Ilke Keser

Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients

BACKGROUND The aims of this study were to test the validity, test-retest reliability, and internal consistency of Turkish version of FIS; the variables affecting FIS score. MATERIALS AND METHODS 71 MS patients and 68 healthy subjects were included to the study. RESULTS Total FIS score and subscale scores were different statistically between MS patients and healthy volunteers in both first and second FIS applications (p<0.001). These results showed that FIS is validated in divergent direction. BDI score was higher in MS patients than healthy volunteers (p<0.001). There was no statistically significant difference between two study groups for cognitive subscale scores, after the effect of depression was eliminated (p>0.05). To assess the test-retest reliability, the scores of two FIS applications did not differ statistically (cognitive t=1.948 p>0.05, physical t=1.420 p=0.160, social t=1.470 p=0.146, total t=1.990 p=0.05). Intraclass correlation coefficients were 0.89 (99% confidence interval: 0.79-0.94) for cognitive, 0.95 (0.91-0.97) for physical, 0.91 (0.83-0.95) for social, and 0.93 (0.86-0.96) for total FIS scores (p<0.001). EDSS correlated with physical subscores in both applications of FIS. CONCLUSION Turkish version of FIS, which is valid and reliable, seems an appropriate tool for the assessment of the effects of fatigue in Turkish MS population.

MRI study of the morphometry of the cervical musculature in F-16 pilots.

INTRODUCTION In fighter pilots neck muscle strengthening exercises are often recommended to protect the neck against pathologies. The aim of the current study was to compare the relative cross-sectional area (rCSA) and muscle:fat ratio of the cervical musculature of F-16 pilots experiencing neck pain and no neck pain (control) pilots. In addition, correlations between these morphometric characteristics, cervical range of motion (CROM), and neck muscle strength were evaluated. METHODS There were 35 male F-16 pilots who volunteered, of which 10 experienced bilateral neck pain. A standardized questionnaire was used to collect personal information. Magnetic resonance imaging (MRI) was assessed at the C5-C6 level to determine rCSA and muscle:fat ratio. The CROM (Zebris) and the maximum isometric strength (David F140 device) were measured. RESULTS The rCSA of the semispinalis cervicis and multifidus was significantly larger in the neck pain group (left: 2.08 cm2; right: 1.81 cm2) on both the left and the right side, in comparison to the control population (left: 1.29 cm2; right: 1.26 cm2). In the pain group, the rCSA of the semispinalis cervicis and multifidus was significant larger on the left than on the right side (left: 2.08 cm2; right: 1.81 cm2). No differences in the muscle:fat ratio between control pilots and pilots with neck pain could be determined. Between groups no differences were found in the CROM and the neck muscle strength. DISCUSSION It is hypothesized that the larger rCSA in the neck pain group compared to the control group might be caused by greater activity of the deep neck muscles in the neck pain group. The asymmetrical operation of the F-16 might cause the asymmetry within this group.

Comparing routine neurorehabilitation program with trunk exercises based on Bobath concept in multiple sclerosis: Pilot study

This study compared trunk exercises based on the Bobath concept with routine neurorehabilitation approaches in multiple sclerosis (MS). Bobath and routine neurorehabilitation exercises groups were evaluated. MS cases were divided into two groups. Both groups joined a 3 d/wk rehabilitation program for 8 wk. The experimental group performed trunk exercises based on the Bobath concept, and the control group performed routine neurorehabilitation exercises. Additionally, both groups performed balance and coordination exercises. All patients were evaluated with the Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), International Cooperative Ataxia Rating Scale (ICARS), and Multiple Sclerosis Functional Composite (MSFC) before and after the physiotherapy program. In group analysis, TIS, BBS, ICARS, and MSFC scores and strength of abdominal muscles were significantly different after treatment in both groups (p < 0.05). When the groups were compared, no significant differences were found in any parameters (p > 0.05). Although trunk exercises based on the Bobath concept are rarely applied in MS rehabilitation, the results of this study show that they are as effective as routine neurorehabilitation exercises. Therefore, trunk exercises based on the Bobath concept can be beneficial in MS rehabilitation programs.

