Özlem Çinar Özdemir

The effect of parity on pelvic floor muscle strength and quality of life in women with urinary incontinence: a cross sectional study.

[Purpose] The purpose of this study was to analyze the pelvic floor muscle (PFM) activity after vaginal birth, and the effect of parity on PFM strength and quality of life (QoL) in women with urinary incontinence. [Subjects and Methods] Patients (n=241) who gave birth vaginally and experienced urinary incontinence were divided into three groups: group 1 consisted of women having 1–3 children, group 2 consisted of women having 4–6 children, and group 3 consisted of women having more than 6 children. All patients underwent detailed examination of the PFM. The Turkish version of the self-administered Incontinence Quality of Life Instrument (I-QoL) questionnaire was used to evaluate the effects of stress urinary incontinence on participants’ QoL. [Results] Comparison of PFM strengths showed a significant intergroup difference. Group 1 showed significantly higher PFM strength scores than those of groups 2 and 3. I-QoL scores related to stress incontinence showed a significant intergroup difference. As number of deliveries increased, quality of life decreased. Comparison of PFM strengths and I-QoL scores related to stress incontinence showed a significant intergroup difference. [Conclusion] Increasing the awareness of PFM training in women will reduce potential postpartum incontinence due to a weak PFM strength; and will increase quality of life.

The effects of short-term use of compression stockings on health related quality of life in patients with chronic venous insufficiency.

[Purpose] This study was aimed to analyse the effects of short-term use of compression stockings (CS) on symptoms and QoL in patients with Chronic Venous Insufficiency (CVI). [Subjects and Methods] Based on the CEAP classification C2 and C3, 117 patients with CVI were enrolled in this study. The participants were divided into two groups. The control group refused to use CS, however, was advised to do exercises and take skin care whereas the CS group used CS and performed exercise. The data were collected by using Nottingham Health Profile (NHP), Venous Insufficiency Epidemiological and Economic Study (VEINES-QoL/Sym) and Beck Depression Inventory (BDI) at baseline and after four weeks of treatment and compared within and in between groups. [Results] The comparison of pre- and post-treatment differences between groups was statistically significant for all parameters. In the study group, pre- and post-treatment scores for each parameter were significantly different. However, elevated scores in the control group suggested worsening of the illness. [Conclusion] This study established that short-term use of CS in patients with CVI significantly improved disease specific and general QoL by reducing venous symptoms. Further studies with larger sample size are necessary to confirm these findings.

The Relationship Between Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms and Nottingham Health Profile Instruments in Older Adults With Chronic Venous Insufficiency

Chronic venous insufficiency is a common progressive disease. Although chronic venous insufficiency is common in general population, its incidence increases with aging and, as a result, the quality of life (QOL) is affected negatively. There are 2 ways to assess QOL in venous diseases: generic and disease-specific surveys. The 36-Item Short Form Health Survey and the Nottingham Health Profile are widely used generic surveys. Disease-specific surveys are popular for studying venous diseases and have a high sensitivity. The Chronic Venous Insufficiency Questionnaire, the Venous Insufficiency Epidemiological and Economic Study Quality of Life/Symptoms (VEINES-QOL/Sym), the Aberdeen Varicose Vein Questionnaire, and the Charing Cross Venous Ulceration Questionnaire are such tools. This study aimed to explore the correlation between the Nottingham Health Profile and VEINES-QOL scales in older adults. This article provided the first empirical, qualitative evidence on the relationship between the Nottingham Health Profile and VEINES-QOL instruments in elderly patients with chronic venous insufficiency.

Complex Decongestive Physiotherapy Treats Skin Changes like Hyperkeratosis Caused by Lymphedema.

Lymphedema is a chronic, progressive, and often debilitating condition. Primary lymphedema is a lymphatic malformation developing during the later stage of lymph angiogenesis. Secondary lymphedema is the result of obstruction or disruption of the lymphatic system, which can occur as a consequence of tumors, surgery, trauma, infection, inflammation, and radiation therapy. Here, we report a 64-year-old woman presenting with hyperkeratosis, a lymphedema due to metastatic uterus carcinoma. In this paper, we present the effects of complex decongestive physiotherapy on lymphedema and hyperkeratosis.

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.

Physiotherapy in Women with Urinary Incontinence

Urinary incontinence is a complex and serious condition that can affect all age groups around the world. It is not only a serious medical condition but also an undeniable psy‐ chosocial problem creating embarrassment and negative self‐perception, and it has a severe impact on a patients quality of life. Today, there are wide different treatment options in urinary incontinence from surgery to conservative modalities. Among these, conservative management approaches are recommended as the first‐line treatment to manage with urinary incontinence. The choice of the most suitable option to treat for urinary incontinence differs according to the underlying pathophysiological mechanism defining subtypes of urinary incontinence and severity of symptoms. In this chapter, we addressed the different components of physiotherapy management of urinary inconti‐ nence, including pelvic floor muscle training, electrical stimulation, biofeedback, vagi‐ nal cones, mechanical devices and magnetic stimulation. We concluded that the optimal physiotherapy care should be individualised to ensure applicability the clinic setting for each patient.

Conservative Management of Chronic Venous Insufficiency

Chronic venous insufficiency (CVI) is a common medical condition with major socioeconomic impact. Prevalence in adult population is estimated to be 5–30%. Its pathology is based on venous hypertension on the lower extremities. This results in edema, subcutaneous fibrosis, pigmentation, chronic pain and ulceration. The severity of chronic venous disease is closely related to the magnitude of venous hypertension. Treatment options for CVI include medical, interventional, surgical and physical treatments. The initial management of CVI involves conservative approaches to reduce symptoms and prevent development of secondary complications and progression of disease. It includes the elevation of the limb together with the supportive methods, pharmacotherapy and structured exercise program, as well as complex decongestive physiotherapy (CDP), intermittent pneumatic compression (IPC), compression stocking (CS), patient education and kinesio tape. CVI is a chronic disease that needs a lifelong care. In this review, we present a discussion about pathophysiology and risk factors for CVI development and conservative treatment options.