Robert Hermosillo

Intra-Articular Laser Therapy May Be a Feasible Option in Treating Knee Osteoarthritis in Elderly Patients

Publisher: Hindawi Limited

Date: 22-11-2022

DOI: 10.1155/2022/3683514

Abstract: Knee osteoarthritis (OA) is a common problem in elderly patients. They are often troubled with altered knee function, such as pain and weakness. However, not all these patients are able to receive autologous platelet-rich plasma (PRP) injections as they may be taking antiplatelet or anticoagulant medications. Their physical condition may not allow them to receive total knee replacement surgery as well. Long-term oral intake of nonsteroidal anti-inflammatory drugs may be detrimental to the gastrointestinal tract. As a result, it is crucial to discover new treatment options that can alleviate painful knee symptoms in elderly knee OA patients. In this study, 19 elderly patients diagnosed with moderate degree of knee OA as well as suprapatellar bursitis were recruited. They received low-level laser therapy (LLLT) to their affected knees. Under ultrasound guidance, flexible fiber optic wire was inserted intra-articularly into the knee joint. Red laser followed by infrared irradiation was performed once every 2 weeks for a total of 3 times. The Lequesne index for knee OA and the volume of suprapatellar synovial fluid (SF) were measured. SF proteomic analyses were also performed up to a period of 6 months. The results revealed that after 3 LLLT, the Lequesne index significantly decreased, signifying improvement in the knee joint functional status. The volume of suprapatellar SF and SF proteins associated with inflammation also decreased significantly in the SF. These findings lasted up to a period of at least 3 months. Therefore, LLLT may be considered as a feasible option in treating elderly patients with knee OA who are not suitable for surgical interventions or intra-articular PRP injections.

Mobile sensor application for kinematic detection of the knees

Publisher: Korean Academy of Rehabilitation Medicine

Date: 2015

DOI: 10.5535/ARM.2015.39.4.599

Prolotherapy at Multifidus Muscle versus Mechanical Needling and Sterile Water Injection in Lumbar Spinal Stenosis

Publisher: Informa UK Limited

Date: 07-2023

DOI: 10.2147/JPR.S417444

Intra-Articular Facet Joint Injection of Normal Saline for Chronic Low Back Pain: A Systematic Review and Meta-Analysis

Publisher: MDPI AG

Date: 28-05-2023

DOI: 10.3390/MEDICINA59061038

Abstract: Objective: This systematic review and meta-analysis compared the patient-reported outcomes of intra-articular facet joint injections of normal saline and selected active substances to identify a more effective agent for treating subacute and chronic low back pain (LBP). Methods: The PubMed, Embase, Scopus, Web of Science, and CENTRAL databases were searched for randomized controlled trials and observational studies published in English. A research quality assessment was performed using ROB2 and ROBINS-I. A meta-analysis was conducted using a random-effects model, and the mean differences (MD) with 95% confidence intervals (CI) in efficacy outcomes, including pain, numbness, disability, and quality of life, were assessed. Results: Of the 2467 potential studies, 3 were included (247 patients). The active substances and normal saline had similar therapeutic effects on pain within 1 h, after 1–1.5 months, and after 3–6 months, with MD and 95% CI of 2.43 and −11.61 to 16.50, −0.63 and −7.97 to 6.72, and 1.90 and −16.03 to 19.83, respectively, as well as on the quality of life after 1 and 6 months. Conclusions: The short- and long-term clinical effects of intra-articular facet joint injections of normal saline are comparable to those of other active substances in patients with LBP.

Ultrasound-Guided Needling and Lidocaine Plus Sterile Water Injection in Lumbar Spinal Stenosis

