Dilşad Sindel | Istanbul University (original) (raw)
Papers by Dilşad Sindel
Türk Osteoporoz Dergisi, 2004
The aim of the study was to compare the T-scores of quantitative ultrasound (QUS) of the calcaneu... more The aim of the study was to compare the T-scores of quantitative ultrasound (QUS) of the calcaneus with those of dual-energy X-ray absorptiometry (DXA) of the lumbar spine and hip in men. We studied on sixty-four male patients (mean age 52.47 + 16.51 years). BMD T-score at the lumbar spine and femoral neck correlated positively with QUS T-score of the calcaneus (r=0.258, p<0.005 and r=0.333, p<0.001 respectively). The kappa score for osteoporosis were 0.16 and 0.27 for QUS T-scores versus spinal and femoral DXA T-scores. With the "–2.5" cut-off level used, sensitivity and specificity of QUS T-score in detecting osteoporosis were 25% and 96% at the lumbar spine, were 0% and 91% at the femoral neck and were 25% and 93% at the total hip. We conclude that QUS T-score has a weak correlation with DXA T-score at the lumbar spine and a moderate correlation with DXA T-score at the femoral neck; QUS has a very low sensitivity and concordance for the diagnosis of osteoporosis c...
Journal of Musculoskeletal & Neuronal Interactions, Mar 1, 2023
Objective: To investigate the effects of mesotherapy in patients with mild to moderate knee osteo... more Objective: To investigate the effects of mesotherapy in patients with mild to moderate knee osteoarthritis (KOA). Methods: The study included 43 patients (56 knees) who were randomly assigned to either the mesotherapy group (MG, n=28) or the saline group (SG, n=28) and received a total of 4 weekly mesotherapy (MG) or saline injections (SG). Pain, functional status and quality of life were evaluated by a Visual Analogue Scale (VAS), the Western Ontario Universities Osteoarthritis Index (WOMAC) and the Short Form-36 (SF-36) subscales at baseline and at 8 and 16 weeks of follow-up. Results: A total of 39 patients (52 knees) completed the study. Eight weeks after treatment, a significant improvement was found in VAS pain scores, WOMAC scores and physical component scores (PCS) of the SF-36 in both groups compared to baseline (p<0.05). The VAS activity pain score, WOMAC-pain, WOMAC-physical function and WOMAC-total scores were found to have decreased significantly in the MG compared to the SG (p<0.001) at both 8 weeks and 16 weeks. The PCS scores significantly improved in the MG compared to the SG at 8- and 16-week follow-ups (p<0.001 and p<0.001, respectively). Conclusions: Mesotherapy is a well-tolerated, safe and effective alternative treatment option in patients with mild and moderate KOA.
Turkish Journal of Physical Medicine and Rehabilitation
Despite the availability of safe and effective anti-osteoporosis treatments, osteoporosis continu... more Despite the availability of safe and effective anti-osteoporosis treatments, osteoporosis continues to be undertreated. The increase in fragility fractures, which is the main clinical consequence of osteoporosis, is a major problem for healthcare systems of countries. A broad range of drugs including antiresorptive and anabolic agents are used in the pharmacological treatment of osteoporosis. Fracture risk assessment in drug selection is of utmost importance in terms of guiding treatment. The recommended thresholds for osteoporosis treatment decision making are based on major osteoporotic and hip fracture probabilities from the Fracture Risk Assessment Tool (FRAX®). Currently, antiresorptive agents are usually the first choice to increase bone mineral density (BMD) and reduce the fracture risk. Bisphosphonates and antiresorptive drugs such as denosumab, a nuclear factor kappa-B ligand (RANKL) inhibitor, are the most widely used drugs in the treatment of osteoporosis. Bisphosphonates...
PubMed, Mar 1, 2023
Objective: To investigate the effects of mesotherapy in patients with mild to moderate knee osteo... more Objective: To investigate the effects of mesotherapy in patients with mild to moderate knee osteoarthritis (KOA). Methods: The study included 43 patients (56 knees) who were randomly assigned to either the mesotherapy group (MG, n=28) or the saline group (SG, n=28) and received a total of 4 weekly mesotherapy (MG) or saline injections (SG). Pain, functional status and quality of life were evaluated by a Visual Analogue Scale (VAS), the Western Ontario Universities Osteoarthritis Index (WOMAC) and the Short Form-36 (SF-36) subscales at baseline and at 8 and 16 weeks of follow-up. Results: A total of 39 patients (52 knees) completed the study. Eight weeks after treatment, a significant improvement was found in VAS pain scores, WOMAC scores and physical component scores (PCS) of the SF-36 in both groups compared to baseline (p<0.05). The VAS activity pain score, WOMAC-pain, WOMAC-physical function and WOMAC-total scores were found to have decreased significantly in the MG compared to the SG (p<0.001) at both 8 weeks and 16 weeks. The PCS scores significantly improved in the MG compared to the SG at 8- and 16-week follow-ups (p<0.001 and p<0.001, respectively). Conclusions: Mesotherapy is a well-tolerated, safe and effective alternative treatment option in patients with mild and moderate KOA.
