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Öğe Comparing the efficacy of exercise, internal and external shoe modification in pes planus: A clinical and pedobarographic study(Ios Press, 2017) Taspinar, Ozgur; Kabayel, Derya Demirbag; Ozdemir, Ferda; Tuna, Hakan; Keskin, Yasar; Mercimek, Oznur Berke; Sut, NecdetPes planus is a condition that can cause pain along the innerfoot due to the absence or abnormal depression of the longitudinal arch. There are few studies available that compare therapy modalities used in these patients. In our study, those treated with conservative therapies-internal and external shoe modifications and pes planus exercises -were compared clinically and pedobarographyically. 60 pes planus patients were included in the study. In the first group; internal modification was performed by placing a medial longitudinal arch support inside the shoe. In the second group, external shoe modification was performed using the Thomas heel. In the third group of patients however, only an exercise program was executed. The patients' foot pain levels, functional asssessment, satisfaction and quality of life were recorded. Pedobarography was used in measuring both static and dynamic plantar pressure. Assessments were carried out at baseline and at the end of the first and third months respectively where intra-and inter-group comparisons were performed. Each group was composed of 20 subjects. While improvement in terms of foot pain, foot function index and quality of life was observed in all the study groups (p < 0.05), the most improvement was observed in the group of patients treated with internal modification (p < 0.016). This was followed by the external modification and the exercise groups respectively. No difference was observed between the internal and external modification groups in terms of patient satisfaction. Cross-sectionally; clinical assessments, pedobarographic analysis were correlated. The changes observed after static and dynamic pedobarographic studies were not significantly different between the study groups. At the end of the study it was observed that internal modification yielded the most significant clinical improvement. In the literature, there are limited publications comparing the conservative treatments with each other. In this study we aimed to compare the conservative treatments for flatfoot.Öğe Comparison of the effectiveness of isokinetic exercise vs isometric exercise performed at different angles in patients with knee osteoarthritis(Ios Press, 2020) Kilinc, Serdar; Kabayel, Derya D.; Ozdemir, FerdaBACKGROUND: Strengthening exercises help improve physical function and muscle strength in knee osteoarthritis (OA). However, optimal exercise programmes for treating knee OA remain unclear. OBJECTIVE: To compare efficacy of isometric exercises performed at different angles and isokinetic exercises in patients with knee OA. METHODS: Patients were randomly divided into two groups. For four weeks, Group I (n = 15) and II (n = 17) patients with grade 2-4 performed isokinetic and isometric exercises at several different angles, respectively. Flexor and extensor knee muscle strengths were measured. Pain and physical function were assessed using VAS, WOMAC, the Lequesne Index and SF-36. All parameters were recorded at three time points: baseline (T0), after treatment (T1) and at 10-week follow-up (T2). RESULTS: VAS on movement, WOMAC, Leuqesne and SF-36 physical scores improved from T0 to T2 within each group, but Grade 3 and Grade 4 patients in the Group I showed better results compared with Group II at T2. Isokinetic exercise yielded higher extensor PM values than its isometric counterpart at T2 (P < 0.05) at 180 degrees/s for Grade 2 and Grade 3 patients. CONCLUSIONS: Both isokinetic and isometric exercises were effective in the treatment of knee OA of all grades in terms of pain reduction and functional improvements. However, isokinetic exercise produced longer lasting effects than isometric exercise.Öğe Do dietary calcium intake and hormone replacement therapy affect bone mineral density in women?(Aves Yayincilik, Ibrahim Kara, 2008) Ozdemir, Ferda; Kabayel, Derya Demirbag; Ture, MevlutObjectives: In this study, the relationship between postmenopausal bone mineral density (BMD), and hormone replacement therapy (HRT) and the level of dietary calcium intake in women was investigated. Patients and Methods: Two hundred postmenopausal women (mean age 58.89 +/- 8.51 years; range 42 to 83 years) were evaluated retrospectively. Menopausal age and duration, HRT status, and daily dietary calcium intake of all patients were recorded. Evaluation of BMD was made with Dual Energy X-Ray Absorptiometry (DEXA) from lumbar spine and femur and the T scores were obtained. Results: There was a significant negative correlation between the patients' age and duration of menopause, and BMD. The BMD values of the patients not receiving HRT were significantly lower than those of the patients receiving HRT In women with dietary calcium intake above 1000 mg/day, spine and femur BMD values were significantly higher than in those with an intake below 600 mg/ day and between 600-1000 mg/day. Conclusion: We think that dietary calcium intake and HRT status can be an indicator for BMD in postmenopausal women.