Effects of Russian and Aussie Currents Combined with Isokinetic Training on Symptoms, Pain, Functional Mobility and Quality of Life in Individuals with Patellofemoral Pain Syndrome: A Randomized, Placebo-Controlled Study.

OBJECTIVE: To find out if burst-modulated medium frequency alternating currents (Russian and Aussie types) contribute to the effects of isokinetic-training in patients with patellofemoral pain, and to compare their effectiveness on symptoms, pain, functional mobility, and quality of life. DESIGN: Forty-five patients with patellofemoral pain were randomized into Russian current, Aussie current or placebo electrical stimulation groups. Patellofemoral Pain Severity Scale, Stair Climbing Test, Anterior Knee Pain Scale, Knee Outcome Survey Activities of Daily Living Scale, and Short Form-36 data were obtained before and after 15 sessions of interventions and at the end of a three-week follow-up period. RESULTS: Severity of symptoms and pain decreased; functional mobility, activity limitations and quality of life improved significantly after interventions (P<0.05), and these effects were maintained at the follow-up period (P<0.05). The amount of improvements in symptom and pain severity, and quality of life was higher in the Russian and Aussie current groups than in the placebo group (P<0.05). CONCLUSION: In patients with patellofemoral pain, burst-modulated medium frequency alternating currents may provide extra benefit in improving symptoms, pain, functional mobility and quality of life, and the Aussie currents provide greater improvement in symptom and pain severity.

Effect of Kinesio taping on wrist kinematics and functional performance: A randomized controlled trial.

BACKGROUND: Kinesio taping (KT) is a popular adjunct treatment modality for musculoskeletal injuries, hand and wrist injuries. The effectiveness of KT on wrist kinematics has been analyzed during single plane movements in general, and no study has investigated its effectiveness during dart throwing motion (DTM). PURPOSE: To compare the effects of different KT techniques on wrist kinematics during DTM and functional performance of hand in healthy participants. STUDY DESIGN: Randomized, double-blind, placebo-controlled, crossover study. METHODS: Seventy-two healthy participants were included. Dominant wrist kinematics during DTM was evaluated by a Leap motion controller and wrist functional performance was evaluated by Minnesota Manual Dexterity Test. In order to compare the effects of KT on different muscles and also the effects of KT and placebo taping (PT), wrists of participants were evaluated under 5 conditions: without any taping, KT on flexor carpi ulnaris (FCU), KT on extensor carpi radialis brevis and longus (ECRB/L), PT on FCU and PT on ECRB/L. Means of outcome measures without any taping and with different 4 tapings were compared by repeated measures analysis of variance. PT and KT effects were compared by Wilcoxon signed rank test. RESULTS: DTM range increased (P = .0) and Minnesota Manual Dexterity Test time decreased (P = .0) after KT and PT applications on FCU and ECRB/L muscles. Amount of change in wrist kinematics (P = .0; effect size = 0.2 and 0.3) and functional performance (P = .0; effect size = 0.6 and 0.8) were more obvious with KT applications, independent from the muscles they were applied on (P = .2 for wrist kinematics and P = .7 for functional performance). CONCLUSIONS: KT on either FCU or ECRB/L muscles improve wrist kinematics and functional performance, significantly. Further studies should investigate if these findings apply for the patients with different wrist injuries, for both immediate- and long-term effectiveness.

Psychometric properties of the Turkish version of L'Insalata Shoulder Rating Questionnaire.

