Diaphragmatic Mobility and Chest Expansion in Patients with Scapulocostal Syndrome: A Cross-Sectional Study.

Scapulocostal syndrome (SCS) is a subset of myofascial pain syndrome affecting the posterior shoulder and upper back area. Some of the affected muscles are attached to the rib cage, which may affect diaphragmatic mobility and chest expansion. The purpose of this study was to investigate the characteristics of diaphragmatic mobility and chest expansion in patients with SCS. Twenty-nine patients with SCS and twenty-nine healthy participants of a similar age, gender, weight, and height were included in the study. All participants were evaluated for diaphragmatic mobility (DM) by real-time ultrasound (RTUS) and for chest expansion (CE) using a cloth tape measure. An independent t-test was used to compare the outcome variables between groups. The DM value in the SCS group was 46.24 ± 7.26 mm, whereas in the healthy group it was 54.18 ± 9.74 mm. The DM value was lower in the SCS group compared to in healthy participants (p < 0.05). Chest expansion at the axilla, the fourth intercostal space (4th ICS), and the xiphoid level in the SCS group was 7.26 ± 1.13, 6.83 ± 0.94, and 6.86 ± 1.25, respectively, while chest expansion at the axilla, 4th ICS, and xiphoid level in the healthy group was 7.92 ± 1.39, 7.54 ± 1.43, and 8.13 ± 1.32, respectively. Chest expansion at the 4th ICS and the xiphoid level in the SCS group was significantly lower than in the healthy group (p < 0.05). Patients with SCS presented a decrease in diaphragmatic mobility and chest expansion. Therefore, SCS treatment programs ought to add breathing exercises to improve lung expansion.

The correlation between scapulocostal syndrome and masticatory myofascial pain on selected pain and functional parameters- an observational study.

OBJECTIVES: Although scapulocostal syndrome (SCS) and masticatory myofascial pain (MMP) occur in different regions, the concept of myofascial linkage and neurophysiology may be proven per the connection of the two disorders. Therefore, this study aimed to investigate the correlation between SCS and MMP on selected pain and functional parameters. METHOD: 75 participants with SCS participated in the protocol. The diagnosis of SCS was considered by the presence of muscle referred pain in the medial scapular muscles. All participants were measured for pain intensity, pressure pain threshold (PPT), and craniovertebral angle (CV-angle) for pain and functional parameters related to SCS. They were measured for pain intensity, PPT, and mouth distance for the pain and functional parameters related to MMP. The diagnosis of MMP was considered by the presence of muscle tenderness of the masticatory muscle and the decreasing of mouth opening distance. The correlation between SCS and MMP was determined using Pearson's correlation coefficient and Spearman's correlation. RESULTS: Participants exhibiting SCS were diagnosed for MMP at 74.67%. The results showed positive correlations in pain intensity and PPT between SCS and MMP (r = 0.367, r = 0.478, p < 0.01), PPT of SCS, and mouth distance amid both pain-free and maximum mouth opening conditions, respectively (r = 0.290, r = 0.282, p < 0.05). CONCLUSION: In conclusion, SCS and MMP present an association with each other in terms of both selected pain, and functional parameters. Thus, a treatment program for SCS patients should be concerned with the masticatory muscles even if they did not report any pain at the jaw area.

Translation, cross-cultural adaptation, and psychometric properties of the Thai version of the Identification of Functional Ankle Instability (IdFAI-THAI) questionnaire.

BACKGROUND: This study developed a Thai version of the Identification of Functional Ankle Instability (IdFAI-THAI) questionnaire. METHODS: To determine construct validity, 200 participants with a history of lateral ankle sprain completed the IdFAI-THAI, the Modified Thai Lower Extremity Functional Scale (LEFS), the Visual Analog Scale of Instability (VAS-I), and the Thai Foot and Ankle Ability Measure (FAAM). Eight days later, 100 randomly selected participants refilled the IdFAI-THAI to assess test-retest reliability and internal consistency. RESULTS: The IdFAI-THAI moderate correlated with the LEFS (rs = -0.62), the VAS-I (rs = 0.62), and the FAAM (rs = -0.63 and -0.69 for the activities of daily living and sports subscales, respectively). The IdFAI-THAI had good test-retest reliability (ICC2,1 = 0.89) and excellent internal consistency (Cronbach's alpha = 0.94). Ceiling and floor effects were absent. CONCLUSION: The valid and reliable IdFAI-THAI can identify chronic ankle instability among Thai speakers in clinical and research settings.

Modified-Active Release Therapy in Patients with Scapulocostal Syndrome and Masticatory Myofascial Pain: A Stratified-Randomized Controlled Trial.

