The effectiveness of aerobic exercise and neck exercises in pediatric migraine treatment: a randomized controlled single-blind study.

BACKGROUND: Migraine is a prevalent condition with debilitating effects. In the context of pediatric migraine, there exists a notable scarcity of data regarding the effectiveness of exercise interventions. Furthermore, despite the prevalent occurrence of neck pain in these patients, the role of cervical musculoskeletal disorders in the etiology continues to be a debated topic. AIMS: This study is aimed at evaluating the effectiveness of aerobic and neck exercises for treatment of pediatric migraine. METHODS: This randomized, controlled, single-blind trial included 51 pediatric migraine patients. Participants were divided into two groups: one performing aerobic exercise and the other performing neck exercises. Assessments included attack frequency, severity, duration, and neck pain for over 3 months. RESULTS: Both exercise groups exhibited significant reductions in the attack frequency, severity, and duration. After 3 months, the aerobic exercise group showed a lower attack frequency than the neck exercise group. Subgroup analysis involving patients with neck pain showed similar neck pain reduction but favored the aerobic exercise group for attack frequency and severity. CONCLUSIONS: Aerobic and neck exercises are effective in reducing the symptoms of pediatric migraine. Aerobic exercise may be particularly beneficial for reducing the attack frequency. These findings contribute to the limited data on exercise interventions for pediatric migraineurs and highlight the importance of tailored exercise programs for managing this condition. Future studies should consider more extensive exercise modalities and include diverse patient cohorts. TRIAL REGISTRATION: Clinicaltrials.gov ID: NCT0606875.

Effectiveness of transcranial direct current stimulation in chronic pain and neurogenic claudication related to lumbar spinal stenosis.

OBJECTIVES: Transcranial direct current stimulation (tDCS) is a promising non-invasive brain stimulation technique for treating chronic pain, yet its effectiveness in chronic lower extremity pain due to lumbar spinal stenosis (LSS) has not been studied. This research aimed to investigate the impact of tDCS on pain, walking capacity, functional status, and quality of life in LSS patients. PATIENTS AND METHODS: In this prospective, randomized, double-blind, sham-controlled study, 32 LSS patients received either real or sham tDCS over the motor cortex contralateral to the patient's painful lower extremity for 10 consecutive weekdays (10 sessions). Evaluations were conducted at baseline, post-session, and 1-3 months later. The pain was evaluated by Visual Analog Scale (VAS), walking duration and distance by Treadmill Walking Test, functional status by Modified Oswestry Disability Questionnaire (MODQ) and quality of life by Short Form-36 (SF-36). RESULTS: In-group comparisons, active tDCS showed sustained analgesic effects for 3-month post-treatment, distinct from sham. After the final session, active group exhibited significantly better asymptomatic walking distance and duration. Active stimulation led to notably lower MOLBDQ scores after 1 month. Significant improvements in SF-36 subscales were seen after 3 months, especially in pain, physical functioning, and general health. Positive tDCS effects on pain, claudication, and some quality of life aspects were evident at 3 months, while functional status improvements were mainly limited to 1 month. CONCLUSION: tDCS shows potential as a safe, non-invasive technique for alleviating chronic LSS-related pain, enhancing mobility, functionality, and quality of life. TRIAL REGISTRATION: Clinicaltrials.gov ID: NCT03958526.

Relative Energy Deficiency in Sport (RED-S) and Goldman's Dilemma: A Case Report in 42 Year-Old Woman Endurance Athlete.

Relative Energy Deficiency in Sport (RED-S) defines insufficient calorie intake for the physiological and athletic functions of the athlete, and accordingly deterioration in the musculoskeletal, hormonal, cardiovascular and immune systems. Herein, we present a 42-year-old female long-distance runner with multiple pelvic stress fractures who didn't complete her prescribed treatment program and wanted to keep running despite being aware of the associated pain and risks. The Goldman dilemma refers to the unsettling reality that a significant number of professional athletes may contemplate sacrificing their lives in order to achieve Olympic glory. This disregard for the numerous challenges stemming from an obsession with success is equally applicable to the amateur athlete depicted in this case. Our patient's fractures were examined in relation to RED-S and managed through conservative treatment methods. The RED-S and Goldman dilemma should be kept in mind not only in professional but also in semi-professional, and amateur athletes.

