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Öğe Bilateral upper-extremity deep vein thrombosis following central cord syndrome(Maney Publishing, 2013) Onmez, Hilal; Cingoz, Havva Turac; Kucuksen, Sami; Anliacik, Emel; Yasar, Ozan; Yilmaz, Halim; Salli, AliDeep vein thrombosis (DVT) is a common complication following spinal cord injury (SCI). Although DVT of the upper extremity is much less common than DVT of the lower extremities, the risk of pulmonary embolism following upper-extremity DVT should not be disregarded. Method: Case report. Findings: A bilateral upper-extremity DVT developed in a 51-year-old woman with SCI (central cord syndrome) being followed in our rehabilitation clinic. Medical treatment resulted in improvement in the clinical status of the patient as well as the regression in the thrombus. Conclusion: In patients with SCI, DVT should be kept in mind in the presence of pain and edema in the upper extremities, and prophylactic DVT treatment should be considered.Öğe DO THE CHANGES OF SCAPULOTHORACIC ANGLE AFFECT WINGED SCAPULA DEVELOPMENT AND FUNCTIONAL SCORES DURING CLAVICLE FRACTURE TREATMENT?(Atha Comunicacao & Editora, 2022) Koc, Mehmet Rauf; Korucu, Ismail Hakki; Yucens, Mehmet; Yorukoglu, Ali Cagdas; Salli, Ali; Yalcin, Sevket; Pekince, OguzhanIntroduction: To compare surgical and conservative management of midshaft clavicle fractures according with scapulothoracic joint angle change, considering clinical, functional, and radiological outcomes. Methods: A total of 95 midshaft clavicle fracture patients aged between 18-70 years with a minimum follow-up duration of 12 months were included in this study. Patients were treated either conservatively (Group I) or surgically (Group 2). Plane deformities, scapulothoracic joint angle, shortness and isokinetic muscle strength were measured. Shoulder Pain, Disability Index (SPADI) and Short Form-3 6 (SF36) were assessed. Results: Scapulothoracic joint angles were higher in the conservative treatment group than in surgery group (p=0.036). Consequently, winged scapula was seen more commonly in the conservative treatment group than in the surgery group (p=0.001). Surgical treatment was associated with significantly better SF-36 physical scores and with SPADI pain and disability scores. However, the two groups did not differ in terms of isokinetic muscle strength. Negative anteroposterior plane deformity (p<0.001) and negative axial plane deformity (p=0.004) were more frequent in the conserva- tive treatment group. Clavicle shortness was more common in the conservative treatment group. Conclusions: According to our findings scapulothoracic joint angle changes were seen in the conservative treatment group more than in the surgery group. Consequently, winged scapula was seen more commonly in the conservative treatment group than in the surgery group (p=0.001). Level of Evidence III; Retrospective comparative study.Öğe DO THE CHANGES OF SCAPULOTHORACIC ANGLE AFFECT WINGED SCAPULA DEVELOPMENT AND FUNCTIONAL SCORES DURING CLAVICLE FRACTURE TREATMENT?(Atha Comunicacao & Editora, 2022) Koc, Mehmet Rauf; Korucu, Ismail Hakki; Yucens, Mehmet; Yorukoglu, Ali Cagdas; Salli, Ali; Yalcin, Sevket; Pekince, OguzhanIntroduction: To compare surgical and conservative management of midshaft clavicle fractures according with scapulothoracic joint angle change, considering clinical, functional, and radiological outcomes. Methods: A total of 95 midshaft clavicle fracture patients aged between 18-70 years with a minimum follow-up duration of 12 months were included in this study. Patients were treated either conservatively (Group I) or surgically (Group 2). Plane deformities, scapulothoracic joint angle, shortness and isokinetic muscle strength were measured. Shoulder Pain, Disability Index (SPADI) and Short Form-3 6 (SF36) were assessed. Results: Scapulothoracic joint angles were higher in the conservative treatment group than in surgery group (p=0.036). Consequently, winged scapula was seen more commonly in the conservative treatment group than in the surgery group (p=0.001). Surgical treatment was associated with significantly better SF-36 physical scores and with SPADI pain and disability scores. However, the two groups did not differ in terms of isokinetic muscle strength. Negative anteroposterior plane deformity (p<0.001) and negative axial plane deformity (p=0.004) were more frequent in the conserva- tive treatment group. Clavicle shortness was more common in the conservative treatment group. Conclusions: According to our findings scapulothoracic joint angle changes were seen in the conservative treatment group more than in the surgery group. Consequently, winged scapula was seen more commonly in the conservative treatment group than in the surgery group (p=0.001). Level of Evidence III; Retrospective comparative study.