Efficacy of capacitive-resistive therapy on the treatment of myofascial pain - A randomized control trial.

BACKGROUND: Myofascial pain syndrome is a painful musculoskeletal condition with muscle spasm, referred pain, stiffness, restricted range of motion. Capacitive-resistive diathermy heats deep tissues by transferring energy through radiofrequency waves. Although this modality is used to treat various musculoskeletal disorders, there is no specific data on myofascial trigger points. Thus, we aimed to evaluate the effectiveness of capacitive-resistive diathermy on the myofascial trigger points. METHODS: Thirty-six volunteers with active myofascial trigger points were included. Patients were randomly and equally allocated into two groups. Group-1 is the capacitive-resistive diathermy treatment group; Group-2 is the placebo capacitive-resistive diathermy (PG). Visual analog scale (VAS), pain pressure threshold (PPT), neck disability index (NDI), neck range of motion (nROM), Short form-36 (SF-36) were used as outcomes before and after the intervention. RESULTS: In both groups, VAS, PPT, NDI score significantly improved within the groups (p < 0.05). The CRG showed a statistically significant improvement in nROM for flexion, extension, and rotation (p < 0.05). However, ROM increase in CRG is not superior to PG (p > 0.05). CONCLUSIONS: There was no significant difference between the two groups. We thought positive results in the PG might attributed to doing exercise. As a result, capacitive-resistive diathermy is not superior to exercise, but can be used as an adjuvant modality in myofascial trigger points treatment.

Diagnostic value of shear-wave elastography for patellar tendinopathy in female volleyball and basketball athletes: a cross sectional case control study.

OBJECTIVES: We aim to investigate the accuracy of shear-wave elastography (SWE) in diagnosing patellar tendinopathy in female volleyball and basketball players. In addition, we compared different parts of the patellar tendon and investigated the effects of different knee angles on elastography measurements. METHODS: This cross-sectional case-control study evaluated 63 female athletes from professional basketball and volleyball teams (NCT06199583). Patellar tendinopathy diagnoses were made using clinical and ultrasonographic criteria. SWE measurements were taken at 30-degree knee flexion and extension. Rectangular regions of interest boxes were placed in three different parts of the tendon (proximal, middle, distal). The global SWE value was calculated by taking the mean of measurements in the three parts. Receiver operating characteristic (ROC) curves were used to identify significant cutoff points for SWE, and 2 × 2 tables were generated to determine sensitivity and specificity. RESULTS: Thirteen (20.6%) of the 63 athletes were diagnosed with patellar tendinopathy. The ROC curves have identified different cutoff scores for SWE measurements. The SWE score of 130.75 from the proximal part showed the highest sensitivity of 89% and specificity of 80% (p < 0.001) with a 4.45 likelihood ratio at the 30-degree knee flexion. The likelihood ratio is 1.5 at a 30-degree angle and 1.65 at a 0-degree angle when measuring the entire tendon, whereas other portions indicate a ratio ranging from 1.12 to 1.73. CONCLUSIONS: Shear-wave elastography is a reliable evaluation method for diagnosing patellar tendinopathy. It has more accuracy when applied to the proximal part and at 30-degree knee flexion compared to measurements taken at knee extension and other parts of the tendon.

Deep phenotyping of miRNAs in exercise-induced cardiac hypertrophy and fibrosis.

