Browsing by Author "Cosar, Sacide Nur Saracgil"

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A Comparison of Physical Therapy Modalities Versus Acupuncture in the Treatment of Fibromyalgia Syndrome: A Pilot Study
(2019) Ozen, Selin; Cosar, Sacide Nur Saracgil; Cabioglu, Mehmet Tugrul; Cetin, Nuri; https://orcid.org/0000-0002-7290-8558; https://orcid.org/0000-0001-8306-463X; 30620209; ABC-1305-2020; AAF-1085-2021
Objectives: Physical therapy (PT) modalities are used in the treatment of fibromyalgia syndrome (FMS). Acupuncture is a treatment option often sought after by FMS patients. The aim of this study was to compare the effects of PT modalities with those of acupuncture on pain, daily function, and quality of life in FMS patients. Design: A comparative effectiveness study. Setting and Subjects: Forty-four female patients between the ages of 18-70 years presenting to Baskent University Faculty of Medicine Department of Physical and Rehabilitation Medicine with a new diagnosis of FMS according to the American College of Rheumatology, with manifestations of chronic widespread musculoskeletal pain symptoms, normal routine blood tests, and a desire to receive PT or acupuncture were included in the study. Exclusion criteria included the presence of neurologic, inflammatory, endocrinologic, and other chronic diseases, psychiatric illness, use of antidepressants or analgesics, and contraindication to treatment with PT modalities. Interventions: One group (n=22) received 15 sessions of hotpack, transcutaneous electrical nerve stimulation (TENS), and ultrasound to the tender points of the cervical and upper back regions. The other group (n=22) received 10 sessions of formulated acupuncture aimed at treating pain of the neck, upper, and lower back regions. Outcome measures: Pain, functionality, and quality of life measured using the Short Form McGill Pain Questionnaire (SF-MPQ) and Fibromyalgia Impact Questionnaire (FIQ) before and after treatment. Results: There was a reduction in all SF-MPQ domains and FIQ scores after treatment in both the PT and acupuncture groups. There was no difference in pre- and post-treatment scores between the two groups. Conclusions: PT modalities and acupuncture can be effectively used in the treatment of FMS. Even though one treatment option was not found to be more beneficial than the other, longer post-treatment follow-up may help determine the superior treatment option.
Does the presence of ideomotor apraxia in stroke patients adversely affect rehabilitation outcomes? A prospective study
(2020) Cosar, Sacide Nur Saracgil; Ozen, Selin; Selcuk, Selin Taflan; Yemisci, Oya Umit; 0000-0001-8306-463X; AAF-1085-2021
Background and Objectives: Ideomotor apraxia is an inability to perform a gesture following a verbal command despite having intact knowledge of the task. The presence of ideomotor apraxia may negatively affect functional outcome of stroke patients. The aim of this study was to evaluate the effect of ideomotor apraxia on rehabilitation outcomes following first ever stroke. Methods: A cross sectional observational study of 35 stroke patients admitted to a rehabilitation unit for treatment. Patients were evaluated for ideomotor apraxia using the ideomotor apraxia test. Function was assessed before and after treatment using the Functional Independence Measure, motricity index and functional ambulation scale. Cognitive function was evaluated using the Functional Independence Measure and mini mental state examination. Results: Ideomotor apraxia was present in 31.4% of patients. Mean Functional Independence Measure motor and cognitive scores of apraxic patients on admission and at discharge were lower than those of non-apraxic patients, (p<0.05). The cognitive and total Functional Independence Measure scores and motricity scores in the ideomotor apraxia group on discharge had not reached the admission values of the non-ideomotor apraxia group. Conclusion: The presence of ideomotor apraxia following stroke has a negative impact on overall function, both before and after rehabilitation, when compared to stroke patients without ideomotor apraxia. Stroke patients must be assessed for ideomotor apraxia prior to commencement of a rehabilitation program in order to guide treatment and determine realistic treatment goals.
