Transcutaneous electrical nerve stimulation in low back pain treatment

Barbara Ratajczak, Ewa Boerner, Arletta Hawrylak, Aneta Demidaś

Barbara Ratajczak, Ewa Boerner, Arletta Hawrylak, Aneta Demidaś – Transcutaneous electrical nerve stimulation in low back pain treatment. Fizjoterapia Polska 2008; 8(2); 179-188

Abstract
Background. The aim of this study was to assess the effectiveness of TENS and its impact on pain intensity, mobility range and functional capacity of the spine in subjects with a diagnosed lumbar discopathy. Material and methods. The study group consisted of 40 patients with a diagnosed lumbar discopathy. This group was subjected to TENS therapy. The intensity of pain, functional status and mobility range of the lumbar spine in the sagittal, frontal and transverse planes were assessed in all patients before and after the therapy.Results. The results indicate that functional capacity correlates significantly with pain level. The sensation of pain is the main determinant of patients’ physical and mental well-being. It is reflected both in differences in pain level owing to TENS (the patients’ physical and mental state was getting better along with decreasing pain level) and in the values of this parameter before and after the TENS therapy. The observed differences were statistically significant, allowing the conclusion that functional capacity correlates significantly with pain intensity.Conclusion. Pain intensity decreased considerably under the influence of TENS, which also had a marked effect on increasing lumbar flexion range in the sagittal plane. The patient’s functional capacity improved significantly with TENS and, consequently, so did their general physical and mental well-being.
Key words:
discopathy, transcutaneus electrical nerve stimulation, pain, functional fitness test
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Practical aspects of the sensory and modulatory function of nociceptors

Maciej Pawlak

Maciej Pawlak – Practical aspects of the sensory and modulatory function of nociceptors. Fizjoterapia Polska 2008; 8(2); 115-127

Abstract
Our rapidly increasing knowledge of neurobiology provides new information that helps understand the nature of pain. Nociceptors, the most component of the nociceptive system, are no longer regarded as structures whose only task is to register noxious stimuli. Nociceptors are also known to be actively involved in inflammatory processes occurring within their environment and have a modulatory function owing to the release of inflammatory transmitters and neuropeptides.An insight into the molecular principles of activation has made it possible to understand transduction processes resulting from activation of membrane channels and receptors by different stimuli and the associated activation of intracellular signalling processes. An understanding of nociceptor sensitization mechanisms and the role of pro- and anti-inflammatory factors enables the selection of specific pharmacological or mechanoprotective drugs which increase the sensitivity threshold of nociceptors or prevent their sensitization.More information about the structure and function of nociceptors, and particularly factors which determine the detection of various sensory stimuli, such as warmth or cold, could shed new light on the role of some physiotherapeutic procedures in pain modulation. On the basis of our own experience and literature reports, we present a review of state-of-the-art knowledge in this area.
Key words:
nociceptor, pain, modulation, neuropeptides, sensitization
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Factors influencing the incidence of shoulder pain in post-stroke patients

Teresa Pop, Agnieszka Dziedzic, Katarzyna Łach-Pop

Teresa Pop, Agnieszka Dziedzic, Katarzyna Łach-Pop – Factors influencing the incidence of shoulder pain in post-stroke patients. Fizjoterapia Polska 2010; 10(2); 103-112

Abstract
Pain and functional impairment of the paretic shoulder are a frequent complication in post-stroke patients. The pain is mostly localised to the glenohumeral joint, but sometimes radiates to the upper arm and, infrequently, to the forearm. The paper aims at assessing the incidence of shoulder joint pain in post-stroke patients, and at investigating the predisposing factors. Material and method. The study group consisted of 81 stroke survivors (41 females and 40 males) hospitalized due to stroke in the Stroke Unit of the Neurology Ward and in the Rehabilitation Ward.The study used a questionnaire to obtain characteristics of the study group, a VAS scale to assess pain intensity, as well as the Ashworth scale and Barthel index. Shoulder joint pain occurred in 58% of the participants. Mean pain intensity was 5 according to the VAS scale. Muscle tone in the upper extremity in the study group averaged at 2 in the Ashworth scale. Among those suffering from shoulder pain, 53% experienced it in the morning.
Key words:
stroke, complications, shoulder, pain
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Efficacy of Ultrasound therapy versus conventional therapy on reducing multiple components of neuropathic pain in diabetic neuropathic patients – comparative study

