347 results on '"Upper limb pain"'
Search Results
2. Atypical presentation of tight filum terminale with thoracic disc herniation: a case report
- Author
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Taiju Miyagami, Hidetoshi Nojiri, Satoru Okada, Kiichi Mitsumoto, Kosuke Uemura, and Toshio Naito
- Subjects
Tight filum terminale ,Disc herniation ,Upper limb pain ,Back pain ,Medicine - Abstract
Abstract Background Tight filum terminale is a rare and challenging condition to diagnose because it presents with nonspecific symptoms and unclear imaging findings. This report documents an atypical case of tight filum terminale. Case presentation The patient was a previously healthy Asian 18-year-old male presenting with recurrent upper extremity and back pain, initially treated as nonspecific musculoskeletal pain. Notably, the patient’s symptoms were inconsistent with the dermatome, showing no correlation with his skin’s sensory innervation areas. In contrast to typical tight filum terminale presentations focused on lower extremity and lumbar region disturbances, this patient experienced pain and weakness predominantly in the upper extremities and back, hypothesized to result from traction myelopathy exacerbated by thoracic disc herniation. Investigations including blood and nerve function tests were inconclusive. However, a magnetic resonance imaging scan revealed a combination of tight filum terminale and tiny thoracic disc herniation. A diagnosis of tethered spinal cord syndrome was confirmed following further tests and imaging. The filum terminale was surgically removed, resolving the symptoms at a 7-month follow-up. Conclusions This case underlines the importance of including tight filum terminale as a differential diagnosis in cases of unexplained upper or lower extremity pain. Primary care practitioners, particularly those managing undefined symptoms, should consider tight filum terminale in their diagnostic approach.
- Published
- 2024
- Full Text
- View/download PDF
3. Exposure Time to Work-Related Hazards and Factors Affecting Musculoskeletal Pain in Nurses.
- Author
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Kim, Woo Jin and Jeong, Byung Yong
- Subjects
MUSCULOSKELETAL pain ,OCCUPATIONAL hazards ,BACKACHE ,LIFTING & carrying (Human mechanics) ,MUSCULOSKELETAL system diseases ,NURSES ,TRANSCRANIAL magnetic stimulation ,STANDING position - Abstract
Nurses who work in hospitals are exposed to various occupational hazards and are recognized as having high rates of musculoskeletal pain. This study aims to estimate the level of exposure to work-related hazards for nurses working in hospitals and derive factors that affect back pain, upper limb pain, and lower limb pain. This study was conducted on 462 nurses from the 6th Korean Working Condition Survey (KWCS) data, deriving exposure time related to physical, biochemical, and ergonomic hazards. Also, using binomial logistic regression analysis, this study determines the factors influencing musculoskeletal pain by comprehensively considering work-related factors and physical, biochemical, and ergonomic hazards. The exposure time for standing is the highest, followed by repetitive movements, awkward postures, patient lifting/carrying, infection, heavy object handling, and vibration. The average exposure times to occupational hazards were higher for nurses experiencing pain in their back, upper limbs, and lower limbs than those without pain complaints. Factors that contribute to back pain include years of work experience (p = 0.002), type of healthcare establishment (p = 0.001), exposure level to vibration (p = 0.029), and awkward posture level (p < 0.001). Factors affecting upper limb pain include the type of shift work (p = 0.013), handling heavy objects (p < 0.001), awkward postures (p = 0.033), and repetitive movements (p = 0.002). The factors that influence lower limb pain are awkward posture (p = 0.001), patient lifting/carrying (p = 0.002), and repetitive movements (p = 0.006). This study emphasizes the importance of implementing strategies to improve occupational hazards to prevent or alleviate musculoskeletal pain. These findings provide practical guidance for managing risk factors and preventing musculoskeletal disorders among nursing professionals. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
4. Atypical presentation of tight filum terminale with thoracic disc herniation: a case report.
- Author
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Miyagami, Taiju, Nojiri, Hidetoshi, Okada, Satoru, Mitsumoto, Kiichi, Uemura, Kosuke, and Naito, Toshio
- Subjects
- *
HERNIA , *MAGNETIC resonance imaging , *LUMBOSACRAL region , *MUSCULOSKELETAL pain , *BACKACHE - Abstract
Background: Tight filum terminale is a rare and challenging condition to diagnose because it presents with nonspecific symptoms and unclear imaging findings. This report documents an atypical case of tight filum terminale. Case presentation: The patient was a previously healthy Asian 18-year-old male presenting with recurrent upper extremity and back pain, initially treated as nonspecific musculoskeletal pain. Notably, the patient's symptoms were inconsistent with the dermatome, showing no correlation with his skin's sensory innervation areas. In contrast to typical tight filum terminale presentations focused on lower extremity and lumbar region disturbances, this patient experienced pain and weakness predominantly in the upper extremities and back, hypothesized to result from traction myelopathy exacerbated by thoracic disc herniation. Investigations including blood and nerve function tests were inconclusive. However, a magnetic resonance imaging scan revealed a combination of tight filum terminale and tiny thoracic disc herniation. A diagnosis of tethered spinal cord syndrome was confirmed following further tests and imaging. The filum terminale was surgically removed, resolving the symptoms at a 7-month follow-up. Conclusions: This case underlines the importance of including tight filum terminale as a differential diagnosis in cases of unexplained upper or lower extremity pain. Primary care practitioners, particularly those managing undefined symptoms, should consider tight filum terminale in their diagnostic approach. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
5. Exposure Time to Work-Related Hazards and Factors Affecting Musculoskeletal Pain in Nurses
- Author
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Woo Jin Kim and Byung Yong Jeong
- Subjects
musculoskeletal disorders ,occupational hazards ,back pain ,upper limb pain ,lower limb pain ,Technology ,Engineering (General). Civil engineering (General) ,TA1-2040 ,Biology (General) ,QH301-705.5 ,Physics ,QC1-999 ,Chemistry ,QD1-999 - Abstract
Nurses who work in hospitals are exposed to various occupational hazards and are recognized as having high rates of musculoskeletal pain. This study aims to estimate the level of exposure to work-related hazards for nurses working in hospitals and derive factors that affect back pain, upper limb pain, and lower limb pain. This study was conducted on 462 nurses from the 6th Korean Working Condition Survey (KWCS) data, deriving exposure time related to physical, biochemical, and ergonomic hazards. Also, using binomial logistic regression analysis, this study determines the factors influencing musculoskeletal pain by comprehensively considering work-related factors and physical, biochemical, and ergonomic hazards. The exposure time for standing is the highest, followed by repetitive movements, awkward postures, patient lifting/carrying, infection, heavy object handling, and vibration. The average exposure times to occupational hazards were higher for nurses experiencing pain in their back, upper limbs, and lower limbs than those without pain complaints. Factors that contribute to back pain include years of work experience (p = 0.002), type of healthcare establishment (p = 0.001), exposure level to vibration (p = 0.029), and awkward posture level (p < 0.001). Factors affecting upper limb pain include the type of shift work (p = 0.013), handling heavy objects (p < 0.001), awkward postures (p = 0.033), and repetitive movements (p = 0.002). The factors that influence lower limb pain are awkward posture (p = 0.001), patient lifting/carrying (p = 0.002), and repetitive movements (p = 0.006). This study emphasizes the importance of implementing strategies to improve occupational hazards to prevent or alleviate musculoskeletal pain. These findings provide practical guidance for managing risk factors and preventing musculoskeletal disorders among nursing professionals.
- Published
- 2024
- Full Text
- View/download PDF
6. Treatment of Neck and Upper Limb Pain Using BurstDR (De Ridder) Stimulation (NU-BURST)
- Published
- 2021
7. Diagnosis and Treatment of Pectoralis Minor Syndrome (Neurogenic Thoracic Outlet)
- Author
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Pietramaggiori, Giorgio, Scherer, Saja, Pietramaggiori, Giorgio, editor, and Scherer, Saja, editor
- Published
- 2020
- Full Text
- View/download PDF
8. Differential Target Multiplexed Spinal Cord Stimulation for the Treatment of Chronic Intractable Upper Limb Pain: 12-Month Results From a Prospective, Multicenter Study.
- Author
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White T, Justiz R, Fishman M, Schultz D, Calodney A, Cordner H, Almonte W, Millet Y, Wu K, Gekht G, Will A, Kim P, Bundschu R, Sirianni J, El-Naggar A, Gupta M, Park W, Cedeño DL, and Vallejo R
- Abstract
Objectives: This prospective, open-label, single-arm, multicenter study evaluated the use of differential target multiplexed (DTM) spinal cord stimulation (SCS) therapy for chronic upper limb pain (ULP)., Materials and Methods: A total of 58 candidates for SCS who had chronic ULP were enrolled at 11 sites in the USA. The safety and effectiveness of DTM SCS for treating chronic intractable ULP were evaluated over 12 months. The primary end point was the percentage of responders (≥50% ULP relief versus baseline) to treatment at three months after device activation. This study also evaluated the extent of disability, patient satisfaction, and patient global impression of change with DTM SCS therapy., Results: The mean baseline pain score (10-cm visual analog scale [VAS-10]) for ULP was 7.2 cm, with a mean age of 56 years and mean ULP duration of ten years; 47 subjects were assessed at the primary end point. The percentage of ULP responders was 92% at three months, which was consistent at six (91%) and 12 months (86%). Significant ULP relief (81% reduction in VAS-10) was observed at the primary end point and sustained throughout the study duration. Significant improvements in disability in addition to high levels (>95%) of satisfaction and feelings of improvement were reported. Frequency of study-related anticipated adverse events was in line with expectations of SCS therapy., Conclusion: In this patient population with difficult-to-treat conditions with limited clinical evidence of the effectiveness of SCS, subjects reported significant reduction in chronic ULP in response to treatment with DTM SCS., Competing Interests: Conflict of Interest Wilson Almonte, Richard Bundschu, Amr El-Naggar, Gennady Gekht, Mayank Gupta, Yoann Millet, Andrew Will, and Kenneth Wu report institutional grant support from SGX Nova. Aaron Calodney reports grant support from Stryker, Boston Scientific, Saluda Medical, and Vivex, and consulting fees from Medtronic, Companion Spine, PainTeq, and Vertos. David L. Cedeño reports institutional grant support from Medtronic, consulting fees from SGX Medical, ownership of SGX Medical, and being coinventor of patents assigned to Medtronic. Harold Cordner and Rafael Justiz report institutional grant support from SGX Nova and consulting fees from Medtronic. Michael Fishman reports institutional grant support from SGX Nova, consulting fees from Medtronic and Saluda Medical, honoraria for speaker engagements for Medtronic and Mainstay Medical, and stock options from Brixton Biosciences, Celeri Health, and Aurora Spine. Philip Kim reports institutional grant support from SGX Nova, Medtronic, Biotronik, Abbott, Saluda Medical, and Boston Scientific, consulting fees from Medtronic and Biotronik, and honoraria for speaker engagements for Medtronic. Wesley Park reports employment with SGX Medical. David Schultz discloses participation in the advisory board for SynerFuse Inc. Ricardo Vallejo reports institutional grant support from Medtronic, consulting fees from SGX Medical and Medtronic, ownership of SGX Medical, and being coinventor of patents assigned to Medtronic. Thomas White reports institutional grant support from SGX Nova, consulting fees and honoraria from Medtronic, and ownership of North Pines Surgery Center. Justin Sirianni reports no conflict of interest., (Copyright © 2024. Published by Elsevier Inc.)
