Conservative treatment has comparable outcome with bouquet pinning of little finger metacarpal neck fractures: a multicentre randomized controlled study of 85 patients

Current literature gives few guidelines regarding indication for operative treatment of little finger metacarpal neck fractures, and some surgeons choose operative treatment when the palmar angulation exceeds 30°. The objective of this study was to determine whether conservative treatment produces comparable outcomes with bouquet pinning in a randomized, controlled trial. Eighty-five patients with little finger metacarpal neck fractures with ≥30° palmar angulation in the lateral view were included. Patients were randomized to two groups: conservative treatment without reduction of the fracture (43 patients); and closed reduction and bouquet pinning (42 patients). After 1 year, there were no statistical differences between the groups in QuickDASH score, pain, satisfaction, finger range of motion, grip strength, or quality of life. There was a trend versus better satisfaction with hand appearance ( p = 0.06), but longer sick leave ( p < 0.001) and more complications ( p = 0.02) in the operative group. Level of evidence: Level 2

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Modulation of the human immune status by spinal thermal massage: a non-randomized controlled study

10.22514/sv.2021.144 ◽

2021 ◽

Keyword(s):

Quality Of Life ◽

Nk Cells ◽

Nk Cell ◽

Controlled Trial ◽

Controlled Study ◽

Control Group ◽

Randomized Controlled ◽

Significant Difference ◽

Experimental Group

Thermal and massage therapies have long been used to control pain. Although spinal thermal massage (STM) has been used worldwide, its effectiveness has not been proven in a controlled clinical study. We here conducted a non-randomized controlled trial to assess the pain-relieving and immunomodulatory effects of STM in old-aged patients experiencing pain or disability. The experimental group was treated with STM five times a week for 8 weeks and rehabilitative regular care (RRC). The control group was treated with only RRC. Pain and immunological parameters were tested before treatment and after 4 and 8 weeks of treatment. The scores of three pain parameters were lowered by STM, and the differences between the groups were statistically significant at the two time points (p < 0.01). Quality of life determined using the 3-level EuroQol five-dimensional questionnaire scores was significantly higher in patients in the experimental group than those in the control group. Effect sizes (ES) were in the range of medium to large in the pain-related measures (0.54–1.22). The total leukocyte counts and the proportions of lymphocytes and subsets were not significantly different between the groups, whereas the proportions of monocytes and natural killer (NK) cells were higher in the experimental group than in the control group after 8 weeks (p < 0.05). The production of interleukin (IL)-4 and interferon γ in T cells was not significantly different between the groups, whereas the production of IL-2 was high in the control group. However, there was a significant increase in IFN-γ production by NK cells in the experimental group (at 4 weeks, p < 0.05). ES were medium in the immunological measures (0.53–0.68). No significant difference was observed in the production of proinflammatory cytokines, IL-1β, tumor necrosis factor α, or IL-6 between the groups. In conclusion, STM treatment has a positive effect on subjective pain and quality of life. It also enhanced NK cell proportion and activity, suggesting that STM may be beneficial in the prevention of viral diseases and cancer in old-aged people.

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Autologous Matrix-Induced Chondrogenesis (AMIC) and AMIC Enhanced by Autologous Concentrated Bone Marrow Aspirate (BMAC) Allow for Stable Clinical and Functional Improvements at up to 9 Years Follow-Up: Results from a Randomized Controlled Study

Journal of Clinical Medicine ◽

10.3390/jcm8030392 ◽

2019 ◽

Vol 8 (3) ◽

pp. 392 ◽

Cited By ~ 8

Author(s):

Laura de Girolamo ◽

Herbert Schönhuber ◽

Marco Viganò ◽

Corrado Bait ◽

Alessandro Quaglia ◽

...

