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Query: UMLS:C0009443 (cold)
 92,137 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study presents concordance data from 3 different tests of small nerve-fibre function on the same diabetic patients and also examines the effects of hyperglycaemia. Thus the TTT-Glasgow automated thermal threshold test, EAR-Electrically evoked axon reflex flare, and GOE-Gastric emptying of a mixed sold/liquid meal and oesophageal emptying of a solid bolus were all measured on 25 diabetic patients. The TTT, EAR and GOE all gave values ranging from within the normal reference range for non-diabetics to markedly dysfunctional readings. Mean warm perception (WPT) on the foot dorsum averaged 0.73 degrees C +/- 0.93 for normal controls, but was 4.67 degrees C +/- 3.99 in the 25 diabetics. Cold perception thresholds (CPT) were 0.48 degrees C +/- 0.55 for normal subjects and 3.75 degrees C +/- 4.28 for diabetics. In the same normal subjects the mean EAR flare laser flux responses (for 8 and 16 noxious TENS pulses) was 2.8 V.min, while for diabetics the mean was 0.2 V.min. Solid and liquid gastric 50% emptying times and oesophageal emptying for non-diabetics were within normal range (mean 78 min and 18 min, 18 sec respectively) but for the 25 diabetics emptying times ranged from normal to very prolonged (mean 114 min and 30 min, 68 sec respectively). A plot of 3 measured variables (TTT, EAR and GOE) showed a high degree of correspondence between the gastro-oesophageal emptying delays and the presence of reduced electrical axon reflex and elevated thermal thresholds. Of 25 patients, 6 could be classed as within normal limits on all 3 variables, but 8 of 25 displayed objective evidence of C-fibre neuropathy--thermal perceptual impairment (C- and A-delta sensory fibres), reduced neurogenic inflammatory flare (peptidergic nociceptive afferents) and delayed gastro-oesophageal emptying (vagal afferent/efferent fibres).
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PMID:Concordance between different measures of small sensory and autonomic fibre neuropathy in diabetes mellitus. 264 39

Management of pain in the person with arthritis requires interdisciplinary team work with the patient being the final manager. It is important that any health care provider perceive the patient as a person who happens to have arthritis--not as 'an "arthritic".' Defining a person by one's disease process is dehumanizing. The patient has the same aspirations as anyone who is ablebodied--to be free from disease. While the patient may know that a cure is not imminent, there is still the hope for one. Therefore, as the patient comes for physiotherapy, there may be a hidden wish that the moist packs, TENS, or therapeutic pool will be curative. It is important that the patient understand that no equipment in the physiotherapy department has curative powers. This will help avoid unnecessary dependency behaviours on the part of the patient. Careful instruction and supervision of the patient by the physiotherapist, in concert with reinforcement from the physician, can prepare the patient to apply heat, cold, or a variety of treatments at home. Although the patient is given the responsibility for this part of his care, periodic follow-up and reassessment should be completed to determine changes in his physiological, psychological, and functional status. Physiotherapists who have a clear understanding of the physical treatment of pain associated with the rheumatic diseases can be a valuable asset to medical care.
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PMID:Physiotherapy methods of relieving pain. 333 14

The effect of conditioning stimulation on thermal sensitivity and clinical pain was studied in 40 patients and six healthy subjects. Thresholds regarding cold, warm and heat pain perception did not differ significantly between the painful and non-painful skin areas in patients or between patients and healthy subjects before stimulation. The patients received either 100 Hz TENS, 2 Hz TENS, 100 Hz vibration, or placebo. No significant changes in thermal sensitivity were observed during and after conditioning stimulation in any of the test groups, although 24/40 (60%) of the patients reported reduction of their clinical pain intensity. The results indicate that (a) thermal sensitivity is not influenced by the presence of clinical pain, (b) the effects of stimulation on thermal sensitivity (thresholds) and clinical pain are not closely related, (c) central inhibitory effects of TENS and vibration are crucial for their pain relieving capacity.
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PMID:Thermal sensitivity is not changed by acute pain or afferent stimulation. 349 86

In the management of functional disturbances of the stomatognathic system symptomatic and causal therapeutic methods can be distinguished. Symptomatic therapy encompasses medication, physical methods (heat, cold, radiation, TENS) in combination with physiotherapy and emergency splint. After one or two weeks of symptomatic therapy the patient should be free of pain allowing precise diagnostic procedures followed by causal therapy managing muscular problems, joint pathology and occlusal disturbances. Splint therapy is used to establish a therapeutic joint position according to articulator mounting. After splint therapy prosthodontic and/or orthodontic treatment is needed to restore occlusion. Interdisciplinary management in the therapy of functional disturbances of the stomatognathic system is of utmost importance due to the relationship between chewing muscles, neck muscles and body posture. In addition to splint therapy, physiotherapy, logopedic therapy, myofunctional therapy, psychologic and psychiatric intervention is performed.
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PMID:[Treatment strategy in functional temporomandibular joint changes]. 1159 1

