Sep
5
2023
Massage can facilitate soft tissue expansion
Weicheng Gao, Shaolin Ma, Xianglin Dong, Tao Qin, Xing Qiao and Quan Fang
Medical Hypotheses
Volume 76, Issue 1, January 2011, Pages 148-149
Soft tissue expansion is a helpful technique in reconstructive plastic surgery. Unfortunately, tissue expansion still needs to be improved. Tissue expansion is one of the most useful techniques in plastic surgery. However, it takes a long time to obtain it. Some investigators have reported several agents that speed up tissue expansion, but none of these agents has been used in routine clinical practice. Tissue expansion is a mechanical process that increases the surface area of local tissue available for reconstructive procedures. Living tissue responds to the application of mechanical force. Continual inflation of an expander increases the overlying tissue by inducing an increase in mitosis and stealing next tissue.
Various agents and topical creams have been found to enhance tissue expansion by different methods. After reviewing the article around the world, we haven’t found any paper that tell the correlation between massage and soft tissue expansion. In our current article we evaluated the effect of comfortable tissue expansion using topical massage application.
Massage is a comprehensive intervention involving a range of techniques to manipulate the soft tissues around the soft tissue expander. For patients who is experiencing soft tissue expansion with depression, anxiety, or other secondary problem, massage may be a useful adjuct to medical treatment. According to our clinical experience, not only massage is a relatively safe form of treatment with high levels of patient satisfaction for pain reduction and simultaneously, anxiety disappear evidently, but also can speed up tissue expansion.
The use of massage for pain and anxiety reduction and, warrants further research to investigate efficacy, effectiveness, mechanism of action, patients’ perceptions, and cost effectiveness for a variety of plastic and reconstructive conditions. Nurses, physical therapists, and massage therapists commonly practice a technique using hand strokes from the distal portion of the limb to the proximal in a circular pattern14; this helps to redirect fluid from one area of the body to another. Furthermore, effleurage, light manual rubbing, a classical type of massage, retrograde self-massage, and gentle, rhythmic stroking may result in a mild pressure gradient, assisting in removing edema from the affected part of the expanding soft tissue; these techniques may be administered by a properly trained therapist, nurse, or by the patient’s significant other following adequate instructions and proper demonstrations. In addition to the physiological benefits of expanding soft tissue massage by a significant other, patients experienced a range of emotional and mental benefits. Patients reported being comfortable and relaxed during massage, especially during the whole process. Bredin described the touch of a massage as a method of communication that expresses the other person’s willingness to tolerate and accept the woman after her disfiguring surgery.
Our experience shows that massage can improve the rate of tissue expansion by local massage application combined with eye ointment cream application. This means that application of topical massage combined with eye ointment cream to facilitate tissue expansion is simple and effective. In summarize, the effect of massage on soft tissue expansion is probably as follows: (1) reduce the pain in the period of inflation; (2) improve anxiety; (3) preventing or improving capsular contracture around the expander ; (4) increasing circulation or blood flow; (5) as a method of communication between plastic surgeon and the patients.
Sep
5
2023
For patients with severe knee pain, supervised exercise therapy is more effective at reducing pain and improving function than usual care, finds a study published on bmj.com.
Patellofemoral pain syndrome is a condition in which pain occurs at the front of the knee during or after exercise and is a common reason to visit the doctor. Women are more likely to be affected than men, and symptoms usually start during adolescence when participation in sporting activities is high.
General advice is to rest during periods of pain and to avoid pain provoking activities. This “wait and see” approach is considered usual care.
A recent study reported only limited evidence for the effectiveness of exercise therapy with respect to pain reduction, while there is conflicting evidence with respect to functional improvement.
So researchers based in the Netherlands investigated the effectiveness of supervised exercise therapy compared with usual care in 131 patients aged between 14 and 40 years with patellofemoral pain syndrome.
A total of 131 participants were included in the study, 65 to a supervised exercise program (intervention group) and 66 to usual care (control group). Both groups received similar written information about the syndrome and similar instructions for home exercises, as well as advice to refrain from painful activities.
Patients rated their recovery, pain at rest, pain on activity, and function scores at the start of the study and again at three and 12 months.
