Carpal Tunnel Syndrome – etiology and diagnostics

The carpal tunnel syndrome (CTS) is one of the most frequent peripheral neuropathies of the upper extremities, caused by increasing pressure in the carpal tunnel or a decrease in its volume, which leads to compression and disturbances in blood supply to the median nerve. This condition significantly affects quality of life, limiting manual dexterity and the ability to perform daily activities. Thus, social needs dictate finding effective treatment methods for CTS

Effect of sonotherapy on symptoms of carpal tunnel syndrome

Ciechanowska Katarzyna, Łukowicz Małgorzata. Effect of sonotherapy on symptoms of carpal tunnel syndrome. Journal of Education, Health and Sport. 2017;7(4):610-621. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.556821 http://ojs.ukw.edu.pl/index.php/johs/article/view/4417 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.04.2017. Revised: 18.03.2017. Accepted: 24.04.2017. Wpływ sonoterapii na objawy zespołu cieśni kanału nadgarstka Effect of sonotherapy on symptoms of carpal tunnel syndrome Katarzyna Ciechanowska1, Małgorzata Łukowicz2 Katedra i Zakład Laseroterapii i Fizjoterapii Collegium Medicum im. Rydygiera w Bydgoszczy Uniwersytet Mikołaja Kopernika w Toruniu Katedra Rehabilitacji, AWF im. Józefa Piłsudskiego Warszawa Streszczenie Wstęp. Zespół cieśni kanału nadgarstka (ZCKN) to jedna z najczęściej występujących neuropatii obwodowych kończyny górnej, która spowodowana jest zwiększeniem ciśnienia w kanale nadgarstka lub zmniejszeniem jego objętości prowadząc do ucisku i zaburzeń ukrwienia nerwu pośrodkowego. Choroba ta w sposób istotny wpływa na jakość życia pacjentów, ograniczając jego możliwości manualne i zdolność do wykonywania czynności życia codziennego. Dlatego szukanie skutecznych metod leczenia tego schorzenia jest związane z potrzebami społecznymi. Głównym celem badań była ocena wpływu oddziaływania terapii falą ultradźwiękową na objawy zespołu cieśni kanału nadgarstka. Materiał i metody. W badaniach wzięli udział 20 pacjentów z rozpoznanym na podstawie badania neurofizjologicznego zespołem cieśni kanału nadgarstka. Pacjentów poddawano zabiegom sonoterapii. Przed i po terapii oceniano dolegliwości bólowe mierzone skalą VAS i zmodyfikowanym kwestionariuszem Laitinena, siłę chwytu bezbolesnego oraz czucie powierzchniowe w zakresie unerwianym przez nerw pośrodkowy. Wykonano również testy prowokacyjne stosowane najczęściej u pacjentów z ZCKN Wyniki i wnioski. Terapia falą ultradźwiękową powoduje wzrost siły chwytu bezbolesnego, zmniejsza dolegliwości bólowe mierzone wzrokowo – analogową skalą VAS i zmodyfikowanym kwestionariuszem Laitinena a także wyraźne polepsza czucia powierzchniowe w zakresie unerwianym przez nerw pośrodkowy wśród chorych z ZCKN. Słowa kluczowe: ZCKN, fizykoterapia, ultradźwięki Summary Admission. Carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies of the upper limb, which is caused by an increase in pressure in the wrist canal or a decrease in its volume leading to compression and mediated nerve endothelial dysfunction. This disease significantly affects the quality of life of patients, limiting its manual capabilities and ability to perform daily activities. Therefore, finding effective treatments for this condition is linked to social needs. The main purpose of the study was to evaluate the influence of ultrasonic wave therapy on the symptoms of carpal tunnel syndrome. Material and methods. Twenty patients with neuropathy diagnosed with carpal tunnel syndrome were included in the study. Patients underwent sonotherapy. Before and after treatment pain scores measured with VAS and modified Laitinen questionnaire, pain grip strength and surface sensation in the midrange area were assessed. Probable tests have also been used most often in patients with CTS Results and conclusions. Ultrasonic wave therapy increases the painless grip strength, reduces visual ailments - analog VAS scale and modified Laitinena questionnaire, and significantly improves surface sensation in the mediated nerve domain of patients with CTS. Keywords: Carpal tunnel syndrome (CTS), physical therapy, ultrasoun

Bitter Sweetness of Malignant Melanoma: Deciphering the Role of Cell Surface Glycosylation in Tumour Progression and Metastasis

