Correlation between the Likert Scale and the Numeric Rating Scale for Evaluating Knee Pain

Abstract Background Genicular nerve radiofrequency ablation (RFA) for the treatment of chronic knee pain has traditionally targeted the superomedial, superolateral, and inferomedial genicular nerves. However, recent cadaveric studies of knee neuroanatomy demonstrate varied locations of these specific nerves as well as additional articular nerves. This work suggests that traditional genicular nerve RFA lesion locations may be inadequate. Objective 1) To describe a novel protocol utilizing a three-tined RFA electrode to target the superomedial (SMGN), superolateral (SLGN), and inferomedial genicular nerves (IMGN), as well as the terminal articular branches of the nerves to the vastus medialis (NVM), intermedius (NVI), and lateralis (NVL). 2) To assess the ability of this technique to reduce chronic knee pain. Methods Case series of consecutive patients with six or more months of refractory knee pain who underwent genicular nerve RFA according to the novel protocol described. Seven discrete RFA lesions were placed to target the SMGN, NVM, NVI, NVL, SLGN, and IGMN. Results Eleven patients underwent RFA, nine with knee osteoarthritis and two postarthroplasty. At one month, 91% (95% CI = 59–100%), 82% (95% CI = 48–98%), and 9% (95% CI = 2–41%), of patients reported ≥50%, ≥80%, and 100% improvement in knee pain on the numeric rating scale, respectively. These results were sustained at six months. There were no complications. Discussion/Conclusions These preliminary data suggest the feasibility and possible effectiveness of genicular nerve RFA using the described novel protocol including a three-tined electrode. Larger-scale studies with comparative groups are warranted.

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A Retrospective Chart Review of 114 Patients with Knee Pain at a Korean Medicine Hospital Who Had Been Involved in a Traffic Accident

Journal of Acupuncture Research ◽

10.13045/jar.2020.00304 ◽

2021 ◽

Vol 38 (2) ◽

pp. 134-139

Author(s):

Ji Won Park ◽

Won Bin Shin ◽

Hyo Jung Choi ◽

Hye Kyung Back ◽

Doo Ri Kim

Keyword(s):

Herbal Medicine ◽

Knee Pain ◽

Traffic Accident ◽

Traffic Accidents ◽

Rating Scale ◽

Retrospective Chart Review ◽

Numeric Rating Scale ◽

Korean Medicine ◽

The Mean ◽

Numeric Rating

Background: This study aimed to investigate the demographic characteristics of patients with knee pain caused by traffic accidents and test the effectiveness of Korean medicine (KM) treatment.Methods: The medical charts of 114 inpatients with knee pain caused by a traffic accident were reviewed from July 1, 2019 to October 31, 2019 at Bucheon Jaseng Hospital of KM. The patients’ demographics including gender, age, period of hospitalization, and type of pharmacopuncture and herbal medicine prescribed were reviewed. The Numeric Rating Scale scores and Western Ontario and McMaster Universities Osteoarthritis Index scores were used to assess subjective knee pain.Results: There were more females (55%) than males in this study. Patients were more likely to be in their 30s (27.2%), be hospitalized for 11-14 days (41.2%), treated with Hwangryunhaedok pharmacopuncture (78.1%), and be prescribed Hwalhyeoljitong decoction (62.3%).The mean Numeric Rating Scale score for patients with knee pain caused by a traffic accident decreased significantly from 4.26 ± 1.39 to 2.53 ± 1.60 (p < 0.001), and the mean Western Ontario and McMaster Universities Osteoarthritis Index score also decreased significantly from 32.72 ± 18.36 to 23.40 ± 15.80 (p < 0.001) following KM treatment.Conclusion: As a result of analyzing 114 hospitalized patients with knee joint pain due to TAs, inpatients were more likely to be female (55%), a patient in their 30s (27.2%), and be a patient hospitalized for 11-14 days (41.2%). KM treatment of traumatic knee injury using pharmacopuncture therapy and herbal medicine can be an may be effective at reducing pain, and healing functional disorders of the knee.

