Chronic primary headache disorders are associated with frequent, severe pain and significant functional impairment, with treatment remaining challenging.
Objective
We examined the feasibility and safety of a novel brain [transcranial direct current stimulation (tDCS)] and spinal cord stimulation [trans-spinal cord direct current stimulation (tsDCS)] treatment in chronic headache.
Methods
Nine participants (3 males; aged, 40 ± 15 years) suffering from chronic daily headache, chronic tension-type headache, or chronic migraine received the combined brain and spinal cord intervention for 5 consecutive days. Stimulation was applied for a total of 40 minutes (20 minutes of tDCS followed by 20 minutes of tsDCS) at 1 mA. Pain sensitivity and headache symptoms (frequency, severity, duration, and medications recorded via a headache diary, 4 weeks before and after treatment) were assessed.
Results
The treatment was safe, feasible, and well tolerated. Headache frequency was reduced following the treatment (p = 0.026) in chronic tension-type headache and chronic migraine, but not in chronic daily headache. Headache severity was reduced immediately post-treatment in 67% of sessions. A trend towards a reduction in medication use was observed (p = 0.075). No changes in headache severity (p = 0.16) or duration (p = 0.34) were present.
Conclusion
These data suggest that combined tDCS and tsDCS intervention is safe and feasible, and may improve headache frequency in patients with chronic primary headache disorders.
{"title":"Combined transcranial and trans-spinal direct current stimulation in chronic headache: A feasibility and safety trial for a novel intervention","authors":"Ghufran Alhassani B.Med.Sc (Hons) , Julia Treleaven PhD , Siobhan S.M. Schabrun PhD","doi":"10.1016/j.hkpj.2016.11.001","DOIUrl":"10.1016/j.hkpj.2016.11.001","url":null,"abstract":"<div><h3>Background</h3><p>Chronic primary headache disorders are associated with frequent, severe pain and significant functional impairment, with treatment remaining challenging.</p></div><div><h3>Objective</h3><p>We examined the feasibility and safety of a novel brain [transcranial direct current stimulation (tDCS)] and spinal cord stimulation [trans-spinal cord direct current stimulation (tsDCS)] treatment in chronic headache.</p></div><div><h3>Methods</h3><p>Nine participants (3 males; aged, 40<!--> <!-->±<!--> <!-->15 years) suffering from chronic daily headache, chronic tension-type headache, or chronic migraine received the combined brain and spinal cord intervention for 5 consecutive days. Stimulation was applied for a total of 40 minutes (20 minutes of tDCS followed by 20 minutes of tsDCS) at 1 mA. Pain sensitivity and headache symptoms (frequency, severity, duration, and medications recorded via a headache diary, 4 weeks before and after treatment) were assessed.</p></div><div><h3>Results</h3><p>The treatment was safe, feasible, and well tolerated. Headache frequency was reduced following the treatment (<em>p</em> <!-->=<!--> <!-->0.026) in chronic tension-type headache and chronic migraine, but not in chronic daily headache. Headache severity was reduced immediately post-treatment in 67% of sessions. A trend towards a reduction in medication use was observed (<em>p</em> <!-->=<!--> <!-->0.075). No changes in headache severity (<em>p</em> <!-->=<!--> <!-->0.16) or duration (<em>p</em> <!-->=<!--> <!-->0.34) were present.</p></div><div><h3>Conclusion</h3><p>These data suggest that combined tDCS and tsDCS intervention is safe and feasible, and may improve headache frequency in patients with chronic primary headache disorders.</p></div>","PeriodicalId":44774,"journal":{"name":"Hong Kong Physiotherapy Journal","volume":"37 ","pages":"Pages 1-9"},"PeriodicalIF":1.5,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hkpj.2016.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37106669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01DOI: 10.1016/S1013-7025(17)30097-0
{"title":"Copyright Transfer Agreement","authors":"","doi":"10.1016/S1013-7025(17)30097-0","DOIUrl":"https://doi.org/10.1016/S1013-7025(17)30097-0","url":null,"abstract":"","PeriodicalId":44774,"journal":{"name":"Hong Kong Physiotherapy Journal","volume":"37 ","pages":"Page e11"},"PeriodicalIF":1.5,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1013-7025(17)30097-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137207925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01DOI: 10.1016/j.hkpj.2017.01.004
Laleh Abadi MS (PT) , Zahra Salahzadeh PhD , Mandana Rezaei PhD , Ali E. Oskouei PhD , Mahmood Reza Azghani PhD
Background
Patients with diabetes and peripheral neuropathy demonstrate significantly reduced peak torques at the peripheral joints.
