Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Assessment of Pain, Joint Range of Motion, and Balance in Patients with Knee Osteoarthritis(2023) Dag, Muhlis Yigitcan; Ergun, Ahmet; Incekas, Caner; Afsar, Sevgi IkbaliItem Lumbar Spinal Stenosis Due to Ligamentum Flavum Hypertrophy in a Patient with Multiple Exostosis Multipl Ekzostozu(2016) Afsar, Sevgi Ikbali; Karatas, Metin; 0000-0002-4003-3646; E-2103-2019Hereditary multiple exostosis is an autosomal dominant disease characterized by multiple exostoses (osteochondromas) usually affecting the metaphysical regions of long bones, usually of the Iover extremity, and seldom occurring in the axial skeleton. In the literature, hereditary multiple exostosis cases that developed spinal canal stenosis due to spinal osteochondromas have been reported. Lumbar spinal stenosis may occur in a hereditary multiple exostosis patient due to ligamentum flavum hypertrophy, which is a hyperosteotic process that differs from exostosis. We discuss one such case, along with pathogenetic mechanisms and clinical features.Item Association Between Gender, Body Mass Index, and Ulnar Nerve Entrapment at the Elbow: A Retrospective Study(2016) Uzunkulaoglu, Aslihan; Afsar, Sevgi Ikbali; Karatas, Metin; 0000-0002-4003-3646; 27300075; E-2103-2019Introduction: Entrapment of the ulnar nerve is the second most common compression neuropathy in the upper extremity, but the etiology is multifactorial and still not clearly understood. The authors aimed to determine whether gender and body mass index (BMI) are risk factors for ulnar nerve entrapment (UNE) at the elbow. Methods: Results of electrodiagnostic studies performed on patients with UNE between January 2008 and February 2013 were examined retrospectively. Patients with BMI <= 22 were considered slender, those with a BMI between 22 and 29, normal, and those with a BMI >29, overweight. The authors compared the data for patients with and without UNE. Results: A total of 622 subjects were studied; 295 were UNE cases (154 men, 141 women) and 327 were controls (110 men, 217 women). There was no difference between control and UNE groups in terms of BMI. In univariate analysis, age and gender are independent risk factors for UNE, but when included in a stepwise Cox regression model, only gender was a significant factor. Male gender was found to be a risk factor for UNE. Conclusions: Male gender is a risk factor for developing UNE, but age and BMI are not significant risk factors. Further studies which examine BMI and gender differences with data about occupational risk factors are required.Item Virtual Reality in Upper Extremity Rehabilitation of Stroke Patients: A Randomized Controlled Trial(2018) Afsar, Sevgi Ikbali; Mirzayev, Ilkin; Yemisci, Oya Umit; Saracgil, Sacide Nur Cosar; 0000-0002-4003-3646; 0000-0002-0501-5127; 0000-0001-8306-463X; 30193810; E-2103-2019; AAJ-8820-2021; AAF-1085-2021Objective: Virtual reality game system is one of novel approaches, which can improve hemiplegic extremity functions of stroke patients. We aimed to evaluate the effect of the Microsoft Xbox 360 Kinect video game system on upper limb motor functions for subacute stroke patients. Methods: The study included 42 stroke patients of which 35 (19 Virtual reality group, 16 control group) completed the study. All patients received 60 minutes of conventional therapy for upper extremity, 5 times per-week for 4 weeks. Virtual reality group additionally received Xbox Kinect game system 30 minutes per-day. Patients were evaluated prior to the rehabilitation and at the end of 4 weeks. Box&Block Test, Functional independence measure self-care score, Brunnstorm stage and Fugl-Meyer upper extremity motor function scale were used as outcome measures. Results: The Brunnstrom stages and the scores on the Fugl-Meyer upper extremity, Box&Block Test and Functional independence measure improved significantly from baseline to post-treatment in both the experimental and the control groups. The Brunnstrom stage-upper extremity and Box&Block Test gain for the experimental group were significantly higher compared to the control group, while the Brunnstrom stage-hand, the Functional independence measure gain and Fugl-Meyer gain were similar between the groups. Conclusions: We found evidence that kinect-based game system in addition to conventional therapy may have supplemental benefit for stroke patients. However, for virtual reality game systems to enter the routine practice of stroke rehabilitation, randomized controlled clinical trials with longer follow-up periods and larger sample sizes are needed especially to determine an optimal duration and intensity of the treatment.Item 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-8965-2021Objective: 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.Item Ulnar Nerve Conduction Abnormalities in Turkish Taxi Drivers(2014) Afsar, Sevgi Ikbali; Cetin, Nuri; Ayas, Sehri; Mumcu, Gamze Akin; Karatas, MetinObjectives: This study aims to investigate the presence of ulnar entrapment neuropathy at the elbow in taxi drivers, and possible relationship between ulnar entrapment neuropathy and habitually leaning the left elbow on the lower edge of the window. Patients and methods: The study was performed between December 2008 and February 2009 in Ankara and included 40 male taxi drivers (mean age 35.5 +/- 7.3 years; range 25 to 54 years) and 40 healthy male controls (mean age 33.6 +/- 6.1 years; range 25 to 54 years). Nerve conduction studies were performed on both upper limbs of all participants. Results: Left side motor and sensory nerve conduction velocities at the elbow segment of the ulnar nerve were significantly decreased, while F latency of the ulnar nerve was significantly prolonged in taxi drivers. Motor and sensory conduction velocity over both left and right ulnar nerve at the elbow segment were significantly decreased, while F latency of the ulnar nerve was significantly prolonged in the taxi drivers compared to the control group. Ulnar nerve conduction parameters and F latency on both sides were statistically similar in the non-leaning group of taxi drivers; however, motor and sensory conduction studies over the left side of the ulnar nerve elbow segment were slower and F latency was longer in the leaning group of taxi drivers, compared to the right side and to the non-leaning group of taxi drivers. Conclusion: Prolonged elbow flexion and habitually leaning the left elbow may cause electrodiagnostically diagnosed ulnar entrapment neuropathy in taxi drivers.Item 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; 26322550Objectives: 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.