Annals of the Rheumatic Diseases, Jun 1, 2013
Background: Causes of osteoporosis in patients with connective tissue diseases (CTD) are more com... more Background: Causes of osteoporosis in patients with connective tissue diseases (CTD) are more complex than in patients with postmenopausal osteoporosis (PO). None of the studies published so far examined the safety and efficacy of once-yearly intravenous zoledronic acid 5 mg administration in CTD patients. Objectives: The aim of the study was to assess safety of the zoledronic acid administration in patients with osteoporosis in the course of CTD and compare it to patients with PO. Methods: We investigated 160 patients with osteoporosis including those without CTD or PO who received in total 278 infusions of intravenous zoledronic acid 5 mg in the period 2010-2012. Two subgroups of patients were identified: 47 with osteoporosis in the course of CTD including 33 with rheumatoid arthritis and 91 with PO. All patients included into the study fulfilled the osteoporosis densitometric criteria according to WHO and had contraindications to the use of oral bisphosphonates. The primary endpoint was the number of complications observed in CTD patients after the zoledronic acid administration compared to the number of complications registered in patients with PO. Results: Both PO and CTD patients groups showed no statistically significant differences in terms of the mean age (73 vs. 70,66 years), T score result before the first administration of zoledronic acid (-2,91 vs.-2,81) and mean number of osteoporotic fractures (1,8 vs. 1,69). The number of complications in patients with CTD was significantly higher (14,89%-7 patients) than in patients with PO (3,29%-3 patients) (p<0,03). Furthermore in patients with PO the only observed type of adverse reaction were flu-like symptoms whereas in patients with osteoporosis associated with CTD also more severe complications were registered such as the renal function impairment (3 cases) and osteonecrosis of the jaw (1 case). Conclusions: The safety and efficacy of a single 5 mg intravenous infusion of zoledronic acid should be further investigated as our retrospective analysis suggests that in patients with CTD treated with zoledronic acid the number of complications is significantly higher and they are more severe as compared to patients with PO.
Pain Physician, Sep 17, 2021
BACKGROUND: Myofascial pain syndrome is a regional musculoskeletal pain syndrome characterized by... more BACKGROUND: Myofascial pain syndrome is a regional musculoskeletal pain syndrome characterized by trigger points. Although there are widely accepted treatment modalities, there is no gold standard treatment. Kinesiotaping represents an interesting modality in the treatment of musculoskeletal disorders and attracts attention with studies emerging in the recent years, but in spite of the proposed benefits of kinesiotaping, its efficacy is still unclear, thus further studies evaluating the effectiveness of kinesiotaping are needed. OBJECTIVES: We aimed to investigate, not only the effectiveness of kinesiotaping applied with the space correction and muscle inhibition techniques (compared to the home exercise program in reducing pain and improving functional status and quality of life in female patients with myofascial pain syndrome related to active trigger points in the upper trapezius), but also to evaluate the superiority of the 2 techniques over each other. STUDY DESIGN: An open-label randomized clinical trial with a parallel assignment intervention model. SETTING: The physical medicine and rehabilitation clinics in Istanbul University, Istanbul Faculty of Medicine. METHODS: Seventy-one female patients with the complaint of pain in the upper trapezius region, diagnosed with myofascial pain syndrome, and having at least one active trigger point in the upper trapezius fibers, were randomly assigned by a computer program to 1 of the 3 groups: kinesiotaping with the space correction technique (KSCT, n = 20), kinesiotaping with the muscle inhibition technique (KMIT, n = 24), and the home exercise program alone (control group [CG], n = 27). The patients were evaluated by the numerical rating scale for pain intensity, the neck disability index for functional status, and the 36-Item Short-Form Health Survey for quality of life in the beginning of the study and at the first, second, and sixth weeks (1-month follow-up). RESULTS: Kinesiotaping was associated with lower pain intensity levels (P = 0.019 at the first week and P = 0.026 at the second week) and better functional status (P = 0.011 at the second week) and it was effective in increasing quality of life by improving physical functions and general health (P = 0.033 and P = 0.003 at the second week, respectively) earlier than in the CG. Role limitations due to physical factors improved in the KMIT group earlier than in the other groups (P = 0.022 at the second