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Amaç: Bu çalışmanın amacı, pes planusu olan ve olmayan genç sedanter bireylerde, alt ekstremitenin biyomekanik özelliklerini, ayağın yapı ve fonksiyonunu ve bel ağrısını karşılaştırmaktı. Yöntem: Çalışma 30 kadın, 30 erkek olmak üzere toplam 60 sedanter bireyin katılımı ile gerçekleştirildi. Bireyler naviküler düşme testi değerlerine göre pes planusu olan ve olmayan olarak iki gruba ayrıldı. Bireylerin ayak fonksiyonunu değerlendirmek için Amerikan Ortopedik Ayak- Ayak Bileği Derneği skorlaması ile Vizüel Analog Skalası-Ayak ve Ayak Bileği Ölçekleri kullanıldı. Belirlenen kaslara kısalık testleri ve kas kuvvet ölçümleri, Q açısı ölçümü ve pelvik inklinasyon açısı ölçümü yapıldı. Bel ağrısını değerlendirmek için Oswestry Özürlülük İndeksi kullanıldı. Pes planusu olan ve olmayan bireylerin değerleri karşılaştırıldı. Sonuçlar: Pes planusu olan ve olmayan bireyler arasında tibialis posterior ve peroneal kas kuvveti, gastroknemius, soleus ve hamstring kas kısalıkları, Q açısı, Amerikan Ortopedik Ayak-Ayak Bileği Derneği skorlaması ile Vizüel Analog Skalası Ayak ve Ayak Bileği skorlarında anlamlı bir fark yoktu (p>0,05). Pes planusu olan bireylerde olmayanlara göre, dominant olmayan tarafta pelvik inklinasyon açısının daha fazla (p=0,042) ve Oswestry Özürlülük İndeksi skorunun daha yüksek (p=0,001) olduğu bulundu. Tartışma: Sonuçlarımız, genç sedanter bireylerde, pes planusun pelvik inklinasyonu artırabildiğini ve bel ağrısına neden olabildiğini göstermekle birlikte, alt ekstremite kas kuvveti, kas kısalığı ve ayak fonksiyonunun bu durumdan etkilenmediğini ortaya koymuştur. Purpose: The objective of the study was to compare the biomechanical features of the lower extremity, foot structure, and function and low back pain in young sedentary subjects with and without pes planus. Methods: The study was conducted with the participation of 60 sedentary subjects consisting of 30 women and 30 men. The subjects were assigned to two groups as with or without pes planus according to navicular drop test results. The American Orthopaedic Foot and Ankle Society score and Visual Analogue Scale Foot and Ankle Scales were used to evaluate the foot function of the subjects. Muscle shortness and strength tests of the selected muscles, Q angle, and pelvic inclination angle measurements were performed. Oswestry Disability Index was used to evaluate low back pain. The subjects with and without pes planus were compared. Results: There were no significant differences between the subjects with and without pes planus regarding tibialis posterior and peroneal muscle strength, gastrocnemius, soleus and hamstring muscle shortness, Q angle, American Orthopaedic Foot and Ankle Society score, and Visual Analogue Scale Foot and Ankle score (p>0.05). The pelvic inclination angle of the non-dominant side was higher (p=0.042), and Oswestry Disability Index score was higher (p=0.001) in subjects with pes planus compared to those without pes planus. Conclusion: Our results indicated that pes planus may increase pelvic inclination and may cause low back pain, while lower extremity muscle strength, muscle shortness, and foot function were not affected from this case in young sedentary subjects.

