Journal of Clinical Medicine最新文献

{"title":"Genicular Artery Embolization: A Technical Review of Anatomy, Pathophysiology, Current Experiences, and Future Directions.","authors":"Joseph M Brown, Zachary T Vandeveer, Danielle Cadoret, James J Morrison, Younes Jahangiri","doi":"10.3390/jcm14062106","DOIUrl":"10.3390/jcm14062106","url":null,"abstract":"<p><p>Genicular artery embolization (GAE) is an emerging minimally invasive procedure for managing knee osteoarthritis (OA), a condition affecting 365 million individuals globally. Initially developed to treat hemarthrosis, GAE selectively embolizes abnormal genicular vasculature, targeting synovial inflammation and reducing neoangiogenesis. This process alleviates pain and improves joint function, providing an alternative for patients with mild-to-moderate OA who are not candidates for surgical interventions due to comorbidities or other factors. Current evidence supports the use of GAE for patients with mild-to-moderate OA who experience persistent symptoms despite conservative treatments such as physical therapy, weight management, or intra-articular injections. The procedure effectively reduces pain, improves functionality, and provides sustained benefits. This review highlights the anatomical principles, procedural techniques, and patient selection criteria for GAE, as well as the clinical evidence supporting its safety and efficacy. It also explores potential future directions for research, including optimizing patient selection, evaluating long-term outcomes, and integrating GAE into routine OA management pathways.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Nuclear Cardiac Imaging: Novel Advances, Emerging Techniques, and Recent Clinical Trials.","authors":"Ilana S Golub, Abhinav Thummala, Tyler Morad, Jasmeet Dhaliwal, Francisco Elisarraras, Ronald P Karlsberg, Geoffrey W Cho","doi":"10.3390/jcm14062095","DOIUrl":"10.3390/jcm14062095","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) is a leading cause of death, accounting for over 30% of annual global fatalities. Ischemic heart disease, in turn, is a frontrunner of worldwide CVD mortality. With the burden of coronary disease rapidly growing, understanding the nuances of cardiac imaging and risk prognostication becomes paramount. Myocardial perfusion imaging (MPI) is a frequently utilized and well established testing modality due to its significant clinical impact in disease diagnosis and risk assessment. Recently, nuclear cardiology has witnessed major advancements, driven by innovations in novel imaging technologies and improved understanding of cardiovascular pathophysiology. Applications of artificial intelligence (AI) to MPI have enhanced diagnostic accuracy, risk stratification, and therapeutic decision-making in patients with coronary artery disease (CAD). AI techniques such as machine learning (ML) and deep learning (DL) neural networks offer new interpretations of immense data fields, acquired through cardiovascular imaging modalities such as nuclear medicine (NM). Recently, AI algorithms have been employed to enhance image reconstruction, reduce noise, and assist in the interpretation of complex datasets. The rise of AI in nuclear medicine (AI-NM) has proven itself groundbreaking in the efficiency of image acquisition, post-processing time, diagnostic ability, consistency, and even in risk-stratification and outcome prognostication. To that end, this narrative review will explore these latest advances in AI in nuclear medicine and its rapid transformation of the cardiac diagnostics landscape. This paper will examine the evolution of AI-NM, review novel AI techniques and applications in nuclear cardiac imaging, summarize recent AI-NM clinical trials, and explore the technical and clinical challenges in its implementation of artificial intelligence.