Burcu Ersoz Huseyinsinoglu

While mirror therapy (MT) has shown efficacy in treating various conditions, its practice remains inconsistent due to the lack of a standardized protocol. This study aimed to assess the impact of integrating shaping activities into MT on motor learning, motor dexterity and reaction time of the non-dominant hand in healthy individuals. This case-control study included 30 healthy adults in the MT group (MTG) and 30 age- and gender-matched controls. MTG underwent shaping activities combined with MT twice a week for four weeks, while controls received no intervention and maintained their usual routines. Motor learning, dexterity and reaction time were assessed at baseline and after four weeks using the the Finger Tapping Test (FTT), Roeder Manipulative Aptitude Test [unilateral (RU), bilateral (RB), total (RT)], and the Nelson Hand Reaction Time Test (NHRTT). The mean age of participants was 23.4 ± 2.41 years in both groups. Significant improvements favoring MTG were found in between group comparisons for RU ( p = 0.013), RT ( p = 0.006), and NHRTT ( p p = 0.552) and FTT ( p = 0.063). Combining MT with shaping method improved unilateral dexterity and reaction time in healthy adults. Further studies are needed to evaluate its feasibility and efficacy in clinical settings.

The purpose was to systematically review the combined effects of active noninvasive brain stimulation (NIBS) and constraint-induced movement therapy (CIMT) in patients with stroke (PwS). Eligible studies were RCTs involving PwS, comparing NIBS+CIMT with sham NIBS+CIMT. Motor impairment was assessed with the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), and functional ability with the Wolf Motor Function and Action Research Arm Test. Performance times from the motor function tests, in addition to strength measures and the Motor Activity Log (MAL) subscales, were extracted. The certainty of evidence was assessed with the GRADE. Ten RCTs (n = 420, mean age: 59.6 years, 40.7% female) were included. Findings suggested that active NIBS+CIMT combinations may improve FMA-UE compared to sham NIBS + CIMT (Hedges' g: 0.55, 95% CI: 0.09-1.1.01, p: 0.02). However, the evidence was of low certainty. No significant improvements were observed in functional ability, performance time, strength, or MAL subscales between groups (p > 0.12 for all). Low-certainty evidence suggests that active NIBS combined with CIMT may lead to modest improvements in upper extremity motor impairment in PwS. However, further research is needed to determine whether active NIBS+CIMT combinations improve upper extremity function.

Purpose : This study compared the effects of Neuro-Developmental Treatment-based trunk training, video game-based trunk training (VG-TT), and VG-TT with an orthotic garment in children with unilateral cerebral palsy. Methods : Forty-two children with unilateral cerebral palsy received usual physiotherapy (2 d/wk) for 8 weeks (control period). They were then randomized to 8 weeks of Neuro-Developmental Treatment-based trunk training, VG-TT, or VG-TT with an orthotic garment (2 d/wk) alongside usual physiotherapy (intervention period). Primary outcomes were the Trunk Control Measurement Scale and Becure Balance Assessment System. Secondary outcomes included the Pediatric Berg Balance Scale and Gillette Functional Assessment Questionnaire. Results : No significant improvements in trunk control were observed during the control period ( P > .05), and all groups showed significant gains during the intervention period ( P < .05). Functional and sitting balance improved in all groups throughout both periods ( P < .05). However, no significant differences were found between intervention groups in trunk control, sitting balance, balance, or walking function ( P > .05). Discussion : Trunk-specific training enhances trunk control and functional balance in children with unilateral cerebral palsy. As no approach proved superior, interventions can be tailored based on individual needs and clinical context.

