Improvement In Pain Intensity Research Articles

Effects of suboccipital inhibition versus soft tissue manipulation on pain intensity and disability in tension-type headache among undergraduate physiotherapy students

BackgroundTension-type headache (TTH) is prevalent among collegiate students due to academic stress. Manual therapies like suboccipital inhibition and soft tissue manipulation have shown efficacy in TTH management. However, comparative studies between these interventions in collegiate populations are scarce. Understanding their relative effectiveness can enhance treatment strategies and improve outcomes, shedding light on optimal manual therapy approaches for TTH among collegiate students. This study aimed to investigate the effects of suboccipital inhibition and soft tissue manipulation on pain intensity and disability in tension-type headache (TTH) among undergraduate physiotherapy students.MethodsForty undergraduate physiotherapy students diagnosed with TTH were randomly assigned to the suboccipital inhibition group (group A, n = 20) and the soft tissue manipulation group (group B, n = 20). The suboccipital inhibition group received manual therapy targeting the suboccipital muscles, while the soft tissue manipulation group received manipulation techniques focusing on the cervical and shoulder girdle muscles. Pain intensity and disability were assessed using Visual Analogue Scale (VAS) and Headache Disability Index (HDI) Questionnaire at baseline and after 6 weeks of intervention. The data were collected and analysed using independent t test.ResultsBoth interventions demonstrated significant reductions in pain intensity and disability after 6 weeks, with the t value − 4.3150 and − 3.3106 at p < 0.05 for VAS and HDI respectively.ConclusionSuboccipital inhibition and soft tissue manipulation are effective interventions for reducing pain intensity and disability among undergraduate physiotherapy students with TTH. However, the suboccipital inhibition group showed improvement in pain intensity and disability and it has been statistically significant when compared to the soft tissue manipulation group.

Saccharomyces boulardii improves clinical and paraclinical indices in overweight/obese knee osteoarthritis patients: a randomized triple-blind placebo-controlled trial.

This study aimed to determine the effect of the probiotic Saccharomyces boulardii (S. boulardii) in patients with knee osteoarthritis (KOA). In this study, 70 patients with KOA were recruited via outpatient clinics between 2020 and 2021 and randomly assigned to receive probiotics or placebo supplements for 12weeks. The primary outcome was a change in pain intensity according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score. Sixty-three patients completed the trial. A linear mixed analysis of covariance (ANCOVA) model analysis showed that probiotic was better than placebo in decreasing the pain intensity measured by visual analogue scale (VAS) [-2.11 (-2.59, -1.62) in probiotic group and -0.90 (-1.32, -0.48) in placebo group, p = 0.002] and WOMAC pain score [-3.57 (-4.66, -2.49) in probiotic group and -1.43 (-2.33, -0.53) in placebo group, p < 0.001]. The daily intake of acetaminophen for pain management significantly decreased in the probiotic group [-267.18 (-400.47, -133.89) mg, p < 0.001] that was significantly better than placebo (p = 0.006). Probiotic significantly decreased the serum levels of high-sensitivity C-reactive protein (hs-CRP) inflammatory index [-2.72 (-3.24, -2.20) µg/ml] and malondialdehyde (MDA) oxidative stress index [-1.61 (-2.11, -1.11) nmol/ml] compared to the placebo (p = 0.002 and p < 0.001, respectively). Probiotic was better than placebo in increasing the scores of role disorder due to physical health (p = 0.023), pain (p = 0.048) and physical health (p = 0.031). Probiotic S. boulardii supplementation in patients with KOA significantly improved pain intensity, some dimensions of QoL, and inflammatory and oxidative stress biomarkers with no severe side effects. Registered on the Iranian clinical trial website ( http://www.irct.ir : IRCT20161022030424N4) on 2019-09-02.

Efficacy of occupational rehabilitation in return to work for back pain: A systematic literature review.

