Change In Visual Analog Scale Research Articles

#3142 Evaluation of antipruritic effect of tacrolimus on hemodialysis patients with uremic pruritus, a double-blind, randomized, clinical trial

Abstract Background and Aims Pruritus in patients undergoing hemodialysis is a highly prevalent complication that affects quality of life. Several medications are currently used for the treatment of uremic pruritus, but these are not satisfactory. There are few studies about the beneficial effect of oral Tacrolimus on dermatologic problems such as pruritus. Considering the condition of hemodialysis in ESKD patients and the probable presence of oral Tacrolimus in their future treatment plan, this trial is designed to assess the antipruritic effect of Tacrolimus compared with placebo. Method This multicenter, randomized, double-blind, placebo-controlled clinical trial included 75 patients undergoing hemodialysis. The patients were randomized to a treatment group (Tacrolimus 1 mg/day) or a control group (placebo). The treatment lasted eight weeks, followed by a 2-week observational period. Visual Analogue Scale (VAS), % affected Body Surface Area (%BSA), and 12-Pruritus Severity Scale questionnaire (12-PSS) were measured before and after treatment periods. Moreover, sleep quality and the effect of sex were also evaluated. Results Seventy-five patients under hemodialysis (mean age of 58.18 ± 09.39 years) completed the study. Mean changes in VAS, %BSA, and 12-PSS after the interventions (Tacrolimus vs. placebo, mean ± SD) were as follows, respectively: −3.77 ± 2.13 vs. −1.07 ± 1.17, −18.97 ± 12.20 vs. 2.44 ± 3.23, and −4.67 ± 3.21 vs. −1.32 ± 2.45 (P < 0.0001). An improvement in sleep quality was found in 52.6% (20/38) of patients after Tacrolimus intake (P < 0.01). Overall, Tacrolimus was more effective in women than men (P < 0.016). Conclusion Based on the preliminary results of this study, Tacrolimus can be introduced as an effective drug for the management of pruritus and can be an add-on therapy in uremic patients.

Genicular artery embolization for the treatment of knee pain secondary to mild to severe knee osteoarthritis: One year clinical outcomes

ObjectiveTo evaluate the safety and efficacy of genicular artery embolization (GAE) in patients with mild-to-severe knee osteoarthritis up to 12 months after GAE. Materials & methodsThis prospective single-center study included patients who had knee osteoarthritis for >1 year with moderate-to-severe pain after failed conservative treatment for >6 months. Baseline imaging features were evaluated to determine Kellgren-Lawrence (KL) grade and magnetic resonance imaging (MOAKS) scores. GAE was performed using 150–350 μm embolic polyvinyl alcohol particles. The visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used to evaluate knee pain, stiffness, and function at baseline and follow-up. The primary endpoints were changes in VAS and WOMAC scores at 12 months. ResultsThirty-three patients (n = 37 knees) aged 66.6 ± 8.7 years were enrolled. The patients were categorized into two groups: mild-to-moderate osteoarthritis (n = 28, KL grades 2–3) and severe osteoarthritis (n = 9, KL grade 4). GAE was successfully performed in all patients, with no major adverse events. Three to six branches of the genicular artery were embolized. The mean VAS and WOMAC scores in the mild-to-moderate group significantly decreased (6.6 at baseline vs. 3.0 at 12 months and 49.4 vs. 27.4, respectively, all P < 0.001). The mean VAS and WOMAC scores in the severe group significantly decreased at 12 months (7.3 vs. 4.4 and 58.1 vs. 40.6, respectively, all P < 0.001). ConclusionGAE is a well-tolerated and effective treatment that significantly improves pain symptoms and function in patients with mild-to-severe knee osteoarthritis.

Impact of static foot disorders on the conservative treatment success in chronic venous disease patients without wounds

ObjectiveChronic venous disease (CVD) and static foot disorders (SFDs) are prevalent conditions that commonly cause lower extremity pain. These conditions share common factors such as age and weight in their etiology. This study aimed to investigate the impact of SFDs on the treatment response of patients undergoing conservative treatment for CVD without wounds. Materials and MethodsA retrospective evaluation was conducted on 328 patients (60 males, 268 females) with CVD. Parameters including age, gender, affected side, body mass index, Visual Analog Scale (VAS), Clinical-Etiological-Anatomical-Pathophysiological (CEAP) classification, and revised Venous Clinical Severity Score (rVCSS) were considered for evaluation. Radiological measurements of calcaneal pitch angle (CPA) were analyzed as a determinant of SFDs. ResultsVAS and rVCSS of the patients were evaluated before and after conservative treatment of CVD without concomitant treatment of SFDs. The presence of SFDs was associated with decreased treatment success (P < .001). Among different types of SFDs, the pes cavus group exhibited the lowest change in VAS and rVCSS scores before and after conservative CVD treatment. In contrast, the normal group demonstrated the highest improvement. Patients with a normal foot medial arch consistently achieved the best treatment outcomes compared with patients with other SFDs. ConclusionsIn conclusion, SFDs affect outcomes of conservative treatment of CVD in CEAP 0 to 3 patients, with the efficacy of treatment dependent upon the severity of SFDs.

