scholarly journals How One Treats Lateral Epicondylitis - A Survey Among Brazilian Orthopedists

2021 ◽  
Author(s):  
Rafael Fuchs Lazarini ◽  
Renato Aroca Zan ◽  
João Carlos Belotti ◽  
Ildeu Afonso de Almeida Filho ◽  
Luiz Fernando Sartori Centenaro ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Physical Therapy ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Hand Surgery ◽  
Cross Sectional Study ◽  
Imaging Method ◽  
Cross Sectional ◽  
Painful Condition ◽  
Management Protocol

Abstract Background: Lateral epicondylitis (LE) or tennis elbow is the most common elbow painful condition. It affects around 1 to 3% of adults. There are various possibilities of treatment described in the literature, without evidence to support a gold standard management protocol. Therefore, the objective of this study is to evaluate how the Brazilian orthopedist diagnoses and treats lateral epicondylitis, to compare these results with the available evidence. Methods: This is an observational, analytical, cross-sectional study. A questionnaire has been prepared for information to the participants and with eight specific questions (2 on diagnosis and 6 on treatment). These had been answered voluntarily by participants at 3 major congresses of orthopedists in Brazil in 2018. The results were analyzed in accordance with the overall number of responses, and were evaluated among groups according to subspecialty. Results: We obtained a total of 501 questionnaires. Of these, 33 were excluded. The mean age was 38.67 years. The majority of respondents (91%) were male. We obtained 26.7% from specialists in hand surgery (Hand group), 36.5% from subspecialists in shoulder and elbow (Shoulder and Elbow group), and 36.8% were from generalists in orthopedics or from other subspecialties (General Orthopedists group). For diagnosis, 24.4% have not initially requested any imaging method. The most requested exam was ultrasonography (54.9%). The most prominent indication for initial treatment was physical therapy. For refractory cases, 78.3% of the respondents prefer doing a local infiltration. The most commonly used substance for local infiltrations is corticosteroids (89.6%). With respect to the surgical treatment option, 75.8% of those who recommend it prefer open techniques and 24.2% arthroscopic treatment. Of the total respondents, 12.8% do not recommend surgical treatment for LE. Conclusion: Most orthopedists begin the treatment of lateral epicondylitis with the use of non-steroidal anti-inflammatory drugs, physical therapy, and an indication of rest, but there is great variability between their recommendations. The use of corticosteroids for infiltration remains the main choice among Brazilian orthopedists, although evidence shows a better effect in the short term and a worse effect in the medium and long term, compared to other treatments.

scholarly journals How one treats lateral epicondylitis – a survey among Brazilian orthopedists

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rafael Fuchs Lazarini ◽  
Renato Arouca Zan ◽  
João Carlos Belloti ◽  
Ildeu Afonso de Almeida Filho ◽  
Luiz Fernando Sartori Centenaro ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Hand Surgery ◽  
Initial Therapy ◽  
Cross Sectional Study ◽  
Imaging Method ◽  
Cross Sectional ◽  
Imaging Tool ◽  
Management Protocol

Abstract Background Lateral epicondylitis (LE), also known as tennis elbow, is the most common painful elbow condition. It affects approximately 1–3% of adults. There are various possible treatments described in the literature, but evidence to support a gold standard management protocol is lacking. Therefore, the objective of this study was to evaluate how Brazilian orthopaedists diagnose and treat lateral epicondylitis and compare these results with the available evidence. Methods This is an observational, analytical, cross-sectional study. A questionnaire was prepared to obtain information from the participants with eight specific questions (2 on diagnosis and 6 on treatment). These questions were answered voluntarily by participants at 3 major congresses of orthopaedists in Brazil in 2018. The results were analysed in accordance with the overall number of responses and were evaluated among groups according to subspecialty. Results We obtained a total of 501 questionnaires. Of these, 33 were excluded. The mean age was 38.67 years. The majority of respondents (91%) were male. We obtained 26.7% from specialists in hand surgery (Hand group), 36.5% from subspecialists in shoulder and elbow (Shoulder and Elbow group), and 36.8% from generalists in orthopaedics or from other subspecialties (General Orthopaedists group). For diagnosis, 24.4% did not initially request any imaging method. The most requested exam was ultrasonography (54.9%). The most prominent indication for initial treatment was physical therapy. For refractory cases, 78.3% of the respondents preferred doing a local infiltration. The most commonly used substance for local infiltrations was corticosteroids (89.6%). With respect to the surgical treatment option, 75.8% of those who recommend it prefer open techniques, and 24.2% prefer arthroscopic treatment. Of the total respondents, 12.8% did not recommend surgical treatment for LE. Conclusion Among Brazilian orthopaedists, the Cozen test is most frequently chosen, and ultrasound is the most commonly used imaging tool. Nonsurgically, oral nonsteroidal anti-inflammatory drugs (NSAIDs) plus physiotherapy is the most popular initial therapy, and corticosteroids are the most popular type of infiltration agent. Most surgeons recommended surgery after 6 months of nonsurgical treatment, and 75.8% preferred the open technique.

