scholarly journals A Role of Complementary Medicine in Rehabilitation of Military Traumatic Brain Injuries

Pain medicine ◽  
2018 ◽  
Vol 3 (2/1) ◽  
pp. 8-8
Author(s):  
T Shitikov ◽  
O Shayrin ◽  
L Danilko
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Outcome Measures ◽  
Rating Scale ◽  
Case Series ◽  
Manual Therapies ◽  
Pain Rating ◽  
Post Concussion Syndrome ◽  
Pain Rating Scale

Background: Military service members and veterans face health issues related to traumat-ic brain injury (TBI), especially during combat, use of heavy equipment, and exposures to environmental hazards and explosives. There were 1.000 TBIs reported in deployed Ukra-nian troops during Russian-Ukranian war in 2014–2017. Studies have indicated that some manual therapies could be helpful for treating patients who have post-concussive syndrome. Objective: This case series report de-scribes the effects of CranioSacral Therapy (CST), Visceral Manipulation (VM), and Neu-ro-muscular Manipulation (NM) modalities for treating patients who have post-concussion syndrome. The goal of this study was to evalu-ate these effects on immobility, pain intensity, quality of life, sleep disorders, and cognition in these patients. Materials and Methods: This single-blind-ed case series was conducted at the Volunteer rehabilitation center, Dnipro, Ukraine. The pa-tients were 45 male participationers of Ukra-nian military forces who had been medically diagnosed with post-concussion syndrome. Each participant received a morning and af-ternoon 1-hour session of these three spe-cific manual therapies, which were capable of accessing and addressing the structural, vascular, and neuro-muscular tissues of the Cranium, Neck, Diafragm, Peritoneal bag and brain-as well addressing far-reaching ramifi-cations throughout the body following trauma. The main outcome measures were scores on the: Impact Neurocognitive Test; Blood Oxigen Saturation Test; Short Form-36 Quality of Life Survey, Headache Impact Test, a numeric pain rating scale; orthopedic range of motion tests (ROM); and vestibular testing. Hours of sleep were also checked. These outcome measures were registered at baseline, after treatment, and after a 3–6-month follow up. Results: Statistically significant differenc-es were seen with a decrease in overall pain rating scale scores (P = 0.034), and cranio-cer-vicogenic pain levels decreased (P = 0.047). There were statistically significant increases of blood oxigen saturation (P = 0.033), Mem-ory Test (P = 0.017) scores, and cervical ROM scores (P = 0.036). Hours of sleep averaged 1 hours on the first day of treatment and in-creased to 2.0 hours at the end of treatment. Results were continuing to increase, as noted at a 5-month evaluation. Conclusions: Six sessions of specific CST/VM/NM therapy resulted in statistically great-er improvements in pain intensity, ROM, mem-ory, cognition, blood oxigen saturation and breathing in concussed patients.

scholarly journals Hand rehabilitation with sonification techniques in the subacute stage of stroke

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alfredo Raglio ◽  
Monica Panigazzi ◽  
Roberto Colombo ◽  
Marco Tramontano ◽  
Marco Iosa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Upper Extremity ◽  
Rating Scale ◽  
Pain Rating ◽  
Numerical Pain Rating Scale ◽  
Subacute Stroke ◽  
End Of Treatment ◽  
Block Test ◽  
Pain Rating Scale

AbstractAfter a stroke event, most survivors suffer from arm paresis, poor motor control and other disabilities that make activities of daily living difficult, severely affecting quality of life and personal independence. This randomized controlled trial aimed at evaluating the efficacy of a music-based sonification approach on upper limbs motor functions, quality of life and pain perceived during rehabilitation. The study involved 65 subacute stroke individuals during inpatient rehabilitation allocated into 2 groups which underwent usual care dayweek) respectively of standard upper extremity motor rehabilitation or upper extremity treatment with sonification techniques. The Fugl-Meyer Upper Extremity Scale, Box and Block Test and the Modified Ashworth Scale were used to perform motor assessment and the McGill Quality of Life-it and the Numerical Pain Rating Scale to assess quality of life and pain. The assessment was performed at baseline, after 2 weeks, at the end of treatment and at follow-up (1 month after the end of treatment). Total scores of the Fugl-Meyer Upper Extremity Scale (primary outcome measure) and hand and wrist sub scores, manual dexterity scores of the affected and unaffected limb in the Box and Block Test, pain scores of the Numerical Pain Rating Scale (secondary outcomes measures) significantly improved in the sonification group compared to the standard of care group (time*group interaction < 0.05). Our findings suggest that music-based sonification sessions can be considered an effective standardized intervention for the upper limb in subacute stroke rehabilitation.

