ABSTRACT
Chronic postoperative pain (CPOP) is a potentially devastating consequence of a surgical procedure. It leads to increased medical costs, painful, and stress experience to the patients. After a surgical decompression performed in a patient with a non-traumatic compartment syndrome, a muscle biopsy confirmed McArdle disease, and after surgery, severe pain of neuropathic characteristics developed in the arm decompressed. Advanced techniques up to neuromedullary stimulation failed to improve the clinical status, after which repeated treatment with capsaicin patch ameliorated the patient's condition. This case report illustrates the need for a high index of suspicion for metabolic diseases in patients who present compartment syndrome without prior history of trauma and also the challenges in treating neuropathic pain after surgery.
ABSTRACT
Rehabilitation treatments have been greatly en-hanced by health-enabling technologies, as these enable more objective and interactive interventions. Multiple studiesindi-cate that gamification is efficient in promoting treatment cus-tomization, adherence, motivation, and engagement, leading to increased patient satisfaction. In this work we study the effectiveness of a novel gamified telerehabilitation system. Pa-tients exercise within a digital game-like experience, with their motion tracked using an user-friendly "invisibles" paradigm, i.e. without requiring sensor placed on the body. Pain, ad-herence and satisfaction data was collected and analysed. Our approach was particularly relevant during the acute stages of the pandemic, during severe restrictions in the access to in-person rehabilitation activities. A total of 62 patients participated in this study, during a 14-month period. Each patient completed an average of 16 sessions, and 85.5% of them were considered fully recovered after the protocol completion. All patients improved their pain level, with an overall 73.3% average pain reduction. Moreover, in the end of the treatment 79.4% of the patients reported their pain in the levels 0 or 1 (in a 0-10 scale). In terms of treatment satisfaction, 95% of the patients would reportedly recommend the proposed solution to a friend of family. Moreover, the main benefits reported were the convenience, time flexibility, and customization. Our results validate the clinical outcomes and the healthcare quality perceived by the patients in the use of the approach in telerehabilitation for shoulder-related conditions, and are encouraging for usage in further physical rehabilitation fields.