Strength–Duration Curves of Radial Nerve in Patients With Lateral Elbow Pain

2020 ◽  
Vol 29 (6) ◽  
pp. 754-759 ◽  
Author(s):  
Blanca de la Cruz Torres
Keyword(s):  
Radial Nerve ◽  
Tennis Elbow ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Painful Condition ◽  
Duration Of Symptoms ◽  
Lateral Epicondyle ◽  
Lateral Elbow Pain ◽  
Left Limb ◽  
The Right

Context:Lateral epicondylalgia (LE) refers to a painful condition at or around the lateral epicondyle of the humerus. LE is one of the most common injuries of the elbow; however, the cause of the pathology is not clear. Patients often experience symptoms consistent with a radial nerve injury; however, data on the involvement of the radial nerve are needed.Objective:To analyze the relationship between electrophysiologic excitability and morphology of the radial nerve in patients with unilateral chronic LE.Design:Cross-sectional study.Setting:Department of Physiotherapy, University of Seville.Patients:A total of 56 elbows (28 right, 28 left) in 28 patients (12 females, 16 males; age 49 [7.37] y) were recruited by convenience sampling.Main Outcome Measures:Strength–duration curves (chronaxia and accommodation index) and cross-sectional area (CSA) of the radial nerve were made in all participants. All parameters were compared between both limbs. Also, pain with palpation in the lateral epicondyle and functional pain of involved extremities was assessed using visual analog scale and the Patient-Rated Tennis Elbow Evaluation, respectively.Results:Symptomatic limb showed higher CSA values of the radial nerve when compared with the asymptomatic limb (P < .001). On the symptomatic limb, duration of symptoms was positively correlated with CSA values. Chronaxia values were all normal and similar between both limbs (P = .35). Regarding accommodation index, 14 (54%) patients showed accommodation indices that suggested pathological radial nerve on the right limb, 4 (14%) on the left limb, 5 (18%) on both limbs, and 4 (14%) had none of the affected nerves. Eight-six percent of patients showed accommodation indices that suggested pathological radial nerve, independently of symptomatic limb. In these cases, affected nerves had higher CSA than the unaffected nerve (P = .01). On the affected nerves, duration of symptoms was positively correlated with accommodation indices.Conclusions:These findings suggest that patients with unilateral chronic LE show a decreased excitability in any radial nerve, independently of the symptomatic limb, and that pathological nerves have higher CSA than the nonpathological nerves.

scholarly journals Physical and functional complications after surgical treatment for breast cancer

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Amanda Estevão ◽  
Cinira Assad Simão Haddad ◽  
Samantha Karlla Lopes de Almeida Rizzi ◽  
Afonso Celso Pinto Nazário ◽  
Gil Facina
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Physical Therapy ◽  
Cross Sectional Study ◽  
Movement Amplitude ◽  
Cross Sectional ◽  
Prevalence Of Pain ◽  
In The Beginning ◽  
The Impact

Introduction: The ideal treatment for breast cancer should be carried out by a multidisciplinary team, aiming at the global approach of the patient. It is usually a prolonged process and can cause relevant changes in the lives of patients, such as limited shoulder movement, pain, lymphedema, adherence scarring, sensitive changes, phlebitis, among others. Physical therapy intervention plays an essential role and can prevent and minimize complications, besides enabling functional recovery. It is extremely important that the physical therapy service is aware of the prevalence of the main physical and functional complications and the impact of its intervention. Objective: To assess the main physical and functional complications in the post-surgical treatment of breast cancer. Methods: This is a cross-sectional study in which we analyzed the medical records of patients treated in the Physical Therapy Ambulatory from 2011 to 2016. We obtained data about the surgery, prevalence of pain, changes in perimeter, movement amplitude, evaluation of scapulohumeral rhythm and presence of axillary cording. Results: We assessed the data of 703 patients, whose mean age was 56 years; 50.1% were married, and body mass index pointed to overweight (mean: 26.8kg/m²). Sedentary lifestyle was prevalent (73.7%). The main surgery performed was quadrantectomy, followed by mastectomy. Pain was present, however, in extremely low levels (mean of pain in the Visual Analog Scale on the seventh postoperative day was 2.55); movement amplitude restrictions were higher in the beginning, and functionally reversed during follow-up; scapular dysfunction is also little prevalent (9.9%), with high percentage of long term resolution. The incidence of axillary cording was high (87.9%), which requires special attention. Conclusion: The study allowed to observe the main physical and functional complications after breast cancer treatment, and show the importance and necessity of early physical therapy.