PURPOSE: The aim of this study was to examine the psychometric properties of the culturally adapted Turkish version of the L'Insalata Shoulder Rating Questionnaire (TrLSRQ). MATERIALS AND METHODS: Comprehensibility and content validity of the TrLSRQ were tested on 14 patients and seven physiotherapists, respectively. Subsequently, 90 volunteer patients with shoulder pain completed the TrLSRQ twice within a week for test-retest analysis. Correlations with Shoulder Pain and Disability Index (SPADI), Oxford Shoulder Score (OSS), Penn Shoulder Score (PSS), and Upper Extremity Functional Index (UEFI) were used to assess convergent validity; and pain intensity and active range of shoulder motions were measured to assess criterion validity. RESULTS: Content validity index of the TrLSRQ was 0.99. The internal consistency was high (Cronbach's α = 0.89); and item-total correlations were 0.37-0.74. In test-retest analysis, ICC values were 0.65-0.95 for all items; and 0.86-0.94 for the subcategories. The TrLSRQ scores were positively correlated with UEFI, and negatively correlated with other scales (p < 0.05). Its correlations with the intensity of pain and shoulder range of motions (p < 0.05) indicated that the questionnaire had good criterion validity. CONCLUSIONS: The TrLSRQ is a reliable and valid measure to assess pain, activities of daily living, sports/recreation, and work in patients with shoulder pain.Implications for RehabilitationPatient-reported outcome measures (PROMs) are important tools to assess the impact of health problems on overall well-being of the patients.The Turkish version of the L'Insalata Shoulder Rating Questionnaire (TrLSRQ) is a PROM that evaluates the impact of shoulder problems on patient's pain, daily activities, sportive/recreational activities, and work; as well as overall satisfaction with his/her shoulder, and ranking of areas in which the patient likes to see improvement.The TrLSRQ scores are well correlated with other relevant PROMs, as well as with the intensity of pain and shoulder range of motions.The TrLSRQ is a reliable and valid measure, which can be used for both clinical and research purposes to evaluate symptoms and functional status of patients with shoulder pain.

Immediate effects of TENS and HVPS on pain and range of motion in subacromial pain syndrome: A randomized, placebo-controlled, crossover trial.

BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is one of the most common methods for managing shoulder pain, and high voltage pulsed currents (HVPS) may be used for reducing pain. However, their immediate effects on resting pain and pain-free active range of shoulder motion (pfROM) in patients with subacromial pain syndrome (SAPS) have not been studied comparatively, yet. OBJECTIVES: The aim of this study was to compare the immediate effects of TENS, HVPS and placebo stimulation on shoulder resting pain and pfROM in patients with SAPS. METHODS: Randomized, placebo-controlled, double-blind, crossover study. One hundred and six patients with SAPS received placebo (predetermined 1st day application), TENS and HVPS with 1-day interval, in a random sequence. Before and after each application, resting pain and pfROM were evaluated by 0-10 cm visual analogue scales and a digital inclinometer, respectively. RESULTS: Intensity of pain decreased significantly after TENS, HVPS and placebo interventions (p< 0.05). While pfROMs increased significantly after TENS and HVPS (p< 0.05), remained unchanged after placebo, except for internal and external rotations (p> 0.05). The most obvious effects on pain and pfROMs occurred after HVPS (p< 0.05). CONCLUSION: In patients with SAPS, both HVPS and TENS, but preferably HVPS can be used effectively to decrease pain and increase pfROM.

Reliability and validity of Five Times Sit to Stand Test in pregnancy-related pelvic girdle pain.

BACKGROUND: Pelvic girdle pain (PGP) is a common musculoskeletal disorder during pregnancy, and functional mobility evaluation is very important in reflecting the treatment effects. OBJECTIVES: To investigate reliability and validity of Five Times Sit-to-Stand (5TSS) test in pregnant women with and without PGP. DESIGN: A cross-sectional observational study. METHODS: One hundred sixty-seven women in the second or third trimester of pregnancy participated in two assessments one week apart. The 5TSS and Timed Up & Go (TUG) tests were used to assess functional mobility, in a randomized sequence, by two independent raters. Time to complete the tests were recorded. Perceived pain and difficulty during functional mobility tests were marked on two Visual Analogue Scales. Following tests of functional mobility, seven clinical tests were used to classify the subjects as with or without PGP. RESULTS: The 25% of subjects had PGP. Inter-rater reliability of 5TSS was excellent for subjects with and without PGP (ICC = 0.999, 95% CI = 0.999-1.000; ICC = 0.999, 95% CI = 0.999-0.999, respectively). Test-retest reliability of 5TSS was also very high for subjects with and without PGP (ICC = 0.986, 95% CI = 0.959-0.995; ICC = 0.828, 95% CI = 0.632-0.920, respectively). The 5TSS scores were positively correlated with TUG scores (r = 0.420, p = 0.006 and r = 0.404, p = 0.000, respectively). The subjects reported higher pain (95% CI = 0.322-0.824) and difficulty (95%Cl = 0.500-1.042) during 5TSS than the TUG test. CONCLUSIONS: The 5TSS test is a reliable and valid functional mobility outcome measure in pregnant women with and without PGP. Further psychometric properties of the measure such as responsiveness, should be investigated in the future.

