Do Relaxation Exercises Decrease Postoperative Pain After .
Do Relaxation Exercises DecreasePostoperative Pain after Rotator CuffRepair? A Randomized Controlled TrialDanielle Weekes, MD, Richard E. Campbell, BS, Christopher J.Hadley, BS, Zaira S. Chaudhry, MPH, Matthew D. Pepe, MD,Bradford Tucker, MD, Kevin Freedman, MD, Fotios P.Tjoumakaris, MDRothman Orthopaedic Institute
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IntroductionWhile effective, opioid medications are associated with significant adverseeffects.1Other analgesic modalities are often expensive or associated with equally adverseeffects.2Cognitive-based relaxation therapy is safe, inexpensive, and easily accessible.Prior Research indicates that relaxation exercises can decrease pain following: General Surgery3,4 Total Joint arthroplasty5,6 Spinal Arthrodesis7,8
PurposePrimary Aim: To determine the effect of relaxation exercises on post-op pain and opioid consumptionafter arthroscopic rotator cuff repair.Secondary Aim: To determine the effect of relaxation exercises on post-op shoulder function afterarthroscopic rotator cuff repair.
Methods: Study DesignProspective Randomized Controlled TrialControl Group:Relaxation Group:Standard Post-op ProtocolStandard Post-op Pain and RehabilitationProtocol Oxycodone /acetaminophen 10/325 mgtablets Cryotherapy cuffs (optional) Oral NSAIDs (optional)Standard Post-op Rehabilitation protocolRelaxation Educational Material 5 minute instructional video Brief Instructional Pamphlet
Study Design: Outcome MeasuresProspective Randomized Controlled TrialPrimary Objectives5-day Post-op Journal: VAS Pain Score2-week Follow-up Survey: Opioid Consumption Subjective EffectivenessSecondary ObjectivesPre-op and Post-op Shoulder Function: American Shoulder and Elbow Surgeons Shoulder Assessment (ASES) Single Assessment Numeric Evaluation (SANE)
Results: DemographicsTotal CohortRelaxation GroupControl Group1517576Age59.5 9.759.2 9.359.8 10.10.70BMI29.0 4.929.0 5.029.0 4.90.94Sample sizep-value0.36GenderMale56.3% (85)60% (45)52.6 (40)Female43.7% (66)40% (30)47.4% (36)
VAS Pain ScoreResults: Post-op VAS ive DayNo significant difference in pain scores between the relaxation and control group (p 0.32)
Results: 2-week post-op Questionnaire 15.0 vs. 25.0 tablets (p 0.01)63% of patients reported relaxationexercises decreased their pain levels.52% of patients reported stillperforming the exercises at two weekspost-op.60Median Opioid Pill CountThe relaxation group consumed lessopioid medication.50*403020100Relaxation GroupControl Group
ASES ScoreResults: ASES perative Time-PointNo significant difference in shoulder function between the relaxation and control group (p 0.31)
Results: SANE ScoreShoulder SANE perative Time-PointNo significant difference in shoulder function between the relaxation and control group (p 0.36)
ConclusionsRelaxation exercises are inexpensive and easily accessible to the majority ofpatients.Relaxation exercises can decrease post-operative opioid use, without increasing(or decreasing) reported post-operative pain.The use of relaxation exercises has no effect on post-operative shoulder function.Relaxation exercises and their potential benefits should be discussed withpatients during the peri-operative period.
References1.2.3.4.5.6.7.8.Schug SA, Zech D, Grond S. Adverse Effects of Systemic Opioid Analgesics. Drug Saf. 1992;7(3):200-213.Uquillas CA, Capogna BM, Rossy WH, Mahure SA, Rokito AS. Postoperative pain control after arthroscopicrotator cuff repair. Journal of Shoulder and Elbow Surgery. 2016;25(7):1204-1213.Topcu SY, Findik UY. Effect of Relaxation Exercises on Controlling Postoperative Pain. Pain Manag Nurs.2012;13(1):11-17.Levin RF, Malloy GB, Hyman RB. Nursing management of postoperative pain: use of relaxation techniqueswith female cholecystectomy patients. J Adv Nurs. 1987;12(4):463-472.Lim YC, Yobas P, Chen HC. Efficacy of relaxation intervention on pain, self-efficacy, and stress-relatedvariables in patients following total knee replacement surgery. Pain Manag Nurs. 2014;15(4):888-896.Lin PC. An evaluation of the effectiveness of relaxation therapy for patients receiving joint replacementsurgery. J Clin Nurs. 2012;21(5-6):601-608.Lawlis GF, Selby D, Hinnant D, McCoy CE. Reduction of postoperative pain parameters by presurgicalrelaxation instructions for spinal pain patients. Spine (Phila Pa 1976). 1985;10(7):649-651.Charette S, Fiola JL, Charest M-C, et al. Guided Imagery for Adolescent Post-spinal Fusion PainManagement: a Pilot Study. Pain Manag Nurs. 2015;16(3):211-220.
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Relaxation exercises can decrease post-operative opioid use, without increasing (or decreasing) reported post-operative pain. The use of relaxation exercises has no effect on post-operative shoulder function. Relaxation exercises and their potential benefits should be
nonnegative relaxation is equivalent to a tighter semidifinite relaxation. Finally, some comparative numerical results are reported to show that the efficiency of the doubly nonnegative relaxation is more promising than that of semidefinite relaxation for solving some specific BQP problems. Keywords—
Progressive muscle relaxation exercises are relaxation techniques that involve progressively tensing and then relaxing muscles or muscle groups. By tightening a muscle and then releasing, you can feel the difference between tense and relaxed. Actively engaging in progressive muscle relaxation exercises effectively loosens and relaxes the muscles.
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Relaxation Techniques . Stress management programs commonly include re laxation techniques. Relaxation techniques have also been studied to see whether they might be of value in managing various health problems. The Importance of Practice . Relaxation techniques are
formulating a semi-de nite convex relaxation which we name PM-SDP. The relax-ation is constructed using standard methods for semi-de nite relaxations of quadratic problems. Using results on semi-de nite matrix completion, the relaxation is reduced to a considerably more e cient SDP relaxation which is equivalent to the original relaxation.
techniques de relaxation et de méditation en TCCE Dr Dominique Servant Consultation stress et anxiété dominique.servant@chru-lille.fr. Qu'est ce que la relaxation ? La réponse de relaxation : état marqué par une diminution du niveau d'alerte, une diminution de la FC, de la FR et de la TA associés à une sensation de détente et de bien être (Benson 1997). Cet état .
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