Ayşe Merve Ata

Introduction/Aims: Evidence comparing hydrodissection techniques using 5% dextrose in water (D5W) for carpal tunnel syndrome (CTS) remains limited. This study evaluated the clinical, ultrasonographic, and electrodiagnostic outcomes of three hydrodissection techniques in patients with mild‐to‐moderate CTS. Methods: In this randomized clinical trial, 74 patients with clinically and electrodiagnostically confirmed mild‐to‐moderate CTS were allocated to ultrasound‐guided in‐plane (IP), ultrasound‐guided out‐of‐plane (OP), or blind anatomical injection. All participants received one 5 mL D5W injection. Pain intensity, symptom severity, functional status, and neuropathic pain were assessed using the Visual Analog Scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ‐SSS/FSS), and Douleur Neuropathique 4 (DN4), respectively, and median nerve cross‐sectional area (CSA) was measured at baseline, 2 weeks, and 3 months. Electrodiagnostic (EDX) studies were performed at baseline and 3 months. Results: VAS, BCTQ‐SSS, BCTQ‐FSS, and DN4 showed no significant group‐by‐time differences (all p > 0.05). Within each group, VAS, BCTQ‐SSS, BCTQ‐FSS, and DN4 improved from baseline at 2 weeks and 3 months (all p < 0.001). Three‐month minimal clinically important difference (MCID) outcomes did not differ significantly among groups (BCTQ‐SSS, BCTQ‐FSS, and DN4) (all p > 0.05). The CSA group‐by‐time interaction was nonsignificant ( p > 0.05), but CSA decreased from baseline at both follow‐ups in all groups (all p < 0.001). No significant group‐by‐time interactions or within‐group changes were observed in EDX outcomes (all p > 0.05). Discussion: Perineural hydrodissection with D5W was associated with short‐term clinical and sonographic improvement in mild‐to‐moderate CTS. Comparable outcomes with ultrasound‐guided IP and OP techniques and the blind technique suggest flexibility in technique selection based on clinician experience and patient comfort.

Aim The purpose of this study was to evaluate the effectiveness of an individualized aerobic exercise program prescribed according to V̇O₂max measured by cardiopulmonary exercise testing (CPET) in a cardiac rehabilitation setting. Methods An observational case-control study. Thirty patients diagnosed with compensated Heart failure and functional capacity New York Heart Association 2-3 were included in the study. Participants underwent a CPET to determine aerobic capacity. Before and after the intervention, CPET and 6-Minute Walk Test (6MWT) for functional exercise capacity, the short form-36 health survey (SF-36) scale to assess quality of life, handgrip strength using a dynamometer for muscle strength, and the Hospital Anxiety and Depression Scale (HADS) were applied. Results The study included 30 patients, 85.7% of whom were male, with a mean age of 52.8 years. The CPET results before and after rehabilitation revealed changes in several parameters; however, only PETCO₂ and resting systolic blood pressure showed statistically significant changes. There were no significant differences in the VO₂ max, VE/VCO₂ slope (EQCO₂), O₂ pulse, or heart rate recovery (HRR) levels after treatment assessment. In the functional assessment, handgrip strength significantly increased (P = .001). The energy/fatigue and social functioning domains of the SF-36 significantly improved after rehabilitation (P = .032 and P = .024, respectively). There was no difference in anxiety or depression assessments (both P > .05). Conclusion A structured rehabilitation program featuring continuous moderate-intensity aerobic exercise significantly improves ventilatory efficiency, blood pressure control, peripheral muscle strength, and certain aspects of quality of life in heart failure patients.

Heart failure (HF) is a medical condition that has a substantial impact on quality of life and is becoming more prevalent worldwide [1]. Increased catabolic stress in the skeletal muscles of patien...

