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Abstract Introduction Septorhinoplasty operates on the nose's bone and cartilage and is ensued by severe postoperative pain. Objective The objective of this study is to evaluate the effects of preoperative administration of intravenous (IV) paracetamol and ibuprofen on postoperative pain scores in patients undergoing septorhinoplasty. Methods A total of 150 patients undergoing septorhinoplasty were randomly assigned into 3 groups with 50 patients in each group. The control group (group A) was administered 100 ml saline solution; the paracetamol group (group B) was administered 1,000 mg of IV paracetamol in 100 ml of saline solution; and the ibuprofen group (group C) was administered 800 mg of IV ibuprofen in 100 ml of saline solution before surgery. Opioid analgesics were employed to achieve postoperative analgesia. Postoperative pain was evaluated using the visual analogue scale (VAS). Postoperative opioid consumption and adverse effects were also recorded for each patient. Results In comparison with group A, the score in the VAS of groups B and C was statistically lower in all the time intervals (p < 0.05). In the 1st and 6th hours postoperatively, group C's score in the VAS in was lower than that of group B (p < 0.05). In the control group, total opioid consumption was highest in all time intervals (p < 0.05). In group C, total opioid consumption was significantly lower than in group B in the 0 to 6 and 6 to 12 hours intervals. (p < 0.05). Conclusion The single-dose preemptive administration of ibuprofen has a more profound postoperative analgesic effect than paracetamol in the first 6 hours after septorhinoplasty. After the first 6 hours postsurgery, there is no difference between ibuprofen and paracetamol in terms of analgesic effect.
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Background: Diabetic peripheral neuropathy is defined as the presence of symptoms and signs of peripheral nerve damage among patients with diabetes, after ruling out other potential causes. Diabetic neuropathies are one among the most common long-term complications of diabetes. About 60% of diabetic patients are affected by neuropathy. Aim and Objectives: This study aims to study the efficacy and safety of tablet duloxetine 60 mg and tablet gabapentin 300 mg among patients with diabetic polyneuropathy. Materials and Methods: This study was randomized, comparative, double-blind parallel group study which was conducted for a period of 6 months. Sixty patients with diabetic polyneuropathic pain were randomly allocated into two groups. One group received duloxetine 60 mg and other group received gabapentin 300 mg. Efficacy was assessed using visual analog scale (VAS), short form of McGill pain questionnaire, and patients global impression of change score. Safety was assessed using adverse drug reaction profile. Results: In the duloxetine group, the mean VAS score at the baseline was 54.97 ± 6.75, and at 3 months, it was 20.07 ± 5.32 which was statistically significant. In the gabapentin group, the mean score at baseline was 53.57 ± 7.85, and at 3 months, it was 26.57 ± 4.39 which was also statistically significant. The difference between the baseline and 3rd month mean McGill score in both groups was statistically significant. Conclusions: We found that both duloxetine 60 mg once daily and gabapentin 300 mg once daily are effective in the treatment of diabetic polyneuropathic pain. However, duloxetine 60 mg once daily is more efficacious than gabapentin 300 mg once daily in the treatment of diabetic neuropathic pain. Both the drugs are well tolerated but gabapentin is better tolerated than duloxetine.
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RESUMO Objetivo Verificar a relação entre zumbido e aptidão cardiorrespiratória em pessoas após COVID-19. Métodos Estudo transversal com amostra de pessoas pós-COVID -19 que responderam à Escala Visual Analógica para zumbido e questionário padronizado contendo dados sobre internação e zumbido. Para avaliar a aptidão cardiorrespiratória, utilizou-se a avaliação clínica e o Teste de Bruce para mensurar o consumo de oxigênio diretamente (via analisador de gases, com utilização do consumo pico de oxigênio - VO2pico). Resultados Participaram 192 pessoas, com média de idade de 47,8 ± 12,6 anos. A prevalência de zumbido autorreferido foi de 27,1% (n = 52). Dos 52 pacientes com zumbido, 27 iniciaram com o sintoma durante ou após o diagnóstico de COVID-19. Houve diferença significativa para o VO2pico absoluto entre os grupos com e sem zumbido (p = 0,035), sendo que o grupo com zumbido apresentou os menores valores; o tamanho do efeito foi pequeno. Não houve correlação entre os escores da Escala Visual Analógica para o zumbido e os valores de VO2pico absoluto e relativo (p > 0,05). Conclusão Houve diferença estatisticamente significativa entre as queixas de zumbido e o VO2pico nas pessoas após a COVID -19, sendo que o grupo com zumbido apresentou o VO2pico absoluto menor do que o grupo sem zumbido. Nos pacientes com zumbido, também foi encontrado VO2pico absoluto e relativo menor para as mulheres, além do VO2pico relativo menor para os hipertensos e obesos.
