Is there a relationship between kinesiophobia, pain, depression, disease activity, functional status and quality of life in patients with ankylosing spondylitis?

To evaluate the presence of kinesiophobia and its potential effects on pain, depres sion, disease activity and quality of life in patients with ankylosing spondylitis (AS). Materials and Methods: The study included 58 AS patients and 55 healthy controls. Tampa Kinesiophobia Scale (TKS) was used to evaluate the presence of kinesiophobia, Visual Analogue Scale (VAS) for severity of pain, Beck Depression Index (BDI) for de pression level, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for disease activity, Bath Ankylosing Spondylitis Functional Index (BAS-FI) for functional status, and Ankylosing Spondylitis Functional Index (ASQoL) for Quality of life. Results: In patient group, kinesiophobia rate was statistically significantly higher (68%) compared tothe healthy control subjects (27%) (p0.05). Conclusion: Kinesiophobia is more common in patients who had AS than in healthy control subjects, and presence of kinesophobia is related toimpaired quality of life and increased pain. Therefore, we propose that strategies to increase awareness of movement fear, cognitive behavioral therapy and physical activity should be involved in the treatment programs

The effect of osteoporosis on quality of life in men

YÖK Tez No: 247191Giriş ve Amaç: Osteoporoz kemik kütlesinde azalma ve kemik mikromimarisinde bozulma sonucu kırıklara neden olabilen ve yaşam kalitesini olumsuz yönde etkileyen bir hastalıktır. Çalışmanın amacı morbidite ve mortalitesi yüksek bir hastalık olan osteoporozda yaşam kalitesini ve yaşam kalitesi üzerine etkili faktörleri değerlendirmektir.Gereç ve Yöntem: Çalışmaya lomber ve femur boynu kemik mineral yoğunlukları dual enerji X-ray absorbsiyometre ile ölçülen ve sonucunda osteoporoz saptanan 113 erkekten oluşan olgu grubu ile her iki bölge kemik mineral yoğunlukları normal bulunan katılımcılardan oluşturulan 67 kişilik kontrol grubuna dahil edildi. Her iki gruba sosyodemografik özellikler ve osteoporoz risk faktörlerini sorgulayan soru formu ve yaşam kalitesi ölçekleri uygulandı. İstatistiksel analizde ikili karsılastırmalar t testi, çoklu karşılastırmalar tek yönlü varyans analizi ve lineer regresyon analizi, sürekli değiskenler arasındaki ilişki Pearson korelasyon analizi ile degerlendirildi. p<0,05 değerleri anlamlı kabul edildi.Bulgular: Osteoporozlu erkeklerde hem lomber hem de femur boynu kemik mineral yoğunluklarının sigara, alkol kullananlarda daha düşük saptandı (p<0,001). Osteoporozun hem SF-36, hem de QUALEFFO-41 ile ölçülen yaşam kalitesini düşürdüğü saptanmıştır. Yaşam kalitesinin; sigara, alkol kullanımı, kırık öyküsü ve günlük yetersiz kalsiyum alımının ilişkili olduğu bulunmuştur (p<0,05).Sonuç: Osteoporozlu olgular taranarak düşük yaşam kalitesi açısından risk altındaki kişilerin tanımlanması, osteoporoz risk faktörleri ve korunma yöntemleri konusunda kişilerin bilgilendirilmesi ve yaşam tarzı değişikliklerinin desteklenmesi gereklidir.Introduction: Osteoporosis is a bone disease which may cause fractures as a result of reduced bone mineral density and disrupted bone micro architecture also decreasing the quality of life.Methods: Bone mineral density of lomber spine and femoral neck were measured by dual enerrgy X-ray absorptiometry and the results with osteoporosis in 113 men identified from the group consisting of the patients with both bone mineral density in normal participants formed the control group 67 persons were included in this study. A questionnaire, which was prepared for assessment of sociodemographic features and risk factors for osteoporosis, and quality of life scales were administered to the 113 osteoporotic cases and control group, consisted of 67 normal. Face to face interview method was used. Student?s t test, ANOVA, Linear regression analysis and Pearson?s correlation analysis were used in statistical assessments. P < 0.05 value was accepted as significant.Results: It has been concluded that osteoporosis decreases the quality of life as measured by both SF-36 and QUALEFFO-41 scales. The factors related to quality of life are fracture, alcohol consuption and smoking. Femoral neck and lumbar spine bone mineral density in men with osteoporosis were lower than those of cigarette and alcohol use (p<0,001).Conclusion: As a result, screening studies to identify osteoporotic cases under high risk for decreased quality of life, educating individuals about the risk factors of osteoporosis and how to prevent them and encouraging for life style modifications is essential