Amaç: Bu çalışmanın amacı, düşme öyküsü olan ve olmayan yaşlılar arasında plantar duyu, postural salınım, düşme korkusu açısından fark olup olmadığını araştırmaktır. Yöntemler: Çalışmaya 21 kadın, 19 erkek olmak üzere 65 yaş üstü 40 birey dahil edildi. Bireyler düşme öyküsü olanlar (n=14) ve olmayanlar (n=26) olarak ikiye ayrıldı. Olguların plantar hafif dokunma-basınç ve statik iki nokta ayrımı duyuları ölçüldü; vücut kütle merkezinin (centre of mass-COM) anteroposterior ve mediolateral yönlerdeki salınım miktar ve hızları, WinTrack® Pedobarografi cihazı ile statik ayakta duruşta, gözler açık ve kapalı olarak kaydedildi. Düşme korkusu ise Düşme Etkinlik Ölçeği ile değerlendirildi. Sonuçlar: Ölçülen plantar duyu ve postural salınım parametreleri açısından düşme öyküsü olan ve olmayan yaşlılar arasında anlamlı bir fark olmadığı (p>0,05), düşme korkusunun ise düşme öyküsü olan yaşlılarda olmayanlara göre yüksek olduğu (p=0,007) bulundu. Tartışma: 65 yaş üstü bireylerin %33'ünden fazlasının yılda en az bir kez düştüğü ve düşme korkusunun ev dışı aktiviteleri limitleyerek yaşam kalitesinde azalmaya neden olduğu bilinmektedir. Literatürde, birinci parmak ve birinci metatarsofalangeal eklemdeki taktil duyu kaybının ve postural salınımdaki artışın düşmelerle ilişkili olduğunu gösteren çalışmalar bulunmaktadır. Bizim çalışmamız, düşme öyküsü olan ve olmayan yaşlılar arasında plantar duyu ve postural salınım açısından fark olmadığını ancak, düşme korkusunun düşme öyküsü olanlarda daha yüksek olduğunu ortaya çıkarmıştır. Yaşlı bireylerde düşme riskinin azaltılmasına dönük tedavi hedefleri arasında düşme korkusunun azaltılması da yer almalıdır, Purpose: The aim of this study is to investigate differences between olders with and without falling story in terms of plantar sensitivity, postural sway and fear of fall.Methods: Fourty subjects consisting of 21 women and 19 men, and over 65 years of age included in this study. Subjects were divided into two groups as with (n=14) and without falling story (n=26). Plantar light touch-tactile and static two point discrimination sensitivity were measured; anteroposterior and mediolateral deviation quantity and speed of the center of mass (COM) were recorded by WinTrack® Pedobarograph under eyes-open and eyes-closed conditions. Fear of fall were evaluated by Falls Efficacy Scale. Results: There were no significant differences between olders with and without falling story in terms of plantar sensitivity and postural sway parameters (p>0.05); fear of fall was higher in olders with falling story according to those without falling story (p=0.007).Discussion: More than 33% of individuals over 65 years fall more than once a year and fear of falling causes decreased quality of life by limiting outdoor activities. There are studies showing that tactile sensory loss in first toe and first metatarsophalangeal joint and increase in postural sway are related to falls. Our study found no difference between olders with and without falling story in terms of plantar sensitivity and postural sway, but higher fear of falling in those with falling story. Reducing fear of falling should take place among treatment targets for reducing the risk of falls in olders