Publisher: Cold Spring Harbor Laboratory

Date: 05-02-2021

DOI: 10.1101/2021.02.03.21251072

Abstract: To study the effect of ultrasound-guided (USG) needling and lidocaine plus sterile water injections in lumbar spinal stenosis (LSS). This retrospective study examined data of LSS patients who received USG lidocaine injection to lumbar facets, medial branches to facet joints, and multifidus muscles with one needle insertion at 4 spinal levels. A total of 213 lumbar spinal stenosis patients—104 patients received USG needling and 1% lidocaine without adrenaline 2 ml plus sterile water 10 ml injection (Group A) and 109 patients received 1% lidocaine without adrenaline 6 ml injection (Group B)—for 4 times, once per week. The VAS of chronic low back pain, radicular pain, claudication, and walking ability of both groups at 3, 6, and 12 months were significantly better than the baseline. Group A reported significantly better chronic low back pain, radicular pain, claudication, and walking ability at 3, 6, and 12 months than Group B. USG needling and 1% lidocaine without adrenaline 2 ml plus sterile water 10 ml injection to lumbar facets, medial branches to facet joints, and multifidus muscles with one needle insertion at 4 spinal levels, once a week for 4 weeks can improve low back pain, radicular pain and gait ability in LSS with long term pain relief at least 12 months. There is evidence of the long-lasting effectiveness of local anesthetic alone for chronic spinal pain on noxious peripheral stimulation, phenotypic changes for neuronal plasticity, and neurotransmitter release responsible for secondary hyperalgesia. USG needling and amount of safety solution as 1% lidocaine without adrenaline 2 ml plus sterile water 10 ml is effective for treating chronic low back pain, radicular pain, and claudication in LSS at least 12 months. These clinical outcomes should be the effects of peripheral and central desensitization. The other possible effect is the mechanical removal of fibrosis and calcification at lumbar facets, medial branches to facet joints, and multifidus muscles.

Effects of repeated injection of 1% lidocaine vs. radial extra-corporeal shock wave therapy for treating myofascial trigger points: a randomized controlled trial

Publisher: Cold Spring Harbor Laboratory

Date: 09-04-2021

DOI: 10.1101/2021.04.04.21254889

Abstract: This study tested the hypothesis that treatment of myofascial trigger points (MTrPs) in the upper trapezius muscle (UTM) with repeated injection of 1% lidocaine results in better alleviation of muscular stiffness and soreness as well as improved metabolism in the hypercontracted MTrP area than treatment with radial extracorporeal shock wave therapy (rESWT). A single-blinded, prospective, randomized controlled trial was conducted on patients suffering from MTrPs in the UTM. Thirty patients were treated with repeated injection of 2 ml of 1% lidocaine (three injections one injection per week). Another 30 patients were treated with rESWT (three treatment sessions one treatment session per week 2000 radial extracorporeal shock waves per treatment session positive energy flux density = 0.10 mJ/mm2). The primary outcome measure was pain severity using the VAS score. The secondary outcome measures included muscle elasticity index, pressure pain threshold and neck disability index. Evaluation was performed at baseline (T1), 15-30 minutes after the first treatment in order to register immediate treatment effects (T2), before the second treatment (i.e., one week after baseline) (T3) and one week after the third treatment (i.e., four weeks after baseline) (T4). There were no statistically significant differences in the primary and secondary outcome measures between the patients in the lidocaine arm and the patients in the rESWT arm at T1 and T4. Within the arms, the mean differences of all outcomes were statistically significant (P 0.001) when comparing the data obtained at T1 with the data obtained at T3 and the data obtained at T4. The results of this pilot study suggest that the use of rESWT in patients with MTrPs in the UTM is safe and leads to reduced pain and improved muscle elasticty, pressure pain threshold and neck disability index, without adverse effects. Larger trials are necessary to verify this. Clinicians should consider rESWT instead of injections of lidocaine in the treatment of MTrPs in the UTM.

Tree induction for diagnosis on movement disorders using gait data

Publisher: IEEE

Date: 2013

DOI: 10.1109/KST.2013.6512786

Ergonomic Recommendations in Ultrasound-Guided Botulinum Neurotoxin Chemodenervation for Spasticity: An International Expert Group Opinion

Publisher: MDPI AG

Date: 31-03-2021

DOI: 10.3390/TOXINS13040249

Abstract: Ultrasound (US)-guided botulinum neurotoxin (BoNT) injections are becoming a mainstay in the treatment of muscle spasticity in upper motor neuron syndromes. As a result, there has been a commensurate increase in US-guided BoNT injection for spasticity training courses. However, many of these courses do not emphasize the importance of ergonomics. This paper aims to highlight the importance of ultrasound ergonomics and presents ergonomic recommendations to optimize US-guided BoNT injection techniques in spasticity management. Expert consensus opinion of 11 physicians (4 different continents representing 8 countries, with an average of 12.6 years of practice using US guidance for BoNT chemodenervation (range 3 to 22 years)). A search using PubMed, College of Physicians and Surgeons of British Columbia database, EMbase was conducted and found no publications relating the importance of ergonomics in US-guided chemodenervation. Therefore, recommendations and consensus discussions were generated from the distribution of a 20-question survey to a panel of 11 ultrasound experts. All 11 surveyed physicians considered ergonomics to be important in reducing physician injury. There was complete agreement that physician positioning was important 91% agreement that patient positioning was important and 82% that ultrasound machine positioning was important. Factors that did not reach our 80% threshold for consensus were further discussed. Four categories were identified as being important when implementing ultrasound ergonomics for BoNT chemodenervation for spasticity workstation, physician, patient and visual ergonomics. Optimizing ergonomics is paramount when performing US-guided BoNT chemodenervation for spasticity management. This includes proper preparation of the workspace and allowing for sufficient pre-injection time to optimally position both the patient and the physician. Lack of awareness of ergonomics for US-guided BoNT chemodenervation for spasticity may lead to suboptimal patient outcomes, increase work-related injuries, and patient discomfort. We propose key elements for optimal positioning of physicians and patients, as well as the optimal setup of the workspace and provide clinical pearls in visual identification of spastic muscles for chemodenervation.