Currently, there is no standard procedure for a return to work (RTW) rehabilitation program used by practitioners. The aim is to investigate the efficacy of occupational rehabilitation programs for workers with back pain. Two independent reviewers screened abstracts and full-text articles in a systematic literature search in three databases conducted in 2023. Subsequently, they extracted data according to the PRISMA Statement. Among the 4,010 articles retrieved, 20 met the inclusion criteria. Data from accepted studies were abstracted into tables relating to the RTW, improvement of pain intensity, quality of life (QOL), and degree of disability in persons with back pain. The risk of bias was assessed using the (SIGN)-criteria. Significant improvements in RTW were shown by a workplace intervention with a physical approach and a multidisciplinary intervention but with a wide range of effect sizes. Five studies showed significant improvements in pain intensity and QOL, six studies observed significant improvements in disability. The studies that stated positive effects on work-related data differed between intervention programs and traditional care. A combination of activity, maintenance therapy, stretching, and manual therapy showed promising results in improving RTW. In addition, the relationship and mediation between employer/workplace and employee seems to be an important aspect of RTW. However, pain intensity, disability, and QOL were enhanced with interventions that included a high proportion of physical activity. However, the intervention programs differed widely, leading to the assumption that the treatment effect of the intervention programs is not established, yet.

Implementation of an integrated primary care prevention and management program for chronic low back pain (LBP): patient-reported outcomes and predictors of pain interference after six months

BackgroundIntegrated primary care programs for patients living with chronic pain which are accessible, interdisciplinary, and patient-centered are needed for preventing chronicity and improving outcomes. Evaluation of the implementation and impact of such programs supports further development of primary care chronic pain management. This study examined patient-reported outcomes among individuals with low back pain (LBP) receiving care in a novel interdisciplinary primary care program.MethodsPatients were referred by primary care physicians in four regions of Quebec, Canada, and eligible patients received an evidence-based interdisciplinary pain management program over a six-month period. Patients were screened for risk of chronicity. Patient-reported outcome measures of pain interference and intensity, physical function, depression, and anxiety were evaluated at regular intervals over the six-month follow-up. A multilevel regression analysis was performed to evaluate the association between patient characteristics at baseline, including risk of chronicity, and change in pain outcomes.ResultsFour hundred and sixty-four individuals (mean age 55.4y, 63% female) completed the program. The majority (≥ 60%) experienced a clinically meaningful improvement in pain intensity and interference at six months. Patients with moderate (71%) or high risk (81%) of chronicity showed greater improvement in pain interference than those with low risk (51%). Significant predictors of improvement in pain interference included a higher risk of chronicity, younger age, female sex, and lower baseline disability.ConclusionThe outcomes of this novel LBP program will inform wider implementation considerations by identifying key components for further effectiveness, sustainability, and scale-up of the program.

EXERCISE PHYSIOLOGIST-LED PAIN SCIENCE COACHING VIA TELEHEALTH IMPROVED PAIN AND FUNCTION IN LIFE INSURANCE CLAIMANTS: A PRAGMATIC COHORT STUDY

INTRODUCTION &amp; AIMS Personal injury and illness compensation claimants are more likely to experience persistent pain and poorer clinical/vocational outcomes than non-compensated clients. Evidence supports the effectiveness of pain science coaching to help people understand and re-train their pain system. This consequently reduces pain intensity, improves function and quality of life. However, the effectiveness of telehealth-delivered, exercise physiologist-led pain science coaching is yet to be evaluated. This study aimed to determine the effectiveness of an accredited exercise physiologist-led pain science coaching intervention via telehealth in Australian life insurance claimants. METHODS This pragmatic cohort study included 1,275 claimants receiving a pain science coaching intervention supported by life insurance compensation. Ethics was approved via Deakin University Human Research Ethics Committee (2023-347). Outcome measures were pain intensity (11 item numerical pain rating scale, range: 0-10 points) and function (two 11-item patient-specific functional scale, range: 0-20 points). Linear mixed models determined within-group change over time. RESULTS Clients (female: 75%, male: 25%) had a mean (SD) age of 50 (10) years (range: 20-69 years) and claim duration of 2 (2) years (range: 0-20 years). Mean (SD) intervention duration was 10 (6) weeks (range: 3-41 weeks), financial cost was A$1,149 (A$202; range: A$510-A$2,040) and included 5 (1) hours (range: 2-11 hours) of pain science coaching. Following the intervention, pain intensity decreased 25% (estimated marginal mean change [95%CI]: -1.49 [-1.59, -1.40] points, P&amp;lt;0.001) and function increased 76% (4.41 [4.21, 4.62] points, P&amp;lt;0.001). Changes surpassed established clinically meaningful effect thresholds for pain intensity (1.17 points) and function (2.6 points). Client Net Promotor Score was +60 (Australian Healthcare Index benchmark ≥ +30) and 91% were satisfied with the intervention. CONCLUSION An exercise physiologist-led pain science coaching intervention resulted in clinically meaningful improvements in pain intensity and function in compensation claimants. Clients reported high satisfaction rates.

