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The aim of this study was to investigate the effect of the cognitive impairment on functional status in patients with subacute stroke. Fifty-two patients with subacute stroke were included in the study. Mini mental state examination (MMSE) test was used for the evaluation of cognitive status. Patients were separated into two groups according to their cognitive functions. Functional follow-up parameters were activities of daily living (ADL), global recovery and ambulation status. All patients were evaluated on admission to rehabilitation unit, at discharge and 6 months after discharge. Forty-four patients were completed the study. Mean age was 66 and 57 years; disease duration on admission was 4,8 and 3,5 months in the cognitively impaired and normal groups, respectively. Significant improvement was found in terms of functional follow-up parameters in both groups at discharge (P < .05). Functional follow-up parameters did not show statistically significant difference between the groups. But community ambulation rate was higher in cognitively normal group at the sixth month visit. As a result of this study, inpatient rehabilitation was effective both cognitively normal and impaired subacute stroke patients

Comparison of the therapeutic efficacy of TENS versus intra-articular hyaluronic acid injection in patients with knee osteoarthritis: A prospective randomized study

Knee osteoarthritis (OA) is perceived as a major public health problem, and today, various treatment modalities are used to manage this condition. The purpose of this study was to assess and compare the efficacy of transcutaneous electrical nerve stimulation (TENS) and intra-articular hylan G-F 20 (Synvisc (R); Genzyme Corporation, Ridgefield, NJ) in patients with symptomatic knee OA. A total of 60 patients with primary knee OA were randomized into 2 treatment groups. TENS was applied for 3 weeks in the first group, and in the second group, hylan G-F 20 was injected intra-articularly once a week for 3 weeks. Patients were then followed for 6 months. Disease severity was measured with the Lequesne Index. Efficacy in terms of pain, functional status, and quality of life was assessed through analysis of changes in Western Ontario and McMaster Universities Osteoarthritis Index WOMAC) and Short Form 36 Health Survey (SF-36) scores. Adverse events were monitored throughout the study. WOMAC pain scores were improved at the first control visit in the TENS group and in the viscosupplementation group; this improvement was statistically significant. WOMAC stiffness scores showed a statistically significant decrease in the TENS group at the first control visit. Stiffness did not decrease during the first month in the second group; however, these patients exhibited improvement during the sixth month after injection. Physical function scores and SF-36 total scores did not change in either group after treatment. Pain relief was observed at the first month and continued throughout the 6-month follow-up period in both groups. Stiffness decreased by the sixth month in both groups. Improvement in WOMAC physical function scores was greater in the intra-articular hylan group than in the TENS group at the end of follow-up; however, quality of life was not improved in either group. These therapies used in combination may alleviate symptoms in patients with OA

Yaşlılarda Fonksiyonel Dengenin Belirleyicileri

Introduction: Various factors may affect the functional balance of older adults. This study aimed to investigate the factors associated with functional balance in older adults living in a community. Materials and Method: In total, 160 people ?65 years of age were included in the study. The Cumulative Illness Rating Scale was used for scoring comorbidities. Functional balance was evaluated with the Activities-specific Balance Confidence scale. The Hospital Anxiety and Depression Scale was used for assessing emotional state. Finally, cognitive status was evaluated with the Mini-Mental State Examination. The factors associated with functional balance were determined using multivariate logistic regression analysis in patients with lower balance confidence. Results: The mean age was 71.3±5.8 years. The group of participants with lower balance confidence (Activities-specific Balance Confidence score ?67) had increased age, height, lower extremity pain, sleeplessness, falling frequency, hypertension, ischaemic heart disease and anaemia ratios, number of drugs used, female ratio and single living ratio; higher Cumulative Illness Rating Scale, Hospital Anxiety and Depression Scale scores and significantly lower (p<0.05) Mini-Mental State Examination scores. The multivariate reduced model analysis revealed that age, height, marital status, number of drugs, number of comorbidities and the anxiety score had statistically significant effects (p<0.05) on functional balance. Conclusion: In clinical practice, it will be useful to consider such factors while evaluating balance in older adults. In this study, the predictors of balance confidence in older adults included age, height, marital status, number of drugs used, number of comorbidities and anxiety level.Giriş: Yaşlılarda fonksiyonel dengeyi etkileyebilecek çok sayıda faktör mevcuttur. Bu çalışmanın amacı toplumdaki yaşlılarda fonksiyonel denge ile ilişkili faktörlerin araştırılmasıdır. Gereç ve Yöntem: Çalışmaya dahil edilme kriterlerine uyan 65 yaş ve üzeri olan 160 kişi alındı. Komorbiditelerin değerlendirilmesinde Ku?mu?latif Hastalık Deg?erlendirme Skalası kullanıldı. Fonksiyonel denge, Aktivitelere-özgü Denge Güven Skalası ile değerlendirildi. Emosyonel durumun değerlendirilmesinde Hastane Anksiyete ve Depresyon Ölçeği kullanıldı. Kognitif durum ise Mini Mental Durum Değerlendirmesi ile değerlendirildi. Denge güveni düşük, düşme riski yüksek olan hastalarda çok değişkenli lojistik regresyon analizi ile fonksiyonel denge ile ilişkili bileşenler belirlendi. Bulgular: Katılımcıların ortalama yaşı 71.3±5.8 yıl idi. Denge güveni düşük olan (ABC skoru?67) grupta yaş, boy, alt ekstremite ağrısı, uykusuzluk, düşme sıklığı, hipertansiyon, iskemik kalp hastalığı ve anemi oranları, kullanılan ilaç sayısı, bayan cinsiyet, tek başına yaşama oranları daha fazla idi; Ku?mu?latif Hastalık Deg?erlendirme Skalası, Hastane Anksiyete ve Depresyon Ölçeği skorları anlamlı olarak daha yüksekti, Mini Mental Durum Değerlendirmesi skoru ise anlamlı olarak daha düşüktü (p?0.05). Çok değişkenli indirgenmiş modelde fonksiyonel denge üzerinde yaş, boy, medeni durum, ilaç sayısı, ek hastalık sayısı, anksiyete düzeyinin anlamlı (p?0.05) etkinliği gözlenmiştir. Sonuç: Yaşlılarda fonksiyonel denge üzerinde birçok faktörün etkili olabileceği klinik pratik yaklaşımda göz önünde bulundurulmalıdır. Bununla beraber bu çalışmada yaşlılarda denge güveninin belirleyicileri yaş, boy, medeni durum, kullanılan ilaç sayısı, ek hastalık sayısı ve anksiyete düzeyi olarak belirlenmiştir

