deficit. Sometimes the pain can be unbearable but the patient does not want surgical intervention. Nerve root compression may stimulate inflammatory processes (14,17), providing a rationale for the use of corticosteroids to inhibit inflammation and alleviate pain. The transforaminal epidural injection of corticosteroids under fluoroscopic guidance delivers high concentrations of therapeutic agents to the site of pathology (5). Appropriately performed transforaminal epidural steroid █ INTRODUCTION R adicular pain is most commonly caused by mechanical compression of the nerve root by lumbar disc herniation or peripheral foraminal stenosis and has considerable economic significance (7). In most cases, the pain stops spontaneously or can be relieved with conservative treatment. However, some lumbar disc herniation cases require surgical intervention because of persistent severe pain or neurological AIM: To compare the outcomes of fluoroscopically guided transforaminal epidural steroid injections between L4-L5 paramedian disc herniation and L5-S1 paramedian disc herniation for the treatment of radicular pain. MATERIAL and METHODS: A total of 593 patients treated by transforaminal epidural steroid injections for the treatment of L4-5 paramedian disc herniation and 504 patients treated by transforaminal epidural steroid injections for the treatment of L5-S1 paramedian disc herniation were included in the study. All the patients were regularly followed up for 12 weeks. Preprocedural Visual Analogue Scale (VAS) scores, 12-week post-procedural VAS scores and complications were recorded. RESULTS: The mean preprocedural and postprocedural VAS scores for L4-5 paramedian disc herniation were 63.09 ± 5.37 and 15.81 ± 3.58, respectively, and the mean preprocedural and postprocedural VAS scores for L5-S1paramedian disc herniation were 61.15 ± 5.45 and 27.06 ± 3.62, respectively, for radicular pain. There was a statistically significant difference between preprocedural and postprocedural VAS scores for L4-5 and L5-S1 paramedian disc herniation (p<0.05). Transforaminal epidural steroid injections for L4-5 paramedian disc herniation were more effective than transforaminal epidural steroid injections for L5-S1 paramedian disc herniation. CONCLUSION: This study showed that transforaminal epidural steroid injections for L4-5 paramedian disc herniation were more effective than transforaminal epidural steroid injections for L5-S1 paramedian disc herniation in the 12-week follow-up period.
ÖZET GİRİŞ: Amacımız subakut inmeli hastalarda, kısmi vücut ağırlık destekli (VAD) yürüme bandı eğitiminin etkilerini araştırmak. GEREÇ ve YÖNTEM: Yirmi hasta randomize olarak iki gruba ayrıldı. Grup1'deki hastalar konvansiyonel tedavi ve kısmi VAD ile yürüme bandı eğitimi, grup2'deki hastalar sadece konvansiyonel tedavi programına alındı. Fonksiyonel Ambulasyon Skalası(FAS), Rivermand Motor Değerlendirme gross(RMD1) ve total gross(RMD2) fonksiyon, Berg denge testi, Barthel İndeksi(Bİ), yürüme mesafesi(6dak), yürüme zamanı(10m), kadans, sağ/sol adım uzunluk oranları ve yüzelsel kas aktivitesi s(EMG) tedavi öncesi (TÖ), tedavi sonrası(TS) ve 3.ayda değerlendirildi. BULGULAR: I.grupta parametrelerin tümünde TS ve 3.ayda anlamlı iyileşme tespit edildi(P<0.05). 2.gruptaki hastalarda FAS, RMD2, tibialis anterior (TA) ve gastroknemius kasları s(EMG) ölçümlerinde, TS ve 3.ayda anlamlı iyileşme gözlenirken (p<0.05) sağ/sol adım uzunluk oranlarında TS ve 3.ayda iyileşme bulunmadı(p>0.05), diğer parametrelerde sadece 3. ayda iyileşme tespit edildi(p>0.05). Gruplar TÖ-TS, TÖ-3.ay farkları açısından karşılaştırıldığında,10m yürüme zamanı hariç grup1 lehine olmak üzere FAS da TS ve 3.ayda(p<0.001),RMD1 de TS (p<0.001), 3.ayda (p<0.05), RMD2, Berg denge testinde TS ve 3.ayda(p<0.01), 6 dak yürüme mesafesi, kadans, TA s(EMG) de TS(p<0.01) 3.ayda(p<0.05) ve gastroknemius s(EMG) ve sağ/sol adım uzunluk oranlarında ise sadece TS(p<0.05) anlamlı farklılık tespit edildi. TARTIŞMA: Konvansiyonel tedaviyle birlikte kısmi VAD'li yürüme bandı eğitiminin, konvansiyonel tedaviye kıyasla, yürüme eğitimi üzerine daha etkili olduğu görülmüştür. Anahtar Sözcükler: Hemipleji, rehabilitasyon, yürüyüş EFFECTIVINESS OF GAIT TRAINING WITH PARTIAL BODY-WEIGHT SUPPORT IN SUBACUTE STROKE PATIENTS SUMMARY BACKROUND AND PURPOSE:Our goal was to determine effects of partial body weight-supported(BWS)-treadmil training on subacute stroke patients. METHODS: Twenty patients were randomly assigned into two groups.Patients in group1 were participated in conventional treatment and partial BWS-treadmil training.Patients in group2 were participated only in conventional treatment.Functional Ambulation Scale(FAS),Rivermead Motor Evaluation gross(RMD1) and total gross(RMD2) function, Berg Balance Scale,Barthel Index(BI), walking-distance(6min), walking-time(10m), cadence rate, ratios of right-left step length,s(EMG), superficial muscle activity were evaluated in pretreatment and posttreatment periods, and 3-months. RESULTS: Patients in group1 showed statistically significant improvements in all parameters at posttreatment and 3-months(p<0.05).In group2, while there were significant improvements in FAS, RMD2, TA, gastrocnemius s(EMG) measurements at posttreatment and 3-months(p<0.05), no improvements were found in ratios of right-left step length at posttreatment period(p>0.05); for remaining parameters, improvements were found at 3-months(p>0.05). When groups were compared with regard to differences between pretreatment and posttreatment and pretreatment and 3-mont...
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