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Öğe The effects of dynamic ankle-foot orthoses in chronic stroke patients at three-month follow-up: a randomized controlled trial(Sage Publications Ltd, 2011) Erel, Suat; Uygur, Fatma; Şimşek, İbrahim Engin; Yakut, YakutObjective: To investigate the short-and long-term effects of dynamic ankle foot orthoses on functional ambulation activities in chronic hemiparetic patients. Design: Randomized controlled trial. Setting: University's neurological rehabilitation outpatient clinic and orthotics department. Subjects: Twenty-eight chronic hemiparetic patients of level 3-5 according to Functional Ambulation Classification and with a maximum spasticity level of 3 according to Modified Ashworth Scale, were randomly assigned to the study and control groups. Interventions: The control group (n = 14) was assessed with tennis shoes whereas the study group (n = 14) was assessed initially with tennis shoes and after three months with dynamic ankle foot orthosis. Measures: Functional Reach, Timed Up and Go, Timed Up Stairs, Timed Down Stairs, gait velocity and Physiological Cost Index. Results: In the initial assessment no difference was found between the groups for any of the measured parameters (P>0.05). After three months, intergroup comparisons while the patients in the study group were wearing dynamic ankle-foot orthosis showed a significant difference in favour of the study group for Timed Up Stairs 12.00 (10.21) seconds study versus 15.00 (7.29) seconds control group; for gait velocity 0.99 (0.45) m/s study versus 0.72 (0.20) m/s control group and for Physiological Cost Index 0.12 (0.06) beats/min study versus 0.28 (0.13) beats/min control group (P<0.05). No difference was found between the groups for Functional Reach, Timed Up and Go, Timed Down Stairs (P>0.05). Conclusion: Chronic hemiparetic patients may benefit from using dynamic ankle-foot orthosis.Öğe The effects of Kinesio (R) taping on sitting posture, functional independence and gross motor function in children with cerebral palsy(Taylor & Francis Ltd, 2011) Şimşek, Tülay Tarsuslu; Türkücüoğlu, Bahriye; Çokal, Nilay; Üstünbaş, Gonca; Şimşek, İbrahim EnginPurpose: The aim of this study was to investigate the effects of Kinesio (R) tape (KT) application on sitting posture, gross motor function and the level of functional independence. Method: The study included 31 cerebral palsied children scored as level III, IV or V according to gross motor functional classification system (GMFCS). Children were randomly separated into two groups as study (n = 15, receiving KT and physiotherapy) and control (n = 15, receiving only physiotherapy). KT application was carried out for 12 weeks. Gross motor function measure (GMFM), functional independence measure for children (WeeFIM) and Sitting Assessment Scale (SAS) were used to evaluate gross motor function, independency in the activities of daily living and sitting posture, respectively. Results: Compared to initial assessments, both groups showed a significant difference in parameters of GMFCS sitting subscale, GMFCS total score and SAS scores (p < 0.05). At the end of 12 weeks, only SAS scores were significantly different in favour of the study group when the groups were compared (p < 0.05). Also, post-intervention WeeFIM scores of the study group were significantly higher compared to initial assessment (p < 0.05), however, no difference was detected in the control group (p > 0.05). Conclusions: No direct effects of KT were observed on gross motor function and functional independence, though sitting posture (head, neck, foot position and arm, hand function) was affected positively. These results may imply that in clinical settings KT may be a beneficial assistive treatment approach when combined with physiotherapy.