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Objectives This study aims to compare the efficacy of paraffin bath therapy and fluidotherapy on pain, hand muscle strength, functional status, and quality of life (QoL) in patients with hand osteoarthritis (OA). Patients and methods This prospective randomized controlled study included 77 patients (8 males, 69 females; mean age: 63.1±10.3 years; range 39 to 88 years) with primary hand OA who applied between July 2017 and March 2018. The patients were randomized into two groups with the sealed envelope method: Paraffin bath therapy (20 min, one session per day, for two weeks) was applied for 36 patients whereas 41 patients received fluidotherapy for the same period. The pain severity of the patients, both at rest and during activities of daily living (ADL) within the last 48 hours was questioned and scored using Visual Analog Scale. Duruoz Hand Index (DHI) was used to evaluate hand functions. Gross grip strength was measured using Jamar dynamometer whereas fine grip strength was measured using pinch meter in three different positions (lateral pinch, tip pinch, and palmar pinch). The 36-Item Short Form (SF-36) was used to analyze the QoL. All measurements were performed before, immediately after, and three months after treatment. Results Improvement was observed in pain score at rest and during ADL, DHI scores, gross and fine grip strengths, and SF-36 subscores in both groups after treatment. However, no significant difference was observed between the groups. Conclusion Both fluidotherapy and paraffin bath therapy have been found to have positive effects on pain, hand muscle strength, functional status, and QoL in the treatment of hand OA. However, no superiority was observed between the two treatment modalities.

WOS: 000404381800020, PubMed: 28618733, Background/aim: The aim of this study was to evaluate and determine the relationships (if any) among pain, depression levels, fatigue, sleep quality, and quality of life in patients with rheumatoid arthritis (RA) aged 65 years and over, and to compare the results with those of RA patients under 65 years of age. Materials and methods: The study included 52 patients with RA aged 65 years and over (Group 1) and 84 patients with RA under 65 years of age (Group 2). Pain, depression levels, fatigue, sleep quality, quality of life, and disease activity of all of the participants were evaluated using a visual analog scale (VAS), the Beck Depression Inventory (BDI), the Checklist Individual Strength (CIS), the Pittsburgh Sleep Quality Index (PSQI), the Short Form-36 (SF-36), and the Disease Activity Score-28, respectively. Results: When the two groups were compared, higher scores for the VAS, BDI, total CIS, and PSQI were found in Group 1 compared to Group 2 (P = 0.003, P = 0.003, P = 0.007, and P = 0.001, respectively). The SF-36 subscales of the physical component summary and mental component summary were not statistically significantly different between the two groups (P > 0.05). Conclusion: This study evaluated the situation in elderly patients with RA and showed that pain, depression level, fatigue, and sleep quality worsen with age.

Background Cardiovascular diseases, among which atherosclerotic heart disease, are known to be one of the most important mortality and morbidity causes in patients with rheumatoid arthritis (RA). Ischemia modified albumin (IMA) is a potential marker that can be used to assess atherosclerosis-related myocardial ischemia. Another frequently used marker for the assessment of atherosclerotic lesions is the carotid intima media thickness (CIMT). Aim To evaluate the role that IMA has on atherosclerosis development and its clinical usability in patients with RA, by assessing the values of IMA and CIMT. Methods and materials Our prospective study was conducted between June 2012 and March 2013 at the Rheumatology Department of Necmettin Erbakan Meram Medical School, Turkey. Fifty-two RA patients, diagnosed according to the 1987 criteria of the American College of Rheumatology, and an age- and sex-matched control group of 46 healthy subjects were included in this study. Results No significant difference was detected between the groups with respect to age, sex and body mass index. In the patient group the IMA and CIMT values were found to be 0.37 ± 0.12 absorbance units (ABSU) and 0.80 ± 0.22 mm, respectively, while in the control group they were 0.31 ± 0.11 ABSU and 0.51 ± 0.18 mm, respectively. The IMA and CIMT values were significantly higher in the patient group (P = 0.022 and P < 0.0001, respectively). A positive correlation was found between IMA, CIMT and Disease Activity Score of 28 joints (P = 0.016 and P = 0.002, respectively). Conclusion Since the values of IMA were higher in the patient group compared to controls and because of its correlation with CIMT, we suggest the use of IMA as an early marker of atherosclerosis in RA patients.

