Turkish Journal of Physical Medicine and Rehabilitation最新文献

Objectives: This study aims to investigate the effects of bodyweight support and therapist supervision on gait parameters and vital signs during overground gait training in stroke patients.

Patients and methods: Between August 2023 and September 2023, a total of 18 stroke patients (10 males, 8 females; mean age: 61.2±12.0 years; range, 32 to 81 years) with hemiparesis were included in this factorial-design study. The patients underwent three different walking conditions: supervised bodyweight support (SBS), unsupervised bodyweight support (UBS), and supervised training without bodyweight support (SWBS). Gait parameters, including velocity, cadence, gait distance, gait cycle, stride length, step length, and single limb support, as well as vital signs (pulse rate and SpO2), were measured and compared using the 4-m walking test (4MWT) and 2-min walking test (2MWT).

Results: Twelve patients had an ischemic stroke, while six had a hemorrhagic stroke. The mean onset period was 9.61±5.96 months. Eight patients had right-sided paralysis, and 10 patients had left-sided paralysis. There were no significant differences in gait parameters or vital signs during the 4MWT and 2MWT among the SBS, UBS, and SWBS groups (p>0.05 for all).

Conclusion: Gait training using therapist supervised walking and bodyweight support may both be beneficial for stroke patients. However, incorporating both conditions into an intervention may not be efficient in terms of cost, space, and personnel utilization.

Objectives: This study aims to examine whether low-level laser therapy (LLLT), when combined with conventional therapy, contributes to the rehabilitation of patients with zone 5 to 8 extensor tendon injuries.

Patients and methods: A total of 55 patients (44 males, 11 females; mean age: 34.2±11.3 years; range, 18 to 55 years) with hand extensor tendon injury were included in the double-blind randomized controlled study between April 30, 2020, and December 30, 2020. Controlled active motion protocol was applied to all patients. In addition, LLLT was applied to one group and sham laser to another group for 10 sessions. Patients were evaluated at baseline and four and eight weeks after intervention. Visual Analog Scale for pain, Quick Disabilities of the Arm, Shoulder, and Hand questionnaire for upper extremity symptoms and functions, and nine-hole peg test for hand dexterity were used. The range of motion of the hand and metacarpophalangeal joint circumference were measured. Grip strength was evaluated only at the eighth postoperative week.

Results: In both groups, significant improvement was observed in all evaluation parameters, except for wrist range of motion at the eighth postoperative week measurement (p<0.05). When the clinical outcomes were compared between the groups, no significant difference was observed in all clinical parameters both in the fourth and eighth week measurements after intervention (p>0.05).

Conclusion: In our study, no additional contribution of LLLT to the rehabilitation of extensor tendon injuries between zones 5 and 8 was observed.

Objectives: This study aims to investigate the reflex bladder's occurrence according to urodynamic parameters in patients with suprasacral spinal cord injury (SCI) within one year after injury.

Patients and methods: Between May 2021 and July 2023, a total of 83 (57 males, 26 females; median age: 32 years; range, 19 to 64 years) suprasacral traumatic SCI patients within one year after injury were included in the study. The patients were divided into two groups as complete or incomplete SCI according to the American Spinal Cord Injury International Standards for Neurological Classification of SCI. Also, the patients were divided into two groups as ≤90 days or 91-365 days according to the duration between injury and urodynamics.

Results: Thirteen (37.1%) of 35 patients within 90 days after injury had detrusor overactivity (DO). During the ≤90 days period, the DO and detrusor-external sphincter dyssynergia (DSD) rates of incomplete suprasacral SCI patients were significantly higher than complete suprasacral SCI patients (p<0.05). Within three months after injury, although the median storage phase maximal detrusor pressure [Pdet (max)] of incomplete suprasacral SCI patients was significantly higher than complete suprasacral SCI patients (p=0.007), the Pdet (max) >40 cmH₂O rates were similar between complete and incomplete patients (p=0.213). The urodynamic parameters of patients with complete and incomplete suprasacral SCI were similar after three months of injury (p>0.05).

Conclusion: Although urodynamics investigation is recommended after spinal shock in SCI patients, detrusor reflex did not recover completely in most of suprasacral SCI patients within three months after injury in our study. The development of DO occurs significantly earlier in patients with incomplete suprasacral SCI than patients with complete suprasacral SCI.

Objectives: This study aimed to compare the effectiveness of mild-moderate intensity continuous training (CT) and low-intensity interval moderate-intensity training (LIIT) aerobic exercises in pulmonary rehabilitation after coronavirus disease 2019 (COVID-19).