SERVICE QUALITY OF PUBLIC AND PRIVATE PHYSIOTHERAPY INSTITUTES: A COMPARATIVE STUDY IN LAHORE

2019 ◽  
Author(s):  
Roohi Abbas
Keyword(s):  
Physical Therapy ◽  
Service Quality ◽  
Cross Sectional Study ◽  
Quality Of Services ◽  
Sectional Study ◽  
Cross Sectional ◽  
Public And Private ◽  
Quality Dimensions ◽  
Service Quality Dimensions

Background: Ever since quality of services is gaining importance in every industry as it is the indicator of consumer/customer satisfaction, it is of utmost importance to measure service quality of educational institutes to determine the satisfaction of students. Thus, the study aimed to determine the important factors in service quality dimensions which contribute to the satisfaction of students. Methods: This was a Comparative Cross Sectional study in which final year department of physical therapy (DPT) students were included from three private and three public physiotherapy institutes. Results: The largest mean Positive Gap scores for Public Physiotherapy Institutes was 0.18 for accessibility and affordability 0.18. The largest negative mean gap score for Private Physiotherapy domain was “Accessibility and Affordability” found to be -1.96. Conclusion: Students were satisfied with service quality of private institutes in all domains except for the “Accessibility and Affordability” whereas, in Public Institutes largest negative quality gaps were found in “Empathy” and “Assurance”.

scholarly journals POS1274 THERAPEUTIC MANAGEMENT OF RHEUMATOLOGISTS VERSUS OTORHINOLARYNGOLOGISTS OF CERVICOGENIC DIZZINESS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 921.2-922
Author(s):  
M. Yasmine ◽  
K. Maatallah ◽  
H. Ferjani ◽  
W. Triki ◽  
D. Ben Nsib ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Treatment Approach ◽  
Cross Sectional Study ◽  
Treatment Modalities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Standard Assessment ◽  
Number Of Patients ◽  
Cervicogenic Dizziness ◽  
No Gold Standard

Background:The treatment of patients presenting with cervicogenic dizziness (CGD) may be challenging. Indeed, there is no consensual treatment approach for CGD, nor is there no gold-standard assessment for diagnosis.Objectives:Our study aimed to assess the management of CGD by rheumatologists versus otorhinolaryngologists.Methods:We conducted a cross-sectional study including Tunisian doctors dealing with CGD. Rheumatologists (RTO) and otorhinolaryngologists (ORL) were invited to answer a questionnaire via google form about CGD daily management. Outcomes of interest were treatment modalities.Results:The study included 30 RTO and 32 ORL. Most of the doctors (RTO, vs ORL) were females (88.3%, vs 56.3%), aged between 35 and 45 (43.3%, vs 62.5%), and worked at a private practice (33.3%, vs 59.4%). The number of patients diagnosed with CGD by RTO was as follows: 1-2 per year (33.3%), 1-2 per month (18.8%), 1-2 per week (20%), less than one patient a year (10%) and none in 3.3% of cases. The number of patients diagnosed with CGD by ORL was as follows: 1-2 per year (50%), 1-2 per month (33.3%), 1-2 per week (6.2%), less than one patient a year (15.7%) and none (9.4%). Most patients presenting with CGD were females in both groups (93.1%, vs 82.8% respectively) with a mean age between 36 and 65 (79.3%, vs 82.1%). Most of the respondents declared treating patients with CGD (93.1%, vs 79.1%). Regarding treatment modalities, physical therapy was the most prescribed in both specialties (81.5% and 48.3%, respectively). Only RTO (18.5%) prescribed manual therapy. Concerning medical treatment, anti-inflammatory were the most prescribed drugs in both groups (92.6, and 34.5%, respectively). Sixty-seven percent of RTO prescribed anti-vertigo medication. Interestingly, it was the least prescribed drug by ORL (6.9%). Only RTO (59.3%) prescribed Muscle relaxants.Conclusion:Despite the disparities in the management of CGD, physical therapy remains the first prescribed treatment by Tunisian doctors. Further studies are needed to establish a consensus to treat CGD.Disclosure of Interests:None declared

scholarly journals Diagnostic Clues and Management of ectopic Pregnancy in Sir Salimullah Medical College and Mitford Hospital, Dhaka

