Functional Disability In Patients Research Articles

The FAITHS2 Model Predicts Functional Disability in Patients With Acute Ischemic Stroke.

The present study aimed to develop a model to predict functional disability at 3months in patients with acute ischemic stroke (AIS) (n = 5,406). The primary outcome was functional disability (modified Rankin Scale [mRS] >2) at 3months. A prediction model including blood biomarkers was developed based on a multivariable logistic regression model, which was internally validated by the 100-time bootstrap method. A nomogram and a web-based calculator were developed for usage in clinical practice. At 3months, 11% (638/5,406) of the patients had functional disability. Seven independent predictors of functional disability at 3months were incorporated into the FAITHS2 model (fasting plasma glucose, age, interleukin-6, stroke history, National Institute of Health Stroke Scale [NIHSS] at admission, sex, and systolic blood pressure). The Area Under Curves (AUCs) were 0.814 (95% confidence interval [CI] 0.796-0.832) and 0.808 (95% CI 0.806-0.810), and the Brier scores were 0.088 ± 0.214 and 0.089 ± 0.003 for the derivation cohort and internal validation, respectively, showing optimal performance of the model. The FAITHS2 model has excellent potential to be a dependable application for individualized clinical decision making.

The effect of instrument-assisted soft tissue mobilization in lumbar disc herniation: A randomized controlled trial

AimTo investigate the effect of instrument-assisted soft tissue mobilization technique on pain, joint range of motion, functionality and quality of life in patients with lumbar disc herniation. MethodsThis is a double blinded, randomized controlled trial. A total of 60 patients were randomly allocated to either an experimental group [n = 30, age = 46.33 ± 12.96 years] or a control group [n = 30, age = 57.03 ± 9.64 years]. The experimental group received instrument-assisted soft tissue mobilization [3 consecutive days a week for 4 weeks] in addition to conventional physiotherapy [five days a week for 4 weeks]. The control group only received the conventional physiotherapy [five days a week for 4 weeks]. Pain intensity, range of motion of the lumbar spine (flexion, extension, lateral flexion), functional disability related to low back pain and quality of life were assessed at the beginning and end of the study. ResultsThe experimental group showed statistically significant improvements in the range of motion in lumbar area (flexion, extension and lateral flexion values) compared to that shown in the control group (p < 0.05). The mean differences in Oswestry disability index were significantly better in experimental group than in the control group (p < 0.05). There were no significant differences between the two groups in terms of pain and quality of life (p > 0.05). ConclusionsInstrument-assisted soft tissue mobilization, in addition to conservative treatment, can improve range of motion in lumbar area and reduce functional disability in patients with Lumbar Region Disc Herniations.

Cognitive impairment and its association with clinical variables in Mexican persons with neuromyelitis optica spectrum disorder

IntroductionCognitive impairment has a substantial impact on the daily function of people living with demyelinating diseases. However, the study of cognitive failures and their association with clinical variables in people suffering from neuromyelitis optica spectrum disorder (NMOSD) has been scarce, especially in the latin american (Mexican) population at early and middle stages of the disease. MethodWe applied the Rao's Brief Repeatable Battery of Neuropsychological tests and obtained data of lesion burden through magnetic resonance imaging (MRI), expression of AQPQ4-IgG antibodies, and degree of disability in 30 patients with NMOSD and 30 healthy participants as a control group. ResultsAbout half of the NMOSD patients (47%) showed some degree of cognitive impairment, especially in the executive domain compared to the control group. Executive function scores were positively associated with the degree of physical disability. We found no associations between cognitive dysfunction and disease duration, AQPQ4-IgG antibodies, lesion burden, nor depression. ConclusionsExecutive functioning impairment is present in NMOSD and may predict the degree of functional disability in patients. Cognitive failures were not associated with immunological or radiological data, which emphasizes the relevance of applying systematic neuropsychological assessments in this clinical population.

Integrated Yoga and Naturopathy Interventions to Modify Functional Disability in Patients With Spinal Cord Injury: A Randomized Controlled Trial.

