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1.
Praxis (Bern 1994) ; 110(12): 661-665, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34521271

RESUMO

The Painful Wrist Abstract. Wrist pain is a problem that can significantly limit patients in their daily activities. The causes are manifold, and treatment is often challenging. A systematic approach is therefore helpful in working up the correct diagnosis. This article aims to demonstrate a straightforward approach to the evaluation of wrist pain in adults.


Assuntos
Articulação do Punho , Punho , Adulto , Artralgia/etiologia , Humanos , Punho/diagnóstico por imagem , Articulação do Punho/diagnóstico por imagem
3.
Geriatr Gerontol Int ; 21(9): 830-835, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34342386

RESUMO

AIM: Post-hip fracture knee pain (PHFKP) develops in 28-37.4% of patients with hip fracture and contributes to prolonged hospitalization. Although reduced balance and gait speed contribute to falls, the effects of PHFKP remain unclear. This study aimed to clarify whether PHFKP is a factor in balance and gait speed. METHODS: We retrospectively reviewed the medical records of patients after hip fracture. Development of PHFKP, basic information, and physical function were examined. Berg balance scale (BBS) and maximum walking speed (MWS) were collected at discharge. These parameters were compared with the presence or absence of PHFKP. In addition, multiple analyses were conducted with BBS and MWS as dependent variables and PHFKP as one of the independent variables. RESULTS: Of the 146 patients enrolled, 43 (29.5%) developed PHFKP, and 37.2% of patients with PHFKP showed residual symptoms at discharge. Intensity of PHFKP was mostly mild to moderate. The PHFKP group showed an extended length of stay (+13.3 days) and a tendency toward more discharges to facilities compared with the control group. Knee extension range of motion limitation, knee extensor strength, and BBS did not differ between groups, while MWS was significantly lower in the PHFKP group (0.85 ± 0.32 m/s vs. 1.07 ± 0.39 m/s). Multiple analyses showed that development of PHFKP was not associated with BBS, but was associated with decreased MWS (standardized beta = -0.202, P = 0.005). CONCLUSIONS: PHFKP was identified as an independent factor in gait speed decline. PHFKP patients should be monitored for reduced gait speed during rehabilitation. Geriatr Gerontol Int 2021; 21: 830-835.


Assuntos
Fraturas do Quadril , Velocidade de Caminhada , Idoso , Artralgia/diagnóstico , Artralgia/etiologia , Marcha , Fraturas do Quadril/cirurgia , Humanos , Pacientes Internados , Estudos Retrospectivos , Caminhada
4.
J Korean Med Sci ; 36(34): e245, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34463066

RESUMO

Since February 26, 2021, when vaccination against coronavirus disease 2019 (COVID-19) began in South Korea, patients who visited the Korea University Guro Hospital with suspected adverse events after COVID-19 vaccination were monitored actively with interest. We encountered five unusual cases of polyarthralgia and myalgia syndrome in patients who received the ChAdOx1 nCOV-19 (AstraZeneca) vaccine. The patients (median age 67 years) were not previously diagnosed with arthropathy and rheumatologic diseases. They developed fever, myalgia, joint pain, and swelling three to seven days after vaccination. The symptoms persisted for up to 47 days despite antipyretic treatment. Arthralgia occurred in multiple joints, including small and large joints. A whole-body Technetium-99m methylene diphosphonate bone scan revealed unusual uptakes in the affected joints. Non-steroidal anti-inflammatory drugs with or without prednisolone relieved the symptoms of all patients. Further monitoring is required to clarify the long-term prognosis of this syndrome.


Assuntos
Artralgia/etiologia , Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Mialgia/etiologia , Vacinação/efeitos adversos , Adulto , Idoso , Antipsicóticos/uso terapêutico , Artralgia/tratamento farmacológico , COVID-19/virologia , Feminino , Humanos , Articulações/diagnóstico por imagem , Articulações/patologia , Mialgia/tratamento farmacológico , República da Coreia , SARS-CoV-2/isolamento & purificação , Tomografia Computadorizada por Raios X
5.
J Fam Pract ; 70(5): 249-251, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34410917

RESUMO

An untreated infection led to a series of unusual signs and symptoms that included difficulty walking.


