Effectiveness of kinesio taping on postoperative morbidity after impacted mandibular third molar surgery: a prospective, randomized, placebo-controlled clinical study

Objective: Our study seeks to investigate the effectiveness of kinesio taping (KT) on postoperative morbidity compared to placebo and control groups after impacted third molar surgery. Methodology: Sixty patients with impacted mandibular third molar were included in this prospective, randomized, placebo-controlled clinical study. After surgical extraction of the impacted tooth, patients were allocated into three groups (20 patients each): group 1 received KT (kinesio), group 2 received placebo taping (placebo), and group 3 received no taping (control). The groups were compared regarding facial swelling, pain and trismus. Swelling was evaluated using a tape measuring method. Pain was assessed by a visual analog scale and the number of analgesic tablets taken. Trismus was determined by measuring maximum mouth opening. Results: In the KT group, all parameters reduced significantly on 2nd and 4th postoperative days compared to other groups; however, placebo and control groups revealed comparable outcomes. On 7th day, all groups showed comparable results. Conclusions: The KT application is an effective method for reducing morbidity after impacted mandibular third molar surgery. However, placebo taping is not as effective as proper taping. Placebo taping shows similar results compared to no taping regarding facial swelling percentage, pain and trismus

Therapeutic ultrasound and effectiveness in knee osteoarthritis

In Turkey, ultrasound is one of the most commonly used methods for physical therapy of knee osteoarthritis. Therapeutic ultrasound affects the cells and tissues by thermal and nonthermal ways. As well as being used as an agent for deep heating, it has effects like stimulation of tissue regeneration, soft tissue repair, regulation of blood flow in chronic ischemic tissues, protein synthesis and bone repair.In this manuscript, detailed technical information on ultrasound is given and studies on knee osteoarthritis in recent years are reviewed. [Archives Medical Review Journal 2013; 22(2.000): 170-183

Transient Osteoporosis of the Hip

WOS: 000269668900008Transient osteoporosis of the hip is often seen in middle-aged men and in women during the third trimester of pregnancy and is characterized by acute, spontaneous hip pain. In suspected cases magnetic resonance imaging shows bone marrow edema within 48 hours from the onset of pain. Transient osteoporosis is a diagnosis of exclusion and differential diagnosis with other diseases presented with hip pain and bone marrow edema should be considered. Although it is a self limiting condition it must be kept in mind that it may migrate and involve other joints in the lower extremities like knee, ankle and contralateral hip. The cornerstone of treatment is joint protection and limited weight bearing and antiresorptive medication may be of benefit. This review summarizes conditions defined with the terms of transient osteoporosis of the hip, migratory osteoporosis, pregnancy induced osteoporosis and transient bone marrow edema syndrome. Turk J Phys Med Rehab 2009; 55 Suppl 1: 41-5

Relation of Quantitative Glenohumeral Subluxation with Clinical Variables in Patients with Post-Stroke Hemiplegic Shoulder Pain

WOS: 000445290000002Objective: The objective of the present study was to evaluate the relationship between glenohumeral subluxation (GHS) and the clinical variables in patients with post-stroke hemiplegia. The hypothesis, "Spasticity, motor recovery and ambulatory status are associated with GHS in hemiplegic patients" was tested. Methods: Post-stroke hemiplegic patients who had undergone anteroposterior shoulder radiography with a complaint of shoulder pain were included in the study. In this retrospectively designed study, demographic features (age, sex), disease duration, Functional Ambulation Scale (FAC) score, upper extremity Brunnstrom's motor recovery stage, spasticity grade of the affected upper limb according to the Modified Ashworth Scale (MAS) were recorded from the electronic medical database. It was also noted whether the patients were diagnosed with GHS or not. In patients with GHS, vertical and horizontal distances were measured on anteroposterior shoulder radiographs, which were taken at the time of physical examination. Results: Data of 47 hemiplegic patients underwent anteroposterior shoulder radiographs due to shoulder pain was obtained. Following the application of exclusion criteria, 41 patients with a mean age of 66.2 +/- 12.1 were analysed. Of them, 22 (53.7%) had GHS. Subluxation rate was significantly higher among patients in Brunnstrom category I (Brunnstrom 1-3) than those in category II (Brunnstrom 4-6) (p0.05). Subluxation frequency was also similar between patients with non-functional (FAC 0-2) and functional ambulation (FAC 3-5) (p>0.05). In patients with GHS, vertical and horizontal distances did not differ by FAC and MAS category (p>0.05). Since Brunnstrom category II did not have enough number of patients for statistical tests, comparative analysis could not be applied. Conclusion: Among patients with post-stroke hemiplegia, presence of GHS is related to the motor recovery stage, but is regardless of ambulation and spasticity level. In patients with GHS, level of ambulation and spasticity had no impact on the quantitative measures of subluxation

