Research Article
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Uyku Kalitesi ile Mental ve Fiziksel Yorgunluğun Mekanik Boyun Ağrısına Etkisi

Year 2022, Volume: 6 Issue: 1, 116 - 124, 31.01.2022
https://doi.org/10.46237/amusbfd.982888

Abstract

Amaç: Mekanik boyun ağrısı toplumda oldukça yaygın görülen ve engelliliğe yol açabilen bir problemdir. Modern toplumlarda iş, aile ve sosyal yaşamda bireylerden beklentilerin artması, uyku bozuklukları, mental ve fiziksel yorgunluğu beraberinde getirmiştir. Çalışmamızın amacı, uyku bozukluğu, mental ve fiziksel yorgunluğun mekanik boyun ağrısına etkilerini incelemekti.
Yöntem: Çalışmamıza yaş ortalaması 28,01±9,97 yıl olan 252 mekanik boyun ağrılı birey dahil edilmiştir. Tüm bireylere Boyun Özür İndeksi, Chalder Yorgunluk Ölçeği ve Pitssburgh Uyku Kalitesi İndeksi uygulanmıştır.
Bulgular: Yapılan regresyon analizi sonucuna göre, yalnızca Chalder Yorgunluk Ölçeği mental yorgunluk alt boyutu, artmış Boyun Özür İndeksi skoru ile ilişkiliydi (β=0,169, p=0,036). Pitssburgh Uyku Kalitesi İndeksi ve Chalder Yorgunluk Ölçeği fiziksel alt parametresinin Boyun Özür İndeksi skoruna anlamlı bir etkisinin olmadığı bulundu (p>0,05).
Sonuç: Mental yorgunluk, boyun özür durumunun bağımsız belirleyicileri arasında bulunmuştur. Bu nedenle mekanik boyun ağrısının tedavisinde zihinsel yorgunluğu içeren daha bütüncül bir yaklaşım benimsenmelidir.

