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Öğe Are the Demographic Characteristics of Patients with Primary Hip Osteoarthritis Effective on Functional Improvements After Total Hip Replacement?(2017) Taşdelen, Özlem Yılmaz; Çankaya, Deniz; Yurdakul, Fatma Gül; Çakır, Yalçın; Keskin, Esra Dilek; Tabak, Yalçın; Bodur, HaticeObjective: The aim of this study was to investigate the influence of demographic features such as age, gender, body mass index (BMI), educational and employment status, place of residence and comorbidities of patients with primary hip osteoarthritis and radiographic severity on the functional improvements of the patients after total hip arthroplasty. Material and Methods: Fifty patients (41 females/9 males) with primary hip osteoarthritis were included. The radiographs were graded according to Kellgren-Lawrence system (KL). The operations were performed by the same orthopedist with the same surgical technique. Functional level was determined with hip disability and Osteoarthritis Outcome Score-Physical function Short-form (HOOS-PS) before and six months after the operation. Results: The functional levels of all the patients improved at the sixth month. Age, BMI, presence of a comorbidity, working in a job or not, place of residence (rural or city) and obesity did not influence the functional improvement rates. The males, the patients with KL grade 4 osteoarthritis and the primary school graduates showed significantly much more improvements. Conclusion: The clinical relevance of this study is that age, gender, BMI, co-morbidities, education degree, place of residence and being an employee or not does not need to be considered by physicians when recommending total hip replacement surgery after failure of conservative treatment in patients with primary hip osteoarthritis. Male patients, patients with radiographically end stage osteoarthritis and educated patients may improve much more in comparison with their counterparts.Öğe Assessment of pain, scapulothoracic muscle strength, endurance and scapular dyskinesis in individuals with and without nonspecific chronic neck pain: A cross-sectional study(Elsevier, 2023) Karaağaç, Ali; Arslan, Saniye Aydoğan; Keskin, Esra DilekIntroduction: This study is aimed to evaluate pain, muscle strength, scapular muscular endurance and scapular kinesis in individuals with Nonspecific Chronic Neck Pain and to compare them with asymptomatic individuals. In addition, to investigate the effect of mechanical changes in the scapular region on neck pain. Method: 40 individuals who applied to Kirikkale University Faculty of Medicine Hospital Physical Therapy and Rehabilitation Center and diagnosed with NSCNP and 40 asymptomatic individuals for the control group were included the study. Pain was evaluated with Visual Analogue Scale, pain threshold and pain tolerance with algometer, cervical deep flexor group muscle strength with Stabilizer Pressure Biofeedback device, and neck and scapulothoracic muscle strength with Hand Held Dynamometer. Scapular Dyskinesia Test, Scapular Depression Test and Lateral Scapular Slide Test were used to evaluate scapular kinesis. A timer was used to evaluate scapular muscular endurance. Result: Pain threshold and pain tolerance values of the NSCNP group were lower (p < 0.05). Muscle strength around neck and scapulothoracic region of the NSCNP group were lower than the asymptomatic individuals (p < 0.05). NSCNP group had more scapular dyskinesia (p < 0.05). Scapular muscular endurance values of the NSCNP group were lower (p < 0.05). Conclusion: As a result, pain threshold and pain tolerance decreased, muscle strength of the neck region and the scapular region decreased, scapular endurance values decreased and the incidence of scapular dyskinesia increased in the individuals with NSCNP compared to the asymptomatic individuals. It is thought that our study will provide a different perspective in the evaluation of neck pain and including the scapular region to the evaluations.