Rating Scale Pain Research Articles

Efficacy of Kampo medicine Kakkonto as acute medication to treat tension-type headache among musculoskeletal pain patients using regular analgesics.

Tension-type headache (TTH) is the most prevalent type of primary headache disorder. Its acute pharmacotherapy is acetaminophen or non-steroidal anti-inflammatory drugs based on the Japanese Clinical Practice Guideline for Headache Disorders 2021. With Japan's aging population, however, the number of TTH patients with comorbidities that have been treated by analgesics is increasing. Under this context, it is sometimes difficult to select an acute pharmacotherapy for TTH. Kakkonto, Japanese traditional herbal kampo medicine, is empirically used for TTH. We hypothesized that kakkonto has efficacy for TTH with painful comorbidities. We prospectively collected 10 consecutive TTH patients who had already taken analgesics for comorbidities. We prescribed 2.5g of kakkonto (TJ-1), and patients took it. A numerical rating scale for pain before and 2 hours after kakkonto intake was evaluated. Eight women and 2 men were included. The mean age was 71.0 ± 13.4 years old. Four patients had lower back pain, 2 had lumbar spinal stenosis, 2 had knee pain, 1 had neck pain, and 1 had shoulder myofasciitis. Celecoxib was used for 4 patients, acetaminophen for 3, loxoprofen for 2, and a combination of tramadol and acetaminophen for 1, as routinely used analgesics. The median numerical rating scale statistically improved from the median of 4 to that of 0. There were no side effects of kakkonto. Kakkonto showed efficacy as an acute medication for TTH with comorbidities that have been treated by analgesic.

Topical Cannabidiol in the Treatment of Digital Ulcers in Patients with Scleroderma: Comparative Analysis and Literature Review

To explore the effect of topical cannabidiol (CBD) in treating digital ulcers in patients with systemic sclerosis (SSc). In total, 45 patients with SSc who had digital ulcers were consecutively enrolled between January 2019 and December 2019. Of the participants, 25 were treated with CBD during surgical debridement and 20 were treated with standard local therapy. A numeric rating scale for pain and Health Assessment Questionnaire Disability Index were administered at the baseline and at the end of treatment. Local treatment with CBD was significantly associated with lower pain scores, higher health assessment scores, and an increase in participants' total hours of sleep. Patients in the control group more frequently required additional analgesic therapy. Topical CBD may be a valuable tool to treat pain related to digital ulcers in patients with SSc.

Evaluation of pain response in children to the SoftClamp™ as an alternative to the metal rubber dam clamp: A randomized clinical trial.

The use of a rubber dam is more important than ever in today's COVID-19 era to limit cross infections. In children, the placement of the metal clamp to retain the rubber dam is perceived to be painful and often requiring a local anesthetic injection. This dissuades many clinicians from placing the rubber dam. Hence, this study evaluated the pain response of children to a SoftClamp™ compared to the conventional metal clamp. This was a randomized controlled, equal allocation ratio, split-mouth clinical trial. Forty-two children aged between 8 and 12 years, having two permanent mandibular molars in need of sealants, were divided into Groups A and B (metal clamp and SoftClamp™, respectively). The pain response was recorded using both an objective and a subjective scale i.e., the Faces Legs Activity Cry Consolability (FLACC) scale and the Wong Baker Faces Pain Rating Scale (WBFPRS). The level of significance was set at 5% (P < 0.05). The pain response recorded from the WBFPRS and the FLACC scale for the metal and the SoftClamp™ were analyzed using the Wilcoxon signed rank test. The difference in pain response between genders and between two age groups (below and above 10 years of age) was analyzed using the Mann-Whitney U-test. The children reported mild discomfort to clamp placement in both the scales. The P values for the FLACC and WBFPRS scores comparing the pain response to the metal and SoftClamp™ were 0.311 and 0.149, respectively. There was no significant difference in the pain response of children to both the clamps. Good rubber dam application practices in children through the use of behavior guidance and a proper topical anesthesia technique may play a far more important role regardless of the clamp used. But the SoftClamp™, with its more child friendly appearance could be a viable alternative to the metal clamp in children.

