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SUMMARY OBJECTIVE: Therapeutic exercises are well documented for the treatment of osteoarthritis; there is less evidence on what the effect of closed kinetic chain exercises is for knee osteoarthritis. The aim of this study was to investigate the effects of open kinetic chain exercises and closed kinetic chain exercises on pain, muscle strength, functional status, and quality of life in patients with knee osteoarthritis. METHODS: The study included a total of 60 patients with primary unilateral knee osteoarthritis grade I and II. The patients were categorized into three groups as open kinetic chain exercises (n=20), closed kinetic chain exercises (n=20), and control group (n=20). The outcome measures, including pain, isokinetic muscle strength, functional status, and quality of life, were collected at baseline and at the end of 6 and 12 weeks. RESULTS: Closed kinetic chain exercises and open kinetic chain exercises had significant improvement in pain, muscle strength, WOMAC, and SF-36 scores after the treatment and at their 6th and 12th week follow-ups compared to their baseline values and compared to the control group (p<0.05). CONCLUSION: The changes in all outcome measures were similar between closed kinetic chain exercises and open kinetic chain exercises (p>0.05). Closed kinetic chain exercises and open kinetic chain exercises were similar for knee osteoarthritis grade I and II. Closed kinetic chain exercises could be safely added to the exercise programs of patients with low-grade knee osteoarthritis.
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Musculoskeletal pain is a common and debilitating symptom in older adults. However, its importance is often underestimated. In this review article, we discuss its proper evaluation and management. Pain evaluation includes detailed history taking, physical examination, imaging, and laboratory investigations. Management of musculoskeletal pain requires a multidomain approach including nonpharmacological, pharmacological, and surgical modalities. A step-wise approach recommended by the World Health Organization can be used for pain management. Common musculoskeletal conditions causing pain are osteoarthritis, low?back pain, gout, pseudogout, rheumatoid arthritis, polymyalgia rheumatica, and fibromyalgia.
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Qual o impacto que a pandemia da COVID-19 trouxe para a saúde osteomuscular dos trabalhadores formais em home office? Para responder esta pergunta foi realizado estudo prospectivo observacional por meio da coleta de dados via questionário online, no período de setembro de 2020 a outubro de 2021. Foram criadas questões sobre o perfil dos trabalhadores formais, frequência de atividades físicas, dores na coluna e outras articulações e demais fatores associados ao trabalho remoto e ao isolamento social. Foi obtida amostra de 98 participantes. Como conclusão, verificou-se alteração do padrão de atividades físicas e, a quantidade de horas trabalhadas no período, acarretou piora e/ou surgimento de dores
What impact has the COVID-19 pandemic brought to the musculoskeletal health of formal home office workers? To answer this question, a prospective observational study was carried out through data collection via an online questionnaire, from September 2020 to October 2021. Questions were created about the profile of formal workers, frequency of physical activities, back pain and others joint and other factors associated with remote work and social isolation. A sample of 98 participants was obtained. In conclusion, there was a change in the pattern of physical activities and, the hours worked in the period, caused worsening and/or emergence of pain
Subject(s)
Humans , Pain , Social Isolation , Back Pain , Pandemics , COVID-19 , Joints , Spine , Surveys and Questionnaires , TeleworkingABSTRACT
On day to day practice most problems in all over the world is joint pain. Especially in female joint pain more common after climacteric period and old age. On these base my study of homeopathic therapeutic effect on joint pain. In my study use homeopathic medicines which are regularly use and easy availability for patient, and benefit to relive the complaint but not completely cure all joint pain. With help of homeopathic medicine improved his/her daily routine work and enjoy his/her life without pain in joint.
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Objective:To understand the characteristics and diagnosis and treatment of brucellosis with joint pain as the first clinical manifestation, and summarize the clinical classification of brucellosis complicated with joint pain, so as to provide reference for clinical diagnosis and treatment.Methods:Cases of brucellosis with first symptom of joint pain diagnosed in the 940th Hospital of PLA Joint Logistic Support Force from January 2015 to January 2020 were selected. The main clinical features, laboratory examination, diagnosis and treatment were analyzed.Results:A total of 82 patients with joint pain of the first symptom were selected, including 61 males and 21 females. Joint pain was the main complaint of the patients, 63.4% (52/82) of the patients visited spine surgery department, 17.1% (14/82) visited minimally invasive orthopedics department, 12.2% (10/82) visited rheumatic immunology department, and 7.3% (6/82) visited traditional Chinese medicine department. Brucellosis patients with cervical lesions accounted for 22.0% (18/82), combined with lumbar lesions accounted for 51.2% (42/82). The patients with elevated C-reactive protein accounted for 68.3% (56/82), abnormal liver function accounted for 52.4% (43/82), anti "O" positive accounted for 3.7% (3/82), abnormal autoantibodies accounted for 6.1% (5/82), and human leukocyte antigen-B27 (HLA-B27) positive accounted for 12.2% (10/82). Four patients with HLA-B27 positive had sacroiliac arthritis. All patients were cured after standard and full course therapy.Conclusion:Joint pain may be the first symptom of brucellosis, and the lumbar spine and cervical spine are the most vulnerable parts.