Knowledge and practice of nursing home caregivers about urinary incontinence.

PURPOSE: The aim of this study was to investigate nursing home caregivers' knowledge and practice of urinary incontinence in Mugla-Turkey. METHODS: Knowledge and practice of urinary incontinence of 34 nursing home caregivers were assessed by a form originated from knowledge and practice instrument and urinary incontinence knowledge scale. Incontinence quiz was also used to assess knowledge about UI. RESULTS: According to the analysis of the items from the knowledge and practice instrument, 20.6% of caregivers never control the amount of urinary incontinence in residents with dementia, document the amount of urinary incontinence and set up a toilet plan for residents with no or slight mental incapacity. According to the analysis of the items from the urinary incontinence knowledge scale, majority of caregivers considered urinary incontinence as a normal result of aging. The mean incontinence quiz score of all participants was 5.5 ± 2.0, indicating poor knowledge about UI. CONCLUSION: Findings indicate the need of developing strategies for improving knowledge and effective practice of urinary incontinence of nursing home caregivers.

Nursing Home Residents' Level of Knowledge About Urinary Incontinence.

BACKGROUND: A common problem in nursing home residents, urinary incontinence (UI) can lead to hygiene and skin problems, sleep disturbance, and decreased quality of life. This study evaluated the level of knowledge regarding UI among nursing home residents in Mugla, Turkey. METHODS: This study included 64 (19 females, 45 males) nursing home resident volunteers. Their physical and sociodemographic characteristics; daily living activities (Barthel Index); and the presence, frequency, severity, and type of UI as well as its impact on daily living were evaluated (International Consultation on Incontinence Questionnaire-Short Form) and history of treatment was queried. An Incontinence Quiz was used to assess the residents' knowledge of incontinence. RESULTS: The participants were living in nursing homes for 34.48±33.16 months. Their educational level was low and most were single. The mean Barthel Index score was 89.75±13.00. Twenty-five participants had UI (18.8% urge, 4.7% stress, 15.6% mixed/other type), and the mean International Consultation on Incontinence Questionnaire-Short Form score was 8.08±4.24. Forty-four percent of the participants had no treatment and none had physiotherapy for incontinence. The mean Incontinence Quiz score was 4.88±1.96, indicating a low level of knowledge. The items with the highest ratio of incorrect responses (second and 14th) were related to the causes of incontinence and care seeking. CONCLUSION: These findings underscore the necessity of increasing knowledge among nursing home residents about the reasons and health care options for UI. Further studies on appropriate strategies to improve UI knowledge in this population will be of great value.

Effect of ankle proprioceptive training on static body balance.