Objectives
The aim of this study was to assess isometric and concentric peak torques of the hip joint in people with type II diabetes with and without peripheral neuropathy in comparison with healthy participants.
Methods
27 patients with type II diabetes including 15 patients without peripheral neuropathy, 12 patients with diabetes and peripheral neuropathy and 15 healthy people participated. Isometric and concentric peak torques of hip flexion, extension, adduction and abduction of the non-dominant leg were measured by motorized dynamometer.
Results
Peak and average peak concentric torques of the hip extension and abduction in patients with diabetes and peripheral neuropathy were lower than those patients with diabetes and control group. Angle of extension peak torque was significantly greater in patients with diabetes and peripheral neuropathy compared with other groups. Angle of flexion peak torque was lower in the patients with diabetes and peripheral neuropathy.
Conclusions
Torque related parameters in patients with type II diabetes with or without peripheral neuropathy, are different from healthy subjects. As a result, patients with diabetes especially with peripheral neuropathy are more susceptible of injury and disability in lower limbs.
{"title":"Hip joint torques in type II diabetes with and without neuropathy","authors":"Laleh Abadi MS (PT) , Zahra Salahzadeh PhD , Mandana Rezaei PhD , Ali E. Oskouei PhD , Mahmood Reza Azghani PhD","doi":"10.1016/j.hkpj.2017.01.004","DOIUrl":"10.1016/j.hkpj.2017.01.004","url":null,"abstract":"<div><h3>Background</h3><p>Patients with diabetes and peripheral neuropathy demonstrate significantly reduced peak torques at the peripheral joints.</p></div><div><h3>Objectives</h3><p>The aim of this study was to assess isometric and concentric peak torques of the hip joint in people with type II diabetes with and without peripheral neuropathy in comparison with healthy participants.</p></div><div><h3>Methods</h3><p>27 patients with type II diabetes including 15 patients without peripheral neuropathy, 12 patients with diabetes and peripheral neuropathy and 15 healthy people participated. Isometric and concentric peak torques of hip flexion, extension, adduction and abduction of the non-dominant leg were measured by motorized dynamometer.</p></div><div><h3>Results</h3><p>Peak and average peak concentric torques of the hip extension and abduction in patients with diabetes and peripheral neuropathy were lower than those patients with diabetes and control group. Angle of extension peak torque was significantly greater in patients with diabetes and peripheral neuropathy compared with other groups. Angle of flexion peak torque was lower in the patients with diabetes and peripheral neuropathy.</p></div><div><h3>Conclusions</h3><p>Torque related parameters in patients with type II diabetes with or without peripheral neuropathy, are different from healthy subjects. As a result, patients with diabetes especially with peripheral neuropathy are more susceptible of injury and disability in lower limbs.</p></div>","PeriodicalId":44774,"journal":{"name":"Hong Kong Physiotherapy Journal","volume":"37 ","pages":"Pages 27-33"},"PeriodicalIF":1.5,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hkpj.2017.01.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37105721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01DOI: 10.1016/S1013-7025(17)30096-9
{"title":"Authorship and Conflict statement","authors":"","doi":"10.1016/S1013-7025(17)30096-9","DOIUrl":"https://doi.org/10.1016/S1013-7025(17)30096-9","url":null,"abstract":"","PeriodicalId":44774,"journal":{"name":"Hong Kong Physiotherapy Journal","volume":"37 ","pages":"Pages e8-e10"},"PeriodicalIF":1.5,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1013-7025(17)30096-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137207924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-01DOI: 10.1016/S1013-7025(17)30047-7
{"title":"Authorship and Conflict statement","authors":"","doi":"10.1016/S1013-7025(17)30047-7","DOIUrl":"https://doi.org/10.1016/S1013-7025(17)30047-7","url":null,"abstract":"","PeriodicalId":44774,"journal":{"name":"Hong Kong Physiotherapy Journal","volume":"36 ","pages":"Pages e8-e10"},"PeriodicalIF":1.5,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1013-7025(17)30047-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136990410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-01DOI: 10.1016/j.hkpj.2016.07.002
Olusola Ayanniyi PhD , Roseline F. Egwu MSc , Ade F. Adeniyi PhD
Background
knee osteoarthritis (OA) is a prevalent condition. Little is known about whether treatments provided by physiotherapists to patients with knee OA in Nigeria follow recommended clinical practice guidelines.
