Fizyoterapi ve Rehabilitasyon Bölümü / Department of Physiotherapy and Rehabilitation

Permanent URI for this collectionhttps://hdl.handle.net/11413/6828

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Open Access
Does Occupational Self-Competence Perception Relate to Functional Outcomes After Total Knee Arthroplasty?
(Hayat Sağlık ve Sosyal Hizmetler Vakfı, 2024) Yılmaz, Güleser Güney; AKEL, BURCU SEMİN; SAİTOĞLU, YELİZ SEVİMLİ; Akı, Esra
Aim: The study investigates the effect of occupational self-perception level on the functional status in the early period after total knee arthroplasty (TKA). Methods: Occupational Self Assessment (OSA), Canadian Occupational Performance Measure (COPM), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Timed Up and Go Test (TUG) tests were administered before and at the 3rd and 6th week after surgery. Changes in COPM, KOOS, and TUG tests were analyzed using Friedman test. The relationship of OSA was examined using the Pearson correlation test. Results: Self-perception score was statistically in relation to TUG (r =- 0.600; p = 0.001). It was not significantly related with other assessment scores (p>0.05). Conclusion: Occupational self-competence perception of individuals affect their actual performance levels therefore; high occupational self-perception level may affect the recovery positively.
Open Access
The Effect of Interferential Currents and Tens on Pain and Functionality in Patients With Chronic Mechanical Low Back Pain
(Galenos Publishing House, 2024) Çolak, Tuğba Kuru; Sert, Nihat; Sert, Buse; APTİ, ADNAN
Objective: This study aimed to compare the effects of interferential current (IFC) and transcutaneous electrical nerve stimulation (TENS) on pain, disability, and flexibility for treating patients with chronic low back pain (CLBP). Materials and Methods: This study included 50 volunteer patients diagnosed with CLBP randomly assigned to IFC and TENS treatment. In addition to electrical stimulation, therapeutic ultrasound, hot packs, and exercise were administered to both groups. All patients underwent 20 sessions of treatment for 4 weeks and 5 days on weekdays. The Numerical Pain Scale, Oswestry Scale (ODI), and sit-and-reach test were used for evaluation. Patients were evaluated 3 times: before treatment, at the 10th session, and after treatment. The paired t-test was used for statistical analysis. Results: Significant improvement was seen in both treatment groups’ pain levels when the levels of pain before and after treatment were compared. Before and after treatment, both groups in the sit-and-reach test and Oswestry evaluation showed a significant improvement (p>0.05). The change in pain and disability scores did not show superiority in the TENS and IFC groups (p>0.05). Only in the sit-and-reach test did the IFC group show significantly more improvement after the 20th session treatment (p=0.026). Conclusion: IFC and TENS should be used in patients with CLBP to control pain and improve function. However, studies with electrical currents determined by different biophysical parameters are needed to determine the superiority of TENS and IFC in terms of treatment outcome measures. ©Copyright 2024 The Author. Published by Galenos Publishing House on behalf of Turkish Spine Society.
Metadata only
Surgical Site Infection Arising from the Operating Room
(W.B. Saunders, 2024) GÜL, ASİYE; Sengul, Tuba; Kirkland-Kyhn, Holly
Open Access
Active Child, Healthy Child Project: The Effects on Dynamic Balance of an Increase in Femoral Anteversion in Healthy Developing Children
(AVES, 2024) APTİ, ADNAN; AKALAN, NAZİF EKİN; AKEL, BURCU SEMİN; EVRENDİLEK, HALENUR; ÖNERGE, KÜBRA; NAS, İMGE
Objective: Increased femoral anteversion (IFA) is defined as the anterior rotation of the femoral head in relation to the transcondylar axis of the knee. The aim of this study was to determine the frequency of IFA in healthy developing children and to investigate the effects of IFA on dynamic balance. Methods: School screening was conducted on 315 school-age children (6-14 years old, mean 9.9 ± 2 years), and IFA was determined in 26 children. From the same sample, 36 children with no IFA were selected as the control group. Data obtained from the Y balance test, handgrip strength with a digital dynamometer, IFA according to the Craig’s test, and joint hypermobility according to the Beighton score were compared between the groups. Independent sample t-test and Pearson’s correlation test were used in the statistical analysis. Results: This study was carried out on a narrow universe of children mean aged 9.9 ± 2 years, and the incidence of IFA was determined as 8.3%. The Y balance scores were found to be higher in the IFA group than in the controls (P=.049 right, P=.027 left). There was no correlation between Craig’s test and the Y balance test results (r=0.04). No difference was found between the groups for muscle strength and joint hypermobility scores associated with balance. Conclusion: Balance may not be one of the causes of frequent falls in children with IFA. Further studies are needed to further examine the biomechanical causes of falls, as studies to improve balance may not provide sufficient benefit to prevent fall-related trauma and injury in children with IFA. © 2024 AVES. All rights reserved.
