Amaç: Diş hekimlerinde çalışma yılı, çalışma yerine ve egzersiz yapma alışkanlığına göre kas iskelet sistemi problemlerini incelemektir. Gereç ve Yöntem: Çalışmaya 203 çalışan diş hekimi dahil edildi. Bireyler çalışma yılları

BACKGROUND:Joint position sense (JPS) deficits and pain are among symptoms observed in patients with chronic neck pain (CNP). OBJECTIVE:To examine the effects of immersive virtual reality (VR) and cervical mobilization (CM) on JPS and pain in patients with CNP. METHODS:This randomized controlled study included 45 patients with CNP, aged 18 to 65. Patients were divided into three groups: VR+traditional exercise, CM+traditional exercise, and traditional exercise alone. The primary outcomes were JPS and pain. The secondary outcomes were balance, functional disability, global perceived effect, and quality of life. Balance outcomes included baropodometric outcomes, 10-meter walking test, four-square step test, and single leg stance test. All patients completed 10 treatment sessions, with outcomes measured before and after the intervention. RESULTS:There were no statistically significant additional effects of VR or CM on improving JPS or pain relief when added to traditional exercises (p > 0.05). The changes in all balance outcomes, functional disability, and global perceived effect were also similar for the three groups (p > 0.05). The combination of CM or VR and traditional exercises resulted in greater improvement in social function quality of life compared to traditional exercises alone (MD = 21.15, 95 % CI: 9.46, 32.85, Cohen's d = 1.52). CONCLUSION:The addition of VR or CM to traditional exercises offers no additional benefits for JPS, pain, balance, and function, for individuals with CNP.

Purpose: To compare the prevalence of musculoskeletal disorders, psychosocial health problems, and body awareness among dental professionals and students. Material and Methods: A total of 443 participants were included: 154 first-year dental students (Group I, mean age = 18.66 +/- 0.95), 148 senior dental students (Group II, 22.66 +/- 1.25), and 141 working dentists (Group III, 35.63 +/- 9.44). Participants completed the Nordic Musculoskeletal Questionnaire (NMQ), Neck Disability Index (NDI), Oswestry Disability Index (ODI), Hospital Anxiety-Depression Scale, Tampa Scale of Kinesiophobia, Nottingham Health Profile (NHP), and Body Awareness Questionnaire (BAQ). Results: NDI and BAQ scores were lower in Group I than in Groups II and III (p <.05). ODI was higher in Group III. NMQ-neck pain differed between Groups I-II and I-III (p <.05), while NMQ-low back pain differed between Groups II-III (p =.004). NHP scores were better in Group III. Conclusion: Neck pain is a musculoskeletal problem that should not be overlooked in the early academic years, whereas low back pain tends to emerge during later professional practice. As musculoskeletal problems among dentists increase over time, the concurrent increase in body awareness is a noteworthy finding. Further studies are warranted to explore this relationship in greater detail.

AIM: To examine the clinical characteristics and early rehabilitation results and to investigate the relationship between rehabilitation initiation time and rehabilitation-related outcome measurements in traumatic brain injury (TBI) patients who have early rehabilitation. MATERIAL and METHODS: Forty-seven TBI patients who were referred for rehabilitation in the neurosurgery department were enrolled in the study retrospectively. Clinical characteristics and rehabilitation-related outcome measurements including consciousness, functional outcome, daily living activities, functional mobility, and ambulation of all patients were recorded. The paired samples t-test was used to compare data before and after rehabilitation. The relationship between rehabilitation initiation time and the other outcomes was analyzed with Pearson's correlation test. RESULTS: Most of the TBI patients were male (83%) and the severities of the trauma were mostly mild (42%). The causes of trauma were mostly falls (53%). Twenty-three (49%) of the patients underwent surgical intervention. The lengths of time between admission and consultation and between surgery and consultation were 19.82 +/- 17.9 and 14.24 +/- 15.4 days, respectively. The lengths of stay in intensive care and hospital were respectively 27.32 +/- 34.93 and 41.35 +/- 32.83 days. The rehabilitation time was 21.50 +/- 24.32 days. The before and after rehabilitation results showed that all rehabilitation-related outcome measurements improved significantly (p<0.001). The relationship between rehabilitation initiation time and the other outcomes was statistically significant (p<0.05). CONCLUSION: This was a descriptive study in terms of demonstrating the demographic and clinical characteristics of TBI patients who need rehabilitation in the neurosurgery department. Early rehabilitation can enhance the rehabilitation-related outcome including consciousness, functional outcome, daily living activities, functional mobility, and ambulation in TBI patients as soon as their medical condition is stable. Early rehabilitation initiation time is important for improving the rehabilitation-related outcomes.

