Aydan Aytar

Comparing hot pack, short-wave diathermy, ultrasound, and TENS on isokinetic strength, pain, and functional status of women with osteoarthritic knees: a single-blind, randomized, controlled trial.

Cetin N, Aytar A, Atalay A, Akman MN: Comparing hot pack, short-wave diathermy, ultrasound, and TENS on isokinetic strength, pain, and functional status of women with osteoarthritic knees: a single-blind, randomized, controlled trial. Am J Phys Med Rehabil 2008;87:443–451. Objective:To investigate the therapeutic effects of physical agents administered before isokinetic exercise in women with knee osteoarthritis. Design:One hundred patients with bilateral knee osteoarthritis were randomized into five groups of 20 patients each: group 1 received short-wave diathermy + hot packs and isokinetic exercise; group 2 received transcutaneous electrical nerve stimulation + hot packs and isokinetic exercise; group 3 received ultrasound + hot packs and isokinetic exercise; group 4 received hot packs and isokinetic exercise; and group 5 served as controls and received only isokinetic exercise. Results:Pain and disability index scores were significantly reduced in each group. Patients in the study groups had significantly greater reductions in their visual analog scale scores and scores on the Lequesne index than did patients in the control group (group 5). They also showed greater increases than did controls in muscular strength at all angular velocities. In most parameters, improvements were greatest in groups 1 and 2 compared with groups 3 and 4. Conclusions:Using physical agents before isokinetic exercises in women with knee osteoarthritis leads to augmented exercise performance, reduced pain, and improved function. Hot pack with a transcutaneous electrical nerve stimulator or short-wave diathermy has the best outcome.

Initial effects of kinesio® taping in patients with patellofemoral pain syndrome: A randomized, double-blind study

The purpose of this randomized, double-blind study was to determine the acute effects of kinesio ® taping on pain. strength, joint position sense and balance in patients with patellofemoral pain syndrome (PFPS). Twenty-two subjects with PFPS participated in the study. Subjects were separated into two groups; kinesio ® taping (KT) and placebo kinesiotaping (PKT). All subjects were assessed before and 45-min after the applications. Muscle strength, joint position sense, static and dynamic balance and pain intensity were used as the main outcome measures. Among all outcome parameters significant differences were found between strength of quadriceps muscle at 60 and 180°/s, and static and dynamic balance scores before and 45-min after application of KT. There was also a significant difference between strength of quadriceps muscle at 60°/s and static balance scores before and 45 minutes after application of the PKT. Therefore KT application does not seem to be an effective treatment method for both decreasing pain and improving joint position sense for patients with PFPS.

Effects of Lower-Extremity and Trunk Muscle Fatigue on Balance

Objective: To examine the impact of lower-extremity and trunk muscle fatigue on static and dynamic balance tests. Methods: An isokinetic dynamometer at constant angular velocities of 60°/s, 90°/s, 120°/s, and 180°/s was used to test the isokinetic strength of knee and trunk muscles in 30 healthy sedentary volunteers (14 men and 16 women). Lower- extremity fatigue was produced with the StairMaster, and trunk muscle fatigue was produced with an isokinetic dyna- mometer. Static and dynamic balance measurements were assessed with a balance assessment system before and after muscle fatigue in each subject. Results: There was a significant difference between the prefatigue - postfatigue trunk and lower extremity muscles and the static balance scores. But the dynamic right, left and front balance test scores were not significantly different before and after fatigue of the trunk and lower-extremity muscles. Conclusion: Balance is affected by a generalized fatigue of trunk muscles and lower-extremity muscles. However, it ap- pears that static balance control is affected by the fatigue of trunk and lower-extremity muscles while dynamic balance is affected partly by trunk and lower-extremity muscular fatigue.

Is there a relationship between core stability, balance and strength in amputee soccer players? A pilot study

Background: The body is a kinetic chain and all the systems and muscle groups play important roles in this chain. Core stability, strength and balance are important components of performance within many sports, and in particular soccer. However, the relationship between these components is not fully understood. Objectives: To investigate the relationship between core stability, balance and strength in amputee soccer players. Study Design: Clinical pilot trial. Methods: Eleven amputee soccer players (mean age = 24.63 ± 6.48 years) participated in our study. A Kinesthetic Ability Trainer device was used to assess balance. Trunk strength was evaluated by isokinetic dynamometer. Gillet test was used to evaluate the sacroiliac joint movement. Modified plank test was used to determined dynamic core stability. Disability was evaluated using the Oswestry Disability Index. Results: The results showed that there was a correlation between flexor isokinetic trunk muscle strength at the velocity of 60°/sec and modified plank test (r = 0.630, p = 0.038). There was a negative correlation between flexor isokinetic trunk muscle strength at the velocity of 180°/sec and Oswestry Disability Index score (r = −0.649, p = 0.031). Conclusions: Amputee soccer is a sport which is generally performed with one limb balance with crutches. It is therefore perceived that a relationship between balance and sacroiliac mobility, and should be considered for evaluation process and performance analysis in amputee soccer. However, in future studies, we recommend that such evaluations on amputee soccer players should be carried out with increased numbers. Clinical relevance Many aspects should be considered in the evaluation of amputee soccer players. Core stability, balance and strength should not be ignored when designing a training program for an amputee soccer team.

