Aim: Patients with plantar fasciitis modify their gait patterns due to the heel pain. We aimed to investigate whether there was a significant difference in the plantar pressure distribution after pain relief due to successful treatment response in plantar fasciitis. Methods: 49 patients diagnosed with chronic unilateral plantar fasciitis received a 3-week physical therapy intervention and home exercises. Visual analog scale, plantar pressure measurement by pedobarographic assessment and magnetic resonance imaging were performed before and 1 month after the intervention. At the 1-month follow up, participants were divided into 2 groups according to successful or poor response to treatment. The treatment's success criteria was defined as a percentage decrease in heel pain exceeding 60% compared to the baseline, assessed one month after the initiation of treatment. Results: A total of 44 subjects successfully completed the study. In group 1, characterized by successful responders, there were 24 subjects, while group 2, comprising poor responders, included 20 subjects. After treatment in group 1, the dynamic plantar pressure on the medial forefoot showed a significant increase (p = 0.015). However, there was no significant change in plantar pressure in the poor responders. Plantar fascia thickness correlated positively with thumb dynamic pressures (coronal p = 0.03 r = 0.434, sagittal r = 0.451 p = 0.02). Conclusion: The results suggest that fascial thickness and dynamic forefoot plantar pressures may be related. Medial forefoot plantar pressures increased as a result of gait restoration with significant pain reduction in adults.

Brown-Sequard syndrome (BSS) is an incomplete spinal cord lesion that reflects the spinal cord's hemi-compression or hemisection, characterized by the loss of ipsilateral motor function resulting from corticospinal tract dysfunction and also contralateral pain and temperature sensation loss due to spinothalamic system dysfunction.The most common causes of this syndrome are traumatic injuries and spinal cord neoplasms. 1,2In addition, other etiologies, including ischemia, epidural hematoma, multiple sclerosis have been described. 3Cervical disc herniation is an exceptional cause of this syndrome.Considering the severity of neurological deficits in BSS, it is im-portant to raise awareness about this syndrome and early diagnosis.The aim of this case report is to emphasize the consideration of BSS as a rare diagnosis in the patients with cervical disc herniation exhibiting atypical clinical findings. CASE REPORTA 31-year-old male patient presented with weakness on the left side for 1 month, loss of the pain and temperature sensation on the right upper and lower extremities.He was having urinating difficulty for a month.He was admitted to another center with these complaints and his brain magnetic resonance imaging

Objectives This study aims to evaluate the relationship between serum angiogenic factor levels and disease activity in patients with rheumatoid arthritis (RA) using both clinical and dynamic wrist magnetic resonance imaging (MRI) data. Patients and methods Simultaneous serum angiogenesis markers [vascular endothelial growth factor (VEGF), angiopoietin-1 (ANG1), ANG2, and tyrosine-protein kinase receptor for angiopoietin (Tie-2)] were studied in 40 patients with RA (13 males, 27 females; mean age 51.1±10.8 years; range, 23 to 69 years) and 20 healthy controls (11 males, 9 females; mean age 47.3±12.8 years; range, 29 to 69 years) and dynamic contrast-enhanced wrist MRI was performed in 40 RA patients and seven controls. Rate of early in 55th second (REE) and Relative enhancement (REt) values were calculated from the signal time curve values obtained from the analysis of images. In clinical assessment, duration of morning stiffness, patient pain assessment [visual analog scale (VAS)], physician and patient global assessments (VAS) were recorded. The number of tender joints and swollen joints were determined. Disease activity score 28 and Ritchie scores were calculated. Health assessment questionnaire was used for functional evaluation. Anti-cyclic citrullinated peptide, rheumatoid factor, erythrocyte sedimentation rate and high sensitive C-reactive protein analyses were performed. Results Serum VEGF, REE and REt values were significantly higher in RA patients than healthy controls (p=0.002, p=0.00, p=0.00, respectively). There was no significant correlation between serum angiogenesis markers and clinical parameters or REE and REt (p>0.05). VEGF value correlated positively with disease duration (p=0.024). Conclusion Serum VEGF was higher in RA patients. While its level was associated with disease duration, no significant correlation was found with disease activity. As a diagnostic test, dynamic contrast-enhanced MRI was a valuable method for showing disease activity.

Background: We aimed to investigate whether a home exercise for self-care program that consists of range of motion (ROM), stretching, and strengthening exercises could improve ROM for foot joints and plantar pressure distribution during walking in diabetic patients to prevent diabetic foot complications. Methods: Seventy-six diabetic patients were recruited (38 with neuropathy and 38 without neuropathy). Neuropathy and nonneuropathy groups were randomly divided into a home exercise group (n = 19) and a control group (n = 19). Exercise groups performed their own respective training programs for 4 weeks, whereas no training was done in the control group. Total contact area and plantar pressure under six foot areas before and after the exercise program were measured. Ankle and first metatarsophalangeal joint ROM were measured before and after the exercise program. Results: In the exercise group, there were significant improvements in ROM for the ankle and first metatarsophalangeal joints (P < .001); static pedobarographic values showed significant reduction in right forefoot-medial pressure (P = .010); and significant decreases were seen in dynamic pedobarographic values of peak plantar pressure at the left forefoot medial (P = .007), right forefoot lateral (P = .018), left midfoot (P < .001), and right hindfoot (P = .021) after exercise. No significant positive or negative correlation was found between the neuropathy and nonneuropathy groups (P > .05). Conclusions: A home exercise program could be an effective preventive method for improving ROM for foot joints and plantar pressure distribution in diabetic patients independent of the presence of neuropathy.

Diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) are two of the most common diseases characterized by ossification of the ligaments and tendons in the axial skeleton and peripheral sites, both. The radiographic appearance of AS and DISH is very similar, but the underlying pathology differs (1). DISH has been referred to be “senile AS’’, several years ago (2). Symptoms of AS, such as inflammatory spinal pain and stiffness and decreasing range Ad dress for Cor res pon den ce/Ya zış ma Ad re si: Zeliha Ünlü MD, Celal Bayar University Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Manisa, Turkey E-mail : zelihaunlu@yahoo.com doi:10.4274/meandros.1733 Received/Geliş Ta rihi : 22.11.2013 Accepted/Ka bul Ta ri hi : 14.10.2014 Anah tar Ke li me ler Diffüz idiyopatik skeletal hiperostozis, ankilozan spondilit, sakroileit

Dupuytren's contracture is a disease that affects the functionality of the hand and causes contractures leading to progressive fibrosis of the palmar fascia. Dupuytren's contracture usually affects the fourth and fifth digits, but thumb involvement is rare. In this article, we presented a rare case of Dupuytren's contracture with bilateral thumb and fifth digit involvement in a 77-year-old male patient who was assessed by ultrasound elastography and gained range of motion after rehabilitation.