BACKGROUND: Although the Pilates method has been reported to be effective in women with low back pain (LBP), the efficacy of Pilates exercises in pregnant women with LBP has not been evaluated widely. OBJECTIVE: The purpose of this study was to determine the effects of clinical Pilates exercises on lumbopelvic stabilization, pain, disability and quality of life in pregnant women with LBP. METHODS: Fourty pregnant women were randomized into either a Pilates exercise group (n= 20) or control group (n= 20). Subjects in the Pilates exercise group performed the exercises two times a week for eight weeks. Subjects in the control group followed regular prenatal care. Lumbopelvic stabilization was assessed with a pressure biofeedback unit, pain with the Visual Analog Scale, disability with the Oswestry Low Back Pain Questionnaire and quality of life with the Nottingham Health Profile (NHP). RESULTS: Pain and disability were significantly improved in the Pilates exercise group after intervention (p= 0.03, p< 0.001, respectively). There were also significant improvements in sleep, physical mobility sub-parameters of NHP and lumbopelvic stabilization after Pilates exercises (p= 0.048, p= 0.007, respectively). However, there were no statistically significant changes in all outcome measures in the control group (p> 0.05). CONCLUSIONS: Pilates exercises can be recommended as an effective and safe method for increasing lumbopelvic stabilization, reducing pain and disability, improving physical mobility and sleep problems in pregnant women with LBP.

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Background: Objective measures of outcome ensure reliable decisions with regard to treatment planning. Oxford Elbow Score (OES) is one of the common outcome measures used for assessing quality of life of patients with elbow disorders. OES consists of three domains: pain, elbow function and social/psychological. The aim of this study is to test the validity and reliability of the Turkish version of the OES. Methods: The study's sample includes 82 patients with elbow problems. The original version of the OES was translated into Turkish using the Isis Outcomes Translation and Linguistic Validation Process. The construct validity of the Turkish version of the OES was tested using a confirmatory factor analysis. For internal consistency, Cronbach's alpha was calculated. A Pearson correlation and a dependent sample t test were utilised for reproducibility of the OES. For convergent validity, the correlation coefficients were calculated between the domains of the OES and Short Form 36 (SF36). An independent sample t test was calculated to determine if there was a significant difference between the scores of the participants from the upper and lower groups. Results: Confirmatory factor analysis (CFA) indicates that the three-factor structure of the OES was confirmed. Most of the fit indices are at the expected level, except for a root mean square error of approximation and an adjusted goodness of fit index. Cronbach's alpha was calculated as 0.91 for the whole scale. The results showed that there are positive and high correlations between the first and follow-up assessments (r = 0.89, p < 0.0001). The Turkish OES version and its dimensions have moderate and significant correlations with domains of SF36 in general. The test results indicated that the mean of each item on three domains of the OES was higher for the upper 27 %, and this difference was significant at the 0.01 level. Conclusions: The Turkish version of the OES is a reliable, valid, reproducible and practical tool. It can be used for patients with elbow disorders and is recommended for clinician use.

Background: Targeted intervention for subgroups is a promising approach for the management of patellofemoral pain. Hypothesis: Treatment designed according to subgroups will improve clinical outcomes in patients unresponsive to multimodal treatment. Study Design: Prospective crossover intervention. Level of Evidence: Level 3. Methods: Patients with patellofemoral pain (PFP; n = 61; mean age, 27 ± 9 years) were enrolled. Patients with PFP received standard multimodal treatment 3 times a week for 6 weeks. Patients not responding to multimodal treatment were then classified into 1 of 3 subgroups (strong, weak and tight, and weak and pronated foot) using 6 simple clinical tests. They were subsequently administered 6 further weeks of targeted intervention, designed according to subgroup characteristics. Visual analog scale (VAS), perception of recovery scale (PRS), 5-Level European Quality 5 Dimensions (EQ-5D-5L), and self-reported version of the Leeds Assessment of Neuropathic Symptoms and Signs scale (S-LANSS) were used to assess pain, knee function, and quality of life before and after the interventions. Results: In total, 34% (n = 21) of patients demonstrated recovery after multimodal treatment. However, over 70% (n = 29/40) of nonresponders demonstrated recovery after targeted treatment. The VAS, PRS, S-LANSS, and EQ-5D-5L scores improved significantly after targeted intervention compared with after multimodal treatment ( P < 0.001). The VAS score at rest was significantly lower in the “weak and pronated foot” and the “weak and tight” subgroups ( P = 0.011 and P = 0.008, respectively). Posttreatment pain intensity on activity was significantly lower in the “strong” subgroup ( P = 0.006). Conclusion: Targeted treatment designed according to subgroup characteristics improves clinical outcomes in patients unresponsive to multimodal treatment. Clinical Relevance: Targeted intervention could be easily implemented after 6 simple clinical assessment tests to subgroup patients into 1 of 3 subgroups (strong, weak and tight, and weak and pronated foot). Targeted interventions applied according to the characteristics of these subgroups have more beneficial treatment effects than a current multimodal treatment program.

