Numeric Pain Rating Scale Research Articles

Two-year outcomes using fast-acting sub-perception therapy for spinal cord stimulation: results of a real-world multicenter study in the United States

ABSTRACT Background Fast-acting Sub-perception Therapy (FAST) is a novel spinal cord stimulation (SCS) modality delivering paresthesia-free pain relief. Our study evaluated the longer-term, real-world impact of FAST on chronic pain. Research design and methods As part of a multicenter, real-world, consecutive case series, we retrospectively identified patients who used FAST-SCS and analyzed their data. The numerical rating scale (NRS) was used to evaluate the overall pain. Results Data from 315 patients were analyzed at baseline and their last available follow-up (median 6.8 months after SCS implantation). At the time of the analysis, 12-, 18-, and 24-month data were available for 112, 86, and 50 patients, respectively. At the last follow-up, NRS pain score was reduced by 5.5 ± 2.5 compared to baseline (from 7.8 ± 1.7 to 2.3 ± 2.0; p < 0.0001). Interim long-term analysis showed that results were sustained for up to 2 years, with 64% of patients reporting a minimal overall pain score (NRS ≤2/10). Conclusion This ongoing, real-world, multicenter study showed that FAST-SCS achieved significant paresthesia-free pain relief, while long-term interim analysis suggests that outcomes could be sustained for up to 2 years. Our data provide preliminary insights into the potential utility of this low-frequency sub-perception SCS paradigm using a biphasic active recharge pulse shape. Trial registration ClinicalTrials.gov (CT.gov identifier: NCT01550575).

Efficacy and safety of a novel cost-effective suspension arthroplasty technique compared to traditional trapeziectomy with abductor pollicis longus arthroplasty Once Looped Around (OLA)/ Once Looped Inside (OLI) in basal thumb arthritis

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim&amp;lt;/strong&amp;gt; Trapeziometacarpal (TMC) joint osteoarthritis is a common source of wrist pain, predominantly affecting women aged 45 to 70 years. While traditional surgical options like trapeziectomy with abductor pollicis longus (APL) arthroplasty are effective, their limitations in advanced disease stages have led to the exploration of alternative techniques. This study compares the clinical outcomes of conventional trapeziectomy with APL arthroplasty to a novel personalized suspensory arthroplasty technique.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Methods&amp;lt;/strong&amp;gt; A retrospective analysis was conducted on 150 patients with Stage III-IV TMC osteoarthritis who underwent either the conventional APL arthroplasty (n=65) or the novel suspensory arthroplasty (n=85) in the period between 2015 and 2018. Outcomes were assessed using the Numeric Pain Rating Scale (NPRS), Disabilities of the Arm, Shoulder, and Hand (DASH) scores, thumb range of motion, grip strength, and patient satisfaction. Statistical analyses included t-test, &amp;amp;chi;2 test, and repeated measures ANOVA.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Results&amp;lt;/strong&amp;gt; Both surgical groups demonstrated significant pain reduction and functional improvement postoperatively. The novel technique resulted in lower NPRS and DASH scores, greater thumb metacarpophalangeal joint flexion-extension, and higher patient satisfaction compared to the traditional method. The prevalence of complications, particularly flexor carpi radialis (FCR) tendinitis, was also lower with the novel technique. Radiographic assessments indicated stable joint positions postoperatively in both groups.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Conclusion&amp;lt;/strong&amp;gt; The novel personalized suspensory arthroplasty technique offers superior clinical outcomes compared to traditional APL arthroplasty, with enhanced pain management, improved function, and reduced complications. This approach represents a cost-effective and minimally invasive alternative for advanced TMC osteoarthritis, leading to better patient satisfaction and faster recovery.&amp;lt;/p&amp;gt;

Effect of Acupressure Techniques and Endorphin Massage on Back Pain Intensity in Third-Trimester Pregnant Women

Back pain in pregnancy is common, especially in the third trimester of pregnancy. In the world of health, alternative methods are being created to reduce pain in mothers during pregnancy and childbirth. Endorphin massage is the best nonpharmacological therapy to deal with these problems. This study aimed to determine the effect of acupressure and endorphin massage techniques on the intensity of back pain in third-trimester pregnant women. This type of research is a pre-experiment with one group pre-test post-test design. Samples were taken from a population that met the inclusion criteria of 20 pregnant women. The sampling technique used an accidental sampling technique. The research instrument used the SOP of acupressure and endorphin massage techniques and the Numeric Rating Scale pain observation sheet. The results showed that before acupressure and endorphin massage, almost half (45%) of all pregnant women experienced severe pain. After acupressure and endorphine massage, none of the respondents (0%) experienced severe pain. The results of the Dependent T-test with α = 0.05 obtained Asymp.Sig.=0.001, so the p-value &lt;0.05 indicates the effect of acupressure and endorphin massage techniques on the intensity of back pain in pregnant women. The conclusion is that there is an effect of acupressure techniques and endorphin massage on the intensity of back pain in third-trimester pregnant women. It is recommended that health workers improve their competence in the service of acupressure techniques and endorphine massage.