WOS: 000369330600007 PubMed: 26714978 The objective of this study is to investigate short- and long-term effects of high-intensity laser therapy (HILT) in lateral epicondylitis (LE) patients. Thirty patients with LE diagnosis (23 unilateral and 7 bilateral in total 37 elbows) were treated using HILT. LE patients were evaluated before, right after, and 6 months following HILT intervention post-treatment using visual analogue scale for pain (VAS) during activity and resting. Disabilities of the Arm, Shoulder, and Hand (DASH) Score and hand grip strength test (HGST) were used. The participants of the present study were also evaluated using Short-Form 36 (SF-36) before and 6 months after the treatment. Out of the 30 patients, 8 were male and 22 female with a mean age of 47.2 +/- 9.7. The activity and resting VAS, DASH, and HGST scores revealed statistically significant improvement (p = 0.001) following treatment. Whereas VAS activity, DASH, and HGST scores increased after treatment until post-treatment 6 months significantly (p = 0.001), VAS resting scores remained stable (p = 0.476). A statistically significant improvement was also evident in the physical and mental components of SF-36 scores following treatment until post-treatment 6 months compared to pre-treatment scores (p = 0.001). In conclusion, the results of the present study suggest that HILT is a reliable, safe, and effective treatment option in LE patients in the short and long term considering pain, functional status, and quality of life.

Objective To evaluate knee proprioception in patients with anterior cruciate ligament (ACL) injuries and to assess the effectiveness of an exercise program consisting mainly of proprioception exercises addressing pain, proprioception, and functional status following ACL reconstruction. Materials and methods Twenty male patients, diagnosed with unilateral ACL injury and scheduled for reconstruction, participated in the study along with 16 age- and sex-matched healthy volunteers. Arthroscopic reconstruction of the ACL using autologous hamstring tendon was performed in every case by the same surgeon. After the operation, a six-month rehabilitation program was initiated. Knee proprioception, pain, and functional status were evaluated before and six months after the reconstruction. An isokinetic dynamometer was used to evaluate proprioception and a visual analog scale (VAS) and the Tegner Lysholm Knee Scoring Scale were used to evaluate pain and functional status respectively. Results Preoperative proprioception loss was detected on the patients' injured side when compared to the uninjured side and to healthy volunteers (p = 0.00). A significant improvement was found in pain severity, proprioception, and functional capacity after the postoperative six-month rehabilitation program (p = 0.00). Conclusion Preoperative proprioception loss was detected in ACL-injured patients. The rehabilitation program predominantly consisting of proprioception exercises provided considerable improvement on knee proprioception and functional status.

Systemic lupus erythematosus (SLE) is a major cause of cardiovascular mortality and morbidity associated with early atherosclerosis. Carotid intima-media thickness (CIMT) is one of the early markers of atherosclerosis. Oxidative stress plays an important role in pathophysiologic mechanisms of SLE. Ischemia modified albumin (IMA) and total oxidant status (TOS) have been associated with oxidative stress in several diseases. In our study we aimed to investigate the relationship between serum IMA and TOS levels with CIMT in patients with SLE and to compare these with control group values. In our study, 60 SLE patients diagnosed according to the American College of Rheumatology (ACR) criteria and 35 healthy controls were included. Serum IMA levels were measured by manually spectrophotometric method. Increased serum TOS and IMA levels and CIMT were found in patients with SLE when compared with control group (p 0.05). Our results suggest that serum levels of IMA and TOS increase in SLE. However lack of association between the tested parameters suggests that further researches are needed.

Background: Few data are available on the specific care giving-related problems of stroke patient’s caregivers and factors that influence the burden of these caregivers. Aim: To study the influences of the active rehabilitation process on anxiety, depression, care burden and perceived social support level of stroke patients caregivers. Design: A prospective clinical trial. Setting: Patients and caregivers entering a rehabilitation program at a university hospital in Turkey. Populations: Ninety patients with a first episode of stroke and 90 caregivers responsible for their care were recruited for our study. Methods: Patients and caregivers were assessed before and after the active rehabilitation process. The functional disability level of the patients was assessed by Functional Independence Measure (FIM). The Beck Anxiety Scale (BAS) and the Beck Depression Scale (BDS) were used for anxiety and depression assessment, the Zarit Care Burden Scale (ZCBS) for care burden assessment and the Multi-Dimensional Scale of Perceived Social Support (MDSPSS) for perceived social support assessment. Results: A statistically significant rise is observed in the special person sub-assessment of MDSPSS in both female and male caregivers. Also, a significant decrease in care burden, anxiety and depression levels of caregivers was noted after the rehabilitation program (p < 0.05). Conclusion: Caregivers accept the rehabilitation period as important social support in addition to the support provided by family and friends. Also, our positive results were associated with an improvement in the patients’ functional level and an increase in the acquisition of knowledge and skill required of caregivers in order to provide care during rehabilitation. Clinical Rehabilitation Impact: The rehabilitation team should be aware of the fact that the perceived care burden may be greater due to the lack of knowledge concerning available resources and due to the inability to cope with stress effectively.

