Medicine and Health Sciences Commons^™

Applying Osteopathic Principles To Formulate Treatment For Patients With Chronic Pain, Michael Kuchera

Michael Kuchera

Osteopathic manipulative medicine (OMM) is a physician-directed approach to patient care that incorporates diagnostic and therapeutic strategies to address body unity issues, enhance homeostatic mechanisms, and maximize structure-function interrelationships. Osteopathic physicians integrate a thorough medical history with palpatory examination of a patient to ascertain distinctive characteristics and origins of the patient's pain, to evaluate how pain uniquely affects the patient, and to determine whether segmental, reflex, or triggered pain phenomena coexist in the patient. Osteopathic manipulative medicine expands differential diagnoses by allowing the physician to consider somatic dysfunction and implement treatment options via integration of specific aspects of complementary care …

Effect Of Therapeutic Massage On Pain In Patients With Dementia, Yamini Kapoor, Rob Orr

Rob Marc Orr

Introduction

The aim was to investigate whether therapeutic massage was effective in relieving pain in elderly residents with dementia.

Methods

A randomized controlled study was conducted in an aged care facility. Ten participants with dementia or advanced dementia were allocated to an intervention group or a control group. The intervention group received 10?min of massage (effleurage, kneading, and trigger point therapy) four times per week for 4 weeks. The Pain Assessment in Advanced Dementia scale was used as the outcome measure.

Results

No significant changes in mean outcome measure scores were found post intervention (Intervention mean?=?5.0?±?3.49; Control mean?=?5.2?±?3.49: t(8)?=?0.09, p?=?0.93). …

Do Patients Undergoing Physical Testing Report Pain Intensity Reliability, Stephen White, Peter Mcnair, Mark Laslett, Wayne Hing

Wayne Hing

Objective To determine the reliability of patient reports of pain intensity during the application of physical tests. Methods A single examiner required participants to use the numeric pain rating scale (NPRS) to report the intensity of pain provoked during physical testing of the hip. Standardized versions of 14 physical tests were used on 18 people with hip pain. Tests were repeated at 1 hour and 2-7 days later. Within- and between-session reliability of reports of pain intensity was calculated using intraclass correlation coefficients (ICCs) and Lin's concordance correlation coefficients (CCCs). Standard errors of measurement (SEMs) were calculated. Results ICC/CCC values …

Defining And Assessing Animal Pain, Lynne U. Sneddon, Robert W. Elwood, Shelley A. Adamo, Matthew C. Leach

Lynne Sneddon, PhD

The detection and assessment of pain in animals is crucial to improving their welfare in a variety of contexts in which humans are ethically or legally bound to do so. Thus clear standards to judge whether pain is likely to occur in any animal species is vital to inform whether to alleviate pain or to drive the refinement of procedures to reduce invasiveness, thereby minimizing pain. We define two key concepts that can be used to evaluate the potential for pain in both invertebrate and vertebrate taxa. First, responses to noxious, potentially painful events should affect neurobiology, physiology and behaviour …

Hydrofiber Dressing With Silver For The Management Of Split-Thickness Donor Sites: A Randomized Evaluation Of Two Protocols Of Care, Sigrid Blome-Eberwein, R Johnson, Sidney Miller, Daniel Caruso, Marion Jordan, Stephen Milner, Edward Tredget, Kevin Sittig, Leslie Smith

Sigrid A Blome-Eberwein MD

BACKGROUND: This randomized, open-label study evaluated Aquacel Ag Hydrofiber dressing with silver (HDS; ConvaTec, Skillman, NJ, USA) with an adherent or gelled protocol in the management of split-thickness donor sites. METHODS: HDS was the primary dressing in the adherent group (gauze as secondary covering) and gelled group (transparent film as secondary covering). Dressings were changed on study day 1 or 2 and study days 5 (optional), 10 (optional), and 14. The primary outcome was healing (>or=90% re-epithelialization) at study day 14. RESULTS: Seventy subjects were treated (36 adherent, 34 gelled). By study day 14, 77% of donor sites had …

Shoulder Pain In Primary Care Part 2: Predictors Of Clinical Outcome To 12 Months, Mark Laslett, Michael Steele, Wayne Hing, Peter Mcnair, Angela Cadogan

Wayne Hing

Objective: Identify predictor variables and models for clinical outcomes for primary care shoulder pain patients to 12 months follow-up. Design: A non-randomized audit with measures of pain and disability at 3 weeks, 3, 6 and 12 months. Patients: Of 208 patients, 161 agreed to participate with 96.9, 98.1, 87.0 and 83.9% follow-up at 3 weeks, 3, 6 and 12 months respectively. Treatment consisted of exercise and manual therapy-based physiotherapy and corticosteroid injection under specified selection criteria. Methods: Potentially useful baseline variables were evaluated in univariate logistic regressions with the dependent variables determined by SPADI Questionnaire at 3 weeks, 3, 6 …

Shoulder Pain Patients In Primary Care Part 1: Clinical Outcomes Over 12 Months Following Standardized Diagnostic Workup, Corticosteroid Injections, And Community Based Care, Mark Laslett, Michael Steele, Wayne Hing, Peter Mcnair, Angela Cadogan

Wayne Hing

Objective: Measure changes in pain and disability of primary care shoulder pain patients over a 12-month period. Design: A non-randomized audit with repeated measures of pain and disability at 3 weeks, 3, 6 and 12 months. Patients: Of 208 patients, 161 agreed to participate with 96.9%, 98.1%, 86.3%, 83.9% follow-up at 3 weeks, at 3, 6 & 12 months, respectively. Mean age was 44 years, mean symptom duration 3.6 months. Methods: Patients were treated with protocol driven corticosteroid injection and community based care. Primary outcome measure was the Shoulder Pain and Disability index (SPADI) questionnaire. Based on the SPADI and …

Resolving Animal Distress And Pain: Principles And Examples Of Good Practice In Various Fields Of Research, Alicia Karas, Matthew C. Leach, Karl A. Andrutis, Kathleen Conlee, John P. Gluck, Andrew N. Rowan, Martin L. Stephens

Andrew N. Rowan, DPhil

Pain and distress are central topics in legislation, regulations, and standards regarding the use of animals in research. However, in practice, pain has received greatly increased attention in recent years, while attention to distress has lagged far behind, especially for distress that is not induced by pain. A contributing factor is that there is less information readily available on distress, including practical information on its recognition, assessment and alleviation.

This chapter attempts to help fill that void by reversing the usual pattern and giving greater attention to distress than to pain. In addition, we also bypass the pain versus distress …

The Minimization Of Research Animal Distress And Pain: Conclusions And Recommendations, Kathleen Conlee, Martin Stephens, Andrew N. Rowan

Andrew N. Rowan, DPhil

While the attention given to preventing, assessing, and alleviating pain in research animals has increased noticeably in recent decades, much remains to be done both in terms of implementing best practices and conducting studies to answer outstanding questions. In contrast, the attention to distress (particularly non-pain induced distress) has shown no comparable increase. There are many reasons for this discrepancy, including the conceptual untidiness of the distress concept, the paucity of pharmacological treatments for distress, and perceived lack of regulatory emphasis on distress. These are challenges that need to be addressed and overcome. This book is intended to help meet …