This study aimed to evaluate the use of integrated yoga and naturopathy intervention to modify functional disability and improve independence in patients with spinal cord injury. In this randomized controlled trial, 48 spinal cord injury patients receiving residential rehabilitation, aged between 23 and 57 years (37.9±11.8) of both genders, were randomly allocated to two groups: (i) experimental group (naturopathy and yoga) and (ii) control group (waitlist with routine care).Subjects were assessed on day 1 (baseline), day 30 (intense phase), and day 90 (follow-up). Assessments were done using the Spinal Cord Independence Measure (SCIM), handheld myometry (HHM), time up and go (TUG), Berg Balance Scale (BBS), and 10-meter walk test (10MWT). There were no significant differences at baseline between groups for all the variables (p>0.05) through one-way analysis of variance (ANOVA). Repeated measures ANOVAs (RM-ANOVAs) were performed to compare between assessments and the groups (p<0.05). Post hoc shows that there is significant SCIM (p<0.001), HHM (p<0.001), TUG (p<0.001), BBS (p<0.001), and 10MWT (p<0.001). The present study shows that there is significant improvement in the functions of both yoga and naturopathy and the control group. So, yoga and naturopathy can be considered as adjuvant along with routine care of physical therapy in spinal cord injury rehabilitation programs.

Left ventricular ejection fraction

Background and objectiveThe association between cardiac dysfunction and functional outcome in acute ischemic stroke (AIS) is not clear. We aimed to investigate the relationship between the routinely assessed left ventricular ejection fraction (LVEF) and functional outcomes in patients with AIS. MethodsData came from a prospective, observational, single-center study (Effect of Cardiac Function on Short-term Functional Prognosis in Patients with Acute Ischemic Stroke, SPARK). The LVEF was assessed with transthoracic echocardiography within 7 days of stroke onset. The primary outcome was functional disability, defined as a modified Rankin Scale score of 3–6 at 90 days (range: 0–6, with higher scores indicating greater disability). We also investigated the association of the LVEF with mortality, early neurological deterioration, hospital stay, and costs. Multivariate logistic regression analysis and 2:1 propensity score matching (PSM) were performed to compare the differences in outcomes. ResultsA total of 1181 patients were included in this analysis, of which 87 (7.4 %) patients were found to have LVEF of <60 %. In the entire study population, LVEF<60 % was significantly associated with functional disability at 90 days (odds ratio [OR]: 1.85, 95 % confidence intervals (CI): 1.01–3.40) after adjusting for all confounders. After PSM, the association was consistently significant (OR: 5.32, 95 % CI: 3.04–9.30). However, associations of the LVEF with mortality, early neurological deterioration, hospital stay, and costs were not consistently significant across all analyses. In the subgroup analysis, the association of LVEF of <60 % with functional disability was statistically significant in patients with non-cardioembolic stroke, but not in patients with cardioembolic stroke (P for interaction = 0.872). ConclusionsAn LVEF of <60 % will likely increase the risk of functional disability in patients with AIS. Future strategies to prevent cardiac dysfunction in the acute phase are needed.

Early neurological changes following endovascular therapy for acute stroke due to intracranial atherosclerotic disease

BackgroundEndovascular therapy (EVT) reduces functional disability in patients with acute large vessel occlusion (LVO). However, the early neurological change after EVT may be limited in patients with intracranial atherosclerotic disease (ICAD). MethodsWe analyzed the Japanese Registry of NeuroEndovascular Therapy (JR-NET) 4 which was a retrospective, nationwide, multicenter registry of patients with LVO between 2015 and 2019. We compared the early neurological change, efficacy and safety of EVT for acute LVO in ICAD and other etiologies. The primary outcome was NIHSS improvement ≥10 points, and secondary outcome were NIHSS worsening ≥4 points 7 days after EVT, effective reperfusion rate, 30-day functional outcomes, and safety outcomes. ResultsAmong the 6710 enrolled patients, 610 (9.1%) had ICAD. The ICAD group was younger (mean 72.0 vs. 75.8 years) and predominantly male (63.4% vs. 56.0%), had lower NIHSS scores before EVT (median 16 vs. 18), and underwent percutaneous transluminal angioplasty and stenting more frequently (43.0% vs. 4.4%, 12.3% vs. 4.4%). In the ICAD group, NIHSS improvement was significantly lower (adjusted odds ratio (aOR) [95% confidence interval (95%CI)] 0.52 [0.41–0.65]), NIHSS worsening was significantly higher (aOR [95%CI] 1.76 [1.31–2.34]), and effective reperfusion was significantly lower (aOR [95%CI] 0.47 [0.36–0.60]). Fewer patients with ICAD had modified Rankin scale 0–2 at 30 days (aOR [95%CI] 0.60 [0.47–0.77]). The risk of acute reocclusion was more prominent in the ICAD group (aOR [95%CI] 4.03 [1.98–8.21]). ConclusionsImprovement in neurological severity after EVT was lower in patients with LVO and ICAD.

