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Biomedical subjects

Uwe Kern

Publications and source records attributed to Uwe Kern.

4 recordsLinked to original sources
PubMed2006

Management of phantom pain with a textile, electromagnetically-acting stump liner: a randomized, double-blind, crossover study.

The treatment of phantom pain is frequently dissatisfying. We wanted to find out whether an electromagnetically shielding stump stocking interwoven with metal (medipro(R)Liner RELAX [medi Bayreuth, Bayreuth, Germany]) could have a positive effect on phantom pain. A double-blind, randomized, crossover trial in a total of 30 leg amputees compared the experimental (=verum) silicon liner (VL) fitted to the amputation stump with a dummy (=placebo) liner (PL). Each liner was worn for two weeks after a two-week baseline period. Daily documentation focused on phantom pain, quality of sleep and improvement of well-being. Twenty-seven of 30 patients completed the 6-week study, and 22 documentations proved valid. On a 0-10 numeric rating scale (NRS), the median pain intensity before treatment was 4, and the median of maximum pain was 6. VL versus PL reduced pain significantly more often (P=0.008), the odds ratio being 5.95. The degree of pain reduction was likewise highly significant (<0.001). Wilcoxon's matched-pairs signed-rank test for the medians of daily maximum pain showed a significant reduction for both PL (P < 0.001) and VL (P <0.001) as compared to baseline, with VL being highly superior again (P < 0.001) versus PL. The experimental device also led to significant amelioration of general well-being (P = 0.037) with an odds ratio of 3.85, and an improvement in the quality of sleep, which was not significantly different than PL (P = 0.223). In this study, the influence of a silicon liner with electromagnetically protecting properties on phantom pain was highly significant. The mechanisms underlying this effect are unclear. Possibilities include reduction of ectopic neuroma activity, shielding from possible electromagnetic weather impulses (sferics), or analgesic effects of changes in the electromagnetic field. PET or fMRI examination with or without a shielding silicon liner might help to elucidate this observation further.

Adult↗
PubMed2004

Does botulinum toxin A make prosthesis use easier for amputees?

Four post-amputation patients (1 with phantom pain, 3 with stump pain) were each treated with 100 IU botulinum toxin A, divided between several trigger points in the distal stump musculature. In 1 female patient (along with a pronounced reduction in phantom pain) hyperhidrosis of the stump ceased completely, probably after diffusion of the drug into the dermal sweat glands, leading to longer and safer use of the prosthesis. Intentional intradermal injection for this issue therefore could be valuable. Another patient was able to use her prosthesis for the whole day again after botulinum toxin A treatment for substantial stump pain, compared with only 4 hours a day before treatment. In 2 male patients, stump pain while wearing the prosthesis subsided to a considerable extent, 1 of the 2 reported an improvement in steadiness of gait. We suggest that stump treatment with botulinum toxin in rehabilitative medicine should be investigated in more detail.

Adult↗
PubMed2004

Effects of botulinum toxin type B on stump pain and involuntary movements of the stump.

Patients who had previously undergone amputation of the arm (n = 2) or leg (n = 2) were treated with botulinum toxin type B injections at several trigger points of their stump musculature. We administered a total dose of 2500 IU of botulinum toxin type B (Neurobloc, Elan Pharma, Munich, Germany) to the arm amputation stumps, 5000 IU for one amputation of the lower leg, and 2500 IU to the other lower leg amputation of a patient with a very low baseline body weight. Two patients reported that the injection was very painful. All patients experienced a reduction in stump pain, which lasted for many weeks. Other reports included a reduction in the frequency of pain attacks, cessation of "balloon feelings," improvement in stump allodynia, and decreased occurrence of involuntary stump movements. In addition, quality of sleep at night significantly improved in one patient. Botulinum toxin type B can therefore be regarded as a new treatment option for possible improvements in the rehabilitation of amputees.

Aged↗