Translation, cultural adaptation, and validation and reliability of assessment of pelvic floor disorders and their risk factors during pregnancy and postpartum questionnaire in Turkish population

Objectives: This study was conducted in order to produce translation, cultural adaptation, and validation of Assessmentof Pelvic Floor Disorders and Their Risk Factors During Pregnancy and Postpartum Questionnaire (APFDQ) to Turkish inpregnant and postpartum population.Material and methods: The study included 80 pregnant women. Internal consistency was tested using Cronbach’s alpha.Questionnaires were applied three different times in order to assess for sensitivity. Patients were asked to complete thequestionnaire first in the third trimester, secondly in postpartum 6th week and finally in postpartum 6th month after birth.For translation process content, face/content validity, reliability, construct validity and reactivity studies were done. Allwomen had undergone pelvic examination and prolapse was assessed by using Pelvic organ Prolapse Quantification System(POP-Q). Urinary symptoms were also evaluated with Urinary Distress Inventory (UDI-6) questionnaire.Results: The mean age of patients was 27.7 ± 5.5 years. Forty-one (51.25%) of the patients had vaginal delivery and39 (48.75%) had a cesarean section. Above 96% of the patients had completed the questionnaires. POP-Q assessments andUDI-6 results were used to evaluate construct validity. Cronbach’s alpha results were found to be 0.7 for all the subscales ofthe questionnaire: bladder: 0.702, bowel: 0.744, prolapse: 0.701, sexual function: 0.706 respectively, indicating adequatereliability. The test/retest reliability was studied and Pabak values showed moderate reliability in the bowel, prolapse andsexuality, and good reliability for bladder subscale. The results of the patients were compared between pregnancy andpostpartum to assess reactivity and shown to be reactive to changes. Also risk factors of the patients were assessed including,family predisposition, maternal age over 35 years, BMI > 25, nicotine use, subjective inability to contract pelvic floorand sense of postpartum wound pain.Conclusions: The Turkish version of APFDQ is a reliable and valid tool. It can be used for assessing the risk factors, incidence,assessing degree of PFDs and evaluating the impact on quality of life in pregnant and postpartum women

Hot and cold knees: exploring differences in patella skin temperature in patients with patellofemoral pain

Objectives: to investigate the distribution of patella skin temperature (Tsk) measurements and to explore the presence of temperature subgroups in patellofemoral pain (PFP) patients. Design: cross-sectional observational study design Participants: One dataset of 58 healthy participants and 232 PFP patients from three different datasets. Main outcome measures: Patella skin temperature, measured by physiotherapists using a low cost hand held digital thermometer. The distribution of patella skin temperature was assessed and compared across datasets. To objectively determine the clinically meaningful number of subgroups, we used the average silhouette method. Finite mixture models were then used to examine the presence of PFP temperature subgroups. Receiver operating characteristic curves were used to estimate optimal patella Tsk thresholds for allocation of participants into the identified subgroups. Results: In contrast to healthy participants, the patella skin temperature had an obvious bimodal distribution with wide dispersion present across all three PFP datasets. The fitted finite mixture model suggested three temperature subgroups (cold, normal and hot) that had been recommended by the average silhouette method with discrimination cut-off thresholds for subgroup membership based on receiver operating curve analysis of Cold=<30.0oC; Normal 30.0-35.2oC; Hot ≥35.2oC. Conclusion: A low cost hand held digital thermometer appears to be a useful clinical tool to identify three PFP temperature subgroups. Further research is recommended to deepen understanding of these clinical findings and to explore the implications to different treatments

Primer Dismenorede Konnektif Doku Masajı ve Kinezyobantlama Uygulamalarının Ağrı ve Yaşam Kalitesi Üzerine Etkilerinin Karşılaştırılması

This study was planned to compare the effectiveness of connective tissue massage (CTM) and kinesiotaping on pain, quality of life and anxiety. Thirty two female patients diagnosed as primary dysmenorrhea were enrolled in the study. Subjects were divided into 2 groups randomly. Participants assigned to the the first group applied CTM for 5 days a week, the second group received taping twice a week for three consecutive menstrual cycle. Women who participated in the study was evaluated in the first menstrual cycle, In the period between the first and second menstrual cycles were treated. Treatment was discontinued during menstruation, between the second and third menstrual cycles treatment were continued and third cycles from the start, treatment was terminated. Short Form McGill Pain Questionnaire was used to measure type of pain during menstruation. Severity of pain was assessed with a visual analog scale. The attitudes and behaviors of women during menstruation was assessed with Menstruation Attitude Questionnaire, health quality was assessed with Short Form-36 quality of life questionnaire and levels of anxiety was assessed using the State-Trait Anxiety Inventory. There was significant improvement on patients' pain during menstruation and many dimensions of the quality of life of patients in the CTM group (p <0.05). At the same time, Kinesiotaping application has been positive effects on the intensity and quality of pain (p <0.05). Comparing the two treatments, positive effects of CTM on the pain and quality of life is seen to be higher (p <0.05). However, there was no improvement on anxiety levels and attitudes toward menstruation with both treatment methods. In conclusion both CTM and Kinesiotaping applications can be used as an effective treatment method in primary dysmenorrhea.Bu çalışma primer dismenorede konnektif doku masajı (KDM) ve kinezyobantlama uygulamalarının ağrı, yaşam ve anksiyete kalitesi üzerine etkilerini karşılaştırmak amacıyla planlandı. Primer dismenore tanısı konmuş 32 kadın hasta çalışmaya alındı. Olgular rastgele iki gruba ayrıldı. Birinci gruba; KDM haftada beş gün, ikinci gruba; bantlama haftada iki kez ardışık üç menstrüel siklus boyunca uygulandı. Çalışmaya katılan kadınlar birinci menstrüel sikluslarında değerlendirildi, birinci ve ikinci menstrüel siklusları arasındaki dönemde tedaviye alındı. Menstruasyon süresince tedaviye ara verildi, ikinci ve üçüncü menstrüel siklusları arasında tedaviye devam edildi ve üçüncü siklus başlamadan tedavi sonlandırıldı. Olguların menstruasyon süresince hissettikleri ağrının tipi, Kısa Form Mc Gill ağrı anketi ile; şiddeti, Görsel Analog Skalası ile değerlendirildi. Kadınların menstruasyon dönemindeki tutum ve davranışları, Menstruasyon Tutum Ölçeği ile, yasam kalite düzeyleri, Kısa Form-36 anketi ile anksiyete düzeyleri ise Durumluk-Sürekli Kaygı Ölçeği kullanılarak değerlendirildi. KDM uygulanan grupta menstruasyon süresince hissettikleri ağrıda (p < 0.05) ve yaşam kalitesinin pek çok boyutunda anlamlı gelişmeler oldu (p < 0.05). Aynı zamanda, kinezyobantlama uygulamasının da ağrı şiddeti ve niteliği üzerine pozitif etkileri oldu (p<0.05). Ancak anksiyete düzeyleri ve menstruasyona yönelik tutumlarında her iki tedavi yöntemiyle de değişim sağlanamadı. İki tedavi yöntemi karşılaştırıldığında ise KDM'nin ağrı ve yaşam kalitesi üzerine olumlu etkisinin daha fazla olduğu görüldü (p<0.05). Sonuç olarak hem KDM hem de Kinezyobantlama uygulamaları primer dismenorede etkili birer tedavi yöntemi olarak kullanılabilir