ABSTRACT Purpose To verify the relation between tinnitus and cardiorespiratory fitness among people after COVID-19. Methods Cross-sectional study with a sample of people post Covid-19 who responded to the Visual-Analog Scale for tinnitus and standardized questionnaire containing data on hospitalization and tinnitus. To evaluate cardiorespiratory fitness, it used the clinical assessment and Bruce test to measure oxygen consumption directly (via gas analyzer, using peak oxygen consumption - VO2peak). Results In total, 192 participants were assessed, with a mean age of 47.8 ± 12.6 years . The prevalence of self-reported tinnitus was 27.1% (n = 52). Of these 52 patients with tinnitus, 27 people started with the symptom during or after the diagnosis of COVID-19. There was a significant difference for the absolute VO2peak and the groups with and without tinnitus (p = 0.035): the tinnitus group showed the lowest values, the effect size was small. There was no correlation between the scores of the Visual-Analog Scale for tinnitus and the absolute and relative VO2peak (p > 0.05). Conclusion There was a statistically significant difference between tinnitus complaints and the VO2peak among people post COVID-19, with the tinnitus group having a lower absolute VO2peak than the non-tinnitus group. In tinnitus patients, we also found lower absolute and relative VO2peak for women, in addition to lower relative VO2peak for hypertensive and obese patients.
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Humans , Male , Female , Adult , Middle Aged , Aged , Tinnitus/diagnosis , Visual Analog Scale , Cardiorespiratory Fitness/physiology , Post-Acute COVID-19 Syndrome , Brazil , Cross-Sectional Studies , Surveys and QuestionnairesABSTRACT
Abstract Objective To evaluate the association between pain intensity in the active phase of the first stage of labor with the use or not of nonpharmacological methods for pain relief in a real-life scenario. Methods This was an observational cross-sectional study. The variables analyzed were obtained by a questionnaire with the mothers (up to 48 hours postpartum) to investigate the intensity of pain during labor using the visual analog scale (VAS). The nonpharmacological pain relief methods routinely used in obstetric practice were evaluated by consulting medical records. The patients were separated into two groups: Group I - patients who did not use nonpharmacological methods for pain relief and Group II -patients who used these methods. Results A total of 439 women who underwent vaginal delivery were included; 386 (87.9%) used at least 1 nonpharmacological method and 53 (12.1%) did not. The women who did not use nonpharmacological methods had significantly lower gestational age (37.2 versus 39.6 weeks, p < 0.001) and shorter duration of labor (24 versus 114 min, p < 0.001) than those who used the methods. There was no statistically significant difference in the pain scale score using the VAS between the group that used nonpharmacological methods and the group that did not (median 10 [minimum 2- maximum 10] versus 10 [minimum 6-maximum 10] p = 0.334). Conclusion In a real-life setting, there was no difference in labor pain intensity between the patients who used nonpharmacological methods and those who did not use them during the active phase of labor.
Resumo Objetivo Avaliar a associação da intensidade da dor na fase ativa da dilatação do parto em mulheres de acordo com a utilização ou não de métodos não farmacológicos para alívio da dor em cenário de vida real. Métodos Trata-se de um estudo observacional de corte transversal. As variáveis analisadas foram obtidas através de questionário com as puérperas (até 48 horas pós-parto) investigando a intensidade da dor no parto pela escala visual analógica (EVA). As medidas não farmacológicas de alívio da dor, utilizadas rotineiramente na prática obstétrica, foram avaliadas pela consulta aos prontuários. As pacientes foram separadas em dois grupos: Grupo I - pacientes que não utilizaram medidas não farmacológicas para alívio da dor e Grupo II - pacientes que utilizaram estas medidas. Resultados Foram incluídas 439 mulheres que tiveram parto vaginal, sendo que 386 (87,9%) utilizaram, pelo menos, uma medida não farmacológica e 53 (12,1%) não utilizaram. As mulheres que não utilizaram as medidas não farmacológicas apresentaram idade gestacional significativamente menor (37,2 versus 39,6 semanas, p < 0,001) e menor duração do trabalho de parto (24 versus 114 minutos, p < 0,001) quando comparadas às que utilizaram as medidas. Não houve diferença estatisticamente significativa na pontuação da escala da dor pela EVA de acordo com a categorização pelo uso ou não de métodos não farmacológicos (mediana 10 [mínimo 2-máximo 10] versus 10 (mínimo 6-máximo 10), p = 0,334]. Conclusão Em cenário de vida real, as pacientes submetidas aos métodos não farmacológicos não apresentaram diferença em relação à intensidade da dor quando comparadas às que não os utilizaram durante a fase ativa do trabalho de parto.
