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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 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 EFFECTIVENESS OF BACK SCHOOL FOR TREATMENT OF PAIN AND FUNCTIONAL DISABILITY IN PATIENTS WITH CHRONIC LOW BACK PAIN: A RANDOMIZED CONTROLLED TRIAL(Foundation Rehabilitation Information, 2011) Sahin, Nilay; Albayrak, Ilknur; Durmus, Bekir; Ugurlu, HaticeObjective: To evaluate the effectiveness of the addition of back school to exercise and,physical treatment modalities in relieving pain and improving the functional status of patients with chronic low back pain. Design: A randomized controlled trial. Patients: A total of 146 patients with chronic low back pain were enrolled in the study. Methods: Subjects were divided into 2 groups: the back school group received exercise, physical treatment modalities and a back school programme; and the control group received exercise and physical treatment modalities. Treatment efficacy was evaluated at the end of treatment and 3 months post-treatment, in terms of pain, measured with the Visual Analogue Scale, and functional status, measured with the Oswestry Low Back Pain Disability Questionnaire. Results: In both groups, Visual Analogue Scale and Oswestry Low Back Pain Disability Questionnaire were significantly reduced after therapy (p<0.01), but the difference between the scores at the end of treatment and 3 months post-treatment was not significant. There was a significant improvement in Visual Analogue Scale and Oswestry Low Back Pain Disability Questionnaire in the back school group compared with the control group at the end of therapy and 3 months post-treatment (p<0.05). Conclusion: The addition of back school was more effective than exercise and physical treatment modalities alone in the treatment of patients with chronic low back pain.Öğe THE EFFECTS OF KINESIO TAPING ON LATERAL EPICONDYLE PAIN AND HANDGRIP MUSCLE STRENGTH DURING TENNIS TOURNAMENT(Univ Zagreb, Fac Kinesiology, 2017) Kafkas, Muhammed Emin; Kafkas, Armagan; Durmus, Bekir; Acak, Mahmut[Abstract Not Available]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 Is it Complex Regional Pain Syndrome Type 1 or Inflammatory Arthritis? A Case Report(Galenos Yayincilik, 2011) Baysal, Ozlem; Altay, Zuhal Ergunay; Durmus, Bekir; Baysal, TamerComplex regional pain syndrome (CRPS) is a painful and disabling chronic progressive disease and its definition is subdivided into CRPS type I and CRPS type II. It can be seen with signs of inflammation such as pain, swelling, redness, as well as different symptoms and findings like sensory and motor dysfunctions and trophic changes. Therefore, it should be included in the differential diagnosis of painful conditions of the upper extremities. We report two cases of patients with CRPS type I with unknown etiologies who were misdiagnosed as inflammatory arthritis and also discussed in view of the literature. Turk J Phys Med Rehab 2011;57:45-50.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 reservedÖğe Pattern of Disease Onset, Diagnostic Delay, and Clinical Features in Juvenile Onset and Adult Onset Ankylosing Spondylitis(J Rheumatol Publ Co, 2009) Ozgocmen, Salih; Ardicoglu, Ozge; Kamanli, Ayhan; Kaya, Arzu; Durmus, Bekir; Yildirim, Kadir; Baysal, OzlemObjective. To assess the frequency of juvenile onset ankylosing spondylitis (JOAS) in Turkish patients with AS and to compare with adult onset AS (AOAS) in a cross-sectional study design. Methods. A total of 322 patients were recruited from the joint database of 5 university hospitals in eastern Turkey. Results. Patients with JOAS (n = 43, 13.4%) had significantly longer diagnostic delay (9.21 vs 5.08 yrs), less severe axial involvement and more prevalent uveitis (OR 2.92, 95% Cl 1.25-6.79), and peripheral involvement at onset (OR 3.25, 95% CI 1.51-6.98, adjusted for current age; and OR 2.26, 95% CI 1.07-4.76, adjusted for disease duration). Patients with AOAS had higher radiographic scores and more restricted clinimetrics but similar functional limitations and quality of life. Conclusion. JOAS and AOAS had distinctive courses and Turkish patients with AS had similar features compared to other Caucasian