Efficacy of electroacupuncture plus warm needling therapy for plantar heel pain: a randomised waitlist-controlled trial.

OBJECTIVE: To investigate the therapeutic effects of electroacupuncture plus warm needling (EAWN) therapy on pain and foot function in adults with plantar heel pain (PHP). METHODS: This prospective, randomised, parallel-group, waitlist-controlled trial was conducted at a Chinese medicine centre in Hong Kong between May 2018 and February 2019. Eighty eligible community-dwelling subjects with PHP (mean age 59.7 years; 85% female) were equally randomised to receive EAWN therapy or remain on a waitlist. The treatment group received six 30-min sessions of standardised EAWN therapy over 4 weeks; the control group received no treatment. The outcome measures were the visual analogue scale (VAS) score for first-step pain, foot function index (FFI) scores and global rating of change (GRC) scale scores. Assessments were made at baseline, week 2 and week 4 (primary endpoint). The treatment group underwent additional assessments at week 8. Outcomes were evaluated by intention-to-treat analysis. RESULTS: Patients who received EAWN therapy exhibited greater improvements in the mean first-step pain VAS and all FFI scores than did those in the control group at weeks 2 and 4, with significant between-group differences (all P < 0.001). Compared with baseline, there were significant decreases in mean first-step pain VAS scores at weeks 2 and 4, and FFI scores at week 4, in the treatment group but not in the control group. The improvements in the treatment group continued until week 8. GRC scores at week 4 indicated improvement in all treated patients and only 22.5% of the control group patients (P < 0.001). There were no study-related adverse events. CONCLUSION: EAWN therapy could be an effective treatment for PHP in middle-aged and older adults. TRIAL REGISTRATION NUMBER: ChiCTR1800014906 (Chinese Clinical Trials Registry).

Comparison of electroacupuncture and manual acupuncture for patients with plantar heel pain syndrome: a randomized controlled trial.

BACKGROUND: Plantar heel pain syndrome (PHPS), also known as plantar fasciitis, affects millions of people worldwide. Electroacupuncture (EA) and manual acupuncture (MA) are the two acupuncture modalities frequently used for PHPS in the clinical setting. However, which modality is more effective has yet to be determined. OBJECTIVE: To examine whether EA is more effective than MA with regards to pain relief for patients with PHPS. METHODS: Participants were randomly assigned (1:1) to receive 12 treatment sessions of EA or MA over 4 weeks with 24 weeks of follow-up. The primary outcome was the proportion of treatment responders, defined as patients with at least a 50% reduction from baseline in the worst pain intensity experienced during the first steps in the morning after a 4-week treatment, measured using a visual analogue scale (VAS, 0-100; higher scores signify worse pain). Analysis was by intention-to-treat. RESULTS: Ninety-two patients with a clinical diagnosis of PHPS were enrolled from 29 July 2018 through 28 June 2019. Of the patients, 78 (85%) completed the treatment and follow-up. The primary outcome occurred in 54.8% (23/42) of the EA group compared to 50.0% (21/42) of the MA group after the 4-week treatment (difference -4.76, 95% confidence interval, -26.10 to 16.57, P = 0.662). There were no significant between-group differences for any secondary outcomes after 4 weeks of treatment and at 16 weeks and 28 weeks of follow-up. There were no serious treatment-related adverse events in either group. CONCLUSION: Among patients with PHPS, EA did not have a better effect with respect to relieving pain intensity than MA at week 4, although both EA and MA appeared to have positive temporal effects, with decreased heel pain and improved plantar function. TRIAL REGISTRATION NUMBER: ChiCTR1800016531 (Chinese Clinical Trial Registry).

Úlcera por presión en talón, en paciente frágil multirresistente a antibióticos / Pressure ulcer in heel, in fragile patient multiresistant to antibiotics

Objetivo: describir el proceso de curación de una úlcera en un paciente frágil. Metodología: antes de realizar el artículo se llevó a cabo la información previa a la familia y la obtención del consiguiente consentimiento informado. Una vez hecho esto, se procedió a la elaboración del mismo sobre los datos ya obtenidos de la práctica enfermera llevada en el centro hasta la curación de la lesión. Resultados: tras 11 meses, se completó el proceso de curación de la úlcera. Conclusiones: en pacientes con procesos crónicos en los que se ve afectado el estado físico y el deterioro es paulatino en todos los ámbitos, es muy probable la aparición de estas lesiones. No obstante, con una buena actuación del equipo de enfermería es posible la curación, a pesar de barreras como fue la multirresistencia a antibióticos de la residente

Objective: To describe the healing process of an ulcer in a fragile patient. Methodology: prior to the completion of the article the previous information was carried out to the family and the consequent informed consent. Once this was done, it was elaborated; On data already obtained from the nurse practice carried out in the center until the lesion was healed. Results: after 11 months, the healing process of the ulcer was completed. Conclusions: in patients with chronic processes in which physical condition is affected and deterioration is gradual in all areas is very likely the appearance of these lesions. However, with a good performance of the nursing team is possible the cure, despite barriers such as multiresistance to antibiotics of the resident

The Effect of Swaddling on Pain, Vital Signs, and Crying Duration during Heel Lance in Newborns.