Objective: To determine the short- and long-term effectiveness of the muscle energy technique (MET) compared with corticosteroid injections (CSIs) for chronic lateral epicondylitis (LE). Design: Randomized controlled trial with 1 year of follow-up. Setting: Outpatient clinic of a university’s department of physical medicine and rehabilitation. Participants: Patients with chronic LE (NZ82; 45 women, 37 men). Interventions: Eight sessions of MET, or a single CSI was applied. Main Outcome Measures: Grip strength, pain intensity, and functional status were assessed using the pain-free grip strength (PFGS), a visual analog scale (VAS), and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, respectively. Measurements were performed before beginning treatment and at 6, 26, and 52 weeks afterward. Results: When the baseline PFGS, VAS, and DASH scores were compared with the scores at the 52-week follow-up, statistically significant improvements were observed in both groups over time. The patients who received a CSI showed significantly better effects at 6 weeks according to the PFGS and VAS scores, but declined thereafter. At the 26- and 52-week follow-ups, the patients who received the MET were statistically significantly better in terms of grip strength and pain scores. At 52 weeks, the mean PFGS score in the MET group was significantly higher (75.08�26.19 vs 62.24 �21.83; PZ.007) and the mean VAS score was significantly lower (3.28�2.86 vs 4.95 � 2.36; PZ.001) than those of the CSI group. Although improvements in the DASH scores were more pronounced in the MET group, the differences in DASH scores between the groups were not statistically significant. Conclusions: This study showed that while both MET and CSI improved measures of strength, pain, and function compared with baseline, subjects receiving MET had better scores at 52 weeks for PFGS and the VAS for pain. We conclude that MET appears to be an effective intervention in the treatment of LE. Archives of Physical Medicine and Rehabilitation 2013;94:2068-74 a 2013 by the American Congress of Rehabilitation Medicine

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease.

Deep vein thrombosis (DVT) is a common complication following spinal cord injury (SCI). Although DVT of the upper extremity is much less common than DVT of the lower extremities, the risk of pulmonary embolism following upper-extremity DVT should not be disregarded.MethodCase report.FindingsA bilateral upper-extremity DVT developed in a 51-year-old woman with SCI (central cord syndrome) being followed in our rehabilitation clinic. Medical treatment resulted in improvement in the clinical status of the patient as well as the regression in the thrombus.ConclusionIn patients with SCI, DVT should be kept in mind in the presence of pain and edema in the upper extremities, and prophylactic DVT treatment should be considered.

To investigate effects of home exercise program including isotonic, isometric and joint range of motion (ROM) exercises on pain, functional capacity and quality of life in knee OA patients. Seventy-five patients with knee OA were included into the study. Patients were exposed to home exercise program including 8-week active ROM, and isometric and isotonic exercises for quadriceps and hamstrings. In patients, severity of pain, functional capacity, severity of disease and quality of life were assessed with Visual Analogue Scale (VAS), The Western Ontario and McMaster Universities Arthritis Index (WOMAC), Lequesne\'s knee severity index (LSI) and 36-Item Short-Form Health Survey (SF-36) on admission, at the end of and 12th week after the treatment, respectively. At the end of 8th week, of 75 patients, 52 were determined to perform home exercise program regularly. At the end of treatment for 52 patients with knee OA, a significant improvement was seen in physical function, bodily pain and social functioning scores among subscales of SF-36, and VAS, WOMAC and LSI, compared to basal findings. The improvement also continued at 12th week after the treatment. Also, a marked amelioration was observed in role limitation physical, health perception, mental health, role limitation emotional and energy scores among subscales of SF-36, after completing exercise program; however, the amelioration disappared at 12th week after the teratment. Our findings indicate home exercise program increases functional level, decreases pain severity and improves quality of life. Therefore, physicians following-up patients with knee OA should take home exercise programs into consideration while planning treatment regimes.

