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To evaluate/compare the effects of the Bobath concept and task-oriented training on motor function, muscle thickness, balance, gait, and perception of goal achievement in patients with stroke. Thirty-two patients were randomly divided into Bobath and task-oriented groups. Exercises were applied for one hour a day, three days a week, for eight weeks. Clinical (Trunk Impairment Scale (TIS), Stroke Rehabilitation Assessment of Movement (STREAM), Goal Attainment Scale (GAS), balance, gait)) and trunk muscle thickness assessments (with ultrasound) were performed. Thirty patients completed the study. TIS, STREAM, and GAS scores were increased in both groups (all p < 0.05). Bilateral rectus abdominis thickness was found to have increased in the Bobath group whereby this increase was better when compared with the task-oriented group (p < 0.05). The limits of stability increased in both groups (p < 0.05). Postural sway was decreased in the anteroposterior (normal stability eyes open) in the Bobath group and the anteroposterior (perturbated stability eyes closed) in the task-oriented group. Velocity, step length, and functional ambulation profile scores increased, and double support of the paretic side decreased in the task-oriented group (all p < 0.05). The Bobath concept appears to be superior to task-oriented training in increasing the thickness of rectus abdominis in patients with stroke. Although the task-oriented training provided significant improvement, especially in terms of gait, no superiority was found between the two rehabilitation approaches in terms of functional ability. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to investigate the effects of a virtual reality–mediated gamified rehabilitation program on upper limb functions, skills, range of motion, muscle tone, and quality of life in children with hemiplegic cerebral palsy. Design: This prospective, randomized, and controlled study included 36 children with hemiplegic cerebral palsy. Children were randomized into two groups, the virtual reality group (n = 18) and the control group (n = 18). Stretching and range-of-motion exercises were performed on the affected upper limb of the children in both groups. In addition to this exercise program, in the virtual reality group, virtual reality–mediated upper limb rehabilitation was performed under supervision. The children were assessed at baseline and 1 and 3 mos after the intervention. Results: There was a significant increase in Assisting Hand Assessment, ABILHAND-Kids, Quality of Upper Extremity Skills Test, and KINDL values in the virtual reality group. In addition, there were significant increases in the active joint range of motion of the finger flexion, wrist flexion, pronation, and supination in the virtual reality group. Conclusions: In this study, it was determined that upper limb function, quality of life, and active joint range of motion of the children with hemiplegic cerebral palsy were increased with virtual reality–mediated upper limb rehabilitation. [ABSTRACT FROM AUTHOR]

To investigate effect of modified constraint-induced movement therapy (mCIMT) administered on consecutive or intermittent days on upper limb function in children with hemiparetic cerebral palsy (CP). Thirty-three children (age range 5–18 y) with hemiparetic CP separated into three groups: consecutive mCIMT group (n = 11), intermittent mCIMT group (n = 11), control group (n = 11). The outcome measures consist of Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Pediatric Balance Scale (PBS), Modified Tardieu Scale (MTS), Jebsen-Taylor Hand Function Test (JTHFT), Children's Hand Use Experience Questionnaire (CHEQ), Abilhand Kids Questionnaire, surface Electromyography (sEMG). The evaluations were made baseline, 10 days after, 5 weeks after the treatment. Improvements were achieved in all groups. The use of upper extremities in daily life activities (p < 0.01), speed of performing the activities (p < 0.001), grasping efficiency (p < 0.001), the amount of a decrease in the children's sense of discomfort while performing activities (p < 0.001) on the affected side in both mCIMT groups were better than the control group. The gain levels in mCIMT groups were similar (p > 0.05). Administration of mCIMT on intermittent days facilitate the adaptation of a child, it was concluded to be a more tolerable method and could be more effective. mCIMT is more effective than low-dose conventional therapeutic interventions in improving paretic upper limb functions in children with hemiparetic CP. The application of mCIMT in the child's natural environment increases the motivation to participate in the treatment. The application of mCIMT on intermittent days will be more easily tolerated in paediatric individuals and will increase participation in the treatment. [ABSTRACT FROM AUTHOR]

