The evaluation of the effect of vitamin D replacement on the symptoms of carpal tunnel syndrome in patients with low vitamin D levels

Aim: To evaluate the effect of vitamin D replacement on carpal tunnel syndrome (CTS) symptoms and signs in CTS patients with low vitamin D levels. Methods: This study was designed prospective observably. The patient population was admitted to the EMG (electromyography) laboratory in a tertiary hospital’s Physical Medicine and Rehabilitation Department between 1 January and 31 July 2018.  Initially, 55 patients were included in the study. The patients were categorized into two groups as group 1 (<10 ng / ml) and group 2 (10-20 ng / ml) according to the vitamin D levels. A total of 39 patients and 63 wrists, 17 patients in group 1 (28 wrists) and 22 patients in group 2 (35 wrists), were included in the analysis. Results: There was a statistically significant decrease in visual analogue scale and quick arm-shoulder-hand disability score in two groups when compared before treatment. In two groups, there was a significant improvement in grip and pinch strength after treatment.  At the same time, after treatment we showed that there was a statistically significant increase in median nerve sensory amplitude in two groups. The increase in median nerve sensory velocity was significant in group 2 whereas it was not statistically significant between group 1 vs group 2. Conclusions: Vitamin D replacement can improve symptoms, functional status and electrophysiological findings in CTS patients with low vitamin D levels

Restless Legs Syndrome with Current Diagnostic Criteria

Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a chronic movement disorder, characterized by an urge to move legs usually accompanied by uncomfortable sensations and sleep disorders. The prevalence of the syndrome ranges from 1% to 15% in the general population, and about 2% during childhood. RLS is the most common movement disorder in pregnancy. However RLS still remains underdiagnosed probably due to lack of accurate information about the disease. Family history is positive in 50-70% of the primary RLS patients. The secondary form of the syndrome is associated with iron deficiency, renal failure, pregnancy, diabetes mellitus and many rheumatologic disorders. Secondary forms generally manifest at older ages and have a rapid progression with a poorer prognosis. The pathophysiology of RLS is focused on the dopaminergic system, reduced central nervous system iron levels and genetic linkages. Diagnosis is based on clinical features and the diagnostic criteria suggested by International RLS Study Group. Secondary causes must be carefully investigated before the treatment. In mild forms of the disease non-pharmacologic therapies might be useful, while in moderate or severe forms of the disease generally pharmacologic therapies such as dopamine agonists, anticonvulsants, opioids and benzodiazepines are required. (Turkish Journal of Osteoporosis 2015;21: 87-95

Effects of Robotic Rehabilitation on Motor Functions in Children with Cerebral Palsy

Objective:The aim of this study was to investigate the effects of robotic rehabilitation (RR) on spasticity and motor functions of children with varying types and functional levels of cerebral palsy (CP).Materials and Methods:A total of 28 children were evaluated aged 6-16 years, with level 2-4 CP according to the Gross Motor Function Classification System (GMFCS) who were planned to undergo 30 sessions of RR. Motor functions were evaluated before and after RR using the Gross Motor Function scale-66 (GMFS-66) B, C, D and E dimensions, gastrosoleus spasticity with the Modified Ashworth scale (MAS) and a target was defined for each patient with a Goal Attainment scale (GAS). Following the RR treatment, the efficacy was evaluated by grouping the patients according to the GMFCS level and the type of CP.Results:11% of the patients were at level 2, 36% were at level 3, and 54% were at level 4.61% of them were identified as bilateral spastic, 21% unilateral spastic and 14% mixed type. The patients comprised 50% male and 50% female children with a mean age of 10.8±2.7 years. Mean participation in the RR program was 23±9.6 sessions. A statistically significant improvement was determined in the D dimension of the GMFS in the children at level 2 and 3 of GMFCS (p<0.05), and there were no differences in respect of the MAS and GAS (p>0.05). No differences were determined between the type of CP groups in respect of GMFS, MAS and GAS. Conclusion:It was concluded that the application of RR was of benefit for the children with CP at the level 2 and 3 of GMFCS in respect of the development of standing activities