Efficacy of Ultrasound Versus Short Wave Diathermy in the Treatment of Chronic Low Back Pain in Patients with Lumbar Disk Herniation: A Prospective Randomized Control Study
(2023) Ozen, Selin; Guzel, Sukran; Senlikci, Huma Boluk; Cosar, Sacide Nur Saracgil; Selcuk, Ebru Selin; 0000-0002-7290-8558; 0000-0001-8306-463X; 37986090; ABC-1305-2020; AAF-1085-2021
Background Lumbar disk herniation (LDH) is a cause of chronic low back pain (CLBP) treated using physical therapy (PT), including exercise and physical modalities such as ultrasound (US) and short wave diathermy (SWD). Despite the use of US and SWD, there is inconclusive evidence on their efficacy. The aim of this study was to investigate the efficacy of US and SWD in the treatment of CLBP in patients with LDH.Method A prospective randomized control clinical study. Individuals with radicular CLBP and LDH on magnetic resonance imaging, presenting to the Physical and Rehabilitation Medicine Department were randomized into 3 treatment groups. All participants received 10 sessions of hotpack, transcutaneous nerve stimulation (TENS) and therapeutic exercises. In addition, Group 1 received 10 sessions of therapeutic US (1 MHz, 1.5W/cm2, 10 min), Group 2 SWD (27.12 MHz, wavelength 11.06 m, induction technique, 20 min) to the lower back. Group 3 (control group) received hotpack, TENS and therapeutic exercises alone. Visual analogue scale (VAS) for LBP, Modified Oswestry Disability Index (MODI) and Short Form 36 (SF-36) were evaluated pre and post treatment and at one and three months follow up.Results In all groups, VAS for LBP and MODI improved with treatment and at the one and three month follow up (p < 0.001). In Groups 1 and 2, MODI scores continued to reduce at 1 and 3 months (p < 0.001 and p = 0.012 respectively). SF-36 physical, social function and pain parameters reduced in all groups (p < 0.05). Role limitation due to physical and emotional problems, emotional well-being, vitality and mental health improved in Groups 1 and 2 (p < 0.05).Conclusions Deep heating agents can be used as part of the physical therapy for CLBP in those with LDH with positive mid-term effects.Trial registrationNCT03835182, 02/04/2019.
Inpatient rehabilitation outcomes in neoplastic spinal cord compression vs. traumatic spinal cord injury
(2022) Afsar, Sevgi Ikbali; Cosar, Sacide Nur Saracgil; Yemisci, Oya Umit; Boluk, Huma; 0000-0002-4003-3646; 0000-0001-8306-463X; 0000-0002-0501-5127; 0000-0001-6771-3265; 32701391; E-2103-2019; AAF-1085-2021; AAJ-8820-2021; AAX-8965-2021
Objective: To compare neurological and functional outcomes, and complications of patients with neoplastic vs traumatic spinal cord injury (SCI) after in-patient rehabilitation. Design: This study is a retrospective analysis. Setting: In-patient rehabilitation unit of a tertiary research hospital. Participants: A total of 252 patients with a SCI were included; 43 with neoplastic SCI (mean age: 60.9 +/- 15.7 years, 60.5% were males) and 209 with traumatic SCI (mean age: 43.1 +/- 16.8 years, 71.3% were males). Outcome measures: Comparisons were made of demographic characteristics, etiology, American Spinal Injury Association (ASIA) impairment scale, functional independence measurement (FIM) and Functional Ambulation Categories (FAC) scores, length of stay (LOS), bladder independence, medical comorbidities and complications in both groups. Results: Patients with neoplastic SCI were significantly older than those with traumatic SCI (P < 0.01). No difference was present between the groups in terms of sex and lesion level (P > 0.05). Incomplete SCI was significantly higher in the neoplastic group when compared with the traumatic group (P < 0.01). The LOS was significantly shorter in the neoplastic group than traumatic group (34.8 +/- 41.03 vs. 60.02 +/- 53.1, P < 0.01). There were no differences in the admission FIM scores (69.3 +/- 24.7 vs. 58.7 +/- 18.9, P > 0.05), discharge FIM scores (82.1 +/- 25.1 vs. 74.02 +/- 23.3, P > 0.05) and FIM efficiencies (0.43 +/- 0.72 vs. 0.36 +/- 0.51, P > 0.05) for the neoplastic and traumatic groups, respectively. However, neoplastic SCI patients demonstrated lower FIM gains compared to traumatic patients (12.9 +/- 11.9 vs. 15.4 +/- 15.2, P < 0.05). During rehabilitation, urinary tract infection (48.4% vs. 69.4%) and decubitus ulcer (11.6% vs. 35.9%) were significantly more common in the traumatic group than the neoplastic group (P < 0.05). Conclusion: Neoplastic SCI patients who commonly present at rehabilitation units exhibit different characteristics from traumatic SCI patients but the rehabilitation results are similar. Similar functional development can be achieved in a shorter period of time with inpatient rehabilitation in the neoplastic SCI group.
