Artroskopik yardımlı mini-açık yöntem ile rotator manşet tamiri yapılan hastalarda gözetimli fizyoterapi programı ile ev egzersiz programının sonuçlarının karşılaştırılması

Objectives: This study aims to compare the results of supervised exercise program versus standardized home-based exercise program after rotator cuff repair with respect to severity of pain, functional status, quality of life, and depression. Patients and methods: Twenty-eight patients (5 males, 23 females; mean age 59.8 +/- 9.1 years; range 40 to 83 years) who had rotator cuff repair were evaluated. Patients were divided into two groups and the first group was treated with supervised physiotherapy (n=15) and the second group was treated with home-based exercise program (n=13). Pendulum exercises and passive exercises within pain limits were performed by all patients in the six-week immobilization period with shoulder sling with abduction pillow after rotator cuff repair. After this period, the patients in home-based exercise program were taught to perform active exercises and the patients in supervised physiotherapy group were treated with active shoulder range of motion exercises under the supervision of the physiotherapist. When patients reached to active full range of motion, strengthening exercises were added to exercise program. Patients were assessed preoperatively and at the end of the postoperative third month. Pain was evaluated with visual analog scale (VAS), functional status with Constant shoulder score, quality of life with short form-36 (SF-36), and depressive symptoms with Beck depression inventory (BDI). Results: There were significant improvements in all evaluation parameters in both groups after rotator cuff repair. Conclusion: There were no statistical differences between the patients who received exercise program under the supervision of the physiotherapist and the patients who were treated with standardized home-based exercise program for the efficacy of treatment in the evaluation of pain, functional status, quality of life, and depression status. When the rehabilitation programs were analyzed for cost effectiveness, the supervised physiotherapy group was found to have higher costs.Amaç: Bu çalışmada rotator manşet tamiri sonrası uygulanan gözetimli fizyoterapi programı ile standardize edilmiş ev egzersiz programının ağrı şiddeti, fonksiyonel durum, yaşam kalitesi ve depresyon durumu açısından sağladığı sonuçlar karşılaştırıldı. Hastalar ve yöntemler: Rotator manşet tamiri yapılan toplam 28 hasta (5 erkek, 23 kadın; ort. yaş 59.8±9.1 yıl; dağılım 40-83 yıl) değerlendirildi. Hastalar iki gruba ayrıldı, birinci gruba gözetimli fizik tedavi (n=15), ikinci gruba ev egzersiz programı (n=13) ile tedavi uygulandı. Tüm hastalara rotator manşet tamiri sonrası altı haftalık omuz abdüksiyon yastıklı kol askısı ile immobilizasyon döneminde ağrı sınırı içinde sarkaç egzersizleri ve pasif egzersizler uygulandı. Bu dönemi takiben ev egzersiz programı grubundaki hastalara aktif egzersizler öğretildi ve gözetimli fizyoterapi grubundaki hastalara fizyoterapist gözetiminde aktif omuz eklem hareket açıklığı egzersizleri yaptırıldı. Hastalar tam aktif eklem hareket açıklığına ulaşınca, egzersiz programına kuvvetlendirme egzersizleri eklendi. Çalışmada hastalar cerrahi öncesi ve sonrası 3. ay sonunda değerlendirildi. Ağrı şiddeti görsel analog skala (GAS) ile fonksiyonel durum Constant omuz skoru ile yaşam kalitesi kısa form-36 (KF-36) ile depresif semptomlar ise Beck depresyon envanteri (BDE) ile değerlendirildi. Bulgular: Her iki grupta da rotator manşet tamiri sonrası tüm değerlendirme verilerinde anlamlı düzeyde gelişme gözlendi. Sonuç: Fizyoterapist gözetiminde egzersiz programı alan hastalar ile standardize edilmiş ev egzersiz programı ile tedavi edilen hastalar arasında, ağrı, fonksiyonel durum, yaşam kalitesi ve depresif durum değerlendirmelerinde tedavi etkinliği için istatistiksel farklılık yoktu. Rehabilitasyon programları maliyet-etkinlik açısından incelendiğinde gözetimli fizyoterapi grubunun daha yüksek maliyete sahip olduğu bulundu

