Central European Journal of Public Health, Nov 1, 2015
Aim: To compare the effects of exergames (EGs) using the Xbox KinectTM device and home exercise (... more Aim: To compare the effects of exergames (EGs) using the Xbox KinectTM device and home exercise (HE) on balance, functional mobility, and quality of life of individuals aged 65 years or older. Method: One hundred participants who met the inclusion criteria were randomized to the EG or HE group. The EG group took part in a 6-week programme using the Xbox360Kinect TM device, and the HE group took part in a 6-week balance exercise programme at home 5 days a week. The Berg Balance Scale (BBS) was used to assess balance, the Timed Up and Go (TUG) test was used to evaluate functional walking, and the Short Form 36 (SF-36) was used to assess quality of life. Results: Forty-eight participants in the EG group and 42 participants in the HE group completed the study. The groups were similar in terms of age, sex, and pretreatment values of BBS, TUG, and SF-36. Although the BBS scores of both groups improved significantly (all p < 0.05), the post-treatment scores of the EG group were better than those of the HE group. The TUG scores improved only in the EG group (p < 0.05). The increase in the BBS scores and decrease in the TUG test scores were significant only in the EG group (all p < 0.05). A significant improvement was also observed in the quality of life parameters of physical functioning, social role functioning, physical role restriction, general health perceptions, and physical component scores in the post-exercise evaluations of the EG group. The participants commented that they found the EG programme very entertaining. Conclusion: The EG can be considered a safe, entertaining and sustainable alternative to HE programmes, and it may have positive effects on balance, functional walking and quality of life in geriatric subjects.
European Journal of Physical and Rehabilitation Medicine, Jun 1, 2018
INTRODUCTION Cervical dystonia (CD) is the most commonly seen focal primary dystonia, characteriz... more INTRODUCTION Cervical dystonia (CD) is the most commonly seen focal primary dystonia, characterized by involuntary contractions of the neck muscles resulting in abnormal movements and posture of the head and neck. Intramuscular botulinum toxin (BoTX) injection is the first-line treatment and several studies have reported its benefit in reducing dystonia and associated symptoms (eg, pain). 1-3 Poor treatment outcomes, weakness of uninjected muscles, and some side effects, however, such as dysphagia, dysphonia, dry mouth, and ptosis, have also been reported after toxin injections. 2,4-8 The 2 likely/ considerable reasons are inaccurate detection of the dystonic muscles and imprecise The authors have nothing to disclose.
American Journal of Physical Medicine & Rehabilitation, Apr 1, 2011
Corticosteroid injection into the carpal tunnel is frequently used for the treatment of carpal tu... more Corticosteroid injection into the carpal tunnel is frequently used for the treatment of carpal tunnel syndrome (CTS). Steroids are usually mixed with local anesthetics, which have positive effects that can aid the treatment of CTS by inhibiting the spontaneous discharge ability of excitable cells. The aim of this study was 3-fold: (1) to determine the efficacy of triamcinolone acetonide injection in the treatment of CTS, (2) to determine the efficacy of procaine hydrochloride (HCl) in the treatment of CTS, and (3) to compare the efficacy of triamcinolone acetonide and that of procaine HCl in the treatment of CTS.