[Purpose] This study aimed to investigate the effect of ankle proprioceptive training on static body balance. [Subjects and Methods] In this randomized-controlled, single-blind study, 59 university students (35 females, 24 males) were randomized into study (n=29) and control (n=30) groups. The study group received a foot and ankle proprioceptive exercise program including stretching, strengthening (plantar and dorsi-flexors, invertor and evertor muscles), and balance board exercises, each with 10 repetitions per session, 5 days a week, for a total of 10 sessions. The control group did not receive any intervention. Static body balance was evaluated by a kinesthetic ability trainer, which showed the balance index scores under both single foot and both feet conditions. This evaluation was repeated at the end of two weeks for both groups. [Results] Outcome measures of the groups were similar at the baseline. Balance index scores of both groups improved at the end of two weeks, and the study group had significantly lower index scores than those of the control group, indicating better balance. [Conclusion] Ankle proprioceptive training had positive effects on static body balance parameters in healthy individuals, and it is worth investigating the effects of this type of training in patients with balance disorders.

Musculoskeletal problems and quality of life of elementary school teachers.

PURPOSE: To investigate prevalence and anatomical distribution of musculoskeletal pain (MSP) and its impact on quality of life (QoL) in elementary school teachers working in Mugla town center. METHODS: Physical, sociodemographic and occupational characteristics of 104 teachers were recorded. Onset, prevalence and consequences of MSP (Extended Nordic Musculoskeletal Questionnaire) and QoL (Short Form-36 Health Survey) of teachers with (n = 37) and without (n = 67) MSP during the last 12 months were compared. RESULTS: The prevalence of MSP was 77% for the lifelong period and 36% for the last 12 months. Physical and sociodemographic characteristics, daily employment period and length of standing and sitting were similar between groups (p > 0.05). The most common painful regions were the neck (39%) and the lower back (38%). MSP of these regions was the common reason for seeking healthcare, prevention from activities and taking sick leave. MSP had negative impact, especially on the physical components of QoL (p < 0.05). CONCLUSIONS: The results reveal high prevalence of MSP among teachers, as well as its negative impacts on QoL. Especially neck and lower back seem to be the most frequently affected regions of the body. These findings draw attention toward the need for developing strategies to prevent MSP among teachers.

Effects of different frequencies of conventional transcutaneous electrical nerve stimulation on pressure pain threshold and tolerance.

BACKGROUND: Pulse frequency is one of the key determinants of analgesic outcomes by transcutaneous electrical nerve stimulation (TENS). However, optimal settings remain unclear. OBJECTIVE: To compare the effects of different frequencies of TENS, on pressure pain threshold and tolerance. METHODS: Currents with pulse duration of 110 µs, and pulse frequencies of 60 pps or 150 pps were applied on the volar aspects of the dominant forearms of 20 healthy volunteers, on two consecutive days, in a randomized order. Threshold and tolerance were measured at the beginning, after the 15th and 30th minutes of the applications, and 30 minutes after the applications. RESULTS: Pressure pain threshold and tolerance values were higher at the 150 pps frequency, at all measurement times (p< 0.05). However, no frequencyXtime interaction and time-dependent changes were found for the outcome measures (p> 0.05). CONCLUSIONS: These findings established that, at 150 pps conventional TENS, threshold and tolerance values were consistently higher. These results are presented to inform future research regarding optimal conventional TENS parameters and to provide support for clinical applications.

Effects of thermal agents on electrical sensory threshold and current tolerance when applied prior to neuromuscular electrical stimulation.

BACKGROUND AND OBJECTIVE: This study aimed to investigate the effects of thermal agents on electrical sensory threshold and current tolerance when applied prior to neuromuscular electrical stimulation. METHODS: In this single-blind and cross-over trial, electrical sensory threshold and current tolerance of 24 healthy volunteers were evaluated by using biphasic symmetrical pulses (240 µsec, 50 pps), before and after thermal agent (cold pack, hot pack and ultrasound) applications. RESULTS: Electrical sensory threshold increased after cold-pack, and current tolerance reduced after hot-pack applications (p< 0.05). Inter-agent comparisons of pre and post-application differences of the investigated parameters revealed that the most obvious effects were caused by application of hot pack. CONCLUSIONS: Hot pack application prior to neuromuscular electrical stimulation (NMES) may reduce current tolerance and limit to reach the desired current intensity for strengthening the electrically induced contractions. Results are considered to be valuable for physiotherapists, who apply thermal agents and NMES consecutively, in their treatment programs.