Correlation between Pain and Functional Disability in Patients with Adhesive Capsulitis

Background: Adhesive capsulitis, commonly known as frozen shoulder, is a condition characterized by pain and restricted shoulder movement, affecting daily activities and quality of life. Despite its prevalence, the correlation between pain levels and functional disability remains inadequately explored, with a need for focused research to inform clinical practices. Objective: To investigate the correlation between pain intensity and functional disability in patients with adhesive capsulitis and assess demographic characteristics to inform better management strategies. Methods: A cross-sectional study was conducted on 60 patients diagnosed with adhesive capsulitis at various medical institutions in Lahore from July 2022 to January 2023. Participants aged 31-70 years were included. The study employed non-probability convenience sampling for data collection, with pain intensity measured using the Numeric Pain Rating Scale (NPRS) and functional disability assessed through the Shoulder Pain and Disability Index (SPADI). Statistical analysis was performed using SPSS version 25.0, focusing on Pearson correlation coefficients to determine the relationship between pain and disability. Results: The majority of patients were females (68.3%), with a significant representation in the 41-50 year age group (31.7%). The mean pain intensity was 5.97 (SD = 0.88), and the mean SPADI score was 73.12 (SD = 10.37), indicating moderate to high levels of pain and disability. A strong positive correlation was observed between pain intensity and functional disability (Pearson correlation = 0.81, p &lt; 0.001), suggesting a direct relationship between the severity of pain and the extent of functional impairment. Conclusion: The study confirmed a significant positive correlation between pain and functional disability in patients with adhesive capsulitis, highlighting the impact of this condition on the affected population's functional capabilities. These findings emphasize the importance of comprehensive management strategies that address both pain and functional limitations to improve overall patient outcomes.

Deterioration of fine motor skills and functional disability in patients with moderate-to-advanced Parkinson disease: A longitudinal follow-up study

IntroductionParkinson disease (PD) caused substantially disability. The impairment of fine motor skills (FMSs) is correlated with the severity of functional disability (FD) cross-sectionally in people with PD (PwP). The present study investigated the decline in FMSs and the predictive value of baseline FMSs for the progression of FD. MethodsPeople with moderate-to-advanced PD who received two evaluations within 1–5 years were identified from the Taiwan Data Bank of Persons with Disability database. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to evaluate FD, and FMSs including pen-holding, buttoning, and knotting were assessed. ResultsOur study included 2,271 people with moderate-to-advanced PD. We observed annual progression of FD in each domain of the WHODAS 2.0, with no difference between the sexes. The most significant correlation between FD and FMSs was that of decline in buttoning ability and deterioration of summary WHODAS 2.0 scores. Deterioration in FD across all domains of WHODAS 2.0 was associated with at least one FMS. The extent of disability in all three types of FMS at baseline was also correlated with deterioration of motility. Additionally, baseline disability in buttoning was significantly correlated with cognitive decline, and disability in knotting was significantly associated with the progression of FD. ConclusionFMSs may be reliable markers for further FD, particularly in the areas of cognition, motility, and life activity. Because of the significant FD observed in people with moderate-to-advanced PD, the availability of predictors is essential for applying precautionary measures and providing appropriate treatment.

Instrumented assessment of gait disturbance in PMM2-CDG adults: a feasibility analysis