Purpose: To specify the relationships between shoe usage and the development of foot deformities, balance, and functional activity performance. Methods: Seventy healthy subjects whose mean age was 22.2±1.7 years were participated in the study. The Foot Wear Assessment Score was used to assess the sufficiency of shoes. Total Foot Deformity Score, Flamingo Balance Test, Star Excursion Balance Test, vertical jump test, 10 meter walk test and heel rise test were conducted to specify foot deformities, static balance, dynamic balance, jumping height, gait speed and the activity of the plantar flexor muscles, respectively. All functional tests were performed with and without shoes to clarify the effect of shoes on function. Results: An association was determined between foot deformities and the two parameters of The Foot Wear Assessment Score, sole material and heel height. When the subjects were compared in the performance tests while barefoot and wearing shoes, a significant difference was found for dynamic balance, jumping height, gait speed, and the activity of the plantar flexors (p0.05). Conclusion: This result implies that it is important to choose the appropriate shoes because while the performance of some functional activities is enhanced by wearing shoes others cause limitation, Amaç: Ayakkabı kullanım alışkanlığı ile ayakta deformite gelişimi ve ayakkabı kullanımı ile denge ve fonksiyonel aktivite performansı arasındaki ilişkileri belirlemekti. Yöntem: Çalışmamıza yaş ortalaması 22.2±1.7 yıl olan 70 sağlıklı birey dahil edildi. Ayakkabı uygunluğunu değerlendirmek için Ayakkabı Uygunluğu Değerlendirme Formu (AUDF) kullanıldı. Ayak deformitelerini, statik dengeyi, dinamik dengeyi, sıçrama mesafesini, yürüme hızını ve plantar fleksörlerin aktivitesini belirlemek için sırasıyla Toplam Ayak Deformite Skorlaması, Flamingo Denge Testi, Star Excursion Balance Test, dikey sıçrama testi, 10 metre yürüme testi ve topuk yükseltme testi yapıldı. Tüm fonksiyonel testler ayakkabılı ve ayakkabısız olarak uygulandı ve ayakkabının fonksiyona olan etkisi araştırıldı. Bulgular: AUDF parametlerinden ayakkabı taban materyali ve topuk yüksekliği ile ayaktaki deformiteler arasında ilişki olduğu saptandı. Bireylerin performans testlerinde ayakkabılı ve ayakkabısız olarak karşılaştırılması sonucunda dinamik denge, sıçrama yüksekliği, yürüme hızı ve plantar fleksörlerin aktivitesi farklı bulunurken (p0.05). Tartışma: Ayakkabı alışkanlığı ile deformite gelişimi ve fonksiyonel performans arasında tespit edilen farklı düzeydeki ilişkiler, bireylerin kendilerine uygun ayakkabılar seçmesinin önemine ve bazı fonksiyonel performans aktivitelerinde ayakkabı giyilmesi olumlu etki yaratırken bazı aktivitelerde de kısıtlılık yarattığına dikkat çekilmiştir

Purpose: The aim of this study was to investigate the relationship between radiographic measurement and American Orthopaedic Foot and Ankle Society’s-Hallux Metatarsophalangeal-Interphalangeal Joint Scale, and Short Form-36 results in hallux valgus deformity assessment. Methods: Forty patients diagnosed the bilateral hallux valgus between ages of 17 and 74 years with 80 feet were evaluated. The first metatarsophalangeal abduction and intermetatarsal angles obtained via antero-posterior radiography for each individual were recorded. The American Orthopaedic Foot and Ankle Society’s-Hallux Metatarsophalangeal-Interphalangeal Joint Scale was applied to all individuals for functional status assessment. The Short Form-36 was applied to assess relationship between deformity and health related quality of life. Results: Results of the present study showed that while there was negative significant relationship between the first metatarsophalangeal angle and Short Form-36 subscores such as physical function, physical role limitation and pain; there was a positive correlation with mental health subscore of Short Form-36. There was a negative correlation between the first metatarsophalangeal, intermetatarsal angle values and Physical Component Score of SF-36. While there was a negative correlation between Mental Component Score of SF-36 and the first metatarsophalangeal angle and there was positively relationship with intermetatarsal angle. Coclusion: In this study, it is demonstrated that increases in angle values are especially directly related with pain and functional level rather than mental health, Amaç: Çalışmanın amacı, halluks valgus deformitesinde oluşan eklemsel değişikliklerin değerlendirilmesinde kullanılan radyografik ölçüm, Amerikan Ortopedik Cerrahları Ayak ve Ayak Bileği Derneği - Halluks Metatarsofalangeal-Interfalangeal Eklemler Skalası ve Kısa Form-36 ile elde edilen sonuçların birbirleriyle ilişkilerinin incelenmesidir. Yöntem: 17-74 yaş aralığında bilateral halluks valgus tanılı 40 bireyde 80 ayak değerlendirildi. Her bir bireyin ön-arka radyografilerle elde edilen 1. Metatarsofalangeal abduksiyon ve intermetatarsal açı değerleri kaydedildi. Fonksiyonel durumun belirlenmesi için Amerikan Ortopedik Cerrahları Ayak ve Ayak Bileği Derneği-Halluks MetatarsofalangealInterfalangeal Eklemler skalası uygulandı. Deformitenin sağlıkla ilişkili yaşam kalitesiyle olan ilişkisini değerlendirebilmek için Kısa Form-36 uygulandı. Bulgular: I. Metatarsofalangeal açısal değerleri ile Kısa Form-36 ölçeğinin fiziksel fonksiyon, fiziksel rol kısıtlılığı ve ağrı alt başlıkları arasında negatif yönde anlamlı ilişki bulunurken; Kısa Form-36 ölçeğinin mental sağlık alt başlığı ile pozitif yönde ilişki bulundu. İntermetatarsal açı ile Kısa Form-36 fiziksel fonksiyon alt başlığı ile negatif yönde ilişki; yaşamsallık ve mental sağlık alt başlıklarıyla ise pozitif ilişki vardı. Kısa Form-36’nın Mental Bileşen Özet skoru ile I. Metatarsofalangeal açı arasında negatif ilişki bulunurken, intermetatarsal açı ile arasında ise pozitif ilişki bulundu (p

