scholarly journals Massage Therapy for Dystonia: a Case Report

Author(s):  
Michelle Lipnicki, BSc, RMT

Background: Dystonia is a neurological disorder, characterized by involuntary muscle spasms and tremors, resulting in abnormal movements and posture. Symptoms include pain, spasms, tremors, and dyskinesia—a difficulty in performing voluntary muscular movements. Conventional treatments include medication, botulism injections, and surgical intervention. Many dystonia patients seek complementary and alternative medicine (CAM) therapies, such as massage, but these treatments are not well documented. This clinical case study documents massage treatment for dystonia for a specific individual. Purpose: To examine the effects of massage therapy on pain, spasms, and dyskinesia in activities of daily living (ADL), in a patient diagnosed with dystonia as an adult, following trauma. Methods: A student massage therapist administered 5 massage treatments over a six-week period to a 51-year-old female patient diagnosed with dystonia. The patient presented with symptoms of pain, spasms, tremors, and dyskinesia in ADL. Techniques applied included Swedish massage and hydrotherapy to decrease pain and spasms, and myofascial release and stretching, to decrease dyskinesia. Treatments aimed to increase overall relaxation. Remedial exercise was given to practice smoother movement patterns. Pre- and postnumeric rating scales (NRS) for pain were evaluated each session. Frequency of night pain and spasms, the Modified Bradykinesia Rating Scale (MBRS), the Timed Up and Go (TUG) test, the Functional Rating Index (FRI) and the Modified Gait Efficacy Scale (MGES) were measured at the start and end of the study. Results: Posttreatment pain intensity generally remained the same or decreased. Positive outcomes were exhibited in the frequency of night pain and spasms, TUG, MBRS, and FRI test scores. The MGES score was negatively affected. Conclusion: The results suggest massage therapy may temporarily decrease pain intensity, pain and spasm frequency, and dyskinesia in ADL, associated with dystonia.

2021 ◽  
Vol 10 (14) ◽  
pp. 3056
Author(s):  
Ada Holak ◽  
Michał Czapla ◽  
Marzena Zielińska

Background: The all-too-frequent failure to rate pain intensity, resulting in the lack of or inadequacy of pain management, has long ceased to be an exclusive problem of the young patient, becoming a major public health concern. This study aimed to evaluate the methods used for reducing post-traumatic pain in children and the frequency of use of such methods. Additionally, the methods of pain assessment and the frequency of their application in this age group were analysed. Methods: A retrospective analysis of 2452 medical records of emergency medical teams dispatched to injured children aged 0–18 years in the area around Warsaw (Poland). Results: Of all injured children, 1% (20 out of 2432) had their pain intensity rated, and the only tool used for this assessment was the numeric rating scale (NRS). Children with burns most frequently received a single analgesic drug or cooling (56.2%), whereas the least frequently used method was multimodal treatment combining pharmacotherapy and cooling (13.5%). Toddlers constituted the largest percentage of patients who were provided with cooling (12%). Immobilisation was most commonly used in adolescents (29%) and school-age children (n = 186; 24%). Conclusions: Low frequency of pain assessment emphasises the need to provide better training in the use of various pain rating scales and protocols. What is more, non-pharmacological methods (cooling and immobilisation) used for reducing pain in injured children still remain underutilized.


2018 ◽  
Vol 18 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Andreas Goebel ◽  
Anu Jacob ◽  
Bernhard Frank ◽  
Paul Sacco ◽  
Guillermo Alexander ◽  
...  

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).


2015 ◽  
Vol 20 (3) ◽  
pp. 159-163
Author(s):  
Nadine Wickboldt ◽  
Georges Savoldelli ◽  
Benno Rehberg-Klug

BACKGROUND: Assessment of dynamic changes in painful experiences, such as labour, using conventional rating scales (eg, numerical rating scale [NRS]) has limitations. An alternative for continuous pain evaluation could be a signal generated by voluntary action of the parturient. Remifentanil administration for obstetric analgesia could be improved by these dynamic measures of labour pain. In the present study, handgrip force was measured by a dynamometer to signal labour pain.OBJECTIVES: To evaluate: whether continuous monitoring of labour pain using handgrip force allows for determination of pain measurement during contractions; and the correlation between handgrip force and pain intensity on NRS.METHODS: The present observational, single-centre study included 43 parturients. After calibration of the dynamometer for individual hand muscle strength, pain was recorded during early and late labour using a dynamometer and an NRS. The primary end point was the correlation coefficient between NRS ratings and peak intensity recorded by the dynamometer.RESULTS: All dynamometer-registered readings were also registered by the external tocogram. All contractions recorded by external tocogram were also registered by the dynamometer. Handgrip force was moderately correlated with pain scores on the NRS. Mean handgrip force during contractions had the highest correlation coefficient (Pearson’s r=0.67) compared with peak handgrip force (r=0.56) and area under the curve of handgrip force (r=0.55).CONCLUSIONS: Pain intensity and duration can be assessed continuously using handgrip force measured via a dynamometer. The feedback of intensity and duration of pain could optimize patient-controlled remifentantil application for obstetric analgesia and other situations of highly variable pain intensity.