week). LIMITATIONS: Being performed in a limited number of female patients only, absence of a placebo group, and lack of blinded assessments. CONCLUSION: Both kinesiotaping methods were associated with lower pain intensity levels and better functional status and were effective in increasing quality of life by improving physical functions and general health earlier than the home exercise program. There was no significant difference between the kinesiotaping methods, except for role limitations due to the physical factors domain of SF-36 which was improved in the KMIT group earlier than in the KSCT group and CGs. KEY WORDS: Myofascial pain syndrome, myofascial trigger point pain, trapezius, kinesiotape, muscle inhibition technique, space correction technique
Background: Studies indicate brain grey matter volumetric changes are associated with chronic pai... more Background: Studies indicate brain grey matter volumetric changes are associated with chronic pain. In people with painful hand osteoarthritis (OA), grey matter volume reductions have been identified in the anterior cingulate cortex (ACC): a key pain-processing region. 1 Objectives: We hypothesised that people with hand OA would have alterations in resting-state functional connectivity networks involving the ACC and other painprocessing brain regions relative to non-OA controls. Furthermore, we hypothesised that treatment with centrally-acting analgesics (pregabalin or duloxetine) would result in connectivity changes in these brain regions. Methods: Resting-state functional MRI (fMRI) of the brain was performed on hand OA participants (n=28) before and after 12 weeks of treatment with duloxetine, pregabalin or placebo, and compared to non-OA participants (n=11) from the same age range (40-75 years). Scans of 7 hand OA participants and 1 control were excluded due to excessive movement artefact. Seed-based correlation analyses were performed using the CONN toolbox 2 to evaluate differences in functional connectivity of networks involving the ACC, insular cortices and thalami between patients and controls, and between pre-and post-treatment states. Results: Relative to non-OA controls, hand OA participants had increased functional connectivity at baseline between the ACC and the cunei, occipital poles, lateral occipital cortices and precuneus (p=0.00054, FDR-corrected for multiple comparisons; MNI coordinates x=-4, y=-86, z=+40; 513 voxels) (figure 1). No differences in baseline functional connectivity were seen in the insular cortices or thalami. After treatment, altered functional connectivity was identified between the left thalamus and the ACC and paracingulate gyri (p FDR =0.038; MNI coordinates x=+2, y=+36, z=+24; 138 voxels). Pairwise comparisons between treatment cohorts suggested that this represented a reduction in connectivity with pregabalin relative to duloxetine, without reaching statistical significance (p FDR =0.062). No significant treatment-associated connectivity changes were evident between duloxetine and placebo, or pregabalin and placebo. Abstract SAT0570-Figure 1. Seed-based correlation analysis demonstrating increased baseline functional connectivity between the ACC and the cunei, occipital poles, lateral occipital cortices and precuneus in hand OA participants, relative to non-OA controls.
Annals of the Rheumatic Diseases, Jun 1, 2013
ABSTRACT
Journal of Back and Musculoskeletal Rehabilitation, Jan 13, 2020
BACKGROUND: Lateral epicondylitis (LE) is a common problem of the arm. Mulligan has proposed the ... more BACKGROUND: Lateral epicondylitis (LE) is a common problem of the arm. Mulligan has proposed the use of mobilization with movement for LE. OBJECTIVES: To investigate the effects of Mulligan's mobilization with movement (MWM) in LE. METHODS: Forty patients were included in the study and randomly assigned to group 1 (n = 20), who received MWM, exercise and cold therapy, or group 2 (n = 20), who received exercise and cold therapy. The sessions were conducted five times a week for two weeks. All measures were conducted at baseline, after treatment, at 1st and 3rd months follow-ups. Mann-Whitney U test, a visual analogue scale (VAS) for pain intensity, Patient-rated Tennis Elbow Evaluation (PRTEE) Questionnaire for pain intensity and functional disability and a dynamometer for hand grip strength were applied. RESULTS: VAS activity pain significantly decreased in group 1 after treatment (p = 0.001), at the 1 st (p < 0.001) and 3 rd months (p = 0.040). There was a significant decrease in VAS night pain in group 1 (p = 0.024), and a significant increase in pain-free grip strength (p = 0.002) after treatment. PRTEE-Pain scores decreased in group 1 after treatment (p < 0.001), 1 st (p < 0.001) and 3 rd months (p = 0.001). CONCLUSIONS: MWM plus exercise and cold therapy is a safe and effective alternative with positive effects on elbow pain, functional capacity, and pain-free, maximum grip strength.
