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Güzel Ş, Şenlikçi HB, Bal HS, Haberal B. Comparison of Plantar Pressure Distribution and Ultrasonographic and Clinical Features After Application of Different Energy Levels of Extracorporeal Shockwave Therapy in Patients with Plantar Fasciitis: A Randomized, Prospective, Double-Blind Clinical Trial. J Am Podiatr Med Assoc 2024; 114:22-047. [PMID: 35932476 DOI: 10.7547/22-047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The effectiveness of different energy levels used in extracorporeal shockwave therapy (ESWT) has been investigated in previous studies, but controversy remains regarding which energy levels should be used in the treatment of plantar fasciitis. We compared the efficacy of different energy levels used in ESWT in the treatment of plantar fasciitis using plantar fascia thickness and pressure distribution. METHODS Between July 2021 and September 2021, a total of 51 patients (71 feet) with plantar fasciitis were randomized into three treatment groups using the sealed envelope method. Group 1 (n = 25) received low energy density (0.09 mJ/mm2), group 2 (n = 25) received medium energy density (0.18 mJ/mm2), and group 3 (n = 21) received high energy density (0.38 mJ/mm2). Each group received three sessions of ESWT at a frequency of 2,000 shocks per minute at 1-week intervals. Patients were evaluated before and after treatment using a visual analog scale (VAS) for pain, the Foot Function Index (FFI), plantar fascia thickness measured by ultrasonography, and plantar pressure distribution. RESULTS Posttreatment VAS and FFI scores were determined to be significantly lower than the values before treatment in the three groups (P < .001). There were no significant differences among groups in pretreatment and posttreatment values of VAS, FFI, plantar fascia thickness, and pressure distribution (P > .05). No significant differences were found among groups in percentage changes in all of the outcome parameters (P > .05). CONCLUSIONS There was no superiority among low, medium, or high levels of ESWT in terms of pain, foot functions, fascia thickness, and pressure distribution in the treatment of plantar fasciitis.
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Affiliation(s)
- Şükran Güzel
- *Department of Physical Medicine and Rehabilitation, Baskent University Medical School, Bahçelievler, Ankara, Turkey
| | - Hüma Bölük Şenlikçi
- †Ankara City Hospital, Physical Medicine and Rehabilitation Hospital, Çankaya, Ankara, Turkey
| | - Hakan Süleyman Bal
- ‡Department of Orthopaedics and Traumatology, Baskent University Medical School, Bahçelievler, Ankara, Turkey
| | - Bahtiyar Haberal
- ‡Department of Orthopaedics and Traumatology, Baskent University Medical School, Bahçelievler, Ankara, Turkey
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Cankurtaran D, Aykın Yığman Z, Güzel Ş, Umay E. The importance of myofascial trigger points in chronic neck pain: An ultrasonography preliminary study. PM R 2023; 15:954-964. [PMID: 36989071 DOI: 10.1002/pmrj.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/04/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Ultrasonographic evaluation of trigger points detected by physical examination in patients with myofascial pain syndrome is being used more frequently in clinical care. However, the sonographic appearance of trigger points, in association with pain and disability, has not been adequately described. OBJECTIVE To reveal the presence of trigger points with ultrasonography in those with myofascial pain syndrome and to determine if ultrasound images can help discriminate between demographic and disease characteristics. METHODS Fifty-two participants with chronic neck pain (NP) were in this cross-sectional study. The pain intensity was evaluated using a 0-10 cm visual analog scale (VAS). The neck disability index measured the NP-induced disability status of the participants. Ultrasonography was used to measure the thicknesses of the paraspinal muscles and the presence of hypoechoic areas within these muscles. RESULTS There was a positive correlation between the VAS scores of the participants and the ultrasonographic detection of myofascial trigger points (MTPs) in the multifidus and middle trapezius muscles (right/left r = .30, p = .027; r = .29, p = .029; r = .32, p = .009, r = .30, p = .011, respectively). These features correlated with the disability levels of the participants and the MTPs on both the right and left sides of the splenius, multifidus, upper trapezius, and middle trapezius (r = .32, p = .028; r = .38, p = .013, r = .25, p = .027; r = .33, p = .016; r = .25, p = .025, r = .32, p = .018, r = .28, p = .013, r = .29, p = .016, respectively). A significant correlation was present between the detection of MTP at ultrasonography and decreased muscle thickness in the relevant muscles (between p = .001 and p = .034). CONCLUSION The detection of MTPs with ultrasonography is associated with the severity of pain and disability in those with chronic NP. Features on ultrasound include hypoechoic changes within muscle and reduced muscle thickness associated with MTPs.