Öğe Do the Brain Perfusion SPECT Findings Reflect the Outcome of Rehabilitation in Stroke Patients?(Lippincott Williams & Wilkins, 2009) Kabayel, Derya Demirbag; Ozdemir, Ferda; Kaya, MeryemThe purpose of this study is to investigate the association between brain perfusion single-photon emission computed tomography (SPECT) changes and the observed improvement in the clinical parameters, and therefore evaluate whether or not SPECT can predict the outcome of the rehabilitation of patients. Nineteen stroke patients were included in the prospective study. Patients were hospitalized within the first month after their stroke and were in the rehabilitation program for 2 months. A clinical evaluation and a brain perfusion SPECT was conducted during the admission, and on the completion of the rehabilitation program. The outcome measurements included Brunnstrom stage, Modified Ashworth Scale, functional independence measurement, functional ambulation categories, and mini-mental state examination. The brain perfusion SPECT was conducted by the evaluation of the regional cerebral blood flow on 12 different regions on both of the hemispheres. The comparison of the first and the third month clinical scores showed a statistically significant difference. However, the brain perfusion SPECT values' first and third month comparisons showed no difference on any of the measured parameters. Furthermore, there was no correlation between the clinical scores and SPECT values, for both the first month measures and the third month measures. The observed clinical improvement observed during the rehabilitation process of the stroke patients has no association to brain perfusion SPECT evaluations. Brain perfusion SPECT could not be a very good predictor for measuring clinical outcomes for stroke patients.Öğe The effect of magnetic field therapy and electric stimulation on experimental burn healing(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Keskin, Yasar; Tastekin, Nurettin; Kanter, Mehmet; Top, Husamettin; Ozdemir, Ferda; Erboga, Mustafa; Taspinar, OzgurObjectives: : In this study, we aimed to compare morphological and histological differences between magnetic field and electric stimulation therapies in an experimental burn injury model in rats. Materials and methods: Between February 2011 and July 2011, a total of 21 Sprague-Dawley female rats were used in this study. Second-degree burns were induced on the back areas of the rats. All rats were equally divided into three groups including seven in each: the first burn group was treated with antibacterial pomade (Group 1, control group); the second group was treated with both antibacterial pomade and pulsed electromagnetic field therapy (Group 2); and the third group was treated with antibacterial pomade and electric stimulation for 14 days (Group 3). Results: Earlier re-epithelialization, wound area contraction, reduction of edema, and hyperaemia were observed on gross examination in the pulsed electromagnetic fields and electric stimulation therapy groups compared to the control group. Neovascularization, collagen density, granulation tissue formation, cell proliferation, and inflammatory cell response of the pulsed electromagnetic fields and electric stimulation group increased, compared to the control group, in the histopathological evaluation (p<0.05). Conclusion: Our study results showed the positive healing effects of electric stimulation and pulsed electromagnetic fields on burn injury. Pulsed electromagnetic fields therapy produced more positive signs of healing than the electric stimulation group.Öğe The effects of medical treatment and rehabilitation in a patient with adult tethered cord syndrome in the late postoperative period(Int Scientific Information, Inc, 2007) Kabayel, Derya Demirbag; Ozdemir, Ferda; Unlu, Ercumnent; Bilgili, Nilgun; Murat, SadiyeThe possibility of functional tethered cord syndrome (TCS) should be considered when adolescent patients present with unexplained lumbar, buttock, and leg symptoms. Symptoms progress if untreated. Success depends on early diagnosis, the complete untethering of the spinal cord, and rehabilitation. A rare case of adult TCS is reported. A 42-year-old female patient with lower back and leg pain, severe flexor reflex responses, and a walking disorder was evaluated. Gabapentin and tizandine were given to treat to the neuropathic pain and flexor reflex responses. An exercise program was applied to improve the walking disorder. Finally, the patient's complaints of pain considerably decreased, flexor reflex responses were reduced, and a more comfortable walking motion was observed. A rehabilitative approach is very important and a multidisciplinary follow-up and treatment procedure is required in the clinical healing process of all patients presenting with a tethered cord condition, whether surgical intervention is carried out or not.