Effectiveness of two different physical therapy programmes in the treatment of knee osteoarthritis

Abstract Combined physical therapy interventions traditionally are frequently used in clinical practice for pain relief and to improve physical function in patients with knee osteoarthritis. The aim of the present study was to evaluate the effectiveness of two different physical therapy programmes on patients with knee osteoarthritis. A total 62 patients who fulfilled clinical and radiological criteria of the American College of Rheumatology for primary knee osteoarthritis were randomly allocated to two groups. After hot pack and transcutaneous electrical nerve stimulation applications, the first group was treated with isokinetic exercises and the second group with isotonic exercises. Both groups showed marked decreases of pain and increases of physical function, according to the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, immediately after treatment and three months later. The patients in both groups also showed a significant improvement in mental health scale of the Medical O...

Scapular resting position, shoulder pain and function in disabled athletes

Background: Despite the fact that the number of disabled individuals participating in sports is increasing, there are only sparse reports in the literature concerning overuse injuries. Objectives: The purpose of this study was to compare scapular resting position, shoulder pain, and function in wheelchair basketball, amputee soccer, and disabled table tennis players. Study design: Descriptive study. Methods: A total of 63 disabled players from amputee soccer, wheelchair basketball, and disabled table tennis participated in our study. Scapular resting position was taken as primary outcome; pain and function were taken as secondary outcome measurements. Scapular resting position was evaluated with Lateral Scapular Slide Test. Visual Analog Scale was used for evaluating shoulder pain intensity. Quick disabilities of the arm, shoulder, and hand questionnaire were used to assess upper extremity function. Results: There was a significant difference in shoulder pain, function, and scapular resting position in all groups (p < 0.05). Paired comparisons between amputee soccer and wheelchair basketball players and also amputee soccer and disabled table tennis showed difference for all measurement parameters (p < 0.05). Conclusion: When the results are evaluated, it may be stated that amputee soccer players have better scapular resting position than other sports. Crutch usage may not negatively affect scapular resting position and perceived function as much as wheelchair usage. Exercise techniques for shoulder and resting position could be included in training programs of disabled athletes. Clinical relevance Wheelchair/crutch usage is a risk, and special exercise techniques for shoulder and dyskinesis could be included in training programs to prevent injury. However, it may not just be important for wheelchair athletes, it may also be important for amputee soccer players. In particular, total upper extremity evaluations and exercises could be added within exercise programs.

The Effects of Scapular Mobilization in Patients With Subacromial Impingement Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

OBJECTIVE To determine the effects of scapular mobilization on function, pain, range of motion, and satisfaction in patients with subacromial impingement syndrome (SAIS). DESIGN Randomized, double-blind, placebo-controlled clinical trial. SETTING University hospital clinics in Turkey. PARTICIPANTS 66 participants (mean ± SD age 52.06 ± 3.71 y) with SAIS. INTERVENTIONS Participants were randomized into 3 groups: scapular mobilization, sham scapular mobilization, and supervised exercise. Before the interventions transcutaneous electrical stimulation and hot pack were applied to all groups. Total intervention duration for all groups was 3 wk with a total of 9 treatment sessions. MAIN OUTCOME MEASURES Shoulder function and pain intensity were primary outcome measures; range of motion and participant satisfaction were secondary outcome measures. Shoulder function was assessed with the short form of the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH). A visual analog scale was used to evaluate pain severity. Active range of motion was measured with a universal goniometer. A 7-point Likert scale was used to evaluate satisfaction. Outcome measurements were performed at baseline, before visits 5 and 10, 4 wk after visit 9, and 8 wk after visit 9. RESULTS There was no group difference for DASH score (P = .75), pain at rest (P = .41), pain with activity (P = .45), pain at night (P = .74), and shoulder flexion (P = .65), external rotation (P = .63), and internal rotation (P = .19). There was a significant increase in shoulder motion and function and a significant decrease in pain across time when all groups were combined (P < .001). The level of satisfaction was not significantly different for any of the questions about participant satisfaction between all groups (P > .05). CONCLUSION There was not a significant advantage of scapular mobilization for shoulder function, pain, range of motion, and satisfaction compared with sham or supervised-exercise groups in patients with SAIS.