Effectiveness of Virtual Reality Distraction on Pain Perception and Fear among Children with Cancer Undergoing IV Cannulation.

Cancer children are subjected to multiple cannulations during hospitalization. Pain and fear are most common during invasive procedures that are performed, especially IV cannulation, which can lead to worry. Exactly 25% of children are reported to have a fear of needle-related procedures. To examine the impact of virtual reality (VR) distraction on pain perception and fear in children with cancer undergoing IV cannulation. Using a quasi-experimental design, 80 cancer children with IV cannulation between ages 7-18 were recruited to the intervention and control group (N = 40 + 40) using the purposive sampling technique. The virtual reality distraction device was used 10 min before the peripheral IV cannulation procedure and remained in place until the procedure was completed in the intervention group, and no device was used in the control group. Wong-Baker Faces Pain Rating Scale and Children's Fear Scale were used to assess the pain and fear of children and their mothers. Pain perception was found to be significantly lower in the VR distraction group among both children and mothers (1.82 ± 0.18, 8.01 ± 3.21) 95% confidence interval (CI) [0.82, 2.16] compared to the control group, respectively (P = 0.001**). Fear was found to be significantly lower in the VR distraction group among both children and mothers (0.81 ± 0.71, 3.01 ± 1.42) 95% CI [0.46, 0.91]. A strong positive correlation was found between children's and mothers' pain perception (r = 0.91, P = 0.001**) and fear (r = 0.84, P = 0.001**). VR distraction can be used as an effective device in pain and fear management among children undergoing IV cannulation.

Outcomes of Gamma Knife Radiosurgery for Drug-Resistant Primary Trigeminal Neuralgia.

To evaluate the result of gamma knife radiosurgery (GKRS) for drug-resistant primary trigeminal neuralgia (TN). Patients who were diagnosed with drug-resistant primary TN were treated with GKRS at the Nuclear Medicine and Oncology Center, Bach Mai Hospital from January 2015 to June 2020. Using the pain rating scale of the Barrow Neurological Institute (BNI), follow-ups and evaluations were conducted at 1 month, 3 months, 6 months, and 9 month, and 1, 2 years, 3 years, and 5 years after radiosurgery. Comparisons of pain levels was performed before and after radiosurgery according to the BNI scale. From January 2015 to June 2020, 33 patients were treated with GKS. There were 23 female patients and 10 male patients; the average age was 61.9. The average onset time of disease was 4.42 years. Among all patients, 84.8% of patients were relieved from pain and 78.8% were pain-free without medication. The mean time for pain relief was 3 months and was not related to the dose of GKS (<80 Gy and ≥80 Gy). The efficacy of pain relief is not related to blood vessel contact with the trigeminal nerve, the dose of GKS, and the onset of disease. The rate of recurrence after the first pain relief was low (14.3%). Gamma knife is an effective method for the treatment of primary drug-resistant TN, especially in elderly patients with underlying medical conditions. The analgesic effect does not depend on the presence of nerve-vascular conflict.

Reliability of three pain assessment tools in children requiring dental treatment: A comparative clinical study.

The appropriate intervention of pain is based on its accurate evaluation, which is a challenge in the pediatric population as they often do not have the language development or cognitive sophistication to describe it correctly. Untreated pain has a negative impact on the psychosocial well-being of children. The study aimed to evaluate and compare the reliability of different pain assessment scales, namely, the Wong Baker Facial Pain Rating scale (WBFPS), Modified Emoji Pain Scale (MEPS), and indigenously developed indigenously made GIF Pain Scale (SPGPS) in children undergoing dental treatment under local anesthesia (LA). The study included 152 children aged 4-6 years with a Frankl behavior rating of score 3 and 4 (positive and definitely positive) requiring dental treatment under LA. After local infiltration, each child with two independent observers was asked to record the response of the current pain on the WBFPS, MEPS, and SPGPS. The reliability of the pain scales was assessed on the basis of similar responses given by all three individuals. The Pearson correlation test was performed to determine the correlation among the scales. A very strong correlation was found between the WBFPS and SPGPS (r = 0.848), while a moderate correlation was found among the WBFPS and MEPS (r = 0.691). A strong correlation was found between the SPGPS and MEPS (r = 0.723). The SPGPS proved to be a more reliable pain assessment tool compared to the WBFPS and MEPS in clinical pediatric dentistry.

