No abstract

It is concluded that a water-based exercises produced better improvement in disability and quality of life of the patients with CLBP than land-based exercise.

Fibromyalgia syndrome (FMS) is a very common rheumatological diagnosis. There are various treatment modalities. This study was planned to investigate the effects of balneotherapy in the treatment of FMS. A total of 42 primary fibromyalgia patients diagnosed according to American College of Rheumatology criteria were included in the study. Their ages ranged between 30 and 55 years. Patients were randomly assigned to two groups. None of them had had a cardiovascular disease before. Group 1 n=22) received 20-min bathing, once a day and five times per week. Patients participated in the study for 3 weeks (total of 15 sessions). Group 2 (n=20) was accepted as the control group. Patients were evaluated by the number of tender points, Visual Analogue Scale for pain, Beck's Depression Index for depression, and Fibromyalgia Impact Questionnaire for functional capacity. Measurements were assessed initially, after the therapy, and at the end of the 6th month. In group 1, there were statistically significant differences in numbers of tender points, Visual Analogue scores, Beck's Depression Index, and Fibromyalgia Impact Questionnaire scores after the therapy program (P<0.001). Also, 6 months later in group 1, there was still an improvement in the number of tender points (P<0.001), Visual Analogue scores, and Fibromyalgia Impact Questionnaire (P<0.005). But there was not a statistical difference in Beck's Depression Index scores compared to the control group (P>0.05). Patients with FMS mostly complain about pain, anxiety, and the difficulty in daily living activities. This study shows that balneotherapy is effective and may be an alternative method in treating fibromyalgia patients.

The aim of this study was to investigate the efficacy of aquatic exercises in fibromyalgia syndrome (FMS). A total of 63 patients were included and allocated to two groups. Group I (n = 33) received an aquatic exercise program and Group II (n = 30) received a home-based exercise program for 60 min, 3x a week, over 5 weeks. Patients were evaluated for pain (visual analogue scale, VAS), number of tender points (NTP), Beck depression inventory (BDI), and functional capacity (fibromyalgia impact questionnaire, FIQ). All assessment parameters were measured at baseline, and at weeks 4, 12, and 24. There were statistically significant differences in FIQ and NTP in both groups at the end and during follow-up (P < 0.05). Group I showed a statistically significant decrease in BDI scores after 4 and 12 weeks (P < 0.05) that remained after 24 weeks (P < 0.001). In Group II, a significant decrease in BDI scores was observed at the end and during follow-up (P < 0.001). Also, a significant improvement was found in VAS at weeks 4 and 12 in both groups (P < 0.001). The average of reduction in pain scores was 40% in Group1 and 21% in Group II. However, this was still significant at week 24 only in the aquatic therapy group. A comparison of the two groups showed no statistically significant difference for FIQ, NTP, and BDI scores except VAS (P < 0.001) Our results showed that both aquatic therapy and home-based exercise programs have beneficial effects on FIQ, BDI, and NTP. In pain management, only aquatic therapy seems to have long-term effects.

Postural changes are sometimes a risk factor for low back pain. Abnormal posture creates a strain on ligaments and muscles that indirectly affects the curvature of the lumbar spine. This study was planned to investigate the relationship between the angles of the lower lumbar spine and spinal mobility in acute and chronic low back pain patients. Fifty patients (25 female, 25 male) with chronic low back pain and fifty (30 female, 20 male) with acute low back pain were included the study. Both groups were subjected to lumbosacral radiography in the lateral position while standing. Patients were assessed by parameters including spinal mobility, sacral inclination angle, lumbosacral angle, and sacral horizontal angle. Spinal mobility included the maximal range of motion of lumbar flexion and extension. The value of the sacral inclination angle was significantly higher and correlated with lumbar extension in chronic low back pain patients ( P<0.005, r=0.32). There was no statistical difference or correlation in lumbosacral and sacral horizontal angles and spinal mobility between the two groups ( P>0.05). Chronic low back pain affects the lower lumbar spine and limits the maximal range of;lumbar extension.

