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Brazilian Dental Journal 2023Root canal infections are typically polymicrobial and involve strong bacterial interactions. The goal of endodontic treatment is to remove infected content from the root...
Root canal infections are typically polymicrobial and involve strong bacterial interactions. The goal of endodontic treatment is to remove infected content from the root canal system to allow the healing of a pre-existing periapical lesion or to prevent infection of the periradicular tissues. Instrumentation alone is not capable of touching all of the root canal walls. Therefore, the irrigation process is an essential step in the endodontic treatment. However, due to the complex anatomy of the root canal system, this cleaning is very challenging. Although syringe and needle irrigation associated with the use of chemical substances is still the most used method, it does not guarantee optimal cleaning of the root canals. As a result, not only alternative irrigating substances but also numerous activation systems - which are technologies that aim to optimize the action of irrigating substances, both chemically and physically - have been developed. This work aimed to review the characteristics of both classic and current alternatives of irrigating substances and irrigation activation systems.
Topics: Root Canal Irrigants; Endodontics; Root Canal Therapy; Root Canal Preparation; Therapeutic Irrigation; Dental Pulp Cavity; Sodium Hypochlorite
PubMed: 37909632
DOI: 10.1590/0103-6440202305577 -
Alternative Therapies in Health and... Oct 2023To investigate water exercise therapy's effect on lower limb function rehabilitation in patients with the first stroke. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To investigate water exercise therapy's effect on lower limb function rehabilitation in patients with the first stroke.
METHOD
160 patients with the first stroke and lower limb dysfunction who received rehabilitation treatment in the Geriatric Hospital of Hainan, China, from May 2020 to June 2021 were randomly divided into two groups, the control group, and the hydrotherapy group. Each group comprises 80 cases in each group. The control group received conventional drug therapy and traditional rehabilitation training, while the hydrotherapy group received underwater exercise training in combination with the routine group treatment plan. The National Health Center Stroke Scale (NIHSS), the modified Rankin scale (MRS), the limb motor function score table (Fugl-Meyer assessment, FMA), Functional Walking Scale (functional ambulation category scale, FAC), Berg Balance Scale (BBS) and the modified Barthel index (MBI) were respectively used to evaluate the neurological function, lower limb motor function, walking function, balance function and daily living ability before and after treatment.
RESULT
There was no significant difference in NIHSS, MRS, FMA, FAC, BBS, and MBI scores between the two groups before treatment (P > .05). However, after 8 weeks of treatment, there was a significant difference in FMA, FAC, BBS, and MBI scores between the two groups (P = .00035). The FMA scores in control group was 16.60 ± 4.49, while 21.45 ± 2.96 after treatment. The FAC scores in control group was 1.45 ± 0.68, while 1.95 ± 0.783 after treatment.
CONCLUSION
Early water exercise training in hemiplegic patients with the first stroke can significantly enhance the balance ability, walking ability as well as limb coordination of patients.
Topics: Humans; Aged; Stroke Rehabilitation; Aquatic Therapy; Hemiplegia; Stroke; Lower Extremity; Treatment Outcome
PubMed: 37573592
DOI: No ID Found -
PloS One 2020WATSU (portmanteau word: water and shiatsu) is a form of passive hydrotherapy in chest-deep thermoneutral water (35°C = 95°F = 308.15 K). It combines elements of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
WATSU (portmanteau word: water and shiatsu) is a form of passive hydrotherapy in chest-deep thermoneutral water (35°C = 95°F = 308.15 K). It combines elements of myofascial stretching, joint mobilization, massage, and shiatsu and is reported to be used to address physical and mental issues. The objective of this systematic review (PROSPERO Registration No. CRD42016029347) and the meta-analyses was to assess the applications, indications, and the effects of WATSU to form a basis for further studies.
METHODS
A search for "WATSU OR watershiatsu OR (water AND shiatsu)" was conducted without any restrictions in 32 databases. Peer reviewed original articles addressing WATSU as a stand-alone hydrotherapy were assessed for risk of bias. Quantitative data of effects on pain, physical function, and mental issues were processed in random model meta-analyses with subgroup analyses by study design. Effect sizes were expressed as Hedges's g (± 95% confidence intervals).
