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عضویت

جستجوی مقالات مرتبط با کلیدواژه « conservative treatments » در نشریات گروه « پزشکی »

  • Vahid Mazloum, Hadi Akbari*
    Introduction

    High prevalence of knee osteoarthritis (OA) in Iran and the subsequent disability have resulted in representing multifarious non-aggressive interventions with distinct influences on the disease. The aim of this study was to review previous domestic studies about the effects of conservative therapeutic options on patients with knee OA.

    Materials and Methods

    Using search engines involving IranMedex, MedLib, ISC, Google Scholar, Magiran, SID, rehabilitation, and medical journals based on defined keywords, 98 Persian language articles were found, and 37 studies were finally included in our study after applying the exclusion criteria. The type of study, the pattern of choosing subjects, patient information, the measurements, interventions, and the results were exploited from each article, and the physiotherapy evidence database (PEDro) scale was administrated to evaluate the studies.

    Results

    Based on analysis of PEDro scale results (Mean±SD for articles score: 5.89±1.29), the quality of most articles was as fair and good. The focus of conservative treatments was on exercise therapy methods, assistive devices, and physical therapy management. From a clinical perspective, the evidence indicates the appropriate effects of such treatment choices on alleviating pain, enhancing function, and improving quality of life in individuals with knee OA.

    Conclusion

    Most conservative methods can reduce pain, and improve quality of life and physical performance in patients with knee OA. However, further high-quality studies with larger sample sizes and long-term follow-ups are required to determine whether knee OA can be managed by conservative methods.

    Keywords: Knee osteoarthritis, Conservative treatments, Exercise therapy, Physicaltherapy, Pain, Function}
  • Seyed Shahab Ghazimirsaeid, Alireza Sadeghi *, Mohammadreza Boustani, Reza Gerami
    Background

     Modic changes (MC) are among the pain generators in the lumbar spine and could affect back pain treatments.

    Objectives

     The current study aimed to investigate the effect of MC on the treatment outcomes of low back pain (LBP) patients who underwent conservative treatments.

    Methods

     This prospective cohort study was performed on 166 nonspecific LBP patients presenting to 501 Hospital receiving conservative treatments. The patients were categorized based on their MC status, which was determined using a magnetic resonance imaging scan at baseline. Japanese Orthopedic Association (JOA) score was considered a measure of back pain and disability using a valid and reliable questionnaire for each participant. The data were collected on the age, gender, and duration of pain for each participant. The follow-up JOA score was also calculated for each patient after 6-month conservative treatments. The patient was considered improved if the JOA change score was higher than 0.

    Results

     The average baseline JOA score in MC patients was 14.3 (2.2); however, it was 14.4 (2.0) in patients without MC (P = 0.750). After 6-month conservative treatments, the average JOA score reached 16.7 (3.4) and 17.1 (2.9) in patients with and without MC, respectively. No statistically significant difference was observed in this regard (P = 0.540). The proportion of improved cases was 70.7%, 82.8%, 63.4%, and 50.0% in no MC, MC type I, MC type II, and MC type III, respectively, with no statistically significant difference among the groups (P = 0.561).

    Conclusions

     A 6-month conservative treatment was a safe and effective approach to improving the clinical condition of patients with LBP. However, there was no association between the presence of MC or any specific type of MC and treatment outcomes.

    Keywords: Diagnostic Imaging, Conservative Treatments, Low Back Pain, Outcome Assessment}
  • طناز احدی، نیما خواجه، بیژن فروغ، لبانه جانبازی، معصومه باقرزاده چم*
    زمینه و هدف

    مداخلات محافظه کارانه زیادی برای کاهش علایم کوکسیدینیا وجود دارد که هر کدام تا اندازه ای درد بیماران مبتلا را کاهش می دهد، اما مشخص نیست که کدام درمان می تواند موثرتر باشد. هدف از این مطالعه مروری بررسی انواع مداخلات محافظه کارانه و اثربخشی هر یک از آنها در کاهش علایم کوکسیدینیا می باشد.

    روش بررسی

    جستجو برای مطالعات تحقیقاتی منتشر شده تا اکتبر 2021 با استفاده از Scopus، Science Direct، Web of Knowledge و Cochrane بدون محدودیت داده انجام شد. کیفیت مقالات با استفاده از Physiotherapy evidence database scale (PEDro) مورد ارزیابی قرار گرفت.

