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At least 919 records · Page 51Linked to original sources
PubMed2005

The effects of repeated thermal therapy for patients with chronic pain.

BACKGROUND: It has been reported that local thermal therapy with a hot pack or paraffin relieves pain. We hypothesized that systemic warming may decrease pain and improve the outcomes in patients with chronic pain. The purpose of this study was to clarify the effects of systemic thermal therapy in patients with chronic pain. METHODS: Group A (n = 24) patients with chronic pain were treated by a multidisciplinary treatment including cognitive behavioral therapy, rehabilitation, and exercise therapy, whereas group B (n = 22) patients were treated by a combination of multidisciplinary treatment and repeated thermal therapy. A far-infrared ray dry sauna therapy and post-sauna warming were performed once a day for 4 weeks during hospitalization. We investigated the improvements in subjective symptoms, the number of pain behavior after treatment and outcomes 2 years after discharge. RESULTS: The visual analog pain score, number of pain behavior, self-rating depression scale, and anger score significantly decreased after treatment in both groups. After treatment, the number of pain behavior was slightly smaller (p = 0.07) and anger score was significantly lower in group B than those in group A (p = 0.05). Two years after treatment, 17 patients (77%) in group B returned to work compared with 12 patients (50%) in group A (p < 0.05). CONCLUSION: These results suggest that a combination of multidisciplinary treatment and repeated thermal therapy may be a promising method for treatment of chronic pain.

Adult↗
PubMed1997

Common soccer injuries. Diagnosis, treatment and rehabilitation.

Soccer is a game with worldwide appeal. Increasing numbers of participants are members of all age groups and skill levels. The game presents to the sports medicine practitioner a wide variety of musculoskeletal and medical problems. Soccer injuries increase in frequency as the age of participant increases, with a low incidence of injury in preadolescent players. Musculoskeletal injuries most commonly affect the lower extremities and include contusions, acute and chronic musculotendinous strains, and ligamentous injuries to the knee and ankle. Most injuries are minor and respond to analgesics, therapy modalities and exercise therapy. Groin pain is a common problem and particularly prevalent among soccer players owing to the game's specific stresses. Other less common but important injuries include facial trauma, mild brain injury (concussion) and heat-related injury. Team physicians, athletic trainers and physical therapists need to possess a basic understanding of the most common injuries and problems in order to maximise safe participation for their athletes.

Ankle Injuries↗
PubMed1999

[Use of sulfonylurea (SU) in the treatment of diabetes mellitus].

The main action of SU in the treatment of diabetes mellitus is the stimulation of insulin secretion, and the extrapancreatic action including stimulation of insulin actions in glycogen synthesis and inhibition of glucose production in liver is also reported. The indication of SU in the treatment of diabetes mellitus is for NIDDM usually after diet therapy or suitable exercise therapy. In IDDM and several special cases including diabetic ketoacidosis, severe infection, pregnancy, poor-controlled NIDDM, gangrane, surgery operation, severe renal or hepatic failure et al. insulin therapy should be started. In mild NIDDM, gliclazide, tolbutamide or acetohexamide is used, and in more severe NIDDM glibenclamide is used. The action time of chlorpropamide is very long, usually from 20 to 60 hours, therefore special care should be taken for hypoglycemia. As the causes for secondary failure, transition from NIDDM to IDDM, failure of diet therapy, glucose toxity and others are considered.

Aged↗
PubMed2002

[Chronic fatigue syndrome: psychiatric perspectives].

Chronic fatigue syndrome (CFS) is a common illness of unknown etiology and pathogenesis characterized by severe disabling fatigue and a variety of musculoskeletal, neurocognitive, mood symptoms and sleep disorders lasting at least six months. A significant proportion of patients fulfilling operative criteria for a diagnosis of CFS will also meet criteria for a psychiatric disorder such as depression, somatization or anxiety disorders. Premorbid lifestyle may play a predisposing, and/or perpetuating role in CFS. Some patients improve with time but most remain functionally impaired for several years. A variety of interventions have been used in the treatment and management of CFS. Interventions which have shown promising results include cognitive behavioural therapy and graded exercise therapy. Antidepressants can be useful particularly in the case of comorbid affective disorders. Development of good therapeutic doctor-patient alliance with empathic care is central to the effective management of CFS. In this article we overview the nature and definition of CFS. The prevalence, the prognosis and the psychopathological issues are presented. The management of this controversial syndrome is discussed.