RESULTS
Of 1,906 unique citations, 27 articles regardless of study design were assessed for risk of bias. WATSU has been applied to individuals of all ages. Indications covered acute (e.g. pregnancy related low back pain) and chronic conditions (e.g. cerebral palsy) with beneficial effects of WATSU regarding e.g. relaxation or sleep quality. Meta-analyses suggest beneficial effect sizes of WATSU on pain (overall Hedges's g = -0.71, 95% CI = -0.91 to -0.51), physical function (overall Hedges's g = -0.76, 95% CI = -1.08 to -0.44), and mental issues (overall Hedges's g = -0.68, 95% CI = -1.02 to -0.35).
CONCLUSION
Various applications, indications and beneficial effects of WATSU were identified. The grade of this evidence is estimated to be low to moderate at the best. To strengthen the findings of this study, high-quality RCTs are needed.
Topics: Acupressure; Humans; Hydrotherapy; Models, Theoretical; Pain Management; Publication Bias; Risk
PubMed: 32168328
DOI: 10.1371/journal.pone.0229705 -
Clinical Rehabilitation May 2018To compare the effects on gait and balance of aquatic physiotherapy versus on-land training, in the context of an inpatient rehabilitation treatment tailored for... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To compare the effects on gait and balance of aquatic physiotherapy versus on-land training, in the context of an inpatient rehabilitation treatment tailored for peripheral neuropathies.
DESIGN
Parallel-group, single-center, single-blind randomized controlled trial.
SUBJECTS AND SETTING
Consecutive patients affected by peripheral neuropathy admitted in our Neuro-Rehabilitation Unit.
INTERVENTIONS
Patients received a four-week rehabilitation program composed by daily sessions of conventional physiotherapy and three sessions/week of specific treatment (aquatic vs. on-land).
MAIN MEASURES
Primary outcome measures were Berg Balance Scale and Dynamic Gait Index. Secondary outcome measures were Neuropathic Pain Scale, Overall Neuropathy Limitations Scale, Functional Independence Measure, Functional Ambulation Classification, Conley Scale and Medical Research Council Scale score for the strength of hip and ankle flexor and extensor muscles. For each scale, we calculated the difference between the scores at discharge and admission and compared it between the two groups.
RESULTS
Forty patients were enrolled: 21 in the water-based rehabilitation group and 19 in the land-based one. Patients were similar between groups. When comparing the groups, we found that "in-water" patients had a significant better improvement in the Dynamic Gait Index score (6.00 (4.00, 7.25) vs. 4.00 (1.25, 6.00), P = 0.0433). On the opposite, the "on-land" group showed a better improvement of the Functional Ambulation Classification score (1.0 (0.75, 1.0) vs. 1.0 (1.0, 2.0), P = 0.0386).
CONCLUSION
Aquatic physiotherapy showed an effect comparable to the land-based rehabilitation on gait and balance dysfunctions of neuropathic patients.
Topics: Aged; Disability Evaluation; Exercise Therapy; Female; Humans; Hydrotherapy; Male; Peripheral Nervous System Diseases; Postural Balance; Single-Blind Method
PubMed: 29232980
DOI: 10.1177/0269215517746716 -
Journal of Athletic Training Apr 2020Among sports-recovery methods, cold-water immersion (CWI), contrast-water therapy (CWT), and whole-body cryotherapy (WBC) have been applied widely to enhance recovery...
CONTEXT
Among sports-recovery methods, cold-water immersion (CWI), contrast-water therapy (CWT), and whole-body cryotherapy (WBC) have been applied widely to enhance recovery after strenuous exercise. However, the different timing effects in exercise-induced muscle damage (EIMD) after these recovery protocols remain unknown.
OBJECTIVE
To compare the effects of CWI, CWT, and WBC on the timing-sequence recovery of EIMD through different indicator responses.
DESIGN
Crossover study.
SETTING
Laboratory.
PATIENTS OR OTHER PARTICIPANTS
Twelve male middle- and long-distance runners from the Beijing Sport University (age = 21.00 ± 0.95 years).
INTERVENTION(S)
Participants were treated with different recovery methods (control [CON], CWI, CWT, WBC) immediately postexercise and at 24, 48, and 72 hours postexercise.