Painful diabetic polyneuropathy and quality of life in Danish type 2 diabetic patients

2017 ◽  
Vol 16 (1) ◽  
pp. 173-173 ◽  
Author(s):  
Sandra Sif Gylfadottir ◽  
Diana Hedevang Christensen ◽  
Sia Kromann Nicolaisen ◽  
Reimar Wernich Thomsen ◽  
Jens Steen Nielsen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Rating Scale ◽  
Diabetic Polyneuropathy ◽  
Numeric Rating Scale ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Abstract Background and aims Painful polyneuropathy (PPN) is a disabling complication of diabetes. This study aims to determine its prevalence and relationship with Quality of Life (QoL) in a nationwide prospective cohort of incident recently diagnosed Danish type 2 diabetic patients. Methods We sent a detailed questionnaire on neuropathy, pain and QoL to 6726 patients prospectively enrolled from general practitioners and hospital specialist outpatient clinics into the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. Patients who reported pain in both feet and a score ≥3 on the Douleur Neuropathique (DN4) questionnaire were considered to have possible PPN. QoL and pain intensity were measured on a numeric rating scale (NRS, 0–10). The Michigan Neuropathy Screening Instrument (MNSI) was used to assess neuropathy. Results A total of 5371 (79.8%) returned a complete questionnaire. 848 (15.8%) recently diagnosed type 2 diabetic patients reported pain in both feet. Of the 619 patients with pain who completed the DN4 questionnaire, 404 (65.2%) had a DN4 score ≥ 3, corresponding to a prevalence in the total population of possible PPN of 10.3%. Mean pain intensity was 5.2 (SD 2.2) and 89% had a MNSI score ≥ 3. Patients with possible PPN had a substantially lower QoL score than those without PPN (median QoL score 6 versus 8 (p < 0.001)), also when correcting for MNSI score. Conclusions Ten percent of newly diagnosed type 2 diabetic patients in Denmark had possible PPN. Patients with PPN had lower QoL than patients without PPN.

scholarly journals Effectiveness of Progressive Resisted Exercise along with Conventional Exercise and Conventional Exercise Program alone in Subjects with Text Neck Syndrome

2021 ◽  
pp. 536-542
Author(s):  
Divya Jain ◽  
Swapna Jawade ◽  
Neha Chitale
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Conventional Therapy ◽  
Rating Scale ◽  
Neck Disability Index ◽  
Exercise Program ◽  
Pain Rating ◽  
Numerical Pain Rating Scale ◽  
Neck Disability ◽  
Pain Rating Scale

Background: "Text neck" is a term coined to describe the posture created by leaning forward for lengthy periods of time, such as when reading and texting on a cellphone which has been linked to stress injuries. Neck pain, upper back discomfort, shoulder pain, frequent headaches, and greater curvature of the spine are all dangerous indications of text neck. According to a survey, 35% of smartphone users suffer from text neck syndrome. People between the ages of 15 and 18 are more likely to have neck pain. This protocol has been created that describes the design of comparative study to evaluate effectiveness of progressive resisted exercise along with conventional exercise and conventional exercise program alone in text neck syndrome. Methods: The participants (n=80) will be recruited in the study suffering from text neck syndrome and meeting the inclusion criteria. Two groups will be formed such that patients in group A will be treated with conventional therapy and group B will be treated with progressive resisted exercise (PRE) along with conventional therapy. The protocol will cover 4 weeks of treatment. In the rehabilitation period, we will evaluate the pain intensity, strength of neck muscles and functional activity. Our outcome measures will be- Numerical pain rating scale (NPRS) and Neck disability index (NDI). Discussion: Efficacy of the intervention will be evaluated by analyzing the pain intensity by using Numerical pain rating scale (NPRS) and level of functional disability by using Neck disability index (NDI). The result of the study will significantly provide affirmation on either using combination therapy of PRE with conventional exercise or conventional exercise alone.

