Budai Irgalmasrendi KórházÁrpád fejedelem u.
ABBREVIATIONS AND DEFINITIONS
BudapestHHungary uh. Published by Elsevier Editora Ltda. All rights reserved. This article has been cited by other articles in PMC. At baseline, at the end of treatment end of Week 2 and at the follow-up visit Week 14the following outcomes were evaluated: disease activity erythrocyte sedimentation rate [ESR], C-reactive rheumatoid arthritis guidelines pdf [CRP], tender and swollen joint counts, pain on a visual analog scale, DAS28, hand function fist making, wrist extension and flexion, hand grip strength and quality of life Health Assessment Questionnaire [HAQ].
Conclusion Underwater ultrasound therapy was better than sham treatment at the end of 2 weeks of treatment, but not at long term 14 weeks in patients with rheumatoid arthritis. A decrease in the ability to make a closed fist and hand grip strength can occur in the hands; subluxation and limitation of flexion and extension may develop in to the wrists.
Non-pharmacological treatment options such as physical therapy along with chemical and biological disease modifying anti-rheumatic drugs DMARDs can be used to preserve physical function and improve quality of life in addition to reducing pain and inflammation. Ultrasound US therapy has been used for medical purposes for more than 70 years. Its biological effects are still not exactly known. The effectiveness of ultrasonic therapy is influenced by its application parameters such as intensity, frequency, continuous or pulsed current, time of irradiation, and type of coupling agent.
Water as a coupling agent is preferable when irregular body parts and bony prominences with little soft tissue coverage are treated, such as small joints of the hand.
Compared to contact mode of treatment, in case of underwater US should be used at a higher intensity to achieve the same tissue temperature. Similarly, Boyaci et al.
Unlike pain and physical function, there has not been any evidence that ultrasound treatment can alter inflammation. The aim of this clinical trial was to determine the effects of underwater US therapy in patients with RA; analgesic and anti-inflammatory effects rheumatoid arthritis guidelines pdf endpointeffects on joint function and quality of life secondary endpoint. It was decided to treat the wrists and the small joints of the hands, since they are the most prevalent, but not equally affected joints during the disease.
Methods This randomized, placebo-controlled, assessor- and patient-blinded trial was conducted in accordance with the ethical principles of the Helsinki Declaration and the guidelines of the International Conference on Harmonization of Good Clinical Practice. Patients were informed verbally about the study procedures, read the Patient Information Sheet and asked to sign an Informed Consent Form.
Patients Inclusion criteria: Patients over 18 years of age mean: Patients were not allowed to receive physical therapy treatments for 1 month prior to starting the study. Exclusion criteria included other concomitant autoimmune diseases, stable-dose pharmacotherapy for less than 2 months, and conditions contraindicating US therapy infection; fever; osteomyelitis.
Sixty patients were screened and 50 patients were enrolled into the trial. Eight patients did not meet inclusion criteria, and two patients refused to sign the Informed Consent Form. All 50 eligible patients were randomly allocated into two groups ultrasound group and control group.
The allocation was concealed by using seales, opaque envelopes. Patients in the ultrasound group received 10 applications 10 working days of continuous underwater US therapy 35—36 Celsius degree tap water; with the transducer at a distance of 2 cm from the treated surface intensity of 0.
Each side of the hand and the wrist were treated in the same treatment period. The control group received sham treatment the US device was not turned on during the 10 sessions for 7 min per session. During the 3-month follow-up period, patients were asked not to have any physical therapy treatment or to change their medication.
- Ujj fájdalom reggelente
- De nouveaux traitements sont en cours de développement, qui devraient permettre de traiter de façon adaptée un nombre de patients toujours plus large.
- Mit tegyek, ha térdfájdalom
- References Az elmúlt másfél évtizedben a biológiai válaszmódosító szerek, különösképpen a TNF-α-gátlók jelentős áttörést hoztak számos immunmediált reumatológiai, gasztroenterológiai és bőrgyógyászati betegség kezelésében.
The analgesic or anti-inflammatory drugs were documented. The outcome parameters were recorded by 1 blinded rheumatologist before the initiation of treatment at Week 0 — Outcomes Testing 1immediately after the 10 treatment sessions at the end of Week 2 — Outcomes Testing 2and 3 months later at Week 14 — Outcomes Testing 3.
Randomization and blinding A concealed allocation random assignment of the enrolled patients to the treatment groups was performed using an Excel computer program by an independent investigator who had never met the patients rheumatoid arthritis guidelines pdf was not otherwise involved in the study procedures.
The study was double-blinded, as neither the study participants nor the ízületi fájdalom kezelés investigator a rheumatologist knew the treatment assignments. The statistician was not involved in the randomization procedures. Outcome parameters At inclusion, the age and gender of patients as well as duration of the disease and DMARD therapy in years were recorded.
Inflammatory laboratory parameters i. Physical function was assessed by measuring range of motion in the wrists in degreesdegree of fist making based on nail tilting, 3 grades were used: 0: insufficient, 1: incomplete, 2: complete ; and hand grip strength in kg was measured with a JAMAR dynamometer.
At the end of treatment period Outcome Measure 2 and at the Month 3 follow-up visit Outcome Measure 3patients evaluated their own condition on a 4-grade scale 1: significantly improved, 2: improved, 3: unchanged, 4: worsened. Normality was verified with the Kolmogorov—Smirnov test.
- Ízületek és porc gyógyszerei gyógyszertárban
- All extracted data will be checked for accuracy by two independent review authors.
- Gerincízületi betegségek
- Abstract Objectives Because drugs do not halt joint destruction in rheumatoid arthritis RAnon-drug treatments are an important adjunct to drug treatment.
Chi-squared test was used for categorical data. We did not use an intention to treat analysis approach.
Results Fifty rheumatoid arthritis patients receiving care at the Rheumatology Outpatient Clinic were involved in the study, which was conducted between and Forty-eight patients completed the study i. Two patients did not start treatment and were excluded ízületi fájdalomtól mit kell venni the analysis i.