ABSTRACT
Objective: To determine mean bone mineral density in patients with chronic low back pain presenting at Armed Forces Institute of Rehabilitation Medicine Rawalpindi based on dual energy x-ray absorptiometry studies
Study Design: Cross sectional study
Place and Duration of Study: Armed Forces Institute of Rehabilitation Medicine [AFIRM], Rawalpindi from Apr 2015 to Mar 2016
Patients and Methods: Two hundred and forty patients having low back pain of more than 6 months duration fulfilling the inclusion criteria were included both from indoor and outdoor departments through non-probability consecutive sampling. Bone mineral density was measured at lumbar spine by dual energy x-ray absorptiometry studies by the same technical staff using the same equipment. A written informed consent was taken from each patient. Data were collected and recorded on specialized proforma by the principal investigator
Results: Spine BMD on DXA scan ranged from 0.90 to 0.98 g/cm2 with a mean of 0.95 +/- 0.02 as shown in. When stratified, the mean BMD decreased significantly with increasing age and severity of LBP; 20-30 years vs. 31-40 years [0.95 +/- 0.01 vs. 0.92 +/- 0.02; p=0.001]. However, there was no significant difference in mean BMD across genders; male vs. female [0.94 +/- 0.01 vs. 0.94 +/- 0.02; p=0.680]. Similarly there was no significant difference in mean BMD across various durations of low back pain; 7-10 vs. 11-14 months [0.94 +/- 0.03 vs. 0.93 +/- 0.01; p=0.617]
Conclusion: The mean bone mineral density at spine was found to be lower in patients with chronic low back pain. It was significantly lower in older patients and those with severe low back pain. However, it didn't change significantly with various durations of low back pain or gender
ABSTRACT
Objective: To compare the intra-articular corticosteroid versus physiotherapy in the management of adhesive capsulitis in terms of mean pain score. Study Design: Randomized controlled trial. Place and Duration of Study: Outpatient department, at Armed Forces Institute of Rehabilitation Medicine, from Jul 2013 to Jul 2015
Material and Methods: A total of 90 patients with adhesive capsulitis were enrolled as per inclusion criteria by non probability consecutive sampling. Forty five patients were assigned to group "A" and were given intra-articular injection of triamcinolone 40mg [2ml] and bupivacain 2ml into the shoulder joint. Group "B", having forty five patients received eight session of physiotherapy on alternate day. Outcome measure included mean pain score using visual analogue scale at six week follow-up
Results: Statistically significant improvement in pain score on visual analogue scale was found in patients with group "A", with improvement in score from 7.2 +/- 0.91 at the start of the study to 5.6 +/- 0.18 at six week follow-up [p<0.001]. Whereas no statistically significant results were obtained in patients with group "B" having pain score on visual analogue scale of 7.4 +/- 0.14 at the start of the study to 7.3 +/- 0.14 at six week follow-up [p=0.54]
Conclusion: The use of intra-articular corticosteroid injection in shoulder joint potentially offers a significantly greater clinical improvement in pain relief over the use of supervised physiotherapy in the management of patients suffering from adhesive capsulitis