Saime Ay

The effectiveness of low laser therapy in subacromial impingement syndrome: a randomized placebo controlled double-blind prospective study

OBJECTIVES: Conflicting results were reported about the effectiveness of Low level laser therapy on musculoskeletal disorders. The aim of this study was to investigate the effectiveness of 850‐nm gallium arsenide aluminum (Ga‐As‐Al) laser therapy on pain, range of motion and disability in subacromial impingement syndrome. METHODS: A total of 52 patients (33 females and 19 males with a mean age of 53.59±11.34 years) with subacromial impingement syndrome were included. The patients were randomly assigned into two groups. Group I (n = 30, laser group) received laser therapy (5 joule/cm2 at each point over maximum 5‐6 painful points for 1 minute). Group II (n = 22, placebo laser group) received placebo laser therapy. Initially cold pack (10 minutes) was applied to all of the patients. Also patients were given an exercise program including range of motion, stretching and progressive resistive exercises. The therapy program was applied 5 times a week for 14 sessions. Pain severity was assessed by using visual analogue scale. Range of motion was measured by goniometer. Disability was evaluated by using Shoulder Pain and Disability Index. RESULTS: In group I, statistically significant improvements in pain severity, range of motion except internal and external rotation and SPADI scores were observed compared to baseline scores after the therapy (p<0.05). In Group II, all parameters except range of motion of external rotation were improved (p<0.05). However, no significant differences were recorded between the groups (p>0.05). CONCLUSIONS: The Low level laser therapy seems to have no superiority over placebo laser therapy in reducing pain severity, range of motion and functional disability.

Adaptation of Turkish version of the questionnaire Quick Disability of the Arm, Shoulder, and Hand (Quick DASH) in patients with carpal tunnel syndrome

The aim of this study was to assess the reliability and validity of the Turkish version of the Quick Disability of the Arm, Shoulder, and Hand (Quick DASH) scale in patients with carpal tunnel syndrome (CTS). Sixty nine patients with idiopathic CTS were included. The Quick DASH questionnaire consists of three subscales including disability/symptom, and work and sports/performing arts. Quick DASH was administered after translation process to subjects twice a week for testing reliability. The validity was based on correlating Quick DASH with the Boston Questionnaire, visual analogue scale—pain (VAS-pain), and pinch and grip strength tests. Reliability of the Turkish version of the Quick DASH scale was very good with high internal consistency (Cronbach’s alpha 0.84 for disability/symptom subscale, 0.937 for work subscale, and 0.926 for sports/performing arts subscale) and test–retest reliability (intraclass correlation coefficient 0.931 for disability/symptom subscale, 0.925 for work subscale, and 0.779 for sports/performing arts subscale). The disability/symptom subscale had moderate correlations with the VAS-pain and grip strength test and good correlation with the pinch strength test. The work subscales had moderate correlations with VAS-pain, and pinch and pinch grip strength tests. A high correlation was found between the disability/symptom and work subscales with Boston symptom severity and Boston functional status subscores. The Turkish version of Quick DASH was reliable and valid for evaluating symptoms and functional disability in patients with CTS. Our results suggest that Quick DASH could be preferred as it is a simple and easy scale to use.

Adiponectin: is it a biomarker for assessing the disease severity in knee osteoarthritis patients?

The results of previous studies regarding the role of adiponectin in the pathogenesis of osteoarthritis (OA) are controversial. The aim of this study is to investigate the relation of plasma adiponectin levels with clinical and radiological disease severity in knee OA patients.

New Approach in Fibromyalgia Exercise Program: A Preliminary Study Regarding the Effectiveness of Balance Training

OBJECTIVES To determine the effectiveness of balance exercises on the functional level and quality of life (QOL) of patients with fibromyalgia syndrome (FMS) and to investigate the circumstances associated with balance disorders in FMS. DESIGN Randomized controlled trial. SETTING Physical medicine and rehabilitation clinic. PARTICIPANTS Patients (N=57) (age range, 18-65y) with FMS were randomly assigned into 2 groups. INTERVENTIONS Group 1 was given flexibility and balance exercises for 6 weeks, whereas group 2 received only a flexibility program as the control group. MAIN OUTCOME MEASURES Functional balance was measured by the Berg Balance Scale (BBS), and dynamic and static balance were evaluated by a kinesthetic ability trainer (KAT) device. Fall risk was assessed with the Hendrich II fall risk model. The Nottingham Health Profile, Fibromyalgia Impact Questionnaire (FIQ), and Beck Depression Inventory (BDI) were used to determine QOL and functional and depression levels, respectively. Assessments were performed at baseline and after the 6-week program. RESULTS In group 1, statistically significant improvements were observed in all parameters (P<.05), but no improvement was seen in group 2 (P>.05). When comparing the 2 groups, there were significant differences in group 1 concerning the KAT static balance test (P=.017) and FIQ measurements (P=.005). In the correlation analysis, the BDI was correlated with the BBS (r=-.434) and Hendrich II results (r=.357), whereas body mass index (BMI) was correlated with the KAT static balance measurements (r=.433), BBS (r=-.285), and fall frequency (r=.328). CONCLUSIONS A 6-week balance training program had a beneficial effect on the static balance and functional levels of patients with FMS. We also observed that depression deterioration was related to balance deficit and fall risk. Higher BMI was associated with balance deficit and fall frequency.

