Vural Kavuncu

Afyon Kocatepe University, Kara Hissar Sahib, Afyonkarahisar, Turkey

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Publications (17)10.56 Total impact

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    ABSTRACT: Objectives: This study aims to evaluate the efficacy of spa therapy on pain and the quality of life in patients with chronic mechanical neck pain. Patients and methods: Seventy patients who applied to our outpatient clinic with chronic mechanical neck pain lasting for 12 weeks were included in the study. Patients were randomized either to spa therapy group (7 males, 28 females; mean age 43.08±9.76 years; range 26 to 66 years) or to exercise therapy group (5 males, 30 females; 46.45±9.65 years; range 27 to 65 years). Spa therapy group received a total of 15 sessions of thermal water, mud therapy, and classic massage to cervical region. Both exercise and spa therapy groups performed home exercise program once a day for 15 days. All the patients were evaluated before treatment, at the first week and at the third month after treatment, a total of three times. In each control; visual analog scale, global assessment of the patient (Patient’s Global Assessment and Physician’s Global Assessment), Neck Pain Disability Scale, and Nottingham Health Profile were assessed. Results: When the measurements at first week were compared to baseline, significant improvements were observed in all the parameters in both groups. However, the decreases in visual analog scale and Neck Pain Disability Scale at the first week after treatment were more significant in spa therapy group compared to exercise therapy group. We observed no statistically significant difference in all the parameters between two groups when the measurements at the third month were compared to baseline. Conclusion: The combination of spa therapy with exercise therapy is superior to exercise therapy alone in decreasing pain and improving functional capacity in the early period after treatment.
    No preview · Article · Jan 2015 · Turkish journal of rheumatology
  • U Dundar · O Solak · H Toktas · U S Demirdal · V Subasi · V Kavuncu · D Evcik
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    ABSTRACT: Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that affects mainly the axial skeleton and causes significant pain and disability. Aquatic (water-based) exercise may have a beneficial effect in various musculoskeletal conditions. The aim of this study was to compare the effectiveness of aquatic exercise interventions with land-based exercises (home-based exercise) in the treatment of AS. Patients with AS were randomly assigned to receive either home-based exercise or aquatic exercise treatment protocol. Home-based exercise program was demonstrated by a physiotherapist on one occasion and then, exercise manual booklet was given to all patients in this group. Aquatic exercise program consisted of 20 sessions, 5× per week for 4 weeks in a swimming pool at 32–33 °C. All the patients in both groups were assessed for pain, spinal mobility, disease activity, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (week 4 and week 12). The baseline and mean values of the percentage changes calculated for both groups were compared using independent sample t test. Paired t test was used for comparison of pre- and posttreatment values within groups. A total of 69 patients with AS were included in this study. We observed significant improvements for all parameters [pain score (VAS) visual analog scale, lumbar flexion/extension, modified Schober test, chest expansion, bath AS functional index, bath AS metrology index, bath AS disease activity index, and short form-36 (SF-36)] in both groups after treatment at week 4 and week 12 (p
    No preview · Article · Mar 2014 · Rheumatology International
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    ABSTRACT: It is a commonly seen condition that the hand deformities which are seen in Parkinson disease (PD) mistakenly diagnosed as Rheumatoid arthritis (RA) so PD and RA have been associated with each other in the literature. Looking for the another view, in autoimmune diseases, such as RA, there is a chronically high concentrations of inflammatory mediators product over long periods of time and it has been hypothesized that these patients may be at increased risk for neurodegenerative diseases such as PD. To contribute to a few recently published reports, we describe five patients, over 65 years old, with a primary diagnosis of RA and coexisting PD and we discuss possible pathogenetic link between RA and PD. The coexisting cases in this report are most probably incidental but the prevalence of coexisting of RA and PD may be higher than that of regularly thought. The present report is draw attention to the possibility of coexisting and to keep in mind the possibility of developing neurodegenerative disorders due to the chronic inflammation in the course of patients with RA.