Klinik Psikofarmakoloji Bulteni-bulletin of Clinical Psychopharmacology, 2011
Servikojenik baş ağrılı hastalarda botulinum toksin tip A tedavisi ile anksiyete ve depresyon düz... more Servikojenik baş ağrılı hastalarda botulinum toksin tip A tedavisi ile anksiyete ve depresyon düzeylerinin değerlendirilmesi Giriş: Servikojenik baş ağrısı'nın (SBA) etiyolojisinde servikal faset eklem patolojisi, servikal üst sinir köklerinin radikülopatisi, oksipital nevralji ve miyofasiyal ağrılar yatar. Botulinum nörotoksin tip A (BoNT-A) uygulaması ile ilgili yapılan çalışmalarda ağrının sıklığı ve şiddetinin azalması ile ilgili çelişkili sonuçlar bulunmuştur. Kronik ağrısı bulunan hastalarda depresyon görülme sıklıklarının %10-100 arasında değiştiği, genellikle %50'nin üstünde olduğu bildirilmektedir. BoNT-A uygulaması sonrası ağrı sıklığı ve şiddeti değişimini gösteren çalışmalar olmasına rağmen hastalardaki anksiyete ve depresyon düzeylerinin azalıp azalmadığını gösteren çalışmaya literatürde rastlanılmamıştır. Amaç: SBA'lı hastalarda BoNT-A uygulamasının tedavi etkinliği, ağrı şiddeti, ağrı sıklığı, anksiyete ve depresyon düzeyleri üzerine etkisini incelemek amaçlanmıştır. Yöntem: Toplam 18 SBA tanılı hasta çalışmaya alındı. Her hastaya toplamda 150 ünite Dysport® (iki taraflı olmak üzere frontal kaslara 10; temporal kaslara 20; servikal bölgede semispinalis capitis, splenius capitis ve trapezius kaslarına 15'er ünite) uygulandı. Uygulama öncesinde her hastanın ağrı şiddetleri VAS (Vizuel Analog Scale) ile kayıt altına alındı, anksiyete ve depresyon düzeyleri Beck anksiyete ve Beck depresyon ölçekleri ile değerlendirildi. Hastaların 6 haftalık izlemleri yapılarak tüm ölçümler tekrarlandı. Bulgular: Hastaların bir ay içindeki ağrı sıklığı ortalaması başlangıçta 19.72±5.71 iken, tedaviden 6 hafta sonra ağrı sıklığı 7.60±4.19 olarak tespit edildi. Ayrıca hastaların ağrı düzeyleri tedavi öncesinde 79.70±10.20 iken, 6 hafta sonunda 45.60±17.25 idi. Hastaların tedavi öncesi anksiyete ve depresyon puanı ortalamaları sırasıyla 31.80±10.44 ve 10.60±3.95 iken, tedaviden 6 hafta sonra sırasıyla 13.48±8.38 ve 8.70±5.01 olarak bulundu. Ağrı şiddeti, ağrı sıklığı ve anksiyete düzeylerindeki azalma istatistiksel olarak anlamlı bulundu (p<0.001): Depresyon düzeylerinde ise belirgin bir değişim olmadı (p=0.118). Yapılan korelasyon analizinde tedavi öncesi ağrı sıklığı ile tedavi öncesi anksiyete düzeyi arasında pozitif korelasyon saptandı (r=0.398, p=0,049). Sonuçlar: BoNT-A uygulaması sonrası ağrı şiddeti ve sıklığında klinik olarak belirgin düzelme saptanmıştır. Ayrıca anksiyete düzeylerinin de bu grup hastalarda azaldığı ancak depresyon düzeylerinde anlamlı bir değişme olmadığı görülmüştür.
Poststroke hemiplegic gait is a mixture of deviations and compensatory motion dictated by residua... more Poststroke hemiplegic gait is a mixture of deviations and compensatory motion dictated by residual functions, and thus each patient must be examined and his/her unique gait pattern identified and documented. Quantitative 3-dimensional gait analysis is the best way to understand the complex multifactorial gait dysfunction in hemiparetic patients. The goals of the present work are to (1) review the temporospatial, kinematic, kinetic, and electromyographic deviations from normal gait that commonly occur after stroke and are of clinical significance, along with the most likely causes of these deviations, and (2) differentiate the departures from normal gait parameters that arise as a direct consequence of poststroke motor problems and those that arise as learned or adaptive compensations for poststroke motor problems.
Journal of Hand Surgery (European Volume), Sep 28, 2016
The purpose of this study was to compare the efficacies of extracorporeal shock wave therapy and ... more The purpose of this study was to compare the efficacies of extracorporeal shock wave therapy and corticosteroid injection for the management of trigger finger. In this prospective randomized clinical trial, 40 patients with actively correctable trigger fingers were randomly assigned to extracorporeal shock wave therapy (1000 impulses and 2.1 bar) or injection groups. The effectiveness of the treatment was assessed using cure rates, a visual analogue scale, the frequency of triggering, the severity of triggering, the functional impact of triggering, and the Quick-Disabilities of the Arm, Shoulder, and Hand questionnaire at 1, 3, and 6 months after treatment. An intention-to-treat analysis was used in this study. Both groups demonstrated statistically significant improvements in all outcome measures after treatment. The intention-to-treat analyses showed no betweengroup differences for cure rates, pain, and functional status at follow-up. We conclude that extracorporeal shock wave therapy could be a non-invasive option for treating trigger finger, especially for those patients who wish to avoid steroid injections.
In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of co... more In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned ankle/foot structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.