Amany Gomaa Atiaa, Osama Fekry Al Balah, Khaled A Hameed Mostafa, Dina Nabil Abas, Heba Hazaa Abd El Wahab

Amany Gomaa Atiaa, Osama Fekry Al Balah, Khaled A Hameed Mostafa, Dina Nabil Abas, Heba Hazaa Abd El Wahab – Efficacy of Ultrasound therapy versus conventional therapy on reducing multiple components of neuropathic pain in diabetic neuropathic patients – comparative study. Fizjoterapia Polska 2021; 21(2); 154-158

Abstract
Background. As diabetic neuropathic pain is associated with various forms of pain sensations. This study was conducted to evaluate the efficacy of adding Ultrasound therapy (US) versus conventional medication only on variety of pain sensation in diabetic neuropathic patients. Materials and Methods. Thirty patients with diabetic neuropathy were recruited from diabetic clinic at Zagazig University Hospital. The Patients were randomly divided into two equal groups: group A [received US therapy beside the traditional medication] and group B (control group that received traditional medication only). Visual analog scale (VAS) and Neuropathic pain scale (NPS) were used for pain assessments. All assessments were conducted pre-treatment and eight weeks post treatment. Result. there was a significant reduction of VAS score, NPSQ1, NPSQ2, NPSQ3, NPSQ4, NPSQ6, NPSQ9, NPSQ10 deep (p < 0.05) at post treatment in compared to pre-treatment for group A. While there was a significant reduction of NPSQ4 (p < 0.05) at post treatment in compared to pre-treatment for group B. Conclusion. US therapy is an effective therapeutic modality in decreasing various forms of pain in diabetic neuropathic patients.
Key words:
pain, diabetic neuropathy, ultrasound, neuropathic pain scale
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Effect of Extracorporeal Shock Wave Therapy on Pain Intensity, Functional Abilities, and Trunk Range of Motion in Patients with Chronic Lumbar Disc Prolapse: A Randomized Clinical Trial

Shaima M. Abdelmageed, Nagwa Ibrahim Rehab, Marwa M Mahfouz, Manal Bakry Abd El Fatah, Dina O. Galal, Mahmoud Y. Elzanaty

Shaima M. Abdelmageed, Nagwa Ibrahim Rehab, Marwa M Mahfouz, Manal Bakry Abd El Fatah, Dina O. Galal, Mahmoud Y. Elzanaty – Effect of Extracorporeal Shock Wave Therapy on Pain Intensity, Functional Abilities, and Trunk Range of Motion in Patients with Chronic Lumbar Disc Prolapse: A Randomized Clinical Trial. Fizjoterapia Polska 2021; 21(2); 116-120

DOI: https://doi.org/10.56984/8ZG0DD311

Abstract
Objectives. This research aimed to assess the impact of extracorporeal shock wave therapy (ESWT) on pain severity, functional abilities, and trunk range of motion in patients with lumbar disc prolapse (LDP). Methods. Design of study was randomized clinical study. Forty male patients had disc prolapse at L5–S1 spine segment with chronic pain. Patients have been randomly divided to two equal groups. The patients in study group received extracorporeal shock wave therapy (ESWT) in addition to conventional physical therapy program. Patients in control group were treated with the conventional physical therapy program which composed of electrotherapy using TENS (15 minutes) and exercise program. Visual analogue scale (VAS) was used to evaluate pain. Functional disability was evaluated by Oswestry disability index (ODI). The Back range of motion device (BROM) has been utilized to measure trunk motion (flexion, extension, side bending, external and internal rotation). For all patients prior to and after six weeks of the therapy program, all outcome measures were evaluated. Results. In the research and control groups, there was a substantial reduction in post-treatment VAS and ODI as compared to pre-therapy (p > 0.001). In both groups, there was a substantial increase in post-therapy ROM compared to pre-therapy (p > 0.001). The comparison among the study and post-therapy control groups showed a substantial decrease in the study group’s VAS and ODI relative to the control group (p > 0.001). There was also a substantial increase in the study group’s trunk flexion, extension, and rotation relative to that of the control group (p > 0.01). Conclusion. The ESWT had a significant analgesic effect and improved functional abilities relative to the conventional physiotherapy program in patients with LDP. Also ESWT had substantial enhancements in trunk ROM relative to conventional physiotherapy.
Key words:
extracorporeal shock wave therapy, lumbar disc prolapse, functional ability, pain
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Pain among women with primary dysmenorrhea