Öğe The effect of acute L-arginine supplementation on repeated sprint ability performance(Mattioli 1885, 2019) Birol, Abdulkadir; Kilinc, Fatma Nisanci; Deliceoglu, Gokhan; Keskin, Esra DilekAim: The aim of this study is to determine the effect of acute L-arginine supplementation on repeated sprint ability performance in football players aged between 18-21 years. Methods: The study was conducted on 20 volunteer healthy male football players playing in the under-21 football team in the 1st league of Turkey. General characteristics of football players were questioned and their anthropometric measurements were taken. The study was performed as a double-blind placebo-controlled design. Players were randomly given 0.15 g/kg/day relative dosage L-arginine or placebo with 500 ml of water 1 hour before repeated sprint ability test (RSAT). The 12x20m RSAT protocol was applied in the synthetic turf football field with a recovery interval of 30 seconds between each sprint and the photocell system was used to determine running time. Results: The mean age of the arginine group is 18.30 +/- 0.48 years and the mean age of placebo group is 18.33 +/- 0.50 years. 85% of the players never used L-arginine, and any dietary supplements. Only the ninth sprint time of the 12 sprints performed after the supplementation was 5.24% faster than the placebo group in the arginine group (p<0.05). However, no difference was detected between the groups in terms of sprint decrement score, total sprint time, blood pressure and heart rate (HR) (p>0.05). Conclusion: In this study, the supplementation of acute L-arginine administered to players had no significant effect on HR, blood pressure and RSAT total sprint time and sprint decrement score.Öğe The effect of aerobic exercise training on postmenopausal patients with knee osteoarthritis(IOS PRESS, 2020) Kılıç, Filiz; Demirgüç, Arzu; Arslan, Saniye Aydoğan; Keskin, Esra Dilek; Aras, MüyesserBACKGROUND: Knee osteoarthritis (OA) is a common musculoskeletal problem encountered in the postmenopausal period. OBJECTIVE: This study aimed to determine the impact of aerobic exercise on functional limitation, exercise tolerance, and performance tests in postmenopausal women with knee OA. METHODS: A total of 50 women (aged between 48-78) with grade 2-3 knee OA according to the Kellgren-Lawrence radiographic scale were enrolled. OA-specific physical performance tests (40 m Fast-Paced Walk Test (40mFPWT), 30 s Chair Stand Test (30sCST), Stair Climb Test (9-step SCT)), six-minute walk test (6MWT), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Visual Analogue Scale (VAS) were performed. Fifty patients were randomized to either the treatment or control groups. The treatment group received an additional aerobic exercise training along with a combined physiotherapy program for six weeks. The aerobic exercise program was carried out by the same physiotherapist every weekday (five days) for six weeks. The control group only received a combined physiotherapy program for six weeks. RESULTS: The post-treatment comparisons of the two groups yielded similar SCT results (p > 0.05), while VAS scores, the results of all performance tests, WOMAC scores, and the distance covered in 6MWT were significantly higher in the treatment group (p < 0.05). CONCLUSIONS: Consequently, this study provides an insight into the efficacy of the aerobic exercise program applied along with a combined physiotherapy program in postmenopausal women with knee OA.Öğe Effects of Inspiratory Muscle Training on Respiratory Muscle Strength, Trunk Control, Balance and Functional Capacity in Stroke Patients: A single-blinded randomized controlled study(Taylor & Francis Ltd, 2022) Aydogan Arslan, Saniye; Ugurlu, Kubra; Sakizli Erdal, Elif; Keskin, Esra Dilek; Demirguc, ArzuObjective: Aim of the study was to examine the effects of inspiratory muscle training (IMT) on respiratory function, respiratory muscle strength, trunk control, balance, and functional capacity in stroke patients. Methods: 21 stroke individuals were randomly divided into two groups as control group and treatment group. Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP) were evaluated. Also, Trunk Impairment Scale (TIS), Timed Up and Go Test (TUG) and Berg Balance Scale (BBS), and Six-Minute Walk Test (6MWT) were performed. Neurodevelopmental treatment program was performed in both groups for 5 days a week for 6 weeks, and IMT was given to the treatment group. IMT was started from 40% of MIP. Results: After treatment, respiratory functions, respiratory muscle strength, and trunk control and balance improved in the treatment group. In the control group; however, only the balance level was improved. When the changes in the evaluation parameters between the groups were compared, there were only statistically significant differences in the TIS, PEF and MIP in the treatment group (p<0.05), the change amounts in other evaluation parameters were similar (p>0.05). When the effect size of the groups was compared, the effect size of the variables in the treatment group was found to be higher. Conclusions: As a conclusion, the IMT, which was given in addition to the neurological physiotherapy and rehabilitation program to our patients, improved inspiratory muscle strength and trunk control. We believe that this result will raise awareness for physiotherapists working in the field of neurological rehabilitation about including respiratory muscle training in the rehabilitation program of stroke patients.Öğe Examination of the Scales and Tests Evaluating the Risk of Falling in Stroke Patients(2021) Arslan, Saniye Aydoğan; Uğurlu, Kübra; Demirci, Cevher Savcun; Keskin, Esra Dilek; Kırmacı, Zekiye İpek KatırcıObjective: The aim of this study was to examine the Berg Balance Scale, Timed Up and Go Test, Functional Reach Test in individuals with stroke and to compare the distinctive sensitivity and specificity of these scales and tests for falling and non-falling individuals. Material and Methods: The 83 stroke individuals participated in the study. The balance level and risk of falling were evaluated with Berg Balance Scale, Timed Up and Go Test and Functional Reach Test. To evaluate the differentiation of Berg Balance Scale, Timed up and Go Test and Functional Reach Test between falling and non-falling individuals with stroke, receiver operating characteristic analysis was used and the area under the curve was calculated. Results: According to the history of falling, we compared values of the Berg Balance Scale, Timed up and Go Test, and Functional Reach Test. It was seen that the individuals with the history of falling had lower Berg Balance Scale and Functional Reach Test values and higher the Timed Up and Go Test score (p?0.05). The clinical cut-off points for the Berg Balance Scale, Timed up and Go Test, Functional Reach Test was calculated as 45.5 points (area under the curve=0.731), 15.22 sec (area under the curve=0.707), 22.25 cm (area under the curve=0.714), respectively. Conclusion: As a result of this study, it was found that all tests identified individuals who fell and did not fall; however, the Berg Balance Scale was more sensitive in determining the risk of falling. Our results are important in terms of showing reference values for clinicians working in neurological rehabilitation.Öğe 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 DilekAbstract 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.Öğe Investigating the relation between upper extremity function and trunk control, balance and functional mobility in individuals with stroke(2021) Arslan, Saniye Aydoğan; Uğurlu, Kübra; Demirci, Cevher Savcun; Keskin, Esra DilekAim: The purpose of our study was to examine the relation between upper extremity function and trunk control, balance andfunctional mobility and to compare trunk control, balance, and mobility with respect to upper extremity motor function levelin individuals with stroke.Material and Method: This study included a total of 39 stroke patients (age 63.87±9.03 years, post stroke 19.18±16.38 month).Upper extremity motor functions were evaluated with the upper extremity sub-scale of the Stroke Rehabilitation Assessmentof Movement (STREAM) Scale and Brunnstrom stages of motor recovery; trunk control, balance, and