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Virginia Fernandes Moça Trevisani - One of the best experts on this subject based on the ideXlab platform.
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Motor Cortex Transcranial Direct Current Stimulation Effects on Knee Osteoarthritis Pain in Elderly Subjects with Dysfunctional Descending Pain inhibitory System: A Randomized Controlled Trial
Brain stimulation, 2021Co-Authors: Daniela Regina Brandão Tavares, Jane Erika Frazao Okazaki, Marcia Valéria De Andrade Santana, Ana Carolina Pereira Nunes Pinto, Karina Kuraoka Tutiya, Fernanda Martins Gazoni, Camila Bonin Pinto, Fania Cristina Santos, Felipe Fregni, Virginia Fernandes Moça TrevisaniAbstract:Abstract Background Although evidence has indicated a positive effect of transcranial direct current stimulation (tDCS) on reducing Pain, few studies have focused on the Elderly population with knee osteoarthritis (KOA). Objective To evaluate whether tDCS reduces KOA Pain in Elderly individuals with a dysfunctional descending Pain inhibitory system (DPIS). Methods in a double-blind trial, individuals ≥ 60 years with KOA Pain and a dysfunctional DPIS, we randomly assigned patients to receive 15 daily sessions of 2mA tDCS over the primary motor cortex (anode) and contralateral supraorbital area (cathode) (M1-SO) for 20 min or sham tDCS. Change in Pain perception indexed by the Brief Pain inventory (BPI) at the end of intervention was the primary outcome. Secondary outcomes included: disability, quantitative sensory testing, Pain pressure threshold and conditioned Pain modulation (CPM). Subjects were followed-up for 2 months. Results Of the 104 enrolled subjects, with mean(SD) age of 73.9(8.01) years and 88(84.6%) female, 102 finished the trial. in the intention-to-treat analysis, the active tDCS group had a significantly greater reduction in BPI compared to the sham group (difference, 1.59; 95% CI, 0.95 to 2.23; P Conclusion M1-SO tDCS is associated with a moderate effect size in reducing Pain in Elderly patients with KOA after 15 daily sessions of stimulation. This intervention has also shown to modulate the DPIS.
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Effects of Transcranial Direct Current Stimulation on Knee Osteoarthritis Pain in Elderly Subjects With Defective Endogenous Pain-inhibitory Systems: Protocol for a Randomized Controlled Trial
JMIR research protocols, 2018Co-Authors: Daniela Regina Brandão Tavares, Jane Erika Frazao Okazaki, Marcia Valéria De Andrade Santana, Ana Carolina Pereira Nunes Pinto, Fania Cristina Santos, Felipe Fregni, Aline Pereira Da Rocha, Vinicius Tassoni Civile, Virginia Fernandes Moça TrevisaniAbstract:Background Knee osteoarthritis (OA) has been the main cause behind chronic Pain and disabilities in the Elderly population. The traditional treatment for knee OA Pain currently concerns a number of combinations of pharmacological and nonpharmacological therapies. However, such combinations have displayed little effects on a significant group of subjects. in addition to this, pharmacological treatments often cause adverse effects, which limits their use on this population. Previous studies showed that chronic knee OA Pain may be associated with maladaptive compensatory plasticity in Pain-related neural central circuits indexed by a defective descending Pain-inhibitory system. Transcranial direct current stimulation (tDCS) can revert some of these maladaptive changes, thus decreasing chronic Pain sensation. Numerous studies have demonstrated that the use of anodal tDCS stimulation over the primary motor cortex (M1) has positive effects on chronic neuropathic Pain. Yet, data on OA Pain in Elderly patients, including its effects on the endogenous Pain-inhibitory system, remain limited. Objective The objective of this study is to evaluate the efficacy of tDCS in reducing Pain intensity caused by knee OA in Elderly subjects with defective endogenous Pain-inhibitory systems. Methods We designed a randomized, sham-controlled, single-center, double-blinded clinical trial. Patients with knee OA who have maintained a chronic Pain level during the previous 6 months and report a Pain score of 4 or more on a 0-10 numeric rating scale (NRS) for Pain in that period will undergo a conditioned Pain modulation (CPM) task. Participants who present a reduced CPM response, defined as a decrease in NRS during the CPM task of less than 10%, and meet all of the inclusion criteria will be randomly assigned to receive 15 sessions of 2 mA active or sham tDCS for 20 minutes. A sample size of 94 subjects was calculated. The Brief Pain inventory Pain items will be used to assess Pain intensity as our primary outcome. Secondary outcomes will include Pain impact on functioning, mobility performance, quality of life, CPM, pressure Pain threshold, touch-test sensory evaluation, and safety. Follow-up visits will be performed 2, 4, and 8 weeks following intervention. The data will be analyzed using the principle of intention-to-treat. Results This study was approved by the institutional review board with the protocol number 1685/2016. The enrollment started in April 2018; at the time of publication of this protocol, 25 subjects have been enrolled. We estimate we will complete the enrollment process within 2 years. Conclusions This clinical trial will provide relevant data to evaluate if anodal tDCS stimulation over M1 can decrease chronic knee OA Pain in Elderly subjects with defective CPM. in addition, this trial will advance the investigation of the role of central sensitization in knee OA and evaluate how tDCS stimulation may affect it. Trial registration ClinicalTrials.gov NCT03117231; https://clinicaltrials.gov/ct2/show/NCT03117231 (Archived by WebCite at http://webcitation.org/73WM1LCdJ). international registered report identifier (irrid) RR1-10.2196/11660.
