The aim of this study was to determine the causes of rehospitalization in patients with spinal cord injury (SCI) treated in Istanbul Physical Medicine and Rehabilitation Centre and to compare the data with previous studies. Patients who were rehospitalized after an initial phase of rehabilitation between 1 January 1996 and 31 December 2001 were enrolled into the study. SCI patients aged 17 years or over at the time of injury were included. This retrospective study was designed using our medical records. In 5 years, 733 SCI patients were treated and 56 of them experienced rehospitalization. We examined the demographic and injury characteristics of rehospitalized patients with SCI. The SPSS computer programme was used for statistical analysis. We found that the rate of rehospitalization was 7.6%, the length of stay (LOS) was 72.21 days and the average age was 34.25 years. The reasons for rehospitalization were, in descending order, spasticity 25%, additional rehabilitation 21.4%, pressure sores 17.9%, urinary infection 16.1%, spinal surgery 8.9%, urinary system surgery 5.4% and pain 5.4%. Statistical significance was found between mean age and causes. The patients who were rehospitalized because of spinal surgery had a lower mean age than those rehospitalized because of pain (P=0.04, F=2.4). The most frequent reasons for rehospitalization of patients over 25 years old were spasticity and pressure sores. In conclusion, SCI patients' LOS was longer than found in previous studies because of a lack of efficient home rehabilitation. The most frequent cause of rehospitalization was spasticity, because of uncontrolled medical therapy. The study demonstrates how education of the patients and their families is important, and that home-based rehabilitation services must be established and supported by government.
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the community. When diagnosed early, it can be easily treated by pharmacological and non-pharmacological methods. The aim of this study was to evaluate wrist range of motion (ROM) and grip strength in women diagnosed with carpal tunnel syndrome and to compare the results with those of the controls. Material and Methods: Twenty-eight women with bilateral CTS were included in this cross-sectional study. The control group consisted of 41 healthy age and gender matched volunteers who had right hand dominancy. Wrist range of motions (ROM) were measured by goniometer. For the intrarater and interrater reliability studies, wrist ROM measurements were performed in 10 healthy volunteers at the beginning of the study. Intraclass correlation coefficient (ICC) values were calculated. Grip strength was measured by hydraulic hand dynamometer. Results: Wrist extension values in the CTS and control groups were 62.66±15.56° and 77±9.9°, respectively. Wrist flexion values were 57.66±11.89° in the CTS and 67.38±4.7° in the control groups. The mean grip strength values in the patient and control groups were 15.32±7.27 kg and 40.40±7.80 kg, respectively (p<0.001). The ICC values were between 0.61-0.98 for the intrarater reliability, ICC values were between 0.76-0.97. Wrist flexion, extension, radial, ulnar deviation and hand grip strength were significantly lower in the CTS group than the control group (p<0.00). Conclusion: Wrist ROM and hand grip strength of patients with CTS resulted in decreased wrist movements and hand grip strength when they were compared with the healthy control group. Evaluating wrist ROM and hand grip strength are measurable parameters that can be used in CTS assessment.
BACKGROUND: Low back pain affects 80% of people worldwide at least once in a lifetime and reduces the quality of life and causes absence from work. OBJECTIVE: To evaluate the pain and functional status of patients with lumbar disc disease who received blind caudal epidural injections (CEI) for pain relief. METHODS: The records of 107 patients who had been given CEI between September 2017 and January 2018 were retrospectively analyzed. The inclusion criteria were age > 18 years, > 3-month history of low back pain, and diagnosis of lumbar disc disease by magnetic resonance imaging. The epidural injection solution consisted of 2 mL of betamethasone sodium and 8 mL saline. Follow-up examinations were conducted 3 and 6 months post-injection and the patients were evaluated using a visual analog scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: The most common disc pathology was at the L4–L5 level. The VAS and ODI scores indicated significantly reduced pain at 3 and 6 months compared with the pre-injection baseline. Two patients experienced total anesthesia and paresis of the lower limbs, but recovered fully after 2 weeks. Blood was aspirated during the injection in two patients, but second-attempt injections were successful in both cases. No other complications were observed. CONCLUSION: Our results suggest that the blind method is safe for administering CEI to patients with chronic low back pain in the absence of radiological screening and results in significant pain relief with improved functional capacity.
Objective: Vitamin D deficiency can cause pain and disability in many diseases. Subacromial impingement syndrome (SAIS) is a common reason for shoulder pain. In this study, we aimed to assess the relationship between vitamin D and the clinical features in patients with SAIS. Methods: Patients with SAIS were evaluated, and age, gender, affected side, disease duration, 25-OH vitamin D, and other laboratory tests were recorded from patients' files. Also, patients' data on shoulder visual analog scale (VAS), shoulder range of motions (ROMs), and scores of Disabilities of the Arm, Shoulder, and Hand (DASH) were obtained. The patients were grouped according to their 25-OH vitamin D levels. (Group 1: <10 ng/mL, Group 2: 10-20 ng/mL, and Group 3: >20 ng/mL). Demographic and clinical features were compared between groups, and the relation of vitamin D with VAS, DASH scores, and ROMs were investigated. Results: Eighty patients with SAIS were included in the study. The mean age of patients was 51.99±11.14 years. There were 35 female and 25 male patients. The mean disease duration was 6.32 months. VAS was statistically higher in Group 1 compared to Group 3. Also, shoulder pain was negatively correlated with 25-OH vitamin D level. There was no statistically significant relation between the 25-OH vitamin D level and DASH score or the 25-OH vitamin D level and shoulder ROMs. Conclusion: Severe deficiency of vitamin D increases shoulder pain in patients with SAIS. Vitamin D deficiency should be taken into consideration in patients with severe shoulder pain in SAIS.
BACKGROUND: Hemiplegic shoulder pain (HSP) is a common morbidity of stroke. Different treatment modalities can be used for optimizing the results and limiting the possible side effects. This research compares the effects of two therapies used to reduce the pain and improve the quality of life of the patients with HSP. OBJECTIVE: This study aimed to compare the effects of transcutaneous electrical nerve stimulation (TENS) and suprascapular nerve blockage (SSNB) in patients with HSP. METHODS: In this clinical research, 24 patients with HSP who participated in a conventional rehabilitation program were randomized into TENS or SSNB treatment groups. A 100 mm visual analogue scale was used to assess the severity of pain. Passive range of motion (ROM) of the shoulder was measured. The Modified Ashworth Scale (MAS) was used to evaluate spasticity of the upper extremities, and the Modified Barthel Scale was used to assess activities of daily living (ADL). Quality of life was measured using the Stroke-specific Quality of Life (SS-QoL) questionnaire. RESULTS: The pain scores of the SSNB group decreased more significantly (p< 0.05) than in the TENS group. SS-QoL scores at the 3rd week in both groups were significantly higher than before treatment (p< 0.05). MAS scores and Barthel scores after treatment did not differ significantly between the groups. CONCLUSION: TENS and SSNB were beneficial in relieving pain and increasing passive shoulder ROM and ADL in all patients. The alleviating of pain was faster in patients who underwent SSNB.
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