Objective
The aims of this study were to investigate Nigerian physiotherapists' treatment preferences for knee osteoarthritis (OA) and to evaluate if their preferences were in line with contemporary clinical practice guidelines and recommendations.
Methods
A cross-sectional survey of 267 physiotherapists from various health institutions in Nigeria were surveyed, using a structured questionnaire incorporating a clinical vignette on knee OA.
Results
Based on the clinical vignette, the majority of the respondents (68.2%) recommended review of x-rays as part of the diagnostic process for knee OA. Thermotherapy was the most utilized modality (86.1%), followed by therapeutic exercise (81.3%). Only 11.1% of the physiotherapists used therapeutic exercise alone. Manual therapy in conjunction with other modalities was the choice for 18% of the physiotherapists. Only 49.1% of the physiotherapists reported including advice on weight control and up to 39% reported bed rest as part of the treatment approach.
Conclusion
There was a poor consensus among the physiotherapists in Nigeria on how knee OA is managed compared with contemporary clinical guidelines and recommendations which emphasized application of core modalities, such as therapeutic exercises, patients' education, and weight control over passive modalities. Some areas of practice are in line with contemporary guidelines, while some were in conflict with evidence-based practice.
{"title":"Physiotherapy management of knee osteoarthritis in Nigeria—A survey of self-reported treatment preferences","authors":"Olusola Ayanniyi PhD , Roseline F. Egwu MSc , Ade F. Adeniyi PhD","doi":"10.1016/j.hkpj.2016.07.002","DOIUrl":"10.1016/j.hkpj.2016.07.002","url":null,"abstract":"<div><h3>Background</h3><p>knee osteoarthritis (OA) is a prevalent condition. Little is known about whether treatments provided by physiotherapists to patients with knee OA in Nigeria follow recommended clinical practice guidelines.</p></div><div><h3>Objective</h3><p>The aims of this study were to investigate Nigerian physiotherapists' treatment preferences for knee osteoarthritis (OA) and to evaluate if their preferences were in line with contemporary clinical practice guidelines and recommendations.</p></div><div><h3>Methods</h3><p>A cross-sectional survey of 267 physiotherapists from various health institutions in Nigeria were surveyed, using a structured questionnaire incorporating a clinical vignette on knee OA.</p></div><div><h3>Results</h3><p>Based on the clinical vignette, the majority of the respondents (68.2%) recommended review of x-rays as part of the diagnostic process for knee OA. Thermotherapy was the most utilized modality (86.1%), followed by therapeutic exercise (81.3%). Only 11.1% of the physiotherapists used therapeutic exercise alone. Manual therapy in conjunction with other modalities was the choice for 18% of the physiotherapists. Only 49.1% of the physiotherapists reported including advice on weight control and up to 39% reported bed rest as part of the treatment approach.