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Affiliation(s)
- Damla Cankurtaran
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Zeynep Aykın Yığman
- Department of Physical Medicine and Rehabilitation, Ankara Mamak State Hospital, Ankara, Turkey
| | - Şükran Güzel
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ebru Umay
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Güzel Ş, Ozen S, Sözay S. Scapula winging secondary to prone plank exercise: a case report. Int J Neurosci 2023; 133:426-429. [PMID: 33930995 DOI: 10.1080/00207454.2021.1924710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Scapular winging occurs when the muscles responsible for the stabilization of the scapula (serratus anterior, trapezius, rhomboid major and minor) are paralyzed due to any reason. The most frequently observed neurological aetiology is serratus anterior muscle dysfunction due to long thoracic nerve palsy. The cause of long thoracic nerve palsy may be traumatic or atraumatic. It has been previously reported that a wide variety of sports can cause long thoracic nerve palsy.Clinical presentation: In this article, we report a case of unilateral winging of the scapula due to injury to the long thoracic nerve which occurred secondary to performing prone plank exercises; the likes of which has not previously been described in the literature and which may have occurred due to the exercise being performed incorrectly. In this patient, nerve recovery became evident one month following conservative treatment and cessation of plank exercises.Conclusion: Long thoracic nerve injury may have occurred due to increased and incorrect scapula loading during plank exercises. In order to prevent compression neuropathies caused by load transfer imbalance, attention should be paid to correct positioning whilst performing core stabilization exercises such as the prone plank.
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Affiliation(s)
- Şükran Güzel
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Baskent University, Ankara, Turkey
| | - Selin Ozen
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Baskent University, Ankara, Turkey
| | - Seyhan Sözay
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Baskent University, Ankara, Turkey
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Bölük Şenlikci H, Güzel Ş, Sözay S. Reliability and validity of the Turkish version of general sleep disturbance scale (GSDS-T) in stroke. Acta Neurol Belg 2023:10.1007/s13760-023-02191-4. [PMID: 36701078 DOI: 10.1007/s13760-023-02191-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/16/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND Stroke is a life-threatening condition with many complications. Sleep disturbances is one of them. Sleep disturbances effect quality of life, recovery and rehabilitation process. It is crucial to reveal sleep disturbances objectively in stroke patients. The aim of the study is to determine reliability and validity of the Turkish version of General Sleep Disturbance Scale (GSDS-T) in stroke patients. METHODS After translation and culture validation of the scale was done, Pittsburgh Sleep Quality Index (PSQI) and the Turkish version of the GSDS was applied at admission and at 24 h to the 58 patients with stroke. RESULTS Cronbach alpha coefficient of total score was found as 0.850 and test re-test reliability-related Cronbach alpha coefficient was 0.785. CONCLUSION GSDS-T is a reliable and valid tool to assess sleep disturbance in stroke patients.
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Affiliation(s)
- Hüma Bölük Şenlikci
- Ankara City Hospital, Physical Medicine and Rehabilitation Hospital, Ankara, Turkey
| | - Şükran Güzel
- Başkent University Medical School, Ankara Hospital, Ankara, Turkey.
| | - Seyhan Sözay
- Başkent University Medical School, Ankara Hospital, Ankara, Turkey
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Güzel Ş, Umay E, Öztürk EA, Gürçay E. Foot Deformity in Patients With Ankylosing Spondylitis: Is It Associated With Functionality and Disease Activity? J Foot Ankle Surg 2022; 61:1017-1022. [PMID: 35227596 DOI: 10.1053/j.jfas.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 11/08/2021] [Accepted: 01/10/2022] [Indexed: 02/03/2023]
Abstract
Foot involvement affects mobility and functionality in patients with ankylosing spondylitis but it remains unknown if foot deformities in ankylosing spondylitis patients affect functionality, disease activity, and quality of life. The aim of this study was to evaluate in detail the presence of a relationship between radiologically detected foot deformities in ankylosing spondylitis patients and both clinical and electrophysiological findings. The cross-sectional study included 110 patients with ankylosing spondylitis who were diagnosed according to the Assessment in Spondyloarthritis International Society criteria and were followed in our hospital. Demographic and clinical data of all patients were recorded. Bilateral lateral foot x-rays and electrophysiology examinations were evaluated in all subjects. The arch in the dominant foot of the patients was classified in 3 groups as pes cavus, pes planus, or normal. The clinical outcomes, physical examination and electrophysiological findings were compared between the groups, and correlations were examined of the foot deformities with these parameters. Foot deformities were determined at a high rate (74.5%). These deformities affected foot pain, disability and quality of life. Pes cavus deformity was found to be associated with hip pain and enthesopathy. In the electrophysiological studies, the presence of pes planus was found to be associated with the findings of the tibial and sural nerve conduction studies, and the presence of pes cavus with the findings of the peroneal nerve conduction study. In conclusion, foot deformities may have an effect on the quality of life and functionality in ankylosing spondylitis patients.
