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Clinical outcomes of running with FAST and contour stimulation in the spinal cord stimulation therapy trial only in Japan 仅在日本进行的脊髓刺激疗法试验中,使用 FAST 和轮廓刺激法跑步的临床结果
Pub Date : 2024-07-02 DOI: 10.15406/ipmrj.2024.09.00379
Hiroyuki Maeda, Mutsuhiro Maeda, Takahiro Maeda
Purpose: Using Fast-Acting Sub-Perception (FAST) and Contour Therapy, new stimulation settings for spinal cord stimulation therapy, we investigated whether patients with low back and leg pain were able to run after surgery in Japan. Method: Spinal cord stimulation trial was conducted from 2023 to 2024 and a prospective study was conducted. Fifteen patients (6 male, 9 female) were evaluated on whether they could run after spinal cord stimulation therapy using the average walking time (seconds) when walking 210 cm and the Numerical Rating Scale (NRS) for pain assessment. Patient satisfaction was rated on a 5-point scale, with 5 being very satisfied, 4 somewhat satisfied, 3 normal, 2 somewhat dissatisfied, and 1 very dissatisfied. Sleep quality was rated on a 10-point scale. Statistical t-test was used and P < 0.01 was considered a significant difference. Results: The NRS showed improvement from 10 to 2.72. The average walking time was 3.48 seconds faster. Regarding patient satisfaction, 11 patients were very satisfied, 2 somewhat satisfied, 1 normal, and 1 somewhat dissatisfied. Sleep quality (good 10 to poor 0) improved from an average of 4.8 to 7.3. Twelve patients were able to run. Significant differences were found. Discussion: FAST and Contour stimulation, new stimulation settings in spinal cord stimulation therapy, improved not only low back and leg pain, but also walking ability and sleep quality. We believe that patients feel more motivated and ultimately patients are able to run and patient satisfaction increase. As a new evaluation of spinal cord stimulation therapy, whether patients will be able to run should also be considered in the future.
目的:在日本,我们使用脊髓刺激疗法的新刺激设置--快速作用亚感知(FAST)和轮廓疗法,研究了腰腿痛患者术后能否跑步。研究方法脊髓刺激试验于 2023 年至 2024 年进行,是一项前瞻性研究。对 15 名患者(6 名男性,9 名女性)进行了脊髓刺激治疗后能否跑步的评估,评估采用的方法是步行 210 厘米时的平均步行时间(秒)和用于疼痛评估的数字评定量表(NRS)。患者满意度采用 5 级评分法,5 级为非常满意,4 级为比较满意,3 级为正常,2 级为比较不满意,1 级为非常不满意。睡眠质量按 10 分制评分。采用统计学 t 检验,P < 0.01 为差异显著。结果显示NRS 从 10 分改善到 2.72 分。平均步行时间缩短了 3.48 秒。在患者满意度方面,11 名患者非常满意,2 名比较满意,1 名正常,1 名比较不满意。睡眠质量(好 10 到差 0)从平均 4.8 提高到 7.3。12 名患者能够跑步。结果显示,两者之间存在显著差异。讨论FAST 和 Contour 刺激是脊髓刺激疗法的新刺激设置,不仅改善了腰腿痛,还改善了行走能力和睡眠质量。我们相信,患者会感到更有动力,最终患者能够跑步,患者满意度也会提高。作为脊髓刺激疗法的一项新评估,今后还应考虑患者是否能够跑步。
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引用次数: 0
Anatomophysiological repercussions of the electronic cigarette with emphasis on the respiratory and nervous systems: a narrative review 电子香烟的解剖生理学影响,重点是呼吸系统和神经系统:叙述性综述
Pub Date : 2024-05-10 DOI: 10.15406/ipmrj.2024.09.00376
Maria Eduarda Sales Rocha, Lívia Nogueira Moreira, Maria Júlia Justino Pimenta, Larissa Vitória Polississo, J. P. Pagnossa, Luciana Vasconcelos
An alternative option to conventional cigarettes, electronic cigarettes are being presented as a new habit, especially among the young population. Offering flavors and high concentrations of nicotine, it has already established itself as a choice among teenagers and young people. Since 2019, lung diseases have been described and associated with electronic cigarette use, but data is still scarce. Thus, this review aims to aggregate data on the effects of electronic cigarettes on the respiratory and nervous systems, becoming a source for new research or information for the population.