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Objective To observe the intervention effect of typical hot spring bathing in Guizhou province on joint pain, serum anti-keratin antibody(AKA), anti-perinuclear factor antibody(APF)and anti-cyclic citrullinated peptide antibody(CCP). Methods A total of 160 people with joint pain symptoms from five typical hot spring areas in Guizhou province were selected as the subjects. They were treated with hot spring bathing intervention for 4 weeks, once a day, 5 times a week, 40 to 50 minutes each time. According to the evaluation index of physiotherapy natural mineral water in the Code for Geological Exploration and Evaluation of Natural Warm Mineral Water Resources(GB/T 13727-2016)and geological types, the five typical hot springs were divided into three different types, namely water temperature type hot springs(water temperature > 36 ℃), metasilicate type hot springs(metasilicate > 50 mg/L)and warm mineral spring type hot springs(total dissolved solids > 1 000 mg/L). WHO pain grading standard was used to score the degree of joint pain before and after hot spring bathing intervention. Serum APF, AKA and CCP antibodies were detected by ELISA kit before and after hot spring bathing. Results The joint pain score of the subjects was 2.60±0.60, and the joint pain score of the total population decreased after intervention(0.61±0.57, P < 0.05). Before intervention, the joint pain scores of water temperature type, metasilicic acid type and warm mineral spring type were 2.78±0.96, 1.98±1.15 and 3.31±0.57, respectively. After intervention, the scores of joint pain of the three kinds of hot spring bathing patients all decreased(P < 0.05), and were 0.50±0.65, 0.48±0.74 and 0.85±0.90, respectively. Before intervention, AKA(ng/L)and CCP(μg/mL)antibody levels of the observed subjects were 34.89±16.06 and 107.58±10.40, respectively, which significantly decreased after intervention(both P < 0.05), namely 26.06±10.68 and 102.93±6.01, respectively. AKA(ng/L)was 35.04±20.01 before intervention, but decreased significantly after intervention(26.61±7.54, P < 0.05). AKA(ng/L)and CCP(μg/mL)were 31.09±17.26 and 106.51±10.13 before intervention, respectively. After intervention, the above two antibody indexes significantly decreased(all P < 0.05)to 24.53±13.98 and 98.57±5.68, respectively. Before intervention, the AKA(ng/L), APF(ng/mL)and CCP(μg/mL)antibody levels were 38.40±8.66, 349.46±118.43 and 104.96±9.66, respectively. After intervention, the above three antibody indexes significantly decreased(all P < 0.05). The values were 34.00±7.55, 269.38±127.55 and 101.65±3.04, respectively. Conclusion The typical hot spring bathing intervention in Guizhou province can relieve the symptoms of joint pain, and the three types of hot springs can reduce the levels of AKA, APF and CCP antibodies to different degrees, and the warm mineral spring type of hot spring is better than the other types of hot spring.
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This case report describes a clinical case of a 53 years aged male with Low Back Pain (LBP) at Sacro Iliac Joint (SIJ). Patient referred to physical therapy department with LBP over the past 3 weeks. Pain extended to posterior aspect of left thigh and worsening with prolonged standing, sitting and with stair climbing. Moreover, he found difficulty to ride his car or going from sit to stand. He had a history of road traffic accident 30 years ago that led to severe pain in his lower back area, he was a farmer as well and was working hardly more than 8 hours daily by lifting heavy objects. Patient came to the department by walking with assistive cane. By palpation, there was a local tenderness at the posterior aspect of the SIJ. Range of motion was limited by pain in lumbar flexion, extension, rotation and bilateral side bending movements. Pain scored 7 out of 10 on Numerical Pain Rating Visual Analogue Scale. Functional disability scored 19 out of 24 on Roland-Morris Disability questionnaire. Patient underwent special test of FABER, SLR and sacroiliac stress tests and Physical therapy modalities of TENS, dry cupping, myofascial release technique and manipulation, medical taping, hot packs applied before and after exercise. Stretching exercises included single knee to chest, trunk rotation, child’s pose and stabilization exercises of bird dog pose, superman’s, bridge, ball squeeze. Outcomes of treatment were assessed with same pretest measures. At the end of 3 weeks, patient improved in all symptoms of reduced pain to 2 out of 10 on Numerical Pain Rating, 3 out of 24 on Roland-Morris disability questionnaire. Post rehabilitative findings on all provocative tests were negative. Evidence on physical therapy management of patients with SIJ pain appears underreported. Patients presenting with SIJ pain should be routinely screened for sacroiliac component in LBP. Physical therapists are encouraged to report their findings so as to strengthen the evidence available for physical therapy for SIJ pain.
