Yücel Yildirim

Effects of fitness and aquafitness exercises on physical fitness in patients with chronic low back pain

Abstract Objectives: To evaluate the effects of two different fitness programmes (water versus land based) on physical fitness level in patients with chronic low back pain. Design: Randomised controlled study. Subjects: Thirty patients with chronic low back pain randomly followed a land based fitness programme or an aquafitness programme. Methods: Subjects were evaluated with the Eurofit test battery for their physical fitness level. Both groups followed their programmes under supervision of a physiotherapist 3 days/week for 4 weeks. Results: Differences of measurements were not significant between the two groups. Significant differences were shown in both groups after the therapy programme with regard to aerobic fitness, motor fitness (single leg balance test with eyes open or closed), musculoskeletal fitness, pain reports, Sorensen and Oswestry low back pain disability index scores. No significant difference was found between the groups. Conclusion: Supervised aquafitness programmes have effects similar...

Identifying factors associated with low back pain among employees working at a package producing industry

BACKGROUND The purpose of this study was to identify factors associated with Low Back Pain (LBP) among employee working at a package producing industry. METHODS A sample of 111 male blue-collar workers, between the ages of 18 to 50 years old and 31 white-collar workers between the ages of 17 to 50 years old completed a questionnaire which included demographic data, educational level, participation in sports activities, activity, postural habits, smoking, work conditions lifting and bending activities during the workday strenuous arm position and questions related with low back pain (LBP). The isometric strength of back muscles were measured using a dynamometer. RESULT The prevalence of LBP during the past 12 months was 55.9% for blue-collar workers and 51.6% for white-collar workers. The chi-square and t-test analysis showed statistically significant relations between LBP and smoking, number of years spent working in the last job, lifting activities between the ages of 30-34 years old. The incorrect standing and sitting posture of the blue-collar workers and the sitting posture with bending forward on the table of the white-collar workers were significantly related with LBP (p< 0.05). CONCLUSIONS Our results identified the risk factors of LBP in a package producing company. The protective approaches aiming to avoid the risk factors could decrease the low back pain prevalence that increases each year passed worked at the company.

A validity and reliability study of the Turkish Multidimensional Assessment of Fatigue (MAF) scale in chronic musculoskeletal physical therapy patients

BACKGROUND AND OBJECTIVES Fatigue is primarily a subjective experience and self-report is the most common approach used to measure fatigue. Numerous self-report instruments have been developed to measure fatigue. Unfortunately, each of these measures was tailored for the situation in which fatigue was studied. Therefore, the aim of this study was to determine the reliability and validity of the Turkish language version of the Multidimensional Assessment of Fatigue Scale (MAF-T) in chronic musculoskeletal physical therapy patients. MATERIAL AND METHODS The MAF-T was supplied by the MAPI Research Institute, and 69 chronic musculoskeletal physical therapy patients were evaluated. To validate MAF-T, all participants completed the MAF-T and Short Form-36 (SF-36). The MAF was administered again one week later to assess test-retest reliability. RESULTS Using Cronbach α, the internal consistency reliability of the MAF-T was 0.90, the Intraclass Correlation Coefficient (ICC) reliability was 0.96. Item-discriminant validity was calculated between r=0.14 and r=0.82. The correlations between the total scores of the MAF-T scale and the subscale scores of SF-36 were negative and significant (p< 0.01). CONCLUSION The MAF-T is a valid and reliable scale for assessing fatigue in chronic musculoskeletal physical therapy patients.

ASSESSMENT OF LOWER EXTREMITY MOTOR COORDINATION IN OPERATED PATIENTS

Objective: To establish any changes up to the second postoperative month in pain, disability, performance, kinesiophobia, and lower extremity motor coordination of patients operated on for lumbar disc hernia. Methods: Forty-five patients with lumbar disc hernia were included in the study preoperatively, and were followed up until the second postoperative month. Pain and disability, walking and stair-climbing performances, and kinesiophobia were measured; and motor coordination tests were practiced with the Lower Extremity MOtor COordination Test (LEMOCOT). Results: The worst scores of pain, disability, performance, kinesiophobia, and LEMOCOT measurements were in the preoperative period; while the best ones were observed in the 2 months following the surgery. Conclusion: The measurements of pain, disability, performance, kinesiophobia, and lower extremity coordination usually performed in the cases operated on with a diagnosis of lumbar disc hernia are significantly affected from the initial period until t...

