The factors that may cause poststroke depression were investigated in the literature focusing on lesion localization, age, stroke severity, and impairments in physical and cognitive function. The aim of this study was to examine the risk factors influencing the development of poststroke depression and to determine the effect of depression on the patients' functional improvement after rehabilitation. Patients in the first 6-month period after stroke who were hospitalized in the Physical Medicine and Rehabilitation Clinic were included in this study. Patients who were admitted to the hospital within 0-30 and 30-120 days from the date of stroke were considered early and late rehabilitation entrants, respectively. The sample of this study included 93 patients. Patients' demographic and clinical characteristics, complications, and medical history were recorded. Upper extremity motor function, ambulation, and mood were evaluated according to the Frenchay Arm Test, the Functional Ambulation Scale, and the Beck Depression Inventory, respectively. The Functional Independence Measure (FIM) was applied to patients at admission to the hospital, at discharge, and 1 month after discharge (follow-up). The mean age of the patients was 58 years and the mean disease duration was 53 days. Depression was diagnosed in 49 (53%) patients. Except for age and disease duration, none of the factors of sex, hemiplegic side, stroke severity, stroke etiology, neglect, spasticity, sedentary lifestyle, poststroke immobility, and early-onset or late-onset to rehabilitation was found to induce statistically significant differences in the development of depression. Statistically significant changes occurred in total FIM levels between the groups with and without depression between admission and discharge, admission and follow-up, and discharge and follow-up. The levels were significantly higher in patients without depression than in patients with depression. Depression was found in a high frequency in stroke patients. Younger age and long disease duration were found to be factors affecting the development of depression. FIM scores were observed to be lower in stroke patients with depression.

Objective: To evaluate the effects of intrathecal baclofen therapy (ITB) in patients with severe spasticity. Material and Methods: Patients who had a baclofen pump implanted between 2004-2012 were included in the study. The inclusion criteria were severe spasticity with nonresponse to medical oral therapy and physiotherapy, modified Ashworth scale (MAS) score 3-4, and Penn's spasm scale (PSS) score 3-4. The ITB assessment criteria were MAS, PSS, visual analog scale (VAS), functional independence measurement (FIM), and short form-36 (SF-36) Tests were given before ITB and 3 months after implantation. Results: Twenty-one patients were given the test dose, and the ITB pump was implanted for 16. There were 11 men (68.75%) and 5 women (31.25%). Mean age was 33±10.34, ranging between 12-53 years. Eleven (68.75%) had spinal cord injury, 2 (12.50%) had multiple sclerosis, 2 (12.50%) had cerebral palsy, and 1 (6.25%) had a hypoxic brain. Eleven (68.75%) of these patients were paraplegic, 4 were (25%) tetraplegic, and 1 had (6.25%) dystonic cerebral palsy. Mean follow-up was 52.25±33.10 months, ranging between 3-100 months. Daily baclofen dose was between 70-475 µg (average 220±110.58 µg). Modified Ashworth scale decreased from 3.43±0.53 to 1.00±0.73 (p=0.00); PSS decreased from 3.50±1.03 to 1.12±1.02 (p=0.001); global pain decreased from 44.37±36.14 to 18.75±19.95, (p=0.003

