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

Diz osteoartriti olan yaşlı hastaların ev egzersiz tedavisine uyumu

Objectives: This study aims to evaluate the compliance to home-based exercise regimen by elderly patients with osteoarthritis of the knee. Patients and methods: Between May 2012 and May 2013 year, a total of 72 patients (54 females, 18 males) over 65 years old with knee osteoarthritis admitted to the Physical Medicine and Rehabilitation outpatient clinic were included in the study. The patients were given a home-based exercise program. They were recommended to perform the exercises 10 times twice a day, for a month. We evaluated the patients’ demographic data, comorbid diseases, whether they exercised previously and compliance to exercise. Results: All patients’ home exercise program compliance was 62.5%. Males were more compliant than female patients and high education and comorbidity were also associated with poor compliance. Conclusion: The compliance of the geriatric patients to home-based exercise program is difficult and multiple variables affect the compliance

Kırık Sekeli Nedeniyle Fizik Tedavi Gören 21 Olgunun Adli Tıp Açısından İrdelenmesi

Mahkemeler zaman zaman travmatik kırığa maruz kalmış şahısların hayati tehlike geçirip geçirmedikleri, mutad iştigalden ne kadar süreyle kaldıkları, uzuv tatili veya devamlı uzuv zaafına duçar olup olmadıkları ve maluliyet oranlarını öğrenmek amacıyla tıbbi bilirkişilerin mütalalarını almaktadır. Bu çalışmada travmatik kırık sonucu sekel kalan ve fizik tedavi uygulaması programına alınan 21 olgu yaş, cinsiyet, meslek, kırık yeri, fizik tedaviye kadar geçen süre gibi bir takım parametreler yönünden incelenmiş, fizik tedaviden önce ve sonraki genel vücut çalışma güçlerinden kayıp oranları hesaplanmış ve durumları uzuv tatili ve devamlı uzuv zaafı açısından tartışılmıştır. Anahtar Kelimeler: Travmatik Kırık, Fizik Tedavi, Maluliye

Acute Calcium Pyrophosphate Arthritis after Parathyroidectomy

Hypocalcemia after parathyroidectomy is a well-known metabolic sequela, but rare conditions such as acute calcium pyrophosphate (CPP) arthritis can be observed. In this study, we presented a case of acute CPP arthritis in both knees after parathyroidectomy. A 48-year-old man presented with pain and swelling in his right knee that started 1 day ago. There was no feature in his background and family history other than parathyroidectomy surgery performed for parathyroid adenomy a week ago. The diagnosis of acute CPP arthritis was made on the basis of blood, imaging and synovial fluid analysis. Evaluation was made after 3 days and acute arthritis in left knee was detected. Similar findings were also observed in the synovial fluid examination. After cold application and colchicine 1 mg/day started, improvement in arthritis and acute phase markers was detected. Acute CPP arthritis after parathyroidectomy is a rare condition and there are various theories in this regard. According to the most widely accepted theory; as a result of the decrease in the calcium level, the solubility of the CPP crystals decreases, and the CPP crystals previously deposited in the articular cartilage are poured into the synovial fluid. As a result; CPP arthritis should also be considered in differential diagnosis in patients with arthritis after parathyroidectomy and synovial fluid analysis should be performed

