Comparison of the therapeutic efficacy of double-modality therapy, phonophoresis and cryotherapy in the management of musculoskeletal injuries in adult Nigerian subjects.

This study was designed to compare the efficacy of double-modality therapy, phonophoresis and cryotherapy in the management of pain among subjects who suffered from musculoskeletal injuries (MSIs).Sixty (60) subjects were assigned randomly to one of three groups: DMT group (n=20) received cryotherapy and 15% methyl salicylate phonophoresis, PHONO group (n=20) received 15% methyl salicylate phonophoresis and CRYO group (n=20) received cryotherapy and "sham? phonophoresis. Ultrasound at an intensity of 1.5 W/cm² and frequency of 1MHz was used to apply methyl salicylate while intermittent cryotherapy was the mode of application. Subjects? pre- and post-treatment pain perception scores (PPS) using visual analogue scale (VAS) were assessed and the sessions of treatment in all groups were recorded. Treatment was administered on alternate days and discharges were made in all groups when subjects were pain free. A total of 275 treatment sessions was recorded - 72 (26.2%) in DMT, 105 (38.2%) in PHONO and 98 (35.6%) in CRYO group respectively which indicated no significant difference (P>0.05). Nineteen (19), thirteen (13) and twelve (12) subjects were pain free in DMT, CRYO or PHONO groups respectively after 1 to 5 treatments. The difference in the severity of pain was significant (P<0.05) in each group post-treatment which suggests that DMT, phonophoresis and cryotherapy were equally effective. The study has demonstrated therapeutic efficacy of DMT, but it was not superior to the single treatment protocol of phonophoresis or cryotherapy. However, it might take fewer sessions in the DMT group to treat and make more than 90% of the subjects pain free and fit to return to active performance.

Health-related quality of life and its determinants in HIV patients with post herpetic neuralgia.

BACKGROUND: Postherpetic neuralgia is a neuralgia caused by the varicella zoster virus. Its natural history involves slow resolution of the pain syndrome. A subgroup of patients may develop severe, long-lasting pain that does not respond to medical therapy. It also accounts for 11-15% of all referrals to pain clinics but little is known about the quality of life of patients with this condition in our locality Nigeria. METHOD: Fifty three Post herpetic Neuralgia patients aged between 25 and 56 years (mean = 37.47 +/- 8.29 years) receiving antiretroviral therapy/treatment at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria participated in this study. The short-form 36 (SF-36) generic health-related Quality of Life questionnaire was used to assess the QoL. Spearman rank correlation procedure was used to evaluate the relationship of HRQoL outcomes with medical and socio-demographic factor. RESULT: Physical functioning), Role limitations due to physical health (LPH), Role limitations due to emotional problems (LEP), Social functioning (SF), General health perceptions (GH) scores were below average (35.59 +/- 19.85, 34.28 +/- 33.16, 33.70 +/- 23.26, 49.07 +/- 17.04, 44.09 +/- 9.72 respectively) while Emotional well being/Mental health (EM) was above average (50.13 +/- 11.56). An average (moderate) symptom scale score was Energy/Fatigue (EF) (51.32 +/- 12.87) while Bodily pain (BP) was severe (31.09 +/- 20.46). Age and sex had no significant influence on any of the functional and symptom scale scores as well as the overall QOL. Inverse relationship was observed between age and each of the LPH, LEP, SF, GH, overall QoL and the entire symptom scales. The overall QoL and each of the symptom scale scores were significantly related (P > 0.05). The functional scale score PF, RPH, REP EM and GH were significantly related to overall QoL while SF was not significantly related (P > 0.01). CONCLUSION: This study has shown that the overall QoL of PHN in HIV positive patients undergoing adjuvant therapy is below average. The predictor factors of the overall QoL of this group of patients have been brought to light. These patients would require ways to improve the QoL, there is the need for health care provider to address the factors uncovered by this study. Four of the determinant factors (PF, LP, BP and EF) are issues that fall within the corridor of physical therapy. Physical therapist should arise to address these significant aspects of the management this group of patients.