1997 ◽  
Vol 6 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Carl G. Mattacola ◽  
David H. Perrin ◽  
Bruce M. Gansneder ◽  
Jennifer D. Allen ◽  
Cheryl A. Mickey

This study evaluated a visual analog scale (VAS) and a graphic rating scale (GRS) for the measurement of pain following delayed onset muscle soreness (DOMS) and following treatment for the symptoms of DOMS. Data from two studies were used to evaluate the scales. Pain intensity was assessed prior to and following induction of DOMS and immediately before and after each treatment session. In Study 1, subjects were randomly assigned to receive a 20-min ice pack followed by a 7-min sham ultrasound treatment or a 20-min ice pack followed by a 7-min nonthermal ultrasound treatment. In Study 2, subjects received a 20-rain microcurrent neuromuscular stimulation (MENS) treatment or a 20-min sham MENS treatment. In both studies, significant differences were found between the VAS and GRS scales for pretest conditions on Days 1 and 2 for all subjects. There were no significant differences between any other days or tests. The differences on Day 1 and Day 2 were attributed to the novelty of filling out the scales. Therefore, a. visual analog or graphic rating scale can be used to evaluate pain intensity following DOMS when repeated measurement is involved, although consideration should be given to potential differences the first one or two times the scales are completed.


Sensors ◽  
2019 ◽  
Vol 19 (9) ◽  
pp. 2101 ◽  
Author(s):  
Francesco Serio ◽  
Cosimo Minosa ◽  
Matteo De Luca ◽  
Pierguido Conte ◽  
Giovanni Albani ◽  
...  

Background: For people with Parkinson’s disease (PD), falls are a critical point. Focal vibration training (FVT) may represent a valid tool to improve postural performances and reduce the risk of falls. The aim of this study was to evaluate the efficacy of FVT to improve the postural stability in PD patients. Methods: Since October 2015, 55 consecutive PD patients have been selected (T0) for an approach including FVT associated with a rehabilitative protocol (RP); after eight weeks (T1), those patients showing a relevant improvement in the clinical rating scales ((Timed Up and Go (TUG), Tinetti, Unified Parkinson’s disease rating scale (UPDRS) Part III, Berg Balance scale (BBS) and falls rate scale), continued with the FVT protocol (FVTRP group). The remaining patients continued with only the RP (RP group). In July 2018, we have extrapolated the data of the last clinical visit (T2) to observe any differences in the rate of falls. Results: The FVTRP group shows a decrement in the rate of falls from 2.1 to 1.25 (p 0.036) and a stability of the levodopa equivalent daily dosage (LEDD). The RP group shows an increment of LEDD and stability in falls. Conclusions: FVT has been confirmed as a valid tool to enhance the effect of the rehabilitation protocol aimed at postural training.


2021 ◽  
Author(s):  
Hadas Nahman-Averbuch ◽  
Cassidy Hughes ◽  
Marie-Eve Hoeppli ◽  
Kristina White ◽  
James Peugh ◽  
...  

A critical aspect for much human pain research is the ability of participants to communicate their first person, experiential perspective to a third person observer. This communication is frequently accomplished via pain ratings. The type of scale and how participants/patients may differentially use the scale has a major influence on the communication of pain experiences. The present study examined the role of sex on the pain rating process using both noxious and innocuous stimuli and two different types of rating scales. Participants underwent noxious heat, auditory and visual stimulation paradigms. Pain intensity and unpleasantness ratings were collected using the visual analog scale (VAS) and numerical rating scale (NRS) in a random order. For noxious heat stimuli, low (44-45 degrees celsius) and high (47-48 degrees celsius) intensity stimuli were delivered. To identify if one rating scale allows better discrimination between different stimulus intensities and if this is dependent on sex, discrimination thresholds were calculated. Significant effect for rating scale and intensity level of stimuli were found for all stimulus modalities (noxious heat, auditory and visual) indicating that higher intensity and unpleasantness ratings were found using the NRS compared to the VAS. No effect of sex or interaction with sex was found. No differences in rating scale and sex were found for the discrimination thresholds. Biases in rating scales usage exist with NRS yielding higher ratings to the same stimuli. However, this bias does not appear to contribute significantly to sex differences in pain.


