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Trends in musculoskeletal surgery and postoperative rehabilitation in patients with rheumatoid arthritis
Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103–e308
ISPR8-1187
ISPR8-1125
Radial extracorporeal shock wave therapy for adhesive capsulitis of the shoulder: A prospective, randomized, placebo controlled, double-blind study with subjective and objective endpoints
Trends in musculoskeletal surgery and postoperative rehabilitation in patients with rheumatoid arthritis
A. Hussein 1 , C. Schmitz 2,∗ , M. Ibrahim 3 Pharos University, Faculty of Physical Therapy, Alexandria, Egypt 2 Ludwig-Maximilians-University of Munich, Chair of Neuroanatomy, Institute of Anatomy, Munich, Germany 3 Health Check Medical Center, Physical and Rehabilitation Medicine, Brooklyn, NY, USA ∗ Corresponding author. E-mail address: [email protected] (C. Schmitz)
1
Introduction/Background This study tested the hypothesis that radial extracorporeal shock wave therapy (rESWT) is effective and safe in the treatment of adhesive capsulitis of the shoulder (adC-S). Material and method One hundred and six patients (mean age, 55.8 years; range, 39–77) with pain and limitations in shoulder mobility due to adC-S lasting for averaged 11.6 months (range, 9–14) were randomly allocated to either rESWT (n = 53) (four sessions, one session per week, Swiss DolorClast [Electro Medical Systems S.A., Nyon, Switzerland], radial handpiece, 15-mm applicator, 2000 rESWT impulses per session, positive energy flux density 0.14 mJ/mm2 , rESWT impulses applied at 8 Hz) or placebo treatment (n = 53). Patients completed the Visual Analog Scale (VAS) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire at baseline (BL) as well as at one month (M1), six months (M6) and twelve months (M12) after baseline. Moreover, passive and active abduction of the arm (pA and aA) as well as passive external rotation of the shoulder (pER) were measured at BL, M1, M6 and M12. Results All patients completed the final review at M12 and were included in the study. Mean pretreatment VAS scores, DASH scores and pA, aA and pER measurements for the rESWT and control groups were 6.3 and 6.3 (VAS), 73.5 and 72.5 (DASH), 98.2 and 99.3 degrees (pA), 65.8 and 68.8 degrees (aA), and 20.3 and 22.0 degrees (pER), respectively. Compared to placebo treatment rESWT resulted in statistically significantly reduced VAS score (by averaged 3.5 points) and statistically significantly improved DASH score (53.8 points), pA (63.9 degrees), aA (79.1 degrees) and pER (43.3 degrees) at all follow-up examinations. Conclusion rESWT as performed in the present study is an effective and safe treatment for adhesive capsulitis of the shoulder. Keywords Adhesive capsulitis; Shoulder; Shock wave therapy Disclosure of interest AH and MI declare that they have no competing interest. CS served (until December 2017) as a paid consultant for and received benefits from Electro Medical Systems (Nyon, Switzerland), the distributor of the Swiss DolorClast extracorporeal shock wave device. However, Electro Medical Systems had no any role in study design, data collection and analysis, decision to publish, or preparation of this abstract. No other potential conflicts of interest relevant to this article were reported. https://doi.org/10.1016/j.rehab.2018.05.274
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S. Maniwa ∗ , N. Maeki , H. Ishihara , T. Tadenuma , Y. Sakai Shimane University, Rehabilitation Medicine, Izumo, Japan ∗ Corresponding author. E-mail address: [email protected] (S. Maniwa) Introduction/Background Trend in the use of methotrexate (MTX) and biological disease-modifying anti-rheumatic drugs (DMARDs) has led to decrease the number of musculoskeletal surgery in patients with rheumatoid arthritis (RA). We investigated the changes in incidence of surgery and prescription of postoperative rehabilitation. Material and method Retrospective study was performed using medical records in Shimane University Hospital from 2002 to 2016. The number of surgery, prescription of postoperative rehabilitation, duration of hospital stay, and status of pharmacological treatment were studied in 152 patients. Linear regression analysis and Bonferroni/Dunn test were used for statistical analysis for the time trends in the incidence of surgeries. Results There was a decreasing trend in the incidence of surgery, especially in the surgery of lower extremities (P = 0.08). On the other hand, there was an increasing trend in the incidence of spinal surgery and operations in upper extremities. Hospitalization days became shorter (P < 0.01) and the incidence of postoperative rehabilitation decreased, especially for occupational therapy (OT). The proportion of patients receiving MTX and DMARDs significantly increased from 33.3% and 0% in 2002 to 63.2% and 52.6% in 2016, respectively. Conclusion The incidence of surgery of lower extremities decreased, however, the number of surgery in upper extremities increased among the patients with improved ADL and QOL owing to the use of effective drugs. Decreasing prescription of OT might bring a negative influence to individualized joint protection education in patients with RA. Keywords Rheumatoid arthritis; Surgery; Postoperative rehabilitation Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.275 ISPR8-2408
Items comparison of questionnaires, scales and clinical outcomes used in ankylosing spondylitis based on the International Classification of Functioning, Disability and Health: A systematic review P. Wang Shanghai Jiaotong University School of Medicine, Ruijin Hospital, Shanghai, China E-mail address: [email protected] Introduction/Background To identify questionnaires and scales used measuring ankylosing spondylitis (AS) patients’ functions, disability and health as well as determining whether these instruments can be matched to the International Classification of Functioning, Disability and Health (ICF) framework. Therefore, comparing the results with available ICF Core Set for AS. Material and method We searched PubMed in English from January 2001 to December 2016 using the search term: ankylosing spondylitis. Among all searched literatures, AS specific questionnaires and scales were identified and classified. Based on the ICF framework, each item of all included instruments was extracted and interpreted into ICF categories.