Assuntos
Artralgia/etiologia , Exantema/etiologia , Ceratose/diagnóstico , Artrite Reativa/complicações , Artrite Reativa/diagnóstico , Pé/fisiologia , Pé/fisiopatologia , Humanos , Ceratose/complicações , Posição Genupeitoral , Masculino , Adulto Jovem
7.
Bone Joint J ; 103-B(8): 1380-1385, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34334043

RESUMO

AIMS: The aim of this study was to assess arthritis of the basal joint of the thumb quantitatively using bone single-photon emission CT/CT (SPECT/CT) and evaluate its relationship with patients' pain and function. METHODS: We retrospectively reviewed 30 patients (53 hands) with symptomatic basal joint arthritis of the thumb between April 2019 and March 2020. Visual analogue scale (VAS) scores for pain, grip strength, and pinch power of both hands and Patient-Rated Wrist/Hand Evaluation (PRWHE) scores were recorded for all patients. Basal joint arthritis was classified according to the modified Eaton-Glickel stage using routine radiographs and the CT scans of SPECT/CT, respectively. The maximum standardized uptake value (SUVmax) from SPECT/CT was measured in the four peritrapezial joints and the highest uptake was used for analysis. RESULTS: According to Eaton-Glickel classification, 11, 17, 17, and eight hands were stage 0 to I, II, III, and IV, respectively. The interobserver reliability for determining the stage of arthritis was moderate for radiographs (k = 0.41) and substantial for CT scans (k = 0.67). In a binary categorical analysis using SUVmax, pain (p < 0.001) and PRWHE scores (p = 0.004) were significantly higher in hands with higher SUVmax. Using multivariate linear regression to estimate the pain VAS, only SUVmax (B 0.172 (95% confidence interval (CI) 0.065 to 0.279; p = 0.002) showed a significant association. Estimating the variation of PRWHE scores using the same model, only SUVmax (B 1.378 (95% CI, 0.082 to 2.674); p = 0.038) showed a significant association. CONCLUSION: The CT scans of SPECT/CT provided better interobserver reliability than routine radiographs for evaluating the severity of arthritis. A higher SUVmax in SPECT/CT was associated with more pain and functional disabilities of basal joint arthritis of the thumb. This approach could be used to complement radiographs for the evaluation of patients with this condition. Cite this article: Bone Joint J 2021;103-B(8):1380-1385.


Assuntos
Artralgia/diagnóstico por imagem , Artralgia/fisiopatologia , Artrite/diagnóstico por imagem , Artrite/fisiopatologia , Articulações Carpometacarpais/fisiopatologia , Estado Funcional , Medição da Dor/métodos , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Idoso , Artralgia/etiologia , Artrite/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
9.
BMC Oral Health ; 21(1): 374, 2021 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-34303363

RESUMO

BACKGROUND: In terms of diagnostic and therapeutic management, clinicians should adequately address the frequent aspects of temporomandibular joint (TMJ) osteoarthritis (OA) associated with disk displacement. Condylar erosion (CE) is considered an inflammatory subset of OA and is regarded as a sign of progressive OA changes potentially contributing to changes in dentofacial morphology or limited mandibular growth. The purpose of this study was to establish a risk prediction model of CE by a multivariate logistic regression analysis to predict the individual risk of CE in TMJ arthralgia. It was hypothesized that there was a closer association between CE and magnetic resonance imaging (MRI) indicators. METHODS: This retrospective paired-design study enrolled 124 consecutive TMJ pain patients and analyzed the clinical and TMJ-related MRI data in predicting CE. TMJ pain patients were categorized according to the research diagnostic criteria for temporomandibular disorders (RDC/TMD) Axis I protocol. Each patient underwent MRI examination of both TMJs, 1-7 days following clinical examination. RESULTS: In the univariate analysis analyses, 9 influencing factors were related to CE, of which the following 4 as predictors determined the binary multivariate logistic regression model: missing posterior teeth (odds ratio [OR] = 1.42; P = 0.018), RDC/TMD of arthralgia coexistant with disk displacement without reduction with limited opening (DDwoR/wLO) (OR = 3.30, P = 0.007), MRI finding of disk displacement without reduction (OR = 10.96, P < 0.001), and MRI finding of bone marrow edema (OR = 11.97, P < 0.001). The model had statistical significance (chi-square = 148.239, Nagelkerke R square = 0.612, P < 0.001). Out of the TMJs, 83.9% were correctly predicted to be CE cases or Non-CE cases with a sensitivity of 81.4% and a specificity of 85.2%. The area under the receiver operating characteristic curve was 0.916. CONCLUSION: The established prediction model using the risk factors of TMJ arthralgia may be useful for predicting the risk of CE. The data suggest MRI indicators as dominant factors in the definition of CE. Further research is needed to improve the model, and confirm the validity and reliability of the model.