Longitudinal Associations Between Provision of Autonomy Support and Well-Being in Spouses of Individuals With Chronic Pain
(2019) Ascigil, Esra; Uysal, Ahmet; Cosar, Sacide Nur Saracgil; 29947732
Background Caregiving spouses of individuals with chronic pain often experience poor well-being. Purpose The current study aimed to examine the association between chronic pain-related provision of autonomy support and well-being in support providers (spouses) of individuals with chronic pain. Methods Spouses of individuals with a diagnosed musculoskeletal chronic pain condition (N = 172) were recruited for a five-time point longitudinal study. Participants completed the questionnaires once every 6 months across 2 years. In a follow-up diary study, participants (N = 41) completed daily records of provision of autonomy support and well-being. Results Multilevel analyses showed that provision of autonomy support was associated with greater well-being in support providers at both within-person and between-person levels. Longitudinal cross-lagged analyses also provided some evidence that it is provision of autonomy support that predicts well-being, and not the opposite. These effects held true in the follow-up diary study; however, some findings also suggested that the short-term associations between provision of autonomy support and well-being could be reciprocal. Conclusions Current findings extend the existing literature by suggesting provision of autonomy support as a beneficial type of support for the provider within the chronic pain context and lay the groundwork for caregiver-focused interventions. Provision of autonomy support to individuals with chronic pain (e.g., understanding their perspective, providing choices, encouraging initiation, minimizing pressure) was beneficial for the well-being of support-providing spouses.
Prognostic Value of Magnetic Resonance Imaging in the Evaluation of Physical Therapy Outcomes in Patients with Adhesive Capsulitis
(2021) Cosar, Sacide Nur Saracgil; Ozen, Selin; Coskun, Mehmet; Yemisci, Oya Umit; Kurtcebe, Ali Niyazi; 0000-0001-8306-463X; 0000-0002-7290-8558; 0000-0002-0501-5127; 34396065; AAF-1085-2021; ABC-1305-2020; AAJ-8820-2021
Objectives: This study aims to investigate whether the treatment outcomes of patients with a clinical diagnosis of adhesive capsulitis (AC) and magnetic resonance imaging (MRI) findings consistent with AC undergoing physical therapy (PT) differs to those with AC in the absence of these MRI findings. Patients and methods: Between January 2012 and October 2012, a total of 30 patients (8 males, 22 females; mean age 55.6 +/- 12.1 years; range, 35 to 85 years) with a clinical diagnosis of AC underwent MRI of the index shoulder. The MRI scans were evaluated for findings associated with AC: intensity of the inferior glenohumeral ligament (IGHL) and rotator interval (RI). All patients received a total of 15 sessions of PT: hot pack, transcutaneous electrical nerve stimulation, ultrasound, and shoulder exercises. The patients were assessed for shoulder range of motion (ROM) using the Visual Analog Scale ( VAS) for shoulder pain, Quick Disabilities of the Arm Shoulder and Hand (Q-DASH), and Health Assessment Questionnaire (HAQ) prior to and following completion of PT. Results: Of the patients, 21 had no MRI findings consistent with AC (Group 1), nine patients had changes in the IGHL and/or RI characteristic of AC (Group 2). In both groups, there was a significant improvement in active and passive shoulder ROM and VAS scores for shoulder pain at rest (Group 1: p<0.001, Group 2: p=0.017) with movement (Group 1: p<0.001, Group 2: p=0.007) and at night (Group 1: p<0.001, Group 2: p=0.012) following PT. However, there was no significant inter-group difference in scores. Similar findings were recorded for Q-DASH and HAQ. Conclusion: Based on these study findings, the presence of characteristic MRI findings of AC with a clinical diagnosis do not predict clinical response to physical therapy.