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Humans , Female , Pregnancy , Pain Measurement , Labor PainABSTRACT
SUMMARY OBJECTIVE: The aim of our study was to compare the traditional radial artery, distal radial artery, and transfemoral artery, which are vascular access sites for coronary angiography, in terms of pain level using the visual analog scale. METHODS: Between April 2021 and May 2022, consecutive patients from three centers were included in our study. A total of 540 patients, 180 from each of the traditional radial artery, distal radial artery , and transfemoral artery groups, were included. The visual analog scale was applied to the patients as soon as they were taken to bed. RESULTS: When the visual analog scale was compared between the groups, it was found to be significantly different (transfemoral artery: 2.7±1.6, traditional radial artery: 3.9±1.9, and distal radial artery: 4.9±2.1, respectively, p<0.001). When the patients were classified as mild, moderate, and severe based on the visual analog scale score, a significant difference was found between the groups in terms of body mass index, process time, access time, and number of punctures (p<0.001). Based on the receiver operating characteristic analysis, body mass index>29.8 kg/m2 predicted severe pain with 72.5% sensitivity and 73.2% specificity [(area under the curve: 0.770, 95%CI: 0.724-0.815, p<0.0001)]. CONCLUSION: In our study, we found that the femoral approach caused less access site pain and a high body mass index predicts severe pain.
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Objective: To observe the efficacy of contralateral needling combined with Maitland ankle mobilization in the treatment of chronic ankle sprain.Methods: A total of 106 patients with chronic ankle sprain were included in the study. They were numbered according to their order of visit, with odd numbers assigned to the control group and even numbers assigned to the observation group, with 53 cases in each group. Patients in the control group were treated with Maitland ankle mobilization, while those in the observation group were given additional contralateral needling treatment. After treatment, we observed the indicators including, ankle circumference, range of motion (ROM) of dorsiflexion, ROM of plantar flexion, thickness of ankle ligaments, and the changes in Baird-Jackson ankle score, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, and visual analog scale (VAS) score to compare the efficacy between the two groups. Results: After treatment, the total effective rate of the observation group was 94.3％ and was significantly higher than that of the control group (81.1％), indicating statistical significance (P<0.05). After treatment, the ankle circumference of both groups decreased, and the ROM of dorsiflexion and the ROM of plantar flexion increased (P<0.05). The changes in the observation group were more significant, indicating inter-group statistical significance (P<0.05). After treatment, the thickness of the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament, as well as the VAS scores decreased in both groups; the changes in the observation group were more significant, indicating inter-group statistical significance (P<0.05). After treatment, the Baird-Jackson ankle score and the AOFAS ankle- hindfoot score increased in both groups, and the scores in the observation group were higher than those in the control group, indicating inter-group statistical significance (P<0.05). Conclusion: The efficacy of contralateral needling combined with Maitland ankle mobilization in the treatment of chronic ankle sprain is superior to that of Maitland ankle mobilization alone.
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Objective: To observe the effects of tendon-regulating and stretching manipulation plus JIN's three-needle therapy for the shoulder on pain and shoulder joint function in subacromial impingement syndrome (SIS). Methods: Eighty patients with SIS were recruited and divided into a control group and a treatment group by the random number table method, with 40 cases in each group. The control group was given JIN's three-needle therapy for the shoulder, and the treatment group received additional tendon-regulating and stretching manipulation. The visual analog scale (VAS) score and constant-Murley score (CMS) were observed before and after the intervention, and the total effective rate was also observed. Results: The total effective rate was 92.5％ in the treatment group versus 70.0％ in the control group, and the difference was statistically significant (P<0.05). The VAS score and CMS changed notably after treatment in both groups (P<0.05), and the improvements were markedly greater in the treatment group than in the control group (P<0.05). Conclusion: Tendon-regulating and stretching manipulation plus JIN's three-needle therapy for the shoulder can facilitate the relief of pain and the improvement of shoulder joint function in SIS patients.
