Objective
Loss of proprioception and balance disorders are commonly observed in patients with knee osteoarthritis. In this study, we aimed to investigate the effects of balance and proprioception ...exercises in patients with knee osteoarthritis.
Design
A single-center randomized trial with three parallel arms.
Setting
A tertiary health care facility in Turkey.
Participants
Female patients with knee osteoarthritis aged 40–70 years.
Interventions
Ten-week exercise program in Biodex training, classical balance training and isometric strengthening groups.
Main measures
Dynamic balance (overall stability index and the modified Clinical Test of Sensory Interaction and Balance), pain (visual analogue scale), physical function (30-s chair stand test and 40-meter fast-paced walk test) and quality of life (Knee Injury and Osteoarthritis Outcome Score).
Results
Eighty-nine patients enrolled in the study. The Biodex training group, the classical training group, and the control group had overall stability index values of 1.0 ± 0.07, 1.4 ± 0.07 and 1.4 ± 0.07, and the Modified Clinical Test of Sensory Interaction and Balance – Condition-3 values of 0.7 ± 0.04, 0.9 ± 0.04 and 0.9 ± 0.04 respectively, at the end of treatment. In terms of pain scores on movement, each group showed significant improvement compared to their baseline, and the classical balance training group had better scores than the control group. No other significant difference was found between the groups. Physical function and quality of life outcomes showed significant main effects only in the time factor.
Conclusions
Balance and proprioception exercises may have positive effects on dynamic balance and pain. The effects on physical function and quality of life should be investigated in further studies with larger sample.
Abstract The aim of this study was to determine the quality of life (QoL) at the third month after stroke and to identify the factors related with and determinants of QoL in geriatric stroke ...patients. Eighty of 122 patients who were assessed within the first week after stroke were reevaluated at the third month. Patients were divided into two groups as those of ≥65 years old (geriatric group) and those of <65 years old (non-geriatric group). The stroke severity, functional status, and ambulation level were assessed by the Canadian neurological scale (CNS), the functional independence measure (FIM), and the functional ambulation classification scale (FACS) within the first week of stroke, respectively. Depression and QoL levels were also determined at the third month using the Zung self-rating depression scale (ZDS) and both the Short Form-36 (SF-36) survey and the stroke-specific quality of life (SSQoL) scale, respectively. The QoL of 80 patients according to the SF-36 were lower than those of general population. No significant difference was found in stroke severity, functional status at baseline and third month, depression and QoL between geriatric and non-geriatric patients ( p > 0.05). The most influenced subscale of QoL was work/productivity in geriatric patients, and the main determinant of QoL was the functional status during the assessment. Stroke patients had an impaired QoL, and geriatric patients did not demonstrate a difference in terms of QoL compared to non-geriatric patients. The fact that the main determinant of QoL was functional status has been suggested that improving of physical function may be helpful to provide a better QoL for stroke patients.
Background In addition to pharmacological treatment, psychotherapeutic approaches are recommended for the treatment of fibromyalgia. There is a suggestion that eye movement desensitization and ...reprocessing (EMDR) therapy may be effective. This study aimed to investigate the impact of EMDR therapy on fibromyalgia symptoms, depression, sleep quality, and traumatic stress in fibromyalgia patients through a randomized controlled study (RCT). Materials and methods The sample for this study comprised 79 individuals diagnosed with fibromyalgia. Participants were randomly assigned to two groups: the “Treatment as Usual” (TAU) group and the TAU + EMDR group. Prior to the study and at six different time points (before starting the study, at the end of the 5th, 10th, and 15th sessions, 1 month later, and 3 months later), participants completed assessments, including the Fibromyalgia Impact Questionnaire (FIQ), Visual Analog Scale (VAS), Fibromyalgia ACR 2010 Diagnostic Criteria Widespread Pain Index (WPI) and Symptom Severity Scale (SSS), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and Trauma Symptom Checklist-40 (TSC-40). Results There were no differences in the sociodemographic variables between the study and experimental groups. Analysis of variance revealed a statistically significant group effect on VAS (p = 0.019), WPI (p = 0.018), BDI (p = 0.019), and TSC-40 (p = 0.21). After applying Bonferroni correction, EMDR was found to be effective for VAS, WPI, SSS, BDI, PSQI, and TSC-40 (p <0.05). Conclusion The results of the current study suggest that EMDR therapy is a viable alternative treatment for fibromyalgia. We believe these findings offer robust evidence supporting the efficacy of EMDR therapy in treating fibromyalgia, particularly in the context of a randomized controlled trial (RCT). The application of EMDR therapy for the treatment of patients with fibromyalgia is likely to be beneficial. Clinical trial registration ClinicalTrials.gov , identifier NCT06265194.