Purpose: To compare the excitation of the six different segments of the latissimus dorsi (LD) while reaching different distances and in different directions in stroke patients and healthy controls.Method:Surface electromyography was used to measure the excitation of the LD segments (LD1-LD6) in 12 chronic stroke patients and 11 healthy controls during reaching tasks. A target was placed in the sagittal and scapular planes at arm's length, 125% of arm's length, and maximum reaching distance. The clinical trial registration number is NCT04181151 (date of registration November 25, 2019).Results: The excitation of the LD segments during the arm's length reaching task was similar between the groups (p greater than 0.05). The excitation of LD1, LD2, and LD5 in the sagittal plane and of LD1, LD2, LD3, and LD5 in the scapular plane was higher during the reaching 125% of arm's length task compared to the controls (p < 0.05). During the maximum reaching task, the excitation of LD1 was higher in the stroke patients in both the sagittal and scapular planes (p < 0.05).Conclusion: The excitation of the LD segments was influenced by the direction and distance of the reaching in the stroke patients. The results of this study may help us to better understand how the LD behaves after stroke and to design rehabilitation approaches with a greater focus on the LD.

OBJECTIVE The pituitary gland is responsible for hormonal balance in the body, and disruption of hormonal balance in patients with pituitary adenoma (PA) indirectly affects quality of life. This study aimed to examine the effects of yoga and combined aerobic and strength training (A+ST) on quality of life and related parameters such as sleep, fatigue, emotional state, sexual function, and cognitive status in women with PA. DESIGN Ten women with PA were included in this randomized crossover study. Group 1 (n=5, mean age 52±13.5 years) received A+ST for the first 6 weeks, a 2-week washout period, and yoga for the second 6 weeks. Group 2 (n=5, mean age 41.8±14 years) received the yoga program first, followed by the A+ST program METHODS: Participants were assessed using the following tools before and after each exercise intervention: Functional Assessment of Cancer Therapy-Brain (FACT-Br), Pittsburg Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Female Sexual Function Index (FSFI), Hospital Anxiety And Depression Scale (HADS), and Montreal Cognitive Assessment Scale (MOCA). RESULTS FACT-Br scores were higher after the yoga program, HADS anxiety score was lower after the A+ST program, and MOCA scores increased after both exercise programs (p<0.05). FSS score decreased after both exercise programs, but not significantly. CONCLUSION A+ST and yoga have positive effects on quality of life in PA . We recommend yoga and A+ST as a supportive therapy in this population that may face comorbidities after surgical and medical treatment. Our results indicate these patients may benefit from physiotherapist-guided exercise programs.

Purpose: The aim of this current study was to investigate adaptation, validity, and reliability of the Turkish version of the Profile-Fitness Mapping Questionnaire (PFMQ) for people with low back pain. Methods: Two hundred and forty participants who had chronic low back pain enrolled to the study. Intra-rater and internal consistency analysis were used for the reliability assessment of the questionnaire. Intra-rater reliability was assessed by intraclass correlation coefficient (ICC) and Cronbach’s alpha was calculated for internal consistency. For concurrent validity, PFMQ scores were compared with ODI and VAS using Pearson’s correlation coefficient analysis. The PFMQ, Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Short Form Health Survey instrument (SF-36) were administered to all participants. Results: For intra-rater reliability, intraclass correlation coefficient scores were varying between 0.643 and 0.767, indicating that intra-rater results were very good. Pearson correlation coefficient of the PFMQ with ODI was calculated 0.594 and it was found with VAS was 0.502 for concurrent validity. For the reliability analysis, the Cronbach alpha value of the PFMQ were recorded as 0.837. The correlations with the SF-36 indices were changed between fair and good (0.28–0.52). Conclusion: The Turkish version of the PFMQ is valid and reliable. This scale can reveal how, how often, and how much can pain affect the symptoms and functional activities of people with chronic low back pain.