Background: In this study, we aimed to examine the etiology and demographic characteristics of the patients by retrospectively looking at the files of hemiplegic patients aged 18 and over who were hospitalized in the physical medicine and rehabilitation clinic of our hospital. Materials and Methods: The study was carried out in the physical medicine and rehabilitation department of Harran University Faculty of Medicine Research and Application Hospital. In the study, the records of patients aged 18 and over who were hospitalized between August 2021 and August 2022 were retrospectively analyzed. In addition to the etiology of the disease, the clinical and demographic characteristics of the patients diagnosed as hemiplegic were examined. Results: A total of 26 patients were evaluated, 14 (53.8%) male and 12 (46.2%) female. The mean age of the patients was determined as 61.76±13,49 (31-82) years. The plegic side was determined as 50% on the right side and 50% on the left side. In etiology, the cause was ischemic factor in 80.8% of the patients, while it was hemorrhagic in 19.2%. In terms of systemic disease, hypertension (HT) was the most common with 84.6%, followed by diabetes mellitus (DM) with 38.5%. Heart disease (CH) was the 3rd most common systemic disease with 26.9%. Those who did not have any systemic disease were only 1 (3.8%) person. HT and DM coexisted in 34.6% of the patients. Conclusions: In conclusion, it should be examined in detail because the frequency of other risk factors increases in hemiplegic patients who have had a stroke, especially chronic diseases such as HT and DM. Therefore, it is important to take preventive measures for risk factors that may cause stroke, in order to prevent possible complications. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The effect of the surgical approach and the duration between the trauma and surgery on the complications, morbidity, and mortality in cranial and spinal penetrating gunshot injuries are investigated. Methods: Evaluation of 63 patients from the Libyan civil war who were referred to the İstanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital neurosurgery clinic for the treatment and surgery between 2015 and 2017. Results: Complications such as meningitis, superficial infection, and abscess developed in 31% of the patients who underwent surgery within the initial 24 h, 58% of the patients who underwent surgery between 24 and 72 h and in all patients who underwent surgery after 72 h. While an improvement was seen in all 14 patients who had preoperative paresis and underwent surgery within 24 h or between 24 and 72 h, only one of the six patients who had paresis and underwent surgery after 72 h improved. One of the patients who underwent surgery within 24 h, three of those who underwent surgery between 24 and 72 h, and four of those who underwent surgery after 72 h died. Conclusion: The complications, morbidity, and mortality increase with a prolonged duration between the injury and surgery after craniospinal gunshot wounding. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to examine the agreement between physiotherapists (PTS), patients and caregivers about the physiotherapy of patients with hemiparesis. Materials and methods: Fifty-two patients with hemiparesis (M = 24, F = 28), caregivers (N = 52) and PTs (N = 52) who applied for the physiotherapy programme were interviewed. Demographic and clinical characteristics of the patients were recorded. A questionnaire composed of six questions was used to describe the expectations of the PTs, caregivers and patients about the physiotherapy programme. Results: The Kappa calculator revealed a statistically moderate level of agreement between PTs and caregivers (K = 0.532, p =.0001), patients and caregivers (K = 0.496, p =.0001) and PTs and patients (K = 0.401, p =.0001) regarding the expectations of physiotherapy programme. Conclusion: Expectations of the patients and caregivers must be considered for rehabilitation; hence, participation in the therapy and efficacy of the physiotherapy programme will increase. Consequently, we believe that the expectations of the patients and caregivers should be considered by the PTs when preparing a treatment programme for patients with hemiparesis. [ABSTRACT FROM AUTHOR]

Background and purpose: Complex regional pain syndrome type I (CPRS I), is a complex of symptoms characterized by diffuse pain usually with associated swelling, vasomotor instability, and severe functional impairment of the affected extremity in stroke patients. Pain is a prominent feature and is often refractory to variety of treatment. Methods: To investigate the clinical, functional, and psychosocial effects of upper extremity aerobic exercise (UEAE) and compare the effect of aerobic exercise with that of conventional physiotherapy in patients with CPRS type 1 following stroke as a randomized controlled assesor blinded 4 week-study. A total of 52 inpatients with stroke [mean age: 65.95 ± 8.7 (min.=53, max.=80) years, and the mean age of the control group was 67.50 ± 11.2 years], all within 6 months post-stroke and diagnosed with CPRS I . The UEAE program consisted of an arm crank ergometer (10W/min), in addition to a conventional physiotherapy (whirlpool, TENS, retrograd massage). Primary outcome measures were CPRS clinical determinants (pain, hyperalgesia, allodynia, and autonomic abnormalities) secondary outcome measures were functional independence measure (FIM), Nottingham Health Profile (NHP), and Beck Depression Scale scores that were performed at 0 month (baseline) and 4 weeks (post-treatment). Results: In UEAE group, patients reported significant pain relief (89.9%) and significant decline in CRPS signs and symptoms. The mean change in pain at shoulder, pain at the hand as well as and NHP and BDS scores between groups were statistically significant (P<0.05). Conclusions: UEAE made an excellent improvement in the symptoms and signs of CRPS I . Combined treatment of conventional physiotherapy and aerobic exercises may be an excellent synthesis for this syndrome in these patients. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effects of Kinesio Tape (KT) application to quadriceps muscles on isokinetic muscle strength, gait, and functional parameters in patients with stroke. Twenty-four patients were allocated into KT and control groups. All patients participated in the same conventional rehabilitation program 5 times/wk for 4 wk. In addition, KT was applied to quadriceps muscles bilaterally to the patients in the KT group. Compared with baseline, peak torque levels increased significantly in both groups (all p < 0.05). However, change levels were significantly higher in the KT group than the control group at 60 degrees/second angular velocity (AV) in extension (p = 0.04) and 60 and 180 degrees/ second AV in flexion (both p = 0.02) on the paretic side. Moreover, the change levels were more prominent in the KT group at 60 and 180 degrees/second AV in extension (p = 0.03 and p = 0.04, respectively) on the nonparetic side. Gait, balance, mobility, and quality of life values improved significantly in both groups (all p < 0.05), yet the change levels between the groups did not reach significance (p > 0.05). KT application to quadriceps muscles in addition to conventional exercises for 4 wk is effective on isokinetic but not functional parameters. [ABSTRACT FROM AUTHOR]

