Evaluation of visual reaction time in patients with fibromyalgia syndrome.

Fibromyalgia syndrome (FMS) has previously been linked to cognitive dysfunction. The aim of this study was to compare visual reaction time (RT) between FMS patients and healthy subjects. The relationship was examined between RT and clinical parameters in FMS patients, and it was aimed to evaluate the effect of drugs used in the treatment of FMS on RT. A total of 112 FMS patients and 110 healthy volunteers were included in this cross-sectional research. Cognitive performance was evaluated with visual RT measurements. FMS patients were assessed using the Fibromyalgia impact questionnaire (FIQ), Beck Depression Inventory (BDI), Fatigue Severity Scale (FSS) and Pittsburgh Sleep Quality Index (PSQI). The drugs used in the treatment of FMS were recorded. Significantly prolonged visual RT measurements were detected in FMS patients (p < 0.001). There was no significant difference in RT measurements between the patients who did not use drugs and those who were treated with serotonin noradrenaline reuptake inhibitor, gabapentinoid and combination therapy (p > 0.05). RT was significantly correlated with FIQ, BDI and PSQI scores in FMS patients (rho: 0.290, p = 0.002 for FIQ; rho: 0.253, p = 0.007 for BDI and rho: 0.312, p = 0.001 for PSQI). No significant correlation was detected between RT scores and FSS values (p > 0.05). Visual RT measurements were seen to be deteriorated in FMS patients. As the disease severity, depression level, and sleep disturbance increased, so the impairment in visual RT values became more prominent. The drugs used in the FMS treatment did not influence the RT scores. Cognitive performance tests should be incorporated in the physical examination and follow-up courses of FMS patients.

The relationship between cervical proprioception and balance in patients with fibromyalgia syndrome.

Proprioceptive abnormalities, balance, and postural disorders have been previously reported in fibromyalgia syndrome (FMS). Unlike previous research, the aim of this study was to compare the proprioception of the cervical region of patients with FMS with a healthy control group. The relationship between cervical proprioception impairment and loss of balance was also examined. A total of 96 female FMS patients and 96 female healthy control subjects were enrolled in this case-control study. The cervical joint position error test (CJPET) was administered to the patient and control groups for cervical proprioception evaluation. FMS patients were assessed with a visual analogue scale (VAS), fibromyalgia impact questionnaire (FIQ), and fatigue severity scale (FSS). Balance tests were applied to both groups. FMS patients had significantly impaired CJPET results in all directions (p < 0.001). There were significant positive correlations between FIQ scores and CJPET results (r = 0.542 and p < 0.001 for right rotation; r = 0.604 and p < 0.001 for left rotation; r = 0.550 and p < 0.001 for flexion; r = 0.612 and p < 0.001 for extension). Significant correlations were found between CJPET measurements and balance tests (for sit-to-stand test; r = 0.510 and p < 0.001 for right rotation; r = 0.431 and p < 0.001 for left rotation; r = 0.490 and p < 0.001 for flexion; r = 0.545 and p < 0.001 for extension), (for timed up and go test; r = 0.469 and p < 0.001 for right rotation; r = 0.378 and p < 0.001 for left rotation; r = 0.410 and p < 0.001 for flexion; r = 0.496 and p < 0.001 for extension) and (for one-legged balance test; r = -0.479 and p < 0.001 for right rotation; r = -0.365 and p < 0.001 for left rotation; r = -0.392 and p < 0.001 for flexion; r = -0.469 and p < 0.001 for extension). Cervical proprioception and balance were impaired in FMS patients. As the disease activity and fatigue level increased, so the deterioration in cervical proprioception became more evident. There were correlations that demonstrated an association between impaired cervical proprioception and poor balance tests. Therefore, proprioception and balance assessments should be integrated into the physical examination processes of FMS patients.

Evaluation of the relationship between osteoporosis, balance, fall risk, and audiological parameters.