    No preview · Article · Jan 2013 · European Journal of General Medicine
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    ABSTRACT: Objective: In this study, we aimed to compare the clinical effect of landbased and water-based exercise programs in patients with subacromial impingement syndrome. Materials and Methods: Seventy shoulders were randomized to waterbased (n=35) or land-based (n=35) exercise program. The intervention in the water-based exercise group consisted of hot pack, transcutaneous electrical nerve stimulation (TENS), ultrasound (US) and exercise in the water; and in the land-based exercise group, consisted of hot pack, TENS, US and land-based exercises. The measurement was performed after the treatment and 3 months after the beginning of the treatment. We used visual analog scale (VAS) for pain assessment and shoulder function was measured with the Shoulder Pain and Disability Index and the Western Ontario Rotator Cuff Index. Results: Patient demographics and baseline values were similar for both groups. The pain reduction in both groups was statistically significant at the first follow-up. A significant reduction in pain at second follow-up was observed in the water-based exercise group compared with the land-based exercise group. We found statistically significant recuperation in both groups for functional index and more recuperation in the water-based exercise group at the second follow-up. Conclusion: A greater improvement in pain and functional capacity was achieved with combination of physical therapy and water-based exercise program in patients with subacromial impingement syndrome. © Turkish Journal of Physical Medicine and Rehabilitation, Published by Galenos Publishing.
    No preview · Article · Jun 2012 · FTR - Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi
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    ABSTRACT: Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder that primarily affects the spine and sacroiliac joints. Recent studies described audiovestibular impairment in AS patients. The aim of this study was to evaluate the hearing and function of the cochlear system in patients with AS. Thirty-seven AS patients and 20 healthy controls were evaluated prospectively. Otorhinolaryngologic examinations were performed in all patients together with pure tone audiometry, speech discrimination test, tympanometry, and distortion product otoacoustic emission (DPOE). Disease duration, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, and hematologic findings (CRP and ESR) were also collected. Pure tone audiometry findings of the patients and controls were significantly different in all frequencies (p < 0.01). Speech discrimination scores were also significantly different (p < 0.01). No significant difference was found between DPOE responses of the patients and controls (p > 0.05). There was no correlation between disease duration, BASDAI scores, hematological findings, and audiometry findings (p > 0.05). This study demonstrated that there is an association between AS and hearing loss, but the cochlea is not the main source of hearing loss.
    Preview · Article · Apr 2012 · Clinical Rheumatology
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    ABSTRACT: Vertebral fractures cause poor quality of life due to the back pain, functional limitations, and loss of utility. Therefore, the effects of vertebral fractures on quality of life is an important clinical issue. This study aimed to evaluate the prevalence and the effects of vertebral fractures on quality of life in seventy patients with osteoporosis. Bone mineral density were performed by dual-energy x-ray absorptiometry. Ouality of life was assessed by Short-Form 36 (SF-36). Spine radiographs were used to evaluate the existence of vertebral fracture. Primary and secondary osteoporosis were determined in 52.9 % and 47.1 % of the patients, respectively. Vertebral fractures were determined in 7 (18.9 %) patients with primary osteoporosis and in 6 (18.2 %) patients with secondary osteoporosis. When scores of SF-36 subgroups were compared, there was no statistically significant difference between the patients with and without vertebral fractures in primary osteoporosis. In conclusion, any meaningful relationship was found between vertebral fracture and quality of life in patients with primary osteoporosis with the instrument of SF-36.