To determine the effect of swaddling on pain, vital signs, and crying duration during heel lance in the newborn. This was a randomized controlled study of 74 (control: 37, experiment: 37) newborns born between December 2013 and February 2014 at the Ministry of Health Bagcilar Training and Research Hospital. An information form, observation form, and Neonatal Infant Pain Scale were used as data collection tools. Data from the pain scores, peak heart rates, oxygen saturation, total crying time, and duration of the procedure were collected using a video camera. Newborns in the control group underwent routine heel lance, whereas newborns in the experimental group underwent routine heel lance while being swaddled by the researcher. The newborns' pain scores, peak heart rates, oxygen saturation values, and crying durations were evaluated using video recordings made before, during, and 1, 2, and 3 minutes after the procedure. Pain was assessed by a nurse and the researcher. No statistically significant difference was found in the characteristics of the two groups (p > .05). The mean pain scores of swaddled newborns during and after the procedure were lower than the nonswaddled newborns (p < .05). In addition, crying duration of swaddled newborns was found to be shorter than the nonswaddled newborns (p < .05). The average preprocedure peak heart rates of swaddled newborns were higher (p < .05); however, the difference was not significant during and after the procedure (p > .05). Although there was no significant difference in oxygen saturation values before and during the procedure (p > .05), oxygen saturation values of swaddled newborns were higher afterward (p < .05). For this study sample, swaddling was an effective nonpharmacologic method to help reduce pain and crying in an effort to soothe newborns. Although pharmacologic pain management is the gold standard, swaddling can be recommended as a complementary therapy for newborns during painful procedures. Swaddling is a quick and simple nonpharmacologic method that can be used by nurses to help reduce heel stick pain in newborns.

Pain relief effect of breast feeding and music therapy during heel lance for healthy-term neonates in China: a randomized controlled trial.

OBJECTIVES: to test the effectiveness of breast feeding (BF), music therapy (MT), and combined breast feeding and music therapy (BF+MT) on pain relief in healthy-term neonates during heel lance. DESIGN: randomised controlled trial. SETTING: in the postpartum unit of one university-affiliated hospital in China from August 2013 to February 2014. PARTICIPANTS: among 288 healthy-term neonates recruited, 250 completed the trial. All neonates were undergoing heel lancing for metabolic screening, were breast fed, and had not been fed for the previous 30 minutes. INTERVENTIONS: all participants were randomly assigned into four groups - BF, MT, BF+MT, and no intervention - with 72 neonates in each group. Neonates in the control group received routine care. Neonates in the other three intervention groups received corresponding interventions five minutes before the heel lancing and throughout the whole procedure. MEASUREMENTS: Neonatal Infant Pain Scale (NIPS), latency to first cry, and duration of first crying. FINDINGS: mean changes in NIPS scores from baseline over time was dependent on the interventions given. Neonates in the BF and combined BF+MT groups had significantly longer latency to first cry, shorter duration of first crying, and lower pain mean score during and one minute after heel lance, compared to the other two groups. No significant difference in pain response was found between BF groups with or without music therapy. The MT group did not achieve a significantly reduced pain response in all outcome measures. CONCLUSIONS: BF could significantly reduce pain response in healthy-term neonates during heel lance. MT did not enhance the effect of pain relief of BF. IMPLICATIONS FOR PRACTICE: healthy-term neonates should be breast fed to alleviate pain during heel lance. There is no need for the additional input of classical music on breast feeding in clinic to relieve procedural pain. Nurses should encourage breast feeding to relieve pain during heel lance.