Clinical and magnetic resonance imaging outcome after proximal hamstring tendon repair at mean 3 years follow-up

PurposeThe purpose of this study was to assess clinical and radiological outcome in patients after proximal hamstring tendon repair. We hypothesized that there is a significant correlation among subjective clinical outcome and interlimb asymmetries in muscle strength, fatty infiltration, and hamstring volume.MethodsThis retrospective monocentric case series included patients with surgical repair after proximal hamstring tendon rupture. Clinical outcome was assessed utilizing: Healthy Days Core Module (CDC HRQOL-4), numeric pain rating scale (NRS), modified Harris Hip Score (mHHS), Tegner Activity Scale (TAS), return to pre-injury activity level (RTPA), and patient satisfaction score. Postoperative hamstring strength was measured using a handheld dynamometer and radiological outcome was determined by postoperative magnetic resonance imaging (MRI).ResultsTwenty-seven patients with a mean age of 51.2 (± 12.6) years were available for follow-up at a mean of 41.11 (± 18.4) months. Patients state a mean of 10.6 (± 11.5) days in the unhealthy days (UHD) index and 88.9% show “good health” in the simple summary score (SSS). Mean subjective outcome scores were as follows: NRS 1.1 (± 2.4), mHHS 90.3 (± 14.8) and TAS 5.7 (± 2.2). A total of 59.3% RTPA and 88.9% state to be somewhat or very satisfied with their surgery. Mean interlimb strength ratio was 0.88 (± 0.21). MRI demonstrated a fully restored muscle–tendon unit, significantly greater fatty infiltration in the injured hamstrings (p = 0.009, d = 0.558), and a mean interlimb hamstring volume ratio of 0.94 (± 0.11). With respect to the 10% benchmark, patients had no significant asymmetries in muscle strength (p = 0.677, d = 0.084) or hamstring volume (p = 0.102, d = − 0.34). Correlation analysis revealed moderate correlation among asymmetries in strength and volume (p = 0.073, r = 0.373). In patients with the operated side inferior to the healthy side (n = 15), there was strong correlation among asymmetries in strength and volume (p = 0.002, r = 0.725). Statistically significant correlation was found between interlimb muscle volume atrophy and increase in fatty infiltration (p = 0.015, r = 0.481).ConclusionProximal hamstring repair results in good clinical outcome with satisfactory recovery of hamstring strength and volume. Interlimb asymmetries, in terms of muscle strength, fatty infiltration, and hamstring volume do not correlate with clinical outcome.Study TypeRetrospective cohort study; Level of evidence, 3.

Two-stage revision anterior cruciate ligament reconstruction reduces failure risk but leads to lesser clinical outcomes than single-stage revision after primary anterior cruciate ligament graft failure: a retrospective cohort study

BackgroundThere are no studies that compare the outcomes and complications of single-versus two-stage revision anterior cruciate ligament reconstruction (ACLR) after primary ACLR failure. This purpose of this study is to examine clinical and functional outcomes and complications associated with single and two-stage revision ACLR after primary ACLR failure.MethodsAll patients who underwent single or two-stage revision ACLR after primary ACLR failure between 2012 and 2021 with a minimum of a 2 year follow-up were included. Patients were excluded if they were not treated at our single academic institution, had inadequate follow-up, or had incomplete medical records. Revision intraoperative data, concomitant injuries, and complications were collected by chart review. Return to sport, numerical pain rating scale (NPRS) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Veteran Rands 12-item health survey (VR-12 scores) were collected.ResultsThe final analysis included 176 patients. A total of 147 (83.5%) had a single-stage revision ACLR (87 male, 60 female), and 29 (16.5%) had a two-stage revision ACLR (13 male, 16 female). Two-stage revision ACLR was significantly associated with anterior knee pain [odds ratio (OR) 4.36; 95% confidence interval (CI) 1.5 to 12.65; P = 0.007] but with lower failure rates (OR 0.12, 95% CI 0.02 to 0.9; P = 0.04). On multivariate analysis, a two-stage revision ACLR reduced the risk of graft failure by 85% (OR 0.15; 95% CI 0.02 to 1.17; P = 0.07). Two-stage revision ACLR was significantly associated with a lower KOOS pain score (OR −11.7; 95% CI −22.35 to −1.04; P = 0.031), KOOS symptoms score (OR −17.11; 95% CI −28.85 to −5.36; P = 0.004), KOOS Activities of Daily Living (ADL) score (OR −11.15; 95% CI −21.71 to −0.59; P = 0.039) and Veterans RAND 12-Item Health Survey (VR-12) physical component score (OR −9.99; 95% CI −15.77 to −4.22; P = 0.001).ConclusionsThe clinical outcomes and subjective patient scores significantly differed between the single-stage and two-stage revision ACLR after primary ACLR failure. Patients with a two-stage revision ACLR had a significantly reduced risk of revision graft failure but higher rates of postoperative anterior knee pain, lower pain scores, and lesser knee functional scores than single-stage revision patients.Study designRetrospective cohort study; level of evidence, 3

