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Biomedical subjects

V Fialka-Moser

Publications and source records attributed to V Fialka-Moser.

33 records · Page 2Linked to original sources
PubMed2000

[Clinical effectiveness of magnetic field therapy--a review of the literature].

To verify the efficacy of electromagnetic fields on various diseases we conducted a computer-assisted search of the pertinent literature. The search was performed with the aid of the Medline and Embase database (1966-1998) and reference lists. Clinical trials with at least one control group were selected. The selection criteria were met by 31 clinical studies. 20 trials were designed double-blind, randomised and placebo-controlled. The studies were categorised by indications. Electromagnetic fields were applied to promote bone-healing, to treat osteoarthritis and inflammatory diseases of the musculoskeletal system, to alleviate pain, to enhance healing of ulcers and to reduce spasticity. The action on bone healing and pain alleviation of electromagnetic fields was confirmed in most of the trials. In the treatment of other disorders the results are contradictory. Application times varied between 15 minutes and 24 hours per day for three weeks up to eighteen months. There seems to be a relationship between longer daily application time and positive effects particular in bone-healing. Patients were treated with electromagnetic fields of 2 to 100 G (0.2 mT to 10 mT) with a frequency between 12 and 100 Hz. Optimal dosimetry for therapy with electromagnetic fields is yet not established.

Clinical Trials as Topic↗
PubMed2000

Exercise therapy for craniomandibular disorders.

OBJECTIVE: To evaluate the use of exercise therapy for the treatment of craniomandibular disorders (CMDs). DESIGN: Before-after trial. All patients were assigned to a waiting list, serving as a no-treatment control period. SETTING: Outpatient clinic for physical medicine and rehabilitation of the University of Vienna. PATIENTS: Thirty consecutive patients suffering from CMD with anteridr disc displacement with reduction who were consulting a CMD service. INCLUSION CRITERIA: (1) symptoms lasting at least 3 months, (2) pain in the temporomandibular region, (3) a positive axiography, and (4) evidence of postural dysfunction. Twenty-six patients completed the study; no adverse effects occurred. INTERVENTIONS: Active and passive jaw movement exercises, correction of body posture, and relaxation techniques. MAIN OUTCOME MEASURES: (1) Pain at rest, (2) pain at stress, (3) impairment, and (4) mouth opening at baseline, before and after treatment, and at 6-month follow-up. RESULTS: During the control period, no changes occurred. After the treatment, pain and impairment were significantly reduced (Wilcoxon test, p < .001). Four patients had a restricted mouth opening, in contrast to 15 before treatment (chi2 test, p < .005). Joint clicking vanished in 13.3% and was reduced in another 13.3% (chi2 test, p < .01). These results did not change until follow-up. Seventy-five percent of the patients were treated successfully. CONCLUSION: Exercise therapy seems to be useful in the treatment of anterior disc displacement with reduction.

Adult↗
PubMed2000

Thermographic parameters in the diagnosis of secondary Raynaud's phenomenon.

OBJECTIVE: To determine the major infrared thermographic parameters in discriminating between patients with and without secondary Raynaud's phenomenon. DESIGN: A cross-sectional study. SETTING: Outpatient clinic of a university department of physical medicine and rehabilitation in Vienna. PATIENTS: Consecutive sample of 86 patients (72 women, 14 men) referred from the Division of Rheumatology for the clarification of a possible secondary Raynaud's phenomenon. MAIN OUTCOME MEASURES: According to color changes induced by cold exposure, clinical classification of Raynaud's phenomenon was performed as follows: no, unlikely, probable, and definite Raynaud's phenomenon. The following thermographic parameters were applied to a stepwise logistic regression analysis: the absolute temperature of the fingertips before, 10, and 20 minutes after cold challenge (Tpre, T10, T20); the longitudinal temperature difference before, 10, and 20 minutes after cold challenge (LTDpre, LTD10, LTD20); the mean area under the rewarming curve of the fingertips; the recovery index 20 minutes after cold challenge (RI20); and the most rapid phase of rewarming of the fingertips of both hands (Gmax right, Gmax left). The sensitivity of thermographic classification into the 4 groups of clinical evaluation was assessed by discriminant analysis using significant parameters from logistic regression analysis. RESULTS: Only LTDpre reached the level of significance (p < .0001). Using LTDpre, 22 of 23 subjects without clinical Raynaud's phenomenon and 20 of 26 patients with definite clinical Raynaud's phenomenon were classified correctly. Patients with unlikely or probable Raynaud's phenomenon were classified as no Raynaud's phenomenon or definite Raynaud's phenomenon. CONCLUSION: LTDpre is the major thermographic parameter to discriminate between patients with and without definite Raynaud's phenomenon by clinical history.

