Turkish Journal of Physical Medicine and Rehabilitation最新文献

Objectives: This study aimed to demonstrate whether a diagnosis given at the asymptomatic stage of patients with DMD can affect the clinical outcomes and to define the clinical characteristics of the patients.

Patients and methods: The cross-sectional study was conducted with 136 male patients (mean age: 8.8±3.7 years; range, 3 to 17 years) with DMD between March 2022 and February 2023. The patients were diagnosed through clinical presentation, pathology studies, and genetic testing. The demographic, clinical, and the laboratory data of the patients were recorded. The patients were evaluated in two groups: those diagnosed at the asymptomatic stage due to elevated creatine kinase (CK) and those diagnosed due to clinical symptoms. Patients were further stratified according to their age groups: those younger than 10 years and those aged 10 years or older. Hand grip, quadriceps muscle strength, and Vignos and Brooke motor functional assessment scales of the two groups were compared.

Results: In patients who were diagnosed with CK levels, CK elevation was significantly more common than other findings. When the age at diagnosis was evaluated, the age at diagnosis in those diagnosed with CK levels was statistically significantly lower than in those diagnosed with clinical findings. No significant difference was detected in clinical findings between the groups under the age of 10 years. Among patients aged 10 years or older, hand muscle strength, quadriceps muscle strength, and Vignos and Brooke motor function scale scores were significantly better in those diagnosed with CK levels compared to those diagnosed with clinical findings.

Conclusion: This study shows that early diagnosis in the preclinical period, which enables earlier medical treatment and rehabilitation, may have a positive effect on motor functions and the course of the disease.

Objectives: The study investigated the influence of starting load position during lifting on postural control in nonspecific chronic low back pain (LBP) and healthy volunteers.

Patients and methods: The cross-sectional study included 20 healthy males (mean age: 31.8±7.4 years; range, 18 to 55 years) and 52 male patients (mean age: 33.4±9.2 years; range, 18 to 55 years) with chronic LBP between February 2016 and April 2018. Postural control characteristics were assessed by a force plate system. Center of pressure signals were obtained at a frequency of 100 Hz, and the mean of three trials was calculated. The participants were told to place their feet hip-width apart on the force plate while standing barefoot. They were then asked to lift a box weighing 10% of their body weight from the ground to waist height and then from waist height to overhead with straight elbows. They moved the box at their selected speed. The examinations began upon the examiner's command.

Results: Results indicated a significant difference (p<0.001) in all postural control variables in chronic LBP patients who lifted a load at different heights. In addition, there was a significant difference between all of the postural control measures of this study in healthy participants during load lifting at different heights (p<0.05), with the exception of the mediolateral standard deviation of velocity (p=0.067).

Conclusion: Different lifting heights impact LBP patients' and healthy people's postural control differently. Postural control was more challenging during waist-to-overhead lifting in the patient group. This may be due to a stiffening strategy. The central nervous system reduces postural sway at higher centers of mass.

Objectives: The study aimed to evaluate the effects of the use of a shoulder sling, shoulder sling with a pillow, or not using a sling on the shoulder functional score and pain levels following arthroscopic rotator cuff tear repair.

Patients and methods: This randomized prospective study was performed with 90 patients (49 males, 41 females; mean age: 56.2±12.2 year; range, 33 to 77 years) with a small-to-mid, full-thickness rotator cuff tear between July 2020 and October 2022. All patients underwent arthroscopic double-row repair. The nonsling group wore no sling, the sling group wore a sling, and the abduction pillow sling group wore a sling with an abduction pillow. The same rehabilitation program was performed. The Visual Analog Scale (VAS) score, Constant-Murley scores, and degrees of flexion and abduction were recorded preoperatively, on the 15^th and 45^th days, and at three months, six months, and one year.

Results: On the 15^th postoperative day, the VAS score was found to be significantly lower in the nonsling group. On the 45^th day, the Constant-Murley score was found to be significantly higher in the abduction pillow sling group. There was no significant difference between the groups regarding the Constant-Murley scores at three weeks, six months, and one year. The shoulder forward flexion angle was significantly lower in the nonsling group on the 45^th day. There was no significant difference between the three groups in respect of the shoulder forward flexion at three months, six months, and one year.