Open Access
Correction to: Residual Gait Deviations in Children Treated by Medial Open Reduction for Developmental Dysplasia of the Hip at Long-Term Follow-up: A Comparison With Healthy Controls (International Orthopaedics, (2024), 48, 10, (2661-2671), 10.1007/s00264-024-06263-9)
(Springer Nature, 2024) Demirel, Mehmet; EVRENDİLEK, HALENUR; AKALAN, NAZİF EKİN; Bilgili, Fuat; Meriç, Emre; Kuchimov, Shavkat; ÖNERGE, KÜBRA
The correct affiliation of Kübra Önerge should be affiliation 2: Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, İstanbul Kültür University, Istanbul, Turkey. and not affiliation 3. The original article has been corrected. © The Author(s) 2024.
Open Access
The Efficacy of Night Bracing in the Treatment of Adolescent İdiopathic Scoliosis: A Systematic Review
(MDPI, 2024) Çolak, Tuğba Kuru; Dereli, Elif Elçin; Akçay, Burçin; APTİ, ADNAN; Maeso, Santiago Lasa
Background/Objectives: The effectiveness of night braces alone or in combination with other treatments for adolescent idiopathic scoliosis remains unclear. This systematic review study aimed to review and analyze the available literature to determine whether night braces are an effective treatment for idiopathic scoliosis. Methods: A total of 162 databases, including Cochrane Library (reviews, protocols, trials), Web of Science, PubMed, Medline, Scopus, PEDro, CINAHL (EBSCO), Ovid and Google Scholar, were searched for published articles from inception to February 2024. The available literature was screened by the following terms: "scoliosis and night-time brace", "scoliosis and night brace", "scoliosis and part-time bracing", "scoliosis and Providence" and "scoliosis and Charleston". Results: Twenty studies were included; only one study was a randomized controlled trial, and most of the studies were retrospectively designed. Providence, Charleston and Boston braces were used as night braces. The Cobb angle was evaluated in all studies, and Cobb angle change after treatment and surgical treatment rates were the parameters that were evaluated the most. In one study, the angle of trunk rotation, quality of life, perception of spinal appearance, and physical activity level were measured. In one study, sagittal plane assessments were performed in addition to the Cobb angle. Conclusions: The results of this review suggest that there is no evidence to support the use of night braces in the treatment of adolescent idiopathic scoliosis. Randomized controlled trials with a well-designed methodology are needed to determine the efficacy of night braces.
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Residual Gait Deviations in Children Treated by Medial Open Reduction for Developmental Dysplasia of the Hip at Long-Term Follow-up: A Comparison With Healthy Controls
(Springer, 2024) Demirel, Mehmet; EVRENDİLEK, HALENUR; AKALAN, NAZİF EKİN; Bilgili, Fuat; Meric, Emre; Kuchimov, Shavkat; ÖNERGE, KÜBRA
Purpose This study aimed to analyze and compare gait patterns and deviations at long-term follow-up in children who received medial open reduction (MOR) before 18 months for unilateral or bilateral hip developmental dysplasia (DDH). Methods A retrospective chart review was conducted on children who underwent MOR. The study population was divided into two groups: the unilateral group, including unilateral (five children with unilateral) and bilateral (five children with bilateral DDH). Ten healthy children were recruited for the control group. Spatiotemporal, kinematic, stiff-knee gait (SKG), and kinetic gait characteristics were analyzed. Results Stance time was significantly shorter in both the unilateral (median [IQR]; 590 ms, [560.0-612.5] and bilateral (575 ms, [550-637.5]) groups than in the control group (650, [602.5-677.5]) (p < 0.001), whereas swing time did not differ substantially (p = 0.065) There was no considerable difference in the mean knee flexion at swing between the unilateral (31.6 degrees, [30-36]) and control (30.11 degrees, [27.8-33.6] groups (p > 0.05), but the bilateral group (28.5 degrees, [24.9-32.1]) showed the lower values than the other groups (p < 0.001 for bilateral vs unilateral group; p = 0.008 bilateral vs unilateral group). All the SKG parameters significantly differed among the groups in multi-group comparisons (p < 0.001 for each parameter). Three children had borderline SKG, and two had not-stiff limbs in the unilateral group. In the bilateral group, four children had stiff limbs, and one had borderline SKG. Most kinetic gait parameters were not statistically different between groups (p > 0.05). Conclusion This study has revealed notable deviations in gait patterns of children with DDH treated by MOR at long-term follow-up compared to healthy children's gait. MOR could negatively affect pelvic motion during gait due to impaired functions of the iliopsoas and adductor muscles, and SKG can be encountered secondary to iliopsoas weakness.
