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    Comparison of the Efficacy of High Intensity Laser and Ultrasound Therapies in Chronic Shoulder Pain; Randomized Controlled Single Blind Study
    (2017) Ökmen, Burcu Metin; Okmen, Korgun; Özkuk, Kağan; Uysal, Bilal; Sezer, Refia; Koyuncu, Engin
    Objective: The aim of our study was to compare the efficacy of the High IntensityLASER Therapy (HILT) and Ultrasound (US) for pain and daily activities of patients with chronicshoulder pain. Material and Methods: In this prospective, randomized, controlled, single blindstudy; 141 patients were randomized into two groups by using random table, as Group 1: US (n=70)and Group 2: HILT (n=71). HILT or US treatment was applied to the patients in addition to 14 sessionsof Hotpack in (HP) +Transcutaneous Electrical Nerve Stimulation (TENS) +Balneotherapy +Exercise. Pre-treatment (W0), Post-treatment 1st day (W2) and Post-Treatment findings 30th day(W6) findings were recorded using the visual analog scale (VAS) and shoulder pain and disabilityindex (SPADI) scoring. Results: There were no statistically significant difference neither in demographiccharacteristics nor pretreatment evaluation parameters between the two groups (p>0.05).In Group 1 and Group 2, statistically significant improvements were found in all the evaluation parametersboth at W2 and W6 (p<0.05). When the groups are compared to each other; statisticallysignificant difference was found in favor of Group 2 both at W2 and W6, in all evaluation parameters(p<0.05). Conclusion: This study demonstrates that in chronic shoulder pain HILT is superiorto US therapy in decreasing pain and improving function in short term.
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    The effects of balneotherapy in elderly patients with chronic low back pain treated with physical therapy: A pilot study
    (2019) Özkuk, Kağan; Dilekçi, Erdal
    Objective: The aim of this study was to compare whether balneotherapy has a positive effect on the treatment of elderly individuals receiving physical therapy for chronic low back pain (CLBP). Methods: 244 participants were randomly placed into two groups. The first group was treated with physical therapy (PT), the second group was treated with PT and balneotherapy (BT). Assessments were made using the PainVAS, Quebec Back Pain Disability Scale (Quebec), Health Assessment Questionnaire (HAQ) before treatment (T0) and after treatment (T1). Results: In both groups, there was a statistically significantly decrease in terms of pain-VAS, Quebec and HAQ scores (p<0.001). When pain-VAS scores were compared between the two groups, pain-VAS T0 was significantly higher and pain-VAS T1 was significantly lower in the BT+PT group than the PT group (p=0.001). When the HAQ and Quebec values were compared between the groups, the T0 value was similar in the BT+PT and PT groups (HAQ p=0.068, Quebec p=0.495) while the BT+PT group HAQ and QuebecT1 scoreswere significantly lower than the PT group (p<0.001). The BT+PT group change values were significantly higher than the PT group (p<0.001). Conclusion: These results recommend that combining therapies may be more effective in treating CLBP and balneotherapy may increase the effectiveness of the treatment.
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    Effects of balneotherapy on serum levels of shingosine-1-phosphate in patients with osteoarthritis
    (Innovision Communications, 2017) Üstyol, Esra Aycan; Karaarslan, Fatih; Bekpınar, Seldağ; Özkuk, Kağan; Erdoğan, Nergis
    Context . Balneotherapy is one of the most commonly used nonpharmacological interventions for osteoarthritis (OA), but its mechanism of action in relieving pain and stiffness and in improving physical function is not well understood. Studies have found that therapy provokes a series of neuroendocrinal reactions with anti-inflammatory and analgesic effects. Sphingosine-1-phosphate (S1P), a bioactive lipid, has been implicated as an important mediator in the maintenance of physiological processes (eg, vascular barrier integrity) and in pathophysiologic processes such as inflammatory conditions. Accordingly, targeting S1P and S1P receptors may offer a potential therapy for arthritis. Objective . The aims of the present study were to determine whether (1) balneotherapy modified the circulating levels of S1P as well as some inflammatory parameters and stress markers, in patients with OA; and (2) to assess the relationship of those parameters to therapeutic efficacy. Design . This study was designed as an uncontrolled longitudinal study. Setting . The study took place at the Bolu Physical Therapy and Rehabilitation Hospital (Bolu, Turkey). Participants . Forty patients who suffered from general OA in at least 3 positions on the body, one of which could be the vertebral column, and who fulfilled the American College of Rheumatology Classification criteria and the Kellgren-Moore radiologic criteria, were enrolled in the intervention group in the study. Intervention . During balneotherapy, the participants were fully immersed in warm thermo-mineral water for 20 min at a temperature of 38 degrees C to 40 degrees C. A total of 15 immersions were performed in a period of 15 d. Outcome Measures . A baseline clinical evaluation of participants' pain, stiffness, and physical function was carried out using the Western Ontario and McMaster Universities questionnaire. Baseline serum levels of S1P, cyclooxygenase 2 (COX-2), matrix metalloproteinase 3 (MMP-3), and heat shock protein 70 (HSP-70) were measured using enzyme-linked immunosorbent assays and high-sensitivity C-reactive protein, with an immunoturbidimetric assay. The clinical evaluations and the biochemical measurements were repeated after completion of the balneotherapy period. Results . Balneotherapy caused a significant reduction in circulating levels of S1P and high-density lipoprotein and a limited increase in HSP-70 levels, in addition to a reduction in pain and stiffness and an improvement in physical function. In the Spearman's correlation analysis, S1P was found to be positively associated with serum levels of HSP-70, COX-2, and MMP-3. Conclusion . Balneotherapy modulated serum S1P levels in patients with OA. The effect of S1P modulation on the clinical outcome of patients with OA should be further investigated.