Ummuhan Bas Aslan

DASH questionnaire for the analysis of musculoskeletal symptoms in industry workers : A validity and reliability study

PURPOSE The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered region-specific outcome instrument developed as a measure of self-rated upper-extremity disability and symptoms. The aim of this study was to evaluate the reliability and the construct validity of the DASH questionnaire by establishing its correlation to the Medical Outcomes Study Short Form-36 (SF-36) in industry workers. Also we aimed to investigate whether the DASH can be used as a standardized questionnaire to evaluate the work-related musculoskeletal disorders (WMSDs) in upper extremity in industrial settings and epidemiological studies. MATERIAL AND METHODS The Turkish versions reliability and construct validity were evaluated in 240 industry workers with upper-extremity musculoskeletal complaints. Workers were asked to complete a packet that included the DASH and the SF-36. Test-retest reliability was assessed in all workers who filled in the DASH questionnaire 15 days later. Construct validity was evaluated by comparing the overall and work component DASH scores with SF-36 summary and subscales. RESULTS The mean DASH score for the textile workers whose duties were confection, dyeing, sewing, quality control and packaging was calculated as 65, 55, 68, 54 and 67, respectively. As a result of this study, pain intensity in shoulder, wrist and hand was significantly associated with the DASH score (p<0.05). Internal consistency of the DASH was high (Cronbach alpha 0.91). Test-retest reliability was excellent for the overall DASH (intraclass correlation coefficient (ICC) 0.92). Moderate correlations (p<0.05) were found between the overall and work component DASH and the SF-36 summary scales. Pearson correlation coefficients of the overall and work component DASH to the SF-36 subscales ranged from -0.33 to -0.82. CONCLUSION These results support that DASH is a reliable and valid instrument to measure functional disability and investigate the ergonomic risk factors in textile workers with upper-extremity musculoskeletal complaints.

A comparison of the effects of hatha yoga and resistance exercise on mental health and well-being in sedentary adults: a pilot study.

OBJECTIVES Physical activity has a positive effect on peoples mental health and well-being. The aim of this study was to compare the effects of hatha yoga and resistance exercises on mental health and well-being in sedentary adults. DESIGN Randomized controlled study. METHODS Fifty-one participants aged mean (SD) 25.6 (5.7) years were randomly divided into three groups: Hatha Yoga Group, Resistance Exercise Group and Control Group. The Hatha Yoga Group and Resistance Exercise Group participated in sessions three days per week for 7 weeks and the Control Group did not participate in any sessions. All the subjects were evaluated through the Rosenberg Self-Esteem Scale, Beck Depression Inventory, Body Cathexis Scale, Nottingham Health Profile and Visual Analog Scale for fatigue pre-and post-session. RESULTS Significant improvements were found in terms of all outcome measures in the Hatha Yoga Group and the resistance exercise group. No improvements were found in the Control Group. Hatha yoga more improved the dimensions fatigue, self-esteem, and quality of life, whilst resistance exercise training more improved body image. Hatha yoga and resistance exercise decreased depression symptoms at a similar level. CONCLUSION The results indicated that hatha yoga and resistance exercise had positive effects on mental health and well-being in sedentary adults. Hatha yoga and resistance exercise may affect different aspects of mental health and well-being.

The Effect of Gender and Level of Vision on the Physical Activity Level of Children and Adolescents with Visual Impairment.

This study was planned in order to determine physical activity levels of visually impaired children and adolescents and to investigate the effect of gender and level of vision on physical activity level in visually impaired children and adolescents. A total of 30 visually impaired children and adolescents (16 low vision and 14 blind) aged between 8 and 16 years participated in the study. The physical activity level of cases was evaluated with a physical activity diary (PAD) and one-mile run/walk test (OMR-WT). No difference was found between the PAD and the OMR-WT results of low vision and blind children and adolescents. The visually impaired children and adolescents were detected not to participate in vigorous physical activity. A difference was found in favor of low vision boys in terms of mild, moderate activities and OMR-WT durations. However, no difference was found between physical activity levels of blind girls and boys. The results of our study suggested that the physical activity level of visually impaired children and adolescents was low, and gender affected physical activity in low vision children and adolescents.

A new tool measuring health-related quality of life (HRQOL): The effects of musculoskeletal pain in a group of older Turkish people

The aims of this study were (1) to show the effects of musculoskeletal pain on health-related quality of life (HRQOL) and (2) to look at gender differences in this field in elderly people living in Turkey. Subjects were 900 men and women (65 years of age or above), with a mean of 70.93+/-5.6 years. The centers for disease control (CDC) HRQOL-4 survey tool was used to measure HRQOL of the subjects. A visual analog scale (VAS) was used to determine pain intensity. The subjects were also asked to indicate sites where they experienced pain in their body. Of the subjects, 72.1% reported musculoskeletal pain. The prevalence of pain was higher among women (85.5%) than men (61.8%). Pain of lower extremities was the most common in both sexes. Whereas the majority of the subjects with musculoskeletal pain reported fair-poor self-rated health, those without pain reported excellent-very good-good health. Compared with subjects who did not report pain, those with pain had increased the number of physically and mentally unhealthy days in the previous 30 days (p=0.0001). The investigators concluded that musculoskeletal pain interfered negatively with HRQOL, increasing the number of unhealthy days and decreasing physical and mental performance in the elderly participants.

Attitudes of physiotherapists and physiotherapy students toward euthanasia: a comparative study.

