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 The relationships of motor-evoked potentials to hand dexterity, motor function, and spasticity in chronic stroke patients: a transcranial magnetic stimulation study(SPRINGER HEIDELBERG, 2016) AKYÜZ, GÜLSEREN DERYA; Cakar, Engin; Akyuz, Gulseren; Durmus, Oguz; Bayman, Levent; Yagci, Ilker; Karadag-Saygi, Evrim; Gunduz, Osman HakanThe standardization of patient evaluation and monitoring methods has a special importance in evaluating the effectiveness of therapeutic methods using drugs or rehabilitative techniques in stroke rehabilitation. The aim of this study was to investigate the relationships between clinical instruments and transcranial magnetic stimulation (TMS)-evoked neurophysiological parameters in stroke patients. This study included 22 chronic post-stroke patients who were clinically assessed using the Motricity Index (MI), finger-tapping test (FTT), Motor Activity Log (MAL) 28, Brunnstrom motor staging and Ashworth Scale (ASH). Motor-evoked potential (MEP) latency and amplitude, resting motor threshold (rMT) and central motor conduction time (CMCT) were measured with TMS. Shorter MEP-latency, shorter CMCT, higher motor-evoked potential amplitude, and diminished rMT exhibited significant correlations with clinical measures evaluating motor stage, dexterity, and daily life functionality. rMT exhibited a negative correlation with hand and lower extremity Brunnstrom stages (r = -0.64, r = -0.51, respectively), MI score (r = -0.48), FTT score (r = -0.69), and also with amount of use scale and quality of movement scale of MAL 28 scores (r = -0.61, r = -0.62, respectively). Higher MEP amplitude and diminished rMT showed positive correlations with reduced ASH score (r = -0.65, r = 0.44, respectively). The TMS-evoked neurophysiologic parameters including MEP latency, amplitude, rMT and CMCT generally have positive correlation with clinical measures which evaluate motor stage, dexterity and daily life functionality. Additionally, spasticity has also remarkable relationships with MEP amplitude and rMT. These results suggest that TMS-evoked neurophysiological parameters were useful measures for monitoring post-stroke patients.Publication Metadata only The clinical aspects and effectiveness of suit therapies for cerebral palsy: A systematic review(2019) KARADAĞ SAYGI, NAİME EVRİM; Karadağ-Saygı, Evrim; Giray, EsraObjectives: The aim of this review to evaluate the clinical aspects and effectiveness of suit therapy for patients with cerebral palsy (CP). Materials and methods: A literature search was performed in the PubMed, SCOPUS, Web of Science, and PEDro databases within the period from the establishment of the relevant database to July 2018. The articles were categorized according to their study design. We included studies published in peer-review journals focusing on the efficacy of suit therapies for CP and excluded review articles, duplications, non-related articles. A narrative synthesis approach was used, as it was not possible to classify extracted and analyzed data, and the overall effect size was unable to be calculated. Data regarding study subjects (number, age, CP type, Gross Motor Function Classification System [GMFCS] level), suit type, intervention including dose of suit therapy, outcome measurements, outcomes, adverse effects, and funding were extracted. The method introduced by Furlan, Pennick, Bombardier, and van Tulder was used to evaluate the risk of bias for the assessment of methodological quality of randomized-controlled trials (RCTs). Results: A total of 29 studies were included of which 10 were Class I, eight were Class II-III, and 11 were Class IV studies. Studies were heterogenous in design, sample size, study population, and outcomes measured. The methodological quality score of RCTs varied between 4 and 10. The results of the high-quality RCTs showed that wearing the suit along with conventional therapy improved proximal stability, gross motor function, and gait. The Class II-III and IV studies supported the findings of the Class I studies. Conclusion: The major improvements from the RCTs were seen in proximal stability, gross motor function and gait, although grading was unable to be done due to the heterogeneity of included studies. In order to obtain gains in the function, it is important to carefully consider intended use, patient selection criteria, and suit type.Publication Metadata only Morton neuroma: Comparative results of two conservative methods(AMER ORTHOPAEDIC FOOT & ANKLE SOC, INC, 2005) KARADAĞ SAYGI, NAİME EVRİM; Saygi, B; Yidirim, Y; Saygi, EK; Kara, H; Esemenli, TBackground. The initial treatment of Morton neuromas consists of conservative methods that include shoe modifications and steroid injections. The purpose of this prospective study was to compare the efficacy of these two methods to determine which is more effective as the initial treatment method. Methods: Eighty-two patients with Morton neuromas were randomly assigned to receive either footwear modification with orthoses or steroid injections as initial treatment. Outcomes were evaluated at 1 month, 6 months, and 12 months. Results: Patient satisfaction was significantly better (p < 0.01) in the group treated with steroid injections than those treated with shoe modifications at all three followup intervals. At 12-month followup, 82% of those treated with steroid injections had complete or partial relief of pain compared to 63% of those treated with footwear modifications alone. Conclusion: Steroid injections as initial treatment and shoe modifications with steroid injections at 6 months appear to give better results in Morton neuromas than shoe modifications alone, but the difference