作为传统香烟的替代选择,电子香烟正在成为一种新的生活习惯,尤其是在年轻人群中。电子香烟提供多种口味和高浓度尼古丁,已经成为青少年和年轻人的一种选择。自 2019 年以来,肺部疾病已被描述并与电子香烟的使用相关联,但数据仍然很少。因此,本综述旨在汇总电子香烟对呼吸系统和神经系统影响的数据,为新的研究或人群信息提供来源。
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引用次数: 0
Outcomes of ECAP-controlled closed-loop spinal cord stimulation therapy in JAPAN: how to increase patient satisfaction with spinal cord stimulation 日本 ECAP 控制闭环脊髓刺激疗法的结果:如何提高患者对脊髓刺激疗法的满意度
Pub Date : 2024-04-10 DOI: 10.15406/ipmrj.2024.09.00373
Hiroyuki Maeda, Mutsuhiro Maeda, Takahiro Maeda
Objective: Orthopedic surgeons commonly encounter patients with low back pain and leg pain. Despite conservative treatment, which may involve the use of weak opioids or NSAIDs, some patients do not experience improvement and may require increased dosages, contributing to concerns about opioid overuse overseas. Spinal cord stimulation (SCS) therapy, which can be trialed without surgical intervention, offers a potential treatment option. We evaluated Inceptiv (Medtronic), a generator that allows new stimulation settings using evoked compound action potentials (ECAPs)-controlled Closed-Loop technology. Methods: We evaluated six patients (four females, two males) who underwent implantation of the Inceptiv generator for SCS therapy. The average walking time (seconds) during a 2.1-meter walk and pain assessment using the Numerical Rating Scale (NRS) were conducted. Patient satisfaction was assessed using a 5-point scale: very satisfied (5), somewhat satisfied (4), neutral (3), somewhat dissatisfied (2), very dissatisfied. (1). Results: The average walking time improved from 11.8 seconds to 6.6 seconds, and the NRS score decreased from 7.6 to 4.2. Patient satisfaction was high, with four patients being very satisfied (5), one somewhat satisfied (4), and one neutral (3). Discussion: SCS therapy with Closed-Loop technology using the Inceptiv generator offers the potential to adjust electrical stimulation to minimize discomfort in daily activities and provide pain relief. It is considered a new treatment option for patients with common orthopedic conditions such as thoracolumbar compression fractures and lumbar spinal stenosis who suffer from chronic refractory pain in routine clinical practice.
目的:骨科医生经常会遇到腰痛和腿痛患者。尽管保守治疗可能涉及使用弱阿片类药物或非甾体抗炎药,但一些患者的病情并没有得到改善,而且可能需要增加剂量,这引起了人们对海外阿片类药物过度使用的担忧。脊髓刺激(SCS)疗法是一种潜在的治疗方案,无需外科手术即可试用。我们对 Inceptiv(美敦力)进行了评估,这是一种利用诱发复合动作电位 (ECAP) 控制闭环技术实现新刺激设置的发生器。方法:我们对接受 Inceptiv 发生器植入 SCS 治疗的六名患者(四名女性,两名男性)进行了评估。采用数字评定量表(NRS)对患者进行了2.1米步行的平均步行时间(秒)和疼痛评估。患者满意度采用 5 级评分法进行评估:非常满意 (5)、比较满意 (4)、中性 (3)、比较不满意 (2)、非常不满意 (1)。(1).结果:平均行走时间从 11.8 秒缩短至 6.6 秒,NRS 评分从 7.6 分降至 4.2 分。患者的满意度很高,4 名患者非常满意(5 分),1 名患者有点满意(4 分),1 名患者持中立态度(3 分)。讨论使用Inceptiv发生器的闭环技术SCS疗法具有调整电刺激的潜力,可将日常活动中的不适感降至最低并缓解疼痛。在常规临床实践中,它被认为是胸腰椎压缩性骨折和腰椎管狭窄症等常见骨科疾病慢性难治性疼痛患者的一种新的治疗选择。
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引用次数: 0
Management of obesity and other metabolic disorders through faecal microbiota transplant technology 通过粪便微生物群移植技术治疗肥胖症和其他代谢性疾病
Pub Date : 2023-07-11 DOI: 10.15406/ipmrj.2023.08.00350
K. Pushkala, PD Gupta
The microbiota regulates health and many diseases both infectious and metabolic. The makeup and density of intestinal microbiota can be influenced by diet and therefore, they play a major role in the development of obesity by regulating energy metabolism. Recent evidence, primarily from investigations from animal models, suggests that the gut microbiota affects nutrient acquisition and energy regulation. Gut microbiota regulates obesity by regulating energy absorption, central appetite, fat storage, chronic inflammation, and circadian rhythms. Several members of phylum Proteobacteria, were reported to be obesity-associated. Among non-antibiotic therapeutic method, the faecal microbiota transfer technology seems to be one of the effective therapeutic and management techniques to treat and/or manage some of the metabolic disorders in particular obesity.
