Background: Osteoarthritis secondary to developmental dysplasia of the hip (DDH) is one of the major causes of hip pain and disability. The aim of the study was to compare the effectiveness of prolotherapy (PrT) injections versus exercise protocol for the treatment of DDH. Material/Methods: There were 46 hips of 41 patients who had osteoarthritis secondary to DDH included in this study. Patients were divided into 2 groups: treated with PrT (PrT group; n=20) and exercise (control group; n=21). Clinical outcomes were evaluated with visual analog scale for pain (VAS) and Harris hip score (HHS) at baseline, 3 weeks, 3 months, 6 months, and a minimum of 1-year follow-up. In PrT group clinical results were also compared in Crowe type I-IV hips. Results: Between group analysis revealed no significant between group differences at baseline. Dextrose injection recipients out performed exercise controls for VAS pain change score at 6 months (-4.6 +/- 2.6 versus -2.8 +/- 2.5; P=0.016), and 12 months (-4.5 +/- 2.4 versus -2.9 +/- 2.5; P=0.017) and for HHS at 6 months (24.2 +/- 14.0 versus 14.8 +/- 12.4; P=0.007) and 12 months (24.3 +/- 13.4 versus 16.5 +/- 11.3; P=0.018). Conclusions: To our best knowledge, this study is the first regarding the effects of an injection method in the treatment of osteoarthritis secondary to DDH. According to our study, PrT is superior to exercises. PrT could provide significant improvement for clinical outcomes in DDH and might delay surgery.

Pain is a symptom caused by a disease process and/or tissue injury. With the prolongation of life expectancy in humans, the incidence of degenerative joint diseases and as a result pain has increased. Unfortunately, a method of treatment that stops or reverses progression by affecting the pathogenesis in these diseases has not been developed. Physical therapeutics such as medicine and physical rehabilitation often are prescribed for patients suffering with pain. Recently, in addition to these routine therapies used in pain treatment, many regenerative injection-based therapies, including prolotherapy (PrT) or platelet-rich plasma (PRP) have been widely used. PrT is using for damaged or degenerated connective tissue healing, such as ligaments, tendons, and cartilage. The combination of local inflammatory effect, stimulation of local growth factor release, and down regulation of neuropathic inflammation can be defined as the mechanism. As a result of these, joint instability and ligament laxity reduce and pain decrease. PRP is the cellular component of the plasma. Although PRP is used for the same reasons as PrT, it can be used in acute cases unlike PrT. This chapter is intended to understand the use of regenerative injection therapies (PrT and PRP) better in the treatment of pain.

Objectives: This study aims to examine musculoskeletal pain, kinesiophobia, and quality of life in individuals with normal body mass index and in individuals with obesity, and to determine the relationship between the variables. Methods: In the study; individuals aged between 20-65 years, with a body mass index of 30 kg/m2 and above (Group obesity) with obesity, and individuals with a range of 18.5-24.9 kg/m2 (Group normal) were included. General Practice Physical Activity Questionnaire, Orebro Musculoskeletal Screening Questionnaire, Short Form-12 Health Survey, and Kinesiophopia Causes Scale were applied to the participants for primary care. Results: When the descriptive characteristics of the individuals in the sample which were divided into two groups as the Group normal (n = 82; 22.6 ± 1.7 kg/m2) and Group obesity (n = 92; 33.0 ± 2.8 kg/m2 were analyzed; while a difference was determined in terms of sex, education level and presence of chronic disease (p ˂ 0.05), no difference was found in terms of age, marital status and regular drug use for the treatment of chronic disease (p ˃ 0.05). Although the activity level rates of Group obesity were lower according to the physical activity questionnaire classification for primary care, no statistically significant difference was found between the groups (p = 0.090). More musculoskeletal pain was found in the individuals of the obesity group (p = 0.003), the physical sub-dimension score of the general quality of life questionnaire was negatively affected (p = 0.014), and a difference in favor of phobia was determined in all domains of the kinesiophobia causes scale (p < 0.001). There was a weak positive correlation between body mass index and musculoskeletal pain, while a moderate positive correlation with kinesiophobia. Conclusions: Although physical activity level is similar to individuals with normal body mass index, musculoskeletal pain and kinesiophobia are higher in individuals with obesity, and their quality of life is negatively affected.

