Fizyoterapi ve Rehabilitasyon Bölümü / Department of Physiotherapy and Rehabilitation

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A novel dorsal trimline approach for passive-dynamic ankle-foot orthoses
(Assoc Mechanical Engineers Technicians Slovenia, Po Box 197-Iv, Ljubljana 61001, Slovenia, 2018) Sürmen, Hasan Kemal; Akalan, Nazif Ekin; Fetvacı, Mahmut Cüneyt; Arslan, Yunus Ziya; 123435; 176320; 19199; 110120
An ankle-foot orthosis (AFO) is an externally applied assistive device that encompasses the lower leg, ankle, and foot of the human body. In the current one-piece passive-dynamic AFO design, the trimming process is performed from lateral and medial parts of the ankle to ensure desired rotational displacement (hereafter referred to as Design I). In most cases, stress concentrations occurring over the trimmed regions during walking can cause permanent damage to the AFO. In this study, to reduce the stress concentration and ensure a homogeneous stress distribution, a new trimming approach is presented, in which the trim zones were transferred from lateral and medial to dorsal (hereafter referred to as Design II). Finite element analyses of the Designs I and II models were carried out. Displacement and von Mises stress values for both models under the same loading and boundary conditions were obtained. Maximum displacement values were 8.51 mm and 9.05 mm for Design I and Design II, respectively. Maximum stress values were 15.19 MPa and 6.70 MPa for Design I and Design II, respectively. For the similar range of motion of ankle joint, the novel design produced less stress and more homogeneous stress distribution than the currently used design, thus indicating that Design II would be more resistant to plastic deformation than Design I.
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Azaltılmış Plantar Ön-Ayak Duyusunun Taban Basıncı Üzerine Etkisinin İncelenmesi
(2018) Önerge, Kübra; Akalan, Ekin; Sert, Rukiye; Kuchimov, Shavkat Nadir; Leblebici, Gökçe; Ertürk, Gamze; Bilgili, Fuat; 283338; 176320; 229941; 268636; 237820
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Comparison of Motor Proficiency and Functional Ambulation in Duchenne Muscular Dystrophy With Healthy Peers
(Taylor & Francis Ltd., 2020) Yıldız, Şulenur; Şahin, Sedef; Bulut, Numan; Tunca Yılmaz, Öznur; Karaduman, Aynur Ayşe; AKEL, BURCU SEMİN
Aims:The study was aimed to investigate the difference between boys with Duchenne muscular dystrophy (DMD) and healthy peers in terms of gross and fine motor proficiency, and determine the relationship between motor proficiency and ambulation. Methods:A total of 24 boys with DMD and 22 healthy peers were evaluated. Demographics and physical characteristics were recorded. The Bruininks Oseretsky Test of Motor Proficiency-Short Form (BOTMP-SF) was administered to evaluate gross and fine motor proficiency in both groups. The 6-minute walk test (6MWT) was performed to evaluate functional walking capacity and North Star Ambulatory Assessment (NSAA) was used to determine ambulatory status of boys with DMD. Results:The gross motor proficiency score was significantly lower in boys with DMD (p = 0.001). No difference was found between the groups in terms of fine motor proficiency (p = 0.962). The gross motor function of BOTMP-SF was significantly related to 6MWT distance (r = 0.696,p = 0.001) and NSAA (r = 0.738,p = 0.001). No relationship was found between BOTMP-SF fine motor proficiency and 6MWT distance (r = 0.210,p = 0.361), and NSAA (r= -0.020,p = 0.928). There were significant correlations between running speed and agility with 6MWT distance (r = 0.585,p = 0.005) and NSAA (r = 0.650,p = 0.056). Conclusions:Boys with DMD were more affected in aspects of gross motor proficiency than healthy peers, while fine motor proficiency were found same. The gross motor proficiency was found more related to the level of ambulation.