Purpose: We aimed to determine the efficacy of the physical therapy program as an adjunct to the Ponseti technique in the treatment of idiopathic clubfoot. This study was carried out with the presumption of a difference in results between the study group who were included in the physiotherapy program and the control group who performed home exercises. Patients and method: Forty affected feet of 29 patients were included in the study. The average ages of the control and study groups were 15.00 ± 21.33 and 20.30 ± 15.78 months, respectively. Passive range of motion of dorsiflexion, plantar flexion, inversion, eversion, rear foot varus angle and forefoot adduction angle were measured and the Dimeglio classification system was utilized in order to determine the severity of clubfoot deformity. Reassessments were carried out for the study group at the end of 1 month's therapy and for the control group during the first month follow-up. Results: Comparison of pre- and post-treatment assessment results revealed a difference in terms of recovery, concerning all parameters except passive inversion values in the study group and for all parameters in the control group (P < 0.05). For study and control group comparisons, since deformity severity was higher in the study group an effect size analysis was carried out. The effect size analysis showed that the change in range of motion of dorsiflexion and Dimeglio and decrease of rear foot varus angle was higher in the study group. Conclusion: The results of this study imply that an intensive physiotherapy program may enhance the effectiveness of the Ponseti protocol.

Objective: The aim of this study was to develop a disease-specific multidimensional hallux valgus(HV) scale, as well as to establish the validity and reliability thereof.Methods: The 14-item Multidimensional Nil Hallux Valgus Scale was developed. The scale has ascore range of 0–60, with higher score indicating increased HV symptoms, complaints, and functionaldisorder. Among the patients referred to our clinic with HV diagnosis based on anterior-posteriornon-weight-bearing radiography of the affected foot, 129 feet of 66 patients (63 bilateral, 3 unilateral)were included in the study. In clinical evaluations of these HV patients, American OrthopaedicFoot and Ankle Society Hallux Metatarsophalangeal Interphalangeal Joints Scale (AOFAS-MTFIF),Manchester Scale, and Short Form 36 Health Survey (SF-36) were used to test the validity andreliability of the new scale.Results: From factor analyses, it was observed that the items clustered in 5 factors, which explained73.2% of the variance. Floor and ceiling effects were observed to be within normal limits (floor effect:3.1%; ceiling effect: 0.8%). The Cronbach’s alpha level related with the overall internal consistency ofthe scale was estimated as 83.3%, and the Cronbach’s alpha for the subheadings of the scale variedbetween 33.9% and 74.2%. High correlation was observed regarding test-retest reliability of the scale.Conclusion: This newly developed scale allows for the holistic evaluation of HV including the condition-specific parameters and is a valid and reliable scale that can be conveniently used by health careprofessionals.

Purpose. To investigate the effects of dynamic ankle-foot orthoses (DAFOs) on functional ambulation activities, weight bearing and spatio-temporal characteristics of hemiparetic gait and to inquire whether wearing a DAFO for 3 months has a carryover effect. Method.Fourteen chronic hemiparetic patients who could walk independently with or without a cane were the subjects of the study. Patients were assessed initially with tennis shoes and were given custom fabricated DAFOs which they wore for three months and were retested under two conditions: with tennis shoes only and with DAFOs worn in these shoes. All patients were assessed for weight bearing percentage of the affected side, cadence, step length of the involved and uninvolved sides, step width, functional reach, timed up and go, timed down stairs, timed up stairs, physiologic cost index and velocity. Results.Comparison of initial and third month assessments with shoes only condition showed that there was no significant improvement for the measured parameters. When comparison was made at the third month while patients were wearing tennis shoes only and when they were wearing DAFO's in their shoes there was a significant difference in favour of the condition where patients were wearing DAFOs. Conclusion.The benefits of using DAFOs in chronic hemiparetic patients are lost when the patients are not wearing their orthoses. © 2011 Informa UK, Ltd.

