Cross-cultural adaptation and validation of the Behavioral Avoidance Test-Back Pain (BAT-Back) to the Turkish language.

OBJECTIVE: Pain-avoidance is considered to be one of the major leading factors to develop a chronic low back pain (CLBP). In this study, we aimed to translate the Behavioral Avoidance Test-Back Pain (BAT-Back) into Turkish and evaluate its psychometric properties in patients with CLBP. METHODS: 115 patients with CLBP filled the provided socio-demographic information form, the "Oswestry Disability Index (ODI)", the "Fear-Avoidance Beliefs Questionnaire (FABQ)", the "Tampa Scale for Kinesiophobia (TSK)", and the "Hospital Anxiety Depression Scale (HADS)". All patients and 40 pain free controls (PFC) were administered the Turkish version (TrBAT-Back) of the "Behavioral Avoidance Test-Back Pain" test. The internal consistency was evaluated with Cronbach's α coefficient. The test-retest reliability was assessed with the intraclass correlation coefficient (ICC). To evaluate the structural validity of TrBAT-Back, its correlation with FABQ, TSK, ODI, and HADS was examined. RESULTS: The internal consistency of TrBAT-Back was excellent (Cronbach's α = 0.97) and its test-retest reliability was good (ICC = 0.87). Its high correlation with the FABQ-physical activity scores and moderate correlation with the TSK scores supported the structural validity. The TrBAT-Back scores showed a statistically significant moderate correlation with the higher level of pain and disability. Despite the low degree of positive correlation, a high level of anxiety (HADS-anxiety) is potentially associated with avoidance behaviour. CLBP patients and controls differed significantly on TrBAT-Back avoidance scores. CONCLUSION: We are of the opinion that, compared to the self-report scales, TrBAT-Back will provide more objective data in detecting avoidance behaviour associated with pain in Turkish speaking patients with CLBP.

A randomized, double-blind study to assess if vitamin D treatment affects the outcomes of rehabilitation and balance in hemiplegic patients.

[Purpose] To investigate the effect of vitamin D supplementation on rehabilitation outcomes and balance in patients having hemiplegia due to ischemic stroke. [Subjects and Methods] Vitamin D levels of 132 patients hospitalized for hemiplegia rehabilitation due to ischemic stroke were tested. Consequently, 86/132 patients had low vitamin D levels, 72 of which met the inclusion criteria and were included in the study. Patients were divided into two groups: Group A (injected with 300,000 IU vitamin D), and Group B (injected intramuscularly with saline). Each patient was tested at the baseline and at the third month using the Brunnstrom recovery staging, functional ambulation scale, modified Barthel index, and Berg balance scale. The findings were compared between the groups. [Results] By the end of the third month, The Berg balance scale results and modified Barthel index scores significantly differed between the two groups, whereas Brunnstrom recovery staging and functional ambulation scale test results did not. [Conclusion] This study found that vitamin D administration increased the activity levels and accelerated balance recovery but did not significantly affect ambulation or motor recovery. These results warrant confirmation by longer follow-up studies with a larger number of participants.

Investigation of C5-C6 radiculopathy and shoulder rotator cuff lesions coexistence frequency.

OBJECTIVE: The aim of this study was to evaluate the coexistence of C5 and/or C6 root compression with rotator cuff pathologies and its effect on pain and disability. METHODS: A total of 65 patients with pain radiating from neck to shoulder were retrospectively evaluated on the basis of demographic data, duration of symptoms, overhead activities, and physical examination. The visual numerical scale (VNS), Quick DASH (Disabilities of the Arm, Shoulder, and Hand), and Shoulder Pain and Disability Index (SPADI) were also used. Cervical magnetic resonance imaging (MRI) was used to evaluate C5-C6 root compression, which was separated into two groups as patients with or without upper trunk root compression (UTRC). These groups were compared according to the MRI findings of patients with rotator cuff pathologies. RESULTS: According to our results, C5 root compression (12.3%), C6 root compression (41.5%), UTRC (44.6%) were detected. There was no difference between the groups regarding the Hawkins and Neer tests. The Yergason and Jobe tests were statistically higher in patients without UTRC. In the shoulder MRIs, the rate of subscapular muscle tear was significantly higher in patients with UTRC. Other shoulder MRI findings were not different between the groups. VNS-neck and SPADI-pain scores were significantly higher in patients without UTRC. There was no difference between the groups in the scores of VNS-shoulder, Quick DASH, SPADI-disability, and SPADI-total. CONCLUSION: Radiating pain from neck to shoulder that is caused by C5-C6 root compression does not create a predisposition for clinical, radiologic, and functional pathologies in shoulder joint. It seems difficult to diagnose the exact origin of pain in patients who present with neck pain radiating to shoulder based on the findings of cervical or shoulder MRI alone.