Validation of a Dyspnea Visual Analogue Scale in Fibrotic Interstitial Lung Disease.

A visual analogue scale (VAS) is a simple and easily administered tool for measuring impact of disease; however, little is known about the use of a Dyspnea VAS in interstitial lung disease (ILD). To validate the use of a Dyspnea VAS in a large and heterogenous cohort of patients with fibrotic ILD, including its minimal clinically important difference (MCID), responsiveness to change, and prognostic significance. Patients with fibrotic ILD were identified from a large prospective registry. Validity of a 100mm Dyspnea VAS was assessed by testing its correlation in change score with other measures of ILD severity, including the University of California San Diego Shortness of Breath Questionnaire (UCSDSOBQ), King's Brief Interstitial Lung Disease quality of life questionnaire Breathlessness and Activities Domain (KBILD-B), European Quality of Life visual analogue scale (EQ-VAS), forced vital capacity (FVC), and diffusion capacity of the lung for carbon monoxide (DLCO). Responsiveness of the Dyspnea VAS was qualitatively confirmed based on there being an observable difference in the change in Dyspnea VAS across tertiles of change in anchor variables. The minimum clinically important difference (MCID) in Dyspnea VAS was calculated using both anchor (linear regression) and distribution (one-half standard deviation) approaches, with anchors including the above variables that had a correlation with Dyspnea VAS (|r|0.30). The association of Dyspnea VAS with time to death or transplant was determined. The cohort included 826 patients with fibrotic ILD, including 127 patients with follow-up measurements at 6 months. Mean baseline Dyspnea VAS was 5324mm. Dyspnea VAS change scores were moderately correlated with UCSDSOBQ (|r|=0.55) and KBILD-B (|r|=0.44), and weakly correlated with EQ-VAS (|r|=0.19), FVC% (|r|=0.21) and DLCO% (|r|=0.05). MCID was 2.7 to 4.5 using the more reliable anchor-based methods and 12.0 based on distribution-based methods. Dyspnea VAS was associated with time to death or transplant in unadjusted models and after adjustment for age and sex (hazard ratio 1.16 and 1.15 respectively, p<0.05 for both). This study provides support for the use of Dyspnea VAS in patients with fibrotic ILD, with an estimated anchor-based MCID of 5mm.

Evaluating the sensitivity of EQ-5D-5L in patients with brain metastases: a secondary analysis of NRG CC001.

EuroQoL EQ-5D is a commonly used measure of health-related quality of life (HRQOL) in clinical trials given the use of its index score as a measure of health utilities. It is unclear whether EQ-5D is sensitive to changes in neurocognitive function and progression that occur following brain radiation. This study sought to evaluate the sensitivity of EQ-5D-5L in reflecting these changes. A secondary analysis of NRG Oncology CC001 was performed. Mean EQ-5D-5L index and visual analog scale (VAS) score changes from baseline between groups of patients stratified by neurocognitive function and intracranial progression status were assessed. MD Anderson Symptom Inventory for brain tumor (MDASI-BT) symptom and interference items were also analyzed between groups. EQ-5D-5L index and VAS score changes between patients who had cognitive failure and those that had preserved cognition showed no significant differences at any time point. In contrast, VAS changes at 4 (1.61 vs -5.13, P = .05) and 6 months (8.17 vs -0.14, P = .04) were significantly improved in the patients who survived without intracranial progression.MDASI-BT cognitive factor scores were significantly improved in the cohort of patients with preserved neurocognitive function at 2 (1.68 vs 2.08, P = .05) and 4 months (1.35 vs 1.83, P = .04). MDASI-BT symptom interference was significantly associated with intracranial progression at 4 months, but not with neurocognitive status. EQ-5D-5L index and VAS scores were not sensitive to neurocognitive changes that patients experienced, but VAS scores were sensitive to progression. This study challenges the routine use of EQ-5D as a QoL metric in brain metastases clinical trials that are focused on preventing neurocognitive dysfunction. NCT# 02360215.

