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1.
Physiother Theory Pract ; : 1-12, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319754

RESUMO

Objectives: To investigate (1) the intrarater, interrater, and test-retest reliability of the timed 360° turn test in people with Multiple Sclerosis (MS); (2) the minimum detectable change in the timed 360° turn test times; (3) the concurrent and discriminant validity of the timed 360° turn test times; and (4) the cut-off times that best discriminate people with MS from healthy people and fallers from non-fallers with MS. Method: Sixty-one people with MS (Expanded Disability Status Scale, EDSS, 0-6.5) and 34 healthy people were recruited in this cross-sectional study. The timed 360° turn test was administered along with the Timed Up and Go Test, Berg Balance Scale, Four Square Step Test, and EDSS by two independent raters. Results: The timed 360° turn test showed good intrarater, interrater, and test-retest reliability. Minimal detectable changes were 1.49 s and 1.53 s for the dominant and non-dominant sides, respectively. The timed 360° turn test was strongly correlated with other outcome measures. Significant differences in 360° turn times were found between people with MS and healthy people and between fallers and non-fallers with MS (p < .001 and p < .001, respectively). The cut-off times of 2.65 s on the dominant side and 2.42 s on the non-dominant best discriminated people with MS from healthy people, while 3.65 s on the dominant side and 3.75 s on the non-dominant best discriminated fallers from non-fallers with MS. Conclusions: The timed 360° turn test is a simple and reliable tool for assessing turning ability in MS.

2.
J Matern Fetal Neonatal Med ; 32(4): 584-589, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29034765

RESUMO

OBJECTIVE: This prospective observational study aimed to identify the effects of labor on cerebral hemodynamics by measuring the middle cerebral artery (MCA) blood flow velocity by transcranial Doppler ultrasound (TCD), and the related factors just before delivery and within the 24 h after delivery. METHODS: The study included 35 healthy pregnant women with a gestational age of >37 weeks who were in labor and a control group including healthy, age-matched, nonpregnant women (n = 24). Demographic characteristics and significant clinical information of pregnant women were recorded. The MCA blood flow velocity was assessed by TCD just before and within 24 h after delivery. The parameters assessed by TCD were mean cerebral blood flow velocity (MCBFV), peak systolic velocity (PSV), pulsatility index (PI), resistance index (RI), and systolic/diastolic ratio. RESULTS: There was no significant difference between the pregnant and nonpregnant women regarding age (27 ± 5 years versus 28 ± 7 years; p = .751). The MCBFV, PSV, PI, and RI showed a significant increase within the 24 h after delivery as compared with those before delivery. Comparison of the pregnant women with the control group in terms of the values of all parameters related to the MCA blood flow velocity revealed that the values that were significantly low before delivery reached to the level of the control group after delivery Conclusion: The findings of this study demonstrated that the blood flow velocity of the MCA decreased during the late pregnancy period and increased in the early postpartum period to the level similar to that of the nonpregnant group.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Trabalho de Parto/fisiologia , Artéria Cerebral Média/fisiologia , Gravidez/fisiologia , Adulto , Estudos de Casos e Controles , Circulação Cerebrovascular/fisiologia , Feminino , Humanos , Artéria Cerebral Média/diagnóstico por imagem , Período Pós-Parto/fisiologia , Terceiro Trimestre da Gravidez/fisiologia , Estudos Prospectivos , Ultrassonografia Doppler Transcraniana , Adulto Jovem
3.
Brain Behav ; 6(12): e00586, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-28032007

