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Objective: A residential environment refers to the physical and social characteristics in a neighbourhood. The physical characteristics include interior housing qualities, exterior neighbourhood characteristics, and the accessibility of essential facilities and services outside the neighbourhood. Older adults especially may be vulnerable to the negative impacts of the residential environment. The aim of this study is to elucidate the problems ageing people face in their neighbourhoods, buildings and public areas. Methods: The study group consisted of a total of 1,001 people over the age of 65 who were admitted to physical medicine and rehabilitation clinics in Turkey and consented to participate. A questionnaire covering demographic, social and environmental information was used. Results: Of the study group, 58.6% was living in an apartment building, but only 23.6% of these buildings had an elevator, and the stairs were inconvenient in 46.7% of the buildings. Only 49% of the elderly people went for a walk regularly. The most frequent complaint about the hospitals, community health centres and other public areas was the inappropriate restroom conditions. Eighty-six percent of the study group were not members of an organization, a foundation or a group, and 73.6% did not have personal hobbies. Conclusions: The layouts of buildings and surroundings are inappropriate for older people, and the opportunities for them to participate in social activities are limited. Health and social programmes and governmental and local policies for older people are needed, and public awareness about this issue should be raised.

Objective: The aim of our study was to assess the efficacy of transcutaneous electrical nerve stimulation (TENS) in knee osteoarthritis with neuropathic pain component. Materials and Methods: The patients were assessed by visual analogue scale (VAS) for pain severity, Western Ontario and McMaster osteoarthritis index (WOMAC) for physical function and the Kellgren-Lawrence system for severity of osteoarthritis, painDETECT questionnaire for presence of neuropathic pain. Patients were divided into two groups according to painDETECT questionnaire scores. Group 1 consisted of 20 patients (39.2%) with likely and possible neuropathic pain, group 2 consisted of 31 patients (60.8%) with unlikely neuropathic pain. All patients received hot pack, TENS and home exercise program was given. Physical therapy agents were given for 3 weeks, 5 days a week. Assessments were evaluated in all patients before and after the treatment. Results: There was no statistically significant difference in demographic features and radiographic evaluations between the groups. The VAS, WOMAC pain and physical function scores were significantly lower after treatment in knee patients with neuropathic pain component, but there was no significant difference between the two groups. Conclusion: TENS is a neuropathic pain component in knee osteoarthritis patients, which is effective in reducing pain and improving physical function. The benefit of TENS therapy is that it can be used in conjunction with drug therapy, thereby reducing the drug dose and drug side effects.

WOS: 000406937200005 PubMed: 27080048 Purpose: In this study, we aimed to describe the sociodemographic characteristics of caregivers of patients in a geriatric unit and to clarify the relationship between caregiver burden and specific clinical variables in the patients and the characteristics of the caregivers. Design: Cross-sectional multicenter study. Methods: One hundred twenty-three patients and 123 caregiver dyads, with mean ages of 72.5 +/- 7.7 years and 51 +/- 14.7 years, respectively, were included. The functional, psychological, and cognitive statuses of the patients were determined, and the sociodemographic characteristics of the caregivers as well as the type and duration of caregiving were recorded. Caregivers completed the Caregiver Burden Inventory (CBI) to measure the perceived burden of care. Most patients were female and generally lived with their family. Findings: Most of the caregivers were family members (90%), female (73.2%), primary school graduates (52.8%), and first-degree relatives (73.1%). The average CBI score was 33, and the highest CBI subscores were for time, developmental, and physical burdens. Caregiver burden correlated with the patient's ambulatory, psychological, and cognitive status and with the caregiver's age, gender, income level, and duration of caregiving. Conclusions: We have highlighted the relationship between caregiver and patient characteristics in a cohort of elderly Turkish patients with neurological and musculoskeletal disorders. In particular, we have highlighted the heavy caregiver burden in a developing country. Clinical Relevance: Our results may guide the nurses to understand the requirements of caregivers and to help them find suitable resources that would meet their needs to cope with their burden.

Background High-tech prostheses are supposed to achieve better functional recovery over mechanical-controlled prostheses in lower-limb amputees. However, quantitative data are insufficient. Objective We aimed to evaluate changes in quality of life, life satisfaction, perception of body image, and functional performance of lower-limb amputees when using a mechanical-controlled prosthesis versus a microprocessor-controlled knee (MPK) or transtibial vacuum-assisted suspension system (VASS) prosthesis. Methods In this pragmatic study, 57 lower-limb amputees were assessed with the Satisfaction with the Prosthesis Questionnaire (SATPRO), revised Amputee Body Image Scale (ABIS-R), Trinity Amputation and Prosthesis Experience Scales (TAPES), Medical Outcomes Study Short Form-36 (SF-36) and 6-min walk test (6MWT). All assessments were performed under 2 conditions (i.e., using a mechanical-controlled prosthesis vs. an MPK/VASS prosthesis. Results Amputees who used an MPK/VASS prosthesis showed significant increases in all SF-36 subscale scores and all subscale scores of TAPES except adjustment to limitation (P = 0.156). The amputees showed clinically relevant improvements in 6MWT (P Conclusion Lower-limb amputees using an MPK/VASS prosthesis had better life satisfaction, quality of life and functional performance than those using a mechanical-controlled prosthesis.

