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1.
Roya Eshaghi Moghadam Leila Rahnama Noureddin Karimi Mohsen Amiri Mahsa Rahnama 《Journal of bodywork and movement therapies》2018,22(3):643-647
Background
As one of the most common work-related musculoskeletal disorders and postural deviations, forward head posture (FHP), is considered to lead to muscle imbalance.Objectives
The aim of this study is to investigate the bilateral cross-sectional area (CSA) of the deep neck flexor muscles at rest and during five stages of the craniocervical flexion (CCF) test in individuals with FHP and the controls with normal head posture.Methods
Eighteen students with FHP and 18 controls with normal head posture, all females aged 18–35 years, participated in this study. Participants were categorized into two groups based on their craniovertebral angle. The CSA of the deep neck flexors was measured using ultrasonography while participants lay supine on the table with a pressure biofeedback unit placed under their necks in order to let the examiner measure the CSA of the muscles during rest and five stages of the CCF test including 22, 24, 26, 28, and 30 mmHg of the pressure biofeedback unit.Results
A significant effect of contraction level was observed in both groups, indicating significant increases of the CSA of the deep neck flexors during contraction (F = 64.37, P < 0.001). No significant difference was evident for the CSA of the deep neck flexors between the groups, although the increase in the CSA of the deep neck flexors was up to 28 mmHg in the normal head posture group compared to 26 mmHg in the FHP group.Conclusions
The results of the present study showed no significant difference between the performance of the deep neck flexors during the CCF test in FHP and normal head posture individuals, which challenge the common belief of the deep neck flexors weakness in individuals sustaining FHP. 相似文献2.
Muhammad Nazim Farooq Mohammad A. Mohseni-Bandpei Syed Amir Gilani Muhammad Ashfaq Qamar Mahmood 《Journal of bodywork and movement therapies》2018,22(1):24-31
Objective
To determine the effect of mobilization and routine physiotherapy on pain, disability, neck range of motion (ROM) and neck muscle endurance (NME) in patients having chronic mechanical neck pain (NP).Methods
Sixty eight patients with chronic mechanical NP were randomly allocated into two groups by using a computer generated random sequence table with 34 patients in the multi-modal mobilization group and 34 patients in the routine physiotherapy group. Baseline values for pain, disability, NME, and neck ROM were recorded using visual analogue scale (VAS), neck disability index (NDI), neck flexor muscle endurance test and universal goniometer respectively, before the treatment. Each patient received 10 treatment sessions over a period of four weeks and at the end of four weeks all the outcome measures were recorded again.Results
A paired t-test revealed significant pre to post treatment differences for all outcome measures in both groups (p ≤ 0.001 in all instances). An independent t-test revealed statistically significant differences for pain, disability, NME, and neck ROM in favor of the multi-modal mobilization group with a between group difference of 1.57 cm for VAS (p < 0.001), 11.74 points for NDI (p = 0.001), 18.45 s for NME (p < 0.001) and 6.06–8.24° for neck ROM (p < 0.05).Conclusion
The results suggest that a combination of cervical mobilization with routine physiotherapy is more effective for reducing pain and disability and improving NME and neck ROM in patients with chronic mechanical NP compared to routine physiotherapy alone. 相似文献3.
Arsalan Ghourbanpour Ghadam Ali Talebi Somayeh Hosseinzadeh Naser Janmohammadi Mohammad Taghipour 《Journal of bodywork and movement therapies》2018,22(2):493-497
Question
What are the effects of patellar taping on pain, functional disability and patellar alignments in Patellofemoral Pain Syndrome (PFPS)?Design
Double-blind randomized clinical trial.Participants
Thirty PFPS Patients were randomly divided into two groups, intervention and control.Intervention: Patients in control group received only the routine physiotherapy. In addition to routine physiotherapy, patellar taping was used in the intervention group. Each patient was treated for 12 sessions over a period of 4 weeks.Outcome measures
The KOOS and VAS questionnaires were used to assess the quality of life (QOL) and pain intensity, respectively. Three components of patellar alignment including Patellofemoral Congruence Angle (PFCA), Lateral Patellofemoral Angle (LPFA) and Lateral Patellar Displacement (LPD) were evaluated using the skyline radiography method.Results
The results indicated that there was no significant difference between the control and intervention groups for LPD (P = 0.586), PFCA (P = 0.704) and LPFA (P = 0.176) variables. No significant difference was found between the two groups in all items of the KOOS questionnaire. The knee pain intensity was significantly reduced in both the intervention (P < 0.001) and control (P = 0.001) groups at the end of the 4th week.Conclusion
The results of the present study indicated that patellar taping compared to routine physiotherapy treatments had no beneficial effects on pain reduction, QOL improvement and correction of patellar alignment in PSPS patients.Trial registration
IRCT201111012851N2. 相似文献4.
