Understanding gender-based foot morphological differences is critical for ergonomic footwear design. This study investigated these variations in young adults using photogrammetric and plantar pressure analysis. We analyzed 200 healthy participants (100 males, 100 females; aged 19–21 years) through digital photogrammetry and RSscan Footscan pressure mapping. Key parameters included foot length (FL), ball width (BWF), hallux valgus angle (HVd), lateral foot angle (LdF), and Clarke’s Index for arch classification. Plantar pressure distribution was assessed across 10 anatomical zones. We revealed significant gender disparities: males had longer (26.6 vs. 25.2 cm) and wider feet (10.2 vs. 9.1 cm), while 75

Aim: Covid-19 pandemic has been reported to cause increased levels of depression, anxiety and posttraumatic stress disorders in the general population. Fibromyalgia syndrome (FMS) patients may be more inclined to develop these problems because of reduced resilience and coping mechanisms. For this reason, we have aimed to assess FMS patients’ levels of resilience, Obsession with covid-19, anxiety and quality of life and compare these values with controls living in the same household. Materials and Methods: Patients diagnosed as having FMS according to the ACR 2016 classification criteria and a control subject living in the same household were included in the study. Subjects were asked to fill out an online questionnaire form containing pain level, Short form 36, covid-19 anxiety scale, Obsession with covid scale and resilience scale for adults. Results were compared between the FMS patients and controls. Results: 39 FMS patients and 39 controls were included in the study. Demographic characteristics were similar between the groups (p>0.05). Subjects with FMS had lower levels of quality of life in addition to worse anxiety and obsession with Covid-19 scores (p<0.05). Surprisingly, most subsections of the resilience scale for adults were not significantly different between the groups (p>0.05), except for structured style subsection (p<0.05). Conclusion: Patients with FMS are affected more negatively psychologically than controls during the Covid-19 pandemic. Regular follow up visits, whether face to face or through telemedicine should include assessment for pandemic related anxiety and obsession may help control pain and other FMS symptoms.

Objective: Chronic pain has significant impact on individuals and society. It is not just a symptom but is considered to be a separate disease in its own right. The aim of this study is to translate into Turkish and assess the validity and reliability of the “Pain Modulation index”, which was developed to be used as an indicator of the changing central pain processing process in individuals presenting with chronic pain. Materials and Methods: Study included 125 patients who had chronic pain. The Turkish translation was carried out using the “forward-backward translation” method. After adjustments were made according to the feedback of 10 volunteers, the study was started on the patient population. To evaluate the reliability of the scale, the test-retest was conducted with a 15-day interval. To evaluate its validity, Pain Detect and the Central Sensitization Inventory were applied on the first visit, along with the Pain Modulation index. Results: Since the scale has 2 factors, the Cronbach’s alpha coefficient was calculated separately for the factors, and it was found to be 0.89 for factor 1 and 0.82 for factor 2. intraclass correlation coefficient values were determined as 0.95 for factor 1 and 0.92 for factor 2. the results of the Turkish version of the pain modulation scale were found to correlate significantly with pain detect and central sensitization inventory (p<0.05). Conclusion: The Turkish version of the pain modulation scale is a fast and easily applicable scale with high validity and reliability for clinical and epidemiological studies in patients presenting with chronic pain.

Objective: The frequent use of intense X-rays in the diagnosis and follow-up of adolescent scoliosis patients results in radiation exposure. This study aims to explore the viability of a patient-friendly digital anthropometry method as an auxiliary tool. It also evaluates the correlation between this digital method and the Cobb method in assessing lumbar scoliosis values. Material and Method: 100 scoliosis patients were examined using the digital anthropometric method with 17 anatomical parameters defined. Lumbar scoliosis degrees were also measured using the Cobb method based on radiological images. Result: The patients had a female to male ratio of 3:1, and 49% were diagnosed with lumbar scoliosis. The patient with the highest lumbar scoliosis displayed a 13.8 degree cervical lordosis angle, a 50.1 degree thoracic hyphosis angle, and a 26.4 degree lumbar lordosis angle. This lumbar lordosis angle was above the mean value. Conversely, the patient with the lowest lumbar scoliosis had a 12.9 degree cervical lordosis angle, a 53.81 degree thoracic hyphosis angle, and a 21.8 degree lumbar lordosis angle, with the latter being below the mean value. A significant positive correlation was observed between the lumbar lordosis angle obtained from the photoanthropometric analysis and the lumbar scoliosis degree measured using the Cobb method (r=0.902, p<0.001). Conclusion: Patient follow-up can be enhanced through the photo-anthropometric method, and due to its patient- friendly nature, it can be more integrally included in treatment programs.