Objectives The aim of this study was to apply the Comprehensive International Classification of Functioning, Disability and Health (ICF)- Core Set for spinal cord injury (SCI) -early post-acute-situation in the Turkish SCI patients and to investigate its construct validity. Patients and methods One-hundred and twenty patients with SCI were included in this prospective and descriptive study. ICF data were primarily collected by conducting interviews with patients as well as from their acute medical management records, physical examination findings and laboratory measurements. The percentage of participants and the frequency of the problems encountered at each level of ICF category were reported. Furthermore, the construct validity was evaluated by calculating the Spearman correlation between the ICF categories and other generic and disease specific measures. Results The study illustrated that 55 of the 63 ICF categories of the Component Body Functions (CBF) and each and every category for the Component Body Structures (CBS) as well as the Component Activities and Participation (CAP) were reported as a problem among the Turkish patients with SCI. Furthermore, 24 ICF categories for the Component Environmental Factors (CEF) were determined as a facilitator while 6 ICF categories were identified as a barrier. The ICF-Core Set for SCI illustrated a high construct validity with some of the generic and disease-specific measures. Conclusion Our results identified the common problems, complications and special needs in a Turkish population with SCI. We suggest that the application of ICF-Core Set in our patients provided us with a unique capability to assess their every aspect of disability, health and functioning.

WOS: 000511167800006, PubMed: 31893270, Objectives: the aim of this study was to evaluate the frequency and course of post-stroke lower urinary tract dysfunction (LUTD) from early term up to a period of six months and to investigate the relation of LUTD with functional and mental status and quality of life (QoL) in stroke patients. Patients and methods: This prospective study included a total of 70 stroke patients (44 males, 26 females; mean age 62.7 +/- 7.0 years; range, 46 to 79 years) from five different centers across Turkey between June 2015 and January 2017. the patients were questioned using the Danish Prostatic Symptom Score (DAN-PSS) to evaluate LUTD and evaluated using the Modified Barthel Index (MBI), Incontinence QoL Questionnaire (I-QOL), and Mini-Mental State Examination (MMSE) at one, three, and six months. Results: At least one symptom of LUTD was observed in 64 (91.4%), 58 (82.9%), and 56 (80%) of the patients according to the DAN-PSS at one, three, and six months, respectively. A statistically significant improvement was found in the DAN-PSS, MBI, MMSE, I-QOL total scores, avoidance and psychosocial subgroup scores at six months compared to the first month scores (p

Objectives: The aim of this study was to evaluate the frequency and course of post-stroke lower urinary tract dysfunction (LUTD) fromearly term up to a period of six months and to investigate the relation of LUTD with functional and mental status and quality of life (QoL)in stroke patients.Patients and methods: This prospective study included a total of 70 stroke patients (44 males, 26 females; mean age 62.7±7.0 years;range, 46 to 79 years) from five different centers across Turkey between June 2015 and January 2017. The patients were questioned using theDanish Prostatic Symptom Score (DAN-PSS) to evaluate LUTD and evaluated using the Modified Barthel Index (MBI), Incontinence QoLQuestionnaire (I-QOL), and Mini-Mental State Examination (MMSE) at one, three, and six months.Results: At least one symptom of LUTD was observed in 64 (91.4%), 58 (82.9%), and 56 (80%) of the patients according to the DAN-PSS atone, three, and six months, respectively. A statistically significant improvement was found in the DAN-PSS, MBI, MMSE, I-QOL total scores,avoidance and psychosocial subgroup scores at six months compared to the first month scores (p

