinesiology Department, Lakehead University, Thunder Bay, Canada
| | - Sarah Niccoli
- Medical Sciences, NOSM University - Thunder Bay Campus, Thunder Bay, Canada
| | - Simon J Lees
- Medical Sciences, NOSM University - Thunder Bay Campus, Thunder Bay, Canada
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Fares KM, Mohamed SAB, Hetta DF, Tohamy MM, Elgalaly NA, Elhusseini NM, El Sherif FA. Analgesic efficacy of sacral neuromodulation for chronic pelvic cancer pain. Saudi J Anaesth 2024; 18:534-539. [PMID: 39600448 PMCID: PMC11587952 DOI: 10.4103/sja.sja_307_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 05/26/2024] [Accepted: 06/04/2024] [Indexed: 11/29/2024] Open
Abstract
Background Neuromodulation has provided promising results in chronic pain management. Sacral neurostimulation (SNS) is a neuromodulatory technique, where the sacral nerve roots are electrically stimulated. Objective Evaluate the efficacy of the trial phase to control severe cancer pain in pelvic organs. Design Pilot study. Methods Chronic pelvic cancer pain patients were managed with morphine ≥ 60 mg daily, duloxetine 30 mg, and celecoxib 200 mg twice daily. Twenty-two adults were divided randomly into two equal groups: the SNS group (N = 11), received a sacral neurostimulator device and opioid analgesics, and the opioid group (N = 11), received increased opioid analgesics to control pain. Results Visual analog scale scores were decreased in the SNS group at 24 h, 4 days, 1, and 2 weeks in SNS compared to the opioid group, medians (IQR) [4 (3-5) vs 6 (5-7), 3 (3-4) vs 5 (5-6), 3 (3-4) vs 5 (5-6), and 3 (3-3) vs 5 (4-6) P < 0.001], daily morphine consumption was reduced in the SNS group compared to the opioid group, median (IQR) [90 (60-90) mg vs 120 (120-150) mg, P < 0.001] and [30 (30-60) mg vs 150 (120-180) mg] during the first and second weeks. The SNS group had a better life quality compared to the opioid group after 2 weeks, median (IQR) was (123 (122.5-124) vs 117 (117-118.5) P < 0.001), respectively. Conclusion The SNS trial device showed effectiveness in managing severe chronic pelvic cancer pain.
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Affiliation(s)
- Khaled M. Fares
- Department of Anesthesia, ICU, and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Sahar A. B. Mohamed
- Department of Anesthesia, ICU, and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Diab F. Hetta
- Department of Anesthesia, ICU, and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Moaaz Mohamed Tohamy
- Department of Anesthesia, ICU, and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Nourhan A. Elgalaly
- Department of Anesthesia, ICU, and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Nayira M. Elhusseini
- Department of Anesthesia, ICU, and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Fatma Adel El Sherif
- Department of Anesthesia, ICU, and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
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Burnier M, Bouteille C, Cievet M. High Rates of Union Following Arthroscopic Treatment of Scaphoid Non-Union: A Systematic Review. Arthroscopy 2024; 40:2507-2521.e4. [PMID: 38331367 DOI: 10.1016/j.arthro.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE To synthesize and analyze the existing literature and report on the outcomes of arthroscopic surgery for the treatment of scaphoid non-union (SNU). METHODS This systematic review conforms to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The authors conducted a search using Medline and Embase databases. Studies that reported outcomes on arthroscopic nonvascularized bone graft for SNU treatment, with no limits to follow-up, sample sizes or prevalence were included. RESULTS We found 17 eligible studies composed of 20 datasets, and all assessed nonvascularized arthroscopic treatment for SNU, with a mean follow-up that ranged from 6 to 38.5 months. Union rates ranged between 86% and 100%, and none of the studies reported any other complications than non-union following arthroscopic SNU. CONCLUSIONS The present systematic review found union rates ranging between 86% and 100%, with a time to union ranging from 2.3 to 7.8 months. Furthermore, the included studies reported satisfactory clinical scores, and the complication rate of non-union ranged between 0% and 14%. LEVEL OF EVIDENCE Level IV, systematic review of level II-IV studies.
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Fernández-Gonzalo S, Navarra-Ventura G, Gomà G, Godoy-González M, Oliveras L, Ridao Sais N, Espinal C, Fortià C, De Haro C, Ochagavía A, Jodar M, Forné C, Santos-Pulpon V, Sarlabous L, Bacardit N, Subirà C, Fernández R, Palao D, Roca O, Blanch L, López-Aguilar J. Characterization of postintensive care syndrome in a prospective cohort of survivors of COVID-19 critical illness: a 12-month follow-up study. Can J Anaesth 2024; 71:1282-1301. [PMID: 39251486 PMCID: PMC11408405 DOI: 10.1007/s12630-024-02811-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 02/14/2024] [Accepted: 03/05/2024] [Indexed: 09/11/2024] Open
Abstract
PURPOSE Studies integrating an exhaustive longitudinal long-term follow-up of postintensive care syndrome (PICS) in critically ill COVID-19 survivors are scarce. We aimed to 1) describe PICS-related sequelae over a 12-month period after intensive care unit (ICU) discharge, 2) identify relevant demographic and clinical factors related to PICS, and 3) explore how PICS-related sequelae may influence health-related quality of life (HRQoL) in critically ill COVID-19 survivors. METHODS We conducted a prospective cohort study in adult critically ill survivors of SARS-CoV-2 infection that did or did not need invasive mechanical ventilation (IMV) during the COVID-19 pandemic in Spain (March 2020 to January 2021). We performed a telemedicine follow-up of PICS-related sequelae (physical/functional, cognitive, and mental health) and HRQoL with five data collection points. We retrospectively collected demographic and clinical data. We used multivariable mixed-effects models for data analysis. RESULTS We included 142 study participants in the final analysis, with a median [interquartile range] age of 61 [53-68] yr; 35% were female and 59% needed IMV. Fatigue/dyspnea, pain, impaired muscle function, psychiatric symptomatology and reduced physical HRQoL were prominent sequelae early after ICU discharge. Over the 12-month follow-up, functionality and fatigue/dyspnea improved progressively, while pain remained stable. We observed slight fluctuations in anxiety symptoms and perception of cognitive deficit, whereas posttraumatic stress disorder (PTSD) and depressive symptoms improved, with a mild rebound at the end of the follow-up. Female sex, younger age, and the need for IMV were risk factors for PICS, while having higher cognitive reserve was a potential protective factor. Physical HRQoL scores showed a general improvement over time, whereas mental HRQoL remained stable. Shorter ICU stay, better functionality, and lower scores for fatigue/dyspnea and pain were associated with better physical HRQoL, while lower scores for anxiety, depression, and PTSD were associated with better mental HRQoL. CONCLUSIONS Postintensive care syndrome was common in COVID-19 critical illness survivors and persisted in a significant proportion of patients one year after ICU discharge, impacting HRQoL. The presence of risk factors for PICS may identify patients who are more likely to develop the condition and who would benefit from more specific and closer follow-up after ICU admission. STUDY REGISTRATION ClinicalTrials.gov ( NCT04422444 ); first submitted 9 June 2020.
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Affiliation(s)
- Sol Fernández-Gonzalo
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical and Health Psychology, International Excellence Campus, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | - Guillem Navarra-Ventura
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
- Department of Medicine, University of the Balearic Islands, IUNICS, IdISBa, Palma, Mallorca, Spain.
| | - Gemma Gomà
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Godoy-González
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
- Department of Clinical and Health Psychology, International Excellence Campus, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | - Laia Oliveras
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
| | - Natalia Ridao Sais
- Physical and Rehabilitation Medicine Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Cristina Espinal
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
| | - Cristina Fortià
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
| | - Candelaria De Haro
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Ochagavía
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Merce Jodar
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical and Health Psychology, International Excellence Campus, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
- Neurology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Carles Forné
- Heorfy Consulting, Lleida, Spain
- Department of Basic Medical Sciences, University of Lleida, Lleida, Spain
| | - Verónica Santos-Pulpon
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
| | - Leonardo Sarlabous
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Neus Bacardit
- Mental Health Department, Althaia Xarxa Assistencial Universitària de Manresa, IRIS Research Institute, Manresa, Spain
| | - Carles Subirà
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Critical Care Department, Althaia Xarxa Assistencial Universitària de Manresa, IRIS Research Institute, Manresa, Spain
| | - Rafael Fernández
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Critical Care Department, Althaia Xarxa Assistencial Universitària de Manresa, IRIS Research Institute, Manresa, Spain
| | - Diego Palao
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Mental Health Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, International Excellence Campus, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | - Oriol Roca
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, International Excellence Campus, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | - Lluís Blanch
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Josefina López-Aguilar
- Critical Care Department, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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9
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Qaddumi J, Arda AM, Alkhawaldeh A, ALBashtawy M, Abdalrahim A, ALBashtawy S, Al Omari O, Bashtawi M, Masa'deh R, ALBashtawy Z, Mohammad KI, ALBashtawy B, Aljezawi M, Khatatbeh H, Ta'an W, Suliman M, Al Dameery K, Bani Hani S. Preoperative anxiety, postoperative pain tolerance and analgesia consumption: A prospective cohort study. J Perioper Pract 2024:17504589241253489. [PMID: 39104294 DOI: 10.1177/17504589241253489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND Anxiety affects the patient's perception of postoperative pain and causes a significant increase in the consumption of analgesia postoperatively. OBJECTIVE This study assesses the relationship between preoperative anxiety, postoperative pain and postoperative pethidine consumption. METHODS A prospective cohort design was used. Data were collected from 100 patients who were undergoing a laparoscopic cholecystectomy at St Joseph Hospital, Jerusalem. Pain-controlled analgesia with pethidine was utilised to manage pain throughout the postoperative period. The visual analogue scale scores and pethidine consumption of all patients were recorded. FINDINGS Participants' mean level of pain was higher in the preoperative period (mean visual analogue scale = 1.3) compared with their mean level of pain in the postoperative period (mean visual analogue scale = 0.5). There is a statistically significant difference between the participants' level of anxiety and postoperative pain level (p < 0.001). Gender, weight, level of education and smoking were predictors of developing preoperative anxiety. Also, gender, smoking and medication were statistically significant predictors of developing postoperative pain. Furthermore, gender, medical history and medication were statistically significant predictors of pethidine consumption postoperatively. CONCLUSIONS The preoperative anxiety reduction intervention should be promoted and implemented as routine care for all surgical patients.
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Affiliation(s)
- Jamal Qaddumi
- Faculty of Nursing, An-Najah National University, Nablus, Palestine
| | | | - Abdullah Alkhawaldeh
- Department of Community and Mental Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Mohammed ALBashtawy
- Department of Community and Mental Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Asem Abdalrahim
- Department of Community and Mental Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | | | - Omar Al Omari
- Faculty of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Mahmoud Bashtawi
- Department of Neuroscience, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rami Masa'deh
- Psychiatric Mental Health Nursing, School of Nursing, Applied Science Private University, Amman, Jordan
| | | | - Khitam Ibrahem Mohammad
- Department of Midwifery, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Bayan ALBashtawy
- Bachelor of Medicine and Surgery, Jordan Ministry of Health (MOH), Irbid, Jordan
| | - Ma'en Aljezawi
- College of Nursing, Sultan Qaboos University, Muscat, Oman
- Princess Salma Faculty of Nursing, AL al-Bayt University, Mafraq, Jordan
| | | | - Wafa'a Ta'an
- Community and Mental Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Suliman
- Department of Community and Mental Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Jordan
| | | | - Salam Bani Hani
- Department of Adult Health Nursing, Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
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10
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Abdollahi Diba M, Sari Sarraf V, Amirsasan R, Dabbagh Nikoukheslat S. Effect of a 12-Week High-Calorie-Expenditure Multimodal Exercise Program on Health Indices in Women With Overweight: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e51599. [PMID: 38870518 PMCID: PMC11216018 DOI: 10.2196/51599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/25/2024] [Accepted: 04/02/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND High-calorie-expenditure training is common among endurance athletes and is an effective strategy for weight loss. Although many training protocols include walking, running, cycling, and swimming according to a target heart rate, there is limited research on high-calorie-expenditure interventions with multimodal training programs using quantitative methods. OBJECTIVE The aims of this research protocol are to (1) develop a high-calorie-expenditure training program to cover target calorie expenditure according to the trainability of women classified as overweight (according to a BMI of 25-29.9 kg/m2); (2) determine the effect of high-calorie-expenditure workouts on conditioning, glycemic variables, and body composition; and (3) evaluate the implementation of the intervention and results in comparison with outcomes obtained under a standard-calorie-expenditure training program. METHODS This is a randomized controlled trial with a pretest-posttest design. Participants include 33 women with a BMI in the overweight range (25-29.9) allocated to three groups: two intervention groups and one control group. The intervention will be conducted for 12 weeks. Participants in the first group will be assigned an exercise program with high energy expenditure of approximately 3000-3500 kilocalories/week in the form of 5 sessions per week with an intensity of 50%-75% maximum oxygen rate (VO2 max) and 60%-80% target heart rate. The second group will be assigned an exercise program with a standard energy expenditure of approximately 1200-1500 kilocalories/week with 3 sessions per week at an intensity of 60%-75% VO2 max, according to The American College of Sports Medicine guideline. The effects of the multimodal training program with daily tasks will be compared to those of the standard-calorie-expenditure and control (no exercise) conditions with respect to changes in glycemic indices and body composition. Daily calories will be calculated through the International Physical Activity Questionnaire and using Nutrition 4 software. RESULTS Preliminary results show significant weight loss in both the high- and standard-calorie-expenditure groups (P=.003). Significant improvements were also found in muscle percentage (P=.05) and BMI (P=.05) for the high-calorie-expenditure group. Analyses are ongoing for glycemic indices, inflammation factors, and blood parameters. CONCLUSIONS High-calorie-expenditure training can cause further weight loss than standard exercise, which can eventually lead to greater fat mass reduction and improvement in glycemic indices. These results demonstrate that, in some cases, it may be necessary to increase the activity of women and use multimodal exercise programs with increased volume and intensity to increase the expenditure of exercise and daily activity. We found a net effect of exercise and daily activity at the individual level, whereas the daily lifestyle and physical behaviors of the participants remained constant. TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT20220202053916N1; https://tinyurl.com/c8jxfw36. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51599.
