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  • Article
    Citation - WoS: 21
    Citation - Scopus: 30
    Quantification of the Effects of Transcutaneous Electrical Nerve Stimulation With Functional Magnetic Resonance Imaging: a Double-Blind Randomized Placebo-Controlled Study
    (W B Saunders Co-elsevier inc, 2010) Kara, Murat; Ozcakar, Levent; Gokcay, Didem; Ozcelik, Erol; Yorubulut, Mehmet; Guneri, Sinem; Cetin, Alp
    Objective: To evaluate the effects of transcutaneous electric nerve stimulation (TENS) by using functional magnetic resonance imaging (fMRI) in patients with carpal tunnel syndrome (CTS). Design: Randomized controlled trial. Settings: University medical center and an outpatient imaging center. Participants: Female patients with CTS (n=20) were randomized into 2 groups receiving either TENS (n=10) or sham TENS (n=10). In both groups, an initial baseline fMRI session was performed via stimulating digits 2, 5, and 3 in turn, I scan run for each. TENS versus sham TENS treatment was given, and a repeat imaging was performed starting 20 minutes after the treatment as follows: second finger on the 20th minute, fifth finger on the 25th minute (ulnar nerve innervated control finger), and third finger on the 30th min. Interventions: Not applicable. Main Outcome Measure: Differences in fMRI activation between the 2 groups were evaluated. Results: Our results demonstrated that 20 to 25 minutes after TENS treatment-but not in the sham TENS group-a significant fMRI signal decrease for digit 2 (post-TENS vs baseline) was observed in the secondary somatosensory regions, ipsilateral primary motor cortex (M1), contralateral supplementary motor cortex (SMA), contralateral parahippocampal gyrus, contralateral lingual gyrus, and bilateral superior temporal gyrus. Measurements on the 25th to 30th minutes for digit 5 were similar between the groups, with presence of activities in areas other than generally activated regions because of painful stimuli. Thirty to 35 minutes after TENS treatment, a significant fMRI signal decrease for digit 3 was detected in the contralateral M1 and contralateral SMA only in the TENS group. Conclusions: Our findings showed that TENS treatment significantly decreased the pain-related cortical activations caused by stimulation of the median nerve innervated fingers up to 35 minutes after treatment.
  • Conference Object
  • Article
    Rehabilitation in Neuromuscular Diseases: Best Turkish Practice Recommendations by Multidisciplinary Experts
    (Springer Heidelberg, 2025) Umay, Ebru; Tanigor, Goksel; Toraman, Fusun; Karaahmet, Ozgur; Bilgilisoy, Meral; Sertpoyraz, Filiz; Nazli, Fatma
    Background and aim:Neuromuscular diseases (NMDs) are a heterogeneous group of diseases including motor neurone diseases (MND), muscle diseases (MD), neuropathies and neuromuscular junction diseases (NMJD). NMDs are characterized by a wide range of symptoms and findings, depending on different underlying issues. Therefore, the literature includes specific management and/or rehabilitation recommendations for each subgroup and even for some diseases within these subgroups. Currently, neither in our country nor globally is there a comprehensive recommendation study that thoroughly addresses all aspects of NMD rehabilitation developed by experienced and specialized multidisciplinary experts in the field.Materials and methodsThe recommendations in this paper have been created by a multidisciplinary team for all patients without age limitation under the headings of peripheral neuropathy/polyneuropathy, MND, MD and NMJD using the seven-step and 3 round modified Delphi method via e-mail. The strength of agreements (SOA) was calculated for each item (recommendation) using percentages (response of between 8 and 10%), median values, and interquartile range with Kappa method.ResultsThe opinions of the experts were analysed according to the 3-round modified Delphi method, and a list of 110 items of recommendations for patients with NMDs of all ages was prepared in as much detail as possible to shed light on almost all questions and problems that may be encountered in clinical practice. There were 5 recommendations in the general management subsection, 20 recommendations in the rehabilitation indications subsection, 8 recommendations in the rehabilitation contraindications section, and 77 recommendations in the rehabilitation section (general principles 7 recommendations, modalities 13 recommendations, exercise characteristics 57 recommendations).ConclusionWe think that this study will be a light for physicians dealing with this patient group in clinical practice, as it includes fine details up to exercise prescriptions.