scholarly journals THE INFLUENCE OF THE PREHOSPITAL PAUSE ON THE OUTCOMES OF EMERGENCY DECOMPRESSIVE-STABILIZING SURGERIES IN PATIENTS WITH TUMOR AND INFECTIOUS SPINE DISEASE

2021 ◽  
Author(s):  
M. A. Mushkin ◽  
A. K. Dulaev ◽  
Z. Yu. Alikov ◽  
A. Yu. Mushkin
Keyword(s):  
Neurological Disorders ◽  
Evaluation Method ◽  
Functional Dependence ◽  
Inverse Correlation ◽  
Pain Syndrome ◽  
High Strength ◽  
Neurological Status ◽  
Functional Independence ◽  
Level Of Evidence ◽  
Neurological Improvement

Resume. Purpose. To assess the relationship between the duration of pathological symptoms developed due to tumor or infectious destruction of the spine, and the medium-term (3 months after surgery) and long-term (1-year) outcomes of operations performed according to urgent indications. Study design: two-center cohort retrospective; level of evidence IIC [1]. Material and methods. 84 patients with tumor (group 1, n = 43) and infectious (group 2, n = 41) lesions of the spine underwent decompression and stabilization operations according to urgent indications in the period from 2016 to 2018. Neurological status (evaluation method -Frankel scale), pain intensity (evaluation method - visual analogue scale, VAS) and functional independence of patients (evaluation method - Karnofsky scale) were assessed before intervention, 3 months and 1 year after surgery. Statistical relationship between treatment outcomes and duration of the prehospital delay has been studied. Results. Only 11 out of 84 patients (13.1%), operated on for urgent indications, were hospitalized in the first 72 hours from the onset of vertebral syndrome; 6 (7.1%) of them had neurological disorders. At the time of surgery, 23 patients in each group had neurological disorders (53.5% and 56.1%, respectively), while the average duration of the prehospital period in both groups (Me) was 14.0 days. In patients without neurological disorders, the duration of the prehospital pause for the group of tumor lesions was 22.5 (14.0; 40; 0), for infectious - 14.5 (6.3; 30.0) days (data format - Me (Q25; Q75). After decompression and stabilization operations, positive neurological dynamics observed in patients with tumor lesions both in plegia and paresis (types B - D according to Frankel), while in infectious destruction - only in patients with mild paresis. An inverse correlation dependence of high strength between the duration of neurological disorders and the possibility of their improvement by 3 months after surgery was revealed in both groups (rs1 = -0.793 and rs2 = -0.828; p 0.001), as well as there was no connection between such outcomes and the duration of the hospital period (the urgency of the operation) (rs1 = -0.257; p = 0.283 and rs2 = -0.218; p = 0.330). When hospitalized for more than 14 days from the onset of pathological symptoms, the possibility of neurological improvement after surgery ceases to be statistically significant (p1 = 0.083, p2 = 0.157 for both groups, respectively), while the likelihood of a decrease in pain syndrome and functional dependence on others remains independent of the duration of the prehospital period. Conclusion. In case of tumor and infectious destruction of the vertebrae, urgent decompression and stabilization operations lead to a significant reduction in pain syndrome and an improvement in the functional independence of patients 3 and 12 months after the operation, regardless of the duration of the prehospital period. The duration of prehospital period of more than 2 weeks is critical for a reliable prognosis of improvement in neurological disorders after urgent surgeries in patients with neoplastic and infectious lesions of the spine.

scholarly journals Combined Hip Abductor and External Rotator Strengthening and Hip Internal Rotator Stretching Improves Pain and Function in Patients With Patellofemoral Pain Syndrome: A Randomized Controlled Trial With Crossover Design

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712198972
Author(s):  
Anis Jellad ◽  
Amine Kalai ◽  
Mohamed Guedria ◽  
Mahbouba Jguirim ◽  
Sana Elmhamdi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Group Standard ◽  
Hip Muscle ◽  
And Function

