Saadet Ufuk Yurdalan

Haemodynamic effects of physiotherapy programme in intensive care unit after liver transplantation.

Objective. To determine the haemodynamic effects of intensive care physiotherapy after liver transplantation. Patients and methods. Thirteen patients were included in the study after liver transplantation. The following physiotherapy programme were applied to the patients in intensive care unit: Respiratory physiotherapy, active joint movements, sitting in bed (first task), sitting at the edge of bed (second task), standing (third task), sitting out of bed (fourth task) and walking (fifth task). Heart rate (HR), mean, systolic and diastolic blood pressures (MBP, SBP, DBP), peripheral oxygen saturation (SpO2), respiration rate (RR) were recorded before treatment, after each task, after treatment and at the fifth minute of recovery. Pain level was assessed with Visual Analogue Scale (0–10). Results. When compared with supine position before treatment, all of the parameters except RR increased after the first task whereas HR, SBP, MBP and pain increased after the second task. After the third task only HR and pain increased. There was no significant difference between the fourth task and pre-treatment values while HR, DBP and pain increased after the fifth task. When measurements of pre-treatment, immediately after treatment and the fifth minute of recovery were compared HR, MBP and pain increased after treatment whereas HR, RR and pain decreased after recovery. There was no significant difference between pre-treatment values and fifth minute of recovery measurements. Conclusion. Returning to initial values after a 5-min period shows that cardiopulmonary changes caused by intensive care physiotherapy after liver transplantation are responded at physiological limits.

Kinesiophobia in relation to physical activity in chronic neck pain.

BACKGROUND Little research is available concerning physical activity and its determinants in people with chronic neck pain. OBJECTIVE To explore the relation between kinesiophobia and physical activity and gender effect on these relations in people with chronic neck pain. METHODS Ninety-nine subjects (34 men and 65 women) with chronic neck pain were participated in the study. Pain intensity was assessed with Visual Analog Scale and kinesiophobia degree was determined by using Tampa Scale of Kinesiophobia. Level of physical activity was assessed with short form of the International Physical Activity Questionnaire. RESULTS There was no statistically correlation between neck pain intensity and kinesiophobia degree (p= 0.246, r= 0.123) and physical activity level (p= 0.432, r= -0.083). It was also found that kinesiophobia degree was not correlated to physical activity level (p= 0.148, r= -0.153). There was a negative correlation between kinesiophobia degree and physical activity level only for women, not for men (p= 0.011, r= -0.318). CONCLUSIONS Our results showed that although people with chronic neck pain reported higher pain intensity and fear of movement, pain intensity and kinesiophobia degree did not associate to their physical activity levels. It can be speculated that high kinesiophobia degrees cause low physical activity levels for women, but not for men.

The application of matrix rhythm therapy as a new clinical modality in burn physiotherapy programmes

PURPOSE The aim of the present study was to investigate the use of matrix rhythm therapy (MRT) as one of the electrotherapeutic modalities in clinics. METHODS This study was carried out in the Burn and Wound Treatment Department of Dr. Lütfi Kırdar Kartal Education and Research Hospital in Istanbul between October 2010 and August 2011. A treatment protocol including whirlpool, MRT and exercise was applied to a group of patients who had burn injury of upper extremity. The evaluation of each patient included assessment of pain, range of motion, muscle strength, skin flexibility and sensory function at pre- and post-treatment. RESULTS There was no significant difference in values of pain, muscle strength and flexibility between pre- and post-treatment assessments (p>0.05). A significant increase was found in the range of motion and sensory function at pre-treatment according to post-treatment (p<0.01). CONCLUSION The usage of MRT in order to maintain and improve the range of motion and to minimise the development of scar tissue was investigated in this study. We suggest conducting randomised controlled studies that carry out a comparison of the MRT with other treatment modalities with more cases and investigate the long-term effects of MRT.

A comparison of three different physiotherapy modalities used in the physiotherapy of burns.

The present study compared the effectiveness of matrix rhythm therapy, ultrasound treatment (UT), laser treatment (LT) used in the physiotherapy of burns. The study was conducted at the Wound and Burn Healing Center, Dr. Lütfi Kırdar Kartal Education and Research Hospital (Turkey) from June 2009 to January 2012. The case series comprised 39 individuals with second- and third-degree upper-limb burns, whose burn traumas ended approximately 1 to 3 months previously. Participants were separated into three groups: matrix rhythm treatment (MRT), UT and LT; each group was also applied a treatment protocol including whirlpool and exercise. Pain, range of motion (ROM), muscular strength, skin elasticity, and sensory functions were evaluated before and after the treatment. Pressure sense and passive ROM were higher in the MRT group than in the LT group (P < .05). Pain was lower in the LT group than in the UT group, and passive ROM was higher in the UT group than the in LT group (P < .05). Active ROM was found to increase in all treatment groups, whereas passive ROM increased only in the MRT and UT groups; pressure sense increased only in the MRT group, and pain decreased only in the LT group (P < .05). MRT was found to be more effective in the restoration of sensory functions than LT, whereas LT was more effective in reducing pain than UT. No significant difference was observed in terms of skin elasticity according to the results of three treatment modalities. It is suggested that further research with more cases should be conducted to examine the long-term effect of treatment modalities.

