Huzurevindeki geriatrik diyabetli bireylerde proprioseptif egzersizin denge ve duyusal fonksiyona etkisi: Randomize kontrollü çalışma

Objective: Diabetes is a chronic disease whose prevalence increases with age and causes severe damages in all systems of the body. The aim of our study was to assess the effects of proprioceptive exercises on balance and sensory function in the geriatric adults with Type 2 diabetes mellitus. Material and Methods: Forty individuals aged 65 and over with Type 2 diabetes mellitus were divided as a study group (n=20) and as a control group (n=20). All patients were evaluated at the baseline and after 8 weeks training. Balance was mea-sured using Berg Balance Scale and Nintendo Wii system. Balance and gait were evaluated by Tinetti Balance and Gait Test. Semmes-Wein-stein monofilament test was used for assessing tactile sensory, diapa-son for vibration and active matching test for joint position sense. Study group received 45 minutes long proprioceptive exercise training 3 times/week for 8 weeks and the control group only received diabetic patient education. Results: Study group demonstrated significant differences in Berg Balance Scale, Wii Fit balance age and Tinetti Balance and Gait Test scores (p<0.05). Vibration perception duration yielded a higher duration in the study group after treatment (p<0.05). Active matching movement and tactile sensory of the sole showed statistically improvement in the study group (p<0.05). Conclusion: Proprioceptive exercises recommended to individuals with geriatric diabetes can be a beneficial approach to increase balance ability to prevent falling and somatosensory loss.Amaç: Diyabet, prevalansı yaşla birlikte artan ve vücudun tüm sistemlerinde ciddi hasarlara neden olan kronik bir hastalıktır. Çalışmamızın amacı, Tip 2 diabetes mellituslu geriatrik erişkinlerde proprioseptif egzersizlerin denge ve duyusal fonksiyon üzerine etkilerini değerlendirmektir. Gereç ve Yöntemler: Tip 2 diabetes mellituslu 65 yaş ve üzeri 40 birey çalışma grubu (n=20) ve kontrol grubu (n=20) olarak ayrıldı. Tüm hastalar başlangıçta ve 8 haftalık eğitimden sonra değerlendirildi. Denge, Berg Denge Ölçeği ve Nintendo Wii sistemi kullanılarak ölçüldü. Denge ve yürüme, Tinetti Denge ve Yürüyüş Testi ile değerlendirildi. Dokunma duyusunu değerlendirmek için SemmesWeinstein monofilament testi, titreşim için diyapazon ve eklem pozisyon duyusu için aktif eşleştirme testi kullanıldı. Çalışma grubu 8 hafta boyunca haftada 3 kez 45 dk’lık proprioseptif egzersiz eğitimi aldı ve kontrol grubuna sadece diyabetik hasta eğitimi verildi. Bulgular: Çalışma grubu, Berg Denge Ölçeği, Wii Fit denge yaşı ve Tinetti Denge ve Yürüyüş Testi puanlarında anlamlı farklılıklar gösterdi (p<0,05). Titreşim algılama süresi, tedaviden sonra çalışma grubunda daha yüksek bir süre ile sonuçlandı (p<0,05). Aktif eşleştirme hareketi ve tabanın taktil duyusu, çalışma grubunda istatistiksel olarak gelişme gösterdi (p<0,05). Sonuç: Geriatrik diyabetli bireylere önerilen proprioseptif egzersizler, düşme ve somatosensoriyel kaybı önlemek için denge becerisini artırmada faydalı bir yaklaşım olabilir

Investigation of the relationship between temporomandibular disorder and postural analysis

