Effect of pilates training on people with fibromyalgia syndrome: a pilot study.

UNLABELLED: Altan L, Korkmaz N, Bingol U, Gunay B. Effect of Pilates training on people with fibromyalgia syndrome: a pilot study. OBJECTIVE: To investigate the effects of Pilates on pain, functional status, and quality of life in fibromyalgia, which is known to be a chronic musculoskeletal disorder. DESIGN: Randomized, prospective, controlled, and single-blind trial. SETTING: Physical medicine and rehabilitation department. PARTICIPANTS: Women (N=50) who had a diagnosis of fibromyalgia syndrome (FMS) according to the American College of Rheumatology criteria. INTERVENTION: The participants were randomly assigned into 2 groups. In group 1, a Pilates exercise program of 1 hour was given by a certified trainer to 25 participants 3 times a week for 12 weeks. In group 2, which was designed as the control group, 25 participants were given a home exercise (relaxation/stretching) program. In both groups, pre- (week 0) and posttreatment (week 12 and week 24) evaluation was performed by one of the authors, who was blind to the group allocation. MAIN OUTCOME MEASURES: Primary outcome measures were pain (visual analog scale) and Fibromyalgia Impact Questionnaire (FIQ). Exploratory outcome measures were number of tender points, algometric score, chair test, and Nottingham Health Profile. RESULTS: Twenty-five Pilates exercise and 24 relaxation/stretching exercise participants completed the study. In group 1, significant improvement was observed in both pain and FIQ at week 12 but only in FIQ at 24 weeks. In group 2, no significant improvement was obtained in pain and FIQ at week 12 and week 24. Comparison of the 2 groups showed significantly superior improvement in pain and FIQ in group 1 at week 12 but no difference between the 2 groups at week 24. CONCLUSIONS: We suggest Pilates as an effective and safe method for people with FMS. Our study is the first clinical study designed to investigate the role of the Pilates method in FMS treatment. We believe that further research with more participants and longer follow-up periods could help assess the therapeutic value of this popular physical exercise method.

Antimicrobial activity of endemic Digitalis lamarckii Ivan from Turkey.

Antimicrobial activity of the methanolic extracts of leaves and flowers of D. lamarckii Ivan, (Scophulariaceae), an endemic plant species of Turkey, was tested on ten bacterial and four yeast strains. Effective antibacterial activity was observed in four bacterial strains. Minimum inhibitory concentration (MIC) was calculated by use of liquid culture tests and in all the four effective bacterial strains, the MIC was found to be > or = 199.5 mg/ml. The minimum bactericidal concentration (MBC) of B. subtilis, S. aureus, and L. monocytogenes was calculated to be > or = 199.5 mg/ml, and MBC value for Shigella was calculated as > or = 399 mg/ml.

Antimicrobial activity of endemic Crataegus tanacetifolia (Lam.) Pers and observation of the inhibition effect on bacterial cells.

Up to now an increasing number of antibiotic-resistant bacteria have been reported and thus new natural therapeutic agents are needed in order to eradicate these pathogens. Through the discovery of plants such as Crataegus tanacetifolia (Lam.) Pers that have antimicrobial activity, it will be possible to discover new natural drugs serving as chemotherapeutic agents for the treatment of nosocomial pathogens and take these antibiotic-resistant bacteria under control. The objective of the present study was to determine antimicrobial activity and the activity mechanism of C. tanacetifolia plant extract. The leaves of C. tanacetifolia, which is an endemic plant, were extracted using methanol and tested against 10 bacterial and 4 yeast strains by using a drop method. It was observed that the plant extract had antibacterial effects on Bacillus subtilis, Shigella, Staphylococcus aureus, and Listeria monocytogenes among the microorganisms that were tested. Minimum inhibitory concentration (MIC) results obtained at the end of an incubation of 24 h were found to be > or =6.16 mg ml(-1) for B. subtilis, < 394 mg ml(-1) for Shigella, and > or =3.08 mg ml(-1) for L. monocytogenes and S. aureus and minimum bactericidal concentration (MBC) were found as > or =24.63 mg ml(-1) for B. subtilis, > or =394 mg ml(-1) for Shigella, > or =6.16 mg ml(-1) for L. monocytogenes, and > or =98.5 mg ml(-1) for S. aureus. According to the MBC results, it was found that the plant extract had bactericidal effects and in order to explain the activity mechanism and cell deformation of bacterial strains treated with plant extract, the scanning electron microscopy (SEM) was used. The results of SEM showed that the treated cells appeared shrunken and there was degradation of the cell walls. This study, in which the antibacterial effect of C. tanacetifolia was demonstrated, will be a base for further investigations on advanced purification and effect mechanism of action of its active compounds.

Balneotherapy and tap water therapy in the treatment of knee osteoarthritis.