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Affiliation(s)
- Mitra Abdollahi Diba
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, University of Tabriz, Tabriz, Iran
| | - Vahid Sari Sarraf
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, University of Tabriz, Tabriz, Iran
| | - Ramin Amirsasan
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, University of Tabriz, Tabriz, Iran
| | - Saeid Dabbagh Nikoukheslat
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, University of Tabriz, Tabriz, Iran
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11
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Luo Y, Rahmati M, Kazemi A, Liu W, Lee SW, Gyasi RM, López Sánchez GF, Koyanagi A, Smith L, Yon DK. Effects of therapeutic ultrasound in patients with knee osteoarthritis: A systematic review and meta-analysis. Heliyon 2024; 10:e30874. [PMID: 38803857 PMCID: PMC11128881 DOI: 10.1016/j.heliyon.2024.e30874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/02/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
Background Therapeutic ultrasound (US) is a treatment for knee osteoarthritis (KOA), but its efficacy and safety are unclear. The objective of this study is to quantify the effect of US on pain relief and function recovery in KOA, and to analyze the US treatment duration and parameters on treatment outcome. Methods We searched PubMed, MEDLINE, EMBASE, Google Scholar, Cochrane databases and ClinicalTrials.gov databases up to April 7, 2023. RCTs that compared the efficacy of therapeutic US with the control in KOA were included in the study, and the methodological quality of the trials was assessed using the Cochrane Risk of Bias tool. Results Twenty-one RCTs (1315 patients) were included. US had a positive effect on visual analog scale (VAS) (SMD = -0.64, 95 % CI [-0.88, -0.40], I2 = 71 %) and Western Ontario and McMaster Universities (WOMAC) total scale (SMD = -0.45, 95 % CI [-0.69, -0.20]; I2 = 67 %). Pulsed US with an intensity ≤2.5 W/cm2 reduced visual analog scale (VAS), and differed in sessions (24 sessions (SMD = -0.80, 95 % CI [-1.07, -0.53], I2 = 0 %) vs 10 sessions (SMD = -0.71, 95 % CI [-1.09, -0.33], I2 = 68 %)). For pulsed US, a duration of treatment of 4-8 weeks (SMD = -0.69, 95 % CI [-1.13, -0.25], I2 = 73 %) appeared to be superior to ≤4 weeks (SMD = -0.77, 95 % CI [-1.04, -0.49], I2 = 0 %) for reducing visual analog scale (VAS). No US treatment-related adverse events were reported. Conclusion Therapeutic US may be a safe and effective treatment for patients with KOA. The mode, intensity, frequency, and duration of US may affect the effectiveness of pain relief. Pulsed US with an intensity ≤2.5 W/cm2, 24 sessions, and a treatment duration of ≤4 weeks appears to have better pain relief.
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Affiliation(s)
- Yan Luo
- Clinical Medicine Eight-Year Program, Xiangya Hospital, Central South University, Changsha, China
| | - Masoud Rahmati
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Abdolreza Kazemi
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Wenbing Liu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou, 325027, China
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University College of Medicine, Suwon, Republic of Korea
| | - Razak M. Gyasi
- African Population and Health Research Center, Nairobi, Kenya
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
| | - Guillermo F. López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
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12
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Carreon LY, Nian H, Archer KR, Andersen MØ, Hansen KH, Glassman SD. Performance of the streamlined quality outcomes database web-based calculator: internal and external validation. Spine J 2024; 24:662-669. [PMID: 38081465 DOI: 10.1016/j.spinee.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND CONTEXT With an increasing number of web-based calculators designed to provide the probabilities of an individual achieving improvement after lumbar spine surgery, there is a need to determine the accuracy of these models. PURPOSE To perform an internal and external validation study of the reduced Quality Outcomes Database web-based Calculator (QOD-Calc). STUDY DESIGN Observational longitudinal cohort. PATIENT SAMPLE Patients enrolled study-wide in Quality Outcomes Database (QOD) and patients enrolled in DaneSpine at a single institution who had elective lumbar spine surgery with baseline data to complete QOD-Calc and 12-month postoperative data. OUTCOME MEASURES Oswestry Disability Index (ODI), Numeric Rating Scales (NRS) for back and leg pain, EuroQOL-5D (EQ-5D). METHODS Baseline data elements were entered into QOD-Calc to determine the probability for each patient having Any Improvement and 30% Improvement in NRS leg pain, back pain, EQ-5D and ODI. These probabilities were compared with the actual 12-month postop data for each of the QOD and DaneSpine cases. Receiver-operating characteristics analyses were performed and calibration plots created to assess model performance. RESULTS 24,755 QOD cases and 8,105 DaneSpine lumbar cases were included in the analysis. QOD-Calc had acceptable to outstanding ability (AUC: 0.694-0.874) to predict Any Improvement in the QOD cohort and moderate to acceptable ability (AUC: 0.658-0.747) to predict 30% Improvement. QOD-Calc had acceptable to exceptional ability (AUC: 0.669-0.734) to predict Any improvement and moderate to exceptional ability (AUC: 0.619-0.862) to predict 30% Improvement in the DaneSpine cohort. AUCs for the DaneSpine cohort was consistently lower that the AUCs for the QOD validation cohort. CONCLUSION QOD-Calc performs well in predicting outcomes in a patient population that is similar to the patients that was used to develop it. Although still acceptable, model performance was slightly worse in a distinct population, despite the fact that the sample was more homogenous. Model performance may also be attributed to the low discrimination threshold, with close to 90% of cases reporting Any Improvement in outcome. Prediction models may need to be developed that are highly specific to the characteristics of the population.
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Affiliation(s)
- Leah Y Carreon
- Norton Leatherman Spine Center, 210 East Gray St, Suite 900, Louisville, KY, USA; Center for Spine Surgery and Research, Region of Southern Denmark, Østre Hougvej 55, DK-5500, Middelfart, Denmark; Institute of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 3, DK-5000, Odense, Denmark.
| | - Hui Nian
- Department of Biostatistics, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
| | - Kristin R Archer
- Center for Musculoskeletal Research, Vanderbilt Orthopaedic Institute, Vanderbilt University Medical Center, Nashville, TN, 37232 USA; Department of Physical Medicine and Rehabilitation, Osher Center for Integrative Health, Vanderbilt University Medical Center, 2201 Children's Way, Suite 1318, Nashville, TN, 37212, USA
| | - Mikkel Ø Andersen
- Center for Spine Surgery and Research, Region of Southern Denmark, Østre Hougvej 55, DK-5500, Middelfart, Denmark; Institute of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 3, DK-5000, Odense, Denmark
| | - Karen Højmark Hansen
- Center for Spine Surgery and Research, Region of Southern Denmark, Østre Hougvej 55, DK-5500, Middelfart, Denmark
| | - Steven D Glassman
- Norton Leatherman Spine Center, 210 East Gray St, Suite 900, Louisville, KY, USA
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Pastor T, Meier R, Merky D, Haug L, Pastor T, Zubler C, Vögelin E. Mid-term Clinical Outcome of Microvascular Gracilis Muscle Flaps for Defects of the Hand. Arch Orthop Trauma Surg 2024; 144:1865-1873. [PMID: 38267722 PMCID: PMC10965656 DOI: 10.1007/s00402-024-05207-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE Gracilis muscle flaps are useful to cover defects of the hand. However, there are currently no studies describing outcome measurements after covering soft tissue defects using free flaps in the hand. AIM To analyze mid-term results of gracilis muscle flap coverage for defects on the hand, with regard to functional and esthetic integrity. METHODS 16 patients aged 44.3 (range 20-70) years were re-examined after a mean follow-up of 23.6 (range 2-77) months. Mean defect size was 124 (range 52-300) cm2 located palmar (n = 9), dorsal (n = 6), or radial (n = 1). All flaps were performed as microvascular muscle flaps, covered by split thickness skin graft. RESULTS Flaps survived in 15 patients. 6 patients required reoperations. Reasons for revisions were venous anastomosis failure with total flap loss (n = 1) requiring a second gracilis muscle flap; necrosis at the tip of the flap (n = 1) with renewed split thickness skin cover. A surplus of the flap (n = 2) required flap thinning and scar corrections were performed in 2 patients. Mean grip strength was 25% (range 33.3-96.4%) compared to the contralateral side and mean patient-reported satisfaction 1.4 (range 1-3) (1 = excellent; 4 = poor). CONCLUSIONS Gracilis muscle flaps showed a survival rate of 94%. Patients showed good clinical outcomes with acceptable wrist movements and grip strength as well as high reported satisfaction rates. Compared to fasciocutaneous free flaps, pliability and thinness especially on the palmar aspect of the hand are advantageous. Hence, covering large defects of the hand with a gracilis muscle flap can be a very satisfactory procedure. LEVEL OF EVIDENCE IV observational.
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Affiliation(s)
- Tatjana Pastor
- Department for Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland.
- AO Research Institute Davos, Davos, Switzerland.
| | - Rahel Meier
- Department for Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Dominique Merky
- Department for Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Luzian Haug
- Department for Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Torsten Pastor
- Department of Orthopedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Cédric Zubler
- Department for Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Esther Vögelin
- Department for Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
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14
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Gofflot A, Croisier JL, Kaux JF, Delvaux F, Tubez F, Tooth C, Bornheim S, Forthomme B. Return to play decision after shoulder dislocation in upper limb athletes: Critical analysis between the habits of medical professionals and the literature. Orthop Traumatol Surg Res 2024; 110:103715. [PMID: 37865233 DOI: 10.1016/j.otsr.2023.103715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/25/2022] [Accepted: 08/26/2022] [Indexed: 10/23/2023]
Abstract
BACKGROUND The return to field is a critical moment for an athlete who has dislocated his shoulder as there is a significant risk of recurrence. The decision to return to field made by the doctor will therefore be crucial for the smooth continuation of the athlete's career. HYPOTHESIS This objective is to compare the criteria most used by specialists in clearing an overhead athlete to return to competition after a first episode of antero-internal dislocation of the glenohumeral joint with or without surgery and those mentioned in the literature. PATIENTS AND METHODS The target population consisted of French-speaking physicians in orthopedic surgery, physical medicine and rehabilitation or sports medicine. This study was conducted by the means of a questionnaire. The questionnaire was validated by three experts in sports medicine and published on an online survey website. RESULTS Sixty-three medical specialists responded to the questionnaire. On average, they use more than nine criteria to decide if an athlete is fit to return to competition. Over the 12 criteria proposed, four are used by more than 90% of respondents: laxity/instability, pain, range of motion and patient's subjective feeling. The methods used to evaluate certain criteria such as pain, joint range or muscular strength are often subjective and very often not validated by the literature. CONCLUSION Doctors use a set of criteria to allow an overhead athlete to return to competition. This study highlights that the techniques employed to evaluate these criteria are not always thoroughly validated by literature reviews. LEVEL OF EVIDENCE III; observational study.
