Visual Analogue Scale Scale Research Articles

Fully digital versus conventional workflow: Are removable complete overdentures equally good? A randomized crossover trial.

Implant-supported removable complete overdentures (IODs) are a common treatment in case of edentulism and malfunctioning of the conventional denture. Manufacturing IODs in a conventional way (C-IODs) is time-consuming, but in a digital workflow, this can be done in three sessions. Digitally produced IODs (3D-IODs) are also more advantageous than C-IODs because lost or broken 3D-IODs can be swiftly reproduced as the digital design is always available. To prove in a non-inferiority study, with a margin of 0.3 point per Oral Health Impact Profile-20 (OHIP-20) question, that IODs made according to a fully digital workflow (3D-IODs), function as good as C-IODs with respect to patient-reported outcome measures (PROMs). This randomized crossover study included 36 fully edentulous patients who showed extreme resorption of the maxillary alveolar process, making denture retention difficult. After a maxillary bone augmentation and the installation of 4-6 implants, each patient wore both types of IOD for 1 year each, with the order reversed in two subsets of patients. The 3D-IODs and C-IODs were fabricated in advance for both jaws (at least two mandibular implants were already present). The OHIP-20 survey was performed at baseline, after 1 year (before the IOD switch), and after 2 years to determine patient satisfaction scores using a visual analog scale (VAS). The general health status was assessed using the Short Form (SF-36) questionnaire. Regarding the PROMs, patients preferred the 3D-IOD: the improvement on the overall OHIP scale (0-4), expressed as a mean, was 0.26 points greater than for the C-IOD (p < 0.001). This applied also to the VAS scale (1-100) with an increase of 7.37 points (p < 0.001). Regarding the SF-36 scale, only for the item "emotional well-being," the 3D-IOD scored significantly better (p = 0.033). Compared with conventionally fabricated C-IODs, fully digitally produced 3D-IODs resulted in significantly higher OHIP-20 and satisfaction scores.

Effectiveness of Aloe Vera and Cabbage Leaf Compress on Breast Swelling Pain in Post-Partners in Bogor Barat District, Bogor City

ASEAN data in 2022 stated that 76,543 postpartum mothers experienced breast engorgement. 17.2 million postpartum mothers worldwide experience breast pain problems while breastfeeding. In Indonesia, the incidence of breastfeeding mothers experiencing breast engorgement reached the highest figure of 37.2% and 16% of working breastfeeding mothers experienced breast engorgement. Breast engorgement is interpreted as increased venous and lymph flow in the breasts to prepare for lactation. This is due to overdistension of the lactation ducts, causing breast swelling pain, and breast engorgement accompanied by an increase in body temperature. The study used a quasi-experimental design with a pretest-posttest two-group design. The sample consisted of 30 postpartum mothers who experienced breast engorgement pain and were divided into 2 intervention groups, namely aloe vera compresses and cabbage compresses, the intervention was carried out for 14 days. The instrument used was the Visual Analogue Scale (VAS). Data were analyzed using the Paired T-Test and Independent T-Test. In the Independent Sample T-Test, the p-value of the VAS scale for the aloe vera group was 0.019 &lt;0.05 with an average score of 2.0 and the VAS scale for the cabbage group was 0.037 &lt;0.05 with an average score of 1.87.

Results of interventions on the celiac plexus in treating patients with chronic pharmacoresistant abdominal pain

