Mahmut Nafiz Akman

Isokinetic measurement of trunk muscle strength in women with chronic low-back pain.

Bayramoğlu M, Akman MN, Kılınç Ş, Çetin N, Yavuz N, Özker R: Isokinetic measurement of trunk muscle strength in women with chronic low-back pain. Am J Phys Med Rehabil 2001;80:650–655. Objectives: To investigate the relationships among chronic low-back pain and obesity, total spinal range of motion, and trunk muscle strength. The short-term impact of trunk muscle strengthening exercises on this condition was also examined. Design: A controlled, prospective study of trunk muscle strengths of patients with chronic low-back pain and the short-term impact of exercise on strength. The study group consisted of 25 female patients who had been experiencing low-back pain for at least 3 mo, and the control group included 20 age-matched women without known low-back trouble. The Davenport Index was used to calculate the body mass indexes of all subjects. The Oswestry Disability Questionnaire was used to assess pain in the study group. Full flexion and extension ranges of motion were measured, then isokinetic measurements of trunk muscles were performed at 60-, 120-, and 180-degrees/sec velocities. Isometric measurements were also recorded for both flexors and extensors at a 60-degree angle. Results: Increased body mass index and decreased trunk muscle strength were found to be directly associated with chronic low-back pain (P < 0.05). After a 15-day standard trunk strengthening exercise program in the patient group, trunk muscle strength was found to be increased (P < 0.05). Conclusions: Obesity and decrease in trunk muscle strength are important factors in chronic low-back pain, and a trunk muscle strengthening program will be helpful in reducing the pain.

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.

Quality of Life After Burn Injury: The Impact of Joint Contracture

We sought to investigate quality of life, and to specifically assess how joint contracture affects it, in patients with burn injuries. The study is involved 22 adults with burn injuries. Patients were divided into two groups according to the presence (n = 11) or absence (n = 11) of any joint contracture. Patient age, sex, date of burn injury, burn type, location, and extent of burn (TBSA) were recorded for each case. Each individual underwent a thorough musculoskeletal system examination, with special focus on range of motion of the joints. Quality of life was evaluated using the Short Form 36 (SF-36). Eight (36.4%) of the patients were women, and 14 (63.6%) were men, and their mean age (± SE) was 24.7 ± 4.68 years. The mean interval from injury to the study assessment was 21.45 ± 14.69 months. Eleven patients (50%) had at least one joint contracture. The patients with one or more contractures had significantly lower scores for the SF-36 subscales of physical functioning, physical role limitations, bodily pain, and vitality (P = .05, P = .01, P = .04, and P = .02, respectively). In the 22 patients overall, TBSA was negatively correlated with the scores for the SF-36 subscales vitality and emotional role limitations (r = −.586 and r = −.805, respectively). Joint contracture does impact burn patients’ quality of life, especially with respect to physical functioning, physical role limitations, bodily pain, and vitality. In addition, the amount of BSA burned is correlated with psychosocial problems and poorer quality of life, regardless of whether joint contractures develop.

Coexistence of fibromyalgia, temporomandibular disorder, and masticatory myofascial pain syndromes

The purpose of this study was to determine the association of fibromyalgia (FM) with temporomandibular disorder (TMD) and masticatory myofascial pain (MMP). Thirty-one consecutive women diagnosed as having FM according to American College of Rheumatology criteria and 21 consecutive women diagnosed as having TMD were included in this prospective study. All patients were examined by a dentist and a physiatrist to identify the coexistence of FM and TMD. In the FM group, TMD was found in 25 (80%) patients, and only 6 (19%) patients had arthrogenous origin with MMP, whereas 19 (81%) patients had only MMP without arthrogeonous orgin of those 25 women exhibited TMD. In the TMD group, the prevalence of FM was 52%, which was significantly higher in those with TMD of arthrogenous origin with MMP. Our results indicate that coexistence of FM and TMD with MMP is high. Pain and tenderness in the masticatory muscles appear to be an important element in FM, so in some patients it may be the leading complaint.

Clinical and epidemiologic evaluation of pressure ulcers in patients at a university hospital in Turkey.

Objective We sought to measure the incidence of pressure ulcer development at a university health center in Turkey, and to determine whether the Waterlow Pressure Sore Risk (PSR) Scale score predicted pressure ulcer development, stage, or number of ulcers. Design We prospectively evaluated patients who were hospitalized at our university-based medical center. Setting and subjects We analyzed data from 22,834 patients hospitalized at the Baskent University Adana Teaching and Medical Research Center in Ankara, Turkey from January 1, 2004 to December 31, 2004, including 360 patients who developed pressure ulcers. Instruments The Waterlow PSR Scale was used to assess pressure ulcer risk. In addition, age, sex, the ward or unit in which the patient was hospitalized, reason for hospitalization, and location and stage of ulcers were collected on a data form designed specifically for this study. Methods A single nurse physiotherapist assessed all patients daily during their hospitalization. When a pressure ulcer was diagnosed by the nurse physiotherapist, a physician staged the pressure ulcers based on the US National Pressure Ulcer Advisory Panel (NPUAP) staging system. Results Three hundred sixty out of 22,834 patients developed 1 or more pressure ulcers, resulting in an incidence rate of 1.6%. Most ulcers (59.2%) occurred in patients hospitalized in the intensive care unit (n = 213). A positive correlation between the Waterlow PSR Scale score and number of ulcers per patient (r: 0.178, P < .01) was identified. No significant correlation was found linking Waterlow PSR Scale score and ulcer stage or the development of a single ulcer. Conclusion We found significantly lower pressure ulcer incidence rates than those commonly reported in the literature, which we believe is principally attributable to short hospital stays and a strong emphasis on preventive nursing care. While high Waterlow PSR scale Scores correlated positively with development of multiple ulcers, this did not predict ulcer stage or the presence of a single pressure ulcer.

Health-Related Physical Fitness in Women with Fibromyalgia Syndrome or Myofascial Pain Syndrome

Background: We evaluated health-related physical fitness in women with fibromyalgia syndrome [FMS] and myofascial pain syndrome [MPS]. Method: Thirty women with FMS, 30 women with MPS, and 30 healthy normal controls [HNC] were studied. Musculoskeletal pain was evaluated with a visual analog scale [VAS] and physical fitness was determined by the ability to perform a variety of physical fitness tests. Results: With a significantly higher mean VAS score, the FMS group had the highest rating of perceived exertion, the lowest total treadmill time, maximum heart rate, and the poorest performance in all fitness measurements. Ratings of perceived exertion were higher; vertical jump, modified pushup, sits up, handgrip strength tests were lower in the MPS compared with the HNC. Conclusions: Compared to healthy subjects, FMS adversely affected the physical fitness performance of the subjects to a greater degree than did MPS.