Modified-active release therapy (mART) was developed to treat patients experiencing upper quarter pain. The objective of the study was to determine the effectiveness of the mART in treating pain, promoting function, and measuring emotions in patients with scapulocostal syndrome (SCS) and masticatory myofascial pain (MMP). A stratified-randomized controlled trial was employed in 38 participants separated into two groups. All participants underwent the same series visual analog scale (VAS), pressure pain threshold (PPT), mouth opening (MO), maximum mouth opening (MMO), craniovertebral angle (CV-angle), and pain catastrophizing scale Thai version (PCS-Thai-version) at the baseline. The mART group underwent the mART program three times a week for 4 weeks with a hot pack and an educational briefing while the control group received only a hot pack and the educational briefing. After treatment, both groups showed significant improvement (p < 0.05) in all parameters except MO, MMO, and CV-angle. When comparing outcomes between the groups, the mART group showed a statistically significant greater number of improvements than did the control group. In conclusion, the mART program can improve pain experienced by patients with SCS and MMP and it can be used as an adjuvant technique with conservative treatment.

Thai version of the Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain: Cross-cultural validation and test-retest reliability.

BACKGROUND: /objective: The Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain (SNAPPS) is a self-report questionnaire which is a specifically designed measurement instrument to identify patellofemoral pain. It has reported high sensitivity, specificity and test-retest reliability to discriminate between people with knee pain, with or without patellofemoral pain. SNAPPS hasn't been studied in Thailand; therefore, the aim of this study was to cross-culturally adapt the questionnaire into Thai. METHOD: This study was separated into two phases: cross-cultural adaptation and test-retest reliability. The Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain was translated into Thai following the guidelines for the cross cultural adaptation of self-report measures including six steps. Thirty four knee pain patients performed the test-retest reliability of the final version of this questionnaire. They were clinically diagnosed with patellofemoral pain by a physical therapist. They were asked to complete the questionnaire twice; with the 1st session and 2nd session having a 30 min break between. The intraclass correlation coefficient (ICC3, 1) method was used to determine test-retest reliability. The correlation of SNAPPS and VAS-U, VAS-W, VAS-S, VAS- J, VAS- R, and VAS- SQ were analyzed by Pearson correlation. RESULTS: The thirty-four participants (19 males, 15 females; with ages ranging 19-24 years) with patellofemoral pain were assessed twice with a 30 min break between the two sessions. The total scores of section 2 and 4 of the questionnaire indicated very strong test-retest reliability, ranging from 0.83 to 0.954 and the total score was ICC 0.91. Moreover, the Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain had a correlation with intensity of pain during ascending and descending stairs. CONCLUSION: The Thai version of the Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain can be used to assess patellofemoral pain in young Thai patients.

Analgesic Effects of 5-Alkyloxy-4-amino-2(5H)-furanones as Cholecystokinin-2 Antagonists.

4-Amino-2(5H)-furanones were synthesized in high yields over two synthetic steps from readily available mucochloric acid. These 5-alkyloxy-4-amino-2(5H)-furanones were screened in a ([125]) I-CCK-8 radioligand receptor binding assay for CCK2 affinity and novel active ligands in the nanomolar range were identified. SAR was optimized leading to the cyclohexyl derivative 25 with an IC50 of 27 nM. Furanone 18 was obtained as a stable crystalline material with an IC50 of 85 nM, but had a higher CCK2 selectivity. It was subsequently tested in the isolated guinea pig ileum assay with sulfated CCK8 , and the CCK antagonizing properties of the ligand were confirmed. The CCK2 selective antagonist 18 was found to potentiate analgesia in the tail flick assay in mice, for the strong opiate morphine, the partial opiate agonist tramadol and the tricyclic antidepressant desimipramine.

The short-term effect of gloving in combination with Traditional Thai Massage, heat, and stretching exercise to improve hand mobility in scleroderma patients.

BACKGROUND: Systemic sclerosis (SSc) is a chronic, multisystem connective tissue disorder characterized by autoimmune activation, microvascular endothelium damage, and excessive collagen proliferation. The most affected hand presents claw hand deformity and microvascular disease. Deformed hands can cause functional disability and decrease the quality of life. A daily home program can improve mobility of scleroderma patients. OBJECTIVE: We sought to determine the effect of a daily home exercise program on hand mobility among scleroderma patients. MATERIALS AND METHODS: This was a randomized control trial. Twenty-eight participants were divided into two groups, both of which received the same daily home treatment: Group 1 with gloves (n = 14) and Group 2 without gloves (n = 14). The 2-week daily home program combined traditional Thai massage (TTM) with stretching exercises and heat. Hand mobility was assessed using hand mobility in scleroderma (HAMIS). The study was conducted in patients who were already on vasodilator drugs. RESULTS: Both groups showed a significant improvement in hand mobility after 2 weeks of daily home exercise program (P < 0.05). Wearing the glove, however, resulted in better thumb mobility. CONCLUSIONS: A daily home exercise program improved hand mobility among patients with scleroderma and wearing gloves may improve thumb mobility.

Antidepressant/anxiolytic and anti-nociceptive effects of novel 2-substituted 1,4-benzodiazepine-2-ones.

