The study aims to assess selected factors contributing to the long-term effects of the conservative treatment of carpal tunnel syndrome (CTS).
Forty-nine individuals diagnosed with CTS were enrolled ...in the study. The symptoms resulted from occupational hand overuse in 37 patients. The assessment involved 78 hands before the therapy (study 1) and 1 year after the end of the therapy (study 2). The clinical symptoms assessed included: pain, numbness, tingling, morning stiffness, vegetative disorders and difficulties in activities of daily living (ADL). The range of motion (ROM) in the hand joints and the pressure generated during the cylindrical grip were measured. Phalen's tests, an electrodiagnostic test and a 2-point discrimination study were performed.
A significant reduction of symptoms and improvement in tested parameters were found in study 2. The largest ROM in the hand, the lowest level of pain and the largest reduction in the frequency of daytime tingling were found in the oldest patients in study 2. In subjects with better initial electrodiagnostic test results, a significant reduction in daytime numbness and daytime tingling was obtained. In individuals previously subjected to conservative therapy, a significant improvement in the ROM of the hand and a better quality of sensation were noted in study 2. A higher level of pain, a lower reduction in the frequency of daytime tingling, and a smaller improvement in ADL capacity were noted in individuals who overused their hands at work after the therapy.
The effects of conservative CTS treatment after 1 year, expressed as the reduction of subjective symptoms, were independent of the patient's age. A worse initial electrodiagnostic test result is a predictor of less favorable therapy results. Hand overuse during occupational activity may negatively affect the effects of conservative treatment in individuals with CTS. A change in the nature of occupational activity positively influenced the long-term maintenance of the effects of conservative treatment. Int J Occup Med Environ Health. 2019;32(2):197-215.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Abstract
Introduction
Over the last few decades, the quality of care and the quality of life of nursing home (NH) residents have significantly improved, but insufficient physical activity and social ...involvement still represent substantial challenges in modern nursing facilities. The main aim of this research was to assess the influence of physical exercises with dance movement therapy (DMT) elements on strength and other fitness components of the upper limbs and the overall functional performance of NH residents in wheelchairs compared to standard exercise programmes and usual care.
Method
The study participants were persons aged 68–85 who lived in NH and used manual wheelchairs as a primary means of mobility. Individuals meeting the inclusion criteria were assigned to one of the three groups: Group 1, basic exercise/BE group (
n
= 55); group 2, physical exercises with elements of dance movement therapy/PED group (
n
= 55); and group 3, control group, usual care/CO group (
n
= 55). The intervention for both exercising groups consisted of a 30-min session, two times a week, for 12 weeks in total. Outcome assessments were performed at baseline, 12 weeks after baseline (immediately after the intervention) and 24 weeks after baseline (12 weeks after the intervention). The main outcome was observed for hand grip strength (HGS), while secondary outcomes for box and block test (BBT), arm curl test (ACT), back scratch test (BS), chair sit-and-reach (CSR), peak expiratory flow (PEF), Barthel Index (BI), Berg Balance Scale (BBS) and the range of motion of the shoulder.
Results
Prior to the start of the exercise programmes, all the tested groups were homogeneous. After 12 weeks the PED group presented higher statistically significant scores in HGS
L
, BBT, ACT, BS, CSR, BI, BBS:
p
< 0.001 and HGS
R
:
p
= 0.01, compared to the BE group. After 24 weeks from the beginning of the intervention the comparison between the PED group and the BE group showed statistically significant differences (
p
< 0.001) in favour of PED group in almost all areas: HGS
R
, HGS
L
, BBT: ACT, PEF, BS, CSR, BI. After 12 and 24 weeks both intervention groups performed better than the CO in all measures except for Katz ADL and shoulder extension.
Conclusion
Twelve weeks of physical exercises had beneficial effects on the strength and fitness of the upper limbs and overall functional performance in both exercise groups. This study demonstrated that group performing physical exercises with elements of DMT obtained statistically better scores in the majority of analysed domains than other groups.
Trial registration
The study was registered in the Sri Lanka Clinical Trials Registry (Registration Number - SLCTR/2018/014 - Date of Registration 16/05/2018. Accessed on
https://slctr.lk/trials/1045
).
Background and objectives: Stroke is one of the leading causes of morbidity, mortality and long-term adult disability. The aim of this study was to assess the changes in body mass composition in ...patients after stroke in connection with selected socio-demographic and clinical factors (sex, age, type of stroke and time from the first symptoms) following the rehabilitation process. Materials and Methods: The study group consisted of 100 post-stroke subjects who participated in a comprehensive rehabilitation program for a duration of five weeks. The measurements of body composition by a Tanita MC 780 MA analyser were performed on the day of admission to hospital, on the day of discharge (after 5 weeks) and 12 weeks after discharge from hospital. Results: It was shown that before rehabilitation (Exam I) in the study group there were significant differences in body composition relative to sex, age and time from stroke. The rates of fat mass % and visceral fat level decreased after rehabilitation (Exam II) in both males and females. Exam II, at the end hospital rehabilitation, showed lower levels of fat mass %, visceral fat level, as well as fat-free mass % and higher values of total body water % and muscle mass %. In Exam III, i.e., 12 weeks after discharge, all of the parameters retained their values. Conclusions: The study shows an association between stroke risk factors (primarily age, sex and time from the onset of the first symptoms of stroke) and body mass composition resulting from rehabilitation. The type of stroke and the effects of rehabilitation on body mass components showed no differences. Comprehensive rehabilitation had a positive effect on the body mass components.