Mycophenolate for persistent complex regional pain syndrome, a parallel, open, randomised, proof of concept trial

2018 ◽  
Vol 18 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Andreas Goebel ◽  
Anu Jacob ◽  
Bernhard Frank ◽  
Paul Sacco ◽  
Guillermo Alexander ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Rating Scales ◽  
Rating Scale ◽  
Pain Syndrome ◽  
Analysis Of Covariance ◽  
Proof Of Concept ◽  
Numeric Rating

Abstract Background and aims: Current therapies for persistent complex regional pain syndrome (CRPS) are grossly inadequate. With accruing evidence to support an underlying immunological process and anecdotal evidence suggesting potential efficacy of mycophenolate, we wished to explore the feasibility and effectiveness of this treatment in patients with CRPS. Methods: A randomised, open, parallel, proof of concept trial was conducted. Patients with Budapest research criteria CRPS of >2-year duration and moderate or high pain intensity (numeric rating scale score ≥5) were enrolled. Eligible patients were randomised 1:1 to openly receive mycophenolate as add-on treatment, or their usual treatment alone, over 5.5 months. They then switched to the other treatment arm for 5.5 months. The main outcome was average the patients’ average pain intensity recorded over 14 days, between 5.0 and 5.5 months post randomisation, on 11-point (0–10) numeric rating scales, compared between trial arms. Skin sensitivities and additional outcomes were also assessed. Results: Twelve patients were enrolled. Nine provided outcomes and were analysed for the main outcome. Mycophenolate treatment was significantly more effective than control [drug-group mean (SD): pre: 7.4 (1.2)- post: 5.2 (1.3), n=4, control: pre: 7.7 (1.4)- post: 8.1 (0.9), n=5; −2.8 (95% CI: −4.7, −1.0), p=0.01, analysis of covariance]. There were four treatment responders (to mycophenolate treatment either before, or after switch), whose initial exquisite skin hyper-sensitivities, function and quality of life strongly improved. Side effects including itchiness, skin-cryptitis, increased pain, and increased depression caused 45% of the subjects to stop taking mycophenolate. Conclusions: Mycophenolate appears to reduce pain intensity and improve quality of life in a subgroup of patients with persistent CRPS. Implications: These results support the feasibility of conducting a definite trial to confirm the efficacy and effect size of mycophenolate treatment for persistent CRPS (EudraCT 2015-000263-14).

scholarly journals 12-Month Cohort Study to Investigate Changes in Patient-Reported Outcomes Pain after Intra-articular Injection of Micro-Fragmented Adipose Tissue for Knee Osteoarthritis

2021 ◽  
Vol 3 (1) ◽  
pp. e19-e28
Author(s):  
Nathan Hogaboom ◽  
Ella D'Amico ◽  
Ken Mautner ◽  
Christopher Rogers ◽  
Gerard Malanga
Keyword(s):  
Quality Of Life ◽  
Adipose Tissue ◽  
Knee Osteoarthritis ◽  
Outcome Measures ◽  
Knee Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Symptomatic Knee ◽  
Patient Reported

BackgroundTo evaluate changes in pain, function, and quality of life after treatment with injected micro-fragmented adipose tissue (MFAT) for knee osteoarthritis in a large cohort of individuals treated at multiple centers. MethodsOne hundred ten individuals were recruited from three private outpatient clinics. Participants had to be diagnosed with symptomatic knee OA (defined by persistent knee pain associated with clinical symptoms of OA and/ or classic imaging findings) and who had not received prior knee surgery or treatment with platelet-rich plasma, cortisone, or hyaluronic acid within the previous 6 weeks. Data from 120 knees were included in the analysis. Outcome measures included Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales (pain, symptoms, activities of daily living [ADL], sports and recreation, quality of life [QOL]) and an 11-point Numerical Rating Scale (NRS) for average knee pain over the past week. Outcomes were collected at baseline and 3, 6, and 12 months. ResultsSignificant increases and decreases in KOOS subscale and NRS scores were observed, respectively, in the cohort as a whole (p< .05). Lower BMI was associated with more significant improvements in pain, sports/recreation, and ADL KOOS subscale scores (p< .05). Greater age was associated with more significant improvements in symptoms and QOL subscale scores (p< .05). ConclusionsA single injection of MFAT improved pain, function, and QOL outcome measures up to 12 months in this cohort for more than half of the participants. Greater BMI and lower age negatively influenced outcomes. It is not known whether improvements continue after this timeframe or why many participants reported little-to-no improvement.