ADHERENCE TO PRESCRIBED EXERCISE AND CLINICAL OUTCOMES IN PEOPLE WITH CHRONIC NONSPECIFIC LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS

BACKGROUND Exercise is widely accepted as a first-line treatment for chronic non-specific low back pain (CNSLBP). However, the benefits of exercise diminish over time, as does adherence to exercise. It is unclear whether greater exercise adherence is associated with improvements in pain intensity (PI) and functional limitation (FL). We explored the relationship between exercise adherence and patient-reported outcomes in people with CNSLBP. METHODS We conducted a secondary analysis of the Cochrane systematic review, ‘Exercise therapy for chronic low back pain’, using a subset of 24 trials that measured exercise adherence compared to usual care. Random-effects meta-analysis was performed in R for PI and FL at the closest time point post-intervention. We used predefined subgroups of exercise adherence of ‘Good’ (90-100%), ‘Moderate’ (70-89%), or ‘Poor’ (14-69%) adherence. We used the risk of bias judgements provided by Cochrane. RESULTS All trials included were deemed low risk of bias. Compared to usual care, ‘Good’ adherence was associated with reduced PI by 17.83 points on a 100-point scale (95% CI -26.23 to -9.43; I2 = 81.7%) and FL by 9.69 points on a 100-point scale (95% CI -12.64 to -6.74; I2 = 18.9%). ‘Moderate’ adherence was associated with reduced PI by 6.93 points (95% CI -10.43 to -3.44; I2 = 18.3%) and FL by 3.80 points (95% CI -6.10 to -1.49; I2 = 0%). ‘Low’ adherence was associated with reduced PI by 7.50 points (95% CI -19.83 to -4.84; I2 = 89.7%) and FL by 3.35 points (95% CI -10.45 to -3.74; I2 = 82.7%). CONCLUSIONS Greater adherence to exercise is associated with greater improvements in PI and FL in adults with CNSLBP. Further research is needed to understand the causal effect of adherence on patient-reported outcomes. Better reporting of this potentially important exercise parameter in randomised trials is also needed.

EFFICACY, FEASIBILITY AND OPTIMAL TRAINING PARAMETERS FOR RUNNING IN ADULTS WITH CHRONIC LOW BACK PAIN: THE ASTEROID RANDOMISED CONTROLLED TRIAL

INTRODUCTION &amp; AIMS Running is common and one of the most accessible forms of exercise training, yet the suitability for adults with chronic low back pain is unknown. This study assessed the efficacy and feasibility of running in adults with chronic low back pain (LBP) and explored the relationship between training parameters and pain intensity. METHODS This two-arm parallel (1:1) individually randomised controlled trial allocated 40 participants (mean [SD] age: 33 [6] years, female: 50%) with non-specific chronic LBP to a 12-week intervention or waitlist control. The intervention was a progressive run-walk interval program comprising three 30-minute sessions per week, that were digitally delivered and remotely supported by an exercise physiologist. Efficacy outcomes were self-reported average and current pain intensity (100-point visual analogue scale) and disability (100-point Oswestry Disability Index). Training parameters examined were fortnightly adherence, pace and distance. RESULTS At 12-week follow-up, the intervention decreased average pain intensity (mean net difference [95%CI]: -15.30 [-25.33, -5.27] points, P=0.003), current pain intensity (-19.35 [32.01, -6.69] points, P=0.003) and disability (-5.20 [-10.12, -0.24] points, P=0.038), compared to control. There was no attrition and mean (SD) training adherence was 70% (20%; i.e. 2.1 of 3 sessions per week). Nine non-serious adverse events deemed potentially study-related were reported (lower limb injury/pain: n=7, cardiac syncope associated with an underlying condition: n=1, LBP: n=1). Greater fortnightly adherence (-0.04 [-0.33, 0.25] points), pace (0.23 [-0.48, 0.02] points) and distance (-0.03 [-0.13, 0.06] points) tended to be associated with greater reductions in pain intensity, yet did not reach statistical significance. CONCLUSION Running was feasible and improved pain intensity and disability in individuals aged 18-45 years with non-specific chronic LBP when compared to control. An individualised and conservative run-walk program should be considered a suitable form of physical activity for adults with chronic LBP.