Keyword(s):

Bone Marrow ◽

Bone Marrow Aspirate ◽

Controlled Trial ◽

Activity Level ◽

Controlled Study ◽

Level Of Evidence ◽

Chondral Lesions ◽

Randomized Controlled ◽

Functional Scores

The aims of the study were to evaluate long-term outcomes after autologous matrix-induced chondrogenesis (AMIC) in the treatment of focal chondral lesions and to assess the possible improvements given by the combination of this technique with bone marrow aspirate concentrate (BMAC). Twenty-four patients (age range 18–55 years) affected by focal knee chondral lesions were treated with standard AMIC or AMIC enhanced by BMAC (AMIC+). Pain (Visual Analogue Scale (VAS)) and functional scores (Lysholm, International Knee Documentation Committee (IKDC), Tegner, Knee injury and Osteoarthritis Outcome Score (KOOS)) were collected pre-operatively and then at 6, 12, 24, 60, and 100 months after treatment. Magnetic resonance imaging (MRI) evaluation was performed pre-operatively and at 6, 12, and 24 months follow-ups. Patients treated with AMIC+ showed higher Lysholm scores (p = 0.015) and lower VAS (p = 0.011) in comparison with patients in the standard AMIC group at the 12 months follow-up. Both treatments allowed for functional and pain improvements with respect to pre-operative levels lasting up to 100 months. MRI revealed consistent cartilage repair at 24 months in both groups. This study shows that AMIC and AMIC+ are effective treatments for focal chondral lesions with beneficial effect lasting up to 9 years. AMIC+ allows for faster recovery from injury, and is thus more indicated for patients requiring a prompt return to activity. Level of evidence: II, randomized controlled trial in an explorative cohort.

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Effects of the introduction of objective criteria for referral and discharge in physical therapy for ischemic stroke in China: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215519896014 ◽

2019 ◽

Vol 34 (3) ◽

pp. 345-356

Author(s):

Nan Xia ◽

Jan D Reinhardt ◽

Shouguo Liu ◽

Juanjuan Fu ◽

Caili Ren ◽

...

Keyword(s):

Quality Of Life ◽

Motor Function ◽

Controlled Trial ◽

Teaching Hospitals ◽

Controlled Study ◽

Control Group ◽

Tier 2 ◽

Randomized Controlled ◽

Tier 3

Objective: To examine the effectiveness of a set of rules for referral and therapy input in a three-tiered physiotherapy program on activities of daily living (ADL), motor function, and quality of life of stroke survivors. Design: Randomized controlled study. Setting: Rehabilitation departments of 11 teaching hospitals. Subjects: A total of 285 participants with stroke. Outcome measures: Primary outcome was ADL independence measured with the Modified Barthel Index (MBI) at weeks 3, 6, 9, 13, and 17. Secondary outcomes were motor function and quality of life measured with Fugel-Meyer Assessment (FMA) and Stroke-Specific Quality-of-Life (SSQOL) scale. Intervention: Two complementary sets of rules governing rehabilitation delivery were introduced: a set of criteria that determined when someone ought to move from tier 1 onto tier 2, and from tier 2 onto tier 3, and a second set of rules that determined the amount and type of physiotherapy input given in each tier. Control group participants received conventional rehabilitation without any specified guidelines. Results: With a difference of 3.97 (95% confidence interval (CI): 1.59–6.36), MBI increased stronger in the study group than in controls between baseline and week 3 ( P = 0.001). This difference could be sustained until study end-point. No significant differences were found for FMA. Differences in increase of SSQOL were higher in the intervention than control at week 9 ( P < 0.05). Conclusion: Introduction of a set of rules for referral and therapy input at different stages of rehabilitation partially improved patients’ ADL and quality of life, but did not improve motor function.

