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 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 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 Does ultrasound imaging of the spastic muscle have an additive effect on clinical examination tools in patients with cerebral palsy?: A pilot study(2022-01-01) AKBAŞ, FIRAT; YAĞCI, İLKER; AKGÜLLE, AHMET HAMDİ; KARADAĞ SAYGI, NAİME EVRİM; Atalay K. G., Saygi E. K., AKBAŞ F., Coskun O. K., AKGÜLLE A. H., YAĞCI İ.OBJECTIVE: The Modified Ashworth Scale, the Modified Tardieu Scale, and measuring the passive range of motion is commonly preferred examination tools for spasticity in cerebral palsy (CP). Ultrasonography has become increasingly used to provide relevant insight into spastic muscle morphology and structure recently. It was aimed to reveal associations between the clinical and ultrasonographic parameters of gastrocnemius medialis (GM) and lateralis muscles in this population. METHODS: Thirty-four children with spastic CP aged between 4 and 12 years who did not have botulinum neurotoxin A intervention within 6 months or had no previous history of any orthopedic or neurological surgery were included. The spasticity of GM and lateralis was evaluated firstly by the Modified Ashworth Scale, Modified Tardieu Scale, and ankle passive range of motion. Then, the cross-sectional area (CSA), muscle thickness (MT), qualitative and quantitative echo intensity (EI) values of both muscles were measured from their ultrasonographic images. RESULTS: The CSA of GM, and qualitative EI of both muscles were found to be mild-to-moderately correlated to all clinical examination tools (p<0.01), whereas the CSA of gastrocnemius lateralis was mildly related to Modified Ashworth Scale (p=0.009). The MT and quantitative EI of both muscles were not associated with any of the clinical tools (p>0.05). CONCLUSION: Ultrasonographic measurements of GM and lateralis partially reflect ankle spasticity in children with CP. Ultrasonography can be used as an alternative tool in this patient population where the clinical evaluation can not perform ideally.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 Open Access Characteristics of sit-to-stand movement are associated with trunk and lower extremity selective control in children with cerebral palsy: a cross-sectional study(2022-09-01) KARADAĞ SAYGI, NAİME EVRİM; KURT, SEFA; Gunes D., Karadag-Saygi E., Giray E., KURT S.Even though the effect of several factors on sit-to-stand (STS) performance of children with CP has been previously explored, the potential role of lower extremity selective control, trunk control and sitting function on the performance of STS has not been examined. This study aimed to investigate the association of trunk control and lower extremity selective motor control with STS performance in children with CP. We recruited 28 children with CP aged between 4 and 10 years whose Gross Motor Function Classification System levels were I and II and 32 age-matched typically developing (TP) children. Trunk control, sitting function, selective control of the lower extremities and STS were evaluated with Trunk Control Measurement Scale (TCMS), sitting section of Gross Motor Function Measure-88 (GMFM-88), Selective Control Assessment of the Lower Extremity (SCALE) and the STS outcomes of a force platform [weight transfer time, rising index, and center of gravity (COG) sway velocity], respectively. In all evaluations, children with CP demonstrated lower scores than TD children. A moderate correlation was found between total scores of TCMS, GMFM-88 sitting section scores and COG sway velocity during STS and a fair correlation between SCALE total scores and COG sway velocity in the CP group (r = -0.51, r = -0.52, r = -0.39, respectively). A fair correlation was found between SCALE total scores and the weight transfer time during STS in children with CP (r = -0.39). Based on these results, improving trunk and lower extremity selective control may enhance STS performance in children with CP.