in the two groups were not statistically significant at one year followup.Publication Metadata only Bizarre parosteal osteochondromatous proliferation of the little toe(AMER PODIATRIC MED ASSN, 2006) ERZİK, CAN; Saygi, B; Karadag-Saygi, E; Erzik, C; Erkan, M; Yildirim, YA 19-year-old woman presented with pain at the lateral side of the fifth toe of her left foot, which was separated from the adjacent toe. Initial examination suggested dislocation of the fifth metatarsophalangeal joint due to a past fracture. Radiographs showed a mass arising from the proximal phalanx of the little toe, with no medullary and cortical continuity. Excisional biopsy of the mass was performed, and a histologic diagnosis of bizarre parosteal osteochondromatous proliferation of bone (Nora's lesion) was made.Publication 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 Modified constraint-induced movement therapy during hospitalization in children with perinatal brachial plexus palsy: A randomized controlled trial(HANLEY & BELFUS-ELSEVIER INC, 2020) KARADAĞ SAYGI, NAİME EVRİM; Eren, Beyhan; Saygi, Evrim Karadag; Tokgoz, Duygu; Leblebicier, Merve AkdenizStudy Design: Prospective single-blind, randomized controlled study. Introduction: Children with perinatal brachial plexus palsy (PBPP) have motion limitations in the affected upper extremity. Modified constraint-induced movement therapy (mCIMT) is one of the treatment options used for the improvement of the function of the affected limb. Purpose of the Study: The purpose of this study was to compare the effect of mCIMT and conventional therapy in improving active range of motion (ROM) and functional use of the affected upper extremity in children with PBPP with injuries to upper and middle trunks in the hospital environment. Materials: 26 patients received conventional rehabilitation program (control group) and 13 patients participated in a mCIMT program (study group). Children had a mean age 56.3 months (range 4-10 years). The mCIMT included 1 hour therapy sessions emphasizing the affected arm use for 14 consecutive days during hospitalization. Their normal arm was also constrained for 6 hour per day. All the patients were assessed at the baseline, one day, one month, and three months after completion of therapy using active ROM, active movement scale, hand dynamometer, box and blocks test. Results: The mCIMT group improved more than the control group in shoulder internal rotation, forearm supination, elbow flexion active ROMs, hand grip strength, and in upper extremity function. Conclusion: mCIMT has a potential to promote functional gains for children with PBPP; this approach should be widely applied within routine clinical practice. (C) 2020 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.Publication Metadata only New treatment alternatives in the ulnar neuropathy at the elbow: ultrasound and low-level laser therapy(SPRINGER HEIDELBERG, 2015) KARADAĞ SAYGI, NAİME EVRİM; Ozkan, Feyza Unlu; Saygi, Evrim Karadag; Senol, Selcen; Kapci, Serap; Aydeniz, Banu; Aktas, Ilknur; Gozke, ErenUlnar nerve entrapment at the elbow (UNE) is the second most common entrapment neuropathy of the arm. Conservative treatment is the treatment of choice in mild to moderate cases. Elbow splints and avoiding flexion of the involved elbow constitute majority of the conservative treatment; indeed, there is no other non-invasive treatment modality. The aim of this study was to investigate the efficacy of ultrasound (US) and low-level laser therapy (LLLT) in the treatment of UNE to provide an alternative conservative treatment method. A randomized single-blind study was carried out in 32 patients diagnosed with UNE. Short-segment conduction study (SSCS) was performed for the localization of the entrapment site. Patients were randomized into US treatment (frequency of 1 MHz, intensity of 1.5 W/cm(2), continuous mode) and LLLT (0.8 J/cm(2) with 905 nm wavelength), both applied five times a week for 2 weeks. Assessments were performed at baseline, at the end of the treatment, and at the first and third months by visual analog scale, hand grip strength, semmes weinstein monofilament test, latency change at SSCS, and patient satisfaction scale. Both treatment groups had significant improvements on clinical and electrophysiological parameters (p < 0.05) at first month with no statistically significant difference between them. Improvements in all parameters were sustained at the third month for the US group, while only changes in grip strength and latency were significant for the LLLT group at third month. The present study demonstrated that both US and LLLT provided improvements in clinical and electrophysiological parameters and have a satisfying short-term effectiveness in the treatment of UNE.Publication Metadata only Sore throat as a side effect of abobotulinum toxin A injection for upper limb spasticity after stroke: A case report(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020) KARADAĞ SAYGI, NAİME EVRİM; Giray, Esra; Karadag-Saygi, EvrimDespite sore throat exists in the product characteristics of abobotulinum toxin A as one of the side effects, no available reports of sore throat after abobotulinum toxin A injection for adult upper limb spasticity could be found in the literature to guide physicians for the management. Herein, we report a case of poststroke spasticity who develop sore throat immediately after abobotulinum toxin A (Dysport) injection of forearm muscles which completely resolved after observation for eight hours. This case report highlights a rare side effect of abobotulinum toxin A and provides information regarding the follow-up process of side effects which would guide physicians for the management.