Amaç: Parkinson hastalarında çift görev koşulları altında ortaya çıkan zorluklar, bireylerin öznel algılarına dayalı ölçekler ile ya da performans testleri aracılığıyla değerlendirilebilmektedir. Ancak bu iki değerlendirme yöntemi arasındaki ilişki henüz yeterince açıklığa kavuşmamıştır. Bu çalışmanın amacı, Parkinson hastalarında algılanan çift görev performansı ile gerçek zamanlı performans testleri arasındaki ilişkiyi incelemek ve farklı çift görev türlerine bağlı olarak gözlemlenen performans farklılıklarını değerlendirmekti. Yöntem: Çalışmaya, İdiyopatik Parkinson hastalığı tanısı almış, Hoehn-Yahr evre 1 ila 3 arasında olan, Mini-Mental Durum Değerlendirme puanı en az 21 olan ve demans öyküsü bulunmayan toplam 117 birey dahil edilmiştir. Gerçek zamanlı çift görev performansı, Zamanlı Kalk Yürü Testi'ne entegre edilen motor ve bilişsel ikincil görevler ile Altı Nokta Adım Testi kullanılarak değerlendirilmiştir. Algılanan performans düzeyi ise İkili Görev Anketi ile ölçülmüştür. İstatistiksel analizlerde Spearman korelasyon katsayısı ve Friedman testi kullanılmıştır. Bulgular: Katılımcıların yaş ortalaması 62,44 ± 10,06 yıl, hastalık süresi ortalaması ise 6,34 ± 4,69 yıldır. Algılanan performans ile Zamanlı Kalk Yürü Testi’nin bilişsel görevli versiyonu arasında (r=0,214; p=0,02) ve motor görevli versiyonu arasında (r=0,277; p=0,002) istatistiksel olarak anlamlı fakat zayıf düzeyde ilişkiler saptanmıştır. Altı Nokta Adım Testi ile algılanan performans arasında anlamlı bir ilişki gözlenmemiştir (r=0,165; p=0,075). Ayrıca, Zamanlı Kalk Yürü Testi’ne entegre edilen motor görevli koşulda gözlemlenen çift görev yükü, bilişsel görevli koşula kıyasla anlamlı düzeyde daha yüksek bulunmuştur (Z=-4,4; p<0,001). Sonuç: Algılanan ve gerçek-zamanlı çift-görev performansı arasındaki zayıf ilişki değerlendirmede bu iki alanın ayrı ayrı gözden geçirilmesi gerektiğini göstermektedir. Ayrıca, yürüme görevine eşlik eden ikincil görevin türü bireylerin çift görev performansı üzerinde farklı sonuçlara neden olabilir. Parkinson hastalarında bu etkilerin ayrıntılı olarak incelenmesi daha etkin rehabilitasyon planı için yol gösterici olacaktır.

This study aimed to investigate and compare the effecs of face-to-face and internet-based Basic Body Awareness Therapy (BBAT), in patients with fibromyalgia (FM). FM-diagnosed patients were randomly allocated to one of three groups: face-to-face BBAT (F2F-BBAT), internet-based BBAT (I-BBAT), or a waiting list control group (CG). The F2F-BBAT group underwent individual 8-week BBAT sessions (2 sessions per week). The I-BBAT group received an equivalent dosage of BBAT via online video conferencing software. The primary outcome was the Fibromyalgia Impact Questionnaire Revised (FIQR). Secondary outcomes included the pressure pain threshold (PPT) via algometer, the PostureScreen Mobile^® (PSM) application, the Short Form McGill Pain Questionnaire (SF-MPQ), the Short Form 36 Health Survey (SF-36), and plasma fibrinogen and haptoglobin levels. A total of 41 patients completed the study. Both the F2F-BBAT (n = 14) and I-BBAT (n = 13) groups showed significant improvements in all outcome measures (p < 0.05) with no significant difference between them (p > 0.05). Conversely, the CG (n = 14) demonstrated no substantial improvements in the outcome measures (p > 0.05). Compared to the CG, both the F2F-BBAT and I-BBAT groups exhibited superior results in FIQR, PPT, PSM, SF-MPQ, and multiple SF-36 sub-parameters (p < 0.05). This study showed that BBAT delivered via internet-based telerehabilitation can have comparable effective results on clinical parameters with conventional face-to face BBAT in patients with FM. ClinicalTrials.gov: NCT04981132.

Background The treatments based on motor control and motor learning principles have gained popularity in the last 20 years, as well as non-invasive brain stimulations that enhance neuroplastic changes after stroke. However, the effect of intermittent theta burst stimulation (iTBS) in addition to evidence-based, intensive neurorehabilitation approaches such as modified constraint-induced movement therapy (mCIMT) is yet to be investigated. Aim We aim to establish a protocol for a randomized controlled study investigating the efficiency of mCIMT primed with iTBS after stroke. Methods In this randomized controlled, single-blind study, patients with stroke (N = 17) will be divided into 3 groups: (a) mCIMT + real iTBS, (b) mCIMT + sham iTBS, and (c) mCIMT alone. 600-pulse iTBS will be delivered to the primary motor cortex on the ipsilesional hemisphere, and then, patients will receive mCIMT for 1 h/session, 3 sessions/week for 5 weeks. Upper extremity recovery will be assessed with Fugl-Meyer Test-Upper Extremity and Wolf Motor Function Test. Electrophysiological assessments, such as Motor-Evoked Potentials, Resting Motor Threshold, Short-Intracortical Inhibition, and Intracortical Facilitation, will also be included. Conclusions In this study, a protocol of an ongoing intervention study investigating the effectiveness of iTBS on ipsilesional M1 prior to the mCIMT in patients with stroke is proposed. This will be the first study to research priming mCIMT with iTBS and it may have the potential to reveal the true effect of the iTBS when it is added to the high-quality neurorehabilitation approaches. Trial registration Trial registration number: NCT05308667

