AIm:The study was conducted to compare the clinical effectiveness of FJ injections (FJI) and FJ radiofrequency (FJRF) denervation in patients with chronic low back pain. mAterIAl and methOds:This study included 100 patients; 50 in FJI 50 in FJRF group. VNS, NASS and EQ-5D were used to evaluate the outcomes. All outcome assessments were performed at baseline, 3 months, 6 months and 12 months. results: FJI in early post-op but FJRF in 1st, 6th and 12th month VNS showed better results (p<0.001). There was no significant difference in the 1st (p=1) and 6th month (p=0.13) but in 12th month (p=0.04) in NASS. Increase in level number showed positive effect in NASS in FJRF group (p=0.018) but no effect in FJI group (p=0.823) in the 12th month follow-up. There was no significant difference with respect to 1st month (p=0.17), 6th month (p=0.22) and 12th month (p=0.11) post-procedure follow-ups in EQ-5D. At the short term FJI was more effective than FJRF however in midterm follow-up FJRF had more satisfying results than FJRF.COnClusIOn: To our knowledge, the first choice should be the FJI and if pain reoccurs after a period of time or injection is not effective, RF procedure should be used for the treatment of chronic lumbar pain.KeywOrds: Facet, Joint, Injection, Radiofrequency, Denervation, Low back pain ÖZ AmAÇ: Lomber faset eklem (FE) bozuklukları kronik bel ağrılarının en sık sebebidir. Bu çalışmada, kronik bel ağrılı hastalarda uygulanan FE enjeksiyonu (FEE) ve radyofrekans denervasyonunun (FER) klinik sonuçlarının karşılaştırılması amaçlamaktadır. yÖntem ve GereÇler: Bu çalışmaya 50 FEE ve 50 FER yapılan 100 hasta dahil edildi. VNS, NASS ve EQ-5D sonuçların değerlendirilmesi amacıyla kullanıldı. Sonuçlar başlangıç, 3. ay, 6. ay ve 12. aylarda elde edildi.BulGulAr: FEE işlem sonrası erken dönemde, FER ise 1., 6. ve 12. ayda daha etkiliydi (p<0,001). NASS sonuçlarında 1. (p=1) ve 6. ayda (p=0.13) anlamlı fark yokken 12. ayda (p=0,04) vardı. İşlem yapılan segment sayısı FER grubunun (p=0,018) 12. aydaki NASS sonucunu pozitif yönde etkilerken FEE grubunda (p=0,823) etkisi yoktu. EQ-5D sonuçları açısından 1. (p=0,17), 6. (p=0,22) ve 12. ayda (p=0,11) iki grup arasında anlamlı fark saptanmadı. Kısa dönemde FEE daha etkiliyken orta dönemde FER'in sonuçları daha başarılıydı. sOnuÇ: Faset eklemden kaynaklanan bel ağrılarında, FEE ve FER birer tedavi seçenekleridir. Sonuçlarımıza göre, kronik bel ağrısının tedavisinde FEE ilk seçenek olarak düşünülmeli ve bir süre sonra tekrarlayan veya FEE etkili olmadığı durumlarda FER tedavi amacıyla kullanılmalıdır.

There is no clear benefit in adjuvant kinesiotaping application with botulinum toxin for correction of spastic equinus in stroke.

Osteoporosis associated with pregnancy and lactation is a rare condition. The prevalence, etiology and its pathogenesis is unknown. It causes one or more vertebral fractures with severe, prolonged back pain and height loss in affected women. Majority of the cases are seen in the third trimester or just after delivery in primagravid women. In this case report, a 30-year-old woman who had severe pregnancy-induced osteoporosis with 8 vertebral fractures was presented. During last month of her first pregnancy she had moderate back pain. After delivery, the back pain has gotten worse. The radiological examinations have shown that there was 50% in T6, T8 and T10; 30% in L2; 20% in L1 height loss and biconcave vertebral images in L3-5. In the bone mineral density, L2-4 T score was -4.7 and total femoral T score was -3.1. There was no abnormality in the laboratory findings except mild elevation in alkaline phosphates. Although pregnancy-associated osteoporosis is a rare condition, when pain occurs in the last trimester or early postpartum period, it should be considered in differential diagnosis.