Öğe The effects of neuromuscular electrical stimulation on clinical improvement in hemiplegic lower extremity rehabilitation in chronic stroke: A single-blind, randomised, controlled trial(Taylor & Francis Ltd, 2009) Mesci, Nilgun; Ozdemir, Ferda; Kabayel, Derya Demirbag; Tokuc, BurcuObjective. In this study, the effectiveness of neuromuscular electrical stimulation (NMES) was evaluated in lower extremity rehabilitation in patients with chronic stroke. Method. The study enrolled 40 patients with chronic stroke. Twenty patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received NMES treatment for hemiplegic foot dorsiflexor muscles for 4 weeks, 5 days a week. The sessions were performed as one session per day and added to a total of 20 sessions. Clinical parameters were evaluated before and after the treatment. Results. Pre-treatment and post-treatment evaluations showed a significant increase in ankle dorsiflexion and a significant decrease in the level of spasticity in the treatment group (p<0.05); however, there were no significant differences in the control group between the pre-treatment and post-treatment measures. Although Brunnstrom Stage, Rivermead leg and trunk score and Functional Independence Measurement motor subscore showed a significant improvement in pre-and post-treatment comparisons for both groups, the treatment group's scores were significantly higher than the control group (p<0.05). Functional Ambulation Categories showed a significant improvement in both groups following the treatment; however, there was no significant difference between the two groups (p>0.05). Conclusions. Use of NMES in hemiplegic foot dorsiflexion can contribute to the clinical improvement of patients when used in combination with rehabilitation programs.Öğe The Effects of Pulsed Electromagnetic Field Treatment in Pain Due to Diabetic Polyneuropathy(Aves Yayincilik, Ibrahim Kara, 2010) Fezyioglu, Pervin; Ozdemir, Ferda; Guldiken, Sibel; Balci, Kemal; Sut, NecdetObjectives: Diabetic polyneuropathy is the most common and disabled complication of diabetes mellitus. Pharmacological treatment of diabetic neuropathy is limited because of the side efects of the drugs, used in the treatment of diabetic neuropthy. Alternative treatments are also used in diabetic neuropathy. Systemic side effects of non-pharmacological treatment modalities are rare. We evaluated the value of pulsed electromagnetic field treatment in patients with pain due to diabetic polyneuropathy. Patients and Methods: Symptomatic 95 patients were included in the study, and from these patients, 25 patients were randomized in pulsed electromagnetic field treatment group and 25 patients were randomized in placebo group. Pulsed electromagnetic field device was applied over both feet of the patients for one hour a day (during 10 days). Visual analog scale and neuropathic pain scale of all patients were performed before and after treatment and 6th week. Electroneuromyography was also performed before treatment and 6th week. Results: Improvement of pain determined by visual analog scale was 53% after treatment and 67% six weeks later. The improvement of visual analog scale scores were statistically significant in study group when compared with control subjects. Conclusion: The pulsed electromagnetic field may be an alternative treatment modality in diabetic patients with neuropathic pain.Öğe Efficacy of Three-Dimensional Contrast-Enhanced Magnetic Resonance Angiography (3D CE-MRA) in the Diagnosis of Thoracic Outlet Syndrome(Galenos Publ House, 2011) Unlu, Ercument; Kabayel, Derya Demirbag; Ozdemir, Ferda; Cagli, Bekir; Tuncel, Sedat A.Objective: The purpose of this study is to evaluate the effect of various upper extremity positions (adduction-abduction) on vascular structures in contrast-enhanced three-dimensional MR angiographic studies performed in patients with thoracic outlet syndrome. Materials and Methods: Twenty-two consecutive patients with clinical symptoms of neurovascular thoracic outlet syndrome were examined by 1.0 T MR unit. Examinations were studied by three-dimensional contrast-enhanced MR angiography with the arms positioned in abduction and adduction in the same patients. Results: In twenty-one of 44 subclavian arteries, impingement or stenosis with different degrees were found. Majority of lesions were localized in the costoclavicular region. Venous phase sequences of contrast-enhanced MR angiography showed compression of the subclavian vein in the 17 areas. Conclusion: Thoracic outlet syndrome remains controversial in both diagnosis and treatment, particulary in patients with no muscle atrophy, hand ischemia findings or venous stasis symptoms. Three-dimensional contrast-enhanced MR angiography is noninvasive and requires neither ionizing radiation nor administration of iodinated contrast material- and may be used to diagnose early compression findings and stenosis of the subclavian vessels.Öğe Efficiency of Magnetic Field Treatment on Pressure Sores in Bedridden Patients(Galenos Publ House, 2011) Ozdemir, Ferda; Kasapoglu, Meliha; Oymak, Figen; Murat, SadiyeObjective: Pressure sores are an important source of complications in patients who are immobilized and bedridden. We aimed to investigate the efficiency of magnetic field treatment in pressure sores. Material and Methods: This was a randomized, double blind controlled design study. 