微生物群调节健康和许多疾病,包括传染病和代谢性疾病。肠道微生物群的组成和密度会受到饮食的影响,因此,它们通过调节能量代谢在肥胖症的发生中扮演着重要角色。最近的证据(主要来自动物模型的研究)表明,肠道微生物群会影响营养获取和能量调节。肠道微生物群通过调节能量吸收、中心食欲、脂肪储存、慢性炎症和昼夜节律来调节肥胖。据报道,蛋白菌门的一些成员与肥胖有关。在非抗生素治疗方法中,粪便微生物群转移技术似乎是治疗和/或控制某些代谢紊乱,尤其是肥胖症的有效治疗和管理技术之一。
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引用次数: 0
Therapeutic electric currents in the treatment of cervicalgy: integrative review 治疗性电流治疗颈椎病:综合评述
Pub Date : 2023-07-07 DOI: 10.15406/ipmrj.2023.08.00349
Milena Soares Lima, Eliane Gouveia de Morais Sanchez, Hugo Machado Sanchez
Neck pain is associated with factors such as sudden exertion, inappropriate postures, emotional issues and bad lifestyle habits. For this reason, physiotherapists use electro-electronic equipment that emits electromagnetic radiation to treat cervical dysfunctions. The aim of this study was to present the applicability of therapeutic electrical currents in the treatment of neck pain. This is bibliographical research, with a search in online libraries in the following databases: SciELO (Scientific Electronic Library Online), Portal of the Coordination for the Improvement of Higher Education Personnel (Capes), US National Library of Medicine National institutes of Health (Pubmed), in addition to Classic books. For the search and analysis of the studies, the following Health Sciences Descriptors (DeCS) were evaluated and used: TENS and neck pain; Neck pain and Electric currents; Functional electrical stimulation and neck pain; combined with Boolean operators (OR and AND). The eligibility criteria for the selection of articles were: articles in Portuguese and English; published in the period from 2012 to 2022; randomized controlled clinical trials and non-controlled studies, applied in a human model. The study reveals that among the main types of therapies used for cervical pain, Transcutaneous Electrical Nerve Stimulation (TENS) was the one that presented the most positive results, according to the studies revisited. It was verified, through the analyzed survey, that the increase of electrotherapy to physiotherapy can potentiate the conducts, especially to relieve pain in cases of acute and chronic neck pain.