Cardiac hypertrophy (CH) is an adaptational enlargement of the myocardium, in exposure to altered stress conditions or in case of injury which can lead to heart failure and death. MicroRNAs (miRNAs) are noncoding RNAs that play a significant role in modulating gene expression. Here, we aimed to identify new miRNAs effective in an experimental CH model and to find an epigenetic biomarker that could demonstrate therapeutic targets responsible for the pathology of heart tissue and serum. In this study, Sprague-Dawley male rats were divided into the training group (TG, n=9) and the control group (CG, n=6). Systolic and diastolic dimensions of the left ventricle and myocardial wall thickness were measured by echocardiography to assess CH. After the exercise program of the rats, miRNA expression measurements and histological analyses were performed. The 25,000 genes in the rat genome were searched using microarray analysis. A total of 128 miRNAs were selected according to the fold change rates, and nine miRNAs were validated for expression analysis. The terminal deoxynucleotidyl transferase dUTP nick (TUNEL) method was used to detect apoptotic cells. Cell proliferation was evaluated by the proliferative cell nuclear antigen (PCNA) method. Necrosis, bleeding, and intercellular edema were detected in TG. The mean histopathological score was higher in TG (p=0.03). There were rarely positive cells for apoptosis of both groups in cardiomyocytes. In the receiver characteristic curve analysis (ROC), the heart tissue rno-miR-290 had an area under the curve (AUC) of 0.920 with 100% sensitivity and 89.90% specificity (p=0.045), rno-miR-194-5p had AUC of 0.940 with 83.33% sensitivity and 100% specificity (p=0.003), and the serum rno-miR-132-3p AUC was 0.880 with 66.67% sensitivity and 100% specificity (p=0.004) in TG. miR-194-5p was used as a therapeutic target for remodeling the cardiac process. While miR-290 contributes to CH as a negative regulator, miR-132 in serum is effective in the pathological and physiological cardiac remodeling process and is a candidate biomarker.

Athlete presentations and injury frequency by sport at a sports medicine university clinic.

BACKGROUND: We aimed to investigate the profile of athletes by determining the branch of sports, type, and area of sustained sports injury, and the frequencies through athletes' presentations to the largest university clinic in one of the most crowded and athlete-populated cities of Turkey, Istanbul. METHODS: The study population comprised 1302 athletes who presented to the sports medicine clinic between the dates of July 1st, 2014, and June 30th, 2015. This record-based study examined all athlete presentations using the physical examination cards. RESULTS: Eight hundred and sixty-five of the athletes were male. The median age of applicants was 21 years (interquartile range 16-30 years), the median body mass index was 22.23 kg/m2 (range, 20.01-24.67 kg/m2), and the median years of sports activity was 5 years (range, 0-10 years). Presentations to the clinic were significantly higher in April (p=0.003). The most commonly injured body part was the knee and soccer was the leading sport among the patients; anterior cruciate ligament injury was the most common pathology among soccer players. CONCLUSIONS: Athletes who presented to our clinic most commonly sustained a lower extremity injury. It was notable that ligament injuries were seen as commonly as muscle injuries.

Effects of a regular exercise program on biochemical parameters of type 2 diabetes mellitus patients.

BACKGROUND: We aimed to investigate the effects of a regular exercise program on exercise capacity, blood biochemical profiles, certain antioxidant and oxidative stress parameters of type 2 Diabetes mellitus (DM) patients. METHODS: Thirty one type 2 DM patients (ages ranging from 42-65 years) who have hemoglobin A1c (HbA1c) levels ≥7.5% and ≤9.5% were included to study and performed two cardiopulmonary exercise tests (CPET) before and after the exercise program. Subjects performed aerobic exercise training for 90 minutes a day; 3 days a week during 12 weeks. Blood samples were collected to analyze certain oxidant and antioxidant parameters (advanced oxidation protein products [AOPP], ferric reducing ability of plasma [FRAP], malondialdehyde [MDA], and sialic acid [SA]), blood lipid profile, fasting blood glucose (FBG) and HbA1c. RESULTS: At the end of the program HbA1c and FBG, triglyceride (TG) and very-low-density lipoprotein (VLDL) levels decreased and high-density lipoprotein (HDL) increased significantly (P=0.000, P=0.001, P=0.008, P=0,001 and P=0.02, respectively). AOPP, FRAP, SA levels of the patients increased significantly following first CPET (P=0.000, P=0.049, P=0.014 respectively). At the end of the exercise program AOPP level increased significantly following last CPET. Baseline SA level increased significantly following exercise program (P=0.002). CONCLUSIONS: We suggest that poor glycemic control which plays the major role in the pathogenesis of DM and its complications would be improved by 12 weeks of a regular exercise program. Whereas the acute exercise induces protein oxidation, regularly aerobic training may enhance the antioxidant status of type 2 DM patients.