Objectives: Hip adductor spasticity may adversely effect shear-force and pressure distribution on... more Objectives: Hip adductor spasticity may adversely effect shear-force and pressure distribution on the buttocks, where ulcerations most frequently appear in patients with spinal cord injury (SCI). Phenol neurolysis of the obturator nerve (ON) is commonly used to manage hip adductor spasticity. This study aimed to determine the effects on the distribution of buttock-seat interface pressure (BSIP) in a group of SCI patients with adductor spasticity that underwent ON blockade with phenol. Methods: We reviewed the records of SCI patients that were admitted to our clinic between January 2009 and December 2009. BSIP values (obtained with an X-sensor 48) and hip adductor spasticity levels of SCI patients with hip adductor spasticity that underwent ON blockade with phenol were collected. BSIP distributions of the patients were divided into two portions: first one is the BSIP distribution at the pressure p37 mm Hg, and the second one is at the pressure 437 mm Hg. Results: The study included 20 SCI patients (19 males and 1 female), with a mean age of 42.85 ± 13.24 years. Although the percentage of BSIP distribution at p37 mm Hg range increased significantly (Po0.001), after ON neurolysis, BSIP distribution at 437 mm Hg range decreased significantly (Po0.001). In addition, mean hip adductor spasticity decreased significantly after ON neurolysis (Po0.001). Conclusion: Phenol neurolysis of the ON is a promising treatment for the management of hip adductor spasticity in SCI patients and also has positive effects on BSIP, which has a crucial function in the development of pressure ulcers.
In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of co... more In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned shoulder structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.
Letters to the Editor should be submitted online to www.editorialmanager.com/ amsurg. (See detail... more Letters to the Editor should be submitted online to www.editorialmanager.com/ amsurg. (See details online under ''Instructions for Authors''.) They should be no more than 3 double-spaced pages excluding an Abstract and sub-headings with a maximum of four (4) references. If figures are included, they should be limited to two (2). The cost of printing color figures is the responsibility of the author.
Context: Developing osteoarthritis is common after anterior cruciate ligament reconstruction (ACL... more Context: Developing osteoarthritis is common after anterior cruciate ligament reconstruction (ACLR). Monitoring changes in femoral cartilage size after ACLR may be a way to detect the earliest structural alterations before the radiographic onset of osteoarthritis. Diagnostic ultrasonography (US) offers a clinically accessible and valid method for evaluating anterior femoral cartilage size. Objective: To compare the US measurements of anterior femoral cross-sectional area and cartilage thickness between limbs in individuals with a unilateral ACLR and between the ACLR limbs of these individuals and the limbs of uninjured control participants. Design: Case-control study. Setting: Research laboratory. Patients or Other Participants: A total of 20 volunteers with an ACLR (37.0 6 26.6 months after surgery) and 28 uninjured volunteers. Main Outcome Measure(s): We used US to assess anterior femoral cartilage cross-sectional area and thickness (ie, medial, lateral, and intercondylar) in the ACLR and contralateral limbs of participants with ACLR and unilaterally in the reference limbs of uninjured participants. Results: The ACLR limb presented with greater anterior femoral cartilage cross-sectional area (96.68 6 22.68 mm 2) than both the contralateral (85.69 6 17.57 mm 2 ; t 19 ¼ 4.47, P , .001) and uninjured (84.62 6 15.89 mm 2 ; t 46 ¼ 2.17, P ¼ .04) limbs. The ACLR limb presented with greater medial condyle thickness (2.61 6 0.61 mm) than both the contralateral (2.36 6 0.47 mm; t 19 ¼ 2.78, P ¼ .01) and uninjured limbs (2.22 6 0.40 mm; t 46 ¼ 2.69, P ¼ .01) and greater lateral condyle thickness (2.46 6 0.65 mm) than the uninjured limb (2.12 6 0.41 mm; t 46 ¼ 2.20, P ¼ .03). Conclusions: Anterior femoral cartilage cross-sectional area and thickness assessed via US were greater in the ACLR limb than in the contralateral and uninjured limbs. Greater thickness and cross-sectional area may have been due to cartilage swelling or hypertrophy after ACLR, which may affect the long-term health of the joint.
Journal of Hand Surgery (European Volume), Jul 24, 2014
The aim of this study was to determine the efficacy of single versus repetitive injection of lign... more The aim of this study was to determine the efficacy of single versus repetitive injection of lignocaine into the carpal tunnel for the management of carpal tunnel syndrome. The 42 patients included were randomly assigned to two Groups: group 1 was injected with 4 mL of 1% lignocaine once and Group 2 was injected with 4 mL of 1% lignocaine twice a week for 2 weeks. Clinical and electrophysiological evaluations were performed at the study onset, and at 6 and 12 weeks following the final injection. Initially, the groups were similar with respect to clinical and electrophysiological findings. All parameters in Group 2 improved 6 weeks post treatment (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), and these improvements persisted at 12 weeks post treatment (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Repetitive local lignocaine injection was effective in reducing the symptoms of carpal tunnel syndrome and improving electrophysiological findings.