Öğe The effect of proprioception exercises on functional status in patients with anterior cruciate ligament reconstruction(Ios Press, 2015) Ordahan, Banu; Kucuksen, Sami; Tuncay, Ibrahim; Salli, Ali; Ugurlu, HaticeOBJECTIVE: To evaluate knee proprioception in patients with anterior cruciate ligament (ACL) injuries and to assess the effectiveness of an exercise program consisting mainly of proprioception exercises addressing pain, proprioception, and functional status following ACL reconstruction. MATERIALS AND METHODS: Twenty male patients, diagnosed with unilateral ACL injury and scheduled for reconstruction, participated in the study along with 16 age-and sex-matched healthy volunteers. Arthroscopic reconstruction of the ACL using autologous hamstring tendon was performed in every case by the same surgeon. After the operation, a six-month rehabilitation program was initiated. Knee proprioception, pain, and functional status were evaluated before and six months after the reconstruction. An isokinetic dynamometer was used to evaluate proprioception and a visual analog scale (VAS) and the Tegner Lysholm Knee Scoring Scale were used to evaluate pain and functional status respectively. RESULTS: Preoperative proprioception loss was detected on the patients' injured side when compared to the uninjured side and to healthy volunteers (p = 0.00). A significant improvement was found in pain severity, proprioception, and functional capacity after the postoperative six-month rehabilitation program (p = 0.00). CONCLUSION: Preoperative proprioception loss was detected in ACL-injured patients. The rehabilitation program predominantly consisting of proprioception exercises provided considerable improvement on knee proprioception and functional status.Öğe Efficacy of vitamin D replacement therapy on patients with chronic nonspecific widespread musculoskeletal pain with vitamin D deficiency(Wiley, 2016) Yilmaz, Ramazan; Salli, Ali; Cingoz, Havva Turac; Kucuksen, Sami; Ugurlu, HaticeAim: The objective of this study is the evaluation of the effect of vitamin D replacement treatment on musculoskeletal symptoms and quality of life in patients with chronic widespread musculoskeletal pain (CWP) including fibromyalgia (FM) and vitamin D deficiency. Method: Patients with nonspecific CWP and vitamin D deficiency (25-OH D3<25ng/mL) were included into the study. Replacement treatments of 50000IU/week oral vitamin D3 for 3months were given to the patients. Patients were assessed pre- and post-treatment in terms of serum levels of Ca, P, alkaline phosphatase, 25-OH D3, severity of pain (visual analogue scale [VAS]-pain), severity of asthenia (VAS-asthenia), Beck Depression Inventory (BDI), quality of life scale (Short Form [SF]-36), tender point count (TPC), severity of waking unrefreshed, headache, tenderness on tibia, meeting the criteria of FM, and level of patient satisfaction. Results: Fifty-eight patients with a mean age of 36.9 +/- 9.2years were included into the study. 25-OH D3 levels of patients elevated from 10.6 +/- 5.1ng/mL to 46.5 +/- 24.0ng/mL after replacement treatment (P<0.001). Marked decrease in VAS-pain, VAS-asthenia, severity of waking unrefreshed, TPC, and BDI and an evident increase in subgroups of SF-36 were established in patients after treatment (P<0.001). The number of FM+ patients was 30 (52%) before treatment and regressed to 20 (34%) after treatment (P=0.013); 85% of patients stated satisfaction with the treatment. Conclusions: Vitamin D replacement treatment in patients with nonspecific CWP has provided improvements in musculoskeletal symptoms, level of depression and quality of life of patients. Patients with CWP should be investigated for vitamin D deficiency.Öğe Evaluation of Sexual Dysfunction in Women with Rheumatoid Arthritis: A Controlled Study(Elsevier Sci Ltd, 2012) Yilmaz, Halim; Polat, Halime Almula Demir; Yilmaz, Sema Dereli; Erkin, Gulten; Kucuksen, Sami; Salli, Ali; Ugurlu, HaticeObjective. To evaluate sexual function in women with rheumatoid arthritis (RA) and compare them with healthy controls. Materials and Methods. Ninety-five patients with RA and 108 healthy controls were included in the study. Depression levels and sexual functions of all participants were evaluated by the Beck Depression Inventory (BDI) and Index of Female Sexual Function (IFSF), respectively. Morning stiffness in women with RA, pain (Visual Analog ScaleVAS), disability rate (Health Assessment QuestionnaireHAQ), and disease activity score (DAS-28) were defined. Results. Total IFSF and mean of IFSF subgroup scores and significance of sexual life score were lower in patients with RA than controls, whereas mean BDI score was higher. The mean of the total IFSF scores was significantly lower in patients with RA with BDI =17 than that of patients with BDI <17. The mean of the total IFSF score decreased as disease severity increased. There was a strong negative correlation between total IFSF and DAS-28 scores, a moderate negative correlation between total IFSF score and HAQ, BDI, VAS score, age, and morning stiffness, and weak negative correlation between total IFSF and body mass index. Conclusion. RA is observed to have negative effects on sexual functions of women. Presence of depressive symptoms with RA and increased disease severity increase the degree of sexual dysfunction. Women patients with RA should also be asked about their sexual lives while being evaluated. Yilmaz H, Polat HAD, Yilmaz SD, Erkin G, Kucuksen S, Salli A, and Ugurlu H. Evaluation of sexual dysfunction in women with rheumatoid arthritis: A controlled study. J Sex Med **;**:****.