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O Knüsel

Publications and source records attributed to O Knüsel.

15 recordsLinked to original sources
PubMed2002

[Low back pain: diagnostic and therapeutic concepts].

During the last couple of years the lumbar back pain has gained importance like no other complaints in rheumatology and orthopaedics. This is mainly due to the chronic futile course and a general increase in relation to socio-economic factors. This is also where new therapeutic concepts have been created, which not only emphasise the pure somatic proceeding but also include the bio-psycho-social concept of treatment that on the one hand takes a lot of time and trouble, yet on the other hand is the treatment most likely to be a therapeutic success. However, in diagnosis one always has to start out from the somatic possibility and construct a working hypothesis within the framework of clear diagnostic steps, which then can be used as a basis for further therapeutic proceeding. Backache of young people differs greatly from backache of adults. New examinations even question the general belief that there is only a pure somatic reason that leads to backache of young people. The ergonomic way of thinking absolutely has to start being used for therapeutic reflections. Moreover, not only the analysis of the place of work and the adaption, yet also the strain in the spare time has to be structured usefully and sensibly.

Adolescent↗
PubMed2001

[Balneology--myth versus reality].

Even though spa resorts play an important role in the history of medicine and even if in almost every culture archaeological discoveries of hot springs and treatment at spa exist, modern medicine hardly accepts the effectiveness of spa treatment. Only few studies exist on evidence based medicine. In balneology the empirical side is extremely important and the therapeutic value of mineral springs, known for millenniums, should be evidence enough to allow this healing power a place (a status) in the today's mechanised world. Studies over decades prove the specific as well as the unspecific efficacy of it. For the patient, however, it is most important that his family doctor knows and introduces him to the possibilities of balneo-therapy.

Balneology↗
PubMed1998

Effectiveness of in-patient rehabilitation for sub-chronic and chronic low back pain by an integrative group treatment program (Swiss Multicentre Study).

In this multicentre intervention study, we compared an integrated group treatment program which combines psychological and education methods into a more active training approach, with the traditional individual approach of physiotherapy and physical procedures for sub-chronic and chronic low back pain. Our 411 patients had a 4-week inpatient treatment: 243 patients in an experimental program and 168 in a traditional program. Outcomes of 283 patients were assessed 3 months and 1 year after entry. The dropout rate was 31.1%. Both conditions demonstrated favourable initial effects on functional and psychological parameters, but the integrated approach showed better long-term results for work rehabilitation than the traditional approach. The most successful patients (n = 58) were younger and had a higher educational level in comparison to the unsuccessful subgroup (n = 71). The main conclusion is that an integrated approach promoting self control and behaviour change through educational measures achieves better long-term results than the traditional individual physiotherapy approach.

Adult↗
PubMed1994

[Pezzi-balls and ergonomic furniture in the classroom. Results of a prospective longitudinal study].

Faulty posture during childhood is an important causal factor for the development of degenerative conditions of the spinal column, which present in adults in the form of back pain, with or without functional disturbances. The reported prevalence of back pain varies widely, although figures of up to 50% have been recorded. The following controlled longitudinal study compared school children in classrooms fitted with ergonomic school furniture to those in a conventional setting. In one classroom, traditional seating was replaced by large air-filled balls (Pezziballs). Before beginning the study and again after one year, every child (n = 46) completed a comprehensive questionnaire and underwent an orthopedic/rheumatologic assessment. At the beginning of the study, 15% of the children reported having already experienced one or more episodes of back pain. Between 15 and 37% of the children demonstrated measurable functional or morphologic changes in different tests. The study showed that the air-filled balls provided a well-received alternative to conventional seating. On the other hand, a greater effect could be achieved by educating teaching staff in the importance of prophylaxis for the prevention of back pain due to poor posture, e.g. in the form of theoretical and practical back-care instruction for teachers. The potential of this group of professionals to act as examples in this respect should be used and supported by school doctors.