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Effects of Transcranial Direct Current Stimulation on Knee Osteoarthritis Pain in Elderly Subjects With Defective Endogenous Pain-inhibitory Systems: Protocol for a Randomized Controlled Trial (Preprint)
2018Co-Authors: Daniela Regina Brandão Tavares, Jane Erika Frazao Okazaki, Ana Carolina Pereira Nunes Pinto, Fania Cristina Santos, Felipe Fregni, Aline Pereira Da Rocha, Vinicius Tassoni Civile, Marcia Valeria De Andrade Santana, Virginia Fernandes Moça TrevisaniAbstract:BACKGROUND Knee osteoarthritis (OA) has been the main cause behind chronic Pain and disabilities in the Elderly population. The traditional treatment for knee OA Pain currently concerns a number of combinations of pharmacological and nonpharmacological therapies. However, such combinations have displayed little effects on a significant group of subjects. in addition to this, pharmacological treatments often cause adverse effects, which limits their use on this population. Previous studies showed that chronic knee OA Pain may be associated with maladaptive compensatory plasticity in Pain-related neural central circuits indexed by a defective descending Pain-inhibitory system. Transcranial direct current stimulation (tDCS) can revert some of these maladaptive changes, thus decreasing chronic Pain sensation. Numerous studies have demonstrated that the use of anodal tDCS stimulation over the primary motor cortex (M1) has positive effects on chronic neuropathic Pain. Yet, data on OA Pain in Elderly patients, including its effects on the endogenous Pain-inhibitory system, remain limited. OBJECTIVE The objective of this study is to evaluate the efficacy of tDCS in reducing Pain intensity caused by knee OA in Elderly subjects with defective endogenous Pain-inhibitory systems. METHODS We designed a randomized, sham-controlled, single-center, double-blinded clinical trial. Patients with knee OA who have maintained a chronic Pain level during the previous 6 months and report a Pain score of 4 or more on a 0-10 numeric rating scale (NRS) for Pain in that period will undergo a conditioned Pain modulation (CPM) task. Participants who present a reduced CPM response, defined as a decrease in NRS during the CPM task of less than 10%, and meet all of the inclusion criteria will be randomly assigned to receive 15 sessions of 2 mA active or sham tDCS for 20 minutes. A sample size of 94 subjects was calculated. The Brief Pain inventory Pain items will be used to assess Pain intensity as our primary outcome. Secondary outcomes will include Pain impact on functioning, mobility performance, quality of life, CPM, pressure Pain threshold, touch-test sensory evaluation, and safety. Follow-up visits will be performed 2, 4, and 8 weeks following intervention. The data will be analyzed using the principle of intention-to-treat. RESULTS This study was approved by the institutional review board with the protocol number 1685/2016. The enrollment started in April 2018; at the time of publication of this protocol, 25 subjects have been enrolled. We estimate we will complete the enrollment process within 2 years. CONCLUSIONS This clinical trial will provide relevant data to evaluate if anodal tDCS stimulation over M1 can decrease chronic knee OA Pain in Elderly subjects with defective CPM. in addition, this trial will advance the investigation of the role of central sensitization in knee OA and evaluate how tDCS stimulation may affect it. CLinICALTRIAL ClinicalTrials.gov NCT03117231; https://clinicaltrials.gov/ct2/show/NCT03117231 (Archived by WebCite at http://webcitation.org/73WM1LCdJ) inTERNATIONAL REGISTERED REPOR RR1-10.2196/11660
Daniela Regina Brandão Tavares - One of the best experts on this subject based on the ideXlab platform.