functional mobilitywere evaluated with Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), and Timed Up and Go Test (TUG) respectively.Result: A moderate relation was determined between the trunk control, balance and functional mobility and upper extremityfunctions (p<0.05). When the trunk control, balance and mobility performances of the individuals were compared accordingto Brunnstrom arm stages, it was seen that those with worse upper extremity motor recovery had poor trunk control, balanceand mobility (p<0.05)Conclusion: As a result of our study, a relation was detected between upper extremity function and trunk control, balanceand mobility. For this reason, it is important to focus on the upper extremity as well as trunk control to improve balance andmobility in physiotherapy and rehabilitation practices.Öğe KARPAL TÜNEL SENDROMU TANISINDA ULTROSONOGRAFİNİN TANI DEĞERİ(2018) Köksal, Murathan; Koparal, S. Suha; Keskin, Esra DilekMedian sinir ele osteofibröz bir kanal olan karpal tüneli geçerek girer. Karpal Tünel Sendromu (KTS) median sinirin karpal tünel içerisinde sıkışma (tuzak-entrapment) nöropatisi olup en sık görülen tuzak nöropatidir. KTS’ye nöroşirurji, ortopedi ve fizik tedavi pratiklerinde sıkça rastlanmaktadır. Sık görülmesi nedeniyle üzerine yoğun olarak çalışılması, klinik, elektrofizyolojik ve tedavi açısından iyi tanımlanması gerekli olmuştur. Median sinirin karpal kanal içerisinde kompresyonu sonucu elde median sinire uyan alanlarda özellikle geceleri ve tekrarlayan el bileği aktiviteleri sonrasında belirginleşen parestezi ve ağrı yakınmaları ön plandadır. Bununla birlikte geç dönemde tenar kaslarda güçsüzlük ve atrofi görülebilir. Sonuçta kişinin günlük akvitelerini engelleyebilir. KTS tanısı hastanın hikayesi, klinik muayene ve EMG ile konur. Radyolojik görüntüleme yöntemleri (Direkt grafi, USG, BT ve MR) KTS’li bazı hastalarda kuşkulu patolojilerin açıklanmasında ve karpal tünel patogenezinin anlaşılmasında yardımcı olmaktadır. Bu çalışmada, klinik olarak ve EMG ile KTS tanısı almış hastaların el bilekleri yüksek rezolüsyonluyüzeyel ultrasonografi ile incelenerek, elde edilen bulgular klinik tanı ile karşılaştırıldı. Sonuçta, inceleme zamam kısa, maliyeti düşük, ulaşılması kolay ve noninvaziv bir yöntem olan ultrasonografinin KTS’deki tanı değeri araştırıldı.Öğe Predictive Factors for Muscle Weakness in Rheumatoid Arthritis(2022) Önder, Mustafa Erkut; Kılıçarslan, Ayşegül; Keskin, Esra Dilek; Bodur, HaticeObjective: We aimed to determine muscle strength in patients with rheumatoid arthritis (RA) and several factors including structural\rjoint damage that may affect decrease in muscle strength. The relations between muscle strength and quality of life and functional disability were examined. Material and Methods: Seventy five RA patients and 51 controls\rwere involved. Demographic characteristics, body mass index, waist circumference, 25-hydroxy vitamin D, and patient global assessments of disease activity (PGA) were documented. Disease Activity Score-28 (DAS28),\rVisual Analog Scale-Pain (VAS-pain), Health Assessment Questionnaire\r(HAQ) and the Rheumatoid Arthritis Quality of Life Questionnaire\r(RAQoL) were calculated. Radiographs of the hands were evaluated by van\rder Heijde modified Sharp score (vdHSS). Grip strength of both hands was\rmeasured by Jamar dynamometer. Results: Demographics (age, gender)\rwere not different between RA patients and control group. Grip strength of\rpatients with RA (22.79±18.58) was lower than control group (26.00±11.25,\rp=0.04). There was a significant correlation with grip strength and disease\rduration, tender joint count, VAS-pain, PGA, DAS28, HAQ, RAQoL, erosion and narrowing score (p<0.05). DAS28 and erosion score were associated\rwith grip strength in multivariate analyses p<0.05). Conclusion: This study\rshowed that RA obtains decreased muscle strength, impaired function and\rquality of life. Joint space narrowing and disease activity are the main parameters that affect muscle strength.