Our department was established in 2002 at Başkent University Adana Research and Application Center, Yüreğir Hospital. Our physical therapy specialist physicians provide outpatient services at both our Yüreğir and Çukurova Centers, and our physical therapy unit is located in the "Başkent Hospital Çukurova Polyclinics" with a closed area of over 1000 m².
In our department, balance and proprioception exercises, as well as posture assessments, can be performed using the Tetrax Static Posturography and Balance Device. This device allows patients to receive visual information about their balance levels and see their progress in numerical and graphical form on the screen through the use of a biofeedback system during exercise and training. Particularly, conditions such as cerebral palsy (stroke), multiple sclerosis, polyneuropathy, which cause balance and coordination disorders, are rehabilitated with this balance device.
Physical Medicine and Rehabilitation Activities
Primarily dealing with the diagnosis, conservative treatment, and rehabilitation of musculoskeletal system diseases, this branch of medicine also rehabilitates individuals with physiological or anatomical insufficiencies due to congenital or acquired diseases from all other systems. Its goal is to maximize existing capacities, reduce dependence on others, and enhance the quality of life. It involves rehabilitation in both inpatient and outpatient settings. This includes physical medicine modalities, medical and manipulative treatments for pain, loss of function, decreased quality of life, and dependency caused by rheumatic, neurological, orthopedic, cardiopulmonary, cancer, and algological diseases.
Outpatient Services
Our department provides outpatient services every weekday and half-day on Saturdays.
Academic and Educational Services
Lectures are provided to students of Başkent University Adana Health Services Vocational School Physical Therapy Program by our doctors with faculty member status and two physiotherapists with teaching staff status.
Our physical medicine and rehabilitation specialist physicians contribute to the English and Turkish medical education at Başkent University Faculty of Medicine. Furthermore, these doctors with teaching staff status contribute to the education of resident doctors in our department.
Diseases
Commonly encountered diseases:
* Knee osteoarthritis (knee degeneration)
* Lumbar and cervical spondylosis (spinal degeneration)
* Lumbar and cervical disc herniation
* Low back pain, neck pain
* Shoulder impingement, frozen shoulder, or muscle tear
* Rheumatic diseases
* Heel spurs
* Cerebral palsy (stroke)
* Cerebral palsy
* Spina bifida, meningomyelocele
* Osteoporosis (bone loss)
* Scoliosis (spinal curvature) – traditional therapy or Schroth therapy
* Lymphedema
* Descriptions of these diseases
Knee Osteoarthritis
The knee joint is a fully mobile joint between the femur, tibia, and patella bones, with cartilage and menisci in between. Over time, wear and tear occur in this cartilage due to 70-80% genetic and 20-30% environmental reasons. Normally, this wear begins after the age of 50, but in some cases, it can occur as early as in the 20s. It is more commonly observed in women. Main complaints include knee pain that increases with walking, going up and down stairs, or sitting on the toilet, sometimes swelling, noise in the knees, and stiffness. The pain decreases with rest and benefits from heat. Diagnosis is made through examination and standard X-ray films. MRI is not necessary. Treatments include avoiding movements that increase pain, such as using elevators instead of stairs, using Western toilets, eating at a table instead of on the floor, and praying on a chair. Physical therapy and muscle strengthening are primary treatments. Spa, sea, and pool treatments are very beneficial. Medications include painkillers, creams, various intra-articular treatments (PRP, steroid, hyaluronic acid), oral glucosamine, and chondroitin sulfate. Surgery may be considered if the disease is advanced, the knee cannot be comfortably opened and closed, or if there is knee pain at night.
Lumbar and Cervical Spondylosis
Spinal degeneration is largely genetically predisposed. Pain lifting, repetitive movements, and standing excessively contribute to its development. It affects both men and women equally. Symptoms include pain in the lower back and neck, occasionally radiating to the arms and legs, numbness and burning in the arms and legs, weakness, and stiffness. Symptoms increase with activity and do not ease with rest. They benefit from heat and increase during winter or seasonal changes. Diagnosis is made by listening to the patient, examination, and standard X-ray films. Treatment primarily involves reducing the load on the spine by losing weight, not standing too much, and not lifting heavy objects. Strengthening the abdominal and back muscles will reduce the load on the spine. Physical therapy
is a fundamental treatment for these patients. For cervical spondylosis, it is very important to wear a scarf in cold weather, not get wet in the rain, avoid air currents, not lie down while reading newspapers, books, or watching television, and maintain a proper posture. Proper work ergonomics should be applied. Those who are constantly in front of a computer at work should take a 1-2 minute break every 20-30 minutes, the computer screen should be 40-50 cm away and at eye level. Regular swimming is very beneficial for lumbar and cervical spondylosis. Swimming for at least 40 minutes three times a week is sufficient. There is currently no known surgical treatment for lumbar and cervical spondylosis.
