Part of the book: Acupuncture
Older people presenting with hip fractures requiring surgery have a high prevalence of hypovitaminosis D, which is an important modifiable risk factor for falls and fractures. Inadequate sun exposure is the main reason for vitamin D deficiency in older people. Vitamin D supplements, with or without calcium, have been shown to reduce falls and fracture risk in this population. A small number of randomised controlled trials (RCTs) have shown that increased 25-OHD levels with a loading dose of vitamin D may improve falls and fractures. It is not previously known whether oral vitamin D replenishment using a loading dose is effective, and if it is, what is the interplay this is with patient characteristics, in particular lower limb mobility and 25-OHD levels. The results of a recent multisite randomised controlled trial (REVITAHIP) provide early evidence of the benefits of an early loading-dose oral vitamin D replenishment on functional mobility, falls, fractures, grip strength, health-related quality of life and mortality.
Part of the book: A Critical Evaluation of Vitamin D
De Quervain’s tenosynovitis (DQT) is a repetitive stress condition located at the first dorsal compartment of the wrist at the radial styloid. The extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons and each tendon sheath are inflamed and this may result in thickening of the first dorsal extensor sheath. Workers who perform repetitive activities of the wrist and hand and those who routinely use their thumbs in grasping and pinching motions in a repetitive manner are most susceptible to DQT. Conservative treatments include activity modification, modalities, orthotics, and manual therapy. This chapter identifies, in an evidence base manner through the literature, the most effective diagnostic measures for DQT. It also examines the evidence base on (or lack thereof) the treatment or treatment combinations to reduce pain and improve functional outcomes for patients with DQT.
Part of the book: Work-related Musculoskeletal Disorders