Acute effect of myofascial stretching exercise on spasticity, balance, ambulation status and mobility of posterior chain muscles in multiple sclerosis.

OBJECTIVE: To investigate the acute effect of myofascial stretching exercises on spasticity, balance, ambulation status and mobility of posterior chain muscles in multiple sclerosis. METHOD: The study was conducted as a randomised controlled experimental study. The study included a total of 80 individuals diagnosed with multiple sclerosis (MS) with a mean age of 43.5 ± 9.62 years (experimental group) and 41.4 ± 10.4 years (control group). All individuals were treated once and evaluated before and after the session. After recording the sociodemographic characteristics, spasticity assessment was performed with the Modified Ashword Scale (MAS), balance assessment with the Berg Balance Scale (BBS), ambulation status with the Timed Up and Go Test (TUG), and posterior chain muscle mobility (PCMM) with finger-to-ground distance measurement. RESULTS: The TUG (time to complete the distance) measurements of the experimental group after treatment were lower than those of the control group (p < 0.05). The value of PCMM measurements of the experimental group before the treatment was lower than that of the control group (p < 0.001). The difference in positive increase in PCMM measurements in the experimental group was higher than that in the control group (p < 0.05). After the treatment, the MAS value in the left knee of the experimental group was lower than that of the control group (p < 0.05). DISCUSSION: Myofascial stretching exercises applied to individuals with MS made an acute contribution to ambulation status and mobility of posterior chain muscles. There was no difference in the evaluation of spasticity and balance.

The Burden and Quality of Life in Caregivers of Individuals With Stroke During the COVID-19 Pandemic in Turkey: A Cross-Sectional Study.

This study investigated the caregiving burden, quality of life and life satisfaction of caregivers of individuals with stroke during the pandemic period. A descriptive a study was performed with a sample of caregivers (n = 80) of inpatient individuals with stroke in Kayseri, Turkey. The Bakas Caregiving Outcomes Scale, Short Form Health Survey-36, and Temporal Satisfaction with Life Scale were used as well as some open-ended questions. Using descriptive analysis and correlations, results showed that caregiving burden of the participants was correlated to quality of life and life satisfaction during the COVID-19 (p < 0.05). Specific types of burden include: stress, isolation, financial issues, disruption of therapy, patient-caregiver relationship, and kinship relations. These findings provide important information about the increased burden of caregivers during the pandemic. This study offers information to design a framework of interventions to reduce the physical, social, and psychological effects on caregivers in similar conditions.

Is the Effect of Complex Decongestive Therapy the Same for Primary and Secondary Lower Lymphedema?

Background: The aim was to compare edema and quality of life (QOL) after complex decongestive therapy (CDT) in two types of lymphedema: primary lower limb lymphedema (PLL) and secondary lower limb lymphedema (SLL). Methods and Results: Participants with PLL (n = 20) and SLL (n = 20) were recruited in this prospective single-blinded study. Patients in both groups were treated with CDT for 4 weeks 5 days a week. The amount of edema in their lower extremities was assessed by circumference measurement. The QOL for the patients was evaluated by a Lymphedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphedema (Lymph-ICF-LL) before and immediately following the therapy. There was no significant difference in the volume reductions between the two groups (p > 0.05). Overall initial QOL was significantly lower in patients with PLL than in patients with SLL scores. Post-CDT differed significantly between PLL and SLL groups, QOL was significantly lower for patients with PLL than for patients with SLL scores (p < 0.05). When the changes in both groups were examined, it was found that their QOL increased after the treatment (p < 0.05). Conclusions: While there was no difference in the amount of edema in both groups, the results of patients with SLL were more positive than patients with PLL in terms of QOL. Lymphedema therapists should approach patients with different therapeutic considerations specific to each type of lymphedema before using CDT in clinical practice.

Palmoplantar pustular psoriasis induced by adalimumab: a case report and literature review.

TNF-α inhibitors (anti-TNF-α) are agents increasingly used in the treatment of rheumatic diseases resistant to classical disease-modifying treatment and they provide significant improvement of disease activity. However, these agents have many cutaneous side effects including psoriasis. Numerous reports of the induction or worsening of psoriasis in patients treated with TNF antagonists indicate that this is not a rare phenomenon. In this study, we present a patient with ankylosing spondylitis who developed palmoplantar pustular psoriasis after receiving anti-TNF-α therapy for 4 months.

Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis?

The aim of this study was to compare the efficacy of sodium hyaluronate (SH) injection with the most common treatment methods, intraarticular steroid injection and physical therapy modalities in patients with adhesive capsulitis (AC). A total of 95 shoulders of 90 patients were included in the study and were randomized in four groups. The patients were treated with SH injection (group 1), triamsinolone acetonide (group 2) or physical therapy modalities (group 3). Group 4 patients were served as controls. Pain severity, passive ranges of motion and functional considerations were measured before, and 15 days and 3 months after the treatments. In all treatment groups, there were significant improvements at both the 15th day and third month in all parameters (for each, p<0.001). The passive abduction values on the 15th day was found significantly higher in group 3 when compared with group 1 and controls (for each, p<0.001). At the third month, the passive abduction values of the groups 2 and 3 were improved when compared with the control group (p<0.001). Constant score was higher in group 3 on 15th day when compared with group 1. At the third month, all treatment groups were improved significantly compared with control group (p<0.001). We provided the best results in physical therapy modalities applied group for AC treatment. However, we think that SH injection may be administered as an alternative treatment method.