After three months, the intervention group reported significantly less pain and better function than the control group. At 12 months, the intervention group continued to show better outcomes than the control group with regard to pain at rest and pain on activity, but not function.
A higher proportion of patients in the exercise group than in the control group reported recovery (42% v 35% at three months and 62% v 51% at 12 months), but these results were not significantly different between the two groups.
This study provides evidence that supervised exercise therapy for patellofemoral pain syndrome in general practice is more effective than usual care for pain at rest, pain on activity, and function at three and 12 months, say the authors. However, supervised exercise therapy had no effect on perceived recovery.
Further research is needed to understand how exercise therapy results in better outcome, they conclude.
Sep
5
2023
Research suggests that exercises that target core muscles may reduce back pain and prevent future injury, but whether these exercises are substantially better than other structured exercise programs for chronic back pain has not been proved. And not all researchers agree on which components of the body’s core muscles are most crucial to preventing a back injury and reducing pain after suffering an injury.
A seminar on the role of core stability in reducing and preventing back pain was held at at the American College of Sports Medicine’s 12th annual Health and Fitness Summit and Exposition in Long Beach 24-27 March 2008. Presenter Marjorie King, director of the graduate athletic training program at Plymouth State University, in Plymouth, N.H., outlined the current state of the field: a need for more research and moderate support for the use of core stabilization exercises to decrease low-back pain and increase low-back function.
King thinks that some who practice core stability are missing at least part of the boat. “One of the biggest misconceptions people have about core stability is that by doing crunches, they’re getting at core stability,” she says. Crunches address the trunk, or “global” muscles, which exercisers more commonly work. But to really target core stability, she says, exercisers need to attend to the often-ignored spinal, or “local” muscles.
Local muscles include the little intersegmental muscles, the multifidi, that run along the vertebrae. These muscles don’t move a lot but are thought to play a role in keeping the spine stable during movement.
Other musculature involved in local stabilization include pelvic floor muscles and the transversus abdominis muscle, the deepest of the abdominal muscles. This muscle is horizontal in design, King says, and functions like a corset, stabilizing the spine.
Core stability training “is the standard of care, it’s what people do, in my field anyway,” says Dr. Christopher Standaert, a physiatrist (a physician specializing in physical medicine and rehabilitation) and clinical associate professor of rehabilitation medicine at the University of Washington in Seattle. But, he adds, “There’s never even been a uniform agreement on the definition.”
Among those who think — based on their clinical experience — that core training works, there are two schools of thought on exactly how it works. Some think, as King does, that local muscles such as the multifidi and the transverse abdominis are critically important.
But, Standaert says, “there are other people who . . . think it’s more about training movement patterns and broader motions and coordination of multiple muscles through your trunk to help your spine move more effectively . . . . So it’s about the whole system.”
In fact, Standaert adds, whether one is talking about local or global core stabilization, the rush to embrace core training has gotten ahead of the science. “People need to know that the scientific clinical foundation, the research, doesn’t match the extent of emphasis that trainers and therapists and all sorts of people put on it,” he says.
As back experts continue their debates and research, those who want to prevent or deal with their back pain need solutions now. Those with persistent, chronic back pain should see a physician and get a proper diagnosis, says Dr. Robert S. Bray Jr., a neurological spinal surgeon and founding director of D.I.S.C. Spine and Sports Center in Marina del Rey. A sports medicine physician or physiatrist are good places to start.
In addition, anyone who is doing exercises to reduce back pain should do so with guidance from an exercise or back-care professional, such as a physical therapist, chiropractor or certified athletic trainer.
Regardless of the state of the science, working the core’s local stabilizers won’t hurt and will probably help, King says. Targeting those muscles doesn’t even require going to the gym.
The best way to stabilize the spine, she says, is to stand up straight (stomach in while still breathing, equal weight on both feet, feet straight ahead, glutes flexed, pulling up through the pelvic floor) and sit up straight (stomach in, both feet on the ground, again, pulling up through the pelvic floor).
“Any time you sit or stand, in the line at the grocery store, stuck in traffic, brushing your teeth” is an opportunity to correct your posture, she says. “You don’t necessarily need a huge difference, you just need a bit of a difference.”
http://www.latimes.com/features/health/la-he-backpain31mar31,1,261211.story
