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Introduction and hypothesis: The aim of this study is to compare the effectiveness of transcutaneous tibial nerve stimulation (TTNS) on quality of life (QoL) and clinical parameters related to incontinence in pharmacological agents (PhAs) naive and refractory women with idiopathic overactive bladder (iOAB). Methods: In this prospective nonrandomized clinical trial, women with resistance to PhAs were included in the first group (n=21), PhA-naive women were included in the second group (n=21). TTNS was performed 2 days a week, a total of 12 sessions for 6 weeks. Every session lasted 30 min. Women were evaluated for the severity of incontinence (Pad test), 3-day voiding diary (voiding frequency, nocturia, incontinence episodes, and number of pads), symptom severity (Overactive Bladder Questionnaire-V8), quality of life (Incontinence Impact Questionnaire-7), treatment satisfaction, positive response, and cure-improvement rates. Results: A statistically significant improvement was found in all parameters for each group at the 6th week compared with the baseline values (p<0.05). It was found that the severity of incontinence, incontinence episodes, symptom severity, treatment satisfaction, and QoL parameters were significantly improved in PhA-naive group compared with the PhA-resistant group at the 6th week (p<0.05). There were no statistically significant differences in the frequency of voiding, nocturia, and number of pads between the two groups (p>0.05). Positive response rates, the primary outcome measure, were statistically significantly higher in the PhA-naive group than in the PhA-resistant group. Conclusions: Although TTNS is more effective in PhA-naive women with iOAB, it appears to be an effective therapy that can also be used in the management of PhA-resistant women with iOAB. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: This study aims to compare the effectiveness of intravaginal electrical stimulation (IVES) with regard to quality of life (QoL) and clinical parameters related to incontinence in women with idiopathic overactive bladder (iOAB) naive or refractory to treatment with pharmacological agents (PhA). Methods: In this prospective trial, PhA-naive women were included in Group 1 (n = 24) and women with PhA-resistant iOAB were included in Group 2 (n = 24). IVES was performed 3 days a week, with a total of 24 sessions for 8 weeks. Every session lasted 20 minutes. Women were evaluated for the severity of incontinence (24-hour pad test), pelvic floor muscle (PFM) strength (perineometer), 3-day voiding diary (frequency of voiding, nocturia, incontinence episodes, and the number of pads), symptom severity (OAB-V8), quality of life (IIQ-7), treatment success (positive response rate), cure/improvement rate, and treatment satisfaction. Results: A statistically significant improvement was found in all parameters for each group at the 8th week compared to the baseline values (p < 0.05). At the 8th week, there were no statistically significant differences in the severity of incontinence, PFM strength, incontinence episodes, nocturia, number of pads, QoL, treatment satisfaction, cure-improvement, or positive response rates between the two groups (p > 0.05). It was found that the frequency of voiding and symptom severity parameters were significantly more improved in Group 1 than in Group 2 (p < 0.05). Conclusions: Although IVES was more effective in PhA-naive women with iOAB, it also appears to be an effective treatment in the management of women with PhA-resistant iOAB. Clinical trial registration: This study was registered with ClinicalTrials.gov under no. NCT05416450. [ABSTRACT FROM AUTHOR]

Purpose: To define transcutaneous medial plantar nerve stimulation (T-MPNS) as a new neuromodulation method and assess the efficacy of T-MPNS on quality of life (QoL) and clinical parameters associated with incontinence in women with idiopathic overactive bladder (OAB). Materials and Methods: Twenty-one women were included in this study. All women received T-MPNS. Two self-adhesive surface electrodes were positioned with the negative electrode near the metatarsal-phalangeal joint of the great toe on the medial aspect of the foot and the positive electrode 2 cm inferior-posterior of the medial malleolus (in front of the medio-malleolar-calcaneal axis). T-MPNS was performed 2 days a week, 30 minutes a day, for a total of 12 sessions for 6 weeks. Women were evaluated for incontinence severity (24-h pad test), 3-day voiding diary, symptom severity (Overactive Bladder Questionnaire [OAB-V8]), QoL (Quality of Life-Incontinence Impact Questionnaire [IIQ-7]), positive response and cure-improvement rates, and treatment satisfaction at baseline and at the 6th week. Results: Statistically significant improvement was found in the severity of incontinence, frequency of voiding, incontinence episodes, nocturia, number of pads, symptom severity, and QoL parameters at the 6th week compared with baseline. Treatment satisfaction, treatment success, and cure or improvement rates were found to be high at the 6th week. Conclusions: T-MPNS was first described in the literature as a new neuromodulation method. We conclude that T-MPNS is effective on both clinical parameters and QoL associated with incontinence in women with idiopathic OAB. Randomized controlled multicenter studies are needed to validate the effectiveness of T-MPNS. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to assess the correlations between disease specific quality of life (QoL), general health status and clinical variables in patients with ankylosing spondylitis (AS), and also to determine a cutoff value for the disease specific QoL questionnaire. Patients and methods: A total of 124 patients (80 males, 44 females; mean age 40.6±11.1 years; range, 20 to 65 years) who fulfilled the modified New York criteria for AS were included in this cross-sectional study. All patients received a comprehensive rheumatologic assessment including disease specific instruments for disease activity, functional status, spinal mobility and QoL. Furthermore, short form-36 (SF-36) was used to determine general health status. Pain levels of the patients were assessed with visual analog scale (VAS). Pearson's analysis was used to assess correlation among variables, with moderate, strong, or very strong correlations if the value was between 0.40-0.69, 0.70-0.89, and 0.90-0.99, respectively. To determine a cutoff value for the ankylosing spondylitis quality of life (ASQoL) score, the area under the receiver operating characteristic curve (AUC) was computed according to clinical parameters which have the strongest correlations with ASQoL. Results: The mean ASQoL score was 8.8±4.9. There was a significantly positive correlation between ASQoL and disease activity, functional status, spinal mobility and pain VAS whereas there was a significantly negative correlation between ASQoL and the SF-36 subscale scores except for mental health and emotional role (p<0.001). The strongest positive correlation was found between ASQoL and the Bath Ankylosing Spondylitis Disease Activity Index (r=0.721, p<0.001) whereas the strongest negative correlation was found between ASQoL and the first question of SF-36 (r=-0.844, p<0.001). A cutoff value of eight in ASQoL showed good discriminative properties for impaired QoL where sensitivity and specificity were simultaneously maximized according to disease activity (AUC=0.84 [95% confidence interval (CI): 0.770-0.908, p<0.001]) and the patients' global health status (AUC=0.85 [95% CI: 0.782-0.923, p<0.001]) in patients with AS. Conclusion: There was a strong correlation between ASQoL and disease activity as well as the patients' global health status in patients with AS. A cutoff value of eight in ASQoL could be used with good discriminative properties for impaired QoL in AS. [ABSTRACT FROM AUTHOR]

ntroduction: The aim of this study was to determine whether there is an association between fall risk measured posturographically and clinical balance tests among people who are over 65 years of age, and to identify the discriminative ability of the posturographic fall risk index. Materials and Methods: Two hundred and twenty participants who were over 65 years of age were included in the study. The balance and fall risk of participants were assessed with the Berg balance scale (BBS) and a posturography device; functional mobility with the Timed Up and Go (TUG) test; lower extremity neuromuscular function with the Chair Stand test (CST) and qual-ity of life with the Short Form-36 (SF-36). Participants were grouped into two, as fallers and non-fallers, on the basis of the past year's fall history. Results: A total of 78 participant (35.5%) had a history of falling, while 142 (64.5%) of the subjects did not. Age, TUG and posturographic fall risk index of fallers were significantly higher than for nonfallers, whilst some subgroups of the SF-36, BBS and mean CST scores were lower (p<0.05). There were negative correlations between posturographic fall risk and the BBS (r=-0.84) and CST (r=-0.40) yet a positive correlation with the TUG (r=0.67) (p<0.05). Using the agreement between the posturographic fall risk index and history of falls, the area under the ROC curve was 0.818. In this study, when the cut-off value 51< was used, sensitivity was found to be 76.9% and specificity was 73.9%, with a higher value for the Youden index: 0.508. Conclusion: It was shown that fallers had poorer balance, functional mobility, lower extrem-ity neuromuscular function and quality of life than nonfallers. The study also demonstrated that posturographically obtained fall risk was significantly correlated with clinical balance tests and had good discriminative ability to identify fallers. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate whether patients with ankylosing spondylitis (AS) have a higher fall risk than healthy subjects and to determine whether fall risk is associated with the clinical features of AS. Patients and methods: Forty AS patients (28 males, 12 females; mean age 37.20+9.92 years; range 20 to 60 years) who met the modified New York criteria and 40 age and gender-matched healthy controls were included. All participants were assessed by a static posturography device which provided numerical values in the percentage for fall risk. Patient interviews were used to assess the history of falls for the previous 12 months. The following tools were used for all AS patients: The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for disease activity, the Bath Ankylosing Spondylitis Functional Index (BASFI) for function, the Bath Ankylosing Spondylitis Metrology Index (BASMI) for spinal mobility, and the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire for quality of life. Results: There were no differences in the sociodemographic characteristics among the AS patients and the healthy controls (p>0.05). The mean fall risk was significantly higher for the AS patients compared to the controls (p<0.05). The ratio of AS patients who had a positive history of falls was significantly higher than controls (p<0.05). Fall risk was positively and significantly associated with the BASDAI (r=0.713, p<0.001), BASFI (r=0.751, p<0.001), BASMI (r=0.527, p<0.001), and ASQoL (r=0.627, p<0.001). The fall risk was not associated with the age, sex, body mass index and disease duration (p>0.05). Conclusion: Fall risk increased in patients with AS which was associated with poor spinal mobility, functional status, quality of life and higher disease activity. Increased risk of falling should be taken into consideration in the rehabilitation of the patients with AS. [ABSTRACT FROM AUTHOR]

Complex regional pain syndrome (CRPS) is a syndrome characterized by a combination of pain, trophic changes, and vasomotor disturbances. Although the case reports in the literature describing the CRPS secondary to lumbar disc herniation (LDH) are abundant, in these case reports CRPS is diagnosed in only one extremity. Based on the most recent information available, this is the first case of CRPS associated with LDH that developed in bilateral lower extremities and could be successfully treated conservatively. A 49-year-old male patient was admitted to the clinic with complaints of pain and swelling of both feet and ankles, particularly on the left side. The patient had a history of an episode of low back pain radiating down the left leg that had developed two months previously after bending and lifting. Lumbar magnetic resonance imaging showed posterocentrally- and bilateral paramedially-located L5-S1 disc protrusion. One month after the onset of low back pain, painful stiffness and swelling developed in the joints of both ankles and feet, accompanied by edema, hyperhydrosis and allodynia in the dorsum of the left foot. He did not have any history of trauma. The medical history and laboratory investigations were normal. A diagnosis of CRPS in bilateral lower extremities was confirmed by direct foot-ankle radiographs and three-phase bone scintigraphy. A comprehensive conservative treatment program consisting of drug treatment (nonsteroidal anti-inflamatory drugs, gabapentin and calcitonin), physical therapy, and rehabilitation methods consisting of active-passive range of motion exercises to both ankles with gentle stretching, desensitization activities, gait training, application of a hot pack, ultrasound and transcutaneous electrical nerve stimulation to the lumbar region were applied. The patient's symptoms were relieved by these conservative treatments in six weeks. No recurrence occurred after a follow-up of 12 months. CRPS should be considered as a cause of persistently painful and swollen bilateral lower extremities in a patient with LDH. Early, accurate diagnosis should permit initiation of appropriate treatment and increase the success of the treatment. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the efficacy of ultrasound (US) and ketoprofen phonophoresis (PH) in the treatment of carpal tunnel syndrome (CTS). Design: This study was a prospective, randomised, controlled, double-blinded clinical trial with follow-up at 8 weeks. Fiftyone patients (76 median nerves) with clinical and electrophysiologic evidence of mild or moderate CTS were included in the study. They were randomly assigned to one of three groups; group 1 received sham US and splinting, group 2 received US and splinting, and group 3 received ketoprofen phonophoresis and splinting. Patients were evaluated by use of electrophysiological variables such as median motor distal latency (mMDL), median sensory distal latency (mSDL), functional status scale (FSS), symptom severity scale (SSS) and visual analog scale (VAS). Electrophysiological variables and scales were evaluated at the beginning, end of therapy (2{nd} week) and 8{th} week. Results: All the randomised patients were included in the intention-to-treat (ITT) analysis. The per protocol (PP) analysis included only those patients who complied with the study protocol. After completing 2 weeks of treatment, seven out of 51 randomized patients did not finish the study protocol