Türkan Akbayrak

Comparison of Manual Lymph Drainage Therapy and Connective Tissue Massage in Women With Fibromyalgia: A Randomized Controlled Trial

OBJECTIVE This study analyzed and compared the effects of manual lymph drainage therapy (MLDT) and connective tissue massage (CTM) in women with primary fibromyalgia (PFM). METHODS The study design was a randomized controlled trial. Fifty women with PFM completed the study. The patients were divided randomly into 2 groups. Whereas 25 of them received MLDT, the other 25 underwent CTM. The treatment program was carried out 5 times a week for 3 weeks in each group. Pain was evaluated by a visual analogue scale and algometry. The Fibromyalgia Impact Questionnaire (FIQ) and Nottingham Health Profile were used to describe health status and health-related quality of life (HRQoL). Wilcoxon signed rank test and Mann-Whitney U test were used to analyze the data. RESULTS In both groups, significant improvements were found regarding pain intensity, pain pressure threshold, and HRQoL (P < .05). However, the scores of FIQ-7 (P = .006), FIQ-9 (P = .006), and FIQ-total (P = .010) were significantly lower in the MLDT group than they were in the CTM group at the end of treatment. CONCLUSIONS For this particular group of patients, both MLDT and CTM appear to yield improvements in terms of pain, health status, and HRQoL. The results indicate that these manual therapy techniques might be used in the treatment of PFM. However, MLDT was found to be more effective than CTM according to some subitems of FIQ (morning tiredness and anxiety) and FIQ total score. Manual lymph drainage therapy might be preferred; however, further long-term follow-up studies are needed.

Effects of mechanical massage, manual lymphatic drainage and connective tissue manipulation techniques on fat mass in women with cellulite

Objective  To evaluate and compare the effectiveness of three different noninvasive treatment techniques onfat mass and regional fat thickness of the patients with cellulites.

Results of two different manual therapy techniques in chronic tension-type headache

This study was performed in order to compare the effectiveness of two different manual treatment methods in patients withchronic tension type headache (TTH).A totalof 35 patients were randomly assigned into two groups; 30 of them completed the treatment programs. Supere cial heat and classical massage were applied to both groups. In addition to these methods, connective tissue manipulation (CTM) was performed to Group I ( n D 15) and Dr. James Cyriax’ s vertebral mobilisation to Group II ( n D 15). Treatment consisted of 20 sessions during four weeks. The following parameters were evaluated before treatment, immediately after treatment, and one month after the treatment in order to compare the effectiveness of the methods: headache index values, active cervical range of motion, and pressure pain threshold values. Results of the study indicated thatall of the parameters showed signie cant improvements in both groups: there were no differences between the groups as regards the headache index, the pressure pain threshold values and the active range of motion (p > 0:05). In conclusion, both treatments can be used in patients with chronic tension-type headache. summary

Complex decongestive therapy and taping for patients with postmastectomy lymphedema: a randomized controlled study.

PURPOSE The purpose of our study was to investigate the effects of Kinesio Taping(®) Application with Complex Decongestive Therapy (CDT) in patients with lymphedema. MATERIALS AND METHODS 45 patients were randomly divided into 3 groups (CDT including Bandage, CDT including Bandage + Kinesio Tape(®), CDT including Kinesio Tape(®) without bandage). Assessments included the severity of the symptoms such as pain, discomfort, heaviness, tension, stiffness and weakness. Bilateral circumference measurements were done for evaluation of the edema. RESULTS Symptoms were decreased in all three groups (p < 0.05). CDT was found effective only during treatment in arm volume (p < 0.05). Kinesio Taping(®) applied with CDT had effect of decreasing edema after 10 days of treatment period (p < 0.05) and for control period (p < 0.05). Only the application of Kinesio Taping(®) group also had significant decrease at edema (p < 0.05). CONCLUSION Kinesio Taping(®) Application along with CDT may have a better effect on decreasing lymphedema which can stimulate the reduction of edema for long term effects.