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Correlations Between Hypermobility, Muscle Strength and 3D Gait Parameters in Children With Increased Femoral Anteversion
(2019-09) EVRENDILEK, HALENUR; 268497
Introduction Increased femoral anteversion is a transverse plane problem that cause gait alterations in developing children and because of the moment arm changes produces muscle weakness around the hip (1). Especially, in addition with hypermobility, these children mostly have fatigue, additional muscle weakness and functional deterioration on lower extremity (2). Therefore, the aim of this study was to determine the relations between the hypermobility, muscle strength and gait parameters in children with IFA. Research Question Are there any correlation between the hypermobility, muscle strength and gait parameters in children with IFA? Methods 7 children with IFA (14 limbs, av.age: 9.14 ± 0.3, trochanteric prominens angle test (TPAT): 28 ± 6.2°) have participated in this study. As part of physical assessment; hypermobility, femoral anteversion angle, maximum isometric hip extensor and abductor, knee extensor and flexor muscles strengths were evaluated by Beighton test (3), TPAT (4) and hand-held dynamometer (HHD) (Lafayette Instruments,USA)(5) respectively. Furthermore, all participants' self-selected of walking were analyzed by 3D gait analysis (BTS Bioengineering). Kinematic gait parameters of pelvis, hip and knee were interested gait parameters. According to data distributions, Pearson's or Spearman's coefficient test were utilized for statistics (p<0.05) and interpreted by Cohen's classification (6). Results High-level correlation was found between Beighton scores and both hip extensor (r: -.70) and knee extensor (r: -.91) muscle strengths, and mean and minimum knee knee flexion angles. TPAT was highly correlated with only hip abductor HHD scores and mean hip rotation angle during walking (Table 1). Discussion In the literature, number of gait alterations were determined in children with IFA as increased mean hip internal rotation, pelvic obliquity range, peak knee extension at stance(7). The present study revealed that some of the kinematic alterations might be related to muscle strengths of the weak hip extensor and abductor, knee extensor and flexor muscles. Although, in agreement with the literature the mean hip internal rotation and hip abductors muscles strength were found significantly related to TPAT. In additionally, hypermobility, which is a commonly seen with the children with IFA, might have a role at the weakness of the hip and knee extensors and hyperextension at stance phase. In conclusion, it is important to strength hip extensor and abductor, knee extensor and flexor muscles to contribute to lower extremity function in children with IFA especially if the child is hypermobile.
Open Access
Covid-19 ve Ergoterapi: Salgın Hastalıklara Hızlı Cevap Verme ve Hazırlıklı Olma Boyutuyla Bir Gözden Geçirme Çalışması
(Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi, 2020) Salar, Sinem; AKEL, BURCU SEMİN
Dünya’nın globalleşmesi salgın hastalıkların yayılmasını kolaylaştırırken toplum sağlığını korumada da birlik içinde olmayı öğretmektedir. Bu nedenle, sağlık sisteminin parçası olan her profesyonel gibi ergoterapistlerin de salgın hastalık gibi halk sağlığını etkileyen durumlarda hazır olması gerekmektedir. Ergoterapistlerin, anlamlı ve amaçlı aktiviteler yoluyla sağlık ve iyi olmayı desteklemek için koruyucu ve destekleyici yaklaşımları uygulama sorumluluğu bulunmaktadır. Bu derlemenin amacı; yeni koronavirüs hastalığı olan, sağlıklı ve dezavantajlı tüm grupları kapsayacak şekilde COVID-19 sürecinde ergoterapinin rol ve sorumluluklarına yönelik bir bakış açısı sunmaktır. Bu süreçte kişilerin okupasyonlarını yürütme ve okupasyonlara ulaşma sırasında yaşadığı değişimler, adaptasyonlar ve bunların sonuçları ergoterapi açısından önemlidir. COVID-19 pandemisi ile ortaya çıkan ihtiyaçlara yönelik ergoterapistlerin hazır olması gereken alanlar bu derleme ile sıralanmıştır. Bireyi bütüncül değerlendiren ergoterapistler güvenli ve sağlıklı kalmak için enfeksiyon kontrol önlemlerine uyma, erişme ve kullanma sırasında hayati ihtiyaçları mental sağlık, irade, psikolojik-fiziksel boyutları ile anlayabilir. Pandemiden en fazla etkilenen ülkelerden gelen yayınlar, Dünya Sağlık Örgütü, Dünya Ergoterapistler Federasyonu, Amerikan Ergoterapi Derneği bazı temel konular üzerinde durmaktadır. Kaynaklara ulaşma, günlük yaşam aktiviteleri, akut bakım, iletişim, mobilite, stigma, sosyal izolasyon, mental sağlık ve iyi olma hali bu konular arasındadır. Bu derlemede, bahsedilen durumlara yönelik hizmet verilmesi için gerekli olan telesağlık, mental sağlık çalışmaları, bireysel/aile/toplum çalışmaları, yardımcı teknoloji, akut bakım konuları ele alınmıştır.
