Purpose: The purpose of this study was to investigate the effect of movement training based on motor control theory on pain and average power of muscles in patients with shoulder impingement syndrome and to develop more effective training methods. Methods: We studied 35 patients with shoulder impingement syndrome. Patients were randomly assigned to an experimental group or a control group according to the intervention. The therapeutic modalities such as superficial heat, deep heat, and electronic stimulus, and motor control training with strengthening exercises were applied to the experimental group and therapeutic modalities only were applied to the control group. All interventions were done 3 times a week for 4 weeks. Before the intervention and again after the 4 weeks, we measured pain utilizing a visual analog scale. We measured average power using isokinetic equipment. Results: After application of the intervention, pain significantly decreased in both the experimental group and the control group. There was a significant difference between the extent of the decrease between experimental and control groups. After the intervention, the average power between the two groups were significant at an angle of $60^{\circ}$/sec and $180^{\circ}$/sec for external rotator and internal rotator muscles. They also showed significant improvement in all variables post-intervention compared to pre-intervention. Conclusion: This study indicates that there is an effect in giving appropriate motor control training to patients with shoulder impingement syndrome. It is assumed that there will be a need for more surveys on various variables for motor control training from now on.
Background: The purpose of this study was to investigate the effects of HBOT (hyperbaric oxygen therapy) on the pain, ROM (range of motion) and muscle fatigue recovery of DOMS (delayed onset muscle soreness). Design: Randomized Controlled Trial. Methods: Twenty-six subjects who are student in their 20s at a university participated in this study, these subjects were assigned into two groups, a control group (n=12) and an experiment group (n=14). The subjects in experimental group were intervened by HBOT (40 minutes, 1.3 ATA), while ones on control group weren't by any intervention after induced DOMS. Results: First, in the comparison of VAS (visual analog scale), there were significant variations with the period (p<0.001), interaction of period (p<0.05) and group (p<0.05). In the comparison of PPT (pressure pain threshold), there were significant variations with the period (p<0.001) and interaction of period (p<0.05). Second, in the comparison of ROM, there were significant variations with the period (p<0.001), interaction of period (p<0.001) and group (p<0.01). Third, in the comparison of CK (creatine kinase) and LDH (lactate dehydrogenase), there no signigicant variations with all measure variables. Conclusion: The above results indicated that HBOT were effective to decrease the pain and improve the ROM in DOMS. Also the statistical significant variations of blood factors of muscle fatigue were not found in this.
Kim, Su Gyeong;Park, Eun Jin;Lim, Jae Eun;Do, Hyun Jeong;Kim, Jeong Yoon;Cho, Sung Woo;Yoon, Hyun Min;Kim, Cheol Hong
Journal of Acupuncture Research
/
v.36
no.3
/
pp.166-171
/
2019
This study aimed to report the effect of Korean medical treatment including miniscalpel acupuncture on 2 patients who underwen tsurgery for rotator cuff tear. They were treated for almost 4 weeks at the Department of Acupuncture and Moxibustion, Dong-Eui University Korean Medicine Hospital. Visual analog scale (VAS), and range of movement (ROM) were used to evaluate treatment effects. In both patients, shoulder pain and restriction of shoulder joint movement improved after miniscalpel acupuncture treatment. In Case 1, shoulder pain decreased from a VAS score 8 to a VAS score 3, and ROM of the shoulder improved from flexion $100^{\circ}$ to $160^{\circ}$, extension $10^{\circ}$ to $30^{\circ}$, abduction $90^{\circ}$ to 1$30^{\circ}$, adduction $10^{\circ}$ to $40^{\circ}$, internal rotation $10^{\circ}$ to $50^{\circ}$, and external rotation $10^{\circ}$ to $50^{\circ}$. In Case 2, shoulder pain, which was rated a VAS score 8 at first-visit, disappeared, and ROM of the shoulder recovered to normal range. These results suggest miniscalpel acupuncture may contribute to the recovery process after rotator cuff tear surgery.
Background: The aim of this study was to compare the local anesthetic effect of tramadol with that of lignocaine in the extraction of immobile (grade 0) maxillary first molars. Methods: This was a randomized, double-blind, equally balanced, controlled trial conducted on a sample population of 116 patients. The patients were randomly divided into two groups: group A (control) and group B (study). Group A and group B participants received 1.8 ml of 2% lignocaine without adrenaline and 1.8 ml of 5% tramadol, respectively through the supra-periosteal infiltration technique before extraction. Intraoperative pain was recorded on the Visual Analog Scale (VAS) and was evaluated using two unpaired t-tests. Results: Intraoperative pain was evaluated in both the control and study groups. In the control group, the mean VAS score was 0.71 ± 0.81, while in the study group, the mean intraoperative VAS score was 1.21 ± 0.86, with the difference between the two mean values being statistically significant (P = 0.001). Conclusion: Tramadol has a less potent local anesthetic effect than lignocaine. As a higher dose of tramadol is required to obtain the desired anesthetic effect, it should be used as a supplement to lignocaine in extensive surgical procedures. It can also be used in patients allergic to lignocaine.