Amaç: Elektrofizyoloji laboratuarımızda karpal tünel sendromu (KTS) tespit edilen olguların tedavisinde B vitamini ile tendon ve sinir germe egzersizlerinin (TSGE) klinik ve elektrofizyolojik parametreler üzerine etkisi incelendi.Yöntemler: Elektrofizyoloji laboratuarımızda KTS tanısı alan ve B vitaminisplint (Grup 1) ile TSGE-splint tedavisi uygulanan (Grup 2) olgularda tedavilerin etkinliği 3 ayın sonunda fonksiyonel durum skalası (FDS), semptom şiddet skalası (SŞS), görsel değerlendirme skalası (VAS) ve elektromiyografi (EMG) ile istatistiksel olarak değerlendirildi. Bulgular Sonuç:Karpal tünel sendromu tedavisinde kullanılan B vitamini ve germe egzersizlerinin etkinliği değerlendirildiğinde olguların şikayetlerinde azalma ve klinik değerlendirmelerinde bunun göstergesi olan VAS, FDS ve SŞS' da anlamlıyken, EMG'de düzelme görülmekle birlikte istatistiksel olarak anlamlı değildi. Uygulanan bu tedavi yöntemleri özellikle duysal semptomların ön planda olduğu KTS tedavisinde kullanılabilir.Anahtar Kelimeler: Karpal tünel sendromu, görsel değerlendirme skalası, semptom şiddet skalası, B vitamini, tendon-sinir germe egzersizleri Objective: In our electrophysiology laboratory, in the cases diagnosed with carpal tunnel syndrome (CTS), the effects of vitamin B and the tendon and nerve stretching exercises (TNSE) on clinical and electrophysiological parameters were analyzed. Methods:In our electrophysiology laboratory, in the cases which were diagnosed with CTS and vitamin B-splint (Group 1) with TNSE-splint treatment (Group 2) was practiced the efficiency of the treatment was evaluated statistically with the functional situation scale (FSS) at the end of three months period, the symptom severity scale (SSS), the visual analog scale (VAS) and electromyography EMG. Results:Of the 45 cases between the ages of 29-66 years (average: 47.86±9.74), 32 were diagnosed with bilateral, and 13 were diagnosed with unilateral CTS (n=77 hand). In the EMG 52 sensory (S), 25 sensory and motor (S+M) effectswere determined. In Group 1, there were 23 S, 13 S+M, in Group 2 there were 29 S, 12 S+M effects. After the treatment 11 cases were electrophysiologically normal, there was S in 41, and S+M in 25. Between Group 1 and Group 2, before and after the treatment, a meaningful relationship was not t observed. However, when the effects of EMG on the values of the FSS, SSS and VAS were analyzed, a meaningful improvement was observed in the measurements of FSS and VAS (p<0.05) whereas this was not observed in the measurements of SSS (p>0.05). Conclusion:When the efficiency of vitamin B and the stretching exercises which were used in the carpal tunnel syndrome were analyzed, a decrease in the complaints of the cases and in VAS, FSS and SSS as indicators of the clinical evaluations of it was meaningful whereas in the EMG, although an improvement was seen, this was not statistically meaningful. This treatment method can be used especially in CTS treatment where sensory symptoms are at the forefront.Key Words: Carpal tunnel syndrome, the visual an...

Postpartum spinal osteoporosis (PPSO) is a rare form of osteoporosis related to pregnancy. It generally appears within the last trimester of pregnancy or postpartum period of the first child. The most common symptoms are low back pain, dorsalgia, loss of height due to vertebral compression fractures and kyphosis. Herein we aimed to draw attention to a case with PPSO, presenting with low back pain and vertebral fracures after postpartum period of the first child. While PPSO is an uncommon and rare disease, it should be considered in differential diagnosis of low back pain because of it's great impact on the physical and psychological health and on the quality of life of pregnant and lactating women and possible negative influence to the development of a normal relationship between mother and child. (Turkish Journal of Osteoporosis 2014;20: 26-8) Postpartum spinal osteoporoz (PPSO) gebelikle ilişkili nadir görülen bir osteoporoz tablosudur. Genellikle ilk gebeliğin son üç aylık döneminde veya puerperal dönemde görülen bel, sırt ağrısı, vertebral kompresyon kırıklarına bağlı boyda kısalma ve kifoz semptomları ile karakterizedir. Burada ilk gebeliğinden sonraki postpartum dönemde bel ağrısı ve vertebralarda kompresyon kırıkları olan bir olguyla PPSO tablosuna dikkat çekmeyi amaçladık. Gebelikle ilişkili PPSO, bel ağrısının sıra dışı, ender bir nedeni olmakla birlikte laktasyon dönemindeki kadının fiziksel ve psikolojik sağlığı ve yaşam kalitesi üzerindeki büyük etkisi, anne-bebek arasındaki ilişkinin gelişimi üzerine olası olumsuz etkileri nedeniyle ayrıcı tanıda göz önünde bulundurulmalıdır. (Türk Osteoporoz Dergisi 2014;20: 26-8) Anah tar ke li me ler: Gebelik, osteoporoz, bel ağrısı