Browsing by Subject "REHABILITATION"
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Item Turkish League Against Rheumatism National Recommendations for the Management of Ankylosing Spondylitis(TURKISH LEAGUE AGAINST RHEUMATISM) Bodur, H; Sivas, F; Yilmaz, Ö; Özgöçmen, S; Günaydin, R; Kaya, T; Ataman, S; Altan, L; Altay, Z; Aydog, E; Birtane, M; Borman, P; Bugdayci, DS; Bütün, B; Çakirbay, H; Duruöz, T; Gürer, G; Hepgüler, S; Kamanli, A; Kuru, Ö; Küçükdeveci, A; Nacir, B; Ölmez, N; Rezvani, A; Yanik, BÇObjectives: To develop Turkish League Against Rheumatism (TLAR) National Recommendations for the management of ankylosing spondylitis (AS). Materials and methods: A scientific committee of 25 experts consisting of six rheumatologists and 19 physical medicine and rehabilitation specialists was formed by TLAR. Recommendations were based on the 2006 ASsessment in Ankylosing Spondylitis International Working Group(ASAS)/European League Against Rheumatism (EULAR) recommendations and a systematic review of associated publications between January 2005 and September 2010. A Delphi process was used to develop the recommendations. Twelve major recommendations were constructed for the management of AS. Voting using a numerical rating scale assessed the strength of each recommendation. Results: The 12 recommendations include patient assessment, patient follow-up along with pharmacological and non-pharmacological methods. Some minor additions and changes have been made to the ASAS/EULAR recommendations. All of the recommendations had sufficient strength. Conclusion: National recommendations for the management of AS were developed based on scientific evidence and consensus expert opinion. These recommendations will be updated regularly in accordance with recent developments.Item Applying the WHO ICF framework to long COVID patients with persistent respiratory symptoms(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK) Köseoglu, BF; Tur, BS; Gökkaya, NKO; Gökmen, IG; Kesiktas, FN; Kaya, BB; Önal, R; Tuncay, F; Genç, A; Findikoglu, G; Dogan, SK; Sütbeyaz, ST; Sarikaya, S; Tikiz, C; Özdemir, H; Kabayel, DD; Atar, MO; Atan, T; Selcen, YObjectives: The aim of this study was to evaluate long COVID patients with persistent respiratory symptoms through the application of the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) framework.Patients and methods: This national, prospective, multicenter, cross-sectional study was conducted with 213 patients (118 females, 95 males; median age 56 years; range, 20 to 85 years) with long COVID between February 2022 and November 2022. The ICF data were primarily collected through patient interviews and from the acute medical management records, physical examination findings, rehabilitation outcomes, and laboratory test results. Each parameter was linked to the Component Body Functions (CBF), the Component Body Structures (CBS), the Component Activities and Participation (CAP), the Component Environmental Factors (CEF), and Personal Factors according to the ICF linking rules. Analysis was made of the frequency of the problems encountered at each level of ICF category and by what percentage of the patient sample.Results: In the ICF, 21 categories for CBF, 1 category for CBS, and 18 categories of CAP were reported as a significant problem in a Turkish population of long COVID patients with persistent respiratory symptoms. Furthermore, eight categories for CEF were described as a facilitator, and four as a barrier.Conclusion: These results can be of guidance and provide insight into the identification of health and health-related conditions of long COVID patients with persistent respiratory symptoms beyond the pathophysiological aspects, organ involvement, and damage of COVID-19. The ICF can be used in patients with long COVID to describe the types and magnitude of impairments, restrictions, special needs, and complications.Item Tension Adjusted Multivectorial Static Suspension With Plantaris Tendon in Facial Paralysis(LIPPINCOTT WILLIAMS & WILKINS) Yoleri, L; Güngör, M; Usluer, A; Çelik, DFacial paralysis in the midface causes loss of cheek tonus, asymmetry at rest, and inability to smile. Static suspension is generally performed in patients who cannot tolerate time-consuming dynamic reanimation. Current methods for static slings are overly simplistic. A sling, which is generally fascia lata or palmaris tendon, is placed between the modiolus and the zygomatic arch or the temporalis fascia, with further extension to the midline of the upper end lower lips in 1 vector. Recently, sutures are placed in a multivectorial approach, but suture failure via breakage is the main problem. In this study, the long, thin, and powerful plantaris tendon was used and divided into 3 slips. Placement of these slips and their tension adjustment were revised to provide strong and long-lasting upper lip and the modiolus pull, along with creation of a well-defined nasolabial fold, and to create sufficient