    یافته ها

    در نهایت 12 مقاله وارد مطالعه مروری شدند. دو مقاله از شوک ویو برون اندامی، دو مقاله از بلوک گانگلیون ایمپار، سه مقاله از درمان های دستی و چهار مطالعه از تزریق استفاده کردند. چهار مطالعه باقی مانده از یونتوفورز با کتوپروفن، درمان بیوفیدبک، طب سوزنی و فیزیوتراپی همراه کینزیوتیپینگ استفاده کردند.

    نتیجه گیری

    درمان با شوک ویو برون اندامی و بلوک گانگلیون ایمپار به طور قابل توجهی درد دنبالچه را بهبود می بخشد و اثرات دایمی تری را در علایم بیماران نشان می دهد. درمان های دستی بیشتر در مواردی که دنبالچه پایدار است کاربرد دارد. به نظر می رسد که رسیدن به پاسخ مطلوب به بیش از شش جلسه نیاز دارد که برای بیماران خوشایند نیست. تزریق ها، به ویژه آنهایی که تحت هدایت فلوروسکوپی انجام می شوند، افزون بر ناخوشایند و دردناک بودن، نیاز به مهارت بالایی دارند. با این حال، این روش در یک جلسه انجام شده، بنابراین نیازی به مراجعه بعدی ندارد.

    کلید واژگان: دنبالچه, درد, درمان های محافظه کارانه, شاک ویوتراپی برون بدنی, تزریقات, درمان های دستی اسکلتی عضلانی}
    Tannaz Ahadi, Nima Khaje, Bijan Forogh, Labaneh Janbazi, Masumeh Bagherzadehcham*
    Background

    There are many conservative interventions to reduce the symptoms of coccydynia, but it is not clear which treatment can be more effective. The aim of this review study was to evaluate the types of conservative interventions and the effectiveness of each of them in reducing coccydynia symptoms.

    Methods

    This systematic review was carried out based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) instruction. A search for research studies published up to October 2021 was conducted in Neuromusculoskeletal Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran, using Scopus, Science Direct, Web of Knowledge and Cochrane without data constraints. The search was carried out in October 2021 and continued for seven months. The quality of the articles was evaluated using the Physiotherapy Evidence Database scale (PEDro). All prospective randomized clinical trial studies in which participants suffered from coccydynia  and were treated with nonsurgical treatments  were included.

    Results

    945 articles were found in the primary search of the databases. After eliminating 493 repetitive papers, 452 studies remained which were screened by the two researchers of this study in terms of the title and abstract. 40 studies were selected for full-text evaluation. Finally, 12 articles were included in the review study. Two papers used extracorporeal shockwave, two papers used impar ganglion block, three papers manual therapy, and four studies injection. The remaining four studies used iontophoresis with ketoprofen, biofeedback therapy, acupuncture, and physiotherapy with Kinesio taping.

    Conclusion

    Treatment with extracorporeal shock wave and impar ganglion block significantly improve tailbone pain and show more permanent effects on patients' symptoms. Manual therapies are mostly used in cases where the tailbone is stable. It seems that achieving the desired response requires more than six sessions, which is not pleasant for patients. Injections, especially those performed under fluoroscopic guidance, require high skill in addition to being unpleasant and painful. However, this procedure is done in one session, so there is no need for the next visit.

    Keywords: coccyx, pain, conservative treatments, extracorporeal shockwave therapy, injections, musculoskeletal manipulations}
  • هدیه رضی کاظمی، منیره احمدی بنی*، هانیه پژومان
    زمینه و هدف

    درمان های محافظه کارانه آرنج تنیس بازان مجموعه ای از روش های غیرجراحی هستند که برای درمان التهاب اپی کندیل خارجی استخوان بازوی افراد مبتلا به سندرم آرنج تنیس بازان از آن ها استفاده می شود. هدف از این مقاله تعیین اثرات درمان های محافظه کارانه بر شاخص های درد، عملکرد و قدرت مشت کردن افراد مبتلا به سندرم آرنج تنیس بازان بود.

    مواد و روش ها:

     در این مرور نظام مند مبتنی بر شواهد، از فرآیند PICO (Patient,Intervention,Comprison,Outcome) استفاده شد. پایگاه های اطلاعاتی PubMed، ISI web of knowledge و Scopus در بازه زمانی سال های 2000 تا 2017 به صورت پیشرفته مورد جستجو قرار گرفتند. مقالاتی که واجد معیارهای ورود بودند مورد مطالعه و مداخله قرار گرفتند.