The Effect of Bone Mineral Density on Quality of Life in Men with Osteoporosis

Objective: Osteoporosis (OP) is a metabolic bone disease characterized by low bone mass and microarchitectural deterioration of bone tissue. OP is an important health problem with regard to morbidity, mortality, and negative effects on quality of life (QOL). The aim of this study was to evaluate the effect of bone mineral density (BMD) on QOL in men with osteoporosis. Materials and Methods: A total of 180 male patients aged between 40-60 years admitted to Bolu Physical Therapy and Rehabilitation Hospital were included in the study. 113 patients (mean age: 50.01±5.01 years) diagnosed with OP according to BMD values at the lumbar spine (L1-L4) and the femur neck measured using Dual Energy X-Ray absorptiometry were formed the case group, 67 patients (mean age: 44.62±3.86 years) not diagnosed with OP were formed control group. A questionnaire prepared for assessment of sociodemographic features and risk factors for osteoporosis was applied in both groups after they gave their consent. The quality of life was assessed by means of Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) and Short Form-36 (SF-36). In the statistical analysis student’s t test and correlation analyses were performed by using SPSS 11.0 computer program and p<0.05 was considered statistically significant. Results: Both femoral neck and lomber spine bone mineral density was lower in the case group than that of the control group (p<0.001). According to QUALEFFO and SF-36 scores, OP was found to reduce the quality of life (p<0.001). Smoking, bone fracture and inadequate daily calcium intake have negative effects on quality of life in the case group (p<0.05). Conclusion: Quality of life was influenced by numerous variables. These results point out that osteoporotic patients should be evaluated multidimensionally and different approaches are needed to improve their quality of life. (Turkish Journal of Osteoporosis 2015;21: 10-4

The Relationship between the Mean Platelet Volume and Subacromial Impingement Syndrome

Objective: Subacromial impingement syndrome (SIS) characterized by inflammation of supraspinatus tendon is one of the most common causes of the shoulder pain. In some studies, platelet activity has been shown as a marker to indicate the inflammation associated with the disease. The mean platelet volume (MPV) shows platelet function and activation. The aim of this study was to investigate the relationship between MPV and SIS. Materials and Methods: Eighty seven inpatients (female/male: 55/32, mean age: 56.34±7.53 years) diagnosed with SIS according to physical examination and MR findings in Bolu Physical Therapy and Rehabilitation Hospital between January 2014- June 2014 constituted the case group, 87 outpatients (female/male 61/26, mean age: 52.97±8.48 years) not diagnosed with SIS constituted the control group. MPV values between case and control group that were similar in terms of age and gender were compared. Results: In case group MPV (8.36±0.73***) was lower than that of the control group (8.44±1.02****) and platelet count (253.75±50.17***) was higher than that of the control group (244.79±56.19***). Both were not statistically significant (p>0.05). Significant negative correlation was found between MPV and platelet level in case group (r=-0.240, p<0.05). Conclusion: These findings present that there is no relationship between MPV and SIS. New prospective studies are needed on this subject. (Turkish Journal of Osteoporosis 2015;21: 15-8

The Evaluation of the Effect of Neuropathic Pain on Functional Disability in Patients with Chronic Low Back Pain