Turkish Journal of Physical Medicine and Rehabilitation, 2017
Objectives: This study aims to evaluate facet tropism in younger patients with lumbar spondylolys... more Objectives: This study aims to evaluate facet tropism in younger patients with lumbar spondylolysis and to investigate the role of facet tropism in the development of spondylolysis. Patients and methods: Between February 2013 and December 2015, a total of 102 male patients with bilateral L5 pars defect including 53 with spondylolysis and 49 control subjects were included in this case-control study. The facet joint angles were measured bilaterally and axially at the level of L3-4, L4-5, L5-S1 using computed tomography (CT). The classification was made as follows: A difference between two reciprocal facet joint angles of <6° indicated no tropism, 6°-12° indicated moderate tropism, and >12° indicated severe tropism. Results: A total of 612 angles including 318 facet joint angles from 53 patients with spondylolysis and 294 facet joint angles from 49 control subjects were measured. L3-4 measurements in the control group showed no tropism in 87.8% (n=43), moderate tropism in 12.2% (n=6), and severe tropism in 0% (n=0). L4-5 measurements in control group showed no tropism in 79.6% (n=39), moderate tropism in 20.4% (n=10), and severe tropism in 0% (n=0). L5-S1 measurements in the control group showed no tropism in 69.4% (n=34), moderate tropism in 28.6% (n=14), and severe tropism in 2.0% (n=1). The mean facet joint angles in the spondylosis group were 32.9±5.1°, 37.5±5.4°, and 41.2±7.8° at the levels of L3-4, L4-5, and L5-S1, respectively. The mean facet joint angles of the control group were 33.2±5.7°, 39.7±4.9°, and 42.2±4.9° at the levels of L3-4, L4-5, and L5-S1, respectively, indicating no significant difference between the right and left mean facet joint angles between the groups (p>0.05). The frequency of facet tropism and the difference between right and left facet joint angles for all three levels were significantly higher in the spondylolysis group (p<0.05). Facet tropism at the level of L5-S1 was significantly more frequent than facet tropism at L3-4 level (p<0.05). Conclusion: Our study results show that the rate of facet joint tropism is higher in the patients with spondylolysis, suggesting that facet tropism seems to play a role in the etiology of spondylolysis as a predisposing factor.
Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, 2020
Ultrasound is a useful imaging method for wrist evaluation, which allows high-resolution anatomy ... more Ultrasound is a useful imaging method for wrist evaluation, which allows high-resolution anatomy imaging while allowing dynamic evaluation of joints, tendons, vessels, nerves and ligaments. There are six compartments on the dorsal part of the wrist, including the tendons of the wrist extensor muscles. Each compartment is lined internally by a synovial sheath and separated from one another by fibrous septa. Dorsal tubercle of radius or Lister's tubercle provides easy identification of tendons in radiological evaluation. 1 A 25-year-old female presented with a mild right forearm pain, which was exacerbated with wrist movements. Her complaints began with a fall on her 55 55 55
Turkish Journal of Physical Medicine and Rehabilitation, 2019
Comparison of the effectiveness of partial body weight-supported treadmill exercises, robotic-ass... more Comparison of the effectiveness of partial body weight-supported treadmill exercises, robotic-assisted treadmill exercises, and anti-gravity treadmill exercises in spastic cerebral palsy.
The Journal of hand surgery, European volume, 2015
The aim of this study was to determine the efficacy of single versus repetitive injection of lign... more The aim of this study was to determine the efficacy of single versus repetitive injection of lignocaine into the carpal tunnel for the management of carpal tunnel syndrome. The 42 patients included were randomly assigned to two Groups: group 1 was injected with 4 mL of 1% lignocaine once and Group 2 was injected with 4 mL of 1% lignocaine twice a week for 2 weeks. Clinical and electrophysiological evaluations were performed at the study onset, and at 6 and 12 weeks following the final injection. Initially, the groups were similar with respect to clinical and electrophysiological findings. All parameters in Group 2 improved 6 weeks post treatment (p < 0.05), and these improvements persisted at 12 weeks post treatment (p < 0.05). Repetitive local lignocaine injection was effective in reducing the symptoms of carpal tunnel syndrome and improving electrophysiological findings.
