Efficacy of platelet-rich plasma in the treatment of hemiplegic shoulder pain.

OBJECTIVE: The aim of this study was to examine the effects of platelet-rich plasma (PRP) on pain and functional outcomes in patients with hemiplegic shoulder pain. We compared the effects of PRP against saline solution by designing a double blind, randomized, prospective study. DESIGN: Forty-four patients with hemiplegia were included in this study. All patients received a total of 3 injections, 1 week apart. The first group received PRP injections while the second group received placebo injections. After 3 months of follow-up, 40 patients completed the trial. Primary outcome measure was movement-induced pain score (VAS), and secondary outcome measures were spontaneous pain score, shoulder passive range of motion (ROM), functional independence measure score, and the amount of paracetamol used. All subjects were evaluated at baseline, 1 week, 1 month, and 3 months after the completion of the last injection. RESULTS: Both groups showed an improvement in spontaneous and movement-related pain scores and shoulder passive ROM values on 1st and 3rd month visits (p < 0.05). No significance difference was detected between groups (p > 0.05). Similarly, FIM scores improved significantly in both groups (p < 0.05) but no difference was found between groups. Paracetamol use did not differ significantly between groups. CONCLUSION: The PRP injections were found not to be superior to placebo. Improvements in both groups can be attributed to the use of rehabilitation techniques and exercises in all patients. There is still need for further research to show whether PRP is a treatment option in the course of hemiplegic shoulder pain. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03931824.

Efficacy of platelet-rich plasma injections in patients with adhesive capsulitis of the shoulder.

PURPOSE: The goal of this study is to investigate whether platelet-rich plasma (PRP) injections are effective in the management of adhesive capsulitis of the shoulder (AC). A triple-blind, randomized controlled trial was designed and conducted in a medical school hospital. METHODS: 32 adult patients with adhesive capsulitis (21 female, 11 male with a mean age of 57, ranging from 23 to 70) were included in this study. Patients had to have shoulder pain and restrictions in movements (at least 25% when compared to the other side, and at least in two directions) for three months minimum and nine months maximum. Patients were randomized to two groups, and one group took PRP injections for three times every two weeks, while the other group took saline injections in same frequency and volume. A standardized exercise program was also applied to all patients. Patients were evaluated with Shoulder Pain and Disability Index (SPADI), Visual Analogue Scales for pain and disability, ranges of movements, and use of analgesics in before, after, and third month after the initiation of the therapy. RESULTS: Baseline comparisons between groups showed no differences. SPADI and ranges of motion in all directions showed significant improvements with therapy, and the group which took PRP injections showed better improvements when compared to the control group (p < 0.05). Visual Analogue Scale was found to be better for the PRP group after therapy and third month, and not for the control group (0.4 ± 1.06 and 0.17 ± 0.72 vs. 2.5 ± 2.6 and 2 ± 2.2, respectively, p < 0.05). Use of analgesics was not found to be significant for both groups (p > 0.05). CONCLUSION: PRP injections were found to be effective in both pain and disability, and showed improvements in a restricted shoulder due to adhesive capsulitis. These findings might point out PRP as a therapeutic option in the management of adhesive capsulitis.

Reliability and validity of the Turkish version of the intermittent self-catheterization questionnaire in patients with spinal cord injury.

PURPOSE: To evaluate the validity and reliability of the Turkish version of the Intermittent Self-Catheterization Questionnaire (ISC-Q) in patients with spinal cord injury (SCI). This questionnaire evaluates four problems related to the use of ISC, which are ease of use, convenience, discreetness and psychological well-being. METHODS: A total of 60 SCI (40 males, 20 females) patients were included in the study. Reliability was assessed using Cronbach's α and intraclass correlation coefficient (ICC) methods, and the validity was assessed using the correlations between the ISC-Q scores and the scores for the King's health questionnaire (KHQ). RESULTS: The mean age of the study sample was 37.07 ± 12.6 years. Of patients, 56.6% were completely injured. Both the internal consistency (Cronbach's alpha coefficient 0.899-0.947) and the test-retest reliability (intraclass correlation coefficient 0.899-0.947) of the ISC-Q were found to be high in patients with SCI. In the validity analysis, significant positive correlation was identified between convenience, psychological well-being, and total score domains and most subgroups of the KHQ, and also significant negative correlation was found between the discreetness of the domain and the impact of urinary incontinence, role limitation, physical limitation, social limitation and emotional status domains of the KHQ. CONCLUSION: The Turkish version of the ISC-Q can be considered a reliable and valid tool for the evaluation of quality of life related to catheterization in patients with SCI.