Functional results of local corticosteroid injections in the management of shoulder pain

Objective: To investigate the intensity of pain, range of motion (ROM) of shoulder and functional status in patients with shoulder pain after subacromial injection. Methodology: Mixed injection which was composed of 1cc/40 mg metilprednizolon asetat and 1 cc/9 mg bupivacaine was applied into subacromial zone for patients with shoulder pain. Patients were evaluated before injection and three months, one year after injection. ROM was measured with goniometer. Pain was evaluated with Visual Analog Scale (VAS). General condition of extremities was evaluated with Constant Shoulder Score and functional status of shoulder was evaluated with Turkish version of Disabilities of Arm, Shoulder and Hand (DASH-T). Short Form-36 was used to assess general health status of the patients. Beck Depression Scale was used for evaluation of depressive symptoms. Results: Sixty two patients were evaluated. Mean age was 51.16 +/- 10.58 years. It was observed that there was significant decrease for pain intensity and BDI scores, and significant increase for ROM of shoulder. Significant improvement in the functional status of upper extremities was also observed in these patients. Conclusion: Improvements for functional status of upper extremities and pain relief in patients with shoulder pain at short term after injection was observed

Efficacy of moderate-intensity walking provided feedback by ECE PEDO on abdominal fat in overweight and obese women: A randomized, exercise study

Objectives: The aim of this study was to investigate the effectiveness of walking with Equipment for Clever Exercise (ECE PEDO) compared to supervised, moderate-intensity, aerobic, treadmill walking exercise in overweight and obese women. Patients and methods: Between September 2014 and January 2015, 28 women with overweight and obesity were assigned to two groups: supervised treadmill walking (Group 1, n=14) or walking with ECE PEDO (Group 2, n=14). The target heart rate (HR) corresponding to values of 50 to 70% VO2max were determined by submaximal treadmill test. Group 1 was instructed walking at their target HR on treadmill. The number of steps in a min corresponding to the target HR was calculated by a criterion pedometer and Group 2 was instructed walking in this step range recorded to the ECE PEDO giving audible feedback. Before and after a 12-week exercise program, all participants were evaluated by Body Mass Index (BMI) and waist circumference (WC). Ultrasonographic visceral fat thickness (VFT) and ergospirometric VO2max. Results: The VFT decreased in both walking groups in association with reduced WC and weight loss and also significant increases in the VO2max after exercise intervention (p<0.05). The VFT decreased only in women by walking with ECE PEDO compared to the other group (p<0.05). Conclusion: Our study results showed that both moderate-intensity exercise provided by a novel pedometer and supervised treadmill walking showed significant improvements in abdominal obesity and VO2max. © 2017 by Turkish Society of Physical Medicine and Rehabilitation

Halı sahada oluşan futbol yaralanmaları

Objectives: Football injuries that occur during football matches played on synthetic fields and the features of these injuries were investigated and the data was pursued for the prevention and reduction of these injuries. Patients and methods: All adolescent and adult trauma cases who admitted to the Emergency Department with football injuries on synthetic fields were retrospectively investigated. Nine hundred and eighty-five male cases were detected with a mean age of 30.1±4.2 years (range 15-57 years). Age, gender, times of admittance to the Emergency Department, site of injury, type of injury, and clinical result data of the cases were examined. Results: 19:00 to 24:00 hours (n=852, 86.5%) and weekdays were the most frequent admittance times. It was detected that lower-extremities (n=583, 59.2%) were the most commonly affected body parts and the upper-extremity injuries (n=281, 28.6%) and the head and neck injuries (n=75, 7.6%) were the second and third most commonly seen injuries, respectively. The most frequently observed injury types were contusions, abrasions and hematomas in all cases (n=364, 37.0%). Sprains/ strains were the second most common types of injuries (n=343, 34.8%). When the final diagnoses of all cases were examined, it was determined that the anterior talofibular ligament injuries were the second most frequent after softtissue injuries (n=217, 22%). Conclusion: Football matches on synthetic fields can lead to serious orthopedic injuries. Investigation of the mechanisms of these injuries, which cause workday and economic losses, will be a guide for the future studies on the prevention of these injuries

