Diz osteoartriti olan hastalarda ev egzersiz programı önermenin etkili bir yolu Var mıdır? randomize kontrollü bir çalışma

Objective: The aim of this study was to evaluate an effective way in prescribing exercise program in patients with knee osteoarthritis (OA). Materials and Methods: Sixty patients were included in the study. Group 1 received exercise program with both visual demonstration and written information materials. In addition, they have learned exercises under the supervision of a physiotherapist at the physiotherapy unit. Group 2 has got written materials describing exercises and they learned exercises under the supervision of a physiotherapist. Group 3 received only written materials about exercise program. Pain severity was assessed using a visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Functional ability was evaluated with WOMAC functional score and WOMAC total score as well as 100-meter walk test, time required to ascend and descend, and chair rises. All assessments were performed before the treatment and one month and three months after the treatment. Results: At the end of three months of follow-up, there were statistically significant improvements in VAS, WOMAC scores, 100-meter walking test, time to ascend and descend stairs and sit-to-stand chair rises in both group 1 and 2 (p<0.05). In group 3, statistically significant improvements were detected in all parameters except for pain severity (p<0.05). After one month of follow-up, there were statistically significant differences between the groups in all parameters except for WOMAC pain scores (p<0.05), however, after three months of follow-up, statistically significant differences were observed in all parameters between the groups (p<0.05). Conclusion: Our results showed that an effective way for prescribing an exercise program seems to be giving both visual demonstration and written materials together. Besides, accompanying training lectures were found to be increasing the effectiveness of therapy in patients with OA

Comparison of injection methods in myofascial pain syndrome: A randomized controlled trial

In this study; we aimed to compare the efficacy of local anesthetic injection and dry needling methods on pain, cervical range of motion (ROM), and depression in myofascial pain syndrome patients (MPS). This study was designed as a prospective randomized controlled study. Eighty patients (female 52/male 28) admitted to a physical medicine and rehabilitation outpatient clinic diagnosed as MPS were included in the study. Patients were randomly assigned into two groups. Group 1 (n=40) received local anesthetic injection (2 ml lidocaine of 1%) and group 2 (n=40) received dry injecting on trigger points. Both patient groups were given stretching exercises aimed at the trapezius muscle to be applied at home. Patients were evaluated according to pain, cervical ROM, and depression. Pain was assessed using Visual Analog Scale (VAS) and active cervical ROM was measured using goniometry. Beck Depression Inventory (BDI) was used to assess the level of depression. There were no statistically significant differences in the pre-treatment evaluation parameters of the patients. There were statistically significant improvements in VAS, cervical ROM, and BDI scores after 4 and 12 weeks in both groups compared to pre-treatment results (p<0.05). No significant differences were observed between the groups (p>0.05). Our study indicated that exercise associated with local anesthetic and dry needling injections were effective in decrease of pain level in MPS as well as increase of cervical ROM and decrease of depressive mood levels of individuals

Cost-effectiveness analysis of chronic mechanical back pain treatment modalities

Objectives: This study aims to evaluate and compare the cost-effectiveness of inpatient physical therapy, outpatient physical therapy applications, and back school education in low back pain (LBP) treatment. Patients and methods: Between March 2011 and September 2011, a total of 105 patients (43 males, 62 females; mean age 44.8 +/- 12.7 years; range, 27 to 58 years) who were treated for chronic LBP were included in this prospective study. Of the patients, 34 received inpatient physical therapy consisting of electrotherapy, superficial-deep heat application, and basic back exercise program, 35 received the same treatment in the outpatient setting, and 36 received back school education. Each patient was evaluated five times during the study using pain intensity Visual Analog Scale (VAS), spinal mobility measurements (inclinometer), general evaluation (VAS), functional disability measurement (Roland-Morris Disability Questionnaire [RMDQ]), and quality of life (Short Form-36 [SF-36]). All expenses and costs for treatment of LBP were estimated. Results: At the end of six months of follow-up, all study groups had a statistically significant improvement in all variables. Improvements in spinal mobility, RMDQ, and SF-36 scores were significantly higher in the inpatient physical therapy group (p<0.001). Direct and total costs were the highest in the inpatient treatment group and were the lowest in the back school education group (p<0.001). No statistically significant differences were observed in terms of additional cost of one-unit improvement in these variables among the study groups. Conclusion: Our study results suggest that all three treatment modalities are effective in chronic LBP. In patients with LBP-related impairment in functional status and quality of life, inpatient physical therapy and rehabilitation should be preferred

The effectiveness of low laser therapy in subacromial impingement syndrome: a randomized placebo controlled double‐blind prospective study

OBJECTIVES: Conflicting results were reported about the effectiveness of Low level laser therapy on musculoskeletal disorders. The aim of this study was to investigate the effectiveness of 850-nm gallium arsenide aluminum (Ga-As-Al) laser therapy on pain, range of motion and disability in subacromial impingement syndrome. METHODS: A total of 52 patients (33 females and 19 males with a mean age of 53.59±11.34 years) with subacromial impingement syndrome were included. The patients were randomly assigned into two groups. Group I (n = 30, laser group) received laser therapy (5 joule/cm² at each point over maximum 5-6 painful points for 1 minute). Group II (n = 22, placebo laser group) received placebo laser therapy. Initially cold pack (10 minutes) was applied to all of the patients. Also patients were given an exercise program including range of motion, stretching and progressive resistive exercises. The therapy program was applied 5 times a week for 14 sessions. Pain severity was assessed by using visual analogue scale. Range of motion was measured by goniometer. Disability was evaluated by using Shoulder Pain and Disability Index. RESULTS: In group I, statistically significant improvements in pain severity, range of motion except internal and external rotation and SPADI scores were observed compared to baseline scores after the therapy (p<0.05). In Group II, all parameters except range of motion of external rotation were improved (p<0.05). However, no significant differences were recorded between the groups (p>0.05). CONCLUSIONS: The Low level laser therapy seems to have no superiority over placebo laser therapy in reducing pain severity, range of motion and functional disability

Is low-level laser therapy effective in acute or chronic low back pain?

