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Improving chronic disability

Neil E O'Connell, Louise Marston, Sally Spencer, Lorraine H DeSouza, Benedict M Wand
BACKGROUND: This is an updated version of the original Cochrane Review published in 2010, Issue 9, and last updated in 2014, Issue 4. Non-invasive brain stimulation techniques aim to induce an electrical stimulation of the brain in an attempt to reduce chronic pain by directly altering brain activity. They include repetitive transcranial magnetic stimulation (rTMS), cranial electrotherapy stimulation (CES), transcranial direct current stimulation (tDCS), transcranial random noise stimulation (tRNS) and reduced impedance non-invasive cortical electrostimulation (RINCE)...
March 16, 2018: Cochrane Database of Systematic Reviews
Deed E Harrison, Paul A Oakley, Joseph W Betz
[Purpose] To present the case of the dramatic reduction in pain, disability, and neurologic symptoms following the reduction of forward head translation and increased cervical curvature in a patient suffering from post-surgical radiculopathy. [Subject and Methods] A 52-year-old male mechanic presented with chronic neck pain, unilateral paresthesia along the C5 and C6 dermatome distributions and diminished unilateral grip strength for 12 years following a C5-C6 cervical discectomy and fusion. Outcome measures included the neck disability index, the numerical pain rating scale, and the Zebris cervical range of motion system...
February 2018: Journal of Physical Therapy Science
Catherine E Ferland, Diana-Luk Ye, Jean A Ouellet
This case report illustrates the value of a comprehensive perioperative pain assessment composed of quantitative sensory testing and self-reported measures that highlight the impact of pain experienced by a 14-year-old boy suffering from chronic low back pain and sciatica. Before surgery, the pain assessment revealed inefficient endogenous inhibitory pain control with presence of temporal summation of pain. The severe pain was constant and lasted for 18 months. The patient was in a high-anxiety state, and reported significant functional disability and poor sleep quality...
March 12, 2018: Journal of Pediatric Health Care
Lucy Gee, Heather C Smith, Zohal Ghulam-Jelani, Hirah Khan, Julia Prusik, Paul J Feustel, Sarah E McCallum, Julie G Pilitsis
BACKGROUND: Chronic pain causes a significant burden to the US health care system, is difficult to treat, and remains a significant contributor to increased opioid use in the United States. Spinal cord stimulation (SCS) has been FDA approved for the treatment of chronic pain. OBJECTIVE: To evaluate the hypothesis that SCS reduces opioid use, and alone maintains clinical outcome measures of pain and psychosocial determinants of health. METHODS: In this prospective cohort study, we evaluated 86 patients undergoing SCS surgery for the treatment of chronic pain between September 2012 and August 2015...
March 12, 2018: Neurosurgery
Goris Nazari, Pavlos Bobos, Evdokia Billis, Joy C MacDermid
BACKGROUND AND PURPOSE: Neck pain is the fourth leading cause of disability in the United States and exerts an important socio-economic burden around the world. The aims of this study were to determine the effectiveness of deep and superficial flexor muscle training in addition to home-based exercises in reducing chronic neck pain and anxiety/depression levels. METHODS: This was a prospective cohort study. Patients between 18 and 65 years old with chronic neck pain were eligible to participate if they had disability levels at least 5 out of 50 on the Neck Disability Index...
March 14, 2018: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
Mark W Werneke, Susan Edmond, Michelle Young, David Grigsby, Brian McClenahan, Troy McGill
BACKGROUND AND PURPOSE: Physiotherapy has an important role in managing patients with non-specific low back pain who experience elevated psychosocial distress or risk for chronic disability. In terms of evidence-based physiotherapy practice, cognitive-behavioural approaches for patients at high psychosocial risk are the recommended management to improve patient treatment outcomes. Evidence also suggests that directional preference (DP) is an important treatment effect modifier for prescribing specific exercises for patients to improve outcomes...
March 14, 2018: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
Zachary L McCormick, Andrew Hendrix, David Dayanim, Bryan Clay, Amy Kirsling, Norman Harden
Objective: We present a technical protocol for rigorous assessment of patient-reported outcomes and psychophysical testing relevant to lumbar sympathetic blocks for the treatment of postamputation pain (PAP). This description is intended to inform future prospective investigation. Design: Series of four participants from a blinded randomized sham-controlled trial. Setting: Tertiary, urban, academic pain medicine center. Subjects: Four participants with a single lower limb amputation and associated chronic PAP...
March 8, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Julia Woodman, Kathleen Ballard, Catherine Hewitt, Hugh MacPherson
Introduction: ATLAS was a pragmatic randomised (1:1:1 ratio), controlled trial recruiting patients with chronic neck pain (N = 517) and evaluating one-to-one Alexander Technique lessons, or acupuncture, each plus usual care, compared with usual care alone. The primary outcome (12-month Northwick Park Neck Pain Questionnaire [NPQ]) demonstrated significant and clinically meaningful reductions in neck pain and associated disability for both interventions compared with usual care alone...
