Search

Outpatient and inpatient rehabilitation, as a complex and multimodal treatment concept, makes significant use of methods that are assigned to conservative orthopedics, in particular the procedures of physical therapy. In contrast to physiotherapy and medical training therapy, physical therapy is a form of therapy provided with technology. The spectrum ranges from hydrotherapy, mechanotherapy and thermotherapy to balneotherapy, massage forms and electrotherapy. Climatotherapy, phototherapy and aerosol/inhalation therapy have less of an impact on the orthopaedic field. Although the forms of therapy are often referred to as passive, the effect is based on physical laws, physiological reactions and adaptation. In addition, these are predominantly forms of therapy, some of which have been in use for centuries, some for thousands of years, these efficient treatments with a good safety and tolerability profile gained by means of empiricism. [ABSTRACT FROM AUTHOR]

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of functional diagnostic is detection of the arthrosis, the classification of the structural findings, functional disturbance and the restriction of the patient. Helpful is the ICD - Classification with the assessment of the ICF - Classification for judging the activity and participation of the patient with instruments for self or external assessments. The clinical symptoms are related by stage. The most importand symptom is pain, related by rest and strain, a look out for the persistent pain at night. The functional clinical investigation includes investigation of the joint movement and course, evaluation of the soft tissue function, joint compartments as well as ligaments and meniscus. Joint stress tests are helpful to detect function disturbences and are helpful in the way of diagnostic. A manual investigation completes the assessment of functional disturbences, local in the joint structures and the functional chains. In addition of the investigation we need imagings (x-ray, sonography) corresponding guidelines. To evaluate the restriction of functional severity and restriction are assessments so well as generic health (SF 36), specific health (WOMAC) and pain (VAS) helpful. The focus in the diagnosis procedure assess pain, functional loss and other symptoms as well as the medication. Non-surgical or conservative measures includes different treatment steps. Adaption of lifestyle and avoidance of stress for movement system is the first action followed by helpful sports activities. In relation of the personal specific situation of the patient an instruction of the doctor is helpful. Physical treatments reduce functional restrictions, pain and also optimize muscular actions and processes for regulation. For that is used technics from thermotherapy included cryotherapy, electrotherapy, phytotherapy, tape, orthosis and technical aids, technics from complementary medicine. Physiotherapy as a "joint school", mobilization, muscle strengthening, optimize of tension and coordination are best to use. The best evidence and recommendation are sports and training, physiotherapy and manual medicine, recommended by the international societies, always related to the local clinical findings. Different examples for therapy of gonarthrosis are showed in the article. Orthopedic aids are helpful. Complaints of arthosis have slow progression overall groups. Every single person is different. We are able to influence predictors often with the conservative therapy - most of all pain and function. The therapy is as good as long as we need other therapy and surgical intervention. [ABSTRACT FROM AUTHOR]

The article presents a report on a conference on disability studies and history, held in Aachen, Germany, on December 7, 2012. Topics of discussion included prosthetic teeth, galvanism and electrotherapy for the treatment of deafness, and the representation of disabilities and people with disabilities in film.

Electroconvulsive therapy is a well-established form of treatment for a broad spectrum of severe psychiatric disorders. The treatment, in which a generalized epileptic seizure is provoked by electrical stimulation of the brain, is performed with the patient under anesthesia and muscle relaxation. Therefore, sufficient knowledge of the physiological and pharmacological characteristics is an essential requirement for safe anesthesia. The following review is intended to provide some new aspects of the procedure and management of anesthesia. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Bipolar depression is linked with substantial burden and a high suicide risk, making a rapid and highly efficacious treatment mandatory. However, similar to mania, aspects of long-term treatment should already be considered at treatment initiation. With comparable efficacy, drugs with a beneficial safety and tolerability profile should be preferred. Additional psychotherapy can also noticeably improve both short- and long-term outcome of bipolar depression. Electroconvulsive therapy (ECT) still has its place in severe, treatment-resistant bipolar depression. Whereas ECT is a domain of specialised centres, correct diagnosis and both pharmacological and psychotherapeutic treatment initiation are essential tasks of primary care practitioners and secondary care psychiatrists. [ABSTRACT FROM AUTHOR]

Urinary incontinence in men most commonly occurs after radical prostatectomy. Of these patients, 3-23% remain incontinent a year after prostatectomy. Data on conservative therapy for postoperative incontinence is contradictory. Nonetheless, conservative treatment strategies must generally be attempted before any operative technique. Early pelvic floor muscle training with or without biofeedback therapy and duloxetine seem to have a positive effect on continence. Further randomised controlled studies are necessary to accurately assess other conservative therapeutic options such as extracorporeal magnetic innervation and electrical stimulation therapy. [ABSTRACT FROM AUTHOR]

Antimuscarinic drugs are regarded as the standard treatment of detrusor overactivity (DO). However, side effects and lack of efficacy cause patients to discontinue long-term therapy. We evaluated the clinical efficacy of functional external electrostimulation (FES) as "second-line" therapy in patients with symptomatic idiopathic or neurogenic DO.In a retrospective study, 52 patients (38 women and 14 men) were evaluated at least 1 year after FES. Eighteen patients (32.7%) regarded FES as successful. No change occurred in 34 patients (65.4%) and 1 patient reported worsening of symptoms. Treatment success lasted for 13.2 months. In successfully treated patients, voiding frequency was significantly reduced from 13.3/24 h to 6.1/24 h under FES and to 6.75/24 h at follow-up. FES is a clinically useful, well-tolerated, conservative second-line treatment option after failed antimuscarinic treatment in patients with idiopathic or neurogenic DO. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Since 2001 magnetic stimulation therapy has been available in Germany for treating urinary incontinence as an alternative to traditional electrical stimulation therapy. The results of 83 patients who underwent magnetic stimulation therapy for stress incontinence, OAB, and pelvic pain syndrome were evaluated. The results differed depending on the underlying disease. Patients with stress incontinence who could not properly contract pelvic floor muscles before could do so in 74% when clinically evaluated and patients with OAB symptoms improved in 54% as assessed by objective and subjective criteria, whereas patients with pelvic pain syndrome only benefited in 23%. Comparison of the results according to age revealed no significant difference between patients >65 years and younger patients. [ABSTRACT FROM AUTHOR]

Worldwide use of electrical stimulation for therapy of postoperative incontinence is based on a few prospective randomized controlled studies. We present a three-arm prospective randomized study evaluating physiotherapeutic pelvic floor training alone and in combination with transanal or perineal electrical stimulation. The study compared specific continence training (CT) and a combination of CT with transanal or perineal electrostimulation. The groups included 60 patients each and were analyzed with regard to self-assessment, objective characteristics of incontinence, standard quality of life questionnaire (QLQ-C 30), and recorded data of the stimulation device. The patients participated in a specific inpatient rehabilitation program and were assessed at the time of admittance, upon discharge, and again after 3 months. Significant improvement could be achieved in every group concerning urinary incontinence and quality of life. Additional use of electrical stimulation was significantly superior to physiotherapeutic training alone. However, these results could only be detected in a highly compliant subgroup. Analysis of device data indicated a high score of errors and lack of patient compliance. Perineal electrical stimulation was better accepted than transanal and showed less side effects and better outcome in the characteristics of incontinence. Improvement in the quality of life was mostly achieved during the weeks of inpatient rehabilitation. Electrical stimulation could not improve quality of life items. Electrical stimulation is an efficient instrument for treatment of postoperative high-grade incontinence, however, only with sufficient patient compliance. [ABSTRACT FROM AUTHOR]