Comparison of different treatment protocols in the treatment of idiopathic detrusor overactivity: a randomized controlled trial

Objective: To investigate and compare the effectiveness of various treatment protocols for the treatment of women with idiopathic detrusor overactivity. Design: Prospective, randomized controlled trial. Setting: Departments of Physiotherapy and Rehabilitation and Obstetrics and Gynaecology, Hacettepe University. Subjects: Forty-six subjects were randomized to three groups. Interventions: The first group received only pharmacotherapy, the second group received only physiotherapy and in the third group pharmacotherapy was combined with physiotherapy (combined therapy group). Main measures: All patients were evaluated at the beginning and at the end of treatment. Assessment parameters were maximum cystometric capacity, electromyographic activity of pelvic floor muscles, voiding diary parameters, the amount of urine leakage and the quality of life score. Results: The maximum cystometric capacity and the electromyographic activity of pelvic floor muscles increased significantly and the number of voids/day and incontinence episodes/day, and the amount of urine leakage reduced significantly (P < 0.05) in both physiotherapy and combined therapy groups while there was no significant difference in the pharmacotherapy group. After treatment, the number of voids/day increased by 0.3 ± 3.4 in the pharmacotherapy group (P > 0.05) and decreased by 5.1 ± 5.5 and 4.7 ± 5.6 in the physiotherapy and combined therapy groups, respectively (P < 0.05). Statistically significant improvements were observed in all groups according to the number of voids/night and the quality of life scores at the end of the treatment. Conclusion: The physiotherapy protocol we introduced in the present study with or without anticholinergic therapy has a substantial positive impact on the treatment of female patients with idiopathic detrusor overactivity.

Validity and reliability of the Turkish version of the Pelvic Floor Distress Inventory-20

Introduction and hypothesisThe aim of this study was to investigate the reliability and validity of the Turkish version of the Pelvic Floor Distress Inventory-20 (PFDI-20).MethodsOne hundred and twenty-eight women with pelvic floor disorders, including pelvic organ prolapse, urinary incontinence, and anal incontinence were enrolled in the study. The Turkish version was developed using forward back translation. Construct validity was examined by correlation of clinical methods. Interclass correlation coefficients (ICC) compared the PFDI-20 and subscale scores. Cronbach’s alpha assessed the internal consistency of the Turkish version.ResultsThe PFDI-20 has three subscales. The test–retest reliability of the PFDI-20 and subscale was excellent (ICC 0.96 to 0.98, p < 0.001). Cronbach’s alpha value (0.79) was moderate for the PFDI-20. Construct validity demonstrated that the PFDI-20 and each subscale displayed significant correlation with other clinical methods used (p < 0.05).ConclusionsThe PFDI-20 is a valid and reliable condition-specific questionnaire for Turkish women with pelvic floor disorders.

The results of connective tissue manipulation in the treatment of tension type headache

AbstractConnective tissue manipulation (CTM) is a manual therapy which stimulates responses of the autonomic nervous system and corrects the changes in skin, underlying connective tissue and muscle. The purpose of this study was to determine the results of CTM in the treatment of tension type headache (TTH). CTM was applied to 20 TTH patients for a total of 20 treatments in four weeks. Before the treatment, all subjects were evaluated retrospectively for pain intensity (using visual analogue scale), duration and frequency, analgesic usage and accompanying symptoms such as nausea, vomiting, sleep disorders, muscle tenderness and the presence of connective tissue tension. It was observed that there was a significant decrease in pain intensity, duration and frequency (p < 0.05) at the end of 6 months followup period. In addition, we observed an improvement in the accompanying symptoms. It can be concluded that, because CTM reduces the drug overuse in TTH patients, it can be used as a non-pharmacological appr...