Assuntos
Luxações Articulares , Disco da Articulação Temporomandibular , Artralgia/etiologia , Humanos , Luxações Articulares/diagnóstico por imagem , Modelos Logísticos , Imageamento por Ressonância Magnética , Mandíbula , Reprodutibilidade dos Testes , Estudos Retrospectivos , Articulação Temporomandibular , Disco da Articulação Temporomandibular/diagnóstico por imagem
10.
Front Immunol ; 12: 686029, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34276671

RESUMO

More than one year since its emergence, corona virus disease 2019 (COVID-19) is still looming large with a paucity of treatment options. To add to this burden, a sizeable subset of patients who have recovered from acute COVID-19 infection have reported lingering symptoms, leading to significant disability and impairment of their daily life activities. These patients are considered to suffer from what has been termed as "chronic" or "long" COVID-19 or a form of post-acute sequelae of COVID-19, and patients experiencing this syndrome have been termed COVID-19 long-haulers. Despite recovery from infection, the persistence of atypical chronic symptoms, including extreme fatigue, shortness of breath, joint pains, brain fogs, anxiety and depression, that could last for months implies an underlying disease pathology that persist beyond the acute presentation of the disease. As opposed to the direct effects of the virus itself, the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is believed to be largely responsible for the appearance of these lasting symptoms, possibly through facilitating an ongoing inflammatory process. In this review, we hypothesize potential immunological mechanisms underlying these persistent and prolonged effects, and describe the multi-organ long-term manifestations of COVID-19.


Assuntos
COVID-19/complicações , SARS-CoV-2/imunologia , Ansiedade/etiologia , Artralgia/etiologia , Autoimunidade , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/virologia , Depressão/etiologia , Dispneia/etiologia , Fadiga/etiologia , Microbioma Gastrointestinal/imunologia , Humanos , Hospedeiro Imunocomprometido , Incidência , Prevalência , Sistema Renina-Angiotensina/imunologia
13.
Surg Obes Relat Dis ; 17(9): 1637-1653, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34116961

RESUMO

Obesity increases the risk of osteoarthritis and the chance of needing joint replacement arthroplasty to reduce lower limb joint pain. Although nonsurgical weight loss interventions can reduce hip and knee joint pain, bariatric surgery may be a more feasible treatment option for people with severe obesity. However, it is unclear whether weight loss through bariatric surgery can positively influence hip and knee joint pain. Our objective was to evaluate the influence of bariatric surgery on hip and knee joint pain in people with obesity by conducting a systematic review of the literature. The PubMed, EMBASE, and Cochrane bibliographic databases were searched for studies published between 1947 and September 2019. Risk of bias of the identified studies was independently assessed by 2 reviewers using JBI's Critical Appraisal Checklist for Case Series and the Newcastle-Ottawa Scale. This review included 23 studies, all of which evaluated knee pain and 9 of which also evaluated hip pain. Reported results regarding hip pain intensity and the proportion of participants with hip pain were too limited to draw useful conclusions. Reported results regarding knee pain suggest that weight loss after bariatric surgery reduced knee pain intensity, as well as the proportion of participants with knee pain. The overall risk of bias of the majority of included studies (83%; n = 19) was judged to be unclear to high. Four small studies were judged as having a low risk of bias. Results of this systematic review suggest that bariatric surgery can positively influence hip and knee joint pain, but conclusive evidence is lacking because most of the included studies were judged as having plausible bias overall and in their key domains. Well-designed randomized controlled trials evaluating the influence of bariatric surgery on hip and knee joint pain using standardized joint pain measures are needed.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Artralgia/etiologia , Humanos , Articulação do Joelho/cirurgia , Obesidade Mórbida/cirurgia , Perda de Peso
14.
Curr Sports Med Rep ; 20(6): 312-318, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34099609

RESUMO

ABSTRACT: Ulnar-sided wrist injuries are common in sports that require repeated pronosupination, wrist radial/ulnar deviation, axial loading, and gripping equipment. Common anatomic structures affected include the triangular fibrocartilage complex, extensor carpi ulnaris tendon, distal radioulnar and ulnocarpal joints, and hamate bone. Presenting symptoms include pain with activity, swelling, possible snapping or clicking, and reproduction of symptoms with provocative maneuvers. Imaging may confirm or rule out pathologies, but abnormal findings also may present in asymptomatic athletes. Initial treatment is usually nonoperative with splinting, load management, activity modification, strengthening the components of the kinetic chain of the particular sport, and pain management. Surgery is usually indicated in ulnar-wrist pain pathology such as hook of hamate fractures and required in associated instability. Future research should address specific treatment and rehabilitation protocols, emphasizing the complete kinetic chain along with the injured wrist.


