Search results for: post-operative pain
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 94

Search results for: post-operative pain

94 Factors Affecting Low Back Pain during Breastfeeding of Thai Women

Authors: N. Klinpikul, P. Srichandr, N. Poolthong, N. Thavarungkul

Abstract:

Breastfeeding has been receiving much attention of late. Prolonged sitting for breastfeeding often results in back pain of the mothers. This paper reports the findings of a study on the effect of some factors, especially lumbar support, on back pain of breastfeeding mothers. The results showed that the use of lumbar support can reduce back pain of breastfeeding mothers significantly. Back pain was found to increase with breastfeeding time and the rate of increase was lower when lumbar supports were used. When lumbar support thickness was increased gradually from zero (no support) to 11 cm., the degree of low back pain decreased; rapidly at first, then slowly, and leveled off when the thickness reached 9 cm. Younger mothers were less prone to back pain than older mothers. The implications of the findings are discussed.

Keywords: back pain, breastfeeding, lumbar support

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93 Metal Streak Analysis with different Acquisition Settings in Postoperative Spine Imaging: A Phantom Study

Authors: N. D. Osman, M. S. Salikin, M. I. Saripan

Abstract:

CT assessment of postoperative spine is challenging in the presence of metal streak artifacts that could deteriorate the quality of CT images. In this paper, we studied the influence of different acquisition parameters on the magnitude of metal streaking. A water-bath phantom was constructed with metal insertion similar with postoperative spine assessment. The phantom was scanned with different acquisition settings and acquired data were reconstructed using various reconstruction settings. Standardized ROIs were defined within streaking region for image analysis. The result shows increased kVp and mAs enhanced SNR values by reducing image noise. Sharper kernel enhanced image quality compared to smooth kernel, but produced more noise in the images with higher CT fluctuation. The noise between both kernels were significantly different (P <0.05) with increment of noise in the bone kernel images (mean difference = 54.78). The technical settings should be selected appropriately to attain the acceptable image quality with the best diagnostic value.

Keywords: Computed tomography, metal streak, noise, CT fluctuation.

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92 Chase Trainer Exercise Program in Athlete with Unilateral Patellofemoral Pain Syndrome (PFPS)

Authors: Asha Hasnimy Mohd Hashim, Lee Ai Choo

Abstract:

We investigated the effects of modified preprogrammed training mode Chase Trainer from Balance Trainer (BT3, HurLab, Tampere, Finland) on athlete who experienced unilateral Patellofemoral Pain Syndrome (PFPS). Twenty-seven athletes with mean age= 14.23 ±1.31 years, height = 164.89 ± 7.85 cm, weight = 56.94 ± 9.28 kg were randomly assigned to two groups: experiment (EG; n = 14) and injured (IG; n = 13). EG performed a series of Chase Trainer program which required them to shift their body weight at different directions, speeds and angle of leaning twice a week for duration of 8 weeks. The static postural control and perceived pain level measures were taken at baseline, after 6 weeks and 8 weeks of training. There was no significant difference in any of tested variables between EG and IG before and after 6-week the intervention period. However, after 8-week of training, the postural control (eyes open) and perceived pain level of EG improved compared to IG (p<0.05). The postural control with eyes closed of EG improved (p<0.05) but the values were not significantly different compared to IG after training. The results suggest that using Chase Trainer exercise program it is possible to improve individual postural control and decreased perceived pain level in athlete with unilateral Patellofemoral Pain Syndrome (PFPS).

Keywords: Patellofemoral Pain Syndrome, perceived pain level, postural control.

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91 The Study of the Variability of Anticipatory Postural Adjustments in Recurrent Non-specific LBP Patients

Authors: Rosita Hedayati , Sedighe Kahrizi , Mohammad Parnianpour , Fariba Bahrami , Anoshirvan Kazemnejad

Abstract:

The study of the variability of the postural strategies in low back pain patients, as a criterion in evaluation of the adaptability of this system to the environmental demands is the purpose of this study. A cross-sectional case-control study was performed on 21 recurrent non-specific low back pain patients and 21 healthy volunteers. The electromyography activity of Deltoid, External Oblique (EO), Transverse Abdominis/Internal Oblique (TrA/IO) and Erector Spine (ES) muscles of each person was recorded in 75 rapid arm flexion with maximum acceleration. Standard deviation of trunk muscles onset relative to deltoid muscle onset were statistically analyzed by MANOVA . The results show that chronic low back pain patients exhibit less variability in their anticipatory postural adjustments (APAs) in comparison with the control group. There is a decrease in variability of postural control system of recurrent non-specific low back pain patients that can result in the persistence of pain and chronicity by decreasing the adaptability to environmental demands.