The Utility of the Faces Pain Scale in the Assessment of Shoulder Pain in Turkish Stroke Patients: Its Relation with Quality of Life and Psychologic Status.

This study was planned to investigate the utility of the vertical Faces Pain Scale (FPS) in the assessment of pain in stroke patients using the shoulder pain model and to assess its utility in the Turkish patient population. The secondary aim was to analyze the association of FPS with the quality of life and depression in the study population. Thirty stroke patients (group I) and 30 controls (group II), all suffering from shoulder pain were included in the study. The patients with subacute shoulder pain and with no other known diseases and impairments were recruited as a control group. Shoulder pain was evaluated by the commonly used pain scales including the Visual Analogue Scale, Likert Pain Scale and 0–10 Numerical Rating Scale besides FPS. Depression was screened using Beck Depression Inventory (BDI) and quality of life was evaluated using Short Form-36 (SF-36). FPS showed good correlations with the other pain scales in both the groups (r=0.950–0.972 and 0.674–0.926, respectively). In group I, there were significant correlations between FPS and physical functioning, pain and emotional role subscales of SF-36 (r=−0.432, 0.707 and −0.461, respectively). Although there was a low correlation between the FPS and BDI scores, it was not statistically significant. In group II, FPS showed significant correlations with the BDI scores and all subscales of SF-36 except social functioning and vitality (r=−0.679 to 0.848). FPS had a high degree of convergent validity and can be used in the assessment of shoulder pain in stroke patients. It may be a good alternative for pain assessment especially in patients with speech disorders and illiterate patients.

The Utility of Faces Pain Scale in a Chronic Musculoskeletal Pain Model

OBJECTIVES The main aim of this study was to investigate the clinical utility and sensitivity to change of faces pain scale (FPS) in patients with shoulder pain, chosen as a chronic pain model. The secondary aim was to determine the association of FPS with psychologic status and quality of life of these patients. METHODS Thirty Turkish patients with chronic shoulder pain were included in the study. Pain intensity was evaluated by visual analog scale (VAS), which is a commonly used pain scale besides FPS. Depression and quality of life were screened by Beck Depression Inventory (BDI) and Short Form-36 (SF-36). All assessments were done before and after the physical therapy. RESULTS There was a statistically significant decrease in pain severity after the treatment as indicated by FPS and VAS (P=0.000). The standardized response mean (SRM) value of FPS of 2.35 was accepted as a good responsiveness. The FPS showed a strong correlation with VAS (r=0.62 and 0.73) both before and after the treatment. Also, moderate to strong correlations were detected between the FPS and physical functioning (PF), physical role (PR), bodily pain (BP), emotional role (ER), general health (GH), mental health (MH) subscales of SF-36 (r=-0.58-0.80), and BDI scores (r=0.39) before the treatment. However, there were moderate and weak correlations with FPS and PR and social functioning (SF) subscales of SF-36 only after the treatment (r=-0.52 and r=-0.39). CONCLUSIONS FPS is a satisfactory tool to assess pain in patients with chronic pain conditions and demonstrates sensitivity to detect changes after the treatment.

Cerebral infarct due to meningovascular neurobrucellosis: a case report.

Brucellosis is a common and multisystemic zoonotic infectious disease. Central nervous system involvement is rarely seen in brucellosis, with an incidence of 0.5-25%. The aim of this report is to underline the importance of brucellosis, which is an endemic infection in our country, during the diagnostic evaluation of stroke.

