CONSERVATIVE TREATMENT OF PLANTAR FASCIITIS WITH DORSIFLEXION NIGHT SPLINTS AND MEDIAL ARCH SUPPORTS: A PROSPECTIVE RANDOMIZED STUDY

Background: Plantar fasciitis is an overuse injury causing inflammation at the origin of the plantar fascia and is characterized by plantar heel pain that is provoked by taking the first few steps in the morning and by prolonged standing. Dorsiflexion night splints are used to address early morning pain by preventing contracture of the plantar fascia and Achilles tendon overnight. Medial arch supports, on the other hand, address the end of the day pain by preventing overstretch of the plantar fascia during prolonged weight bearing. Therefore, both night splints and arch supports may be necessary to treat plantar fasciitis as they complement each other by both controlling nocturnal contracture of the plantar fascia and Achilles tendon and reducing stresses imposed on the plantar fascia during the day, respectively. Hypotheses: We hypothesized that the night splint and arch support together would be more effective in the treatment of plantar fasciitis than a night splint or arch support alone in terms of increasing the range of pain-free passive ankle dorsiflexion, relieving heel tenderness and pain, and reducing disability imposed by the heel pain/plantar fasciitis. A secondary hypothesis of this study was that those with less passive dorsiflexion of the ankle would benefit from a night splint more than those with greater passive dorsiflexion of the ankle and those with a lower medial longitudinal arch would benefit from an arch support more than those with a higher medial longitudinal arch in terms of the previously mentioned outcome measures. Methodology: Subjects of this study were randomly assigned to one of three treatment groups. Group I was treated with night splints, group II with arch supports, and group III with a combination of night splints and arch supports. Range of motion was measured with a goniometer; heel tenderness was measured with a pressure algometer; and pain and disability were measured by the Foot Function Index before and after six weeks of treatment. Results: Ninety patients with plantar fasciitis (23 men and 67 women) were enrolled in the study, 30 in each group. Demographic, compliance and baseline evaluation data showed no significant differences between the groups. Analysis of the post-intervention evaluation data demonstrated significant differences between group I and III and group II and III, but not between group I and II, for all outcome measures. The range of pain-free passive ankle joint dorsiflexion and medial longitudinal arch height were not useful predictors of the success of treatment with a night splint and arch support for all outcome measures. Discussion: Using night splints and arch supports together may speed time to recovery by accelerating the healing process. Limitations of the study include observer's bias, subjects' bias, and short follow-up period. Conclusion: It was concluded that a night splint and arch support together may be more effective in the treatment of plantar fasciitis than either a night splint or arch support alone. Patients with plantar fasciitis who have less passive dorsiflexion of the ankle joint do not benefit from a night splint more than those with greater passive dorsiflexion of the ankle joint. Patients with plantar fasciitis who have a lower medial longitudinal arch do not benefit from an arch support more than those with a higher medial longitudinal arch

Pain Management in Knee Osteoarthritis

Osteoarthritis (OA) of the knee is the commonest degenerative joint disease affecting older adults. Risk factors for the knee OA includes female gender, advanced age, overweight, obesity, previous knee injuries, previous knee surgery, and certain jobs that require continuous knee bending. Pain is the major symptom of knee OA and increased pain causes reduced physical function and poor quality of life. In addition to pain, patients may have joint stiffness, knee extensor muscle weakness, and altered proprioception. A multitude of structural, physical, and psychosocial factors influences symptom and severity of pain in knee OA. Rehabilitation of knee OA aims to train the patients in coping strategies, improves physical health, quality of life, and maintains their independence in daily livings. Management of knee OA often requires a combination of pharmacologic and nonpharmacologic treatment approaches

Prevalence of Musculoskeletal Pain in Construction Workers in Saudi Arabia

The objective of this study was to find out the prevalence, characteristics, and distribution of musculoskeletal pain among construction workers in Saudi Arabia. A questionnaire about musculoskeletal pain in different parts of the body was completed by 165 construction workers from the construction industries in Dammam and Riyadh cities. The descriptive data were analyzed using chi-square test. The level of statistical significance was set at P<0.05. Eighty (48.5%) of the responding workers had pain in neck, shoulders, lower back, hand, knee, or ankle. The majority of respondents had low back pain (50%) followed by knee pain (20%). The average intensity of pain at all sites during activity and rest was 6.65 and 3.59, respectively. Thirty-four (42.5%) respondents had dull aching pain and 24 (30%) had cramping pain. There was an association between years of experience, duration of break during work, and use of protective equipment with the prevalence of musculoskeletal pain in construction workers (P<0.05). Most of the workers complaining of pain got medical treatment (62.5%) and only 25% received physical therapy. It can be concluded from this study that the prevalence of musculoskeletal pain among construction workers in Saudi Arabia is high

Psychometric analysis of the perceived stress scale among healthy university students