due to non-compliance to splinting, illness and lost to follow-up. Those patients were excluded from PP analysis. Participants were similar in all clinical, electrophysiological and demographic respects (p>0.05). An improvement was found in all parameters (VAS, FSS, SSS, mMDL and mSDL) for all groups at the end of the treatment and 8th week. It was found that pain score was significantly lower in group 3 compared to other treatment groups at 8{th} week according to ITT and PP analysis (p= 0.002, p=0.004 and p=0.001, p=0.001). Conclusion: Ketoprofen PH as adjuvant therapy on splinting is effective with respect to reduction of pain. Adding US therapy to the splinting is not superior to the splinting alone in patients with CTS. [ABSTRACT FROM AUTHOR]

The aims of this study were to assess the health-related quality of life (HRQoL) in patients with knee osteoarthritis (OA) using the Nottingham Health Profile (NHP) and to determine its relationships with conventional clinical measures and self-reported disability. One hundred and forty patients with knee OA (104 female, 36 male, mean age 59.39 ± 7.62 years, mean disease duration 58.56 ± 56.78 months) and 40 sex and age-matched controls were included in the study. HRQoL, disability and pain were assessed using NHP, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS), respectively. Results showed that the six subgroups of the NHP revealed higher scores in the knee OA patients compared with controls ( p < 0.001). All subgroups of the NHP significantly correlated to VAS-rest, VAS-activity, 15-m walk test and WOMAC scores ( p < 0.05, p < 0.01, p < 0.005, p < 0.001, respectively). The knee flexion or restricted extension range of motion was significantly correlated with the pain, energy and physical mobility subgroups of the NHP ( p < 0.05, p < 0.005). Although there were statistically significant correlations between the NHP pain, emotional reaction, and physical mobility subgroup scores and body mass index (BMI) ( p < 0.01, p < 0.05, p < 0.05, respectively), there were no correlations between all the NHP scores and duration of disease ( p > 0.05). We conclude that patients with knee osteoarthritis undergo a significant impact on multiple dimensions of HRQoL, compared with healthy controls. The NHP is related to the clinical status and functional ability of patients with knee OA, and it can be used as a sensitive health status measure for clinical evaluation. [ABSTRACT FROM AUTHOR]

The objective is to report a patient with concomitant ankylosing spondylitis (AS) and Behçet’s disease (BD) successfully treated with adalimumab. A 44-year-old male diagnosed as AS applied to our outpatient clinic with complaints of morning stiffness, pain and limitation of motion at spine, concurrence of oral and genital ulcerated lesions. He was on sulfasalazine together with different NSAIDs for the past 1 year. According to the criteria of International Study Group, he was diagnosed as BD. The patient was considered as refractory to current treatment and adalimumab treatment was started. During follow-up, not only AS was in remission, but also no new oral and genital ulcerations appeared. There were no complications related to the use of anti-TNFα therapy. In our case it was observed that anti-TNFα therapy, specifically adalimumab, was effective for symptoms of both AS and BD. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of therapeutic exercises alone and in combination with a single physical agent - ultrasound - in patients with lumbar spinal stenosis. Design: Randomized, prospective, controlled trial. Setting: Department of Physical Medicine and Rehabilitation, University Hospital. Subjects: Forty-five patients presenting with symptoms of neurological claudication and magnetic resonance image-proven lumbar spinal stenosis were assigned to one of three groups: ultrasound plus exercise group (group 1, n = 15), sham ultrasound plus exercise group (group 2, n = 15) and no exercise - no treatment group (control group, n = 15). Interventions: Stretching and strengthening exercises for lumbar, abdominal, leg muscles as well as low-intensity cycling exercises were given as therapeutic exercises. Ultrasound was applied with 1 mHz, 1.5W/cm² intensity, in continuous mode on the back muscle for 10 minutes in group 1 while ultrasound on/off mode was applied in group 2. Main outcome measures: Before and after a three-week period, all subjects were evaluated by pain, disability, functional capacity and consumption of analgesic. Results: Thirty-two of the participants were women and 13 were men, with an average age of 53.2 ± 12.68 years (range 25-82 years). After a three-week treatment period, leg pain decreased in group 1 (-1.47 ± 3.02) and group 2 (-2.47 ± 3.75) compared with the control group (P<50.05). Disability score decreased in group 1 (-3.94 ±7.20) and group 2 (-7.80 ± 10.26) compared with control group (P<50.05). We did not find any statistically significant difference between groups 1 and 2 (P<40.05). The amount of analgesic consumption is significantly less in the group with ultrasound application compared to that in the control group (P>50.05). Conclusion: The results of our study suggest that therapeutic exercises are effective for pain and disability in patients with lumbar spinal stenosis and that addition of ultrasound to exercise therapy lowers the analgesic intake substantially. [ABSTRACT FROM AUTHOR]

