[Show abstract][Hide abstract] ABSTRACT: Measurement of the femoral cartilage thickness by using in-vivo musculoskeletal ultrasonography (MSUS) has been previously shown to be a valid and reliable method in previous studies; however, to our best notice, normative data has not been provided before in the healthy population.The aim of our study was to provide normative data regarding femoral cartilage thicknesses of healthy individuals with collaborative use of MSUS.
Journal of Back and Musculoskeletal Rehabilitation 11/2013; 27(2). DOI:10.3233/BMR-130441 · 1.04 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Osteoarthritis is the most common age-related degenerative joint disease. It affects all the joints containing hyaline cartilage. Knee osteoarthritis is the most cumbersome in terms of prevalence and disability. The aim of this study to evaluate the efficacy of intra-articular hyaluronic acid in patients with knee osteoarthritis with regard to joint pain and function, as well as patient satisfaction, assessed at one month and at one year, and by age group.
In this prospective randomised study, 172 patients who were diagnosed knee OA and who received three consecutive intra-articular injections of HA weekly were included. Patients 65 years of age or older were accepted as the "elderly group", and those under 65 were accepted as the "middle-aged group". Clinical evaluations of efficacy and safety were conducted at the beginning of the study, one month after the third injection, and one year after the third injection.
In the two groups, the intragroup analysis revealed significant improvements following injection when compared with preinjection values. According to the last followup controls (after 12 months) in the middle-aged group, VAS activity pain, VAS rest pain, WOMAC physical function, and WOMAC pain values were found to be statistically lower when compared with pre-injection values. In the elderly group, no statistically significant differences were found between pre-injection and after 12 months.
We can conclude that intra-articular joint HA injections are effective in both young and old patients with OA with regard to pain and functional status over a short-term period. Further, HA injections in patients younger than 65 years can be planned for a one-year period.
The Open Rheumatology Journal 07/2013; 7:38-41. DOI:10.2174/1874312901307010038
[Show abstract][Hide abstract] ABSTRACT: Background and objectives: To test the hypothesis that dry needling is more effective than sham dry needling in relieving myofascial pain of the temporomandibular muscles. Material and method: Fifty-two subjects with established myofascial trigger points were randomized into two groups; study group (N: 26) and placebo group (N: 26). Dry needling was applied using acupuncture needles. Sham dry needling was applied to the placebo group. Pain pressure threshold was measured with pressure algometry, pain intensity was rated using a 10-cm visual analog scale (VAS) and the unassisted jaw opening without pain measurement was performed. Evaluations were done by a physician blinded to the data. Results: Of 52 patients assigned, 50 completed the study. Mean algometric values were significantly higher in the study group when compared to the placebo group (p values being less than 0.05). There were no differences between the two groups in terms of VAS and unassisted jaw-opening without pain values. Conclusion: Dry needling appears to be an effective treatment method in relieving the pain and tenderness of myofascial trigger points.
Journal of Back and Musculoskeletal Rehabilitation 01/2012; 25(4):285-290. DOI:10.3233/BMR-2012-0338 · 1.04 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: (i) To compare individuals with self-reported bruxism and non-bruxist individuals in terms of maximal bite force (MBF) and temporomandibular joint (TMJ) primary assessment parameters and (ii) to examine the relationship between MBF and tooth wear in these subjects.
Twenty-nine bruxist subjects and 29 healthy controls were enrolled. MBF measurements were carried out by the use of bite force recorder. Tooth wear indices, maximal mouth opening, maximal lateral excursions and maximal protrusions were measured for every subject.
MBF and tooth wear index scores were significantly higher in bruxists (p values <0.05) compared to non-bruxists. MBF and tooth wear index scores were found to be significantly correlated in the bruxist group (r=0.79, p=0.00). Less significant correlation was observed in the non-bruxist group (r=0.38, p=0.04). No differences in masticatory clinical examination parameters were identified between the groups.
This study is the first to show that MBF can increase in bruxist individuals and that the increase in MBF are correlated with tooth wear in bruxist subjects. Further studies regarding the possible role of MBF in bruxism are to be done.