Assessment of Sexual Dysfunction in Patients with Fibromyalgia Syndrome

Objectives: The aim of our study is to determine the presence, quality of sexual dysfunction in patients with fibromyalgia syndrome and to compare with normal population. Material and Methods: A total of 55 sexually active women who were admitted to Department of Physical Therapy and Rehabilitation of Antalya Research and Training Hospital and diagnosed with fibromyalgia syndrome according to 1990 and 2010 American College of Rheumatology (ACR) criteria. A control group composed of 50 sexually active women who were admitted to our clinic with various musculoskeletal system complaints were also included in the study in order to compare the parameters used for clinical assessment of patients and to determine whether the patients differ from normal population. Patients and controls who met inclusion criteria were applied Female Sexual Function Index (FSFI) for assessment of sexual function. This test was developed by Rosen and colleagues in 2000, it is composed of 19 questions and inquires six different dimensions including desire, arousal, lubrication, orgasm, sexual satisfaction and pain. Turkish validation test was done by Turkish Society Of Andrology in 2003, answers are multiplied with a coefficient and each section is evaluated on six scores. Minimum score is 2.4 and maximum is 36 and standardly used for assessment of female sexual dysfunction in Turkey. Results: Subscale and total score of Female Sexual Function Index of Fibromyalgia syndrome patients were found statistically significantly lower than those of control group (p<0.05). Conclusion: Disorders of sexual function or its quality are one of the problems seen in fibromyalgia syndrome patients. It should be noticed that sexual function assessment must be a part of treatment of fibromyalgia syndrome. It is quite difficult to determine the mechanism between sexual dysfunction and fibromyalgia syndrome and new and larger studies are needed to determine this mechanism. (Turkish Journal of Osteoporosis 2013;19: 65-8

Postoperative spondylodiscitis in a patient with ankylosing spondylitis diaphragmatic rupture

Bu olguda ankilozan spondilit tanısı olan, koksartroz nedeniyle sağ total kalça protezi cerrahisi geçirdikten sonra spondilodiskit gelişen hasta sunulmuştur. Cerrahi sonrası bacaklarda kuvvetsizlik, hareketle artan şiddetli bel ağrısı oluşan hastada parapleji gelişmesi sonucu çekilen manyetik rezonans görüntülemede torakal 11-12 vertebralar seviyesinde korda bası yapan spondilodiskit tespit edilmiş olup, hastaya T11 total laminektomi+kostatransversektomi uygulanıp, rehabilitasyon amaçlı servisimize yatırılmıştır. Etiyolojik bir neden bulunamamıştır. Tedavi sonrası alt ekstremite kas kuvvetleri düzelen hasta çift kanedyenle mobilize bir şekilde taburcu edilmiştir. Bu olguyu, cerrahi sonrası şiddetli bel ağrısı ve kas gücü kaybında tanı olarak spondilodiskiti de düşünmemiz ve ankilozan spondilitli hastalarda spondilodiskit komplikasyonunu hatırlatmak için hazırladık.In this case we present a patient with ankylosing spondylitis for 35 years who had spondylodiscitis after right total hip replacement operation. After right total hip replacement operation, patient had a progressive paraparesis of lower extremity, advanced to paraplegia, so we performed a thoracic magnetic resonance imaging which had spondylodiscitis with spinal cord compression at thoracic 11-12 vertebra levels. The patient is hospitalised for rehabilitation after T11 total laminectomy+- costotransversectomy. We couldn’t find any etiologic factor after our examination. Patient was discharged with better muscle strength with double crutches. We presented this case to remind spondylodiscitis after surgery and spondylodiscitis as a complication of ankylosing spondylitis

EFFECT OF STRENGTH AND ENDURANCE TRAINING ON COGNITION IN OLDER PEOPLE

The purpose of this study was to investigate the effect of moderate strength and endurance training on cognition evaluated by event-related potentials (ERP) in older people. Thirty-six adults, aged 60-85 years, were randomly divided into three groups: sedentary control (C), strength training (ST), and endurance training (ET). Participants performed functional fitness tests and ERP data were recorded before and after nine weeks of training. Training involved three sessions per week. Functional fitness test performance improved significantly in the ST and ET groups. The latencies of the N1, N2, and P2 components and the amplitudes of the N1P2, P2N2, and N2P3 components differed significantly between groups (p < 0.05). After training, the latencies of the P2 and N2 components at the Fz and Cz sites, decreased significantly, and the amplitudes of the N1P2, P2N2, and N2P3 components at the Fz site and the N1P2 and N2P3 components at the Cz site, increased significantly in the ST group compared with the ET group. After training, the latencies of N1, N2, and P2 components shortened significantly, and the amplitudes of the N1P2, P2N2, and N2P3 components increased significantly in the ST group compared with the C group. The latencies of the N2 and P2 components shortened significantly in the ET group compared with the C group, although the amplitudes of the ERP recordings did not differ significantly between groups. These data suggest that strength training might facilitate early sensory processing and cognitive functioning in older individual