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Motor Cortex Transcranial Direct Current Stimulation Effects on Knee Osteoarthritis Pain in Elderly Subjects with Dysfunctional Descending Pain inhibitory System: A Randomized Controlled Trial
Brain stimulation, 2021Co-Authors: Daniela Regina Brandão Tavares, Jane Erika Frazao Okazaki, Marcia Valéria De Andrade Santana, Ana Carolina Pereira Nunes Pinto, Karina Kuraoka Tutiya, Fernanda Martins Gazoni, Camila Bonin Pinto, Fania Cristina Santos, Felipe Fregni, Virginia Fernandes Moça TrevisaniAbstract:Abstract Background Although evidence has indicated a positive effect of transcranial direct current stimulation (tDCS) on reducing Pain, few studies have focused on the Elderly population with knee osteoarthritis (KOA). Objective To evaluate whether tDCS reduces KOA Pain in Elderly individuals with a dysfunctional descending Pain inhibitory system (DPIS). Methods in a double-blind trial, individuals ≥ 60 years with KOA Pain and a dysfunctional DPIS, we randomly assigned patients to receive 15 daily sessions of 2mA tDCS over the primary motor cortex (anode) and contralateral supraorbital area (cathode) (M1-SO) for 20 min or sham tDCS. Change in Pain perception indexed by the Brief Pain inventory (BPI) at the end of intervention was the primary outcome. Secondary outcomes included: disability, quantitative sensory testing, Pain pressure threshold and conditioned Pain modulation (CPM). Subjects were followed-up for 2 months. Results Of the 104 enrolled subjects, with mean(SD) age of 73.9(8.01) years and 88(84.6%) female, 102 finished the trial. in the intention-to-treat analysis, the active tDCS group had a significantly greater reduction in BPI compared to the sham group (difference, 1.59; 95% CI, 0.95 to 2.23; P Conclusion M1-SO tDCS is associated with a moderate effect size in reducing Pain in Elderly patients with KOA after 15 daily sessions of stimulation. This intervention has also shown to modulate the DPIS.
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Effects of Transcranial Direct Current Stimulation on Knee Osteoarthritis Pain in Elderly Subjects With Defective Endogenous Pain-inhibitory Systems: Protocol for a Randomized Controlled Trial
JMIR research protocols, 2018Co-Authors: Daniela Regina Brandão Tavares, Jane Erika Frazao Okazaki, Marcia Valéria De Andrade Santana, Ana Carolina Pereira Nunes Pinto, Fania Cristina Santos, Felipe Fregni, Aline Pereira Da Rocha, Vinicius Tassoni Civile, Virginia Fernandes Moça TrevisaniAbstract:Background Knee osteoarthritis (OA) has been the main cause behind chronic Pain and disabilities in the Elderly population. The traditional treatment for knee OA Pain currently concerns a number of combinations of pharmacological and nonpharmacological therapies. However, such combinations have displayed little effects on a significant group of subjects. in addition to this, pharmacological treatments often cause adverse effects, which limits their use on this population. Previous studies showed that chronic knee OA Pain may be associated with maladaptive compensatory plasticity in Pain-related neural central circuits indexed by a defective descending Pain-inhibitory system. Transcranial direct current stimulation (tDCS) can revert some of these maladaptive changes, thus decreasing chronic Pain sensation. Numerous studies have demonstrated that the use of anodal tDCS stimulation over the primary motor cortex (M1) has positive effects on chronic neuropathic Pain. Yet, data on OA Pain in Elderly patients, including its effects on the endogenous Pain-inhibitory system, remain limited. Objective The objective of this study is to evaluate the efficacy of tDCS in reducing Pain intensity caused by knee OA in Elderly subjects with defective endogenous Pain-inhibitory systems. Methods We designed a randomized, sham-controlled, single-center, double-blinded clinical trial. Patients with knee OA who have maintained a chronic Pain level during the previous 6 months and report a Pain score of 4 or more on a 0-10 numeric rating scale (NRS) for Pain in that period will undergo a conditioned Pain modulation (CPM) task. Participants who present a reduced CPM response, defined as a decrease in NRS during the CPM task of less than 10%, and meet all of the inclusion criteria will be randomly assigned to receive 15 sessions of 2 mA active or sham tDCS for 20 minutes. A sample size of 94 subjects was calculated. The Brief Pain inventory Pain items will be used to assess Pain intensity as our primary outcome. Secondary outcomes will include Pain impact on functioning, mobility performance, quality of life, CPM, pressure Pain threshold, touch-test sensory evaluation, and safety. Follow-up visits will be performed 2, 4, and 8 weeks following intervention. The data will be analyzed using the principle of intention-to-treat. Results This study was approved by the institutional review board with the protocol number 1685/2016. The enrollment started in April 2018; at the time of publication of this protocol, 25 subjects have been enrolled. We estimate we will complete the enrollment process within 2 years. Conclusions This clinical trial will provide relevant data to evaluate if anodal tDCS stimulation over M1 can decrease chronic knee OA Pain in Elderly subjects with defective CPM. in addition, this trial will advance the investigation of the role of central sensitization in knee OA and evaluate how tDCS stimulation may affect it. Trial registration ClinicalTrials.gov NCT03117231; https://clinicaltrials.gov/ct2/show/NCT03117231 (Archived by WebCite at http://webcitation.org/73WM1LCdJ). international registered report identifier (irrid) RR1-10.2196/11660.
