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    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, Yakut
    Objective: 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.
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    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, Yakut
    Purpose: 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.