Purpose: The aim of this study was to compare the efficacy of the tunnel technique for root coverage using a new xenogeneic acellular dermal matrix vs. connective tissue grafting (CTG) for the treatment of multiple maxillary adjacent recessions (recession type 1) at 12 months postoperatively. Methods: This study enrolled 12 patients with at least 3 contiguous, bilateral, symmetrical maxillary gingival recessions (i.e., at least 6 recessions per patient). In total, 74 recessions were treated using the modified coronally advanced tunnel (MCAT) technique combined with a novel porcine-derived acellular dermal matrix (PADM) at 37 test sites or CTG at 37 control sites. The following clinical parameters were measured: recession height, clinical attachment level, width of keratinized tissue, probing depth, recession width, gingival thickness, mean root coverage (MRC), and complete root coverage (CRC). Comparisons between test and control groups were made for pain visual analog scale scores at 14 days. Results: At 12 months, the MCAT with PADM (test) yielded a statistically significant improvement in all clinical parameters studied. MRC was significantly higher on the control sides (80.6%±23.7%) than on the test sides (68.8%±23.4%). Similarly, CRC was 48.7%±6.8% on the control sides (CTG), in contrast to 24.3%±8.2% on the test sides (PADM). Statistically significant differences were observed in favor of the control sides for all clinical parameters studied. Nevertheless, the MCAT in adjunction with PADM was clearly superior at reducing mean and maximum patient-reported postoperative pain intensity and pain duration in the first week after surgery. Conclusions: The use of PADM to treat multiple recessions improved clinical parameters at 12 months, but these outcomes were nevertheless poorer than those observed for CTG. However, PADM reduced morbidity, particularly the pain experienced by patients.
Purpose: This study investigated the short-term effectiveness of extracorporeal shock wave therapy (ESWT) on pain, the ankle instability, the ankle function, dorsiflexion range of motion (ROM), and dynamic balance in patients with chronic ankle instability (CAI). Methods: Eighteen participants were divided into an experimental (n=9) and control group (n=9). The ESWT in the experimental group was applied to the lateral collateral ligament in combination with the tibialis anterior whereas the ESWT was applied to the lateral collateral ligament of the ankle alone in the control group. Pain, the ankle instability, the ankle function, dorsiflexion ROM, and dynamic balance were measured using the Visual analog scale, Cumberland ankle instability tool, American Orthopedic Foot and Ankle Society ankle-hindfoot score, weight-bearing lunge, and Y-balance test, before and after ESWT intervention. Results: Significant interactions (group × time) and time effects were observed in the dorsiflexion ROM and dynamic balance. Bonferroni's post-hoc analysis showed that the experimental group revealed a more significant change in dorsiflexion ROM and dynamic balance than the control group. There was a significant time effect in the pain, the ankle instability, and the ankle function, but no significant interaction (group × time) was observed. Conclusion: The ESWT could improve the pain, ankle instability, ankle function, dorsiflexion ROM, and dynamic balance in patients with CAI. Furthermore, the ESWT combined with lateral ankle ligaments and tibialis anterior more improves the dorsiflexion ROM and dynamic balance.
Background: This was a randomized controlled clinical trial that aimed to evaluate the anesthetic efficacy of 2% lidocaine combined with different concentrations of epinephrine (plain, 1:200,000 and 1:80,000) during endodontic treatment of maxillary molars with symptomatic irreversible pulpitis. Methods: The trial included 144 adult patients who were randomly allocated to three treatment groups. All patients received buccal-plus-palatal infiltration. After 10 min, pulp sensibility testing was performed using an electric pulp test (EPT). If a tooth responded positively, anesthesia was considered to have failed. In the case of a negative EPT response, endodontic access was initiated under rubber dam isolation. The success of anesthesia was defined as having a pain score less than 55 on the Heft Parker visual analog scale (HP VAS), which was categorized as 'no pain' or 'faint/weak/mild' pain on the HP VAS. Baseline pre-injection and post-injection maximum heart rates were recorded. The Pearson chi-square test was used to analyze the anesthetic success rates at 5% significance. Results: Plain 2% lidocaine and 2% lidocaine with 1:200,000 epinephrine and 1:80,000 epinephrine had anesthetic success rates of 18.75%, 72.9%, and 82.3%, respectively. Statistical analysis indicated significant differences between the groups (P < 0.001, 𝛘2 = 47.5, df = 2). The maximum heart rate increase was seen with 2% lidocaine solution with epinephrine. Conclusion: Adding epinephrine to 2% lidocaine significantly improves its anesthetic success rates during the root canal treatment of maxillary molars with symptomatic irreversible pulpitis.
