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.

Myofascial pain syndrome (MPS) of the trapezius muscle is one of the main causes of neck pain. In this randomized, double-blind study, we evaluated the effects of high-intensity laser therapy (HILT) in female patients with chronic MPS of the trapezius muscle. The patients were assigned to two groups. The HILT group was treated with HILT and exercise, and the sham therapy group was treated with placebo HILT and exercise. The patients were assessed for pain, cervical active range of motion, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (weeks 4 and 12). Both groups showed significant improvement in all parameters at weeks 4 and 12. However, in a comparison of the percentage changes in the parameters at weeks 4 and 12 relative to pretreatment values, the HILT group showed greater improvement in pain scores, the neck disability index, and several subparts of the short-form 36 health survey (SF-36) (physical functioning, role limitations due to physical functioning, bodily pain, general health perceptions, social functioning, and role limitations due to emotional problems) than did the sham therapy group. We conclude that HILT is an effective therapeutic method in the treatment of patients with chronic MPS of the trapezius muscle.

Simultaneous bilateral spontaneous pneumothorax (SBSP) is a very rare condition, mainly seen in patients with underlying lung disease. Up to now, there are 65 patients who have been published. Twelve consecutive patients who presented with SBSP as definitive diagnosis were recruited for this study. They represented 1 % of all patients with spontaneous pneumothorax. All patients had immediate bilateral chest tubes on admission. Five of the 12 patients (42%) had no underlying lung disease. In 7 patients, SBSP was secondary to pulmonary metastases, histiocytosis X, undefined interstitial pulmonary disease, tuberculosis, pneumonia and chronic obstructive pulmonary disease. None of the patients died during hospitalization. Eleven patients were treated with chemical pleurodesis, whereas thoracotomy and pleurectomy were necessary in 7 patients. Reexpansion of the lungs was achieved in all patients. Immediate bilateral chest tube insertion and pleurodesis are of major importance in the treatment of SBSP although a subset of patients needed surgical pleurectomy. Combination of these treatments provides successful and uneventful treatment of the disease.

Lateral epicondylitis (LE) is a common disorder that causes pain on the outside of the elbow, as well as pain and weakness during gripping. In this prospective, randomized, controlled, assessor-blinded trial, we planned to investigate the effects of high-intensity laser therapy (HILT) in patients with LE and to compare these results with those of a brace and placebo HILT. Patients were randomly assigned to three treatment groups. The first group was treated with HILT. The second group (sham therapy group) received placebo HILT, while the third group (brace group) used the lateral counterforce brace for LE. The patients were assessed for grip strength, pain, disability, and quality of life. Outcome measurements and ultrasonographic examination of the patients were performed before treatment (week 0) and after treatment (after 4 and 12 weeks). HILT and brace groups showed significant improvements for most evaluation parameters (pain scores, grip strength, disability scores, and several subparts of the short-form 36 health survey (physical function, role limitations due to physical functioning, bodily pain, general health, and vitality)) after treatment (after 4 and 12 weeks). However, the improvements in evaluation parameters of the patients with LE in HILT and brace groups were not reflected to ultrasonographic findings. Furthermore, comparison of the percentage changes of the parameters after treatment relative to pretreatment values did not show a significant difference between HILT and brace groups. We conclude that HILT and splinting are effective physical therapy modalities for patients with LE in reducing pain and improving disability, quality of life, and grip strength.

A high index of suspicion and early surgical treatment determine the successful management of TDR, with or without the herniation of abdominal organs. The surgical approach to TDR is individualized. Acute left-sided injuries are best approached through the abdomen, although we prefer the chest approach, adding laparotomy when necessary. Acute right-sided injuries and chronic injuries should be approached through the chest.

This study indicates that pulmonary rehabilitation can prevent loss of muscle strength in ICU. Nevertheless, we consider that further studies with larger populations are needed to examine the impact of NMES and/or active and passive muscle training in bedridden ICU patients who are mechanically ventilated.

RT combined with CP produced better improvement in FIM, MMSE, BRS lower extremity categories, and all subparts of SF-36 of the patients with subacute and chronic stroke (up to 1 year) than the CP program.

The prevalence of OSAS in AS patients is higher than reported in the general population. The diagnosis of OSAS should be kept in mind and OSAS symptoms should be considered especially in AS patients at the age of >or=35 years and in AS patients with a disease duration of >or=5 years.