Background: Piriformis syndrome (PS) is a painful musculoskeletal condition characterized by a deep gluteal pain that may radiate to the posterior thigh and leg. This study was designed to compare the effectiveness of ozone and BTX to lidocaine injection in treating piriformis syndrome that was resistant to medication and/or physical therapy. Study design: Between November 2018 and August 2019, we involved eighty-four subjects diagnosed with piriformis syndrome in a double-blinded, prospective, randomized comparative study to receive an ultrasound-guided injection of lidocaine (control group), botulinum toxin A, or local ozone (28 patients each group) in the belly of the piriformis muscle. Pain condition evaluated by the visual analog score (VAS) was used as a primary outcome, and the Oswestry Disability Index (ODI) as a secondary outcome, before, at one month, two months, three months, and six months following the injection. Results: The majority (58.3%) of patients were male, while (41.7%) were female. At one month, a highly significant decrease occurred in VAS and ODI in the lidocaine and ozone groups compared to the botulinum toxin group (p < 0.001). At six months, there was a highly significant decrease in VAS and ODI in the botulinum toxin group compared to the lidocaine and ozone groups (p < 0.001). Conclusion: Botulinum toxin may assist in the medium- and long-term management of piriformis syndrome, while lidocaine injection and ozone therapy may help short-term treatment in patients not responding to conservative treatment and physiotherapy.
Background: The most frequent movement issue seen in clinical practice is tremors. It is known as repetitive, involuntary oscillations. The diagnostic process for tremor patients can be time-consuming and complicated, as the identification of “Essential Tremor” and its distinction from other types of tremor. Objectives: This study aimed to describe the electrophysiological findings of essential, enhanced physiological, and physiological tremors, using surface electromyography and an accelerometer. Patients and Methods: The study included 24 patients with essential tremors, 10 patients with enhanced physiological tremors, and 10 patients with physiological tremors. We assessed the frequency, amplitude, and muscular contraction pattern of tremors during rest, posture, and a 1 kg load. Results: The tremor frequency of essential tremor patients was about 4.2-10.1 Hertz, while enhanced physiological tremor and physiological tremor were increased to 6.1–12.7 Hertz and 5.1-10.2 Hertz, respectively. The essential tremor group muscle contraction pattern was predominantly synchronous, as do all enhanced physiological, and physiological tremor patients, but with more fine low amplitude muscle bursts. By varying the tremor frequency and the weight load effect, tremor analysis could discriminate essential from enhanced physiological, and physiological tremors. Conclusions: The tremor analysis using surface electromyography and an accelerometer is sufficient to differentiate between essential tremors, enhanced physiological tremors, and physiological tremors.
Mobility limitations in stroke survivors yield negative impacts on the quality of life for such individuals. Rehabilitation is needed to help them recover and regain mobility. Accordingly, this study aims to design and validate a “Robotic Exoskeleton” intended for stroke rehabilitation. The basic principles of this robotic exoskeleton device are its dependence on electromyography signal and electronic microcontroller to provide an efficient physiotherapy exercises system.The robotic exoskeleton is a one degree of freedom which performs the flexion and extension of the elbow joint. After the design was completed, 19 subjects participated in this study: 4 healthy subjects, and 15 post-stroke patients.The results showed the benefit of robotic exoskeleton in increasing the elbow range of motion, where angle of elbow flexion was raised from the first physiotherapy session to maximum elbow flexion in the last session.
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