Türkiye fiziksel tıp ve rehabilitasyon dergisi, 2013
Pain Physician, 2021
BACKGROUND: Myofascial pain syndrome is a regional musculoskeletal pain syndrome characterized by... more BACKGROUND: Myofascial pain syndrome is a regional musculoskeletal pain syndrome characterized by trigger points. Although there are widely accepted treatment modalities, there is no gold standard treatment. Kinesiotaping represents an interesting modality in the treatment of musculoskeletal disorders and attracts attention with studies emerging in the recent years, but in spite of the proposed benefits of kinesiotaping, its efficacy is still unclear, thus further studies evaluating the effectiveness of kinesiotaping are needed. OBJECTIVES: We aimed to investigate, not only the effectiveness of kinesiotaping applied with the space correction and muscle inhibition techniques (compared to the home exercise program in reducing pain and improving functional status and quality of life in female patients with myofascial pain syndrome related to active trigger points in the upper trapezius), but also to evaluate the superiority of the 2 techniques over each other. STUDY DESIGN: An open-lab...
Blood, 2007
Osteoporosis, osteosclerosis and lytic lesions, have been observed in patients with SM possibly r... more Osteoporosis, osteosclerosis and lytic lesions, have been observed in patients with SM possibly reflecting different amounts of infiltrating mast cells and variation in the active substances they secrete. SM patients may be prone to pathological fractures. In a former study using dual energy X-ray absorptiometry (DXA), it was reported that SM patients with more severe disease had significantly higher bone density at the L1–L4 spine and femoral neck then those patients with less severe disease. We therefore investigated the value of quantitative ultrasound QUS of the calcaneus expressed as the stiffness index in the assessment of BMD in SM patients, as well as BMD of lumbar spine (L1–L4), femoral neck and distal radius using DXA and biochemical markers of bone turnover, plasma tryptase levels and their correlation with the clinical features. Fourteen adult patients (4 females, 10 males, median age 37, and range 23–64) with mastocytosis were included in this study. Overall, nine out o...
Annals of Physical and Rehabilitation Medicine, 2018
Conclusion Intra-articular ozone in comparison to HA or hypertonic dextrose injections, may have ... more Conclusion Intra-articular ozone in comparison to HA or hypertonic dextrose injections, may have quietly equal effects in the treatment of mild to moderate knee OA patients throughout short term period; However by 3-6 months after injection, this therapeutic effect would be disappeared, more earlier than other control injections. Keywords Knee osteoarthritis; Intra-articular ozone injection; Systematic review with meta-analysis Disclosure of interest The authors declare that they have no competing interest.
Osteoporosis International, 1996
Osteoporosis International, 1996
Without Abstract
Acta Orthop Traumatol …, 2004
... 100 olguda fraktür osteoporoz ilişkisi Güzin Dilşen(1), Nurten Eskiyurt(1) Dilşad Sindel(1), ... more ... 100 olguda fraktür osteoporoz ilişkisi Güzin Dilşen(1), Nurten Eskiyurt(1) Dilşad Sindel(1), Necla Hüseyinoğlu(1), Mişel Koki nO(1), Aydan Oral(1), ... OrlOpedi ve Trav lIlaıoloji .4nahılilıı Dalı, (.!) Istanhııl Uııi\'ersiıe.-;i 15wJI/)ul Tıp Fahiiıesı Orropedi ,'e TrannalOloji Anabilim Dal!, ...
... Yeşim Gökçe Kutsal , Ayçe Atalay , Şule Arslan , Aynur Başaran , Ferhan Cantürk , Abdullan Ci... more ... Yeşim Gökçe Kutsal , Ayçe Atalay , Şule Arslan , Aynur Başaran , Ferhan Cantürk , Abdullan Cindaş , Merih Eryavuz , Jale İrdesel , Kıymet İkbal Karadavut , Yeşim Kirazlı , Dilşad Sindel , Kazım Şenel , Füsun Güler Uysal , Kadir Yıldırım. ÖZET. ...
Work
BACKGROUND: Upper extremity injuries may cause not only physical but also serious social and psyc... more BACKGROUND: Upper extremity injuries may cause not only physical but also serious social and psychological problems in workers. OBJECTIVE: The aim of this study was to compare demographic and work-related features of persons with hand injuries who sustained a work-related or a non-work-related injury to gain insights into possible predisposing factors for work-related injuries as well as psychosocial consequences of hand injuries from the social work perspective. METHODS: This case-control study was conducted on 30 work-related and 30 non-work-related hand injury patients. The patients were evaluated using a questionnaire designed by the authors based on the principles of social work involving demographics, work-related features, thought-emotion-behaviour features, family and friend relationships, need for family support and professional psychosocial support. Survey data from both groups were statistically analysed using descriptive statistics, Chi-square and Fisher Exact test. RESU...