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Objective@#To explore the effect of RW splints on the position and occlusal relationship of classⅡ malocclusion patients with temporomandibular disorder (TMD) to provide a basis for the diagnosis and design of this kind of patient. @*Methods @#Fifteen patients with class Ⅱ malocclusions with TMD were enrolled in this study. After 8 months of RW-splint treatment, the changes in jaw position (∠ANB, SN-MP, ∠S-G0/N-Me) and occlusal relationship (molar, cuspid teeth displacement and anterior overbite/overjet value) were recorded by a condylar displacement measuring instrument at the CR position and CO position.@*Results@#After RW-splint treatment, the mean values of ∠ANB (t=4.971, P=0.001) and ∠SN-MP (t=9.895, P ＜ 0.01) were increased in all 15 patients, and the mean value of S-G0/N-Me (t=5.342, P=0.005) was decreased. The mean values of the distal movement of the first molars on the left and right sides of the mandible were (1.57 ± 0.79) mm and (1.69 ± 1.29) mm, respectively; the mean values of the distal movement of the canines on the left and right sides of the mandible were (1.54 ± 0.50) mm and (1.51 ± 1.08) mm, respectively; and the mean values of the overbite were (1.16 ± 0.60) mm and (1.99 ± 0.85) mm, respectively. @*Conclusion@# After RW-splint treatment, the jaw rotates clockwise, and the relationship between the molars and canines changes obviously in class Ⅱ patients with TMD, which provides a reference for the diagnosis and treatment plan of this kind of patient.
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El dolor sacroilíaco es una causa generalmente subdiagnosticada de dolor lumbar, que afecta del 15% a 30% de los pacientes con dolor lumbar bajo crónico no radicular. La articulación sacroilíaca (ASI) recibe continuo stress durante la bipedestación y marcha, siendo estabilizada por estructuras ligamentarias, capsulares y miofasciales fuertes, que reciben una abundante inervación. Destaca la dificultad en el diagnóstico del dolor sacroilíaco; debido a su naturaleza heterogénea. Éste se debe sospechar en todo paciente con síndrome de dolor lumbar no radicular, unilateral y no central. El examen físico debería descartar patología de cadera y columna lumbar. La realización de maniobras de provocación del dolor sacroilíaco aporta en el diagnóstico, teniendo la combinación de 3 o más maniobras positivas una sensibilidad de 85% y especificidad de 79%. Se ha recurrido a inyecciones diagnósticas con anestésicos locales, tanto intraarticulares como de ligamentos circundantes. El tratamiento del dolor sacroilíaco es multimodal e individualizado para cada paciente. El tratamiento conservadorbasado en terapia física y antiinflamatorios no esteroidales es la terapia de primera línea. Las infiltraciones esteroidales tanto intra como extraarticulares pueden proveer alivio en un grupo de pacientes con inflamación activa. La denervación de los ramos dorsales laterales con radiofrecuencia ha mostrado ser un tratamiento exitoso en pacientes con dolor sacroilíaco, logrando 6 meses a 1 año de alivio del dolor. En pacientes con dolor refractario, la fusión de la articulación sacroilíaca es una opción, prefiriéndose la técnica mínimamente invasiva de fijación trans-sacroilíaca.