Assuntos
Artralgia , Traumatismos em Atletas , Traumatismos dos Tendões , Ulna , Traumatismos do Punho/complicações , Artralgia/diagnóstico , Artralgia/etiologia , Artralgia/terapia , Atletas , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/terapia , Beisebol/lesões , Beisebol/fisiologia , Fenômenos Biomecânicos , Golfe/lesões , Golfe/fisiologia , Ginástica/lesões , Ginástica/fisiologia , Hamato/lesões , Hóquei/lesões , Hóquei/fisiologia , Humanos , Traumatismos dos Tendões/diagnóstico , Traumatismos dos Tendões/etiologia , Traumatismos dos Tendões/terapia , Tênis/lesões , Tênis/fisiologia , Fibrocartilagem Triangular/lesões , Traumatismos do Punho/epidemiologia , Articulação do Punho/anatomia & histologia , Articulação do Punho/fisiologia
15.
Jt Dis Relat Surg ; 32(2): 546-550, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34145838

RESUMO

Our goal is to draw attention to the inflammation of the iliopectineal bursa being a rare condition, which can cause lower limb swelling and anterior pain of the hip even years after total hip arthroplasty. A 67-year-old woman was admitted seven years after hip arthroplasty (cemented total endoprosthesis [TEP]) with swelling and feeling of excessive fullness of the lower extremity and with tolerable anterior hip pain. The physical examination and blood tests were non-specific for septic condition. Ultrasound showed a cystic mass in the inguinal region with a direct contact to the common femoral vein. Deep vein thrombosis was excluded. The single-photon emission computed tomography-computed tomography (SPECT-CT) was administered to decide the surgical plan, either making a bursa extirpation or making revision hip arthroplasty. The SPECT-CT excluded the possibility of aseptic loosening. Methylene blue was injected into the bursa intraoperatively which did not enter the strong pseudo-capsule of the joint and, therefore, we did not administer revision of the TEP, and the bursa was extirpated. Two weeks after the operation, the patient had no pain, was able to walk, and the swelling decreased. Four months after surgery, the pain and feeling of fullness disappeared, with minimal lower limb swelling. In conclusion, in case of increasing complaints of patients who left years behind without any problem following total hip arthroplasty, the pathogenic role of the iliopectineal bursa should be taken into account, after excluding more frequent causes such as aseptic loosening or periprosthetic joint infection. As long as we consider about a rare disease, we can find a solution to the patient's complaint sooner.


Assuntos
Artralgia/diagnóstico , Artroplastia de Quadril/efeitos adversos , Articulação do Quadril/fisiopatologia , Dor Pós-Operatória/diagnóstico , Idoso , Artralgia/etiologia , Feminino , Humanos , Hungria , Dor Pós-Operatória/etiologia
16.
Medicine (Baltimore) ; 100(26): e26542, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34190191

RESUMO

BACKGROUND: GreenCross Wellbeing Corporation (GCWB) 106 is a food item based on Chrysanthemum zawadskii var. latilobum extract. It has an inhibitory effect on joint inflammation. OBJECTIVE: This study investigated the efficacy and safety of GCWB106 for osteoarthritis (OA) of the knee joint. METHODS: Overall, 121 participants with mild OA were recruited and randomly divided into two groups. One group received GCWB106 for 12 weeks and the other group received placebo for 12 weeks. Outcomes were evaluated using the Korean-Western Ontario and McMaster Universities Index (K-WOMAC), visual analog scale, Korean Short Form Health Survey 36 score, and laboratory test results. RESULTS: After 12 weeks of study treatment, the GCWB106 group exhibited a significant improvement compared with the placebo group in overall K-WOMAC score (P = .042) and K-WOMAC physical function score (P = .015). The GCWB106 group showed significant improvement in the visual analog scale pain score (P < .001) compared with the placebo group after 6 weeks and 12 weeks; no adverse drug reactions or serious adverse events were reported in either group. CONCLUSION: GCWB106 can safely reduce pain and improve knee function with therapeutic effects in OA of the knee joint. LEVEL OF EVIDENCE: Randomized, double-blind, placebo-controlled clinical study, Level I.


