Sevtap Badil Güloğlu

Aims: To investigate the association between daily smartphone screen time (DSST) and nonspecific neck pain (NSNP) and to evaluate its relationship with pain intensity and disability.Methods: This age- and sex-matched case-control study included 128 participants (64 NSNP, 64 controls). DSST was obtained from device-based records. Pain intensity and disability were assessed using the Visual Analog Scale (VAS) and Neck Disability Index (NDI). Group comparisons, correlation analyses, and multivariable logistic regression were performed.Results: DSST did not differ between the NSNP and control groups and was not associated with NSNP in either continuous or categorical analyses. No significant relationship was found between DSST and pain intensity, disability, or pain duration. In contrast, heavy lifting and desk-based work were independently associated with NSNP. Younger age was associated with higher screen exposure.Conclusion: Daily smartphone use duration was not associated with the presence or severity of NSNP. Occupational and ergonomic factors appear to play a more important role. Preventive and therapeutic strategies should therefore prioritize biomechanical and workplace-related risk factors rather than focusing solely on-screen time. Additionally, given the higher levels of smartphone use observed in younger individuals, attention should be directed toward potential long-term health implications, including problematic use and related adverse outcomes, and early preventive strategies should be considered.

Objective: This study aimed to compare the clinical effectiveness of 5% and 15% dextrose prolotherapy (PrT), combined with exercise therapy and bracing, versus exercise therapy alone in patients with chronic lateral epicondylitis (LE). Methods: This retrospective study included patients with LE, and participants were divided into three groups: exercise only ( n = 29), 5% PrT + exercise ( n = 30), and 15% PrT + exercise ( n = 36). PrT was performed under ultrasound guidance at weeks 0, 3, and 6 targeting the forearm extensor muscles and annular ligament entheses. All patients used an epicondylitis brace and followed a 12-week home exercise program. Pain [visual analog scale (VAS)], function [patient-rated tennis elbow evaluation (PRTEE)], and grip strength were measured at baseline, week 6, and week 12. Results: All groups showed significant within-group improvements in VAS, PRTEE, and grip strength. Both PrT groups had significantly greater improvements in pain and function than those of the exercise-only group at weeks 6 and 12. Grip strength in flexion was significantly higher in both PrT groups than that in the exercise group at week 12. No significant differences were found between the 5% and 15% PrT groups in extension and pinch grip strength across groups. Conclusion: 5% and 15% dextrose prolotherapy are both more effective than exercise alone in improving pain, function, and grip strength in chronic LE. The increased handgrip strength at week 12 suggests that prolotherapy may aid muscle strength recovery. The absence of significant differences between the prolotherapy groups indicates that higher concentrations of dextrose may not be necessary to achieve clinical improvement.

Background/aim: Telemedicine (TM) can overcome travel barriers in nonspecific neck pain (NNP), yet a comprehensive, physiatrist-supervised TM model has not been directly compared to standard in-clinic care. The aim of this study was to determine whether a video-based exercise and remote follow-up program is as effective as conventional follow-up in reducing pain and disability in NNP. Materials and methods: This parallel-group randomized controlled trial (registered in ClinicalTrials.gov) included 68 adults (mean age = 40.52 years) with NNP who were randomly allocated 1:1 to the TM group (TG, n = 34) or control group (CG, n = 34). Both received identical exercises via prerecorded video (TG) or printed brochure (CG) to be performed for 3 months. TG visits were via video call; CG visits were in the clinic. Primary outcomes were pain measured by the visual analog scale (VAS) at baseline, day 15, month 1, and 3, and disability measured by the neck disability index (NDI) at baseline and month 3. Secondary outcomes were exercise adherence, patient satisfaction, and travel/time burden. Analyses followed the intention-to-treat principle using linear mixed models. Results: Both groups achieved clinically important VAS reductions (TG: 6.56 to 3.02, CG: 6.44 to 2.96). The only between-group difference appeared at day 15, favoring CG (p = 0.038) and the group × time interaction was nonsignificant overall (p = 0.111). NDI improved similarly in both groups (p = 0.473). Adherence in TG and CG (67.90% and 71.21%, respectively) and satisfaction (4.25 and 4.42, respectively) were comparable. TG participants avoided a mean of 38.88 km/175.74 min of travel across 3 virtual visits. Conclusion: A structured TM program with remote physiatrist follow-up matches conventional outpatient care in managing NNP. Larger, long-term studies should define optimal support and assess cost effectiveness across diverse populations.