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Affiliation(s)
- Amandine Gofflot
- Department of Rehabilitation and Sports Sciences, University of Liege, Liege, Belgium; Department of Physical Medicine and Sports Traumatology, SportS(2), FIFA Medical Center of Excellence, IOC Research Center for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liege, Liege, Belgium; Laboratory of Human Motion Analysis, University of Liege, Liege, Belgium.
| | - Jean-Louis Croisier
- Department of Rehabilitation and Sports Sciences, University of Liege, Liege, Belgium; Department of Physical Medicine and Sports Traumatology, SportS(2), FIFA Medical Center of Excellence, IOC Research Center for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liege, Liege, Belgium; Laboratory of Human Motion Analysis, University of Liege, Liege, Belgium
| | - Jean-François Kaux
- Department of Rehabilitation and Sports Sciences, University of Liege, Liege, Belgium; Department of Physical Medicine and Sports Traumatology, SportS(2), FIFA Medical Center of Excellence, IOC Research Center for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liege, Liege, Belgium
| | - François Delvaux
- Department of Rehabilitation and Sports Sciences, University of Liege, Liege, Belgium; Department of Physical Medicine and Sports Traumatology, SportS(2), FIFA Medical Center of Excellence, IOC Research Center for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liege, Liege, Belgium; Laboratory of Human Motion Analysis, University of Liege, Liege, Belgium
| | - François Tubez
- Laboratory of Human Motion Analysis, University of Liege, Liege, Belgium
| | - Camille Tooth
- Department of Rehabilitation and Sports Sciences, University of Liege, Liege, Belgium; Laboratory of Human Motion Analysis, University of Liege, Liege, Belgium
| | - Stephen Bornheim
- Department of Rehabilitation and Sports Sciences, University of Liege, Liege, Belgium; Department of Physical Medicine and Sports Traumatology, SportS(2), FIFA Medical Center of Excellence, IOC Research Center for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liege, Liege, Belgium
| | - Bénédicte Forthomme
- Department of Rehabilitation and Sports Sciences, University of Liege, Liege, Belgium; Department of Physical Medicine and Sports Traumatology, SportS(2), FIFA Medical Center of Excellence, IOC Research Center for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liege, Liege, Belgium; Laboratory of Human Motion Analysis, University of Liege, Liege, Belgium
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15
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Lambertini L, Di Maida F, Cadenar A, Nardoni S, Grosso AA, Valastro F, Spinelli P, Fantechi R, Tuccio A, Vittori G, Mari A, Masieri L, Minervini A. Stentless florence robotic intracorporeal neobladder (FloRIN), a feasibility prospective randomized clinical trial. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:107259. [PMID: 38011784 DOI: 10.1016/j.ejso.2023.107259] [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: 07/14/2023] [Revised: 10/15/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Aim of the study was to evaluate perioperative, postoperative and mid-term functional outcomes of Florence intracorporeal neobladder (FloRIN) configuration technique performed with stentless procedure. MATERIALS AND METHODS This single institution randomized 1:1 prospective series included consecutive patients treated with Robot-Assisted Radical Cystectomy (RARC) and FloRIN reconfiguration from January 2021 to February 2022. Postoperative complications were graded according to Clavien Dindo classification and divided in early (<30 days from discharge) and delayed (>30 days). RESULTS Overall, 63 patients were included in the analysis. Among these 32 (50.8 %) were treated with RARC + stentless FloRIN while 31 (49.2 %) underwent stent placement procedure. No differences were found in terms of baseline characteristics between the two groups. Stentless procedure was associated with significant shorter console time 328 vs 374 min (p = 0.04) and lower estimated blood loss (EBL) 330 vs 350 ml (p = 0.04) comparing to stent group. As regards perioperative features, no significant differences were recorded in terms of canalization (p = 0.58) and time to drainage removal (p = 0.11) while a shorter length of hospital stay was found in case of stentless procedure (p = 0.04). Early postoperative complications Clavien ≥ 3a occurred in 9.3 % and 12.9 % of patients while delayed major complications were recorded in the 3.1 % and 9.6 % of patients treated with stentless and stent FloRIN, respectively (p = 0.09). As regards the mid-term functional outcomes, no differences were found in terms of kidney function loss in both 3rd and 6th month assessment (p = 0.13 and p = 0.14, respectively). CONCLUSIONS In conclusion, Stentless FloRIN is a feasible and safe IntraCorporeal Neobladder technique, as confirmed by the worthy functional and perioperative outcomes achieved in comparison with the standard FloRIN ureteral management strategy.
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Affiliation(s)
- Luca Lambertini
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Fabrizio Di Maida
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Anna Cadenar
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Samuele Nardoni
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Antonio Andrea Grosso
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Francesca Valastro
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Pietro Spinelli
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Riccardo Fantechi
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Agostino Tuccio
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Gianni Vittori
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Andrea Mari
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Lorenzo Masieri
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.
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Tez M, Şahingöz E, Martlı HF. Non-pharmacological pain palliation methods in chronic pancreatitis. World J Clin Cases 2023; 11:8263-8269. [PMID: 38130624 PMCID: PMC10731199 DOI: 10.12998/wjcc.v11.i35.8263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 10/30/2023] [Accepted: 12/01/2023] [Indexed: 12/14/2023] Open
Abstract
Chronic pancreatitis (CP) is a condition characterized by persistent and often severe pain resulting from the inflammatory disease of the pancreas. While pharmacological treatments play a significant role in palliative pain management, some patients require non-pharmacological methods. This review article focuses on non-pharmacological approaches used to alleviate pain in CP. The article examines non-pharmacological palliation options, including surgery, endoscopic approaches, neurostimulation techniques, acupuncture, and other alternative medicine methods. The effectiveness of each method is evaluated, taking into consideration patient compliance and side effects. Additionally, this article emphasizes the importance of personalized pain management in CP and underscores the need for a multidisciplinary approach. It aims to summarize the existing knowledge on the use of non-pharmacological palliation methods to improve the quality of life for patients with CP.
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Affiliation(s)
- Mesut Tez
- Department of Surgery, University of Health Sciences, Ankara City Hospital, Ankara 06800, Turkey
| | - Eda Şahingöz
- Department of General Surgery, Sağlık Bilimleri University, Ankara 06100, Turkey
| | - Hüseyin Fahri Martlı
- Department of General Surgery, Ankara Atatürk Sanatoryum Training and Research Hospital, Ankara 06100, Turkey
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Mohammed El Husaini M, Maberry A, Martin AE. Validation of a modified visual analogue scale to measure user-perceived comfort of a lower-limb exoskeleton. Sci Rep 2023; 13:20484. [PMID: 37993504 PMCID: PMC10665473 DOI: 10.1038/s41598-023-47430-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023] Open
Abstract
User perceived exoskeleton comfort is likely important for device acceptance, but there is currently no validated instrument to measure it. The Visual Analogue Scale (VAS) is an existing tool to measure subjective human feedback by asking the user to mark a point on a line with each end of the line representing an opposing anchor statement. It can be modified to show the previous response, allowing the subject to directly indicate if the current condition is better or worse than the previous one. The goal of this study was to determine how well the modified VAS could measure user-perceived comfort as the exoskeleton control parameters were varied. To validate the survey, 14 healthy subjects walked in a pair of ankle exoskeletons with approximately ten distinct sets of control parameters tested in a prescribed order. Each set of control parameters was tested twice. After each trial, user-perceived comfort was measured using a two-question VAS survey. The repeatability coefficient was approximately 40 mm, similar to the total range of responses. The results were also inconsistent, with relative rankings between consecutive pairs of conditions matching for approximately 50% of comparisons. Thus, as tested, the VAS was not repeatable or consistent. It is possible that subject adaptation within the trial and over the course of the experiment may have impacted the results. Additional work is needed to develop a repeatable method to measure comfort and to determine how perceived comfort varies as subjects' gain exoskeleton experience.
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Affiliation(s)
| | - Axl Maberry
- Department of Mechanical Engineering, Pennsylvania State University, University Park, PA, 16802, USA
| | - Anne E Martin
- Department of Mechanical Engineering, Pennsylvania State University, University Park, PA, 16802, USA.
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18
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Takekawa T, Chino T, Yamada N, Watanabe S, Abo M, Sengoku R. Multimodal treatment, including extracorporeal shock wave therapy, for refractory chronic tension-type headache: a case report. J Med Case Rep 2023; 17:478. [PMID: 37907963 PMCID: PMC10617078 DOI: 10.1186/s13256-023-04092-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 07/20/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Few reports have described multidisciplinary treatment, including extracorporeal shock wave therapy, for patients with refractory chronic tension-type headache. In this study, we conducted multidisciplinary treatment for a patient with chronic tension-type headache who suffered from chronic headache refractory to treatment. CASE PRESENTATION The patient was a 45-year-old Japanese male suffering from 20 years of headache. As his headache had worsened recently, he visited a local clinic. With the diagnosis of suspected tension-type headache, its treatment was unsuccessful and he was referred to our hospital. The neurology department confirmed the tension-type headache and prescribed another medication, but he showed no improvement. Then, the patient was referred to the rehabilitation medicine department for consultation. At the initial visit, we identified multiple myofascial trigger points in his bilateral posterior neck and upper back regions. At the initial visit, he was prescribed 10 mL of 1% lidocaine injected into the muscles in these areas. In addition, he received 2000 extracorporeal shock wave therapy into bilateral trapezius muscles, and was instructed to take oral Kakkonto extract granules, benfotiamine, pyridoxine hydrochloride, and cyanocobalamin. Cervical muscle and shoulder girdle stretches and exercises were also recommended. At follow-up treatment visits, we used extracorporeal shock wave therapy to bilateral trapezius muscles, which led to immediate pain relief. After 11 weeks, he was not taking any medication and his headache was subjectively improved and his medical treatment ended. CONCLUSION A patient with chronic tension-type headache refractory to regular treatment was successfully treated with a multimodal approach including extracorporeal shock wave therapy in addition to standard treatment. For patients with tension-type headache accompanied by myofascial trigger points, it may be recommended to promptly consider aggressive multimodal treatment that includes extracorporeal shock wave therapy.
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Affiliation(s)
- Toru Takekawa
- Department of Rehabilitation Medicine, School of Medicine, The Jikei University, 3-19-18, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8471, Japan.
| | - Toshifumi Chino
- Department of Rehabilitation Medicine, School of Medicine, The Jikei University, 3-19-18, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Naoki Yamada
- Department of Rehabilitation Medicine, School of Medicine, The Jikei University, 3-19-18, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Shu Watanabe
- Department of Rehabilitation Medicine, School of Medicine, The Jikei University, 3-19-18, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Masahiro Abo
- Department of Rehabilitation Medicine, School of Medicine, The Jikei University, 3-19-18, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Renpei Sengoku
- Department of Neurology, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan
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19
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Baumann AN, Curtis DP, Chen M, Baldwin KD. The Impact of the Addition of a Physical Therapy Assistant to the Treatment Team for Management of Neck Pain: A Retrospective Analysis of Outpatient Physical Therapy Clinics. Cureus 2023; 15:e42751. [PMID: 37654958 PMCID: PMC10468008 DOI: 10.7759/cureus.42751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction The impact of physical therapy assistants (PTAs) on patient outcomes, mostly in the acute and subacute setting, is well known in the literature. However, no study to date has examined the impact of using PTAs as part of a treatment team in the outpatient setting for common musculoskeletal conditions. The purpose of this study is to determine if physical therapy team composition, either physical therapists (PTs) only or a team consisting of PTs and PTAs, has a significant impact on patient outcomes in adult patients with musculoskeletal neck pain to help investigate an ideal practice pattern for outpatient physical therapy. Methods This is a retrospective cohort study analyzing the impact of physical therapy treatment team composition (PTs only, or team consisting of PTs and PTAs) on pain, active range-of-motion (AROM), and disability outcomes via the Neck Disability Index (NDI) in the conservative treatment of neck pain. All patients were treated with usual physical therapy care. Inclusion criteria involved patients with a diagnosis of neck pain (M48.2), older than 18 years old, a physical therapy evaluation procedure code (97161, 97162, 97163), and at least two visits per bout of physical therapy. Primary outcome measures were pain, bilateral rotation AROM, disability, and number of visits. Results Included patients (n=195) had an average age of 60.8 years ± 16.1 years with an average number of total physical therapy visits of 7.4 visits ± 4.3 visits (range, 2 visits - 22 visits) with 120 patients (61.5%) treated by a PT only (PT-only group) and 75 patients (38.5%) treated by a team consisting of a PT and a PTA (PTA group). The PT-only group had significantly fewer visits than the PTA group (p<0.001). The PT-only group had a pain improvement of 2.1 points ± 2.3 points whereas the PTA group had a pain improvement of 2.2 points ± 2.4 points with no significant difference between the two groups (p=0.573). The PT-only group (n=46 patients) had an average rotation AROM improvement of 20.0 ± 17.4 degrees whereas the PTA group (n=40 patients) had an average rotation AROM improvement of 16.8 degrees ± 23.0 degrees with no significant difference between the level of rotation AROM improvement between the two groups (p=0.408). Furthermore, there was also no significant difference in the amount of NDI improvement seen in both groups (p=0.594). Conclusion There was no significant difference in patient outcomes for pain, AROM, and disability when PTAs were added to the physical therapy treatment team in the conservative management of neck pain in the outpatient setting. However, patients treated with a treatment team consisting of PTAs had significantly more visits, despite no significant change in outcomes. Randomized controlled trials are needed as the reasons for these findings can be many and require further research.
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Affiliation(s)
- Anthony N Baumann
- Department of Rehabilitation Services, University Hospitals, Cleveland, USA
| | - Deven P Curtis
- College of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Mingda Chen
- College of Medicine, Case Western Reserve University, Cleveland, USA
| | - Keith D Baldwin
- Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, USA
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20
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Bae S, Jung J, Moon D. Impact of Movement Control Training Using a Laser Device on the Neck Pain and Movement of Patients with Cervicogenic Headache: A Pilot Study. Healthcare (Basel) 2023; 11:healthcare11101439. [PMID: 37239725 DOI: 10.3390/healthcare11101439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/03/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
This study verified the effect of movement control training using a laser device on the neck pain and movement of patients with cervicogenic headache. A total of twenty outpatients recruited from two Busan hospitals were equally divided into two groups. The experimental group underwent movement control training with visual biofeedback, while the control group performed self-stretching. Both groups received therapeutic massage and upper cervical spine mobilization. A four-week intervention program was also conducted. Measurement tools including the cervical flexion-rotation test, visual analog scale, Headache Impact Test-6, pressure pain threshold, range of motion, sensory discrimination, and Neck Disability Index helped assess the participating patients before and after the intervention. Additionally, the Wilcoxon signed-rank test and the Mann-Whitney U test helped determine inter and intra-group variations, respectively, before and after the intervention. Most of the measurement regions revealed significant changes post-intervention within the experimental group, while only the cervical flexion-rotation test, visual analog scale, Headache Impact Test-6, and Neck Disability Index indicated significant changes post-intervention within the control group. There were also considerable inter-group differences. Thus, movement control training using a laser device more effectively improves neck pain and movement of patients with cervicogenic headache.