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Effects of Transcranial Direct Current Stimulation on Knee Osteoarthritis Pain in Elderly Subjects With Defective Endogenous Pain-inhibitory Systems: Protocol for a Randomized Controlled Trial (Preprint)
2018Co-Authors: Daniela Regina Brandão Tavares, Jane Erika Frazao Okazaki, Ana Carolina Pereira Nunes Pinto, Fania Cristina Santos, Felipe Fregni, Aline Pereira Da Rocha, Vinicius Tassoni Civile, Marcia Valeria De Andrade Santana, Virginia Fernandes Moça TrevisaniAbstract:BACKGROUND Knee osteoarthritis (OA) has been the main cause behind chronic Pain and disabilities in the Elderly population. The traditional treatment for knee OA Pain currently concerns a number of combinations of pharmacological and nonpharmacological therapies. However, such combinations have displayed little effects on a significant group of subjects. in addition to this, pharmacological treatments often cause adverse effects, which limits their use on this population. Previous studies showed that chronic knee OA Pain may be associated with maladaptive compensatory plasticity in Pain-related neural central circuits indexed by a defective descending Pain-inhibitory system. Transcranial direct current stimulation (tDCS) can revert some of these maladaptive changes, thus decreasing chronic Pain sensation. Numerous studies have demonstrated that the use of anodal tDCS stimulation over the primary motor cortex (M1) has positive effects on chronic neuropathic Pain. Yet, data on OA Pain in Elderly patients, including its effects on the endogenous Pain-inhibitory system, remain limited. OBJECTIVE The objective of this study is to evaluate the efficacy of tDCS in reducing Pain intensity caused by knee OA in Elderly subjects with defective endogenous Pain-inhibitory systems. METHODS We designed a randomized, sham-controlled, single-center, double-blinded clinical trial. Patients with knee OA who have maintained a chronic Pain level during the previous 6 months and report a Pain score of 4 or more on a 0-10 numeric rating scale (NRS) for Pain in that period will undergo a conditioned Pain modulation (CPM) task. Participants who present a reduced CPM response, defined as a decrease in NRS during the CPM task of less than 10%, and meet all of the inclusion criteria will be randomly assigned to receive 15 sessions of 2 mA active or sham tDCS for 20 minutes. A sample size of 94 subjects was calculated. The Brief Pain inventory Pain items will be used to assess Pain intensity as our primary outcome. Secondary outcomes will include Pain impact on functioning, mobility performance, quality of life, CPM, pressure Pain threshold, touch-test sensory evaluation, and safety. Follow-up visits will be performed 2, 4, and 8 weeks following intervention. The data will be analyzed using the principle of intention-to-treat. RESULTS This study was approved by the institutional review board with the protocol number 1685/2016. The enrollment started in April 2018; at the time of publication of this protocol, 25 subjects have been enrolled. We estimate we will complete the enrollment process within 2 years. CONCLUSIONS This clinical trial will provide relevant data to evaluate if anodal tDCS stimulation over M1 can decrease chronic knee OA Pain in Elderly subjects with defective CPM. in addition, this trial will advance the investigation of the role of central sensitization in knee OA and evaluate how tDCS stimulation may affect it. CLinICALTRIAL ClinicalTrials.gov NCT03117231; https://clinicaltrials.gov/ct2/show/NCT03117231 (Archived by WebCite at http://webcitation.org/73WM1LCdJ) inTERNATIONAL REGISTERED REPOR RR1-10.2196/11660
H. Suzuki - One of the best experts on this subject based on the ideXlab platform.
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lysis of adhesions and epidural injection of steroid local anaesthetic during epiduroscopy potentially alleviate low back and leg Pain in Elderly patients with lumbar spinal stenosis
BJA: British Journal of Anaesthesia, 2004Co-Authors: T Igarashi, Y. Hirabayashi, N. Seo, K. Saitoh, Hirokazu Fukuda, H. SuzukiAbstract:Background. Lumbar spinal stenosis causes various forms of back or leg Pain, and is recognized with increasing frequency in Elderly patients whose physical status is not always suitable for surgery. Epiduroscopy, a new, minimally invasive diagnostic and therapeutic technique, may be useful for Pain relief in such patients. We investigated the epiduroscopic findings and immediate and long-term changes in back and leg Pain after epiduroscopy in Elderly patients with spinal stenosis. Methods. Patients with degenerative lumbar spinal stenosis (n=58, median age 71 yr) were divided into two groups based on presenting symptoms: a monosegmental group (n=34) and a multisegmental group (n=24). Each patient underwent epiduroscopy, and the findings were evaluated using visual analogue scales for low back and leg symptoms. Epiduroscopy included breaking down adhesions in the epidural space by injections of saline, and injection of steroids/local anaesthetic. Results. Epiduroscopy showed that the amount of fatty tissue and the degree of vascularity were greater in the monosegmental group than in the multisegmental group. Relief of low back Pain was observed up to 12 months after epiduroscopy in both groups. Relief of leg Pain was evident up to 12 months after epiduroscopy in the monosegmental group, and up to 3 months after epiduroscopy in the multisegmental group. None of the patients showed deterioration of motor or sensory deficits during follow-up. One patient was excluded from analysis because of accidental dural puncture during the procedure. Conclusions. The findings of epiduroscopy corresponded to the symptoms. Epiduroscopy may reduce low back and leg Pain in Elderly patients with degenerative lumbar spinal stenosis, particularly those with radiculopathy.
