TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14365/4
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Article The Relationship Between Trunk Control and Disability in Persons with Early Relapsing Multiple Sclerosis(2025-12-31) Uçar, Hasret; Ceylan, Nursena; Özvar, Güngör Beyza; Cinar, Bilge Piri; Acikgoz, Mustafa; Uçar, Arzucan Toksal; Ozakbas, SerkanThis study aims to investigate the relationship between physical disability and trunk control, balance, and gait parameters in persons with Relapsing Remitting Multiple Sclerosis (RRMS) who have a low Expanded Disability Status Scale (EDSS) score. Materials and Methods: Twenty-three RRMS patients with an age range of 18-50 years, EDSS score ≤ 3 were included in this study. The patients' level of disability (EDSS), trunk control) Trunk Impairment Scale - TIS), lower extremity functionality (Timed 25-Foot Walk Test - T25FW), upper extremity functionality (Nine Hole Peg Test- 9HPT), balance (Biodex Balance System) and gait (Zebris® FDM 2) were evaluated. Results: The mean EDSS score of 23 patients who participate in the study was 2,10±0,67. A moderate, negative correlation (r= -0.429) was found between EDSS and TIS-dynamic parameter, while a moderate, positive correlation (r= 0.608) was found with T25FW (p<0.05). A moderate, positive correlation was also found between EDSS and dominant and non-dominant 9HPT scores (respectively, r= 0.423, r= 0.498) (p<0.05). Conclusion: EDSS, is not sufficient alone in terms of functionality, especially in patients with low disability. In these early stage patients, trunk, upper extremity, gait and balance assessments should be included in routine assessments.Article Ankilozan Spondilitli Bireylerde Hangi Solunum Eğitimi Daha Etkilidir: 360-Derece Ekspanse Diyafram Egzersizleri Mi, Standart Diyafram Egzersizleri Mi? Randomize Kontrollü Çalışma(2025-09-30) Urak, Özkan; Sari, Ismail; Gurpinar, Baris; Yeşilyurt, Seda YakıtAmaç: Solunum komplikasyonları genellikle asemptomatik olsa da Ankilozan Spondilit (AS) hastalarında önemli bir morbidite ve mortalite nedenidir. Egzersizin AS yönetimindeki kanıtlanmış faydalarına rağmen, geleneksel diyafram nefesi ile göğüs kafesinin tamamını hedefleyen çok boyutlu, yenilikçi yaklaşımların karşılaştırıldığı sınırlı sayıda çalışma bulunmaktadır. Bu çalışma, standart diyafram nefesi ile sensör destekli 360 derece ekspanse diyafram nefesi egzersizlerinin solunum fonksiyonu, hastalık aktivitesi ve fiziksel kapasite üzerindeki etkilerini değerlendirerek bu boşluğu doldurmayı amaçlamıştır. Gereç ve Yöntem: AS tanısı almış 50 birey, standart diyafram nefesi grubu (DG) veya 360 derece ekspanse diyafram nefesi grubu (360DG) olmak üzere rastgele iki gruba ayrılmıştır. Her iki gruba da altı hafta boyunca haftada iki kez denetimli egzersiz uygulanmıştır. Değerlendirilen sonuçlar arasında solunum fonksiyon testleri, maksimal inspiratuvar ve ekspiratuvar basınçlar (MIP/MEP) ve AS’ye özgü indeksler yer almıştır. Bulgular: Her iki grupta da işlevsel indeksler ve solunum parametrelerinde anlamlı iyileşmeler gözlemlenmiş, ancak gruplar arası farklar istatistiksel olarak anlamlı bulunmamıştır (p>0,05). Özellikle, DG grubunda FEV1/FVC oranında anlamlı bir artış (p = 0,017), 360DG grubunda ise FVC değerinde anlamlı bir artış (p = 0,007) saptanmıştır. Solunum kas gücü (MIP ve MEP) her iki grupta da anlamlı şekilde artmıştır (p<0,05). Sonuç: Bu randomize kontrollü çalışma, AS’de 360 derece ekspanse diyafram nefesi egzersizlerini değerlendiren ilk çalışmalardan biridir. Bulgular hem standart hem de sensör destekli nefes egzersizlerinin solunum ve fonksiyonel sonuçları iyileştirmede güvenli ve etkili olduğunu göstermektedir. Bu sonuçlar, fizyoterapistler ve klinisyenler için kişiye özel solunum eğitiminin AS rehabilitasyon programlarına entegre edilmesinin klinik önemini vurgulamakta ve hasta bakımını geliştirmek için esnek, kanıta dayalı stratejiler