Ümit Bingöl

Effect of Pilates Training on People With Fibromyalgia Syndrome: A Pilot Study

UNLABELLED Altan L, Korkmaz N, Bingol U, Gunay B. Effect of Pilates training on people with fibromyalgia syndrome: a pilot study. OBJECTIVE To investigate the effects of Pilates on pain, functional status, and quality of life in fibromyalgia, which is known to be a chronic musculoskeletal disorder. DESIGN Randomized, prospective, controlled, and single-blind trial. SETTING Physical medicine and rehabilitation department. PARTICIPANTS Women (N=50) who had a diagnosis of fibromyalgia syndrome (FMS) according to the American College of Rheumatology criteria. INTERVENTION The participants were randomly assigned into 2 groups. In group 1, a Pilates exercise program of 1 hour was given by a certified trainer to 25 participants 3 times a week for 12 weeks. In group 2, which was designed as the control group, 25 participants were given a home exercise (relaxation/stretching) program. In both groups, pre- (week 0) and posttreatment (week 12 and week 24) evaluation was performed by one of the authors, who was blind to the group allocation. MAIN OUTCOME MEASURES Primary outcome measures were pain (visual analog scale) and Fibromyalgia Impact Questionnaire (FIQ). Exploratory outcome measures were number of tender points, algometric score, chair test, and Nottingham Health Profile. RESULTS Twenty-five Pilates exercise and 24 relaxation/stretching exercise participants completed the study. In group 1, significant improvement was observed in both pain and FIQ at week 12 but only in FIQ at 24 weeks. In group 2, no significant improvement was obtained in pain and FIQ at week 12 and week 24. Comparison of the 2 groups showed significantly superior improvement in pain and FIQ in group 1 at week 12 but no difference between the 2 groups at week 24. CONCLUSIONS We suggest Pilates as an effective and safe method for people with FMS. Our study is the first clinical study designed to investigate the role of the Pilates method in FMS treatment. We believe that further research with more participants and longer follow-up periods could help assess the therapeutic value of this popular physical exercise method.

The effect of balneotherapy on patients with ankylosing spondylitis

Objective: To compare the effect of balneotherapy on physical activity and quality of life as well as the symptoms of pain and stiffness with exercise alone in ankylosing spondylitis (AS) patients. Methods: A total of 60 patients who had a diagnosis of AS according to the modified New York criteria were included in the study. The patients were randomly assigned to two groups. In Group I (n = 30) the patients received balneotherapy in a therapeutic pool for 30 min once a day for 3 weeks. All patients received instructions on the exercise programme, which they were requested to repeat once a day for 30 min during the study. The patients in this group continued the same exercise programme after the end of the balneotherapy protocol to complete a course of 6 months. In Group II the patients were given the same exercise protocol but did not receive balneotherapy. Patients were evaluated before the start of the study and at 3 weeks and 24 weeks. Evaluation parameters were daily and night pain, morning stiffness, the patients global evaluation and the physicians global evaluation (according to a scoring system of 1 to 5), the Bath Ankylosing Spondilitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Dougados Functional Index (DFI), tragus–wall distance, chest expansion, modified Shober test (MST), fingertip–fibula head distance, and Nottingham Health Profile (NHP). Results: Evaluations were completed in 54 patients in the two groups. Comparison of the groups showed significantly superior results for Group I for parameters of BASDAI, NHP total, pain, physical activity, tiredness and sleep score, patients global evaluation and the physicians global evaluation at 3 weeks, but only for the parameters of patients global evaluation and MST at 24 weeks. Conclusion: Balneotherapy has a supplementary effect on improvement in disease activity and functional parameters in AS patients immediately after the treatment period. However, in the light of our medium‐term evaluation results, we suggest that further research is needed to assess the role of balneotherapy applied for longer durations in AS patients.

Investigation of the Supplementary Effect of GaAs Laser Therapy on the Rehabilitation of Human Digital Flexor Tendons

OBJECTIVE To investigate the effect of laser photostimulation in rehabilitation of human digital flexor tendons with a placebo-controlled double-blind prospective study model. BACKGROUND DATA Low-energy laser therapy has been applied in several rheumatoid and soft tissue disorders with a varying rate of success and it has also been shown to have a positive effect on tendon healing in animal experiments, but no clinical study on laser photostimulation in the treatment of human tendons has been reported to date. MATERIALS AND METHODS This study was performed in a total of 25 patients with 41 digital flexor tendon injuries in five anatomical zones. In Group I (21 digits in 13 patients), whirlpool and infrared GaAs diode laser with a frequency of 100 Hz. was applied between the 8th and 21st days postoperatively and all patients were given the Washington rehabilitation program until the end of the 12th week. In Group II (20 digits in 12 patients), the same treatment protocol was given but the laser instrument was switched off during applications. RESULTS The results of the study showed a significant improvement in the laser-treated group only for the parameter of edema reduction (p < 0.01) but the difference between the two groups was non-significant for pain reduction, hand grip strength, and functional evaluation performed according to Strickland and Buck-Gramcko systems using total active motion and fingertip-to distal palmar crease distance parameters (p > 0.05). CONCLUSIONS Significant improvement obtained in edema reduction both immediately and 12 weeks after supplementary GaAs laser application in our study has been interpreted as an important contribution to the rehabilitation of human flexor tendon injuries because edema is known to have a detrimental effect on functional recovery during both early and late stages of tendon healing. However, our study has failed to show a significant positive effect of supplementary GaAs laser application on the other functional recovery parameters of human flexor tendon injury rehabilitation and we suggest further clinical study in this topic be done using different laser types and dosages in order to delineate the role of this promising treatment modality.