Background: Parkinson’s disease (PD) is a common neurodegenerative illness associated with motor symptoms. Aim: The aim of study was to compare the effects of synchronous telerehabilitation-based Lee Silverman Voice Treatment® BIG (LSVT® BIG) protocol and progressive structured mobility training in patients with Parkinson’s disease (PD). Methods: Thirty-two patients diagnosed with PD (aged 40–72 years, Hoehn-Yahr stage 1–3) were randomly allocated into LSVT® BIG (Group 1) and Progressive Structured Mobility Training (Group 2) groups. Exercises were performed in both groups for 60 min a day, 4 days a week, for 4 weeks under the supervision of a physiotherapist with synchronous online videoconference method. Dynamic balance was assessed with Mini-Balance Evaluation Systems Test (Mini-BESTest) as a primary outcome measure. The secondary outcome measurements were Timed Up and Go Test (TUG), spatiotemporal parameters of gait from Kinovea® software, and postural stability from the Biodex Balance System. Other outcome measures were Activity-Specific Balance Confidence Scale-Short Form (ABC-SF), Parkinson’s Activity Scale (PAS), and Parkinson’s Disease Quality of Life Questionnaire (PDQ-39). Results: This study showed significant group-by-time interactions on Mini-BEST (p = 0.042), ABC-SF (p = 0.029), and PAS (p = 0.022) in favor of group 1. Also, TUG (p < 0.01), spatiotemporal parameters of gait (p < 0.01), and PDQ-39 (p < 0.01) were improved in both groups. Conclusion: Both synchronous telerehabilitation-based exercise protocols enhanced balance and gait, as well as activity level and quality of life in patients with PD. LSVT® BIG may be preferred to improve dynamic balance, balance confidence, and activity status in the early stages of PD. These results should be confirmed in future studies with more robust methodology. Trial registration: NCT04694872.

Amaç: Parkinson Hastalığı (PH) sonucu ortaya çıkan yürüme ve denge bozuklukları, motor donma atakları düşme riskini arttırarak fonksiyonel bağımsızlığın ve yaşam kalitesinin azalmasına neden olmaktadır. Motor imgeleme (Mİ) ve eylem gözlemi (EG) stratejileri son yıllarda PH’de fizyoterapi ve rehabilitasyon girişimleri içinde sıklıkla kullanılan yöntemlerdir. Bu derlemenin amacı; PH rehabilitasyonunda donma fenomeni, yürüme ve denge bozukluklarının azaltılması amacıyla kullanılan Mİ ve EG stratejilerinin etkinliğini araştıran klinik araştırmaların sonuçlarını incelemekti. Yöntem: Bu amaçla 2000-2021 yılları arasında PH rehabilitasyonunda Mİ ve EG stratejilerine yer veren randomize kontrollü çalışmalar ele alındı. Literatür taraması Medline (PubMed), Physiotherapy Evidence Database (PEDro), Web of Science ve Cochrane veri tabanlarında gerçekleştirildi. Bulgular: Literatür taraması sonucu 9 çalışmanın (n=267) dahil edilme kriterlerini sağladığı tespit edildi. Bu çalışmaların 4 tanesinde Mİ stratejisi, 4 tanesinde EG stratejisi tek başına kullanılırken; 1 tanesinde ise her iki stratejinin beraber uygulandığı görüldü. Çalışmaların 2 tanesinde ev-temelli tedavi programları uygulanmıştı. Uygulanan tedavi süreleri 5-45 dk/ seans, 1-3 seans/hafta ve 8 gün-12 hafta arasında idi. Parkinson hastalarında EG ve Mİ stratejilerinin egzersiz uygulamalarına ek olarak kullanıldığında yürüyüş ve mobilite üzerinde olumlu etkisi olduğu gözlemlendi. Donma fenomeni ve denge performansını iyileştirmeyi amaçlayan çalışmaların sonuçları ise çelişkiliydi. Sonuç: EG ve Mİ stratejilerinin Parkinson hastalarında yürüyüş ve mobilite üzerine olumlu etkileri olduğu görülürken; denge ve donma fenomeni üzerindeki etkilerine dair kesin bir yargıya varmak için çalışmaların sayısı yetersizdir. Bu stratejilerin kliniklerde kullanımının yanı sıra ev-temelli olarak da uygulanabildiği görüldü. Gelecek çalışmalarda Mİ ve EG stratejilerinin özellikle donma fenomeni ve denge performansı üzerine etkileri araştırılmalıdır.