INTRODUCTION: Muscular and ligamentous structures connect the temporomandibular joint (TMJ) to the cervical region to form a functional unit. Changes in one of the two regions, either TMJ or cervical spine, may affect the other region due to changes in the muscle segment. Our aim is to evaluate and compare whether individuals with temporomandibular disorders differ from healthy individuals in the global postural alignment by objective evaluation method. METHODS: Group 1 (N=30) consist of mixed type temporomandibular disorder (TMD), Group 2 (N=30) consist of healthy temporomandibular joint, totally 60 individuals between the ages of 18-35 were included in this study. Posture Screen Mobile® (PSM) and New York Posture Scale (NYPS) were used for assessment of posture and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for diagnosis of TMD and healthy joints. DISCUSSION AND CONCLUSION: It may be beneficial to consider that some postural disorders can be caused by TMD or that TMD can lead to this posture. Being careful about postural alignment in these patients may be important in terms of multidisciplinary approach to TMD patients for proper treatment program and prevention of possible disorders.GİRİŞ ve AMAÇ: Kas ve ligamentöz yapılar temporomandibular eklemi (TME) servikal bölgeye bağlayarak fonksiyonel bir birimoluşturur. İki bölgeden birinde, TME veya servikal omurgada meydana gelen değişiklikler, kas segmentindeki değişiklikler nedeniyle diğer bölgeyi etkileyebilir. Amacımız, temporomandibular bozukluğu olan bireylerin global postural dizilimde sağlıklı bireylerden bir farklılık gösterip göstermediğini objektif değerlendirme methodu ile değerlendirip karşılaştırmaktır. YÖNTEM ve GEREÇLER: Grup 1 (N = 30) mixed tip temporomandibular bozukluktan (TMD), Grup 2 (N = 30) sağlıklı temporomandibular eklemden oluşmakta olup, 18-35 yaşları arasında toplam 60 kişi çalışmaya alındı. Postürü değerlendirmek için PostureScreen Mobile® (PSM) ve New York Postür Skalası (NYPS), sağlıklı eklem ve temporomandibular disfonksiyon tanısı için ise Temporomandibular BozukluklardaAraştırma Teşhis Kriterleri (RDC / TMD) kullanıldı. BULGULAR: Sagital düzlemde diz translasyonu Grup 1’de daha yüksekti (p <0,05). Diğer bölgelerde anlamlı postüral farklılıklar bulunmadı (p≥0,05). NYPS toplam skorları Grup 1’de anlamlı olarak düşüktü (p <0,05). TARTIŞMA ve SONUÇ: Bu postural bozuklukların TMD’den kaynaklanabileceğini veya TMD’nin bu duruşa yol açabileceğini düşünmek yararlı olabilir. Bu hastalarda postüral dizilim konusunda dikkatli olmak, uygun tedavi programı ve olası bozuklukların önlenmesi için TMD hastalarına multidisipliner yaklaşım açısından önemli olabilir

Respiratory muscle strengths and its association with body composition and functional exercise capacity in non-obese young adults

Background. The assessment of cardiopulmonary problems, exercise capacity, and inspiratory and expiratory muscle strength all depend on body composition, which is a crucial factor in determining human health. Objectives. The present study aimed to examine the effect of body composition and functional exercise capacity on respiratory muscle strength in young healthy adults. Material and methods. In the prospective study, sixty individuals aged between 18-25 years of age who were non-obese were evaluated in terms of body composition by body mass index, respiratory muscle strength by mouth pressure threshold and functional exercise capacities by six minute walking test and sit to stand test. Also, sociodemographic characteristics such as age, gender, education level, height and weight of the participants were recorded. Results. The relationship between body density (BD) parameters and inspiratory muscle strength was found to be moderate (r = 0.394, p 0.05). Conclusions. Present study showed a significant correlation between body density and inspiratory and expiratory respiratory muscle strength. However, no correlation was found between body composition and functional exercise capacity and respiratory muscle strength. Body density increment will affect respiratory muscle strength negatively

A multi-resonance thickness-shear mode (MTSM) measurement technique for quantitative characterization of biological interfacial processes

Biological interfaces constitute one of the most dynamic and expanding fields in science and technology and affect such disciplines as tissue engineering, biomaterials, and biosensors. A typical biological interface consists of several distinct layers representing such processes as protein binding, cell adhesion and many others. It is important to know quantitative characteristics of those layers, specifically their mechanical and geometrical properties. One of very powerful technique for characterization of mechanical and geometrical properties of layered systems has been the technique based on multi-resonant thickness-shear monitor (MTSM) measurement technology. However, until this moment, the thickness shear mode (TSM) measurement technique has provided only incomplete set of quantitative data. In this project, a combination of multi-resonant thickness shear mode (MTSM) measurement technique and genetic algorithm (GA)-based data analysis method is proposed for quantitative characterization of multi-layer biological processes, and for determination of mechanical and geometrical properties of the layered structures. Specifically, MTSM measurement technique provides a unique tool capable of simultaneous interrogation of the interface at different depths ranging from tens of nanometers to several microns in real time with high accuracy. Next, a genetic algorithm (GA)-based data analysis technique capable of accurate extraction of material properties was developed and integrated with the MTSM technique. The strengths and limitations of the MTSM/GA technique were studied both theoretically and experimentally. For example, it was shown that MTSM/GA can provide the mechanical and structural properties of single and two-layer viscoelastic systems theoretically with less than %1 error. The proposed MTSM/GA was experimentally verified with several chemical systems (polymers) and biological systems (collagen, cells, and antibody). Finally, mechanical and structural properties of the antibody and bovine aortic endothelial cells (BAECs) monolayers attached on the MTSM sensor surface were determined. The obtained results demonstrated that this novel approach can be a very useful tool in quantification and interpretation of biological, chemical, and physical interfacial structures and processes.Ph.D., Biomedical Engineering -- Drexel University, 201