Keywords: EMG Onset Latency, Variability, Posture, Non - specific Low Back Pain

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90 Pain and Lumbar Muscle Activation before and after Functional Task in Nonspecific Chronic Low Back Pain

Authors: Lídia E. O. Cruz, Adriano P. C. Calvo, Renato J. Soares, Regiane A. Carvalho

Abstract:

Individuals with non-specific chronic low back pain may present altered movement patterns during functional activities. However, muscle behavior before and after performing a functional task with different load conditions is not yet fully understood. The aim of this study is to analyze lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground (with and without load) in individuals with nonspecific chronic low back pain. 20 subjects with nonspecific chronic low back pain and 20 healthy subjects participated in this study. A surface electromyography was performed in the ilio-costal, longissimus and multifidus muscles to evaluate lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground, with and without load. The symptomatic participants had greater lumbar muscle activation compared to the asymptomatic group, more evident in performing the task without load, with statistically significant difference (p = 0,033) between groups for the right multifidus muscle. This study showed that individuals with nonspecific chronic low back pain have higher muscle activation before and after performing a functional task compared to healthy participants.

Keywords: Chronic low back pain, functional task, lumbar muscles, muscle activity.

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89 Study of Chest Pain and its Risk Factors in Over 30 Year-Old Individuals

Authors: S. Dabiran

Abstract:

Chest pain is one of the most prevalent complaints among adults that cause the people to attend to medical centers. The aim was to determine the prevalence and risk factors of chest pain among over 30 years old people in Tehran. In this cross-sectional study, 787 adults took part from Apr 2005 until Apr 2006. The sampling method was random cluster sampling and there were 25 clusters. In each cluster, interviews were performed with 32 over 30 years old, people lived in those houses. In cases with chest pain, extra questions asked. The prevalence of CP was 9% (71 cases). Of them 21 cases (6.5%) were in 41-60 year age ranges and the remainders were over 61 year old. 19 cases (26.8%) mentioned CP in resting state and all of the cases had exertion onset CP. The CP duration was 10 minutes or less in all of the cases and in most of them (84.5%), the location of pain mentioned left anterior part of chest, left anterior part of sternum and or left arm. There was positive history of myocardial infarction in 12 cases (17%). There was significant relation between CP and age, sex and between history of myocardial infarction and marital state of study people. Our results are similar to other studies- results in most parts, however it is necessary to perform supplementary tests and follow up studies to differentiate between cardiac and non-cardiac CP exactly.

Keywords: Chest pain, myocardial infarction, risk factor, prevalence

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88 Understanding Grip Choice and Comfort Whilst Hoovering

Authors: S.R.Kamat, A.Yoxall, C.Craig , M.J.Carré, J.Rowson

Abstract:

The hand is one of the essential parts of the body for carrying out Activities of Daily Living (ADLs). Individuals use their hands and fingers in everyday activities in the both the workplace and home. Hand-intensive tasks require diverse and sometimes extreme levels of exertion, depending on the action, movement or manipulation involved. The authors have undertaken several studies looking at grip choice and comfort. It is hoped that in providing improved understanding of discomfort during ADLs this will aid in the design of consumer products. Previous work by the authors outlined a methodology for calculating pain frequency and pain level for a range of tasks. From an online survey undertaken by the authors with regards manipulating objects during everyday tasks, tasks involving gripping were seen to produce the highest levels of pain and discomfort. Questioning of the participants showed that cleaning tasks were seen to be ADL's that produced the highest levels of discomfort, with women feeling higher levels of discomfort than men. This paper looks at the methodology for calculating pain frequency and pain level with particular regards to gripping activities. This methodology shows that activities such as mopping, sweeping and hoovering shows the highest numbers of pain frequency and pain level at 3112.5 frequency per month while the pain level per person doing this action was 0.78.The study then uses thin-film force sensors to analyze the force distribution in the hand whilst hoovering and compares this for differing grip styles and genders. Women were seen to have more of their hand under a higher pressure than men when undertaking hoovering. This suggests that women may feel greater discomfort than men since their hand is at a higher pressure more of the time.

Keywords: hovering, grip, pain

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87 Sociocultural Context of Pain Management in Oncology and Palliative Nursing Care

Authors: Andrea Zielke-Nadkarni

Abstract:

Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: Pain management, migrants, sociocultural context, palliative care.

