Person: KARADAĞ SAYGI, NAİME EVRİM
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KARADAĞ SAYGI
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NAİME EVRİM
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Publication Open Access Comparison of cutaneous silent period parameters in patients with primary sjogren's syndrome with the healthy population(2022-06-01) KARADAĞ SAYGI, NAİME EVRİM; GÜNDÜZ, OSMAN HAKAN; Yolcu G., Abacar K., Kenis-Coskun O., Inanc N., Karadag-Saygi E., Gunduz O. H.Background: Neurological involvement has a great importance in the clinical spectrum of primary Sjögren’s syndrome (pSS) (1). The presence of small fiber neuropathy (SFN), which cannot be detected in routine electrophysiological examinations, causes the peripheral nervous system involvement to be underestimated in the course of the disease and causes pain-related symptoms in patients that cannot be explained by routine examinations (2). Various methods can be used in the detection of SFN, and cutaneous silent period (CSP) measurement is gaining popularity recently due to its non-invasiveness and practical application (3). Objectives: Evaluating SFN involvement in patients with pSS using CSP and evaluating its relationship with clinical parameters. Methods: Patients with a diagnosis of pSS followed in the rheumatology outpatient clinic and healthy volunteers demographically homogeneous with the patient group were included in the study. The CSP responses were recorded over the abductor pollicis brevis muscle in the upper extremity of all participants. The latency and duration values of the responses were obtained. In patient group, EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), Hospital Anxiety and Depression Scale (HADS), Short Form-36 (SF-36) questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) and Central Sensitization Inventory (CSI) were applied for the evaluation of symptom severity, mood, quality of life, presence of neuropathic pain and central sensitization, respectively. Comparison of CSP parameters between patients with pSS and healthy volunteers was determined as the primary outcome measure. The secondary outcome measure was the relationship between CSP parameters and ESSPRI, HADS, SF-36, LANSS and CSI scores. Results: A total of 36 patients and 36 healthy controls were included in the final analyses. There was no significant difference between the two groups in terms of demographic data. The mean CSP latency was significantly longer in patients with a mean of 78.18 (±7.51) when compared to controls with a mean of 67.91 (±6.41) (95% CI: 6.98- 13.55, p<0.001). Mean CSP duration was also significantly shorter in patients with a mean of 33.40 (±6.93) (95% CI: 9.57 -15.31, p<0.001). There were no significant differences in CSP parameters (latency and duration, respectively) according to patients’ neuropathic pain or central sensitization profile (p>0.05 for all analyses). There were significant correlations of CSP parameters with ESSPRI dryness (r=0.469, p=0.004; r=-0.553, p<0.001), fatigue (r=0.42, p=0.011; r=-0.505, p=0.002), pain (r=0.428, p=0.009; r=-0.57, p<0.001) subscores and mean ESSPRI score (r=0.631, p<0.001; r=-0.749, p<0.001). Significant correlations were not found between CSP parameters and SF-36 scores, other than CSP duration and “pain” subscore (r=-0.395, p=0.017). When the other correlations were investigated there were no significant correlations other than CSP duration and the HADS anxiety score (r=-0.201, p=0.02). Conclusion: As an indicator of CSP measurement, SFN is more common in patients with pSS than in the healthy population. The association with important clinical symptoms of the disease course such as dryness, fatigue, pain and anxiety highlights the importance of detecting small fiber neuropathyPublication Metadata only Validity and Reliability of Quick Motor Function Test in Ambulatory Duchenne Muscular Dystrophy Patients(2022-12-06) KENİŞ COŞKUN, ÖZGE; KARADAĞ SAYGI, NAİME EVRİM; Imamoglu S., KENİŞ COŞKUN Ö., Deveci M., Ozturk G., Karadag-Saygi E.The quick motor function test (QMFT) is used to evaluate Pompe patients\" motor function. This study aims to evaluate the convergent validity and reliability of the cross-culturally adapted Turkish version of QMFT in patients with Duchenne muscular dystrophy (DMD). Twenty-eight patients diagnosed with DMD were included in the study. The QMFT was translated and adapted to Turkish. The functionality of the patients was assessed with the north star ambulatory assessment (NSAA) and the 6-minute walk test (6MWT); muscle strength was evaluated with a hand-held dynamometer. There were two separate