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Cross-Cultural Adaptation, Reliability, and Validity of a Turkish Version of the Work Rehabilitation Questionnaire (WORQ-Turkish)
(Springer Plenum, 2021) Aran, Orkun Tahir; Abaoğlu, Hatice; Çağlar, Gamze Ekici; AKEL, BURCU SEMİN; Aki, Esra; Karahan, Sevilay; Kayıhan, Hülya
PurposeThe Work Rehabilitation Questionnaire (WORQ) is an instrument based on the International Classification of Functioning Vocational rehabilitation core set. The aim of this study was to analyze the validity, reliability and cross-cultural adaptation of the WORQ to Turkish and evaluate its psychometric properties.MethodsThe cross-cultural adaptation and translation procedures were conducted following Beaton's guidelines. The test-re-test reliability was examined by Spearman Brown Coefficient (split half analysis), internal consistency was examined by Cronbach's alpha. Criterion related validity of the WORQ was determined by Beck Depression Inventory using Pearson correlation coefficient and known group differences regarding age, gender, work and educational levels using one-way ANOVA and t test. Construct validity was examined by confirmatory factor analysis using AMOS.ResultsTwo hundred and fifty-seven participants with disabilities were included to the study from seven different provinces of Turkey. The WORQ-Turkish showed excellent internal consistency (0.906), good test-retest reliability (0.811), and good construct validity (good model fit indices). Criterion related validity analysis showed medium correlations between WORQ and Beck Depression Inventory (p < 0.001), however there were no statistical significant differences regarding known group parameters (p > 0.05).ConclusionsIn this study, the cross-cultural adaptation, and validity and reliability of WORQ-Turkish self-reported version were examined and the results indicated that WORQ-Turkish was a valid and reliable scale for analyzing vocational rehabilitation process of people with disabilities.
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Determination of Biomechanical İnfluences of İncreased Femoral Anteversion (twisted leg) on Running for Developing İndividua
(2018-08) Apti, Adnan; 259584
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Determination of Playing Related Postural Problems in Guitar Students
(2019-06) Akel, Burcu Semin; 114564
Objective: A significant percentage (%37) of musicians suffer musculoskeletal disorders that are sufficiently serious to affect performance. A common risk factor for musculoskeletal disorders is a poor posture.ln this study, we aimed to determine of playing-related postural problems in guitar students. Materials and Methods: Nineteen guitar bachelor students participated. Demographic data were recorded and static and dynamic posture analysis were performed via observation and video recordings; which were analyzed by a physiotherapist, an occupationaltherapist and a guitarist. Awkward postures were recorded. Posture was evaluated both globally and for individual body regions. Overall posture was divided into 3 categories: rigid, slumped, physiological. Pain was assessed with The Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians. Results: Most of the individuals (55%) experienced pain or problems that might hinder their playing skills in the last year.The most common locations of pain or problems were: shoulder, wrist, scapula and neck.The overall static posture was poor in 38% of participants when standing(33%rigid, 5% slumped). During playing, the posture was more often slumped than rigid(66%). The location of the gravity axis in the sagittal plane were forward-shifted(%55), however the physiological posture was maintained at the frontal plane.The most common problems encountered were shoulder imbalance (%61), rotation of the head(%77), rotation of body(%72), right wrist excessive ulnar deviation(%33) and thumb positioning(%72). Conclusions: According to the posture analysis, rotation and slumpy positioning was the main problem. This situation puts greater problems on the muscles of the back and abdomen and may effect proper breathing. The regions that have poor posture was neck, shou Ider, wrist and thumb. Considering this, we believe that educating music students in proper playing posture and postural awareness can be beneficial in decreasing performance-related postural problems.