\rÖğe Reliability and validity of the Turkish version of Function in Sitting Test (FIST-T) in stroke(Taylor & Francis Ltd, 2022) Erol, Busra Nur; Aydogan Arslan, Saniye; Yasar, Evren; Keskin, Esra Dilek; Demirci, Cevher SavcunBackground: Trunk control in sitting position after stroke is one of the most important determinants of independence in daily living activities and there is no gold standard assessment used to measure sitting postural control. Objectives: The aim of this study is to determine the reliability and validity of the Turkish version of Function in Sitting Test (FIST-T). Methods: After translation was conducted, Function in Sitting Test, Berg Balance Scale, Functional Independent Measure and Trunk Impairment Scale were applied to 72 stroke patients (mean age was 59.26 +/- 16.38 years; post-stroke time was 95.93 +/- 59.64 days). For reliability and validity analysis the spearman correlation analysis was used. Results: A positive, high correlation was found between the first application and repetition of Function in Sitting Test-T (ICC = 0.97, r = 0.95, p = .001). The internal consistency was high (Cronbach Alpha = 0.97), interrater correlation was high (Cronbach Alpha = 0.98) and a positive, high correlation was found with the scores obtained from the Berg Balance Scale (r = 0.82, p = .001), Functional Independent Measure (r = 0.84, p = .001) and Trunk Impairment Scale (r = 0.80, p = .001). Conclusions: It is concluded that the Turkish version of Function in Sitting Test is a valid and reliable scale for use in stroke patients, in clinical and scientific researches.Öğe RELIABILITY AND VALIDITY OF TURKISH VERSION OF THE BRIEF-BESTEST -T IN STROKE PATIENTS(TAYLOR & FRANCIS LTD, 2020) Aydogan Arslan, Saniye; Demirci, Cevher Savcun; Katirci Kirmaci, Zekiye Ipek; Ugurlu, Kubra; Keskin, Esra DilekBackground The Brief-BESTest is the short version of the BESTest used to evaluate balance and fall risk in a multiple disease populations. The clinicians need practical, short application scales to evaluate the risk of falling, balance and rehabilitation results. Objective This study aims to investigate the validity and reliability of the Turkish version of the Brief-BESTest (Brief-BESTest-T) in stroke patients. Methods This study included a total of 40 subacute and chronic stroke patients (mean age of 60.28 +/- 9.96 years). The Brief-BESTest, Berg Balance Scale (BBS), Timed Up and Go Test (TUG), Functional Reach Test (FRT), Falls Efficacy Scale (FES) and 10 m walking test were applied to the patients. Results A strong correlation was observed between the1st and 2nd evaluation Brief-BESTest-T total scores (r = 0.933). Cronbach's alpha coefficient was excellent. According to the correlation analysis performed to test the inter-rater reliability, a very high correlation (r = 0.906) was observed between the Brief-BESTest-T total scores. A high correlation was found between the Brief-BESTest-T and BBS and TUG, while a moderate correlation was found between the FRT, FES, and 10 m walking test. The clinical cutoff point for the Brief-BESTest - T was determined to be 9 points with an AUC of 0.872. There were no floor and ceiling effects found. Conclusions This study showed that the Brief-BESTest-T had excellent internal consistency, intra-rater, and inter-rater reliability. Its concurrent, discriminant, and known-groups validity were also good and had no substantial floor and ceiling effects.Öğe Serum Glucocorticoid-Inducible Kinase-1(Sgk1) Levels In Patients With Psoriatic Arthritis(Acta Dermato-Venereologica, 2018) Keskin, Goksal; Inal, Ali; Keskin, Esra Dilek; Olmez, Umit…Öğe The Effectiveness of Wet Cupping Therapy andEvaluation of Changes in Lactic Acid Levels inPatients with Myofascial Pain Syndrome(2020) Aras, Müyesser; Badem, Nermin Dindar; Kültür, Turgut; Boyunağa, Hakan; Keskin, Esra Dilek; Rajput, Kaleem Ullah; Dursun, GamzeObjective: Wet cupping therapy is used as a traditional and complementary therapy with a wide application all around the world for especially pain conditions. The aim of this study was to evaluate the effectiveness of wet cupping therapy (WCT) and to assess the changes in lactic acid (LA) levels in isolated leucocyte of the venous and cupping blood samples in patients with myofascial pain syndrome (MPS). Material and Methods: Patients aged between 18 and 65, and diagnosed with MPS were included the study. The Visual Analogue Scale (VAS) was recorded baseline, at 1st and 3rd months, Nothingham Health Profile (NHP) and Beck Depression Index (BDI) scores were recorded at baseline and 1st month follow-up in patients. The level of LA in isolated leucocyte of venous and cupping blood were also measured before and after 15 days WCT. Results:There was a significant decrease in VAS level from baseline to 1 and 3 months (p<0.001) and in BDI, NHP from baseline to 1 month (p <0.05). We found a significant decrease in the concentration of LA in isolated leucocyte of cupping blood 15 days after WCT (p<0.05). The median level of LA in isolated leucocyte of venous blood was lower than the levels before WCT but it wasn’t statistically significant (p>0.05). Conclusion: In conclusion, WCT is found to be effective in clinical improvements of VAS, BDI and NHP scores in our study. This study also suggests that WCT may be beneficial for pain through reducing LA levels in cupping blood in patients with MPS.Öğe Turkish Adaptation, Validity, and Reliability of the Subjective Index of Physical and Social Outcome (SIPSO)(2024) Ağır, Hatice; Keskin, Esra Dilek; Karaca, Gülten; Gökmen, DeryaObjective: 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.Öğe The Turkish League Against Rheumatism Recommendations for the Management of Hand Osteoarthritis Under Guidance of the Current Literature and 2018 European League Against Rheumatism Recommendations(2020) Ayhan, Fikriye Figen; Sunar, İsmihan; Umay, Ebru; Keskin, Esra Dilek; Altan, Lale; Dinçer, Fitnat; Duruöz, TuncayObjectives: This study aims to explore the accordance to the 2018 European League Against Rheumatism (EULAR) recommendations for the management of hand osteoarthritis (OA) among the Turkish League Against Rheumatism (TLAR) expert panel and composition of TLAR recommendations for the management of hand OA under guidance of the current literature. Materials and methods: The TLAR convener designated an expert panel of 10 physicians experienced in hand OA for this process. The 2018 EULAR recommendations for the management of hand OA and the systematic review of the literature were sent to the expert panel via e-mails. The e-mail process which included Delphi round surveys was completed. The EULAR standard operational procedure Appraisal of Guidelines for Research and Evaluation II was followed. The level of agreement was calculated for each item and presented as mean, standard deviations, minimum and maximum and comparisons of 2018 EULAR recommendations were performed. Results: Five overarching principles and 10 recommendations were discussed. Revisions were held for the sixth, seventh, and ninth recommendations with lowest level of agreements. These recommendations were revised in accordance with suggestions from the experts and re-voted. The revised forms were approved despite the lack of statistically significant difference between these forms (p=0.400, p=0.451, p=0.496, respectively). Except for the ninth recommendation about surgery (p=0.008), no significant difference in level of agreements was observed between the EULAR and TLAR hand OA recommendations. The 11th recommendation about paraffin bath was added. Conclusion: The optimal treatment of hand OA consists of personalized non-pharmacological (self-management, exercise, splint), pharmacological (topical non-steroidal anti-inflammatory drugs as the first choice), and interventional procedures (only for refractory cases) based on shared decision between the patient and physician. TLAR hand OA recommendations were created mainly based on the most recent literature and the last EULAR hand OA management recommendations, which are widely approved among the TLAR experts.