To adapt the Western Ontario Rotator Cuff (WORC) index for use in Turkey and to investigate its reliability and validity; the Turkish version of the WORC was developed according to the guidelines in the literature. Seventy-two patients with rotator cuff disease were administered the questionnaire and were also evaluated by using the University of California Los Angeles (UCLA) shoulder rating scale, Constant score, and Short Form (SF)-36 to test validity. The WORC questionnaire was repeated in 35 patients after a mean interval of 2.9 days (range 2-7 days) to evaluate test-retest reliability. Cronbach's alpha was calculated as 0.92 for the total questionnaire. The intraclass correlation coefficients were very high and ranged between 0.96 and 0.98 for each section. There was a significant negative correlation between the Turkish version of WORC and UCLA (r = -0.598, P < 0.01), Constant score (r = -0.630, P < 0.01), and all subscales of SF-36 (P < 0.01). The Turkish version of the WORC index is a reliable and valid instrument for use in clinical trials in patients with rotator cuff disorders.
This study was designed to investigate the additive effect of EMG-biofeedback in rehabilitation of knee osteoarthritis. Forty patients, aged 45-70, with the diagnosis of knee osteoarthritis according to American College of Rheumatology (ACR) criteria were taken into the study. The patients were randomly assigned in two groups. One group (n = 20) received strengthening exercise program with EMG-biofeedback while the other group (n = 20) had the same exercise program without biofeedback for 3 weeks. The clinical outcome was assessed on the basis of pain with visual analog scale (VAS), function with Western Ontario McMaster Osteoarthritis Index (WOMAC) and quality of life with Nottingham Health Profile (NHP). Quadriceps strength was measured with Cybex isokinetic dynamometer, isokinetically at the angular velocities of 60 and 180 degrees /s and isometric strength at 65 degrees of knee flexion. Pain, WOMAC scores and muscle strength improved in both groups but there was no statistically significant differences between two groups (p > 0.05). In both groups physical mobility, pain scores of NHP improved significantly (p < 0.001) while in EMG-biofeedback group energy and sleep scores also improved after treatment (p < 0.05). As reported in the literature, in our study, strengthening exercises improved pain, function, muscle strength and quality of life in patients with knee osteoarthritis. But it seems that there is no significant additive effect of EMG-biofeedback to regular strengthening exercise program in these patients.
Rotator cuff tears are a common cause of shoulder pain and disability. Although many studies have reported about the surgical results of full-thickness tears of the rotator cuff, there are few studies about the efficacy of conservative treatment. The aim of this study was to investigate the efficacy of conservative treatment in patients with full-thickness rotator cuff tears by using objective and subjective measurements. Twenty patients with full-thickness rotator cuff tears were included in the study. Outcome measures were range of motion, pain and function according to the shoulder index of the American Shoulder and Elbow Surgeons (ASES), Constant score, Short-Form 36 Health Survey (SF-36), isokinetic shoulder strength, and patient response. Patients were assessed at baseline and after 6 months. In addition, patients were contacted by telephone at 1 year and at 3 years for functional assessment according to ASES, and patient response. The treatment protocol included activity modification, oral nonsteroidal antiinflammatory medications, physical modalities, and a specific exercise program. Statistically significant improvements were obtained in range of motion, pain and function scores according to ASES, Constant score, SF-36 scores, and isokinetic strength (P < 0.05). At the 6-month evaluation, 11 patients (55%) reported that they were "much better", and 9 patients (45%) "better". Conservative treatment of full-thickness rotator cuff tears yields satisfactory results both subjectively and objectively.
We had satisfactory clinical, proprioceptive, and functional results in achieving dynamic and static stability of the knee with the modified accelerated rehabilitation program after ACL reconstruction with a PT graft.
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