Zeynep Guven

Hypermobility in women with fibromyalgia syndrome

The purpose of this study was to evaluate the relationship between hypermobility and fibromyalgia syndrome (FS) in women. Ninety-three women with FS who met the American College of Rheumatology criteria for FS and 58 healthy women without FS were included in this study. All women were examined for hypermobility by blinded observers using the Beighton criteria. The mean age was 43.5±9.9 (21–68) and 40.2±11.1 (21–63) years in the FS and control groups, respectively, and the two groups were statistically similar (p>0.05). The mean Beighton total score was 4.7±2.1 and 2.9±2.4 in the FS and control groups, respectively (p<0.0001). The frequency of joint hypermobility was 64.2% in the FS group and 22% in the control group. In accordance with the Beighton criteria (p<0.05), we found that the joint hypermobility ratio was significantly higher in patients with FS than in subjects without FS. Additionally, we evaluated the correlation between the total Beighton score and the age and number of trigger points. There were negative correlations between the total Beighton score and the age (r=−0.42, p<0.001) and number of trigger points (r=−0.24, p=0.03) in all patients. Hypermobility syndrome is more common in women with FS than in those in the control group. Therefore, the relationship between hypermobility and FS should be taken into consideration in the diagnosis and follow-up of women, especially those with widespread pain.

Quality of life in patients with fibromyalgia syndrome and rheumatoid arthritis

The objective of this study was to determine and compare the quality of life (QOL) of patients with fibromyalgia syndrome (FS) and rheumatoid arthritis (RA) and to assess patients’ psychological and functional status in each group. This prospective study included 62 female FS patients and 60 female RA patients diagnosed by the American College of Rheumatology criteria. The Turkish translations of the Arthritis Impact Measurement Scale II (AIMS II) and Beck Depression Index (BDI) were given to all of the patients and they were asked to complete the two questionnaires. The scores of AIMS II, pain, and QOL were evaluated in the FS and RA groups. There were no statistically significant differences between the FS and RA groups (p>0.05) in terms of QOL. The affect subgroup scores of the AIMS II and BDI were highly correlated in the FS and RA groups (p<0.002, r=0.85 and p<0.05, r=0.80, respectively). The results show that the QOL is negatively but similarly affected in FS and RA groups.

High Voltage Galvanic Stimulation in Myofascial Pain Syndrome

Objective: The aim of this study is to show the effectiveness of high voltage galvanic stimulation [HVGS] in the treatment of trigger points [TrPs] in myofascial pain syndrome. Design: A placebo-controlled study. Setting: The study was performed in the physiotherapy unit of the Department of Physical Medicine and Rehabilitation in Marmara University Hospital. Patients: The patients formed three groups, one of them being the treatment group, the second placebo group, and a third being the control group who received exercise treatment only. Group A: HVGS+ exercise, Group B: Placebo HVGS +exercise, Group C: exercise only. Main Outcome Measure: Patients were evaluated before sessions, after the sessions, and 15 days after the treatment with the use of visual analog scale for pain, TrP tenderness index, analgesic use, and the patients general assessment. Result: At the end of the study pain levels decreased in patients of all three groups, but the decrease was more significant in HVGS group [P < 0.05]. Trigger point tenderness index was decreased significantly in the treatment group [P < 0.05]. Patients in the placebo group had the same complaints. Conclusions: We conclude that HVGS is effective in the treatment of tenderness in myofascial TrPs. Useful effects of HVGS continues in the midterm follow-up. High voltage galvanic stimulation can be accepted as a useful adjunctive modality in the treatment of myofascial TrPs.

Health-related Quality of Life in Patients with Myofascial Pain Syndrome

Health-related quality of life is being emphasized because people who are living with a chronic illness are demanding that the qualities of their lives are enhanced. Health-related quality of life defines the effects of diseases or symptoms including musculoskeletal conditions on functioning and a sense of well being. This review highlights the results of quality-of-life measurements in patients with myofascial pain syndrome while providing a comparison with various musculoskeletal disorders, emphasizing the domains that are affected for each specific disease. Also, myofascial pain studies that included quality-of-life measurement as an outcome variable are considered.

Comparison of the long-term effectiveness of progressive neuromuscular facilitation and continuous passive motion therapies after total knee arthroplasty.

[Purpose] The aim of this longitudinal study was to examine the long term functional effectiveness of proprioceptive neuromuscular facilitation (PNF) after total knee arthroplasty. [Subjects and Methods] We included 30 patients and they were randomly assigned to two groups. In addition to the standard rehabilitation program the PNF group received proprioceptive neuromuscular facilitation therapy and the CPM group received continuous passive motion therapy. The outcome measures included range of motion using a goniometer, pain scores using a numeric pain rating scale, days to reach functional benchmarks, the Beck depression scale and isokinetic torque and isometric strength measurements. [Results] There were no significant differences between the two groups in terms of baseline demographic data, clinical findings and length of stay. Days to reach range of motion benchmarks were similar in the two groups. Pain at the 8th week was slightly higher in the PNF group. With the exception of walking with a walker, days to reach functional benchmarks were statistically significantly fewer in patients of the PNF group despite similar isokinetic measurements. Administration of PNF resulted in earlier functional gains in patients after total knee arthroplasty. These functional accomplishments were more pronounced in the PNF group despite it having isokinetic torque measurements similar to those of the CPM group. [Conclusion] PNF techniques can positively affect functional outcomes over the long term.

Exercise Prescription for Painful Hip Disorders

The hip is the joint that serves as a force transmitter for the upper and lower extremities and is vital for daily activities, such as walking. The hip joint has a deep socket and surrounding strong muscles; it relies on a balance of muscle flexibility and strength. For the prescription of exercises for the hip, the imbalance between muscle groups, muscles with signs of weakness, muscles under overload, and muscle shortness should be assessed. Strength progression usually advances as isometric, isotonic, isokinetic, and plyometrics; however, full strength can not be achieved until flexibility is restored. In this review, we aimed to summarize the exercises that can be used for the treatment of disorders, such as hip osteoarthritis, inflammatory conditions, osteoporosis, piriformis syndrome, great trochanteric pain syndrome, tendinopathies, labral tears, and femoroacetabular impingement, under the light of scientific evidence.