2020 ◽  
Vol 33 (1) ◽  
pp. 49-53
Author(s):  
Nazia Islam
Keyword(s):  
Surgical Treatment ◽  
Ectopic Pregnancy ◽  
Expectant Management ◽  
Cross Sectional Study ◽  
Abdominal Pregnancy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Ectopic Pregnancies ◽  
Condition Diagnosis

Background: Ectopic pregnancy is a common clinical condition. Diagnosis and managementof this condition is necessary in due to day practice. Methods: A cross sectional study on ectopic pregnancy was conducted in Sir SalimullahMedical College and Mitford Hospital (SSMC & MH) , Dhaka, with the objective to analyzethe risk factors and assess the results of management with respect to maternal morbidityand mortality of ectopic pregnancy during the last two years. Result: Fifty patients were admitted with ectopic pregnancy from 1st January 2008 to 31stDecember 2010.Frequency of ectopic pregnancy were 1.5% of total 3252 pregnancies. Riskfactors were found in 45% of cases. Surgical treatment were performed in total 43 patients.There was one heterotrophic pregnancy and one case of abdominal pregnancy. Four patientswere given intramuscular Methotrexate and two un-ruptured ectopics resolved spontaneouslyafter by expectant management. Conclusion: Conservative management was an option but surgical treatment was donemore often because of late referrals. Screening of high risk cases, early diagnosis and earlyintervention would reduce the morbidity in ectopic pregnancies. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 49-53

scholarly journals PREVALENCE OF COMPUTER VISION SYNDROME AMONG UNDERGRADUATE PHYSICAL THERAPY STUDENTS

2021 ◽  
Vol 10 (2) ◽  
pp. 63-68
Author(s):  
Farah Deeba
Keyword(s):  
Computer Vision ◽  
Physical Therapy ◽  
Screen Time ◽  
Cross Sectional Study ◽  
Blurred Vision ◽  
Visual Rehabilitation ◽  
Cross Sectional ◽  
Ocular Symptoms ◽  
Computer Vision Syndrome ◽  
Physical Therapy Student

BACKGROUND AND AIM Computers and other digital screens have become an integral part of our life. It raises various ocular problems in the user due to excessive screen time, this study aims to determine the frequency of computer vision syndrome (CVS) in population of under graduate physical therapy student. METHODOLOGY This was cross-sectional study conducted at Ziauddin College of Rehabilitation Sciences; Karachi during June 2019 to September 2020.A total number of 340 candidates of age 22 years ± 1.8 including both genders participated in this study. A questionnaire was designed to collect data which was statistically analyzed on SPSS version 20. Whereas descriptive data was calculated as mean, median, mode and standard deviation using graphical representations. RESULTS 88.5% of the students used mobile phones for study purpose out of which 35.3% use it for 4-7 hour and 33% use for 7 to 10 hours a day. The ocular symptoms that students face was burning of eyes (40%), tearing (55%), eye redness (45.3%), diplopia 31.8%, blurred vision (42.9%), eye dryness (23.8%), while extra ocular symptom that was noticed in the study included headache too was (67.9%). CONCLUSION This study showed that most of the students were found to have a CVS thus screen time guide lines and visual rehabilitation must established.

scholarly journals Level of Knowledge of Sports Coaches and Physical Education Teachers in Physical Therapy in Jordan

2021 ◽  
pp. 105-112
Author(s):  
Riziq Allah Gaowgzeh ◽  
Shenbaga Sundaram Subramanian ◽  
Mikhled Falah Maayah ◽  
Saad S. Alfawaz ◽  
Ziyad Neamatallah ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Physical Education ◽  
Significant Proportion ◽  
Selection Criterion ◽  
Final Analysis ◽  
Cross Sectional Study ◽  
Physical Education Teachers ◽  
Cross Sectional ◽  
Demographical Data ◽  
Sports Coaches