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Balanced Resuscitation in Trauma.","authors":"Tanya Anand, Hannah Shin, Asanthi Ratnasekera, MyDuyen Luong Tran, Rebekah Huckeby, Lindsey Butts, Ivy Stejskal, Louis J Magnotti, Bellal Joseph","doi":"10.3390/jcm14062111","DOIUrl":"10.3390/jcm14062111","url":null,"abstract":"<p><p>Hemorrhagic shock from traumatic injury results in a massive systemic response with activation of the hypothalamic-pituitary-adrenal (HPA) axis, pro-thrombotic and clot-lysis pathways as well as development of an endotheliopathy. With ongoing hemorrhage, these responses become dysregulated and are associated with worsening coagulopathy, microvascular dysfunction, and increased transfusion requirements. Our transfusion practices as well as our understanding of the molecular response to hemorrhage have undergone significant advancement during war. Currently, resuscitation practices address the benefit of the early recognition and management of acute coagulopathy and advocates for balanced resuscitation with either whole blood or a 1:1 ratio of packed red blood cells to fresh frozen plasma (respectively). However, a significant volume of evidence in the last two decades has recognized the importance of the early modulation of traumatic endotheliopathy and the HPA axis via the early administration of plasma, whole blood, and adjunctive treatments such as tranexamic acid (TXA) and calcium. This evidence compels us to rethink our understanding of 'balanced resuscitation' and begin creating a more structured practice to address additional competing priorities beyond coagulopathy. The following manuscript reviews the benefits of addressing the additional interrelated physiologic responses to hemorrhage and seeks to expand beyond our understanding of 'balanced resuscitation'.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Support Surface and Shooting Action on Muscle Activity of Trunk Muscles in Ice Hockey Players: A Cross-Sectional Study.","authors":"Seongmin Oh, Taewoong Jeong, Yijung Chung","doi":"10.3390/jcm14062090","DOIUrl":"10.3390/jcm14062090","url":null,"abstract":"<p><p><b>Background:</b> This study aimed to investigate the effect of different support surfaces on trunk muscle activity during slap shots and wrist shots in ice hockey players by analyzing muscle activation patterns across varying conditions. <b>Methods:</b> A total of 22 healthy male collegiate ice hockey players participated in this study. Ice hockey players were assessed for muscle activity in their trunk muscles (rectus abdominis, external oblique, internal oblique, and erector spinae). Each player performed a slap shot and wrist shot on solid ground, a slap shot and wrist shot on ice, and a skating slap shot and wrist shot on ice. Data from a 3 s interval, excluding the first and last second of the 5 s measurement period, were used for analysis. All electromyography signals were normalized using maximal voluntary isometric contraction. <b>Results:</b> Significant differences were found in all muscles except for the external oblique, depending on the support surface and shooting method. (<i>p</i> < 0.05). The muscle activity of the rectus abdominis was significantly greater for the slap shot and wrist shot on ice than for the slap shot and wrist shot on the ground, and the slap shot and skating slap shot on ice than for the wrist shot on the ground (<i>p</i> < 0.05). The internal oblique was significantly higher for slap shots and wrist shots on ice than for slap shots and wrist shots on the ground (<i>p</i> < 0.05). The erector spinae was significantly greater for the skating slap shot and wrist shot on ice than for the wrist shot on the ground, and the skating slap shot on ice was significantly greater than the skating wrist shot on ice (<i>p</i> < 0.05). <b>Conclusions:</b> To enhance the shooting efficiency of ice hockey players competing on ice, exercises on unstable surfaces and targeted trunk muscle training are considered to be effective.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Properties of the Depression Anxiety Stress Scales (DASS-42 and DASS-21) in Patients with Hematologic Malignancies.","authors":"Serkan Güven, Ertuğrul Şahin, Nursel Topkaya, Öznur Aydın, Sude Hatun Aktimur, Mehmet Turgut","doi":"10.3390/jcm14062097","DOIUrl":"10.3390/jcm14062097","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Patients with hematologic malignancies undergo prolonged, intensive treatments involving frequent hospitalizations and experience debilitating side effects. Consequently, they are at increased risk of developing symptoms of depression, anxiety, and stress, which can undermine their quality of life. However, there is a scarcity of instruments validated for the simultaneous assessment of depression, anxiety, and stress within hematologic cancer populations. The aim of this study is to examine the construct validity, convergent and discriminant validity, and reliability of the Depression Anxiety Stress Scales (DASS-42 and DASS-21) among hematologic cancer patients. <b>Methods</b>: We collected data from 452 hematologic cancer patients across three studies. <b>Results</b>: Confirmatory factor analyses indicated that the theoretical correlated three-factor model and bifactor model for DASS-42 and DASS-21 responses were sufficient to explain the underlying factor structure of the scales in hematologic cancer patients. However, the bifactor model for DASS-42 and DASS-21 fit better with the data compared to the theoretical correlated three-factor model. In addition, we found the correlated three-factor model and the bifactor structure to exhibit scalar measurement invariance across gender for DASS-42 and DASS-21. DASS-42 and DASS-21 subscales demonstrated weak to strong negative correlations with measures of psychological well-being (happiness, well-being, life satisfaction) and strong positive correlations with measures of similar constructs (depression, anxiety, and stress), thereby supporting their convergent and discriminant validity with theoretically and empirically expected correlations with external criteria. The reliability analyses demonstrated that both DASS-42 and DASS-21 subscales exhibited strong internal consistency and test-retest reliability when assessing symptoms of depression, anxiety, and stress among patients with hematologic malignancies. Moreover, the item-scale convergent and discriminant validity analyses demonstrated that items exhibited higher corrected item-total correlations with their intended subscales than with other subscales across the DASS-42 and DASS-21, providing evidence for the distinct measurement properties of each subscale. <b>Conclusions</b>: The findings suggest that the DASS-42 and DASS-21 are psychometrically robust instruments for use in Turkish hematologic cancer patients.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Pranoprofen After Strabismus Surgery in Children.","authors":"Wojciech Pawłowski, Beata Urban, Joanna Zawistowska, Alina Bakunowicz-Łazarczyk","doi":"10.3390/jcm14062104","DOIUrl":"10.3390/jcm14062104","url":null,"abstract":"<p><p><b>Objectives</b>: The aim of our study is to evaluate the efficacy of pranoprofen 0.1% in preventing the occurrence of postoperative complications, including postoperative ocular inflammation after strabismus surgery in children. <b>Methods:</b> 90 children operated on for strabismus in the Department of Paediatric Ophthalmology and Strabismus of the Medical University of Bialystok between 2022 and 2023 were included in the study. The patients were aged from 2 to 17 years old. Patients were divided into three groups of 30 patients according to the method of topical postoperative treatment (group I: tobramycin, pranoprofen, dexpanthenol; group II: tobramycin, dexamethasone, dexpanthenol; group III: tobramycin, pranoprofen, dexamethasone, dexpanthenol). Patients were followed up the day after surgery, on postoperative day 14 and then 3 months after surgery. <b>Results</b>: No child showed signs of postoperative infection. There was one case of allergic reaction each in groups I and III. Most complications were present in group II (six cases: there were allergic reactions that occurred in three patients. Two patients experienced a complication in the form of delle, while one patient developed a granuloma), which was a statistically significant difference compared to groups I and III (<i>p</i> = 0.032). <b>Conclusions</b>: Pranoprofen used postoperatively is as effective as a glucocorticosteroid, and from our observations, carries fewer complications in cases requiring prolonged use of the anti-inflammatory treatment. Systematic postoperative follow-up is essential for the diagnosis and possible management of postsurgical complications.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Depressive Symptoms in Patients with Type 1 and Type 2 Diabetes Mellitus and with Diagnosed Prediabetes in Poland: A Cross-Sectional Study.","authors":"Mariola Mroz, Dorota Sadowska, Mateusz Zarychta, Grazyna Iwanowicz-Palus, Adam Kretowski, Mateusz Cybulski","doi":"10.3390/jcm14062093","DOIUrl":"10.3390/jcm14062093","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Diabetes mellitus is one of the most common chronic diseases worldwide. In addition to short-term and long-term complications, diabetes has a detrimental effect on the patients' mood. The main psychiatric disorder occurring among diabetic patients is depression. The rates of depression in the developed and