Turkish Journal of Physical Medicine and Rehabilitation最新文献

Local corticosteroid injections are commonly used for carpal tunnel syndrome. Rarely, hand infections can occur after injection. This report presented a 60-year-old female patient who developed a horseshoe abscess after corticosteroid injection for carpal tunnel syndrome. Early surgical intervention, intravenous antibiotics, and early mobilization led to successful management. Proper sterilization is crucial to prevent complications. Understanding hand anatomy is essential for prompt diagnosis and treatment of infections.

Objectives: The objective of study was to compare the effects of pelvic myofascial trigger point release and structured pelvic floor muscle training (PFMT) in patients with female sexual dysfunction after vaginal delivery.

Patients and methods: In this prospective randomized controlled trial, 126 patients with female sexual dysfunction after vaginal delivery were included between October 2022 and December 2023. The participants were randomly allocated to receive either trigger point release and structured PFMT (63 females; mean age, 30.4±2.8 years; range, 25 to 35 years) or only structured PFMT (63 females; mean age, 31.4±3.1 years; range, 24 to 35 years). The primary outcome was Female Sexual Function Index (FSFI) score of the participants. Secondary outcomes were Glazer pelvic floor electromyography and the Visual Analog Scale score of urogenital pain map, pelvic floor muscle pain map, and bladder pain map.

Results: The observation group manifested a significant improvement in the FSFI total score and each individual subitem compared to the control group (p<0.01). In addition, in Glazer pelvic floor electromyography, the observation group exhibited a significant decrease in pre-resting value and post-resting value compared to the control group after treatment (p<0.01). Additionally, there was significant decrease in Visual Analog Scale scores in the observation group compared to the control group (p<0.01). Moreover, after therapy, the observation group demonstrated a significantly greater enhancement in pelvic floor muscle strength than the control group (p<0.05).

Conclusion: Pelvic myofascial trigger point release combined with structured PFMT is an efficient treatment for female sexual dysfunction after vaginal delivery compared to structured PFMT alone.

Objectives: This study aims to compare the efficacy of dry needling and balneotherapy in the treatment of trapezius muscle myofascial pain syndrome (MPS).

Patients and methods: This prospective study was conducted between February 2020 and May 2020. One hundred twenty patients (23 males, 97 females; mean age: 42.3±6.8 years; range, 18 to 50 years) were divided into three groups: dry needling (Group 1), balneotherapy (Group 2), and dry needling + balneotherapy combination (Group 3). Pain was assessed using a Visual Analog Scale (VAS) and the pressure pain threshold (PPT), cervical joint range of motion (ROM) using goniometry, mood using the Beck Depression Scale (BDS), anxiety levels using the Beck Anxiety Scale (BAS), fear of movement using the Tampa Kinesiophobia Scale (TKS), disability using the Neck Disability Index (NDI), and quality of life using the 36-item Short-Form Health Survey (SF-36). The measurements were repeated before the treatment and at the first week and third month after the treatment.

Results: There were significant improvements in all parameters after the treatment in all three groups (p<0.05). It was found that Group 1 was superior to Group 2 in terms of VAS (p=0.010), BDS (p<0.001), BAS (p=0.007), and NDI (p<0.001) values. There was no difference between Group 1 and Group 2 in PPT evaluations (p=0.070). There was no difference between the groups in ROM measurements (p>0.05). The highest level of well-being was detected in Group 3 (p<0.001) in the TKS values. Considering SF-36 scores, statistically more significant score increases occurred in dry needling groups (Group 1 and Group 3) than in the group that received only balneotherapy treatment (Group 2; p<0.005).

Conclusion: Both dry needling and balneotherapy were effective in improving pain, cervical ROM, depressive mood, anxiety, kinesiophobia, functionality, and quality of life scores in MPS. Combination of these two methods increased the success of the treatment.

Objectives: The aim of this study was to investigate the effect of cervical alignment parameters on outcomes of fluoroscopy-guided cervical interlaminar epidural steroid injection.

Patients and methods: This prospective observational clinical study included 63 patients (40 females, 23 males; mean age: 45.3±9.4 years; range, 24 to 69) with radicular pain due to central/paracentral cervical disc herniation between June 2022 and April 2023. Cervical anteroposterior, lateral, and oblique radiographs were taken before the procedure. The C7 slope, spinocranial angle (SCA), and cervical sagittal vertical axis (cSVA) were measured. Pain intensity was assessed using the Numerical Rating Scale (NRS) before and at three weeks and three months after the procedure. The disability and quality of life were evaluated with the Neck Disability Index (NDI) and the 12-item Short-Form Heath Survey (SF-12).

Results: Considering the outcomes at the three-month follow-up, there were moderate positive correlations between SCA and the improved NRS and NDI scores. Moderate negative correlations were determined between C7 slope and the improved NRS and NDI scores. There were also moderate negative correlations between cSVA and the improved NRS and NDI scores. Regarding the improvement in the physical component summary of SF-12, there was a moderate negative correlation with the C7 slope, a weak negative correlation with the cSVA, and a weak positive correlation with the SCA. The improved mental component summary of SF-12 was weakly positively correlated with SCA and weakly negatively correlated with C7 slope and cSVA.

Conclusion: The C7 slope, cSVA, and SCA are cervical alignment parameters affecting the success of cervical interlaminar epidural steroid injection treatment.