Results of stroke rehabilitation in Thailand

Publisher: Informa UK Limited

Date: 2003

DOI: 10.1080/0963828031000152039

Mechanical Needling with Sterile Water versus Steroids Injection for Facet Joint Syndrome: A Retrospective Observational Study

Publisher: Hindawi Limited

Date: 09-02-2022

DOI: 10.1155/2022/9830766

Abstract: Objective. This present study aimed to explore the clinical effects of ultrasound-guided (USG) mechanical needling with sterile water injection for lumbar facet joint syndrome. Methods. This was a retrospective cohort study that assessed the clinical outcome of ageing patients who received USG mechanical needling with sterile water injection. In addition, the clinical outcome of age- and gender-matched patients randomly selected from patients who received mechanical needling with sterile water was compared to the patients injected with steroids in a 2 : 1 ratio. The data were extracted from the medical records of ageing patients with facet joint syndrome who received USG injection at the lumbosacral spine by the first author. Low back pain or axial pain, and leg pain or radicular pain were assessed by the visual analogue scale (VAS), and gait ability with walking distance was obtained at 6 different time points. Results. A total of 4,276 medical records were examined. Four thousand two hundred twenty-eight ageing patients received needling with sterile water injection and found that the efficacy lasted up to 6 months. Ninety-six patients were compared with 48 patients who received steroid injection. Those who received steroids had less back and leg pain at 1 week after injection however, pain returned at 3 months and 6 months after injection. Conclusions. USG mechanical needling with sterile water could help relieve axial and radicular pain for at least 6 months. Reduced sensitization and removal of calcification and fibrosis were all possible mechanisms.Keywords: Mechanical needling, Sterile water, Ultrasound guided (USG) injection, Facet joint syndrome, Pain

Thermal Oscillation Changes the Liquid-Form Autologous Platelet-Rich Plasma into Paste-Like Form

Publisher: Hindawi Limited

Date: 09-05-2022

DOI: 10.1155/2022/6496382

Abstract: Objectives. The texture of the autologous platelet-rich plasma (PRP) that is used in treating degenerative joint diseases such as knee osteoarthritis (OA) is usually in liquid form. However, the turnover rate of protein metabolism in the knee synovial fluid (SF) is less than one hour. This study examined the feasibility of the thermal oscillation technique in converting the liquid-form PRP into an injectable viscous paste-like PRP that may delay the degradation of PRP and continuously release growth factors in the knee joint for a longer period of time. Methods. This study was conducted in the rehabilitation department of a tertiary hospital. A total of 10 elderly patients with an average age of greater than 65 years and diagnosed with moderate degree of knee OA were recruited. The RegenPRP (RegenLab, Le Mont-sur-Lausanne, Switzerland) test tube chamber was used for PRP generation. A total of 60 milliliters (mL) of blood was drawn from each patient. 10 mL of blood was injected into each PRP test tube chamber. As a result, a total of 6 test tube chambers were obtained and each chamber was centrifuged for 15 minutes. Approximately 5 mL of PRP supernatant (the liquid-form end product) was aspirated and sent for thermal oscillation treatment. Five temperatures were tested: 55, 65, 75, 85, and 95 degrees Celsius. Oscillation was set at 200 revolutions per minute (rpm) for 15 minutes. The enzyme-linked immunosorbent assay (ELISA) was applied in measuring the concentration of platelet-derived growth factor (PDGF) in picogram/milliliter (pg/mL). Repeated measures ANOVA followed by the Bonferroni post hoc test was used to compare the PDGF concentrations between each testing condition. Results. Under 75 degrees Celsius of heating, the resultant paste-like PRP end product had the highest concentration of PDGF in picograms per milliliter (pg/mL) as compared with other heating conditions ( p 0.05 ). The viscosity of the paste-like PRP was measured to be 70,000 centipoise (cP), which is similar to the viscosity of a toothpaste. The paste-like PRP end product was able to release PDGF continuously for about 14 days, with the highest concentration achieved on the 8th day with an average of 35646 ± 2499 pg / mL . In nonthermally treated liquid-form PRP s le, the highest number of PRP was observed on the 4th day with an average value of 8444 ± 831 pg / mL . Under the heating conditions of 55 and 95 degrees Celsius, the highest concentration of PDGF was observed on the 5th day ( 13346 ± 764 pg / mL and 3440 ± 303 pg / mL , respectively). Under the heating conditions of 65 and 85 degrees Celsius, the highest concentration of PDGF was observed on the 7th day ( 15468 ± 744 pg / mL and 20432 ± 1118 pg / mL , respectively). Conclusion. Through thermal oscillation, liquid-form PRP can be converted to paste-like PRP end product with a viscosity similar to that of a toothpaste. The best heating condition was discovered to be 75 degrees Celsius. The paste-like PRP was able to release PDGF continuously for about 2 weeks, with the highest concentration obtained on the 8th day. The findings in this study suggested that paste-like PRP may be a viable option in treating degenerative knee joint diseases.