Öğe Validity and reliability of the full cup test in patients with chronic low back pain(Kare Publ, 2022) Agir, Hatice; Aras, Muyesser; Keskin, Esra Dilek; Ozer, Hafsa Feyza; Karaca, Gulten; Ergun, Ufuk; Yorubulut, SerapObjectives:This study aims to determine the validity and reliability of the full cup test (FCT), evaluating the pain severity in patients with chronic low back pain. Methods: A total of 100 patients (70 women and 30 men) aged over 18 years with mechanical low back pain were enrolled in the study. Demographic and clinical characteristics were recorded. Pain severity was evaluated using the visual analog scale (VAS) and FCT, the functional state was assessed by the Oswestry Disability Index (ODI), and the quality of life was assessed using the Nottingham Health Profile (NHP). FCT was performed on the 1st day by two independent observers (G1 and G2) and 3 days after the first application, patients were readministered the FCT by G1. Results:The mean age of participants was 56.04 +/- 12.33 years and mean body mass index was 27.7 +/- 4.3 kg/m(2). The reliability of the FCT and intraclass correlation coefficient (ICC) was found to be 0.989 for intrarater compliance, ICC was found to be 0.984 for inter-rater compliance, and Cronbach's alpha reliability coefficient was alpha=0.994. External construct validity of the scale was confirmed with expected correlations with all subgroups of NHP except for social isolation, VAS and ODI (p<0.01). Conclusion:This study concludes that the FCT provides a reliable and valid instrument for measuring pain severity and loss of the function in patients with chronic mechanical back pain. We consider that FCT is a simple and easy test in patients with low education and advanced age.Öğe Zor kaynayan kemik kırıklarının tedavisine yönelik kemik morfojenik proteini içeren biyobozunur polimerik salım sistemleri tasarlanması(2003) Hasırcı, Vasıf; Korkusuz, Feza; Tezcaner, Ayşen; Keskin, Esra DilekKemik morfojenetik proteinler (KMP) kemik oluşumunu uyarıcı özellikleri nedeniyle çeşitli kemik hastalıkları üzerinde klinik araştırmaları yoğun bir şekilde sürmekte olan proteinlerdir. Kemik oluşumundaki güçlü etkileri nedeniyle tedavide lokal olarak sadece hasarlı kemik bölgesine uygulanmaları gerekmektedir. Bu amaçla son yıllarda KMP içeren değişik birçok polimer ilaç salım sistemi araştırılmıştır. Bu klinik ihtiyacı düşünerek KMP yüklü disk şeklinde çözülebilir Kollajen ve kondroitin sülfat içeren taşıyıcı bir sistem tasarlanmıştır. İn situ salım deneyleri model olarak seçilen bir protein (floresan işaretli protein A) ile yapılmış ve bunların sonucunda çok yüksek salım hızı (hemen hemen bütün malzemenin 24 saatte salındığı) gözlenmiştir. Çözünebilir kollajenin yüksek su bağlanma kapasitesiyle açıklanabilen bu problem sistemin poli(L-laktit), (PLLA) ve sükroz asetat izobutirat (SAIB) polimerlerinin karışımıyla kaplanması ile çözülmüştür. Böylece model ilaç için salım süresi 12 güne uzatılabilmiştir. Aynı sistemin KMP ile yapılan in situ salım deneyleri KMP ye özel ELISA kitleri ile yapılmış ve model ilaçtan daha yavaş salım ele edilmiştir. KMP sahraları ilacın yarısının 15 günde salındığını göstermiştir. Osteoblast hücreleri ile yapılan in vitro deneylerde 2 $\\mu$g KMP içeren impantların ALP enzim aktivitesinde anlamlı farklılıklar bulunmuştur. KMP salım sistemini in vivo uygulamalar sırasında kemikte hasarlı bölgede sabit tutabilmek ve aynı zamanda kemiğe de destek sağlamak amacıyla, Vicryl ameliyat ipliklerinin örülüp, daha sonra poli(L-laktit-ko-glikolit) (PLGA) ile fiber bağlanma yöntemi ile bağlanması ile bir ağ yapı hazırlanmıştır. Bu ağ yapı ile Kemikteki iyileşme düzeyi iki zaman süreci (1 hafta ve 3 hafta) için değerlendirilmiştir. KMP taşıyıcı sistemin kemik oluşumunu indükleyici (osteoinductive) etkisi histolojik skorlama, x-ışınları (röntgen analizleri) ile değerlendirilmiştir. İn vitro deneyler KMP yüklü PLLA-SAIB kaplanmış kollajen, kondroitin sülfat disklerinin iyi biyouyumluluk ve optimum osteojenik uyarıcı etkisi olduğunu göstermiştir. Histoloji mikrograflarındaki l hafta sonundaki yapısal değişiklikler doza bağlı periostta kemikleşme göstermektedir. 3 hafta sonundaki histolojik bulgularda ise her iki dozda da (1 ve 2$\\mu$ g) sonuçlar yaklaşık aynıdır.