Diz osteoartriti olan yaşlı hastaların ev egzersiz tedavisine uyumu

Amaç: Bu çalışmada diz osteoartriti olan yaşlı hastaların ev egzersiz programına uyumları değerlendirildi.Hastalar ve yöntemler: Mayıs 2012 ve Mayıs 2013 tarihleri arasında Fiziksel Tıp ve Rehabilitasyon polikliniğine diz osteoartriti nedeni ile başvuran 65 yaş üstü 72 hasta (54 kadın, 18 erkek) çalışmaya dahil edildi. Hastalara ev egzersiz programı verildi. Egzersizleri bir ay boyunca günde iki kez 10 tekrar şeklinde yapmaları önerildi. Hastaların demografik verileri, eşlik eden hastalıkları, önceden egzersiz yapıp yapmadıkları ve egzersiz uyumları değerlendirildi.Bulgular: Tüm hastaların ev egzersiz programına uyumları %62.5 idi. Erkekler kadın hastalara kıyasla egzersiz programına daha uyumlu iken yüksek eğitim düzeyi ve eşlik eden hastalıkların varlığı zayıf uyum ile ilişkiliydi.Sonuç: Yaşlı hastaların ev egzersiz programlarına uyumu zordur ve birçok değişken uyumu etkilemektedirObjectives: This study aims to evaluate the compliance to home-based exercise regimen by elderly patients with osteoarthritis of the knee.Patients and methods: Between May 2012 and May 2013 year, a total of 72 patients (54 females, 18 males) over 65 years old with knee osteoarthritis admitted to the Physical Medicine and Rehabilitation outpatient clinic were included in the study. the patients were given a home-based exercise program. They were recommended to perform the exercises 10 times twice a day, for a month. We evaluated the patients' demographic data, comorbid diseases, whether they exercised previously and compliance to exercise.Results: All patients' home exercise program compliance was 62.5%. Males were more compliant than female patients and high education and comorbidity were also associated with poor compliance.Conclusion: the compliance of the geriatric patients to home-based exercise program is difficult and multiple variables affect the complianc

Postoperative spondylodiscitis in a patient with ankylosing spondylitis diaphragmatic rupture

Bu olguda ankilozan spondilit tanısı olan, koksartroz nedeniyle sağ total kalça protezi cerrahisi geçirdikten sonra spondilodiskit gelişen hasta sunulmuştur. Cerrahi sonrası bacaklarda kuvvetsizlik, hareketle artan şiddetli bel ağrısı oluşan hastada parapleji gelişmesi sonucu çekilen manyetik rezonans görüntülemede torakal 11-12 vertebralar seviyesinde korda bası yapan spondilodiskit tespit edilmiş olup, hastaya T11 total laminektomi+kostatransversektomi uygulanıp, rehabilitasyon amaçlı servisimize yatırılmıştır. Etiyolojik bir neden bulunamamıştır. Tedavi sonrası alt ekstremite kas kuvvetleri düzelen hasta çift kanedyenle mobilize bir şekilde taburcu edilmiştir. Bu olguyu, cerrahi sonrası şiddetli bel ağrısı ve kas gücü kaybında tanı olarak spondilodiskiti de düşünmemiz ve ankilozan spondilitli hastalarda spondilodiskit komplikasyonunu hatırlatmak için hazırladık.In this case we present a patient with ankylosing spondylitis for 35 years who had spondylodiscitis after right total hip replacement operation. After right total hip replacement operation, patient had a progressive paraparesis of lower extremity, advanced to paraplegia, so we performed a thoracic magnetic resonance imaging which had spondylodiscitis with spinal cord compression at thoracic 11-12 vertebra levels. The patient is hospitalised for rehabilitation after T11 total laminectomy+- costotransversectomy. We couldn’t find any etiologic factor after our examination. Patient was discharged with better muscle strength with double crutches. We presented this case to remind spondylodiscitis after surgery and spondylodiscitis as a complication of ankylosing spondylitis