January 2018: European Journal of Integrative Medicine
Jonas Verbrugghe, Anouk Agten, Bert O Eijnde, Enzo Olivieri, Xavier Huybrechts, Henk Seelen, Frank Vandenabeele, Annick Timmermans
BACKGROUND: Although low to moderate intensity exercise therapy is a predominant part of rehabilitation in nonspecific chronic low back pain (NSCLBP), effect sizes are small and optimal exercise modalities/intensities are unclear. Conversely, effects of high intensity training have not yet been investigated in this population. OBJECTIVE: The aim of this study is to investigate the feasibility of high intensity training (HIT) and to explore the magnitude of the effects of a HIT program may have on exercise capacity and disease related outcome measures compared to conventional therapy for persons with NSCLBP...
March 2, 2018: Journal of Back and Musculoskeletal Rehabilitation
Gisela Cristiane Miyamoto, Katherinne Ferro Moura Franco, Johanna M van Dongen, Yuri Rafael Dos Santos Franco, Naiane Teixeira Bastos de Oliveira, Diego Diulgeroglo Vicco Amaral, Amanda Nery Castelo Branco, Maria Liliane da Silva, Maurits W van Tulder, Cristina Maria Nunes Cabral
OBJECTIVES: To evaluate the effectiveness and cost-utility of the addition of different doses of Pilates to an advice for non-specific chronic low back pain (NSCLBP) from a societal perspective. DESIGN: Randomised controlled trial with economic evaluation. SETTING: Physiotherapy clinic in São Paulo, Brazil. PARTICIPANTS: 296 patients with NSCLBP. INTERVENTIONS: All patients received advice and were randomly allocated to four groups (n=74 per group): booklet group (BG), Pilates once a week (Pilates group 1, PG1), Pilates twice a week (Pilates group 2, PG2) and Pilates three times a week (Pilates group 3, PG3)...
March 10, 2018: British Journal of Sports Medicine
Chantal F Hillebregt, Eline W M Scholten, Marjolijn Ketelaar, Marcel W M Post, Johanna M A Visser-Meily
INTRODUCTION: Many patients and family members experience a large gap between the protected environment during inpatient medical rehabilitation and life in the community after discharge. They feel insufficiently prepared to cope with the consequences of their disability in daily life. This study protocol describes the design measuring the effectiveness and implementation of family group conferences on the empowerment of patients with a high risk of chronic disability and their significant others...
March 8, 2018: BMJ Open
Michael A McCaskey, Brigitte Wirth, Corina Schuster-Amft, Eling D de Bruin
Sensorimotor training (SMT) is popularly applied as exercise in rehabilitation settings, particularly for musculoskeletal pain. With insufficient evidence on its effect on pain and function, this exploratory randomised controlled trial investigated the potential effects of SMT in rehabilitation of chronic non-specific low back pain. Two arms received 9x30 minutes physiotherapy with added interventions: The experimental arm received 15 minutes of postural SMT while the comparator arm performed 15 minutes of added sub-effective low-intensity training...
2018: PloS One
Francesca Palandri, Giulia Benevolo, Alessandra Iurlo, Elisabetta Abruzzese, Angelo M Carella, Chiara Paoli, Giuseppe A Palumbo, Massimiliano Bonifacio, Daniela Cilloni, Alessandro Andriani, Attilio Guarini, Diamante Turri, Elena Maria Elli, Antonietta Falcone, Barbara Anaclerico, Pellegrino Musto, Nicola Di Renzo, Mario Tiribelli, Renato Zambello, Caterina Spinosa, Alessandra Ricco, Letizia Raucci, Bruno Martino, Mario Annunziata, Silvia Pascale, Anna Marina Liberati, Giorgio La Nasa, Margherita Maffioli, Massimo Breccia, Novella Pugliese, Silvia Betti, Gianfranco Giglio, Antonietta Cappuccio, Luigi Reale
PURPOSE: Myelofibrosis (MF) is a chronic myeloproliferative neoplasm characterised by an aggressive clinical course, with disabling symptoms and reduced survival. Patients experience a severely impaired quality of life and their families face the upheaval of daily routines and high disease-related financial costs. The aim of this study was to investigate the perceptions of Italian patients and their caregivers about living with MF and the burden of illness associated with MF. METHODS: A quali-quantitative questionnaire and a prompted written narrative survey were administered to patients affected by primary or post-essential thrombocythemia/post-polycythaemia vera MF and their primary caregiver in 35 Italian haematological centres...