Sacroiliac pain is an frecuent underdiagnosed source of low back pain, affecting 15% to 30% of individuals with chronic, non-radicular pain. The sacroiliac joint (SIJ) is subject to continuous stress during standing position and gait, being stabilized by strong ligament, capsular and myofascial structures with rich innervation. Due to its heterogeneous nature, SIJ pain is difficult to diagnose, and it should be suspected in all patients with non-radicular unilateral and non-central low back pain syndrome. Physical examination should rule out hip and lumbar spine pathology. SIJ provocation maneuvers are used for diagnosis, with the combination of 3 or more positive maneuvers resulting in a sensitivity of 85% and a specificity of 79%. Diagnostic injections of local anesthetics, both intra-articular and in the surrounding ligaments have been used. treatment of SIJ pain is multimodal and individualized for each patient. Conservative treatment, based on physical therapy and non-steroidal anti-inflammatory drugs (NSAIDs) is the first line therapy. Both intra- and extra-articular steroid infiltrations can provide relief in a group of patients with active inflammation. Radiofrequency denervation of lateral dorsal branches has proven to be a successful treatment in SIJ pain patients, achieving 6 to 12 months of pain relief. In patients with refractory pain, SIJ fusion is an option, with minimally invasive trans-sacroiliac fixation being the preferred technique.
Subject(s)
Humans , Sacroiliac Joint/pathology , Low Back Pain/diagnosis , Low Back Pain/therapy , Low Back Pain/etiology , Low Back Pain/physiopathology , Diagnosis, DifferentialABSTRACT
INTRODUÇÃO: A fisioterapia dispõe de vários recursos para o tratamento da disfunção temporomandibular, como a estimulação elétrica nervosa transcutânea (TENS), mas com muitas variações nos protocolos e parâmetros dosimétricos. OBJETIVO: Analisar a eficácia da estimulação elétrica nervosa transcutânea (TENS), com duração de fase e frequência fixas, na analgesia e funcionalidade de disfunções temporomandibulares. MÉTODOS: A amostra foi composta por 20 indivíduos, separados em grupo tratado e placebo, ao longo de 2 semanas de tratamento, avaliados pelo Questionário de Sintomas Mandibulares e Hábitos Orais, analisando dor e função articular. RESULTADOS: Ambos os grupos apresentaram redução na dor e escore geral, comparados ao momento préintervenção, para a função, apenas o TENS apresentou redução dos valores, mas, não houve diferenças entre os grupos. CONCLUSÃO: TENS não foi diferente do placebo no controle da dor porém, promoveu a melhora funcional nos voluntários.
INTRODUCTION: Physiotherapy has several resources for the treatment of temporomandibular dysfunction, such as transcutaneous electrical nerve stimulation (TENS), but with many variations in protocols and dosimetric parameters. OBJECTIVE: To analyze the efficacy of transcutaneous electrical nerve stimulation (TENS), with fixed phase duration and frequency, in the analgesia and functionality of temporomandibular disorders. METHODS: The sample consisted of 20 individuals, separated in a treated group and placebo, during 2 weeks of treatment, evaluated by Questionnaire on Mandibular Symptoms and Oral Habits, analyzing pain and joint function. RESULTS: Both groups presented reduction in pain and general score, compared to the pre-intervention moment, for the function, only the TENS showed a reduction of the values, but there were no differences between the groups. CONCLUSION: TENS was not different from placebo in pain control, however, it promoted functional improvement in volunteers.
Subject(s)
Temporomandibular Joint , Transcutaneous Electric Nerve Stimulation , Electric StimulationABSTRACT
OBJECTIVE@#To observe the clinical efficacy of warm acupuncture combined with yoga posture method in the treatment of periarthritis with frozen period.@*METHODS@#Ninety patients with periarthritis who met the inclusion criteria were randomly divided into a control group 1, a control group 2 and an observation group, 30 cases in each group. Warm acupuncture was applied in the control group 1 (Jianzhen (SI 9), Jianyu (LI 15), Jianliao (TE 14), etc were selected), yoga posture method was applied in the control group 2, warm acupuncture combined with yoga posture method were given in the observation group, the treatment was given once a day, 10 times as a course with 2 days between courses and continuous for 2 courses. After 2 courses of treatment, the shoulder joint pain score and shoulder function grading were used to evaluate the clinical efficacy, and the clinical efficacy was observed.@*RESULTS@#①The pain scores of the three groups were significantly lower after treatment (all 0.05). ②After treatment, the functional classification of shoulder joints were significantly improved in the three groups (all 0.05). ③After 2 courses of treatment, the effective rate of the observation group was 86.7% (26/30), which was better than 70.0% (21/30) in the control group 1 and 76.7% (23/30) in the control group 2 (both <0.05).@*CONCLUSION@#Warm acupuncture combined with yoga posture method can effectively relieve shoulder pain and improve dysfunction. The clinical comprehensive effect is better than simple acupuncture and yoga posture method.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Periarthritis , Therapeutics , Posture , Treatment Outcome , YogaABSTRACT
