How much does clinical prediagnosis correlate with electrophysiological findings?: a retrospective study.

Background: Electrodiagnostic testing (EDX) is important in the diagnosis and follow-up of neuropathic and myopathic diseases. This study aimed to demonstrate the compatibility between clinical prediagnosis and electrophysiological findings. Methods: EDX results from 2004 to 2020 at the physical medicine and rehabilitation (PM&R) clinic were screened. Tests with missing data, reevaluation studies, and cases of peripheral facial paralysis were excluded. The clinical prediagnosis and EDX results were recorded, and their compatibility was evaluated. Results: A total of 2,153 tests were included in this study. The mean age was 49.0±13.9 years and 1,533 of them (71.2%) were female. The most frequently referred clinic was the PM&R clinic (90.0%). Numbness (73.6%) was the most common complaint, followed by pain (15.3%) and weakness (13.9%). The most common prediagnosis was entrapment neuropathy (55.3%), radiculopathy (16.1%), and polyneuropathy (15.7%). Carpal tunnel syndrome was the most frequently identified type of entrapment neuropathy (78.3%). Six hundred and seventy EDX results (31.1%) were within normal limits. While the EDX results were consistent with the prediagnosis in 1,328 patients (61.7%), a pathology different from the prediagnosis was detected in 155 patients (7.2%). In the discrepancy group, the most common pathologies were entrapment neuropathy (51.7%), polyneuropathy (17.3%), and radiculopathy (15.1%). The most common neuropathy type was carpal tunnel syndrome (79.3%). Conclusion: After adequate anamnesis and physical and neurological examinations, requesting further appropriate tests will increase the prediagnosis accuracy and prevent unnecessary expenditure of time and labor.

The Impact of Combination of Aerobic and Resistive Exercise on Activities of Daily Living and Risk of Fall in Osteosarcopenic Patients.

Objectives: It is aimed to explain the impact of the combination of aerobic and resistive exercise on activities of daily living and the risk of falls in osteosarcopenic patients. Methods: Female and male patients over 70 years of age followed up from the osteoporosis outpatient clinic were screened. Appropriate patients were evaluated for sarcopenia gait speed, grip strength and skeletal muscle mass. Patients with sarcopenia who did not have the exclusion criteria were included in the 3-month aerobic and resistive exercise program. Changes in skeletal muscle mass measurements, physical performance and balance tests were evaluated at 1 month and 3 months. Results: Sarcopenia was screened in 91 patients with osteoporosis and osteopenia. Sarcopenia was detected in 27 patients and 23 completed the 3-month study. The mean age of the patients was 78.4±5.7 years and the number of female patients was 16 (69.6%). There was no significant change in skeletal muscle mass measurements and Katz Activities of Daily Living Scale performed at 1 and 3 months (p>0.05). Short Physical Performance Battery (SPPB), Timed Up and Go Test (TUGT) and Berg Balance Test (BBT) were found to improve significantly in the first month, and it continued to develop in the third month (p<0.05). Conclusion: Although the combination of aerobic and resistive exercise in osteosarcopenic patients did not lead to a significant increase in skeletal muscle mass, It has a significant effect on physical performance and balance. It can be foreseen that this will increase the independence of the person while reducing the risk of falling.

Effects of Aerobic and Resistive Exercise on Muscle Measurements and Body Composition in Female Patients With Rheumatoid Arthritis.

OBJECTIVE: This study aimed to show the effects of different exercise types on disease activity, pain, functional status, and quality of life in female patients with rheumatoid arthritis with low disease activity or in remission and supported these findings with body composition and muscle measurements. DESIGN: This randomized controlled prospective study screened female patients aged 20-50 years with rheumatoid arthritis. The patients were randomized into 12-wk resistance exercise, aerobic exercise, and control groups. RESULTS: The mean age of the 66 patients was 42.5 ± 5.6 yrs. In the resistance and aerobic exercise groups compared with the control group, a positive significant difference was found in the pain, disease activity, several subparameters of quality of life, M. gastrocnemius, and M. biceps femoris muscle thickness measurements, and fat mass in the lower limbs before and after treatment ( P < 0.05). Compared with the other groups, the resistance exercise group showed a significant improvement in M. rectus femoris and M. vastus intermedius muscle thickness measurements, whole body fat mass, whole body and lower extremity lean body mass, and timed up and go test when comparing before and after treatment ( P < 0.05). CONCLUSIONS: In rheumatoid arthritis patients, resistance exercises led to a significant increase in muscle thickness, functional status, lean body mass compared with other exercises; resistance exercises also resulted in a significant reduction in pain and disease activity.

