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    Case with atrophy and proximal muscle weakness: seronegative Lambert Eaton Myasthenic Syndrome
    (Pamukkale University, 2019) Say, Bahar; Ergün, Ufuk; Karaca, Gülten
    Lambert Eaton Myasthenic Syndrome (LEMS) is a rare neuromuscular junction disease characterized by proximal muscle weakness, decrease or loss of reflexes, moderate ocular and autonomic findings with antibody development to presynaptic voltage-dependent calcium channels. It can be paraneoplastic or autoimmun. Paraneoplastic LEMS is most commonly associated with small-cell lung cancer. Primary autoimmune may be associated with diabetes, rheumatoid arthritis, systemic lupus erythematosus, autoimmune thyroid diseases. Diagnosis is based clinical findings and electrophsyologic studies include repetetif nerve stimulation or single fiber electromyelography. Treatment includes 3,4 diaminopyridine, intravenous immunglobulin, plasmapheresis, prednisolone and azothiopurine according to the case. © 2019, Pamukkale University. All rights reserved.
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    Effect of plantar vibration on static and dynamic balance in stroke patients: a randomised controlled study
    (Elsevier Ltd, 2022) Önal, Birol; Sertel, Meral; Karaca, Gülten
    Objective: To investigate the effects of local vibration applied to the plantar region of the foot on static and dynamic balance in stroke patients. Design: Randomised, controlled trial. Setting: Inpatient. Participants: Thirty patients with stroke were randomised equally to the vibration and control groups. Intervention: The control group underwent conventional physical therapy (CPT) for 4 weeks. The vibration group underwent local vibration therapy at a frequency of 80 Hz and CPT for 4 weeks. Outcome measures: The primary outcome measure was the Overall Stability Index (OSI). The secondary outcome measures were: the Anteroposterior Stability Index, Mediolateral Stability Index, fall risk, Berg Balance Scale, Functional Reach Test (FRT), and Timed Up and Go Test (TUG) to assess balance; the Trunk Impairment Scale to measure trunk function; and the 10-m Walk Test (10MWT) to measure walking speed. Results: Participants receiving plantar vibration experienced greater improvements in static and dynamic balance assessments compared with participants in the control group. The mean change in OSI score between baseline and 4 weeks was 0.8 [standard deviation (SD) 0.8] for the vibration group and 0.02 (SD 0.6) for the control group [mean difference 0.4, 95% confidence interval (CI) 0.1 to 0.7]. The median change in fall risk score was 0.7 [interquartile range (IQR) 0.4 to 1.4] for the vibration group and 0.1 (IQR -0.1 to 0.6) for the control group (median difference 0.5, 95% CI 0.2 to 0.7). The median change in TUG time was 4 (IQR 1 to 7) seconds for the vibration group and 4 (IQR 0 to 2) seconds for the control group (median difference 2.5, 95% CI 1.5 to 3.5). Conclusion: These findings suggest that plantar vibration is useful in stroke patients. Plantar vibration can be applied to support CPT. Clinicaltrials.gov registration number: NCT03784768. © 2022 Chartered Society of Physiotherapy
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    Immediate Effects of Plantar Vibration on Fall Risk and Postural Stability in Stroke Patients: A Randomized Controlled Trial
    (ELSEVIER, 2020) Önal, Birol; Karaca, Gülten; Sertel, Meral
    Background: Local vibration can improve balance problems of individuals with stroke when applied to the plantar region. Aims: This study aimed to determine the immediate effect of local vibration applied to the plantar region on fall risk and postural stability in patients with stroke. Study Design: Randomized controlled study. Methods: 30 patients (23 male,7 female) with stroke were randomized to either vibration (n = 15; 58.47 +/- 8.23 years) or control (n = 15; 58.27 +/- 9.50 years) groups. Before and after the intervention, the patients were evaluated using a Biodex Balance System. Local vibration was applied to the plantar region of two feet in the supine position using a vibration device for a total of 15 min to the individuals in the vibration group. While the patients in the placebo group were in the supine position, the device was brought into contact and no vibration was applied to the plantar region of two feet for 15 min. Results: While significant improvements were observed in the postural stability and fall risk of the vibration group (p < 0.05), no significant change was observed in the placebo group (p 0.05). Furthermore, significant improvements occurred in the SD values of the postural stability expressing postural oscillation in the vibration group (p < 0.05). Conclusion: As a result of local vibration applied to the plantar region, immediate (within 5 min) significant improvements in postural stability and fall risk values were detected.
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    Turkish Adaptation, Validity, and Reliability of the Subjective Index of Physical and Social Outcome (SIPSO)
    (2024) Ağır, Hatice; Keskin, Esra Dilek; Karaca, Gülten; Gökmen, Derya
    Objective: The Subjective Index of Physical and Social Outcome (SIPSO) has been reported as a valid and reliable tool for measuring the level of community integration in stroke survivors. This study aims to adapt the SIPSO into the Turkish language and to test its reliability and validity in stroke survivors by using modern psychometric analysis (Rasch analysis). Material and Methods: The cross-cultural adaptation was performed according to the current recommendations. Internal construct validity was assessed by Rasch analysis, reliability by internal consistency and Person Separation Index (PSI). External construct validity was evaluated by analyzing correlations between the SIPSO and the Beck Depression Scale (BDS), Mini Mental Test, Functional Independence Measure (FIM), Barthel Index (BI), Functional Ambulation Scale (FAS), Rivermead Mobility Index (RMI), and the Stroke Impact Scale 3.0 (SIS 3.0). Test-retest reliability was assessed by intraclass correlation coefficient and Rasch analysis. Results: A total of 179 community-dwelling stroke survivors were included. Internal consistency of the SIPSO physical subscale showed good to excellent results with Cronbach’s ? of 0.92 and PSI of 0.95. The internal consistency of the SIPSO social subscale showed good to excellent with Cronbach’s ? and PSI of 0.86. External construct validity was highly correlated with BDS, FIM, BI, FAS, RMI, and the SIS 3.0 scales (p<0.001). Conclusion: The Turkish version of the SIPSO is a valid and reliable scale for measuring activities and participition in patients with stroke.