Assessment of Epstein-Barr virus, Candida albicans, and some periodontal pathogens in rheumatoid arthritis patients with periodontitis.

OBJECTIVE: To comparatively investigate the periodontal results and microbial load in subgingival biofilm samples (SBS) in rheumatoid arthritis subjects and healthy volunteers. METHODS: One hundred twenty subjects were classified into different cohorts: healthy (H-C); periodontitis with good systemic health (H-P); rheumatoid arthritis (RA) and good periodontal health (RA-C); and periodontitis with RA (RA-P). The periodontal parameters were recorded, and SBS were collected to determine periodontal pathogens including Epstein-Barr Virus (EBV) and Candida albicans using reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Subjects that had greater disease course, determined by moderate or high disease activity scores 28 (DAS28), suffered from worse oral health conditions (higher plaque index, gingival index, bleeding on probing, probing depth, and excessive clinical attachment loss) than those with low DAS28 scores. A higher prevalence of Treponema denticola (T. denticola) was observed in the RA-P group. Cyclic citrullinated peptide was associated with the occurrence of T. denticola and Campylobacter rectus. DAS28 using C-reactive protein (DAS28-CRP) had a significant association with Capnocytophaga gingivalis and EBV. The duration of the RA disease was associated with the presence of T. denticola. CONCLUSION: Subgingival microbial difference could reliably discriminate RA from healthy individuals. Especially, T. denticola and EBV may play a key role in periodontitis associated with RA.

The effect of robot-assisted gait training frequency on walking, functional recovery, and quality of life in patients with stroke.

AIM: This study aims to investigate the effects of robot-assisted gait training (RAGT) frequency on walking, functional recovery, QoL and mood. METHODS: Sixty patients aged 50-75, diagnosed with post-stroke hemiplegia were entered into the retrospective analysis. Participants who scored maximum 3 on the Modified Rankin Scale and were diagnosed with moderate stroke according to The NIH Stroke Scale were included in the study. The participants in group 1 (G1) received only conventional treatment (CT), in group 2 (G2) participants received one session of RAGT per week in addition to the CT program, and group 3 (G3) received two sessions of RAGT per week in addition to the CT program. 6-min walk test (6-MWT), Barthel Index (BI), Stroke-Specific Quality of Life Scale (SSQoL), and Beck Depression Inventory (BDI) were recorded. RESULTS: Median change in SSQoL of G3 was significantly higher from median change of G1 (p < 0.05), and median change in BDI of G3 was significantly lower than median change of G1 (p < 0.05). Median change in BDI of G3 was also significantly lower from change of G2 (p < 0.05). CONCLUSION: Two weekly sessions of RAGT in addition to CT exhibit positive effects on QoL and mood but no additional contribution to functional status.

Are static posturography-assisted biofeedback exercises effective in Parkinson's disease?

BACKGROUND: Parkinson disease (PD) is a progressive condition that causes disorders in movement and balance. OBJECTIVE: To evaluate the effectiveness of static posturography-assisted biofeedback exercises in PD-related balance disorder. METHODS: We screened 83 patients, 48 of whom were enrolled, and 41 completed the study. The sample was randomized into two groups, one submitted to static posturography-assisted biofeedback exercises and the other, to a conventional exercise program. The patients in the biofeedback group (n = 20) performed biofeedback exercises in addition to conventional balance exercises. Those in the conventional exercise group (n = 21) performed classic balance exercises. Both groups were treated for 20 minutes per session 3 times a week for 6 weeks. The patients were evaluated using the Hoehn and Yahr Scale, the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), the Berg Balance Scale (BBS), the Tinetti Gait and Balance Assessment (TGBA), the Timed Up and Go Test (TUG), the Tandem Stance Test (TST), a Turkish version of the Stanford Health Assessment Questionnaire (HAQ), and the Beck Depression Inventory (BDI) before and at the end of the treatment. RESULTS: No statistically significant differences were observed between the two groups in terms of the MDS-UPDRS, BBS, TGBA, TST, TUG, HAQ, or BDI measurements before and after the treatment (p > 0.05). CONCLUSIONS: Improved balance parameters were observed following balance training in the patients with PD, although static posturography-assisted biofeedback exercises appeared to provide no additional benefit. However, larger, randomized controlled trials are needed to investigate their effectiveness.