Opinions of male nursing students about violence against women: A qualitative study.

AIM: This study aims to explore the opinions of male nursing students on violence against women in Turkey. INTRODUCTION: The prevalence of violence against women in the world is increasing every passing day. Although women try to deal with the changes their lives bring along, they are faced with physical, sexual, psychological, and economic violence for various reasons at the same time. BACKGROUND: Inclusion of men in studies can have a strong impact on how strategies are developed and implemented. Tackling the issue of violence against women requires active engagement of men and, therefore, knowing the knowledge, attitudes, and understanding of male nursing students is important. METHODS: In this qualitative study, 18 male nursing students participated. The participants were selected through purposive sampling, and data were collected through individual semi structured interviews. The data were analyzed using the thematic analysis method designed by Clarke and Braun. FINDINGS: The findings of the study are presented in seven themes and these are definition of violence, causes of violence, reactions to witnessing violence, impacts of violence on society, solutions to violence, efforts regarding violence in Turkey, and being a male nurse. Among the striking results of the study were that students considered violence with its many dimensions, that they stated that violence could be prevented, that they found that efforts regarding the issue were insufficient in Turkey, and that they stated that important responsibilities for preventing violence against women lay with nurses. CONCLUSION/IMPLICATIONS FOR PRACTICE: Students considered violence and its various dimensions. They felt that violence could be prevented, that the efforts regarding the issue were insufficient in Turkey, and that important responsibilities for preventing violence against women lay with nurses. The views of male nursing students on violence against women are promising as it encourages the empowerment of future nurse professionals, who are expected to be the pioneers of necessary changes in the field of health in order to defend women.

A case report of a patient with COVID-19 infection and widespread heterotopic ossification.

Since the beginning of the novel coronavirus disease-2019 (COVID-19) pandemic, physical medicine and rehabilitation specialists have played an important role in fighting this disease apart from the pulmonary rehabilitation. As a high number of patients have needed immobilization and intensive care unit (ICU) treatment, many complications have emerged inevitably. Heterotopic ossification (HO) is one of these complications. Herein, we present a case of young male patient who had widespread HO in his shoulders, elbows, and hips. Although he managed to survive, he still has difficulty in ambulation and daily living activities. Given the continuing high prevalence of COVID-19, many patients would need immobilization and ICU treatment. Therefore, causes of HO should be scrutinized, physicians and caregivers need to raise vigilance, and comprehensive protective measures should be put in place. On the other hand, as HO is used to be diagnosed quite frequently in the patients with neurological diseases, diagnosis of HO in the COVID-19 patients should not automatically be linked to the stay in the ICU. Yet, it is a fact that impaired immune response is prevalent both in COVID-19 and HO. The correlation between COVID-19 and HO is remarkable, but further research is needed to establish a causal relationship.

Demographic and clinical characteristics of inpatient stroke patients in Turkey.