The cost to society and the individual of treating asthma has been increasing in developed countries. This has given rise to studies of the efficacy of complementary treatments. The aim of this study was to evaluate the efficacy of traditional Chinese Acupuncture in patients with mild asthma. The method used for evaluation of efficacy was total airway resistance at 5Hz (R5) as measured by impulse oscillometry (IOS)--a forced oscillation technique, at baseline and after a bronchial challenge with voluntary isocapnic hyperventilation of cold air (IHCA). The study was a parallel group randomised placebo controlled trial with evaluator blinding. Twenty-seven asthmatics were recruited and 24 completed the study, 10 of them received acupuncture and 14 received a placebo treatment (mock-TENS). Treatment continued for 15 weeks, and efficacy was tested two weeks following the last treatment. Randomisation resulted in female over representation in the acupuncture group, but lung-function and bronchial responsiveness to IHCA were comparable in the two populations before the start of treatment (p>0.05 vs. p > 0.05). There were no statistically significant effects of the treatment before (p > 0.05) or after IHCA (p > 0.05) in either of the groups. The statistical power of the study to show a clinically relevant difference in bronchial responsiveness to IHCA after treatment was near 80%. We conclude that there were no significant effects of traditional Chinese Acupuncture on airway status in our patients with asthma.
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PMID:No effect of chinese acupuncture on isocapnic hyperventilation with cold air in asthmatics, measured with impulse oscillometry. 1221 3

The following conclusions can be made based on review of the evidence: There is limited but positive evidence that select physical modalities are effective in managing chronic pain associated with specific conditions experienced by adults and older individuals. Overall, studies have provided the most support for the modality of therapeutic exercise. Different physical modalities have similar magnitudes of effects on chronic pain. Therefore, selection of the most appropriate physical modality may depend on the desired functional outcome for the patient, the underlying impairment, and the patient's preference or prior experience with the modality. Certain patient characteristics may decrease the effectiveness of physical modalities, as has been seen with TENS. These characteristics include depression, high trait anxiety, a powerful others locus of control, obesity, narcotic use, and neuroticism. The effect on pain by various modalities is generally strongest in the short-term period immediately after the intervention series, but effects can last as long as 1 year after treatment (e.g., with massage). Most research has tested the effect of physical modalities on chronic low back pain and knee OA. The effectiveness of physical modalities for other chronic pain conditions needs to be evaluated more completely. Older and younger adults often experience similar effects on their perception of pain from treatment with physical modalities. Therefore, use of these modalities for chronic pain in older adults is appropriate, but special precautions need to be taken. Practitioners applying physical modalities need formal training that includes the risks and precautions for these modalities. If practitioners lack formal training in the use of physical modalities, or if modality use is not within their scope of practice, it is important to consult with and refer patients to members of the team who have this specialized training. Use of a multidisciplinary approach to chronic pain management is of value for all adults and older individuals in particular [79-81]. Historically, physical therapists have been trained to evaluate and treat patients with the range of physical modalities discussed in this article. Although members of the nursing staff traditionally have used some of these modalities (e.g. some forms of heat or cold and massage), increasing numbers of nurses now are being trained to apply more specialized procedures (e.g., TENS). Healthcare professionals must be knowledgeable about the strength of evidence underlying the use of physical modalities for the management of chronic pain. Based on the limited research evidence available (especially related to assistive devices, orthotics, and thermal modalities), it often is difficult to accept or exclude select modalities as having a potential role in chronic pain management for adults and older individuals. Improved research methodologies are needed to address physical modality effectiveness better.
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PMID:Physical modalities in chronic pain management. 1456 4