Conclusion: No difference was determined between the groups at the six-month and one-year functional results. Not using a sling bandage can be recommended by reducing pain in the early postoperative period.

Objectives: This study aims to investigate the effects of different kinesiotaping methods on muscle contraction of fatigued biceps.

Patients and methods: Between April 01, 2019 to September 30, 2019, a total of 24 adults (11 males, 13 females; mean age: 31.8±6.1 years; range, 24 to 47 years) were recruited in the study. Each participant needed to receive all four types of tape attachment, including facilitation attachment (from origin to insertion), relaxation attachment (from insertion to origin), cross attachment, and control attachment after fatigue procedure. The order of taping approaches was randomly assigned. The outcome parameters were maximal isometric contraction strength, peak contraction speed, maximal 10-s power, and isokinetic contraction work.

Results: The results revealed no significant differences among the four tape attachment methods for any of the parameters. However, the facilitation attachment exhibited the highest trend of improvement in all muscle contraction performance during fatigue, and the cross attachment exhibited the lowest trend of improvement in maximal isometric contraction and speed.

Conclusion: None of the kinesiotape attachment methods significantly enhanced the contraction of fatigued muscles regardless of the attachment direction, including origin to insertion, insertion to origin and cross. Facilitation attachment exhibited the most effective trend of improvement and is, therefore, recommended for clinical applications. Cross attachment was not suggested to use due to the least effective trend.

Objectives: The study aimed to determine the level of health literacy in patients with knee osteoarthritis and investigate the relationship between health literacy and exercise approaches and physical therapy use.

Patients and methods: The cross-sectional study included 203 patients (143 females, 60 males; mean age: 63.5±9.2 years) between November 2018 and September 2019. Sociodemographic data, exercise habits, the number of applications to the physical medicine and rehabilitation outpatient clinic, and physical therapy applications were recorded. The Turkish Health Literacy Scale-32 (THLS-32), was used to determine health literacy. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used to evaluate pain and physical function. The relationship between THLS-32 and the number of admissions to the outpatient clinic, the number of physical therapy applications, exercise frequency, and WOMAC scores were investigated.

Results: The median THLS-32 of the patients was 33.8 (13-46.8). A statistically significant negative correlation was found between THLS-32 scores and the number of admissions to the physical medicine and rehabilitation outpatient clinic for knee pain in the last year, the number of physical therapies, the exercise frequency, and total WOMAC scores.

Conclusion: Increasing health literacy strengthens the capacities and participation of patients, reduces the costs of physical therapy, as well as medication costs, and consequently increases efficiency in the use of health services.

Objectives: The primary objective of this study was to assess and compare the response to the breast cancer-related lymphedema (BCRL) treatment with Breast Cancer-Related Lymphedema of the Upper Extremity (CLUE) scores, bioimpedance spectroscopy (BIS), and the volume-assessments /measurements. The secondary objective of the study was to investigate whether CLUE played a role in the treatment response and to examine its correlation with the other measures of lymphedema.

Patients and methods: Between January 2019 and June 2019, a total of 40 patients (2 males, 38 females; mean age: 57.8±12.5 years; range, 45 to 70 years) who were diagnosed with unilateral Stage 2-3 BCRL and underwent treatment were included. The patients' upper extremity volumes were assessed and the patients were evaluated with the CLUE score, the Disabilities of the Arm, Shoulder, and Hand Outcome Measure (QuickDASH) score, BIS, and hand grip strength before and after the complete decongestive therapy.

Results: Correlation analyses revealed that CLUE total score and BIS values were correlated with the reduction in the volumes (p=0.04 and p<0.001, respectively). The CLUE total score was also found to be positively correlated with the BIS values (p<0.001). Hand grip strength and QuickDASH scores were not found to be correlated with the changes in the volume and CLUE total scores.

Conclusion: The development of a structured clinical assessment such as CLUE provides clinicians for a standardized evaluation for BCRL. The diagnosis of subclinical lymphedema can be detected earlier by using the BIS and CLUE scale and lymphedema comorbidity and treatment costs can be reduced.

Objectives: This study aims to evaluate the monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), plateletto-lymphocyte ratio (PLR), and C-reactive protein (CRP)-to-albumin ratio levels between individuals with mild to moderate knee osteoarthritis (OA) and those with severe knee OA.