Objectives: This study aims to assess the stroke rehabilitation facilities provided by university hospitals (UHs) and training and research hospitals (TRHs) and to evaluate the geographical disparities in stroke rehabilitation. Patients and methods: Between April 2013 and April 2014 a total of 1,529 stroke patients (817 males, 712 females; mean age: 61.7±14.0 years; range, 12 to 91 years) who were admitted to the physical medicine and rehabilitation clinics in 20 tertiary care centers were retrospectively analyzed. Demographic, regional and clinical characteristics, details of rehabilitation period, functional status, and complications were collected. Results: The median duration of stroke was five (range, 1 to 360) months. The ratio of the patients treated in the TRH in the Marmara region was 77%, but only 25% of the patients were living in the Marmara region. Duration of hospitalization was longer in the TRHs with a median of 28 days compared to those of UHs (median: 22 days) (p<0.0001). More than half of the patients (55%) were rehabilitated in the Marmara region. Time after stroke was the highest in the Southeast region with a median of 12 (range, 1 to 230) months and the lowest in the Aegean region with a median of four (range, 1 to 84) months. Conclusion: This study provides an insight into the situation of stroke rehabilitation settings and characteristics of stroke patients in Turkey. A standard method of patient evaluation and a registry system may provide data about the efficacy of stroke rehabilitation and may help to focus on the problems that hinder a better outcome.

Does Dry Needling Increase the Efficacy of Botulinum Toxin Injection in the Management of Post-Stroke Spasticity: A Randomized Controlled Study.

Introduction: The purpose of the current study was to investigate the antispastic efficacy of dry needling in combination with botulinum toxin-A injections. Methods: Thirty stroke patients with elbow flexor spasticity were randomised into two groups; the patients treated with botulinum toxin-A injections and exercise into the BTX-A group, and patients treated with botulinum toxin-A injections, exercise, and dry needling in the BTX-A+Dry needling group. Spasticity was evaluated using the modified Ashworth scale and modified Tardieu scale before treatment, immediately after treatment, the third day after treatment, second week after treatment and at the third month after treatment. The upper extremity motor function was evaluated using the Fugl-Meyer upper extremity motor function scale. Results: A statistically significant difference in all parameters was found after treatment in both groups compared to before treatment (p<0.05). In all evaluation parameters immediately after treatment, on the third day after treatment, the second week after treatment and the third month after treatment, a statistically significant difference in favour of the BTX-A+Dry needling group was achieved compared to before treatment (p<0.05). Conclusion: Dry needling combined with botulinum toxin-A injections performed over a total of four sessions with three-day intervals, contribute to the antispastic effect. Also combined therapy is more effective and provides longer-lasting results.

Adolescent marriage and motherhood in Turkey: A qualitative study exploring determinants, impacts and opinions about preventive strategies.

AIM: This study aimed to understand the determinants of child marriages, becoming a child mother, their impacts and opinions about preventive strategies. DESIGN: The phenomenological research approach was adopted with one-to-one semi-structured interviews between December 2017 and May 2018. METHODS: The population of the study consisted of 36 adolescent married mothers registered in the Family Health Centres. Interviews were recorded, transcribed and evaluated based on a thematic analysis was conducted. RESULTS: In the study, four main themes and 12 subthemes were determined. Adolescent marriages determinants occurred as patriarchal cultural norms, the perception that girls would be safe under the protection of another man, and poverty. Adolescent brides experienced partner violence and were subjected to physical, psychological and sexual violence in their marriage. Adolescent mothers had low maternal self-confidence, childcare challenges and were late to take on childcare responsibilities, and their children were neglected. As a result of early marriage, the participants experienced psychological problems and burnout later in their lives. Improving family-child communication, and eliminating financial inadequacies were among the opinions on prevention strategies of child marriages. CONCLUSION: The findings of this study identified the determinants and impact of adolescent marriages and revealed the problems experienced by adolescent brides and mothers. IMPACT: The most important contribution of this study is that it deals with the motherhood experiences. In addition, it is one of the important findings of this study that it draws attention to their neglected children's due to lack of knowledge and experience of their mothers about childcare.

The relationship between personality traits, menopausal symptoms, and marital adjustment.

This study was aimed at determining the relationship between personality traits, menopausal symptoms and marital adjustment in postmenopausal women. This cross-sectional study was conducted with 599 postmenopausal women who presented to the family health centers between September 2018 and February 2019. Data were collected with the Personal Information Form, Marital Adjustment Test, Cervantes Personality Scale and Menopause Rating Scale. The mean marital adjustment score of the postmenopausal women was 44.03 ± 10.75. The correlation analysis revealed significant negative correlations between marital adjustment, and personality traits and menopausal symptoms. Education level, economic status, duration of menopause, neurotic and inconsistent personality traits, somatic, psychological and urogenital symptoms were determined to be statistically significant predictive factors of marital adjustment in postmenopausal women.