The objective of this study was to assess the prevalence of fibromyalgia (FM) in patients with episodic migraine and to evaluate the relationship between migraine characteristics and FM. One hundred and eighteen consecutive patients (mean age = 38 years, 75 % women) fulfilling the International Classification of Headache Disorders-II criteria for migraine with (n = 22) and without (n = 96) aura from an outpatient headache clinic of a university hospital were evaluated. The diagnosis of FM was made based on the 1990 American College of Rheumatology classification criteria. Participants completed some self-administered questionnaires ascertaining sociodemographics, headache severity, frequency and duration, headache-related disability (Headache Impact Test [HIT-6]) and Migraine Disability Assessment Scale, widespread musculoskeletal pain (visual analog scale), depression (Beck depression inventory), anxiety (Beck anxiety inventory), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Assessment of Fatigue), and quality of life (Short Form-36 Health Survey [SF-36]). In patients with FM, the tender point count and the Fibromyalgia Impact Questionnaire were employed. FM was diagnosed in 37 (31.4 %) of the patients. FM comorbidity was equally distributed across patients with and without aura. Severity of migraine headache, HIT-6, and anxiety were especially associated with FM comorbidity. Patients suffering from migraine plus FM reported lower scores on all items of the SF-36. This study indicates that the assessment and management of coexisting FM should be taken into account in the assessment and management of migraine, particularly when headache is severe or patients suffer from widespread musculoskeletal pain.

Bu vaka ankilozan spondilit ve myotoni konjenitanın birlikte görüldüğü ilk sunumdur. Ankilozan spondilit aksiyal iskelet infla- masyonu ve sistemik tutulumla karekterize sistemik romatolojik bir hastalıktır. Miyotoninin en belirgin bulgusu tutukluk ve kas kasıldıktan sonra gevşeme gecikmesidir. Tutukluk ve tanı gecikmesi bu iki hastalıkta ortak bulgudur., This is the first report about the association of ankylosing spondylitis and myotonia congenita. Ankylosing spondylitis is a systemic rheumatologic disease that is characterized by axial skeletal inflammation and accompanied by systemic involvement. The most significant findings of myotonia are the stiffness and the delayed relaxation following the muscle contraction. Both of these pa- thologies can cause stiffness and also delaying of diagnosis of each other.

WOS: 000398230800006, PubMed: 27860257, Aim: The objective of this study is the evaluation of the effect of vitamin D replacement treatment on musculoskeletal symptoms and quality of life in patients with chronic widespread musculoskeletal pain (CWP) including fibromyalgia (FM) and vitamin D deficiency. Method: Patients with nonspecific CWP and vitamin D deficiency (25-OH D3

WOS: 000360767400004, PubMed ID: 25900081, AimRheumatoid arthritis (RA) is an inflammatory autoimmune disease with unknown etiology and systemic involvement. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are two new inflammatory markers used in the assessment of systemic inflammation. The aim here is to study NLR and PLR in patients with RA to investigate their relation with Disease Activity Score of 28 joints (DAS-28). MethodsThe study included 104 patients with RA and a control group of 51 age- and gender-matched healthy subjects. We divided the patients into two groups according to the DAS-28 score. Group 1 included patients with a score of lower than 2.6 by the DAS-28 (patients in remission) and Group 2 included patients with a score of 2.6 and higher (patients with active disease). ResultsNLR was 2.120.83 in the patient group and 1.58 +/- 0.57 in the control group. PLR was 136.50 +/- 53.52 in the patient group and 114.84 +/- 29.41 in the control group. There was a statistically significant difference in NLR and PLR between the patient and control groups (P0.0001 and P=0.001, respectively). Patients in Group 1 had an NLR of 1.84 +/- 0.61 and a PLR of 119.25 +/- 41.77. Patients in Group 2 had an NLR of 2.29 +/- 0.90 and a PLR of 147.28 +/- 56.96. There was a statistically significant difference in NLR and PLR between the two groups (P=0.003 and P=0.005 respectively). A correlation was observed between NLR and PLR by DAS-28 (r=0.345, P0.0001 and r=0.352, P0.0001, respectively). ConclusionsThe present study showed us that NLR and PLR were two new inflammatory markers which could be used to assess disease activity in patients with RA.

