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    Evaluation of knee proprioception and effects of proprioception exercise in patients with benign joint hypermobility syndrome
    (SPRINGER HEIDELBERG, 2008) Sahin, Nilay; Baskent, Akin; Cakmak, Aysegul; Salli, Ali; Ugurlu, Hatice; Berker, Ender
    The first aim is to show if there is a disorder in proprioception in cases with benign joint hypermobility syndrome (BJHS) when compared to healthy subjects. The second aim is to evaluate the effect of proprioception exercise in BJHS cases. To evaluate the proprioceptive sensibility of the knee joint with 40 BJHS and 30 healthy subjects enrolled in the study. Then, cases with BJHS were randomized into two groups; proprioceptive exercises were applied to 15 patients for 8 weeks in clinic and 25 patients were taken as controls. Outcome measures included proprioceptive sensation, AIMS2 and VAS. Proprioception is significantly impaired in cases with BJHS. In BJHS group, significant decreases in VAS levels were detected in cases who did exercise compared with cases who did not, and statistically significant improvements were detected in occupational activity. For this reason proprioception exercises cause decrease in pain and improvement of functional status in BJHS group.
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    Evaluation of Sympathetic Response in Cases With Failed Back Surgery Syndrome
    (2009) Şahin, Nilay; Müslümanoğlu, Lütfiye; Karataş, Ömer; Çakmak, Ayşegül; Özcan, Emel; Berker, Ender
    Objectives: The aim of this study was to investigate whether sympathetic skin response (SSR) was affected in cases with failed back surgery syndrome (FBSS). Methods: Twenty-nine cases admitted to our department and diagnosed as FBSS were recruited for the study. All the cases had back, leg or back and leg pain in the months or in one year following spinal surgery. The control group consisted of 13 healthy hospital personnel. Electrophysiologic nerve conduction studies and SSR recordings were applied on the symptomatic side (29 legs) in study cases and both sides (26 legs) in the control group. SSRs of the study group were compared with those of the sex-, body mass index- and age-matched control group of 13 people. Patients having peripheral nerve entrapment syndromes, peripheral vascular disease, neurologic or psychiatric disease, alcoholism, or drug abuse were excluded from the study. Pain intensity was recorded by visual analog scale (VAS) and depression was recorded by Beck Depression Inventory (BDI). Results: Latency duration in SSR in the study group was significantly higher (p=0.006) when compared with the healthy controls. There was no SSR in 4 patients and there was a positive correlation between BDI and SSR (r=0.46). Conclusion: It was concluded that the sympathetic nervous system is affected in FBSS patients with changes in SSR, and that the dysfunction of the sympathetic nervous system may contribute to the intensity and chronicity of pain states in this group of patients.
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    Isokinetic evaluation of knee extensor/flexor muscle strength in patients with hypermobility syndrome
    (SPRINGER, 2008) Sahin, Nilay; Baskent, Akin; Ugurlu, Hatice; Berker, Ender
    Benign joint hypermobility syndrome (BJHS) is a syndrome with musculoskeletal pain originating from the increased laxity of the joints and the ligaments. The study was to compare the isokinetic strength of knee extensor/flexor muscles of BJHS patients with healthy controls. Forty patients diagnosed as having BJHS with Brighton criteria and 45 years of age, height and weight-matched healthy controls were recruited for the study. Isokinetic testing was performed with isokinetic dynamometry of Biodex System 3Pro and measurements were recorded at knee extension/flexion pattern concentrically at 60, 180, and 240/s angular velocities. The study group was also evaluated for functional impairment and pain by HAQ and VAS respectively. Knee extensor muscle strength was significantly lower in the patient group compared with the controls. It was hypothesized that the muscle weakness in the study group was related to lengthening of the quadriceps muscle and pain-related inactivity as well as joint instability and proprioception defect.
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    Servikal Miyofasyal Ağrı Sendromlu Hastalarda Demografik Özellikler, Klinik Bulgular ve Fonksiyonel Durum
    (2008) Şahin, Nilay; Karataş, Ömer; Özkaya, Murat; Çakmak, Ayşegül; Berker, Ender
    Servikal bölgede miyofasyal ağrısı bulunan kişiler çeşitli klinik bulgularla karşımıza çıkabilirler. Bu çalışmanın amacı servikal miyofasyal ağrı sendromlu hastalarda demografik özellikler, klinik bulgular ve fonksiyonel durumu incelemektir. Kliniğimize başvuran 94 servikal miyofasyal ağrı sendromlu hasta değerlendirmeye alındı. Hastalarda kısa form-36 yaşam kalitesi (SF-36), ağrı, depresyon, demografik ve fiziksel özellikler değerlendirildi. Son durum ölçütleri; SF-36 yaşam kalitesi, görsel analog skala, Beck Depresyon İndeksi, anamnez ve fizik muayeneydi. Toplamda servikal miyofasyal sendrom tanısı almış 82 hasta çalışmaya dahil edildi. Hastaların hepsi genç olup yaş ortalamaları 37.49 ve %87.8’ I kadın idi. Hastaların %53.1’ i otonomik fenomen benzeri deri kızarıklığı, lakrimasyon ve vertigo ile birlikte trapezius kasında tetik noktaya sahipti. %58.5’ u önceden geçirilmiş servikal travmaya, %40.2’ si Fibromiyalji sendromuna ve %18.5’ u Benign eklem hipermobilite sendromuna sahipti. Otonomik fenomenler ve erken başlangıçlı servikal yaralanması bulunan genç, bayan hastalar servikal miyofasyal ağrı sendromu ve bu hastalarda da Fibromiyalji sendromu oranı yüksek olduğu için Fibromiyalji sendromu açısından değerlendirilmelidirler.