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Affiliation(s)
- Songui Bae
- Department of Physical Therapy, Graduate School, Dong-Eui University, Busan 47340, Republic of Korea
| | - Juhyeon Jung
- Department of Physical Therapy, College of Nursing, Healthcare Sciences and Human Ecology, Dong-Eui University, Busan 47340, Republic of Korea
| | - Dongchul Moon
- Department of Physical Therapy, Gimhae College, Gimhae-si 50811, Republic of Korea
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21
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Baumann AN, Orellana K, Landis L, Crawford M, Oleson CJ, Rogers H, Curtis DP, Baldwin KD. The McKenzie Method Is an Effective Rehabilitation Paradigm for Treating Adults With Moderate-to-Severe Neck Pain: A Systematic Review With Meta-Analysis. Cureus 2023; 15:e39218. [PMID: 37337494 PMCID: PMC10276901 DOI: 10.7759/cureus.39218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 06/21/2023] Open
Abstract
Neck pain is a common musculoskeletal condition frequently managed with numerous conservative interventions. The McKenzie method of mechanical diagnosis and therapy (MMDT) is a form of physical therapy evaluation and treatment that aims to improve pain and disability in patients with musculoskeletal pain, including neck pain. To date, no systematic review with meta-analysis has examined the use of the McKenzie MMDT for neck pain. This study aimed to examine the effectiveness of the McKenzie MMDT in adult patients with neck pain. A systematic review and meta-analysis were performed using PubMed, ScienceDirect, MEDLINE, CINAHL, Web of Science, and Google Scholar. Full search terms were "McKenzie method" OR "McKenzie approach" OR "McKenzie treatment" AND "neck pain." Inclusion criteria were the use of the McKenzie MMDT, level I randomized control trials (RCTs), adults, and outcomes of pain (0-10 scale) and disability (neck disability index). A total of 11 RCTs met the final selection criteria from 1,955 articles on initial search with 289 patients receiving the McKenzie MMDT out of 677 total patients. For meta-analysis, there was a clinically insignificant but statistically significant improvement in pain (1.14/10 points) in patients receiving the McKenzie MMDT versus control interventions (p<0.02). There was no significant improvement in the neck disability index score between the McKenzie MMDT versus control interventions (p=0.19). For severity of pain, there was a clinically and statistically significant improvement in moderate or severe pain (2.06/10 points; p<0.01), but not in mild-to-moderate pain (p=0.84) when comparing the McKenzie MMDT to control interventions. Overall, the McKenzie MMDT provides very small but statistically significant improvements in neck pain of all severity compared to control interventions. However, the McKenzie MMDT does provide clinically and statistically significant pain improvement in moderate-to-severe neck pain. Use of the McKenzie MMDT did not provide any significant improvement in disability compared to control interventions. This study is the first systematic review with meta-analysis on the effectiveness of the McKenzie MMDT for adult patients with neck pain.
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Affiliation(s)
- Anthony N Baumann
- Department of Rehabilitation Services, University Hospitals, Cleveland, USA
| | - Kevin Orellana
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Leah Landis
- Department of Rehabilitation and Sports Therapy, Cleveland Clinic Akron General, Akron, USA
| | - Marc Crawford
- Department of Physical Therapy, Stability Physical Therapy, Ashtabula, USA
| | - Caleb J Oleson
- Department of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Hudson Rogers
- Department of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Deven P Curtis
- Department of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Keith D Baldwin
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, USA
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22
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Iwasa M, Ando W, Uemura K, Hamada H, Takao M, Sugano N. Association between magnitude of femoral head collapse and quality of life in patients with osteonecrosis of the femoral head. Mod Rheumatol 2023; 33:416-421. [PMID: 35260881 DOI: 10.1093/mr/roac023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/12/2022] [Accepted: 03/04/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The magnitude of femoral head collapse (MFHC) is one of the criteria for staging osteonecrosis of the femoral head (ONFH). The present study aimed to clarify the relationship between MFHC and hip pain or functional quality of life (QOL) scores in patients with ONFH. METHODS Seventy patients with ONFH who had femoral head collapse without osteoarthritic changes were divided into four groups based on MFHC by 1 mm. Pain was assessed using the visual analogue scale (VAS). QOL was evaluated using patient-reported outcome measures such as the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), Oxford Hip Score (OHS), and Short Form-12 Health Survey, version 2 (SF-12v2). We also explored the relationship between MFHC and QOL. RESULTS Pain score and satisfaction score in the VAS, JHEQ pain subscale, JHEQ movement subscale, and JHEQ total score were significantly associated with MFHC, and no significant differences were found between groups in any subscale or total score for OHS and SF-12v2. CONCLUSION In patients with ONFH, differences in MFHC by 1 mm were associated with deterioration of some pain VAS and QOL outcomes.
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Affiliation(s)
- Makoto Iwasa
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Wataru Ando
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Keisuke Uemura
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hidetoshi Hamada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaki Takao
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Nobuhiko Sugano
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
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23
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Dias RA, de Faria Cardoso C, Ghimouz R, Nono DA, Silva JA, Acuna J, Baltatu OC, Campos LA. Quantitative cardiac autonomic outcomes of hydrotherapy in women during the first stage of labor. Front Med (Lausanne) 2023; 9:987636. [PMID: 36660001 PMCID: PMC9844258 DOI: 10.3389/fmed.2022.987636] [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: 07/06/2022] [Accepted: 09/05/2022] [Indexed: 01/04/2023] Open
Abstract
Introduction Most hydrotherapy studies during childbirth report findings related to pain using a widespread set of subjective measures. In this study, ECG biomarkers as quantitative cardiac autonomic outcomes were used to assess the effects of warm shower hydrotherapy on laboring women during the first stage of labor. Methods This was a prospective single-blind cohort study on stage I delivering women. Their cardiac autonomic function was assessed using heart rate variability (HRV) measures during a deep breathing test using point-of-care testing comprised of an HRV scanner system with wireless ECG enabling real-time data analysis and visualization. Labor pain and anxiety were assessed using the Visual Analog Scale for Pain (VASP) and the Beck Anxiety Inventory (BAI). A total of 105 pregnant women in the first stage of labor who received warm shower hydrotherapy, intravenous analgesia (scopolamine + sodium dipyrone), or spinal anesthetic (bupivacaine + morphine) were enrolled. Results In women during the first stage of labor, parasympathetic modulation reflected through RMSSD (root mean square of successive RR interval differences) was significantly reduced by hydrotherapy and intravenous analgesia (before vs. after mean rank diff. 35.73 and 65.93, respectively, p < 0.05). Overall HRV (SDNN, standard deviation of RR intervals) was significantly decreased only by intravenous analgesia (before vs. after mean rank diff. 65.43, p < 0.001). Mean heart rate was significantly increased by intravenous analgesia, while spinal anesthesia reduced it, and hydrotherapy did not alter it (before vs. after mean rank diff. -49.35*, 70.38*, -24.20 NS , respectively, *p < 0.05, NS not significant). Conclusion This study demonstrates that warm shower therapy may impact the sympathovagal balance via parasympathetic withdrawal in women during the initial stage of labor. The findings of this study provide quantitative support for using warm shower hydrotherapy during labor via point-of-care testing. The dependability of hydrotherapy as a non-pharmacological treatment is linked to the completion of more clinical research demonstrating quantitative evidence via outcome biomarkers to support indications on stress and birth progress.
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Affiliation(s)
- Raquel Aparecida Dias
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil
| | - Cláudia de Faria Cardoso
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil
| | - Rym Ghimouz
- Fatima College of Health Sciences, Abu Dhabi, United Arab Emirates
| | - Daniel Alessander Nono
- Center for Special Technologies, National Institute for Space Research (INPE), São José dos Campos, Brazil
| | | | - Juan Acuna
- Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil,Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates,*Correspondence: Ovidiu Constantin Baltatu,
| | - Luciana Aparecida Campos
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil,Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates,Luciana Aparecida Campos,
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24
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Semi-occlusive dressing therapy versus surgical treatment in fingertip amputation injuries: a clinical study. Eur J Trauma Emerg Surg 2022; 49:1441-1447. [DOI: 10.1007/s00068-022-02193-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
Abstract
Objectives
Treatment of fingertip amputations is subject of controversial debates. Recently, semi-occlusive dressings have increased in popularity in these injuries.
Aims
To compare clinical outcomes of conservative semi-occlusive dressing therapy versus surgical treatment of fingertip amputations.
Methods
Eighty-four patients with fingertip amputations were re-examined clinically after a mean follow-up of 28.1 months (range 9.6–46.2). Sixty-six patients (79%) were treated with semi-occlusive dressings (group 1) and 18 (21%) underwent surgery (group 2). Range of motion, grip strength, and two-point discrimination were measured at the final follow-up. Furthermore, VAS score, Quick-DASH score, subjective aesthetic outcome and loss of working days were obtained.
Results
Group 1 demonstrated healing in all 66 patients (100%) while in Group 2 5 out of 18 patients (28%) failed to achieve healing after a mean of 17 days (range 2–38) due to graft necrosis. Group 1 showed significantly lower VAS scores and significantly lower loss of two-point discrimination compared to Group 2. Work absence was significantly shorter in Group 1 versus Group 2. Trophic changes in finger (46%) and nail (30%) were significantly lower in Group 1 compared to Group 2 (44% and 70%, respectively). Disturbance during daily business activities (14%) and cold sensitivity (23%) were significantly lower in Group 1 compared to Group 2 (86% and 77%, respectively).
Conclusions
Semi-occlusive dressing therapy for fingertip amputations demonstrated excellent healing rates. Compared to surgical treatment, it resulted in significantly better clinical outcomes, lower complication rates and significantly higher reported satisfaction rates. Therefore, semi-occlusive dressing for fingertip injuries is a very successful procedure and shall be preferred over surgical treatment in most cases.
Level of evidence
III therapeutic.
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25
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Ulivi M, Meroni V, Viganò M, Colombini A, Lombardo MDM, Rossi N, Orlandini L, Messina C, Sconfienza LM, Peretti GM, Mangiavini L, de Girolamo L. Micro-fragmented adipose tissue (mFAT) associated with arthroscopic debridement provides functional improvement in knee osteoarthritis: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2022:10.1007/s00167-022-07101-4. [PMID: 36040510 PMCID: PMC9424810 DOI: 10.1007/s00167-022-07101-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/30/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE Current conservative treatments for knee OA provide limited benefits, with symptoms relief for a short amount of time. Regenerative medicine approaches such as the use of microfragmented adipose tissue (mFAT) showed promising results in terms of durable effects and the possibility to enhance tissue healing and counteract the progression of the pathology. Nevertheless, up to today, the large part of clinical data about mFAT use refers to uncontrolled studies, especially in the surgical setting. The purpose of this study was to evaluate the effectiveness of mFAT applied in association with arthroscopic debridement (AD) for the treatment of knee OA, in terms of symptoms relief and tissue healing. METHODS This study is a prospective, randomized controlled clinical trial. 78 patients affected by knee OA grade 3-4 according to KL classification were randomly assigned to AD or AD + mFAT treatment groups. Clinical, radiological and serological assessments were performed at 6 months after treatment. Additional clinical evaluation was performed at the end of the study with an average follow-up of 26.1 ± 9.5 months. VAS, KOOS, WOMAC and SF-12 were also collected at both timepoints, KSS only at 6 months. RESULTS Treatment with AD + mFAT improved functional scores at both 6 months (KOOS-PS: + 11.7 ± 20.2 vs + 24.4 ± 22.5, in AD and AD + mFAT, respectively, p = 0.024; KSS: + 14.9 ± 15.9 vs + 24.8 ± 23.5, in AD and AD + mFAT, respectively, p = 0.046) and 24-month follow-ups (KOOS-PS Functional subscale: - 2.0 ± 3.5 vs - 4.7 ± 4.2, in AD and AD + mFAT, respectively, p = 0.012). Lower T2-mapping scores were obtained in AD + mFAT-treated group in medial and lateral condyle compartments (p < 0.001). Slight increase was observed in the levels of a serum biomarker of cartilage deposition (PIIINP) in both groups at 6-month follow-up (p = 0.037). CONCLUSION mFAT improves functional outcome and MRI appearance when used in association with AD, therefore supporting its use in the treatment of knee OA in an arthroscopic setting.