- Published
- 2024
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- View/download PDF
9. Multicentre, clinical trial of burst spinal cord stimulation for neck and upper limb pain NU-BURST: a trial protocol.
- Author
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Al-Kaisy, Adnan, Vajramani, Girish, Love-Jones, Sarah, Patel, Nikunj K., Royds, Jonathan, Palmisani, Stefano, Pang, David, Wesley, Samuel, Park, Hyun-Joo, Raza, Adil, and Agnesi, Filippo
- Subjects
- *
NECK pain , *SPINAL cord , *FAILED back surgery syndrome , *STATISTICAL hypothesis testing , *EPIDURAL space , *NEURALGIA - Abstract
Background: Spinal cord stimulation (SCS) is an established therapy for chronic neuropathic pain and most frequently utilised for Failed Back Surgery Syndrome (FBSS). BurstDR™ also known as DeRidder Burst-SCS, a novel waveform, has demonstrated superiority to conventional tonic stimulation of the thoracic spine in FBSS. There are case reports of an improvement in multidimensional pain outcomes using DeRidder Burst-SCS in the cervical spine for chronic neck and cervical radicular pain. The safety and efficacy of cervical DeRidder Burst-SCS stimulation still however remain undetermined. Methods/design: This is a prospective, multicentre feasibility trial evaluating the safety and therapeutic efficacy of DeRidder Burst-SCS stimulation for the treatment of chronic intractable neck pain with or without radiation to the arm, shoulder, and upper back. After baseline evaluation, subjects will undergo an SCS trial using the Abbott Invisible Trial system according to standard clinical procedures. During the trial phase, SCS leads will be implanted in the cervical epidural space. At the end of the SCS trial, subjects experiencing at least 50% pain relief will be considered for permanent implant. Pain intensity, medication usage, and other multidimensional pain outcomes will be collected. The timing of these will be at baseline, end of the SCS trial and at 3-, 6-, and 12-month visits. Incidence of adverse events will be collected throughout the study duration. Discussion: The results of this feasibility study will validate the efficacy and safety of DeRidder Burst-SCS stimulation in the cervical spine. The results obtained in this study will potentially be used to generate a level 1 evidence-based study with formal statistical hypotheses testing. Trial registration: www.clinicaltrials.gov Identifier: NCT03159169. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
10. A Hybrid Algorithm for the Assessment of the Influence of Risk Factors in the Development of Upper Limb Musculoskeletal Disorders
- Author
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Busto Serrano, Nélida M., García Nieto, Paulino J., Suárez Sánchez, Ana, Sánchez Lasheras, Fernando, Riesgo Fernández, Pedro, Hutchison, David, Series Editor, Kanade, Takeo, Series Editor, Kittler, Josef, Series Editor, Kleinberg, Jon M., Series Editor, Mattern, Friedemann, Series Editor, Mitchell, John C., Series Editor, Naor, Moni, Series Editor, Pandu Rangan, C., Series Editor, Steffen, Bernhard, Series Editor, Terzopoulos, Demetri, Series Editor, Tygar, Doug, Series Editor, Weikum, Gerhard, Series Editor, de Cos Juez, Francisco Javier, editor, Villar, José Ramón, editor, de la Cal, Enrique A., editor, Herrero, Álvaro, editor, Quintián, Héctor, editor, Sáez, José António, editor, and Corchado, Emilio, editor
- Published
- 2018
- Full Text
- View/download PDF
11. The impact of work-related risk factors on the development of neck and upper limb pain among low wage hotel housekeepers in Gondar town, Northwest Ethiopia: institution-based cross-sectional study
- Author
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Sintayehu Daba Wami, Awrajaw Dessie, and Daniel Haile Chercos
- Subjects
Neck pain ,Upper limb pain ,Musculoskeletal disorders ,Hotel housekeepers ,Gondar ,Ethiopia ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Musculoskeletal disorders are a major source of disability accounting for considerable economic loss globally. Studies showed that housekeepers suffer from exposure to many high-risk factors for neck and upper limb musculoskeletal disorders. In Ethiopia, little is known and the information is limited in scope about the magnitude of the problem among hotel housekeepers. Therefore, this study aimed to determine the magnitude of the neck and upper limb musculoskeletal disorders and identify the associated risk factors among hotel housekeepers. Methods Institution-based cross-sectional study design was employed from March 1 to May 20, 2017. Systematic random sampling was used to select 422 study participants among the Gondar town hotels, Ethiopia. The standardized Nordic questionnaire for the analysis of musculoskeletal symptoms was used to measure the neck and upper limb musculoskeletal disorders. Bivariate and multivariable binary logistic regression analyses were performed using SPSS version 20. The significance level was obtained at 95% CI and p value ≤ 0.05. Results The overall magnitude of a self-reported neck and upper limb musculoskeletal disorders among hotel housekeepers in the last 12 months was 62.8% (95% CI 58.3, 67.8). The main body areas of concern were neck pain (50.7%), shoulder pain (54%), elbow/forearm (47.2%), and hand/wrist (45.5%). Age, rest break taken, repetitive movement, reaching/overstretching, organization concern for health and safety, and job satisfaction were the risk factors significantly associated with neck and upper limb musculoskeletal disorders. Conclusions A higher proportion of hotel housekeepers were found to be affected by neck and upper limb musculoskeletal disorders in Gondar town. Repetitive movement and reaching/overstretching were strongly associated risk factors with neck and upper limb musculoskeletal disorders. Therefore, ergonomic, organizational and personal measures, which focus on minimizing repetitive movement and awkward working position and facilitating rest break with exercise, are important to tackle neck and upper limb musculoskeletal disorders among hotel housekeepers.
- Published
- 2019
- Full Text
- View/download PDF
12. Correlations between pain in the back and neck/upper limb in the European Working Conditions Survey
- Author
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Emanuele Rizzello, Georgia Ntani, and David Coggon
- Subjects
Low back pain ,Upper limb pain ,Prevalence ,International variation ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Recent research has suggested that wide international variation in the prevalence of disabling regional pain among working populations is driven largely by factors predisposing to musculoskeletal pain in general and not specific to individual anatomical sites. We sought to confirm this finding, using data from an independent source. Methods Using data from the fifth (2010) and sixth (2015) European Working Conditions Surveys, we explored correlations between the one-year prevalence of pain in the back and neck/upper limb among people of working age across 33 European countries, and between changes in pain prevalence at the two anatomical sites from 2010 to 2015. Results Each survey recruited ≥1000 participants per country, response rates ranging from 11 to 78%. In 2010, the estimated one-year population prevalence of back pain ranged from 23% in Ireland to 66% in Portugal, and that of pain in the neck/upper limb from 25% in Ireland to 69% in Finland, the prevalence of pain at the two anatomical sites being correlated across the 33 countries (r = 0.42). A similar pattern was apparent in 2015. For back pain, the percentage change in prevalence from 2010 to 2015 varied from − 41.4% (Hungary) to + 29.6% (Ireland), with a mean across countries of − 3.0%. For neck/upper limb pain, the variation was from − 41.0% (Hungary) to + 44.1% (Romania), with an average of − 0.1%. There was a strong correlation across countries in the change in pain prevalence at the two anatomical sites (r = 0.85). Conclusions Our findings accord with the hypothesis that international variation in common pain complaints is importantly driven by factors that predispose to musculoskeletal pain in general.
- Published
- 2019
- Full Text
- View/download PDF
13. Dorsal arachnoid web: A rare cause of syringomyelia and myelopathy
- Author
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Prasad Krishnan and Sayan Das
- Subjects
Dorsum ,Cord ,medicine.diagnostic_test ,business.industry ,Upper limb pain ,Magnetic resonance imaging ,Anatomy ,General Medicine ,medicine.disease ,Spinal cord ,nervous system diseases ,body regions ,Myelopathy ,medicine.anatomical_structure ,Pathognomonic ,Medicine ,Surgery ,Neurology (clinical) ,business ,Syringomyelia - Abstract
Dorsal arachnoidal webs are condensations of arachnoidal tissue densely adherent to the pial surface of the posterior aspect of the dorsal spinal cord. Infrequently described in literature they disrupt the flow of CSF in the spinal subarachnoid space leading to syringomyelia and myelopathy. While there are several theories on their origin, the “scalpel sign” on magnetic resonance imaging is considered to be pathognomonic of this condition. An illustrative case of a 58 year old man with syringomyelia and dorsal cord indentation who presented with spastic paraparesis, gait instability, parasthesias and bilateral non radicular upper limb pain that resolved following excision of the web is described to highlight the importance of considering this diagnosis when cases of so called “idiopathic” syringomyelia are encountered.
- Published
- 2022
14. Post-stroke upper limb spasticity incidence for different cerebral infarction site
- Author
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Jin Yi and Zhao Yuan
- Subjects
post-stroke upper limb spasticity ,cerebral infarction site ,upper limb pain ,Medicine - Abstract
The purpose of this study was to evaluate the incidence rate of post-stroke upper limb spasticity and its correlation with cerebral infarction site.
- Published
- 2018
- Full Text
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15. Work-related musculoskeletal pain among physical therapists: a cross-sectional study in Kyoto and Shiga prefectures, Japan.
- Author
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Tsuji S, Kitahara T, Tsujimura H, Shirahoshi SI, Iwakura H, Tomitagawa S, and Taoda K
- Subjects
- Humans, Japan epidemiology, Female, Cross-Sectional Studies, Male, Adult, Middle Aged, Prevalence, Risk Factors, Surveys and Questionnaires, Job Satisfaction, Logistic Models, Occupational Diseases epidemiology, Occupational Diseases etiology, Physical Therapists statistics & numerical data, Musculoskeletal Pain epidemiology, Musculoskeletal Pain etiology, Low Back Pain epidemiology, Low Back Pain etiology
- Abstract
Objectives: This study aimed to determine the actual working conditions and prevalence of musculoskeletal pain among physical therapists in Japan, and the risk factors associated with low back pain (LBP) and upper limb pain (ULP)., Methods: A cross-sectional study of physical therapists in the Kyoto and Shiga prefectures was conducted using a self-administered questionnaire. The survey contents included questions regarding personal, work-related, and musculoskeletal pain factors. Logistic regression models were used to analyze factors associated with LBP and ULP., Results: Responses from 1479 participants were included in the analyses. The prevalence of LBP at the time of the survey and in the past year was 40.1% and 74.3% in females, and 37.8% and 69.9% in males, respectively. The prevalence of ULP was 34.8% and 64.2% in females, and 27.2% and 53.3% in males. The numbers of patients who performed manual therapy per day, worked using a fixed-height bed, performed manual therapy, had job dissatisfaction and stress, were over 40 years old, and slept less than 6 hours were associated with LBP and ULP. Assistance task was a risk factor only for LBP, and female sex a risk factor only for ULP., Conclusions: The prevalence of LBP and ULP among physical therapists in Japan was as high as that in nurses and care workers. Work-related factors associated with LBP and ULP were identified among physical therapists. Thus, to prevent work-related musculoskeletal disorders, measures to reduce the physical burden from the perspective of occupational health are required., (© The Author(s) [2024]. Published by Oxford University Press on behalf of Journal of Occupational Health.)