Long-term efficacy of spironolactone on pain, mood, and quality of life in women with fibromyalgia: An observational case series

2014 ◽  
Vol 5 (2) ◽  
pp. 63-71 ◽  
Author(s):  
Heinrich Wernze ◽  
Thomas Herdegen
Keyword(s):  
Quality Of Life ◽  
Rating Scale ◽  
Dose Range ◽  
Fibromyalgia Impact Questionnaire ◽  
Case Series ◽  
Treatment Resistant ◽  
Positive Effects ◽  
Long Term Treatment

AbstractObjectiveNo single drug is broadly efficacious in the long-term treatment of fibromyalgia syndrome (FMS). Spironolactone is known to ameliorate mood and tension headache or migraine in women with premenstrual syndrome or clinical signs of hyperandrogenism. In a case series of women with treatment resistant FMS spironolactone was therefore added to their medication, and they were observed for at least 12 months.Methods31 women with treatment-resistant FMS received spironolactone as add-on medication to various pain modulating drugs. 15 women responded to spironolactone and baseline data were compared with assessments over 12–14 months on treatment with spironolactone (ALDACTONE®) in dose range 100–200 mg/day. The efficacy was evaluated by the fibromyalgia impact questionnaire (FIQ) total score and 8 FIQ subtests, a German mood inventory (BSKE-EWL), and further assessments of changes in relevant psychological and physical complaints. 16 women had no effect and stopped the treatment early.ResultsThe subsequent data refer to the 15 responders. The FIQ total score (maximal score = 80) decreased from 56.6 ± 10.0 at baseline to 17.1 ± 11.9 (mean ± SD) 12–14 months later, and pain intensity on an 11 point numeric rating scale (NRS) decreased from 8.8 ± 1.6 to 2.6 ± 1.9 (mean ± SD). Similar changes in FIQ subscores were found for fatigue, morning tiredness, stiffness, anxiety, and depression. Emotional functioning consistently improved: positive mood from 20.0 ± 5.4 to 37.7 ± 5.4 (maximal score = 48), and negative mood from 35.4 ± 5.3 to 10.0 ± 4.4 (maximal score = 60) (each mean ± SD) as well as other mental and physical dysfunctions including non-restorative sleep. All these changes at 4–6 weeks remained on this level for 11–13 months. The drug was well-tolerated and safe, no serious adverse effects were observed. Regular monitoring of serum potassium did not reveal hyperkalemia. All 15 women were able to reduce or discontinue concomitant drugs.ConclusionFifteen of 31 women with otherwise treatment-resistant FMS experienced a number of prolonged beneficial effects from spironolactone on their complex pain-condition.Implications and discussionWe hypothesise that spironolactone affects several central and peripheral neurotransmitter systems such as γ-aminobutyric acid (GABA) activity and dopaminergic transmission. The high rate of non-responsive patients underlines that FMS may represent several subgroups. Pain relief and improvement of associated FHS-symptoms and positive effects on additional diseases or dysfunctions give reasons for marked and sustained improvement in the quality of life.Well-controlled, double-blind, and randomised trials are necessary to confirm our potentially very important observations.

scholarly journals Cannabidivarin for the treatment of HIV-associated neuropathic pain: a randomized, blinded, controlled clinical trial

2019 ◽  
Author(s):  
Luca Eibach ◽  
Simone Scheffel ◽  
Madeleine Cardebring ◽  
Marie Lettau ◽  
Ozgur Celik ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Neurological Complication ◽  
Receptor Activation ◽  
Pain Medication ◽  
Controlled Clinical Trial ◽  
Pain Characteristics

Background: HIV remains a major burden to the health care system and neuropathic pain is the most common neurological complication of HIV-infection. Since current treatment strategies often lack satisfying pain relief, cannabinoids are discussed as a new option. We investigated Cannabidivarin as treatment for HIV-associated neuropathic pain. Methods: We conducted a randomized, double-blind, placebo-controlled cross-over study. Patients underwent two successive treatment phases (4 weeks each) and were treated with Cannabidivarin (400mg/d) or placebo in a randomized order. A 3-week wash-out phase was designed to eliminate potential carry-overeffects and patients were followed up for 3 weeks after the end of the second treatment phase. The primary endpoint was pain intensity on an 11-point numeric rating scale and was recorded in a diary. Secondary endpoints were additional pain medication, pain characteristics and quality of life. Results: We included 32 (31 male) patients. The mean pain intensity under Cannabidivarin was by 0.62 points higher compared to placebo (p=0.16; 95% CI -0.27 to 1.51). Cannabidivarin did not influence the amount of additional pain medication, pain characteristics or quality of life. No suspected unexpected adverse reactions occurred during the trial. Discussion: Cannabidivarin was safe but failed to reduce neuropathic pain intensity in HIV-patients. This may be explained by a lack of cannabinoid receptor activation, as indicated by preclinical experiments. Further studies on larger sample sizes are needed.

