Pressure-Controlled Palpation: A New Technique Which Increases the Reliability of Manual Palpation

Cephalalgia ◽  
1995 ◽  
Vol 15 (3) ◽  
pp. 205-210 ◽  
Author(s):  
L Bendtsen ◽  
R Jensen ◽  
NK Jensen ◽  
J Olesen
Keyword(s):  
Pain Intensity ◽  
Myofascial Pain ◽  
Tension Type Headache ◽  
New Technique ◽  
Future Research ◽  
Manual Palpation ◽  
A New Technique ◽  
Type Headache ◽  
First Time ◽  
Pressure Controlled

The objective of the present study was to investigate whether the reliability of tenderness evaluation can be increased by using a new technique called “pressure-controlled palpation” (pcp). The technique has been made possible by a newly invented piece of equipment called a palpometer, with which a pressure-sensitive plastic film attached to the index finger records the pressure exerted. In 15 patients with chronic tension-type headache and in 15 healthy volunteers, 2 investigators studied myofascial tenderness using conventional palpation and pressure-controlled palpation. Tenderness was scored on a 4–point scale in each of the examined pericranial regions. The sum of tenderness scores recorded by two observers using conventional palpation differed significantly ( p = 0.0003), while results did not differ between observers using pressure-controlled palpation ( p = 0.89). During palpation with seven different pressure intensities a positive and linear relation between pressure and pain intensity was found ( p = 0.00006). Pain intensity reported by the subjects correlated highly with tenderness scored by the observer (rs = 0.95, p < 0.0001). These results demonstrate for the first time that tenderness scores can be compared between observers if palpation pressure is controlled. Pressure-controlled palpation represents a major improvement on current palpation techniques and should be standard in future research on myofascial pain disorders.

History of Headache Research in Denmark

Cephalalgia ◽  
2001 ◽  
Vol 21 (7) ◽  
pp. 748-752 ◽  
Author(s):  
P Tfelt-Hansen
Keyword(s):  
Migraine With Aura ◽  
Tension Type Headache ◽  
Regional Cerebral Blood ◽  
Danish Population ◽  
Genetic Studies ◽  
History Of ◽  
Headache Clinic ◽  
Type Headache ◽  
Acute Headache ◽  
First Time

Headache research in Denmark started with the description in 1949 by Dalsgaard-Nielsen of the percutaneous nitroglycerin test. In 1976 Jes Olesen started The Copenhagen Acute Headache Clinic and from that time modern headache research began in Denmark. Specific changes in regional cerebral blood flow during attacks of migraine with aura, spreading oligaemia, were described for the first time in 1980. The first headache classification with operational diagnostic criteria was published in 1988 and used in a Danish population study from 1989. The lifetime prevalence of migraine was 8% in men and 25% in women. An intravenous nitroglycerin test was introduced in 1989 and has been developed as an experimental headache model. In 1993 it was suggested by Jes Olesen et al. that NO supersensitivity could be a possible molecular mechanism of migraine pain. Recent genetic studies have supported the distinction between migraine with aura and migraine without aura. From the middle of the 1980s the pathophysiology of tension-type headache has been investigated and recent results indicate central sensitization in patients with chronic tension-type headache.

scholarly journals Effectiveness of Neck Myofascial Release Techniques and Exercise Therapy on Pain Intensity and Disability in Patients with Chronic Tension-Type Headache

2016 ◽  
Vol 9 (6) ◽  
pp. 47
Author(s):  
Mohammad Hosseinifar ◽  
Razieh Bazghandi ◽  
Zahra Azimi ◽  
Bahareh Khodadadi Bohlouli
Keyword(s):  
Pain Intensity ◽  
Exercise Therapy ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Tension Type Headache ◽  
Control Group ◽  
Myofascial Release ◽  
Headache Intensity ◽  
Headache Disability ◽  
Type Headache

PURPOSE: Tension type headache (TTH) is one of the most prevalent types of headache. TTH is classified as episodic if it occurs on less than 15 days a month and as chronic if it occurs more often. Tension, anxiety and depression are some etiological factors for TTH which leads to work efficiency reduction. Today the interest in non-pharmacological methods is increasing; massage is one of these approaches which has no side effects. Aim of this study was to investigate the effects of neck Myofascial Release (MFR) techniques and exercise therapy on pain intensity and disability in patients with chronic tension-type headache.METHODS: This randomized clinical trial study was investigated on 30 females suffering from TTH. Participants were randomly assigned into two equal groups (n=15). The MFR group received neck MFR massage and exercise therapy four times a week for 3 weeks, each session lasting 45 minutes. Control group had no intervention. Outcomes were headache intensity and disability measured by numerical rating scale (NRS) and headache disability index (HDI), respectively. Data was analysed through independent and pair t-test.RESULTS: Between group comparison showed significant improvement of headache intensity and disability rate in MFR group (p<0.05) than control group (p=0.000).DISCUSSION: This study provides evidences that MFR technique and exercise therapy have significant effect on patients with TTH.

