Physical therapy
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Comparative Study
A psychosocial risk factor--targeted intervention for the prevention of chronic pain and disability following whiplash injury.
The objective of this study was to determine whether the addition of a psychosocial intervention improved return-to-work rates beyond those associated with participation in a functional restoration physical therapy intervention. Subjects who had sustained whiplash injuries participated in the Progressive Goal Attainment Program (PGAP), which is a 10-week psychosocial intervention program that aims to increase activity involvement and minimize psychological barriers to rehabilitation progress. ⋯ The findings suggest that a psychosocial risk reduction intervention can be an effective means of improving function and facilitating return to work in people who are at risk for prolonged pain-related disability.
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The direct effects of ultrasound (US) and phonophoresis of a nonsteroidal anti-inflammatory drug (NSAID) on injured peripheral tissue have been widely investigated, but evidence concerning the effects of central spinal nociceptive modulation seems to be lacking. The purpose of this study was to investigate the peripheral influences of US and phonophoresis on the modulation of spinal inducible nitric oxide synthase (iNOS) expression elicited by hind paw stimulation with an ankle injection of complete Freund adjuvant (CFA). ⋯ Ultrasound and phonophoresis treatments probably modulate and prevent the CFA-insult-induced increase in total and regional iNOS-LI neurons. Peripheral use of diclofenac phonophoresis offers little advantage over US alone in affecting the central mechanisms of nociception. The peripheral influences of US and phonophoresis on the central modulation of the spinal nociceptive processing system are important and may reflect the work being done through the neuroplasticity of spinal cord in response to peripheral input of US and phonophoresis.