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Objective The aim of this study was to determine the balance problems and risk of falling by using digital or computerized methods in patients who underwent total knee arthroplasty (TKA) and have satisfactory functional scores in the early postoperative period. Methodology A total of 31 participants (24 women, seven men; mean age: 61.93 ±10.75 years; range: 49-82 years) who underwent unilateral TKA were included. The fall risk was evaluated using the time up-and-go (TUG) test and computerized platforms. Patient-reported pain, stiffness, and physical functional outcome measures [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Oxford Knee Score (OKS)] and posture (New York Posture Rating Chart) were evaluated. Results Based on the WOMAC scores, there was a significant impact on self-reported pain (p˂0.001), function (p=0.001), and stiffness (p=0.001) between preoperative and postoperative results. The OKS (p=0.006) and the TUG score (p=0.004) improved significantly, but the posture scores remained the same after the surgery. There was a statistically significant difference between the preoperative and third-month postoperative test results of the stabilometric test, bipedal opened eye, bipedal closed eye, monopedal right, and monopedal left foot static balance tests (p˂0.05). However, the disequilibrium and equilibrium dynamic balance values ​​remained unchanged three months after TKA. Conclusions Satisfactory functional scores according to WOMAC or OKS were achieved in the early postoperative period. However, posture and dynamic balance problems related to falling risk continued to persist in the same period. Although the TUG test results were statistically significant, they also showed fall risk values. Fall risk and postural problems should be analyzed objectively using computerized methods. Early rehabilitation programs after TKA in elderly individuals should be designed accordingly and close attention must be paid to fall risks.

Background: Using high-heeled shoes in daily life affects the stability of walking, body posture, and functionality. So, the present study was aimed to determine the immediate effect of Kinesio-taping (KT) on functionality, static and dynamic balance, exercise capacity, posture in young women using high-heeled shoes. Methods: Thirty-seven females who were used high-heeled shoes with a mean age of 20.32±1.37 years were divided into two groups: control (n:20) and study group(n:17). The study group’s both limbs were taped medially, laterally, and dorsally with KT; no application was made to the control group. Balance [Techno Body Postural Line], functionality [vertical jump and functional reach test], exercise capacity [6-min walk test], human body posture [New York Posture Rating Chart] was assessed. Results: Use of high-heeled shoes was 8(7-9) hours/day, 5(3-5) days/week, 3(2-6.5) years in the study group versus 6(6-8) hours/day, 4(2.5-5.75) days/week for 4(2.5-5.75) years in the control group. Statistical significance in functional reach distance (cm) was found within the control (p:0.010) and study groups (p:0.005) but not between the groups (p>0.05). Stabilometric mono pedal right foot elips area (mm2; p:0.006) and perimeter (mm;p:0.009); left foot elips area (mm2;p:0.016), perimeter (mm;p:0.023) and front/backward standard deviation (p:0.018); dynamic balance area gap percentage (%; p:0.030) were significant within the study group. Posture, vertical jump distance, exercise capacity, stabilometric test results, bipedal closed-eye&opened eye results were similar within and between the groups (p>0.05). Conclusions: Kinesio-taping has no immediate effect on exercise capacity, vertical jump function, posture, and bipedal static balance but can modulate the functional reach function, static mono pedal leg balance, and dynamic equilibrium. Further studies are recommended to investigate the additive effect of KT with high heels and after 45 minutes, 24 hours and 72 hours.

In the literature, information about injury patterns, risk factors and management strategies is limited for wheelchair athletes. The purpose of this study was to determine the prevalence and nature of injuries in wheelchair sports participants. Demographic data, sport history, type, area, cause and story of the injury and barriers of collecting this sport information were recorded. A total of 15 individuals were included in the study. The biggest barrier to play the sport was the cost of the wheelchair. 26.6% of them had injury in the past one year and 75% of them had injuries because of muscle tears. Injuries while playing wheelchair sports are common, and mostly occurred while driving the wheelchair. Mostly their fingers are squeezed and stuck to the wheelchair. Education for prevention of injuries should be given to all the players. Protective equipment for hands should be considered to protect against injuries. Keywords: Injury, wheelchair, basketball players, wheelchair athletes