Purpose: Lymphomas are the third most common childhood malignant disease after leukemia and central nervous system (CNS) tumors. Early diagnosis of these complications will reduce mortality and morbidity. In this study we aimed to review the neurological complications of childhood non Hodgkin Lymphoma (NHL). Patients and methods: Forty four children with NHL between 2006 and 2012 were investigated retrospectively and 14 cases with neurological complications were identified. Results: The most common symptom was alteration of the consciousness (10 patients, 71.4 %) followed by convulsion (5 patients, 35.7 %), and hallucination (4 patients, 28.5 %); headache, eye pain, neurogenic bladder, speech disability and facial paralysis, and hemiplegia, were less common and each of them was seen in 1 (7.1 %) of the patients. The neurological complications were mostly seen in children with precursor T lymphoblastic lymphoma followed by anaplastic large cell lymphoma. The complications were secondary to medications (Eight patients) infection (two patients); CNS relapse (two patients); or CNS involvement of the primary disease (two patients). Chemotherapy-related neurologic complications were secondary to intrathecal methotrexate, l-asparaginase, vincristine, and ifosfamide Conclusion: Advanced disease and PTLL subtype can be suggested as predictors of neurological complication. The survival rates of neurological complications are fairly good unless it is secondary to involvement of the primary disease. In patients with drug-induced neurological complications, the treatment can be safely re-administered after controlling the neurological complications. Therefore, clinicians managing children with NHL must be informative about neurological complications. [ABSTRACT FROM AUTHOR]

Objectives: Examination of relations between urinary dysfunction and Functional Independence Measurement (FIM) values and other clinical factors. Materials and methods: Twenty-nine patients with TBI were included in the study. Patients' demographic values, lower urinary tract symptoms (LUTS) and urinary drainage methods were recorded. Functional assessment was performed using FIM. Urodynamic studies were carried out and maximum cystometric capacity (MCC), storage and voiding function, type of detrusor, urodynamic abnormality and post-void residual urine volume values were investigated. Results: Total FIM and FIM sphincter control sub-group scores were significantly lower in patients with storage dysfunction and urodynamic abnormality than patients without storage dysfunction and urodynamic abnormality ( p < 0.05). In tetraparetic patients, frequency of storage dysfunction was significantly higher than hemiparetic patients ( p < 0.05). Urodynamic abnormality was detected in five of nine patients with LUTS and in 12 of 20 patients without LUTS. There was no significant correlation between LUTS and urodynamic abnormality ( p > 0.05). Conclusions: Storage dysfunction and urodynamic abnormality is associated with poorly functional outcomes in TBI patients. There is a direct correlation between motor deficit and urodynamic abnormality. All of the TBI patients with or without LUTS should be evaluated neuro-urologically; urodynamic evaluation and treatment should be arranged if needed. [ABSTRACT FROM AUTHOR]