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86 Burnout Recognition for Call Center Agents by Using Skin Color Detection with Hand Poses

Authors: El Sayed A. Sharara, A. Tsuji, K. Terada

Abstract:

Call centers have been expanding and they have influence on activation in various markets increasingly. A call center’s work is known as one of the most demanding and stressful jobs. In this paper, we propose the fatigue detection system in order to detect burnout of call center agents in the case of a neck pain and upper back pain. Our proposed system is based on the computer vision technique combined skin color detection with the Viola-Jones object detector. To recognize the gesture of hand poses caused by stress sign, the YCbCr color space is used to detect the skin color region including face and hand poses around the area related to neck ache and upper back pain. A cascade of clarifiers by Viola-Jones is used for face recognition to extract from the skin color region. The detection of hand poses is given by the evaluation of neck pain and upper back pain by using skin color detection and face recognition method. The system performance is evaluated using two groups of dataset created in the laboratory to simulate call center environment. Our call center agent burnout detection system has been implemented by using a web camera and has been processed by MATLAB. From the experimental results, our system achieved 96.3% for upper back pain detection and 94.2% for neck pain detection.

Keywords: Call center agents, fatigue, skin color detection, face recognition.

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85 Study on the Effect of Pre-Operative Patient Education on Post-Operative Outcomes

Authors: Chaudhary Itisha, Shankar Manu

Abstract:

Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: Patient education, post-operative pain, patient satisfaction, post-operative outcome.

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84 The Effects of Extracorporeal Shockwave Therapy on Pain, Function, Range of Motion and Strength in Patients with Plantar Fasciitis

Authors: P. Sanzo

Abstract:

Ten percent of the population will develop plantar fasciitis (PF) during their lifetime. Two million people are treated yearly accounting for 11-15% of visits to medical professionals. Treatment ranges from conservative to surgical intervention. The purpose of this study was to assess the effects of extracorporeal shockwave therapy (ECSWT) on heel pain, function, range of motion (ROM), and strength in patients with PF. One hundred subjects were treated with ECSWT and measures were taken before and three months after treatment. There was significant differences in visual analog scale scores for pain at rest (p=0.0001); after activity (p= 0.0001) and; overall improvement (p=0.0001). There was also significant improvement in Lower Extremity Functional Scale scores (p=0.0001); ankle plantarflexion (p=0.0001), dorsiflexion (p=0.001), and eversion (p=0.017),and first metatarsophalangeal joint flexion (p=0.002) and extension (p=0.003) ROM. ECSWT is an effective treatment improving heel pain, function and ROM in patients with PF.

Keywords: Extracorporeal shockwave therapy, shockwave therapy, plantar fasciitis, heel pain, function, range of motion, strength.

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83 Musculoskeletal Pain, Work Characteristics and Presenteeism among Hotel Employees

Authors: Ruey-Yu Chen, Yao-Tsung Chang, Ching-Ying Yeh, Yu-Ting Huang

Abstract:

Musculoskeletal problems in the hotel sector have been little studied. The aim of this study was to examine relationships of musculoskeletal pain and work characteristics with presenteeism, i.e., feeling sick but going to work anyway. Data of a self-reported questionnaire were collected from 1,101 employees, who joined the study on a voluntary basis from four hotels in northern Taiwan. The results showed that respondents who were female, were younger, had a higher educational level, and worked in the real-service department had higher presenteeism. There were significant positive associations between presenteeism and heavy loads, frequent beatings or hits of hard objects, improper bench height, employees’ lower limb and lower back pain. Our study results imply that knowledge of work characteristics and employees' musculoskeletal problems could be advantageously used to reduce presenteeism in the workplace.

Keywords: Musculoskeletal pain, absenteeism, presenteeism, hotel employees.

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82 Payment for Pain: Differences between Hypothetical and Real Preferences

Authors: J. Trarbach, S. Schosser, B. Vogt

Abstract:

Decision-makers tend to prefer the first alternative over subsequent alternatives which is called the primacy effect. To reliably measure this effect, we conducted an experiment with real consequences for preference statements. Therefore, we elicit preferences of subjects using a rating scale, i.e. hypothetical preferences, and willingness to pay, i.e. real preferences, for two sequences of pain. Within these sequences, both overall intensity and duration of pain are identical. Hence, a rational decision-maker should be indifferent, whereas the primacy effect predicts a stronger preference for the first sequence. What we see is a primacy effect only for hypothetical preferences. This effect vanishes for real preferences.

