Efficacy of Rehabilitative Techniques on Pain Relief in Patients With Vulvodynia: A Systematic Review and Meta-Analysis.

OBJECTIVE: Vulvodynia is a chronic clinical condition characterized by provoked or non-provoked vulvar pain for at least 3 months of unknown etiology. The onset of vulvodynia involves a complex interplay of peripheral and central pain mechanisms, such as pelvic floor muscle and autonomic dysfunction, and interpersonal factors. A stepwise approach of pelvic floor physical therapy as medical management is suggested. In this scenario, by this meta-analysis of randomized controlled trials, we aimed to evaluate the efficacy of rehabilitation interventions in patients with vulvodynia. METHODS: On October 13, 2022, PubMed, Scopus, and Web of Science were systematically searched for randomized controlled trials that assessed the efficacy of the rehabilitative approach to pain during intercourse in patients with vulvodynia. The quality assessment was performed with the Cochrane risk-of-bias tool for randomized trials. The trial registration number is CRD42021257449. At the end of the search, 9 studies were included for a total of 332 patients. A pairwise meta-analysis was performed to highlight the efficacy of rehabilitative approaches for reducing pain during intercourse, as measured with a visual analog scale or a numerical rating scale. RESULTS: Meta-analysis showed that all these rehabilitative approaches had an overall effect size of -1.43 (95% CI = -2.69 to -0.17) in decreasing vulvodynia pain in terms of the visual analog scale. In the subgroup analysis, a significant effect size in acupuncture (effect size = -2.36; 95% CI = -3.83 to -0.89) and extracorporeal shockwave therapy (effect size = -2.94; 95% CI = -4.31 to -1.57; I2 = 58%) was observed. According to the Cochrane risk-of-bias tool, a low risk of bias for outcome selection in 89% of studies. CONCLUSION: Findings from this meta-analysis suggested that the physical agent modalities and complementary medicine techniques in people with vulvodynia appear to be more effective than placebo, sham, or waiting list. Further evidence on physical agent modalities and complementary therapies are warranted in the future. IMPACT: This was the first systematic review and meta-analysis of randomized controlled trials to provide evidence on the efficacy of rehabilitation interventions in patients with vulvodynia.

Progress in Functional Urology Reflected in Recent Papers in the Journal of Clinical Medicine.

Benign conditions of the lower urinary tract, including benign prostatic hyperplasia, overactive bladder syndrome, and stress urinary incontinence, are frequent in the general population. Despite their benign nature, they have major adverse effects on the quality of life of the afflicted patients and their partners. Despite major progress in the diagnosis and treatment of these conditions, improved understanding and management of these patients remain substantial medical needs. This editorial discusses some recent high-quality articles published in the Journal of Clinical Medicine on the understanding of the epidemiology, pathophysiology, diagnostic, and treatment of benign diseases of the lower urinary tract tissues such as the bladder and prostate.

Efficacy of electrophysical agents in fibromyalgia: A systematic review and network meta-analysis.

OBJECTIVE: To examine the effectiveness of electrophysical agents in fibromyalgia. DATA SOURCES: CINAHL, Cochrane Library, Embase, Medline, PEDro, and Web of Science were searched from their inceptions to March 27, 2023. METHODS: This study was registered in PROSPERO (CRD42022354326). Methodological quality of included trials was assessed using PEDro scale, and the quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system. The primary outcomes were pain, functional status, and mood. RESULTS: Fifty-four studies involving 3045 patients with fibromyalgia were eligible for qualitative synthesis and 47 (pain), 31 (functional status), and 26 (mood) for network meta-analysis. The network consistency model revealed that, when compared with true control, transcutaneous electrical nerve stimulation and microcurrent improved pain symptoms (P = 0.006 and P = 0.037, respectively); repetitive transcranial magnetic stimulation improved patient functional status (P = 0.018); and microcurrent (P = 0.001), repetitive transcranial magnetic stimulation (P = 0.022), and no treatment (P = 0.038) significantly improved mood after intervention. Surface under the cumulative ranking indicated that microcurrent was most likely to be the best for managing pain and mood (surface under the cumulative ranking: 70% and 100%, respectively); low-level laser therapy for pain and mood (80% and 70%, respectively); and repetitive transcranial magnetic stimulation for improving functional status and mood (80% and 70%, respectively). CONCLUSION: This review found low to moderate quality evidence that microcurrent, laser therapy, and repetitive transcranial magnetic stimulation are the most effective electrophysical agents for improving at least one outcome in fibromyalgia.

Physical agent detection ability of occupational health technical service institutions in Guangdong Province / 中国职业医学

@#Objective To analyze the physical agent detection ability of occupational health technical service institutions in Methods Guangdong Province. A total of 92 institutions in Guangdong Province that participated in the inter laboratory comparison of physical agents organized in 2020 were taken as the research subjects using purposive sampling method. The ， Results certified physical factor items number of measuring instruments and measurement standards were investigated. The ， ， certification and accreditation project on physical agents in 92 institutions with certification and accreditation rate >80.0% ， ， ， - were noise high temperature ultraviolet radiation hand transmitted vibration and illumination. The certification approval rates ， ， ， ， of power frequency magnetic field 1 Hz to 100 kHz electric field 1 Hz to 100 kHz magnetic field laser radiation physical ， - < （ ） labor intensity and whole body vibration were 60.0%. The certification and accreditation rate of noise 98.9% was the ， （ ） （P< ） ， highest and that of the physical labor intensity 3.3% was the lowest 0.01 . As for the number of measuring instruments （ ） the number of noise measuring instruments accounted for the highest proportion 52.6% in 92 institutions. The number of ， （P< ） measuring instruments from the most to the least was grade A grade B and unqualified institutions 0.01 . The number of - （P< ） measuring instruments in private institutions was greater than that in non private institutions 0.01 . In the measurement ， ， standards some institutions that have certified power frequency electric field power frequency magnetic field and microclimate ， - projects still used the abandoned standard. Some institutions that have certified microclimate illuminance and whole body Conclusion ， vibration used the wrong measurement standards. Among the physical agents the certification and accreditation ， rate of noise is the highest and the number of noise related measuring instruments is the largest. The qualified institutions and private institutions have greater number of certification and accreditation projects on physical agents and measuring instruments.