The purpose of this study was to evaluate the relationship between hypermobility and fibromyalgia syndrome (FS) in women. Ninety-three women with FS who met the American College of Rheumatology criteria for FS and 58 healthy women without FS were included in this study. All women were examined for hypermobility by blinded observers using the Beighton criteria. The mean age was 43.5+/-9.9 (21-68) and 40.2+/-11.1 (21-63) years in the FS and control groups, respectively, and the two groups were statistically similar (p>0.05). The mean Beighton total score was 4.7+/-2.1 and 2.9+/-2.4 in the FS and control groups, respectively (p<0.0001). The frequency of joint hypermobility was 64.2% in the FS group and 22% in the control group. In accordance with the Beighton criteria (p<0.05), we found that the joint hypermobility ratio was significantly higher in patients with FS than in subjects without FS. Additionally, we evaluated the correlation between the total Beighton score and the age and number of trigger points. There were negative correlations between the total Beighton score and the age (r=-0.42, p<0.001) and number of trigger points (r=-0.24, p=0.03) in all patients. Hypermobility syndrome is more common in women with FS than in those in the control group. Therefore, the relationship between hypermobility and FS should be taken into consideration in the diagnosis and follow-up of women, especially those with widespread pain.

Objective: To investigate the effect of an ankle-foot orthosis (AFO) on certain walking parameters in patients with hemiplegia. Design: Retrospective study. Setting: Gait and Motion Analysis Laboratory at MossRehab. Participants: A total of 1150 records of patients with stroke who were referred to the Gait and Motion Analysis Laboratory between 2000 and 2008 for an evaluation of their walking. Of this group, 217 patients wore braces at the time of the gait evaluation and were selected for a more in-depth review. Among these patients, 42 records were selected because of the existence of available data from temporal spatial analysis meeting 2 conditions: walking with bare feet and walking with an AFO during the same visit. Methods and Main Outcome Measurements: Under both conditions, temporal spatial parameters of gait, including self-selected velocity, cadence, stance time, swing time, double support time, step length, and width of the base of support, were assessed by the use of an electronic gait mat (Gait Mat II, EQ Inc.) originally designed in the Moss Rehabilitation Engineering Center. Results: Walking velocity, cadence, percent stance, double support, and step length significantly increased, whereas affected side percent swing and width of the base of support decreased when patients used an AFO. Symmetries of stance time (P ϭ .0001) and step length (P ϭ .002) improved as well when patients used an AFO compared with walking barefoot. Conclusion: In this sample of patients with stroke, the use of an AFO improved the symmetry of several of the temporal spatial parameters of gait, and consequently, the gait pattern of these hemiparetic patients was enhanced.

The purpose of this study was to evaluate the efficacy of calcitonin on beta-endorphin levels in female patients experiencing back pain associated with postmenopausal osteoporosis. The secondary purpose was to assess the pain and quality of life in these patients. There were 30 patients with a mean age of 58.2+/-5.4 years in the treatment group and 26 patients with a mean age of 58.8+/-5.2 years in the placebo group in this randomized, placebo-controlled study. The patients subcutaneously received 100 IU salmon calcitonin or placebo injections and 1,000 mg elementary calcium for 2 weeks. Baseline plasma beta-endorphin levels were measured and repeated after 2 weeks. Patients' pain and quality of life (QOL) were evaluated by using the Visual Analogue Scale, Modified Face Scale, Beck Depression Index, and Nottingham Health Profile. Patients' global assessment of disease activity was also performed at baseline and at the end of the first and second week. We found that plasma beta-endorphin levels in the treatment group were significantly higher than the placebo group at the end of the second week (p<0.001). Although pain and QOL scores were improved at the end of the second week in both groups (p<0.05), the improvement in the treatment group was more significant when compared with the placebo group (p<0.05). Therefore, calcitonin is an analgesic agent, as it increases the plasma beta-endorphin levels in patients with postmenopausal osteoporosis, which consequently improves QOL.

The aim of this study was to investigate the early effect of nasal salmon calcitonin on a bone-resorption marker, "Crosslaps", in postmenopausal osteoporotic women. In this randomized, single-blind and placebo-controlled study we included 78 postmenopausal women with osteoporosis, between 45 and 65 years of age, with at least 5 years duration of menopause. Patients were randomly divided into two groups, the treatment and the placebo groups. Patients in the treatment group were given 100 IU day(-1) nasal salmon calcitonin, 1,000 mg day(-1) elemental calcium, and 400 IU day(-1) vitamin D. Patients in the placebo group took only 1,000 mg day(-1) elemental calcium, and 400 IU day(-1) vitamin D. The outcome measurements were urinary deoxypyridinoline, serum alkaline phosphatase, osteocalcin, and Crosslaps. The treatment group consisted of 39 patients whose mean age was 60.4 +/- 6 years and the placebo group included 39 patients with a mean age of 60.5 +/- 4.9 years. There was no significant difference between two groups in terms of demographic characteristics. The results of bone marker measurements were analyzed statistically. Crosslaps levels in the treatment group were significantly lower (P < 0.05) than in the placebo group. Other bone marker levels at the end of the study were not significantly lower (P > 0.05) than those at baseline in both treatment and placebo groups, however. Salmon calcitonin affects bone turnover within a few months and bone-resorption markers such as Crosslaps can be used to monitor the effect of nasal salmon calcitonin in the early phase of treatment for postmenopausal osteoporosis.

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