RESUMO

OBJECTIVE: The aim of the present study was to investigate the prevalence and pattern of cognitive dysfunction observed in primary Sjögren's syndrome (PSS) and to examine the relationships between cognitive abilities, depression, fatigue, and quality of life. MATERIALS AND METHODS: Thirty-two subjects with PSS were compared with 19 healthy controls on comprehensive neuropsychological, depression, fatigue, health state, and daily-life activities tests. RESULTS: There was low performance in Clock Drawing, COWAT, Paced Auditory Serial Addition Test (PASAT), Colorless Word Reading (Stroop1) and Recognizing Colors (Stroop2) Patterns of STROOP test, SDLT, Auditory-Verbal Learning Test (AVLT), immediate and long-term verbal memory, Benton Judgment of Line Orientation Test (BJLOT), and in all the patterns of RCFT in PSS patients compared to the healthy control group (p < .05). It was observed an increased depression frequency and fatigue severity, impairment in health condition, and a decreased quality of life in PSS cases compared to the healthy controls (p < .05). All the depression, fatigue severity, and quality of life tests showed a significant positive correlation with each other (p < .05). A significant negative correlation between Clock Drawing and SF-36-BP (p = .031, r = -.382) and SF-36-GH (p = .027, r = -.392) was observed. CONCLUSIONS: Clock Drawing, PASAT, and AVLT are very useful tests to determine the subclinical and clinical cognitive dysfunction to evaluate attention, information processing speed, executive functions, and short-term and long-term verbal memory in PSS patients. Depression and fatigue may not affect the neuropsychological tests performance.


Assuntos
Disfunção Cognitiva/etiologia , Depressão/etiologia , Fadiga/etiologia , Síndrome de Sjogren/fisiopatologia , Síndrome de Sjogren/psicologia , Atividades Cotidianas , Adulto , Estudos de Casos e Controles , Disfunção Cognitiva/diagnóstico , Depressão/diagnóstico , Fadiga/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida
4.
Neuropsychiatr Dis Treat ; 12: 2143-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27621629

RESUMO

INTRODUCTION: Previous studies have shown that olfactory functioning is affected by multiple sclerosis (MS). This study assessed the level of the olfactory impairment in early MS by using the Sniffin' Sticks Test. METHODS: This study included 30 patients with MS and 30 healthy controls. We collected demographic and clinical data from participants and administered the Sniffin' Sticks Test. RESULTS: We found no differences between the MS and control groups in odor discrimination, odor identification, and threshold discrimination identification scores, but odor threshold (OT) scores were higher in the control group than in the MS group (P=0.49). In addition, we did not find any correlation between MS patients' olfactory test scores and their scores on the Mini-Mental State Examination (MMSE), Expanded Disability Status Scale (EDSS), disease duration, history of optic neuritis, or being on immunomodulatory therapy. CONCLUSION: In recent studies, odor threshold impairment seemed to be the most striking finding in patients with MS. Although the present study found a mild alteration in odor threshold, olfactory dysfunction appears to be a consequence of neurodegeneration in the higher order olfactory brain regions, which is thought to be a time-dependent process.

5.
Int J Rheum Dis ; 19(10): 981-988, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27455357

RESUMO

AIM: Cognitive dysfunction is a neurologic manifestation in primary Sjögren syndrome (PSS). On the other hand, several antibodies are related to cognitive dysfunction. The aim of this study is to assess the cognitive dysfunction of PSS patients via detailed neurologic tests. Moreover, its associations with antibodies were also evaluated. METHOD: Twenty-eight female patients with PSS and 17 healthy controls comprised the study groups. Short-term memory, long-term memory, verbal learning, visual memory, visual spatial perception, attention, verbal frequency function, executive functions and information processing speed were evaluated with neurologic tests in both of the study groups. Furthermore, anti-N-methyl-D-aspartate (NMDA) type anti-glutamate-receptor antibody, anti-ribosomal-p and antiganglioside antibodies were assessed in the study groups. RESULTS: The attention, data processing speed, verbal learning, short-term verbal memory and visuo-spatial perception performances were lower in the patients with PSS when compared to the healthy controls. The difference reached statistical significance in Paced Auditory Serial Addition Test (P < 0.01), Serial Digit Learning Test (P < 0.01), clock drawing (P = 0.03), Auditory Verbal Learning Test immediate verbal memory (P = 0.01) and Benton Judgement of Line Orientation Test (P = 0.03). Even if antiganglioside antibodies were more likely to be present in the PSS group when compared to the healthy controls, no relationship was found between its positivity and cognitive dysfunction. CONCLUSION: Results of this study suggest that cognitive dysfunction is quite prevalent in PSS patients without being associated with studied antibodies.