Bone Diseases, Developmental↗
PubMed1992

[Gait pattern of patients with hip arthritis].

Automatic recording of the kinematic and kinetic gait pattern has so far not been commonly used in the diagnosis of problems affecting the human loco motor apparatus. In recent decades gait analysis has increasingly been applied in the development of endoprostheses and sports shoes and in rehabilitation, especially of patients with neurological diseases. When a gait laboratory is set up, this demands interdisciplinary cooperation, biomechanical knowledge in physicians and (physio-)therapists, and elaboration of treatment plans allowing direct therapeutic exploitation of the gait data. There are determinant factors in gait pattern, which does not vary qualitatively in the sagittal plane (flexion/extension) with sex and age until the age of 70 years. Quantitatively there is a great deal of individual variation, and the diagnosis of a pathologic function in a particular patient can be difficult. A normal reference population was used to determine the gait pattern characteristic for 32 patients with osteoarthritis of the hip on one or on both sides, and the possible significance of the results for physical and surgical therapy is discussed. The main characteristic of this gait pattern ist the limitation of hip extension before toe-off in the late stance phase. One-third of the patients answer compensate with this increased hip flexion at heel strike, which in turn leads to an increased load on the (more severely) affected side. In consequence, the increased load might lead to progression of the osteoarthritis. In the development of endoprostheses it should be borne in mind that the design may influence the gait pattern, producing overloading of the extremity and perhaps reducing the life of the prosthesis.

Adult↗
PubMed1982

Double-blind comparative clinical trial of carprofen versus diclofenac-Na in patients with coxarthrosis.

A randomized double-blind trial was performed in 50 patients with moderate to severe coxarthrosis, 25 receiving 300 mg carprofen and 25 150 mg diclofenac-Na daily in 3 doses. The patients were treated for 21 days. With regard to clinical effect (anti-inflammatory and analgesic), both carprofen and diclofenac-Na exhibited good efficacy; statistical evaluation failed to reveal a significant difference between the therapy groups for the parameters considered (Fisher's exact test, Mann-Whitney U-test). Few adverse reactions were registered; they were severe enough to justify interruption of treatment in 1 patient receiving carprofen and 3 receiving diclofenac-Na.

Adult↗
PubMedDate not supplied

[Interactions of oral anti-diabetic agents and non-steroid anti-rheumatic agents].

Due to the relative increase of age-diabetes and to the different forms of rheumatic diseases, long-term medicament therapy and the question of possible interactions between oral antidiabetic drugs ( OAD ) and nonsteroidal anti-inflammatory drugs (NSAID) become more important. Unfortunately there exist studies on most of the well-known NSAID, but carried out on different conditions. The present study is intended to summarize the results at hand and to evaluate them in a certain sense. From almost all the NSAID, except from the salicylates and those connected with, as well as the pyrazolones, one may say, based on published data and long-term experience, that interactions with the OAD in use nowadays are not to be expected unless without clinical relevance.

Administration, Oral↗
PubMedDate not supplied

[Case report and discussion of a patient with polymyositis, fibrosing alveolitis and scleroderma-like involvement of the right hand].

It is important to know the diagnostic procedure and therapy of polymyositis (PM) inspite of its rare incidence. We describe a case with PM, interstitial lung disease, high titers of anti-Jo-1-antibodies and affection of the right hand, that could be followed over 11 years. The differentiation of PM from neurologic diseases and toxic myopathies is mentioned. The patient was successfully treated with cyclosporin over a period of 20 months, but he is now in remission while receiving steroids alone. We emphasize the importance of early treatment of PM with high-dose steroids and the addition of immunosuppressive drugs (azathioprin, methotrexate, cyclophosphamid) in cases with high disease activity or resistance to steroids. In the treatment of PM/DM immunoglobulins play an increasingly important role. The problems of long-term treatment with steroids are of special interest.

Adult↗