Fast improvements in functional status after osteopathic manipulative treatment based on myofascial release in patients with moderate or severe fibromyalgia: a retrospective study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Fulvio Dal Farra ◽  
Angelo Chiesa ◽  
Roberta Giulia Risio ◽  
Luca Vismara ◽  
Andrea Bergna
Keyword(s):  
Quality Of Life ◽  
Retrospective Study ◽  
Functional Status ◽  
Pain Syndrome ◽  
Osteopathic Manipulative Treatment ◽  
Functional Impact ◽  
Myofascial Release ◽  
Clinical Records

Abstract Objectives Fibromyalgia (FM) is a chronic pain syndrome characterized by a large variety of symptoms. Evidence suggests that an alteration of central nervous system processing of pain could be involved. The purpose of this study is to analyze clinical records of patients affected by FM who underwent osteopathic manipulative treatment (OMT), predominantly based on a myofascial release approach (MFR). Methods This retrospective study considered records of 21 FM patients with moderate or severe functional impact, who consented to OMT in addition to their usual care. The assessment considered the following measures: FIQ (functional status), SF36 (quality of life), VAS (pain), TSK (kinesiophobia) and PSQI (quality of sleeping). Patients were preliminarily assessed over a 1 month run-in phase, then after 1, 2 and 4 months; a 1 month follow-up was also considered. Results After one month, 71% of patients reported a decrease in functional impact and scores remained stable until follow-up (from 69.8 to 52.37, p≤0.001). Overall, after four months, patients improved their quality of life, with a score ranging from 33.47 to 42.6 (p≤0.05). We also observed a reduction of pain (p≤0.05). Conclusions A series of OMT sessions based on MFR could play a therapeutic role in improving functional status, pain and quality of life over a period of 4 months.

Spinal Cord Stimulation Is Effective in Management of Complex Regional Pain Syndrome I: Fact or Fiction

Neurosurgery ◽  
2011 ◽  
Vol 69 (3) ◽  
pp. 566-580 ◽  
Author(s):  
Krishna Kumar ◽  
Syed Rizvi ◽  
Sharon Bishop Bnurs
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Functional Status ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Pain Syndrome ◽  
Sf 36

Abstract BACKGROUND: Complex regional pain syndrome (CRPS) I is a debilitating neuropathic pain disorder characterized by burning pain and allodynia. Spinal cord stimulation (SCS) is effective in the treatment of CRPS I in the medium term but its long-term efficacy and ability to improve functional status remains controversial. OBJECTIVE: To evaluate the ability of SCS to improve pain, functional status, and quality of life in the long term. METHODS: We retrospectively analyzed 25 patients over a mean follow-up period of 88 months. The parameters for evaluation were visual analog scale (VAS), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), EuroQoL-5D (EQ-5D) and Short Form 36 (SF-36), and drug consumption. Evaluations were conducted at point of entry, 3 months, 12 months, and last follow-up at 88 months (mean). RESULTS: At baseline, the mean scores were VAS 8.4, ODI 70%, BDI 28, EQ-5D 0.30, and SF-36 24. In general, maximum improvement was recorded at follow-up at 3 months (VAS 4.8, ODI 45%, BDI 15, EQ-5D 0.57, and SF-36 45). At last follow-up, scores were 5.6, 50%, 19, 0.57, and 40, respectively. Despite some regression, at last follow-up benefits were maintained and found to be statistically significant (P < .001) compared with baseline. Medication usage declined. SCS did not prevent disease spread to other limbs. Best results were achieved in stage I CRPS I, patients under 40 years of age, and those receiving SCS within 1 year of disease onset. CONCLUSION: SCS improves pain, quality of life, and functional status over the long term and consequently merits early consideration in the treatment continuum.

scholarly journals Use of percutaneous microwave ablation for the treatment of bone tumors: a retrospective study of clinical outcomes in 47 patients

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Min-hao Wu ◽  
Ling-fei Xiao ◽  
Fei-fei Yan ◽  
Shi-Liang Chen ◽  
Chong Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Retrospective Study ◽  
Pain Relief ◽  
Microwave Ablation ◽  
Bone Tumors ◽  
Short Term ◽  
Sf 36 ◽  
Percutaneous Microwave Ablation