practitioners on the first day of the QMFT study; it was applied a second time by the first practitioner 14 days later. The mean age of DMD patients was 9.03 +/- 3.39 (minimum 4-maximum 18. Twenty-seven patients concluded all the necessary assessments. Intrarater reliability of QMFT in patients with DMD was intraclass correlation coefficient (ICC) = 0.98, and interrater reliability ICC = 0.98 was excellent. QMFT correlated very well with 6MWT ( r (s) = 0.86; p < 0.001) and NSAA ( r (s) = 0.91; p < 0.001). Both the QMFT and NSAA show stronger correlations with proximal muscle groups (convergent validity) than with distal muscle groups (divergent validity). QMFT is a reliable and valid test for evaluating motor function in patients with DMD.Publication Open Access The effect of telerehabilitation on quality of life, anxiety, and depression in children with cystic fibrosis and caregivers: A single-blind randomized trial(2022-05-01) KENİŞ COŞKUN, ÖZGE; KARADAĞ SAYGI, NAİME EVRİM; KENİŞ COŞKUN Ö., Aksoy A. N., Kumas E. N., Yilmaz A., Guven E., Ayaz H. H., Sozer T., ERGENEKON A. P., Karadag-Saygi E.Background Postural and aerobic exercises are essential in rehabilitation in cystic fibrosis (CF). The aim of this study is to examine the effect of telerehabilitation on the quality of life, depression, and anxiety levels of children with CF and their caregivers\" mood and anxiety levels. Materials and Methods Patients between the ages of 6-13 with CF were randomized into two groups. Study group received an exercise program three times a week via Zoom for 12 weeks. Cystic Fibrosis Revised Questionnaire (CFQ-R), Anxiety and Depression Scale in Children-Revised (RCADS) were applied to the patients and State-Trait Anxiety Scale (STAI) and Beck Depression Inventory (BDI) were applied to the caregivers in the beginning and at the end of the program. Patients\" FEV1 levels and 6-min walk tests were also measured. Results Twenty-eight patient-caregiver dyads, 14 dyads in each group, completed the study. The initial mean RCADS-Major depressive disorder score of the patients in the exercise group was 6.21 +/- 3.11, and this value decreased to 3.92 +/- 3.79 at the end of the study and was significantly better (p < 0.02). A similar significant change was observed when the RCADS-generalized anxiety disorder score decreased from the initial mean level of 6.28 +/- 2.81 to 3.42 +/- 2.65 (p < 0.01). There were significant changes in improvement in the body image in telerehabilitation group. Similar significant changes were not observed in the control group. Caregivers\" anxiety and depression levels did not change significantly. Conclusion A short-term telerehabilitation program improved patients\" anxiety and depression levels, body image, and functional status. However, caregiver anxiety and depression levels did not change significantly.Publication Metadata only Small touches to big walks-the impact of rehabilitation on Sjögren-Larsson syndrome: A case report(2022-07-16) YOLCU, GÜNAY; KENİŞ COŞKUN, ÖZGE; KARADAĞ SAYGI, NAİME EVRİM; YOLCU G., Huseynli L., KENİŞ COŞKUN Ö., Karadag-Saygi E.© 2022-IOS Press. All rights reserved.Sjögren-Larsson syndrome (SLS) is a rare neurocutaneous disorder characterized by the presence of congenital ichthyosis, spasticity, and mental retardation. As with other rare genetic diseases, treatment is mainly symptomatic. Due to the absence of definitive treatment, lifelong follow-up and support of patients are important to improve the quality of life. A 7-year-old female child who was diagnosed as having SLS was referred to the rehabilitation clinic. After 20 sessions of a rehabilitation program, she started walking independently with the additional contribution of ankle-foot orthoses (AFOs). The contribution of the short-term rehabilitation approach and especially the administration of AFOs to the independence level of the patient is emphasized herein.Publication Open Access The impact of the COVID-19 pandemic on children with disabilities and their parents or caregivers(2023-01-01) KARADAĞ SAYGI, NAİME EVRİM; ÇAPAN N., Taşkiran Ö. Ö., Saygi E. K., Yalçinkaya E. Y., Hüner B., Aydin R.Objectives: The study aimed to determine the impact of the pandemic on parents/caregivers and children with neurologic disabilities. Patients and methods: This multi-center cross-sectional study was conducted with 309 parents/caregivers (57 males, 252 females) and their 309 children (198 males, 111 females) with disabilities between July 5, 2020, and August 30, 2020. The parents/caregivers were able to answer the questions and had internet access. The survey included questions on the utilization