Physiotherapy is a profession that helps to restore movement and function following an injury or illness. This study sought to identify the physical therapy knowledge of physical education teachers and sports coaches in Jordan. This study is a cross-sectional study conducted on several sports coaches and physical education teachers in Jordan. Participants were given the questionnaire through google forms, and they were all advised to fill it up. A predetermined selection criterion was used to select the participants. Out of 250 volunteers chosen for the study, only 152 questionnaires were selected for the final analysis. A self-administer questionnaire consisting was developed, which includes two parts. Part I collects the demographical data, and part II contains the questionnaires, including physiotherapy. The consent form is attached with the questionnaire, and those who gave consent to use the data were included in the analysis. Collected data were analyzed using SPSS 20.0. with the alpha set for significance at <0.05. Overall, it identified that 84% of the sports coaches and physical education teachers know physiotherapy services well. This study concluded that a more significant proportion of the sports coaches and physical education teachers have a good understanding of physical therapy services provided to the sports personnel in Jordan. They have good knowledge of physical therapy techniques and services provided, and they also have a good understanding of their role in on-field and off-field management.

scholarly journals Physical therapy students’ perceptions of the educational environment at physical therapy institutes in Pakistan

2020 ◽  
Vol 17 ◽  
pp. 7
Author(s):  
Muhammad Adeel ◽  
Asad Chaudhry
Keyword(s):  
Physical Therapy ◽  
Cross Sectional Study ◽  
Educational Environment ◽  
Physical Therapy Students ◽  
Cross Sectional ◽  
Public And Private ◽  
Student Centered ◽  
Doctor Of Physical Therapy ◽  
The Mean ◽  
Convenience Sampling

This study assessed doctor of physical therapy (DPT) students’ perceptions of the educational environment at public and private physical therapy institutes in Pakistan. This cross-sectional study was conducted at 6 physical therapy institutions in Punjab, Pakistan from April 2018 to December 2019. In total, 500 Dundee Ready Educational Environment Measure (DREEM) questionnaires were distributed among DPT students identified through convenience sampling (response rate, 86.4%). The correlations between each item of the DREEM score were analyzed. The mean overall DREEM score was 128±19.63 for all 5 subscales (range, 33 to 166; standard error of the mean, 0.954). The correlations of atmosphere, learning, and self-perception with the overall educational environment were r=0.896, r=0.853, and r=0.846, respectively. Student-centered approaches were found to be more effective than teacher-centered approaches for promoting a positive educational environment.

scholarly journals Comparison between prolozone therapy and extracorporeal shockwave therapy in management of pain and function in resistant cases of lateral epicondylitis: a randomised controlled trial

2020 ◽  
Vol 7 (8) ◽  
pp. 1216
Author(s):  
Margaret Chabungbam ◽  
Akoijam Joy Singh ◽  
Longjam Nilachandra Singh ◽  
Yumnam Ningthemba ◽  
Sreejith C. ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Tennis Elbow ◽  
Controlled Trial ◽  
Lateral Epicondylitis ◽  
Painful Condition ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Vas Score ◽  
Randomised Controlled

Background: Lateral epicondylitis also known as the tennis elbow is a painful condition of the elbow caused by overuse. The disease imparts significant disability to those affected in terms of the quantity and quality of work done.Methods: A randomised controlled trial was conducted in the Department of Physical Medicine and Rehabilitation, RIMS, Imphal for a period of 1 year from February 2017 to January 2018. Eighty-four patients with resistant lateral epicondylitis recruited were divided into 2 groups- group A received Prolozone injection while group B underwent Extracorporeal Shockwave Therapy (ESWT).Results: Assessments of VAS (Visual Analog Scale) and PRTEE (Patient Rated Tennis Elbow Evaluation) were done at 8 weeks and 24 weeks. The mean VAS score in Prolozone group improved from 7.22±0.89 to 4.04±1.01 at 8 weeks to 1.67±0.70 at end of 24 weeks. In ESWT group, mean VAS score improved to 3.91±0.72 at 8 weeks and reduced to 2.3±0.68 at end of 24 weeks. PRTEE improved significantly in both the groups, from 85.33±3.29 to 24.87±2.10 in Prolozone group, and from 85.17±2.83 to 41.89±3.17 in ESWT group.Conclusions: The improvement in pain and disability is better in prolozone group than ESWT (p<0.05) in chronic lateral epicondylitis.

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