There is no consensus on whether conservative treatment with night splints is indicated also in moderate and severe stages of carpal tunnel syndrome (CTS). The goal of this study was to compare the ...efficacy of night-time splinting at different stages of CTS.
Forty-five patients with electrodiagnostic (EDX) features of CTS included in the study were divided into 2 groups based on nerve conduction studies. The patients in the first group had only median nerve sensory fiber involvement, whereas the patients in the second group had also motor fiber involvement. The custom-made volar night splint was the only treatment for all of the included patients. The patients were assessed before the fabrication of orthosis and after 12 weeks of its use. The parameters measured were hand grip strength and the
for pain and paraesthesia. The patients further completed the
(BCTQ) and a shorter version of the
(QuickDASH).
In the first group, a statistically significant improvement was established in paraesthesia and hand grip strength (p = 0.019, p = 0.024, respectively), but there was no statistically significant improvement in pain, and the results of both BCTQ and QuickDASH. In the second group, a statistically significant improvement was found in paraesthesia, the
and QuickDASH results (p = 0.008, p < 0.001, p = 0.011, respectively), whereas no statistically significant improvement was established in pain, hand grip strength and the
. However, when comparing the change in the outcome measures between the 2 groups, no statistically significant differences were found.
This study has shown that 12-week night-time splinting is beneficial not only for patients with mild CTS but also for those with advanced CTS, and those awaiting surgical treatment. Therefore, splinting is recommended for all patients with CTS. Int J Occup Med Environ Health. 2020;33(6):771-80.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The main purpose of this research was to develop a new method for differentiating between scoliotic and healthy subjects by analysing the curvatures of their spines in the cranio-caudal view.
The ...study included 247 subjects with physiological curvatures of the spine and 28 subjects with clinically confirmed scoliosis. The curvature of the spine was determined by a computer analysis of the surface of the back, measured with a non-invasive, 3D, laser-triangulation system. The determined spinal curve was represented in the transversal plane, which is perpendicular to the line segment that was defined by the initial point and the end point of the spinal curve. This was achieved using a rotation matrix. The distances between the extreme points in the antero-posterior (AP) and left-right (LR) views were calculated in relation to the length of the spine as well as the quotient of these two values LR/AP. All the measured parameters were compared between the scoliotic and control groups using the Student's t-Test in case of normal data and Kruskal-Wallis test in case of non-normal data. Besides, a comprehensive diagram representing the distances between the extreme points in the AP and LR views was introduced, which clearly demonstrated the direction and the size of the thoracic and lumbar spinal curvatures for each individual subject.
While the distances between the extreme points of the spine in the AP view were found to differ only slightly between the groups (p = 0.1), the distances between the LR extreme points were found to be significantly greater in the scoliosis group, compared to the control group (p < 0.001). The quotient LR/AP was statistically significantly different in both groups (p < 0.001).
The main innovation of the presented method is the ability to differentiate a scoliotic subject from a healthy subject by assessing the curvature of the spine in the cranio-caudal view. Therefore, the proposed method could be useful for human posture diagnostics as well as to provide a long-term monitoring of scoliotic spine curvatures in preventive and curative clinical practice at all levels of health care.
Summary
Aim
To evaluate the efficacy of combined physical and occupational therapy in comparison with physical therapy alone in patients with conservatively treated distal radius fracture.
Methods
...Sixty-one participants, conservatively treated after a distal radius fracture, were included in a randomized and single-blind trial. Group A had physical therapy only (
n
= 31) and group B had physical and occupational therapy (
n
= 30). The assessment was performed three times: upon inclusion in the study in the first week after removal of the cast (T1), immediately after the end of the rehabilitation (T2), and 1 month after completing the rehabilitation (T3). The passive wrist range-of-motion, grip strength, and Disabilities of Arm, Shoulder and Hand (DASH) score were used as rehabilitation outcomes.
