The effect of high-intensity laser therapy on pain and lower extremity function in patellofemoral pain syndrome: a single-blind randomized controlled trial.

Patellofemoral pain syndrome (PFPS) is a set of symptoms that negatively affect the daily life activities of the individual, leading to functional disability and significant loss of labor, especially in young adults. PFPS is usually due to weakness of the vastus medialis obliquus (VMO) resulting in abnormal patellar tracking and pain. Our study aims to compare the efficacy of high-intensity laser therapy (HILT) on pain and lower extremity function in the treatment of PFPS with different electrophysical agents (EPAs). The study was designed as a single-blind randomized controlled trial. Forty-five people with PFPS (aged 25-45 years) were included in the study. The patients were randomly divided into three groups and a total of ten sessions of treatment were administered to all three groups for 2 weeks, 5 days a week. High-intensity laser (HILT) and exercise program were applied to group 1. Ultrasound (US), transcutaneous electrical nerve stimulation (TENS), and exercise program were applied to group 2. In group 3, US, interferential current (IFC), and exercise program were applied. Both groups underwent three evaluations: pre-treatment, post-treatment, and 12 weeks after treatment. Outcome measures included the visual analog scale for pain severity (VAS), knee flexion range of motion (FROM), Q angle, pain threshold, muscle strength of quadriceps and hamstring, Kujala patellofemoral scoring, lower extremity functional scale (LEFS), and Timed Up and Go Test (TUG). The ANOVA was used for comparing the data of the groups, and two-way repeated measure ANOVA was used to compare at the pre-post and post-intervention 3rd month. The LSD and Bonferroni post hoc tests were also used to identify the between-group differences. Groups 2 and 3 were statistically effective in pain and functionality (p < 0.05). Group 1 was found to be statistically more effective than other groups in reducing pain (95% confidence interval (CI), 0.000/0.000; p = 0.000), increasing knee flexion angle (95% CI, 127.524/135.809; p = 0.000), and increasing lower extremity function (95% CI, 75.970/79.362; p = 0.000). This study indicated that high-intensity laser therapy was found to be a more effective method in the treatment of patellofemoral pain syndrome after 3 months of follow-up compared to US-TENS combination and US-interferential current combination treatments. Also, HILT can be used as an effective method in combination with an appropriate exercise program including vastus medialis strengthening to reduce pain and increase functionality in the patients with PFPS.

Treatment of trigger finger with metacarpophalangeal joint blocking orthosis vs relative motion extension orthosis: A randomized clinical trial.

BACKGROUND: The metacarpophalangeal joint blocking orthosis (MCPJ-BO) is one of the first-line orthotic treatment for patients with trigger finger (TF). Relative motion extension orthosis (RME-O) has recently emerged as a treatment option for various hand disorders involving TF. PURPOSE: The primary objective of this study was to compare the effectiveness of 6 weeks of orthotic treatment with the MCPJ-BO and the RME-O for pain relief. Function and satisfaction with the orthosis were assessed as secondary objectives. STUDY DESIGN: Randomized clinical study. METHODS: Thirty patients with an average age of 50 years with Froimson stage 1-3 A1 pulley triggering participated in the study. They were randomly assigned to either the MCPJ-BO (n = 15; 10 females, five males) or the RME-O group (n = 15; 12 females, three males). The orthoses were worn full time for 6 weeks. All patients received patient education, activity modification, and flexor tendon gliding exercises as part of the rehabilitation program. Pre- and post-assessments included Numeric Pain Rating Scale, Disability of the Arm, Shoulder, and Hand questionnaire, and Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire. The Mann-Whitney U test was conducted to analyze the difference between the two groups. RESULTS: There were no significant differences between the two groups in pain and function before treatment (p < 0.05). Within-group comparisons indicated that both orthoses relieved pain, but the MCPJ-BO group achieved greater pain relief (p = 0.001). There was a significant improvement in function in the MCPJ-BO group, with a mean change of 12.7 (p = 0.0001). The overall success rates for the MCPJ-BO group and RME-O group were 60% and 27%, respectively. Patients in both groups had high satisfaction with the orthosis. CONCLUSIONS: MCPJ-BO and RME-O could be used for pain relief in the treatment of TF. The MCPJ-BO appears to be more effective than the RME-O in improving function.

Investigation of the effects of a short opponens splint and structured hand exercise program in computer engineers with wrist pain: a randomized controlled trial.