Anxiety Disorders↗
PubMed2006

[Chronic fatigue syndrome].

BACKGROUND: Chronic fatigue syndrome (CFS) is characterized by severe fatigue and other non-specific symptoms. It causes disturbance of normal function. Uncertainty about etiology and the appropriate treatment, combined with high prevalence of psychiatric comorbidity, cause a problem in the perception of the disease by the patient, physician and society. OBJECTIVES: This review recapitulates the updated information regarding CFS. It addresses the following aspects: definitions, diagnosis, demographic figures, etiology and treatment options. Since much about CFS is yet to be known, a large amount of work has recently been performed on this subject. Current perceptions, as recognized today, are also presented. METHODS: A literature search was performed using Medline. RESULTS: Accurate diagnosis of CFS patients is low despite the disabling fatigue. CFS patients present certain demographic characteristics and the illness etiology is as yet unclear. Nonetheless, many possible directions exist with inconclusive evidence about certain suspected causes. There are no treatment guidelines available. Different treatment approaches were investigated without consensus on the results. CONCLUSIONS: CFS is an illness that should be taken seriously by the medical establishment. Conscious awareness of the malady might reduce rates of undiagnosed patients. The different etiologic factors showing some degree of involvement in CFS, might suggest that this syndrome is a multi-factorial condition. Despite the fact that there is no distinct undisputed treatment, there are 2 treatments (cognitive behavioral therapy and graded exercise therapy) that might be effective.

Demography↗
PubMed1991

[Evaluation of speech therapy and rehabilitation exercises in mouth-breathers].

Mouth breathing induces a low rest posturing of the tongue and tongue thrusting in many cases. This disturbs the development of the oral functions. The first stage of the reeducation is nose breathing's rehabilitation in order to "liberate" the tongue. Nasal breathing cannot be taught exteriorly . It's a result of the physical well-being. It's important to observe the mouth breathers and understand their needs. The second stage of the reeducation concerns the tongue moving tonicity and suppleness. Every exercise relies on the proprioceptive control that makes the child aware of each motion of the tongue. The next stages will be the recovering of the different functions as the rest tongue posture, swallowing, chewing. The use of phonation (lingual alveolar speech sounds) will facilitate the automatism of the new functions, because the children feel the elevation of the tongue.

Child↗
PubMed1990

Care of the person with rheumatoid arthritis.

The therapeutic choices in rheumatoid arthritis have expanded greatly in the past decade and continue to do so. We are unable to predict which drugs will be best for an individual patient, but the vast majority of patients do respond to therapy, and the destructive consequences of rheumatoid arthritis can be modified or prevented. An over-reliance on pharmacology to the exclusion of such things as occupational therapy, counseling, and exercise therapy, however, will hamper us in achieving our ultimate goal of a creative, functional person who has achieved some freedom from disease.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1997

[Reducing cholesterol in cardiovascular rehabilitation--exercise versus drug therapy].

Prospective epidemiological studies have proven a close link between the improvement of the lipoprotein profile and reduction of coronary heart mortality in coronary heart disease (CHD) patients. Both, regular physical activity and pharmacological intervention are capable of improving the lipoprotein profile and may independently reduce coronary stenoses and cardiac events in CHD patients. Because of the multifactorial genesis of atherosclerosis, regular physical activity is of major importance for cardiac rehabilitation and improvements of other risk factors besides the lipoprotein profile e.g. rheology, hypercoagulability, hypertension, peripheral insulin resistance and oxidative status may be expected. The combination of life-style changes e.g. physical activity, diet and smoking cessation together with pharmacological intervention, if risk factors remain high, seems to be the best therapy for patients with CHD. A sole pharmacological intervention seems to be insufficient.

Anticholesteremic Agents↗
PubMed1982

Electromyographic feedback in the remobilization of stroke patients: a controlled trial.

Electromyographic biofeedback was compared with simple exercise therapy as to its effectiveness in improving foot-drop in 22 stroke patients. The study was designed to be a rigorous trial of biofeedback and the patients tested were aged and had stroke of long duration. One group of 11 patients underwent 6 weeks of exercise therapy 2 sessions per week for 15 minutes per session; the 2nd group of 11 patients underwent similar therapy with EMG feedback. All therapy was conducted by a research assistant who was not a trained therapist. The groups were assessed blind before treatment, after treatment and a 6-week follow-up. The significantly greater improvements in the biofeedback group in terms of muscle strength at the end of treatment were maintained at follow-up. On the range of movement and gait analysis measures, both groups showed some improvement after treatment. However, at follow-up this improvement had relapsed for the exercise group while for the biofeedback group it had been maintained. It is argued that controlled trials are possible in biofeedback and that using patients as their own controls is not justified in view of the present findings and the previously reported literature.

