Comparison of supervised exercise and home exercise after ankle fracture

Ankle fractures are common fractures of the lower extremities that have an incidence rate of 101 fractures per 100.000 person-years. It is not clear which rehabilitation intervention should be performed after an ankle fracture. The aims of this study are to compare the effectiveness of a supervised exercise program with that of a home exercise program and to determine and compare the costs of these programs. A supervised exercise program and a home exercise program were performed for 8 weeks. The supervised exercise group consisted of 35 patients (mean age 39.23 years), and the home exercise group consisted of 73 patients (mean age 41.78 years). The average follow-up was 27.86 +/- 9.88 months. Demographic information, injury details, type and classification of fracture, pain severity, and ankle range of motion were recorded. The clinical outcomes were determined by using the Pain Disability Index, the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score, and the Short-Form 36 Health Survey. Surgical and rehabilitation satisfaction was evaluated with the use of a numeric scale. American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scores were statistically significantly higher in the home exercise group (p = .036), and rehabilitation satisfaction of the supervised exercise group was statistically significantly better (p = .047). The total rehabilitation crude cost of a patient in the supervised exercise group is 1113.63 Turkish lira (310.25 U.S. dollars) versus 182.31 Turkish lira (50.79 U.S. dollars) in the home exercise group. Considering that the crude cost of the home exercise program is very low and clinical outcomes are satisfactory, we recommend that patients with surgically treated isolated ankle fractures be followed up with a postoperative home exercise program

Improved thermal stability in doped MnN/CoFe exchange bias systems

We investigated the influence of doping antiferromagnetic MnN in polycrystalline MnN/CoFe exchange bias systems, showing high exchange bias of up to 1800 Oe at room temperature. The thermal stability of those systems is limited by nitrogen diffusion that occurs during annealing processes. In order to improve the thermal stability, defect energies of elements throughout the periodic table substituting Mn were calculated via density functional theory. Elements calculated to have negative defect energies bind nitrogen stronger to the lattice and could be able to prevent diffusion. We prepared exchange bias stacks with doping concentrations of a few percent by (reactive) co-sputtering, testing doping elements with defect energies ranging from highly negative to slightly positive. We show that doping with elements calculated to have negative defect energies indeed improves the thermal stability. Y doped MnN layers with doping concentrations below 2% result in systems that show exchange bias fields higher than 1000 Oe for annealing temperatures up to 485{\deg} C

Residential Indoor Safety Through the Eyes of Elderly Users

Aim: One of the foundations of a healthy life, the quality of the house and its arrangement accord-ing to the user is important for the older adult who are at risk for home accidents. In this study, it was aimed to examine the security situation of the interior space in the residence for the elderly and to present a table containing the interior space criteria necessary for home safety. Method: 287 older adults with a mean age of 71.80±6.28 years participated in the study. Demographic and descriptive information of the participants were recorded. Home security level was evaluated with the Elderly Home Safety Checklist in Residential Interiors prepared by the researchers. At the end of the study, the participants were trained by interior architects and physiotherapists for interior arrangements and prevention of falls. Results: The majority of the older adults have sufficient natural and artificial lighting (% 90.2), the lighting switches are accessible (% 94.8), the furniture is of appropriate size (% 88.9), and the layout in the interior of their dwellings allows them to move comfortably and safely (% 94.1) reported. However, 54.4% of the partici-pants stated that the furniture was not fixed, 52.3% stated that precautions were not taken on the sharp corners of the furniture and surfaces to prevent injury, 76% stated that there were slippery floors in the interior of the house and 72.8% stated that there were thresholds. Con-clusion: It is thought that home accidents and injuries can be prevented to a large extent by evaluating the homes of the older adults by professionals, taking the necessary regulations and precautions, and spreading information about home accidents, home safety and falls

Artroskopik yardımlı mini-açık yöntem ile rotator manşet tamiri yapılan hastalarda gözetimli fizyoterapi programı ile ev egzersiz programının sonuçlarının karşılaştırılması