Efficacy of Qingpeng ointment (a Tibetan medicine) for acute gouty arthritis: a multi-center, randomized, double-blind, placebo-controlled trial

BackgroundThis study aims to assess the efficacy and safety of Qingpeng ointment (QPO), a Tibetan medicine for alleviating symptoms in individuals with acute gouty arthritis (AGA).MethodsThis study was a randomized, double-blind, placebo-controlled trial that involved individuals with AGA whose joint pain, as measured on a visual analog scale (VAS) from 0 to 10, was equal to or greater than 3. The participants were randomly assigned to either the QPO or the placebo group and received their respective treatments twice daily for seven consecutive days. In case of intolerable pain, the participants were allowed to use diclofenac sodium sustained-release tablets as a rescue medicine. The primary outcomes measured were joint pain and swelling, while the secondary outcomes included joint mobility, redness, serum uric acid levels, C-reactive protein levels, and the amount of remaining rescue medicine. Any adverse events that occurred during the trial were also recorded.ResultsA total of 203 cases were divided into two groups, with balanced baselines: 102 in the QPO group and 101 in the placebo group. For joint pain, differences between the groups were notable in the VAS scores [1.75 (0, 3.00) versus 2.00 (1.00, 3.50); P = 0.038], changes in VAS [5.00 (3.00, 6.00) versus 4.00 (2.00, 6.00); P = 0.036], and disappearance rate [26.47% compared to 15.84%; P = 0.046] after treatment. Concerning joint swelling, significant between-group differences were observed in the VAS scores [1.00 (0, 2.30) versus 2.00 (0.70, 3.00); P = 0.032] and disappearance rate [33.33% compared to 21.78%; P = 0.046] at treatment completion. The QPO group exhibited a statistically significant mobility improvement compared to the placebo group (P = 0.004). No significant differences were found in other secondary outcomes. Five patients, four from the QPO group and one from the other, encountered mild adverse events, primarily skin irritation. All of these cases were resolved after dosage reduction or discontinuation of the medication.ConclusionsCompared to the placebo, QPO exhibits positive effects on AGA by alleviating pain, reducing swelling, and enhancing joint mobility, without causing significant adverse effects.Trial RegistrationISRCTN34355813. Registered on 25/01/2021.

Ten-Year Minimum Follow-up Study of First Metatarsophalangeal Joint Fusion in Young vs Old Patients.

Painful degenerative joint disease (DJD) of the first metatarsophalangeal joint (MTP I), or hallux rigidus, mainly occurs in later stages of life. For end-stage hallux rigidus, MTP I arthrodesis is considered the gold standard. As young and active patients are affected considerably less frequently, it currently remains unclear, whether they benefit to the same extent. We hypothesized that MTP I arthrodesis in younger patients would lead to an inferior outcome with decreased rates of overall with lower rates of patient postoperative pain and function compared to an older cohort. All patients aged <50 years who underwent MTP I arthrodesis at our institution between 1995 and 2012 were included in this study. This group was then matched and compared with a group of patients aged >60 years. Minimum follow-up was 10 years. Outcome measures were Tegner activity score (TAS), a "Virtual Tegner activity score" (VTAS), the visual analog scale (VAS), and the Foot Function index (FFI). Sixty-one MTP I fusions (n = 28 young, n = 33 old) in 46 patients were included in our study at an average of 14 years after surgery. Younger patients experienced significantly more pain relief as reflected by changes in VAS and FFI Pain subscale scores. No difference in functional outcomes was found with change in the FFI function subscale or in the ability to have desired functional outcomes using the ratio of TAS to VTAS. Revision rate did not differ between the two groups apart from hardware removal, which was significantly more likely in the younger group. In patients below the age of 50 years with end-stage DJD of the first metatarsal joint, MTP I arthrodesis not only yielded highly satisfactory postoperative results at least equal outcome compared to an older cohort of patients aged >60 years at an average 14 years' follow-up. Based on these findings, we consider first metatarsal joint fusion even for young patients is a valid option to treat end-stage hallux rigidus. Level III, a case-control study.

Application of functional magnetic resonance imaging for evaluation of cartilage injury effect on knee joint function by recurrent patellar dislocation.

