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Öğe Acceptability, validity and reliability of the Turkish QUALIOST ® in postmenopausal women with osteoporosis(2013) Hepguler S.; Atamaz F.C.; Pinar Y.; Ozturk C.The quality-of-life questionnaire in osteoporosis (QUALIOST ®) is commonly used and accepted generic instrument in osteoporosis. This study aimed to translate QUALIOST® into Turkish language and assess its reliability, validity and acceptability in women with postmenopausal osteoporosis (PMO). After the questionnaire was translated into Turkish, it was administered to 110 with PMO. The reliability studies were assessed by test-retest reliability (ICC) and internal consistency (Cronbach's alpha). Construct validity was assessed by using correlating QUALIOST ® with SF-36. Results showed that ICC values were 0.92, 0.91 and 0.92, for physical domain, emotional domain and total QUALIOST® scores, respectively. Similarly, Cronbach's alpha was acceptable in all domains (0.85, 0.83 and 0.84, respectively). Significant moderate-to-high correlations were obtained between QUALIOST® and SF-36 dimensions (r value between -0.39 and -0.72, p < 0.001). Also, there were moderate-high correlations between the domains of questionnaire and pain intensity and disease duration (r value between 0.35 and 0.45, p < 0.05). In conclusion, this study, which reported firstly psychometric properties and usefulness of the Turkish QUALIOST®, showed that it is a potentially useful measure with a high validity and reliability standards. © 2012 Springer-Verlag.Öğe Comparison of the efficacy of transcutaneous electrical nerve stimulation, interferential currents, and shortwave diathermy in knee osteoarthritis: A double-blind, randomized, controlled, multicenter study(2012) Atamaz F.C.; Durmaz B.; Baydar M.; Demircioglu O.Y.; Iyiyapici A.; Kuran B.; Oncel S.; Sendur O.F.Objective: To compare the effectiveness of transcutaneous electrical nerve stimulation (TENS), interferential currents (IFCs), and shortwave diathermy (SWD) against each other and sham intervention with exercise training and education as a multimodal package. Design: A double-blind, randomized, controlled, multicenter trial. Setting: Departments of physical medicine and rehabilitation in 4 centers. Participants: Patients (N=203) with knee osteoarthritis (OA). Interventions: The patients were randomized by the principal center into the following 6 treatment groups: TENS sham, TENS, IFCs sham, IFCs, SWD sham, and SWD. All interventions were applied 5 times a week for 3 weeks. In addition, exercises and an education program were given. The exercises were carried out as part of a home-based training program after 3 weeks' supervised group exercise. Main Outcome Measures: Primary outcome was a visual analog scale (0-100mm) to assess knee pain. Other outcome measures were time to walk a distance of 15m, range of motion, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Nottingham Health Profile, and paracetamol intake (in grams). Results: We found a significant decrease in all assessment parameters (P<.05), without a significant difference among the groups except WOMAC stiffness score and range of motion. However, the intake of paracetamol was significantly lower in each treatment group when compared with the sham groups at 3 months (P<.05). Also, the patients in the IFCs group used a lower amount of paracetamol at 6 months (P<.05) in comparison with the IFCs sham group. Conclusions: Although all groups showed significant improvements, we can suggest that the use of physical therapy agents in knee OA provided additional benefits in improving pain because paracetamol intake was significantly higher in the patients who were treated with 3 sham interventions in addition to exercise and education. © 2012 American Congress of Rehabilitation Medicine.Öğe The effectiveness of tetanus toxin on sciatic nerve regeneration: A preliminary experimental study in rats(John Wiley and Sons Inc., 2014) Gunay H.; Kucuk L.; Erbas O.; Atamaz F.C.; Kucuk U.; Coskunol E.Object The purpose was to investigate the effects of local tetanus toxin (TeTx) application on sciatic nerve regeneration following a rat model of transection injury. Methods After both sciatic nerves were transected and repaired with three epineural sutures, 12 male Wistar albino rats were divided into two groups. 