Functional status, patient satisfaction and quality of life in patients with arthroscopic partial meniscectomy

Objectives: This study aims to investigate the effects of clinical and demographic variables on functional status, patient satisfaction and quality of life following arthroscopic partial meniscectomy. Patients and methods: Between January 2001 and December 2010, 98 patients (44 males, 54 females; mean age 52.1±12.5 years; range 18 to 88 years) who underwent arthroscopic partial meniscectomy in our clinic and were eligible for the study. Demographic and clinical data of patients and surgical characteristics were recorded. Preoperative activity levels of patients were measured. Severity of activity pain and patient satisfaction following surgery were evaluated using Visual Analog Scale (VAS). Functional status was evaluated by Lysholm knee score and WOMAC (Osteoarthritis Index Western Ontario and McMaster Universities), while quality of life was evaluated by Short Form-36 (SF-36). Results: Postoperative mean time from surgery was 62.5±26.1 (8-120) months, VAS score at rest was 1.7±2.6 (0-10), VAS activity score was 3.4±3.3 (0-10) and VAS patient satisfaction score was 7.0±3.0 (0-10). It was found that 68 of the patients (69.4%) were evaluated themselves as excellent or better than preoperative period with a mean Lysholm knee score of 73.8±17.4 (24-95). Significant influences of body mass index and preoperative symptom duration on evaluation parameters were not detected. Male gender, less than five years after surgery, less intraoperative joint degeneration and moderate to severe activity level before the onset of symptoms had a positive influence on the severity of pain, patient satisfaction and functional status. Conclusion: Our study provided critical data for optimal patient selection during the preoperative period to predict which patients may have better results in the mid-term follow-up after arthroscopic partial meniscectomy

Cost analysis and related factors in patients with traumatic hand injury

The aim of this study was to measure the direct and indirect costs and factors influencing these costs in patients presenting following traumatic hand injury. We assessed patients aged 18-65 years who were in work. Hand injury severity and functional status were assessed. Direct costs, including medical care expenses, and indirect costs, including lost productivity, were calculated. Seventy-nine patients of a mean age of 32 years were included. The mean direct cost for each patient was $1772 (47$1891 (53% of total cost). Injury severity, time to return to work, and hospitalization time were the main parameters of increased total cost in a linear regression analysis. © The Author(s) 2012

Functional outcomes and quality of life in patients with proximal row carpectomy

Objectives: This study aims to assess pain, functional status, patient satisfaction, and quality of life in patients with proximal row carpectomy. Patients and methods: Between December 2007 and November 2011, demographic, clinical, and operational data, and physical therapy program of 16 patients (11 males, 5 females; mean age 41.4±16.6 years; range 19 to 77 years) with proximal row carpectomy were recorded. Pain (0-no pain, 10-severe pain), and patient satisfaction (0-not satisfied, 10-very satisfied) were assessed with visual analog scale (VAS). Wrist range of motion, and hand grip strength were evaluated. The quick-disabilities of the arm, shoulder and hand (Q-DASH), and Mayo wrist score were used for functional evaluation of the upper limb. Short form-36 (SF-36) was used for the evaluation of quality of life. Results: Postsurgical duration was 20.6±16.4 (range; 6-56) months. Complex regional pain syndrome (CRPS) was detected in two patients (%12.5). The mean session numbers of physical therapy were 16.7±9.4 (range; 0-30), satisfaction VAS was 8.4±2.1, rest VAS 0.8±0.9, activity VAS was 2.3±2.2, grip strength of operated side 82% of nonoperated side, Q-DASH score was 13.4±16.5 (substantially good), and Mayo wrist score was 80.0±19.4 (good). Significant improvement was detected in postoperative flexion-extension arc compared to preoperative status (p=0.001). A correlation was detected between hand grip strength percentage and session numbers of physical therapy (p=0.025, r=0.558). Relationships between quality of life-pain subscore and activity pain (p=0.001, r= -0.819), Q-DASH (p=0.003, r= -0.698), and Mayo wrist score (p=0.037, r=0.525) were detected. The presence of complication was the only independent variable for prediction of functional status in multivariate linear regression analysis. Conclusion: Increased number of physical therapy session results in improved hand grip strength following the proximal row carpectomy, while CRPS complication which can be seen after surgery affects the functional status adversely