BACKGROUND:The transversus abdominis (TrA) is an important muscle for spinal stabilization. The abdominal draw-in maneuver (ADIM) is a method that selectively activates the TrA without overactivation of the external oblique (EO) and internal oblique (IO). Individuals with low back pain may have trouble in understanding proper contraction of the TrA. OBJECTIVE:The aim of this study was to investigate the differences between two feedback techniques to re-educate the TrA. METHODS:One hundred eighty healthy volunteers (123 female, 57 male) were randomized into two groups. The ADIM was performed with different feedback methods: conventional (verbal and tactile) feedback and visual feedback from real-time ultrasound images. RESULTS:A within-group comparison revealed a significant increase in the thickness of the TrA, IO, and EO during the ADIM (p< 0.001) in both groups. The mean change (SD) in the thickness of the TrA and IO between rest and the ADIM was an increase of 2.541.25 and 1.882.14 in group 1 and 1.821.27 and 1.241.87 in group 2, respectively (p< 0.001). No significant differences were observed in EO thickness between the two groups. CONCLUSIONS:Although visual biofeedback shows a greater effect on ADIM training, both approaches are applicable, and clinicians may decide on which to use based on their clinical environment and experience.

Amaç: Bu çalışma lumbal stabilizasyon egzersizleri ve sağlıklı beslenme programının lumbal disk hernisine bağlı bel ağrısı olan kişilerin fiziksel ve fonksiyonel düzeyleri üzerine etkisini incelemek amacıyla yapılmıştır.Gereç ve Yöntem: Çalışmaya lumbal disk hernisi tanısı konulan iki birey dahil edildi. Bir hastaya lumbal stabilizasyon egzersizleri (Olgu 1), diğer hastaya stabilizasyon egzersizlerine ek olarak diyetisyen kontrolünde sağlıklı beslenme programı (Olgu 2) verildi. Egzersizler 8 hafta, haftada 3 gün fizyoterapist gözetiminde yaptırıldı. Tedavi öncesi ve 8. haftada ağrı, Transversus Abdominus ve Multifidus kas kalınlığı, gövde ve alt ekstremite kas kuvveti, antropometrik ölçüm, fiziksel aktivite, enerji ve besin öğeleri ölçümleri yapıldı.Bulgular: 8 haftalık tedavi sonrasında her iki olguda da ağrıların azaldığı, kas kalınlığında belirgin değişiklik olmadığı, gövde ve alt ekstremite kas kuvvetinin arttığı, vücut ağırlıklarının ve yağ kütlesinin azaldığı görüldü. Olgu 2’de ise fiziksel aktivite düzeyinin belirgin arttığı, enerji ve besin alımının normale yaklaştığı görüldü.Sonuç: Bu çalışma egzersiz ve sağlıklı beslenme programının lumbal disk hernisinde bireylerin fiziksel ve fonksiyonel düzey üzerine etkisini inceleyen ilk çalışmadır. Bel ağrılı kişilerin egzersiz ile birlikte sağlıklı beslenme programlarına yönlendirilmesinin fiziksel ve fonksiyonel düzey üzerine olumlu etki sağlayacağını düşünmekteyiz.