patient Populations. (First Release Nov 1 2009; J Rheumatol 2009;36:2830-3; doi: 10.3899/jrheum.090435)Öğe The performance of psoriatic arthritis classification criteria in Turkish patients with psoriatic arthritis(Wiley, 2017) Nas, Kemal; Karkucak, Murat; Durmus, Bekir; Ulu, Mehmet Ali; Karatay, Saliha; Capkin, Erhan; Ulusoy, HasanObjectivesTo investigate performance of some of the published psoriatic arthritis (PsA) classification criteria as well as Assessment of Spondyloarthritis International Society (ASAS) criteria for peripheral spondyloarthritis (SpA) in Turkish patients with PsA (in early and late disease subgroups). MethodsPatients were recruited using case report forms and physical examination methods proposed by the Anatolian Group for the Assessment in Rheumatic Diseases (ANGARD). The Moll and Wright (MW), modified Fournie (MF), modified McGonagle (mMG), Vasey and Espinoza (VE), classification of PsA (CASPAR) criteria and ASAS criteria were assessed in patients with PsA who were diagnosed based on expert opinion. ResultsOne hundred and twenty-eight patients with PsA (58 male, 70 female, mean age 41.8years) were included. Thirty patients were in the early PsA and 98 patients were in the late PsA groups. Diagnostic delay was 2.6years. In the 15.6% of patients arthritis developed before the skin findings. The proportion of patients fulfilling the MW, MF, mMG, VE, CASPAR and ASAS criteria were at a ratio of 90.6%, 82.8%, 62.5%, 84.4%, 96.1% and 76.5%, respectively. In early PsA (< 12months disease duration) the proportions were 93.4%, 83.3%, 76.7%, 76.7%, 96.7% and 66.6%, respectively. On the other hand, in late PsA the proportions were 89.8%, 82.6%, 57.1%, 86.7%, 95.9%, 79.5%, respectively. ConclusionsEven though the sensitivity of PsA classification criteria in Turkish patients changes, the CASPAR criteria seems to be more prominent among all criteria for both early and late cases with its high sensitivity.Öğe Postural stability in patients with ankylosing spondylitis(Taylor & Francis Ltd, 2010) Durmus, Bekir; Altay, Zuhal; Ersoy, Yuksel; Baysal, Ozlem; Dogan, ErdalPurpose. The aim of this study is to determine whether the postural changes in ankylosing spondylitis (AS) affected postural stability. Method. A total of 64 patients with a diagnosis of AS and 50 healthy volunteers were included in the study. The patients were divided into two groups according to a tragus-to-wall distance <15 cm (Group I, n = 30) and >= 15 cm (Group II, n = 34). The control group (Group III) consisted of 50 healthy volunteers. The postural stability was evaluated with the Biodex Stability System (BSS). The results of Antero-Posterior Stability Index (APSI), Medio-Lateral Stability Index (MLSI) and Overall Stability Index (OSI) were evaluated. Results. There were statistically significant differences between the three groups for OSI, APSI and MLSI. MLSI results were significantly different among patient groups. When Group II and the control group were compared, there were significant differences for OSI, APSI, and MLSI. Comparing Group I with the control group revealed a more significant difference for OSI, APSI, and MLSI. Conclusions. We have found that postural stability decreases in patients with AS in both the early and the late stages of the disease, but especially in the latter ones. This result may be thought to be related with increased kyphosis which is seen during the course of the disease.Öğe Predictive Effects of Different Clinical Balance Measures and the Fear of Falling on Falls in Postmenopausal Women Aged 50 Years and Over(Karger, 2009) Ersoy, Yuksel; MacWalter, Ronald S.; Durmus, Bekir; Altay, Zuhal E.; Baysal, OzlemBackground: Falls among the elderly are associated with a high morbidity and mortality and can involve high-cost medical interventions. The risk of falls often remains undiagnosed until an episode occurs but if the risk is high, preventative measures could be introduced. Objectives: This 6-month prospective study investigated whether different postural clinical measures and fear of falling (FOF) itself can predict future falls in postmenopausal women aged >= 50 years. Methods: 125 postmenopausal women were studied comparing the outcome