Lee, Guen Young;Lee, Joon Woo;Lee, Eugene;Yeom, Jin S.;Kim, Ki-Jeong;Shin, Hyung-Ik;Kang, Heung Sik
The Korean Journal of Pain
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v.35
no.3
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pp.336-344
/
2022
Background: The U.S. Food and Drug Administration has prohibited epidural steroid injection (ESI) with particulate steroids. Thus, this study aimed to compare the efficacy and safety of ESI with two nonparticulate steroids, dexamethasone and betamethasone. Methods: The eligible patients (n = 600) who received ESI (0 week) with dexamethasone (ESI-dexa) or betamethasone (ESI-beta) had follow-up visits at 2, 4, and 8 weeks with a phone interview at 12 weeks. The primary endpoint was the proportion of effective responders without pain or who were much improved at 2 weeks. The secondary endpoints were the proportion of crossover injections at 2 weeks; changes in the visual analog scale (VAS) and disability index scores at 2, 4, and 8 weeks; the number of additional ESIs in 12 weeks; the number of participants having spinal surgery, as well as the incidence of adverse events over the 12 weeks. Results: The proportion of effective responders at 2 weeks was not different between ESI-beta (72/216, 33.3%) and ESI-dexa (63/200, 31.5%; P = 0.670). Adverse events were more common with ESI-dexa (40/200, 20.0%) than with ESI-beta (24/216, 11.1%; P = 0.012). VAS scores decreased more with ESI-beta than with ESI-dexa at 2 weeks (difference, 0.35; P = 0.023) and 4 weeks (difference, 0.42; P = 0.011). The disability score improved significantly more with ESI-beta compared with ESI-dexa at 2 weeks (difference, 3.37; P = 0.009), 4 weeks (difference, 4.01; P = 0.002), and 8 weeks (difference, 3.54; P = 0.007). Conclusions: Betamethasone would be more appropriate for ESI.
Purpose: Concomitant ankle injuries associated with tibial shaft fractures can affect postoperative ankle joint pain and various postoperative ankle complications. This study compared the clinical outcomes between surgical treatment and conservative treatment of concomitant ankle injuries associated with tibial shaft fractures. Materials and Methods: From January 2015 to June 2020, a retrospective study was conducted on 118 tibia shaft fractures at the orthopedics department of the hospital. Associated ankle injuries were analyzed using plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and intraoperative stress exams. The clinical outcomes were compared using the pain visual analog scale (pain VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score (AOFAS score), and Karlsson-Peterson ankle score (KP score). Results: Seventy-two (61.02%) of the 118 cases were diagnosed with associated ankle injuries. Fifty-six cases underwent surgery for the ankle injury, and 16 cases underwent conservative treatment. The clinical results (according to the pain VAS score, AOFAS score, the KP score) were 1.79±1.26, 94.48±4.03, and 94.57±3.60, respectively, in the surgical treatment group, and 3.00±1.03, 91.06±3.02, and 91.25±3.31, respectively, in the conservative treatment group. Conclusion: Surgical treatment showed better clinical outcomes than conservative treatment in concomitant ankle injury in tibia fractures. Therefore, surgical treatment produces better clinical outcomes than conservative treatment in concomitant ankle injuries in tibia fractures. Hence to improve the clinical outcomes, more attention is needed on ankle joint injury in tibial shaft fractures for selecting suitable surgical treatments for those patients.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.28
no.1
/
pp.9-17
/
2022
Background: Functional massage is a therapeutic massage that incorporates joint motion in non-end-range to reduce pain and improve range of motion (ROM) in patients. This study was aimed at investigating the immediate effect of functional massage on pain, range of motion, balance ability and, gait speed of patients having undergone total hip replacement. Methods: Twenty patients were treated by one participating orthopedic manual physical therapist and randomly assigned to the control group (n=10) or the experimental group (n=10). To treat patients of each group, functional massage and range of motion exercises were used. The experimental group received a functional massage and the control group received range of motion exercise for minutes for one session. The visual analog scale was used for pain assessment. Balance ability was measured using a timed up and go test and a one-leg standing test for patients. The 10-meter walk test was used for the measurement of gait speed assessment of patients. Results: Significant improvements were observed in terms of balance ability (p<.05), gait speed (p<.05), and ROM (p<.05) after functional massage. There was no significant inter-group difference (p>.05). Conclusion: Application of the functional massage showed that statistically significant improvements in ROM, gait speed, and balance ability after a single treatment session. This technique may be a useful treatment in patients having undergone total hip replacement.
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