Preliminary Development and Validation of Automated Nociception Recognition Using Computer Vision in Perioperative Patients.

Effective pain recognition and treatment in perioperative environments reduce length of stay and decrease risk of delirium and chronic pain. We sought to develop and validate preliminary computer vision-based approaches for nociception detection in hospitalized patients. Prospective observational cohort study using red-green-blue camera detection of perioperative patients. Adults (≥18 years) admitted for surgical procedures to the San Francisco Veterans Affairs Medical Center (SFVAMC) were included across 2 study phases: (1) algorithm development phase and (2) internal validation phase. Continuous recordings occurred perioperatively across any postoperative setting. We inputted facial images into convolutional neural networks using a pretrained backbone, to detect (1) critical care pain observation tool (CPOT) and (2) numerical rating scale (NRS). Outcomes were binary pain/no-pain. We performed external validation for CPOT and NRS classification on data from University of Northern British Columbia-McMaster University (UNBC) and Delaware Pain Database. Perturbation models were used for explainability. We included 130 patients for development, 77 patients for validation cohort and 25 patients from UNBC and 229 patients from Delaware datasets for external validation. Model area under the curve of the receiver operating characteristic for CPOT models were 0.71 (95% confidence interval [CI] 0.70, 0.74) on the development cohort, 0.91 (95% CI 0.90, 0.92) on the SFVAMC validation cohort, 0.91 (0.89, 0.93) on UNBC and 0.80 (95% CI 0.75, 0.85) on Delaware. NRS model had lower performance (AUC 0.58 [95% CI 0.55, 0.61]). Brier scores improved following calibration across multiple different techniques. Perturbation models for CPOT models revealed eyebrows, nose, lips, and foreheads were most important for model prediction. Automated nociception detection using computer vision alone is feasible but requires additional testing and validation given small datasets used. Future multicenter observational studies are required to better understand the potential for automated continuous assessments for nociception detection in hospitalized patients.

Antepartum multidisciplinary approach improves postpartum pain scores in patients with opioid use disorder.

Pregnancies affected by opioid use disorder (OUD) face difficulties with postpartum pain control. This study aims to determine if prenatal anesthesia consultation for patients on medication for opioid use disorder (MOUD) affects maternal postpartum pain control. This is a retrospective cohort study of pregnant patients diagnosed on MOUD who received prenatal care and delivered at a single academic institution between January 2017 and July 2023. Subjects were divided into those who received prenatal anesthesia consultation and those who did not. Severe pain (numerical rating scale 0-10) was defined as score≥7. Statistical analysis was performed using Chi-square, Mann-Whitney U, and multivariable logistical regression tests with significance defined as p<0.05. The cohort included 359 women on MOUD. Of these, 17.8 % (n=64) received anesthesia consultation and 82.2 % (n=295) did not. Factors found associated with receiving anesthesia consultation were prenatal care with an obstetric provider trained in maternal OUD (p<0.01), psychiatric diagnosis (p<0.01) and higher number of prenatal care visits (10.12 vs. 8.99, p=0.007). When comparing pain scores in the first 24 h postpartum, patients with prenatal anesthesia consultation had statistically significant lower rates of severe pain compared to those who did not (25 vs. 44.7 %, p=0.004). Anesthesia consultation (OR 0.34) and cesarean section (OR 2.81) were independent predictors of severe postpartum pain in the first 24 h after delivery. Patients on MOUD who received antenatal anesthesia consultation report lower postpartum pain scores than those without consultation, which supports that multidisciplinary care for pregnant patients with OUD may help the postpartum experience.