Assuntos
Transtornos Cognitivos/etiologia , Cognição , Síndrome de Sjogren/complicações , Adulto , Atenção , Autoanticorpos/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/psicologia , Função Executiva , Feminino , Gangliosídeos/imunologia , Humanos , Memória , Pessoa de Meia-Idade , N-Metilaspartato/imunologia , Testes Neuropsicológicos , Sistema de Registros , Proteínas Ribossômicas/imunologia , Síndrome de Sjogren/sangue , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/imunologia , Percepção Espacial , Percepção Visual
6.
NeuroRehabilitation ; 36(3): 345-53, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26409338

RESUMO

BACKGROUND: We thought that the application of Kinesio Tape (KT) on the foot and ankle in stroke patients may improve the quality of somatosensory information and may activate ankle muscles which have an important role in postural control and that ultimately balance could be improved in stroke patients. OBJECTIVE: The purpose of this study was to evaluate the effects of KT on balance in stroke patients. METHODS: Nineteen stroke patients and 16 healthy controls were included in the study. The study group was evaluated with and without KT. Balance of the all subjects was evaluated Sensory Organization Tests (SOT) by using the Computerized Dynamic Posturography. Equilibrium, Strategy Analysis and Composite Equilibrium Scores were investigated in SOT. RESULTS: Statistically significant differences were observed in all of the SOT parameters between stroke patients and healthy controls (p <  0.05). When the results with and without KT application were compared, the Equilibrium Scores in the conditions 3, 4, 6, Strategy Analysis Score in the conditions 2, 4, 6 and the Composite Equilibrium Score of the SOT were found to be improved in stroke patents (p <  0.05). CONCLUSIONS: The results obtained from KT application are promising in improving balance in stroke patients.


Assuntos
Articulação do Tornozelo/fisiologia , Fita Atlética/estatística & dados numéricos , Modalidades de Fisioterapia , Equilíbrio Postural/fisiologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/diagnóstico , Adulto , Idoso , Fixadores Externos/estatística & dados numéricos , Feminino , Pé/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Modalidades de Fisioterapia/instrumentação
7.
Case Rep Neurol Med ; 2014: 214648, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24716016

RESUMO

Susac's syndrome is an uncommon neurologic disorder of unknown cause. It has been described as a clinical triad of encephalopathy, hearing loss, and branch retinal artery occlusions. Clinically the diagnosis is difficult when the patient presents only a portion of a triad. We present a case with vision loss and sensorineural deafness and who had been diagnosed with MS for 20 years. Susac's syndrome is presumed to be an autoimmune endotheliopathy. Neurologic symptoms and signs are diffuse and multifocal, acute or subacute in onset, and progress during the active phase of the disease. In some patients the onset was stroke like and in others that of subacute dementia. Headache, often with migrainous features, was a prominent feature initially in more than one half of the patients. A high index of suspicion leading to correct diagnosis and early appropriate therapy may reduce the permanent sequel seen with this disease. Misdiagnosis is common. In patients in whom diagnosis and treatment are delayed permanent morbidity is higher in terms of visual loss, hearing loss, and neurologic debility. In patients in whom rapid diagnosis has led to early administration of immunosuppressive therapy, recovery can be almost complete.

8.
NeuroRehabilitation ; 34(2): 337-42, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23949064

RESUMO

BACKGROUND: Although there are evidences as to Pilates developing dynamic balance, muscle strength and flexibility in healthy people, evidences related to its effects on Multiple Sclerosis patients are insufficient. OBJECTIVES: The aims of this study were to investigate the effects of Pilates on balance, mobility, and strength in ambulatory patients with Multiple Sclerosis. METHODS: Twenty six patients were divided into two groups as experimental (n = 18) and control (n = 8) groups for an 8-week treatment program. The experimental group underwent Pilates and the control group did abdominal breathing and active extremity exercises at home. Balance and mobility were measured with Berg Balance Scale and Timed up and go test, upper and lower muscle strength with hand-held dynamometer. Confidence in balance skills while performing daily activities was evaluated with Activities Specific Balance Confidence Scale. RESULTS: Improvements were observed in balance, mobility, and upper and lower extremity muscle strength in the Pilates group (p < 0.05). No significant differences in any outcome measures were observed in the control group (p > 0.05). CONCLUSION: Due to its structure which is made up of balance and strengthening exercises, Pilates training may develop balance, mobility and muscle strength of MS patients. For this reason, we think that, Pilates exercises which are appropriate for the disability level of the patient may be suggested.