References

  • 1. Fernandez-de-las-Penas, C., Alonso-Blanco, C., & Miangolarra, J. C. (2007). Myofascial trigger points in subjects presenting with mechanical neck pain: a blinded, controlled study. Man Ther, 12(1), 29-33.
  • 2. Fejer, R., Kyvik, K. O., & Hartvigsen, J. (2006). The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J, 15(6), 834-848.
  • 3. Stranges, S., Tigbe, W., Gomez-Olive, F. X., Thorogood, M., & Kandala, N. B. (2012). Sleep problems: an emerging global epidemic? Findings from the INDEPTH WHO-SAGE study among more than 40,000 older adults from 8 countries across Africa and Asia. Sleep, 35(8), 252-26.
  • 4. Madrid-Valero, J. J., Martinez-Selva, J. M., Ribeiro do Couto, B., Sanchez-Romera, J. F., & Ordonana, J. R. (2017). Age and gender effects on the prevalence of poor sleep quality in the adult population. Gac Sanit, 31(1), 18-22.
  • 5. Sayar, K., Arikan, M., & Yontem, T. (2002). Sleep quality in chronic pain patients. Can J Psychiatry, 47(9), 844-848.
  • 6. van de Water, A. T., Eadie, J., & Hurley, D. A. (2011). Investigation of sleep disturbance in chronic low back pain: an age- and gender-matched case-control study over a 7-night period. Man Ther, 16(6), 550-556. doi:10.1016/j.math.2011.05.004
  • 7. McBeth, J., Wilkie, R., Bedson, J., Chew-Graham, C., & Lacey, R. J. (2015). Sleep disturbance and chronic widespread pain. Curr Rheumatol Rep, 17(1), 465- 469.
  • 8. Finan, P. H., Goodin, B. R., & Smith, M. T. (2013). The association of sleep and pain: an update and a path forward. J Pain, 14(12), 1539-1552.
  • 9. Hjollund, N. H., Andersen, J. H., & Bech, P. (2007). Assessment of fatigue in chronic disease: a bibliographic study of fatigue measurement scales. Health and quality of life outcomes, 5(1), 1-5.
  • 10. Okuyama, T., Akechi, T., Kugaya, A., Okamura, H., Shima, Y., Maruguchi, M., et al. (2000). Development and validation of the cancer fatigue scale: a brief, three-dimensional, self-rating scale for assessment of fatigue in cancer patients. J Pain Symptom Manage, 19(1), 5-14.
  • 11. Finsterer, J., & Mahjoub, S. Z. (2014). Fatigue in healthy and diseased individuals. Am J Hosp Palliat Care, 31(5), 562-575.
  • 12. Markowitz, A. J., & Rabow, M. W. (2007). Palliative management of fatigue at the close of life: "it feels like my body is just worn out". JAMA, 298(2), 217.
  • 13. Andreucci, A., Madrid-Valero, J. J., Ferreira, P. H., & Ordonana, J. R. (2020). Sleep quality and chronic neck pain: a cotwin study. J Clin Sleep Med, 16(5), 679-687.
  • 14. Bonvanie, I. J., Oldehinkel, A. J., Rosmalen, J. G. M., & Janssens, K. A. M. (2016). Sleep problems and pain: a longitudinal cohort study in emerging adults. Pain, 157(4), 957-963.
  • 15. Telci, E. A., Karaduman, A., Yakut, Y., Aras, B., Simsek, I. E., & Yagli, N. (2009). The cultural adaptation, reliability, and validity of neck disability index in patients with neck pain: a Turkish version study. Spine (Phila Pa 1976), 34(16), 1732-1735.
  • 16. Buysse, D. J., Reynolds, C. F., 3rd, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The burgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res, 28(2), 193-213.
  • 17. Ağargün, M. Y., Kara, H., & Anlar, Ö. (1996). The validity and reliability of the Pittsburgh Sleep Quality Index. Turk Psikiyatri Derg, 7(2), 107-115.
  • 18. Chalder, T., Berelowitz, G., Pawlikowska, T., Watts, L., Wessely, S., Wright, D., et al. (1993). Development of a fatigue scale. J Psychosom Res, 37(2), 147-153.
  • 19. Adın, R. M. (2019). Chalder Yorgunluk Ölçeği’nin Türkçe’ye uyarlanması ve genç yetişkin bireylerde psikometrik özelliklerinin incelenmesi (Turkish adaptation of Chalder Fatigue Scale and investigating its psychometric properties in young adults). (Yayımlanmamış Yüksek Lisans Tezi). Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
  • 20. Theadom, A., Cropley, M., & Humphrey, K. L. (2007). Exploring the role of sleep and coping in quality of life in fibromyalgia. J Psychosom Res, 62(2), 145-151.
  • 21. Auvinen, J. P., Tammelin, T. H., Taimela, S. P., Zitting, P. J., Jarvelin, M. R., Taanila, A. M., et al. (2010). Is insufficient quantity and quality of sleep a risk factor for neck, shoulder and low back pain? A longitudinal study among adolescents. Eur Spine J, 19(4), 641-649.
  • 22. Valenza, M. C., Valenza, G., Gonzalez-Jimenez, E., De-la-Llave-Rincon, A. I., Arroyo-Morales, M., & Fernandez-de-Las-Penas, C. (2012). Alteration in sleep quality in patients with mechanical insidious neck pain and whiplash-associated neck pain. Am J Phys Med Rehabil, 91(7), 584-591.