Patient-reported outcome trajectories the first 24 months after surgery for cervical spondylotic myelopathy: a Quality Outcomes Database study.

Cervical spondylotic myelopathy (CSM) shows varying levels of improvement after surgical treatment. While some patients improve soon after surgery, others may take months to years to show any signs of improvement. The goal of this study was to evaluate postoperative improvement, patient-reported outcomes, and patient satisfaction up to 2 years after surgical treatment for CSM, which will help optimize the current treatment strategies and effectively manage patient expectations. This was a retrospective study of prospectively collected data using the Quality Outcomes Database. The primary outcomes of interest were achievement of the minimal clinically important difference (MCID) for the numeric rating scale for neck and arm pain, modified Japanese Orthopaedic Association, Neck Disability Index, and EQ-5D scores and postoperative satisfaction (North American Spine Society scale). Early and sustained improvement was defined as MCID achievement in at least one patient-reported outcome measure (PROM) at the 3-, 12-, and 24-month follow-ups. Transient improvement was defined as MCID achievement only at the 3-month and/or 12-month follow-up but not at the 24-month follow-up. Late improvement was defined as MCID achievement in at least one PROM only at the 24-month follow-up. There were 630 patients included in the comparative analysis. A total of 463 (73.5%) patients achieved early and sustained improvement, 105 (16.7%) patients experienced transient improvement with subsequent decline, 25 (4.0%) patients reported late improvement, and 37 (5.9%) patients did not report any clinically meaningful improvement after surgery. Patients with an anterior approach were more likely to be in the early and sustained improvement group. African American patients (OR 2.98, 95% CI 1.14-7.76; p = 0.03) were more likely to report late improvement when compared with White patients. The overall satisfaction rate at the 24-month follow-up was 87.8%. These findings indicate that 73.5% of patients achieve early and sustained improvement, and 87.8% of patients are satisfied with surgery 24 months postoperatively.

Utilization of telemedicine in conjunction with wearable devices for patients with chronic musculoskeletal pain: a randomized controlled clinical trial

The present randomized controlled trial aimed to investigate the effects of home-based telemedicine with wearable devices and usual care on pain-related outcomes in patients with chronic musculoskeletal pain, compared to usual care alone. The patients with chronic musculoskeletal pain were randomly allocated to the usual care group or the telemedicine group, which participated in telemedicine with wearable devices, the objective data from which were recorded, in conjunction with usual care for six months. The primary outcome measure was the Numeric Rating Scale (NRS) for pain. The secondary outcome measures were the Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Disability Assessment Scale (PDAS), and EuroQol-five dimensions-three level (EQ-5D-3L). Seventy-one participants were analyzed. At 1 and 3 months, there were no significant differences in the NRS scores between the groups; however, the telemedicine group had a significantly superior effect on all of the outcome measures at 6 months compared to the usual care group. The number of steps and distance were significantly increased at 6 months compared to baseline in the telemedicine group. Home-based telemedicine with wearable devices and usual care has a modest effect on pain-related outcomes compared to usual care in patients with chronic musculoskeletal pain.This study was registered (UMIN000052994 - 04/12/2023).

Ultrasound-Guided Repair of the Anterior Talofibular Ligament With or Without Gould Augmentation Is Safe and Improves Clinical Outcomes for Chronic Lateral Ankle Instability: A Case Series of 49 Patients.

We have previously shown that ultrasound-guided repair results in an accurate anchor placement and restores ankle joint stability using cadaveric models. The objective is to assess the safety and clinical outcomes of ultrasound-guided ATFL repair with or without augmentation. Forty-nine patients with chronic lateral ankle instability underwent ultrasound-guided ATFL repair with or without augmentation. Following the procedure, patients completed a standardized post-operative rehabilitation protocol. The primary outcome was the complication rate in 49 subjects. The clinical outcomes were analyzed as a secondary outcome for 28 patients (20 athletes and 8 non-athletes) after excluding 21 subjects with such concomitant injuries that could affect clinical course. These included (1) Numerical Rating Scale (NRS) for pain, (2) Foot and Ankle Outcome Score (FAOS), (3) Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale (a Japanese equivalent of the American Orthopedic Foot and Ankle Society Ankle-Hindfoot score), and (4) Self-Administered Foot Evaluation Questionnaire Sports (SAFE-Q Sports) score at baseline, 3 months, and 6 months. The overall complication rate was 2.0% with one superficial peroneal nerve irritation out of 49 cases, which was improving at 6 months. All 4 clinical outcome scores resulted in statistically significant improvement at 6 months. NRS decreased from 3.6 ± 2.1 at baseline to 1.3 ± 1.6 (p < 0.001, student's t-test). FAOS increased from 74.7 ± 11.9 to 93.4 ± 8.1 (p < 0.001). JSSF scale increased from 56.9 ± 15.1 to 90.9 ± 10.2 (p < 0.001). All 20 athletes returned to sports at a pre-injury level, and their SAFE-Q sports activity scores increased from 40.7 ± 17.6 to 90.6 ± 0.2 (p < 0.001). Ultrasound-guided ATFL repair with or without augmentation for chronic lateral ankle instability is safe and results in clinical improvement at 6 months. V.