Türk Osteoporoz Dergisi, 2004
The aim of the study was to compare the T-scores of quantitative ultrasound (QUS) of the calcaneu... more The aim of the study was to compare the T-scores of quantitative ultrasound (QUS) of the calcaneus with those of dual-energy X-ray absorptiometry (DXA) of the lumbar spine and hip in men. We studied on sixty-four male patients (mean age 52.47 + 16.51 years). BMD T-score at the lumbar spine and femoral neck correlated positively with QUS T-score of the calcaneus (r=0.258, p<0.005 and r=0.333, p<0.001 respectively). The kappa score for osteoporosis were 0.16 and 0.27 for QUS T-scores versus spinal and femoral DXA T-scores. With the "–2.5" cut-off level used, sensitivity and specificity of QUS T-score in detecting osteoporosis were 25% and 96% at the lumbar spine, were 0% and 91% at the femoral neck and were 25% and 93% at the total hip. We conclude that QUS T-score has a weak correlation with DXA T-score at the lumbar spine and a moderate correlation with DXA T-score at the femoral neck; QUS has a very low sensitivity and concordance for the diagnosis of osteoporosis c...
Journal of Musculoskeletal & Neuronal Interactions, Mar 1, 2023
Objective: To investigate the effects of mesotherapy in patients with mild to moderate knee osteo... more Objective: To investigate the effects of mesotherapy in patients with mild to moderate knee osteoarthritis (KOA). Methods: The study included 43 patients (56 knees) who were randomly assigned to either the mesotherapy group (MG, n=28) or the saline group (SG, n=28) and received a total of 4 weekly mesotherapy (MG) or saline injections (SG). Pain, functional status and quality of life were evaluated by a Visual Analogue Scale (VAS), the Western Ontario Universities Osteoarthritis Index (WOMAC) and the Short Form-36 (SF-36) subscales at baseline and at 8 and 16 weeks of follow-up. Results: A total of 39 patients (52 knees) completed the study. Eight weeks after treatment, a significant improvement was found in VAS pain scores, WOMAC scores and physical component scores (PCS) of the SF-36 in both groups compared to baseline (p<0.05). The VAS activity pain score, WOMAC-pain, WOMAC-physical function and WOMAC-total scores were found to have decreased significantly in the MG compared to the SG (p<0.001) at both 8 weeks and 16 weeks. The PCS scores significantly improved in the MG compared to the SG at 8- and 16-week follow-ups (p<0.001 and p<0.001, respectively). Conclusions: Mesotherapy is a well-tolerated, safe and effective alternative treatment option in patients with mild and moderate KOA.
Turkish Journal of Physical Medicine and Rehabilitation
Despite the availability of safe and effective anti-osteoporosis treatments, osteoporosis continu... more Despite the availability of safe and effective anti-osteoporosis treatments, osteoporosis continues to be undertreated. The increase in fragility fractures, which is the main clinical consequence of osteoporosis, is a major problem for healthcare systems of countries. A broad range of drugs including antiresorptive and anabolic agents are used in the pharmacological treatment of osteoporosis. Fracture risk assessment in drug selection is of utmost importance in terms of guiding treatment. The recommended thresholds for osteoporosis treatment decision making are based on major osteoporotic and hip fracture probabilities from the Fracture Risk Assessment Tool (FRAX®). Currently, antiresorptive agents are usually the first choice to increase bone mineral density (BMD) and reduce the fracture risk. Bisphosphonates and antiresorptive drugs such as denosumab, a nuclear factor kappa-B ligand (RANKL) inhibitor, are the most widely used drugs in the treatment of osteoporosis. Bisphosphonates...
PubMed, Mar 1, 2023
Objective: To investigate the effects of mesotherapy in patients with mild to moderate knee osteo... more Objective: To investigate the effects of mesotherapy in patients with mild to moderate knee osteoarthritis (KOA). Methods: The study included 43 patients (56 knees) who were randomly assigned to either the mesotherapy group (MG, n=28) or the saline group (SG, n=28) and received a total of 4 weekly mesotherapy (MG) or saline injections (SG). Pain, functional status and quality of life were evaluated by a Visual Analogue Scale (VAS), the Western Ontario Universities Osteoarthritis Index (WOMAC) and the Short Form-36 (SF-36) subscales at baseline and at 8 and 16 weeks of follow-up. Results: A total of 39 patients (52 knees) completed the study. Eight weeks after treatment, a significant improvement was found in VAS pain scores, WOMAC scores and physical component scores (PCS) of the SF-36 in both groups compared to baseline (p<0.05). The VAS activity pain score, WOMAC-pain, WOMAC-physical function and WOMAC-total scores were found to have decreased significantly in the MG compared to the SG (p<0.001) at both 8 weeks and 16 weeks. The PCS scores significantly improved in the MG compared to the SG at 8- and 16-week follow-ups (p<0.001 and p<0.001, respectively). Conclusions: Mesotherapy is a well-tolerated, safe and effective alternative treatment option in patients with mild and moderate KOA.
