Yazar "Altay, Zuhal" seçeneğine göre listele
Listeleniyor 1 - 20 / 29
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Ankilozan spondilitli hastalarda etanercept tedavisinin etkinliği ve güvenilirliği(2010) Kalı, Gökhan; Ersoy, Yüksel; Durmuş, Bekir; Altay, Zuhal; Baysal, Özlem; Ersoy, YaseminAmaç: Bu çalışmanın amacı; ankilozan spondilit (AS)’li hastalarda etanercept tedavisinin etkinliğini ve güvenilirliğini araştırmaktır. Gereç ve Yöntem: 21 AS’li hasta tedavi öncesi ve 6 aylık tedaviden sonra klinik ve laboratuvar parametrelerle değerlendirildi. Tedavinin etkinliği ayrıca Uluslararası AS Çalışma Grubu (ASAS)’nun AS’te tedaviye yanıt kriterleri olan ASAS-20, ASAS-40, ASAS-5/6, ASAS parsiyel remisyon ve BASDAI-50 yanıtı ile belirlendi. Bulgular: 6 aylık etanercept tedavisinden sonra klinik ve laboratuvar değerlendirme parametrelerinin tümünde istatistiksel olarak anlamlı iyileşme görüldü. Ayrıca 18 hastada ASAS-20, 16 hastada ASAS-40, 14 hastada ASAS-5/6, 10 hastada ASAS parsiyel remisyon ve 16 hastada BASDAI-50 yanıtları elde edildi. Ciddi yan etki nedeni ile tedaviyi bırakmak zorunda kalan hasta olmadı. 4 hastada enjeksiyon yeri reaksiyonu, 1 hastada eritem, 1 hastada bulantı-kusma şikayeti tespit edildi. Sonuç: Bulgularımız, etanercept tedavisinin AS’li hastalarda etkili olduğunu ve güvenle kullanılabileceğini göstermektedir.Öğe Ankilozan spondilitli hastalarda yaş ve cinsiyete göre düzeltilmiş göğüs ekspansiyonunun klinik pratikte kullanımı(Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 2011) Durmuş, Bekir; Altay, Zuhal; Baysal, Özlem; Ersoy, Yüksel; Hacıevliyagil, Süleyman Savaş; Baysal, Tamer; Aytemur, Zeynep Ayfer; Doğan, ErdalÖz: Amaç: Bu çalışmanın amacı; ankilozan spondilit (AS)’li hastalarda yaş ve cinsiyete göre düzeltilmiş göğüs ekspansiyonunun klinik pratikte kullanı mının uygun olup olmadığını ve göğüs ekspansiyonunun pulmoner fonk siyonlar ve hastalık şiddeti ile ilişkisini araştırmaktır. Gereç ve Yöntem: Çalışmaya 82 AS’li hasta ve 42 sağlıklı gönüllü alındı. Hastalar, yaş, cinsiyet ve düzeltilmiş göğüs ekspansiyonuna göre; göğüs ekspansiyonu kısıtlanmış ve kısıtlanmamış olmak üzere iki gruba ayrıldı. Hastalar, klinik parametrelere ek olarak, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI) ve Bath AS Metrology Index (BASMI) ile değerlendirildi. Bulgular: Zorlu vital kapasite ve 1. saniyedeki zorlu ekspiratuar hacim; göğüs ekspansiyonu kısıtlanmış hastalarda, kısıtlanmamış hastalar ve kont rol grubuna göre anlamlı derecede azalmış bulundu. Ağrı, BASFI ve BASMI skorları, göğüs ekspansiyonu kısıtlanmış grupta istatistiksel olarak anlamlı düzeyde yüksekti. Göğüs ekspansiyonu, klinik parametreler ve solunum fonksiyon testleri ile anlamlı derecede korele idi. Sonuç: AS’li hastalarda yaş ve cinsiyete göre düzeltilmiş göğüs ekspansi yonunun klinik pratikte kullanılmasının daha uygun olduğu ve göğüs eks pansiyonunun pulmoner fonksiyonlar ve hastalık şiddeti ile ilişkili olduğu kanısına varıldı. Türk Fiz Tıp Rehab Derg 2011;57: 128-33. Başlık (İngilizce): Clinical use of chest expansion corrected for age and sex in patients with ankylosing spondylitisÖğe Ankilozan spondilit’li erkek hastaların omurga deformitelerinin ve günlük yaşam kalitesinin değerlendirilmesi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2014) Canbay, Özden; Köse, Evren; Öner, Zülal; Altay, Zuhal; Ekinci, NihatAmaç: Postür, vücudun her hareketinde eklemlerin aldığı pozisyonların birleşimidir. Çalışmamızın amacı; Ankilozan Spondilit’li (AS) hastalarda postür analizine bakılarak omurga deformitelerinin belirlenmesi ve bunların AS’li hastaların günlük yaşam aktiviteleri ve kalitesi üzerine nasıl bir etkide bulunduğunun araştırılmasıdır. Gereç ve Yöntem: Çalışmaya 30 AS’li ve 30 sağlıklı birey alındı. Tüm bireylere postür analizi, SF-36 yaşam kalitesi değerlendirme anketi ve Beck Depresyon ölçeği uygulandı. Kaslarda kısalık ve kas kuvveti değerlendirildi. Bulgular: Postür analizi değerlendirmesi sonucunda hasta bireylerin torakal kifoz artışı, lumbal lordozda azalma, yuvarlak omuz, genu valgum ve pes planus deformitelerinin anlamlı oranda arttığı gözlendi. Vücut