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Determining the Relationship Between the Impairment of Selective Voluntary Motor Control and Gait Deviations in Children With Cerebral Palsy Using Simple Video-Based Analyses
(Elsevier Ireland Ltd., 2021) Sardogan, Cansu; Muammer, Rasmi; AKALAN, NAZİF EKİN; Sert, Rukiye; Bilgili, Fuat
Background: The impairment of selective voluntary motor control (SVMC) in children with cerebral palsy (CP) has been shown to correlate with their gait characteristics using complex 3D gait analysis systems (3DGA); however, this relationship has not been investigated using simple video-based observational gait analysis (VBOGA). The aim of this study was to determine the relationship between VBOGA and SVMC of the lower extremities in children with CP. Methods: Forty-two CP children 10.9 +/- 5.7 years old with Gross Motor Function Classification System (GMFCS) levels I-III participated in the study. Their gait characteristics were assessed using the Edinburgh Visual Gait Score (EVGS), and selective voluntary motor control was tested using the Selective Control Assessment of the Lower Extremity (SCALE). Spearman's rho correlation test with Cohen's classification were used in the statistical analyses. Results: The GMFCS levels (r = 0.604, p < 0.001), foot clearance (r = -0.584. p < 0.001), and maximum ankle dorsiflexion (r = -0.567, p < 0.001) during the swing phase had strong correlations with total SCALE scores. There was also a moderate correlation between total SCALE scores and total EVGS (r = -0.494, p < 0.001), knee extension in the terminal swing phase (r = -0.353, p < 0.001), peak sagittal trunk position (r = -0.316, p < 0.005), and maximum lateral shift (r = -0.37, p < 0.001). Conclusion: Impaired lower extremity SVMC was noticeably related to the foot and ankle movements in the swing phase and initial stance during walking as well as the total EVGS scores and sagittal and frontal trunk movements. The SCALE correlations with VBOGA were similar those observed in the complex 3DGA in the literature; therefore, we suggest that SVMC impairment of gait could be evaluated using simple VBOGA. These findings may help to tailor physical therapy programs for CP children to increase their motor control and walking quality.
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Distinguishing the Influences of Increased Femoral Anteversion From Hypermobility During Walking For Neurologically Intact Individuals
(2018-09) Akalan, Ekin; Karaca, Gülşah; Apti, Adnan; Kuchimov, Shavkat Nadir; Bilgili, Fuat; Temelli, Yener; Leblebici, Gökçe; Önerge, Kübra; Ertürk, Gamze; Evrendirek, Halenur; 176320; 268498; 259584; 237820; 190878; 229941; 283338; 268636; 268497
Increased femoral anteversion (IFA) is a transverse plane problem that may lead to alterations on lower body kinematics during walking (1,2). IFA and hypermobility syndrome are commonly seen together in healthy individuals (3). Therefore, describing the pure effects of IFA related gait parameters is very difficult for children with hypermobility and IFA together.
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Does clinically measured ankle plantar flexor muscle strength or weakness correlate with walking performance in healthy individuals?
(2018) Akalan, N.Ekin; Kuchimov, Shavkat Nadir; Apti, Adnan; Temelli, Yener; Ören, Merve; Nene, Anand
OBJECTIVE: Muscle strength is usually measured using isometric hand-held dynamometers (HHDs) in the clinic. However, during functional activities, the muscle acts more dynamically. The aim of this study was to investigate the relation between clinically measured plantar flexor (PF) muscle strength (PFMS) and laboratory measurements of peak ankle plantar flexion power generation (APFPG), peak ankle moment (PAM), peak plantar flexion velocity (PFV) and mean gait velocity in healthy participants. METHODS: The maximum PFMS on non-dominant sides in 18 able-bodied persons 23.88 (SD 3.55 years) was measured before (Pre-S) and after a stretching (Post-S) procedure (135 sec. x 13 rep. with 5 sec. rest) by using a HHD. The stretching procedure was used to generate temporary PF muscle weakness. Gait analysis was carried out for Pre-S and Post-S conditions. Normalized (by weight and height) and non-normalized HHD scores and differences for both conditions were correlated by Pearson correlation coefficient calculations (p < 0.05). RESULTS: Reduced PFMS (%23, p < 0.001) in Post-S, according to the HHD scores, has only a weak correlation with APFPG (r > 0.3, p < 0.5). Gait velocity was found to be strongly correlated with APFPG only in the Post-S condition (r = 0.68, p < 0.002). HHD scores and PAM were moderately correlated with the non-normalized Post-S condition (r = 0.44, p = 0.70) and strongly correlated with the non-normalized Pre-S condition (r = 0.62, p < 0.01). DISCUSSION: HHD scores of plantar flexor muscles give very limited information about the PF performance during walking in healthy individuals. Simple normalization did not improve the relations. Clinically measured isometric muscle strength and muscle weakness have only moderate strengths for establishing a treatment protocol and for predicting performance during walking in neurologically intact individuals.
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Does hip flexor muscle weakness cause stiff-knee gait in long-term after medial open reduction surgery for children with developmental dislocation?