Annals of the Rheumatic Diseases, Jun 1, 2013
Background: Causes of osteoporosis in patients with connective tissue diseases (CTD) are more com... more Background: Causes of osteoporosis in patients with connective tissue diseases (CTD) are more complex than in patients with postmenopausal osteoporosis (PO). None of the studies published so far examined the safety and efficacy of once-yearly intravenous zoledronic acid 5 mg administration in CTD patients. Objectives: The aim of the study was to assess safety of the zoledronic acid administration in patients with osteoporosis in the course of CTD and compare it to patients with PO. Methods: We investigated 160 patients with osteoporosis including those without CTD or PO who received in total 278 infusions of intravenous zoledronic acid 5 mg in the period 2010-2012. Two subgroups of patients were identified: 47 with osteoporosis in the course of CTD including 33 with rheumatoid arthritis and 91 with PO. All patients included into the study fulfilled the osteoporosis densitometric criteria according to WHO and had contraindications to the use of oral bisphosphonates. The primary endpoint was the number of complications observed in CTD patients after the zoledronic acid administration compared to the number of complications registered in patients with PO. Results: Both PO and CTD patients groups showed no statistically significant differences in terms of the mean age (73 vs. 70,66 years), T score result before the first administration of zoledronic acid (-2,91 vs.-2,81) and mean number of osteoporotic fractures (1,8 vs. 1,69). The number of complications in patients with CTD was significantly higher (14,89%-7 patients) than in patients with PO (3,29%-3 patients) (p<0,03). Furthermore in patients with PO the only observed type of adverse reaction were flu-like symptoms whereas in patients with osteoporosis associated with CTD also more severe complications were registered such as the renal function impairment (3 cases) and osteonecrosis of the jaw (1 case). Conclusions: The safety and efficacy of a single 5 mg intravenous infusion of zoledronic acid should be further investigated as our retrospective analysis suggests that in patients with CTD treated with zoledronic acid the number of complications is significantly higher and they are more severe as compared to patients with PO.
Pain Physician, Sep 17, 2021
BACKGROUND: Myofascial pain syndrome is a regional musculoskeletal pain syndrome characterized by... more BACKGROUND: Myofascial pain syndrome is a regional musculoskeletal pain syndrome characterized by trigger points. Although there are widely accepted treatment modalities, there is no gold standard treatment. Kinesiotaping represents an interesting modality in the treatment of musculoskeletal disorders and attracts attention with studies emerging in the recent years, but in spite of the proposed benefits of kinesiotaping, its efficacy is still unclear, thus further studies evaluating the effectiveness of kinesiotaping are needed. OBJECTIVES: We aimed to investigate, not only the effectiveness of kinesiotaping applied with the space correction and muscle inhibition techniques (compared to the home exercise program in reducing pain and improving functional status and quality of life in female patients with myofascial pain syndrome related to active trigger points in the upper trapezius), but also to evaluate the superiority of the 2 techniques over each other. STUDY DESIGN: An open-label randomized clinical trial with a parallel assignment intervention model. SETTING: The physical medicine and rehabilitation clinics in Istanbul University, Istanbul Faculty of Medicine. METHODS: Seventy-one female patients with the complaint of pain in the upper trapezius region, diagnosed with myofascial pain syndrome, and having at least one active trigger point in the upper trapezius fibers, were randomly assigned by a computer program to 1 of the 3 groups: kinesiotaping with the space correction technique (KSCT, n = 20), kinesiotaping with the muscle inhibition technique (KMIT, n = 24), and the home exercise program alone (control group [CG], n = 27). The patients were evaluated by the numerical rating scale for pain intensity, the neck disability index for functional status, and the 36-Item Short-Form Health Survey for quality of life in the beginning of the study and at the first, second, and sixth weeks (1-month follow-up). RESULTS: Kinesiotaping was associated with lower pain intensity levels (P = 0.019 at the first week and P = 0.026 at the second week) and better functional status (P = 0.011 at the second week) and it was effective in increasing quality of life by improving physical functions and general health (P = 0.033 and P = 0.003 at the second week, respectively) earlier than in the CG. Role limitations due to physical factors improved in the KMIT group earlier than in the other groups (P = 0.022 at the second