Development of gait training system with realtime auditory biofeedback for telerehabilitation

Publisher: IEEE

Date: 03-2017

DOI: 10.1109/IEECON.2017.8075902

Effects of aquatic exercise and land-based exercise on postural sway in elderly with knee osteoarthritis

Publisher: Walter de Gruyter GmbH

Date: 10-2010

DOI: 10.2478/ABM-2010-0096

Abstract: Background: Knee Osteoarthritis (knee OA) is the most common joint disease in the elderly. It is a major cause of walking disability and balance impairment. The balance impairment or increase postural sway may result in increased risk of fall. Objectives: Compare effects of aquatic exercise and land-based exercise on postural sway and physical performance (pain, quality of life, leg muscle strength and leg muscle flexibility) in the elderly with knee OA. Subjects and methods: Fifty elderly women with knee OA were recruited for this study. They were randomized into aquatic exercise (n=25) and land-based exercise group (n=25). Postural sway views by anterior-posterior litude, medio-lateral litude, and total area were measured in subjects with eye opened or closed during double and single leg stance after six-week training, using the Force platform. Functional outcome was tested by the modified WOMAC. Knee injury and Osteoarthritis Outcome Score (KOOS), and pain scale were tested by Visual Analog Scale (VAS). Leg muscle strength was measured by chair stand, and leg muscle flexibility was measured by sit-andreach test. Aquatic group exercised at King Chulalongkorn Memorial Hospital therapeutic pool, while landbased group exercised at home. Results: In comparing postural sway before and after exercise, reduction in postural sway and pain, and increase in strength, the aquatic group were significantly better than those for land-based group (p .05). WOMAC, KOOS scores, and sit-and-reach test after six-weeks training were improved after exercise, but these were not significantly different between groups (p .05). Conclusion: Elderly patients with knee OA need exercise to improve balance and reduce sway. Six-week aquatic exercise was better than land-based exercise in sway reduction.

Elastic bandage vs. neoprene thumb stabilizer splint in acute De Quervain's tenosynovitis

Publisher: Walter de Gruyter GmbH

Date: 04-2011

DOI: 10.5372/1905-7415.0502.035

Abstract: Background: De Quervain’s tenosynovitis is a common disease among the patients who performed unaccustomed repetitive movement of the thumb side of the wrist. A neoprene thumb stabilizer splint is often used to restrict thumb movement. However, because of its cost, usage of an elastic bandage made of cheaper materials is proposed. Objective: Compare the effectiveness between the elastic bandage and the neoprene thumb stabilizer splint in acute De Quervain’s tenosynovitis. Methods: Forty participants with acute De Quervain’s tenosynovitis were ided into two groups (20 participants each). The first group used the elastic bandage, and the second group used the neoprene thumb stabilizer splint. Visual Analog Scale (VAS) pain, lateral and palmar pinch strength were measured before and after using the bandage and the splint for one or two weeks. Results: The average ages in the bandage and the splint group were 53.15±10.42 and 48±11.7 years, respectively. The VAS pain score of the bandage and splint group over week 0, 1, and 2 were 58.50, 33.90 and 19.55, and 51.60, 35.85 and 25.20, respectively. The bandage and splint group had the lateral pinch strength over the time of 9.40, 10.70 and 11.25 lbs, and 8.90, 9.88 and 10.57 lbs, respectively. Furthermore, they had the palmar pinch strength of 3.63, 4.68 and 5.28 lbs, and 3.07, 3.92 and 4.29 lbs, respectively. Conclusion: The pain and strength were not significantly different between the bandage and the splint group in acute De Quervain tenosynovitis. Using the bandage may be more cost-effectiveness than using the splint.