Objectives. This study aimed to examine the effects of a short opponens splint and hand exercise program on pain, hand functionality, daily activities, and work efficacy in computer engineers with wrist pain. Methods. Forty-five engineers were randomized into three groups: group 1 (n = 15) utilized both splints and exercises, group 2 (n = 15) engaged in exercises only and group 3 (n = 15) received no treatment, across 8 weeks, thrice weekly. Only exercises were applied to group 2 (n = 15). No treatment was applied for group 3 (n = 15). The progress of subjects was controlled periodically each week. Outcome measurements including the Jamar hand dynamometer, pinchmeter, nine-hole peg test (9-NHPT), visual analog scale, Boston carpal tunnel syndrome questionnaire and Michigan hand outcome questionnaire (MHQ) were evaluated pre and post treatment during the study period. Results. Comparing the outcome measurements of the three groups showed a statistically significant difference between them except for the 9-NHPT and MHQ pain and esthetics (p < 0.05). According to post-hoc tests, groups 1 and 2 had more significant differences than group 3. Also, there was no statistically significant difference in any parameter between group 1 and group 2 (p > 0.017). Conclusion. Non-restrictive minimal orthosis or exercise programs are advisable for individuals with wrist pain.

Comparison of the efficacy of pharmacological and nonpharmacological treatments in women with primary dysmenorrhea: randomized controlled parallel-group study.

OBJECTIVES: To compare the effectiveness of pharmacological (PT) and nonpharmacological treatments (NPT) in women with primary dysmenorrhea (PD) and determine the most effective treatment method. MATERIAL AND METHODS: We enrolled 85 PD participants with PD who were randomly classified into five groups: pharmacological groups; naproxen sodium (NS) and micronized purified flavanoid fraction (MPFF), nonpharmacological groups; motor imagery focused pelvic floor exercise (MOPEXE) and acupressure, and no treatment group; control. Initial assessment was conducted in all groups on the first day of the menstrual cycle. After the end ofthe third menstrual cycle, the specialist physiotherapist and the obstetrician conducted a final evaluation. Intensity and nature of pain were evaluated with the Short-Form McGill Pain Questionnaire (SF-MPQ), and menstrual attitudes and behaviors were evaluated using the Menstruation Attitude Questionnaire (MAQ). RESULTS: In the total pain dimension scores, which are the sum of the affective dimension of pain and sensory dimension scores, the pre-post treatment difference was the highest in the mean of the total pain dimension. The highest was for MOPEXE (15.12 ± 4.44), followed by MPFF (7.53 ± 6.8); acupressure (7.47 ± 5.28) and NS (4.47 ± 4.91) showed more significant change than the control group (p = 0.001). The mean difference in visual analog scale (VAS) scores was highest in MOPEXE (4.53 ± 1.5), followed by acupressure (2.35 ± 1.66); MPFF (1.88 ± 1.73) and NS (1.65 ± 1.84) scores were more significant than the control group (p = 0.001). Regarding total pain intensity, the highest was MOPEXE (2.59 ± 0.94), followed by MPFF (1.18 ± 0.88); acupressure (1.06 ± 0.83) and NS (0.82 ± 1.01) scores were more significant compared to the control group (p = 0.001). There was no significant change in the pre-post difference values in the MAQ subparameters: menstruation as deliberate event, menstruating as bothersome event, menstruation as natural event, anticipation and prediction of the onset of menstruation, and denial of any effects of menstruation; menstruation as a natural event resulted in insignificant changes in parameters (p = 0.579, p = 0.074, p = 0.892, p = 0.056, p = 0. 377). CONCLUSIONS: PT and NPT methods in the study were effective in coping with PD-associated pain. MPFF was more effective than the NS group in terms of relieving pain. In terms of pain, MOPEXE and acupressure groups were as effective as PT. The most effective of these treatment methods was the MOPEXE group created by the researcher.

Are oropharyngeal exercises effective in Obstructive Sleep Apnea Syndrome?

OBJECTIVE: This study has been conducted to examine the effects of posture, cervical region and oropharyngeal exercises in patients with Obstructive Sleep Apnea Syndrome (OSAS). METHOD: Thirty patients with OSAS have been randomly divided into two groups. The first group received supervised exercise program including oropharyngeal, posture and cervical region exercises for 12 weeks. The patients in the control group have been informed about the posture but the exercise was not recommended. Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Short Form 36 (SF-36), International Physical Activity Questionnaire-Short Form (IPAQ-SF) and 6 Minute Walk Test (6MWT) have been used in the evaluation of individuals participating in the study. Evaluations have been made at the beginning of the treatment and at the end of the 12-week exercise program. RESULTS: Statistically significant improvements have been observed in the exercise group in PSQI total value, ESS score, SF-36 General Health Subscale and 6MWT (p< 0.05). Statistical significance could not be reached for other parameters. CONCLUSIONS: Sleep quality, general health, and functional capacity have been found to improve in OSAS patients with oropharyngeal exercises.

Evaluation of balance after surgery for cerebellopontine angle tumor.

