Turkish Journal of Physical Medicine and Rehabilitation最新文献

Objectives: This study aims to investigate the effectiveness of Rocabado exercises in patients with rheumatoid arthritis (RA) in remission with temporomandibular joint (TMJ) involvement.

Patients and methods: Between May 2023 and July 2023, a total of 42 patients (4 males, 38 females; mean age: 47.8±13.9 years; range, 21 to 73 years) were included in this single-center, single-blind, randomized-controlled study. Only the RA patients in remission for at least three months, with TMJ complaints and who had TMJ involvement detected by magnetic resonance imaging (MRI) were included. The patients were randomized into the Rocabado exercise group (n=21) and standard TMJ exercise group (n=21). The home-based exercise programs for both groups continued for six weeks. A Visual Analog Scale (VAS) was used to evaluate pain. The TMJ examination findings were recorded. The maximum interincisal distances were measured. To evaluate the quality of life, the patients were asked to fill the Turkish Oral Health Impact Profile-14 (OHIP-14).

Results: Demographic and baseline characteristics were similar between the groups. Standard TMJ exercises group showed an improvement only for OHIP-14 after treatment. Rocabado exercises group showed a statistically significant improvement for interincisal distance, OHIP-14, VAS pain, number of patients with limited mouth opening, TMJ pain with palpation, and pterygoid pain with palpation after treatment.

Conclusion: Our study results indicate that Rocabado exercises may be effective in RA patients with TMJ involvement in relieving pain and improving the quality of life due to oral health.

Objectives: This study aimed to compare the treatment outcomes between dorsal root ganglion (DRG) pulsed radiofrequency (PRF) and DRG PRF plus transforaminal epidural steroid injection (TFESI) in patients with chronic lumbosacral radicular pain.

Patients and methods: Eighty-one patients (39 males, 42 females; mean age: 57.5±11.9 years; range 18 to 65 years) who underwent DRG PRF (Group 1) and 59 patients (34 males, 25 females; mean age: 58.7±12.3 years; range 18 to 65 years) who underwent DRG PRF plus TFESI (Group 2) between February 2021 and June 2022 were enrolled in the retrospective study. A Visual Analog Scale (VAS) was used to assess pain severity. Patients in both groups were evaluated before treatment and at four weeks and six months after treatment.

Results: The four-week and six-month VAS scores were significantly lower than the baseline VAS scores in both groups. There was no significant difference between the groups in terms of the VAS scores at baseline, four weeks, and six months. There was no significant difference between the groups in terms of the rate of pain reduction of 50% or more at either measurement point. The presence or absence of a previous lumbar surgery had no effect on achieving a significant decrease in pain.

Conclusion: Although DRG PRF and TFESI are easy to apply together, adding corticosteroids to DRG PRF treatment for patients with chronic radicular pain did not improve long-term outcomes.

Objectives: The present study aimed to analyze the effect of high-frequency, low-magnitude whole-body vibration (WBV) therapy in horizontal position on bone, quality of life, pain, and balance in postmenopausal women.

Patients and methods: Sixty postmenopausal women were included in this prospective, randomized controlled study between May 2015 to September 2015. The patients were randomized into three groups, with 20 participants in each group: (i) WBV + infrared group, (ii) infrared group, and (iii) control group. Bone mineral density of the lumbar and femoral regions of all the patients was measured using dual-energy X-ray absorptiometry. In addition, osteocalcin and hydroxyproline values were measured. Quality of life was assessed using the Short Form-36, pain was assessed using the Visual Analog Scale, and balance was assessed based on the participants' performance in the Berg balance test.

Results: Seven patients (two from the vibration + infrared group and five from the infrared group) could not continue the study, and the analyses were conducted with the remaining 53 patients (mean age: 56.9±5.1 years; range, 45 to 65 years). At the end of a three-month treatment period, no statistically significant difference was found in bone mineral density, bone turnover markers, pain, and quality of life of the patients in all three groups compared to the pretreatment values. Berg balance test results showed a statistically significant increase after treatment in all three groups.

Conclusion: High-frequency, low-magnitude WBV performed under supervision in postmenopausal women was not found to be effective in improving bone, quality of life, pain, and balance. Future studies for determining effective vibration protocols having a longer duration and higher frequency of sessions are warranted.

Objectives: This study aims to assess the effect of short-wave therapy (SWT) devices emitting radiofrequency (RF) waves on the proliferation rates of fibroblasts and neoplastic cells.