Optimizing Intravenous Patient-Controlled Analgesia for Cancer Pain: A Randomized Controlled Trial on Adjusted Background Infusion Rates.

Patient-controlled analgesia (PCA) has been considered for managing cancer pain; however, limited research has been conducted on optimizing continuous infusion rates with PCA. This study aimed to evaluate the efficacy and safety of a method that optimizes background infusion (BI) alongside PCA for titrating intravenous (IV) morphine in managing cancer-related pain. Forty-four patients with solid tumors who could not manage pain with oral or transdermal opioid analgesics were randomly assigned in a 1:1 ratio to receive IV morphine through PCA or the conventional method. In the PCA group, the BI rate was automatically adjusted on the basis of the frequency and interval of bolus button presses; contrastingly, BI rate in the conventional group was adjusted at the discretion of the medical staff. The primary outcome was the daily number of patient complaints of breakthrough pain (numeric rating scale ≥4). The PCA group reported a significant decrease in breakthrough pain complaints at 24 hours (median, 0 v 3 times/d; P = .012) and a lower proportion of nonresponders at 24 hours (21% v 55%; P = .048) compared with the conventional group. The total daily IV dose of morphine increased in the PCA group and exhibited a significant difference between two groups within 48 hours (median, 76.80 v 44.42 mg/d; P = .036). No uncontrolled opioid-related adverse effects were observed in either group. PCA, with an optimized BI rate, facilitated faster titration of IV morphine than the conventional method, achieving tolerable and rapid pain relief.

Comparison of postoperative analgesia between dezocine plus flurbiprofen axetil and sufentanil in patients with CRC undergoing tumor resection: A prospective, observational study.

Flurbiprofen axetil is a nonsteroidal anti-inflammatory drug used for analgesia. Its combination with dezocine has previously shown a superior postoperative analgesic effect compared with that of opioids. The present study compared the analgesic effect between dezocine plus flurbiprofen axetil (DFA) and sufentanil in patients with colorectal cancer (CRC) following resection of the tumor. The study was performed as a prospective, observational study. It included 107 patients who were treated using a patient-controlled analgesia (PCA) pump following the resection of CRC. Patients in the DFA group were given a loading dose of 5 mg dezocine and 50 mg flurbiprofen axetil, followed by PCA with a combination comprising 30 mg dezocine, 200 mg flurbiprofen axetil and 8 mg ondansetron. Patients in the control group were treated with sufentanil at a loading dose of 5-10 µg followed by PCA with a combination of 100 µg sufentanil and 8 mg ondansetron. The DFA group reported lower pain numerical rating scale scores at 2 h (2.4±1.2 vs. 2.9±1.2) and 12 h (2.0±1.0 vs. 2.5±1.2) and reduced rates of moderate-to-severe pain at 12 h (6.7 vs. 21.0%) compared with those in the control group. In addition, the number of PCA boluses in the DFA group was lower than that in the control group [median (interquartile range), 6.0 (4.5-8.5) vs. 8.5 (5.0-11.0)]. The total satisfaction rate was increased, albeit not significantly, in the DFA group compared with that in the control group (80.0 vs. 62.9%). The levels of tumor necrosis factor-α at 24 and 48 h, and of interleukin-6 at 24 h were decreased in the DFA group compared with those in the control group. The incidences of adverse events did not differ between the groups. These findings indicate that DFA provides more effective analgesia, improves patient satisfaction and reduces the levels of pro-inflammatory cytokines with similar adverse effects compared with those of sufentanil in patients after CRC resection.