The aim of the study was to assess the effect of various diets on BMI and selected components of body mass, i.e., fat mass (FAT%), visceral fat (VFAT level), muscle mass (PMM %), body water (TBW %), ...and functional fitness during a 4-month observation period. Examinations were conducted three times in a group of 100 people after a stroke. The study group was divided into four subgroups according to the type of diet applied. The components of body mass were assessed using the electrical bioimpedance method, and functional fitness using the Barthel scale, the Brunnström scale, and the modified Ashworth scale. Despite the fact that there were no significant differences among the diets applied, it was observed that each of them had a positive effect on the reduction of the mean BMI, FAT%, VFAT level, and the increase in TBW% and PMM%. At the same time, there was a significant improvement in the functional fitness of the hand and upper limb. Weight control and a change in eating habits after a stroke incident is extremely important as it promotes faster recovery and improved functional fitness.
Magnetic fields are commonly used in therapies designed for subjects with rheumatic diseases, yet the effects of magnetotherapy are not entirely clear in these disorders. This study is designed to ...examine the literature investigating applications of magnetotherapy in the treatment of rheumatoid arthritis (RA). The review focused on publications related to administering magnetotherapy in patients with RA. The databases Science Direct, SpringerLink, Medline, PubMed, and Polska Bibliografia Lekarska were searched for reports published since 2005. Despite the numerous reports showing an impact of magnetic field in subjects with RA, the effectiveness of magnetotherapy has not been explicitly confirmed. Given the above, further research appears to be necessary to clarify the impact of magnetic fields on biological systems, and the relationship between magnetic field intensity and the obtained results as well as their durability. The majority of clinical trials have failed to identify any undesirable outcomes or side effects of this physical therapeutic factor.
Introduction: Carpal tunnel syndrome (CTS) is common compression neuropathy of the upper limb. Median nerve compression in the carpal tunnel causes nerve conduction disorders, paraesthesia and hand ...dysfunction. Sonotherapy is used to improve median nerve conductivity in CTS patients. The effectiveness of sonotherapy may depend on the type of ultrasonic wave and treatment energy. The aim of the study was to assess changes in the conductivity of the median nerve in CTS patients depending on the type of ultrasonic wave. Material and methods: 44 patients with CTS were included in the study. Conductivity of the median nerve was assessed using: electroneurography, a traditional electrodiagnostic test and the two-point discrimination test. The therapy protocol included: sonotherapy of the carpal tunnel, whirlpool massage, neuromobilization of the median nerve. Group 1 (37 hands) was treated using a pulsed wave with a 1/5 duty cycle, while Group 2 (29 hands) with a continuous wave. The energy of the applied treatment was 1,080 J. Results: Statistically significant improvement of electroneurographic parameters in sensory fibres and an increase in the amplitude of potentials in motor fibres were observed after pulse wave sonication. Increased rheobase and accommodation factor were also noted. After continuous wave sonication, statistically significant improvement regarding electroneurographic parameters was observed in motor fibres. The differences between the study groups were not statistically significant. Conclusion: The effect of sonotherapy in patients with CTS is not affected by the nature of the ultrasonic wave, but only by the amount of energy transferred to the tissues during the procedure.
In clinical practice there is a need for a specific scale enabling detailed and multifactorial assessment of gait in children with spastic hemiplegic cerebral palsy. The practical value of the ...present study is linked with the attempts to find a new, affordable, easy-to-use tool for gait assessment in children with spastic hemiplegic cerebral palsy. The objective of the study is to evaluate the Wisconsin Gait Scale (WGS) in terms of its inter- and intra-rater reliability in observational assessment of walking in children with hemiplegic cerebral palsy.
The study was conducted in a group of 34 patients with hemiplegic cerebral palsy. At the first stage, the original version of the ordinal WGS was used. The WGS, consisting of four subscales, evaluates fourteen gait parameters which can be observed during consecutive gait phases. At the second stage, a modification was introduced in the kinematics description of the knee and weight shift, in relation to the original scale. The same video recordings were rescored using the new, paediatric version of the WGS. Three independent examiners performed the assessment twice. Inter and intra-observer reliability of the modified WGS were determined.
The findings show very high inter- and intra-observer reliability of the modified WGS. This was reflected by a lack of systematically oriented differences between the repeated measurements, very high value of Spearman's rank correlation coefficient 0.9 ≤ |R| < 1, very high value of ICC > 0.9, and low value of CV < 2.5% for the specific physical therapists.
