Articles: back-pain.
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Arch Phys Med Rehabil · Aug 2017
Randomized Controlled Trial Multicenter StudyLong-Term Effects of Repeated Injections of Local Anesthetic With or Without Corticosteroid for Lumbar Spinal Stenosis: A Randomized Trial.
To determine the overall long-term effectiveness of treatment with epidural corticosteroid injections for lumbar central spinal stenosis and the effect of repeat injections, including crossover injections, on outcomes through 12 months. ⋯ For lumbar spinal stenosis symptoms, epidural injections of corticosteroid plus lidocaine offered no benefits from 6 weeks to 12 months beyond that of injections of lidocaine alone in terms of self-reported pain and function or reduction in use of opioids and spine surgery. In patients with improved pain and function 6 weeks after initial injection, these outcomes were maintained at 12 months. However, the trajectories of pain and function outcomes after 3 weeks did not differ by injectate type. Repeated injections of either type offered no additional long-term benefit if injections in the first 6 weeks did not improve pain.
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The case report details to use of three-dimensional (3D) printing as an aid to neuromodulation. ⋯ Neuromodulation techniques can provide the optimal analgesic techniques for individual patients. At times these can fail due to lack of access to the site for intervention, in this case epidural access. 3D printing may provide additional information to improve the likelihood of access when anatomy is distorted and standard approaches prove difficult.
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IEEE Trans Neural Syst Rehabil Eng · Aug 2017
Use of Virtual Reality Feedback for Patients with Chronic Neck Pain and Kinesiophobia.
This study examined how individuals with and without neck pain performed exercises under the influence of altered visual feedback in virtual reality. Chronic neck pain (n=9) and asymptomatic (n=10) individuals were recruited for this cross-sectional study. Participants performed head rotations while receiving programmatically manipulated visual feedback from a head-mounted virtual reality display. ⋯ The head rotation angle increased 4.29° for every 0.1 decrease in gain. On average, chronic pain individuals reported that neck rotation was feasible for 84% of the unity gain trials, 66% of the individual just-noticeable difference trials, and 50% of the "nudged" just-noticeable difference trials. This research demonstrated that virtual reality may be useful for promoting the desired outcome of increased range of motion in neck rehabilitation exercises by altering visual feedback.
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Cross-sectional design. ⋯ 2.