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Comparison of pain intensity, emotional status and disability level in patients with chronic neck and low back pain

OBJECTIVE This study was planned to compare of pain, emotional status and disability level in patients with chronic neck pain and low back pain. METHODS In this study, fifty patients with chronic low back pain (Group I) and fifty patients with chronic neck pain (Group II) at least 6 months were evaluated. A Visual Analog Scale was used to describe pain intensity. To determine emotional status of the subjects, the Beck Depression Scale was used The Oswestry Disability Index and the Neck Disability Index were used to evaluate disability level. RESULTS The mean age of the patients with low back pain and neck pain were 39.70 ± 9.71 years, 45.44 ± 10.39 years, respectively. It was not found a significant difference between in low back pain (Group I) and neck pain (Group II) in results of pain intensity (p= 0.286) and pain duration (p= 0.382). It was found a significant difference between group I and group II in results of emotional status (p= 0.000) and disability level (p= 0.000). The emotional status and disability level scores were found highest in patients with low back pain. CONCLUSION Chronic low back pain is affect in patients than chronic neck pain as a emotional status and disability level.

Investigation of the relationship between kinesiophobia, physical activity level and quality of life in patients with chronic low back pain1

OBJECTIVE The aim of our study is to examine the relationship between kinesiophobia (fear of movement), physical activity level and quality of life. METHODS In this study, we assessed 112 patients consulting for low back pain (LBP) of ≥ 3 months duration. We used Visual Analog Scale (VAS) for pain intensity, the International Physical Activity Questionnaire (IPAQ) for physical activity level, Tampa Kinesiophobia Scale for perception of kinesiophobia, Oswestry Disability Index for disability status of low back. RESULTS The results of this study, there was no statistically significant correlation between International Physical Activity Questionnaire, duration of pain, intensity of pain at rest and Tampa Kinesiophobia Scale (p> 0.05). It was found a statistically significant correlation between pain intensity at activity (p= 0.009), disability level (p= 0.000) and Tampa Kinesiophobia Scale. Tampa Kinesiophobia Scale were highly negative correlated with sub-scale of SF-36 Quality of Life Index (general health, physical function, social status, bodily pain, role limitations due to physical health) (p= 0.000). CONCLUSION The kinesiophobia adversely affect the quality of life limiting the physical activity status of patients with chronic low back pain.

The effects of brain stimulation of subthalamic nucleus surgery on gait and balance performance in Parkinson disease. A pilot study

Introduction Parkinsons disease (PD) is a progressive neurodegenerative disorder characterized by tremor, rigidity and bradykinesia. Gait and postural difficulties supersede tremor, rigidity and bradykinesia as drivers of disease burden in patients with advanced PD. The aim of this study was to describe the effects of deep brain stimulation of the subthalamic nucleus on gait ability and balance performance in patients with PD. Material and methods We studied 19 consecutive patients who underwent bilateral stimulation of the subthalamic nucleus. Patients were evaluated preoperatively and at the 5th day and 6th month after surgery. Timed Up and Go Test, 12 m Walking Test, Chair Stand Test and Berg Balance Scale (BBS) were used to assess mobility and balance performance. Unified Parkinsons Disease Rating Scale (UPDRS III) and Hoehn and Yahr Scale were also used. Results All the patients’ mobility ability and balance performance improved after surgery (p < 0.05). At the 6th month after surgery, the Timed Up and Go Test scores were decreased from 56.05 ±42.52 to 21.47 ±20.36, the 12 m Walking Test scores were decreased from 100.44 ±66.44 to 28.84 ±19.79, the Chair Stand Test scores were increased from 4.00 ±4.66 to 11.68 ±4.43 and the BBS score was increased from 12.84 ±6.89 to 38.89 ±8.79. UPDRS total scores were significantly improved 6 months after surgery (p < 0.001). UPDRS total scores were decreased from 98.26 ±37.69 to 39.36 ±18.85. The Hoehn and Yahr Scale score was significantly decreased after surgery (p < 0.05). Conclusions Surgical therapy is an effective treatment to improve gait ability and balance performance in Parkinsons patients.

Expectations from Rehabilitation of Children with Cerebral Palsy: The Agreement between the Physiotherapists and Mothers

[Purpose] The aim of this study was to examine the agreement between physiotherapists (PTs) and mothers (Ms) about the treatment of children with cerebral palsy (CP) who received treatment in special education and rehabilitation centers. [Subjects] Ms of 130 children with CP (75 boys, 55 girls) and 130 PTs who applied rehabilitation programs were interviewed. [Methods] Clinical types and gross motor function levels of the children were recorded. A questionnaire consisting of 6 open-ended questions was used to describe the expectations and views of the PTs and Ms about the physiotherapy and rehabilitation programs for the children. [Results] The mean age of the children was 89.80±52.05 months. The mean treatment period for the children was 73.62±42.11 months. The mean age of the mothers was 35.47±5.79 years, and the mean age of the PTs was 28.07±7.28 years. We found a statistically moderate level of agreement between the PTs and Ms regarding the appropriateness of the treatment provided to the children. There was statistically insignificant agreement regarding the applied treatment methods and the appropriateness of the applied rehabilitation programs. [Conclusion] We believe that the views and expectations of the Ms should be taken into account by the PTs when preparing a treatment program for children with CP.