颈部疼痛与突然用力、姿势不当、情绪问题和不良生活习惯等因素有关。因此,物理治疗师使用发射电磁辐射的电子设备来治疗颈椎功能障碍。本研究旨在介绍治疗性电流在治疗颈部疼痛中的适用性。这是一项书目研究,在以下数据库的在线图书馆中进行了搜索:SciELO(科学电子图书馆在线)、高等教育人员改进协调门户网站(Capes)、美国国立卫生研究院国家医学图书馆(Pubmed),以及经典书籍。在搜索和分析研究时,评估并使用了以下健康科学描述符(DeCS):TENS和颈痛;颈痛和电流;功能性电刺激和颈痛;结合布尔运算符(OR和AND)。选择文章的资格标准为:葡萄牙语和英语文章;发表于 2012 年至 2022 年期间;随机对照临床试验和应用于人体模型的非对照研究。研究结果表明,在用于治疗颈椎疼痛的主要疗法中,经皮神经电刺激疗法(TENS)的疗效最为显著。通过分析调查证实,在物理疗法中增加电疗法可以增强治疗效果,尤其是缓解急性和慢性颈部疼痛。
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引用次数: 0
Preliminary study on the potential benefits of proprioceptive activity in functional recovery:comparison between two athletes affected by ankle sprain 本体感觉活动在功能恢复中的潜在益处的初步研究:两名踝关节扭伤运动员的比较
Pub Date : 2023-05-16 DOI: 10.15406/ipmrj.2023.08.00345
A. Fogliata, Alessandra Garassino
The purpose of this study was to evaluate the effectiveness of general proprioception (Sincrony method) as an integrative tool for functional recovery in young athletes who had suffered a grade 2 ankle sprain. The study was a case report conducted on a 13-year-old athlete, G.P., and a same-aged, history, and sport-role-matched control athlete (both left-side attackers). Both athletes had suffered a similar injury in the dynamics of landing from a jump with eversion of the right ankle, about 65 days apart. They had the same hospital and medical prognosis, but only one was proposed a general proprioceptive work protocol with attention focused on the injury and consequent increase in blood flow during the complete stop phase following the injury. The athletes were evaluated using the Five Step Test at three different times during the inactive period before the start of functional recovery. The tests applied, like the chosen inventory exercise, were selected to isolate the physiological component as much as possible from the psychological ones. Although not statistically significant, the results showed a drastic improvement in the athlete who integrated the medical protocol with the proprioceptive one, suggesting the development of new studies in this field.
本研究的目的是评估一般本体感觉(Sincrony方法)作为一种综合工具对遭受2级踝关节扭伤的年轻运动员的功能恢复的有效性。该研究是对一名13岁的运动员gp和一名年龄相同,有运动历史和运动角色匹配的对照组运动员(都是左侧攻击者)进行的病例报告。这两名运动员在起跳落地时都受到了类似的损伤,右脚踝外翻,前后相隔约65天。他们有相同的医院和医疗预后,但只有一个被提出了一个通用的本体感觉工作方案,重点关注损伤和损伤后完全停止阶段血流的增加。在功能恢复开始前的非活动期间,运动员在三个不同的时间使用五步测试进行评估。所采用的测试,如选定的清单练习,都是为了尽可能地将生理成分与心理成分分离开来。虽然没有统计学上的显著性,但结果表明,将医学方案与本体感觉方案结合起来的运动员有了显著的改善,这表明在这一领域开展新的研究。
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引用次数: 0
Rehabilitation of cerebral palsy and need for collaborative assessment using rehabilitation problem solving (RPS) form 使用康复问题解决(RPS)量表对脑瘫康复的需求进行协作评估
Pub Date : 2023-05-02 DOI: 10.15406/ipmrj.2023.08.00344
Mohammad Habibur Rahman
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引用次数: 0
Selective mutism: report of a successful case 选择性缄默症一例成功报告
Pub Date : 2023-03-27 DOI: 10.15406/ipmrj.2023.08.00343
Natasha M. Ganem
The present study reports a successful case of selective mutism in a four-year-old child. it goes according to the current literature that says that combined treatment (CBT + medication) and early intervention ensure a good prognosis.