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Objective: To observe the immediate effect of small-angle Tui-Pushing and An-Pressing anti-rotation bone-setting manipulation in improving the correction of braces for adolescent idiopathic scoliosis. Methods: A total of 50 cases of adolescent idiopathic scoliosis were selected and given brace correction first. The whole spine anteroposterior and lateral radiographs were taken, the Cobb angle was measured, and the visual analog scale (VAS) score of pain caused by brace wearing was recorded. After removal of the brace, small-angle Tui-Pushing and An-Pressing anti-rotation bone-setting manipulation was performed once. After treatment, the same brace was put on again to take a whole spine anteroposterior radiograph, the Cobb angle was measured, and the VAS score was recorded. The changes in Cobb angle and VAS score after manipulation were compared, and the immediate efficacy was evaluated. Results: After the manipulation, the Cobb angle was significantly smaller than that before treatment (P<0.01) and the VAS score was significantly lower than that before treatment (P<0.01). Conclusion: Small-angle Tui-Pushing and An-Pressing anti-rotation bone-setting manipulation can improve the immediate efficacy of brace in treating adolescent idiopathic scoliosis and relieve the pain caused by brace wearing at the same time.
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Objective:To evaluate the clinical efficacy of acupuncture combined with extracorporeal shock wave therapy in the treatment of piriformis syndrome.Methods:Eighty patients with piriformis syndrome who received treatment in Huaihe Energy Occupational Disease Prevention Hospital Rehabilitation Medicine Center from February 2021 to December 2022 were included in this study. They were divided into a treatment group ( n = 40) and a control group ( n = 40) according to different treatment methods using a retrospective cohort study design. The treatment group was treated with acupuncture combined with extracorporeal shock wave therapy, once every 7 days for 3 consecutive weeks. The control group was treated with extracorporeal shock wave therapy alone once every 7 days for 3 consecutive weeks.Pre- and post-treatment visual analogue scale scores and clinical efficacy were compared between the two groups. Results:There was no significant difference in baseline data between the two groups (all P > 0.05). After treatment, the visual analogue scale score decreased in each group. After adjusting for covariates, there was no significant difference in visual analogue scale score between the two groups ( F = 112.38, P < 0.001). After adjusting the pre-treatment visual analogue scale score, the post-treatment visual analogue scale score in the treatment group was lower than that in the control group [1.417 (95% CI: 1.151-1.683)]. The total response rate in the treatment group was 97.5% (39/40), which was significantly higher than 82.5% (33/40) in the control group ( Z = -2.03, P = 0.042). Conclusion:Acupuncture combined with extracorporeal shock wave therapy is highly effective on piriformis syndrome.
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Objective@# To investigate the effect of root canal therapy (RCT) on inflammatory cytokines level in peripheral blood, anxiety, and depression in patients with pulpitis.@*Methods @#A total of 155 patients with pulpitis admitted to the Stomatology Hospital of the Fourth Military Medical University from June 2021 to June 2022 were treated with root canal therapy. Another 155 persons who received health examinations during the same period were selected as the control group. The Generalized Anxiety Disorder-7 (GAD-7) scores and the Patient Health Questionnaire-9 (PHQ-9) scores of the two groups were compared. The GAD-7, PHQ-9 and pain scores of the test group before treatment and 3 and 6 weeks after treatment were compared. Pain was assessed with a visual analog scale (VAS). Inflammatory cytokine [interleukin-8 (IL-8), interleukin-1 β (IL-1β), tumor necrosis factor-α (TNF-α), c-reactive protein (CRP)] levels in the test group before treatment and 3 and 6 weeks after treatment were compared. @*Results @#The GAD-7 and PHQ-9 scores in the test group were higher than those in the control group before treatment (P<0.05). The GAD-7 and PHQ-9 scores in the test group at 3 and 6 weeks after treatment were lower than those before treatment (P<0.05); there was no significant difference between the GAD-7 and PHQ-9 scores at 3 and 6 weeks after treatment(P>0.05). The pain scores of the experimental group at 3 and 6 weeks after treatment were lower than those before treatment (P<0.05), and the pain scores 6 weeks after treatment were lower than those at 3 weeks after treatment (P<0.05). The levels of IL-8, IL-1β, TNF-α and CRP in the peripheral blood of the experimental group were lower 3 and 6 weeks after treatment than before (P<0.05), and the levels of IL-8 and IL-1β in the peripheral blood at 6 weeks after treatment were significantly lower than at 3 weeks after treatment (P<0.05). The levels of TNF-α and CRP in the peripheral blood at 6 weeks after treatment were not significantly different from those at 3 weeks after treatment (P>0.05).@*Conclusion @#The peripheral blood of patients with pulpitis has a high level of inflammatory cytokines, and the patients suffer from obvious anxiety and depression. Root canal therapy can relieve their anxiety and depression by reducing their level of inflammatory cytokines in peripheral blood.