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Affiliation(s)
- Michele Ulivi
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Valentina Meroni
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Marco Viganò
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy
| | | | - Michele D. M. Lombardo
- Residency Program in Orthopedics and Traumatology, University of Milan, via Festa del Perdono 7, 20122 Milan, Italy
| | - Nicolò Rossi
- Residency Program in Orthopedics and Traumatology, University of Milan, via Festa del Perdono 7, 20122 Milan, Italy
| | - Luca Orlandini
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy ,Department of Biomedical Sciences for Health, University of Milan, Via Luigi Mangiagalli, 31, 20133 Milan, Italy
| | - Luca M. Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy ,Department of Biomedical Sciences for Health, University of Milan, Via Luigi Mangiagalli, 31, 20133 Milan, Italy
| | - Giuseppe M. Peretti
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy ,Department of Biomedical Sciences for Health, University of Milan, Via Luigi Mangiagalli, 31, 20133 Milan, Italy
| | - Laura Mangiavini
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161, Milan, Italy. .,Department of Biomedical Sciences for Health, University of Milan, Via Luigi Mangiagalli, 31, 20133, Milan, Italy.
| | - Laura de Girolamo
- IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161 Milan, Italy
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Li AC, Wong KK, Chio FH, Mak WW, Poon LW. Delivering Mindfulness-Based Interventions for Insomnia, Pain, and Dysfunctional Eating Through a Text Messaging App: Three Randomized Controlled Trials Investigating the Effectiveness and Mediating Mechanisms. J Med Internet Res 2022; 24:e30073. [PMID: 35503653 PMCID: PMC9115660 DOI: 10.2196/30073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 02/09/2022] [Accepted: 02/24/2022] [Indexed: 01/16/2023] Open
Abstract
Background Although text messaging has the potential to be the core intervention modality, it is often used as an adjunct only. To improve health and alleviate the distress related to insomnia, pain, and dysregulated eating of people living in urban areas, text messaging–based mindfulness-based interventions were designed and evaluated in 3 randomized controlled trials. Objective This study investigated the effectiveness and mediating mechanisms of text messaging–based mindfulness-based interventions for people with distress related to insomnia, pain, or dysregulated eating. Methods In these trials, 333, 235, and 351 participants were recruited online and randomized to intervention and wait-list control conditions for insomnia, pain, and dysregulated eating, respectively. Participants experienced 21 days of intervention through WhatsApp Messenger. Participants completed pre-, post-, 1-month follow-up, and 3-month follow-up self-report questionnaires online. The retention rates at postmeasurements were 83.2% (139/167), 77.1% (91/118), and 72.9% (129/177) for intervention groups of insomnia, pain, and dysregulated eating, respectively. Participants’ queries were answered by a study technician. Primary outcomes included insomnia severity, presleep arousal, pain intensity, pain acceptance, and eating behaviors. Secondary outcomes included mindfulness, depression, anxiety, mental well-being, and functional impairments. Mindfulness, dysfunctional beliefs and attitudes about sleep, pain catastrophizing, and reactivity to food cues were hypothesized to mediate the relationship between the intervention and outcomes. Results For all 3 studies, the intervention groups showed significant improvement on most outcomes at 1-month follow-up compared to their respective wait-list control groups; some primary outcomes (eg, insomnia, pain, dysregulated eating indicators) and secondary outcomes (eg, depression, anxiety symptoms) were sustained at 3-month follow-up. Medium-to-large effect sizes were found at postassessments in most outcomes in all studies. In the intervention for insomnia, mediation analyses showed that dysfunctional beliefs and attitudes about sleep mediated the effect of the intervention on all primary outcomes and most secondary outcomes at both 1-month and 3-month follow-ups, whereas mindfulness mediated the intervention effect on presleep arousal at 1-month and 3-month follow-ups. In the intervention for pain, pain catastrophizing mediated the effect of intervention on pain intensity and functioning at both 1-month and 3-month follow-ups, whereas mindfulness only mediated the effect of intervention on anxiety and depressive symptoms. In the intervention for dysregulated eating, power of food mediated the effect of intervention on both uncontrolled and emotional eating at both 1-month and 3-month follow-ups and mindfulness was found to mediate the effect on depressive symptoms at both 1-month and 3-month follow-ups. Conclusions These 3 studies converged and provided empirical evidence that mindfulness-based interventions delivered through text messaging are effective in improving distress related to sleep, pain, and dysregulated eating. Text messaging has the potential to be a core intervention modality to improve various common health outcomes for people living a fast-paced lifestyle. Trial Registration Clinical Research and Biostatistics Clinical Trials Registry CUHK_CCRB00559; https://tinyurl.com/24rkwarz
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Affiliation(s)
- Amanda Cm Li
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Keith Kl Wong
- Clinical Psychological Services, New Life Psychiatric Rehabilitation Association, Hong Kong, Hong Kong
| | - Floria Hn Chio
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong
| | - Winnie Ws Mak
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Loretta Wh Poon
- newlife.330, New Life Psychiatric Rehabilitation Association, Hong Kong, Hong Kong
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Baamer RM, Iqbal A, Lobo DN, Knaggs RD, Levy NA, Toh LS. Utility of unidimensional and functional pain assessment tools in adult postoperative patients: a systematic review. Br J Anaesth 2022; 128:874-888. [PMID: 34996588 PMCID: PMC9074792 DOI: 10.1016/j.bja.2021.11.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/18/2021] [Accepted: 11/03/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND We aimed to appraise the evidence relating to the measurement properties of unidimensional tools to quantify pain after surgery. Furthermore, we wished to identify the tools used to assess interference of pain with functional recovery. METHODS Four electronic sources (MEDLINE, Embase, CINAHL, PsycINFO) were searched in August 2020. Two reviewers independently screened articles and assessed risk of bias using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. RESULTS Thirty-one studies with a total of 12 498 participants were included. Most of the studies failed to meet the methodological quality standards required by COSMIN. Studies of unidimensional assessment tools were underpinned by low-quality evidence for reliability (five studies), and responsiveness (seven studies). Convergent validity was the most studied property (13 studies) with moderate to high correlation ranging from 0.5 to 0.9 between unidimensional tools. Interpretability results were available only for the visual analogue scale (seven studies) and numerical rating scale (four studies). Studies on functional assessment tools were scarce; only one study included an 'Objective Pain Score,' a tool assessing pain interference with respiratory function, and it had low-quality for convergent validity. CONCLUSIONS This systematic review challenges the validity and reliability of unidimensional tools in adult patients after surgery. We found no evidence that any one unidimensional tool has superior measurement properties in assessing postoperative pain. In addition, because promoting function is a crucial perioperative goal, psychometric validation studies of functional pain assessment tools are needed to improve pain assessment and management. CLINICAL TRIAL REGISTRATION PROSPERO CRD42020213495.
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Affiliation(s)
- Reham M Baamer
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK; Pharmacy Practice Department, Faculty of Pharmacy, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Ayesha Iqbal
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Dileep N Lobo
- Nottingham Digestive Diseases Centre, National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, UK; MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
| | - Roger D Knaggs
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK; Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Nicholas A Levy
- Department of Anaesthesia and Perioperative Medicine, West Suffolk Hospital NHS Foundation Trust, Bury St. Edmunds, UK
| | - Li S Toh
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK
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Hug NF, Smith BW, Sakamuri S, Jensen M, Purger DA, Spinner RJ, Wilson TJ. Research reporting in cubital tunnel syndrome studies: an analysis of the literature. Acta Neurochir (Wien) 2022; 164:1337-1345. [PMID: 34993620 DOI: 10.1007/s00701-021-05102-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/23/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE There is a strong need for a set of consensus outcomes to be utilized for future studies on cubital tunnel syndrome. The goal was to assess the outcome measures utilized in the cubital tunnel syndrome literature as a way of measuring popularity/acceptability and then to perform a literature review for the most commonly used outcomes. METHODS A literature search was performed using the pubmed.gov database and Medical Subject Headings (MeSH). For each article, the following data were abstracted: study type, motor outcome(s), sensory outcome(s), composite outcome(s), patient-reported outcome (PRO) metric(s), pain outcome(s), psychological outcome(s), electrodiagnostic outcome(s), and any other outcomes that were used. RESULTS A composite outcome was reported in 52/85 (61%) studies, with the modified Bishop score (27/85; 32%) most common. A motor outcome was reported in 44/85 (52%) studies, with dynamometry (38/85; 45%) most common. The majority of studies (55%) did not report a sensory outcome. The majority of studies (52%) did not report a PRO. A specific pain outcome was reported in the minority (23/85; 27%), with the visual analogue scale (VAS) (22/85; 26%) most common. Pre- and postoperative electrodiagnostic results were presented in 22/85 studies (26%). DISCUSSION Understanding current clinical practice and historical outcomes reporting provides a foundation for discussion regarding the development of a core outcome set for cubital tunnel syndrome. We hope that the data provided in the current study will stoke a discussion that will culminate in a consensus statement for research reporting in cubital tunnel syndrome studies.
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Foizer GA, Paiva VCD, Nascimento RDD, Gorios C, Cliquet Júnior A, Miranda JBD. Is There Any Association between the Severity of Disc Degeneration and Low Back Pain? Rev Bras Ortop 2022; 57:334-340. [PMID: 35652022 PMCID: PMC9142238 DOI: 10.1055/s-0041-1735831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 04/07/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To access the possibility that higher degrees of disc degeneration lead to higher levels of pain and dysfunction. Methods Magnetic resonance imaging (MRI) scans of 85 patients with low back pain lasting for more than 12 weeks were evaluated, and the degree of disc degeneration was quantified according to the Pfirrmann grading system. The Pfirrmann degree in each disc space from L1-L2 to L5-S1, the maximum degree of Pfirrmann (Pfirrmann-max) between the lumbar discs, and the sum of Pfirrmann (Pfirrmann-sum) degrees were correlated (through the Spearman test) with the Oswestry Disability Index (ODI) and the Visual Analogical Scale (VAS) for pain. Results In total, 87% of the patients had moderate to severe lumbar disc degeneration measured by Pfirrmann-max, and the most degenerated discs were L4-L5 and L5-S1. There was a week to moderate correlation regarding the Pfirrmann-max (r = 0,330; p = 0.002) and the Pfirrmann-sum (r = 0,266; p = 0,037) and the ODI, and the Pfirrmann scores in L1-L2 were correlated with the ODI and the VAS. Conclusion Patients with chronic idiopathic low back pain frequently have moderate to severe lumbar disc degeneration, which has a negative impact on the quality of life of the patients. Low degrees of degeneration in L1-L2 might be related with higher degrees of pain and of functional disability.
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Affiliation(s)
- Guilherme Augusto Foizer
- Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
- Ambulatório de Coluna Vertebral, Hospital Geral de Carapicuíba, São Paulo, SP, Brazil
| | | | | | - Carlos Gorios
- Ambulatório de Coluna Vertebral, Hospital Geral de Carapicuíba, São Paulo, SP, Brazil
| | - Alberto Cliquet Júnior
- Departamento de Ortopedia, Reumatologia e Traumatologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
| | - João Batista de Miranda
- Departamento de Ortopedia, Reumatologia e Traumatologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
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Mårtensson LB, Gunnarsson BM, Karlsson S, Lee N, Bergh I. Effect of topical local anaesthesia on injection pain associated with administration of sterile water injections - a randomized controlled trial. BMC Anesthesiol 2022; 22:35. [PMID: 35105307 PMCID: PMC8805377 DOI: 10.1186/s12871-022-01573-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/10/2022] [Indexed: 12/18/2022] Open
Abstract
Background Sterile water injections can provide effective pain relief during childbirth, particularly for low back pain related to childbirth. However, the pain associated administering the injections can negatively impact women’s impressions of the procedure. It may discourage women from considering repeat doses despite the quality of analgesia experienced. Determining strategies to reduce the pain related to the administration of sterile water injections would improve the acceptability of the technique. Therefore, the aim of this study was to evaluate the effect of topical local anesthesia on the pain associated with administration of sterile water injections. Methods The study was designed as a multi-arm single-blind, randomized, controlled trial and 120 female healthy students were randomly divided according to one of four groups. The Intervention group received sterile water injections with topical local anesthesia. Control group 1 received sterile water injections without topical local anesthesia, control group 2 received injections of isotonic saline 0.9% with topical local anesthesia and control group 3 received injections of isotonic saline 0.9% without topical local anesthesia. Pain Immediately after the injections and subsidence in pain were recorded using a visual analogue scale. Sensations in the injection area were reported 15 min and the day after the injections. Results The main finding of this study was that local anesthesia with EMLA® reduces the pain associated with the administration of intracutaneous sterile water injections. There was a significant difference in the self-assessed pain score immediately following the injections between the control (73.3 mm) and intervention groups (50.0 mm), p = 0.001. No adverse side effects were reported. Conclusion Local anesthesia with EMLA® reduces the pain associated with intracutaneous administration of sterile water injections. Trial registration The study was registered 08/07/2014 at ClinicalTrials.gov Identifier: NCT02213185.