本研究报告了一例4岁儿童选择性缄默症的成功病例。根据目前的文献,联合治疗(CBT +药物)和早期干预可以确保良好的预后。
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引用次数: 0
Determinants of hypertension crisis and stroke among hypertensive patients in South Wollo and Oromia special zones public hospitals 南沃罗和奥罗米亚特区公立医院高血压患者高血压危象和中风的决定因素
Pub Date : 2023-03-13 DOI: 10.15406/ipmrj.2023.08.00337
Belachew Tegegne, Debernesh Goshiye, Zemen Mengesha, Mekuriaw Wuhib
Background: Uncontrolled hypertension results in hypertension crisis, and it is an important public health concern around the world. The incidence of complicating hospitalizations with hypertension continues to grow and is associated with increased mortality and adverse discharge. Hypertension crisis and stroke are caused by numerous factors; however, there is a paucity of studies to identify determinants of hypertension crisis and stroke in Ethiopia, particularly the study area. Objective: To identify determinants of hypertension crisis and stroke among hypertensive patients in South Wollo zone and Oromia special zone public hospitals, 2022. Methods: An institution based cross-sectional study was conducted among 416 participants in South Wollo and Oromia special zones public hospitals. Systematic random sampling technique was used to select study participants. Data were entered into Epidata version 3.1 and analyzed using Statistical package for social sciences version 23. Variables having P<0.25 in binary logistic regression was retained in the multivariable analysis to control the effect of confounding. Finally, determinants were identified based on adjusted odds ratio along with 95% confidence level at p-value less than 0.05. Model fitness was checked using Hosmer-Lemshow test. Results: In this study, the magnitude of hypertensive crisis was 35.6%(95%CI:31.1,40.4). Age(41-60years)(AOR=0.76,95%CI:0.42,0.98), Social support(AOR=0.82,95%CI:0.41,0.93), living in urban(AOR=0.56,95%CI:0.24,0.86) and good medication adherence(AOR=0.48,95%CI:0.29,0.83) were determinants of hypertensive crisis. Another, the magnitude of stroke was 5.0%(95%CI:3.1,7.8). Rural residence (AOR=3.4,95%CI:1.23,9.44), Systolic blood pressure (AOR=9.6,95%CI:2.71,34.06), family history of stroke (AOR=0.26,95%CI:0.07,0.79) were determinants of stroke. Conclusion and recommendation: The magnitude of hypertensive crisis was high, whereas the magnitude of stroke was relatively low. Age 41-60 years, urban residence, having social support and good medication adherence were determinants of hypertensive crisis, while rural residence, systolic blood pressure and family history of stroke were determinants of stroke. Thus, health care providers should screen aged patients and patients with family history of stoke.
背景:高血压不受控制可导致高血压危像,这是世界范围内一个重要的公共卫生问题。高血压住院并发症的发生率持续增长,并与死亡率和不良出院增加有关。高血压危象和脑卒中是由多种因素引起的;然而,在埃塞俄比亚,特别是在研究地区,缺乏确定高血压危机和中风决定因素的研究。目的:探讨2022年南沃罗区和奥罗米亚特区公立医院高血压患者高血压危象和脑卒中的影响因素。方法:采用基于机构的横断面调查方法,对南沃罗和奥罗米亚特区公立医院的416名参与者进行调查。采用系统随机抽样方法选择研究对象。数据输入Epidata 3.1版本,使用Statistical package for social sciences version 23进行分析。在多变量分析中保留二元逻辑回归中P<0.25的变量,以控制混杂的影响。最后,根据调整后的优势比和p值小于0.05的95%置信水平确定决定因素。采用Hosmer-Lemshow检验模型适应度。结果:本组患者高血压危重程度为35.6%(95%CI:31.1,40.4)。年龄(41-60岁)(AOR=0.76,95%CI:0.42,0.98)、社会支持(AOR=0.82,95%CI:0.41,0.93)、居住在城市(AOR=0.56,95%CI:0.24,0.86)和良好的药物依从性(AOR=0.48,95%CI:0.29,0.83)是高血压危重症的决定因素。另一方面,卒中程度为5.0%(95%CI:3.1,7.8)。农村居住(AOR=3.4,95%CI:1.23,9.44)、收缩压(AOR=9.6,95%CI:2.71,34.06)、卒中家族史(AOR=0.26,95%CI:0.07,0.79)是卒中的决定因素。结论与建议:高血压危象的严重程度较高,而卒中的严重程度相对较低。41 ~ 60岁城市居住、社会支持和药物依从性是高血压危重的决定因素,农村居住、收缩压和卒中家族史是卒中的决定因素。因此,医疗保健提供者应该筛查老年患者和有家族病史的患者。
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引用次数: 0
The mechanism of interaction between natural physical factors and the holistic organism forms the basis of the general theory of physiotherapy 自然物理因素与整体有机体相互作用的机制构成了物理治疗一般理论的基础
Pub Date : 2023-01-27 DOI: 10.15406/ipmrj.2023.08.00335
Bitsoyev Vladimir Dodtievich