Lumbar and Cervical Disc Herniation
Also known as disc herniation, this disease involves the inner content of the disc between the vertebrae protruding out and pressing on the nearby nerve root. This pressure causes pain, numbness, burning, electric shock-like sensations, and weakness. Heavy lifting, standing too much, being overweight, and not exercising can predispose individuals to these symptoms. The patient's complaints related to the hernia usually decrease within 2-3 weeks. Sometimes the symptoms may intensify and recur, but they do not always remain at the same intensity. In lumbar and cervical hernias, the first choice of treatment is usually non-surgical. Physical therapy can rapidly alleviate symptoms. To maintain this improvement, strengthening the neck, back, and abdominal muscles is essential. Swimming is the ideal sport for this purpose. The buoyancy of the water allows the muscles to strengthen effectively without excessive fatigue. Less than 1% of hernias require surgery. However, sudden weakness in the arm or leg muscles, incontinence of urine and feces, is an emergency situation and requires surgical decision.
Rheumatic Diseases
Rheumatic disease is not just one disease; it has dozens of varieties. These include rheumatoid arthritis (inflammatory joint rheumatism), ankylosing spondylitis (inflammatory spinal rheumatism), psoriatic arthritis (psoriasis rheumatism), reactive arthritis, and fibromyalgia (non-inflammatory muscle rheumatism). Joint swelling and morning stiffness are specific to rheumatoid arthritis. If the patient has back pain that occurs at night and eases with activity but does not ease with rest, ankylosing spondylitis should be considered.
Cerebral Palsy (Stroke)
Although it can occur at a young age, stroke is generally a disease of advanced age. It manifests as a clot or cerebral hemorrhage when there is a problem in the brain's vessels. 20% of patients lose their lives before reaching the hospital.
* High blood pressure,
* Uncontrolled diabetes,
* Arteriosclerosis increases susceptibility to the disease.
In a stroke, the initial intervention is urgently performed by neurology specialists. Once the patient's condition stabilizes and the life-threatening situation is overcome, rehabilitation begins.
The first goal of treatment is to keep blood pressure normal and control sugar and fat levels. This is because half of the patients experience another stroke attack within the first year. Rehabilitation should start as early as possible and continue actively in a rehabilitation center for at least 6 months. Afterward, exercises should continue at home. Despite all efforts, half of the patients cannot continue their lives independently and without needing others by the end of the first year. Walking aids, walkers, canes, and hand devices are frequently needed by our patients.
Cerebral Palsy
This condition arises due to causes during birth or shortly before or after birth, leading to developmental delays in children. These children exhibit slower motor and mental development compared to their peers. Some children do not have mental retardation. Lifelong rehabilitation is necessary for these patients. Without rehabilitation, the gap with their peers does not close; on the contrary, it widens.
Osteoporosis
Osteoporosis, also known as bone loss, is not actually a process of bone melting. It is characterized by a decrease in bone density and an increased risk of bone fractures due to the impaired ability of bones to retain calcium. The bones most commonly affected are the vertebrae in the back, hip bones, and wrists. Fractures in the back vertebrae start around the age of 50, causing back pain and hunching. Hip fractures occur in the age range of 80-85 and can be fatal. Wrist fractures usually heal with three weeks of casting after the fracture.
Osteoporosis is often observed in postmenopausal women due to the withdrawal of female hormones. It is diagnosed with bone density measurement and treated with medication. However, muscle-strengthening exercises, especially those against gravity, are the most suitable exercises for patients who can perform them. The continuation of medication treatment is decided with annual repetitions of bone density measurements.
Commonly Used Diagnostic Methods
Typically, patient history, examination, and radiological imaging methods are used. Bone density measurement is necessary for osteoporosis (bone loss). EMG is performed for nerve compressions and nerve ending inflammations. EMG stands for electromyography. The condition of nerves and muscles is examined by applying electricity. The most commonly examined condition is nerve compression in the wrist. In wrist nerve compression, there is pain and numbness starting from the wrist, especially increasing at night, and the symptoms ease by shaking the hand or holding it under cold water.
Precautions Before and After EMG
After a doctor requests the EMG test, it is performed by a physical medicine and rehabilitation specialist. The procedure is electrical and can be somewhat painful. If necessary, the condition of muscles can be examined with a needle. Patients are advised to come on an empty stomach for the procedure and not to bring metal objects such as rings or watches that may be on their hands or feet. The procedure can last between 45 minutes and 1.5 hours, depending on the disease.