Keywords: Decision making, primacy effect, real incentives, willingness to pay.

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81 A Hybrid Data Mining Method for the Medical Classification of Chest Pain

Authors: Sung Ho Ha, Seong Hyeon Joo

Abstract:

Data mining techniques have been used in medical research for many years and have been known to be effective. In order to solve such problems as long-waiting time, congestion, and delayed patient care, faced by emergency departments, this study concentrates on building a hybrid methodology, combining data mining techniques such as association rules and classification trees. The methodology is applied to real-world emergency data collected from a hospital and is evaluated by comparing with other techniques. The methodology is expected to help physicians to make a faster and more accurate classification of chest pain diseases.

Keywords: Data mining, medical decisions, medical domainknowledge, chest pain.

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80 Modeling of Radiofrequency Nerve Lesioning in Inhomogeneous Media

Authors: Nour Ismail, Sahar El Kardawy, Bassant Badwy

Abstract:

Radiofrequency (RF) lesioning of nerves have been commonly used to alleviate chronic pain, where RF current preventing transmission of pain signals through the nerve by heating the nerve causing the pain. There are some factors that affect the temperature distribution and the nerve lesion size, one of these factors is the inhomogeneities in the tissue medium. Our objective is to calculate the temperature distribution and the nerve lesion size in an inhomogeneous medium surrounding the RF electrode. A two 3-D finite element models are used to compare the temperature distribution in the homogeneous and inhomogeneous medium. Also the effect of temperature-dependent electric conductivity on maximum temperature and lesion size is observed. Results show that the presence of an inhomogeneous medium around the RF electrode has a valuable effect on the temperature distribution and lesion size. The dependency of electric conductivity on tissue temperature increased lesion size.

Keywords: Finite element model, nerve lesioning, pain relief, radiofrequency lesion.

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79 Efficacy of Recovery Tech Virtual Reality Rehabilitation System for Shoulder Impingement Syndrome

Authors: Kasra Afsahi, Maryam Soheilifar, Nazanin Vahed, Omid Seyed Esmaeili, S. Hossein Hosseini

Abstract:

The most common cause of shoulder pain occurs when rotator cuff tendons become trapped under the bony area in the shoulder. This pilot study was performed to evaluate the feasibility of Virtual Reality based rehabilitation of shoulder impingement syndrome in athletes. Three consecutive patients with subacromial impingement syndrome were enrolled. The participants were rehabilitated for 5 times a week for 4 weeks, 20 sessions in total (with duration of each session being 60 minutes). In addition to the conventional rehabilitation program, a 10-minute game-based virtual reality exercise was administered. Primary outcome measures were range of motion evaluated with goniometer, pain sensation, disability intensity using ‘The Disabilities of the Arm, Shoulder and Hand Questionnaire’, muscle strength using ‘dynamometer’; pain threshold with 'algometer' and level of satisfaction. There were significant improvements in the range of motion, pain sensation, disability, pain threshold and muscle strength compared to basis (P < 0.05). There were no major adverse effects. This study showed the usefulness of VR therapy as an adjunct to conventional physiotherapy in improving function in patients with shoulder impingement syndrome.

Keywords: Shoulder impingement syndrome, VR therapy, feasibility, rehabilitation.

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78 Dynamic Balance, Pain and Functional Performance in Cruciate Retaining, Posterior Stabilized and Uni-Compartmental Knee Arthroplasty

Authors: Ahmed R. Z. Baghdadi, Amira A. A. Abdallah

Abstract:

Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much.

Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA) and uni-compartmental knee arthroplasty (UKA) on dynamic balance, pain and functional performance following rehabilitation.

Methods: Fifteen patients with CRTKA (group I), fifteen with PSTKA (group II), fifteen with UKA (group III) and fifteen indicated for arthroplasty but weren’t operated on yet (group IV) participated in the study. The mean age was 54.53±3.44, 55.13±3.48, 52.8±1.93 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99, 35.6±1.88 and 35.73±1.03 kg/m2 for group I, II, III and IV respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four and eight weeks pre- and post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-8th weeks) programs.

Results: The Mixed design MANOVA revealed that group III had significantly higher BBS scores, and lower pain scores and TUG and SC time than groups I and II four and eight weeks post-operatively. In addition, group I had significantly lower pain scores and SC time compared with group II eight weeks post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly eight weeks post-operatively compared with the three other assessments in group I, II and III with the opposite being true four weeks post-operatively.

