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    THE EFFECT OF CERVICAL MANIPULATION TREATMENT IN BENIGN PAROXYSMAL POSITIONAL VERTIGO PATIENTS WITH NECK PAIN
    (2020) Kültür, Turgut; Şimşek, Gökce; Agir, Hatice
    Objective: Recurrence is common in the treatment of Benign Paroxysmal Positional Vertigo (BPPV) with an Epley maneuver. Methods such as manipulation are also effective in treatment. The study was aimed to determine the effect of cervical manipulation added to the Epley maneuver in treatment of patients with BPPV who has cervical lordosis and neck pain. Material and Methods: Patients diagnosed with BPPV who has flattened cervical lordosis with at least level 6 neck pain in VAS and over 18 years of age were included in the study. Patients were stratified into two groups according to age and gender. In the first and control examination one month later, cervical manipulation was performed in addition to Epley maneuver to the first group (combined therapy), and only Epley maneuver to the second group. Patients were examined with video-head-impulse test (VHIT), the severity of neck pain determined with VAS and symptoms were questioned with the vertigo symptom scale (VSS) prior and after treatment. Results: There was no difference between the groups in terms of VAS-pain, VSS and VHIT parameters before treatment (p? 0.05). While there was no difference in vestibulo-ocular reflex (VOR) gains between the study groups (p? 0.05), there was a significant difference in terms of VSS and VAS-pain (p = 0.01), after treatment. When compared by pathological VHIT findings, there was a significant difference in terms of improvement in favor of the combined treatment group after treatment (p = 0.02). At intragroup comparisons, VSS, VAS-pain, values were significantly decreased after treatment in both groups (p=0.01). While intragroup pathologic VHİT findings were considered before and after treatment, there was no significant difference in improvement after treatment in the Epley group (p?0.05). Contrarily difference was significant in the combined treatment group (p=0.01). Conclusion: Epley and manipulation therapy are more successful when applied together.
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    Full cup test (FCT) for symptom severity assessment in carpal tunnel syndrome/comparing scores with clinical and neurophysiological findings
    (2020) Say, Bahar; Ergun, Ufuk; Agir, Hatice; Karaca, Gulten; Keskin, Esra Dilek
    Abstract Aim: Carpal tunnel syndrome (CTS) is a compression neuropathy. There is neuropathic pain in the clinic. Treatment is planned according to electrodiagnostic testing (EDX) and symptom severity. This study was planned to evaluate of full cup test (FCT) to demonstrate symptom severity in CTS and investigate the relationship between FCT and EDX. Material and Methods: This study included patients with idiopathic CTS. The self-administered Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and FCT were used to determine the severity of clinical symptoms. The severity of CTS was classified as mild, moderate and severe according to EDX. Results: A total of 97 hands (55 right, 42 left) were evaluated. 29 patients had bilateral symptoms. The severity of CTS was 51.5% mild, 44.3% moderate, and 4.1% severe. The mean FCT score was 51.13 ± 20.80 (min: 6.6-max: 100). The mean symptom severity scale (SSS) of the BCTQ was 24.25 ± 7 and the functional severity scale (FSS) was 13.26 ± 4.55. The score of FCT was significantly correlated with SSS and the FSS (r=0.60 p <0.001, r=0.65 p <0.001). Significant correlation was observed between FCT and EDX (r=0.57, p=0.001). Conclusion: FCT can be used to assess the severity of neuropathic pain in CTS and may be a guide in planning treatment.
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    Öğe
    The Effect of Lower Urinary Tract Dysfunction on Quality of Life and Caregiver Burden in Stroke Patients
    (2023) Agir, Hatice; Okumuş, Müyesser; Keskin, Dilek
    ABSTRACT Objective: Lower urinary tract dysfunction (LUTD) is an important burden factor for patients and their caregivers. In this study, we aimed to investigate the impact of LUTD on caregiver burden and quality of life of stroke patients. Material and Methods: The study included 75 stroke patients and their caregivers followed in the physical medicine and rehabilitation clinic. Zarit Caregiver Burden Scale (ZCBS) was used to evaluate the caregiver burden, and the Incontinence Quality of Life (I-QOL) Scale was used to evaluate the effect of urinary symptoms on patients' quality of life. Urinary symptoms of the patients were evaluated with Danish Prostatic Symptom Score (DAN-PSS-1), functional status and activities of daily living were evaluated with Functional Independence Measure (FIM) and Barthel Index (BI). The patient's mood status was questioned with Hospital Anxiety and Depression Scale (HADS). Results: A total of 75 stroke patients, 38 (50.7%) women, and 37 (49.3%) men, with a mean age of 61.76±10.6 (37-80) years, and 75 caregivers participated in the study. A statistically significant difference was observed regarding FIM, BI, I-QOL and subgroups, DAN-PSS-1 scores between low/moderate and severe/overburden caregivers (p<0.001). The ZCBS scores of the caregivers of the patients whose HADS were higher than normal were significantly higher (p<0.01 and p<0.001, respectively). A statistically significant correlation was observed between the patients' DAN-PSS-1 and I-QOL-total and subgroups, BI, FIM total, and sub-scores (p<0.01). Conclusion: We found that LUTD in stroke patients reduces the patient's quality of life and increases the caregiver burden.