ANTERIOR OR POSTERIOR ANKLE FOOT ORTHOSES FOR ANKLE SPASTICITY: WHICH ONE IS BETTER?

Publisher: Cold Spring Harbor Laboratory

Date: 05-03-2021

DOI: 10.1101/2021.03.02.21251574

Abstract: Ankle foot orthoses ( AFOs) have been widely used in stroke patients to assist in safe, energy efficient walking. Since they provide mediolateral ankle stability during stance, adequate toes clearance during swing phase and also facilitation of heel strike. To compare the efficacy of anterior or posterior plastic ankle foot orthoses (AFOs) for ankle spasticity. Crossover design with randomization for the interventions, blinded assessors was used. 20 patients with chronic stroke, Modified Ashworth scale (MAS) of ankle ≤ 2 and Tardieu angle ≥ 20 degrees. The participants were random to treat with anterior or posterior plastic AFOs and then were crossover to treat with the other one. Outcomes measurement was performed by using passive range of motion (PROM), MAS, walking velocity, stretch reflex surface EMG and walking surface EMG of medial gastrocnemius muscle. Patient satisfaction was evaluated at 1 month. Twenty stroke patients with ankle spasticity were recruited. Mean age was 46.60(38-60) years old.Mean duration. of times since stroke was 9.35 (6-15) months. Comparison between two types of orthoses revealed statistically significant improvement of walking surface EMG of medial gastrocnemius muscles when using anterior plastic AFO more than posterior plastic AFO at p=0.015. Patients satisfaction were statistically significant higher when using anterior plastic AFO more than posterior plastic AFO at p .05. Anterior plastic AFO has more efficacy in reduced dynamic ankle spasticity during walking than posterior plastic AFO proven by comparison the dynamic electromyography changes in dynamic spasticity during walking.

Effects of Repeated Injection of 1% Lidocaine vs. Radial Extracorporeal Shock Wave Therapy for Treating Myofascial Trigger Points: A Randomized Controlled Trial

Publisher: MDPI AG

Date: 26-03-2022

DOI: 10.3390/MEDICINA58040479

Abstract: Background and Objectives: This study tested the hypothesis that treatment of myofascial trigger points (MTrPs) in the upper trapezius muscle (UTM) with repeated injection of 1% lidocaine results in better alleviation of muscular stiffness and soreness as well as improved metabolism in the hypercontracted MTrP area than treatment with radial extracorporeal shock wave therapy (rESWT). Materials and Methods: A single-blinded, prospective, randomized controlled trial was conducted on patients suffering from MTrPs in the UTM. Thirty patients were treated with repeated injection of 2 mL of 1% lidocaine (three injections one injection per week). Another 30 patients were treated with rESWT (three treatment sessions one treatment session per week 2000 radial extracorporeal shock waves per treatment session positive energy flux density = 0.10 mJ/mm2). The primary outcome measure was pain severity using the VAS score. The secondary outcome measures included muscle elasticity index, pressure pain threshold and neck disability index. Evaluation was performed at baseline (T1), 15–30 min after the first treatment in order to register immediate treatment effects (T2), before the second treatment (i.e., one week after baseline) (T3) and one week after the third treatment (i.e., four weeks after baseline) (T4). Results: There were no statistically significant differences in the primary and secondary outcome measures between the patients in the lidocaine arm and the patients in the rESWT arm at T1 and T4. Within the arms, the mean differences of all outcomes were statistically significant (p 0.001) when comparing the data obtained at T1 with the data obtained at T3 and the data obtained at T4. Conclusions: The results of this pilot study suggest that the use of rESWT in patients with MTrPs in the UTM is safe and leads to reduced pain and improved muscle elasticity, pressure pain threshold and neck disability index, without adverse effects. Larger trials are necessary to verify this. Clinicians should consider rESWT instead of injections of lidocaine in the treatment of MTrPs in the UTM.

Anterior or Posterior Ankle Foot Orthoses for Ankle Spasticity: Which One Is Better?