To investigate if spa water is superior to tap water (TW) in relieving the symptoms of pain, joint motion, life quality in knee osteoarthritis (KOA) patients. In this randomized placebo-controlled trial, 52 patients with KOA were followed in two groups. In group I (n = 27), patients were treated in the pool full of spa water at 37 degrees C for 20 min a day, 5 days a week, for a period of 2 weeks. In group II (n = 25), the same protocol was used but spa water was replaced by TW heated to 37 degrees C. Patients in both groups were given a home-based standardized exercise program. Evaluation parameters were pain (pVAS), tenderness score (TS), 50-ft walking duration, quadriceps muscle strength (QMS), active flexion degree (AFD), WOMAC OA index, and Nottingham Health Profile (NHP). The first evaluation was done after the informed consent was obtained. Second and third evaluations were done at the 2nd and 12th week. PVAS, 50-ft walking duration, AFD, TS, WOMAC, and NHP variables improved in group I. Same variables except QMS improved also in group II. Comparison of the groups just after treatment showed that only pVAS (P = 0.015), NHP pain score (P = 0.020), and TS (P = 0.002) differed significantly in favor of group I at the 2nd or 12th week. Both of the thermal treatment modalities were found to be effective in the management of the clinical symptoms and quality of life in KOA patients. However, pain and tenderness improved statistically better with balneotherapy. There were no significant differences between the groups for the other variables.

Low-power laser treatment for shoulder pain.

OBJECTIVE: The objective of this study is to investigate the effect of low-power gallium-arsenide laser treatment on the patients with shoulder pain. BACKGROUND DATA: Low-energy laser therapy has recently been popularized in the treatment of various rheumatologic, neurologic, and musculoskeletal disorders such as osteoarthritis, rheumatoid arthritis, fibromyalgia, carpal tunnel syndrome, rotator cuff tendinitis, and chronic back pain syndromes. METHODS: A total of 40 patients who applied to our clinic with shoulder pain and complied with the selection criteria were included in the study. The patients were randomly assigned into Group I (n = 20, laser treatment) and Group II (n = 20, control). In Group I, patients were given laser treatment and an exercise protocol for 10 sessions during a period of 2 weeks. Laser was applied over tuberculum majus and minus, bicipital groove, and anterior and posterior faces of the capsule, regardless of the existence of sensitivity, for 1 min at each location at each session with a frequency of 2000 Hz using a GaAs diode laser instrument (Roland Serie Elettronica Pagani, wavelength 904 nm, frequency range of 5-7000 Hz, and maximum peak power of 27 W, 50 W, or 27 x 4 W). In Group II, placebo laser and the same exercise protocol was given for the same period. Patients were evaluated according to the parameters of pain, palpation sensitivity, algometric sensitivity, and shoulder joint range of motion before and after treatment. RESULTS: Analysis of measurement results within each group showed a significant posttreatment improvement for some active and passive movements in both groups, and also for algometric sensitivity in Group I (p < 0.05-0.01). Posttreatment palpation sensitivity values showed improvement in 17 patients (85%) for Group I and six patients (30%) for Group II. Comparison between two groups showed superior results (p < 0.01 and p < 0.001) in Group I for the parameters of passive extension and palpation sensitivity but no significant difference for other parameters. CONCLUSIONS: The results of our study have shown better results in palpation sensitivity and passive extension, but no significant improvement in pain, active range, and algometric sensitivity in laser treatment group compared to the control group in the patients with shoulder pain.

Investigation of the effect of GaAs laser therapy on cervical myofascial pain syndrome.

Low-energy laser therapy has been applied in several rheumatoid and soft tissue disorders with varying rates of success. The objective of our study was to investigate the effect of laser therapy on cervical myofascial pain syndrome with a placebo-controlled double-blind prospective study model. It was performed with a total of 53 patients (35 females and 18 males) with cervical myofascial pain syndrome. In group 1 (n = 23), GaAs laser treatment was applied over three trigger points bilaterally and also one point in the taut bands in trapezius muscle bilaterally with a frequency of 1000 Hz for 2 min over each point once a day for 10 days during a period of 2 weeks. In group 2 (n = 25), the same treatment protocol was given, but the laser instrument was switched off during applications. All patients in both groups were instructed to perform daily isometric exercises and stretching just short of pain for 2 weeks at home. Evaluations were performed just before treatment (week 0), immediately after (week 2), and 12 weeks later (week 14). Evaluation parameters included pain, algometric measurements, and cervical lateral flexion. Statistical analysis was done on data collected from three evaluation stages. The results were evaluated in 48 patients (32 females, 16 males). Week 2 and week 14 results showed significant improvement in all parameters for both groups. However, comparison of the percentage changes both immediately and 12 weeks after treatment did not show a significant difference relative to pretreatment values. In conclusion, the results of our study have not shown the superiority of GaAs laser therapy over placebo in the treatment of cervical myofascial pain syndrome, but we suggest that further studies on this topic be done using different laser types and dosages in larger patient populations.

Investigation of the supplementary effect of GaAs laser therapy on the rehabilitation of human digital flexor tendons.