Oxygen-ozone therapy for pain relief in patients with trapeziometacarpal osteoarthritis: a proof-of-concept study

Purpose Trapeziometacarpal osteoarthritis (TMC-OA) is a prevalent hand disorder affecting a growing number of people worldwide. While a multidisciplinary approach might provide additional advantages, the analgesic and anti-inflammatory role of intra-articular oxygen-ozone (O2O3) injections combined with physical therapy is still unknown. To assess the impact of a multimodal therapeutic approach combining O2O3 injections with physical therapy in patients with TMC-OA. Materials and methods A prospective open-label study conducted in the Physical and Rehabilitation Medicine Unit of the "Renato Dulbecco" University Hospital of Catanzaro. We assessed patients with TMC-OA who had not responded to standard medical therapy. Participants received O2O3 therapy and targeted physical therapy for 4 weeks. Pain relief, muscle strength, and physical functioning were assessed at baseline and after 4, 12 and 24 weeks (respectively T0, T1, T2, and T3) Results Seventeen patients with a mean age of 67.1 ± 6.1 years were included in the study. Short-term improvements in pain intensity were observed (T0: 6.221 ± 1.514; T1: 3.172 ± 1.1451; p < .001) and were maintained over a 24-week follow-up period (T0: 6.221 ± 1.514; T3: 4.393 ± 1.438; p: 0.006). Significant changes were reported also in terms of muscle strength and physical functioning. O2O3 therapy was well-tolerated with no adverse effects. Conclusions A combination of O2O3 injections and physical therapy might be considered in patients with TMC-OA. Further investigation is warranted to assess the effectiveness of O2O3 therapy in managing TMC-OA.

Exploring the effects of fitbit incentive on treatment outcomes in veterans undergoing intensive pain rehabilitation program

ObjectiveThis study compares clinical pain outcomes between patients in a pain treatment program that received a Fitbit, to patients that did not. We also explored: (1) cognitive, emotional, and psychological factors that may have impacted the decision to opt in to receiving a Fitbit; and (2) whether the choice to receive a Fitbit impacted changes in cognitive, emotional, and psychological factors following treatment.MethodsAmong 58 patients in a multidisciplinary pain treatment program at a Veterans Affairs Healthcare System hospital, 31 patients opted to receive a Fitbit as adjunct treatment, while 27 did not. This study utilized patient-reported and practitioner-collected data from the pain treatment program.ResultsCompared to the non-Fitbit group, the Fitbit group displayed a significant decrease in average pain intensity, however showed no correlation between Fitbit activity and average pain intensity. Additionally, treatment satisfaction was the only predictor of treatment group, when modeling pre- and post-treatment outcomes changes.ConclusionThe implementation of a Fitbit may lead to improved pain intensity. Initial evidence suggests that opting to receive a Fitbit during a pain treatment program indicates treatment engagement leading to greater treatment satisfaction. Future work is needed to verify and expand upon this potential mechanism.