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The Effects of Improvement in Upper Extremity Function on Gait and Balance in Children With Upper Extremity Affected
(Elsevier Ireland Ltd., 2024) Leblebici, Gökçe; Tarakcı, Ela; Kısa, Eylül Pınar; AKALAN, NAZİF EKİN; Kasapçopur, Özgür
Background: This study aimed to investigate the effects of functional improvement in the upper extremity on gait and balance in children with upper extremity affected. Research question: What are the effects of functional improvement in the upper extremity on gait and balance in children with upper extremity affected? Methods: Eighteen children with a diagnosis of rheumatologic diseases and 15 healthy children were evaluated with Shriners Hospital Upper Extremity Assessment, Jebsen-Taylor Hand Function Test, Abilhand Rheumatoid Arthritis Scale, 10-meter walk test and Childhood Health Assessment Questionnaire. For static balance assessment, the Biodex Balance was used. Ground reaction forces (peak forces (heel strike and push-off) and minimum force (loading response), single-limb support duration, Center-of-Force displacement and walking speed were evaluated with the Sensor Medica. Arm swing was evaluated with the Kinovea 2D motion analysis. Results: Before treatment, single-limb support duration and push-off force was higher and center-of-force displacement was lower on affected side compared to unaffected side in rheumatologic group. After the 6week rehabilitation program, upper extremity function, quality of life and functional gait score improved. Single-limb support duration decreased on affected side and increased on unaffected side. On affected side, pushoff force decreased. The arm swing parameters were similar before and after treatment. Significance: Improving upper extremity function can help with gait balance by decreasing the difference in walking and balance parameters between the affected and unaffected sides and providing for more symmetrical weight transfer.
Open Access
The Immediate Effect of Hanging Exercise and Muscle Cylinder Exercise on the Angle of Trunk Rotation in Adolescent Idiopathic Scoliosis
(MDPI, 2024) Akçay, Burçin; Çolak, Tuğba Kuru; APTİ, ADNAN; Çolak, İlker
(1) Background: Semi-hanging and muscle cylinder exercises have been defined as scoliosis-specific corrective exercises. The aim of this study was to evaluate the immediate effect of muscle cylinder and semi-hanging exercises on the angle of trunk rotation in patients with adolescent idiopathic scoliosis (AIS). (2) Methods: Twenty-seven patients with AIS with a mean age of 18.6 years were retrospectively analyzed. The angle of trunk rotation (ATR) values were measured before and after performing semi-hanging and standing muscle cylinder exercises. Both exercises were performed for three to five respiratory cycles. The semi-hanging exercise was performed first, followed by the muscle cylinder exercise, in this order, in all participants. For statistical analysis, the Wilcoxon signed-rank test was used to analyze ATR changes after the exercises, and the Kruskal-Wallis test was used to compare ATR changes according to the main curve location. (3) Results: The thoracic, thoracolumbar and lumbar maximum ATR values were significantly increased after the semi-hanging exercise (p < 0.001) and decreased after the muscle cylinder exercise (p < 0.001). The ATR change was greater in the lumbar region than in the thoracic and thoracolumbar regions. (4) Conclusion: The results of this study of a small group of patients emphasized that one of the scoliosis-specific corrective exercises, the standing muscle cylinder exercise, improved ATR, while the other, the semi-hanging exercise, worsened ATR in patients with AIS. It is recommended that each scoliosis-specific corrective exercise be evaluated and redesigned to maximize the three-dimensional corrective effect, considering the biomechanics of the spine and the pathomechanics of scoliosis.