Objective: The aim of this study was to evaluate both the prevalence of neuropathic pain (NP) and the effect of functional disability of NP in patients with chronic low back pain (CLBP). Materials and Methods: In this study, outpatients data were reviewed retrospectively from January 2014 to December 2014 to determine the patients with CLBP. 190 patients with CLBP meeting the inclusion criteria were included. NP scores of the patients were assessed using Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) and the evaluation of pain was performed using the Visual analoque scale (VAS) and functional disability scores was determined by the Oswestry disability index (ODI). Results: In this study NP was detected in 39.4% of the patients with CLBP. The number of female patients with NP (n=60, %80) was significantly higher than the number of male patients with NP (n=15, %20), (p<0.05). ODI and VAS scores of the patients with NP [(19.81±7.28), (5.08±0.76)] was significantly higher than those of the patients without NP [(15.28±6.83), (4.44±1.14)], (p<0,001). Conclusion: It was found that the co-existence of NP with CLBP increases pain and functional disability

The impact of extracorporeal shock wave therapy on pain, grip strength and functionality in patients with medial epicondylitis and lateral epicondylitis

The aim of this study was to evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) and conventional physical therapy applications on pain, grip strength and functionality in medial and lateral epicondylitis treatment and to compare the results. Materials and Methods: A total of 116 patients diagnosed with medial and lateral epicondylitis were included in the study. The patients were divided into ESWT group and control group. The patients in the control group received a total of 15 sessions of conventional physical therapy (Hotpack, Transcutaneous electrical nerve stimulation (TENS)) once a day for 30 minutes.Whereas, ESWT was applied to the patients in the ESWT group as 2 sessions per week, for a total of 6 sessions. Pain severity of the patients was measured with Visual Pain Scale (VAS), grip strength with a hand dynamometer and functional level with the Patient Based Forearm Assessment Questionnaire (PFEQ).Measurements were made in all groups before treatment, after treatment and 1 month after treatment. Results: In comparisons between groups, there was a significant decrease in VAS and PFEQ values after treatment compared to the control group in the ESWT group (p <0.05). In the evaluation of the hand tightening force, it was observed that the hand tightening force in the ESWT group after treatment (p: 0.043) and 1st month controls increased significantly compared to the control group (p: 0.038). Conclusions: Based on these results, our study demonstrated that the combination of conventional physical therapy and ESWT produced clinically positive effects in patients with epicondylitis

May neutrophil lymphocyte ratio and platelet lymphocyte ratio be used as inflammatory markers in patients with epicondylitis? Inflammatory markers in patients with epicondylitis

*Karakoyun, Ahmet ( Aksaray, Yazar )Aim: The aim of this study was to determine whether there is any correlation between neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and acute phase reactants such as C-reaktive protein (CRP), erythrocyte sedimentation rate (ESR) in patients with epicondylitis.Material and Methods: Our study included 274 patients. 154 patients with epicondylitis constituted the epicondylitis group and 120 healthy individuals constituted the control group. Demographic data such as age, gender, and laboratory values such as NLR and PLR were analyzed retrospectively. Both groups were compared in terms of dermographic data, leukocyte, neutrophil, lymphocyte, platelet count, CRP, ESR, NLR and PLR.Results: There was no significant differences between patient and control groups in term of demographic data such as height and weight, and laboratory values such as nuetrophil, lymphocyte, platelet, ESR and CRP (p>0,05 for all). Besides, no significant difference was found between the two groups in terms of NLR and PLR values (p>0,05 for both). There was a significant positive correlations between NLR or PLR and ESR or CRP values in the patient group (p<0,001 for all).Conclusions: In our study, no significant difference was found between NLR, PLR and other blood paramaters in patients with epicondylitis compared to those of controls. As a result, we determined that it is not meaningful to use these rates to show the presence of inflammation in epicondylitis pathogenesis, and there is no correlation between the severity of epicondylitis and these rates. There is a need for further studies with more patient numbers and clinical evaluation parameters

