scholarly journals Efficacy of baclofen in combination with intensive rehabilitation in spastic cerebral palsy- a randomized clinical trial

2015 ◽  
Vol 23 (1) ◽  
pp. 18-23
Author(s):  
Md Ruhul Amin ◽  
Narayan Chandra Saha ◽  
Sohely Rahman ◽  
Md Shahadat Hossain ◽  
Md Jahidul Islam ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cerebral Palsy ◽  
Randomized Clinical Trial ◽  
Rating Scale ◽  
Muscle Tone ◽  
The Body ◽  
Spastic Cerebral Palsy ◽  
Medical College ◽  
Superior Efficacy ◽  
Intensive Rehabilitation

Objective: To find out the combined efficacy of baclofen and intensive rehabilitation in the treatment of spastic cerebral palsy. Methods: This randomized clinical trial was conducted over 60 patients in Dhaka Medical College Hospital, Dhaka, between January and December 2011. The patient satisfying the inclusion and exclusion criteria was randomly enrolled into two groups; Group A (case) included 30 patients received only intensive rehabilitation and Group B (control) included 30 patients who received baclofen orally two times daily according to the body weight regularly in combination with intensive rehabilitation 1 hour daily five times a week for 24 weeks. All patients were followed up at 4 weeks interval and were evaluated for a total of 24 weeks. Results: Combination of baclofen and intensive rehabilitation has superior efficacy in reducing tone in spastic cerebral palsy over only rehabilitation measured by using Modified Ashworth scale (p<0.001). Combination of baclofen and intensive rehabilitation is also superior in physician rating scale crouch (p<0.0001) and foot contact, (p<0.0001) and also improvement in gross motor function (p<0.01). Conclusion: Combination of baclofen and intensive rehabilitation group has superior efficacy than only rehabilitation group for reduction of generalized spasticity regarding muscle tone, range of motion of the joint and improvement of gait in cerebral palsy patients. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22688 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 18-23

scholarly journals Role of Baclofen in Combination with Intensive Rehabilitation in Spastic Cerebral Palsy

2015 ◽  
Vol 1 (1) ◽  
pp. 18-21
Author(s):  
Md Ruhul Amin ◽  
Sohely Rahman ◽  
Narayan Saha ◽  
Md Shahadat Hossain ◽  
Md Jahidul Islam ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Rating Scale ◽  
Muscle Tone ◽  
The Body ◽  
Spastic Cerebral Palsy ◽  
College Hospital ◽  
Medical College ◽  
Modified Ashworth Scale ◽  
Physician Rating ◽  
Intensive Rehabilitation

Background: The treatment of cerebral palsy is multifactorial.Objective: In this study we find out the combined efficacy of baclofen and intensive rehabilitation in the treatment of spastic cerebral palsy.Methodology: This observational study was conducted over 30 patients in Dhaka Medical College Hospital from January 2011 to December 2011.The patient satisfying the inclusion and exclusion criteria was randomly enrolled in this study. They received Baclofen orally two times daily according to the body weight regularly in combination with intensive rehabilitation 1 hour daily five times a week for 24 weeks. All patients were followed up at 4 weeks interval and were evaluated for a total of 24 weeks.Result: Combination of Baclofen and intensive rehabilitation is effective in reducing tone in spastic cerebral palsy by using Modified Ashworth scale (p<0.05). Combination of Baclofen and intensive rehabilitation is also effective in joint angle improvement in spastic cerebral palsy measured by physician rating scale crouch (p<0.05) and foot contact, (p<0.05) and also improvement in gross motor function (p <0.05).Conclusion: For reduction of generalized spasticity regarding muscle tone, range of motion of the joint and improvement of gait in cerebral palsy patients, combination of Baclofen and intensive rehabilitation may be used.J. Natl Inst. Neurosci Bangladesh 2015;1(1):18-21

scholarly journals Role of intensive rehabilitation in spastic cerebral palsy

2016 ◽  
Vol 45 (2) ◽  
pp. 61-65
Author(s):  
Md Ruhul Amin ◽  
Mohammad Moniruzzaman ◽  
Md Shahadat Hossain ◽  
Md Jahidul Islam ◽  
SM Asaduzzaman ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Rating Scale ◽  
Muscle Tone ◽  
Spastic Cerebral Palsy ◽  
Childhood Disability ◽  
College Hospital ◽  
Medical College ◽  
Physician Rating ◽  
And Function ◽  
Intensive Rehabilitation

Cerebral palsy is the most common childhood disability with a prevalence of 1.5 to 3 per 1000 live births. Spasticity is one of the common features of cerebral palsy as it contributes to limitations in body structure and function, leading to deformity. The treatment of cerebral palsy is multifactorial. In this study we find out the efficacy of intensive rehabilitation in the treatment of spastic cerebral palsy. This observational study was conducted over 30 patients in Dhaka Medical College Hospital from January 2011 to December 2011.The patient satisfying the inclusion and exclusion criteria was randomly enrolled in this study. They received intensive rehabilitation 1 hour daily five times a week for 24 weeks. All patients were followed up at 4 weeks interval and were evaluated for a total of 24 weeks. Intensive rehabilitation is effective in reducing tone in spastic cerebral palsy by using Modified ashworth scale (p<0.05). Intensive rehabilitation is also effective in joint angle improvement in spastic cerebral palsy measured by physician rating scale crouch (p<0.05) and foot contact, (p<0.05) and also improvement in gross motor function (p<0.05). For reduction of generalized spasticity regarding muscle tone, range of motion of the joint and improvement of gait in cerebral palsy patients, intensive rehabilitation may be used.Bangladesh Med J. 2016 May; 45 (2): 61-65