- Published
- 2024
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16. Neck pain in computer users
- Author
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Khan, Aysha Siddiqua Kalim and Faizan, Mohammed
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- 2016
- Full Text
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17. An investigation of factors affecting the performance of wheelchair transfers.
- Author
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Barbareschi, Giulia and Holloway, Catherine
- Subjects
- *
ANALYSIS of variance , *BIOMECHANICS , *CHI-squared test , *QUESTIONNAIRES , *SCALE analysis (Psychology) , *SITTING position , *STATISTICS , *SURVEYS , *T-test (Statistics) , *WHEELCHAIRS , *DATA analysis , *CROSS-sectional method , *TRANSPORTATION of patients , *DATA analysis software , *DESCRIPTIVE statistics , *KRUSKAL-Wallis Test - Abstract
Purpose: Being able to transfer in and out of their wheelchair is an important task for wheelchair users that can be affected by a variety of different factors. The aim of this study was to investigate the interplay between personal characteristics, wheelchair users' transferring technique and the other factors that can affect the performance of wheelchair transfers. Method: A cross-sectional survey study was designed to recruit wheelchair users, aged 18 or older, performing sitting-pivot or standing-pivot wheelchair transfers, independently or with assistance. Results: Forty-two usable surveys were returned. Transferring technique is usually determined by the individual's impairment. In turn, transferring technique will greatly affect the perceived difficulty of different types of wheelchair transfers and, the number of transfers that people will perform in a day. The presence of upper limb pain increased the difficulty reported for certain types of transfers while the use of assistive technologies appears to be only partially successful in facilitating the performance of wheelchair transfers. Conclusion: This study highlights the complexity of the factors included in the performance of wheelchair transfers. Findings from this survey can be utilized to broaden the boundaries of future research. Transferring technique is usually determined by the individual?s impairment. In turn, transferring technique will greatly affect the perceived difficulty of different types of wheelchair transfers and, the number of transfers that people will perform in a day. The performance of wheelchair transfers exacerbate the painful symptomatology of the person, regardless of their medical condition or transferring technique. The presence of pain increases the reported difficulty of wheelchair trasnfers. Use of assistive technologies during transfers is linked to the increased body weight of the person, while the choice of the type of assistive technology seems to be dependent of the transferring technique used by the person. Overall, available ATs are only moderately effective in enabling people to perform wheelchair transfer and they can be cause of frustration for the users due to their high cost and limited functionality. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
18. The impact of work-related risk factors on the development of neck and upper limb pain among low wage hotel housekeepers in Gondar town, Northwest Ethiopia: institution-based cross-sectional study.
- Author
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Wami, Sintayehu Daba, Dessie, Awrajaw, and Chercos, Daniel Haile
- Abstract
Background: Musculoskeletal disorders are a major source of disability accounting for considerable economic loss globally. Studies showed that housekeepers suffer from exposure to many high-risk factors for neck and upper limb musculoskeletal disorders. In Ethiopia, little is known and the information is limited in scope about the magnitude of the problem among hotel housekeepers. Therefore, this study aimed to determine the magnitude of the neck and upper limb musculoskeletal disorders and identify the associated risk factors among hotel housekeepers. Methods: Institution-based cross-sectional study design was employed from March 1 to May 20, 2017. Systematic random sampling was used to select 422 study participants among the Gondar town hotels, Ethiopia. The standardized Nordic questionnaire for the analysis of musculoskeletal symptoms was used to measure the neck and upper limb musculoskeletal disorders. Bivariate and multivariable binary logistic regression analyses were performed using SPSS version 20. The significance level was obtained at 95% CI and p value ≤ 0.05. Results: The overall magnitude of a self-reported neck and upper limb musculoskeletal disorders among hotel housekeepers in the last 12 months was 62.8% (95% CI 58.3, 67.8). The main body areas of concern were neck pain (50.7%), shoulder pain (54%), elbow/forearm (47.2%), and hand/wrist (45.5%). Age, rest break taken, repetitive movement, reaching/overstretching, organization concern for health and safety, and job satisfaction were the risk factors significantly associated with neck and upper limb musculoskeletal disorders. Conclusions: A higher proportion of hotel housekeepers were found to be affected by neck and upper limb musculoskeletal disorders in Gondar town. Repetitive movement and reaching/overstretching were strongly associated risk factors with neck and upper limb musculoskeletal disorders. Therefore, ergonomic, organizational and personal measures, which focus on minimizing repetitive movement and awkward working position and facilitating rest break with exercise, are important to tackle neck and upper limb musculoskeletal disorders among hotel housekeepers. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
19. Correlations between pain in the back and neck/upper limb in the European Working Conditions Survey.
- Author
-
Rizzello, Emanuele, Ntani, Georgia, and Coggon, David
- Abstract
Background: Recent research has suggested that wide international variation in the prevalence of disabling regional pain among working populations is driven largely by factors predisposing to musculoskeletal pain in general and not specific to individual anatomical sites. We sought to confirm this finding, using data from an independent source.Methods: Using data from the fifth (2010) and sixth (2015) European Working Conditions Surveys, we explored correlations between the one-year prevalence of pain in the back and neck/upper limb among people of working age across 33 European countries, and between changes in pain prevalence at the two anatomical sites from 2010 to 2015.Results: Each survey recruited ≥1000 participants per country, response rates ranging from 11 to 78%. In 2010, the estimated one-year population prevalence of back pain ranged from 23% in Ireland to 66% in Portugal, and that of pain in the neck/upper limb from 25% in Ireland to 69% in Finland, the prevalence of pain at the two anatomical sites being correlated across the 33 countries (r = 0.42). A similar pattern was apparent in 2015. For back pain, the percentage change in prevalence from 2010 to 2015 varied from - 41.4% (Hungary) to + 29.6% (Ireland), with a mean across countries of - 3.0%. For neck/upper limb pain, the variation was from - 41.0% (Hungary) to + 44.1% (Romania), with an average of - 0.1%. There was a strong correlation across countries in the change in pain prevalence at the two anatomical sites (r = 0.85).Conclusions: Our findings accord with the hypothesis that international variation in common pain complaints is importantly driven by factors that predispose to musculoskeletal pain in general. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
20. Adjusting Wheelchair Set-Up to Minimize Shoulder Joint Forces During Propulsion
- Author
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Sarah R. Dubowsky, Ph.D., Postdoctoral Fellow
- Published
- 2008
21. The use of ultrasound in the emergency department for the detection of thoracic outlet syndrome: A single case study.
- Author
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Tung-Chen, Yale, Marín-Baselga, Raquel, Tejada-Sorados, Renzo, and Enfedaque-Castilla, Israel
- Subjects
CERVICAL vertebrae radiography ,ARM ,ENTRAPMENT neuropathies ,HOSPITAL emergency services ,PAIN ,THORACIC outlet syndrome ,POINT-of-care testing ,EARLY diagnosis - Abstract
Introduction: Thoracic outlet syndrome (TOS) refers to a spectrum of syndromes related to the compression of the brachial plexus (neurogenic TOS), subclavian vein or artery in the general region of the thoracic outlet, which is the area just above the first rib and behind the clavicle. Case report: We report a 27-year-old healthy man who presented to the emergency department with right upper limb pain, tingling and weakness. Point-of-care ultrasonography was performed following a dynamic protocol in the supraclavicular fossa in the right upper limb. A congenital cervical rib, as well as narrowing of the costoclavicular gap, causing vein, artery and spinal roots compression was evidenced. This maneuver reproduced the symptoms, confirming the suspicion of neurogenic TOS. Discussion: Early diagnosis is important, because the neurogenic compression associated with neurogenic TOS, if prolonged, can lead to muscle weakness and atrophy, being irreversible. Selected patients with neurogenic TOS who have progressive weakness, disabling pain, or who have failed to improve with conservative measures are considered for first rib resection. Conclusion: Using the dynamic approach during point-of-care ultrasonography examination, in combination with physical examination and cervical radiography, could help identify neurogenic TOS. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
22. Occupational therapy with or without combined acupuncture on upper limb pain and hand functions in children with spastic hemiplegic cerebral palsy: A three-arm randomized, placebo-controlled trial
- Author
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Xiao-jie Xia, Qiang-qiang Fu, Ci Han, Li-ping Yue, Fei-Yi Zhao, Yan Xu, and Si-han Chen
- Subjects
Occupational therapy ,medicine.medical_specialty ,business.industry ,Hand functions ,Modified Ashworth scale ,Upper limb pain ,Acupuncture treatment ,medicine.anatomical_structure ,Complementary and alternative medicine ,Acupuncture ,Physical therapy ,Medicine ,Upper limb ,business ,Adverse effect - Abstract
Objective This study is conducted to investigate the effects of occupational therapy (OT) with or without combined acupuncture for upper limb pain and hand functions among children with spastic hemiplegic cerebral palsy. Methods A total of 90 patients who met the inclusion criteria were enrolled in a three-arm randomized, placebo-controlled trial, and were allocated to mono-occupational therapy (OT) group (patients= 30), OT combined with real-acupuncture (ORA) group (patients= 30), and OT combined with placebo-acupuncture (OPA) group (patients= 30), respectively. In addition to receiving the conventional OT program as the basic treatment for total 8 weeks, patients in ORA and OPA group also received corresponding acupuncture treatment 5 days per week for the first two weeks, 3 days per week for the next two weeks, 2 days per week for another two weeks, and 1 day per week for the last two weeks. Non-communicating children's pain checklist-revised scale (NCCPC-R) was used for assessing the upper limb pain among patients. Squeeze dynamometry, modified Ashworth scale (MAS), manual muscle testing (MMT), Jebsen-Taylor hand function test (JTHFT) and box and block test (BBT) were used for assessing various aspects of upper limb and hand functions among patients. Meanwhile, adverse effects were monitored and recorded. Results After 8-week treatment, NCCPC-R global scores witnessed a dramatic decline in ORA group (P 0.05) or OT group (P > 0.05). Dramatic increases were identified in both squeeze dynamometry scores and MMT scores in all three groups (all P 0.05). The BBT global scores of all three groups significantly increased (all P Conclusion ORA is a potential and promising alternative therapy for mitigating upper limb pain as well as improving both upper limb and hand functions among children with spastic hemiplegic cerebral palsy.