OBJECTIVE To determine the prevalence of nocturnal polyuria (NP) in patients with spinal cord injury (SCI) during three different particular phases, and investigate the impact of injury level and injury type on the prevalence of NP. DESIGN A cross-sectional study. SETTING Neurogenic Bladder Study Group from six different rehabilitation centers across the country. PARTICIPANTS 40 patients with SCI. OUTCOME MEASURES Patients were divided into three groups according to mobilization phase; 1st group included patients confined to bed (n = 14), 2nd group included patients sitting on a wheelchair (n = 19) and 3rd group included patients standing with an assistive ambulation device (n = 7). NP was assessed by nocturnal polyuria index (NPi) and nocturnal urine production (NUP) indexes. RESULTS No significant difference was found between the groups (P = 0.312 for NPi and P = 0.763 for NUP) in terms of the presence of NP according to their mobilization phase. The night and 24-hour urine volumes showed no significant difference between the groups (P = 0.907 and P = 0.395 respectively). The NPi and NUP values did not show a significant difference between male and female patients (P = 0.826, P = 0.364 respectively), patients with the injury level of ≥T6 and <T6 (P = 0.236, P = 1.00) and patients with a complete and incomplete injury (P = 0.826, P = 0.283). CONCLUSION In this study, NP was found to be a common problem in patients with SCI regardless of their mobilization phase, injury level and injury type. It was revealed that both NPi and NUP parameters could be used to determine the prevalence of NP in this patient group.

Objectives:The purpose of the study was to contribute further to this debated topic by investigating the correlation of magnetic resonance imaging (MRI) findings with the clinical picture in lumbar spondylosis patients. Patients and methods:This multicenter retrospective study (as part of the epidemiological project of the TLAR-OASG [Turkish League Against Rheumatism-Osteoarthritis Study Group]) included 514 patients (101 males, 413 females; mean age: 63.6±10.8 years; range, 40 to 85 years) who were diagnosed as lumbar spondylosis by clinical examination and direct X-ray between December 2016 and June 2018. Demographic characteristics of patients, Visual Analog Scale for pain, presence of radiating pain, Roland-Morris disability questionnaire, straight leg raise test, deep tendon reflexes, neurogenic intermittent claudication symptoms, any decrease of muscle strength, and abnormality of sensation were recorded. Lumbar MRI findings of the patients were recorded as positive or negative in terms of disc herniation, intervertebral disc degeneration, root compression, osteophytes, spinal stenosis. Statistical analysis was done to assess the correlation between the clinical symptoms, physical examination, and MRI findings. Results:Correlation analysis of the MRI results and the clinical findings showed a significant correlation between straight leg raise test and root compression (p<0.001, r=0.328) and a significant correlation between neurogenic intermittent claudication and spinal stenosis (p<0.001, r=0.376). Roland-Morris disability questionnaire had a significant correlation with all MRI findings (p<0.05, r<0.200). Conclusion:The results of this study corroborate the notion that diligent patient history and physical examination are more valuable than MRI findings, even though a higher incidence of abnormal MRI findings have been obtained in patients with disability and dermatomal radiating pain.

