Does Dry Needling Increase the Efficacy of Botulinum Toxin Injection in the Management of Post-Stroke Spasticity: A Randomized Controlled Study.

Introduction: The purpose of the current study was to investigate the antispastic efficacy of dry needling in combination with botulinum toxin-A injections. Methods: Thirty stroke patients with elbow flexor spasticity were randomised into two groups; the patients treated with botulinum toxin-A injections and exercise into the BTX-A group, and patients treated with botulinum toxin-A injections, exercise, and dry needling in the BTX-A+Dry needling group. Spasticity was evaluated using the modified Ashworth scale and modified Tardieu scale before treatment, immediately after treatment, the third day after treatment, second week after treatment and at the third month after treatment. The upper extremity motor function was evaluated using the Fugl-Meyer upper extremity motor function scale. Results: A statistically significant difference in all parameters was found after treatment in both groups compared to before treatment (p<0.05). In all evaluation parameters immediately after treatment, on the third day after treatment, the second week after treatment and the third month after treatment, a statistically significant difference in favour of the BTX-A+Dry needling group was achieved compared to before treatment (p<0.05). Conclusion: Dry needling combined with botulinum toxin-A injections performed over a total of four sessions with three-day intervals, contribute to the antispastic effect. Also combined therapy is more effective and provides longer-lasting results.

Ultrasonographic assessment of femoral cartilage thickness in patients with Helicobacter pylori infection.

OBJECTIVES: Helicobacter pylori is a major cause of gastritis and a potential trigger of inflammatory disease. The effect of H pylori infection on distal femoral cartilage has yet to be evaluated. The aim of this study was to evaluate femoral cartilage thickness in patients with H pylori infection and to find whether this infection affects femoral cartilage thickness. METHODS: This cross-sectional study included 199 patients. To measure the thickness of femoral articular cartilage, 99 patients with H pylori infections and 100 with H pylori-negative controls were enrolled into two groups. The measurements were made using linear probe ultrasonography with the patients in supine positions and their knees in maximum flexion. Demographic, clinical, endoscopic and laboratory data were collected for all patients. RESULTS: Both the right and left femoral condyles had thinner cartilage thickness in the H pylori-positive group than in the H pylori-negative group (P = .016, P = .036). For the intercondylar area and lateral femoral condyles, although the H pylori-positive patients had thinner femoral cartilage thickness than the H pylori-negative individuals for both extremities, this finding was not statistically significant (P > .05). CONCLUSION: Femoral cartilage was thinner in patients with H pylori than patients without H pylori for right and left medial femoral condyles. This study suggests that H pylori infections may affect femoral cartilage thickness and potentially increase the risk of cartilage degeneration.

Ultrasonographic Assessment of Knee Cartilage Thickness in Patients with Ulcerative Colitis: Decreased Femoral Cartilage Thickness May Be an Indicator of Extraintestinal Manifestation in Patients with Mild Activity Ulcerative Colitis.

OBJECTIVES: Ulcerative colitis is a systemic inflammatory disease which primarily involves the gut but presented by numerous extraintestinal manifestations. The effect of ulcerative colitis on knee cartilage has not been evaluated up to the present. In the current study, we aimed to investigate the possible relationship between the presence of ulcerative colitis and femoral cartilage thickness. DESIGN: Sixty-two patients with confirmed diagnosis of ulcerative colitis and 70 healthy controls aged 18 to 50 years referred to the gastroenterology outpatient department between January 2018 and January 2019 participated in this cross-sectional study. The measurements were made by ultrasonography with the patient in a supine position and the knees in complete flexion. Demographic, clinical, endoscopic and laboratory data were collected for all the subjects. RESULTS: The groups of ulcerative colitis and control group were similar with regard to sex, mean age, weight, height, body mass index, extremity dominancy, and existence of knee pain (P > 0.05). Medial femoral condyles, intercondylar areas, and lateral femoral condyles of both right and left knees had thinner cartilage thickness in ulcerative colitis group than control group (P < 0.001). CONCLUSION: Knee cartilage was thinner in subjects with mild activity ulcerative colitis than in healthy controls. Decreased knee cartilage thickness may be an indicator of extraintestinal manifestation in patients with mild activity ulcerative colitis. This association between ulcerative colitis and knee cartilage degeneration may be effective in early detection of possible risk factors and potential treatment strategies for both ulcerative colitis and specific subtypes of knee osteoarthritis.

Ultrasonographic assessment of femoral cartilage thickness in patients with and without uveitis in Behçet's disease.

The objective for this study is to evaluate the femoral cartilage thickness in patients with/without uveitis in Behçet's disease (BD). Patients with BD aged 18-70 years were included. The demographic and clinical characteristics of the patients were recorded. The thickness of femoral articular cartilage was measured with musculoskeletal ultrasound. Cartilage thickness was measured bilaterally from the central points of medial condyle (MFC), lateral condyle (LFC), and intercondylar area (ICA). 20 patients with uveitis [uveitis (+)] and 20 patients without uveitis [uveitis (-)] were included. Both right and left MFC and LFC had statistically significant thinner cartilage in uveitis (+) group (p < 0.05). For the ICA, uveitis (+) patients had thinner femoral cartilage than uveitis (-) patients; however, in the left side, statistically significance could not be detected. Femoral cartilage was thinner in uveitis (+) patients than in uveitis (-) patients in BD. This relationship between uveitis and femoral cartilage thickness may be helpful in the prevention and early treatment of cartilage degeneration.

Does kinesiotaping increase the efficacy of lidocaine injection in myofascial pain syndrome treatment? A randomized controlled study.

BACKGROUND: Myofascial pain syndrome is a common form of musculoskeletal disorder that originates from a painful site in a muscle or related fascia. There are various non-invasive and invasive treatment methods. OBJECTIVE: To investigate the efficacy of myofascial trigger point kinesiotaping with that of local anesthetic injection alone on the degree of pain and quality of life in myofascial pain syndrome. METHODS: Seventy-six patients with myofascial pain syndrome were randomly assigned to three study groups. Group 1 (n= 26) received only local anesthetic (1 ml lidocaine of 0.5% for each trigger point) injection. Group 2 (n= 25) received local anesthetic injection + sham kinesiotaping. Group 3 (n= 25) received local anesthetic injection + kinesiotaping. Pain intensity was measured by visual analog scale (VAS) at baseline, immediately after treatment, and in the 1st and 4th week post-treatment. To evaluate the effect of treatment on quality of life, Short Form-12 (SF-12) was used at baseline and at 4th week post-treatment. RESULTS: Group 3 showed significantly more improvement than other groups at post-treatment VAS, SF-12 physical component evaluations (p< 0.05). No significant difference was found between groups 2 and 3 in the mental component of SF-12 (p> 0.05), but the patients in group 3 performed significantly better than group 1 (p< 0.05). No significant difference was found between groups 1 and 2 in VAS, SF12 Physical Components Summary and SF-12 Mental Components Summary scores at post-treatment evaluations. CONCLUSION: This study indicated that kinesiotaping may be useful to increase the efficacy of myofascial trigger point lidocaine injection in myofascial pain syndrome.