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Frontiers in Medicine 2024Total knee arthroplasty (TKA) is a widely-used treatment for end-stage knee osteoarthritis. However, it is common for patients to experience issues with knee joint...
Study protocol for a randomized controlled trial: evaluating the effect of isokinetic eccentric training of the hamstring on knee function and walking function after total knee arthroplasty.
INTRODUCTION
Total knee arthroplasty (TKA) is a widely-used treatment for end-stage knee osteoarthritis. However, it is common for patients to experience issues with knee joint function and abnormal gait following the surgery. Previous studies have primarily focused on concentric contraction of the quadriceps during TKA, neglecting the potential benefits of eccentric isokinetic training for the hamstrings. This protocol outlines a randomized, single-blind, controlled trial aimed at assessing the impact of eccentric isokinetic training for the hamstring muscles on pain, function, and gait in patients after TKA.
METHODS AND ANALYSIS
Fifty participants between the ages of 50 and 80 with knee osteoarthritis undergo unilateral total knee arthroplasty (TKA) for the first time. They will be transferred to the rehabilitation department 10-14 days after the operation. The participants are randomly divided into two groups, with 25 participants in each group: the control group and the Hamstring training group. The Control group will receive routine rehabilitation treatment, while the Hamstring training group will receive a combination of routine rehabilitation treatment and isokinetic eccentric training of the hamstring. The intervention will last four consecutive weeks. Both groups will be assessed at three different times: before the intervention, after 4 weeks of intervention, and 4 weeks after the interventions (follow-up). The primary outcome will be functional capacity (TUGT) and Hospital for Special knee Score (HSS). Secondary outcomes will be knee-related health status (isokinetic knee position perception, Peak torque of hamstring strength), pain intensity (Visual analog scale, VAS) and 3D gait analysis.
DISCUSSION
The study aims to provide relevant evidence on the effectiveness of eccentric hamstring muscle contraction training in improving knee joint function and walking function after TKA.
CLINICAL TRIAL REGISTRATION
https://www.chictr.org.cn/showproj.html?proj=195544, Identifier ChiCTR2300073497.
PubMed: 38846149
DOI: 10.3389/fmed.2024.1404736 -
Frontiers in Psychology 2024Soundscape in dental clinics has varying degrees of impact on the emotions of healthcare workers and young patients. Emotions such as restlessness, anxiety, anger, and...
INTRODUCTION
Soundscape in dental clinics has varying degrees of impact on the emotions of healthcare workers and young patients. Emotions such as restlessness, anxiety, anger, and nervousness are commonly found among dental healthcare workers. Pediatric dental clinics are an important part of dental clinics, but there is a lack of research on the soundscape within pediatric dental clinics.
METHODS
This study focuses on a typical pediatric dental clinic, using a combination of field questionnaires and objective measurements. It aims to determine the impact of dominant sound sources on the emotional perception (nervousness, restlessness, anger, fear, pain) and hostile emotional responses of users in the pediatric dental clinic.
RESULTS
In the soundscape of pediatric dental clinics for young pediatric patients, users experience negative emotional perceptions (nervousness, restlessness, anxiety, anger, fear, and pain) and emotional responses of hostility. The dominant sound sources can be divided into two categories: dental (dental drill, air-water syringe, and saliva ejector) and nondental (children crying). Under the influence of dental dominant sound sources, there was a significant negative correlation between the emotional perceptions of healthcare workers and their negative emotional perceptions ( < 0.05). Conversely, for young pediatric patients aged 0-11 years, a significant positive correlation was observed between their emotional perceptions and negative emotional perceptions. The mean perceived degrees of nervousness and fear in young pediatric patients were 1.82 and 1.71 times stronger, respectively, than those observed in healthcare workers. Under the influence of non-dental dominant sound sources, the average degree of emotional perception among healthcare workers was 0.71 higher than that of young pediatric patients, and anxiety perception was significantly enhanced ( < 0.05). The mean degree of nervousness perception was 1 point higher in healthcare workers compared to young pediatric patients, restlessness perception was 1.1 stronger, and there was a presence of mild pain perception. In terms of demographic/social factors, age, occupation, and years of work significantly affected the perceptions of fear and restlessness among healthcare workers, while age had a significant impact on the emotional reaction of hostility in young pediatric patients.
DISCUSSION
The results of this study indicate that the soundscape is an important factor in creating a comfortable treatment environment in pediatric dental clinics. Healthcare workers and young pediatric patients are significantly affected by the dominant sound sources in the clinic, and these effects are closely related to demographic and social factors such as age, profession, and years of experience. This finding can provide more targeted methods and strategies for the design and creation of soundscapes in dental clinics.
