Both corticosteroid injection and PRP demonstrate initial efficacy where steroid appears to provide superior pain relief, as you can see here going down within the first four weeks, whereas PRP demonstrated longer lasting effect, as you can see that the VAS score is actually going down all the way up to 24 weeks, where the corticosteroid injections kind of peak at four weeks, and then slowly the pain comes back to its original level by 24 weeks, maybe around, even like a 12 weeks’ time mark. So, both steroid and PRP are considered safe and an effective treatment for the GTPS. But in more recently years, it seems like PRP has a better efficacious indication over CSI for the treatment of GTPS. In a recent system review, it was concluded that PRP seems to be safe and effective when treating degenerative meniscus tears. However, additional studies are warranted. It seems like I'm going to sound like a broken record here, but truly understanding clinical implications of PRP on meniscus treatment due to heterogeneity of the studies reviewed. Similarly, in a recent review, although PRP appears to yield improvements in clinical outcomes. its clinical significance remains uncertain given, again, heterogeneity of the studies. Regarding knee ligament injuries, injection treatment is typically not common for knee ligament related injuries, but injection therapies have a role in reflective cases or when there are significant functional limitations due to pain.
Introduction by Dr. Francis Lopez.
Q&A followed Part 2.
Dr. Haruki Ishii discussed a review paper on the risks and benefits of corticosteroid injections versus plasma injections in patients. The aim of this review was to compare the evidence for clinical applications of these injectates as a treatment for a variety of musculoskeletal conditions in patients. Platelet-Rich Plasma (PRP) injections for clinical use as discussed here, is defined as autologous plasma, extracted from minimally processed blood, and then containing activated platelets. So PRP delivers concentrated growth factors and cytokines acting as extra cell signaling molecules at the side of the injection. Key clinical applications of PRP include tendinopathies, osteoarthritis, muscle injuries, and then post -surgical healing treatment. The first study looked at is one published in 2021, a systemic review article. What it showed was that the corticosteroid injection yielded significant superior functional recovery and in pain compared with the PRP injections for rotator cuff lesions during the short -term follow-up period. He referred to an article that looked at the difference between a corticosteroid injection and a PRP injection for frozen shoulder patients, involving the functional outcome between those two injectates.
Introduction by Dr. Francis Lopez.
Dr. Kathleen Martin Ginis is a Distinguished University Scholar and a Professor in the Department of Medicine (Division of Physical Medicine and Rehabilitation) and in the School of Health and Exercise Sciences at The University of British Columbia. She holds the Reichwald Family Chair in Preventive Medicine and is a Fellow of the Royal Society of Canada, the Canadian Academy of Health Sciences, the Canadian Society for Psychomotor Learning and Sport Psychology, and as is an International Fellow of the National Academy of Kinesiology.
The focus of Dr. Martin Ginis’s research is placed on understanding and changing physical activity behaviour, particularly among people living with spinal cord injury. She is deeply committed to knowledge translation; specifically, the development and implementation of evidence-based best-practices to improve health and well-being among people with disabilities. By example, Dr. Martin Ginis spearheaded the formulation and knowledge translation of scientific exercise guidelines for adults with spinal cord injury. These guidelines have been translated into nearly 20 languages and are used worldwide in clinical and community settings.
Part 2
Eighty percent admittedly is an arbitrary number, but it's one that most exercise scientists use as a sort of the minimum threshold for deeming someone adherent to the protocol. There were no differences in pain reduction between those with neuropathic versus musculoskeletal pain, but the small ends, small sample sizes for those two groups, make it difficult to really confirm that there is no difference in exercise outcomes for those two groups. She thinks we need to look at that further with bigger samples for each type of pain. Given the pragmatic nature of the trial that we let people exercise on their own in the community, she thinks this speaks to the feasibility of using exercise as a pain self-management strategy, but with the caveat that it's likely not going to be effective for everyone. Fifty percent of people with spinal cord injury report no leisure time physical activity whatsoever. In other words, no activity that could potentially improve cardiorespiratory fitness or muscle strength. And that's not the fault of people with spinal cord injury. Factors that influence physical activity don't just rest within the person, but they rest within society.