scholarly journals Pain, functional status, social function and conditions of habitation in elderly unilaterally lower limb amputees

2007 ◽  
Vol 64 (12) ◽  
pp. 837-843 ◽  
Author(s):  
Aleksandar Djurovic ◽  
Dejan Ilic ◽  
Zorica Brdareski ◽  
Aleksandra Plavsic ◽  
Slavisa Djurdjevic
Keyword(s):  
Pain Intensity ◽  
Functional Status ◽  
Lower Limb ◽  
Rating Scale ◽  
Social Function ◽  
Functional Independence ◽  
Phantom Pain ◽  
Observation Study ◽  
Social Dysfunction ◽  
Number Of Patients

Background/Aim. Few authors are involved in home rehabilitation of amputees or their reintegration into the community. It has been remarked that there is a discontinuity between the phases of the amputee rehabilitation in Serbia. The aim of the study was to establish pain characteristics and functional status of amputees two months after the amputation and to determine their social function and the conditions of their habitation. Methods. This prospective observation study involved 38 elderly amputees with unilateral lower limb amputations. The patients were tested at the hospital on discharge and at their homes two months after the amputation. Pain intensity and functional status were measured by a visual analogue scale (VAS) and by Functional Independence Measure (FIM). The patients? social function was assessed using the Social Dysfunction Rating Scale (SDRS) and conditions of their habitation by the self-created Scale of Conditions of Habitation (SCH). In statistic analysis we used the Student t test, ?2 test and Analysis of variance (ANOVA). Results. The majority of patients (63%) underwent below knee amputation caused by diabetes (89%). A significant number of patients (84%, ?2 = 17.78; p < 0.01) was not visited by a physiotherapist nor an occupational therapist during two months at home. In this period, the majority of the amputees (68%) had phantom pain or residual limb pain (21%). Two months after amputation the pain intensity was significantly lower (VAS = 4.07?2.19; 2.34?1.41; p < 0.001), and the functional status significantly better than on discharge (FIM = 75.13?16.52; 87.87?16.48; p < 0.001). The amputees had the average level of social dysfunction (SDRS = 62.00?11.68) and conditions of habitation (SCH = 7.81?1.97). Conclusion. A total 38 elderly amputees with unilateral lower limb amputations achieved significant functional improvement and reduction of pain, in spite of their social dysfunction, the absence of socio-medical support and inadequacy of the conditions of habitation.

Social function, clinical symptoms and personality disturbance

2004 ◽  
Vol 21 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Ula Nur ◽  
Peter Tyrer ◽  
Stephen Merson ◽  
Tony Johnson
Keyword(s):  
Personality Disorder ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Psychiatric Symptoms ◽  
Randomised Trial ◽  
Treatment Strategies ◽  
Social Function ◽  
Personality Pathology ◽  
Social Dysfunction ◽  
Personality Disturbance

AbstractObjectives: To investigate the relationship between psychiatric symptoms, personality disturbance, and social function.Method: Longitudinal study of 100 psychiatric patients presenting as emergencies originally entered to a randomised trial of community and hospital-based treatment strategies. Ratings of social function using the Social Functioning Questionnaire, personality status using the Personality Assessment Schedule, and clinical symptomatology using the Comprehensive Psycho-pathological Rating Scale were recorded at baseline with assessment of social function repeated at two, four and 12 weeks. Correlation, regression, and path analysis were performed to test the hypothesis that personality status had more influence than clinical symptoms on social function.Results: Path and regression analysis showed, that at baseline both psychopathology and personality pathology contributed to social dysfunction equally, but from two weeks onwards personality abnormality contributed to a greater degree than clinical psychopathology. Of the 100, 35 patients had a personality disorder and in these there was a strong correlation between social function scores at baseline and 12 weeks (48% of variation explained) whereas in those with no personality disorder the correlation was much weaker (14%); regression analyses confirmed this conclusion.Conclusions: Psychopathology and personality status contribute to social dysfunction in patients presenting as emergencies but persistent social dysfunction is more likely to reflect personality pathology than other forms of mental disorder.