Objectives: This study aims to compare the results of supervised exercise program versus standardized home-based exercise program after rotator cuff repair with respect to severity of pain, functional status, quality of life, and depression. Patients and methods: Twenty-eight patients (5 males, 23 females; mean age 59.8 +/- 9.1 years; range 40 to 83 years) who had rotator cuff repair were evaluated. Patients were divided into two groups and the first group was treated with supervised physiotherapy (n=15) and the second group was treated with home-based exercise program (n=13). Pendulum exercises and passive exercises within pain limits were performed by all patients in the six-week immobilization period with shoulder sling with abduction pillow after rotator cuff repair. After this period, the patients in home-based exercise program were taught to perform active exercises and the patients in supervised physiotherapy group were treated with active shoulder range of motion exercises under the supervision of the physiotherapist. When patients reached to active full range of motion, strengthening exercises were added to exercise program. Patients were assessed preoperatively and at the end of the postoperative third month. Pain was evaluated with visual analog scale (VAS), functional status with Constant shoulder score, quality of life with short form-36 (SF-36), and depressive symptoms with Beck depression inventory (BDI). Results: There were significant improvements in all evaluation parameters in both groups after rotator cuff repair. Conclusion: There were no statistical differences between the patients who received exercise program under the supervision of the physiotherapist and the patients who were treated with standardized home-based exercise program for the efficacy of treatment in the evaluation of pain, functional status, quality of life, and depression status. When the rehabilitation programs were analyzed for cost effectiveness, the supervised physiotherapy group was found to have higher costs.Amaç: Bu çalışmada rotator manşet tamiri sonrası uygulanan gözetimli fizyoterapi programı ile standardize edilmiş ev egzersiz programının ağrı şiddeti, fonksiyonel durum, yaşam kalitesi ve depresyon durumu açısından sağladığı sonuçlar karşılaştırıldı. Hastalar ve yöntemler: Rotator manşet tamiri yapılan toplam 28 hasta (5 erkek, 23 kadın; ort. yaş 59.8±9.1 yıl; dağılım 40-83 yıl) değerlendirildi. Hastalar iki gruba ayrıldı, birinci gruba gözetimli fizik tedavi (n=15), ikinci gruba ev egzersiz programı (n=13) ile tedavi uygulandı. Tüm hastalara rotator manşet tamiri sonrası altı haftalık omuz abdüksiyon yastıklı kol askısı ile immobilizasyon döneminde ağrı sınırı içinde sarkaç egzersizleri ve pasif egzersizler uygulandı. Bu dönemi takiben ev egzersiz programı grubundaki hastalara aktif egzersizler öğretildi ve gözetimli fizyoterapi grubundaki hastalara fizyoterapist gözetiminde aktif omuz eklem hareket açıklığı egzersizleri yaptırıldı. Hastalar tam aktif eklem hareket açıklığına ulaşınca, egzersiz programına kuvvetlendirme egzersizleri eklendi. Çalışmada hastalar cerrahi öncesi ve sonrası 3. ay sonunda değerlendirildi. Ağrı şiddeti görsel analog skala (GAS) ile fonksiyonel durum Constant omuz skoru ile yaşam kalitesi kısa form-36 (KF-36) ile depresif semptomlar ise Beck depresyon envanteri (BDE) ile değerlendirildi. Bulgular: Her iki grupta da rotator manşet tamiri sonrası tüm değerlendirme verilerinde anlamlı düzeyde gelişme gözlendi. Sonuç: Fizyoterapist gözetiminde egzersiz programı alan hastalar ile standardize edilmiş ev egzersiz programı ile tedavi edilen hastalar arasında, ağrı, fonksiyonel durum, yaşam kalitesi ve depresif durum değerlendirmelerinde tedavi etkinliği için istatistiksel farklılık yoktu. Rehabilitasyon programları maliyet-etkinlik açısından incelendiğinde gözetimli fizyoterapi grubunun daha yüksek maliyete sahip olduğu bulundu

Şehirde ve kırsal kesimdeki yaşlıların ev güvenliğinin i̇ncelenmesi

AMAÇ: Yaşlanma sürecinde oluşan fizyolojik değişiklikler ve kronik hastalıklar yaşlıların, özelikle evlerinde yalnız yaşayanların kaza riskini artırmaktadır. Ev kazaları yaşlılar arasında en sık karşılaşılan sağlık problemidir. Bu çalışma bir ev güvenlik ve kontrol listesi kullanarak, şehirde ve kırsal kesimde yaşayan yaşlıların ev güvenlik durumunu belirlemek amacıyla tanımlayıcı olarak yapılmıştır. YÖNTEM: Aralık–Mart 2007 tarihleri arasında Türkiye’de şehirde yaşayan 330 ve kırsal kesimde yaşayan 182 olmak üzere toplam 512 yaşlı birey yüz yüze gözlem altında değerlendirilmiştir. Sosyodemografik bilgilere ilave olarak, katılımcıların ev durumları ve yaşam şekillerini belirten soruların yer aldığı bir anket uygulanmıştır. Ev güvenlik düzeyini belirlemek için bir Ev Güvenlik Kontrol Listesi kullanılmıştır. BULGULAR: Şehirdeki yaşlıların %51,8’i ve kırsal kesimdeki yaşlıların %42,8’i 65–69 yaşları arasında olup; şehirdeki yaşlıların %59,4’ü, kırsal kesimde yaşayan yaşlıların ise %61,5 eşi ile birlikte yaşadıkları saptanmıştır. Şehirde yaşayan yaşlıların %63,9’unun evinde kendine ait özel bir odası varken, kırsal kesimde yaşayan yaşlıların ise %53,8’inin kendine ait özel odası olduğu belirlenmiştir. Şehirde yaşayan yaşlıların sadece %2,1, kırsal kesimde yaşayan yaşlıların ise %0,5 ev güvenlik skoru mükemmel bulunmuştur. SONUÇ: Çalışmamızdan elde edilen sonuçlar Türkiye’de yaşayan yaşlıların birçoğunun evlerinin güvenlik açısından tehlikeli ve riskli olduğunu göstermiştir. Bu nedenle sağlık elemanları ve mimarların ev kazalarını önlemek için birlikte çalışmaları gerekmektedir