The aim of the study is to investigate the factors such as balance and audiology parameters and bone mineral density (BMD), which were thought to be associated with the increased risk of fall in osteoporotic patients. Ninety-nine female patients between the ages of 40 and 75 were included in the study. Noise exposure, tinnitus, and vertigo were investigated. BMD measurement, Berg Balance Scale (BBS), Timed Up and Go (TUG), and stabilometry tests were applied to the patients. Patients were divided into three groups according to BMD measurements. Patients with a T score of - 1 and below were considered normal (control) (group 1), those with a T score of - 1 to - 2.5 were considered osteopenic (group 2), and those with a T score of - 2.5 and above were considered osteoporotic (OP) (group 3). BBS was 42.06 ± 5.00, 47.74 ± 5.18, and 51.65 ± 3.64 in groups1, 2, and 3, respectively. The difference between the groups was statistically significant (p = 0.001). OP patients had higher oscillation values in all measurements compared with the control group. However, the difference was statistically significant especially on mobile platforms (p < 0.05). Mean tones of pure tone thresholds at 500-8000 Hz for ears were significantly different in patients with OP compared with controls (p < 0.05 for 500-2000 Hz, p < 0.01 for 4000-8000 Hz). This study demonstrated that BMD reduction was correlated with balance parameters and audiological measurements. Therefore, it can be concluded that OP may affect the risk of fracture occurrence not only by decreasing BMD but also by increasing the risk of falling. KEY POINTS: • In the present study, the effects of balance and audiology parameter measurements on osteoporosis (OP) were investigated. In addition, the associations between vertigo, tinnitus, history of falling, body made index, vitamin D, and calcium values and osteoporosis were evaluated. • We determined that bone mineral density (BMD) reduction was related to balance and audiological parameters. It can be speculated that OP may affect the risk of fracture occurrence not only by decreasing BMD but also by increasing the risk of falling. We think that early diagnosis, appropriate treatment, and rehabilitation of hearing loss and OP may decrease the incidence of falling and improve the quality of life of the affected individuals.

YouTube as a source of patient information for ankylosing spondylitis exercises.

INTRODUCTION/OBJECTIVES: Ankylosing spondylitis (AS) is a rheumatic disorder characterized by structural impairments and postural deformities which restrict daily life activities. Nonpharmacologic methods, particularly exercise therapies, play a key role in the treatment. Obtaining online health-related information has become increasingly popular. We aimed to assess the quality of the most viewed YouTube videos on AS exercises. METHOD: We searched for the key words "ankylosing spondylitis exercise," "ankylosing spondylitis rehabilitation," "ankylosing spondylitis physical therapy," and "ankylosing spondylitis physiotherapy" on YouTube on October 10th, 2018. The educational quality of YouTube videos was evaluated according to the Global Quality Scale, and three groups were formed: high quality, intermediate, and low quality. Video parameters were compared between the groups. RESULTS: Of the 56 videos evaluated, 48.2% (n = 27) were of high quality, 17.9% (n = 10) were of intermediate quality, and 33.9% (n = 19) were of low quality. When video parameters compared among the groups, no significant differences were found in the number of views per day, likes per day, and comments per day (p > 0.05). Significant differences were found in the number of dislikes per day and DISCERN scores between the groups (p = 0.02, p < 0.001, respectively). CONCLUSIONS: YouTube can be considered as an important source of high-quality videos. Nearly half of the videos were of high quality. Physicians should inform patients about the importance of video resources during the use of YouTube and should guide patients to the accurate sources of information.

Foot functions in ankylosing spondylitis.

ABTRACT: AIM: Because of the wide diversity of developmental stages in spondyloarthropathies (SpA), clinical and radiographic weak correlations are often found in the development of enthesopathies. In this study, foot functions of ankylosing spondylitis (AS) patients were analyzed with clinical and radiological features. METHOD: Sixty-two AS patients and 39 age-matched, gender-matched, and body mass index (BMI)-matched healthy volunteers were included in this study. Acute-phase reactant levels of participants were recorded. The disease activity and functionality were assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI). Foot functional index (FFI) and timed up and go test (TUG) were performed by the same educated nurse. Radiographically, the SpA-tarsal radiographic index (TRI) and the calcaneal inclination angle (CIA) were measured by the same physician to assess midfoot and arches. RESULTS: FFI subscores and total, TUG results, and CIA measurements were found to be significantly higher in the AS group (p < 0.05). FFI-pain, FFI-disability, and FFI-activity limitation subscores were significantly and positively correlated with BASDAI and BASFI scores (p < 0.05). Radiological changes ranging from grade 1 to grade 4 were detected in 68% of the AS paients according to TRI. Nineteen AS patients had pes planus and 26 AS patients had pes cavus deformity. CONCLUSION: The foot and ankle are frequently affected during the course of AS. Foot involvement and its functional impacts should be assessed regardless of the disease activity parameters in AS patients.