PubMed: 38845766
DOI: 10.3389/fpsyg.2024.1379450 -
PloS One 2024The aim of this present clinical trial is to evaluate the effectiveness of a multicomponent prehabilitation programme administered through educational videos versus... (Randomized Controlled Trial)
Randomized Controlled Trial
The effects of a prehabilitation programme based on therapeutic exercise, back care education, and pain neuroscience education in patients scheduled for lumbar radiculopathy surgery: A study protocol for a randomised controlled trial.
The aim of this present clinical trial is to evaluate the effectiveness of a multicomponent prehabilitation programme administered through educational videos versus another programme based on written exercise recommendations, in patients scheduled for lumbar radiculopathy surgery. This study will be a multicentre, controlled, randomised, parallel clinical trial. One hundred participants undergoing lumbar radiculopathy surgery who meet the established inclusion criteria will be recruited at different Spanish hospitals. The experimental group will follow a 4-week prehabilitation programme combining therapeutic exercise, back care education, and pain neuroscience education delivered through videos designed for consumption at home. The control group will be provided with written instructions to perform therapeutic exercises during the same prehabilitation time period. The primary outcome of the study will be disability, assessed using the Spanish version of the Oswestry Disability Index. The secondary outcomes will be pain perception, health-related quality of life, fear avoidance, kinesiophobia, catastrophising, anxiety, depression, physical activity, and the treatment satisfaction of the patients. This study will provide evidence for the effectiveness of a home-based multicomponent prehabilitation programme that addresses some already identified barriers to patient attendance in face-to-face programmes. Understanding the medium and long-term effects of pre-surgery lumbar muscle training and pain neuroscience education administered via instructional videos watched by patients at home, will help improve the design of prehabilitation programmes in this population while also improving the cost-effectiveness of such interventions.
Topics: Humans; Radiculopathy; Patient Education as Topic; Exercise Therapy; Preoperative Exercise; Female; Male; Quality of Life; Randomized Controlled Trials as Topic; Low Back Pain; Adult; Middle Aged; Treatment Outcome; Neurosciences; Pain Management
PubMed: 38843271
DOI: 10.1371/journal.pone.0303979 -
Clinical Drug Investigation Jun 2024Musculoskeletal disorders are an important cause of work absence. Clinical practice guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs) for grade I-II... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Musculoskeletal disorders are an important cause of work absence. Clinical practice guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs) for grade I-II cervical sprains. The combination of thiamine + pyridoxine + cyanocobalamin vitamins has been used, alone and in combination with NSAIDs, for pain and inflammation in musculoskeletal disorders.
OBJECTIVE
The objective of this study was to demonstrate the analgesic synergy of dexketoprofen, and the combination of vitamins thiamine + pyridoxine + cyanocobalamin in a fixed-dose combination (FDC) for the treatment of acute pain caused by grade I-II cervical sprains.
METHODS
We conducted a multicentre, prospective, randomized, double-blind, phase IIIb clinical study comparing two treatment groups: (1) dexketoprofen 25 mg/vitamin B (thiamine 100 mg, pyridoxine 50 mg and cyanocobalamin 0.50 mg) in an FDC (two or more active ingredients combined in a single dosage form) versus (2) dexketoprofen 25 mg monotherapy (single drug to treat a particular disease), one capsule or tablet orally, every 8 h for 7 days. Final mean, average change, and percentage change in pain perception (measured using a visual analogue scale [VAS]) were compared with baseline between groups. A p value < 0.05 was considered statistically significant. Analyses were conducted using SPSS software, v.29.0.
RESULTS
A statistically significant reduction in pain intensity was observed from the third day of treatment with the FDC compared with monotherapy (- 3.1 ± - 1.5 and - 2.6 ± - 1.1 cm, respectively) measured using the VAS (p = 0.011). Regarding the degree of disability, using the Northwick Park Neck Pain Questionnaire (NPQ), statistical difference was observed for the final measurement (7.5%, interquartile range [IQR] 2.5, 10.5; vs. 7.9%, IQR 5.0, 13.8; p = 0.028). A lower proportion of adverse events was reported when using the FDC.
CONCLUSIONS
The FDC of dexketoprofen/thiamine + pyridoxine + cyanocobalamin vitamins demonstrated superior efficacy and a better safety profile compared with dexketoprofen monotherapy for pain treatment in patients with grade I-II cervical sprains.
CLINICAL TRIALS REGISTRATION
NCT05001555, registered 29 July 2021 ( https://clinicaltrials.gov/study/NCT05001555 ).