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Lysis of adhesions and epidural injection of steroid/local anaesthetic during epiduroscopy potentially alleviate low back and leg Pain in Elderly patients with lumbar spinal stenosis
British journal of anaesthesia, 2004Co-Authors: T Igarashi, Y. Hirabayashi, N. Seo, K. Saitoh, Hirokazu Fukuda, H. SuzukiAbstract:Background. Lumbar spinal stenosis causes various forms of back or leg Pain, and is recognized with increasing frequency in Elderly patients whose physical status is not always suitable for surgery. Epiduroscopy, a new, minimally invasive diagnostic and therapeutic technique, may be useful for Pain relief in such patients. We investigated the epiduroscopic findings and immediate and long-term changes in back and leg Pain after epiduroscopy in Elderly patients with spinal stenosis. Methods. Patients with degenerative lumbar spinal stenosis (n=58, median age 71 yr) were divided into two groups based on presenting symptoms: a monosegmental group (n=34) and a multisegmental group (n=24). Each patient underwent epiduroscopy, and the findings were evaluated using visual analogue scales for low back and leg symptoms. Epiduroscopy included breaking down adhesions in the epidural space by injections of saline, and injection of steroids/local anaesthetic. Results. Epiduroscopy showed that the amount of fatty tissue and the degree of vascularity were greater in the monosegmental group than in the multisegmental group. Relief of low back Pain was observed up to 12 months after epiduroscopy in both groups. Relief of leg Pain was evident up to 12 months after epiduroscopy in the monosegmental group, and up to 3 months after epiduroscopy in the multisegmental group. None of the patients showed deterioration of motor or sensory deficits during follow-up. One patient was excluded from analysis because of accidental dural puncture during the procedure. Conclusions. The findings of epiduroscopy corresponded to the symptoms. Epiduroscopy may reduce low back and leg Pain in Elderly patients with degenerative lumbar spinal stenosis, particularly those with radiculopathy.
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CLinICAL inVESTIGATIONS Lysis of adhesions and epidural injection of steroid=local anaesthetic during epiduroscopy potentially alleviate low back and leg Pain in Elderly patients with lumbar spinal stenosis {
2004Co-Authors: T Igarashi, Y. Hirabayashi, N. Seo, K. Saitoh, Hirokazu Fukuda, H. SuzukiAbstract:Background. Lumbar spinal stenosis causes various forms of back or leg Pain, and is recognized withincreasingfrequencyinElderlypatientswhosephysicalstatusisnotalwayssuitableforsurgery. Epiduroscopy,anew,minimallyinvasivediagnosticandtherapeutictechnique,maybeusefulforPain relief in such patients. We investigated the epiduroscopic findings and immediate and long-term changes in back and leg Pain after epiduroscopy in Elderly patients with spinal stenosis. Methods.Patientswithdegenerativelumbarspinalstenosis(n=58,medianage71yr)weredivided into two groups based on presenting symptoms: a monosegmental group (n=34) and a multisegmental group (n=24). Each patient underwent epiduroscopy, and the findings were evaluated using visual analogue scales for low back and leg symptoms. Epiduroscopy included breaking down adhesions in the epidural space by injections of saline, and injection of steroids=local anaesthetic. Results. Epiduroscopy showed that the amount of fatty tissue and the degree of vascularity were greater in the monosegmental groupthan in the multisegmental group. Relief of low back Pain was observed up to 12 months after epiduroscopy in both groups. Relief of leg Pain was evident up to 12monthsafterepiduroscopyinthemonosegmentalgroup,andupto3monthsafterepiduroscopy in the multisegmental group. None of the patients showed deterioration of motor or sensory deficits during follow-up. One patient was excluded from analysis because of accidental dural puncture during the procedure. Conclusions. The findings of epiduroscopy corresponded to the symptoms. Epiduroscopy may reduce low back and leg Pain in Elderly patients with degenerative lumbar spinal stenosis, particularly those with radiculopathy. Br J Anaesth 2004; 93: 181‐7
Hiroshi Kitakoji - One of the best experts on this subject based on the ideXlab platform.