Background/aim:The Profile Fitness Mapping neck questionnaire (ProFitMap-neck) is a reliable and valid assessment instrument for measuring neck-related symptoms and functional limitations in people with neck pain, but a Turkish version of it had not been published. The purpose of this study was to investigate the adaptation, validity, and intrarater reliability of the Turkish version of the ProFitMap-neck.Materials and methods:Two hundred and thirty-five individuals with chronic neck pain were enrolled in the study. Intrarater reliability was assessed by intraclass correlation coefficient (ICC) and Cronbach’s alpha was calculated for internal consistency. For concurrent validity, ProFitMap-neck scores were compared with neck disability index (NDI) and visual analoguepain scale (VAS) scores using Pearson’s correlation coefficient analysis. The ProFitMap-neck, NDI, VAS, and short form health survey (SF-36) were administered to all participants.Results:For intrarater analysis, ICC ranged between 0.72 and 0.84. The total score was 0.83, indicating excellent reliability. The correlation of the ProFitMap-neck with NDI and VAS was 0.71 and 0.68, respectively, indicating good concurrent validity.Conclusion:The ProFitMap-neck is an evaluation instrument with sufficient validity and reliability to be used for evaluating Turkish patients with neck pain. Use of this scale can reveal how, how often, and how much these patients’ pain affects their symptoms and functional activities.

BACKGROUND: Cervical stabilization exercises and local vibration may improve proprioception and balance and prevent musculoskeletal problems. OBJECTIVE: To compare the effects of local vibration and cervical stabilization exercises on balance, cervical joint position sense, and muscle performance in healthy participants. METHODS: Forty-eight healthy male participants without neck pain were included. The participants were randomly divided into three groups: a home exercise program lasting eight weeks to the cervical stabilization group; 60 s of vibration to the neck muscles of the local vibration group and a control group. Balance, joint position sense, and muscle performance were evaluated twice in all subjects, before and after the intervention. RESULTS: Joint position sense error values were decreased in both the local vibration and cervical stabilization groups. Balance was improved (p < 0.001) in the local vibration group while improvement in muscle performance parameters was only seen in the cervical stabilization group (p < 0.05). CONCLUSIONS: The methods used in the present study may be used for improving the proprioceptive and vestibular components of balance in individuals with musculoskeletal problems such as cervical disc herniation, cervical spondylosis, or neck pain. However, given the limitations, much more research is needed to firmly establish these recommendations.

AIM:To investigate the effects of lumbar stabilization exercises on pain severity, functional disability, and physical performance after two weeks following radiofrequency denervation in patients with lumbar facet joint syndrome (LFJS).MATERIAL AND METHODS:Thirty-nine patients diagnosed with LFJS and had radiofrequency denervation were assigned to study and control groups. The study group (n=20) received a six-week stabilization exercise program and was informed about spine biomechanics, while the control group (n=19) received only informations about spine biomechanics. Pain severity with visual analogue scale, perceived disability with Oswestry disability index, physical performance with physical performance tests and gait speed test were applied before and after radiofrequency denervation, and after six weeks of intervention program.RESULTS:Despite the similar improvements were shown in terms of all outcomes in both groups following radiofrequency denervation (p > 0.05), the improvements were more in favor of study group after six week intervention program (p < 0.05).CONCLUSION:These results indicate that radiofrequency denervation is effective in improving the pain, disability, and physical performance in patients with LFJS and this effect is further enhanced by the stabilization exercises following this procedure. Adding stabilization exercises to radiofrequency denervation yielded positive outcomes and these exercise are strongly advised in physiotherapy and rehabilitation program.

BACKGROUND: Diaphragm is an important component of spinal stability. In presence of low back pain, there may be some alterations in this muscle like other muscles that are responsible for lumbal stabilization. OBJECTIVE: This study aims to assess the effects of stabilization exercises on diaphragm muscle thickness and motion along with lumbopelvic stability. METHODS: Twenty-one women with low back pain participated in the study. Stabilization exercises including motor control training were performed on treatment group (n = 11). In control group (n = 10), strentghening exercises were peformed for back muscles, abdominal muscles and hip muscles. The patients underwent a total of 30 sessions of treatment, 3 days in a week for 10 weeks. The diaphragm muscle thickness and motion was evaluated using ultrasound (US), and lumbopelvic stability was evaluated using lumbopelvic stability tests. RESULTS: After the treatment, in the treatment group, increase in diaphragm thickness and improvement in lumbopelvic stability were statically significant (p < 0.05). However, there were no significant changes in diaphragm motion in both groups (p > 0.05). CONCLUSIONS: As a result, stabilization exercises increase diaphragm muscle thickness and improve lumbopelvic stability in women with low back pain. Therefore, stabilization exercises should be considered as a part of the treatment program in low back pain.

