Objective. To compare the effectiveness of virgin coconut oil and mineral oil as an adjunct in the alleviation of pain and improvement of range of motion when used as a coupling medium in therapeutic ultrasound. Methods. A randomized controlled double blind study was conducted in an industrial out-patient clinic in Pasig City. A total of 43 patients with musculotendinous pain were enrolled in the study and were randomized into two groups. The experimental group (n = 20) was given virgin coconut oil (VCO) and the control group (n = 23) was given mineral oil (MO), each used as a coupling medium during therapeutic ultrasound treatment. Four participants were not able to proceed with the study. All patients were given analgesics and/or nonsteroidal anti-inflammatory medications for the duration of the study. All participants underwent baseline evaluation and re-evaluation after three therapy sessions per week for a total of two weeks. The outcome measures used for the study were change in pain scores using the numerical rating scale and change in flexion and extension range of motion of involved joints using goniometric measurement from baseline to second follow-up and third follow-up. The results were analyzed using STATA statistical software with level of significance at p<0.05. Results. Repeated measures ANOVA showed that there were reductions in the pain scores by visits, i.e., from baseline to first follow-up and from first follow-up to second follow-up were marginally significant (p=0.07). However, the difference between VCO and MO in terms of reduction of pain scores in all three visits was not statistically significant (p=0.27). There was no interaction between treatment groups and visits (p=0.34). As to the range of motion of the joints involved, there was statistically significant increase in range of motion noted for extension (p=0.03) as compared with flexion (p=0.07) from baseline to first follow-up. There were no reported adverse effects from the use of VCO and MO, physical therapy program and pain medications in both groups. Conclusion. The use of virgin coconut oil is a relatively safe and well-tolerated coupling medium in therapeutic ultrasound. Virgin coconut oil was shown to be seemingly more effective as mineral oil in terms of the reduction of pain and more effective in improvement of flexion and extension range of motion of affected joint.
Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; PHONOPHORESIS ; THERAPEUTICS ; DRUG THERAPY ; DRUG ADMINISTRATION ROUTES ; OILS ; PAIN ; NERVOUS SYSTEM DISEASES ; NEUROLOGIC MANIFESTATIONS

Background: Stroke is a significant health concern globally, and dysphagia has been a very common complication. Early intervention for managing dysphagia is challenging with a lack of universally accepted treatment protocols. Non-invasive repetitive transcranial magnetic stimulation (rTMS) is emerging as a treatment option for stroke dysphagia. However, there is no standardized rTMS treatment protocol for it, leading to challenges in clinical decision-making. Objective: To determine available rTMS protocols for unilateral hemispheric stroke dysphagia. Methods: A scoping review using PubMed, ProQuest, and EBSCOHost databases was conducted using the keywords “dysphagia,” “stroke,” “repetitive transcranial magnetic stimulation,” “conventional therapy,” and “swallowing examination.” Eligible studies published from inception to April 2020 were appraised using the Oxford Centre for Evidence-Based Medicine and analyzed qualitatively. Results: Out of 42 articles, five randomized controlled trials met the eligibility criteria. A total of 108 patients with stroke and oropharyngeal dysphagia were randomized into one of the following treatment groups: (1) rTMS (unilateral or bilateral); (2) conventional dysphagia therapy (CDT); and (3) combined intervention (CI) of rTMS and CDT. The CI gave significant improvements in swallowing function and quality of life compared to CDT alone. The bilateral rTMS protocol resulted in more significant improvements than unilateral rTMS. Conclusion There are various and heterogeneous treatment protocols involving neuromodulation available for stroke dysphagia. The combination of bilateral excitatory-inhibitory rTMS and CDT seems to result in an optimal outcome for swallowing function among patients with unilateral hemispheric stroke dysphagia.
Deglutition Disorders ; Transcranial Magnetic Stimulation ; Stroke

Parkinson’s disease (PD) is a chronic, neurodegenerative condition resulting in various motor impairments, including speech disorders. However, at the height of the coronavirus disease 2019 pandemic, a patient with PD could not access traditional in-person neurorehabilitation care. This case report highlights the feasibility of telerehabilitation to deliver speech therapy over a distance using available resources in a developing country. We describe a Filipino elderly woman, public speaker, and marriage counselor, seeking teleconsultation for her voice problems (slow and soft) attributed to PD. At that time, most center-based outpatient rehabilitation centers in Manila were closed due to the pandemic, and the patient preferred to stay at home for safety reasons. Hence, she was evaluated and managed remotely by an interdisciplinary team (neurologist, physiatrist, speech-language pathologist) through video calls. Since the ideal rehabilitation set up (in-person evaluation and therapy; use of Lee Silverman Voice Therapy) could not be done, the clinicians had to find practical alternatives, such as remotely administering subjective perceptual voice assessments, objective speech analysis using the Praat™ computer application, and speech teletherapy through synchronous (videocalls, phone calls) and asynchronous (e-mails, text messages, pre-recorded exercise videos) techniques. Notable speech improvements were observed by the clinicians, patient, and patient’s frequent communicative partners after at least four teletherapy sessions. However, the carry-over of the improvements was affected by the patient’s lack of compliance with the prescribed home exercise program. Telerehabilitation using synchronous and asynchronous techniques for speech disorders due to PD was found feasible, beneficial, safe, and practical amid social distancing and low resources in a developing country
Speech Therapy ; Telerehabilitation ; Parkinson Disease ; Voice Disorders ; COVID-19