Results
Rehabilitation outcomes were analyzed using two-way mixed analysis of variance. The effect of time was statistically significant (
p
< 0.001) for all outcomes. The group (therapy) factor was statistically significant for grip strength only (
p
= 0.038). The interaction effect was statistically significant for rotation (
p
= 0.034) and grip strength (
p
= 0.021). A comparison between time points T3:T1 showed statistically significant difference in grip strength in favor of group B 67 % (95 % CI 60–74 %) versus group A 53 % (95 % CI 45–61 %),
p
= 0.024.
Conclusion
The combined therapy resulted in a statistically significant increase of grip strength in comparison with isolated physical therapy in the period of 12–16 weeks after the fracture. This effectiveness was not confirmed with DASH score results.
Summary
Purpose
To determine which of the three surgical techniques for acute unilateral complete rupture of Achilles tendons in use at the University Clinical Centre Maribor gives the best ...short-term functional results.
Methods
In the retrospective analysis of the results of 3 surgical techniques, 262 patients of which 244 (93.1%) were men (mean age 41.6 ± 10.0 years, range 21.5—83.0 years) operated on during the period from 2000 to 2008 were included. Group A (open technique with fascial augmentation) included 42 (16%) patients, group B (original modification of percutaneous suturing according to Čretnik and Kosanović) included 159 (60.7%) patients, and group C (original percutaneous fixation with two embracing and crossed loops according to Kruščić) included 61 (23.3%) patients. The rehabilitation protocol for group C included use of individually manufactured closed ankle functional orthosis, which replaced the plaster cast after 2 weeks of immobilization and permits early ankle range-of-motion exercising and full weight bearing. The functional outcome and incidence of postsurgical complications were analysed from medical records covering the period of 6 months.
Results
Patients from group C achieved the best functional results in the shortest time. The duration of immobilization (5.3 ± 0.1 weeks) and use of crutches (5.3 ± 0.5 weeks) were the shortest. The ability to rise up on toes on the affected leg, to walk on toes and heels, and duration of restriction of physical activities including sports were shorter than in the other two groups (p < 0.001 for all variables). Two reruptures were experienced in group B, one in group C, and none in group A.
Conclusions
Good functional results and a relatively small number of postsurgical complications advocate the use of percutaneous suturing techniques. The best and fastest functional recovery was attained in the group treated with the original technique of percutaneous fixation with two embracing and crossed thread loops according to Kruščić.
We wanted to analyze the impact of the pandemic on the treatment and rehabilitation of these patients.
The COVID-19 pandemic has had a major impact on medical services globally and it also affected ...the field of elective surgery and rehabilitation medicine. Among the most common procedures is the arthroscopic knee surgery, which is an intervention that warrants postoperative physical therapy.
The study included 105 patients subdivided in three groups, namely those treated before the pandemic, those treated during lockdown and those treated during the pandemic. We compared the decline in the number of patients and the rehabilitation outcome of the referred patients. The rehabilitation outcome was assessed by measuring the range of knee flexion.
There were 132 patients included in the analysis of the decline in the number of referred patients during the pandemic. The decline was 36 %. Out of these patients, 105 were included in the analysis of the effectiveness of rehabilitation, and we demonstrated that there were no statistically important differences in improvement among the groups (p=0.246).
Shorter treatment due to the COVID-19 pandemic did not have a statistically significant effect on the achieved knee flexion, but we noticed a reduction in the number of patients referred to our ward after knee arthroscopy (Tab. 6, Ref. 14).
The article deals with the role of physical and rehabilitation medicine in treating patients in health resorts. In addition, it focuses on doctrinal and clinical foundation for balneorehabilitation ...at Slovene health resorts. The article features a short historical overview of balneorehabilitation in Slovenia. Modern planning aspects and monitoring of medical rehabilitation as well as criteria for thermal cure referrals are also presented. Current issues dealing with patient referral to medical rehabilitation are also emphasized in this paper. Furthermore, the author describes the importance of integrated approaches within health resorts and rehabilitation with balneorehabilitation for health tourism. The author also discusses standard as well as novel diagnostic and therapeutic rehabilitation methods.