Abstract Objective The present study aimed to evaluate the short-term clinical performance and safety of percutaneous microwave ablation (MWA) techniques for the treatment of bone tumors. Methods This single-institution retrospective study investigated 47 cases of bone tumors treated by MWA from June 2015 to June 2018. The study included 26 patients (55.3%) with benign bone tumors and 21 patients (44.7%) with malignant bone tumors. The tumors were located in the spine or sacrum (15, 31.9%), the upper extremities (6, 12.8%), the lower extremities (17, 36.2%) and the pelvis (9, 19.1%). Outcomes regarding clinical efficacy, including pain relief, quality of life, and intervention-related complications, were evaluated before and after MWA using the visual analog scale (VAS) and the 36-item Short-Form Health Survey (SF-36) scoring system. Results Of the 47 patients included in this study, all of them completed follow-up examinations, with a mean follow-up duration of 4.8 ± 1.6 months (range, 2–9 months). Significantly improved VAS and SF-36 scores were recorded after the initial treatment (P<0.001), suggesting that almost 100% of patients experienced pain relief and an improved quality of life following surgery. No major intervention-related complications (e.g., serious neurovascular injury or infection) occurred during or after the treatment. We recorded only three minor posttreatment complications (6.4%, 3/47), which were related to thermal injury that caused myofasciitis and affected wound healing. Conclusion In our study, the short-term efficacy of MWA was considerably favorable, with a relatively low rate of complications. Our results also showed that MWA was effective for pain relief and improved patients’ quality of life, making it a feasible treatment alternative for bone tumors.

Surgery of Intradural Extramedullary Tumors

Neurosurgery ◽  
2014 ◽  
Vol 75 (5) ◽  
pp. 509-514 ◽  
Author(s):  
Roberto Tarantino ◽  
Pasquale Donnarumma ◽  
Loenzo Nigro ◽  
Marika Rullo ◽  
Antonio Santoro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rating Scale ◽  
Neurological Deficits ◽  
Statistical Interpretation ◽  
Intradural Extramedullary ◽  
Examination Quality ◽  
Clinical Records ◽  
University Of Rome

Abstract BACKGROUND: Intradural extramedullary tumors (IDEMTs) are uncommon lesions that cause pain and neurological deficits. OBJECTIVE: To evaluate the effects of surgery for IDEMTs. METHODS: This cohort study recruited all patients operated on for IDEMTs at the Department of Neurology and Psychiatry of Sapienza University of Rome from January 2003 to January 2013. The analysis was conducted on clinical records evaluation over a 1-year follow-up. The Graphic Rating Scale was used to assess pain. Neurological deficits were detected through neurological examination. Quality of life was evaluated with the EuroQol (EQ-5D). Statistical interpretation of the data was performed with SPSS version 19 software. RESULTS: One hundred seven patients were recruited. Three were lost to follow-up. Patients reported lower level of pain 1 year after surgery (before surgery, 6.05; after surgery, 3.65). Mean comparison showed a significant decrease of −2.400 (P &lt; .001). Ninety-two patients (88.5%) were neurologically asymptomatic 1 year after surgery. Only 12 patients (11.5%) presented with a deficit, with a global decrease of 39% (χ2 = 27.6; P &lt; .005). The quality of life in patients was middle to high (mean rating of EQ-5D visual analog score, 61.78%). The lowest levels of quality of life were found in patients with sphincter dysfunctions (mean, 33.4). CONCLUSION: Surgery for IDEMTs has a good outcome. Patients reported lower levels of pain and a drastic reduction in neurological symptoms 1 year after surgery. The quality of life is middle to high. It is influenced mainly by the neurological outcome.

Long-term follow-up after cystectomy for bladder pain syndrome: Pain status, sexual function and quality of life

2019 ◽  
Vol 18 (1) ◽  
pp. e1977
Author(s):  
L. Mateu Arrom ◽  
C. Gutierrez Ruiz ◽  
O. Mayordomo ◽  
V. Martínez ◽  
J. Palou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Function ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Pain Status ◽  
Long Term Follow Up

Patient-Related Outcomes of Elective Major Orthopedic Surgery in Severe Hemophilia Patients: A Review of the Literature and a Proposed Agenda for Research.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 965-965
Author(s):  
Marc F. Botteman ◽  
Rahul Ballal ◽  
Ashish V. Joshi
Keyword(s):  
Quality Of Life ◽  
Functional Status ◽  
Orthopedic Surgery ◽  
Severe Pain ◽  
Severe Hemophilia ◽  
Post Surgery ◽  
Major Orthopedic Surgery ◽  
And Function