  • 23. Stallones, L., Beseler, C., & Chen, P. (2006). Sleep patterns and risk of injury among adolescent farm residents. Am J Prev Med, 30(4), 300-304.
  • 24. Kaila-Kangas, L., Kivimaki, M., Harma, M., Riihimaki, H., Luukkonen, R., Kirjonen, J., et al. (2006). Sleep disturbances as predictors of hospitalization for back disorders-a 28-year follow-up of industrial employees. Spine (Phila Pa 1976), 31(1), 51-56.
  • 25. Meier-Ewert, H. K., Ridker, P. M., Rifai, N., Regan, M. M., Price, N. J., Dinges, D. F., et al. (2004). Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol, 43(4), 678-683.
  • 26. Campbell, R. C., Batley, M., Hammond, A., Ibrahim, F., Kingsley, G., & Scott, D. L. (2012). The impact of disease activity, pain, disability and treatments on fatigue in established rheumatoid arthritis. Clin Rheumatol, 31(4), 717-722.
  • 27. Cohen, B. L., Zoega, H., Shah, S. A., Leleiko, N., Lidofsky, S., Bright, R., et al. (2014). Fatigue is highly associated with poor health-related quality of life, disability and depression in newly-diagnosed patients with inflammatory bowel disease, independent of disease activity. Aliment Pharmacol Ther, 39(8), 811-822.
  • 28. Novaes, G. S., Perez, M. O., Beraldo, M. B., Pinto, C. R., & Gianini, R. J. (2011). Correlation of fatigue with pain and disability in rheumatoid arthritis and osteoarthritis, respectively. Rev Bras Reumatol, 51(5), 451-455.
  • 29. de la Vega, R., Racine, M., Castarlenas, E., Sole, E., Roy, R., Jensen, M. P., et al. (2019). The Role of Sleep Quality and Fatigue on the Benefits of an Interdisciplinary Treatment for Adults With Chronic Pain. Pain Pract, 19(4), 354-
  • 30. Nadal-Nicolas, Y., Rubio-Arias, J. A., Martinez-Olcina, M., Reche-Garcia, C., Hernandez-Garcia, M., & Martinez-Rodriguez, A. (2020). Effects of Manual Therapy on Fatigue, Pain, and Psychological Aspects in Women with Fibromyalgia. Int J Environ Res Public Health, 17(12). 124-131.
  • 31. Thacker, D., Jameson, J., Baker, J., Divine, J., & Unfried, A. (2011). Management of upper cross syndrome through the use of active release technique and prescribed exercises. Logan College of Chiropractic.
  • 32. Merriwether, E. N., Frey-Law, L. A., Rakel, B. A., Zimmerman, M. B., Dailey, D. L., Vance, C. G. T., et al. (2018). Physical activity is related to function and fatigue but not pain in women with fibromyalgia: baseline analyses from the Fibromyalgia Activity Study with TENS (FAST). Arthritis Res Ther, 20(1), 199-201.
  • 33. Bjornsdottir, S. V., Jonsson, S. H., & Valdimarsdottir, U. A. (2014). Mental health indicators and quality of life among individuals with musculoskeletal chronic pain: a nationwide study in Iceland. Scand J Rheumatol, 43(5), 419-423.
  • 34. Morone, N. E., Greco, C. M., & Weiner, D. K. (2008). Mindfulness meditation for the treatment of chronic low back pain in older adults: a randomized controlled pilot study. Pain, 134(3), 310-319.
  • 35. Linton, S. J. (2000). A review of psychological risk factors in back and neck pain. Spine (Phila Pa 1976), 25(9), 1148-1156.
  • 36. Makela, M., Heliovaara, M., Sievers, K., Impivaara, O., Knekt, P., & Aromaa, A. (1991). Prevalence, determinants, and consequences of chronic neck pain in Finland. Am J Epidemiol, 134(11), 1356-1367.
  • 37. Casey, Y. C., Greenberg, M. A., Nicassio, P. M., Harpin, R. E., & Hubbard, D. (2008). Transition from acute to chronic pain and disability: a model including cognitive, affective, and trauma factors. Pain, 134(1-2), 69-79.
  • 38. McCarthy, L. H., Bigal, M. E., Katz, M., Derby, C., & Lipton, R. B. (2009). Chronic pain and obesity in elderly people: results from the Einstein aging study. J Am Geriatr Soc, 57(1), 115-119.
  • 39. Valera-Calero, A., Lluch Girbes, E., Gallego-Izquierdo, T., Malfliet, A., & Pecos-Martin, D. (2019). Endocrine response after cervical manipulation and mobilization in people with chronic mechanical neck pain: a randomized controlled trial. Eur J Phys Rehabil Med, 55(6), 792-805.
  • 40. Plaza-Manzano, G., Molina-Ortega, F., Lomas-Vega, R., Martinez-Amat, A., Achalandabaso, A., & Hita-Contreras, F. (2014). Changes in biochemical markers of pain perception and stress response after spinal manipulation. J Orthop Sports Phys Ther, 44(4), 231-239.
  • 41. Jiang, N. C., Wang, J. P., Yu, Y. X., & Han, J. S. (1987). [Pressor effects of intracerebroventricularly administered substance P are mediated by enkephalins and beta-endorphin in rats]. Sheng Li Xue Bao, 39(3), 235-241.
  • 42. McEwen, B. S. (2000). Allostasis and allostatic load: implications for neuropsychopharmacology. Neuropsychopharmacology, 22(2), 108-124.