kitle indeksi ortalamaları ile postür analizi sonuçlarından servikal lordozda artış, düşük omuz ve genu varum açısından anlamlı bir fark bulunmadı. Belirli kas gruplarında ise kas kuvvetinde azalma ve kas kısalığı tespit edildi. Ankilozan spondilit’li hastalarda yaşam kalitesinin postüre bağlı olarak olumsuz etkilendiği belirlendi. Sonuç: Ankilozan spondilit’li hastalarda postürün bozulduğu, kaslardaki kısalığın hareketleri sınırlandırdığı ve buna bağlı olarak ortaya çıkan kas zayıflamasından dolayı yaşam kalitesinin düştüğü düşünülmektedir. Ayrıca eğitim seviyesi düşük olan bireylerin, hastalık hakkında yeterli bilgiye sahip olmadığı ve gereken önemi göstermedikleri görülmektedir.Öğe Atlanto odontoid osteoarthritis in rheumatoid arthritis dynamic CT findings(Clin Rheumatol, 2004) Baysal, Özlem; Baysal, Tamer; Sığırcı, Ahmet; Ersoy, Yüksel; Altay, ZuhalWe analyzed the CT appearances of degenerative change in the atlanto-odontoid joint (AOJ) in patients with rheumatoid arthritis (RA) and evaluated the effect of these changes on atlanto-axial joint (AAJ) rotation by dynamic CT. This revealed that 9 patients (24%) treated with methotrexate had degenerative features in the AOJ. The ratio of AAJ rotation to the total rotation of the cervical spine was significantly higher in normal subjects (54±3%) than in patients (38±12%). The degree of AAJ rotation was significantly lower in the patient group with degenerative features in the AOJ (20.9±8.4) than in patients without degenerative features (28.5±7.4). RA patients with a history of longstanding disease and treatment with antirheumatic drugs may develop AO OA. Although secondary OA was described as healing phenomena in the joints of RA patients, it can limit rotation in the AAJ and cause suboccipital neck pain. A regular check-up of the AAJ and AOJ by means of dynamic CT in all RA patients is proposed to avoid possible antirheumatic drug complications.Öğe Bel ağrısı olan hastalarda hot-pack, TENS, ultrasound ve egzersizin HAM-D skorlarına etkisi(Anadolu Psikiyatri Dergisi, 2000) Özcan, M. Erkan; Yurtsızoğlu, Özlem; Balki, Selvin; Altay, Zuhal; Eğri, MücahitÖz: Amaç: Bu çalışmada bel ağrısı olan hastalarda gözlenen depresif belirti ve bulguların fiziksel sağaltım yöntemlerine nasıl yanıt verdiği incelenmiştir. Yöntem: Lomber disk hernisi olan 42 hastaya bel ağrısını azaltmak ve ortadan kaldırmak amacıyla hot-pack, TENS, ultrasound ve egzersiz Yöntemleri uygulanmıştır. Bu yöntemlerin uygulanmasından önce ve sonra psikiyatrik muayene yapılarak HAM-D skorları elde edilmiştir. Sonuçlar: Üç haftalık fiziksel sağaltım uygulaması ile ortalama HAM-D skorları 20.815±7.508'ten 12.236±7.947'ye inmiştir (t=7,48, p<0.05). Tartışma; Bel ağrısı olan hastalarda gözlenen depresif belirti ve bulgular, antidepresan tedavi verilmediği halde, salt fiziksel sağaltım yöntemlerinin uygulanması ile önemli oranda azalmaktadır.Öğe Benign paroksismal pozisyonel vertigo tedavisinde semont ve modifiye epley manevralarının etkinliği ve brandt-daroff egzersizlerinin nüksleri önlemedeki etkisi(Fırat Tıp Dergisi, 2010) Durmuş, Bekir; Fırat, Yezdan; Yıldırım, Tülay; Kalcıoğlu, Tayyar; Altay, ZuhalÖz: Amaç: Bu çalışmanın amacı; BPPV'li hastalarda Semont ile Modifiye Epley manevrasının etkinliğini ve manevralardan sonra uygulanan Brandt-Daroff egzersizlerinin tekrarları önleyici etkisi olup olmadığını araştırmaktır. Gereç ve Yöntemler: Çalışmaya, tipik öykü ve Dix-Hallpike testi pozitif olan 17'si erkek, 29'u kadın 46 hasta alındı. Hastalar randomize olarak Semont ve Modifiye Epley Manevrası uygulananlar olmak üzere iki gruba ayrıldılar. Manevralar hastaların iyileşme durumuna göre en fazla üç kez uygulandı. Üçüncü manevradan sonra hastalar iki hafta süre ile Brandt-Daroff egzersizlerini uyguladılar. Hastalar manevradan sonra ve egzersiz uygulamasından sonra vertigonun kaybolması ve Dix-Hallpike testi ile değerlendirildiler. Hastalar 6 ay süre ile nüks açısından takip edildi. Bulgular: Semont manevrası uygulanan grupta birinci, ikinci ve üçüncü manevradan sonraki iyileşme oranları sırasıyla %65,2, %78,2 ve %87 idi. Modifiye Epley manevrası uygulanan