Open Access
Effects of Arm Swing on Plantar Pressure Behavior During Walking
(İstanbul Üniversitesi-Cerrahpaşa Sağlık Bilimleri Fakültesi, 2023) Leblebici, Gökçe; AKALAN, NAZİF EKİN; ÖNERGE, KÜBRA; KUCHIMOV, SHAVKAT; Ören, Meryem
Objective: This study aimed to investigate the influence of different arm swing conditions on plantar pressure behavior during walking in healthy individuals. Methods: The study included 29 healthy (22.55 ± 1.02 years) volunteers. The foot pressure was analyzed under 3 conditions: both arms should be freely swinging and the dominant arm should be restricted and should be held. Time and magnitudes of peak forces, gait velocity, duration of stance subphases, peak forces for 5 different areas in foot-sole, accelerations of the center of pressure, and mediolateral displacements of center of pressure were the interesting parameters. Results: When the arm swing was held, the onset of terminal stance was earlier and the anterior-posterior center of pressure acceleration decreased at the midfoot on the affected side (0.32 ± 0.04 seconds, 2.96 ± 0.27 m/ms 2) than on the contralateral side (0.34 ± 0.05 seconds, 3.12 ± 0.28 m/ms 2) (P = .04, P = .02). The differ- ences in anterior-posterior center of pressure acceleration between heel and forefoot and the mediolateral displacements of center of pressure were lower on the affected side at held (3.75 ± 0.31 m/ms 2, 0.06 ± 0.02 m, respectively) compared to the free swing (3.82 ± 0.30 m/ms 2, 0.07 ± 0.02 m) (P = .02, P = .01), while the peak force at the medial forefoot was lower on the contralateral side when the arm was held (28.87 ± 6.22 N) compared to the free swing (30.54 ± 5.86 N) (P= .01). Conclusion: The lack of arm swing may interact with ipsilateral early onset and longer late stance phase during walking in healthy individuals. The foot pressure behaviors during walking should be investigated for unilaterally affected patients.
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Functional Bandaging in Children with Idiopathic Toe-Walking
(NLM (Medline), 2023) Tuncer, Deniz; AKALAN, NAZİF EKİN; Çalışkan, M. Mine; Temelli, Yener; Yiğit, Pakize
Background: Idiopathic toe-walking (ITW) is a persistent gait pattern with no known etiology characterized as premature heel rise or no heel contact. We investigated the effects of functional bandaging in children with ITW on heel contact during stance phase and on gait quality. Methods: Nineteen children aged 4 to 16 years with ITW and ten age-matched healthy children were included in the study. Elastic adhesive bandages were applied to children with ITW to assist with dorsiflexion. Before bandaging (T0) and immediately (T1) and 1 week (T2) after initial bandaging, the initial contact, loading response, and midstance subphases of gait were analyzed using light pressure sensors and the Edinburgh Visual Gait Score (EVGS). Ten age-matched children with typical gait participated for comparison in T0. The data were analyzed with Friedman and Wilcoxon signed rank tests for within-group comparisons and Mann-Whitney U tests for between-group comparisons. Results: In T0, for the ITW group, no heel contact was observed during stance. In T1, all of the participants achieved heel contact at initial contact and loading response and 56.8% at midstance. In T2, all of the heels continued contact at initial contact and loading response and 54.3% at midstance. The EVGS significantly improved. The Friedman test showed that there were noteworthy improvements between T0-T1 and T0-T2 in video-based observational gait analysis and EVGSs (P < .001), although no difference was found between T1-T2 in video-based observational gait analysis (P = .913) and EVGSs (P = .450). Conclusions: In children with ITW, dorsiflexion assistive functional bandaging was an effective tool to help achieve heel contact on the ground and improve walking quality for a short period after application. Further studies with longer follow-up and larger sample sizes are required to confirm the long-term therapeutic effects of this promising functional bandaging.
Open Access
Normative Values for Cervical and Lumbar Range of Motion in Healthy Young Adults
(Galenos Publishing House, 2023) APTİ, ADNAN; Çolak, Tuğba Kuru; Akçay, Burçin
Objective: The cervical and lumbar spines are the more mobile parts of the spinal column than the thoracic spine. Reference range of motion (ROM) measurements is one of the important clinical outcome measures used in patient assessment and follow-up of treatment efficacy. The aim of this study was to obtain normative values of cervical and lumbar ROM in young adults. Materials and Methods: The sample comprised 300 healthy volunteers (198 female, 102 male, mean age: 21.4±1.9 years, range, 18-29 years). Cervical (C) and lumbar (L) ROM values were measured in three planes with a two-arm digital goniometer according to the American Academy of Orthopaedic Surgeons (AAOS) criteria. The mean ROM measurements were analyzed according to gender using the Mann-Whitney U test. Results: Cervical ROM values were determined to be: cervical flexion 57.7±8.2º, extension 59.1±10.2º, right-left lateral flexion 42.1±7.9º-41.4±7.7º, and right-left rotation 71.1±10.5º-70.2±9.7º. There was no statistically significant difference between the genders with respect to the cervical ROM (p>0.05). The lumbar ROM values were determined to be lumbar flexion 69.9±14.5º, extension 40±10.2º, right-left lateral flexion 36.3±6.4º-36.2±6.6º, and right-left rotation 38.4±8.7º-38.6±9.4º. The lumbar flexion ROM values were statistically significantly higher in females than in males (p=0.043). Conclusion: The flexion and extension angles of the lumbar spine in the sagittal plane were higher in females than in males, and there was no difference between the genders regarding all the other cervical and lumbar joint ROM values. These goniometrically measured cervical and lumbar ROM values were found to be generally similar to the widely used reference values of AAOS and Kendall McCreary. Further research is needed on the effects of individual differences such as physical activity or inactivity.
