Effects of sensory deficits on balance, functional status and trunk control in patients diagnosed with guillain-barre syndrome.

OBJECTIVE: To investigate the effects of sensory deficits on balance, functional status and trunk control in patients diagnosed with Guillain-Barre syndrome (GBS). METHODS: Twenty patients who were diagnosed with GBS and who were in the neurology department of Mustafa Kemal University in 2017, participated in this descriptive study. There were 11 males and 9 females, and the average age was 41.55+/-18.49 years. The trunk control of the GBS patients was assessed using the trunk impairment scale (TIS), reaching function was assessed using the functional reaching test (FRT) in the sitting position and body balance assessed using the Berg balance scale (BBS). Light touch was assessed using Semmes-Weinstein monofilament test, proprioception was assessed using the distal proprioception test and disability status was assessed using the Guillain-Barre syndrome disability scale (GBSDS). RESULTS: We found a moderate, positive and significant correlation between proprioception scores and the BBS and between proprioception scores and the TIS. The correlation between proprioception and FRT in the sitting position and between proprioception and the GBSDS was not significant. We found a moderate and negative correlation between light touch and the FRT in the sitting position, TIS, BBS, but a moderate and positive correlation between light touch and the GBSDS. CONCLUSION: Neurologists and physiotherapists should both take sensory and motor function into consideration in the assessment and rehabilitation program of patients diagnosed with GBS.

The effect of walking sticks on balance in geriatric subjects.

[Purpose] Guidelines and clarity regarding the information for deciding the need for walking sticks and the suitability of these sticks is insufficient. This study aimed to evaluate the suitability of walking stick and its effects on the balance in the elderly. [Subjects and Methods] A total of 39 elderly subjects aged between 65-95 years (mean age, 76.15 ± 8.35 years) and living in the Residential Aged Care and Rehabilitation Center were included. Sociodemographic data of the individuals, the material of the walking stick, who made the decision of usage and length of walking sticks were questioned. The Berg Balance Scale (BBS) scores were used to evaluate balance. [Results] Subjects' BBS scores while using the walking stick were higher than that without the walking stick. A significant difference was observed in BBS scores obtained with the stick and without the stick, according to body mass index parameters. Majority of the subjects also started to use walking sticks by themselves. No significant difference was observed between the ideal length and actual length of the walking stick was used. [Conclusion] Our study demonstrated that the elderly generally decide to use walking stick by themselves and chose the appropriate materials; which improves their balance.

Improvement of muscle strength and fatigue with high voltage pulsed galvanic stimulation in multiple sclerosis patients--a non-randomized controlled trial.

OBJECTIVE: To examine the effects of High Voltage Pulsed Galvanic Stimulation (HVPGS), that was applied to the spasticity associated weakness in knee flexors and ankle dorsiflexors, on strength and fatigue, in Multiple Sclerosis (MS) patients, in a non-randomized controlled trial. METHODS: A total of 33 MS patients were included. Fatigue and strength were analyzed with 3rd and 30th second data by dynamometric measurements synchronously with surface electromyography (EMG) [power spectrum analysis (amplitude, mean frequency, median frequency and root means square]. In the experimental group HVPGS and in the control group repetitive contractions from Proprioceptive Neuromuscular Facilitation (PNF) technique were applied for 18 treatment sessions. RESULTS: In both groups and all muscle groups, dynamometric measurement and EMG results in the 30th second were significantly lower according to in the 3rd second before and after the treatments. Both strength and fatigue improved after the treatment both in the HVPGS and PNF group. CONCLUSION: It was concluded that, MS patients have both central and peripheral fatigue. FO2 localized and intensive effects in strength and fatigue, HVPGS was more impressive than the PNF. PNF was more effective to obtain general effects. Moreover, the application of HVPGS with other rehabilitation techniques may be more appropriate and effective.

The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients.

The aims of this study were to investigate the Fatigue Severity Scale's Turkish version's validity, reproducibility, internal consistency and parameters. Multiple sclerosis patients' disability levels were determined by the Expended Disability Status Scale and depression status was established with the Beck Depression Inventory. The Fatigue Severity Scale and Beck Depression Inventory were administered through self-report methods and assistance, without guidance, given where needed. An interval of 1 week was allowed between the applications. Seventy-two definitely diagnosed multiple sclerosis patients and matched 76 healthy controls were included. The multiple sclerosis patients' median Expended Disability Status Scale score was 4.0 (1.0-9.5). There were statistically significant differences between multiple sclerosis patients' and healthy controls' Fatigue Severity Scale scores (P<0.001). After controlling for depression, Fatigue Severity Scale scores were lowered, but there was still a significant difference between them (P<0.001). There was no significant difference between the interviews for Fatigue Severity Scale1 and Fatigue Severity Scale2 (P=0.719). Internal consistency for Fatigue Severity Scale was good for multiple sclerosis patients (ICC=0.81, P<0.001). Cronbach's alpha of Fatigue Severity Scale1 was 0.89; Fatigue Severity Scale2 was 0.94. Expended Disability Status Scale scores (P<0.05) and Beck Depression Inventory scores (P<0.001) have a significant effect on the Fatigue Severity Scale. In conclusion, scales have a great importance in following up and assessing the results of treatment strategies. The Turkish validation of the Fatigue Severity Scale is reliable and valid, and is an appropriate tool to assess fatigue in the Turkish multiple sclerosis population.