    No preview · Article · Mar 2010 · Goztepe Tip Dergisi
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    ABSTRACT: Aim: Osteoporotic vertebral fractures and increased kyphotic angle may cause disturbances in pulmonary functions. Our aim was to evaluate pulmonary function and quality of life in osteoporotic patients. Material and Methods: Fifty-one patients with osteoporosis and 19 osteopenic subject, followed in our outpatient clinic, were included. Their demographics were recorded. All the subjects were submitted to pulmonary function test (PFT) and dorsal lateral radiography was obtained to measure Cobb angle. Global body pain was assessed using Visual Analogue Scale (VAS) and quality of life was assessed using Short Form-36 (SF-36) questionnaire. Results: The mean ages were 63.3±8.7 in osteoporosis and 55.3±7.3 in osteopenia groups (p=0.001). Body mass index of the osteoporosis group was significantly lower than osteopenia group (28.8±5.7 and 32.2±5.5, respectively, p=0.029). In osteoporosis group compared to osteopenia group, the absolute forced expiratory volume in 1 second (FEVl) (1.8±0.4 and 2.1±0.5, respectively, p=0.018) and absolute forced vital capacity (FVC) (2.2±0.5 and 2.6±0.6, respectively, p=0.005) were significantly lower. No differences were found between two groups concerning other PFT parameters. The mean Cobb angle was higher in osteoporosis group than osteopenia group, but the difference was not significant (32.7±12.4 and 28.5±9.5, respectively. p=0.194). When all the subjects were considered, no correlation was found between Cobb angle and PFT parameters (p>0.05). No significant difference was found between two groups in respect to VAS and SF-36 scores (p>0.05). Conclusion: We found absolute FEV1 and absolute FVC significantly lower in osteoporosis group compared to osteopenia group. But we observed no differences in % predicted FEV1 and % predicted FVC. We supposed that the differences were because the subjects in osteopenia group were younger and fatter. The pulmonary functions and quality of life of the osteoporotic patients with a kyphotic angle up to studied are not worse than the osteopenic people.
    No preview · Article · Apr 2009 · Osteoporoz Dunyasindan
  • V Kavuncu · Umit Dundar · I H Ciftci · D Evcik · I Yigit
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    ABSTRACT: Screening studies indicate a prevalence of celiac disease (CD) of up to 1% in populations of European ancestry, yet the majority of cases remain undiagnosed. One of the common complication of CD is intestinal osteopathy or osteoporosis [bone mineral density (BMD) based diagnosis]. Available data regarding the prevalence of CD in the patients with osteoporosis are limited and controversial. The objective of this study was to perform serological testing to screen for CD among postmenopausal women with osteoporosis. We studied 192 postmenopausal women with low BMD with a mean age of 62.75 +/- 8.58 years. Among the patients, a total of 137 had osteoporosis and 55 had osteopenia. Venous blood samples were obtained for serological screening of CD and evaluation of bone metabolism. The serological screening protocol consisted of determining serum level of IgA antigliadin antibodies (AGA), IgG-AGA, IgA endomysial antibody (EMA), IgG-EMA. Subjects who were positive for both IgA-AGA and IgA-EMA were classified as having CD. Bone metabolism was evaluated by serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, 25 (OH) vitamin D, osteocalcin, serum C-telopeptide cross-linked collagen type I levels. Of the 192 patients evaluated, only one (0.5%) was found to have positive for both IgA-AGA and IgA EMA tests and accepted as having CD. Prevelance of CD in postmenopausal women with low BMD (0.5%) did not differ from prevelance of CD in normal healthy population (0.3-1%). BMD values at proximal femur level were significantly lower in IgA-AGA (+) patients when compared to IgA-AGA (-) patients. However, the mean levels of bone metabolism markers were found similiar in both IgA-AGA (+) and (-) patients. In conclusion, the results of our study suggest that there is no need for routine screening of CD in postmenopausal women with osteoporosis.