ObjectiveTo get information-driven insights from expert physicians regarding multiple aspects of the patient journey in knee and hip OA and establish a consensus for future studies and decision tree models in Turkey.Design157 questions were asked in total during this three-round modified Delphi-method panel to 10 physical medicine and rehabilitation specialists (2 have rheumatology and 3 have algology subspeciality), one orthopaedic surgeon and one algology specialist from anaesthesia specialty background. A consensus was achieved when 80% of the panel members agreed with an item. Contradictions between different disciplines were accepted as a non-consensus factor.ResultsPanellists agreed that American College of Rheumatology classification criteria is mostly sufficient to provide an OA diagnosis in clinical practice, OA patients with ≥5 Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain or physical function score can be defined as moderate-to-severe OA if they have an additional ≥2 Kellgren-Lawrence (KL) score, a minimum improvement of 30% from baseline in WOMAC pain or function subscales or in PGA score can be accepted as moderate treatment response where ≥50% improvement from baseline in those scores as substantial response. Panellists stated that arthroplasty procedures need to be delayed as long as possible, but this delay should not jeopardize a beneficial and successful operation.ConclusionsThese findings show that there is a significant disease burden, unmet treatment needs for patients with moderate-to-severe OA in Turkey from experts’ perspective. Therefore, an updated systematic approach and decision tree models are needed to be implemented.

Objectives:This study aims to define and compare sensory phenotypes in cervical radiculopathy patients exhibiting neu-ropathic pain (NP) components with healthy volunteers using clinical examination and quantitative sensory test (QST) findings. Another aim of the study is to show whether symptomatic components of the pain detect questionnaire (PDQ) are correlated with the QST findings, which may help clinicians indicate patients with sensory abnormalities without the use of specialized tests.Methods: Fifty-seven participants were included in the study, including patients with NP (n=20) and healthy volunteers (n=37). After obtaining the sociodemographic and clinical data of the participants, the PDQ was performed in patients with pain followed by QST analysis in all participants.Results: Analyses between painful and non-painful extremities yielded no differences in all groups for QST (p>0.05). Sensory thresholds were found to be higher in the NP group compared to healthy volunteers, and the pain threshold test was found to be lower (p<0.05) in the intergroup analyses. The changes described were found in both painful and non-painful limbs. Pain with slight pressure was found to be correlated with the lower heat pain threshold values (R=-0.602, p=0.005).Conclusion: Patients with NP were found to have lower thresholds for pain and higher sensory thresholds when compared to healthy volunteers. Moreover, pain with pressure component in PDQ was found to be associated with hyperalgesia in QST.

This study aimed to evaluate whether there was a difference in functional magnetic resonance imaging (fMRI) findings in patients who were found having hyperalgesia or hypoesthesia according to Quantitative Sensory Tests (QST). Forty participants were included in the study: 20 with neuropathic pain (NP) due to cervical disc pathology (NP group) and 20 healthy volunteers. After obtaining the socio-demographic and clinical data of the participants, the painDETECT questionnaire was administered, followed by QST analysis to show the presence of hypoesthesia and/or hyperalgesia, and fMRI examinations, which included sensory stimulation of both extremities. Sensory threshold tests were found to be higher in the NP group compared with the healthy volunteers, and the heat pain threshold was found to be lower in the tests showing pain thresholds in the intergroup analyses (p < 0.05). The changes described were found in both painful and non-painful limbs. In the hypoesthetic NP group, a lower somatosensory cortex activity was found in non-painful limbs compared with the healthy volunteers (p < 0.05). In the unilateral hyperalgesic NP group, a lower somatosensory cortex activity was found on the painful side, and if the hyperalgesia was widespread, lower blood oxygen-level-dependent activity was also found in the operculum and insular cortex (p < 0.05). The patients with different phenotypes of NP had different activities in the areas related to the processing of pain, and were more prominent in patients with widespread hyperalgesia. Studies with larger numbers of patients are required for a definite statement.