Effects of scapular treatment on chronic neck pain: a systematic review and meta-analysis of randomized controlled trials

BackgroundChronic neck pain (CNP) is a common public health problem that affects daily living activities and quality of life. There is biomechanical interdependence between the neck and scapula. Studies have shown that shoulder blade function might be related to chronic neck pain. We therefore evaluated the effects of scapular targeted therapy on neck pain and function in patients with CNP.MethodsDatabases, including MEDLINE (via PubMed), EMBASE (via Ovid), Ovid, Web of Science, and Scopus, were systematically searched for randomized controlled trials published in English investigating treatment of the scapula for CNP before July 16, 2023.ResultsA total of 313 participants were included from 8 RCTs. Compared with those in the control group, the intervention in the scapular treatment group exhibited greater improvement in pain intensity (standardized mean difference (SMD) = 2.55; 95% CI = 0.97 to 4.13; P = 0.002), with moderate evidence. Subgroup analysis for pain intensity revealed a significant difference between the sexes, with only the female population (SMD = 6.23, 95% CI = 4.80 to 7.65) showing better outcomes than those with both sexes (SMD = 1.07, 95% CI = 0.57 to 1.56) (p < 0.00001). However, moderate evidence demonstrated no improvement in neck disability after scapular treatment (SMD of 0.24[-0.14, 0.62] of Neck Disability Index or Northwick Park Neck Pain Questionnaire). No effect of scapular treatment was shown on the pressure pain threshold (PPT). The cervical range of motion (CROM) and electromyographic activity of neck muscles could not be conclusively evaluated due to limited support in the articles, and further study was needed. However, the patient’s head forward posture appeared to be corrected after scapular treatment.ConclusionScapular therapy was beneficial for relieving pain intensity in patients with CNP, especially in women. Head forward posture might also be corrected with scapular therapy. However, scapular therapy may have no effect on the PPT or neck disability. However, whether scapular therapy could improve CROM and cervical muscle activation in patients with CNPs had not been determined and needed further study.

894 Comparison of Intraoperative Neural Changes During Tonic Versus High-Frequency Spinal Cord Stimulation in Chronic Pain Patients

INTRODUCTION: Chronic pain is a prevalent issue that may affect up to 34% of US adults, and spinal cord stimulation (SCS) is a promising therapy. However, SCS device selection remains a challenge because there are currently no objective biomarkers to evaluate chronic pain, or to predict which patients will be responders. METHODS: Intraoperative EEG signals were recorded in 24 chronic pain patients (14 women) during permanent SCS electrode placement surgery. Neural responses were captured with respect to tonic (60 Hz/300 µs) and high-frequency (1 kHz/30 µs) SCS paradigms in a randomized manner and correlated to Numeric Rating Scale (NRS) scores. All data were analyzed offline in MATLAB and SPSS v28.0.1.1. RESULTS: Our analyses for the main effects demonstrated a significant difference between cortical regions (F(2.88,57.7) = 7.60 , p &lt; 0.001) and a marginal difference between stimulation conditions (F(2,40) = 2.970, p = 0.063). The post hoc analysis for these factors revealed that alpha/theta peak power ratio was significantly different between in central regions (C3-C4) between tonic and HF stimulation (p = 0.006) and temporal regions (T3-T4) between baseline and HF stimulation (p = 0.049). The comparison of NRS scores before and 3 months after surgery indicated a significant improvement in pain intensity (p &lt; 0.001) at the group level. The neural features found to be significantly correlated with preoperative NRS scores in PFC (p = 0.036 and p = 0.025) and temporal regions (p = 0.041 and p = 0.012) under both stimulations. CONCLUSIONS: Our preliminary results support the possibility that different stimulation patterns affect the electrophysiological activity differently in various cortical regions. Such differences might account for the variability in pain suppression in patients with chronic pain treated with SCS. Future work will utilize this dataset to develop a machine learning classifier to support objective device selection strategies.

Virtual reality based rehabilitation in adults with chronic neck pain: a systematic review and meta-analysis of randomized clinical trials