    No preview · Article · Dec 2008 · Rheumatology International
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    O Solak · M Kulac · M Yaman · S Karaca · H Toktas · O Kirpiko · V Kavuncu
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    ABSTRACT: The main cause of lichen simplex chronicus (LSC) is not known but there is evidence to suggest that neurological abnormalities may be implicated in its aetiology. To investigate neuropathy in patients with LSC on the limbs. In total, 23 consecutive patients [15 women (65.2%) and 8 men (34.8%); mean +/- SD age 48.2 +/- 14.03 years, range 20-71] with LSC on the limbs were included in the study. Mean +/- SD duration of disease was 22.86 +/- 21.38 months (range 1-60). Radiography, magnetic resonance imaging (MRI) and electrophysiological studies were performed for all patients. In total, 8 patients (34.8%) had LSC on the arms and 15 patients (65.2%) had LSC on the legs; 3 (37.5%) of the 8 patients with LSC on the arms and 6 (40%) of the 15 patients with LSC on the legs had radiculopathy in the electrophysiological studies. The prevalence of radiculopathy in patients with LSC on the limbs was higher than in asymptomatic subjects in the electrophysiological studies. Damage to the peripheral nervous system, such as radiculopathy and neuropathy, can play a critical role in the aetiology of LSC on the limbs. Both nerve-root compression in MRI scans and radiculopathy in nerve-conduction studies are common findings in asymptomatic subjects, but they seem to be more common in patients with LSC on the limbs. Therefore, these patients should be evaluated for the possibility of underlying neuropathy.
    Full-text · Article · Dec 2008 · Clinical and Experimental Dermatology
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    ABSTRACT: Objective: Assessment of disease activity is very important for successful management of rheumatoid arthritis (RA). The use of high sensitivlty C-reactive protein (hs-CRP), assays was recently recommended as a measure to identify low disease activity in RA. The aim of this study was to compare hs-CRP and C-reactive protein (CRP) levels to evaluate inflammation in patients with RA and to investigate their association with disease activity and the number of swollen/tender joints. Material and Methods: Eighty-six patients with RA and 65 age and sex matched healthy controls were enrolled in this study. All patients fulfilled the American College of Rheumatology (ACR) classification criteria for RA. Disease Activity Score (DAS) 28 was used for the assessment of disease activity. Number of swollen joints, number of tender joints and global assessment of the patient by using visual analog scale (VAS) were noted. CRP, hs-CRP, erythrocyte sedimentation rate (ESR) of the patients with RA and controls were measured. We analyzed the association between hs-CRP, CRP and ESR versus other clinical variables. Results: The patients with RA had significantly higher levels of ESR, hs-CRP and CRP compared with controls (p< 0.05). The hs-CRP was more closely associated with DAS 28 (r: 0.73, p< 0.001), VAS (r: 0.69, p< 0.001), number of swollen joints (r: 0.46, p= 0.005) and number of tender joints (r: 0.42, p= 0.001) than CRP. Conclusion: Our findings suggested that hs-CRP might be used to evaluate disease activity and inflammation in RA and that hs-CRP testing might reflect systemic inflammation in a more accurate way than routine CRP assays.
    No preview · Article · Dec 2008 · Turkiye Klinikleri Journal of Medical Sciences
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    ABSTRACT: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic, progressive, systemic inflammatory rheumatic diseases that lead to serious disability. The objective of this study was to investigate the demographic and clinical characteristics of the patients with RA and AS who were treated in tertiary hospitals in Turkey and to analyze their current medical management. A total of 562 RA and 216 AS patients were evaluated. The mean age of RA patients was 52.1 +/- 12.6 years. The female to male ratio was 3.7:1. Of the RA patients, 72.2% had positive rheumatoid factor (RF), 62.9% had high C-reactive protein, and 75.2% had radiological erosion. The ratio of patients with Disease Activity Score (DAS) 28 >3.2 was 73.9% and of those with Health Assessment Questionnaire (HAQ) > or =1.5 was 20.9%. There was a statistically significant increase in RF positivity and HAQ scores in the group with higher DAS 28 score. Frequency of extraarticular manifestations was 22.4%. The ratio of the patients receiving disease modifying antirheumatic drugs (DMARD) was 93.1%, and 6.9% of the patients were using anti-tumor necrosis factor (TNF) blocking agents. In AS, the mean age of the patients was 38.1 +/- 10.6, and the female to male ratio was 1:2.5. The time elapsed between the first symptom and diagnosis was 4.3 years. The ratio of peripheral joint involvement was 29.4%. Major histocompatibility complex, class I, B 27 was investigated in 31.1% of patients and the rate of positivity was 91%. In 52.4% of the patients, Bath AS Disease Activity Index (BASDAI) was > or =4. The erythrocyte sedimentation rate, Bath AS Functional Index, and peripheral involvement were significantly higher in the group with BASDAI > or =4. Frequency of extraarticular involvement was 21.2% in AS patients. In the treatment schedule, 77.5% of AS patients were receiving sulphasalazine, 15% methotrexate, and 9.9% anti-TNF agents. Despite widespread use of DMARD, we observed high disease activity in more than half of the RA and AS patients. These results may be due to relatively insufficient usage of anti-TNF agents in our patients and therefore these results mostly reflect the traditional treatments. In conclusion, analysis of disease characteristics will inform us about the disease severity and activity in RA and AS patients and could help in selecting candidate patients for biological treatments.