Comparing routine neurorehabilitation programme with callisthenic exercises in multiple sclerosis

We conducted a study that examined the effectiveness of callisthenic exercises in multiple sclerosis. 30 individuals were divided into two groups. The first group did 15~callisthenic exercises and the second group did routine neurorehabilitation programme. Both groups did the programmes for three days per week over six weeks. Visual Analogue Scale for Fatigue (VAS-F), muscle strength tests, Berg Balance Scale (BBS), Multiple Sclerosis Functional Composite (MSFC), Turkish versions of Short Form of 36 (SF-36), and Hospital Anxiety and Depression Scale (HAD) were used for evaluation. After physiotherapy programmes VAS-F, muscle strength, BBS scores decreased significantly in both groups. HAD anxiety score of the first group and HAD depression score of the second group changed significantly. There were no differences in MSFC and SF-36 scores in any groups. The difference between groups was not significant in any parameters, except for the muscle test for upper limbs of the second group. Callisthenic exercises are seen as a new therapy choice, which are different from routine exercises, in order to decrease fatigue, improve balance and muscle strength. Callisthenics are thought to be a beneficial tool for MS patients.

The positive impact of regular exercise program on stem cell mobilization prior to autologous stem cell transplantation

AIM The present study was planned to determine the effects of regular exercise program on hematopoietic stem cell (HSC) mobilization prior to autologous stem cell transplantation. METHOD Twenty-two consecutive patients were enrolled in the study. A regular 20 min exercise program was administered to the patients. The hematopoietic stem cell mobilization outcome, number of Granulocyte Colony-Stimulating Factor (G-CSF) and aphaeresis application days were compared with 20 case-matched controls who did not receive exercise program during HSC mobilization. RESULTS The median number of CD34(+) stem cells collected in the exercise and control groups were 8.15 × 10(6)/kg (range: 2.85-33.06 × 10(6)/kg) and 7.3 × 10(6)/kg (range: 1.78-25.9 × 10(6)/kg), respectively (p=0.696). G-CSF was administered for a median of 8 days (range, 5-10) in the exercise group and 8 days (range, 5-12) in the control group (p=0.848). The median apheresis duration was 1 day (range, 1-3) in both exercise and control groups (p=0.226). CONCLUSION Exercise seems to have a positive impact on stem cell mobilization though without statistical significance.

The Validity and Test-Retest Reliability of the Leeds Multiple Sclerosis Quality of Life Scale in Turkish Patients.

The aim of the study was to translate and test the reliability and validity of the Leeds Multiple Sclerosis Quality of Life Scale (LMSQoL) in Turkish patients with multiple sclerosis (MS). Demographic data of MS patients who had a registration in and followed up by a university hospital were recorded. The LMSQoL and Turkish Quality of Life questionnaire were applied to the patients. The internal consistency of the scales was assessed by Cronbachs alpha coefficient. The validity of LMSQoL was examined by using correlation between the total scores of LMSQoL and Turkish Quality of Life questionnaire. Test-retest reliability was examined by using the correlation for the first and second applications of LMSQoL. Sixty-nine MS patients, (40.6% male, 59.4% female) were enrolled in the study. Cronbachs alpha coefficient was found as 0.67 for the three positive items of LMSQoL. For the five negative items, Cronbachs alpha was found as 0.78. The correlation coefficient between the total scores of the scales was 0.80 (P<0.001). The Turkish version of the LMSQoL is a reliable and valid instrument and can be effectively used for measuring the impact of MS on the QoL.