Objective: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy caused by median nerve compression. Steroid injections provide temporary relief in mild to moderate CTS, whereas 5% dextrose prolotherapy (PrT) has recently emerged as a regenerative alternative. This study compares the efficacy of ultrasound-guided perineural 5% dextrose PrT and corticosteroid injections. Methods: In this retrospective analysis, 74 individuals aged between 18 and 70 years, meeting both clinical and electrophysiological criteria for mild to moderate CTS, were included. 36 patients received a single ultrasound-guided injection of 40 mg triamcinolone acetonide (steroid group), while 38 patients underwent three perineural 5% dextrose PrT sessions at three-week intervals (PrT group). All patients followed a 12-week conservative protocol with wrist splinting and nerve/tendon gliding exercises. Outcomes were assessed at baseline, week 6, and week 24. The primary outcome was Visual Analog Scale (VAS) pain and numbness score. Secondary outcomes were QuickDASH, grip and pinch strengths, and median nerve conduction studies. Results: Both groups showed significant within-group clinical and functional improvements (p<0.05). At 6 weeks, the steroid group showed higher grip strength compared with PrT (MD = −1.25, 95% CI −4.12 to 1.62, p = 0.048) and pinch (MD = −0.32, 95% CI −0.87 to 0.23, p = 0.005) compared with the prolotherapy group. At 24 weeks, PrT resulted in lower daytime pain VAS compared with steroids (MD −1.15, 95% CI −2.23 to −0.07, p = 0.026), surpassing the minimal clinically important difference (MCID) for CTS pain reduction. Electrophysiological improvements occurred only in the steroid group, especially in motor and sensory conduction parameters, without corresponding long-term clinical superiority. Conclusion: Perineural PrT and steroid injections appear to be effective non-surgical options for managing mild to moderate CTS. While steroids may provide faster symptom relief and earlier improvements in strength, dextrose PrT demonstrated more sustained pain reduction. It should be noted, however, that the injection protocols differed—the steroid group received a single dose, whereas the PrT group underwent three sessions—an approach based on our review of the existing literature. This discrepancy should be considered when interpreting the results. Further randomized controlled trials are needed to confirm these findings and clarify the regenerative mechanisms of dextrose prolotherapy.

Objective: This study assessed the impact of a 20-minute osteoporosis education session on awareness and lifestyle changes in 76 elderly participants in senior day centers. Material and Methods: In this single-group interventional study, participants completed the Osteoporosis Knowledge Assessment Tool (OKAT) before and after the educational session. Also one month follow up was conducted with 41 participants, in which the primary focus was on OKAT score changes and secondary outcomes related to dietary calcium intake, exercise, and sun exposure. Results: The mean pre-education OKAT score was 9.76 (±3.40). It was higher in the highly-educated participants (p=0.04). The mean post-education OKAT score was 14.04 (±2.72), and the OKAT scores significantly improved following education (p

