Search

Objectives: The aim of this study was to investigate the caregiver burden (CB) of informal caregivers for stroke survivors with and without dysphagia and to assess the relationship between the CB levels of informal caregivers for stroke survivors with dysphagia, patients’ swallowing-related quality of life (QoL), and patients’ stroke-specific QoL. Patients and methods: This multi-center, prospective, cross-sectional study included a total of 120 stroke patients (76 males, 44 females; mean age: 61.1±12.3 years; range, 19 to 86 years) between October 2019 and 2020. Of the patients, 57 had dysphagia and 63 had no dysphagia. The Functional Oral Intake Scale (FOIS) was used to classify the degree of functional dietary limitation caused by each patient’s swallowing impairment. Patients and caregivers completed the Eating Assessment Tool (EAT-10), Swallowing Quality of Life (SWQoL) questionnaire, Stroke Impact Scale (SIS), and the Zarit Caregiver Burden Interview (ZBI). Results: The CB levels were higher in those caring for stroke patients with dysphagia than in those caring for stroke patients without dysphagia. Caregiver burden was found to be associated with patients’ swallowing-related QoL and stroke-related QoL. Significant predictors of high CB scores (F=2.55, R2=0.59; p=0.007) were being an employed caregiver (B=17.48, p=0.003), being a caregiver with high school (B=-19.6, p=0.03), and secondary school (B=-16.28, p=0.02) educational status, being son, daughter (B=30.63, p=0.007) or other relative of the patient (B=20.06, p=0.01), lower FOIS stage (B=-3.14, p=0.011), lower SWQoL (B=0.52, p=0.009) and lower SIS (B=-0.37, p=0.04) scores. Conclusion: Caregivers of stroke patients with dysphagia suffer from a higher CB than those without dysphagia. In stroke patients with dysphagia, swallowing-related QoL is associated with the QoL levels of stroke patients and the CB levels of their caregivers. Employment status, educational status of caregiver, caregiver’s relativity to the patient, FOIS stage, swallowing and stroke related QoL of the patients are factors related to burden levels of caregivers of stroke patients with dysphagia. These results may help health professionals to understand dysphagia as an essential source of CB and consider it, while planning treatments. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate cross-sectional area of the amputated-limb rectus femoris compared to the intact-limb and controls and to determine its correlation with functional strength and walking tests in prosthesis users with transtibial amputation. Patients and methods: Between October 2018 and April 2019, a total of 14 prosthesis users (12 males, 2 females; mean age: 47.1±16.2 years; range, 26 to 73 years) who met the inclusion criteria, and 14 age-, sex-, and dominancy-matched able-bodied controls (12 males, 2 females; mean age: 47.1±16.2 years; range, 26 to 73 years) were included in this case-control study. Cross-sectional area of rectus femoris (CSA-RF) was evaluated bilaterally by two independent examiners. Knee extension strength was measured bilaterally by using a handheld dynamometer. Functional strength and walking were assessed by Step-Up-Over and Walk-Across tests of the NeuroCom Balance Master® device. Results: The CSA-RF was found to be reduced in amputated-limb compared to the intact-limb and able-bodied controls (p<0.01). In the prosthesis users, the cross-sectional area difference between both limbs rectus femoris muscles was shown to be correlated with actual and functional knee extension strength, step length, and walking speed (p<0.05). Intra- and inter-observer reliability of CSA-RF on both sides were found to be good to excellent (intraclass correlation coefficient: 0.856-0.936). Conclusion: Ultrasonographic measurement of CSA-RF is a valid and reliable tool to assess the functional strength and walking in the prosthesis users with unilateral transtibial amputation. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to assess psychosocial functioning in relation to lesion level and ambulatory status in children with spina bifida (SB) and compare them to their peers. Patients and methods: Between March 2013 and May 2013, a total of 31 patients with SB (11 males, 20 females; mean age: 9.4 years; range, 6 to 14.7 years) and 36 typically developing peers (16 males, 20 females; mean age: 9.8 years; range, 6.5 to 14.8 years) were included in the study. All participants were assessed using a semi-structured psychiatric diagnostic interview via the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL), Wechsler Intelligence Scale for Children-Revised (WISC-R), Behavioral Rating Inventory of Executive Functions (BRIEF) parent form, Social Responsiveness Scale (SRS), and Aberrant Behavior Checklist (ABC). Results: In the SB group, the rate of psychiatric disorders was significantly higher (p=0.001) and the SRS scores and the planning and organizational components of the executive function were higher than their peers (p=0.02 and p=0.007, respectively). The psychiatric diagnosis rate, BRIEF, and SRS total scores did not significantly differ according to lesion level and ambulatory status. The BRIEF initiate and organization of materials subtest scores and ABC scores were significantly lower at high lesion levels (p=0.02, p=0.02, and p=0.02, respectively) and non-community walkers (p=0.002, p=0.03, and p=0.003, respectively). Conclusion: Psychiatric disorders, impairment in social responsiveness, and planning and organization components of the executive function are prevalent in children with SB with no intellectual disabilities, compared to their peers. Therefore, psychosocial counseling and multidisciplinary follow-up for SB patients seem to be beneficial. [ABSTRACT FROM AUTHOR]

In the article, the authors present their report on the publications from Turkey regarding physical medicine and rehabilitation (PMR). Also cited are the 2020 Scientific and Technological Research Council of Turkey (TUBITAK) field-based competency analysis report on the research performances of universities, and the topics covered by the research like rehabilitation, rheumatology, and orthopedics.

