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1.
J Stroke Cerebrovasc Dis ; 28(12): 104372, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31562041

RESUMO

AIM: Systemic lupus erythematosus (SLE) is an unusual risk factor for cerebral venous sinus thrombosis (CVST). As few CVST patients with SLE have been reported, little is known regarding its frequency as an underlying etiology, clinical characteristics, or long-term outcome. We evaluated a large cohort of CVST patients with SLE in a multicenter study of cerebral venous thrombosis, the VENOST study, and their clinical characteristics. MATERIAL AND METHOD: Among the 1144 CVST patients in the VENOST cohort, patients diagnosed with SLE were studied. Their demographic and clinical characteristics, etiological risk factors, venous involvement status, and outcomes were recorded. RESULTS: In total, 15 (1.31%) of 1144 CVST patients had SLE. The mean age of these patients was 39.9 ± 12.1 years and 13 (86.7%) were female. Presenting symptoms included headache (73.3%), visual field defects (40.0%), and altered consciousness (26.7%). The main sinuses involved were the transverse (60.0%), sagittal (40.0%), and sigmoid (20.0%) sinuses. Parenchymal involvement was not seen in 73.3% of the patients. On the modified Rankin scale, 92.9% of the patients scored 0-1 at the 1-month follow-up and 90.9% scored 0-1 at the 1-year follow-up. CONCLUSIONS: SLE was found in 1.31% of the CVST patients, most frequently in young women. Headache was the most common symptom and the CVST onset was chronic in the majority of cases. The patient outcomes were favorable. CVST should be suspected in SLE patients, even in those with isolated chronic headache symptoms with or without other neurological findings.


Assuntos
Lúpus Eritematoso Sistêmico/epidemiologia , Trombose dos Seios Intracranianos/epidemiologia , Adulto , Distribuição por Idade , Transtornos da Consciência/diagnóstico , Transtornos da Consciência/epidemiologia , Feminino , Transtornos da Cefaleia/diagnóstico , Transtornos da Cefaleia/epidemiologia , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Trombose dos Seios Intracranianos/diagnóstico , Fatores de Tempo , Turquia/epidemiologia , Transtornos da Visão/diagnóstico , Transtornos da Visão/epidemiologia
2.
J Neuroophthalmol ; 39(3): 324-329, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31430269

RESUMO

BACKGROUND: This study aimed to identify the reversibility of MRI findings indicative of increased intracranial hypertension in idiopathic intracranial hypertension (IIH) patients after treatment. METHODS: This retrospective, observational study included demographic and clinical data from 10 patients with IIH and 10 controls. Brain MRI findings in IIH patients were recorded twice: once when patients had papilledema and again after resolution of papilledema. Neuroradiologists graded MRI findings in both groups based on an imaging grading scale. RESULTS: After resolution of papilledema, all patients showed improvement in 2 or more of the MRI characteristics of IIH. This was especially the case for the height of the midsagittal pituitary gland and optic nerve sheath thickness (ONST), which were significantly different in all pairwise group comparisons. Sellar configuration, globe configuration, and horizontal orbital optic nerve tortuosity were different between the IIH pre-treatment group and controls, but not between controls and the IIH post-treatment group. We found no difference in optic nerve head hyperintensity or optic nerve thickness among the 3 groups. CONCLUSIONS: We demonstrated that several morphometric MRI characteristics in IIH are reversible to a certain extent after treatment. Enlarged subarachnoid spaces filled with cerebrospinal fluid seem to remain reduced, and the ONST and height of the pituitary gland are not fully normalized after treatment.

