Murat Toprak

The validity and reliability of the Turkish version of the Revised Fibromyalgia Impact Questionnaire

The Revised Fibromyalgia Impact Questionnaire (FIQR) attempts to address the limitations of the Fibromyalgia Impact Questionnaire (FIQ). As there is no Turkish version of the FIQR available, we aimed to investigate the validity and reliability of a Turkish translation of the FIQR in Turkish female fibromyalgia (FM) patients. After translating the FIQR into Turkish, it was administered to 87 female patients with FM. All of the patients filled out the questionnaire together with a Turkish version of the FIQ, hospital anxiety and depression scales (HADS), short form-36 (SF-36). The tender-point count (TPC) was also calculated from tender points identified by thumb palpation. One week later, FM patients filled out the Turkish FIQR at their second visit. The test–retest reliability of the Turkish FIQR questions ranged from 0.714 to 0.898. The test and retest reliability of total FIQR score was 0.835. Cronbachs alpha was 0.89 for FIQR visit 1 (the first assessment) and 0.91 for FIQR visit 2 (the second assessment), indicating acceptable levels of internal consistency for both assessments. The total scores of the FIQR and FIQ were significantly correlated (r = 0.87, P < 0.01). Significant correlations for construct validity were also obtained between the FIQR total and domain scores and the FIQ, the HADS and the subscales of the SF-36 (FIQR total versus SF-36 physical component score and mental component score were r = −0.63, P < 0.01 and r = −0.51, P < 0.01, respectively). The Turkish FIQR is a reliable and valid instrument for measuring health status in FM, showing sufficient reliability and construct validity. It may be utilized for both clinical practice and research use in the Turkish-speaking population in place of FIQ, since its Turkish version has problems in the wording, omissions, concepts, and scoring from the original FIQ.

Decreased neck muscle strength in patients with the loss of cervical lordosis.

BACKGROUND The loss of cervical lordosis is associated with some negative clinical outcomes. No previous study has examined cervical muscle strength, specifically in patients with the loss of cervical lordosis. This study aims to investigate whether there is weakness of the cervical muscles or an imbalance between cervical flexor and extensor muscle strength in patients with the loss of cervical lordosis compared with healthy controls matched by age, gender, body mass index (BMI), and employment status. METHODS Thirty-two patients with the loss of cervical lordosis (23 F, 9 M) and 31 healthy volunteers (23 F, 8 M) were included in the study. Maximal isometric neck extension and flexion strength, and the strength ratio between extension and flexion were used as evaluation parameters. All measurements were conducted by a blinded assessor using a digital force gauge. The participants were positioned on a chair in a neutral cervical position and without the trunk inclined during measurements. FINDINGS Maximal isometric neck extension and flexion strength values were significantly lower in the patients versus healthy controls (P<0.001 and P=0.040, respectively). The mean (SD) values of the extension/flexion ratio were 1.21 (0.34) in the patients and 1.46 ± 0.33 in the controls (P=0.004). INTERPRETATION According to our results, patients with the loss of cervical lordosis have reduced neck muscle strength, especially in the extensors. These findings may be beneficial for optimizing cervical exercise prescriptions.

Restless Legs Syndrome in Behçet's Disease

The prevalence of restless legs syndrome (RLS) and its association with the clinical features of Behçets disease (BD) has not previously been elucidated. The inflammatory character, central nervous system involvement and neuropathies of BD led to this investigation of RLS risk in BD patients. A total of 116 BD patients and 104 healthy control subjects were included; seven BD patients were excluded because of concurrent diseases, pregnancy or alcohol misuse that might cause RLS symptoms, and the remaining 109 BD patients were included in the analysis. The prevalence of RLS was significantly higher in patients with BD (32/109; 29.4%) than in controls (5/104; 4.8%). No significant differences were found between BD patients with and without RLS with regard to the clinical features of BD. RLS severity positively correlated with age in BD patients. In conclusion, BD-related RLS should be considered in symptomatic RLS secondary to rheumatological disorders and BD patients should be examined for RLS. Further studies are needed to clarify the pathogenetic mechanisms underlying BD-related RLS.

Lumbar spinal stenozlu hastalarda iki farklı fizik tedavi programının etkinliklerinin karşılaştırılması.

Aim: To assess the effectiveness of therapeutic exercises and transcutaneus electrical nevre stimulation (TENS) alone and in combination with ultrasound (US) in patients with lumbar spinal stenosis. Materials and Methods: In this randomized, prospective, controlled clinical trial which performed in Department of Physical Medicine and Rehabilitation, University Hospital, 48 patients presenting with symptoms of neurological claudication and magnetic resonance image-proven lumbar spinal stenosis were randomized to one of two 6-week (30 sessions, 5 session each week) physical therapy programs. One program included exercise + TENS group (group 1, n=24), while the other included exercise+TENS plus ultrasound (group 2, n=24). Stretching and strengthening exercises for lumbar, abdominal, leg muscles were given as therapeutic exercises. TENS was applied countinously with 80 MHz frequency for 30 minutes. In addition to these treatment modalities ultrasound was applied with 1 mHz, 1.5W/cm2 intensity, in continuous mode on the back muscle for 10 minutes to group 2. Recovery was evaluated by Oswestry, a numerical pain rating scale (VAS), and a treadmill walking test. Testing occurred at baseline, 6 weeks, and 3 month. Results: Statistically significant improvements were found in all of the post-treatment parameters (the leg pain score, Oswestry Disability Index score, treadmill walking distance) in both groups compared with the pre-treatment values in 6-weeks and 3-month follow-up evaluations (p<0.05), Improvements in disability, satisfaction, VAS in exercise, TENS and US group (group 2) were significantly more than that of those in exercise, TENS group (group 1) at all follow-up points. Conclusion: The results of our study suggest that patients with lumbar spinal stenosis can benefit from physical therapy. Therapeutic exercises and TENS are effective for pain and disability in patients with lumbar spinal stenosis and that addition of ultrasound to exercise therapy and TENS may further improve the parameters of follow-up in these patients.

Shoulder Subluxation and Shoulder-Hand Syndrome After Stroke; Effect of Brain Lesion Location And Side

49 Levent Ediz1, Ozcan Hız1, Mehmet Fethı Ceylan2 , Murat Toprak1 1Department of Physical Medicine and Rehabilitation, 2 Department of Orthopaedics, Yuzuncu Yil University, Medical Faculty, Van, Turkey. İnme Sonrası Omuz Subluksasyonu ve Omuz El Sendromu Shoulder Subluxatıon and Shoulder-Hand Syndrome After Stroke İnme Sonrası Omuz Subluksasyonu ve Omuz El Sendromu; Beyin Lezyon Tarafı ve Lokalizasyonunun Etkisi