Background: Dysphagia is frequently seen in stroke patients. Although various factors have been identified as negative predictors of dysphagia recovery, swallowing muscle atrophy has also been emphasized. Objective: The aim of this study was to examine the swallowing muscles in stroke patients with or without dysphagia using ultrasound (US), to determine the predictors on swallowing function and to identify independent predictors of dysphagia. Method: Patients with stroke were evaluated. Mini Nutritional Assessment‐Short Form (MNA‐SF), Functional Oral Intake Scale (FOIS), Eating Assessment Tool (EAT‐10) and Functional Independence Measure (FIM) were assessed. The thicknesses of masseter, temporal and mylohyoid muscles, and cross‐sectional areas of geniohyoid and digastric anterior muscles were measured. Results: A total of 42 stroke patients were included. The patients with dysphagia were older ( p = 0.004). MNA‐SF, FOIS, and FIM scores were lower in the dysphagia group ( p < 0.001). Muscle measurements decreased on the hemiplegic side in the digastric anterior muscle of the dysphagia group ( p = 0.032). Hemiplegic side masseter muscle thickness ( p = 0.011), non‐hemiplegic side masseter ( p = 0.021) and mylohyoid muscle thicknesses ( p = 0.005), digastric anterior cross‐sectional area ( p = 0.017) were lower in the dysphagia group. Multivariate logistic regression analysis showed that lower MNA‐SF scores were associated with a higher probability of dysphagia (OR = 0.734, p = 0.048). Conclusions: Although swallowing muscles were affected in post‐stroke dysphagia, a muscle group that predicts dysphagia has not been identified. MNA‐SF was independently related to dysphagia; however, the observed association should be considered within the bidirectional framework. The assessment of swallowing muscles by US and the identification of affected muscles can improve the development of targeted rehabilitation programs.

Falls are a growing public health issue with severe impacts on older adults, their families, and healthcare systems. This study aims to identify the root causes and risk factors of falls in a tertiary rehabilitation center and suggest measures to reduce fall-related hospital stays. This retrospective, cross-sectional study included 248 patients who were reported to have fallen among the patients receiving inpatient rehabilitation at a tertiary rehabilitation center. Demographic and clinical characteristics such as gender, age, diagnosis, day of fall in the rehabilitation hospital, history of chronic disease, polypharmacy, place of fall, time of fall, vitamin D, total (25 OH) levels and albumin levels at the time of admission were recorded. The fall rate was 1.8%, with a median patient age of 56. Falls were most common in stroke (23%), spinal cord injury (18.5%), and pediatric rehabilitation (17.7%) clinics, mainly occurring in patient rooms (47.6%), bathrooms (25%), and clinic corridors (14.9%), typically between 8:00 and 16:00 (48%). In adults, fall risk increased with age (r=0.338, p<0.001) and was higher in those with comorbidities (p=0.011) or polypharmacy (p<0.011). In pediatric group, fall risk score was negatively correlated with albumin level (r=-0.472, p=0.048). Falls were most common among middle-aged hemiplegia and paraplegia patients with complex medical conditions. Identifying high srisk patients at admission and conducting regular assessments are key to effective fall prevention.

The aim of this study was to evaluate the effect of Transfer Energy Capacitive and Resistive (TECAR) therapy on pain, symptom severity and function in patients diagnosed with carpal tunnel syndrome (CTS) and to compare it with ultrasound (US) therapy. A total of 42 patients aged between 18 and 65 years, were divided into two groups; group 1 received US therapy, group 2 received TECAR therapy. Both groups received paraffin therapy and wrist orthosis. All Patients were evaluated using the Visual Analog Scale (VAS) for pain and paresthesia levels, the Boston Carpal Tunnel Questionnaire (BCTQ) for symptom severity and functional levels. Additionally, median nerve cross sectional area (CSA) was measured by ultrasound, at the baseline, post-treatment, first and third months. According to our results, VAS and BCTQ (symptom and function) scores significantly improved in both groups during follow-ups (all p < 0.01). However, there was no significant difference between the groups other than the VAS score at 3 months. At 3 months, Group 1 had a lower VAS score than Group 2 (p = 0.013). In Group 1, median nerve CSA decreased significantly after treatment (p < 0.001), and it was maintained during the first- and third-months follow-ups (p = 0.002 and p = 0.006, respectively). In Group 2, median nerve CSA decreased after treatment (p = 0.017) compared to before treatment and it returned to baseline levels in the third month (p = 0.770). While TECAR therapy may be beneficial in lowering pain and improving symptoms and functions in CTS patients, its effects were not as long-lasting as US. Clinical trial number: NCT06451094.

Cite this article as: Tezen Ö, Merve Ata A. Response to comment on “comparison of the efficacy of radial and focused extracorporeal shock wave therapy in dupuytren’s disease: A pilot study”. Arch Health Sci Res. 2025; 12, 1691, doi:10.5152/ArcHealthSciRes.2025.251691.