Publisher: MDPI AG

Date: 28-03-2022

DOI: 10.3390/BRAINSCI12040454

Abstract: Background and Objectives: Ankle foot orthoses (AFOs) are commonly used by stroke patients to walk safely and efficiently. Both posterior AFOs (PAFOs) and anterior AFOs (AAFOs) are available. The objective of this study was to compare the efficacy of AAFOs and PAFOs in the treatment of ankle spasticity. Materials and Methods: A crossover design with randomization for the interventions and blinded assessors was used. Twenty patients with chronic stroke, a Modified Ashworth Scale (MAS) score of the ankle joint of 2, and a Tardieu angle ≥20 degrees were recruited. The patients were assigned to wear either an AAFO or PAFO at random and subsequently crossover to the other AFO. Results: Twenty stroke patients with ankle spasticity were recruited. The mean age was 46.60 (38–60) years. The mean time since stroke onset was 9.35 (6–15) months. It was discovered that the AAFO improved walking speed as well as the stretch reflex dynamic electromyography (dEMG) and walking dEMG litudes of the medial gastrocnemius muscles more significantly than the PAFO (p 0.05). Conclusions: The AAFO had greater efficacy in reducing both static and dynamic ankle spasticity, and allowed for faster walking than the PAFO. The stretch reflex and walking dEMG litudes could be used for quantitative spasticity assessment.

Nonoperative treatment for pain sensitization in patients with low back pain: protocol for a systematic review

Publisher: Springer Science and Business Media LLC

Date: 04-04-2022

DOI: 10.1186/S13643-022-01927-2

Abstract: Low back pain is a disability that occurs worldwide. It is a heterogeneous disorder that affects patients with dominant nociceptive, neuropathic, and central sensitization pain. An important pathophysiology of low back pain involves pain sensitization. Various nonoperative interventions are available for treatment, but there is inconclusive evidence on the effectiveness of these interventions for pain sensitization, leading to arbitrary nonoperative treatments for low back pain. We will conduct a systematic review of RCTs evaluating the effectiveness and safety of nonoperative treatment for pain sensitization in patients with low back pain. The primary outcomes will be static quantitative sensory testing, dynamic quantitative sensory testing, and pain algometry. The secondary outcome will be adverse events. We will search the PubMed, Embase, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Library databases. Two independent authors will screen the titles and abstracts, review full texts, extract data, assess the risk of bias, and evaluate the quality of evidence. We will qualitatively and quantitatively synthesize the results using a random effects model for meta-analysis. This systematic review aims to provide evidence regarding which treatment, if any, provides the greatest benefit for pain sensitization and safety among patients with low back pain. Evidence synthesized from this systematic review will inform clinical practice and further research. Since there is still a small amount of research, additional studies might need to be conducted in the future. Submitted to PROSPERO on March 20, 2021, CRD42021244054

The Change in Body Positioning to Improve Safety in Performing Ultrasound-Guided Supraclavicular Brachial Plexus Nerve Block

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 12-07-2020

DOI: 10.1097/PHM.0000000000001527

The study of cueing devices by using visual, auditory and somatosensory stimuli for improving gait in Parkinson patients

Publisher: IEEE

Date: 2010

DOI: 10.1109/ICBBT.2010.5478983

Local botulinum toxin type A injections in the treatment of spastic toes

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 10-2002

DOI: 10.1097/00002060-200210000-00009

Mechanical Needling With Sterile Water Versus Lidocaine Injection for Lumbar Spinal Stenosis

Publisher: SAGE Publications

Date: 04-05-2022

DOI: 10.1177/21925682221094533

Abstract: Study Design: This was a retrospective observational study that assessed the clinical outcome of ageing patients who received ultrasound-guided (USG) mechanical needling with sterile water injection. In addition, the clinical outcome of age-and gender matched patients randomly selected from patients who received needling with sterile water was compared to the patients injected with lidocaine in a 1:1 ratio. Objective: This present study aimed to explore the clinical effects of USG mechanical needling with sterile water injection for lumbar spinal stenosis (LSS). Methods: The data was extracted from the medical records of ageing patients with LSS who received USG injection at the lumbosacral spine by the first author. Low back pain or axial pain, and leg pain or radicular pain were assessed by the visual analogue scale, and gait ability with walking distance were obtained at six different time points. Results: A total of 4328 medical records were examined. Four thousand two hundred and twenty-eight ageing patients received mechanical needling with sterile water injection and found the efficacy lasted up to 6 months. One hundred patients were compared with 100 patients who received lidocaine injection. Those who received lidocaine had pain returned at 3 months and 6 months post-injection. Conclusions: USG mechanical needling with sterile water injection could help relieve axial and radicular pain for at least 6 months. Removal of calcification and fibrosis as well as reduction of sensitization are all possible mechanisms.