3.
NeuroRehabilitation ; 44(1): 67-77, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30814369

RESUMO

BACKGROUND: Balance disorders cause disability in stroke and increase risk of falls. The Balance Evaluation Systems Test (BESTest), examines balance, determines parameters causing balance disorders, provides information on risk factors for falls. OBJECTIVE: To investigate the sensitivity and specificity of the BESTest in determining the risk of falls in stroke patients. METHODS: Fifty patients with chronic stroke were included in the study. Balance was assessed using BESTest, Berg Balance Scale (BBS), Activity Specific Balance Confidence scale (ABC) and Biodex-BioSway Balance System. To examine the content validity of BESTest, the relationship between BESTest and other balance assessment methods was examined. The internal consistency reliability of BESTest was evaluated by Cronbach's α coefficient. Analysis of receiver operating characteristics (ROC) was performed to determine cut-off point, sensitivity and specificity. RESULTS: BESTest, BBS, ABC and Biodex-BioSway Balance System results of faller stroke patients were worse than that of non-faller (p <0.05). Internal consistency of BESTest was found to be Cronbach's α = 0.960. The BESTest value of area under curve (AUC) was 0.844, with a cut-off point of 69.44%, a sensitivity of 75% and a specificity of 84.6% (p < 0.01). CONCLUSION: BESTest is reliable and valid with high sensitivity and specificity in determining the risk of fall in stroke patients.


Assuntos
Acidentes por Quedas/prevenção & controle , Avaliação da Deficiência , Equilíbrio Postural/fisiologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modalidades de Fisioterapia/normas , Psicometria , Curva ROC , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade
4.
Turk J Med Sci ; 49(1): 318-326, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30761855

RESUMO

Background/aim: Following stroke, damage to the central nervous system and adaptive changes in muscle tissue are factors responsible for the loss of muscle strength. Even though it is suggested that early physiotherapy and mobilization prevent structural adaptive changes in muscle tissue, studies regarding this issue are insufficient. The aim of this study is to investigate the effects of early physiotherapy and mobilization on quadriceps muscle thickness (QMT) in stroke patients. Materials and methods: Twelve stroke patients who were admitted to the neurology intensive care unit and 13 healthy controls were included in the study. QMT was examined at admission and discharge for each subject. Additionally, functional extremity movements, balance, and functional ambulation status were evaluated with the Stroke Rehabilitation Assessment of Movement Scale (STREAM). All of the patients were mobilized as early as possible by a physiotherapist and included in a treatment program consisting of the neurodevelopmental Bobath approach. Results: The patients' QMT values at admission and discharge were found to be similar to those of the healthy control group (P > 0.05). When the patients' QMT at the time of admission and discharge were compared, it was seen that the affected side and the nonaffected side were similar (P > 0.05). Additionally, when the admission and discharge results were compared, improvements in functional extremity movements, balance, and functional ambulation levels were observed (P < 0.05). Conclusion: It can be seen that QMT can be preserved and functional improvements can be provided through intense physiotherapy and mobilization initiated in the early period following stroke.


Assuntos
Músculo Quadríceps/diagnóstico por imagem , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso , Equilíbrio Postural/fisiologia , Músculo Quadríceps/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Ultrassonografia , Caminhada/fisiologia
5.
Rheumatology (Oxford) ; 58(4): 600-608, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29992235

RESUMO

OBJECTIVE: This study was performed to determine the rate of cerebral venous sinus thrombosis (CVST) among cases of Behçet's disease (BD) included in a multicentre study of cerebral venous sinus thrombosis (VENOST). METHODS: VENOST was a retrospective and prospective national multicentre observational study that included 1144 patients with CVST. The patients were classified according to aetiologic factors, time of CVST symptom onset, sinus involvement, treatment approach and prognosis. RESULTS: BD was shown to be a causative factor of CVST in 108 (9.4%) of 1144 patients. The mean age of patients in the BD group was 35.27 years and 68.5% were men, whereas in the non-BD CVST group, the mean age was 40.57 years and 28.3% were men (P < 0.001). Among the aetiologic factors for patients aged 18-36 years, BD was predominant for men, and puerperium was predominant for women. The onset of symptoms in the BD group was consistent with the subacute form. The transverse sinuses were the most common sites of thrombosis, followed by the superior sagittal sinuses. The most common symptom was headache (96.2%), followed by visual field defects (38%). CONCLUSIONS: BD was found in 9.4% of patients in our VENOST series. Patients with BD were younger and showed a male predominance. The functional outcome of CVST in patients with BD was good; only 12% of patients presenting with cranial nerve involvement and altered consciousness at the beginning had a poor outcome (modified Rankin Score ⩾2).


