The influence of magnethotherapy on blood pressure in patients with and without arterial hypertension treated for lumbar back pain syndrome

Wstęp. Wśród metod fizjoterapii stosowanych w zespołach bólowych kręgosłupa znajduje się magnetoterapia. Wielu spośród pacjentów z zespołem bólowym kręgosłupa cierpi na nadciśnienie tętnicze (NT). Wpływ pola magnetycznego (PM) na ciśnienie tętnicze krwi (RR) jest nie do końca poznany i często budzi obawy przed stosowaniem tego rodzaju terapii u pacjentów z nadciśnieniem tętniczym. Celem pracy jest ocena wpływu zabiegów magnetoterapii stosowanej w zespołach bólowych kręgosłupa lędźwiowo-krzyżowego na wartości ciśnienia tętniczego i tętna u pacjentów z rozpoznanym i leczonym nadciśnieniem tętniczym (NT) oraz u chorych bez NT. Materiał i metody. Do badania zakwalifikowano 60 chorych z zespołem bólowym kręgosłupa lędźwiowo-krzyżowego, których podzielono na 2 grupy w zależności od współistnienia NT. U wszystkich pacjentów wykonywano zabiegipolem magnetycznym o następujących parametrach: indukcja magnetyczna 9 mT, częstotliwość zmian natężenia pola magnetycznego 40 Hz, czas impulsu 0,5 s, kształt pola prostokątny. U każdego pacjenta wykonywano czterokrotnie pomiar RR oraz tętna: przed, w połowie czasu, po, oraz 10 min. po wykonanym zabiegu. Wyniki. W grupie 1 obserwowano wyższe wartości RR przed, w trakcie i po zabiegu. Stwierdzono istotne zmniejszenie RR i zwolnienie tętna w trakcie zabiegów magnetoterapii w obu grupach. Nie zaobserwowano trwałych zmian RR po 10 zabiegach magnetoterapii. Wnioski. 1. W trakcie zabiegów magnetoterapii dochodzi do istotnego spadku RR skurczowego i tętna u chorych z NT i bez NT. 2. Ciśnienie rozkurczowe w trakcie zabiegów magnetoterapii ulega obniżeniu u chorych z NT i bez NT. 3. Obniżenie skurczowego ciśnienia tętniczego i tętna podczas zabiegu magnetoterapii utrzymuje się po 10 minutach od zakończenia zabiegu w grupie chorych z NT. 4. Magnetoterapia powoduje istotne podwyższenie ciśnienia rozkurczowego krwi po 10 minutach od zakończenia zabiegu w grupie z NT i bez NT. Długość trwania takiego efektu wymaga jednak potwierdzenia w kolejnych badaniach.Background: Magnetotherapy is one of the methods applied in the treatment of back pain syndromes. Many patients with back pain syndromes suffer from arterial hypertension (AH). The influence of magnetic fields (MF) on blood pressure is not clearly recognized and its application in patients with arterial hypertension causes some concern. The aim of the study was to assess the influence of magnetotherapy applied in patients with lumbar and sacral back pain syndromes on blood pressure and pulse rate in patients diagnosed with arterial hypertension and treated for it and those without hypertension. Materials and methods: 60 patients (pts) with lumbar and sacral back pain syndromes were included in the study. The patients were divided into 2 groups depending on the coexistence of hypertension. Magnetic fields procedures(magnetic induction 9 mT, frequency 40 Hz, impulse time – 0,5 s, impulse shape - rectangular) were performed in every patient. Blood pressure and pulse rate were measured 4 times in every patient: before, half time, after and 10 minutes after the procedure was completed. Results: Higher blood pressure measurements before, during and after the procedure were observed in group 1. Significant blood pressure and pulse rate decrease during magnetotherapy procedures was observed in both groups. Reduction of blood pressure was not observed after 10 procedures. Conclusions: 1. In the course of magnetotherapy procedure a significant decrease in systolic BP and pulse is observed in patients with hypertension and without AH. 2. Diastolic blood pressure is reduced during magnetotherapy in patients with hypertension and without AH. 3. The reduction in systolic BP and pulse lasts up to 10 minutes after the end of magnetotherapy procedure in patients with hypertension. 4. Magnetic field causes a significant increase in diastolic BP 10 minutes after the end of the procedure in the group with AH and without AH. The duration of this effect, however, requires confirmation in further studies