Ultrasound-guided Medial Branch Blocks, Facet Joint, and Multifidus Muscle Injections

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 03-2020

DOI: 10.1097/ALN.0000000000003043

Abstract: Supplemental Digital Content is available in the text.

Effects of Thai traditional dance on balance performance in daily life among older women

Publisher: Springer Science and Business Media LLC

Date: 08-10-2019

DOI: 10.1007/S40520-018-1040-8

Abstract: Previous research indicates that dance training may improve balance among older adults. This study investigated the effects of Thai traditional dance on balance performance among older women. Forty-three women aged 60-80 years, with mean scores between 45 and 52 points on the Berg Balance Scale (BBS), were recruited and randomly assigned into two groups: a Thai traditional dance group (TTDG) (n = 22) and a control group (CG) (n = 21). TTD program comprised three dance sessions of 30-60 min per week over the course of 12 weeks while the CG kept their normal daily activities. Balance performance was assessed using standardized tests including the NeuroCom Balance Master The results revealed that overall balance was better for those in TTDG compared to the CG. There was a significantly lower sway velocity and faster weight transfer in the Sit-to-Stand Test (p ≤ 0.001) for those in the dance group. TTDG had quicker turn time in the Step Quick Turn Test (p ≤ 0.001), improved Step Up Over Test and Walk Across Test, faster movement time, walking speed, and a better score in the TUG after training (p ≤ 0.001). A 3-weekly Thai traditional dance intervention significantly improved balance and mobility among older community-dwelling women as compared to normal daily activities. Thai traditional dance could potentially prevent age-related mobility and balance decline and its related fall risk.

New sources and instrumentation for neutrons in biology

Publisher: Elsevier BV

Date: 04-2008

DOI: 10.1016/J.CHEMPHYS.2008.02.030

The therapeutic effect of intra-articular facet joint injection with normal saline as a comparator for chronic low back pain: a systematic review and meta-analysis

Publisher: Cold Spring Harbor Laboratory

Date: 29-01-2021

DOI: 10.1101/2021.01.27.21250595

Abstract: Intra-articular facet joint injection (FJI) has been increasingly used as a treatment for chronic low back pain (LBP). Choice of the substance has been based on clinical experience with unclear evidence on marginal effectiveness of active substance over normal saline as a placebo control. This systematic review investigates the comparative effectiveness between normal saline and active substances on patient-reported outcomes (PROs). Systematic search was conducted in five databases: PubMed, Embase, Scopus, Web of Science, and CENTRAL for randomized controlled trials and observational studies of evaluating the PROs of FJI comparing active injected substances with normal saline as placebo in chronic LBP patients in the English language without publication date restriction. Quality assessment was performed using ROB2 and ROBINS-I. The meta-analysis was done using a random-effects model. Mean difference with 95% CIs of efficacy outcomes including pain, numbness, disability, quality of life were measured. Of 2,467 potential studies, three were included in the systematic review and meta-analysis (247 patients). Compared to other active substances, normal saline provided similar therapeutic effects on pain outcome within one hour (MD 2.43, 95% CI –11.61 to 16.50), at 1–1.5 months follow up (MD –0.63, 95% CI –7.97 to 6.72), and at 3 to 6 months (MD 1.90, 95% CI –16.03 to 19.83) as well as the quality of life at one and six months follow-up. The short-term and long-term clinical improvements of intra-articular FJI using normal saline are comparable to the other active substances in LBP patients. registration number CRD42020216426

<p>Effectiveness of robotics fall prevention program among elderly in senior housings, Bangkok, Thailand: a quasi-experimental study</p>

Publisher: Informa UK Limited

Date: 02-2019

DOI: 10.2147/CIA.S182336

The Efficacy of a Newly Developed Cueing Device for Gait Mobility in Parkinson’s Disease

Publisher: Hindawi Limited

Date: 18-05-2022

DOI: 10.1155/2022/7360414

Abstract: Background. External cues are effective in improving gait in people with Parkinson’s disease (PD). However, the most effective cueing method has yet to be determined. Objective. The aim of this study was to compare the immediate effects of using visual, auditory, or somatosensory cues on their own or in combination during walking compared to no cues in people with PD. Methods. This was a single blinded, randomly selected, controlled study. Twenty people with PD with an age range of 46–79 years and Hoehn and Yahr scores of 1–3 were recruited. Participants were studied under 4 cueing conditions no cue, visual, auditory, or somatosensory cues, which were randomly selected in idually or in a combination. Results. A repeated measures ANOVA with pairwise comparisons using Bonferroni correction showed that any single or combination of the cues resulted in an improvement in gait velocity and stride length compared to no cue. Some significant differences were also seen when comparing different combinations of cues, specifically stride length showed significant improvements when additional cues were added to the light cue. The statistically significant difference was set at p 0.05 . Conclusions. Walking using visual, auditory, or somatosensory cues can immediately improve gait mobility in people with PD. Any or a combination of the cues tested could be chosen depending on the ability of the in idual to use that cue.