Establishing the Patient-Acceptable Symptom State for the Numeric Rating Scale-Pain Score in a Postoperative Non–Shoulder Hand and Upper-Extremity Population

The patient-acceptable symptom state (PASS) is a threshold score on a patient-reported outcome measurement beyond which patients consider themselves "well." Our purpose was to establish the PASS for the numeric rating scale (NRS) for pain in a 1-year postoperative hand surgery population. This retrospective study included adult patients undergoing non-shoulder upper-extremity surgery at a single, tertiary medical center identified over a 9-month period. At 1 year after surgery, NRS pain and responses to a pain-specific anchor question were collected. Patients were dichotomized based on achieving "PASS(+)" or failing to achieve "PASS(-)" an acceptable symptom state based upon their response to a pain-specific anchor question. Threshold values of a PASS(+) state were calculated for the NRS pain score using the following three methods: (1) mean score of PASS(+) patients, (2) Tubach method (75th percentile threshold for PASS(+) patients), and (3) the Youden index (receiver operating curve analysis to maximize sensitivity and specificity). Of 233 included patients, mean age was 54 years (±17), and 58% (n= 136) were women. Mean NRS pain scores differed between PASS(+) and PASS(-) patients (0.7 ± 1.2 vs 3.8 ± 2.7, respectively). PASS(-) patients were more likely to be non-White and have a diagnosed psychiatric comorbidity. Patient-acceptable symptom state estimates ranged from 0.73 to 2.1 for NRS pain, depending on the calculation method (0.73 for the mean score method, 1.0 for the Tubach method, and 2.1 for the Youden index). The area under the curve for the Youden index method was 0.86 consistent with excellent discrimination. We propose the value of 2.1 to represent the PASS threshold for the NRS pain score in this population. This PASS value should be used when interpreting NRS pain score outcomes at a population level. This threshold is expected to yield excellent discrimination for patient satisfaction when applied to a postoperative hand surgery population.

Psychometric Properties of the Persian Version of Sickness Impact Profile-30 (SIP-30) in Community-Dwelling Older Adults.

Purpose: Accurate measurement tools are essential for evaluating the health-related quality of life in older adults. We aimed to translate and evaluate the psychometric properties of the Sickness Impact Profile-30 (SIP-30) in community-dwelling older adults. Materials and Methods: One hundred and fifty older adults participated in this study. To evaluate construct validity, its correlation with General Health Questionnaire-28, Geriatric Depression Scale-15, Hospital Anxiety and Depression Scale, Modified Health Assessment Questionnaire, Numeric Pain Rating Scale, and Fullerton Advanced Balance Scale was assessed. Reliability features were also investigated. Results: The results of construct validity analysis demonstrated a moderate to high (r = 0.61-0.84) correlation between the total score of SIP-30 and GHQ-28, GDS-15, HADS, MHAQ, and NPRS. There was a moderate inverse (r = -0.67) correlation between the total score of the SIP-30 and the FAB Scale. Test-retest reliability (ICC > 0.83) and internal consistency (α = 0.94) of the Persian SIP-30 were high. Conclusions: The results indicated that the Persian SIP-30 is a reliable and valid measure to assess health-related quality of life in community-dwelling older adults.

Impact of Ergonomics on Undergraduate Physiotherapy Students in Bangladesh

Background: Poor ergonomics is a global concern, contributing to musculoskeletal complaints mostly muscle imbalance, strain, and fatigue among university students due to abnormal posture. Purpose: The purpose of the study was to identify the impact of ergonomics on undergraduate physiotherapy students in Bangladesh. Methodology: The cross-sectional study was carried out from November 2021 to July of 2022. The convenience sampling technique was used to collect data from 210 undergrad physiotherapy students studying at different physiotherapy colleges or institute in Bangladesh. The modified ergonomics related self-questionnaire was used to explore the idea, knowledge and awareness about the correct posture, and the Numeric Pain Rating Scale (NPRS) was used to collect data about the severity of musculoskeletal pain. Data was collected through face-to-face interviews, and the Statistical Package for Social Sciences (SPSS) version 26.0 was used for analysis. Results: The mean age ± SD of the students was 23.13 ± 2.484. Out of 210 respondents, the majority of the respondents (54.8%) were males, and most of them from crowed area (50.5%). The most of the student’s was Muslim (89.0%) while maximum were single (80.5%). The most of the students have to attend on the class in sitting posture up to 6-8 hours (69.5%) daily. The students have lack of postural awareness and forward bending is their preferred posture. The maximum participants (57.90%) had lower back pain, while 25.8% of had been prevented from doing their normal work due to pain. The results of the study showed a strong association between the study hours daily and correct sitting posture of the students (χ2 = 11.008, df = 5, and p = 0.004). Conclusion: The study found that professional physiotherapy students have low ergonomics awareness and the benefits of its proper use. The preventive training and physiotherapy programs could effectively reduce musculoskeletal complaints among the undergraduate students.