BackgroundCongenital disorders of glycosylation (CDG) are genetic diseases caused by impaired synthesis of glycan moieties linked to glycoconjugates. Phosphomannomutase 2 deficiency (PMM2-CDG), the most frequent CDG, is characterized by prominent neurological involvement. Gait disturbance is a major cause of functional disability in patients with PMM2-CDG. However, no specific gait assessment for PMM2-CDG is available. This study analyses gait-related parameters in PMM2-CDG patients using a standardized clinical assessment and instrumented gait analysis (IGA).ResultsSeven adult patients with a molecular diagnosis of PMM2-CDG were followed-up from February 2021 to December 2022 and compared to a group of healthy control (HC) subjects, matched for age and sex. Standardized assessment of disease severity including ataxia and peripheral neuropathy along with isometric muscle strength and echo-biometry measurements at lower limbs were performed. IGA spatiotemporal parameters were obtained by means of a wearable sensor in basal conditions. PMM2-CDG patients displayed lower gait speed, stride length, cadence and symmetry index, compared to HC. Significant correlations were found among the used clinical scales and between disease severity (NCRS) scores and the gait speed measured by IGA. Variable reduction of knee extension strength and a significant decrease of lower limb muscle thickness with conserved echo intensity were found in PMM2-CDG compared to HC.ConclusionsThe study elucidates different components of gait disturbance in PMM2-CDG patients and shows advantages of using wearable sensor-based IGA in this frame. IGA parameters may potentially serve as quantitative measures for follow-up or outcome quantification in PMM2-CDG.

Impact of Spencer Technique on Pain, Range of Motion, and Functional Disability in Patients With Frozen Shoulder: A Pilot Study.

Background and objective The shoulder is the most flexible ball- and socket-type joint in the human body. The pathological condition that can commonly affect this joint is the frozen shoulder. This condition is marked by pain and stiffness in the area surrounding the shoulder complex. This leads to difficulty in doing the daily activities of living. Exercise and physical therapy are mostly recommended to decrease pain and improve and maintain the range of motion (ROM). Mainly traditional techniques such as Mulligans, Maitland, and Kaltenborn are used, along with electrotherapy and exercises, for the treatment of this condition. The effect of the Spencer technique is seen in baseball players' shoulder function. Thus, the purpose of this study is to determine how the Spencer approach affects patients with frozen shoulders in terms of pain, ROM, and functional impairment. Methodology This study included 20 patients aged between 40 and 60 years with stage 2 and 3 diagnosed frozen shoulder. This is a single-group pilot study that received the Spencer technique along with a moist heat pack and Codman's exercises on the affected shoulder for three weeks. Outcome measures used for assessment before and after treatment were the visual analogscale (VAS), shoulder ROM, and shoulder pain and disability index (SPADI). After the second, third, and sixth months, a follow-up was conducted.Two patients were lost to follow-up; consequently, statistical analysis was performed on the data from 18 patients. Results The current study's results suggested that there was an improvement in the mean values of VAS, ROM, and SPADI at post-three weeks, anda sustained effect was observed at the second, third, and sixth months. A statistically significant difference (P< 0.05) was found. Conclusions The study's conclusions demonstrated improved pain, ROM, and SPADI scores post-intervention. Treatment effects persisted, as seen by follow-up at the two, three, and six-month marks. As a result, the Spencer technique utilized in this pilot study on frozen shoulder patients proved effective. Also, the outcome effects were sustained, which suggests its utility in frozen shoulder rehabilitation.

Efficacy of Core-Strengthening and Intensive Dynamic Back Exercises on Pain, Core Muscle Endurance, and Functional Disability in Patients with Chronic Non-Specific Low Back Pain: A Randomized Comparative Study.