Resumen Introducción El esguince de tobillo es una patología frecuente y uno de los principales motivos de incapacidad laboral, a pesar de ello, no se cuenta con un tratamiento estandarizado y existe controversia con respecto a la inmovilización o una movilización temprana. Objetivo Determinar el mejor tratamiento para los esguinces de tobillo grado II, ofreciendo un resultado satisfactorio con periodos de incapacidad más cortos. Material y métodos Ensayo clínico-aleatorizado, ciego simple de enero a junio de 2016. Dos grupos: inmovilización y vendaje funcional. Se interrogó dolor inicial y al término del tratamiento con escala de EVA, ambos grupos con mismo manejo analgésico, antiinflamatorio y rehabilitación, se evaluó funcionalidad al mes del inicio del padecimiento con escala de Karlsson. Resultados Todos los pacientes con dolor inicial arriba de 70 (de moderado a severo), sin diferencia en media entre grupos (férula 86.3 ± 9.6 contra vendaje de 86.1 ± 8.5; p = 0.95), ambos con disminución del dolor; el grupo con vendaje obtuvo niveles más bajos (férula media 55.2 ± 15.5 contra vendaje 40.3 ± 12.8, p ≤ 0.001). Grupo con férula 24 (88.9%) al final calificaron su dolor como moderado y tres (11.1%) como leve contra el grupo con vendaje, de los cuales, 17 (73.1%) tuvieron dolor moderado y siete (26.9%) leve (p = 0.15). Conclusión El vendaje funcional es una excelente opción de manejo para esguince de tobillo grado II, ofrece buenos resultados con periodos de incapacidad y costos más reducidos.
Abstract Background The grade II ankle sprain it is one of the most frequent pathologies in the musculoskeletal system and one of the principal motives of laboral inability. Despite the fact this pathology is one of the most common reasons for ER visiting there is not a standard treatment for it, and exist controversy about the immobilization vs. an early mobilization. Objective Determine the best treatment for grade II ankle sprains, offering a satisfactory result with a minor time of labor inability. Material and methods Single-blind randomized controlled clinical trial with two groups immobilization versus functional bandage, both groups with VAS evaluation at the beginning and at the end of treatment, same AINES management and rehabilitation, 30 days after the injury we evaluate the functional outcome with Karlsson score. Results At the beginning all patients report pain over 70 (moderate-severe) without difference in the average of both groups (immobilization 86.3 ± 9.6 versus functional bandage treatment of 86.1 ± 8.5; p = 0.95). Both groups present less pain at the end of the treatment, the bandage group present lower values, (Immobilization average 55.2 ± 15.5 versus functional bandage treatment 40.3 ± 12.8, p ≤ 0.001). In the immobilization group 24 (88.9%) at the end of the treatment had moderate pain and 3 (11.1%) light pain against the functional treatment group where 17 (73.1%) had moderate pain and 7 (26.9%) light (p = 0.15). Conclusion Functional bandage is an excellent treatment option for grade II ankle sprain, offering good results with a lower time of inability and cost.
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Temporomandibular joint dislocation is described as the movement of mandibular condyle out of the fossa beyond its anatomical and functional boundaries causing pain and discomfort. It is often managed by conservative methods, but in long-standing, chronic conditions, surgical treatment is the only option. The goal of surgical treatment is to reposition the condyle and prevent further recurrences. Materials and Methods: This retrospective analysis involving a single center and a surgeon with 19 patients and 23 joint surgeries performed over a 10-year period. Patients who fulfilled inclusion and exclusion criteria and had earlier undergone surgical correction with hook-shaped miniplates and miniscrews fixed with or without bone grafts formed the study group. Results: In all, 12 were female (mean age, 41.9 ± 12.07 years) and the rest 9 were male (mean age, 39.8 ± 13.6 years), ranging from 32 years to 58 years. All patients had the dislocation for an average period of 19.26 ± 12.6 months before the surgery. The mean maximal mouth opening (without pain) preoperatively was 17.78 ± 2.13 mm (12–25 mm) while postoperatively it was 32.28 ± 3.17 mm (27–37 mm). There were no immediate or late surgical complications in the follow-up period that ranged from 8 to 37 months. Discussion: When proper case selection is employed and properly done, using hook-shaped miniplates with or without bone graft is more cost-effective, giving excellent short- and long-term effects. Conclusion: The results in this Indian population are very similar to that reported from other parts of the world.