Background: Active rehabilitation has an important role in the management of patellofemoral pain syndrome (PFPS). Although some studies have shown the benefit of hip-muscle strengthening, the effect of combining hip-muscle stretching with strengthening has not yet been defined. Purpose: To evaluate the effect of combined strengthening of the hip external rotators and abductors and stretching of the hip internal rotators on pain and function in patients with PFPS. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 109 patients with PFPS (75 female and 34 male; mean age, 31.6 ± 10.8 years) were first randomly assigned to protocol A (n = 67) of the A-B arm (AB group; standard rehabilitation) or protocol B (n = 42) of the B-A arm (BA group; standard rehabilitation with strengthening of the hip external rotators and abductors and stretching of the hip internal rotators). Each protocol consisted of 3 sessions a week for 4 weeks. After a washout period, corresponding to a symptom-free period, rehabilitation programs were crossed over. A visual analog scale (VAS) evaluating perceived pain, the Functional Index Questionnaire (FIQ), and the Kujala score were administered at baseline, the end of each rehabilitation protocol, and 12 weeks after the completion of the second protocol for each group. Results: Until the final follow-up, VAS, FIQ, and Kujala scores were significantly improved in both the A-B and B-A arms ( P < .05 for all). Compared with protocol A, protocol B provided significant improvement in terms of pain and function in both the BA (VAS and Kujala; P < .001) and AB (VAS and Kujala; P < .001) groups. Conclusion: Combined strengthening of the hip abductors and external rotators with stretching of the hip internal rotators provided better outcomes, which were maintained for at least 12 weeks, in terms of pain and function in patients with PFPS.

scholarly journals Neurological status and imaging spinal cord in patients with infectious spondylitis: is it possible to comparisons with spondylogenic myelopathy?

2017 ◽  
Vol 15 (2) ◽  
pp. 64-72 ◽  
Author(s):  
Marina E Makogonova ◽  
Aleksandr Yu Mushkin ◽  
Pavel V Gavrilov
Keyword(s):  
Spinal Cord ◽  
Neurological Disorders ◽  
Neurological Status ◽  
Pathological Process ◽  
Literary Analysis ◽  
Resonance Imaging ◽  
Radicular Symptoms ◽  
Symptoms And Signs ◽  
Infectious Spondylitis

Spend a literary analysis of the role of radiation diagnosis in the first place - magnetic resonance imaging to visualize changes in the spinal cord in infectious spondylitis. Neurological disorders, manifested by radicular symptoms and signs of spinal cord irritation to deep paresis and plegia in violation of the pelvic organs, are observed in the majority of patients with spondylitis and may be due to the spinal cord and its roots and / or a breach of its microcirculation on the background of the pathological process in the vertebrae. Dynamic (pre- and postoperative) imaging of the spinal canal and its contents in tuberculous and nonspecific spondylitis is important for a more complete assessment of the disease, and for the prediction of the dynamics of neurological disorders. (For citation: Makogonova ME, Mushkin AYu, Gavrilov PV. Neurological status and imaging spinal cord in patients with infectious spondylitis: is it possible to comparisons with spondylogenic myelopathy?. Reviews on Clinical Pharmacology and Drug Therapy. 2017;15(2):64-72. doi: 10.17816/RCF15264-72).

scholarly journals RESEARCH ON THE EFFECT OF SPORTS ON STUDENTS’ PHYSICAL FITNESS UNDER THE HEALTH INTERVENTION POLICY

2021 ◽  
Vol 27 (5) ◽  
pp. 468-471
Author(s):  
Yong Yuan ◽  
Xiqiong Yi
Keyword(s):  
College Students ◽  
Physical Education ◽  
Physical Exercise ◽  
Physical Fitness ◽  
Teaching Methods ◽  
Evaluation Method ◽  
First Grade ◽  
Health Intervention ◽  
Level Of Evidence ◽  
Teaching Content

ABSTRACT Introduction: The main reason for the decline in college students’ physical fitness and health is the lack of physical exercise, the emphasis on study and the neglect of physical exercise, and the lowering of the physical fitness requirements of college students. Objective: The paper analyzes the status quo and existing problems of college students’ physical fitness and proposes that the school party committee issues policy-based health intervention measures, encourages school physical education teachers to participate in students’ after-school physical exercises, and extensively develops school mass sports activities. Methods: The paper uses a literature method, questionnaire survey, comprehensive evaluation method, etc., to analyze the internal and external factors of college students’ physical decline. Results: Through the practice density test of students in physical education teaching, it is learned that physical education in the first grade can fully develop students’ physical fitness, and the practice density of each class reaches 60%. The practice density of the second-grade optional courses is about 20%, and it cannot achieve the purpose of effective physical exercise. Conclusions: The current teaching content and teaching methods of physical education classes cannot effectively complete physical education tasks. It is necessary to adjust the teaching content further and improve the teaching methods. Level of evidence II; Therapeutic studies - investigation of treatment results.