Age Factors↗
PubMedDate not supplied

[Effect of physical exercise conducted at various times of the day on the regulation of carbohydrate metabolism in patients with diabetes mellitus].

A study was made of the levels of glucose, IRI, STH, ACTH and cortisol in the blood serum (plasma) of 39 patients with diabetes mellitus prior to and after physical exercise testing. 25 patients performed physical exercises on an empty stomach in the morning (8-9 a.m.) 14 patients in the daytime (4-5 p.m.). Exercise therapy in the morning hours resulted in the readjustment of hormonal regulation characterized by the predominance of the activity of the counterinsular systems over the insular one. In the daytime the IRI level in patients with diabetes mellitus increased and the activity of the hypophyseoadrenal system before and after physical exercise testing decreased as compared to morning indices producing a beneficial effect on the carbohydrate metabolic status. Daytime hours seem optimum for exercise therapy of patients with diabetes mellitus of both types.

Adolescent↗
PubMed2004

[The Dutch Institute for Health Care Improvement (CBO) guideline for the diagnosis and treatment of aspecific acute and chronic low back complaints].

Under the auspices of the Dutch Institute for Healthcare Improvement (CBO), a guideline has been developed for the diagnosis and treatment of aspecific low-back pain, based on the recent scientific literature. So-called 'red flags' are used to identify physical disorders. To obtain insight into psychosocial factors, 'yellow flags' are used. Acute low-back pain (0-12 weeks) is treated in a time-contingent manner. Staying active is better than bed rest. If chronicity threatens, exercise therapy can be advised. As part of an activating management, manipulation can be used. For pain relief, paracetamol is the drug of choice. The treatment of chronic low-back pain is aimed at the optimisation of the patients' functionality. Staying active is preferred here as well. Varied exercise therapy is advised. Back training may be considered. Manipulation can be used as part of an activating management. Paracetamol is preferred for pain relief. There is a limited role for percutaneous lumbar facet denervation. Behaviour therapy can be employed and there is a place for multidisciplinary programmes if other methods of treatment have proved insufficiently effective.

Acetaminophen↗
PubMed2006

Instantaneous effects of resynchronisation therapy on exercise performance in heart failure patients: the mechanistic role and predictive power of total isovolumic time.

BACKGROUND: Cardiac resynchronisation therapy improves peak oxygen uptake (peak VO(2)) 3-9 months after device implantation. In chronic heart failure, total isovolumic time (t-IVT) is a major determinant of peak VO(2) and of cardiac output at peak dobutamine stress. In selected patients, resynchronisation can instantaneously shorten t-IVT. We sought to determine the acute effect of resynchronisation on exercise performance and determine, with pharmacological stress echocardiography, the mechanism underlying this effect. METHODS AND RESULTS: Twenty-two patients with resynchronisation were studied within 3 months after device implantation. On a single study day, sequential cardiopulmonary exercise tests were performed during native activation (left bundle branch block) and resynchronisation (atrio-biventricular pacing) in random order. Total-IVT and cardiac output (at rest and peak dobutamine stress) were then measured in each activation mode. Resynchronisation acutely increased peak VO(2) by 1.6 (SD 1.5) ml/kg/min (p<0.001) and shortened peak stress t-IVT by 10 (SD 7) s/min (p<0.001), with the effects in individual patients showing a correlation (r = -0.46, p<0.05). Amongst all measurements during native activation, the best predictor of gain in peak VO(2) from resynchronisation was peak stress t-IVT (r = 0.71, p<0.001) with every increment of 5 s/min of peak stress t-IVT during native activation predicting an 8% gain in peak VO(2). No conventional measures during native activation at rest or on stress (including QRS duration, Tei index, tissue Doppler intraventricular delay, and resting t-IVT) added significant additional information. CONCLUSIONS: In eligible patients, resynchronisation can acutely augment peak VO(2), possibly through a mechanism of t-IVT shortening. Under native activation, long t-IVT during peak stress is the single best predictor of acute resynchronisation-mediated increment in peak VO(2).