Migrenli hastalarda fiziksel aktivite seviyesinin ağrı, fonksiyonellik ve yaşam kalitesine etkisi

OBJECTIVES: This study aimed to determine the physical activity (PA) level of individuals with migraine and examine its effects on pain intensity (PI), disability, and quality of life (QoL). METHODS: Individuals diagnosed with migraine between the ages of 18 and 55 were included in the study. PA levels are assessed by the International PA Questionnaire Short Form (IPAQ-SF), PI with the McGill Melzack Pain Questionnaire, disability with the Migraine Disability Assessment Scale (MIDAS), and QoL with the World Health Organization QoL Scale Short Form (WHOQOL-BREF). RESULTS: A total of 88 individuals, with a mean age of 34.11±10.51 years, were included in the study; 53.41% were low active (LA), 30.68% were moderate active (MA), and 15.91% were high active (HA). The physical health of LAs (p=0.047) was lower than that of MAs. General (p<0.001), physical (p[removed].Amaç: Bu çalışmada, migrenli bireylerin fiziksel aktivite düzeylerinin belirlenmesi ve ağrı şiddeti, engellilik seviyesi ve yaşam kalitesi üzerindeki etkilerinin incelenmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 18-55 yaş arası migren tanısı almış bireyler dahil edildi. Uluslararası Fiziksel Aktivite Anketi Kısa Formu (IPAQ-SF), McGill Melzack Ağrı Anketi ile ağrı şiddeti, Migren Özürlülük Değerlendirme Ölçeği (MIDAS) ile engellilik ve Dünya Sağlık Örgütü Yaşam Kalitesi Skalası Kısa Formu (WHOQOL-BREF) ile yaşam kalitesi değerlendirildi. Bulgular: Çalışmaya yaş ortalaması 34,11±10,51 yıl olan toplam 88 kişi dahil edildi; %53,41’i düşük aktif, %30,68’i orta aktif, %15,91’i yüksek aktifti. Düşük aktiflerin fiziksel sağlığı (p=0,047) orta aktiflerden daha düşüktü. Genel (p<0,001), fiziksel (p<0,001), psikolojik (p=0,003) sağlık puanları yüksek aktiflerden daha düşüktü. Düşük aktifler yüksek aktiflerden daha yüksek engelliliğe (p=0,042) ve ağrı şiddetine (p=0,001) sahipti. Fiziksel aktivite ile ağrı şiddeti (p=0,001) ve engellilik (p=0,005) arasında zayıf negatif korelasyon, fiziksel aktivite düzeyleri ile sosyal (p=0,007) ve çevresel (p=0,013) sağlık puanları arasında zayıf pozitif korelasyon ve fiziksel (p=0,000), genel (p=0,000) ve psikolojik (p=0,000) puanlarıyla orta düzeyde pozitif korelasyon vardı. Sonuç: Migrenli hastalarda fiziksel aktivite düzeyi arttıkça ağrı şiddetinin azaldığı, fonksiyonellik ve yaşam kalitesinin arttığı gözlendi. Egzersiz devamlılığının sağlanması migrenin olumsuz etkilerini iyileştirmede etkili görünmektedir

Effect of First-Pass Reperfusion on Outcome After Endovascular Treatment for Ischemic Stroke