The relationship between objective balance, perceived sense of balance, and fear of falling in stroke patients

Abstract Objective: The objective of our study was to investigate the relationship between objective balance, fear of falling, and perceived sense of balance (PSB) in stroke patients. Methods: Seventy patients aged 18–65 years with chronically developed hemiplegia or hemiparesis were enrolled in the study. Patients’ objective balance scores, fear of falling, and PSB were obtained using the berg balance scale (BBS), the falls efficacy scale (FES), and a visual analog scale, respectively. The Standard Mini-Mental Examination was performed to exclude patients with mental disorders from the study. Results: There was a moderate negative correlation between PSB and BBS scores (p = 0.001, ρ = −0.588); a strong negative correlation between BBS and FES scores (p = 0.001, ρ = −0.808); and a strong positive correlation between PSB and FES scores (p = 0.001, ρ = 0.714). We found that BBS scores had negative correlation with PBS scores in left hemiplegic patients while there was no any relationship between BBS and PBS scores in right hemiplegic patients. Conclusion: PSB assessment, besides the BBS, should be considered among the routine assessment methods that enable the rehabilitation team to be aware of patients’ balance capacities.

Cultural adaptation and validation of Patient and Observer Scar Assessment Scale for Turkish use

BACKGROUND This study aimed to evaluate cross-cultural adaptation, validation, and reliability of Patient and Observer Scar Assessment Scale (POSAS) for its Turkish use. METHOD This study included 50 burn patients with hypertrophic scars who were aged 18-65 years (mean, 37.5±1.4years) and were admitted to Wound and Burn Treatment Center from February 2014 to April 2014. With regard to the cultural adaptation of POSAS from English to Turkish, the scale was translated by two people who worked in different health fields. POSAS was administered to the patients with a 1-week interval to evaluate the validity and reliability of the scale. Internal consistency of the scale was tested using the Cronbach alphamethod. RESULTS The Cronbach alpha value for the observer measurements was found to be 0.93 (excellent), and that for patient measurements was found to be 0.77 (good). Accordingly, the internal consistency of the scale was established. CONCLUSION The Turkish version of POSAS is a valid, reliable and culturally appropriate survey for evaluating hypertrophic scars. We believe that the Turkish version of POSAS will be an important clinical/scientific tool in the field of burn physiotherapy in Turkey, which will lead to new researches in this field.

The Effectiveness of Bobath Treatment Approach in Physiotherapy ofCase with Ehlers-Danlos Syndrome

Ehlers-Danlos Syndrome (EDS) is one of the most frequent connective tissue diseases (1:5,000–1:10,000) and characterized by multiple clinical findings depending on connective tissue weakness in body system. Most of EDS patients consists of “hypermobility type (EDS-HT)” Physiotherapy program has an important place in the treatment of children with EDS-HT diagnosis and Bobath therapy aims to regulate muscle tone, provide postural alignment with special grip techniques and improve functions with the active participation of individual. The case with EDS-HT diagnosis is 5 year- old female child with 14 kg body weight, and 96.7 cm height. In 18th month, the case was directed to physiotherapy program towards hypotony and postural control problems in Private YA±ldA±z Cocuk Special Education and Rehabilitation Center. The case was evaluated three times for three years. Motor functions of the case were evaluated using Gross Motor Function Measurement (GMFM) scale, the disability level of the case was determined using Gross Motor Function Classification Scale and the functional independence level of the case was evaluated using Functional Independence Measure for Children (WeeFIM) scale. The applied physiotherapy program was designed from the exercises used in Bobath treatment approach. According to subsequent evaluations made through GMFM and weeFIM for throughout 3 years when the case received physiotherapy, a significant increase was observed in the scores of all parameters of GMFM and weeFIM, and an increase at one level in disability level was observed in GMFCS evaluation.