Behçet’s disease (BD) is a systemic disease characterizedby oral aphthosis, genital ulcers, ocular lesions andalso gastrointestinal, musculoskeletal, neurological andvessel involvements may develop. Venous manifestationsare more common than arterial involvement. Venousinvolvement often occurs in the veins of lower extremity.Upper extremity venous involvement is rare. In this paperwe report a case of BH presenting with upper extremitysuperficial vein thrombosis.Key words: Behçet’s disease, upper extremity, superficialvein thrombosis

Behcet’s disease (BD) is a disease which has effects on different systems. Genital ulcer, aphthous stomatitis and iritis are characterized by triple symptom complex of BD. BD is considered to be a systemic vasculitis. BD was previously accepted in spondyloarthropathy (SSpA) group, but there are many reasons for not classifying BD as one of SSpA group. Ankylosing spondylitis (AS) is a prototype of seronegative spondyloarthropathy, and mainly axial skeleton is affected. In this paper, we aimed to present a-33-year old female patient with coexistence of BD and AS. In addition, the coexistence was aimed to be discussed.

SUMMARY Background: The aim of the study was to determine serum ischemia modified albumin and malondialdehyde levels as markers of oxidative stress and serum superoxide dismutase activity as a marker of antioxidant defense and their associations with clinical outcomes in patients with fibromyalgia. Methods: 59 patients with fibromyalgia and 38 age and gender matched healthy controls were included in the study. The diagnosis of fibromyalgia was based on the classification criteria declared by American College of Rheumatology in 1990. All patients underwent the clinical assessment, consisting of evaluation for tender point count, visual analogue scale for pain, fibromyalgia impact questionnaire, multidimensional assessment of fatigue, Beck anxiety inventory, Beck depression inventory, and the health assessment questionnaire. Serum levels of ischemia modified albumin, malondialdehyde, and superoxide dismutase activities were measured using colorimetric methods. Results: Malondialdehyde levels of fibromyalgia patients were significantly higher than they were in the control group. Ischemia modified albumin levels in the fibromyalgia group were not significantly different from the control values. There was no significant correlation between ischemia modified albumin and malondialdehyde and clinical measures with the exception that malondialdehyde levels positively correlated with health assessment questionnaire scores. Conclusions: We concluded that increased malondialdehyde levels in patients with fibromyalgia could be considered as a sign of increased oxidative stress. Ischemia modified albumin values were not in concordance with malondialdehyde levels and could not be considered as an oxidative stress marker in the follow-up of fibromyalgia. Further studies are needed to investigate IMA levels in newly diagnosed fibromyalgia patients. (Clin. Lab. 2014;60:1609-1615. DOI: 10.7754/Clin.Lab.2014.131017)

Plantar fasciitis often leads to disability. Optimal treatment for this clinical condition is still unknown.To compare the effectiveness of wearing a full-length silicone insole with ultrasound-guided corticosteroid injection in the management of plantar fasciitis.Randomized clinical trial.Forty-two patients with chronic unilateral plantar fasciitis were allocated randomly to have an ultrasound-guided corticosteroid injection or wear a full-length silicone insole. Data were collected before the procedure and 1 month after. The primary outcome measures included first-step heel pain via Visual Analogue Scale and Heel Tenderness Index. Other outcome measures were the Foot and Ankle Outcome Score and ultrasonographic thickness of the plantar fascia.After 1 month, a significant improvement was shown in Visual Analogue Scale, Heel Tenderness Index, Foot and Ankle Outcome Score, and ultrasonographic thickness of plantar fascia in both groups. Visual Analogue Scale scores, Foot and Ankle Outcome Score pain, Foot and Ankle Outcome Score for activities of daily living, Foot and Ankle Outcome Score for sport and recreation function, and plantar fascia thickness were better in injection group than in insole group (p0.05).Although both ultrasound-guided corticosteroid injection and wearing a full-length silicone insole were effective in the conservative treatment of plantar fasciitis, we recommend the use of silicone insoles as a first line of treatment for persons with plantar fasciitis.