Objectives This study aims to evaluate the clinical, functional, and radiological features of hand osteoarthritis (OA) and to examine their relationships in different geographic samples of the Turkish population. Patients and methods Between April 2017 and January 2019, a total of 520 patients (49 males, 471 females; mean age: 63.6±9.8 years) with hand OA were included in the study from 26 centers across Turkey by the Turkish League Against Rheumatism (TLAR). The demographic characteristics, grip strengths with Jamar dynamometer, duration of hand pain (month), the severity of hand pain (Visual Analog Scale [VAS]), and morning stiffness were evaluated. The functional disability was evaluated with Duruöz Hand Index (DHI). The Kellgren-Lawrence (KL) OA scoring system was used to assess the radiological stage of hand OA. Results The DHI had significant correlations with VAS-pain (r=0.367, p<0.001), duration of pain (r=0.143, p=0.001) and bilateral handgrip strengths (r=-0.228, p=0.001; r=-0.303, p<0.001). Although DHI scores were similar between the groups in terms of the presence of hand deformity (p=0.125) or Heberden's nodes (p=0.640), the mean DHI scores were significantly higher in patients with Bouchard's nodes (p=0.015). The total number of nodes had no significant correlations with the VAS-pain and DHI score (p>0.05). The differences between the groups of radiological hand OA grades in terms of age (p=0.007), VAS-pain (p<0.001), duration of pain (p<0.001), and DHI (p<0.001) were significant. There were no significant differences between radiological hand OA grades according to the duration of the stiffness, grip strength, and BMI (p>0.05 for all). Conclusion In our population, the patients with hand OA had pain, functional disability, and weak grip strength. The functional impairment was significantly correlated with the severity of the pain, and the functional status was worse in high radiological hand OA grades.

Traconia fish is a member of the Trichinidea family, all members are poisonous. In the literature, edema develops in the affected area after trachonia fish bite, followed by a wide spectrum of cases ranging from subcutaneous inflammation to myonecrosis. In this case report, we present a patient who was injured with the back spines of traconia fish and had limited edema and range of motion. The absence of pain in the joint restriction that developed over time and the normal bilateral hand radiography exclude us from the diagnosis of complex regional pain syndrome. The patient was treated with self-adherent wrap to reduce swelling in addition to soft tissue mobilization, range of motion exercises, and a contracture splint that forced metacarpophalangeal joints into flexion to increase joint mobility. We applied 15 sessions of treatment to the patient. On the post-rehabilitation examination, we found that the edema in the dorsum of the left hand decreased. We measured the range of motion of the patient as normal.