Yang Liu Xinxing Zhang Yuqing Wang Canhong Zhu Mingyue Fan Xunwu Dou Chuangli Hao Yongdong Yan Wei Ji Guixiong Gu Jiangyan Lou Zhengrong Chen 《Journal of infection and chemotherapy》2018,24(10):789-794
Background
Inappropriate inflammatory response in children with M. pneumoniae infection might be associated with disease severity. The role of Granulocyte macrophage colony stimulating factor (GM-CSF) in hospitalized children with Mycoplasma pneumoniae pneumonia (MPP) has not been fully discussed.Methods
Clinical and laboratory data of a total 40 children with MPP were collected. GM-CSF and myeloperoxidase (MPO) were detected by ELISAs. Meanwhile, normal human bronchial epithelium was infected by M. pneumoniae and neutrophils were stimulated by GM-CSF to explore GM-CSF and MPO release in supernatant, respectively.Results
Compared to control group, a significant increased percentage of neutrophils and decreased percentage of macrophages in bronchoalveolar lavage fluid of children with MPP was observed (P < 0.05). Children with MPP had significantly higher levels of GM-CSF (P = 0.0047) and MPO (P = 0.0002) in BALF compared to the controls. Level of GM-CSF in BALF was associated with duration of fever (r = 0.42, P = 0.007) and strongly correlated with level of MPO (r = 0.075, P = 0.0005). Levels of GM-CSF and MPO significantly decreased (both P < 0.05) after treatment. In vitro, M. pneumoniae induced GM-CSF expression in a time-dependent manner during a 72-h period (P < 0.05) and MPO secretion significantly increased by recombinant human GM-CSF stimulation at 24h (P < 0.05).Conclusion
GM-CSF could be induced by M. pneumoniae infection in vivo and vitro. Childen with high level GM-CSF had longer duration of fever. GM-CSF probably plays a vital role in neutrophil inflammation in M. pneumoniae infection. 相似文献5.
Background
Neck pain is a common musculoskeletal complaint in computer users due to prolonged static or awkward work postures. It has been shown that pathogenesis of neck pain is associated with scapular movement impairment syndromes. However, there is a dearth of literature in treatment based on these syndromes.Aim
To identify the effects of movement impairment-based treatment in the management of mechanical neck pain, in computer users.Methods
In the present study, twenty-seven subjects were recruited. Based on the identified scapular impairment syndrome, they were trained with scapular movement impairment-based exercises for four weeks. Pain, disability and cervical range of motion were measured with numeric pain rating scale, neck disability index and inclinometer, respectively, at baseline and at four weeks.Results
Twenty-one subjects completed the study. After four weeks, a significant difference of 4.81 points for numeric pain rating scale and 24.47% for neck disability index at 95% CI were found. The cervical range of motion showed a significant change (p < 0.05) of 10.09° for flexion, 24.47° for extension, 7.42° for right lateral flexion, 6.23° for left lateral flexion, 15.52° for right rotation and 14.95° for left rotation at 95% CI.Conclusions
Exercises based on scapular impairment syndromes were given for four weeks. It was found to be effective in relieving pain and reducing dysfunction in computer users with mechanical neck pain 相似文献6.