grupta ise bu oranlar sırasıyla %73,9, %86,9 ve %91,3 idi. Gruplar arasında istatistiksel olarak anlamlı fark yoktu. Egzersiz sonrası iyileşme oranı Semont grubunda %92,3'e ulaşırken, Modifiye Epley grubunda hastaların tamamı iyileşti. Ancak altı ay sonunda Semont grubunda %19, Modifiye Epley grubunda ise %26,1 oranında vertigonun tekrarladığı görüldü. Sonuç: Semont ve Modifiye Epley manevralarının her ikisinin de BPPV tedavisinde oldukça etkili manevralar olduğu, Brandt-Daroff egzersizlerinin tekrarları önleyici etkisinin olmadığı sonucuna varıldı. Başlık (İngilizce): The efficacy of semont and modified epley maneuvers in benign paroxysmal positional vertigo and preventative effect of brandt-daroff exercises on recurrence Öz (İngilizce): Objective: The aim of this study is to investigate the efficacy of Semont and Modified Epley maneuvers in patients with benign paroxismal positional vertigo (BPPV) and the preventative effect of Brandt-Daroff exercises performed after the maneuvers on recurrence of BPPV. Materials and Methods: Fourty-six (17 male and 29 female) patients with a history and positive Dix-Hallpike test consistent with BPPV were entered in the study. Patients were randomly allocated to Semont and Modified Epley maneuvers applied groups. Maneuvers were completed if the patient responded with complete relief of BPPV after one to three sessions. All patients performed Brandt-Daroff vestibular habituation exercises for two weeks after maneuvers. Patients were evaluated with the presence and absence of vertigo and Dix-Hallpike test. For recurrence of BPPV, the patients were followed up for six months. Results: The recovery ratios for Semont maneuver applied group after first, second and third maneuvers were 65,2%, 78,2% and 87% respectively. The ratios for Modified Epley maneuver applied group were 73,9%, 86,9% and 91,3% respectively. There was no statistically significant difference between groups. After exercises, while the recovery ratio for Semont group reached to 92,3%, all of patients in Modified Epley group got recovered. After 6 months, vertigo was recurred in 19% and 26,1% of patients respectively in Semont and Modified Epley groups. Conclusion: It was concluded that both Semont and Modified Epley maneuvers are very effective maneuvers in the treatment of BPPV. Although Brandt-Daroff exercises have no preventative effect on recurrence of BPPV.Öğe Clinical Use of Chest Expansion Corrected for Age and Sex in Patients with Ankylosing Spondylitis(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2011) Durmus, Bekir; Altay, Zuhal; Baysal, Ozlem; Ersoy, Yuksel; Hacievliyagil, Suleyman Savas; Baysal, Tamer; Aytemur, Zeynep AyferObjective: The aim of this study was to investigate if the chest expansion corrected by age and sex was appropriate for clinical practice or not and to evaluate the relation of chest expansion with pulmonary functions and disease severity in patients with ankylosing spondylitis (AS). Metarials and Methods: Eighty-two patients with AS and 42 healthy controls were included in the study. The patients were divided into two groups according to chest expansion corrected by age and sex: restricted and non-restricted groups. Additional to the clinical evaluation, the Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Bath AS Metrology Index (BASMI) were used to evaluate disease activity functional impairment, and mobility respectively. Results: Forced vital capacity and forced expiratory volume in the first second were significantly decreased in the restricted group when compared to the non-restricted and control groups. Pain, BASFI, and BASMI scores were significantly higher in the restricted group compared to the non-restricted one. Chest expansion was significantly correlated with clinical parameters and pulmonary function tests. Conclusion: Chest expansion measurement corrected for age and sex is appropriate for clinical practice and chest expansion is associated with pulmonary functions and disease severity. Turk J Phys Med Rehab 2011;57:128-33.