Explore the therapeutic effect of vastus medialis oblique plasty and the reliability and applicability of functional magnetic resonance imaging as a diagnostic method for early cartilage degeneration and injury diagnosis. From July 2020 to July 2022, there were 53 patients with recurrent patellar dislocation who met the inclusion criteria for surgery, including 34 women and 19 men, aged 11 to 53 years, with an average age of 24.4 years. After patient selection, functional magnetic resonance imaging was performed before surgery. According to the presence or absence of cartilage injury, they were divided into cartilage injury group (n = 28) and non-cartilage injury group (n = 25), and underwent vastus medialis oblique plasty. Preoperative patellar axial radiographs were performed in both groups of patients to measure the patellar tilt angle and lateral patellofemoral angle. The Lysholm, Kujala, and VAS (visual analogue scale) scores were applied to assess changes in knee joint function and anterior knee pain. All patients were postoperatively followed up. The patellar tilt angle and lateral patellofemoral angle of the 2 groups were significantly improved postoperatively (P < .05), with no statistical difference between the 2 groups (P > .05). Significant differences were observed in the VAS changes between the cartilage injury group and the non-cartilage injury group before and after operation (P < .05). There was a statistical difference in VAS score between the groups (P < .05). The changes in the Lysholm and Kujala scores before and after the operation in the cartilage injury and the non-cartilage injury groups were statistically different (P < .05). There was statistical difference between the 2 groups in Lysholm score and Kujala score after operation (P < .05). Vastus medialis oblique plasty significantly improved knee joint function and pain. Patients with cartilage injury had worse preoperative and postoperative knee function than patients without cartilage injury. Functional magnetic resonance imaging can reflect the early-stage changes in the biochemical cartilage components caused by recurrent patellar dislocation.

Frontal EEG response to alcohol craving elicited by individually tailored video cues.

Most findings on the pathophysiology of alcoholism are based on studies using resting-state electroencephalography (EEG). There are few studies on cue-induced craving and on its utility as an electrophysiological index. We examined quantitative EEG (qEEG) activities in alcoholics and social drinkers exposed to video cues and compared their association with subjective alcohol craving and other related psychiatric symptoms, including anxiety and depression. This is a between-subjects design. Adult male alcoholics (n=34) and healthy social drinkers (n=33) participated. In a laboratory, EEGs were recorded while the participants were presented with craving-inducing video stimuli. Measures used were the Visual Analog Scale (VAS) for subjective alcohol craving, Alcohol Urge Questionnaire (AUQ), Michigan Alcoholism Screening Test (MAST), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) scores. One-way analysis of covariance with age showed that alcoholics had significantly increased beta activity in the right DLPFC region (F4) (F=4.029, p=0.049), compared to social drinkers when craving-inducing stimuli were presented. Beta activity at the F4 electrode was positively correlated with AUQ (r=.284, p=0.021), BAI (r=.398, p=0.001), BDI (r=.291, p=0.018), and changes in VAS (r=.292, p=0.017) scores in both alcoholics and social drinkers. In alcoholics, beta activity was significantly correlated with BAI (r=.392, p=0.024). These findings imply functional importance of hyperarousal and negative emotions upon exposure to craving-inducing cues. Frontal EEG indices with beta power could serve as an objective electrophysiological index of craving induced by individually tailored video cues in alcohol consumption behavior.

A Study of 45 Patients with Chronic Neck Pain to Compare the Effects on Pain and Disability of 4 Weeks of Physical Therapy with the Active Release Technique and Strain-Counterstrain Manipulation with Massage Alone, Before and After Treatment.

BACKGROUND Active release technique (ART) and strain-counterstrain (SCS) have been reported to be beneficial for patients with trigger point pain. Therefore, this study of 45 patients with chronic neck pain aimed to compare the effects of 4 weeks of physical therapy with the ART and SCS manipulation with massage alone, evaluated before and after treatment, using the visual analog scale (VAS) for pain, the neck disability index (NDI), and the pressure pain threshold (PPT). MATERIAL AND METHODS The participants were 45 adults with neck pain lasting >12 weeks, divided into the ART group (n=15), SCS group (n=15), and control group (n=15). All groups received clinical massage (CM) for 15 min twice a week for 4 weeks. The control group received only CM, the ART group received CM and ART for 15 min twice a week for 4 weeks, and the SCS group received CM and SCS for 15 min twice a week for 4 weeks. VAS, NDI, and PPT were measured before and after the interventions. RESULTS In all groups, there were significant changes in VAS, NDI, and PPT after the interventions (P<0.05), and there was a significant difference among groups in the difference before and after intervention (P<0.05). VAS and NDI showed the greatest difference among before and after intervention in the ART group (VAS pre-post 3.38±0.76, NDI pre-post 5.69±2.78). PPT showed the greatest difference among before and after intervention in the SCS group (PPT pre-post 1.75±0.62). CONCLUSIONS The ART technique and the SCS technique effectively reduced neck pain and neck disorders in adults with chronic neck pain.