Muscular Disorders in Tension-Type Headache

Cephalalgia ◽  
1996 ◽  
Vol 16 (2) ◽  
pp. 97-103 ◽  
Author(s):  
R Jensen ◽  
BK Rasmussen
Keyword(s):  
Diagnostic Criteria ◽  
Tension Type Headache ◽  
Receiver Operating Characteristics ◽  
Operating Characteristics ◽  
Pain Thresholds ◽  
Muscular Disorders ◽  
Muscle Tenderness ◽  
Manual Palpation ◽  
Type Headache ◽  
Receiver Operating

In order to evaluate the diagnostic criteria for muscular disorders in tension-type headache, pericranial muscle tenderness and pressure pain thresholds were studied in a random sample population of 735 adults aged 25–64. In addition, quantitative EMGs were recorded in 547 of these subjects. The correlation between the three diagnostic tests was assessed and the discriminality and cut-off points were analysed using Receiver Operating Characteristics analysis. Local tenderness from the temporal muscles was closely related to the total tenderness scores from 14 pairs of muscles. In chronic tension-type headache, tenderness was positively related to EMG and inversely related to pain thresholds. In the episodic form the total tenderness score was inversely related to pain thresholds, whereas no significant relation to EMG was noted. The Receiver Operating Characteristics curves indicated that tenderness recorded by manual palpation was the most specific and sensitive test, whereas EMG and pain thresholds were of limited diagnostic value. Eighty-seven percent of subjects with the chronic, and 66% of subjects with the episodic form were found to have a “muscular disorder” defined as increased tenderness recorded by either manual palpation or pressure algometry and/or increased EMG levels. However, muscle tenderness increased significantly during pain, so the headache state should be considered in future studies. Suggestions for revision of the present diagnostic criteria for muscular disorders are given.

scholarly journals Interference-contrast optical activity: a new technique for probing the chirality of anisotropic samples and more

2020 ◽  
Vol 7 (5) ◽  
pp. 192201 ◽  
Author(s):  
R. P. Cameron ◽  
U. Vogl ◽  
N. Trautmann
Keyword(s):  
Pharmaceutical Industry ◽  
Optical Activity ◽  
Optical Rotation ◽  
New Technique ◽  
Future Research ◽  
Linear Birefringence ◽  
New Class ◽  
Potential Applications ◽  
A New Technique ◽  
Chiral Crystals

We introduce interference-contrast optical activity (ICOA) as a new technique for probing the chirality of anisotropic samples and more. ICOA could underpin a new class of ‘chiral microscopes’, with potential applications spanning the range of chirality and beyond. Two possible versions of ICOA are described explicitly; one designed to probe the optical rotation of a transparent sample regardless of the sample’s linear birefringence (ICOA-OR) and another designed to probe gradients in the optical rotation of a transparent sample (ICOA-GOR). Simulated results for α -quartz lead us to suggest that ICOA-GOR might be applied to help monitor the growth of chiral crystals in the pharmaceutical industry. Possible directions for future research are highlighted.

Noticing Aloud: Uncovering Mathematics Teacher Noticing in the Moment

2020 ◽  
Vol 8 (2) ◽  
pp. 25-36
Author(s):  
Jen Munson
Keyword(s):  
Cognitive Processes ◽  
Mathematics Teacher ◽  
New Technique ◽  
Future Research ◽  
Teacher Noticing ◽  
Student Work ◽  
Growing Body ◽  
A New Technique ◽  
The Moment

Understanding mathematics teacher noticing has been the focus of a growing body of research, in which student work and classroom videos are often used as artifacts for surfacing teachers’ cognitive processes. However, what teachers notice through reflecting on artifacts of teaching may not be parallel to what they notice in the complex and demanding environment of the classroom. This article used a new technique, side-by-side coaching, to uncover teacher noticing in the moment of instruction. There were 21 instances of noticing aloud during side by side coaching which were analyzed and classified, yielding 6 types of teacher noticing aloud, including instances in which teachers expressed confidence, struggle, and wonder. Implications for coaching and future research on teacher noticing are discussed.