A Comparison of the Effects of Stabilization Exercises Plus Manual Therapy to Those of Stabilization Exercises Alone in Patients With Nonspecific Mechanical Neck Pain: A Randomized Clinical Trial

STUDY DESIGN Randomized clinical trial. BACKGROUND Little is known about the efficacy of providing manual therapy in addition to cervical and scapulothoracic stabilization exercises in people with mechanical neck pain (MNP). Objectives To compare the effects of stabilization exercises plus manual therapy to those of stabilization exercises alone on disability, pain, range of motion (ROM), and quality of life in patients with MNP. METHODS One hundred two patients with MNP (18-65 years of age) were recruited and randomly allocated into 2 groups: stabilization exercise without (n = 51) and with (n = 51) manual therapy. The program was carried out 3 days per week for 4 weeks. The Neck Disability Index, visual analog pain scale, digital algometry of pressure pain threshold, goniometric measurements, and Medical Outcomes Study 36-Item Short-Form Health Survey were used to assess participants at baseline and after 4 weeks. RESULTS Improvements in Neck Disability Index score, night pain, rotation ROM, and the Medical Outcomes Study 36-Item Short-Form Health Survey score were greater in the group that received stabilization exercise with manual therapy compared to the group that only received stabilization exercise. Between-group differences (95% confidence interval) were 2.2 (0.1, 4.3) points for the Neck Disability Index, 1.1 (0.0, 2.3) cm for pain at night measured on the visual analog scale, -4.3° (-8.1°, -0.5°) and -5.0° (-8.2°, -1.7°) for right and left rotation ROM, respectively, and -2.9 (-5.4, -0.4) points and -3.1 (-6.2, 0.0) points for the Medical Outcomes Study 36-Item Short-Form Health Survey physical and mental components, respectively. Changes in resting and activity pain, pressure pain threshold, and cervical extension or lateral flexion ROM did not differ significantly between the groups. Pressure pain threshold increased only in those who received stabilization exercise with manual therapy (P<.05). CONCLUSION The results of this study suggest that stabilization exercises with manual therapy may be superior to stabilization exercises alone for improving disability, pain intensity at night, cervical rotation motion, and quality of life in patients with MNP. LEVEL OF EVIDENCE Therapy, level 1b.

Effect of Connective Tissue Manipulation on Symptoms and Quality of Life in Patients With Chronic Constipation: A Randomized Controlled Trial

OBJECTIVE The purpose of this study was to examine the effects of connective tissue manipulation (CTM) on the severity of constipation and health-related quality of life in individuals diagnosed with chronic constipation. METHODS Fifty patients with a diagnosis of chronic constipation according to Rome III criteria were recruited and randomized to an intervention (n = 25) or control group (n = 25). The intervention group received CTM in addition to the lifestyle advice, whereas the control group was given only lifestyle advice for constipation. All assessments were performed at baseline and at the end of 4 weeks. The primary outcome measure was the Constipation Severity Instrument. Secondary outcomes included Patient Assessment of Constipation Quality of Life Questionnaire, Bristol Stool Scale, and 7-day bowel diary. Differences between groups were analyzed with t tests, Mann-Whitney U test and χ(2) test. RESULTS Compared with the control group, subjects in the intervention group reported significantly greater improvement in total and subscale scores of the Constipation Severity Instrument and Patient Assessment of Constipation Quality of Life Questionnaire (P < .05). Based on the results from bowel diaries, the improvements in the number of bowel movements, duration of defecation, stool consistency, and the feeling of incomplete evacuation in the intervention group were also significantly more than the control group (P < .05). CONCLUSION This study showed that CTM and lifestyle advice were superior to reducing symptoms of constipation and quality of life compared with lifestyle advice alone for patients with chronic constipation.

Comparison of balance and gait in visually or hearing impaired children.

The study was planned to evaluate the effect of loss of hearing and vision on balance and gait in 60 children, 20 of whom had hearing loss (M age = 9.3 yr., SD = 0.9), 20 who were visually impaired (M age = 12.2 yr., SD = 2.5), and 20 controls with no disability (M age = 9.4 yr., SD = 0.6). Standing Balance subtests of the Southern California Sensory Integration Tests were used. Gait analysis was conducted on a powdered surface. When the gait analysis results of the three groups of children were compared, statistically significant differences were noted. Scores for the hearing impaired group were more like those of the control group than those of the visually impaired group. Results show that children with visual impairment had more problems with balance and gait than controls.