Patients with chronic abdominal pain are a complex cohort of patients who undergo treatment by many specialists for a long time: surgeons, urologists, gynecologists, neurologists, psychiatrists, etc. However, despite all diagnostic and treatment measures, the pain syndrome persists or worsens. Objective ‒ evaluation of the effectiveness, safety and long-term results of treating patients with abdominal pain syndromes, which includes the use of various methods of minimally invasive interventions on the celiac plexus (CP) taking into account the peculiarities of the origin, nature and localization of pain. Materials and methods. An analysis of the results of 26 interventions on CP in 21 patients was performed. Inclusion criteria for participants in the study were individuals with persistent pharmacoresistant abdominal pain for ≥3 months, aged 19 to 73 years. There were 13 (62.0%) male and 8 (38.0%) were female. Mean age was 55.2±15.2 years. Patients were divided into two groups. The first (n=16) included patients with pancreatic cancer, the second (n=5) included patients with non-oncological chronic abdominal pain syndromes: functional abdominal pain syndrome was diagnosed in three cases, and one observation each of solaritis and chronic pancreatitis. All procedures were performed under CT. To assess the intensity of the pain syndrome, a visual analogue scale (VAS) of pain from 1 to 10 cm was used, where 0 cm is the absence of pain, 10 cm is unbearable pain; functional status (FS) - according to the Karnofsky scale (KS) from 0 to 100%. Estimation of the daily dose of opioid analgesics was estimated using the oral morphine equivalent daily dose (oMEDD). Patients were observed for 6 months, evaluations were carried out after 1 week, 1, 3 and 6 months, respectively. Results. In the first group, 17 interventions on CP were performed in 16 participants, sympatholysis was performed twice in one patient. In the second group - 9 interventions in 5 patients: 4 Celiac Plexus Blocks (CPBs) of the central nervous system using "Depo-Medrol®" (methylprednisolone) and 5 neurolysis with 96% ethyl alcohol. Two patients were initially treated with CPB and then sympatholysis due to the recurrence of pain syndrome with the aim of a more stable sympatholytic and analgesic effect. In one patient, neurolysis of CP was performed three times. In all cases, no complications were recorded during the procedures. VAS before the procedure in the general group (n=26) was 9.6±0.6 cm, one week after the intervention it was 4.5±1.6 cm (P&lt;0.0001), after one month it was 3.2±1 .5 cm (P&lt;0.0001), after 3 months – 3.0±1.6 cm (P&lt;0.0001), after six months – 4.4±1.6 cm (P&lt;0.0001). The FS indicator according to the KS before the procedure in the general group was 65.8±7.0%, one week after the intervention – 80.8±8.0% (P&lt;0.0001), one month later – 81.5±8.3 % (P&lt;0.0001), after 3 months – 75.0±9.5% (P&lt;0.0010), after six months – 68.0±9.4% (P=0.4042). The oral morphine equivalent daily dose before the procedure in the general group was 123.8±86.0 mg per day, one week after the intervention on CP oMEDD was 57.3±61.2 mg (P&lt;0.0001), after 1 month – 41.0±47.3 mg (P&lt;0.0001), after 3 months – 44.0±51.3 mg (P&lt;0.0001), after 6 months – 80.6±77.2 mg (P&lt;0,0001). Conclusions. Computed tomography-guided celiac plexus neurolysis is a useful and effective tool in treating patients with both abdominal pain caused by inoperable pancreatic cancer and chronic non-oncological pharmacoresistant abdominal pain. Minimally invasive interventions on CP provide a significant reduction of pain syndrome according to the VAS scale (p&lt;0.001), reduce the need to take opioids analgesics (p&lt;0.001) after 1, 3, 6 months and increase the FS of patients according to the KS (p&lt;0.001) after 1, 3 months. Taking into account the high percentage of recurrence of pain syndrome in the studied patients of the group of non-oncology pain, the need for repeated interventions for the purpose of long-term pain control, interventions on CP in this cohort of patients require further research with an increase in the number of observations.

Effects of varied aerobic exercise on health related outcomes of fibromyalgia patients: a randomized controlled trial

Background and purpose Fibromyalgia (FM) is a chronic illness affecting the immune system. Women are more likely than men to be diagnosed with this condition. It causes widespread muscle and bone pain and is most commonly experienced by people between the ages of 20 and 60. Recent studies have shown that people with fibromyalgia may experience heart abnormalities and arrhythmias after exercise. This study explores how different aerobic exercise levels affect pain, cholesterol levels, and overall quality of life (QoL) for women with fibromyalgia. Materials and Methods In a study conducted at Abu-Kabir Central Hospital in Al Sharquia, 60 women diagnosed with fibromyalgia were randomly allocated to a moderate-intensity aerobic exercise (AE) (n=30) or a low-intensity aerobic exercise AE (n=30). The women were between the ages of 30 and 40 and had a body mass index (BMI) between 20 and 26 kg/m2. Before and after the intervention, all patients in both groups were evaluated using a visual analog scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), symptom severity scale (SS-scale), and cholesterol level measurements. Results After the intervention, the group that engaged in moderate-intensity aerobic exercise showed significant improvements in all measured outcomes compared to the group that engaged in low-intensity aerobic exercise. The effect size was high for VAS (MD = -3.73; ES = 0.395 and p = 0.001), cholesterol level (MD = -52.19; ES = 0.681 and p = 0.001), FIQ (MD=-36.26; ES = 0.746 and p = 0.001), and symptom severity scale (MD = -473; ES = 0.273 and p = 0.001). Conclusion Our research has shown that moderate-intensity AE performed at 60% to 70% of maximum heart rate, is more effective in reducing pain, improving overall QoL, and lowering cholesterol levels than low-intensity AE at 45% to 55%.

Effects of platelet-rich plasma injection on electrical activity and biomechanics of the erector spinae muscles in lumbar myofascial pain syndrome