Background and Aims: To investigate whether there were changes in the sympathetic skin responses (SSR) in the limbs with complex regional pain syndrome (CRPS) type I in hemiplegic patients.Setting: A physical medicine and rehabilitation center in Turkey.Materials and Methods: Sympathetic skin responses were evaluated in 69 stroke patients (41 with CRPS and 28 without CRPS) and 20 healthy volunteers. SSR were recorded on the paretic and healthy hands after stimulation of the ipsilateral median nerve. Patients' ages ranged from 33 to 77 years, with a mean of 60.0+/-12.9 years.Results: The SSR were obtained in all patients with CRPS, whereas SSR was absent in 9 of 28 patients with hemiplegia who did not have CRPS after stimulation of the plegic side and the difference was statistically significant (P=0.023). SSR amplitudes were increased at the hemiplegic limbs in patients affected by CRPS compared to individuals unaffected; this group difference was statistically significant (P=0.014). The mean amplitude of the SSR in the advanced stage of CRPS was greater than lower stage and the difference was statistically significant (P=0.035).Conclusion: Our results suggest that SSR can be obtained in stroke patients with CRPS even in the early stages of CRPS. SSR acquirability and amplitude increase as the stage of the disease advances. As an electrophysiologic technique, SSR may be used in the evaluation of the sympathetic function in hemiplegic patients and also in the diagnosis of CRPS and in monitoring of its treatment. [ABSTRACT FROM AUTHOR]

The aim of this cross-sectional study was to determine the prevalence of cerebral palsy (CP) among children in Turkey between the ages of 2 and 16 years. Samples were selected from cities, towns, districts, and villages using the cluster sampling method; 41861 children were selected. Data was collected by parental interview and physical examination. One hundred and eighty-six children were identified with CP. The prevalence of CP was determined as 4.4 per 1000 live births and included postnatally acquired CP. Origin of CP was classified as prenatal in 49 (26.6%), perinatal/neonatal in 34 (18.5%), postnatal in 11 (5.9%), and unclassifiable in 90 participants (48.9%; data was unobtainable for two individuals). Type of CP was diplegia in 39.8% of children, hemiplegia in 28%, tetraplegia in 19.9%, ataxia in 5.9%, and dyskinetic in 6.4%. Prenatal factors were seen more frequently in the groups with a high socioeconomic status while perinatal factors were encountered more often in those with a low socioeconomic status (p<0.05). Place of residence and sex had no significant effect on the prevalence of CP (p>0.05). This cross-sectional study shows that the prevalence of CP in Turkey is higher than that in developed countries but the aetiology is probably similar. Although the high prevalence of CP in Turkey could originate from an increased level of obstetric and neonatal problems, the lack of a possible aetiological factor in approximately half the children suggests that the high level might also be due to other factors, such as genetic disorders. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the reliability and validity of the Turkish version of the Bath Ankylosing Spondylitis (AS) Patient Global Score (BAS-G). Seventy-one consecutive patients with AS were enrolled into the study. Patients were requested to fill in the questionnaire on the day of admission (first visit), on a second occasion within 24 h after admission (second visit) for test–retest reliability analysis, and on a third occasion for assessing sensitivity to change. Construct validity was assessed by correlation analysis with the Bath AS Functional Index (BASFI), Dougados Functional Index (DFI), Dougados Articular Index (DAI), physical examination findings, and several other parameters. Test–retest reliability analysis of individual BAS-G scores at initial and second visits showed good intraclass correlations [ n=46, intraclass correlation=0.928 (0.870–0.960) and intraclass correlation=0.853 (0.725–0.920), for 1-week and 6-month scores, respectively]. Both 1-week and 6-month scores showed moderate correlations with the BASFI ( r=0.586 and r=0.503, respectively, P=0.000 for both). The 1-week score also showed moderate correlation with the DFI ( r=0.530, P=0.000). The 1-week score showed weak correlations with finger-to-floor distance ( r=0.263, P=0.027), chest expansion ( r=−0.245, P=0.039), and DAI ( r=0.271, P=0.036). Change in the 1-week score at the third visit showed good correlation with the BASFI score ( r=0.670, P=0.000, n=36) and moderate correlation with the DFI ( r=0.440, P=0.017, n=29). The Turkish version of the BAS-G has good reliability and validity. It is a good tool for assessing patients with AS or other rheumatic diseases in clinical practice and research. [ABSTRACT FROM AUTHOR]

Aim: To define clinical features of patients with alternating hemiplegia of childhood. Methods: We retrospectively reviewed the clinical presentation and course of the disease in patients diagnosed between January 2003 and December 2008 at the Pediatric Neurology Department of the Istanbul Medical Faculty. Results: The nine patients had a mean age of 6.6 months (2-15 months) at the onset of symptoms. Paroxysmal eye movements were the early symptom of five patients. All patients had recurrent alternating hemiplegic episodes and relief of symptoms while sleeping. Duration of events varied widely from few minutes to several days and was associated with slowly progressive neurological deterioration. Flunarizine might decrease frequency of events but is not effective to neurological deterioration. Amantadine as an alternative agent is used in add-on therapy, but epileptogenic side effect prevented the evaluation of long-term efficacy. Conclusion: Trials on new agents like amantadine are necessary for more effective control of the disease. [ABSTRACT FROM AUTHOR]