Objective: Orienteering is an extreme sport which require different physical and cognitive properties from other sports. We aimed to predict whether the athletes will be successful or not in the competitions by pre-season performance tests. Material and Methods: Total 45 athletes who are in the same orienteering club were included in the study. Demographic data, balance, coordination and strength parameters were assessed before season. Tanita Body Composition Analyzer, Holtain skinfold, vernier caliper, Vmax Encore Viasys Program, Balance System SD and Biodex System 4 Pro were used. According to the individual ranking list created as the result of the same year's competitions, athletes were divided into two groups: Successful and Unsuccessful. Groups were compared as to measurement results. Kolmogorov Smirnov, Mann-Whitney U, Pearson's chi-square, Wilcoxon Signed-Rank tests and ROC curve analysis (area under the curve) were used for statistical analyses. Results: Left OSI (overall stability index), right OSI, left API (anterior posterior index) and right API were statistically significant differences (p=0.032, p=0.013, p=0.045, p=0.009, respectively). ROC curve analysis of measurements: The first value is right API 0.749 (95% confidence interval in 0.582-0.915), the second right OSI 0.737 (95% confidence interval in 0.573-0.901), the third left OSI 0.712 (95% confidence interval in 0.535-0.888) and the fourth left API 0.694 (95% confidence interval in 0.517-0.871) in total statistics. Left OSI 0.908 (95% confidence interval in 0.729-1.000) in males and 0.540 (95% confidence interval in 0.275-0.805) in females. Conclusions: For determining the competition success of an orienteering athlete; balance tests may be the best choice.

Objective: Based on the hypothesis that exercise addiction must be in accordance with general rules of addiction, it may be associated with healthy eating obsession as orthorexia and emotion blindness as alexithymia. This study aimed to determine the relationship between exercise addiction level and alexithymia and orthorexia. Materials and Methods: A cross-sectional survey was conducted on individuals who regularly exercise for more than 150 minutes a week. The descriptive characteristics of the participants were recorded, and the 'Exercise Addiction Scale, Teruel Orthorexia Scale, and Toronto Alexithymia Scale' were applied. According to the Exercise Addiction Scale, the athletes (n=95) were divided into two groups addicted (≥52) and risky (<51). Toronto Alexithymia Scale was used to categorize individuals with 51 point cut of values 'non-alexithymic' and 'alexithymic'. Results: Athletes were found to be 22.1% (n=21) risky, 77.9% (n=74) addicted, and 31.6% (n=30) alexithymic. There was a significant difference between the 'risky' and 'addicted' groups in all sub-dimension scores of the Exercise Addiction Scale (p=0.001). There was a positive relationship between exercise addiction, exercise duration, orthorexia nervosa, and alexithymia at different levels from weak to high (p˂0.05). Conclusion: Higher exercise addiction is a risk factor for alexithymia and orthorexia nervosa.

Objectives: This study aimed to compare the acute effects of radial extracorporeal shockwave therapy (r-ESWT) and focused extracorporeal shockwave therapy (f-ESWT) on pain, muscle strength, and function in patients with lateral epicondylitis (LE). Patients and methods: Fifty-six patients (31 males, 25 females; mean age: 44.6±8.4 years; range, 19 to 60 years) who were diagnosed with LE participated in the randomized study between August 2023 and October 2023. The patients were stratified by pain level to have four r-ESWT or f-ESWT treatments once a week. Patients were evaluated on the first day of treatment and one week after the last treatment. The outcome measures used were the Visual Analog Scale for pain, isokinetic dynamometer for wrist muscle strength measurement, the DASH (Disabilities of the Arm, Shoulder, and Hand) score for functional status, and the 36-item Short-Form Health Survey (SF-36) for health-related quality of life. Results: After the treatment, the pain at rest and during activity decreased in both groups (p=0.018, p=0.001, p=0.003, and p<0.001). Nocturnal pain was found to be lower in the f-ESWT group (p=0.028). The isokinetic muscle strength of the wrist extensors was higher in the r-ESWT group compared to the f-ESWT group (p=0.002 and p=0.017). The DASH performance score of the r-ESWT group was higher compared to the f-ESWT group (p=0.009). Both groups showed improvements in SF-36 scores (p<0.05). Conclusion: Both groups showed a decrease in pain levels, but the effects were superior in the f-ESWT group. However, r-ESWT was found to present better results in terms of its effect on isokinetic muscle strength. While f-ESWT may be more effective in reducing pain, r-ESWT may be more effective in increasing muscle strength.