Effects of scapular exercises on trunk control ın patients with acute stroke: a double-blind randomized controlled study

Purpose/aim: The ability to perform routine tasks during reaching and activities of daily living (ADLs) is impaired as a result of deterioration in the postural adjustments after stroke. Trunk stability is needed to maintain balance, correct scapular position and posture while moving the upper extremity. The objective was to examine the effect of scapular exercises on the scapular stability, trunk control and ADLs.Materials and methods: Patients (50-85 years) with acute hemiparetic stroke were participated in this double blind randomized controlled study. The patients in both group were treated with the exercise program according to the Bobath concept and isometric scapular exercises were applied to the study group in addition to these exercises. The participants in both groups were taken into the physiotherapy program for 5 days and each program were taken 30 min. Patient assessment included Lateral scapular slide test (LSST), Trunk Impairment Scale (TIS), Trunk Control Test (TCT), Modified Barthel Index (MBI) and Reaching Performance Test (RPT).Results: Significant increases were observed distance in protraction, between protraction - retraction at 90 degrees of shoulder abduction and flexion and retraction in 90 degrees of shoulder abduction within both groups. Only the study group produced improvement in protraction of 90 degrees of shoulder flexion (p 0.05). While both groups achieved a significant improvement in TIS, MBI, RPT scores, TCT scores increased significantly only in study group (p 0.05).Conclusions: The adding isometric scapular exercises to the rehabilitation program significantly increased the effectivity of neurorehabilitation on increasing trunk control, independence during ADLs, reaching performance and reducing trunk impairment

Characteristics of neuropathic pain in patients with diabetes mellitus

AbstractAim: Epidemiological data on the frequency, quantity, and consequences of symptomatic diabetic neuropathy remain poor. We conducted this study to examine the characteristic of neuropathic pain in patients with diabetes mellitus (DM).Materials and Methods: Average daily pain intensity was measured using a 100 mm visual analog scale (VAS). Localization of the pain, position that aggravated pain, frequency of the pain, duration of the pain, pain’s influence on daily living activities were examined.Results: The average patient age was 62.56 years and the number of males was 21 (42%). 29 Patients had only DM and 13 patients had hypertension (HT) plus DM, 4 patients had DM+HT+heart disease. The mean of pain according to VAS was 6.86±2.79. Thirtytwo patients defined that the pain affected their daily living activities negatively; 30 patients’ pain localization was lower extremity,12patients’ was upper and lower extremity; mostly pain was aggravated by standing and 40 patients’ pain frequency was as every day; 24 patients’ pain duration was less than 1 year and 18 patients’ was between 1-5 years.Conclusion: Studies on diabetic neuropathy are important drivers to improve the treatment of these patients. Neuropathic pain is considered to be more serious than other types of pain. So patients diagnosed with DM should be examined for neuropathic pain and the treatment plan should include pain decreasing medication and/or neurosurgical interventions