Elli-altmış beş yaş arasındaki postmenopozal Türk kadınlarda, vücut kompozisyonu ve el kavrama gücünün, aksiyal kemik mineral yoğunluğuna etkisi: Yağsız vücut kitlesi belirleyici midir?

Amaç: Postmenopozal kadınlarda, vücut kitle indeksi (VKİ), yağsız vücut kütlesi, yağ kütlesi, ve el kavrama gücü, kemik mineral yoğunluğunun (KMY) belirleyicileridir. Bu çalışmanın amacı, 50 yaş ve üstü kadınlarda, VKİ, vücut kompozisyonu, ve el kavrama gücünün, lomber ve femoral boyun bölgesi KMY üzerine etkisini araştırmaktır. Gereç ve Yöntem: Yaşları 50-65 (55,6±3,9) arasında olan 161 kadın hasta çalışmaya alındı. Kemik mineral yoğunluğu ve vücut kompozisyonu DEXA ile ölçüldü (Norland XR-46). El kavrama gücü JAMAR el dinamometresi ile değerlendirildi. Spearman korelasyon katsayıları hesaplandı. Çeşitli değişkenlerin KMY ile olası ilişkisi açısından multipl lineer regresyon analizi uygulandı. Bulgular: Yağsız vücut kitlesiyle yaş arasında negatif korelasyon saptandı. Yağsız vücut kitlesi lomber ve femur boyun bölgesi ile korele idi. Yağsız vücut kütlesi aynı zamanda el kavrama gücü ve VKİ ile korele idi. El kavrama gücü, yaş ve menopoz süresi ile negatif olarak korele idi. Sonuç: Yağsız vücut kitlesi ve el kavrama gücünün yaşa bağlı olarak azalması, 50-65 yaş arası kadınlarda KMY azalması ile ilişkilidir. Bu yüzden, bu hastalarda, egzersiz ile yağsız vücut kitlesi arttırılmalıdır.Objective: Body mass index, lean mass, fat mass and peripheral muscle strength are often found the determinants of bone mineral density (BMD) in postmenopausal women. The aim of the present study is to investigate the effect of body mass index, body composition and hand grip strength on femoral neck and lumbar spine in postmenopausal women aged 50-65 years. Materials and Methods: We studied 161 women aged 50-65 (55.6±3.9) years. Bone mineral density and body composition were measured by DEXA (Norland X-R 46). Hand grip strength was measured by JAMAR hand held dynamometer. Spearman's correlation's coefficients were calculated. Multiple linear regressions were performed using all variables possibly associated with BMD. Results: Lean mass was correlated negatively with age. Lean mass was correlated with lumbar spine and femoral neck BMD. It was also correlated with hand grip strength and body mass index. Hand grip strength was correlated negatively with age and years since menopause. Conclusion: These results suggest that, age related decline of lean mass and grip strength are associated with the decline of BMD in postmenopausal women aged 50-65 years. Therefore, we encourage these patients to increase lean mass by exercise

The effects of robotic and conventional gait training in addition to neurodevelopmental treatment on balance, mobility, and health-related quality of life in patients with stroke

Objective: The aim of this study was to investigate the eects of robotic and conventional gait training in addition to neuro-logic rehabilitation programs based on neuro-developmental therapy (NDT-Bobath) principles on balance, mobility, and quality of life in patients with stroke. Methods: A total of 64 patients with chronic stroke were included in the study. All patients participated in the neurologic rehabilitation program based on NDT-Bobath principles. Thirty-two patients had robotic gait training in addition, whereas the other 32 patients had conventional gait training in addition. After recording the demographic data, the Timed-Up and Go Test, Rivermead Mobility Index, Berg Balance Test, and Nottingham Health Prole were used to assess the balance, mobility, and quality of life. All patients had 30 sessions of NDT-Bobath therapy. In addition to the NDT-Bobath therapy, patients in the robotic gait group participated in total of 15 sessions of robotic gait training, 3 times per week, and the other group had 15 sessions of conventional gait training, 3 times per week. All assessments were repeated after the treatment. Results: There were signicant improvements (p0.05). Conclusions: Both conventional and robotic gait training in addition to NDT-Bobath therapy are eective in the rehabilitation of patients with stroke in terms of balance, mobility, and quality of life, and their application in clinical setting is reliable

The effects of robotic and conventional gait training in addition to neurodevelopmental treatment on balance, mobility, and health-related quality of life in patients with stroke

