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Aim: Shoulder pain and disability is a complication that can be seen frequently after implantable cardioverter defibrillator (ICD) implantation. The aims of this study were to determine the causes of shoulder problems and related factors in patients with ICD implantation and to investigate the effects of shoulder problems on quality of life and psychological status. Material and Methods: A total of ninety-four consecutive patients (average age 59.38±10.75 years) who admitted to ICD follow up clinic were included in the study. Patients who had shoulder problems were referred to our physical therapy and rehabilitation outpatient clinic for further evaluation. The Shoulder Pain and Disability Index (SPADI), Short Form-36 (SF-36) and The Hospital Anxiety and Depression Scale (HADS) were used as the clinical assessment scales. Results: Thirty-nine (41.5%) patients had shoulder complaints. The patients were divided into two groups according to presence of shoulder problem. The statistical analysis revealed no significant differences between the groups in terms of the socio-demographic and clinical characteristics. None of these characteristics was demonstrated as a risk factor for the development of shoulder problem (p>0.05). There were significantly lower SF-36 subgroup scores and higher HADS depression and anxiety scores in patients with shoulder complaints. The SPADI scores also showed significant correlations with shoulder pain VAS score, several subgroups of SF-36 and HADS scores (p<0.05). Conclusion: Our study revealed that patients with shoulder complications had decreased quality of life and deteriorated psychological status. In patients with ICD, awareness should be increased in terms of shoulder problems and appropriate management strategies should be determined. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate the effects of complex decongestive therapy (CDT) on upper extremity functions, the severity of pain, and quality of life. We also searched the impact of the sociodemographic and clinical characteristics on the improvement in upper extremity functions. Methods: A total of 37 women with breast cancer-related lymphedema (BCRL) [age, 53.6 ± 11.2 (28–72)] were included in this study. All patients underwent CDT-phase 1 program, including meticulous skin care, manual lymphatic drainage, remedial exercises, and compression bandages. Arm volume was calculated by a formula for truncated cone using circumferential measurements. A baseline questionnaire, including sociodemographic and clinical properties, was used for each patient. Short Form-36 (SF-36), Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and Visual Analog Scale (VAS) for pain and heaviness were used as clinical assessment scales. Results: The mean of the posttreatment volume of the affected limb was lower compared to pretreatment volume (2741.81 ± 696.85 and 2990.67 ± 745.49, respectively), and the mean percentage change in edema volume was 38.1% ± 26.5%. We observed a statistically significant reduction in pain and heaviness VAS scores and improvement of shoulder mobility among upper extremities with lymphedema (p < 0.001) after CDT. The mean of posttreatment DASH score was lower compared to pretreatment score (37.19 ± 16.01, 49.81 ± 18.84, respectively, p < 0.001). All subgroups of the SF-36 parameters were increased after the CDT application (p < 0.01). Besides being under 65 years old, having a body mass index above 30 and short duration of lymphedema were found to be related to greater improvement in upper extremity functions. Conclusions: CDT provides enhancement of upper extremity functions and quality of life in patients with BCRL. The reduction in lymphedema volume, pain, and heaviness and the improvement in shoulder mobility may be the contributed factors. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIM: In patients diagnosed with coronary artery disease (CAD), we aimed to determine the characteristics and risk factors of co-occurring musculoskeletal pain and examine its effects on functional capacity, psychological status and health-related quality of life. PATIENTS AND METHODS: A total of 100 patients with (n = 50) and without (n = 50) musculoskeletal pain were enrolled. All patients were assessed on sociodemographic and clinical properties. The Duke Activity Status Index (DASI), the Hospital Anxiety and Depression Scale (HADS) and the Short Form-36 (SF-36) were applied as clinical assessment scales. RESULTS: Patients with musculoskeletal pain were mostly female, and had a lower education level and annual income. The pain was mostly nociceptive, intermittent, sharp/stabbing in character, and located in the chest and spine. Having musculoskeletal pain resulted in lower levels on the DASI and all subgroups of the SF-36, and higher levels on the HADS. Female gender, lower education level and severity of emotional distress proved to be independent risk factors for the development of musculoskeletal pain. CONCLUSIONS: In CAD, the co-occurrence of musculoskeletal pain leads to a further decrease in health-related quality of life and functional status, and increased severity of anxiety and depression. This stresses the importance of the detection and optimal treatment of musculoskeletal pain in patients diagnosed with CAD. [ABSTRACT FROM AUTHOR]

[Purpose] Early admission to inpatient rehabilitation is critical for reducing post-stroke disability. Assessing admission timing and other trends in inpatient rehabilitation are essential for improving health outcomes. This study is the first to evaluate the timing of admission of stroke patients to inpatient rehabilitation in Turkey. [Subjects and Methods] We retrospectively analyzed acute stroke survivors who were admitted to the inpatient rehabilitation program in the Ministry of Health, Ankara Physical Medicine and Rehabilitation Training and Research Hospital between January 2009 and December 2010. [Results] The mean onset of inpatient rehabilitation was 9.8 ± 6.7 weeks post-stroke in the entire cohort. Occurrence of ischemic stroke and undergoing acute stroke care at a teaching hospital were most strongly associated with early admission. These results did not change after multivariate analysis. [Conclusion] Turkish stroke survivors begin inpatient rehabilitation later than patients in other countries. The type of stroke and type of hospital in which the patient undergoes acute stroke treatment affects early admission.

This study evaluated cardiopulmonary and metabolic responses to maximum exercise and aerobic capacity in hemiplegic patients and clarified the relationship between the resulting data and motor disability. Twenty patients with stroke and fifteen healthy controls were included in the study. Cardiopulmonary and metabolic responses to maximum exercise were investigated with an electronically braked arm crank ergometer. Vital capacity, forced expiratory volume in 1 second, peak expiratory flow rate, forced vital capacity, maximum voluntary ventilation, peak power output, respiratory exchange ratio, and exercise time were reduced in stroke patients when compared with the controls. No relationship was found between these data and motor disability. The hemiplegic patients showed a significant respiratory dysfunction and reduced exercise tolerance. These findings suggest that a program of ventilatory and aerobic training should be considered early after stroke to avoid cardiorespiratory problems and deconditioning.