Evaluation of four different methods of analgesia for pain relief in patients of dilatation &amp; curettage: A randomized comparative study

Introduction: Dilatation and curettage is a diagnostic procedure in management of abnormal uterine bleeding. In a developing country like India with dense population and limited resources it becomes a necessity to provide simple, effective, inexpensive and low-risk method of pain relief which can be used in an outpatient setup. So, this study was planned to determine an effective modality of pain relief for this procedure. Methods: This was a prospective, randomized, comparative study conducted among 140 patients. The patients were divided into 4 groups: Group A: Paracervical block Group B: Paracervical block with intrauterine lignocaine Group C: Intravenous diclofenac Group D: Intravenous diclofenac with intrauterine lignocaine Pain was analyzed using pain rating scale immediately and 30 min after the procedure. Patient was assessed 2 hourly after the procedure using PADSS score (post anaesthetic discharge scoring system scale) and patient was discharged if PADSS score is more than 9. Results: The patients were well matched in age, parity, weight, number of vaginal births, menopausal status and indications for intervention among the groups and no statistically significant differences were observed in the baseline characteristics. Patients in Group B (Paracervical block with intrauterine lignocaine) had significantly low pain score immediately (1.69±0.47)as well as 30 min after the procedure(2.37±0.49), followed by group D (intravenous diclofenac with intrauterine lignocaine 3.71±0.75, 4.51±0.65). Group A and Group C required rescue analgesic in 25 and 22 patients respectively. However, rescue analgesic was required in only 3 patients of group D Early discharge of the patient was observed in group using combination of paracervical block with intrauterine lignocaine which had maximum PADDS score (11.71±0.45 at 2 hours after the procedure). No serious adverse effects were observed during the study. Most common adverse effect observed was nausea and vomiting apart from other minor adverse effect like dizziness, light-headiness, nausea/vomiting, metallic taste and perioral numbness. Conclusion: Adequate intraoperative and postoperative analgesia is ensured when combination of analgesic/ anaesthetic agent is used. Maximum pain relief, as reflected by pain scores was in group using combination of paracervical block and intrauterine lignocaine which also had highest PADDS score that allowed early discharge of the patient.

Effectiveness of Jacobson Relaxation and Lamaze Breathing Techniques in the Management of Pain and Stress During Labor: An Experimental Study.

Background and objective The mother's ability to tolerate labor discomfort has an impact on how the labor progresses. Good pain management will boost mothers' ability to labor collaboratively and will shorten the time it takes for the uterus to open completely. Many women prefer not to use pharmaceutical or invasive pain relief during labor, which may have contributed to the popularity of complementary pain relief approaches. This study aimed to assess the effectiveness of the Jacobson relaxation technique and Lamaze breathing technique in the management of pain and stress during labor. Methods Thirty-six women aged between 25 and 35 years were randomly assigned totwo groups for the purpose of this study. Group A received the Jacobsonrelaxation technique while Group B received the Lamaze breathing technique for four weeks. The patients were instructed to practice breathing techniques at the time of labor. The outcomes measure included the Numerical pain Rating Scale (NPRS) and Perceived Stress Scale (PSS), which would be measured before and after the delivery. Results The subjects showed improved labor pain and anxiety following the physiotherapy intervention. The results were found to be statistically significant (p<0.05). Conclusion Based on our findings, physiotherapy intervention plays an integral role in the multidisciplinary approach to relieving labor pain and helping patients have a normal vaginal delivery.