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High-Voltage Intraarticular Pulsed Radiofrequency for Chronic Knee Pain Treatment: A Single-Center Retrospective Study

January 2018 - Pain Physician ◽

10.36076/ppj.2020/23/e549 ◽

2020 ◽

Vol 5;23 (9;5) ◽

pp. E549-E558

Author(s):

Peng Yao

Keyword(s):

Knee Pain ◽

High Voltage ◽

Rating Scale ◽

Low Voltage ◽

Oxford Knee Score ◽

Numeric Rating Scale ◽

Pulsed Radiofrequency ◽

Chronic Knee Pain ◽

Numeric Rating

Background: Intraarticular pulsed radiofrequency (IAPRF) for the treatment of painful knee osteoarthritis (KOA) is a less invasive treatment method. It has fewer adverse effects and can quickly reduce KOA-related pain and improve knee joint dysfunction. Objectives: We compared the effectiveness of high- and low-voltage IAPRF for the treatment of chronic knee pain. Study Design: Retrospective comparative study design. Setting: This study took place at Shengjing Hospital of China Medical University. Methods: A total of 57 patients with KOA who were hospitalized between July 2018 and July 2019 were randomly allocated into the high-voltage (n = 29) and low-voltage (n = 28) IAPRF groups. IAPRF was performed under the guidance of computed tomography (CT). Numeric Rating Scale (NRS-11), Oxford Knee Score (OKS), degree of pain relief, global perceived effect, and side effects at baseline and 1 week, 2 weeks, 1 month, 3 months, and 6 months after the procedure were recorded and analyzed. Results: NRS-11 scores decreased significantly in both groups after the procedure, but gradually increased after the 6-month follow-up period. There was a significant difference in NRS-11 scores between the 2 groups at all follow-up periods postprocedure. OKS were similar between the 2 groups. Patients with pain relief rate 50% or greater at 1, 3, and 6 months after the procedure accounted for 72.41%, 72.41%, and 55.17% in the high-voltage group, and 46.43%, 46.43%, and 28.57% in the low-voltage group, respectively. The difference between the 2 groups was statistically significant. No significant adverse reactions were observed in the 2 groups, however, patient satisfaction in the high-voltage group was significantly higher compared with patients in the low-voltage group. Limitations: This study was a single-center retrospective study with a relatively small sample cohort and short follow-up period. Conclusions: CT-guided high-voltage IAPRF is more beneficial in reducing knee pain and improving knee function compared with low-voltage IAPRF. In addition, patients who received high-voltage IAPRF were more satisfied with their treatment. Key words: Pulsed radiofrequency, knee osteoarthritis, intraarticular, high voltage, Oxford Knee Score, Numeric Rating Scale

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Twelve-month analgesia and rescue, by cooled radiofrequency ablation treatment of osteoarthritic knee pain: results from a prospective, multicenter, randomized, cross-over trial

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2018-100051 ◽

2019 ◽

Vol 44 (4) ◽

pp. 499-506 ◽

Cited By ~ 11

Author(s):

Tim Davis ◽

Eric Loudermilk ◽

Michael DePalma ◽

Corey Hunter ◽

David A Lindley ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Knee Pain ◽

Rating Scale ◽

Numeric Rating Scale ◽

Clinical Trial Registration ◽

Provide Pain Relief ◽

Registration Number ◽

The Mean ◽

Numeric Rating

Background and objectivesAs a follow-up to the 6-month report,12 this study investigated the analgesic effect of cooled radiofrequency ablation (CRFA) in patients with knee osteoarthritis (OA) 12 months postintervention and its ability to provide pain relief in patients who experienced unsatisfactory effects of intra-articular steroid injection (IAS).MethodsSeventy-eight per cent (52/67) of patients originally treated with CRFA were evaluated at 12 months, while at 6 months post-IAS, 82% (58/71) of those patients crossed over to CRFA and assessed 6 months later.ResultsAt 12 months, 65% of the original CRFA group had pain reduction ≥50%, and the mean overall drop was 4.3 points (p<0.0001) on the numeric rating scale. Seventy-five per cent reported ‘improved’ effects. The cross-over group demonstrated improvements in pain and functional capacity (p<0.0001). No unanticipated adverse events occurred.ConclusionsThis study demonstrates that analgesia following CRFA for OA knee pain could last for at least 12 months and could rescue patients who continue to experience intolerable discomfort following IAS.Clinical trial registrationThe ClinicalTrials.gov registration number for this study is NCT02343003.