© 2020 Anwer et al. Background: There is a gradual increase in the prevalence of stress during professional courses. Previous studies reported a high incidence of stress among university students. The psychometric properties of the perceived stress scale-10 (PSS-10) have been established in different populations. The current study aimed to assess psychometric properties of the PSS10 in Saudi university students. Methods: Healthy university students (n= 192) participated in this cross-sectional study. All the participants were explained about the aim and procedures of the study. Participants were requested to complete the English version of the PSS, the generalized anxiety disorder-7 (GAD-7), the sleep hygiene index (SHI), and demographic details. Results: The range of the PSS-10 total score was 0–35; 1% reported minimum score of 0, but none reported maximum score of 40. Therefore, there was no issue of ceiling or floor effect in the PSS-10 total score. Positive and significant correlations of the PSS total and the PSS Factor-1 (distress perception) with the GAD-7 total score, SHI item-8 and SHI item-13 score support its convergent validity. Negative or no correlation of the PSS Factor-2 score (coping perception) with the GAD-7 total score, SHI item-8 and SHI item-13 scores demonstrate its divergent validity. The internal homogeneity test indicated moderate to strong positive correlations (r=0.60–0.82) between the PSS Factors and the items loading on them. The internal consistency test showed a good agreement for the PSS Factor-1 and the PSS Factor-2 scores (Cronbach’s alpha 0.78 and 0.71, respectively), suggesting an acceptable level of consistency. Factor analysis favored a 2-Factor model of the PSS in the Saudi students. Conclusion: The current study supported the use of the PSS-10 to assess the perceived stress among Saudi university students

Beliefs and attitudes of paramedical college staff towards complementary and alternate medicine

Background: Complementary and alternate medicine (CAM) has been defined as a group of diverse medical and healthcare systems, practices, and products not presently considered part of conventional medicine (CM). Studies in different countries have revealed a geographical difference in the knowledge about CAM therapies, especially among medical school staff and students. This study aimed to assess the extent of CAM use among staff working in paramedical colleges in the Riyadh region of Saudi Arabia and to examine their perception and attitudes towards such medicines.Materials and methods: Eighty paramedical staff members of different age groups and specializations were invited to participate in the study. A self-administered questionnaire adapted from similar studies was used in this study.Results: The response rate was 99%. The majority of respondents (56%) reported believing that CAM therapies play an important complementary role to the action of CM.Conclusion: To the best of the authors’ knowledge, this is the first study of its kind to assess peoples’ attitudes towards CAM use in the region. As the use of healing practices outside of CM rise among patients, ignorance of CAM by future medical practitioners can cause a communication gap between people and the profession that serves them. It is encouraging that the majority of medical staff in this study recognizes and is enthusiastic to rectify this lack of knowledge.Keywords: Complementary and alternate medicine, paramedical staffs, attitude, perception, belief

Effect of posture on swallowing.

Background: Swallowing is a systematic process. Any structural, physiological or neurological disturbance in this process may cause dysphagia. Although there are studies that report head/neck movements during mastication, there are fewer studies that show the effect of different head/neck postures on difficulty while swallowing. Objectives: To observe the effect of different body postures on the self-perceived difficulty while swallowing in normal healthy subjects. Methods: Participants were asked to swallow 25 ml of water in one go while sitting upright, sitting with head/neck flexed, head/ neck extended and lying supine. Following this, they had to rate their self-perceived difficulty while swallowing on a scale of 0-10, 0 being most easy and 10 being most difficult. Results: 186 subjects with mean age 32.7 SD 9.04 participated in this study. It was found to be least difficult to swallow when subjects were asked to swallow in upright sitting position. Statistically significant differences were found between sitting upright, sitting with head/neck flexed, head/neck extended and lying supine. Conclusion: Postural modification may help in rehabilitation of patients with dysphagia by affecting bolus flow to improve speed and safety of swallowing by closure of airways to prevent aspiration

BELIEFS AND ATTITUDES OF PARAMEDICAL COLLEGE STAFF TOWARDS COMPLEMENTARY AND ALTERNATE MEDICINE

Background: Complementary and alternate medicine (CAM) has been defined as a group of diverse medical and healthcare systems, practices, and products not presently considered part of conventional medicine (CM). Studies in different countries have revealed a geographical difference in the knowledge about CAM therapies, especially among medical school staff and students. This study aimed to assess the extent of CAM use among staff working in paramedical colleges in the Riyadh region of Saudi Arabia and to examine their perception and attitudes towards such medicines. Materials and methods: Eighty paramedical staff members of different age groups and specializations were invited to participate in the study. A self-administered questionnaire adapted from similar studies was used in this study. Results: The response rate was 99%. The majority of respondents (56%) reported believing that CAM therapies play an important complementary role to the action of CM. Conclusion: To the best of the authors’ knowledge, this is the first study of its kind to assess peoples’ attitudes towards CAM use in the region. As the use of healing practices outside of CM rise among patients, ignorance of CAM by future medical practitioners can cause a communication gap between people and the profession that serves them. It is encouraging that the majority of medical staff in this study recognizes and is enthusiastic to rectify this lack of knowledg