Research Report Abstracts - Gesundheit

WPT2011, Research Report Abstracts eS823
Methods: Participants were tested twice by two investigators
on two occasions two weeks apart, i.e. four tests in total.
Thermal detection (cold and warm) and thermal pain (cold
and heat) thresholds were determined on the dorsal hand
using a Medoc NeuroSensory Analyser (TSA 2001 II Medoc,
Israel). The study was approved by the Human Research
Ethics Committee- Life Sciences, University College Dublin.
Analysis: Results were analysed using descriptive statistics,
intraclass correlation coefficients (ICC) and coefficients of
variation (CV).
Results: Mean intra-individual differences were small for all
measures except cold pain thresholds. ICC values for intraand
inter- rater reliability ranged between 0.27 and 0.55 for
cold detection; 0.33–0.69 for warm detection and 0.39–0.86
for heat pain thresholds. ICC values for cold pain thresholds
were excellent (0.87–0.94). CV values for detection thresholds
were low (CDT: 3.9–6.25%; WDT: 7.9–8.7%) as were
CV values for heat pain (5.2–5.8%) however, CV values for
cold pain ranged between 84.9% and 90.2%.
Conclusions: Despite low–moderate ICC values, cold detection,
warm detection and heat pain were found to be consistent
when analysing mean intra-individual differences and CV
values. Conversely, cold pain thresholds yielded high ICC
values for both intra- and inter-rater reliability but were found
to have large variation in intra-individual differences and CV.
As this study investigated a small sample of healthy controls,
care must be taken extrapolating results to patient groups.
Implications: Cold and warm detection thresholds as well as
heat pain thresholds may be suitable for group comparisons
and use in clinical settings. CPT measures may be suitable
for group analysis in research settings but large variance in
the data limits clinical applicability.
Keywords: Neurophysiology; QST; Reliability
Funding acknowledgements: This research was funded by
the Irish Research Council for Science Engineering and Technology
(PhD Scholarship).
Ethics approval: Ethics approval was granted by the Human
Research Ethics Committee - Sciences, University College
Dublin.
Research Report Poster Display
Number: RR-PO-305-19-Tue Tuesday 21 June 13:00
RAI: Exhibit Halls 2&3
AN AUDIT TO EVALUATE THE EFFECT OF
FEMORAL NERVE BLOCKS ON REHABILITATION
OUTCOMES POST TOTAL KNEE ARTHROPLASTY
Monaghan B.
Purpose: To investigate the relationship between femoral
nerve blocks and rehabilitation outcomes post total knee
arthroplasty.
Relevance: The effect of nerve blocks on rehabilitation outcomes
such as early return of range of movement and strength
are very relevant to patient outcome and are poorly investigated
in the literature.
Participants: Rehabilitation outcomes were compared in
26 patients post total knee arthroplasty-12 patients with
indwelling femoral nerve cathether blocks and 14 patients
with usual post operative analgesia
Methods: The femoral nerve blocks were administered by
bolus injection via an indwelling femoral cathether over
the first 24 hours post operatively. The primary outcome
measurement tool was the Western Ontario and Mc Master
Universities index questionnaire. The questionnaire was
completed pre operatively and repeated at day 5. Secondary
outcomes included length of stay, visual analogue pain scales
days to achieve straight leg raise and 90 degrees flexion and
discharge destination.
Analysis: Data was analysed using SPSS 14.0 for windows.
Initial evaluation demonstrated there was not a normal distribution
and non parametric statistics were used. The Wilcoxon
signed ranks test was used to determine if there was any significant
change in scores over the selected time frame and the
Mann Whitney U test was then used to determine if there was
any difference in scores pre operatively at three weeks or at
six weeks..
Results: The Wilcoxon signed ranks test demonstrated both
the blocked and unblocked groups improved significantly in
pain, stiffness and function as measured by the WOMAC
questionnaire at one week compared with the pre operative
scores. The Mann Whitney U test demonstrated no significant
difference between groups either pre operatively or at one
week post surgery.
Conclusions: This audit showed there was no relationship
between peripheral nerve blockade injections and the primary
outcomes of pain, stiffness and function as evaluated by the
WOMAC questionnaire also there was no difference between
femoral nerve blocks and the secondary outcomes evaluated.
Implications: This is the first study to evaluate the effect of
femoral bolus injections on the outcomes of rehabilitation
post total knee replacement. Further randomised control trial
are recommended specifically focused on quadriceps inhibition
are recommended. Return of straight leg raise was found
to be slower initially in the blocked group but statistical analysis
of the results was not possible in this study. In addition all
outcomes of rehabilitation in the early post operative period
warrant further investigation.
Keywords: Femoral nerve blocks; Rehabilitation; Early outcomes
Funding acknowledgements: No funding received for this
research project.
Ethics approval: Yes.