Quick Carpal Tunnel Syndrome Test

In our last e-magazine, we showed some manual testing fro Carpal Tunnel Syndrome. However, there may be an even easier and quicker way to pick up carpal tunnel syndrome, say researchers from the Institute of Clinical Neurophysiology at the University Medical Center Ljubljana, Slovenia.

They took 100 patients with suspected carpal tunnel who had been referred to the Institute's electrodiagnostic unit for nerve tests and gave them a series of seven questions about their symptoms. Three questions were especially useful in identifying people with carpal tunnel syndrome:

• Do you get tingling in at least two of the first four fingers?
• Are symptoms worse during the night or on awakening?
• Do the symptoms get better when you shake your hand?

If you answered 'yes' to two of these questions, there's a 97 per cent probability you have carpal tunnel syndrome and need to have nerve and muscle conduction tests, say the researchers.

http://www.abc.net.au/health/thepulse/stories/2008/10/16/2374239.htm

Lacking of evidence on massage benefits for athletes?

According to the authors of (another) review "It’s unclear, based on current research, whether massage therapy for post-exercise muscle soreness and recovery actually helps or not". The usual explanation again : “More standardized research needs to be done,” Dr. Furqan Haq of the Ohio State University College of Medicine in Columbus.

Despite the lack of scientific evidence for its benefits, massage is widely believed to help ease muscle recovery after exercise and even improve performance when administered before competition, Haq and colleagues note in the Clinical Journal of Sports Medicine.  They reviewed 27 studies that employed a wide variety of approaches; for example, massaging different parts of the body, using different massage techniques, and massaging for different amounts of time. None of the studies specified the amount of force applied during massage. Evidence for massage’s benefits from the 17 case series was questionable, the researchers concluded, but the 10 randomized controlled trials provided “moderate evidence for the efficacy of massage therapy.”

Their analysis suggested that massage was most effective when given within two hours of exercise, Haq noted. Future research should use a standardized massage protocol, should examine the effectiveness of massage given before exercise, and should also investigate the effects of giving several massage sessions, rather than just one, Haq said.

Reference: Effectiveness of Sports Massage for Recovery of Skeletal Muscle From Strenuous Exercise. Critical Review. Clinical Journal of Sport Medicine. 18(5):446-460, September 2008.

Massage for Lower back pain

A new review from Cochrane was published recently on the effectiveness of massage for lower back pain. Cochrane provides a systematic review from published clinical trials of the effects of healthcare interventions.

Massage in this review is defined as soft-tissue manipulation using hands or a mechanical device on any body part. Non-specific LBP indicates that no specific cause is detectable, such as infection, neoplasm, metastasis, osteoporosis, rheumatoid arthritis, fracture, inflammatory process or radicular syndrome (pain, tingling or numbnness spreading down the leg).

Thirteen randomized trials (1596 participants) assessing various types of massage therapy for low-back pain were included in this review. Eight had a high risk and five had a low risk of bias. Massage was more likely to work when combined with exercises (usually stretching) and education. The amount of benefit was more than that achieved by joint mobilization, relaxation, physical therapy, self-care education or acupuncture. The beneficial effects of massage in patients with chronic low-back pain lasted at least one year after the end of the treatment. Two studies compared two different techniques of massage. One concluded that acupuncture massage produces better results than classic (Swedish) massage and another concluded that Thai massage produces similar results to classic (Swedish) massage. One study showed that reflexology on the feet had no effect on pain and functioning.

No serious adverse events were reported by any patient in the included studies. However, some patients reported soreness during or shortly after the treatment. Some patients also reported an allergic reaction (e.g. rash or pimples) to the massage oil.

The authors concluded that, massage might be beneficial for patients with subacute (lasting four to 12 weeks) and chronic (lasting longer than 12 weeks) non-specific low-back pain, especially when combined with exercises and education.

I think that the problem with this kind of review is that it viewed treatment as a standard procedure or a type of "medication". And you can get odd conclusions such as Thai massage is superior than Swedish massage (if the research is a proponent of Thai massage). The usual conclusion is : It is unclear or not shown, based on current research, whether massage therapy is effective". And “More standardized research needs to be done”.

Bee Gees hit could save your life

US medics have found the Bee Gees’ 1977 hit Stayin’ Alive is an ideal beat to follow to perform chest compressions on a victim of a cardiac arrest. Research says it contains 103 beats per minute, close to the recommended rate of 100 chest compressions per minute.