Zohreh Khosrokiani Amir Letafatkar Yahya Sokhanguei 《Journal of bodywork and movement therapies》2018,22(1):217-224
Background
Treatment of movement faults in the neck is known as an important factor in treatment of chronic neck pain. Along with the identification of site and direction of the faults, direction-movement control intervention retrains the control of the movement faults.Purpose
This study was designed to investigate long-term effects of a direction-movement control training on pain, disability, head repositioning accuracy, function, cervical flexor endurance, and range of motion in female patients with chronic nonspecific neck pain.Material and methods
Thirty women (36.5 ± 5.7 years) with chronic nonspecific neck pain were randomly allocated into two groups, i.e., an experimental group (n = 15) and a control group (n = 15). The experimental group performed the direction-movement control training for 30 min/day, three days per week for six months.All subjects were evaluated using the visual analog scale (VAS), range of motion (TOM), progressive iso-inertial lifting evaluation (PILE), neck disability Index (NDI), helmet attached with laser pointer using for head repositioning accuracy (HRA), and Trott's test (deep neck flexor endurance), in pre- and six-months post-treatment intervention.Results
Significant differences were observed for the pain, neck disability Index, function endurance, head repositioning accuracy, range of motion, and cervical flexor endurance in the experimental group compared to that of control group.Conclusion
Direction-movement control training is likely to be an effective training program to enhance body functionality through improvement of pain, function, endurance, head repositioning accuracy, range of motion, and cervical flexor endurance. Due to the high reported effect size for direction-movement control exercises, the application of the training is suggested as a supplementary method to improve chronic nonspecific neck pain in females. 相似文献7.
Paulo Fernandes Pires Delaine Rodrigues-Bigaton 《Journal of bodywork and movement therapies》2018,22(3):720-726
Background
Surface electromyography (EMG) has been used as a reliable tool for the evaluation of electrical muscle activity.Objective
The purpose of this study was to evaluate the EMG indices of the masticatory muscles (masseter, anterior temporalis and suprahyoid) in women with temporomandibular disorder (TMD) and asymptomatic controls in the time domain, by the integrated EMG signal (IEMG) and in the frequency domain, using the median power frequency (MPF).Methods
An observational, cross-sectional study was conducted involving 30 asymptomatic women as the control (mean age: 25.85 ± 2.57 years) and 74 women with myogenous TMD (mean age: 26.54 ± 2.45 years) diagnosed using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Three EMG readings were taken during maximum voluntary clenching (MVC) of the molars on parafilm for five seconds with a three-minute rest interval between readings. The mixed-model analysis of variance test followed by the Bonferroni correction or the Student-t test was used for the analyses, with the level of significance set to 5% (p < 0.05).Results
IEMG values were significantly higher in the masseter muscles than the anterior temporalis muscles in the control group (p < 0.01). IEMG values were significantly higher in the masseter muscles of the control group than the group with myogenous TMD (p < 0.05). MPF values of the suprahyoid muscles were significantly higher in the myogenous TMD group than the control group.Conclusions
These significant findings show that women with myogenous TMD have reduction of electrical activity of their masseter muscles and increased firing rate of the motor units of the suprahyoid muscles. These findings may help the treatment of myogenous TMD in women. 相似文献8.
Maryam Hayati Saeed Talebian Catherine Sherrington Hassan Ashayeri Behrouz Attarbashi Moghadam 《Journal of bodywork and movement therapies》2018,22(2):361-365
Introduction
The separate and combined impacts of age and walkway obstruction on reaction time, anticipatory postural adjustment phases of gait initiation and cognitive dual task performance are not well understood. This study aimed to a) examine the impact of age and task complexity on reaction and anticipatory postural adjustment phases separately b) examine the impact of age and walkway obstruction on cognitive task performance while walking.Method
Nineteen older adults (mean age± SD: 66.73 ± 3.38 years) and twelve younger adults (mean age± SD: 26.5 ± 4.37 years), participated in this study. The tests were performed in four conditions: a smooth walkway; a smooth walkway with concurrent cognitive task; an obstructed walkway; and an obstructed walkway with a concurrent cognitive task. Reaction and anticipatory postural adjustment phases were measured from the recorded center of pressure trajectory data.Results
Reaction time phase was significantly longer in the older group (P = 0.04), but there was no significant impact of task complexity (P = 0.95). Conversely, there was a significant impact of task complexity on anticipatory postural adjustment phase (P = 0.04), but there was no significant difference between the age groups (P = 0.38). Cognitive task response time was not significantly different between age groups or with walkway obstruction (P = 0.19 and P = 0.90 respectively).There were no significant interactions between age group and task complexity.Conclusion
Reaction time phase but not anticipatory postural adjustment phase was longer in healthy older than younger adults. Anticipatory postural adjustment phase but not reaction time phase was slower for more complex gait initiation tasks. Cognitive task performance was similar across age groups and conditions. 相似文献9.