(2019-09) EVRENDILEK, HALENUR; 268497
Introduction Medial open reduction surgery (MOR) is performed as a treatment for children with developmental dislocation of the hip (DDH) by sectioning iliopsoas tendons [1]. A 10 years follow-up study of MOR was determined that hip flexor strength decreased in children with DDH [2] . Furthermore, the weakness of iliopsoas muscle was any one of the reasons of stiff knee gait pattern (SKG) [3], Therefore, the aim of the study was to determine whether the sagittal plane knee kinematics alters in long-term after bilateral MOR for children with DDH. Research Question What are the long-term biomechanical effects of bilateral MOR on sagittal plane knee kinematics in children with dislocation of the hip? Methods Five children (DDH group, 10 limbs, Av. age: 11.2 ± 2.8 y.o.) who had medial open reduction surgery bilaterally (10.4 years ago, Av. age: 9.6 ± 6 months o.) and six children without any orthopedic disorder (Control group, 12 limbs, Av. age: 10.8 ± 2.4 y.o) have participated in this study. All participants' selfselected speed of gait were analyzed by 3D gait analysis (BTS Bioengineering). The spatiotemporal parameters, sagittal plane hip and knee parameters and four defined SKG parameters (Pl: peak knee flexion angle, P2: range of knee flexion from toe-off to peak flexion, P3: total range of knee motion, P4: timing of peak knee flexion in swing, >3 significantly changed SKG parameters described as stiff knee ) [4] were examined. Independent t-test and Mann Whitney U test were used for comparison (p < 0.05) Results Between two groups, age, mean velocity were not significantly different (p>0.05). In DDH group, sagittal plane hip and knee range, P l, P2, P3,P4, maximum hip and knee flexion velocity were lower significantly than control group (Table 1). Discussion Normally, in late-stance, the iliopsoas is elongated depending on hip extension, then contracts at the beginning of the swing to initiate hip flexion. [5], Weakness of iliopsoas muscle, as a long-term effect of MOR surgery, reduces hip and knee flexion velocity at pre-swing and swing phases. This study showed that DDH altered all four SKG parameters significantly [4] relative to controls. This study also confirmed that hip flexion weakness may cause SKG pattern even neurologically intact individuals (3). Because of the SKG pattern increases not only the risk of reduced toe clearance and tripping but also energy expenditure [4], adding hip flexor strengthening exercises into rehabilitation programs might have a critical role for SKG treatment.
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Does One Leg Standing Duration Have Relation With GMFM Scores and Stability in Stance Phase for Hemiplegic Children ?
(2018-09) N. Ekin Akalan; Halenur, Evrendilek; Karaca, Gülşah; Bilgili, Fuat; Ertürk, Gamze; 268636; 176320; 268497; 268498; 237820
This paper reports the results of a study to validate a measure of gross motor function in detecting change in the motor function of disabled children. Physiotherapists used this instrument to assess 111 patients with cerebral palsy, 25 with head injury and 34 non-disabled preschool children on two occasions, the second after an interval of four to six months. Parents and therapists independently rated the children's function within two weeks of each assessment, and a sample of paired assessments was videotaped for 'blind' evaluation by therapists. Correlations between scores for change on this measure and the judgments of change by parents, therapists and 'blind' evaluators supported the hypothesis that the instrument would be responsive to both negative and positive changes.
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Effects of High Intensity Interval Training and Sprint Interval Training in Patients With Asthma: A Systematic Review
(Taylor & Francis Ltd, 2022) UZUNOĞLU, GAMZE ERTÜRK; Günday, Çiçek; EVRENDİLEK, HALENUR; Sağır, Kübra; Aslan, Göksen Kuran
Objective The aim of this study is to review the effects of high-intensity interval training (HIIT)/sprint interval training (SIT) on asthma symptoms, cardiorespiratory functions, and other variables among asthmatic patients. Data sources Randomized controlled trials published between January 2000 and January 2021 were searched in PubMed/MEDLINE, Web of Science, and Cochrane Library databases. Study selections Following pre-specified inclusion criteria, this review included 7 randomized controlled studies that compare HIIT/SIT as an intervention with any other intervention and/or control group. Results Of the included studies only four reported the chronic phase effects of the HIIT/SIT protocols. HIIT and SIT protocols applied in studies differ. HIIT improved forced expiratory volume in 1 s (FEV1) in the acute phase and maximal oxygen consumption (VO2max) in the chronic phase in the asthmatic patients (p < 0.05). Conclusion To our knowledge, our systematic review is the first study evaluating the effects of HIIT/SIT protocols on asthma patients. HIIT/SIT protocols have beneficial effects on asthma patients. In order to better understand the results of these training procedures, studies that will be designed with high methodology are needed.
