Effects of postural changes on balance due to ankylosing spondylitis

Ankilozan spondilit (AS), spinal mobilitede kısıtlılığa ve yapısal bozukluğa neden olan primer olarak aksiyal iskeleti etkileyen kronik inflamatuar romatizmal bir hastalıktır. Spinal mobilite kısıtlılığı hastalığın temel bulgusudur. Buna bağlı olarak denge ve postural kontrol ilgili sorunlar yaşanabilmektedir. Postürde bozulmaya bağlı olarak denge kayıpları ve düşmeler görülebilir. Bu hastalarda tedavide hastalığa özel egzersiz eğitimiyle dengeye yönelik eğitimlere yer verilmesi gerekmektedir. Bu çalışmanın amacı AS?deki postüral değişikliklerin denge üzerine etkisini incelemektir. Çalışmada yaş ve kiloları birbirine uygun olan 34 hasta ve 34 sağlam kontrol değerlendirildi. Her iki gruba da ayrıntılı kas iskelet sistemi muayenesi yapılarak denge ölçüm testleri uygulandı. Hastalar kendi içlerinde diz ve kalça fleksiyon kontraktürü olup olmamasına göre değerlendirildi. Dengenin değerlendirilmesinde; Berg denge ölçeği, öne ve yanlara fonksiyonel uzanma testi, statik denge indeksi (SDİ) kullanıldı. Postural salınım, Emed-SX sistemi kullanılarak değerlendirildi. Hasta ve sağlam kontrol grubunun SDİ skor ve postural salınıma bağlı basınç merkezinin yer değiştirme miktarları incelendiğinde SDİ, göz açık ve kapalı iken öne ve arkaya salınım değerleri hasta grupta istatistiksel anlamlı olarak daha yüksek bulundu (p0.05). Denge testlerinin spinal mobilite ölçüm parametreleriyle yapılan korelasyon analizinde Berg denge ölçeği skoru ve öne, yanlara FUS ile el-yer, oksiput-duvar ve tragus-duvar mesafeleri arasında negatif yönde, lomber schoeber ile pozitif yönde korelasyon saptandı. Statik denge indeksi skorunun spinal mobilite parametreleriyle yapılan korelasyon analizinde BASMI ve el yer mesafesi ile pozitif yönde korelasyon saptanırken, lomber schoeber ile negatif yönde korelasyon bulundu. Bütün bu sonuçlar spinal mobilitenin kısıtlanmasının denge üzerine olumsuz etkisini desteklemektedir. Çalışmamızda AS'li hastalarda postür bozukluğuna bağlı dengenin etkilendiği gösterilmiştir. Bu hasta populasyonun tedavi prokolünde hastalığa özel egzersiz eğitiminin yanısıra düşme riskinin önlenmesi ve hastaların hayat kalitesini arttırmak amacıyla dengeye yönelik uygulama ve eğitimlere de yer verilmesi gerekmektedir.Ankylosing spondylitis is a chronic-inflammatuary rheumatic disease which leads to limited movements in spinal mobility and structural deformity by affecting axial skeleton in the first place. Limited movements in spinal mobility is the classical sign of this disease and problems related to balance and postural stability control can occur due to this pathology. Deterioration at the postural stability can lead to balance problems and falls. The aim of this study is to investigate the effect of postural changes on the balance at ankylosing spondylitis patients. Age and weight adjusted thirty-four ankylosing spondylitis patients and 34 control subjects are enrolled to this study. Balance measurement tests carried out with comprehensive musculoskeletal examination to both of the groups. Patients also have been evaluated for the presence or absence of knee and hip flexion contracture. Berg balance scale, anterior and right-left side functional reach test and static balance index have been used to assess the balance. Postural sway was calculated by Emed-SX system. The static balance index, eyes open anteroposterior center of pressure sway and eyes closed anteroposterior center of pressure sway have been found significantly higher at the patients? group (p0.05). Results of correlation analyses between balance tests and spinal mobility parameters demonstrated that Berg balance scale score and anterior, two- sided functional reach tests were negatively correlated with occiput-wall and tragus-wall distances and positive correlated with lomber schoeber. Static balance index score was positively correlated with Bath Ankylosing Spondylitis Metrology Index and hand-ground distance and negatively correlated with lomber schoeber. All these results support the negative effect of the limited movements in spinal mobility on balance. Balance deterioration due to postural changes at the ankylosing spondylitis patients has shown in our study. Therefore, the treatment strategy of this patient population should include disease specific exercise prescription and educations oriented towards balance for the prevention of falling risk and to increase the life quality, as well

