Browsing by Author "Analan, Pinar Doruk"

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Association Between the Elasticity of Hip Muscles and the Hip Migration Index in Cerebral Palsy
(2019) Analan, Pinar Doruk; Aslan, Hulya; https://orcid.org/0000-0002-3528-3712; https://orcid.org/0000-0002-7138-246X; 30779197; AAA-8043-2021; AAK-9104-2021
Objectives-Cerebral palsy (CP) increases the risk of hip displacement during childhood. Abnormal hip muscle forces have been proposed as the predisposing factors. In CP, the amount of hip displacement is commonly evaluated by the Reimers hip migration index (MI) on an anteroposterior pelvic radiograph. To the best of our knowledge, the association between the elasticity of hip muscles measured by shear wave elastography and the MI has not been studied yet. Herein, we aimed to analyze the correlation between the elasticity of hip muscles and the MI. Methods-Bilateral hips of 25 children with spastic CP were included prospectively in this study. Anteroposterior pelvic radiographs were used to measure the MI. Shear wave elastography was performed to evaluate the elasticity of muscles. The correlation between the MI and the elasticity of hip flexor and adductor muscle groups was assessed. Also, the association between the elasticity of agonist/antagonist muscles was analyzed. Results-The MI showed fair to good correlations with hip flexors and adductors for both readers (0.71 >= r >= 0.52). The mean MIs of the patients +/- SDs were 22.64% +/- 7.79% for reader 1 and 21.55% +/- 8.83% for reader 2. The elasticity of agonist/antagonist muscle groups showed little/no to a weak correlation for both readers (0.32 >= r >= -0.07). Conclusions-Although, hip flexor and adductor muscle elasticity showed a correlation with MI, it seems very hard to say that increased elasticity of hip flexor and adductor muscles causes hip dislocation.
Balance and fall risk in peritoneal dialysis patients
(2019) Analan, Pinar Doruk; Ozelsancak, Ruya; 0000-0002-3528-3712; 0000-0002-0788-8319; 30248027; AAA-8043-2021; AAD-5716-2021
BACKGROUND: Vestibular, neurological and musculoskeletal functions are affected in patients with renal failure. These problems can in turn affect the balance system in peritoneal dialysis (PD) patients. Previously, postural balance changes were shown in hemodialysis patients. This is the first study that evaluates whether there are similar changes in patients with PD. OBJECTIVE: This study aimed to compare balance and fall risk between patients undergoing PD treatment and healthy subjects, and aimed to determine the correlation between biochemical parameters and fall risk and balance assessments in PD patients. METHODS: This controlled study included 58 patients receiving PD treatment (PD Group) and 75 healthy subjects (Control Group). The Berg Balance Scale (BBS) and Tetrax (R) Interactive Balance System were used for the comparison of balance between groups. For patients in the PD Group, duration of PD, blood pressure, Kt/V-urea (actual mass of urea removed via peritoneal dialysis), and serum biochemical parameters were recorded and correlation analysis was performed between these parameters and balance measurements. RESULTS: There were no statistically significant differences between groups in terms of demographics or BBS scores (p > 0.05). The fall risk of patients in the PD Group was significantly higher than those in the Control Group (p < 0.0001) according to Tetrax measurements. Female gender, older age, higher BMI, and higher blood glucose levels were negatively correlated with balance parameters of PD patients (r > 0.3). There was no statistically significant correlation between duration of PD, blood pressure, and Kt/V-urea with balance parameters or fall risk. CONCLUSIONS: Balance was impaired in patients undergoing PD in comparison to healthy subjects. Fall risk may be evaluated using the Tetrax (R) instead of BBS for this population. Serum glucose level, BMI and age appear to affect balance and fall risk. Therefore, optimization of body weight and normalization of serum glucose levels are important factors for improving balance. The duration of PD, blood pressure, and Kt/V-urea do not affect balance system.