Amaç: Egzersiz tedavisi, kronik non-spesifik bel ağrısı (NSKBA) tanısı alan hastalarda en yaygın önerilen tedavi şeklidir. Ancak bir egzersiz yönteminin başka bir egzersiz yöntemine üstün olup ...olmadığı tartışmalıdır.
Gereç ve Yöntem: Bu çalışmada NSKBA olan hastalar deney grubu (gözetimli aerobik egzersiz + ev egzersizi) ve kontrol grubu (sadece ev egzersizi) olmak üzere iki gruba randomize edildi. Hastalar tedavi öncesi, tedavi bitimi ve tedavi bitiminden üç ay sonra ağrı şiddeti, spinal mobilite, lomber ektansör kas dayanıklılığı, depresif semptom varlığı ve şiddeti, özürlülük ve yaşam kalitesi bakımından değerlendirildi.
Bulgular: Deney grubunda tüm değerlendirmelerde anlamlı düzelme saptanırken kontrol grubunda, ağrı, spinal mobilite ve yaşam kalitesinin fiziksel komponentinde anlamlı düzelme saptandı. Kontrol grubuna göre, deney grubunda değerlendirme parametrelerinde zamanla meydana gelen olumlu değişim anlamlı olarak daha yüksekti.
Sonuç: Aerobik egzersiz, NSKBA olan hastaların yetersizliklerinin düzeltmesine, aktivite düzeylerinin ve katılım düzeylerinin arttırılmasına katkı sağlayabilir. Ancak hangi aerobik egzersiz tipinin (sıklığının, süresinin ve yoğunluğunun) daha etkili olduğuna yönelik çalışmalara ihtiyaç vardır.
Purpose: Exercise therapy is the most commonly recommended form of treatment for patients diagnosed with non-specific chronic low back pain (NSCBP). However, it is controversial whether an exercise method is superior to other ones.
Materials and Methods: In this study, patients with NSCBP were randomized into two groups as experimental group (supervised aerobic exercise + home-based exercise) and control group (home-based exercise alone). The patients were evaluated in terms of pain severity, spinal mobility, lumbar extensor muscle endurance, presence and severity of depressive symptoms, disability, and quality of life at the time points of before treatment, treatment ends, and three months after treatment ends.
Results: In the experimental group, there was a significant improvement in all assessments, while in the control group, there was a significant improvement in pain severity, spinal mobility, and the physical component of quality of life. In the experimental group, the positive change in assessment parameters over time was significantly higher than in the control group.
Conclusion: Aerobic exercise may contribute to correcting the impairments, increasing activity and participation levels of patients with NSCBP. However, studies are needed to determine which type of aerobic exercise (frequency, duration, and intensity of that type) is more effective.
The aim of the present study was to compare patients with ankylosing spondylitis (AS) with healthy controls with respect to subclinical atherosclerotic cardiovascular disease (CVD).
A total of 44 ...patients with AS with no history of CVD, diabetes mellitus, hypertension, chronic kidney disease, and lipid-lowering drug use were compared with 40 age- and sex-matched healthy controls with respect to carotid intima-media thickness (CIMT) and pulse wave velocity (PWV), which are surrogate markers of subclinical atherosclerosis. Correlation analysis was also performed to examine the association between surrogate markers and disease activity with inflammation Ankylosing spondylitis disease activity score with C-reactive protein (ASDAS-CRP).
In addition to age and sex, both groups were comparable with respect to cigarette smoking, body mass index, and high-density lipoprotein cholesterol (p=0.425, p=0.325, and p=0.103, respectively). The level of total cholesterol was significantly lower in patients with AS (p=0.002). Nonsteroidal anti-inflammatory drug and tumor necrosis factor alpha inhibitor use ratios in patients with AS were 79.5% and 65.9%, respectively. There was no significant difference between both groups regarding PWV and CIMT (p=0.788 and p=0.253, respectively). In patients with AS, there was a significant correlation between ASDAS-CRP and CIMT (r=0.315, p=0.038), but the correlation between ASDAS-CRP and PWV was not significant (r=-0.183, p=0.234).
The results of the present study could not provide sufficient evidence whether disease activity with inflammation caused subclinical atherosclerotic CVD in patients with AS without overt CVD. The increased atherosclerotic CVD risk is most probably multifactorial in patients with AS, but the extent of the contribution of disease activity with inflammation to increased atherosclerosis is controversial.
The aim of this study was to determine the prevalence of impairments relevant to upper extremity following breast cancer surgery and its impact on disability and health-related quality of life.