Interpretation/Conclusion: CRTKA is preferable to PSTKA with UKA being generally superior to TKA, possibly due to the preserved human proprioceptors in the un-excised compartmental articular surface.

Keywords: Dynamic Balance, Functional Performance, Knee Arthroplasty, Pain.

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77 The Active Imagination Technique for Bruxism Treatment

Authors: Lyra S. R., Zaura-Bremm T., Boleta-Ceranto D. C. F.

Abstract:

The research purpose was to evaluate the effect of Active Imagination Technique (AIT) for bruxism treatment. This project was approved by the Ethics Committee on Human Research (CAAE: 05619512.9.0000.0109). Twenty-one volunteers using interocclusal splint completed the study. Initially they filled in a questionnaire about their condition, composed of objective questions on signs and symptoms. Following they were underwent asingle session of AIT. After 15 days, the volunteers met again the same initial questionnaire. The results were compared and showed that the vast majority had pain symptoms, difficulty opening the mouth, pain when chewing, reduced, some of the participants abandoned the interocclusal splint during the evaluate period. It is concluded that the technique can be used in bruxism treatment. Results seem to be promising and demonstrates the need of highlighting Active Imagination Technique since it points a possibility of bruxism cure and that is unprecedented.

Keywords: Active Imagination, bruxism, orofacial pain, treatment

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76 Long-Term Follow-up of Dynamic Balance, Pain and Functional Performance in Cruciate Retaining and Posterior Stabilized Total Knee Arthroplasty

Authors: Ahmed R. Z. Baghdadi, Mona H. Gamal Eldein

Abstract:

Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much. Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA on dynamic balance, pain and functional performance following rehabilitation. Methods: Thirty patients with CRTKA (group I), thirty with PSTKA (group II) and fifteen indicated for arthroplasty but weren’t operated on yet (group III) participated in the study. The mean age was 54.53±3.44, 55.13±3.48 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99 and 35.73±1.03 kg/m2 for groups I, II and III respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks preand post-operatively, three, six and twelve months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs, follow-up to all groups for twelve months. Results: The Mixed design MANOVA revealed that group I had significantly lower pain scores and SC time compared with group II three, six and twelve months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly six months post-operatively compared with four weeks pre- and post-operatively and three months postoperatively in groups I and II with the opposite being true four weeks post-operatively. But no significant differences in BBS scores, pain scores and TUG and SC time between six and twelve months postoperatively in groups I and II. Interpretation/Conclusion: CRTKA is preferable to PSTKA, possibly due to the preserved human proprioceptors in the un-excised PCL.

Keywords: Dynamic Balance, Functional Performance, Knee Arthroplasty, Long-Term.

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75 Effect of Cold, Warm or Contrast Therapy on Controlling Knee Osteoarthritis Associated Problems

Authors: Amal E. Shehata, Manal E. Fareed

Abstract:

Osteoarthritis (OA) is the most prevalent and far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint. Patients suffering from osteoarthritis often complain of dull ache pain on movement. Physical agents can fight the painful process when correctly indicated and used such as heat or cold therapy Aim. This study was carried out to: Compare the effect of cold, warm and contrast therapy on controlling knee osteoarthritis associated problems. Setting: The study was carried out in orthopedic outpatient clinics of Menoufia University and teaching Hospitals, Egypt. Sample: A convenient sample of 60 adult patients with unilateral knee osteoarthritis. Tools: three tools were utilized to collect the data. Tool I : An interviewing questionnaire. It comprised of three parts covering  sociodemographic data, medical data and adverse effects of the treatment protocol. Tool II : Knee Injury and Osteoarthritis Outcome Score (KOOS) It consists of five main parts. Tool II1 : 0-10 Numeric pain rating scale. Results: reveled that the total knee symptoms score was decreased from moderate symptoms pre intervention to mild symptoms after warm and contrast method of therapy, but the contrast therapy had significant effect in reducing the knee symptoms and pain than the other symptoms. Conclusions: all of the three methods of therapy resulted in improvement in all knee symptoms and pain but the most appropriate protocol of treatment to relive symptoms and pain was contrast therapy.

Keywords: Knee Osteoarthritis, Cold, Warm and Contrast Therapy.