Despite sore throat exists in the product characteristics of abobotulinum toxin A as one of the side effects, no available reports of sore throat after abobotulinum toxin A injection for adult upper limb spasticity could be found in the literature to guide physicians for the management. Herein, we report a case of poststroke spasticity who develop sore throat immediately after abobotulinum toxin A (Dysport®) injection of forearm muscles which completely resolved after observation for eight hours. This case report highlights a rare side effect of abobotulinum toxin A and provides information regarding the follow-up process of side effects which would guide physicians for the management. [ABSTRACT FROM AUTHOR]

Progressive pseudorheumotoid dysplasia (PPD) is a rare hereditary musculoskeletal disorder which is usually misdiagnosed due to its clinical resemblance to juvenile idiopathic arthritis. It has a high incidence in the Middle East, Gulf States, and countries of Mediterranean basin. Herein, we present four cases of PPD from Turkey (two siblings pair from the same kindred who are far paternal cousins) showing different disease courses. The progression of disease was particularly aggressive in the male sibling who suffered from severe scoliosis with more crippling joint disease. These four cases of PPD support the clinical heterogeneity and variable expressivity of PPD. In this article, we draw attention to the effects of patient education and early rehabilitation which helped to slow progression of range of motion loss. [ABSTRACT FROM AUTHOR]

Ankylosing spondylitis (AS) is a chronic inflammatory disease which is characterized by the primary involvement of axial spine and sacroiliac joints and also extraarticular involvements including ophthalmological, cardiac, pulmonary, or neurological effects. Cardiac involvement in patients with AS has been reported to be 2 to 10%. Ventricular dysfunctions have been previously reported in patients with AS. However, there is only one case report describing primary cardiomyopathy due to AS and management with better control of inflammation and medications. Herein, we present a case of cardiomyopathy in AS in whom ejection fraction and New York Heart Association (NYHA) functional class improved and disease activity decreased after cardiac rehabilitation program. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this review to evaluate the clinical aspects and effectiveness of suit therapy for patients with cerebral palsy (CP). Materials and methods: A literature search was performed in the PubMed, SCOPUS, Web of Science, and PEDro databases within the period from the establishment of the relevant database to July 2018. The articles were categorized according to their study design. We included studies published in peer-review journals focusing on the efficacy of suit therapies for CP and excluded review articles, duplications, non-related articles. A narrative synthesis approach was used, as it was not possible to classify extracted and analyzed data, and the overall effect size was unable to be calculated. Data regarding study subjects (number, age, CP type, Gross Motor Function Classification System [GMFCS] level), suit type, intervention including dose of suit therapy, outcome measurements, outcomes, adverse effects, and funding were extracted. The method introduced by Furlan, Pennick, Bombardier, and van Tulder was used to evaluate the risk of bias for the assessment of methodological quality of randomized-controlled trials (RCTs). Results: A total of 29 studies were included of which 10 were Class I, eight were Class II-III, and 11 were Class IV studies. Studies were heterogenous in design, sample size, study population, and outcomes measured. The methodological quality score of RCTs varied between 4 and 10. The results of the high-quality RCTs showed that wearing the suit along with conventional therapy improved proximal stability, gross motor function, and gait. The Class II-III and IV studies supported the findings of the Class I studies. Conclusion: The major improvements from the RCTs were seen in proximal stability, gross motor function and gait, although grading was unable to be done due to the heterogeneity of included studies. In order to obtain gains in the function, it is important to carefully consider intended use, patient selection criteria, and suit type. [ABSTRACT FROM AUTHOR]

