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12. Short-term cutaneous vasodilatory and thermosensory effects of topical methyl salicylate.

Author

Versteeg, Ninja, Wellauer, Vanessa, Wittenwiler, Selina, Aerenhouts, Dirk, Clarys, Peter, and Clijsen, Ron

Subjects
TRP channels, SPECKLE interference, TOPICAL drug administration, OXYGEN saturation, SPECKLE interferometry
Abstract

Introduction: Methyl salicylate, the main compound of wintergreen oil, is widely used in topical applications. However, its vascular and thermosensory effects are not fully understood. The primary aim was to investigate the effects of topical methyl salicylate on skin temperature (Tskin), skin microcirculation (MCskin) and muscle oxygen saturation (SmO2) compared to a placebo gel. The secondary aim was to assess thermosensory responses (thermal sensation, thermal comfort) and to explore to which extent these sensations correspond to the physiological responses over time. Methods: 21 healthy women (22.2 ± 2.9 years) participated in this single-blind, randomized controlled trial. Custom-made natural wintergreen oil (12.9%), containing methyl salicylate (>99%) and a placebo gel, 1 g each, were applied simultaneously to two paravertebral skin areas (5 cm × 10 cm, Th4-Th7). Tskin (infrared thermal imaging), MCskin (laser speckle contrast imaging) and SmO2 (deep tissue oxygenation monitoring) and thermosensation (Likert scales) were assessed at baseline (BL) and at 5-min intervals during a 45 min post-application period (T0-T45). Results: Both gels caused an initial decrease in Tskin, with Tskin(min) at T5 for both methyl salicylate (BL-T5: Δ-3.36°C) and placebo (BL-T5: Δ-3.90°C), followed by a gradual increase (p < .001). Methyl salicylate gel resulted in significantly higher Tskin than placebo between T5 and T40 (p < .05). For methyl salicylate, MCskin increased, with MCskin(max) at T5 (BL-T5: Δ88.7%). For placebo, MCskin decreased (BL-T5: Δ-17.5%), with significantly lower values compared to methyl salicylate between T0 and T45 (p < .05). Both gels had minimal effects on SmO2, with no significant differences between methyl salicylate and placebo (p > .05). Thermal sensation responses to topical methyl salicylate ranged from "cool" to "hot", with more intense sensations reported at T5. Discussion: The findings indicate that topical methyl salicylate induces shortterm cutaneous vasodilation, but it may not enhance skeletal muscle blood flow. This study highlights the complex sensory responses to its application, which may be based on the short-term modulation of thermosensitive transient receptor potential channels. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Effectiveness of exercise therapy in treatment of patients with patellofemoral pain syndrome: systematic review and meta-analysis

Author

Clijsen, Ron, Fuchs, Janine, and Taeymans, Jan

Subjects
Care and treatment, Usage, Patient outcomes, Methods, Exercise therapy -- Usage -- Patient outcomes, Musculoskeletal diseases -- Care and treatment, Pain management -- Methods, Pain -- Care and treatment
Abstract

Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder in physically active individuals aged 15 to 30 years. (1,2) The prevalence ranges from 21% to 45% in active adolescents and [...], Background and Purpose. This systematic review and meta-analysis was accomplished to determine whether exercise therapy is an effective intervention to reduce pain and patient-reported measures of activity limitations and participation restrictions (PRMA1JP) in patients with patellofemoral pain. Data Sources and Study Selection. Randomized controlled trials in English and German languages published in the MEDLINE, Physiotherapy Evidence Database (PEDro), International Clinical Trials Registry Platform, and Cochrane databases were searched. Eligibility was assessed in 2 stages. The methodological quality of the studies was rated using the PEDro scale. Data were pooled using random-effects meta-analysis, allowing for variability among studies. For clinical use, overall estimates were re-expressed in the original visual analog scale scores. Significance was set at 5%. Data Extraction and Data Synthesis. Fifteen studies, with a total of 748 participants, were included and pooled for the meta-analysis. Six studies compared the effect of exercise therapy with a control group receiving neither exercise therapy nor another intervention. Four studies compared the effect of exercise therapy versus additive therapy, and 5 studies compared different exercise interventions. In both comparisons, exercise therapy resulted in strong pain reduction and improvement of PRMALP effects. Significant short-term effects (≤ 12 weeks) of exercise therapy were found for pain and PRMALP, whereas long-term effects (≥26 weeks) were observed for PRMALP only. Limitations and Conclusion. The 15 studies included in this analysis were of variable quality. Large-scale, high-quality randomized controlled trials are needed to further the evaluation of the possible effects of different exercise therapy modalities on patellofemoral pain. This meta-analysis presents evidence that exercise therapy has a strong pain-reducing effect and decreases PRMALP in patients with patellofemoral pain. However, the question of which exercise modality yields the strongest reducing effect on pain and PRMALP remains unanswered.