Effectiveness of laser therapy along with eccentric exercises vs laser therapy with concentric exercises for subjects with Haglund’s deformity

Introduction. Haglund’s deformity is an inflammation of the bursa in the posterior calcaneus, posing a significant challenge in orthopedic care. This study examines the effectiveness of combining laser therapy with either eccentric or concentric exercises in managing Haglund’s deformity, a bony enlargement on the heel that causes pain and discomfort. Eccentric and concentric exercises are commonly used in rehabilitation to improve tendon function and reduce symptoms. Aim of the study. The aim of this study was to evaluate the effectiveness of eccentric exercises with laser therapy versus concentric exercises with laser therapy in reducing pain and enhancing functionality in people with Haglund’s deformity. Materials and methods. A total of 30 subjects with Haglund’s deformity were randomly selected for this study. Inclusion criteria: participants aged 20 to 35 years of both genders diagnosed with Haglund’s deformity. Exclusion criteria: history of foot fractures, open wounds in the hindfoot area, or non-cooperative behavior. Participants were divided into two groups: Group A (laser therapy with eccentric exercises) and Group B (laser therapy with concentric exercises), with 15 individuals in each group. For both groups, pre-test results from the American Orthopedic Foot and Ankle Score (AOFAS) and Numeric Pain Rating Scale (NPRS) were documented. Treatment intervention consisted of 3 weeks of exercises (3 sets per session, 15 reps per set, 5 days a week). Results. The post-treatment mean NPRS value for Group A was 4.87, whereas it was 6.53 for Group B. The post-treatment mean AOFAS for Group A was 79.33, whereas it was 63.33 for Group B. It was discovered that Group A was more effective in reducing discomfort and enhancing function in individuals with Haglund’s deformity. Conclusion. The study concluded that the combination of laser therapy with eccentric exercises was more successful than laser therapy with concentric exercises in reducing pain and improving functionality for Haglund’s deformity.

Immediate effects of exercise snacking on physical fatigue, mood, and pain in elderly adults with knee osteoarthritis

BackgroundExercise has been reported to be beneficial in reducing pain and fatigue, as well as improving mood, in patients with knee osteoarthritis (KOA). However, long bouts of exercise have been linked to an increase in fatigue and pain level in elderly adults. Currently, there are very few investigations into the immediate effects of breaking exercise into shorter and frequent bouts, otherwise known as exercise snacking on physical fatigue, mood, and pain in elderly adults with KOA. The aim of this study was to investigate the immediate impact of exercise snacking versus continuous exercise on physical fatigue, mood, and pain level in elderly adults with KOA.MethodsThis was a randomized experimental study, with 37 participants aged 60 years and above with KOA. Participants were recruited and randomly assigned into a five bouts of 2-min exercise snacking and 10-min continuous exercise groups, with the bicycle ergometer as the exercise mode. Physical fatigue, mood, and pain of participants were assessed at baseline and immediately after the exercise using Numerical Fatigue Rating Scale (NFRS), Visual Analog Mood Scale (VAMS), and Numerical Pain Rating Scale (NPRS) respectively. Descriptive statistics and inferential statistics of Wilcoxon Rank test, Mann–Whitney U, and ANCOVA were used to analyze the data with p value set at 0.05.ResultsThere were significant differences (p < 0.001) in physical fatigue, mood, and pain between baseline and post-intervention values within groups. Between-group comparisons revealed significant reductions in physical fatigue (p < 0.001) and pain levels (p = 0.048) in the exercise snacking group compared to the continuous exercise group. However, no significant between-group differences were found for mood.ConclusionExercise snacking yielded significant improvements in physical fatigue and pain in elderly with KOA. However, both exercise snacking and continuous aerobic exercise were comparable in their immediate effects on mood in elderly adults with KOA.Trial registrationPACTR202308724795310 Registered 28th September 2023, https://www.edctp.org/pan-african-clinical-trials-registry/.