of fallers vs. non-fallers within the 6-month follow-up study period. Clinical measures, history of falls and FOF data were determined at baseline and the number of falls and FOF were ascertained at the final visit or by telephone interview at 6 months. Results: Of the clinical measures investigated, the Falls Efficacy Scale International (FES-I) >26 points (OR = 7.28, per additional point, 95% CI 2.25-23.61, p = 0.001) and Berg Balance Scale (BBS) <= 52 points (OR = 4.77, per additional point, 95% CI = 1.15-19.82, p = 0.031) performed best in prediction of the future falls. Conclusions: Postmenopausal women aged >= 50 years who had FES-I scores >26 points and BBS <= 52 points should be examined for risk factors of future falls and offered preventative measures. Copyright (C) 2009 S. Karger AG, BaselÖğe Prevalence of atopic disorders in rheumatic diseases(Springer, 2013) Karatay, Saliha; Yildirim, Kadir; Ugur, Mahir; Senel, Kazim; Erdal, Akin; Durmus, Bekir; Baysal, OzlemThe aim of this study was to assess the point prevalences of hay fever, asthma, and atopic dermatitis in OA, RA, and AS, and to compare with healthy controls. A total of 935 patients and healthy controls were included. Demographic and clinical features were recorded, and a questionnaire assessing the existence of atopic disorders like asthma, hay fever, and atopic dermatitis in all groups was applied. Either atopy implied that an individual was either diagnosed with or had symptoms of one or more of these disorders, such as asthma, hay fever, or atopic dermatitis. When compared to the controls, only patients with AS had an increased risk for hay fever (OR 1.52, 95 % CI 1.00-2.41). Patients with RA had increased risks for hay fever, atopic dermatitis, and either atopy compared to the patients with OA (2.14, 95 % CI 1.18-3.89; 1.77, 95 % CI 1.00-3.18; and 3.45, 95 % CI 1.10-10.87, respectively). Steroid use had no effect on the prevalence of atopic disorders in patients with RA. Patients with OA, RA, and AS seem to have similar risks for asthma, atopic dermatitis, and either atopy to healthy controls. However, the prevalence of hay fever may increase in AS. Patients with RA have a higher risk of atopy than patients with OA.Öğe Relationship between psychological status and disease activity and quality of life in ankylosing spondylitis(Springer Heidelberg, 2011) Baysal, Ozlem; Durmus, Bekir; Ersoy, Yuksel; Altay, Zuhal; Senel, Kazim; Nas, Kemal; Ugur, MahirOur aim in this study was to compare the depression and anxiety risk in patients with AS and healthy controls and also to determine the relationship between disease activity, quality of life and psychological well-being. Two hundred and forty-three patients with ankylosing spondylitis (AS) and 118 age-, sex- and education-matched healthy controls were enroled into the study. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Functional Index, and Metrology Index, Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S), Hospital Anxiety and Depression Scale (HADS) including depression subscale (HADS-D) and anxiety subscale (HADS-A), Ankylosing Spondylitis Quality of Life (ASQoL) Scale, duration of morning stiffness, pain-visual analogue scale (VAS), patient and physician's global assessment of disease activity (100 mm VAS) were used to assess clinical and psychological status. Patients had similar HADS-D but higher HADS-A than healthy controls. Patients with high risk for depression and anxiety had higher scores in BASDAI, BASFI and also poorer scores in VAS pain, patient global assessment, physician global assessment, HAQ-S and ASQoL. There was a negative correlation of HADS-D and HADS-A scores with educational level of the patients. Higher scores in HADS-D and HADS-A indicated poorer functional outcome and quality of life. Multivariate logistic regression analysis revealed that the HADS-D (OR = 6.84), HAQ-S (OR = 1.76), VAS pain score (OR = 1.03) and ESR (OR = 1.02) were independent risk factors for higher anxiety scores whereas HADS-A (OR = 1.36) and ASQoL (OR = 1.24) were independent risk factors for higher depression scores. The psychological status had close interaction with disease activity and quality of life in patients with AS.