</p></div><div><h3>Conclusion</h3><p>There was a poor consensus among the physiotherapists in Nigeria on how knee OA is managed compared with contemporary clinical guidelines and recommendations which emphasized application of core modalities, such as therapeutic exercises, patients' education, and weight control over passive modalities. Some areas of practice are in line with contemporary guidelines, while some were in conflict with evidence-based practice.</p></div>","PeriodicalId":44774,"journal":{"name":"Hong Kong Physiotherapy Journal","volume":"36 ","pages":"Pages 1-9"},"PeriodicalIF":1.5,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hkpj.2016.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37106271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-01DOI: 10.1016/S1013-7025(17)30048-9
{"title":"Copyright Transfer Agreement","authors":"","doi":"10.1016/S1013-7025(17)30048-9","DOIUrl":"https://doi.org/10.1016/S1013-7025(17)30048-9","url":null,"abstract":"","PeriodicalId":44774,"journal":{"name":"Hong Kong Physiotherapy Journal","volume":"36 ","pages":"Page e11"},"PeriodicalIF":1.5,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1013-7025(17)30048-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136990411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-01DOI: 10.1016/j.hkpj.2016.10.001
Taofeek O. Awotidebe PhD, PT , Victor O. Adeyeye MBChB, FWACP , Rufus A. Adedoyin PhD, PT , Suraj A. Ogunyemi MBChB, FWACP , Kayode I. Oke PhD, PT , Rita N. Ativie MSc, PT , Goodness B. Adeola BMR, PT , Mukadas O. Akindele PhD, PT , Michael O. Balogun MBChB, FWACP
Background
Adequate sleep improves physical and mental alertness. However, there is a dearth of empirical data on functional capacity (FC) and sleep quality (SpQ) in patients with chronic heart failure (CHF).
Objective
This study investigated the relationship between FC and SpQ of patients with CHF and apparently healthy controls (HCs).
Methods
This case-control study recruited 50 patients with CHF whose left ventricular ejection fraction (LVEF) was <40%, attending cardiac clinics of selected government hospitals in Osun State. Furthermore, 50 age- and sex-matched healthy individuals were recruited as controls. Socio-demographic characteristics and cardiovascular parameters were assessed. The FC (VO2 max) and SpQ were assessed using the 6-minute walk test (6-MWT) and Pittsburgh Sleep Quality Index (PSQI), respectively. Data were analysed using descriptive and inferential statistics. Alpha level was set at p < 0.05.
Results
Patients had a significantly lower FC and poorer SpQ than HCs, 4.6 ± 0.5 versus 11.3 ± 1.6 mL/kg/min (t = −3.452; p = 0.001) and 8.74 ± 1.6 versus 3.8 ± 1.3 (t = −5.371; p = 0.001), respectively. HCs were about five times more likely to walk longer distance [odds ratio (OR), 4.8; confidence interval (CI), 2.0–11.1] and had a better heart rate (OR, 2.8; CI, 1.4–5.3) than patients. SpQ had a significant negative correlation with FC of patients (r = −0.362; p = 0.001) but a significant positive correlation with HCs (r = 0.481; p = 0.041). Furthermore, there were significant correlations between FC and body mass index in both groups (CHF: r = 0.247, p = 0.022; HCs: r = 0.321, p = 0.040).
Conclusion
Patients with heart failure demonstrated lower functional capacity and poorer sleep quality.