Patients and methods: In this experimental study, fibroblasts cultured from sternal mesenchymal cells of a bypass surgery patient were enriched using stem cell techniques between January 2004 and February 2004. The K-562 and ML-1 neoplastic cell lines were prepared for analysis. Fibroblasts and neoplastic cell lines were exposed to 27.12 MHz short-waves at different energy levels. Continuous short-wave (CSW) was applied at 200 W power, and pulsed short-wave (PSW) was applied at three different mean powers: 1.6 W (PSW-1), 14.9 W (PSW-2), and 54 W (PSW-3). Fibroblast colonies were counted using inverted microscopy, and neoplastic cell proliferation rates were measured using enzyme-linked immunosorbent assay. All short-wave-exposed cells were compared to the controls with no exposure.

Results: Short-waves increased the number of fibroblast colonies three- to four-fold across all power levels (1.6 W, 14.9 W, 54 W, and 200 W). They significantly increased K-562 cell proliferation only at 1.6 W and 54 W power levels (p=0.044 and p=0.004, respectively). In contrast, there was no significant increase in ML-1 cell proliferation at any power level tested (p>0.05).

Conclusion: This study found that short-waves can boost fibroblast proliferation, potentially aiding tendon healing. However, it also had unpredictable proliferative effects on K-562 cells, as an inconsistent correlation with energy levels was observed. The ML-1 cells were not affected by short-waves, suggesting variability in tumor biology. These findings emphasize the need for precise dosing and personalized treatment strategies when using SWT devices.

Objectives: This study aims to evaluate the efficacy of combined pulsed electromagnetic field (PEMF) treatment and physical therapy on pain, stiffness, and functional limitation in patients with knee osteoarthritis (OA).

Patients and methods: In this double-blind, randomized-controlled study, a total of 70 female patients with primary knee OA (mean age: 59.74±9.82 years; range, 40 to 80 years) were randomly allocated into PEMF and sham groups between March 2014 and July 2015. Both groups received 15 sessions of physical therapy over three weeks. Additionally, the PEMF group received PEMF treatment for 30 min/day, while the control group received sham PEMF. The patients were assessed by the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the Physician Global Assessment (PGA) scale before and three and seven weeks after treatment.

Results: Regardless of the group, all patients' pain levels were significantly improved in both scales at three and seven weeks after treatment (p<0.001). The PEMF group had significantly less pain than the sham group based on the VAS score (p=0.003). The PEMF group had significantly lower functional limitation and stiffness at seven weeks (p=0.008). Recovery ratios based on the PGA score were significantly higher in the PEMF group both at three and seven weeks (p<0.05).

Conclusion: Patients with knee OA who receive PEMF therapy in addition to physical therapy have more pain reduction and physical improvement. Based on these findings, PEMF is a safe and well-tolerated treatment of choice in this patient population.

Objectives: This study aims to investigate the effects of core and routine training on joint function, anterior tibia translation and balance in patients with knee joint injury.

Patients and methods: Between March 2021 and March 2022, a total of 70 patients (49 males, 21 females; mean age: 31.2±5.3 years; range, 17 to 44 years) with knee ligament injury or meniscus injury were included. The patients were divided into core training group (n=35) and conventional training group (n=35) by matching method. During the recovery process, the regular training group performed routine training, whereas the core training group engaged in core training. Both groups were trained for a total of eight weeks. After training, the Visual Analog Scale (VAS), knee Lysholm score, KT-2000 tibial anterior translation, and the star excursion balance test (SEBT) results were collected.

Results: The mean VAS scores in both groups were decreased from baseline values. The mean Lysholm score increased from baseline data; the degree of tibial anterior translation decreased compared with baseline data (p<0.05). The mean SEBT scores showed significant improvement over baseline data. In contrast with the routine training group, the mean VAS score of core training was lower and the total score of Lysholm was higher (p<0.05). When bending the knee at 90°, the mean tibial anterior translation was 3.87±1.23 mm in the core training group, significantly lower than in the regular training group (p<0.05). The SEBT results showed that, after eight weeks of training, healthy and injured legs in core training group exceeded those of the regular training group in the farthest distance (p<0.05).

Conclusion: Our study results indicate that core training is more successful than regular training in reducing pain, and it can ameliorate the dynamic balance stability of patients with knee injury.

Objectives: The aim of this study was to investigate the correlation between the use of real acupuncture and the quantities of intracellular oxidized, reduced, and total glutathione, as well as clinical indices including pain, depression, and quality of life in patients diagnosed with fibromyalgia syndrome (FMS).

Patients and methods: Between June 2019 and January 2020, a total of 52 female patients (mean age: 45.5±7.5 years; range, 30 to 56 years) who suffered from FMS and 26 healthy females (mean age: 44.2±6.8 years; range, 29 to 52 years) were included in a prospective manner. The patients were divided into two groups: those who received real acupuncture (n=26) and those who received sham acupuncture (n=25). The clinical features of the subjects were assessed at three time points: before therapy (T0), after the last session of treatment (T1), and one month following intervention (T2). The levels of intracellular oxidized, reduced, and total glutathione were assessed in whole sample at two time points, T0 and T2.