scholarly journals Luaran Penggunaan Analgesik Opiat pada Pasien Kanker

2019 ◽  
Vol 9 (4) ◽  
pp. 284
Author(s):  
Salma Fajar Puspita ◽  
Zullies Ikawati, Apt. ◽  
Retno Muliawati
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Disease Status ◽  
Cancer Center ◽  
Transdermal Fentanyl ◽  
Reduction Of Pain

Cancer pain might reduce the quality of life of cancer patients. Opioids are the drug of choice in cancer pain management. Fentanyl and other opioids are often prescribed. This study was aimed to compare the pain intensity reduction and quality of life of patients with cancer pain using transdermal fentanyl and other opioids. This prospective cohort study Oinvolved cancer outpatients with pain at the Tulip International Cancer Center of RSUP Dr. Sardjito, Yogyakarta fulfilling inclusion and exclusion criteria. Follow-up was carried out 2 weeks after recruitment. Pain intensity and quality of life were obtained through interview process using Numerical Rating Scale (NRS) and EORTC QLQ-C30 questionnaire. Patient demographic and disease status were obtained from medical records. Clinical outcomes (reduction in pain intensity and achievement of pain targets) and quality of life in the transdermal fentanyl and oral opioid groups were presented descriptively because of the low research power. Total respondents involved were 111 patients, 13 (11.71%) patients used transdermal fentanyl and 98 (88.29%) patients used oral opiates. The effect of opioid on reduction of pain intensity, achievement of pain targets and quality of life cannot be justified even though descriptively transdermal fentanyl shows better outcomes than oral opioid. The reduction of pain intensity was influenced by age (p = 0,000) and global health status was influenced by the stage of the cancer (p = 0.045).

Responsiveness of the Numeric Pain Rating Scale in Patients With Shoulder Pain and the Effect of Surgical Status

2011 ◽  
Vol 20 (1) ◽  
pp. 115-128 ◽  
Author(s):  
Lori A. Michener ◽  
Alison R. Snyder ◽  
Brian G. Leggin
Keyword(s):  
Shoulder Pain ◽  
Outcome Measures ◽  
Rating Scale ◽  
Effect Sizes ◽  
Outpatient Rehabilitation ◽  
Pain Rating ◽  
Characteristic Analysis ◽  
Point Change ◽  
Numeric Pain Rating Scale ◽  
Pain Rating Scale

Context:The Numeric Pain Rating Scale (NPRS) is commonly used to assess pain. Change in the NPRS across time can be interpreted with responsiveness indices.Objective:To determine the minimal clinically important difference (MCID) of the NPRS.Design:Single-group repeated measures.Setting:Outpatient rehabilitation clinics.Patients:Patients with shoulder pain (N = 136).Main Outcome Measures:At the initial evaluation patients completed the Penn Shoulder Score (PSS), which includes pain, satisfaction, and function sections. Pain was measured using an 11-point NPRS for 3 conditions of pain: at rest, with normal daily activities, and with strenuous activities. The NPRS average was calculated by averaging the NPRS scores for 3 conditions of pain. The final PSS was completed after 3–4 wk of rehabilitation. To determine the MCID for the NPRS average, the minimal detectible change of 8.6 points for the PSS function scale (0–60 points) was used as an external criterion anchor to classify patients as meaningfully improved (≥8.6 point change) or not improved (<8.6-point change). The MCID for the NPRS average was also determined for subgroups of surgical and nonsurgical patients. Cohen’s effect sizes were calculated as a measure of group responsiveness for the NPRS average.Results:Using a receiver-operating-characteristic analysis, the MCID for the average NPRS for all patients was 2.17, and it was 2.17 for both the surgical and nonsurgical subgroup: area-under-the-curve range .74–.76 (95%CI: .55–.95). The effect size for all patients was 1.84, and it was 1.51 and 1.94 for the surgical and nonsurgical groups, respectively.Conclusions:The NPRS average of 3 pain questions demonstrated responsiveness with an MCID of 2.17 in patients with shoulder pain receiving rehabilitation for 3–4 wk. The effect sizes indicated a large effect. However, responsiveness values are not static. Further research is indicated to assess responsiveness of the NPRS average in different types of patients with shoulder pain.

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