MAIN OUTCOME MEASURE(S)
We measured perceived sensation using a visual analog scale (VAS), plasma creatine kinase (CK) activity, plasma C-reactive protein (CRP) activity, and vertical-jump height (VJH) pre-exercise, immediately postexercise, and at 1, 24, 48, 72, and 96 hours postexercise.
RESULTS
For the VAS score and CK activity, WBC exhibited better timing-sequence recovery effects than CON and CWI ( < .05), but the CWT demonstrated better effects than CON ( < .05). The CRP activity was lower after WBC than after the other interventions ( < .05). The VJH was lower after WBC than after CON and CWI ( < .05).
CONCLUSIONS
The WBC positively affected VAS, CK, CRP, and VJH associated with EIMD. The CWT and CWI also showed positive effects. However, for the activity and timing-sequence effect, CWT had weaker effects than WBC.
Topics: Athletic Injuries; Cross-Over Studies; Cryotherapy; Humans; Hydrotherapy; Immersion; Male; Muscle, Skeletal; Myalgia; Pain Measurement; Running; Treatment Outcome; Young Adult
PubMed: 32160058
DOI: 10.4085/1062-6050-529-18 -
Jornal de Pediatria 2022The present study aimed to evaluate the effects of hydrotherapy and tactile-kinesthetic stimulation on the birth weight of preterm infants admitted in the Neonatal... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The present study aimed to evaluate the effects of hydrotherapy and tactile-kinesthetic stimulation on the birth weight of preterm infants admitted in the Neonatal Intensive Care Unit.
METHOD
It was a randomized controlled trial, without blinding, in which 44 preterm infants of both sexes with gestational age between 32 and 34 weeks were included into two groups: hydrotherapy group (n = = 22) and tactile-kinesthetic stimulation group (n = 22). Weight gain was the parameter assessed daily.
RESULTS
In the tactile-kinesthetic stimulation group there was a variation in weight gain, but without significant difference (p = 0,43). However, in the hydrotherapy group, it was observed that increased weight gain started from the 2nd day (p < 0,001).
CONCLUSIONS
Hydrotherapy group presented significantly increased weight after the interventions, indicating that this technique can interfere with weight gain in preterm infants.
Topics: Female; Humans; Hydrotherapy; Infant; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Male; Massage; Weight Gain
PubMed: 34181888
DOI: 10.1016/j.jped.2021.04.011 -
Indian Journal of Dental Research :... 2021Overzealous application of endodontic irrigants affects the root canal dentin mechanical properties. The effect of volume of endodontic irrigants on the microhardness of...
INTRODUCTION
Overzealous application of endodontic irrigants affects the root canal dentin mechanical properties. The effect of volume of endodontic irrigants on the microhardness of root canal dentin has not been studied.
AIM
This study assessed the effect of volume of endodontic irrigants used in different final irrigation activation techniques on root canal dentin microhardness (RCDM).
METHODOLOGY
Sixty human maxillary central incisors were embedded in acrylic resin in Kuttler's endodontic cube to the level of cementoenamel junction. The root samples were randomly divided into 4 experimental groups (n = 15): Group-NI-needle irrigation, Group-PUI-continuous passive ultrasonic irrigation, Group-EndoVac-apical negative pressure system, Group combination- EndoVac + PUI irrigation. Root canals were instrumented up to size 40 (F4). The resin mounted specimens were sectioned longitudinally into two halves and were reassembled in Kuttler's kube to carry out final irrigation activation. A predetermined standardized volume of irrigants was used in each group. The RCDM was measured after root canal instrumentation and after final irrigation using Vicker microhardness tester (coronal, middle, and apical third). The reduction in RCDM values (p < 0.0086) were analyzed using Kruskal Wallis and Mann Whitney-U tests.
RESULTS
Reduction in RCDM was observed with all the endodontic irrigating techniques tested. EndoVac and combination irrigation techniques showed maximum reduction in RCDM in all thirds of root canal.
CONCLUSION
It is concluded that the volume of irrigants and agitation plays a role in reducing RCDM. The overall volume of irrigants to cause maximum reduction was 25 ml, beyond which neither volume nor agitation affects RCDM.