To compare the effects of low level laser therapy (LLLT) and corticosteroid injection in patients with moderate carpal tunnel syndrome (CTS). Eighty-seven patients (143 wrists) with moderate CTS were randomized to the corticosteroid or LLLT groups. 40 mg of triamcinolone acetate solution was applied to carpal tunnel of 44 patients (74 wrist). LLLT was applied to 43 patients (70 wrist) five times a week, for a total of 15 sessions (fluence of 6 j/cm² for 1 min per point at a wavelength of 830 nm). Outcome measures were numbness and pain, QuickDASH questionnaire, grasping tests, Tinel and Phalen tests, electrophysiological tests and MRI evaluations, which were tested at the baseline and 1st and 6th months after the treatment. Eighty patients (133 wrists) completed the study at the end of 6 months. VAS and Quick DASH scores were better in the corticosteroid group in the 1st month, but there were no significant differences between groups in the 6th month. Phalen and Tinel tests, strength tests, and motor distal latency improved significantly and similarly in both groups at the 1st and 6th months. Sensory distal latency and sensory nerve conduction velocity showed significant improvements in the 1st and 6th months only in the corticosteroid group. In both groups, median nerve intensity rate and palmary spring rate improved significantly after the treatment. Based on this study, corticosteroid injection and LLLT groups showed statistically significant difference at the 1st month (short-term), whereas there was no significant difference at the 6th month (intermediate-term).

Objectives: In this study, we aimed to evaluate and compare the efficacy of low-level laser therapy (LLLT) and extracorporeal shock wave therapy (ESWT) in the treatment of calcaneal spurs. Patients and methods: A total of 62 patients (14 males, 48 females; mean age: 47.6±11.7 years; range, 18 to 70 years) who were diagnosed with calcaneal spurs based on clinical examination and plain radiography between April 2019 and September 2019 were included in this study. A total of 15 sessions of plantar fascia gastroc-soleus stretching exercises and cold pack treatments were given to both groups. The LLLT (904 nm wavelength, 3,000 Hz, 8 J/cm2 dose to the painful heel area and insertion of the plantar fascia on the medial calcaneal area, five points for a total of 5 min for three weeks) was applied to the first group (n=31), whereas ESWT (10 Hz, 2,000 shock waves with a 2.5 bar pressure into the areas of the painful heel, insertion of the plantar fascia on the medial calcaneal area) was applied the second group (n=31). All patients were evaluated using the Visual Analog Scale (VAS) and Foot Function Index (FFI) before and after treatment. Results: In both groups, the median VAS and FFI scores after treatment showed a significant improvement, compared to pre-treatment scores (p=0.001). There was no significant difference between the groups in terms of the median post-treatment VAS scores (p>0.05). In the ESWT group, the median FFI pain and total scores after treatment were significantly lower than in the LLLT group (p=0.033). The change in the median FFI pain and total scores were significantly higher in the ESWT group (p=0.046). Conclusion: Both treatment modalities are effective and not superior to each other in terms of disability and activity limitation reduction, although a greater improvement in the FFI pain and total scores can be achieved with the ESWT. Based on these findings, we recommend both non-invasive treatment methods to be used in the treatment of calcaneal spurs in the clinical practice.

Myofascial Pain Syndrome (MPS) is known as a chronic pain syndrome, which is often associated with decreased life quality, depressive, and anxiety disorders. Affective temperament characteristics a...

The aim of this study was to compare the efficacy of low-level laser treatment (LLLT) and extracorporeal shock wave therapy (ESWT) in the treatment of subacromial impingement syndrome (SIS). Seventy-one patients with subacromial impingement were randomly assigned to LLLT (n = 37) and ESWT (n = 34) groups. The patients received a total of 15 sessions of LLLT or once a week for 3 sessions of ESWT. All patients, before treatment, at the end of treatment, and 3 months after treatment, were evaluated with range of motion (ROM), visual analogue pain scale (VAS pain), Shoulder Pain and Disability Index (SPADI), Beck Depression and Anxiety Inventories, the Short Form Health Survey (SF-36), and Pittsburgh Sleep Quality Index (PSQI). In both groups, there was a significant improvement in all outcome measures (p < 0.05) except the mental health score in the LLLT group. ESWT group showed more improvements in terms of SPADI disability and total scores, PSQI, and physical-mental health scores at the end of treatment (p < 0.05). The improvement in VAS pain day and SPADI scores at the third month was significantly more evident in the ESWT group (p < 0.05). Both LLLT and ESWT treatments are effective in the treatment of SIS in the short-medium term and can be used in clinical practice. Future larger prospective clinical trials are needed to investigate the long-term efficacy and optimal treatment protocol of LLLT and ESWT in SIS.