Öğe Discrimination ability of ASDAS estimating disease activity status in patients with ankylosing spondylitis(Wiley-Blackwell, 2010) Nas, Kemal; Yildirim, Kadir; Cevik, Remzi; Karatay, Saliha; Erdal, Akin; Baysal, Ozlem; Altay, ZuhalObjectives: To investigate discrimination ability of the Assessment of Spondyloarthritis International Society (ASAS) endorsed disease activity score (ASDAS) versions evaluating low and high disease activity in an unselected group of patients with ankylosing spondylitis (AS). Methods: Patients consecutively included into the joint database of five university hospitals were analyzed for low or high disease activity according to different criteria. Standardized mean differences (SMD) for two ASDAS versions were evaluated. Results: The ASDAS versions (back pain, morning stiffness, patient global pain, pain/swelling of peripheral joints, plus either erythrocyte sedimentation rate or C-reactive protein) discriminated high and low disease activity in subgroups according to Bath Ankylosing Spondylitis Disease Activity Score (BASDAI) and ASAS remission/partial remission criteria. ASDAS versions were also not influenced by peripheral arthritis and correlated well with other outcome measurements and acute-phase reactants. The ASDAS versions performed better than patient-reported measures or acute-phase reactants discriminating high and low disease activity status. Conclusion: Both ASDAS versions, consisting of both patient-reported data and acute-phase reactants, performed well in discriminating low and high disease activity. Further longitudinal data may better estimate the usefulness of ASDAS to assess disease activity subgroups and treatment response.Öğe Does vitamin D affect disease severity in patients with ankylosing spondylitis?(Chinese Medical Assoc, 2012) Durmus, Bekir; Altay, Zuhal; Baysal, Ozlem; Ersoy, YukselBackground Vitamin D has been found to have a role in the function of the immune system. There have been a lot of studies investigating a relation between vitamin D and disease activity in ankylosing spondylitis (AS). However, there have not been any studies arranging AS in groups according to vitamin D levels and determining any differences among these patients in terms of disease activity, functional status, quality of life, and other clinical parameters. The aim of this study is to compare 25-hydroxy-vitamin D3 (25(OH)D3) levels in AS patients with those in normal healthy subjects and to determine the relationship between 25(OH)D3 levels and AS disease activity, functional status, and quality of life. Methods Ninety-nine consecutive patients and 42 healthy volunteers were included in this study. After a comparison between the patient group and the control group, the patient group was divided into normal, insufficient and deficient subgroups according to the plasma 25(OH)D3 levels for another comparison. Results The differences in the 25(OH)D3 level between the patient and the control groups were statistically insignificant. The number of AS patients whose 25(OH)D3 levels were classified as normal, insufficient, and deficient were 34, 29, and 36, respectively. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Bath AS Disease Activity Index (BASDAI) scores were higher in the low (including insufficient and deficient) 25(OH)D3 level subgroups (P <0.05). The Bath AS Functional Index (BASFI) and AS Quality of Life (ASQoL) scores were significantly different between the normal and the deficient subgroups (P <0.05). Pain, BASDAI, ESR, and CRP were inversely correlated to the 25(OH)D3 levels (P <0.05). Conclusions The plasma 25(OH)D3 levels may decrease in AS patients and this may negatively affect disease activity, functional status and quality of life. Chin Med J 2012;125(14):2511-2515Öğe Effect of increase in cortisol level due to stress in healthy young individuals on dynamic and static balance scores(2018) Yıldız, Sedat; Altay, Zuhal; Özbağ, Davut; Çevirgen, Furkan; Sert, Deniz Şenol; Uçar, Cihat; Çay, MahmutAbstract: OBJECTIVE: Stress is a condition caused by various factors and characterized by imbalance in body functioning, impair in nervous system, and tension. The purpose of this study was