EFFICACY OF MUSCLE ENERGY TECHNIQUE ON SHOULDER ADHESIVE CAPSULITIS POST MASTECTOMY

Background: Shoulder pain, disability and impaired movements are frequently reported complication in post- mastectomy patients. Most individuals who have had a mastectomy suffer from adhesive capsulitis, which causes shoulder pain and impairment. Aim: The current study was conducted to investigate the effectiveness of Muscle energy technique (MET) on shoulder adhesive capsulitis post mastectomy. Patients and methods: The present work was carried-out on sixty patients with adhesive capsulitis after mastectomy who participated in this study, they were aged from 40 to 60 years. The individuals were recruited from National Cancer Institute, Cairo University. They were randomized into 2 groups; every group included 30 patients. Group (A) (study group): were givenMET5 days per week for eight weeks as well as their traditional physiotherapy program (Mobilization exercises, stretching of the Posterior capsule, as well as Range of motion (ROM) exercises). Group (B) (control group):received only the conventional physical therapy program, 5 days per week for eight weeks. Visual analogue scale (VAS) was utilized to measure the shoulder pain. Goniometer was utilized to evaluate shoulder ROM. Shoulder pain and disability index (SPADI) was utilized to evaluate shoulder function. All assessments were conducted pretreatment as well as post treatment. Results: In both Groups A and B, post-treatment VAS as well as SPADI scores were significantly lower than pre-treatment scores (p &lt; 0.001). the percentage of change of VAS as well as SPADI in Group A was 68.28% and 71.88% respectively, while it was, 45.76% and 54.4% in group B respectively. In both groups, post-treatment shoulder flexion, abduction, as well as lateral rotation were all significantly higher than pre-treatment values. Shoulder flexion, abduction, as well as external rotation all increased by 128.25, 75.76, and 99.95% in group A, whereas they increased by 97.58, 59.9, and 89.38% in group B, respectively. Pretreatment comparisons showed no statistically significant differences among the groups. Post-treatment comparisons between the two groups showed that VAS and SPADI scores were significantly lower in Group A compared to Group B (p &lt; 0.001). Shoulder flexion, abduction, as well as external rotation were significantly improved in group A than in group B after treatment (p &lt; 0.001). Conclusion: adding MET in rehabilitation program can improve the shoulder pain, ROM as well as function in adhesive capsulitis management Postmastectomy.

The trend of changes in spine-pelvic sagittal parameters before and after surgery in patients with double-segment lumbar spondylolisthesis and their evaluating for surgery efficacy

To explore the trend of changes in the parameters of the spine-pelvic sagittal plane before and after surgery in patients with double-segment lumbar spondylolisthesis (LSL) and to evaluate the value of the surgical effect. A retrospective analysis of 95 double-segment lumbar spondylolisthesis patients treated with posterior lumbar interbody fusion from October 2019 to October 2020 were analyzed, including 31 males and 64 females;age ranging from 41 to 63 years old, with an average of (52.10±4.35) years old;degree of lesion, 47 patients with gradeⅠand 48 patients with gradeⅡ. The surgical efficacy was evaluated according to the Oswestry dysfunction index(ODI) improvement rate at 3 months after operation. ODI improvement rate ≥50% was considered good, and <50% was considered bad. Ninety-five patients were divided into good curative effect group (74 cases) and poor curative effect group (21 cases) according to surgical curative effect. The clinical data, such as gender, age, body mass index, course of disease, degree of disease, operation time, intraoperative blood loss, and comorbidities were compared between two groups were compared. The parameters of spine pelvis sagittal plane were observed before and 3 months after operation, including spine sacral angle (SSA), T1 pelvic angle (TPA), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS). Clinical symptoms were evaluated using visual analogue scale (VAS) and ODI. The correlation between the changes of spine pelvis sagittal plane parameters and the changes of VAS and ODI before and after surgery were analyzed, and the value of spine pelvis sagittal plane parameters in evaluating the surgical efficacy of patients with double level lumbar spondylolisthesis at 3 months after surgery was evaluated. The courses of disease and surgical time in the group with poor efficacy were longer than those in the group with good efficacy, and the degree of lesion was higher in the group with poor efficacy (P<0.05). The SSA, TPA, LL, and SS of the group with good efficacy were higher than those of the group with poor efficacy before and 3 months after surgery, while the PT was lower than that of the group with poor efficacy (P<0.05). The changes in SSA, TPA, LL, PT, and SS before and after surgery in the group with good efficacy were greater than those in the group with poor efficacy (P<0.05). The VAS and ODI of both groups were lower at 3 months after surgery than before, and the group with good efficacy was lower(P<0.05). The changes in VAS and ODI before and after surgery in the group with good efficacy were greater than those in the group with poor efficacy (P<0.05). The changes in SSA, TPA, LL, PT, SS before and after surgery were positively correlated with the changes in VAS and ODI (P<0.05). Three months after surgery, SSA, TPA, LL, PT, and SS were used to evaluate the surgical efficacy of patients with dual level lumbar spondylolisthesis. The area under the curve (AUC) was 0.868, 0.797, 0.875, 0.822, and 0.853, respectively. The combined evaluation of all indicators resulted in the highest AUC, 0.927, and the best sensitivity and specificity were 90.50% and 91.89%, respectively. The spine pelvis sagittal plane parameters SSA, TPA, LL, and SS of patients with double level lumbar spondylolisthesis before and after surgery show an upward trend;PT shows a downward trend;PI do not change significantly. And the changes of SSA, TPA, LL, SS, and PT are closely related to the patient's pain level and the improvement of lumbar function, which can be used as parameters to evaluate the surgical efficacy.