Sigara İçicisi Olan ve Olmayan Sağlıklı Sedanter Bireylerde Yorgunluk Seviyesi ve Fiziksel Aktivite Düzeyi

Amac : Bu calismada; sigara icicisi olan ve olmayan saglikli sedanter bireylerin yorgunluk seviyeleri ve fiziksel aktivite duzeylerinin arastirilmasi amaclandi. Yontemler : Calisma; gonullu ve aydinlatilmis onami alinan 191 saglikli sedanter universite ogrencisi (sigara kullananlar; 21,01±1,34 yas, sigara kullanmayanlar; 20,76±1,65 yas) ile gerceklestirildi. Fiziksel aktivite duzeyi, Uluslararasi Fiziksel Aktivite Anketi (UFAA)’ nin kisa formu ve yorgunluk seviyesi Piper Yorgunluk Olcegi (PYO) ile degerlendirildi. Bulgular : Sigara kullanim durumu ile yuksek, orta, dusuk siddetli fiziksel aktivite ve toplam fiziksel aktivite duzeyi arasinda anlamli fark bulunmadi (p>0,05). Sigara kullanan ve kullanmayan bireylerin duygusal yorgunluk seviyesi arasinda anlamli fark bulunmazken (p>0,05); bilissel, duyusal, davranissal ve toplam yorgunluk seviyesi sigara icenlerde anlamli yuksek bulundu (p<0,05). Sonuc : Calisma sonucunda sigara kullaniminin genc sedanter universite ogrencilerinde duyusal, davranissal, bilissel ve toplam yorgunluk seviyesi uzerinde olumsuz etkileri tespit edilmistir. Sigara kullaniminin yorgunluk uzerine etkileri hakkinda universite ogrencilerini bilgilendirmeye yonelik calismalarin yapilmasi toplum sagligi acisindan faydali olabilir.

FRI0583-HPR The Effects of Kinesiologic Taping Applied on Quadriceps and Hamstring Muscles on Functions of Lower Extremity in Patients with Knee Osteoarthritis

Background One of the most common musculoskeletal diseases, osteoarthritis (OA) is characterized by the progressive loss of articular cartilage in synovial joints (1). One of the first and most widely seen symptoms among patients with knee OA is muscle weakness (2). In the patients with OA, some symptoms like the decrease in the quality of life and in the ability to move, functional limitation in daily life activities might be seen frequently (3). The taping method is a physiotherapy approach that is recommended by clinic guides for patients with knee osteoarthritis (4). Objectives While studies investigating the effect of taping applied on patellar tendon in the patients with knee OA are available in the literature, no study investigating the effect of kinesiologic taping applied on quadriceps femoris and hamstring muscles has been found.Our study aim was to investigate the effects of kinesiologic taping applied on two muscle groups on pain, range of motion, muscle strength, postural balance, functionality and effusion in patients with knee OA. Methods A total of 54 patients with knee OA, who applied to the Private Meditepe Medical Center for treatment, were included in the study between the dates of November, 2012-February, 2013. Pain levels were measured with a visual analog scale, range of motion was calculated with a universal goniometer, effusion was measured with a tape measure, muscle strength was measured with a digital muscle strength dynamometer, functional condition was measured with a KOOS scale, and postural balance level was taken with a Libra EasyTech Balance device. Patients were separated into two groups randomly. A total of 28 people were included in the study group, the remaining 26 people were included in the control group. The treatment started after the first assessment and was applied as 15 sessions for a total of three weeks, five sessions per week. Results It was found that there were significant improvements in all measurements for post-treatment compared to pre-treatment in the control group (p<0.05). It was also found that there were significant increases in all measurements except hamstring muscle strength value for post-treatment compared to pre-treatment in the study group (p<0.05). There was no statistically significant difference between post-treatment values of two groups (p>0.05). Conclusions According to the results of the study, kinesiologic taping applied on quadriceps and hamstring muscles in addition to physiotherapy programme has no effect on range of motion, muscle strength, postural balance, pain level, and functionality. References Sezgin M, Erdal ME, Altintas ZM, Ankarali HC, Barlas IO, Turkmen E, Sahin G. Lack of association polymorphisms of the IL1RN, IL1A, and IL1B genes with knee osteoarthritis in Turkish patients. Clin Invest Med. 2007;30(2):E86-92. Stensrud S, Risberg MA, Roos EM. Knee function and knee muscle strength in middle-aged patients with degenerative meniscal tears eligible for arthroscopic partial meniscectomy. Br J Sports Med. 2012 Dec 14. Liao CD, Liou TH, Huang YY, Huang YC. Effects of balance training on functional outcome after total knee replacement in patients with knee osteoarthritis: a randomized controlled trial. Clin Rehabil. 2013 Aug;27(8):697-709. Page C.J., R.S. Hinman and K.L. Bennell. Physiotherapy Management Of Knee Osteoarthritis. International Journal Of Rheum Dis 2011;14(2): 145-151. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4602