Association of Radiological Grading with Clinical Variables and Functional Status in Patients with Hip and Knee Osteoarthritis

WOS: 000264851900017Objective: The general opinion is that there is a disparity between symptoms and radiological abnormalities in osteoarthritis (OA), but some recent studies emphasize the potential contribution of underlying joint disease to the degree of pain and disability. Our aim was to assess the relationship between radiographic grading and demographic features, clinical variables and functional status in patients with hip and knee OA. Material and Methods: 128 patients (61.8 +/- 9.5 years, 84 knee and 44 hip OA) were included in the study. Demographic features, duration of disease and stiffness, and severity of pain were assessed using visual analog scale (VAS). Range of motion (ROM) measurements and radiological grading were performed. Western Ontario and McMaster Universities OA Index (WOMAC) was used for evaluating pain, stiffness and physical functions, and Short Form-36 (SF-36) was used for evaluating general health status. These variables were compared between three groups based on Kellgren-Lawrence radiological grades (grade 2, 3, 4). Results: Age, body mass index, ROM values, VAS (p = 0.0001), WOMAC pain, function and total score (p = 0.007, p = 0.03 and p = 0.03 respectively), physical functioning, bodily pain, social functioning and emotional role of SF-36 (p = 0.007, p = 0.008, p = 0.02 and p = 0.009 respectively) were worsened according to radiological grade in knee OA. Duration of disease, ROM values, VAS (p = 0.006) and bodily pain subscale of SF-36 (p = 0.03) were worsened in hip OA; no significant difference was detected in WOMAC subscales and total score. Conclusion: Clinical variables, functional status and quality of life deteriorated with radiological grade in knee OA patients and this deterioration was significant in grade 4. However, this association, especially of functional status, could not be confirmed in hip OA patients

Use of Zoledronic Acid in Thalassemia-Induced Osteoporosis: Two Case Reports and Review of the Literature

WOS: 000306640000015The life span of thalassemia major patients has been extended with early diagnosis and treatment modalities. This condition has resulted in an increase in osteoporosis-related problems. Even with optimal transfusions, the bone marrow of these patients remains hyperactive. For this reason, despite blood transfusion, iron chelation, and sex hormone replacement therapy, generalized osteoporosis and osteopenia are still frequent in thalassemia patients. In thalassemia-induced osteoporosis, bone resorption increases. This condition makes biphosphonates, which are potent inhibitors of osteoclast function, the drug of choice. In this article, two sisters with thalassemia major and secondary osteoporosis are discussed and the results of treatment with intermittent zoledronic acid (iv. 4 mg) for 6 years are presented. We also performed a review of the literature on the etiopathogenesis of thalasemia-induced osteoporosis and the treatment modalities. Turk J Phys Med Rehab 2072;58:754-8

Musculoskeletal Disorders in an Automotive Manufacturing Plant and the Outcomes of Ergonomics and Exercise Training in Workers Who Used Sick Leave