Comparison of femoral geometry among cases with and without hip fractures.

Hip fractures have high morbidity and mortality rate for the people as a complication of osteoporosis and is generally seen in old age. It is known that femoral geometric measurements are important in the assessment of hip fracture risks. This study aimed to examine the association between hip geometry and hip fracture in post-menopausal elderly females. In the present study, 232 hip X-rays were taken from women with no hip fractures (Group 1) and 29 post-menopausal women with hip fractures (Group 2) after a minor trauma. After standard anterior-posterior plain pelvic X-ray radiographs were obtained, various radiographic measurements were performed in all cases, including the hip axis length (HAL), femoral neck axis length (FAL), acetabular width (AW), femoral head width (HW), femoral neck width (FW), femoral shaft width (FSW), intertrochanteric width (TW), lateral and medial cortical thickness of the femoral shaft (LCT, SMCT), femoral neck cortical thickness (NMCT) and femoral neck-shaft angle (Q-angle). In group 1, the mean age, weight and height were 62.5 +/- 7.4 years, 70.8 +/- 12.5 kg, and 157.5 +/- 6.7 cm, respectively. In group 2, these values were 70.17 +/- 6.8 years, 64.7 +/- 11.5 kg, and 158.3 +/- 2.7 cm, respectively. There were no statistically significant differences in the measurements of HAL, FAL, AW and HW between the two groups. In group 2, the mean FW value was significantly higher than in group 1 (p= 0.01). The mean values for FSW, TW, NMCT, SMCT, LCT were statistically lower in group 2 than those in group 1 (p= 0.01, p=0.038, p=0.001, p < 0.001, p < 0.001, respectively). Q-angle was also significantly higher in cases with hip fracture than in cases with no hip fracture (p=0.01). The values of FW, FSW, TW, NMCT, SMCT, LCT and Q-angle seem to be important parameters in the evaluation of hip fracture risks. However, further studies are needed to clarify this conclusion.

Bone mineral density in women with sarcoidosis.

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Almost any organs of the body, but mostly the lungs, are involved. Bone mineral density (BMD) can be affected directly or indirectly in chronic granulomatous systemic diseases such as sarcoidosis. The aim of our study was to evaluate BMD in premenopausal and postmenopausal sarcoidosis patients with or without prednisone treatment and to compare their BMD values with those of a control group having the same menopausal status. Thirty-five premenopausal women (18 untreated, 8 treated, and 9 controls) and 21 postmenopausal women (5 untreated, 5 treated, and 11 controls) were included in the study. All of the patients had a histologically proven diagnosis and were being followed-up at the Sarcoidosis Outpatient Clinic of our unit. BMD of the lumbar (L) spine and femoral neck was measured by dual-energy absorptiometry (DEXA). The subgroups of premenopausals and postmenopausals were compared separately. Comparison among the groups was performed by using analysis of variance. Age, duration of the disease, and body mass index were comparable in treated, untreated, and control subgroups of the pre- and postmenopausal groups, and the subgroups of postmenopausals had comparable durations since menopause. For premenopausals, BMD values at L1-4 were not significantly different among the subgroups (0.920 +/- 0.08 g/cm(2), 0.801 +/- 0.09 g/cm(2), and 0.910 +/- 0.05 g/cm(2), for untreated, treated, and controls, respectively). However, the BMD value at the femoral neck in treated patients (0.921 +/- 0.1 g/cm(2)) was significantly lower than the values in untreated patients (1.080 +/- 0.2 g/cm(2); P < 0.01) and in controls (1.028 +/- 0.17 g/cm(2); P < 0.05). For postmenopausals, the BMD value at L1-4 in controls (1.019 +/- 0.07 g/cm(2)) was significantly higher than the values in untreated patients (0.783 +/- 0.01 g/cm(2)) and in treated patients (0.751 +/- 0.08 g/cm(2); P < 0.001 for both). The BMD value at the femoral neck in controls (0.890 +/- 0.1 g/cm(2)) was higher than the values in untreated patients (0.745 +/- 0.08 g/cm(2)) and treated patients (0.747 +/- 0.1 g/cm(2)), but the difference was not statistically significant (P = 0.06). We concluded that sarcoidosis patients, especially postmenopausal patients with corticosteroid treatment, may have an increased risk of bone mineral loss. Large-scale studies are warranted in order to delineate the exact roles of the disease itself, menopausal status, and corticosteroid treatment in this bone mineral loss.