scholarly journals The Use of Multimedia as a Distraction to Reduce Anxiety Reaction among Paediatric Patients During Cast Removal at Hospital Tengku Ampuan Afzan

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Tengku Kashfil
Keyword(s):  
Heart Rate ◽  
Experimental Study ◽  
Upper Limb ◽  
Pulse Oximeter ◽  
Control Group ◽  
Anxiety Reaction ◽  
Paediatric Patients ◽  
The Mean ◽  
Limb Fractures ◽  
Upper Limb Fractures

Introduction: Cast removal procedures can be a daunting experience for children giving rise to anxiety. The objective of this study is to measure the level of anxiety in children during cast removal at Hospital Tengku Ampuan Afzan. Materials and method: An experimental study was conducted with a sample of 40 paediatric patients with upper limb fractures and cast removal were randomly assigned into two groups: with multimedia distraction or without (control). Patient's heart rate was measured using a pulse oximeter before, during and after cast removal. Results: A total number of 20 children were randomized to multimedia distraction and another 20 to control with no distractions. The mean rise in heart rate between preprocedure and during procedure 5.3 beats/min in multimedia distraction group and 16.35 beats/min in control group (P = 0.001). The mean difference in heart rate between the pre-procedure and during the procedure was 5.64 beats/min in the multimedia distraction group and 13.13 beats/ min in the control group (P = 0.05). Conclusion: There was significant decrease in heart rate during cast removal with multimedia distraction. Therefore multimedia distraction is a useful tool in reducing anxiety among children during cast removal.

scholarly journals FRI0617-HPR GRADED MOTOR IMAGERY IN POSTTRAUMATIC STIFFNESS OF THE ELBOW: A PILOT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 913.2-914
Author(s):  
T. Birinci ◽  
E. Kaya Mutlu ◽  
S. Altun
Keyword(s):  
Pilot Study ◽  
Motor Imagery ◽  
Upper Limb ◽  
Exercise Program ◽  
Control Group ◽  
Elbow Fracture ◽  
Stiff Elbow ◽  
Limb Fractures ◽  
Upper Limb Fractures ◽  
Graded Motor Imagery

Background:Elbow fracture is treated either conservatively or surgically followed by a period of immobilization with casting or splinting. A splint used to immobilize upper limbs for many weeks results in changes in both the peripheral musculature and the central nervous system. It is well known that common complaints after upper limb fractures include weakness, pain, and stiffness; therefore, pain management is important in the early stages of the rehabilitation of upper limb fractures.Objectives:This pilot study aimed to investigate the efficacy of graded motor imaginary (GMI) on pain, range of motion (ROM), and function in patients with posttraumatic stiff elbow.Methods:Fourteen patients with posttraumatic stiff elbow (6 women, mean age: 45.42 ± 11.26 years, mean body mass index: 24.29 ± 3.38 kg\m2and mean duration of immobilization: 4.75 ± 1.03 weeks) were randomly allocated to either GMI or control groups. The GMI group received GMI treatment in addition to a structured exercise program, and the control group received a structured exercise program (two days per week for six weeks) (Figure 1). The assessments included pain at rest and during activity using the visual analog scale (VAS), elbow active ROM with a digital goniometer (Baseline Evaluation Instrument, Fabrication Enterprises, Inc., White Plains, NY), and upper extremity functional status using the Disability of the Arm, Shoulder and Hand Questionnaire (DASH). The assessments were performed at baseline and after the 6-week intervention.Figure 1.Graded motor imagery performed with mirror boxResults:After the 6-week intervention, there was a significant increase in elbow flexion-extension ROM and supination-pronation ROM, and improvement in DASH score in both groups (p<0.05). However, improvement in VAS-rest and VAS-activity was significantly higher in the GMI group than the control group (p=0.03 and p=0.01, respectively).Conclusion:A conservative treatment program consisting of GMI treatment in addition to a structured exercise program applied twice a week for 6 weeks, has been found more effective in decreasing pain in the posttraumatic stiff elbow. It could be concluded that GMI is an effective treatment method for elbow fracture in patients with predominant elbow pain.References:[1] Harris JE, Hebert A. Utilization of motor imagery in upper limb rehabilitation: a systematic scoping review. Clin Rehab. 2015:29(11):1092-1107.[2] Opie GM, Evans A, Ridding MC, Semmler JG. Short-term immobilization influences use-dependent cortical plasticity and fine motor performance. Neuroscience. 2016:330:247-256.[3] Birinci T, Razak Ozdincler A, Altun S, Kural C. A structured exercise programme combined with proprioceptive neuromuscular facilitation stretching or static stretching in posttraumatic stiffness of the elbow: a randomized controlled trial. Clin Rehab. 2019:33(2):241-252.Acknowledgments:The present work was supported by the Scientific Research Projects Coordination Unit of Istanbul University-Cerrahpasa (Project No: TDK-2019-33997).Disclosure of Interests:None declared

