Turkish Journal of Physical Medicine and Rehabilitation最新文献

Objectives: This study aims to investigate and compare the treatment efficacy of extracorporeal shockwave therapy (ESWT) and high-intensity laser therapy (HILT) regarding pain management and functionality in patients with de Quervain tenosynovitis (DQT).

Patients and methods: Between May 2022 and November 2022, a total of 60 patients with DQT (16 males, 34 females; mean age: 43.3±7.7 years; range, 18 to 65 years) were included in this study. The patients were randomly divided into two groups as follows: Group A (ESWT, n=29) and Group B (HILT, n=31). The patients were asked to refrain from all types of exercise 24 h before the experiment. The pain level of the patients at the time of presentation was evaluated via Visual Analog Scale (VAS), and the function outcome was evaluated with Quick Disabilities of Arm, Shoulder and Hand (QDASH) before and after the treatment. Muscle strength was evaluated with a Jamar hand dynamometer, and an algometer was used to measure pressure pain threshold (PPT). The Global Assessment Scale (GAS) was used to measure the treatment success.

Results: The intragroup comparisons revealed significant improvements in all parameters after the treatment in both groups (p<0.05). The VAS-rest score, the VAS-movement score, the QDASH score, pain-free grip strength (PFGS), and PPT showed a significant difference before treatment at three weeks and three months (p<0.01). The difference between the PPT values of the groups at three weeks was significant (p<0.01). The third-week PPT value of Group B was higher than the PPT value of Group A. The difference between GAS 1 and GAS 2 of both groups was statistically significant at three weeks and three months (p<0.05).

Conclusion: Both ESWT and HILT treatments are safe and effective in DQT treatment. The ESWT is a recent, non-invasive therapeutic modality which is effective, convenient, and safe in DQT. On the other hand, HILT is a non-invasive, reliable method which has a greater effect on DQT.

Objectives: This study aimed to investigate the effects of different carrier frequencies of interferential current (IFC) treatment on a Visual Analog Scale (VAS) for pain, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 10-m walk test, and the amount of paracetamol taken.

Patients and methods: The double-blind, randomized controlled study included 61 patients (16 males, 45 females; mean age: 63.7±9.8 years; range, 50 to 80 years) with knee osteoarthritis who were randomized to three treatment groups: 2,000 Hz, 4,000 Hz, and 8,000 Hz. The study was conducted between February 2019 and October 2019. Subjects received IFC treatment for 20 min five times per week for three weeks. All subjects were prescribed a home exercise program. Patients were evaluated at baseline and at three and seven weeks. The primary outcome was VAS to assess knee pain.

Results: Treatment with IFC yielded significant results in VAS pain, WOMAC pain, and WOMAC function parameters in all three groups, but no significant difference was shown among the three groups. The WOMAC stiffness parameter was found to benefit from the treatment only in the first group, while the 10-m walk test improved for the first and third groups. The number of paracetamol tablets taken differed significantly neither in nor among the treatment groups.

Conclusion: Previous trials have found a significant reduction in knee pain levels and an increase in function with IFC treatment, although there is no consensus on which carrier frequencies and duration to choose for IFC treatment. In this study, we detected significant benefits for all the different carrier frequency groups but were not able to show any to be superior to the others.

Objectives: This study aimed to evaluate the accuracy of four clinical tests confirmed by ultrasonography (USG) and to evaluate the role of age, sex, handedness, subcutaneous tissue thickness (STT), tendon thickness (TT), and STT/TT in determining the absence of the palmaris longus muscle.

Patients and methods: In this descriptive study, 282 wrists of 141 healthy individuals (71 females, 70 males; mean age: 29±9.6 years; range, 21 to 55 years) were included between September 2021 and November 2022. The palmaris longus muscle tendon was identified by Schaeffer's test, Mishra's test I, Thompson's test, and Pushpakumar's test and then evaluated with USG. Before the tests, age, sex, and dominant hand information of the individuals were obtained. The STT and TT were measured with USG.

