Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item Comparison Of Efficacy Of Oral Versus Intra-Articular Corticosteroid Application In The Treatment Of Frozen Shoulder: An Experimental Study In Rats(2022) Cinar, Bekir Murat; Battal, Vahit Erdal; Bal, Nebil; Guler, Umit Ozgur; Beyaz, Salih; 35234132Objective: The aim of this study was to compare clinical and histopathological effects of oral versus intraarticular corticosteroid application in a rat model of frozen shoulder. Methods: In this study, eighty adult Sprague-Dawley rats were used. The animals were divided into 5 equal groups. The frozen shoulder model was created by immobilizing animals' shoulders with internal fixation with sutures for 8 weeks. At the 8th week, sham(n: 16) and control (n: 16) groups were sacrificed to collect data for healthy and affected shoulders. Also, at the 8th week, 50 mg/kg methylprednisolone was started for the oral treatment group, and a single dose of 0.5mg/kg triamcinolone acetonide was injected for the intraarticular treatment group. The effect of additional steroid treatment was expected for 2 weeks, then all remaining treatment and natural course groups were sacrificed on the 10th week. Results: After sacrification, specimens taken as "en bloc" scapulothoracic disarticulation were randomly divided into two groups for a range of motion measurement and histopathological examination. The control (frozen shoulder model) group's shoulder range of motion in all directions was lower than the sham (healthy) group (P < 0.01). Natural course and intraarticular steroid groups, compared to the frozen shoulder model showed a significant increase in the direction of abduction (P < 0.05). Also, it was found for treatment groups that in all directions the range of motion was not as good as the healthy values (P < 0.01). The intraarticular treatment group showed higher degrees of abduction compared to the natural course and oral steroid treatment groups (P < 0.01). Oral steroid treatment group's range of motion was not significantly better than the disease model and had no superiority to the natural course group (P > 0.05). Histopathologically, no statistically significant difference was observed between the groups for signs of frozen shoulder which was found in the immobilized group (P > 0.05). Histopathologically, immobilization was found to cause thickening of the capsule that cannot be resolved by treatment. (P < 0.05). Conclusion: In frozen shoulder disease, intraarticular steroid injection seems to be superior in increasing the range of motion than oral steroid treatment.Item Prognostic Value of Magnetic Resonance Imaging in the Evaluation of Physical Therapy Outcomes in Patients with Adhesive Capsulitis(2021) Cosar, Sacide Nur Saracgil; Ozen, Selin; Coskun, Mehmet; Yemisci, Oya Umit; Kurtcebe, Ali Niyazi; 0000-0001-8306-463X; 0000-0002-7290-8558; 0000-0002-0501-5127; 34396065; AAF-1085-2021; ABC-1305-2020; AAJ-8820-2021Objectives: This study aims to investigate whether the treatment outcomes of patients with a clinical diagnosis of adhesive capsulitis (AC) and magnetic resonance imaging (MRI) findings consistent with AC undergoing physical therapy (PT) differs to those with AC in the absence of these MRI findings. Patients and methods: Between January 2012 and October 2012, a total of 30 patients (8 males, 22 females; mean age 55.6 +/- 12.1 years; range, 35 to 85 years) with a clinical diagnosis of AC underwent MRI of the index shoulder. The MRI scans were evaluated for findings associated with AC: intensity of the inferior glenohumeral ligament (IGHL) and rotator interval (RI). All patients received a total of 15 sessions of PT: hot pack, transcutaneous electrical nerve stimulation, ultrasound, and shoulder exercises. The patients were assessed for shoulder range of motion (ROM) using the Visual Analog Scale ( VAS) for shoulder pain, Quick Disabilities of the Arm Shoulder and Hand (Q-DASH), and Health Assessment Questionnaire (HAQ) prior to and following completion of PT. Results: Of the patients, 21 had no MRI findings consistent with AC (Group 1), nine patients had changes in the IGHL and/or RI characteristic of AC (Group 2). In both groups, there was a significant improvement in active and passive shoulder ROM and VAS scores for shoulder pain at rest (Group 1: p<0.001, Group 2: p=0.017) with movement (Group 1: p<0.001, Group 2: p=0.007) and at night (Group 1: p<0.001, Group 2: p=0.012) following PT. However, there was no significant inter-group difference in scores. Similar findings were recorded for Q-DASH and HAQ. Conclusion: Based on these study findings, the presence of characteristic MRI findings of AC with a clinical diagnosis do not predict clinical response to physical therapy.