The Effectiveness of Portable Audio Biofeedback Device in Myofascial Pain Syndrome in Neck and Upper Trapezius Muscles

Abstract Objective: The aim of this study was to investigate the effectiveness of a portable audio biofeedback device in the treatment of myofascial pain syndrome [MPS]. Methods: Patients referred to the clinic with MPS involving the upper neck and trapezius who were were randomly assigned into two groups. Group 1 was to use a portable audio biofeedback device for 30 min twice a day in addition to completing a home based exercise program. Group 2 received only the home-based exercise program. The home-based exercise program was comprised of neck isometric-isotonic, back extensor stretching and posture exercises five times a week, performing each exercise once a day with 15 repetitions for 4 weeks. Measurements were taken before and after the treatment. The severity of the pain was measured by visual analog scale. The number of trigger points, pressure pain threshold, cervical joint range of motion and head-shoulder angles were also recorded. Disability was assessed by the Neck Pain Disability Scale. Results: About 90 patients with MPS were recruited and 60 patients [45 females, 15 males, 30 patients per treatment group] completed the study. All parameters were improved in both groups [p < 0.05] except cervical range of motion values [p > 0.05] after the treatment. In Group 1, more improvements were detected in head angles compared to Group 2 and the differences were statistically significant [p = 0.017]. There were statistically significant differences between the groups in head angles, while no significant differences were detected in the visual analog scale, number of trigger points, pressure pain threshold, cervical range of motion, shoulder angle or Neck Pain Disability Scale scores [p > 0.05] after the treatment. Conclusion: Exercise therapy seems to be effective in the treatment of MPS; however, portable audio biofeedback treatment does not provide any additive effect except correcting head angle in the treatment of MPS.

Laser Acupuncture Treatment Improves Pain and Functional Status in Patients with Subacromial Impingement Syndrome: A Randomized, Double-Blind, Sham-Controlled Study

Objective The present study aims to determine the effect of laser acupuncture in patients with subacromial impingement syndrome (SAIS). Design Randomized, double-blind, sham-controlled study. Setting Physical medicine and rehabilitation outpatient clinic. Subjects A total 73 patients with SAIS were randomly assigned into a treatment group (n = 36) and a control group (n = 37). Methods The treatment group received laser acupuncture, and the control group received sham laser acupuncture. Eleven acupuncture points (GB 21, LI 4, LI 11, LI 14, LI 15, LI 16, SI 9, SI 10, SI 11, TE 14, and TE 15) were irradiated using a gallium-aluminium-arsenide continuous wave diode-laser, with a wavelength of 850 nm and a power output of 100 mV. The laser acupuncture treatment at each acupuncture point was administered at 4 joules/cm 2 (total dose = 40 joules). All patients were also treated with a hot pack. The patients were assessed at baseline and after 15 sessions of laser treatment. Pain severity and doctors and patients global assessments were measured via visual analog scale (VAS). Range of motion (ROM) and functional status were measured using a digital inclinometer and the Shoulder Pain Disability Index, respectively. Results Statistically significant improvements were observed in all parameters in the treatment group. All parameters of pain and functional status in the treatment group were significantly better than those in the control group at week 3. Conclusions To the best of our knowledge, this is the first study that investigates the effect of laser acupuncture in SAIS. The positive results of the present study should lead to further laser acupuncture studies with combinations of different acupuncture points, at different wavelengths, and with long-term follow-up periods.

The effectiveness of Kinesio Taping on pain and disability in cervical myofascial pain syndrome

OBJECTIVE The aim of this study was to investigate the effectiveness of Kinesio Taping and sham Kinesio Taping on pain, pressure pain threshold, cervical range of motion, and disability in cervical myofascial pain syndrome patients (MPS). METHODS This study was designed as a randomized, double-blind placebo controlled study. Sixty-one patients with MPS were randomly assigned into two groups. Group 1 (n=31) was treated with Kinesio Taping and group 2 (n=30) was treated sham taping five times by intervals of 3 days for 15 days. Additionally, all patients were given neck exercise program. Patients were evaluated according to pain, pressure pain threshold, cervical range of motion and disability. Pain was assessed by using Visual Analog Scale, pressure pain threshold was measured by using an algometer, and active cervical range of motion was measured by using goniometry. Disability was assessed with the neck pain disability index disability. Measurements were taken before and after the treatment. RESULTS At the end of the therapy, there were statistically significant improvements on pain, pressure pain threshold, cervical range of motion, and disability (p<0.05) in both groups. Also there was a statistical difference between the groups regarding pain, pressure pain threshold, cervical flexion-extension (p<0.05); except cervical rotation, cervical lateral flexion and disability (p>0.05). CONCLUSION This study shows that Kinesio Taping leads to improvements on pain, pressure pain threshold and cervical range of motion, but not disability in short time. Therefore, Kinesio Taping can be used as an alternative therapy method in the treatment of patients with MPS.