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ESMAC 2021 Abstracts
(Elsevier Ireland Ltd., 2021) AKALAN, NAZİF EKİN; GÖRGÜLÜ, M.; AYDIN, B.; Sert. R.; Bilgili F.
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Evaluation of the effects of neural therapy in patients diagnosed with fibromyalgia
(2019) Altınbilek, Turgay; Terzi, Rabia; Başaran, Aynur; Tolu, Sena; Küçüksaraç, Seher
Objectives: This study aims to compare the effects of neural therapy and exercise on pain, quality of life, depression, anxiety, and functioning status in patients diagnosed with fibromyalgia syndrome (FMS). Patients and methods: This multi-center study included a total of 72 patients (60 females, 12 males; mean age: 39.2 +/- 9.5 years; range, 22 to 53 years) who were diagnosed with FMS according to the 1990 American College of Rheumatology (ACR) criteria between January 2015 and June 2015. The patients were randomly divided into two groups: the first group (n=30) received an exercise program (strengthening, stretching, relaxation, and aerobic exercises, three days a week), and the second group (n=42) received a total of six sessions of neural therapy as one session a week in addition to the same exercise program. Pain severity was assessed with the Visual Analog Scale (VAS), emotional state with the Beck Depression Scale (BDS) and Beck Anxiety Inventory (BAI), quality of life with Short Form-36 (SF-36), and functioning status with the Fibromyalgia Impact Questionnaire (FIQ). The patients were evaluated at the end of treatment (week 6) and one month after the end of treatment. Results: The mean disease duration was 34.3 +/- 9.3 months, the mean VAS score was 7.3 +/- 2.2, and the mean FIQ score was 58.4 +/- 13.2. There were significant improvements in the VAS, FIQ, SF-36, BDS, and BAI scores after the treatment in both groups (p<0.05). Post-treatment BDS and VAS scores were significantly lower in the neural therapy group (p=0.038; p=0.049; p<0.05). There was no significant difference in any parameter one month after the treatment between the groups (p>0.05). Conclusion: When neural therapy is combined with exercise in FMS patients, it may be advantageous in terms of pain and depression, compared to exercise alone.
Open Access
Examination of Fatigue, Well-Being and Life Habits in Children with Cancer Diagnosis
(Bezmiâlem Vakıf University, 2021) Sevgili, Sümeyye; Şahin, Sedef; AKEL, BURCU SEMİN
Objective: In this study, it was planned to examine fatigue, well-being and life habits in children with cancer. Methods: This cross-sectional analytical study was conducted between September 2019-January 2020. "24-Hour Child Fatigue Scale", "Child Well-being Assessment" and Child Life Habit Questionnaire (LIFE-H for Children 1.0)" were administered to 20 children with cancer aged 5-15 years. Pearson's correlation coefficient was used to determine the statistical relationship between life habits, fatigue and well-being. Statistical significance level was accepted as p<0.05. Results: There were significant relationships between fatigue and personal care, shelter and mobility parameters of life habits (r=-0.66, r=0.54, r=0.45, p<0.01, respectively) and there were significant relationships between fatigue and negative emotions (r=0.46), overall life satisfaction (r=-0.52), general happiness (r=-0.49) and positive emotions (r=-0.44 *) parameters of well-being assessment. Life habits scale was found to be related with nutrition, physical fitness and communication parameters of Child Life Habit Questionnaire were found to be most related with the meaning and purpose parameter of the well-being assessment (p<0.01). There were significant relationships between positive emotions and recreation (r=0.45, p=0.04); optimism and communication (r=-0.44, p=0.04); personal care (r=-0.49, p=0, 02), social life (r=-0.46, p=0.04) and autonomy; and mobility and negative emotions (r=-0.45, p=0.04). Conclusion: Considering the relationships determined in this study, the evaluation of the children with cancer and treatment approaches can be shaped. The fact that fatigue affects all aspects of children's life reveals the importance of dealing with fatigue. It is recommended to focus on the meaning and purpose and regain autonomy for children in order to rearrange the life habits of the children and ensure their well-being.