Assuntos
Síndrome de Behçet/complicações , Trombose dos Seios Intracranianos/etiologia , Adulto , Fatores Etários , Síndrome de Behçet/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Trombose dos Seios Intracranianos/patologia
6.
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
7.
J Pediatr Endocrinol Metab ; 31(3): 275-281, 2018 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-29373321

RESUMO

BACKGROUND: Obesity affects all major organ systems and leads to increased morbidity and mortality. Whole blood viscosity is an important independent regulator of cerebral blood flow. The aim of the present study was to evaluate the effect of whole blood viscosity on cerebral artery blood flow velocities using transcranial Doppler ultrasound in pediatric patients with obesity compared to healthy controls and analyze the effect of whole blood viscosity and blood pressure status to the cerebral artery blood flow velocities. METHODS: Sixty patients with obesity diagnosed according to their body mass index (BMI) percentiles aged 13-18 years old were prospectively enrolled. They were grouped as hypertensive or normotensive according to their ambulatory blood pressure monitoring. Whole blood viscosity and middle cerebral artery velocities by transcranial Doppler ultrasound were studied and compared to 20 healthy same aged controls. RESULTS: Whole blood viscosity values in hypertensive (0.0619±0.0077 poise) and normotensive (0.0607±0.0071 poise) groups were higher than controls (0.0616±0.0064 poise), with no significance. Middle cerebral artery blood flow velocities were higher in the obese hypertensive (73.9±15.0 cm/s) and obese normotensive groups (75.2±13.5 cm/s) than controls (66.4±11.5 cm/s), but with no statistical significance. CONCLUSIONS: Physiological changes in blood viscosity and changes in blood pressure did not seem to have any direct effect on cerebral blood flow velocities, the reason might be that the cerebral circulation is capable of adaptively modulating itself to changes to maintain a uniform cerebral blood flow.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Pressão Sanguínea/fisiologia , Viscosidade Sanguínea/fisiologia , Circulação Cerebrovascular/fisiologia , Hipertensão/fisiopatologia , Obesidade/fisiopatologia , Adolescente , Monitorização Ambulatorial da Pressão Arterial , Índice de Massa Corporal , Feminino , Humanos , Hipertensão/complicações , Resistência à Insulina , Lipídeos/sangue , Masculino , Artéria Cerebral Média , Obesidade/complicações , Ultrassonografia Doppler Transcraniana
8.
Turk J Med Sci ; 47(5): 1482-1491, 2017 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-29151320

RESUMO

Background/aim: The aim of the study was to investigate the effects of whole blood viscosity and plasma nitric oxide on cerebral and cardiovascular risks associated with chronic kidney disease. Materials and methods: The study group consisted of 40 pediatric patients and 21 healthy control subjects. Hematologic and biochemical variables, viscosity and plasma nitric oxide levels, echocardiographic findings, and middle cerebral artery blood flow velocity were examined. Results: Viscosity values of patients were significantly lower than those of the control group. Lower values of hematocrit, total protein, and albumin and higher values of ferritin in all patient groups resulted in significantly low viscosity levels. Plasma nitric oxide levels were higher in all patient groups than those in the controls. No statistically significant difference was present in middle cerebral artery blood flow velocity between the patient and control groups. Even when systolic functions were normal, the patient group had significant deterioration in diastolic functions, suggesting morbidity and mortality risks. Conclusions: Cerebral blood flow velocities were not affected by viscosity and nitric oxide levels, suggesting that cerebral circulation has the ability to make adaptive modulation. The metabolism of nitric oxide levels needs further investigation and studies in patients with chronic renal disease.

9.
Cardiovasc Intervent Radiol ; 40(9): 1338-1343, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28477214

RESUMO

PURPOSE: This study was designed to present our preliminary experience with the Roadsaver® double-layer micromesh (DLM) stent in the endovascular treatment of supra-aortic and visceral aneurysms and to utilize the flow-diverting effect of this new design in the treatment of these aneurysms. METHODS: DLM stent (Roadsaver®, Terumo, Tokyo, Japan) was used in five patients (median age 61.8 years; three men) for treating arterial aneurysms (one common carotid artery, one vertebral artery V1 segment, one superior mesenteric artery, and two renal artery aneurysms). RESULTS: All stents were successfully deployed. Follow-up imaging with conventional catheter angiography or computed tomography showed successful treatment of all aneurysms. CONCLUSIONS: The new DLM stent appears to be promising for the treatment of supra-aortic and visceral aneurysms.