The effects of balance and postural stability exercises on spa based rehabilitation programme in patients with ankylosing spondylitis

BACKGROUND Ankylosing spondylitis (AS) can cause severe functional disorders that lead to loss of balance. OBJECTIVE The aim of this study was to investigate the effects of balance and postural stability exercises on spa based rehabilitation programme in AS subjects. METHODS Twenty-one participants were randomized to the study (n= 11) and control groups (n= 10). Patients balance and stability were assessed with the Berg Balance Scale (BBS), Timed Up and Go (TUG) Test, Single Leg Stance Test (SLST) and Functional Reach Test (FRT). AS spesicied measures were used for assessing to other parameters. The treatment plan for both groups consisted of conventional transcutaneous electrical nerve stimulation (TENS), spa and land-based exercises 5 days per week for 3 weeks. The study group performed exercises based on postural stability and balance with routine physiotherapy practice in thermal water and in exercise room. RESULTS The TUG, SLST and FUT scores were significantly increased in the study group. In both groups, the BASMI, BASFI, BASDAI and ASQoL scores decreased significantly by the end of the treatment period (p< 0.05). CONCLUSIONS In AS rehabilitation, performing balance and stability exercises in addition to spa based routine approaches can increase the duration of maintaining balance and can improve the benefits of physiotherapy.

Does Lymphedema Affect the Postural Stability in Women After Breast Cancer

Aim: The aim of this study was to evaluate the static postural stability and fall risk of preelderly women with unilateral secondary lymphedema after breast cancer. Methods: This study was conducted on 46 preelderly women (24 with unilateral secondary lymphedema and 22 healthy) aged from 52 to 69 years. The Biodex Balance System was used to measure the parameters of postural stability and fall risk. The data acquisition involved 3 trials of 20 seconds to test the postural stability test. It was made in 3 directions (overall, anterior-posterior [AP], and mediolateral [ML]) and 2 conditions (once with open eyes, once with eyes closed). The fall-risk test was performed under the following conditions: (1) eyes open, firm surface; (2) eyes closed, firm surface; (3) eyes open, foam surface; and (4) eyes closed, foam surface. Results: For the postural stability, significant differences (P ⩽ .000) were observed in overall, AP, and ML displacement parameters in eyes closed condition between the lymphedema and healthy groups. There were no statistically significant differences in the fall-risk test results among the lymphedema and healthy group (P > 0.05). Conclusion: Preelderly women with unilateral lymphedema exhibited a lower postural stability compared with health women. These results lead to think us that asymmetric fluid distribution in the upper body parts increases postural sway and leaving them more vulnerable to falls.

Acute physiological responses to physiotherapy applications pre and post autologous stem cell transplantation: an experimental study

Abstract Objective We aimed to investigate the acute physiological responses (APR) to physiotherapy applications in patients undergoing autologous stem cell transplantation (ASCT), the difference between pre- and post-ASCT according to APR. Methods Twenty-six patients who were hospitalized for ASCT attended regular physiotherapy program. APR was recorded in the beginning and at the end of each exercise session. The differences in APR were calculated for each session. The mean values of the differences in APR were computed in pre-conditioning, pre-, and post-ASCT. Daily complete blood counts were also recorded during ASCT. Results Hemoglobin and platelet counts were significantly lower pre- and post-ASCT. Neutrophil counts were significantly lower post-ASCT. The difference in systolic blood pressure (SBP) in the beginning and at the end of the exercise sessions was significantly higher post-ASCT in comparison to pre-ASCT. Conclusion There was no significant change in APR except the SBP which suggests that similar level of exercise intensity could be tolerated in pre- and post-ASCT periods as well as preconditioning.

Malpractice leading to secondary lymphedema after radical mastectomy: case report.

Background: With this case report we want to demonstrate the results of chemotherapy application to the mastectomized side in a patient who had undergone radical mastectomy. Case Report: A patient who was accidentally given chemotherapy on the mastectomized side (PCMS) and a control patient who received chemotherapy on the non-affected side (PCNS) were included in this study. Edema, pain, muscle strength, and shoulder mobility were evaluated. The results of the 2 patients were compared. After chemotherapy, PCMS experienced edema and pain in the affected arm compared to PCNS. Increased circumference measurement, and decreased shoulder mobility and muscle strength were observed in PCMS. Conclusion: It was suggested that chemotherapy application on the mastectomized side triggered lymphedema. Our findings on the subject revealed that education of health care professionals and patients alike is very important.