Central European Journal of Public Health, Nov 1, 2015
Aim: To compare the effects of exergames (EGs) using the Xbox KinectTM device and home exercise (... more Aim: To compare the effects of exergames (EGs) using the Xbox KinectTM device and home exercise (HE) on balance, functional mobility, and quality of life of individuals aged 65 years or older. Method: One hundred participants who met the inclusion criteria were randomized to the EG or HE group. The EG group took part in a 6-week programme using the Xbox360Kinect TM device, and the HE group took part in a 6-week balance exercise programme at home 5 days a week. The Berg Balance Scale (BBS) was used to assess balance, the Timed Up and Go (TUG) test was used to evaluate functional walking, and the Short Form 36 (SF-36) was used to assess quality of life. Results: Forty-eight participants in the EG group and 42 participants in the HE group completed the study. The groups were similar in terms of age, sex, and pretreatment values of BBS, TUG, and SF-36. Although the BBS scores of both groups improved significantly (all p < 0.05), the post-treatment scores of the EG group were better than those of the HE group. The TUG scores improved only in the EG group (p < 0.05). The increase in the BBS scores and decrease in the TUG test scores were significant only in the EG group (all p < 0.05). A significant improvement was also observed in the quality of life parameters of physical functioning, social role functioning, physical role restriction, general health perceptions, and physical component scores in the post-exercise evaluations of the EG group. The participants commented that they found the EG programme very entertaining. Conclusion: The EG can be considered a safe, entertaining and sustainable alternative to HE programmes, and it may have positive effects on balance, functional walking and quality of life in geriatric subjects.
European Journal of Physical and Rehabilitation Medicine, Jun 1, 2018
INTRODUCTION Cervical dystonia (CD) is the most commonly seen focal primary dystonia, characteriz... more INTRODUCTION Cervical dystonia (CD) is the most commonly seen focal primary dystonia, characterized by involuntary contractions of the neck muscles resulting in abnormal movements and posture of the head and neck. Intramuscular botulinum toxin (BoTX) injection is the first-line treatment and several studies have reported its benefit in reducing dystonia and associated symptoms (eg, pain). 1-3 Poor treatment outcomes, weakness of uninjected muscles, and some side effects, however, such as dysphagia, dysphonia, dry mouth, and ptosis, have also been reported after toxin injections. 2,4-8 The 2 likely/ considerable reasons are inaccurate detection of the dystonic muscles and imprecise The authors have nothing to disclose.
American Journal of Physical Medicine & Rehabilitation, Apr 1, 2011
Corticosteroid injection into the carpal tunnel is frequently used for the treatment of carpal tu... more Corticosteroid injection into the carpal tunnel is frequently used for the treatment of carpal tunnel syndrome (CTS). Steroids are usually mixed with local anesthetics, which have positive effects that can aid the treatment of CTS by inhibiting the spontaneous discharge ability of excitable cells. The aim of this study was 3-fold: (1) to determine the efficacy of triamcinolone acetonide injection in the treatment of CTS, (2) to determine the efficacy of procaine hydrochloride (HCl) in the treatment of CTS, and (3) to compare the efficacy of triamcinolone acetonide and that of procaine HCl in the treatment of CTS.
Klinik Psikofarmakoloji Bulteni-bulletin of Clinical Psychopharmacology, 2011
Servikojenik baş ağrılı hastalarda botulinum toksin tip A tedavisi ile anksiyete ve depresyon düz... more Servikojenik baş ağrılı hastalarda botulinum toksin tip A tedavisi ile anksiyete ve depresyon düzeylerinin değerlendirilmesi Giriş: Servikojenik baş ağrısı'nın (SBA) etiyolojisinde servikal faset eklem patolojisi, servikal üst sinir köklerinin radikülopatisi, oksipital nevralji ve miyofasiyal ağrılar yatar. Botulinum nörotoksin tip A (BoNT-A) uygulaması ile ilgili yapılan çalışmalarda ağrının sıklığı ve şiddetinin azalması ile ilgili çelişkili sonuçlar bulunmuştur. Kronik ağrısı bulunan hastalarda depresyon görülme sıklıklarının %10-100 arasında değiştiği, genellikle %50'nin