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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 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 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 Short-term results of intensive physiotherapy in clubfoot deformity treated with the Ponseti method(Wiley-Blackwell, 2011) Bek, Nilgün; Erel, Suat; Şimşek, Engin İbrahim; Uygur, Fatma; Yakut, YakutPurpose: We aimed to determine the efficacy of the physical therapy program as an adjunct to the Ponseti technique in the treatment of idiopathic clubfoot. This study was carried out with the presumption of a difference in results between the study group who were included in the physiotherapy program and the control group who performed home exercises. Patients and method: Forty affected feet of 29 patients were included in the study. The average ages of the control and study groups were 15.00 +/- 21.33 and 20.30 +/- 15.78 months, respectively. Passive range of motion of dorsiflexion, plantar flexion, inversion, eversion, rear foot varus angle and forefoot adduction angle were measured and the Dimeglio classification system was utilized in order to determine the severity of clubfoot deformity. Reassessments were carried out for the study group at the end of 1 month's therapy and for the control group during the first month follow-up. Results: Comparison of pre- and post-treatment assessment results revealed a difference in terms of recovery, concerning all parameters except passive inversion values in the study group and for all parameters in the control group (P < 0.05). For study and control group comparisons, since deformity severity was higher in the study group an effect size analysis was carried out. The effect size analysis showed that the change in range of motion of dorsiflexion and Dimeglio and decrease of rear foot varus angle was higher in the study group. Conclusion: The results of this study imply that an intensive physiotherapy program may enhance the effectiveness of the Ponseti protocol.Öğe Th e eff ects of taping and foot exercises on patients with hallux valgus: a preliminary study(2011) Bayar, Banu; Erel, Suat; Şimşek, Ibrahim Engin; Sümer, Erkan; Bayar, KılıçhanAmaç: Bu çalışmanın amacı bantlama ve ayak egzersizlerinin halluks valgus tanılı hastalar üzerindeki etkilerini belirlemektir. Yöntem ve gereç: Çalışmaya 20 kadın hasta dahil edilmiştir. Olgular çalışma ve kontrol grubu olmak üzere iki gruba ayrılmıştır. Çalışma grubu bantlama ve ayak egzersizleri, kontrol grubu ise sadece ayak egzersizleri almıştır. Halluks valgus açısını belirlemek için gonyometre kullanılmıştır. Ayak ağrı şiddetini değerlendirmek için Görsel Analog Skalası, yürüme yeteneğini değerlendirmek için Yürüme Yeteneği Skalası kullanılmıştır. Bulgular: Sekiz haft alık tedavi süresi sonunda her iki grupta halluks valgus açısı, istirahat ağrısı ve yürüme ağrısında anlamlı bir azalma bulunmuştur (P < 0,05). Yürüme yeteneği çalışma grubunda en az bir seviye gelişmiştir. Tedavi sonrası değerler iki grup arasında karşılaştırıldığında halluks valgus açısındaki azalma, istirahat ve yürüme ağrısı, yürüme yeteneği açısından sonuçlar çalışma grubu lehine anlamlı bulunmuştur (P < 0,05). Sonuç: Bizim sonuçlarımız halluks valguslu hastalarda bantlama ve egzersizden oluşan tedavi programının halluks valgus açısı, ayak ağrısı ve yürüme yeteneği üzerine daha yararlı etkiye sahip olduğunu göstermiştir.
