Clinical Outcomes of Extracorporeal Shock Wave Therapy in Patients With Secondary Lymphedema: A Pilot Study.
Clinical Outcomes of Extracorporeal Shock Wave Therapy in Patients With Secondary Lymphedema: A Pilot Study.
Ann Rehabil Med. 2013 Apr; 37(2): 229-234
Bae H, Kim HJ
To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with secondary lymphedema after breast cancer treatment.In a prospective clinical trial, ESWT was performed consecutively 4 times over two weeks in 7 patients who were diagnosed with stage 3 secondary lymphedema after breast cancer treatment. Each patient was treated with four sessions of ESWT (0.056-0.068 mJ/mm(2), 2,000 impulses). The parameters were the circumference of the arm, thickness of the skin and volume of the arm. We measured these parameters with baseline values before ESWT and repeated the evaluation after each ESWT treatment. Subjective data on skin thickness, edema and sensory impairment were obtained using a visual analogue scale (VAS).The mean volume of the affected arm after four consecutive ESWT was significantly reduced from 2,332 to 2,144 mL (p<0.05). The circumference and thickness of the skin fold of the affected arm were significantly decreased after the fourth ESWT (p<0.05). The three VAS scores were significantly improved after the fourth ESWT. Almost all patients were satisfied with this treatment and felt softer texture in their affected arm after treatment.ESWT is an effective modality in the treatment of stage 3 lymphedema after breast cancer treatment. ESWT reduced the circumference and the thickness of arms with lymphedema and satisfied almost all patients with lymphedema. Therefore, this treatment provides clinically favorable outcome to patients with breast cancer-related lymphedema. HubMed – rehab
Causes of Hand Tingling in Visual Display Terminal Workers.
Ann Rehabil Med. 2013 Apr; 37(2): 221-228
Oh S, Kim HK, Kwak J, Kim T, Jang SH, Lee KH, Kim MJ, Park SB, Han SH
To offer the basic data about the causes and distribution of hand tingling, symptoms and physical findings, and pressure pain threshold in desk workers.Five physiatrists participated in the screening test composed of history and physical examination. A total of 876 desk workers were evaluated and of them 37 subjects with hand tingling were selected. For further analyzing, detailed history taking and meticulous physical examination were taken. Pressure pain threshold (PPT) at the infraspinatus, upper trapezius, flexor carpi radialis, rhomboideus, and flexor pollicis longus were examined. PPT measurements were repeated three times with two minute intervals by a pressure algometer. Electrodiagnostic study was done to detect potential neurologic abnormalities.THE CAUSES OF HAND TINGLING IN ORDER OF FREQUENCY WERE: myofascial pain syndrome, 68%; cervical radiculopathy, 27%; rotator cuff syndrome, 11%; tenosynovitis, 8%; and carpal tunnel syndrome, 5%. The location of trigger points in the myofascial pain syndrome, which were proven to evoke a tingling sensation to the hand in order of frequency were: infraspinatus, 65.4%; upper trapezius, 57.7%; flexor carpi radialis, 38.5%; rhomboideus 15.4%; and flexor pollicis longus 11.5%. The PPT of the affected side was significantly lower than that of the unaffected side in myofascial pain syndrome (p<0.05).The most common cause of hand tingling in desk workers was myofascial pain syndrome rather than carpal tunnel syndrome. Common trigger points to evoke hand tingling were in the infraspinatus and upper trapezius. HubMed – rehab
Ultrasonographic Evaluation of Needle Insertion Site for the Flexor Pollicis Longus.
Ann Rehabil Med. 2013 Apr; 37(2): 215-220
Lee SM, Kim K, Lee SM, Lee HS
To establish the safest approach to needle electrode insertion into the flexor pollicis longus (FPL) regarding possible needle injury to the superficial radial nerve (SRN) or radial artery by ultrasonography.We evaluated 54 forearms of 27 healthy subjects. Three levels were defined in the forearm. Level 1 is the junction of the middle and distal third of the forearm, level 3 is the midpoint of forearm length, and level 2 is the midpoint between two levels. At each level, the distance between the most prominent point of the radius and the SRN (region A), the distance between the SRN and the radial artery (region B), and the depth from the skin surface to the FPL were measured.The distance of region A was 1.20±0.41 cm in level 1, 1.62±0.45 cm in level 2, and 1.95±0.49 cm in level 3. The distance of region B was 1.02±0.29 cm in level 1, 0.61±0.24 cm in level 2, and 0.37±0.19 cm in level 3. The depth from the skin surface to the FPL was 0.92±0.20 cm in level 1, 1.14±0.26 cm in level 2, and 1.45±0.29 cm in level 3.The safest needle insertion point to the FPL is the middle of the forearm within approximately 0.8 cm from the most prominent point of the radius. We recommend that the needle is inserted at the above point perpendicular to the skin surface until the needle meets the FPL at a depth of approximately 1.45 cm from the skin surface. HubMed – rehab
A Comparison of the Short-Term Effects of a Botulinum Toxin Type A and Triamcinolone Acetate Injection on Adhesive Capsulitis of the Shoulder.
Ann Rehabil Med. 2013 Apr; 37(2): 208-214
Joo YJ, Yoon SJ, Kim CW, Lee JH, Kim YJ, Koo JH, Song SH
To evaluate the short-term clinical effects of the intra-articular injection of botulinum toxin type A (BoNT-A) for the treatment of adhesive capsulitis.A prospective, controlled trial compared the effects of intra-articular BoNT-A (Dysport; 200 IU, n=15) with the steroid triamcinolone acetate (TA; 20 mg, n=13) in patients suffering from adhesive capsulitis of the shoulder. All patients were evaluated using a Numeric Rating Scale (NRS) of the pain intensity and a measurement of the range of motion (ROM) at baseline (before treatment) and at 2, 4, and 8 weeks post-treatment.The NRS at 2 weeks (BoNT-A vs. TA; 5.0 vs. 5.2), 4 weeks (4.1 vs. 4.9) and 8 weeks (3.8 vs. 4.6) of both treatment groups were significantly lower than that measured at baseline (7.4 vs. 7.6). The ROM of patients’ shoulders increased significantly from baseline in both treatment groups. There was no significant difference in the NRS of pain intensity or the ROM between the two groups. Reduction in the pain intensity score was maintained for 8 weeks post-injection in both groups. There were no significant adverse events in either treatment group.The results suggest that there are no significant short-term differences between the intra-articular injections of BoNT-A and TA. Although BoNT-A has a high cost, it may be used as a safe alternative of TA to avoid the steroid-induced side effects or as a second-line agent, for patients who have failed to respond to the current treatments. HubMed – rehab