A Comparison of The Effects of Lidocaine and Saline Injection on Pain, Disability, and Shear-Wave Elastography Findings in Patients with Myofascial Trigger Points
(2019) Analan, Pinar Doruk; Aslan, Hulya; Umay, Sermin Tok; 0000-0002-7161-016X; AAW-6708-2020
BACKGROUND/AIMS To compare the effects of lidocaine injection (LI) and saline injection (SI) on the myofascial trigger points (MTrPs) in the trapezius muscle on pain, disability, and shear-wave elastography (SWE) in patients with myofascial pain syndrome (MPS). The secondary aim was to evaluate the correlations between SWE and pain with disability scores. MATERIAL and METHODS This prospective study included 45 patients with MTrPs due to MPS. The patients were evaluated using the visual analog scale (VAS), Neck Disability Index (NDI), and SWE immediately before and 15 days after the injections. The patients were randomly assigned to an LI (n=20, 30 MTrPs) or an SI (n=25, 32 MTrPs) group. The LI group was treated with lidocaine, and the SI group was treated with SI. RESULTS Visual analog scale and NDI scores improved significantly in both groups after injection (p <= 0.05). In addition, 16 MTrPs in the LI group and 3 MTrPs in the SI group were completely resolved. Maximum shear-wave velocity (V(s)max) and mean shear-wave velocity significantly decreased in the SI group after injection (p=0.025). The size of MTrPs decreased in the LI group (p=0.02). Pre-injection V(s)max and resting VAS were weakly correlated (r=0.309). No significant correlation was found on other SWE measurements with VAS and NDI scores (r<0.3). CONCLUSION Lidocaine injection and SI effectively improved the disability and pain in patients with MPS. LI is more effective than SI in reducing the size of the trigger points and resolving MTrPs. SWE findings may not completely reflect the severity of pain and correlate with disability.
The Effect of Patellar Height by Using Insall Salvati Index on Pain, Function, Muscle Strength and Postural Stability in Patients with Primary Knee Osteoarthritis
(2021) Analan, Pinar Doruk; Ozdemir, Hulya; 0000-0002-3528-3712; 0000-0002-7138-246X; 32811402; AAA-8043-2021; AAK-9104-2021
Purpose: The Insall-Salvati Index (ISI) is the ratio of the patellar tendon length to the length of the patella. This ratio is the most commonly used method for evaluating patellar placement and patellofemoral imbalance. The position of the patella is important for the knee joint function and also for biomechanics. The abnormal position of the patella may lead to patellofemoral malalignment and instability. Herein, we aimed to analyze the relationship between the ISI and pain, physical function, muscle strength, fall risk, and postural stability in patients with primary knee osteoarthritis (OA). Methods: Sixty-two symptomatic knees of 45 patients (aged between 40 -75 years) who were suffering from the primary knee OA according to the American College of Rheumatology criteria were included retrospectively in the study. Patients with stages II and III osteoarthritis according to the Kellgren-Lawrence (K/L) radiological grading system were included. The ISI was measured on the lateral knee radiograph in a 30 degrees flexed posture. Visual Analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and Lequesne indexes were recorded for evaluating pain and function. Tetrax Interactive Balance System was used to assess fall risk and postural stability. Isokinetic muscle strength measurements of quadriceps and hamstrings were recorded at the constant angular velocities of 60 and 180 degrees/sec. Results: The mean age of the study population was 58.52 +/- 8.01 years. The frequency of the patellar situation types was as follows; patella alta; 15 (24.2%), patella baja; n=2(3.2%), and normal patellar height; n=45(72.6%). The mean ISI was 1.19 +/- 0.17 on the right side and 1.18 +/- 0.16 on the left side. There was no significant correlation between the ISI and VAS, WOMAC and Lequesne indexes, postural stability scores, and isokinetic measurements (r<0.3, p>0.05). Conclusion: In primary knee OA, the ISI may not have an effect on pain, physical function, fall risk, postural stability, and isokinetic muscle strength.
