Neurofeedback intervention in fibromyalgia syndrome; a randomized, controlled, rater blind clinical trial.

İstanbul Bilim Üniversitesi, Tıp Fakültesi.We designed a randomized, rater blind study to assess the efficacy of EEG Biofeedback (Neurofeedback-NFB) in patients with fibromyalgia syndrome (FMS). Eighteen patients received twenty sessions of NFB-sensory motor rhythm (SMR) treatment (NFB group) during 4 weeks, and eighteen patients were given 10 mg per day escitalopram treatment (control group) for 8 weeks. Visual Analog Scales for pain and fatigue, Hamilton and Beck Depression and Anxiety Inventory Scales, Fibromyalgia Impact Questionnaire and Short Form 36 were used as outcome measures which were applied at baseline and 2nd, 4th, 8th, 16th, 24th weeks. Mean amplitudes of EEG rhythms (delta, theta, alpha, SMR, beta1 and beta2) and theta/SMR ratio were also measured in NFB group. All post-treatment measurements showed significant improvements in both of the groups (for all parameters p 0.05 for all). However, theta/SMR ratio showed a significant decrease at 4th week compared to baseline in the NFB group (p < 0.05). These data support the efficacy of NFB as a treatment for pain, psychological symptoms and impaired quality of life associated with fibromyalgia

Neurofeedback Intervention in Fibromyalgia Syndrome; a Randomized, Controlled, Rater Blind Clinical Trial

We designed a randomized, rater blind study to assess the efficacy of EEG Biofeedback (Neurofeedback-NFB) in patients with fibromyalgia syndrome (FMS) Eighteen patients received twenty sessions of NFB-sensory motor rhythm (SMR) treatment (NFB group) during 4 weeks, and eighteen patients were given 10 mg per day escitalopram treatment (control group) for 8 weeks Visual Analog Scales for pain and fatigue, Hamilton and Beck Depression and Anxiety Inventory Scales, Fibromyalgia Impact Questionnaire and Short Form 36 were used as outcome measures which were applied at baseline and 2nd 4th, 8th, 16th, 24th weeks Mean amplitudes of EEG rhythms (delta, theta, alpha, SMR, betal and beta2) and theta/SMR ratio were also measured in NFB group All post-treatment measurements showed significant improvements in both of the groups (for all parameters p 0 05 for all) However theta/SMR ratio showed a significant decrease at 4th week compared to baseline in the NFB group (p < 0 05) These data support the efficacy of NFB as a treatment for pain psychological symptoms and impaired quality of life associated with fibromyalgi

Neurofeedback in fibromyalgia syndrome

İstanbul Bilim Üniversitesi, Tıp Fakültesi.EEG Biofeedback (Neurofeedback-NFB) is a learning strategy that enables people to alter their brainwaves. In the present case study, we applied a NFB protocol on three patients with Fibromyalgia Syndrome (FMS). The existing symptoms and clinical conditions of the patients attributed to FMS, Visual Analog Scale for pain and fatigue, Hamilton Depression and Anxiety Inventory Scales, Beck Depression and Anxiety Inventory Scales, and SF-36 were recorded before and after NFB training. Most of the symptoms were decreased after ten sessions. There was also improvement in all of the scales after the treatment. The results of the present study may suggest NFB training as a novel treatment method in FMS.EEGbiyofeedback (Nörofeedback-NFB), kişilerin beyin dalgalarını değiştirebilmelerini sağlayan bir öğrenme stratejisidir. Bu olgu sunumunda, Fibromyalji Sendromu (FMS) bulunan üç hastaya NFB protokolü uyguladık. Vizüel Analog Skala ile ağrı değerlendirmesi, yorgunluk, Hamilton Depresyon ve Anksiyete Çizelgesi Ölçeği, Back Depresyon ve Anksiyete Çizelgesi Ölçeği ve SF-36 kayıtları, NFB uygulaması öncesinde ve sonrasında değerlendirildi. On seans sonunda semptomların çoğu azaldı. Ölçeklerin tümünde tedavi sonrası ilerleme kaydedildi. Bu çalışmanın sonuçları, NFB uygulamasına FMS tedavisinde yeni bir metot olabileceğini düşündürmektedir

Switching from onabotulinumtoxin-A to abobotulinumtoxin-A in children with cerebral palsy treated for spasticity: A retrospective safety and efficacy evaluation

Objectives: To determine whether switching from onabotulinumtoxinA to abobotulinumtoxinA in children with cerebral palsy is safe and whether therapeutic efficacy is maintained. Methods: This retrospective observational study of routine care included 118 children with cerebral palsy (mean age 81.4 months (standard deviation; SD 38.9)) who had switched from onabotulinumtoxinA to abobotulinumtoxinA injections into their lower extremities due to a change in hospital policy. Analysis was limited to the final onabotulinumtoxinA treatment-cycle prior to switch, and the first abobotulinumtoxinA treatment-cycle following switch. The primary objective was to document the safety and tolerability of switching products. Efficacy endpoints included muscle tone, spasticity, and gait function based on Modified Ashworth Scale (MAS), Tardieu Scale (TS) and Observational Gait Scale (OGS) scores. Results: Treatment-emergent adverse events were recorded in 41 (34.7%) and 31 (26.3%) patients during the onabotulinumtoxinA and abobotulinumtoxinA treatment cycles, respectively. Treatment-related adverse events were reported in 5 patients in the onabotulinumtoxinA treatment-cycle vs 7 in the abobotulinumtoxinA treatment-cycle (p?=?0.774). Treatment efficacy (46 weeks post-treatment) was similar in the onabotulinumtoxinA and abobotulinumtoxinA treatment-cycles for all variables (MAS, TS, OGS). Conclusion: In children with cerebral palsy, switching from onabotulinumtoxinA to abobotulinumtoxinA is safe and generally well-tolerated and therapeutic efficacy is maintained