Haglund's syndrome, which is an inflammation of the bursa and a bony enlargement on the back of the heel that most often leads to painful bursitis, is a rare cause of retrocalcaneal pain. The clinical diagnosis is often confusing as the clinical picture may mimic other causes of hindfoot pain such as isolated retrocalcaneal bursitis or hindfoot involvement from more systemic disorders such as seronegative spondyloarthropathies (Reiter's syndrome, ankylosing spondylitis) or rheumatoid arthritis. This report is of a 60-year-old woman with a painful swelling of the right heel, who was diagnosed with Haglund syndrome. The characteristic clinical photograph (showing the prominent 'pump bump'), radiographical and magnetic resonance imaging features are presented.

To evaluate sexual function in women with rheumatoid arthritis (RA) and compare them with healthy controls.Ninety-five patients with RA and 108 healthy controls were included in the study. Depression levels and sexual functions of all participants were evaluated by the Beck Depression Inventory (BDI) and Index of Female Sexual Function (IFSF), respectively. Morning stiffness in women with RA, pain (Visual Analog Scale--VAS), disability rate (Health Assessment Questionnaire--HAQ), and disease activity score (DAS-28) were defined.Total IFSF and mean of IFSF subgroup scores and significance of sexual life score were lower in patients with RA than controls, whereas mean BDI score was higher. The mean of the total IFSF scores was significantly lower in patients with RA with BDI≥17 than that of patients with BDI17. The mean of the total IFSF score decreased as disease severity increased. There was a strong negative correlation between total IFSF and DAS-28 scores, a moderate negative correlation between total IFSF score and HAQ, BDI, VAS score, age, and morning stiffness, and weak negative correlation between total IFSF and body mass index.RA is observed to have negative effects on sexual functions of women. Presence of depressive symptoms with RA and increased disease severity increase the degree of sexual dysfunction. Women patients with RA should also be asked about their sexual lives while being evaluated.

Objective The aim of the study was level of anxiety, depression and alexithymia in patients with rheumatoid arthritis (RA). Introduction Alexithymia is defined as the difficulty in verbal expression of feelings. Alexithymia is more common seen in patients with chronic and temporary health problems. Method One hundred forty eight patients with rheumatoid arthritis and a hundred healthy subject were included into the study. The level of alexithymia was assessed with Toronto Alexithymia Scale- 20 (TAS-20). Depression and anxiety disorders severity and quality of life (QoL) were assessed Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), World Health Organization Quality of Life Assessment- Brief (WHOQoL-BREF), respectively. Results TAS-20 scores in patients group was higher than control group. The patients with rheumatoid arthritis had significantly poorer scores in all domains of WHOQoL-BREF (p Conclusions The results of this study suggest that alexithymia is more common in patients with RA. Treatment of alexithymia may improve QoL, depressive and anxiety symptoms.

WOS: 000367280800006, PubMed ID: 26924141, OBJECTIVE: Ankylosing spondylitis (AS) is a progressive chronic inflammatory disease mainly characterized by axial skeleton and sacroiliac joint involvement. We aimed to investigate the relation between neutrophil-to-lymphocyte ratio (NLR) and disease severity of AS and to explore its availability in clinical practice. METHODS: A total of 102 AS patients and 60 individuals who were age- and gender-compatible with the control group were included into the study. Patients were divided into 2 groups according to Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores. Patients with BASDAI scores