Arterial Stiffness in Patients Taking Second-generation Antipsychotics.

OBJECTIVE: That treatment with second-generation antipsychotics (SGAs) causes metabolic side effects and atherosclerosis in patients with schizophrenia and bipolar disorder (BD) is well-known. Increased arterial stiffness is an important marker of arteriosclerosis and has been identified as an independent risk factor for cardiovascular diseases. We measured pulse wave velocity (PWV) as a marker of arteriosclerosis in patients with schizophrenia and BD who use SGAs. METHODS: Patients and controls were collected from our psychiatry outpatient clinics or family medicine. Mental illness was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Mean age, gender, systolic and diastolic blood pressure, body mass index, Framingham risk score (FRS), etc. were determined. Simultaneous electrocardiography and pulse wave were recorded with an electromyography device. The photo-plethysmographic method was used to record the pulse wave. Inclusion criteria included use of SGAs for at least the last six months. Patients with diseases that are known to cause stiffness and the use of typical antipsychotics were excluded. RESULTS: Ninety-six subject (56 patients, 40 controls) were included in our study. There were 49 females, 47 males. Patients had schizophrenia (n=17) and BD (n=39). Their treatments were quetiapine (n=15), risperidone (n=13), olanzapine (n=15), and aripiprazole (n=13). Although differences in mean age, gender, and FRS in the patient and control groups were not statistically significant (p=1), PWV was greater in patients in the antipsychotic group (p=0.048). CONCLUSION: This study supported the liability to stiffness in patients with schizophrenia and BD. Using SGAs may contribute to arterial stiffness in these patients.

Intraperitoneal Alpha-Lipoic Acid to prevent neural damage after crush injury to the rat sciatic nerve.

OBJECTIVE: Crush injury to the sciatic nerve causes oxidative stress. Alfa Lipoic acid (a-LA) is a neuroprotective metabolic antioxidant. This study was designed to investigate the antioxidant effects of pretreatment with a-LA on the crush injury of rat sciatic nerve. METHODS: Forty rats were randomized into four groups. Group I and Group II received saline (2 ml, intraperitoneally) and a-LA (100 mg/kg, 2 ml, intraperitoneally) in the groups III and IV at the 24 and 1 hour prior to the crush injury. In groups II, III and IV, the left sciatic nerve was exposed and compressed for 60 seconds with a jeweler's forceps. In Group I (n = 10), the sciatic nerve was explored but not crushed. In all groups of rats, superoxide dismutase (SOD) and catalase (CAT) activities, as well as malondialdehyde (MDA) levels were measured in samples of sciatic nerve tissue. RESULTS: Compared to Group I, Group II had significantly decreased tissue SOD and CAT activities and elevated MDA levels indicating crush injury (p < 0.05). In the a-LA treatment groups (groups III and IV), tissue CAT and SOD activities were significantly increased and MDA levels significantly decreased at the first hour (p < 0.05) and on the 3rd day (p < 0.05). There was no significant difference between a-LA treatment groups (p > 0.05). CONCLUSION: A-LA administered before crush injury of the sciatic nerve showed significant protective effects against crush injury by decreasing the oxidative stress. A-LA should be considered in the treatment of peripheral nerve injuries, but further studies are needed to explain the mechanism of its neuroprotective effects.

The effects of therapeutic ultrasound on heart rate variability: a placebo controlled trial.

The effect of therapeutic ultrasound (US) on nervous system is controversial and the effect on autonomic nervous system is not clear. Therefore, the present placebo-controlled trial was planned to investigate the effects of therapeutic US application on right-side stellate ganglion, by using analysis of heart rate variability (HRV). A total 12 healthy volunteers were included in the study. RR intervals were recorded for 5 min before and after the US application, in supine and sitting positions. All procedures were repeated in all participants with sham US one week later. The heart rate (HR) was obtained by time-domain analysis and low frequency (LF) power (%), high frequency (HF) power (%) and LF/HF ratio values were obtained by frequency-domain (power spectral density) analysis. After the US application, there was a decrease in the HR (p = 0.002) and the HF power (%) component (p = 0.015) in supine position and a decrease in HR (p = 0.002) and LF/HF ratio (p = 0.028) in sitting position. There was no significant difference after the sham US application. In conclusion, we observed that therapeutic US application on stellate ganglion causes alterations on HRV parameters.