Bone Loss in Ankylosing Spondylitis: A Controlled Study - Original Investigation

Osteoporosis is common in ankylosing spondylitis (AS), which is a chronic inflammatory rheumatic disease.The aim of this study was to assess the bone loss and the effects of disease activity on bone mineral density in patients with AS. Thirty-three (29 men ,4 women ) patients with AS were included in the study. All of the patients were evaluated as their age, sex, height, weight, history, physical examination, laboratory and AP-lateral thoracic and lumbar vertebrae radiographic findings. Control group was consisted of 35 (31 men 4 women) age and sex-matched healthy person. Mean age and disease duration of the patient group were 43.2 ± 9.9 and 13.18 ± 10.6 years, respectively. Bone mineral density (BMD) was measured by dual energy x-ray absorptiometry (DXA) at lumbar spine and proximal femur regions. BMD did not show statistically significant difference at lumbar region between two groups. However BMD values were 10% lower at femur neck in patient group than controls. The rate of osteopenia and osteoporosis was 42.8 % at the femur neck region in the patient group and 22.8 % in the control group. BMD values at femur neck correlated with age and disease duration. There was no correlation between BMD and BASDAI and BASMI, BASFI, BASGI scores. In conclusion, bone loss is common in AS. Ligament calcification and syndesmophytes may lead to higher BMD values at lumbar region in AS .Thus proximal femur BMD is valuable in the patients with long disease duration. Disease activity has no negative effect on bone density in our study. (Osteoporoz Dünyasından 2006;12:81-3

Knee injury and osteoarthritis outcome score: Reliability and validation of the Turkish version

Objective: Knee injury and osteoarthritis outcome score (KOOS) is a useful scale in evaluating symptoms and functional status related to knee injury and knee osteoarthritis. This tool has five subscales, namely pain, symptoms, daily living, sports and recreational activities, and quality of life related to the knee. The purpose of this study was to evaluate the reliability and validity of the KOOS Turkish version in patients with knee osteoarthritis

Frequency, features, and factors for falls in a group of subacute stroke patients hospitalized for rehabilitation in Istanbul

Falling is a major complication seen in stroke patients. The purpose of this study was to investigate the frequency, features, and factors for falls affecting subacute stroke patients hospitalized for rehabilitation. Ninety-nine subacute stroke patients, hospitalized for rehabilitation were evaluated prospectively in this study. All patients were evaluated using the functional independence measurement (FIM), the Barthel index (BI), the Berg balance scale (BBS), the mini mental state examination (MMSE), the hospital anxiety depression scale (HADS), and the Downton index (DI), performed by the same physician. Proximal femur bone mineral density (BMD) measurements were performed using the dual-energy X-ray absorbtiometry (DXA). During the period of hospitalization, 17 patients (17.2%) reported falling once. The calculated incidence rate for falls was 6.3/1000 hospital days (95% confidence interval, CI = 3.7-10.1). Furthermore, 41% of the falls occurred in patients' rooms, 82% between the hours 06:00- 20:00, 47% while walking and 65% on the side affected from the stroke. Despite the fact that 30% of the patients had osteoporosis, no fractures were observed after these falls, 88% had only soft tissue injury. Overall, 88% of the patients reported they had a fear for falling. Admission DI scores were significantly lower in the group of patients with no falls compared to the group with falls (p < 0.05). Falls occurred most frequently during daytime, while subacute stroke patients were walking. DI is useful in stroke patients that are to be hospitalized for rehabilitation and accordingly, preventive action taken on those patients with a high risk for falls. (C) 2010 Elsevier Ireland Ltd. All rights reserved