Adolescent↗
PubMed2000

Relationship between craniomandibular disorders and poor posture.

The purpose of this research was to show that a relationship between craniomandibular disorders (CMD) and postural abnormalities has been repeatedly postulated, but still remains unproven. This study was intended to test this hypothesis. Twenty-five CMD patients (mean age 28.2 years) were compared with 25 gender and age matched controls (mean age 28.3 years) in a controlled, investigator-blinded trial. Twelve postural and ten muscle function parameters were examined. Measurements were separated into three subgroups, consisting of those variables associated with the cervical region, the trunk in the frontal plane, and the trunk in the sagittal plane. Within these subgroups, there was significantly more dysfunction in the patients, compared to control subjects (Mann-Whitney U test p < 0.001, p < 0.05, p < 0.01). Postural and muscle function abnormalities appeared to be more common in the CMD group. Since there is evidence of the mutual influence of posture and the craniomandibular system, control of body posture in CMD patients is recommended, especially if they do not respond to splint therapy. Whether poor posture is the reason or the result of CMD cannot be distinguished by the data presented here.

Adult↗
PubMed1999

[Skeletal muscle strength following orthotopic heart transplantation].

AIM OF THE STUDY: Strength measurement of thigh muscles of patients after orthotopic heart transplantation (HTX) with a sedentary lifestyle, entering a cardiac rehabilitation program. DESIGN: Cross-sectional study; values are compared to patients with chronic heart failure (CHF) and healthy controls. METHODS: Isometric and isokinetic peak torque of knee extensor and flexor muscles measured on a Cybex 6000. Twenty minutes' muscle fatigue test of knee extensor muscles. Test of motor tasks of daily living. RESULTS: HTX group: n = 18, age 59 +/- 7 years, body mass index (BMI) 29 +/- 5, months after HTX 46 +/- 36 months; CHI group: n = 24, age 55 +/- 8 years, BMI 25 +/- 4, months after CHF 19 +/- 16 months; control group: n = 10, age 55 +/- 6 years, BMI 26 +/- 5. The HTX group differed significantly (p < 0.05) from the CHI group. Peak torque of knee extensor muscles: HTX: 120.3 +/- 8.4; CHI: 127.8 +/- 8.0 Nm; controls: 158.3 +/- 5.5 (ANOVA p < 0.05); peak torque of knee flexor muscles: HTX 65.6 +/- 5.9 Nm; CHI 70.1 +/- 6.2 Nm; controls 84.4 +/- 3.1 Nm(ANOVA p < 0.01). Peak torque of knee extensor muscles related to body weight: HTX: 137.4 +/- 10.0 Nm%, CHI: 162.6 +/- 9.3 Nm%, control group 202.8 +/- 5.7 Nm% (ANOVA p < 0.01). Muscle fatigue test of knee extensor muscles: isometric maximal strength (maximal voluntary contraction, MCV; HTX vs. CHI): 331.6 +/- 14.7 N vs. 335.5 +/- 18.6 N (n.s.), MVC after 5 minutes 296.3 +/- 15.7 N vs. 288.4 +/- 16.7 N; MVC after 10 minutes: 283.5 +/- 15.7 N vs. 282.5 +/- 17.7 N; MVC after 15 minutes 275.7 +/- 13.7 N vs. 280.6 +/- 21.6 N. No significant differences between groups were observed. All values were significantly lower than those of healthy controls (406.2 N; 385.9 N; 373.7 N and 369.6 N). There was a significant decline in MVC after 5 minutes compared to initial values (p < 0.01), in both patients groups but not in the control group. No further decline in MVC was observed beyond the 5th minute of the fatigue test (p > 0.05). CONCLUSION: Peak torque related to body weight and muscle endurance of knee extensor muscles of sedentary patients after orthotopic HTX do not significantly differ from those of comparable patients with CHF but do differ from those of healthy controls. Specific training of muscle strength is needed for patients even several years after orthotopic heart transplantation.

