One way to measure the effectiveness of a specific treatment is to utilize measurements designed specifically for the disorder. Western Ontario Shoulder Instability Index (WOSI) is a subjective self-report scale indicating the latest condition of the patients with shoulder instability. The objective is to study the cultural adaptation, validity, and reliability of WOSI in Turkish population with shoulder disability. First, WOSI was translated and culturally adapted from English into Turkish. Afterward, in order to determine the level of reliability, internal consistency and test-retest analyses were conducted. Reliability (test-retest) analyses were conducted by means of retest 72 h later with a sub-group of 30 patients. Construct validity of the WOSI was checked through convergent validity with Disabilities of Arm, Shoulder and Hand Scale, Rowe Score Questionnaire, Oxford Shoulder Instability Questionnaire, and Western Ontario Rotator Cuff Index by 60 patients with shoulder instability. The Turkish version of the questionnaire displayed high internal consistency (0.77-0.91) with a Cronbach's Alpha value of 0.91. As for the test-retest reliability, the ICC value was found to be high (95% CI 0.97). Floor and ceiling effects (15%) were observed neither in sub-parameters (0-4.9%) nor in total score (0%). WOSI total score was found to have a negative good correlation with the Rowe Score (r = -0.57) and a very good-excellent correlation with other questionnaires (r = 0.67-0.89). The Turkish version of WOSI is a valid and reliable scale for use in studies to evaluate the final condition of the patients with shoulder disabilities.
[Purpose] It has been well-established that exercise-induced muscle damage occurs following intense exercise. Massage is commonly used to manage muscle damage resulting from exercise. However the effect of massage after exercise is still not clear. The purpose of this study was to examine the effect of manual lymph drainage on muscle damage and on the removal of blood lactate following submaximal exercise (SE), as part of a solution to the challenging problem in sports medicine of muscular recovery after exercise. [Subjects and Methods] Eighteen healthy male students, with moderate exercise training, were randomly assigned to either receive manual lymph drainage (MLD) or serve as controls. Both groups were subjected to a graded exercise test, performed on a treadmill ergometer, to determine each subject’s individual anaerobic threshold (IAT). Seven days later, all subjects were made to run for 30 minutes on the same treadmill ergometer, at a running speed equivalent to the IAT. One group received MLD treatment, while the control subjects received no treatment. [Results] Following an increase immediately after exercise, lactic acid (LA) and lactate dehydrogenase (LDH) serum levels dropped rapidly and significantly at the end of MLD application and two hours after SE in the subjects receiving MLD. The course of creatine kinase (CK) and myoglobin levels was comparable, and with myoglobin showing a significant difference at 2 h after SE, and CK at 24 h after SE. [Conclusion] Manual lymph drainage after SE correlated with a more rapid fall in LA and of the muscular enzymes of LDH, CK and myoglobin, and may have resulted in an improvement in the regenerative processes elicted by structural damage to the muscle cells.
The Turkish version of the Penn Shoulder Score is a reliable and valid measure for assessing patients with shoulder dysfunctions. Implications for Rehabilitation The Turkish version of the Penn shoulder score is valid and reliable outcome measure for assessing patients with shoulder dysfunctions. The Turkish version of the Penn shoulder score could be easily performed by patients and it is easy to score by clinicians. It is recommended to use in clinical settings and in research.
GirişLenfödem (LÖ), yetersiz lenfatik drenaj sebebiyle proteinden zengin sıvının interstisyel aralıkta anormal birikimi sonucu oluşan kronik ve ilerleyici bir durumdur (1). Lenfatik sistemin kapasitesindeki herhangi bir azalma sonucu bu sıvı interstisyel aralıktan süzülür ve venöz dolaşıma geri döner. Bunun sonucunda da lenf sıvısı etkilenen vücut bölgesindeki deri ve subkutanöz dokularda birikir (2). LÖ'nün en önemli sebepleri; kanser ve tedavisi (sekonder LÖ), lenfatik sistemin konjenital anomalitesi (primer LÖ), kronik venöz yetmezlik sonucu gelişen flebolenfostatik ödemdir. Ayrıca kişisel faktörler (obezite gibi), paraziter bir enfeksiyon ya da travma sonucu sekonder LÖ gelişebilir. Primer LÖ ise ailesel ya da genetik faktörler gibi intrinsik faktörler sonucu meydana gelir (3, 4).Meme kanseri, tüm dünyada kadınlar arasında %28 oranında görülen en sık kanserdir. Türkiye'deki kadınlarda da %35,47 oranıyla en sık görülen kanser, yine meme kanseridir (5). Amerika'da ise 2,6 milyonun üzerinde kadına meme kanseri teşhisi konulduğu tahmin edilmektedir (6). ABSTRACTLymphedema (LE) is a chronic and progressive condition which is an abnormal retention of protein-rich fluid in the interstitial space because of inadequate lymphatic drainage. One of the most important complications of breast surgery is LE that can occur in the arm, hand and trunk. The incidence of breast cancer associated LE is reported 6-30%. The most important risk factors of LE are the type of axillary surgery and amount of chemotherapy and/or radiotherapy exposure after surgery. Recent studies showed that sentinel lymph node biopsy replaces axillary lymph node dissection in breast cancer treatment. For diagnosis of LE; clinical properties such as the unilateral or asymmetric character of edema, normal skin color, positive Stemmer sign, increased density of edema and extremity pain should be considered. After diagnosis, assessment of the patient includes obtaining information about anamnesis, physical tests, metastasis and risk of deep vein thrombosis. Treatment of the condition can be summarized under the topic of medical treatment, surgery and physiotherapy. Complex Decongestive Therapy (CDT) is accepted as the golden standard for LE treatment. CDT concept consists of four basic components (manual lymph drainage, skin care, compression treatment, therapeutic exercise) and two phases. Finally it should not be forgotten and should be learned that LE is a chronic condition that needs lifelong care. In this review; incidence, risk factors, approaches for protection of this factors, assessment methods and therapy options for LE are have been discussed. ÖZETLenfödem (LÖ), yetersiz lenfatik drenaj sebebiyle proteinden zengin sıvının interstisyel aralıkta anormal birikimi sonucu oluşan kronik ve ilerleyici bir durumdur. Meme kanseri tedavisinin en önemli komplikasyonlarından biri de; kol, el ve gövdede gelişebilecek LÖ'dür. Meme kanseri ile ilişkili LÖ görülme insidansının %6-30 arasında olduğu belirtilmektedir. LÖ'nün en önemli risk faktörleri; aksiller cer...
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