WOS: 000324665000008Objective: To evaluate the frequency of musculoskeletal disorders (MSD) in workers in an automotive manufacturing plant and the effectiveness of exercise and ergonomics training in those who used sick leave due to MSD. Materials and Methods: The workers were screened with a detailed questionnaire including the Nordic Musculoskeletal Questionnaire. Those. who used sick leave in the previous 12 months were taken into a training program. Training on low back, neck and upper extremity pain, and office ergonomics were given in small groups by an interactive method using exercise materials and practice sessions. A self-assessment pain scale was applied before and after 6 months of training. Results: Six hundred eighty workers were screened. 44% reported that MSD affected their tasks and 3% declared that their jobs were changed. While low back pain was more frequent in blue-collars, neck pain was prevalent in white-collars. 70 workers (10.3%) had used sick leave. Following training, there were significant reduction in pain scores in both blue (p<0.001) and white collars (p=0.008). However, there were no statistical difference between the groups (p=0.99). Conclusion: MSD are frequent even in a factory engaged in the process of establishing occupational health and safety culture. Each enterprise should take the necessary measures to ensure protection

Bilateral Incomplete Atypical Femoral Fracture due to Long-Term Bisphosphonate Use: A Case Report

WOS: 000410750200011Although the overall safety profile of bisphosphonates (BP) is favorable, adverse effects associated with long-term use have came up during recent years. In this report, a case of bilateral incomplete atypical femoral fracture (AFF) due to prolonged BP use was presented. A 69-year-old patient, who has been in surgical menopause for 20 years and was started on BP following vertebral fracture almost 10 years ago, was admitted with thigh pain, which was increased two weeks ago. On physical examination, she had antalgic gait, increased thoracic kyphosis and tenderness to percussion over the thoracolumbar region. Lateral cortical thickness in the subtrochanteric region of both femurs and cortical radiolucency on the left femur were observed on plain radiography. Loss of height in L3 and L4 vertebrae was detected on vertebral radiography. Serum 25-hydroxy vitamin D [25(OH) D], parathyroid hormone, alkaline phosphatase and calcium levels, along with osteoporosis markers were all within the normal ranges. As the patient was diagnosed with AFF, BP therapy was terminated and vitamin D-calcium supplementation was continued. Since she did not have severe pain, conservative management (limited weight bearing, using a walking stick) was recommended for 3 months. Teriparatide therapy was started and she was discharged with recommendations. AFF, which is a rare disorder, should be kept in mind in patients on long-term BP treatment who are admitted with thigh pain and, necessary interventions should be tailored before the occurrence of complete fracture

The Effects of Steroid Phonophoresis on Clinical Parameters and Nerve Conduction Velocities in Carpal Tunnel Syndrome

Objective: This study was aimed to investigate the effects of steroid phonophoresis on electroneurophysiological and clinical parameters and to compare these effects with ultrasound (US) and sham US in carpal tunnel syndrome (CTS). Material-Method: 39 patients with CTS (69 hands) were included in the study. Patients were randomized to phonophoresis (n=13 patients, 21 hands), US (n=13 patients, 24 hands) and sham US (n=13 patients, 24 hands) groups. Steroid phonophoresis, using dexamethasone as conductive agent, was applied at 1.0 W/cm2 to the phonophoresis group. Ultrasound at 1.0 W/cm2 and imitative US at 0.0 W/cm2 were applied to the US and sham US groups respectively. All groups were asked to perform tendon and nerve gliding exercises. Distal motor latency (mMDL) and sensory nerve conduction velocity (mSNCV) of median nerve, visual analogue scale (VAS) and Boston Scale were assessed at the beginning, 2nd week and in the 12th week. Results: All of the variables were significantly improved in the 12th week in steroid phonophoresis group, whereas VAS, symptom severity and functional capacity of Boston scale were improved in US and sham US groups. mSNCV was also improved in sham US group. The differences between 12th week-pre treatment values (delta) were used for group comparisons. Delta values of electroneurophysiological parameters of phonophoresis group were found to be significantly different, whereas no significant differences were found between the groups for the other variables. Conclusion: Steroid phonophoresis has favorable effects on electroneurophysiological studies and these effects last longer. Favorable effects on clinical findings and patient based assessments were observed in all groups. The improvements seen in sham US group may suggest the effectiveness of tendon and nerve gliding exercises. [Cukurova Med J 2012; 37(1): 17-26