Europa medicophysica最新文献

{"title":"Ergonomic and physiotherapeutic interventions for treating work-related complaints of the arm, neck or shoulder in adults. A Cochrane systematic review.","authors":"A P Verhagen, C Karels, S M A Bierma-Zeinstra, A Feleus, S Dahaghin, A Burdorf, H C W De Vet, B W Koes","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Conservative interventions such as physiotherapy and ergonomic adjustments (such as keyboard adjustments or ergonomic advice) play a major role in the treatment of most work-related complaints of the arm, neck or shoulder (CANS). Objectives. This systematic review aims to determine whether conservative interventions have a significant impact on outcomes for work-related CANS in adults. Search strategy. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (March 2005) and Cochrane Rehabilitation and Related Therapies Field Specialised Register (March 2005), the Cochrane Controlled Trials Register (The Cochrane Library, Issue 1, 2005), PubMed, EMBASE, CINAHL, AMED and reference lists of articles. The date of the last search was March 2005. No language restrictions were applied. Selection criteria. We included randomised controlled trials and concurrent controlled trials studying conservative interventions (e.g. exercises, relaxation, physical applications, biofeedback, myofeedback and work-place adjustments) for adults suffering CANS. Data collection and analysis. Two authors independently selected trials from the search yield, assessed the methodological quality using the Delphi list, and extracted relevant data. We pooled data or, in the event of clinical heterogeneity or lack of data, we used a rating system to assess levels of evidence.</p><p><strong>Main results: </strong>For this update we included six additional studies; twenty-one trials in total. Seventeen trials included people with chronic nonspecific neck or shoulder complaints, or nonspecific upper extremity disorders. Over twenty-five interventions were evaluated; six main subgroups of interventions could be determined: exercises, manual therapy, massage, ergonomics, energised splint and individual treatment versus group therapy. Overall, the quality of the studies was poor. In 14 studies a form of exercise was evaluated, and contrary to the previous review we now found limited evidence about the effectiveness of exercises when compared to massage and conflicting evidence when exercises are compared to no treatment. In this update there is limited evidence for adding breaks during computer work; massage as add-on treatment on manual therapy, manual therapy as add-on treatment on exercises; and some keyboard designs when compared to other keyboards or placebo in participants with carpal tunnel syndrome.</p><p><strong>Conclusions: </strong>There is limited evidence for the effectiveness of keyboards with an alternative force-displacement of the keys or an alternative geometry, and limited evidence for the effectiveness of exercises compared to massage, breaks during computer work compared to no breaks; massage as an add-on treatment to manual therapy, and manual therapy as an add-on treatment to exercises.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 3","pages":"391-405"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27036896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repetitive magnetic stimulation of the sacral roots for the treatment of stress incontinence: a brief report.","authors":"P Manganotti,&nbsp;F Zaina,&nbsp;E Vedovi,&nbsp;L Pistoia,&nbsp;E Rubilotta,&nbsp;A D'Amico,&nbsp;M Falso","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to investigate the short and long-term effects of repetitive magnetic stimulation on the sacral roots in a homogeneous group of patients affected by stress incontinence.</p><p><strong>Methods: </strong>Twenty women with urinary stress incontinence were randomly assigned to an active or a sham stimulation group. Fifteen-Hz repetitive magnetic stimulation of the sacral roots (S2-S4) was applied for 15 min. Patients were treated with magnetic stimulation for 3 days a week for 2 weeks (6 times in all). The clinical outcome was assessed before (T1) and 1 week (T2) and 1 month (T3) after stimulation. Main outcome measures were: the King's Health Questionnaire, the SEAPI-QMM scale and the amount of urinary loss in a 1-h pad test and stress test.</p><p><strong>Results: </strong>At T2 patients in the active stimulation group showed improvement in health perception (P<0.001), social limitation (P<0.01), sleep/energy performance (P<0.05) and severity measure score (P<0.05) not observed in the sham stimulation group; a significant decrease in SEAPI-QMM score was noted only in the active group at T2 (P<0.05). These results were no longer observed at T3. We also observed a decrease in the amount of urine loss quantified with the pad test and stress test in the active stimulation group.</p><p><strong>Conclusion: </strong>Repetitive magnetic stimulation of the sacral roots has a short-term effect on some aspects of the quality of life of the patients, but it did not prove effective using quantified measurement.