• Percutaneous tibial nerve stimulation (PTNS) and transcutaneous tibial nerve stimulation (TTNS) were more effective than bladder training alone in women with idiopathic overactive bladder. • These 2 tibial nerve stimulation methods had similar clinical efficacy. • TTNS has shorter preparation time, less discomfort level and higher patient satisfaction than PTNS. Different studies have reported the efficacy of percutaneous tibial nerve stimulation (PTNS) and transcutaneous tibial nerve stimulation (TTNS) in treating idiopathic overactive bladder (OAB). However, no study has compared the effectiveness of PTNS and TTNS added to bladder training (BT) in idiopathic OAB. To compare the efficacy of PTNS and TTNS added to BT in women with idiopathic OAB. We randomised 60 women with idiopathic OAB into 3 groups. Group 1 (n = 19) received BT, Group 2 (n = 19) received PTNS in addition to BT, and Group 3 (n = 20) received TTNS in addition to BT. PTNS and TTNS were performed 2 days a week, for 30 min a day, for a total of 12 sessions for 6 weeks. Patients were evaluated by incontinence severity (pad test), a 3-day voiding diary (frequency of voiding, incontinence episodes, nocturia and number of pads used), symptom severity, quality of life, treatment success (positive response rate), treatment satisfaction (Likert scale), discomfort level and preparation time for stimulation (sec). At the end of treatment; severity of incontinence, frequency of voiding, incontinence episodes, nocturia, number of pads used, symptom severity and quality of life were significantly improved in Groups 2 and 3 versus Group 1 (P < 0.0167). Treatment success and treatment satisfaction were higher in Groups 2 and 3 than Group 1 (P < 0.001 and P < 0.0167, respectively). Level of discomfort was lower, treatment satisfaction was higher and preparation time for stimulation was shorter in Group 3 than Group 2 (P < 0.05). Both the PTNS plus BT and TTNS plus BT were more effective than BT alone in women with idiopathic OAB. These 2 tibial nerve stimulation methods had similar clinical efficacy but with slight differences: TTNS had shorter preparation time, less discomfort level and higher patient satisfaction than PTNS. [ABSTRACT FROM AUTHOR]

Introduction: Medial antebrachial cutaneous nerve (MACN) neuropathy is reported to be caused by iatrogenic reasons. Although the cases describing the posterior branch of MACN neuropathy are abundant, only one case caused by lipoma has been found to describe the anterior branch of MACN neuropathy in the literature. As for the reason for the forearm pain, we report the only case describing isolated anterior branch of MACN neuropathy which has developed due to repeated minor trauma. Case presentation: We report a 37-year-old woman patient with pain in her medial forearm and elbow following the shaking of a rug. Pain and symptoms of dysestesia in the distribution of the right MACN were found. Electrophysiological examination confirmed the normality of the main nerve trunks of the right upper limb and demonstrated abnormalities of the right MACN when compared with the left side. Sensory action potential (SAP) amplitude on the right anterior branch of the MACN was detected to be lower in proportion to the left. In the light of these findings, NSAI drug and physical therapy was performed. Dysestesia and pain were relieved and no recurrence was observed after a follow-up of 14 months. Conclusion: MACN neuropathy should be taken into account for the differential diagnosis of the patients with complaints of pain and dysestesia in medial forearm and anteromedial aspect of the elbow. [ABSTRACT FROM AUTHOR]

Aim To identify physical, cognitive, and metabolic factors affecting gait speed in patients with type-2 diabetes mellitus (T2DM) without neuropathy. Methods This cross-sectional study enrolled 71 diabetic patients without neuropathy (mean age 55.87 ± 7.74 years, 85.9% women). Neuropathy status was assessed with Douleur Neuropathique 4. We used a cut-off point for gait speed of 1 m/s to classify the participants into two groups: slow walkers (SW) and average and brisk walkers (ABW). The groups were compared in terms of age, sex, body mass index (BMI), hemoglobin A1c (HbA1c), fasting glucose, systolic blood pressure, maximal aerobic capacity (VO2 max), percentage of muscle mass, percentage of lower extremity muscle mass, Mini-Mental State Examination (MMSE) score, and years of education. Results Compared with the ABW group, the SW group had significantly lower VO2max (14.49 ± 2.95 vs 16.25 ± 2.94 mL/kg/min) and MMSE score (25.01 ± 3.21 vs 27.35 ± 1.97), fewer years of education, and these patients were more frequently women (P < 0.05). In the multivariate regression models, the combination of VO2 max, sex, and MMSE score explained only 23.5% of gait speed (P < 0.001). MMSE score and VO2 max independently determined gait speed after adjustment for age, BMI, HbA1c, fasting glucose, systolic blood pressure, percent of muscle mass, percent of lower extremity muscle mass, and years of education. Conclusion In diabetic patients without neuropathy, physical impairment and disability could be prevented by an improvement in aerobic capacity and cognitive function. [ABSTRACT FROM AUTHOR]