    Full-text · Article · Mar 2008 · Clinical Rheumatology
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    ABSTRACT: Low back pain (LBP) is an important clinical, social, and public health problem. Balneotherapy is a type of therapy by hot or warm waters containing minerals. The aim of this study was to investigate the effects of balneotherapy with exercise on pulmonary functions, aerobic exercise capacity, resting metabolic rate, body fat %, psychosocial condition and its efficiency on therapy in patients with LBP. Balneotherapy and exercise program were applied to group 1 (14 female, 9 male). Only an exercise program was applied to group 2 (13 female, 8 male). The measurements of maximal oxygen consumption, resting metabolic rate, pulmonary function tests, body fat %, Oswestry disability index, visual analog scale, quality of life measure, symptom checklist-90-revised, the hospital anxiety and depression scale, spine joint mobility tests from all participants were performed before and after the treatment. An improvement was found in pulmonary function test (maximal volunteer ventilation), aerobic exercise capacity, pain and disability scores, spine mobility (extension distance), quality of life, and all psychiatric symptoms (except anxiety) in group 1 following therapy period. Also some improvements were observed in body fat percentage, pulmonary function tests (forced vital capacity, forced expiratory volume in 1 second, forced expiratory flow at 25% to 75% vital capacity and peak expiratory flow), and other spine joint mobility tests before and after therapy in group 1, though they were not statistically significant. Balneotherapy with exercise could be alternative therapy methods in patients with LBP.
    Full-text · Article · Jan 2008 · Journal of Back and Musculoskeletal Rehabilitation
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    ABSTRACT: Objectives: To compare the effects of water exercise and land exercise on balance, quality of life and depression in postmenopausal women with osteoporosis. Design: Prospective study Setting: Tertiary level of care, 1 center participated in the study. Participants: Sixty postmenopausal women with osteoporosis were consecutively selected from patients of Osteoporosis Outpatient Clinic. Interventions: They performed either water exercise (WE) or land exercise (LE). WE group (n=30) received a 3-week water exercise program. LE group (n=30) received a 3-week home exercise program. Main outcome measures: Balance, quality of life and depression level were evaluated using step test, Short Form 36 (SF-36) questionnaire and Beck Depression Inventory (BDI), respectively. Results: In WE group, there were significant improvements in step test on both sides after exercise and on the right side 2 months after exercise. In WE group, there were significant increases in all domains of SF-36 questionnaire after exercise and in five domains 2 months after exercise. In WE group, the rate of the patients whose depression level became normal were greater than those in LE group after exercise and 2 months after exercise. In LE group, there were no significant improvements in step test on both sides after exercise and 2 months after exercise. In LE group, only physical function domain of SF-36 increased significantly after exercise. Conclusions: Water exercise rather than land exercise is more effective in improving balance, quality of life and depression in postmenopausal women with osteoporosis.