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- 2022
23. Superior Vena Cava Obstruction with Thrombolytic Therapy in Primary Antiphospholipid Syndrome
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Shady Mashhour, Marwa Mashaal, Kareem Mahmoud, Haytham Soliman, and Manal Adel
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medicine.medical_specialty ,business.industry ,Antiphospholipid syndrome ,Superior vena cava ,Female patient ,medicine ,Upper limb pain ,cardiovascular diseases ,General Medicine ,business ,medicine.disease ,Primary antiphospholipid syndrome ,Surgery - Abstract
We report a case of superior vena cava obstruction of a 39 years old female patient with primary antiphospholipid syndrome presented with upper limb pain and swelling ,which improved on thrombolytic therapy ,we review patients with Antiphospholipid syndrome and management with thrombolytic therapy .
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- 2022
24. Tattoo artists and dental workers have similar musculoskeletal pain patterns
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R Ingel, Asaf Weisman, Uri Gottlieb, Tomer Yona, and Youssef Masharawi
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medicine.medical_specialty ,Population ,Upper limb pain ,Occupational safety and health ,Musculoskeletal Pain ,Risk Factors ,Surveys and Questionnaires ,medicine ,Back pain ,Humans ,Musculoskeletal Diseases ,education ,Neck pain ,education.field_of_study ,Neck Pain ,Tattooing ,business.industry ,Public Health, Environmental and Occupational Health ,Chronic pain ,Human factors and ergonomics ,medicine.disease ,Low back pain ,Occupational Diseases ,Back Pain ,Physical therapy ,medicine.symptom ,business - Abstract
Background Tattoo artists are an understudied population with regards to musculoskeletal (MSK) pain. Aims To explore the characteristics of MSK pain among Israeli tattoo artists and determine whether they are similar to those of dental workers. Methods An online survey including demographics and the Hebrew version of the Extended Nordic Musculoskeletal Questionnaire was disseminated via Israeli social media groups. We directly compared tattoo artists, dental workers and office workers as a reference group. Results Altogether, 114 tattoo artists, 161 dental workers and 296 office workers responded. The most prevalent pain sites were lower back (56%), neck (47%) and hand (36%) among office workers; neck (67%), lower back (62%) and upper back (42%) among the dental workers; and lower back (72%), neck (66%) and hand (55%) among tattoo artists. Contrast analysis suggested office workers were less likely to report pain in the previous 12 months compared with dental workers and tattoo artists (adjusted odds ratios [95% confidence intervals]: ORs [95% CIs] for upper limb pain: 1.13 [1.01–1.28], neck pain: 1.3 [1.15–1.47], upper back pain: 1.27 [1.12–1.43] and low back pain: 1.15 [1.02–1.3]). No significant differences were observed between dental workers and tattoo artists (upper limb pain: 1.18 [0.9–1.54], neck pain: 1.06 [0.81–1.4], upper back pain: 1.22 [0.94–1.58] and low back pain: 1.24 [0.95–1.64]). Conclusions Tattoo artists and dental workers have similar MSK pain characteristics and are different from those of office workers. These characteristics are seemingly a direct result of the physical demands associated with their line of work.
- Published
- 2021
25. Post-stroke upper limb spasticity incidence for different cerebral infarction site.
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Yi Jin and Yuan Zhao
- Abstract
Objective. The purpose of this study was to evaluate the incidence rate of post-stroke upper limb spasticity and its correlation with cerebral infarction site. Methods. A total of 498 inpatient and outpatient cases are included in the present study. The post-stroke upper limb spasticity rate of different cerebral infarction site was calculated. Results. A total of 498 patients with cerebral infarction are enrolled in this study. Of these patients, 91 have dropped out and 407 have completed the study. Of the completed cases, 172 are in the spasm group and 235 are in the non-spasm group. The total incidence of upper limb spasticity is 34.5%. The incidences of upper extremity spasms are 12.5%, 20%, 22.5%, 35%, 40%, and 42.5% in 2 weeks, 1 month, 2 months, 3 months, 6 months, and 12 months, respectively. The incidence of upper extremity spasms increases with time. The incidences of upper limb spasticity are 12.1%, 63.3%, 58.5%, 9.4% and 8.3% when cerebral infarction occurs in the cortical and subcortical mixed areas, basal ganglia and internal capsule, cerebral cortex, brainstem and cerebellum respectively. The incidence of upper limb spasticity varies in different infarction sites (P < 0.05). Conclusion. The post-stroke upper limb spasticity rates were different according to the different cerebral infarction site. Patients with the ganglia and internal capsule infarctions had the highest risk of developing post-stroke upper limb spasticity. [ABSTRACT FROM AUTHOR]
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- 2018
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26. Asymptomatic common extensor tendon pathology in patients with carpal tunnel syndrome
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Tze Chao Wee and Neil G. Simon
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0301 basic medicine ,medicine.medical_specialty ,Physiology ,Upper limb pain ,030105 genetics & heredity ,Asymptomatic ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Physiology (medical) ,Medicine ,Carpal tunnel syndrome ,medicine.diagnostic_test ,business.industry ,Common extensor tendon ,Epicondylitis ,Ultrasound ,medicine.disease ,nervous system diseases ,medicine.anatomical_structure ,Neurology (clinical) ,Radiology ,Elastography ,Abnormality ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Introduction Carpal tunnel syndrome (CTS) and lateral epicondylitis are both highly prevalent conditions. Our objective was to determine the prevalence of B-mode ultrasound abnormalities of the common extensor tendon (CET) in patients with CTS and establish the relationship between CET stiffness as measured by shear wave elastography (SWE) and CTS severity. Methods Patients without symptoms or signs of lateral epicondylitis were recruited from referrals to a Neurophysiology laboratory for possible CTS. These patients were examined for clinical features of CTS before undergoing electrodiagnostic testing followed by an ultrasound examination, consisting of B-mode, power Doppler and SWE. Results 39 limbs with clinically diagnosed CTS and 20 control limbs were included. 61.5% of CTS limbs had sonographically abnormal CET compared to 35% of controls. The mean CET sonographic abnormality score was higher in CTS patients compared to controls (p=0.006). CTS patients with sonographically abnormal CET had more severe CTS by electrophysiological criteria. The mean CET stiffness in CTS patients was lower than in controls (p=0.033). Discussion Sonographic abnormalities of the CET are common in CTS patients with no clinical evidence of lateral epicondylitis and may relate to common pathogenetic mechanisms. These findings suggest that isolated ultrasound abnormalities in the CET are not diagnostically useful in patients presenting with upper limb pain unless there are clinical features of lateral epicondylitis. This article is protected by copyright. All rights reserved.
- Published
- 2021
27. Pain mapping and characteristics in breast cancer survivors during task-oriented training: analysis at 3, 6, and 9 months
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Anke Bergmann, Kamilla Zomkowski, Natália de Souza Cunha, Mariana Dos Santos Hermes, Bruna Baungarten Hugen Back, and Fabiana Flores Sperandio
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Adult ,Shoulder ,medicine.medical_specialty ,Movement ,Population ,Upper limb pain ,Breast Neoplasms ,Upper Extremity ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Cancer Survivors ,Musculoskeletal Pain ,Surveys and Questionnaires ,Dash ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,education ,Exercise ,Pain Measurement ,education.field_of_study ,business.industry ,Middle Aged ,medicine.disease ,Trunk ,Exercise Therapy ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Arm ,Physical therapy ,Upper limb ,Female ,Analysis of variance ,business - Abstract
To evaluate the frequency and characteristics of trunk and upper limb pain in women diagnosed with breast cancer, in different movement planes, during task-oriented training (TOT) 3, 6, and 9 months after surgery. A prospective cohort study with 20 women. The body pain diagram (BPD), VAS, and McGill questionnaire were used. The TOT consisted of 20 exercises based on the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) questionnaire. BPD overlay was performed in GIMP® image editor. The chi-square test was applied to the relationship between population characteristics and pain. Freedman's ANOVA and the Cochran's Q test were used in the comparison of pain site frequencies and intensity over time. In total, 297 BPDs were generated, which identified the affected upper limb as the body area with the highest frequency of pain at the three moments. However, at 9 months, the unaffected upper limb presented the same frequency as the affected limb. Radiotherapy presented a statistically significant relationship (p
- Published
- 2021
28. Multicentre, clinical trial of burst spinal cord stimulation for neck and upper limb pain NU-BURST: a trial protocol
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Adil Raza, Hyun-Joo Park, Stefano Palmisani, Samuel Wesley, Sarah Love-Jones, Adnan Al-Kaisy, Jonathan Royds, Girish Vajramani, Filippo Agnesi, Nikunj K. Patel, and David Pang
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medicine.medical_specialty ,Upper limb pain ,Dermatology ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Failed Back Surgery Syndrome ,Spinal Cord Stimulation ,Neck pain ,integumentary system ,business.industry ,Chronic pain ,General Medicine ,medicine.disease ,Epidural space ,Clinical trial ,Psychiatry and Mental health ,Treatment Outcome ,medicine.anatomical_structure ,Spinal Cord ,nervous system ,Radicular pain ,Neuropathic pain ,Arm ,Physical therapy ,Neurology (clinical) ,Neurosurgery ,medicine.symptom ,business ,tissues ,030217 neurology & neurosurgery - Abstract
Spinal cord stimulation (SCS) is an established therapy for chronic neuropathic pain and most frequently utilised for Failed Back Surgery Syndrome (FBSS). BurstDR™ also known as DeRidder Burst-SCS, a novel waveform, has demonstrated superiority to conventional tonic stimulation of the thoracic spine in FBSS. There are case reports of an improvement in multidimensional pain outcomes using DeRidder Burst-SCS in the cervical spine for chronic neck and cervical radicular pain. The safety and efficacy of cervical DeRidder Burst-SCS stimulation still however remain undetermined. This is a prospective, multicentre feasibility trial evaluating the safety and therapeutic efficacy of DeRidder Burst-SCS stimulation for the treatment of chronic intractable neck pain with or without radiation to the arm, shoulder, and upper back. After baseline evaluation, subjects will undergo an SCS trial using the Abbott Invisible Trial system according to standard clinical procedures. During the trial phase, SCS leads will be implanted in the cervical epidural space. At the end of the SCS trial, subjects experiencing at least 50% pain relief will be considered for permanent implant. Pain intensity, medication usage, and other multidimensional pain outcomes will be collected. The timing of these will be at baseline, end of the SCS trial and at 3-, 6-, and 12-month visits. Incidence of adverse events will be collected throughout the study duration. The results of this feasibility study will validate the efficacy and safety of DeRidder Burst-SCS stimulation in the cervical spine. The results obtained in this study will potentially be used to generate a level 1 evidence-based study with formal statistical hypotheses testing. www.clinicaltrials.gov Identifier: NCT03159169.
- Published
- 2021
29. Functional Connectivity between the Primary Sensory Area and Prefrontal Cortex Predicts the Efficacy of Spinal Decompression Surgery for Upper Limb Pain
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Toshihiro Munemitsu, Takuro Nakae, Masato Hojo, and Masahiro Sawada
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Surgical decompression ,medicine.medical_specialty ,Physical medicine and rehabilitation ,business.industry ,Functional connectivity ,medicine ,Upper limb pain ,Sensory system ,Prefrontal cortex ,business - Published
- 2021
30. Do intensity of pain alone or combined with pain duration best reflect clinical signs in the neck, shoulder and upper limb?