Abstract In this cross-sectional study; in order to evaluate the subjective and objective effects of High Tibial Osteotomy (HTO) and Total Knee Arthroplasty (TKA) operations on the same patient, 11 cases undergone these operations on each knee in different time periods were retrospectively reviewed. The mean age was 63 for HTO and 68 for TKA at the time of operations. There were 1 man and 10 women. Mean follow-up was 7.6 Years for HTO, 3.6 years for TKA. Subjective evaluation form of the knee which includek patient satisfaction, symptoms and visual analog score for pain and objective clinical evaluation by \"Knee Society\"s scores were used. Radioghraphic evaluation of both knees and EMG studies of muscle groups of both lower extremities were also performed. Six of the patients (55%) was more satisfied from the TKA side. The improvement of visual analog score for pain were equal in both groups (76% 78%). Although the follow up periods were different; the mean range of motion (ROM) after HTO were better (100° and 88°), but the residual patello-Femoral problems were the mean complaint after HTO they were noticeable greater than after the TKA (63% and 10%). Also, symptoms related to the lateral compartment were greater in the HTO group. In both groups no significant differencies were obtained with respect to the \"Knee society\"s scores. According to the EMG evaluation; HTO side was apparently better for the muscle physiology because the vastus medialis and vastus lateralis latencies were longer and patellar reflex amplitudes were lower on the TKA side. Although there has been a great difference in the post-operative period, we saw that, HTO sides have significantly more problems about lateral compartment and patellofemoral woint, but on the other hand, it is advantageous to conserve proprioception, ROM and potential longevity of the results. Özet Aynı bireydeki yüksek tibial osteotomi (YTO) ve total diz artroplastisi (TDA) uygulamalarının, dizin sübjektif ve objektif durumuna etkilerini araştırmak amacı ile dizlerinden birine değişik zamanlarda YTO, diğerine ise TDA uygulanan 11 olgu kesitsel olarak değerlendirildi. Operasyon sırasında yaş ortalaması YTO için 63, TDA için 68 idi. Olguların 1 i erkek, 10 u kadın olup YTO lu taraf için ortalama takip süresi 7.6 yıl, TDA lı taraf için ise ortalama 3.6 yıldı. Sübjektif değerlendirmede, hasta memnuniyeti ve yakınmalarını değerlendiren \"Diz Sübjektif Değerlendirme Formu\" ve ağrı yönünden \"Vizüel Analog Skorlama\" kullanıldı. Objektif klinik değerlendirme \"Diz Cemiyetleri Skorları\" ile yapıldı. Ayrıca radyolojik ve her iki alt ekstremitedeki kas gruplarının elektrofizyolojik değerlendirmesi uygulandı. Olguların 6 sı (%55) TDA uygulanan taraftan daha hoşnuttu. Ağrı yönünden vizüel analog skordaki iyileşme YTO ve TDA gruplarında eşdeğerdi (%76 ve %78). Takip sürelerindeki farklılığa karşın YTO grubunun ortalama hareket genişliği daha fazla idi (100° ve 88°). Ancak YTO grubunda rezidüel patello femoral sorunlar başlıca yakınmaları oluşturmakla ve TDA ne oranla anlamlı olarak fazla idi (%63 ve %IO). Yine lateral kompartmana yönelik yakınmalar YTO lu tarafta daha fazla idi. Olgularda diz cemiyeti skorları yönünden anlamlı bir fark bulunamadı (YTO: 72, TDA 73.7). Ancak ağrı parametresi tek başına alındığında TDA tarafının daha az ağrılı olduğu belirlendi. Olguların EMG değerlendirmesinde: TDA uygulanan tarafta patellar reflekse ilişkin vastus medialis ve vastus lateralis lanaslanmn daha uzun; amplitüdlerinin ise daha düşük bulunduğu için, YTO uygulanan taraf kas fizyolojisi yönünden daha avantajlı görünmekteydi. Aralarında takip süresi yönünden farklılık olmakla birlikte, aynı bireyde YTO ve TDA uygulamalarının karşılaştırılmasında; YTO nin özellikle patellofemoral ve lateral kompartmana lokalize ağrı sorunlarına kalıcı çözüm getirmemekle birlikte; hareket genişliği, potansiyel süreklilik ve propriosepsiyonun korunması avantajlarına sahip olduğu belirlenmiştir.

Iliac wing osteonecrosis coexisting with sacral insufficiency fracture rarely causes low back pain. Radiotherapy (RT) applied to the pelvic area is an important precipitating factor. Here, we present a patient who was referred to our outpatient clinic with mechanical lower back pain that was present for 3 months. The patient had received RT to the pelvic region due to colorectal cancer. Contrast-enhanced magnetic resonance imaging studies revealed iliac wing osteonecrosis and sacral insufficiency fracture. After ruling out the possibility of metastasis and making a definitive diagnosis, the patient was followed-up and bed rest and calcium and vitamin D supplementations were recommended. Despite these precautions, the patient still developed another sacral insufficiency fracture. Mechanical low back pain has a myriad of etiologies and standard X-rays may underdiagnose rarer causes of pain, such as osteonecrosis and insufficiency fractures. Clinical suspicion of these entities, especially in patients with a history of RT, may help in diagnosis and treatment.