cheek tonus. The first slip was positioned at 35 to 45 degrees to the horizontal plane between the modiolus and the upper preauricular area, second slip at 55 to 60 degrees between the upper lip and the deep temporal fascia, and the third slip at 0 to 10 degrees between the lower lip and lower preauricular area with gradually decreasing tension from above to below in 9 patients. Upper 2 slings were also sutured to the dermis of the nasolabial fold to define it optimally. Results were assessed both objectively and subjectively. Symmetry at rest, sufficient cheek tightness to prevent drooling, and a well-defined fold were obtained.Item Demographic and clinical characteristics of inpatient stroke patients in Turkey(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK) Külcü, DG; Kuran, B; Karahan, AY; Özgirgin, N; Basaran, S; Yaliman, A; Savas, S; Tikiz, C; Aktas, I; Bardak, A; Tuncer, T; Yilmaz, F; Erhan, B; Sirzai, H; Çelik, B; Durlanik, G; Dogu, B; Öncü, J; Hüner, B; Öztürk, G; Eskiyurt, N; Akpinar, FM; Özkan, FU; Paker, N; Bugdayci, DS; Gündüz, B; Satir, Ö; Atalay, NS; Yildiz, N; Altindag, Ö; Demir, SE; Kaya, E; Uçar, D; Sari, A; Karatas, GK; Taskiran, ÖÖObjectives: This study aims to assess the stroke rehabilitation facilities provided by university hospitals (UHs) and training and research hospitals (TRHs) and to evaluate the geographical disparities in stroke rehabilitation. Patients and methods: Between April 2013 and April 2014 a total of 1,529 stroke patients (817 males, 712 females; mean age: 61.7 +/- 14.0 years; range, 12 to 91 years) who were admitted to the physical medicine and rehabilitation clinics in 20 tertiary care centers were retrospectively analyzed. Demographic, regional and clinical characteristics, details of rehabilitation period, functional status, and complications were collected. Results: The median duration of stroke was five (range, 1 to 360) months. The ratio of the patients treated in the TRH in the Marmara region was 77%, but only 25% of the patients were living in the Marmara region. Duration of hospitalization was longer in the TRHs with a median of 28 days compared to those of UHs (median: 22 days) (p<0.0001). More than half of the patients (55%) were rehabilitated in the Marmara region. Time after stroke was the highest in the Southeast region with a median of 12 (range, 1 to 230) months and the lowest in the Aegean region with a median of four (range, 1 to 84) months. Conclusion: This study provides an insight into the situation of stroke rehabilitation settings and characteristics of stroke patients in Turkey. A standard method of patient evaluation and a registry system may provide data about the efficacy of stroke rehabilitation and may help to focus on the problems that hinder a better outcome.Item LIMPRINT Study: The Turkish Experience(MARY ANN LIEBERT, INC) Borman, P; Moffatt, C; Murray, S; Yaman, A; Denizli, M; Dalyan, M; Unsal-Delialioglu, S; Eyigör, S; Ayhan, F; Çakit, BD; Vural, S; Özdemir, O; Kurt, E; Çelik, EC; Cerrahoglu, L; Kepekçi, M; Terzioglu, F; Donmez, AABackground: Lymphedema and chronic edema is a major health care problem in both developed and nondeveloped countries The Lymphoedema Impact and Prevelance - International (LIMPRINT) study is an international health service-based study to determine the prevalence and functional impact in adult populations of member countries of the International Lymphoedema Framework (ILF). Methods and Results: A total of 1051 patients from eight centers in Turkey were recruited using the LIMPRINT study protocol. Data were collected using the core and module tools that assess the demographic and clinical properties as well as disability and quality of life (QoL). Most of the Turkish patients were recruited from specialist lymphedema services and were found to be women, housewives, and having secondary lymphedema because of cancer treatment. The duration of lymphedema was commonly <5 years and most of them had International Society of Lymphology (ISL) grade 2 lymphedema. Cellulitis, infection, and wounds were uncommon. The majority of patients did not get any treatment or advice before. Most of the patients had impaired QoL and decreased functionality, but psychological support was neglected. Although most had social health security access to lymphedema centers, nevertheless access seemed difficult because of distance and cost. Conclusion: The study has shown the current status and characteristics of lymphedema patients, treatment conditions, the unmet need for the diagnosis and treatment, as well as burden of the disease in both patients and families in Turkey. National health policies are needed for the prevention, diagnosis, and treatment in Turkey that utilize this informative data.Item Factors determining the response to treatment in patients with vestibular migraine(TAYLOR & FRANCIS LTD) Ak, AK; Çelebisoy, N; Özdemir, HN; Gökçay, F; Durmaz, GS; Karti, DT; Toydemir, HE; Yayla, V; Isikay, AIÇ; Erkent, I; Özçelik, P; Akdal, G; Ataç, C; Biçakci, S; Ozaydin-Göksu, E; Uyaroglu, FGPurpose