The aim of this study is to compare the effect of phonophoresis, ultrasound and placebo ultrasound therapies in the treatment of myofascial pain syndrome (MPS). This is a randomized, double-blind placebo controlled study. Sixty patients (48 women, 12 men, mean age 37.9 ± 12.2 years) with MPS were included in this study. Patients were allocated into three groups. Group 1(n = 20) was received diclofenac phonophoresis, group 2(n = 20) was received ultrasound and group 3(n = 20) was received placebo ultrasound therapies over trigger points, 10 min a day for 15 session during 3 weeks (1 MHz-1,5 watt/cm²). Additionally, all patients were given neck exercise program including isotonic, isometric and stretching. Patients were assessed by means of pain, range of motion (ROM) of neck, number of trigger points (NTP), algometric measurement and disability. Pain severity was measured by visual analog scale (VAS) and Likert scale. The neck pain disability index (NPDI) was used for assessing disability. Measurements were taken before and after treatment. After treatment, there were statistically significant improvements in pain severity, NTP, pressure pain threshold (PPT), ROM and NPDI scores both in phonophoresis and in ultrasound therapy groups (P < 0.05). Statistically significant increase in cervical lateral flexion and rotation was observed in the placebo US group. While there was no statistically significant improvement in the cervical flexion-extension joint movement, pain levels, number of trigger points and NPDI score, pressure pain threshold (P > 0.05), also there were no significant differences in all parameters between group 1 and 2 (P = 0.05). Both diclofenac phonophoresis and ultrasound therapy were effective in the treatment of patients with MPS. Phonophoresis was not found to be superior over ultrasound therapy.
The aim of this study was to assess the reliability and validity of the Turkish version of the Quick Disability of the Arm, Shoulder, and Hand (Quick DASH) scale in patients with carpal tunnel syndrome (CTS). Sixty nine patients with idiopathic CTS were included. The Quick DASH questionnaire consists of three subscales including disability/symptom, and work and sports/performing arts. Quick DASH was administered after translation process to subjects twice a week for testing reliability. The validity was based on correlating Quick DASH with the Boston Questionnaire, visual analogue scale-pain (VAS-pain), and pinch and grip strength tests. Reliability of the Turkish version of the Quick DASH scale was very good with high internal consistency (Cronbach's alpha 0.84 for disability/symptom subscale, 0.937 for work subscale, and 0.926 for sports/performing arts subscale) and test-retest reliability (intraclass correlation coefficient 0.931 for disability/symptom subscale, 0.925 for work subscale, and 0.779 for sports/performing arts subscale). The disability/symptom subscale had moderate correlations with the VAS-pain and grip strength test and good correlation with the pinch strength test. The work subscales had moderate correlations with VAS-pain, and pinch and pinch grip strength tests. A high correlation was found between the disability/symptom and work subscales with Boston symptom severity and Boston functional status subscores. The Turkish version of Quick DASH was reliable and valid for evaluating symptoms and functional disability in patients with CTS. Our results suggest that Quick DASH could be preferred as it is a simple and easy scale to use.
Objectives
This study aims to evaluate and compare the cost-effectiveness of inpatient physical therapy, outpatient physical therapy applications, and back school education in low back pain (LBP) treatment.
Patients and methods
Between March 2011 and September 2011, a total of 105 patients (43 males, 62 females; mean age 44.8±12.7 years; range, 27 to 58 years) who were treated for chronic LBP were included in this prospective study. Of the patients, 34 received inpatient physical therapy consisting of electrotherapy, superficial-deep heat application, and basic back exercise program, 35 received the same treatment in the outpatient setting, and 36 received back school education. Each patient was evaluated five times during the study using pain intensity Visual Analog Scale (VAS), spinal mobility measurements (inclinometer), general evaluation (VAS), functional disability measurement (Roland-Morris Disability Questionnaire [RMDQ]), and quality of life (Short Form-36 [SF-36]). All expenses and costs for treatment of LBP were estimated.
Results
At the end of six months of follow-up, all study groups had a statistically significant improvement in all variables. Improvements in spinal mobility, RMDQ, and SF-36 scores were significantly higher in the inpatient physical therapy group (p<0.001). Direct and total costs were the highest in the inpatient treatment group and were the lowest in the back school education group (p<0.001). No statistically significant differences were observed in terms of additional cost of one-unit improvement in these variables among the study groups.
Conclusion
Our study results suggest that all three treatment modalities are effective in chronic LBP. In patients with LBP-related impairment in functional status and quality of life, inpatient physical therapy and rehabilitation should be preferred.
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