Oxazepam (4a) has been used as overall starting material in the synthesis of novel 2-substituted 1,4-benzodiazepines.By reacting Oxazepam 4a with commercially available hydrazines, hydrazides, semicarbazide, aminoguanidine and N,N-dimethylamino aniline in ethanol under acetic conditions, a series of diazenyl-1,4-benzodiazepines 5aâ5i and 2-amino-1,4-benzodiazepine 5k were obtained in good yields.These novel compounds served as new chemical entities (NCE) for testing in mice. The diazo-benzodiazepine 5d has shown a promising antidepressant effect in initial experiments in vivo at a dose of 5 mg/kg. The highly coloured 2-aminobenzodiazepine derivative 5k showed over a dose range from 5â50 mg/kg an analgesic effect in mice.

In vivo evaluation of substituted 3-amino-1,4-benzodiazepines as anti-depressant, anxiolytic and anti-nociceptive agents.

Oxazepam (CAS 604-75-1) 4a served as building block in the synthesis of substituted 3-amino-1,4-benzodiazepines, which were subsequently tested in various CNS animal models. The hydroxy group of oxazepam was either activated as a chloride (Method A) or as a phosphor-oxy derivative (Method B) giving the desired 3-amino-1,4-benzodiapines 6a-6r in high yields with primary and secondary amines in a typical nucleophilic substitution reaction. Eighteen 3-substituted 1,4-benzodiazepines were prepared and served as new chemical entities and for lead structure discovery. The mixed cholecystokinin (CCK) antagonist 6e showed anxiolytic and antidepressant effects from 10 microg/kg in mice in the elevated x-maze test and the forced swimming test. The CCK1 antagonist 6 g has shown antidepressant effects from the same dose, but lacked anxiolytic properties. Both compounds potentiated at a dose of 0.5 mg/kg morphine antinociception with a maximum possible effect (MPE) about 35%. By assessing initially the MPE of antinocipection for the 18 newly synthesised benzodiazepines in the tail-flick test, 4 other benzodiazepines were found active. In further in vive evaluation the cyclohexyl derivative 6 i displayed anxiolytic, antidepressant and antinociceptive properties as single agent at a dose of 5 mg/kg without toxicity. The benzodiazepines 6i and 6p, which initially showed a higher MPE in terms of morphine potentiation (43/44%) showed analgesic effects as single agents, without having anxiolytic or antidepressant properties. The amino-piperidinyl derivative 6p displayed a similar dose-response relationship to morphine, but was 3 times more potent.

Synthesis and evaluation of N-(3-oxo-2,3-dihydro-1H-pyrazol-4-yl)-1H-indole-carboxamides as cholecystokinin antagonists.

The structure-activity relationship optimization of the pyrazoline template 3a resulted in novel 3-oxo-1,2-diphenyl-2,3-dihydro-1H-pyrazol-4-yl)-indole carboxamides 4a-4e. These non-peptidal CCK ligands have been shown to act as potent CCK1 ligands in a [125]I-CCK-8 receptor binding assay. The best amides (4c and 4d) of this series displayed an IC50 of 20/25 nM for the CCK1 receptor. In a subsequent in-vivo evaluation using various behaviour pharmacological assays, an anxiolytic effect of these novel 3-oxo-1,2-diphenyl-2,3-dihydro-1H-pyrazol-4-yl)-indole carboxamides was found at high doses in the elevated plus-maze. In the despair swimming test, a model for testing antidepressants, an ED50 of 0.33/0.41 mg kg(-1) was determined for amide 4c/4d and the antidepressant effect had a magnitude comparable to desimipramine.

Synthesis and evaluation of N-(5-methyl-3-oxo-1,2- diphenyl-2,3-dihydro-1H-pyrazol-4-yl)-N'-phenylureas as cholecystokinin antagonists.

In the search for new cholecystokinin (CCK) ligands, ureidopyrazolines were identified in combinatorial libraries using 168 chemically diverse amines. The structure-activity relationship optimisation of this pyrazoline template 4a resulted in novel 3-oxo-1,2-diphenyl-2,3-di-hydro-1H-pyrazol-4-yl)-N'-phenylureas 5a-5o. These novel CCK ligands have shown to act as mixed CCK-A/CCK-B ligands in a [125]I-CCK-8 receptor binding assay. The best pyrazoline 5e of this series displayed an IC50 of 20 and 25 nmol/L for the CCK-A, and CCK-B receptor, respectively. In a subsequent in vivo evaluation using various behavior pharmacological assays, an anxiolytic effect of these novel diphenylpyrazolinyl ureas was found in the elevated x-maze with an ED50 of 1.7 mg/kg. In the despair swimming test, a model for testing antidepressants, an ED50 of 0.69 mg/kg was determinated for urea 5e and the antidepressant effect had a magnitude comparable to desimipramine.