Conservative Treatment in Adult Degenerative Scoliosis: a Prospective Cohort Study.

Background: Adult degenerative scoliosis (ADS) is a coronal deviation of the spine greater than 10° resulting from the progressive degeneration of the vertebral elements in middle age, which is a three-dimensional deformity. In this study, the effect of conservative treatment methods on pain, disability, and quality of life of patients with ADS was evaluated. Methods:Thirty females with ADS were included in the present study. Demographic characteristics, Cobb angles, Visual Analog Scale (VAS), Short Form-36 (SF-36), Scoliosis Research Society-22 (SRS-22) and Roland Morris Disability Questionnaires (RMDQ) were noted. Fifteen sessions of physical therapy (hotpack, TENS and ultrasound) and exercises were administered to all patients. All assessment scales were used for evaluation at baseline as well as one month and three months after treatment. Results:Visual Analog Scale scores statistically differed between the first, second and third measurements (p<0,001). There was a significantly improvement in RMDQ between periods of time (p<0,001). While the second assessment was significantly lower than the first measure (p=0,001), there was no difference between the third and second measures (p=0,496). Similarly, quality of life assessments (SRS-22, SF-36) significantly differed between the first and second assessments and continued at the third assessment. Conclusion:Given the difficulties of surgical treatment and patients' comorbidities, conservative treatment methods are becoming important for ADS. Non-surgical treatments for ADS should be taken into consideration to improve pain, disability and quality of life outcomes.

Chronic fatigue syndrome in caregivers of children with cerebral palsy and affecting factors.

OBJECTIVE: In this study, the frequency of chronic fatigue syndrome (CFS), sleep disturbances, and quality of life levels in mothers of children with cerebral palsy (CP) was compared in relation to the functional status of the child. METHODS: The caregivers were evaluated with the sociodemographic data form, Chalder fatigue scale (ChFS), Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index, and Short Form-12, respectively. In addition, the functional status of the child with CP was evaluated with the gross motor function classification system, manual ability classification system (MACS), communication function classification system, and eating and drinking ability classification system. RESULTS: According to CDC-1994 criteria, 80.4% of the participating mothers have CFS (n=45). While the mean ChFS and FSS scores of housewives were found to be significantly higher than those of full-time workers (p=0.002; p=0.003, respectively), the mean SF-12 MCS was found to be significantly lower (p=0.007). The rate of housewives was found to be significantly higher in those diagnosed with CFS (p<0.001). The relationship between independent variables and dependent variables data sets as a result of canonical correlation analysis was obtained as 0.815. While the variable with the highest effect among the independent variables is the MACS variable, the variable with the highest percentage of explanation for the dependent variables is ChFS. CONCLUSION: The frequency of CFS is very high in mothers of children with CP, and the most important factors in the presence and severity of CFS are the mother's occupational status and the child's manual skills.

Trajectory of Anxiety, Depression and Quality of Life in Ankylosing Spondylitis: A Descriptive Study.

OBJECTIVE: To investigate anxiety, depression, and health-related quality of life (HRQoL) over 15 years and associations between demographic, disease-related variables, anxiety and depression, and HRQoL in patients with AS. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Istanbul Medeniyet University Goztepe Prof. Dr. Suleymsan Yalcin City Hospital, from June to December 2021. METHODOLOGY: Seventy-five patients with AS, who were followed up in Physical Medicine and Rehabilitation outpatient clinic for 15 years, were included in this study, after their diagnosis was confirmed by the hospital system. The demographic information (gender, age, accommodation status, educational status, employment status, and time unemployed), diagnosis time, remission time, drugs used, usage of TNF-inhibitor drugs and duration of usage were recorded. Bath ankylosing spondylitis disease activity index (BASDAI) was used to the measure the disease activity, the hospital anxiety depression scale (HADS) was used for anxiety and depression screening and Short Form-36 (SF-36) was used for HRQoL. RESULTS: SF-36 physical component summary score, general health, social functioning, and role limitations due to physical health subscale scores improved significantly (p=0.004; p<0.000; p=0.024; p=0.002, respectively). It was observed that the effects of BASDAI, HADS anxiety and depression scores were significant on SF-36 (p=0.044; p=0.050; p=0.023), and time has a substantial impact on SF-36 (p=0.003). The effects of gender, education level, and occupation were not found statistically significant (p>0.05 for each). CONCLUSION: Within 15 years, quality of life increased, anxiety and depression decreased in AS patients. Along with disease activity, anxiety and depression were found to be the most important factors affecting the change in quality of life over time. KEY WORDS: Ankylosing spondylitis, Anxiety, Depression, Disease activity, Quality of life.

Obesity in ambulatory children with cerebral palsy in Turkey: A cross-sectional study.

PURPOSE: Obesity prevalence and the relationship between obesity and motor function in children with ambulatory cerebral palsy (CP) were investigated. METHODS: This was a cross-sectional study. The obesity profile of 75 children aged 2-18 years with ambulatory CP was investigated. GMFCS levels were recorded, and BMI was calculated using height and weight data and converted into Z-scores. Age- and gender-specific growth charts were used for children and adolescents. RESULTS: The mean BMI of the participants was 17.78, with an obesity rate of 18.67% and an overweight rate of 16%. Gross motor function was found to be associated with height, weight, and BMI (p < 0.05). No relationship was found between obesity + overweight and gender and CP subtype (p > 0.05). CONCLUSION: Turkish children with CP had a higher rate of obesity compared to typically developing peers and also their counterparts in other countries. There is a need for studies to identify the causes of obesity and to develop effective intervention programs for prevention of it in children with CP.

Relationship between the Properties of Paraspinal Muscles and Bone Mineral Density in Osteoporotic Patients.

OBJECTIVE: To investigate the properties of paraspinal muscle structures in osteoporotic patients, lumbar computed tomography (CT) and their relationship with lumbar and femoral neck bone mineral density (BMD). STUDY DESIGN: A Descriptive study. PLACE AND DURATION OF STUDY: Department of Radiology and Physical Medicine, Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey, between June 2020 and June 2021. METHODOLOGY: Ninety patients with osteoporosis, who received lumbar spine CT and dual-energy X-ray absorptiometry (DEXA) examinations, were retrospectively included. Cross-sectional areas (CSA), densities, index values, and Hounsfield unit average calculation(HUAC) values were measured for psoas, multifidus, erector spinae, and quadratus lumborum muscles at the L3 level, and their associations with BMD were investigated. RESULTS: A total of 90 patients including 71 females were evaluated. The mean age was 63.31±11.90 years. A moderate correlation of lumbar spine (r=0.32, p<0.01) and femur neck BMD (r=0.28, p<0.05) with erector spinae CSA was defined. Small correlation between psoas CSA (r=0.28, p<0.05) and psoas muscle index (PMI, r=0.24, p<0.05) with lumbar spine BMD was found. The CSA of all the paraspinal muscles (p<0.01) and densities, except psoas muscle (p<0.05), were higher in males. In non-obese osteoporotic patients, the density and HUAC values of the paraspinal muscles, except the psoas muscle, were found to be significantly higher (p<0.05). CONCLUSION: The properties of the paraspinal muscles measured by the lumbar CT scan are found to be related to BMD. The psoas and erector spinae CSA and index values are the most significantly associated parameters with the lumbar spine BMD. KEY WORDS: Bone mineral density, Computed tomography, Osteoporosis, Paraspinal muscles, Psoas.