•The PRWHE is widely used PROM for hand and wrist disorders.•The PRWHE-Slo showed excellent internal consistency and test-retest reliability.•The PRWHE-Slo is freely available for use in clinical and ...research practice.
The Patient-Rated Wrist and Hand Evaluation (PRWHE) is one of the widely used PROMs in the hand rehabilitation.
To develop the Slovenian version of the PRWHE (PRWHE-Slo) and to evaluate its psychometric properties.
A single-centre observational prospective cohort study.
Fifty patients with distal radius fracture (DRF) were enrolled in the study. Construct validity was assessed by examining the correlations between the PRWHE-Slo and QuickDASH, EQ-5D-5L, wrist ROM, and grip strength. Reliability was evaluated by determining internal consistency (Cronbach...s alpha) and test-retest reliability (intraclass correlation coefficient (ICC)). The standard error of measurement (SEM) and the minimal detectable change (MDC) were determined. The responsiveness of the PRWHE-Slo was assessed with the effect size (ES) and standardised response mean (SRM).
The Cronbach’s alpha value of 0.96 and the ICC (95% CI) value of 0.95 showed excellent internal consistency and reliability for the total PRWHE-Slo score. When assessing construct validity of PRWHE-Slo, there was a strong positive correlation between all subscales and total scores of the PRWHE-Slo and the QuickDASH (r-values ranging from 0.72 to 0.83). The unrelated dimensions such as the function subscale of the PRWHE and the mobility and anxiety/depression subscales of the EQ-5D-5L were not statistically significantly correlated. Grip strength was moderately negatively correlated with all PRWHE subscales, whereas ROM showed no statistically significant correlations with any of the PRWHE-Slo subscales. SEM and MDC for the total PRWHE-Slo score were 5.40 and 14.97, respectively. The PRWHE-Slo proved to be highly responsive in DRF patients with SRM and ES values of 1.27 and 0.91, respectively.
The psychometric analysis of this study shows the PRWHE-Slo to be reliable, valid, and responsive PROM for assessing pain and disability in patients after DRF.
Traumatic brain injury is any non-degenerative and non-congenital injury of brain and surrounding tissue caused by external mechanical force. Its short and long term consequences on cognitive, ...behavioral and physical functioning are not limited to injury itself but is severly connected with the secondary cellular metabolic and vascular changes after the acute impact. Due to high mortality, extremelly demanding acute treatment, long term need for intensive rehabilitation and inevitably permanent deficits on subject`s multi-level functioning, we understand severe traumatic brain injury as the most severe medico-social problem of the developed world. There are many different national guidelines available in literature for rehabilitation of subjects after traumatic brain injury. Protocol for early recognition and prevention of highly expected complications after and during admission in rehabilitation progremme, serves as a protection against events that to often prevent the effective progress in rehabilitation, mean serious long-term consequenses for patient and cause additional costs of medical care. Slovenian guidelines for the rehabilitation moderate / severe traumatic brain injury in acute and post-acute phase are presented in the paper.
Traumatic brain injury is any non-degenerative and non-congenital injury of brain and surrounding tissue caused by external mechanical force. Its short and long term consequences on cognitive, ...behavioral and physical functioning are not limited to injury itself but is severly connected with the secondary cellular metabolic and vascular changes after the acute impact. Due to high mortality, extremelly demanding acute treatment, long term need for intensive rehabilitation and inevitably permanent deficits on subject`s multi-level functioning, we understand severe traumatic brain injury as the most severe medico-social problem of the developed world. There are many different national guidelines available in literature for rehabilitation of subjects after traumatic brain injury. Protocol for early recognition and prevention of highly expected complications after and during admission in rehabilitation progremme, serves as a protection against events that to often prevent the effective progress in rehabilitation, mean serious long-term consequenses for patient and cause additional costs of medical care. Slovenian guidelines for the rehabilitation moderate / severe traumatic brain injury in acute and post-acute phase are presented in the paper.
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