The frequency of neuropathic pain in Turkish patients with low back pain: a cross-sectional study.

The aim of this study was to evaluate the frequency of neuropathic pain (NP) in patients with low back pain (LBP) and the relationship of NP with demographic characteristics and pain duration. Four hundred and forty patients were evaluated with respect to NP. Demographic data were collected and Douleur Neuropathique 4 Questions (DN4) questionnaire was used to identify NP. Any difference in demographic characteristics or duration of pain was investigated between the patients with and without NP. Sociodemographic factors which are independently associated with NP were analyzed. According to DN4, 43.9% of the patients had NP. Mean age of the patients was 44.8 years (± 13.7). 343 (77.9%) of the patients had chronic LBP (more than 3 months). The patients with NP were older (p < 0.001), had higher BMI (p = 0.005) and longer LBP duration (p < 0.001) and had lower educational level (p 0.018). NP was significantly more common in unemployed patients and less common in high-activity employees (p 0.001). Logistic regression analyses identified that high-active workers' risk of having NP was 1.76 times lesser than other groups (office workers, housewives and retired patients). Nearly half of the patients with LBP were accompanied by NP. It was remarkably more common in sedentary patients and patients with low socioeconomic status. High physical activity at work was found to decrease the risk of having NP. Clinicians should emphasize on exercise training as a therapeutic intervention while LBP is being treated.

Assessment of quality of life in relation to spasticity severity and socio-demographic and clinical factors among patients with spinal cord injury.

Objective: To assess the impact of spasticity severity as well as socio-demographic and clinical factors on quality of life (QOL) and to identify factors predicting poor QOL among patients with spinal cord injury (SCI)Design: Descriptive cross-sectional study.Setting: Tertiary care clinic in Istanbul, Turkey.Participants: A total of 110 patients with SCI (mean (SD) age: 43.8 (14.7) years, 58.2% were males) were enrolled.Assessments: The American Spinal Injury Association (ASIA) Impairment Scale (AIS), Modified Ashworth Scale (MAS) and Turkish version of the World Health Organization Quality of life questionnaire (WHOQOL-BREF) were utilized to determine the SCI category, severity of spasticity and QOL scores, respectively.Outcome measures: The WHOQOL-BREF scores were evaluated with respect to the severity of spasticity, aetiology and duration of SCI, AIS category and method of bladder management.Results: The mean (SD) physical health (41.9 (15.3) vs. 46.5 (10.9), P = 0.029), social relationships (45.6 (20.2) vs. 53.8 (17.3), P = 0.025) and total WHOQOL-BREF scores were significantly lower in patients with more severe spasticity. Multivariate linear regression analysis revealed that severity of spasticity was a significant predictor of decreased WHOQOL-BREF total scores, physical domain scores and social relations domain scores by 11.381 (P = 0.007), 11.518 (P = 0.005) and 17. 965 (P = 0.004), respectively.Conclusion: In conclusion, addressing QOL in relation to severity of spasticity for the first time among Turkish SCI patients, our findings revealed a negative impact of the spasticity severity on the WHOQOL-BREF scores, particularly for physical health and social relationship domains.

Unexpected foreign body in the bladder of a spinal cord injured patient: A case report.

Context: Bladder dysfunction is common in patients with spinal cord injuries. Clean intermittent catheterization is a preferred method of neurogenic bladder management among spinal cord injured patients. Some complications may occur due to the use of clean intermittent catheterization.Findings: In this report, we presented a case with an unexpected foreign body detected in the bladder of a patient who used to perform clean intermittent catheterization for her neurogenic bladder management, to our knowledge, which has not been reported in the literature so far.Conclusion/Clinical Relevance: In this case report, we want to emphasis the importance of different kind of foreign bodies remaining in the bladder during clean intermittent catheterization.

Wharton's Jelly-Derived Mesenchymal Stem Cell Transplantation in a Patient with Hypoxic-Ischemic Encephalopathy: A Pilot Study.

Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) have been introduced as a possible therapy in hypoxic-ischemic encephalopathy (HIE). We report a 16-year-old boy who was treated with WJ-MSCs in the course of HIE due to post-cardiopulmonary resuscitation. He received a long period of mechanical ventilation and tracheostomy with spastic quadriparesis. He underwent the intrathecal (1×106/kg in 3 mL), intramuscular (1×106/kg in 20 mL) and intravenous (1×106/kg in 30 mL) administrations of WJ-MSCs for each application route (twice a month for 2 months). After stem cell infusions, progressive improvements were shown in his neurological examination, neuroradiological, and neurophysiological findings. To our best knowledge, this is a pioneer project to clinically study the neural repair effect of WJ-MSCs in a patient with HIE.

Persistent de Quervain tenosynovitis induced by somatotropin treatment.