Objective:The aim of this study was to investigate the effects of robotic and conventional gait training in addition to neurologic rehabilitation programs based on neuro-developmental therapy (NDT-Bobath) principles on balance, mobility, and quality of life in patients with stroke. Methods: A total of 64 patients with chronic stroke were included in the study. All patients participated in the neurologic rehabilitation program based on NDT-Bobath principles. Thirty-two patients had robotic gait training in addition, whereas the other 32 patients had conventional gait training in addition. After recording the demographic data, the Timed-U p and Go Test, Rivermead Mobility Index, Berg Balance Test, and Nottingham Health Profile were used to assess the balance, mobility, and quality of life. All patients had 30 sessions of NDT-Bobath therapy. In addition to the NDT-Bobath therapy, patients in the robotic gait group participated in total of 15 sessions of robotic gait training, 3 times per week, and the other group had 15 sessions of conventional gait training, 3 times per week. All assessments were repeated after the treatment. Results: There were significant improvements (p<0.05) in balance, mobility, and quality of life between baseline and after treatment in both groups. After comparing the obtained differences in all parameters between baseline and after treatment, no difference was found between the groups (p>0.05). Conclusions: Both conventional and robotic gait training in addition to NDT-Bobath therapy are effective in the rehabilitation of patients with stroke in terms of balance, mobility, and quality of life, and their application in clinical setting is reliable

Serum IGF-1 and IGFBP-3 Levels in Middle Aged Turkish Males: Relationships with Bone Mineral Density and Markers of Bone Turnover (Male Osteoporosis & IGF-1, IGFBP-3) - Original Investigation

Aim: The aim of this study was to determine whether circulating levels of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) were associated with bone mineral density (BMD) and bone turnover markers in middle aged Turkish males. Patients and Methods: At the beginning, a total of 160 Turkish men aged between 35 and 65 years were included to this study. The final sample comprised of 112 men because 48 men were excluded from the study. BMD of the spine and the hip was measured with dual energy x-ray absorptiometry. After an overnight fasting, serum IGF-1, IGFBP-3, intact parathyroid hormone, 25-hydroxy vitamin D, osteocalcin, C-terminal telopeptide, calcium, phosphorous and alkaline phosphatase levels were measured. Urinary concentrations of calcium, phosphorous and creatinine were also estimated. Results: Twenty-one men (18.8%) had a bone mineral density of ≤ -2.5 SD (T score). There was a significant difference in IGF-1 levels between men with normal BMD and men with reduced BMD (132.5 ± 38.1 and 116.1 ± 40.6 respectively and p: 0.04). Serum IGF-1 levels were positively correlated with BMD of the lumbar spine (r: 0.28, p:0.006), but there was no correlation between IGFBP-3 and BMD of any sites tested. IGF-1, IGFBP-3 and BMD were not correlated with bone turnover markers except serum alkaline phosphatase level. Conclusion: Serum IGF-1 levels were lower in men with reduced BMD and positively correlated with BMD of the lumbar spine. Neither IGF-1 nor IGFBP-3 was correlated with bone turnover markers. Further studies of these factors in skeletal cells are needed to explain their role in the pathophysiology of idiopathic male osteoporosis. (From the World of Osteoporosis 2007;13:37-43

Are Bioactive and Free Sex Steroids Associated with Bone Mineral Density and Bone Turnover Markers in Middle Aged Men? - Original Investigation

Aim: To investigate whether bioactive and free sex steroids are associated with bone mineral density (BMD) and bone turnover markers in middle aged men. Material and Methods: One hundred and fifteen out of 165 volunteers aged 35-65 years presenting to our outpatient clinic were included in the study. Serum albumin, total testosterone (T), total estradiol (E2), SHBG, osteocalcin (OC) and C-terminal telopeptide (CTx) levels were measured. Free and bioactive sex steroids, free androgen index (FAI) and free estrogen index (FEI) were calculated. BMD in the lumbar spine and the hip was measured in all participants and effects of sex steroids on BMD and bone turnover markers were investigated. Results: The mean age and the mean body mass index (BMI) in all participants were 52.4±7.8 years and 26.1±3.4 kg/m2 respectively. There was no significant difference in sex hormone levels and bone turnover markers between the individuals with osteoporosis and osteopenia and the individuals with normal BMD (p>0.05). There was a significant relation between age and FAI (r=-0.23, p=0.01), but there was no significant relation between age and bioactive and free sex steroids, FEI and SHBG. However, there was a positive correlation between BMI and bioactive E2 (r=0.35, p:0001), free E2 (r=0.29, p:0.002) and FEI (r=0.39, p=0.0001). After an adjustment for variables effective on BMD was made; no relation was found between BMD measures from the lumbar spine and the hip and serum bioactive sex steroids, free sex steroids, FAI, FEI and SHBG (p>0.05). However, there was a weak positive relation between serum bioactive T, FEI and OC, CTx levels (p=0.05). Conclusion: We think that bioactive and free sex steroids are not independent variables effective on BMD in the spine and the hip in middle aged men and that further studies are needed to elucidate the pathophysiology of idiopathic male osteoporosis. (From the World of Osteoporosis 2009;15:59-65