Risk factors for failed back surgery syndrome following open posterior lumbar surgery for degenerative lumbar disease

BackgroundWith the growing number of traditional posterior open surgery, the incidence of failed back surgery syndrome (FBSS) increases gradually. We aimed to investigate the incidence and risk factors for FBSS following open posterior lumbar surgery for degenerative lumbar disease (DLD).MethodA multivariable regression analysis was performed for 333 consecutive patients to identify potential risk factors for FBSS. Clinical outcomes were evaluated by the validated North American Spine Society (NASS) Questionnaire and numerical rating scale (NRS) for pain. Demographics, diagnostic characteristics, surgical data, radiographic parameters for each patient were analyzed.Result16.8% of the included patients were classified as FBSS. Univariate analysis showed that age, hypertension, symptom location, intermittent claudication, preoperative pain NRS-leg, HIZ, Modic changes (MCs), surgical strategy and postoperative rehabilitation were related to FBSS. Multivariable logistic regression analysis demonstrated that preoperative NRS-leg (OR:0.80, 95%CI:0.71–0.91, P = 0.001), hypertension (OR: 2.22, 95%CI: 1.10–4.51, P = 0.027), intermittent claudication with waking distance > 100 m (OR: 4.07, 95%CI: 1.75–9.47, P = 0.001) and waking distance ≤ 100 m (OR: 12.43, 95%CI: 5.54–27.92, P < 0.001), HIZ (OR: 8.26, 95%CI: 4.00–17.04, P < 0.001), MCs (OR: 3.41, 95%CI: 1.73–6.71, P < 0.001), postoperative rehabilitation (OR: 2.63, 95%CI: 1.13–6.12, P = 0.024) were risk factors for FBSS.ConclusionOpen posterior lumbar surgery is an effective treatment for DLD which provides pain reduction and lumbar curve improvement with a considerable satisfaction rate. Lower preoperative NRS-leg, hypertension, intermittent claudication, HIZ, MCs and postoperative rehabilitation are risk factors for FBSS, which can serve as a tool for clinicians to identify at-risk population and provide more effective management to mitigate the doctor-patient contradictions and further occupation of medical resources.

Opioid sparing analgesia: Continuous intraoperative infusion of dexmedetomidine versus lidocaine for intracranial surgeries in children: A double-blind randomized clinical trial

ABSTRACT Background The usage of opioid sparing analgesia in different surgeries leads to varied results. The aim of this study is to compare between the effects of continuous intraoperative infusion of dexmedetomidine versus lidocaine as opioid sparing analgesia in children undergoing intracranial surgeries. Methods It is a double-blind randomized clinical study in which, 64 children were randomly allocated into 2 equal groups; 32 children for each group. The first one was dexmedetomidine group which received continuous intraoperative dexmedetomidine iv infusion [1ug/kg dexmedetomidine over 15 minutes as a loading dose and 0.5ug/kg/h for maintenance]. The second one was lidocaine group which received continuous intraoperative lidocaine iv infusion [1.5mg/kg lidocaine over 15 minutes as a loading dose and 1.5mg/kg/h for maintenance]. The continuous intraoperative iv infusion of each tested drug was stopped 10 minutes before the end the surgical procedure. Results Intraoperative total fentanyl consumption was significantly reduced in dexmdetomidine compared to lidocaine group ([19.33±11.15 vs 43.10±21.15] ug, 95% CI, -45.8 to -1.7). Children in dexmedetomidine group were significantly more sedated compared to lidocaine group. The time to reach Wong–Baker Faces Pain Rating Scale (WBFPS) scores 4 or more was around 4 hours in dexmedetomidine and around 1hour in lidocaine group. The time to first call of naluphine with dexmedetomidine was significantly prolonged compared to lidocaine ([235.03±5.02 vs 55.87±6.28] min, 95% CI, 176.3-182) with significantly reduced total postoperative naluphine consumption in dexmedetomidine compared to lidocaine ([4.22±1.46 vs 7.96±2.8] mg, 95% CI,-4.9 to -2.6) . The duration of PACU stay was significantly prolonged in lidocaine compared to dexmedetomidine ([99.75±14.36 vs 114.28±10.56] min, 95% CI,-20.8 to -8.2). Conclusion Continuous Intraoperative intravenous infusion of dexmedetomidine was superior to lidocaine in opioid sparing analgesia during intracranial surgeries in children.