Introduction: Epilepsy is defined as a sudden, abnormal and hypersynchronous discharge of neuron community that has a specific function in central nervous system. Increased arterial pH as a result of excessive breathing activity may cause an epileptic seizure in individuals with epileptic seizures. Aim: To evaluate changes in respiratory parameters and to determine relationship between sleep quality and respiratory problems in patients with epileptic seizure. Methods: 30 patients (mean age 26.56±6.64) who were diagnosed with epilepsy included in study. Pulmonary function (spirometry), respiratory muscle strength [MIP, MEP (mouth pressure device], dyspnea [(Modified Medical Research Council dyspnea scale (MMRC) and BORG scale], physical activity levels [International Physical Activity Questionnaire (IPAQ)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were evaluated. Results: There was no statical difference in MIP and MEP, respiratory function test, respiratory frequency, MMRC, BORG, IPAQ total score and PSQI between gender (p>0.05). A moderate positive correlation was found between the FEV1/FVC and PSQI total scores (r=0.44; p 0.05). Conclusion: Gender, age, age of seizure onset and dyspnea status were effected the respiratory function and sleep quality in patient with epileptic seizures. Studies about investigating the reasons of respiratory problems in patients with epileptic seizure are needed.

Purpose: The aim of this study was to test a simple technique to augment the pullout resistance of an anchor in an over-drilled sheep humerus model. Methods: Sixty-four paired sheep humeri were harvested from 32 male sheep aged 18 months. Specimens were divided into an augmented group and non-augmented group. FASTIN RC 5-mm titanium screw anchors (DePuy Mitek, Raynham, MA) double loaded with suture material (braided polyester, nonabsorbable USP No. 2) were used in both groups. Osteoporosis was simulated by over-drilling with a 4.5-mm drill. Augmentation was performed by fixing 1 of the sutures 1.5 cm inferior to the anchor insertion site with a washer screw. This was followed by a pull-to-failure test at 50 mm/min. The ultimate load (the highest value of strength before anchor pullout) was recorded. A paired t test was used to compare the biomechanical properties of the augmented and non-augmented groups. Results: In all specimens the failure mode was pullout of the anchor. The ultimate failure loads were statistically significantly higher in the augmented group (P < .0001). The mean pullout strength was 121.1 +/- 10.17 N in the non-augmented group and 176.1 +/- 10.34 N in the augmented group. Conclusions: The described augmentation technique, which is achieved by inferior-lateral fixation of 1 of the sutures of the double-loaded anchor to a fully threaded 6.5-mm cancellous screw with a washer, significantly increases the ultimate failure loads in the over-drilled sheep humerus model. Clinical Relevance: Our technique is simple, safe, and inexpensive. It can be easily used in all osteoporotic patients and will contribute to the reduction of anchor failure. This technique might be difficult to apply arthroscopically. Cannulated smaller screws would probably be more practical for arthroscopic use. Further clinical studies are needed.

Objective: The aim of this study was to ascertain the effect of gender and cultural habits on hip, knee and ankle range of motion (ROM) and to determine the differences between the ROM of right and left side symmetric joints of the lower extremities.Methods: The study included 987 (513 males and 474 females) healthy volunteers. Individuals with a history of illness, prior surgery or trauma involving any joint of either lower extremity wereexcluded from the study. The terminology and techniques of measurements used were those suggested by the American Academy of Orthopedic Surgeons.Results: Left side passive hip flexion and active internal rotation was higher than the right side. Passive flexion of the hip joint was higher in male subjects and internal and external rotation was higher in female subjects. In the knee joint, passive extension was higher in males. Plantarflexion and inversion of the ankle joint were higher in male subjects and dorsiflexion and eversion were higher in female subjects. The differences were considered insignificant in clinical terms as all were less than 3 degrees.Conclusion: There is no clinically significantly difference between right and left side hip, knee and ankle joints ROM. Gender and cultural habits do not appear to have clinically significantly effects on lower extremity joint ROM., Amaç: Bu çalışmanın amacı, cinsiyetin ve kültürel alışkanlıkların kalça, diz ve ayak bileği eklem hareket açıklığına (EHA) olan etkisini ve alt ekstremitenin sağ ve sol taraf simetrik eklemlerinin EHA’ları arasında fark olup olmadığını belirlemekti.Çalışma planı: Çalışmaya 987 (513 erkek ve 474 kadın) gönüllü alındı. Alt ekstremite eklemlerinden herhangi birisiyle ilgili hastalık öyküsü bulunan, ameliyat veya travma geçirmiş olanlar çalışmaya dahil edilmedi. Terminoloji ve ölçüm tekniklerinde Amerikan Ortopedik Cerrahlar Akademisi’nin yönergeleri temel alındı.Bulgular: Sol taraf kalça pasif fleksiyonu ve aktif iç rotasyonu sağ tarafa göre daha yüksek olarak ölçüldü. Kalça ekleminde; pasif fleksiyon erkeklerde daha yüksek olduğu halde, iç ve dış rotasyon kadınlarda daha yüksekti. Dizde; pasif ekstansiyon erkeklerde daha yüksekti. Ayak bileğinde; plantarfleksiyon ve inversiyon erkeklerde daha fazla iken, dorsifleksiyon ve eversiyonun kadınlarda daha fazla olduğu görüldü. Ölçülen farklılıkların hiçbiri üç dereceden fazla olmadığı için klinik olarak anlamlı değildi.Çıkarımlar: Kalça diz ve ayak bileği EHA’larında sağ ve sol taraf arasında klinik olarak anlamlı bir fark olmadığı, cinsiyet ve kültürel alışkanlıkların alt ekstremite eklemlerindeki EHA’yı klinik olarak anlamlı bir şekilde etkilemediği saptandı.