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effects of trigger point acupuncture on chronic low back Pain in Elderly patients a sham controlled randomised trial
Acupuncture in Medicine, 2006Co-Authors: Kazunori Itoh, Yasukazu Katsumi, Satoko Hirota, Hiroshi KitakojiAbstract:introduction There is some evidence for the efficacy of acupuncture, but it remains unclear whether trigger point acupuncture is effective. Our objective was to evaluate the effects of trigger point acupuncture on Pain and quality of life in chronic low back Pain patients compared with sham acupuncture. Methods Twenty-six consecutive out-patients (17 women, 9 men; age range: 65–91 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back Pain for at least six months and normal neurological examination, were randomised to two groups. Each group received one phase of trigger point acupuncture and one of sham acupuncture with a three week washout period between them, over 12 weeks. Group A (n=13) received trigger point acupuncture in the first phase and sham acupuncture in the second. Group B (n=13) received the same interventions in the reverse order. Outcome measures were Pain intensity (visual analogue scale, VAS) and Roland Morris Questionnaire. Results Nineteen patients were included in the analysis. At the end of the first treatment phase, group A receiving trigger point acupuncture scored significantly lower VAS (P<0.001) and Roland Morris Questionnaire scores (P<0.01) than the sham control group. There were significant within-group reductions in Pain in both groups during the trigger point acupuncture phase but not in the sham treatment phase. However, the beneficial effects were not sustained. Conclusion These results suggest that trigger point acupuncture may have greater short term effects on low back Pain in Elderly patients than sham acupuncture.
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Effects of trigger point acupuncture on chronic low back Pain in Elderly patients – a sham-controlled randomised trial
Acupuncture in medicine : journal of the British Medical Acupuncture Society, 2006Co-Authors: Kazunori Itoh, Yasukazu Katsumi, Satoko Hirota, Hiroshi KitakojiAbstract:introduction There is some evidence for the efficacy of acupuncture, but it remains unclear whether trigger point acupuncture is effective. Our objective was to evaluate the effects of trigger point acupuncture on Pain and quality of life in chronic low back Pain patients compared with sham acupuncture. Methods Twenty-six consecutive out-patients (17 women, 9 men; age range: 65–91 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back Pain for at least six months and normal neurological examination, were randomised to two groups. Each group received one phase of trigger point acupuncture and one of sham acupuncture with a three week washout period between them, over 12 weeks. Group A (n=13) received trigger point acupuncture in the first phase and sham acupuncture in the second. Group B (n=13) received the same interventions in the reverse order. Outcome measures were Pain intensity (visual analogue scale, VAS) and Roland Morris Questionnaire. Results Nineteen patients were included in the analysis. At the end of the first treatment phase, group A receiving trigger point acupuncture scored significantly lower VAS (P
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trigger point acupuncture treatment of chronic low back Pain in Elderly patients a blinded rct
Acupuncture in Medicine, 2004Co-Authors: Kazunori Itoh, Yasukazu Katsumi, Hiroshi KitakojiAbstract:Objective There is some evidence for the efficacy of acupuncture in chronic low back Pain, but it remains unclear which acupuncture modes are most effective. Our objective was to evaluate the effects of two different modes of trigger point acupuncture on Pain and quality of life in chronic low back Pain patients compared to standard acupuncture treatment. Methods Thirty five consecutive out-patients (25 women, 10 men; age range: 65–81 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back Pain for at least six months and normal neurological examination, were randomised to one of three groups over 12 weeks. Each group received two phases of acupuncture treatment with an interval between them. Nine patients dropped out during the course of the study. The standard acupuncture group (n=9) received treatment at traditional acupuncture points for low back Pain, while the other acupuncture groups received superficial (n=9) or deep (n=9) treatments on trigger points. Outcome measures were VAS Pain intensity and Roland Morris Questionnaire. Results After treatment, the group that received deep needling to trigger points reported less Pain intensity and improved quality of life compared to the standard acupuncture group or the group that received superficial needling to trigger points, but the differences were not statistically significant. There was a significant reduction in Pain intensity between the treatment and interval in the group that received deep needling to trigger points (P<0.01), but not in the standard acupuncture group or the group that received superficial needling to trigger points. Conclusion These results suggest that deep needling to trigger points may be more effective in the treatment of low back Pain in Elderly patients than either standard acupuncture therapy, or superficial needling to trigger points.
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Trigger point acupuncture treatment of chronic low back Pain in Elderly patients--a blinded RCT.
