Effect of laser and ultrasound treatments on myofascial pain syndrome: a comparative study

Myofascial pain syndrome [MPS] is one of the main musculoskeletal diseases whose main complications are decrease of function, decrease quality of life and functional problems. MPS has many treatment options including pharmaceutical treatments such as [Non-steroidal anti-inflammatory drugs, tri-cyclic antidepressants and other antidepressants, anti-epileptics and opioids], physical therapy [hotpacks, TENS, ultrasound, stretching and laser] and injections. Because of lacking potent evidence for routine treatments and their side effects, controversy about efficacy of laser, and lack of documents about this matter in our country, we evaluated effects of laser on patients suffering from MPS. In this randomized clinical trial, patients referring to Shohadaye Tajrish Hospital [affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran] who were diagnosed to have upper trapezius MPS by the history and physical exam, filled the informed consent documents and their pain severity was measured at rest, movement and at night by visual analogue scale [VAS] questionnaires. Also the patients filled neck disability index form [NDI] and pain threshold were determined by algometric evaluation. Then patients were classified to A, B, C groups randomly for [laser, ultrasound, and sham laser]. After 6 weeks the patients were visited again, the forms were filled and data were gathered for statistic analysis. Ultrasound was effective in decreasing the VAS at movement and algometric evaluation [p < 0.01], and in decreasing the VAS at night and at rest and NDI [p < 0.05]. Laser also was effective in decreasing the VAS at movement [p < 0.01], at night and at rest [p < 0.05] and was effective in improving algometric evaluation and NDI [p < 0.001]. Laser was more effective than Ultrasound in decreasing the NDI and improving algometric evaluation

Impaire effects of MLD and IPC on cure of breast cancer lymphoma

Lymphedema is a common complication after surgical treatment of breast cancer. MLD is standard care of it, but this treatment has some limitation such as time consumption and dependence of therapist. An alternative treatment modality is IPC. In this study we compared therapeutic effects of these two modalities on lymphedema in surgically-treated breast cancer patients who referred to physical medicine and rehabilitation service of shohada medical center in 2008-2009. This study was final studental research. In this randomized clinical trials we studied patients with unilateral lymphedema of upper limb as a complication of mastectomy for breast cancer treatment who referred to our service. 11 patients were treated by IPC method [cases group] and 12 patients were treated by MLD method [control group]. Each patient was treated for 10 session. Before trial, 5th and 10th session after treatment the Lymphedema was assessed in five part of limb [hand, wrist, 5 cm below elbow, 5 and 10 cm above elbow]. Results were compared between groups and also in each group before and after treatment with t-paired test [independent and paired] and repeated measure ANOVA and SPSS 16th edition. The mean [ +/- SD] of age was 46.6 +/- 9.4 years in cases and 45.8 +/- 9.3 years in control group. The mean [ +/- SD] of lymphedema was 133 +/- 9 [cm] in cases and 135 +/- 9 [cm] in control groups after 10 session treatment. There was no significant difference between two groups. Our results suggest that improvement of lymphedema have not significant different in these methods, but further studies are necessary for final judgment

[Electrodiagnostic prevalence of accessory peroneal nerve in admitted patients in Shohada hospital]

Accessory peroneal nerve [APN] is an anatomic variation which can disturb electrodiagnostic studies. This anomaly is detected when the response CMAP [Compound muscle action potential] of EDB [Extensor digitrum brevis] to peroneal nerve stimulation is measured smaller in distal when compared to proximal. In this study, we have assessed the prevalence of APN in a group of patients admitted to Shohada-Tajrish hospital. CMAP of DPN was measured by Neuro-Screen Toennis instrument. If no CMAP of EDB was detected in ankle, a record was obtained below lateral malleous and the presence of APN was confirmed when CMAP in distal was lesser than proximal. The study population included 143 females [62.7%] and 87 [17.9%] males with a mean age of 42.1 +/- 13.5 years. APN was detected in 28 patients, among whom 5 [17.9%] had bilateral APN. Sexual distribution of APN was the same, with half of the cases [14 patients] were females. The prevalence of APN was 12.2%. Approximately, 17.9% of cases were bilateral

[ role of nerve and tendon gliding exercies in the conservative treat ment of carpal tunnel syndrome]

Carpal tunnel syndrome [CTS] with mild to moderate severity can often be effectively treated by Non- Surgical Measures in a primary care environment. In this study, we investigated the efficacy of nerve and tendon gliding exercises in the treatment of CTS. In a prospective randomized controlled trial, 38 hands with the diagnosis of CTS were randomly divided to two groups. Both groups were prescribed to wear a Custom molded wrist splint. The patients in group 2 were also instructed to perfom nerve and tendon gliding exercises. Duration of treatment for both groups were 4 weeks. Patients were evaluated with clinical and electrophysiological parameters, symptom severity scale, and functional status scale. There was statistically significant improvement in all parameters in both groups, The Improvement in group 2 was slightly better, but the difference between the two groups was not significant [p<0.05]. Patient's satisfaction was investigated during the follow up period [5-8 months], A total of 11 [61.1%] of the patients in group land 13 [76.0%] of the patients in group 2 reported good or excellent results but the difference between the two groups was not statistically significant. Conservative treatment in both groups was effective but without significant difference between them. Further studies with more patients and longer duration of follow up with clinical and electrophysiological parameters are recommended