Patients and methods: This prospective study was conducted between January 2021 and January 2022. Sixty-three patients (47 males, 16 females; mean age: 54.3±11.3 years; range, 25 to 81 years) with one or more residual symptoms following COVID-19 infections were randomly included in the CT (n=33) or LIIT (n=30) groups. Fifteen sessions (60 min, 3-5/week) of aerobic exercise (20-min 40% of peak workload for CT; 40% peak workload with 3-min loaded and 1-min nonloaded intervals for LIIT, with 5 min warm-up and cool-down), breathing, and upper extremity strengthening exercises were applied. Outcome measures were symptom-limited submaximal exercise test, and six-minute walk test (6MWT), the modified Medical Research Council (mMRC) dyspnea scale, modified Borg dyspnea scale, and Borg 6-20 rate of perceived exertion scale, hand grip strength, fat-free mass, Hospital Anxiety and Depression Scale (HADS), and 36-item Short-Form Health Survey.

Results: The maximum load and time reached during the exercise test, the 6MWT distance, hand grip strength, mMRC, HADS, and SF-36 scores significantly improved in both groups (p<0.05). Resting modified Borg dyspnea scores, heart rate, rate of perceived exertion, and oxygen supplementation requirement decreased significantly in the LIIT group (p<0.05). All posttreatment measures were similar in both groups (p>0.05). The changes in mMRC, resting heart rate, and 6MWT distance were significantly higher in the LIIT group compared to the CT group (p<0.05).

Conclusion: Both CT and LIIT improved functional capacity, dyspnea, tachycardia, depression, and quality of life measures safely and effectively in COVID-19 survivors with residual symptoms. Patients with poor clinical status who cannot tolerate CT after an acute pulmonary condition such as COVID-19 may benefit from LIIT.

Objectives: This study aimed to evaluate the effectiveness of a home training program using web-based services to manage obesity and improve functional independence in individuals with spinal cord injury (SCI).

Patients and methods: Fifteen individuals (12 males, 3 females; mean age: 40.7±10.8 years; range, 28 to 60 years) with SCI paraplegia were included in the study conducted between August 2020 and December 2020. All participants remotely completed a six-week resistance program using Thera-Band with the aid of training videos. The program comprised chest press, lateral raise, front raise, shoulder press, and arm curl exercises, performed for five sets of 8 to 10 repetitions, and exercise intensity was increased by 5% each week.

Results: Lean body mass (p=0.042) and high-density lipoprotein cholesterol levels (p=0.038) increased, and C-reactive protein levels decreased without significance. Significant improvements were observed in the 6-min push test (p=0.009), peak oxygen uptake (VO₂ peak; p<0.001), VO₂ peak/kg (p<0.001), VO₂ (p=0.004), VO₂/kg (p=0.002), and ventilation (p=0.019), while statistically insignificant increases were observed in the respiratory exchange ratio, maximum inspiratory pressure/mean, maximum inspiratory pressure, maximum expiratory pressure/mean, maximum expiratory pressure, and shoulder and chest press weights. Heart rate values decreased without significance. Arm curl repetitions (left, p=0.008; right, p=0.032) and lateral pull weight increased (p=0.038).

Conclusion: Home training using Thera-Band is feasible for persons with SCI to manage obesity and improve cardiopulmonary function, muscle strength, and endurance. It can facilitate the maintenance of physical activity in individuals with SCI who have limited mobility and access to training facilities.

Objectives: This study aimed to explore the clinical efficacy of acupuncture therapy combined with breathing training in patients with stroke complicated with pulmonary infection.

Patients and methods: In this prospective randomized controlled study, a total of 72 patients with pulmonary infection after stroke who were admitted between May 2020 and May 2021 were randomly divided into the intervention group (n=36; 28 males, 8 females; mean age: 59.9±13.4 years; range, 28 to 80 years) and the control group (n=36; 23 males, 13 females; mean age: 57.8±12.2 years; range, 35 to 79 years). Both groups were treated with conventional drug therapy, rehabilitation therapy, and breathing training for two consecutive weeks. The intervention group additionally received acupuncture therapy. The following data was collected to evaluate clinical efficacy: the traditional Chinese medicine syndrome score and the clinical pulmonary infection score before and after treatment, inflammatory factors, time of symptom disappearance, and pulmonary indexes.