Effect of Different Foam Rolling Sensitivities on the Amount of Change in Range of Motion: A Randomized Controlled Trial

Foam rolling (FR) is an easy-to-perform self-care activity to improve the range of motion in patients with injuries. However, even if FR is performed at the same intensity, the feeling differs depending on the patient. In addition, FR affects the contralateral side. This phenomenon is called cross education. Therefore, the main purpose of this study was to examine the relationship between FR sensitivities and FR efficacy. The secondary purpose was to determine how FR intensity perception influences cross education. In this study, FR sensitivity was calculated using the Visual Analogue Scale (VAS). The difference in the effect of FR sensitivity was evaluated using the correlation between the amount of change in PRE-test to POST- test ROM and VAS. The experimental procedure in this study first measures ankle dorsiflexion range of motion (ROM) on the left and right leg. Immediately after measurement, 3sets of FR were performed on one random leg. Participants wrote the VAS of FR for each set during the rest period of each FR intervention set. Immediately after 3 sets of FR, the ROM was measured in the left and right legs. Statistical analysis performed Two-way repeated measures ANOVA in group comparison. As a result, two-way ANOVA did not show a significant effect of group (F = 0.003, P = 0.95) or interaction effect (F = 2.28, P = 0.14). In contract, time had a significant effect (F = 39.65, P = 0.001). Post hoc result in [Dominant leg] PRE: 19.7 ± 7.6° POST: 22.2 ± 7.3° P = 0.001 Δ = 0.33. [Non-dominant leg] PRE: 20.0 ± 7.8° POST: 21.6 ± 7.8° P = 0.01, Δ = 0.21). On the other hand, Pearson’s correlation coefficient was used for the correlation between the amount of change in ROM and VAS. As a result, a dominant leg significant negative correlation was observed between the 3dr set of FR VAS score and the amount of change in ROM (r = -0.38, P = 0.04). Non-dominant leg significant correlations were observed third set of FR VAS score and amount of change in ROM (r = 0.41, P = 0.03). The result of this study suggested that it is necessary to perform FR with a comfortable stimulus on the dominant leg to maximize the effect of FR.

Changes in Transversus Abdominis Muscle Thickness, Low Back Pain, and Standing Balance after Foam Roller Exercise in Female Adults: A Randomized Controlled Trial

Objectives: The purpose of this study was to compare transversus abdominis muscle thickness and exercise performance before and after foam roller exercise (FRex).Methods: This was a randomized controlled trial (RCT). Twenty-four adult female subjects were randomly divided into two groups: (1) an intervention group that underwent FRex, and (2) a control group that remained in the supine position for the same period. Transversus abdominis muscle thickness, modified Star Excursion Balance Test (mSEBT) score, and degree of back pain experienced during daily work were measured before and after the intervention in each group using a visual analog scale (VAS), and a within-group comparison was conducted for each value. The amount of change before and after the intervention was calculated, and the correlation between each measurement item was examined.Results: Pre-intervention and post-intervention comparisons in the intervention group revealed significantly greater values for transversus abdominis lower fiber thickness and mSEBT scores, and significantly lower values for low back pain after the intervention. A moderate negative correlation was found between changes in lower back pain VAS scores and changes in transversus abdominis lower fiber thickness and mSEBT scores. Moreover, a moderate positive correlation was noted between changes in the transversus abdominis lower fiber thickness and mSEBT scores.Conclusions: These results suggest that FRex may be beneficial for preventing low back pain and improving balance.

Imaging Findings, Fluoroscopic Time, and Results of the Lumbosacral Selective Nerve Root Block: Focus on the L5 Nerve Root Block.