developing countries are 15% and 11%, respectively. This study aimed to determine the prevalence of depressive symptoms among patients with type 1 and type 2 diabetes and prediabetes in Poland using the example of the Podlaskie Province and taking into account selected sociodemographic variables. <b>Methods</b>: A total of 874 patients participated in the study, including 448 women (55.8%) and 386 men (44.2%). The study was conducted from July 2022 to July 2023 among the participants of the \"Zatrzymaj cukrzycę! Polski Rejestr Diabetologiczny PolRed\" (\"Stop Diabetes! Polish Diabetes Registry (PolRed)\") project or those hospitalised in the Department of Endocrinology, Diabetology and Internal Medicine at the University Clinical Hospital in Bialystok. The study used a diagnostic survey method using a survey questionnaire developed by the authors and the Beck Depression Inventory (BDI). <b>Results</b>: The highest severity of depressive symptoms according to the Beck Depression Inventory was found in patients with type 2 diabetes (M = 12.18; SD ± 9.48) and the lowest in those with type 1 diabetes (M = 8.11; SD ± 7.55). The assessment of the differences in the severity of depressive symptoms according to the Beck Depression Inventory showed that participants with type 1 diabetes differed statistically significantly (<i>p</i> < 0.001) from those with type 2 diabetes and from those in a prediabetic state. In the group of type 2 diabetes (r = 0.336; <i>p</i> < 0.001) patients and prediabetic state patients (r = 0.231; <i>p</i> < 0.01), there were positive correlations of age with the severity of depressive symptoms. In the group of participants with type 2 diabetes, a statistically significant relationship (<i>p</i> < 0.001) was observed between age and the severity of depressive symptoms. <b>Conclusions</b>: The prevalence of mood disorders in patients with type 1 and type 2 diabetes and diagnosed prediabetes from the Podlaskie Province depends on the type of hyperglycaemic disorder. The prevalence of depressive symptoms among patients with type 1 and type 2 diabetes and prediabetes is determined by specific socio-demographic factors, including, above all, age and gender. The highest severity of a disturbed emotional state according to the Beck Depression Inventory is found in individuals with type 2 diabetes and the lowest in those with type 1 diabetes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Coronavirus Disease 2019 Risk Factors: A Text Network Analysis Approach.","authors":"Min-Ah Kang, Soo-Kyoung Lee","doi":"10.3390/jcm14062084","DOIUrl":"10.3390/jcm14062084","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The coronavirus disease 2019 (COVID-19) pandemic has significantly affected global health, economies, and societies, necessitating a deeper understanding of the factors influencing its spread and severity. <b>Methods:</b> This study employed text network analysis to examine relationships among various risk factors associated with severe COVID-19. Analyzing a dataset of published studies from January 2020 to December 2021, this study identifies key determinants, including age, hypertension, and pre-existing health conditions, while uncovering their interconnections. <b>Results:</b> The analysis reveals five thematic clusters: biomedical, occupational, demographic, behavioral, and complication-related factors. Temporal trend analysis reveals distinct shifts in research focus over time. In early 2020, studies primarily addressed immediate clinical characteristics and acute complications of COVID-19. By mid-2021, research increasingly emphasized long COVID, highlighting its prolonged symptoms and impact on quality of life. Concurrently, vaccine efficacy became a dominant topic, with studies assessing protection rates against emerging viral variants, such as Alpha, Delta, and Omicron. This evolving landscape underscores the dynamic nature of COVID-19 research and the adaptation of public health strategies accordingly. <b>Conclusions:</b> These findings offer valuable insights for targeted public health interventions, emphasizing the need for tailored strategies to mitigate severe outcomes in high-risk groups. This study demonstrates the potential of text network analysis as a robust tool for synthesizing complex datasets and informing evidence-based decision-making in pandemic preparedness and response.