Combination treatment of physical modalities in the treatment of musculoskeletal pain syndromes: a prospective-controlled study

The aim of the study was to evaluate the effect of combinations of several physical therapies in the treatment of musculoskeletal pain syndromes by a prospective, controlled study. Forty patients (5 men and 35 women, 18-80 years) with musculoskeletal pain syndrome were included. Thirty patients were assigned to the intervention group and 10 patients to the control group. The intervention group received a combination of physical therapies according to the clinical needs (electrotherapy, fango packs, mud packs, ultrasound, massage, exercise therapy). Treatment consisted of 10 sessions. The control group did not receive any physical therapy in the waiting period. The intervention group was examined at the beginning and the end of the treatment period. The control group was evaluated at the beginning and the end of the waiting period (before their physical therapy treatment started). Main outcome measurements were: Visual analogue scale for pain (VAS); Timed Get up and Go Test (TUG); Functional Reach Test (FRT). In addition bodily, emotional and social functioning was accessed by selected ICF-Items and items of the SF-36 health survey (SF-36). The main outcome measures showed significant improvement in the intervention group compared to the control group. Furthermore, ICF- and SF-36-Items also improved. In conclusion significant pain relief and improvement of function was achieved by a combination treatment of physical therapies in patients with musculoskeletal pain syndromes

ICF Core Sets for Depression

Objective: To report on the results of the consensus process integrating evidence from preliminary studies to develop the first version of a Comprehensive ICF Core Set and a Brief ICF Core Set for depression.Methods: A formal decision-making and consensus process integrating evidence gathered from preliminary studies was followed. Preliminary studies included a Delphi exercise, a systematic review and an empirical data collection. After receiving training in the ICF and based on these preliminary studies, relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds.Results: The preliminary studies identified a set of 323 ICF categories at the second, third and fourth ICF levels with 163 categories on body functions, 22 on body structures, 91 on activities and participation and 47 on environmental factors. Twenty experts attended the consensus conference on depression. Altogether 121 categories (89 second-level and 32 third-level categories) were included in the Comprehensive ICF Core Set with 45 categories from the component body functions, 48 from activities and participation and 28 from environmental factors. The Brief ICF Core Set included a total of 31 categories with 9 on body functions, 12 on activities and participation and 10 on environmental factors.Conclusion: A formal consensus process integrating evidence and expert opinion based on the ICF framework and classification led to the definition of ICF Core Sets for depression. Both the Comprehensive ICF Core Set and the Brief ICF Core Set were defined

Rheumatoid arthritis in remission : Decreased myostatin and increased serum levels of periostin

Background Chronic inflammation of rheumatoid arthritis (RA) is associated with disturbances in muscle and bone metabolism. Aim The purpose of this study was to investigate whether endocrine regulators of myogenesis and bone metabolism in patients with rheumatoid arthritis (RA) in remission differed from unaffected healthy controls. An additional point was whether these were associated with patients health-related functioning or particular bodily functions of the International Classification of Functioning, Disability and Health (ICF). Methods Bone turnover and the markers for muscle, i.e. myostatin (MSTN), follistatin (FSTN), growth differentiation factor (GDF-15) and for bone, i.e. sclerostin (SOST), dickkopf 1 (Dkk1), periostin (PSTN) metabolism were determined in 24 female RA patients and matched healthy controls. The chair rising test (CRT), timed up and go test (TUG), 6min walking test, maximum hand grip and back extensor strength tests were used to assess patients health-related functions. Additionally, bone mineral density of the lumbar spine and the hip region was measured. Results For the bone turnover markers no differences were observed between patients and controls. In contrast, the markers MSTN and Dkk1 were significantly lower and FSTN and PSTN significantly higher in patients than controls. Patients performed worse in the CRT and TUG. Some correlations reflected associations between these endocrine factors and physical function. Conclusion Anti-inflammatory therapy may be responsible for the positive effect on endocrine factors influencing myogenesis. Elevation of PSTN probably reflects the increased risk of fragility fractures in RA patients.(VLID)365221