Chronic back pains are progressively disabling working individuals, including 60-80% of the general population, for which their diagnosis is challenging to healthcare workers worldwide, thereby becoming a burden to nations. The study aimed to investigate the efficacy of core strengthening exercise (CSE) and intensive dynamic back exercise (IDBE) on pain, core muscle endurance, and functional disability in patients with chronic non-specific low back pain (LBP). The study was based on a three-arm parallel-group randomized control design. Forty-five participants with chronic non-specific LBP were recruited and randomly divided into the CSE, IDBE, and Control groups. The CSE and IDBE groups received CSE and IDBE, respectively. However, the Control group received no intervention. Numeric pain rating scale, Oswestry Disability Index, core flexors, extensors, and side bridge tests assessed pain intensity, functional disability, and endurance of core muscles. Outcome scores for the dependent variables were collected at baseline (pre-intervention) and six-week post-intervention. There were no follow-up measurements in this study. A one-way multivariate analysis of covariance (MANCOVA) was used to analyze the intervention effects on the outcomes within groups and between groups, respectively; keeping the significance-level alpha at 95%, i.e., p < 0.05. A univariate F-test was performed to observe the superiority of one treatment over another. Pearson's correlation coefficient test was conducted to determine a relation between the dependent variables. In all statistical analyses, the level of significance α was kept at 0.05. All forty-five out of sixty-three participants with chronic non-specific low back pain (male, 32 and female, 23; average age, 20.24 ± 1.46 years; average pain duration, 19.6 ± 5.42 weeks) completed the study and their data were analyzed. The MANCOVA test showed a significant difference between the treatment groups on the combined multiple endurance tests for the core muscles (flexors, extensors, side bridge tests to the right and left), Visual Analog Scale (VAS), and Oswestry Disability Index (ODI) scores after controlling for baseline scores of all the dependent variables: F (6, 12) = 23.381; p < 0.05; Wilks' Λ = 0.033; partial η2 = 0.819. A post hoc pair-wise comparison followed by a univariate F-test indicated that a significant improvement was found between the CSE vs. IDBE vs. Control groups on the post-test scores of all the dependent variables except VAS and EET (CSE vs. IDBE only). A Pearson's correlation coefficient test revealed a notable relation between the dependent variables. The experimental group CSE was found to be more effective than IDBE on improving functional disability, cores' flexors, and side bridges' endurance tests than IDBE. The magnitude of this improvement exceeded the minimal clinically important difference (MCID), suggesting a clinically relevant enhancement in functional disability, core flexors, and side bridge endurance for participants engaged in CSE. However, CSE vs. IDBE revealed non-significant differences on reducing pain and core extensors' endurance. The absence of statistically significant differences suggests that the observed changes did not exceed the established MCID for pain intensity and core extensors' endurance. In addition, partial eta-squared value revealed the superiority of CSE over IDBE and Control groups. This suggests that the observed differences between the two interventions are not only statistically significant, but also clinically relevant, surpassing the established MCID.

Chronic traumatic encephalopathy: predictors of the development of cognitive disorders and functional disability

Background. Predicting the individual risk of developing cognitive impairment and functional disability in everyday life among patients with chronic traumatic encephalopathy (CTE) will allow timely and adequate treatment to prevent dementia. Therefore, the study aimed to develop a mathematical model for predicting the risk of cognitive disorders and functional disability in patients with CTE based on the analysis of polymorphic variants of the ACE, AT2R1, eNOS, ePON1, IL-1β, IL-10, TNF-α genes, as well as cofactors (gender, age group, follow-up, presence/absence of somatic comorbidity). Materials and methods. We examined 145 individuals with CTE who were undergoing inpatient treatment in the Communal Non-Profit Enterprise “Ternopil Regional Clinical Psychoneurological Hospital” in 2021–2022 and were included in the retrospective analysis. The molecular and genetic testing was performed for 26 patients. The molecular and genetic differentiation of the studied polymorphic variants of genes was carried out in the molecular and genetic laboratory of the State Institution “Reference Centre for Molecular Diagnostics of the Ministry of Health of Ukraine” in Kyiv. Cognitive functions were studied using the Montreal Cognitive Assessment (MoCA), activities of daily living — with the Barthel index. Statistical analysis was done using Microsoft Excel and Statistica 13.0 computer software. A logistic regression analysis was performed to determine the likelihood of cognitive impairment and functional disability in patients with CTE. Results. When analyzing polymorphic variants of the ACE, AT2R1, eNOS, ePON1, IL-1β, IL-10, TNF-α genes, as well as such cofactors as gender, age group, follow-up, presence/absence of somatic comorbidity in the context of the development of cognitive disorders in patients with CTE, it has been found that the I/D polymorphism of the ACE gene has the most significant prognostic value (in the presence of the D/D genotype, the probability of cognitive impairment is 83.33 %). At the same time, patients with CTE who were carriers of the D allele of the ACE gene had a significant decrease in the MoCA score compared to the group of those who didn’t carry this allele. Regarding the development of functional disability in patients with CTE, the C108T polymorphism of the PON1 gene has the most significant prognostic value (in the presence of the T/T genotype, the risk of functional disability is 41.49 %, with significantly lower Barthel index compared to the C/C homozygotes). Conclusions. It was found that the I/D polymorphism of the ACE gene and the C108T polymorphism of the PON1 gene are likely associated with the development of cognitive impairment and functional disability in patients with CTE that indicates the feasibility of further studies involving a larger sample of patients.

