Kinesiologic tape for labor pain control: Randomized controlled trial

Background: Kinesiologic taping has been studied for managing diverse types of dysfunctions and pain, but not for managing pain during labor. Objective: This study evaluated the effectiveness and safety of using kinesiologic tape (KT) during labor relative to pain, maternal satisfaction, and obstetric and neonatal outcomes. Method: The study was a single-blind randomized controlled trial composed of 60 pregnant women divided into two groups. In the kinesiologic tape group (KTG), the tape was applied to the region of spinal nerves T10–L1 and S2–S4; in the control group (CG), the tape was applied to the region of spinal nerves T1–T4. Study participants were low-risk pregnant women with spontaneous onset of labor and no previous Cesarean section. Outcomes evaluated were pain, duration of labor, type of delivery, uterotonic and anesthetic requirement, neonatal vitality, and satisfaction with delivery and tape use. Intention-to-treat analysis was performed, and risk ratios with a 95% CI were estimated. Results: After the first hour of tape use, a significant increase in pain was observed in the CG (p = 0.002). However, there were no differences between groups relative to the remaining outcomes assessed. In the KTG, 59% of participants reported satisfaction with tape use, whereas in the CG, 44% reported satisfaction with tape use. Conclusion: Despite its safety, the KT technique did not prove to effectively control labor pain.     

Geburtsschmerz—Entstehung,Erregungsleitung und Folgen

In the first stage of labor, pain is caused by distension of the cervix and low uterine segments in combination with isometric contraction of the uterus. Pain in the second stage of labor is dominated by tissue damage in the pelvis and perineum. Labor pain is due to an activation of nociceptors partly resulting from ischemia. The impulses thus generated are conducted into the spinal cord by afferent C fibers from the cervix and lower uterine segments, and by afferent Adelta and C fibers from the pelvis, pelvic organs and perineum. Labor pain is referred to the dermatomes T(11) and T(12) in the early stage of labor. It spreads to the neighboring dermatomes T(10) and L(1) and eventually involves the dermatomes S(2-4) during the second stage of labor and delivery. As in any other type of pain, labor pain stimulates respiration. This reduces the CO(2) concentration in the blood so that, in pain-free periods, respiratory stimulation is lacking and, in consequence, oxygen concentration in maternal and fetal blood is lowered. Pain-induced sympathetic activation will increase cardiac output in a way that may be deleterious in parturients with heart disease, eclampsia and anemia. Moreover, slowing of gastric emptying may cause nausea and vomiting, and slowing of intestinal propulsive movements may result in ileus and oliguria. An increase in plasma catecholamines and glucocorticoids influences uterine contractions. The amount of beta-endorphin released from the pituitary and placenta into the blood is relatively high but obviously not sufficient to depress pain effectively. Adequate nerve block and epidural anesthesia, as well as measures to relieve anxiety, will help markedly to reduce the risks associated with labor pain.     

3 M自粘弹力绷带用于皮肤癌全厚皮片移植术下肢供皮区伤口包扎的临床观察

目的 探讨3 M自粘弹力绷带在皮肤癌全厚皮片移植术下肢供皮区包扎中的应用。方法 选择2018年11月至2019年11月在中国医学科学院皮肤病医院行皮肤癌植皮术患者92例，随机分为对照组和观察组，均为46例。术后下肢供皮区对照组采用普通宽绷带包扎，观察组采用3 M自粘弹力绷带加压包扎。观察比较两组患者的供皮区伤口包扎固定时间、伤口渗血、伤口疼痛、满意度等情况。结果 观察组患者下肢供皮区伤口包扎固定时间、伤口渗血、伤口疼痛情况优于对照组,满意度高于对照组，差异有统计学意义(均P＜0.05）。结论 皮肤癌植皮术下肢供皮区采用3 M自粘弹力绷带加压包扎，延长了固定时间，减少伤口渗血，缓解伤口疼痛，提高了患者满意度。     

Effects of Kinesio Taping on postural balance in patients with low back pain,a randomized controlled trial

