Medicine and Health Sciences Commons^™

Is Viscosupplementation Effective In Reducing Osteoarthritis Knee Pain?, Amalia Antonoplos

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not viscosupplementation is effective in reducing osteoarthritis knee pain

STUDY DESIGN: Review of three randomized, double blind, placebo control trials between 2009- 2010

DATA SOURCES: Three randomized, double blind, placebo control trials were found via PubMed and NCBI

OUTCOMES MEASURED: Each randomized control trial measured knee pain and/or patient satisfaction following their intervention (placebo or hyaluronic acid) in patients with knee osteoarthritis, which was measured via WOMAC pain scale and patient global assessment forms.

RESULTS: (P<0.05) for change in pain at 14-26 weeks after injection (NNT=6- 8 for Chevalier et al and 4 for Kul-Panza & Berker). Patient satisfaction was higher in the experimental groups as compared to the control with conclusions of NNT between 11 and 20 for Chevalier et al and Kul-Panza & Berker respectively. Chavelier et al found adverse events such as arthralgias and joint effusion in <10% of their study population (NNH=39). No dichotomous data was presented in Diacoglu et al; however an ANOVA was deemed statistically significant (p<0.01).

CONCLUSION: Review of these articles concludes that the use of hyaluronic …

Is Laser Therapy An Effective Alternative Treatment For Women With Fibromyalgia?, Michelle B. Astrove

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not, “Is the use of laser therapy an effective alternative treatment for women with fibromyalgia?”

STUDY DESIGN: Review of three English language primary studies, published between 2002 and 2013.

DATA SOURCES: Three randomized controlled trials (RCTs) were found using Cochrane Systematic Reviews. These studies analyzed the effectiveness of laser therapy in women with fibromyalgia.

OUTCOMES MEASURED: Main outcomes measured were improvement in pain, number of tender points, muscular spasm, skinfold tenderness, sleep disturbance, fatigue and morning stiffness measured by an ordinal likert scale, Pain and FM impact …

Is Acupuncture, Including Electroacupuncture, Effective In Treating Pain In Plantar Fasciitis?, Alicia Campiglia

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether the use of acupuncture, including electroacupuncture, is effective in treating pain in patients with plantar fasciitis.

STUDY DESIGN: Review of 3 RCTs published between 2011-current, all in the English language.

DATA SOURCES: Three RCTs analyzed the effectiveness of acupuncture therapy compared to a control group using alternate analgesic therapies. All studies were found using EBSCOhost and PubMed and were selected based on relevance to the proposed clinical question.

OUTCOMES MEASURED: Each of the 3 articles analyzed the effectiveness of treating pain with acupuncture treatment in patients diagnosed with …

Is Vitamin D Supplementation Effective At Reducing Idiopathic Musculoskeletal (Mss) Pain?, Darra O. Markland

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine “Is Vitamin D supplementation effective at reducing idiopathic musculoskeletal (MSS) pain?”

Study Design: Review of primary studies published between the years 2012-2014.

Data Sources: One double blind randomized controlled trial (RCT), one semi-crossover RCT, and one before and after observational study. These were found using Cochrane Review and PubMed databases.

Outcomes Measured: Clinical outcomes were measured in these studies utilizing the Visual Analogue Scale for Pain, the 5-point Likert Pain Scale, the Standard Nordic Questionnaires and numerical grading of pain level, and number of pain sites before and after …

Do Epidural Injections With Local Anesthetic With Steroids Have Superiority Over Injections With Local Anesthetic Alone When Treating Chronic Back Pain Due To An Intervertebral Disc Herniation In Men And Women Over 18 Years Old?, Julia S. Ross

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not, “Do epidural injections with local anesthetic with steroids have superiority over injections with local anesthetic alone when treating chronic back pain due to an intervertebral disc herniation in men and women over 18 years old?”

STUDY DESIGN: Review of three, double blind, randomized controlled trials (RCTs) published between 2011-2014, all in English language. The articles compared epidural injections containing local anesthetic with steroids to epidural injections containing local anesthetics alone.

