Byun, Jong Min;Park, Hahck Soo;Woo, Jae Hee;Kim, Jin
The Korean Journal of Pain
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제27권4호
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pp.334-338
/
2014
Background: Lumbar transforaminal epidural steroid injections (TFESIs) are performed to provide symptom relief in patients with radicular pain. Recent articles suggested that injected volume itself have analgesic effects and higher volumes are associated with better outcomes. To date, few studies have been conducted to investigate the effects of volume. Therefore, well-designed controlled studies were necessary to confirm the effect of volume itself on pain relief. The purpose of this study was to examine the effectiveness of a forceful saline injection on lumbar TFESI using non-particulate steroids. Methods: Fifty consecutive patients with lumbar radicular pain were enrolled. The participants were allocated into one of two groups: dexamethasone with volume (Group DV) and dexamethasone alone (Group DO). The volume was delivered by a forceful injection of 5ml of normal saline. The primary end-point for this study was a VAS pain score and modified MacNab score indicating the rate of effectiveness at the four-week follow-up. Results: There were no significant post-procedural VAS differences between two groups (P = .252). The effectiveness rate among the patients was 47.8% in DV group, 34.8% in DO group, measured by modified MacNab score. The difference was not statistically significant (P = .117). Conclusions: A forceful saline injection did not have a significant effect during the treatment of radicular pain. Further studies with greater volumes and with additional techniques would offer a more conclusive perspective.
Choi, Young Doo;Jo, Su Jeong;Jung, Chan Yung;Kim, Kap Sung;Lee, Seung Deok
Journal of Acupuncture Research
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제33권2호
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pp.77-87
/
2016
Objectives : This is a pilot study for a large randomized controlled trial to investigate the efficacy and safety of a newly developed contrast therapy device-- alternating topical heat and cold -- for patients with chronic low back pain. The main objective of this study is to confirm the feasibility of the study design. Methods : The design was a randomized, 2-arm, parallel-group, single-blind, placebo controlled trial. Patients in each group received real or sham contrast therapy in an acupuncture point 10 times over four weeks. The primary outcome measure was pain intensity on a 100-mm visual analogue scale (VAS). The secondary outcomes were back-related dysfunction based on the Oswestry Disability Index (ODI), the Roland-Morris disability questionnaire (RMDQ), and range of motion of lumbar spine based on the modified Schober test (mSchober test), Finger-to-Floor distance (FTF distance), and Finger-to-Thigh distraction (FTT distraction). Results : A total of 30 subjects with chronic low back pain were randomly assigned to a contrast therapy group (n=15) or a sham group (n=15). A repeated-measures analysis of variance showed statistically significant group time interaction for VAS, RMDQ, mSchober test and FTF distance (p<0.05). The treatment group showed significant improvement in pain intensity and functional disability as compared to the sham group. Conclusion : Contrast therapy may be an effective and safe treatment for chronic low back pain.
Donohue, Nicholas K.;Tarima, Sergey S.;Durand, Matthew J.;Wu, Hong
The Korean Journal of Pain
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제33권2호
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pp.192-198
/
2020
Background: Previous studies have shown varying results between lumbosacral transforaminal epidural steroid injections (TFESIs) performed with particulate versus non-particulate corticosteroids. The purpose of this study was to investigate the difference in pain relief and functional improvement between particulate and nonparticulate lumbosacral TFESIs in patients who had undergone both injections, sequentially. Methods: This was a self-controlled, retrospective study of 20 patients who underwent both a methylprednisolone and a dexamethasone TFESI to the same vertebral level and side. Primary outcomes included pain relief according to the visual analogue scale (VAS) and functional improvement determined by a yes/no answer to questions regarding mobility and the activities of daily living. Post-injection data was recorded at 2, 3, and 6 months. Results: A decrease in VAS scores of -3.4 ± 3.0 (mean ± standard deviation), -3.1 ± 3.1, and -2.8 ± 3.4 was seen for the methylprednisolone group at 2, 3, and 6 months, respectively. Similar decreases of -3.9 ± 3.5, -3.4 ± 2.8, and -2.3 ± 3.4 were seen in the dexamethasone group. There was no significant difference in pain relief at any point between the two medications. The percentage of subjects who reported improved function at 2, 3, and 6 months was 65%, 51%, and 41%, respectively, for the methylprednisolone group and 75%, 53%, and 42% for the dexamethasone group. Conclusions: These findings support the use of non-particulate corticosteroids for lumbosacral TFESIs in the context of documented safety concerns with particulate corticosteroids.