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Femoral Anteversiyon Artışı Olan Çocuklarda Hipermobilite, Kas Kuvveti ve 3 Boyutlu Yürüme Analizi Parametreleri Arasındaki İlişki
(2019-10-18) EVRENDILEK, HALENUR; Akalan, Nazif Ekin; Önerge, Kübra; Karaca, Gülşah; Ertürk, Gamze; Bilgili, Fuat
AMAÇ Çalışmanın amacı; femoral anteversiyon artışı (FAA) olan çocuklarda hipermobilite, kas kuvveti ve 3 boyutlu yürüme analizi parametreleri arasındaki ilişkiyi araştırmaktır. YÖNTEM FAA olan 7 çocuk (14 bacak, ort.yaş:9.14 ± 0.3, trokanter prominens açı testi(TPAT):28 ± 6.2°) çalışmaya dahil edildi. Çocukların femoral anteversiyon açıları, eklem mobiliteleri ve maksimal izometrik kas kuvvetleri sırasıyla TPAT, Beighton testi ve el dinamometresiyle (Lafayette Instruments,USA) değerlendirildi. Tüm katılımcılara normal hızlarında yürürken 3 boyutlu yürüme analizleri yapılarak pelvis, kalça ve diz kinematik parametreleri incelendi. Parametreler arasındaki ilişkiler, verilerin normal dağılımlarına göre Pearson ve Spearman korelasyon testleri kullanılarak değerlendirildi. Verilerin istatistiksel olarak anlamlılık düzeyi (p<0.05) olarak kabul edildi ve sonuçlar Cohen sınıflamasına göre yorumlandı. BULGULAR Beighton testi skoru ile kalça ekstansör(r: -.70) ve diz ekstansör(r: -.91) kas kuvvetleri, minimum diz fleksiyon açısı(r: -.83) arasında yüksek korelasyon bulundu. TPAT değerleri ise kalça abduktör kas kuvveti(r: -.77) ve ortalama kalça rotasyon açısıyla yüksek korelasyon gösterdi(r: .60). TARTIŞMA Literatürde, FAA olan çocukların yürüme sırasında ortalama kalça iç rotasyon, pelvik oblikite ve duruş fazında diz ekstansiyon parametrelerinin arttığı gösterilmiştir. Bu çalışma, zayıf kalça ekstansör ve abduktür, diz fleksör ve ekstansör kaslarındaki zayıflığın kinematik değişimlerle ilişkili olabildiğini göstermiştir. Ayrıca, literatürle uyumlu olarak ortalama kalça internal rotasyon parametresiyle kalça abdüktör kas kuvvetinin TPAT açısıyla anlamlı olarak ilişkili olduğu bulumuştur. FAA olan çocuklarda sıkça görülebilen hipermobilitenin, kalça ve diz ekstansör kas zayıflığı ile duruş fazında hiperekstansiyon artışında rolü olabilir. Sonuç olarak, kalça abdüktör ve ekstansör, diz fleksör ve ekstansör kas kuvvetlerinin arttırılması, FAA olan hipermobil çocuklarda alt ekstremite fonksiyonun iyileştirilmesi için önemlidir.