Low back pain (LBP) is a highly prevalent disease. Among the various causes of LBP, one of the most frequent is myofascial pain syndrome (MPS) which affects the spinal stabilizer muscles. The aims of this study were to compare the differences in muscular electrical activity and biomechanical properties between the painful and non-painful sides in patients with unilateral MPS and to verify the feasibility of surface electromyography (sEMG) and MyotonPRO for assisting in MPS assessment. Forty patients with unilateral lumbar MPS were recruited via the Department of Rehabilitation Medicine Center of West China Hospital Sichuan University from October 2022 to October 2023. The electrical properties of the bilateral erector spinae muscles were characterized by sEMG signals during a trunk extension task. The following four time-domain features of sEMG were extracted: root mean square (RMS), mean absolute value (MAV), integrated EMG (iEMG), and waveform length (WL). And two frequency domain features were extracted: the median frequency (MDF) and mean power frequency (MPF). The mechanical properties of the muscles were assessed by MyotonPRO at rest. The following biomechanical parameters were acquired: oscillation frequency [Hz], dynamic stiffness [N/m], logarithmic decrement, relaxation time [ms], and Creep. The visual analog scale (VAS) was used to evaluate the pain severity, and the Oswestry Disability Index (ODI) was used to evaluate the severity of disability and disruption to lifestyle activities caused by LBP pain. The outcome measures were obtained prior to the Platelet-rich plasma (PRP) treatment and repeated two weeks after treatment. (1) Prior to the PRP treatment, all sEMG time-domain features on the painful side were significantly higher than those on the non-painful side (RMS, p < 0.001; MAV, p < 0.001; iEMG, p < 0.001; WL, p = 0.001). However, there was no significant difference in the sEMG frequency-domain features (MPF, p = 0.478; MDF, p = 0.758). On the mechanical side, there were significant differences in oscillation frequency (p = 0.041) and logarithmic decrement (p = 0.022) between the painful side and non-painful side, but no significant differences in dynamic stiffness, relaxation time, and creep (both p > 0.05). (2) Two weeks after the PRP treatment, statistically significant decreases were observed in both post-treatment VAS (p < 0.001) and ODI scales (p < 0.001), indicating the PRP treatment clinically significantly reduced the level of. MPS. This change coincided with all sEMG time-domain features, in which the values at the painful side decreased significantly (RMS, p = 0.001; MAV, p = 0.001; iEMG, p = 0.001; WL, p = 0.001). However, no significant difference in the sEMG frequency-domain features (MPF, p = 0.620; MDF, p = 0.850) was found. On the mechanical side, only logarithmic decrement on the painful side increased significantly (p < 0.001). Our combined MyotonPRO and sEMG results indicated that MPS likely leads to increased muscle tone and decreased muscle elasticity, manifested by abnormal time-domain features of sEMG and biomechanical properties. The changes in these objective measurements were agreed with the changes in subjective outcome measures of pain and function currently assessed in the patients with MPS. A single PRP treatment may alleviate muscle dysfunction caused by MPS. These preliminary results demonstrated the potential feasibility of using sEMG and MyotonPRO as tools for assessing the neuromuscular function of MPS.

Ultrasound-guided supraclavicular block versus Bier block for emergency reduction of upper limb injuries: statistical analysis plan

BackgroundUltrasound-guided supraclavicular block (UGSCB) is an emerging technique gaining interest amongst emergency physicians that provides regional anaesthesia to the upper limb to tolerate painful procedures. It offers an alternative to the more traditional technique of a Bier block (BB). However, the effectiveness or safety of UGSCB when performed in the emergency department (ED) is unclear.MethodsSUPERB (SUPraclavicular block for Emergency Reduction versus Bier block) is a prospective open-label non-inferiority randomised controlled trial comparing the effectiveness of UGSCB versus BB for closed reduction of upper limb fractures and/or dislocations. Adult patients presenting with upper limb fracture and/or dislocation requiring closed reduction in ED were randomised to either UGSCB or BB. Once regional anaesthesia is obtained, closed reduction of the injured part was performed and immobilised. The primary outcome is maximal pain experienced during closed reduction measured via a visual analogue scale (VAS). Secondary outcomes include post-reduction pain, patient satisfaction, total opioid requirement in ED, ED length of stay, adverse events and regional anaesthesia failure.ResultsPrimary outcome analysis will be performed using both the intention-to-treat and per-protocol populations. The between-group difference in maximum pain intensity will be assessed using linear regression modelling with trial group allocation (UGSCB vs BB) included as a main affect. A pre-specified non-inferiority margin of 20 mm on the VAS scale will be used to establish non-inferiority of UGSCB compared to BB.ConclusionSUPERB is the first randomised controlled trial to investigate the effectiveness and safety of UGSCB in the ED. The trial has the potential to demonstrate that UGSCB is an alternative safe and effective option for the management of upper extremity emergencies in the ED.

Comparison of Measures of Pain Intensity During Sickle Cell Disease Vaso-Occlusive Episodes

We aimed to determine the minimal clinically important difference (MCID) in pain severity and agreement between the visual analog scale (VAS) and the verbal numeric rating scale (NRS) in people with sickle cell disease (SCD) experiencing an acute vaso-occlusive episode in the emergency department. In the COMPARE-VOE trial (NCT03933397), participants were administered the VAS (0–100), NRS (0–100), and descriptor scale (a lot better, a little better, same, a little worse, much worse) every 30 minutes while in the emergency department. We analyzed data from 100 participants (mean age 30.2 years; 61% female). We calculated the mean differences and 95% confidence intervals (CIs) between current and preceding scores when the participant reported a little worse or a little better pain for each scale (255 VAS and 150 NRS observations) to assess the MCID for the VAS and NRS. Pearson correlation and the Bland-Altman method were used to assess the agreement among 411 paired VAS and NRS observations. Our results indicated that the MCID for the VAS was 8.77 mm (95% CI: 7.43 mm, 10.83 mm) and the NRS was 8.29 (95% CI: 6.47, 11.60). The VAS and NRS scales had a correlation of .88 (P < .001). The Bland-Altman method indicated a mean difference of −4.6 ± 1.96 and the 95% limits of agreement ranged from 20 to −29. Despite high correlation, there was considerable variability of agreement between the VAS and NRS scales, indicating that these scales are not interchangeable to assess pain during a vaso-occlusive event. PerspectiveThe MCID in pain severity for individuals with a SCD vaso-occlusive episode using the VAS (8.77 mm) is lower than previously reported, and the MCID for NRS was 8.29. The agreement between the VAS and NRS was determined and the scales cannot be used interchangeably to measure SCD pain intensity.

