Scopus Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10760
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Item 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-1085-2021Objectives: 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.Item Physical therapy versus radial extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome: A randomized-controlled study(2022) Saglam, Gonca; Alisar, Dilek Cetinkaya; Ozen, Selin; 35949973Objectives: This study aims to compare the efficacy of physical therapy (PT) and radial extracorporeal shock wave therapy (rESWT) in the treatment of carpal tunnel syndrome (CTS). Patients and methods: Between May 2020 and July 2020, a total of 125 wrists of 95 patients (22 males, 73 females; mean age: 54.3 +/- 11.3 years; range, 19 to 69 years) with mild-to-moderate CTS were allocated into three groups. The control group (Group 1, n=42) was treated with splinting and an exercise program. Group 2 (n=42) was treated with a total of three sessions of rESWT, splinting and an exercise program. Group 3 (n=41) was treated with a total of 15 sessions of PT modalities, splinting, and an exercise program. Each patient was evaluated before, three weeks and 12 weeks after treatment using a Visual Analog Scale (VAS), the Boston Carpal Tunnel Questionnaire (BCTQ), the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale, and electrodiagnostic testing. Results: The reduction in VAS, BCTQ, LANSS, and improvement in sensory nerve conduction velocity were significantly greater at three and 12 weeks of follow-up in Groups 2 and 3, compared to Group 1 (p<0.001). A greater improvement was observed in all clinical parameters in Group 2, compared to Group 3 (p<0.001). Conclusion: This is the first study to compare the treatment outcomes of PT and rESWT in the treatment of CTS. The results of this study show that both PT and rESWT are effective in the treatment of CTS; however, rESWT yields superior treatment effects compared to conventional PT. The practicalities of administering rESWT and its efficacy in the treatment of CTS may make it the treatment of choice.Item An uncommon case of primary biliary cirrhosis and Hashimoto thyroiditis followed by the concurrent onset of multiple sclerosis and Sjogren syndrome(2022) Guzel, Sukran; Ozen, Selin; 0000-0001-9852-0917; 35949967; AAG-3148-2021A 51-year-old woman with a diagnosis of primary biliary cirrhosis and Hashimoto thyroiditis followed by concurrent onset of multiple sclerosis and Sjogren syndrome for seven years was admitted. The patient was treated with pulse steroid and cyclophosphamide combined with a physical therapy program. This is a case of four autoimmune diseases coexisting in a single patient, a finding which has not previously been described in the literature. This combination of autoimmune diseases should be kept in mind in patients with the relevant symptoms and signs of each to provide early diagnosis and appropriate treatment.Item Ultrasonographic And Electrophysiological Outcomes Of Carpal Tunnel Syndrome Treated With Low-Level Laser Therapy: A Double-Blind, Prospective, Randomized, Sham-Controlled Study(2022) Nalbant, Merve; Yemisci, Oya Umit; Ozen, Selin; Tezcan, Sehnaz; https://orcid.org/0000-0002-0501-5127; 35949869; AAJ-8820-2021Objectives: The aim of this study was to investigate the therapeutic effects of low-level laser therapy (LLLT) on clinical, ultrasonographic (US), and electrophysiological findings in carpal tunnel syndrome (CTS). Patients and methods: Between January 2015 and August 2015, 42 patients (7 males, 35 females; mean age: 50.4 +/- 8.7 years; range, 32 to 65 years) with mild-to-moderate CTS were randomly assigned to one of two groups: active LLLT (therapy group, n=22) 0.8 J/painful point and sham LLLT groups (n=20). Both groups wore neutral wrist orthoses. The patients were evaluated before and after 15 sessions of therapy (670 nm, 4 J/session over the carpal tunnel). Follow-up parameters included the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) Symptom Severity Scale (SSS), Functional Status Scale (FSS), nerve conduction studies and US evaluation of the median nerve cross-sectional area (CSA), vascularization (via power Doppler), flattening ratio (FR), and palmar bowing of the flexor retinaculum. Results: Nocturnal paresthesia improved in both groups; however, pain and patients with a positive Phalen's test reduced only in the therapy group (p=0.031). The FSS and SSS scores also improved only in the therapy group (p<0.001). Electrophysiologically, median sensory nerve conduction velocities showed a significant improvement only in the therapy group (p=0.002). The CSA, FR, and vascularization of the median nerve showed a significant improvement in the therapy group alone (p<0.001, p=0.048, and p=0.021, respectively). Conclusion: Improvements in the signs and symptoms of CTS and hand function, the improvements in sensory nerve conduction studies, and reduction in median nerve CSA, FR and vascularity in the LLLT group can be attributed to the anti-inflammatory and analgesic effects of LLLT. This study provides new US data demonstrating efficacy of LLLT along with a clinical and electrophysiological improvement. The LLLT seems to be an easily applied, non-invasive treatment option.Item 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-8820-2021Objectives: 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.Item 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-1305-2020Motor 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.Item Exercise, Manipulative Therapy, and Physical Modalities in the Treatment of Notalgia Paresthetica: A Case Report(2021) Ozen, Selin; Cosar, Sacide NurSaracgil; Sozay, Seyhan; 35496723Objective: The purpose of this case report is to describe the care of a patient with notalgia paresthetica (NP).& nbsp;Clinical Features: A 61-year-old man presented with a 7-year history of upper back pain, concentrated in the right periscapular region. Physical examination revealed a hyperpigmented area in the right dorsal paravertebral and infrascapular region with local paraesthesia. After investigations, a diagnosis of NP was made.& nbsp;Intervention and Outcome: An exercise program including back and shoulder stretching and shoulder strengthening exercises, and transcutaneous electrical nerve stimulation resulting in a reduction of symptoms.& nbsp;Conclusion: In the case described here, the patient's symptoms regressed when treated conservatively with exercise and physical therapy modalities.& nbsp;Item Ultrasound-guided versus blind subacromial corticosteroid and local anesthetic injection in the treatment of subacromial impingement syndrome: A randomized study of efficacy(2020) Akbari, Najibeh; Ozen, Selin; Senlikci, Huma Boluk; Haberal, Murat; Cetin, Nuri; 0000-0002-9950-8917; 0000-0002-7290-8558; 0000-0002-8211-4065; 32160504; AAK-4129-2021; ABC-1305-2020; R-9398-2019Objectives: This study aims to compare the effects of ultrasound (US)-guided and blind subacromial corticosteroid and local anesthetic (LA) injection in the treatment of subacromial impingement syndrome (SIS) on shoulder pain, range of motion (ROM), and functionality. Patients and methods: The prospective study was conducted between 01 February 2017 and 31 May 2017. A total of 29 patients with clinical findings and magnetic resonance imaging (MRI) consistent with SIS were randomized into two groups: 14 patients received US-guided subacromial corticosteroid and LA injection and 15 patients received a blind subacromial corticosteroid and LA injection. Patients were evaluated before and one month after treatment. One patient was lost to follow up. The primary outcome measure was a visual analog scale (VAS) for shoulder pain. Secondary outcomes were active shoulder ROM in flexion and abduction, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the modified Constant-Murley Score (CMS). Results: Twenty eight patients (11 males, 17 females; mean age 39.5 in the US guided group and 42.5 in the blind group: range 20 to 64 years in both groups) completed the study. There was a significant improvement in VAS for shoulder pain, active ROM, DASH questionnaire score and modified CMS in both groups four weeks after treatment (p<0.05). There was no between-group difference in VAS, ROM or DASH questionnaire scores. Following treatment, the modified CMS in the US-guided injection group was higher than in the blind injection group (p=0.02). However, when the mean change in modified CMS in the US-guided injection group was compared to that of the blind injection group, the difference was insignificant (p=0.23). Conclusion: Both US-guided and blind subacromial steroid injection improve shoulder pain, ROM, and functionality in SIS; one treatment option was not found to be superior to the other. Therefore, blind injection can be performed in clinical settings where US is not available. Equally, blind injection can also be performed in patients who have a definite diagnosis of SIS based on clinical and MRI findings.Item Platelet-rich plasma injection in a patient with adhesive capsulitis due to chronic kidney disease(2020) Boluk Senlikci, Huma; Ikbali Afsar, Sevgi; Ozen, Selin; 0000-0002-4003-3646; 0000-0002-7290-8558; 32297967; E-2103-2019; ABC-1305-2020