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74 Survey of Epidemiology and Mechanisms of Badminton Injury Using Medical Check-Up and Questionnaire of School Age Badminton Players

Authors: Xiao Zhou, Kazuhiro Imai, Xiaoxuan Liu

Abstract:

Badminton is one type of racket sports that requires repetitive overhead motion, with the shoulder in abduction/external rotation and requires players to perform jumps, lunges, and quick directional changes. These characteristics could be stressful for body regions that may cause badminton injuries. Regarding racket players including badminton players, there have not been any studies that have utilized medical check-up to evaluate epidemiology and mechanism of injuries. In addition, epidemiology of badminton injury in school age badminton players is unknown. The first purpose of this study was to investigate the badminton injuries, physical fitness parameters, and intensity of shoulder pain using medical check-up so that the mechanisms of shoulder injuries might be revealed. The second purpose of this study was to survey the distribution of badminton injuries in elementary school age players so that injury prevention can be implemented as early as possible. The results of this study revealed that shoulder pain occurred in all players, and present shoulder pain players had smaller weight, greater shoulder external rotation (ER) gain, significantly thinner circumference of upper limbs and greater trunk extension. Identifying players with specific of these factors may enhance the prevention of badminton injury. This study also shows that there are high incidences of knee, ankle, plantar, and shoulder injury or pain in elementary school age badminton players. Injury prevention program might be implemented for elementary school age players.

Keywords: Badminton injury, epidemiology, medical check-up, school age players.

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73 Managing an Acute Pain Unit Based on the Balanced Scorecard

Authors: Helena Costa Oliveira, Carmem Oliveira, Rita Moutinho

Abstract:

The Balanced Scorecard (BSC) is a continuous strategic monitoring model focused not only on financial issues but also on internal processes, patients/users, and learning and growth. Initially dedicated to business management, it currently serves organizations of other natures - such as hospitals. This paper presents a BSC designed for a Portuguese Acute Pain Unit (APU). This study is qualitative and based on the experience of collaborators at the APU. The management of APU is based on four perspectives – users, internal processes, learning and growth, and financial and legal. For each perspective, there were identified strategic objectives, critical factors, lead indicators and initiatives. The strategic map of the APU outlining sustained strategic relations among strategic objectives. This study contributes to the development of research in the health management area as it explores how organizational insufficiencies and inconsistencies in this particular case can be addressed, through the identification of critical factors, to clearly establish core outcomes and initiatives to set up.

Keywords: Acute pain unit, balanced scorecard, hospital management, organizational performance, Portugal.

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72 The Characteristics of Static Plantar Loading in the First-Division College Sprint Athletes

Authors: Tong-Hsien Chow

Abstract:

Background: Plantar pressure measurement is an effective method for assessing plantar loading and can be applied to evaluating movement performance of the foot. The purpose of this study is to explore the sprint athletes’ plantar loading characteristics and pain profiles in static standing. Methods: Experiments were undertaken on 80 first-division college sprint athletes and 85 healthy non-sprinters. ‘JC Mat’, the optical plantar pressure measurement was applied to examining the differences between both groups in the arch index (AI), three regional and six distinct sub-regional plantar pressure distributions (PPD), and footprint characteristics. Pain assessment and self-reported health status in sprint athletes were examined for evaluating their common pain areas. Results: Findings from the control group, the males’ AI fell into the normal range. Yet, the females’ AI was classified as the high-arch type. AI values of the sprint group were found to be significantly lower than the control group. PPD were higher at the medial metatarsal bone of both feet and the lateral heel of the right foot in the sprint group, the males in particular, whereas lower at the medial and lateral longitudinal arches of both feet. Footprint characteristics tended to support the results of the AI and PPD, and this reflected the corresponding pressure profiles. For the sprint athletes, the lateral knee joint and biceps femoris were the most common musculoskeletal pains. Conclusions: The sprint athletes’ AI were generally classified as high arches, and that their PPD were categorized between the features of runners and high-arched runners. These findings also correspond to the profiles of patellofemoral pain syndrome (PFPS)-related plantar pressure. The pain profiles appeared to correspond to the symptoms of high-arched runners and PFPS. The findings reflected upon the possible link between high arches and PFPS. The correlation between high-arched runners and PFPS development is worth further studies.

Keywords: Sprint athletes, arch index, plantar pressure distributions, high arches, patellofemoral pain syndrome.

