We designed a study to compare effects of complete decongestive therapy (CDT) and kinesiology taping (KT) (with exercise and skin care) on limb circumference, lymphedema volume, grip strength, functional status, and quality of life in patients with unilateral breast cancer-related lymphedema (BCRL). Forty patients with unilateral stage 2 BCRL were randomized to either the CDT group (n=20) or the KT group (n=20). Patients in the CDT group underwent 30-min manual lymphatic drainage (MLD) and multi-layer, short-stretch bandaging once a week for four weeks. Patients in the KT group underwent taping once a week for four weeks. In addition, all patients were informed about skin care and given an exercise program throughout the treatment. Upper extremity circumference and volume differences as primary outcomes and grip strength, Quick-Disabilities of the Arm, Shoulder and Hand (Q-DASH), and Functional Assessment of Cancer Therapy-Breast (FACT-B) scores as secondary outcomes were assessed initially, after treatment (4 weeks), and at the 1st month follow-up. Limb circumference and volume differences were significantly reduced in the CDT group after the 4-week treatment compared with the KT group (p=0.012 and p=0.015, respectively), but there was no difference between the groups in the 1st month follow-up (p>0.05). There was no difference between the groups in terms of grip strength, Q-DASH, and FACT-B scores after treatment and at the 1st month follow-up (p>0.05). Our results show that both KT and CDT were found to significantly reduce limb volume and circumference individually at 4-weeks and the one-month follow-up in patients with BCRL and that CDT significantly reduced both limb volume and circumference compared to KT at the 4-week time point, but not at the follow-up. Further randomized controlled trials with patients at different stages of BCRL are needed to confirm and expand these results.
Our aim was to investigate the prevalence of sarcopenia in stroke patients, the relationship between sarcopenia detected with different low muscle mass (LMM) adjustment methods, and between stroke-related parameters. Eighty-one patients with chronic stroke who underwent inpatient rehabilitation were included. Spasticity was evaluated by modified Ashworth scale, Brunnstrom staging approach was used for motor function evaluation, physical independence was evaluated using Barthel Index, quality-of-life was evaluated by EQ-5D-3L, and the Cumulative Illness Rating Scale was used to measure multimorbidity. Muscle strength was evaluated by handgrip strength, muscle quantity through a bioelectric impedance analysis, and physical performance by gait speed and short physical performance battery. LMM was calculated through two different methods: Skeletal muscle mass (SMM)/height2, and SMM/BMI. For the definition of sarcopenia, we followed the EWGSOP2 recommendation. Associated sarcopenia factors were predicted by multivariate binary logistic regression analysis. The prevalence of probable sarcopenia was 32.1%. The prevalence of confirmed/sarcopenia when LMM was adjusted for BMI was higher than when adjusted for height2 (16 and 1.2%, respectively). Age was significantly higher in those with probable sarcopenia (P = 0.006). Stroke duration was shorter in those with probable or confirmed sarcopenia (P = 0.004, P < 0.001, respectively). EQ-5D-3L scores were significantly lower in those with confirmed sarcopenia (P = 0.050). The strongest associated factor with confirmed sarcopenia was stroke duration (OR: 0.77; 95% CI, 0.618–0.965). This study suggests that prevalence of sarcopenia after a stroke is significantly high. LMM adjusted for BMI comes in front as the adjustment method for LMM after a stroke.
Objectives: The aim of this study was to evaluate and compare the effects of radial extracorporeal shock wave therapy (rESWT) and supervised exercises with neuromuscular inhibition (NMI) technique in improving pain, function, and grip strength in the treatment of patients with lateral epicondylitis (LE).
Patients and methods: A total of 50 patients with LE (11 males, 30 females; median age: 46 years; range, 23 to 57 years) whose symptoms persisted for at least three months between February 2015 and August 2015 were included in the prospective, randomized-controlled, clinical study. The patients were divided into two groups as the rESWT group (n=25) receiving a total of three rESWT sessions (once per week with 1.8 bar pneumatic pressure, 10 Hz frequency, and with 2,000 pulses) and the exercise group (n=25) receiving supervised exercises with NMI (three times per week for three weeks). Pain and function were evaluated using Visual Analog Scale, the total Patient-Rated Tennis Elbow Evaluation, the Roles and Maudsley score, while the grip strength was evaluated using a hand dynamometer at one and three months after treatment compared to baseline.
Results: A significant improvement was observed in all outcome criteria at one and three months after treatment, compared to baseline, in both the rESWT and exercise groups (p<0.05). There was no significant difference in terms of the changes in the outcome criteria between the groups (p>0.05).
Conclusion: The rESWT seems to provide no significantly superior benefit than supervised exercises with NMI at least until the three months in the treatment of LE.
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