Background/objective: Heterotopic ossification characterized by new bone formation in the periarticular regions of large joints in patients with neurologic injury most commonly occurs on the neurologically involved side. This study presents a very rare localization of heterotopic ossification that developed in the non-paretic limbs of a hemiplegic patient with traumatic brain injury (TBI). Case report: A 25-year-old left hemiplegic male with TBI due to a gunshot wound was admitted to the rehabilitation centre after a 2.5-month period of coma in the intensive care unit. He had limited range of motion accompanied by pain in the bilateral hip, bilateral elbow and right knee joints. Neurological examination revealed upper motor neuron lesions only on the left side in neurological exam. Plain radiographs of the involved joints revealed bilateral heterotopic ossification, which was more severe on the non-paretic side. Discussion: Clinicians should keep in mind that heterotopic ossification can occur in non-hemiplegic extremities as well as hemiplegic extremities in patients with TBI in whom the extent of neurologic damage cannot be definitely established. [ABSTRACT FROM AUTHOR]

Background and Purpose: Transcranial direct current stimulation (tDCS) is a treatment used in the rehabilitation of stroke patients aiming to improve functionality of the plegic upper extremity. Currently, tDCS is not routinely used in post stroke rehabilitation. The aim of this study was to establish the effects of bihemspheric tDCS combined with physical therapy (PT) and occupational therapy (OT) on upper extremity motor function., Methods: Thirty-two stroke inpatients were randomised into 2 groups. All patients received 15 sessions of conventional upper extremity PT and OT over 3 weeks. The tDCS group (n = 16) also received 30 minutes of bihemispheric tDCS and the sham group (n = 16) 30 minutes of sham bihemispheric tDCS simultaneously to OT. Patients were evaluated before and after treatment using the Fugl Meyer upper extremity (FMUE), functional independence measure (FIM), and Brunnstrom stages of stroke recovery (BSSR) by a physiatrist blind to the treatment group RESULTS: The improvement in FIM was higher in the tDCS group compared to the sham group (P = .001). There was a significant within group improvement in FMUE, FIM and BSSR in those receiving tDCS (P = .001). There was a significant improvement in FIM in the chronic (> 6months) stroke sufferers who received tDCS when compared to those who received sham tDCS and when compared to subacute stroke (3-6 months) sufferers who received tDCS/sham., Conclusions: Upper extremity motor function in hemiplegic stroke patients improves when bihemispheric tDCS is used alongside conventional PT and OT. The improvement in functionality is greater in chronic stroke patients., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: To evaluate whether combining fluidotherapy to conventional rehabilitation program provides additional improvements on pain severity, upper extremity functions, and edema volume in patients with poststroke complex regional pain syndrome (CRPS)., Design: Randomized controlled trial., Setting: Training and research hospital., Participants: Thirty hemiplegic patients with subacute stage CRPS type-1 of the upper extremity., Interventions: The patients randomly divided into 2 groups. Both groups received a 3 week conventional rehabilitation program (5 days/week, 2-4 hours/day). Experimental group received 15 sessions additional fluidotherapy application to the affected upper extremity (40 °C, 20 minutes in continuous mode, 5 sessions/week)., Main Outcome Measures: We evaluated the distal upper arm edema with a volumeter. Other used clinical assessment scales were Brunnstrom recovery stages of the arm and hand for motor recovery, motor items of the functional independence measure for functional status, visual analog scale for pain severity, and the painDETECT questionnaire for presence and the severity of neuropathic pain., Results: The mean age of the participants was 64.3 ± 11.66 (28-84). At the post-treatment evaluation, significant improvements were revealed regarding to the edema volume, pain visual analog scale, painDETECT and functional independence measure scores, and the Brunnstrom stages of upper extremity and hand in both groups (P < .05). But among the parameters mentioned above, only the decrease in edema volume and the painDETECT scores were greater in fluidotherapy group than the control group (P < .05)., Conclusions: Addition of the fluidotherapy to the conventional rehabilitation program provides better improvements on neuropathic pain and edema volume in subacute stage poststroke CRPS., (Copyright © 2019. Published by Elsevier Inc.)