EgeUn###, Background: Review of the literature clearly reveals that little is known about the association between functional and mental status, and Lower Urinary Tract Dysfunction (LUTD) in patients with stroke. Objective: The aim of this study was to assess functional and mental status in stroke patients and to identify possible associations with the prevalence, severity and bother of LUTD. Material and methods: This study was designed as a cross-sectional study and included 260 stroke patients enrolled from six different hospitals in Turkey. The patients were questioned using the Danish Prostatic Symptom Score (DAN-PSS) Questionnaire to evaluate LUTD, and evaluated using the Modified Barthel Index (MBI), Incontinence Quality of Life Questionnaire (I-QoL), and the Mini Mental State Examination (MMSE). Results: At least one LUTD finding was reported in 243 (93.5%) patients; the most commonly encountered complaint in these patients was nocturia (75.8%). The mean MBI, MMSE, and I-QoL scores were found to be significantly lower in LUTD (+) patients compared to LUTD (-) patients (p = 0.000, p = 0.005, and p < 0.01, respectively). Similarly all parameters (MBI, MMSE, and I-QoL scores) assessed were found to be significantly lower for patients with urinary incontinence than those without incontinence (p = 0.000, p = 0.000, and p < 0.01, respectively). Conclusion: LUTD is a common problem in patients with stroke. LUTD is associated with poorer cognitive and functional status and the quality of life in these patients. We, therefore, suggest that bladder dysfunction should not be overlooked during rehabilitation of stroke patients.

To elucidate the effects of Kinesio Taping (KT) in addition to neurodevelopmental therapy (NDT) on posture and sitting, and to compare the effects of KT and neuromuscular electrical stimulation (NMES).Seventy-five children were randomized into control, KT, and NMES groups. NDT was applied to all children 4 times a week for 4 weeks. In addition, KT and NMES were applied to KT and NMES groups, respectively. Sitting subset of Gross Motor Function Measure (GMFM) and kyphosis levels of the groups were analyzed by two way mixed ANOVA.GMFM and kyphosis values improved significantly in all groups (all p 0.01), yet change levels were more prominent in the KT and NMES groups than the control group. Moreover, NMES group showed better improvement.KT or NMES application for four weeks in addition to NDT is effective on improving kyphosis and sitting. Besides, NMES is more effective than KT.

We determined the developmental level of 107 children (mean age, 66.41 ± 32.92 mo) with cerebral palsy in an inpatient rehabilitation program and assessed both the difference between calendar age and developmental age and the effect of developmental level on motor function improvement. The Denver II test was used to reveal the difference between calendar age and developmental age, and we determined whether there was a statistically significant difference between the admission and discharge motor function measurements of the subjects. The effect of the Denver II developmental levels of language, fine-motor, personal-social, and gross-motor skillson motor function was investigated. Wefound a statisticallysignificant difference between thedevelopmental levelsandcalendar agesof thestudy subjects. Denver II testresultsrevealed astatisticallysignificant difference between the personal-social, gross-motor, and fine-motor levels of the subjects. We found no difference only between personal- social and language levels. Gross-motor development was the most delayed value by calendar age. Regardless of developmental level, there was a statistically significant difference between motor activity levels at admission and discharge as revealed by the Gross-motor Functional Classification System and the Gross-motor Function Measure. The developmental ages of the subjects were much lower than their calendar ages. We concluded that the Denver II language and fine-motor developmental level did not have an effect on functional gains but that the subjects with good personal-social and gross-motor function developmental levels exhibited relatively better motor function gains at the time of discharge.

Objectives: The aim of this study is to investigate the effects of respiratory muscle strength and pulmonary involvement on functional status, fatigue, and health related quality of life (HRQoL) in patients with systemic sclerosis. Patients and methods: Thirty-three patients (2 males, 31 females; mean age 46.2±13.4 years; range 27 to 77 years) with systemic sclerosis and 34 healthy volunteers (3 males, 31 females; mean age 40.9±12.8 years; range18 to 65 years) were included in the study. Pulmonary involvement and respiratory muscle strength were evaluated by measuring forced vital capacity, vital capacity, maximum voluntary ventilation, high resolution computed tomography, pulmonary artery systolic pressure, and visual analog scale for dyspnea. Functional status, HRQoL and fatigue were measured with Health Assessment Questionnaire Disability Index, Medical Outcomes Study Short Form-36 (SF-36), and Fatigue Severity Scale, respectively. Results: Compared to healthy controls, our patients had lower functional status and HRQoL, and a higher fatigue level. Respiratory muscle strength had significant contribution on functional status and SF-36 physical component summary scores. Pulmonary arterial hypertension had significant predictive value for SF-36 physical component summary. Interstitial lung disease affected the functional status only. Dyspnea had significant predictive value for fatigue and mental component summary of SF-36. Conclusion: Since a significant association is present between pulmonary involvement, respiratory muscle strength, functional status, HRQoL, and fatigue in patients with systemic sclerosis, these parameters should also be evaluated in the early period of the disease. Once respiratory muscle weakness and pulmonary involvement are detected in this population with limited treatment options, a comprehensive pulmonary rehabilitation program including respiratory muscle exercises should be designed to improve functional status, HRQoL, and fatigue.

