Rehab Centers: Spinal Cord Stimulation Reduces Hypersensitivity Through Activation of Opioid Receptors in a Frequency-Dependent Manner.
Spinal cord stimulation reduces hypersensitivity through activation of opioid receptors in a frequency-dependent manner.
Filed under: Rehab Centers
Eur J Pain. 2012 Oct 12;
Sato KL, King EW, Johanek LM, Sluka KA
BACKGROUND: Spinal cord stimulation (SCS) is used for the management of chronic intractable neuropathic pain. While used clinically, it is unclear if SCS produces its effects by activation of opioid receptors. The current study aimed to determine if endogenous opioids mediate the analgesia produced by SCS at different frequencies of stimulation in rats with neuropathic pain [spared nerve injury (SNI) model]. METHODS: Mechanical withdrawal thresholds of the paw were tested before and after 6?h of SCS at different frequencies (4?Hz, 60?Hz and sham) given daily for 4 days at 90% motor threshold 2 weeks after SNI. Rats were given naloxone (3-10?mg/kg/h), naltrindole (1?mg/kg/h) or were made tolerant to morphine (375?g pellets daily), and effects of SCS were tested. RESULTS: A dose of 3?mg/kg/h naloxone prevented the analgesia produced by 4-Hz, but not 60-Hz, SCS; 10?mg/kg/h prevented the analgesia produced by 60-Hz SCS. Naltrindole prevented the analgesia produced by 60-Hz, but not 4-Hz, SCS. In morphine-tolerant rats, 4-Hz SCS had no effect on withdrawal thresholds, but 60-Hz SCS remained effective as seen by increased withdrawal thresholds. CONCLUSION: These results suggest that both 4- and 60-Hz SCS, in part, work through opioid receptor mechanisms, with 4-Hz SCS activating ?-opioid receptors while 60-Hz SCS activated ?-opioid receptors.
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Postgraduate education to increase adherence to a Dutch physiotherapy practice guideline for hip and knee OA: a randomized controlled trial.
Filed under: Rehab Centers
Rheumatology (Oxford). 2012 Oct 11;
Peter WF, van der Wees PJ, Verhoef J, de Jong Z, van Bodegom-Vos L, Hilberdink WK, Fiocco M, Vliet Vlieland TP
Objective. To compare the effectiveness of two educational courses aiming to improve adherence to recommendations in a Dutch physiotherapy practice guideline for hip and knee OA.Methods. Physiotherapists (PTs) from three regions in The Netherlands were invited to participate in a study comparing an interactive workshop (IW) with conventional education (CE). Participants were randomly assigned to one of the two courses. Satisfaction with the course (scale 0-10), knowledge (score range 0-76) and guideline adherence (score range 0-72) were measured at baseline, immediately after the educational course and 3 months after that. Data were analysed using a linear mixed model.Results. In total, 203 (10%) PTs participated in the IW (n = 108) and the CE (n = 95). There were no differences between groups at baseline. Satisfaction was significantly higher in the IW than in the CE group [mean scores (s.d.) 7.5 (1.1) and 6.7 (1.6), respectively (P < 0.001)]. A significantly greater improvement in adherence was seen over time in the IW group compared with the CE group (F = 3.763, P = 0.024), whereas the difference in improvement of knowledge was not significant (F = 1.283, P = 0.278).Conclusion. An IW led to greater satisfaction and was more effective in improving adherence to recommendations in a PT guideline on hip and knee OA than CE, whereas the increase in knowledge did not differ significantly. HubMed – rehab
Development and Reliability Testing of Spanish Language and English Language Versions of the Multidimensional Task Ability Profile.
Filed under: Rehab Centers
J Occup Rehabil. 2012 Oct 13;
Verna JL, Matheson LN, Gables S, Hause R, Mayer JM
Purpose The purpose of this study was to assess the: (1) test-retest reliability of the English and Spanish language versions of the Multidimensional Task Ability Profile (MTAP), (2) cross-cultural adaptation of the Spanish language version of the MTAP, and (3) practicality of both versions in terms of time required for administration. The MTAP is a patient-reported outcome measure of physical function that uses a combination of text and pictorial illustrations. Methods An observational study was conducted with a convenience sample of patients with musculoskeletal disorders from three outpatient physical rehabilitation centers. Participants (n = 110) completed the MTAP two times, whereby the second test was completed 24-72 h after the first test. Focus groups were conducted at the end of the study. Correlation analyses were used to assess test-retest reliability and qualitative analyses were used to assess cultural adaptation of the MTAP. Results The English and Spanish versions of the MTAP displayed good test-retest reliability (ICC 2,1 = 0.87-0.97, p < 0.05). Qualitative analyses demonstrated adequate cross-cultural adaptation of the Spanish language version of the instrument. Conclusions The findings of this study indicate that the MTAP has been adequately adapted from its original English version for use with Spanish-speaking individuals. The MTAP in its current form of 50 items is reliable when administered to individuals with musculoskeletal disorders in either English or Spanish. HubMed – rehab
Workplace Rehabilitation and Supportive Conditions at Work: A Prospective Study.
Filed under: Rehab Centers
J Occup Rehabil. 2012 Oct 13;
Ahlstrom L, Hagberg M, Dellve L
Purpose To investigate the impact of rehabilitation measures on work ability and return to work (RTW), specifically the association between workplace rehabilitation/supportive conditions at work and work ability and RTW over time, among women on long-term sick leave. Methods Questionnaire data were collected (baseline, 6 and 12 months) from a cohort of women (n = 324). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability index (WAI), work ability score and working degree. These analyses were performed with different models; the explanatory variables for each model were workplace rehabilitation, supportive conditions at work and time. Results The individuals provided with workplace rehabilitation and supportive conditions (e.g. influence at work, possibilities for development, degree of freedom at work, meaning of work, quality of leadership, social support, sense of community and work satisfaction) had significantly increased WAI and work ability score over time. These individuals scored higher work ability compared to those individuals having workplace rehabilitation without supportive conditions, or neither. Additionally, among the individuals provided with workplace rehabilitation and supportive conditions, working degree increased significantly more over time compared to those individuals with no workplace rehabilitation and no supportive conditions. Conclusion The results highlight the importance of integrating workplace rehabilitation with supportive conditions at work in order to increase work ability and improve the RTW process for women on long-term sick leave.
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