Frequently Used Treatment Methods
Physical therapy methods involve the use of physical agents in medicine. Heat, light, sound, electricity, and force applications are among the foremost.
Descriptions of These Treatment Methods
Physical therapy is applied in sessions, and at least 10 sessions should be conducted. The number of sessions increases depending on the severity of the disease. Sessions last about 1 hour. Sessions should be consecutive, ideally without gaps between days. It is medically acceptable to have treatments every 3-4 months. For instance, it is safe for a patient with back pain to undergo 10 sessions of treatment, find relief, and then have physical therapy again after 4 months if the symptoms recur.
Recommendations for Patients Coming for Physical Therapy
Patients are advised to come for treatment after having eaten something light. They should continue taking their routine medications (such as for blood pressure, diabetes, Parkinson's disease, etc.). Wearing comfortable clothes and appropriate shoes to the treatment session ensures the patient's comfort.
Robotic walking therapy is a treatment method used for neurological or orthopedic disorders that cause loss or restriction of walking functions in humans. This therapy includes the use of robotic devices and other technologies designed to restore or improve walking functions. Robotic devices are used to support and guide the patient's walking movements, providing support to the legs, feet, and hips to ensure safer and more accurate walking movements. These devices also track the patient's walking movements and collect data for analysis.
Robotic walking therapy is used for the treatment of neurological or orthopedic disorders such as stroke, cerebral palsy, spinal cord injuries, multiple sclerosis, Parkinson's disease, muscular dystrophy, and loss of walking functions after surgery. However, it is recommended that individuals considering this treatment first consult a health professional and evaluate their treatment options.
Robotic walking therapy can provide strong motivation and self-confidence during the patient's rehabilitation process. Additionally, enabling more accurate walking movements can reduce the risk of injury and increase the patient's independence. However, the effectiveness of this treatment can vary from person to person, and it is important to select the right technological devices and develop an appropriate treatment plan for the success of the treatment.
Robotic rehabilitation methods can also be used in the treatment of pediatric diseases. They are used in the treatment of pediatric diseases such as cerebral palsy, multiple sclerosis, post-traumatic rehabilitation, as well as in supporting children's neuromotor development.
Robotic walking therapy is generally aimed at patients with neurological disorders. Patients with the following conditions can benefit from robotic walking therapy:
- Paralysis: Paralysis is a condition of muscle weakness or paralysis resulting from an interruption or damage to the brain's blood flow. Robotic walking therapy can be used to improve the mobility and walking abilities of patients who have suffered a stroke.
- Spinal Cord Injuries: Spinal cord injuries occur when the nerves that send messages from the brain to other parts of the body are damaged. Robotic walking therapy can be
used to improve the walking functions of these patients.
- Parkinson's Disease: Parkinson's disease is a neurological disorder caused by a disruption in dopamine production in the brain. Robotic walking therapy can be used to improve the walking and movement abilities of patients with Parkinson's disease.
- Multiple Sclerosis: Multiple sclerosis is an autoimmune disease that damages the nervous system, affecting the brain and spinal cord. Robotic walking therapy can be used to improve the walking functions of patients with multiple sclerosis.
- Balance Disorders: Balance disorders can occur in individuals with neurological or orthopedic disorders causing balance and coordination problems. Robotic walking therapy can be used to improve the balance and coordination of these patients.
- Pediatric Rehabilitation: For example, robotic rehabilitation therapy can be used for children with cerebral palsy to increase their mobility and muscle control. For children with polio, robotic walking therapy can help them regain their walking functions. Additionally, robotic rehabilitation therapy can increase children's motivation to perform physical exercises and actively participate in their treatment process. It can also help develop social skills and boost self-confidence in children. However, the diseases for which robotic walking therapy can be applied are not limited to the ones listed above. The treatment is an option that should be evaluated by a health professional according to the patient's specific needs and condition.
Pediatric rehabilitation is a treatment method used to improve, maintain, and restore developmental and physical functions in children. This treatment method is designed to enhance children's quality of life, develop their independence and functional skills, and help them adapt better to their daily lives. It can be used to treat physical, neurological, or orthopedic problems in children, whether congenital or acquired. These include cerebral palsy, spinal cord injuries, brain damage, Down syndrome, muscular dystrophy, orthopedic injuries, walking disorders, sports injuries, congenital anomalies, developmental coordination disorder, and neurological diseases.