Improvement of Pain and Function by Using Botulinum Toxin Type A Injection in Patients with an Osteoarthritic Knee with Patellar Malalignment: An Electromyographic Study.

Objective: To determine the pain and electromyographic (EMG) amplitude ratio of the vastus medialis oblique (VMO) to the vastus lateralis (VL) after botulinum toxin type A (BTA) was injected in the bilateral osteoarthritic knee of patients with patellar malalignment for analysis. Material and methods: A total of fifteen patients were recruited; the more symptomatic knee of each patient received a BTA injection (BTA side). The other set of patients were left untreated. In all, fifteen healthy participants comprised the control group. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and numeric rating scale (NRS) for pain were assessed. The EMG amplitude of VL and VMO activity was recorded using an isokinetic dynamometer and synchronized using the BIOPAC MP100. The data were collected before and at 4, 8, and 12 weeks post−BTA injection. Results: The EMG ratios of the patient group were lower than those of the control group at all testing velocities (p < 0.05). The VMO/VL ratio improved significantly on the BTA side only. The VMO/VL ratios on the BTA side were higher than those on the untreated side (p < 0.05). Knee pain decreased significantly after the BTA injection. The EMG ratios were negatively correlated with the NRS and WOMAC scores. Conclusion: BTA injection effectively reduces knee pain and restores the EMG ratio between the VMO and VL.

PENGARUH LATIHAN BIRTH BALL TERHADAP PENGURANGAN RASA NYERI PERSALINAN

Maternal mortality is still high. The maternal mortality rate (MMR) in Indonesia was recorded at 177 deaths per 100 thousand live births in 2017. This ratio is already better than the previous dozen years, which was more than 200 deaths per 100 thousand live births. However, Indonesia's MMR is still the third highest in Southeast Asia. (World Bank, (Lidwina, 2021). The Maternal Mortality Rate (MMR) based on the 2015 SUPAS report was 305 per 100,000 live births. This figure shows a decrease compared to the 2012 IDHS, which was 359 per 100,000 live births (Profile Lampung, 2020).In Lampung Province, there was an increase in 2020 that the number of cases of maternal death increased compared to 2019, from 110 cases to 115 cases (Profile Lampung, 2020).Based on the Health and Nutrition Section of the Lampung Provincial Health Office in 2020 that MMR occurred in Central Lampangg Regency. as many as 22 cases. Pain during labor arises as a result of the mother's physical and psychological reflexes. Emotional tension due to anxiety will worsen the mother's perception of the pain felt during childbirth. Pain that arises during labor requires proper pain management and this should be a concern for women, families and health workers. Pain in labor during the I m is pain with a scale of weight felt by the mother in labor for a l onger time. Non-pharmacological (complementary) methods are proven to reduce labor pain, one of which is by using Birth Ball exercises.To analyze the effectiveness of birth ball exercises in the first stage of labor to reduce labor pain in the Independent Midwife Practice (PMB) "E" in Central Lampung Regency.Experimental research with Pre and Post-Test Control Group Design approach. The population was primigravida maternity mothers in the active phase of the first phase with a total of 15 samples. The research was conducted at the Independent Midwife Practice (PMB) "E" in Central Lampung Regency. The instrument used was an observation sheet on the intensity of labor pain using the Faces Pain Rating Scale. Results: Statistical tests were carried out using the Wilcoxon test, the p-value (0.001 &lt;0.05) was obtained, so it can be concluded that there is a significant difference in the intensity of labor pain before and after being given Birth Ball exercises to women giving birth. Birth Ball exercise is one of the complementary midwifery care that can be given easily, cheaply, simple, effective, and without adverse effects for maternity mothers and can significantly reduce labor pain in first-stage primigravida mothers.