Clinical Outcomes, Structure, and Function Improve With Both Heavy and Moderate Loads in the Treatment of Patellar Tendinopathy: A Randomized Clinical Trial

2021 ◽  
Vol 49 (4) ◽  
pp. 982-993
Author(s):  
Anne-Sofie Agergaard ◽  
Rene B. Svensson ◽  
Nikolaj M. Malmgaard-Clausen ◽  
Christian Couppé ◽  
Mikkel H. Hjortshoej ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Outcome ◽  
Randomized Clinical Trial ◽  
Clinical Outcomes ◽  
Rating Scale ◽  
Power Doppler ◽  
Patellar Tendinopathy ◽  
Short Term ◽  
Level Of Evidence

Background: Loading interventions have become a predominant treatment strategy for tendinopathy, and positive clinical outcomes and tendon tissue responses may depend on the exercise dose and load magnitude. Purpose/Hypothesis: The purpose was to investigate if the load magnitude influenced the effect of a 12-week loading intervention for patellar tendinopathy in the short term (12 weeks) and long term (52 weeks). We hypothesized that a greater load magnitude of 90% of 1 repetition maximum (RM) would yield a more positive clinical outcome, tendon structure, and tendon function compared with a lower load magnitude of 55% of 1 RM when the total exercise volume was kept equal in both groups. Study Design: Randomized clinical trial; Level of evidence, 1. Methods: A total of 44 adult participants with chronic patellar tendinopathy were included and randomized to undergo moderate slow resistance (MSR group; 55% of 1 RM) or heavy slow resistance (HSR group; 90% of 1 RM). Function and symptoms (Victorian Institute of Sport Assessment–Patella questionnaire [VISA-P]), tendon pain during activity (numeric rating scale [NRS]), and ultrasound findings (tendon vascularization and swelling) were assessed before the intervention, at 6 and 12 weeks during the intervention, and at 52 weeks from baseline. Tendon function (functional tests) and tendon structure (ultrasound and magnetic resonance imaging) were investigated before and after the intervention period. Results: The HSR and MSR interventions both yielded significant clinical improvements in the VISA-P score (mean ± SEM) (HSR: 0 weeks, 58.8 ± 4.3; 12 weeks, 70.5 ± 4.4; 52 weeks, 79.7 ± 4.6) (MSR: 0 weeks, 59.9 ± 2.5; 12 weeks, 72.5 ± 2.9; 52 weeks, 82.6 ± 2.5), NRS score for running, NRS score for squats, NRS score for preferred sport, single-leg decline squat, and patient satisfaction after 12 weeks, and these were maintained after 52 weeks. HSR loading was not superior to MSR loading for any of the measured clinical outcomes. Similarly, there were no differences in functional (strength and jumping ability) or structural (tendon thickness, power Doppler area, and cross-sectional area) improvements between the groups undergoing HSR and MSR loading. Conclusion: There was no superior effect of exercising with a high load magnitude (HSR) compared with a moderate load magnitude (MSR) for the clinical outcome, tendon structure, or tendon function in the treatment of patellar tendinopathy in the short term. Both HSR and MSR showed equally good, continued improvements in outcomes in the long term but did not reach normal values for healthy tendons. Registration: NCT03096067 (ClinicalTrials.gov identifier)

Dance Rhythms Improve Motor Symptoms in Individuals with Parkinson’s Disease: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Jéssica A. Moratelli ◽  
Kettlyn H. Alexandre ◽  
Leonessa Boing ◽  
Alessandra Swarowsky ◽  
Clynton L. Corrêa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Clinical Trial ◽  
Parkinson's Disease ◽  
Randomized Clinical Trial ◽  
Rating Scale ◽  
Freezing Of Gait ◽  
Motor Symptoms ◽  
Score Change ◽  
Significant Difference ◽  
Binary Group

Background: Evidence-based practices involving dance modalities found in binary (two-beat rhythm) or quaternary (four-beat rhythm) show that dance positively influences the motor aspects of disease.Aim: This randomized clinical trial aimed to analyze the effect of two dance rhythm (binary and quaternary) on the balance, gait, and mobility in individuals with Parkinson’s disease (PD). Methods: Thirty-one individuals with PD were randomized into the binary group (n = 18) and the quaternary group (n = 13). Both groups participated in different dance rhythms lasting 12 weeks, twice a week, for 45 minutes. Results: The binary group showed a significant difference in balance (p = 0.003), freezing of gait (p = 0.007), as well as in the motor aspects of MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), with emphasis on the total values with a score change of 3.23. In the quaternary group, significant differences were found in balance (p = 0.021) with a score change of -2.54 and in the motor aspects of the MDS-UPDRS Part III where the total values stood out with a change of 3.54. Discussion: When comparing the possible effects of binary and quaternary rhythms on the motor symptoms of individuals with PD, it was demonstrated that binary rhythm improved balance, freezing gait, and UPDRSIII. As for the quaternary rhythm, the benefits were in balance and the UPDRSIII. Conclusion: The binary and the quaternary rhythm dance protocols positively influenced the motor symptoms of individuals with PD after 12 weeks of intervention.