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A Prospective Randomized Comparison of the Efficacy of Ultrasound- vs FluoroscopyGuided Genicular Nerve Block for Chronic Knee Osteoarthritis

January 2018 - Pain Physician ◽

10.36076/ppj/2019.22.139 ◽

2019 ◽

Vol 2 (22.2) ◽

pp. 139-146

Author(s):

Seong-Soo Choi

Keyword(s):

Pain Relief ◽

Knee Osteoarthritis ◽

Knee Pain ◽

Nerve Block ◽

Rating Scale ◽

Numeric Rating Scale ◽

Pain Clinic ◽

Nerve Blocks ◽

Numeric Rating

Background: Recently, genicular nerve block and radiofrequency ablation were introduced to alleviate knee pain in patients with chronic knee osteoarthritis. Both ultrasound- and fluoroscopyguided genicular nerve blocks have been used. However, whether one is superior to the other remains unknown. Objectives: The present study compares the efficacy of ultrasound- vs fluoroscopy-guided genicular nerve blocks. Study Design: This research used a prospective randomized comparison design. Setting: The study took place at a single pain clinic within a tertiary medical center in Seoul, Republic of Korea. Methods: From July 2015 to September 2017, a randomized controlled study was performed to analyze the difference in the efficacy of ultrasound- vs fluoroscopy-guided genicular nerve blocks. The Numeric Rating Scale (NRS-11), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Global Perceived Effect Scales (GPES), and complications were evaluated preprocedure, and 1 and 3 months after genicular nerve block. Results: A total of 80 patients were enrolled and randomly distributed to groups U (ultrasoundguided, n = 40) and F (fluoroscopy-guided, n = 40). Those who were lost to follow-up or had undergone other interventions were excluded, resulting in 31 and 30 patients in groups U and F, respectively. No differences in NRS-11 or WOMAC were observed between the 2 groups at baseline or during the follow-up period. GPES and complication rates were also similar between both groups. Limitations: We were unable to perform double-blind randomization and did not evaluate patients’ baseline emotional states. Conclusions: Pain relief, functional improvement, and safety were similar between groups receiving ultrasound- and fluoroscopy-guided genicular nerve blocks. Therefore, either of the 2 imaging devices may be utilized during a genicular nerve block for chronic knee pain relief. However, considering radiation exposure, ultrasound guidance may be superior to fluoroscopic guidance. The study protocol was approved by our institutional review board (2015-0369), and written informed consent was obtained from all patients. The trial was registered with the Clinical Research Information Service (KCT 0002846). This work was presented in part as D-H Kim’s MS thesis at the University of Ulsan College of Medicine (2018). Key words: Genicular nerve block, ultrasound, fluoroscopy, knee osteoarthritis, Numeric Rating Scale, The Western Ontario and McMaster Universities Osteoarthritis Index

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Foot Massage Menurunkan Nyeri Post Operasi Sectio Caesarea Pada Post Partum

Jurnal Kesehatan Komunitas ◽

10.25311/keskom.vol6.iss2.528 ◽

2020 ◽

Vol 6 (2) ◽

pp. 164-170

Author(s):

Dewi Nurlaela Sari ◽

Aay Rumhaeni

Keyword(s):

Daily Living ◽

Rating Scale ◽

Post Partum ◽

Numeric Rating Scale ◽

Sectio Caesarea ◽

P Value ◽

Test Design ◽

Purposive Sampling ◽

Post Test ◽

Numeric Rating

ABSTRAK Sectio caesarea merupakan tindakan alternatif dalam proses persalinan untuk menyelamatkan ibu dan janin. Ibu Bersalin dengan operasi sectio caesarea dilakukan pembedahan pada dinding abdomen dan dinding rahim. Dampak yang paling sering muncul dirasakan oleh postpartum dengan post operasi sectio caesarea adalah nyeri. Nyeri akan berdampak pada bounding attachment terganggu, mobilisasi terbatas, Activity Daily Living (ADL) terganggu serta berpengaruh terhadap Inisiasi Menyusui Dini (IMD). Asuhan yang diberikan terbatas pada terapi farmakologi dibandingkan non farmakologi. Foot massage adalah salah satu terapi non farmakologi yang dapat membantu menutup gerbang di posterior horns dari sumsum tulang belakang dan memblokir bagian dari nyeri ke sistem saraf pusat. Tujuan penelitian ini untuk mengetahui pengaruh foot massage terhadap skala nyeri pada klien post operasi sectio caesarea di RS AMC. Penelitian ini merupakan penelitian pre eksperimen dengan pendekatan one group pre test post test design. Jumlah sampel yang digunakan berjumlah 27 orang dengan menggunakan teknik purposive sampling. Instrumen yang digunakan adalah Numeric Rating Scale (NRS) dan prosedur kerja foot massage. Responden dilakukan foot massage selama 20 menit selama 2 hari. Data di analisis dengan menggunakan uji wilcoxon. Hasil penelitian menunjukkan lebih dari setengah klien post operasi sectio caesarea berada di skala nyeri 6 sebelum dilakukan foot massage dan hampir setengah memiliki skala nyeri 3 sesudah dilakukan foot massage dan didapatkan nilai p value = 0.000, sehingga disimpulkan ada pengaruh foot massage terhadap skala nyeri pada klien post operasi sectio caesarea. Diharapkan rumah sakit dapat menjadikan foot massage sebagai salah satu alternatif manajemen non farmakologi dalam penanganan nyeri. Kata kunci: Foot Massage; Post Partum; Nyeri; Sectio Caesarea

