[Purpose] The aim of this study was to determine the functional differences between total
knee arthroplasty (TKA) patients who were treated with supervised physiotherapy or a
standardized home program and perform a cost analysis. [Subjects and Methods] Patients who
received total knee arthroplasty between January 2009 and June 2011 were enrolled in this
study; those with mean ages of 64.25±3.86 (60–68) years (n=18) and 68.08±6.25 (61–79)
years (n=16) were placed in the supervised physiotherapy and standardized home program
groups, respectively. All patients were evaluated by the same researcher before and after
surgery, and the therapy programs were applied by another physiotherapist. All patients
were evaluated for joint range of motion (ROM), pain, functional status (WOMAC), overall
quality of life (SF-36), and depressive symptoms (BECK Depression Scale). [Results] A
significant clinical improvement was observed in postoperative assessments. A
statistically significant difference could not be found between ROM and functional levels
of the patients in both groups. [Conclusion] No difference was found between the patients
performing supervised or standardized home program with respect to the effects on
functional status. A home exercise program can be used in the rehabilitation of patients
with TKA, and implementation of home exercise programs can also reduce health-care
spending.
The results after primary repair of zone 2 flexor tendon injuries were evaluated in 263 fingers in 192 patients using two different early-controlled mobilisation programmes. There were 126 men and 66 women (age range 18 to 57 years) divided into two groups. Ninety-eight patients with 137 fingers were treated by early active mobilisation with dynamic splinting method according to a modified Kleinert regimen (Washington regimen), and 94 patients with 126 fingers were managed with a controlled passive movement regimen postoperatively. During this evaluation patients were evaluated for total active movement (TAM), grip strength, and disabilities of arm, shoulder, and hand (DASH) questionnaire. All patients were also reviewed 12 weeks after operation and the results assessed by the Buck-Gramcko-II system. Total active movement was "excellent" in the Washington regimen group (n=119, 87%), while excellent results of the fingers were achieved in the controlled passive movement group (n=94, 75%). The mean grip strength of the injured hand was 89% that of the non-injured side in the Washington regimen group, compared with 81% in the controlled passive movement group. The mean DASH score was 30 and 42 in the two groups, respectively. We think that controlled active mobilisation with dynamic splinting improves the outcome in the upper extremity, including range of movement, grip strength, and functional state of the hand in repairs of the flexor tendons.
BACKGROUND: Low back pain (LBP) is a common problem that causes pain, disability, and gait and balance problems. Neurodynamic techniques are used in the treatment of LBP. OBJECTIVE: The aim of this study was to compare the effects of electrotherapy and neural mobilization on pain, functionality, gait, and balance in patients with LBP. MATERIALS AND METHODS: A total of 41 patients were randomly assigned to either the neural mobilization group (NMG, n= 20) or electrotherapy group (ETG, n= 21). Assessment tools used were Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI) for functionality, straight leg raise test (SLRT) for neural involvement, and baropedographic platform (Zebris FDM-2TM) for gait and static balance measurements. RESULTS: Both groups showed a significant decrease in pain and functional disability, while only the NMG group showed a significant increase in SLRT scores (p< 0.05). However, there were no statistically significant pre- to post-treatment changes in gait or static balance parameters in either group (p< 0.05). CONCLUSION: Neural mobilization was effective in reducing pain and improving functionality and SLRT performance in patients with LBP, but induced no change in gait and static balance parameters. Neural mobilization may be used as self-practice to supplement standard treatment programs.
The present study was planned to translate and culturally adapt the Olerud-Molander Ankle Score (OMAS) and assess the validity and reliability of the Turkish translation of the OMAS in patients with surgically treated malleolar fracture. The OMAS was adapted for use in Turkish by first translating it and then back-translating it in accordance with published guidelines. The final Turkish version of the OMAS was administered to 91 patients participating in the present study. The OMAS questionnaire was repeated 7 days later to assess test-retest reliability. Spearman's rank correlation analysis was used for each question's score and the total score, and the intraclass correlation coefficient was calculated for test-retest reliability. The internal consistency of the OMAS-TR was assessed using Cronbach's α. Concurrent validity was evaluated by comparing the OMAS with the Foot and Ankle Outcome Score and global self-rating function (GSRF). The GSRF has 5 options: very good, good, fair, poor, and very poor. These are assessed using a 5-point Likert scale. Before validity analysis, the GSRF score was reduced to 3 groups. In the test-retest reliability assessment, the OMAS showed high correlation (r = 0.882). The intraclass correlation coefficient was 0.942. Cronbach's α was 0.762 and 0.731 at days 1 and 7 (adequate internal consistency). The correlation coefficients versus the 5 subscales of the Foot and Ankle Outcome Score ranged from r = 0.753 to r = 0.809 (p = .000) and versus the GSRF was r = -0.794 (p = .000). According to results of the present study, the Turkish version of the OMAS demonstrated adequate test-retest reliability, excellent internal consistency, and evidence of validity for Turkish-speaking patients treated surgically for ankle fracture.
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