The new, ordinal, paediatric version of WGS, proposed by the authors, seems to be useful as an additional tool that can be used in qualitative observational gait assessment of children with spastic hemiplegic cerebral palsy. Practical dimension of the study lies in the fact that it proposes a simple, easy-to-use tool for a global gait assessment in children with spastic hemiplegic cerebral palsy. However, further research is needed to validate the modified WGS by comparing it to other observational scales and objective 3-dimensional spatiotemporal and kinematic gait parameters.
anzctr.org.au , ID: ACTRN12617000436370 . Registered 24 March 2017.
Huntington's disease is a progressive neurodegenerative disorder that usually manifests in adulthood and is inherited in an autosomal dominant manner. The main aim of the study was to assess the ...psychometric properties of the 12-item WHO Disability Assessment Schedule (WHODAS) 2.0 in studying the level of disability in people with Huntington's disease.
This is a cross-sectional study that covered 128 people with Huntington's disease living in Poland. We examined scale score reliability, internal consistency, convergent validity, and known-group validity. The disability and quality of life of people with Huntington's disease were also assessed.
The scale score reliability of the entire tool for the research group was high. The Cronbach's α test result for the whole scale was 0.97. Cronbach's α for individual domains ranged from 0.95 to 0.79. Time consistency for the overall result was 0.99 and for particular domains ranged from 0.91 to 0.99, which confirmed that the scale was consistent over time. All of the 12-item WHODAS 2.0 domains negatively correlated with all of the Huntington Quality of Life Instrument (H-QoL-I) domains. All correlation coefficients were statistically significant at the level of
< 0.001. The results obtained in the linear regression model showed that with each subsequent point of decrease in BMI the level of disability increases by an average of 0.83 points on the 12-item WHODAS 2.0 scale. With each subsequent year of the disease, the level of disability increases by an average of 1.39 points.
This is the first study assessing disability by means of the WHODAS 2.0 in the HD patient population in Poland, and it is also one of the few studies evaluating the validity of the WHODAS 2.0 scale in assessing the disability of people with HD in accordance with the recommendations of DSM-5 (R). We have confirmed that the 12-item WHODAS 2.0 is an effective tool for assessing disability and changes in functioning among people with Huntington's disease.
Introduction: In order to assess hand spasticity in post-stroke patients, it is necessary to apply an objective and sensitive method which allows for characterising motor control. It is significant ...due to the necessity to monitor the effects of the therapeutic process according to the requirements of Evidence-Based Medicine (EBM). The aim of the study was to assess the usefulness of the measurement of pressure generated during a maximal palmar grasp and after its release for evaluating the level of hand motor control in poststroke patients compared to subjective scales. Material and methods: In order to characterise motor control, a numerical indicator calculated on the basis of the measurements of pressure generated during a maximal palmar grasp and after its release was suggested. To perform the measurements, 12 poststroke patients with hemiparesis were included in the study. In the research, the level of hand paresis was assessed with Brunnström Approach, the intensity of spasticity was graded with Modified Ashworth Scale, while hand motor function was classified with Fugl-Meyer Assessment (FMA). Pressure generated during a palmar grasp and after its release as well as palm area were measured with the use of a photometric method. The assessment was made twice, i.e. on the day of admission to the in-patient rehabilitation ward and after a three-week hospital treatment. Results: In the second measurement, a slight decrease in paresis intensity according to Brunnström Approach and lower intensity of spasticity according to Ashworth Scale were noted. A higher number of points in the FMA scale was observed. The values of the suggested indicator changed; however, in no case were these changes statistically significant. Conclusions: 1. Compared to other subjective scales, the usefulness of the measurement of pressure generated during a maximal palmar grasp and after its release for assessing the level of hand motor control in post-stroke patients was not confirmed. 2. The usefulness of the recommended method of spastic hand motor control assessment needs to be verified in further research carried out according to EBM requirements.
The aim of the study was to evaluate the frequency of incidence and analysis of the risk factors for the occurrence of back pain (BP) in a group of professionally active inhabitants of the ...Podkarpackie Region of south-east Poland.
The study was carried out with a method of social survey on a randomly selected group of 2,000 the inhabitants of the Podkarpackie Region, age: 30-50 years. In the study group, 71.5% people reported back pain, 61% of whom indicated the pain being located in the lumbar-sacral region.
It was shown that the chief factors increasing the frequency of occurrence of BP was the physical character of work connected with lifting heavy loads, as well as long-term work in one position with continual repetition of the same movements. The persons reporting BP were more frequently those who opted for passive forms of relaxation (p=0.0280), and the difference was significant. No significant relationship was found between body stature and the frequency of incidence of BP (p=0.6327). In the study group, there was no relationship found between the frequency of occurrence of spinal pain syndrome (SPS) and the living environment.
In the study group of the randomly selected working inhabitants of the Podkarpackie Region, it was shown that the frequency of incidence of back pain is on the same level as in the other regions of the country. In the study group, the living environment was found not to have any significant influence on the frequency of back pain.
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