Topics: Humans; Double-Blind Method; Thiamine; Ketoprofen; Female; Adult; Pyridoxine; Male; Anti-Inflammatory Agents, Non-Steroidal; Vitamin B 12; Middle Aged; Tromethamine; Drug Combinations; Prospective Studies; Vitamin B Complex; Pain Measurement; Young Adult
PubMed: 38842764
DOI: 10.1007/s40261-024-01370-2 -
Journal of Sports Science & Medicine Jun 2024In the recent past, practical blood flow restriction (pBFR) using non-pneumatic, usually elastic cuffs has been established as a cost-effective alternative to... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
Low-load Resistance Exercise with Perceptually Primed Practical Blood Flow Restriction Induces Similar Motor Performance Fatigue, Physiological Changes, and Perceptual Responses Compared to Traditional Blood Flow Restriction in Males and Females.
In the recent past, practical blood flow restriction (pBFR) using non-pneumatic, usually elastic cuffs has been established as a cost-effective alternative to traditional blood flow restriction (BFR) using pneumatic cuffs, especially for training in large groups. This study investigated whether low-load resistance exercise with perceptually primed pBFR using an elastic knee wrap is suitable to induce similar motor performance fatigue as well as physiological and perceptual responses compared to traditional BFR using a pneumatic nylon cuff in males and females. In a randomized, counterbalanced cross-over study, 30 healthy subjects performed 4 sets (30-15-15-15 repetitions) of unilateral knee extensions at 20% of their one-repetition-maximum. In the pBFR condition, each individual was perceptually primed to a BFR pressure corresponding to 60% of their arterial occlusion pressure. Before and after exercise, maximal voluntary torque, maximal muscle activity, and cuff pressure-induced discomfort were assessed. Moreover, physiological (i.e., muscle activity, muscle oxygenation) and perceptual responses (i.e., effort and exercise-induced leg muscle pain) were recorded during exercise. Moderate correlations with no differences between pBFR and BFR were found regarding the decline in maximal voluntary torque and maximal muscle activity. Furthermore, no to very strong correlations between conditions, with no differences, were observed for muscle activity, muscle oxygenation, and perceptual responses during exercise sets. However, cuff pressure-induced discomfort was lower in the pBFR compared to the BFR condition. These results indicate that low-load resistance exercise combined with perceptually primed pBFR is a convenient and less discomfort inducing alternative to traditional BFR. This is especially relevant for BFR training with people who have a low cuff-induced discomfort tolerance.
Topics: Humans; Female; Resistance Training; Male; Cross-Over Studies; Muscle Fatigue; Adult; Young Adult; Muscle, Skeletal; Regional Blood Flow; Torque; Myalgia; Perception; Oxygen Consumption; Blood Flow Restriction Therapy; Electromyography; Knee
PubMed: 38841639
DOI: 10.52082/jssm.2024.326 -
Frontiers in Veterinary Science 2024Intramedullary cord tumors present diagnostic and therapeutic challenges. Furthermore, spinal cord tumors can move across compartments, making antemortem diagnosis...
Case report: Magnetic resonance imaging features with postoperative improvement of atypical cervical glioma characterized by predominant extramedullary distribution in a dog.
INTRODUCTION
Intramedullary cord tumors present diagnostic and therapeutic challenges. Furthermore, spinal cord tumors can move across compartments, making antemortem diagnosis difficult, even with advanced imaging. This report presents a rare case of a cranial cervical spinal glioma, confirmed by surgical histopathology, with postoperative improvement in a dog.
CASE DESCRIPTION
A 9-year-old female Maltese dog presented with kyphotic posture, progressive left hemiparesis, and decreased appetite. Neurological examination revealed neck pain and decreased proprioception in the left limbs along with intact deep pain perception. Two days later, the patient developed non-ambulatory tetraparesis. Magnetic resonance imaging (MRI) revealed an ovoid, well-defined mass with homogeneously marked contrast enhancement in the second cervical spinal cord that severely compressed the spinal cord. This mass was heterogeneously hyperintense on T2-weighted images and iso-to-hypointense on T1-weighted images, showing an appearance resembling the "golf-tee" and "dural tail" signs. The MRI findings suggested an intradural extramedullary tumor. Intraoperatively, a well-demarcated mass which was locally adherent to the spinal meninges was removed. Both histopathological and genomic tumor tests were indicative of a glioma. Approximately 2 weeks postoperatively, the patient's neurological signs returned to normal.
CONCLUSION
This case report describes an atypical cervical glioma with complicated MR characteristics in a dog, where MRI helped guide surgical intervention.
PubMed: 38840642
DOI: 10.3389/fvets.2024.1400139 -
Neuromuscular Disorders : NMD Jul 2024Myotonic dystrophy type 1 (DM1) is a hereditary disease characterized by muscular impairments. Fundamental and clinical positive effects of strength training have been...