Sabrina Eun Kyung Lee Claudio Andre Barbosa de Lira Viviane Louise Andree Nouailhetas Rodrigo Luiz Vancini Marilia Santos Andrade 《Journal of bodywork and movement therapies》2018,22(2):430-437
Introduction
Several studies have been developed to determine which type of muscular action (isometric, isotonic and isokinetic) elicits more gains in functional strength and muscle mass. The comparisons between training outcomes are inconclusive due to lack of exercise standardization.Objective
To compare muscle strength, mass, and functional performance in response to isometric, isotonic, and isokinetic contractions, when training loads (volume and intensity) are equated.Method
Data were derived from a university community-recruited sample (n = 31 men).Interventions
Untrained men were assigned to isotonic (IT), isometric (IM), or isokinetic (IK) group, and trained their dominant quadriceps muscle 3 sessions/week for 8 weeks with a dynamometer. Muscle strength was assessed using Cybex 6000 dynamometer; the triple-hop-distance test was used to assess functional performance, and dual energy x-ray absorptiometry to assess lean muscle mass.Results
After training, muscle lean muscle mass increased in isometric (+3.1%, p < 0.01) and isotonic groups (+3.9%, p < 0.01); only the isokinetic group showed a significant improvement in the triple-hop-distance test (4.84%, p < 0.01).Conclusion
Clinicians should consider isometric training as an alternative for isotonic training to gain muscle mass, and isokinetic training to improve functional performance of daily activities and/or sports. 相似文献10.
Najmeh Sedighimehr Farideh Dehghan Manshadi Nasim Shokouhi Alireza Akbarzadeh Baghban 《Journal of bodywork and movement therapies》2018,22(1):92-96
Aim
This study aimed to compare the prevalence of pelvic musculoskeletal dysfunctions in women with and without Chronic Pelvic Pain (CPP).Materials &Methods
A total of 84 women with and without CPP (42 in each group), participated in this cross-sectional analytical study. After collecting demographic information, clinical examinations were carried out to compare pelvic musculoskeletal dysfunctions between two groups. Kolmogorov-Smirnov (K-S) goodness-of-fit, Independent t, X2 and Pearson correlation tests were used for data analysis. Values of p < 0.05 were considered statistically significant.Findings
Significant differences were found in the asymmetric iliac crest and pubic symphysis height (45.2% vs 9.5%), positive sacroiliac provocation and positive Carnett's tests (50% vs 4.8%), (p < 0.05). CPP Patients exhibited more tenderness at Levator ani, Piriformis, and Obturator Internus muscles, also higher degrees of pelvic inclination (p < 0.05).Conclusion
Higher frequency of pelvic musculoskeletal dysfunctions in women with CPP suggests the value of routine musculoskeletal examinations for earlier diagnosis of musculoskeletal originated CPP and effective management of these patients. 相似文献11.
Sergio R. Thomaz Felipe A. Teixeira Alexandra C.G.B. de Lima Gerson Cipriano Júnior Magno F. Formiga Lawrence Patrick Cahalin 《Journal of bodywork and movement therapies》2018,22(2):293-299
Background
Heart Failure (HF) patients usually present with increased arterial resistance and reduced blood pressure (BP) leading to an impaired functional capacity. Osteopathic Manual Therapy (OMT) focused on myofascial release techniques (MRT) and in the balancing of diaphragmatic tensions, has been shown to improve blood flow in individuals using the resistive index (RI). However, its effects in HF patients have not been examined.Purpose
To evaluate the acute response of selected osteopathic techniques on RI, heart rate (HR), and BP in patients with HF.Methods
Randomized-controlled clinical trial of HF patients assigned to MRT (six different techniques with three aimed at the pelvis, two at the thorax, and one at the neck for 15 min) or Control group (subjects in supine position for 15 min without intervention). The RI of the femoral, brachial and carotid arteries was measured via doppler ultrasound while HR and BP were measured via sphygmomanometry before and after a single MRT or control intervention.Results
Twenty-two HF patients equally distributed (50% male, mean age 53 years; range 32–69 years) (ejection fraction = 35.6%, VO2peak: 12.9 mL/kg?1 min?1) were evaluated. We found no intra or inter group differences in RI of the carotid (ΔMRT: 0.07% vs Δ Control:11.8%), brachial (ΔMRT:0.17% vs ΔControl: 2.9%), or femoral arteries (ΔMRT:1.65% vs ΔControl: 0.97%) (P > 0.05) and no difference in HR or BP (ΔMRT:0.6% vs ΔControl: 3%), (P > 0.05).Conclusion
A single MRT session did not significantly change the RI, HR, or BP of HF patients. 相似文献12.