Öğe Full-length silicone insoles versus ultrasound-guided corticosteroid injection in the management of plantar fasciitis: A randomized clinical trial(Sage Publications Ltd, 2013) Yucel, Ufuk; Kucuksen, Sami; Cingoz, Havva T.; Anliacik, Emel; Ozbek, Orhan; Salli, Ali; Ugurlu, HaticeBackground: Plantar fasciitis often leads to disability. Optimal treatment for this clinical condition is still unknown. Objective: To compare the effectiveness of wearing a full-length silicone insole with ultrasound-guided corticosteroid injection in the management of plantar fasciitis. Study design: Randomized clinical trial. Methods: Forty-two patients with chronic unilateral plantar fasciitis were allocated randomly to have an ultrasound-guided corticosteroid injection or wear a full-length silicone insole. Data were collected before the procedure and 1 month after. The primary outcome measures included first-step heel pain via Visual Analogue Scale and Heel Tenderness Index. Other outcome measures were the Foot and Ankle Outcome Score and ultrasonographic thickness of the plantar fascia. Results: After 1 month, a significant improvement was shown in Visual Analogue Scale, Heel Tenderness Index, Foot and Ankle Outcome Score, and ultrasonographic thickness of plantar fascia in both groups. Visual Analogue Scale scores, Foot and Ankle Outcome Score pain, Foot and Ankle Outcome Score for activities of daily living, Foot and Ankle Outcome Score for sport and recreation function, and plantar fascia thickness were better in injection group than in insole group (p < 0.05). Conclusions: Although both ultrasound-guided corticosteroid injection and wearing a full-length silicone insole were effective in the conservative treatment of plantar fasciitis, we recommend the use of silicone insoles as a first line of treatment for persons with plantar fasciitis. Clinical relevance Silicone insole may be considered as a first-line treatment option in patients with plantar fasciitis.Öğe An Investigation of Sexual/Reproductive Health Issues in Women with a Physical Disability(Springer, 2014) Altuntug, Kamile; Ege, Emel; Akin, Belgin; Kal, H. Esra; Salli, AliWomen with a physical disability continue to live with many physical, psychological, and social challenges. Long-term disability in women leads to negative consequences on their sexual functions. The study was designed to investigate sexual challenges in women with a physical disability. Employing a qualitative design, the study was conducted with ten married women with a physical disability, who fit into the inclusion criteria and had applied to the Physical Treatment and Rehabilitation Department of the Meram Medical Faculty, Necmettin Erbakan University, in Konya, Turkey. The data related to women's sexual experiences, were analyzed using descriptive and content analysis. All participants were homemakers from middle-income families, with at least one child, and were socially supported by their families since their disorder. In addition to physical disability in all cases, seven participants were diagnosed with concomitant hypertension with diabetes mellitus, and three with concomitant chronic obstructive pulmonary disease with diabetes mellitus. All were found to experience sexual problems. Sexual dysfunction is seen as a frequently encountered health challenge in women with a physical disability and should definitely be evaluated in each patient. In light of our findings, it may be suggested that healthcare professionals should be made aware of the sexual lives of women with a physical disability and should be trained for counseling.Öğe Is pain the only symptom in patients with benign joint hypermobility syndrome?(Springer London Ltd, 2015) Albayrak, Ilknur; Yilmaz, Halim; Akkurt, Halil Ekrem; Salli, Ali; Karaca, GultenThe aims of this study were to evaluate pain, depression level, fatigue, sleep, and quality of life (QoL) among patients with benign joint hypermobility syndrome (BJHS) and to compare their results with those of healthy controls. The study involved 115 patients and 114 healthy volunteers. Pain level was rated using visual analogue scale (VAS) for all patients. Depression level, fatigue, sleep quality, and QoL of all the participants were evaluated by the Beck Depression Inventory (BDI), the Checklist Individual Strength (CIS), the Pittsburgh Sleep Quality Index (PSQI), and the Short Form-36 (SF-36), respectively. VAS value was 6.29 +/- 0.94 in the patient group. Comparison of two groups showed that there were statistically significant differences between the patient group and the control group with respect to BDI, total CIS, PSQI scores, SF-36 subscales (physical function, role physical, bodily pain, general health, role emotional, and mental health), and mental component summary (p < 0.001). While pain is the predominant symptom among BJHS patients, depression, fatigue, impaired sleep, and QoL also commonly occur. Thus, all of these components should be taken into account when assessing patients with BJHS.