Comparison of efficacy of neural therapy and physical therapy in chronic low back pain

The aim of this prospective study was to evaluate the effects of neural therapy, and physical therapy on level of pain, disability, quality of life, and psychological status in patients with chronic low back pain. Patients admitted to the physical therapy and rehabilitation outpatient clinic with the complaint of low back pain of at least 3 months duration. Group 1 (n=27), physical therapy (PT, hotpack, ultrasound, TENS 15 sessions), group 2 (n=33), neural therapy (NT, 1:1 mixture of 20 mg/mL Lidocaine HCl (Jetokain simplex®) and saline for 5 sessions. For pain, Visual Analogue Scale (VAS), for disability Roland Morris Disability Questionnaire (RMDQ), for quality-of-life Nottingham-Health-Profile (NHP), for depression, and anxiety, Hospital Anxiety-Depression Scale (HADS) were used before and after the treatment. Mean age was 47.3±11.32 years, symptom time was 13.78±11.98 months. There were no differences for demographic variables between groups. Significant improvements were detected for VAS, RMDQ, NHP-Pain, NHP-Physical activity, HADS for both of two groups after treatment. In addition to these findings, significant improvements were found for NHP-Energy, NHP-Social isolation in NT group. The differences of pre- and post-treatment values of parameters were evaluated for each group. Although there were no differences for VAS, NHP-sleep, NHP-Emotional reaction, HADS between groups, RMDQ, NHP-Pain, NHP-Physical activity, NHP-Social isolation were higher in NT than PT before treatment, the improvements for these parameters were better in NT than PT. In conclusion both of NT and PT are effective on pain, function, quality of life, anxiety, and depression in patients with chronic low back pain

Test-retest reliability of tetrax® static posturography system in young adults with low physical activity level

Purpose/Background: Assessment of postural sway with force plates can be affected by type of measurement and various clinical parameters such as age and activity level of the individual person. For this reason, variability is detected in postural reactions of healthy subjects without balance impairment. Test-retest reliability of postural sway in adolescent athletes has been measured using a force plate and additional test-retest studies have been suggested for subjects of different age groups with different activity levels. Therefore, the purpose of this research was to assess test-retest reliability of Tetrax (R) Static Posturography in young adults with low physical activity level, and examine the relationship between posturography results and low activity level.Methods: Young adults older than 18 years of age were included in the study. Demographic characteristics of the cases were recorded including age, weight, height, body mass index (BMI, kg/m(2)) and dominant extremity. Number of falls in the previous six months, lower body endurance (sit to stand test) and single-leg eyes closed stance test were recorded. Activity level of participants was determined according to the International Physical Activity Questionnaire (IPAQ). Posturographic evaluation of all volunteers was completed using the Tetrax (R) Interactive Postural Balance System (Sunlight Medical Ltd, Israel). Fall risk and general stability index (SI) calculated by the Tetrax (R) were recorded. Following the first test, measurements were repeated 24 to 48 hours later for reliability purposes.Results: Sixty-five subjects (28 male, 37 female; mean age 22.2 +/- 1.1 years, mean BMI 22.6 +/- 3.3 kg/m(2)) were evaluated. All participants were classified as minimally active according to mean IPAQ score (1042.1 +/- 517.7 [231 -2826] MET-minutes per week). ICC scores between the first and second tests for fall index and total stability index were excellent (ICC2,1 = 0.858, 0.850, respectively). Fall risk determined by using the Tetrax (R) device was negatively correlated with lower body endurance (p=0.001, r=-0.446), vigorous activity score (p=0.011, -0.312) and total activity score (p=0.029, r=-0.271), and positively correlated with single leg stance score (p=0.001, r=0.606). There was a weak correlation between fall risk history and the fall risk determined by using Tetrax (R) device (p=0.04, r=0.255). There were no correlations between fall risk and height, weight, and BMI (p>0.05).Conclusions: The results demonstrated the high test-retest reliability of Tetrax (R) interactive balance system in young healthy adults with low physical activity level. Future studies are needed to determine the effectiveness of increasing physical activity level on postural control