Shedding light on work-related and non-work-related hand injuries from the social work perspective.

BACKGROUND: Upper extremity injuries may cause not only physical but also serious social and psychological problems in workers. OBJECTIVE: The aim of this study was to compare demographic and work-related features of persons with hand injuries who sustained a work-related or a non-work-related injury to gain insights into possible predisposing factors for work-related injuries as well as psychosocial consequences of hand injuries from the social work perspective. METHODS: This case-control study was conducted on 30 work-related and 30 non-work-related hand injury patients. The patients were evaluated using a questionnaire designed by the authors based on the principles of social work involving demographics, work-related features, thought-emotion-behaviour features, family and friend relationships, need for family support and professional psychosocial support. Survey data from both groups were statistically analysed using descriptive statistics, Chi-square and Fisher Exact test. RESULTS: When compared with the non-work-related hand injury group, the majority of the subjects of the work-related hand injury group were blue-collar workers (p = 0.003), had a lower level of education (p < 0.001), worked off-the-clock (p = 0.015), held the employer responsible for the accident (p < 0.001), needed more time to return to work (p = 0.014), were worried about the future (p = 0.045), and expressed loss of joy (p = 0.004). CONCLUSION: Hand injuries, regardless of their relation to work, lead to important psychosocial problems which need to be evaluated widely and carefully focusing on the patient and patient's environment, work environment in this case.

Acute Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Hand Tremor in Parkinson's Disease: A Pilot Study of Case Series.

Objectives: The aim of this study is to investigate the effects of non-invasive vagus nerve stimulation (VNS) on tremor in Parkinson's disease (PD). Methods: This single-center, prospective, and implementation study with before-after design included five participants diagnosed with PD. Auricular VNS was applied to each participant 3 times on different days. VNS was applied to the participants as the right ear, left ear, and bilateral ear. The cardiovascular parameters of the participants were evaluated with Kubios HRV Standard and tremor with UPDRS tremor subscale and smartphone application before and after the intervention. Results: Significant decrease in diastolic blood pressure (p=0.043) was found in participants who underwent bilateral auricular VNS. Although there was no significant change in the UPDRS tremor subscale, decreases in the maximum tremor amplitude in the x (p=0.043) and y (0.014) planes were detected in the measurements made with the smartphone application. Conclusion: In this study, a decrease in the tremor amplitude measured in the 3D plane with auricular VNS was found in patients with PD.

Validity and reliability of the Turkish version of the central sensitization inventory.

Objectives: The aim of this study was to translate the Central Sensitization Inventory (CSI) into the Turkish language, to perform a psychometric validation, and to investigate its reliability in patients with chronic spinal pain with an organic origin, patients with fibromyalgia, and pain-free control individuals. Patients and methods: Between April 2016 and February 2017, the translation of the original English version of the CSI into Turkish was performed using the forward-backward translation method. A total of 100 fibromyalgia patients (6 males, 94 females; mean age: 45.0±8.4 years; range, 25 to 60 years), 100 patients with chronic spinal pain with an identified organic origin (CSPO), (10 males, 90 females; mean age: 43.8±9.7 years; range, 21 to 60 years), and 100 healthy controls (8 males, 92 females; mean age: 35.8±10.1 years; range, 25 to 55 years) were included in the study. Demographic characteristics were collected. Test-retest reliability was determined by re-administering the CSI-Turkish (CSI-Turk) two weeks after the first application. Results: The internal consistency (Cronbach's alpha) was found to be 0.92 and the intraclass correlation coefficient was 0.93. Patients with fibromyalgia, a very common central sensitivity syndrome (CSS), had the highest mean CSI-Turk scores, and healthy controls had the lowest. Using the recommended cut-off score of 40 resulted in 87% sensitivity and 90% specificity in distinguishing between fibromyalgia and control individuals. Conclusion: This study suggests that the CSI-Turk can be effectively used as a screening tool to elucidate CS-related symptomology among patients with chronic pain with a high internal consistency, test-retest reliability, sensitivity, and specificity.