Comparative Study of Ropivacaine and Ropivacaine With Dexmedetomidine in Transversus Abdominis Plane (TAP) Block for Post-operative Analgesia in Patients Undergoing Cesarean Sections.

Background Adequate post-operative analgesia in the obstetric patient is necessary to facilitate breastfeeding and the care of the newborn. Considering the limitations of intravenous analgesic options such as non-steroidal anti-inflammatory drugs (NSAIDs) and opioids, other alternatives have been tried for offering better analgesia with fewer potential side effects. Transversus abdominis plane (TAP) block is one such option that has been tried with various local anesthetic drugs, either alone or in combination with other adjuvants. The addition of dexmedetomidine to bupivacaine in TAP block has been shown to prolong the duration of post-operative analgesia when compared to local anesthetic alone. This study was conducted to determine the efficacy of dexmedetomidine, as an adjuvant to ropivacaine, when administered in TAP block in patients undergoing cesarean section. Methodology The study was a prospective, randomized, parallel assignment, triple-blinded controlled trial. Hundred patients posted for elective lower segment cesarean section, fulfilling the inclusion criteria, were randomly divided into two equal groups, group R and group RD, comprising 50 patients each. Patients in group R were administered bilateral TAP block by landmark technique using ropivacaine alone, whereas patients in group RD were administered TAP block with dexmedetomidine 1 micrograms/kg, in addition to a similar dose of ropivacaine. Mean arterial pressure (MAP), heart rate (HR), visual analog scale (VAS)-R (pain score on VAS scale at rest), VAS-C (pain score on VAS scale on coughing), nausea and vomiting, and Ramsay sedation score were recorded on admission to post-operative care unit (PACU), and at first, fourth, eighth, 12th, 18th,and 24th hours post-operatively. Rescue analgesia was provided with intravenous morphine. Short Assessment of Patient Satisfaction Score (SAPS) was noted on a five-point scale after 24 hours based on patient satisfaction regarding the quality of post-operative analgesia. Results While there was no significant difference between groups R and RD with respect to VAS-C and VAS-R immediately after shifting and at the first, fourth, and eighth hours, a significant difference was observed at the 12th and 18th hours post-operatively. After 24 hours, no significant difference was observed between groups R and RD with respect to VAS-C and VAS-R. While 50% of patients needed rescue analgesia in group R, only 28% of patients needed rescue analgesia in group RD. There was significantly better patient satisfaction measured by the Short Assessment of Patient Satisfaction Score (SAPS) with respect to the quality of analgesia in patients in group RD as compared to those in group R. Conclusions The addition of dexmedetomidine to ropivacaine increased the duration of post-operative analgesia up to 18 hours post-operatively in cases of elective lower segment cesarean section. Also, the quality of post-operative analgesia is better in such patients, as shown by a significant difference in patient satisfaction scores between the two groups.

A prospective, randomized, controlled, double-blind, multi-center study to evaluate the efficacy and safety of a blue light device for the treatment of chronic back pain.

Chronic back pain is one of the most prevalent conditions and has a large socio-economic impact. The lack of routine use of non-pharmacological options and issues associated with pharmacological treatments underscore high unmet needs in the treatment of back pain. Although blue light phototherapy has proven efficacy in dermatology, limited information is available about its use in back pain. In this proof-of-concept, randomized controlled trial, a pain relief patch (PRP) delivered blue light at the site of back pain for 30 min during five treatment sessions. The comparator device delivered green light for 5 s but was worn for 30 min. A follow-up visit took place after the last treatment. The primary objective was to demonstrate the superiority of treatment by PRP, compared to the control device, in reducing pain intensity at the end of the treatment period. The post-treatment visual analog scale (VAS) pain intensity score for each group was calculated across the five treatment sessions and compared to the baseline. Secondary objectives included the disability score (Roland-Morris Disability Questionnaire) and safety. The full analysis set included 171 patients. A statistically significant reduction in pain intensity occurred after the use of PRP (p < 0.02), but the study did not meet its primary objective of a superiority trial aimed at demonstrating a 0.6 cm difference in favor of PRP on the VAS scale. There was no significant change in the disability scores. Subgroup analyses were performed to identify the treatment response by patient characteristics such as pain intensity at baseline and skin type. As expected, safety data showed erythema and skin discoloration in the PRP group but not in the control group. This trial had multiple limitations that need to be addressed in future research. Although the primary objective was not achieved, this proof-of-concept study provides important efficacy and safety data in relation to the use of blue light in the treatment of chronic back pain and key insights that may support further research on similar devices. ClinicalTrials.gov, identifier NCT01528332.

A Double-Blind Study on the Effectiveness of Polarized Light Therapy in the Treatment of Venous leg Ulcers-Pilot Study.

