- Email: [email protected]
826 ULTRASOUND THERAPHY EFFECT IN PATIENTS WITH CARPAL TUNNEL SYNDROME: A PLACEBO CONTROLLED STUDY
Topic E: TREATMENT APPROACHES (PHYSICAL)
S215
826 ULTRASOUND THERAPHY EFFECT IN PATIENTS WITH CARPAL TUNNEL SYNDROME: A PLACEBO CONTROLLED STUDY
828 ANALGESIC EFFICACY OF APS (ACTION POTENTIAL SIMULATION). PILOT STUDY AT THE PATIENTS WITH CHRONIC PAIN IN MUSCULOSKELETAL DISORDERS
A. Ekim ° , O. Armagan, C. Oner. Department of Physical Therapy and Rehabilitation, Osmangazi University, Faculty of Medicine Eskisehir, Turkey
A. Pyszora1 ° , M. Krajnik1 , M. Graczyk1 , A. Adamczyk1 , J. Budzy´nski2 , M. Łukowicz3 , Z. Zylicz1 . 1 Chair and Department of Palliative Care, 2 Chair and Department of Gastroenterology, Vascular Diseases and Internal Diseases, 3 Chair and Department of Rehabilitation, Nicolaus Copernicus University Collegium Medicum, Bydgoszcz, Poland
Objective: To investigate the efficacy of low intensity ultrasound therapy (US), a conservative option of treatment of mild to moderate carpal tunnel syndrome (CTS). Material and Method: Nineteen patients, with unilateral CTS confirmed by electromyographic examination were included. Patients were randomly assigned to US (10 hands) and placebo group (9 hands). Ultrasound therapy, with intensities of 1.5 W/cm2 US group, and 0.0 W/cm2 placebo group was applied once a day to palmar carpal tunnel area for 5 minutes, 5 days a week, for 2 weeks. Clinical assessments were performed at baseline, at the end of the treatment. Patients were evaluated with clinical parameters, as functional status scale (FSS), visual analog scale (VAS), symptom severity scale (SSS), and grip-strength. Electrophysiologic examination were performed of all hands. Results: Clinical and electromyographic parameters, were similar at baseline in both groups. In the US group and placebo group, significant improvement were observed in VAS (p < 0.001, p < 0.01 respectively) and SSS (p < 0.001, p < 0.05 respectively) after treatment. At the posttreatment, significant improvements were found in the FSS, grip-strength sign in only US group. When compared two groups showed significant improvement in VAS (p < 0.001) and SSS (p < 0.001) in favor of US group after therapy. There were not statistically significant improvements in motor and sensory distal latencies. Conclusion: Our results indicated that of US and placebo US theraphy are effective on pain and clinical symptoms in CTS, we to considered that US is much more effective on pain, clinical symptoms and functional status in patients with CTS.
827 FREQUENCY OF HEADACHE RELIEF EPISODES ACCOMPANYING SHORT-TERM EXPOSURES TO NORMOBARIC HYPOXIA – FIVE YEAR STUDY RESULTS IN PREGNANT WOMEN S.A. Korobov ° . The ’Lermontovskii’ Clinical Sanatorium, Odessa, Ukraine Background and Aims: In 1998, I had accidentally found that short-term exposures to normobaric hypoxia (STENH) had been accompanied with headache relief in some patients with various chronic diseases. I had then observed this phenomenon in high risk pregnancy women as well. The aim of this study was to assess the frequency of such headache relief episodes summarizing the results obtained in pregnant women during five years. Methods: 408 pregnant women (mean age 26.8 years; mean gestational age 22.6 weeks) were intermittently provided with normobaric hypoxic (12% to 16% oxygen, depending on a case) gas mixtures. A session consisted of one or two 15-minute exposure(s) performed daily or every other day during two or three weeks respectively. Before each session, the women were in passing asked about the availability of headache. Those with headache were in no way informed about possible pain relief as a result of the procedure. Results: Of the women, 58 (14%) had headache immediately before STENH. In 45 (77%) of those ladies, the procedures had been accompanied with headache relief (30 episodes) or even headache disappearance (22 ones). Five sessions were immediately followed by headache transposition to another region of the head what was definitely deemed favourable by all the headachers. In 12 women (21%), no effect had been seen. In one case, an aggravation took place. Conclusions: Headache relief accompanying STENH is so frequent that requires certainly more detailed research including a search of ways of the use of this approach in headache management.