DATA SOURCES: Three Randomized controlled trials found using PubMed. All articles were published in peer-reviewed journals …

Is Regenerative Injection Therapy (Prolotherapy) Effective At Reducing Pain Associated With Knee Osteoarthritis?, Ashley Aloi

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is regenerative injection therapy (prolotherapy) effective at reducing pain associated with knee osteoarthritis?”

Study Design: Review of all English language primary studies published in 2012 and 2013.

Data Sources: One randomized control trial, one randomized crossover study and one single-arm uncontrolled study were found using PubMed and Ebscohost.

Outcomes Measured: Clinical outcome for all three articles was measured using the Western Ontario McMaster University Osteoarthritis Index (WOMAC); which specifically focuses on quality of life, function, and pain reduction after the use of prolotherapy versus the saline …

Is Treatment With Topical Glyceryl Trinitrate Effective In Reducing Elbow Pain In Patients With Lateral Epicondylitis?, Benjamin Chartier

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not treatment with topical glyceryl trinitrate is effective in reducing elbow pain in patients with lateral epicondylitis.

Study Design: Review of two English language randomized controlled trials and one primary study published 2003, 2009, 2011.

Data Sources: Two double blind randomized controlled and one prospective comparison study comparing the effectiveness of gylceryl trinitrate to placebo in the treatment of pain related to lateral epicondylitis, found using PubMed, EBSCOhost, and CINAHL Plus.

Outcome(s) Measured: The outcome studied was patient self-rated elbow pain at rest, pain with activity, pain …

In The Treatment Of Patients With Knee Joint Osteoarthritis, Are Platelet Rich Plasma Injections More Effective Than Hyaluronic Acid Injections?, Darshit Gandhi

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not "In the treatment of patients with knee joint osteoarthritis, are Platelet Rich Plasma injections more effective than Hyaluronic acid injections?"

Study Design: Review of one randomized double-blind trial, one randomized cohort study, and one randomized control trial published in the English language in the year 2012.

Data Sources: All studies were published in peer-reviewed journals found via the use of PubMed.

Outcome(s) Measured: Patients were divided into two groups: those who received platelet rich plasma injections (PRP) and those who received hyaluronic injections (HA). Efficacy of …

Is Ayurvedic Effective In Reducing Osteoarthritis Pain In Adults?, Reja Khan

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Ayurvedic is effective in reducing osteoarthritis pain in adults.

Study Design: Review of three English language randomized controlled trials published between from 2004-2013.

Data Sources: Two double blind randomized controlled trials and one open label randomized controlled clinical trial were found using PubMed and Cochrane Library databases.

Outcomes Measured: To measure the effectiveness, the following parameters were utilized visual analog scale (VAS) reported by the patient to assess reduction in pain symptoms of osteoarthritis.

Results: Three randomized controlled studies results found that Ayurvedic medicine was beneficial …

Is Ginger Effective In Reducing Knee Pain In Adults With Osteoarthritis?, Joseph Heng

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this evidence based medicine review is to determine whether ginger is effective in reducing knee pain in adults with osteoarthritis.

Study Design: Three double blind, randomized controlled trials were reviewed and selected based on their relevance to the clinical question and their inclusion of patient oriented outcomes (POEMS).

Data Sources: Each study was obtained by searching Cochrane and PubMed database.

Outcomes Measured: The outcomes were measured using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) via Likert scale and Knee Pain rated via Knee injury and knee Osteoarthritis Outcome score (KOOS) questionnaire which is a …

Is Red Yeast Rice Tolerable In Treating Patients With Dyslipidemia Who Have Statin-Associated Myalgia?, Carie Lam

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not patients who have statin-associated myalgia have improved tolerability for red yeast rice (RYR) as an alternative treatment.

Study Design: This review consists of three double blinded randomized controlled trials published in English in 2009, 2010, 2013.

Data Sources: Three randomized, controlled, double blinded clinical trials on the tolerability of red yeast rice were found on PubMed and Ebsco Host. Two trials comparing red yeast rice to placebo and the third trial comparing red yeast rice to pravastatin.

Outcomes Measured: Each of the three articles analyzed whether …

Does Vibration Training Increase Stability In Functionally Unstable Ankles?, Nicole Bryan

PCOM Physician Assistant Studies Student Scholarship

OJECTIVE: The objective of this selective EBM review is to determine whether or not vibration training increases stability in functionally unstable ankles.