to examine the effects of cortisol level, which increases in healthy young individuals due to stress, on dynamic and static balance scores as well as to present the results caused by high levels of stress. METHODS: In this study, 107 healthy medicine faculty students in their second year (who will take the same committee exam) aged between 19 and 23 years were included. The first balance measurements and saliva samples were taken 40 days before the committee exam, and this period was acknowledged as the relaxed period. The same students were considered for balance measurements again on the day of committee exam; saliva samples were collected, and cortisol concentration was determined. This period was acknowledged as the stressful period. The State-Trait Anxiety Inventory (STAI) was given to the participants in their relaxed and stressful periods. Dynamic balance scores were measured with Star Excursion Balance Test (SEBT). Static balance scores were measured with One Leg Standing Balance Test (OLSBT). RESULTS: The mean cortisol level was found to increase approximately 9 times in stressful periods compared with that in relaxed periods. STAI, which shows state anxiety, showed an increase supporting this increase. In stressful periods, dynamic balance scores showed obvious decrease in all directions. In addition, in stressful periods, an obvious decrease was observed in static balance scores compared with those in relaxed periods. CONCLUSION: This study showed that stress negatively affected dynamic and static balance, even for short periods of time. We believe that our study will form a positive source and basis when correlated with long terms stress and balance measurements.Öğe Effect of increase in cortisol level due to stress in healthy young individuals on dynamic and staticbalance scores(Kare publ, concord ıstanbul, dumlupınar mah, cıhan sk no 15, b blok 162 kadıkoy, ıstanbul, 00000, turkey, 2018) Cay, Mahmut; Ucar, Cihat; Senol, Deniz; Cevirgen, Furkan; Ozbag, Davut; Altay, Zuhal; Yildiz, SedatOBJECTIVE: Stress is a condition caused by various factors and characterized by imbalance in body functioning, impair in nervous system, and tension. The purpose of this study was to examine the effects of cortisol level, which increases in healthy young individuals due to stress, on dynamic and static balance scores as well as to present the results caused by high levels of stress. METHODS: In this study, 107 healthy medicine faculty students in their second year (who will take the same committee exam) aged between 19 and 23 years were included. The first balance measurements and saliva samples were taken 40 days before the committee exam, and this period was acknowledged as the relaxed period. The same students were considered for balance measurements again on the day of committee exam; saliva samples were collected, and cortisol concentration was determined. This period was acknowledged as the stressful period. The State-Trait Anxiety Inventory (STAI) was given to the participants in their relaxed and stressful periods. Dynamic balance scores were measured with Star Excursion Balance Test (SEBT). Static balance scores were measured with One Leg Standing Balance Test (OLSBT). RESULTS: The mean cortisol level was found to increase approximately 9 times in stressful periods compared with that in relaxed periods. STAI, which shows state anxiety, showed an increase supporting this increase. In stressful periods, dynamic balance scores showed obvious decrease in all directions. In addition, in stressful periods, an obvious decrease was observed in static balance scores compared with those in relaxed periods. CONCLUSION: This study showed that stress negatively affected dynamic and static balance, even for short periods of time. We believe that our study will form a positive source and basis when correlated with long terms stress and balance measurements.