    No preview · Article · Jan 2008 · Neurology Psychiatry and Brain Research
  • M Metin · H Esme · O Solak · M Yaman · A Pekcolaklar · A Gurses · V Kavuncu
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    ABSTRACT: Background: Chronic post-thoracotomy pain (CPTP) consists of different types of pain. Some characteristics of CPTP are the same as those of recognized neuropathic pain syndromes. Objective: We aimed to determine the safety and efficacy of gabapentin (GP) in comparison to naproxen sodium (NS) in patients with CPTP. Methods: Forty consecutive patients with CPTP after posterolateral/lateral thoracotomy were prospectively evaluated. Twenty patients were given GP and another 20 were given NS treatment. Visual Analogue Scale (VAS) and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scorings were performed pretreatment (day 0) and on the 15th, 30th, 45th and 60th days. Adverse events were questioned. The mean ages were 45.7 +/- 14.9 and 49.8 +/- 15.2 years and the mean durations of pain were 3.8 +/- 0.9 and 3.8 +/- 1.1 months, respectively. Results: The mean pretreatment VAS scores (VAS0) were 6.4 +/- 0.6 and 6.8 +/- 0.6, the mean pretreatment LANSS scores (LANSS0) were 18.85 +/- 1.6 and 20.75
    No preview · Article · Jul 2007
  • U Dundar · O Solak · I Yigit · V Kavuncu
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    ABSTRACT: Bilateral symmetric calcification involving striatum pallidum with or without deposits in the dentate nucleus, thalamus and white matter is commonly referred to as Fahr′s syndrome. Symptoms of the disorder may include deterioration of motor function, spasticity, spastic paralysis, dysarthria, dementia, seizures, headache and athetosis. The clinical and imaging abnormalities are restricted to the central nervous system (CNS). We report an unusual association of Fahr′s syndrome with polyarticular juvenile idiopathic arthritis in a girl.
    No preview · Article · Jul 2007 · Journal of Pediatric Neurosciences
  • U Dundar · D Evcik · F Samli · H Pusak · V Kavuncu
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    ABSTRACT: The efficacy of low-level laser therapy (LLLT) in myofascial pain syndrome (MPS) seems controversial. A prospective, double-blind, randomized controlled trial was conducted in patients with chronic MPS in the neck to evaluate the effects of low-level 830-nm gallium arsenide aluminum (Ga-As-Al) laser therapy. The study group consisted of 64 MPS patients. The patients were randomly assigned into two groups. In group 1 (n = 32), Ga-As-Al laser treatment was applied over three trigger points bilaterally for 2 min over each point once a day for 15 days during a period of 3 weeks. In group 2 (n = 32), the same treatment protocol was given, but the laser instrument was switched off during applications. All patients in both groups performed daily isometric exercise and stretching exercises for cervical region. Parameters were measured at baseline and after 4 weeks. All patients were evaluated with respect to pain (at rest, movement, and night) and assessed by visual analog scale, measurement of active range of motion using an inclinometer and a goniometer, and the neck disability index. In both groups, statistically significant improvements were detected in all outcome measures compared with baseline (p < 0.05). However, no significant differences were obtained between the two groups (p > 0.05). In conclusion, although the laser therapy has no superiority over placebo groups in this study, we cannot exclude the possibility of effectivity with another treatment regimen including different laser wavelengths and dosages (different intensity and density and/or treatment interval).
    No preview · Article · Jun 2007 · Clinical Rheumatology
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    ABSTRACT: Alkaptonuria is a rare hereditary disorder which may result with arthropathy in multiple joints. Clinical findings are similar to degenerative joint diseases. It mostly involves the spine and extremities especially large joints. There is no consensus in the treatment of the disease. In this case we present the effect of physical therapy program in the treatment of back pain and a four year follow up results. ÖZET: Alkaptonüre bir çok eklemde artropatiye yol aça-bilen, nadir görülen herediter bir hastalıktır. Klinik bulgu-lar dejeneratif hastalıklarla benzerlik göstermektedir. Ço-ğunlukla omurga ve ekstremitelerde büyük eklemleri tutar. Hastalığın tedavisinde kesinleşmiş bir görüş birliği mevcut değildir. Bu olguda, bel ağrısı tedavisinde fizik tedavinin etkinliğini ve dört yıllık takip sonuçlarını bildirmekteyiz.
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