Vein diseases are one of the most common civilization diseases. The most advanced form chronic venous insufficiency are venous leg ulcers. The study included 40 patients, 20 male (50%) and 20 female (50%) in age between 52 and 88 years (mean age: 68.00 ± 8.55 years) with venous leg ulcers lasting 12.50 ± 5.45 months. Patients were distributed randomly in a double-blind study into two equal groups including 20 patients each (group 1-polarized light therapy and group 2-sham exposure). Patients from both groups received routine pharmacological treatment, specialistic medical dressings and compression therapy. In addition, patients were exposed to a cycle of polarized light therapy procedures or to sham exposures (30 procedures performed in two series of 15 procedures). Wound surface area was evaluated by computerized planimetry and pain intensity was assessed with the use of Visual Analog Scale (VAS) before and after therapy (2.5 months). The analysis showed a statistically significant reduction of surface ulcers area between groups 1 and 2. The median (IQR) size of wounds in group 1 was 2.4 (1.95-2.9) cm2, in group 2; 2.8 (2.6-3.1) cm2 (p = 0.038). The level of pain (VAS) after treatment was assessed in group 1, median (IQR): 2 (2-3) points, in group 2 4.5 (4-5) points; and the observed difference was also statistically significant (p < 0.001). In group 1, after treatment, the area of ulcers decreased-median (IQR): 33.05 (28.7-41.48) %, in group 2 by 18.99 (15-24.4) % (p < 0.001). In group 1, the pain intensity measured using the VAS scale decreased with a median (IQR): 71.42 (61.25-71.42) %, in group 2: 37.5 (28.57-50) % (p < 0.001). Complex therapy with polarized light therapy added to standard care was more effective than standard care alone in reducing of ulcers surface area and intensity of pain ailments in patients with chronic venous leg ulcers.

Postsurgical pain intensity in children on the VAS and FLACC scale across various analgesic techniques. Mathematical prediction as a component of justification

Nowadays, in pediatric practice, the Visual Analogue Scale (VAS) and the Face, Legs, Activity, Cry, Consolability (FLACC) scale are effective for assessing postsurgical pain. The modern concept of pain management includes a multimodal approach, including regional analgesia techniques. The aim of the study was to present a mathematical model to assess the efficacy of regional analgesia techniques in managing postsurgical pain intensity on the VAS and FLACC scale up to the fifth day of the study and predict the behaviour of the experimental data function up to day 87 following surgery using the autoregressive probability model. Materials and Methods. 89 patients operated on the anterior abdominal wall were divided into 3 groups depending on the type of anesthesia. The assessment of pain management quality and the presence of acute pain was conducted using the VAS and FLACC scale on days 1, 2, 3, and 5 post-operatively in all children. The ‘predict’ function in РТС MathCad Prime 7.0. software was used to automate calculating predictions based on the Burg method. Results. Studying the efficiency of the proposed treatment using regional analgesia techniques versus conventional analgesia enabled the prediction of varying postsurgical pain intensities on the VAS and FLACC scale based on their mathematical models, with coefficient of determination R2=0.9876, R2= 0, 9827, R2=0.9952 for the FLACC scale and R2=0.9868, R2=0,915, R2=0.9774 for the VAS. Conclusions. The use of regional analgesia techniques in children undergoing anterior abdominal wall surgery has been confirmed to be associated with a significant reduction in postsurgical pain intensity to the fifth day of observation and predicted to remain so up to day 87

Comparative evaluation of postoperative pain after root canal obturation using resin-based sealer (AH plus) and bioceramic sealer (IROOT SP) in adult mandibular molars: A double blinded randomized controlled trial

ABSTRACT Aim: The aim of this randomized clinical trial was to compare the occurrence and intensity of postoperative pain following root canal obturation using a bioceramic (IROOT SP, Innovative BioCeramix, Inc.,) and a resin-based endodontic sealer (AH plus) using visual analog scale (VAS). Methods: A total of 40 subjects with chronic irreversible pulpitis needing root canal treatment were included in this double blinded randomized clinical trial. Randomization was done using manually generated sealed envelopes. According to the sealers used, the patients were divided into 2 groups where in Group 1 (n = 20): AH plus sealer and Group 2 (n = 20): Bioceramic sealer. Postoperative pain was assessed using VAS scale. Mann–Whitney U test was used for statistical analysis. Results: The occurrence of postoperative pain was similar in both groups. Postoperative pain intensity decreased in both the groups after 48 h. No statistically significant difference was found in the occurrence of postoperative in either group (P &gt; 0.05). Conclusion: AH Plus and bioceramic sealer perform similarly in terms of the occurrence and intensity of postoperative pain with no significant difference. The average pain levels and number of rescue medication taken were similar in both the groups.

Office-based blue laser therapy for inferior turbinate hypertrophy: a pilot study.