Aged↗
PubMed1999

Cross-cultural adaptation of the Roland-Morris questionnaire for German-speaking patients with low back pain.

STUDY DESIGN: Cross-cultural adaptation and cross-sectional psychometric testing. OBJECTIVES: To develop and validate a cross-cultural version of the Roland-Morris Questionnaire for use in German-speaking patients with low back pain. SUMMARY OF THE BACKGROUND DATA: Clinical research related to the management of back pain would be facilitated enormously if a small number of patient-oriented questionnaires became widely used. If the transposition of a questionnaire from its original cultural context is done by simple translation, it is unlikely to be successful because of language and cultural differences. Therefore, a simple direct translation of a questionnaire from one language to another does not permit its use in clinical trials. METHODS: The instrument was translated and back-translated, pretested, and reviewed by a committee. The German version of the Roland-Morris Questionnaire was tested in 125 patients with low back pain. The study was conducted at the spa resort at Senftenberg, Austria, which is visited by patients from all countries of German-speaking Europe. Reliability and concurrent construct validity were assessed with Pearson's correlation coefficient on the Roland-Morris Questionnaire scores compared with the scales of the Medical Outcome Study Short Form-36 questionnaire. RESULTS: Pearson's correlation coefficient for test-retest reliability of the German version was r = 0.82 (P = 0.0001), and Cronbach's alpha was 0.81. The concurrent validity was r = 0.81 (Roland-Morris Questionnaire/pain rating; P = 0.0001), r = 0.48 (Roland-Morris Questionnaire/forward bending; P = 0.0001), and r = -0.47 (Roland-Morris Questionnaire/lateral bending; P = 0.0001). Correlation between the functional scales of the Medical Outcome Study Short Form-36 questionnaire and the Roland-Morris Questionnaire sum scores ranged from r = -0.29 (emotional limitations; P = 0.0011) to r = -0.71 (physical limitations; P = 0.0001). CONCLUSION: Because the German version of the Roland-Morris Questionnaire seems to be reliable and valid for the assessment of the functional status in German-speaking patients with low back pain, the use of this translated instrument can be recommended in future clinical trials.

Cross-Cultural Comparison↗
PubMed1999

Ultrasound therapy for calcific tendinitis of the shoulder.

BACKGROUND AND METHODS: Although ultrasound therapy is used to treat calcific tendinitis of the shoulder, its efficacy has not been rigorously evaluated. We conducted a randomized, double-blind comparison of ultrasonography and sham insonation in patients with symptomatic calcific tendinitis verified by radiography. Patients were assigned to receive 24 15-minute sessions of either pulsed ultrasound (frequency, 0.89 MHz; intensity, 2.5 W per square centimeter; pulsed mode, 1:4) or an indistinguishable sham treatment to the area over the calcification. The first 15 treatments were given daily (five times per week), and the remainder were given three times a week for three weeks. Randomization was conducted according to shoulders rather than patients, so a patient with bilateral tendinitis might receive either or both therapies. RESULTS: We enrolled 63 consecutive patients (70 shoulders). Fifty-four patients (61 shoulders) completed the study. There were 32 shoulders in the ultrasound-treatment group and 29 in the sham-treatment group. After six weeks of treatment, calcium deposits had resolved in six shoulders (19 percent) in the ultrasound-treatment group and decreased by at least 50 percent in nine shoulders (28 percent), as compared with respective values of zero and three (10 percent) in the sham-treatment group (P=0.003). At the nine-month follow-up visit, calcium deposits had resolved in 13 shoulders (42 percent) in the ultrasound-treatment group and improved in 7 shoulders (23 percent), as compared with respective values of 2 (8 percent) and 3 (12 percent) in the sham-treatment group (P=0.002). At the end of treatment, patients who had received ultrasound treatment had greater decreases in pain and greater improvements in the quality of life than those who had received sham treatment; at nine months, the differences between the groups were no longer significant. CONCLUSIONS: In patients with symptomatic calcific tendinitis of the shoulder, ultrasound treatment helps resolve calcifications and is associated with short-term clinical improvement.

