BackgroundHeadache is a leading disabler in adults worldwide. In children and adolescents, the same may be true but the evidence is much poorer. It is notable that published epidemiological studies of these age groups have largely ignored headaches not fulfilling any specific set of ICHD criteria, although such headaches appear to be common. A new approach to these is needed: here we introduce, and investigate, a diagnostic category termed “undifferentiated headache” (UdH), defined in young people as recurrent mild-intensity headache of < 1 h’s duration.MethodsWe conducted a nationwide cross-sectional survey in 31 schools in six regions of Turkey selected by mixed convenience-based and purposive modified cluster-sampling. A validated, standardised self-completed structured questionnaire was administered by a physician-investigator to entire classes of pupils aged 6–17 years.ResultsOf the identified sample of 7889 pupils, 7088 (89.8%) participated. The 1-year prevalence of UdH was 29.2%, of migraine (definite and probable) 26.7%, and of tension-type headache (TTH) (definite and probable) 12.9%. UdH differed with respect to almost all headache features and associated symptoms from both migraine and TTH. Burden of headache and use of acute medication were lower in UdH than in migraine and TTH. Headache yesterday was less common in UdH than migraine (OR 0.32; 95% CI 0.28–0.37) and TTH (OR 0.64; 95% CI 0.56–0.77). Quality of life (QoL) was better in UdH (33.6 ± 5.2) than in migraine (30.3 ± 5.6; p < 0.001) and TTH (32.4 ± 5.3; p < 0.001), but worse than in pupils without headache (35.7 ± 4.7; p < 0.001).ConclusionsThis large nationwide study in Turkey of pupils aged 6–17 years has shown that many children and adolescents have a headache type that does not conform to existing accepted diagnostic criteria. This new diagnostic category of presumably still-evolving headache (undifferentiated headache) is common. UdH differs in almost all measurable respects from both migraine and TTH. Although characterised by mild headaches lasting < 1 h, UdH is associated with significant adverse impact on QoL. Longitudinal cohort studies are needed to evaluate the prognosis of UdH but, meanwhile, recognition of UdH and its distinction from migraine and TTH has implications for epidemiological studies, public-health policy and routine clinical practice.

Due to the coronavirus disease-2019 (COVID-19) pandemic, there have been major changes in the way almost every business works. This study examines the relationship between the changing working conditions [working from home (WFH)] related to COVID-19 on low back pain (LBP) and the associated kinesiophobia, disability, physical activity, and job satisfaction. Material and Methods: One-hundred-one white-collar workers who were WFH were included in the study, and demographic characteristics, presence of LBP, and other musculoskeletal disorders were questioned. Numerical Rating Scale for low-back pain and other musculoskeletal pain, Oswestry Disability Index (ODI) for determination of disability level, Tampa Scale of Kinesiophobia (TSK) for the presence of kinesiophobia, International Physical Activity Questionnaire (IPAQ)for physical activity level, and Utrecht Work Engagement Scale-6 (UWES-6) questionnaire for job satisfaction were applied via an online survey. Results: Of the participants 56.4% had LBP. The most common musculoskeletal disease following LBP was neck pain and/or dorsalgia (39.6%). The ODI (p<0.001), TSK (p <0.001) and the presence of kinesiophobia (p=0.016) were higher in participants with LBP. LBP was positively correlated with the ODI and TSK (r=0.489; p=<0.001, r=0.409; p=<0.001), and the other musculoskeletal pain has a positive correlation with the ODI (r=0.228; p=0.023). No relationship was found between UWES-6 and IPAQ with LBP. Conclusion: During the COVID-19 pandemic, white-collar workers WFH with LBP experience higher kinesiophobia and disability. Disability is increasing with LBP level and other musculoskeletal disease pain level. There was no relationship between the presence of LBP with job satisfaction and physical activity level.

Objectives:This study aims to identify the relationship between balance and sagittal spinopelvic alignment (SSA) in ankylosing spondylitis (AS) and compare patients with or without lumbopelvic mismatch in terms of balance. Patients and methods: We enrolled 41 patients (22 males, 19 females; mean age 41.3±8.9 years; range 21 to 57 years) into the study. SSA was evaluated measuring thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt and pelvic incidence on lateral standing X-rays of the whole spine including the femoral heads. Patients were grouped according to presence of lumbopelvic mismatch (lumbar lordosis-pelvic incidence >10 o ). Clinical parameters including age, body mass index, pain (Visual Analog Scale), disease activity (Bath Ankylosing Spondylitis Disease Activity Index), and disease duration were recorded. Posture was evaluated measuring tragus-to-wall distance, modified Schober's test and chest expansion. A computerized pressure plate system (NeuroCom Balance Master®) was used for evaluating static and dynamic balance. Correlations between SSA parameters and balance were analyzed. Patients with or without lumbopelvic mismatch were compared in terms of balance. Results: Patients took shorter steps, as thoracic kyphosis increased and sacral slope decreased (r= -0.391, p=0.012; r=0.344, p=0.028). Patients with lumbopelvic mismatch had significantly higher sway velocity on firm base with eyes closed and on foam base when the eyes open and closed . They also walked more slowly compared to patients without lumbopelvic mismatch (p>0.05). Conclusion: Lumbopelvic mismatch impaired both static and dynamic balance, while increased thoracic kyphosis and decreased sacral slope impaired only the dynamic balance in patients with AS. Further studies with larger sample size and longer follow-ups need to be conducted to identify the mechanism of spinal deformities and balance disorders in patients with AS.

Bilgilendirme broşürleri işlem öncesi anksiyete seviyesi ve transforaminal epidural steroid enjeksiyonu sonrası akut ağrı düzeyini etkiler mi? Prospektif randomize kontrollü bir çalışma