Immediate effects of microsystem acupuncture in patients with oromyofacial pain and craniomandibular disorders (CMD): a double-blind, placebo-controlled trial.

BACKGROUND: Patients presenting with oromyofacial disorders and pain in the head and neck area are often resistant to conventional therapy. Acupuncture has been shown to be effective in pain reduction. METHODS: Twenty-three patients with craniomandibular disorders, headache and, in particular, local pain in the orofacial, cervical and temporomandibular joint areas were randomised into acupuncture or placebo laser therapy groups. Pain was assessed by a visual analogue scale (VAS) and by palpation of 14 muscles and groups of muscles immediately before and after treatment, the assessor being blinded to the patients' allocation. Applicable acupuncture points were searched and pricked using the 'very-point' technique. FINDINGS: Pain reduction measured by VAS was significantly more pronounced after acupuncture than after placebo treatment (p=0.031). Sum of pain scores across 14 muscles was considerably more reduced after acupuncture as compared to sham laser treatment. INTERPRETATION: Acupuncture may bring about immediate pain relief in patients with oromyofacial disorders, increasing the chance to initiate other therapeutic measures.

[Ambulatory rehabilitation after myocardial infarct in Austria]. / Ambulante Rehabilitation nach Herzinfarkt in Osterreich.

Cardiac rehabilitation after myocardial infarction has a positive effect on the patient's quality of life and on the prognosis of the disease as well. The cost-saving effect is of importance from the socioeconomical viewpoint. A measurable benefit of such rehabilitation programs can only be achieved by long-term comprehensive care, however. Therefore a hospital rehabilitation program should be followed by regular participation in a long-term community rehabilitation program. The network of cardiac rehabilitation centres in Austria is highly developed and consequently it is possible for every insured patient to be placed for inpatient follow-up therapy on recovering from myocardial infarction. On the other hand, the long-term community cardiac rehabilitation programs are organized only on a sketchy and small scale. A survey amongst patients after myocardial infarction carried out all over Austria showed that 700 patients are currently being treated in 56 community programs. The sponsorship varies a lot. A majority of these groups is organized and financed by the patients themselves. The medical and physiotherapeutic services are mainly organized by the patients as well. They are only partly trained for their task. The care programs take place on a regular basis and the provided services appear adequate, some groups excepted. Medical follow-up examinations to evaluate progress hardly exist. Therefore, quality control of the work in the community programs is not possible at the moment in Austria. A well-organized community care rehabilitation program covering the whole region exists only in Vorarlberg. This program mainly follows the "Feldkircher Modell". The results of this study indicate the urgent necessity to establish additional community care programs for outpatient cardiac rehabilitation in Austria. Furthermore, a common register of the groups, a common organisational model and sponsorship, as well as quality control based on regular medical examination of the patients are essential requirements. A constant exchange of experience with the inpatient rehabilitation centres is to be recommended as well.

[Rehabilitation after myocardial infarct. Autogenic training in the ambulatory coronary-sports group]. / Rehabilitation nach Herzinfarkt. Autogenes Training in der ambulanten Koronarsportgruppe.

19 patients after myocardial infarction were examined in an out-patient coronary sport group setting. One group did sport and AT (Autogenic Training), one group only sport. 7 patients, all belonging to the sport group without AT left the coronary sport group early: a clear indication of the motivating function of AT. Furthermore, the results showed that the "coronary-A-behaviour" (infarction prone behaviour) was less pronounced after therapy, and in particular in the AT plus sport patients more distinctly than in the purely sport patients. Therefore a protective effect of the AT against myocardial infarction was observed. It seems to help the patients to a better insight into behaviour and it also seems to favour their motivation for active prophylactic measures.