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71 The Effects of Extracorporeal Shockwave Therapy on Pain, Function, Range of Motion, and Strength in Patients with Insertional Achilles Tendinosis

Authors: P. Sanzo

Abstract:

Increased physical fitness participation has been paralleled by increasedoveruse injuries such as insertional Achilles tendinosis (AT). Treatment has provided inconsistentresults. The use of extracorporeal shockwave therapy (ECSWT) offers a new treatment consideration.The purpose of this study was to assess the effects of ECSWTon pain, function, range of motion (ROM), joint mobility and strength in patients with AT. Thirty subjects were treated with ECSWT and measures were takenbefore and three months after treatment. There was significant differences in visual analog scale (VAS) scores for pain at rest (p=0.002); after activity (p= 0.0001); overall improvement(p=0.0001); Lower Extremity Functional Scale (LEFS) scores (p=0.002); dorsiflexion range of motion (ROM) (p=0.0001); plantarflexion strength (p=0.025); talocrural joint anterior glide (p=0.046); and subtalar joint medial and lateral glide (p=0.025).ECSWT offers a new intervention that may limit the progression of the disorder and the long term healthcare costs associated with AT.

Keywords: Extracorporeal shockwave therapy, shockwave therapy, Achilles tendinosis, range of motion, strength, joint mobility

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70 Antinociceptive and Anti-inflammatory Effects of Hydroalcohol Extract of Vitex agnus castus Fruit

Authors: M. Ramezani, Gh. Amin, E. Jalili

Abstract:

In present study the effects of anti-inflammatory and antinociceptive of vitex hydro-alcoholic extract were evaluated on male mice. In inflammatory test mice were divided into 7 groups: first group was control. The second group, positive control group, received dexamethasone (15 mg/kg) and the other five groups received different doses of hydroalcohol extract of Vitex fruit (265, 365, 465, 565, and 665 mg/kg). The inflammation was caused by xylene-induced ear edema. Formalin test was used for evaluation of antinociceptive effect of extract. In this test, mice were divided into 7 groups: control, morphine (10mg/kg) as positive control group, and Vitex extract groups ((265, 365, 465, 565, and 665 mg/kg). All drugs were administered intrapritoneally, 30 min before each test. The data were analyzed using one-way ANOVA followed by Tukey-kramer multiple comparison test. Results have shown significant antiinflammatory effects of extract at all dosed as compared with control (P<0.05). In the first phase of formalin test (0-5 min) none doses of extract could inhibit acute pain, but in the second phase (15-30 min) chronic pain decreased at 265, 365, 465, and 565 mg/kg doses (P<0.05). The results of this research indicated that Vitex extract remarkably inhibited inflammation and second phase of nociception (inflammatory pain) and can be used for treatment of inflammatory diseases.

Keywords: Anti-inflammatory, Antinociceptive, Mice, Vitexagnus castus.

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69 Applying the Regression Technique for Prediction of the Acute Heart Attack

Authors: Paria Soleimani, Arezoo Neshati

Abstract:

Myocardial infarction is one of the leading causes of death in the world. Some of these deaths occur even before the patient reaches the hospital. Myocardial infarction occurs as a result of impaired blood supply. Because the most of these deaths are due to coronary artery disease, hence the awareness of the warning signs of a heart attack is essential. Some heart attacks are sudden and intense, but most of them start slowly, with mild pain or discomfort, then early detection and successful treatment of these symptoms is vital to save them. Therefore, importance and usefulness of a system designing to assist physicians in early diagnosis of the acute heart attacks is obvious. The main purpose of this study would be to enable patients to become better informed about their condition and to encourage them to seek professional care at an earlier stage in the appropriate situations. For this purpose, the data were collected on 711 heart patients in Iran hospitals. 28 attributes of clinical factors can be reported by patients; were studied. Three logistic regression models were made on the basis of the 28 features to predict the risk of heart attacks. The best logistic regression model in terms of performance had a C-index of 0.955 and with an accuracy of 94.9%. The variables, severe chest pain, back pain, cold sweats, shortness of breath, nausea and vomiting, were selected as the main features.

Keywords: Coronary heart disease, acute heart attacks, prediction, logistic regression.