Influence of Physical Therapy Modalities on Pain in Osteoporosis Patients: initial results of the treatment with physical therapy

2016 ◽  
Vol 70 (1) ◽  
pp. 19-23
Author(s):  
Valentina Koevska ◽  
Snezana Perchinkova-Mishevska ◽  
Erieta Nikolik-Dimitrova ◽  
Biljana Mitrevska
Keyword(s):  
Physical Therapy ◽  
Pain Intensity ◽  
Rating Scale ◽  
Chronic Back Pain ◽  
Low Frequency ◽  
Physical Therapy Modalities ◽  
Number Of Patients ◽  
Therapeutic Exercises ◽  
Significant Difference ◽  
A Prospective Study

Abstract Introduction. Osteoporosis causes chronic back pain leading to restriction of functional capacity and quality of life. The aim of this study was to examine the influence of physical therapy modalities on pain in patients with osteoporosis. Methods. This is a prospective study of patients with osteoporosis, randomly chosen and followed for three months in the Institute of Physical Medicine and Rehabilitation (IPMR). Physical therapy consisted of physical modalities and therapeutic exercises. Physical therapy modalities included interferential currents and pulsed low-frequency electromagnetic field conducted each day with weekend breaks, 21 in total. Patients had therapeutic exercises 3 times a week during the entire follow-up period. Patients were assigned into two groups. The first group consisted of nine patients who underwent physical procedures and the second group consisted of nine patients who did not receive physical therapy modalities. Two check-ups were made on day 21 and at the end of the third month. Assessment of pain intensity was made by the use of a numeric pain rating scale. Results. No significant difference between the groups was observed regarding mean age of patients (p<0.21). The first check-up showed a significantly higher pain score in the second group of patients (p=0.0003). There was no significant difference in pain intensity between both groups of patients in the three-month period of investigation (p<0.63). Conclusion. Physical therapy modalities influence on pain in patients with osteoporosis. Our investigation included a small number of patients and hence further studies are necessary.

scholarly journals Quality of models of scales of consciousness level, functional state, and General somatic severity in patients with consequences of brain damage in intensive care and rehabilitation department.

2020 ◽  
pp. 303-314
Author(s):  
Yuri Yuri. Y. Kiryachkov ◽  
Marina V. Petrova Marina V.Petrova ◽  
Igor V. Pryanikov Igor V. Pryanikov ◽  
Dmitry L. Kolesov Dmitry L. Kolesov ◽  
Alexander L. Parfenov Alexander L. Parfenov ◽  
...  
Keyword(s):  
Functional Status ◽  
Brain Damage ◽  
Functional State ◽  
Glasgow Outcome Scale ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Level Of Consciousness ◽  
Vegetative Status

Aims: development and substantiation of a typical scheme for the clinical use of scales of the level of consciousness, general somatic and functional status of patients with of brain damage. Methods: Included 118 patients on 20-50 days after traumatic brain injury, anoxic damage; consequences of acute cerebral circulatory disorders, and neurosurgical operations. In groups of patients who are in a coma, vegetative status, a state of minimal consciousness and a state of clear consciousness, the analysis of the statistical quality of clinical scales was carried out: scales of consciousness: the Glasgow coma Scale (GCS); FOUR (Full Outline of UnResponsiveness); CRS-R-Coma Recovery Scale-Revised; the Glasgow outcome Scale (COS); the extended scale of the Glasgow coma (COSE - Glasgow outcome scale extended); Rancho Los Amigos scale-scale of consciousness and interaction with the environment (the Rancho Los Amigos scale - RLAS); Functional status scales: DRS (the Disability Rating Scale); modified Rankin Scale mRS; Barthel Activities of Daily Living (ADL) Index; functional independence measure-FIM; Karnovsky Index; Rivermead Mobility Index self-assessment of everyday life opportunities in Merton and Sutton (checklist self-maintenance. Merton and Sutton community NHS trust); Scales of General somatic severity: assessment of multi-organ dysfunction on the APACHE II scale (Acute Physiology and Chronic Health Evaluation); APACHE IV scale; SAPS II scale (Simplified Acute Physiology Score); SOFA scale (Sequential Organ Failure Assessment). The functional state of the ANS was recorded using HRV parameters by recording 5-minute RR intervals of the electrocardiogram. Results: There are 4 groups of patients who are in a state of coma, vegetative status, a state of minimal consciousness and a state of clear consciousness. In 67 patients out of 118 examined (56.8%) the parameters of ANS functional activity are in the zone of pathological (sympathetic/parasympathetic hyperactivity) values. Conclusions: Various scales of the level of consciousness, functional and general somatic severity of patients objectively differ in clinical significance in the gradation of coma - vegetative status - minimal consciousness - clear consciousness.

scholarly journals Perbandingan Intensitas Nyeri dan Kadar Prostaglandin Kombinasi Tramadol dan Deksketoprofen dengan Tramadol dan Parasetamol Intravena pada Pasien Bedah Ortopedi Ekstremitas Bawah