Purpose: to identify postural balance changes in subjects with low back pain after the application of Kinesio Taping, which is then compared to a no treatment control group, using baropodometric evaluation. Methods: This randomized controlled trial was carried out on 50 individuals (both sexes) with chronic low back pain. They were then randomized into two groups: an experimental group - EG (treated with Kinesio Taping in the lumbar region) and a control group - CG (no intervention). Both groups underwent a baropodometric evaluation (mean plantar pressure, peak plantar pressure, plantar surface, mass distribution on right foot and left foot, mass distribution on forefoot and rear foot and base width) at four different moments: pre-intervention, 10 minutes, 48 hours, and 10 days after the intervention on the EG. The level of statistical significance was established at 5%. Results: Significant changes were observed in the EG compared to the CG. In the EG, peak pressure reduced on both right and left foot after Kinesio Taping application; the right base width was reduced, and the mass distribution between the forefoot and the rear foot normalized towards the ideal 50% distribution. These changes happened 48 hours after the Kinesio Taping application, with effects lasting up to 10 days. Conclusion: The use of Kinesio Taping in the lumbar region of subjects with chronic low back pain improved postural balance. This is proved by changes in peak plantar pressure, plantar surface, and mass distribution 48 h after Kinesio Taping application, with effects lasting up to 10 days.     

水中待产对提高阴道分娩产妇镇痛效果的评价

目的探讨水中待产对阴道分娩的镇痛效果。方法选择2009年6月至2011年2月产科住院、自愿行水中待产且符合条件的产妇38例为观察组（水中待产组）,以同期、一般情况及产科条件相近、选择阴道分娩的产妇70例为对照组（传统分娩组）。比较2组产妇疼痛情况、产程、阴道分娩率及满意度等。结果观察组产妇入水后疼痛级别较入水前明显降低,且不影响产程进展,阴道分娩率高。结论水中待产可有效缓解分娩疼痛,提高阴道分娩率,对产程无影响,对母婴无不良影响,适用范围广,是值得推广应用的一种安全有效的分娩镇痛方法。     

Effects of Functional Fascial Taping on pain and function in patients with non-specific low back pain: a pilot randomized controlled trial

Objectives: To compare the short-term and medium-term effect of Functional Fascial Taping to placebo taping on pain and function in people with non-specific low back pain. Design: A pilot randomized controlled trial with a 2-week intervention, and 2-, 6- and 12-week follow-up. Setting: Individuals with non-specific low back pain recruited from local communities. Participants: Forty-three participants with non-specific low back pain for more than 6 weeks were randomized into either Functional Fascial Taping group (n = 21) or placebo group (n = 22). Interventions: The intervention group was treated with Functional Fascial Taping while the control group was treated with placebo taping. Both groups received four treatments over 2 weeks. Main outcome measures: Worst and average pain and function were assessed at baseline, after the 2-week intervention, and at 6 and 12 weeks follow-up. Results: The Functional Fascial Taping group demonstrated significantly greater reduction in worst pain compared to placebo group after the 2-week intervention (P = 0.02, effect size = 0.74; 95% confidence interval 0.11-1.34). A higher proportion of participants in Functional Fascial Taping group attained the minimal clinically important difference in worst pain (P = 0.007) and function (P = 0.007) than those in placebo group after the 2-week intervention. There were no significant differences in either group's disability rating or clinically important difference in average pain at any time. Conclusions: Functional Fascial Taping reduced worst pain in patients with non-acute non-specific low back pain during the treatment phase. No medium-term differences in pain or function were observed.     

Physiotherapy for anterior knee pain: a randomized controlled trial. (City Hospital Nottingham, Nottingham, United Kingdom) Ann Rheum Dis 2000;59:700–704.

