Fizyoterapi ve Rehabilitasyon
https://hdl.handle.net/20.500.12511/232
2024-03-28T23:03:53ZFarmakolojik tedaviye ilaveten uygulanan tek seans ve tekrarlanan seanslı rTMS’ in Alzheimer Hastalığı’nda bilişsel fonksiyonlara uzun dönemde etkisi
https://hdl.handle.net/20.500.12511/9131
Farmakolojik tedaviye ilaveten uygulanan tek seans ve tekrarlanan seanslı rTMS’ in Alzheimer Hastalığı’nda bilişsel fonksiyonlara uzun dönemde etkisi
Şahin, Büşra; Özdamar Doğan, Feyza; Budak, Miray; Hanoğlu, Lütfü
Amaç: Alzheimer Hastalığı (AH), bilişsel fonksiyonlarda kademeli bir düşüşle karakterize nörodejeneratif ve ilerleyici bir hastalıktır. Farmakolojik
tedavi ve tekrarlı Transkranial Manyetik Stimülasyon (rTMS) AH’de önerilmektedir. Bu çalışmanın amacı, AH’de farmakolojik tedaviye ilaveten
tek/çoklu-kür rTMS tedavisinin hastalığın seyri, bilişsel fonksiyonlar, davranışsal durum, depresyon ve yaşam kalitesi üzerindeki uzun dönem
sonuçlarını incelemekti.
Gereç ve Yöntem: Çalışmaya 65 yaş ve üzeri 28 AH’li birey dahil edildi. Katılımcılar tek-kür rTMS grubu (n=8), çoklu-kür rTMS grubu (n=14) ve
kontrol grubu (n=6)’na ayrıldı. Farmakolojik tedaviye ilaveten, tek-kür (1 kez 10 seans) ve çoklu-kür (en az 2 kez 10 seans) 20 Hz rTMS Bilateral
Dorsolateral Prefrontal Korteks’e uygulandı. Kontrol grubu sadece farmakolojik tedavi aldı. Bilişsel fonksiyonlar Nöropsikiyatrik Test Bataryası,
davranışsal durum Nöropsikometrik Envanter (NPE), depresyon Geriatrik Depresyon Ölçeği (GDÖ), yaşam kalitesi Alzheimer Hastalığı Yaşam
Kalitesi Ölçeği ile tedavi öncesinde ve sonrasında değerlendirildi.
Bulgular: Ortalama 24 aylık takip sonrasında tüm gruplarda bilişsel kayıp izlendi. Sadece farmakolojik tedavi alan kontrol grubunda sözel bellek,
Mini Mental Durum Testi (MMDT) ve NPE’de istatistiksel olarak anlamlı kötüleşme bulundu (P < ,05). Tek-kür rTMS grubunda, görsel ve sözel
bellek, MMDT ve NPE’de istatistiksel olarak anlamlı kötüleşme izlendi (P < ,05). Çoklu-kür rTMS grubunda, yürütücü işlevler, sözel akıcılık, görsel
bellek ve NPE’de istatistiksel olarak anlamlı kötüleşme ile GDÖ’de istatistiksel olarak anlamlı iyileşme izlendi (P < ,05). Gruplar arası değerlendirmede sözel bellek, NPE ve GDÖ’de çoklu-kür rTMS grubu lehine istatistiksel olarak daha az bozulma şeklinde anlamlı fark bulundu (P < ,05). Sonuç: Sonuç olarak, uzun süreli takipte sadece çoklu-kür rTMS uygulaması duygu durumundaki iyileşmeden kaynaklı genel bilişsel duruma iyileşme şeklinde yansıyabilmektedir; Objective: Alzheimer’s Disease (AD) is characterized by a gradual decline in cognitive functions. Pharmacological treatment (PT) and repeated Transcranial Magnetic Stimulation (rTMS) are recommended for the treatment of AD. The aim of this study was to investigate the long-term results of single cure (1 time 10 sessions) and multi-cure(at least 2 times 10 sessions) in addition to PT on the course of the disease, cognition, behavior, mood and quality of life (QoL). Material and Methods: Twenty-eight patients with AD aged 65 years and older. Participants were divided into single-cure rTMS group (n=8), multi-cure rTMS group (n=14) and control group (n=6). In addition to PT, 20 Hz rTMS was applied on bilateral DLPFC as a single-cure and multicure. The control group received only PT. Neuropsychiatric Test Battery, Neuropsychometric Inventory (NPI), Geriatric Depression Scale (GDS), and AD-QoL Scale were used in the evaluations before and after treatment. Results: After a mean follow-up of 24 months, cognitive loss was observed in all groups. Significant worsening was found in verbal memory, MiniMental State Test (MMST) and NPE in the control group; were observed in visual and verbal memory, MMST, and NPI in the single-cure rTMS group; and were observed in executive functions, verbal fluency, visual memory and NPI in the multi-cure rTMS group (P < ,05). Significant improvement was found in GDS in the multi-cure rTMS group (P < ,05). There were significant difference in verbal memory, NPI and GDS in favor of the multicure rTMS group (P < ,05). Conclusion: In conclusion, in long-term follow-up, only multi-cure rTMS can reflect in the form of improvement in cognition due to improvement in mood.
2021-01-01T00:00:00ZClinical outcomes comparing two prosthetic knee designs in individuals with unilateral transfemoral amputation in Turkey
https://hdl.handle.net/20.500.12511/7684
Clinical outcomes comparing two prosthetic knee designs in individuals with unilateral transfemoral amputation in Turkey
Yazgan, Ayşe; Kutlutürk, Seval; Lechler, Knut
BACKGROUND: Clinical outcome assessments provide important input for the rehabilitation of individuals with transfemoral amputation. Differences in prosthetic knee designs may influence clinical outcomes. OBJECTIVE(S): The aim of this study was to compare functional mobility, balance, prosthetic satisfaction and quality of life in individuals with unilateral transfemoral amputation with microprocessor-controlled (MPK) and non-microprocessor knee designs (Non-MPK). METHODOLOGY: The study included ten experienced MPK (Rheo Knee) users (Group 1) and ten experienced Non-MPK (Total Knee® 2000) users (Group 2). For mobility; the 6 Minute Walk Test (6MWT), for balance; the Berg Balance Scale (BBS), Single Leg Stand Test (SLST) and Four Square Step Test (FSST), for quality of life; the Nottingham Health Profile (NHP) and for prosthetic satisfaction; the Satisfaction with Prosthesis Questionnaire (SATPRO) were administered. FINDINGS: 6MWT results of the MPK group were significantly higher than Non-MPK group (p <0.05). In the MPK group a strong negative correlation was found between the FSST and the 6MWT (r= -0.661, p=0.038). No statistically significant differences were found between the groups (p>0.05) comparing balance, prosthesis satisfaction and quality of life values. CONCLUSION: The findings will inform about the patient's prognosis and the expected clinical outcomes when prescribing an MPK or an Non-MPK. Individuals with unilateral transfemoral amputation covered longer distances using an MPK compared to Non-MPK.
2021-01-01T00:00:00Z