March 8, 2018: Quality of Life Research
Yohannes Adama Melaku, Andre Renzaho, Tiffany K Gill, Anne W Taylor, Eleonora Dal Grande, Barbora de Courten, Estifanos Baye, David Gonzalez-Chica, Elina Hyppӧnen, Zumin Shi, Malcolm Riley, Robert Adams, Yohannes Kinfu
BACKGROUND: Diet is a major determining factor for many non-communicable chronic diseases (NCDs). However, evidence on diet-related NCD burden remains limited. We assessed the trends in diet-related NCDs in Australia from 1990 to 2015 and compared the results with other countries of the Organization for Economic Co-operation and Development (OECD). METHODS: We used data and methods from the Global Burden of Disease (GBD) 2015 study to estimate the NCD mortality and disability-adjusted life years (DALYs) attributable to 14 dietary risk factors in Australia and 34 OECD nations...
March 7, 2018: European Journal of Nutrition
Federica Sancassiani, Sergio Machado, Antonio Preti
People with severe psychosocial disabilities have a 20-years shorter lifespan due to chronic somatic comorbidities and the long-term consequences of the side-effects of antipsychotic drugs. They often are sedentary and show lower levels of physical activity, factors which can contribute to their shorter lifespan, because of the greater cardiovascular risk. An increasing amount of evidence, including clinical trials, pointed out that sport, physical activity and structured exercise programs improve physical and psychological wellbeing of people with psychosocial disabilities, playing also an important role against their social isolation and self-stigma...
2018: Clinical Practice and Epidemiology in Mental Health: CP & EMH
Veronika Vielsmeier, Martin Schecklmann, Winfried Schlee, Peter M Kreuzer, Timm B Poeppl, Rainer Rupprecht, Berthold Langguth, Astrid Lehner
While brain stimulation techniques have been examined as treatment options for chronic tinnitus for many years, they have recently been extended to multimodal treatment approaches. As chronic tinnitus is often accompanied by comorbid muscular tension in the neck and back, we performed a one-arm pilot study to explore the feasibility of a new multimodal treatment approach. In detail, repetitive peripheral magnetic stimulation (rPMS) of the back was performed before and after each session of repetitive transcranial magnetic stimulation (rTMS) of the brain...
2018: Frontiers in Neuroscience
Jodie Stephenson, Erik Nutma, Paul van der Valk, Sandra Amor
Neurodegenerative diseases, the leading cause of morbidity and disability is gaining increased attention as it imposes a considerable socioeconomic impact, due in part to the ageing community. Neuronal damage is a pathological hallmark of Alzheimer's and Parkinson's disease, amyotrophic lateral sclerosis, Huntington's disease, spinocerebellar ataxia and multiple sclerosis, although such damage is also observed following neurotropic viral infections, stroke, genetic white matter diseases and paraneoplastic disorders...
March 7, 2018: Immunology
Ardalan Shariat, Pardis Noormohammadpour, Amir Hossein Memari, Noureddin Nakhostin Ansari, Joshua A Cleland, Ramin Kordi
A 40-year-old retired male elite athlete with more than 20 years' experience in wrestling and bodybuilding with mild elbow pain and disability of 2 years presented to our clinic reporting an acute pain in medial aspect of the elbow. Physical examination revealed symptoms of left Golfer's elbow during target-directed movements. The results of sonography in left elbow showed low level of hypo echo irregularity and increased blood flow in color Doppler mode in the common flexor origin. The pain amplitude was moderate at rest and extremely high during kinetic and intentional movements...
February 2018: Journal of Exercise Rehabilitation
Mads Ammitzbøll Danielsen
Rheumatod arthritis is a chronic systemic autoimmune disease, characterized by inflammation in joints and tendon sheaths, which frequently leads to permanent and serious disability due to joint destruction, but also tendon and ligament ruptures. Clinical management of rheumatoid arthritis has traditionally been supported by biochemical and radiographic findings. However, imaging modalities like ultrasound and magnetic resonance imaging (MRI) have improved the possibility for better management of rheumatoid arthritis patients, due to higher sensitivity and specificity for detecting ongoing inflammation, this thesis is focusing on tenosynovitis as recent studies have shown that inflammation in tendon sheaths, i...
March 2018: Danish Medical Journal
Daniel Mønsted Shabanzadeh
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by pain, swelling and progressive destruction of the joints leading to loss of function and invalidity. The bone destruction in RA is characterised by two distinct features: structural joint damage and hand bone loss, and their prevention is an important treatment goal. Inhibitors of tumour necrosis factor alpha (TNF-inhibitors) have markedly improved the treatment options in RA patients who fail treatment with conventional synthetic Disease Modifying Anti Rheumatic Drugs (sDMARDS), but their effectiveness with regards to structural joint damage and hand bone loss, predictors thereof and the association with disease activity during treatment have mainly been investigated in randomized controlled trials (RCTs) with limited generalizability due to strict in- and exclusion criteria...
March 2018: Danish Medical Journal
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