üstünde olduğu bildirilmektedir. BoNT-A uygulaması sonrası ağrı sıklığı ve şiddeti değişimini gösteren çalışmalar olmasına rağmen hastalardaki anksiyete ve depresyon düzeylerinin azalıp azalmadığını gösteren çalışmaya literatürde rastlanılmamıştır. Amaç: SBA'lı hastalarda BoNT-A uygulamasının tedavi etkinliği, ağrı şiddeti, ağrı sıklığı, anksiyete ve depresyon düzeyleri üzerine etkisini incelemek amaçlanmıştır. Yöntem: Toplam 18 SBA tanılı hasta çalışmaya alındı. Her hastaya toplamda 150 ünite Dysport® (iki taraflı olmak üzere frontal kaslara 10; temporal kaslara 20; servikal bölgede semispinalis capitis, splenius capitis ve trapezius kaslarına 15'er ünite) uygulandı. Uygulama öncesinde her hastanın ağrı şiddetleri VAS (Vizuel Analog Scale) ile kayıt altına alındı, anksiyete ve depresyon düzeyleri Beck anksiyete ve Beck depresyon ölçekleri ile değerlendirildi. Hastaların 6 haftalık izlemleri yapılarak tüm ölçümler tekrarlandı. Bulgular: Hastaların bir ay içindeki ağrı sıklığı ortalaması başlangıçta 19.72±5.71 iken, tedaviden 6 hafta sonra ağrı sıklığı 7.60±4.19 olarak tespit edildi. Ayrıca hastaların ağrı düzeyleri tedavi öncesinde 79.70±10.20 iken, 6 hafta sonunda 45.60±17.25 idi. Hastaların tedavi öncesi anksiyete ve depresyon puanı ortalamaları sırasıyla 31.80±10.44 ve 10.60±3.95 iken, tedaviden 6 hafta sonra sırasıyla 13.48±8.38 ve 8.70±5.01 olarak bulundu. Ağrı şiddeti, ağrı sıklığı ve anksiyete düzeylerindeki azalma istatistiksel olarak anlamlı bulundu (p<0.001): Depresyon düzeylerinde ise belirgin bir değişim olmadı (p=0.118). Yapılan korelasyon analizinde tedavi öncesi ağrı sıklığı ile tedavi öncesi anksiyete düzeyi arasında pozitif korelasyon saptandı (r=0.398, p=0,049). Sonuçlar: BoNT-A uygulaması sonrası ağrı şiddeti ve sıklığında klinik olarak belirgin düzelme saptanmıştır. Ayrıca anksiyete düzeylerinin de bu grup hastalarda azaldığı ancak depresyon düzeylerinde anlamlı bir değişme olmadığı görülmüştür.
Poststroke hemiplegic gait is a mixture of deviations and compensatory motion dictated by residua... more Poststroke hemiplegic gait is a mixture of deviations and compensatory motion dictated by residual functions, and thus each patient must be examined and his/her unique gait pattern identified and documented. Quantitative 3-dimensional gait analysis is the best way to understand the complex multifactorial gait dysfunction in hemiparetic patients. The goals of the present work are to (1) review the temporospatial, kinematic, kinetic, and electromyographic deviations from normal gait that commonly occur after stroke and are of clinical significance, along with the most likely causes of these deviations, and (2) differentiate the departures from normal gait parameters that arise as a direct consequence of poststroke motor problems and those that arise as learned or adaptive compensations for poststroke motor problems.
Journal of Hand Surgery (European Volume), Sep 28, 2016
The purpose of this study was to compare the efficacies of extracorporeal shock wave therapy and ... more The purpose of this study was to compare the efficacies of extracorporeal shock wave therapy and corticosteroid injection for the management of trigger finger. In this prospective randomized clinical trial, 40 patients with actively correctable trigger fingers were randomly assigned to extracorporeal shock wave therapy (1000 impulses and 2.1 bar) or injection groups. The effectiveness of the treatment was assessed using cure rates, a visual analogue scale, the frequency of triggering, the severity of triggering, the functional impact of triggering, and the Quick-Disabilities of the Arm, Shoulder, and Hand questionnaire at 1, 3, and 6 months after treatment. An intention-to-treat analysis was used in this study. Both groups demonstrated statistically significant improvements in all outcome measures after treatment. The intention-to-treat analyses showed no betweengroup differences for cure rates, pain, and functional status at follow-up. We conclude that extracorporeal shock wave therapy could be a non-invasive option for treating trigger finger, especially for those patients who wish to avoid steroid injections.
In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of co... more In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned ankle/foot structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.