This observer blind, prospective, factorial design randomized controlled trial determined the efficacy of the individual components of physiotherapy in subjects with anterior knee pain. Eighty‐one young adults with anterior knee pain were randomly allocated to one of four treatment groups: (1) exercise, tapping, and education; (2) exercise and education; (3) taping and education; and (4) education alone. Each group received 6 physiotherapist‐led treatments over 3 months. Follow up took place at 3 months using the following outcomes measures: Patient satisfaction; a visual analogue pain score; the WOMAC lower limb function score; the Hospital Anxiety and Depression scale (HAD); and quadriceps strength. At 12 months the WOMAC and HAD were assessed by postal questionnaire. All groups showed significant improvements in WOMAC, visual analogue, and HAD scores; these improvements did not vary significantly between the four groups or between exercising/nonexercising and taped/nontaped patients at 3 and 12 months. However, patients who exercised were significantly more likely to be discharged at 3 months than nonexercising patients. Taping was not significantly associated with discharge. Significantly greater improvements in WOMAC, visual analogue, and the anxiety score were seen in patients who were discharged than in those who were referred. Conclude the proprioceptive muscle stretching and strengthening aspects of physiotherapy have a beneficial effect at 3 months sufficient to permit discharge from physiotherapy. These benefits are maintained at 1 year. Taping does not influence the outcome. Comment by Phillip S. Sizer Jr., MEd, P.T. The investigators evaluated a total of 81 patients (36 female and 45 male) between the ages of 16 and 40 years with a history of anterior knee pain of more than three months. Patients were evaluated through history, locomotor examination, WOMAC score and Hospital Anxiety and Depression scale (HAD). In addition, isometric quadriceps strength and power were measured before and after treatment. Patients were randomly assigned to one of four different groups: (1) exercise, taping, and education; (2) taping and education; (3) exercise and education; and (4) education alone. Each patient received six treatments over a three‐month period. Through a 2 × 2 factorial analysis design, the investigators discovered that the group participating in exercise were significantly more likely to be discharged than non‐participants. Additionally, they found that taping alone was not significantly associated with discharge. Furthermore, they observed no difference between groups for the WOMAC score and the visual analogue pain score. Finally, they found that education alone resulted in the sufficient improvement of 60% of those subjects without need for other intervention, supporting the value of therapist contact and simple advice. These investigators embarked upon the evaluation of a controversial condition whose etiology is not well understood.¹ Recent investigators have revealed alternative explanations for persistent anterior knee pain, including increased patelo‐femoral joint stress^2,3 and receptor neuro‐sensitization within the lateral retinaculum.⁴ These outcomes may reflect the influence of exercise on those factors and support the use of physical therapy in the treatment of anterior knee pain.     

分娩时局部和全身应用阿片类药物镇痛的系统评价

目的运用Cochrane系统评价的方法，评价分娩时局部和全身应用阿片类药物镇痛的有效性与安全性。方法计算机检索PubMed（1966-2008．1）、EMbase（1980-2008．1）、Cochrane图书馆（2008年第1期）、CBM（1978-2008．1）、CNKI（1979-2008．1），同时筛选纳入研究的参考文献，收集有关比较局部和全身应用阿片类药物镇痛的随机对照试验，由两名评价员独立评价文献质量，并采用RevMan4．2．10软件对纳入研究结果进行Meta分析：结果共纳入12个研究，5909例产妇。Meta分析结果显示，局部和全身应用阿片类药比较进行分晚镇痛．母亲对局部应用阿片类药分娩镇痛疼痛缓解更满意[RR=I．63，95％CI（1．27，2．09）]，两组5min新生儿Apgar评分〈7，差异无统计学意义：RR=0．63，95％CI（0.40，1．01）]：结论现有证据显示，与局部用药比较，全身心用阿片类药物镇痛的母亲对分娩疼痛缓解更满意。但两组均存在对母亲和新生儿的不良影响。因此，要证明哪种途径应用阿片类药进行分娩镇痛更加有效和安全，尚需开展更多高质量的随机对照研究。     

The effectiveness of biomechanical taping and Kinesiotaping on shoulder pain,active range of motion and function of participants with Trapezius Myalgia: A randomized controlled trial

BackgroundTrapezius Myalgia (TM) is characterized by shoulder pain and dysfunction. Kinesio Taping is commonly used in symptom management of TM. Biomechanical Taping (BMT), a novel intervention, may provide equally effective management.ObjectivesThis paper reports on the effectiveness of Biomechanical Taping compared with Kinesio Taping in improving shoulder pain, active range of motion (AROM), and function.MethodsTwo groups of participants with TM were recruited through simple random sampling of participants from nine call centers and purposively-sampled participants from one fast-food chain and one community based rehabilitation center in Manila, Philippines. Participants were randomly allocated to either Kinesio Taping or biomechanical taping group in a double-blind clinical trial. Irrespective of the type of taping, participants performed gentle passive stretching of upper trapezius for six times each held for 30 s on Days 1, 3, and 5. On Days 2 and 4, participants performed gentle passive stretch of upper trapezius three times a day. Pre- and post-intervention measures were taken of Visual Analogue Scale for pain intensity, AROM for shoulder movement, and Disability of Arm, Shoulder, and Hand for function.ResultsOf 68 participants, 62 had shoulder symptoms secondary to TM. Similar significant within group improvements were found for Visual Analogue Scale scores, and Disability of Arm, Shoulder and Hand for biomechanical taping and Kinesio Taping interventions when comparing between group results (p < 0.05).ConclusionBiomechanical Taping appears to be as effective as Kinesio Taping in the short term in decreasing pain and improving function of individuals with TM. Both taping techniques did not restrict shoulder AROM of included participants.Mesh TermsAthletic Tape, Myalgia, Pain Measurements, Shoulder PainNon-Mesh TermsBiomechanical Taping Technique     

