American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Dec 2011
Randomized Controlled Trial Comparative StudyEffect of lidocaine iontophoresis on pain during needle electromyography.
Pain during needle electrode examination (NEE) is often poorly tolerated. No previous studies have evaluated the effect of lidocaine iontophoresis on pain reduction during NEE. Our objective was to determine whether pretreatment with lidocaine iontophoresis mitigates the pain felt during NEE. ⋯ Pretreatment with iontophoresis significantly reduced pain during NEE. However, the lack of group differences between lidocaine and saline iontophoresis suggested that the analgesic effect may have been attributable primarily to the iontophoresis modality itself rather than to the medication administered with iontophoresis.
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Am J Phys Med Rehabil · Dec 2011
Randomized Controlled Trial Comparative StudyRemote therapeutic effectiveness of acupuncture in treating myofascial trigger point of the upper trapezius muscle.
This study aimed to investigate the remote effect of acupuncture (AcP) on the pain intensity and the irritability of the myofascial trigger point in the upper trapezius muscle. ⋯ The myofascial trigger point irritability could be suppressed after a remote acupuncture treatment. It appears that needling to the remote AcP points with multiple needle insertions of modified AcP technique is a better technique than simple needling insertion of simple needling technique in terms of the decrease in pain intensity and prevalence of endplate noise and the increase in pressure pain threshold in the needling sites (represented either AcP points and or myofascial trigger points). We have further confirmed that the reduction in endplate noise showed good correlation with a decreased in pain.
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Am J Phys Med Rehabil · Jul 2011
Randomized Controlled TrialExercise, manual therapy, and education with or without high-intensity deep-water running for nonspecific chronic low back pain: a pragmatic randomized controlled trial.
The aim of this study on persons with nonspecific chronic low back pain was to evaluate the effect of a multimodal physical therapy program with or without the addition of deep-water running on pain, physical disability, and general health. ⋯ Pain, disability, health status, muscle strength and endurance, and lumbar range of motion significantly improved in both groups. The addition of a deep-water running program at an individual workload of the aerobic threshold to the multimodal physical therapy program produced a significant improvement in pain in patients with nonspecific chronic low back pain, but this was not significantly different when compared with multimodal physical therapy program alone. Disability, health status, muscle strength and endurance, and lumbar range of motion significantly improved to a similar level in both intervention groups.
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Am J Phys Med Rehabil · May 2011
Randomized Controlled TrialSensory transcutaneous electrical stimulation fails to decrease discomfort associated with neuromuscular electrical stimulation in healthy individuals.
Sensory transcutaneous electrical nerve stimulation (TENS) is frequently used for pain modulation. Neuromuscular electrical stimulation used to induce strong muscle contractions is often limited by muscular discomfort and by discomfort associated with the electrical current. The objective of this study was to determine whether the application of TENS can reduce the discomfort associated with neuromuscular electrical stimulation, leading to stronger maximal electrically induced contractions. ⋯ Sensory TENS was not effective in modulating the discomfort associated with neuromuscular electrical stimulation in individuals with no known impairment. During periods of maximal electrically induced contractions, the pulling sensation of the muscle is generally more disconcerting than the sensation of the electrical current. Further studies are necessary to determine the effect of different stimulation parameters in patients with pathologic conditions.
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Am J Phys Med Rehabil · Apr 2011
Randomized Controlled Trial Comparative StudyThe effectiveness of triamcinolone acetonide vs. procaine hydrochloride injection in the management of carpal tunnel syndrome: a double-blind randomized clinical trial.
Corticosteroid injection into the carpal tunnel is frequently used for the treatment of carpal tunnel syndrome (CTS). Steroids are usually mixed with local anesthetics, which have positive effects that can aid the treatment of CTS by inhibiting the spontaneous discharge ability of excitable cells. The aim of this study was 3-fold: (1) to determine the efficacy of triamcinolone acetonide injection in the treatment of CTS, (2) to determine the efficacy of procaine hydrochloride (HCl) in the treatment of CTS, and (3) to compare the efficacy of triamcinolone acetonide and that of procaine HCl in the treatment of CTS. ⋯ Local procaine HCl injection and steroid injection effectively reduced the symptoms of CTS and equally improved electrophysiologic findings. As such, procaine HCl can be used in CTS patients in whom steroid use is contraindicated.