Calcinosis↗
PubMed1999

Quality of life in patients with chronic heart failure: a randomized controlled trial of changes induced by a regular exercise program.

The aim of this study was to evaluate the impact of a three-month exercise program on the perception of quality of life in patients with severe chronic heart failure. In a randomized controlled setting, 27 patients with a left ventricular ejection fraction of 18.1 +/- 8.0% were entered into the study. The training group performed aerobic exercises for three hours/week while the control group continued their usual activities of daily living. Quality of life was measured using the German version of the MOS SF-36. Two patients required a change in their drug regimen and were therefore withdrawn from the study. Twenty-five patients completed the study. In the exercise group the perception of quality of life improved significantly in the domains of vitality (p = 0.0001), physical role fulfillment (p = 0.001), physical (p = 0.02) and social (p = 0.0002) functioning. Exercise was effective in increasing peak oxygen uptake and exercise time (p < 0.01). Only weak correlations were registered between parameters of physical performance and quality of life domains. The results of the study indicate that aerobic exercise can improve the perception of quality of life in patients with severe chronic heart failure.

Chronic Disease↗
PubMed1999

Physical medicine and rehabilitation: past - present - future.

The inaugural lecture reflects a little on the past, but above all considers the present and future of physical medicine and rehabilitation and stresses the most important aspects on scientific expertise. Physical medicine entered the German language in the late 19th century. An important milestone in the history was the opening in February 1991 of the Central Department of Physical Medicine and Rehabilitation, which was the first to begin work in the New General Hospital. 15 staff doctors, 74 physiotherapists, 12 occupational therapists, seven masseurs and eight qualified medical assistants are constantly occupied in clinical practise. To illustrate the recent academic activities at the Department of Physical Medicine and Rehabilitation the results of research from the individual working groups are compiled. First clinical and technical diagnostic studies are focused on. Essentially such studies demonstrate the efficacy of physical treatments, which are being reported. Current rehabilitation concepts are presented subsequently. Finally some light is shed on future areas of interest.

Austria↗
PubMed1999

Acupuncture in the treatment of posttraumatic pain syndrome.

To test the hypothesis that classical Chinese acupuncture provides an additional benefit subjectively as well as objectively in patients suffering from reflex sympathetic dystrophy, a double-blind, placebo-controlled prospective trial was performed. Fourteen patients suffering clinically and scintigraphically from acute CRPS of the upper limb lasting of more than one but less than 6 months were studied. Patients were randomly assigned to either the classical acupuncture (group A) or sham acupuncture (group S), which was applied five times a week for three weeks and required 30 minutes. Both groups received the same defined standard treatment. The current state of pain was assessed by means of a visual analogue scale. Subjective success of treatment was rated by the patients by means of a rating scale. Each patient underwent a clinical examination and was investigated by 5-phase bone scan in order to confirm the diagnosis. The current state of pain as well as clinical parameters were almost identical in patients of group A and of group S at the beginning. During therapy clinical parameters as well as pain improved in both groups and reached nearly normal levels after 6 months. Owing to the small number of patients in our study, no differences between sham and treatment group could be recognized. For a definitive statement the treatment of further patients in both groups is planned. Determinations of the effect of acupuncture on clinical parameters, based on long-term follow-ups are projected.