肩周肌群训练联合肌内效贴治疗肩袖损伤的疗效观察

目的：研究肩周肌群训练联合肌内效贴治疗肩袖损伤的临床疗效。方法：选取符合肩袖损伤标准的患者40例,随机分成研究组和对照组各20例。对照组进行肩周肌群训练,研究组在对照组基础上增加肌内效贴布,治疗疗程为4周。2组在治疗前（T1）、治疗4周后（T2）、治疗结束后1个月随访时（T3）进行评估,评价指标采用视觉模拟评分法（VAS）、Constant-Murley肩关节评分系统(CMS)、美国加州大学肩关节评分系统(UCLA)、患侧肩关节活动范围(ROM)。结果：在T2和T3时,2组患者VAS评分均较T1时明显下降（均P＜0.05）,CMS及UCLA评分均较T1时明显提高（均P＜0.05）,前屈、外展、内外旋活动度均较T1时明显增加（均P＜0.05）,且研究组VAS评分均更低于对照组（均P＜0.05）,CMS及UCLA评分均更高于对照组（均P＜0.05）,前屈、外展、内外旋活动度均更高于对照组（均P＜0.05）;在T3随访时,研究组VAS评分较T2时明显下降（P＜0.05）,CMS及UCLA评分均较T2时明显提高（均P＜0.05）,前屈、外展、内外旋活动度均较T2时明显增加（均P＜0.05）,而对照组各项评分和肩关节ROM较T2时差异均无统计学意义。结论：说明肩周肌群训练联合肌内效贴治疗肩袖损伤效果更好,而且在治疗结束后1个月内肌内效贴仍能够维持一定的效果,值得临床推广应用。     

Compression bandaging: types and skills used in practical application

This article discusses long- and short-stretch compression bandages and the theory underpinning their practical application. The Laplace equation is outlined to estimate sub-bandage pressures. Challenges associated with applying therapeutic levels of compression include bandage tension, number of layers, limb circumference and bandage width. Multi-layer bandaging is important for the management of chronic oedema. As poor bandaging techniques can lead to tissue damage, pain, oedema and necrosis, practitioners should be skilled in their application. Through collaboration between specialists and generalists and ongoing practice development, patient outcomes can be improved.     

Effect of the Buzzy Application on Pain and Injection Satisfaction in Adult Patients Receiving Intramuscular Injections

AimThe aim of this study was to investigate the effect of the Buzzy application on pain and satisfaction during injections.BackgroundIntramuscular injections usually cause some degree of pain at the injection site. Patients are often afraid of receiving injections because they perceive that it will be painful.DesignThe study was a single-blind, randomized controlled trial.MethodPatients (n = 65) who receive diclofenac sodium intramuscularly at a state hospital in a city in the western region of Turkey were included in the study. The study data were collected by The Patient Information Form and Visual Analog Scale (VAS). Pain intensity and injection satisfaction scores were evaluated using the VAS.ResultsAccording to the findings of this research, the post-injection pain intensity and injection satisfaction scores of patients in the application group were found to be higher than in the control group.ConclusionIn conclusion, the Buzzy device has the potential to reduce injection related pain in adult patients who may be fearful of receiving such injections.     

Expectant fathers and labor epidurals

PURPOSE: A qualitative research study was conducted to describe and explain expectant father's experiences during labor when their partners receive labor epidurals. DESIGN: Grounded theory. METHODS: Seventeen couples were interviewed using a semi-structured interview format. RESULTS: Two major concepts were identified: "Losing Her" and "She's Back." The men reported that these were the two critical points at which the epidural affected their experience. The theory, "Cruising through Labor," explained the fathers' experiences. CLINICAL IMPLICATIONS: Childbirth preparation classes that describe and explain women's responses to the increasing pain of labor contractions, the exhaustion of labor, and the effect of epidural analgesia could possibly assist men in preparing for the changes they will witness in their partners during the labor experience. Knowing that these changes are normal responses to the effects of labor might reduce men's levels of anxiety, frustration, and sense of helplessness. The labor nurse is a major support to the expectant fathers. Labor nurses who remain in the room during this phase, explain what is happening, and include the expectant father in their nursing care provide the best support.     