The purpose of this study was to compare the effectiveness of low-level laser therapy (LLLT) on pain and functional capacity in patients with acute and chronic low back pain caused by lumbar disk herniation (LDH). LLLT has been used to treat acute and chronic pain of musculoskeletal system disorders. This study is a randomized, double-blind, placebo-controlled study. Forty patients with acute (26 females/14 males) and 40 patients with chronic (20 females/20 males) low back pain caused by LDH were included in the study. Patients were randomly allocated into four groups. Group 1 (acute LDH, n=20) received hot-pack + laser therapy; group 2 (chronic LDH, n=20) received hot-pack + laser therapy; group 3 (acute LDH, n=20) received hot-pack + placebo laser therapy, and group 4 (chronic LDH, n=20) received hot-pack + placebo laser therapy, for 15 sessions during 3 weeks. Assessment parameters included pain, patients' global assessment, physician's global assessment, and functional capacity. Pain was evaluated by visual analog scale (VAS) and Likert scale. Patients' and physician's global assessment were also measured with VAS. Modified Schober test and flexion and lateral flexion measures were used in the evaluation of range of motion (ROM) of lumbar spine. Roland Disability Questionnaire (RDQ) and Modified Oswestry Disability Questionnaire (MODQ) were used in the functional evaluation. Measurements were done before and after 3 weeks of treatment. After the treatment, there were statistically significant improvements in pain severity, patients' and physician's global assessment, ROM, RDQ scores, and MODQ scores in all groups (p<0.05). However, no significant differences were detected between four treatment groups with respect to all outcome parameters (p>0.05). There were no differences between laser and placebo laser treatments on pain severity and functional capacity in patients with acute and chronic low back pain caused by LDH

Is balance training exercise program effective in fibromiyalgia syndrome?

15th Annual European Congress of Rheumatology (EULAR) -- JUN 11-14, 2014 -- Paris, FRANC

A comparison of the DN4 and LANSS questionnaires in the assessment of neuropathic pain: validity and reliability of the Turkish version of DN4

A screening tool that quickly and correctly differentiates neuropathic pain from non neuropathic pain is essential Although there are many screening tools in the assessment of neuropathic pain many physicians still have the problem of not being able to identify their neuropathic pain patients easily In this study we assessed the test retest reliability internal consistency and validity of the Turkish version of DN4 questionnaire Within the same group of patients we also corn pared the DN4 with the LANSS questionnaire A total of 180 patients (n = 121 with neuropathic pain and n = 59 with non neuropathic pain characteristics) were enrolled In our study population peripheral origin of neuropathic pain mainly radiculopathies and polyneuropathies dominated The reliability and validity of Turkish version of DN4 were found to be high The sensitivities of the DN4 and the LANSS were 95% and 70 2% respectively The specificity of both tests was 96 6% The strengths and weaknesses of these questionnaires are discussed Perspective The Turkish version of DN4 questionnaire is reliable and valid It is also an easier quicker and more sensitive screening tool (1 minute test) compared with the Turkish version of LANSS questionnaire These features of the DN4 may help clinicians to identify their neuropathic pain patients accurately in daily clinical practice and research studies (C) 2010 by the American Pain Societ

Adiponectin: is it a biomarker for assessing the disease severity in knee osteoarthritis patients?

AimThe results of previous studies regarding the role of adiponectin in the pathogenesis of osteoarthritis (OA) are controversial. The aim of this study is to investigate the relation of plasma adiponectin levels with clinical and radiological disease severity in knee OA patients. MethodSixty patients with knee OA and 25 healthy controls were included in the study. Patients were divided into two subgroups: lean (Group 1, n = 30) and obese (Group 2, n = 30). Healthy controls were accepted as Group 3 (n = 25). Pain intensity was measured with a visual analogue scale (VAS), functional disability with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Quality of Life (QoL) with Short Form-36 (SF-36). Also all patients were radiologically evaluated and graded according to Kellgren-Lawrence (KL) scale. Plasma concentrations of adiponectin levels were measured by enzyme-linked immune-sorbent assay (ELISA). ResultsSerum adiponectin levels were higher in OA patient subgroups than those in the control group but the difference did not reach a significant level after adjustments for age, gender and body mass index (P = 0.078). There was a positive correlation between adiponectin concentration and KL grading scores. Additionally, there was a positive correlation between adiponectin levels and clinical variables (VAS and WOMAC total scores) in patient subgroups (r = 0.326 P = 0.012, r = 0.583 P < 0.001, respectively). SF-36 scores were inversely associated with adiponectin levels. ConclusionPlasma adiponectin concentrations were associated with both clinical and radiological disease severity in knee OA patients. Thus, adiponectin hormone might be a potential clinically useful biomarker while assessing disease severity in the future.Turkish League Against Rheumatism (TLAR)This study was funded by Turkish League Against Rheumatism (TLAR)