Background:Lumbar multifidus is a muscle which is responsible for lumbopelvic stability primarily. Foot-ankle posture and function disorders affecting the lumbopelvic region muscles and biomechanics, cause increased stress in the lumbopelvic region and may cause low back pain in many studies (1,2,3). However, it is not known whether the lumbar multifidus muscle is affected by this condition (4,5).Objectives:Plantar pressure distribution can change due to foot-ankle postural disorders. Our aim is to examine whether the plantar pressure distribution affects the lumbar multifidus muscle thickness.Methods:40 healthy young adults aged 18 to 25 years were included in the study. Static and dynamic pedobarographic assessments were performed to determine the plantar pressure distribution, on a 3x1 meter sensored walking platform with the DIASU Digital Analysis System®. Peak pressures (N/cm²) of 9 zones of the foot (medial of heel, lateral of foot, 5 metatarsal, thumb and 2.3.4 and 5. digits) were recorded. Ultrasonographic imaging was used to assess lumbar multifidus muscle thickness.Results:There was statistically significant correlation between lumbar multifidus muscle thickness and peak pressure medial of heel and 1. metatarsal bone in static pedobarographic analysis (p<0.05). As the peak pressure on the medial part of foot increased, m. lumbar multifidus muscle thickness was reduced. There was statistically significant correlation between lumbar multifidus muscle thickness and pressure medial of heel and 2.3.4. and 5. digits in dynamic pedobarographic analysis (p<0.05). As the peak pressure on the medial part of foot increased, m. lumbar multifidus muscle thickness was reduced.Conclusions:Our results show that plantar pressure distribution affected lumbar multifidus muscle thickness. Based on these results, the lumbopelvic region and foot posture should be considered together in therapeutic interventions.References1. Bird AR, Payne CB. Foot function and low back pain. Foot1999;9(4):175–80. 2. Botte RR. An interpretation of the pronation syndrome and foot types of patients with low back pain. J Am Podiatry Assoc1981;71(5):243–53. 3. Barwick A, Smith J, Chuter V. The relationship between foot motion and lumbopelvic-hip function: a review of the literature. Foot (Edinb)2012;22(3):224–31. 4. Brantingham JW, Adams KJ, Cooley JR, Globe D, Globe G. A single-blind pilot study to determine risk and association between navicular drop, calcaneal eversion and low back pain. J Manipulative Physiol Ther2007;30(5):380–5. 5. Fourchet F, Kelly L, Horobeanu C, Loepelt H, Taiar R, Millet G. High-intensity running and plantar-flexor fatigability and plantar-pressure distribution in adolescent runners. J Athl Train2015;50(2):117–25.Disclosure of Interest:None declared

This study was performed to investigate whether there is a relationship between cervical region pain threshold and joint position sense (JPS) in healthy subjects. The subjects were 38 healthy volunteers in the Hacettepe University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department. Pain thresholds in the right and left cervical paravertebral regions of participants were assessed with a digital algometer (Wagner Instruments, Greenwich, USA). The JPS of the cervical region was assessed with the Cervical Range of Motion 3 (CROM 3) device. While the pain thresholds in the left and right cervical paravertebral regions increased, the JPS error levels in the cervical region of the extension direction decreased (right and left cervical paravertebral region p = 0.003 and r = -0.475, p = 0.020 and r = -0.377, respectively). At the end of this study, the position sense error was higher in the participants with a low pain threshold. In participants in which the pain threshold is lower, prematurely stimulated pain receptors can decrease JPS by causing suppression of proprioceptive receptors. JPS should be assessed in individuals who define pain in the neck region. According to the result of this study, it is necessary to improve JPS in patients with neck pain, or healthy individuals who have lower pain threshold may be able to avoid neck pain when they receive appropriate proprioceptive training to improve their JPS. In conclusion, when healthy individuals were included in proprioceptive training, it was observed that neck pain could be prevented in the early period. [Med-Science 2019; 8(1.000): 97-101]