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Abstract Objectives: Visual vertigo occurs after a vestibular disorder compromising daily living. It can be assessed by "the Visual Vertigo Analogue Scale" (VVAS), a self-administered questionnaire without Portuguese version. To perform the translation, cross cultural adaptation, and validation of VVAS from English to Portuguese. Methods: Prospective study involving the translation and cross-cultural adaptation of the VVAS into the Portuguese language, according to recognized guidelines. It was completed by 63 healthy controls and 198 participants with vestibulopathy who also completed the Dizziness Handicap Inventory (DHI) to further explore the link between DHI and VVAS. Groups were compared for severity of visual vertigo and VVAS reliability and internal consistency were tested. Results: The VVAS score was significantly higher in vestibular group (p < 0.001). A Cronbach's α of 0.9 confirmed the valid internally consistent of the applied version. The severity score of VVAS showed a positive strong correlation with DHI (p < 0.0001). Conclusion: The present Portuguese translation of the scale showed satisfactory properties for the assessment of self-perceived and severity of visual vertigo in a significant group of vestibular Portuguese patients. Level of evidence: 2.
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Background: Diabetes is a form of chronic illness requiring a collective treatment approach such as glycemic monitoring, self-management, education, and adequate support to prevent the occurrence of acute complications. One of the most frequently occurring complication in Type 2 diabetes has been diabetic peripheral neuropathy (DPN) or distal symmetrical polyneuropathy. Newer anticonvulsants such as Gabapentin and Pregabalin have been proven beneficial in patients with peripheral neuropathic pain. Aims and Objectives: The aim of the study was to compare the efficacy of Gabapentin and Pregabalin in relieving the pain in patients of DPN. Materials and Methods: This is an open label, randomized, multi-dose, two treatment, single-period, single-center, parallel study comparing Gabapentin and Pregabalin for efficacy in patients suffering with DPN using visual analog scale, daily sleep interference score, patient’s global impression of change, and clinician’s global impression of change. Results: One hundred patients were randomized into two groups and the treatment started as and when they reported to the hospital. Statistical analysis was done in SPSS version 23 and intent to treat principle is employed for analysis. Results were distributed in demographics and treatment comparison. Decreased sleep interference and global impression of change reported during first visit, in which participants under Pregabalin group had better improvement score comparing Gabapentin group alone was found statistically significant (P < 0.05). Conclusion: Our study revealed that Pregabalin is found to be more efficacious when compared to Gabapentin among Type 2 diabetes mellitus patients with painful peripheral neuropathy. Hence, we conclude that Pregabalin provided significant improvement in pain relief and other perspectives.
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Aim: The aim of this study was to evaluate the intracanal effectiveness of cryotherapy, curcumin irrigant, and normal saline as a final irrigant in reducing postendodontic pain in primary teeth. Materials and Methods: A total of 120 teeth between the ages of 4 and 7 years requiring pulpectomy in primary teeth were included in the study. The teeth were randomly assigned to one of the three treatment groups: intracanal cryotherapy using 2.5°C cold saline, curcumin irrigant, or normal saline. Following completion of chemomechanical preparation, final irrigation with 2.5°C cold saline, curcumin irrigant, and normal saline solution at room temperature were employed in the groups. Participants were asked to rate the severity of their postoperative pain on the Visual Analog Scale before, immediate postoperative after wearing of local anesthetic effect, and 24 h after the procedure. The results were analyzed statistically. Results: The differences in reduction of postendodontic pain between the three irrigating regimens were statistically not significant. Cryotherapy utilizing 2.5°C cold saline or curcumin irrigant can be used instead of normal saline as a final irrigant in pulpectomy of primary teeth. Conclusions: Cryotherapy can be a straightforward, cost-effective, and nontoxic treatment option for the management of postendodontic pain. Curcumin irrigant with its anti-inflammatory properties is also a better alternative as a final irrigant for reducing postoperative pain in primary teeth.