Purpose: To evaluate the effects of a hand splint with reflex inhibitory characteristics on balance and functional ambulation activities by means of a randomly allocated controlled study. Methods: Nineteen chronic stroke patients were randomly allocated to the control (n = 9) and study (n = 10) groups to compare the immediate and long-term effects of a splint with reflex inhibitory characteristics. The patients in the splinted group were asked to wear their splints at least 2 hours each day, during ambulation or when they felt the need. Subjects were evaluated initially and after 2, 4, and 6 months of splint usage with the Berg Balance Scale, Functional Reach test (FR), Timed Up & Go test (TUG), and L test. The same tests were used to evaluate the control group. Results: Timed within-group assessments showed no difference in the control group across the time interval. A favorable difference was detected in some of the evaluations for FR, TUG, and L test in the study group. Intergroup comparisons showed that the only difference between the groups was seen for TUG values at the fourth assessment in favor of the study group. Qualitative evaluations showed that the patients were compliant and generally satisfied with their splints. Conclusion: Hand splints with reflex inhibitory characteristics have no significant effect on balance and functional ambulation activities in chronic poststroke patients. Further studies investigating their effect on pain and associated reactions in this patient population are warranter. © 2011 Thomas Land Publishers, Inc.

WOS:000292201600017 PubMed: 20831648 Purpose: We aimed to determine the efficacy of the physical therapy program as an adjunct to the Ponseti technique in the treatment of idiopathic clubfoot. This study was carried out with the presumption of a difference in results between the study group who were included in the physiotherapy program and the control group who performed home exercises. Patients and method: Forty affected feet of 29 patients were included in the study. The average ages of the control and study groups were 15.00 +/- 21.33 and 20.30 +/- 15.78 months, respectively. Passive range of motion of dorsiflexion, plantar flexion, inversion, eversion, rear foot varus angle and forefoot adduction angle were measured and the Dimeglio classification system was utilized in order to determine the severity of clubfoot deformity. Reassessments were carried out for the study group at the end of 1 month's therapy and for the control group during the first month follow-up. Results: Comparison of pre- and post-treatment assessment results revealed a difference in terms of recovery, concerning all parameters except passive inversion values in the study group and for all parameters in the control group (P < 0.05). For study and control group comparisons, since deformity severity was higher in the study group an effect size analysis was carried out. The effect size analysis showed that the change in range of motion of dorsiflexion and Dimeglio and decrease of rear foot varus angle was higher in the study group. Conclusion: The results of this study imply that an intensive physiotherapy program may enhance the effectiveness of the Ponseti protocol.

Ayak problemleri, günümüzde sıklıkla karşılaşılan ve bireylerin yürüme, ayakkabı giyme, ayakta durma gibi fonksiyonel aktivitelerini zorlaştıran sorunlardandır. Ne yazık ki, yetişkin birer birey olana dek, ayaklardaki sorunların habercisi olan bazı uyarılar dikkate alınmamakta, ayak problemlerinin hazırlayıcısı olan bazı faktörler gözden kaçırılmaktadır. Literatüre bakıldığında, yetişkin ayağında ortaya çıkan çoğu problemin okul çağına dayandığı belirtilmektedir. Bu nedenle çocukluk çağında ayağa yük bindirecek, normal yüklenmesini değiştirebilecek faktörler, bazı deformite ve bozukluklar için hazırlayıcı faktörlerin bilinmesi ve normal ayak gelişimi süresince göz önünde bulundurulması, ayak sağlığı açısından önem taşımaktadır