Effects of physiotherapy on pain and functional activities after cesarean delivery.

PURPOSE: To investigate the effects of a physiotherapy program on incision pain and functional activities in the early post-cesarean period. METHODS: Fifty women were evaluated after Cesarean operation with regard to times of ambulation and return of bowel activity, intensity of incision pain, difficulty in functional activities and number of analgesics required additional to routine pain control procedure. Twenty-four women received only routine nursing care, and a physiotherapy program was applied to the study group (n = 26), additionally. RESULTS: Postoperative ambulation and return of bowel activity were earlier in the study group (p < 0.05). Incision pain and difficulty in functional activities decreased significantly within 2 days in both groups, and the values were lower in the study group (p < 0.05). Study group needed less medication for pain control (p < 0.05). CONCLUSIONS: Findings revealed the effectiveness of a physiotherapy program in the early post-cesarean period in a wider perspective than the current literature, and are considered to be valuable for increasing the quality and productivity of the postnatal care, therefore improving well-being after childbirth.

Functional mobility, depressive symptoms, level of independence, and quality of life of the elderly living at home and in the nursing home.

OBJECTIVES: To compare functional mobility, depressive symptoms, level of independence, and quality of life of the elderly living at home and in the nursing home. DESIGN: A prospectively designed, comparative study. SETTING: A nursing home and a university hospital department. PARTICIPANTS: In this study, 33 elderly living in a nursing home and 25 elderly living at home, who fulfilled the inclusion criteria and volunteered to participate, were included. MEASUREMENTS: Sociodemographic characteristics were recorded. Functional mobility (Timed Up & Go Test), depressive symptoms (Geriatric Depression Scale), level of independence (Kahoku Aging Longitudinal Study Scale), and quality of life (Visual Analogue Scale) scores were compared between the groups. RESULTS: Functional mobility and independence level of the nursing home residents were higher than the home-dwelling elderly (95% CI: -4.88, -0.29 and 0.41, 6.30, respectively), but they had more depressive symptoms (95% CI: 0.30, 5.45), and their level of QoL was lower (95% CI: -15.55, -2.93). CONCLUSION: These findings are thought to be important and of benefit for health care professionals and caregivers as indicating the areas that need to be supported for the elderly living at home (functional mobility and independence) and in the nursing home (depressive symptoms and quality of life).

Effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea.

OBJECTIVE: To compare the effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea. DESIGN: A prospective, randomized, and controlled study. SETTING: Hacettepe University School of Physical Therapy and Rehabilitation. PATIENTS: Thirty-four volunteer subjects with primary dysmenorrhea (mean age: 21.35 +/- 1.70 years) were included. Statistical analyses were performed in 32 subjects who completed all measures. INTERVENTIONS: Fifteen subjects received interferential current application for 20 minutes and 17 subjects received transcutaneous electrical nerve stimulation for 20 minutes when they were experiencing dysmenorrhea. OUTCOME MEASURES: Physical characteristics, years since menarche, length of menstrual cycle (days), and duration of menstruation (days) were recorded. Visual analog scale ( VAS) intensities of menstrual pain, referred lower limb pain, and low back pain were recorded before treatment, and immediately, 8 hours, and 24 hours after treatment. RESULTS: Intensities of the evaluated parameters decreased beginning from just after the applications in both groups (P<0.05). Intensity of referring low back pain in first three measurement times was different between the groups (P<0.05), but this difference is thought to be due to the baseline values of the groups. So, it can be said that no superiority existed between the methods (P>0.05). CONCLUSION: Both transcutaneous electrical nerve stimulation and interferential current appear to be effective in primary dysmenorrhea. As they are free from the potentially adverse effects of analgesics, and no adverse effects are reported in the literature nor observed in this study, a clinical trial of their effectiveness in comparison with untreated and placebo-treated control groups is warranted.