Assuntos
Técnicas de Exercício e de Movimento/métodos , Extremidade Inferior/fisiopatologia , Movimento/fisiologia , Esclerose Múltipla/reabilitação , Força Muscular/fisiologia , Equilíbrio Postural/fisiologia , Adulto , Feminino , Humanos , Locomoção/fisiologia , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/fisiopatologia , Método Simples-Cego , Resultado do Tratamento
9.
NeuroRehabilitation ; 33(2): 293-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23949051

RESUMO

BACKGROUND: Muscle strength and standing balance decrease in patients with Multiple Sclerosis (MS). OBJECTIVE: The aim of the present study was to investigate the relationship between the lower extremity isometric muscle strength and standing balance in patients with MS. METHODS: Forty-seven patients with MS and 10 healthy volunteers were included. Neurological disability level was assessed using Expanded Disability Status Scale (EDSS). Isometric strength of seven lower extremity muscles (hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor) was assessed using hand-held dynamometer. Duration of static one-leg standing balance was measured using digital chronometer. RESULTS: Hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor isometric muscle strength, and duration of one-leg standing balance were decreased in patients with MS when compared with controls (p < 0.05). All assessed lower extremity isometric muscle strength and EDSS level was related duration of one-leg standing balance in patients with MS. All assessed lower extremity isometric muscle strength (except ankle dorsal flexor) was related with EDSS. CONCLUSIONS: Hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor isometric muscle strength decreases in ambulatory MS patients. Lower extremity muscle weakness and neurological disability level are related with imbalance in MS population. Hip and knee region muscles weakness increases the neurological disability level. For the better balance and decrease neurological disability level whole lower extremity muscle strengthening should be included in rehabilitation programs.


Assuntos
Contração Isométrica/fisiologia , Extremidade Inferior/fisiopatologia , Esclerose Múltipla/fisiopatologia , Força Muscular/fisiologia , Equilíbrio Postural/fisiologia , Adulto , Feminino , Humanos , Masculino
10.
NeuroRehabilitation ; 33(3): 431-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23949074

RESUMO

BACKGROUND: Multiple Sclerosis (MS) patients are often referred to aquatic physical therapy, but unfortunately, researches on the effects of aquatic therapy in MS patients are limited. OBJECTIVE: The purpose of this study was to investigate the effects of Ai-Chi on balance, functional mobility, strength and fatigue in ambulatory patients with MS. METHODS: Twenty-three ambulatory female patients were divided into two groups as experimental (n = 15) or control (n = 8) for an 8-week treatment program. The experimental group underwent Ai-Chi exercises in a swimming pool and the control group performed active arm and leg exercises combined with abdominal breathing exercises at home. Static standing balance was measured with duration of one-leg stance, functional mobility was evaluated with Timed-up and Go test and 6 minute walk test, upper and lower muscle strength was assessed with hand-held dynamometer and fatigue was evaluated with Fatigue Severity Scale. RESULTS: Improvements were observed in static standing balance, functional mobility, upper and lower extremity muscle strength and fatigue in the Ai-Chi group (p < 0.05), but no significant differences in any outcome measures were observed in the control group (p > 0.05) after the intervention. CONCLUSIONS: According to these findings Ai-Chi may improve balance, functional mobility, upper and lower extremity muscle strength and fatigue in patients with MS.