Anxiety and Psychological Flexibility in Women After Childbirth in the Rooming-in Unit during the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has intensified perinatal anxiety disorders. Psychological flexibility (PF), considered a specific mental toughness, has not been examined with regard to its relationship with anxiety in women after childbirth. We aimed to compare levels of anxiety, PF, and pain in women depending on the mode of birth, parity, and the magnitude of risk of developing an anxiety disorder. We also investigated the association of anxiety with PF and pain. A total of 187 women after childbirth completed validated questionnaires for anxiety (State-Trait Anxiety Inventory, Hospital Anxiety and Depression Scale-Anxiety, Numerical Rating Scale for anxiety [NRS-A]), PF, and pain (Numerical Rating Scale for pain). Specific postpartum anxieties were assessed with a numerical scale from 0 to 10. The relationship of anxiety with PF and pain was examined. Women at low and high risk of developing anxiety disorder were compared in terms of PF, anxiety, and pain. On the second postpartum day, women after cesarean birth demonstrated significantly greater anxiety on NRS-A and pain than those after vaginal birth. Primiparous women experienced significantly greater anxieties and pain compared to multiparous women. The higher the PF patients demonstrated, the less anxiety and pain they had. Patients at high risk of developing an anxiety disorder had a lower level of PF (P < .001) and higher levels of anxiety (P < .001) and pain (P < .01) than patients at low risk of developing an anxiety disorder. No difference in the anxiety of getting COVID-19 was observed between the groups (P > .05). PF is an important psychological construct related to the mental and physical condition of women after childbirth. Increasing PF in women after childbirth may be considered as an important goal of preventive and intervention measures.

Poorer surgical outcomes at 2 years postoperatively in patients with lumbar spinal stenosis with long-term preoperative leg numbness: a single-center retrospective study

BackgroundThe purpose of this study was to assess whether differences in duration of preoperative leg numbness lead to different surgical outcomes.MethodsThis study included patients with lumbar spinal stenosis (LSS) who underwent lumbar fusion surgery in our hospital from January 2018 to September 2020. Patients were divided into three groups based on duration of preoperative leg numbness: no numbness (NN) group, short-term numbness (STN) group (leg numbness ≤ 3 months) and long-term numbness (LTN) group (leg numbness > 3 months). The Numerical Rating Scale of leg pain (NRS-LP) and leg numbness (NRS-LN), Oswestry Disability Index (ODI) and Short-Form Health Survey (SF-36) were collected before surgery and at 3, 6, 12 and 24 months postoperatively.Results178 patients were included in this study. At 24 months postoperatively, NRS-LP was significantly higher in LTN than in NN [NN vs. STN vs. LTN: 0 (0,1) vs. 0 (0,1) vs. 1 (0,1)] (p = 0.033). NRS-LN in STN [2 (1,3)] was significantly lower than in LTN [3 (2,3)] (p < 0.001). SF-36 was significantly lower in LTN than in other two groups (NN vs. STN vs. LTN: 86.10 ± 6.02 vs. 84.09 ± 5.59 vs. 78.93 ± 6.57) (p < 0.001). ODI was significantly higher in LTN than in other two groups [NN vs. STN vs. LTN: 18 (15,22) vs. 18 (16,20) vs. 21 (19,24)] (p = 0.001).ConclusionsPatients with LSS with long-term preoperative leg numbness have poorer outcomes at 2 years postoperatively. Surgical intervention should be performed before persistent leg numbness for more than 3 months to obtain a better prognosis.

