Lumbar Sympathetic Block for Postherpetic Neuralgia of Lower Limb: Familiar for a Long Time! – Comment to Ozturk et al ., 2021 Pain Practice

BACKGROUND: Many occupations require workers to stand for prolonged periods, which can cause discomfort, pain and even injures. Some supermarkets in life provide a foot pad for checkout staff to let them stand on it at work, thereby reducing standing fatigue caused by standing for a long time. The inclined platform is the same as the foot pad mentioned above. That is, the staff stepped on it and relieved standing fatigue to a certain extent. OBJECTIVE: The study aims to analyze how the standing angle affects fatigue among prolonged standing workers and tries to find an inclined platform with a specific angle to reduce standing fatigue. METHODS: This experiment studied fatigue of the inclined platforms with different angles on prolonged standing workers, eight participants were selected to participate in the test. The plantar pressures and sEMG (Surface Electromyography) were used to collect the physiological information change of prolonged standing participants in the lower limb and waist. The visual analogue scale was used as a subjective method to measure the psychological fatigue. RESULTS AND CONCLUSION: The study highlights the relationship between standing angle and lower limb fatigue. The inclination of the standing platform has different effects on the participants under different time conditions. When participants stand on inclined platforms at 0°, 5° and 10°, the iEMG (Integrated Electromyography) values of the gastrointestinal muscle were not significantly different until the third sampling point (40 minutes). After that self-regulation of lower limb muscles is better when standing on an inclined platform between 5° and 10°, it has a certain effect on alleviating lower limb fatigue. This knowledge is crucial for the design of the inclined working platforms fitting the needs of prolonged standing workers.

Download Full-text

Dual motor disability in an outpatient rehabilitation center

Acta Fisiátrica ◽

10.11606/issn.2317-0190.v27i1a169617 ◽

2020 ◽

Vol 27 (1) ◽

Author(s):

Marina Portugal Makhoul ◽

Kelly de Jesus Santana ◽

Uleida de Brito Lima Lopes ◽

Nádia Baggio Barreto Rodrigues ◽

Christina de Farias Dell’Aglio ◽

...

Keyword(s):

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Outpatient Rehabilitation ◽

Time Interval ◽

Rehabilitation Center ◽

Motor Disability ◽

Rehabilitation Period ◽

Long Time ◽

Social Demographic

Objectives: To estimate the prevalence of dual motor disability and to identify social, demographic, clinical and rehabilitation-related characteristics. Methods: Retrospective descriptive study in an outpatient rehabilitation center with individuals with dual motor disability from major lower limb amputation associated to post-stroke hemiparesis. Social demographic, clinical and rehabilitation characteristics data were collected from medical record. Results: The prevalence of dual motor disability was 5.4%. Seventy-six subjects were evaluated, 69.7% were male, with a mean age of 65.6 ± 9.3 years. Hypertension was present in 96.1% of subjects, and 25% were smokers. Over 73% of patients had had the stroke prior to amputation. Time elapsed between lesions had a median of 23 months, and sequelae were ipsilateral in 51.3% of patients. Of these, 54 patients (71%) were referred to physical therapy. The time interval between dual disability and the beginning of therapy was 28 months, with total rehabilitation time of 14.3 months. At rehabilitation completion, 36% achieved their goals but 30% were discharges consequent to lack of compliance. Conclusion: The prevalence of dual motor disability due to hemiparesis secondary to stroke and lower limb amputation in a rehabilitation center was 5.4%. Our population showed singular characteristics related to the rehabilitation process, such as a long time between the occurrence of dual disability and the beginning of rehabilitation, and long rehabilitation period.

Download Full-text

SUPRACONDYLAR FRACTURE FEMUR

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.10.1725 ◽

2016 ◽

Vol 23 (10) ◽

pp. 1214-1220

Author(s):

Faheem Ahmed Memon ◽

Mehtab Pirwani ◽

Abbas Memon

Keyword(s):

Lower Limb ◽

Open Fracture ◽

Cross Sectional Study ◽

Union Rate ◽

Cross Sectional ◽

Articular Fractures ◽

Long Time ◽

Surgery Department ◽

Study Hospital

Objectives: Our experience by dynamic condylar screw in the treatment ofsupracondylar femur fracture, which is quite a long time, has stayed challengeable issue inorthopedic surgery, at LUH. Study Design: An observational cross sectional study. Setting:Orthopedic Surgery Department, Liaquat University. Methodology: Cases along both sexeswith additional articular fractures, conceded inside of 2-3 days were incorporate and caseshaving open epiphysis, open fracture, pathological and intra articular fractures were not a pieceof this study. Hospital stay average was 18 days. Follow up was done of every one of thePatients after each third week for two only visits, then every 6th week for about 6 months. Allthe data were recorded on particularly outlined proforma. Results: In this study 19(63.3%) maleand 11 female (36.6%) patients. Mean age was found 35yrs. Commonest cause of injury wasRTA in 80% patients. 65% patients got injury to left lower limb while 35% to right lower limb. Therewere only two infections i.e. the infection rate was 6.66%. Union rate was 93.3% and nonunionrate was 3.3% and there was only one mal union i.e. mal union rate was 3.3% .Bone grafting wasdone in 21 patients. The overall good to excellent results were in 84% cases and fair to poor in16% cases. Conclusions: DCS gives solid fractures fixation after decrease and makes postoperativerecovery simple, so in light of patient’s financial state in Pakistan. DCS is perfect insertfor distal femoral exceptionally for these fractures.

