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Knee pain – and central sensitisation

Conclusion People living with OA in their knees often spend many years having difficulty managing their pain before they are able to have surgery. From recent research in New Zealand, I don’t think many people are offered a pain “education” approach, and indeed, I’d bet there are a lot of people who don’t get referred for movement-based therapy either. Misunderstanding is rife in OA, with some people uncertain of the difference between osteoarthritis and rheumatoid arthritis, and others very worried that they’re going to “wear the joint out” if they exercise. While OA isn’t as sexy as low back pain, doesn’t have the economic cost of low back pain, and has a reasonable surgical option – it is still a significant problem for many people. Helping those people be more confident to move, helping reduce their uncertainty about the effect of movement on their joints, and giving them an opportunity to think differently about their knee pain would be a real step forward. Surgery, while helpful for many, is either not available or unsuccessful for others, and it’s time we attended to their needs as well.   Courtney CA, Kavchak AE, Lowry CD, et al. (2010). Interpreting joint pain: quantitative sensory testing in musculoskeletal management. Journal of Orthopaedic Sports Physical Therapy. 40:818–825. Lluch Girbes E, Meeus M, Baert I, et al. (2015) Balancing “hands-on” with “hands-off&rdquo...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Assessment Pain Pain conditions Research biopsychosocial Clinical reasoning disability function healthcare rehabilitation science treatment Source Type: blogs

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Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
Conclusion: Very limited evidence to support recreational activity and walking intervention was found for knee osteoarthritis, in the short-term on pain and physical function, respectively.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
Conclusions: In relieving pain and improving self-report function, PRP showed no superiority over hyaluronic acid in well-designed double-blind trials, and beneficial effects of PRP in most trials probably resulted from insufficient blinding methods. However, PRP is still considered more effective than placebo on the basis of present evidence.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
Objective: The aim of this study was to investigate the effects of antigravity treadmill training on gait, balance, and fall risk in children with diplegic cerebral palsy. Design: Thirty children with diplegic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received antigravity treadmill training (20 mins/d, 3 d/wk) together with traditional physical therapy for 3 successive mos and (2) a control group that received only traditional physical therapy program for the same period. Outcomes included selected gait parameters, postural stability, a...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
Abstract: Despite frequent muscle strength or muscle oxidative capacity (based on exercise-onset oxygen uptake [VO2] kinetics) assessments in patients with multiple sclerosis, the impact of time of day on these parameters is often not taken into account. Based on observations in healthy subjects, it remains to be studied whether muscle strength, and/or exercise-onset VO2 kinetics, varies between the morning and the afternoon in patients with multiple sclerosis. In this prospective observational pilot study, walking capacity, exercise-onset VO2 kinetics, isometric knee extension/flexion strength (dynamometry), and self-repo...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Brief Reports Source Type: research
Abstract: A 13-yr-old adolescent boy presented with wrist pain after falling off a scooter onto his outstretched hand. Radiographs revealed a nondisplaced hairline fracture of the scaphoid bone and an irregular radiolucent line in the proximal metaphysis of the second metacarpal bone, consistent with an anomalous growth plate, or complete pseudoepiphysis. Complete pseudoepiphysis is a rare finding, with only a few cases reported. Learning about the common locations of growth plates and the radiographic differences between normal, injured, and anomalous growth plates can help decrease physician error and improve patient outcomes.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Case Reports Source Type: research
In this report, a paraparetic patient who has ochronotic spondiloarthropathy with the presence of HLA B27 antigen is described. He had low back and leg pain and morning stiffness for 5 yrs. Last year, these were followed by tingling, numbness, and weakness the in lower extremities and he was operated on with preliminary diagnosis of prolapsed disc herniation and cord compression. Surgery is suggested for disc herniations related to ochronotic spondyloarthropathy if it is necessary or neurologic symptoms are present. However, his pain and weakness have partially recovered after the operation. After medical and physical trea...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Case Reports Source Type: research
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Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Visual Vignettes Source Type: research
Ketamine, used illegally as a party drug, may be an effective treatment for those who fail to respond to other medications, claim experts at Thomas Jefferson University Hospital, Philadelphia.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
CONCLUSIONS: The quality of the evidence examining physical activity and exercise for chronic pain is low. This is largely due to small sample sizes and potentially underpowered studies. A number of studies had adequately long interventions, but planned follow-up was limited to less than one year in all but six reviews.There were some favourable effects in reduction in pain severity and improved physical function, though these were mostly of small-to-moderate effect, and were not consistent across the reviews. There were variable effects for psychological function and quality of life.The available evidence suggests physica...
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
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