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68 Arduino Pressure Sensor Cushion for Tracking and Improving Sitting Posture

Authors: Andrew Hwang

Abstract:

The average American worker sits for thirteen hours a day, often with poor posture and infrequent breaks, which can lead to health issues and back problems. The Smart Cushion was created to alert individuals of their poor postures, and may potentially alleviate back problems and correct poor posture. The Smart Cushion is a portable, rectangular, foam cushion, with five strategically placed pressure sensors, that utilizes an Arduino Uno circuit board and specifically designed software, allowing it to collect data from the five pressure sensors and store the data on an SD card. The data is then compiled into graphs and compared to controlled postures. Before volunteers sat on the cushion, their levels of back pain were recorded on a scale from 1-10. Data was recorded for an hour during sitting, and then a new, corrected posture was suggested. After using the suggested posture for an hour, the volunteers described their level of discomfort on a scale from 1-10. Different patterns of sitting postures were generated that were able to serve as early warnings of potential back problems. By using the Smart Cushion, the areas where different volunteers were applying the most pressure while sitting could be identified, and the sitting postures could be corrected. Further studies regarding the relationships between posture and specific regions of the body are necessary to better understand the origins of back pain; however, the Smart Cushion is sufficient for correcting sitting posture and preventing the development of additional back pain.

Keywords: Arduino Sketch Algorithm, biomedical technology, pressure sensors, Smart Cushion.

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67 Efficacy of Biofeedback-Assisted Pelvic Floor Muscle Training on Postoperative Stress Urinary Incontinence

Authors: Asmaa M. El-Bandrawy, Afaf M. Botla, Ghada E. El-Refaye, Hassan O. Ghareeb

Abstract:

Background: Urinary incontinence is a common problem among adults. Its incidence increases with age and it is more frequent in women. Pelvic floor muscle training (PFMT) is the first-line therapy in the treatment of pelvic floor dysfunction (PFD) either alone or combined with biofeedback-assisted PFMT. The aim of the work: The purpose of this study is to evaluate the efficacy of biofeedback-assisted PFMT in postoperative stress urinary incontinence. Settings and Design: A single blind controlled trial design was. Methods and Material: This study was carried out in 30 volunteer patients diagnosed as severe degree of stress urinary incontinence and they were admitted to surgical treatment. They were divided randomly into two equal groups: (Group A) consisted of 15 patients who had been treated with post-operative biofeedback-assisted PFMT and home exercise program (Group B) consisted of 15 patients who had been treated with home exercise program only. Assessment of all patients in both groups (A) and (B) was carried out before and after the treatment program by measuring intra-vaginal pressure in addition to the visual analog scale. Results: At the end of the treatment program, there was a highly statistically significant difference between group (A) and group (B) in the intra-vaginal pressure and the visual analog scale favoring the group (A). Conclusion: biofeedback-assisted PFMT is an effective method for the symptomatic relief of post-operative female stress urinary incontinence.

Keywords: Stress urinary incontinence, pelvic floor muscles, pelvic floor exercises, biofeedback.

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66 Poststreptococcal Reactive Arthritis in Children: A Serial Case

Authors: A. Lubis, S. S. Pasulu, Z. Hikmah, A. Endaryanto, A. Harsono

Abstract:

Infection by group A streptococci (GAS) can trigger an autoantibody that cause a poststreptococcal reactive arthritis (PSRA). Four patients with PSRA aged 10 years to 14 years old with the main complaint of joint pain for five days to 10 days after suffering a fever and sore throat. The joint pain was persistent, additive, and non migratory. All patients revealed an increase in erythrocyte sedimentation rate (ESR) and anti-streptolysin O (ASLO), but the chest x-ray, electrocardiography, and echocardiography were normal. Bone imaging showed no destruction on the affected joint. Jones Criteria were not fulfilled in all patients. Erythromycin and ibuprofen were given in all patients and an improvement was shown. Erythromycin was continued for one year and routine controls were conducted for cardiac evaluation. The prognosis of all the patients was good.

Keywords: Arthritis, group A streptococcus, autoantibody, Jones criteria.

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65 Preserved Relative Differences between Regions of Different Thermal Scans

Authors: Tahir Majeed, Michael Handschuh, René Meier

Abstract:

Rheumatoid Arthritis patients have swelling and pain in joints of the hand. The regions where the patient feels pain also show increased body temperature. Thermal cameras can be used to detect the rise in temperature of the affected regions. To monitor the progression of Rheumatoid Arthritis, patients must visit the clinic regularly for scanning and examination. After scanning and evaluation, the dosage of the medicine is regulated accordingly. To monitor the disease progression over time, the correlation of the images between different visits must be established. It has been observed that the thermal measurements do not remain the same over time, even within a single scanning, when low-cost thermal cameras are used. In some situations, temperatures can vary as much as 2◦C within the same scanning sequence. In this paper, it has been shown that although the absolute temperature varies over time, the relative difference between different regions remains similar. Results have been computed over four scanning sequences and are presented.

Keywords: Relative thermal difference, rheumatoid arthritis, thermal imaging, thermal sensors.

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