Quality of life and related factors in degenerative lumbar spinal stenosis: A controlled study.

OBJECTIVE: The purpose of this study was to compare the quality of life of patients with lumbar spinal stenosis (LSS) with that of the controls' and to investigate the factors related with the quality of life in LSS. METHODS: Fifty-four patients with LSS were included in the study whose diagnosis were made by clinically and magnetic resonance imaging (MRI). Control group consisted of age and sex matched 54 individuals. Both of the patient and control groups were evaluated with the Short Form-36 (SF-36) health survey and Hospital Anxiety Depression Scale (HADS). The Oswestry Pain and Disability Index (ODI) was used for the assessment of the disability. RESULTS: SF-36 scores in the LSS group was lower than that of the controls'. There was a significantly positive correlation between the SF-36 scores and walking distance in LSS group. A moderately negative correlation was found between the SF-36 and the ODI, HADS anxiety and depression scores. There was a significantly positive correlation between the ODI and the HADS anxiety and depression scores. HADS anxiety and depression scores in the patient group were significantly higher than that of the controls'. CONCLUSIONS: As a result, quality of life was decreased in subjects with LSS. The factors related with the quality of life were the walking distance, severity of the disability and emotional status in LSS.

The effects of using the Internet on the health-related quality of life in people with spinal cord injury: a controlled study.

STUDY DESIGN: Prospective cohort study. OBJECTIVES: To compare the health-related quality of life (HRQoL) in people with spinal cord injury (SCI) who use the Internet versus those who don't and with a control group of able-bodied individuals. To investigate the frequency of Internet usage before and after injury. To evaluate the differences in terms of demographic features of both groups, analyze the variation in the Internet usage pattern of people with SCI before and after the injury. SETTING: Istanbul, Turkey. METHODS: A total of 60 people with SCI (38 Internet users, 22 nonusers) were included in the study. The control group consisted of 33 healthy persons of similar age and sex. The HRQoL was evaluated with the SF-36 Health Survey. RESULTS: The scores of all the subscales of the SF-36, except vitality, were significantly lower in people with SCI than those of the controls'. The bodily pain subscale and physical component scores were found to be significantly higher in people with SCI using the Internet than the nonuser group with SCI (P<0.05). The Internet usage frequency increased significantly in people with SCI after injury (P<0.05). A significant correlation was found between time since injury and Internet use (r=0.365, P=0.007). CONCLUSION: Although HRQoL scores were lower in people with an SCI, the physical status component score was better in the Internet user SCI group. As there is a significant increase in the time spent online after injury, the Internet could be an effective modality to contact and educate people with an SCI.

Reliability and validity of the Turkish version of spinal cord lesion-related coping strategies.

OBJECTIVE: Spinal Cord Lesion-Related Coping Strategies Questionnaire (SCL CSQ) is a specific test that is developed for evaluating the coping strategies of the persons with spinal cord injury (SCI). The aim of this study was to evaluate the reliability and validity of the Turkish version of SCL CSQ (SCL CSQ-T) in persons with SCI. METHODS: One hundred persons with SCI were included in the study. All participants were evaluated with SCL CSQ-T and Brief Coping Styles Inventory (BCSI) at the baseline. SCL CSQ-T was repeated twice in 15 days. American Spinal Injury Association Impairment Scale and Functional Independence Measurement were used for the evaluation of the neurological loss severity and functional status. Emotional status was assessed by Hospital Anxiety and Depression Scale (HADS). Internal consistency reliability, test-retest reliability and construct validity of SCL CSQ-T were evaluated. RESULTS: Intraclass correlation coefficients of the SCL CSQ-T were between 0.51-0.86. Cronbach's alpha values and test-retest reliability of the acceptance, fighting spirit and social reliance subscales were good. Three factors were found in exploratory factor analysis. There was a positive correlation between the subscales of SCL CSQ-T. There was a statistically significant positive correlation between acceptance strategy of SCL CSQ-T and self-confidence and optimism of BCSI. The fighting spirit strategy positively correlated with self-confidence and optimistic strategies. The social reliance strategy positively correlated with helplessness and seeking social support. Coping strategies did not correlate with HADS. CONCLUSION: The results of this study revealed good internal consistency reliability, test-retest reliability and concurrent validity of the SCL CSQ-T factors acceptance and fighting spirit in relation to general coping strategies. The coping strategy social reliance needs revisions.

Efficacy of supervised exercise combined with transcutaneous electrical nerve stimulation in women with fibromyalgia: a prospective controlled study.

The aim of this study was to investigate the results of a supervised exercise with transcutaneous electrical nerve stimulation (TENS) in an exercise controlled study in women with fibromyalgia. Sixty-six women with fibromyalgia who admitted to the outpatient clinic of our hospital were randomized into two treatment groups. The patients in both groups participated in a supervised combined exercise program for 12 weeks. The women in first group had additional TENS in the first 3 weeks of the study. All subjects were analyzed at the baseline, at the end of the 3rd and 12th weeks. Outcome measures were tender point count (TPC), myalgic pain score (MPS), Fibromyalgia Impact Questionnaire (FIQ) and Short Form-36 (SF-36) Health Survey. Sixty women with fibromyalgia completed the study. The patients in both groups showed improvement in terms of TPC, MPS, FIQ, physical and mental summary scores and total scores of SF-36 at the end of the 3rd and 12th weeks. The improvement in MPS at the third week was higher in the first group (p = 0.01). But there was no difference in terms of the improvement in MPS between the groups at the end of the 12th week control (p = 0.87). There was no significant difference between the improvement in the other outcome parameters of the two groups. As a result, supervised exercise program was successful to improve the myalgic pain, functional status and quality of life in women with fibromyalgia. Exercises combined with TENS might be useful due to quick myalgic pain relief in the treatment of fibromyalgia in everyday practice.

Comparison of the coping strategies, anxiety, and depression in a group of Turkish spinal cord injured patients and their family caregivers in a rehabilitation center.

BACKGROUND: Spinal cord injury (SCI) effects the emotional states and coping strategies of the patients and their families. The interesting point is the interaction between the emotional status and coping strategies. AIM: The aim of this study was to investigate the coping strategies and emotional states of the individuals with SCI and their caregivers and to compare the results of the groups. DESIGN: Cross-sectional SETTING: Inpatient rehabilitation. POPULATION: Thirty one patients with traumatic SCI and 31 family caregivers admitted to the inpatient rehabilitation were evaluated. METHODS: The injury duration was ≤12 months. Coping strategies and emotional status of the participants were evaluated by Brief Ways of Coping Questionnaire and Hospital Anxiety and Depression Scale. ASIA impairment scale and Functional Independence Measurement (FIM) were used for the assessment of the lesion severity and functional status. RESULTS: The most common coping strategies were self confidence and optimistic strategies both in the patient and caregiver groups. There was no statistically significant difference between the coping strategies and emotional status of the groups (P>0.05). A positive correlation was found between helplessness strategy and age in patients with SCI. Coping strategies did not show correlation with FIM. Anxiety in caregivers correlated negatively with SCI duration (P<0.05). CONCLUSION: As a result, the coping strategies and emotional status in the SCI patients and family caregiver groups showed similarity. CLINICAL REHABILITATION IMPACT: SCI patients and also their family caregivers must be evaluated in terms of coping strategies, anxiety and depression. The couples with maladaptive coping styles and emotional mood disorders might be supported with special interventions to help the adaptation to SCI and to improve the rehabilitation efficacy.