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1.
Pain Manag Nurs ; 20(4): 316-322, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31103513

RESUMO

BACKGROUND: This study assessed the feasibility of implementing a yoga intervention adapted for participants diagnosed with chronic pain in a large Midwest neuroscience pain clinic. Although conducted using a small convenience sample, this was a novel program in that it was led by an advanced practice nurse certified in pain management and to teach yoga. She was therefore uniquely qualified to tailor the yoga practice to suit individual needs of study participants. DESIGN: The intervention consisted of a weekly 1-hour class for 10 weeks. Feasibility measures included patient recruitment, program adherence, patient satisfaction, global impression of change, and likelihood of continuing yoga practice. In addition, it was hypothesized that the program would positively affect participants' pain interference, physical function, pain intensity, pain behavior, mood, sleep, and pain medication usage. METHODS: Survey measurements were conducted 10 weeks before class start, immediately before the first class, and immediately after the last class. CONCLUSIONS: Although there is a strong body of research supporting the benefits of yoga for chronic pain conditions, our experience highlights some of the challenges of implementing an adaptive yoga program. Our study found that recruitment of patient through physician referral was highly feasible; however, retention rates for participants were very low. Program adherence is a barrier for research on yoga in chronic pain, as well as for clinical practice. A slight reduction in pain interference and physical function over time and trend toward improvement in all exploratory outcomes was identified. None of these trends were statistically significant, likely because of small sample size.


Assuntos
Dor Crônica/terapia , Manejo da Dor/normas , Modalidades de Fisioterapia/normas , Yoga , Adulto , Dor Crônica/psicologia , Estudos de Viabilidade , Feminino , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Minnesota , Manejo da Dor/métodos , Manejo da Dor/estatística & dados numéricos , Satisfação do Paciente , Seleção de Pacientes , Inquéritos e Questionários , Cooperação e Adesão ao Tratamento/psicologia , Cooperação e Adesão ao Tratamento/estatística & dados numéricos
2.
Artigo em Inglês | MEDLINE | ID: mdl-30774986

RESUMO

Introduction: Low back pain is a leading disability worldwide; however, it is not often the result of a serious underlying condition such as a tumor. As a result, diagnosis of a serious underlying cause of low back pain may be delayed, such as in this case. Case presentation: We describe a case of a man presenting with low back pain, who was eventually diagnosed with solitary bone plasmacytoma (SBP) causing spinal cord compression from approximately T7-T9. The patient was classified as T8 ASIA C-Incomplete Paraplegia. He underwent an emergency T7-T9 open posterior laminectomy and resection of the epidural mass/tumor. Following an intensive course of rehabilitation treatment, the patient progressed to ASIA D. Discussion: Although SBP of the spine is rare, back or neck pain is a common initial presentation. This case is unique in that we provide a detailed description of both medical and rehabilitation diagnosis and treatment. We also suggest that persistent back pain warrants complete MRI spinal imaging to provide proper diagnosis and prompt treatment for cases with a serious underlying condition.


Assuntos
Dor nas Costas/diagnóstico , Plasmocitoma/diagnóstico , Compressão da Medula Espinal/diagnóstico , Neoplasias da Coluna Vertebral/diagnóstico , Vértebras Torácicas/diagnóstico por imagem , Idoso , Humanos , Laminectomia , Imageamento por Ressonância Magnética , Masculino , Plasmocitoma/complicações , Plasmocitoma/cirurgia , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/reabilitação , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/cirurgia , Vértebras Torácicas/cirurgia
3.
Am J Phys Med Rehabil ; 98(10): e119-e122, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30557157

RESUMO

Longitudinal myelitis secondary to an acute flare of systemic lupus erythematosus has been reported in the literature. There have been few published cases of complete functional recovery in patients with systemic lupus erythematosus-related longitudinal myelitis (systemic lupus erythematosus-related longitudinal myelitis). Of those cases, none have described in detail the rehabilitation course of treatment. In the current case, intensive rehabilitation was coupled with aggressive pharmaceutical treatment resulting in almost full functional recovery. A 23-yr-old African American woman with a history of systemic lupus erythematosus was originally admitted as an inpatient for flank pain. Overnight, she progressed rapidly to complete flaccid paraplegia classified as T3 American Spinal Injury Association Impairment Scale A based on the International Standards for Neurological Classification of Spinal Cord Injury. Throughout the next year, she participated in acute inpatient rehabilitation, followed by outpatient rehabilitation (physical, occupational, and aquatic therapies). A year after her initial hospital admission, she progressed to full community ambulation T3 American Spinal Injury Association Impairment Scale D. This case illustrates the importance of proper medical treatment and a comprehensive rehabilitation program, which improved functional outcomes for a patient with a complete spinal cord injury due to systemic lupus erythematosus-related longitudinal myelitis.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Mielite Transversa/etiologia , Mielite Transversa/terapia , Reabilitação Neurológica , Feminino , Humanos , Mielite Transversa/diagnóstico , Recuperação de Função Fisiológica , Adulto Jovem
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