Effects of Compressive Myofascial Release of Vastus Lateralis on Lateral Patellar Tracking in Patients with Knee Osteoarthritis

Knee osteoarthritis is highly prevalent around the world and 4th leading cause of disability. Lateral patellar tracking is a common complain of knee osteoarthritis. It causes Q-angle at knee joint to increase that further leads to gait abnormalities. Objective: To determine the effect of compressive myofascial release of vastus lateralis on lateral patellar tracking in terms of pain, range of motion, and functional disability in patients with knee OA. Methods: This Randomized controlled trial was conducted at the Ahad Medicare Clinic and Physiotherapy Centre, Rawalpindi, spanning from December 2020 to June 2021. In this study, 52 participants were carefully selected using the Open Epi software. These individuals were aged 50 years and above and had previously been diagnosed with Grade 2-3 knee osteoarthritis. Participants were then evaluated for the presence of lateral patellar tracking by measuring Q-angle. After meeting eligibility criteria participants were divided into two groups: the Experimental group (n=26) and the Control group (n=26). Numeric Pain Rating Scale (NPRS), Goniometer, and Western Ontario and McMaster Universities Arthrosis Index (WOMAC) were used to take measurements at baseline and at 15 days follow-up. Results: Statistical analysis revealed a significant difference (p&lt;0.05) between the Experimental and Control groups in terms of pain reduction and knee extension range of motion (ROM). Conclusions: The study's findings revealed that the experimental group exhibited more significant improvements in pain reduction and knee extension compared to the conventional treatment group.

Особливості когнітивного функціонування та функціональної неспроможності у пацієнтів з травматичною енцефалопатією

Abstracts of the report "Peculiarities of cognitive functioning and functional disability in patients with traumatic encephalopathy"

CHRONIC ALCOHOL-INDUCED ENCEPHALOPATHY: PREDICTORS OF COGNITIVE IMPAIRMENT AND FUNCTIONAL DISABILITY

Introduction: Predicting the risk of cognitive dysfunction and disability in everyday life among chronic alcohol-induced encephalopathy (CAIE) patients allows timely treatment to prevent dementia.&#x0D; The aim: to develop a mathematical model for predicting the risk of developing cognitive disorders and functional disability in patients with CAIE based on the analysis of polymorphic variants of the genes ACE, AT2R1, eNOS, PON1, IL-1β, IL-10, TNF-α, as well as cofactors (gender, age group, the disease duration, and presence/absence of somatic comorbidity).&#x0D; Materials and methods: We examined the 102 patients with CAIE who were undergoing inpatient treatment in the communal non-profit enterprise «Ternopil Regional Clinical Psychoneurological Hospital» during 2021-2022 and were included in the retrospective analysis. The molecular-genetic testing was performed for 26 patients of the general group. The molecular-genetic differentiation of the studied polymorphic variants of genes was carried out in the molecular-genetic laboratory of the state institution «Reference Centre for Molecular Diagnostics of the Ministry of Health of Ukraine», Kyiv. Cognitive functions were assessed using the Montreal Cognitive Test (MoCA); activities of daily living were assessed using the Barthel index. A logistic regression analysis was performed to determine the risk of cognitive impairment and functional disability developing in patients with CAIE.&#x0D; Results: Analyzing polymorphic variants of the ACE, AT2R1, eNOS, PON1, IL-1β, IL-10, TNF-α genes, as well as such cofactors as gender, age group, history and presence/absence of somatic comorbidity in the context of the development of cognitive disorders in patients with CAIE it has been established that the C108T polymorphism of the PON1 gene has the most significant prognostic value (in the presence of the T/T genotype, the probability of cognitive impairment is 39.84 %). At the same time, carriage of both the T allele and the C allele of the PON1 gene is associated with a significant decrease in the MoCA score. Regarding the development of functional disability in patients with CAIE, the C108T polymorphism of the PON1 gene also has the most significant prognostic value (in the presence of the T/T genotype, the probability of functional disability is 48.08 %, respectively, C/C – 30.96 % and CT – 39.22 %, however, no statistically significant differences in the Barthel index values were found in carriers of the above genotypes).&#x0D; Conclusions: It was established that the C108T polymorphism of the PON1 gene is significantly associated with the development of cognitive impairment and functional disability in patients with CAIE, which indicates the feasibility of further studies involving a larger sample of patients.

