Pain types and risk factors in post-COVID-19.

Objectives: This study aims to accurately evaluate pain lasting longer than three months and falls under the category of chronic pain and to determine the risk factors to follow up and treat properly and to develop appropriate diagnostic and treatment algorithms. Patients and methods: Between March 2021 and December 2021, a total of 437 patients (162 males, 275 females; mean age: 44±14.6 years; range, 12 to 82 years) who were referred to the participating centers due to pain complaints and were diagnosed with post-COVID-19 condition according to the criteria defined by the World Health Organization (WHO) were included in the study. The patients were divided into three groups as nociceptive pain, neuropathic pain, and central sensitization, based on the physician's clinical evaluation and the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Central Sensitization Inventory scores. Results: The most common diagnosis was nociceptive pain followed by central sensitization. Patients with nociceptive pain had less pain. It was found that not exercising regularly, having a chronic disease and being a woman were risk factors for central sensitization, having thyroid disease before COVID-19, and defining the current pain as very severe were risk factors for neuropathic pain. Conclusion: In the evaluation of post-COVID-19 pain, neuropathic pain and central sensitization should be also considered in addition to nociceptive pain and the severity of pain, systemic diseases and physical activity should be questioned.

Stroke severity to determine musculoskeletal symptoms in family caregivers. / Gravedad de accidentes cerebrovasculares para determinar síntomas osteomusculares en cuidadores familiares.

OBJECTIVE: the objective of this study is to examine the relationship between the musculoskeletal problems experienced by the family members who care for stroke patients, physical health and disability levels. METHOD: the subjects included in the study were patients and family caregivers admitted to the Kanuni Sultan Suleyman Training and Research Hospital Physical Medicine and Rehabilitation outpatient clinic with a stroke diagnosis between May 30 th, 2019, and May 30 th, 2021. The caregivers were assessed using the Extended Nordic Musculoskeletal Questionnaire. Validated scales were employed to evaluate stroke patients' physical health and disability level. RESULTS: a total of 104 stroke patients and 104 caregivers who met our inclusion criteria took part in this study. Low back complaints in the last month were associated with the patients' Functional Ambulation Score (FAS), Functional Independence Measure (FIM), Stroke Impact Scale (SIS) and Brunnstrom scores. Neck pain was the second musculoskeletal complaint, but was not statistically associated with patient-related factors. Upper limb problems were associated with FAS, FIM, SIS, Brunnstrom and the Modified Ashworth Scale scores. CONCLUSION: according to our findings, the low back is the body area most affected by musculoskeletal complaints in family caregivers of stroke patients, closely related to the patients' functional capacity and disability levels. CLINICAL TRIALS NUMBER: NCT04901637 (1) Stroke survivors highly depend on informal caregivers for daily living. (2) Family caregivers are at an increased risk of experiencing musculoskeletal problems. (3) The caregivers' musculoskeletal symptoms are related to the level of the patient disability. (4) Preventive medicine should become a part of nursing education for family caregivers.

Risk factors of neck disability in computer-using office workers: a cross-sectional study.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04821024.

Demonstrating the effectiveness of Platelet Rich Plasma and Prolotherapy treatments in knee osteoarthritis.

BACKGROUND: Platelet-rich plasma(PRP) and prolotherapy(PRL) are regenerative treatment approaches in the knee osteoarthritis (KOA). AIM: To see how efficient PRP and PRL are in treating KOA. METHODS: A total of 108 patients with a diagnosis of KOA who received either PRL, PRP, or exercise therapy and whose 3-month follow-up data were available were included in this retrospective study (PRL n = 35 or PRP n = 35, exercise n = 38). Visual Analogue Scale(VAS) and The Western Ontario McMaster University Osteoarthritis Index(WOMAC) were used as outcome measures at baseline, 1 month, and 3 months. RESULTS: There were no statistically significant differences between the three groups in terms of demographic parameters, baseline assessments of pain intensity, or WOMAC scores. At the first and third months, all groups showed a substantial improvement in the VAS activity, resting and WOMAC values as compared to before treatment(p < 0.05). When the groups were compared, the VAS activity, resting, and WOMAC values in PRP and PRL improved significantly in the first and third months compared to the exercise group. At one month, there was a statistically significant improvement in VAS activity and WOMAC pain and total scores compared to PRP and PRL, but this improvement was not significant at 3 months. CONCLUSION: Pain and disability were significantly improved with PRL and PRP compared with exercise therapy. Although PRP is more effective than PRL in the first month after treatment, PRL may be preferred due to its low cost, long-term efficacy, and low complication rates due to the periarticular application.

Demonstration of kinesio taping effect by ultrasonography in neck pain.