The purpose of this study was to exhibit the effect of combined therapy (spa and physical therapy) on pain in various chronic diseases.Retrospectively, 472 (58.1% female and 41.9% male) spa and physical therapy patients with a mean age of 53.4 +/- 12.5 years were evaluated during 2001-2004 from the archives of Dumlupinar University TUTAV Thermal Cure Center. Before, after therapy and before discharging, visual analog scale (VAS) for pain, heart and respiratory rates, systolic and diastolic blood pressures were measured for hemodynamic evaluations.Arthrosis (230 patient, 48.7%) was found to be the main problem in our patients. Ankle arthrosis, fibromyalgia and cervical disc herniation were found with the highest VAS values compared to other pathologies before spa therapy (p0.05). Immediately after spa therapy and before discharge, VAS values were lower than before treatment (p0.05). Immediately after spa therapy, the highest decreases in VAS values were observed in coxarthrosis and gonarthrosis patients (p0.05). Coxarthrosis and nonarticular patients had the lowest VAS values before discharge than other pathologies (p0.05). No statistical differences were found between male and female VAS values in all stages of treatment (p0.05). Heart and respiratory rate were statistically increased (p0.01), diastolic blood pressure was decreased (p0.01) but not changed in systolic blood pressure (p0.05) immediately after spa therapy. Before discharging, all hemodynamic parameters were found statistically decreased before treatment and immediately after spa therapy (p0.01).A combination of spa and physical therapy decreases pain and improves functional capacity without any hemodynamic risk in rheumatological, neurological and cardiac patients.

Amaç: Çalışmada glenohumeral eklemin abdüksiyon ve fleksiyon hareketleri sırasında skapular elevasyon meydana gelip gelmediği belirlendi. Hastalar ve yöntemler: Çalışmamızın birinci aşamasında 32 sağlıklı birey rastgele olarak iki gruba ayrıldı. Skapular çentiğin hareketliliği ilk grupta (5 erkek, 10 kadın; ort. yaş; 21.1 yıl; dağılım 18-24 yıl) glenohumeral eklem fleksiyonda iken, ikinci grupta (8 erkek, 9 kadın; ort. yaş 22.1 yıl; dağılım 18-27 yıl) ise abdüksiyonda iken açık manyetik rezonans görüntüleme (MRG) yöntemi ile değerlendirildi ve hareket açıklığının 0 ile 150 derece arasında olduğu saptandı. Çalışmanın ikinci aşamasında ise pasif humeral hareketler sırasında skapular çentik hareketleri otopsi üzerinde incelendi. Bulgular: Açık MRG sonuçlarına göre, glenohumeral eklemin pasif fleksiyonu ve abdüksiyonu sırasında skapulada elevasyon veya depresyon meydana gelmedi. Glenohumeral eklemin abdüksiyonu sırasında skapular çentik hafif şekilde mediale hareket ederken, glenohumeral eklem fleksiyonda iken hareketlilik gözlenmedi. Otopsi çalışmasında da glenohumeral abdüksiyon ve fleksiyon hareketleri sırasında skapulada vertikal yönde hareket gözlenmedi. Sonuç: Glenohumeral fleksiyon ve abdüksiyon sırasında skapula vertikal yönde hareket etmemektedir. Abdüksiyon hariç, fleksiyonda da medial yönde hareket söz konusu değildir.