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Introducción: la articulación temporomandibular (ATM) es muy compleja y está compuesta por el hueso temporal y el maxilar inferior o mandíbula. La disfunción temporomandibular (DTM) comprende una serie de signos y síntomas, entre ellos el dolor bucofacial y las alteraciones funcionales como los ruidos articulares y las limitaciones a los movimientos mandibulares. Objetivo: realizar revisión bibliográfica sobre las causas más frecuentes de la DTM y sus posibles tratamientos en pacientes adultos. Metodología: se realizó una revisión bibliográfica de bases de datos electrónicas de los últimos 10 años. Se excluyeron reportes de casos. Resultados: se detectaron 40 artículos en bases bibliográficas de internet de los cuales se incluyeron 30 que reunían los criterios de inclusión. Se encontró al dolor y al ruido articular como síntomas más frecuentes de la DTM y está asociada con el sexo femenino y el bruxismo o parafunción en mayores porcentajes. La placa neuromiorelajante es el tratamiento más mencionado. Conclusiones: el dolor de la ATM fue la variable medida en mayor proporción. Entre los factores que se encontraron asociados a la DTM, tuvo mayor porcentaje el sexo femenino seguido del bruxismo o parafunción y los pacientes parcialmente edéntulos.
Introduction: the temporomandibular joint is very complex and is composed of the temporal bone and the lower jaw or mandible. Temporomandibular dysfunction (TMD) comprises a series of signs and symptoms, including orofacial pain and functional alterations such as joint noises and limitations to mandibular movements. Objective: to describe the most frequent causes of TMD and its possible treatments in adult patients. Methodology: a bibliographic review of electronic databases of the last 10 years was carried out. Case reports were excluded. Results: 40 articles were detected in internet bibliographic bases, of which 30 were included that met the inclusion criteria. Joint pain and noise were found as the most frequent symptoms of TMD and are associated with female sex and bruxism or parafunction in higher percentages. The neuromyorelaxing plaque is the most mentioned treatment. Conclusions: TMJ pain was the most widely measured variable. Among the factors that were found associated with TMD, the female sex had a higher percentage followed by bruxism or parafunction and partially edentulous patients.
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To analyze the application of ear-acupuncture for post-operative syndromes of breast cancer so as to provide method and evidence for the syndromes. The related clinical literature was retrieved from CNKI, WANFANG and VIP databases from the database establishment time to August 30, 2017. We found ear-acupuncture are mainly used in treating nausea and vomiting caused by radiation and chemotherapy (shenmen (TF), jiaogan (AH), wei (CO), pi (CO), etc), insomnia in the rehabilitation period (xin (CO), pizhixia (AT), shenmen (TF), etc), depression and anxiety (pizhixia (AT), shenmen (TF), pi (CO), wei (CO), xin (CO), gan (CO), etc), and joint pain (pain point), etc.
Subject(s)
Humans , Acupuncture Points , Acupuncture, Ear , Breast Neoplasms , Postoperative Period , SyndromeABSTRACT
<p><b>OBJECTIVE</b>To verify the clinical therapeutic effects on shoulder joint pain of rotator cuff injury treated with electroacupuncture (EA) and Mulligan's mobilization.</p><p><b>METHODS</b>A total of 120 patients of shoulder joint pain of rotator cuff injury were randomized into an EA group, a rehabilitation group and a combined therapy group, 40 cases in each one. In the EA group, EA was applied to Jianzhen (SI 9), Jianliao (TE 14), Jianyu (LI 15), Tianzong (SI 11), Jianqian (extra) and Binao (LI 14) in the affected side. Of these acupoints, Jianliao (TE 14) and Jianyu (LI 15), Jianzhen (SI 9) and Tianzong (SI 11) were stimulated with's electric apparatus. In the rehabilitation group, Mulligan's mobilization was used, including scapular mobilization, static joint mobilization and dynamic joint mobilization. In the combined therapy group, EA was used in combination with Mulligan mobilization. The treatment was given once a day in each group, 5 sessions a week, totally for 6 weeks. The pain intensity of shoulder joint (VAS), the University of California at Los Angeles shoulder rating scale (UCLA) and the range of motion (ROM) of shoulder joint were evaluated before and 6 weeks after treatment separately. The adverse reactions were recorded in each group.</p><p><b>RESULTS</b>VAS scores were all reduced, UCLA scores increased and ROM improved after treatment as compared with those before treatment in the patients of the three groups (all<0.05). After treatment, VAS score, UCLA score and ROM in the combined therapy group were remarkably improved as compared with those in the EA group and the rehabilitation group (all<0.05). Regarding the improvements of VAS and UCLA scores, the results in the EA group were better than those in the rehabilitation group (both<0.05). Regarding ROM improvement, the results in the rehabilitation group were superior to those in the EA group (all<0.05). There was no adverse reaction in the two groups.</p><p><b>CONCLUSION</b>The combined therapy of EA and Mulligan's mobilization relieves shoulder joint pain of rotator cuff injury, better than the simple application of either EA or Mulligan's mobilization.</p>
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Resumen La tuberculosis monoarticular aislada de la muñeca es una forma infrecuente de presentación de esta enfermedad, siendo más común el compromiso vertebral. Las formas extravertebrales representan sólo 2 a 3% de las infecciones óseas por Mycobacterium tuberculosis. Presentamos el caso clínico de una mujer de 49 años, con antecedentes de trabajar en labores de aseo en un hospital, que posterior a un trauma de baja energía evolucionó con un cuadro de dolor en la articulación de la muñeca derecha. Diagnosticada inicialmente como una tendinopatía flexora, recibió tratamiento con antiinflamatorios y fisioterapia. Ocho meses después la paciente continuó con dolor a la movilización por lo que se realizó un estudio imagenológico, biopsia y cultivos de tejido óseo. El estudio histopatológico y de biología molecular del tejido confirmó una tuberculosis de muñeca derecha. Se trató con terapia anti-tuberculosa y fisioterapia, consiguiéndose la recuperación funcional de la muñeca.