Neurological rehabilitation is a series of therapeutic approaches used to treat physical, emotional, and cognitive dysfunctions arising from brain and nervous system diseases. Neurological rehabilitation is aimed at improving patients' quality of life, regaining daily activities and independence, enhancing functional independence, and assisting in return-to-work processes. Neurological rehabilitation can be used for many different neurological diseases and conditions. Some examples include:
- Stroke: A stroke is a condition resulting from problems such as brain hemorrhage, interruption, or reduction of blood flow to the brain. Neurological rehabilitation is used to cope with symptoms such as paralysis after a stroke.
- Traumatic Brain Injuries: These are conditions resulting from direct or indirect injuries to the brain. Neurological rehabilitation is used to cope with symptoms such as memory loss, attention deficit, and motor function impairment.
- Parkinson's Disease: Parkinson's disease is a condition caused by the gradual death of nerve cells. Neurological rehabilitation is used to cope with symptoms such as muscle stiffness, slow movements, and balance problems.
- Multiple Sclerosis: Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord. Neurological rehabilitation is used to cope with symptoms such as muscle strength loss, balance loss, and fatigue.
- Brain Tumors: Brain tumors are a condition resulting from the growth of abnormal cells in the brain. Neurological rehabilitation is used to cope with symptoms after brain surgery or radiotherapy.
Orthopedic rehabilitation is a rehabilitation method used in the treatment of musculoskeletal system diseases. This method is applied to address musculoskeletal system problems that restrict movement. Orthopedic rehabilitation is part of non-surgical treatments and typically includes physical exercises, manual therapy, stretching techniques, balance and coordination exercises, etc., to strengthen muscles, bones, and joint movements.
Injuries: Orthopedic rehabilitation is used in the treatment of musculoskeletal system injuries caused by sports injuries, falls, car accidents, etc. This treatment method is applied to accelerate the healing of injuries, reduce pain, and increase flexibility.
Rheumatic Diseases: Orthopedic rehabilitation is also used in the treatment of chronic musculoskeletal system diseases such as rheumatic diseases. These diseases include osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, etc. Orthopedic rehabilitation is applied to reduce the symptoms of these diseases, increase mobility, and maintain patients' independence.
Post-Surgical Rehabilitation: Orthopedic rehabilitation is also used in the post-surgical recovery process. This treatment method is applied to accelerate the recovery process, reduce pain, and restore musculoskeletal system functions.
Congenital Disorders: Orthopedic rehabilitation is used in the treatment of musculoskeletal system problems such as congenital disorders. These disorders include cerebral palsy, spinal curvature, congenital hip dislocation, etc. Orthopedic rehabilitation is a treatment method focused on the musculoskeletal health and movement abilities of patients. The appropriate rehabilitation program may vary depending on the patient's condition and needs.
Robotic Gloves
Robotic gloves are a technology used in the treatment of patients experiencing muscle strength and mobility loss during the physical therapy and rehabilitation process. These gloves are designed to stimulate muscles and encourage movement. Composed of sensors, motors, and microcontrollers that mimic hand movements, robotic gloves are instrumental in the treatment of patients with muscle strength and mobility loss. Therefore, they can be used in the treatment of various diseases.
Diseases Where Robotic Gloves Are Used
- Stroke: Stroke can cause loss of muscle strength or mobility on one side of the body due to brain damage or a problem in blood flow. Robotic gloves can activate the hand muscles of stroke patients, thereby increasing muscle strength and mobility.
- Cerebral Palsy: Cerebral palsy can lead to muscle strength and mobility loss due to brain damage or developmental issues in the brain. Robotic gloves can activate the hand muscles of patients with cerebral palsy, increasing muscle strength and mobility.
- Multiple Sclerosis: Multiple sclerosis, a neurological disease, can cause loss of muscle strength and mobility. Robotic gloves can activate the hand muscles of patients with multiple sclerosis, enhancing muscle strength and mobility.
- Spinal Cord Injuries: Spinal cord injuries, due to damage or severance in the spinal cord, can result in muscle strength and mobility loss. Robotic gloves can activate the hand muscles of patients with spinal cord injuries, improving muscle strength and mobility.
- Rheumatic Diseases: Some rheumatic diseases, especially those affecting the hands, wrists, or finger joints, can lead to pain and mobility loss. Robotic gloves can be used for the rehabilitation of these problems caused by rheumatic diseases.
In the physical therapy process, the use of robotic gloves can be an effective method for rehabilitating patients who have lost muscle strength and mobility, especially following neurological disorders like strokes. Robotic gloves are designed to assist in moving the hand and can activate the hand muscles, enhancing muscle strength and mobility.
The use of robotic gloves can be combined with other treatment methods in physical therapy, or they can be used alone.