Effect of Group Activity Therapy (TAK) Progressive Muscle Relaxation on Pain Scale and Mental Health in the Elderly

The Elderly is a risk group prone to physical and psychological changes. Physical and psychological changes in the elderly cause disturbances in daily activities. The physical and mental health of the elderly are two things that have a reciprocal relationship that requires pharmacological and non-pharmacological treatment. This study aims to examine the effect of progressive muscle relaxation therapy on physical health (pain) and mental health (stress, anxiety, and depression) in the elderly. This research is Quasi-Experimental research using a one-group pre-post test design approach. The population in this study were all elderly living in the homestead at the Tresna Wredha Social Institution in the Jember Region. The Numerical Rating Scale for pain and DASS-21 measures pain, stress, anxiety, and depression in the elderly before and after implementing progressive muscle relaxation therapy. The results of this study showed that there were significant differences between before and after administration of progressive muscle relaxation therapy for pain (p-value = 0.000), stress (p-value = 0.000), anxiety (p-value = 0.000), and depression (p-value =0.000) in the elderly. The results of this study are expected to be the basis for implementing progressive muscle relaxation therapy to reduce pain, stress, anxiety, and depression in the elderly so that it is expected that the physical and psychological health of the elderly can improve.

Efficacy of Visual Feedback Training for Motor Recovery in Post-Operative Subjects with Knee Replacement: A Randomized Controlled Trial.

To evaluate the effects of visual feedback training on motor recovery in postoperative patients with a total knee replacement (TKR). The performance of 40 first-ever TKR patients (27 females; mean age: 70.5 (67.2-74.0) years) was evaluated in a single center, single-blind, randomized controlled study. The patients were randomly and equally distributed into two demographically/clinically matched groups undergoing experimental or traditional treatments. All patients have been treated in a 1 h session, 2/day for 5 days a week, for six consecutive weeks. The first group ("control") underwent conventional physical therapy, whereas the experimental group received advanced knee training with visual feedback using the TecnoBody® device (Walker View 3.0 SCX, Dalmine (BG), Italy). The clinical scales and kinematic parameters coming from the gait analysis were evaluated to demonstrate the dynamic balance function in a standing position before and after each treatment. After the treatment, both experimental and control groups improved significantly and similarly, as measured by the clinical scales (Numeric Rating Scale for Pain and Barthel index). A significant boosting of the motor performance was detected in the experimental group with respect to the control group in the terms of symmetry index 84 (80.8-85.4) vs. 87.15 (84-92.8) p = 0.001 *; single stance support 34.9 (34.1-36.5) vs. 37.8 (36.6-38.9); p &lt; 0.001; and obliquity parameters 58.65 (51.3-70.3) vs. 73 (62.3-82.1); p &lt; 0.001. Applying visual feedback training in addition to traditional rehabilitation strategies improves the knee function and motor control in postoperative TKR patients.

Analysis of shortcomings, obstacles and problems in the practice of pain-reliaf at the prehospital stage of care for patients with traumatic injuries

Goal of study. Identification of shortcomings, obstacles and problems in the implementation of pain-relief in patients with concomitant injuries by questioning.Material and methods. A survey of 400 emergency physicians was conducted. The questionnaire consisted of 18 questions with multiple choice of answers. The average age of doctors who completed the survey was 53,5±3,4 years, men — 275 (67,5%), women — 130 (32,5%).Results. Questioning of doctors revealed insufficient knowledge of emergency medical doctors about modern aspects of prehospital pain-relief, about the use of pain rating scale in practice. 80% of the respondent’s preferred pain-relief with metamisol, 17% preferredopioids. 95% of doctors surveyed believe that the use of narcotic analgesics will take in difficult to further diagnose impaired consciousness.Conclusion. There are problems and shortcomings in implementation of pain-relief at the prehospital stage in patients with a combined injury, requiring improvement of the training program, including special lectures and practical exercises on the problem of pain-relief and aspects of care for patients with a combined injury.

Development of a set of patient reported outcome measures for patients with benign liver tumours and cysts: patient focus groups and systematic review.

