Wiley
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* Dữ liệu chỉ mang tính chất tham khảo
To assess the literature on outcomes of corticosteroid injections for adhesive capsulitis, and, in particular, image‐guided corticosteroid injections.
Systematic search and review.
The databases used were PubMed (1966‐present), EMBASE (1947‐present), Web of Science (1900‐present), and the Cochrane Central Register of Controlled Trials. Upon reviewing full‐text articles of these studies, a total of 25 studies were identified for inclusion. The final yield included 7 prospective studies, 16 randomized trials, and 2 retrospective studies.
This systematic review was formatted by using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Study criteria were limited to clinical trials, prospective studies, and retrospective studies that specifically evaluated intra‐articular corticosteroid injections, both alone and in combination with other treatment modalities, for shoulder adhesive capsulitis. We included studies that were not randomized control trials because our review was not a meta‐analysis. Data items extracted from each study included the following: study design, study population, mean patient age, duration of study, duration of symptoms, intervention, single or multiple injections, location of injections, control population, follow‐up duration, and outcome measurements. A percentage change in outcome measurements was calculated when corresponding data were available. Risk of bias in individual studies was assessed when appropriate.
All the studies involved at least 1 corticosteroid injection intended for placement in the glenohumeral joint, but only 8 studies used image guidance for all injections. Seven of these studies reported statistically significant improvements in range of motion at or before 12 weeks of follow‐up. Ninety‐two percent of all the studies documented a greater improvement in either visual analog pain scores or range of motion after corticosteroid injections in the first 1‐6 weeks compared with the control or comparison group.
Corticosteroid injections offer rapid pain relief in the short‐term (particularly in the first 6 weeks) for adhesive capsulitis. Long‐term outcomes seem to be similar to other treatments, including placebo. The added benefit of image‐guided corticosteroid injections in improving shoulder outcomes needs further assessment.
Competitive sports for people with disabilities has grown rapidly over the past several decades, and opportunities for participation are increasingly available throughout the spectrum from developmental to elite. The Paralympic Games, seen as the pinnacle sporting event that represents the broader Paralympic Movement, has provided a platform to showcase the abilities of people with disabilities while also serving as a catalyst for disability rights through ensuring integration, equality of opportunity, and accessibility of the built environment. Concurrently, media coverage of the Paralympic Games has led to an increased awareness of opportunities for sport participation for individuals with disabilities and, with it, the adjustment of norms regarding expectations for exercise as a component of preventive health. In addition, there is evidence of the power of sports to stimulate confidence, self‐efficacy, and a self‐perceived high quality of life for individuals with disabilities above and beyond the basic benefits to cardiometabolic fitness. When taken together, the promotion of health, disability rights, and social integration through sports has the power to transform the lives of those who participate and to further stimulate the expansion of opportunities available to the next generation of athletes with disabilities.
Recently, investigators began using radiofrequency to manage knee osteoarthritis pain in patients at high risk who cannot undergo surgical intervention. To our knowledge, no study has investigated the use of radiofrequency ablation of the genicular nerves to alleviate chronic knee pain after total knee replacement. A single case is presented here in which genicular nerve ablation successfully improved pain and restored function. We believe that these preliminary results could be used in the development of future prospective cohort studies and randomized controlled trials that focus on the use of radiofrequency ablation to treat persistent knee pain after total knee replacement.
The purpose of this open‐label study was to assess the effectiveness and tolerability of levetiracetam (LEV) in the treatment of patients with lower lumbar radiculopathy diagnosed by clinical presentation, physical examination, and electrodiagnostics.
Open‐label, forced titration, prospective cohort intent‐to‐treat analysis.
Major teaching hospital.
Participants were recruited from the university pain clinic and through referrals from the community. Subjects were eligible to participate if they (1) were older than 18 years, (2) had leg pain greater than back pain, (3) had been symptomatic for 6 months and <5 years, (3) had a baseline visual analog scale of at least 6 on the 0‐10 scale, (4) had undergone lumbar spine magnetic resonance imaging within the last 12 months that showed no surgically correctable etiology for their radicular symptoms, and (5) had undergone electrodiagnostics that was positive for lumbar radiculopathy (L4, L5, or S1 nerve roots). Twenty‐six patients were enrolled, and 24 (92.3%) completed the study.
Patients initially received LEV 500 mg twice a day for 2 weeks. Dosages were then increased to 750 mg twice day for 2 weeks, and then to 1500 mg twice a day for the remainder of the study. Patients were observed for 8 weeks after reaching the maximum dose.
Treatment effectiveness was assessed with the use of biweekly brief pain inventory and patient global assessment scales. Frequency and severity of adverse events were recorded.
The mean biweekly worst and average pain scores decreased from 7.17 and 6.27 at baseline to 4.2 and 3.9, respectively, at week 12 (
This study showed that LEV might be a well‐tolerated and effective treatment for lumbar radiculopathy. A large randomized placebo‐controlled trial is recommended and comparative studies with alternative agents should be sought.
To introduce a noninvasive method for electrodiagnostic evaluation of the infrapatellar nerve (IPN).
A prospective cohort study.
Electrodiagnostic laboratory, rehabilitation department, Hadassah University Hospital.
A total of 38 healthy adults; 57 asymptomatic limbs were studied.
Sensory nerve action potential of the IPN was recorded with surface electrodes placed 2.5 cm below the distal pole of the patella and 2 cm medially from the medial border of the patellar tendon. Transcutaneous antidromic electrical stimulation of IPN was applied above the medial femoral condyle and 8‐10 cm proximally from the active surface electrode.
The sensory nerve action potential mean (n = 38) onset latency was 1.69 ± 0.32 ms. Peak latency was 2.36 ± 0.47 ms, and amplitude was 6.96 ± 3.68 μV.
This article describes a novel and simple technique for IPN conduction electrodiagnostic examination. The method used provides a new tool to evaluate IPN injury in reference to anterior or inferior knee pain with associated sensory deficit.
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