2019 ◽  
Vol 7 (2) ◽  
pp. 75-82
Author(s):  
Clara Valentia Josephine ◽  
Muhammad Ramli Ahmad ◽  
Hisbullah Hisbullah ◽  
Abdul Wahab
Keyword(s):  
Pain Intensity ◽  
Lower Limb ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Numeric Rating Scale ◽  
T Test ◽  
Skin Closure ◽  
Pge2 Level ◽  
Ps I ◽  
Paired T Test

Analgesia multimodal adalah prinsip manajemen nyeri pascaoperasi. Penelitian ini merupakan uji klinis rancangan acak tersamar ganda. Tujuan penelitian ini membandingkan efek kombinasi analgesik tramadol dan deksketoprofen dengan tramadol dan parasetamol terhadap intensitas nyeri dan kadar prostaglandin (PGE2) di RSUP Dr. Wahidin Sudirohusodo serta Rumah Sakit Jejaring di Makassar pada bulan Juli–September 2018. Empat puluh enam pasien ASA PS I dan II yang menjalani operasi ortopedi ekstremitas bawah dibagi menjadi dua kelompok. Kelompok D adalah pasien yang menerima 50 mg tramadol dengan 50 mg deksketoprofen dan kelompok P adalah pasien yang menerima 50 mg tramadol dengan 1.000 mg parasetamol intravena. PGE2 dan intensitas nyeri dicatat selama penutupan kulit sebelum pemberian obat 8 dan 16 jam sesudahnya. Data dianalisis menggunakan Uji Mann-Whitney U dan paired t-test yang sesuai. Numeric rating scale (NRS) kelompok tramadol dan deksketoprofen lebih rendah dibanding dengan kelompok tramadol dan parasetamol dengan perbedaan bermakna (p<0,05). Kadar PGE2 menurun pada kelompok tramadol dan deksketoprofen (T1–T2 p=0,009 dan T0–T2 p=0,01), sedangkan kadar PGE2 pada kelompok tramadol dan parasetamol meningkat (T2–T1 p=0,227 dan T0–T2 p=0,706). Simpulan, kombinasi tramadol dan deksketoprofen mengurangi tingkat PGE2 dan intensitas nyeri dibanding dengan kombinasi tramadol dan parasetamol. Dexketoprofen Combination and Tramadol Paracetamol Combination in Lower Limb Orthopedic SurgeryMultimodal analgesia is one of the principles of postoperative pain management. This study aimed to compare the effect of analgesic combination of tramadol dexketoprofen and tramadol paracetamol on pain intensity and prostaglandin (PGE2) level. Forty-six ASA PS I and II patients undergoing lower limb orthopedic surgery were allocated into two groups. Group D received 50 mg tramadol with 50 mg dexketoprofen and group P received 50 mg tramadol with 1,000 mg paracetamol intravenously. The PGE2 and pain intensity were recorded during skin closure prior to drug administration, 8 and 16 hours afterwards. Data were analyzed as appropriate using Mann-Whitney U and paired t-test. The NRS of two groups were significantly different where the NRS of the Tramadol Dexketoprofen group was lower than that of the tramadol and paracetamol group (NRS T1 p=0.049, NRS T2 p=0.035). The PGE2 levels decreased in the tramadol dexketoprofen groups (T1–T2 p=0.009 and T0–T2 p=0.01), whereas PGE2 levels in tramadol paracetamol group increased (T2–T1 p=0.227 and T0–T2 p=0.706). In conclusion, tramadol dexketoprofen combination reduces the PGE2 level and pain intensity as opposed to tramadol paracetamol combination. 

scholarly journals 8% Capsaicin Patch in Treatment of Peripheral Neuropathic Pain

2020 ◽  
Vol 5;23 (9;5) ◽  
pp. E541-E548
Author(s):  
Décia Gonçalves
Keyword(s):  
Neuropathic Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Syndrome ◽  
Peripheral Neuropathic Pain ◽  
Patch Application ◽  
Analgesic Therapy ◽  
Number Of Patients ◽  
Painful Area