Background and Aims: APS-therapy (Action Potential Simulation) falls under the broad definition of MET (Microcurrent Electrical Stimulation). MET may be an useful treatment for many pain-related disorders, providing fast relief of symptoms. The aim of this pilot clinical study was to investigate the analgesic efficacy of APS-therapy in chronic pain due to musculoskeletal disorders. Methods: The study involved 12 patients with musculoskeletal disorders who suffered from chronic pain. Each patient received treatment for 3 weeks time. APS-therapy was administered for a period of 16 minutes, 5 times a week. Treatment was given by portable unit, that generated a monophasic waveform (pulse width 800 ms, frequency 150 Hz and intensity 0.5–1.5 mA). NRS (Numerical Rating Scale) evaluations were performed for 3 days of pre-treatment period, before each treatment which reflected the pain situation of the previous 24h and once daily for 2 weeks after treatment. Statistical analysis included ANOVA with Shefe post hoc test. Results: The initial mean NRS in pre-treatment period was 5.53 (SD = 1.94), decreased after APS –therapy to 3.45 (SD = 1.4) (p = 0.002) and even more to 2.56 (SD = 1.23) in the post–treatment period (p = 0.0003). In the Shefe post hoc test the main pain intensity decreased significantly after 11 therapeutical sessions and remained on the same level up to 2 weeks of post-treatment observation. Conclusion: APS-therapy may be an effective method of nonpharmacological treatment of chronic pain in muscoskeletal disorders.
829 EFFECT OF PRETREATMENT OF THE SKIN FOR AC IONTOPHORESIS T. Shibaji1 ° , C. Kato2 , Y. Yamazaki1 , Y. Ando1 , N. Suzuki1 , M. Umino3 , M. Shimada1 . 1 Orofacial Pain Management, Graduate School, 2 Faculty of Dentistry, 3 Anesthesiology and Clinical Physiology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan Background and Aims: Iontophoresis with an alternating current (AC) has been used for the treatments for neuropathic pains in the facial region. The aim of this study is to determine the effects of a pretreatment of the skin on the efficiency of the AC iontophoresis. Methods: AC iontophoresis was performed in the forearm skin of healthy volunteers with 4% lidocaine hydrochloride. A pulsed AC voltage with a frequency of 30 Hz was impressed for 10, 20, 30, 40, 50 minutes, respectively. The electrodes were made of cotton (70 mm×50 mm) soaked with lidocaine hydrochloride and aluminum foil. Pain thresholds of the skin were determined with S-W monofilaments before and after AC iontophoresis. The forearm skin was scrubbed 30 times by alcohol cotton before putting on the electrodes in pretreatment group. Results: The pain threshold after AC iontophoresis of the skin increased threefold within 10 min. in the pretreatment group. It takes about 20 min. for the pain threshold in the non-treatment group to increase threefold. Conclusions: The cornified layer of the skin acts as a barrier in iontophoresis. The pretreatment of skin with alcohol cotton made AC iontophoresis more effective.
S215
826 ULTRASOUND THERAPHY EFFECT IN PATIENTS WITH CARPAL TUNNEL SYNDROME: A PLACEBO CONTROLLED STUDY
828 ANALGESIC EFFICACY OF APS (ACTION POTENTIAL SIMULATION). PILOT STUDY AT THE PATIENTS WITH CHRONIC PAIN IN MUSCULOSKELETAL DISORDERS
A. Ekim ° , O. Armagan, C. Oner. Department of Physical Therapy and Rehabilitation, Osmangazi University, Faculty of Medicine Eskisehir, Turkey
A. Pyszora1 ° , M. Krajnik1 , M. Graczyk1 , A. Adamczyk1 , J. Budzy´nski2 , M. Łukowicz3 , Z. Zylicz1 . 1 Chair and Department of Palliative Care, 2 Chair and Department of Gastroenterology, Vascular Diseases and Internal Diseases, 3 Chair and Department of Rehabilitation, Nicolaus Copernicus University Collegium Medicum, Bydgoszcz, Poland
Objective: To investigate the efficacy of low intensity ultrasound therapy (US), a conservative option of treatment of mild to moderate carpal tunnel syndrome (CTS). Material and Method: Nineteen patients, with unilateral CTS confirmed by electromyographic examination were included. Patients were randomly assigned to US (10 hands) and placebo group (9 hands). Ultrasound therapy, with intensities of 1.5 W/cm2 US group, and 0.0 W/cm2 placebo group was applied once a day to palmar carpal tunnel area for 5 minutes, 5 days a week, for 2 weeks. Clinical assessments were performed at baseline, at the end of the treatment. Patients were evaluated with clinical parameters, as functional status scale (FSS), visual analog scale (VAS), symptom severity scale (SSS), and grip-strength. Electrophysiologic examination were performed of all hands. Results: Clinical and electromyographic parameters, were similar at baseline in both groups. In the US group and placebo group, significant improvement were observed in VAS (p < 0.001, p < 0.01 respectively) and SSS (p < 0.001, p < 0.05 respectively) after treatment. At the posttreatment, significant improvements were found in the FSS, grip-strength sign in only US group. When compared two groups showed significant improvement in VAS (p < 0.001) and SSS (p < 0.001) in favor of US group after therapy. There were not statistically significant improvements in motor and sensory distal latencies. Conclusion: Our results indicated that of US and placebo US theraphy are effective on pain and clinical symptoms in CTS, we to considered that US is much more effective on pain, clinical symptoms and functional status in patients with CTS.