Diagnostic guidlines for occupational epicondylitis

Making final decisions on the occupational etiology of musculoskeletal diseases is often difficult and problematic at every stage of the diagnostic procedure. Taking into account the need to facilitate decision-making about the causal relationship between the diagnosed disease entity and the working conditions guidelines for the recognition of work-related musculoskeletal diseases have been developed. This paper presents the guidelines for the diagnosis of occupational etiology of humeral epicondylitis, one of the most common occupational disease of the musculoskeletal system in Poland. The developed guidelines have been based on the literature data concerning occupational risk factors of humeral epicondylitis, workload classification, including repetitive movements, awkward postures, and force. Some criteria applied in ergonomic evaluation methods were also included. The presented diagnostic guidelines define approximate benchmarks for stating (after excluding non-occupational etiology) that the identified humeral epicondylitis, is related to the way of working. Crucial work factors that should be analyzed include an operating time of movements overloading tendons connecting to the epicondyle, repetition and force used to perform occupational activities. The developed guidelines are aimed to facilitate occupational physicians diagnostic and certification procedures in case of humeral epicondylitis and determination whether there is a likelihood of its occupational etiology. Med Pr 2015;66(3):443–45

Clinical replicability of rehabilitation interventions in randomized controlled trials reported in main journals is inadequate

Objective: The objective of this study was to study if randomized controlled trials (RCTs) in rehabilitation (a field where complex interventions prevail) published in main journals include all the details needed to replicate the intervention in clinical practice (clinical replicability). Study Design and Setting: Forty-seven rehabilitation clinicians of 5 professions from 7 teams (Belgium, Italy, Malaysia, Pakistan, Poland, Puerto Rico, the USA) reviewed 76 RCTs published by main rehabilitation journals exploring 14 domains chosen through consensus and piloting. Results: The response rate was 99%. Inter-rater agreement was moderate/good. All clinicians considered unanimously 12 (16%) RCTs clinically replicable and none not replicable. At least one “absent” information was found by all participants in 60 RCTs (79%), and by a minimum of 85% in the remaining 16 (21%). Information considered to be less well described (8–19% “perfect” information) included two providers (skills, experience) and two delivery (cautions, relationships) items. The best described (50–79% “perfect”) were the classic methodological items included in CONSORT (descending order: participants, materials, procedures, setting, and intervention). Conclusion: Clinical replicability must be considered in RCTs reporting, particularly for complex interventions. Classical methodological checklists such as CONSORT are not enough, and also Template for Intervention Description and Clinical replication do not cover all the requirements. This study supports the need for field-specific checklists. © 2019 Elsevier Inc

Clinical replicability of rehabilitation interventions in randomized controlled trials reported in main journals is inadequate

OBJECTIVE: The objective of this study was to study if randomized controlled trials (RCTs) in rehabilitation (a field where complex interventions prevail) published in main journals include all the details needed to replicate the intervention in clinical practice (clinical replicability). STUDY DESIGN AND SETTING: Forty-seven rehabilitation clinicians of 5 professions from 7 teams (Belgium, Italy, Malaysia, Pakistan, Poland, Puerto Rico, the USA) reviewed 76 RCTs published by main rehabilitation journals exploring 14 domains chosen through consensus and piloting. RESULTS: The response rate was 99%. Inter-rater agreement was moderate/good. All clinicians considered unanimously 12 (16%) RCTs clinically replicable and none not replicable. At least one "absent" information was found by all participants in 60 RCTs (79%), and by a minimum of 85% in the remaining 16 (21%). Information considered to be less well described (8-19% "perfect" information) included two providers (skills, experience) and two delivery (cautions, relationships) items. The best described (50-79% "perfect") were the classic methodological items included in CONSORT (descending order: participants, materials, procedures, setting, and intervention). CONCLUSION: Clinical replicability must be considered in RCTs reporting, particularly for complex interventions. Classical methodological checklists such as CONSORT are not enough, and also Template for Intervention Description and Clinical replication do not cover all the requirements. This study supports the need for field-specific checklists.status: publishe