Acupuncture Therapy↗
PubMed1999

Neuromuscular electrical stimulation after anterior cruciate ligament surgery.

This randomized, double blind, controlled trial was designed to determine the effectiveness of neuromuscular electrical stimulation of the knee extensor and flexor muscles in the prevention of muscular weakening after anterior cruciate ligament surgery. Neuromuscular electrical stimulation treatment was given in addition to an early exercise therapy regimen and compared with an early exercise therapy regimen alone. Forty-nine patients after anterior cruciate ligament surgery were assigned randomly either to a neuromuscular electrical stimulation and exercise group, a transcutaneous electrical nerve stimulation as analgesic and exercise group, or an exercise alone group as control. All groups received a standard regimen of rehabilitation after anterior cruciate ligament surgery. The neuromuscular electrical stimulation and transcutaneous electrical nerve stimulation group additionally received electrical stimulation during the first 6 weeks after surgery. Patients were measured for isometric and isokinetic torque in the knee extensor and flexor muscles after 6, 12, and 52 weeks. No statistical difference among groups was observed. It is concluded that neuromuscular electrical stimulation in combination with an early exercise therapy regimen is not significantly more effective in reducing weakening than an early exercise therapy regimen alone after anterior cruciate ligament surgery.

Adult↗
PubMed1998

[Cold and cryotherapy. A review of the literature on general principles and practical applications].

Cryotherapy increases the threshold of pain and induces physiological changes. It influences hemodynamics (reduction of skin- and muscle temperature through vasoconstriction), metabolism (reduction of ischemia due to hypoxia), and neural control (reduction of nerve conduction velocity and muscle tone). Cryotherapy is indicated mainly in locomotor system related pain. Such pain can be induced by degenerative changes, postoperatively, and during mobilisation of contracted joints. Cryotherapy may be used as short term therapy (less than 15 min) as well as long term therapy (more than 20 min). For maximal efficacy the intensity of application as well as the application medium must be considered. Due to biorhythm, cold application seems to be more effective in the afternoon.

Circadian Rhythm↗
PubMed1995

[Iontophoresis in the treatment of pain].

UNLABELLED: The objective has been to verify the effectiveness of iontophoresis in alleviating conditions of pain by means of a computer-assisted search of the pertinent literature. The search was performed with the aid of the Medline database (1984 bis 1993) and reference lists (studies from 1954). SELECTION CRITERIA: all clinical trials performed with at least one control group as well as all experimental studies conducted within the same period. The selection criteria were met by 10 experimental and 15 clinical studies. The studies were categorized by substance group. The following groups of substances were applied (experimentally/clinically): local anaesthetics (0/6), non steroidal anti-inflammatory drugs (2/3), vinca-alkaloids (1/2), corticosteroids (3/1), morphine (0/1), iodide (4/1) and fluoride (0/1). Both short-term effects (lidocaine, procaine, flufenamic acid, morphine) and long-term effects (benzocaine-salicylamide, diclofenac, Mobilat, vinca-alkaloids, dexamethasone-lidocaine, iodide, fluoride) were studied. Comparisons were made against placebo iontophoresis (lidocaine, procaine, flufenamic acid, diclofenac, Mobilat, vinca-alkaloids, dexamethasone-lidocaine, morphine, fluoride), solely topical administration (procaine, benzocaine-salicylamide, flufenamic acid), placebo administration without current (procaine, flufenamic acid), and other methods (lidocaine, iodide). With one single exception (lidocaine), none of the studies included groups without treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Analgesics↗
PubMed1994

[Postural disorders in children and adolescents].

Posture is defined as the upright well balanced position of an individual person. A postural fault is a posture that deviates from normal alignment without structural limitations. Postural faults are established in adolescence causing pain syndromes in adulthood. Major components of spinal structure and function are reviewed. The dynamics of posture are described. Characteristics and etiology of common postural faults in childhood and adolescence are characterised. Based on standardised diagnostic techniques, principles of how to manage posture and treatment of postural dysfunctions are discussed.

Adolescent↗