2012 ◽  
Vol 21 (4) ◽  
pp. 136-143
Author(s):  
Lynn E. Fox

Abstract The self-anchored rating scale (SARS) is a technique that augments collaboration between Augmentative and Alternative Communication (AAC) interventionists, their clients, and their clients' support networks. SARS is a technique used in Solution-Focused Brief Therapy, a branch of systemic family counseling. It has been applied to treating speech and language disorders across the life span, and recent case studies show it has promise for promoting adoption and long-term use of high and low tech AAC. I will describe 2 key principles of solution-focused therapy and present 7 steps in the SARS process that illustrate how clinicians can use the SARS to involve a person with aphasia and his or her family in all aspects of the therapeutic process. I will use a case study to illustrate the SARS process and present outcomes for one individual living with aphasia.


2006 ◽  
Vol 22 (4) ◽  
pp. 259-267 ◽  
Author(s):  
Eelco Olde ◽  
Rolf J. Kleber ◽  
Onno van der Hart ◽  
Victor J.M. Pop

Childbirth has been identified as a possible traumatic experience, leading to traumatic stress responses and even to the development of posttraumatic stress disorder (PTSD). The current study investigated the psychometric properties of the Dutch version of the Impact of Event Scale-Revised (IES-R) in a group of women who recently gave birth (N = 435). In addition, a comparison was made between the original IES and the IES-R. The scale showed high internal consistency (α = 0.88). Using confirmatory factor analysis no support was found for a three-factor structure of an intrusion, an avoidance, and a hyperarousal factor. Goodness of fit was only reasonable, even after fitting one intrusion item on the hyperarousal scale. The IES-R correlated significantly with scores on depression and anxiety self-rating scales, as well as with scores on a self-rating scale of posttraumatic stress disorder. Although the IES-R can be used for studying posttraumatic stress reactions in women who recently gave birth, the original IES proved to be a better instrument compared to the IES-R. It is concluded that adding the hyperarousal scale to the IES-R did not make the scale stronger.


Methodology ◽  
2011 ◽  
Vol 7 (3) ◽  
pp. 88-95 ◽  
Author(s):  
Jose A. Martínez ◽  
Manuel Ruiz Marín

The aim of this study is to improve measurement in marketing research by constructing a new, simple, nonparametric, consistent, and powerful test to study scale invariance. The test is called D-test. D-test is constructed using symbolic dynamics and symbolic entropy as a measure of the difference between the response patterns which comes from two measurement scales. We also give a standard asymptotic distribution of our statistic. Given that the test is based on entropy measures, it avoids smoothed nonparametric estimation. We applied D-test to a real marketing research to study if scale invariance holds when measuring service quality in a sports service. We considered a free-scale as a reference scale and then we compared it with three widely used rating scales: Likert-type scale from 1 to 5 and from 1 to 7, and semantic-differential scale from −3 to +3. Scale invariance holds for the two latter scales. This test overcomes the shortcomings of other procedures for analyzing scale invariance; and it provides researchers a tool to decide the appropriate rating scale to study specific marketing problems, and how the results of prior studies can be questioned.


2020 ◽  
Vol 24 (1) ◽  
pp. 101-104
Author(s):  
Muhammad Rafiq

Recent findings have indicated that hypnotic interventions produce significant decrease in pain intensity. This current case studies are focused to highlight significant impact on pain management including headache. All the patients underwent a complete observation and clinical interview and only patients with psychological pain were included in the study group. For the management of headache, a novel hypnotic intervention - Circle Therapy (CT), was applied on a group of ten patients indicating their pain intensity in the range of 8-10 on subjective pain rating scale. According to rating scale, headache above 8 was considered as severe, 5-8 moderate and < 5 as mild.  CT is a brief hypnotic technique limited to about 10 min. Post hypnosis ratings were also measured. The pre and post hypnosis data were recorded and analyzed by paired samples t test. Use of CT showed significant results between pre and post rating e.g. 9 ± 0.25 vs. 1 ± 0.21 (p < 0.001). This brief CT intervention provided an immediate relief from headache, however, this is limited to few case studies focusing on just headache. So, we recommend large sample studies to document the effects of CT in different types of pain. Citation: Rafiq M. Circle therapy for headache management: case studies. Anaesth pain intensive care 2020;24(1):__ DOI: https://doi.org/10.35975/apic.v24i1. Received – 28 December 2019; Reviewed – 10 January 2020; Accepted - 10 January 2020;


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