Download Full-text

Pulsed Radiofrequency Of Sympathetic Lumbar Plexus Versus Sympathetic Block In The Management Of Lower Limb Complex Regional Pain Syndrome Type 1

Journal of Pain & Relief ◽

10.4172/2167-0846.1000138 ◽

2014 ◽

Vol 03 (02) ◽

Author(s):

Freitas TS

Keyword(s):

Complex Regional Pain Syndrome ◽

Lower Limb ◽

Pain Syndrome ◽

Lumbar Plexus ◽

Syndrome Type ◽

Pulsed Radiofrequency ◽

Sympathetic Block

Download Full-text

Phenol Lumbar Sympathetic Block in Diabetic Lower Limb Ischemia

European Journal of Cardiovascular Prevention & Rehabilitation ◽

10.1177/174182679500200512 ◽

1995 ◽

Vol 2 (5) ◽

pp. 467-469 ◽

Cited By ~ 12

Author(s):

A. Mashiah ◽

D. Soroker ◽

S. Pasik ◽

T. Mashiah

Keyword(s):

Lower Limb ◽

Limb Ischemia ◽

Sympathetic Block ◽

Lower Limb Ischemia

Download Full-text

Phenol lumbar sympathetic block in diabetic lower limb ischemia

Journal of Cardiovascular Risk ◽

10.1097/00043798-199510000-00012 ◽

1995 ◽

Vol 2 (5) ◽

pp. 467???470 ◽

Cited By ~ 8

Author(s):

Aharon Mashiah ◽

David Soroker ◽

Shlomo Pasik ◽

Tonni Mashiah

Keyword(s):

Lower Limb ◽

Limb Ischemia ◽

Sympathetic Block ◽

Lower Limb Ischemia

Download Full-text

Haemodynamic Effects and Complications of Unilateral Spinal versus Standard Spinal Anesthesia in Elderly with Low Ejection Fraction Undergone Lower-Limb Surgery

Delta Medical College Journal ◽

10.3329/dmcj.v5i1.31426 ◽

2017 ◽

Vol 5 (1) ◽

pp. 20-24

Author(s):

Md Mushfiqur Rahman ◽

Md Mahbubul Hasan Munir ◽

Raihanuddin ◽

Shafiul Alam Shaheen ◽

Md Abdus Salam Khan ◽

...

Keyword(s):

Spinal Anesthesia ◽

Spinal Anaesthesia ◽

Lower Limb ◽

Motor Block ◽

Sympathetic Block ◽

Hyperbaric Bupivacaine ◽

Unilateral Spinal Anesthesia ◽

Lower Limb Surgery ◽

Group A ◽

Group B

Background: Cardiovascular system may be profoundly affected by spinal anaesthesia due to unavoidable sympathetic blockade which is more prominent in elderly.A restricted sympathetic block during spinal anesthesia may minimize hemodynamic changes.Objective: To assess whether a unilateral spinal anaesthesia using 0.5% hyperbaric bupivacaine will restrict the sympathetic block to avoid the undesired cardio vascular effects.Materials and method: In this prospective study 60 ASA Ill and IV patients aged between 60-90 years undergoing unilateral lower limb surgery were included. Patients were divided into two groups. In group-A, dural puncture was performed with the patient in the lateral decubitus position with 1.5 mL of hyperbaric bupivacaine. In group-B, it was performed with the patient in a seated position using 1.5 mL hyperbaric bupivacaine. Each patient was then placed in supine position. The speed of injection was 1 mL/30s. Patients were placed in the lateral position with operated side down and kept in this position for 10 minutes. Motor and sensory levels were assessed, and haemodynamic alterations were monitored just after block, 5, 10, 15 and 30 minutes of spinal anaesthesia.Results: The demographic data were found similar in both groups. The time to the onset of the sensory and motor block was significantly shorter in group-B. The duration of motor and sensory block was significantly shorter in group-A. Haemodynamically all the parameters revealed better out come in unilateral spinal anesthesia. The incidence of complications (nausea, headache, and hypotension) was also lower in group A.Conclusion: When unilateral spinal anesthesia was performed using a low-dose, low-volume and low-flow injection technique, it provides adequate sensory-motor block and helps to achieve stable hemodynamic parameters during surgery on a lower limb. Furthermore, this technique avoids unnecessary paralysis on the non-operated side.Delta Med Col J. Jan 2017 5(1): 20-24

Download Full-text