BACKGROUND: Growth hormone deficiency is a well-known clinical entity that is usually treated with somatotropin (growth hormone). Growth hormone has some frequent side effects such as intracranial hypertension, lymphedema and diabetes mellitus. CASE PRESENTATION: We report the case of a 14-year-old girl with a history of wrist pain and clumsiness. Magnetic resonance imaging revealed de Quervain tenosynovitis. The patient had a history of using growth hormones for 12 months. We conservatively managed the patient with corticosteroid injections and oral nonsteroidal anti-inflammatory drugs and followed the course. However, the conservative treatment methods failed, and we recommended surgery, which was rejected. She was given nonsteroidal anti-inflammatory drugs and was followed up for 2 years, at the end of which her visual analog scale had decreased from 80 to 50. CONCLUSIONS: To the best of our knowledge this is the first case of de Quervain tenosynovitis related to somatotropin treatment. Physicians should consider the possibility of musculoskeletal side effects after somatotropin treatment.

Kinesio Taping in patients with lumbar disc herniation: A randomised, controlled, double-blind study.

BACKGROUND: Lumbar disc herniation (LDH) causes pain and working day loss when activated. Patients spend most of their time in the hospital. And also it may limit patients' daily living activities. Kinesio Taping (KT) is a method that can be easily applied to the patients and does not interfere with their daily activities or movements of body. OBJECTIVE: This study investigated the effects of KT in patients with low back pain due to LDH. METHODS: Randomised-placebo controlled double blind clinical trial. Sixty Patients with low back pain due to LDH were randomised as KT group or placebo taping group. Taping was performed once a week for three weeks. Patients were followed up during twelve weeks. Numeric rating scale (NRS), lumbar flexion, Health Assessment Questionnaire (HAQ), Oswestry Disability Index (ODI) and paracetamol tablets taken were used for outcome measurements. RESULTS: Demographic and clinical features of the groups were similar. There were significant improvements in all parameters during intervention period in groups. Improvements in NRS-activity, HAQ and ODI continued to twelfth weeks only in KT group. In KT group, analgesic need was significantly less at follow-up. CONCLUSIONS: KT reduced analgesic need of patients with LDH when compared with placebo taping.

Validity and reliability of a Turkish Brief Pain Inventory Short Form when used to evaluate musculoskeletal pain.

BACKGROUND: The Brief Pain Inventory (BPI) is both a questionnaire and an outcome measure that is used widely in clinical trials to assess pain associated with many conditions. The BPI Short Form has been extensively translated into foreign languages. The aim of this study was to assess the validity and reliability of a Turkish Brief Pain Inventory Short Form (BPI-TR) to evaluate musculoskeletal pain. METHODS: In total, 297 patients with musculoskeletal pain participated in the study. Demographic characteristics and brief medical histories were recorded. Pain intensity was assessed using a visual analogue scale (VAS) and quality-of-life was assessed using the Short Form 36 (SF-36). Pain was evaluated using the BPI-TR in all patients. Internal consistency and test-retest analysis were used to assess reliability. The internal consistency of the scale items was assessed by calculating Cronbach's α value, which was expected to be > 0.7. The criterion validity of the BPI-TR was assessed by correlation with VAS scores. RESULTS: Pain intensity, pain interference, and other components of the Turkish version were consistent with validity thereof. Cronbach's α was 0.84 for pain intensity and 0.89 for pain interference. The extent of BPI-TR and VAS correlation was statistically significant. CONCLUSIONS: The BPI-TR may be used for assessment of musculoskeletal pain.

Influence of patient training on persistence, compliance, and tolerability of different dosing frequency regimens of bisphosphonate therapy: An observational study in Turkish patients with postmenopausal osteoporosis.

OBJECTIVE: In our study, we aimed to evaluate the influence of training on compliance and persistence with bisphosphonate treatment given on a weekly vs. monthly basis in postmenopausal osteoporosis patients. METHODS: A total of 979 patients with postmenopausal osteoporosis (mean age: 63.2 ± 7.2 years) were included in this national, multicenter, prospective non-interventional observational cohort registry study. Patients were randomized into training (n = 492, 50.3%, mean age: 63.4 ± 7.2 years) and control (n = 487, 49.7%, mean age: 63.0 ± 7.1 years) groups. Patients in each intervention group were given weekly (44.9% and 44.6% for training and control subjects, respectively) or monthly (55.1% and 55.4%, respectively) bisphosphonate regimens. After the initial visit, patients were followed up at three-month intervals throughout 12 months of treatment for evaluation of persistence, compliance and adverse events. RESULTS: On average, 79.4% of the patients were persistent with the treatment with a mean of 350.4 days of duration during the 12-month follow-up period. The mean compliance in the compliant and fully compliant group remained at an average of 86.6%. No significant difference was detected between the training and control groups in terms of compliance and persistence. Significantly longer persistence (360.0 ± 89.0 vs. 345.0 ± 108.0 days; p = 0.035), higher percentage of persistent patients (83.4% vs. 74.2%; p = 0.012) and higher compliance rates (88.8% vs. 83.3%; p = 0.002) were noted in monthly regimen patients in comparison to those given weekly regimen. CONCLUSION: Our findings revealed remarkably high rates for persistence and compliance with bisphosphonate treatment in postmenopausal osteoporosis, with no impact of training on compliance and persistence rates. Longer persistence and better compliance rates were achieved with the monthly bisphosphonate regimen when compared to the weekly regimen.

Rehabilitation outcomes of children with cerebral palsy.