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 3","pages":"339-44"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26519396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeated botulinum toxin injections can improve mobility in patients with spinal cord lesions.","authors":"A Catz,&nbsp;H Barkol,&nbsp;F Steinberg,&nbsp;J Ronen,&nbsp;V Bluvshtein,&nbsp;O Keren","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to increase the knowledge about the response to botulinum toxin (BTX) injections to spastic leg muscle motor points (MP) in spinal cord lesion (SCL) patients, and describe improvement of mobility with repeated BTX injections.</p><p><strong>Methods: </strong>Six patients with ASIA grade C or D SCL were studied at the Loewenstein Rehabilitation Center, Israel. The main outcome measures were: modified Ashworth scale scores, range of motion (ROM), and mobility spinal cord independence measure (SCIM) scores. BTX was injected twice within a few weeks' interval to the MP of spastic leg muscles. The outcome measures were monitored before each injection and 2 weeks or more after the second injection.</p><p><strong>Results: </strong>Following the first BTX injection the tonus decreased, ROM increased in all 6 patients, and mo- bility functioning improved in 4 of them. Following the repeated injection the tonus further decrea- sed, ROM further improved in 5 of 6 patients, and mobility functions further improved in 4 of 6 patients.</p><p><strong>Conclusion: </strong>BTX can improve mobility in patients with SCL. Repeated injections may enhance the effect despite the concern for resistance formation. Further research is needed to support the findings and determine the optimal BTX doses and intervals between injections.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 3","pages":"319-25"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26743530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty in the elderly: the physical dimension.","authors":"M Abate,&nbsp;A Di Iorio,&nbsp;D Di Renzo,&nbsp;R Paganelli,&nbsp;R Saggini,&nbsp;G Abate","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Frailty may be considered as a vulnerable status, which can precede the onset of overt disability. Operational definitions of frailty vary widely according to the conceptual framework: some authors consider frailty in a broad sense, which encompasses the physical, social, cognitive, psychological dimensions and comorbidity, whereas others define the syndrome more restrictively, mainly on the basis of performance parameters, such as gait speed, grip strength and physical activity. All these definitions are provided of a high predictive value for adverse outcomes, such as disability, hospitalization and mortality. Sarcopenia (i.e. the reduction of muscular mass and function) plays a predominant role in the pathogenesis of frailty. Among the factors responsible for sarcopenia (such as proinflammatory cytokines, low growth hormone and testosterone levels, increased production of oxygen free radicals, malnutrition and reduced neurological drive), immobility and lack of exercise have a preponderant role. Therefore, the diagnosis of frailty is mandatory for the early identification of a subset of elderly subjects at high risk, which can receive benefit from rehabilitation. A self-report and objective evaluation of physical performance are the best indicators of frailty in elderly subjects, a poor performance suggesting the need of an early and proper intervention. Structured exercise programs are effective in contrasting the progression of frailty, but an healthy and active lifestyle may be sufficient for delaying the onset of disability. In conclusion, there is clear evidence for prescription of exercise within the mainstream of the medical practice, rather than as an optional adjunct to standard care of the oldest old, given the public health implication of frailty, whose prevalence is going to increase in western populations.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 3","pages":"407-15"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26374110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Europa Medicophysica, the European and Mediterranean evidence-based clinical Journal of Physical and Rehabilitation Medicine.","authors":"S Negrini","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 3","pages":"299-301"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27035400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Back posture education in elementary schoolchildren: stability of two-year intervention effects.","authors":"E Geldhof,&nbsp;G Cardon,&nbsp;I De Bourdeaudhuij,&nbsp;D De Clercq","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>The study's first objective was to evaluate class teachers' efforts to promote good body mechanics after a structured back education program was finished and to evaluate whether their support during follow-up resulted in better intervention effects at 1-year follow-up. Secondary, the stability of intervention effects on children's back posture knowledge, fear-avoidance beliefs and back pain reports following a 2-school-year multi-factorial back education program was evaluated at 1-year follow-up. An additional focus was put on what young children learned about good body mechanics in the obligatory school curriculum compared to intensive back posture promotion.