Öğe Long term effects of high intensity laser therapy in lateral epicondylitis patients(Springer London Ltd, 2016) Akkurt, Ekrem; Kucuksen, Sami; Yilmaz, Halim; Parlak, Selman; Salli, Ali; Karaca, GultenThe objective of this study is to investigate short- and long-term effects of high-intensity laser therapy (HILT) in lateral epicondylitis (LE) patients. Thirty patients with LE diagnosis (23 unilateral and 7 bilateral in total 37 elbows) were treated using HILT. LE patients were evaluated before, right after, and 6 months following HILT intervention post-treatment using visual analogue scale for pain (VAS) during activity and resting. Disabilities of the Arm, Shoulder, and Hand (DASH) Score and hand grip strength test (HGST) were used. The participants of the present study were also evaluated using Short-Form 36 (SF-36) before and 6 months after the treatment. Out of the 30 patients, 8 were male and 22 female with a mean age of 47.2 +/- 9.7. The activity and resting VAS, DASH, and HGST scores revealed statistically significant improvement (p = 0.001) following treatment. Whereas VAS activity, DASH, and HGST scores increased after treatment until post-treatment 6 months significantly (p = 0.001), VAS resting scores remained stable (p = 0.476). A statistically significant improvement was also evident in the physical and mental components of SF-36 scores following treatment until post-treatment 6 months compared to pre-treatment scores (p = 0.001). In conclusion, the results of the present study suggest that HILT is a reliable, safe, and effective treatment option in LE patients in the short and long term considering pain, functional status, and quality of life.Öğe Muscle Energy Technique Versus Corticosteroid Injection for Management of Chronic Lateral Epicondylitis: Randomized Controlled Trial With 1-Year Follow-up(W B Saunders Co-Elsevier Inc, 2013) Kucuksen, Sami; Yilmaz, Halim; Salli, Ali; Ugurlu, HaticeObjective: To determine the short- and long-term effectiveness of the muscle energy technique (MET) compared with corticosteroid injections (CSIs) for chronic lateral epicondylitis (LE). Design: Randomized controlled trial with 1 year of follow-up. Setting: Outpatient clinic of a university's department of physical medicine and rehabilitation. Participants: Patients with chronic LE (N=82; 45 women, 37 men). Interventions: Eight sessions of MET, or a single CSI was applied. Main Outcome Measures: Grip strength, pain intensity, and functional status were assessed using the pain-free grip strength (PFGS), a visual analog scale (VAS), and the Disabilities of the Aim, Shoulder and Hand (DASH) questionnaire, respectively. Measurements were performed before beginning treatment and at 6, 26, and 52 weeks afterward. Results: When the baseline PFGS, VAS, and DASH scores were compared with the scores at the 52-week follow-up, statistically significant improvements were observed in both groups over time. The patients who received a CSI showed significantly better effects at 6 weeks according to the PFGS and VAS scores, but declined thereafter. At the 26- and 52-week follow-ups, the patients who received the MET were statistically significantly better in terms of grip strength and pain scores. At 52 weeks, the mean PFGS score in the MET group was significantly higher (75.08 +/- 26.19 vs 62.24 +/- 21.83; P=.007) and the mean VAS score was significantly lower (3.28 +/- 2.86 vs 4.95 +/- 2.36; P=.001) than those of the CSI group. Although improvements in the DASH scores were more pronounced in the MET group, the differences in DASH scores between the groups were not statistically significant. Conclusions: This study showed that while both MET and CSI improved measures of strength, pain, and function compared with baseline, subjects receiving MET had better scores at 52 weeks for PFGS and the VAS for pain. We conclude that MET appears to be an effective intervention in the treatment of LE. (C) 2013 by the American Congress of Rehabilitation MedicineÖğe The prevalence of fibromyalgia and its relation with headache characteristics in episodic migraine(Springer London Ltd, 2013) Kucuksen, Sami; Genc, Emine; Yilmaz, Halim; Salli, Ali; Gezer, Ilknur Albayrak; Karahan, Ali Yavuz; Salbas, EnderThe objective of this study was to assess the prevalence of fibromyalgia (FM) in patients with episodic migraine and to evaluate the relationship between migraine characteristics