Öğe The effects of pre-obesity on quality of life, disease activity, and functional status in patients with ankylosing spondylitis(Kare Publ, 2017) Toy, Seyma; Ozbag, Davut; Altay, ZuhalOBJECTIVE: This study was an investigation of effects of pre-obesity on clinical characteristics and quality of life in patients with ankylosing spondylitis (AS). METHODS: Total of 28 AS patients and 30 age-and sex-matched healthy controls were included in the study. Patients and controls with any systemic inflammatory disease and/or cognitive and mental problems were excluded. Disease activity and functional capacity were measured using the Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index. For quality of life assessment, 36-Item Short Form Health Survey was used in both groups, and AS group also responded to Ankylosing Spondylitis Quality of Life questionnaire. RESULTS: There was no significant difference in sociodemographic characteristics between AS patients and healthy controls (p>0.05). Mean quality of life scores were significantly lower in the pre-obese AS patients compared with controls (p<0.05). Functional capacity was positively and significantly associated with body mass index (BMI) (p=0.024) and disease activity was significantly associated with female gender (p=0.011). CONCLUSION: Increased BMI in patients with AS is factor that affects quality of life, disease activity, and functional capacity. Multidisciplinary rehabilitation programs will support improved quality of life for pre-obese patients with AS.Öğe The effects of pre-obesity on quality of life, disease activity, and functional status in patients with ankylosing spondylitis (vol 4, pg 52, 2017)(Kare Publ, 2021) Toy, Seyma; Ozbag, Davut; Altay, Zuhal; Kavakli, Ahmet[Abstract Not Available]Öğe Effects of scapular stabilization exercises in patients of chronic neck pain with scapular dyskinesis: A quasi-experimental study(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2021) Ozdemir, Filiz; Toy, Seyma; Kizilay, Fatma; Avci, Zeynep Tugce; Altay, Zuhal; Colak, CemilObjectives: This study aims to investigate the effectiveness of scapular stabilization exercises in patients with chronic neck pain and scapular dyskinesis. Patients and methods: This single-center, prospective study included a total of 36 patients (17 males, 19 females; mean age: 41 +/- 12.8 years; range, 25 to 57 years) with chronic neck pain and scapular dyskinesis between April 2018 and September 2018. The patients were randomly assigned to three treatment groups. Group 1 (n=13) consisted of those receiving scapular stabilization exercises by a physiotherapy specialist control in addition to the routine physiotherapy and rehabilitation program; Group 2 (n=12) consisted of those receiving the routine physiotherapy and rehabilitation program in addition to scapular stabilization exercises in-home training program; and Group 3 (n=11) consisted of those receiving the routine physiotherapy and rehabilitation program alone. The assessments were made using the Visual Analog Scale (VAS) and Northwick Park Neck Pain Questionnaire (NPQ). Results: Significant differences were found in the pre- and post-treatment VAS scores, and Group 1 and Group 2 created this significant difference (p<0.05). A significant difference was also observed in the pre- and post-treatment NPQ scores among the groups (p<0.05). Group 1 showed the most significant improvement of the NPQ scores (p<0.05). Conclusion: Our study results suggest that addition of scapular stabilization exercises to the routine physiotherapy components may be an effective method for improving pain and functional results.Öğe Expert opinion and key recommendations for the physical therapy and rehabilitation of patients with ankylosing spondylitis(Wiley, 2012) Ozgocmen, Salih; Akgul, Ozgur; Altay, Zuhal; Altindag, Ozlem; Baysal, Ozlem; Calis, Mustafa; Capkin, ErhanAim: Physiotherapy is an integral part of the management of ankylosing spondylitis (AS) and there is a need for recommendations which focus on the rehabilitation of patients with AS. We aimed to develop recommendations for the physical therapy and rehabilitation of patients with AS based on the evidence and expertise. Methods: The Anatolian Group for the Assessment in Rheumatic Diseases (ANGARD) is a scientific group of Turkish academicians (physiatrists and rheumatologists) who are experts in the rehabilitation of patients with AS. A systematic literature search summarizing the current available physiotherapy and rehabilitation trials in AS were presented to the experts before a special 2-day meeting. Experts attending this meeting first defined a framework based on the main principles and thereafter collectively constructed six major recommendations on physiotherapy and rehabilitation in AS. After the meeting an email survey was conducted to rate the strength of the recommendations. Results: Six key recommendations which cover the general principles of rehabilitation in AS in terms of early intervention, initial and follow-up assessments and monitoring, contraindications and precautions, key advice for physiotherapy methods and exercise were constructed. Conclusion: These recommendations were developed using evidence-based data and expert opinion. The implementation of these recommendations should encourage a more comprehensive and methodical approach in the rehabilitation of patients with AS. Regular lifelong exercise is the mainstay of rehabilitation and there is a considerable need for well-designed studies which will enlighten the role of physical therapy in the management of AS.Öğe Femoral cartilage thickness measurements in healthy individuals: Learning, practicing and publishing with TURK-MUSCULUS(Ios Press, 2014) Ozcakar, Levent; Tunc, Hakan; Oken, Oznur; Unlu, Zeliha; Durmus, Bekir; Baysal, Ozlem; Altay, ZuhalBACKGROUND AND OBJECTIVES: Measurement of the femoral cartilage thickness by using in-vivo musculoskeletal ultrasonography (MSUS) has been previously shown to be a valid and reliable method in previous studies; however, to our best notice, normative data has not been provided before in the healthy population. The aim of our study was to provide normative data regarding femoral cartilage thicknesses of healthy individuals with collaborative use of MSUS. METHODS: This is across-sectional study run at Physical and Rehabilitation Medicine Departments of 18 Secondary and Tertiary Centers in Turkey. 1544 healthy volunteers (aged between 25-40 years) were recruited within the collaboration of TURK-MUSCULUS (Turkish Musculoskeletal Ultrasonography Study Group). Subjects who had a body mass index value of less than 30 and who did not have signs and symptoms of any degenerative/inflammatory arthritis or other rheumatic diseases, history of knee trauma and previous knee surgery were enrolled. Ultrasonographic measurements were performed axially from the suprapatellar window by using linear probes while subjects' knees were in maximum flexion. Three (mid-point) measurements were taken from both knees (lateral condyle, intercondylar area, medial condyle). RESULTS: A total of 2876 knees (of 817 M, 621 F subjects) were taken into analysis after exclusion of inappropriate images. Mean cartilage thicknesses were significantly lower in females than males (all p < 0.001). Thickness values negatively correlated with age; negatively (females) and positively (males) correlated with smoking. Men who regularly exercised had thicker cartilage than who did not exercise (all p < 0.05). Increased age (in both sexes) and absence of exercise (males) were found to be risk factors for decreased cartilage thicknesses. CONCLUSION: Further data pertaining to other countries would be interesting to uncover whether ethnic differences also affect cartilage thickness. Collaborative use of MSUS seems to be promising in this regard.