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Efektivitas pencucian luka menggunakan daun jambu biji terhadap tingkat malodor klien luka kaki diabetik

Riset Informasi Kesehatan ◽

10.30644/rik.v8i2.251 ◽

2019 ◽

Vol 8 (2) ◽

pp. 152

Author(s):

Adi Antoni ◽

Yanna Wari Harahap

Keyword(s):

Diabetic Foot ◽

Rating Scale ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Numeric Rating Scale ◽

P Value ◽

Consecutive Sampling ◽

Guava Leaves ◽

Guava Leaf ◽

Numeric Rating

Abstrak Latar belakang: Diabetes mellitus (DM) merupakan penyakit kronik dan menjadi masalah global. Salah satu komplikasi yang ditimbulkan dari DM adalah luka kaki diabetic. Langkah awal dalam perawatan luka kaki diabetic adalah mencuci luka. Tujuan penelitian ini adalah mengetahui keefektifan dari rebusan daun jambu biji sebagai cairan pencuci luka terhadap tingkat malodor pada luka kaki diabetic. Metode: Desain penelitian yang digunakan adalah quasy experiment dengan rancangan one group pretests-posttest only. Teknik sampling yang digunakan adalah consecutive sampling dengan jumlah sampel 16 orang. Kriteria sampel yang digunakan adalah klien luka kaki diabetic, tingkat malodor 1-10 dengan NRS. Alat ukur yang digunakan adalah Numeric Rating Scale (NRS). Analisa data yang digunakan dalam penelitian ini menggunakan uji paired t test. Hasil: tingkat malodor sebelum intervensi pencucuan luka menggunakan rebusan daun jambu biji rata-rata sebesar 4.40 dan sesudah intervensi sebesart 2.44 dengan p value < 0.001. Selisih tingkat malodor antara sebelum dan sesudah intervensi sebesar 1.96. Hasil penelitian ini menunjukkan bahwa daun jambu dapat digunakan sebagai cairan pencuci luka dalam mengatasi tingkat malodor pada luka kaki diabetik. Kesimpulan : daun jambu biji dapat digunakan sebagai cairan pencuci luka pada luka kaki diabetic. Perawat diharapkan dapat memanfaatkan daun jambu biji sebagai salah satu alternatif dalam pencucian luka kronik khususnya luka kaki diabetik. Kata kunci: Daun Jambu Biji, Tingkat Malodor, Luka Kaki Diabetik Abstract Background: Diabetes mellitus (DM) is a chronic disease and a global problem. One of the complications that arise from DM is diabetic foot ulcer. The first step in treating diabetic foot ulcer is washing the wound. The purpose of this study was to determine the effectiveness of guava leaf decoction as a washing fluid for malodor levels in diabetic foot ulcer. Method: The research design used was quasy experiment with one group pretests-posttest only design. The sampling technique used was consecutive sampling with a sample of 16 people. Sample criteria used were diabetic foot ulcer clients, malodor level 1-10 with NRS. The measuring instrument used is the Numeric Rating Scale (NRS). Analysis of the data used in this study used paired t test. Results: the level of malodor before intervening in wound washing using guava leaf decoctions on average was 4.40 and after the intervention was 2.44 with p value <0.001. The difference in the level of malodor between before and after the intervention was 1.96. The results of this study indicate that guava leaves can be used as a washing fluid in dealing with malodor levels in diabetic foot ulcer. Conclusion: Guava leaves can be used as a washing fluid for diabetic foot wounds. Nurses are expected to be able to use guava leaves as an alternative in washing chronic wounds, especially diabetic foot injuries. Key words: Guava Leaf, Malodor Level, Diabetic foot ulcer.

