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    The clinical efficacy of low-power laser therapy on pain and function in cervical osteoarthritis
    (Springer-Verlag, 2001) Özdemir, F; Birtane, M; Kokino, S
    Pain is a major symptom in cervical osteoarthritis (COA). Low-power laser (LPL) therapy has been claimed to reduce pain in musculoskeletal pathologies, but there have been concerns about this point. The aim of this study was to evaluate the analgesic efficacy of LPL therapy and related functional changes in COA. Sixty patients between 20 and 65 years of age with clinically and radiologically diagnosed COA were included in the study. They were randomised into two equal groups according to the therapies applied, either with LPL or placebo laser. Patients in each group were investigated blindly in terms of pain and pain-related physical findings, such as increased paravertebral muscle spasm, loss of lordosis and range of neck motion restriction before and after therapy. Functional improvements were also evaluated. Pain, paravertebral muscle spasm, lordosis angle, the range of neck motion and function were observed to improve significantly in the LPL group, but no improvement was found in the placebo group. LPL seems to be successful in relieving pain and improving function in osteoarthritic diseases.
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    Cognitive evaluation and functional outcome after stroke
    (Lippincott Williams & Wilkins, 2001) Özdemir, F; Birtane, M; Tabatabaei, R; Ekuklu, G; Kokino, S
    Objective: To investigate the initial overall cognitive ability and its components as a predictor of functional improvement and ambulation during rehabilitation. Initial cognitive status is widely known to be a predictive factor in functional recovery in patients with stroke although some reports have found no such relationship. Design: Baseline cognitive status was scored by Minimental State Examination and its subsections with such headings as orientation, registration, attention and calculation, recall, and language in 43 patients with postacute stroke, aged between 51 and 68 yr. Function was evaluated in terms of motor FIM(TM) and functional ambulation as categorized in Adapted Patient Evaluation and Conference System functional scale at the time of admission and discharge. Results: Only total baseline Minimental State Examination score showed a significant correlation with discharge motor FIM improvement (r = 0.31, P = 0.04) and baseline orientation score correlated significantly with functional ambulation score improvement (r = 0.31, P = 0.03). In stepwise linear regression model, the same Variables had an effect on similar outcome parameters. Conclusions: Cognitiveion evaluation should be taken as a whole to predict functional outcome in patients with postacute stroke, except for the baseline orientation score that seemed more predictive for ambulation.
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    Comparing stroke rehabilitation outcomes between acute inpatient and nonintense home settings
    (W B Saunders Co-Elsevier Inc, 2001) Özdemir, F; Birtane, M; Tabatabaei, R; Kokino, S; Ekuklu, G
    Objective: To compare outcomes in stroke survivors who received rehabilitation services in an acute inpatient rehabilitation setting (multidisciplinary rehabilitation team) with outcomes in survivors in a home-based setting (family caregivers, limited team supervision). Design: Randomized clinical trial, with mean follow-up after 60 days. Setting: Inpatient rehabilitation setting and home-based settings. Patients: Sixty patients (age range, 43-80yr) who had a stroke between 1996 and 1999 and had been referred after medical stabilization, randomly divided into 2 groups: group 1, inpatient rehabilitation; group 2, home-based rehabilitation. Interventions: Group 1: therapeutical and neuromuscular exercises with occupational therapy with professional supervision; group 2: conventional exercises with family caregiver and limited professional supervision. Main Outcome Measures: Spasticity was evaluated with the Ashworth Scale, motor status with Brunnstrom's stages, functional status with the FIMTM instrument, and cognitive status with the Mini-Mental State Examination before and after rehabilitation. Results: Patients rehabilitated in acute inpatient settings had better motor, functional, and cognitive outcomes (p < .05). Spasticity changes did not differ between the groups. Conclusion: Intense inpatient rehabilitation services for stroke survivors provide significantly more favorable functional and cognitive outcomes with relatively low complications than did nonintense rehabilitation efforts in home settings.