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Markus Koch, Kaj Bo Veiersted, Lars-Kristian Lunde, Therese N Hanvold, Stein Knardahl, and Morten Wærsted
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Adult ,Male ,Shoulder ,medicine.medical_specialty ,Adolescent ,Neck shoulder ,Upper limb pain ,Physical examination ,Upper Extremity ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Musculoskeletal Pain ,Shoulder Pain ,Epidemiology ,medicine ,Humans ,030212 general & internal medicine ,Low correlation ,Pain duration ,medicine.diagnostic_test ,business.industry ,030210 environmental & occupational health ,Intensity (physics) ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Physical therapy ,Upper limb ,Female ,Neurology (clinical) ,business ,Neck - Abstract
Objectives It is important to validate self-reported musculoskeletal pain used in epidemiological studies for evaluation of pain outcome measures. The main objective of this paper was to assess the association between self-reported neck/shoulder/upper limb pain and clinical signs of disorders in the region, especially by comparing a measure that only used pain intensity with a measure that combined pain intensity and pain duration. Methods Four hundred and twenty technical school students of both genders were included with a median age of 17 years (16–28). The students stated the pain in four intensity grades and the pain duration in four period lengths within the preceding four weeks period. A pain severity index was calculated by multiplying the pain intensity (0–3) and the duration (1–4). A clinical examination was performed within a week after completing the form. The associations were evaluated by agreement, correlation and symmetric strength of association (contingency). Results The study found low correlation and low positive agreement for neck/shoulder and upper limb pain related to clinical signs of disorders in the region. However, the relationship showed high negative agreement and high contingency. The negative agreement increased for the neck/shoulder region with higher cut-off points for dichotomization, but not for the upper limb region. The index combining reports of pain intensity with pain duration, do not improve agreement, correlation or contingency with clinical signs compared to use of pain intensity alone. Conclusions This study showed an association between self-reported neck/shoulder/upper limb pain intensity and clinical signs of musculoskeletal disorders of the region. An index combining pain intensity and duration (Pain Severity Index) did not increase this association. From the results we suggest using pain intensity reports alone and if dichotomizing is wanted, choosing a cut-off point at high pain levels, especially for neck and shoulder pain.
- Published
- 2020
31. Ten kilohertz SCS for Treatment of Chronic Upper Extremity Pain (UEP): Results from Prospective Observational Study
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Anand Rotte, Mona Maneshi, Anu Kansal, Abram H. Burgher, Steven M. Rosen, Todd A. Bromberg, Michael Esposito, Steven Surrett, Ashish Gulve, Jeyakumar Subbaroyan, Bradford E. Gliner, Paul Wu, W. Porter McRoberts, Peter Kosek, and Ashish Udeshi
- Subjects
Neck pain ,education.field_of_study ,medicine.medical_specialty ,business.industry ,Visual analogue scale ,Population ,Upper limb pain ,Clinical trial ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,030202 anesthesiology ,Concomitant ,medicine ,Physical therapy ,Upper limb ,Observational study ,medicine.symptom ,business ,education ,030217 neurology & neurosurgery - Abstract
Background Chronic upper extremity pain (UEP) has complex etiologies and is often disabling. It has been shown that 10 kHz SCS can provide paresthesia-free and durable pain relief in multiple pain types and improve the quality of life of patients. Objective To gain additional evidence on the safety and effectiveness of 10 kHz SCS for the treatment of chronic UEP. Study design It was a prospective, multicenter, and observational study. The study was registered on ClinicalTrials.gov prospectively (clinical trial identifier: NCT02703818). Setting Multicenter. Patients intervention and main outcomes A total of 43 subjects with chronic UEP of ≥5 cm (on a 0-10 cm visual analog scale; VAS) underwent a trial of 10 kHz SCS, and subjects with ≥40% pain relief received a permanent implant. All subjects had upper limb pain at baseline, while some had concomitant shoulder or neck pain. Subject outcomes were assessed for 12 months, and the primary outcome was the responder rate (percentage of subjects experiencing ≥50% pain relief from baseline) at three months. Results Thirty-eight subjects successfully completed the trial (88.3% success rate), 33 received permanent implants (five withdrew consent), and 32 had device activation (per protocol population). There were no paresthesias or uncomfortable changes in stimulation related to changes in posture during the study and there were no neurological deficits. Responder rates at 12 months for upper limb, shoulder, and neck pain in per protocol population (N=32) were 78.1%, 85.2%, and 75.0%, respectively. At 12 months, 84.4% of subjects were satisfied or very satisfied with 10 kHz SCS, and 38.7% either reduced or eliminated opioid usage. Conclusion This study further supports the effectiveness of 10 kHz SCS for chronic UEP treatment and documents the safety profile of the therapy. Clinical trial identifier NCT02703818.
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- 2020
32. The Upper Limb Disorders among Schoolteachers Involved in E-learning during the Pandemic of COVID-19: A Cross-Sectional Study.
- Author
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Ghaderpanah, Rezvan, Farpour, Hamid Reza, Seifi, Pedram, and Sadrian, Seyyedhassan
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WRIST ,COVID-19 pandemic ,TELECOMMUTING ,TEACHERS ,CROSS-sectional method ,DIGITAL learning ,ARTIFICIAL arms - Abstract
Background: Due to the COVID -19 pandemic, many people in the public sector, including teachers, have had to work remotely via social media. This may have contributed to their exposure to musculoskeletal pain. Objective: The purpose of this study was to investigate upper extremity disorders as a consequence of online teaching. Material and Methods: This cross-sectional study involved 410 teachers (75% male and 25% female) with a mean age of 40.1 years working with telecommunications. Participants were asked to fill out an online survey that included sociodemographic information, type of pain, location of pain, and a self-assessment of pain intensity. Results: The majority of participants (92%) reported upper limb pain. Among the upper limbs, the shoulder was the most commonly affected joint, as 29% of teachers who had upper limb complaints reported pain in the shoulder. Teachers also reported pain sensations in different parts of the upper limbs as follows: 20% in the wrist, 14% in the hands, 12% in the arm, 8% in the elbow, and 8% in the forearm. In addition, 48% of teachers reported that they rarely exercise. Conclusion: Despite telecommunications helping teachers to stay healthy by reducing the risk of infections, they also impose new requirements on the workplace that can endanger the health of workers. Preventive factors, such as upper limb exercises during remote work or the provision of an ergonomic environment by health policy makers, can also help reduce the risk of musculoskeletal disorders. [ABSTRACT FROM AUTHOR]
- Published
- 2023
33. Upper limb pain due to cervical hydatid cyst
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Navid Soroush, Vahid Zehi, Kazem Rezaee, and Reza Rezaei
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medicine.medical_specialty ,RD1-811 ,business.industry ,medicine ,Upper limb pain ,Surgery ,Hydatid cyst ,Cardiology and Cardiovascular Medicine ,business ,Internal medicine ,RC31-1245 ,Letter to the Editor - Published
- 2021
34. Does the Contrast Dispersion Pattern During Fluoroscopically Guided Cervical Transforaminal Epidural Steroid Injection Predict Short-Term Pain and Functional Outcomes? An Exploratory Analysis of Prospective Cohort Data
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Shellie Cunningham, Zachary L McCormick, Russel Petersen, Aaron Conger, Richard Kendall, Masaru Teramoto, Beau P. Sperry, A. Michael Henrie, Erica F Bisson, Keith T. Kuo, Dustin Randall, Cole W Cheney, and Fabio Salazar
- Subjects
medicine.medical_treatment ,Injections, Epidural ,Upper limb pain ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Humans ,Medicine ,Prospective Studies ,Radiculopathy ,Prospective cohort study ,Neck pain ,Neck Pain ,business.industry ,Epidural steroid injection ,General Medicine ,Numeric Pain Scale ,medicine.disease ,Confidence interval ,Epidural space ,Treatment Outcome ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Radicular pain ,Anesthesia ,Steroids ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Summary of Background DataNo study has evaluated the relationship between contrast dispersion patterns and outcomes after fluoroscopically guided cervical transforaminal epidural steroid injection (CTFESI).ObjectivesDetermine whether contrast dispersion patterns predict pain and functional outcomes after CTFESI.MethodsSecondary analysis of data collected during two prospective studies of CTFESI for the treatment of refractory radicular pain. Contrast dispersion patterns visualized by true anteroposterior (AP) projections during CTFESIs were categorized by flow: 1) completely external to the lateral border of the neuroforamen (zone 1); 2) within the neuroforamen but without entry into the lateral epidural space (zone 2); and 3) with extension into the lateral epidural space (zone 3). At baseline and at 1 month post-CTFESI, neck pain, arm pain, and “dominant index pain” (the greater of arm or neck pain) were evaluated using a numeric rating scale (NRS); physical function was assessed using the Five-Item Version of the Neck Disability Index (NDI-5).ResultsOne-month post-CTFESI, neck pain, arm pain, and “dominant index pain” reductions of ≥50% were observed in 39.4% (95% confidence interval [CI], 28.2–51.8), 55.6% (95% CI, 43.0–67.5), and 44.1% (95% CI, 32.7–56.2) of participants, respectively. Regarding “dominant index pain,” 72.7% (95% CI, 40.8–91.2), 39.4% (95% CI, 24.2–57.0), and 37.5% (95% CI, 20.5–58.2) of participants reported ≥50% pain reduction when zone 1, zone 2, and zone 3 contrast flow patterns were observed. Contrast dispersion zone was not significantly associated with subgroup differences in neck pain, arm pain, or NDI-5 scores (P>0.05).ConclusionImprovements in pain and function 1 month after treatment with CTFESI did not differ significantly based on the contrast dispersion pattern. Future study is needed to confirm or refute these findings in other procedural settings, in broader patient populations, and with longer-term outcome assessment.
