ABSTRACT
Osteoarthritis (OA) is a serious sociomedical problem, one of the leading causes of persistent disability and reduced quality of life. Modern publications on the use of transdermal drug formulations for OA evaluate the efficiency and safety of isolated drug administration. Pulse magnetotherapy is a modern method for potentiating the therapeutic effects of both the drug and the magnetic field (MF) in the single magnetophoretic technique. AIM: to determine the effect of pulsed MF on the clinical efficacy and tolerability of magnetophoretic transdermal diclofenac delivery in patients with gonarthrosis. SUBJECTS AND METHODS: A clinical randomized placebo-controlled study was conducted in 65 patients with Kellgren-Lawrence grade 2-3 knee OA, who were divided into 3 groups. Group 1 including 25 patients received magnetophoretic diclofenac gel delivery using a traveling MF (intensity, 20 mT; frequency, 6.25 Hz; exposure. 20 min, 12 sessions); Group 2 consisting of 20 patients used placebo magnetotherapy with diclofenac without MF; Group 3 comprising 20 patients had low-frequency pulse magnetotherapy with traveling MF without topical diclofenac therapy. VAS and WOMAC and the EQ-5D questionnaire were used during the examination. The results of treatment were analyzed according to the OMERACT-OARSI criterion. RESULTS: According to VAS and WOMAC scores, combination therapy showed a marked analgesic effect in the patients who had received magnetotherapy (p<0.01), as well as a significant reduction in stiffness and an improvement in functional characteristics, which were more pronounced in those who had magnetophoresis (p<0.001). According to the EQ-5D questionnaire, magnetotherapy was noted to have a positive impact on quality-of-life indicators. Analysis according the OMERACT-OARSI criterion demonstrated a high rate (67.8%) of response to magnetophoretic sis using diclofenac application formulations. CONCLUSION: Magnetophoretic transdermal diclofenac delivery using low-frequency pulsed MF is effective and safe for patients with knee OA and causes no serious adverse events.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Diclofenac/administration & dosage , Drug Delivery Systems/methods , Magnetic Phenomena , Osteoarthritis, Knee/drug therapy , Administration, Cutaneous , Humans , Quality of Life , Treatment OutcomeABSTRACT
AIM: To investigate the efficacy and safety of the exoskeleton ExoAtlet in complex therapy of patients with multiple sclerosis (MS). MATERIAL AND METHODS: A pilot study within the prospective open controlled program was conducted. Eighteen patients with relapsing-remitting MS (RRMS) in remission and secondary progressive MS (SPMS) with the level of neurological deficit on the EDSS from 3 to 7 points have completed the study. EDSS, MSFC, HADS, MoCA scales were administered and the force measuring insoles F-Scan Tekscan (USA) were used to study the biomechanics of walking. RESULTS AND CONCLUSION: Good tolerability of workload within 30-40 min. was observed. The improvement in the EDSS was detected in 9 patients, in whole, a significant positive trend (p<0.01) was shown. The study of the biomechanics of the walk showed its significant impairment compared to healthy individuals: reduction of parameters of rate, speed and step length, significant instability, pronounced asymmetry, the decrease in support and shock lower limb function, high coefficient of variability of the parameters, the phenomenon of recurrence of the vertical component of support reactions. After a course of exercise of walking in the exoskeleton, the walking speed and stability increased, oscillation of the body decreased, support function increased, the phenomenon of cyclical changes of the vertical component of support reactions reduced. The results of the pilot study showed promising future research opportunities for robotic-assisted walking and maintenance of the vertical posture with the help of the exoskeleton ExoAtlet to restore the abilities of movement in MS patients with locomotor disorders.
Subject(s)
Exoskeleton Device , Multiple Sclerosis, Chronic Progressive , Multiple Sclerosis, Relapsing-Remitting , Walking , Humans , Multiple Sclerosis, Chronic Progressive/therapy , Multiple Sclerosis, Relapsing-Remitting/therapy , Pilot Projects , Prospective Studies , RoboticsABSTRACT
Basic difficulties of the adequate and precise electrophysiological examination of radial nerve injuries are traditionally conditioned by the impossibility to separate the muscle, isolated from the muscles, innervated by the ulnar or medial nerves. The phenomenon of flexor motor units potentials propagation by the stimulating electroneuromyography and M-flow registration from extensor muscles has been described in literature. To prevent the false interpretation of the examination results, 98 patients with radial nerve injuries were examined using the original program of separate assessment of motor and sensor fibers.