Background First-pass reperfusion (FPR) is associated with favorable outcome after endovascular treatment. It is unknown whether this effect is independent of patient characteristics and whether FPR has better outcomes compared with excellent reperfusion (Expanded Thrombolysis in Cerebral Infarction [eTICI] 2C-3) after multiple-passes reperfusion. We aimed to evaluate the association between FPR and outcome with adjustment for patient, imaging, and treatment characteristics to single out the contribution of FPR. Methods and Results FPR was defined as eTICI 2C-3 after 1 pass. Multivariable regression models were used to investigate characteristics associated with FPR and to investigate the effect of FPR on outcomes. We included 2686 patients of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry. Factors associated with FPR were as follows: history of hyperlipidemia (adjusted odds ratio [OR], 1.05; 95% CI, 1.01-1.10), middle cerebral artery versus intracranial carotid artery occlusion (adjusted OR, 1.11; 95% CI, 1.06-1.16), and aspiration versus stent thrombectomy (adjusted OR, 1.07; 95% CI, 1.03-1.11). Interventionist experience increased the likelihood of FPR (adjusted OR, 1.03 per 50 patients previously treated; 95% CI, 1.01-1.06). Adjusted for patient, imaging, and treatment characteristics, FPR remained associated with a better 24-hour National Institutes of Health Stroke Scale (NIHSS) score (-37%; 95% CI, -43% to -31%) and a better modified Rankin Scale (mRS) score at 3 months (adjusted common OR, 2.16; 95% CI, 1.83-2.54) compared with no FPR (multiple-passes reperfusion+no excellent reperfusion), and compared with multiple-passes reperfusion alone (24-hour NIHSS score, (-23%; 95% CI, -31% to -14%), and mRS score (adjusted common OR, 1.45; 95% CI, 1.19-1.78)). Conclusions FPR compared with multiple-passes reperfusion is associated with favorable outcome, independently of patient, imaging, and treatment characteristics. Factors associated with FPR were the experience of the interventionist, history of hyperlipidemia, location of occluded artery, and use of an aspiration device compared with stent thrombectomy

Acute Endovascular Treatment of Patients With lschemic Stroke From Intracranial Large Vessel Occlusion and Extracranial Carotid Dissection

Introduction: Carotid artery dissection (CAD) and atherosclerotic carotid artery occlusion (ACAO) are major causes of a tandem occlusion in patients with intracranial large vessel occlusion (LVO). Presence of tandem occlusions may hamper intracranial access and potentially increases the risk of procedural complications of endovascular treatment (EVT). Our aim was to assess neurological, functional and technical outcome and complications of EVT for intracranial LVO in patients with CAD in comparison to patients with ACAO and to patients without CAD or ACAO. Methods: We analyzed data of the MR CLEAN trial intervention arm and MR CLEAN Registry, acquired in 16 Dutch EVT-centers. Primary outcome was the change in stroke severity by comparing the National Institute of Health Stroke Scale (NIHSS) score at 24–48 h after treatment vs. baseline. Secondary outcomes included reperfusion rate and symptomatic intracranial hemorrhage (sICH). We compared outcomes and complications between patients with CAD vs. patients with ACAO and patients without CAD or ACAO. Results: In total, we identified 74 (4.7%) patients with CAD, 92 (5.9%) patients with ACAO and 1398 (89.4%) patients without CAD or ACAO. Neurological improvement at short-term after EVT in patients with CAD was significantly better compared to ACAO (resp. mean −5 vs. mean −1 NIHSS point; p = 0.03) and did not differ compared to patients without CAD or ACAO (−4 NIHSS points; p = 0.62). Rates of successful reperfusion in patients with CAD (47%) was comparable to patients with ACAO (47%; p = 1.00), but was less often achieved compared to patients without CAD or ACAO (58%; p = 0.08). Occurrence of sICH did not differ significantly between CAD patients (5%) and ACAO (11%; p = 0.33) or without CAD/ACAO (6%; p = 1.00). Conclusion: EVT in patients with intracranial LVO due to CAD results in neurological improvement comparable to patients without tandem occlusions. Therefore, carotid artery dissection by itself should not be a contraindicati

An investigation of the relationship between temporomandibular disorder with posture and pedobarographic analysis