- Published
- 2020
35. The effectiveness of ergonomics interventions in reducing upper limb work-related musculoskeletal pain and dysfunction in sonographers, surgeons and dentists: a systematic review
- Author
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Jillian L. Clarke, Martin Mackey, Jacqueline Spurway, Karen A. Ginn, and Kristie Sweeney
- Subjects
Laparoscopic surgery ,Work ,medicine.medical_specialty ,medicine.medical_treatment ,Dentists ,Upper limb pain ,Physical Therapy, Sports Therapy and Rehabilitation ,Human Factors and Ergonomics ,Work related ,law.invention ,Upper Extremity ,03 medical and health sciences ,0302 clinical medicine ,Musculoskeletal disorder ,Randomized controlled trial ,Musculoskeletal Pain ,law ,medicine ,Humans ,0501 psychology and cognitive sciences ,Occupational Health ,050107 human factors ,Ultrasonography ,Surgeons ,business.industry ,05 social sciences ,Human factors and ergonomics ,030229 sport sciences ,medicine.disease ,Occupational Diseases ,Systematic review ,medicine.anatomical_structure ,Physical therapy ,Upper limb ,Ergonomics ,business - Abstract
The aim of this systematic review was to summarise the effects of ergonomics interventions on work-related upper limb musculoskeletal pain and dysfunction, and on productivity in sonographers, surgeons and dentists. A total of 31 studies were included. All studies reported effects on upper limb pain. Nine studies reported effects on dysfunction and only two studies reported effects on productivity. Moderately strong evidence in reducing upper limb pain was found for instigation of microbreaks into long duration surgical procedures, and the use of wider, lighter handles in dental instruments. Moderate evidence was also found for use of prismatic glasses and favourable positioning in reducing upper limb pain. Weak, inconsistent or no evidence was found for all other ergonomics interventions in reducing upper limb pain and dysfunction and increasing productivity. The lack of high quality research, particularly in sonographers and in the outcome of productivity, should be addressed. Practitioner summary: This systematic review investigates the effectiveness of ergonomics interventions on upper limb pain, dysfunction and productivity in sonographers, dentists and surgeons. Instigation of microbreaks during long duration procedures and the use of wider, lighter instrument handles were most effective in reducing upper limb work-related pain. Abbreviations: ANOVA: analysis of variance; CLS: conventional laparoscopic surgery; DMAIC: define, measure, analyze, improve and control; GRADE: grading of recommendations, assessment, development and evaluations; HD: high definition; PRISMA: preferred reporting items for systematic reviews and meta-analyses; PROSPERO: The International Prospective Register of Systematic Reviews; RCT: randomised control trial; SILS: single incision laparoscopic surgery; VITOM: video telescopic operative microscope; WNSWLHD: Western New South Wales Local Health District; WMSD: work related musculoskeletal disorder.
- Published
- 2020
36. Functional Connectivity Analysis and Prediction of Pain Relief in Association with Spinal Decompression Surgery
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Toshihiro Munemitsu, Masato Hojo, Takuro Nakae, and Masahiro Sawada
- Subjects
Male ,Decompression ,Pain relief ,Upper limb pain ,03 medical and health sciences ,Surgical decompression ,Spinal Stenosis ,0302 clinical medicine ,Neural Pathways ,medicine ,Humans ,Aged ,Postcentral gyrus ,business.industry ,Functional connectivity ,Brain ,Decompression, Surgical ,Right middle frontal gyrus ,Magnetic Resonance Imaging ,Dorsolateral prefrontal cortex ,Cross-Sectional Studies ,Spinal Fusion ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Anesthesia ,Cervical Vertebrae ,Neuralgia ,Female ,Surgery ,Spondylosis ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background Although spinal decompression surgery is an effective treatment for myelopathy-induced upper limb pain, some postoperative patients suffer from residual pain in spite of adequate decompression. However, the neural mechanism underlying the poor outcome of pain relief is still unclear. The goal of this study was to explore the brain mechanisms involved in the poor recovery of upper limb pain after the spinal decompression surgery by using functional connectivity (FC) analysis. Methods In this cross-sectional study, 17 patients who underwent cervical spinal decompression surgery were included. Functional MRI (fMRI) during a tactile stimulus for each hand was performed at 1 day before and 7 days after the surgery. In total, 34 fMRI scans (17 left and right upper limbs, respectively) were obtained before and after the surgery, respectively. The patients were divided into poor-recovery and good-recovery groups, and then we searched for the FC that was related to poor-recovery. Results The poor-recovery group (n = 15) showed significantly stronger connectivity between the postcentral gyrus (postCG) and dorsolateral prefrontal cortex (DLPFC) than the good-recovery group (n = 12) preoperatively. When the cutoff value of the preoperative FC between the left postCG and right middle frontal gyrus included in DLPFC was >0.17, the sensitivity and specificity for poor recovery were 73% and 75%, respectively. Conclusions Our study showed that FC between the postCG and DLPFC may be a predictor of pain relief. This result suggested that assessing FC can lead to more informed surgical interventions for cervical spondylotic myelopathy.
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- 2020
37. 10 kHz spinal cord stimulation for chronic upper limb and neck pain: Australian experience
- Author
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Adele Barnard, John Salmon, David Caraway, Paul Verrills, Marc Russo, and Bradford E. Gliner
- Subjects
Visual analogue scale ,Upper limb pain ,Spinal cord stimulation ,Upper Extremity ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Clinical endpoint ,Humans ,Pain Management ,Orthopedics and Sports Medicine ,Prospective Studies ,Spinal Cord Stimulation ,030222 orthopedics ,Neck pain ,Neck Pain ,business.industry ,Australia ,Clinical trial ,Treatment Outcome ,medicine.anatomical_structure ,Spinal Cord ,Anesthesia ,Upper limb ,Surgery ,Human research ,Chronic Pain ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Intractable upper limb and neck pain has traditionally been a challenging pain condition to treat, with conventional spinal cord stimulation (SCS) often inducing positional variation in paraesthesia and/or inadequate coverage of axial neck pain. The purpose of this Australian multi-centre prospective, clinical trial was to assess the safety and effectiveness of paraesthesia-independent 10 kHz SCS for the treatment of upper limb and neck pain. Subjects with chronic, intractable neck and/or upper limb pain of ≥ 5 cm (on a 0–10-cm visual analogue scale) were enrolled (ACTRN12614000153617) following human research ethics committee approval. Subjects were implanted with two epidural leads spanning C2–C6 vertebral bodies. Subjects with successful trial stimulation were implanted with a Senza® system (Nevro Corp., Redwood City, CA, USA) and included in the safety and effectiveness evaluation at 3 months post-implant (primary endpoint assessment, PEA) and followed to 12 months. Overall, 31/38 (82.6%) subjects reported a successful 10 kHz SCS trial and proceeded to a permanent implant. Twenty-three of 30 subjects (76.7%) met the PEA. Subjects reported a reduction in neck pain and upper limb pain from baseline at the PEA (8.1 ± 0.2 cm vs. 2.9 ± 0.5 cm, 7.3 ± 0.3 cm vs. 2.5 ± 0.5 cm, respectively, p ≤ 0.0001). Disability, as measured by pain disability index score, decreased from 42.6 ± 2.6 at baseline to 22.7 ± 3.2 at PEA. Results were maintained 12 months post-implant. No neurological deficits, nor reports of paraesthesia, were observed. Stable, long-term results demonstrated that 10 kHz SCS is a promising therapy option for intractable chronic upper limb and neck pain.
- Published
- 2020
38. Cervical Spine Discectomy, Osteo-facetectomy by Noble Art of Cloward Procedure and Its Modification- A Single Centre study
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Aurangzeb Kalhoro, Abid Saleem, and A. Sattar M. Hashim
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Upper limb pain ,Cervical spine ,Cervical surgery ,Surgery ,Single centre ,medicine.anatomical_structure ,Discectomy ,Facetectomy ,medicine ,Iliac spine ,Prospective cohort study ,business - Abstract
Objectives: To analyze the surgical outcome of cervical spine osteo-facetectomy discectomy, and modified Cloward procedure.Materials and Methods: A prospective study was conducted at the Neurospinal & cancer care institute, Karachi. The duration of study was from 1st June 2017 to 25th November 2019. Patients having prolapsed intervertebral cervical discs included in the study, while those with trauma, cervical radiation, previous cervical surgery andmultiple level involvement were excluded. Pre and post-surgical data was collected. Titanium Hashmi cage was used in all operated patients at single level instrumentation.Results: A total of 113 patients satisfied the inclusion criteria and were considered in the study. Among them, 77 patients were male and 36 were female. The age range from 26 to 65 with a base age of 53 years ± 2.5. C5 – C6 was the commonest level for fusion C6 – C7, C3 – C4 and C4 – C5 were less common. For the outcome of theprocedure Odom’s criteria, was followed the results showed excellent improvement in 88 (77.87%), Good results in 18 (15.9%), fair in 5 (4.42%) and 2 patient had Poor (1.76%) results. Fusion was seen in 86 patients, superficial infection in two cases.Conclusion: Patients with single-level degenerative disc and treated with modified titanium Hashmi cage provided a good fusion with the relief of upper limb pain without donor site morbidity at anterior iliac spine.
- Published
- 2020
39. An experimental analysis of different point specific musculoskeletal pain among selected adolescent-club cricketers in Dhaka City
- Author
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Sharmin Ahmed, Salauddin Al Azad, Mohammad Kamrujjaman, Mohammad Rashaduzzaman, and Mohammad Ariful Islam
- Subjects
Musculoskeletal pain ,medicine.medical_specialty ,business.industry ,Physical therapy ,Medicine ,Upper limb pain ,Club ,business ,Lower limb pain - Published
- 2020
40. Co-morbidity between trigeminal autonomic cephalalgias and complex regional pain syndrome: Two case reports
- Author
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Philip M. Finch and Peter D. Drummond
- Subjects
Photophobia ,business.industry ,Cluster headache ,Hyperacusis ,Upper limb pain ,Pain ,General Medicine ,Comorbidity ,medicine.disease ,Trigeminal Autonomic Cephalalgias ,medicine.anatomical_structure ,Complex regional pain syndrome ,Anesthesia ,Stellate ganglion ,Hyperalgesia ,medicine ,Humans ,Neurology (clinical) ,medicine.symptom ,Morbidity ,Trigeminal autonomic cephalalgia ,business ,Complex Regional Pain Syndromes - Abstract
Background Trigeminal autonomic cephalalgias and complex regional pain syndrome are rare conditions, and their co-occurrence has not been reported previously. Clinical findings: In two patients, ipsilateral trigeminal autonomic cephalalgias developed after the onset of upper limb complex regional pain syndrome. Hyperalgesia to thermal and mechanical stimuli extended beyond the affected limb to encompass the ipsilateral forehead, and was accompanied by ipsilateral hyperacusis and photophobia. In addition, examination of the painful limb and bright light appeared to aggravate symptoms of trigeminal autonomic cephalalgias. Detailed examination of the association between facial and upper limb pain indicated that both sources of pain cycled together. Furthermore, in one case, stellate ganglion blockade inhibited pain for an extended period not only in the affected limb but also the face. Conclusions These findings suggest some overlap in the pathophysiology of complex regional pain syndrome and trigeminal autonomic cephalalgias. Specifically, central sensitization and/or disruption of inhibitory pain modulation on the affected side of the body in complex regional pain syndrome might trigger ipsilateral cranial symptoms and increase vulnerability to trigeminal autonomic cephalalgias.
- Published
- 2021
41. Sequential Supraclavicular Brachial Plexus and Stellate Ganglion Neurolysis for Upper Limb Pain in Metastatic Breast Cancer
- Author
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Titiksha Goyal, Anil Kumar Paswan, Dhruv Jain, and Nimisha Verma
- Subjects
lcsh:R5-920 ,medicine.medical_specialty ,cancer pain ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,Chronic pain ,Upper limb pain ,Case Report ,medicine.disease ,sympathetic mediated pain ,Surgery ,neurolysis ,medicine.anatomical_structure ,Stellate ganglion ,Neuropathic pain ,Medicine ,stellate ganglion ,Brachial Plexopathy ,lcsh:Medicine (General) ,business ,Cancer pain ,Brachial plexus ,Neurolysis - Abstract
Neuropathic pain in cancer can result in severe debilitation to a patient with limited treatment options. Interventional modalities like nerve destruction can provide relief but at the expense of motor paralysis. Sympathetic pain is often an undiagnosed and undertreated condition that may accompany cases of chronic pain. We describe a case of severe neuropathic pain in brachial plexopathy in a middle-aged woman caused by metastatic breast cancer that was managed by chemical neurolysis of brachial plexus. Residual pain was treated by neurolysis of stellate ganglion due to the presence of sympathetic pain. This case report highlights the importance of the dual nature of pain and its management by chemical neurolysis in severe refractory neuropathic and sympathetic mediated pain.