To investigate the subjective effect of office-based blue laser therapy for inferior turbinate hypertrophy in patients with nasal obstruction. Patients with nasal obstruction who underwent office-based blue laser for the inferior turbinate hypertrophy between October 2022 and December 2023 were included in the study. The two outcome measures used to gauge the improvement in nasal obstruction and success of surgery were the Nasal Obstruction Symptom Evaluation (NOSE) scale and the Visual Analogue Scale (VAS). Patient's level of comfort during the procedure was also rated using a 10-point VAS scale. A total of 14 patients were included in this study. The mean age of the study group was 41.47 ± 18.52 and the F/M ratio was 4.67. All patients reported significant improvement in nasal breathing. The mean NOSE score decreased significantly from 13.07 ± 3.89 pre-operatively to 2.64 ± 2.43 post-operatively (p = 0.002). Similarly, the mean VAS score decreased from 7.43 ± 0.85 to 2.0 ± 1.57 (p = 0.002) following surgery. The procedure was well-tolerated by all participants and the mean total score ranged from 6 to 9 with an average of 7.59 ± 1.34. Office-based blue laser therapy for inferior turbinate hypertrophy may be an effective treatment modality for nasal obstruction from the patient's perspective. Although the procedures were tolerated well with no complications noted, these results should be cautiously interpreted until studies using objective measures are conducted.

Prospective Study of the Assessment of Anxiety Symptoms after Minimally Invasive Lumbar Decompression.

Objective To analyze associations between anxiety and postsurgical clinical outcomes in patients who underwent minimally invasive lumbar decompression surgery in addition to comparing symptoms of anxiety and depression before and after surgery. Methods This prospective cohort study of patients who underwent minimally invasive lumbar decompression surgery. Clinical outcomes were measured before and 6 months after surgery using the Visual Analog Scale (VAS), Global Perceived Effect of Change (GPE), Hospital Anxiety and Depression Scale (HADS), and Oswestry Disability Index (ODI). Based on the presurgical anxiety score, patients were categorized into anxious and non-anxious patients, and the outcomes were compared. Results The patients of both groups obtained similar results concerning the clinical outcomes evaluated. Preoperative HADS scores decreased significantly 6 months after surgery in both anxiety (8.70 ± 3.48 vs. 5.75 ± 3.91) and depression (6.95 ± 3.54 vs. 5.50 ± 2.99). The VAS scale for the back (-2.8 ± 3.64) and legs (-5.5 ± 3.5) showed a reduction in pain. Conclusion Minimally invasive lumbar decompression surgery promoted clinical and functional improvement, not being affected by preoperative anxiety symptoms. Mental health indicators showed a significant reduction in symptoms 6 months after surgery.

A New Approach to Postoperative Rehabilitation following Mosaicplasty and Bone Marrow Aspiration Concentrate (BMAC) Augmentation.

Chondral defects in the knee present a significant challenge due to their limited self-healing capacity, often leading to joint degeneration and functional disability. Current treatments, including surgical approaches like mosaicplasty and regenerative therapies such as bone marrow aspirate concentrate (BMAC) augmentation, aim to address these defects and improve patient outcomes. This study conducted a single-center, randomized controlled trial to evaluate the efficacy of different treatment approaches and rehabilitation protocols for chondral defects. Thirty-seven subjects presenting with symptomatic chondral or osteochondral defects (>3 cm2) in the weight-bearing region of the femoral condyle were partitioned into three groups, and underwent mosaicplasty with or without BMAC augmentation, followed by either a 6-week or 12-week rehabilitation program. Group 1 (n = 10) received mosaicplasty combined with BMAC augmentation and engaged in a twelve-week two-phase rehabilitation protocol. Group 2 (n = 15) underwent mosaicplasty alone and participated in the same twelve-week two-phase rehabilitation regimen. Meanwhile, Group 3 (n = 12) underwent mosaicplasty and underwent a shorter six-week one-phase rehabilitation program. Clinical assessments were performed using the visual analog scale (VAS) for pain, goniometry for the knee's range of motion (ROM), manual muscle testing (MMT) for quadricep strength, and the Western Ontario and McMaster University Arthritis Index (WOMAC) for functional evaluation in three test phases. Significant differences in WOMAC scale scores were observed between the three groups at the intermediate (F(2, 34) = 5.24, p < 0.010) and final (F(2, 34) = 111, p < 0.000) stages, with post hoc Tukey tests revealing variations shared among all three groups. The between-group analysis of the VAS scale demonstrated no statistically significant difference initially (F(2, 34) = 0.18, p < 0.982), but significant differences emerged following the intermediate (F(2, 34) = 11.40, p < 0.000) and final assessments (F(2, 34) = 59.87, p < 0.000), with post hoc Tukey tests revealing specific group variations, notably between Group 1 and both Group 2 and Group 3, and also between Group 3 and Group 2. The between-group analysis of quadricep muscle strength using MMT scores revealed no statistically significant differences initially (F(2, 34) = 0.376, p < 0.689) or following the intermediate assessment (F(2, 34) = 2.090, p < 0.139). The one-way ANOVA analysis showed no significant difference in the knee ROM initially (F(2, 34) = 1.037, p < 0.366), but significant differences emerged following intermediate (F(2, 34) = 9.38, p < 0.001) and final assessments (F(2, 34) = 11.60, p < 0.000). Post hoc Tukey tests revealed significant differences between Groups 1 and 2, Groups 1 and 3, and Groups 2 and 3 at intermediate and final assessments. The patients who received BMAC augmentation and completed a 12-week rehabilitation protocol had significantly better outcomes in pain relief, knee function, and ROM when compared to those who did not receive BMAC augmentation or those who completed a shorter rehabilitation period. Our findings suggest that combining mosaicplasty with BMAC augmentation and a comprehensive rehabilitation program can lead to superior clinical outcomes for patients with chondral defects in the knee.