Abstract Objectives: Severe hemophilia patients experience frequent spontaneous joint hemorrhages, which lead to severe pain and swelling, reduced flexion and function, and ultimately debilitating arthropathy. Elective major orthopedic surgery (e.g., total joint replacement) in patients with advanced arthropathy is increasingly considered to reduce pain, improve function, and reduce joint bleeds. This analysis reviewed the impact of surgery on quality of life and other humanistic outcomes in hemophilia patients with advanced arthropathy. Materials and Methods: A systematic search of the published literature was conducted to identify studies reporting on the humanistic and patient-related outcomes of major orthopedic surgery in patients with hemophilia and advanced arthropathy. Studies were included if they reported quality of life (QOL), pain, functional status and work and productivity outcomes. Wherever possible, data were extracted and normalized across various scoring systems (WOMAC, WFH, HSS, Cleveland Rating, and Knee Society) for comparisons across studies. Results: A total of 32 studies were examined. Among those, only one included a formal, validated QOL instrument (WOMAC) with pre/post surgery data. This study documented dramatic improvements in objective and patient perceived QOL measures. Of the other 31 studies, 4 provided sufficient pre/post surgery data to facilitate a quantitative assessment of other key humanistic and patient-related outcomes. In 50 patients pooled across these four studies, all (100%) had moderate or severe pain in the targeted joint prior to surgery. After surgery 86% (43/50) reported no pain at follow up. Improvements were also reported regarding functional status, where 100% of 16 cases pooled across two studies had severe or moderate loss of function prior to joint surgery and 31% (5/16) regained full function upon follow up. Similar, if not better, results were reported in studies that reported only average scores across pain and function parameters. It was found that joint pain was the most prevalent complaint prior to surgery and was the primary indication for surgery. Anecdotal evidence from the 32 studies indicates that improvements in pain and function following surgery were so significant in some patients that they were able to rejoin the workforce and take part in recreational activities, including sports. There were several reports of patients who were unable to walk long distances or were confined to wheelchairs before surgery who became able to walk several blocks unaided following surgery. Conclusions: Major elective orthopedic surgery in hemophilia patients with advanced arthropathy is one of the most effective medical interventions, with success rates in terms of pain reduction over 80%. However, the broader impact of surgery on QOL outcomes, which appears excellent, remains to be better documented. To that effect, the systematic use of a set of validated instruments to be administered before and after surgery is recommended to help document the outcomes of these surgeries.

scholarly journals Mid-term outcomes with the use of extracorporeal membrane oxygenation for cardiopulmonary failure secondary to massive pulmonary embolism

2020 ◽  
Vol 58 (5) ◽  
pp. 923-931
Author(s):  
Federico Sertic ◽  
Dieynaba Diagne ◽  
Lexy Chavez ◽  
Thomas Richards ◽  
Ashley Berg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Hospital Mortality ◽  
Functional Status ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Acute Pe

Abstract OBJECTIVES There has been increasing interest in using extracorporeal membrane oxygenation (ECMO) to rescue patients with pulmonary embolism (PE) in the advanced stages of respiratory or haemodynamic decompensation. We examined mid-term outcomes and risk factors for in-hospital mortality. METHODS We conducted a retrospective study of 36 patients who required ECMO placement (32 veno-arterial ECMO, 4 veno-venous) following acute PE. Survival curves were estimated using the Kaplan–Meier method. Risk factors for in-hospital mortality were assessed by logistic regression analysis. Functional status and quality of life were assessed by phone questionnaire. RESULTS Overall survival to hospital discharge was 44.4% (16/36). Two-year survival conditional to discharge was 94% (15/16). Two-year survival after veno-arterial ECMO was 39% (13/32). In patients supported with veno-venous ECMO, survival to discharge was 50%, and both patients were alive at follow-up. In univariable analysis, a history of recent surgery (P = 0.064), low left ventricular ejection fraction (P = 0.029), right ventricular dysfunction ≥ moderate at weaning (P = 0.083), on-going cardiopulmonary resuscitation at ECMO placement (P = 0.053) and elevated lactate at weaning (P = 0.002) were risk factors for in-hospital mortality. In multivariable analysis, recent surgery (P = 0.018) and low left ventricular ejection fraction at weaning (P = 0.013) were independent factors associated with in-hospital mortality. At a median follow-up of 23 months, 10 patients responded to our phone survey; all had acceptable functional status and quality of life. CONCLUSIONS Massive acute PE requiring ECMO support is associated with high early mortality, but patients surviving to hospital discharge have excellent mid-term outcomes with acceptable functional status and quality of life. ECMO can provide a stable platform to administer other intervention with the potential to improve outcomes. Risk factors for in-hospital mortality after PE and veno-arterial ECMO support were identified.

scholarly journals Periprosthetic Infection on a Revised Total Hip Prosthesis Treated with Deep Lavage and Vacuum Dressings: A Case Report with 4-Year Follow-Up

2021 ◽  
pp. 202-209
Author(s):  
Mohamad Darwish ◽  
Hicham Abdel Nour ◽  
Elias Saidy ◽  
Dany Aouad ◽  
Georgio Lati ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Functional Status ◽  
Periprosthetic Infection ◽  
Hip Prosthesis ◽  
Total Hip Prosthesis ◽  
Total Hip ◽  
Orthopedic Surgeons

Periprosthetic hip infections are a dreaded complication met among most orthopedic surgeons after arthroplasty procedures especially in susceptible patients. We report a case of a patient with periprosthetic infection after a revised total hip arthroplasty. She was treated with deep lavage and debridement, combined with IV anti-biotherapy and vacuum dressings. A 4-year follow-up shows an infection-free patient with an acceptable functional status and quality of life. Suppression of the infection, with salvage of the prosthesis and maintaining an acceptable functional status, is a satisfactory result that can be achieved in selected cases.

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