Study design
Randomized controlled trial.Objectives
To improve hip function by an additional targeted mobilization and strength training of the hip muscles within the first postoperative week following a total hip arthroplasty (THA) in contrast to standard physiotherapy.Background
The aim of early postoperative physiotherapy is to improve the functioning of the artificial hip joint as well as the restoration of mobility and independence of the patient. Minimally invasive surgical techniques allow early mobilization with immediate full weight-bearing.Methods
39 patients were divided into an intervention (IG) and control group (CG). After implantation of THA the CG completed standard physiotherapy, while the IG had an intensified active treatment with additional mobilization and strength training. Passive range of motion (flexion, extension, abduction), thigh circumference, holding force of the gluteal muscles, one-leg stance, covered distance walked in 6-min and subjective parameters were tested one day before and six days after surgery.Results
Improvements in IG compared to CG were recorded in range of motion (flexion p < 0.01, extension p < 0.001, abduction p < 0.01) and gait performance (p < 0.001). No differences between groups were detected as regard thigh circumference, holding force of the gluteal muscles, one-leg stance and subjective parameters. Deterioration in IG compared to CG did not occur.Conclusion
An additional, targeted mobilization and strength training of the hip muscles with full weight-bearing, which begins at the 3rd day after implantation of a THA is tolerated well and improves within one week hip range of motion and gait performance compared to standard physiotherapy. 相似文献13.
Stefano Negrini Luciano Bissolotti Alessandro Ferraris Fulvia Noro Mark D. Bishop Jorge Hugo Villafañe 《Journal of bodywork and movement therapies》2017,21(1):117-123
Background
Impaired postural stability places individuals with Parkinson's disease (PD) at an increased risk for falls.Objective
We evaluated the effectiveness of 10 vs. 15 sessions of Nintendo Wii Fit for balance recovery for outpatients PD.Methods
Twenty-seven patients, 48.1% female (66 ± 8 years), with PD. Patients with PD were consecutively assigned to one of two groups receiving either 10 or 15 sessions (low dose or high dose group, respectively) with Nintendo Wii Fit in recovering balancing ability. All outcome measures were collected at baseline, immediately following the intervention period, and 1-month following the end of the intervention. Main outcome measure: Falls risk test (FRT), Stability index (PST), Berg balance scale (BBS) and Tinetti scale.Results
The patients undergoing the 10 sessions demonstrated significantly improvement on the balance performances (Tinetti balance and gait scales, BBS and BSF) (all, P < 0.05) as those undergoing 15 treatment with Nintendo Wii Fit, but no significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way.Conclusions
The results suggest that functional improvement can be made in fewer visits during outpatient rehabilitation sessions with Nintendo Wii Fit improving the efficiency of intervention. 相似文献14.
Background
A variety of tests have been proposed to measure the performance of neck flexor muscles, but head-to-head comparisons hardly have been documented.Objective
To compare reliability indexes, construct validity, and ability to discriminate between individuals with and without neck pain of 4 muscle tests (deep neck flexors endurance test [DNFET]; 2 variations of the craniocervical flexion test [CCFT1 and CCFT2]; and dynamometry).Design
Reliability and validity study.Setting
General community.Participants
A total of 66 participants, 33 with chronic idiopathic neck pain (mean ± standard deviation pain intensity: 3.2 ± 1.9) and 33 without neck pain, from the general population.Methods/Main Outcome
Neck muscle functioning was assessed with the CCFT1, the CCFT2, the DNFET, and dynamometry on 2 separate sessions. Participants with neck pain also were assessed for pain intensity, disability, pain catastrophizing, and fear of movement.Results
Relative reliability of all tests was at least moderate (intraclass correlation coefficient ≥ 0.62), whereas measurement error was high, particularly for the DNFET (95% minimum detectable change ≥ 23.00 seconds). All tests showed moderate correlation (r ≥ 0.3) with at least 2 pain-related measures and moderate-to-strong correlations with each other. Principal component analysis retained 2 factors explaining 68%-73% of the variance of the 4 muscle tests. Significant differences between groups were found for the DNFET and dynamometry (P < .05).Conclusion
The reliability indexes suggest that the DNFET and the CCFT may be more appropriate for group comparisons than for individual comparisons. The 4 tests seem to have construct validity, but they also seem to measure slightly different constructs.Level of Evidence
III 相似文献15.