Objective To investigate the effects of the kinesio tape application to the tibialis anterior on rehabilitation outcomes of the stroke patients. Design and setting Twenty patients with stroke were allocated into two groups: the first group of ten patients was assigned to receive kinesio tape in addition to the conventional rehabilitation program while a second group of 10 patients was assigned to receive a conventional rehabilitation program only. Main outcome measures The clinical variables and health-related quality of life (HRQoL) were evaluated at baseline and at the end of the forth week. Results The present study showed that kinesio tape application to the tibialis anterior has significant effects on motor recovery of the lower extremity, spasticity, ambulation capacity, HRQoL and gait compared to the control group and baseline. Conclusions The results of this study suggest that kinesio tape can be used as an ankle training method.

Objectives This study aims to investigate the neuropathic pain (NP) component in patients with osteoarthritis (OA) of the knee and its association with physical function, risk factors, and stages of OA. Patients and methods One hundred and nine patients (16 males, 93 females; mean age 62.5±8.5 years; range 44 to 81 years) diagnosed with knee OA according to the American College of Rheumatology criteria were enrolled in this study between July 2014 and June 2015. Patients were evaluated with visual analog scale for pain severity, PainDETECT questionnaire for presence and severity of neuropathic pain, Western Ontario and McMaster Universities osteoarthritis index for physical function, and the Kellgren-Lawrence system for severity of OA. Presence of the associated risk factors were also questioned. Results A total of 12 patients (11%) were classified as having likely NP and 23 patients (21.1%) were classified as having possible NP. PainDETECT scores were significantly correlated with the visual analog scale scores and Western Ontario and McMaster Universities osteoarthritis index pain, physical function and total scores. Patients with neuropathic pain had significantly longer symptom duration than the patients without NP. However, we found no relationship between the other risk factors and NP. Conclusion This study demonstrated that some of the knee OA patients had a NP component as the underlying cause of knee pain. Patients with NP had longer symptom duration, increased severity of pain, and disability. Therefore, the presence of NP component in these patients should be considered. Once it is determined, appropriate intervention strategies for NP should be incorporated in the routine treatment modalities of knee OA.

This study aimed to determine the prevalence of and factors contributing to musculoskeletal system complaints (MSC) in office workers of a vehicle production factory and absenteeism due to these complaints. A total of 86.2% (n = 333) of the workers completed the survey. Of the workers, 73 (21.9%) were women, and 260 (78.1%) were men, and the mean age was 36.9 ± 8.75 years. The majority of the personnel had more than one symptom with a prevalence of 80.8%. The most frequently observed discomfort was tension and pain in the back muscles (58.6%) and in the neck muscles (58.3%), followed by low back pain (41%) and shoulder pain (30.3%). Pain in the shoulders, neck, and the back and pain and numbness in the fingers were statistically significantly more prevalent in employees who spent more than 5 hours per day performing desk work. Furthermore, all of the complaints, excluding pain in the elbows and knees, were statistically significantly more common in the women. When each complaint and the effects of contributing risk factors were analyzed by logistic regression analysis, pain in the shoulders, neck, and back; pain that spread to the arms; and pain in the fingers were correlated with longer work hours and the female gender (p < 0.05). The number of employees who had used sick leave within the past year due to MSCs was 11.7%. In conclusion, duration of work hours, frequency of breaks, and gender were determined as the most important risk factors in computer users regarding MSCs. © 2011 Wiley Periodicals, Inc. © 2011 Wiley Periodicals, Inc.

Objective We aimed to determine the effect of the cerebrovascular accident etiology in the geriatric patients with hemiplegia included in our physical medicine and rehabilitation program on functional improvement. Methods A total of 46 geriatric patients with hemiplegia attending the inpatient physical medicine and rehabilitation program were included in the study. The patients were divided into two groups–thromboembolic vessel disease (TEVD) and intracerebral hemorrhage (ICH)–depending on the cerebrovascular accident etiology. The daily living activities of the patients in both groups were evaluated using the Barthel Index (BI) and the ambulation levels were evaluated using the Functional Ambulation Classification (FAC) at admittance and at discharge from hospital. Results There was a statistically significant difference between admission and discharge BI values in both groups. There was no significant difference between the admission and discharge BI scores of the TEVD and ICH groups. For both groups, on admission there were 19 (82.5%) patients at the FAC 0, 1, and 2 levels, and 4 (17.3%) patients at the FAC 3 and 4 levels. On discharge there were 11 (47.8%) patients in the TEVD group at the FAC 0 and 2 levels, and 12 (52.1%) patients at the FAC 3, 4, and 5 levels; whereas in the ICH group there were 8 (34.7%) patients at the FAC 0, 1, and 2 levels, and 15 (65.2%) patients at the FAC 3, 4, and 5 levels. Conclusions We found that the disease etiology did not influence the rehabilitation results for our geriatric patients with hemiplegia attending a physical medicine and rehabilitation program following TEVD or ICH.

