Long term effects of high intensity laser therapy in lateral epicondylitis patients.

The objective of this study is to investigate short- and long-term effects of high-intensity laser therapy (HILT) in lateral epicondylitis (LE) patients. Thirty patients with LE diagnosis (23 unilateral and 7 bilateral in total 37 elbows) were treated using HILT. LE patients were evaluated before, right after, and 6 months following HILT intervention post-treatment using visual analogue scale for pain (VAS) during activity and resting. Disabilities of the Arm, Shoulder, and Hand (DASH) Score and hand grip strength test (HGST) were used. The participants of the present study were also evaluated using Short-Form 36 (SF-36) before and 6 months after the treatment. Out of the 30 patients, 8 were male and 22 female with a mean age of 47.2 ± 9.7. The activity and resting VAS, DASH, and HGST scores revealed statistically significant improvement (p = 0.001) following treatment. Whereas VAS activity, DASH, and HGST scores increased after treatment until post-treatment 6 months significantly (p = 0.001), VAS resting scores remained stable (p = 0.476). A statistically significant improvement was also evident in the physical and mental components of SF-36 scores following treatment until post-treatment 6 months compared to pre-treatment scores (p = 0.001). In conclusion, the results of the present study suggest that HILT is a reliable, safe, and effective treatment option in LE patients in the short and long term considering pain, functional status, and quality of life.

Comparison of High Intensity Laser and Epicondylitis Bandage in the Treatment of Lateral Epicondylitis.

OBJECTIVES: This study aims to investigate the effects of high-intensity laser therapy (HILT) and epicondylitis bandage treatment in patients with lateral epicondylitis (LE). PATIENTS AND METHODS: Sixty-five patients with unilateral LE (18 males, 47 females; mean age 46.5±8.1 years; range 30 to 61 years) with unilateral complaints were included. Patients were randomly assigned into two treatment groups. The first group (n=31) was treated with HILT for 10 sessions, while the second group (n=34) used only LE bandage for treatment. The patients were assessed for handgrip strength, pain, disability, and quality of life at baseline and sixth week after treatment by using visual analog scale, the Disabilities of the Arm Shoulder and Hand questionnaire, and Short-Form 36 (SF-36). RESULTS: Both groups showed significant improvement in all evaluated parameters including pain scores, hand grip strength, disability, and SF-36 scores at sixth week after the treatment (all p<0.05). A comparison of percentage changes in parameters between treatment groups did not show a significant difference, except for resting visual analog scale (p=0.036) and SF-36 physical component subscale (p=0.049) scores which indicated better improvement in HILT group. CONCLUSION: Our findings showed significant improvement in handgrip strength, pain, disability, and quality of life parameters in both groups. However, HILT produced better resting visual analog scale and SF-36 physical component subscale scores compared to LE bandage.

Increased bone resorption in the proximal femur in patients with hemiplegia.

OBJECTIVES: To investigate the relationship between the proximal femoral bone mineral density and bone resorption markers, determinants of calcium metabolism and vitamin D levels in elderly stroke patients. DESIGN: A total of 80 patients and 20 controls were enrolled in the study. Bone mineral density measurements were obtained at the proximal femur. In all subjects, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, intact parathyroid hormone, osteocalcin, deoxypyridinoline, and ionized calcium concentrations were measured. Barthel Index and Motricity Index Leg Score were recorded all patients. RESULTS: The serum concentrations of deoxypyridinoline, intact parathyroid hormone, and the mean serum ionized calcium levels were significantly higher in patients with stroke than that of the control subjects. The mean serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations in patients were significantly lower than those of the control group (P < 0.05). The bone mineral density of proximal femurs of paretic limbs was decreased significantly compared with those of the control group (P < 0.05). There were significant correlations between the Z score of the hemiplegic side and the patients' Barthel Index, Motricity Index Leg Score, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, calcium, and deoxypyridinoline. CONCLUSIONS: This study provides clear evidence that decreased mobility, vitamin D status, and bone turnover variables in patients after stroke are important factors in the greater bone loss in the paretic leg.

Mechanical evaluation for the finite element analysis of intramedullary nailing and plate screw system used in humerus transverse fractures.

Aim: This study aims to examine the commonly used plate screw system and intramedullary nailing method in osteosynthesis in humeral shaft fractures in terms of stress shielding using finite element analysis. Material and methods: Images were obtained by computerized tomography (CT) to create a 3D model of the humerus bone. After the CT images were transferred to the ANSYS 2021 R2 program (ANSYS, Inc., Canons-burg, PA), a transverse fracture model was created from the shaft region of the humeral bone meshed to the humerus bone and modeled in the 3D environment. Results: The tetrahedron mesh structure was used for the finite element models in our study. The element size was chosen as 3.5 mm for the bone model and 2 mm for the plate and intramedullary nail models. The node numbers of bone, intramedullary nail, and plate were 91230, 462578, and 581352, respectively. The element numbers of bone, intramedullary nail, and plate were 61350, 311285, and 370350, respectively. Maximum stress values of 260 MPa on the nail and 280 MPa on the plate were detected in this study. Conclusion: Fewer stress values were obtained and stress concentrations were not formed on the implant in osteosynthesis performed by intramedullary nailing. It can be concluded that this study may guide further studies for those focusing on it and may contribute to the development of a more comprehensive understanding of the topic.