    یافته ها:

     از میان 76 مقاله اولیه بازیابی شده، 18 مقاله معیارهای ورود به مطالعه را دارا بودند که از میان آن ها 15 مقاله در گروه فیزیوتراپی و سه مقاله در گروه اسپیلنت قرار داشتند. از بین این مطالعات چهار مقاله مربوط به اثر درمانی لیزر، چهار مطالعه مربوط به شاک ویودرمانی، دو مطالعه مربوط به آکوپانچر، سه مطالعه مربوط به مدالیته های ترکیبی و سه مقاله مربوط به بریس (Brace) بودند. هم چنین در یک مطالعه، اثر تنس (TENS؛Transcutanous electrical nerve stimulation) و در مطالعه دیگر، اثر تکنیک های بانداژ بررسی شده بود.

    نتیجه گیری: 

    انواع مدالیته های درمانی با مکانیزم های عملکردی متفاوت برای درمان افراد مبتلا به سندرم آرنج تنیس بازان موثر است و مداخلات ترکیبی نسبت به تک مداخلات ارجحیت دارد. هم چنین ارجحیت یک نوع مداخله خاص به طور قطعی بر مداخله دیگر گزارش نشده است و عوارض جانبی خاصی در خصوص مدالیته ها نیز بیان نشده است.

    کلید واژگان: درمان های محافظه کارانه, درد, عملکرد, قدرت مشت کردن, سندرم آرنج تنیس بازان, التهاب اپی کندیلیت خارجی آرنج}
    H. Razi Kazemi, M. Ahmadi Bani*, H. Pazhooman
    Background and Objectives

    Conservative treatments for patients with tennis elbow syndrome include a set of nonsurgical methods to cure the inflammation of lateral epicondyle of humerus. The purpose of this article was to evaluate the effects of conservative treatments on pain, function and grip strength among patients with tennis elbow syndrome.

    Materials and Methods

    In an evidence-based systematic review and according to PICO (Patient, Intervention, Comparision, Out come) method, scientific databases including PubMed, ISI Web of Science and Scopus were searched for articles published during 2000 to 2017. Then titles and abstracts of the retrieved articles were reviewed and intervened according to the including criteria.

    Results

    Among 76 preliminary articles, 18 articles had the including criteria. 15 articles included physiotherapy methods and 3 articles included splints. 4 articles were about laser, 4 articles about shockwave therapy, 2 articles about acupuncture, 3 articles about combined conservative treatment methods, 3 articles about braces, 1 article was about transcutaneous electrical nerve stimulation (TENS) and 1 article about taping.

    Conclusion

    All treatment modalities are effective to cure tennis elbow. Combined methods are more preferable in comparison with single method treatments. There is no report of definite preference among different treatments. There were no mentions of side effects in any of the articles.