In this study; we aimed to compare the efficacy of local anesthetic injection and dry needling methods on pain, cervical range of motion (ROM), and depression in myofascial pain syndrome patients (MPS). This study was designed as a prospective randomized controlled study. Eighty patients (female 52/male 28) admitted to a physical medicine and rehabilitation outpatient clinic diagnosed as MPS were included in the study. Patients were randomly assigned into two groups. Group 1 (n = 40) received local anesthetic injection (2 ml lidocaine of 1%) and group 2 (n = 40) received dry injecting on trigger points. Both patient groups were given stretching exercises aimed at the trapezius muscle to be applied at home. Patients were evaluated according to pain, cervical ROM, and depression. Pain was assessed using Visual Analog Scale (VAS) and active cervical ROM was measured using goniometry. Beck Depression Inventory (BDI) was used to assess the level of depression. There were no statistically significant differences in the pre-treatment evaluation parameters of the patients. There were statistically significant improvements in VAS, cervical ROM, and BDI scores after 4 and 12 weeks in both groups compared to pre-treatment results (p < 0.05). No significant differences were observed between the groups (p > 0.05). Our study indicated that exercise associated with local anesthetic and dry needling injections were effective in decrease of pain level in MPS as well as increase of cervical ROM and decrease of depressive mood levels of individuals.

Frailty is one of the geriatric syndromes and has an important relationship with mortality and morbidity. The aim of this study is to present the characteristics, prevalence, and related factors of frailty in older adults in our country. The study included 1126 individuals over 65 years of age from 13 centers. Frailty was evaluated using the Fried Frailty criteria, and patients were grouped as Bfrail,^Bpre-frail,^and Bnon-frail.N utritional status was assessed with BMini Nutritional Test,^psychological status with the BCenter for Epidemiological Studies Depression Scale-CES-D,^and additional diseases with the "Charlson Comorbidity index." Approximately 66.5 % of the participants were between 65 and 74 years of age and 65.7 % were AGE (2015) women. Some 39.2 and 43.3 % of the participants were rated as frail and pre-frail, respectively. The multinomial logistic regression analysis was used to determine the factors associated with frailty. It was observed that age, female gender, low education level, being a housewife, living with the family, being sedentary, presence of an additional disease, using 4 or more drugs/day, avoiding to go outside, at least one visit to any emergency department within the past year, hospitalization within the past year, non-functional ambulation, and malnutrition increased the risk of frailty (p<0.05). Establishing the factors associated with frailty is highly important for both clinical practice and national economy. This is the first study on this subject in our country and will provide guidance in determining treatment strategies.

Osteoarthritis (OA) of the knee is a very common rheumatological disease, and there are various treatment modalities for it. The aim of this study was to investigate the effects of home-based exercise and walking programs in the treatment of OA. A total of 90 patients with knee osteoarthritis were included. Their ages ranged between 48 and 71 years. The patients were separated into three groups. None of them had practiced a daily simple exercise program during the previous year. Group 1 ( n=30) was given a home-based exercise program. Group 2 ( n=30) had regular a walking program three times per week, starting with 10-min duration. Group 3 ( n=30) was accepted as the control group. Patients were assessed according to pain, functional capacity, and quality of life parameters. Pain was evaluated by the Western Ontario McMaster osteoarthritis index (WOMAC) of pain score and visual analogue scale (VAS). Functional capacity was measured by WOMAC physical function index. Quality of life was assessed by the Nottingham Health Profile questionnaire (NHP). All groups continued the program for 3 months. At the end of the therapy, the patients were called and 81 were accepted to come to the hospital. Although WOMAC pain and physical functional scores and VAS scores were statistically lower in both groups than in the control group ( P<0.001), the difference between groups 1 and 2 was not statistically significant ( P>0.05). But the result of the NHP showed a statistically significant improvement in the walking group when compared to the home-based exercise and control groups ( P<0.001). As a result, we conclude that a simple home-based exercise therapy and a regular walking program are effective in treating the symptoms of OA.