Kardiyak Rehabilitasyon Hastalarında Tedavi Öncesi Yorgunluk, Depresyon ve Hayat Kalitesinin Değerlendirilmesi

Amaç: Bu çalışmada kardiyak rehabilitasyona alınacak hastaların tedavi öncesinde hastaların tedaviye uyumunu etkileyeceği düşünülen genel hayat kalitesi, yorgunluk ve depresyon durumlarının belirlenmesi hedeflendi.Gereç ve Yöntem: Çalışmaya hastanemiz Fizik Tedavi ve Rehabilitasyon bölümüne başvuran 31 hasta ve 30 sağlıklı gönüllü birey dahil edildi. Hastaların tedavi öncesi hayat kalitesi ölçümleri SF-36 Kısa form-36 yaşam ölçeği anketi ile, yorgunluk durumları Görsel Analog Skala-Yorgunluk VAS-F skalası ile değerlendirildi. Hastaların depresyon ve anksiyete durumları için HAD Hastane depresyon anksiyete anketi kullanıldı.Bulgular: Hastaların yaş ortalaması 59.3 ± 8.5 yıl idi. Hasta grubunda VAS-F ve HAD depresyon ve anksiyete skorları sağlam kontrollere göre anlamlı derecede yüksekti

DO POSTURAL CHANGES AFFECT BALANCE IN PATIENTS WITH ANKYLOSING SPONDYLITIS?

Objective: To investigate the effect on balance control of postural changes related to ankylosing spondylitis. Design: Thirty-four subjects with ankylosing spondylitis and 34 healthy individuals were enrolled. Examination of postural alignment was conducted using lumbar Schober, hand to ground distance, tragus to wall distance and occiput to wall distance measurements, and Bath Ankylosing Spondylitis Metrology Index. Balance was evaluated by Berg Balance Scale, Functional Reach Test, Lateral Reach Test, and Static Balance Index. Postural sway during quiet standing was assessed by centre of pressure displacement in 2 conditions: eyes open and eyes closed. Results: Functional reach test and right-side lateral reach tests were significantly lower in subjects with ankylosing spondylitis. Eyes closed anteroposterior centre of pressure sway was significantly higher in the subject group. Conclusion: Ankylosing spondylitis can lead to balance deterioration due to postural changes

EFFECTIVENESS OF WII-BASED REHABILITATION IN STROKE: A RANDOMIZED CONTROLLED STUDY

Objective: To investigate the efficacy of Nintendo Wii Fit (R)-based balance rehabilitation as an adjunctive therapy to conventional rehabilitation in stroke patients. Methods: During the study period, 70 stroke patients were evaluated. Of these, 23 who met the study criteria were randomly assigned to either the experimental group (n= 12) or the control group (n= 11) by block randomization. Primary outcome measures were Berg Balance Scale, Functional Reach Test, Postural Assessment Scale for Stroke Patients, Timed Up and Go Test and Static Balance Index. Secondary outcome measures were postural sway, as assessed with Emed-X, Functional Independence Measure Transfer and Ambulation Scores. An evaluator who was blinded to the groups made assessments immediately before (baseline), immediately after (post-treatment), and 4 weeks after completion of the study (follow-up). Results: Group-time interaction was significant in the Berg Balance Scale, Functional Reach Test, anteroposterior and mediolateral centre of pressure displacement with eyes open, anteroposterior centre of pressure displacement with eyes closed, centre of pressure displacement during weight shifting to affected side, to unaffected side and total centre of pressure displacement during weight shifting. Demonstrating significant group-time interaction in those parameters suggests that, while both groups exhibited significant improvement, the experimental group showed greater improvement than the control group. Conclusion: Virtual reality exercises with the Nintendo Wii system could represent a useful adjunctive therapy to traditional treatment to improve static and dynamic balance in stroke patients

Carpal Tunnel Syndrome in Patients with Psoriatic Arthritis: Ultrasonography and Magnetic Resonance Imaging Findings