Escobar (multiple pterygium) syndrome: Multidisciplinary approach to a very rare syndrome.

Escobar (multiple pterygium) syndrome is progressive and a very rare syndrome. It is generally characterized by multiple pterygia that are found in the cervical, antecubital and popliteal regions. In this report, we present the treatment management of a 14-year-old case with late stage Escobar syndrome who was admitted due to multiple pterygia and bilateral knee contractures. The treatment of this case was conducted in collaboration with the department of orthopedics and the department of physical therapy. The treatment of the case was done in three stages: soft tissue procedures, femoral recurvatum osteotomy and triple arthrodesis, respectively. In addition to all these, the patient did intensive physical therapy for one year. As a result of the operations and physical therapy, adequate muscle strength was obtained.

Bladder wall thickness and ultrasound estimated bladder weight in healthy adults with portative ultrasound device.

BACKGROUND: The aim of this study was to investigate bladder wall thickness (BWT) and ultrasound estimated bladder weight (UEBW) values in healthy population with a portative ultrasound device and their relationship with demographic parameters. MATERIALS AND METHODS: The study was carried out in Neurorehabilitation Clinic of Ege University Hospital. Ninety-five subjects (48 women and 47 men) aged between 18 and 56 were included in the study. BWT and UEBW were determined non-invasively with a portative ultrasound device; Bladder Scan BVM 6500 (Verathon Inc., WA, USA) at a frequency of 3.7 MHz at functional bladder capacity. These values were compared by gender, and their relation was assessed with age, body mass index (BMI) and parity. RESULTS: Mean BWT was 2.0 ± 0.4 mm and UEBW was 44.6 ± 8.3 g at a mean volume of 338.0 ± 82.1 ml. Although higher results were obtained in men at higher bladder volumes, the results did not differ significantly by gender. Correlation analyses revealed statistically significant correlation between UEBW and age (r = 0.32). BWT was negatively correlated with volume (r = -0.50) and bladder surface area (r = -0.57). Also, statistically significant correlations were observed between UEBW and volume (r = 0.36), bladder surface area (r = 0.48) and BWT (r = 0.25). CONCLUSION: Determined values of BWT and UEBW in healthy population are estimated with portative ultrasound devices, which are future promising, for their convenient, easy, non-invasive, time-efficient hand-held use for screening.

Validity and reliability of a new test for Turkish-speaking aphasic patients: Ege Aphasia Test.

Due to the fact that the phonetic, morphological and syntactic structures of the Turkish language differ significantly from other European languages, the translated forms of the currently available aphasia assessment batteries are not adequate for Turkish-speaking aphasic patients. The aim of this study was to assess the validity and reliability of the Ege Aphasia Test that we have developed. The test, which includes the 8 subtests of praxia, spontaneous language, auditory and verbal comprehension, repetition, naming, reading, writing and calculating, was applied into 100 aphasic patients, 40 dysarthric patients and 40 healthy subjects. All test-retest intra-class correlation coefficients were found to be excellent (ICC = 0.99). The Cronbach's coefficients ranged from 0.71 to 0.91. All the subtests showed significantly greater scores in aphasic patients (p < 0.05). Significant correlations were found between the subtests and corrected total score (p < 0.05). Finally, the Ege Aphasia Test has an acceptable validity and reliability. It seems to be a promising battery for evaluation of aphasia in the Turkish language, which is spoken mainly in Turkey and in the surrounding regions. We believe that this study will pioneer the development of aphasia rehabilitation in these countries and contribute to future studies.

Reference data for ulnar nerve short segment conduction studies at the elbow.

INTRODUCTION: The aim of this study was to generate reference data for ulnar nerve short segment conduction studies (SSCSs) at 2-cm intervals. METHODS: Ulnar nerve SSCS data were collected from dominant and non-dominant arms of 200 healthy volunteers. The effects of age, gender, weight, height, and body mass index (BMI) on SSCSs were also investigated. RESULTS: High percentile values for short segment latency changes varied from 0.4 to 0.7 ms. Ulnar nerve conductions were slower in the segments 2 cm below and above the elbow compared with the other segments. The amplitude was found not to decrease by >15% in subsequent short segments. There were no significant effects of age and gender on the SSCS parameters. Conductions over the short segments tended to be faster as BMI increased. CONCLUSIONS: Reference values should be determined separately over each 2-cm segment, and the effect of BMI should be considered when interpreting SSCSs.