Çalışmanın amacı, Temporomandibular Rahatsızlığı olan ve sağlıklı temporomandibular ekleme sahip kontrol grubunu oluşturan bireylerde tüm vücut postürünü ve plantar basınç dağılımlarını değerlendirmektir. Çene ağrısı ile başvuran, Temporomandibular Rahatsızlıklarda Araştırma Teşhis Kriterleri (TMR/ATK) ile tanısı konulmuş 18-35 yaş aralığındaki 30 kişilik çalışma grubu ve aynı yaş aralığındaki sağlıklı 30 kişilik kontrol grubu çalışmaya dahil edildi. Her iki gruba da dört yönlü fotoğraf çekimi ile ölçüm yapan PostureScreen Mobile® (PSM) programı kullanılarak ve New York Postür Skalası (NYPS) ile posterior ve lateralden global postüral değerlendirme yapıldı. Statik pedobarografik ölçümler alındı. PSM ile yapılan postür ölçümlerinde gruplar kendi aralarında anterior ve posterior yönden karşılaştırıldığında gruplar arası istatistiksel anlamlı bir fark tespit edilmedi (p>0.05), sagittal plandaki değerlendirmede ise sağ ve sol yandan diz translasyon ve angulasyonunda fark bulundu (p0,05). Sol yandan yapılan ölçümlerde ise boyun, göğüs, alt sırt ve gövde postürü ile toplam skorlar yönünden gruplar arası farklılık belirlendi (p0,05). Sonuç olarak, postürdeki dizilim bozukluklarının TMR gelişmesine etken olabileceği veya TMR sonucu postürde dizilim bozukluklarının karşımıza çıkabileceği görüldü. Postüral bozuklukların fizyoterapist tarafından değerlendirilip, postüral düzgünlük egzersizleri verilmesi TMR gelişmesini önlemede veya TMR tedavisinde etkin role sahip olacağı kanısında bulunuldu.The aim of the study is, to evaluate the whole body posture and plantar pressure distributions in individuals with Temporomandibular Disorder and also in people with healthy temporomandibular joints. A study group aged between 18-35 years, 30 patients, who were diagnosed with Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) who applied us with jaw pain and 30 healthy people at the same age range as a control group were included in the study. Both groups received global postural assessments by using PostureScreen Mobile® (PSM) program which is using four side photographs and the New York Posture Scale (NYPS). Static pedobarographic measurements were taken. There was no statistically significant difference between groups from anterior and posterior posture assesments in using PSM (p>0.05). On the right and left lateral sagittal plane, knee translation and angulation were significantly different (p0,05). On the left side, there was difference between the groups in terms of total scores, neck, chest, lower back and trunk posture (p0.05). In conclusion, postural misalignments may result in development of TMD or as a consequence of Temporomandibular Disorder. Assessment of postural alignment and giving postural alignment exercises by physiotherapists will play an active role in preventing or treating TMD

Investigetion of distance learning applications in education of individuals with special needs according to the opinions of special education teachers

Yüksek Lisans TeziBu araştırma özel gereksinimli bireylerin eğitiminde, uzaktan eğitime yönelik özel eğitim öğretmenlerinin görüşlerinin incelenmesi amaçlanmıştır. Bu amaçla çalışmada nitel araştırma yöntemlerinden açıklayıcı durum çalışması yönteminin bütüncül tek durum araştırması temelinde desenlemiştir. Araştırmanın çalışma grubu Türkiye'nin farklı illerinden olmak üzere toplam 25 ilin merkez ilçelerinde özel eğitim uygulama okullarında görev yapan 84 öğretmen oluşturmaktadır. Araştırma verilerinin toplanmasında görüşme tekniklerinden standartlaştırılmış açık uçlu görüşme yaklaşımı kullanılarak Google Form üzerinden Sabit Form Görüşme Anketi kullanılmıştır. Araştırma verileri COVID-19 sürecinde 2020 yılının aralık ayında toplanmıştır. Araştırma kapsamında toplanan veriler içerik analizi yöntemiyle çözümlenmiştir. Tezde içerik analizi sonucunda araştırma amaçları ve soruları dikkate alınarak özel eğitimde uzaktan öğretim uygulamalarına ilişkin dokuz tema belirlenmiştir: Bunlar: en kolay karşılanan ihtiyaçlar; zor karşılanan ihtiyaçlar; uzaktan eğitimin avantajları ve dezavantajları; uzaktan eğitim sürecinde yapılan uygulamalar; karşılaşılan güçlükler; uzaktan eğitimin verimliliğini artırma yolları; uzaktan eğitimde öğretmen ihtiyaçları; uzaktan eğitimde aileler ile ilgili öneriler ve Milli Eğitim Bakanlığından beklentilerdir. Tez bulgularına göre her bir tema alan yazın temelinde tartışılmış ve önerilerde bulunulmuştur.In this research, it is aimed to examine the opinions of special education teachers about distance education in the education of individuals with special needs. For this purpose, the study was designed on the basis of a holistic single case study of the descriptive case study method, one of the qualitative research methods. The study group of the research consists of 84 teachers working in special education practice schools in the central districts of 25 provinces, from different provinces of Turkey. An interview form over Google Form was used in the collection of research data, using the standardized open-ended interview approach, one of the interview techniques. Research data were collected in December 2020 during the COVID- 19 process. The data collected within the scope of the research were analyzed by content analysis method. As a result of the content analysis in the thesis, considering the research objectives and questions, nine themes related to distance education applications in special education were determined: These are: the most easily met needs; hard-to-met needs; advantages and disadvantages of distance education; applications made in the distance education process; difficulties encountered; ways to increase the efficiency of distance education; teacher needs in distance education; recommendations for families in distance education and expectations from the Ministry of National Education. According to the thesis findings, each theme was discussed on the basis of the literature and suggestions were made