- Email: [email protected]
Is steroid phonophoresis effective in the treatment of subacromial impingement syndrome? Randomized controlled study
e12
Oral abstracts / Annals of Physical and Rehabilitation Medicine 61S (2018) e1–e102
was a statistically significant difference in pain severity, shoulder ROM, UCLA Shoulder Rating Scale, SDS and NHP (pain, energy, sleep, social isolation, mobility) between two groups (P < 0.05). Conclusion Steroid phonophoresis can be used as a well tolerated non-invasive therapy option for SIS. Keywords Subacromial impingement syndrome; Treatment; Steroid phonophoresis Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.027 ISPR8-0284
Diagnostic value of the clinical examination for diagnosing carpal tunnel syndrome assisted with nerve conduction studies
O. Küc¸ükakkas¸ ∗ , O.V. Yurdakul Bezmialem University, Faculty of Medicine, Istanbul, Turkey ∗ Corresponding author. E-mail address: [email protected] (O. Küc¸ükakkas¸) Fig. 3 Ultrasonoscopy that three trunks of the brachial plexus passed between the anterior and middle scalene muscles. AS: anterior scalene; MS: middle scalene, white triangle represent brachial plexus, the white dotted lines demarcate the muscles.
Keywords Neurogenic thoracic outlet syndrome; Ultrasound-guided; Therapy Disclosure of interest The author has not supplied his declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.026 ISPR8-0167
Is steroid phonophoresis effective in the treatment of subacromial impingement syndrome? Randomized controlled study S. Kutlay 1,∗ , E. Kars 1 , D. Oztuna 2 , S. Ergin 1 Ankara University Medical School, Department of PMR, Ankara, Turkey 2 Ankara University Medical School, Department of Biostatistics, Ankara, Turkey
1
Introduction/Background Subacromial impingement syndrome (SIS) is the most common cause of shoulder pain. Although, there are conservative and surgical treatment options for SIS, there isn’t a gold standard therapy. The aim of this study was to evaluate the effectiveness of steroid phonophoresis in patients with SIS. Material and method Sixty patients with SIS were participated in this prospective, single-blind randomized controlled study and randomly divided into 2 groups: intervention group (steroid phonophoresis) and control group (sham ultrasound). Hot pack and shoulder exercises including pendulum, range of motion (ROM) and strengthening exercises were given all patients. Steroid phonophoresis was applied with 1% hydrocortisone cream (2 g/session hydrocortisone with 1.5 watt/cm2 ultrasound for 7 minutes). All participants completed 15 treatment session and were assessed with visual analog scale for pain intensity, shoulder ROM, muscle strength, University of California Los Angeles (UCLA) Shoulder Rating Scale, Shoulder Disability Scale (SDS) and Nottingham Health Profile (NHP) for quality of life at pretreatment, post-treatment and 3rd month of treatment. Results Baseline demographic characteristics of two groups were found similar except of their ages (the mean age ± SD 49.57 ± 6.73 for intervention group, 53.97 ± 5.81 for control group). Statistically significant improvements were observed in all parameters in both groups at the end of the therapy and 3 months afterwards. There
Introduction/Background Nerve conduction studies (NCS) are the most reliable methods in diagnosis of carpal tunnel syndrome (CTS). Although there are many clinical finding associated with CTS, there are a limited number of studies in the literature indicating the objective value of these finding for diagnosing. To evaluate the reliability of clinical examination in diagnosing CTS, with the help of NCS and detection of comorbid diseases likely to be risk factors in the CTS. Material and method We accepted 463 patients, who visited our outpatient clinic and presented with paresthesia or pain at the median nerve distribution. Demographic data, clinical findings and comorbidities were recorded. According to the NCS results, patients were divided two groups (positive or negative) and analyzed. Results Only 51.1% of the patients were negative and 48.9% were positive according to NCS. The highest sensitivity was at Durkan’s test (95.6%) and lowest was at thenar atrophy (22.1%). The highest specificity and positive predictive value were at thenar atrophy (100%) and the lowest were at Tinel’s test (40.9% and 59.1). The highest negative predictive value was at Durkan’s test (94%) and the thenar atrophy was the lowest (57.4%). There was a significant difference between the clinical findings in NCS groups (P< 0.001). A total of 46.9% of the patients were had comorbidities. Hypertension, diabetes and obesity were the most common comorbidities. There was a significant difference between the groups for diabetes, obesity, rheumatoid arthritis, hypothyroidism and gout (P < 0.05). Conclusion Thenar atrophy and sensory loss were highly specific in CTS but had limited value in early detection, due to their low sensitivities and observations in more advanced stage patients. For their low specificity, provocative tests seem to be insufficient to establish a definite CTS diagnosis. Maybe only Durkan’s test could be considered primarily with more balanced values. Diabetes, obesity, rheumatoid arthritis, hypothyroidism and gout were significantly increasing the CTS risk. Keywords Carpal tunnel syndrome; Nerve conduction studies; Diagnosis Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.028
Oral abstracts / Annals of Physical and Rehabilitation Medicine 61S (2018) e1–e102
was a statistically significant difference in pain severity, shoulder ROM, UCLA Shoulder Rating Scale, SDS and NHP (pain, energy, sleep, social isolation, mobility) between two groups (P < 0.05). Conclusion Steroid phonophoresis can be used as a well tolerated non-invasive therapy option for SIS. Keywords Subacromial impingement syndrome; Treatment; Steroid phonophoresis Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.027 ISPR8-0284
Diagnostic value of the clinical examination for diagnosing carpal tunnel syndrome assisted with nerve conduction studies
O. Küc¸ükakkas¸ ∗ , O.V. Yurdakul Bezmialem University, Faculty of Medicine, Istanbul, Turkey ∗ Corresponding author. E-mail address: [email protected] (O. Küc¸ükakkas¸) Fig. 3 Ultrasonoscopy that three trunks of the brachial plexus passed between the anterior and middle scalene muscles. AS: anterior scalene; MS: middle scalene, white triangle represent brachial plexus, the white dotted lines demarcate the muscles.