Expectations of patients with hemiparesis from physiotherapy programme: concordance among patients, patients’ caregiver and physiotherapists

Abstract Purpose: The aim of this study was to examine the agreement between physiotherapists (PTS), patients and caregivers about the physiotherapy of patients with hemiparesis. Materials and methods: Fifty-two patients with hemiparesis (M = 24, F = 28), caregivers (N = 52) and PTs (N = 52) who applied for the physiotherapy programme were interviewed. Demographic and clinical characteristics of the patients were recorded. A questionnaire composed of six questions was used to describe the expectations of the PTs, caregivers and patients about the physiotherapy programme. Results: The Kappa calculator revealed a statistically moderate level of agreement between PTs and caregivers (K = 0.532, p = .0001), patients and caregivers (K = 0.496, p = .0001) and PTs and patients (K = 0.401, p = .0001) regarding the expectations of physiotherapy programme. Conclusion: Expectations of the patients and caregivers must be considered for rehabilitation; hence, participation in the therapy and efficacy of the physiotherapy programme will increase. Consequently, we believe that the expectations of the patients and caregivers should be considered by the PTs when preparing a treatment programme for patients with hemiparesis.

Stress and depression levels of mothers who give care to children with Cerebral Palsy and Mental Retardation: A comparison study

Erdoğan Kavlak Yazışma Adresi: Pamukkale University, School of Physical Therapy and Rehabilitation, Denizli. e-mail: kavlake@hotmail.com Abstract Purpose:Assessment of mothers who give care to children with Cerebral Palsy (CP) and mentally retarded children (MR) by Bakas Caregiving Outcomes Scale and Caregiver Strain Index. Materials and methods: Fifty-six mothers living in Denizli (children with CP n=33, children with MR n=23) were included the study. Stress of mothers of CP and MR children at the process of giving care, were assessed with Bakas Caregiving Outcomes Scale and Caregiver Strain Index and conditions of depression were assessed with Beck Depression Inventory. Motor development levels of children with CP and MR were determined with Classic Motor Development Level. Results: When Classic Motor Development Level of children with CP were compared with Bakas Caregiving Outcomes Scale of mothers, a statistically significant and negative correlation was found (p=0.01). In comparison of Bakas Caregiving Outcomes Scale of mothers having children with CP and MR, there was a statistically significant difference towards stress burden of mothers with cerebral palsy children was higher (p=0.03). Conclusion: We found that caregiving stress of mothers of children with CP was higher. Better motor development level provides less burden of caregiving and depressive symptoms of mothers in disabled children.

Frontal kavernoma cerrahisi sonrası fizyoterapi ve rehabilitasyon sonuçları

Calismamiz frontal kavernom cerrahisi sonrasinda fizyoterapi ve rehabilitasyon programina alinan hastanin fonksiyonel sonuclarini incelemek amaciyla yapilmistir. Bu calismada sol frontal lobda kortikal yerlesimli kavernom sebebiyle cerrahi geciren ve ardindan fizyoterapi programina alinan 23 yasindaki bir olgu sunulmustur. Olgu cerrahi sonrasinda besincigunde ve ucuncu ayda degerlendirilmistir. Bu surecte el becerilerini arttirmaya yonelik olarak kavrama egitimi, yurume egitimi, merdiven cikma-inme ve denge egzersizlerini iceren fizyoterapi programi uygulanmis ve ev programi verilerek taburcu edilmistir. Fizyoterapi programindan sonra hasta onemli gelisme kaydetmistir. Frontal kavernoma cerrahisi sonrasi hastaya uygulanacak fizyoterapi ve rehabilitasyon programinin hastanin fonksiyonel geri donusune katkida bulunacagi dusunulmektedir.