- Published
- 2021
42. Loneliness, social isolation, and pain following the COVID-19 outbreak: data from a nationwide internet survey in Japan
- Author
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Takahiro Tabuchi, Keiko Yamada, Kenta Wakaizumi, Yasuhiko Kubota, and Hiroshi Murayama
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Science ,Pain ,Upper limb pain ,Article ,Disease Outbreaks ,Young Adult ,Medical research ,Japan ,Rheumatology ,Surveys and Questionnaires ,Prevalence ,medicine ,Humans ,Social isolation ,Young adult ,Aged ,Internet ,Multidisciplinary ,business.industry ,Incidence ,Loneliness ,Incidence (epidemiology) ,Chronic pain ,COVID-19 ,Odds ratio ,Middle Aged ,medicine.disease ,Low back pain ,Social Isolation ,Neurology ,Risk factors ,Physical therapy ,Medicine ,Female ,Chronic Pain ,medicine.symptom ,business - Abstract
The aim of cross-sectional study was to investigate the association between loneliness, increased social isolation, and pain following the COVID-19 outbreak. A total of 25,482 participants, aged 15–79 years, were assessed using an internet survey; the University of California, Los Angeles Loneliness Scale (Version 3), Short Form 3-item (UCLA-LS3-SF3) was used to assess loneliness, and a modified item of the UCLA-LS3-SF3 was used to measure the perception of increased social isolation during the pandemic. The outcome measures included the prevalence/incidence of pain (i.e., headache, neck or shoulder pain, upper limb pain, low back pain, and leg pain), pain intensity, and the prevalence of past/present chronic pain. Pain intensity was measured by the pain/discomfort item of the 5-level version of the EuroQol 5 Dimension scale. Odds ratios of pain prevalence/incidence and past/present chronic pain prevalence according to the UCLA-LS3-SF3 scoring groups (tertiles) and the frequency of the perceived increase in social isolation (categories 1–5) were calculated using multinomial logistic regression analysis. The mean pain intensity values among different loneliness and social isolation levels were tested using an analysis of covariance. Increased loneliness and the severity of the perceived social isolation were positively associated with the prevalence/incidence of pain, pain intensity, and the prevalence of past/present chronic pain.
- Published
- 2021
43. Web Axillary Pain Syndrome-Literature Evidence and Novel Rehabilitative Suggestions: A Narrative Review
- Author
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Francesco Agostini, Enrica Maggiori, Teresa Paolucci, Andrea Bernetti, Alberto Migliore, Massimiliano Mangone, Raffaele Di Marzo, Massimo Mammucari, Carmine Attanasi, Marco Paoloni, Edoardo del Monte, and Domenico Russo
- Subjects
medicine.medical_specialty ,axillary web syndrome ,Secondary lymphedema ,Health, Toxicology and Mutagenesis ,medicine.medical_treatment ,Upper limb pain ,Pain ,Breast Neoplasms ,Review ,rehabilitation ,Manual lymphatic drainage ,Postoperative Complications ,breast cancer ,medicine ,Humans ,Lymphedema ,physiotherapy ,Rehabilitation ,business.industry ,lymphadenectomy ,mesotherapy ,axilla ,female ,humans ,lymph node excision ,pain ,postoperative complications ,breast neoplasms ,lymphedema ,Public Health, Environmental and Occupational Health ,Axillary web syndrome ,Mesotherapy ,medicine.anatomical_structure ,Axilla ,Physical therapy ,Medicine ,Upper limb ,Lymph Node Excision ,Lymphadenectomy ,Female ,medicine.symptom ,business - Abstract
Axillary web syndrome (AWS) is defined as a visible and palpable network of cords in the skin of the axillary cavity that are tensed by shoulder abduction following surgery for breast cancer, causing significant functional limits of the ipsilateral upper limb (UL) and pain. The purpose of this narrative review is to discuss rehabilitation approaches for greater efficacy with respect to pain and novel suggestions. AWS is a frequent complication of axillary lymphadenectomy that necessitates a thorough follow-up in the medium to long term. Physiotherapy is effective in the treatment of functional limb deficits, the management of pain, and the treatment of upper limb disability. The best management approach involves the use of soft tissue techniques to slow the natural course of the syndrome, in association with therapeutic exercises for functional recovery and muscle strengthening. AWS is linked secondary lymphedema, requiring integration with manual lymphatic drainage. The physiotherapy management of AWS is currently fragmented, and insufficient information is available on the nature of the disease. Thus, randomized and controlled studies that compare rehabilitation approaches in AWS are desirable, including the possibility of using mesotherapy in the treatment of axillary and upper limb pain.
- Published
- 2021
44. Back, Lower Limb, and Upper Limb Pain Among U.S. Adults, 2019
- Author
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Jonaki Bose, Jacqueline W. Lucas, and Eric M Connor
- Subjects
medicine.medical_specialty ,business.industry ,Shoulders ,Chronic pain ,Upper limb pain ,medicine.disease ,Low back pain ,medicine.anatomical_structure ,Quality of life ,Health care ,medicine ,Physical therapy ,Upper limb ,Body region ,medicine.symptom ,business - Abstract
Location-specific pain, such as back, neck, arm, and hip pain is associated with short- and long-term health effects, ranging from minor discomfort to musculoskeletal impairment (1), diminished quality of life (2), and escalating health care costs (3). Existing studies of location-specific pain are mostly limited to small or special populations with limited generalizability (4-6). This report provides national estimates of any pain regardless of body region as well as estimates of back, lower limb (hips, knees, or feet), and upper limb (hands, arms, or shoulders) pain in the past 3 months among U.S. adults aged 18 and over by selected sociodemographic characteristics.
- Published
- 2021
45. Investigating the Depression Status in Patients with Upper Limb Pain
- Author
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Mani Mahmoudi, Shaghayegh Khosravifar, Mahdi Abounoori, Hamed Jafarpour, Mohammadmoein Maddah, and Shahrzad Khosravifar
- Subjects
medicine.medical_specialty ,business.industry ,Physical therapy ,Medicine ,Upper limb pain ,In patient ,business ,Depression (differential diagnoses) - Abstract
Introduction: Depression is considered as the most common psychological problem in societies. Depression, anxiety disorders, and substance abuse are more common in patients with pain compared to the general population. In this study, the state of depression in patients with upper limb pain with radiculopathy or without paraclinical signs of radiculopathy has been investigated. Material and Methods: We conducted the depression status in patients with upper limb pain with and without radiculopathy in a descriptive cross-sectional study in Sari in 2017. Beck Depression Inventory (BDI-II), Short Form (36) Health Survey (SF-36), short-form McGill pain questionnaire was used to evaluate the status of major depressive disorder, health status and quality of life, and severity of pain in them, respectively. The data was analyzed by SPSS 22. Results: From 120 patients with the mean age 44.97±9.77 years, 19% had mild depression, 18% moderate depression and 11% severe depression. The mean score of SF36 was 29.94±6.86. The mean scores of McGill pain scale was 13.31±6.02. The mean depression score had a significant difference between the two groups studied (P=0.04). The McGill pain score had also a significant difference between the two study groups (P=0.012). The mean score of SF36 had no significant difference in both groups (P=0.41).Conclusion: The depression score and the prevalence of moderate and severe depression were also higher in patients with chronic upper limb pain with cervical radiculopathy than in patients without cervical radiculopathy.
- Published
- 2021
46. Upper Limb Function in Survivors of COVID-19 Requiring Mechanical Ventilation
- Author
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S. Lovage, B. Mehta, Suveer Singh, A. Hudson, Lydia J. Finney, R. Doughty, and William D.-C. Man
- Subjects
Mechanical ventilation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Upper limb pain ,Prone position ,medicine.anatomical_structure ,Intensive care ,Dash ,Physical therapy ,Breathing ,Medicine ,Upper limb ,Brachial Plexopathy ,business - Abstract
Rationale Upper limb dysfunction is well recognised in survivors of intensive care (Gustafson et al Crit Care Med 2018;46:1769-1774). A mainstay of respiratory support through the COVID-19 pandemic has been use of repeated patient prone positioning to improve ventilation. Potential complications reported with prone positioning of sedated patients include brachial plexopathy, shoulder subluxation and peripheral nerve injury. We hypothesised that there would be a high prevalence of upper limb dysfunction, disability and pain in survivors of COVID-19 requiring mechanical ventilation, particularly in those who were prone positioned. Methods Eligible patients were laboratory-confirmed swab positive for SARS-CoV-2, mechanically ventilated for a minimum of 72 hours on the Royal Brompton Hospital Adult Intensive Care Units. We measured handgrip strength (HGS), normalised for age and sex, the Disability of Arm Shoulder Hand (DASH) questionnaire (Beaton et al J Hand Ther 2001;14:128-146) and Upper limb Pain Numerical Rating Scale (from 0-10). Health related quality of life was measured using the EuroQol-5 dimensions 5-level (EQ5D5L Utility Index (UI) and Visual Analogue Score (VAS)). Patients were stratified according to whether they received prone positioning or not. Results Twenty-seven consecutive patients were assessed at mean 45 days after hospital discharge. Baseline demographics, admission characteristics, and follow-up upper limb assessment data are shown in Table 1. There was evidence of upper limb weakness (mean (SD) right HGS: 44.77(19.31) %predicted;left HGS 47.69 (18.41) %predicted), with 63% showing upper limb dysfunction (DASH ≥ 16) and 33% showing severe upper limb dysfunction (DASH ≥40). Median (IQR) pain scores were 4 (0.75-6.25) with 53% reporting severe pain (≥ 5). DASH correlated significantly with EQ5D5L UI and VAS (r=-0.69 and r=-0.73 respectively;both p
- Published
- 2021
47. Prevalence of upper limb pain and disability and its correlates with demographic and personal factors
- Author
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Ahmad H. Alghadir, Amir Iqbal, Amal Al-momani, Fidaa Almomani, and Alia A. Alghwiri
- Subjects
Response rate (survey) ,education.field_of_study ,medicine.medical_specialty ,Descriptive statistics ,business.industry ,Population ,Upper limb pain ,Survey research ,Future career ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,030202 anesthesiology ,Dash ,Physical therapy ,Medicine ,Early identifications ,business ,education ,030217 neurology & neurosurgery - Abstract
Purpose The present study aimed to assess the prevalence of upper limb pain and disability and to investigate potentially correlated factors among university students in Jordan. Methods This was a cross-sectional questionnaire-based survey study that was conducted among university students. The upper limb pain and disability were assessed by the Disabilities of the Arm, Shoulder, and Hand (DASH) outcome questionnaire. The DASH outcome questionnaire was distributed to 2100 students from the population of 2 public and 2 private universities in the north of Jordan. Demographic and personal information were collected. Data were analyzed using descriptive statistics and linear regression analysis. Results A total of 1929 DASH outcome questionnaires were returned, with a high response rate of 91.86%. The age of the subjects was between 18-28 years (52% male; 48% female). The majority of subjects (85.2%) used at least one smartphone. The majority of them had been using a smartphone for more than 5 years. The prevalence of upper limb pain and disability among university students was 24%. Several factors were found to be significantly connected with upper limb pain and disability among university students, such as smartphone use, computer use, the presence of musculoskeletal problems, not living with their families, using public transport (bus), and daily housekeeping. Conclusion The results of this study can be used globally to promote the health and well-being of university students, improve their academic performance and future career. Identifying high-risk groups will assist in early identifications and prevention programs for upper limb pain and disability among university students.