and FM. One hundred and eighteen consecutive patients (mean age = 38 years, 75 % women) fulfilling the International Classification of Headache Disorders-II criteria for migraine with (n = 22) and without (n = 96) aura from an outpatient headache clinic of a university hospital were evaluated. The diagnosis of FM was made based on the 1990 American College of Rheumatology classification criteria. Participants completed some self-administered questionnaires ascertaining sociodemographics, headache severity, frequency and duration, headache-related disability (Headache Impact Test [HIT-6]) and Migraine Disability Assessment Scale, widespread musculoskeletal pain (visual analog scale), depression (Beck depression inventory), anxiety (Beck anxiety inventory), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Assessment of Fatigue), and quality of life (Short Form-36 Health Survey [SF-36]). In patients with FM, the tender point count and the Fibromyalgia Impact Questionnaire were employed. FM was diagnosed in 37 (31.4 %) of the patients. FM comorbidity was equally distributed across patients with and without aura. Severity of migraine headache, HIT-6, and anxiety were especially associated with FM comorbidity. Patients suffering from migraine plus FM reported lower scores on all items of the SF-36. This study indicates that the assessment and management of coexisting FM should be taken into account in the assessment and management of migraine, particularly when headache is severe or patients suffer from widespread musculoskeletal pain.Öğe Quality of Life in Osteoporosis: A Controlled Study(Galenos Yayincilik, 2012) Yilmaz, Halim; Erkin, Gulten; Polat, Halime Almula Demir; Kucuksen, Sami; Salli, Ali; Ugurlu, HaticeAim: To evaluate quality of life in women without vertebral and nonvertebral fractures, with postmenopausal osteoporosis (PMO), osteopenic and normal bone mineral density (BMD), and to determine effective factors on quality of life. Materials and Methods: Without fractures, 266 women with PMO, 310 with osteopenia and 255 with normal women BMD were enrolled in the study. BMD measurement was performed on lumbar vertebra (L1-L4) and femur neck via dual energy X-ray absorbtiometry (DXA). Quality of life was assessed with Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). QUALEFFO total scores and subscales were compared in all groups. Factors about quality of life in women with PMO were defined with correlation analysis. Variations of the highest correlation and quality of life were included into linear regression model. Results: In non-fractured women with PMO, QUALEFFO total scores and subscales were higher than those with osteopenia and normal BMD. In women with PMO, a positive correlation was found between QUALEFFO total scores, and age, Body Mass Index (BMI), parity and duration of menopause, and a negative correlation between QUALEFFO total scores, and level of education, economical status and femur neck BMD scores. In linear regression analysis, among significant factors of quality of life were BMI, femur neck BMD, parity and duration of menopause. Conclusion: Our results indicate that quality of life in non-fractured women with PMO is disordered higher than those with osteopenia and normal BMD, and quality of life are affected by numerous factors.Öğe Quality of life in rheumatological patients: The impact of personality disorders(Sage Publications Inc, 2015) Uguz, Faruk; Kucuk, Adem; Cicek, Erdinc; Kayhan, Fatih; Salli, Ali; Guncu, Hatice; Cilli, Ali SavasObjectiveRheumatological diseases are associated with lower quality of life (QoL) levels. Psychiatric disturbances are frequently observed in these patients. This study examined the impact of personality disorders on the QoL of patients with rheumatological diseases. MethodThe study sample consisted of 142 participants including patients suffering from rheumatological disease with a personality disorder (n=30), without any personality disorder (n=112), and healthy control participants without physical or psychiatric disorders (n=60). The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I) and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders (SCID-II) were used to determine Axis I and Axis II psychiatric disorders, respectively. QoL levels were assessed by means of the World Health Organization QoL Assessment-Brief. ResultsThe subscale scores of physical health, psychological health, and social relationships were significantly lower in patients with rheumatological disease regardless of the existence of personality disorder compared with the control participants. Rheumatological patients with a personality disorder had significantly lower subscale scores of psychological health (p=0.003) and social relationships (p<0.003) compared with patients without any personality disorder. ConclusionsPersonality disorders seem to be a relevant factor that maybe associated with QoL in patients suffering from rheumatological disease.