Effectiveness of Neuro-Developmental Treatment (Bobath Concept) on postural control and balance in Cerebral Palsied children

BACKGROUND AND OBJECTIVE The aim of this study was to show the effects of an 8-week Neurodevelopmental Treatment based posture and balance training on postural control and balance in diparetic and hemiparetic Cerebral Palsied children (CPC). METHODS Fifteen CPC (aged 5-15 yrs) were recruited from Denizli Yağmur Çocukları Rehabilitation Centre. Gross Motor Function Classification System, Gross Motor Function Measure, 1-Min Walking Test, Modified Timed Up and Go Test, Paediatric Balance Scale, Functional Independence Measure for Children and Seated Postural Control Measure were used for assessment before and after treatment. An 8-week NDT based posture and balance training was applied to the CPC in one session (60-min) 2 days in a week. RESULTS After the treatment program, all participants showed statistically significant improvements in terms of gross motor function (p< 0.05). They also showed statistically significant improvements about balance abilities and independence in terms of daily living activities (p< 0.05). Seated Postural Control Measure scores increased after the treatment program (p< 0.05). CONCLUSIONS The results of this study indicate that an 8-week Neurodevelopmental Treatment based posture and balance training is an effective approach in order to improve functional motor level and functional independency by improving postural control and balance in diparetic and hemiparetic CPC.

The Effects of Physical Therapy and Rehabilitation On Pain, Disability, Depressive Symptoms and Sleep Quality of Subjects With Chronic Back Pain

Özet GİRİŞ ve AMAÇ: Kişinin fiziksel fonksiyonunu, sosyal yaşamını, yaşam kalitesini olumsuz yönde etkileyen ve uyku düzenine kadar birçok aktivitesini etkileyen kronik bel ağrısında (KBA) fizik tedavi ve rehabilitasyon (FTR) sıklıkla tercih edilen nonfamakolojik bir tedavi seçeneğidir. Bu çalışma KBA olan olgularda fizik tedavi ve rehabilitasyon programının ağrı, özürlülük, depresif bulgular ve uyku kalitesi üzerine etkilerini incelemek amacıyla yapıldı YÖNTEM ve GEREÇLER: Bu çalışmaya Denizli ilindeki özel bir tıp merkezine en az altı aydır bel ağrısı şikâyeti nedeniyle başvuran ve FTR programına yönlendirilen 35 (K: 20, E: 15) olgu dahil edildi. Olgular haftada 5 gün toplam 15 seans FTR programına alındı. Olguların demografik verileri kaydedildi. Tedavi öncesi ve sonrasında olguların ağrı şiddeti Görsel Analog Skalası (GAS), özürlülük düzeyi Oswestry Disabilite İndeksi (ODİ) ve depresif bulgular Beck Depresyon Ölçeği (BDÖ) ile değerlendirildi. Uyku kalitesinin değerlendirilmesinde ise Pitsburg Uyku Kalitesi indeksi (PUKİ) kullanıldı. BULGULAR: Olguların yaş ortalaması 47,83± 14,35 (min: 27max: 65) yıldır. Olguların tedavi öncesi ve sonrası GAS, BDI, OÖİ ve global PUKİ skorları karşılaştırıldığında istatistiksel olarak anlamlı farklılık bulundu (p<0,05). Olguların tedavi sonrasında ağrı şiddeti, depresif bulguları ve özürlülük düzeyi anlamlı şekilde azaldı, minimal düzeyde bozukluk olan uyku kalitesinde ise anlamlı bir artış olduğu görüldü TARTIŞMA ve SONUÇ: Kronik bel ağrılı olgularda yüzeyel ve derin sıcaklık uygulamaları, fizik tedavi modaliteleri ve egzersiz eğitimini içeren FTR programlarının ağrıyı azaltıp bunun sonucunda da fonksiyonelliği arttırması nedeniyle etkili bir tedavi seçeneği olduğunu, ayrıca depresif bulgular ve uyku kalitesinde olumlu etkileri olabileceğini düşünüyoruz. Abstract INTRODUCTION: Chronic back pain (CBP) affects physical functions, social life, and quality of life negatively and causes to abnormal behaviors, even sleep disorders as a result of pain. The physical therapy and rehabilitation (PTR) intervention is one of the common nonpharmacological choices in treatment of CBP. The aim of this study was to analyze the effects of PTR on pain, disability, depressive symptoms and sleep quality in subjects with CBP. METHODS: Thirty-five subjects (F: 20,M: 15) with CBP for at least six months who applied to a private medical center in Denizli and were referred for PTR were included in this study. The subjects received 15 séance PTR for 5 days a week. The demographic data of subjects were recorded. The pain level was measured by Visual Analog Scale (VAS), the disability level was measured by Oswestry Disability Index (ODI) and the depressive symptoms were assessed by Beck Depression Scale (BDS). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. RESULTS: The average age of subjects was 47,83± 14,35 (min: 27max: 65) years. When the results of VAS, ODI, BDS and PSQI were compared, a significant difference was found (p<0,05). The pain and disability levels, and the depressive symptoms of subjects significantly decreased and an increase in minimally deteriorated sleep quality was observed after PTR. DISCUSSION AND CONCLUSION: We think that PTR, including superficial/deep thermal therapy, physical modalities and exercise, is an effective choice of treatment which increase functionality and also can have positive effects on depressive symptoms and sleep quality