Topics: Dental Pulp Cavity; Dentin; Humans; Root Canal Irrigants; Root Canal Preparation; Sodium Hypochlorite; Therapeutic Irrigation
PubMed: 34810395
DOI: 10.4103/ijdr.IJDR_709_18 -
BMJ Clinical Evidence Mar 2015Ear wax only becomes a problem if it causes a hearing impairment or other ear-related symptoms. Ear wax is more likely to accumulate and cause a hearing impairment when... (Review)
Review
INTRODUCTION
Ear wax only becomes a problem if it causes a hearing impairment or other ear-related symptoms. Ear wax is more likely to accumulate and cause a hearing impairment when normal extrusion is prevented; for example, by the use of hearing aids, or by the use of cotton buds to clean the ears. Ear wax can visually obscure the ear drum, and may need to be removed for diagnostic purposes.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of methods to remove ear wax? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found nine studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: ear irrigation (syringing); manual removal (other than ear irrigation); wax softeners prior to irrigation; and wax softeners alone.
Topics: Cerumen; Hearing Loss; Humans; Therapeutic Irrigation
PubMed: 25738938
DOI: No ID Found -
Australian Family Physician Oct 2015Ear syringing is a very common practice among general practitioners (GPs). It is used by many as the treatment of choice for cerumen (ear wax), and is usually effective... (Review)
Review
BACKGROUND
Ear syringing is a very common practice among general practitioners (GPs). It is used by many as the treatment of choice for cerumen (ear wax), and is usually effective and safe. However, complications from syringing are an increasingly common reason for presentation to ear, nose and throat (ENT) specialists and medico-legal complaints against GPs.
OBJECTIVE
The aim of this article is to provide GPs with the knowledge to safely manage cerumen.
DISCUSSION
Ear wax is an important part of a normal functioning ear. It is mostly asymptomatic and requires no treatment. Softening ear drops may be necessary to help the ear fulfil its self-cleaning function, and should be considered first-line treatment. Syringing can be safely performed if this fails by taking a thorough history and examination to exclude contraindications, gaining patient consent and ensuring the appropriate use of equipment. Referral to an ENT clinic for manual removal with microsuctioning may be necessary in the event of contraindications, complications or failure.
Topics: Cerumen; Ear; Humans; Syringes; Therapeutic Irrigation
PubMed: 26484488
DOI: No ID Found -
International Journal of Environmental... Jan 2020Children diagnosed with Autism Spectrum Disorder (ASD) are less physically active than typically developing children due to reduced socialisation and delayed gross-motor... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Children diagnosed with Autism Spectrum Disorder (ASD) are less physically active than typically developing children due to reduced socialisation and delayed gross-motor skills, negatively impacting social, emotional and physical well-being. This study aimed to determine whether hydrotherapy influences behaviours which impact mental health and well-being in children with ASD.
METHODS
A within-subjects, randomised crossover-controlled pilot trial was used over 8 weeks. Children aged 6-12 years and diagnosed with ASD (n = 8) were randomly allocated to Group 1 (n = 4) or Group 2 (n = 4). All children participated in hydrotherapy intervention from either weeks 1 to 4 or weeks 5 to 8. The Child Behaviour Checklist (CBCL) measured behaviour changes impacting mental health and well-being, administered at weeks 0, 4 and 8.
RESULTS
No observable differences were found in CBCL subscales between Group 1 or 2 at baseline (week 0). Paired-samples t-tests revealed significant improvements post-intervention: Anxious/Depressed subdomain (p = 0.02) and the Internalising Problems Domain Summary (p = 0.026), with large effect size (d = 1.03 and d = 1.06 respectively). Thought Problems (p = 0.03) and Attention Problems (p = 0.01) both significantly improved post-intervention. The Total Problems score significantly improved post-intervention (p = 0.018) with a large effect size (d = 1.04).
CONCLUSION
Hydrotherapy may enhance behaviours impacting mental health and well-being of children with ASD and could be considered a beneficial therapy option.
Topics: Attention; Autism Spectrum Disorder; Behavior; Checklist; Child; Child Development; Cross-Over Studies; Female; Humans; Hydrotherapy; Male; Mental Health; Pilot Projects; Thinking
PubMed: 31952323
DOI: 10.3390/ijerph17020558