Amaç: Travmatik beyin hasarlı hastalarda nörolojik rehabilitasyon etkinliğini araştırmak.Garaç ve Yöntem: Çalışmaya travmatik beyin hasarı sonrası rehabilite edilen 45 hasta alındı. Hastaların sosyodemografik özellikleri, yaralanma nedeni, koma süresi, posttravmatik amnezi süresi, yaralanma sonrası diğer kliniklerde kalış süresi, yaralanma ile rehabilitasyon kliniğine yatış arasındaki süre, rehabilitasyon kliniğinde kalma süreleri ve uzun dönem komplikasyonları belirlendi. Hastaların kliniğimize ilk yatışları ile son kontrolleri arasındaki fark fonksiyonel açıdan; Özürlülük Derecelendirme Ölçütü (Disability Rating Scale, DRS), Fonksiyonel Bağımsızlık Ölçütü (Functional Independence Measure, FIM) ve Fonksiyonel Ambulasyon Skalası (FAS), bilişsel açıdan ise Rancho Los Amigos bilişsel fonksiyon düzeyleri skalası (RLAS) son durum ölçütleri kullanılarak karşılaştırıldı.Bulgular: Nörolojik rehabilitasyon sonrasında hastaların fonksiyonel durumlarında belirgin iyileşme oldu. Başlangıç ve tedavi sonrası DRS, FİM, FAS ve RLAS skorlarında istatistiksel olarak anlamlı değişimler oldu. Başlangıç DRS skoru düşük, FİM ve RLAS skoru yüksek olanlarda fonksiyonel son durumun daha iyi olduğu tespit edildi.Sonuç: Travmatik beyin hasarı sonrası nörolojik rehabilitasyon fonksiyonel son durumun daha iyi olmasını sağlamaktadır., Objective: The aim of this study is to investigate the effectiveness of neurological rehabilitation in patients with traumatic brain injury. Materials and Method: Forty-five patients who were rehabilitated after traumatic brain injury were included in the study. The sociodemographic characteristics of the patients, the cause of the injury, the duration of coma and posttraumatic amnesia, the duration of stay in the other clinics after injury, the time between injury and admission to the rehabilitation clinic, the duration of stay in the rehabilitation clinic and long-term complications were determined. The functional differences between the admission of the patients and their final control examinations were compared using Disability Rating Scale (DRS), Functional Independence Measure (FIM), and Functional Ambulation Scale (FAS), and cognitive differences were compared using their recent status criteria, with Rancho Los Amigos Scale (RLAS).Results: There was a significant improvement in the functional status of patients after neurological rehabilitation. There were statistically significant changes in DRS, FIM, FAS and RLAS scores after treatment compared to initial status. Better improvement in the functional status was detected in patients with lower initial DRS scores and higher FIM and RLAS scores. Conclusion: The neurologic rehabilitation significantly affects the recovery of functional status after traumatic brain injury.

Diz osteoartritli (OA) hastalarda izotonik, izometrik ve eklem hareket açıklığı (EHA) egzersizlerinden oluşan ev programının ağrı, fonksiyonel kapasite ve yaşam kalitesi üzerine etkisini araştırmak. Diz OA tanısı alan 75 hasta çalışmaya alındı. Hastalara 8 hafta aktif EHA, kuadriseps ve hamstringler için izometrik ve izotonik egzersizlerden oluşan ev programı uygulandı. Hastalarda bazalde, tedavi bitiminde ve tedavi bittikten sonra 12 haftada Vizüel Analog Skala (VAS) ile ağrı şiddeti, The Western Ontario and Mcmaster Universities Arthritis İndeks (WOMAC) ile fonksiyonel durum, Lequesne diz eklemi şiddet indeksi (LŞİ) ile hastalığın şiddeti, 36- Item Short-Form Health Survey (SF-36) ile yaşam kalitesi belirlendi. 8 haftanın sonundaDiz OAli 75 hastanın 52nin ev egzersiz programını düzenli uyguladığı tespit edildi. 52 diz OAli hastanın tedavi bitiminde VAS, WOMAC, LŞİ ve SF-36 alt skorlarından fiziksel fonksiyon, ağrı ve sosyal fonksiyon skorlarında bazale göre belirgin düzelme mevcuttu ve bu düzelme azalmakla birlikte tedavi bittikten sonra 12 haftada da devam ediyordu. Yine hastalarda egzersiz programı bitiminde SF-36 alt skorlarından mental sağlık, emosyonel rol, fiziksel rol, genel sağlık ve vitalite skorlarında bazale göre belirgin düzelme mevcuttu, ancak bu düzelme tedavi bittikten sonra 12 haftada devam etmiyordu. Sonuçlarımız diz OAli hastalarda ev egzersiz programının fonksiyonel düzeyi arttırdığı, ağrı düzeyini azalttığı ve yaşam kalitesini düzelttiğini göstermektedir. Bu nedenle diz OAli hastaları takip eden sağlık profesyonelleri tedavi planlarken ev egzersiz programlarını mutlaka gözönünde bulundurmalıdır., To investigate effects of home exercise program including isotonic, isometric and joint range of motion (ROM) exercises on pain, functional capacity and quality of life in knee OA patients. Seventy-five patients with knee OA were included into the study. Patients were exposed to home exercise program including 8-week active ROM, and isometric and isotonic exercises for quadriceps and hamstrings. In patients, severity of pain, functional capacity, severity of disease and quality of life were assessed with Visual Analogue Scale (VAS), The Western Ontario and McMaster Universities Arthritis Index (WOMAC), Lequesnes knee severity index (LSI) and 36-Item Short-Form Health Survey (SF-36) on admission, at the end of and 12th week after the treatment, respectively. At the end of 8th week, of 75 patients, 52 were determined to perform home exercise program regularly. At the end of treatment for 52 patients with knee OA, a significant improvement was seen in physical function, bodily pain and social functioning scores among subscales of SF-36, and VAS, WOMAC and LSI, compared to basal findings. The improvement also continued at 12th week after the treatment. Also, a marked amelioration was observed in role limitation physical, health perception, mental health, role limitation emotional and energy scores among subscales of SF-36, after completing exercise program; however, the amelioration disappared at 12th week after the teratment. Our findings indicate home exercise program increases functional level, decreases pain severity and improves quality of life. Therefore, physicians following-up patients with knee OA should take home exercise programs into consideration while planning treatment regimes.