Chronic neck pain is one of the most frequent musculoskeletal disorders, with high prevalence worldwide. Rehabilitation is an essential component of therapeutic strategy. Virtual reality based rehabilitation (VRBR) is a powerful distraction technique that could be beneficial for chronic neck pain patients. The objective of this systematic review was to analyse the effectiveness of VRBR in chronic neck pain treatment. We followed the PRISMA guidelines and used four databases (CINAHL, Medline (Via PubMed), Scopus and Web of Science) from their inception to August 2023. Eligibility criteria were established using PICOS. Methodological quality was evaluated with the Downs and Black scale and the risk of bias with the Revised Cochrane risk-of-bias tool. The meta-analysis was performed using the RevMan software. Six studies were included in the systematic review and the meta-analysis. We observed significant differences in favour of VRBR for pain intensity (SMD = − 0.46; 95% CI = − 0.74, − 0.19; p = 0.001), disability (MD = − 2.84; 95% CI = − 4.23, − 1.45; p < 0.0001), global perceived effect (MD = 0.49; 95% CI = 0.25, 0.72; p < 0.0001) and patient satisfaction (MD = 0.62; 95% CI = 0.38, 0.86; p < 0.00001). However, at short-term follow-up significant differences were only obtained for disability (MD = − 3.52; 95% CI = − 5.85, − 1.20; p = 0.003). VRBR can significantly improve pain intensity, disability, global perceived effect and patient satisfaction. The small number of articles included in the analysis is a limitation, even considering the good methodological quality of these studies. Investigating the effects of VRBR on mid and long-term follow-up and exploring different types of VR are needed.PROSPERO database, registration number ID: CRD42020222129.

Promoting pain coping skills in haemophilia: A remote intervention integrating exercise and pain education.

Chronic joint pain is a significant and widespread symptom in people with haemophilia (PWH). Despite medical advancements, effective pain management remains challenging. This study presents an innovative approach that integrates remote physical exercises, pain neuroscience education, and coping strategies to address chronic pain in PWH. The remote intervention consisted of sixteen 5-min videos encompassing physical exercises for chronic pain management and pain education strategies. These videos formed an 8-week remote intervention program. Clinical and physical assessments were conducted before and after the intervention. A total of thirty-one PWHs, with a median age of 34 years (ranging from 16 to 59years), completed the remote intervention. The study revealed significant improvements in pain intensity, disability, and physical performance among PWH with chronic pain. Enhanced functional capacity was evident in the Timed Up and Go and Single Leg Stance tests, accompanied by improved scores on the Functional Independence Score in Haemophilia (FISH). Although lacking a control group, our findings are consistent with other successful exercise and pain education programs. This innovative intervention holds promise for managing chronic pain in PWH, underscoring patient empowerment, education, and collaboration. Notably, our study stands out by uniquely combining pain education and coping strategies, bolstering evidence for effective pain management.

Neurophysiological outcomes that sustained clinically significant improvements over 3 years of physiologic ECAP-controlled closed-loop spinal cord stimulation for the treatment of chronic pain

IntroductionA novel, spinal cord stimulation (SCS) system with a physiologic closed-loop (CL) feedback mechanism controlled by evoked compound action potentials (ECAPs) enables the optimization of physiologic neural dose and the...

Efficacy of rehabilitation interventions on functioning in patients with hemophilic arthropathy: A systematic review with meta-analysis.

Hemophilic arthropathy is a detrimental condition that crucially affects functional outcomes in hemophilic patients.In recent years, due to the advances in systemic therapies, growing attention has been raised in the rehabilitation field in order to improve functional outcomes of hemophilic patients. However, the optimal rehabilitation modalities in these patients are far from being fully characterized. The present study aimed to assess the effects of different rehabilitation interventions on physical functioning and health-related quality of life of hemophilic arthropathic patients. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Five databases were systematically searched for randomized controlled trials (RCTs) published until June 22nd, 2023. The selection criteria included adult patients with hemophilia A and B receiving rehabilitation interventions. The outcomes were muscle strength, physical function, pain intensity, physical performance, and health-related quality of life. Out of 1,743 identified records, 17 studies were included in the qualitative synthesis. Rehabilitation interventions were categorized into exercise intervention, fascial therapy, and multimodal intervention. The findings suggested positive outcomes in terms of muscle modifications, range of motion improvements, joint health enhancements, pain intensity reduction, and quality of life improvements. More in detail, meta-analyses showed significant improvements in pain intensity [ES: -1.10 cm (-1.37, -0.82), p< 0.00001], joint health [ES: -1.10 (-1.38, -0.82), p< 0.00001], In accordance, exercise interventions showed significant benefits in terms of joint health [ES: -2.54 (-3.25, -1.83), p< 0.00001)] and quality of life [ES: 1.17 (0.48, 1.86), p< 0.0000)]. Rehabilitation interventions have a positive impact on functional outcomes and health-related quality of life of hemophilic arthropathic patients. Further studies are needed to better elucidate the role of a comprehensive intervention combining different rehabilitation approaches to treat hemophilic arthropathy.