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Affiliation(s)
- Lena B Mårtensson
- School of Health Sciences, University of Skövde, P.O. Box 408, SE-541 28, Skövde, Sweden. .,School of Nursing, Midwifery and Social Work University of Queensland, Chamberlain Building, University of Queensland,, St Lucia, Queensland, 4072, Australia.
| | - Britt-Marie Gunnarsson
- School of Health Sciences, University of Skövde, P.O. Box 408, SE-541 28, Skövde, Sweden
| | - Sandra Karlsson
- School of Health and Welfare, Jönköping University, P.O. Box 1026, SE-551 11, Jönköping, Sweden
| | - Nigel Lee
- School of Nursing, Midwifery and Social Work University of Queensland, Chamberlain Building, University of Queensland,, St Lucia, Queensland, 4072, Australia
| | - Ingrid Bergh
- School of Health Sciences, University of Skövde, P.O. Box 408, SE-541 28, Skövde, Sweden
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Lian L, Wang JX, Xu YC, Zong HX, Teng YZ, Xu SQ. Sarcopenia May Be a Risk Factor for Osteoporosis in Chinese Patients with Rheumatoid Arthritis. Int J Gen Med 2022; 15:2075-2085. [PMID: 35237070 PMCID: PMC8882659 DOI: 10.2147/ijgm.s349435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/16/2022] [Indexed: 12/19/2022] Open
Abstract
Purpose Osteoporosis (OP) has been classically considered a co-morbidity of rheumatoid arthritis (RA). This investigation determined the clinical significance of sarcopenia in patients with RA combined with OP or whether sarcopenia influences RA when combined with OP. Materials and Methods Data pertaining to the duration of RA, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) were collected from 549 RA cases and 158 healthy individuals. Disease activity score at 28 joints (DAS28), the body mass index (BMI), health assessment questionnaire (HAQ), bone mineral density (BMD), and Sharp score were compared between the 2 groups. Results The prevalence of OP (33.3% vs 12.7%, χ2= 69.992, P < 0.0001) and sarcopenia (61.7% vs 9.0%, χ2= 135.336, P < 0.01) was greater in patients with RA than in healthy controls. RA patients with sarcopenia had a higher incidence of OP at all measured sites than RA patients without sarcopenia (all P < 0.0001), and the incidence of OP was significantly higher than in patients with mild-to-moderate or severe RA without sarcopenia (P < 0.0001). Differences in age, gender, course of disease, CRP level, ESR, DAS28, BMI, HAQ, BMD, and Sharp score were statistically different between the RA with or without sarcopenia groups (P < 0.01). The incidence of OP and sarcopenia was higher in RA patients treated than not treated with glucocorticoids [GCs] (36.4% vs 29.3%, P < 0.05 and 66.1% vs 56.0%, respectively; P < 0.05). Logistic regression showed that the risk factors for OP in RA individuals were female (OR, 14.671; 95% CI, 6.877–31.300; P < 0.0001), age (OR, 1.100; 95% CI, 1.076–1.124; P < 0.0001), and sarcopenia (OR, 3.561; 95% CI, 2.214–5.726; P < 0.0001). Conclusion OP and sarcopenia are common in RA patients. Sarcopenia may be a risk factor for OP occurrence in Chinese patients with RA.
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Affiliation(s)
- Li Lian
- Department of Rheumatology & Immunology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, People’s Republic of China
| | - Jian-Xiong Wang
- Department of Rheumatology & Immunology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, People’s Republic of China
| | - Yue-Chen Xu
- Anhui Medical University, Hefei, 230032, Anhui, People’s Republic of China
| | - He-Xiang Zong
- Department of Rheumatology & Immunology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, People’s Republic of China
| | - Yu-Zhu Teng
- Department of Rheumatology & Immunology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, People’s Republic of China
| | - Sheng-Qian Xu
- Department of Rheumatology & Immunology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, People’s Republic of China
- Correspondence: Sheng-Qian Xu, Department of Rheumatology & Immunology, the first Affiliated Hospital of Anhui Medical University, No. 218, Ji-xi Road, Hefei, 230022, Anhui, People’s Republic of China, Tel/Fax +86 551 62922262, Email
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Liu Y, Zhang C, Wu J, Yu H, Xie C. Evaluation of the relationship among dental fear, scaling and root planing and periodontal status using periodontitis stages: A retrospective study. J Dent Sci 2022; 17:293-299. [PMID: 35028050 PMCID: PMC8739248 DOI: 10.1016/j.jds.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/01/2021] [Indexed: 12/20/2022] Open
Abstract
Background/purpose Patients with periodontal disease have higher dental fear levels, which may have negative effects on their clinical outcome during scaling and root planing (SRP). The present study used the new classification of periodontitis and validated questionnaires to assess the relationship among dental fear, SRP pain and periodontal status. Materials and methods A total of 120 periodontitis patients were enrolled and staging according to the new classification of periodontitis. SRP was performed, and the visual analog scale (VAS) to assess pain was used with every patient after treatment. Questionnaires, including Corah's Dental Anxiety Scale (DAS), Dental Fear Survey (DFS), and short-form Dental Anxiety Inventory (S-DAI) were implemented from the first attendance and subsequent visits after 6 months. The patients were grouped by DAS scores. The statistical analysis was performed using T-test, chi-square, Pearson and Spearman correlative analysis. Results Compared to pre-SRP treatment, the dental fear level on DFS was decreased in the posttreatment period for all periodontitis stages. There were no statistically significant differences in S-DAI and DAS between pretreatment and posttreatment periods in stage I and II; meanwhile, there were statistically differences in stage III and IV. The correlation among periodontitis stages, VAS and dental fear level was significant. The proportion of high periodontitis stages was increased in high dental fear group. Conclusion SRP can reduce dental fear levels in all periodontitis stages, especially in stage III and IV. Correlations exist among periodontal status, dental fear and SRP pain. High dental fear is associated with poor periodontal status.
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Affiliation(s)
- Yeungyeung Liu
- Department of Periodontology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Caimei Zhang
- Department of Endodontics, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Jingyi Wu
- Department of Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Huimin Yu
- Department of Periodontology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Chengjie Xie
- Department of Periodontology, Stomatological Hospital, Southern Medical University, Guangzhou, China
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Influence of the Amount of Change in Quadriceps Tendon Young’s Modulus on Amount of Change in Walking Speed before and after Total Knee Arthroplasty. Medicina (B Aires) 2021; 57:medicina57121329. [PMID: 34946274 PMCID: PMC8705036 DOI: 10.3390/medicina57121329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives: Walking speed after total knee arthroplasty (TKA) is an important outcome. However, the effect of quadriceps tendon stiffness on walking speed remains unclear. This study aimed to clarify the influence of the amount of change in quadriceps tendon stiffness on the degree of change in walking speed before and after TKA. Materials and Methods: Sixteen patients who underwent TKA for knee osteoarthritis participated in this study (median age: 74.0 years (interquartile range: 64.5–75.8)). Shear-wave elastography was deployed to measure quadriceps tendon stiffness using Young’s modulus. A motion analysis system was used to assess kinematic parameters and walking speed. Participants’ knee circumference, range of motion, extension strength, one-leg standing time, walking pain level, and activity level were measured preoperatively and one year after TKA, and changes in values were calculated. We used path analysis to clarify the influence of the amount of change in the quadriceps tendon Young’s modulus on the change in walking speed. Results: The quadriceps tendon Young’s modulus negatively affected the knee flexion angle during swing (standardized partial regression coefficients (β) = −0.513, p = 0.042). The knee flexion angle during swing positively affected step length (β = 0.586, p = 0.017). Step length positively affected cadence (β = 0.733, p = 0.001). Step length and cadence positively affected walking speed (β = 0.563, p < 0.001, β = 0.502, p < 0.001, respectively). Conclusions: The amount of change in the quadriceps tendon Young’s modulus may affect the degree of change in walking speed after TKA through the amount of change in the knee flexion angle during swing, step length, and cadence. Clinically, reducing quadriceps tendon stiffness can be addressed in rehabilitation programs to increase walking speed after TKA.
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Torrekens M, Vanmierlo B, Van Isacker T. The effectiveness of a Botulinum Toxin A infiltration in the management of bicipital cramps after arthroscopic biceps tenotomy. Acta Orthop Belg 2021; 87:765-769. [PMID: 35172446 DOI: 10.52628/87.4.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A challenging complication of arthroscopic biceps surgery is the persistent painful cramping of the biceps. There is a paucity of data upon nonsurgical treatment of this debilitating complication. We pro- pose an intramuscular injection of botulinum toxin A (BTX-A) for painful bicipital cramping after tenotomy of the long head of the biceps brachii tendon (LHBT). Ten patients with a painful Popeye sign after tenotomy of LHBT, were treated with intramuscular injection of 100 IU of BTX-A. Mean patient age was 56 years and mean time from surgery to infiltration was 317 days. The Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score was obtained. Pain was objectified by a visual analogue scale (VAS). Patient satisfaction was described as excellent, good, satisfactory, or poor, three and six months after injection. Mean VAS prior to infiltration was 6.8 and decreased significantly to 2.6 at follow-up. Mean QuickDash was 54.04 prior to infiltration and decreased to 19.84 at follow-up. Patient satisfaction was excellent in 9 and good in 1 patient. We report a significant pain reduction and functional improvement following BTX-A infiltration as treatment of painful bicipital cramping after tenotomy of LHBT.
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Sit MT, Schmidt TW, Edmonds LD, Kelly JA, Sky KM, Thornton JA, McNeary-Garvin AM, Thom SR, Slade JB. The Effects of Hyperbaric Oxygen on Rheumatoid Arthritis: A Pilot Study. J Clin Rheumatol 2021; 27:e462-e468. [PMID: 32947434 DOI: 10.1097/rhu.0000000000001540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND/OBJECTIVE This case series pilot study assessed the effects of hyperbaric oxygen therapy (HBO2) for treating rheumatoid arthritis (RA). METHODS Ten RA subjects received 30 HBO2 treatments over 6 to 10 weeks. Serial rheumatologic evaluations (ie, the Disease Activity Scale [DAS28], the Routine Assessment of Patient Index Data 3, and the Pain and Sleep Quality Questionnaire) were completed at baseline, throughout the course of the study, and at the 6-month follow-up. RESULTS There was a statistically significant effect of HBO2 therapy over time on the DAS28-Global Health (p = 0.01), the DAS28-C-reactive protein (p = 0.002), and the DAS28-erythrocyte sedimentation rate (p = 0.008) measures; these analyses excluded 2 patients who were in clinical remission at baseline. Selected post hoc comparisons showed significantly lower DAS28-Global Health, DAS28-C-reactive protein, and DAS28-erythrocyte sedimentation rate scores at 3 and 6 months relative to baseline. In addition, statistically significant decreases in pain as measured by the Routine Assessment of Patient Index Data 3 and Pain and Sleep Quality Questionnaire were observed at the end of HBO2 relative to baseline. CONCLUSIONS Hyperbaric oxygen therapy is effective for joint pain in patients with RA based on data from multiple, validated clinical measures. Further research with more subjects and the use of a control group is necessary.
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Affiliation(s)
- Michelle T Sit
- From the David Grant USAF Medical Center, Travis Air Force Base, CA
| | | | - Lance D Edmonds
- From the David Grant USAF Medical Center, Travis Air Force Base, CA
| | - Jason A Kelly
- Hyperbaric Medicine Department, David Grant USAF Medical Center, Travis Air Force Base
| | | | - Jennifer A Thornton
- Hyperbaric Medicine Department, David Grant USAF Medical Center, Travis Air Force Base
| | | | - Stephen R Thom
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - John B Slade
- Hyperbaric Medicine Department, David Grant USAF Medical Center, Travis Air Force Base
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Yue B, Wang Y, Zhang C, Ding Y, Liu Z. Efficacy of Shaobei injection in the treatment of grade II-III hemorrhoids and the effect on fibulin protein expression: A study protocol of a randomized controlled trial. Medicine (Baltimore) 2021; 100:e27706. [PMID: 34797296 PMCID: PMC8601367 DOI: 10.1097/md.0000000000027706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 10/21/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Hemorrhoids are a common and seriously disruptive condition that seriously affects people's lives in terms of treatment. Injection therapy is an effective minimally invasive scheme for the treatment of grade II-III hemorrhoids, but its clinical application is limited by the adverse reactions caused by injection drugs. Some clinical studies have confirmed the efficacy and safety of Shaobei injection as a traditional Chinese medicine extract. However, there is no standard randomized controlled study to verify its efficacy and explore its potential mechanism. METHODS This is a prospective, randomized, single blind, parallel controlled trial to study the efficacy of Shaobei injection in the treatment of grade II-III hemorrhoids and its effect on the expression of fibulin-3 and fibulin-5 in fibulin protein family. The patients will be randomly divided into a treatment group and control group. The treatment group will be treated with Shaobei injection, and the control group will be treated with rubber band ligation. The observation indexes include: visual analysis scale, postoperative hospital stay, total use of painkillers, fibulin-3 and fibulin-5, hemorrhoids recurrence, and adverse events. Finally, the data will be statistically analyzed by SPASS 18.0 software. DISCUSSION This study will compare the efficacy of Shaobei injection with the rubber band ligation method in the treatment of grade II-III haemorrhoids and investigate its effect on the expression of fibulin-3 and fibulin-5 in the fibulin protein family. The results of this study will provide a basis for the clinical use of Paeoniflora injection as an alternative to traditional sclerosing agent in the treatment of grade II-III haemorrhoids.Trial registration: OSF Registration number:DOI 10.17605/OSF.IO/MKVDB.