Introduction Selective nerve root block (SNRB) is a valuable diagnostic and therapeutic tool. In some cases, intra-nerve root puncture is difficult and time-consuming, and radiation exposure time for the surgeon may be prolonged. The aim of this study is to examine the contrast findings, fluoroscopic time, and outcomes of SNRB. Methods A total of 139 cases of SNRB were included in the study. We investigated radiating pain presence, duration of fluoroscopic time, contrast types for nerve roots, and SNRB outcomes. Contrast patterns of nerve roots were categorized into three types, which were: type 1: the presence of contrast along the nerve roots; type 2: the presence of contrast within the intravertebral foramen but not in the nerve root; and type 3: the absence of both nerve root and intravertebral foramen contrast. Results The mean fluoroscopic time was 12.8 ± 15.3 seconds for type 1, 11.1 ± 8.9 seconds for type 2, and 23.6 ± 18.8 seconds for type 3. Statistically significant differences were found between the three groups (p = 0.007), and subsequent multiple comparisons showed significant differences between type 1 and type 2 (p = 0.010) and between type 2 and type 3 (p = 0.015). The visual analog scale (VAS) score before and 30 minutes after SNRB demonstrated a significant improvement in all patients. The mean change in VAS before and after nerve root block was 49.6 ± 21.7 mm for type 1 cases, 49.8 ± 25.2 mm for type 2 cases, and 37.8 ± 23.6 mm for type 3 cases, with no statistically significant difference between the three groups (p = 0.090). The proportion of patients with subjective symptomatic improvement before and after SNRB was 91.3% in type 1 cases, 88.5% in type 2 cases, and 85.7% in type 3 cases, with no statistically significant difference between the three groups (p = 0.641). Conclusions The above findings indicate that type 3 is beneficial for both diagnostic and therapeutic purposes.

Effect ofsarilumab onunacceptable pain andinflammation control inJapanese patients with moderately-to-severely active rheumatoid arthritis: Post hoc analysis ofa Phase III study (KAKEHASI).

The aim of this study is to investigate the effects of sarilumab on unacceptable pain [UP; visual analogue scale (VAS) >40 mm] and inflammation in patients with moderately-to-severely active rheumatoid arthritis. In this post hoc analysis of the KAKEHASI study, 243 patients received methotrexate with sarilumab 150 or 200 mg or placebo every other week, over 52 weeks. The proportion of patients with UP and correlations of changes in pain VAS from baseline with uncontrolled inflammation (C-reactive protein ≥1 mg/dl) and disease activity indices were assessed. Almost 80% of patients (192/243) had UP at baseline, including ∼60% of patients with uncontrolled inflammation. Among patients receiving sarilumab, inflammation decreased rapidly, with 90% of patients achieving controlled inflammation by Week 2, while 63.1% continued to have UP. The proportion of patients with UP further decreased by Week 16 (28.5%, sarilumab vs. 64.0%, placebo). By Week 52, only ∼10% of patients had UP. Changes in pain VAS correlated with most disease activity indices and patient-reported outcomes. However, marked correlations between changes in pain VAS and C-reactive protein were observed only at Week 16. Sarilumab treatment reduced UP and inflammation in Japanese patients with rheumatoid arthritis.

Investigatıon of the effect of weight loss after laparoscopic sleeve gastrectomy on cobb angle, waist and back pain: a prospective study

BackgroundIn many studies, it has been stated that obesity causes severe increases in the risks of disc degeneration, vertebral fracture, low back, and back pain. One of the most effective treatment options for obesity is bariatric surgery. ObjectivesIn this study, the effect of weight loss on these parameters was investigated by evaluating the Cobb angle, low back, and back pain. SettingUniversity Hospital MethodsA total of 89 patients were included in the study. Laparoscopic sleeve gastrectomy (SG) was performed on all patients. In addition, Cobb angle, height, weight, and body mass index (BMI) measurements were recorded at each visit. Investigating the quality and quantity of low back pain and the loss of function caused by the patients; visual analog scale (VAS), Oswestry Low Back Pain Disability Questionnaire (OLBPDQ), Roland-Morris Disability Questionnaire (RMDQ), and SF-36 Quality of Life Questionnaire (SF36) were administered. ResultsAccording to the preoperative Cobb angles, the decrease in the 6th month (P = .029) and 12th month (P = .007) measurements after the operation was found to be statistically significant (P < .05), but it was found to be clinically insignificant. When the changes in RMDQ, OLBPDQ, VAS, and SF-36 scores were examined, the decrease in the 6th month (P = .001) and 12th month (P = .001) scores after the operation was found to be significant compared to the preoperative scores (P < .01). ConclusionsIn this study, weight loss after SG improved for patients with chronic low back and back pain and significantly improved their quality of life.

Acute effects of Whole Body Electrostimulation combined with stretching on lower back pain.

