Objectives In COVID-19, severe lung involvement develops in some patients. The reason for the predisposition to lung involvement in some patients is not yet fully understood. Genetic variabilities in angiotensin-converting enzyme (ACE) may explain why some patients are more susceptible to lung injury. Thus, the ACE gene insertion/deletion (I/D) polymorphism was investigated in COVID-19 patients with and without lung involvement. Methods The study involved 216 patients who were divided into two groups as with and without pulmonary involvement according to their thoracic computed tomography (CT) scan findings. The ACE I/D gene polymorphism was determined. Results Carriers of the DD genotype had a 4.05-fold (OR=4.05, 95% CI: 1.66–9.86, p=0.001) greater incidence of pulmonary involvement. The probability of lung involvement was 2.41-fold higher in D allele carriers (OR=2.41, 95% CI: 1.62–3.60, p=0.000). The I allele was found to be protective and diminished the occurrence of lung involvement (OR=0.41, 95% CI: 0.28–0.62, p=0.000). Conclusions In COVID-19 patients, the I allele may lower the risk of lung injury and provide a protective effect. Conversely, the D allele may raise the risk of lung injury and lead to poor outcomes.

Objectives: This study aims to examine the effect of virtual reality (VR) training, frequently included in rehabilitation programs, on lower extremity functional status, mobility, balance, and walking speed in chronic stroke patients. Patients and methods: This randomized, controlled study was conducted with 60 chronic stroke patients (26 males, 34 females; mean age: 64.0 years; range, 33 to 80 years) who presented to the physical therapy and rehabilitation outpatient clinic of the Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital between February 2019 and February 2020. The participants were randomized to the VR group and the control group by simple randomization with 1:1 allocation. The VR group received 30 min of VR training and 30 min of conventional physiotherapy, while the control group received 60 min of conventional physiotherapy. The patients were evaluated before and after treatment using the Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Rivermead Mobility Index (RMI), 10-m walk test (10MWT), and Berg Balance Scale (BBS). Results: The FMA-LE, RMI, 10MWT, and BBS scores significantly improved in both groups after treatment (p<0.001). The post-treatment change in the FMA-LE score was significantly higher in the VR group than in the control group (Z=-3.560, p<0.001). Similarly, the change in the BBS score was significantly higher in the VR group (Z=-3.769, p<0.001). Post-treatment changes in the RMI and 10MWT were not significant (p>0.05). Conclusion: Virtual reality training combined with conventional physiotherapy was found to be superior to conventional physiotherapy alone in improving lower extremity functional status in chronic stroke patients; therefore, adding a VR component to rehabilitation programs will have a favorable impact on treatment outcomes.

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This study aimed to investigate the relationship between pain severity and depression level and quality of life in elderly patients with chronic non-specific low back pain (CNLBP) and determine the effect of age group on the quality of life, pain severity and depression symptom levels of patients. Evaluation parameters were obtained using scales specific to geriatric patients. Pain severity, depression, and quality of life were evaluated using the Geriatric Pain Measure (GPM), Geriatric Depression Scale (GDS), and World Health Organization Quality of Life Questionnaire-Older Adults Module (WHOQOL-OLD), respectively. The study included a total of 231 patients with CNLBP (age ≥65 years), of whom 62.3% (n=144) were female and 37.7% were male (n=87). There was a moderate correlation between the patients’ GDS and GPM scores (r=0.53; p&lt;0.05). GDS also had a moderate correlation with the ‘past-present-and-future activities’ (r=-0.52) and ‘social participation’ (r=-0.48) subdomains of WHOQOL-OLD (p&lt;0.05). According to age groups, the only statistically significant difference was observed in ‘sensory abilities’ (p&lt;0.05). Quality of life is negatively affected by the level of depression and pain intensity in elderly individuals with CNLBP. Evaluation of pain severity and depressive symptom levels in elderly patients with CNLBP may contribute to the establishment of an elderly population with improved quality of life and treatment approach. There is a need for further studies to reveal the reasons for poorer quality of life and increased depression and pain.

Aim: The aim of this study was to investigate the efficacy of a home-based breathing exercise program on dyspnea, quality of life, depression and sleeping disorders in patients with COVID-19 after discharge from the hospital. Methods: The study was completed with a total of 60 participants. The intervention group (n=39) received a homed-based exercise program including controlled breathing techniques and low-intensity upper and lower extremity exercises. The control group (n=21) did not receive any intervention. The patients were evaluated with the Modified Borg Scale (MBS), Nottingham Health Profile (NHP), Insomnia Severity Index (ISI) and Beck Depression Inventory (BDI) before and at the end of the intervention. Results: After treatment, the MBS scores significantly decreased in both the intervention and control groups compared with the baseline values(p

