The H-Wave small muscle fiber stimulator, a nonpharmacologic alternative for the treatment of chronic soft-tissue injury and neuropathic pain: an extended population observational study.

In a previous study, the H-Wave small-muscle fiber stimulator significantly reduced chronic pain and restored physical function among patients with pain in the lower and upper extremities and spine. In this extended population observational study, a cross-sectional,computer-administered 10-item survey was administered to 6774 patients (3367 men [49.7%], 3406 women [50.3%], and 1 sex not reported [<1%]; mean+/-SD age, 45.28+/-10.08 y; range, 18-65 y) with chronic soft-tissue injury or neuropathic pain to assess their therapeutic response. The mean+/-SE duration of self-administered H-Wave treatment before the survey was completed was 87.35+/-1.39 d. Sixty-five percent of study participants reported a reduced or eliminated need for pain medication; 79% reported improved functional capacity or activity; and 78% reported 25% or greater reduction of pain. This cross-sectional evaluation represents the largest outcome study on the benefits of the H-Wave device in patients with chronic soft-tissue injury or neuropathic pain. The results suggest that this nonpharmacologic approach may provide an important alternative to standard pharmacologic treatment.

Exercise and the bottom line: promoting physical and fiscal fitness in the workplace: a commentary.

One important way that physicians can promote regular exercise by patients is to encourage employers to establish exercise facilities and programs in the workplace. Physicians can also help design such programs. Employers who offer exercise opportunities may benefit from reduced healthcare costs, absenteeism, injury rates, and turnover and improved job performance, productivity, and morale.

Expanding medical horizons.

When I was completing my orthopedic surgery residency in the early 1980s, a slogan on a T-shirt caught my attention: "Exercise Is Medicine." The idea made great sense to me, especially considering its rich tradition going back to Hippocrates. At that time, however, the clinical role for exercise as medicine was minimally defined.

Osteoarthritis: how to make exercise part of your treatment plan.

The idea of exercising with swollen, painful joints and weakened muscles may seem counterintuitive. But increasingly research shows that the vicious cycle of immobility and dependence initiated by osteoarthritis can be interrupted by making exercise part of therapy. A well-designed program of aerobic and resistance training and whole-body flexibility and joint mobility exercise should join other interventions such as weight loss, medication, physical therapy, joint protection, and surgery to improve symptoms and reduce the impact of osteoarthritis on patients' lives.

Patient adviser: exercise for osteoarthritis.

Proper treatment for osteoarthritis will help control pain and other symptoms, and let you live a more vigorous, satisfying life. Exercise is a vital part of osteoarthritis treatment: It's a scientifically proven way for you to help yourself. The right kind of exercise will benefit the joints that have been damaged by osteoarthritis, and it will boost your overall energy and ability to enjoy your favorite activities. Different kinds of exercise aerobic, strengthening, flexibility, and specific joint exercises can improve your health in different ways.

Youth fitness--problems and solutions.

Review of the current data in the area of youth fitness reveals some alarming trends. Children in the United States are fatter, slower, and weaker than their counterparts in other developed nations. In addition, U.S. children seem to be adopting a sedentary lifestyle at earlier ages. Although there is no easy solution to this problem, there are specific recommendations that can ensure improvement in this area. The cornerstone for any meaningful change must involve programs that seek to increase physical activity both in school and at home. Daily, quality physical education in grades K-12 should be mandated in all states. Parents should be educated regarding the critical importance and the multitude of benefits to be derived from their involvement in fitness-related activities with their children. A healthy balance must be established between sedentary activities, e.g., television and video games, and physical activity. All schools should establish fitness testing programs for children and these should be based on health-fitness parameters rather than on athletic performance variables. To ensure improvements in youth fitness across our nation, other interventions are also necessary. These include appropriate involvement of local communities, state and federal governments, the medical health professions, and the media. Specific strategies are available for each group.

Strength training.

Strength training has become quite popular and is now recommended as part of a well-balanced fitness program in healthy individuals. It is also useful in a wide variety of other clinical circumstances. An understanding of the pertinent basic science and research endeavors will help in the design and prescription of safe, effective programs.

Arthroscopy of the postmeniscectomy knee.

A retrospective study of 152 arthroscopic examinations following meniscectomy cites definitive findings with arthroscopy in comparison to plain x-rays and arthrograms. Degenerative findings are quantified, with confirmation of the vulnerability of the cruciate deficient knee and questions regarding the function of a regenerated meniscus.