Effects of Sleep Quality and Mental and Physical Fatigue on Mechanical Neck Pain

Year 2022, Volume: 6 Issue: 1, 116 - 124, 31.01.2022
https://doi.org/10.46237/amusbfd.982888

Abstract

Objective: Mechanical neck pain is a very common problem in society and can lead to disability. In modern societies, increasing expectations from individuals in work, family and social life have brought along sleep disorders, mental and physical fatigue. The aim of our study was to examine the effects of sleep disorder, mental and physical fatigue on mechanical neck pain.
Method: Two hundred fifty-two individuals with mechanical neck pain having a mean age of 28.01±9.97 years were included in our study. Neck Disability Index, Chalder Fatigue Scale, and Pitssburg Sleep Quality Index were applied to all individuals.
Results: According to the regression analysis results, only the mental fatigue sub-dimension of the Chalder Fatigue Scale was associated with increased Neck Disability Index score (β=0.169, p=0.036). Pitssburgh Sleep Quality Index and the physical sub-dimension of Chalder Fatigue Scale were found not to have a significant effect on Neck Disability Index score (p>0.05).
Conclusion: Mental fatigue was found among the independent determinants of neck disability. Therefore, a more holistic approach including mental fatigue should be adopted in the treatment of mechanical neck pain.

References

  • 1. Fernandez-de-las-Penas, C., Alonso-Blanco, C., & Miangolarra, J. C. (2007). Myofascial trigger points in subjects presenting with mechanical neck pain: a blinded, controlled study. Man Ther, 12(1), 29-33.
  • 2. Fejer, R., Kyvik, K. O., & Hartvigsen, J. (2006). The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J, 15(6), 834-848.
  • 3. Stranges, S., Tigbe, W., Gomez-Olive, F. X., Thorogood, M., & Kandala, N. B. (2012). Sleep problems: an emerging global epidemic? Findings from the INDEPTH WHO-SAGE study among more than 40,000 older adults from 8 countries across Africa and Asia. Sleep, 35(8), 252-26.
  • 4. Madrid-Valero, J. J., Martinez-Selva, J. M., Ribeiro do Couto, B., Sanchez-Romera, J. F., & Ordonana, J. R. (2017). Age and gender effects on the prevalence of poor sleep quality in the adult population. Gac Sanit, 31(1), 18-22.
  • 5. Sayar, K., Arikan, M., & Yontem, T. (2002). Sleep quality in chronic pain patients. Can J Psychiatry, 47(9), 844-848.
  • 6. van de Water, A. T., Eadie, J., & Hurley, D. A. (2011). Investigation of sleep disturbance in chronic low back pain: an age- and gender-matched case-control study over a 7-night period. Man Ther, 16(6), 550-556. doi:10.1016/j.math.2011.05.004
  • 7. McBeth, J., Wilkie, R., Bedson, J., Chew-Graham, C., & Lacey, R. J. (2015). Sleep disturbance and chronic widespread pain. Curr Rheumatol Rep, 17(1), 465- 469.
  • 8. Finan, P. H., Goodin, B. R., & Smith, M. T. (2013). The association of sleep and pain: an update and a path forward. J Pain, 14(12), 1539-1552.
  • 9. Hjollund, N. H., Andersen, J. H., & Bech, P. (2007). Assessment of fatigue in chronic disease: a bibliographic study of fatigue measurement scales. Health and quality of life outcomes, 5(1), 1-5.
  • 10. Okuyama, T., Akechi, T., Kugaya, A., Okamura, H., Shima, Y., Maruguchi, M., et al. (2000). Development and validation of the cancer fatigue scale: a brief, three-dimensional, self-rating scale for assessment of fatigue in cancer patients. J Pain Symptom Manage, 19(1), 5-14.
  • 11. Finsterer, J., & Mahjoub, S. Z. (2014). Fatigue in healthy and diseased individuals. Am J Hosp Palliat Care, 31(5), 562-575.
  • 12. Markowitz, A. J., & Rabow, M. W. (2007). Palliative management of fatigue at the close of life: "it feels like my body is just worn out". JAMA, 298(2), 217.