The main purposes of the study are to determine the intra-inter rater reliability of a new special designed clinical evaluation system; to measure the amount of the vertical axial rotation of the tibia resulting from passive rotation of knee and subtalar joints. To achieve this, the Measuring the Vertical Axial Rotation Tibial Shaft (MVARTS) system was designed. The system apparatus is applied to each knee and measured the vertical axial rotation of the tibia and subtalar rotations together. Fifty healthy subjects were e together. Fifty healthy subjects were examined using the suggested system. Two evaluators measured the tibial internal and external rotations, passively. The pure tibial rotation was also measured radiologically on the X-Ray in only 24 subjects The intra and inter observer variation was calculated between 2.1 and 38 degrees with high correlation (0.84-0 98). There was no significant difference between intra and inter observers' results (p 005). On the other hand, amount of the internal combined rotations was lower than the external rotation (p 001) The radiological extermal pure tibial rotations are 19.8t62 de g ( right ) , 170 1.6 İ ng ( left ) for the males whilst 28. 7+40 deg (right), 230+5.3 deg (left) for the females. The difference between the male and female subjects was also seen to be significant (p D.05). The results showed that the MVARTS system is an appropriate, noninvasive, fast to measure combined tibial and subtalar joint rotation in addition to be economically very efficient.

Objective: Spa therapy is commonly used in the treatment of daily chronic diseases practice, but its benefits are still the subjects of discussion. This study investigates possible effects of a combined spa and physical therapy program on pain and hemodynamic responses in various chronic diseases. Methods: The pain intensity and hemodynamic responses of 472 patients involved in a spa and physical therapy program were studied retrospectively. Assessment criteria were pain [Visual Analog Scale (VAS)] and hemodynamic responses (heart rate, blood pressure, respiratory rate). Assessments took place before, immediately after treatment, and after completion of the spa program (before discharge). Results: The patients with ankle arthrosis, fibromyalgia and cervical disc herniation reported the highest VAS score before treatment program (P < 0.05). After the therapy program, VAS scores were seen to decrease compared to before treatment (P < 0.05). The patients with osteoarthritis of the hip (1.3 ± 1.2) and soft tissue rheumatism (1.3 ± 1.2) had the lowest VAS score before discharge compared to patients with other pathologies (P < 0.05). No statistically significant differences were detected between both sexes in terms of pain improvement (P > 0.05). On discharge, all hemodynamic responses decreased significantly compared to before and immediately after initiation of the therapy program (P < 0.01). Conclusion: To decrease pain and high blood pressure without hemodynamic risk, a combined of spa and physical therapy program may help to decrease pain and improve hemodynamic response in patients with irreversible pathologies. © 2005 Elsevier Ltd. All rights reserved.

Introduction. Although it is used in clinical practice, there are no data concerning scapular elevation during glenohumeral abduction. Materials and methods. Scapular elevation of 30 healthy volunteers in supine and sitting positions were measured at 90-180 deg of glenohumeral abduction by two examiners. In addition, radiographs of the ten subjects were taken in supine position at 0-180 deg of glenohumeral abduction, and the scapular elevation measurements were repeated. Also, the movements of five anatomical landmarks (acromioclavicular joint, center of glenoid cavity, scapular notch, angulus superior and inferior) were measured with regard to transverse and vertical axes. Results. The values obtained for scapular elevation during 90, 120, 150, and 180 deg of glenohumeral abduction were (mean and SD) 26.63 and 3.96, 31.77 and 4.36, 35.97 and 5.15, 40.10 and 5.18 deg, respectively. There were no significant differences with regard to side, gender, and position of the subject. No correlation was found between the clinical and radiological measurements. Movements of certain points did not reveal progressive upward motion. Conclusion. There is no scapular elevation but rather rotation during glenohumeral joint abduction. Normal values given in the present study can be used in clinical examinations.