Objective: Cervical fixation is the most common treatment of vertebral fractures, osteosarcoma, osteomyelitis, arthritis, and congenital disorders. Mortal complications, such as internal carotid artery, vertebral artery (VA), and spinal cord damages, may occur during the application. The aim of this study was to create the application of the actual three-dimensional (3D) personalized model which was exercised for screwing insertion in C2 damage patients. Methods: Two patients with Type II of C2 fractures were treated with personalized spine models. These models were investigated to achieve particular information of non- and bony elements such as the highness, thickness, and the field of pedicles and vascular diameters for an intraoperative reference. The model was to determine the probable variations and to observe the success of screw rate in the treatment of C2 fractures. The operation duration, instrumentation time, blood loss volume, and clinical and radiological assessment were done. The 3D model's perception was evaluated. Results: Cervical models were defined to secure intervention areas of the VA pedicles and screws. Neither vascular nor neurologic damages were happened in all cases. Besides, the cases did not include broken nails, screw pullout, fracture of bone structure, or infection. Cervical models demonstrated (1) examination of the VA pattern, (2) valuation of virtual screw trajectory line before screw fixation, (3) the application of prebent rods during procedure to contribute to the safety of the posterior instrumentation, (4) postsurgical confirmation, and (5) examined movements of the neck postoperatively. The perception of 3D model for treating C2 fracture was thereby diminishing surgical time, bleeding amount and operative complications. Survey perception of model was calculated in statistical significance (P < 0.05). Conclusion: Personalized model is active and confident in achieving an accurate and safe screw fixation during surgery, especially in anatomically abnormal cases. Cervical model provides an accurate representation of the fracture location, pedicle size, and VA shapes. It is therefore useful in surgical planning as it maximizes the possibility of ideal screw position, as well as providing individualized information concerning cervical spinal anatomy.

Objective : This study examines the effect of the lower limb misalignment and its possible compensatory effect on plantar pressure in a normal population. The aim of this paper is to present a structured method for the analysis of posture and its changes using a standardized digital photography technique and plantar pressure measuring device. Design : Cohort. Setting : Laboratory. Participants : A total of 200 adult volunteers between 18 and 22 years of age who had no current symptoms of pain and foot or ankle pathology participated in the study. Main Outcome Measures : The gold standard measure of lower limb alignment with weight-bearing status is the mechanical axis and their angles using Image J software. Structural and functional measurements of the same foot were taken using a plantar pressure measuring device. In this study, 5 alignment (thigh, knee, leg, ankle, and foot) characteristics were measured on the lower limb using the 2 techniques, and, additionally, the foot contact area, peak pressure, foot axis, rearfoot angle, and subtalar joint flexibility score were analyzed in 10 different regions of the foot. Results : This study has shown a reasonable correlation between digitalized measurements and plantar pressures values. Quadriceps angle affected midfoot impulse, foot axis angle, subtalar joint minimum angle, and rearfoot angle positively. Subtalar joint flexibility scores were analyzed in 10 different regions of the foot. There was a positive correlation between rearfoot angle and quadriceps angle ( P = .009, r = .261). Results of both methods show that they endorse each other. Conclusions : The posture of the standing feet may have influence on lower limb alignment. Currently, there are no studies carried out by using digital photogrammetry and foot scan. The authors claim that patient-friendly digital photogrammetry would have a positive contribution to the monitoring of patients, even including new ones in the treatment programs, reducing any possible loss in the personal and national economy.

In the recently published study by Zhong et al, “A Randomized Controlled Trial on the Effects of Low-Dose Extracorporeal Shockwave Therapy in Patients With Knee Osteoarthritis,” the researchers studied low-dose extracorporeal shockwave therapy (ESWT) treatment in patients with knee osteoarthritis. They stated that ESWT was superior to placebo in both pain and functional improvement, as well as in terms of negative effects on the articular cartilage. Response to Letter Regarding “A Randomized Controlled Trial on the Effects of Low-Dose Extracorporeal Shockwave Therapy in Patients With Knee Osteoarthritis”Archives of Physical Medicine and RehabilitationVol. 101Issue 7PreviewWe would like to express our appreciation to the authors of the letter to the editor for their interest in our recent article.1 They argued that the control group in our study should be considered a very low dose extracorporeal shockwave therapy (ESWT) group rather than a placebo. We see their comments as an opportunity to provide more insight into designing a placebo in the ESWT study. The following is our explanation of the control group as a placebo group in our trial. Full-Text PDF