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This study aimed to evaluate the effect of using the lubricated eyelid speculum on the overall pain perception by the subject patients who underwent cataract surgery by phacoemulsification technique under topical anesthesia. Methods: A prospective interventional randomized comparative study was conducted at the tertiary eye care center, wherein adult patients scheduled for bilateral cataract surgery with phacoemulsification techniques under topical anesthesia were randomized to undergo surgery with two different modes of eyelid speculum insertion, either with or without lubrication of the eyelid speculum. Fifty percent of the patients underwent surgery with eyelid speculum without lubrication, and 50% with lubrication of the eyelid speculum. The primary outcome was to compare the level of overall pain perception among the subject patients of the two groups by using the Visual Analogue Scale (VAS) in the immediate postoperative period. Results: The study included 130 patients who underwent bilateral cataract surgery (n = 260 eyes) under topical anesthesia, wherein n = 130 eyes underwent surgery using lubricated eyelid speculum and n = 130 eyes underwent surgery with dry eyelid speculum. Pain perception score assessed on the VAS (0–10 cm) ranged from 0.5 to 6, with a mean ± standard deviation of 2.06 ± 1.12. A significant correlation was found with two different methods of eyelid speculum insertion with reduced overall pain perception in patients with the use of lubricated eyelid speculum compared to the dry eyelid speculum (P = 0.0001). Conclusion: The overall pain perception associated with cataract surgery performed by phacoemulsification technique under topical anesthesia can be further minimized by lubricating the eyelid speculum prior to insertion for exposing the globe
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Background: Rheumatoid arthritis (RA) is an autoimmune disease that causes pain, stiffness, swelling, loss of joint function, and a rise in acute-phase reactant levels. Pain causes much discomfort in patients with RA. Disease-Modifying Antirheumatic Drugs, Non-Steroidal Anti-Inflammatory Drugs, and Glucocorticoids are commonly used to treat RA, but these medications alleviate the inflammatory process to improve short- and long-term goals of treatment. Vitamin D has immunomodulatory properties that may be effective in RA patients, suggesting that Vitamin D may have a remedial effect in these patients. Aims and Objectives: The aim of this study was to evaluate the effectiveness of vitamin D in controlling the inflammatory response thus controlling pain in patients with RA. Materials and Methods: The study analyzed 96 diagnosed cases of RA presenting to our tertiary care center. The subjects were allocated into two groups one in which Vitamin D was supplemented and other in which placebo was given. Their disease activity was measured and VAS score was analyzed at presentation and 1 month and 3 months of follow-up. Results: At presentation levels of Vitamin D were inversely correlated with disease activity. Mean VAS score decreased subsequently during the follow up from 3.2 ± 1.7 at presentation to 2.25 ± 1.12 in Vitamin D group and from 4.38 ± 1.79 at presentation to 2.67 ± 1.19 at 3 months follow-up in placebo group, respectively. Conclusion: Vitamin D supplementation did not statistically significantly improved the VAS score thus requiring the need for further research for the evaluation of Vitamin D supplementation in the treatment of RA.