Erector spinae block reduces intraoperative and postoperative opioid consumption in patients undergoing laparoscopic sleeve gastrectomy: A randomized controlled trial

Background: Obese patients are at increased risk of postoperative respiratory complications because of sedatives and opioids. The erector spinae block is a novel regional block that has been used in different surgeries. It offers an easier approach and a better safety profile. This study aimed to assess the role of erector spinae plane block (ESPB) in reducing postoperative pain scores and opioid consumption in patients undergoing sleeve gastrostomies. Methods: Institutional committee approval was obtained for this randomized controlled trial. Inclusion criteria included patients aged between 18 and 65 years with American Society of Anesthesiologists (ASA) scores 1–3 who were scheduled to undergo laparoscopic sleeve gastrectomy under general anesthesia. Simple randomization using sealed opaque envelopes was used to allocate study patients to either of the two groups. The intervention group received erector spinae block using 0.2% ropivacaine just after induction of anesthesia while the control group did not receive a block. Primary outcome variables were pain scores during the first 24 hours after surgery. Results: A total of 60 patients were included in the study. There was no significant difference in the baseline characteristics between two groups. Numerical rating scale (NRS) pain scores in the postoperative period were lower in the ESPB group but there was no statistical significance. Intraoperative remifentanil consumption was statistically lower in the ESPB group compared to the control group (P &lt; 0.01). ESPB also reduced 24-hour opioid consumption (P = 0.002). There was no statistical difference in the incidence of adverse events between the two groups. Conclusion: The use of ESPB in laparoscopic sleeve gastrectomy patients is associated with a significant reduction in intraoperative and 24-hour postoperative opioid consumption. Trial registration ID The trial was registered with Clinicaltrials.gov as trial ID-NCT04368195.

Risk Factors and Prevalence of Sleep Disturbance in Degenerative Cervical Myelopathy.

Sleep disturbances, especially those lasting more than one hour, are under-researched in patients with degenerative cervical myelopathy (DCM). This study aims to investigate the prevalence and risk factors for such disturbances in DCM patients undergoing decompression surgery and to identify factors contributing to poor postoperative improvement. A multicenter retrospective observational study was conducted on consecutive patients diagnosed with DCM who underwent cervical decompression surgery between April 2018 and August 2022. The neck disability index (NDI) sleep component was assessed at baseline and 12 months post-surgery. Univariate and multivariable logistic regression analyses were used to identify risk factors for persistent sleep disturbances and poor improvement. Of the 1912 patients included, 54.8% reported sleep disturbances, with 33.0% experiencing disturbances of more than one hour at baseline. Multivariable analysis identified male sex, high BMI, high numerical rating scale (NRS) for arm pain, high NDI, and high Core Outcome Measures Index (COMI) Neck as significant risk factors for sleep disturbances. At 12 months, 35.2% of these patients continued to experience significant sleep issues. The presence of ossification of the posterior longitudinal ligament (OPLL) and high baseline NRS for neck pain were significant predictors of poor improvement. The study highlights that OPLL and high baseline neck pain are significant risk factors for persistent sleep disturbances post-surgery in DCM patients. Early identification and targeted interventions may be necessary to improve outcomes.

Effect of Thai Yoga Exercise for Reducing Pain and Improve Functional Disability in Patients with Text Neck Syndrome: A Randomized Controlled Trial

Text neck syndrome (TNS) is prevalent among mobile users, and exercise is a simple, non-invasive approach, for treating chronic neck pain. Research on Thai yoga (TY) exercise to relieve or reduce neck and shoulder pain in people with TNS is still limited. This study aimed to investigate the effects of TY exercise on health, physical function and quality of life in patients with TNS. A randomized clinical trial was conducted from April to July 2023 (TCTR20230920002, 10/2023). Seventy-eight volunteers with TNS participated in the study, performing TY exercises, while continuing their routine daily life (CON) for 6 weeks, with week 8 as a follow-up appointment. Clinical evaluation was conducted using a numerical pain-rating scale, functional disability scored by the neck disability index questionnaire (NDI), range of motion (ROM) and cervical vertebral angle, rounded shoulder angle by goniometry, and health-related quality of life (QoL) assessed by the 36-Item Short Form Survey. The results of the numerical pain-rating scale for TY group in the follow-up (6.71±0.52 weeks) were significantly different (p-value &lt; 0.001) from the baseline (4.18±0.95) while the CON group showed no change. The NDI also decreased from the baseline (5.03±1.38) in the TY group, while the CON group remained at 12.03±1.98. The data of craniovertebral angle of TY group show an increase from baseline (62.44±2.32) while CON group was 39.37±4.73. The results showed that the rounded shoulder angle of TY group decreased to the normal range. The TY group shows an increased degree from baseline. The results for the TY group demonstrated a significant increase in QoL. These findings suggest that TY exercise is effective for relieving TNS when compared with the CON group. These positive outcomes provide strong support for the use of TY as an effective intervention for treating TNS symptoms.