week). LIMITATIONS: Being performed in a limited number of female patients only, absence of a placebo group, and lack of blinded assessments. CONCLUSION: Both kinesiotaping methods were associated with lower pain intensity levels and better functional status and were effective in increasing quality of life by improving physical functions and general health earlier than the home exercise program. There was no significant difference between the kinesiotaping methods, except for role limitations due to the physical factors domain of SF-36 which was improved in the KMIT group earlier than in the KSCT group and CGs. KEY WORDS: Myofascial pain syndrome, myofascial trigger point pain, trapezius, kinesiotape, muscle inhibition technique, space correction technique
Background: Studies indicate brain grey matter volumetric changes are associated with chronic pai... more Background: Studies indicate brain grey matter volumetric changes are associated with chronic pain. In people with painful hand osteoarthritis (OA), grey matter volume reductions have been identified in the anterior cingulate cortex (ACC): a key pain-processing region. 1 Objectives: We hypothesised that people with hand OA would have alterations in resting-state functional connectivity networks involving the ACC and other painprocessing brain regions relative to non-OA controls. Furthermore, we hypothesised that treatment with centrally-acting analgesics (pregabalin or duloxetine) would result in connectivity changes in these brain regions. Methods: Resting-state functional MRI (fMRI) of the brain was performed on hand OA participants (n=28) before and after 12 weeks of treatment with duloxetine, pregabalin or placebo, and compared to non-OA participants (n=11) from the same age range (40-75 years). Scans of 7 hand OA participants and 1 control were excluded due to excessive movement artefact. Seed-based correlation analyses were performed using the CONN toolbox 2 to evaluate differences in functional connectivity of networks involving the ACC, insular cortices and thalami between patients and controls, and between pre-and post-treatment states. Results: Relative to non-OA controls, hand OA participants had increased functional connectivity at baseline between the ACC and the cunei, occipital poles, lateral occipital cortices and precuneus (p=0.00054, FDR-corrected for multiple comparisons; MNI coordinates x=-4, y=-86, z=+40; 513 voxels) (figure 1). No differences in baseline functional connectivity were seen in the insular cortices or thalami. After treatment, altered functional connectivity was identified between the left thalamus and the ACC and paracingulate gyri (p FDR =0.038; MNI coordinates x=+2, y=+36, z=+24; 138 voxels). Pairwise comparisons between treatment cohorts suggested that this represented a reduction in connectivity with pregabalin relative to duloxetine, without reaching statistical significance (p FDR =0.062). No significant treatment-associated connectivity changes were evident between duloxetine and placebo, or pregabalin and placebo. Abstract SAT0570-Figure 1. Seed-based correlation analysis demonstrating increased baseline functional connectivity between the ACC and the cunei, occipital poles, lateral occipital cortices and precuneus in hand OA participants, relative to non-OA controls.
Annals of the Rheumatic Diseases, Jun 1, 2013
ABSTRACT
Journal of Back and Musculoskeletal Rehabilitation, Jan 13, 2020
BACKGROUND: Lateral epicondylitis (LE) is a common problem of the arm. Mulligan has proposed the ... more BACKGROUND: Lateral epicondylitis (LE) is a common problem of the arm. Mulligan has proposed the use of mobilization with movement for LE. OBJECTIVES: To investigate the effects of Mulligan's mobilization with movement (MWM) in LE. METHODS: Forty patients were included in the study and randomly assigned to group 1 (n = 20), who received MWM, exercise and cold therapy, or group 2 (n = 20), who received exercise and cold therapy. The sessions were conducted five times a week for two weeks. All measures were conducted at baseline, after treatment, at 1st and 3rd months follow-ups. Mann-Whitney U test, a visual analogue scale (VAS) for pain intensity, Patient-rated Tennis Elbow Evaluation (PRTEE) Questionnaire for pain intensity and functional disability and a dynamometer for hand grip strength were applied. RESULTS: VAS activity pain significantly decreased in group 1 after treatment (p = 0.001), at the 1 st (p < 0.001) and 3 rd months (p = 0.040). There was a significant decrease in VAS night pain in group 1 (p = 0.024), and a significant increase in pain-free grip strength (p = 0.002) after treatment. PRTEE-Pain scores decreased in group 1 after treatment (p < 0.001), 1 st (p < 0.001) and 3 rd months (p = 0.001). CONCLUSIONS: MWM plus exercise and cold therapy is a safe and effective alternative with positive effects on elbow pain, functional capacity, and pain-free, maximum grip strength.
