Amaç: Bu çalışmada boyun ve sırt bölgesinde miyofasiyal ağrı sendromu (MAS) bulunan hastalarda kuru iğneleme, lidokain enjeksiyonu ve oral flurbiprofen tedavilerinin etkinliği karşılaştırıldı. Hastalar ve yöntemler:Bu prospektif çalışmaya toplam 60 hasta (7 erkek, 53 kadın; ort yaş 33.7 yıl; dağılım 18-50 yıl) dahil edildi. Hastalar blok randomizasyon ile üç gruba ayrıldı. Bir gruba tetik noktalara kuru iğneleme, bir gruba lidokain enjeksiyonu (çift kör) ve diğer gruba yedi gün süresince 200 mg/gün oral flurbiprofen tedavisi verildi. Ayrıca hastaların tümüne tutulan kasın gerilmesini temel alan standart bir ev egzersiz programı da verildi. Tedavi öncesi ve tedaviden sonraki üçüncü ve 14. günlerde ağrı şiddeti, görsel analog ölçeği (GAÖ) ile tetik noktaların duyarlılık derecesi algometre ile boyun ve omuz aktif eklem hareket açıklıkları gonyometre ile ve yaşam kalitesi Nottingham Sağlık Profili ile değerlendirildi. Bulgular: Üç grupta da tedaviden sonraki üçüncü ve 14. günlerde tedavi öncesine göre ağrı şiddeti, tetik nokta hassasiyeti, eklem hareket açıklıkları ve yaşam kalitesi açısından iyileşme saptandı. Tedavilerin etkinlikleri açısından gruplar arasında anlamlı fark bulunmadı.Sonuç: Miyofasiyal ağrı sendromunun tedavisinde, ev egzersizleri ile birlikte kuru iğneleme, lidokain enjeksiyonu ve oral flurbiprofen tedavilerinin tümü etkindir.Anahtar sözcükler: Kuru iğneleme; flurbiprofen; lidokain; miyofasiyal ağrı sendromu. Objectives:The aim of this study was to assess and compare the efficiency of dry needling, lidocaine injection and oral flurbiprofen treatments in patients with myofascial pain syndrome (MPS) involving the neck and back region. Patients and methods:A total of 60 patients (7 males, 53 females; mean age 33.7 years; range 18 to 50 years) were included in this prospective study. The patients were divided into three groups by block randomization. Each group was assigned to dry needling for trigger points, lidocaine injection (double blind) or oral flurbiprofen 200 mg/day over seven days. All patients were also prescribed a standardized home exercise program based on stretching of the affected muscles. Before treatment and on the third and 14 days after treatment, pain severity was assessed by visual analog scale (VAS), degree of tenderness at the trigger points by algometry, active joint range of motion of the neck and shoulders by goniometry, and the quality of life by Nottingham Health Profile.Results: There was a significant improvement in pain severity, trigger point tenderness, joint range of motion, and quality of life in all three groups on the third and 14 th days of treatment. No significant difference was found in treatment efficiency among the groups. Conclusion:Treatments with dry needling, lidocain injection and oral flurbiprofen along with home exercises are all effective in the management of MPS.
Objective: Investigating and comparing the effects of exercise and physical therapy accompanying exercise treatments in patients with chronic low back pain. Materials and Methods: Twenty three patients with mechanical type low back existing more than 3 months were included one of the exercise or the physical therapy+exercise groups according to their application sequence. Both of the groups performed lumbar flexion and extension exercises, strengthening of the lumbar and abdominal muscle exercises and iliopsoas, hamstring and quadriceps stretching exercises two times a day for 14 days. The physical therapy group was given hot pack+therapeutic ultrasound+ interferential current for 10 days additionally. Degree of the low back pain was evaluated with visual analog scale (VAS), range of joint motion was evaluated with hand finger floor distance (HFFD) and Modified Schober test, functional status was evaluated with Modified Oswestry Low Back Pain Scale and quality of life was evaluated with Short form-36 (SF-36) before and a month after the treatments. Results: In both groups (exercise group: average age 59 years, 21 females, 2 males; physical therapy group: average age 60 years, 20 females, 3 males) pain intensity and HFFD decreased and Modified Schober increased, functionality recovered, pain and physical functions of SF-36 improved after the treatments. SF-36-physical role difficulty also improved in the exercise group. Decrease in pain, increase in HFFD and
Aim: Our study aimed to evaluate patient satisfaction 12 weeks after total knee arthroplasty (TKA) and determine preoperative and postoperative factors which influence short term patient satisfaction following TKA. Material and Method: Patients who underwent 40 primary TKAs were included. Patients were assessed by using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form-36 (SF36), Visual Analog Scale (VAS)-pain, 50-meter walking test preoperatively and 12 weeks after TKA. The duration of walking was measured while the patients walked 50 m. Both pre and postoperative flexion and extension range of motion (ROM) of the knee were recorded. Postoperatively patient satisfaction was evaluated. Results: Preoperatively, there was no difference between satisfied and dissatisfied patients in terms of age, VAS-pain, SF36 sub scores, WOMAC sub scores, active and passive flexion and extension ROMs (p>0.05). Postoperatively, VAS-pain and SF36 general health and physical-emotional sub scores were lower and passive knee flexion was higher in satisfied patient group (p<0.05). Among clinical parameters, only postoperative VASpain had a significant negative impact on patient satisfaction (p<0.05). Other parameters including age, gender, pre and postoperative active flexion and extension ROMs, preoperative VASpain, WOMAC and 50-metre walking duration had no impact on patient satisfaction (p>0.05). Conclusion: Preoperative pain, disability and quality of life had no effect on postoperative short term patient satisfaction. Postoperative pain severity, knee flexion ROM degree and deterioration in quality of life had significant negative impact on postoperative patient satisfaction. Larger studies are necessary to further clarify the factors associated with dissatisfaction following TKA.
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