ASEAN Journal of Rehabilitation Medicine

Notes from the Editor-in-Chief

2025-01-10T09:09:00+07:00

Efficacy of Single-Session Focused Extracorporeal Shockwave Therapy in Patients with Moderate-degree Carpal Tunnel Syndrome Versus Steroid Injection Therapy: A Single-Blind Randomized Controlled Trial

2024-08-19T15:45:41+07:00

Objectives: To compare the efficacy of single-session focused extracorporeal shockwave therapy (fESWT) and steroid injection in moderate-degree carpal tunnel syndrome

Study design: A single-blind, randomized controlled trial

Setting: Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Nakhon Nayok, Thailand

Subjects: Patients with electrophysiological evidence of moderate-degree carpal tunnel syndrome.

Methods: Thirty-three patients with a combined total of 36 affected hands were enrolled. The mean age was 56.9 (10.68) years. Among the affected hands, 25 were right hands and 11 were left hands. Equal numbers of the thirty-six affected hands were randomly assigned to the experimental group, which received single-session fESWT with energy flux density ranging from 0.03 to 0.10 mJ/mm², 2,000 shocks per session at a frequency 6-8 Hz and the comparative group which received an injection of 10 milligrams of triamcinolone acetonide in 1 milliliter of solution. Outcomes were assessed using the following questionnaires: 1. Visual Analog Scale (VAS) for pain, 2. VAS for paresthesia, 3. Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) scores, and 4. Total Boston Carpal Tunnel Questionnaire (BCTQ). Scores were recorded both before the interventions and at follow-up weeks 4, 8, and 12.

Results: There were no significant differences in demographic characteristics between the groups. After treatment, both groups showed reductions in VAS for pain, VAS for paresthesia, QDASH scores, and total BCTQ scores between baseline and weeks 4 and 12 follow-ups, with no statistically significant differences between the groups.

Conclusions: There was no evidence indicating a difference in clinical efficacy between single-session fESWT and steroid injection therapy in patients with moderate-degree carpal tunnel syndrome over a 12-week period. Therefore, noninvasive fESWT could be considered an option to which can avoid possible side effects of steroid injection.

The Effect of Mindful Movement on Pain Intensity, Leg Muscle Fitness and Psychological Features in University Athletes with Chronic Patellofemoral Pain - A Randomized Controlled Trial Pilot Study

2024-06-28T09:11:56+07:00

Objectives: To evaluate and compare the effects of mindful movement therapy and general exercise therapy on pain intensity, leg muscle fitness, and psychological features in university athletes with chronic patellofemoral pain

Study design: Randomized controlled trial, a pilot study

Setting: Sport laboratory room, Department of Health and Sport Science, Mahasarakham University

Subjects: Thirteen athletes with chronic patellofemoral pain

Methods: The participants were males and females aged 19 to 25 years old who had had anterior knee pain for over three months. The self-report questionnaire and clinical tests diagnosed patellofemoral pain. The thirteen people were divided into two groups by block randomized allocation: the mindful movement group (n=7) and the general exercise therapy group (n=6). They were assessed for pain intensity, leg muscle fitness, and psycho-logical features before and after the eight-week study. Both groups visited the physiotherapist to train three times a week for eight weeks.

Results: After the 8-week intervention, both groups showed significant improvement in pain intensity, pain catastrophizing scale, fear-avoidance beliefs questionnaire, and strength, endurance, and power tests of the legs over baseline (p < 0.05), but the acceptance scores of the mindful movement group (p = 0.286) and all levels of mindfulness of the general exercise therapy group showed no statistically significant difference (p = 0.904). The differences in average outcomes between the two groups at baseline were not statistically significant with the exception of leg power (p = 0.008). Moreover, there was no significant difference in the change in all outcomes between the two groups after the 8-week intervention (p > 0.05).

Conclusions: Both interventions can reduce pain intensity and improve physical and psychological features, even though the athletes had continued to perform other physical activities in daily life while participating in the program. Future studies with a larger sample size and a determination of retention time are needed.

Comparison of Effects of the Five Points Hands Free Program Versus Standard Eye Exercises in Office Workers with Computer Vision Syndrome in Trang Hospital

2024-08-01T08:51:58+07:00

Objectives: To compare the effects of the five-point hands free (FPHF) exercise program and standard eye exercises on computer vision syndrome (CVS) and vestibulo-ocular symptoms among Trang Hospital staff.

Study design: A prospective, comparative, cluster-randomized study

Setting: Trang Hospital, Trang, Thailand

Subjects: Sixty-two office workers with CVS symptoms

Methods: Participants were divided into a standard exercise group (n=31) and a FPHF group (n=31). CVS symptoms were assessed using the CVS questionnaire. Vestibular ocular motor function was evaluated using the Vestibular/Ocular Motor Screening (VOMS) tool before and after a 3-week intervention.

Results: After three weeks, both the FPHF and the standard group improved CVS and VOMS scores. The FPHF group had a reduction in almost all symptoms, similar to the standard group. The FPHF group significantly reduced headaches, dizziness, and fogginess during VOMS (p < 0.05). However, between-group differences in CVS and VOMS cumulative scores were not statistically significant.