OBJECTIVE: This study aimed to demonstrate the effectiveness of kinesio taping in nonspecific neck pain and to assess whether ultrasonographic parameters of the upper trapezius muscle can be used in the follow-up of kinesio taping treatment. METHODS: This was a single-blind, prospective, randomized controlled trial study involving 60 participants with nonspecific neck pain. The participants were randomly assigned into two groups. Kinesio taping group (n=29) received a 4-week neck exercise program, with kinesio taping applied twice a week for a total of four times, and the exercise group (n=28) received a 4-week neck exercise program. Participants were evaluated according to pain intensity (Visual Analog Scale), cervical range of motion, and disability (Neck Disability Index). Also, trigger point diameter and upper trapezius muscle thickness were evaluated with ultrasonography. Before and after the therapy, as well as the first month, all measures were taken by an investigator other than the practitioner of the treatment program. RESULTS: The results showed that the Visual Analog Scale and Neck Disability Index scores in the kinesio taping group were statistically significantly improved when compared to the exercise group (p<0.05). In addition, the thickness of the upper trapezius muscle and the diameter of the trapezius muscle trigger point were statistically significantly improved in the kinesio taping group compared to the exercise group (p<0.05). In the kinesio taping group, there was no statistical significance in cervical range of motion as compared to the exercise group. CONCLUSION: The combination of kinesio taping and exercise therapy was effective in reducing nonspecific neck pain and neck disability. Also, this study showed that ultrasonographic evaluation of the trapezius muscle could be used in the follow-up of kinesio taping therapy.

Effect of dry-needling and exercise treatment on myofascial trigger point: A single-blind randomized controlled trial.

AIM: To investigate the effectiveness of dry-needling(DN) together with exercise therapy on pain, ultrasonographic parameters of myofascial trigger points(MTrPs), and upper trapezius(UT) muscles, and neck disability in patients with myofascial pain syndrome. MATERIAL AND METHODS: This was a single-blind, prospective, randomized, and controlled trial. Participants aged 18-45 years with persistent neck pain for >3 months caused by the active MTrPs in the UT muscles were included. The exercise therapy was performed 3 times/week for 3 months. DN therapy was applied once a week, for a total of three sessions. The pain intensity, ultrasonographic measurements of the thickness of the UT muscle, and diameter of the MTrPs in the UT muscle were the primary outcomes. The secondary outcome was the neck disability. RESULTS: Seventy participants were randomized into two groups: the dry-needling together with exercise group(DNG, n = 35) and the exercise-only group(EG, n = 35). A total of 8 participants dropped out of the study, and the study was completed with 62 participants(DNG = 33; EG = 29). There was a significant difference in terms of VAS(at night, at rest, and during activity)(p < 0.001) at post-treatment and after 3 months, the thickness of UT muscle(p = 0.004), and diameter of MTrP(p = 0.021) at post-treatment between the groups. No statistical differences were identified in terms of NDI(p = 0.065). CONCLUSION: This study demonstrated the effects of DN applied together with exercise therapy on reduction of the pain intensity at short(post-treatment) and mid-term(after 3 months), and the ultrasonographic parameters of MTrPs and UT muscles at short-term(post-treatment).

The comparative effects of spinal manipulation, myofascial release and exercise in tension-type headache patients with neck pain: A randomized controlled trial.

OBJECTIVES: To evaluate the effects of two manual treatment methods on pain, disability, and pressure pain threshold (PPT) in tension-type headache (TTH) patients with and neck pain. METHODS: Forty-five patients with TTH were randomly assigned to one of three groups and received eight sessions treatment: manipulation plus exercise (manipulation), suboccipital inhibition plus exercise (myofascial release), and exercise only (control). Headache frequency, pain severity (VAS-headache, VAS-neck pain) and headache and neck disability (HIT-6 and NDI, respectively) were measured at baseline, posttreatment, and at the third month follow-up. PPT was also evaluated on the temporalis muscle. RESULTS: Manipulation group was statistically better than myofascial release group in terms of headache frequency, headache severity, and PPT scores. Also, manipulation group showed statistically significant improvements in all outcome criteria when compared control group. CONCLUSIONS: Manipulation and exercise, in addition to pharmacologic treatment in TTH patients with cervical dysfunction appear to be a promising approach.

Comparison of platelet-rich plasma and extracorporeal shock wave therapy in patients with chronic lateral epicondylitis: A prospective, randomized-controlled study.