    Keywords: Conservative treatments, Pain, Function, Grip strength, Tennis elbow syndrome, Lateral epicondylitis of elbow}
  • Hormoz Zahiri, Christopher Zahiri, Mansour Eghbali*
    Background
    Idiopathic osteoarthritis of the trapeziometacarpal (TMC) joint is common. Spontaneous attenuation of either the anterior oblique ligament (Beak ligament) or the dorsoradial ligament has been reported as the cause of the joint laxity, resulting in subsequent wear and tear of the articular cartilages. So far, no cause has been reported for the spontaneous attenuation of these key supporting ligaments of the TMC joint and no effective method of prevention or treatment has been reported for the early stages of the condition.
    Objectives
    The authors reported a conservative method for the prevention as well as reversal of the early stages of the joint instability before the process of wear and tear sets in and the condition progresses towards osteoarthritis.
    Materials And Methods
    A retrospective study was performed on 17 patients with early stages of idiopathic TMC joint osteoarthritis. The patients were treated through a conservative management protocol with an average follow-up of 28.4 months. The protocol consisted of performing specifically devised isometric exercises and a functional abduction brace.
    Results
    The result of the conservative treatment was postural correction of the thumb, anatomical stability of the TMC joint and resolution of the symptoms as well as findings including pain, swelling and joint dorsoradial translation. The mean pain score of the patients was 3.6 before the treatment was begun and was zero after the treatment was completed.
    Conclusions
    The presented conservative method is recommended for either prevention or reversal of the early stages of TMC joint instability before the osteoarthritic changes set in.
    Keywords: Trapeziometacarpal Joint, Osteoarthritis, Conservative Treatments, Prevention}
  • سیما کدخدایان، گلرخ شرافتی*
    زمینه و هدف
    سرویکس محل نادر و خطرناکی برای حاملگی نابجاست. وقتی محل چسبندگی جفت پایین تر از سوراخ داخل سرویکس باشد، حاملگی سرویکال باید تلقی کرد. از درمان های محافظه کارانه استفاده از متوترکسات و کلریدپتاسیم، گلوکز هیپراسمولار و پروستاگلاندین است. همچنین درمان های جراحی با حفظ باروری مطرح شده است. هدف از این مطالعه گزارش دو بیمار با حاملگی سرویکال و درمان محافظه کارانه با حفظ باروری بود.
    معرفی بیمار: بیمار اول با حاملگی شش هفته سرویکال و جنین دارای ضربان قلب معرفی می شود که پس از تجویز دو دوز متوترکسات حاملگی به طور کامل از بین رفته است. بیمار دوم با حاملگی هشت هفته سرویکال دارای ضربان قلب به ما مراجعه نمود. سه روز پس از تجویز دو دوز متوترکسات، کورتاژ ناحیه اندوسرویکس انجام و حاملگی ختم شد.
    نتیجه گیری
    از روش های محافظه کارانه برای درمان حاملگی سرویکال در بیمارانی که تمایل به حفظ قدرت باروری دارند می توان استفاده کرد که با موفقیت بالایی همراه است.
    کلید واژگان: حاملگی سرویکال, درمان محافظه کارانه, متوترکسات در حاملگی خارج از رحم}
    Sima Kadkhodayan, Golrokh Sherafati *
    Background
    Cervix is a rare and dangerous site for ectopic pregnancy. When the placenta is implanted lower than internal cervical os, it is called “cervical pregnancy”. Known risk factors for cervical pregnancy are previous cesarean section, cigarette smoking, premature transfer of fertilized ovum before having suitable endometrium and pelvic inflammatory disease. In the past, hysterectomy was the usual treatment. Nowadays, with the newer diagnostic and therapeutic managements, cases of cervical pregnancy treated by fertility sparing methods have been reported. Conservative treatments include using methotrexate and KCl, hyperosmolar glucose, and prostaglandins. Also, surgical methods with fertility sparing have been reported. The purpose of this study is introducing two cases of cervical pregnancies treated by fertility sparing.
    Case Presentation
    The first patient had six weeks pregnancy with live fetus and detectable fetal heart beat. There was six weeks menstrual retard and βhCG titer was 10.000 UI/ml. Two doses of methotrexate were prescribed and pregnancy terminated successfully. The other patient had eight weeks pregnancy with fetal heart beat. There was eight weeks retardation and βhCG titer was 70379 UI/ml with no gestational sac in sonography in both patients. After prescribing two doses of methotrexate and doing curettage three days after the last dose of methotrexate, pregnancy terminated. The known risk factors for our patients were history of endometrial curettage in one and history of cesarean section in both of them.
    Conclusion
    Conservative method may be considered for the treatment of cervical pregnancy in patients who desire to preserve their fertility. The treatment is associated with high success rates. Methotrexate (MTX) is the most common medicine for resolving ectopic cervical pregnancy, other medications such as KCl, hyperosmolar glucose, RU486 and prostaglandins have also been used with different success rate. Methotrexate may be administered systemic (intramuscular or intravenous) or local (intra-amniotic transfusion or intrauterine).
    Keywords: cervical pregnancy, conservative treatments, methotrexate in EP}
نکته
  • نتایج بر اساس تاریخ انتشار مرتب شده‌اند.
  • کلیدواژه مورد نظر شما تنها در فیلد کلیدواژگان مقالات جستجو شده‌است. به منظور حذف نتایج غیر مرتبط، جستجو تنها در مقالات مجلاتی انجام شده که با مجله ماخذ هم موضوع هستند.
  • در صورتی که می‌خواهید جستجو را در همه موضوعات و با شرایط دیگر تکرار کنید به صفحه جستجوی پیشرفته مجلات مراجعه کنید.
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