The Toronto Clinical Scoring System has been preferred in clinical trials owing to its ease of use and its ability to classify the severity of neuropathic pain. The aim of this study to apply the Turkish version of Toronto Clinical Scoring System to Turkish patients and to determine its validity and reliability. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This study enrolled a total of 103 patients including 39 with diabetic polyneuropathy (diabetic polyneuropathy, group 1), 32 with diabetes mellitus but without diabetic polyneuropathy (group 2), and 32 healthy individuals (group 3). The gender, body mass index, hemoglobin A 1c and duration of diabetes were recorded respectively. The Toronto Clinical Scoring System was translated into Turkish language to determine the validity. The Leeds Assessment of Neuropathic Symptoms and Signs, Pain Detect Questionnaire, Michigan Neuropathy Screening Instrument were performed. Correlations between Toronto Clinical Scoring System and the other 3 neuropathy diagnosis scales and their relationships with the data of nerve conduction velocity were evaluated. R Re es su ul lt ts s: : There was a strong positive correlation and a statistically significant relationship between the Toronto Clinical Scoring System and the other neuropathy diagnosis scales. When the item about "upper extremity symptoms" was removed from the first part of the Turkish version of the Toronto Clinical Scoring System, Cronbach's Alpha coefficient increased from 0.132 to 0.943. There was a significant relationship between the Toronto Clinical Scoring System and the nerve conduction velocity data. The sensitivity and specificity of Toronto Clinical Scoring System score ≥5 were 100% and 96.88%, respectively. C Co on nc cl lu us si io on n: : Turkish version of the Toronto Clinical Scoring System is a reliable and valid instrument for the measurement of neuropathic pain in Turkish speaking patients with polyneuropathy. K Ke ey y W Wo or rd ds s: : Toronto clinical scoring system; diabetic polyneuropathy; nerve conduction velocity; the Leeds assessment of neuropathic symptoms and signs; pain detect questionnaire; michigan neuropathy screening instrument
First, is there any difference in health related quality of life (HRQOL) scores between breast cancer-related lymphedema (BCRL) patients and healthy controls? Second, is there any difference in HRQOL scores of BCRL patients according to lymphedema severity? Material and Methods: The medical records of a total of 50 healthy volunteers and 78 unilateral BCRL patients were examined between 01 January 2012 and 31 December 2018 in the Physical Medicine and Rehabilitation Training and Research Hospital which is a tertiary center. Age, gender, BMI, surgical interventions (modified radical mastectomy (MRM) + axillary lymph node dissection (ALND) or lumpectomy), chemotherapy, radiotherapy, hormone therapy, pain, numbness, shoulder joint range of motion measurement, time after surgery, remove metastasis, metastatic lymph nodes, number of metastatic lymph nodes, number of resected lymph nodes, lymphedema status, and the SF-36 HRQOL scores of BCRL patients were noted from the files. Results: Seventy-eight women with BCRL and 50 healthy women were included in the study. When the parameters of the SF-36 HRQOL were compared between the BCRL group and the control group; physical functioning(42.57±8.3 vs. 46.84±7.4, p=0.004), physical role functioning (38.02±12.2 vs. 44.63±10.8, p=0.001), and physical component summary(40.47±8.4 vs. 45.30±9.7, p=0.005) scores were significantly lower in the BCRL group. Other SF-36 HRQOL parameters were similar between the groups (p>0.05). When the parameters of SF-36 HRQOL were compared between the lymphedema ≤ 3 cm and the lymphedema > 3 cm subgroups; all of the parameters were similar(p>0.05). Conclusion: In our study, compared to the lymphedema and control group SF-36, physical function, physical role function and physical component scores in lymphedema patients were lower and statistically significant. Interestingly, no statistically significant difference was found when SF-36 scores were compared between the lympedema ≤3 cm and >3 cm subgroups. These results show that the presence of lymphedema is much more important than the lymphedema severity in impairing quality of life.
Background: The authors aimed to compare the effects of a one-time ultrasound (US)-guided subacromial corticosteroid injection and three-time ozone (O 2 -O 3 ) injection in patients with chronic supraspinatus tendinopathy. Methods: Participants were randomly assigned to the corticosteroid group (n = 22) or ozone group (n = 22). Injections in both groups were administered into subacromial bursa with an US-guided in-plane posterolateral approach. Primary outcome measure was the change in the Western Ontario Rotator Cuff Index (WORC) score between baseline and 12-weeks post-injection. Secondary outcome measures included visual analog scale and Shoulder Pain and Disability Index scores. Assessments were recorded at baseline, and 4-weeks and 12-weeks post-injection. Results: Forty participants completed this study. Based on repeated measurement analysis of variance, a significant effect of time was found for all outcome measures in both groups. Both the groups showed clinically significant improvements in shoulder pain, quality of life, and function. Baseline, 4-week post-injection, and 12-week post-injection WORC scores (mean ± standard deviation) were 57.
Objective Taking care of a patient can significantly impact both physical and psychological statuses of caregivers. This study aimed to examine musculoskeletal problems, health status, and quality of life of caregivers. This study is novel in determining musculoskeletal disorders, pain characteristics, activity levels, sleep condition, general and psychological health statuses, and quality of life of caregivers. Design A cross-sectional study Patients and Methods A total of 240 participants were enrolled in this prospective and cross-sectional study conducted at a tertiary rehabilitation center (patients, n = 120; caregivers, n = 120). The demographic and clinical characteristics of the participants were recorded during the evaluation process. The Functional Ambulation Classification Scale (FAS) and Barthel Scale scores of the patients were determined. The pain level of the caregivers was evaluated according to the Visual Analog Scale (VAS). The International Physical Activity Questionnaire (IPAQ)–short form was used to evaluate caregivers’ activity levels. The quality of life of caregivers was evaluated with the World Health Organization Quality of Life Assessment Scales score (WHOQOL-BREF). The anxiety and depression status of the caregivers were interpreted using the Hospital Anxiety and Depression Scale, The health level of the caregivers was evaluated using the Health Assessment Questionnaire. Results A statistically significant positive correlation was found between the duration of caregiving (hours per week) and the pain duration of the caregiver (month) (P = 0.000, r = 0.766). the caregivers who provided longer-term care for their patients (hours per week) had higher VAS scores (P = 0.000, r = 0.944). A significant reverse correlation was found between the duration of caregiving (hours per week) and IPAQ-Walking MET (metabolic equivalent) scores (minutes/week) (P = 0.000, r = –0.811). On the contrary, a positive significant association was detected between the duration of caregiving (hours per week) and IPAQ-Vigorous MET scores (minutes/week) due to the caregiving activities of the patients such as lifting, positioning, and so forth. Also, a significant positive correlation was observed between the duration of caregiving (hours per week) and Hospital Depression Scale scores (P = 0.000, r = 0.394), Hospital Anxiety Scale scores (P = 0.000, r = 0.548), and Health Assessment Questionnaire scores (P = 0.000, r = 0.415). Conclusion Providing protective exercise programs, including walking activity, to caregivers and organizing education programs that include caregiving techniques can positively affect the quality of life of caregivers.
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