sunmaktadır.Article Multipl Sklerozlu Bireylerde Üriner Semptomlar, Bağırsak Semptomları ve Cinsel İşlev Bozukluğunun Tedavisinde Pelvik Taban Kas Eğitimi: Geleneksel Derleme(2024) Kahraman, Turhan; Yavaş, İpek; Ertekin, ÖzgeMultipl skleroz (MS), santral sinir sisteminin otoimmün kaynaklı nöro dejeneratif bir hastalığıdır. MS’li bireyler santral sinir sistemi tutulumuna bağlı çok çeşitli semptomlar yaşayabilmektedir. MS’li bireylerin %80’inden fazlası üriner semptomlar, %39-73’ü bağırsak semptomları ve %40-90’ı cinsel işlev bo zukluğu bildirmektedir. Aynı zamanda bu semptomlar MS’li bireyin yaşam ka litesini olumsuz yönde etkileyen bir dizi soruna yol açmaktadır. Bu semptomların tedavisinde kullanılan fizyoterapi yöntemlerinden olan pelvik taban kas eğitimi günümüzde üriner inkontinans, pelvik organ prolapsusu ve fekal inkontinans için öncelikli tercih edilen bir tedavi seçeneğidir ayrıca cinsel işlevi iyileştirmede et kili olabileceğini gösteren çalışmalar bulunmaktadır. Bu derlemenin amacı, MS’li bireylerde pelvik taban kas eğitiminin önemini ve MS’ye bağlı üriner semptom lar, bağırsak semptomları ve cinsel işlev bozukluğunun yönetimindeki yerini vur gulamaktır. MS’li bireylerde pelvik taban kas eğitimi üriner inkontinans, aşırı aktif mesane ve cinsel işlev bozukluğu tedavisinde etkili bir yöntemdir. Ayrıca pelvik taban kas eğitimi alan MS’li bireylerde yaşam kalitesi de artmaktadır. Li teratürde biofeedback eğitiminin fekal inkontinans ve konstipasyon için etkili ol duğunu gösteren çalışmalar bulunmaktadır. Çalışmalar müdahalelerini pelvik taban kas eğitimi olarak tanımlanmasa da biofeedback eğitimi pelvik taban kas eğitiminde egzersizlerin doğrulanması ve eğitimin gerçekleşmesi amacıyla kul lanılan bir yöntemdir bu nedenle de pelvik taban kas eğitiminin fekal inkonti nansı ve konstipasyonu tedavi etmede etkili bir yöntem olduğu görülmektedir. MS’li bireylerde üriner retansiyonun tedavi edilmesinde mevcut bir çalışma bu lunmasa da ümit vaat eden bir alandır ve araştırılması gerekmektedir. Ayrıca mev cut kanıtların güçlendirilmesi ve net bir tedavi protokolünün tanımlanması için metodolojik olarak kaliteli araştırmalara ihtiyaç vardır.Article Citation - Scopus: 1Evaluation of Response to Treatment in Breast Cancer-Related Lymphedema(Turkish Society of Physical Medicine and Rehabilitation, 2024-10-31) Eyigor, Sibel; Çınar, Ece; Tanigor, Goksel; İnbat, Menekse Ozgur; Güvercin, Ezgi Yıldız; Kabayel, Sedef Çalışkan; Çalışkan Kabayel, Sedef; Yıldız Güvercin, EzgiObjectives: The primary objective of this study was to assess and compare the response to the breast cancer-related lymphedema (BCRL) treatment with Breast Cancer-Related Lymphedema of the Upper Extremity (CLUE) scores, bioimpedance spectroscopy (BIS), and the volume-assessments /measurements. The secondary objective of the study was to investigate whether CLUE played a role in the treatment response and to examine its correlation with the other measures of lymphedema. Patients and methods: Between January 2019 and June 2019, a total of 40 patients (2 males, 38 females; mean age: 57.8±12.5 years; range, 45 to 70 years) who were diagnosed with unilateral Stage 2-3 BCRL and underwent treatment were included. The patients’ upper extremity volumes were assessed and the patients were evaluated with the CLUE score, the Disabilities of the Arm, Shoulder, and Hand Outcome Measure (QuickDASH) score, BIS, and hand grip strength before and after the complete decongestive therapy. Results: Correlation analyses revealed that CLUE total score and BIS values were correlated with the reduction in the volumes (p=0.04 and p<0.001, respectively). The CLUE total score was also found to be positively correlated with the BIS values (p<0.001). Hand grip strength and QuickDASH scores were not found to be correlated with the changes in the volume and CLUE total scores. Conclusion: The development of a structured clinical