Yuhua Bao Renee C. Maciejewski Melissa M. Garrido Manish A. Shah Paul K. Maciejewski Holly G. Prigerson 《Journal of pain and symptom management》2018,55(4):1113-1121.e3
Context
For patients with metastatic cancer and limited life expectancy, potential benefits of chemotherapy must be balanced against harms to quality of life near death and increased out-of-pocket costs of care.Objectives
To evaluate the association between chemotherapy use by patients with Stage IV pancreatic cancer and health care use and Medicare and out-of-pocket costs in the last 30 days of life.Methods
We conducted a retrospective cohort study of 3825 patients aged 66 years or older when diagnosed with Stage IV pancreatic cancer in 2006–2011, using the linked Surveillance, Epidemiology, and End Results–Medicare data. Using a propensity score matched sample, we examined associations between initiation of chemotherapy shortly after the metastatic diagnosis (and secondarily, continued chemotherapy use in the last 30 days of life) and health care use and costs (both Medicare payment and patient out-of-pocket costs) in the last 30 days of life.Results
Chemotherapy use was associated with increased rates of hospital admissions (45.0% vs. 29.2%, P < 0.001), emergency department visits (41.3% vs. 27.2%, P < 0.001), and death in a hospital (14.2% vs. 9.1%, P < 0.001); fewer days in hospice care (11.5 days vs. 15.7 days, P < 0.001); and more than 50% increase in patient out-of-pocket costs for care ($1311.5 vs. $841.0, P < 0.001) in the last 30 days of life. Among patients who initiated chemotherapy, more stark differences in these outcomes were found by whether patients received chemotherapy in the last 30 days of life.Conclusion
Chemotherapy use among older patients diagnosed with metastatic pancreatic cancer was associated with substantially increased use of health care and higher patient out-of-pocket costs near death. 相似文献16.
Hiroyuki Tsuboi Yukihide Nishimura Takeshi Sakata Hideaki Tanina Hideki Arakawa Takeshi Nakamura Yuichi Umezu Fumihiro Tajima 《PM & R》2018,10(2):175-182
Background
Lumbar spondylolysis is a defect in the pars interarticularis that is common in young athletes; the stress distribution at the pars interarticularis is the highest in extension and rotation movements. The paraspinal muscles play an important role in stabilization of the lumbar spine; however, no study has assessed the properties of paraspinal muscles in athletes with lumbar spondylolysis.Objective
To evaluate the properties of paraspinal muscles in athletes with lumbar spondylolysis.Design
Cross-sectional study.Setting
Laboratory.Participants
Six high school baseball players with terminal-stage lumbar spondylolysis and 11 high school baseball players without organic lumbar lesions of similar anthropometric characteristics.Methods
All subjects performed the unsupported trunk holding test combined with surface electromyographic (EMG) power spectral analysis until exhaustion. The results of EMG power spectral analysis were compared between the spondylolysis and control groups.Main Outcome Measurements
The median frequency (MF) was computed from the raw EMG signal of the erector spinae and multifidus during trunk holding test using fast Fourier transform spectrum analysis. The initial MF and MF slope were calculated.Results
No significant differences in endurance time were found between the spondylolysis and control groups. The initial MF and the MF slopes of the erector spinae and multifidus were significantly lower in the spondylolysis group than in the control group.Conclusions
The results suggest lower fast-twitch motor unit recruitment in the erector spinae and multifidus of high school baseball players with terminal-stage lumbar spondylolysis compared with the control.Level of Evidence
IV 相似文献17.