Einfluss von Carbonsäuren auf den Abscheidungsprozess von Chrom aus Chrom(III)-Elektrolyten

Der Ersatz von hexavalenten Chromverbindungen in der galvanischen Industrie ist seit der Registrierung, Bewertung, Zulassung und Beschränkung chemischer Stoffe (REACH-Verordnung) der Europäischen Union ein zentrales Thema. In der dekorativen Verchromung ist die Substitution durch adäquate Alternativen sehr vielversprechend. Allerdings ist der Ersatz von CrVI-Verbindungen in der funktionellen Verchromung herausfordernd, denn Chromschichten aus trivalenten und hexavalenten Elektrolyten unterscheiden sich bspw. in der Farbe und Korrosionsbeständigkeit. In dieser Arbeit wird die Wirkungsweise verschiedener organischer Säuren auf die Abscheidung von dickeren Chromschichtdicken (> 1 µm) untersucht. Wichtige Instrumente, um die Reaktion und die Chromabscheidung zu untersuchen, sind zum einen die Hochleistungsflüssigkeits-Chromatographie (HPLC, engl. High performance liquid chromatography), elektrochemische Quarzmikrowaage (EQCM), Polarographie (DPP, engl. differential pulse polarography), die Zyklovoltammetrie (CV, engl. Cyclic voltammetry) und zum anderen Querschliffanalysen. Die Schichtcharakterisierung erfolgte über die Rasterelektronenmikroskopie (REM). Die Ergebnisse der Untersuchungen zeigten, dass Reaktionsgeschwindigkeit, Abscheideraten und der daraus resultierende Schichtaufbau, von der Art und Konzentration der Carbonsäuren abhängen. Es konnten Aussagen über die Wirkung der Carbonsäuren als Komplexbildner getroffen und mit dem Chelat-Effekt erklärt werden. Mit einer optimalen Elektrolytzusammensetzung konnten Schichtdicken von 25 bis zu 85 µm abgeschieden werden. Möglichkeiten, die eine gleichmäßige, rissarme Abscheidung unterstützen, wurden untersucht. Ein abschließender Vergleich der Chromschichten aus einem industriell genutzten sechswertigen Hartchromverfahren und dem hier beschriebenen dreiwertigen Elektrolyten zeigt gute Übereinstimmungen. Lediglich der Korrosionsschutz der Chromschicht aus dem trivalenten Elektrolyten ist nur mit Hilfe einer zusätzlichen Nickelschicht zu gewährleisten.The substitution of hexavalent chromium compounds in the electroplating industry has been a key issue since the European Union's Registration, Evaluation, Authorization and Restriction of Chemicals (REACH) regulation. In decorative chromium plating, substitution with adequate alternatives is very promising. However, the substitution of CrVI compounds in functional chromium plating is challenging, because chromium layers from trivalent and hexavalent electrolytes differ, e.g. in color and corrosion resistance. In this work, the effect of different organic acids on the deposition of thick chromium layers (> 1 µm) is investigated. Important tools to study the reaction and chromium deposition are high performance liquid chromatography (HPLC), electrochemical quartz microbalance (EQCM), differential pulse polarography (DPP), cyclic voltammetry (CV) and cross-section analysis. Layer characterization was performed by scanning electron microscopy (SEM). The results of the investigations showed that the reaction rate of the complex formation, deposition rates and the resulting layer structure depend on the type and concentration of the carboxylic acids. Statements could be made about the effect of the carboxylic acids as complexing agents and could be explained with the chelate effect. With an optimized electrolyte composition, layer thicknesses of 25 to 85 µm could be achieved. Possibilities to deposit uniform layers with a low number of cracks were investigated. A final comparison of the chromium layers from an industrially used hexavalent hard chromium process and the trivalent electrolyte described in this work shows good agreement. However, high corrosion protection of the chromium layer from the trivalent electrolyte can only be guaranteed with the aid of an additional nickel layer

Functional results of local corticosteroid injections in the management of shoulder pain

Objective: To investigate the intensity of pain, range of motion (ROM) of shoulder and functional status in patients with shoulder pain after subacromial injection. Methodology: Mixed injection which was composed of 1cc/40 mg metilprednizolon asetat and 1 cc/9 mg bupivacaine was applied into subacromial zone for patients with shoulder pain. Patients were evaluated before injection and three months, one year after injection. ROM was measured with goniometer. Pain was evaluated with Visual Analog Scale (VAS). General condition of extremities was evaluated with Constant Shoulder Score and functional status of shoulder was evaluated with Turkish version of Disabilities of Arm, Shoulder and Hand (DASH-T). Short Form-36 was used to assess general health status of the patients. Beck Depression Scale was used for evaluation of depressive symptoms. Results: Sixty two patients were evaluated. Mean age was 51.16 +/- 10.58 years. It was observed that there was significant decrease for pain intensity and BDI scores, and significant increase for ROM of shoulder. Significant improvement in the functional status of upper extremities was also observed in these patients. Conclusion: Improvements for functional status of upper extremities and pain relief in patients with shoulder pain at short term after injection was observed