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Effects of daily mindfulness practice on fatigue, kinesiophobia, and quality of life in patients with acute myocardial infarction: a randomized controlled trial

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuab020.138 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

Author(s):

C Karadas ◽

M Oksul ◽

N Ozer ◽

L Ozdemir

Keyword(s):

Quality Of Life ◽

Controlled Trial ◽

Mindfulness Practice ◽

Controlled Study ◽

Control Group ◽

Randomized Controlled ◽

Significant Difference ◽

Quality Of Life Scale ◽

Tampa Scale For Kinesiophobia

Abstract Funding Acknowledgements Type of funding sources: None. Background and Aim Mindfulness meditation (MM) leads to controlled blood pressure and positive improvements in other symptoms which may trigger acute coronary diseases. The present randomized controlled study was aimed to investigate the effect of the MM on fatigue, kinesiophobia, and the quality of life (QoL) in patients with acute MI. Method The study was carried out with 56 MI patients. Participants were randomly assigned to meditation group (MG; n = 28) or control group (CG; n = 28). The MG patients received a 15 min MM session comprising sitting and breathing for a total of eight weeks, while the CG patients received only a single-time attention-matched education. Piper Fatigue Intervention, Tampa Scale for Kinesiophobia-Heart and MacNew Quality of Life scales were utilized for data collection. Results After completion of the 8-week MM, any significant difference was not found in the fatigue scores of the patients (p > 0.05). On the other hand, kinesiophobia scores in the MG were significantly lower in the 4th, 8th and 12th weeks (p < 0.05). Similarly, the QoL scores were significantly higher in the MG in 8th week (p < 0.05). Significant change in the emotional function sub-dimension of QoL continued in the follow-up assessment at 12th week (p < 0.05). Conclusion The MM can significantly improve the QoL and decrease kinesiophobia in patients with MI. Beneficial effect of MM is maintained particularly in the emotional aspect. Based on the results of the study, MM may be recommended as a mind-body based complementary approaches within the scope of secondary protection after MI. Comparison of the study groupsGroupBaseline(Mean ± SD)4th week(Mean ± SD)8th week(Mean ± SD)12th week(Mean ± SD)PFSMM2.08 ± 1.870.90 ± 0.990.47 ± 0.780.44 ± 0.76CG1.56 ± 2.011.12 ± 1.590.98 ± 1.520.76 ± 1.33tp1.004 0.32-0.6210.54-1.5840.12-1.0850.28TSK-HMM40.25 ± 5.0436.18 ± 4.4934.39 ± 4.6134.96 ± 4.71CG41.71 ± 7.2841.89 ± 6.7441.82 ± 5.8441.00 ± 5.54tp-0.8750.39-3.7340.001-5.279 0.000-4.3900.00MacNewMM5.04 ± 0.715.53 ± 0.455.76 ± 0.475.77 ± 0.47CG5.17 ± 0.855.32 ± 0.605.37 ± 0.525.53 ± 0.46t; p-0.640; 0.531.436; 0.162.933; 0.0051.964; 0.06(Mean ± SD): Mean ± Standard Deviation; PFS: Piper Fatigue Scores; TSK-H: Tampa Scale for Kinesiophobia-Heart; MacNew: MacNew Quality of life Scale; EFS: emotional functioning sub-dimension; PFS: physical functioning sub-dimension; SFS: social functioning sub-dimension; t= Student T Test value; p< 0.05

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The efficacy of acupressure in managing opioid-induced constipation: Single-blind a randomized controlled study

10.21203/rs.3.rs-717911/v1 ◽

2021 ◽

Author(s):

DİLEK YILDIRIM ◽

Vildan KOCATEPE ◽

Gül KÖKNEL TALU

Keyword(s):