The Reproducibility of Cephalic Pain Pressure Thresholds in Control Subjects and Headache Patients

Cephalalgia ◽  
1997 ◽  
Vol 17 (7) ◽  
pp. 748-755 ◽  
Author(s):  
T Sand ◽  
JA Zwart ◽  
G Helde ◽  
G Bovim
Keyword(s):  
Pain Intensity ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cervicogenic Headache ◽  
Tension Type Headache ◽  
Control Subjects ◽  
Cephalic Pain ◽  
Type Headache ◽  
The Right ◽  
Headache Patients

Pain pressure thresholds (PPT) were measured at 13 cephalic points bilaterally in 30 headache patients (10 with tension-type headache, 10 with migraine and 10 with cervicogenic headache) and 10 control subjects on three different days. During the sessions, the subjects reported their pain intensity on the right and left sides of the head on a visual analogue scale (VAS). The variability between days was estimated as a coefficient of repeatability (CR=2 standard deviations of intraindividual differences). The mean CR across all 13 locations was larger in headache patients (2.0 kg/cm2) than in controls (1.68 kg/cm2). Variability (CR) was larger in headache patients as compared to control subjects for 11 of the 13 points (p=0.02). Reliability was better in controls (intraclass correlation coefficients (ICC) ranging from 0.55 to 0.85) than in headache patients (ICC ranging from 0.43 to 0.78). A moderate negative association between PPT and pain intensity was demonstrated. The intraindividual PPT difference (PPT on the most painful occasions-PPT on the least painful occasions) was negative at 12 of 13 cephalic points (p=0.003, across-location mean difference: -0.20 kg/cm2). The PPT differed significantly from one day to the next. A part of this variation was presumably related to the circumstances around the procedure; thresholds were lower when the subjects came directly to algometry without any preceding medical examination at all 13 points (p=0.0002). These results have implications for the planning of future algometer studies. The sample size that is required in studies of headache patients is greater than that in studies of healthy subjects, especially when patients suffer from pain during the PPT session. Particular attention should be paid to circumstances (e.g. preceding medical investigations) around the algometry procedure in order to reduce variability.

Efficacy and Safety of Metamizol vs. Acetylsalicylic Acid in Patients With Moderate Episodic Tension-Type Headache: A Randomized, Double-Blind, Placebo- and Active-Controlled, Multicentre Study

Cephalalgia ◽  
2001 ◽  
Vol 21 (5) ◽  
pp. 604-610 ◽  
Author(s):  
P Martínez-Martín ◽  
E Raffaelli ◽  
F Titus ◽  
J Despuig ◽  
YD Fragoso ◽  
...  
Keyword(s):  
Pain Relief ◽  
Acetylsalicylic Acid ◽  
Pain Intensity ◽  
Pain Reduction ◽  
Tension Type Headache ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Maximum Pain ◽  
Type Headache

We assessed the efficacy and safety of oral single doses of 0.5 and 1 g metamizol vs. 1 g acetylsalicylic acid (ASA) in 417 patients with moderate episodic tension-type headache included in a randomized, double-blind, placebo- and active-controlled, parallel, multicentre trial. Eligibility criteria included 18–65 years of age, history of at least two episodes of tension-type headache per month in the 3 months prior to enrolment, and successful previous pain relief with a non-opioid analgesic. Treatment arms were metamizol 0.5 g ( n = 102), metamizol 1 g ( n = 108), ASA 1 g ( n = 102) and placebo ( n = 105). The analgesic efficacy of 0.5 and 1 g metamizol vs. placebo was highly statistically significant (α: 0.025; one-sided) for sum of pain intensity differences, maximum pain intensity difference, number of patients with at least 50% pain reduction, time to 50% pain reduction, maximum pain relief and total pain relief. A trend towards an earlier onset of a more profound pain relief of 0.5 and 1 g metamizol over 1 g ASA was noticed. All medications including placebo were almost equally safe and well tolerated.

scholarly journals The Mostafa Maged hemostatic flipping-over technique to control and prevent the post-partum bleeding from the lower uterine segment in placenta previa cases

2021 ◽  
Vol 11 (1) ◽  
pp. 237
Author(s):  
Mostafa Maged Ali
Keyword(s):  
Placenta Previa ◽  
Post Partum ◽  
Lower Uterine Segment ◽  
New Technique ◽  
Post Partum Hemorrhage ◽  
Short Period ◽  
Long Time ◽  
A New Technique ◽  
First Time ◽  
Post Partum Bleeding

Post-partum hemorrhage is still a headache to all obstetricians around the whole world. Every obstetrician exerts his own full effort to control bleeding which can occur post-partum by applying all maneuvers to preserve the fertility and the uterus for the patient. We demonstrate a new technique (Mostafa Maged) technique to control and prevent post-partum hemorrhage. It is so simple maneuver and easy to be applied within short period of time. Satisfactory hemostasis can be assessed after application. The aim of this technique is to see the Success in Controlling and prevention of the bleeding from placenta previa cases from lower uterine segment. The average duration of this new technique is (5-7) minutes. The results have shown that the hysterectomy done to one patient with new technique (1/13) (7.6%) cases because of the uncontrollable bleeding, blood was creeping down from the flipped sutured lower uterine segment. All of patients are introduced to the operating room as first-time cesarean section. One patient (7.6%) out of thirteen patients were tachycardiac post-operatively due to the more loss of blood as the new (Mostafa Maged) technique took a long time in these two patients (8 minutes). The tests of success were expected if hemostasis is done by the bimanual compression at first place.

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