Comparison of upper extremity function, pain, and tactile sense between the uneffected side of hemiparetic patients and healthy subjects

[Purpose] The aim of this study was to compare the unaffected upper extremity of patients with hemiparesis with that of healthy subjects in terms of function, pain, and tactile sense. [Subjects and Methods] Upper extremity evaluation parameters of 20 patients with hemiparesis were compared with an age-matched control group of 20 healthy subjects. A shorter version of the Disability of Arm and Shoulder Questionnaire, Upper Extremity Functional Index, and Simple Shoulder Test were used to evaluate the upper extremity functionality. The Visual Analog Scale was used to measure pain severity at rest, at night, and during activity. Tactile sensation levels were assessed by Semmes-Weinstein monofilaments at four palmar areas. [Results] A statistically significant difference was found in the upper extremity functionality between the groups. Pain severity at rest was significantly higher in the hemiparetic group. There was no significant difference in night and activity pain severities or tactile sensation levels between the groups. [Conclusion] According to our results, the unaffected side of patients with hemiparesis differs in functionality and pain at rest compared with that of healthy persons. Studies with larger sample size and various evaluation tests are needed to further investigate the unaffected side of patients with hemiparesis.

The Upper Extremity Functional Index (UEFI): Cross-cultural adaptation, reliability, and validity of the Turkish version

BACKGROUND Turkish version of the Upper Extremity Functional Index (UEFI) may help to assess shoulder function in patients with shoulder impingement syndrome (SAIS). OBJECTIVE To translate and cross-culturally adapted UEFI into Turkish and to assess its acceptability, reliability, validity in patients with SAIS. METHODS This study conducted with 93 SAIS participants. UEFI, the short version of the Disability of the Arm, Shoulder and Hand scale (Quick DASH), the Shoulder Pain and Disability Index, and the Short Form-36 Health Survey (SF-36) were administered. Acceptability was assessed in terms of refusal rate, rates of missing responses, and administration time. Test-retest reliability was assessed with intra class correlation coefficient (ICC), internal consistency was assessed with Cronbachs alpha coefficient. Validity was assessed by floor and ceiling effects, skew of distributions and Pearsons correlation coefficients. RESULTS Cronbachs alpha coefficients for the UEFI at Time 1 and Time 2 were as follows: α = 0.89 and α = 0.89. Average measure ICC was 0.80. The UEFI score demonstrated strong negative correlations with SPADI total score and Quick DASH score. There was not a significant correlation between the UEFI and mental health subscale score derived from SF-36. CONCLUSIONS The Turkish version of UEFI is acceptable, valid, and reliable.

KRONİK KAS-İSKELET SİSTEMİ HASTALIĞI OLAN HASTALARDA YETERSİZ SAĞLIK OKURYAZARLIĞININ YAYGINLIĞI VE İLİŞKİLİ FAKTÖRLER

Amac: Yetersiz saglik okuryazarliginin boyutlarinin bilinmemesi, sadece saglik calisanlari icin degil tum toplum icin onemli bir halk sagligi sorunudur. Bu yuzden politikacilarin bunu bir yatirim olarak gormesini saglamak ve etkin kaynaklara hizmeti tesvik etmek gerekmektedir. Yeni ve farkli stratejiler gelistirmek icin yetersiz saglik okuryazarligininin farkinda olmak onemlidir. Bu calismanin amaci, yetersiz saglik okuryazarligi yayginligini belirlemek ve saglik okuryazarliginin kronik kas-iskelet hastaliklari olan hastalarda sosyodemografik ozellikler ile iliskisini incelemekti. Yontem: Calismaya cesitli kronik kas-iskelet sistemi hastaliklari olan 423 hasta alindi. Saglik okuryazarligi duzeyi Tipta Yetiskin Okuryazarligi Hizli Tahmini ve En Yeni Yasamsal Bulgu anketleri kullanilarak olculdu. Katilimcilarin bilissel duzeyi Mini Mental Durum Degerlendirme Testi ile belirlendi. Sonuclar: Tipta Yetiskin Okuryazarligi Hizli Tahmini ile degerlendirilen hastalarin yaklasik % 17,3’unde yetersiz saglik okur yazarligi oldugu belirlendi. En Yeni Yasamsal Bulgu anketi kullanilarak degerlendirilen hastalarin % 27,2’den fazlasinda yetersiz saglik okuryazarligi ve dusuk aritmetik beceriler oldugu bulundu. Tartisma: Kronik kas-iskelet sistemi hastaliklari olan kisilerde yetersiz saglik okuryazarligi ve aritmetik beceriler yaygindir. Bu durum ileri yas, dusuk egitim duzeyi ve dusuk bilissel duzeyi ile iliskilidir. Saglik hizmetlerinde cesitli stratejiler ile saglik okuryazarligi gelistirilerek tedavide daha basarili sonuclar elde edilebilir.