Introduction of a simple guideline to improve neurological assessment in paediatric patients presenting with upper limb fractures

2016 ◽  
Vol 33 (4) ◽  
pp. 273-277 ◽  
Author(s):  
Andrew G Marsh ◽  
James S Robertson ◽  
Anna Godman ◽  
Jennifer Boyle ◽  
James S Huntley
Keyword(s):  
Upper Limb ◽  
Neurological Assessment ◽  
Paediatric Patients ◽  
Limb Fractures ◽  
Upper Limb Fractures

scholarly journals What is the real impact of upper limb cast immobilisation on activity-related energy expenditure in children?

2018 ◽  
Vol 4 (1) ◽  
pp. e000359 ◽  
Author(s):  
Albane B R Maggio ◽  
Xavier Eric Martin ◽  
Anne Tabard-Fougère ◽  
Cécile Delhumeau ◽  
Dimitri Ceroni
Keyword(s):  
Energy Expenditure ◽  
Energy Intake ◽  
Upper Limb ◽  
Positive Energy ◽  
Healthy Controls ◽  
Cast Immobilisation ◽  
Related Energy ◽  
The Mean ◽  
Limb Fractures ◽  
Upper Limb Fractures

BackgroundUpper limb fractures and subsequent cast immobilisation constitute a potential cause of reduction in childhood levels of physical activity (PA), with subsequent decrease of energy consumption. The main objective of this study was thus to quantify the decrease of activity-related energy expenditure (AEE) due to upper limb cast immobilisation .MethodsWe conducted a longitudinal matched case-control study that included 35 children and teenagers with a first episode of upper limb fracture and 35 healthy cases. PA was assessed during cast immobilisation by accelerometer. AEE was the calculated using an equation based on the total counts per day measured by accelerometers.ResultsAEE in children and teenagers with upper limb fractures was estimated to be 7.4 % lower than healthy controls. The mean difference corresponded to 1.35 kcal/kg per mean valid recorded time (750  min), that is, the waking hours. When converted in kcal per mean subjects’ weight, the difference in AEE amounted 63.5 kcal/day, which corresponds approximately to 26  min of walking at a speed of 4  km/hours. In comparison with the mean AEE in healthy controls (18.2 kcal/kg), the noted decrease (1.35 kcal/kg) represents only 7.4 % of AEE.ConclusionReduction of AEE in children and teenagers with upper limb fractures may lead to a slight positive energy balance, as there is usually no compensatory reduction of energy intake. An increase of light PA has to be counselled in this situation or patients should be advised to reduce their energy intake during the immobilisation period.Level of evidenceLevel I: high-quality prospective study (all patients were enrolled at the same point in their disease with ≥80 % follow-up of enrolled patients).

scholarly journals A youngest reported case of type II Monteggia lesion associated with a posterior ulnohumeral dislocation

2019 ◽  
Vol 26 (1) ◽  
pp. 23-25
Author(s):  
Avadhoot Kantak
Keyword(s):  
Upper Limb ◽  
Injury Pattern ◽  
Type Ii ◽  
Rare Injury ◽  
Monteggia Lesion ◽  
Injury Mechanisms ◽  
High Incidence ◽  
Limb Fractures ◽  
Upper Limb Fractures

Monteggia fractures are uncommon injuries, despite a high incidence of upper limb fractures in teenage children. We describe a case of a type 2 Monteggia variant in an adolescent. This injury pattern consisted of ulnohumeral dislocation in combination with type 2 Monteggia lesion. We discuss the possible injury mechanisms of this rare injury and review available literature.