Amaç: Bu çalışmada vertebral veya non-vertebral kırığı olmayan postmenopozal osteoporozlu (PMO), osteopenik ve normal kemik mineral yoğunluğuna (KMY) sahip kadınların yaşam kalitesini değerlendirmek ve yaşam kalitesi üzerine etkili faktörleri belirlemek amaçlandı. Gereç ve Yöntemler: Kırığı olmayan PMO’lu 266 kadın, 310 osteopenik kadın ve 255 normal KMY’li kadın çalışmaya alındı. KMY ölçümü, dual enerji X-ray absorbsiyometri (DXA) ile lomber vertebra (L1-4) ve femur boyundan yapıldı. Yaşam kalitesi Avrupa Osteoporoz Kurumu Yaşam Kalitesi Anketi (QUALEFFO) kullanılarak değerlendirildi. Grupların QUALEFFO total skorları ve alt grup skorları karşılaştırıldı. Korelasyon analizi ile PMO’lu kadınlarda yaşam kalitesi ile ilişkili faktörler belirlendi. Yaşam kalitesi ile en yüksek korelasyona sahip değişkenler lineer regresyon modeline alındı. Bulgular: Kırığı olmayan PMO’lu kadınlarda QUALEFFO total skor ve alt grup skorları osteopenik ve normal KMY’e sahip gruba göre anlamlı derecede yüksekti. PMO’lu kadınlarda QUALEFFO total skoru ile yaş, vücut kitle indeksi (VKİ), doğum sayısı ve menapoz süresi arasında pozitif korelasyon, eğitim düzeyi, gelir düzeyi, femur boyun KMY skorları arasında negatif korelasyon tespit edildi. Lineer regresyon analizi sonucunda, yaşam kalitesinin en önemli belirleyicileri olarak VKİ, femur boyun KMY, doğum sayısı ve menapoz süresi tespit edildi. Sonuç: Bu çalışmanın sonuçları kırığı olmayan PMO’lu kadınların yaşam kalitelerinin osteopenik ve normal KMY’ye sahip kadınlara göre belirgin derecede bozulduğunu ve yaşam kalitesinin birçok faktörden etkilendiğini göstermektedir. (Türk Osteoporoz Dergisi 2012;18: 47-52), Aim: To evaluate quality of life in women without vertebral and nonvertebral fractures, with postmenopausal osteoporosis (PMO), osteopenic and normal bone mineral density (BMD), and to determine effective factors on quality of life. Materials and Methods: Without fractures, 266 women with PMO, 310 with osteopenia and 255 with normal women BMD were enrolled in the study. BMD measurement was performed on lumbar vertebra (L1-L4) and femur neck via dual energy X-ray absorbtiometry (DXA). Quality of life was assessed with Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). QUALEFFO total scores and subscales were compared in all groups. Factors about quality of life in women with PMO were defined with correlation analysis. Variations of the highest correlation and quality of life were included into linear regression model. Results: In non-fractured women with PMO, QUALEFFO total scores and subscales were higher than those with osteopenia and normal BMD. In women with PMO, a positive correlation was found between QUALEFFO total scores, and age, Body Mass İndex (BMI), parity and duration of menopause, and a negative correlation between QUALEFFO total scores, and level of education, economical status and femur neck BMD scores. In linear regression analysis, among significant factors of quality of life were BMI, femur neck BMD, parity and duration of menopause. Conclusion: Our results indicate that quality of life in non-fractured women with PMO is disordered higher than those with osteopenia and normal BMD, and quality of life are affected by numerous factors. (Turkish Journal of Osteoporosis 2012;18: 47-52)