Assuntos
Artralgia , Chrysanthemum , Osteoartrite do Joelho , Extratos Vegetais , Qualidade de Vida , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/efeitos adversos , Artralgia/diagnóstico , Artralgia/tratamento farmacológico , Artralgia/etiologia , Método Duplo-Cego , Feminino , Estado Funcional , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/psicologia , Medição da Dor/métodos , Componentes Aéreos da Planta , Extratos Vegetais/administração & dosagem , Extratos Vegetais/efeitos adversos , Índice de Gravidade de Doença , Resultado do Tratamento
17.
Rheumatol Int ; 41(7): 1263-1271, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33978818

RESUMO

To describe the rheumatic and musculoskeletal symptoms at hospitalization as well as their persistence/severity after discharge with coronavirus disease 2019 (COVID-19) and to identify whether age, sex, body mass index (BMI), and length of hospital stay are associated with persistence of these symptoms. In this single-center cohort study, comprising 300 participants, two phone interviews were conducted (2-week and 1-month after hospitalization) and symptoms were queried with a standardized form. This form included musculoskeletal symptoms and other COVID-19 symptoms. Considering all symptoms (musculoskeletal and other), 100.0%, 86.7%, and 72.0% of patients reported one or more symptoms, at hospitalization, 2-week, and 1-month, respectively. Considering only musculoskeletal symptoms, 92.3%, 72.7%, and 56.3% of patients reported any musculoskeletal symptom at hospitalization, 2-week, and 1-month, respectively. The musculoskeletal symptoms were fatigue (44.3% of patients reported), back pain (22.7%), arthralgia (22.0%), myalgia (21.0%), low back pain (16.3%), and neck pain (10.3%); the other symptoms were shortness of breath (26.3%), loss of taste (15.0%), cough (14.0%), loss of smell (12.3%), loss of appetite (10.3%), headache (8.7%), sore throat (3.0%), diarrhea (1.3%), dizziness (1.3%), and fever (0.3%) at 1-month. Increasing BMI was associated with higher odds of persistence of fatigue (OR: 1.08, 1.03 to 1.13), myalgia (OR: 1.08, 1.01 to 1.14), and arthralgia (OR: 1.07, 1.02 to 1.14, p = 0.012) at 1-month. Nearly three-quarters reported one or more symptoms, with more than half of patients reported any musculoskeletal symptom at 1 month. The most common musculoskeletal symptom was fatigue, followed by back pain, arthralgia, myalgia, low back pain, and neck pain. The persistence of fatigue, myalgia, and arthralgia was related to BMI. The study results increase our understanding of the spectrum of COVID-19, which, in turn, may lead to more efficient and better care for COVID-19 survivors.


Assuntos
Artralgia/etiologia , Dor nas Costas/etiologia , COVID-19/complicações , Fadiga/etiologia , Mialgia/etiologia , SARS-CoV-2 , Adulto , Idoso , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas , Alta do Paciente , Estudos Prospectivos
18.
Medicine (Baltimore) ; 100(18): e25671, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950946

RESUMO

BACKGROUND: The incidence of knee osteoarthritis is increasing year by year, which seriously affects people's quality of life, especially the elderly, and has become a major public health problem. A lot of evidence shows that physical therapy has advantages in the treatment of knee joints, but there are a number of physical therapy schemes, and the efficacy of each scheme is different. This study will evaluate the clinical efficacy of different physical therapy regimens in the treatment of knee osteoarthritis (KOA) by means of network meta-analysis. METHODS: According to the search strategy, we will retrieve the randomized controlled studies of non-invasive physical therapy in the treatment of knee osteoarthritis from CNKI, Wanfang, VIP, China Biomedical medicine, PubMed, Embase, Web of Science, and The Cochrane Library databases. The retrieval time was from the establishment of the database to March 2021. We will assess the quality of the studies using the Cochrane Risk Bias Assessment Tool and assess the strength of the evidence using the GRADE methodology. All data analyses will be performed by RevMan5.3, GEMTC 0.14.3, and Stata 14.0. RESULTS: This study will evaluate the efficacy of different physical therapy in the treatment of knee osteoarthritis by evaluating the total response rate, pain relief degree, joint function score, quality of life score, adverse reactions, etc. CONCLUSIONS: This study will provide a reliable evidence-based basis for the selection of better physical therapy for the treatment of knee osteoarthritis. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/VX98B.