Background: Neuropathic pain is a complex condition that is difficult to control and has a high impact on quality of life. 8% Capsaicin patch can be a therapeutic strategy in the treatment of peripheral neuropathic pain. Objectives: This study aims to (1) evaluate clinical efficacy and (2) tolerability of 8% capsaicin patch in a Pain Unit. Study Design: Retrospective observational study Setting: Portuguese Pain Unit Methods: A sample of 120 patients diagnosed with peripheral neuropathic pain, underwent treatment with the 8% capsaicin patch between February 2011 and February 2019 in a Portuguese Pain Unit. Patients were included in one of the following groups according to the etiology of pain: postherpetic neuralgia (PHN), chronic post-surgical pain (CPSP), post traumatic neuropathic pain (PTNP), diabetic neuropathy (DN), regional pain syndrome. complex I and II (CRPS I / II), HIVassociated neuropathy (HIVN), lumbar neuropathic pain (LNP), trigeminal neuralgia (TN) and other neuropathies (O). The evaluated parameters were: pain intensity according to unit protocol (numerical rating scale), pain characteristics, location, size of the painful area. The evolution of pain intensity after treatment (patients were considered as responders to therapy if the decrease in NRS was equal to or greater than 30%; patients with a decrease in NRS of 50% or more were also analyzed), the area of pain and the need for adjuvant analgesic therapy, as well as the tolerability to treatment and the identification of eventual predictors of its efficacy were evaluated, at 15 days, 8 weeks and 12 weeks after 8% capsaicin patch. Results: Of the 120 patients in the sample, 40.8% had a ≥ 30% decrease in basal pain intensity 15 days after treatment, 43.3% after 8 weeks and 45.0% after 12 weeks. 30.8% of patients had ≥ 50% decreased basal pain intensity 15 days after treatment, 27.5% after 8 weeks and 30.0% after 12 weeks. Pain area decreased in 36.7% of patients and 18.3% reduced chronic analgesic therapy within 12 weeks after 8% capsaicin patch application. There was only one case of intolerance to the treatment. Limitations: This study has the limitations inherent to a retrospective study. The study period was only 12 weeks and some diagnostic groups included a small number of patients. Conclusion: Treatment of peripheral neuropathic pain with 8% capsaicin patch seem to be effective in the short and medium term, both in decreasing pain intensity and in reducing the painful area. Its application is tolerated by most patients. Key words: 8% capsaicin patch, peripheral neuropathic pain, pain intensity, painful area

Neuromas in patients with peripheral nerve injury and amputation - An ongoing study

2017 ◽  
Vol 16 (1) ◽  
pp. 168
Author(s):  
N.S. Buch ◽  
E. Qerama ◽  
N.B. Finnerup ◽  
L. Nikolajsen
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Ongoing Study ◽  
Phantom Pain ◽  
Spontaneous Pain ◽  
Stump Pain ◽  
Number Of Patients

AbstractBackground and aimsInjury to peripheral nerves associated with trauma, amputation, or surgery may lead to the formation of neuromas that can cause severe pain. Unfortunately, neuromas are frequently refractory to medical and surgical treatment. This ongoing study examines whether neuromas are more frequent in patients experiencing pain after peripheral nerve injury or amputation than in patients without pain.MethodsIn this observational cohort study, 80 patients with peripheral nerve injury or amputation will be recruited. Patients will answer pain questionnaires and undergo a clinical examination with quantitative sensory testing performed within the area of spontaneous pain, including areas of brush-evoked allodynia and pinprick hyperalgesia. Neuromas are identified using ultrasound.ResultsPatient inclusion is ongoing. At present, fourteen amputees have participated in the study: nine males and four females, aged 38–77 years. Six patients had no neuromas. Stump pain in this group ranged from 0 to 8 and phantom pain from 0 to 10 on a numerical rating scale, 0–10. Eight patients had neuromas. Stump pain in this group ranged from 0 to 7 and phantom pain from 0 to 8. Further results will be presented at the congress.ConclusionsBecause of a limited number of patients included, it is not yet possible to conclude if neuromas are more frequent in patients with pain.Hopefully, this study will increase our understanding of the role of neuromas in patients with pain after peripheral nerve injury and amputation.