20 patients in the study group received magneto-therapy, once a day for 30 minutes and with 150G, keeping to the BTL09 magnetotherapy device's program. In the control group, 20 patients received the dressing only once a day. The surface areas of the pressure sores were evaluated at the onset of the treatment (1(st) day), and on the 7(th) and 15(th) days. Results: When within group comparisons were conducted, a significant difference was observed between the 1(st) and 7(th) day, 7(th) and 15(th) day, and 1(st) and 15th day measures in both the groups in terms of the scar area. The average healing time for the treatment group was 10.80 +/- 4.06 (6-20) days, and the average healing time for the control group was 18.85 +/- 9.75 (5-32) days. There was a statistically significant difference between the two groups (z=-2.114, p=0.034). Also, there was a significant difference in the scar area between the two groups in the 15th day measure (z=-3.818, p=0.000). Conclusion: The healing process of the tissue can be accelerated with the use of magnetotherapy in the treatment of pressure sores of stage II and III,Öğe Evaluation of the efficacy of therapeutic ultrasound on bone mineral density in postmenopausal period(Springer Heidelberg, 2008) Ozdemir, Ferda; Zateri, Coskun; Murat, SadiyeTherapeutic ultrasound is a frequently used modality in the practice of physical therapy. However, its effects on osteoporosis (OP) are not clear. We investigate the effect of therapeutic ultrasound on bone mineral density (BMD). We examined retrospectively 1,610 postmenopausal patients' data and we created two groups. The treatment group consisted of 36 patients who have been applied only the ultrasound treatment and the control group consisted of 38 patients who have never received any kind of physical treatment. Both of two groups have never received OP treatment. The mean values of BMD showed no significant difference between the treatment and control groups. Patients' BMD values, within the treatment group, were compared according to the treatment application region. There was no significant difference among groups. We determined that the ultrasound application has no effect on BMD. However, we consider that therapeutic ultrasound will help to decrease the skeletal system related complaints of the patients, improve their exercise capacity, and decrease the risk of osteoporosis.Öğe Factors Affecting the Age of Admission of Postmenopausal Women to an Osteoporosis Outpatient Clinic(Turkish League Against Rheumatism, 2010) Ozdemir, Ferda; Yazici, Senay Demir; Kabayel, Derya Demirbag; Sut, NecdetObjective: In the present study, the factors that may potentially affect the age of admission of postmenopausal women to an osteoporosis (OP) outpatient clinic were evaluated. Materials and Methods: Two hundred and twenty-six postmenopausal women admitted to our OP outpatient clinic were studied retrospectively. The level of education, occupation, age at menopause, duration of menopause, history of hormone replacement therapy (HRT), exercise routine, history of medication use that may cause secondary OP, and family history of OP were questioned. Lumbar spine and femur bone mineral density (BMD) measurements were performed by dual energy x-ray absorptiometry (DEXA). The data were analyzed by linear regression. Results: The mean age of the patients was 58.8 +/- 8.7 years (range, 37-82 years) and the mean age at menopause was 45.2 +/- 5.8 years. Multiple backward stepwise linear regression was performed. When factors which could potentially affect the age of admission to OP outpatient clinic were included in the model, only 2 factors (age at menopause and duration of menopause) were shown to affect the age of admission. These two variables explained 98.9% of the variation (adjusted R(2)) in admission age (p < 0.001). Conclusion: The most important factors affecting the age of admission of postmenopausal women to the OP outpatient clinic were determined to be the age at menopause and the duration of menopause. (Turk J Rheumatol 2010; 25: 72-6)Öğe Frequency, Distribution and Severity of Prevalent Osteoporotic Vertebral Fractures in Postmenopausal Women(Turkish Neurosurgical Soc, 2013) Kilincer, Cumhur; Demirbag Kabayel, Derya; Cagli, Bekir; Unlu, Ercument; Wicki, Barbara; Ozdemir, FerdaAIM: Assessment of previous vertebral fractures provides useful information to predict future fracture risk. This study aimed to determine the frequency, distribution and severity of prevalent osteoporotic vertebral fractures in postmenopausal women. MATERIAL and METHODS: Data on patient characteristics, bone densitometry values, and spine radiographs (T2-L5) were reviewed in 232 postmenopausal women admitted to our osteoporosis clinic. RESULTS: Prevalent vertebral fractures were detected in 28 (12.1%) women (95%Cl: 7.8 16.3). Fifteen women (6.5%) had mild fractures and 13 (5.6%) had moderate or severe fractures according to Genant's semi-quantitative technique. The T-score was associated with the presence of prevalent vertebral fractures (OR= 0.61; 95%Cl: 0.38-0.96, P= 0.034). The most frequently fractured vertebrae were T11 and T12, followed by T7 and T9. Sixty percent of fractures were wedge-type while 40% were biconcave. The frequency of wedge-type fractures at the T11-T12 levels (93.8%) was higher compared to that at all other levels (44.1%) (P= 0.001). CONCLUSION: We determined the frequency, distribution, and severity of prevalent fractures and identified certain distribution patterns of fracture locations and types. To verify our results and detect possible predictive factors for fracture risk, population-based larger trials are needed.