Decreased Pulsatile Blood Flow in the Patella in Patellofemoral Pain Syndrome

2007 ◽  
Vol 35 (10) ◽  
pp. 1668-1673 ◽  
Author(s):  
Jan Näslund ◽  
Markus Walden ◽  
Lars-Göran Lindberg
Keyword(s):  
Blood Flow ◽  
Confidence Interval ◽  
Knee Flexion ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Systematic Change ◽  
Pulsatile Blood Flow ◽  
Level Of Evidence

Background Anterior knee pain without clinical and radiologic abnormalities has primarily been explained from a purely structural view. A recently proposed biologic and homeostatic explanation questions the malalignment theory. No objective measurement of the pathophysiology responsible for changes in local homeostasis has been presented. Hypothesis Flexing the knee joint interferes with the perfusion of the patellar bone in patellofemoral pain syndrome. Study Design Case control study; Level of evidence, 4. Methods Pulsatile blood flow in the patella was measured continuously and noninvasively using photoplethysmography. Measurements were made with the patient in a resting position with knee flexion of 20° and after passive knee flexion to 90°. In total, 22 patients with patellofemoral pain syndrome were examined bilaterally, and 33 subjects with healthy knees served as controls. Results The pulsatile blood flow in the patient group decreased after passive knee flexion from 20° to 90° (systematic change in position, or relative position [RP] = —0.32; 95% confidence interval for RP, —0.48 to —0.17), while the response in the control group showed no distinct pattern (RP = 0.17; 95% confidence interval for RP, —0.05 to 0.31). The difference between the groups was significant (P = .0002). The median change in patients was —26% (interquartile range, 37). Conclusions Pulsatile patellar blood flow in patellofemoral pain syndrome patients is markedly reduced when the knee is being flexed, which supports the previous notion of an ischemic mechanism involved in the pathogenesis of this pain syndrome.

scholarly journals Use of an Elastomeric Knee Brace in Patellofemoral Pain Syndrome: Short-Term Results

Joints ◽  
2018 ◽  
Vol 06 (02) ◽  
pp. 085-089 ◽  
Author(s):  
Francesco Uboldi ◽  
Paolo Ferrua ◽  
Daniele Tradati ◽  
Pietro Zedde ◽  
Jim Richards ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Return To Sport ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Rehabilitation Program ◽  
Return To Sports ◽  
Level Of Evidence ◽  
Group A ◽  
Group B

Purpose This article verifies the effectiveness of a new brace on patellofemoral pain syndrome (PFPS) in adjunct to a specifically developed rehabilitation program. Methods Two groups of 30 patients with PFPS were prospectively and randomly allocated to a rehabilitation protocol, with (group A) or without (group B) the use of a specific brace. All the patients were assessed at 3, 6, and 12 months using the disease-specific Kujala scale and a visual analog scale (VAS) for pain; time to return to sport and patient satisfaction with the brace were also recorded. Results Kujala scale's values showed constant and progressive improvement. The mean score at 6 months was 79.8 ± 6.8 points in group A and 76.8 ± 8.6 in group B, rising at 12 months to 80.9 ± 7.5 in group A and 78.4 ± 8.3 in group B. VAS scores significantly differed (p < 0.05) between the two groups at both 6 and 12 months; the score recorded at 12 months was 0.9 ± 1.3 in the brace-treated group and 1.8 ± 1.6 in the controls. The patients who used a brace showed a quicker return to sports and 75% of the patients in this group were satisfied. Conclusion All the scores improved progressively in both groups. The most significant improvement concerned pain, showing that the brace used in this study may allow a better subjective outcome and a quicker return to sport. Level of Evidence Level II, prospective randomized controlled trial.

scholarly journals Interdisciplinary Therapy for patients with dementia

2014 ◽  
Vol 8 (3) ◽  
pp. 285-290
Author(s):  
Maysa Luchesi Cera ◽  
Daniela Cristina Carvalho de Abreu ◽  
Rosângela de Abreu Venancio Tamanini ◽  
Amanda Carla Arnaut ◽  
Patrícia Pupin Mandrá ◽  
...  
Keyword(s):  
Intervention Program ◽  
Functional Performance ◽  
Functional Dependence ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Clinical Dementia Rating ◽  
Interdisciplinary Intervention

