Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/7
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Article The Effect of Mirror Therapy on Spasticity in Adult Patients With Stroke: a Systematic Review and Meta-Analysis(Taylor & Francis Ltd, 2025) Tosun, Anil Tekeoglu; Isiklar, Cagdas; Yeldan, Ipek; Tekeoğlu Tosun, AnılObjective This study aims to investigate the effects of Mirror Therapy (MT) on spasticity and related parameters in stroke patients Methods A systematic review was performed in databases PubMed, Web of Science, Science Direct, Cochrane, and Scopus databases for published RCTs (Randomized Controlled Trials) from the date of each database's inception to May 2021. Modified Ashworth Scale (MAS) in adult patients with stroke compared to conventional therapy, sham, and additional therapy control were included. Physiotherapy Evidence Database Scale was used to assess the methodological quality of each study. Results The overall effect of MT on MAS was statistically significant and beneficial when studies were analyzed in terms of both upper and lower extremities (p < 0.001). MT demonstrated a large and beneficial overall effect on the Brunnstrom Assessment compared to conventional therapy (p < 0.001). The overall impact of MT on Fugl-Meyer Assessment (FMA) was large and statistically significant (p < 0.001). However, a meta-analysis of three studies using the 10-meter walk test showed that the overall effect of MT was not statistically significant (p = 0.258). Conclusion This systematic review and meta-analysis demonstrates reductions in upper and lower extremity spasticity and improved motor recovery with MT, both isolated and combined with other treatments, in adults with stroke. PROSPERO registration number CRD42021255154.Article Citation - WoS: 21Citation - Scopus: 23Effectiveness of Conventional Dysphagia Therapy (cdt), Neuromuscular Electrical Stimulation (nmes), and Transcranial Direct Current Stimulation (tdcs) in Acute Post-Stroke Dysphagia: a Comparative Evaluation(Springer, 2024) Bengisu, Serkan; Demir, Numan; Krespi, YakupThis study aims to compare the effectiveness of conventional dysphagia therapy (CDT), neuromuscular electrical stimulation (NMES), and transcranial direct current stimulation (tDCS) in the treatment of post-stroke dysphagia. A single-blind randomized controlled trial was conducted with 40 acute stroke patients - 18 females and 22 males with a mean age of 65.8 +/- 11.9. The subjects were grouped into 4, with 10 individuals in each. The procedures administered to groups were as follows: the first group, sham tDCS and sham NMES; the second group, tDCS and sham NMES; the third group, NMES and sham tDCS; and the fourth group, all therapy procedures. CDT was applied to all groups either as a standalone procedure or combined with one or two of the instrumental techniques. Gugging Swallowing Screen (GUSS) and Videofluoroscopic Swallowing Study (VFSS) were employed to determine the severity of dysphagia and the effectiveness of treatment modalities. Additionally, the Penetration Aspiration Scale (PAS), Functional Oral Intake Scale (FOIS), and Dysphagia Severity Rating Scale (DSRS) were administered to interpret VFSS data. Pre- and post-treatment comparisons of all groups have revealed a statistically significant difference for all parameters except for the PAS scores at International Dysphagia Diet Standardization Initiative (IDDSI)-Level 4 consistencies. However, the differences between pre- and post-treatment scores of the fourth group across all parameters were significant - GUSS (p = 0.005), FOIS (p = 0.004), DSRS (p = 0.005), PAS IDDSI-4 (p = 0.027), PAS IDDSI-0 (p = 0.004). Inter-group comparisons, on the other hand, pointed out that the difference between pre- and post-treatment GUSS, FOIS, DSRS, and PAS scores at IDDSI Level-0 consistencies was statistically significant for all groups - GUSS (p = 0,009), FOIS (p = 0,004), DSRS (p = 0,002), PAS IDDSI-0 (p = 0,049). Closer examination of treatment groups indicated that the tDCS + CDT group, the NMES + CDT group, and the group that underwent the combination of three modalities made better progress than the one that was treated with only CDT. Though not statistically significant, the NMES + CDT group achieved better improvement than the tDCS + CDT group. This study has yielded that the group in which NMES, tDCS, and CDT were applied in combination has achieved better results than all the other groups. All treatment modalities applied to accelerate the general recovery process in acute stroke patients with dysphagia were found to be effective for the treatment of post-stroke swallowing disorders. The use of instrumental treatments such as NMES and tDCS enhanced the effectiveness of the treatment and provided more significant progress. Furthermore, combining treatment modalities such as NMES and tDCS was more effective when compared to using only conventional therapy. As a result, the most effective treatment outcomes were obtained by the group receiving CDT, NMES, and tDCS in combination. Therefore, the use of combined approaches has been recommended in appropriate patients; yet the provisional results should be tested in randomized trials with more participants.Article Citation - WoS: 9Citation - Scopus: 9The Effect of Electromyography (emg)-Driven Robotic Treatment on the Recovery of the Hand Nine Years After Stroke(Hanley & Belfus-elsevier inc, 2023) Ogul, Ozden Erkan; Coskunsu, Dilber Karagozoglu; Akcay, Sumeyye; Akyol, Kubra; Hanoglu, Lutfu; Ozturk, NeclaObjective: To investigate the effect of electromyography (EMG)-driven robotic therapy on the recovery of the hand in a stroke case lasting 9 years.Case: An 18-year-old patient with hemiparesis due to the ischemic lesion was admitted to our clinic with hand impairment. Fifteen sessions (5 weeks x 3 times) of robotic rehabilitation were applied with the Hand of Hope. Average EMG (mV) of flexor digitorum superficialis (FDS) muscle, average force (N) and the rate of force development (RFD)(N/s) were also assessed before and after the treatment following the 5th and 10th sessions and at the end of treatment. Also, Fugl-Meyer Assessment of Upper Extremity Scale (FMU-UE), Motor Activity Log (MAL), Canadian Occupational Performance Score (COPM) and Visual Analog Scale (VAS) were used for assessment before and after the treatment.Results: The average EMG measured from FDS increased from 0.093-0.133 mV. The average force and average RFD increased from 45.6-97.7 and from 135.6-172.6 respectively. While affected and/or unaffected side force ratio increased dramatically from 54%-82%, the FMA-UE score increased from 56-59. The MAL quality of use score increased from 3.93-4.13. Performance and satisfaction scores of COPM changed from 5.25-7.25 and 4.5-8.25 respectively. VAS score for fatigue changed from 6 to 4.Discussion: The improvement achieved 9 years later with 15 sessions of rehabilitation suggests that im-provement may be possible for chronic stroke patients.(c) 2021 Elsevier Inc. All rights reserved.