Evaluation of vitamin D levels in patients with chronic low back-leg pain

Objective: We aimed to examine the relationship between the levels of vitamin D and patients with chronic low back-leg pain (CLBLP) and to investigate its effects on pain and functional capacity. Methods: 145 patients (female/male:103/42) with CLBLP, aged between 35 and 65 years (mean age: 53,06 ± 8,14), participated in the study. Visual Analog Pain Scale (VAS) was used to measure the state of pain. Pain-related functional capacity was evaluated through Oswestry Disability Index (ODI). Patients were classified into three groups based on their serum vitamin D levels: normal (≥30 ng/ml), vitamin D insufficiency (21–29 ng/ml), and vitamin D deficiency (≤20 ng/ml). Results: We found that 22,8% of patients (n:33) had vitamin D deficiency, 42,8% (n:62) had vitamin D insufficiency, and 34,5% (n:50) had normal levels of vitamin D. VAS scores were 4,75 ± 0,93; 4,66 ± 0,97 and 4,52 ± 0,90 for patients with vitamin D deficiency, vitamin D insufficiency, and normal levels of vitamin D, respectively. We found that there was no significant relationship between vitamin D level and VAS score (p>0,05). ODI scores were 18,78 ± 7,89; 15,46 ± 5,57 and 14,52 ± 7,19 for patients with vitamin D deficiency, vitamin D insufficiency, and normal levels of vitamin D, respectively. CLBLP-related functional capacity was found to be significantly lower in patients with vitamin D deficiency when compared to other two groups (p < 0,05). Conclusion: Vitamin D deficiency may lead to lower functional capacity, and clinically, Vit D levels should be checked in musculoskeletal pain patients at risk of Vit D deficiency. Level of Evidence: Level IV, Diagnostic study. Keywords: Vitamin D, Chronic low back-leg pain, Functional capacity, Myopath

Evaluation of physical medicine and rehabilitation consultations requested for inpatients in a university hospital