Malignant melanoma is the sixth most commonly diagnosed cancer in developed countries. Like in many cancers, survival rates are closely associated with the time of melanoma detection. Regrettably, most cases of melanoma are caught at diffuse state and methods used in clinical practice and experimental trials are not effective. Thus, there is a great interest in discovering biomarkers that could be used for screening those with melanoma, as prognostic and prediction factors as well as new potential targets for melanoma treatment. For this purpose, many groups have examined alteration in the structure and expression of carbohydrate part of glycoconjugates to identify changes that occur with melanoma. The observed changes include increased β1,6 branching correlating with higher abundance of polylactosamine extension, increased sialylation accompanied by differences in the position of sialic acid residues, increased fucosylation, higher levels of T and Tn antigens as well as changes in the expression of ganglioside structures. As a consequence of glycan modification, the loosened matrix adhesion, increased motility, higher invasive potential and metastasis formation have been observed. Growth and migration of melanoma cells have been also found to be stimulated by advanced glycation end products. Biomarker discovery is a multi-step process and the recent glycomic data on melanoma are mostly related to the discovery phase, as the first one leading to validation and standardisation steps

Cadherins and their Role in Malignant Transformation: Implications for Skin Cancer Progression

Cadherins are a large family of Ca2+dependent adhesion proteins. They are transmembrane or closely related to membrane glycoproteins localized in specialized adhesive junction. The expression of various cadherins may be concomitant with cancer progression steps and the term ‘cadherin switch’ has been created due to the observation of down-regulation of E-cadherin (suppressor of metastatic potential) and up-regulation of N-cadherin (promoter of metastatic potential) expression during tumour progression. These changes are thought to be closely related to epithelial-to-mesenchymal transition of cells of many different types of cancer including skin cancers, and accompany the increase of their motility and invasion abilities resulting in the metastasis formation. The cadherin polypeptide is a potential substrate for post-translational modification, for example, N-glycosylation, and its important role in the regulation of cadherin function has been described. The changed glycosylation of cadherins has been described in various skin cancers including melanoma and was consistent with cadherins’ role in epithelial-to-mesenchymal transition. The detailed analysis of cadherin expression and cadherin-related glycosylation changes taking place during malignant transformation could be a key for better understanding of the nature of this process and may open new opportunities for the creation of more effective anticancer therapeutics and diagnostic tools

Analgesic efficacy of APS (Action Potential Simulation). Pilot study of the patients with chronic pain due to musculoskeletal disorders

Background and aims. Pain in musculoskeletal disorders is common medical problem, however frequently difficult to treat. That is why different methods of physical therapies have been tried with the controversial results. APS-therapy (Action Potential Simulation) falls under the broad definition of MET (Microcurrent Electrical Stimulation). MET may be a useful treatment for many pain-related disorders, providing fast relief of symptoms. The aim of this pilot clinical study was to investigate the analgesic efficacy of APS- -therapy in chronic pain due to musculoskeletal disorders. Methods. The study involved 12 patients with musculoskeletal disorders who suffered from chronic pain. Each patient received treatment for 3 weeks’ time. APS-therapy was administered for a period of 16 minutes, 5 times a week. Treatment was given by portable unit, that generated an APS waveform (monophasic, pulse width 800 ms, frequency 150 Hz and intensity 0.5–1.5 mA). NRS (Numerical Rating Scale) evaluation was performed for 3 days of pre-treatment period, before each treatment which reflected the pain situation of the previous 24 h, and once daily for 2 weeks after treatment. Results. The initial mean NRS in pre-treatment period was 5.53 (SD = 1.94), decreased after APS-therapy to 3.45 (SD = 1.4) (p = 0.002) and even more to 2.56 (SD = 1.23) in the post-treatment period (p = 0.0003). Mean pain intensity decreased significantly after 11 sessions and remained on the same level up to 2 weeks of post-treatment observation. Conclusion. APS-therapy may be an effective method of nonpharmacological treatment of chronic pain in muscoskeletal disorders.Background and aims. Pain in musculoskeletal disorders is common medical problem, however frequently difficult to treat. That is why different methods of physical therapies have been tried with the controversial results. APS-therapy (Action Potential Simulation) falls under the broad definition of MET (Microcurrent Electrical Stimulation). MET may be a useful treatment for many pain-related disorders, providing fast relief of symptoms. The aim of this pilot clinical study was to investigate the analgesic efficacy of APS-therapy in chronic pain due to musculoskeletal disorders. Methods. The study involved 12 patients with musculoskeletal disorders who suffered from chronic pain. Each patient received treatment for 3 weeks' time. APS-therapy was administered for a period of 16 minutes, 5 times a week. Treatment was given by portable unit, that generated an APS waveform (monophasic, pulse width 800 ms, frequency 150 Hz and intensity 0.5-1.5 mA). NRS (Numerical Rating Scale) evaluation was performed for 3 days of pre-treatment period, before each treatment which reflected the pain situation of the previous 24 h, and once daily for 2 weeks after treatment. Results. The initial mean NRS in pre-treatment period was 5.53 (SD = 1.94), decreased after APS-therapy to 3.45 (SD = 1.4) (p = 0.002) and even more to 2.56 (SD = 1.23) in the post-treatment period (p = 0.0003). Mean pain intensity decreased significantly after 11 sessions and remained on the same level up to 2 weeks of post-treatment observation. Conclusion. APS-therapy may be an effective method of nonpharmacological treatment of chronic pain in muscoskeletal disorders