scholarly journals Effect of Self-care Training on Upper Limb Function and Pain After Breast Cancer Surgery

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Somyye Noura ◽  
Fatemeh Kiani ◽  
Nezarali Moulaei ◽  
Mojtaba Tasbandi ◽  
Ebrahim Ebrahimi Tabas
Keyword(s):  
Breast Cancer ◽  
Upper Limb ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Limb Function ◽  
Upper Limb Function ◽  
Care Training ◽  
The Mean ◽  
And Control

Background: Breast cancer patients who undergo mastectomy encounter numerous problems, the most annoying of which is lymphedema followed by pain and decreased function in the affected limb. Objectives: This study examined the effect of self-care training on upper limb function and pain after breast surgery. Methods: This quasi-experimental study was performed on two groups of 60 patients with breast cancer in the Oncology Ward of Zahedan University of Medical Sciences in 2021. The patients were selected based on the inclusion criteria and through convenience sampling and were then randomly divided into intervention and control groups. The patients in the intervention group attended self-care training and exercise programs implemented in five sessions in addition to the routine care. One and three months after the intervention, upper limb function and pain were measured with DASH and McGill pain questionnaires. The repeated measures analysis of variance (ANOVA) and Bonferroni test were used to compare the pre-, and post-intervention mean scores and mean differences in the two groups. Results: The mean scores of upper limb function one and three months after the training program in the intervention group were lower than the mean scores of the control group. In other words, the quality of upper limb function was not significantly different despite the changes in the first month, but upper limb function significantly improved three months after the intervention (P < 0.001 vs. P = 0.06). The mean pain scores before, one month, and three months after the intervention in the intervention group were 10.4, 35.7, and 6.26, respectively, and the corresponding values in the control group were 10.8, 41.7, and 21.1, respectively, showing significant differences between the two groups, with the intervention group having lower pain scores than the control group (P = 0.001). Conclusions: Since lymphedema and its consequences, including decreased upper limb function and pain, are very serious issues, medical staff can give priority to this training program and implement it to prevent and control these complications.

Implantology in Pediatric Upper Limb Fractures

2021 ◽  
pp. 1-22
Author(s):  
Antonio Andreacchio ◽  
Flavia Alberghina ◽  
Federico Canavese ◽  
Ashok Johari
Keyword(s):  
Upper Limb ◽  
Limb Fractures ◽  
Upper Limb Fractures

Increased heart rate accelerates norepinephrine washout from normal myocardium

1987 ◽  
Vol 253 (6) ◽  
pp. H1581-H1585 ◽  
Author(s):  
R. J. Henning ◽  
J. Cheng ◽  
A. M. Bhat ◽  
M. N. Levy
Keyword(s):  
Heart Rate ◽  
Ventricular Myocardium ◽  
Neuronal Uptake ◽  
Control Group ◽  
Inotropic Response ◽  
Sympathetic Stimulation ◽  
Uptake Mechanism ◽  
The Mean ◽  
Time Required ◽  
Experimental Group

We determined whether a change in heart rate affected the decay of the ventricular inotropic response to sympathetic stimulation in an experimental group and in a control group of anesthetized dogs. We induced complete heart block in each animal and paced the ventricles at rates of 90, 120, and 150 min-1 during two observation periods. In the experimental group, desipramine hydrochloride was given during the second period to block the neuronal uptake mechanism. The control animals did not receive desipramine during either period. The time required for the ventricular inotropic response to decay by 50% after cessation of a 2-min train of sympathetic stimulation was used as an index of the rate of norepinephrine washout from the myocardial interstitium. As we increased the pacing rate over the range of 90-150 min-1 in the experimental group, the mean decay half times (+/- SE) decreased by 36 +/- 4% (P less than 0.001) before desipramine and by 26 +/- 6% (P less than 0.001) in the presence of desipramine. These decrements in the decay half times were not significantly different from each other. The mean decay half times decreased by 36 +/- 4% (P less than 0.001) in the control dogs; the effects did not change appreciably from the first to the second observation period. We conclude that an increase in pacing frequency facilitates the washout of norepinephrine from the ventricular myocardium; this facilitation is equally pronounced regardless of whether the neuronal uptake mechanism is intact or suppressed.

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