El ruido en el ambiente laboral estomatológico / Noise in the stomatological working environment

Se realizó un estudio observacional, descriptivo y transversal de 59 trabajadores que se encontraban laborando físicamente en el Servicio de Estomatología del Policlínico Docente Julián Grimau García de Santiago de Cuba, desde julio de 2015 hasta igual mes de 2016, con el objetivo de identificar los niveles de ruido existentes en el ambiente laboral de dicho Servicio. En la serie se obtuvo que los departamentos de mayor nivel de ruido resultaron ser: Prótesis (73,2 dB), Ortodoncia y Periodoncia (72,7 dB) y Conservadora (71,2 dB), en ese orden; asimismo, en cuanto al ruido de fondo, las mayores mediciones se registraron en los departamentos de Conservadora y de Prótesis (68,6 y 68,1 dB, respectivamente). Por otra parte, 62,7 por ciento del total de trabajadores presentaron problemas de hipoacusia por estar expuestos permanentemente a este agente físico negativo

An observational, descriptive and cross-sectional study of 59 workers that were physically working in the Stomatology Service of Julián Grimau Teaching Polyclinic in Santiago de Cuba was carried out from July, 2015 to the same month in 2016, aimed at identifying the noise level existing in the working environment of this Service. The departments with higher noise level according to the series were: Prosthesis department (73.2 dB), Orthodontics and Periodontics departments (72.7 dB) and Conservative department (71.2 dB), in that order; as for the back noise, the higher measurements were recorded in the Conservative and Prosthesis departments (68.6 and 68.1 dB, respectively. On the other hand, 62.7 percent of all the workers presented hearing deficit for being permanently exposed to this negative physical agent

La iluminación como agente físico negativo en un servicio estomatológico / Illumination as negative physical agent in a stomatological service

Se realizó un estudio observacional, descriptivo y transversal de 59 trabajadores que se encontraban laborando físicamente en el Servicio de Estomatología del Policlínico Docente Julián Grimau de Santiago de Cuba, desde julio de 2015 hasta igual mes de 2016, con el fin de identificar la iluminación como agente físico negativo en el ambiente laboral. En la serie predominaron el sexo femenino (93,2 por ciento), el grupo etario de 50-54 años (23,7 por ciento), los estomatólogos generales integrales (44,0 por ciento), así como el departamento de Ortodoncia y Periodoncia como el de menor iluminación. Por otra parte, 81,4 por ciento de los trabajadores estaban expuestos a esta problemática y 93,8 por ciento presentaban afecciones oculares. Se evidenció que la iluminación deficiente encontrada en todos los departamentos del mencionado centro resulta perjudicial para la salud de los profesionales de la estomatología

An observational, descriptive and cross-sectional study of 59 workers that were physically working in the Stomatological Service of Julián Grimau Teaching Polyclinic in Santiago de Cuba, was carried out from July, 2015 to the same month in 2016, with the purpose of identifying the illumination as negative physical agent in the working environment. In the series there was a prevalence of the female sex (93.2 percent), the 50-54 years age group (23.7 percent), the comprehensive general dentists (44.0 percent), as well as the Orthodontics and Periodontics department as that of less illumination. On the other hand, 81.4 percent of the workers were exposed to this problem and 93.8 percent presented ocular disorders. It was evidenced that poor illumination found in all the departments of the mentioned center is harmful for the stomatology professionals health

Physical agent modalities in physical therapy and rehabilitation of small animals.

Physical agent modalities can be effective components of the overall rehabilitation of small animals. This article reviews the effects, indications, contraindications, and precautions of cold, superficial heat, therapeutic ultrasound, and electrical stimulation.

Superimposed electrical stimulation improves mobility of pre-stiff thumbs after ulnar collateral ligament injury of the metacarpophalangeal joint: a randomized study.

OBJECTIVE: This study aimed at testing the ability of the superimposed electrical stimulation technique to restore the mobility of pre-stiff thumbs after operative repair for rupture of the ulnar collateral ligament. MATERIAL AND METHODS: Eight patients demonstrating a pre-stiff metacarpophalangeal joint were involved in two rehabilitation sessions of a counterbalanced design. In the voluntary contraction session, they performed 20min of repeated active flexions of the impaired metacarpophalangeal joint. In the superimposed electrical stimulation session, they performed 20min of percutaneous neuromuscular electrical stimulations which were superimposed to voluntary flexion. RESULTS: Mean active range of motion improvement from pre- to post-session was significantly greater in the superimposed electrical stimulation condition compared to the voluntary contraction condition (11±5 deg versus 3±4 deg; P<0.01). CONCLUSION: Superimposing electrical stimulation to voluntary contractions is an efficient technique to improve active range of motion of the pre-stiff metacarpophalangeal joint of the thumb.