Assuntos
Terapia por Exercício , Fadiga/reabilitação , Força Muscular/fisiologia , Equilíbrio Postural/fisiologia , Transtornos das Sensações/reabilitação , Adulto , Fadiga/etiologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Dinamômetro de Força Muscular , Projetos Piloto , Transtornos das Sensações/etiologia , Método Simples-Cego , Estatísticas não Paramétricas , Adulto Jovem
11.
Int J Neurosci ; 123(1): 31-7, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22916723

RESUMO

BACKGROUND: Although the immunopathogenesis of multiple sclerosis (MS) has been intensely investigated in recent years, some associated molecules still have not been examined. For instance, no study has been conducted to investigate a possible polymorphism in the fractalkine receptor gene. METHODS: In order to examine fractalkine gene receptor polymorphisms, 3 mL of serum from 92 MS patients and 91 controls were stored at -20°C. DNA was extracted from the serum samples that were purified, and the gene regions in CX3CR1 (i.e., the fractalkine regions) containing the T280M and V294I fractalkine receptor haplotypes were amplified via the polymerase chain reaction (PCR) technique. The obtained fragments were then cut using restriction enzymes, and agarose gel electrophoresis was performed. RESULTS: In a comparison of the patients and controls, we found that the median values of the Expanded Disability Status Scale (EDSS) scores among genotypes of the V294I polymorphism in the fractalkine gene receptor were statistically higher in genotype II than genotype VI. Also, relapsing/remitting MS (RRMS) was statistically higher in genotype VI than in genotype II, whereas the frequency of secondary progressive MS (SPMS) was statistically higher in genotype VV than in the genotype VI for the same polymorphism. CONCLUSIONS: Although many polymorphism studies have focused on patients with MS, there is no polymorphism study about the fractalkine receptor which is a chemokine and plays an important role in neuroinflammation and neurodegeneration. Our results provide information about disease progression and may also be beneficial in developing new strategies for the treatment of the disease.


Assuntos
Quimiocina CX3CL1/genética , Predisposição Genética para Doença/genética , Esclerose Múltipla/genética , Polimorfismo de Nucleotídeo Único/genética , Adolescente , Adulto , Idade de Início , Análise de Variância , Análise Mutacional de DNA , Avaliação da Deficiência , Feminino , Genótipo , Humanos , Isoleucina/genética , Masculino , Metionina/genética , Pessoa de Meia-Idade , Estatísticas não Paramétricas , Treonina/genética , Valina/genética , Adulto Jovem
12.
Neuro Endocrinol Lett ; 34(7): 643-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24463994

RESUMO

OBJECTIVES: Metabolic disease affect all systems in the body, including the peripheral nervous system, but there is a controversy as whether to consider hyperlipidemia is a cause of peripheral neuropathy. The aim of the present study was to evaluate whether hyperlipidemic subjects with no clinical symptom or sign of peripheral neuropathy showed nerve conduction abnormalities or subclinical peripheral neuropathy according to the universally accepted electrophysiological criteria. METHODS: The study group consisted from 29 female and 16 male patients (mean age: 47±7) while the control group consisted from 22 female and 10 male healthy volunteer subjects with a mean age of (43±9). All participants underwent an electrographic study in the classical manner described in the literature. Median and ulnar nerves in one upper, peroneal posterior tibial and sural nerves were studied in both lower extremities. RESULTS: Median nerve 2nd digit-wrist segment sensory nerve conduction velocity were slow and sensory nerve action potential amplitude (SNAP) were low relative to controls. Sural nerve sensory nerve conduction velocity in the lower extremities were low relative to controls. DISCUSSION: In this study the hyperlipemic group consisted from subjects with a relatively young age and with not very high serum lipid levels. Finding abnormal nerve conduction in distal sensory nerves in both upper and lower extremities in these hyperlipidemic patients made us think that; aging or uncontrolled hyperlipidemia may make these subjects susceptible to generalized peripheral neuropathy in the future. CONCLUSION: Hyperlipidemia may affect nerve conduction in peripheral nerves and precede peripheral neuropathy.