Intra-Articular Leukocyte-Rich Platelet-Rich Plasma versus Intra-Articular Hyaluronic Acid in the Treatment of Knee Osteoarthritis: A Meta-Analysis of 14 Randomized Controlled Trials

Publisher: MDPI AG

Date: 07-08-2022

DOI: 10.3390/PH15080974

Abstract: (1) Background: To evaluate the clinical effects of leukocyte-rich platelet-rich plasma (LR-PRP) and hyaluronic acid (HA) injections in treating patients suffering from knee osteoarthritis (OA) (2) Methods: Randomized controlled trials (RCTs) were searched from PubMed, Web of Science, and Cochrane Library. Keywords were: platelet-rich plasma, LR-PRP, leukocyte-rich, hyaluronic acid, and knee osteoarthritis. The included RCTs were published between the 1st of November 2011 and the 3rd of February 2021. Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, visual analog scale (VAS) scores, International Knee Documentation Committee (IKDC) scores, and adverse events were used as outcomes for evaluation (3) Results: A total of 14 RCTs were enrolled. At 6 months, revealed that the LR-PRP group was better than the HA group in WOMAC total, pain, and physical function scores. At 12 months, the LR-PRP group was better than the HA group in WOMAC stiffness and physical function scores. There was no significant difference in adverse events (4) Conclusion: LR-PRP injection showed no significant pain relief effect as compared with HA injection. However, LR-PRP demonstrated better overall outcomes as compared to HA in knee OA patients at the follow-up periods of 3, 6, and 12 months. LR-PRP injection may be recommended as a feasible option in treating patients with knee OA.

Baseline brain function in the preadolescents of the ABCD Study

Publisher: Springer Science and Business Media LLC

Date: 07-06-2021

DOI: 10.1038/S41593-021-00867-9

Ultrasound-Guided Lumbar Spine Medial Branch Blocks for the Treatment of Low Back Pain

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 15-09-2020

DOI: 10.1097/PHM.0000000000001591

Managing spasticity in pediatric cerebral palsy using a very low dose of botulinum toxin type A: Preliminary report

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 07-2000

DOI: 10.1097/00002060-200007000-00002

Abstract: To determine if very low doses of botulinum toxin type A (BTX-A) could reduce spasticity and improve gait in cerebral palsied children when combined with rehabilitation therapy. Ten trainable (IQ > 80), ambulatory, spastic diplegic or hemiplegic cerebral palsied children, with no fixed contractures in at least one limb, were selected for the study. Patients with a score of 3 on a modified Ashworth scale received 0.5 units of BTX-A/kg/muscle. Patients with an Ashworth score of 4 received 1.0 BTX-A/kg/muscle. After BTX-A injection, all patients received rehabilitation therapy and plastic ankle and foot orthoses for walking. Both groups exhibited improvement in Ashworth score and in gait within 72 hr of injection with botulinum toxin. Beneficial effects persisted for 10 to 12 mo in most patients, with three patients exhibiting benefits for at least 20 mo. The results of the present study indicate that a very low dose of botulinum toxin type A combined with'rehabilitation therapy resulted in a long-lasting decrease in spasticity and an improvement in gait in children with cerebral palsy.

Oregon Health & Science University

Location: United States of America

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University Of Minnesota

Location: United States of America

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Mount Sinai Hospital

Location: United States of America

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Harvard Medical School

Location: United States of America

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European Accreditation Council For Continuing Medical Education (EACCME) And International Neurotoxin Association (INA)

Location: Denmark

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Colorado Neurological Institute

Location: United States of America

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Chulalongkorn University Faculty Of Medicine

Location: Thailand

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Australian Institute Of Ultrasound (AIU)

Location: Australia

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World Institute Of Pain (WIP)

Location: Hungary

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World Academy Of Pain Management Ultrasonography ( WAPMU)

Location: United States of America

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Toxin Academy Of International Society Of Neurology And Rehabilitation Medicine

Location: Switzerland

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The Association Of Radial Pain Therapy, Switzerland

Location: Switzerland

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Tahoe Center For Orthopedics And Barton University Endorsed By American Academy Of Physical Medicine And Rehabilitation (AAPMR) And American College Of Sports Medicine

Location: United States of America

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