Keywords Neurogenic thoracic outlet syndrome; Ultrasound-guided; Therapy Disclosure of interest The author has not supplied his declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.026 ISPR8-0167
Is steroid phonophoresis effective in the treatment of subacromial impingement syndrome? Randomized controlled study S. Kutlay 1,∗ , E. Kars 1 , D. Oztuna 2 , S. Ergin 1 Ankara University Medical School, Department of PMR, Ankara, Turkey 2 Ankara University Medical School, Department of Biostatistics, Ankara, Turkey
1
Introduction/Background Subacromial impingement syndrome (SIS) is the most common cause of shoulder pain. Although, there are conservative and surgical treatment options for SIS, there isn’t a gold standard therapy. The aim of this study was to evaluate the effectiveness of steroid phonophoresis in patients with SIS. Material and method Sixty patients with SIS were participated in this prospective, single-blind randomized controlled study and randomly divided into 2 groups: intervention group (steroid phonophoresis) and control group (sham ultrasound). Hot pack and shoulder exercises including pendulum, range of motion (ROM) and strengthening exercises were given all patients. Steroid phonophoresis was applied with 1% hydrocortisone cream (2 g/session hydrocortisone with 1.5 watt/cm2 ultrasound for 7 minutes). All participants completed 15 treatment session and were assessed with visual analog scale for pain intensity, shoulder ROM, muscle strength, University of California Los Angeles (UCLA) Shoulder Rating Scale, Shoulder Disability Scale (SDS) and Nottingham Health Profile (NHP) for quality of life at pretreatment, post-treatment and 3rd month of treatment. Results Baseline demographic characteristics of two groups were found similar except of their ages (the mean age ± SD 49.57 ± 6.73 for intervention group, 53.97 ± 5.81 for control group). Statistically significant improvements were observed in all parameters in both groups at the end of the therapy and 3 months afterwards. There
Introduction/Background Nerve conduction studies (NCS) are the most reliable methods in diagnosis of carpal tunnel syndrome (CTS). Although there are many clinical finding associated with CTS, there are a limited number of studies in the literature indicating the objective value of these finding for diagnosing. To evaluate the reliability of clinical examination in diagnosing CTS, with the help of NCS and detection of comorbid diseases likely to be risk factors in the CTS. Material and method We accepted 463 patients, who visited our outpatient clinic and presented with paresthesia or pain at the median nerve distribution. Demographic data, clinical findings and comorbidities were recorded. According to the NCS results, patients were divided two groups (positive or negative) and analyzed. Results Only 51.1% of the patients were negative and 48.9% were positive according to NCS. The highest sensitivity was at Durkan’s test (95.6%) and lowest was at thenar atrophy (22.1%). The highest specificity and positive predictive value were at thenar atrophy (100%) and the lowest were at Tinel’s test (40.9% and 59.1). The highest negative predictive value was at Durkan’s test (94%) and the thenar atrophy was the lowest (57.4%). There was a significant difference between the clinical findings in NCS groups (P< 0.001). A total of 46.9% of the patients were had comorbidities. Hypertension, diabetes and obesity were the most common comorbidities. There was a significant difference between the groups for diabetes, obesity, rheumatoid arthritis, hypothyroidism and gout (P < 0.05). Conclusion Thenar atrophy and sensory loss were highly specific in CTS but had limited value in early detection, due to their low sensitivities and observations in more advanced stage patients. For their low specificity, provocative tests seem to be insufficient to establish a definite CTS diagnosis. Maybe only Durkan’s test could be considered primarily with more balanced values. Diabetes, obesity, rheumatoid arthritis, hypothyroidism and gout were significantly increasing the CTS risk. Keywords Carpal tunnel syndrome; Nerve conduction studies; Diagnosis Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.028