PURPOSE: The objectives of this study were to investigate the effects of physical therapy provided at home on the motor function, activity of daily living (ADL), and level of pain in veterans men with disabilities, and to provide the information. METHODS: The participants were 108 patients men with disabilities living in the cities Seoul, Pusan, Daegu, Gwangju and Daejeon; they performed physical therapy at home-provided by physical therapy services- that included therapeutic exercise for 50 minute, 1~2 times a week for 24 weeks. The motor function was measured by using motor assessment scale (MAS) and ADL, the level of pain were recorded both before and after physical therapy. The data form both before and after physical therapy were analyzed by using the paired t-test. All statistical tests in this study were performed with the level of significance set at .05. RESULTS: After 24 weeks of physical therapy, we observed significant improvement in the MAS and ADL scale, as well as significant decrease in the level fo pain in the participants (p<.01). Significant improvement was also observed in the MAS and ADL scale, as well as a decrease in the level of pain among participants with stroke and spinal disease (p<.05). CONCLUSION: The findings of this study show that physical therapy provided at home can lead to an improvement in the motor function as well as improved ADL and pain control; physical therapy also has positive effects in relieving symptoms of veterans with disabilities.
Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.
Background: It is necessary to find and develop the effective way of intervention for patients with neck pain, since the neck pain is becoming increasingly common throughout the world. To identify the altered motor control in patient with neck pain would be informative to find and develop the effective way of intervention. Objects: The aim of this study was to review literature regarding the altered motor control in patients with neck pain, measured by using surface electromyography (sEMG), ultrasonography, and functional magnetic resonance imaging (fMRI), and to suggest prospective research work on neck pain. Methods: Case-control (neck pain/healthy) studies published between 2004 and 2015 that investigated neck muscle activation, thickness, cross-sectional area, and fat infiltrate were searched in Scopus, PubMed, and ScienceDirect. Twenty-eight articles were included in this study. Results: sEMG, ultrasonography, and fMRI were used complementarily to investigate the altered superficial and deep neck muscle activation, thickness, cross-sectional area, and fat infiltrate in patients with neck pain. They showed the following altered motor control when compared retrospectively with healthy subjects or during specific functional tasks: (1) increased superficial muscle activation, (2) lesser deep muscle thickness, (3) smaller cross-sectional area of the deep muscle, and (4) greater fat infiltrate in deep muscles. In particular, among the women, the office workers showed higher muscle activation of superficial neck muscles during functional tasks, although they did not have neck pain, than those who were not office workers. Conclusion: Studies revealed that patients with neck pain showed an altered motor control when compared with healthy subjects by using various assessment modalities. Understanding this phenomenon would help researchers design an effective intervention for alleviating neck pain or to evaluate the effectiveness of the intervention. In addition, we recommend that female office workers take measures to care for their necks before developing neck pain.
Fakhri, Sajad;Sabouri, Shahryar;Kiani, Amir;Farzaei, Mohammad Hosein;Rashidi, Khodabakhsh;Mohammadi-Farani, Ahmad;Mohammadi-Noori, Ehsan;Abbaszadeh, Fatemeh
The Korean Journal of Pain
/
제35권3호
/
pp.291-302
/
2022
Background: Spinal cord injury (SCI) is one of the most debilitating disorders throughout the world, causing persistent sensory-motor dysfunction, with no effective treatment. Oxidative stress and inflammatory responses play key roles in the secondary phase of SCI. Naringenin (NAR) is a natural flavonoid with known anti-inflammatory and antioxidative properties. This study aims at evaluating the effects of intrathecal NAR administration on sensory-motor disability after SCI. Methods: Animals underwent a severe compression injury using an aneurysm clip. About 30 minutes after surgery, NAR was injected intrathecally at the doses of 5, 10, and 15 mM in 20 µL volumes. For the assessment of neuropathic pain and locomotor function, acetone drop, hot plate, inclined plane, and Basso, Beattie, Bresnahan tests were carried out weekly till day 28 post-SCI. Effects of NAR on matrix metalloproteinase (MMP)-2 and MMP-9 activity was appraised by gelatin zymography. Also, histopathological analyses and serum levels of glutathione (GSH), catalase and nitrite were measured in different groups. Results: NAR reduced neuropathic pain, improved locomotor function, and also attenuated SCI-induced weight loss weekly till day 28 post-SCI. Zymography analysis showed that NAR suppressed MMP-9 activity, whereas it increased that of MMP-2, indicating its anti-neuroinflammatory effects. Also, intrathecal NAR modified oxidative stress related markers GSH, catalase, and nitrite levels. Besides, the neuroprotective effect of NAR was corroborated through increased survival of sensory and motor neurons after SCI. Conclusions: These results suggest intrathecal NAR as a promising candidate for medical therapeutics for SCI-induced sensory and motor dysfunction.
