At 1-year follow-up, a PRP injection was found to be no more effective in improving quality of life, pain, disability, and shoulder range of motion than placebo in patients with chronic RCT who were treated with an exercise program.
Objective: To investigate the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) on intractable neuropathic pain in patients with spinal cord injury (SCI). Design: A single center, prospective, randomized, double-blinded, controlled study. Setting: SCI rehabilitation unit of university rehabilitation center. Participants: Seventeen patients with SCI and chronic neuropathic pain who met the inclusion criteria recruited between April 2010 and January 2012. Interventions: Ten daily treatment sessions of real or sham rTMS (30 trains of 10-Hz stimuli for a duration of 5 seconds; a total of 1500 pulses at intensity equal to 110% of the resting motor threshold) was applied over vertex using a figure-of-8-shaped coil. Outcome measures: Pain was assessed with visual analog scale (VAS) at baseline and 10 days, 6 weeks and 6 months after the treatment. Patients' satisfactions obtained using a 5-point Likert scale at 6 months. Results: Both real and sham rTMS provided a significant reduction in the VAS scores (real rTMS group, P = 0.004; sham rTMS group, P = 0.020). Post hoc analysis revealed the significant difference was at 10 days and 6 weeks compared to baseline in the real rTMS group and only at 10 days compared to baseline in the sham rTMS group. Comparison of VAS scores and patient satisfaction did not show any significant difference at each assessment point (P > 0.05). Conclusion: Our results demonstrated analgesic effect of rTMS on intractable neuropathic pain in SCI was not superior to placebo. However, middle-term (over 6 weeks) pain relief by rTMS is encouraging and suggests the need for future studies with a larger sample size.
Background:Pregnancy-induced hormonal and physiologic changes increase the risk of musculoskeletal problems in pregnancy. The purpose of this report is to provide a comprehensive look at the musculoskeletal pain and symptoms experienced during pregnancy.Methods:A total of 184 women (mean age 30.9 ± 5.0 years) who gave birth in the obstetrics clinic of a tertiary hospital were included in the study. The participants who had given birth at 37–42 weeks of pregnancy (term pregnancy) and aged over 18 years were selected for participation. Basic demographic and clinical characteristics of the participants including age, body mass index, weight gained during pregnancy, education level, occupation, parity, sex of baby, and exercise habits were collected from the medical chart and face-to-face interviews. Musculoskeletal pain sites were defined as hand–wrist, elbow, shoulder, neck, back, low back, hip, knee, and ankle–foot in a diagram of the human body. The interviews with participants were performed to assess their musculoskeletal pain separately at each trimester follow-up visit.Results:The most frequent musculoskeletal complaints during pregnancy were low back pain (n = 130, 70.7%), back pain (n = 80, 43.5%), hand–wrist (n = 61, 33.2%) and hip pain (n = 59, 32.1%). The participants experienced musculoskeletal pain most in the third trimester except for elbow, shoulder and neck pain compared with the first and second trimesters (p < 0.05).Conclusions:The results of the study suggest that numerous musculoskeletal problems may complicate pregnancy especially in the third trimester.
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