scholarly journals Functional Electrical Stimulation Changes Dynamic Resources in Children With Spastic Cerebral Palsy

2006 ◽  
Vol 86 (7) ◽  
pp. 987-1000 ◽  
Author(s):  
Chia-Ling Ho ◽  
Kenneth G Holt ◽  
Elliot Saltzman ◽  
Robert C Wagenaar
Keyword(s):  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Stride Length ◽  
The Body ◽  
Stride Frequency ◽  
Spastic Cerebral Palsy ◽  
Significant Difference ◽  
Muscle Complex ◽  
Spring System

Abstract Background and Purpose. Children with cerebral palsy (CP) often are faced with difficulty in walking. The purpose of this experiment was to determine the effects of functional electrical stimulation (FES) applied to the gastrocnemius-soleus muscle complex on the ability to produce appropriately timed force and reduce stiffness (elastic property of the body) and on stride length and stride frequency during walking. Subjects and Methods. Thirteen children with spastic CP (including 4 children who were dropped from the study due to their inability to cooperate) and 6 children who were developing typically participated in the study. A crossover study design was implemented. The children with spastic CP were randomly assigned to either a group that received FES for 15 trials followed by no FES for 15 trials or a group that received no FES for 15 trials followed by FES for 15 trials. The children who were having typical development walked without FES. Kinematic data were collected for the children with CP in each walking condition and for the children who were developing typically. Impulse (force-producing ability) and stiffness were estimated from an escapement-driven pendulum and spring system model of human walking. Stride length and stride frequency also were measured. To compare between walking conditions and between the children with CP and the children who were developing typically, dimensional analysis and speed normalization procedures were used. Results. Nonparametric statistics showed that there was no significant difference between the children with CP in the no-FES condition and the children who were developing typically on speed-normalized dimensionless impulse. In contrast, the children with CP in the FES condition had a significantly higher median value than the children who were developing typically. The FES significantly increased speed-normalized dimensionless impulse from 10.02 to 16.32 when comparing walking conditions for the children with CP. No significant differences were found between walking conditions for stiffness, stride length, and stride frequency. Discussion and Conclusion. The results suggest that FES is effective in increasing impulse during walking but not in decreasing stiffness. The effect on increasing impulse does not result in more typical spatiotemporal gait parameters. [Ho CL, Holt KG, Saltzman E, Wagenaar RC. Functional electrical stimulation changes dynamic resources in children with spastic cerebral palsy. Phys Ther. 2006;86:987–1000.]

scholarly journals Intravenous Paracetamol vs Intranasal Desmopressin for Renal Colic in the Emergency Department: A Randomized Clinical Trial

Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3437-3442
Author(s):  
Hamed Basir Ghafouri ◽  
Niloofar Abazarian ◽  
Mohammadreza Yasinzadeh ◽  
Ehsan Modirian
Keyword(s):  
Clinical Trial ◽  
Emergency Department ◽  
Pain Score ◽  
Randomized Clinical Trial ◽  
Renal Colic ◽  
Rating Scale ◽  
Pain Scores ◽  
Intravenous Paracetamol ◽  
Significant Difference ◽  
Intranasal Desmopressin

Abstract Objective To evaluate the analgesic efficacy of intranasal desmopressin alone vs intravenous paracetamol in patients referred to the emergency department with renal colic. Design Randomized clinical trial. Setting This study was conducted in the emergency unit of a university hospital. Subjects Patients referred to the emergency room with renal colic. Primary Outcome Effect of intranasal desmopressin in pain relief in comparison with intravenous paracetamol. Methods In this trial, 240 patients diagnosed with renal colic were randomly divided into two groups to compare the analgesic effect of intravenous paracetamol (15 mg/kg) and intranasal desmopressin spray (40 μg). Pain scores were measured by a numeric rating scale at baseline and after 15, 30, and 60 minutes. Adverse effects and need for rescue analgesic (0.05 mg/kg max 3 mg morphine sulphate) were also recorded at the end of the study. Results Three hundred patients were eligible for the study; however, 240 were included in the final analysis. The patients in the two groups were similar in their baseline characteristics and baseline pain scores. The mean pain score after 15 minutes was more reduced and was clinically significant (&gt;3) in the desmopressin group (P &lt; 0.0001). There was no significant difference between mean pain scores in the two groups after 30 minutes (P = 0.350) or 60 minutes (P = 0.269), but the efficacy of the two drugs was significant in terms of pain reduction (&gt;6). Conclusions Our study showed that intranasal desmopressin is as effective as intravenous paracetamol for renal colic pain management; however, significant clinical reduction in pain score occurred faster with intranasal desmopressin.

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