Monoarticular tuberculosis of the wrist is a rare presentation of primary tuberculosis, being more common skeletal forms involving the spine. Extraspinal tuberculous osteomyelitis is rare and comprises only 2 to 3% of all cases of osteoarticular Mycobacterium tuberculosis infections. We present a case of a 49 years old female patient, who worked as an hospital cleaning employed without other comorbidity. After a low energy injury of the wrist she suffered pain syndrome diagnosticated as a flexor tendinopathy, managed with nonsteroidal antiinflammatory drugs and physical therapy. Eight months later patient evolves with chronic pain in range of motion of right wrist joint, leading to a complete radiological, surgical biopsy and cultures. Histology, and molecular biology confirmed the wrist joint tuberculosis diagnosis. Pharmacological treatment and physical therapy were initiated with appropriated response.
Subject(s)
Humans , Female , Middle Aged , Tuberculosis, Osteoarticular/diagnostic imaging , Wrist/microbiology , Wrist/diagnostic imaging , Tuberculosis, Osteoarticular/therapy , Magnetic Resonance Imaging , Radiography , Ultrasonography , Treatment Outcome , Antitubercular Agents/therapeutic useABSTRACT
OBJECTIVE: To compare the effectiveness of patellar denervation versus non-patellar denervation in reducing anterior knee pain on a follow-up period of at least one year after total knee arthroplasty. METHOD: Data from 84 patients, who underwent total knee arthroplasty were analyzed. Participants were divided into 2 groups; group A: 42 patients who previously underwent total knee arthroplasty with patellar denervation; and group B: 42 patients who previously underwent total knee arthroplasty without patellar denervation. Results were evaluated using WOMAC and KSS questionnaires, and the VAS pain measurement. Knee ranges of motion were measured. Preoperative clinical conditions of both groups were similar. RESULTS: Postoperatively, the following results were observed. (a), the WOMAC scores for group A were significant better when compared to group B (27.95 ± 5.89 vs. 33,55 ± 6.23; (b) better results were also found in KSS scores for group A vs. group B (86.19 ± 7.10 vs. 83,07 ± 4.88); (c) the range of knee flexion was smaller than in group A vs. group B (119.0 ± 10.7 vs 125.5 ± 11.0 degrees); (d) there was no significant difference between the mean of range of knee extension between the two groups groups; (e) in terms pain referred by the patient, no difference was observed according to VAS pain. CONCLUSION: Patellar denervation does not show better effect in pain reduction compared with TKA with non-patellar denervation. However, it had a better beneficial effect on knee function score, as measured through the KSS and WOMAC questionnaires.