Öğe The effects of osteopathic treatment on constipation in children with cerebral palsy: a pilot study(Mosby-Elsevier, 2009) Tarsuslu, Tülay; Bol, Hüseyin; Şimşek, İbrahim Engin; Toylan, İmran Erkanat; Çam, SabahatObjective: This pilot study was designed to investigate the effectiveness of osteopathic treatment in children with cerebral palsy and chronic constipation. Methods: This study included 13 children with cerebral palsy diagnosed as having chronic constipation by a gastroenterologist. The subjects were separated into 2 groups. Group 1 was treated with osteopathic methods and group 2 underwent both medical and exactly the same osteopathic treatments of group 1. Osteopathic treatments included fascial release, iliopsoas muscle release, sphincter release, and bowel mobilizations. Gross Motor Functional Classification System, Functional Independence Measure for Children, and Modified Ashworth Scale were used to determine the level of disability, functional independence, and muscle tonus, respectively. In addition, Constipation Assessment Scale was administered to the subjects to determine the severity of constipation. The satisfaction from the treatment was measured using a Visual Analogue Scale at 3 and 6 months. Results: Most of the children included in this study were determined as level IV or V according to Gross Motor Functional Classification System. The satisfaction of the subjects or the families with the treatments was not different when the groups were compared (P > .05). Constipation Assessment Scale scores decreased significantly in both groups (P < .05). Pretreatment (initial evaluation) and posttreatment (follow-ups at 3 and 6 months) results revealed no difference between the groups in either aspects (P > .05). However, both groups showed significant improvements compared with baseline evaluations (P < .05). Conclusion: Osteopathic methods were as effective as osteopathic methods in addition to medical care for both treatment groups. The results of this study suggest that osteopathic methods may be helpful as an alternative treatment in constipation. Additional advanced studies should be conducted. (J Manipulative Physiol Ther 2009;32:648-653)Öğe The effects of pain on health-related quality of life and satisfaction with life in older adults(Lippincott Williams & Wilkins, 2010) Şimşek, İbrahim Engin; Şimşek, Tülay Tarsuslu; Yümin, Eylem Tütün; Sertel, Meral; Öztürk, Asuman (Saltan); Yümin, MuratPurpose: This study was designed to investigate the relations between pain, health-related quality of life, and satisfaction with life in older adults above the age of 65 years. Subjects and methods: A total of 163 subjects, 58 (35.6%) females and 105 (64.4%) males, with an average age of 73.26 +/- 6.58 years participated in the study. After gathering sociodemographic data, Nottingham Health Profile (NHP) was used to assess health-related quality of life. Satisfaction with life and level of pain were evaluated using Visual Analogue Scale. Results: Eighty-eight (54%) subjects reported pain that mainly originated from lower back, knees, and extremities with an average Visual Analogue Scale score of 5.75 +/- 2.18. There were significant differences between older adults reporting pain and those who did not report pain in the aspects of satisfaction with life and NHP (total and all subscales) (P < .05). Also, severity of pain was found to have a negative effect on NHP and social isolation subscale (NHP) (P < .05). Conclusion: This study demonstrated the adverse impact of pain on quality of life. Pain is a significant problem and needs to be routinely assessed and treated in older-adult population.Öğe The effects of taping and foot exercises on patients with hallux valgus: A preliminary study(2011) Bayar, Banu; Erel, Suat; Şimşek, İbrahim Engin; Sümer, Erkan; Bayar, KılıçhanAim: To determine the eff ects of taping and foot exercises on patients with hallux valgus Materials and methods: Th e study included 20 female patients. Th e subjects were divided into 2 groups, the study and control groups. Th e study group was treated with taping and foot exercises, and the control group was treated only with foot exercises. A goniometer was used to determine the angle of hallux valgus. Foot pain intensity was assessed by the visual analog scale (VAS), and walking ability was evaluated using the walking ability scale (WAS). Results: At the end of the 8-week treatment period, a signifi cant decrease was found in hallux valgus angle, resting pain, and walking pain in both groups (P < 0.05). Also, walking ability improved at least 1 grade in the study group. When the post-treatment results between the 2 groups were compared, the results were signifi cantly diff erent in favor of the study group with regard to decreased hallux valgus angle, resting and walking pain, and walking ability (P < 0.05). Conclusion: Our results suggest that a combined treatment program consisting of both taping and exercise had more benefi cial eff ects than exercise alone on hallux valgus angle, foot pain, and walking ability in patients with hallux valgus.