The efficacy of balance and proprioception exercises in female patients with knee osteoarthritis: A randomized controlled study.

OBJECTIVE: Loss of proprioception and balance disorders are commonly observed in patients with knee osteoarthritis. In this study, we aimed to investigate the effects of balance and proprioception exercises in patients with knee osteoarthritis. DESIGN: A single-center randomized trial with three parallel arms. SETTING: A tertiary health care facility in Turkey. PARTICIPANTS: Female patients with knee osteoarthritis aged 40-70 years. INTERVENTIONS: Ten-week exercise program in Biodex training, classical balance training and isometric strengthening groups. MAIN MEASURES: Dynamic balance (overall stability index and the modified Clinical Test of Sensory Interaction and Balance), pain (visual analogue scale), physical function (30-s chair stand test and 40-meter fast-paced walk test) and quality of life (Knee Injury and Osteoarthritis Outcome Score). RESULTS: Eighty-nine patients enrolled in the study. The Biodex training group, the classical training group, and the control group had overall stability index values of 1.0 ± 0.07, 1.4 ± 0.07 and 1.4 ± 0.07, and the Modified Clinical Test of Sensory Interaction and Balance - Condition-3 values of 0.7 ± 0.04, 0.9 ± 0.04 and 0.9 ± 0.04 respectively, at the end of treatment. In terms of pain scores on movement, each group showed significant improvement compared to their baseline, and the classical balance training group had better scores than the control group. No other significant difference was found between the groups. Physical function and quality of life outcomes showed significant main effects only in the time factor. CONCLUSIONS: Balance and proprioception exercises may have positive effects on dynamic balance and pain. The effects on physical function and quality of life should be investigated in further studies with larger sample.

Is Kinesio Taping Effective for Knee Osteoarthritis? Randomised, Controlled, Double-blind Study.

OBJECTIVE: To determine the effects of Kinesio taping on pain, functional performance, range of motion, and postural stability in patients with knee osteoarthritis. STUDY DESIGN: Randomised double-blind controlled trial. PLACE AND DURATION OF STUDY: Department of Physical Medicine and Rehabilitation, University of Health Sciences, Izmir Bozyaka Training and Research Hospital, Turkey, from November 2019 to October 2021. METHODOLOGY: Fifty-seven patients with knee osteoarthritis (grade II or higher) according to the Kellgren-Lawrence classification received Kinesio tape or sham-Kinesio tape on the rectus femoris muscle three times a week. Patients were evaluated using the visual analogue scale (VAS), Western ontario and McMaster Universities Osteoarthritis Index (WOMAC), 50-meter walk time, range of motion (ROM), and postural stability index at baseline, 1st hour, 3rd week, 7th week. A mixed model analysis of repeated measures was used to test the effect of KT on outcome measures. Calculations were based on an intention-to-treat analysis. RESULTS: The only significant difference between groups was in the dynamic medio-lateral stability index [F (2.6,144.1)=3.83, p=0.015], indicating the inferiority of KT at week 3. There were differences within groups in 50-meter walking time and VAS at rest, which showed improvements over time in both groups. No significant difference was found between or within groups for other outcomes. CONCLUSION: The KT intervention for three consecutive weeks showed no superiority over sham-KT in terms of pain intensity, knee-related health status, knee ROM, functional performance, and postural stability. KEY WORDS: Kinesio taping, Knee osteoarthritis, Pain, Gait, Functions.

Is the left/right judgment task performance altered in unilateral carpal tunnel syndrome: And associated with symptom severity?

BACKGROUND: Left/right judgment task performance (LRJT) is impaired in severe neuropathic pain conditions. However, comparison of LRJT performance in patients with carpal tunnel syndrome (CTS) with a control group with similar cognitive functions has not been investigated. OBJECTIVE: The aim of the study was to compare the LRJT performance of CTS patients with healthy controls and the unaffected side. METHODS: Seventy-five CTS patients with dominant, right-hand involvement and 75 control subjects were included in the study. The Recognize® tablet application was used for LRJT performance. Tactile acuity (Two-point discrimination) and handgrip strength; pain severity (Visual Analog Scale) and neuropathic component of pain (Pain Detect Questionnaire); symptom severity and functional impact of CTS (Boston CTS Assessment Test) were evaluated. Mixed-design ANOVAs and correlation analyses were used for data analysis. DESIGN: Cross-sectional study. RESULTS: Analysis of variance showed that there was no significant effect of side (affected versus unaffected) or group (CTS versus control group) on recognition accuracy or time. Significant group*site interactions were found for the two-point discrimination F (1,148) = 6.388, p = 0.013; and for handgrip strength F (1,148) = 17.552, p < 0.01. A statistically significant negative correlation was found between recognition accuracy and symptom duration and a significant positive correlation was found between recognition accuracy and handgrip strength in CTS patients (r = -0.267, p = 0.020; r = 0.290, p = 0.012). CONCLUSION: CTS patients recognize the affected side as accurately and quickly as the unaffected side and control group. Further research is needed to clarify the relationship between LRJT performance in the severely affected CTS group. GOV REGISTRATION NUMBER: NCT04967144 CLINICALTRIALS. GOV REGISTRATION DATE: 19 July 2021.

Adverse events report of inactivated COVID-19 vaccine from 4040 healthcare workers.