0.25 ml (2.5 flocculation units) TeTx was injected into a piece of absorbable gelatin sponge in TeTx group. In controls, 0.25 ml saline injected. Assessments were performed by using climbing degrees, compound muscle action potentials (CMAPs) and histological parameters (axon number and axonal diameter) 12th week. Results CMAPs amplitudes were 11.6±4.7 mV and 1.4±1.3 mV in gastrocnemius and interdigital muscles in TeTx group (5.8±2.4 mV and 0.2±0.1 mV, P < 0.05). Climbing degrees were significantly different (61.6±1.7 vs. 38.3±2.6, P<0.05). Total axon numbers were higher (1341.1±57.3 vs. 877.5±34.9, P<0.05) and the mean axon diameter was smaller (4.2±2.1 vs. 2.5±1.9, P<0.05) in the TeTx group. Conclusion This preliminary study firstly demonstrated the effectiveness of TeTx on nerve repair in experimental sciatic rat model based on functional, electromyographic and histological parameters. © 2014 Wiley Periodicals, Inc. Microsurgery 34:384-389, 2014. © 2014 Wiley Periodicals, Inc.Öğe Efficacy of therapeutic ultrasound for the management of knee osteoarthritis: A randomized, controlled, and double-blind study(Lippincott Williams and Wilkins, 2014) Cakir S.; Hepguler S.; Ozturk C.; Korkmaz M.; Isleten B.; Atamaz F.C.Objective: The aim of this study was to compare whether the effectiveness of continuous ultrasound (US) was superior against pulsed US and against sham US in knee osteoarthritis. Design: A randomized controlled study was carried out on 60 patients diagnosed with knee osteoarthritis according to American College of Rheumatology. The patients were randomized into the following three treatments: (1) continuous US (at a frequency of 1 MHz with intensity of 1 W/cm), (2) pulse US (same frequency and intensity on 1:4 pulse ratio), and (3) sham US. All treatments were applied with 5-cm head US device five times a week for 2 weeks in addition to home exercise program including quadriceps isometric exercise, muscle strength exercises, and stretching exercises of the lower extremity muscles for at least three times per week. Assessments were performed at baseline, at the end of the treatment, and at the end of the treatments and at the sixth month using the following measurements: Western Ontario and McMaster University Osteoarthritis Index-pain, stiffness, function, visual analog scale-pain at rest, visual analog scale-pain on movement, visual analog scale-disease severity, and 20-m walking time. Among these parameters, the Western Ontario and McMaster University Osteoarthritis Index-pain was the primary outcome. Results: All groups showed a significant improvement in all parameters in both following visits (P < 0.05). However, there was no significant difference between the groups. Although the mean reduction percent in Western Ontario and McMaster University Osteoarthritis Index-pain was significantly higher in group I (continuous US) when compared to sham group (46.5% vs 28.9%, P < 0.05) at the end of the treatment, this result was not found in other pain parameters. Conclusions: The present study demonstrated that all assessment parameters significantly improved in all groups without a significant difference. This result suggested that therapeutic US provided no additional benefit in improving pain and functions in addition to exercise training. © 2014 Lippincott Williams & Wilkins.Öğe Is it necessary to strictly diagnose fibromyalgia syndrome in patients with chronic widespread pain?(Springer-Verlag London Ltd, 2015) On A.Y.; Aykanat D.; Atamaz F.C.; Eyigor C.; Kocanogullari H.; Oksel F.The applicability of the American College of Rheumatology (ACR) 1990 and 2010 criteria for the diagnosis of fibromyalgia syndrome (FMS) was determined in 284 patients with chronic widespread pain (CWP) including those with regional and systemic painful disorders. On the basis of initial evaluation, patients were classified into three groups. Group 1, those without any comorbid disease (N = 105), group 2, those having regional non-inflammatory painful disorders (N = 104), and group 3, those with a diagnosis of an inflammatory rheumatic disease (N = 75). Overall, 65 % of the patients fulfilled the 1990 criteria, while 94 % of them fulfilled the 