Aneta Kościelny, Aneta Dąbek, Witold Rekowski

Aneta Kościelny, Aneta Dąbek, Witold Rekowski – Pain among women with primary dysmenorrhea. Fizjoterapia Polska 2021; 21(2); 84-92

Abstract
Objective. The objective of the study was to assess pain in a group of women with primary dysmenorrhea (PD) and to identify factors that may affect pain intensity. Material and methods. The study involved 336 women with PD symptoms, aged 18–35 years (mean age 23 ± 3.7). The study was conducted using an extensive online questionnaire. The research tools were: the authors’ questionnaire, the NRS numerical pain rating scale, the IPAQ International Physical Activity Questionnaire – short version and the PSS-10 scale of perceived stress. Results. Based on the conducted analysis, a high level of menstrual pain was observed in 64.6% of the women participating in the study. There was no significant correlation between the level of physical activity and pain (p = 0.280). The correlation between physical activity and the duration of menstruation was statistically significant (p = 0.05), as was the correlation between stress and pain (p = 0.05). BMI, pelvic position and body type did not correlate with menstrual pain (p > 0.05). Conclusions. 1. Most of the women participating in the study experienced high levels of pain in the lower abdomen in the first two days of menstruation. 2. Physical activity did not affect pain in the case of the women participating in the study, neither did: BMI, waist circumference, body type or pelvic position. 3. The high level of stress intensified pain in women with PD.
Key words:
pain, primary dysmenorrhea, physical activity
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Analgesic effect of static magnets – efficacy according to evidences

Piotr Tederko, Marek Krasuski

Piotr Tederko, Marek Krasuski – Analgesic effect of static magnets – efficacy according to evidences. Fizjoterapia Polska 2011; 11(4); 289-301

Abstract
Alternative and complimentary modes of treatment gain popularity and compete with evidence based therapies. Deve­lopment of alternative methods is enhanced by the demands of the market of medical devices designed for home treatment without need of a physician’s consultation. Application of devices with static magnets is advertised as a safe and effective pain therapy. The purpose of the paper is to analyze scientific evidence of efficacy and safety of static magnetic fields (SMF) applied as therapeutic modality for pain. Survey of peer-reviewed scientific publications resulted in identification of 45 papers including 40 primary publications and 5 meta-analyses. 4 original studies were excludes as uncontrolled trials or case studies. One paper was disqualified because of simultaneous application of alternating magnetic field. Among randomized controlled trials on clinical applications of SMF against pain 10 support hypothesis of analgesic effect of SMF, 9 neither confirm nor exclude therapeutic efficacy of SMF, and 16 give the evidence against SMF superiority over placebo. Frequent failure to blind the study, small sample sizes, short follow-up period limit evidence value of the analyzed results. Expectations resulting from frequent sponsorship of studies by manufacturers of SMF equipment appear to influence the objectivity of several conclusions. SMF of inductances within the range of those used in analyzed devices are not classifiable due to their potential risk of chronic exposure by inconclusive evidence. According to theoretical deliberations, pregnancy, infancy, pacemakers, ferromagnetic implants and application of electronic devices regulating life functions are considered contraindi­cations for the use of therapeutic devices emitting SMF. The current state of knowledge does not allow for unambiguous confirmation of SMF therapeutic efficacy. Devices for therapy with SMF should not be sold as analgesic modalities before evidence of efficacy and safety in each particular indication is confirmed.
Key words:
static magnets, medical devices, Pain, Analgesia
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The Influence of Photobiomodulation on Pain and Knee Swelling in Patients Post Knee Arthroplasty

Ahmed Mahmoud Nasr Tolba, Rania N. Karkousha, Fatma Seddek Amin, Adham ARE Elgeidi

Ahmed Mahmoud Nasr Tolba, Rania N. Karkousha, Fatma Seddek Amin, Adham ARE Elgeidi – The Influence of Photobiomodulation on Pain and Knee Swelling in Patients Post Knee Arthroplasty. Fizjoterapia Polska 2021; 21(1); 114-118

