Zeliha Başkurt

Motor assessment of upper extremity function and its relation with fatigue, cognitive function and quality of life in multiple sclerosis patients

OBJECTIVES The aim of this study was to assess the motor function of upper extremity and its relation with fatigue, cognitive function and quality of life in Multiple Sclerosis (MS) patients. DESIGN Cross-sectional and controlled study. SETTING Outpatient clinic in a university hospital. SUBJECTS Thirty-one patients with MS (25 women, 6 men; mean age 39.74 +/- 10.10 years; mean EDSS, 2.56 +/- 1.91) and 30 healthy subjects (20 women, 10 men; mean age 33.56 +/- 8.85 years) were enrolled into the study. MAIN MEASURES Nine-hole peg test (9-HPT) and Valpar Component Work Sample Test (VCWS-4), Upper Extremity Index (UEI), Paced Auditory Serial Addition Test (PASAT), Fatigue Severity Scale (FSS), and the Multiple Sclerosis Quality of Life-54 (MSQOL-54). RESULTS MS patients showed significant impairment in upper extremity motor functions, cognitive function and excessive fatigue compared to controls (p < 0.05). 9-HPT in MS group correlated with EDSS, UEI and MSQOL-54 physical health and cognitive function, whereas VCWS-4 scores (assembly right, assembly left and disassembly) correlated only with EDSS and UEI. No correlation was found between the VCWS-4 and cognitive function and fatigue in both of the groups. Compared to control group, a strong correlation existed between the 9-HPT and VCWS-4 in MS patients (p < 0.05). CONCLUSION The results indicate that disability level (EDSS), UEI and cognitive function in MS patients are related with impairment in upper extremity motor function. This again contributes to an impairment in physical domain of quality of life. A strong correlation of the 9-HPT with VCWS-4 supports the use of the 9-HPT as a measure of manual dexterity and gross motor functions.

The effectiveness of scapular stabilization exercise in the patients with subacromial impingement syndrome

OBJECTIVE The study investigated the effectiveness of stretching, strengthening exercises, and the scapular stabilization exercises on the pain, shoulder range of motion (ROM), muscle strength, joint position sense (JPS), scapular dyskinesis and quality of life (OL) in the patients with subacromial impingement syndrome (SIS). METHODS 27 women and 13 men, mean age 51 (24-71) years old, were included in this study. All the patients were separated into 2 groups according to simple random table. Stretching and strengthening exercises were given to the group I (n=20) and scapular stabilization exercises were added to the group II (n=20). The pain severity, shoulder ROM, muscle strength, JPS, lateral scapular slide test (LSST), Western Ontario Rotator Cuff (WORC) Index were evaluated before and after treatment. Patients completed a 6-week rehabilitation program, three times a week. RESULTS The results showed that all measurements improved statistically in both groups after treatment (p < 0.05). And the improvements in the muscle strength, JPS and scapular dyskinesia were significantly different in group II (p < 0.05). CONCLUSION It is suggested that in the treatment of SIS; scapular stabilization exercises, given with stretching and strengthening exercises, can be more effective in increasing the muscle strength, developing the JPS and decreasing the scapular dyskinesis.

The immediate effects of heat and TENS on pressure pain threshold and pain intensity in patients with Stage I shoulder impingement syndrome

Abstract Aim: Our study was planned to compare the immediate effects of heat, transcutaneous electrical nerve stimulation (TENS) and heat plus TENS applications on the pain related to stage I shoulder impingement syndrome. Methods: 92 patients who had shoulder impingement syndrome were separated randomly in three groups. The heat was applied to 31 patients in the first group for 20 min, TENS (100 Hz 0.1 ms pulse duration, symmetric biphasic wave form, tolerable intensity) was used for 30 patients in the second group for 20 min and heat plus TENS was applied to the 31 patients in the third group for 40 min. Before and immediately after the applications, pressure pain threshold (PPT) was measured by a dolorimeter in the painful points on the anterobrachial area. Measurements were repeated three times and the mean value was recorded. The severity of subjective pain was recorded using a visual analogue scale (VAS) before and after the applications.One-way ANOVA was used to compare differences of PPT, VAS, and...