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Affiliation(s)
- Bin Yue
- Shenyang Coloproctology Hospital, Shenyang City, Liaoning Province, China
| | - Yangang Wang
- Weifang People's Hospital, Weifang, Shandong Province, China
| | - Chunxia Zhang
- Shenyang Coloproctology Hospital, Shenyang City, Liaoning Province, China
| | - Yunlong Ding
- Weifang People's Hospital, Weifang, Shandong Province, China
| | - Zhipeng Liu
- Weifang People's Hospital, Weifang, Shandong Province, China
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Ebihara B, Mutsuzaki H, Fukaya T, Iwai K. Interpretation of causal relationship between quadriceps tendon Young's modulus and gait speed by structural equation modeling in patients with severe knee osteoarthritis. J Orthop Surg (Hong Kong) 2021; 29:23094990211034003. [PMID: 34355609 DOI: 10.1177/23094990211034003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To clarify the causal relationship between quadriceps tendon stiffness and gait speed in patients with severe knee osteoarthritis (OA) using structural equation modeling. METHODS Participants were 36 patients with knee OA (median age, 75.0 [interquartile range, 67.3-76.0] years; Kellgren-Lawrence grade 3 or 4). We measured quadriceps tendon stiffness using Young's modulus by ShearWave Elastography. Gait speed and kinematics parameters were measured using a motion analysis system. Additional data collected for each patient included age, sex, height, body weight, body mass index, femorotibial angle, knee range of motion, knee extension torque, and pain. We performed structural equation modeling for interpretation of the causal relationship. RESULTS The comparative fit index of the structural equation modeling was 0.990. Quadriceps tendon Young's modulus was a predictor of maximum knee flexion angle during the swing phase (standardized partial regression coefficients [β] = -0.67, P < 0.001). Maximum knee flexion angle during the swing phase was a predictor of cadence and step length (β values 0.35 and 0.55, P = 0.035 and <0.001, respectively). Cadence and step length were predictors of gait speed (β values 0.50 and 0.63, P < 0.001 and <0.001, respectively). CONCLUSION Our results showed a causal relationship between quadriceps tendon stiffness and gait speed in patients with severe knee OA. Quadriceps tendon Young's modulus can affect gait speed through the maximum knee flexion angle during the swing phase, cadence, and step length. Adding therapeutic intervention to decrease the quadriceps tendon Young's modulus may lead to increased gait speed.
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Affiliation(s)
- Bungo Ebihara
- Graduate School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Inashiki-gun, Ibaraki, Japan.,Department of Rehabilitation, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
| | - Hirotaka Mutsuzaki
- Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences, Inashiki-gun, Ibaraki, Japan
| | - Takashi Fukaya
- Department of Physical Therapy, Faculty of Health Sciences, Tsukuba International University, Tsuchiura, Ibaraki, Japan
| | - Koichi Iwai
- Center for Humanities and Sciences, Ibaraki Prefectural University of Health Sciences, Inashiki-gun, Ibaraki, Japan
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Sugawara AT, Lima MDC, Dias CB. Predictive factors of response in radial Extracorporeal Shock-waves Therapy for Myofascial and Articular Pain: A retrospective cohort study. J Back Musculoskelet Rehabil 2021; 34:485-490. [PMID: 33492278 DOI: 10.3233/bmr-200152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Myofascial Pain Syndrome causes disability in daily life activities and despite all efforts, it continues to be a challenge, perpetuating suffering, overloading services and costs. New treatment options need to be tested. OBJECTIVE We aimed to quantify the rESWT short-term analgesic effect and identify the predictors of success through comparing results achieved in MPS and Articular Pain (AP). METHOD Retrospective cohort study of 1,580 patients with Myofascial Pain Syndrome or Articular Pain underwent two weekly radial Extracorporeal Shock-wave Therapy sessions. The pain intensity was measured by Visual Analog Scale before and one week after the end of the treatment (3 weeks). RESULTS The therapy decreases pain by 62.50% (p< 0.0001), with a high success rate (91.59%) and a low worsening of baseline conditions rate (2.1%). The best recommendation is for patients with intense myofascial pain (Visual Analog Scale ⩾ 70 mm), using high shock-wave frequency (⩾ 15 Hz). CONCLUSIONS Two rESWT sessions promote pain relief, with a high success rate and low rates of treatment abandonment and worsening. The best results are obtained in myofascial pain patients with high pain intensity, treated with high-frequency dosage.
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Affiliation(s)
- André Tadeu Sugawara
- Department of Physical and Rehabilitation Medicine, Hospital do Servidor Publico Estadual, Sao Paulo, Brazil
| | - Moises da Cunha Lima
- Department of Physical and Rehabilitation Medicine, Hospital do Servidor Publico Estadual, Sao Paulo, Brazil
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Tharion JG, Kale S. Patient Satisfaction Through an Immersive Experience Using a Mobile Phone-Based Head-Mounted Display During Arthroscopic Knee Surgery Under Spinal Anesthesia: A Randomized Clinical Trial. Anesth Analg 2021; 133:940-948. [PMID: 34283040 DOI: 10.1213/ane.0000000000005666] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Patient satisfaction is an important element of high-quality health care. Virtual reality has been studied for its sedative and analgesic effects, as it immerses the patient into an artificial interactive environment. Deriving from this concept, we hypothesized that an immersive experience that engulfs the senses with noninteractive visual and auditory stimuli would have a positive effect on satisfaction and anxiety in patients undergoing spinal anesthesia. METHODS We enrolled and randomized 90 patients undergoing spinal anesthesia for arthroscopic knee surgery into an immersive experience arm and an intravenous midazolam sedation arm. The immersive experience was provided through a mobile phone-based head-mounted display showing binocular monoscopic video and noise-canceling headphones playing audio. The primary outcome measure was postoperative satisfaction, measured using a visual analog scale and compared using the Mann-Whitney U test; secondary outcomes included anxiety score (measured using the 6-item State-Trait Anxiety Inventory), hemodynamic stability, and additional sedative requirement. RESULTS The visual analog scale satisfaction score with immersive experience was significantly higher than with midazolam (median [interquartile range {IQR}] of 93 [82-98] and 80 [73-93], respectively, P = .004), with Hodges-Lehmann median difference estimate of 7 (95% confidence interval, 3-14). The change in anxiety scores from the preoperative to postoperative period between the groups was not significantly different (P = .08), with a Hodges-Lehmann median difference estimate of 3.3 (95% confidence interval, 0-6.7). All patients were hemodynamically stable, were without significant adverse events, and did not require additional sedatives. CONCLUSIONS We have found that an immersive experience is an effective and acceptable intraoperative alternative to pharmacological sedation in patients undergoing arthroscopic knee surgery under spinal anesthesia, with higher satisfaction levels and no detected difference in preoperative to postoperative anxiolytic effect.
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Affiliation(s)
- Joseph G Tharion
- From the Department of Anaesthesia, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Women's Sexual Health During the Pandemic of COVID-19: Declines in Sexual Function and Sexual Pleasure. CURRENT SEXUAL HEALTH REPORTS 2021; 13:76-88. [PMID: 34248426 PMCID: PMC8254666 DOI: 10.1007/s11930-021-00309-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 12/14/2022]
Abstract
Purpose of the Review The World Health Association declared COVID-19 a pandemic more than 1 year ago. We conducted a systematic review of the literature on the topic of women’s sexual health during the pandemic, with a focus on sexual function and sexual pleasure. Our aim is to describe current findings and to discuss implications for women’s sexual health during this period. Recent Findings Thirty-four articles, from 18 countries, were identified. These studies addressed topics ranging from individual aspects, such as cognitive, emotional, and personality factors affecting sexuality during the pandemic, to contextual factors, including relationship, childrearing, and employment status in this period. Summary Research identified a deterioration of women’s sexual function across countries, with an emphasis on sexual desire. Most studies found decreases in the frequency of sexual intercourse during the pandemic and increases in solitary sexual behavior. Many women also experienced declines in sexual satisfaction and relationship satisfaction. Findings suggested that gender inequalities contributed to lower indices of sexual function and satisfaction, and might have exacerbated the pleasure gap between men and women.
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Pei X, Song S, Li H, Lu D. Efficacy and safety of acupoint catgut embedding in treating postoperative pain of mixed hemorrhoids: A randomized controlled trial protocol. Medicine (Baltimore) 2021; 100:e25948. [PMID: 34106667 PMCID: PMC8133192 DOI: 10.1097/md.0000000000025948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Pain is a common complication after mixed hemorrhoids, which seriously affects the recovery of patients and prolongs the length of hospital stay. Acupoint catgut embedding has advantages in improving a variety of acute and chronic pain diseases, but there is still a lack of rigorous randomized controlled studies to verify its efficacy and safety in the treatment of postoperative pain of mixed hemorrhoids. Therefore, the purpose of this randomized controlled trial is to evaluate the clinical efficacy of acupoint catgut embedding in the treatment of postoperative pain of mixed hemorrhoids. METHODS This is a prospective randomized controlled trial to study the efficacy and safety of acupoint catgut embedding in the treatment of postoperative pain of mixed hemorrhoids. Approved by the clinical research ethics committee of our hospital, the patients were randomly divided into observation group and control group according to 1:1. The observation group received acupoint catgut embedding before the operation, while the control group received no special treatment. The efficacy and safety indexes were concerned after the operation, and the observation indexes included: resting state and visual analogue scale (VAS) score during defecation, postoperative hospitalization time, total amount of analgesic use, adverse reactions, etc. Finally, we carried on the data statistical analysis through the SPSS version 19.0. DISCUSSION This study will evaluate the efficacy and safety of acupoint catgut embedding in the treatment of postoperative pain of mixed hemorrhoids, and the results of this study will provide a new idea for the selection of postoperative analgesia for mixed hemorrhoids resection. TRIAL REGISTRATION OSF Registration number: DOI 10.17605/OSF.IO/T2ZGY.
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Affiliation(s)
- Xiaorui Pei
- Department of General Surgery, Tianjin TEDA Hospital
| | - Shijun Song
- Department of Hepatobiliary and Pancreatic Surgery, Tianjin Nankai Hospital, Tianjin, China
| | - Haotian Li
- Department of General Surgery, Tianjin TEDA Hospital
| | - Debao Lu
- Department of General Surgery, Tianjin TEDA Hospital
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Zhou Y, Wang W, Tian K, Huang H, Jia M. Efficacy and safety of electroacupuncture in treatment of cervical spondylosis: A protocol of randomized controlled trial. Medicine (Baltimore) 2021; 100:e25570. [PMID: 33950931 PMCID: PMC8104160 DOI: 10.1097/md.0000000000025570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Cervical Spondylotic radiculopathy (CSR) is the most common spinal degenerative disease. Its clinical manifestations are pain and numbness in the neck and arm and limitation of neck movement, which greatly affects the life and work of patients. Acupuncture and electroacupuncture are commonly used in China, the efficacy of acupuncture has been confirmed. Existing evidence shows that electroacupuncture seems to be better than acupuncture, but there is a lack of clinical research to directly compare the two. METHODS This is a prospective randomized controlled trial to compare the efficacy of electroacupuncture and acupuncture in the treatment of CSR and to explore the safety and potential mechanism of electroacupuncture in the treatment of CSR. Approved by the Clinical Research Ethics Committee of our hospital, the patients are randomly divided into an experimental group (electroacupuncture group) or control group (acupuncture group). The patients are followed up for 30 days after 4 weeks of treatment. Observation indexes included VAS score, Neck Disability Index, Yasuhisa Tanaka 20 Score Scale, adverse reactions and so on. Finally, the data will be analyzed by SPSS 18.0 software. DISCUSSION This study will directly compare the advantages and disadvantages of electroacupuncture and acupuncture in the treatment of CSR. The results of this study will help to guide patients with CSR to choose appropriate treatment. TRIAL REGISTRATION OSF Registration number: DOI 10.17605/OSF.IO/9MKPN.
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Affiliation(s)
| | - WenGang Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, China
| | - Ke Tian
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, China
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Holwerda SW, Holland MT, Green AL, Pearson ACS, Pierce GL. Dissociation between reduced pain and arterial blood pressure following epidural spinal cord stimulation in patients with chronic pain: A retrospective study. Clin Auton Res 2021; 31:303-316. [PMID: 32323062 PMCID: PMC8456508 DOI: 10.1007/s10286-020-00690-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/13/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Acute pain and resting arterial blood pressure (BP) are positively correlated in patients with chronic pain. However, it remains unclear whether treatment for chronic pain reduces BP. Therefore, in a retrospective study design, we tested the hypothesis that implantation of an epidural spinal cord stimulator (SCS) device to treat chronic pain would significantly reduce clinic pain ratings and BP and that these reductions would be significantly correlated. METHODS Pain ratings and BP in medical records were collected before and after surgical implantation of a SCS device at the University of Iowa Hospitals and Clinics between 2008 and 2018 (n = 213). RESULTS Reductions in pain rating [6.3 ± 2.0 vs. 5.0 ± 1.9 (scale: 0-10), P < 0.001] and BP [mean arterial pressure (MAP) 95 ± 10 vs. 89 ± 10 mmHg, P < 0.001] were statistically significant within 30 days of SCS. Interestingly, BP returned toward baseline within 60 days following SCS implantation. Multiple linear regression analysis showed that sex (P = 0.007), baseline MAP (P < 0.001), and taking hypertension (HTN) medications (P < 0.001) were significant determinants of change in MAP from baseline (Δ MAP) (model R2 = 0.33). After statistical adjustments, Δ MAP was significantly greater among women than among men ( - 7.2 ± 8.5 vs. - 3.9 ± 8.5 mmHg, P = 0.007) and among patients taking HTN medications than among those not taking hypertension medications ( - 10.1 ± 8.7 vs. - 3.9 ± 8.5 mmHg, P < 0.001), despite no group differences in change in pain ratings. CONCLUSIONS Together, these findings suggest that SCS for chronic pain independently produces clinically meaningful, albeit transient, reductions in BP and may provide a rationale for studies aimed at reducing HTN medication burden among this patient population.