Patients with dementia require rehabilitation involving several health professionals, where interdisciplinary care can further enhance the routine of patients and their families.OBJECTIVE:To compare the functional performance of elderly with dementia before and after an interdisciplinary intervention program provided by a healthcare service of medium complexity.METHODS: Three cases with clinically-confirmed dementia enrolled on an interdisciplinary rehabilitation program were reported. The following instruments were applied: Mini Mental-State Exam, Clinical Dementia Rating, Geriatric Depression Scale, Lawton & Brody Index, and the Functional Independence Measure for adults (FIM). The therapeutic strategies were individualized and designed based on patient performance on the FIM, according to the criteria of the Classification of Functionality, Disability and Health, implemented at the house of therapy of the Center for Integrated Rehabilitation together with provision of guidance.RESULTS: A reduction in functional dependence was observed after intervention, evidenced by less supervision needed to carry out Activities of Daily Living. Conclusion: The three patients benefited from the interdisciplinary intervention.

scholarly journals FUNCTIONAL INDEPENDENCE OF PEDIATRIC PATIENTS WITH MUCOPOLYSACCHARIDOSES

2019 ◽  
Vol 27 (4) ◽  
pp. 212-215
Author(s):  
Paloma Silva Lopes ◽  
Diógenes Pires Serra Filho ◽  
Marcos Antônio Almeida Matos
Keyword(s):  
Pediatric Patients ◽  
Case Series ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Cross Sectional Study ◽  
Cognitive Domain ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Documentary Analysis ◽  
The Mean

ABSTRACT Objective: To measure the functional independence to perform activities of daily living of pediatric patients diagnosed with mucopolysaccharidoses. Methods: A descriptive cross-sectional study was carried out with the population of pediatric patients with a confirmed enzymatic diagnosis of mucopolysaccharidoses, enrolled in the Orthopedics outpatient clinic of a hospital in the State of Bahia. The data were collected between October 2016 and March 2017, based on the documentary analysis of the assessment forms used in the department. The variables of this study comprised sex, age, type of MPS and level of functional independence, measured by the Functional Independence Measure scale. Results: Twenty-six patients participated in the study. These were predominantly male (61.5%), with a mean age of 10 ± 4.5 years, affected by MPS VI (73.1%). In the motor domain, the mean score was 65 (± 19.9 points); the cognitive domain obtained a mean score equal to 28 (± 8.2 points); and the total FIM score was 93 (± 26.5). Conclusion: Impaired functional independence was observed among children and adolescents with mucopolysaccharidoses. Tasks related to dressing, toileting, bathing, problem solving and social interaction were those that required the most assistance and/or supervision. Level of Evidence IV, Case Series.

scholarly journals Optimising the management of bladder pain syndrome

2020 ◽  
pp. 205141582095473
Author(s):  
Waleed Al-Singary ◽  
Reena Patel ◽  
Ujjal Sarkar ◽  
Hiten RH Patel
Keyword(s):  
Pain Control ◽  
Symptomatic Relief ◽  
Pain Syndrome ◽  
Skin Lesions ◽  
Bladder Pain Syndrome ◽  
Pain Clinic ◽  
Level Of Evidence ◽  
Bladder Pain ◽  
Irritable Bowel ◽  
Good Pain Control

Objective: Clinicians have shown variable practice in the diagnosis and management of bladder pain syndrome (BPS). This study assessed pain localisation sites, common co-morbidities, investigations and treatment patterns in clinical practice. Patients and methods: We performed a retrospective analysis of 412 patients attending our pelvic pain clinic between 2004 and 2016. Frequency counts were used to summarise findings. Results: Pain in women ( N=388) was localised to the lower abdomen (92.0%), lower back (71.1%) and vagina (60.8%). Men ( N=24) typically presented with testicular pain with painful ejaculation (70.8%). Nearly all (95.4%) patients reported sexual dysfunction. Visceral neuropathic pain and autoimmune co-morbidities, such as irritable bowel syndrome, chronic headaches or migraines and skin lesions, were more prevalent in our cohort than in the general population. All patients had urine culture and sensitivities and flexible cystoscopy. Laparoscopy, urodynamic studies and bladder biopsies were mostly normal, but were essential in excluding other pathologies. Good pain control was achieved on amitriptyline (83.0%). Hydro-distension and benign bladder ulcer cauterisation provided temporary symptomatic relief. Conclusion: This study demonstrates that patient expectation management and education is essential in BPS, with most achieving good pain control with conservative measures and amitriptyline. Those receiving intravesical treatments will most likely require subsequent revisions. Level of evidence: Not applicable for this single-centre audit.

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