The effect of physician experience on the measurement reliability of the Reimers' hip migration percentage in children with cerebral palsy
(2015) Analan, Pinar Doruk; Yilmaz, Emine Ece; Adnan, Mehmet; Leblebici, Berrin; 26644686
[Purpose] Reimers' hip migration percentage (MP) is commonly used to document the extent of hip displacement in children with cerebral palsy (CP). However, factors such as poor administration of pelvic radiographs, a lack of concentration, inexperience, or a busy clinical environment may result in variations in the MP measurements. The aim of this study was to compare the differences in the MP results of two physiatrists with varying levels of experience to determine the role of experience in the measurement's accuracy. [Subjects and Methods] This retrospective study included 62 hip radiographs of 31 children with spastic CP. Two physiatrists with different experience levels calculated the baseline MP on two occasions six weeks apart. Correlations, intra-and inter-rater reliabilities, and differences in the MPs were compared. [Results] Correlations and inter-and intra-rater reliabilities of the measurements were excellent. There were no statistically significant intra-or inter-rater differences for either of the two measurement points. Inter-rater correlations for each session were 0.94. [Conclusion] Experience does not appear to be a factor in the evaluation of MP, and inter-rater differences do not cause problems regarding patient follow-up. Therefore, repeated pelvic radiographs are not necessary in the evaluation of MP in children with CP unless indicated.
The Effect of Serum 25(OH)D3 Level on Breast Cancer-Related Lymphedema
(2019) Analan, Pinar Doruk; Kaya, Emine; 31140909
Background: The aim of this study was to evaluate the effect of serum 25-hydroxyvitamin D3 [25(OH)D3] levels on the presence and severity of lymphedema, and on the levels of pain, disability, and function in patients with breast cancer-related lymphedema (BCRL). Methods and Results: This controlled study included 71 patients diagnosed with breast carcinoma. Participants were divided into two groups. The BCRL group included 37 breast cancer patients with lymphedema and the control group included 34 breast carcinoma patients without lymphedema. Demographic information, dominant extremity, affected breast, duration of malignancy, and serum 25(OH)D3 levels were recorded for all patients. The 25(OH)D3 levels were then compared between groups. The correlations between serum 25(OH)D3 levels and the visual analog scale (VAS) and Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (Q-DASH) scales and the volumetric and diametric differences between the upper extremities were analyzed in the BCRL group. Serum 25(OH)D3 levels did not show statistically significant differences between groups (p > 0.05). There was no correlation in the BCRL group between 25(OH)D3 levels and the VAS and Q-DASH scores or the diametric and volumetric differences of extremities (r <= 0.3; p > 0.05). Conclusions: Serum 25(OH)D3 levels do not appear to affect the presence or severity of lymphedema, pain, disability, or physical function in BCRL patients. In routine clinical practice, evaluation of this vitamin level does not appear to be necessary for lymphedema in BCRL patients.
Effects of chronic flexed wrist posture on the elasticity and cross-sectional area of the median nerve at the carpal tunnel among chronic stroke patients
(2018) Aslan, Hulya; Analan, Pinar Doruk; 0000-0002-3528-3712; 29400371; AAA-8043-2021
Aim: To investigate the effects of chronic flexed wrist posture following spasticity on the elasticity and cross-sectional area (CSA) of the median nerve at the carpal tunnel among chronic stroke patients. Material and method: This prospective study included 24 consecutive patients (mean age, 56.5 +/- 11.56 years) with unilateral wrist spasticity following a stroke in a chronic phase. The CSA of the median nerve was measured by ultrasound (US). The elasticity was measured by Virtual Touch tissue imaging quantification (VTIQ; Siemens, Erlangen, Germany). SWV and CSA of the median nerves of the affected and unaffected sides for each patient were compared. The correlations between duration of time since the stroke, SWV and CSA of the median nerve were assessed. The interobserver agreement was assessed. Results: The CSA of the median nerve at the affected side was significantly lower than that of the unaffected side (p = 0.03). The SWV of the median nerve at the affected side was significantly higher than that on the unaffected side (p < 0.001). The interobserver agreement was excellent for both CSA and SWV measurements. There was a negatively fair correlation between CSA at the affected side and duration of time since stroke (r = -0.58, p < 0.05). The SWV of the median nerve at the affected side was not correlated with the duration of time since stroke (r <= 0.3, p >= 0.05). Conclusions: These results suggest that chronic flexed wrist posture may cause atrophy of the median nerve due to chronic compression after stroke and increase in the stiffness of the median nerve.
