Der Schmerz
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Review
[Innovative interventions in pain physiotherapy : Advancing care for people with chronic pain].
Chronic pain, with a prevalence of at least 17%, is a costly health problem associated with a high burden of disease. Musculoskeletal chronic pain is particulary common, which in many cases is treated with physiotherapy. ⋯ Despite the predominantly positive results from systematic reviews, implementation in everyday care is difficult due to conditions of care and the contemporary education system for physiotherapists in Germany. Health services research can play an important role in accelerating the transfer of innovations into practice.
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The treatment of carpal tunnel syndrome (CTS) usually involves surgical decompression of the nerve or splinting and additional medication. Physiotherapy and sports therapy could be non-invasive and alternative treatment approaches with a simultaneous low risk of side effects. ⋯ For the management of mild to moderate CTS, physiotherapy and sports therapeutic interventions are characterized primarily by success after as little as 2 weeks of treatment as well as comparable success to surgery and 3 months of postoperative treatment. In addition, patients are not exposed to surgical risks. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the number 42017073839.
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Review
[Physical therapy knowledge, skills, and competencies in the care of people with chronic pain].
Between 8 and 16 million people in Germany are affected by chronic pain, causing costs of up to 28.7 billion euros annually. Chronic pain is complex and has biopsychosocial aspects. Physiotherapeutic care requires special knowledge, skills and competencies. A publicly accessible description of these requirements does not currently exist in Germany. ⋯ This overview may provide a basis for the development of a competency profile that can be used to develop contents for the modular design and standardisation of curricula in courses of study or training.
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Exercise prescription is a central tenet of physiotherapy. One of the numerous benefits of exercise is its influence on endogenous pain modulation. Exercise-induced hypoalgesia (EIH) refers to a short-term change in pain sensitivity following an acute bout of exercise. ⋯ Recommendations regarding outcome measures and exercise parameters are required, and further understanding of reliability and validity of EIH is needed. There is a demand to further elucidate these parameters and contextual factors to advance our understanding of EIH. Additional clinical research, especially in patient populations, is required to then provide implications for rehabilitation.