To investigate the effect of functional electrical stimulation (FES) for the treatment of shoulder subluxation and shoulder pain in hemiplegic patients.A total of 50 hemiplegic patients with shoulder subluxation and shoulder pain were included in the study. The patients were randomly divided into the study and control groups. All patients were put on a rehabilitation program using conventional methods while the study group patients were additionally applied FES to supraspinatus and posterior deltoid muscles. The shoulder pain of all patients during resting, passive range of motion (PROM) and active range of motion (AROM) was measured with the visual analog scale (VAS) while the shoulder subluxation levels were evaluated with the classification developed by Van Langenberghe and by using the millimetric measurements on anteroposterior shoulder X-ray before and after the physical treatment and rehabilitation program and compared.Comparison of the resting AROM vs. PROM VAS value changes showed no significant difference between the groups. There was a significant difference between the two groups for the amount of change in shoulder subluxation in favor of the study group.The results of our study have shown that applying FES treatment to the supraspinatus and posterior deltoid muscles in addition to conventional treatment when treating the subluxation in hemiplegic patients is more beneficial than conventional treatment by itself.

WOS: 000343521300003, Objective: Cardiopulmonary (CPR) programs were developed to improve and stabilize the physical, psychological, social, mental, professional, and economic conditions of patients with cardiovascular and pulmonary diseases. Although it is known that CPR reduces mortality and morbidity, it is not widely implemented as it is in Turkey. In this study, we aimed to determine the level of CPR awareness among physicians and allied health professionals. Material and Methods: This was a multi-center, cross-sectional survey study. The study included physicians, nurses, physiotherapists, and other allied health professionals who were informed about the survey and provided written consent to participate. Results: A total of 727 volunteers from 12 different centers were included in the study. Of the participants, 59.5% were physicians, 31.4% were nurses, 5.9% were physiotherapists, and 3.2% were other allied health professionals; 79.3% participants answered the question on if they have had any idea about CPR. Participants indicated that patients should be referred to cardiac pulmonary rehabilitation after a coronary artery bypass (83.8%), chronic obstructive pulmonary disease (83.2%), and cardiac valve surgery (38.9%). Only 40.1% of the survey participants provided information about CPR to patients, while 20.5% did not provide any information about CPR. Conclusion: This survey study determined that in centers where CPR could be implemented, health professionals have knowledge about CPR. If the study were conducted nationwide, the level of awareness might be even lower. Although it is an idea of CPR, the level of knowledge for this issue is not adequate. As the number of the CPR centers will increase, the knowledge of doctors and allied health professionals will advance.

Amaç: Bu çalışmada postmenopozal kadınlarda osteoporoz ile ilişkilendirilen klinik risk faktörlerinin sıklığı belirlendi.Hastalar ve yöntemler: Bu kesitsel, gözlemsel, çokmerkezli çalışmada toplam 730 postmenopozal kadın osteoporozun klinik risk faktörleri açısından değerlendirildi. Değerlendirmede şu klinik risk faktörlerinin kaydedildiği standart bir sorgulama formu kullanıldı: ailesel ve kişisel kırık öyküsü, uzamış hareketsizlik, güneş maruziyeti, yaşam boyu hareketsiz yaşam biçimi, sigara kullanımı, çocukluk ve erişkinlik döneminde düşük kalsiyum alımı, aşırı kafein alımı, yüksek sodyum alımı, yetersiz protein alımı, gebelik sayısı, menopoz yaşı, prematür menopoz varlığı, primer ve sekonder amenore, tıbbi hastalıklar ve kronik reçeteli ilaç kullanımı.Bulgular: Osteoporoz açısından en sık rastlanan klinik risk faktörleri, yetersiz güneş maruziyeti (%53.3), mevcut hareketsiz yaşam biçimi (%52.9), erişkin (%45.1) ve çocukluk çağında (%41.9) düşük kalsiyum alımı ve ergenlik döneminde hareketsiz yaşam biçimi (%27.9) idi. Toplam 707 hasta (%96.5) birden fazla klinik risk faktörü tanımlarken, hastaların %74.3'ü sekonder osteoporoz açısından en az bir klinik risk faktörü bildirdi.Sonuç: Yeterli güneş maruziyeti, çocukluktan itibaren beslenmede yeterli kalsiyum alımı ve hareketli bir yaşam biçimi, postmenopozal kadınların osteoporozdan korunmasında rol oynayabilir. Buna ilave olarak, hekimler bu hasta grubundaki yüksek sekonder osteoporoz olasılığının farkında olmalıdırlar., Objectives: This study aims to identify the frequency of clinical risk factors associated with osteoporosis in postmenopausal women. Patients and methods: In this cross-sectional, observational, multicenter study, a total of 730 postmenopausal women were assessed for risk factors associated with osteoporosis. The assessment included a standardized questionnaire which recorded the following clinical risk factors: family and personal histories of fractures, prolonged immobilization, sun exposure, lifelong sedentary lifestyle, smoking history, low calcium intake in childhood and adulthood, excessive caffeine intake, high sodium intake, inadequate protein intake, number of pregnancies, age at menopause, the presence of premature menopause, primary and secondary amenorrhea, medical conditions, and chronic use of prescription drugs. Results: The most frequent clinical risk factors for osteoporosis were inadequate sun exposure (53.3%), current sedentary lifestyle (52.9%), low calcium intake in adulthood (45.1%) and childhood (41.9%), and sedentary lifestyle in adolescence (27.9%). A total of 707 patients (96.5%) described more than one risk factor, while 74.3% of the patients reported one clinical risk factor at least for secondary osteoporosis. Conclusion: Adequate sun exposure and proper intake of dietary calcium beginning in childhood combined with lifelong daily physical activity may play a role in preventing osteoporosis in postmenopausal women. In addition, physicians should be aware of the high probability of secondary osteoporosis in this patient group.