...Sixty-seven female patients being treated with modified radical mastectomy or breast conserving surgery were included. They were evaluated for impairments (arm edema, loss of handgrip strength, limited shoulder joint range of motion, and pain), physical disability using the disabilities of the arm, shoulder, and hand (DASH) questionnaire, and for health related quality of life by means of the functional assessment of cancer therapy-breast+4 (FACT-B+4).
The most common impairment observed was arm pain on motion; the cause of 20% variance in disability score (r = 0.203, P = 0.000). Arm pain on motion, anterior chest wall pain, loss of grip strength, and shoulder flexion were significant factors in different domains of quality of life according to the FACT-B+4 questionnaire.
Pain relief should be the priority of treatment along with the prevention of joint movement restriction to ensure a sufficient quality of life for surgically treated breast cancer patients.
The objective is to develop a Turkish version of the foot and ankle outcome score (FAOS) and to investigate its validity and reliability. The Turkish version of FAOS was developed after the ...translation and back-translation. The translated version was pretested on 20 patients with rheumatoid arthritis. Then, the Turkish FAOS was administered to 55 patients having foot and ankle problems. They were also evaluated by using the four subscales of the Turkish version of AIMS2, and the Turkish version of SF-36 questionnaire to test validity. Fifty patients filled out the FAOS for second time to determine test–retest reliability. Construct validity was investigated with use of Spearman’s rank correlation coefficient. Test–retest reliability was assessed with use of the intraclass correlation coefficient (ICC) and Cronbach’s alpha score. The psychometric properties of the Turkish FAOS were generally similar to the original FAOS. The random ICC for the five subscales ranged from 0.70 to 0.96. The Cronbach’s alpha coefficient ranged from 0.79 to 0.97. Construct validity of the FAOS was good. The Turkish FAOS correlated with the SF-36 and AIMS2 scales. The Turkish version of FAOS was valid and reliable instrument to assess the foot and ankle related problems. However, to assess its responsiveness further studies are needed.
Spontaneous bilateral quadriceps rupture is rarely seen in systemic diseases. Although the underlying mechanism in tendon rupture is not clearly understood, β2-amyloidosis, chronic acidosis, impaired ...collagen metabolism, accumulation of uremic toxins and secondary hyperparathyroidism are held to be responsible. The patients with bilateral spontaneous quadriceps rupture can be able to achieve significant functional improvement with the postoperative rehabilitation program. In this article, we aimed to present a patient with hemodialysis who developed spontaneous bilateral quadriceps and unilateral triceps rupture and discuss in company with the literature.
Spontan bilateral quadriceps rüptürü, sistemik hastalıklarda nadiren görülebilmektedir. Tendon rüptürlerininde altta yatan mekanizma
net olarak anlaşılamamakla birlikte, β2-amiloidoz, kronik asidoz, ...bozulmuş kollajen metabolizması, üremik toksinlerin birikimi ve sekonder
hiperparatiroidizm sorumlu tutulmaktadır. Bilateral spontan quadriceps rüptürü olan hastalar postoperatif rehabilitasyon programıyla anlamlı
fonksiyonel gelişme gösterebilmektedirler. Bu makalede, hemodiyaliz programında olan, spontan bilateral quadriceps ve unilateral triceps
rüptürü gelişen bir hastayı sunmayı ve literatür eşliğinde tartışmayı amaçladık.
Objective In this study, it was aimed to evaluate the relationship between vitamin D level and pain severity, localization and duration in patients with non-specific musculoskeletal pain. Materials ...and Methods Patients who applied to physical medicine and rehabilitation outpatient clinics due to non-specific muscle pain in 19 centers in Turkey were retrospectively screened. Three thousand four hundred fourpatients were included in the study, whose pain level was determined by visual analog scale (VAS) and the painful region, duration of pain and vitamin D level were reached. D group was found to be D deficient (group 1) when 25 (OH)D level was 20 ng/mL or less and group D 2 (vitamin D deficiency) was higher than 30 ng/mL (group 3). The groups were compared in terms of pain duration, localization and severity. In addition, the correlations of pain localization, severity and duration with vitamin D levels were examined. Results D vitamin deficiency was detected in 2202 (70.9%) of 3 thousand four hundred and four registered patients, and it was found that vitamin D deficiency in 516 (16.6%) and normal vitamin D in 386 (12.4%). The groups were similar in terms of age, body mass index, income level, duration of complaint, education level, family type and working status (p>0.05). There was no statistically significant difference between groups in terms of VAS, pain localization and duration scores (p>0.05). Conclusion Our study shows that vitamin D deficiency in patients with nonspecific musculoskeletal pain is not associated with the severity and duration of pain.
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