S140

hospital. Participants: 88 female AIS patients and 58 healthy female

controls from 10 to 16 years of age were included. Interventions: Not
applicable. Main Outcome Measures: Quantitative ultrasound
measurements were performed at the left distal end of the radius, and the
standard method to estimate SOS was recorded. Z-score was then calculated. Level of Evidence: Level 2. Results: The SOS values of 88 female
AIS patients were signicantly lower than age-matched adolescent controls
(p<0.01). However there was no statistical correlations between bone
density and types of scoliosis as well as family history (p>0.05). The SOS
values among different severity groups of curvature were found to be
signicant, particularly between 10 to 20 degrees and 20 to 40 degree
groups, but there was no signicant correlation between SOS and Cobb
angles. Statistically signicant correlations were also found between pre- and
post-menarche status. There was signicant difference in the SOS values in
different Risser stages (p < 0.05) and more skeletally immature patients
were more osteopenic. Conclusions: Female AIS patients have generally
lower bone quality measuring by quantitative ultrasound. Slower maturation
may be one of the factors that affect the bone quality in these patients.
Different types of scoliosis and family history have no effect on the bone
quality in these patients. Although there were signicant differences between
SOS values and Cobb angles, this may be due to slower bone maturation
than the severity of the AIS curve. It is recommended that quantitative
ultrasound measurement should be undertaken in AIS patients.
No. 242 Predictors of an Unfavorable Intermediate and
Long-Term Outcome After First Time Lumbar Disc Surgery.
Ebenbichler Gerold; Salomon Nora; Koenig Franz.
Aim: To identify among several clinical, biometrical, and psychosocial
variables those that would best predict an unfavorable functional outcome
1.5 and 12 years after rst time lumbar disc surgery in patients who suffered
from an acute or subacute preoperative onset of complaints that led to the
operation. Study Design: Prospective observation of a cohort that had
participated in a RCT. Setting: Outpatient department of PMR.
Patients: A total of 99 and 78 patients who underwent rst-time disc
surgery and participated in follow-up assessments 1.5 and 12 years later.
Interventions: At baseline demographic, biometric, functional, and
psychosocial variables were assessed. At both of the follow-up examinations,
patients back-related functional health was examined using the validated
Low Back Pain Rating Scale (LBPRS; Manniche 1994). Main Outcome
Measures: A score exceeding 19.5 points on the total LBPRS and one
exceeding 4.5 points on the LBPRS disability subscale were dened as
unfavorable outcome. Level of Evidence: 1. Results: Unfavorable
outcomes were registered in 50.5% of the patients at 1.5 years and in
another 52.6% 12 years after surgery. Out of a total of 43 potential
predictors investigated, 7 were able to presage the intermediate term and 4
variables the long-term outcome. Physical activity status and pain
intensity in the rst week after surgery were those variables that predicted
an unfavorable outcome at both 1.5 and 12 years after surgery. Conclusions: Low physical activity levels and perception of severe pain
immediately after surgery negatively impact postoperative outcome after
lumbar disc herniation. Management of patients identied with these risk
factors should include optimized postoperative pain management and
comprehensive rehabilitation.
No. 244 Validation of the Turkish Version of the Fear
Avoidance Belief Questionnaire.
Ketenci A; Kesiktas N; Sindel D; Disci R.
Objective: Anticipated pain and fear avoidance beliefs that seemed to
be cause of prolonged work loss, joblessness, and chronic disability have
been suggested as important factors for the classication and treatment
outcome of patients with LBP. The objective of this cross-cultural adaptation
study was to assess the reliability and validity of the Turkish version of the
Fear Avoidance Belief Questionnaire (FABQ TR). Participants and
Method: The questionnaire was tested in two groups of 30 and 150
patients with chronic low back pain. The Fear Avoidance Belief

PRESENTATIONS

Questionnaire was translated into Turkish. Test-retest reliability was

assessed in 30 patients. Construct validity was assessed in 150 patients.
Results: Test-retest reliability was high with an intraclass correlation
coefcient value of 0.85 for fear avoidance belief about work, 0.82 for fear
avoidance belief about physical activity, and 0.88 for fear avoidance belief
total. Four factors were extracted which accounted for 65.58% of the total
variance. Factor 2 was the same as the one extracted in the original version
and represents attitudes and beliefs about physical activities. Factors 1, 3,
and 4 represent attitudes and beliefs about professional activities. Factor 1
beliefs about ability to return to work, factor 3 represents fear of work
activities, and factor 4 beliefs about the responsibility of work with chronic
symptoms. Conclusion: FABQ TR has sufciently good psychometric
properties to be used to assess fear avoidance attitudes and beliefs in
Turkish-speaking patients with low back pain.
No. 245 The Effectiveness of Therapeutic Ultrasound in Non
Specic Mechanical Cervical Pain and Comparison of
Different Application Methods for Clinical Practice.
Aysegul Ketenci; Oznur Celik; Sina Esmaeilzadeh; Dilsad Sindel.
Objectives: The aim of this study was to investigate the effectiveness of
therapeutic ultrasound (US) in non-specic mechanical neck pain and to
compare the effects of intermittent and continuous US applications on pain
severity and functional disability. Materials and Methods: 71 patients
aged between 18 and 65 with non-specic mechanical neck pain suffering
for less than three months were included the study. After the baseline
measurements, patients were randomized to three physical treatment
groups. US was applied intermittently in the rst group, continuously in the
second group, while the third group received sham US application during
10 sessions. Three groups were also treated with TENS. Patients were
evaluated by visual analog scale, algometer, neck disability, and goniometer.
Control measurements were three months later after therapy. Results: Pain
severity was improved statistically signicant in three groups three months
later after therapy (p<0001). Pain pressure threshold (PPT) was increased
statistically signicant in the rst and second group after the treatment
(p<005), while PPT was decreased in control group. Three months later
after therapy, PPT was increased statistically signicant in all of three groups
(p<005). Continuous US was observed more effective than intermittent
application in cervical rotation range when the groups were compared after
the physical therapy sessions. Continuous application was observed more
effective when the group were compared in terms of functional recovery.
Conclusions: Therapeutic US applications are effective in reducing the
severity of pain; furthermore it affects the functional status positively by
increasing cervical range of motion.
No. 246 Reliability of Isometric Trunk Moment
Measurements in Chronic Low Back Pain Patients.
Thomas Kienbacher; Philipp Anders; Josef Kollmitzer;
Gerold Ebenbichler.
Disclosure: None. Objective: To determine the short- and long-term
reliability of maximum isometric trunk moment measurements in chronic
low back pain patients older than 50 years of age and to compare the results
with those from younger patients. Design: Prospective cohort study.
Setting: Outpatient rehabilitation clinic. Participants: 73 older patients
(42 females; 50-90 years) and 82 younger patients (41 females; 18-49 years).
Main Outcome Measures: Maximum isometric trunk extension,
exion, and rotation torques were evaluated for age- and gender-specic
groups. Retest-reliability was assessed with intraclass correlation coefcient
(ICC21), standard error of measurement, and smallest real difference
(absolute and in percent). Patients performed maximum isometric trunk
extension, exion, and rotation. They repeated the tests after 1-2 days
(short-term) and after 6 weeks (long-term). Results: For the older groups,
smallest real differences in extension and exion torques varied up to 31%
and were similar to those obtained from younger groups. Precision of the
trunk rotation tests was lower in all groups tested. Retest agreement (ICC21)
was high for all tests without differences between gender- and age-specic