Measuring Effects on Pain and Quality of Life after Abobotulinum Toxin A Injections in Children with Cerebral Palsy

Sixty-seven percent of children with cerebral palsy (CCP) experience pain. Pain is closely interrelated to diminished quality of life. Despite this, pain is an overlooked and undertreated clinical problem. The objective of this study was to examine the analgesic effect of a single lower extremity intramuscular injection of Abobotulinum toxin A/Dysport in CCP. Twenty-five CCP with at least moderate pain (r-FLACC ≥ 4) during passive range of motion were included. Localized pain and pain in everyday living were measured by r-FLACC and the Paediatric Pain Profile (PPP), respectively. Functional improvements were evaluated by the goal attainment scale (SMART GAS). Quality of life was evaluated by either the CPCHILD or the CP-QOL. The subjects were evaluated at baseline before injection, then after 4, 12, and 28 weeks. Twenty-two subjects had a significant mean and maximum localized pain reduction (p < 0.001) at four weeks post-treatment in 96% (21/22). The reduction was maintained at 12 (19/19) and 28 weeks (12/15). Daily pain evaluated by the PPP was significantly reduced and functional SMART GAS goals were significantly achieved from 4 to 28 weeks. Quality of life improved significantly at four weeks (CPCHILD). Significant functional gains and localized and daily pain reduction were seen from 4 to 28 weeks.

CLOSING THE GAP FOR PHARMACOLOGICAL TREATMENT OF PAINFUL DIABETIC NEUROPATHY : THE POTENTIAL ROLE OF VITAMIN D

Painful neuropathic pain is a challenging chronic pain to treat. It is heterogeneous in symptoms and could be resistant to the available treatments regimen. Current pharmacological treatments fail to achieve adequate pain relief in a most patients. The previous review showed that only less than 50% of patients can achieve good pain reduction with standard adjuvant treatment. The available adjuvants analgesic only focus in the symptom control, and do not interfere with the progressing damage of the nerve. Vit D insufficiency is quite frequent in type 2 diabetes patients.diabetes, particularly those with symptoms of DPN. The studies also showed that low serum vitamin D levels are an independent predictor of DPN development. Vitamin D supplementation is necessary for diabetic neuropathy patients since it promotes the synthesis of neurotrophins and neurotransmitters. Additional vitamin D therapy have big role in nerve growth factor and the regulation of neurotrophin and Ca2+ homeostasis in neurons, and provides protection for neurons in the peripheral nervous system. In this review, we do systematically search the studies about Vitamin D for the treatment of painful diabetic neuropathic condition. We used PubMed, Cochrane, Clinical Key, and search Google Scholar for papers that used vitamin D phrases. and painful diabetic neuropathy as our major database for this review and we make a systematic table to explain our review. However, there is still an unmet need in the management of neuropathic pain. The unmet needs maybe caused by the gap between pharmacological treatmnet in pain reduction in painful diabetic neuropathy patients. Therefore, in this review we discuss about the potential use of vitamin D as an add-on therapy to closing the gap in the management of neuropathic pain.

Reducing Pain Through Affective Computing

For a long time, the primary approach to control pain in patients involved the use of specially designed drugs. While these drugs have proved to be sufficient to reduce the perception of pain in patients of all ages, they do not come without any potential side effects. The prolonged use of such drugs can have adverse effects on the health of a patient. This research proposes a shift away from such practices and proposes the use of technology as an adjunct tool to help patients cope with pain. Through the adoption of affective computing, this research presents Morpheus results obtained at the time of writing confirm that the approach presented by this research is indeed useful and can achieve results that are in line with the set out as part of this study. The authors firmly believe that the approach presented in this research can lay the foundations for the research and development of similar applications in pain reduction scenarios.

Characteristics of postoperative pain after mini invasive and conventional mitral surgery in Hanoi Heart Hospital

Introduction: Mini invasive mitral valve surgery had some advantages over conventional surgery in recovery and cosmestic results. Postoperative pain was an interested factor for comparing these two methods, with reported results remained unclear. We realized this study for evaluate the characteristics of postoperative pain between mini invasive and conventional mitral surgery in Hanoi Heart Hospital. Methods: A cross sectional study on patient underwent mitral valve replacement with mini invasive and conventional sternotomy approach. Results: There were 66 patients in the study, divided into 2 group: 43 patient underwent conventional surgery and 23 patient underwent mini invasive surgery. Mean age was 50,7 ± 9,3, female was 78,8% and mean BMI was 20,9 ± 2,7. Erector spinae plane (ESP) block was performed on 16 patients (24,2%) of conventional surgery group. The VAS score at 3 days, 7 days , and 1 month after surgery was 7,7 ± 1,2; 5,2 ± 1,5; 0,9 ± 1,1 in sternotomy group and 6,6 ± 1,6; 3,8 ± 1,5; 1,7 ± 0,9 in mini invasive group, respectively. In patients with ESP block, mean dose of morphine administered in first two days was 0 and 2,3 ± 5,0 mg/kg comparing to the dose of 19,7 ± 5,5 và 17,7 ± 7,1 in sternotomy patients without ESP block. Conclusions: Postoperative pain reduction may not be an advantage of mini invasive mitral surrgery comparing to conventional surrgery, but the time for pain suffering in this group was shorter. ESP was an efficient method for early pain reduction after conventional surgery.

