Physical Medicine / OMM
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21695
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Browsing Physical Medicine / OMM by Author "Liu, Howe"
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Item The Effect and Mechanism of Botulinum Toxin Type A For Knee Osteoarthritis Through Ultrasound Guidance(2017-03-14) Baker, Stephen; salem, yasser; quiben, myla; Liu, Howe; Bao, XiaoObjective: Knee osteoarthritis (OA) is a chronic and progressive disease that affects the geriatric population. OA is characterized by cartilaginous degeneration, subcartilaginous bone reconstruction and osteophyte formation. It causes joint pain, swelling, joint dysfunction and affects the quality of life, even leading to depression. The treatment of knee osteoarthritis usually includes medications, physical therapy and traditional Chinese acupuncture. These treatments could be useful for most of OA. Refractory OA in which conventional treatment is ineffective could induce intensive pain, disability and reduce the life quality of the patient. Given that, we need obtain new methods with good curative effect for refractory OA. BoNT-A is the marketing name given to a neurotoxin and is found to be effective for partial muscle spasm of post-stroke. Recently the use of BoNT-A is extended to be used as pain management in conditions such as low back pain and myofascial pain. Usually, injection of BoNT-A is guided through an anatomical landmark or pain location. However, there is risk for injection without ultrasound-guidance such as fat pad disturbance. So, we plan to proceed the Intra-articular injection of BoNT-A through the ultrasound-guided method for refractory knee osteoarthritis of older individuals and study changes of the knee joint before and after intervention via MRI and radiograph imaging, and provide the new choice for refractory knee osteoarthritis of older individuals. Methods: Sixty patients with refractory knee osteoarthritis were randomly divided into three groups (A:saline, B: BoNT-A, C: sodium hyaluronate). Evaluation of WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) questionnaire score, VAS ((Visual Analogue Scale) score and SF-36 ((the MOS item short from health survey) at baseline, 4 weeks and 8 weeks follow-up were recorded respectively. Results: WOMAC, VAS and SF-36 were improved in group B and group C patients compared baseline to 4 weeks and 8 weeks respectively (P Conclusions: The treatments of Botulinum toxin type A were beneficial and safe for patients suffering from refractory knee OA.Item Variation of the Origins of the Phrenic and Long Thoracic Nerves – A Case Report(2017-03-14) Liu, Hao; Truong, Tony; Holmes, Clayton; Liu, Howe; Arguello, EricIntroduction: In humans the phrenic nerve originates from the convergence of 3 individual nerve branches off the spinal roots of C3-C5, while the long thoracic nerve originates from the convergence of 3 branches off the spinal roots of C5-C7. However, a variation of the origins of these two nerves was found in a cadaver during dissection. Methods: This study of anatomical variation was conducted on an 86-year-old male cadaver provided for physical therapy students in a gross anatomy lab. Students and faculty members dissected the cadaver. The variations were identified when the neck and brachial areas were exposed for students to study. Results: On the left neck area, a short communicating nerve trunk is found connecting the beginning parts of both the cervical plexus and upper trunk of the brachial plexus. The phrenic nerve is the only branch off this communicating nerve and travels along the anterior surface of anterior scalene muscle. At the origin of this phrenic nerve, a small muscular branch divides and passes posteriorly to innervate the middle scalene muscle. On the right axillary area, the long thoracic nerve is found to branch off from the end of the posterior cord or initial part of the radial nerve of the brachial plexus and then travels distally and inferiorly to innervate the serratus anterior muscle. Conclusions: Findings of variation of the phrenic and long thoracic nerves in this study may provide additional information for clinicians to understand potential injury related to these two nerves. It is possible that an overstretch to the upper trunk of brachial plexus like with Erb-Duchenne palsy or a lesion to the posterior cord or initial portion of the radial nerve may cause involvement of injury to the phrenic and long thoracic nerves