Effects of Chronic Osteoarthritis Pain on the Pressure-Pain Thresholds and Proprioceptive Sense

Objectives: The aim of the study was to determine the effects of the chronic pain severity and pain duration in patients with osteoarthritis [OA] on pressure-pain threshold [PPT] and proprioception. Methods: The study groups consisted of patients with painful joints and healthy normal controls with painless joints. The chronic pain degree was evaluated with The Chronic Pain Grade Questionnaire. The PPT was measured with a dolorimeter and proprioception was evaluated passively. Results: Sixty-three patients with OA, mean aged 55 ± 10.60 years, were included in this study. Twenty-four patients had knee arthritis, eight patients had hip arthritis, and 31 patients had shoulder arthritis. The patients with OA had experienced pain for a duration of 41.09 ± 53.35 [12 to 72] months. The PPT was decreased and joint position sense and kinesthesia were altered in the painful joint when compared with the painless joint [P < 0.05]. No correlation was found between age, body mass index, pain duration, pain intensity score and PPT, joint position sense, or kinesthesia [P > 0.05]. However, the chronic pain grade was correlated with PPT [r = −0.418], joint position sense [r = 0.445], and kinesthesia [r = 0.535]. Similarly, correlations were found between disability points and PPT [r = −0.369], joint position sense [r = 0.473], and kinesthesia [r = 0.505]. Conclusions: Chronic pain grade correlates inversely with PPT, but it correlates directly with joint position sense, and kinesthesia senses in patients with OA. However, pain duration and pain intensity do not correlate with PPT, joint position sense, or kinesthesia.

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.

The Acute Effect of Static Stretching Applied to Different Muscle Groups of the Lower Extremity on Sprint Running

Stretching is a conventional method applied by athletes to reach the maximum performance at the warm-up stage and to protect them from injuries. Although it is frequently applied by athletes, there is no consensus on the acute effects of stretching exercises on the performance. The aim of this study is to examine the acute effect of static stretching applied to quadriceps and/or hamstring muscle groups on sprint running. 45 males (average (±SD) age 22,9 (±1,3) years; height 178,1 (±6,4) cm; body weight 77,7 (±12) kg) participated in the study. Following a 5-minute of submaximal warm-up run, 3 different stretching protocols (Method I: only 5minute warm-up run; Method II: 5minute warm-up run and static hamstring stretching; Method III: 5minute warm-up run, static hamstring and Quadriceps femoris stretching) were applied to the participants by being randomized on non-consecutive days. A 20-meter sprint test was conducted after the stretching protocols. At the end of the study, it was identified that passive stretching applied to the hamstring muscle had a numerically positive effect on the acute sprint performance, however, there was no statistically significant difference between Method I, II, III (p>0.05). It was observed that static stretching exercises applied to different muscle groups of the lower extremity did not have a negative effect on the 20meter sprint time performance. Therefore, we think that short-term static stretching exercises should be performed before the competition, without the concern of performance loss.

The examination of work-related musculoskeletal discomforts and risk factors in veterinarians

Abstract This study aimed to determine the frequency of work-related musculoskeletal discomforts (WMSDs) observed in veterinarians and the risk factors that may bring about these. Two hundred and seven veterinarians working in three provinces in south west Turkey were included in the study. The demographic and occupational information on the participants was recorded. The Modified Nordic Musculoskeletal Questionnaire was used to evaluate the musculoskeletal problems of different body parts, which cause difficulties at work and result in staying away from work. 49.8 % of veterinarians mostly have problems with lower back, 41.1 % with back, and 39.1 % with neck. The frequency of WMSDs tends to increase with the progress of professional experience. Three work-related activities during which veterinarians experience most difficulties while at work are obstetric procedures (28 %), vaccination (25.6 %), and driving (23.2 %). It is statistically significant that arm problems are observed more in veterinarians working with large animal types (p<0.05). The high level of job related stress and low job satisfaction statistically significantly affect the formation of WMSDs (p<0.05). The study showed that a large number of veterinarians experienced work-related musculoskeletal pain and discomforts that could be caused by some physical and psychosocial risk factors. Therefore, it is recommended for veterinarians to receive education on ergonomics and exercise from the beginning of their professional lives to prevent WMSDs.