Background: This study aimed to assess the efficacy of the adductor canal block (ACB) in comparison to intra-articular steroid-lidocaine injection (IASLI) to control chronic knee osteoarthritis (KOA) pain. Methods: A randomized, single-blinded trial in an outpatient rehabilitation clinic re-cruiting chronic KOA with pain ≥ 6 months over one year. Following randomization,subjects received either a single ACB or IASLI under ultrasound guidance. Numerical rating scale (NRS) scores for pain, and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were recorded at baseline, 1 hour, 1 month, and 3 months postinjection. Results: Sixty-six knees were recruited; 2 were lost to follow-up. Age was normally distributed (P = 0.463), with more female subjects in both arms (P = 0.564). NRS scores improved significantly for both arms at 1 hour, with better pain scores for the IASLI arm (P = 0.416) at 1st month and ACB arm at 3rd month (P = 0.077) with larger effect size (Cohen’s d = 1.085). Lower limb function improved significantly in the IASLI arm at 1 month; the ACB subjects showed greater functional improvement at 3 months (Cohen’s d = 0.3, P = 0.346). Quality of life (QoL) improvement mirrored the functional scores whereby the IASLI group fared better at the 1st month (P = 0.071) but at the 3rd month the ACB group scored better (Cohen’s d = 0.08, P = 0.710). Conclusions ACB provides longer lasting analgesia which improves function and QoL in chronic KOA patients up to 3 months without any significant side effects.

Purpose: To assess the feasibility of a technology-assisted intervention in a hybrid cardiac rehabilitation program among patients with coronary heart disease. Methods: This study was a two-arm parallel randomized controlled trial. Twenty-eight patients with coronary heart disease were randomly assigned to either the intervention group, receiving a 12-week technology-assisted intervention (n = 14), or the control group (n = 14), receiving usual care. Guided by the Health Belief Model, the intervention group received three center-based, supervised exercise training sessions, a fitness watch that served as a cue to action, six educational videos, and a weekly video call. The Self-efficacy for Exercise, exercise capacity, and Health Promoting Lifestyle Profile II were assessed at baseline and immediately post-intervention (12-weeks). Results: Among the 28 patients who participated in this study, 85.7% completed the program, with a relatively low attrition rate (14.3%). The number of exercise training sessions accomplished by the participants in the intervention group was 51.27 ± 19.41 out of 60 sessions (85.5%) compared to 36.46 ± 23.05 (60.8%) in the control group. No cardiac adverse events or hospitalizations were reported throughout the study. Participants in the intervention group showed greater improvement in health-promoting behaviors when compared with the control group at 12 weeks. Within-group effects demonstrated improvement in exercise self-efficacy and exercise capacity among participants in the intervention group. A participant satisfaction survey conducted immediately post-intervention revealed that participants were “very satisfied” (23.1%) and “satisfied” (76.9%) with the technology-assisted intervention. Conclusions The findings demonstrated that technology-assisted intervention in a hybrid cardiac rehabilitation program was feasible and suggested to be beneficial in improving exercise self-efficacy, exercise capacity, and health promoting behavior among patients with coronary heart disease. A full-scale study is needed to determine its effectiveness in the long term.

Introduction: Rotator cuff (RC) tears account for about 20% of RC disorders and presents with severe shoulder pain that can significantly impact activities of daily life. Case report: A 34-year-old male with a history of chronic right shoulder pain presents with tenderness at the lateral shoulder, positive subacromial impingement tests, painful end range of motion and pain score of 6. Ultrasound shows a partial supraspinatus tear at the bursal side. The patient was treated with 15% dextrose to the supraspinatus tendon intrasubstance 3 times, for 4 weeks. Result: Significant pain improvement after the first treatment (VAS 1), with pain-free full range of motion until 4 weeks after treatment and sonographic evidence of supraspinatus tendon healing. Discussion: Dextrose concentrations higher than 12.5% produce an osmotic gradient which stimulates the accumulation of growth factors and inflammatory cells, which in turn can initiate the wound healing process. In this case we can find that the healing process translates to good clinical outcome by ultrasound imaging. Conclusion Dextrose prolotherapy can be used as an option for supraspinatus tendon partial tear with good results.
Rotator Cuff|prolotherapy