Is Dry Needling Treatment an Extra Contribution to Conventional Treatment for Hemiplegic Shoulder Pain? A Prospective, Randomized Controlled Study.

Objective: This research was conducted to evaluate the effect of adding dry needling (DN) treatment to conventional rehabilitation for pain, range of motion (ROM), and functionality in patients with hemiplegic shoulder pain (HSP). Materials and Methods: Patients with HSP (n = 38) were divided into 2 groups. A multimodal rehabilitation protocol, including physical therapy and exercise treatments, was given to both groups (5 sessions per week for 15 sessions). In addition to this rehabilitation, 3 sessions of DN therapy were given to one of the 2 groups. Measurements were a visual analogue scale; ROM; and 2 other scales (Quick Disability of the Arm, Shoulder, Hand; and the Fugl-Meyer Assessment Upper Extremity). Evaluations were made before, after, and at the third month after treatment. Results: While a statistically significant improvement was seen in both groups in all parameters after their treatments, a statistical superiority was found in the conventional treatment+DN group (P < 0.05). However, the differences were not greater than the minimal clinically important difference values (MCID). At the 3rd month follow-up, there was no difference in pain and functionality parameters between the groups, while flexion and abduction measurements were higher in the conventional treatment+DN group (P < 0.05). Conclusions: Adding DN treatment to conventional rehabilitation did not show any difference except in some joint ROM measurements in the subacute time. Although the changes found were statistically significant, they were not clinically significant as they did not reach MCID values.This study was registered prospectively at ClinicalTrials.gov (ref. no: NCT04790071).

Investigating the correlation between pulmonary function tests and ultrasonographic diaphragm measurements and the effects of respiratory exercises on these parameters in hemiplegic patients.

OBJECTIVE: To investigate the correlation of DUS and pulmonary function tests (PFTs), and investigate the effects of respiratory exercises on the above parameters. METHODS: For the treatment group (n=20), neurological rehabilitation and respiratory exercise program, and for the control group (n=21), only a neurological rehabilitation program was implemented for 30 sessions. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), end-inspiration diaphragm thickness (IDT), end-expiratory diaphragm thickness (EDT), and diaphragm thickening ratio (DTR) were measured pre- and post-treatment. RESULTS: IDTs and EDTs as well as DTRs of affected side (p < .001, .001, and .03, respectively) and intact side (p < .001, .001, and .02, respectively) were found to improve post-treatment than before treatment in the treatment group. Similarly, FVC, FEV1, and FEV1/FVC, were better post-treatment than before treatment in the treatment group. Moreover, the affected side IDT was positively correlated with FVC and FEV1 before treatment (r = .38, p = .03 and r = .35, p = .02) and post-treatment (r = .46, p = .02 and r = .39, p = .03). The affected side DTR was positively correlated with FVC and FEV1 before treatment (r = .44, p = .01 and r = .40, p = .02) and post-treatment (r = .32, p = .03 and r = .40, p = .04). CONCLUSION: DUS can be used for the evaluation of respiratory problems in stroke patients. Moreover, breathing exercises improve these parameters in stroke patients, and they can be followed up by DUS.

Comparison of Effects of Pulsed Electromagnetic Field Stimulation on Platelet-Rich Plasma and Bone Marrow Stromal Stem Cell Using Rat Zygomatic Bone Defect Model.

BACKGROUND: Reconstruction of bone defects that occur because of certain reasons has an important place in plastic and reconstructive surgery. The objective of the treatments of these defects was to reinstate the continuity of tissues placed in the area in which the defect has occurred. In this experimental study, the effect of pulsed electromagnetic field stimulation on platelet-rich plasma (PRP) and bone marrow stromal cell, which propounded that they have positive impact on bone regeneration, was evaluated with the bone healing rate in the zygomatic bone defect model enwrapped with superficial temporal fascia. METHODS: After creating a 4-mm defect on the zygomatic bone of the experiments, the defect was encompassed with a superficial temporal fascial flap and a nonunion model was created. After surgery, different combinations of the PRP, bone marrow stromal cell, and electromagnetic field applications were implemented on the defective area. All the experiments were subjected to bone density measurement. RESULTS: The result revealed that the PRP and pulsed electromagnetic field implementation were rather a beneficial and an effective combination in terms of bone regeneration. CONCLUSIONS: It was observed that the superficial temporal fascial flap used in the experiment was a good scaffold choice, providing an ideal bone regeneration area because of its autogenous, vascular, and 3-dimensional structures. As a result, it is presumed that this combination in the nonhealing bone defects is a rather useful treatment choice and can be used in a reliable way in clinical applications.

Antioxidant support in composite musculo-adipose-fasciocutaneous flap applications: an experimental study.

Free radicals are chemicals that play roles in the etio-pathogenesis of ischaemia-reperfusion injury. Various antioxidants have been used in an attempt to mitigate the damage induced by these chemicals. In the present study, the antioxidative effects of grape seed extract (proanthocyanidin), tomato extract (lycopene), and vitamin C (ascorbic acid) on a composite re-established-flow inferior epigastric artery based rectus abdominis muscle-skin flap model on which experimental ischaemia was induced were investigated. The rats have been administered antioxidants for 2 weeks prior to the surgery and for 2 more weeks thereafter. Macroscopic, histopathological, and biochemical analyses were carried out at the decision of the experiment. It was found that flap skin island necrosis was significantly reduced in the proanthocyanidin, lycopene, vitamin C groups (p < 0.001). Statistical analyses showed significant decreases in inflammation, oedema, congestion, and granulation tissue in the proanthocyanidin and lycopene groups compared to the vitamin C and control groups (p < 0.001). When the viability rates of fat and muscle tissues were examined, significant improvements were found in the proanthocyanidin and lycopene groups in comparison to the other groups (p < 0.001). Serum antioxidant capacity measurements revealed significant differences in the lycopene group compared to all other groups (p < 0.001). It is concluded that lycopene and proanthocyanidin are protective antioxidants in rat composite muscle-skin flap ischaemia-reperfusion models.

Treatment of osteoporosis by long-term magnetic field with extremely low frequency in rats.

BACKGROUND: Osteoporosis is characterised by low bone mass and structural deterioration of bone tissue. In this study, the role of long-term extremely low frequency magnetic field (ELFMF) on osteoporosis was evaluated. METHODS: The experiments were performed on 45 female Sprague-Dawley rats. The rats were divided into three groups (n = 15): Group I (ovariectomy (OVX) + ELFMF exposure), Group II (ovariectomised rats did not receive any treatment) and Group III (cage-control). Six months, 50 Hz, 1.5 mT magnetic field (MF) was used on Group I and Group II. Total body images of the animals were obtained with dual-energy X-ray absorptiometry. RESULTS: Bone mineral content (BMC) and bone mineral density values were increased significantly in ELFMF group, decreased in the group of OVX and not changed in cage-control. At the end of the 6 months after exposure with ELFMF, alteration in studied biochemical markers were detected significant. Bone specific alkaline phosphatase (BAP) levels were increased in ELFMF and decreased in OVX groups when compared with cage-control group. N-telopeptide levels in OVX group were significantly higher than other groups. Testosterone and cortisol levels in OVX group were significantly higher and estradiol was lower than other groups. CONCLUSIONS: Our study suggests that ELFMF may be useful in the prevention and treatment of osteoporosis.