ANTECEDENTES: A doença de Parkinson (DP) é uma doença degenerativa que causa alterações no movimento e no equilíbrio. OBJETIVO: Avaliar a eficácia dos exercícios com biorretroalimentação assistidos por posturografia estática na alterações do equilíbrio derivadas da DP. MéTODOS: Selecionamos 83 pacientes, 48 dos quais foram incluídos, e 41 completaram o estudo. A amostra foi randomizada e dividida em dois grupos, um submetido a exercícios com biorretroalimentação assistidos por posturografia estática, e outro submetido a um programa de exercícios convencional. Os pacientes do grupo de biorretroalimentação (n = 20) fizeram exercícios com biorretroalimentação e exercícios convencionais de equilíbrio. E o grupo dos exercícios convencionais (n = 21), fez exercícios clássicos de equilíbrio. Ambos os grupos receberam tratamento durante 20 minutos por sessão, 3 vezes por semana, por 6 semanas. Os pacientes foram avaliados antes e depois do tratamento pela Escala de Hoehn e Yahr, Escala Unificada de Avaliação da Doença de Parkinson (EUADP) da Movement Disorder Society (MDS), a Escala de Equilíbrio Berg (EEB), Avaliação de Equilíbrio e Marcha Tinetti (AEMT), o Teste Timed Up and Go (TUG), o Teste de Apoio Tandem (TAT), a versão em turco do Questionário de Avaliação de Saúde (QAS) de Stanford, e o Inventário de Depressão de Beck (IDB). RESULTADOS: Não se observaram diferenças estatisticamente significativas entre os dois grupos quanto às medições do EUADP, EEB, AEMT, TAT, TUG, QAS ou IDB realizadas antes e depois do tratamento (p > 0.05). CONCLUSõES: Verificou-se uma melhoria dos parâmetros de equilíbrio após os exercícios de equilíbrio nos pacientes com DP, apesar de não ter sido detectado sem nenhum benefício adicional aparente dos exercícios com retroalimentação assistidos por posturografia estática. Contudo, é necessário efetuar ensaios maiores, randomizados e controlados para estudar a sua eficácia.

Effect of pulsed electromagnetic field therapy in patients with supraspinatus tendon tear.

OBJECTIVE: The aim of this study was to compare the effect of transcutaneous electrical nerve stimulation (TENS), ultrasound (US), and pulsed electromagnetic field (PEMF) combination with TENS and US therapy alone in patients with supraspinatus tear. METHODS: Forty patients were included in this study. The patients were randomly divided into two groups as follows: PEMF (n=20) and Sham (n=20) groups. PEMF was applied to the first group at a frequency of 50 Hz, 25 G intensity, and 20 min/session. The device was turned off while PEMF was applied to the second group. Diathermy (US) and electrotherapy (TENS) were applied to both groups for 10 sessions. Numerical Rating Scale (NRS), University of California-Los Angeles (UCLA) Shoulder Scale, and Shoulder Pain and Disability Index (SPADI) were used as outcome measures. RESULTS: In both groups, there was a significant improvement in the NRS, UCLA Shoulder Scale, and SPADI scores after treatment compared with pretreatment (p<0.05). In the comparison of the difference between the pretreatment and posttreatment measurement values between the groups, no significant difference was found between PEMF and Sham groups according to the NRS (p=0.165), UCLA Shoulder Scale (p=0.141), and SPADI (p=0.839) scores. CONCLUSIONS: In our study, a combination of PEMF therapy with conventional physical therapy modalities was not found to be superior to the conventional therapy alone, and adding it to the routine treatment of symptomatic supraspinatus tear would not provide any additional benefit.

Comparison of dry needling and kinesio taping methods in the treatment of myofascial pain syndrome: A single blinded randomised controlled study.