Results: Sensitivity values by side were as follows (right/left respectively): Schaeffer's 92%/73%, Mishra's I 91%/93%, Thompson's 84%/87%, and Pushpakumar's 86%/91%. Specificity values by side were as follows (right/left respectively): Schaeffer's 87%/95%, Mishra's I 78%/82%, Thompson's 78%/79%, and Pushpakumar's 84%/82%. Sensitivity values by sex were as follows (female/male respectively): Schaeffer's 81%/96%, Mishra's I 92%/94%, Thompson's 85%/90%, and Pushpakumar's 91%/92%. Specificity values by sex were as follows (female/male respectively): Schaeffer's 68%/90%, Mishra's I 72%/90%, Thompson's 72%/85%, and Pushpakumar's 78%/85%. The intraclass correlation coefficient between clinical tests and USG was 0.94 for the left side and 0.95 for the right side.

Conclusion: Mishra's test I and Pushpakumar's test can be used in females, while Schaeffer's test and Mishra's test I can be used in males as a mutually supportive clinical test. Furthermore, while there may be false negative and false positive test results due to muscle variations, it should be noted that STT/TT is also effective, particularly on the right side.

Objectives: This study aims to investigate the effect of extracorporeal shock wave therapy (ESWT) and manual therapy (MT) on active trigger points of the sternocleidomastoid muscle (SCM) in patients with cervicogenic headache (CEH).

Patients and methods: A total of 42 patients were included (27 females, 15 males; mean age: 33.2±7.7 years; range, 18 to 45 years) in the randomized controlled trial between March 2022 and December 2022. The patients were randomly divided into the ESWT group (n=21) and the MT group (n=21). Each group received therapy once a week for four weeks. The primary outcome measure was the Visual Analog Scale (VAS), and secondary outcome measures were pressure pain threshold (PPT), Neck Disability Index (NDI), and stiffness (shear elastic modulus) of the SCM measured at baseline, postintervention, and four weeks after treatment.

Results: One patient from the ESWT group was lost to follow-up. The missing data were imputed for intention-to-treat analysis. Significant decreases of VAS, NDI, and shear elastic modulus of SCM were found at postintervention and four weeks after treatment in both groups (p<0.01). The PPT scores markedly increased over time compared to baseline in both groups (p<0.01). The repeated measures of analysis of variance revealed a significant time effect (p<0.001) in each outcome variable for both groups. There were no significant differences between the two groups in VAS, PPT, NDI, and the stiffness of SCM at each time point.

Conclusion: Extracorporeal shock wave therapy and MT were equally effective in pain relief, functional recovery, and reduction of muscle stiffness. Extracorporeal shock wave therapy may be used as an alternative treatment method for CEH patients with active myofascial trigger points of the SCM.

In this case report, the rehabilitation process of a 38-year-old female patient who developed cauda equina syndrome due to spinal manipulation for the treatment of lumbar disc herniation was presented. The aim was to discuss the outcomes of rehabilitation after cauda equina syndrome, as well as the challenges associated with it. Despite the difficulties experienced during the rehabilitation process, a comprehensive multidisciplinary rehabilitation program is beneficial in terms of gaining independence and returning to daily activities, social life, and work for patients with cauda equina syndrome.

Objectives: This study aimed to compare the acute effects of radial extracorporeal shockwave therapy (r-ESWT) and focused extracorporeal shockwave therapy (f-ESWT) on pain, muscle strength, and function in patients with lateral epicondylitis (LE).

Patients and methods: Fifty-six patients (31 males, 25 females; mean age: 44.6±8.4 years; range, 19 to 60 years) who were diagnosed with LE participated in the randomized study between August 2023 and October 2023. The patients were stratified by pain level to have four r-ESWT or f-ESWT treatments once a week. Patients were evaluated on the first day of treatment and one week after the last treatment. The outcome measures used were the Visual Analog Scale for pain, isokinetic dynamometer for wrist muscle strength measurement, the DASH (Disabilities of the Arm, Shoulder, and Hand) score for functional status, and the 36-item Short-Form Health Survey (SF-36) for health-related quality of life.