Assuntos
Hiperlipidemias/fisiopatologia , Condução Nervosa/fisiologia , Doenças do Sistema Nervoso Periférico/fisiopatologia , Células Receptoras Sensoriais/fisiologia , Potenciais de Ação/fisiologia , Adulto , Eletrofisiologia , Feminino , Humanos , Hiperlipidemias/complicações , Masculino , Nervo Mediano/fisiologia , Pessoa de Meia-Idade , Doenças do Sistema Nervoso Periférico/complicações , Nervo Fibular/fisiologia , Nervo Sural/fisiologia , Nervo Ulnar/fisiologia
13.
Case Rep Med ; 2013: 290719, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24454396

RESUMO

The restless legs syndrome (RLS) is a common central nervous system disorder. It is characterized by complaints of unpleasant sensation in the legs occurring during periods of leg inactivity which worsen or only occur in the evening or at night and relieved partially or totally by movement. The RLS may be idiopathic or due to secondary causes. It is associated with several pathological or physiological conditions. Iron metabolism and dysfunctions of the dopaminergic system are the most important factors in the pathophysiology. There are several studies suggesting multiple sclerosis as one of the causes of symptomatic RLS. Here, we report a case of RLS as the initial presentation of MS. The sudden onset of RLS symptoms in our patient suggested the possibility of an underlying cause. His diagnostic evaluation excluded other causes of RLS and his clinical course suggested that RLS was due to MS. MS with the spinal cord involvement is mostly associated with RLS, but any lesion in the hypothalamic-spinal connection may cause disinhibition of lower spinal levels, resulting in RLS. RLS as the initial presentation of MS reflects that the pathophysiology of RLS in MS is related to inflammatory demyelination rather than axonal degeneration.

14.
NeuroRehabilitation ; 30(4): 369-74, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22672953

RESUMO

The purpose of this study was to investigate the relationships between the upper extremity functions, upper extremity strength and hand sensation in patients with Multiple Sclerosis (MS). Twenty-two patients with MS (mean age: 38.5 ± 8.31 years, median Expanded Disability Status Scale (EDSS): 2) and 10 healthy subjects were included. Upper extremity function was measured with the Nine-hole peg test, upper extremity strength (shoulder flexion-abduction, elbow flexion, pinch and grip) with hand-held dynamometer, hand grip dynamometer and manual pinch meter, threshold of light touch-pressure with Semmes-Weinstein monofilament, duration of vibration with 128-Hz frequency tuning fork, and distance of two-point discrimination with an aesthesiometer. Strength and functional level of the upper extremity, light touch-pressure, two-point discrimination, vibration sensations of the hand were lower in patients with MS compared with healthy controls (p < 0.05). Light touch-pressure sensation of thumb and index fingers, two-point discrimination of index finger and elbow flexion strength were found to be related with upper extremity function in patients with MS (p< 0.05). These results indicate that the hand sensation, upper extremity strength and function were affected in MS patients. Additionally upper extremity functions seem to be related with light touch-pressure and two-point discrimination sensations of the hand and elbow flexion strength. Upper extremity strengthening and sensorial training of the hand may contribute to the upper extremity function in patients with MS.


Assuntos
Força da Mão/fisiologia , Mãos/inervação , Esclerose Múltipla/patologia , Esclerose Múltipla/fisiopatologia , Sensação/fisiologia , Extremidade Superior/fisiopatologia , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tato/fisiologia , Vibração , Adulto Jovem
15.
J Rehabil Med ; 44(1): 80-6, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22234321