Talalgia. Revisión bibliográfica / Talalgia. Bibliographic review

Objetivo. Analizar los conceptos generales del dolorlocalizado en el talón que pudiera estar en relación conla irritación de la fascia plantar o del hueso del talón,donde se precisará la epidemiología del dolor, laetiopatogenia, el cuadro clínico referido por el pacienteasí como los estudios de imagenología que ayudarían asu diagnóstico.Método. El tratamiento se debe comenzar con medidassimples y con baja probabilidad de efectos secundarioshaciendo recomendaciones a los pacientes;posteriormente indicando medicamentos analgésicosy/o antinflamatorios no esteroideos y medidas físicasrehabilitadoras como termoterapia, ultrasonidos,magnetoterapia, hidroterapia, láser, iontoforesis,corrientes analgésicas de baja y media frecuencia, ondasde choque extracorpóreas, ortesis, taloneras, calzadoadecuado, yesos, masajes y ejercicios de estiramiento dela fascia plantar y en algunos casos bloqueo, anestésicodel nervio tibial posterior, infiltraciones con esteroides y en caso de ser necesario o estuviera indicado, la conducta quirúrgica.Conclusiones. Su diagnóstico precoz, el tratamientodel dolor, la descarga de la tensión de la fascia plantary la corrección de las anomalías del antepié y retropiéson factores que contribuyen atenuar las molestiasen el paciente y a disminuir la discapacidad queocasiona esta enfermedad de quienes la padecen

Objective. To analyze the general concepts of heel located pain that might be related to the irritation of the plantar fascia or bone of the heel, which require pain epidemiology, pathogenesis, clinical manifestationsreported by the patient and imaging studies that wouldhelp its diagnosis.Methods. Treatment should begin with simple measuresand with low probability of side effects recommendingpatients; subsequently indicating pain medication and /or non-steroidal antiinflammatory and physicalrehabilitative measures as thermotherapy, ultrasound,magnetotherapy, hydrotherapy, laser, iontophoresis, lowand medium frequency analgesic currents, extracorporealshock waves, bracing, plantar insoles, appropriatefootwear, plasters, massage and stretching exercises of the plantar fascia, and in some cases anesthetic blockade of the posterior tibial nerve, steroid infiltration and if necessary or indicated, surgical treatment.Conclusions. The early diagnosis and treatment,pain, discharge from the tension of the plantar fascia,the correction of forefoot and rearfoot anomalies arecontributing factors to ease discomfort in the patientand to reduce the disability that causes this diseaseto whom suffer

A Scottish study of heel-prick blood sampling in newborn babies.

OBJECTIVE: to conduct a randomised-controlled trial to investigate the effectiveness of two heel-prick devices (Tenderfoot and Genie Lancet) used in the newborn-baby screening test. DESIGN: a randomised-controlled trial. PARTICIPANTS AND SETTING: the homes of 340 healthy term newborn babies discharged from the maternity unit of Stirling Royal Infirmary, Scotland. Data were collected between April and November 2003. INTERVENTIONS: babies were randomly allocated to be tested with either the Tenderfoot or Genie Lancet heel-prick device. MEASUREMENTS: primary study outcomes include (1) quality of the blood sample; (2) time taken to collect the sample; (3) number of heel pricks required to take the sample; (4) whether squeezing of heel was required; (5) pain expressed by the baby; and (6) presence of bruising. A potential intervening variable was the experience of the midwife. FINDINGS: on all outcomes, the Tenderfoot device was more effective than the Genie Lancet. Experienced midwives were more efficient in sample collection. KEY CONCLUSIONS: this study shows that the Tenderfoot device saves significant time for midwifery staff, improves baby care and reduces the need for more than one heel prick at each test, making it superior to the Genie Lancet device. IMPLICATIONS FOR PRACTICE: there is a case to be made for midwives to be issued with the Tenderfoot device for neonatal screening.

Hot spring burns.

This case report describes a woman who, while visiting a hot spring, received partial- and full-thickness immersion scald burns of both ankles and heels. The prevention of such accidents is most important; efforts should be made to educate guides and tourists about the potential hazards inherent in these resorts.

Ulceras por decúbito e Hidroterapia en las termas de Copahue / Decubitus ulcers and hydrotherapy in the Copahue Thermal Complex

Se presenta el caso de una niña de 9 años con paraparesia y escaras por decúbito de más de 6 meses de evolución, tratada con hidroterapia integral en las Termas de Copahue (Neuquén-Argentina). Mediante esta terapeútica pudimos observar una rápida y excelente respuesta, tanto de las lesiones cutáneas como de su cuadro general

Ulceras por decúbito e Hidroterapia en las termas de Copahue / Decubitus ulcers and hydrotherapy in the Copahue Thermal Complex

Se presenta el caso de una niña de 9 años con paraparesia y escaras por decúbito de más de 6 meses de evolución, tratada con hidroterapia integral en las Termas de Copahue (Neuquén-Argentina). Mediante esta terapeútica pudimos observar una rápida y excelente respuesta, tanto de las lesiones cutáneas como de su cuadro general