Published
2014
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30. Barrieren und Förderfaktoren in der evidenzbasierten Praxis (EBP) der Physiotherapie – Eine Bestandsaufnahme und Eruierung von Barrieren und Förderfaktoren zur Anwendung von EBP mit Physiotherapeut*innen der deutschsprachigen Schweiz

Author

Freitag, Livia, Hohenauer, Erich, Deflorin, Carlina, Clijsen, Ron, Movement and Nutrition for Health and Performance, and Movement and Sport Sciences

Abstract

Hintergrund Die Akademisierung der Gesundheitsberufe führte in der Physiotherapie zu einem Wechsel von primär erfahrungsbasiertem zu evidenzbasiertem Arbeiten. Obwohl das Konzept der evidenzbasierten Praxis (EBP) in der Physiotherapie weitgehend akzeptiert ist, zeigen sich Probleme bei der Umsetzung in die Praxis. Ziel Identifikation potentieller Barrieren und unterstützender Faktoren für die Umsetzung der evidenzbasierten Praxis in der Physiotherapie. Methode Anhand eines Onlinefragebogens mit 49 Fragen wurden Physiotherapeut*innen (n = 138) zur evidenzbasierten Praxis befragt. Die Resultate des Fragebogens wurden deskriptiv wiedergegeben. Ergebnisse Physiotherapeut*innen mit Masterabschluss arbeiten im Arbeitsalltag evidenzbasierter als Physiotherapeut*innen mit anderen Abschlüssen und zeigen eine höhere Bereitschaft, evidenzbasierte Praxis anwenden zu wollen. Unsicherheiten wurden vorwiegend beim Formulieren von Fragestellungen sowie bei der Suche und kritischen Bewertung von wissenschaftlichen Artikeln festgestellt. Eine Aus- oder Weiterbildung zur evidenzbasierten Praxis führt zu mehr Sicherheit bei deren Anwendung. Klinische Entscheidungswege basieren vorwiegend auf der eigenen Praxiserfahrung, dem Befinden von Patient*innen und auf Informationen aus Fachzeitschriften. Zeitmangel, sich während der Arbeit weiterzubilden, stellt die Hauptbarriere dar. Zusammengefasste Forschungsergebnisse publiziert auf einem evidenzbasierten Internetportal, per E-Mail-Versand oder in einer Fachzeitschrift sind die meistgenannten Förderfaktoren für die Anwendung evidenzbasierter Praxis. Schlussfolgerung Fach- und Hochschulen sowie Arbeitgeber*innen spielen eine wichtige Rolle bei der Vermittlung von Kenntnissen und der Umsetzung von evidenzbasierter Praxis in der Physiotherapie.

Published
2021

31. Assessment of neuropathic pain after spinal cord injury using quantitative pain drawings

Author

Rosner, Jan; https://orcid.org/0000-0002-1973-1773, Lütolf, Robin; https://orcid.org/0000-0002-4635-693X, Hostettler, Pascal, Villiger, Michael, Clijsen, Ron; https://orcid.org/0000-0001-7125-5332, Hohenauer, Erich; https://orcid.org/0000-0002-2101-0211, Barbero, Marco, Curt, Armin, Hubli, Michèle, Rosner, Jan; https://orcid.org/0000-0002-1973-1773, Lütolf, Robin; https://orcid.org/0000-0002-4635-693X, Hostettler, Pascal, Villiger, Michael, Clijsen, Ron; https://orcid.org/0000-0001-7125-5332, Hohenauer, Erich; https://orcid.org/0000-0002-2101-0211, Barbero, Marco, Curt, Armin, and Hubli, Michèle

Abstract

Study design: Clinimetric cross-sectional cohort study in adults with paraplegic spinal cord injury (SCI) and neuropathic pain (NP). Objective: To assess the reliability of standardized quantitative pain drawings in patients with NP following SCI. Setting: Hospital-based research facility at the Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland. Methods: Twenty individuals with chronic thoracic spinal cord injury and neuropathic pain were recruited from a national and local SCI registry. A thorough clinical examination and pain assessments were performed. Pain drawings were acquired at subsequent timepoints, 13 days (IQR 7.8-14.8) apart, in order to assess test-retest reliability. Results: The average extent [%] and intensity [NRS 0-10] of spontaneous NP were 11.3% (IQR 4.9-35.8) and 5 (IQR 3-7), respectively. Pain extent showed excellent inter-session reliability (intraclass correlation coefficient 0.96). Sensory loss quantified by light touch and pinprick sensation was associated with larger pain extent (rpinprick = -0.47, p = 0.04; rlight touch = -0.64, p < 0.01). Conclusion: Assessing pain extent using quantitative pain drawings is readily feasible and reliable in human SCI. Relating information of sensory deficits to the presence of pain may provide distinct insights into the interaction of sensory deafferentation and the development of neuropathic pain after SCI.

Published
2021

43. Efficacy of a new device for passive continuous patellar mobilization

Author

Hohenauer, Erich, Stoop, Rahel, Clijsen, Ron, Movement and Nutrition for Health and Performance, and Movement and Sport Sciences

Abstract

Patellafemoral joint diseases are commonly treated from physiotherapists. Patellar mobilisations can be performed either manually, but automated, passive continuous mobilisation devices are popular and frequently used in the clinical practice. The Patello device is a new developed product, but its effectiveness has not been verified yet. The purpose of this pilot-study was to investigate the effects of this passive continuous motion device (CPMD) on patellar cranial-caudal translation. Nine healthy participants (mean age: 36.0±10.74 yrs, mean height: 172.7±8.1 cm, mean mass: 72.4±8.6 kg) volunteered for this study. The participants' right knee was investigated and placed at a flexion angle of 45° inside the device. The Patella bone was fixed to the device with two pincers to ensure full contact. A total of 50 repetitions, with a constant mobilisation speed, was conducted and the degree of translation was assessed after 1, 10, 20, 30 and 50 repetitions. The results of this pilot-study indicate, that the CPMD was effective to translate the patella within the trochlear groove after 1 (mean translation: 0.819cm, p0.05) were observed between the repetitions. In conclusion, the CPMD proved to be effective to mobilize the patellar bone in a healthy population. Further studies should investigate the possible effects of passive continuous mobilisations in a clinical setting.

Published
2020

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