[Analysis of quality of life in patiens with low back pain after receiving transcutaneous electrical nerve stimulation (TENS)]

INTRODUCTION

Low back pain (LBP) is one of the most common disorders affecting office employees working with a computer, which inevitably leads to lower quality of life. The aim of this study was to analyze the quality of life of patients with LBP after application of TENS (Transcutaneous Electrical Nervous Stimulation).

MATERIAL AND METHODS

The study group included 30 computer workers (26 females and 4 males) aged 30-60 years (45 +/- 12). The quality of life was assessed using the World Health Organization Quality of Life instrument-Abbreviated version (WHOQOL-Bref) before and after 10 applications of TENS. Outcomes were evaluated with a visual analog score (VAS) for pain and Schober's test to measure the ability of a patient to flex his or her lower back.

RESULTS

The mean VAS value decreased significantly from 3.83 +/- 1.31 cm at baseline to 3.36 +/- 1.21 cm after treatment. Patients reported pain relief. The highest quality of life scores in terms of social relationships were found in the social category evaluating personal relationships, social support and sexual activity (15.91 +/- 2.07) and mental health (14.32 +/- 1.59). After treatment a significant increase in the flexion of lower back was observed in the majority of patients. No significant correlations between the quality of life and the intensity of pain and the flexion of lower back before and after treatment were found.

CONCLUSIONS

TENS therapy is an effective technique for pain relief in patients with LBP. TENS can also be used with other methods of LBP treatment and may improve the patients' quality of life.

Cortical somatosensory evoked potentials and spasticity assessment after botulinum toxin type A injection in children with cerebral palsy

PURPOSE

The mechanism of Botulinum Toxin Type A (BTX-A) action at the neuromuscular junction is well known. But from the introduction of BTX-A, some authors have suggested a central action of BTX-A and possible side effects far from the site of injection. Some studies demonstrate an improvement of cortical SEPs associated with reduction of spasticity after BTX-A injection. The aim of the present study was to determine the effect of BTX-A treatment on cortical somatosensory potentials (SEP).

MATERIAL AND METHODS

A group of twenty nine children ranging from 2 to 17 years old with cerebral palsy were studied. Each patients spasticity level was evaluated before, 2 weeks and 6 weeks after BTX-A injection by the Modified Ashworth Scale and modified Gait Physician's Rating Scale. The SEPs from lower and upper extremities were performed before and between 2 and 6 weeks (19.34 +/- 8.82 days) after BTX-A administration.

RESULTS

The mean spasitity level was significantly lower 2 and 6 weeks after BTX-A injection. The gait analysis by modified Physician's Rating Scale (PRS) showed significant improvement two weeks and six weeks after BTX-A injection. SEPs results were abnormal before BTX-A injection in 25 children with cerebral palsy. However we didn't find any significant changes of SEPs latencies after BTX-A injection.

CONCLUSIONS

The results of SEP after BTX-A administration in children with cerebral palsy do not confirm the central action of BTX-A on somatosensory pathways. We did not find any significant changes of SEP latencies associated with clinical reduction of spasticity. It seems that SEP results could support the opinion, that BTX-A does not have any direct central effect on sensory pathways. Remote side effects may be explained by an indirect mechanism due to modification of the central loops of reflexes or to hematogenous spread of BTX-A.

Clinical-electroencephalographic analysis of brain bioelectrical activity in children with myelomeningocele and internal hydrocephalus

PURPOSE

The aim of the current study was the clinical and electroencephalographic (EEG) analysis of the brain bioelectrical activity in patients with myelomeningocele and internal hydrocephalus.

MATERIAL AND METHODS

The present study included 86 children (44 boys and 42 girls) with myelomeningocele. The children were aged 1-17 years (mean 7 +/- 4.4 years). Thoracic myelomeningocele was identified in 24 children (28%), lumbar in 53 (62%) and sacral in 9 cases (10%).

RESULTS

The standard EEG examination performed in the waking state revealed generalized changes in 53 patients (62%), including 19 (79%) with thoracic, 28 (53%) with lumbar and 6 (66%) with sacral myelomeningocele. Approximately 70% of the patients underwent ventriculoperitoneal shunting and epilepsy was found in 27 children (31.4%). The prevalence of changes detected in the left temporal region did not differ between the respective myelomeningocele types. No correlations were noted between the degree of spinal cord injury and the changes observed in the left temporal region in EEG recording. Likewise, changes found in the centroparietal region in EEG did not correlate with the site of myelomeningocele. Focal changes in the frontotemporal (p < 0.0067) and right temporal region (p < 0.0314) showed a positive correlation with the degree of spinal cord injury and were most frequent in patients with thoracic myelomeningocele.

CONCLUSION

The analysis of EEG might facilitate evaluation and prognosis of epileptic seizures in children with myelomeningocele and internal hydrocephalus.

Time of cooing appearance and further development of speech in children with cerebral palsy

PURPOSE

The aim of the study was to determine the significance of the time of cooing appearance for further development of speech in children with infantile cerebral palsy (CP).

MATERIAL AND METHODS

The study was performed on a group of 46 children with the pyramidal form of CP, aged 3-16 years, treated in The Department of Pediatric Neurology and Rehabilitation, Medical University of Bialystok. It included a logopaedic assessment and a history of speech development obtained from mothers.

RESULTS

Speech development in CP children varied according to the time of cooing appearance. Particular difficulties were observed in children with delayed cooing, who usually said their first words between 2 and 5 years of age, sentences between 3 and 5 years or even later (8 or 11 years of age); 35% of these children did not use sentences at all. Moderate and severe dysarthria, limited lexical and grammatical development and problems with speech understanding of varied degree were observed.

CONCLUSIONS

Delayed cooing in CP is an important prognostic sign of further speech retardation and indicates the necessity of early logopaedic rehabilitation.