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INTRODUÇÃO: A cervicalgia é uma importante causa de incapacidade em todo o mundo, causada por várias condições como doenças de base, anormalidades mecânicas e neuropáticas. A Diatermia por Ondas Longas (LWD) é uma modalidade de aquecimento terapêutico usada para tratar muitas condições musculoesqueléticas. OBJETIVO: Avaliar a eficácia da LWD na dor, incapacidade e amplitude de movimento (ADM) na dor no pescoço. MÉTODOS E MATERIAIS: O estudo foi conduzido após aprovação ética da universidade e registro em registro de ensaio clínico (PTY/2022/155 e CTRI/2022/06/043033). 30 pacientes com cervicalgia de 20-60 anos foram alocados aleatoriamente em dois grupos. O grupo controle (n=15) realizou exercícios domiciliares simples, enquanto no grupo experimental (n=15) a diatermia de ondas longas também foi administrada juntamente com exercícios domiciliares, 3 vezes/semana por 2 semanas. As medidas de resultado, como a escala visual analógica (EVA), índice de incapacidade do pescoço (IIP) e amplitude de movimento do pescoço, foram avaliadas na linha de base, no final de 2 semanas (pós-tratamento) e após um acompanhamento de 2 semanas. RESULTADOS E CONCLUSÃO: Houve melhora significativa da dor, incapacidade e ADM pós-intervenção no grupo controle e no grupo experimental. Além disso, houve diferença significativa na dor após o acompanhamento em ambos os grupos. A comparação entre os grupos sugeriu que houve uma diferença significativa para EVA, IIPe ADM de extensão do pescoço (p<0,05), mas não para ADM em outras direções. Portanto, pode-se concluir que a LWD é uma intervenção terapêutica eficaz para melhorar a dor, a incapacidade do pescoço e a amplitude de movimento do pescoço, juntamente com exercícios de pescoço em pacientes com dor no pescoço.
INTRODUCTION: Neck pain is a significant cause of disability worldwide, caused by various conditions like underlying diseases, mechanical and neuropathic abnormalities. Longwave Diathermy (LWD) is a therapeutic heating modality used to treat many musculoskeletal conditions. OBJECTIVE: To evaluate the efficacy of LWD on pain, disability, and range of motion (ROM) in neck pain. METHODS AND MATERIALS: The study was conducted after ethical approval from the university and registration in clinical trial registry (PTY/2022/155 & CTRI/2022/06/043033). Thirty patients with neck pain of 20-60 years were randomly allocated into two groups. The control group (n=15) performed simple home-based exercises, while in the experimental group (n=15) longwave diathermy was also given along with home exercises, 3 times/week for 2 weeks. The outcome measures like the Visual analogue scale (VAS), neck disability index (NDI), and Neck range of motion were assessed at baseline, at the end of 2 weeks (post-treatment), and after a followup of 2 weeks. RESULTS AND CONCLUSION: There was a significant improvement in pain, disability, and ROM post-intervention in the control group and experimental group. Additionally, there was a significant difference in pain after follow-up in both groups. The between-group comparison suggested that there was a significant difference for VAS, NDI, and neck extension ROM (p<0.05) but not for ROM in other directions. Therefore, it can be concluded that LWD is an effective therapeutic intervention for improving pain, neck disability, and neck range of motion along with neck exercises in patients with neck pain.
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Diathermy , Pain , Neck PainABSTRACT
Objective: To observe the clinical efficacy of warm needling moxibustion plus Tuina (Chinese therapeutic massage) for knee osteoarthritis (KOA).Methods: A total of 60 patients with KOA were randomized into an observation group and a control group by the random number table, with 30 cases in each group. The control group was treated with warm needling moxibustion, and the observation group was treated with additional Tuina treatment. The treatments were performed once every other day, for a total of 10 times. The visual analog scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) were scored before and after treatment, and the surface electromyography (sEMG) signals of quadriceps femoris were collected. Results: The total effective rate of the control group was 76.7％, and that of the observation group was 90.0％. The difference between the two groups was statistically significant (P<0.05). The WOMAC and VAS scores in both groups after treatment were improved, and the integrated electromyography (iEMG) and median frequency (MF) of quadriceps femoris were increased. The intra-group differences were statistically significant (P<0.05). After treatment, the WOMAC and VAS scores in the observation group were lower than those in the control group, and the differences between the two groups were statistically significant (P<0.05). The improvement of quadriceps femoris function in the observation group was more notable than that in the control group, and the iEMG value and MF were significantly higher than those in the control group (P<0.05). Conclusion: Warming needling moxibustion plus Tuina can effectively relieve the pain in patients with KOA, improve their daily activity function, and increase the sEMG signals of the quadriceps femoris.