An author of the study said many people were put off performing cardiopulmonary resuscitation (CPR)as they were not sure about keeping the correct rhythm. He said CPR could triple cardiac arrest survival rates when performed properly.

The study by the University of Illinois College of Medicine saw 15 doctors and students performing CPR (cardiopulmonary resuscitation) on mannequins while listening to Stayin’ Alive. They were asked to time their chest compressions with the beat.

Five weeks later, they did the same drill without the music, but were told to think of the song while doing compressions. The average number of compressions the first time was 109 per minute; the second time it was 113 - more than recommended by the American Heart Association, but better than too few, according to Dr Matlock. “It drove them and motivated them to keep up the rate, which is the most important thing,” he told the Associated Press.

A spokesman for the American Heart Association, Dr Vinay Nadkarni, said it had been using Stayin’ Alive as a training tip for CPR instructors for about two years, although it was not aware of any previous studies that tested the song.

http://news.bbc.co.uk/1/hi/health/7678371.stm

Appropriate Exercise Can Help Prevent ACL Injuries In Female Athletes

The American Physical Therapy Association (APTA) is urging female athletes — particularly soccer players — to consider a new warm-up program to help lower their growing risk of anterior cruciate ligament (ACL) injuries. Concurring with a new study published in the American Journal of Sports Medicine (August 2008), APTA says specialized stretching, strengthening, agility and jumping exercises could lower the overall ACL injury rate among female athletes.

The study evaluated outcomes of NCAA Division 1 female soccer players who performed the Prevent Injury, Enhance Performance (PEP) program, designed by physical therapists at Santa Monica (CA) Orthopedic and Sports Medicine Group. Those who performed the PEP program had an overall ACL injury rate 41 percent lower than a group of female athletes who did their regular warm-up. This was one of the largest studies conducted in the NCAA with 1,435 athletes participating.

The PEP program, one example of the many physical therapy-based programs that have demonstrated an equal ability to reduce ACL injuries among female athletes, consists of sport-specific agility exercises and addresses potential deficits in the strength and neuromuscular coordination of the stabilizing muscles around the knee joint. Physical therapist and APTA spokesperson Holly Silvers, MPT, who helped develop PEP, says, “The program was created to address the deficits that are seen in female athletes, particularly weakness in the lateral hip muscles, gluteal, and core muscles.” These deficits can contribute to ACL injuries, notes Silvers.

According to physical therapist and APTA spokesperson Mark Paterno, PT, MS, MBA, SCS, ATC, coordinator of orthopedic and sports physical therapy at Cincinnati Children’s Hospital Medical Center, recent research published in the British Journal of Sports Medicine found that ACL tears occur four times more frequently in females than in males involved in the same amount of sports participation. He says the difference in neuromuscular control, or the way our muscles contract and react, is one of four primary factors contributing to why women are more susceptible to knee injuries than men. Other discrepancies are anatomical (men and women are structurally differently), hormonal (women’s hormonal makeup affects the integrity of the ligament, making it more lax), and bio-mechanical (the positions our knees get in during athletic activities).

Sample exercises athletes can perform to avoid ACL injuries can be found on the APTA Web site. http://www.apta.org/AM/Template.cfm?Section=News_Archive&Template=/CM/ContentDisplay.cfm&ContentID=51955

“Women perform athletic tasks in a more upright position, putting added stress on parts of the knee such as the ACL, resulting in less controlled rotation of the joint,” said Paterno. “While men use their hamstring muscles more often, women rely more on their quadriceps, which puts the knee at constant risk. To combat these natural tendencies, physical therapists may develop a treatment program to improve strength, flexibility, and coordination, as well as to counteract incorrect existing patterns of movement that may be damaging to joints,” he added.

Silvers notes that physical therapist-designed programs can teach athletes how to avoid abnormal movement patterns and lessen stress on the knee, which may include exercises to strengthen hamstring and core muscles. “Whether patients are athletes or not, physical therapist expertise includes not only rehabilitation and restoration of normal levels of function, but also education regarding how to prevent further injury,” says Silvers.

American Physical Therapy Association (2008, October 2). Physical Therapists Say Appropriate Exercise Can Help Prevent ACL Injuries In Female Athletes. ScienceDaily. Retrieved October 21, 2008, from http://www.sciencedaily.com­ /releases/2008/09/080926194609.htm