WOS: 000313861500002, Objective: The aim of this study was to identify the ones with osteoporosis (OP) in elderly patients presenting with musculoskeletal complaints and to evaluate the distribution of region of pain and the medications used for the musculoskeletal disease(s) in these patients. Materials and Methods: 1141 elderly patients who were consecutively admitted to the outpatient clinics in nine different provinces were screened for the diagnosis of OR Age, gender, complaints, diagnosis and current medications related to musculoskeletal system disorder(s) were recorded. Results: 382 elderly (341 female, 41 male) with a mean age of 71.9 +/- 5.3 years had the diagnosis of OR Low (54.5%) and upper back (39.6%) pain were the most common complaints in both sexes. These were followed by knee, hip, cervical and shoulder pain, respectively. Osteoarthritis (36%), lumbar (21%) and cervical spondylosis/stenosis (10%) were the most common musculoskeletal diseases accompanying OR The mean number of drugs used was 3.0 +/- 1.2. The most commonly prescribed anti-osteoporotic agents were bisphosphonates (59%). For the musculoskeletal pain, non-steroidal anti-inflammatory drugs (systemic and/or topical) were used in 46.6% and paracetamol in 24.6% of patients. Conclusion: It is crucial to perform a thorough physical examination to reveal the underlying cause of back pain in elderly osteoporotic patients. Besides, in order to minimize polypharmacy, it should be kept in mind that non-pharmacological approaches can be used for the management of musculoskeletal diseases. Turk J Phys Med Rehab 2012;58:263-6.

Amaç: Bu çok merkezli tanımlayıcı araştırmanın amacı ülkemizdeki fiziatristlerin birincil ve ikincil osteoporozu olan hastalarda anti-osteoporotik ilaç tercihlerini saptamaktır. Gereç ve Yöntemler: Çalışma Türkiye’nin 10 ilinde yürütüldü. Osteoporoz tanısı; dual-energy x-ray absorptiometry kullanılarak Dünya Sağlık Örgütü kriterlerine göre konuldu. Omurga ve–veya kalçada T skoru ?-2,5 olan hastalar osteoporotik olarak kabul edildi. Çalışmaya 18 yaş üstünde birincil veya ikincil osteoporozu olan 714 hasta alındı. Hastaların sosyodemografik özelliklerinin yanı sıra olarak ikincil osteoporoza neden olan kronik ilaç kullanımı ve-veya ek sistemik hastalıkları sorgulandı ve hekimleri tarafından önerilen anti-osteoporotik ilaçları kaydedildi. Bulgular: Hem birincil hem de ikinci osteoporozu olan hastalarda hekimlerin öncelikli tedavi seçeneği olarak vitamin D ve kalsiyum kullandıkları, medikal tedavi seçenekleri içinde ise ilk tercihlerinin bifosfonat grubundan alendronat olduğu saptandı. Bunları birincil osteoporoz grubunda ibandronat, risedronat, stronsiyum ranelat, kalsitonin, zoledronat, raloksifen, paratiroid hormon (PTH) ve hormon replasman tedavisinin (HRT) izlediği, ikincil osteoporoz grubunda ise risedronat, ibandronat, kalsitonin, stronsiyum ranelat, zoledronat, PTH, HRT ve raloksifenin izlediği belirlendi. Sonuç: Hekimler hastanın kırık riskini, tıbbi öyküsünü, osteoporoz için uygulanan önceki tedavilerini, diğer hastalıklarını, tedavi kaynaklı riskleri ve yararları, finansal maliyet ve potansiyel yarar ilişkisini de göz önüne alarak hasta için en uygun tedaviyi seçmelidir. (Türk Os­te­opo­roz Dergisi 2012;18: 42-6), Aim: The purpose of this multicenter descriptive study is to determine the preferences of physiatrists in our country for anti-osteoporotic drugs in patients with primary and secondary osteoporosis. Materials and Methods: This study was carried out in 10 provinces of Turkey. The diagnosis of osteoporosis was based on World Health Organization criteria using dual-energy x-ray absorptiometry. Patients with a spine and/or hip T-score ≤-2.5 were considered as osteoporotic. 714 patients over 18 years old with primary or secondary osteoporosis were included in the study. In addition to socio-demographic characteristics and chronic use of medications and/or additional systemic diseases that cause secondary osteoporosis were questioned and antiosteoporotic drugs that are recommended by their physicians were recorded.Results: The physicians’ preferred vitamin D and calcium as the prior treatment both in primary and secondary osteoporosis. The most commonly used anti-osteoporotic agent was alendronate from the biphosphonate group. It was followed by ibandronate, risedronate, strontium ranelate, calcitonin, zoledronate, raloxifene, parathyroid hormone (PTH) and hormone replacement therapy (HRT) in the primary osteoporosis and risedronate, ibandronate, calcitonin, strontium ranelate, zoledronate, PTH, HRT and raloxifene in the secondary osteoporosis, respectively. Conclusion: The physician should choose the most suitable treatment for the patient based on fracture risk, medical history, previous treatments for osteoporosis, concomitant diseases, treatment-induced risks and benefits, and the relation between financial cost and potential benefit. (Turkish Journal of Osteoporosis 2012;18: 42-6)