PURPOSE: The purpose of this study was to determine the effect of exercise therapy on low back pain (LBP), the function of paraspinal and abdominis muscles, and the sacrohorizontal angle as seen on the radiographs of the lumbar spine in a young female golf player with LBP. METHODS: This case report describes an 11-year-old female golfer who presented with LBP. The exercise therapy program comprised lumbar joint mobilization, lumbar spine flexion distraction, abdominal bridge, plank, side plank, and single-leg extensions from a 4-point kneeling position for 40 min/day; this was done twice a week for 8-weeks. LBP [visual analog scale (VAS) and Oswestry disability index (ODI)] and function of paraspinal and abdominis muscles [Ito test, curl-up test, $90^{\circ}$ stop test, squat test, opened eye one leg stance test (OEOL), and closed eye one leg stance test (CEOL)] were measured before and after 4 and 8 weeks of exercise therapy. The radiographs were analyzed for the lumbar Cobb's angle and sacrohorizontal angle before and after 8 weeks of exercise therapy. RESULTS: After 4 and/or 8 weeks of exercise therapy, VAS and ODI scores decreased; results for the Ito test, curl-up test, $90^{\circ}$ stop test, squat test, and OEOL and CEOL of muscle function improved; and the lumbar Cobb's angle and sacrohorizontal angle improved. CONCLUSION: These results suggest that exercise therapy improves LBP, muscle function, and radiographic parameters associated with LBP in young golf players. These findings have clinical implications for exercise therapy in young female golf players who have LBP.
Background: Kyphoplasty is a minimally invasive procedure that can stabilize osteoporotic and neoplastic vertebral fractures. We retrospectively evaluated the clinical outcomes of kyphoplasty for the treatment of vertebral compression fractures in cancer patients. Methods: We reviewed the clinical data of 27 cancer patients who were treated with kyphoplasty (55 vertebral bodies) between May 2003 and Feb 2008. The clinical parameters, using a visual analog 10 point scale (VAS) and the mobility scores, as well as consumption of analgesic, were evaluated preoperatively and at 1 week after kyphoplasty. Results: A total 55 cases of thoracic and lumbar kyphoplasties were performed without complications. The mean age of the patients was 66 years. All the patients experienced a significant improvement in their subjective pain and mobility immediately after the procedures. The pain scores (VAS), mobility scores and other functional evaluations using the Oswestry disability score and the SF-36 showed significant differences between the pre- and postoperational conditions. Conclusions: Kyphoplasty is an effective, minimally invasive procedure that can relieve the pain of patients with vertebral compression fractures and these fractures are the result of metastasis.
Purpose : The purpose of study was to better understand the effects of Interferential Current (IFC) and Ultrasound on the ROM and pain in patients with chronic back muscle pain. Methods : Twenty patients with chronic back pain were randomly assigned to IFC stimulation groups and Ultrasound stimulation groups. Both groups used the same method for 20 minutes each session, three times a week for 4 weeks at the same time point and with the same amount of treatment. Measurement items are visual analogue scale (VAS) and range of motion (ROM). Results : This study showed that the IFC stimulation group and the ultrasound stimulation group demonstrated significant improvement in ROM increase and pain reduction. Both groups showed a significant reduction in VAS; however, the ultrasound stimulation group decreased more than ultrasound stimulation group. And, both groups showed a significant increase in ROM. The ultrasound stimulation group increased significantly more than the IFC stimulation group in ROM of flexion and extension. The IFC stimulation group increased significantly more than the ultrasound stimulation group in ROM of lateral flexion. Conclusion : Pain relief was more effective in the ultrasound group. The ultrasound showed a more significant effect than IFC in ROM of flexion and extension. The IFC showed a more significant effect than ultrasound in ROM lateral flexion. The results of this study suggest that the treatment effects are different on patients with chronic back pain, according to treatment methods.
Objectives : Burning mouth syndrome (BMS) is characterized by chronic pain or a burning sensation in the mouth. There is limited evidence available to provide clear guidelines for treating BMS patients and a variety of different treatments have been used. This study was designed to investigate the Effects of Korean medicine therapies on oral pain in patients with BMS. Methods : We surveyed 30 BMS patients who newly visited the Oral Diseases Clinic in the Kyung Hee University Korean Medicine Hospital from February 2012 to March 2013. When the patients visited the clinic for the first time, they were evaluated on sociodemographic characteristics, BMS questionnaire, severity of pain using visual analogue scale (VAS) and pressure pain threshold (PPT) of the acupuncture point CV17. After 3 weeks of Korean medicine therapies (acupuncture, electroacupuncture, pharmacopuncture and herbal medicine), they were re-evaluated with the VAS and the PPT. Results : After 3 weeks of Korean medicine therapies, 30 patients' oral pain improved and the PPT score on CV17 rose, which means decrease of qi-stagnation score. Conclusions : Korean medicine therapies were effective on oral pain in patients with BMS. To confirm the additional curative effect and evaluate the efficacy of each treatment, well-designed randomized controlled trials will be needed in the future.