腹股沟疝术后使用弹性腹带及毛巾加压包扎切口的效果观察

目的 观察腹股沟疝术后使用弹性腹带+毛巾加压包扎切口的效果。方法 选择南通市第三人民医院2016年1月至2017年12月收治的89例行手术治疗的腹股沟疝患者为观察对象。普外科二区（实验组）45例术后切口处使用弹性腹带+毛巾加压包扎法;普外科一区（对照组）44例术后切口仍使用传统的砂袋压迫法。比较两组患者术后切口渗血量、疼痛程度和舒适度的情况。结果 与对照组相比,实验组患者术后切口出血较少,切口疼痛程度较轻,术后舒适度更高,两组比较差异有统计学意义（P＜0.05）。结论 弹性腹带+毛巾加压包扎法可增加腹股沟疝术后患者的舒适度、减少切口出血量、减轻切口疼痛。     

一对一全产程陪护的优质护理在产房护理工作中的应用效果

目的探讨一对一全产程陪护的优质护理在产房护理工作中的应用效果。方法随机将2018年6月至2019年6月入住我院产科的132例产妇分为观察组(一对一全产程陪护的优质护理)与对照组(常规护理),各66例。比较两组护理效果。结果观察组产后2 h出血量、阴道助产率、会阴侧切率均低于对照组,阴道分娩率及新生儿Apgar评分高于对照组(P<0.05)。观察组第一、二、三产程时长均短于对照组(P<0.05)。护理后,两组SAS、SDS评分均降低,且观察组低于对照组(P<0.05)。观察组护理满意度高于对照组(P<0.05)。结论实施一对一全产程陪护的优质护理有利于缩短产程,改善母婴结局和产妇的负性情绪,提高其护理满意度。     

疼痛教育对初产妇分娩疼痛及分娩方式的影响

目的探讨疼痛教育对初产妇分娩疼痛及分娩方式的影响。方法选择400例足月妊娠头位待产的初产妇,按入院时间先后分为观察组和对照组各200例。对照组采用常规教育,观察组在此基础上实施一对一疼痛教育。比较两组产妇的分娩疼痛程度及分娩方式。结果与对照组比较,观察组产妇分娩疼痛评分低、自然分娩例数多。结论疼痛教育能降低初产妇分娩疼痛程度,提高自然分娩率。     

The Royal North Shore Hospital ICU nurse initiated telephone follow up service.

The intensive care follow up telephone service has been in progress since July 2001. The aims of the service are to offer former patients an opportunity to explore the intensive care experience and provide support during the recovery phase. Patient experiences vary during recovery but include physical fatigue, sleep disturbances and financial difficulties. Patients who have been telephoned say they are grateful for the opportunity to talk about their experience, say thank you and receive general health related information about diet and exercise. The nurses who have participated in the service have enjoyed greater work satisfaction related to exposure to the patients who are recovering. It offers an opportunity to complete the episode of care. In addition we have been able to feed back patients' suggestions into existing quality frameworks. The information received from former patients has assisted in the development of a home based physical rehabilitation programme, which will be evaluated using a randomised control trial. The follow up service positively contributes to patient outcomes and the positive profile of critical care nursing in the community.     

The use of continuous femoral nerve blocks versus extended release epidural morphine: a study comparing outcomes in total knee arthroplasty procedures

The purpose of this study was to compare the effectiveness of continuous femoral nerve block (CFNB) protocol, to extended release epidural morphine DepoDur protocol, in patients having a total knee arthroplasty (TKA) enrolled in a structured joint replacement educational program. Overall, the results of this randomized controlled study demonstrate that CFNB and DepoDur protocol pain strategies were well tolerated in TKA patients during this study with expected side effects and appropriate side effect management. Moreover, the DepoDur protocol enhanced pain management experience and satisfaction and provided superior prolonged analgesia compared with CFNB protocol. The occurrence of adverse events, cost, length of stay, and functional outcomes was comparable between groups.