OBJECTIVE:To investigate the effectiveness of interferential current implementation following total knee arthroplasty surgery.DESIGN:Double-blind randomized controlled study.SETTING:Orthopedics and traumatology in-patient clinic.PARTICIPANTS:From an initial enrollment of 132 patients, 113 who met the study inclusion criteria were randomly separated into two groups: the interferential current group ( n = 57) and the sham current group ( n = 56). A total of 98 patients completed the study: 49 in the interferential current group and 49 in the sham group.INTERVENTION:Patients in the interferential current group received interferential current treatment for 30 minutes, twice a day for five days postoperatively. For the patients in the sham interferential current treatment group, the same pads were applied to the patients for the same time periods but no electrical stimulation was applied.MAIN OUTCOME MEASURES:Patients were assessed in respect of pain, range of motion (ROM), edema, and the amount of paracetamol used at baseline and on the 5th and 30th days after surgery.RESULTS:No significant difference was determined between the groups in respect of pain, ROM, and edema at days 0, 5, and 30. At the end of the 5th day, the amount of paracetamol used was significantly lower in the interferential current group ( P < 0.05).CONCLUSION:In this study, both groups showed significant improvements in pain, ROM, and edema with no significant difference between the groups. Although there was a significant difference in paracetamol intake of the two groups, this cannot be argued as showing the effectiveness of interferential current.

STUDY DESIGN:This study was a prospective, randomized, controlled study. OBJECTIVE:The aim of this study was to determine whether transcutaneous electrical nerve stimulation (TENS) or interferential current (IFC) increase the effectiveness of neck stabilization exercises (NSEs) on pain, disability, mood and quality of life for chronic neck pain (CNP). SUMMARY OF BACKGROUND DATA:Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Electrotherapies, such as IFC and TENS, have been applied solo or combined with exercise for management of neck pain; however, the efficacy of these combinations is unclear. METHODS:A total of 81 patients with CNP were included in this study. Patients were randomly assigned into three groups regarding age and gender. First group had NSE, second group had TENS and NSE, and third group had IFC and NSE. Pain levels [visual analogue scale (VAS)], limits of cervical range of motion (ROM), quality of life (short form-36), mood (Beck depression inventory), levels of disability (Neck Pain and Disability Index), and the need for analgesics of all patients were evaluated before treatment, at 6th and 12th week follow-up. Physical therapy modalities were applied for 15 sessions in all groups. All participants had group exercise accompanied by a physiotherapist for 3 weeks and an additional 3 weeks of home exercise program. RESULTS:According to the intragroup assessment, the study achieved its purpose of pain reduction, ROM increase, improvement of disability, quality of life, mood and reduction in drug use in all three treatment groups (P < 0.05). However, clinical outcomes at 6th and 12 th week had no significant difference among the three groups (P > 0.05). CONCLUSION:TENS and IFC therapies are effective in the treatment of CNP patients. However, they have no additional benefit or superiority over NSE. LEVEL OF EVIDENCE:2.

In a Turkish League Against Rheumatism (TLAR) project, evidence-based recommendations for the management of knee osteoarthritis (OA) was developed for the first time in our country in 2012 (TLAR-2012). In accordance with developing medical knowledge and scientific evidence, recommendations were updated. The committee was composed of 22 physical medicine and rehabilitation specialists (4 have rheumatology subspeciality also) and an orthopaedic surgeon. Systematic literature search were applied on Pubmed, Embase, Cochrane and Turkish Medical Index for the dates between January the 1st 2012 and January the 29th of 2015. The articles were assessed for quality and classified according to hierarchy for the level of evidence, and the selected ones sent to committee members electronically. They were asked to develop new recommendations. In the meeting in 2015, the format of the recommendations was decided to be patient-based and considering the grade and the severity of the disease. By the discussion of the each item under the light of new evidences, the final recommendations were developed. Each item was voted electronically on a 10-cm visual analogue scale (VAS) and the strength of recommendation (SoR) was calculated. In the light of evidences, totally 11 titles of recommendations were developed; the first 7 were applicable to each patient in every stages of the disease, remaining were for defined specific clinical situations. The mean SoR value of the recommendations was between 7.44 and 9.93. TLAR-2012 recommendations were updated in a new format. We think that, present recommendations will be beneficial for the physicians who manage, as well as the patients who suffer from the disease.