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    Effectiveness of virtual reality therapy in chronic unilateral vestibular hypofunction: A randomized controlled study
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2023) Hasimova, Zohre; Sahbaz, Tugba; Karacay, Basak Cigdem; Karan, Ayse
    Objectives: The aim of the study was to investigate the superiority of rehabilitation with virtual reality (Nintendo Wii) over habituation exercises in chronic vestibular hypofunction. Patients and methods: Eighty-seven patients (44 males, 43 females; mean age: 45.8 +/- 12.2 years; range, 19 to 70 years) with chronic unilateral vestibular hypofunction were included in the prospective randomized controlled study conducted between October 2017 and June 2018. Patients were randomized into two groups: the treatment group (TG; n=45) and the control group (n=42). Each group received vestibular rehabilitation exercises. The TG exercised with visual stimulation (virtual reality) in addition to the standard exercises. The patients were evaluated before the treatment and at two and three months. The frequency of dizziness was questioned. Visual analog scale, timed up and go test, Berg balance test, Romberg test, and Dizziness Handicap Inventory questionnaire were used to assess the patients. Results: There was a statistically significant decrease in the severity of dizziness in both groups at two- and three-month controls (p<0.001). In the comparison between the groups, severity of dizziness, frequency of attacks, and daily frequency were significantly improved in the TG (p<0.001). Conclusion: Adding virtual reality therapy to habituation exercises is effective in reducing the frequency of attacks.
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    Gravedad de accidentes cerebrovasculares para determinar síntomas osteomusculares en cuidadores familiares
    (Univ Sao Paulo, Escola De Enfermagem De Ribeirao Preto, 2023) Sahbaz, Tugba; Medin-Ceylan, Cansin
    Objetivo: el objetivo de este estudio es examinar la relacion entre los problemas osteomusculares sufridos por cuidadores familiares que tienen a su cargo velar por pacientes que han sufrido un accidente cerebrovascular y los niveles de salud fisica y discapacidad. Metodo: los sujetos incluidos en el estudio eran pacientes y cuidadores familiares atendidos en la clinica de servicios ambulatorios de Fisioterapia y Rehabilitacion del Hospital Universitario y de Investigacion Kanuni Sultan Suleyman por diagnosticos de ACV entre el 30 de mayo de 2019 y el 30 de mayo de 2021. Los cuidadores fueron evaluados mediante el Extended Nordic Musculoskeletal Questionnaire. Se emplearon escalas validadas para evaluar los niveles de salud fisica y discapacidad de los sobrevivientes de accidentes cerebrovasculares. Resultados: los participantes de este estudio fueron 104 sobrevivientes de accidentes cerebrovasculares y 104 cuidadores que cumplieron con nuestros criterios de inclusion. Las quejas relacionadas con la region lumbar durante el ultimo mes se asociaron con las puntuaciones obtenidas por los pacientes en el Functional Ambulation Score (FAS), la Functional Independence Measure (FIM) y la Stroke Impact Scale (SIS), ademas de las puntuaciones Brunnstrom. El dolor de cuello fue la segunda queja osteomuscular, aunque no se asocio estadisticamente con factores relacionados con los pacientes. Los problemas en las extremidades superiores se asociaron con las puntuaciones obtenidas en los instrumentos FAS, FIM, SIS, Brunnstrom y Modified Ashworth Scale. Conclusion: de acuerdo con nuestros hallazgos, la region lumbar es la parte del cuerpo mas afectada por quejas osteomusculares en cuidadores familiares de sobrevivientes de accidentes cerebrovasculares, demostrando una estrecha relacion con los niveles de capacidad funcional y discapacidad de los pacientes. Numero de registro de ensayos clinicos: NCT04901637
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    Gravidade do AVC e determinação dos sintomas musculoesqueléticos dos cuidadores familiares
    (Univ Sao Paulo, Escola De Enfermagem De Ribeirao Preto, 2023) Sahbaz, Tugba; Medin-Ceylan, Cansin