BACKGROUND: The origin of about 10% of tumors located in the intracranial region is the cerebellopontine angle. Therefore Cerebellopontine Angle (CPA) tumors affect patients' balance. OBJECTIVE: The aim of this study was to compare the balance in individuals who underwent surgery for CPA tumors with healthy individuals. METHODS: Thirty patients who were being followed-up by the Department of Neurosurgery and had been operated on CPA tumor and 31 healthy individuals were included in the study as group 1 and group 2, respectively. The participants were evaluated using Romberg Test, Sharpened Romberg Test, One-leg Stance (OLS), Tandem Walking, Walk Across, Berg Balance Scale (BBS), Dizziness Handicap Inventory (DHI) and Short Form 36 (SF-36). RESULTS: In comparison of the groups, OLS tests (p< 0.001), BBS (p< 0.05) and DHI (p< 0.05) were significantly different in favor of healthy group. SF-36 results revealed a significant difference between the groups, except for Bodily Pain and Vitality (p< 0.05). CONCLUSIONS: The results of this study demonstrated a decrease in balance parameters and quality of life in individuals who underwent CPA tumor surgery in comparison to healthy individuals. Evaluation of balance in the preoperative and postoperative period should not be ignored in these patients and they are suggested to start rehabilitation in the early postoperative period.

The effects of Clinical Pilates exercises on patients with shoulder pain: A randomised clinical trial.

AIM: The purpose of this study was to determine the effect of Clinical Pilates exercises on patients with shoulder pain. MATERIAL AND METHODS: Thirty-three patients, experiencing shoulder pain continuously for at least four weeks were selected as study subjects. The patients were randomly divided into two groups, namely Clinical Pilates exercise (n = 17) group and conventional exercise (n = 16) group. The patients were treated for five days a week, the total treatment being carried out for 10 days. The assessment of pain and disability amongst the patients were done at the baseline and at the end of the treatment sessions, using Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI). RESULTS: The clinical Pilates exercise group showed a significant improvement in all scores used for assessment (p < 0.05), while the conventional exercise group demonstrated a significant improvement only in the SPADI total score (p < 0.05). A comparison of scores for the VAS, SPADI-Pain and SPADI-Total between the two groups, revealed a significant improvement in the Clinical Pilates exercise group (p < 0.05). CONCLUSION: It was demonstrated by the study that Clinical Pilates exercise is an efficient technique for patients experiencing shoulder pain, as it helps reduce pain and disability among them.

Examining the postural awareness and flexibility changes in physical therapy students who took clinical Pilates class.

OBJECTIVE: This study aimed to evaluate postural awareness and changes in posture and flexibility of students who took Clinical Pilates class as an elective course at the undergraduate level. METHODS: The study conducted from 2013-2016 included 98 students who took Clinical Pilates class at the Department of Physical Therapy and Rehabilitation, School of Health Sciences, Istanbul Medipol University, Turkey. The flexibility levels of the study participants were measured before and after the Clinical Pilates education using finger-to-floor test and modified Schober's test. Observational posture analysis and postural awareness were recorded using the scale prepared by the researchers. RESULTS: The post-education evaluations showed that postural distortions were fixed, and a significant increase in the postural awareness of the students was observed compared with the pre-education period. The results of both modified Schober's test and finger-to-floor test, which were used to measure the flexibility levels, showed a statistically significant increase in post-education scores compared with those of the pre-education period. CONCLUSION: This study showed that the Clinical Pilates course increased postural awareness and flexibility of physical therapy students and fixed postural distortions. Thus, the inclusion of Clinical Pilates class in the undergraduate education is considered to be important.

Effects of microbial transglutaminase, fibrimex and alginate on physicochemical properties of cooked ground meat with reduced salt level.

Effects of microbial transglutaminase (MTGase), fibrin/thrombin combination (fibrimex), alginate or combination of these binding agents on physicochemical parameters of cooked ground beef with reduced salt level were investigated. Seventeen treatments included three control (no binding agent) groups incorporated with varying concentrations of salt (0.5, 1, 2%, w/w) and fourteen treatment groups produced with MTGase or fibrimex or alginate or their combinations at 0.5 or 1% salt levels. The samples were analyzed for cooking loss (CL), pH, color, moisture, fat, protein, ash, salt, texture and TBARS. The results indicated that the use of MTGase or fibrimex or MTGase/fibrimex combination had significant effect on preventing textural deterioration caused by salt reduction. Even though the use of MTGase resulted in higher CL values, formulation of ground beef with fibrimex or alginate or MTGase/fibrimex/alginate combinations reduced CL when compared with the control groups. The use of fibrimex in ground beef resulted in a decrease in TBARS, lightness, redness and pH values. However, the use of alginate caused an increase in pH, lightness and redness values of ground beef. Based on the present study, the use of fibrimex or a combination of fibrimex with MTGase in the product formulation can be an effective strategy to reduce cooking loss, to improve or maintain the textural properties and to extend shelf life of cooked ground beef with reduced salt level.