Objectives: In this study, we aimed to investigate the effectiveness of intra-articular platelet-rich plasma (PRP) injection in adhesive capsulitis. Patients and methods: Between January 2019 and December 2019, a total of 40 patients (21 males, 19 females; mean age: 57.1±6.5 years; range, 44 to 72 years) with idiopathic adhesive capsulitis were included. The patients were randomly assigned into two equal groups as the PRP and the control group. The PRP group received two doses of PRP via intra-articular route biweekly under ultrasound guidance. No injection was performed to the control group. In both groups, stretching and Codman exercises were applied as a home- based program. The Visual Analog Scale (VAS), range of motion (ROM), and Shoulder Pain and Disability Index (SPADI) scores were evaluated before the treatment and at 2, 6 and 12 weeks after the treatment. Results: There were significant differences in all VAS, SPADI, and ROM scores at all time points after treatment compared to baseline in both groups. At the end of the study, there were significant differences in the active flexion, passive flexion, active abduction, passive abduction, and active external rotation scores at 12 weeks between the groups (p=0.012, p=0.015, p=0.008, p=0.019, and p=0.040, respectively). No significant difference was observed between the groups in terms of VAS and SPADI scores and the other parameters (active and passive extension, active and passive internal rotation, passive external rotation) at 2, 6, and 12 weeks (p>0.05). Conclusion: The addition of PRP to exercise treatment can improve patients' joint mobility, but not pain and disability in patients with adhesive capsulitis.
Rotator manşon yırtıkları (RMY) omuz ağ rısının toplumda sık ğo ru len nedenleri arasında yer almaktadır. Tedavisinde o ncelikle konservatif tedavi yo ntemleri uyğulanmaktadır. Bu çalışmada Kayseri Şehir Hastanesi Fiziksel Tıp ve Rehabilitasyon (FTR) kliniğ imize RMY tanısıyla yatan 69 hastanın dosyaları retrospektif olarak incelendi. Hastalar parsiyel ve tam kat yırtık olmak u zere iki ğruba ayrıldı. Parsiyel RMY ğrubunu hastaların % 52.6'sı (30/57) oluşturmakta olup erkek oranı %15.7 (9/57) ve kadın oranı %36.9 (21/57) kadın idi. Tam kat RMY ğrubunu hastaların %47.4'si (27/57) oluşturmakta olup erkek oranı %8.7 (5/57) ve kadın oranı % 38.4'si (22/57) idi. Grupların konservatif tedavi o ncesi ve sonrası Eklem Hareket Açıklığ ı (EHA) ve Vizu el Anoloğ Skala (VAS) değ erleri incelendi. İ ki ğrupta da tedavi sonrasında VAS değ erlerinde tedavi o ncesine ğo re azalma oldu (parsiyel için p<0.001; tam kat için p<0.001). Hastaların tedavi sonrasında EHA değ erleri ise tedavi o ncesine ğo re (fleksiyon, abduksiyon, iç ve dış rotasyon) artış ğo stermiştir (parsiyel, tam kat sırasıyla; fleksiyon p<0.001, p<0.001; abduksiyon p<0.001, p<0.001; iç rotasyon p=0.03, p=0.03; dış rotasyon p=0.01, p=0.04). Ancak bu değ erler iki ğrup arasında karşılaştırıldığ ında istatistiksel olarak fark saptanmamıştır. Sonuç olarak parsiyel ve tam kat RMY'de konservatif tedavinin omuz ağ rı ve fonksiyonu u zerinde etkinlikleri benzerdir. Konservatif tedavi, parsiyel veya tam kat RMY ğo zetmeksizin etkindir.
Siringomyeli spinal kordun kronik, dejenaratif, progresif bir hastalığı olup, servikotorasik kordun santralinde longutidinal kavitasyonlarla karakterizedir. Siringomiyelide, kas atrofisi, güçsüzlük, denge bozukluğu, yüzeyel ve derin duyu bozukluğu gibi belirtiler görülebilir ve ilerleyen dönemlerde hastalarda nöropatik artropati gelişebilmektedir(1,2).Bu vaka sunumunda siringomyeli tanısıyla takip edilen erkek hastada sol dirsekte saptanan nöropatik artropati sunulmaktadır. 2008 yılından beri siringomyeli tanısıyla takip edilen 64 yaşında erkek hasta, iki buçuk aydır sol dirsekte şişlik ve sol kola doğru yayılan elektriklenme hissi şikayetleri ile fiziksel tıp ve rehabilitasyon polikliniğine başvurdu. Yapılan fizik muayene ve radyolojik değerlendirmeler sonucunda nöropatik artropati saptanan hastaya eklem hareket açıklığını korumaya yönelik fizik tedavi programı uygulandı. Dirsek ekleminde nöropatik artropatinin nadir görülmesi nedeniyle ve hastalarda özellikle ağrısız şişlik ile ortaya çıktığından, eklemde mevcut olan problemin göz ardı edilmesine neden olduğundan bu vakayı sunmak istedik.
Introduction This study examines the neck extensor muscle thickness of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) by comparing them with healthy volunteers. It also aims to evaluate the relationship between muscle thickness and disease activity, functional parameters, neck disability and quality of life in patients with AxSpA. Method In this cross-sectional study, 30 patients with AS and 30 patients with nr-AxSpA who were admitted to a Physical Medicine and Rehabilitation outpatient clinic were included consecutively. Thirty healthy participants were included as a control group. The thickness of muscles was measured bilaterally by ultrasound and the muscle thickness average was recorded. All patients with axSpA were asked to complete the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), the Ankylosing spondylitis Quality of Life (AsQoL) scale and the Neck Disability Index (NDI). Results Mean patient age was 42.36±10.0 in the AS group, 38.13±7.94 in the nr-axSpA group and 39.06±8.25 in the healthy group. A statistically significant decrease was found in multifidus, semispinalis capitis, semispinalis cervicis and splenius capitis muscle thickness in AS patients compared with the healthy group, and in semispinalis cervicis muscle thickness in nr-axSpA patients compared with the healthy group. However, when trapezius muscle thickness was compared between the groups, no statistical difference was found. There was a significant negative correlation between neck extensor muscle thickness and age, BASDAI, NDI and AsQoL in patients with axSpA. Conclusion The thickness of the neck extensor muscles is decreased in patients with AxSpA compared with healthy individuals, and this situation can be reliably detected by ultrasound.
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