At present, there is no reliable antianginal drug therapy for patients with cardiac syndrome X. Therefore, the effect of electrical neuromodulation on refractory angina pectoris and myocardial perfusion in cardiac syndrome X was assessed. Eight patients (aged 55+/-7 years) with heterogeneous myocardial perfusion and no esophageal abnormalities were included. The subjects were nonresponders to antianginal drug therapy. Angina pectoris attacks and myocardial perfusion dynamics were evaluated by positron emission tomography at baseline and following 4 weeks of (transcutaneous electrical nerve stimulation) TENS. Following TENS there was a reduction of angina pectoris episodes (baseline 20+/-3, TENS 3+/-1; p=0.012), and short acting nitroglycerin intake per week (baseline 10+/-3, TENS 2+/-1; p=0.008). The rate pressure product (mmHg min(-1)) during the cold pressor test (CPT) was reduced during TENS (baseline 12800+/-1200, TENS 11500+/-900; p=0.02). Following TENS, the perfusion reserve ratio between rest and dipyridamole flow increased (baseline 1.59+/-0.15, TENS 1.90+/-0.11 ml min(-1)x 100g; p=0.05). The coronary vascular resistance had a trend towards a reduction (baseline 0.96+/-0.04, TENS 0.85+/-0.06 mmHg min(-1)x 100 g/ml; p=0.06) during CPT. This observation may suggest that neurostimulation improves angina pectoris with a concomitant improvement of myocardial perfusion in cardiac syndrome X.
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PMID:Electrical neuromodulation improves myocardial perfusion and ameliorates refractory angina pectoris in patients with syndrome X: fad or future? 1457 63

Physiotherapy in osteoporosis essentially takes the form of stimulatory therapy tailored to the findings and the pathomechanism. The choice of therapy and its dosage depend on the desired result (prevention, cure, rehabilitation). Physical therapy applied in osteoporosis includes electrical, thermic (hydrothermic, high frequency thermic, light thermic) and mechanical (massage, physiotherapy) stimuli, which can be applied regionally, locally or hoistically. To be efficient, a pain therapy requires that the various painful states be differentiated between: whereas, for example, in the case of acute pain physiotherapy fulfils the function of immediate therapy (normally rest and "mild" cold applications), in chronic pain it has to fulfil the function of an adaptive performance therapy of neuronal structures (formative-adaptive physiotherapy, thermic therapy improving trophism, direct current, transcutaneous electric nerve stimulation/TENS). It is necessary and extremely important forday-to-day clinical practice that physiotherapy strategies that are tailored to each patient's needs and also economically justifiable be implemented. The article isintended to contribute to this.
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PMID:[Physiotherapy strategies in osteoporosis--recommendations for daily practice]. 1692 53

Electrophysiological studies suggest that there are differential frequency effects during TENS. The aim of this experimental study was to assess the effects of strong non-painful TENS administered at 3 pulses per second (pps) and 80 pps on cold-pressor pain in healthy human participants. A repeated measure design was used with participants receiving TENS at 3 pps and 80 pps in the same experiment. There were six cold-pressor pain tests conducted on the hand with each type of TENS delivered via four electrodes on the ipsilateral forearm for 20 min. Outcomes were differences in pain threshold (s) and intensity (VAS) after 5 and 15 min of TENS. A 2 x 3 factorial repeated measure ANOVA was performed on data. Thirty-five participants completed the experiment. Statistically significant effects were detected for condition, time and interactions between time x condition for both threshold and intensity. There were statistically higher pain thresholds and lower pain intensities for 3 pps when compared to 80 pps after 5 and 15 min of TENS. The differences after 15 min of TENS were 1.70 s to 3.70 s (95% CI) for threshold and 6.63-15.5 mm (95% CI) for pain intensity. In conclusion, strong non-painful TENS at 3 pps was superior to 80 pps at reducing experimentally induced cold-pressor pain. The implications of these findings are discussed.
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PMID:A comparison of transcutaneous electrical nerve stimulation (TENS) at 3 and 80 pulses per second on cold-pressor pain in healthy human participants. 2066 77

TENS can be administered in conventional (high frequency, low intensity) or acupuncture-like (AL-TENS: low frequency, high intensity) formats. It is claimed that AL-TENS produces stronger and longer-lasting hypoalgesia than conventional TENS, although evidence is lacking. This randomised controlled parallel group study compared the effects of 30 minutes of AL-TENS, conventional TENS, and placebo (no current) TENS, on cold-pressor pain threshold (CPT), in 43 healthy participants. Results showed a greater increase in mean log(e) cold-pressor pain threshold relative to baseline for both AL-TENS and conventional TENS vs. placebo TENS, and for AL-TENS vs. placebo 5 and 15 minutes after TENS was switched off. There were no statistically significant differences between conventional TENS vs. placebo or between AL-TENS vs. conventional TENS at 5 or 15 minutes after TENS was switched off. In conclusion, AL-TENS but not conventional TENS prolonged post-stimulation hypoalgesia compared to placebo TENS. However, no differences between AL-TENS and conventional TENS were detected in head-to-head comparisons.
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PMID:Comparison of post-treatment effects of conventional and acupuncture-like transcutaneous electrical nerve stimulation (TENS): A randomised placebo-controlled study using cold-induced pain and healthy human participants. 2200 92


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