Myotonic dystrophy type 1 (DM1) is a hereditary disease characterized by muscular impairments. Fundamental and clinical positive effects of strength training have been reported in men with DM1, but its impact on women remains unknown. We evaluated the effects of a 12-week supervised strength training on physical and neuropsychiatric health. Women with DM1 performed a twice-weekly supervised resistance training program (3 series of 6-8 repetitions of squat, leg press, plantar flexion, knee extension, and hip abduction). Lower limb muscle strength, physical function, apathy, anxiety and depression, fatigue and excessive somnolence, pain, and patient-reported outcomes were assessed before and after the intervention, as well as three and six months after completion of the training program. Muscle biopsies of the vastus lateralis were also taken before and after the training program to assess muscle fiber growth. Eleven participants completed the program (attendance: 98.5 %). Maximal hip and knee extension strength (p < 0.006), all One-Repetition Maximum strength measures (p < 0.001), apathy (p = 0.0005), depression (p = 0.02), pain interference (p = 0.01) and perception of the lower limb function (p = 0.003) were significantly improved by training. Some of these gains were maintained up to six months after the training program. Strength training is a good therapeutic strategy for women with DM1.
Topics: Humans; Myotonic Dystrophy; Female; Resistance Training; Muscle Strength; Adult; Middle Aged; Depression; Muscle, Skeletal; Anxiety; Apathy; Treatment Outcome; Fatigue; Lower Extremity
PubMed: 38824906
DOI: 10.1016/j.nmd.2024.05.009 -
Current Biology : CB Jun 2024Somatosensation is essential for animals to perceive the external world through touch, allowing them to detect physical contact, temperature, pain, and body position....
Somatosensation is essential for animals to perceive the external world through touch, allowing them to detect physical contact, temperature, pain, and body position. Studies on rodent vibrissae have highlighted the organization and processing in mammalian somatosensory pathways. Comparative research across vertebrates is vital for understanding evolutionary influences and ecological specialization on somatosensory systems. Birds, with their diverse morphologies, sensory abilities, and behaviors, serve as ideal models for investigating the evolution of somatosensation. Prior studies have uncovered tactile-responsive areas within the avian telencephalon, particularly in pigeons, parrots, and finches, but variations in somatosensory maps and responses across avian species are not fully understood. This study aims to explore somatotopic organization and neural coding in the telencephalon of Anna's hummingbirds (Calypte anna) and zebra finches (Taeniopygia guttata) by using in vivo extracellular electrophysiology to record activity in response to controlled tactile stimuli on various body regions. These findings reveal unique representations of body regions across distinct forebrain somatosensory nuclei, indicating significant differences in the extent of areas dedicated to certain body surfaces, which may correlate with their behavioral importance.
Topics: Animals; Finches; Prosencephalon; Touch; Birds; Male; Touch Perception; Female
PubMed: 38815578
DOI: 10.1016/j.cub.2024.04.081 -
Frontiers in Pain Research (Lausanne,... 2024Fabry disease (FD) causes cold-evoked pain and impaired cold perception through small fiber damage, which also occurs in polyneuropathies (PNP) of other origins. The...
BACKGROUND
Fabry disease (FD) causes cold-evoked pain and impaired cold perception through small fiber damage, which also occurs in polyneuropathies (PNP) of other origins. The integrity of thinly myelinated fibers and the spinothalamic tract is assessable by cold-evoked potentials (CEPs). In this study, we aimed to assess the clinical value of CEP by investigating its associations with pain, autonomic measures, sensory loss, and neuropathic signs.
METHODS
CEPs were examined at the hand and foot dorsum of patients with FD ( = 16) and PNP ( = 21) and healthy controls ( = 23). Sensory phenotyping was performed using quantitative sensory testing (QST). The painDETECT questionnaire (PDQ), FabryScan, and measures for the autonomic nervous system were applied. Group comparisons and correlation analyses were performed.
RESULTS
CEPs of 87.5% of the FD and 85.7% of the PNP patients were eligible for statistical analysis. In all patients combined, CEP data correlated significantly with cold detection loss, PDQ items, pain, and autonomic measures. Abnormal CEP latency in FD patients was associated with an abnormal heart frequency variability item ( = -0.684; adjusted = 0.04). In PNP patients, CEP latency correlated significantly with PDQ items, and CEP amplitude correlated with autonomic measures ( = 0.688, adjusted = 0.008; = 0.619, adjusted = 0.024). Furthermore, mechanical pain thresholds differed significantly between FD (gain range) and PNP patients (loss range) ( = 0.01).
CONCLUSIONS
Abnormal CEPs were associated with current pain, neuropathic signs and symptoms, and an abnormal function of the autonomic nervous system. The latter has not been mirrored by QST parameters. Therefore, CEPs appear to deliver a wider spectrum of information on the sensory nervous system than QST alone.
PubMed: 38812855
DOI: 10.3389/fpain.2024.1352711