Mustafa Corum

Objectives: Whole-body vibration (WBV) is applied to the sole of the foot, whereas local mechanical vibration (LMV) is applied directly to the muscle or tendon. The time required for the mechanical stimulus to reach the muscle belly is longer for WBV. Therefore, the WBV-induced muscular reflex (WBV-IMR) latency may be longer than the tonic vibration reflex (TVR) latency. The aim of this study was to determine whether the difference between WBV-IMR and TVR latencies is due to the distance between the vibration application point and the target muscle. Methods: Eight volunteers participated in this study. The soleus reflex response was recorded during WBV, LMVs, and tendon tap. LMVs were applied to the Achilles tendon and sole of the foot. The latencies were calculated using the cumulative averaging technique. Results: The latency (33.4 +/- 2.8 ms) of the soleus reflex induced by the local foot vibration was similar to the soleus TVR latency (30.9 +/- 3.2 ms) and T-reflex (32.0 +/- 2.4 ms) but significantly shorter than the latency of the soleus WBV-IMR (42.3 +/- 3.4 ms) (F-(3,F-21)=27.46, p=0.0001, partial eta(2)=0.797). Conclusions: The present study points out that the neuronal circuitries of TVR and WBV-IMR are different.

Objectives: The aim of this study was to evaluate and compare the effects of radial extracorporeal shock wave therapy (rESWT) and supervised exercises with neuromuscular inhibition (NMI) technique in improving pain, function, and grip strength in the treatment of patients with lateral epicondylitis (LE). Patients and methods: A total of 50 patients with LE (11 males, 30 females; median age: 46 years; range, 23 to 57 years) whose symptoms persisted for at least three months between February 2015 and August 2015 were included in the prospective, randomized-controlled, clinical study. The patients were divided into two groups as the rESWT group (n=25) receiving a total of three rESWT sessions (once per week with 1.8 bar pneumatic pressure, 10 Hz frequency, and with 2,000 pulses) and the exercise group (n=25) receiving supervised exercises with NMI (three times per week for three weeks). Pain and function were evaluated using Visual Analog Scale, the total Patient-Rated Tennis Elbow Evaluation, the Roles and Maudsley score, while the grip strength was evaluated using a hand dynamometer at one and three months after treatment compared to baseline. Results: A significant improvement was observed in all outcome criteria at one and three months after treatment, compared to baseline, in both the rESWT and exercise groups (p0.05). Conclusion: The rESWT seems to provide no significantly superior benefit than supervised exercises with NMI at least until the three months in the treatment of LE.

Background: The aim of this study was to compare the effects of complex decongestive therapy (CDT) accompanied by resistance exercises on extremity circumference, lymphedema volume, grip strength, functional status, and quality of life in the treatment of breast cancer-related lymphedema (BCRL) in patients with and without pain. Methods and Results: Fifty patients with unilateral BCRL were divided into groups: with pain (Group 1, n = 25) and without pain (Group 2, n = 25). Thirty minutes of manual lymphatic drainage and multilayered short-stretch bandaging were applied to all patients five times a week for 4 weeks. In addition, all patients were informed about skin care and given a supervised resistance exercise program throughout the treatment. During the 1-month follow-up period, patients were asked to use low-tension elastic garments and to continue their home exercise program. Differences in upper extremity circumference and volume; grip strength; Quick Disabilities of the Arm, Shoulder, and Hand; and Functional Assessment of Cancer Therapy-Breast scores were evaluated at baseline, after treatment (week 4), and at 1-month follow-up. Moreover, the pain intensity of patients in Group 1 was measured using the visual analog scale (VAS). Patients in both Group 1 and Group 2 showed a statistical improvement in all outcome measures after treatment and at follow-up ( p < 0.05); however, no significant difference was observed between the groups ( p > 0.05). In Group 1, a statistically significant decrease was observed in the VAS score both at the end of treatment (−1.7 ± 0.9) and at 1-month follow-up (−3.5 ± 1.2) ( p < 0.05). Conclusion: Combined CDT and resistance exercises appear to be effective in BCRL patients both with and without pain.

Objective: The purpose of this study is to investigate upper cervical segmental dysfunctions in female patients with chronic TMD with and without neck pain and to compare them with healthy subjects. Method: Patients admitted to our hospital with jaw pain were evaluated in this study, and a total of 152 patients and healthy subjects who met the inclusion criteria for the study were divided into 3 groups: TMD with neck pain (n = 94), TMD without neck pain (n = 28) and control (n = 30). Patients with myofascial pain (category I) or disc displacements (category II) were diagnosed based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) guidelines. Upper cervical segmental dysfunctions were identified using functional and pain provocation tests in patients with TMD and healthy subjects. Results: When patients with TMD were classified, there was a significant difference between TMD with neck pain (category I, 62.8%; category II, 37.2%) and TMD without neck pain (category I, 28.6%; category II, 71.4%) groups (p = 0.002). There was a statistically significant dysfunction [difference] in all upper cervical segments in favor of the TMD with neck pain group compared TMD without neck pain group and healthy control group (p < 0.05). 51.1% Occiput-C1, 81.9% C1-C2 and 53.2% C2-C3 segment dysfunction rates were detected in TMD with neck pain group. Conclusion: Upper cervical segmental dysfunction rate was higher in TMD group with neck pain than TMD without neck pain and healthy control group.

Objectives: To investigate the effects of whole body vibration (WBV) training on isokinetic muscular performance, pain, function. and quality of life in patients with patellofemoral pain (PFP). Methods: Forty women with PFP were included in this study and assigned to either a WBV group that received WBV training plus home exercise or a control group that performed home exercise only. A supervised WBV training was performed in 24 sessions on a synchronous vertical vibration platform three times a week for eight weeks. The home exercise program in the control group was identical to that in the WBV group. isokinetic measurements were performed at baseline and post-treatment. In addition, patients were assessed after 6 months using a visual analog scale (VAS), Kujala Patellofemoral Score (KPS), and Short Form-36 (SF-36). Results: Total work of knee extensors and VAS improved significantly post-treatment in the WBV group compared to the control group (P=0.041, P=0.003, respectively). However, there was no significant difference between groups at the 6-month follow-up (P>0.05). Conclusions: The present findings recommended that eight weeks of WBV training plus home exercise can more effectively reduce pain and improve the endurance of the knee extensors than that of home exercise of patient with PFP.

Lumbar disc herniation is a rare disease in children. Children and adolescents with symptomatic lumbar disc herniation have a history of trauma or sports injury before pain begins. There is no difference in the frequency of disc herniation between the sexes in children. The segmental placement of disc herniation in children is similar to that seen in adults. A girl aged 14 years presented to our clinic complaining of a one-year low back pain and pain was radiating to the right leg. There was a significant posterocentral disc protrusion at the L5-S1 level on magnetic resonance imaging (MRI). Complete symptomatic relief was achieved at the end of a course of conservative treatment.