Conservative therapy

保守治疗
  • 文章类型: Journal Article
    目的:比较外科专家的治疗方法,运动医学和康复专家,以及在治疗犬的二头肌肌腱疾病或腱鞘炎时获得康复认证的兽医,并将这些信息与现有研究相结合,以开发一种治疗算法,该算法提供了治疗二头肌腱鞘炎的框架。
    方法:223对经过董事会认证的兽医进行互联网调查的受访者,董事会认证的运动医学和康复治疗师,和有康复认证的兽医。
    方法:该调查是通过多个列表服务器进行的,专科学院时事通讯,和私人相关社交媒体网站。编制答案并提交统计分析。
    结果:与康复治疗师(RTh)相比,外科医生不太重视肱二头肌肌腱的稳定功能及其在预防其他肩部疾病中的作用。同样,与RTh相比,外科医生更倾向于选择手术作为主要治疗方法,并将保守治疗结果归因于预后不太乐观.在执行保守治疗计划时,外科医生和RTh之间存在多种差异,RTh更有可能推荐治疗性锻炼,体外冲击波,再生医学,治疗性超声,运动限制,光生物调节,和脉冲电磁场治疗。RTh不太可能开NSAIDS或注射皮质类固醇。尽管存在上述差异,也有多个协议领域。
    结论:共识协议,结合现有研究,用于创建治疗算法,建议如何最好地解决二头肌肌腱病的多种表现。这样的指南可以被认为是针对这种常见病症的指导治疗策略。
    OBJECTIVE: To compare the therapeutic approach of surgical specialists, sports medicine and rehabilitation specialists, and veterinarians with rehabilitation certification when treating bicipital tendon disease or tenosynovitis in dogs and to combine this information with existing research to develop a treatment algorithm that provides a framework for treating bicipital tenosynovitis.
    METHODS: 223 respondents to an internet survey of board-certified veterinary surgeons, board-certified sports medicine and rehabilitation therapists, and veterinarians with rehabilitation certification.
    METHODS: The survey was promoted via multiple listservs, specialist college newsletters, and private relevant social media sites. Answers were compiled and submitted for statistical analysis.
    RESULTS: Compared to rehabilitation therapists (RTh), surgeons placed less value on the stabilizing function of the biceps tendon and its role in preventing other shoulder morbidities. Similarly, compared to RTh, surgeons were more inclined to select surgery as the primary therapeutic approach and attributed a less optimistic prognosis to conservative therapy outcomes. There were multiple differences between surgeons and RTh in executing a conservative therapy program, with RTh more likely to recommend therapeutic exercise, extracorporeal shockwave, regenerative medicine, therapeutic ultrasound, exercise restriction, photobiomodulation, and pulsed electromagnetic field therapy. RTh were less likely to prescribe NSAIDS or inject corticosteroids. Despite the above noted differences, there were also multiple areas of agreement.
    CONCLUSIONS: Consensus agreement, combined with existing research, was used to create a treatment algorithm suggesting how to best address multiple manifestations of bicipital tendinopathy. Such guidelines can be considered to direct therapeutic strategies for this common condition.
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  • 文章类型: Journal Article
    自2018年《颞下颌关节紊乱病(TMD)韩国医学临床实践指南(KMCPG)》发布以来,已经发布了许多最新的临床研究结果。因此,有必要更新现有的临床实践指南(CPG)。本研究根据截至2020年2月发表的最新研究数据,提出了TMD治疗的最新建议。通过对偏倚风险的评估和基于建议评估等级的选定文献的荟萃分析,确定了建议的证据水平和建议等级的草案版本。发展,和评估(等级)。最终指南是使用德尔菲法得出的。针对TMD的8项韩国药物治疗得出了18项建议。与以前用于TMD的韩国医学CPG相比,七级建议,包括针灸,药物穿刺,和Chuna手动疗法,增加了。两项建议的等级已更改。增加了六项新建议,以充分反映临床实际情况。针灸,药物穿刺,在临床实践中,TMD患者建议使用Chuna手动疗法。在颞下颌关节紊乱病患者的临床实践中,应考虑与韩国药物同时进行常规保守治疗或韩国药物的组合。
    Many updated clinical research results have been published since the Korean Medicine Clinical Practice Guidelines (KMCPGs) for temporomandibular disorders (TMDs) were published in 2018. Therefore, it is necessary to update the existing clinical practice guidelines (CPGs). This study presents updated recommendations for TMD treatment based on current research data published up to February 2020. The draft version of the level of evidence and grade of recommendation was determined through an assessment of the risk of bias and a meta-analysis of selected literature based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The final guidelines were derived using the Delphi method. Eighteen recommendations were derived for eight items of Korean medicine treatment for TMDs. Compared with previous Korean medicine CPGs for TMDs, the grades of seven recommendations, including acupuncture, pharmacopuncture, and Chuna manual therapy, were increased. The grades of the two recommendations have been changed. Six new recommendations were added to fully reflect clinical reality. Acupuncture, pharmacopuncture, and Chuna manual therapy are recommended for TMD patients in clinical practice. Concurrent conventional conservative therapy with Korean medicine or a combination of Korean medicines should be considered in clinical practice in patients with temporomandibular disorders.
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