  • 13. Andreucci, A., Madrid-Valero, J. J., Ferreira, P. H., & Ordonana, J. R. (2020). Sleep quality and chronic neck pain: a cotwin study. J Clin Sleep Med, 16(5), 679-687.
  • 14. Bonvanie, I. J., Oldehinkel, A. J., Rosmalen, J. G. M., & Janssens, K. A. M. (2016). Sleep problems and pain: a longitudinal cohort study in emerging adults. Pain, 157(4), 957-963.
  • 15. Telci, E. A., Karaduman, A., Yakut, Y., Aras, B., Simsek, I. E., & Yagli, N. (2009). The cultural adaptation, reliability, and validity of neck disability index in patients with neck pain: a Turkish version study. Spine (Phila Pa 1976), 34(16), 1732-1735.
  • 16. Buysse, D. J., Reynolds, C. F., 3rd, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The burgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res, 28(2), 193-213.
  • 17. Ağargün, M. Y., Kara, H., & Anlar, Ö. (1996). The validity and reliability of the Pittsburgh Sleep Quality Index. Turk Psikiyatri Derg, 7(2), 107-115.
  • 18. Chalder, T., Berelowitz, G., Pawlikowska, T., Watts, L., Wessely, S., Wright, D., et al. (1993). Development of a fatigue scale. J Psychosom Res, 37(2), 147-153.
  • 19. Adın, R. M. (2019). Chalder Yorgunluk Ölçeği’nin Türkçe’ye uyarlanması ve genç yetişkin bireylerde psikometrik özelliklerinin incelenmesi (Turkish adaptation of Chalder Fatigue Scale and investigating its psychometric properties in young adults). (Yayımlanmamış Yüksek Lisans Tezi). Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
  • 20. Theadom, A., Cropley, M., & Humphrey, K. L. (2007). Exploring the role of sleep and coping in quality of life in fibromyalgia. J Psychosom Res, 62(2), 145-151.
  • 21. Auvinen, J. P., Tammelin, T. H., Taimela, S. P., Zitting, P. J., Jarvelin, M. R., Taanila, A. M., et al. (2010). Is insufficient quantity and quality of sleep a risk factor for neck, shoulder and low back pain? A longitudinal study among adolescents. Eur Spine J, 19(4), 641-649.
  • 22. Valenza, M. C., Valenza, G., Gonzalez-Jimenez, E., De-la-Llave-Rincon, A. I., Arroyo-Morales, M., & Fernandez-de-Las-Penas, C. (2012). Alteration in sleep quality in patients with mechanical insidious neck pain and whiplash-associated neck pain. Am J Phys Med Rehabil, 91(7), 584-591.
  • 23. Stallones, L., Beseler, C., & Chen, P. (2006). Sleep patterns and risk of injury among adolescent farm residents. Am J Prev Med, 30(4), 300-304.
  • 24. Kaila-Kangas, L., Kivimaki, M., Harma, M., Riihimaki, H., Luukkonen, R., Kirjonen, J., et al. (2006). Sleep disturbances as predictors of hospitalization for back disorders-a 28-year follow-up of industrial employees. Spine (Phila Pa 1976), 31(1), 51-56.
  • 25. Meier-Ewert, H. K., Ridker, P. M., Rifai, N., Regan, M. M., Price, N. J., Dinges, D. F., et al. (2004). Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol, 43(4), 678-683.
  • 26. Campbell, R. C., Batley, M., Hammond, A., Ibrahim, F., Kingsley, G., & Scott, D. L. (2012). The impact of disease activity, pain, disability and treatments on fatigue in established rheumatoid arthritis. Clin Rheumatol, 31(4), 717-722.
  • 27. Cohen, B. L., Zoega, H., Shah, S. A., Leleiko, N., Lidofsky, S., Bright, R., et al. (2014). Fatigue is highly associated with poor health-related quality of life, disability and depression in newly-diagnosed patients with inflammatory bowel disease, independent of disease activity. Aliment Pharmacol Ther, 39(8), 811-822.
  • 28. Novaes, G. S., Perez, M. O., Beraldo, M. B., Pinto, C. R., & Gianini, R. J. (2011). Correlation of fatigue with pain and disability in rheumatoid arthritis and osteoarthritis, respectively. Rev Bras Reumatol, 51(5), 451-455.