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Affiliation(s)
- Şükran Güzel
- Baskent University, Faculty of Medicine, Physical Medicine and Rehabilitation Clinic, Ankara Hospital, Ankara, Turkey.
| | - Ebru Umay
- Associate Professor, University of Health Sciences, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Physical Medicine and Rehabilitation Clinic, Ankara, Turkey
| | - Erhan Arif Öztürk
- Associate Professor, University of Health Sciences, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Physical Medicine and Rehabilitation Clinic, Ankara, Turkey
| | - Eda Gürçay
- Professor, University of Health Sciences, Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
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Gurcay E, Karaahmet OZ, Cankurtaran D, Nazlı F, Umay E, Güzel Ş, Gurcay AG. Functional electrical stimulation cycling in patients with chronic spinal cord injury: a pilot study. Int J Neurosci 2021; 132:421-427. [PMID: 33998960 DOI: 10.1080/00207454.2021.1929212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the therapeutic value of lower extremity functional electrical stimulation (FES) - evoked cycling on functional independence, health status, gait parameters, pulmonary functions, and biochemical values in patients with chronic complete/incomplete spinal cord injury (SCI). MATERIALS AND METHODS Fifteen patients with SCI (duration of more than 6 months) who were able to stand up and walk with long leg braces or assistive devices and had stable neurological status and trunk balance undertook FES cycling for 6 weeks (three times per week). The main outcomes were: Functional Independence Measure (FIM), Nottingham Health Profile (NHP), 6-minute walk test (6MWT), and 20-meter walk test (20MWT). Secondary outcomes include measurements of pulmonary function tests and biochemical values. All parameters were evaluated at the beginning and end of the program. RESULTS Improvements were seen in motor and total scores of FIM (p = 0.007), physical mobility subscale of NHP (p = 0.011), 6MWT (p = 0.001), and 20MWT (p = 0.011). In pulmonary functions, only forced vital capacity (FVC) levels demonstrated a significant increase compared with baseline (p = 0.011). Biochemical values reached no significant level. CONCLUSION The results of this study showed that the FES cycling exercise program improves motor and total FIM scores, gait parameters, and FVC values of pulmonary functions in patients with chronic SCI experience. The FES cycle might be a valuable and well-tolerated intervention in clinical rehabilitation.
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Affiliation(s)
- Eda Gurcay
- Gaziler Physical Therapy and Rehabilitation Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ozgur Zeliha Karaahmet
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Damla Cankurtaran
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Fatma Nazlı
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ebru Umay
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Şükran Güzel
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Baskent University, Ankara, Turkey
| | - Ahmet Gurhan Gurcay
- School of Medicine, Department of Neurosurgery, Yıldırım Beyazıt University, Ankara, Turkey
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Abstract
Peroneal nerve palsy most commonly occurs due to focal compression of the peroneal nerve at the level of the fibular head and causes foot drop and variable sensory loss. Mononeuropathies infrequently occur in childhood, bilateral peroneal palsy is very rare. In this article, we report the case of a 14-year-old boy with bilateral peroneal nerve entrapment which developed secondary to a prolonged sitting posture. We discuss the clinical assessment, diagnosis, and treatment of this rare case of bilateral peroneal palsy following prolonged immobility in light of the current literature.
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Affiliation(s)
- Şükran Güzel
- Physical Medicine and Rehabilitation Clinic, Baskent Unıversity Faculty of Medicine, Ankara, Turkey
| | - Selin Ozen
- Physical Medicine and Rehabilitation Clinic, Baskent Unıversity Faculty of Medicine, Ankara, Turkey
| | - Sacide Nur Coşar
- Physical Medicine and Rehabilitation Clinic, Baskent Unıversity Faculty of Medicine, Ankara, Turkey
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Güzel Ş, Bal A, Gündoğdu İ, Erdoğdu D, Çakcı A. Diffüz idiyopatik iskelet hiperostozlu bir hastada minör travma ile gelişen subakut torakal omurilik yaralanması. Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.416022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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