OBJECTIVES: In this study, we aimed to investigate the effectiveness or comparative therapeutic superiority of exercise, extracorporeal shock wave therapy (ESWT), and platelet-rich plasma (PRP) on pain, grip strength and functional activities in chronic lateral epicondylitis (LE). PATIENTS AND METHODS: Between January 2016 and February 2017, a total of 74 patients (14 males, 60 females; mean age; 49.7±7.6 years, range, 26 to 60 years) with chronic LE were included in this prospective, randomized-controlled study. All patients received stretching and eccentric strengthening exercises for three months. The patients were divided into three groups. The first group (Exercises group, n=24) was given home exercises. The second group (ESWT+Exercises group, n=25) received one session of ESWT added once a week for three weeks. The third group (PRP+Exercises group, n=25) received one session of PRP in addition to the exercise program. All patients were evaluated for pain by Visual Analog Scale (VAS), for functionality by Disabilities of Arm, Shoulder and Hand (DASH) questionnaire and Patient-Rated Tennis Elbow Evaluation (PRTEE), handgrip strength by a dynamometer, and extensor tendon thickness by ultrasonography (USG) at baseline and at one, two, three, and six months. RESULTS: A significant improvement was found in the VAS, DASH, PRTEE, handgrip strength values at six months compared to between in all groups (p<0.001). Extensor tendon thickness as assessed by USG indicated no significant difference (p>0.05). Regarding the VAS activity levels, there was a significant difference in the PRP+Exercises group compared to the Exercises group at six months of follow-up (p<0.001). The decrease in the DASH scores during six-month follow-up was significantly higher in the PRP+Exercises group compared to the Exercises group (p=0.004). For the PRTEE scores at six months, the PRP+Exercises group showed a statistically significant improvement than both Exercises (p<0.001) and ESWT+Exercises (p=0.007) groups. CONCLUSION: In the treatment of chronic LE, PRP combined with exercise seems to be superior to exercise or ESWT in terms of pain and functionality in chronic LE patients.

Investigation of Copy Number Variation by arrayCGH in Turkish Children and Adolescents Diagnosed with Autism Spectrum Disorders.

AIM: The development of whole-genome screening methodologies for the detection of copy number variations (CNVs), such as array-based comparative genomic hybridization (aCHG), provides a much higher resolution than karyotyping leading to the identification of novel microdeletion and microduplication syndromes often associated with an autism spectrum disease (ASD) phenotype. The aim of the study was to determine CNVs of patients with ASD by using array-based comparative genomic hybridization. METHODS: Fifty-three patients diagnosed with ASD between 20.01.2014 and 14.01.2015 were included in the study. Chromosome analysis of the patients was performed from peripheral blood cultures and analysed as normal. All patients were evaluated with P064C1 and P096A2 MLPA probes in terms of 16 mental retardation related syndromes. For aCGH method, SurePrint G3 Human microarrays 8x60K were used with genomic DNA isolated from peripheral blood. RESULTS: According to results of 53 patients who were included in and performed with arrayCGH, 8 (15%) patients had CNVs classified as pathogenic or variant of unknown significance (VOUS) in the study. We detected a pathogenic NRXN1 gene partial CNV deletion (2p16.3) in two patients. Also we identified a 900 kb duplication of 4p15.31 including SLIT2 gene, and a 245 kb duplication of 15q11.2 including PWRN1 gene in one patient. Our other findings are considered to be a variant of unknown significance (VOUS). CONCLUSION: The results of the study support the literature knowledge, where the copy number variations that cannot be detected with conventional cytogenetics methods in terms of size may happen in patients with ASD.

The Probable Prevalence and Sociodemographic Characteristics of Specific Learning Disorder in Primary School Children in Edirne.

INTRODUCTION: The aim of this study was to research the probable prevalence of Specific Learning Disorder (SLD) in primary school children in Edirne City and the relationships with their sociodemographic characteristics. METHODS: The sample of our study was composed of 2,174 children who were educated in primary schools in second, third, and fourth grades in the academic year 2013-2014 in Edirne City. The teachers and parents of these children were given Specific Learning Difficulties Symptom Scale, Learning Disabilities Symptoms Checklist (teacher and parent forms), and sociodemographic data forms to fill in. Binary logistic regression analysis was used to assess the risk factors for SLD. RESULTS: Our study revealed that the probable prevalence of SLD was 13.6%; 17% for boys and 10.4% for girls. Reading impairment was 3.6%, writing impairment was 6.9%, and mathematic impairment was 6.5%. We determined that consanguineous marriages, low income, history of neonatal jaundice were found as risks for SLD; born by caesarean, developmental delay of walking, and history of neonatal jaundice were found as risks for mathematic impairment. A history of learning difficulties of parents was a risk factor for forming SLD and subtypes. CONCLUSION: Our findings were consistent with other study results about the prevalence of SLD. The relationships between the probable prevalence rates and sociodemographic data were discussed.