OBJECTIVE: The aim of this study was to investigate the changes of the functionality, mood and life quality of patients diagnosed with hemiplegia due to an ischemic or hemorrhagic stroke during the COVID-19 pandemic. MATERIAL AND METHODS: A total of 83 patients (mean age, 62.0±6.43 years) diagnosed with hemiplegia due to stroke, who received 30 sessions of rehabilitation therapy, before the COVID-19 pandemic, were included in this study. Data regarding the participants’ age, gender, body mass index (BMI), duration of stroke, stroke type, affected side, and education level were recorded. All the assessments were undertaken before the COVID-19 pandemic and repeated at the first year after the beginning of the pandemic. The functional status of the patients was evaluated with the Functional Independence Measure (FIM). The depression levels of the participants were evaluated using the Beck Depression Inventory (BDI). The life quality of the participants was evaluated using the Stroke-Specific Quality of Life Scale (SS-QOL). RESULTS: There were significant differences in the FIM total scores of the patients evaluated before and during COVID-19 (91.32±15.94 and 87.15±15.60, respectively, p&lt;0.001).When the FIM domain scores were evaluated before COVID-19 and at the first-year control during COVID-19, the FIM self-care scores were 27.45±6.62 and 25.27±7.08, respectively, the FIM sphincter control scores were 10.10±2.56 and 9.39±2.87, respectively, the FIM transfers scores were 14.67±3.36 and 13.61±3.54, respectively, the FIM social cognition scores were 18.40±1.86 and 17.67±1.93 respectively (p&lt;0.001). The BDI score was 10.06±3.18 before the pandemic and 13.66±3.04 at the first year of the pandemic, the SS-QOL scores was 136.48±29.63 before the pandemic and 133.63±29.63 at the first year evaluation (p&lt;0.001). CONCLUSIONS: The COVID-19 pandemic has caused delays in both follow-up and rehabilitation therapy in patients with chronic hemiplegia. The functionality, life quality and mood of the patients have been affected due to the lack of therapy and social isolation.

Objectives: This study aims to investigate the effect of the hot pack application on the morphology of healthy median and ulnar nerves. Patients and methods: Between August 2021 and September 2022, a total of 54 healthy volunteers (17 males, 37 females; mean age: 31.9±9.4 years; range, 21 to 63 years) were included in the study. The cross-sectional area (CSA) and depth of the right median and ulnar nerve were measured using ultrasonography before and after 20-min hot pack application. The right median nerve CSA and depth from the level of the scaphoid bone (at the level of the carpal tunnel) and from the mid-forearm were also measured. The right ulnar nerve CSA and depth from the level of the hook of hamate and the mid-forearm were evaluated. The depth measurements between the skin and the outer hyperechoic border of the nerve were performed. Results: After the hot pack application, there was an increase in both the median nerve CSA at the carpal tunnel (from 0.06±0.01 to 0.09±0.02 cm2) and forearm (from 0.06±0.02 to 0.09±0.02 cm2) levels (p<0.001) and the ulnar nerve CSA at the hook of hamate (from 0.04±0.03 to 0.06±0.01 cm2) and forearm (0.05±0.01 to 0.08±0.02 cm2) levels (p<0.001). No statistically significant difference was observed between the pre- and post-application depth measurements (p>0.05). Conclusion: Our study results show that the hot pack application leads to acute swelling of the median and ulnar nerves. In future studies, the relationship between morphological changes in healthy and pathological nerves and electrodiagnostic findings should be investigated.

Mirror therapy is a method that increases the functionality of the affected extremity and is effective in the treatment of chronic pain. In this study, we aimed to investigate the effect of mirror therapy on shoulder impingement syndrome. The study included 62 participants, including 31 in the intervention group (IG) and 31 in the control group (CG) who met the inclusion criteria. IG received mirror therapy with conventional physiotherapy while CG received only conventional physiotherapy. The patients were evaluated before treatment and immediately after treatment with Visual Analog Scale (VAS) score for pain, goniometric measurement for shoulder range of motion, modified Constant-Murley score for functionality, and Tampa Kinesiophobia Scale (TSK) for kinesiophobia. After treatment, the change in the VAS score was 5.51 ± 1.89 for IG, 2.80 ± 2.61 for CG, and the significance was p&lt;0.01. The change in the TSK score was 10.83 ± 9.53 for IG and 1.66 ± 4.85 for CG (p&lt;0.01). The change in the total Constant-Murley score was 23.77 ± 11.41 for IG and 9.60 ± 9.70 for CG, and the significance was calculated as p&lt;0.01. This study showed that the addition of mirror therapy to conventional treatment can improve pain severity, functionality, and levels of kinesiophobia in patients with unilateral shoulder impingement syndrome. The decrease in fear of movement along with pain in impingement syndrome has shown that mirror theraphy can be used in the treatment of different diseases for which it has not been used before.