Kara E. Bischoff David L. O&#x;Riordan Kristyn Fazzalaro Anne Kinderman Steven Z. Pantilat 《Journal of pain and symptom management》2018,55(3):881-889
Context
Pain is a common and distressing symptom. Pain management is a core competency for palliative care (PC) teams.Objective
Identify characteristics associated with pain and pain improvement among inpatients referred to PC.Methods
Thirty-eight inpatient PC teams in the Palliative Care Quality Network entered data about patients seen between December 12, 2012 and March 15, 2016. We examined patient and care characteristics associated with pain and pain improvement.Results
Of patients who could self-report symptoms, 30.7% (4959 of 16,158) reported moderate-to-severe pain at first assessment. Over 40% of these patients had not been referred to PC for pain. Younger patients (P < 0.0001), women (P < 0.0001), patients with cancer (P < 0.0001), and patients in medical/surgical units (P < 0.0001) were more likely to report pain. Patients with pain had higher rates of anxiety (P < 0.0001), nausea (P < 0.0001), and dyspnea (P < 0.0001). Sixty-eight percent of patients with moderate-to-severe pain improved by the PC team's second assessment within 72 hours; 74.7% improved by final assessment. There was a significant variation in the rate of pain improvement between PC teams (P < 0.0001). Improvement in pain was associated with improvement in anxiety (OR = 2.9, P < 0.0001) and dyspnea (OR = 1.4, P = 0.03). Patients who reported an improvement in pain had shorter hospital length-of-stay by two days (P = 0.003).Conclusion
Pain is common among inpatients referred to PC. Three-quarters of patients with pain improve and improvement in pain is associated with other symptom improvement. Standardized, multisite data collection can identify PC patients likely to have marked and refractory pain, create benchmarks for the field, and identify best practices to inform quality improvement. 相似文献18.
Flávia Belavenuto Rangon Vânia Tiê Koga Ferreira Monique Silva Rezende Amanda Apolinário Ana Paula Ferro Elaine Caldeira de Oliveira Guirro 《Journal of bodywork and movement therapies》2018,22(1):69-75
Objective
assess the effects of ischemic compression and kinesiotherapy on the rehabilitation of breast cancer survivors with chronic myofascial pain.Methods
A randomized, controlled, blinded clinical trial was performed with 20 breast cancer survivors with myofascial trigger point in the upper trapezius muscle. Patients were randomly allocated to ischemic compression + kinesiotherapy (G1, n = 10) and kinesiotherapy (G2, n = 10). Both groups were submitted to 10 sessions of treatment. The variables evaluated were: Numeric Rating Scale, Pain Related Self-Statement Scale, pressure pain threshold, Functional Assessment of Cancer Therapy-Breast and Infrared thermography.Results
A significant reduction (p < 0.05) was observed in pain intensity after 10 sessions in Groups 1 and 2, a significant increase (p < 0.05) in pressure pain threshold in both the operated and non-operated side after 10 sessions for Group 1.Conclusion
Ischemic compression associated with kinesiotherapy increases the pressure pain threshold on the myofascial trigger point in the upper trapezius muscle and reduces the intensity of pain in breast cancer survivors with myofascial pain. 相似文献19.
Yuan-yuan Song Ru-jun Hu Yong-shu Diao Lin Chen Xiao-lian Jiang 《Journal of pain and symptom management》2018,55(4):1184-1195
Context
Hemodialysis (HD) patients experience a heavy symptom burden that leads to a decreased quality of life. Pharmacological treatment is effective but costly and has adverse effects. Exercise is a promising approach for symptom management, but the effect of exercise on restless legs syndrome (RLS), depression, sleep quality, and fatigue in HD patients is still uncertain.Objectives
This meta-analysis was conducted to identify whether exercise training is beneficial in the treatment of the symptoms of RLS, depression, poor sleep quality, and fatigue in patients receiving HD.Methods
A systematic search of PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Central Register of Controlled Trials, and Web of Science was conducted to identify randomized controlled trials (RCTs) comparing exercise training with routine care on RLS, depression, sleep quality, and fatigue among HD patients. Quality assessment was conducted using the Cochrane risk of bias tool, and RevMan 5.3 was used to analyze the data.Results
Fifteen RCTs that met our inclusion criteria were included. The pooled effect size showed that exercise training was effective on RLS (P < 0.001), depression (P < 0.001), and fatigue (P < 0.001). However, effect size combinations for sleep quality were not performed owing to the sensitivity analysis results.Conclusion
Exercise training may help HD patients to reduce the severity of RLS, depression, and fatigue. More high-quality RCTs with larger samples and comparative RCTs focused on different exercise regimens are needed. 相似文献20.
Barret Rush Katie Wiskar Landon Berger Donald E. Griesdale 《The Journal of emergency medicine》2017,52(5):615-621