Use of tape measure in people with or without back pain in assessment of reposition error.

AIM Examining lumbar repositioning error (RE) using a tape measure in nonspecific low back pain (NLBP) and control groups and determining whether RE is different in subjects with nonspecific back pain than in controlled subjects. MATERIAL AND METHODS The study was totally applied to 36 subjects of whom 18 were healthy subjects and 18 were NLBP patients. The ability of the subjects to take the targeted positions was assessed. In subjects with NLBP the evaluation of the pain was assessed by using Visual Analog Scale (VAS), and disability measurement was made using Oswestry Disability Index (ODI). RESULTS RE was found in all the measurements except for lumbar flexion with eyes open(p=0.15) in control group (p < 0.05). There were RE for all the measurements in NLBP grpup (p < 0.05). When RE of two groups compared only lumbar flexion with eyes open measurement (p = 0.04) in NLBP group was higher then control group. CONCLUSION As a result of our study, it has been seen that RE measurement of the lumbar spine with tape measure, which is cheap and clinically practical, is a reliable method, and can be used in the assessment of NLBP patients and in the determination of the rehabilitation program.

Relationship between learning strategies of patients and proper perception of the home exercise program with non-specific low back pain

OBJECTIVES This study explored how the effectiveness of prescription exercises for a home program for patients with non-specific low back pain by using the method with specified describing style in accordance with ATLAS (The Assessing the Learning Strategies of Adults) and traditional method that we often use in clinic. PATIENTS AND METHODS Twenty-six patients with non-specific low-back pain were referred to the physical therapy department for exercise therapy. Subjects were randomly assigned to control group, and experimental group. The stability exercise procedures were considered for each group. For patients in control group, exercises procedures were demonstrated with wording that we often use in clinic. For patients in experimental group, it was done by using the method with specified describing style in accordance with ATLAS (The Assessing the Learning Strategies of Adults). An Exercise Assessment Scale was also developed to measure exercise performance for this study. RESULTS All demographic parameters, functionality scores, and distribution of learning strategies were homogeneous in two groups. The correlation tests showed no significant relationship between personal factors and properly perception of the home exercise program in control and experimental group. Exercise Assessment Scale scores were compared in both groups which showed a significantly superiority in experimental group compared to the control group. CONCLUSIONS The wording that we often use in clinic to describe home exercise program in patients with non-specific low back pain is not sufficient. While the method of specified describing style in accordance with ATLAS is more effective in understanding of exercises.

The Impact of Disability Level on Intention to Perform Home Exercises in Patients with Spinal Pain

Objectives: The aim of our study is to determine whether or not disability level affects the practice and perception of home exercises. Methods: Seventy-five patients diagnosed with cervical and lumbar disc herniation were included in this study. Some had undergone an operation, others had not. The patients were divided into three groups according to the lumbar and cervical Oswestry Disability Index [ODI] scores. Group 1 comprised those with minimal disability, Group 2 with moderate disability, and Group 3 had patients with severe disability. The patients were questioned on their performance of home exercises with a questionnaire developed from the Triandis model consisting of items about perceived consequences, affects, and social factors. Results: When the various sections of the home-based questionnaire were examined according to the groups, no difference was found in the General Intention scores among the three groups [p <.05]. However, the Perceived Consequences scores were found to be significantly lower in Group 2 compared to other groups. In Group 3, the Social Factors scores were in the worst condition when compared to other groups [p <.05]. The affect scores in Group 3 was significantly higher compared to Group 1 [p <.05]. Conclusions: Improving the perception of home exercises assigned to spinal pain patients according to disability status requires implementing more effective methods, such as written exercise sheets and video demonstrations, especially in the patients with lower disability status.