Comparative effects of patient-specific 3-dimensional and 2-dimensional lumbar traction on pain and functional disability in patients with lumbar radiculopathy

BackgroundLow back pain (LBP) resides as a most common type of symptom pointing towards lumber radiculopathy. It is defined as burning sharp leg pain that originates from the back and goes all the way down your legs and extends into the toes and foot. Lumbosacral radiculopathy is caused by pathology of the intervertebral disk or associated structures. Different dimensional traction has been used to treat lumbar radiculopathy. This study aimed to compare the effects of 3-dimensional and 2-dimensional lumbar traction on pain and functional disability in patients with lumbar radiculopathy. The randomized clinical trial study of 4 weeks was carried out at the Lifeline Health Care Imaging and Pain Center and the Hamza Hospital Lahore. Twenty-six subjects were included in the clinical trial and divided into two groups after randomization. Group A received three-dimensional lumbar traction with traction force 50% of total body weight on Spine MT 3D traction machine, and group B received two-dimensional lumbar traction with traction force 50% of total body weight. Pre- and post-values of NPRS and ODI were noted.ResultsParametric tests were used during statistical analysis because data was normally distributed. NPRS pre- and posttreatment values showed significant results with p-value < 0.05. ODI pre- and post-values were also obvious with p-value < 0.05. Independent sample T-test was used to assess across the group comparison, suggesting that both groups showed significant improvements of NPRS and ODI post-treatment with p-value (< 0.001).ConclusionThe study concluded that 3D traction significantly reduced pain levels and improved functional impairment more effectively than 2D traction in patients with lumbar radiculopathy.Trial registrationTrial was registered with ClinicalTrials.gov: NCT05356689.

Muscle Energy Technique Versus Dry Needling of Active Trigger Points in Quadratus Lumborum: A Comparative Study on Functional Disability in Low Back Pain

Background: Lower back pain (LBP) is a prevalent condition that significantly impacts the quality of life and mobility of individuals. Active trigger points in the quadratus lumborum muscle are a common source of LBP, often requiring effective physiotherapeutic interventions. Dry needling (DN) and Muscle Energy Techniques (METs) are two commonly used treatments, though their comparative efficacy has not been extensively studied. Objective: The study aimed to compare the effects of DN and METs on the functional disability of patients with active quadratus lumborum trigger points contributing to lower back pain. Methods: In this randomized controlled trial, 24 patients were equally divided into two groups to receive either DN or METs over a three-week period, with sessions conducted twice weekly. The Modified Oswestry Disability Index (MODI) was employed to measure functional disability at baseline, after the first, third, and sixth sessions. Repeated measures ANOVA was utilized for intra-group and inter-group comparisons. Results: Both interventions showed a decrease in MODI scores, indicating an improvement in functional disability. However, DN was significantly more effective than METs in reducing disability scores (p &lt; 0.05). Notably, no significant difference was found between the post-treatment NPRS and PPT scores within or between the groups. Conclusion: DN appears to be a more effective intervention than METs for reducing functional disability associated with active trigger points in the quadratus lumborum among LBP patients. Despite the efficacy of both treatments, DN may be prioritized as a preferred modality in clinical settings.

Comparative effects of Bowen therapy and tennis ball technique on pain and functional disability in patients with thoracic myofascial pain syndrome