Objectives: Hip adductor spasticity may adversely effect shear-force and pressure distribution on... more Objectives: Hip adductor spasticity may adversely effect shear-force and pressure distribution on the buttocks, where ulcerations most frequently appear in patients with spinal cord injury (SCI). Phenol neurolysis of the obturator nerve (ON) is commonly used to manage hip adductor spasticity. This study aimed to determine the effects on the distribution of buttock-seat interface pressure (BSIP) in a group of SCI patients with adductor spasticity that underwent ON blockade with phenol. Methods: We reviewed the records of SCI patients that were admitted to our clinic between January 2009 and December 2009. BSIP values (obtained with an X-sensor 48) and hip adductor spasticity levels of SCI patients with hip adductor spasticity that underwent ON blockade with phenol were collected. BSIP distributions of the patients were divided into two portions: first one is the BSIP distribution at the pressure p37 mm Hg, and the second one is at the pressure 437 mm Hg. Results: The study included 20 SCI patients (19 males and 1 female), with a mean age of 42.85 ± 13.24 years. Although the percentage of BSIP distribution at p37 mm Hg range increased significantly (Po0.001), after ON neurolysis, BSIP distribution at 437 mm Hg range decreased significantly (Po0.001). In addition, mean hip adductor spasticity decreased significantly after ON neurolysis (Po0.001). Conclusion: Phenol neurolysis of the ON is a promising treatment for the management of hip adductor spasticity in SCI patients and also has positive effects on BSIP, which has a crucial function in the development of pressure ulcers.
In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of co... more In this protocol, the patient/probe positionings, anatomical drawings and ultrasound images of commonly scanned shoulder structures are described. This practical guide is prepared (with an international consensus of several expert physiatrists) to serve as a uniform/standard approach especially for beginner sonographers.
Letters to the Editor should be submitted online to www.editorialmanager.com/ amsurg. (See detail... more Letters to the Editor should be submitted online to www.editorialmanager.com/ amsurg. (See details online under ''Instructions for Authors''.) They should be no more than 3 double-spaced pages excluding an Abstract and sub-headings with a maximum of four (4) references. If figures are included, they should be limited to two (2). The cost of printing color figures is the responsibility of the author.
Context: Developing osteoarthritis is common after anterior cruciate ligament reconstruction (ACL... more Context: Developing osteoarthritis is common after anterior cruciate ligament reconstruction (ACLR). Monitoring changes in femoral cartilage size after ACLR may be a way to detect the earliest structural alterations before the radiographic onset of osteoarthritis. Diagnostic ultrasonography (US) offers a clinically accessible and valid method for evaluating anterior femoral cartilage size. Objective: To compare the US measurements of anterior femoral cross-sectional area and cartilage thickness between limbs in individuals with a unilateral ACLR and between the ACLR limbs of these individuals and the limbs of uninjured control participants. Design: Case-control study. Setting: Research laboratory. Patients or Other Participants: A total of 20 volunteers with an ACLR (37.0 6 26.6 months after surgery) and 28 uninjured volunteers. Main Outcome Measure(s): We used US to assess anterior femoral cartilage cross-sectional area and thickness (ie, medial, lateral, and intercondylar) in the ACLR and contralateral limbs of participants with ACLR and unilaterally in the reference limbs of uninjured participants. Results: The ACLR limb presented with greater anterior femoral cartilage cross-sectional area (96.68 6 22.68 mm 2) than both the contralateral (85.69 6 17.57 mm 2 ; t 19 ¼ 4.47, P , .001) and uninjured (84.62 6 15.89 mm 2 ; t 46 ¼ 2.17, P ¼ .04) limbs. The ACLR limb presented with greater medial condyle thickness (2.61 6 0.61 mm) than both the contralateral (2.36 6 0.47 mm; t 19 ¼ 2.78, P ¼ .01) and uninjured limbs (2.22 6 0.40 mm; t 46 ¼ 2.69, P ¼ .01) and greater lateral condyle thickness (2.46 6 0.65 mm) than the uninjured limb (2.12 6 0.41 mm; t 46 ¼ 2.20, P ¼ .03). Conclusions: Anterior femoral cartilage cross-sectional area and thickness assessed via US were greater in the ACLR limb than in the contralateral and uninjured limbs. Greater thickness and cross-sectional area may have been due to cartilage swelling or hypertrophy after ACLR, which may affect the long-term health of the joint.
Journal of Hand Surgery (European Volume), Jul 24, 2014
The aim of this study was to determine the efficacy of single versus repetitive injection of lign... more The aim of this study was to determine the efficacy of single versus repetitive injection of lignocaine into the carpal tunnel for the management of carpal tunnel syndrome. The 42 patients included were randomly assigned to two Groups: group 1 was injected with 4 mL of 1% lignocaine once and Group 2 was injected with 4 mL of 1% lignocaine twice a week for 2 weeks. Clinical and electrophysiological evaluations were performed at the study onset, and at 6 and 12 weeks following the final injection. Initially, the groups were similar with respect to clinical and electrophysiological findings. All parameters in Group 2 improved 6 weeks post treatment (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), and these improvements persisted at 12 weeks post treatment (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Repetitive local lignocaine injection was effective in reducing the symptoms of carpal tunnel syndrome and improving electrophysiological findings.