Shoulder Instability–Return to Sports After Injury Scale Shows That Lack of Psychological Readiness Predicts Outcomes and Recurrence Following Surgical Stabilization

PurposeThis study aimed to evaluate the predictive ability of psychological readiness to return to sports on clinical outcomes and recurrences in athletes who return to sports following shoulder instability surgery. MethodsA retrospective analysis was performed of patients who underwent shoulder instability surgery between September 2020 and October 2021 (arthroscopic Bankart repair or Latarjet procedure) with a minimum follow-up of 2 years. Patients were grouped according to the achievement of psychological readiness to return to play using the SIRSI scale (≥ 55 points) measured at 6 months following surgery. Recurrences were measured and functional outcomes were evaluated by the Visual Analogue Scale (VAS), Rowe, and Athletic Shoulder Outcome Scoring System (ASOSS). The minimal clinically important difference (MCID) for the VAS and Rowe scores was calculated using the distribution-based method of ½ standard deviation of the delta (difference between postoperative and preoperative scores). The patient acceptable symptomatic state (PASS) for the VAS scale was set at 2.5 based on previous literature. To evaluate the predictive ability of SIRSI a regression model analysis and a receiver operating characteristic (ROC) curve were used. ResultsA total of 108 who achieved psychological readiness (PSR) and 41 who did not (NPSR) met the study criteria. PSR achieved significantly higher percentages of MCID and PASS thresholds for VAS than NPSR (MCID: 68.5% vs 48.7%, p=0.026; PASS: 92.5% vs 58.5%, p<0.001). However, there were no differences in the percentage of patients achieving MCID for the Rowe score between groups (98.1% vs 100%, p=0.999). The only strongest independent predictor of postoperative outcomes was being psychologically ready to return to sports. The SIRSI scale had an excellent predictive ability for recurrences (area under curve 0.745, 95% CI 0.5-0.8). Of those who sustained a recurrence, 20% were not psychologically ready compared to 4.3% who were (p= 0.002). A power analysis was not conducted for this study. ConclusionThe SIRSI scale is associated with postoperative clinical outcomes and recurrences in patients who returned to sports following shoulder instability surgery. Patients who were not psychologically ready following shoulder instability surgery had worse clinical outcomes with fewer patients achieving clinically significant outcomes (PASS and MCID) for pain, and a higher risk of recurrence. Level of EvidenceLevel IV, Retrospective cohort study.

P132 Longitudinal changes in the Scleroderma Health Assessment Questionnaire visual analogue scales in patients with systemic sclerosis: a retrospective cohort study

Abstract Background/Aims The aim was to examine the course, impact of baseline predictors, and relationship with functional ability, of the six Scleroderma Health Assessment Questionnaire (SHAQ) visual analogue scales (VAS) over time in patients with SSc. Methods A retrospective analysis of patients attending annual review visits at a tertiary SSc center between 2005 and February 2020. Linear Mixed-effect models were used to assess longitudinal trajectories and effect of potential prognostic factors on the six different SHAQ VAS, except finger ulcers where the VAS scale was dichotomised (presence/absence) and analysed using a random intercept logistic regression model. To assess whether longitudinal changes in SHAQ VAS correlated with the HAQ-DI/11-point scleroderma functional index, we obtained the gradients of individual linear regression models, overall and by disease type. Results 537 patients (75% lcSSc) with at ≥ 2 available time-points were included. Mean follow-up time and number of review visits were 6.8 (SD = ±4.2) years 6.4 (SD = ±3.7) visits, respectively. The mean (SD) RP and disease duration (defined as the first non-RP symptom) were 7.6 (11.9) and 8.0 (8.2) years, respectively. Time-in-study (Table 1) was associated with increase in VAS intestinal (p = 0.004), overall disease (p = 0.001) and presence of ulcers (p = 0.013). There was a trend observed concerning RP VAS (p = 0.068) and VAS breathing (p = 0.074), and no difference with VAS pain (p = 0.183). Time since RP onset showed a significant negative association with VAS pain (b=-0.01, [95%CI= -0.01 to 0.00], p = 0.032). Age had a significant negative effect on intestinal VAS (b=-0.01 [95%CI= -0.01 to -0.00], p = 0.040). Presence of ulcers increased with disease duration (OR = 0.97 [95%Cl= 0.94 to 1.00], p = 0.026), and in those with diffuse disease (OR = 0.54 [95%CI= 0.31 to 0.95], p = 0.033). For patients who were anti-RNP positive (compared to negative), the overall disease score VAS was higher (b = 0.23, 95%Cl= 0.00 to 0.45, p = 0.048) higher. All correlations between SHAQ VAS scales and function (HAQ-DI and 11-point scleroderma functional index) were positive (Table 2), and were almost exclusively stronger in patients with diffuse disease. Conclusion Longitudinal assessment of the SHAQ VAS scales provides important insights into disease trajectory. We have identified baseline factors associated with VAS outcomes, and associations with function over time. Disclosure M. Hughes: None. Y. Sylvestre: None. J. Manning: None. M. Mandzuk: None. M. Samaranayaka: None. G. Dinsdale: None. A. Herrick: None.