ISPR8-1187
ISPR8-1125
Radial extracorporeal shock wave therapy for adhesive capsulitis of the shoulder: A prospective, randomized, placebo controlled, double-blind study with subjective and objective endpoints
Trends in musculoskeletal surgery and postoperative rehabilitation in patients with rheumatoid arthritis
A. Hussein 1 , C. Schmitz 2,∗ , M. Ibrahim 3 Pharos University, Faculty of Physical Therapy, Alexandria, Egypt 2 Ludwig-Maximilians-University of Munich, Chair of Neuroanatomy, Institute of Anatomy, Munich, Germany 3 Health Check Medical Center, Physical and Rehabilitation Medicine, Brooklyn, NY, USA ∗ Corresponding author. E-mail address: [email protected] (C. Schmitz)
1
Introduction/Background This study tested the hypothesis that radial extracorporeal shock wave therapy (rESWT) is effective and safe in the treatment of adhesive capsulitis of the shoulder (adC-S). Material and method One hundred and six patients (mean age, 55.8 years; range, 39–77) with pain and limitations in shoulder mobility due to adC-S lasting for averaged 11.6 months (range, 9–14) were randomly allocated to either rESWT (n = 53) (four sessions, one session per week, Swiss DolorClast [Electro Medical Systems S.A., Nyon, Switzerland], radial handpiece, 15-mm applicator, 2000 rESWT impulses per session, positive energy flux density 0.14 mJ/mm2 , rESWT impulses applied at 8 Hz) or placebo treatment (n = 53). Patients completed the Visual Analog Scale (VAS) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire at baseline (BL) as well as at one month (M1), six months (M6) and twelve months (M12) after baseline. Moreover, passive and active abduction of the arm (pA and aA) as well as passive external rotation of the shoulder (pER) were measured at BL, M1, M6 and M12. Results All patients completed the final review at M12 and were included in the study. Mean pretreatment VAS scores, DASH scores and pA, aA and pER measurements for the rESWT and control groups were 6.3 and 6.3 (VAS), 73.5 and 72.5 (DASH), 98.2 and 99.3 degrees (pA), 65.8 and 68.8 degrees (aA), and 20.3 and 22.0 degrees (pER), respectively. Compared to placebo treatment rESWT resulted in statistically significantly reduced VAS score (by averaged 3.5 points) and statistically significantly improved DASH score (53.8 points), pA (63.9 degrees), aA (79.1 degrees) and pER (43.3 degrees) at all follow-up examinations. Conclusion rESWT as performed in the present study is an effective and safe treatment for adhesive capsulitis of the shoulder. Keywords Adhesive capsulitis; Shoulder; Shock wave therapy Disclosure of interest AH and MI declare that they have no competing interest. CS served (until December 2017) as a paid consultant for and received benefits from Electro Medical Systems (Nyon, Switzerland), the distributor of the Swiss DolorClast extracorporeal shock wave device. However, Electro Medical Systems had no any role in study design, data collection and analysis, decision to publish, or preparation of this abstract. No other potential conflicts of interest relevant to this article were reported. https://doi.org/10.1016/j.rehab.2018.05.274
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S. Maniwa ∗ , N. Maeki , H. Ishihara , T. Tadenuma , Y. Sakai Shimane University, Rehabilitation Medicine, Izumo, Japan ∗ Corresponding author. E-mail address: [email protected] (S. Maniwa) Introduction/Background Trend in the use of methotrexate (MTX) and biological disease-modifying anti-rheumatic drugs (DMARDs) has led to decrease the number of musculoskeletal surgery in patients with rheumatoid arthritis (RA). We investigated the changes in incidence of surgery and prescription of postoperative rehabilitation. Material and method Retrospective study was performed using medical records in Shimane University Hospital from 2002 to 2016. The number of surgery, prescription of postoperative rehabilitation, duration of hospital stay, and status of pharmacological treatment were studied in 152 patients. Linear regression analysis and Bonferroni/Dunn test were used for statistical analysis for the time trends in the incidence of surgeries. Results There was a decreasing trend in the incidence of surgery, especially in the surgery of lower extremities (P = 0.08). On the other hand, there was an increasing trend in the incidence of spinal surgery and operations in upper extremities. Hospitalization days became shorter (P < 0.01) and the incidence of postoperative rehabilitation decreased, especially for occupational therapy (OT). The proportion of patients receiving MTX and DMARDs significantly increased from 33.3% and 0% in 2002 to 63.2% and 52.6% in 2016, respectively. Conclusion The incidence of surgery of lower extremities decreased, however, the number of surgery in upper extremities increased among the patients with improved ADL and QOL owing to the use of effective drugs. Decreasing prescription of OT might bring a negative influence to individualized joint protection education in patients with RA. Keywords Rheumatoid arthritis; Surgery; Postoperative rehabilitation Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.275 ISPR8-2408
Items comparison of questionnaires, scales and clinical outcomes used in ankylosing spondylitis based on the International Classification of Functioning, Disability and Health: A systematic review P. Wang Shanghai Jiaotong University School of Medicine, Ruijin Hospital, Shanghai, China E-mail address: [email protected] Introduction/Background To identify questionnaires and scales used measuring ankylosing spondylitis (AS) patients’ functions, disability and health as well as determining whether these instruments can be matched to the International Classification of Functioning, Disability and Health (ICF) framework. Therefore, comparing the results with available ICF Core Set for AS. Material and method We searched PubMed in English from January 2001 to December 2016 using the search term: ankylosing spondylitis. Among all searched literatures, AS specific questionnaires and scales were identified and classified. Based on the ICF framework, each item of all included instruments was extracted and interpreted into ICF categories.