Results: After treatment, the traditional Chinese medicine syndrome score and the clinical pulmonary infection score were significantly lower in the intervention group than in the control group (both p<0.05). The intervention group also experienced earlier fever resolution and faster disappearance of cough, expectoration, and moist rales in the lungs than the control group (all p<0.05). Furthermore, white blood cell count, C-reactive protein, and calcitonin levels were significantly lower in the intervention group than in the control group (all p<0.05). The total effective rates of the intervention group and control group were 94.44% (n=34) and 77.78% (n=28), respectively (chi-squared = 4.181, p=0.041). Additionally, forced vital capacity, forced expiratory volume in the first second, and peak expiratory flow were significantly higher in the intervention group than in the control group (all p<0.05).

Conclusion: Acupuncture therapy combined with breathing training achieved high efficacy in patients with stroke complicated with pulmonary infection. It may improve the symptoms of pulmonary infection and suppress inflammatory responses.

Objectives: This study aimed to compare the effects of Neurodevelopmental Treatment Approach-Bobath (NDT-B) and Nintendo Wii Fit balance-based video games on balance, motor skills, and functionality in individuals with ambulatory cerebral palsy (CP) and to examine the long-term the effects of Wii Fit balance-based video games and NDT-B.

Patients and methods: A total of 20 individuals with ambulatory CP were included in the randomized-controlled study between June 2018 and September 2019. The participants were randomized into two groups: the Nintendo Wii Fit balance-based video games group (Wii group; 8 males, 2 females; mean age: 13.0±3.3 years; range: 5 to 18 years) and the NDT-B group (control group; 8 males, 2 females; mean age: 9.3±3.9 years; range: 5 to 18 years). Personalized NDT-B was applied to both groups for a total of 12 sessions. Personalized posture and balance activities were applied to the control group, while Nintendo Wii Fit balance-based video games were applied to the Wii group. Motor and functional tests were used for the assessment of functional status and abilities. Balance tests and Nintendo Wii Fit balance assessment were used for balance assessment. The outcomes were recorded before treatment, after treatment, and three months after treatment.

Results: Static balance improved in both groups, with the effect sustained after three months in the control group (p<0.05). At the end of the treatment, the decrease in Timed Up and Go test and the increase in Sit-to-Stand test scores were significant in the Wii group, and these improvements were sustained at three months following the treatment (p<0.05). There was a significant increase in the game scores for balance, weight shift, and walking speed at the end of the treatment (p<0.05).

Conclusion: The current study results suggest that Wii Fit balance-based video games can be used as an additional and complementary therapy to the NDT-B treatment program in the rehabilitation of individuals with CP with sustainable clinical effects in the long-term.

Objectives: This study aimed to validate the Brief International Classification of Functioning, Disability, and Health (ICF) Core Set for chronic ischemic heart disease (CIHD) in a Turkish patient population, identifying the most common problems in ICF categories and testing its construct validity.

Patients and methods: A total of 85 patients (28 males, 57 females; mean age: 64.4±12.2 years; range, 37 to 88 years) diagnosed with CIHD who were referred to our cardiac rehabilitation outpatient clinic were included in the cross-sectional study between February 2014 and August 2015. Brief ICF Core Set for CIHD, which includes 36 second-level categories, was used to assess the most common impairments. Correlations between these impairments and various clinical assessment scales were analyzed to test construct validity.

Results: The most impaired categories in body functions were heart functions, blood pressure functions, exercise tolerance functions, blood vessel functions, sensations associated with cardiovascular and respiratory functions, and energy and drive functions. In the body structure component, the structure of the cardiovascular system was identified as a problem in 97.6% of patients. The activities and participation component revealed that moving around, remunerative employment, and carrying out daily routines were frequently problematic. All of the environmental factors were identified as both barriers and facilitators. Significant correlations were found between these categories and various clinical assessment scales.

Conclusion: The Brief ICF Core Set for CIHD is a valid tool for assessing the multifaceted impact of CIHD in a Turkish patient population. This validation supports its use for comprehensive, patient-centered evaluations in clinical settings, emphasizing the need for a holistic approach to managing CIHD.

Pectus deformities, particularly pectus excavatum and pectus carinatum, are among the most common congenital chest wall abnormalities in children. These deformities may have varying degrees of physical, psychological, and functional effects. This review provides a concise overview of the current state of knowledge regarding the history, epidemiology, etiopathogenesis, clinical presentation, classification, and rehabilitation of these deformities, focusing on the pediatric population.