Value of Spinal Infection Treatment Evaluation Score, Pola Classification, and Brighton Spondylodiscitis Score from Decision to Surgery in Patients with Spondylodiscitis: A Receiver-Operating Characteristic Curve Analysis.

This was a retrospective study. This study aimed to assess the value of the Spinal Infection Treatment Evaluation (SITE) score, Brighton Spondylodiscitis Score (BSDS), and Pola classification to predict the need for surgical intervention in patients with spondylodiscitis. Spondylodiscitis is a rare disease, and the prediction of its outcome is crucial in the decision-making process. All case records were assessed to extract information on the American Spinal Injury Association (ASIA), Visual Analog Scale (VAS), and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores before and after surgery. The SITE score, Pola classification, and BSDS were recorded. The receiver-operating characteristic (ROC) curve analysis and the area under the curve (AUC) were applied to estimate the predictive ability of the scoring systems. Patients' satisfaction with surgery outcomes was evaluated using the VAS, ASIA, JOABPEQ, and Likert scale for quality-of-life evaluation. In all 148 patients, case records were reviewed. The mean±standard deviation age of the patients was 54.6±14.7 years. Of these, 112 patients underwent surgery. The AUC scores were 0.86, 0.81, and 0.73 for the SITE score, BSDS, and Pola classification, respectively. In the comparison of the AUC of ROC curves, SITE score vs. BSDS showed a significantly greater AUC, 0.13 (Z =2.1, p =0.037); SITE score vs. Pola classification, 0.05 (Z =0.82, p =0.412); and Pola classification vs. BSDS, 0.08 (Z =1.22, p =0.219). The optimal cutoff score was 8.5 (sensitivity, 80.6%; specificity, 81.2%) for the SITE score and 9.5 (sensitivity, 52.8%; specificity, 83.0%) for the BSDS in the decision to surgery. VAS back pain and JOABPEQ subscales showed a significant difference when compared with preoperative scores. According to ASIA grading, none of the patients experienced neurological deterioration. Overall, patients' satisfaction was observed. The findings suggest that the SITE score is a useful measure and helps clinicians make clinically sound decisions in patients with spondylodiscitis.

Impact of Minimally Invasive Intra-Capsular Metatarsal Osteotomy on Plantar Pressure Decrease: A Cross-Sectional Study.

Background: Metatarsalgia is a common pathology that is initially treated conservatively, but failure to do so requires surgery, such as the minimally invasive distal metatarsal osteotomy (DICMO). Methods: In this prospective study of 65 patients with primary metatarsalgia who underwent DICMO, plantar pressures, American Orthopaedic Foot and Ankle Society MetaTarsoPhalangeal-InterPhalangeal scale (AOFAS-MTP-IP) and Visual Analog Scale (VAS) were evaluated pre-operatively and post-operatively and there was a subgroup in which an inclinometer was used to observe the importance of the inclination of the osteotomy. Results: The results show a significant reduction in plantar pressures after DICMO surgery without overloading the adjacent radii, especially in the subgroup with an inclinometer to guide the osteotomy. The AOFAS-MTP-IP scale evidenced a marked improvement in metatarsal function and alignment with scores close to normal. The VAS scale showed a substantial decrease in pain after DICMO osteotomy. Conclusions: DICMO, with an inclinometer for a 45° osteotomy, proved to be a safe and effective procedure for primary metatarsalgia, although further comparative studies are needed to confirm its superiority.

Totally intracorporeal colorectal anastomosis (TICA) versus classical mini-laparotomy for specimen extraction, after segmental bowel resection for deep endometriosis: a single-center experience

PurposeThe surgical approach to bowel endometriosis is still unclear. The aim of the study is to compare TICA to conventional specimen extractions and extra-abdominal insertion of the anvil in terms of both complications and functional outcomes.MethodsThis is a single-center, observational, retrospective study conducted enrolling symptomatic women underwent laparoscopic excision of deep endometriosis with segmental bowel resection between September 2019 and June 2022. Women who underwent TICA were compared to classical technique (CT) in terms of intra- and postoperative complications, moreover, functional outcomes relating to the pelvic organs were assessed using validated questionnaires [Knowles-Eccersley-Scott-Symptom (KESS) questionnaire and Gastro-Intestinal Quality of Life Index (GIQLI)] for bowel function. Pain symptoms were assessed using Visual Analogue Scale (VAS) scores.ResultsThe sample included 64 women. TICA was performed on 31.2% (n = 20) of the women, whereas CT was used on 68.8% (n = 44). None of the patients experienced rectovaginal, vesicovaginal, ureteral or vesical fistula, or ureteral stenosis and uroperitoneum, and in no cases was it necessary to reoperate. Regarding the two surgical approaches, no significant difference was observed in terms of complications. As concerns pain symptoms at 6-month follow-up evaluations on stratified data, except for dysuria, all VAS scales reported showed significant reductions between median values, for both surgery interventions. As well, significant improvements were further observed in KESS scores and overall GIQLI. Only the GIQLI evaluation was significantly smaller in the TICA group compared to CT after the 6-month follow-up.ConclusionsWe did not find any significant differences in terms of intra- or post-operative complications compared TICA and CT, but only a slight improvement in the Gastro-Intestinal Quality of Life Index in patients who underwent the CT compared to the TICA technique.