The purpose of this study was to examine the self-rated health and to find various factors affecting it for elderly women in a rural community, to provide data necessary to establish health promotion programs for elderly. The subjects of the study included a total of 245 women with above 70 years of age reside in one rural community. VAS (Visual Analogue Scale) for self-rated health, Lawton's physical & instrumental activity of daily living scales, social network were evaluated. The results of the study were as follows: 1. The self-rated health of the elderly women were measured on a 100 point(VAS) scale and the score was 53.6, indicating that women rated their health as moderate. 2. Factors such as income(p=0.008), family size(p=0.031), the level of ADL(p=0.039), urinary symptom(p=0.039), nocturia(p=0.001), visual difficulty(p=0.023), the number of chronic diseases(p=0.015), presence of arthritis or neuralgia(p=0.015), social network(p=0.002), housework assistant(p=0.008), emotional support(p=0.031) were significantly related to self-rated health. 3. Through the stepwise multiple regression, social network, family size, visual difficulty, and housework assistant were identified as significant predictors of self-rated health(p<0.05), explaining $21.0\%$ of the variance of the dependent variable. Better understanding of the determinants of healthy aging hopefully will lead to effective interventions to improve the quality of life of the elderly.
Purpose: The aim of this study is to assess the influence exerted by the observer's dental specialization and compare patients' opinion with observers' opinion of the esthetics of maxillary single-tooth implants in the esthetic zone. Methods: Forty-one adult patients, who were treated with a single implant in the esthetic zone, were enrolled in this study. Eight observers (2 periodontists, 2 prosthodontists, 2 orthodontists and 2 senior dental students) applied the pink esthetic score (PES)/white esthetic score (WES) to 41 implant-supported single restorations twice with an interval of 4 weeks. We used a visual analog scale (VAS) to assess the patient's satisfaction with the treatment outcome from an esthetic point of view. Results: In the PES/WES, very good and moderate intraobserver agreements were noted between the first and second rating. The mean total PES/WES was $11.19{\pm}3.59$. The mean PES was $5.17{\pm}2.29$ and mean WES was $6.02{\pm}1.96$. In the total PES/WES, the difference between the groups was not significant. However, in the WES, the difference between the groups was significant and prosthodontists were found to have assigned poorer ratings than the other groups. Periodontists gave higher ratings than prosthodontists and senior dental students. Orthodontists were clearly more critical than the other observers. The statistical analysis revealed statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth. However, the correlation between the total PES/WES and the VAS score for the first premolar was not statistically significant. Conclusions: The PES/WES is an objective tool in rating the esthetics of implant supported single crowns and adjacent soft tissues. Orthodontists were the most critical observers, while periodontists were more generous than other observers. The statistical analysis revealed a statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth.
Purpose: This study aimed to develop a questionnaire for the diagnosis of chronic fatigue syndrome (CFS) designed based on the systematic exertion intolerance disorder (SEID) criteria, and to validate the reliability of the questionnaire. Methods: A literature search on questionnaires for CFS diagnosis was conducted to develop a SEID questionnaire (SEID-Q27), followed by a pilot survey to identify the reliability of the questionnaire. Adults (Daejeon university personnel) with a Chalder fatigue scale (CFQ) score ≥15 were invited for the survey. We commenced the survey in November 2019 with a two weeks of interval for the test and retest method. The reliability of the questionnaire was investigated in three angles: 1. Cronbach's α, 2. correlations (r) of the questions, numerical rating scale (NRS), and visual analog scale (VAS), and 3. kappa (k) analysis. Results: Among the total 275 adults registered, 55 (20%) participants with a CFQ score ≥15 were invited, and 31 (11%) [15 male, 16 female] completed the questionnaire. The total Cronbach's α was 0.944 for the test and 0.949 for the retest. The reliability (r) of questions by CFQ score (≥15, ≥18, ≥20) ranged from 0.533-0.928 (p <0.05), and the r score of the NRS and VAS were the highest in CFQ scores ≥20, at 0.933 (p<0.001). The agreement rate of the SEID-Q27 between the test and retest was 87% (kappa k=0.743). Conclusions: The SEID-Q27 seems to be reliable. Further studies are needed to measure the validity of the tool and the cutoff point.
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