Assuntos
Artralgia/terapia , Osteoartrite do Joelho/terapia , Modalidades de Fisioterapia , Amplitude de Movimento Articular/fisiologia , Artralgia/diagnóstico , Artralgia/etiologia , Humanos , Articulação do Joelho/fisiopatologia , Metanálise em Rede , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/fisiopatologia , Medição da Dor , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto , Resultado do Tratamento
19.
Medicine (Baltimore) ; 100(18): e25797, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950977

RESUMO

ABSTRACT: To compare the postoperative effects of arthroscopy for rotator cuff injury with patients in the lateral-lying position (LLP) and beach chair position (BCP), and to identify factors influencing these effects.Data from patients with rotator cuff injuries who underwent shoulder arthroscopy in the LLP (n = 115, 53.24%) or BCP (n = 101, 46.76%) between January 2013 and 2016 and were followed for >3 years were analyzed. The American Shoulder and Elbow Surgeons shoulder score, University of California at Los Angeles shoulder score (UCLASS), and visual analog scale (VAS) score were used to evaluate patients' shoulder function and pain preoperatively and at the last follow-up examination. The abduction and lateral rotation angles were measured. The influences of patient characteristics were compared between the LLP and BCP subgroups defined by UCLASSs (excellent, good, acceptable, poor).Postoperative injury characteristics, UCLASSs, and VAS scores were better in the LLP group than in the BCP group (all P < .05). Among patients with good UCLASSs, preoperative pain duration was longer in the LLP group than in the BCP group (P < .05); among those with acceptable UCLASSs, this duration was longer in the BCP group than in the LLP group (P < .05). The preoperative flexion angle differed between groups (P < .05). Among patients with excellent and good UCLASSs, the postoperative external rotation angle was greater in the LLP group than in the BCP group (P < .05). The LLP group contained more excellent UCLASSs than did the BCP group (P < .05). It also contained more small, medium, and large tear cases than did the BCP group (all P < .05).The effect of arthroscopy for rotator cuff injury was better when the operation was performed with the patient in the LLP. Either position is suitable for the arthroscopic treatment of partial rotator cuff tears. The LLP is more suitable in cases of small and medium-sized tears and those with large preoperative lateral rotation angles. The BCP should be used for patients with large preoperative flexion angles.


Assuntos
Artralgia/cirurgia , Artroscopia/métodos , Posicionamento do Paciente/métodos , Lesões do Manguito Rotador/cirurgia , Articulação do Ombro/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Artralgia/diagnóstico , Artralgia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Amplitude de Movimento Articular , Lesões do Manguito Rotador/complicações , Lesões do Manguito Rotador/diagnóstico , Índice de Gravidade de Doença , Resultado do Tratamento
20.
Medicine (Baltimore) ; 100(20): e26025, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011108

RESUMO

BACKGROUND: Chronic joint injury of the elbow joint is common in patients with hemophilia. Myofascial release is used for the management of pain and functionality in patients with chronic restrictions. OBJECTIVE: To evaluate the effectiveness of myofascial release in patients with hemophilic elbow arthropathy. METHODS: Sixty-nine patients with hemophilia took part in this randomized controlled trial. They were recruited from 10 hemophilia patient Associations. They were randomly allocated to experimental (n = 35) or control group (n = 34). The intervention consisted of three 50-min sessions of fascial therapy over a 3-week period. The intervention included 11 bilaterally administered maneuvers in both upper limbs (from shoulder girdle to forearm). The study variables were frequency of elbow bleeding (self-report), joint status (Hemophilia Joint Health Score), and joint pain (visual analog scale) at baseline, after the intervention, and at the 3-month follow-up. RESULTS: There were significant changes (P < .001) in the repeated measures factor in the frequency of hemarthrosis (F = 20.64), joint status (F = 31.45), and perceived joint pain (F = 30.08). We found group interaction with the (P < .001) in the frequency of hemarthrosis (F = 21.57), joint status (F = 99.98), and perceived joint pain (F = 44.26). There were changes (P < .01) in the pairwise comparison analysis between the pretreatment assessment and the posttreatment and follow-up assessments. CONCLUSIONS: Myofascial release decreases frequency of elbow bleedings, and improved joint status and perception of elbow pain in patients with hemophilic elbow arthropathy. Myofascial release may be recommended to improve joint status and joint pain in patients with hemophilic elbow arthropathy.


Assuntos
Artralgia/prevenção & controle , Articulação do Cotovelo , Hemartrose/prevenção & controle , Hemofilia A/complicações , Manipulações Musculoesqueléticas/métodos , Adulto , Artralgia/diagnóstico , Artralgia/etiologia , Feminino , Hemartrose/diagnóstico , Hemartrose/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
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