PURPOSE: The purpose of this study was to investigate the effects of sensory motor training using ball exercise on shoulder range of motion, pain, dysfunction, and quality of life in Breast Cancer Women after Mastectomy. METHODS: A total of 26 patients from D University Hospital in Daejeon were included and randomly allocated to two groups (n=13 per group). The two groups performed the exercise five times a week for 4 weeks. A sensory motor training group (SMTG) received general physical treatment for 10 minutes and sensorimotor training for 20 minutes. A control group (CG) received general physical therapy for 30 minutes. Shoulder pain (the Visual Analog Scale), range of motion, disability (the shoulder pain and disability index) and quality of life (the Functional Assessment Cancer Therapy-Breast instrument) were measured in both groups before and after 4-weeks intervention. RESULTS: A significant difference was found in joint range of motion, shoulder pain, functional disability level, and quality of life within the two groups (p <.05). In addition, changes in joint range of motion, pain, functional disability level, and quality of life after then intervention were significantly different between the two groups (p <.05). CONCLUSION: These results suggest that a sensory motor training program is feasible, safe, and suitable exercise for shoulder functions and quality of life in Breast Cancer Women after Mastectomy.
Objective : This experiment was conducted to evaluate the effectiveness of Acupuncture, Bee Venom Acupuncture (BVA) and Bee Venom Herbal Acupuncture (BVHA) on post-stroke hemiplegic shoulder pain. Methods : 30 patients were randomly allocated into Acupuncture group, BVA group and BVHA group and was monitored weekly for 4 weeks; initial($T_0$), 1 week($T_1$), 2 weeks($T_2$), 3 weeks($T_3$) and 4 weeks($T_4$). Results : Visual analogue scale of shoulder pain showed significant decrease in BVA and BVHA groups compared to the Acupuncture group at T4 evaluation. Painless passive ROM of shoulder external rotation and Fugl-Meyer Motor Assessment of Upper Limb motor function showed significant increase in all groups. Modified Ashworth scale of the spasticity of upper limb showed no differences between the three groups. Conclusion : BVA & BVHA appears to be an effective in treating post-stroke hemiplegic shoulder pain. Further clinical studies must be done to obtain more concrete findings.
Hemiplegic shoulder pain(HSP) is one of the most frequent and difficult problems affecting poststroke hemiplegic patients. Honeybee venom acupuncture therapy(BVAT) is known for its pain relieving effects in arthralgia. To evaluate the effectiveness of BVAT on HSP, 24 patients were sequential1y allocated into BVA T treatment group and control group and monitored for 4 weeks at time interval of initial(T0), 1 week(T1), 2 weeks(T2) and 4 weeks(T4). In treatment group, 1:10000 honeybee venom solution 0.2㎖ was injected into acupoint(s) following Deqi three times a week. Kyonu(LI15) was used in the first week. Thereafter Kyonu(LI15) and Nosu(SI10) were used. Visual analogue scale of pain severity showed significant decrease in treatment group compared to control group at T2 and T4 evaluation. Painless passive range of motion of shoulder external rotation showed significant increase in treatment group compared to control group at T4 evaluation. Fugl-Meyer Motor Assessment of upper limb motor function and Modified Ashworth scale of the spasticity of upper limb showed no difference between two groups. BVAT showed as an effective therapy in HSP and further extensive clinical studies are expected.