Karakoyun, Ahmet ( Aksaray, Yazar )T Objective: The aim of this study was to evaluate the consultations requested from the department of physical medicine and rehabilitation (PM&R) with regard to socio-demographic characteristics, clinics of the patients, reasons for consultation, diagnoses and given treatment. Material and Methods: The study included patients who were hospitalized between January 1 and December 31, 2017 and who were asked for a PM&R consultation. Consultation forms were scanned retrospectively and examination findings and evaluations were recorded. Results: The study included 235 patients who were hospitalized in 13 different clinics. Of the patients, 128 (54.5%) were women and 107 (45.5%) were men. The mean age of the patients was 62 (range: 0-94) years. The departments that most frequently requested PM&R consultation were neurology (48.5%), internal medicine (11.1%), chest diseases (10.6%). The reasons for consultation were cerebrovascular disease (51.5%), walking disorder (13.6%), low back pain (12.2%), knee pain (9.8%), neck pain (6.5%), other causes (3.5%) and respiratory system problems (2.9%), respectively. 23.8% of patients who had PM&R consultation had no history of any additional disease, 40.9% had hypertension, 7.7% had asthma, 6.8% had hypertension and diabetes mellitus and 5.5%.had only diabetes mellitus. As a result of consultations, the most diagnosed disease groups were neurological diseases (59.5%) and musculoskeletal disorders (37%). On the other hand, exercise after consultations 47.6% of the patients were treated only with therapeutic therapy, 31.4% with exercise and medical treatment, 25.5% with exercise and conventional physical therapy, 9.3% with medical and physical therapy and 8% were applied all three treatment modalities.Conclusion: This study shows that all departments are in contact with the PM&R clinic, PM&R consultation is needed especially due to neurological diseases and musculoskeletal pathologies, and also emphasizes the value of consultation requests and the importance of interdepartmental cooperation.Amaç: Bu araştırmanın amacı fiziksel tıp ve rehabilitasyon (FTR) bölümünden istenen konsültasyon hizmetlerinin hastaların sosyodemografik özelliklerine, konsültasyon istenen kliniklere, istenme nedenlerine, konulan tanılara ve verilen tedavilere göre dağılımını incelemekti. Gereç ve Yöntemler: Bu çalışmaya, 1 Ocak-31 Aralık 2017 tarihleri arasında yatarak tedavi gören ve FTR konsültasyonu istenen hastalar dahil edildi. Hastaların konsültasyon formları geriye dönük olarak tarandı ve muayene bulgu ve değerlendirmeleri kaydedildi. Bulgular: Çalışmaya, 13 farklı klinikte yatarak tedavi gören ve bu klinikler tarafından FTR uzman hekim konsültasyonu istenen 235 hasta dahil edilmiştir. Hastaların 128’ini (%54,5) kadınlar, 107’sini (%45,5) erkekler oluşturmuştur. Hastaların yaş ortalaması 62 (0-94) idi. Hastanemizde en sık FTR konsültasyonu isteyen kliniklerin sırasıyla nöroloji (% 48,5), dahiliye (%11,1), göğüs hastalıkları (%10,6), beyin cerrahi (%6,8) ve ortopedi (%6,4) olduğu görüldü. Konsültasyon istem sebepleri ise sırasıyla serebrovasküler hastalık (%51,5), yürüme bozukluğu (%13,6), bel ağrısı (%12,2), diz ağrısı (%9,8), boyun ağrısı (%6,5), diğer nedenler (%3,5) ve solunum sistemi problemleri (%2,9) şeklindeydi. FTR konsültasyonu istenilen hastaların %23,8’inin özgeçmişlerinde herhangi bir ek hastalık öyküsü yok iken, %40,9’unda hipertansiyon, %7,7’sinde astım, %6,8’inde hipertansiyon ile diabetes mellitus bir arada ve %5,5’inde sadece diabetes mellitus vardı. Konsültasyonlar sonucunda en çok tanı konulan hastalık grupları; nörolojik hastalıklar (%59,5), kas-iskelet sistemi hastalıkları (%37) olarak tespit edildi. Diğer taraftan, konsültasyonlar sonrasında hastaların %47,6’sına sadece teropötik egzersiz tedavisi, %31,4’üne egzersiz ve medikal tedavi, %25,5’ine egzersiz ve konvansiyonel fizik tedavi, %9,3’üne medikal tedavi ve fizik tedavi ile %8,9’una her üç tedavi modaliteleribirlikte uygulanmıştı. Sonuç: Bu çalışma, bütün bölümlerin FTR kliniği ile ilişki içerisinde olduğunu, özellikle nörolojik hastalıklar ve kas iskelet sistemi orijinli patolojiler nedeniyle FTR konsültasyonuna gereksinim duyulduğunu göstermekte olup, ayrıca konsültasyon istemlerinin değeri ve bölümler arası işbirliğinin önemini vurgulamaktadır