Effects of therapeutic ultrasound and exercise on pain, function, and isokinetic shoulder rotator strength of patients with rotator cuff disease
(2015) Analan, Pinar Doruk; Leblebici, Berrin; Adam, Mehmet; 26644656
[Purpose] The aim of this prospective, double-blind, randomized, placebo-controlled study was to evaluate the effects of therapeutic continuous ultrasound (US) on patients with rotator cuff disease. [Subjects and Methods] Twenty-two patients were treated with a standard physiotherapy program consisting of a hot-pack, transcutaneous electrical nerve stimulation (TENS), exercises, and US that was supervised by the same physiotherapist. The patients were randomly assigned to either a group that received true US (n=11) or one that received sham US (n=11). [Results] There were significant differences between the pre- and post-intervention UCLA Shoulder Rating Scale and Constant-Murley Shoulder Outcome scores, VAS, and external rotation (ER) peak torque 60 degrees/second values for both the true and sham US groups. However, the between-group differences were not statistically significant. [Conclusion] In patients with rotator cuff disease, physiotherapy interventions effectively treat the pain, improve the clinical status, and increase the muscle strength of the shoulder ER at a low constant angular velocity, with functional improvement being seen immediately after treatment. However, at the end of the intervention, the US had yielded no additional efficacy to the physiotherapy treatment regimen of the patients with rotator cuff disease.
Evaluation of postural balance and risk of fall in a healthy adult population
(2016) Analan, Pinar Doruk; Yilmaz, Emine Ece; Leblebici, Berrin
Purpose: In this retrospective study, it was aimed to evaluate the risk of fall and balance, and to determine whether there is a correlation between the risk of fall and vestibular evoked myogenic potentials, which are the evaluating the vestibular system, in the healthy adults who are working in a factory. Material and Methods: The data of 69 male participants have been reached. Bilateral Vestibular Evoked Myogenic Potentials data and Berg Balance Scale of the participants have been recorded along with balance tests and risks of fall by using the Tetrax Interactive Balance System. The correlations between these measurements were measured Results: There was no statistically significant correlation between age and the risk of fall. Also, There ere no significant correlation between the values of latency and amplitude of the bilateral Vestibular Evoked Myogenic Potential waves, Berg Balance Scale, balance tests, and risk of fall. Berg Balance Scale scores showed a considerably good balance while the risk of fall ranged between 0% and 78%. Conclusion: Advanced age may be not alone significant factor for the risk of fall. Berg Balance Scale may not exactly show the risk of fall in the young adult population. Vestibular Evoked Myogenic Potentials measurements may not provide a significant contribution to evaluate the risk of fall and balance. Our study underlines that there may be a risk of falling more than expected in the community.
Factors Associated with Fibromyalgia Syndrome in Peritoneal Dialysis Patients
(2019) Ozelsancak, Ruya; Analan, Pinar Doruk; Leblebici, Berrin; 0000-0002-3528-3712; 0000-0002-0788-8319; 30787502; AAA-8043-2021; AAD-5716-2021
Purpose: We evaluated the prevalence of fibromyalgia syndrome (FMS) in peritoneal dialysis (PD) patients and whether this syndrome is associated with gender, age, duration of PD, or other laboratory parameters. Methods: A total of 60 chronic PD patients (26 women, 34 men) and 60 healthy controls (30 women, 30 men) were included. We recorded each participant's age, gender, cause of kidney failure, PD duration, laboratory parameters, education level, and symptoms related to FMS, diagnosed according to the 2010 American College of Rheumatology criteria. Results: Eleven patients (18%) in the PD group and nine (15%) in the control group met the diagnostic criteria for FMS. There were no statistically significant differences in age; gender; education level; PD duration; laboratory parameters; or sleepdisturbance, fatigue, or cognitive symptoms between the FMS and non-FMS groups among the PD patients. We next compared control and PD patients with FMS. Both groups were of a similar age and gender and had similar sleep disturbance and cognitive symptoms, but more patients had fatigue in the control group. Conclusions: The prevalence of FMS among PD patients was similar to that in the general population, and FMS was not associated with gender, age, duration of PD, or other laboratory parameters.