Effects of Robot-Assisted Gait Training in Patients With Multiple Sclerosis: A Single-Blinded Randomized Controlled Study.

OBJECTIVE: This study aims to evaluate and compare the effects of conventional and robot-assisted gait training (RAGT) programs on fatigue, mood, and quality of life in patients with multiple sclerosis who have fatigue. METHODS: In this single-blinded, randomized controlled study, 37 patients with multiple sclerosis were randomized into two groups: RAGT ( n = 18) and conventional gait training ( n = 19). The RAGT group had gait training with RoboGait, whereas the conventional gait training group received conventional physiotherapist-assisted gait training. Outcome measures were the Fatigue Severity Scale, Hospital Anxiety Depression Scale, Multiple Sclerosis Quality of Life-54, Extended Disability Status Scale, Functional Ambulation Category, Berg Balance Test, and 6-min walk test. RESULTS: Baseline demographic, clinic, and functional data were similar. Both groups showed improvements in the Fatigue Severity Scale, Hospital Anxiety Depression Scale-Depression, Multiple Sclerosis Quality of Life, Berg Balance Test, and 6-min walk test scores after treatment. Only the RAGT group showed an improvement in Hospital Anxiety Depression Scale-Anxiety score. The RAGT group had better Fatigue Severity Scale, and Hospital Anxiety Depression Scale scores. CONCLUSION: In combination with the standard rehabilitation program, both RAGT and conventional gait training are effective for multiple sclerosis. However, RAGT has superior effects in terms of fatigue, depression, and anxiety. Therefore, it may be preferred in multiple sclerosis patients who exhibit prominent symptoms of fatigue, depression, or anxiety.

Relationships between leadership orientations and emotional intelligence in nursing students.

PURPOSE: To describe the relationship between leadership orientation and emotional intelligence levels of nursing students. METHOD: The study is a cross-sectional and descriptive correlational study. RESULTS: This study was carried out with 320 nursing students. There was a positive relationship between the mean scores for the Leadership Orientations subdimensions and the mean scores for the overall Emotional Intelligence Evaluation Scale and its subdimensions. PRACTICE IMPLICATIONS: More studies are needed to examine the relationship between students' emotional intelligence and leadership orientations.

The Effect of the Modified Constraint-Induced Movement Therapy on the Upper Extremity Functions of Obstetric Brachial Plexus Palsy Patients.

Objectives: Functional limitation of the upper extremity (UE) in obstetrical brachial plexus paralysis (OBPP) restricts a child's participation in daily living and social activities. In treatment, the participation of UE in rehabilitation is important. Constraint-induced movement therapy (CIMT) is a promising rehabilitation approach that is used to improve the UE functions of patients with neurological dysfunctions. Methods: This single-blinded randomized controlled clinical trial includes 30 pediatric patients diagnosed with chronic OBPP aged between 2 and 12 years. The patients were divided into two groups as a modified CIMT group and a control group. Patients in both groups underwent classical rehabilitation treatment 4 times a week for 8 weeks. Range of motion (ROM), stretching, strengthening, and proprioceptive exercises were given to both control and CIMT group. The patients in the CIMT group had to wear constraining arm slings 2 h per day and 4 days a week for 8 weeks. The patients were evaluated both before and after treatment using the Mallet classification system and the Melbourne unilateral upper limb assessment-2 (The MA2) scale. Results: In both groups, the Mallet and MA2 scores significantly increased after the treatment process. However, the percentage of improvement was higher for the CIMT group. Conclusion: Modified CIMT improves the joint ROM and the functional use of the extremity among OBPP-diagnosed children. This improvement is greater in the CIMT group compared to the improvement in the control group. Implementation of CIMT in a routine rehabilitation process may be helpful.

The effect of vitamin D and exercise on balance and fall risk in postmenopausal women: A randomised controlled study.

