impact of chronic low back pain on physical performance, fear avoidance beliefs, and depressive symptoms: a comparative study on Turkish elderly population

Objectives: The purposes of this study were: [1] to show the impact of chronic low back pain [CLBP] on physical performance, fear avoidance behavior and depressive symptoms in older adults; [2] to describe the relationships between outcome measurements obtained in this study

Methodology: Ninety-one participants with or without chronic low back pain were included in this study. Only four tests in the Back Performance Scale were used to assess the physical performance of the participants. A Fear Avoidance Beliefs Questionnaire related to physical activity and the Geriatric Depression Scale were also used to examine each subject

Results: The level of performance shown by elderly adults with low back pain was worse than elders without low back pain in the sock test and the pick-up test [p < 0.05]. Little correlation between the finger-to-floor test and fear avoidance behaviour related to physical activity was found [p < 0.05]. There was little/poor correlation between all performance tests and depressive symptoms [p < 0.05]

Conclusions: The findings indicate that CLBP decreases physical performance, but increases fear avoidance behavior and depressive symptoms in elderly adults. At the same time, it was determined that performance level of elderly adults with back pain was related especially with depressive symptoms

Comparison of electrical stimulation and isometric training on isokinetic strength of knee extensors: a randomized clinical trial

The purposes of this study were [1] to investigate and [2] to compare effects of isometric exercises and electrical stimulation on isokinetic strength for healthy quadriceps femoris muscle. Twenty healthy volunteers [range, 20-25; mean age, 20.9 +/- 1.1 yr] participated in the study. All participants were divided into two groups [Group I and Group II]. Each group consisted of 10 subjects. While Group I received electrical stimulation with Russian current, Group II trained with maximal volunteer isometric exercises [10s contraction and 50 s relaxing periods with 10 repetitions] for three days per week for six weeks. Before and after the training program, each subject was evaluated using the following tests; anthropometrical measurements, fixed weight repetition, step-up, decline squat, single leg hop, and isokinetic assessments [peak torque, work per repetition, initial peak torque, fatigue index, total work done,%BW]. After a 6-week training program, significant differences in terms of physical functioning and isokinetic parameters in the two groups were found [p<0.05]. Physical functioning and isokinetic strength of quadriceps femoris muscle were seen to be increased in two group after training programs [p<0.05]. There were no significant differences between the groups [p>0.05]. Quadriceps femoris hypertrophy was only found in electrical stimulation group [p<0.05]. The results obtained from this study show that the two strengthening techniques just used in the study can be used to improve muscle strength, performance and isokinetic parameters in healthy quadriceps femoris muscle [p<0.05]. But, there is no superiority on each other. In conclusion, these results indicate that electrical stimulation and maximal volunteer isometric exercises can be used to increase isokinetic strength as an alternative for isokinetic dynamometer in clinical setting

effects of epilepsy surgery on physical functioning, emotional status and health - related quality of life

The study was conducted to investigate the effects of epilepsy surgery on physical functioning, emotional status and health-related quality of life in patients with epilepsy. Thirty four participants were evaluated in this study. Group I consisted of 17 consecutive patients who underwent epilepsy surgery. Group II included 17 healthy controls. While each patient was evaluated three times: before surgery, after surgery [6th month], and at the end of the first year after surgery, the controls were evaluated just one time. The Nottingham Health Profile [NHP] was used to assess quality of life. Beck Depression Inventory [BDI] was applied to detect depressive symptoms. A 12- meter Walking Test [mobility] and the Barthel Index [Daily Living Activities] were used to evaluate physical functions. The results showed that the patients' quality of life and their mobility improved after surgery [p<0.05]. Most of the patients reported decreased depressive symptoms after surgery [p<0.001]. No significant differences in terms of daily living activities were found. The results of this study also showed that the BDI scores were highly correlated with NHP scores [p<0.05]. At 6th month after surgery, although the patients' scores in terms of all outcomes measurements were worst compared to the controls, the scores of the two groups were more or less similar after one year [p>0.05]. Epilepsy surgery is an effective treatment improving physical functioning and QOL, and supporting emotional status of the patients with epilepsy, positively

Reliability and validity of the Turkish version of the CDC Hrqol-4 scale in patients with chronic low back pain

This study investigates reliability and validity of Turkish version of CDC Core Healthy Days Measures assessing health related quality of life [CDC HRQOL-4] in chronic low back pain [CLBP] patients. One hundred eighty nine CLBP patients and 117 healthy controls participated. All respondents filled the following scales; the CDC HRQOL-4, Rolland Morris Questionnaire [RMQ], and the Hospital Anxiety and Depression Scale [HAD]. Cronbach's alpha of CDC HRQOL-4-items in CLBP patients was 0.69. Of 57.1% CLBP patients and 13.7% healthy controls defined their health status as fair or poor. The number of physically and mentally unhealthy days, and activity limitation days was found to be higher in the CLBP patients than the healthy controls [p<0.05]. The CLBP patients with fair or poor health reported more physically unhealthy days, mentally unhealthy days, and activity limitation days than the CLBP patients with excellent, very good, or good health [p<0.05]. Correlation coefficients between physically unhealthy days [r=0.30] and activity limitation days [r=0.22], and RMQ scores were significant, but low in magnitude. Moderate correlations between mentally unhealthy days and HAD scores [r=0.41 for anxiety; r=0.39 for depression] were found. The results of this study indicate that the Turkish version of the CDC HRQOL-4 is a short, reliable and valid tool to assess HRQOL in CLBP patients

Comparison of the physical and non-physical functioning between the patients with multiple sclerosis and healthy subjects