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Femoral Anteversiyon Artışı ve PesPlanovalgusu Olan Çocuklarda Tabanlığın Yürüme Kinematiğine Etkisi
(2018) Evrendirek, Halenur; Akalan, Ekin; Sert, Rukiye; Kuchimov, Shavkat Nadir; Karaca, Gülşah; Ertürk, Gamze; Bilgili, Fuat; 268497; 176320; 268498; 268636; 237820
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Fizyoterapi ve Rehabilitasyon Bölümü Öğrencilerinin Öğretim Üyesi Memnuniyeti ve Ders Memnuniyeti Arasındaki İlişkinin İncelenmesi
(2019-10-17) Akel, Burcu Semin; Ertürk, Gamze; KARACA, GÜLŞAH; Önerge, Kübra; EVRENDILEK, HALENUR; akalan, ekin; APTI, ADNAN; 114564; 268636; 268498; 283338; 173320; 259584
Giriş: Yükseköğretim kurumlarında akreditasyon çalışmaları Bologna sürecinin başlaması ile birlikte ağırlık kazanmıştır. Yükseköğretim Kurumu (YÖK) tarafından da eğitim-öğretimin ders süreçleri, ders yükleri, öğrencilerin katılımları, öğrencilerin ve öğretim üyelerinin memnuniyeti gibi konularda incelenmesi için gerekli çalışmaların yapılmasına hem destek hem de önem verilmektedir. Üniversitelerin iç paydaşlarından biri olan öğrencilerin öğretim üyesi ve ders memnuniyetinin değerlendirilmesi ve her iki değerlendirme parametresinin birbirleri ile olan ilişkisinin belirlenmesi önemlidir. Değerlendirme sonucunda elde edilecek sonuçlar, eğitimde kalitenin arttırılması; sağlık alanının insan yaşamı ile doğrudan ilgili olduğu göz önüne alındığında işini en doğru ve güvenilir şekilde yapabilecek donanıma sahip sağlık profesyonellerinin yetiştirilmesi; nitelikli yetişen profesyonellere bağlı olarak Türkiye'de sağlık sisteminin daha ileriye taşınması ve toplumsal refah seviyesinin arttırılması konusunda yapılması gerekenler için bir çıktı olacaktır. Amaç: Akreditasyon kapsamında öğretim üyesi ve ders memnuniyetinin değerlendirilmesi gerekmektedir. Fakat değerlendirmelerin sonucundaki memnuniyet düzeylerinin tutarlılığı konusunda net bir sonuç yoktur. Bu nedenle çalışmadaki amacımız Fizyoterapi ve Rehabilitasyon bölümü öğrencileri tarafından değerlendirilen öğretim üyesi memnuniyeti düzeyi (ÖÜMD) ve ders memnuniyeti düzeyi (DMD) arasındaki ilişkinin incelenmesidir. Gereç-Yöntem: Çalışmaya, İstanbul Kültür Üniversitesi Sağlık Bilimleri Fakültesi Fizyoterapi ve Rehabilitasyon Bölümü öğrencilerinden 34 kişi katıldı. Tüm öğrencilerin okulda geçirdikleri 2. ve 3. dönem verileri toplanarak analiz yapıldı. Her bir öğrenciden, fakülte öğretim üyeleri tarafından hazırlanan ve toplam 35 sorudan oluşan "Öğretim Üyesi ve Ders Değerlendirme Anketi"ni doldurmaları istendi. Anketin ilk 25 sorusu öğrencilerin ÖÜMD'ni değerlendiren sorulardan (öğretim elemanının öğrencilerle olan ilişkisi, kullandığı yöntemler, zaman yönetimi vb.) oluşurken diğer 10 soru ise DMD'ni değerlendiren sorulardan (dersin amaç ve içeriği, mesleki gelişime katkısı, değerlendirilme yöntemleri, ders kaynakları vb.) oluşmaktaydı. Her bir soru 0-5 puan (0=kesinlikle katılmıyorum,5=kesinlikle katılıyorum) arasında puanlandı. Anketler, öğrenciler tarafından toplam 20 ders (13 zorunlu,3 zorunlu seçmeli,4 alan içi seçmeli) ve 17 öğretim üyesi için dolduruldu. İstatiksel analiz için SPSS 25 programı kullanıldı. Veriler normal dağılımlarına göre değerlendirildikten sonra korelasyon analizi için Pearson Korelasyon Katsayısı testi kullanıldı. Korelasyon kuvvetini belirlemek için Cohen korelasyon sınıflaması kullanıldı. Sonuçlar: Öğretim üyesinden memnuniyet ortalaması 4.24±0.46, ders içeriğinden memnuniyet ortalaması ise 4.23+0.48 olarak bulundu, her iki değerlendirme arasında pozitif yönde çok yüksek dereceli korelasyon bulundu (p<0,05,r: 0,9s)1. Tartışma: Çalışmamızın sonucuna göre öğrencilerin ders memnuniyet düzeyi ile öğretim üyesi memnuniyet düzeyi birbiriyle ilişkilidir. Öğretim üyesinin öğrencilerin derse karşı olan memnuniyet düzeyini etkileyebileceği, bu durumun da öğrenci başarısında rol oynayabileceği düşünülmektedir. Bu nedenle öğretim üyelerinin yeterliliklerinin geliştirilmesine yönelik çalışmalar öğrenci memnuniyetinde rol oynayabilir. Öğrenci memnuniyetinin değerlendirilmesine ilişkin çalışmaların arttırılması yükseköğretim seviyesinde verilen eğitimin iyileştirilmesi için yararlı olabilir.

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