Objective: Penile vibratory stimulation is the first treatment option for anejaculation in men with spinal cord injury. It has been postulated that it also has an antispasticity effect. The purpose of this study was to determine the effect of penile vibratory stimulation on spasticity in patients with spinal cord injury. Design: Ten male patients with spinal cord injury were included in the study. They were examined at the baseline and 3, 6, 24, and 48 hrs later. After their baseline examination, they performed penile vibratory stimulation. The outcome variables were spasticity (Ashworth scale), spasm frequency, spasm severity, painful spasms, plantar stimulation response, deep tendon reflexes, clonus, and effect on function. Results: Ashworth grade showed a statistically significant decrease at hour 3 and hour 6 examinations (P = 0.001 and P = 0.03, respectively, with Tukey test). The patients showed a tendency toward having less frequent and less severe spasms throughout the study; however, it did not reach to a significant level. Similarly, clonus showed a nonsignificant decrease during follow-up examinations. The other variables did not change considerably. Conclusions: Penile vibratory stimulation may contribute to the relief of the spasticity in men with spinal cord injury, in treating spasticity, all the factors that increase or decrease the tone should be considered. [ABSTRACT FROM AUTHOR]

BACKGROUND: Myofascial pain syndrome (MPS) which is an important cause of musculoskeletal pain has shown a dramatic increase in recent years. OBJECTIVES: We aimed to evaluate the efficacy of intramuscular electrical stimulation therapy (IMS) and low-level-laser-therapy (LLLT) in patients with MPS. METHODS: Patients were randomly divided into three groups. First group were treated with LLLT and stretching exercise. Second group were treated with IMS and stretching exercise. Third group were treated with only stretching exercise. The patients were evaluated through the pain intensity, pain threshold, cervical joint movement range and the neck disability index parameters. RESULTS: An improvement was found in all parameters for all groups, except for the pain threshold within the control group at the end of the treatment and one month after the treatment. It was found that pain score was significantly lower in Group 1 and 2 at one month after the treatment compared to Group 3. Similarly, it was found that pain threshold score was significantly higher in Group 2 at one month after the treatment compared to Group 3. CONCLUSIONS: In this study we observed that both LLLT and IMS treatments added on to stretching are effective in improving pain parameters in patients with MPS. [ABSTRACT FROM AUTHOR]

In this study, the bladder emptying methods at different stages of the post-stroke period along with the effects of demographic and clinical parameters on spontaneous voiding frequency were investigated. The frequencies of bladder emptying methods at admission to the rehabilitation clinic, after neurourological and urodynamic assessment and at home after discharge were spontaneous voiding (SV) 51/99 (51.5 %), 62/99 (62.6 %), 73/99 (73.7 %), emptying without a urinary catheter + an external collector system (EWUC + ECS) 24/99 (24.2 %), 18/99 (18.2 %), 17/99 (17.2 %), intermittent catheterization (IC) 1/99 (1.0 %), 15/99 (15.2 %), 6/99 (6.1 %), indwelling urethral catheter (IUC) 23/99 (23.2 %), 4/99 (4.0 %) and 3/99 (3.0 %), respectively. Lower spontaneous voiding frequencies were observed in single-divorced and geriatric individuals ( p < 0.05). The number of patients who modified the method at home was 2/62 for SV, 5/18 for EWUC + ECS, 9/15 for IC, and 2/4 for IUC. The majority of stroke patients were able to void spontaneously and the spontaneous voiding frequency increased at follow-up. The spontaneous voiding frequency was low in geriatric and single-divorced subgroups. The method in which the most changes occurred was IC. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to compare the efficacy of mature mud pack and hot pack therapies on patients with knee osteoarthritis. Design: This study was designed as a prospective, randomized-controlled, and single-blinded clinical trial. Twenty-seven patients with clinical and radiologic evidence of knee osteoarthritis were randomly assigned into two groups and were treated with mature mud packs (n 15) or hot packs (n=12). Patients were evaluated for pain [based on the visual analog scale (VAS)], function (WOMAC, 6 min walking distance), quality of life [Short Form-36 (SF-36)], and serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and insulin-like growth factor-1 (IGF-1) at baseline, post-treatment, and 3 and 6~months after treatment. Results: The mud pack group shows a significant improvement in VAS, pain, stifness, and physical function domains of WOMAC. The difference between groups of pain and physical activity domains is significant at post-treatment in favor of mud pack. For a 6 min walking distance, mud pack shows significant improvement, and the difference is significant between groups in favor of mud pack at post-treatment and 3 and 6 months after treatment. Mud pack shows significant improvement in the pain subscale of SF-36 at the third month continuing until the sixth month after the treatment. Significant improvements are found for the social function, vitality/energy, physical role disability, and general health subscales of SF-36 in favor of the mud pack compared with the hot pack group at post-treatment. A significant increase is detected for IGF-1 in the mud pack group 3 months after treatment compared with the baseline, and the difference is significant between groups 3 months after the treatment. Conclusion: Mud pack is a favorable option compared with hotpack for pain relief and for the improvement of functional conditions in treating patients with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to compare the efficacy of mature mud pack and hot pack therapies on patients with knee osteoarthritis. Design: This study was designed as a prospective, randomized-controlled, and single-blinded clinical trial. Twenty-seven patients with clinical and radiologic evidence of knee osteoarthritis were randomly assigned into two groups and were treated with mature mud packs (n 15) or hot packs (n=12). Patients were evaluated for pain [based on the visual analog scale (VAS)], function (WOMAC, 6 min walking distance), quality of life [Short Form-36 (SF-36)], and serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and insulin-like growth factor-1 (IGF-1) at baseline, post-treatment, and 3 and 6~months after treatment. Results: The mud pack group shows a significant improvement in VAS, pain, stifness, and physical function domains of WOMAC. The difference between groups of pain and physical activity domains is significant at post-treatment in favor of mud pack. For a 6 min walking distance, mud pack shows significant improvement, and the difference is significant between groups in favor of mud pack at post-treatment and 3 and 6 months after treatment. Mud pack shows significant improvement in the pain subscale of SF-36 at the third month continuing until the sixth month after the treatment. Significant improvements are found for the social function, vitality/energy, physical role disability, and general health subscales of SF-36 in favor of the mud pack compared with the hot pack group at post-treatment. A significant increase is detected for IGF-1 in the mud pack group 3 months after treatment compared with the baseline, and the difference is significant between groups 3 months after the treatment. Conclusion: Mud pack is a favorable option compared with hotpack for pain relief and for the improvement of functional conditions in treating patients with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Introduction: To determine the relationship between vitamin-D (vitD) levels and balance, fall risk, functional mobility, lower extremity neuromuscular function and quality-of-life and to examine short-term effects of vitD replacement in the elderly. Materials and Method: 100 people 65 years and older, who were able to communicate and stand independently were included in the study. They were grouped according to serum 25- hydroxy-vitD levels as low (<20ng/ml) or normal (≤20ng/ml) vitD levels. The two groups were compared for balance and fall risk; with posturography and Berg balance scale (BBS), functional mobility;with Timed-Up and Go Test (TUG), lower extremity neuromuscular function; with Chair Stand Test (CST) and quality-of-life; with Short-Form-36 (SF-36). 150.000 units of cholecalciferol was administered orally to vitD deficient group and the parameters were reevaluated after one month. Results: Vitamin D levels were measured as low in 78 and as normal in 22 of the 100 subjects. Body mass index, parathormone (PTH) levels and mean TUG scores were higher in vitD deficient group while mean score of CST was lower (p<0.05). After replacement therapy, there was a significant decrease in fall risk, PTH levels and TUG scores and a significant increase was found in BBS scores and physical function and physical role subgroup scores of SF-36 in the vitD deficient group (p<0.05). Conclusion: Vitamin D deficiency is highly encountered among people 65 years and older. Replacement therapy could be effective in improvement of balance, functional mobility, lower extremity neuromuscular function and quality-of-life related with physical functions for people with low vitD levels. [ABSTRACT FROM AUTHOR]