    Objetivo: o objetivo deste estudo & eacute; examinar a rela & ccedil;& atilde;o entre os problemas musculoesquel & eacute;ticos vivenciados pelos familiares que cuidam de pacientes com AVC, a sa & uacute;de f & iacute;sica e o n & iacute;vel de defici & ecirc;ncia do paciente. M & eacute;todo: foram inclu & iacute;dos no estudo pacientes e familiares cuidadores admitidos no hospital Kanuni Sultan Suleyman com diagn & oacute;stico de AVC entre 30 de maio de 2019 e 30 de maio de 2021. Os cuidadores foram avaliados utilizando o question & aacute;rio Extended Nordic Musculoskeletal Questionnaire. Escalas validadas foram usadas para avaliar a sa & uacute;de f & iacute;sica e o grau de incapacidade dos pacientes com AVC. Resultados: um total de 104 pacientes com AVC e 104 cuidadores atenderam aos crit & eacute;rios de inclus & atilde;o do estudo. As queixas lombares no & uacute;ltimo m & ecirc;s foram associadas aos escores do Functional Ambulation Score (FAS), Functional Independence Measure (FIM), Stroke Impact Scale (SIS) e teste de Brunnstrom do paciente. A dor no pesco & ccedil;o foi a segunda queixa musculoesquel & eacute;tica, mas n & atilde;o foi estatisticamente associada a fatores relacionados ao paciente. Os problemas nas extremidades superiores foram associados aos escores FAS, FIM, SIS, Brunnstrom e & agrave; Modified Ashworth Scale. Conclus & atilde;o: de acordo com os nossos achados, a regi & atilde;o lombar & eacute; a & aacute;rea do corpo mais afetada por queixas musculoesquel & eacute;ticas nos cuidadores familiares de pacientes com AVC, que est & atilde;o intimamente relacionadas ao n & iacute;vel de capacidade funcional e ao grau de incapacidade dos pacientes. N & uacute;mero do estudo cl & iacute;nico: NCT04901637.
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    Investigation of the relationship between probable sleep bruxism, awake bruxism and temporomandibular disorders using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)
    (Wroclaw Medical Univ, 2023) Karacay, Basak Cigdem; Sahbaz, Tugba
    Background. The causal relationship between bruxism and temporomandibular disorders (TMD) is not clear.Objectives. The present study investigated which TMD are associated with probable sleep bruxism (SB) and awake bruxism (AB) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). The study further evaluated the association between probable SB and AB and TMD. Material and methods. A total of 143 patients were selected - bruxers (SB and AB) and non-bruxers. A diagnosis of probable bruxism was made after a physical examination and when the symptoms were detected. The patients were evaluated using DC/TMD. From among Axis I assessment instruments, the TMD Pain Screener, the Symptom Questionnaire and the Clinical Examination Form were used. Moreover, the Graded Chronic Pain Scale (GCPS) (v. 2), the Jaw Functional Limitation Scale-8 (JFLS-8), the Patient Health Questionnaire-4 (PHQ-4), and the Oral Behaviors Checklist (OBC) were applied within the scope of Axis II. Results. Diagnoses of muscle disorders and disk displacement with reduction were significantly more frequent in the SB and AB groups than in non-bruxers. A diagnosis of arthralgia was significantly more prevalent in the AB group than in non-bruxers. The JFLS-8 scores and the TMD Pain Screener scores were higher in the AB group than in the SB group and in non-bruxers. Distress levels, and the GCPS and OBC scores were higher in the SB and AB groups as compared to non-bruxers. The results of binary logistic regression analysis showed that only the OBC score was significantly higher in the TMD subgroup (OR (odds ratio) = 1.228; 95% CI (confidence interval): 1.014-1.488).Conclusions. Both SB and AB were associated with pain-related TMD and intra-articular joint disorders. The muscle disorders and disk displacement with reduction subtypes were associated with SB and AB. Unlike SB, AB was also associated with arthralgia. Bruxers (both SB and AB) displayed parafunctional habits. However, AB was associated with greater functional limitation of the jaw as compared to SB.