Effects of robot-assisted gait training in chronic stroke patients treated by botulinum toxin-a: A pivotal study

ObjectiveTo investigate combined effects of robot-assisted training (RAT) and physical therapy versus physical therapy only on balance and gait function of chronic stroke patients after botulinum toxin-A (BoNT-A) treatment

Risk of falls in patients with ankylosing spondylitis

Bu çalışma, EULAR 2013 Konferansı'nda bildiri olarak sunulmuştur.Background: Risk of vertebral fractures is increased in patients with ankylosing spondylitis (AS). The underlying mechanisms for the elevated fracture risk might be associated with bone and fall-related risks. The aims of this study were to evaluate the risk of falls and to determine the factors that increase the risk of falls in AS patients. Methods: Eighty-nine women, 217 men, a total of 306 AS patients with a mean age of 40.1 +/- 11.5 years from 9 different centers in Turkey were included in the study. Patients were questioned regarding history of falls within the last 1 year. Their demographics, disease characteristics including Bath AS Disease Activity Index, Bath AS Metrology Index (BASMI), Bath AS Functional Index (BASFI), and risk factors for falls were recorded. The Short Physical Performance Battery (SPPB) test was used for evaluation of static and dynamic balance. Erythrocyte sedimentation rate, C-reactive protein, and 25-hydroxyvitamin D levels were measured. Results: Forty of 306 patients reported at least 1 fall in the recent 1 year. The patients with history of falls had higher mean age and longer disease duration than did nonfallers (P = 0.001). In addition, these patients' BASMI and BASFI values were higher than those of nonfallers (P = 0.002; P = 0.000, respectively). We found that the patients with history of falls had lower SPPB scores (P = 0.000). We also found that the number of falls increased with longer disease duration and older age (R = 0.117 [P = 0.041] and R = 0.160 [P = 0.005]). Our results show that decreased SPPB scores were associated with increased number of falls (R = 0.183, P = 0.006). Statistically significant correlations were found between number of falls and AS-related lost job (R = 0.140, P = 0.014), fear of falling (R = 0.316, P = 0.000), hip involvement (R = 0.112, P = 0.05), BASMI (R = 0.234, P = 0.000), and BASFI (R = 0.244, P = 0.000). Conclusions: Assessment of pain, stiffness, fatigue, and lower-extremity involvement as well as asking for a history of falls will highlight those at high risk for further falls. In addition to the general exercise program adopted for all patients, we suggest that a balance rehabilitation program should be valuable for the patients with risk factors for fall. Exercise may improve fear of falling and BASFI and BASMI scores. However, further study is needed to investigate these hypotheses. We believe that clinicians should train and support the patients via reducing fear of falls and maintaining good posture and functional capacity

Attitudes of patients with spondylarthritis or rheumatoid arthritis regarding biological treatment during COVID-19 pandemic: A multi-center, phone-based, cross-sectional study

Objectives: In this study, we aimed to investigate the medical treatment attitudes of patients with spondylarthritis or rheumatoid arthritis (RA) who were using biological drugs during the novel coronavirus-2019 (COVID-19) pandemic. Patients and methods: In this multi-center, cross-sectional study, a total of 277 patients (178 males, 99 females; median age: 45 years; range, 20 to 77 years) who were using biological disease-modifying anti-rheumatic drugs (bDMARDs) for rheumatic diseases and were reached by phone between June 1st, 2020 and June 30th, 2020 were included. Demographic characteristics, working status, type of the rheumatic disease, comorbidities, smoking habits, and type of the bDMARDs were recorded. Disease activity was evaluated using the Visual Analog Scale (VAS). The patients were asked whether they continued the treatment plan, as it was before or changed and, if changed, how they changed the plan and what happened after the change. Results: Of the patients, 229 had spondylarthritis and 48 had RA. A total of 36.1% of the patients were smokers, and the most common comorbidity was hypertension (17.3%). Totally, 5.8% of the patients had a history of contact with a COVID-19 positive person. Only three (1.1%) patients were diagnosed with COVID-19 infection and none of them died. Of the patients, 64.3% continued their treatment, while 35.7% adopted various changes. Most patients made the decision about the treatment plan on their own (n=160, 57.8%), while 38.3% of them consulted their physicians and 13.9% of them consulted any health staff. The only significant parameter for changing the drug course was receiving intravenous bDMARDs (by infusion at hospital) (p=0.001). These patients had also a higher disease activity as measured by VAS, compared to the patients receiving non-infusion therapy (p=0.021). As a result of these changes, severity of the symptoms increased in 91 (32.9%) patients. Disruption of regular biological treatment and prior infusion therapy more likely worsened the complaints (p<0.001 and p=0.024, respectively). Conclusion: Intravenous bDMARD therapy seems to be the main factor affecting the continuity of the treatment in the pandemic period. During the pandemic period, alternative treatment options should be considered other than infusion therapy not to interrupt the treatment of these patients