of educational and health care services (whether they could obtain medicine, orthosis, botulinum toxin injection, or rehabilitation) during the pandemic. A Likert scale was used to evaluate the effect of the specific health domains, including mobility, spasticity, contractures, speech, communication, eating, academic, and emotional status. The Fear of COVID-19 Scale was used to assess fear of COVID-19. Results: Among the children, 247 needed to visit their physician during the pandemic; however, 94% (n=233) of them could not attend their physician appointment or therapy sessions. The restricted life during the first wave of the pandemic in Türkiye had negatively affected 75% of the children with disabilities and 62% of their parents. From the perspective of the parents/caregivers, mobility, spasticity, and joint range of motion of the children were affected. Forty-four children required repeated injections of botulinum toxin; however, 91% could not be administered. The Fear of COVID-19 Scale scores were significantly higher in the parents who could not bring their children to the routine physician visit (p=0.041). Conclusion: During the pandemic, access to physical therapy sessions was disrupted in children with neurological disabilities, and this may have harmful consequences on the functional status of children.Publication Open Access Validity and reliability of the Turkish version of the hand-use-at-home questionnaire for children with unilateral cerebral palsy and neonatal brachial plexus palsy(2023-01-01) KARADAĞ SAYGI, NAİME EVRİM; Evkaya-Acar A., Karadag-Saygi E., Simsek A., Karali-Bingul D., ELBASAN B.Purpose: To translate the Hand-Use-at-Home questionnaire (HUH), assesses the amount of spontaneous use of the affected hand in children with 18 bimanual activities, into Turkish and examine its validity and reliability on children with neonatal brachial plexus palsy (NBPP) or unilateral cerebral palsy (UCP). Materials and methods: The HUH was translated and cross-culturally adapted to Turkish and administered to children with NBPP (n = 25) and UCP (n = 42) between 3 and 10 years. The psychometric analyses included reliability by internal consistency (Cronbach’s alpha) and test/retest reliability (intraclass correlation coefficient, ICC) structural validity was evaluated with exploratory factor analysis, and construct validity was investigated by matching the HUH with the Pediatric Outcome Data Collection Instrument Upper Extremity Scale (PODCI) (NBPP only), and Children’s Hand-Use Experience Questionnaire (CHEQ) (UCP only). Results: HUH showed excellent test–retest reliability (ICC2,1 = 0.988 Cl (0.977–0.992)), excellent internal consistency (Cronbach’s-α = 0.989), and moderate correlation with CHEQ (rs = 0.558) in UCP and high correlation with PODCI Scale (rs = 0.789) in NBPP group. The HUH had low and moderate correlation respectively lesion-extent levels (r=-0.457) in NBPP and 5 Manual Ability Classification System levels (r=-0.688) in the UCP group. Conclusion: The HUH is a valid and reliable tool to assess the amount of spontaneous use of the affected hand in Turkish children with NBPP and UCP.Publication Open Access Pediatric dysphagia overview: best practice recommendation study by multidisciplinary experts(2022-11-01) KARADAĞ SAYGI, NAİME EVRİM; KARADAĞ, BÜLENT TANER; DURMUŞ KOCAASLAN, FATMA NİHAL; TUTAR, ENGİN; Umay E., Eyigör S., Giray E., Saygi E. K., Karadağ B. T., Kocaaslan N. D., Yuksel D., Demir A. M., Tutar E., Tıkız C., et al.Background Currently, there is no comprehensive and multidisciplinary recommendation study covering all aspects of pediatric dysphagia (PD). This study aimed to generate PD management recommendations with methods that can be used in clinical practice to fill this gap in our country and in the world, from the perspective of experienced multidisciplinary experts. Methods This recommendation paper was generated by a multidisciplinary team, using the seven-step process and a three-round modified Delphi survey via e-mail. First, ten open-ended questions were created, and then detailed recommendations including management, diagnosis, treatment, and follow-up were created with the answers from these questions. Each recommendation item was voted on by the experts as overall consensus (strong recommendation), approaching consensus (weak recommendation) and divergent consensus (not recommended). Results In the 1st Delphi round, a questionnaire of 414 items was prepared based on the experts\" responses to ten open-ended questions. In the 2nd Delphi round, 59.2% of these items were accepted as pre-recommendation. In the 3rd Delphi round, 62.6% of 246 