Conclusions: The FPHF program demonstrated potential benefits in reducing CVS and vestibulo-ocular symptoms, suggesting that it may be a viable alternative intervention for managing CVS. However, further research is needed to establish its long-term effectiveness compared to standard exercises.

Prevalence of and Factors Associated with Depression in Caregivers of Children with Cerebral Palsy

2024-08-05T21:35:13+07:00

Objectives: To investigate the prevalence of depression in caregivers of children with cerebral palsy including the quality of life of caregivers and factors associated with depression

Study design: Cross-sectional study

Setting: Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University

Subjects: Ninety-two caregivers of children with cerebral palsy

Methods: Caregivers of children with cerebral palsy were recruited and asked to complete a three-section questionnaire: demographic and personal information of both caregivers and the children they care for, The Patient Health Questionnaire-9 (PHQ-9) Thai version, and The World Health Organization Quality of Life Brief Thai version (WHOQOL-BREF-THAI).

Results: Sixty-three percent of the participants were female, with a median age of 39 and an interquartile range (IQR) of 32-44. The children with cerebral palsy had a median age of 8 years (IQR: 4-11). The prevalence of depression in the primary caregivers of children with cerebral palsy was 20.7%, with statistically significant findings indicating that caregivers of children with cerebral palsy who were non-verbal were more likely to experience depression at a rate 3.4 times higher than caregivers of children who could communicate using language (p < 0.05). Overall, the quality of life of the primary caregivers of children with cerebral palsy was moderate (65.5%). Caregivers with depression had significantly lower quality of life scores in all domains with the exception of social relationships.

Conclusions: The prevalence of depression among primary caregivers of children with cerebral palsy at Siriraj Hospital was 20.7%, with lack of language communication of their children with cerebral palsy a significant factor

Clinical Competency Needs of Physiatrists in Thailand: A Cross-Sectional study

2024-09-02T09:29:24+07:00

Objectives: To determine the degree to which the clinical competency needs of Thai practicing physiatrists in the current rehabilitation medicine residency curriculum align with topics validated by the Board of Training and Examination in Rehabilitation Medicine of Thailand

Study design: Cross-sectional study

Setting: Department of Rehabilitation Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Subjects: Total Thai physiatrists in 2020-2021

Methods: A total of 731 physiatrists in Thailand were surveyed using the questionnaire which was composed of two parts. The first part covered participants’ characteristics. The second part included 96 rehabilitation medicine topics which had been validated by the Board of Training and Examination in Rehabilitation Medicine of Thailand. Participants rated each of the topics on afour-point (1-4) Likert scale for both “Frequency” and “Importance”. Frequency refers to how often the participant applied each topic in their practice and importance refers to the significance of each topic in their clinical practice.

Results: The response rate was 15.3% (112/731). The five most frequently encountered conditions rated 4 were low back pain (N=86.6%), osteoarthritis of the knee (N=83.0%), stroke (N=79.5%), spondylosis/spondylolisthesis (N=78.6%), and radiculopathy (N=70.5%). The five most essential conditions rated 4 were stroke (N=87.5%), osteoarthritis of the knee (N=79.5%), low back pain (N=78.6%), chronic pain (N=75.9%), and radiculopathy (N=75.0%).

Conclusions: The survey provides essential information which the Royal College of Physiatrists of Thailand and could use to help improve the curriculum content for entrustable professional activities.

Correlation Between 6-Minute Walk Distance, Severity of Airflow Limitation and Dyspnea Score in COPD Patients: A Retrospective Study

2024-08-31T07:24:47+07:00

Objectives: To determine the correlation between 6-minute walk distance (6MWD) and severity of airflow limitation as well as modified Medical Research Council (mMRC) dyspnea score in Chronic obstructive pulmonary disease (COPD) patients

Study design: Retrospective study

Setting: Outpatient Rehabilitation Clinic, Trang Hospital.

Subjects: Patients diagnosed with COPD who completed the 6-minute walk test (6MWT) between January 1, 2022 and December 31, 2023.

Methods: The patients’ baseline characteristics were obtained from medical records. The Forced Expiratory Volume in one second (FEV₁), 6MWD, and mMRC dyspnea scores were collected and analyzed.

Results: One hundred and ninety-seven patients with COPD were recruited, of whom 91.9% were male. The average 6MWD was 403.4 meters (SD=78.4). Half the patients had moderate COPD. The majority of the patients had an mMRC dyspnea score of 1. There was a weak positive correlation between 6MWD and FEV₁ (r = 0.299, p < 0.001) and a weak negative correlation between 6MWD and mMRC dyspnea score (r = -0.266, p < 0.001). However, there was a strong negative correlation between 6MWD and the mMRC dyspnea score (r = -0.727, p < 0.05) in patients with very severe degree COPD.

Conclusions: The study showed a significant weak correlation between 6MWD and FEV₁ as well as 6MWD and mMRC dyspnea score. However, in patients with very severe COPD, the correlation between 6MWD and mMRC dyspnea score was stronger than in others. This suggests that 6MWT and mMRC dyspnea score should be routinely evaluated in patients with COPD to monitor clinical change.