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoperfusion Using the Oxiris Membrane in Septic Shock Patients with Preserved Kidney Function: A Case Series.","authors":"Darja Smirnova, Rihards Serzans, Mara Klibus, Valdis Liguts, Anna Lece, Andrejs Skesters, Gianluca Villa, Olegs Sabelnikovs","doi":"10.3390/jcm14062113","DOIUrl":"10.3390/jcm14062113","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Sepsis, a life-threatening condition caused by a dysregulated immune response to infection, is associated with high mortality. Endotoxin and cytokine overload play a crucial role in sepsis-induced organ dysfunction. The Oxiris^® membrane, traditionally used as a hemofilter for renal replacement therapy, has demonstrated the capacity to adsorb endotoxins and cytokines. This study investigates the clinical effect during hemoperfusion with the Oxiris^® membrane in patients with septic shock and preserved renal function. <b>Methods</b>: We present three adult patients with septic shock who were admitted to the intensive care unit with high vasopressor requirements and elevated inflammatory markers. As they were refractory to standard therapy and renal function was preserved, a 12-hour hemoperfusion session with an Oxiris^® membrane was initiated. Hemodynamic parameters, inflammatory biomarkers, and endotoxin concentrations were evaluated before, during, and after hemoperfusion treatment. <b>Results</b>: All patients demonstrated hemodynamic stabilization, with norepinephrine support reduced by 10.3% to 70.0%. Key inflammatory markers decreased significantly, including interleukin-6 (-41.6% to -94.0%), procalcitonin (-29.3% to -49.5%), and C-reactive protein (4.7% to -37.2%). Endotoxin concentrations decreased by 62.0% and 13.6% in two of the three patients. No adverse effects related to hemoperfusion were observed. <b>Conclusions</b>: Hemoperfusion with the Oxiris^® membrane effectively reduced vasopressor support, inflammatory markers, and endotoxin concentrations in patients with refractory septic shock. This approach may offer a novel strategy for early immune modulation in sepsis before renal dysfunction occurs. Further studies with larger cohorts are required to validate these findings and determine optimal treatment protocols.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real Versus Sham-Based Neurodynamic Techniques in the Treatment of Cubital Tunnel Syndrome: A Randomized Placebo-Controlled Trial.","authors":"Tomasz Wolny, Michał Wieczorek","doi":"10.3390/jcm14062096","DOIUrl":"10.3390/jcm14062096","url":null,"abstract":"<p><p><b>Background/Objective:</b> To assess the effectiveness of therapy based on sliding and tensioning neurodynamic techniques in the conservative treatment of mild and moderate forms of cubital tunnel syndrome (CuTS) compared to sham therapy. <b>Methods:</b> A single-blinded, randomized placebo-controlled trial. The study was conducted at several medical clinics. Individuals diagnosed with CuTS (initially 136 subjects, of whom 91 completed the full protocol) participated in the experiment. In the experimental group (MT), sliding and tensioning neurodynamic techniques were applied, whereas in the control group (ST), a sham therapy was used, involving the performance of neurodynamic techniques in an intermediate position without following the specific neurodynamic sequence for the ulnar nerve. The therapy was administered five times per week over the course of 10 sessions. All participants underwent assessments, including nerve conduction studies, ultrasound imaging (cross-sectional area and shear modulus), pain levels, two-point discrimination sensation, cutaneous sensory perception threshold, symptoms, ability to perform certain activities, and changes in improvement following treatment. <b>Results:</b> A baseline assessment revealed no significant inter-group differences in all examined parameters (<i>p</i> > 0.05). After therapy, there was a statistically significant intra-group improvement in all parameters tested (<i>p</i> < 0.01). In the MT group, the intra-group differences were significant across all parameters tested (<i>p</i> < 0.01). However, in the ST group (sham therapy), only the shear modulus showed statistically significant changes, while the other tested parameters remained unchanged. <b>Conclusions:</b> Neurodynamic techniques demonstrate superior therapeutic effects compared to sham therapy in the treatment of mild to moderate forms of CuTS.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}