  • 29. de la Vega, R., Racine, M., Castarlenas, E., Sole, E., Roy, R., Jensen, M. P., et al. (2019). The Role of Sleep Quality and Fatigue on the Benefits of an Interdisciplinary Treatment for Adults With Chronic Pain. Pain Pract, 19(4), 354-
  • 30. Nadal-Nicolas, Y., Rubio-Arias, J. A., Martinez-Olcina, M., Reche-Garcia, C., Hernandez-Garcia, M., & Martinez-Rodriguez, A. (2020). Effects of Manual Therapy on Fatigue, Pain, and Psychological Aspects in Women with Fibromyalgia. Int J Environ Res Public Health, 17(12). 124-131.
  • 31. Thacker, D., Jameson, J., Baker, J., Divine, J., & Unfried, A. (2011). Management of upper cross syndrome through the use of active release technique and prescribed exercises. Logan College of Chiropractic.
  • 32. Merriwether, E. N., Frey-Law, L. A., Rakel, B. A., Zimmerman, M. B., Dailey, D. L., Vance, C. G. T., et al. (2018). Physical activity is related to function and fatigue but not pain in women with fibromyalgia: baseline analyses from the Fibromyalgia Activity Study with TENS (FAST). Arthritis Res Ther, 20(1), 199-201.
  • 33. Bjornsdottir, S. V., Jonsson, S. H., & Valdimarsdottir, U. A. (2014). Mental health indicators and quality of life among individuals with musculoskeletal chronic pain: a nationwide study in Iceland. Scand J Rheumatol, 43(5), 419-423.
  • 34. Morone, N. E., Greco, C. M., & Weiner, D. K. (2008). Mindfulness meditation for the treatment of chronic low back pain in older adults: a randomized controlled pilot study. Pain, 134(3), 310-319.
  • 35. Linton, S. J. (2000). A review of psychological risk factors in back and neck pain. Spine (Phila Pa 1976), 25(9), 1148-1156.
  • 36. Makela, M., Heliovaara, M., Sievers, K., Impivaara, O., Knekt, P., & Aromaa, A. (1991). Prevalence, determinants, and consequences of chronic neck pain in Finland. Am J Epidemiol, 134(11), 1356-1367.
  • 37. Casey, Y. C., Greenberg, M. A., Nicassio, P. M., Harpin, R. E., & Hubbard, D. (2008). Transition from acute to chronic pain and disability: a model including cognitive, affective, and trauma factors. Pain, 134(1-2), 69-79.
  • 38. McCarthy, L. H., Bigal, M. E., Katz, M., Derby, C., & Lipton, R. B. (2009). Chronic pain and obesity in elderly people: results from the Einstein aging study. J Am Geriatr Soc, 57(1), 115-119.
  • 39. Valera-Calero, A., Lluch Girbes, E., Gallego-Izquierdo, T., Malfliet, A., & Pecos-Martin, D. (2019). Endocrine response after cervical manipulation and mobilization in people with chronic mechanical neck pain: a randomized controlled trial. Eur J Phys Rehabil Med, 55(6), 792-805.
  • 40. Plaza-Manzano, G., Molina-Ortega, F., Lomas-Vega, R., Martinez-Amat, A., Achalandabaso, A., & Hita-Contreras, F. (2014). Changes in biochemical markers of pain perception and stress response after spinal manipulation. J Orthop Sports Phys Ther, 44(4), 231-239.
  • 41. Jiang, N. C., Wang, J. P., Yu, Y. X., & Han, J. S. (1987). [Pressor effects of intracerebroventricularly administered substance P are mediated by enkephalins and beta-endorphin in rats]. Sheng Li Xue Bao, 39(3), 235-241.
  • 42. McEwen, B. S. (2000). Allostasis and allostatic load: implications for neuropsychopharmacology. Neuropsychopharmacology, 22(2), 108-124.
There are 42 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

Hasan Erkan Kılınç 0000-0002-6629-1619

Banu Ünver 0000-0001-9758-6607

Publication Date January 31, 2022
Published in Issue Year 2022 Volume: 6 Issue: 1

Cite

APA Kılınç, H. E., & Ünver, B. (2022). Effects of Sleep Quality and Mental and Physical Fatigue on Mechanical Neck Pain. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 6(1), 116-124. https://doi.org/10.46237/amusbfd.982888