Influence of virtual reality approach on phantom pain in trans-tibial amputation

Background: Phantom limb pain (PLP): is a common complaint after lower limb amputation can be defined as discomfort or pain in a missing part of the limb. This study was conducted in the research laboratory section, Faculty of Physical Therapy, Cairo University, Giza, Egypt. Purpose: To investigate the effect of Virtual reality (VR) on phantom limb pain and lower limb Function in trans tibial amputation. Methods: sixty patient with phantom pain were enrolled into 2 equal groups: a study group and a control group. Outcome measures included pain intensity level was measured by McGill pain questionnaire and Lower Extremities Function was measured by Lower Extremities Function Scale. That were assessed at baseline and 4 weeks postintervention. Results: A statistically significant effect (p &lt; 0.0001) of treatment and time was revealed in both groups for all measured variables. Between-group analysis implied a higher improvement in post-intervention results in group B (p &lt; 0.05). Conclusion: This study indicated that Using VR with conventional treatment is more effective in case of Phantom pain in trans-tibial amputation that in improving pain intensity level (reduce pain) and Lower Extremities Function than conventional treatment alone.

Comparative Efficacy of Mind-Body Exercise for Treating Chronic Non-Specific Neck Pain: A Systematic Review and Network Meta-Analysis.

This systematic review and network meta-analysis aims to compare the efficacy of different mind-body exercise (MBE) interventions, including Yoga, Pilates, Qigong, and Tai Chi, in managing chronic non-specific neck pain (CNNP). We searched randomized controlled trials in PubMed, Embase, Web of Science and Cochrane Library. After screening eligible studies and extracting relevant data, risk of bias of included studies was assessed by the Cochrane Risk of Bias assessment tool, and network meta-analysis was performed by the Stata software version 16.0. Of the 1019 studies retrieved, 18 studies with 1442 subjects were included. Fourteen studies were graded as high quality. Yoga plus hot sand fomentation was the most effective in reducing pain intensity and functional disability, and improving the quality of physical life in patients with CNNP. Yoga achieved the most improvement in cervical mobility. And Pilates was the best MBE intervention for improving the quality of mental life. Overall, Yoga, Pilates, Qigong, and Tai Chi demonstrated considerable effectiveness in improving pain intensity, functional disability, cervical mobility, and quality of life in patients with CNNP. Yoga or Yoga plus heat therapy was the most effective method for patients with CNNP. Additional high-quality, large-scale, multi-center, long-term follow-up studies are necessary to fully understand the comparative effectiveness of different MBE interventions for CNNP, and to recognize the potential benefits of each MBE intervention and the need for individualized treatment approaches.

Efficacy of Core Muscle Exercise Combined with Interferential Therapy in Alleviating Chronic Low Back Pain in High-Performance Fighter Pilots: A Randomized Controlled Trial

BackgroundChronic low back pain (LBP) related to flight is a prevalent health issue in military aviation, impacting pilots. The objective of this investigation was to ascertain if the application of core muscle training in conjunction with interferential current (IFC) therapy results in a reduction in pain severity and associated disability, consequently enhancing core muscle functionality in Chinese Air Force high-performance fighter pilots experiencing chronic LBP.MethodsFifty-three fighter pilots with chronic LBP were randomized into 3 groups: a core muscle exercise combined with IFC group (CG, n = 19), a core muscle exercise group (EG, n = 19), and an IFC group (IG, n = 15). The three groups underwent therapeutic intervention 5 times a week for 12 weeks. The primary outcomes were pain intensity, Oswestry Disability Index (ODI) score and SF-12 health-related quality of life (PCS and MCS) score. Secondary outcomes included evaluations of trunk muscle strength, endurance, and range of motion (ROM) during medial/lateral rotation to assess muscle functionality. Measurements were obtained both before and after the implementation of the intervention therapy.ResultsAfter 12 weeks of intervention therapy, all the health condition parameters significantly improved among the three groups. However, the CG had a significant improvement in pain intensity compared to the EG (MD = − 0.84 scores; 95% CI = − 1.54 to − 0.15; p = 0.013) and the IG (MD = − 1.22 scores; 95% CI = − 1.96 to − 0.48; p = 0.000). Additionally, the CG led to greater conservation of ODI and improved SF-12 PCS scores than did the IG (p < 0.05). Finally, compared with those at baseline, the core muscle function parameters in the CG and EG improved significantly at the end of the study, but no statistically significant differences were observed between the two groups (p > 0.05).ConclusionAmong participants with chronic LBP, three intervention therapies appear effective in reducing pain, diminishing disability, and enhancing quality of life. Also, combined therapy significantly improved pain and disability compared to the other two monotherapies; moreover, combined therapy and core muscle exercise provided similar benefits in terms of core muscle function after 12 weeks of intervention therapy.