[Purpose] To evaluate the results of Bobath-based rehabilitation performed at a pediatric cerebral palsy (CP) inpatient clinic. [Subjects and Methods] The study subjects were 28 children with CP who were inpatients at a pediatric service. Inclusion criteria were: being an inpatient of our hospital aged 2-12 with a diagnosis of CP; having one permanent primary caregiver; and the caregiver having no medical or psychotic problems. All of the patients received Bobath treatment for 1 hour per day, 5 days a week. The locomotor system, neurologic and orthopedic examination, Gross Motor Function Measure (GMFM) of the patients, and Short Form-36 (SF-36) of permanent caregivers were evaluated at the time of admission to hospital, discharge from hospital, and at 1 and 3 months after discharge. [Results] Post-admission scores of GMFM at discharge, and 1 and 3 months later showed significant increase. Social function and emotional role subscores of SF-36 had increased significantly at discharge. [Conclusion] Bobath treatment is promising and randomized controlled further studies are needed for rehabilitation technics.

Femoral cartilage thickness measurements in healthy individuals: learning, practicing and publishing with TURK-MUSCULUS.

BACKGROUND AND OBJECTIVES: Measurement of the femoral cartilage thickness by using in-vivo musculoskeletal ultrasonography (MSUS) has been previously shown to be a valid and reliable method in previous studies; however, to our best notice, normative data has not been provided before in the healthy population.The aim of our study was to provide normative data regarding femoral cartilage thicknesses of healthy individuals with collaborative use of MSUS. METHODS: This is across-sectional study run at Physical and Rehabilitation Medicine Departments of 18 Secondary and Tertiary Centers in Turkey. 1544 healthy volunteers (aged between 25-40 years) were recruited within the collaboration of TURK-MUSCULUS (Turkish Musculoskeletal Ultrasonography Study Group). Subjects who had a body mass index value of less than 30 and who did not have signs and symptoms of any degenerative/inflammatory arthritis or other rheumatic diseases, history of knee trauma and previous knee surgery were enrolled. Ultrasonographic measurements were performed axially from the suprapatellar window by using linear probes while subjects' knees were in maximum flexion. Three (mid-point) measurements were taken from both knees (lateral condyle, intercondylar area, medial condyle). RESULTS: A total of 2876 knees (of 817 M, 621 F subjects) were taken into analysis after exclusion of inappropriate images. Mean cartilage thicknesses were significantly lower in females than males (all p< 0.001). Thickness values negatively correlated with age; negatively (females) and positively (males) correlated with smoking. Men who regularly exercised had thicker cartilage than who did not exercise (all p < 0.05). Increased age (in both sexes) and absence of exercise (males) were found to be risk factors for decreased cartilage thicknesses. CONCLUSION: Further data pertaining to other countries would be interesting to uncover whether ethnic differences also affect cartilage thickness. Collaborative use of MSUS seems to be promising in this regard.

Low back pain prevalence and characteristics in caregivers of stroke patients: a pilot study.

PURPOSE: The aim of this study was to determine the frequency and features of low back pain (LBP) among stroke caregivers. METHOD: Participants included 64 caregivers of stroke survivors in our inpatient clinic. Age, gender, body weight, FIMTM, and Brunnstrom Scale of patients and low back pain history, Short Form-36 (SF-36), Beck Depression Measure (BDM), and Oswestry Disability Scale (ODS) of caregivers were reported. Descriptive statistics, Spearman correlation, and Mann-Whitney U test were used. RESULTS: Fifty-three (82.8 %) of caregivers had LBP. Stroke survivors of caregivers with LBP (group 1) had significantly lower FIMTM scores when compared with stroke survivors of caregivers without LBP (group 2) (P < .05). All SF-36 subscores and total score of group 1 except mental health were significantly lower than SF-36 scores of group 2. DISCUSSION: The lifetime, 12-month period, and point prevalence of LBP were 44.1%, 34.0%, and 19.7%, respectively, in our country. Caregivers had a higher frequency of LBP in this study. However it was a study with a small number of participants. There are many studies about stroke caregivers' depression and life quality. LBP should also be investigated.

Effects of age, gender, and cognitive, functional and motor status on functional outcomes of stroke rehabilitation.

Our objective was to evaluate the relation between age, gender, initial functional, cognitive and motor condition, spasticity, diabetes mellitus, and functional outcome after rehabilitation of stroke patients. Eighty-eight patients who had suffered stroke were administered in this study. Participants were stroke patients undergoing rehabilitation in Istanbul Physical Treatment and Rehabilitation Training and Research Hospital. Functional condition (Functional Independence Measurement (FIM)), spasticity (Ashworth Scale), cognitive condition (Mini Mental State Evaluation (MMSE)), post-treatment FIM were measured. A significant positive association between MMSE at admission and the functional discharge measures was observed. A significant positive association Brunnstrom (upper lower extremity assessment) scores and the functional discharge measures was observed. A significant positive association between spasticity at admission and the functional discharge measures was observed. In conclusions, the admission functional, motor, cognition condition, age, spasticity were a significant predictors of total and motor FIM score at discharge, but not gender and diabetes mellitus.