Türkiye fiziksel tıp ve rehabilitasyon dergisi, 2013
Pain Physician, 2021
BACKGROUND: Myofascial pain syndrome is a regional musculoskeletal pain syndrome characterized by... more BACKGROUND: Myofascial pain syndrome is a regional musculoskeletal pain syndrome characterized by trigger points. Although there are widely accepted treatment modalities, there is no gold standard treatment. Kinesiotaping represents an interesting modality in the treatment of musculoskeletal disorders and attracts attention with studies emerging in the recent years, but in spite of the proposed benefits of kinesiotaping, its efficacy is still unclear, thus further studies evaluating the effectiveness of kinesiotaping are needed. OBJECTIVES: We aimed to investigate, not only the effectiveness of kinesiotaping applied with the space correction and muscle inhibition techniques (compared to the home exercise program in reducing pain and improving functional status and quality of life in female patients with myofascial pain syndrome related to active trigger points in the upper trapezius), but also to evaluate the superiority of the 2 techniques over each other. STUDY DESIGN: An open-lab...
Blood, 2007
Osteoporosis, osteosclerosis and lytic lesions, have been observed in patients with SM possibly r... more Osteoporosis, osteosclerosis and lytic lesions, have been observed in patients with SM possibly reflecting different amounts of infiltrating mast cells and variation in the active substances they secrete. SM patients may be prone to pathological fractures. In a former study using dual energy X-ray absorptiometry (DXA), it was reported that SM patients with more severe disease had significantly higher bone density at the L1–L4 spine and femoral neck then those patients with less severe disease. We therefore investigated the value of quantitative ultrasound QUS of the calcaneus expressed as the stiffness index in the assessment of BMD in SM patients, as well as BMD of lumbar spine (L1–L4), femoral neck and distal radius using DXA and biochemical markers of bone turnover, plasma tryptase levels and their correlation with the clinical features. Fourteen adult patients (4 females, 10 males, median age 37, and range 23–64) with mastocytosis were included in this study. Overall, nine out o...
Annals of Physical and Rehabilitation Medicine, 2018
Conclusion Intra-articular ozone in comparison to HA or hypertonic dextrose injections, may have ... more Conclusion Intra-articular ozone in comparison to HA or hypertonic dextrose injections, may have quietly equal effects in the treatment of mild to moderate knee OA patients throughout short term period; However by 3-6 months after injection, this therapeutic effect would be disappeared, more earlier than other control injections. Keywords Knee osteoarthritis; Intra-articular ozone injection; Systematic review with meta-analysis Disclosure of interest The authors declare that they have no competing interest.
Osteoporosis International, 1996
Osteoporosis International, 1996
Without Abstract
Acta Orthop Traumatol …, 2004
... 100 olguda fraktür osteoporoz ilişkisi Güzin Dilşen(1), Nurten Eskiyurt(1) Dilşad Sindel(1), ... more ... 100 olguda fraktür osteoporoz ilişkisi Güzin Dilşen(1), Nurten Eskiyurt(1) Dilşad Sindel(1), Necla Hüseyinoğlu(1), Mişel Koki nO(1), Aydan Oral(1), ... OrlOpedi ve Trav lIlaıoloji .4nahılilıı Dalı, (.!) Istanhııl Uııi\'ersiıe.-;i 15wJI/)ul Tıp Fahiiıesı Orropedi ,'e TrannalOloji Anabilim Dal!, ...
... Yeşim Gökçe Kutsal , Ayçe Atalay , Şule Arslan , Aynur Başaran , Ferhan Cantürk , Abdullan Ci... more ... Yeşim Gökçe Kutsal , Ayçe Atalay , Şule Arslan , Aynur Başaran , Ferhan Cantürk , Abdullan Cindaş , Merih Eryavuz , Jale İrdesel , Kıymet İkbal Karadavut , Yeşim Kirazlı , Dilşad Sindel , Kazım Şenel , Füsun Güler Uysal , Kadir Yıldırım. ÖZET. ...
Work
BACKGROUND: Upper extremity injuries may cause not only physical but also serious social and psyc... more BACKGROUND: Upper extremity injuries may cause not only physical but also serious social and psychological problems in workers. OBJECTIVE: The aim of this study was to compare demographic and work-related features of persons with hand injuries who sustained a work-related or a non-work-related injury to gain insights into possible predisposing factors for work-related injuries as well as psychosocial consequences of hand injuries from the social work perspective. METHODS: This case-control study was conducted on 30 work-related and 30 non-work-related hand injury patients. The patients were evaluated using a questionnaire designed by the authors based on the principles of social work involving demographics, work-related features, thought-emotion-behaviour features, family and friend relationships, need for family support and professional psychosocial support. Survey data from both groups were statistically analysed using descriptive statistics, Chi-square and Fisher Exact test. RESU...