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RCT on the effectiveness of the intraligamentary anesthesia and inferior alveolar nerve block on pain during dental treatment

Clinical Oral Investigations ◽

10.1007/s00784-021-03787-x ◽

2021 ◽

Author(s):

Bahaa R. Youssef ◽

Andreas Söhnel ◽

Alexander Welk ◽

Mohamed H. Abudrya ◽

Mohamed Baider ◽

...

Keyword(s):

Postoperative Complications ◽

Nerve Block ◽

Rating Scale ◽

Dental Treatment ◽

Inferior Alveolar Nerve ◽

Numeric Rating Scale ◽

Inferior Alveolar Nerve Block ◽

Posterior Teeth ◽

Mandibular Posterior Teeth ◽

Numeric Rating

Abstract Objective To compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth. Materials and methods In this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes. Results Patients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations. Conclusion This study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed. Clinical relevance ILA could be considered as an effective alternative for routine dental treatment. Trial registration NCT04563351

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Prevalence of Psychological Distress and Its Risk Factors in Patients with Primary Bone and Soft Tissue Tumors

Healthcare ◽

10.3390/healthcare9050566 ◽

2021 ◽

Vol 9 (5) ◽

pp. 566

Author(s):

Masato Ise ◽

Eiji Nakata ◽

Yoshimi Katayama ◽

Masanori Hamada ◽

Toshiyuki Kunisada ◽

...

Keyword(s):

Risk Factors ◽

Psychological Distress ◽

Soft Tissue ◽

Rating Scale ◽

Numeric Rating Scale ◽

Soft Tissue Tumors ◽

Number Of Patients ◽

Primary Bone ◽

Associated Risk Factors ◽

Numeric Rating

Psychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient’s distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D ≥ 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain.

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Frequency, severity, and impact on daily life of delayed and intercycle chemotherapy-induced nausea, vomiting, and retching

Tumori Journal ◽

10.1177/0300891621990434 ◽

2021 ◽

pp. 030089162199043

Author(s):

Silvia Gonella ◽

Dino S. Di Massimo ◽

Marinella Mistrangelo ◽

Gianmauro Numico ◽

Paola Berchialla ◽

...

Keyword(s):

Rating Scale ◽

Daily Life ◽

Numeric Rating Scale ◽

Cross Sectional Study ◽

Common Side Effect ◽

Cross Sectional ◽

Chemotherapy Administration ◽

Effect Of Treatment ◽

Numeric Rating ◽

Observation Period

Introduction: Chemotherapy-induced nausea, vomiting, and retching (CINVR) remains a common side effect of treatment. Most previous studies have focused on vomiting control; nausea and retching have been less explored. This study aimed at describing the incidence, severity, and impact on daily life (IDL) of CINVR in the acute (0–24 hours), delayed (>24–120 hours), and overall (0–120 hours) postchemotherapy periods and beyond 120 hours (until next chemotherapy administration); and the pharmacologic and nonpharmacologic strategies adopted by patients to relieve symptoms. Methods: This was a single-center, cross-sectional study of 60 patients undergoing chemotherapy. Participants reported the frequency, severity, and IDL of CINVR from the day of chemotherapy administration up to 120 hours thereafter and nausea and vomiting that occurred beyond 120 hours, as well as pharmacologic and nonpharmacologic remedies used. Results: Forty-seven (78.3%, 95% confidence interval [CI] 66.4–86.9), 37 (61.7%, 95% CI 49.0–72.9), and 35 (58.3%, 95% CI 45.7–69.9) patients reported no nausea (Numeric Rating Scale ⩽1), vomiting, or retching in the acute, delayed, and overall periods, respectively. Nausea was more frequent, more severe, and had a greater IDL than did vomiting and retching across the overall observation period; beyond 120 hours, 11 (18.3%, 95% CI 10.6–29.9) patients reported nausea and none reported vomiting, with a median IDL of 1/10 (interquartile range: 0.75–5.00; 95% CI 0–7.6). Metoclopramide (n = 57 administrations), dexamethasone (n = 28), eating small servings of food (n = 13), and aloe (n = 11) were the most commonly used rescue therapies. Conclusions: Future studies should set hard outcomes, such as the absence of any symptoms, as a primary end point, and these should be assessed across and beyond the 120-hour period.

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