Aged↗
PubMed2004

Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee--the MOVE consensus.

OBJECTIVES: Exercise is an effective and commonly prescribed intervention for lower limb osteoarthritis (OA). Many unanswered questions remain, however, concerning the practical delivery of exercise therapy. We have produced evidence-based recommendations to guide health-care practitioners. METHODS: A multidisciplinary guideline development group was formed from representatives of professional bodies to which OA is of relevance and other interested parties. Each participant contributed up to 10 propositions describing key clinical points regarding exercise therapy for OA of the hip or knee. Ten final recommendations were agreed by the Delphi technique. The research evidence for each was determined. A literature search was undertaken in the Medline, PubMed, EMBASE, PEDro, CINAHL and Cochrane databases. The methodological quality of each retrieved publication was assessed. Outcome data were abstracted and effect sizes calculated. The evidence for each recommendation was assessed and expert consensus highlighted by the allocation of two categories: (1) strength of evidence and (2) strength of recommendation. RESULTS: The first round of the Delphi process produced 123 propositions. This was reduced to 10 after four rounds. These related to aerobic and strengthening exercise, group versus home exercise, adherence, contraindications and predictors of response. The literature search identified 910 articles; 57 intervention trials relating to knee OA, 9 to hip OA and 73 to adherence. The evidence to support each proposition is presented. CONCLUSION: These are the first recommendations for exercise in hip and knee OA to clearly differentiate research evidence and expert opinion. Gaps in the literature are identified and issues requiring further study highlighted.

Contraindications↗
PubMedDate not supplied

Blood pressure and hormonal responses to aerobic exercise.

Twelve patients with essential hypertension (WHO stages I-II) were subjected to mild aerobic exercise for 10 to 20 weeks. The time course of changes in the resting blood pressure and multiple hormonal responses (plasma catecholamines, prostaglandin E, renin-angiotensin system, kallikrein-bradykinin system) were monitored. Depressor response of both systolic and diastolic pressures was seen, and after 5 weeks of exercise blood pressure stabilized at a significantly lower level. Adjustment of work load in response to increased physical fitness at the 10th week produced further reduction of blood pressure especially in diastole. After exercise therapy we found significant reductions in plasma catecholamine levels, and increases in levels of plasma prostaglandin E and the urinary excretion of sodium. A reduction in systolic/diastolic (mean) pressures by more than 20/10 (13) mm Hg was seen in 50% of patients after 10 weeks and in 78% after 20 weeks of exercise. Those who achieved effective blood pressure fall after 10 weeks of training (n = 6) were compared with the rest (n = 6). This analysis revealed that the initial value of plasma renin activity of the former was significantly lower than that of the latter. Significant negative correlations (r = -0.78) also were observed between the blood pressure reduction and corresponding initial value of plasma renin activity. These results indicate that exercise therapy is a potent nonpharmacological tool for the treatment of essential hypertension, especially of the low renin type. Both diminished sympathoadrenergic activity and enhancement of prostaglandin mechanisms might be responsible for the falls in arterial pressure.

Adult↗
PubMed2006

Nonsurgical management of acute and chronic low back pain.

A variety of nonsurgical treatment alternatives exists for acute and chronic low back pain. Patients should receive appropriate education about the favorable natural history of low back pain, basic body mechanics, and methods (eg, exercises, activity modification, behavioral modification) that can reduce symptoms. Nonprescription medication is efficacious for mild to moderate pain. Nonsteroidal anti-inflammatory drugs, alone or in combination with muscle relaxants, relieve pain and improve overall symptoms of acute low back pain. Exercise therapy has limited value for acute low back pain, but strong evidence supports exercise therapy in the management of chronic low back pain. Moderately strong evidence supports the use of manipulation in acute back pain. Evidence is weak for the use of epidural corticosteroid injections in patients with acute low back pain, strong for short-term relief of chronic low back pain, and limited for long-term relief of chronic low back pain. The use of facet injections in the management of acute low back pain is not supported by evidence, nor is the effectiveness of orthoses, traction, magnets, or acupuncture. Trigger point injections are not indicated for nonspecific acute or chronic low back pain, and sacroiliac joint injections are not indicated in the routine management of low back pain. Conflicting evidence exists regarding the use of transcutaneous electrical nerve stimulation.

Acute Disease↗