Turkish Journal of Physical Medicine and Rehabilitation最新文献

Objectives: This study aims to investigate the effect of the hot pack application on the morphology of healthy median and ulnar nerves.

Patients and methods: Between August 2021 and September 2022, a total of 54 healthy volunteers (17 males, 37 females; mean age: 31.9±9.4 years; range, 21 to 63 years) were included in the study. The cross-sectional area (CSA) and depth of the right median and ulnar nerve were measured using ultrasonography before and after 20-min hot pack application. The right median nerve CSA and depth from the level of the scaphoid bone (at the level of the carpal tunnel) and from the mid-forearm were also measured. The right ulnar nerve CSA and depth from the level of the hook of hamate and the mid-forearm were evaluated. The depth measurements between the skin and the outer hyperechoic border of the nerve were performed.

Results: After the hot pack application, there was an increase in both the median nerve CSA at the carpal tunnel (from 0.06±0.01 to 0.09±0.02 cm² ) and forearm (from 0.06±0.02 to 0.09±0.02 cm² ) levels (p<0.001) and the ulnar nerve CSA at the hook of hamate (from 0.04±0.03 to 0.06±0.01 cm² ) and forearm (0.05±0.01 to 0.08±0.02 cm² ) levels (p<0.001). No statistically significant difference was observed between the pre- and post-application depth measurements (p>0.05).

Conclusion: Our study results show that the hot pack application leads to acute swelling of the median and ulnar nerves. In future studies, the relationship between morphological changes in healthy and pathological nerves and electrodiagnostic findings should be investigated.

Objectives: The aim of this study was to evaluate the results of the construct validity of the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Multiple Sclerosis (MS) and to identify the impact of MS on specific health domains according to the ICF categories in Turkish individuals.

Patients and methods: Between December 2011 and December 2012, a total of 150 individuals with MS (69 males, 81 females; mean age: 39.8±8.0 years; range, 19 to 52 years) who were diagnosed by a neurologist at least six months previously were included. The Comprehensive ICF Core Set for MS was used to assess functioning, disability, and environmental factors in all participants. The Spearman correlation coefficient was used to determine construct validity of the ICF Core Set between the ICF components and disease-specific and general measurements.

Results: The most frequently coded impairments in the body functions component were b280 sensation of pain, b134 sleep functions, b1301 motivations, and b740 muscle endurance functions. The most frequently coded impairments in the body structures component were s110 structure of brain, s120 spinal cord and related structures and s750 structure of lower extremity. A significant problem was documented in 47 of the 53 categories of the activities and participation. Of the 38 categories in the environmental factors, 23 were identified as a facilitator, while 12 categories were identified as a barrier. All body function, structure, activities and participation and environmental factors categories showed a significant correlation with disease-specific and generic measures.

Conclusion: Based on these results, the ICF Core Set may help to determine major facilitators or barriers to functioning and disability and a targeted rehabilitation approach in patients with MS.

Functional leg length discrepancy results from soft tissue tightness or weakness across any joint in the lower extremity or spine. Herein, we present a 23-year-old female patient with leg length discrepancy due to a nontraumatic myositis ossificans (MO). Interpretation of the imaging findings is quite decisive in diagnosing soft tissue pathologies. It is particularly valid for MO to differentiate from other malignant or infectious lesions. There is no consensus on the treatment of nontraumatic MO. Although there are studies stating the contrary, surgical interventions should be considered as second option for patients who failed with nonsurgical treatments such as physical therapy.

Compartment syndrome can be defined as an increase in pressure in an anatomical compartment in the body resulting in muscle and nerve damage. Acute compartment syndrome mostly develops after crushing traumas and fractures to the extremities and is a condition that requires urgent intervention. Fasciotomy of the affected extremity segment in the early stage of the compartment syndrome is the gold standard in treatment of crush injury. Rehabilitation after fasciotomy is extremely important in regaining extremity functions. In this review, we discuss current approaches to compartment syndrome and rehabilitation principles following fasciotomy.

Objectives: This study aims to compare the effectiveness of pulsed and continuous modes of therapeutic ultrasound (US) for phonophoresis in the treatment of subacromial impingement syndrome (SAIS). Patients and methods: Between April 2019 and January 2021, a total of 66 patients with SAIS (17 males, 49 females; mean age: 48.2±8.6 years; range, 19 to 64 years) were included. The patients were randomized to the phonophoresis with continuous mode group (n=22), phonophoresis with pulsed mode group (n=22), and phonophoresis with sham US group (n=22). Five grams of ibuprofen phonophoresis was applied in five sessions per week for three weeks for all groups. Primary outcomes were pain intensity as assessed by the Visual Analog Scale (VAS) and shoulder functions by the short version of Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH). The secondary outcome was the quality of life as assessed by the Nottingham Health Profile (NHP). All patients were evaluated at pre-treatment, post-treatment, and at three months after the end of the treatment. Results: There was a significant improvement in pain during activity, shoulder function, and quality of life after treatment in phonophoresis with continuous and pulsed modes compared to phonophoresis with sham US (p <0.05). Phonophoresis with continuous mode was superior to other groups in reducing pain at rest (p <0.05). Changes between pre-treatment and the three-month follow-up showed a significant improvement in pain during activity and shoulder functions in phonophoresis with continuous and pulsed modes, compared to phonophoresis with sham US (p <0.05). Phonophoresis with pulsed mode was more effective than the other interventions in improving quality of life during the same period (p<0.05). Conclusion: Despite a significant change in phonophoresis with continuous and pulsed modes, it is more pronounced for rest pain in the early period in continuous mode and for quality of life during follow-up in pulsed mode.

Objectives: This study aimed to evaluate the effect of manual lymphatic drainage (MLD) combined with targeted rehabilitation therapies on the recovery of upper limb function in patients with breast cancer after modified radical mastectomy.

Patients and methods: In the randomized controlled study conducted between October 2019 and June 2020, 104 eligible breast cancer patients who underwent modified radical mastectomy were randomly divided into two groups. The routine functional exercise group (Group RF) received regular functional exercise guidance. In addition, the MLD combined with targeted rehabilitation therapies group (Group MLDT) received MLD, targeted rehabilitation therapies, and regular functional exercise guidance. The primary endpoints were shoulder range of motion, arm circumference and the incidence of axillary web syndrome (AWS). The secondary endpoints included the duration of axillary drainage, the duration of chest wall drainage, and complications.

Results: One hundred participants (mean age: 51.9±8.0 years; range, 28 to 72 years) were included in the final analysis as four patients could not complete the study. A significant improvement in shoulder range of motion was observed in Group MLDT compared to Group RF (p<0.05). Additionally, in Group MLDT, the duration of chest wall drainage was reduced (p=0.037). The frequency of AWS in Group RF was twice that in Group MLDT (p=0.061), but there was no significant difference in arm circumference (p>0.05) or the duration of axillary drainage (p=0.519). Regarding complications, there was one case of necrosis in the MLDT group and four cases in the RF group, including wound infection and seroma.

Conclusion: Manual lymphatic drainage combined with targeted rehabilitation therapies is an effective strategy to improve shoulder function, shorten the duration of chest wall drainage, reduce complications, and partly lower the incidence of AWS.