Turkish Journal of Physical Medicine and Rehabilitation, 2017
Objectives: This study aims to evaluate facet tropism in younger patients with lumbar spondylolys... more Objectives: This study aims to evaluate facet tropism in younger patients with lumbar spondylolysis and to investigate the role of facet tropism in the development of spondylolysis. Patients and methods: Between February 2013 and December 2015, a total of 102 male patients with bilateral L5 pars defect including 53 with spondylolysis and 49 control subjects were included in this case-control study. The facet joint angles were measured bilaterally and axially at the level of L3-4, L4-5, L5-S1 using computed tomography (CT). The classification was made as follows: A difference between two reciprocal facet joint angles of <6° indicated no tropism, 6°-12° indicated moderate tropism, and >12° indicated severe tropism. Results: A total of 612 angles including 318 facet joint angles from 53 patients with spondylolysis and 294 facet joint angles from 49 control subjects were measured. L3-4 measurements in the control group showed no tropism in 87.8% (n=43), moderate tropism in 12.2% (n=6), and severe tropism in 0% (n=0). L4-5 measurements in control group showed no tropism in 79.6% (n=39), moderate tropism in 20.4% (n=10), and severe tropism in 0% (n=0). L5-S1 measurements in the control group showed no tropism in 69.4% (n=34), moderate tropism in 28.6% (n=14), and severe tropism in 2.0% (n=1). The mean facet joint angles in the spondylosis group were 32.9±5.1°, 37.5±5.4°, and 41.2±7.8° at the levels of L3-4, L4-5, and L5-S1, respectively. The mean facet joint angles of the control group were 33.2±5.7°, 39.7±4.9°, and 42.2±4.9° at the levels of L3-4, L4-5, and L5-S1, respectively, indicating no significant difference between the right and left mean facet joint angles between the groups (p>0.05). The frequency of facet tropism and the difference between right and left facet joint angles for all three levels were significantly higher in the spondylolysis group (p<0.05). Facet tropism at the level of L5-S1 was significantly more frequent than facet tropism at L3-4 level (p<0.05). Conclusion: Our study results show that the rate of facet joint tropism is higher in the patients with spondylolysis, suggesting that facet tropism seems to play a role in the etiology of spondylolysis as a predisposing factor.
Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, 2020
Ultrasound is a useful imaging method for wrist evaluation, which allows high-resolution anatomy ... more Ultrasound is a useful imaging method for wrist evaluation, which allows high-resolution anatomy imaging while allowing dynamic evaluation of joints, tendons, vessels, nerves and ligaments. There are six compartments on the dorsal part of the wrist, including the tendons of the wrist extensor muscles. Each compartment is lined internally by a synovial sheath and separated from one another by fibrous septa. Dorsal tubercle of radius or Lister's tubercle provides easy identification of tendons in radiological evaluation. 1 A 25-year-old female presented with a mild right forearm pain, which was exacerbated with wrist movements. Her complaints began with a fall on her 55 55 55
Turkish Journal of Physical Medicine and Rehabilitation, 2019
Comparison of the effectiveness of partial body weight-supported treadmill exercises, robotic-ass... more Comparison of the effectiveness of partial body weight-supported treadmill exercises, robotic-assisted treadmill exercises, and anti-gravity treadmill exercises in spastic cerebral palsy.
The Journal of hand surgery, European volume, 2015
The aim of this study was to determine the efficacy of single versus repetitive injection of lign... more The aim of this study was to determine the efficacy of single versus repetitive injection of lignocaine into the carpal tunnel for the management of carpal tunnel syndrome. The 42 patients included were randomly assigned to two Groups: group 1 was injected with 4 mL of 1% lignocaine once and Group 2 was injected with 4 mL of 1% lignocaine twice a week for 2 weeks. Clinical and electrophysiological evaluations were performed at the study onset, and at 6 and 12 weeks following the final injection. Initially, the groups were similar with respect to clinical and electrophysiological findings. All parameters in Group 2 improved 6 weeks post treatment (p < 0.05), and these improvements persisted at 12 weeks post treatment (p < 0.05). Repetitive local lignocaine injection was effective in reducing the symptoms of carpal tunnel syndrome and improving electrophysiological findings.
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