OBJETIVO: Comparar a eficácia de denervação patelar em relação à não-denervação patelar na redução da dor anterior do joelho em um período de acompanhamento de no mínimo um ano após a artroplastia total do joelho (ATJ). MÉTODO: Foram analisados dados de 84 pacientes, submetidos a ATJ e divididos em 2 grupos: grupo A formado por 42 pacientes submetidos à ATJ com denervação patelar (PD) e grupo B formado por 42 pacientes submetidos a ATJ sem a denervação (ND). Os resultados foram avaliados utilizando os questionários WOMAC e KSS, além da escala analógica visual da dor (EVA). Também foi avaliada a amplitude de movimento em graus. As condições clínicas pré-operatórias dos dois grupos foram semelhantes. RESULTADOS: Comparando a pontuação do questionário WOMAC, o grupo A apresentou melhores resultados, com media de 27,95 ± 5,89, enquanto o grupo B apresentou média de 33,55 ± 6,23. Melhores resultados foram também observados no KSS para o grupo A, apresentando média de 86,19 ± 7,10, em comparação ao grupo B, com média de 83,07 ± 4,88. Observou-se menor amplitude de flexão do joelho no grupo A, 119,0 ± 10,68 graus, em comparação com o grupo B, com média de 125,5 ± 11,02 graus. Analisando exclusivamente a dor, não foi observada diferença entre a dor referida pelo paciente, de acordo com a escore da escala EVA. CONCLUSÕES: A DP não demonstrou melhores efeitos na redução da dor em comparação com ND na ATJ. No entanto um melhor efeito da denervação nos escores de função, através dos questionários KSS e WOMAC sugerem que a denervação pode ser benéfica neste cenário.
Subject(s)
Humans , Patella/innervation , Arthralgia/therapy , Arthroplasty, Replacement, Knee/rehabilitation , Denervation/methods , Pain Measurement/methodsABSTRACT
Objective To investigate the clinical value and effect of spinal nerve medial branch ablation through transforaminal endoscopic in treatment of lumbar zygapophysial joint pain. Methods From August 2008 to October 2013 ,96 patients diagnosed as lumbar zygapophysial joint pain were included in the research. 36 patients were treated by spinal nerve medial branch ablation through transforaminal endoscopic ,while 60 patients received conservative treatment. The visual analogue scale (VAS) and Japanese Orthopedics Association(JOA) scores before treatment,1,3,6 and 12 months after treatment were recorded and analyzed. The MacNab scores were recorded and analyzed 12 months after treatment. Results The VAS and JOA scores of surgical treatment group showed significant improvement compared with that before operation (P < 0.05),and there were no significant difference at each time point after surgery. The VAS and JOA scores of conservative treatment group in showed significant improved at 1 months after treatment compared with that before treatment(P<0.05),but there were no significant difference at each time after treatment compared with pretreatment. The VAS and JOA scores of surgical treatment group showed significant improvement compared with conservative treatment group at each time after treatment(P<0.05). The MacNab scores of surgical treatment group(94.44%)was significantly higher than that of conservative treatment group(33.33%). Conclusion The spinal nerve branches ablation under transforaminal endoscopic is an effective and safe minimally invasive spine surgery technique with important clinical value in the treatment of lumbar zygapophysial joint pain.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the differences in the clinical therapeutic effects on chronic knee joint pain between the combination of the central-square needling technique of thumb-tack needles with the routine therapy of acupuncture, moxibustion andand the routine therapy of acupuncture, moxibustion and.</p><p><b>METHODS</b>One hundred and twenty patients of chronic knee joint pain were randomized into an observation group and a control group, 60 cases in each one. In the control group, the routine therapy of acupuncture, moxibustion andwas adopted. In the observation group, at the end of treatment with the routine therapy of acupuncture, moxibustion and, the subcutaneous embedding therapy was followed with four thumb-tack needles at the sites 1 to 1.5 cm above, below and bilateral to the main point (point) separately, and the needles were retained for 24 h to 48 h. The treatment was given once every two days, three times a week, totally 6 times in two weeks; and the follow-up visit was done for 3 months in patients of the two groups. The visual analogue scale (VAS) score before and after each treatment, Lequesne index score before treatment and at the end of follow-up and the case numbers of proactive use of painkillers or receiving acupuncture treatment in the follow-up stage were compared and observed in the patients of the two groups.</p><p><b>RESULTS</b>The VAS score was reduced gradually after treatment in the patients of the two groups. The differences were significant statistically after the second treatment as compared with those before the treatment in the two groups (all<0.05), in which, the improvements in VAS scores after the third treatment in the observation group were more obvious than those in the control group (all<0.05). At the end of follow-up visit, Lequesne index scores were all improved as compared with those before treatment in the two groups (both<0.05) and the improvements were similar between the two groups (>0.05). In the follow-up stage, there were 0 case in the observation group and 9 cases in the control group in terms of proactive use of painkillers (<0.05). There were 5 cases in the observation group and 1 case in the control group receiving acupuncture treatment again (>0.05).</p><p><b>CONCLUSION</b>The acupuncture scheme in assistance with the central-square needling technique of thumb-tack needles obviously relieves chronic knee joint pain, much better sustains the analgesic effects of acupuncture and improves patient compliance.</p>