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.
This study was a prospective, randomized, controlled study.
To compare the effectiveness of aquatic exercise interventions with land-based exercises in the treatment of chronic low back pain (CLBP).
...Land-based exercise and physiotherapy are the main treatment tools used for CLBP. Clinical experience indicates that aquatic exercise may have advantages for patients with musculoskeletal disorders.
A total of 65 patients with CLBP were included in this study. Patients were randomly assigned to receive aquatic exercise or land-based exercise treatment protocol. Aquatic exercise program consisted of 20 sessions, 5 x per week for 4 weeks in a swimming pool at 33 degrees C. Land-based exercise (home-based exercise) program were demonstrated by a physiotherapist on one occasion and then they were given written advice The patients were assessed for spinal mobility, pain, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (week 4 and week 12).
In both groups, statistically significant improvements were detected in all outcome measures (except modified Schober test) compared with baseline. However, improvement in modified Oswestry Low Back Pain Disability questionnaire and physical function and role limitations due to physical functioning subpart of Short-Form 36 Health Survey were better in aquatic exercise group (P < 0.05).
It is concluded that a water-based exercises produced better improvement in disability and quality of life of the patients with CLBP than land-based exercise.
The worldwide pandemic of coronavirus disease 2019 (COVID-19) was known to predominantly affect the lungs, but it was realized that COVID-19 had a large variety of clinical involvement. ...Cardiovascular, gastrointestinal, neurological, and musculoskeletal systems are involved by direct or indirect mechanisms with various manifestations. The musculoskeletal involvement can manifest during COVID-19 infection, due to medications used for the treatment of COVID-19, and in the post/long COVID-19 syndrome. The major symptoms are fatigue, myalgia/arthralgia, back pain, low back pain, and chest pain. During the last two years, musculoskeletal involvement increased, but no clear consensus was obtained about the pathogenesis. However, there is valuable data that supports the hypothesis of angiotensinconverting enzyme 2, inflammation, hypoxia, and muscle catabolism. Additionally, medications that were used for treatment also have musculoskeletal adverse effects, such as corticosteroid-induced myopathy and osteoporosis. Therefore, while deciding the drugs, priorities and benefits should be taken into consideration. Symptoms that begin three months from the onset of the COVID-19 infection, continue for at least two months, and cannot be explained by another diagnosis is accepted as post/long COVID-19 syndrome. Prior symptoms may persist and fluctuate, or new symptoms may manifest. In addition, there must be at least one symptom of infection. Most common musculoskeletal symptoms are myalgia, arthralgia, fatigue, back pain, muscle weakness, sarcopenia, impaired exercise capacity, and physical performance. In addition, the female sex, obesity, elderly patients, hospitalization, prolonged immobility, having mechanical ventilation, not having vaccination, and comorbid disorders can be accepted as clinical predictors for post/long COVID-19 syndrome. Musculoskeletal pain is also a major problem and tends to be in chronic form. There is no consensus on the mechanism, but inflammation and angiotensin-converting enzyme 2 seem to play an important role. Localized and generalized pain may occur after COVID-19, and general pain is at least as common as localized pain. An accurate diagnosis allows physicians to initiate pain management and proper rehabilitation programs.
To determine the effectiveness of balance exercises on the functional level and quality of life (QOL) of patients with fibromyalgia syndrome (FMS) and to investigate the circumstances associated with ...balance disorders in FMS.
Randomized controlled trial.
Physical medicine and rehabilitation clinic.
Patients (N=57) (age range, 18-65y) with FMS were randomly assigned into 2 groups.
Group 1 was given flexibility and balance exercises for 6 weeks, whereas group 2 received only a flexibility program as the control group.
Functional balance was measured by the Berg Balance Scale (BBS), and dynamic and static balance were evaluated by a kinesthetic ability trainer (KAT) device. Fall risk was assessed with the Hendrich II fall risk model. The Nottingham Health Profile, Fibromyalgia Impact Questionnaire (FIQ), and Beck Depression Inventory (BDI) were used to determine QOL and functional and depression levels, respectively. Assessments were performed at baseline and after the 6-week program.
In group 1, statistically significant improvements were observed in all parameters (P<.05), but no improvement was seen in group 2 (P>.05). When comparing the 2 groups, there were significant differences in group 1 concerning the KAT static balance test (P=.017) and FIQ measurements (P=.005). In the correlation analysis, the BDI was correlated with the BBS (r=-.434) and Hendrich II results (r=.357), whereas body mass index (BMI) was correlated with the KAT static balance measurements (r=.433), BBS (r=-.285), and fall frequency (r=.328).
A 6-week balance training program had a beneficial effect on the static balance and functional levels of patients with FMS. We also observed that depression deterioration was related to balance deficit and fall risk. Higher BMI was associated with balance deficit and fall frequency.