Patient reported outcome measures (PROMs) may be useful for patients with benign liver tumours and cysts (BLTC) to evaluate the impact of treatment and/or guide shared decision making. Yet, a set of PROMs relevant to patients with BLTC is currently unavailable. In this study, we selected a PROMs set for patients with BLTC. Potentially relevant patient reported outcomes (PROs) were selected by psychologist-researchers based on keywords used or suggested by participants of two virtual focus groups meetings consisting of thirteen female BLTC patients with a median age of 50years. Subsequently, patients were asked to report their most relevant PROs. PROMs identified by systematic literature review and computerized adaptive tests (CATs) in the Patient-Reported Outcomes Measurement Information System (PROMIS) were considered in selecting the final PROMs set to assess relevant outcomes. The most important PROs were: insecurity/anxiety (11/12 patients), pain (9/12 patients), fatigue (8/12 patients), and limitations in daily life (5/12 patients). The literature review included 23 studies, which used various generic and disease-specific PROMs, often not measuring (all) relevant PROs. The final selected PROMs set included numerical rating scales for pain, two questions on overall health and quality of life and four PROMIS CATs. A PROMs set generically and efficiently measuring outcomes relevant for patients with BLTC was developed and may be used in future research and clinical practice.

Proprioceptive neuromuscular facilitation in chronic low back and neck pain and disability: A systematic review and meta-analysis

BACKGROUND: Proprioceptive neuromuscular facilitation (PNF) is one of the neurophysiological techniques aimed at reducing pain and disability. This systematic review objective addresses the current evidence on PNF techniques’ effectiveness in chronic low back and neck pain. METHODS: Literature search in PubMed, Scopus, Cochrane, Wiley and Ovid databases were searched until 2021. The content of the titles and the abstracts were analysed to gather information about the effects of PNF in chronic back and neck pain with outcomes of pain and disability. The quality of the studies was analysed by the Joanna Briggs Institute (JBI) critical appraisal score. Meta-analysis was performed on Visual Analogue Scale (VAS), Numerical Rating Scale (NRS) for chronic low back pain and Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMDQ) for disability. RESULTS: Nine studies addressed the different PNF based interventions on chronic low back pain, with a total of 416 participants. The intervention period ranged 3–6 weeks, and two studies conducted 12-weeks follow-up. Many studies measured pain using a VAS and NRS, whereas the disability through ODI and RMDQ. The JBI score ranged from 6/13 to 11/13. None of the PNF studies treated chronic neck pain. CONCLUSION: PNF might be beneficial for reducing low back pain and related disability. The long term effects of PNF on chronic low back pain, and also to determine its benefits on chronic neck pain are warranted in future studies.

Long-Term Follow-Up of Intensive Integrative Treatment including Motion Style Acupuncture Treatment (MSAT) in Hospitalized Patients with Lumbar Disc Herniation: An Observational Study.

This study aimed to investigate the long-term effects of and satisfaction with integrative Korean medicine treatment and motion style acupuncture treatment (MSAT) in patients with lumbar disc herniation (LDH). We retrospectively analyzed medical charts and prospectively surveyed adult patients aged between 19 and 64 years treated for lumbar disc herniation for at least 6 days at three Korean hospitals from 1 January 2015 to 31 December 2020. The primary outcome was the Numeric Rating Scale (NRS) for back pain. Secondary outcome measures included the NRS for radiating leg pain, the Oswestry Disability Index (ODI), and the European Quality of Life-5 Dimension-5 Level (EQ-5D-5L) questionnaire. The NRS scores for low back pain decreased from 5.40 ± 1.58 to 2.92 ± 2.09, NRS for radiating leg pain from 5.57 ± 1.56 to 1.78 ± 2.36, and ODI from 46.39 ± 16.72 to 16.47 ± 15.61 at baseline and survey, respectively. The EQ-5D-5L increased from 0.57 ± 0.19 to 0.82 ± 0.14. In conclusion, Korean medicine and MSAT could be effective treatment methods for patients with LDH. The results of this study can be used as helpful information for clinicians who treat patients with LDH in real clinical settings.