Pain Reduction during Rapid Palatal Expansion Due to LED Photobiomodulation Irradiation: A Randomized Clinical Trial

Objective: The purpose of this research is to assess the analgesic efficiency of Photobiomodulation (PBM) in pain reduction in young patients during rapid maxillary expansion therapy. Materials and Methods: Thirty patients were included and allocated to an experimental group [Rapid Palatal Expansion (RPE) and PBM] and a control group (RPE only) at random. Inclusion criteria were skeletal age from CVS1 to CVS3, examined on the cephalometric lateral teleradiography, with cervical vertebra staging and completed eruption of upper first molar. Exclusion criteria were previous orthodontic treatment, bone disease, disability, or skeletal age from CVS4. Patients referred the pain they felt using a Numerical scale rate (NRS), ranging from 0 to 10, with specific intervals of time: 6 h, 12 h, 24 h, and from days 2 to 7. The Wilcoxon-Mann-Whitney test was used to evaluate differences in NRS reported values between the two groups. Results: The final sample included 30 patients, 14 males and 16 females, with a mean age of 7.8 ± 1.2 years. The pain that was felt at each time interval and the maximum score of pain were significantly lower in the experimental group (p < 0.05) and decreased faster in the experimental group, with a score test near to 0 after 2/3 days. Conclusions: PBM is efficient in reducing the intensity and the time of pain felt by young patients that undergo rapid maxillary expansion.

Gambaran Penurunan Nyeri Pada Penderita Neck Pain Setelah Dilakukan Muscle Energy Technique (MET) : Literature Review

Neck pain or neck pain is a musculoskeletal complaint such as pain in the neck and stiffness that is often experienced by the community. Around 16.6% of the adult population in Indonesia complains of neck pain every year. To reduce pain in patients with neck pain, interventions can be given, one of which is Muscle Energy Technique (MET). This study aims to determine the description of pain reduction in patients with neck pain after accepting the Muscle Energy Technique (MET). Writing this article uses a literature review system using PICO. This article was obtained from searching the Microsoft Academic and Scilit online database with predetermined inclusion and exclusion criteria. The measuring instrument used in the literature review is the Visual Analogue Scale (VAS). The results of the literature review analysis of these 5 articles found that the results of pain reduction from the results of the pre-test were 6.13 and post-test were 2.37. So there is a decrease in pain after accepting the Muscle Energy Technique (MET). Muscle Energy Technique (MET) has an effect on reducing pain in Neck Pain cases. It is hoped that this research should be able to increase knowledge about the management of pain reduction in cases of neck pain after accepting the Muscle Energy Technique (MET).Keywords : Neck pain; muscle energy technique (MET); visual analogue scale (VAS). AbstrakNeck pain atau nyeri leher merupakan keluhan muskuloskeletal seperti terasa sakit dibagian leher dan kaku yang sering dialami oleh masyarakat. Sekitar 16,6% setiap tahunnya populasi orang dewasa di Indonesia mengeluhkan rasa nyeri pada leher. Untuk menurunkan nyeri pada penderita Neck pain dapat diberikan intervensi salah satunya adalah Muscle Energy Technique (MET). Penelitian ini bertujuan untuk mengetahui gambaran penurunan nyeri pada penderita Neck pain setelah dilakukan Muscle Energy Technique (MET). Penulisan Artikel ini menggunakan sistem literature review dengan menggunakan PICO. Artikel ini didapatkan dari penelusuran data base online Microsoft Academic dan Scilit dengan kriteria insklusi dan eksklusi yang telah ditentukan. Alat ukur yang digunakan dalam literature review adalah Visual Analogue Scale (VAS). Hasil analisis literature review dari ke 5 artikel ini didapatkan bahwa hasil penurunan nyeri dari hasil pre test 6,13 dan post test 2,37. Jadi ada penurunan nyeri setelah dilakukan Muscle Energy Technique (MET). Muscle Energy Technique (MET) berpengaruh terhadap penurunan nyeri pada kasus Neck pain. Diharapkan Penelitian ini hendaknya dapat meningkatkan pengetahuan terhadap penanganan penurunan nyeri pada kasus Neck pain setelah dilakukan Muscle Energy Technique (MET).Kata Kunci: Neck pain; muscle energy technique (MET);visual analogue scale (VAS).