During the novel coronavirus disease 2019 (COVID-19) pandemic, dozens of cases of acute transverse myelitis have been reported, either related to the disease itself or to various types of vaccines. However, rare cases of longitudinal extensive transverse myelitis (LETM) with relatively good prognosis have been reported, particularly after other COVID-19 vaccines, such as adenovirus vector vaccine (Oxford™, AstraZeneca), messenger ribonucleic acid (mRNA) vaccine (BioNTech™, Pfizer) and protein subunit vaccine (Corbevax™, Dynavax). This case report presents the third, worst prognosis and youngest case of LETM documented in the literature in association with an inactivated COVID-19 vaccine. A 39-year-old female patient developed sudden-onset severe cervical and thoracic predominantly paresthesia which rapidly progressed to tetraplegia, widespread sensory loss, bowel and bladder dysfunction two weeks after the second dose of Sinovac™ (Sinovac Biotech) vaccine. Spine magnetic resonance imaging showed LETM from C3 to T3 spinal cord segments. The outcome of this Sinovac™-induced LETM patient, who was inadequately treated with corticosteroids in the acute phase, showed a poor prognosis despite months of neurorehabilitation.

Objectives: This study aims to assess patients' level of satisfaction with physical therapy modalities from different centers in Türkiye.

Patients and methods: In this cross-sectional study, a "Patient Satisfaction Questionnaire in the Treatment with the Physical Therapy Modalities" was created by the Turkish Society of Physical Medicine and Rehabilitation, the Physical Therapy Modalities Working Group and it was applied to a total of 2,466 patients (847 males, 1,619 females; mean age: 51.8±14.6 years; range, 18 to 90 years) from 13 different hospitals. The participants were selected from patients who were treated in the physical therapy and rehabilitation departments of nine universities and four training and research hospitals for musculoskeletal complaints. The questionnaire included questions assessing demographic data, disease characteristics and level of satisfaction with the treatment program. Consecutive patients that were enrolled in treatment programs for musculoskeletal problems were included in the study.

Results: The cumulative rate of patients who were very satisfied and satisfied with these treatments was 54.1%. The higher the education level, the higher the satisfaction rate was. The satisfaction level of the currently employed was higher than that of retirees. The patients who were most satisfied with physical therapy were those who presented with cervical spinal complaints. The rate of patients who never received physical therapy before was 51.5%, indicating higher satisfaction levels. Outpatient physical therapy patients reported higher satisfaction rates than inpatients. The patients conveyed their satisfaction with the therapist performing the treatment and expressed their intention to choose physical therapy again, if necessary.

Conclusion: Patients express high levels of satisfaction with physical therapy modalities, and they encounter minimal or no issues in practice.

Objectives: This study aims to investigate whether exercise capacity changes following coronavirus disease 2019 (COVID-19), to clarify its relationship with age, sex, physical activity, disease severity, and comorbidities, and to identify the factors affecting exercise capacity.

Patients and methods: Between June 2021 and June 2022. A total of 132 participants (61 males, 71 females; mean age: 43.3±12.4 years; range, 24 to 74 years) who were older than 18 years and had a history of COVID-19 were included at least 30 days after the recovery of all COVID-19 symptoms. The International Physical Activity Questionnaire-Short Form, six-minute walk test, pulmonary function tests, and cardiopulmonary exercise test were performed.

Results: Of the study population, 23.1% had decreased exercise capacity 86 days after the COVID-19 diagnosis. Younger age (p=0.049), male sex (p=0.003), and disease severity (p=0.007) were related to lower VO_2max (adjusted R² =0.132, p<0.001). Compared to individuals with normal exercise capacity, in those with decreased exercise capacity, vital capacity (p<0.001), forced vital capacity (p=0.002), forced expiratory volume in 1 sec (p=0.006), and maximum voluntary ventilation (p=0.027) were lower, and the anaerobic threshold was reached earlier (p<0.001).

Conclusion: The exercise capacity of certain individuals was low nearly three months after COVID-19. Younger age, male sex, and COVID-19 severity were related to low exercise capacity. Respiratory dysfunctions and physical inactivity-induced deconditioning were the factors affecting exercise capacity.

Lymphedema in children and young people (CYP) is a complex condition which impacts multiple aspects of their lives. Addressing these challenges requires a multidisciplinary approach, including medical treatment, psychological support, and social inclusion strategies. By understanding and managing the physical symptoms and providing emotional and social support, healthcare providers, families, and communities can help improve the quality of life for CYP living with lymphedema. Early intervention and ongoing care are crucial to minimizing its impact and supporting their overall wellbeing.

Objectives: This study aims to examine the clinical effects of the continuous mobility training in participants with prolonged mechanical ventilation.

Patients and methods: Between February 2023 and June 2023, this randomized-controlled study included a total of 56 participants (33 males, 23 females; mean age: 70.1±15.9 years; range, 35 to 91 years) who were randomly assigned with 28 participants in the experimental group and 28 participants in the control group. The experimental group underwent routine ventilator weaning plan and continuous mobility training plan. The control group underwent the routine ventilator weaning plan and hand bicycle training. The length of mechanical ventilation, length of stay at the respiratory care center, total length of hospital stay and success rate of ventilator weaning were analyzed.

Results: The mean length of mechanical ventilation (17.1±10.5 vs. 29.0±13.4 days, p=0.000) and stay at the respiratory care center (21.5±9.6 vs. 34.8±14.6 days, p=0.000) were shorter in the experimental group than the control group, indicating statistically significant differences. The mean total length of hospital stay of the experimental was shorter than the control groups (59.3±21.5 vs. 70.5±24.4 days), indicating a statistically significant difference (p=0.075). The success rate of ventilator weaning in the experimental group and control group were 89.3% and 67.9%, respectively, without statistically significant difference (p=0.051).

Conclusion: The continuous mobility training in individuals with prolonged mechanical ventilation can reduce the length of mechanical ventilation and stay at the respiratory care center, but has no significant benefit for the total length of hospital stay and the success rate of ventilator weaning.