Optimal combination of drug therapy and physical factors increases the effectiveness of treatment and medical rehabilitation of patients. It is regrettable that search for methods of improvement of individual dosing of applied energies with approximation to the cellular level of dynamism (constant correction of parameters of applied physical factors during the whole period of treatment) and complex (in the presence of several diseases) treatment is conducted today obviously insufficiently. Perhaps this search is hampered by the current lack of a general theory of physiotherapy and imperfect classification of physical factors. In connection with this there appeared a necessity of development of principles and methods of comprehensive study of the action of physical methods in clinical conditions, and requirements for testing new apparatuses for physiotherapy increased sharply. The author of this direction was the outstanding scientist Vladimir Sergeyevich Ulashchik. In his opinion, creation of general theory of physiotherapy is one of the perspective tasks of scientific physiotherapy. It is known that since the end of XIX century the principles of neurovism and reflex theory have been the theoretical basis of domestic physiotherapy. Subsequently, to the reflex theory of the mechanism of healing action of the International Physical Medicine & Rehabilitation Journal Review Article Open Access external environment (natural and preformed physical factors) the influence of humoral and endocrine changes was added, but still with the leading principle of neurovism. It should be noted that there have always been doubts that the reflexive theory can fully explain all causes and consequences of the interaction of external physical factors with the human body. On this basis, “permanent” problems remained unresolved: • common and specific in the action of physical factors; • the selectivity of their action; • correlation of nervous and humoral, local and general, functional and morphologic3al at single and course application of physiotherapeutic influence; • inability to determine “dose-effect”; • the nature of the organism’s primary reactions to environmental influences; • the direction of the processes that predetermine the final result of the interaction between external physical factors and the whole organism; • realization of all potential possibilities of obtaining the maximum desired positive clinical effect in physiotherapy. Thanks to the tremendous advances in quantum mechanics (optics), chemistry, biology, supramolecular chemistry, and fiber-optic physics, it became necessary to review the mechanism of action of a physical factor and the response of the whole body in order to diagnose, prevent, treat, and rehabilitate patients. Quantum therapy emerged before our era, when man began to consciously apply “natural factors” for therapeutic purposes with controlling “verbal support and explanation”. With the subsequent development of scientific, technica
药物治疗与物理因素的最佳结合提高了患者的治疗效果和医学康复。令人遗憾的是,目前对改进应用能量的个别剂量的方法的研究显然不够充分,这种方法近似于细胞的动力水平(在整个治疗期间不断修正应用物理因素的参数)和复杂(在存在几种疾病的情况下)治疗。也许这项研究受到目前缺乏物理治疗的一般理论和不完善的物理因素分类的阻碍。与此相关的是,有必要发展综合研究物理方法在临床条件下的作用的原理和方法,并且对物理治疗测试新设备的需求急剧增加。这个方向的作者是杰出的科学家Vladimir Sergeyevich Ulashchik。他认为,创建物理治疗一般理论是科学物理治疗的远景任务之一。众所周知,自十九世纪末以来,神经主义原理和反射理论一直是国内物理治疗的理论基础。随后,在国际物理医学与康复杂志评论文章开放获取的关于愈合作用机制的反射理论中,加入了外界环境(自然的和预先形成的物理因素)对体液和内分泌变化的影响,但仍以神经主义为主。需要指出的是,反身性理论能否充分解释外界物理因素与人体相互作用的一切因果关系一直存在疑问。在此基础上,“永久性”问题仍未解决:•物理因素作用的共同和具体;•行为的选择性;•神经和体液、局部和全身、功能和形态学在单次和疗程应用物理治疗影响的相关性;•无法确定“剂量效应”;•生物体对环境影响的主要反应的性质;•预先确定外部物理因素与整个有机体之间相互作用的最终结果的过程的方向;•实现在物理治疗中获得最大期望的积极临床效果的所有潜在可能性。由于量子力学(光学)、化学、生物学、超分子化学和光纤物理的巨大进步,为了诊断、预防、治疗和康复病人,有必要审查一个物理因素的作用机制和整个身体的反应。量子疗法出现在我们这个时代之前,人类开始有意识地将“自然因素”用于治疗目的,并控制“语言支持和解释”。随着科学、技术和人文学科(数学、力学、物理、化学、生物学等)的发展,利用自然因素进行治疗的理念发生了变化。与此同时,外界对任何力量和手段的整体有机体的影响的文化也发生了变化和改善,即以治疗为目的的“自然因素”的应用随着医学中新的科学学科“物理疗法”的出现而获得了系统的特征。它的根本是所有的宇宙、空间和周围世界都是由基本粒子(量子)组成的,没有重复,存在于三维空间中。
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引用次数: 0
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International Physical Medicine &amp; Rehabilitation Journal
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