Comparison of the effects of conventional physiotherapy and proprioception exercises on pain and ankle proprioception in patients with lumbar radiculopathy.

BACKGROUND: Lumbar radiculopathy is characterized by a significant amount of backache causing loss of workforce and is a significant health problem frequently seen in the general population. OBJECTIVE: The purpose of this study was to compare the effects of conventional physiotherapy (CT) and proprioception exercises (PE) on ankle proprioception and lumbar pain between patients with lumbar radiculopathy and a healthy control group. METHODS: In this randomized clinical trial, 89 patients referred to the Physical Medicine and Rehabilitation outpatient clinic were selected through convenience sampling. They were randomly assigned to three groups: CT (n= 27), PE (n= 31), CT&PE (n= 31). Thirty healthy volunteers were included in the study as the control group. Proprioception measurements were made with an isokinetic dynamometer at 10∘ dorsiflexion (DF), 11∘, and 25∘ plantarflexion (PF) angles. Lumbar pain was assessed by using the Numerical Pain Rating Scale (NPRS). The data were analyzed by IBM SPSS Statistics version 22.0 via the Kruskal-Wallis and Mann-Whitney U tests. RESULTS: There was a statistically significant difference between the groups in terms of ankle proprioception and NPRS measurements in post-treatment evaluations (p< 0.05). Statistically significant differences were found between CT and PE groups and CT&PE and control groups. There was no statistically significant difference in comparing CT and PE groups and CT&PE and control groups within themselves (p> 0.05). CONCLUSION: The combined use of CT and PE is an effective method that can be used in the clinic to reduce angular differences in ankle proprioception which is one of the primary factors of balance and coordination and lumbar pain.

Use of a stabilized sewage sludge in combination with gypsum to improve saline-sodic soil properties leached by recycled wastewater under freeze-thaw conditions.

Soil salinization is a major environmental hazard that limits agricultural production. Using sewage sludge and recycled wastewaters in amelioration of saline-sodic soils is one of the most effective ways to dispose waste. However, a very low initial permeability of soil in the freeze-thaw conditions can make improvement difficult. Therefore, column experiments at a soil depth of 15 cm have been conducted to determine the effects of the combination of four stabilized sewage sludge doses (0, 50, 100, 150 t ha-1), three freeze-thaw cycles (0, 5, 10 times) and two water types (FW: freshwater, RWW: recycled wastewater) on gypsum-treated saline-sodic soil properties. The effects of non-saline-sodic RWW on the soil properties were similar to the FW in total 22.5 cm leaching amount. Compared to gypsum alone and initial values, sewage sludge increased wet aggregate stability, organic matter, total N and exchangeable Ca + Mg while it decreased pH, exchangeable Na and CaCO3. Saturated hydraulic conductivity was not induced by sewage sludge although exchangeable sodium percentage and electrical conductivity were reduced by 44% and 63.6%, respectively. Negative effects of freeze-thaws on hydraulic conductivity and salinity and sodicity elimination were not observed, while pH and aggregate stability were negatively affected from ten freeze-thaws. Overall, it can be concluded that the improvement of hydraulic conductivity is attributed to the further improvement of soil structure from more strong wet aggregate stability via additional sewage sludge and leaching amounts.

The effect of stress-induced cortisol increase on the sense of ankle proprioception.

OBJECTIVES: The aim of this study is to analyze the effect of stress-induced cortisol increase on the sense of ankle proprioception. PATIENTS AND METHODS: Between April 2016 and May 2016, a total of 60 students (30 males, 30 females; mean age: 19.2±1.5 years; range, 19 to 20 years) from Inönü University, Faculty of Medicine, Department of Freshmen were included in the study. Separate measurements were made for the right and left ankle to make ankle proprioception measurements a month before the committee exam during their relaxed period using a device designed with digital inclinometer. The sense of ankle proprioception was measured at 10° dorsiflexion (DF), 11° plantar flexion (PF), and 25° PF angles with open eyes and closed eyes using active reproduction test. Salivary samples were taken for stress assessment and State Trait Anxiety Inventory-I (STAI-I) was conducted. The same tests were repeated on the day of committee exam. RESULTS: Test results showed no statistically significant difference between the right and left ankle proprioception measurements of 10° DF, 11° PF, and 25° PF angles with open eyes (p>0.05). However, a statistically significant difference was found between the right and left ankle proprioception scores at the same angles with closed eyes (p<0.05). According to the Wilcoxon analysis conducted for the comparison of the relaxed and stressed periods of cortisol and STAI-I inventory, a statistically significant difference was found (p<0.05). The Spearman's Rho analysis showed no significant correlation between the right and left ankle proprioception scores and cortisol and STAI-I with open eyes, while there was a statistically significantly positive direction and low correlation between the same angles with closed eyes. CONCLUSION: Our study results show that the increase in the stress-related cortisol is negative for the ankle proprioception sense.