Acupuncture in medicine : journal of the British Medical Acupuncture Society, 2004Co-Authors: Kazunori Itoh, Yasukazu Katsumi, Hiroshi KitakojiAbstract:Objective There is some evidence for the efficacy of acupuncture in chronic low back Pain, but it remains unclear which acupuncture modes are most effective. Our objective was to evaluate the effects of two different modes of trigger point acupuncture on Pain and quality of life in chronic low back Pain patients compared to standard acupuncture treatment. Methods Thirty five consecutive out-patients (25 women, 10 men; age range: 65–81 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back Pain for at least six months and normal neurological examination, were randomised to one of three groups over 12 weeks. Each group received two phases of acupuncture treatment with an interval between them. Nine patients dropped out during the course of the study. The standard acupuncture group (n=9) received treatment at traditional acupuncture points for low back Pain, while the other acupuncture groups received superficial (n=9) or deep (n=9) treatments on trigger points. Outcome measures were VAS Pain intensity and Roland Morris Questionnaire. Results After treatment, the group that received deep needling to trigger points reported less Pain intensity and improved quality of life compared to the standard acupuncture group or the group that received superficial needling to trigger points, but the differences were not statistically significant. There was a significant reduction in Pain intensity between the treatment and interval in the group that received deep needling to trigger points (P
Ana Carolina Pereira Nunes Pinto - One of the best experts on this subject based on the ideXlab platform.
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Motor Cortex Transcranial Direct Current Stimulation Effects on Knee Osteoarthritis Pain in Elderly Subjects with Dysfunctional Descending Pain inhibitory System: A Randomized Controlled Trial
Brain stimulation, 2021Co-Authors: Daniela Regina Brandão Tavares, Jane Erika Frazao Okazaki, Marcia Valéria De Andrade Santana, Ana Carolina Pereira Nunes Pinto, Karina Kuraoka Tutiya, Fernanda Martins Gazoni, Camila Bonin Pinto, Fania Cristina Santos, Felipe Fregni, Virginia Fernandes Moça TrevisaniAbstract:Abstract Background Although evidence has indicated a positive effect of transcranial direct current stimulation (tDCS) on reducing Pain, few studies have focused on the Elderly population with knee osteoarthritis (KOA). Objective To evaluate whether tDCS reduces KOA Pain in Elderly individuals with a dysfunctional descending Pain inhibitory system (DPIS). Methods in a double-blind trial, individuals ≥ 60 years with KOA Pain and a dysfunctional DPIS, we randomly assigned patients to receive 15 daily sessions of 2mA tDCS over the primary motor cortex (anode) and contralateral supraorbital area (cathode) (M1-SO) for 20 min or sham tDCS. Change in Pain perception indexed by the Brief Pain inventory (BPI) at the end of intervention was the primary outcome. Secondary outcomes included: disability, quantitative sensory testing, Pain pressure threshold and conditioned Pain modulation (CPM). Subjects were followed-up for 2 months. Results Of the 104 enrolled subjects, with mean(SD) age of 73.9(8.01) years and 88(84.6%) female, 102 finished the trial. in the intention-to-treat analysis, the active tDCS group had a significantly greater reduction in BPI compared to the sham group (difference, 1.59; 95% CI, 0.95 to 2.23; P Conclusion M1-SO tDCS is associated with a moderate effect size in reducing Pain in Elderly patients with KOA after 15 daily sessions of stimulation. This intervention has also shown to modulate the DPIS.
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Effects of Transcranial Direct Current Stimulation on Knee Osteoarthritis Pain in Elderly Subjects With Defective Endogenous Pain-inhibitory Systems: Protocol for a Randomized Controlled Trial
JMIR research protocols, 2018Co-Authors: Daniela Regina Brandão Tavares, Jane Erika Frazao Okazaki, Marcia Valéria De Andrade Santana, Ana Carolina Pereira Nunes Pinto, Fania Cristina Santos, Felipe Fregni, Aline Pereira Da Rocha, Vinicius Tassoni Civile, Virginia Fernandes Moça TrevisaniAbstract:Background Knee osteoarthritis (OA) has been the main cause behind chronic Pain and disabilities in the Elderly population. The traditional treatment for knee OA Pain currently concerns a number of combinations of pharmacological and nonpharmacological therapies. However, such combinations have displayed little effects on a significant group of subjects. in addition to this, pharmacological treatments often cause adverse effects, which limits their use on this population. Previous studies showed that chronic knee OA Pain may be associated with maladaptive compensatory plasticity in Pain-related neural central circuits indexed by a defective descending Pain-inhibitory system. Transcranial direct current stimulation (tDCS) can revert some of these maladaptive changes, thus decreasing chronic Pain sensation. Numerous studies have demonstrated that the use of anodal tDCS stimulation over the primary motor cortex (M1) has positive effects on chronic neuropathic Pain. Yet, data on OA Pain in Elderly patients, including its effects on the endogenous Pain-inhibitory system, remain limited. Objective The objective of this study is to evaluate the efficacy of tDCS in reducing Pain intensity caused by knee OA in Elderly subjects with defective endogenous Pain-inhibitory systems. Methods We designed a randomized, sham-controlled, single-center, double-blinded clinical trial. Patients with knee OA who have maintained a chronic Pain level during the previous 6 months and report a Pain score of 4 or more on a 0-10 numeric rating scale (NRS) for Pain in that period will undergo a conditioned Pain modulation (CPM) task. Participants who present a reduced CPM response, defined as a decrease in NRS during the CPM task of less than 10%, and meet all of the inclusion criteria will be randomly assigned to receive 15 sessions of 2 mA active or sham tDCS for 20 minutes. A sample size of 94 subjects was calculated. The Brief Pain inventory Pain items will be used to assess Pain intensity as our primary outcome. Secondary outcomes will include Pain impact on functioning, mobility performance, quality of life, CPM, pressure Pain threshold, touch-test sensory evaluation, and safety. Follow-up visits will be performed 2, 4, and 8 weeks following intervention. The data will be analyzed using the principle of intention-to-treat. Results This study was approved by the institutional review board with the protocol number 1685/2016. The enrollment started in April 2018; at the time of publication of this protocol, 25 subjects have been enrolled. We estimate we will complete the enrollment process within 2 years. Conclusions This clinical trial will provide relevant data to evaluate if anodal tDCS stimulation over M1 can decrease chronic knee OA Pain in Elderly subjects with defective CPM. in addition, this trial will advance the investigation of the role of central sensitization in knee OA and evaluate how tDCS stimulation may affect it. Trial registration ClinicalTrials.gov NCT03117231; https://clinicaltrials.gov/ct2/show/NCT03117231 (Archived by WebCite at http://webcitation.org/73WM1LCdJ). international registered report identifier (irrid) RR1-10.2196/11660.