Assuntos
Falso Aneurisma/terapia , Aneurisma/terapia , Procedimentos Endovasculares/instrumentação , Stents , Idoso , Artéria Carótida Primitiva , Desenho de Equipamento , Feminino , Humanos , Japão , Masculino , Artéria Mesentérica Superior , Pessoa de Meia-Idade , Artéria Renal , Fatores de Tempo , Tomografia Computadorizada por Raios X , Artéria Vertebral , Vísceras/irrigação sanguínea
10.
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.

12.
Pediatr Nephrol ; 31(3): 473-83, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26482254

RESUMO

BACKGROUND: Hypertension (HT) is a major comorbidity of obesity that is associated with an increased risk of cardiovascular disease and higher mortality. The aim of our study was to evaluate cardiac function in obese hypertensive (OHT) and obese normotensive (ONT) pediatric patients and determine the effects of plasma nitric oxide (NOx) values on cardiac function, while demonstrating the role of plasma NOx in HT in obese pediatric patients. METHODS: The study population consisted of 62 patients (27 boys, 35 girls), aged 13-18 years and 21 age-matched healthy controls. All subjects enrolled in the study underwent echocardiography (Echo) evaluation and ambulatory blood pressure monitoring for HT. Plasma NOx and biochemical values were studied in both patient groups separately. RESULTS: Plasma NOx levels were found to be lower in the OHT group than in the ONT and control groups (p < 0.001) and to be negatively correlated with left ventricular mass index values (p < 0.05). Both the OHT and ONT groups had concentric hypertrophy of the heart. CONCLUSIONS: Plasma NOx plays an essential role in obesity-induced HT. Concentric hypertrophy of the left ventricle was found in both the OHT and ONT groups, indicating structural deformation of the heart.


Assuntos
Hipertensão/sangue , Hipertrofia Ventricular Esquerda/etiologia , Óxido Nítrico/sangue , Obesidade Pediátrica/sangue , Função Ventricular Esquerda , Remodelação Ventricular , Adolescente , Biomarcadores/sangue , Monitorização Ambulatorial da Pressão Arterial , Estudos de Casos e Controles , Ecocardiografia Doppler , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Nitratos/sangue , Nitritos/sangue , Obesidade Pediátrica/complicações , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia
13.
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
14.
Neurosciences (Riyadh) ; 19(4): 322-5, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25274594

RESUMO

Congenital, infectious, toxic, and demyelinating disorders are common etiological causes of deafness. Tuberculous meningitis, as one of the infectious causes, should be considered in the differential diagnosis since tuberculosis represents an endemic public health problem in developing countries. Multiple cranial nerve palsies can be expected due to basal meningitis; however, presentation with bilateral hearing loss is quite rare. Early diagnosis and treatment are crucial to prevent mortality and residual neurologic deficits. The focus of this discussion is a 42-year-old female presenting with bilateral hearing loss and nonspecific complaints who was finally diagnosed with chronic tuberculous meningitis. We also demonstrate the characteristic radiological and histopathological findings.


Assuntos
Perda Auditiva Bilateral/etiologia , Perda Auditiva Neurossensorial/etiologia , Tuberculose Meníngea/complicações , Adulto , Antituberculosos/uso terapêutico , Implante Coclear , Diagnóstico Tardio , Quimioterapia Combinada , Reações Falso-Negativas , Feminino , Perda Auditiva Bilateral/cirurgia , Perda Auditiva Neurossensorial/cirurgia , Humanos , Imunocompetência , Imagem por Ressonância Magnética , Tuberculoma/diagnóstico , Tuberculoma/tratamento farmacológico , Tuberculose Meníngea/diagnóstico , Tuberculose Meníngea/tratamento farmacológico
16.
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.

17.
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
18.
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
19.
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
20.
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
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