</p><p><strong>Methods: </strong>The quasi-experimental study included at baseline 398 elementary schoolchildren aged 8-11 years. The back education program consisted of 13 h back education and the stimulation of postural dynamism in the class through support and environmental changes lasting 2 school-years. Controls received the obligatory curriculum, not including back education. Evaluation consisted of a questionnaire, which was filled out by 121 intervention children and 124 controls at baseline, post-test and follow-up. Teachers were interviewed at the end of the follow-up school-year.</p><p><strong>Results: </strong>Teachers continued with initiatives to increase postural dynamism in the class when they had been instructed about that matter. However, teachers' efforts to continue the promotion of good body mechanics showed no additional effect on children's knowledge. Improved back posture knowledge demonstrated stability at 1-year follow-up. Whereas the obligatory curriculum provided children with fundamental postural knowledge, the back posture program added important aspects. Fear-avoidance beliefs and self-reported pain were not increased at 1-year follow-up.</p><p><strong>Conclusion: </strong>The stable intervention effects point out that intensive implementation of a structured multifactorial back education program in the elementary school curriculum is effective.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 3","pages":"369-79"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26691388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practicability of segmental stabilizing exercises in the context of a group program for the secondary prevention of low back pain. An explorative pilot study.","authors":"B Rackwitz,&nbsp;H Limm,&nbsp;T Wessels,&nbsp;T Ewert,&nbsp;G Stucki","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>Segmental stabilizing exercises (SSE) for specific dysfunction of local muscles (m. transversus abdominis, m. multifidus, pelvic floor muscles and diaphragm pelvis) have been advocated in patients with low back pain (LBP). The specific aims of this study were to examine: 1) whether participants of a group program learn SSE; 2) whether they respond to SSE with a reduction in present LBP and 3) to what extent people report using SSE in daily living.</p><p><strong>Methods: </strong>One-hundred nurses participated in this explorative pilot study. Data from a 12-week multimodal program including SSE as intervention for the prevention of LBP were analysed. The prone test was taken as an indicator for the participants' ability to perform SSE correctly. Present back pain was assessed on a numerical rating scale (0-10). A compliance questionnaire and a transfer questionnaire assessed compliance and transfer of SSE into daily living.</p><p><strong>Results: </strong>After the intervention, 72% of participants were able to perform SSE correctly as measured by the prone test. Between 48% and 78% of the participants with present LBP experienced a minimal, clinically important change (minimal clinical changes, [MCC]) while performing SSE. No strong interrelations between the ability to correctly perform SSE and the MCC of LBP could be identified. Participants reported exercising SSE for 12 min on average 4-5 days a week. At 3 months after the intervention, 76% of participants reported using SSE ''always'' in their work with patients.</p><p><strong>Conclusion: </strong>First findings are that SSE can be learned by the majority of the participants of a group program for the prevention of LBP. Additionally, SSE reduces present LBP and so can help people with LBP learn to help themselves. We are unable to explain how participants benefited from SSE even when they were unable to perform SSE correctly, as measured by the prone test.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 3","pages":"359-67"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27010718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of desmopressin in the management of nocturnal enuresis in patients with spinal cord injury.","authors":"A Zahariou,&nbsp;G Karagiannis,&nbsp;P Papaioannou,&nbsp;K Stathi,&nbsp;X Michail","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study is to evaluate the use of desmopressin acetate (DDAVP) in the management of nocturnal enuresis in patients with spinal cord injury (SCI), as well as arginine vasopressin (AVP) daily production, urine output, urine osmolarity and clean intermittent catheterization (CIC) before and after the use of desmopressin.</p><p><strong>Methods: </strong>We studied 11 patients with SCI (7 men 4 women). All patients attended a rehabilitation program and used a wheelchair for locomotion. To improve bladder function and achieve socially acceptable continence all patients were placed on a regimen of anticholinergic drugs (oxybutynin 5 mg, 1x3 daily), evening antibiotic prophylaxis and CIC. The subjects were also on night CIC in order to avoid nocturnal incontinence. DDAVP was given intranasally (20 mg before bedtime) in association with other standard therapy. Urine samples were collected under sterile conditions from all patients at 6:00 a.m. and 6:00 p.m. Urine volume was measured and the amount of urine per hour was calculated. Blood samples were also taken to measure serum AVP, urea, creatinine and serum electrolyte.