Quality Of Life ◽

Negative Impact ◽

Controlled Trial ◽

Routine Care ◽

Controlled Study ◽

Life Questionnaire ◽

Control Groups ◽

Randomized Controlled ◽

Significant Difference

Abstract Purpose Opioid-induced constipation is one of the heath problems with a negative impact on the quality of life. This randomized-controlled trial aimed to investigate the effects of acupressure therapy on the management of opioid-induced constipation. Methods The trial was conducted on 140 patients, who were assigned to the acupressure (n = 70) and the control groups (n = 70). In addition to routine care, patients in the acupressure group received 8-min acupressure from the Zhongwan (CV12), Guanyuan (CV4) and Tianshu (ST25) acupoints once a day for 4 weeks. The outcomes included Defacationa Diary (DD), Visual Analog Scale Questionnaire (VASQ) and Patient assessment of constipation quality of life questionnaire (PAC-QOL). Results DD scores obtained by the acupressure and the control groups. There was a statistically significant difference between the acupressure and control groups in terms of stool consistency (2.22 ± .49 vs 1.80 ± .55) (p = 0.001), straining (1.98 ± .71 vs 2.91 ± .37) (p = 0.001), incomplete evacuation (0.37 ± .29 vs 0.61 ± .43) (p = 0.001), stool amount (0.93 ± .14 vs .95 ± .20) (p = 0.001) and the number of defecations (0.70 ± .22 vs 0.46 ± .29), (p = 0.001) measured at the fifth week. Besides, with the exception of stool amount, there was a statistically significant increase in the DD scores obtained by the acupressure group between the first and the fifth weeks. Inter-group comparison of the pre-test and post-test scores showed that acupressure group obtained statistically significantly higher scores from the PAC-QOL (p = .0001). Conclusions Findings of this trial suggested that 4-week acupressure was an effective way to improve the quality of life and reduce both subjective and objective constipation symptoms in patients with opioid-induced constipations.

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Comparison of Clinical and Radiographic Outcomes of Vertical Simple Stitch Versus Modified Mason-Allen Stitch in Arthroscopic Bankart Repairs: A Prospective Randomized Controlled Study

The American Journal of Sports Medicine ◽

10.1177/0363546518816679 ◽

2018 ◽

Vol 47 (2) ◽

pp. 398-407 ◽

Cited By ~ 4

Author(s):

Jin-Young Park ◽

Seok Won Chung ◽

Jong Soo Lee ◽

Kyung-Soo Oh ◽

Jae-Hyung Lee

Keyword(s):

Computed Tomography ◽

Functional Outcome ◽

Clinical Outcomes ◽

Controlled Trial ◽

Bankart Repair ◽

Controlled Study ◽

Level Of Evidence ◽

Randomized Controlled ◽

Outcome Scores ◽

Retear Rate

Background: In spite of the probable advantages of Bankart repair with modified Mason-Allen technique, there has been no study to evaluate the clinical outcomes of the modified Mason-Allen technique for Bankart repair. Purpose: To prospectively compare the anatomic and clinical outcomes between the vertical simple stitch and the modified Mason-Allen stitch with respect to the labral height, retear rate, redislocation/apprehension, and various functional outcome scores. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Patients who underwent arthroscopic Bankart repair with double-loaded suture anchors were randomly allocated to 1 of 2 groups: the vertical simple stitch method (SS; n = 45) or the Bankart repair using modified Mason-Allen technique (BRUMA; n = 41). All patients underwent computed tomography arthrography at 6 months postoperatively and various functional outcome measurements at least 2 years postoperatively. The labral height and width at the 3-, 4-, and 5-o’clock positions were measured preoperatively and at 6 months after surgery on axial computed tomography arthrography; the redislocation/apprehension rate, the retear rate, and various functional outcome scores were evaluated at each follow-up visit. Results: Postoperative labral height and width were significantly increased at all locations (all P < .001) in both groups, but they were not statistically different between groups (all P > .05). Two patients in the SS group (4.4%) and 2 in the BRUMA group (4.9%) experienced redislocation after surgery, and 4 patients in the SS group (8.9%) and 2 in the BRUMA group (4.9%) group showed apprehension after surgery. Additionally, 5 patients in the SS group (11.1%) and 2 in the BRUMA group (4.9%) showed retear at 6 months ( P = .239). There were no differences in any functional outcome scores (all P > .05). Conclusion: There was no difference in the radiologic outcomes at 6 months and the clinical outcomes assessed at least 2 years after surgery between the groups.

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