Purpose : The purposes of this study were to find correlations among Fugl-Meyer Assessment Scale, walking velocity, walking asymmetry and balance ability. Methods : The study sample consisted of 50 stroke patients referred to the Department of Rehabilitation Medicine in the Sanggye Paik, Ilsan Paik, Seoul Paik, and Dobong Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed on Fugl-Meyer Assessment scale and walking velocity, walking asymmetry. The data were analyzed using independent t-test, ANOVA, and multiple regression. Results : The results revealed that upper extremity coordination, balance and pain items of Fugl-Meyer Assessment scale were significantly correlated with walking velocity and upper extremity and upper extremity motor and balance items of Fugl-Meyer Assessment scale were significantly correlated with walking asymmetry. Fugl-Meyer Assessment scale was not significantly correlated with Static Balance Index, Dynamic Balance Index and Weight Distribution Asymmetry Index. Their power of explanation regarding comfortable walking velocity and comfortable walking asymmetry were 60.3%, 42.5% respectively. Conclusion : These results showed that Fugl-Meyer Assessment scale is significantly correlated with walking velocity, asymmetry and not significantly correlated with balance ability. Therefore Fugl-Meyer Assessment scale is an appropriate assessment tool to predict walking ability of patients with stroke. Futher study about walking velocity and asymmetry by change of Fugl-Meyer Assessment scale is needed using a longitudinal study design.
Background: In the field of dentistry, topical anesthetics play an important role in reducing pain during needle pricks. The anesthetic property of betel leaves remain unexplored, even though they have been widely used for the treatment of various ailments. The purpose of this study was to compare and evaluate pain perception following topical application of lignocaine gel, clove gel, ice, and newly developed betel leaf extract gel during intraoral injection in children. Methods: Sixty children aged 6-10 years who met the inclusion criteria were divided into four groups. Topical anesthetic agents, 2% lignocaine (Lox-2% Jelly, Neon, Mumbai, India), 4.7% clove gel (Pain Out Dental Gel, Colgate Palmolive India Ltd, Solan, India), 10% betel leaf extract gel, and ice were applied to each group for one min, followed by administration of infiltration anesthesia. Pain perception was analyzed during needle insertion. The Wong Bakers FACES pain rating scale (WBFPRS) was used for subjective assessment and the Sound, Eye, Motor (SEM) scale for objective assessment. Recorded values were tabulated and subjected to appropriate statistical analysis using SPSS software with a P value set at 0.05. Results: The clove oil and betel leaf groups demonstrated the highest WBFPRS scores, followed by the ice and lignocaine groups. The clove, betel leaf extract, and ice groups showed equal and highest SEM scores, followed by the lignocaine group. The mean WBFPRS and mean SEM scores were statistically significant. Conclusion: Betel leaf extract gel is effective in reducing pain and can act as an alternative topical anesthetic agent.
Objective: The purpose of this study was to evaluate the relationship between quality of life (QoL) of the caregiver and disease severity with motor function in children with cerebral palsy (CP). Design: Cross-sectional study. Methods: Research data were collected in the Rehabilitation Clinic of Daegu University. The Gross Motor Function Measure (GMFM-88) and the functional independence measure (FIM) were used for assessment by three occupational therapists, and the 36-item short form health survey (SF-36) were applied to the caregivers. One hundred six caregivers of under 18 years who were diagnosed with CP completed a survey and interview. The caregivers' QoL was evaluated using Medical Outcomes Study SF-36. The children's motor function was scored using GMFM-88 in five dimensions: lying and rolling; sitting; crawling and kneeling; standing and walking, running and jumping and CP's FIM scores. Results: Out of the 8 domains of the Medical Outcomes Study SF-36, the "physical functioning", "physical role functioning", "mental health", and "bodily pain" domains were significantly correlated to "total" percentage scores of the GMFM-88 (p<0.05). In addition, the "mental health" domain was correlated to each subdomain of the GMFM-88, which includes, "lying and rolling", and "crawling and kneeling". Similarly, of Medical Outcomes Study SF-36, "physical functioning", "bodily pain", and "mental health" domains were significantly correlated with "transfer" and "locomotion" of FIM scores (p<0.05). Conclusions: This study showed that the QoL of the caregivers were well correlated with the motor function of children with CP. It is also important to support not only physical health but also psychological health of caregivers of children with CP, especially those with severe motor function.
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