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Objective: To observe the efficacy of acupuncture combined with sitting-position knee-adjustment manipulations in treating patellofemoral osteoarthritis. Methods: Ninety-two patients with patellofemoral osteoarthritis were randomized into an observation group and a medication group, with 46 cases in each group. The observation group received acupuncture and sitting-position knee-adjustment manipulations, and the medication group received oral celecoxib capsules. After 8-week treatment, changes in the short-form McGill pain questionnaire (SF-MPQ) and Lysholm knee scoring scale (LKSS) scores were observed, and the clinical efficacy was compared.Results: The total effective rate was 87.0％ in the observation group and 63.0％ in the control group; the between- group difference was statistically significant. Before treatment, there were no significant differences in the SF-MPQ score or LKSS score (P>0.05). After 8-week treatment, the SF-MPQ [including pain rating index (PRI), visual analog scale (VAS), and present pain intensity (PPI)] and LKSS scores showed notable changes in both groups (P<0.05); the SF-MPQ and LKSS scores in the observation group were significantly different from those in the control group (P<0.05).Conclusion: Combining acupuncture and sitting-position knee-adjustment manipulations can reduce pain and ameliorate joint function in patients with patellofemoral osteoarthritis, producing more significant efficacy than oral celecoxib capsules.
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Objective: To observe the efficacy of mild moxibustion combined with arthroscopic meniscal repair in the treatment of meniscal injury and to explore its action mechanism. Methods: Ninety-eight patients with meniscal injury were divided into a surgery group and a moxibustion plus surgery group by the random number table method, with 49 cases in each group. Both groups received arthroscopic meniscal repair, and the moxibustion plus surgery group was treated with add-on mild moxibustion. The Lysholm score, visual analog scale (VAS) score, and mobility of the affected knee were measured before and after treatment, and transforming growth factor (TGF)-β1 and platelet-derived growth factor (PDGF) levels were measured in the fluid of the affected knee joint. The healing of the meniscus was recorded at a follow-up visit 3 months after the surgery. Results: After treatment, the Lysholm score increased, the VAS score decreased in both groups, and the intra-group differences in both groups were statistically significant (P<0.05). The Lysholm score was higher in the moxibustion plus surgery group than in the surgery group, and the VAS score was lower in the moxibustion plus surgery group than in the surgery group. The differences between groups in both scores were statistically significant (P<0.05). The mobility of the affected knee joint increased in both groups (P<0.05), and it was greater in the moxibustion plus surgery group than in the surgery group (P<0.05). When compared with pretreatment, the levels of TGF-β1 and PDGF in the fluid of the knee joint increased in both groups (P<0.05), and the levels of TGF-β1 and PDGF in the fluid of the affected knee joint were higher in the moxibustion plus surgery group than in the surgery group (P<0.05). The healing of the meniscus in the moxibustion plus surgery group was significantly better than that in the surgery group at the follow-up visit 3 months after the surgery (P<0.05). Conclusion: The effect of mild moxibustion combined with arthroscopic meniscal repair is better than the surgery alone in improving knee function, relieving pain, increasing mobility of the affected knee, and promoting meniscal healing, which may be related to the up-regulation of TGF-β1 and PDGF levels in the fluid of knee joint.
ABSTRACT
Objective: To examine the effect of acupuncture-like transcutaneous electrical nerve stimulation (ACUTENS) on labor pain in nulliparous women. Methods: This randomized clinical trial was conducted at Razi Hospital in Qazvin, Iran between January and July 2018. After the screening process, 144 out of 184 pregnant women were selected by convenience sampling and assigned to an intervention group or a control group by the block randomization method. The intervention group received ACUTENS at Hegu (LI4), Shenmen (HT7), Sanyinjiao (SP6), and Neimadian (Extra) during various stages of delivery in addition to routine labor care at the delivery room. For the control group, the same routine labor care was performed alone. The severity of pain was assessed in the two groups using the visual analog scale (VAS). The data were analyzed using R software (ver. 4.0.2) and repeated measurement analysis of variance. Results: ACUTENS reduced the mean score of pain intensity in the first stage of labor in the intervention group more than that in the control group (P<0.001). Also, the mean scores of pain intensity in the second stage of labor, episiotomy, and one hour after delivery in the intervention group were significantly lower than those in the control group (P<0.001). Conclusion: ACUTENS at Hegu (LI4), Shenmen (HT7), Sanyinjiao (SP6), and Neimadian (Extra) can decrease the intensity of labor pain in nulliparous women. It can be used as a non-pharmacological method for reducing pain in and after labor.