assessment such as CLUE provides clinicians for a standardized evaluation for BCRL. The diagnosis of subclinical lymphedema can be detected earlier by using the BIS and CLUE scale and lymphedema comorbidity and treatment costs can be reduced.Article Predictors of Gross Motor Function Level in Spastic Type Cerebral Palsy: a Retrospective Study(Turkey Assoc Physiotherapists, 2024-12-23) Ayaz Tas, Seda; Yakıt Yeşilyurt, Seda; Birinci Olgun, Tansu; Danis, Aysegul; Olgun, Tansu BİRİNCİ; Yeşi̇Lyurt, Seda YAKIT; Yakit Yebilyurt, Seda; Taş, Seda AYAZ; Birinci, TansuPurpose: This study was conducted to identify the determinants of gross motor function in patients with spastic-type Cerebral Palsy (CP) who received physiotherapy from a single center for two years. Methods: One hundred and eight children with spastic-type CP (mean age: 6.43 +/- 4.83 years) were evaluated twice, before and after the two-year physiotherapy. The outcomes were the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS). Binary logistic regression analysis was used to determine whether factors such as age, sex, topographical distribution, and levels of GMFCS, MACS, CFCS, and EDACS could predict the improvement in GMFCS level after the two-year physiotherapy. Results: The odds ratio of improvement in GMFCS level was found to vary significantly with the topographical distribution, CFCS level, and EDACS level (p<0.05). Compared to the children with CFCS Level I, children with CFCS Level II, Level III, and Level IV were 0.001, 0.005, and 0.006 times less likely to improve in GMFCS level, respectively. Similarly, children with EDACS Level III and Level IV were respectively 1.605 and 1.548 times less likely to improve in GMFCS level compared to those with Level I. Conclusion: CFCS and EDACS were significant predictors of gross motor function level in spastic- type CP. Healthcare professionals can use CFCS and EDACS to predict the progression of gross motor function levels, thereby providing more appropriate interventions and more realistic predictions.Article Duchenne Muscular Dystrophy Patients Diagnosed at the Asymptomatic Stage: What Are the Benefits of Early Diagnosis(Turkish Society of Physical Medicine and Rehabilitation, 2024-11-14) Sertpoyraz, Filiz Meryem; Tanigor, Goksel; Baydan, Figen; Kale, Murat Yildirim; Tanigoer, GoekselObjectives: This study aimed to demonstrate whether a diagnosis given at the asymptomatic stage of patients with DMD can affect the clinical outcomes and to define the clinical characteristics of the patients. Patients and methods: The cross-sectional study was conducted with 136 male patients (mean age: 8.8±3.7 years; range, 3 to 17 years) with DMD between March 2022 and February 2023. The patients were diagnosed through clinical presentation, pathology studies, and genetic testing. The demographic, clinical, and the laboratory data of the patients were recorded. The patients were evaluated in two groups: those diagnosed at the asymptomatic stage due to elevated creatine kinase (CK) and those diagnosed due to clinical symptoms. Patients were further stratified according to their age groups: those younger than 10 years and those aged 10 years or older. Hand grip, quadriceps muscle strength, and Vignos and Brooke motor functional assessment scales of the two groups were compared. Results: In patients who were diagnosed with CK levels, CK elevation was significantly more common than other findings. When the age at diagnosis was evaluated, the age at diagnosis in those diagnosed with CK levels was statistically significantly lower than in those diagnosed with clinical findings. No significant difference was detected in clinical findings between the groups under the age of 10 years. Among patients aged 10 years or older, hand muscle strength, quadriceps muscle strength, and Vignos and Brooke motor function scale scores were significantly better in those diagnosed with