RESUMO

OBJECTIVE: To compare functional exercise capacity, pulmonary function and respiratory muscle strength in fully ambulatory patients with multiple sclerosis with different disability levels and healthy controls, and to elucidate the determinant factors of functional exercise capacity. METHODS: Forty-three fully ambulatory patients with multiple sclerosis and 30 healthy controls were included in the study. Patients were grouped according to Expanded Disability Status Scale (EDSS); Group I (EDSS 0-2), Group II (EDSS 2.5-4.5). Functional exercise capacity was evaluated using a six-minute walk test, and measurement of pulmonary function, and maximal inspiratory and expiratory pressures (MIP, MEP). The Pulmonary Index was used as a clinical predictor of respiratory dysfunction. RESULTS: Respiratory muscle strength was lower in multiple sclerosis groups compared with controls, but the difference in MIP and %MIP did not reach statistical significance in Group I. The six-minute walk test distance was significantly shorter and peak expiratory flow was lower in multiple sclerosis groups (p < 0.05). Of the variance in the six-minute walk test distance, 75% was explained by EDSS (R2 = 0.55, p < 0.001), difference in heart rate (R2 = 0.06, p = 0.007), age (R2 = 0.05, p = 0.009) and gender (R2 = 0.09, p = 0.003). CONCLUSION: Respiratory muscles are weakened, functional exercise capacity is reduced and pulmonary function is affected even in the early phase of multiple sclerosis. Ambulatory patients with multiple sclerosis who have a higher level of disability have lower pulmonary function, respiratory muscle strength and functional capacity than less disabled ones and controls. Neurological disability level, age, gender and heart rate difference on exertion are the determinants of functional exercise capacity.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Tolerância ao Exercício/fisiologia , Exercício/fisiologia , Esclerose Múltipla/fisiopatologia , Força Muscular/fisiologia , Músculos Respiratórios/fisiopatologia , Teste de Esforço , Feminino , Humanos , Masculino , Esclerose Múltipla/reabilitação , Testes de Função Respiratória
16.
Gait Posture ; 34(2): 275-8, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21683600

RESUMO

The aims of the present study were to investigate the relationship between the foot sensations and standing balance in patients with Multiple Sclerosis (MS) and find out the sensation, which best predicts balance. Twenty-seven patients with MS (Expanded Disability Status Scale 1-3.5) and 10 healthy volunteers were included. Threshold of light touch-pressure, duration of vibration, and distance of two-point discrimination of the foot sole were assessed. Duration of static one-leg standing balance was measured. Light touch-pressure, vibration, two-point discrimination sensations of the foot sole, and duration of one-leg standing balance were decreased in patients with MS compared with controls (p<0.05). Sensation of the foot sole was related with duration of one-leg standing balance in patients with MS. In the multiple regression analysis conducted in the 27 MS patients, 47.6% of the variance in the duration of one-leg standing balance was explained by two-point discrimination sensation of the heel (R(2)=0.359, p=0.001) and vibration sensation of the first metatarsal head (R(2)=0.118, p=0.029). As the cutaneous receptors sensitivity decreases in the foot sole the standing balance impairs in patients with MS. Two-point discrimination sensation of the heel and vibration sensation of the first metatarsal head region are the best predictors of the static standing balance in patients with MS. Other factors which could be possible to predict balance and effects of sensorial training of foot on balance should be investigated.


Assuntos
Pé/inervação , Esclerose Múltipla Recidivante-Remitente/fisiopatologia , Equilíbrio Postural/fisiologia , Sensação/fisiologia , Adulto , Feminino , Humanos , Masculino , Limiar Sensorial , Tato , Vibração
17.
Neurol Sci ; 29(6): 435-44, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19002651

RESUMO

OBJECTIVE: This study investigated the presence of sub-clinical cognitive dysfunction in patients with clinically isolated syndrome (CIS) and the abnormalities of cognitive event-related potentials (ERPs). METHODS: Subclinical cognitive dysfunction was assessed in 20 patients with CIS and in 20 healthy controls. RESULTS: Patients had impairments in verbal learning and long-term memory, evaluating attention, executive function and visuospatial skills, in decreasing order of frequency. SDLT and SIT were the most, and COWAT and BNT were the least affected tests. The N200 and P200 latencies were prolonged, and N100, N200 and P200 amplitudes were reduced in the patients relative to the controls, from the Fz, Cz and Pz electrode positions (p<0.05). CONCLUSION: Detailed cognitive testing is valuable in determining subclinical cognitive dysfunction in CIS patients. ERP abnormalities as well as abnormalities in detailed cognitivetesting in patients with CIS are helpful in the diagnosis of sub-clinical cognitive dysfunction.


