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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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

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

Abstract
Background. Back problems become a medical and social problem in the era of modern civilization. Wide variety of pain syndromes, their recurrent character and persisting pain in chronic cases prompts the search for effective diagnostic and therapeutic methods. The aim of the study was to compare the effectiveness of two spa therapy programs in alleviating pain and eliminating functional limitations in office workers with degenerative disease of the cervical spine.
Material and methods. The study involved 144 office workers aged 45-55, staying on a rehabilitation stay due to pain in the cervical spine caused by degenerative changes. Patients were divided into two groups depending on the rehabilitation programme administered. Research tools was functional tests of the cervical spine (Valsalva, Kernig, compression test and traction test), linear measurements of ranges of cervical spine, NRS scale and NDI questionnaire. The data were analyzed based on the Chi-square test, Student t test, Mann Whitney U test, Wilcoxon test.
Results. In both groups, after improvement, a statistically significant improvement was noted in terms of functional test results, cervical spine movement ranges, NRS scale values and NDI index. The differences in the results obtained in Test II in relation to I were significantly greater for patients from group I. The application of both therapeutic programs had an effect on alleviating pain and improving functional capacity.
Conclusions. Application of both programs contributed to the relief intensity of pain and improved functional capacity, however, the extent of improvement was significantly greater in the case of patients subjected to a program containing mud therapy.

Key words:
cervical spine, pain, functional capacity, balneotherapy

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Comparison of the effectiveness of physical treatments with central stabilization training in the treatment of patients with lower back pain syndrome

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

Abstract
Introduction. Spinal pain syndromes have become a social problem. Among the many factors causing pain, the most frequently mentioned are: congenital anomalies, degenerative changes, inflammations, neoplastic diseases, injuries, overload pains, metabolic disorders, psychological problems, social problems. In the treatment of back pain, kinesitherapy, physiotherapy and pharmacological treatment are most commonly used.
Purpose of research. Comparison of the effectiveness of physical treatments with central stabilization training in the treatment of patients with low back pain syndrome.
Material and methods. The study was performed on a group of 40 patients (22 women and 18 men) with diagnosed lower back pain syndrome. The subjects were assigned to two groups. Group A has undergone a series of treatments in the field of physical therapy. Group B performed central stabilization training without using physical therapy. Before the beginning of the treatments and after the end of rehabilitation, the degree of pain and their impact on everyday life comfort were assessed using the Oswestry questionnaire (ODI) and the VAS scale.
Results of the research. There was no significant difference in the results regarding the subjective assessment of pain in the lower spine, verified with the VAS scale. In both groups a highly significant (p <0.01) drop in pain sensations after therapies in relation to the results from the pre-therapy period was observed. There was no significant difference in the results of daily living comfort verified by the ODI questionnaire depending on the research group (p <0.05). Highly significant (p <0.01) difference concerns the comparison of results before and after therapy in two groups. None of the applied therapies shows greater effectiveness in improving the comfort of everyday life, despite the fact that both therapies in the assessment of patients improve this comfort.
Conclusions. Central stabilization exercises are an effective alternative to widely used physiotherapeutic procedures in the treatment of lower back pain syndrome or should be effectively complemented. Our own studies did not show unambiguously higher effectiveness of physical treatments in relation to the concept of central stabilization exercises.

Key words:
core stabilization, pain, lumbar section, physical therapy

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