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    Does quantitative tibial ultrasound predict low bone mineral density defined by dual energy X-ray absorptiometry?
    (Yonsei Univ College Medicine, 2008) Tuna, Hakan; Birtane, Murat; Ekuklu, Galip; Cermik, Fikret; Tuna, Filiz; Kokino, Siranus
    Purpose: Efforts for the early detection of bone loss and subsequent fracture risk by quantitative ultrasound (QUS), which is a non-invasive, radiation free, and cheaper method, seem rational to reduce the management costs. We aimed in this study to assess the probable correlation of speed of sound (SOS) values obtained by QUS with bone mineral density (BMD) as measured by the gold standard method, dual energy X-ray absorptiometry (DEXA), and to investigate the diagnostic value of QUS to define low BMD. Materials and Methods: One hundred twenty-two postmenopausal women having prior standard DEXA measurements were included in the study. Spine and proximal femur (neck, trochanter and Ward's triangle) BMD were assessed in a standard protocol by DEXA. The middle point of the right tibia was chosen for SOS measurement by tibial QUS. Results: The SOS values were observed to be significantly higher in the normal BMD (t score > - 1) group at all measurement sites except for the lumbar region, when compared with the low BMD group (t score < - 1). SOS was negatively correlated with age (r = - 0.66) and month since menopause (r = - 0.57). The sensitivity, specificity, and positive and negative predictive values for QUS t score to diagnose low BMD did not seem to be satisfactory at either of the measurement sites. Conclusion: Tibial SOS was correlated weakly with BMD values of femur and lumbar spine as measured by DEXA and its diagnostic value did not seem to be high for discriminating between normal and low BMD, at these sites.
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    Manual Therapy for Neck Pain and Headache: Review
    (Ortadogu Ad Pres & Publ Co, 2009) Kokino, Siranus; Kabayel, Derya Demirbag; Ozdemir, Ferda
    Chronic neck pain and headache are prevalent and a common source of disability in the population. The treatment of neck pain and headache is usually traditional including pharmacotherapy, physiotherapy, exercises and manual therapy. Opinions are controversial for manual therapy, which takes a significant part in the overall treatment of functional and degenerative disorders involving spine joints and muscles. The aim of manual therapy applied to cervical spine is to enhance restricted movement caused by blockage of cervical spinal joints keeping postural balance, to restore function and to maintain optimal spinal mechanics. There is little information available from randomized clinical trials to support manipulation and mobilization for treating neck pain. Cervical spine manipulations may be associated with vascular, neurological and other serious complications. These complications include radiculopathy, myelopathy, cervical disc herniation, arterial dissection and stroke, vertebral artery occlusion, Brown-Sequard syndrome, diaphragmatic paralysis, odontoid fracture, atlantoaxial injury, tracheal rupture and hearing loss. The manipulation techniques require good anatomy knowledge and clinical experience since they may cause serious complications especially of the neck area.
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    THE RELATION OF FUNCTIONAL INDEPENDENT MEASUREMENT AND AMBULATION WITH BONE MINERAL DENSITY IN PATIENTS WITH STROKE
    (Nobel Ilac, 2011) Murat, Sadiye; Ozdemir, Ferda; Kabayel, Derya Demirbag; Kasapoglu, Meliha; Kokino, Siranus; Berkarda, Sakir
    Objective: The aim of this study was to investigate the relationship between loss of functions and bone mineral density (BMD) in hemiplegic patients after stroke. Material and Method: 41 patients were evaluated. The Brunnstrom values, the Functional Independent Measurement (FIM) and the Functional Ambulation Categories (FAC) values were recorded. BMD measurements were evaluated with dual-energy X-ray absorbtiometry (DXA). Results: BMD decrease was significantly greater on the paretic side compared with the non paretic side. Patients who had not ambulated lost of their BMD in the paretic side and the loss was significantly higher than those who had ambulated. There was a positive correlation between FIM score and BMD values in the affected side. Conclusion: Our results suggest that the rapidity of the BMD loss is correlated to the functional independent and ambulation categories in poststroke hemiplegic patients.