2010 criteria. Almost all of the patients (97 %) with CWP did meet at least one of the criteria set, regardless of whether they have accompanying painful disorders. Widespread pain index (WPI), symptom severity scale (SS), and fibromyalgia impact questionnaire (FIQ) scores were found to be significantly higher in the patients who satisfied the 1990 criteria than those who did not (P < 0.001). Tender point counts were found to be significantly correlated with WPI, SS, FIQ, and Beck depression inventory (BDI) scores (P < 0.001). The findings of the study support the suggestion that FMS is just a continuum of CWP, rather than a distinct diagnostic entity. As treatment of FMS is usually identical with that of CWP, strict diagnosis of FMS will provide little or no significance from the viewpoint of clinical practice. We suggest that future research should be directed toward classification of CWP to provide guidance to clinicians in selecting effective therapies. © 2015, International League of Associations for Rheumatology (ILAR).Öğe Normative data for quantitative calcaneal ultrasonometry in Turkish children aged 6 to 14 years: Relationship of the stiffness index with age, pubertal stage, physical characteristics, and lifestyle(John Wiley and Sons Ltd, 2013) Yesil P.; Durmaz B.; Atamaz F.C.Objectives-Quantitative ultrasonometry is commonly used to assess bone health. The aim of this study was to define normative data for the stiffness index of the calcaneus in healthy Turkish children. Methods-Quantitative ultrasonometric measurements of the calcaneus were obtained in 1617 healthy schoolchildren (811 boys and 806 girls) aged 6 to 14 years. Results-The stiffness index increased by 19.3% and 12% in boys and girls, respectively. The greatest increases were seen in the age groups of 12 to 13 and 13 to 14 years in boys (3.9%) and 11 to 12 and 12 to 13 years in girls (4.1%). There was a significant increase in stiffness index values among all Tanner stages except stage 4 (P < .05). Although the stiffness index was related to age, weight, and height, no correlation was seen between the stiffness index and calcium intake or physical activity. Conclusions-This study provides stiffness index data by age group and Tanner stage that may be useful for assessment of the bone status of Turkish children and can serve as comparative data for other patient groups. © 2013 by the American Institute of Ultrasound in Medicine.Öğe Phagocytic and oxidative burst activity of neutrophils in patients with spinal cord injury(2013) Kanyilmaz S.; Hepguler S.; Atamaz F.C.; Gokmen N.M.; Ardeniz O.; Sin A.Objective: To evaluate phagocytic activity and neutrophil oxidative burst functions in patients with spinal cord injury (SCI) because alterations in neutrophil metabolic activity can be one of the causes of immune mechanism damage contributing to repeated bacterial infections. Design: A controlled and cross-sectional study. Setting: Departments of physical medicine and rehabilitation and immunology. Participants: Patients with SCI (N=34) and 28 healthy controls. Interventions: Phagocytosis and oxidative burst in whole-blood neutrophils were assessed by flow cytometry. The percentage of phagocytizing cells after in vitro incubation with Escherichia coli, phagocytic activity (mean intensity of fluorescence [MIF]) and the percentage of neutrophiloxidative burst, and the MIF value of the production of reactive oxygen intermediates (ROIs) were analyzed. In addition, clinical assessment including the level of injury, American Spinal Injury Association scores, and functional status were carried out. Main Outcome Measures: Not applicable. Results: Although the percentage of E. coli phagocytizing neutrophils was not different between groups, the MIF value of absorbed E. coli was significantly lower in patients with SCI than in controls (P<.05). The MIF value of ROI production by neutrophils with both stimulator of phorbol 12-myristate 13-acetate and E. coli was significantly higher in patients with SCI (P<.05). Conclusions: In patients with SCI, decreased phagocytic activity of neutrophils may be a result of a regulatory mechanism to minimize the deleterious effects of increased neutrophil burst activity. © 2013 American Congress of Rehabilitation Medicine.