Data from recent studies suggest that whole-body electromyostimulation (WB-EMS) is a time-effective and tailored intervention for chronic lower back pain (CLBP). The aim of this non-randomized controlled study was to compare the efficacy of a WB-EMS training and the association between WB-EMS specific training with passive stretching (Well Back System, [WBS]) on CLBP. Forty patients with CLBP, 43-81 years old, were assigned to one of the two groups: WB-EMS (n=20) and WB-EMS+WBS (n=20). Both groups completed 12 sessions (8 weeks) WB-EMS protocol (2 x 20 minutes/week). The second group performed core-specific exercises with WB-EMS plus 6 extra stretching sessions (30 minutes each). Primary study endpoints were based on changes on visual analogue scale (VAS) and changes on Oswestry Low Back Disability Questionnaire (ODI). Secondary study endpoints were percentage changes of maximum trunk flexion (Sit & Reach, [SR]) and changes on assumption of painkillers. Both interventions significantly improved VAS, ODI and SR values (p range: 0.04; <0.001). However, the change of VAS (-46% vs -17%, p<0.001), ODI (-53% vs -17%, p<0.001), and SR (+7 vs +3 cm, p=0.001) were significantly higher in the WB-EMS+WBS group compared to the WB-EMS group. The working method with WB-EMS+WBS can be a joint-friendly, individualized form to decrease CLBP.

Effects of a virtual reality-based motivational reinforcement + desensitization intervention program on psychological craving and addiction memory in female MA-dependent young adults.

The aim of this study was to explore the effects of a virtual reality (VR)-based motivational reinforcement + desensitization intervention program on psychological craving and addiction memory in female methamphetamine (MA)-dependent young adults. We recruited 60 female MA-dependent young adults in a compulsory isolation drug rehabilitation facility in Sichuan Province, and randomly assigned them to intervention (mean age = 23.24 ± 2.06) and control groups (mean age = 23.33 ± 2.09). The intervention group received a VR-based motivational enhancement + desensitization intervention (total of eight sessions over a 4-week period), while the control group received regular detoxification management during the same period. Assessments were conducted before, immediately after, and 1 month after the intervention, with a visual analogue scale (VAS) being used to assess subjective craving, electronic sphygmomanometer employed to measure physiological parameters, and the Addiction Memory Intensity Scale (AMIS) applied to assess addiction memory intensity. Generalized estimating equation analysis showed significant main effects of group on changes in heart rate difference, systolic blood pressure difference, VAS and AMIS scores (all p < 0.01), and a significant time main effect on changes in diastolic blood pressure difference, VAS and AMIS scores (all p < 0.01), and a significant group × time interaction effect on changes in the difference values of three physiological parameters, VAS and AMIS scores (p < 0.01 or p < 0.05). After the intervention, the differences in three physiological parameters, and the VAS and AMIS scores, were significantly lower in the intervention than in the control group (all p < 0.05), and the difference between the two groups remained significant 1 month after the end of the intervention (both p < 0.01). VAS scores, heart rate difference, and diastolic blood pressure difference in the intervention group were significantly lower than baseline scores, both at the end of the intervention and 1 month thereafter (all p < 0.01); the systolic blood pressure difference in the intervention group was significantly lower at the end of the intervention than at baseline (p < 0.05); AMIS scores in the intervention group were significantly lower than the baseline scores 1 month after the end of the intervention (p < 0.01). Our VR-based motivational reinforcement + desensitization intervention program can effectively reduce psychological craving and physiological reactivity for drugs, and the intensity of addictive memories in female MA-dependent young adults, even after 1 month.

Computational fluid dynamics calculations in inferior turbinate surgery: a cohort study

PurposeTo investigate how the results of nasal computational fluid dynamics (CFD) simulations change due to inferior turbinate surgery and how the results correlate with patient specific subjective assessment and volumetric results in the nasal cavities.MethodsThe steady inspiratory airflow of 25 patients was studied pre- and postoperatively with heat transfer from the mucous membrane by performing CFD calculations to patient-specific nasal cone beam computed tomography images. These results were then compared to the severity of the patients’ nasal obstruction Visual Analogue Scale (VAS) and Glasgow Health Status Inventory assessments, and acoustic rhinometry measurements.ResultsTotal wall shear forces decreased statistically significantly (p < 0.01) in the operated parts of the inferior turbinates. Patients’ subjective nasal obstruction VAS assessment changes between the pre- and postoperative conditions correlated statistically significantly (p = 0.04) with the wall shear force results.ConclusionInferior turbinate surgery lead to decreased total wall shear force values postoperatively. Changes in subjective nasal obstruction VAS results against total wall shear force changes between the pre- and postoperative conditions were statistically significant. CFD data have a potential to be used for the evaluation of nasal airflow.