Evaluation of early period physical performance, physical activity, pain and disability levels of patients operated for cervical disc hernia

Abstract. Study design: A prospective study made into cervical disc hernias.Objectives: To assess the changes in the early postoperative period of the patients with cervical disc hernia in terms of the painand disability we measured according to ‘The Neck Pain and Disability Scale’, physical performance, fatigue, fear of activity(kinesiophobia), physical activity levels.Setting: Neurosurgical department.Summaryofbackgrounddata: Kinesiophobiaanditsassociatedavoidancebehaviorinthedevelopmentofchronicmusculoskeletalpain has been of great concern over the past decade, thus rendering appropriate and detailed assessments in the postoperativeperiod very important.Methods: Sixteenpatients operated onbecause ofcervical discherniawereincluded inourstudy. Thepain anddisability, physicalperformance, fatigue, kinesiophobia, and physical levels of the patients were evaluated pre-postoperatively, during discharge andat the end of the second month.Results: While pain, disability measured according to ‘The Neck Pain and Disability Scale’ fatigue were decreasing, allperformance measurements except the sit/stand, lying/sit and loaded reach were getting highest scores on the 2nd postoperativemonth. Although kinesiophobia, peaked at the 2nd postoperative month, physical activity level had also arrived the preoperativelevel at this time.Conclusion: Increased kinesiophobia, affected the physical performances and physical activity levels of the patients in daily livesin spite of decreased pain, disability and fatigue. Kinesiophobia had effects on postoperative recovery duration, daily life, andreturn to work. A detailed evaluation should be performed particularly for kinesiophobia in early postoperative period.Keywords: Cervical fusion, neck pain, performance, physical activity, performance early period

Evaluation of functional results according to Body Mass Index in patients with acute non-specific low back pain

Objective: The aim of our study was to detect the factors which might affect the recovery of the patients with Acute Non-Specific Low Back Pain (ANSLBP) according to their Body Mass Index (BMI), and to determine the effects of these factors on disability and the perceived functional level with quality of life. Design: A retrospective study. Patients: Ninety-three patients were included in the study, and separated as three groups according to BMI (normal weight group, Grade1 obesity group, Grade 2 obesity group). Methods: Acute Low Back Pain Screening Questionnaire (ALBPSQ) and SF-36 Physical Functioning Scale (PFS) were used in the evaluation of the patients. Results: The ALBPSQ and SF-36 PFS results of our patients in all three groups before and after the treatment were found to be significant in the direction of positive scores ( p< 0.05). When the SF-36 PFS scores and the total scores of ALBPSQ were compared among the groups according to the increase of the obesity, there existed a significant difference ( p< 0.05). Between the ALBPSQ and SF-36 PFS scores, in the three groups correlation was determined in the negative direction. Conclusion: With the treatment applied to our patients, pain and disability with the quality of life showed positive differences, but the results were observed to be affected unfavorably through the increase of obesity based on the functional status and decrease in the quality of life.

Evaluation of the kinesthetic sense and function of the hand in early period in operated cervical disc hernia.

A prospective study made into cervical disc hernias. To determine the kinesthetic sense and hand functions, which are important for the patients with cervical disc hernia to return to work life and daily activities that need skill. Neurosurgical department. Data Symptoms in cervical disc hernias and hand functions are affected depending on long-term pain. The evaluation of the hand is essential in assessing the patients’ overall recovery and ability to return to daily activities and work life. Thirty-four patients with cervical disc hernia, who were operated on, were included in the study. Eight different test positions in the assessment of the hand’s kinesthetic sense and hand function sort (HFS) in the evaluation of the hand function were applied. The disability levels of the patients were determined with The Neck Pain and Disability Scale, on the preoperative and postoperative discharge day and in the postoperative second month. Patients were divided into groups according to the side involved. In the evaluation of the kinesthetic test of the hand, only in the postoperative second month was a significant difference observed between the 1, 2, 3, and 4 test positions of the right side of the groups. On the other hand, no significant difference was found between the groups in the assessment of the hand function. In the measurement of hand functions and disability levels, strong and important correlations were determined. An early assessment of the hand’s kinesthetic sense and function is instrumental in the patients’ evaluation of recovery and resumption of work.