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    The relationship between serum leptin, insulin-like growth factor-1, and insulin-like growth factor binding protein-3 levels and clinical parameters in primary fibromyalgia patients
    (Assoc Medica Brasileira, 2023) Atamer, Yildiz; Sahbaz, Tugba; Asik, Hatice Kubra; Sarac, Serdar; Atamer, Aytac
    OBJECTIVE: The aim of this study was to investigate the levels of leptin, growth hormone, insulin-like growth factor-1, and insulin-like growth factor binding protein-3 and their relations with clinical parameters in patients with primary fibromyalgia and healthy controls.METHODS: Our study was performed on 30 female patients with primary fibromyalgia and 30 healthy controls. The levels of insulin-like growth factor-1 and insulin-like growth factor binding protein-3 were measured by a two-site immunoradiometric assay. The serum level of leptin was measured by the ELISA kit.RESULTS: The serum level of leptin was significantly higher, but the serum levels of insulin-like growth factor-1 were significantly lower in patients with fibromyalgia syndrome than healthy controls (p<0.001). The leptin level was positively correlated with the Visual Analog Scale, Fibromyalgia Impact Questionnaire score, Beck Depression Inventory score, tender point count, age, and duration of disease (p<0.001), but it was negatively correlated with insulin-like growth factor-1 (p<0.001). The insulin-like growth factor-1 level was negatively correlated with age, Visual Analog Scale, Fibromyalgia Impact Questionnaire and Beck Depression Inventory scores, duration of disease, and tender point count (p<0.001).CONCLUSION: Our results indicate that high levels of serum leptin and low levels of serum insulin-like growth factor-1 may play a role in the physiopathogenesis of fibromyalgia and may be related to some symptoms.
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    Serum paraoxonase activities, nitric oxide, and malondialdehyde levels are altered in patients with primary fibromyalgia syndrome
    (Springer London Ltd, 2023) Atamer, Yildiz; Sarac, Serdar; Asik, Hatice Kubra; Sahbaz, Tugba
    BackgroundFibromyalgia patients who are exposed to extreme oxidative stress may face more severe clinical features or oxidative stress may be increased by the severity of the disease.AimThe purpose of these investigation were to determine serum paraoxonase activities (PON-1) and nitric oxide (NO) activities and malondialdehyde (MDA) level in fibromyalgia and whether there were any associations between these enzymes activities, MDA level, and clinical parameters.MethodsThe study groups were consisted of 30 primer fibromyalgia patients and 30 healthy subjects. Clinical findings, pain severity, functional disability, general health status, anxiety, and depression assessed, and serum PON-1 activity, MDA, and NO levels were measured.ResultsThe primer fibromyalgia group had significantly higher MDA, low density lipoprotein-cholesterol (LDL-C), and decreased PON-1 activity, NO, and high density lipoprotein-cholesterol (HDL-C) with respect to controls. The paraoxonase activity was negatively correlated with MDA, LDL-C, Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire score (FIQ score), tender point score, age, and BDI score, while positively correlated with NO and HDL-C. MDA level was positively correlated with VAS, FIQ score, tender point score, age, and negatively correlated with NO level.ConclusionThese results suggest that FMS patients have an alteration in levels of MDA, NO, and PON-1 activities. We think that impaired oxidant/antioxidant status may affect the symptoms of the disease. Also, they may be of importance in the complex physiopathologic mechanism behind the development of FMS.
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    Stroke severity to determine musculoskeletal symptoms in family caregivers
    (Univ Sao Paulo, Escola De Enfermagem De Ribeirao Preto, 2023) Sahbaz, Tugba; Medin-Ceylan, Cansin
    Objective: the objective of this study is to examine the relationship between the musculoskeletal problems experienced by the family members who care for stroke patients, physical health and disability levels. Method: the subjects included in the study were patients and family caregivers admitted to the Kanuni Sultan Suleyman Training and Research Hospital Physical Medicine and Rehabilitation outpatient clinic with a stroke diagnosis between May 30th, 2019, and May 30th, 2021. The caregivers were assessed using the Extended Nordic Musculoskeletal Questionnaire. Validated scales were employed to evaluate stroke patients' physical health and disability level. Results: a total of 104 stroke patients and 104 caregivers who met our inclusion criteria took part in this study. Low back complaints in the last month were associated with the patients' Functional Ambulation Score (FAS), Functional Independence Measure (FIM), Stroke Impact Scale (SIS) and Brunnstrom scores. Neck pain was the second musculoskeletal complaint, but was not statistically associated with patient-related factors. Upper limb problems were associated with FAS, FIM, SIS, Brunnstrom and the Modified Ashworth Scale scores. Conclusion: according to our findings, the low back is the body area most affected by musculoskeletal complaints in family caregivers of stroke patients, closely related to the patients' functional capacity and disability levels. Clinical trials number: NCT04901637