Derya Demirbağ Kabayel

The effects of neuromuscular electrical stimulation on clinical improvement in hemiplegic lower extremity rehabilitation in chronic stroke: a single-blind, randomised, controlled trial.

Objective. 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 groups 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.

Frequency, distribution and severity of prevalent osteoporotic vertebral fractures in postmenopausal women.

AIM 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%CI: 7.8 16.3). Fifteen women (6.5%) had mild fractures and 13 (5.6%) had moderate or severe fractures according to Genants semi-quantitative technique. The T-score was associated with the presence of prevalent vertebral fractures (OR= 0.61; 95%CI: 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.

The Cut-off Values for the Diagnosis of Hamstring Shortness and Related Factors

Background: Hamstrings are one of the most frequently evaluated muscle groups for flexibility in the lower extremity. Passive and active knee extension angle values are used as an indirect indicator of hamstring flexibility. However, the lack of consensus on the cut-off values leads to the use of inconsistent angle values in determining the hamstring tightness. Aims: To establish the normative and cut-off values of the passive and active knee extension angles for healthy young adults and to determine the associated factors including the quadriceps strength. Study Design: A cross-sectional study. Methods: A total of 123 volunteer university students, aged 18-24 years, who met the inclusion criteria were included in this study. Passive and active knee extension assessments of the subjects were performed. Subsequently, on the next day, both knee extensor concentric muscle strength of the participants was measured in the isokinetic system. The knee extension angles and the knee extensor strength were recorded as the mean values of the right and the left sides. Results: Passive knee extension angles of 17.1°±9.1° and 9.8°±5.7° and active knee extension angles of 17.8°±9.1° and 13.4°±6° were described as normative values in men and women, respectively. The cut-off values for the diagnosis of hamstring shortness were as follows: passive knee extension angle >32.2° for males and >19.2° for females and active knee extension angle >33.0° for males and >23.4° for females. A significant positive correlation was observed between knee extension angles and isokinetic knee extensor muscle strength in all participants. The knee extension angle and hamstring flexibility were not affected by dominance. Conclusion: The knee extension angles of healthy young people seem to be lower than the results currently reported in the literature. There s a positive correlation between knee extension angles and isokinetic knee extensor muscle strength.