items were accepted for inclusion in the proposals. The final version recommendations consisted of 154 items. Conclusions This study includes comprehensive and detailed answers for every problem that could be posed in clinical practice for the management of PD, and recommendations are for all pediatric patients with both oropharyngeal and esophageal dysphagia.Publication Open Access Effect of Nusinersen treatment on motor functions in children and adolescents with spinal muscular atrophy who gave a break to physiotherapy during covid-19 pandemic(2022-01-01) TÜRKDOĞAN, DİLŞAD; KARADAĞ SAYGI, NAİME EVRİM; ÜNVER, OLCAY; Ozturk G., Saygi E. K., ÜNVER O., TÜRKDOĞAN D.Publication Open Access Comparison of telerehabilitation versus home-based video exercise in patients with Duchenne muscular dystrophy: a single-blind randomized study(2022-10-01) KENİŞ COŞKUN, ÖZGE; ÖZTÜRK THOMAS, GÜLTEN; KARADAĞ SAYGI, NAİME EVRİM; KENİŞ COŞKUN Ö., Imamoglu S., Karamancioglu B., Kurt K., ÖZTÜRK G., Karadag-Saygi E.Introduction Patients with Duchenne muscular dystrophy (DMD) have lost their access to on-site rehabilitation due to the COVID-19 pandemic. Telerehabilitation can be a viable approach for these patients to protect their muscle strength and functional status. The aim of this study is to compare telerehabilitation with home-based video exercises. Patients and methods Male, ambulatory DMD patients were randomized into telerehabilitation and video-exercise groups. Nineteen patients were included in the fnal analyses. Telerehabilitation consisted of live online exercises, while video exercise implemented a pre-recorded video as a home-based program. Both programs spanned 8 weeks, three times a week. Patients’ muscle strength with a hand-held dynamometer, Quick Motor Function Test, North-Star Ambulatory Assessment (NSAA), 6-Minute Walk Test (6MWT) and Caregiver Burden were recorded before and after treatment. Results The 6MWT of the telerehabilitation group was391.26±95.08 m before and387.75±210.93 after treatment (p=0.94) and 327.46±103.88 m before treatment and313.77±114.55 after treatment in video group (p=0.63). The mean NSAA score of the telerehabilitation group were26.70±8.04 before treatment and 25.20±11.33 after treatment (p=0.24). In the video group scores were 21.66±6.65 before to 22.00±8.61 after treatment (p=0.87). There were no signifcant changes between groups at the end of the treatments. The telerehabilitation group's neck extension, bilateral shoulder abduction, and left shoulder fexion, bilateral knee fexion and extension, bilateral ankle dorsifexion, and left ankle plantar fexion strength improved signifcantly and were better than the video group (p<0.05 for all measurements). Conclusion A telerehabilitation approach is superior in improving muscle strength than a video-based home exercise, but none of the programs improved functional outcomes in ambulatory patients with DMD.Publication Metadata only Internet-based basic body awareness therapy in fibromyalgia syndrome: A report of three cases(2023-02-01) ERSÖZ HÜSEYİNSİNOĞLU, BURCU; YOLCU, GÜNAY; KARADAĞ SAYGI, NAİME EVRİM; Tahran O., ERSÖZ HÜSEYİNSİNOĞLU B., YOLCU G., Saygi E. K.Previous literature has shown that basic body awareness therapy (BBAT) may be an effective treatment for fibromyalgia syndrome (FMS). This study constitutes the first case study evaluating internet-based BBAT for FMS. The purpose of this case study was to describe the feasibility and preliminary outcomes of an internet-based BBAT training for a total of 8 weeks in three patients with FMS. The patients underwent a synchronous individual internet-based BBAT training. Outcomes were assessed using Fibromyalgia Impact Questionnaire Revised, Awareness-Body-Chart, Short-Form McGill Pain Questionnaire (SF-MPQ), and plasma fibrinogen level. These measures were administered at baseline and after the treatment. Patient satisfaction with the treatment was evaluated using a structured questionnaire. At the post-treatment evaluation, each patient showed improvements in all outcome measures. All patients had clinically significant changes in Fibromyalgia Impact Questionnaire Revised. The SF-MPQ total score in Patients 1 and 3 exceeded the minimal clinically important difference. All patients\" pain severity exceeded the minimal clinically important difference for Visual Analogue Scale (SF-MPQ). Besides, we found some benefits in body awareness and the level of dysautonomia. At the end of the treatment, patient satisfaction with the programme was very high. Based on this case study, the application of internet-based BBAT seems feasible and promising for clinical benefits.