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Affiliation(s)
- Seth W Holwerda
- Department of Anesthesiology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas, KS, 66160-7415, US.
| | | | - Alexander L Green
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Amy C S Pearson
- Department of Anesthesia, University of Iowa, Iowa City, IA, US
| | - Gary L Pierce
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, US
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA, US
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Wang Z, Sun J, Sun Y, Gu Y, Xu Y, Zhao B, Yang M, Yao G, Zhou Y, Li Y, Du D, Zhao H. Machine Learning Algorithm Guiding Local Treatment Decisions to Reduce Pain for Lung Cancer Patients with Bone Metastases, a Prospective Cohort Study. Pain Ther 2021; 10:619-633. [PMID: 33740239 PMCID: PMC8119531 DOI: 10.1007/s40122-021-00251-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/23/2021] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION As life expectancy increases for lung cancer patients with bone metastases, the need for personalized local treatment to reduce pain is expanding. METHODS Patients were treated by a multidisciplinary team (MDT), and local treatment including surgery, percutaneous osteoplasty, or radiation. Visual analog scale (VAS) and quality of life (QoL) scores were analyzed. VAS at 12 weeks after treatment was the main outcome. We developed and tested machine learning models to predict which patients should receive local treatment. Model discrimination was evaluated by the area under curve (AUC), and the best model was used for prospective decision-making accuracy validation. RESULTS Under the direction of MDT, 161 patients in the training set, 32 patients in the test set, and 36 patients in the validation set underwent local treatment. VAS in surgery, percutaneous osteoplasty, and radiation groups decreased significantly to 4.78 ± 1.28, 4.37 ± 1.36, and 5.39 ± 1.31 at 12 weeks, respectively (p < 0.05), with no significant differences among the three datasets, and improved QoL was also observed (p < 0.05). A decision tree (DT) model that included VAS, bone metastases character, Frankel classification, Mirels score, age, driver gene, aldehyde dehydrogenase 2, and enolase 1 expression had a best AUC in predicting whether patients would receive local treatment of 0.92 (95% CI 0.89-0.94) in the training set, 0.85 (95% CI 0.77-0.94) in the test set, and 0.88 (95% CI 0.81-0.96) in the validation set. CONCLUSION Local treatment provided significant pain relief and improved QoL. There were no significant differences in reducing pain and improving QoL among training, test, and validation sets. The DT model was best at determining whether patients should receive local treatment. Our machine learning model can help guide clinicians to make local treatment decisions to reduce pain. TRIAL REGISTRATION Trial registration number ChiCRT-ROC-16009501.
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Affiliation(s)
- Zhiyu Wang
- Department of Internal Oncology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Jing Sun
- Department of Internal Oncology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Yi Sun
- Department of Radiation, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Yifeng Gu
- Department of Intervention, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Yongming Xu
- Department of Pain, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Bizeng Zhao
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Mengdi Yang
- Department of Internal Oncology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Guangyu Yao
- Department of Internal Oncology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Yiyi Zhou
- Department of Internal Oncology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Yuehua Li
- Department of Intervention, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Dongping Du
- Department of Pain, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China.
| | - Hui Zhao
- Department of Internal Oncology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, People's Republic of China.
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Mattap SM, Laslett LL, Squibb K, Wills K, Otahal P, Pan F, Aitken D, Keen H, Cicuttini F, Winzenberg T, Jones G. Hand Examination, Ultrasound, and the Association With Hand Pain and Function in Community‐Based Older Adults. Arthritis Care Res (Hoboken) 2021; 73:347-354. [DOI: 10.1002/acr.24128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 12/10/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Siti Maisarah Mattap
- Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia
| | - Laura L. Laslett
- Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia
| | - Kathryn Squibb
- Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia
| | - Karen Wills
- Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia
| | - Petr Otahal
- Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia
| | - Feng Pan
- Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia
| | - Helen Keen
- University of Western Australia Crawley Western Australia Australia
| | | | - Tania Winzenberg
- Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia
| | - Graeme Jones
- Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia
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Spatola N, Kühnlenz B, Cheng G. Perception and Evaluation in Human–Robot Interaction: The Human–Robot Interaction Evaluation Scale (HRIES)—A Multicomponent Approach of Anthropomorphism. Int J Soc Robot 2021. [DOI: 10.1007/s12369-020-00667-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ma L, Xu Y, Xu X, Pan Q, Xu Y. Application of biomimetic double-layer biofilm stent in arthroscopic rotator cuff repair: A protocol of randomized controlled trial. Medicine (Baltimore) 2021; 100:e23960. [PMID: 33429756 PMCID: PMC7793376 DOI: 10.1097/md.0000000000023960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Rotator cuff injury is the most common cause of shoulder dysfunction. Despite the continuous advancement of surgical techniques, the incidence of re-tearing after rotator cuff repair is still high. The main reason is that it is difficult to reconstruct the normal tendon bone interface and the process is slow, and the application of tissue engineering technology can promote tendon and bone healing. This study will evaluate the effect of the bionic double membrane stent on the rotator cuff healing after arthroscopic rotator cuff repair. METHODS This is a prospective randomized controlled trial to study the effect of biomimetic double-layer biofilm stent on rotator cuff healing. Approved by the clinical research ethics committee of our hospital. The patients were randomly divided into 1 of 2 treatment options: (A) a biomimetic double-layer biofilm stent group and (B) a non-bionic dual-layer biofilm stent group. Observation indicators include: visual analog scale score, University of California Los Angeles score, American Shoulder & Elbow Surgeons score and Constant-Murley score. Data were analyzed using the statistical software package SPSS version 16.0 (Chicago, IL). DISCUSSION This study will evaluate and evaluate the effect of the bionic double-layer membrane stent on the rotator cuff healing after arthroscopic rotator cuff repair. The results of this experiment will provide new treatment ideas for promoting rotator cuff tendon bone healing. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/FWKD6.
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Mollaioli D, Sansone A, Ciocca G, Limoncin E, Colonnello E, Di Lorenzo G, Jannini EA. Benefits of Sexual Activity on Psychological, Relational, and Sexual Health During the COVID-19 Breakout. J Sex Med 2021; 18:35-49. [PMID: 33234430 PMCID: PMC7584428 DOI: 10.1016/j.jsxm.2020.10.008] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/03/2020] [Accepted: 10/16/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND The COVID-19-related lockdown has profoundly changed human behaviors and habits, impairing general and psychological well-being. Along with psychosocial consequences, it is possible that sexual behavior was also affected. AIMS With the present study, we evaluated the impact of the community-wide containment and consequent social distancing on the intrapsychic, relational, and sexual health through standardized psychometric tools. METHODS A case-control study was performed through a web-based survey and comparing subjects of both genders with (group A, N = 2,608) and without (group B, N = 4,213) sexual activity during lockdown. The Welch and chi-square tests were used to assess differences between groups. Univariate analysis of covariance, logistic regression models, and structural equation modeling were performed to measure influence and mediation effects of sexual activity on psychological, relational, and sexual outcomes. OUTCOMES Main outcome measures were General Anxiety Disorder-7 for anxiety, Patient Health Questionnaire-9 for depression, Dyadic Adjustment Scale for quality of relationship and a set of well-validated sexological inventories (International Index of Erectile Function, Female Sexual Function Index, and male-female versions of the Orgasmometer). RESULTS Anxiety and depression scores were significantly lower in subjects sexually active during lockdown. Analysis of covariance identified gender, sexual activity, and living without partner during lockdown as significantly affecting anxiety and depression scores (P < .0001). Logistic regression models showed that lack of sexual activity during lockdown was associated with a significantly higher risk of developing anxiety and depression (OR: 1.32 [95% CI: 1.12 - 1.57, P < .001] and 1.34 [95% CI: 1.15 - 1.57, P < .0001], respectively). Structural equation modeling evidenced the protective role of sexual activity toward psychological distress (βmales = -0.18 and βfemales = -0.14), relational health (βmales = 0.26 and βfemales = 0.29) and sexual health, both directly (βmales = 0.43 and βfemales = 0.31), and indirectly (βmales = 0.13 and βfemales = 0.13). CLINICAL TRANSLATION The demonstrated mutual influence of sexual health on psychological and relational health could direct the clinical community toward a reinterpretation of the relationship among these factors. STRENGTHS AND LIMITATIONS Based on a large number of subjects and well-validated psychometric tools, this study elucidated the protective role of sexual activity for psychological distress, as well for relational and sexual health. Main limitations were the web-based characteristics of the protocol and the retrospective nature of prelockdown data on psychorelational and sexual health of subjects recruited. CONCLUSIONS COVID-19 lockdown dramatically impacted on psychological, relational, and sexual health of the population. In this scenario, sexual activity played a protective effect, in both genders, on the quarantine-related plague of anxiety and mood disorders. Mollaioli D, Sansone A, Ciocca G, et al. Benefits of Sexual Activity on Psychological, Relational, and Sexual Health During the COVID-19 Breakout. J Sex Med 2021;18:35-49.
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Affiliation(s)
- Daniele Mollaioli
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ciocca
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Erika Limoncin
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Elena Colonnello
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giorgio Di Lorenzo
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Aboufazeli M, Afshar-Mohajer N, Jafarpisheh MS, Heidari M, Akbari M. Recovery of the lumbar multifidus muscle size in chronic low back pain patients by strengthening hip abductors: A randomized clinical trial. J Bodyw Mov Ther 2020; 26:147-152. [PMID: 33992236 DOI: 10.1016/j.jbmt.2020.12.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/02/2020] [Accepted: 12/22/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Decrease in cross-sectional thickness of lumbar multifidus (MF) muscles during prolonged low back pain episodes commonly occurs. Restoration of the MF muscle size can be an effective way of treating chronic low back pain (CLBP) patients. Traditionally, clinicians apply muscle stabilization exercises for these patients. Recent studies support the need for active strengthening exercises for treatment of the CLBP patients. OBJECTIVE The MF muscles provide lumbar stability, and therefore we hypothesized that strengthening of these muscles can be more effective than the MF muscle stabilization exercises in restoration of the muscle size. DESIGN Study design was a randomized allocation control trial with two groups of adult female CLBP patients (n = 12 each; age range of 20-45). Patients in the control group underwent stabilization exercises and the patients in the intervention group underwent the hip abductor strengthening exercises. SETTING For all subjects of each group, the trials continued in 24 sessions distributed over 8 weeks and the MF muscles were measured in the beginning of the first session and one week after completion of the last session. MAIN OUTCOME MEASURES Statistical significance (p-value) of the change in the average MF muscle thickness, pain, and disability scores along with for each group were estimated. RESULTS Both regimens of exercises can significantly decrease the pain and disability: average pain and disability reductions of 46% (p-value of 0.001) and 33% (p-value of 0.02) via stabilization versus average pain and disability reductions of 65% (p-value of 0.001) and 59% (p-value of 0.001) via hip abductor strengthening. However, the hip abductor strengthening is the sole statistically significant exercise regimen (p-value of 0.014 vs 0.94) for increasing the MF muscle size. CONCLUSION Replacement of the traditional stabilization exercises with the hip abductor strengthening exercises for effective treatment of female adults with CLBP is recommended.
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Affiliation(s)
- Mahnaz Aboufazeli
- Department of Physical Therapy, School of Rehabilitation Sciences, International Campus of Iran University of Medical Sciences, Tehran, Iran; College of Health Sciences, Western University of Health Sciences, Pomona, CA, USA
| | | | | | - Mohsen Heidari
- Department of Orthopaedic, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Akbari
- Department of Physical Therapy, School of Rehabilitation Sciences, International Campus of Iran University of Medical Sciences, Tehran, Iran.
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Ferreira CM, de Carvalho CD, Gomes R, Bonifácio de Assis ED, Andrade SM. Transcranial Direct Current Stimulation and Mirror Therapy for Neuropathic Pain After Brachial Plexus Avulsion: A Randomized, Double-Blind, Controlled Pilot Study. Front Neurol 2020; 11:568261. [PMID: 33362687 PMCID: PMC7759497 DOI: 10.3389/fneur.2020.568261] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 11/20/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction: Although transcranial direct current stimulation (tDCS) and mirror therapy (MT) have benefits in combating chronic pain, there is still no evidence of the effects of the simultaneous application of these techniques in patients with neuropathic pain. This study aims to assess the efficacy of tDCS paired with MT in neuropathic pain after brachial plexus injury. Methods: In a sham controlled, double-blind, parallel-group design, 16 patients were randomized to receive active or sham tDCS administered during mirror therapy. Each patient received 12 treatment sessions, 30 min each, during a period of 4 weeks over M1 contralateral to the side of the injury. Outcome variables were evaluated at baseline and post-treatment using the McGill questionnaire, Brief Pain Inventory, and Medical Outcomes Study 36-Item Short-Form Health Survey. Long-term effects of treatment were evaluated at a 3-month follow-up. Results: An improvement in pain relief and quality of life were observed in both groups (p ≤ 0.05). However, active tDCS and mirror therapy resulted in greater improvements after the endpoint (p ≤ 0.02). No statistically significant differences in the outcome measures were identified among the groups at follow-up (p ≥ 0.12). A significant relationship was found between baseline pain intensity and outcome measures (p ≤ 0.04). Moreover, the results showed that state anxiety is closely linked to post-treatment pain relief (p ≤ 0.05). Conclusion: Active tDCS combined with mirror therapy has a short-term effect of pain relief, however, levels of pain and anxiety at the baseline should be considered. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT04385030.
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Affiliation(s)
| | | | - Ruth Gomes
- Neuroscience and Aging Laboratory, Federal University of Paraíba, João Pessoa, Brazil
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