Background:To investigate the effects of moderate aerobic exercise on the hemoglobin, hematocrit, and red blood cell (RBC) mass of women with rheumatoid arthritis (RA).Materials and Methods:This randomized clinical trial was conducted at the Specialized Clinic of Physical Medicine and Rehabilitation, Al-Zahra Hospital of Isfahan, during a 4-month period in 2014. We included patients with RA who did not have any malignancy and hematologic disorder. Two groups — one group receiving aerobic therapy along with medical therapy (N = 16) and the other group receiving medical therapy alone (N = 17) both for a period of 8 weeks. The levels of RBC mass, Hb, and HCT were measured before and after the intervention. The changes in these parameters were compared between the two study groups.Results:There was no significant difference between the two study groups regarding the baseline characteristics. The aerobic exercise resulted in increased RBC mass (P < 0.001), Hb (P < 0.001), and HCT (P < 0.001). However, those who received medical therapy alone did not experience any significant changes in these parameters. We found that the RBC mass (P = 0.581), Hb (P = 0.882), and HCT (P = 0.471) were comparable between the two study groups after 8 weeks of intervention.Conclusion:Although the aerobic exercise results in increased Hb, HCT, and RBC mass in patients with RA, the increase was not significant when compared to that in controls. Thus, the increase in the HB, HCT, and RBC could not be attributable to aerobic exercise.

Background:The aim of this study is to determine the predictive value of ultrasonography for results of local steroid injection in patients with carpal tunnel syndrome (CTS).Materials and Methods:This prospective cohort study was conducted during a 1-year period in outpatient clinics of rehabilitation and physical medicine including 35 patients with moderate and severe CTS who receive ultrasonography-guided local steroid injection. The Boston self-assessment questionnaire and electrodiagnosis parameters were recorded at baseline, 1 month, and 3 months after therapy. We also recorded the baseline ultrasonography parameters to determine the predictors of outcome.Results:The sensory severity score and functional status scale along with electrodiagnosis parameters decreased significantly at 1 month (P < 0.001) and remained unchanged after 3 months. Volar bulging was negatively associated with sensory nerve action potential latency (r = −0.392; P = 0.020). Cross-sectional area (CSA) of maximal swelling (MS; r = 0.409; P = 0.015), CSA at 2-cm of MS (r = 0.563; P < 0.001), and CSA at 12-cm of MS (r = 0.521; P = 0.001) correlated positively with compound muscle action potential (CMAP) amplitude while maximal swelling/12-cm MS ratio (r = −0.439; P = 0.008) and maximal swelling/2-cm MS ratio (r = −0.342; P = 0.045) correlated negatively. CSA at 12-cm of MS also correlated positively with CMAP amplitude nerve conduction velocity (r = 0.436; P = 0.010).Conclusion:Volar bulging, CSA of maximal swelling, CSA of MS at 2-cm, and CSA of MS at 12-cm are among the ultrasonographic predictors of response to local steroid injection in patients with CTS.

Background: Carpal tunnel syndrome (CTS) is the most prevalent entrapment neuropathy occurring due to increased pressure in the carpal tunnel. Objectives: The study aimed to evaluate the degree of symptom improvement, safety, and the change in electrophysiological findings after ultrasound (US)-guided versus Landmark (LM)-guided local steroid injection for the treatment of CTS. Methods: This randomized clinical trial recruited 52 patients with moderate or moderate-to-severe CTS. The subjects were randomly assigned to US-guided or LM-guided corticosteroid injection groups and received 40 mg methylprednisolone. After four weeks and 12 weeks of treatment, the patients were evaluated using the Boston questionnaire and electrophysiological parameters were determined. Results: All variables, including symptom/functional scores and electrophysiological findings, improved significantly in both groups after four weeks (all P < 0.05), except for compound muscle action potential (CMAP) amplitude in the LM-guided group. The LM-guided group showed a regress in all variables in the 12th week compared to the 4th week; however, these improvements persisted at week 12 post-treatment in the US-guided group (P < 0.05), except for the functional status scale (FSS) and sensory nerve action potential (SNAP). The improvement in the CMAP amplitude at week 12 was more in the US-guided group than in the LM-guided group (P < 0.05); however, the SNAP amplitude and SNAP nerve conduction velocity (NCV) improved more significantly in the LM-guided group. Significant differences were not observed between the groups with respect to the symptom severity score (SSS), FSS, SNAP latency, and CMAP latency at weeks 4 or 12 after treatment (P > 0.05). Conclusions: The symptom severity, functional status, and all electrophysiological parameters improved significantly in both US-guided and LM-guided corticosteroid injection groups and generally, no statistically significant difference was observed between both methods.