Effects of Myofascial Release Technique along with Cognitive Behavior Therapy in University Students with Chronic Neck Pain and Forward Head Posture: A Randomized Clinical Trial.

The purpose of this randomized controlled trial was to evaluate the effectiveness of the Myofascial Release Technique (MRT) along with Cognitive Behavioral Therapy (CBT) on pain, craniovertebral angle (CVA), and neck disability in university students with chronic neck pain and forward head posture. A total of sixty-six eligible participants with chronic neck pain and forward head posture were randomized into the Myofascial Release Therapy (MRT) group (n = 33) and MRT and Cognitive Behavior Therapy (CBT) group (n = 33). Clinical outcomes included neck pain measured using the numerical pain rating scale, neck disability measured through the neck disability index, and forward head posture measured through the cranial vertebral angle. The outcomes were assessed at baseline and the four and eight weeks after the intervention. Both groups showed significant improvement in pain intensity, CVA, and neck disability after the intervention. However, the CBT group demonstrated greater improvements than the MRT group. The difference in outcomes between the groups was statistically significant. Myofascial Release Therapy combined with CBT is an effective treatment method for patients with chronic neck pain and forward head posture.

Effects of Pilates Exercises as a Treatment Approach in Patients with Non-Specific Low Back Pain

Background: Chronic non-specific low back pain (NSLBP) poses significant challenges to healthcare systems worldwide, primarily due to its prevalence and the complexity of its management. Core muscle weakness and impaired motor control are commonly associated with NSLBP, affecting functional capacity and quality of life. Pilates, an exercise regimen emphasizing core strength, flexibility, and mindful movement, has been proposed as a therapeutic intervention to address these underlying issues. Objective: This study aimed to evaluate the effectiveness of a Pilates exercise program in improving pain intensity and lumbar range of motion in individuals with NSLBP. Methods: A randomized controlled trial was conducted at the Outpatient Departments of Madinah Teaching Hospital and Allied Hospital, Faisalabad. Thirty participants aged 30-50 years with NSLBP were randomly assigned to either an experimental group receiving Pilates exercises plus baseline hot pack treatments or a control group receiving only hot pack treatments. The intervention lasted four weeks, with assessments of pain intensity using the Numeric Pain Rating Scale (NPRS) and lumbar range of motion using the Modified Schober’s Test conducted pre- and post-intervention. Statistical analysis involved Wilcoxon tests, paired and independent sample t-tests, and Mann-Whitney U tests, as appropriate, using SPSS version 25. Results: The experimental group demonstrated significant improvements post-treatment, with NPRS scores reducing from a mean of 4.73 (SD=1.033) to 2.93 (SD=0.594) (p&lt;0.001), and lumbar flexion and extension increasing (pre-test lumbar flexion: mean 5.76, SD=1.487 to post-test: mean 6.01, SD=1.368, p=0.002; pre-test lumbar extension: mean 2.56, SD=0.405 to post-test: mean 2.75, SD=0.360, p=0.001). The control group showed no significant changes in NPRS scores or lumbar range of motion. Between-group analyses confirmed the superior effectiveness of the Pilates intervention in improving pain and functional outcomes. Conclusion: Pilates exercises significantly improved pain intensity and lumbar range of motion in patients with NSLBP compared to a control treatment, suggesting that Pilates can be an effective, non-invasive treatment option for managing NSLBP.