Purpose: The objective of this study was to investigate if the appearance of an orthosis manufactured according to the same biomechanical principles as the orthosis formally used affected patient satisfaction, acceptance of the orthosis and compliance to the given orthotic program. Material and methods: The subjects were children between 3-14 years of age with neurological problems who had been using plastic ankle foot orthoses (PAFO's) and who had applied to renew their orthosis. The parents were asked to fill out a questionnaire inquiring acceptance, satisfaction and compliance to the orthotic program for the PAFO their children had been using. The children, who were able to, were asked to answer the questions on a satisfaction scale. A new orthosis was manufactured utilizing the same biomechanical principles but with children friendly material. Upon using the new orthosis for one week the questionnaires were repeated. Results: The data obtained from the pre-post orthotic application questionnaires were compared. The results showed that there was a statistically significant difference in favour of the orthosis using child friendly material with respect to the answers of both the parents and children for each item in the questionnaires and for the total scores (p

ÖZET Konjenital talipesekinovarusta (PEV), fizyoterapi rehabilitasyonun etkinliğini araştırmak amacıyla planlanan çalışma, Hacettepe Üniversitesi, Fizik Tedavi ve Rehabilitasyon Y.O., Ortez ve Biomekanik Ünitesine ortez istemiyle başvuran 29 olgunun 42 ayağı üzerinde gerçekleştirilmiştir. Yaş ortalamaları 10.58±5.10 ay olan olgular; deformitelerine ilişkin özellikleri açısından homojen dağılım gösterecek şekilde, fizyoterapi ve ev programı grubu olmak üzere iki gruba aynlmışlardır. Konservatif ve post- operatif müracaat eden olguların, dördüne dizaltı, diğerlerine dizüstü ve diz fleksiyon pozisyonunda olmak üzere tümüne polietilen ayak-ayakbileği ortezi yapılmıştır. Olgular, antero-posterior ve lateral filmlerden elde edilen talocalcaneal, talus- 1. metatarsal açı ölçümleri, ayak uzunluğu, baldır atrofisi, ayakbileği eklem hareket genişlikleri gibi klinik yöntemlerle; ilk başvuruda, 1.5 ay sonra, 3 ay sonra ve 6 ay sonra olmak üzere 4 kez değerlendirilmişlerdir. Lokal sıcaklık uygulaması, patern şeklinde pasif eklem hareketleri, germe ve mobilizasyon egzersizleri ve Yüksek Voltaj Kesikli Galvanik Stimulasyon (HVPGS) uygulamasından oluşan 20 seans fizyoterapi programı uygulanan tedavi grubu ile aileye öğretilen 4 egzersizden oluşan ev programı grubuna ilişkin sonuçlar karşılaştınlmıştır. İstatistiksel analiz sonuçlan, fizyoterapi grubunda tedavi sonrası yapılan ölçümlerde (her iki grupta azalma gözlenmekle birlikte) deformitenin ekin, varus ve adduksiyondan oluşan üç komponentinde de, kontrol grubuna göre anlamlı azalma olduğunu göstermiştir (p

ÖZET Alt motor nöron patolojisine bağlı olarak, düşük ayak bulgusu görülen, 19 hastanın yürüyüşleri, zaman-mesafe karekteristikleri, gözlemsel yürüyüş analizi ve sübjektif değerlendirme yöntemi kullanılarak, ortezsiz, eklemli mold ve eklemsiz mold durumlarında karşılaştırılmıştır. Zaman-mesafe özellikleri açısından belirli farklar bulunmasına karşın, istatistiksel olarak anlamlı görülmemiştir (p>0,05). Gözlemsel yürüyüş analizi ve sübjektif değerlendirme sonuçlan, eklemli moldun normal yürüyüşün açısal değerlerine yakın bir yürüyüşe izin verdiği ve hastalar tarafından rahat ve güvenli olarak algılandığı yönünde istatistiksel olarak anlamlı bulunmuştur. 63 SUMMARY The gaits of 19 patients, having complaints of drop-foot due to sec ond motor neuron pathology were evaluated through time-distance char acteristics, observational kinematic gait analysis, subjective criteria as per- cieved by the patient, whilst walking bare-foot, with a rigid ankle foot orthosis (AFO) and a hinged AFO. Although a difference was found between the three situations in the time-distance characteristics of gait, this difference was not statiscally sig nificant. It was observed that with the hinged AFO the patients walked at closer angular values to normal gait and that the patient felt more com fortable safe and less tired, when compared with the rigid AFO or bare foot. 88