This interventional study was undertaken to assess the impact of physiotherapy education on the knowledge and attitudes of physiotherapists (PTs) and physiotherapy students (PSs) toward euthanasia. The study, which was conducted during the period between 2004 and 2005, included a total of 494 participants (311 PTs; 183 PSs) aged 18 to 52 y from the western and central portions of Turkey, who responded to a self-report questionnaire (response rate, 96.4%) that was based on data from the literature. Results indicated that PTs (48.9%) were more likely to approve of euthanasia than PSs (38.3%) (P<.05). The legalization of euthanasia was favored by 43.7% of PTs, compared with 29.5% of PSs (P<.05). On the other hand, PTs and PSs expressed similar views regarding euthanasia, including reasons for accepting or opposing euthanasia and acceptable conditions for its use (P> .05). Overall results showed that sex and age had no effect on whether euthanasia was accepted (P> .05); religiousness was found to have the greatest effect on attitudes toward euthanasia (P<.05). The findings of the current study suggest that (1) the attitudes of PTs are different from those of PSs, and (2) the Islamic point of view has a negative impact on the attitudes of PTs and PSs toward euthanasia.

Implementation of Matrix Rhythm Therapy and Conventional Massage in Young Females and Comparison of Their Acute Effects on Circulation

OBJECTIVES To examine and compare the effects of massage and matrix rhythm therapy in young women on the peripheral blood circulation. DESIGN Randomized, double-blind, controlled trial. SETTING Pamukkale University in Denizli, Turkey. PATIENTS Fifteen healthy women age 19-23 years. INTERVENTION Matrix rhythm therapy was applied to the left lower extremity for a single 30-minute session. At least 1 week later, massage was applied to the left lower extremity for 30 minutes in a single session. The same physiotherapist applied both sessions. OUTCOME MEASURES The blood velocity (cm/s), artery diameter (mm), and blood flow (ml/min) of the popliteal and the posterior tibial arteries were measured with color Doppler ultrasonography. All images were evaluated by the same radiologist. RESULTS After matrix rhythm therapy and massage application, blood velocity, artery diameter, and blood flow in arteries increased. However, matrix rhythm therapy caused a more prominent increase in the amount of blood flow in the popliteal and in the posterior tibial artery than did massage. After matrix rhythm therapy application, the average increases in the blood flow rates in the popliteal and the posterior tibial arteries were 25.29%±16.55% and 34.33%±15.66%, respectively; after the massage, the increases were 17.84%±17.23% and 16.07%±10.28%, respectively. CONCLUSION Matrix rhythm therapy and massage increased peripheral blood flow in young women. Matrix rhythm therapy method resulted in more prominent increases.

Investigation of Biomechanical Characteristics of Intact Supraspinatus Tendons in Subacromial Impingement Syndrome: A Cross-sectional Study with Real-time Sonoelastography.

ObjectiveThe aim of this work was to evaluate the real-time sonoelastography (RTSE) in the assessment of the supraspinatus tendon in patients with subacromial impingement syndrome (SIS). MethodsTwenty-five patients with unilateral shoulder pain that was diagnosed as SIS according to magnetic resonance imaging findings were included in the study. Healthy shoulders of the patients comprised the control group. Bilateral shoulder RTSE examinations were performed by a radiologist who was blinded to the involved side of the participants. The RTSE images were recorded and assessed by 2 radiologists individually 1 month later. American Shoulder and Elbow Surgery shoulder index, Quick Disabilities of Arm Shoulder and Hand Questionnaire, and Constant scores were applied to evaluate the disability and functional status. The correlation between strain ratio and functional scores were investigated. ResultsOf the 25 participants, 9 (36%) were men and 16 (64%) were women. The RTSE findings were pathologic in tendons of 23 patients (92%) with SIS. The strain ratio was significantly higher in the affected shoulders (P < 0.001). The interobserver agreement was good for image analysis. There was no significant correlation between strain ratio and functional scores. ConclusionStructural changes in the supraspinatus tendon can be demonstrated with RTSE in patients with SIS.

Exploring the relation between impairment rating by DAS-28 and body function, activity participation, and environmental factors based on ICF hand core set in the patient with rheumatoid arthritis

Hand problems associated with rheumatoid arthritis lead to subjective impairment, activity limitation, and restrictions on participation. This relation is very complex. Assessment of individuals’ activities is important to determine how hand problems affect not only body functions but also daily life activities. The aim of this study was to link and allocate items of disability questionnaires with ICF components based on ICF hand core set. The other objective was to examine the relationship between impairment and ICF components determined on the basis of disability questionnaires in participants with rheumatoid arthritis. Impairment was evaluated by use of Disease Activity Score-28. Disability questionnaires were Disabilities of Arm, Shoulder and Hand Questionnaire, Michigan Hand Outcomes Questionnaire, Duruoz Hand Index, and Arthritis Impact Measurement Scales 2 (n = 100). Items of disability questionnaires were linked with ICF hand core set as a result of three expert opinions. Michigan Hand Outcomes Questionnaire covered the highest number of body function categories and Arthritis Impact Measurement Scales 2 covered the highest number of ICF hand core set. For all questionnaires, while impairment (Disease Activity Score-28) had moderate correlation with subjective impairment (body function scores) and activity/participation; subjective impairment had high and moderate correlation with activity participation. Arthritis Impact Measurement Scale 2 is the most appropriate to perform a more comprehensive biopsychosocial assessment. Clinician’s assessments and impairment levels reported by patients with rheumatoid arthritis are interrelated. Impairment levels reported by patients with rheumatoid arthritis are also affected by environmental factors.