[Show abstract][Hide abstract] ABSTRACT: Objective
Vertigo is a common clinical problem, particularly in older people. Benign paroxysmal positional vertigo (BPPV) is one of the most frequent causes of vertigo. It may be dangerous, especially in older individuals, because unsteadiness associated with BPPV can lead to falls. We aimed to investigate therapeutic effects of canalith repositioning maneuvers in patient with BPPV.
Patients complaining of vertigo referred to our Physical Medicine Outpatient Clinic for vestibular rehabilitation.
26 patients (14 male, 12 female) were studied; mean age was 52.5 ± 6.5 year (range 35–65), and mean symptom duration was 9.5 ± 20 months (range 0.25–96).
Detailed clinical examination, tests, and imaging studies were performed to exclude other possible diseases that may cause vertigo. Previous falls from the onset of symptoms were recorded. The Dix–Hallpike test for posterior and anterior semicircular canals (SCC) BPPV, and the supine roll test for horizontal SCC BPPV were performed. In all patients, the Epley maneuver (canalith repositioning maneuver, CRM) was performed initially. The Semont (liberatory) maneuver was performed in those patients who showed no signs of improvement with the Epley maneuver. Patients were followed up during 3 months.
All patients were diagnosed as having posterior SCC BPPV. Eight patients described immediate relief of their vertigo following the first maneuver. Ten days later 16 patients (61.5%) showed complete relief from vertigo. The Epley maneuver was repeated in five patients who showed moderate improvement with the first maneuver. Five patients with little or no improvement following the Epley maneuver undertook the Semont maneuver (liberatory maneuver): complete relief from vertigo was found in two. Patients were followed up during 3 months. No recurrence was observed in any patients during the study period. After 3 months, six patients still had the symptoms of BPPV but to a lesser degree.
Our results indicate that BPPV can be diagnosed easily and treated using a simple maneuver. On the basis of patient history and the Dix–Hallpike test it seems to be unnecessary to perform other diagnostic examinations routinely before trying CRM. Diagnosis and appropriate therapy is important for the prevention of further complications.
[Show abstract][Hide abstract] ABSTRACT: For symptomatic relief of low back pain, non-steroidal antiinflammatory drugs (NSAIDs) and analgesics are often in used in
combination with muscle relaxants. However adverse effects, especially sedation, limit the use of some muscle relaxants. Thiocolchicoside
(TCC) is a non-sedating muscle relaxant that has been shown to be safe and effective as monotherapy in the treatment of this
problem. The present study was carried out to determine if the combination of thiocolchicoside and standard treatment is more
effective than standard treatment alone.
Ninety-three Turkish centers recruited adults presenting with acute and subacute low back pain. Each physician included four
patients. Patients were randomized to receive either a NSAID or an analgesic for 5 to 7 days (referred to as “standard treatment”)
or standard treatment plus 8 mg TCC (Muscoril) twice daily for 5 to 7 days. On inclusion and again on day 7, low back pain
was evaluated with a visual analogue scale (VAS) and disability was evaluated with the Roland-Morris disability questionnaire.
Pain and disability were evaluated again on day 31.
A total of 155 patients were randomized to receive standard treatment alone and 174 received standardtreatment and TCC. The
vast majority (98.2%) of the patients received a NSAID as standard treatment. The mean VAS and disability questionnaire scores
of the two groups were equivalent at inclusion. At day 7, patients in both groups were improved but patients receiving TCC
had significantly less pain (p<0.003) and disability (p=0.0005) than patients on standard treatment alone; this was also true at day 31. (p<0.005 and p=0.0005, respectively). The addition of TCC to NSAID standard treatment resulted more effective for the symptomatic treatment
of low back pain than the NSAID alone. In addition, the combination was well tolerated and produced no more adverse effects
than the NSAID alone.
Journal of Orthopaedics and Traumatology 01/2002; 3(2):103-108. DOI:10.1007/s101950200036