Abstract
Purpose. This study aimed to investigate the effect of Photobiomodulation on pain and immediate swelling after knee arthroplasty. Materials and Methods. 40 patients with knee arthroplasty participated in this study. Their ages ranged from 50-70 years. They were assigned randomly into two equal groups; control and study groups. Control group received intensive functional rehabilitation program only. Study group received a laser dose of 6 J/cm2 at the surgical incision, medial and lateral femoral condyle, patellar up and down, and popliteal space with 650 nm continuous wave, 60 seconds/point with total dose of 48J each session and intensive functional rehabilitation program. All patients received 12 treatment sessions in six weeks. The pain was measured by pressure algometer and level of knee swelling was measured by tape measurement. Results. Both groups showed significant difference in all variables between pre and post treatment (P < 0.05). Regarding between groups pretreatment statistics, no significant difference was found in level of knee swelling (P > 0.05) and significant difference in level of pain intensity (P < 0.05). While post treatment statistics showed significant difference in pain and knee swelling (P < 0.05). Conclusion. Photobiomodulation is effective in improving pain and knee swelling after knee arthroplasty. Also, it can be concluded that adding photobiomodulation to rehabilitation program after knee arthroplasty gives more improvement in level of pain and knee swelling.
Key words:
photobiomodulation, pain, swelling, knee arthroplasty
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对因退行性变化过程中产生颈椎疼痛的上班族所进行的两种水疗法的疗效比较

Ewa Puszczałowska-Lizis, Kamila Dobrucka, Izabela Zbrońska

E. Puszczałowska-Lizis, K. Dobrucka, I. Zbrońska – Comparison of the effectiveness of two health resort therapy programs in office workers with the pain in the cervical spine occurring in the course of degenerative changes. Fizjoterapia Polska 2019; 19(4); 126-135

摘要
简介。在现代文明时代,腰椎病痛成为医学和社会问题,在慢性病中的多种疼痛综合症、复发性质和疼痛持续性促使人们去寻求有效的诊断和治疗方法。研究目的在比较两种水疗法对减轻上班族颈椎退行性疾病的疼痛和消除功能限制方面的有效性。
材料和方法。共144名年龄在45-55岁间的女性上班族参与研究,她们参与退行性变化过程中所产生颈椎疼痛的康复治疗。根据所应用的康复计划不同,这些女患者被分成两组。实验工具包括颈椎功能测试(Valsalva、Kernig、压缩测试及牵引测试)、颈椎活动范围的线性测量、NRS量表及NDI指数等。分析时所采取的测试包括:卡方检验、学生 t检定、曼-怀-威三氏检验等。
结果。两组康复治疗结束后,在功能测试、颈椎活动范围、NRS标度值及NDI指数方面均观察到具统计学意义的显著改善。第二组患者所取得的研究结果差异比第一组更大。
结论。两种治疗计划的使用均有助于减轻疼痛并改善功能效率,然而接受包含泥疗法在内计划的患者所获得的改善程度更大。

关键词:
颈椎、疼痛、功能效率、浴疗法

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下腰痛综合症患者治疗采用物理疗法及中枢稳定训练的疗效比较

Paweł Gąsior

P. Gąsior – Comparison of the effectiveness of physical treatments with central stabilization training in the treatment of patients with lower back pain syndrome. Fizjoterapia Polska 2019; 19(4); 80-91

摘要
简介。腰椎疼痛已成为社会性的问题,最常被提及的疼痛出现原因为以下各项:天生异常、退行性变化、炎症、癌症、受伤、超负荷疼痛、代谢紊乱、心理问题和社会问题等。腰痛治疗中最常使用运动疗法、物理治疗和药物治疗。
研究目的。下腰椎疼痛综合症患者治疗采用物理疗法及中枢稳定训练的疗效比较
材料和方法。该研究针对有下腰痛症状的40名患者进行(其中包括22名女性及18名男性),受试者被分为两组,A组接受一系列的物理治疗,B组进行中枢稳定训练,不包含物理治疗。治疗开始前及康复结束后,使用欧氏问卷调查表(ODI)及VAS量表评估疼痛程度及其对日常生活的影响。
研究结果。关于以VAS量表验证下腰疼痛主观评估的结果无显著差异,与治疗前的结果比较,两组在治疗后的疼痛感均显著降低(p < 0.01)。根据实验组的不同,ODI问卷调查证实在日常生活的舒适性上无显著差异(p < 0.05),两组治疗前后的结果比较有显著差异(p < 0.01)。尽管患者肯定此二种治疗对舒适度有所改善,然而皆无法更有效地改善日常生活的舒适度。
结论。中枢稳定练习在治疗下腰痛综合症所广泛采用的物理治疗中为有效的替代方法,或应有效地加以补充。自有研究明确显示出,物理治疗与中枢稳定练习概念比较下,并非更有效。

关键词:
中枢稳定、疼痛、腰椎区、物理治疗

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