BackgroundThoracic myofascial pain syndrome is a clinical problem arising from the muscles and soft tissues of thoracic region, which include the mid and upper back area. Risk factors associated with myofascial pain syndrome are muscle overuse and repetitive strain, poor posture, trauma or injury, emotional and psychological stresses. The management of myofascial pain syndrome (MPS) typically involves a multidimensional approach that focuses on relieving pain, reducing muscle tension, and improving muscle function. Bowen therapy and tennis ball technique are also recommended for treating myofascial pain syndrome.ObjectiveThe objective of this study was to compare the effects of Bowen therapy and tennis ball technique on pain and functional disability in patients with thoracic myofascial pain syndrome.MethodsIt was a randomized clinical trial conducted on thirty patients. It was carried out in physiotherapy outpatient department of D.H.Q Hospital, Kasur. Non-probability convenience sampling technique was used. Data collection was done from the patients of thoracic myofascial pain syndrome by using Numeric Pain Rating Scale (NPRS) for pain and Pain Disability Questionnaire (PDQ) for functional disability. Participants were randomly allocated into two groups using computer generated random number method. Group A received Bowen therapy, and group B received tennis ball technique. Outcome measures were measured at baseline, after second week treatment session and after fourth week with three sessions in a week on alternate days. Data analysis was done by using Statistical Package for the Social Sciences (SPSS) version 26.ResultsThere was significant difference between the mean values of NPRS and PDQ in both groups at baseline, second week and fourth week with p value < 0.05. The results indicated that both treatments were significant but Bowen therapy is more effective treatment than tennis ball technique. Within-group difference calculated with repeated-measure ANOVA indicated that there was significant difference from pre- to post-values of both groups.ConclusionThis study concluded that Bowen therapy produced statistically significant and clinically relavant results for all the outcome measures. Trial registration. (IRCT20190717044238N7).

The Effect of Contrast Bath Therapy and Knee Pad Device on Pain, Range of Motion, and Functional Disability in Patients With Osteoarthritis Knee: A Randomized Control Trial.

Background and objective A degenerative joint condition mostly affecting the weight-bearing joints is osteoarthritis (OA). The majority of the time, it involves the knee joint. Pain and stiffness are common in grade 1 and 2 OA. And that's the main reason people ask for help. Physiotherapy treatment can be helpful for symptomatic management of early OA. Along with exercises, contrast bath therapy (CBT) is a therapeutic alternative to medication to alleviate pain and stiffness in OA. Many studies have been done using the traditional water immersion CBT. However, there is a paucity of studies on contrast therapy given using a device. This study intends to find the effect of a knee pad device(KPD) on pain, range of motion, and functional disability in knee OA patients when compared with CBT. Methods About 60 patients having unilateral knee OA were selected and randomly divided into two groups: group A received CBT for 20 minutes, and group B was treated with a KPD for 20 minutes and the Otago exercise programwas given in both groups for 30 minutes. Both groups received treatment for three sessions per week for two weeks.Outcome measures used for assessment at baseline and post-treatment were visual analog scale (VAS), knee range of motion, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scale, and distance covered in a two-minute walk test. Results Both the groups showed significant improvement post-treatment (p < 0.05). Group B showed more significant improvement when compared with group A. The enhancement in VAS (2.39, p < 0.020), range of motion (2.11, p < 0.039), WOMAC (2.09, p < 0.04), and two-minute walk test (2.03, p < 0.046) showed improvement in functional ability. Conclusion The findings of this study showed that both groups showed improvementfollowing treatment, but that the use of a KPD in combination with strengthening and balance retraining is more efficient in reducing pain and enhancing quality of life in patients with grade 1 or 2 knee OA than conventional CBT.

Lipid Profile in Multiple Sclerosis: Functional Capacity and Therapeutic Potential of Its Regulation after Intervention with Epigallocatechin Gallate and Coconut Oil.

Multiple sclerosis (MS) patients present dyslipidemia and functional disability. Epigallocatechin gallate (EGCG) and coconut oil have been shown to be effective against dyslipidemia. To analyze the relationship between lipid profiles, fat consumption, and functional disability in patients with MS after administering EGCG and coconut oil. A four-month pilot study was conducted on 45 MS patients, divided into an intervention group (IG) and a control group (CG). The IG received 800 mg of EGCG and 60 mL of coconut oil. Lipid profiles were measured before and after the intervention, along with other data such as dietary habits, inflammatory markers, and functional capacity. Dyslipidemia did not correlate with the patients' fat consumption. After the intervention, triglycerides (TG) levels were lower in IG compared to CG. This decrease was positively correlated with an improvement in functional disability (determined by the Expanded Disability Status Scale (EDSS)) and negatively with high-density cholesterol (HDL) and apolipoprotein A1. Significant and positive correlations were observed between EDSS and C-reactive protein (CRP) in the IG. These changes in the IG could be related to body fat decrease, whose percentage shows a positive correlation with CRP and TG levels, and a negative correlation with HDL levels. Patients with MS present a certain type of dyslipemia not associated with their nutritional habits. The administration of EGCG and coconut oil seems to decrease blood TG levels, which could explain the functional improvements.