Öğe Improvement in Work and Household Productivity for Patients with Rheumatoid Arthritis and Ankylosing Spondylitis Treated with Anti-TNFs in Routine Clinical Practice in Turkey(Wiley, 2015) Ataman, Sebnem; Kirnap, Mehmet; Seferoglu, Buminhan; Altay, Zuhal; Rezvani, Aylin; Kuru, Omer; Capkin, Erhan[Abstract Not Available]Öğe Injection Therapy in Patients with Lateral Epicondylalgia: Hyaluronic Acid or Dextrose Prolotherapy? A Single-Blind, Randomized Clinical Trial(Mary Ann Liebert, Inc, 2020) Apaydin, Hakan; Bazancir, Zilan; Altay, ZuhalObjective:To compare the effects of hyaluronic acid (HA) and dextrose prolotherapy (DPT) injections in patients with chronic lateral epicondylalgia (LE). Materials and Methods:Thirty-two patients with at least 6 months of signs and symptoms of LE were randomly allocated into two groups: an HA group (n = 16) and a DPT group (n = 16). HA injection was performed as a single dose of 30 mg/2 mL 1500 kDa high-molecular-weight preparation (baseline). DPT injection was administered with 15% dextrose solution in three doses (baseline, third week, and sixth week). Severity of pain using the visual analog scale score, grip strength with a hand dynamometer, and physical function as determined by the Quick-Disabilities of the Arm, Shoulder, and Hand (Q-DASH) score were determined. Results:DPT was favored over HA for improvements from 0 to 12 weeks for pain with activity (4.81 +/- 1.2 vs. 3.18 +/- 2.3;p = 0.04), pain at night (5.1 +/- 1.9 vs. 4.1 +/- 2.2;p = 0.03), and pain at rest (3.8 +/- 2.09 vs. 2.7 +/- 1.7;p = 0.04). Q-DASH scores improved significantly more from 0 to 12 weeks in the DPT group (43.5 +/- 17.6 vs. 28.4 +/- 13.4;p = 0.04). No between-group improvement was observed for grip pain (7.3 +/- 6.4 vs. 4.8 +/- 3.2;p = 0.38). Conclusions:HA and DPT injections were both effective in reducing pain and increasing grip strength and function in patients with chronic LE. DPT injection was more effective in the short term than HA injection, in terms of pain relief and functional outcome. The study was registered atClinicalTrials.govunder the identifier number NCT04395417.Öğe Isokinetic strength of the trunk flexors and extensors in ankylosing spondylitis(Ios Press, 2013) Durmus, Bekir; Sahin, Nilay; Baysal, Ozlem; Ersoy, Yuksel; Baysal, Tamer; Koca, Tuba Tulay; Altay, ZuhalBACKGROUND: Objective measurement of trunk muscles strength in ankylosing spondylitis (AS) may provide clinical information that can be used to evaluate functional disability. OBJECTIVE: To compare the isokinetic strength of trunk muscles in AS patients with healthy subjects. METHODS: Thirty-four patients with AS and thirty-one healthy subjects were enrolled. Patients with spinal ankylosis and bridged syndesmophytes in the lumbar and dorsal vertebrae were excluded. Trunk flexor and extensor strength was measured at: 60 and 90 degrees/sec. RESULTS: When compared with the control group, AS patients demonstrated 38% and 24% decrease in the extensor and flexor strength, respectively (p < 0.05). In addition, the flexor/extensor strength ratio was 1.0 and 0.8 in the patients and control subjects, respectively. CONCLUSIONS: In view of the relatively selective extensor weakness we recommend assessment of trunk muscle strength in these patients for guiding clinicians regarding possible reconditioning exercises in the early period of AS.Öğe Lower extremity isokinetic muscle strength in patients with Parkinson's disease(Elsevier Sci Ltd, 2010) Durmus, Bekir; Baysal, Ozlem; Altinayar, Sibel; Altay, Zuhal; Ersoy, Yuksel; Ozcan, CemalWe evaluated lower extremity isokinetic muscle strength to determine affected muscle groups and their dependence on movement velocity, and to establish the relationship between muscle strength and clinical severity, as well as muscle strength and falls, in Parkinson's disease (PD) Twenty-five patients diagnosed with PD and 24 healthy volunteers were enrolled in this study Lower extremity muscle strength was measured using an isokinetic dynamometer Each participant's clinical status was examined in accordance with the Unified Parkinson's Disease Rating Scale, fall history was also recorded We observed a significant decrease in isokinetic muscle strength in the patient group, especially in both hip and knee flexors and extensors Decreased muscle strength was independent of velocity, and col related with clinical severity and falls Movement velocity-independent lower extremity isokinetic muscle weakness has been observed in patients with PD, especially in the knee and hip joints The evaluation of isokinetic muscle strength may be a useful tool for the assessment of clinical severity and falls in PD (C) 2010 Elsevier Ltd All rights reserved