Gambaran Penurunan Nyeri pada Penderita Plantar Fasciitis Sebelum dan Sesudah Pemberian Modalitas Ultrasound : Literature Review

Plantar fasciitis is an example of one of the problems in the field of musculoskeletal physiotherapy. It is estimated that 10% of the general population will develop plantar fasciitis in their lifetime. The highest incidence of plantar fasciitis is between the ages of 40 and 65 years. Ultrasound modality is a therapeutic tool that helps increase blood vessels, aims to repair damaged tissue, the frequency used in therapy is between 1-3 MHz. This literature review study aims to determine the description of ultrasound modality to reduce plantar pain in plantar fasciitis patients. The selection of articles in this study used the PICO mnemonic. This article search used literature search through Google Scholar (2), PubMed (1), Science Direct (1) dan Sage Journal (1). Inclusion and exclusion criteria according to keywords, published from 2010-2021, articles in full text and not a systematic review. The results of a literature review of 5 articles showed that the ultrasound modality was proven to reduce plantar pain with an average pain reduction using the Visual Analogue Scale (VAS) before and before intervention with a pre-test value of 6.06 and a post-test of 3.33 and got the average difference in pain reduction is 2.73. The literature review study shows that women are more dominant in experiencing plantar fasciitis in the number of 117 people (62.6%), the average age of those experiencing plantar fasciitis is 49.8 years. This research can be used as a basis for the development of the physiotherapy profession, on the problem of reducing plantar pain in plantar fasciitis patients with ultrasound modality intervention.Keywords: Pain; plantar fasciitis; ultrasound AbstrakPlantar fasciitis merupakan contoh dari salah satu kasus masalah dibidang fisioterapi musculoskeletal. Diperkirakan 10% dari populasi umum akan menderita plantar fasciitis dalam hidupnya. Insiden plantar fasciitis tertinggi adalah diantara rentang usia 40 dan 65 tahun. Modalitas ultrasound merupakan alat terapi yang membantu meningkatkan pembuluh darah, bertujuan untuk memperbaiki jaringan yang mengalami kerusakan, frekuensi yang digunakan dalam terapi antara 1-3 MHz Penelitian literature review ini bertujuan untuk mengetahui gambaran modalitas ultrasound terhadap penurunan nyeri pada plantaris pada penderita plantar fasciitis. Pemilihan artikel pada penelitian ini menggunakan mnemonic PICO. Penelusuran artikel ini menggunakan penelusuran literature melalui Google Scholar (2), PubMed (1), Science Direct (1) dan Sage Journal (1). Kriteria inklusi dan eksklusi sesuai dengan kata kunci, dipublikasi dari rentan waktu 2010-2021, artikel dalam teks lengkap dan bukan systematic review. Hasil literature review 5 artikel menunjukan bahwa modalitas ultrasound terbukti mengurangi nyeri pada plantaris dengan hasil rata- rata penurunan nyeri dengan alat ukur Visual Analogue Scale (VAS) Sebelum dan sesudah intervensi dengan nilai pre test 6,06 dan post test 3,33 dan mendapatkan rata-rata selisih penurunan nyeri 2,73. Studi literature review menunjukan perempuan lebih mendominasi mengalami plantar fasciitis sejumlah 117 orang (62,6%), rata-rata usia yang mengalami plantar fasciitis usia 49,8 tahun. Study literatur review menunjukan bahwa modalitas ultrasound berpengaruh terhadap penurunan nyeri plantaris pada penderita plantar fasciitis. Penelitian ini dapat digunakan sebagai dasar dari pengembangan profesi fisioterapi, pada masalah penurunan nyeri pada plantaris pada penderitas plantar fasciitis dengan intervensi modalitas ultrasound.Kata kunci : Nyeri; plantar fasciitis; ultrasound

Specific versus Non-Specific Exercises for Chronic Neck or Shoulder Pain: A Systematic Review

The current systematic review aimed to compare the effect of injury-focused (specific) exercises versus more general (non-specific) exercises on pain in patients with chronic neck or shoulder pain. We searched PubMed, EMBASE, and Web of Science. Two reviewers screened and selected studies, extracted outcomes, assessed risk of bias, and rated the quality of evidence. A total of nine eligible studies, represented in 13 articles, were identified, with a considerable risk of bias. One article investigated the acute effect of single bouts of exercise on pain and reported an immediate pain reduction after non-specific exercise. Regarding short-term effects, seven out of the nine studies found no differences in pain between interventions, with inconsistent results among two other studies. Concerning the long-term effects, while pain reduction seems to be favored by specific exercises (two out of four articles), the best format is still unclear. Based on the acute effects, a single bout of non-specific exercise seems to be a better option for pain-relief for patients with chronic neck or shoulder pain. For short-term effects, there are no differences in pain between specific and non-specific exercises. Regarding long-term effects, specific exercises seem to be the best option. Nevertheless, more studies are warranted.