To investigate the relationship between physical functioning, non-physical functioning, and upper extremity functional abilities in patients with multiple sclerosis [MS] and healthy subjects. A total of 63 patients with MS [Expanded Disability Status Scale [EDSS] score; 3-8] and 52 healthy subjects attending the Pamukkale University, School of Physical Therapy and Rehabilitation in Denizli, Turkey were studied in the period from February 2006 to June 2006. To allow further evaluation, 63 individuals with MS were divided into 2 groups according to their ambulation ability level. The physical functioning was assessed with the Functional Independence Measure [FIM], the Purdue Pegboard Test, and the Jebsen Hand Function Test, and the non-physical functioning was assessed with the Beck Depression Inventory [BDI]. Depressive symptoms were significantly elevated in the MS group versus the control group based on the BDI [p<0.0001]. In MS subjects, while there was good positive correlation between EDSS and BDI scores, there was a good negative correlation between EDSS and FIM scores [p<0.0001]. Non-physical functioning, especially depression, is strongly associated with activities of daily living and decreases functional abilities in MS patients. For this reason, we recommend that non-physical functioning should also be evaluated in patients with MS to plan the most suitable physical therapy program

Upper extremities function in patients undergoing hemodialysis treatment

To determine the effects of hemodialysis treatment on upper extremities functional ability. This study was carried out from June 2003 to March 2004 at Pamukkale University School of Physical Therapy, Denizli, Turkey. One hundred patients with chronic renal failure [CRF] undergoing hemodialysis treatment for at least 2 months participated in the study, and were compared with a control group [N=40 healthy subjects]. The 100 patients were divided into 4 groups according to the length of hemodialysis duration: 19 patients dialyzing for less than one year [Group 1]; 42 patients dialyzing for 1-4 years [Group 2]; 21 patients dialyzing for 4.1-8 years [Group 3]; 18 patients dialyzing for 8.1 or more years [Group 4]. All participants were evaluated for range of motion by goniometry, muscle strength by manual muscle testing, sensation disturbances by Semmes-Weinstein monofilaments, static grip strength by hand dynamometer, and functional status of upper limbs by the Disabilities Arm Shoulder Hand Questionnaire [DASH-T]. The results showed that the patients with CRF had significantly more functional problems associated with CRF and hemodialysis treatment than the healthy controls. In addition to these results, the scores of the DASH-T also showed that the most independent group was the control group with a mean score of 0.72 +/- 0.86, whereas, the most dependent group was the 3rd group of the hemodialysis groups [mean score of 2.70 +/- 1.77]. Musculoskeletal or functional problems decreasing functional ability of the upper limbs are a common complaint in hemodialysis patients

Indirect effect of electrical stimulation of tibialis anterior on gastro-soleus muscles in children with spastic hemiplegic cerebral palsy

To investigate the effects of tetanic faradic stimulation in an antagonist muscle [tibialis anterior] on agonist muscles [gastro-soleus]. In addition, to show the effects of maintaining agonist muscle strength on antagonist spastic muscle group to improve gait parameters in children with spastic hemiplegia. We carried out the study at Pamukkale University, School of Physical Therapy, Denizli, Turkey between June 2001 and December 2002. We included 16 ambulant cerebral palsied children with a mean of age 6.25 2.89 years in the study. Each subject practiced a 20-minute electrical stimulation session plus neurodevelopmental approach [Bobath Technique] once a day, 4 days a week for 5 weeks. We performed faradic tetanic stimulation to stimulate and strengthen the tibialis anterior [antagonist muscle]. We performed all tests, including goniometric measurement, the Modified Ashworth Scale, and gait analysis at the start of the treatment program, after the program, and one month after first follow up. After treatment, we found significant improvements in goniometric measurements and Modified Ashworth Scale in comparison with the baseline measurements [p<0.001]. However, the improvements did not continue after the first month of treatment [p>0.05]. The results of the gait analysis showed only a significant difference concerning step width [p>0.05]. The results suggest that tetanic faradic stimulation was effective in improving aspects of ankle function, decreasing muscle tone and increasing range of motion in children with hemiplegic cerebral palsy during a physical therapy program

Effect of combined spa and physical therapy on pain in various chronic diseases

The purpose of this study was to exhibit the effect of combined therapy [spa and physical therapy] on pain in various chronic diseases. Retrospectively, 472 [58.1% female and 41.9% male] spa and physical therapy patients with a mean age of 53.4 +/- 12.5 years were evaluated during 2001-2004 from the archives of Dumlupinar University TUTAV Thermal Cure Center. Before, after therapy and before discharging, visual analog scale [VAS] for pain, heart and respiratory rates, systolic and diastolic blood pressures were measured for hemodynamic evaluations. Arthrosis [230 patient, 48.7%] was found to be the main problem in our patients. Ankle arthrosis, fibromyalgia and cervical disc herniation were found with the highest VAS values compared to other pathologies before spa therapy [p<0.05]. Immediately after spa therapy and before discharge, VAS values were lower than before treatment [p<0.05]. Immediately after spa therapy, the highest decreases in VAS values were observed in coxarthrosis and gonarthrosis patients [p<0.05]. Coxarthrosis and nonarticular patients had the lowest VAS values before discharge than other pathologies [p<0.05]. No statistical differences were found between male and female VAS values in all stages of treatment [p>0.05]. Heart and respiratory rate were statistically increased [p<0.01], diastolic blood pressure was decreased [p<0.01] but not changed in systolic blood pressure [p>0.05] immediately after spa therapy. Before discharging, all hemodynamic parameters were found statistically decreased before treatment and immediately after spa therapy [p<0.01]. A combination of spa and physical therapy decreases pain and improves functional capacity without any hemodynamic risk in rheumatological, neurological and cardiac patients