OBJECTIVES: The aim of this study was to compare the effectiveness of kinesio taping (KT) and dry needling (DN) in the treatment of myofascial pain syndrome (MPS) of the trapezius muscle. METHODS: The patients with MPS were divided into 3 groups as those who received exercise only (control group), those who received KT and exercise (KT group) and those who received DN and exercise (DN group) by using a sealed opaque envelope randomisation method. Visual Analog Scale (VAS), Pressure Pain Threshold (PPT), Neck Disability Index (NDI) and Global Perceived Effect Scale (GPES) were measured twice at baseline and at the end of the second week by blinded evaluator. RESULTS: A total of 26 patients were assigned to KT group, 32 to DN group and 30 to control group. The results of the study showed that PPT, VAS and NDI scores were significantly improved in the KT (1.61 ± 1.25, -2.66 ± 1.24 and -7.08 ± 6.24, respectively) and DN (1.30 ± 1.13, -3.34 ± 1.40 and -10.63 ± 7.80 respectively) groups (P < .001 for all). In the control group, no significant improvement was found in the VAS (.10 ± 1.39) and NDI (-.83 ± 4.91) scores (P > .05), with a significant decrease in PPT (-.98 ± 1.92) (P = .014). KT and DN methods in MPS treatment have more positive effects in terms of pain, disability and global effect compared to the control group. CONCLUSIONS: In the treatment of MPS, adding DN or KT to exercise programme may provide important contributions to the treatment.

Comparison of outpatient and inpatient spa therapy in knee osteoarthritis.

Osteoarthritis (OA) is a common condition that impacts many people worldwide and involves weight-bearing joints, resulting in chronic pain. In this study, we aimed to compare the effectiveness of inpatient and outpatient physical therapy modalities and spa combination treatments on pain and functional status in patients with knee osteoarthritis. Seventy-four patients diagnosed with primary knee osteoarthritis were included in this study. The patients were randomized into two groups, inpatient (n = 37) and outpatient (n = 37) physical therapy. All patients received a physical therapy program (superficial heater + deep heater + transcutaneous electrical nerve stimulation) for 2 weeks and spa therapy. All cases were evaluated clinically, laboratory, and radiographically. In order to evaluate pain and functional status, the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and Timed Up and Go (TUG) test were used before and after treatment. There was no significant difference between the two groups in the TUG test and WOMAC scores (p > 0.05). However, a significant difference was found in VAS scores in favor of the outpatient group (p < 0.05). As a result, although there was a significant improvement in pain scores in the outpatient group, multicenter studies with larger patient groups may provide more evidence.

Effect of pulsed electromagnetic field therapy in patients with supraspinatus tendon tear

SUMMARY OBJECTIVE: The aim of this study was to compare the effect of transcutaneous electrical nerve stimulation (TENS), ultrasound (US), and pulsed electromagnetic field (PEMF) combination with TENS and US therapy alone in patients with supraspinatus tear. METHODS: Forty patients were included in this study. The patients were randomly divided into two groups as follows: PEMF (n=20) and Sham (n=20) groups. PEMF was applied to the first group at a frequency of 50 Hz, 25 G intensity, and 20 min/session. The device was turned off while PEMF was applied to the second group. Diathermy (US) and electrotherapy (TENS) were applied to both groups for 10 sessions. Numerical Rating Scale (NRS), University of California-Los Angeles (UCLA) Shoulder Scale, and Shoulder Pain and Disability Index (SPADI) were used as outcome measures. RESULTS: In both groups, there was a significant improvement in the NRS, UCLA Shoulder Scale, and SPADI scores after treatment compared with pretreatment (p<0.05). In the comparison of the difference between the pretreatment and posttreatment measurement values between the groups, no significant difference was found between PEMF and Sham groups according to the NRS (p=0.165), UCLA Shoulder Scale (p=0.141), and SPADI (p=0.839) scores. CONCLUSIONS: In our study, a combination of PEMF therapy with conventional physical therapy modalities was not found to be superior to the conventional therapy alone, and adding it to the routine treatment of symptomatic supraspinatus tear would not provide any additional benefit.

Effect of Leap Motion-based 3D Immersive Virtual Reality Usage on Upper Extremity Function in Ischemic Stroke Patients.