827 FREQUENCY OF HEADACHE RELIEF EPISODES ACCOMPANYING SHORT-TERM EXPOSURES TO NORMOBARIC HYPOXIA – FIVE YEAR STUDY RESULTS IN PREGNANT WOMEN S.A. Korobov ° . The ’Lermontovskii’ Clinical Sanatorium, Odessa, Ukraine Background and Aims: In 1998, I had accidentally found that short-term exposures to normobaric hypoxia (STENH) had been accompanied with headache relief in some patients with various chronic diseases. I had then observed this phenomenon in high risk pregnancy women as well. The aim of this study was to assess the frequency of such headache relief episodes summarizing the results obtained in pregnant women during five years. Methods: 408 pregnant women (mean age 26.8 years; mean gestational age 22.6 weeks) were intermittently provided with normobaric hypoxic (12% to 16% oxygen, depending on a case) gas mixtures. A session consisted of one or two 15-minute exposure(s) performed daily or every other day during two or three weeks respectively. Before each session, the women were in passing asked about the availability of headache. Those with headache were in no way informed about possible pain relief as a result of the procedure. Results: Of the women, 58 (14%) had headache immediately before STENH. In 45 (77%) of those ladies, the procedures had been accompanied with headache relief (30 episodes) or even headache disappearance (22 ones). Five sessions were immediately followed by headache transposition to another region of the head what was definitely deemed favourable by all the headachers. In 12 women (21%), no effect had been seen. In one case, an aggravation took place. Conclusions: Headache relief accompanying STENH is so frequent that requires certainly more detailed research including a search of ways of the use of this approach in headache management.
Background and Aims: APS-therapy (Action Potential Simulation) falls under the broad definition of MET (Microcurrent Electrical Stimulation). MET may be an useful treatment for many pain-related disorders, providing fast relief of symptoms. The aim of this pilot clinical study was to investigate the analgesic efficacy of APS-therapy in chronic pain due to musculoskeletal disorders. Methods: The study involved 12 patients with musculoskeletal disorders who suffered from chronic pain. Each patient received treatment for 3 weeks time. APS-therapy was administered for a period of 16 minutes, 5 times a week. Treatment was given by portable unit, that generated a monophasic waveform (pulse width 800 ms, frequency 150 Hz and intensity 0.5–1.5 mA). NRS (Numerical Rating Scale) evaluations were performed for 3 days of pre-treatment period, before each treatment which reflected the pain situation of the previous 24h and once daily for 2 weeks after treatment. Statistical analysis included ANOVA with Shefe post hoc test. Results: The initial mean NRS in pre-treatment period was 5.53 (SD = 1.94), decreased after APS –therapy to 3.45 (SD = 1.4) (p = 0.002) and even more to 2.56 (SD = 1.23) in the post–treatment period (p = 0.0003). In the Shefe post hoc test the main pain intensity decreased significantly after 11 therapeutical sessions and remained on the same level up to 2 weeks of post-treatment observation. Conclusion: APS-therapy may be an effective method of nonpharmacological treatment of chronic pain in muscoskeletal disorders.
829 EFFECT OF PRETREATMENT OF THE SKIN FOR AC IONTOPHORESIS T. Shibaji1 ° , C. Kato2 , Y. Yamazaki1 , Y. Ando1 , N. Suzuki1 , M. Umino3 , M. Shimada1 . 1 Orofacial Pain Management, Graduate School, 2 Faculty of Dentistry, 3 Anesthesiology and Clinical Physiology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan Background and Aims: Iontophoresis with an alternating current (AC) has been used for the treatments for neuropathic pains in the facial region. The aim of this study is to determine the effects of a pretreatment of the skin on the efficiency of the AC iontophoresis. Methods: AC iontophoresis was performed in the forearm skin of healthy volunteers with 4% lidocaine hydrochloride. A pulsed AC voltage with a frequency of 30 Hz was impressed for 10, 20, 30, 40, 50 minutes, respectively. The electrodes were made of cotton (70 mm×50 mm) soaked with lidocaine hydrochloride and aluminum foil. Pain thresholds of the skin were determined with S-W monofilaments before and after AC iontophoresis. The forearm skin was scrubbed 30 times by alcohol cotton before putting on the electrodes in pretreatment group. Results: The pain threshold after AC iontophoresis of the skin increased threefold within 10 min. in the pretreatment group. It takes about 20 min. for the pain threshold in the non-treatment group to increase threefold. Conclusions: The cornified layer of the skin acts as a barrier in iontophoresis. The pretreatment of skin with alcohol cotton made AC iontophoresis more effective.