MANAGING ARTHRITIS PAIN: MEDICATIONS AND LIFESTYLE CHANGES.

This study aims to characterize and contrast the triennial rates at which doctors prescribe PT, determine patient, doctor, and practicing characteristics related to every therapy suggestion, and assess pain relievers, lifestyle counseling, and PT as effective treatments for knee osteoarthritis (OA). We analyzed the National Ambulatory Medical Care Survey. Nonsteroidal anti-inflammatory drugs (NSAID), narcotics prescriptions, physical therapy referrals, and primary care physician visits for knee OA have been determined and evaluated. The average yearly rate after three years of therapy was determined. Using multivariable logistic modeling with adjustments for complicated sample design, we analyzed the relationships among patient, physician, and practice characteristics and treatments. Over time the patients were prescribed physical therapy to improve their lifestyle whereas the percentage of patients who were prescribed NSAIDs or drugs. Physical therapy, lifestyle therapy, and drugs were prescribed at similar rates across time for basic care doctor visits. There was an association between nonclinical characteristics and treatment suggestions, such as provider type, practice setting, and geographic proximity. Physical therapy (PT) and lifestyle counseling (LC) seem underused in patients with knee OA, but prescriptions for pain medication rose over the studied period. The treatment decisions varied due to variables outside of medicine. Increased usage of physical therapy and lifestyle changes, as well as decreased treatment variance for knee OA, are important areas for further study.

NEUROPLASTICITY AND BRAIN STIMULATION: DEVELOPING INTERVENTIONS TO PROMOTE RECOVERY FROM STROKE AND TRAUMATIC BRAIN INJURY.

This article's purpose is to explore how "non-invasive brain stimulation" (NBS) can be used to treat "traumatic brain injury" (TBI) and promote neuroplasticity. Along with the pathophysiological processes that occur after a TBI, "transcranial direct current stimulation" (tDCS) and "transcranial magnetic stimulation" (TMS) are described. These processes are based on a study of the relevant literature. Individualized treatment plans are required because the pathophysiological processes that result from TBI change over time. Given their neurophysiological effects, TMS and tDCS may be used to (a) significant suppression of post-traumatic cerebral hyper excitability; (b) control synaptic plasticity over the long run to prevent unfavorable outcomes; and (c) in addition to other forms of treatment such as physical and behavioral, assist some neural networks to reorganize and consolidate their learning. These treatments have the potential to reduce the disabling symptoms of brain injury.Animal and human research show that NBS may help reduce the severity of injuries and increase plastic changes in lesioned brain tissue, both of which are necessary for the successful acquisition of new knowledge and the restoration of lost functions. However, at present, this evidence is mostly speculative. The relevance of NBS in TBI, further elucidating its therapeutic benefits, and defining appropriate stimulation levels all need investigations in TBI patients due to safety concerns.