Assuntos
Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/fisiopatologia , Eletroencefalografia/métodos , Potenciais Evocados/fisiologia , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/fisiopatologia , Adulto , Córtex Cerebral/fisiopatologia , Transtornos Cognitivos/etiologia , Avaliação da Deficiência , Progressão da Doença , Feminino , Humanos , /fisiopatologia , Masculino , Transtornos da Memória/diagnóstico , Transtornos da Memória/fisiopatologia , Esclerose Múltipla/complicações , Testes Neuropsicológicos , Valor Preditivo dos Testes , Tempo de Reação/fisiologia , Adulto Jovem
18.
Addict Behav ; 32(7): 1470-3, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17081702

RESUMO

In order to evaluate the effect of alcohol consumption and the effect of abstinence on central nervous system generated parameters, we performed pattern visual evoked potential (PVEP) recordings on chronic alcoholics. The study was conducted on forty patients diagnosed as chronic alcoholics according to DSM IV criteria. They were aged mean: 42, and had histories of alcohol abuse for at least six years (mean: 21). 15% of the patients demonstrated abnormal VEP results at least in one tested eye. In order to test the effect of abstinence period on P100 latency values, alcoholics were divided in to two subgroups. Group I (Gr I) consisted twenty-four alcoholics who had been abstinent for less than thirty days (mean: 14), and Group II (Gr II) consisted sixteen alcoholics who had been abstinent for more than thirty and less than seventy-six days (mean: 38) The mean P100 latency of Gr I and Gr II was 101 and 102 milliseconds (ms) respectively; and when compared to normal controls the difference was statistically significant (p: 0.016, p: 0.009). Abnormal VEP in asymptomatic chronic alcoholics suggests that they may be useful in the detection of early changes and in following the progress of patients with the disorder.


Assuntos
Alcoolismo/diagnóstico , Potenciais Evocados Visuais/fisiologia , Adulto , Doença Crônica , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino
19.
J Headache Pain ; 7(2): 75-82, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16538424

RESUMO

This study was planned to investigate the economic impact of headache on Turkish headache sufferers attending a tertiary care outpatient headache clinic.A total of 937 headache patients were included in this study and questioned using a questionnaire for the profile of patients and headache, quality of life of patients and economic impact of headache. The median total direct cost was found to be 88.0 USD and the median total cost was 160.7 USD. The drug treatment cost was the highest item followed by the specialist outpatient care cost. The average lost and inefficient work/school days was 1.5 (0-45) and 8.4 (0-100) days for one year. It was shown that loss of productivity was higher for migraine without aura group when compared with the episodic and chronic tension-type headache groups. The results of this nationwide university hospital based study methshowed that headache, especially migraine, has considerable economic impact on patients.


Assuntos
Efeitos Psicossociais da Doença , Transtornos da Cefaleia Primários/economia , Transtornos da Cefaleia Primários/epidemiologia , Hospitais Universitários , Adolescente , Adulto , Pesquisa Biomédica/economia , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Turquia/epidemiologia
20.
J Neuroimmunol ; 171(1-2): 184-8, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16325275

RESUMO

The certain etiology migraine is unknown. The study was aimed at determining to the efficiency of cytokines, chemokines and nitric oxide (NO) to the pathophysiology of migraine. The levels of cytokines, chemokines and NO in serum of 25 patients with migraine during attacks and attack-free periods and 25 healthy controls were investigated. The levels of cytokines and chemokines were determined by enzyme-linked immunosorbent assay. NO concentrations were determined by a nitrate/nitrite colorimetric assay kit. In attack groups, IL-10 levels were found higher than in attack-free groups and healthy controls (p<0.05). IL-6 levels in migraine patients were significantly higher than in healthy controls. The levels of RANTES were high in attacks groups. There was an increase NO concentrations in migraine attacks. The study's results reflect that the etiology of migraine is multifactorial and probably related to immunological changes.


Assuntos
Quimiocinas/sangue , Citocinas/sangue , Transtornos de Enxaqueca/sangue , Transtornos de Enxaqueca/fisiopatologia , Óxido Nítrico/sangue , Adulto , Análise de Variância , Estudos de Casos e Controles , Quimiocina CCL5/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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