OBJECTIVES: Numerous vaccination studies are conducted to protect against COVID-19 infection, and preclinical and clinical studies are still ongoing worldwide. During this extraordinary period, the necessity to perform COVID-19 vaccine studies and immunization programs together has emerged. Vaccine Adverse Effects (VAEs) need to be documented quickly. We aimed to determine the VAEs and to compare the frequency of VAEs between groups according to sociodemographic characteristics after the inactivated vaccine (CoronaVac) was administered to healthcare workers (HCWs) in Turkey. METHODS: An online questionnaire was delivered to 4040 volunteer HCWs across the whole country who were vaccinated with CoronaVac. Sociodemographic characteristics, medical history, history of COVID-19 infection, and VAEs occurring after the first and second doses of the inactivated vaccine were evaluated. RESULTS: The most common local and systemic VAEs after first and second doses of the COVID-19 vaccine were reported as, pain at the injection site (37.9%; 37.6%), headache (21.5%; 16.8%), fatigue (18%; 15%), drowsiness (9.6%; 8.2%), back pain (8.8%; 8.2%), nausea (6.3%; 4.8%), and joint pain (4.7%; 4.7%). Individuals with a history of allergies (generalized or vaccine-related) and females had a higher rate of VAE. Participants aged 60 and over reported less frequent VAEs. CONCLUSION: It is extremely important to identify and document the VAEs occurring in the early postvaccination period in different groups of the community. These initial findings may provide reassurance to healthcare providers and vaccine recipients and promote confidence in the safety of this inactive COVID-19 vaccine, however longitudinal follow-up studies are recommended.

Horner's Syndrome and Vertebral Artery Occlusion Concomitant With Brachial Plexus Injury in a Patient With Anterior Approach Cervical Disc Herniation Surgery.

Horner's syndrome is one of the rare complications after anterior approach intervertebral disc herniation surgery. Here, we described a 35-year-old male patient with Horner's syndrome accompanied by brachial plexus injury at the upper trunk level and vertebral artery occlusion after anterior ipsilateral approach cervical discectomy and cervical disc prosthesis operation. We are not aware of a similar case of these complications after this operation in the literature. After the six-month follow-up period the patient's Horner's syndrome slightly improved and he partially gained right upper extremity muscle strength.

Dextrose Prolotherapy Versus Normal Saline Injection for the Treatment of Lateral Epicondylopathy: A Randomized Controlled Trial.

Objective: To compare the effect of dextrose prolotherapy (DPT) with saline in the treatment of chronic lateral epicondylopathy (LE). Design: Triple-blinded randomized controlled trial. Setting: Physical medicine and rehabilitation outpatient clinic. Subjects: Sixty cases of chronic LE participants were included in the study. Methods: Participants were randomly divided into two groups as DPT and normal saline. Saline or hypertonic dextrose (15%) was injected at the baseline, and at the end of the 4th and 8th week. Assessments were performed at baseline, and at the end of the 4th, 8th, and 12th week. Outcome measures: Primary outcome measures were Visual Analog Scale (VAS) for pain, Patient Rated Tennis Elbow Evaluation (PRTEE-Total [PRTEE-T], PRTEE-Pain, PRTEE-Function); secondary outcome measures were Disabilities of the Arm, Shoulder, and Hand Score (DASH) and pain-free handgrip strength. Results: Intragroup analysis demonstrated that both groups significantly improved in VAS, PRTEE, DASH scores, and handgrip strength during the study period (p < 0.001, for all outcome measurements in both groups). Intergroup analysis showed that PRTEE-T score changes between baseline-4th and -12th week; VASrest change between baseline and 4th week in the DPT group were significantly higher than the saline group (p = 0.041, p = 0.038, p = 0.013 respectively). There was no significant difference between groups in VAS, DASH scores, and handgrip strength between any time points, in terms of improvement (p > 0.05). Conclusion: Our study results showed that DPT outperformed saline in PRTEE-T score. Although saline seems to be a comparable clinical effect with DPT, further studies comparing the effects of saline injection and DPT are necessary, in chronic LE.

Assessment of subclinical atherosclerotic cardiovascular disease in patients with ankylosing spondylitis.

OBJECTIVE: The aim of the present study was to compare patients with ankylosing spondylitis (AS) with healthy controls with respect to subclinical atherosclerotic cardiovascular disease (CVD). METHODS: A total of 44 patients with AS with no history of CVD, diabetes mellitus, hypertension, chronic kidney disease, and lipid-lowering drug use were compared with 40 age- and sex-matched healthy controls with respect to carotid intima-media thickness (CIMT) and pulse wave velocity (PWV), which are surrogate markers of subclinical atherosclerosis. Correlation analysis was also performed to examine the association between surrogate markers and disease activity with inflammation [Ankylosing spondylitis disease activity score with C-reactive protein (ASDAS-CRP)]. RESULTS: In addition to age and sex, both groups were comparable with respect to cigarette smoking, body mass index, and high-density lipoprotein cholesterol (p=0.425, p=0.325, and p=0.103, respectively). The level of total cholesterol was significantly lower in patients with AS (p=0.002). Nonsteroidal anti-inflammatory drug and tumor necrosis factor alpha inhibitor use ratios in patients with AS were 79.5% and 65.9%, respectively. There was no significant difference between both groups regarding PWV and CIMT (p=0.788 and p=0.253, respectively). In patients with AS, there was a significant correlation between ASDAS-CRP and CIMT (r=0.315, p=0.038), but the correlation between ASDAS-CRP and PWV was not significant (r=-0.183, p=0.234). CONCLUSION: The results of the present study could not provide sufficient evidence whether disease activity with inflammation caused subclinical atherosclerotic CVD in patients with AS without overt CVD. The increased atherosclerotic CVD risk is most probably multifactorial in patients with AS, but the extent of the contribution of disease activity with inflammation to increased atherosclerosis is controversial.