CK levels compared to those diagnosed with clinical findings. Conclusion: This study shows that early diagnosis in the preclinical period, which enables earlier medical treatment and rehabilitation, may have a positive effect on motor functions and the course of the disease.Article Bağımsız Bileşen Analizi ve Makine Öğrenmesi Kullanılarak Omurilik Yaralanması Olan Kişilerden Alınan Eeg Sinyallerinden El Hareketlerinin Sınıflandırılması(2024-09-15) Sayılgan, EbruBu çalışmanın temel amacı, Omurilik Yaralanması (OY) olan kişilerin, kol ve el hareketlerinin, kodu çözülebilir nöral bağıntılarını koruduğunu göstermektir. OY’li on kişiden pronasyon, süpinasyon, palmar kavrama, lateral kavrama ve el açma hareketleri düşündürülerek alınan ElektroEnsefaloGrafi (EEG) sinyallerinin ayırt edici hareket bilgisi araştırılmıştır. Bunu yaparken kullanılan yöntemlerde Bağımsız Bileşen Analizi (BBA/ICA) yöntemi hem artefakt gidermede hem de yeni bir yaklaşım olarak öznitelik vektörlerini çıkarmada kullanılmıştır. Önerilen yöntemde öznitelik vektörleri bağımsız bileşenlerde ortak bilgi matrisi çıkarılarak oluşturulmuştur. Çıkarılan ve seçimi yapılan öznitelik vektörleri dört farklı makine öğrenmesi modeli (Destek Vektör Makinesi (DVM), k-En Yakın Komşuluk (k-EYK), AdaBoost ve Karar Ağaçları (KA)) ile test edilmiştir. Model değerlendirme aşamasında aşırı öğrenmenin önüne geçmek için 5-katlamalı çapraz doğrulama ve hata matrisi yöntemleri kullanılmıştır. Sonuç olarak, incelenen beş sınıfa göre elde edilen başarım oldukça yüksek çıkmıştır. Deneklerin ortalaması alındığında elde edilen model doğruluk değerleri sırasıyla DVM’de 0.9024±0.0781, k-EYK’da 0.8582±0.0985, AdaBoost’ta 0.7924±0.0937 ve KA’da 0.8089±0.0645 olarak hesaplanmıştır. Bu sonuçlara dayanarak OY olan bireylerin kol ve el hareketlerinin ayırt edicilik performansının önerilen yöntem ile oldukça yüksek sonuçlar verdiği görülmektedir. BBA yöntemine dayalı bir öznitelik çıkarma ve DVM modeli ile sınıflandırma metodolojisinin OY’li hastaların rehabilitasyon tedavisinde EEG temelli beyin bilgisayar arayüzü uygulamalarına önemli bir katkısı olacağı düşünülmektedir.Article An Incidental Study of the Effects of COVID-19 Lockdowns on the Muscle Strength of Patients With Postpolio Syndrome: Do These Patients Need a Break(Wolters Kluwer Medknow Publications, 2024-04) Tanigor, Goksel; Cinar, Ece; Darilgen, Atinc; Kancay, Mustafa Sedat; On, Arzu YagizIntroduction: This study was designed before the emergence of the COVID 19 pandemic, to assess the annual changes in muscle strength in relatively young Turkish people with postpolio syndrome (PPS). After we completed the baseline measurements, the COVID 19 pandemic emerged and lockdowns followed right after. Thus, the purpose of the study turned to how these lockdowns, which induced a sedentary lifestyle, have affected muscle strength in participants with PPS compared to healthy controls. Materials and Methods: This study included 49 hip joints (21 PPS vs. 28 healthy controls) and 51 knee joints (23 PPS vs. 28 healthy controls). Concentric isokinetic testing of bilateral hip and knee muscles was performed in all participants with PPS and controls just before the outbreak of the COVID 19 pandemic. The measurements were repeated after 1 year of lockdowns. Results: Perceived physical activities were reported to be decreased by 35.9% and 32.2% in participants with PPS and controls, respectively. No significant changes were observed in muscle strengths, and these changes did not differ between PPS and healthy controls. Conclusion: This is the first and possibly the only study to show that the muscle strengths of participants with PPS did not change significantly during 1 year of physical restraints due to the COVID 19 pandemic. These findings may support the basic principle in the rehabilitation of participants with PPS, which includes conserving energy and avoiding the overuse of