OBJECTIVE: To evaluate the effects of vitamin D and exercise on balance, fall risk and quality of life (QoL) in postmenopausal women. METHODS: In this prospective, randomised, controlled, single-blind study postmenopausal women aged 50-70 years were included. Participants with <25nmol/L 25(OH) vitamin D were randomised to three groups: group-I (vitamin D replacement) (n = 21), group-II (core and balance exercises) (n = 18), and group-III (vitamin D replacement plus core and balance exercises) (n = 20). The participants with >75nmol/L 25(OH) vitamin D (group-IV) (n = 40) were designated as control group and received the core and balance exercises. The participants were evaluated before and after 8 weeks with Berg balance test and Biodex balance system (postural stability and fall risk tests) for balance and Nottingham Health Profile (NHP) for QoL. RESULTS: Group IV had better baseline BBT, NHP pain, NHP emotional reactions, NHP social isolation subdomain and total score. After treatment, all groups showed significant improvement in balance (except group I, mediolateral stability index) and QoL (except group II). There was no significant difference between groups (I, II and III) after intervention. CONCLUSION: Vitamin D replacement therapy has positive effects on balance and QoL. Core strengthening and balance exercises are essential for better balance and fall prevention in postmenopausal women. Any superior effect of vitamin D or exercise on each other was not determined.

Relationship between self-esteem, perception of gender and attitudes towards dating violence among university students.

PURPOSE: The aim of this study was to determine the relationship between self-esteem, perception of gender, and attitudes towards dating violence among university students. DESIGN AND METHODS: This descriptive study with a correlational and cross-sectional design was conducted with the participation of 686 university students. FINDINGS: Mother's educational level, gender, having a dating relationship, being exposed to dating violence in the relationship, perception of gender, self-esteem, and being exposed to/witnessing sexual/domestic violence were determined to be statistically significant predictive factors of the attitudes of the students towards dating violence. PRACTICE IMPLICATIONS: Nurses should plan evidence-based and individualized counseling services for young people who are the victims of dating violence by considering possible risk factors.

Determination of Dyadic Adjustment, Happiness and Related Factors in Married Turkish Women Living in Anatolia.

Nowadays, divorce rate increases rapidly; therefore evaluation, of dyadic adjustment and happiness at marriage gains importance. In the study, 910 women were reached and 772 married women agreed to participate in the study. Women have a mild level for dyadic adjustment and happiness with spouses. Sociodemographic factors such as income status, age, age at first marriage, the number of children, duration of marriage, woman's and her husband's education level and type of marriage affect dyadic adjustment and relationship happiness. It is recommended that within the scope of primary healthcare, women should be followed in terms of dyadic adjustment and factors affecting dyadic adjustment, happiness and that couples who are at risk should be provided counseling services.

Prenatal distress levels of pregnant women in Turkey and affecting factors: a multicentre study.

This study was conducted to determine prenatal distress levels of pregnant women from seven provinces of Turkey and factors affecting prenatal distress levels. The multicentre descriptive study included 2365 pregnant women who were in the twentieth gestational week and above. The data were collected using the pregnancy information form, prenatal distress questionnaire and spousal support scale. Descriptive statistics, Student's t-test, ANOVA and logistic regression were used to evaluate the data. The results of this study demonstrated that pregnant women's prenatal distress levels are affected by such factors as the region lived in, lack of spousal support and being a primary school graduate. Nurses should develop intervention strategies that involve the pregnant woman's spouse to reduce prenatal distress and the factors affecting prenatal distress.Impact statementWhat is already known on this subject? Prenatal distress can have significant effects on pregnancy, maternal health and human development across the lifespan.What the results of this study add? Spousal support could also have an effect on the psychological health of mothers.What the implications are of these findings for clinical practice and/or further research? Nurses and midwives monitor the pregnant women, and therefore, they should evaluate the prenatal distress levels in the prenatal period, plan intervention strategies for pregnant women with high stress levels and include the pregnant women's spouses in these intervention strategies.