Patients and methods: One hundred eighty-two participants (131 females, 51 males; mean age: 67.7±10.2 years; range, 43 to 91 years) affected by knee OA were involved in the cross-sectional retrospective study between January 2018 and January 2021. Kellgren and Lawrence (K-L) classification was performed in accordance with two-view (lateral and anteroposterior) plain radiograph examinations of each knee. The patients were grouped as follows: 98 patients had mild to moderate knee OA (K-L Grades 1-2), and 84 had severe knee OA (K-L Grades 3-4). Demographic data, neutrophil, monocyte, platelet, and lymphocyte levels, erythrocyte sedimentation rate, albumin, and CRP levels were documented. C-reactive protein-to-albumin ratio, NLR, MLR, and PLR levels were calculated.

Results: The MLR was significantly elevated in the severe knee OA group (p=0.047). A significant positive relationship was found with disease stage, MLR (r=0.206; p=0.005), and NLR levels (r=0.158; p=0.033). Receiver operating characteristic curve analyses for blood MLR demonstrated a sensitivity of 57% and specificity of 60%.

Conclusion: The study results suggest that while MLR and NLR may reflect the inflammatory response in knee OA, they are not highly diagnostic inflammatory markers that can be used to evaluate the severity or prognosis of the disease.

Objectives: The aim of this study was to investigate the relationship between serum adiponectin and leptin levels, which are cytokines released from fatty tissue, and pain, function and intervertebral disc degeneration (IVDD).

Patients and methods: Between January 2018 and November 2019, a total of 85 patients (34 males, 51 females; mean age: 42.1±10.7 years; range, 18 to 62 years) who were diagnosed with IVDD and 84 healthy volunteers (34 males, 50 females; mean age: 41.9±10.7 years; range, 22 to 64 years) were included in this cross-sectional study. The Visual Analog Scale (VAS, 0-10 cm) and Oswestry Disability Index (ODI) scales were used in the patient group. Serum adiponectin and leptin levels were measured in all participants. The grading of IVDD was determined using the Pfirrmann Classification.

Results: There was no significant difference in serum adiponectin (p=0.35) and leptin (p=0.19) levels between the patient group and the control group. No relationship was found between serum adiponectin and leptin levels and pain intensity (VAS), pain duration, and disability (ODI) in patients with low back pain. No relationship was found between the severity of IVDD as evidenced by magnetic resonance imaging (MRI) and adiponectin (p=0.18) and leptin (p=0.11) levels. There was a positive correlation between the severity of disc degeneration and body mass index (r=0.35, p=0.008) and waist circumference (r=0.34, p=0.01).

Conclusion: Serum adipokine levels were not associated with low back pain symptoms and IVDD severity as evidenced by MRI. These findings suggest that the effects of obesity on chronic low back pain and disc degeneration cannot be explained by systemic inflammatory effects alone.

Objectives: The purpose of the study was to validate the effectiveness of inspiratory muscle training (IMT) in preventing poststroke sarcopenia and to examine the impact of IMT on the prognosis for stroke recovery.

Patients and methods: In the randomized controlled trial, 367 patients with a first stroke event between December 2021 and May 2023 were randomly allocated to an experimental group and a control group. Of the patients, 329 (179 males, 150 females; mean age: 61.0±8.7 years; range, 35 to 78 years) completed the experiment and were included in the analyses (experimental group, n=164; control group, n=165). Both groups received conventional neurological rehabilitation treatment, and the experimental group also received IMT. The incidence of poststroke sarcopenia and pneumonia during four weeks of treatment were examined and compared. Additionally, an analysis was conducted on the variations between the two groups in maximal inspiratory pressure (MIP), modified Rankin scale (mRS), trunk impact scale (TIS), and modified Barthel index (MBI).

Results: Following four weeks of therapy, the experimental group experienced a reduced incidence of poststroke sarcopenia (p=0.004) and pneumonia (p=0.017) than the control group. The trial group performed better than the control group in MBI (p=0.002), TIS (p<0.001), MIP (p<0.001), and mRS (p=0.011) scores after intervention.

Conclusion: In conclusion, the findings demonstrate that early IMT can significantly lower the risk of poststroke sarcopenia and pneumonia while also improving the prognosis for stroke patients' recovery.