Results: At time T0, the quantity of intracellular oxidized, reduced, and total glutathione were higher in FMS patients than the control group, indicating higher levels of oxidative stress (p=0.001). In the group that received real acupuncture, there was a notable increase in the levels of intracellular oxidized, reduced, and total glutathione in T2 compared to T0. The difference in antioxidant activity was statistically significant (p=0.001). While comparing the percentage alterations in clinical variables and oxidative stress indicators between the real and sham groups at T0 and T2, the differences in the real acupuncture group were much higher (p=0.001).

Conclusion: Our study results indicate that real acupuncture may have an effect on the oxidative homeostasis in individuals with FMS.

Objectives: This study aims to investigate the curative efficacy of acupuncture on knee osteoarthritis (KOA) and its improvement on related scores and blood indexes.

Patients and methods: Between January 2019 and January 2020, a total of 108 patients (48 males, 60 females; mean age: 61.0±6.8 years; range 43 to 79 years) with KOA were randomly divided into control group (n=54) and patient group (n=54). Both groups received standard treatment, including adequate rest and exercise and oral celecoxib capsules. The patient group performed acupuncture operations on the Inner knee eye (EX-LE4), outer knee eye (EX-LE5), Yanglingquan (GB34), and Zusanli (ST36). In the control group, three non-acupuncture points were determined for sham acupuncture. The level of Michel Lequesne index of severity for osteoarthritis (ISOA) score, Visual Analog Scale (VAS), Lysholm Knee Score Scale (LKSS), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-1beta (IL-1β), IL-6, transforming growth factor-beta (TGF-β), insulin-like growth factor-1 (IGF-1), fibroblast growth factor-2 (FGF-2) and p38 mitogen-activated protein kinase (p38 MAPK) were compared before and after treatment.

Results: The reduction of inflammatory markers in the patient group was greater than that in the control group after treatment. The levels of cytokines such as TGF-β, IGF-1, and FGF-2 were significantly increased after treatment, and the levels in the patient group were higher than those in the control group during the same period. In addition, p38 MAPK messenger ribonucleic acid (mRNA) was significantly downregulated after treatment, and the level in the patient group was lower than that in the control group during the same period.

Conclusion: Acupuncture combined with standard treatment can effectively promote the relief of symptoms and the improvement of knee joint function and effectively inhibit the expression of p38 MAPK signaling pathway.

Objectives: The study aimed to determine the reliability and cross-cultural validation of the Turkish translation of the Spinal Cord Injury Secondary Conditions Scale (SCI-SCS) in individuals with spinal cord injuries (SCIs).

Patients and methods: After the translation/validation process, the SCI-SCS was administered to 93 patients (69 males, 24 females; mean age: 47.9±14.3 years; range, 18 to 78 years) with SCI, diagnosed according to the American Spinal Injury Association impairment scale (grades from A to D), with at least one year after the injury, recruited between December 2022 and July 2023. Fifty-seven patients rated the SCI-SCS two to three days apart to investigate the test-retest reliability. Correlations between the first rates of the SCI-SCS and the Spinal Cord Independence Measure III (SCIM-III), Spinal Cord Injury Spasticity Evaluation Tool, Penn Spasm Frequency Scale, 36-item Short Form Health Survey (SF-36), Beck Depression Inventory, Beck Anxiety Inventory, and the pain-DETECT questionnaire were investigated for the evaluation of convergent validity.

Results: There were 65 patients with paraplegia and 28 patients with tetraplegia. The SCI-SCS showed good internal consistency (alpha=0.753). The three-factor model demonstrated a good fit to the data (relative chi-square=1.12, comparative fit index=0.981, Tucker-Lewis index (TLI)=0.977, root mean square error of approximation=0.037, standardized root mean square residual=0.120). The test-retest reliability was excellent, with an intraclass correlation coefficient of 0.79 (95% confidence interval 0.67-0.87). There were statistically significant correlations between the total SCI-SCS and all other administered questionnaires, except for the social function, emotional, physical, and general health domains of SF-36 and the self-care, total, and mobility subscales of SCIM-III.

Conclusion: The study demonstrated that the 14-item SCI-SCS represents a valuable scale for the assessment of secondary conditions among the Turkish population with SCI.

Thousands died in the Kahramanmaraş-centered earthquake in February 2023, and even more were injured. Some were administered transdermal fentanyl patches (TFPs) due to severe pain. Two pediatric patients, both severely injured victims of the earthquake, developed dependence on TFPs and experienced difficulties during the cessation of fentanyl treatment. The first child was discharged while still being administered fentanyl after four months. In the second case, TFPs could be ceased after four months. This study aimed to emphasize that TFPs can lead to dependence in pediatric patients as well; hence, they should be used more carefully to avoid any potential dependency.