Gray Scale Histogram Analysis of Carpal Tunnel Syndrome with Ultrasonography
(2019) Umay, Sermin Tok; Analan, Pinar Doruk; 0000-0002-3528-3712; 31989885; AAA-8043-2021
Purpose: In this study, we aim to evaluate the diagnostic value of echogenicity ratio with histogram analyses. Materials & Methods: This retrospective study was performed on 22 patients with 44 hands. The patients had clinical presentations consistent with CTS, in at one hand. Quantitative ultrasound scanning and image capture were completed using a diagnostic sonography machine. For gray scale histogram analysis, image J software was used. Results: Mean flexor tendons histogram analysis echogenicity/Mean median nerve histogram analysis echogenicity was significantly high for 1,7 cutoff value. Conclusion: Mean FTE/MNE ratio may be a useful sonographic parameter for CTS.
Intraneural Vascular Resistive Index of the Median Nerve as a Predictor of Severity of Carpal Tunnel Syndrome
(2020) Pekoz, Burcak Cakir; Pekoz, Mehmet Taylan; Analan, Pinar Doruk; 0000-0002-3528-3712; AAA-8043-2021
Objective: There is a limited data about resistive index (RI) of median nerve (MN) in patients with carpal tunnel syndrome (CTS). In our study, we aimed to evaluate the relationship between CTS severity and MN-RI. Methods: A total of 115 CTS patient wrists, and 49 wrists of control subjects without CTS, were examined on ultrasonography (US) and color Doppler US (CDUS), pulsed Doppler ultrasonography (PDUS), and by electrophysiological evaluations. MN peak-systolic velocity (MN-PSV), MN end-diastolic velocity, MN-RI and MN pulsatility index (MN-PI) were measured by PDUS. Patients were divided into 3 groups according to electrophysiological examinations severity findings of CTS as mild (Group-I), moderate (Group-II), and severe (Group-III). Results: MN-PSV, MN-PI and MN-RI increased significantly from Group-I to Group-III and these parameters were significantly higher in Group-III than other two groups. MN-RI independently determines the patients to have severe CTS. Increased MN-RI (per-0.1) was found to increase the risk of having severe CTS by 3.45-times. In the ROC analysis, the area under the curve was 0.846 for MN-RI. When the MN-RI cut-off value was taken as 0.80, it determines patients to be severe CTS with 85.2% sensitivity and 78.2% specificity. Conclusion: The increase in MN-RI in CTS patients is independently associated with disease severity and may be used in the clinical follow-up of these patients.
Postural Stability in Patients with Lower Limb Lymphedema
(2019) Analan, Pinar Doruk; Kaya, Emine; 31329503
Background: Impaired mobility and musculoskeletal dysfunctions are commonly seen in patients with lymphedema and can affect the balance system in patients in whom the lower limb is affected. This study aims at comparing postural stability between patients with lower limb lymphedema (LLL) and healthy subjects. Methods and Results: This controlled study included 36 patients with LLL (LLL group) and 36 healthy subjects (control group). Fall risk, stability index, and Fourier index measurements of Tetrax (R) Interactive Balance System were compared. There were no statistically significant differences between groups in terms of demographics parameters (p > 0.05). Some stability and Fourier index measurements were significantly higher in subjects in the LLL group than in the control group. However, the fall risk was not statistically different in patients with LLL than healthy subjects (p > 0.05). Conclusion: LLL may cause balance impairments. However, this impairment may not lead to increased fall risk. The evaluation of postural stability in LLL patients would be a useful addition to routine clinical practice due to the relationship between LLL and balance impairments.
Unilateral peroneal paralysis after squat exercise
(2016) Analan, Pinar Doruk; Kaya, Emine; 0000-0002-3528-3712; AAA-8043-2021
Peroneal nerve entrapment neuropathy is the most common entrapment neuropathy in the lower extremity. Peroneal nerve may be damaged while passing over the upper neck of fibula or the tunnel shaped space on the origin of peroneus longus muscles. As a result of this neuropathy, walking difficulties and drop-foot secondary to muscle weakness may develop in patients. In this article; clinical assessment, diagnosis and treatment planning of a patient diagnosed drop-foot after squatting exercise were discussed.