Scapular Winging Secondary to Iatrogenic Spinal Accessory Nerve Lesions
(2021) Ozen, Selin; Cosar, Sacide Nur Saracgil; Afsar, Sevgi Lkbali; Ayas, Sehri; 0000-0002-7290-8558; 34500533; ABC-1305-2020
Motor innervation of trapezius and sternocleidomastoid (SCM) muscles is provided solely by the spinal accessory nerve (SAN). SAN palsy most often occurs as a result of iatrogenic injury to the nerve. A patient, who had undergone neck dissection for thyroid cancer, presented with pain and reduced range of motion of the shoulders. Electroneuromyography revealed denervation of the trapezii and SCM muscles secondary to SAN injury. The patient was treated with a course of physical therapy (PT). This case reminds us that a SAN lesion should be considered in the differential diagnosis of a patient presenting with shoulder pain following surgery of the neck. Even though unilateral SAN injury can eventually lead to atrophy of the trapezius, muscle asymmetry may not be obvious, especially in bilateral iatrogenic SAN injuries. In our experience, these patients benefit from PT. However, evidence to support the use of PT in the treatment of shoulder dysfunction secondary to SAN injury is insufficient; the optimum type and timing of PT requires further investigation. Development of best-practice guidelines in terms of management is necessary.
Sympathetic skin responses and electromyographic reaction times in chronic autoimmune thyroiditis: An overlooked electrodiagnostic study
(2022) Yemisci, Oya Umit; Ozen, Selin; Sisman, Tubanur Ozturk; Anil, Cuneyd; Cosar, Sacide Nur Saracgil; 0000-0002-0501-5127; 0000-0001-8306-463X; 35949958; AAJ-8820-2021; AAF-1085-2021
Objectives: This study aims to evaluate peripheral nerve functions, sympathetic skin responses (SSRs), and electromyographic (EMG) reaction times in hypothyroid patients and to compare them to healthy individuals. Patients and methods: Between January 2007 and September 2007, a total of 54 patients with Hashimoto's thyroiditis including 35 euthyroid (3 males, 32 females; mean age: 45.2 +/- 10.2 years; range, 35 to 60 years) and 19 with subclinical hypothyroidism (2 males, 17 females; mean age: 43.2 +/- 12.6 years; range, 40 to 65 years) were included in the study. The control group consisted of 35 healthy individuals (5 males, 30 females; mean age: 39.1 +/- 9.3 years; range, 29 to 52 years). Nerve conduction studies (NCSs), SSRs of the hand and foot obtained by stimulation of the contralateral median nerve, and EMG reaction times of the extensor indicis proprius muscle were performed in all subjects. Results: There was no significant difference in peripheral NCSs and SSRs between patients and the control group. However, reaction times were longer in the AIT patients compared to the healthy individuals suggesting alterations in cognitive function related to the primary disease process in AIT. Conclusion: Electrodiagnosis of autonomic nervous system involvement and cognitive impairment can be challenging in AIT. However, EMG reaction times and SSRs are practical and useful tools that are often overlooked. On the other hand, SSRs may be combined with more quantitative tests, such as sudomotor axon reflex testing, to allow us to better determine the extent of involvement of the autonomic nervous system in AIT.
An unresolved relationship: the relationship between lesion severity and neurogenic bladder in patients with spinal cord injury
(2016) Afsar, Sevgi Ikbali; Sarifakioglu, Banu; Yalbuzdag, Seniz Akcay; Cosar, Sacide Nur Saracgil; 26322550
Objectives: We aimed to investigate the relationship between the severity of the spinal lesion and urodynamic findings, bladder drainage method at discharge, and incidence of renal calculi in patients with spinal cord injury (SCI). Studydesign: Retrospective. Setting: In-patient rehabilitation unit of a tertiary research hospital. Methods: A total of 131 patients who were admitted to our clinic with a diagnosis of SCI and placed into a rehabilitation program were included in the study. The severity of the lesion was determined according to the American Spinal Injury Association Impairment Scale (AIS). We evaluated the relationship between the severity of the lesion and the detrusor hyperactivity and compliance as determined by urodynamic investigation, the bladder drainage method used at discharge, and the renal calculi rate as determined by ultrasonography. Results: While no difference was found between the patients with complete and incomplete injuries in terms of age, sex, disease duration, detrusor hyperactivity and compliance, the bladder drainage method was found to show a significant change according to the severity of the lesion. None of the patients were found to have hydronephrosis and the rate of renal calculi showed no statistically significant difference according to the severity of the lesion. Conclusions: We concluded that urodynamic examination is required in each patient with SCI as the severity of the lesion is not sufficient to determine the bladder type, and patients with complete and incomplete injuries should be monitored with the same sensitivity in terms of complications.