muscles. However, more data from studies with a larger number of participants and longer follow ups, which will hopefully never happen again in a situation like this, are required to draw a conclusion.Article Citation - WoS: 1Practices of Physiotherapists on the Risk of Falls and Prevention in Clients Aged 65 and Older: Online Survey Results(Dokuz eylul univ inst health sciences, 2024-01-31) Tuna, Hülya; Gurpınar, Barış; İlçin, NursenPurpose: Physiotherapists frequently interact with elderly clients. We aimed to determine the physiotherapists' practices for fall risk and prevention in clients at 65 years and older. Material and Methods: Seventy-two physiotherapists responded to online survey including questions about demographic and professional characteristics, the awareness and practices of physiotherapists on falling and preventing falls. Results: Ninety-one point seven percent of physiotherapists reported that fall risk should be determined in all clients at 65 years and older. Thirty point six percent of them stated that they evaluated the risk of falling in case of necessity, 83.3% stated that they did not use a standard assessment-treatment flow chart for risk of falling. In elderly clients with low or no risk of falling, 8.1% of physiotherapists; In elderly clients with high risk of falling 83.3% of physiotherapist applied a preventive physiotherapy approach to prevent falls. The rate of physiotherapists who provide education and advice on fall prevention to elderly clients with low or no fall risk is 67.9%, while 73.5% prefer assistive device reclamation in elderly clients with a high risk of falling. Conclusion: Interventions should be planned to improve fall risk awareness and practices among physiotherapists by following a standard assessment-treatment flow chart for their clients 65 years and older.Article Investigation of the Relationship Between Lumbar Spine Mri Findings and Pain in Patients Who Received and Did Not Receive Parkinson's Treatment(2023-07-03) Issı, Zeynep; Eren, Fatma Ayşen; Gürsoy Çirkinoğlu, Gözde; Beyaz, Serbülent Gökhan; Tuncer, Zeynep; Gürsoy, GözdeObjectives: Parkinson's disease is a chronic, progressive neurodegenerative disorder. Pain is a common symptom in Parkinson's disease, but the prevalence, characteristics, and documentation of its relationship with Parkinson's disease are insufficient. In this study, it was aimed to evaluate the relationship between lumbar spine magnetic resonance imaging (MRI) findings in patients who received and did not receive Parkinson's treatment. Methods: The demographic characteristics of patients with diagnosed Parkinson's disease were retrospectively obtained from the records. Their pain was grouped and the Hoehn Yahr stage at the first examination, and the interventional treatments performed were recorded. MRI measurements were made in the axial plane and sagittal plane of the spinal canal, whereas Ligamentum flavum measurements were made on both the right and left sides. Results: Twenty-six patients were included in the study. The average age was 73.5. Notably, 57.7% of patients were not diagnosed with Parkinson's disease prior to admission, while the Hoehn Yahr stage mostly comprised Stage 2 with 53.8%. Additionally, low back, waist, and hip pain was observed in 84.6% (n = 22), whereas 61.5% (n = 16) of patients experienced radicular pain. Epidural injections accounted for 33.2%. On lumbar MRI, the most narrow spinal segment on axial measurement was shown to be L4-L5. The axial spinal canal measurement of the Hoehn Yahr 1 group was observed to be significantly lower than the Hoehn Yahr 2 group. Conclusions: Optimal management for lumbar pain that increases with age is currently inadequate. There is a need to conduct larger studies on pain complaints, which is one of the frequently experienced non-motor symptoms in Parkinson's disease, as well as the interventional methods applied.