STUDY DESIGN: Review of three English language randomized control trials (RCTs) published in 2006, 2008 and 2010.

DATA SOURCES: Three non-blind randomized control trials found via PubMed.

OUTCOMES MEASURED: Efficacy was measured with one (experimental) group receiving vibration training and the other (control) group using either non-vibration exercise techniques or no exercise. Increased stability was measured with electromyography (EMG), balance testing or an isokinetic dynamometer.

RESULTS: Vibration training is a useful tool to …

Is The Addition Of Omega-3 Fatty Acids To Other Treatment Methods Effective In Reducing Pain In Adult Patients With Osteoarthritis?, Lisa C. Martin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: Is the addition of Omega-3 fatty acids to other treatment methods effective in reducing pain in adult patients with osteoarthritis?

STUDY DESIGN: Review of three published, double blind, randomized controlled trials were used for this review and were selected based on their relevance to the clinical question.

DATA SOURCE: The most recent randomized control trials examining the relief of osteoarthritic pain with intake of omega-3 fatty acids in addition to traditional medical therapies were found using Medline, PubMed, and OVID databases.

OUTCOME MEASURED: Relief of osteoarthritic pain with the addition of omega-3 fatty acids to …

Does Daily Intake Of Glucosamine Supplements Prevent The Need For Knee Replacements Later In Life For Adult Patients Predisposed To Osteoarthritis?, Nancy Helmy

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not daily intake of glucosamine supplements prevents the need for knee replacements later in life for adults predisposed to osteoarthritis.

STUDY DESIGN: Review of three English language primary randomized controlled trial studies published between 2001 and 2008

DATA SOURCES: Three double blind randomized control trials comparing glucosamine supplements to placebo were found using PubMed.

OUTCOMES MEASURED: Outcomes were measured using radiographic studies of the knees, joint space measurements, and symptoms were evaluated using Lequesne and WOMAC indexes.

RESULTS: The Reginster (2001) and Pavelka (2002) studies demonstrated no …

Is Valdecoxib An Effective Treatment Option To Improve Pain In Adults With Diagnosed Osteoarthritis Of The Hip Or Knee?, Karen A. Mcsorley

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Valdecoxib is an effective treatment option to improve pain in adults with osteoarthritis of the hip or knee.

STUDY DESIGN: This review consists of three randomized control trials; two were published in 2002 and the third in 2006.

DATA SOURCES: Sources were studies comparing groups taking Valdecoxib 10mg QD to placebo, which were found via Pubmed, MEDLINE, Ovid, and Cochrane databases.

OUTCOMES MEASURED: The three articles measured various outcomes: pain improvement, stiffness, physical improvement, adverse effects, and onset of analgesia during acute pain …

Is Phlogenzym Effective In Reducing Moderate To Severe Osteoarthritis Pain In Adults?, Vanessa K. Wood

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Phlogenzym (or ERC) effective in reducing moderate to severe osteoarthritis pain in adults.

STUDY DESIGN: Review of three randomized controlled trials in the English language from 2001 to 2006.

DATA SOURCES: Two double blind RCTs and one open RCT was found using Cochrane Library EBM Online Database, Ovid Medline, and PubMed Online.

OUTCOMES MEASURED: Each of the three studies measured for pain at rest, pain with motion, and restricted function at baseline assessing efficacy using the Lequesne’s Algofunctional Index, visual analog scales, and …

Is Radial Extracorporeal Shock Wave Therapy An Effective Treatment For Chronic Plantar Fasciitis In Adults?, Lauren H. Rucker

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not radial extracorporeal shock wave therapy (ESWT) is an effective treatment in adults with chronic plantar fasciitis.

STUDY DESIGN: Review of three English language primary studies published between 2008 and 2010.

DATA SOURCES: Two randomized control trials and one cohort study analyzing the effects of radial extracorporeal shock wave therapy on chronic plantar fasciitis were found using the OVID, Medline and Cochrane Databases.

OUTCOMES MEASURED: Each of the three studies measured improvement in pain from baseline after patients were treated with ESWT. Pain levels were quantified using …