Results: After the treatment, the pain at rest and during activity decreased in both groups (p=0.018, p=0.001, p=0.003, and p<0.001). Nocturnal pain was found to be lower in the f-ESWT group (p=0.028). The isokinetic muscle strength of the wrist extensors was higher in the r-ESWT group compared to the f-ESWT group (p=0.002 and p=0.017). The DASH performance score of the r-ESWT group was higher compared to the f-ESWT group (p=0.009). Both groups showed improvements in SF-36 scores (p<0.05).

Conclusion: Both groups showed a decrease in pain levels, but the effects were superior in the f-ESWT group. However, r-ESWT was found to present better results in terms of its effect on isokinetic muscle strength. While f-ESWT may be more effective in reducing pain, r-ESWT may be more effective in increasing muscle strength.

Objectives: The aim of this study was to investigate the effect of neck exercises in addition to vestibular rehabilitation treatment in unilateral peripheral vestibular system (PVS) diseases accompanied by neck pain and to evaluate the relationship between neck pain severity and clinical balance parameters in this patient population.

Patients and methods: In this prospective, randomized-controlled study, a total of 70 patients (30 males, 40 females; mean age: 52.6±14.9 years; range, 37 to 68 years) who were diagnosed with unilateral PVS disease with concomitant neck pain were included between September 2019 and May 2022. The patients were randomized into two equal groups. Group 1 (n=35) received a vestibular rehabilitation program for four weeks, and Group 2 (n=35) received neck exercises in addition to the standard rehabilitation protocol. As the compensation improved in the vestibular rehabilitation treatment, additional compelling exercises were added to the program. At Week 4, all patients were evaluated with clinical parameters including the severity of balance, neck pain, dizziness, Dizziness Handicap Inventory (DHI), Functional Gait Assessment (FGA), Activity-specific Balance Confidence (ABC) scale, Dynamic Gait Index (DGI), Berg Balance Scale (BBS), Timed Up-and-Go (TUG) test, Falls Efficacy Scale (FES)-International, postural stability, and Neck Disability Index (NDI).

Results: After the rehabilitation program, a statistically significant improvement was observed in all clinical parameters in both groups (p<0.05). Compared to Group 1, there was a statistically significant difference in all other clinical parameters in Group 2, except for the two parameters: the Romberg eye-open time and TUG test (p<0.05). A significant correlation was found between the severity of neck pain and the severity of dizziness, BBS, DHI, FGA, and NDI (p<0.05).

Conclusion: Neck exercises may yield positive clinical outcomes when combined with vestibular rehabilitation and should be taken into consideration for planning rehabilitation program in patients with unilateral PVS disease and neck pain.

Objectives: This study aims to assess the impact of a Tai Chi exercise program (TCEP) on pain, spinal flexibility, muscle strength, stability and balance, functional status, and quality of life (QoL) among home-dwelling patients with osteoarthritis (OA) or inflammatory arthritis (iA).

Patients and methods: Between October 2018 and April 2019, a total of 28 participants (4 males, 24 females; median age: 62 years; range, 34 to 79 years) who completed the training program participating in at least 18 sessions were included. The TCEP consisted of 50 sessions for 60 min twice a week. The average attendance rate was high (78%, 39 sessions).

Results: Chest mobility (breathing index, p<0.001), sagittal mobility of cervical (p<0.001), thoracic (p=0.009), and lumbar spine (Schober's test, p<0.001) improved significantly in participants with OA and iA. The improvement in functional status was significant only in participants with OA (Lequesne index, p=0.014). Although the change in Lequesne index was statistically significant, the median value remained in the range of severe disability and the change did not reach the minimal clinically important difference. Although the trends were positive, the changes in pain (Visual Analog Scale pain, p=0.599), stability and balance (functional reach test, p=0.341), muscular strength (wall sit test, p=0.069), and health-related QoL (15D, p=0.065) were non-significant in participants with OA and iA.

Conclusion: Our study results suggest that a 25-week TCEP is safe and can improve chest and spinal mobility in home-dwelling individuals with OA or iA.