OBJECTIVE: To investigate the effect of laser photostimulation in rehabilitation of human digital flexor tendons with a placebo-controlled double-blind prospective study model. BACKGROUND DATA: Low-energy laser therapy has been applied in several rheumatoid and soft tissue disorders with a varying rate of success and it has also been shown to have a positive effect on tendon healing in animal experiments, but no clinical study on laser photostimulation in the treatment of human tendons has been reported to date. MATERIALS AND METHODS: This study was performed in a total of 25 patients with 41 digital flexor tendon injuries in five anatomical zones. In Group I (21 digits in 13 patients), whirlpool and infrared GaAs diode laser with a frequency of 100 Hz. was applied between the 8th and 21st days postoperatively and all patients were given the Washington rehabilitation program until the end of the 12th week. In Group II (20 digits in 12 patients), the same treatment protocol was given but the laser instrument was switched off during applications. RESULTS: The results of the study showed a significant improvement in the laser-treated group only for the parameter of edema reduction (p < 0.01) but the difference between the two groups was non-significant for pain reduction, hand grip strength, and functional evaluation performed according to Strickland and Buck-Gramcko systems using total active motion and fingertip-to distal palmar crease distance parameters (p > 0.05). CONCLUSIONS: Significant improvement obtained in edema reduction both immediately and 12 weeks after supplementary GaAs laser application in our study has been interpreted as an important contribution to the rehabilitation of human flexor tendon injuries because edema is known to have a detrimental effect on functional recovery during both early and late stages of tendon healing. However, our study has failed to show a significant positive effect of supplementary GaAs laser application on the other functional recovery parameters of human flexor tendon injury rehabilitation and we suggest further clinical study in this topic be done using different laser types and dosages in order to delineate the role of this promising treatment modality.

[The prognostic value of the Hand Injury Severity Score in industrial hand injuries]. / El Yaralanmasi Ciddiyet Skoru'nun endüstriyel el yaralanmalarinda prognozu belirlemedeki rolü.

BACKGROUND: We evaluated the value of the "Hand Injury Severity Score" (HISS) in determining the prognosis of industrial hand injuries. METHODS: Hand injury severity scores of 112 patients (17 females, 95 males; mean age 31 years; range 15 to 54 years) were calculated following surgery for industrial hand injuries. During the course of rehabilitation program, the patients were followed-up regularly. Pearson correlation coefficients were used to determine the relationship between the HISS scores and the time intervals from injury to healing and return to work. RESULTS: The mean HISS score was 37.1+/-27 (range 6 to 116). The time to healing ranged from 12 to 210 days (mean 73.7+/-40.7 days). All the patients returned to work after a mean of 80.4+/-52.9 days (range 7 to 300 days), mainly to previous working places with (12%) or without (79%) changing job activities. Nine per cent of the workers had to change their jobs. The HISS scores were found to be correlated with the healing period and the time to work (p<0.05 and p<0.000, respectively). CONCLUSION: The results of this study indicated that HISS was a useful system in predicting the prognosis in the early stages of industrial hand injuries.

Investigation of the effects of pool-based exercise on fibromyalgia syndrome.

OBJECTIVE: The aim of this study was to compare pool-based exercise and balneotherapy in fibromyalgia syndrome (FMS) patients. METHODS: Fifty female patients diagnosed with FMS according to the American College of Rheumatism (ACR) criteria were randomly assigned to two groups: group 1 (n=25) with pool-based exercise, and in group 2 (n=25) balneotherapy was applied in the same pool without any exercise for 35 min three times a week for 12 weeks. In both groups, pre- (week 0) and post-treatment (weeks 12 and 24) evaluation was performed by one of the authors, who was blind to the patient group. Evaluation parameters included pain, morning stiffness, sleep, tender points, global evaluation by the patient and the physician, fibromyalgia impact questionnaire, chair test, and Beck depression inventory. Statistical analysis was done on data collected from three evaluation stages. RESULTS: Twenty-four exercise and 22 balneotherapy patients completed the study. Pretreatment (week 0) measurements did not show any difference between the groups. In group 1, statistically significant improvement was observed in all parameters ( P<0.01) except for the chair test at both weeks 12 and 24. In group 2, week 12 measurements showed significant improvement in all parameters ( P<0.01) except for the chair test and Beck depression inventory. Week 24 evaluation results in group 2 showed significant improvements in pain and fatigue according to visual analogue scale (VAS), 5-point scale, number of tender points, algometric and myalgic scores, and patient and physician global evaluation (P<0.01 and P<0.05, respectively), while improvements were nonsignificant in morning stiffness, sleep, fibromyalgia impact questionnaire (FIQ), chair test, and Beck depression inventory parameters in this group. Comparison of the two groups based on the post-treatment (weeks 12 and 24) percent changes and difference scores relative to pretreatment (week 0) values failed to show a significant difference between the groups for any parameter except Beck depression inventory (P<0.01). CONCLUSION: The results of our study showed that pool-based exercise had a longer-lasting effect on some of the FMS symptoms, but statistical analysis failed to show a significant superiority of pool-based exercise over balneotherapy without exercise. While we believe that exercise is a gold standard in FMS treatment, we also suggest in light of our results that balneotherapy is among the valid treatment options in FMS, and further research regarding the type and duration of the exercise programs is necessary.