Öğe Manual Therapy for Neck Pain and Headache: Review(Ortadogu Ad Pres & Publ Co, 2009) Kokino, Siranus; Kabayel, Derya Demirbag; Ozdemir, FerdaChronic 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.Öğe Pain, Body Mass Index, and Bone Mineral Density in Patients with Postmenopausal and Senile Osteoporosis(Haworth Press Inc, 2009) Ozdemir, Ferda; Rodoplu, Meliha; Zateri, CoskunObjective: Osteoporosis [OP] itself does not cause pain and usually has no signs or symptoms. However, pain occurs when there is a fracture or a posture change due to OP. The purpose of this retrospective study was to explore the pain condition in patients with postmenopausal and senile OP. Methods: We studied symptoms of pain in 909 postmenopausal women between the ages of 33 and 89 years. The patients were retrospectively assessed in our outpatient service. Menopause age, duration of menopause, bone mineral density [BMD] values [gr/cm2], their reports of pain, duration of the pain experienced, and body mass index [BMI] were recorded. Results: We found 695 patients [76.45 percent] reported experiencing pain and 214 patients [23.54 percent] reported no pain. The duration of pain was 8.7 5.27 [minimum: 1, maximum: 26] years. We detected 82 cervical [11.79 percent], 77 dorsal [11.07 percent], 175 lumbar [25.17 percent], 183 knee [26.33 percent], and 177 general [25.46 percent] cases of pain. There was no significant difference in BMD between patients with and without pain [P 0.05]. The mean BMI of patients with pain were significantly higher than the mean BMIs of patients without pain. Among the patients who reported experiencing pain, the highest BMI values were in the knee pain group. Mean BMIs of the knee pain and dorsal pain groups were significantly higher than the mean BMIs of the painless group. Conclusion: OP commonly affects the spine and may cause debilitating pain. Pain can be either a warning sign of weakened bones and potential injury for women or a symptom of a spinal fracture. However, we did not find a significant association between a change in BMD and pain in postmenopausal and senile women. We detected a relationship between pain and BMI in the patients with knee, dorsal, and general pain.Öğe 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, SakirObjective: 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.Öğe The relationship between magnetic resonance Imaging findings and postural Maneuver and physical examination tests in patients with thoracic outlet syndrome: Results of a double-blind, controlled study(W B Saunders Co-Elsevier Inc, 2007) Demirbag, Derya; Unlu, Ercument; Ozdemir, Ferda; Genchellac, Hakan; Temizoz, Osman; Ozdemir, Huseyin; Demir, KemalObjectives: To investigate the differences in findings from magnetic resonance imaging (MRI) in the neutral and provocative positions, and to examine the relationship between these differences and the results of physical examination tests in patients with thoracic outlet syndrome (TOS). Design: Prospective. Setting: University physical medicine and rehabilitation outpatient and radiology clinics. Participants: Twenty-nine patients and 12 healthy controls. All of the patients had positive bilateral TOS stress tests; control group participants were symptom free and had negative TOS stress tests bilaterally. Interventions: Not applicable. Main Outcome Measures: All participants underwent Adson's test, the Halsted maneuver, and a hyperabduction test. All were evaluated with MRI while in 2 positions: the neutral position (upper extremities adducted) and in a provocative position. Measurements were obtained at the interscalene triangle, at the costoclavicular space, and at the retropectoralis minor space. Results: There was a significant difference in MRI findings between the neutral and provocative position in the patient (P<.05), but there were no significant differences in the control group. There was a significant difference in the positional change values in MRI between the patients and the control subjects (P<.05). The difference was found in the minimum costoclavicular distance between patients with a positive Halsted maneuver and a negative Halsted maneuver (P<.05). Conclusions: Our findings indicate that MRI findings in patients in a provocative position are more valuable in the diagnosis of TOS, and these findings are in accord with findings from the physical evaluation tests.