Amaç: Topuk dikeni klinikte sıkça karşılaşılan, kronik plantar topuk ağrısına neden olan klinik bir tablodur. Hastalara uygulanan kortikosteroid enjeksiyonu, steroid olmayan antiinflamatuvar ilaçlar ...ve çeşitli fizik tedavi modaliteleri gibi seçeneklerin yanında, ‘Extracorporeal Shock Wave Therapy’ (ESWT) cerrahi olmayan yöntemler arasında yerini almıştır. Bu prospektif kontrollü çalışmanın amacı klinik ve radyolojik olarak topuk dikeni tanısı alan hastalarda ESWT tedavisinin etkinliğini araştırmaktır. Gereç-Yöntem: Çalışmaya klinik ve radyolojik olarak topuk dikeni tanısı konan 49 hasta alındı. Hastalar randomize olarak iki gruba ayrıldı. Grup 1 (n=25) dört gün aralıkla 3 seans boyunca 8 Hz frekans ile her seans 1000 atım olacak şekilde ESWT tedavisi aldı. Grup 2 (n=24) ise kontrol grubu olarak kabul edildi ve sadece silikon tabanlık kullandı. Ağrı şiddeti gece ağrısı, sabah ilk basma sırasındaki ağrı, hareket ile ağrı, istirahat ağrısı, engebeli zeminde ağrı ve gün sonunda ağrı olmak üzere Görsel Analog Skala (GAS) ile ve ayak aktiviteleri ile ilgili fonksiyonel düzey ise Foot Ankle Outcome Score (FAOS) indeksi ile değerlendirildi. Ölçümler hastalar tedaviye alınmadan önce ve 4 haftalık izlem sonrasında yapıldı. Bulgular: Tedavi sonrasında her iki grupta tüm parametrelerde istatistiksel olarak anlamlı iyileşme saptandı (p<0,05). Gruplar arası değerlendirmede ise tedavi sonrasında GAS ile hesaplanan gece ağrısı ve sabah ilk basma sırasındaki ağrıda (p<0,05) ESWT grubu lehine olacak şekilde anlamlı düzelme olduğu gözlemlendi. Diğer parametrelerde ise her iki grup arasında anlamlı fark bulunmadı (p>0,05). Sonuç: Çalışmamızın sonuçları; ESWT uygulamasının topuk dikeni tedavisinde etkili olduğunu ve diğer konservatif yöntemler arasında etkin bir seçenek olabileceğini desteklemektedir.
The aim of this study was to investigate the efficacy of aquatic exercises in fibromyalgia syndrome (FMS). A total of 63 patients were included and allocated to two groups. Group I (
n
= 33) ...received an aquatic exercise program and Group II (
n
= 30) received a home-based exercise program for 60 min, 3× a week, over 5 weeks. Patients were evaluated for pain (visual analogue scale, VAS), number of tender points (NTP), Beck depression inventory (BDI), and functional capacity (fibromyalgia impact questionnaire, FIQ). All assessment parameters were measured at baseline, and at weeks 4, 12, and 24. There were statistically significant differences in FIQ and NTP in both groups at the end and during follow-up (
P
< 0.05). Group I showed a statistically significant decrease in BDI scores after 4 and 12 weeks (
P
< 0.05) that remained after 24 weeks (
P
< 0.001). In Group II, a significant decrease in BDI scores was observed at the end and during follow-up (
P
< 0.001). Also, a significant improvement was found in VAS at weeks 4 and 12 in both groups (
P
< 0.001). The average of reduction in pain scores was 40% in Group1 and 21% in Group II. However, this was still significant at week 24 only in the aquatic therapy group. A comparison of the two groups showed no statistically significant difference for FIQ, NTP, and BDI scores except VAS (
P
< 0.001) Our results showed that both aquatic therapy and home-based exercise programs have beneficial effects on FIQ, BDI, and NTP. In pain management, only aquatic therapy seems to have long-term effects.
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.
This prospective, randomized, placebo-controlled trial aimed to investigate the efficacy of laser therapy in the treatment of carpal tunnel syndrome (CTS).
Low-level laser therapy (LLLT) has been ...found to have positive effects in the treatment of CTS and various musculoskeletal conditions.
A total of 81 patients were included in this study. Diagnosis of CTS was based on both clinical examination and electromyographic (EMG) study. Patients were randomly assigned into two groups. Group 1 (n = 41) underwent laser therapy (7 joules/2 min) over the carpal tunnel area. Group 2 (n = 40) received placebo laser therapy. All patients received therapy five times per week, for a total of 10 sessions. Patients also used a wrist splint each night. Patients were assessed according to pain, hand-pinch grip strength, and functional capacity. Pain was evaluated by Visual Analog Scale (VAS; day-night). Hand grip was measured by Jamar dynometer, and pinch grip was measured by pinchmeter. Functional capacity was assessed by a self-administered questionnaire for severity of symptoms.
The mean age of the patients (70 women, 11 Men) was 49.3 +/- 11.0 (range, 26-78). After therapy there were statistically significant improvements in VAS, pinch grip, and functional capacity measurement in both groups (p < 0.001). Hand grip was found to have been improved in the laser group. In EMG, there were statistically improvements in sensory nerve velocity, and sensory and motor distal latancies in the laser group (p < 0.001). Only sensory nerve velocity was meaningful in the placebo group.
In using LLLT, (1) there was no difference relative to pain relief and functional capacity during the follow-up in CTS patients; (2) there were positive effects on hand and pinch grip strengths.
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.
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.
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).
The Low level laser therapy seems to have no superiority over placebo laser therapy in reducing pain severity, range of motion and functional disability.
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