Immersive virtual reality (VR) is a technology that provides a more realistic environmental design and object tracking than ordinary VR. The aim of this study was to investigate the effectiveness of immersive VR on upper extremity function in patients with ischemic stroke. Sixty-five patients with ischemic stroke were included in this randomized, controlled, double-blind study. Patients were randomly divided into VR (n = 33) and control (n = 32) groups. The VR group received 60 minutes of the upper extremity immersive VR rehabilitation program and the control group received 45 minutes of conventional therapy and 15 minutes of a sham VR program. Rehabilitation consisted of 18 sessions of therapy, three days per week, for six weeks. The outcome measures were the Action Research Arm Test (ARAT), Functional Independence Measure (FIM), Fugl-Meyer Upper Extremity Scale (FMUE) and Performance Assessment of Self-Care Skills (PASS). In both the VR and control groups all parameters except the PASS improved over time. However independent t-test results showed that all of the FMUE, ARAT, FIM and PASS scores were significantly higher in the VR group compared with the control (p < 0.05). The minimal clinically important difference (MCID) scores of the FMUE and ARAT were higher than the cut-off MCID scores described in the literature in the VR group, whereas the FIM scores were below the cut-off MCID scores. All scores in the control group were below the cut-off scores. Immersive VR rehabilitation appeared to be effective in improving upper extremity function and self-care skills, but it did not improve functional independence.

Effect of Leap Motion-based 3D Immersive Virtual Reality Usage on Upper Extremity Function in Ischemic Stroke Patients / Efeito do uso imersivo da realidade virtual 3D baseada em movimento de salto na função de extremidade superior em pacientes com AVC isquêmico

ABSTRACT Immersive virtual reality (VR) is a technology that provides a more realistic environmental design and object tracking than ordinary VR. The aim of this study was to investigate the effectiveness of immersive VR on upper extremity function in patients with ischemic stroke. Sixty-five patients with ischemic stroke were included in this randomized, controlled, double-blind study. Patients were randomly divided into VR (n = 33) and control (n = 32) groups. The VR group received 60 minutes of the upper extremity immersive VR rehabilitation program and the control group received 45 minutes of conventional therapy and 15 minutes of a sham VR program. Rehabilitation consisted of 18 sessions of therapy, three days per week, for six weeks. The outcome measures were the Action Research Arm Test (ARAT), Functional Independence Measure (FIM), Fugl-Meyer Upper Extremity Scale (FMUE) and Performance Assessment of Self-Care Skills (PASS). In both the VR and control groups all parameters except the PASS improved over time. However independent t-test results showed that all of the FMUE, ARAT, FIM and PASS scores were significantly higher in the VR group compared with the control (p < 0.05). The minimal clinically important difference (MCID) scores of the FMUE and ARAT were higher than the cut-off MCID scores described in the literature in the VR group, whereas the FIM scores were below the cut-off MCID scores. All scores in the control group were below the cut-off scores. Immersive VR rehabilitation appeared to be effective in improving upper extremity function and self-care skills, but it did not improve functional independence.

RESUMO A VR imersiva é uma tecnologia que fornece design ambiental e rastreamento de objetos mais realistas do que a VR comum. O objetivo deste estudo foi investigar a eficácia da VR imersiva na função da extremidade superior em pacientes com AVC isquêmico. Sessenta e cinco pacientes com AVC isquêmico foram incluídos neste estudo randomizado, controlado e duplo-cego (clinictrials.gov. ID: NCT03135418). Os pacientes foram divididos aleatoriamente em VR (n = 33) e controle (n = 32). O grupo VR recebeu 60 minutos do programa de reabilitação imersiva da extremidade superior e o grupo controle recebeu 45 minutos de terapia convencional e 15 minutos de um programa falso de VR. A reabilitação consistiu em 18 sessões de terapia, 3 dias por semana, durante 6 semanas. As medidas de resultado foram Teste de braço de pesquisa-ação (ARAT), Medida de independência funcional (FIM), Escala de extremidades superiores de Fugl-Meyer (FMUE) e Avaliação de desempenho de habilidades de autocuidado (PASS). Nos grupos VR e controle, todos os parâmetros, exceto o PASS, melhoraram com o tempo. No entanto, os resultados dos testes t independentes mostraram que todos os escores FMUE, ARAT, FIM e PASS foram significativamente maiores no grupo VR em comparação ao controle (p <0,05). Os escores de FMUE e ARAT de diferença minimamente clinicamente importante (MCID) foram maiores que os pontos de corte de MCID descritos na literatura no grupo VR, enquanto os escores de FIM estiveram abaixo dos pontos de corte de MCID. Todas as pontuações no grupo controle estiveram abaixo das pontuações de corte. A reabilitação imersiva da VR parece ser eficaz para melhorar a função da extremidade superior e as habilidades de autocuidado, mas não melhora a independência funcional.