- Published
- 2019
48. Field testing of the revised neuropathic pain grading system in a cohort of patients with neck and upper limb pain
- Author
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Rajiv Menon, Jiajie Tan, Angela Jacques, Helen Slater, Shushana Gijohn George, Brigitte Tampin, Rachel Elizabeth Broe, and Lee Lee Seow
- Subjects
Male ,medicine.medical_specialty ,Pain medicine ,Upper limb pain ,Disease ,Sensitivity and Specificity ,Upper Extremity ,Surveys and Questionnaires ,Humans ,Mass Screening ,Medicine ,Pain Measurement ,Retrospective Studies ,business.industry ,Gold standard ,Retrospective cohort study ,Pain scale ,Middle Aged ,Anesthesiology and Pain Medicine ,Neuropathic pain ,Cohort ,Physical therapy ,Neuralgia ,Female ,Neurology (clinical) ,business ,Neck - Abstract
Background and aims In 2008, the International Association for the Study of Pain Special Interest Group on Neuropathic Pain (NeuPSIG) proposed a clinical grading system to help identify patients with neuropathic pain (NeP). We previously applied this classification system, along with two NeP screening tools, the painDETECT (PD-Q) and Leeds Assessment of Neuropathic Symptoms and Signs pain scale (LANSS), to identify NeP in patients with neck/upper limb pain. Both screening tools failed to identify a large proportion of patients with clinically classified NeP, however a limitation of our study was the use of a single clinician performing the NeP classification. In 2016, the NeuPSIG grading system was updated with the aim of improving its clinical utility. We were interested in field testing of the revised grading system, in particular in the application of the grading system and the agreement of interpretation of clinical findings. The primary aim of the current study was to explore the application of the NeuPSIG revised grading system based on patient records and to establish the inter-rater agreement of detecting NeP. A secondary aim was to investigate the level of agreement in detecting NeP between the revised NeuPSIG grading system and the LANSS and PD-Q. Methods In this retrospective study, two expert clinicians (Specialist Pain Medicine Physician and Advanced Scope Physiotherapist) independently reviewed 152 patient case notes and classified them according to the revised grading system. The consensus of the expert clinicians’ clinical classification was used as “gold standard” to determine the diagnostic accuracy of the two NeP screening tools. Results The two clinicians agreed in classifying 117 out of 152 patients (ICC 0.794, 95% CI 0.716–850; κ 0.62, 95% CI 0.50–0.73), yielding a 77% agreement. Compared to the clinicians’ consensus, both LANSS and PD-Q demonstrated limited diagnostic accuracy in detecting NeP (LANSS sensitivity 24%, specificity 97%; PD-Q sensitivity 53%, specificity 67%). Conclusions The application of the revised NeP grading system was feasible in our retrospective analysis of patients with neck/upper limb pain. High inter-rater percentage agreement was demonstrated. The hierarchical order of classification may lead to false negative classification. We propose that in the absence of sensory changes or diagnostic tests in patients with neck/upper limb pain, classification of NeP may be further improved using a cluster of clinical findings that confirm a relevant nerve lesion/disease, such as reflex and motor changes. The diagnostic accuracy of LANSS and PD-Q in identifying NeP in patients with neck/upper limb pain remains limited. Clinical judgment remains crucial to diagnosing NeP in the clinical practice. Implications Our observations suggest that in view of the heterogeneity in patients with neck/upper limb pain, a considerable amount of expertise is required to interpret the revised grading system. While the application was feasible in our clinical setting, it is unclear if this will be feasible to apply in primary health care settings where early recognition and timely intervention is often most needed. The use of LANSS and PD-Q in the identification of NeP in patients with neck/upper limb pain remains questionable.
- Published
- 2019
49. A Prospective Comparison of CT-Epidurogram Between Th1-Transforaminal Epidural Injection and Th1/2-Parasagittal Interlaminar Epidural Injection for Cervical Upper Limb Pain
- Author
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Keisuke Watanabe, Keiji Hashizume, Hiroaki Yamagami, Aki Fujiwara, Shohei Iwasaki, and Masahito Kamihara
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Radiography ,Injections, Epidural ,Upper limb pain ,Epidurogram ,Radiography, Interventional ,law.invention ,Upper Extremity ,Randomized controlled trial ,law ,medicine ,Humans ,Pain Management ,Fluoroscopy ,Prospective Studies ,Prospective cohort study ,Adverse effect ,Neck Pain ,medicine.diagnostic_test ,Epidural steroid injection ,business.industry ,Middle Aged ,Surgery ,Treatment Outcome ,Anesthesiology and Pain Medicine ,Surgery, Computer-Assisted ,Neuralgia ,Female ,Tomography, X-Ray Computed ,business - Abstract
Background: Cervical epidural injections for treating neck and upper limb pain are performed by 2 methods: transforaminal and interlaminar. Many serious complications caused by inadvertent intravascular injection have been reported with the use of cervical transforaminal epidural steroid injection through the anterior-lateral approach. Despite international practical guidelines that have been proposed, cervical transforaminal epidural injection is still less recommended than cervical interlaminar epidural injection. Objectives: The objective of this study is to introduce Th1-transforaminal epidural injection (Th1- TFEI) through the posterior-lateral approach, compare the injectate spread in Th1-TFEI with that of Th1/2-parasaggital interlaminar epidural injection (Th1/2-pILEI), and clarify the clinical characteristics of Th1-TFEI. Study Design: This research involved a prospective study of 30 patients receiving both Th1-TFEI and Th1/2-pILEI. Methods: Thirty patients with unilateral upper limb pain were enrolled for this prospective study. Th1-TFEI and Th1/2-pILEI were administered on each case in random order under fluoroscopy, and computed tomographic (CT) epidurograms were compared. Changes in circulatory dynamics, presence of Horner’s syndrome, changes in the Numerical Rating Scale (NRS-11), and adverse events were investigated. Results: Patients included 15 men and 15 women and included 24 cases of cervical spine disease and 6 cases with other upper limb pain. The Th1-TFEI group had significantly higher rates of “Th1 root filling” (100%), “ventral spread” (70.0%), and “lateral limitation” (26.7%) compared to the Th1/2-pILEI group. In the Th1-TFEI group, cephalad spread averaged 2.97 vertebral bodies, reaching approximately up to C6. The Th1/2-pILEI group had an average of 4.76 vertebral bodies, approximately up to C4. The 2 groups showed significant differences in cephalad spread. Horner’s syndrome appeared in the Th1-TFEI group at a rate of 56.7%, significantly higher than that in the Th1/2-pILEI group at 17.2%. The presence of Horner’s syndrome showed significant correlations with “ventral spread” and “spread up to C6.” There were no significant differences in NRS-11 improvement and changes in circulatory dynamics between the groups. There were no major complications. Limitations: The components of injectate were standardized; however, the needle gauge numbers were varied. In addition, interpretation of the CT-epidurogram was not blinded. The sample size was small; therefore, multivariate analysis was not possible. Conclusions: CT-epidurogram comparison revealed that Th1/2-pILEI was not localized on the injection side, and there was better dorsal spread – although ventral spread was small. Contrarily, Th1-TFEI was localized on the injection side, and better ventral spread was shown while cephalad spread was limited. We expected the addition of a sympathetic block effect suggested by the Horner’s syndrome as well as the merits of the ventral spread. However, short-term clinical effects were equal to those of Th1/2 pILEI. In future research, we need to standardize the diseases to include and to increase the number of cases to enable evaluation of clinical effectiveness.Key words: Epidural, cervical, transforaminal, interlaminar, fluoroscopy, CT-epidurogram, dorsal, ventral, cephalad, Horner’s syndrome
- Published
- 2019
50. The association between long working hours and work-related musculoskeletal symptoms of Korean wage workers: data from the fourth Korean working conditions survey (a cross-sectional study)
- Author
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Kyung Jae Lee, Guang Hwi Kim, June-Hee Lee, Sang-Woo Kim, Sung Won Jung, and Jae-Gwang Lee
- Subjects
Korean working conditions survey (KWCS) ,medicine.medical_specialty ,Cross-sectional study ,Psychological intervention ,Upper limb pain ,Work related ,03 medical and health sciences ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Odds ratio ,030210 environmental & occupational health ,Industrial medicine. Industrial hygiene ,Lower limb pain ,Long working hours ,RC963-969 ,Physical therapy ,Work-related musculoskeletal disorders (WMSDs) ,Public aspects of medicine ,RA1-1270 ,business ,Psychosocial ,Research Article - Abstract
Background It has been reported that long working hours are hazardous to the workers’ health. Especially, work-related musculoskeletal disorders (WMSDs) have been considered as one of the significant health issues in workplace. The objective of this study was to identify the association between long working hours and work-related musculoskeletal symptoms. Methods The analysis was conducted using data from the Fourth Korean Working Conditions Survey (KWCS). Subjects of this study were 24,783 wage workers and divided into three groups according to the weekly working hours, which were ≤ 40, 41–52 and > 52 h. The relationship between long working hours and work-related musculoskeletal symptoms was analyzed by multivariate logistic regression method after adjusting for general, occupational characteristics including specific working motions or postures and psychosocial factors. Results Approximately 18.4% of subjects worked more than 52 h per week and 26.4 and 16.4% of male subjects and 33.0 and 23.4% of female subjects experienced work-related upper and lower limb pains, respectively, over the last 12 months. Moreover, the prevalence of upper and lower limb pain was increased in both genders as the weekly working hours increased. The odds ratios (ORs) of upper limb pain for those working 41–52 h and more than 52 h per week when adjusted for general, occupational characteristics including specific motions or postures and psychosocial factors were 1.36 and 1.40 for male workers and 1.26 and 1.66 for female workers compared to the reference group, respectively. Furthermore, ORs of lower limb pain for the same weekly working hour groups were 1.26 and 1.47 for male workers and 1.20 and 1.47 for female workers, respectively. Conclusions Long working hours were significantly related to work-related musculoskeletal symptoms in Korean wage workers and appropriate interventions should be implemented to reduce long working hours that can negatively affect workers’ health.
- Published
- 2018
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