Posts Tagged ‘Pain’

Central post-stroke pain syndrome (CPSP)

Central post-stroke pain syndrome (CPSP) is described by patients as sharp, stabbing, or burning pain and the experience of hyperpathia – an abnormally exaggerated subjective response to painful stimuli and allodynia – where normally non-painful stimuli evoke pain. Pharmacological therapy, magnetic stimulation, and invasive electrical stimulation are reviewed and recommendations made for the treatment of Central post-stroke pain syndrome (CPSP) in Topics in Stroke Rehabilitation, 05/08/2013. The researchers are from the Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA.


Chronic pain syndromes after ischemic stroke

Chronic pain syndromes after ischemic stroke and are associated with increased functional dependence and cognitive decline.

Writing in Stroke, 05/01/2013 O’Donnell MJ et al from McMaster University Ontario,Canada looks at a large cohort with ischemic stroke. Of these stroke patients ~ 11% reported new chronic post stroke pain, with 3% central post stroke pain and 1.5% with peripheral neuropathic pain and 1.3% with pain from spasticity. The group concluded that Chronic pain syndromes after ischemic stroke and are associated with increased functional dependence and cognitive decline.


Physiotherapists home exercise supervision should be provided in UK primary care

Interviews with specialist neuro-rehabilitation physiotherapists in Greater Manchester, UK show that patients with idiopathic and inherited ataxias should be given more that 6 PT sessions and also benefit from a supervised home exercise programme. The interviews with the physical therapists were summarized by Daker–White G et al. in Physiotherapy, 04/05/2013. Ataxia is described as a lack of coordination of the voluntary muscles resulting in irregular movements of the body.

Exercise therapy after TKA means less pain, improved physical function, and better quality of life

Published in Clinical Rehabilitation, 03/12/2013 Dr. Liao et al and team from Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan look at the effects of additional physical therapy and balance training on functional outcome after total knee replacement in patients with knee osteoarthritis (TKR).

By the year 2020, it is estimated that more than 3 million total knee arthroplasty (TKA) surgeries will be performed in the USA for end-stage arthritis in the knee joint.TKA Surgery shows rapid and substantial improvement in knee pain however 37% of patients have limited functional improvement 1 year after the surgery.
Common limitations include diminished walking speed, difficulty ascending and descending stairs.
This work follows up on work done by Dr. Riva and team from Department of Physical Therapy, University of Pittsburgh USA and published in Journal of American Physical therapy Association that also showed that additional balance training in people with TKA was supported by high exercise adherence with a relatively low dropout rate, and no adverse events.
Improvements in lower-extremity functional ability was shown by higher gait speed, single-leg stance time.
In Dr. Liao trial the control group received conventional function training for eight weeks and the experimental group received the same conventional training a +  additional balance exercises program.
Studies have shown the effectiveness of exercise therapy including range of motion, stretching, strengthening, and endurance exercises after hospital discharge. Home based and out patient exercise therapy improves the outcomes of patients after TKA including less pain, improved physical function, and better quality of life.
Main outcome measures were distance of functional forward reach; duration of single leg stance; timed sit-to-stand test; timed up-and-down stair test; timed 10-m walk; timed up-and-go test.


Telerehabilitation in the UK a solution for timely access to physiotherapy

Writing in the January edition of the BMJ  Dr Salisbury – professor of primary healthcare and his colleagues Dr. Hall – lead for outpatient physiotherapy and Dr.Foster – professor of musculoskeletal health in primary care show that telephone assessment and advice services for patients with musculoskeletal problems is as clinically effective as usual care and provides faster access to physiotherapy. Therefore tele rehabilitation has the potential of providing timely access to physiotherapy (a problem in the National Health Service (NHS). In the UK General practitioners refer about 1.23 million patients for physiotherapy each year in the U.K. The referrals are mostly for lower limb, back, upper limb and cervical pain, respectively.

Pain After Spinal Cord Injury

Pain Spinal Cord Injury

Writing in Topics in Spinal Cord Injury Rehabilitation Dr. Mehta and his team review physical and behavioral treatment for neuropathic pain after Spinal Cord Injury (SCI). The team found that physical interventions demonstrated the strongest evidence in the non pharmacological treatment of post SCI pain. Of these interventions, transcranial electrical stimulation had the strongest evidence of reducing pain. However the team concluded that despite increasing research there is still a lack of data on the use of non pharmacological therapies for SCI pain.

Pain and Parkinsons disease

pain and Parkinsons disease

Reporting in Parkinsonism & Related Disorders Dr. Fil and his group from the Rehabilitation Unit, Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey discuss the treatment of pain in Parkinsons disease (PD).

As we are aware, Parkinson’s disease (PD) is a degenerative neurological disease which presents with motor and non–motor signs and symptoms. This means that approximately 30–50% of the patients experience pain. It is not clear what is the mechanism of pain in PD. The group conclude that although pain is one of the major non–motor symptoms associated with PD it is not always  recognized and inadequately treated in contrast to motor movement impairments.