Kinesio taping versus dry needling in the treatment of myofascial pain of the upper trapezius muscle: A randomized, single blind (evaluator), prospective study.

BACKGROUND: Although a number of therapeutic interventions for trigger-point inactivation have been studied, it remains controversial which intervention is better. OBJECTIVE: To compare the effectiveness of the kinesio taping and dry needling methods in patients with trigger-point related myofascial pain syndrome of the upper trapezius muscle. METHODS: A total of 42 patients were randomly allocated to the kinesio taping group (n= 23) and dry needling group (n= 19). The patients were assessed for pain, pressure pain threshold (PPT), cervical range of motion (CROM), and function at baseline, at short- and medium-term stages after treatment. To investigate the effects of the interventions over time, two-way repeated measures analysis of variance (ANOVA) was used. RESULTS: There was a significant improvement in pain intensity at rest and cervical motion, in the PPT readings (p< 0.05), in CROM (p< 0.05), and in function (p< 0.05) in both groups, with no superiority either (p> 0.05). CONCLUSIONS: Kinesio taping may be a choice of trigger point inactivation in patients who do not want to be needled or who show contraindication(s) to treatments other than kinesio taping.

Are We Able to Suppress Disease Activity Adequately in Patients With Established Rheumatoid Arthritis? An Observational and Cross-Sectional Study.

OBJECTIVES: This study aims to explore current disease activity status and simultaneous pharmacological therapies in patients with established rheumatoid arthritis (RA) to determine the extent to which treatment targets are achieved. PATIENTS AND METHODS: One hundred patients (7 males, 93 females; median age 57 years; range 31 to 76 years) with established RA receiving any conventional synthetic disease modifying anti-rheumatic drug (DMARD) and/or biological DMARD for at least three months were enrolled. Disease activity was determined by using the Simplified Disease Activity Index. First, patients were categorized into four groups as remission, low disease activity, moderate disease activity, and high disease activity. Then, they were divided into two subgroups, namely a remission/low disease activity subgroup and moderate disease activity/high disease activity subgroup. RESULTS: Fifty-one percent of the patients had remission or low disease activity. The most frequently used conventional synthetic DMARDs were methotrexate (50%) and leflunomide (34%). Forty-five percent of patients were receiving glucocorticoid therapy. In patients receiving only conventional synthetic DMARDs, the proportion of remission and low disease activity was 54% (42/78). Forty-two percent (8/19) of the patients receiving biological DMARDs were in remission or had low disease activity. A comparison of subgroups revealed that median age and sulfasalazine use were significantly higher in the moderate disease activity/high disease activity subgroup. CONCLUSION: The results of this study demonstrated that half of patients with established RA had moderate or high disease activity in our local outpatient clinic. Some barriers might be responsible for the difficulties in controlling disease activity. Determining such barriers might result in a better clinical response during the management of patients with established RA in real-life practice.

Comparison of the DAS28-CRP and DAS28-ESR in patients with rheumatoid arthritis.

AIM: To compare the Disease Activity Score with 28 joint (DAS28) using erythrocyte sedimentation rate (ESR) (DAS28-ESR) and DAS28 using C-reactive protein (CRP) (DAS28-CRP) with thresholds validated for DAS28-ESR in Turkish patients with rheumatoid arthritis. METHOD: The DAS28 data of 112 patients with rheumatoid arthritis followed in a local outpatient clinic were used. First, the correlation between DAS28-CRP and DAS28-ESR and the correlation between their unique components ([0.36 × In (CRP + 1) + 0.96] and [0.70 × In (ESR)]) were analyzed. Second, a Bland-Altman plot was constructed for the evaluation of the level of agreement between DAS28-CRP and DAS28-ESR. Lastly, the agreement between these two methods was analyzed by κ coefficient. RESULTS: Although there was a strong correlation between DAS28-CRP and DAS28-ESR, the correlation between their unique components was fair. Although more than 95% of the point data fall between the upper and lower bounds of the limit of agreement, the percentage error (46%) was higher than the acceptable proportion of 30%. The κ coefficient of agreement between DAS28- ESR and DAS28-CRP with validated thresholds for DAS28-ESR was 0.42, which was close to the lower boundary for moderate agreement. CONCLUSION: The results of this study demonstrated that there is discordance between DAS28-ESR and DAS28-CRP with the validated thresholds for DAS28-ESR. Using the DAS28-CRP with threshold values validated for DAS28-ESR may lead to errors in the determination of disease activity and therefore may lead to errors in the management of patients with rheumatoid arthritis.