This study aimed to investigate the efficiency of FES application on the abdomen-posterior back muscles in children with CP that were enrolled into physical therapy and rehabilitation (PTR) program.The study included 55 spastic diplegic children that were hospitalized for rehabilitation. Those with deformities that could disrupt the balance in sitting and cause problems in evaluations were excluded. The patients were randomly divided into two equal groups according to their time of presentation. Thirty-two children completed the study. The control group received PTR program only for 4 weeks. The children in the FES group received PTR in addition to electrical stimulation. Electrical stimulation was applied 5 days a week for 4 weeks to abdomen-posterior back muscles in 30-minute-long sessions. To evaluate the balance in sitting, sitting score of gross motor function measurement (GMFM) and to evaluate the trunk asymmetry in sitting, radiographic measurements were used. Thus, kyphosis, Cobb and sacral angles were measured.The comparisons of the measurements of the two groups before and after the treatment showed that the GMFM sitting score and the sacral angle were statistically significantly increased, and the kyphotic and Cobb angles were statistically significantly decreased. After the treatment, both groups demonstrated an increase in the GMFM score, but the increase in the FES group was statistically significantly higher than that in the control group. With respect to radiological measurements, the changes observed in both the kyphotic and Cobb angles after the treatment were statistically significantly higher in the FES group than in the control group. The rates of the changes in the sacral angle did not differ among the groups.We believe to provide balance in sitting for children with CP, FES applied on abdomen-back muscles along with conventional therapy to maintain trunk control is more effective than conventional therapy alone.

