Objectives:To assess the feasibility and safety of an 8-week multimodal pulmonary rehabilitation (PR) program in adults with radiographic axial spondyloarthritis (r-axSpA) and to describe exploratory pre- to post-intervention changes in clinical outcomes. Patients and Methods:This prospective, single-center, single-arm pilot feasibility study enrolled 20 adults with stable r-axSpA. The program included two supervised hospital sessions and one structured home session per week for 8 weeks, combining aerobic conditioning, resistance and mobility exercises, and respiratory exercises. Primary outcomes were assessment retention, supervised-session attendance, and adverse events. Clinical measures were exploratory and included 6-minute walk distance (6MWD), dyspnea, spirometry, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index, Hospital Anxiety and Depression Scale, and Turkish 36-Item Short Form Health Survey. Results:Seventeen of 20 participants completed the full week 8 assessment (assessment retention 85%). Median supervised attendance was 14 of 16 planned sessions (87.5%), and no serious adverse events were recorded. The mean 6MWD change was +25.7 m [95% confidence interval (CI): 20.0 to 32.5]. The Borg dyspnea score changed by -0.7 (95% CI: -0.9 to -0.5), and BASDAI changed by -0.41 (95% CI: -0.76 to -0.14). Nominal improvements were also observed in selected spirometric and psychosocial measures. Conclusion:The multimodal PR program was feasible and safely deliverable in this small cohort. Because the study utilized a single-arm design, included participants with low baseline dyspnea, and was not powered to test effectiveness, the observed clinical changes are strictly hypothesis-generating. These findings do not establish clinically meaningful benefit but provide a strong rationale and foundational metrics for designing adequately powered, randomized controlled trials with objective adherence monitoring.
Objectives:The Semmes-Weinstein monofilament (SWM) test is commonly used to evaluate tactile sensation in individuals with neurological or orthopedic conditions. This study aimed to examine practitioner-related factors affecting SWM testing, particularly focusing on adherence to protocol guidelines and the accuracy of force-controlled application, and to assess the intra-rater reliability of the measurements obtained. Patients and Methods:Fifty-three inexperienced occupational therapists, trained in SWM application, participated in the study. Standardized tests were conducted using three monofilaments (4.31/2 g, 4.56/4 g, 5.07/10 g). A specialized instrument measurement system recorded maximum buckling forces (Max F), contact durations (T), and intervals between applications (L). Participants applied each filament perpendicularly to the sensor three times consecutively with 1.5-second intervals. Intrarater reliability was assessed using the intraclass correlation coefficient (ICC). Results:None of the participants achieved the exact prescribed buckling forces. Significant differences were observed between the prescribed buckling forces, application times, and intervals (p<0.05). However, each participant showed consistency across repeated trials (p>0.05). ICCs indicated good-to-excellent reliability for Max F, T, and L. Conclusion:Most errors in SWM testing were due to incorrect buckling force and failure to adhere to application timing. Future research should focus on improving practitioner training and minimizing variability in SWM test performance.
Objectives:In this study, we aimed to investigate the effectiveness of dry needling (DN) in addition to conventional physical therapy and rehabilitation (PTR) program in patients with supraspinatus tendinopathy presenting with shoulder pain. Patients and Methods:Our study was designed as a single-center, prospective, observational study. Between November 2023 and January 2024, 64 patients diagnosed with supraspinatus tendinopathy were included in our study. The patients were divided into two groups: group 1, in which DN and conventional PTR program were applied together, and group 2, in which only conventional PTR program was applied. Primary endpoint of our study was shoulder pain [visual analog scale (VAS)] and secondary outcome measurements were shoulder pain and disability index (SPADI), passive shoulder range of motion (ROM), handgrip (HG) strength, Tampa kinesiophobia scale (TKS), supraspinatus tendon and muscle thickness. These parameters were evaluated at the beginning, 1st and 3rd months. Independent sample t-test, and Mann-Whitney U test, Kruskal-Wallis H test were used to compare quantitative data. Two-way ANOVA test was used for repeated measurements of the participants. Results:Significant improvements were observed over time in both treatment groups in pain level, ROM, functional capacity, and other parameters. Patients in group 1 had a statistically significant increase in passive shoulder ROM, muscle thickness and tendon thickness in patients with partial tear at 3 months compared to pre-treatment (all p<0.05). There was a significant decrease in VAS scores, SPADI scores, and TKS scores in favor of group 1 (all p<0.05). There was a statistically significant increase in HG strength scores at 3rd month in favor of group 1 compared to 1st month (p=0.029). There was also a statistically significant increase in supraspinatus tendon thickness in partial tear patients in group 1 (p<0.001). Conclusion:We think that the addition of DN to the conventional PTR program in treatment of patients with supraspinatus tendinopathy is beneficial in terms of both pain and functionality until the 3rd month after treatment.
Lumbar epidural steroid injections (ESI) are frequently used to treat radicular pain; however, various early and late complications, such as steroid-induced osteoporosis and fracture risk, have been reported. This case report describes a 77-year-old male patient who developed a femoral neck fracture two hours after transforaminal ESI. The patient presented with acute pain and difficulty walking shortly after discharge. Radiographic evaluation confirmed the femoral neck fracture, and total hip arthroplasty was performed. This rare case highlights the importance of assessing osteoporosis and fracture risk in elderly patients.
Objectives:This study aimed to determine the messenger ribonucleic acid (mRNA) expression levels of interleukin (IL)-1α, IL-1β, IL-6, IL-17, and A Disintegrin and Metalloproteinase with Thrombospondin Motifs (ADAMTS) -5 in an acute ischemia/reperfusion (I/R)-induced pressure ulcer (PU) model, in order to characterize the early inflammatory cytokine profile and explore the potential role of ADAMTS-5 in extracellular matrix (ECM) remodeling. Patients and Methods:Ten BALB/c mice were randomly allocated to control and PU groups. Acute PUs were generated on the dorsal skin using a repeated I/R protocol achieved with ceramic magnetic plaques. Skin biopsies obtained from ulcerated and control areas were examined histologically using hematoxylin-eosin staining. mRNA expression levels of IL-1α, IL-1β, IL-6, IL-17, and ADAMTS-5 were analyzed by quantitative real-time PCR and compared statistically between groups. Results:Compared with controls, mRNA expression levels of IL-1α, IL-6, IL-17, and ADAMTS-5 were significantly increased in the PU group (p<0.05). In contrast, IL-1β expression showed an increase that did not reach statistical significance. Conclusion:These findings indicate that proinflammatory cytokines and ADAMTS-5 are activated early during PU formation following I/R injury. The observed upregulation of ADAMTS-5, a molecule that has been rarely examined in PU models, suggests a possible role for early ECM degradation in ulcer development. Further experimental and clinical studies are warranted to clarify the relevance of these pathways for PU progression and targeted local therapies.