Influence of radial shockwave on the mechanical properties of quadriceps femoris muscle fibres of a football player: case study

Radial Shockwave Therapy (RSWT) is a physical procedure often used in sports physiotherapy. Most often, the Radial Shockwave Therapy is used to loosen tight muscle strands, stimulate connective tissue, relax the fascia, treat superficial trigger points, and trigger metabolic changes in muscle fibers. The database of scientific literature lacks reports on the impact of RSWT on the muscular properties of muscles in football players. The purpose of this case report is to assess the impact of RSWT on the mechanical parameters of muscle fibres of quadriceps muscles: (Dm) – displacement of muscle, (Tc) – Time of contraction. RSWT was applied to a healthy football player on the quadriceps muscle of the thigh, finishing the lower right and left. The tensiomyography (TMG) was used to evaluate the mechanical properties of muscles fibres. The tensiomyography (TMG) was performed, followed by radial shockwave therapy (RSWT), second TMG after RSWT procedure and third TMG measurement after 5 hours from the second measurement. The tensiomyography (TMG) detected changes in the parameters of muscle work after the use of RSWT and is a useful tool to assess the impact of physical on muscle work

Evaluation of neurotherapy for a patient with chronic impaired self-awareness and secondary ADHD after severe TBI and long term coma using event-related potentials

We examined the effectiveness of neurotherapy for chronic, impaired self-awareness and secondary ADHD (SADHD) diagnosed in the patient after severe TBI. We hypothesized a good response to relative beta training. Patient A.A., age 30, after severe TBI and long-term coma, suffered from chronic, impaired self-awareness and SADHD, manifesting two years post trauma. Only slight progress was made after behavioral training. The patient took part in a neurotherapy program consisting of 40 sessions of relative beta training. We used standardized neuropsychological testing, as well as ERPs before and after the completion of neurotherapy. At baseline, A.A. showed an excess of relative mu-rhythm, possibly associated with ADHD (alpha subtype); decreased beta generated centrally, indicating hyperactivation of the central medial cortical area and possibly associated with anxiety; and a decreased visual-related component, an indicator of TBI. There was no significant improvement of the P300 NOGO component after the conclusion of the neurotherapy program. However, as hypothesized, she showed improvements in cognitive parameters, especially attention, memory and executive function, including remission of the impaired self-awareness and SADHD. The patient finished her studies and has now started working. A neurofeedback program using relative beta-theta training produced slight physiological changes in our TBI patient, but major cognitive and behavioral changes, including reduced impaired self-awareness and SADHD. ERPs can be used to assess SADHD and functional brain changes induced by neurotherapy, but has limited application for interpreting the brain mechanism of chronic, impaired self-awareness after severe TBI and long term coma

Therapeutic procedures in shoulder impingement syndrome (SIS) for professionally active people: randomized research

Objectives. Pain and limitation of motions in the glenohumeral joint are frequently the consequence of the shoulder impingement syndrome (SIS). Misdiagnosis or improper treatment of the illness may effect in a serious functional impairment of the upper limb. The treatment, dependent on the medical condition, involves: rest, NSAID therapy, physiotherapy as well as kinesitherapeutic procedures. The aim of the research was to conduct a detailed diagnosis of the shoulder impingement syndrome and the efficacy assessment of the matched rehabilitating procedures considering the symptoms.Material and methods. The research was conducted in 39 people aged 30 to 81 treated for SIS. 85% of the respondents were professionally active.In order to assess the efficacy of the therapy the following were carried out: the pain assessment test, functional tests (Neer’s, Ludington’s, Hawkins’, Apley’s, Job’s and the active painful arc test) as well as measurements of the active range of motion of the joint. The patients were subjected to two kinds of physiotherapy – ultrasound therapy (US) procedures and the short wave diathermy (SWD), both connected with procedures aiming at mobilization of the shoulder complex and off-load exercises. The outcome was submitted to statistic analysis. Results. The results obtained in both groups of patients were compared via the Mann-Whitney U test. No significant differences between the SWD and the US groups in the efficacy of the conducted procedures were observed. The data analysis within therapeutic groups revealed the existence of significant differences (p&lt;0,01) before and after the therapy, in the VAS and Laitinen scales as well as in the measurements of the range of motions. Conclusions. The outcome of both conducted therapies in both research groups included: decrease in pain, increase in the range of motions of the glenohumeral joint and improved function of the upper limb. Both procedures may be successfully employed in the treatment of SIS in professionally active people.</p