Influence of Fear-Avoidance Beliefs on Functional Status Outcomes for People With Musculoskeletal Conditions of the Shoulder

2012 ◽  
Vol 92 (8) ◽  
pp. 992-1005 ◽  
Author(s):  
Bhagwant S. Sindhu ◽  
Leigh A. Lehman ◽  
Sergey Tarima ◽  
Mark D. Bishop ◽  
Dennis L. Hart ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Functional Status ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Functional Change ◽  
Minimal Detectable Change ◽  
Fear Avoidance ◽  
Computerized Adaptive Test ◽  
Fear Avoidance Beliefs ◽  
Musculoskeletal Conditions

Background The influence of elevated fear-avoidance beliefs on change in functional status is unclear. Objective The purpose of this study was to determine the influence of fear-avoidance on recovery of functional status during rehabilitation for people with shoulder impairments. Design A retrospective longitudinal cohort study was conducted. Methods Data were collected from 3,362 people with musculoskeletal conditions of the shoulder receiving rehabilitation. At intake and discharge, upper-extremity function was measured using the shoulder Computerized Adaptive Test. Pain intensity was measured using an 11-point numerical rating scale. Completion rate at discharge was 57% for function and 47% for pain intensity. A single-item screen was used to classify patients into groups with low versus elevated fear-avoidance beliefs at intake. A general linear model (GLM) was used to describe how change in function is affected by fear avoidance in 8 disease categories. This study also accounted for within-clinic correlation and controlled for other important predictors of functional change in functional status, including various demographic and health-related variables. The parameters of the GLM and their standard errors were estimated with the weighted generalized estimating equations method. Results Functional change was predicted by the interaction between fear and disease categories. On further examination of 8 disease categories using GLM adjusted for other confounders, improvement in function was greater for the low fear group than for the elevated fear group among people with muscle, tendon, and soft tissue disorders (Δ=1.37, P&lt;.01) and those with osteopathies, chondropathies, and acquired musculoskeletal deformities (Δ=5.52, P&lt;.02). These differences were below the minimal detectable change. Limitations Information was not available on whether therapists used information on level of fear to implement treatment plans. Conclusions The influence of fear-avoidance beliefs on change in functional status varies among specific shoulder impairments.

Repeated Intravenous Lidocaine Infusions for Patients with Fibromyalgia: Higher Doses of Lidocaine Have a Stronger and Longer-Lasting Effect on Pain Reduction

Pain Medicine ◽  
2019 ◽  
Vol 21 (6) ◽  
pp. 1230-1239 ◽  
Author(s):  
Igor Wilderman ◽  
Olga Pugacheva ◽  
Vsevolod (Sev) Perelman ◽  
Michael C T Wansbrough ◽  
Yuri Voznyak ◽  
...  
Keyword(s):  
Pain Relief ◽  
Pain Intensity ◽  
Magnesium Sulfate ◽  
Statistical Difference ◽  
Rating Scale ◽  
Retrospective Chart Review ◽  
Numeric Rating Scale ◽  
Subjective Impression ◽  
Number Of Patients ◽  
Significant Difference

Abstract Objectives To determine the effect of escalating doses of lidocaine infusion with or without added magnesium on pain levels and the duration of pain relief in patients with fibromyalgia (FM). Methods A retrospective chart review of 74 patients diagnosed with FM who underwent at least three escalating doses of intravenous (IV) lidocaine infusions (5 mg/kg of body weight, 7.5 mg/kg, and 7.5 mg/kg of lidocaine + 2.5 g of magnesium sulfate) was conducted. Each patient’s subjective impression of change in pain intensity and duration of pain relief after each treatment was recorded, along with an 11-point numeric rating scale (NRS) for pain intensity, immediately before and after each infusion. Results Short-term lidocaine analgesia was evaluated by the reduction in NRS pain score according to the patients reported pre- (immediately before treatment) and post-treatment (immediately after treatment) values. There was a statistical difference in the NRS score reduction between doses 5 mg/kg and 7.5 mg/kg of lidocaine (P = 0.009). Long-term analgesia was evaluated at follow-up visits by the patient’s subjective impression of change in pain intensity and duration of pain relief. There was a statistical difference in the percentage of pain relief and the mean duration of pain relief between the treatments with 5 mg/kg and 7.5 mg/kg of lidocaine (P = 0.007 and P = 0.003). Although there was a trend of greater response to magnesium sulfate as a beneficial adjunct to the lidocaine infusion, we were unable to find a statistically significant difference for any of the variables studied. Conclusions This study demonstrated that escalating doses of IV lidocaine to 7.5 mg/kg safely and effectively reduced the pain with prolonged effect in a significant number of patients diagnosed with fibromyalgia. Larger, prospective clinical studies are required to confirm this finding.

Social Dysfunction Rating Scale

1969 ◽  
Author(s):  
Margaret W. Linn ◽  
William B. Sculthorpe ◽  
Margaret Evje ◽  
Phillip H. Slater ◽  
Spencer P. Goodman
Keyword(s):  
Rating Scale ◽  
Social Dysfunction
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