Evaluation of eye findings in fibromyalgia patients

WOS: 000465583400005Amaç: Fibromiyalji (FM), etiyolojisi tam olarak bilinmeyen, yaygın vücut ağrısına sebep olan romatizmal bir hastalıktır. FM hastalarında, diğer romatizmal hastalıklarla birlikte veya tek başına çok çeşitli göz bulguları ortaya çıkmaktadır. Bu göz bulguları romatizmal hastalıklarda tanı için klinisyeni uyaran ilk bulgular olabilir. Bizim bu çalışmadaki amacımız FM’li hastalardaki göz bulgularının klinik olarak değerlendirmesini yapmaktır. Gereç ve Yöntem: Çalışmaya, Aksaray Üniversitesi Eğitim ve Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Polikliniği’ne başvurup FM tanısı almış ve daha sonrasında göz polikliniğine de muayene olmuş 18-75 yaş arası hastalar alındı. Hastaların dosyaları retrospektif olarak tarandı. Hastaların dosyalarından klinik tanıları, sosyo-demografik özellikleri, göz muayene bulguları, özgeçmişleri, soygeçmişleri ve yapılan tedavilerinin sonuçları not edildi. Çalışmaya özgeçmişinde göz ameliyatı geçirmiş olanlar, romatolojik hastalık, diyabetik retinopati, glokom, sistemik enfeksiyon, otoimmuün hastalık, serebrovasküler hastalık, majör depresyon, anormal laboratuvar değerleri ve malignensi öyküsü olanlar dahil edilmedi. FM tanısı 2016 yılında güncellenen Amerikan Romatizma Birliği kriterlerine göre konuldu. Bulgular: Çalışmaya, uygun kriterleri karşılayan 94 hastanın dosyası alındı. Hastaların ortalama yaşı 38,2 (18-75) idi. Hastaların 80’i (%85) kadın, 14’ü (%15) erkekti. Göz bulgularına göre 57 hastada (%57,4) göz ağrısı, %28,2’sinde kızarıklık, %26,9’unda yanma-batma, %15,1’inde bulanıklık, %6,3’ünde çapaklanma ve %3,7’sinde kaşıntı bulundu. Göz ağrısının nedenleri arasında ise %49,1’inde kuru göz, %24,6’sında refraksiyon kusuru, %12,3’ünde blefarit, %3,5’inde alerji bulunurken, %10,5’inde herhangi bir neden saptanmadı. Sonuç: Çalışmamızda FM hastalarında büyük oranda göz ağrısı tespit edilmiş olup, göz ağrısının da en önemli sebebi olarak göz kuruluğu saptanmıştır. Bu sonuç bize FM’li hastalarda kronik yaygın vücut ağrısına çeşitli göz bulgularının eşlik edebileceğini ve FM gibi kronik hastalıklara multidisipliner yaklaşımın önemli olduğunu göstermektedir. Anahtar kelimeler: Fibromiyalji, göz ağrısı, göz kuruluğu, romatizmal hastalık.Objective: Fibromyalgia (FM) is a rheumatic disease which exactly unknown etiology, causes widespread body pain. In FM patients, a large variety of ocular findings, especially dry eye, occur with and without other rheumatic diseases. These ocular findings may be the first findings to warn the clinician for diagnosis in rheumatic diseases. The aim of this study is to evaluate the eye findings as clinically in patients with FM. Materials and Methods: The patients of those between the ages of 18-75, who were admitted to the Aksaray University Training and Research Hospital, Physical Medicine and Rehabilitation Polyclinic and diagnosed with FM, and then examined in the Ophthalmology Polyclinic, were included in the study. Patients' files were reviewed retrospectively. The clinical diagnosis, socio-demographic characteristics, ocular examination findings, history, family history and the results of the treatments were recorded. Those who had undergone eye surgery, rheumatologic disease, diabetic retinopathy, glaucoma, systemic infection, autoimmune disease, cerebrovascular disease, major depression, abnormal laboratory values, and history of malignancy, were not included in the study. The diagnosis of FM was determined according to the American College of Rheumatology updated in 2016. Results: The files of 94 patients who met the appropriate criteria were included in the study. The mean age of the patients was 38.2 (18-75), and 80 (85%) were female and 14 (15%) were male. According to the ocular findings, 57 patients (57.4%) had eye pain, 28.2% had redness, 26.9% had burning-stinging, 15.1% had turbidity, 6.3% had burring, and 3.7% had itching. Among the causes of eye pain were 49.1% dry eye, 24.6% refractive failure, 12.3% blepharitis, and 3.5% allergy, while no cause was found in 10.5%. Conclusion: In our study; it was detected that the patients with FM have a large extent of eye pain, and the most important cause of the eye pain was dry eye. The result of study shows that patients with FM may be accompanied by various ocular findings in addition to chronic widespread body pain and multidisciplinary approach is important in chronic diseases such as FM