Amaç: Bu çalışmada amaç, Fiziksel Tıp ve Rehabilitasyon (FTR) polik liniklerine başvuran geriatrik hastaların demografik ve klinik özelliklerini belirlemek, bu klinik ve demografik özelliklerin, yaş, cinsiyet ve öğrenim düzeylerine göre farklılıklarını ortaya çıkarmaktı. Gereç ve Yöntem: Çok merkezli çalışma kapsamına 20 FTR polikliniğine başvuran 65 yaş üzeri toplam 820 hasta alındı. Demografik verilerin yanın da; yakınmaları, hastalıkları, ağrı düzeyleri, kullandıkları ilaçlar, alışkanlıkları ve tıbbi durumları kaydedildi. Yaş, cinsiyet ve öğrenim düzeyinin yakın malar, hastalıklar ve alışkanlıklar üzerindeki etkisi araştırıldı. Bulgular: Hastaların yaş ortalaması 71,7±5,5 yıl idi. %16,7’si tek başına yaşıyordu, %61,7’si ev hanımı idi. %86'sının bir veya daha fazla komorbid hastalığı mevcuttu; en sık hipertansiyon (HT) daha sonra mide ve kalp hastalıkları görülmekte idi. En sık yakınma nedenleri sıklığı sırasıyla eklem ağrısı, halsizlik-yorgunluk, yaygın vücut ağrısıydı. Günde yutulan ilaç sayısı ortalama 4,02±0,9 (ortanca 4), VAS'a göre ağrı ortalaması 5,1±1,3 (ortan ca 5) olarak belirlendi. %16,5’nin düşme öyküsü mevcuttu. %30,1’i yürüyüş yapıyor ve sadece %15,4’ü ev içinde egzersiz yapıyordu. Omurga deformitesi, omurga ağrısı, idrar kaçırma, görme sorunu, yutma güçlüğü, duymada azalma, denge ve diş sorunu 75 yaşın üzerindekilerde istatistiksel açıdan anlamlı olarak daha fazla görülmekteydi. Sonuç: FTR polikliniklerinde hastaların çoğunluğunu yaşlı popülasyon oluş turmaktadır. İleri yaş grubunda komorbid hastalıkların varlığı, kullanılan ilaç sayısının fazla olması, osteoporoz ve düşme sıklığının artması, FTR heki minin hem medikal tedavi planlama aşamasında ve hem de rehabilitasyon programı hazırlarken dikkatli davranmasını gerektirmektedir. İleri yaş grubunun günlük yaşamlarında bağımsız ve daha aktif olabilmesi için sadece kas-iskelet yakınmaları değil, bütün organ sistemleri değerlendiril erek kapsamlı ve çok yönlü bir geriatrik rehabilitasyon programı düzenlen melidir. Türk Fiz Tıp Rehab Derg 2011;57:143-9., Aim: The aim of this study was to define the demographic and clinical characteristics of geriatric patients who referred to physical medicine and rehabilitation (PMR) outpatient clinics and to detect the differences between these characteristics in regard to age, sex and education level. Materials and Methods: 820 patients over 65 years old who attended 20 outpatient clinics were included in the study. In addition to demographic data, the complaints, comorbid diseases, pain levels, drugs being used, exercise and medical status of the patients were recorded. The effects of age, sex and education level on complaints, comorbid diseases and exercise habits were investigated. Results: The mean age of the patients was 71.7±5.5 years. 16.7% were living alone, 61.7% were housewives. 86% of the patients had one or more comorbid diseases - hypertension, gastric problems and heart disease were mostly encountered. The most common complaints were joint pain, fatigue and widespread body pain. The average number of pills taken per day was 4.02±0.9 (median 4), and the VAS pain score was 5.1±1.3 (median 5.0). History of falling was present in 16.5% of patients. 30.1% were routinely walking and 15.4% were performing exercise at home. In patients over 75 years, vertebral pain and deformity, urinary incontinence, eye problem, difficulty in swallowing, decrease in hearing, as well as balance and teeth problems were significantly more frequent than in younger subjects. Conclusion: Aged population constitutes most of the PMR outpatient clinic patients. Considering comorbid diseases, high number of daily taken drugs and falls, PMR specialist should be cautious in prescribing drugs and planning rehabilitation programme. For independence in activities of daily living in this age group, besides the musculoskeletal system, all other systems should be evaluated and a comprehensive geriatric rehabilitation programme should be constructed. Turk J Phys Med Rehab 2011;57:143-9.

We evaluated the effect of ankle-foot orthosis (AFO; articulated, plantar flexion stopped) use on balance and mobility in hemiparetic stroke patients in this study. Fifty-one hemiplegic patients who had completed the rehabilitation programme were included in the study. Subjects were assessed during the Ashburn walking and stair test, the time UpGo test, the Berg Balance Scale (BBS) and the mobility subscale of the stroke rehabilitation assessment of movement (STREAM) in the presence and absence of AFO. The patients were asked about their evaluations of AFO in terms of its desirability/undesirability. All the subjects showed improvements in gait speed, balance and mobility with AFO use. However, there was no statistically significant difference between the durations of stair climbing with or without AFO; 45.1%% of the subjects indicated that their gait speed increased; 35.3%% indicated that they step on more confidently and 60.8%% indicated that they consider AFO unaesthetic. It was determined that the use of an AFO resulted in improvements in both balance and ambulation activities of hemiparetic patients.

The objective was to determine the effect of the body mass index (BMI) and age on the bone mineral density (BMD) in geriatric women and men. 900 geriatric patients were included in the study. BMD was measured in the right femoral neck and the antero-posterior lumbar region. All geriatric patients were classified in 1 of 4 categories on the basis of their BMI, as underweight, ideal weight, overweight, and obese. They were separated into three groups, 65-74, 75-84 and 85 and older, according to age groups. While a significant relationship was only determined between the femoral BMD measurements and the BMI in men; significant relationship was shown between both the lumbar and the femoral BMD measurements and the BMI in women. Significant relationship was also determined between the femoral BMD measurements and the BMI and age among women. While the BMDs of those aged 65-74 years group were found to be high compared to those aged 75-84 years and those aged 85 years and older groups, no difference was found between the two groups. This study confirms the effect of a high BMI on femoral neck and L2-L4 BMD among older men and women, but the effect of age was not shown above 75 years of age.