</p><p><strong>Results: </strong>Our data suggest that nocturnal polyuria in SCI patients occurs due to a lack of diurnal variation of antidiuretic hormone (ADH) secretion. The use of desmopressin produced a statistically significant increase in urine production rate during the day (56.2 vs 81.2 mL/h, P<0.001) and a decrease in nocturnal urine production (59.2 vs 27.7 mL/h, P<0.001). Desmopressin treatment reflects also on urine osmolarity, which did not change during the day (496 vs 489 mOsm/mL, P>0.5) but showed a significant increase during the night (385 vs 862 mOsm/mL, P<0.001). There was a significant decrease in night CIC. No serious adverse effects were observed.</p><p><strong>Conclusion: </strong>Our results suggest that desmopressin administration is an beneficial treating option for patients with SCI when fluid restriction and other preventive measures are not able to control abnormal nocturnal polyuria.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 3","pages":"333-8"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26292893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of physical and rehabilitation medicine topics as developed by the Cochrane Collaboration.","authors":"S Negrini, S Minozzi, M Taricco, V Ziliani, F Zaina","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this paper is to give an overview of the Cochrane Collaboration, its development over the years, and its usefulness for physical and rehabilitation medicine specialists. After introducing the Cochrane Collaboration, we systematically analyzed all titles of the reviews in each of the 50 review groups. For ''Rehabilitation,'' we included not only exercise and physical therapy, but also all of the educational and pharmacological interventions aimed at supporting rehabilitation. The search was performed using Issue 2, 2007 of the Cochrane Library. We retrieved 138 completed reviews that dealt with rehabilitation interventions performed by 20 review groups. No umbrella reviews could be found at present. The most prolific groups in the rehabilitation field were: musculoskeletal (28 reviews), stroke (20), back (18), and the movement disorder group (13). The most discussed intervention was exercise (37 reviews), dealing with physical medicine (20) and pharmacological intervention (11). Six other reviews dealt with multidisciplinary rehabilitation. Low back pain treatment and stroke were the most investigated topics. The Cochrane Collaboration serves today as a main step in increasing an evidence-based approach to medicine and rehabilitation. Europa Medicophysica is continuously increasing its importance and presence in the world of physical and rehabilitation medicine, and part of its mission is to increase and strengthen an evidence-based approach to this field. We will continue to look at the contents of the Cochrane database and regularly report on its updates concerning topics of interest for physical and rehabilitation medicine.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 3","pages":"381-90"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27036895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation and outcome measurement: where is Rasch analysis-going?","authors":"L Tesio,&nbsp;A Simone,&nbsp;M Bernardinello","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Outcomes are clinical or functional changes at the whole-person level. Measures are based on questionnaires which summate scores assigned to a series of items representing a person's variable. The metric properties of raw scores are known to be of limited validity. Yet, such variables represent the main target of outcome assessment in Rehabilitation Medicine as far as they may cover performances, perceptions and knowledge. Rasch statistical models, first available in English to a large readesrship in late 70s, allow to transform the arbitary raw scores into true linear measures. Rehabilitation seemed a privileged field for the application of Rasch models, yet these are still far from becoming popular. A bibliometric study was conducted across ten leading digital libraries. A MEDLINE search showed a dramatic increment of published papers covering the intersection between the MESH terms ''Rehabilitation'' and ''Outcome assessment'', which rose in from 5 to 4 302 between the 1981-90 and 2001-07 time frames, respectively. ''Rasch'' paper also rose remarkably from 35 to 539. When the triple intersection was considered, articles only rose from 0 to 12. Results point towards a privileged application of Rasch analysis to build and refine questionnaires, rather than to actually measuring people. Commentaries and suggestions are invited.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 3","pages":"417-26"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27036897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}