Öğe Kronik özürlü çocuklarda fonksiyonel bağımsızlık ile sağlıkla ilgili yaşam kalitesi arasındaki ilişki(2011) Tarsuslu Şimşek, Tülay; Şimşek, İbrahim Engin; Tütün Yümin, Eylem; Sertel, Meral; Elbasan, BülentObjective: The aim of this study was to examine the relation between the functional independence and health related quality of life (HRQoL) in children with chronically disabled. Material and Methods: 78 children and their mothers were included in the study. After taking sociodemographic in formation, the Child Health Questionnaire Parent Form (CHQ-PF50) was used to assess (HRQoL) and functional independence measuring (WeeFIM), was used to evaluate functional independence levels. Results: The age average of children was found to be 7.60 ± 3.43 years. 46 of the children (59%) were diagnosed as cerebral palsy, 6 had (7.7%) muscle disease, and 26 (33.3%) had mental motor retardation. Lowest values in quality of life and level of independence were obtained in children with muscle disease and in children with cerebral palsy, respectively. There were positive correlations between WeeFIM and total CHQ and between WeeFIM and subsections of CHQ except physical function, pain and discomfort and mental health (p< 0.05). There were no differences between CHQ and WeeFIM when the groups were compared (p> 0.05). Conclusion: The results of this study showed a clear relation between functional status and health related quality of life. In addition, although no significant correlation can be showed children with muscle disease had the lowest quality of life. Also, familial compliance parameter was found to be most effected from quality of life. More studies are needed investigating the effects of level of independence on health related quality of life in children with different chronic disabilities.Öğe Short- and long-term effects of an inhibitor hand splint in poststroke patients: A randomized controlled trial(Maney Publishing, 2011) Erel, Suat; Şimşek, İbrahim Engin; Bek, Nilgün; Yavuz, Yakut; Uygur, FatmaPurpose: To evaluate the effects of a hand splint with reflex inhibitory characteristics on balance and functional ambulation activities by means of a randomly allocated controlled study. Methods: Nineteen chronic stroke patients were randomly allocated to the control (n = 9) and study (n = 10) groups to compare the immediate and long-term effects of a splint with reflex inhibitory characteristics. The patients in the splinted group were asked to wear their splints at least 2 hours each day, during ambulation or when they felt the need. Subjects were evaluated initially and after 2, 4, and 6 months of splint usage with the Berg Balance Scale, Functional Reach test (FR), Timed Up & Go test (TUG), and L test. The same tests were used to evaluate the control group. Results: Timed within-group assessments showed no difference in the control group across the time interval. A favorable difference was detected in some of the evaluations for FR, TUG, and L test in the study group. Intergroup comparisons showed that the only difference between the groups was seen for TUG values at the fourth assessment in favor of the study group. Qualitative evaluations showed that the patients were compliant and generally satisfied with their splints. Conclusion: Hand splints with reflex inhibitory characteristics have no significant effect on balance and functional ambulation activities in chronic poststroke patients. Further studies investigating their effect on pain and associated reactions in this patient population are warranted.Öğe Unilateral alt ekstremite amputelerinde protez memnuniyeti anketinin Türkçe güvenirliği ve geçerliği: Pilot çalışma(2010) Şimşek, İbrahim Engin; Şener, Gül; Yakut, YavuzAmaç: Bu çalışmanın amacı Protez Memnuniyet Anketi’nin (PMA) Türkçe versiyonunun güvenirlik ve geçerliğini araştırmaktı. Gereç ve yöntem: Bu çalışmaya unilateral alt ekstremite amputasyonu geçirmiş 40 gönüllü katıldı. Gönüllülere PMA ve Nottingham Sağlık Profili (NSP) uygulandı. Güvenirlik analizi için Intraclass Korelasyon Katsayısı (ICC), uyum geçerliğin testi için ise NSP’nin alt başlıkları kullanıldı. Sonuçlar: PMA test ve tekrar testlerde oldukça güvenilir sonuçlar ortaya koydu (ICC=0.903). NSP’nin fiziksel aktivite ve ağrı alt bölümleri PMA’nin sonuçları ile korele idi (p<0.05). Tartışma: Bu çalışma PMA’nın Türkçe versiyonun unilateral alt ekstremite amputelerinde kullanılabilecek güvenilir ve geçerli bir araç olduğunu ortaya koydu.
