Med Bull Sisli Etfal Hosp. 2018; 52(1): 64-69 | DOI: 10.14744/SEMB.2017.69772

The Effect of Associated Parkinsonism on Rehabilitation in Stroke Patients: A Case Series

Selda Çiftci¹, Banu Kuran¹, Zehra Duman¹, Figen Yýlmaz¹, Cansu Mert¹, Gülgün Durlanýk¹, Jülide Öncü¹, Bilge Düden¹, Hüseyin Bertan¹, Cem Erçalýk², Rana Terlemez^1
1Department of Physical Therapy and Rehabilitation, Þiþli Hamidiye Etfal Training and Research Hospital, Ýstanbul, Turkey
²Department of Physical Therapy and Rehabilitation, Arel Universty Faculty of Health Sciences, Ýstanbul, Turkey

Stroke and Parkinson's disease are 2 major causes of movement impairment and a decreased ability to perform daily activities. The aim of this case series was to demonstrate the difficulty of rehabilitation in stroke patients with accompanying parkinsonism. Four stroke patients with parkinsonism who underwent rehabilitation at the Physical Medicine and Rehabilitation Clinic between March and May of 2016 were evaluated. The Standardized Mini-Mental State Examination (SMMSE), the Functional Independence Measure (FIM), the Barthel Index (BI), the Berg Balance Scale (BBS), and the Stroke Impact Scale version 3.0 (SIS) were used in the assessment. Of the 4 patients, 3 were female, and the mean age was 74.5±9.3 years. The mean hospital stay was 19±5.3 days. The initial test scores recorded were low, and they remained low at the time of discharge. After rehabilitation, the mean FIM score in the group was 42% of the maximum possible score, the mean SMMSE was 55%, the BI was 18%, the BBS was 0.08%, and the SIS was 25%. Three patients required a wheelchair, and 1 patient could ambulate with a walker at discharge. A stroke accompanied by parkinsonism negatively affects mobility and functional status, primarily through the deterioration of balance. In this study, cognitive function was reduced to half of the maximum, and the balance and function loss was more than 50%. Barthel index; berg balance scale; functional independence measure; mini-mental state examination; parkinsonism; stroke; stroke impact scale.

Keywords: Barthel Index, Berg Balance Scale, Functional Independence Measure, Mini-Mental State Examination, parkinsonism, stroke, Stroke Impact Scale.

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Ýnmeli Olgularda Eþlik Eden Parkinsonizm Bulgularýnýn Rehabilitasyona Etkisi: Olgu Serisi

Selda Çiftci¹, Banu Kuran¹, Zehra Duman¹, Figen Yýlmaz¹, Cansu Mert¹, Gülgün Durlanýk¹, Jülide Öncü¹, Bilge Düden¹, Hüseyin Bertan¹, Cem Erçalýk², Rana Terlemez^1
1Saðlýk Üniversitesi, Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Fiziksel Týp ve Rehabilitasyon Kliniði, Ýstanbul
²Arel Üniversitesi, Saðlýk Bilimleri Fakültesi, Ýstanbul

Ýnme ve Parkinson Hastalýðý (PH), kiþide hareket yeteneðini, kendine bakým aktivitelerini azaltan iki önemli hareket bozukluðu nedenidir. Bu sunumda inmeli olgularda, eþlik eden Parkin-sonizm bugularý nedeniyle rehabilitasyonun güçleþtiðini, klinik ölçeklerle açýklamayý amaçladýk. Fiziksel Týp ve Rehabilitasyon Kliniði’nde Mart-Mayýs 2016 tarihlerinde yatan dört inme olgusunda Parkinsonizm birlikteliðini gözden geçirdik. Hastalarýn giriþ ve taburculuk sýrasýnda klinik ölçeklerle rehabilitasyonun etkinliði deðerlendirdik. Deðerlendirmede kullanýlan klinik ölçekler Standardize Mini Mental Test (SMMT), Fonksiyonel Baðýmsýzlýk Ölçeði (FBÖ), Barthel Ýndeksi (BI), Berg Denge Ölçeði (BDÖ) ve Ýnme Etki Ölçeði versiyon 3.0 (ÝEÖ 3.0) idi. Olgularýn üçü kadýn, biri erkek, yaþ ortalamasý 74.5±9.3 yýl, ortalama yatýþ süresi 19.0±5.3 gün idi. Giriþ sýrasýnda düþük olan puanlar taburculuk sýrasýnda da düþüktü. En iyi puana göre kýyaslandýðýnda, olgularýn FBÖ ortalamasý en yüksek deðerin %42’si, SMMT ortalamasý %55’i, taburculuk BI ortalamasý %18’i, BDÖ ortalamasý %0.08’i, ÝEÖ 3.0 ortalamasý %25’i kadardý. Üç olgu tekerlekli sandalye, bir olgu yürüteçle yürüme seviyesinde taburcu edildi. Ýnme ile birlikte Parkinsonizm bulgularý varlýðýnýn, özellikle denge bozukluðu olmak üzere, hastalarýn mobilite ve fonksiyonel durumunu olumsuz etkilediðini gözledik. Kognitif fonksiyonlarý normalin yarýsý kadar olmakla beraber dengeleri ve fonksiyonel durumlarý yarýdan fazla oranda olumsuz etkilenmiþti.

Anahtar Kelimeler: Barthel indeksi, berg denge ölçeði, fonksiyonel baðýmsýzlýk ölçeði, inme, inme etki ölçeði versiyon 3.0, parkinson hastalýðý, standardize mini mental testi

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