Prevalence, etiology, and biopsychosocial risk factors of cervicogenic dizziness in patients with neck pain: A multi-center, cross-sectional study.

OBJECTIVES: This study aims to investigate the prevalence, etiology, and risk factors of cervicogenic dizziness in patients with neck pain. PATIENTS AND METHODS: Between June 2016 and April 2018, a total of 2,361 patients (526 males, 1,835 females; mean age: 45.0±13.3 years; range, 18 to 75 years) who presented with the complaint of neck pain lasting for at least one month were included in this prospective, cross-sectional study. Data including concomitant dizziness, severity, and quality of life (QoL) impact of vertigo (via Numeric Dizziness Scale [NDS]), QoL (via Dizziness Handicap Inventory [DHI]), mobility (via Timed Up-and-Go [TUG] test), balance performance [via Berg Balance Scale [BBS]), and emotional status (via Hospital Anxiety- Depression Scale [HADS]) were recorded. RESULTS: Dizziness was evident in 40.1% of the patients. Myofascial pain syndrome (MPS) was the most common etiology for neck pain (58.5%) and accompanied with cervicogenic dizziness in 59.7% of the patients. Female versus male sex (odds ratio [OR]: 1.641, 95% CI: 1.241 to 2.171, p=0.001), housewifery versus other occupations (OR: 1.285, 95% CI: 1.006 to 1.642, p=0.045), and lower versus higher education (OR: 1.649-2.564, p<0.001) significantly predicted the increased risk of dizziness in neck pain patients. Patient with dizziness due to MPS had lower dizziness severity scores (p=0.034) and milder impact of dizziness on QoL (p=0.005), lower DHI scores (p=0.004), shorter time to complete the TUG test (p=0.001) and higher BBS scores (p=0.001). CONCLUSION: Our findings suggest a significant impact of biopsychosocial factors on the likelihood and severity of dizziness and association of dizziness due to MPS with better clinical status.

Association between Turkish clinical nurses' perceptions of individualized care and empathic tendencies.

PURPOSE: This study aimed to determine the association between nurses' perceptions of individualized care and empathic tendencies. DESIGN AND METHODS: This cross-sectional study was conducted with 269 nurses working in Yozgat City Hospital between June 2018 and December 2018. Data were collected with the Personal Information Form, Individualized Care Scale-A-Nurse Version, Empathic Tendencies Scale. For the analysis, descriptive statistics, t test, analysis of variance, Pearson's correlation, multivariate linear regression analysis were used. FINDINGS: Marital status, education level, length of service, clinic worked in, number of patients, and empathic tendency level was determined to be statistically significant predictive factors for nurses' perceptions of individualized care (P < .05). PRACTICE IMPLICATIONS: Nurse managers can organize in-service training programs to improve clinical nurses' perceptions of individualized care, empathic tendencies, and skills.

Transient Osteoporosis of the Hip: A Case Report.

Transient osteoporosis of the hip, idiopathic, is a table, beginning with hip pain without a history of trauma, usually self-limiting and seen in middle-aged men and pregnant women. In this case report, a male patient who was admitted because of hip pain and detected transient osteoporosis go the hip was discussed. The purpose of the case presentation is to emphasize the necessity of transient osteoporosis of the hip in the differential diagnosis of sudden onset of hip pain and to review the literature on this subject.

Idiopathic Lumbosacral Neuropathy Syndrome: Case Report.

Idiopathic lumbosacral plexitis or lumbosacral radiculoplexus neuropathy is a disease characterized by nerve damage in lumbar and/or sacral plexus without trauma, mass effect or diabetic complications. A 47-year-old male patient with right groin pain and loss of right leg muscle strength is presented in this case report. Neuropathy was detected in the L4 nerve root by electromyography and magnetic resonance neurrographic imaging. The underlying cause was investigated; however, it is linked to the idiopathic outcome. Idiopathic lumbosacral neuropathy is a lumbosacral plexus disease in which no underlying pathology plays a role in causing severe pain and muscle weakness. Patients should be avoided urgently operation because of the sudden onset symptoms.