Pain types and risk factors in post-COVID-19.

Objectives: This study aims to accurately evaluate pain lasting longer than three months and falls under the category of chronic pain and to determine the risk factors to follow up and treat properly and to develop appropriate diagnostic and treatment algorithms. Patients and methods: Between March 2021 and December 2021, a total of 437 patients (162 males, 275 females; mean age: 44±14.6 years; range, 12 to 82 years) who were referred to the participating centers due to pain complaints and were diagnosed with post-COVID-19 condition according to the criteria defined by the World Health Organization (WHO) were included in the study. The patients were divided into three groups as nociceptive pain, neuropathic pain, and central sensitization, based on the physician's clinical evaluation and the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Central Sensitization Inventory scores. Results: The most common diagnosis was nociceptive pain followed by central sensitization. Patients with nociceptive pain had less pain. It was found that not exercising regularly, having a chronic disease and being a woman were risk factors for central sensitization, having thyroid disease before COVID-19, and defining the current pain as very severe were risk factors for neuropathic pain. Conclusion: In the evaluation of post-COVID-19 pain, neuropathic pain and central sensitization should be also considered in addition to nociceptive pain and the severity of pain, systemic diseases and physical activity should be questioned.

Investigation of Effectiveness of Two Different Kinesiotaping Techniques in Myofascial Pain Syndrome: An Open-Label Randomized Clinical Trial.

BACKGROUND: Myofascial pain syndrome is a regional musculoskeletal pain syndrome characterized by trigger points. Although there are widely accepted treatment modalities, there is no gold standard treatment. Kinesiotaping represents an interesting modality in the treatment of musculoskeletal disorders and attracts attention with studies emerging in the recent years, but in spite of the proposed benefits of kinesiotaping, its efficacy is still unclear, thus further studies evaluating the effectiveness of kinesiotaping are needed. OBJECTIVES: We aimed to investigate, not only the effectiveness of kinesiotaping applied with the space correction and muscle inhibition techniques (compared to the home exercise program in reducing pain and improving functional status and quality of life in female patients with myofascial pain syndrome related to active trigger points in the upper trapezius), but also to evaluate the superiority of the 2 techniques over each other. STUDY DESIGN: An open-label randomized clinical trial with a parallel assignment intervention model. SETTING: The physical medicine and rehabilitation clinics in Istanbul University, Istanbul Faculty of Medicine. METHODS: Seventy-one female patients with the complaint of pain in the upper trapezius region, diagnosed with myofascial pain syndrome, and having at least one active trigger point in the upper trapezius fibers, were randomly assigned by a computer program to 1 of the 3 groups: kinesiotaping with the space correction technique (KSCT, n = 20), kinesiotaping with the muscle inhibition technique (KMIT, n = 24), and the home exercise program alone (control group [CG], n = 27). The patients were evaluated by the numerical rating scale for pain intensity, the neck disability index for functional status, and the 36-Item Short-Form Health Survey for quality of life in the beginning of the study and at the first, second, and sixth weeks (1-month follow-up). RESULTS: Kinesiotaping was associated with lower pain intensity levels (P = 0.019 at the first week and P = 0.026 at the second week) and better functional status (P = 0.011 at the second week) and it was effective in increasing quality of life by improving physical functions and general health (P = 0.033 and P = 0.003 at the second week, respectively) earlier than in the CG. Role limitations due to physical factors improved in the KMIT group earlier than in the other groups (P = 0.022 at the second week). LIMITATIONS: Being performed in a limited number of female patients only, absence of a placebo group, and lack of blinded assessments. CONCLUSION: Both kinesiotaping methods were associated with lower pain intensity levels and better functional status and were effective in increasing quality of life by improving physical functions and general health earlier than the home exercise program. There was no significant difference between the kinesiotaping methods, except for role limitations due to the physical factors domain of SF-36 which was improved in the KMIT group earlier than in the KSCT group and CGs.

Effectiveness of Multilevel Botulinum Toxin A Injection with Integrated Treatment Program on Spasticity Reduction in Non-Ambulatory Young Children with Cerebral Palsy.

OBJECTIVE: The aim of the present study was to evaluate the effectiveness of multilevel Botulinum Toxin A (BTX-A) injection, as part of an integrated approach, for the treatment of spasticity in non-ambulatory young children with diplegic cerebral palsy (CP). SUBJECTS AND METHODS: Seventeen non-ambulatory patients aged 4-8 years with diplegic CP (Gross Motor Function Classification System [GMFCS] level IV) were evaluated before and at 1st, 3rd, and 6th months after BTX-A injection. The effect of BTX-A on spasticity of gastrocnemius and hamstring muscles was assessed using the Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS). The velocity-dependent properties of spastic muscle as both slow (R2) and fast (R1) stretches were evaluated in MTS. RESULTS: A statistically significant improvement was observed in R1 angles of gastrocnemius and hamstring muscles at 1st and 3rd months after BTX-A injection in non-ambulatory young children with CP. Statistically significant improvement was found in MAS of gastrocnemius and hamstring muscles and R2 angles of knee and ankle joint after 1st month of BTX-A injection. CONCLUSION: Multilevel BTX-A injection, as part of an integrated approach, can be used for focal treatment of spasticity, especially of hamstring and gastrocnemius muscles, in non-ambulatory young children with CP GMFCS level IV.