充足的睡眠可以提高身体和精神的警觉性。然而，关于慢性心力衰竭(CHF)患者的功能容量(FC)和睡眠质量(SpQ)的经验数据缺乏。目的探讨慢性心力衰竭(CHF)患者与表面健康对照组(HCs) FC和SpQ的关系。方法本病例对照研究招募50例左室射血分数(LVEF)为40%的CHF患者，在奥松州选定的政府医院心脏门诊就诊。此外，还招募了50名年龄和性别匹配的健康个体作为对照。评估社会人口学特征和心血管参数。分别采用6分钟步行测试(6-MWT)和匹兹堡睡眠质量指数(PSQI)评估FC (VO2 max)和SpQ。数据分析采用描述性和推断性统计。α水平设为p <0.05.结果患者的FC和SpQ均显著低于对照组，分别为4.6±0.5 mL/kg/min和11.3±1.6 mL/kg/min (t =−3.452;p = 0.001)和8.74±1.6和3.8±1.3 (t =−5.371;P = 0.001)。高脂肪人群行走较长距离的可能性是正常人的5倍[优势比(OR)， 4.8;置信区间(CI)， 2.0-11.1]，心率更好(OR, 2.8;CI(1.4-5.3)高于患者。SpQ与患者FC呈显著负相关(r = - 0.362;p = 0.001)，但与hcc呈显著正相关(r = 0.481;p = 0.041)。此外，两组的FC与体重指数之间存在显著相关性(CHF: r = 0.247, p = 0.022;HCs: r = 0.321, p = 0.040)。结论心力衰竭患者功能能力下降，睡眠质量较差。
{"title":"Assessment of functional capacity and sleep quality of patients with chronic heart failure","authors":"Taofeek O. Awotidebe PhD, PT , Victor O. Adeyeye MBChB, FWACP , Rufus A. Adedoyin PhD, PT , Suraj A. Ogunyemi MBChB, FWACP , Kayode I. Oke PhD, PT , Rita N. Ativie MSc, PT , Goodness B. Adeola BMR, PT , Mukadas O. Akindele PhD, PT , Michael O. Balogun MBChB, FWACP","doi":"10.1016/j.hkpj.2016.10.001","DOIUrl":"10.1016/j.hkpj.2016.10.001","url":null,"abstract":"<div><h3>Background</h3><p>Adequate sleep improves physical and mental alertness. However, there is a dearth of empirical data on functional capacity (FC) and sleep quality (SpQ) in patients with chronic heart failure (CHF).</p></div><div><h3>Objective</h3><p>This study investigated the relationship between FC and SpQ of patients with CHF and apparently healthy controls (HCs).</p></div><div><h3>Methods</h3><p>This case-control study recruited 50 patients with CHF whose left ventricular ejection fraction (LVEF) was <40%, attending cardiac clinics of selected government hospitals in Osun State. Furthermore, 50 age- and sex-matched healthy individuals were recruited as controls. Socio-demographic characteristics and cardiovascular parameters were assessed. The FC (VO<sub>2</sub> max) and SpQ were assessed using the 6-minute walk test (6-MWT) and Pittsburgh Sleep Quality Index (PSQI), respectively. Data were analysed using descriptive and inferential statistics. Alpha level was set at <em>p</em> < 0.05.</p></div><div><h3>Results</h3><p>Patients had a significantly lower FC and poorer SpQ than HCs, 4.6 ± 0.5 versus 11.3 ± 1.6 mL/kg/min (<em>t</em> = −3.452; <em>p</em> = 0.001) and 8.74 ± 1.6 versus 3.8 ± 1.3 (<em>t</em> = −5.371; <em>p</em> = 0.001), respectively. HCs were about five times more likely to walk longer distance [odds ratio (OR), 4.8; confidence interval (CI), 2.0–11.1] and had a better heart rate (OR, 2.8; CI, 1.4–5.3) than patients. SpQ had a significant negative correlation with FC of patients (<em>r</em> = −0.362; <em>p</em> = 0.001) but a significant positive correlation with HCs (<em>r</em> = 0.481; <em>p</em> = 0.041). Furthermore, there were significant correlations between FC and body mass index in both groups (CHF: <em>r</em> = 0.247, <em>p</em> = 0.022; HCs: <em>r</em> = 0.321, <em>p</em> = 0.040).</p></div><div><h3>Conclusion</h3><p>Patients with heart failure demonstrated lower functional capacity and poorer sleep quality.</p></div>","PeriodicalId":44774,"journal":{"name":"Hong Kong Physiotherapy Journal","volume":"36 ","pages":"Pages 17-24"},"PeriodicalIF":1.5,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hkpj.2016.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37106273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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