Calcitonin and calcium combined therapy in osteoporosis: effects on vertebra trabecular bone density.

Calcitonin is a hormone produced by the parafollicular cells of the thyroid gland. Like calcium salts, calcitonin acts by reducing bone resorption. In this study, 26 osteoporotic patients were given 100 IU salmon calcitonin for 10 days and, thereafter, 100 IU calcitonin every other day for 80 days combined with 1000 mg/day calcium salts. Prior to and after the combined therapy, the mean trabecular bone densities from the levels of thoracic 12 and lumbar 1 and 2 were obtained and routine thoracic and lumbar radiography performed. Combined calcitonin and calcium therapy for 3 months produced significant increases in vertebra trabecular bone density. The evaluation of the trabecular bone density and the number of non-traumatic compression fractures in 26 osteoporotic patients prior to the therapy did not indicate any close relationship between them. It is concluded that, in addition to other factors reported previously, microtraumas during daily activities have some effect on the incidence of fractures.

The effects of physical training on physical fitness tests and auditory and visual reaction times of volleyball players.

Twenty male volleyball players were taken for this study and during an 8-week-period they did physical conditioning exercises by weight training 5 days a week. Physical fitness tests, auditory and visual reaction times were measured at the beginning and at the end of training period. When results statistically analysed, it was observed that physical conditioning exercises affected their physical fitness positively and moreover auditory and visual reaction times were shortened.

Etiological and functional evaluation of the pediatric population with spinal cord injuries.

Spinal cord lesions are the result of many etiological factors and are associated with motor, sensorial and autonomic dysfunctions. The subjects evaluated were a total of 217 paraplegics and quadriplegics who had been enrolled in a rehabilitation program during the last five years conducted by the Department of Physical Medicine and Rehabilitation of the Hacettepe University Faculty of Medicine. Forty-three of these patients were in the pediatric age group. In this clinical trial, the patients with spinal cord injuries were examined according to their age, sex, etiological factors and functional status. Frankel's scale was used for functional assessment. The mean age of patients was 9.19 +/- 4.19 years and varied between 1-16 years. The results of our classification according to etiological factors were as follows: Nineteen patients with tumors (44.1%), nine patients with infections (20.93%), five patients with congenital abnormalities (11.63%), five patients with vascular lesions (11.63%), four patients with trauma (9.30%), and one patient with a degenerative central nervous system disorder (2.32%). The effect of the rehabilitation program on the functional status of the patients is discussed.

Diurnal variation of antidiuretic hormone and urinary output in spinal cord injury.

INTRODUCTION: Healthy individuals have a nocturnal decrease in urine output due to increased plasma antidiuretic hormone levels at night. This does not occur in spinal cord injury and most patients experience nocturnal polyuria, which triggers dysreflexic crises secondary to urinary bladder overdistension, and interferes with patients' sleep due to the need for extra catheterization. OBJECTIVE: To evaluate the diurnal variation in ADH level, urinary output, and plasma and urine osmolality in SCI patients with regard to their level of injury and in comparison with age- and sex-matched healthy individuals. MATERIALS AND METHODS: Sixteen ASIA-A spinal cord-injured patients, eight with paraplegia, eight with tetraplegia, and eight healthy individuals, were evaluated for urinary output, urine and serum osmolality, and antidiuretic hormone levels during day and night hours. RESULTS: Absence of diurnal variation in urinary output and antidiuretic hormone secretion was detected in both paraplegic and tetraplegic patients, while antidiuretic hormone levels rose significantly at night in the control group. CONCLUSION: Antidiuretic hormone levels should be monitored both day and night in spinal cord injury patients, with severe nocturnal polyuria. Treatment with desaminocystein-D-arginine vasopressin can be attempted when conservative measures fail to control nocturnal polyuria, especially in patients who are on an intermittent catheterization program.

Assessment of spasticity using isokinetic dynamometry in patients with spinal cord injury.

OBJECTIVES: To determine the value of isokinetic dynamometric measurement of passive resistance in quantifying spasticity. SETTING: Turkey. METHODS: Thirty-three spastic spinal cord-injured patients and 14 age-matched normal individuals were studied. Five consecutive flexion-extensions of the knee, abduction-adductions of the hip, and dorsal-plantar flexions of the ankle were performed at specific velocities (15, 30, 60, 90 and 120 degrees /s) using a computerized isokinetic dynamometer set at the continuous passive motion mode. We recorded maximum torque and the sum of torque amplitudes for five repetitions of each type of joint motion at all velocities. RESULTS: Maximum torque values and the sum of torque amplitudes were both significantly higher in spastic patients than in controls, and there was a positive correlation between torque values and Ashworth scores. There was no significant linear increase in torque values associated with increasing velocity for any of the motions in either controls or patients. CONCLUSION: Isokinetic dynamometric measurement of passive resistance appeared to be a valuable tool for assessing and quantifying spasticity, as well as other types of hypertonus.

Isokinetic measurement of trunk muscle strength in women with chronic low-back pain.

OBJECTIVES: To investigate the relationships among chronic low-back pain and obesity, total spinal range of motion, and trunk muscle strength. The short-term impact of trunk muscle strengthening exercises on this condition was also examined. DESIGN: A controlled, prospective study of trunk muscle strengths of patients with chronic low-back pain and the short-term impact of exercise on strength. The study group consisted of 25 female patients who had been experiencing low-back pain for at least 3 mo, and the control group included 20 age-matched women without known low-back trouble. The Davenport Index was used to calculate the body mass indexes of all subjects. The Oswestry Disability Questionnaire was used to assess pain in the study group. Full flexion and extension ranges of motion were measured, then isokinetic measurements of trunk muscles were performed at 60-, 120-, and 180-degrees/sec velocities. Isometric measurements were also recorded for both flexors and extensors at a 60-degree angle. RESULTS: Increased body mass index and decreased trunk muscle strength were found to be directly associated with chronic low-back pain (P < 0.05). After a 15-day standard trunk strengthening exercise program in the patient group, trunk muscle strength was found to be increased (P < 0.05). CONCLUSIONS: Obesity and decrease in trunk muscle strength are important factors in chronic low-back pain, and a trunk muscle strengthening program will be helpful in reducing the pain.