Mechanical compression at any point along the lateral femoral cutaneous nerve (LFCN) may result in meralgia paresthetica (MP). A 54-year-old male patient presented with pain and tingling on the anterolateral side of thigh. After excluding other causes of pain radiating to legs, he was diagnosed with MP. Inguinal lymphadenopathy which caused the compression of LFCN was found on ultrasonographic examination. Tinea pedis infection was also identified during the detailed investigation for lymphadenopathy. Associated MP symptoms partially resolved immediately after ultrasound-guided LFCN block and a complete recovery was achieved after the treatment of tinea pedis. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate pain in children with cerebral palsy (CP), to investigate its association with dependency level, verbal abilities, and the quality of life (QoL) of children and sociodemographic status, depression levels, and QoL of their caregivers. Patients and methods: Between February 2016 and April 2016, a total of 85 children (56 males, 29 females; mean age 7.1±2.5 years; range, 4 to 12 years) with CP were included. Their sociodemographic data, gross motor functional levels, verbal abilities (verbal and nonverbal) were evaluated. The children were categorized as independent (Gross Motor Function Classification System [GMFCS] 1), partially dependent (GMFCS 2,3), and totally dependent (GMFCS 4,5). The Non-Communicating Children’s Pain Checklist - Revised (NCCPC-R), the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD), the Nottingham Health Profile (NHP), and the Beck Depression Inventory (BDI) were used for the evaluation. Results: A total of 50 (58.8%) of the children were verbal, while 35 (41.2%) were non-verbal. Of the patients, 47.1% were totally dependent, 37.6% were partially dependent, and 15.3% were independent. Pain was less frequent in the independent group, compared to the partially and totally dependent groups (p=0.04; p=0.013). There were no statistically significant difference in perceived pain according to the CPCHILD and NCCPC-R scores, when low and high socioeconomic status were compared (p>0.05). The QoL scores of children who were totally dependent and non-verbal were statistically significantly lower than those of the other children (p=0.0001, p=0.0001). A statistically significantly negative correlation between increased totally dependent children’s QoL scores and decreased QoL scores of the caregivers was observed (r=-0.429 p=0.006). The children with pain had a decreased QoL (p=0.03). The QoL of caregivers decreased and the depression scores of caregivers increased, as the pain scores of the children increased (r=0.291, p=0.007; r=-0.455, p=0.0001). Conclusion: Our study results show that pain is more frequent in children with CP who are dependent and non-verbal, and it negatively affects the QoL of both caregivers and children. Evaluation of pain and the identification of CP patients who are at high risk of experiencing pain is worthwhile, as these individuals have difficulty in verbalizing pain due to their cognitive problems, although they are at risk of experiencing pain due to chronic physical problems, such as spasticity and contracture, as well as interventions for complicated medical problems. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate whether the use of a lycra-based compression orthosis known as stabilizing input pressure orthosis (SPIO) vest improves trunk posture and hip lateralization in children with cerebral palsy (CP) and to compare the effects of two- and six-hours daily wear of the orthosis. Patients and methods: Between December 2013 and July 2015, a total of 24 children with CP (5 boys, 19 girls; mean age 61.1 months; range 35 to 105 months) with impaired trunk control were included in this single-blind, randomized-controlled study. All were randomized to either of the three groups as the control group (received only conventional exercise therapy), the SPIO 2-hour group (worn orthosis two hours during therapy), and the SPIO 6-hour group (worn orthosis four hours in addition to two hours of wear during therapy). The Sitting Assessment Scale (SAS), Cobb angle, kyphotic angle, and Migration Index were used to evaluate the trunk posture and hip lateralization before treatment and at six months after treatment. Results: The SAS scores improved compared to baseline in all groups. The Cobb angle and kyphotic angle showed a significant decrease at six months after treatment only in the SPIO groups, while intra-group analysis of the Migration Index did not show a statistically significant difference. Changes in the radiographic assessments were similar among the groups, except for the kyphotic angles. The kyphotic angle showed less change in the control group. Comparison of the SPIO groups showed no significant differences in terms of the variables assessed. Conclusion: The SPIO vest improves the kyphotic posture, but not scoliosis and hip lateralization in children with CP with impaired trunk control when used in combination with the conventional therapy. Using the SPIO vest for two and six hours also yields similar outcomes. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate if function and mood involvement correlate in female patients who have a pre-diagnosis of carpal tunnel syndrome (CTS) and its correlation with physical examination and electrodiagnostic findings. Patients and methods: A total of 170 patients between the ages of 18-65 who applied to Physical Medicine and Rehabilitation outpatient clinics with CTS symptoms between May 2014 and December 2015 were enrolled. The mean age of patients was 44.6±11 years. Before electrophysiological testing (electromyography; EMG), Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), Beck Depression Inventory, Tinnel, Phalen and Durkan tests, grip and pinch strength measurement by JAMAR hand dynamometer were performed. The patients also used a Visual Analog Scale (VAS) to determine the severity of their symptoms during the day and at night. Results: In 98 patients (57.6%) the diagnosis of CTS was confirmed by EMG, while 72 patients (42.4%) had normal electrodiagnostic findings. In patients who had normal EMG, Beck Depression Inventory and QuickDASH scores were not significantly different from the patients who had an electrodiagnosis of CTS. Pain experienced in the night was significantly higher in patients who had an electrodiagnosis of CTS, and these patients had significantly higher Beck Depression Inventory and QuickDASH scores. Conclusion: The lack of electrodiagnostic evidence in patients who have CTS symptoms does not show that function and mood are not affected in these patients. However, mood is significantly affected in patients with severe CTS. [ABSTRACT FROM AUTHOR]

The article presents a case study related to 34-year-old female who had traumatic brain injury caused by a gunshot 13 year ago was seen for anterior drooling. Topics include the underwent several blind botulinum toxin injections into the parotid and submandibular gland, and the ultrasound and electromyography & electrical stimulation-guided 25 IU of onabotulinum toxin A injection (a total of 50 IU) was applied to each parotid gland.

The article presents a case study of a 15-year-old boy with mucopolysaccharidosis type IV suffered from cardiopulmonary arrest after cervical stenosis surgery and was resuscitated and three days after the injection, the treating physicians and nurses who were responsible with the care of the patient being reported an increased mouth opening distance, easier care of oral cavity, and no more need for rocuronium infusion.