Amaç: Bu çalışma dismenoresi olan ve olmayan kadınların menstruasyona yönelik tutumlarını ve stres düzeylerini karşılaştırmak böylece dismenore ile menstruasyona yönelik tutum arasındaki ilişkiyi belirlemek amacıyla planlandı.Yöntemler: Çalışmaya 18 yaş üzeri, 52 dismenoreli, 48 sağlıklı toplam 100 kadın öğrenci dahil edildi. Kadınların menstruasyon dönemindeki tutum ve davranışları Menstruasyon Tutum Ölçeği, yaşantılarındaki stres vericilerin algılanış düzeyi ise Algılanan Stres Ölçeği kullanılarak menstruasyon esnasında ve menstruasyondan 15 gün sonra değerlendirildi. Menstruasyon sırasında oluşabilen karın krampları, mide bulantısı, kusma, ishal, iştah kaybı, baş dönmesi, güçsüzlük, baş, bacak ile sırt ağrıları gibi ek semptomlar sorgulandı. Sonuçlar: Menstruasyon tutum ölçeğinin sadece "menstruasyonu doğal bir olgu olarak gör-me" alt ölçeği skorları dismenoreli grupta kontrol grubuna göre istatistiksel açıdan anlamlı olarak düşüktü (p<0.05). Ancak diğer alt ölçeklerinde iki grup arasında istatistiksel bir fark yoktu (p>0.05). Algılanan stres ölçeği skorları menstruasyon sırasında dismenoreli grupta kontrol grubuna göre anlamlı olarak yüksek iken (p<0.05), menstruasyondan 15 gün sonra algılanan stres ölçeği skorlarında her iki grup arasında istatistiksel bir fark yoktu (p>0.05). Menstrüel semptomlardan karın krampları, mide bulantısı ve güçsüzlük şiddeti dismenoreli grupta istatistiksel olarak yüksekti (p<0.05).Tartışma: Bu çalışma dismenoresi olan kadınların menstruasyona yönelik bazı önemli tutum değişiklikleri olduğunu göstermektedir. Özellikle menstruasyonu doğal bir süreç olarak kabul etmede problem yaşamaktadırlar. Aynı zamanda dismenoreli kadınlarda normal menstruasyon geçiren kadınlara oranla daha fazla iştah kaybı, kramp, güçsüzlük gibi fizyolojik ya da psikolojik kaynaklı semptomlar görülmektedir. Bu kişilerde uygulanacak bilişsel davranış ve algı terapisi gibi uygulamalar menstruasyona yönelik algıyı değiştirmesi durumunda dismenore tedavisine katkı sağlayabilir. RESEARCH ARTICLE CHANGES OF MENSTRUAL ATTITUDE AND STRESS PERCEPTION IN WOMEN WITH DYSMENORRHEA ABSTRACTPurpose: This study was planned to compare the attitudes toward menstruation and stress levels of women with and without dysmenorrhea. Methods:A total of 100 female students (52 subjects with and 48 subjects without dysmenorrhea, respectively) over 18 years old were enrolled in this study. The attitude of women was assessed during menstruation by Menstruation Attitude Questionnaire. Level of perceived stress was evaluated with Percieved Stress Scale during menstruation and 15 days after menstruation. Additional menstrual symptoms such as abdominal cramps, nausea, vomiting, diarrhea, loss of appetite, dizziness, weakness, headache, back pain, leg symptoms were questioned during menstruation. Results:Only "menstruation as a natural event" subscale scores of Menstruation Attitude Questionnaire were significantly lower in women with dysmenorrhea than controls. Perceived Stress Scale scores during menstruation were significantly lower in the...