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Aug 2 06 3:23 PM
Aug 23 06 9:14 AM
Aug 31 06 8:43 PM
Quote:The results of the meta-analysis present no evidence to support the use or nonuse of TENS alone in the treatment of chronic low back pain.
Quote:What is the potential effectiveness of the intervention / impact of the issue?The current state of evidence suggests that the physiological effects of US observed in vitro,either do not occur in vivo, or have not been proven to have a clinical effect under theseconditions.1 There is therefore insufficient evidence to support the use of US in the treatment ofmusculoskeletal injury. It has been argued that knowledge of cellular mechanisms and resultsfrom in vitro studies coupled with judicial use of clinical reasoning constitutes good practice.9 Itis however important to establish its clinical effect, both related to different types of injury, andwith regards to the exact application of the treatment. This will allow for the most optimaltreatment and recovery, and should help to eliminate unnecessary costs both of equipment andtreatment time.
Quote:Based on the available evidence, especiallythe studies by Basford et al and Papadopoulos et al, Idecided that LLLT would not be an effective interventionfor my patient with lateral epicondylitis.
Quote:Evidence for...* Laser and pulsed electromagnetic field for RC tendinopathy* U/S for short term pain relief for adhesive capsulitis* U/S and pulsed electromagnetic field for calcific tendinitisEvidence against...* U/S not better than exercise for general shoulder painInsufficient Evidence...*Any modality for RC tear, Instab/Hypermob of GH joint, RA or OA of the shoulder, AC joint injuries
Quote:Overall, it can be concluded that, at present, there is no evidence on the effectiveness of electrotherapy in treating mechanical neck disorders.
Quote:There is no proof that modalities improve the outcome of low back pain. However, as a short term relief and as an aid for activity resumption some of them, such as moist heat and ice can be easily taught to the patient. It is important that patients (and therapists) understand that these modalities are for controlling symptoms only and that an active approach will produce the best results.
Sep 1 06 8:00 AM
Sep 1 06 9:05 AM
Quote:TENS is used extensively in health care to managepainful conditions because it is cheap, safeand can be administered by patients themselves.Success with TENS depends on appropriateapplication and therefore patients and therapistsneed an understanding of the principles ofapplication.
Quote:Systematic reviews of RCTs report thatthere is weak evidence to support the use ofTENS in the management of postoperative andlabour pain. However, these findings have beenquestioned as they contrast with clinical experienceand it would be inappropriate to dismissthe use of TENS in acute pain until the reasonsfor the discrepancy between experience andpublished evidence is fully explored.
Quote:Systematicreviews are more positive about the effectivenessof TENS in chronic pain. However, betterqualitytrials are required to determinedifferences in the effectiveness of different typesof TENS and to compare the cost effectiveness ofTENS with conventional analgesic interventionsand other electrotherapies.
Quote:This meta-analysis lacked data on how TENS efficacy is affected by four important factors: type of applications, site of application, treatment duration of TENS, and optimal frequencies and intensities.
Quote:This study shows a progressive fall in Oswestry Disability Index and pain visual analog scale scores in patients with low back pain treated with eitherinterferential therapy or motorized lumbar traction and massage.
Quote:Recent research has shown that the use of the industrial, scientific, and medical (ISM) frequency of 915 MHz is more efficient than the currently used 2450-MHz microwave frequency in terms of maximum power transfer to deep tissues. The results also show that in addition to thermal applications, microwave energy can be used for the controlled transcutaneous stimulation of nerve action potentials via implanted miniature microwave diodes.
Quote:The Canadian Coordinating Office for Health Technology Assessment evaluated the clinical value of TENS in pain management and concluded that there is little evidence of the effectiveness of TENS in treating chronic pain
Quote:It has been claimed that IFS is highly effective in reducing (i) pain and use of pain medications, (ii) edema and inflammation, (iii) healing time, as well as in improving (i) range of motion, (ii) activity levels, and (iii) quality of life. However, there are very few well designed studies such as randomized, double blind, controlled clinical trials that support such claims. Low (198 stated that in spite of widespread agreement among physiotherapists that IFS has a marked pain relieving effect, there is a paucity of objective investigations into this analgesic effect. He claimed that both the therapeutic and physiological effects of interferential currents require further investigation.
Quote:In a Cochrane review on pulsed electric stimulation for the treatment of OA (Hulme et al, 2002), the authors stated that current evidence suggests that electrical stimulation therapy may provide significant improvements for knee OA, but further studies are required to confirm whether the statistically significant results shown in these trials confer clinically significant and durable benefits.
Sep 1 06 10:13 AM
Quote:The RCT (40 people with acute whiplash who all receivedanalgesia and a neck collar) compared pulsed electromagnetic field treatment versussham pulsing electromagnetic field treatment.68 It found that electromagnetic fieldtreatment significantly reduced pain compared with sham treatment after 4 weeks(P < 0.05), but not after 3 months (reported as non-significant, P value not reported;absolute results for both outcomes presented graphically).
Quote:Cold application such as ice packs and ice massage might be considered at the timeof disease flare up where there is associated swelling. Hot packs are not effective for OA-relatedswelling.
Quote:Pulsed electromagnetic fields or stimulation- Consider electrical stimulation for symptomatic treatment of OA.
Sep 1 06 4:53 PM
Sep 1 06 7:20 PM
Sep 1 06 8:07 PM
Sep 2 06 11:40 AM
Quote:Are you trained to be clinicians who diagnose musculoskeletal problems then prescribe a course of treatment?
Quote:In your countries (wherever all these readers are from), what emphasis does electro have?
Quote:It is just that i have found that using manual therapy and specific exercises much more effective.
Sep 2 06 8:31 PM
Sep 4 06 5:19 AM
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