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Effects of Transcranial Direct Current Stimulation on Knee Osteoarthritis Pain in Elderly Subjects With Defective Endogenous Pain-inhibitory Systems: Protocol for a Randomized Controlled Trial (Preprint)
2018Co-Authors: Daniela Regina Brandão Tavares, Jane Erika Frazao Okazaki, Ana Carolina Pereira Nunes Pinto, Fania Cristina Santos, Felipe Fregni, Aline Pereira Da Rocha, Vinicius Tassoni Civile, Marcia Valeria De Andrade Santana, Virginia Fernandes Moça TrevisaniAbstract:BACKGROUND Knee osteoarthritis (OA) has been the main cause behind chronic Pain and disabilities in the Elderly population. The traditional treatment for knee OA Pain currently concerns a number of combinations of pharmacological and nonpharmacological therapies. However, such combinations have displayed little effects on a significant group of subjects. in addition to this, pharmacological treatments often cause adverse effects, which limits their use on this population. Previous studies showed that chronic knee OA Pain may be associated with maladaptive compensatory plasticity in Pain-related neural central circuits indexed by a defective descending Pain-inhibitory system. Transcranial direct current stimulation (tDCS) can revert some of these maladaptive changes, thus decreasing chronic Pain sensation. Numerous studies have demonstrated that the use of anodal tDCS stimulation over the primary motor cortex (M1) has positive effects on chronic neuropathic Pain. Yet, data on OA Pain in Elderly patients, including its effects on the endogenous Pain-inhibitory system, remain limited. OBJECTIVE The objective of this study is to evaluate the efficacy of tDCS in reducing Pain intensity caused by knee OA in Elderly subjects with defective endogenous Pain-inhibitory systems. METHODS We designed a randomized, sham-controlled, single-center, double-blinded clinical trial. Patients with knee OA who have maintained a chronic Pain level during the previous 6 months and report a Pain score of 4 or more on a 0-10 numeric rating scale (NRS) for Pain in that period will undergo a conditioned Pain modulation (CPM) task. Participants who present a reduced CPM response, defined as a decrease in NRS during the CPM task of less than 10%, and meet all of the inclusion criteria will be randomly assigned to receive 15 sessions of 2 mA active or sham tDCS for 20 minutes. A sample size of 94 subjects was calculated. The Brief Pain inventory Pain items will be used to assess Pain intensity as our primary outcome. Secondary outcomes will include Pain impact on functioning, mobility performance, quality of life, CPM, pressure Pain threshold, touch-test sensory evaluation, and safety. Follow-up visits will be performed 2, 4, and 8 weeks following intervention. The data will be analyzed using the principle of intention-to-treat. RESULTS This study was approved by the institutional review board with the protocol number 1685/2016. The enrollment started in April 2018; at the time of publication of this protocol, 25 subjects have been enrolled. We estimate we will complete the enrollment process within 2 years. CONCLUSIONS This clinical trial will provide relevant data to evaluate if anodal tDCS stimulation over M1 can decrease chronic knee OA Pain in Elderly subjects with defective CPM. in addition, this trial will advance the investigation of the role of central sensitization in knee OA and evaluate how tDCS stimulation may affect it. CLinICALTRIAL ClinicalTrials.gov NCT03117231; https://clinicaltrials.gov/ct2/show/NCT03117231 (Archived by WebCite at http://webcitation.org/73WM1LCdJ) inTERNATIONAL REGISTERED REPOR RR1-10.2196/11660