Objective: The aim of the present study is to assess carpal tunnel syndrome's (CTS's) ultrasonography (US) and magnetic reso-nance imaging (MRI) findings in patients with psoriatic arthritis (PsA) and compare them with healthy controls.Methods: Thirty-nine PsA and twenty-eight healthy volunteers were examined in this study. Demographic and clinical features were recorded. CTS-6, a diagnostic algorithm, was used to estimate the probability of CTS. Electrodiagnostic study (EDS) was applied to all wrists included in the report, where the diagnosis of CTS was made by EDS. The cross-sectional area (CSA) of the median nerve was measured at pisiform bone level by US and MRI.Results: Regarding to the demographic characteristics, no statistically significant difference was found between the groups. Twelve of 39 (30.76%) PsA patients had CTS, whereas CTS was not detected in the control group (p=0.001). US and MRI showed increased median nerve CSA in PsA patients compared to healthy controls (p=0.005, p<0.001; respectively). Also, US and MRI showed increased median nerve CSA in CTS patients compared to others (p=0.002, p<0.001; respectively). The Pearson correla-tion coefficient between MRI and US measurements of the CSA was 0.85 (p<0.001).Conclusion: CTS frequency in PsA patients is found higher than healthy controls. The relationship between CTS diagnosed by EDS and CSA measured by both US and MRI was observed in PsA patients

Evaluation of hepatitis serology and frequency of viral reactivation in patients with inflammatory arthritis receiving biologic agents: a multicenter observational study

Article; Early AccessTo evaluate of hepatitis serology and reactivation frequency in patients with rheumatic disease receiving biologic agents. Our study included patients with inflammatory rheumatic diseases from 23 centers, who were followed up with biological therapy. Demographic and clinical characteristics of the patients, duration of drug use and hepatitis serology and the state of viral reactivation were analyzed. A total of 4060 patients, 2095 being males, were included in our study. Of the patients, 2463 had Ankylosing Spondylitis (AS), 1154 had Rheumatoid Arthritis (RA), 325 had Psoriatic Arthritis (PsA), and 118 had other inflammatory rheumatic diseases. When the viral serology of the patients was evaluated, 79 patients (2%) who were identified as HBs Ag positive, 486 (12%) patients who were HBs Ag negative and anti-HBc IgG positive and 20 patients (0.5%) who were anti-HCV positive. When evaluated on a disease-by-disease basis, the rate of HBsAg was found to be 2.5% in RA, 2% in AS and 0.9% in PsA. Viral reactivation was detected in 13 patients while receiving biologic agents. HBs Ag was positive in nine patients with reactivation and negative in four patients. Anti-HBc IgG, however, was positive. Six of these patients had AS, four had RA, and three had PsA. The development of hepatitis reactivation in 11.4% of HBs Ag positive patients and 0.82% of anti-HBc IgG positive patients due to the use of biologic agents is an important problem for this group of patients. Antiviral prophylaxis is recommended to be started especially in patients who are HBs Ag positive and who are using biologic agents due to viral reactivation. Therefore, it is important to carry out hepatitis screenings before biologic agent treatment and to carefully evaluate the vaccination and prophylaxis requirements. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature

Evaluation of hepatitis serology and frequency of viral reactivation in patients with inflammatory arthritis receiving biologic agents: a multicenter observational study

To evaluate of hepatitis serology and reactivation frequency in patients with rheumatic disease receiving biologic agents. Our study included patients with inflammatory rheumatic diseases from 23 centers, who were followed up with biological therapy. Demographic and clinical characteristics of the patients, duration of drug use and hepatitis serology and the state of viral reactivation were analyzed. A total of 4060 patients, 2095 being males, were included in our study. Of the patients, 2463 had Ankylosing Spondylitis (AS), 1154 had Rheumatoid Arthritis (RA), 325 had Psoriatic Arthritis (PsA), and 118 had other inflammatory rheumatic diseases. When the viral serology of the patients was evaluated, 79 patients (2%) who were identified as HBs Ag positive, 486 (12%) patients who were HBs Ag negative and anti-HBc IgG positive and 20 patients (0.5%) who were anti-HCV positive. When evaluated on a disease-by-disease basis, the rate of HBsAg was found to be 2.5% in RA, 2% in AS and 0.9% in PsA. Viral reactivation was detected in 13 patients while receiving biologic agents. HBs Ag was positive in nine patients with reactivation and negative in four patients. Anti-HBc IgG, however, was positive. Six of these patients had AS, four had RA, and three had PsA. The development of hepatitis reactivation in 11.4% of HBs Ag positive patients and 0.82% of anti-HBc IgG positive patients due to the use of biologic agents is an important problem for this group of patients. Antiviral prophylaxis is recommended to be started especially in patients who are HBs Ag positive and who are using biologic agents due to viral reactivation. Therefore, it is important to carry out hepatitis screenings before biologic agent treatment and to carefully evaluate the vaccination and prophylaxis requirements