To find out clinical features associated with poor response to treatment in vestibular migraine (VM) Methods VM patients treated with drugs recommended in migraine prophylaxis were included in this multicenter study. Migraine features including type, age of onset of headache and vertigo attacks, attack frequency, intensity, associated symptoms, triggering factors, presence of interictal dizziness/imbalance, anxiety, depression, history of motion sickness, and family history of migraine were noted. Amitriptyline, flunarizine, propranolol, topiramate and venlafaxine were chosen depending on patients' individual requirements. Maximum dose of each drug was tried for 2 months to decide its efficacy. In the case of inefficacy, it was changed with another preventive drug of different class. If there was still no improvement, two drugs of different classes were combined. >= 50% reduction in attack frequency and severity in patients using one drug and a combination of two drugs was compared, with patients showing <50% reduction despite combination therapy, regarding their clinical features. Results The results of 430 VM patients, 65 men and 365 women with a mean age of 42.2 +/- 12.2 years (range: 17-74 years), were analyzed. Conclusion Cutaneous allodynia frequently associated with female sex, comorbid anxiety and depression and interictal dizziness/imbalance enhanced with comorbid anxiety were risk factors for reduced treatment response. Aural fullness might be the clue of impending concomitant Meniere's disease not responding to migraine preventives.Item Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part I: Management, Diagnosis, and Follow-up(SPRINGER) Umay, E; Eyigor, S; Ertekin, C; Unlu, Z; Selcuk, B; Bahat, G; Karahan, AY; Secil, Y; Gurcay, E; Kiylioglu, N; Keles, BY; Giray, E; Tikiz, C; Gezer, IA; Yaliman, A; Sen, EI; Vural, M; Saylam, G; Akaltun, MS; Sari, A; Alicura, S; Karaahmet, F; Inanir, M; Demirhan, A; Aydeniz, B; Bilgilisoy, M; Yuksel, A; Ozcete, ZA; Calik, Y; Alemdaroglu, E; Keskin, D; Sahin, S; Oztekin, MF; Sezgin, B; Karaahmet, O; Bengisu, S; Gokler, TY; Mercimekci, SDysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic, and as in our country, there may not be specialists specific for dysphagia, such as speech-language pathologists (SLP), in every hospital. This study aimed to raise awareness and create a common opinion of medical specialists for stroke patients with dysphagia. This recommendation paper has been written by a multidisciplinary team and offers 45 recommendations for stroke patients with dysphagia. It was created using the eight-step Delphi round via e-mail. This study is mostly specific to Turkey. However, since it contains detailed recommendations from the perspective of various disciplines associated with stroke, this consensus-based recommendation paper is not only a useful guide to address clinical questions in practice for the clinical management of dysphagia in terms of management, diagnosis, and follow-up, but also includes detailed comments for these topics.Item The importance of motor functional levels from the activity limitation perspective of ICF in children with cerebral palsy(LIPPINCOTT WILLIAMS & WILKINS) Mutlu, A; Akmese, PP; Gunel, MK; Karahan, S; Livanelioglu, AOur purpose in this study was to evaluate performance and capacity as defined by Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) from the 'activity limitation' perspective of International Classification of Functioning, Disability, and Health (ICF) and to investigate the relationship between the two classification systems in different subtypes of cerebral palsy (CP). This prospective cross-sectional study was performed on 448 children with CP ranging from 4 to 15 years of age. Activity limitations were studied with the GMFCS for gross motor function and MACS for manual ability. The Spearman's correlation coefficient, contingency coefficient, and Cramer's V coefficient were used to assess the strength and significance of the association between GMFCS and MACS. The overall agreement between GMFCS and MACS was found to be 41%. The agreement was 42% in spastic children, 40% in dyskinetic children, 50% in ataxic children, and 28% in mixed type children. The overall kappa value was kappa=0.235 (P<0.001). The kappa coefficient was 0.252 in spastic children, 0.245 in dyskinetic children, 0.318 in ataxic children, and 0.023 in mixed type children. All the kappa coefficients except the value for the mixed type were found to be significant. The usage of two different classification systems, GMFCS and MACS, to describe the capacity and performance in children with CP as defined by the ICF provides an easy and quick classification tool for indicating 'activity limitations' of ICF in children with CP. The next step in research should be to highlight the other domains such as participation restrictions in these children.