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Adaptation, Reliability, and Validation of the Turkish Version of the Bad Sobernheim Stress Questionnaire-Deformity in Patients With Adolescent Idiopathic Scoliosis
(Wolters Kluwer Health, 2023) Akçay, Burçin; Kuru Çolak, Tuǧba; APTİ, ADNAN
Background:There is a limited number of disease-specific outcome measurement scales in Turkish, which can be used for individuals with adolescent idiopathic scoliosis (AIS). The aim of this study was to translate, adapt, and evaluate the validity and reliability of the Turkish version of the Bad Sobernheim Stress Questionnaire-Deformity (TRv.BSSQD) questionnaire in Turkish patients with AIS.Objective(s):After the translation and back-translation process, the TRv.BSSQD and Scoliosis Research Society-22 questionnaires were completed in face-to-face interviews with 49 patients with AIS. The TRv.BSSQD questionnaire was readministered to the same patients 2 weeks later to assess test-retest reliability.Results:The Cronbach alpha value calculated for internal reliability was 0.806. The intraclass correlation coefficient values of the items of the TRv.BSSQD ranged from 0.809 (P < 0.001) (question 8) to 0.955 (P < 0.001) (question 7). The test-retest correlation coefficient for the item-total score was 0.960 (P < 0.001). Validity analysis showed a significantly positive correlation between the TRv.BSSQD total score and pain, self-image, and mental subgroup and the total scores of the SRS-22r scale (P < 0.05).Conclusions:This patient-reported outcome instrument, the TRv.BSSQD, showed good internal consistency, good reliability with test-retest analysis, and construct validity, suggesting that it is an appropriate assessment instrument for Turkish patients with AIS.
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Translation, Reliability and Validity of the Turkish Version of Scoliosis Japanese Questionnaire-27 in Adolescent Idiopathic Scoliosis
(Springer, 2023) Çolak, Tuğba Kuru; APTİ, ADNAN; Çolak, İlker; Akçay, Burçin; Dereli, Elif Elçin
PurposeDisease-specific scales which evaluate QoL are needed to evaluate treatment outcomes, and to compare the effects of different treatments. The outcome measures evaluating quality of life in adolescent idiopathic scoliosis are limited. The purpose of this study was to examine the validity and reliability of the Turkish version of the Scoliosis Japanese Questionnaire-27 (SJ-27) in adolescent idiopathic scoliosis.MethodsThe SJ-27 questionnaire was translated into Turkish and 61 female patients filled out the translated version (TRv.SJ-27) twice to measure the test-retest reliability of the scale. Internal reliability of the questionnaire was estimated using Cronbach's alpha coefficient. The intraclass correlation coefficient was analysed for each item. Discriminant validity and convergent validity were determined by correlations with Cobb angle, ATR and the SRS-22r scale.ResultsThe mean Cobb angle was 25.8 degrees and the ATR angle was 8.8 degrees. Cronbach's alpha value was estimated as 0.935. The test-retest correlation coefficient for the item-total score was 0.877 (p = 0.000). Validity analysis showed a significantly positive correlation between the TRv.SJ-27 total score and Cobb and ATR angles, and a significantly negative relationship was found between the TRv.SJ-27 and SRS-22r scores.ConclusionsIt would be useful to use different outcome measures to assess the scoliosis-specific quality of life in clinical practice and research. The findings suggest that the Turkish version of Scoliosis Japanese Questionnaire-27 is a valid and reliable measure to assess Turkish patients with AIS.
Open Access
Comparison of Kinesio Taping, Trigger Point Injection, and Neural Therapy in the Treatment of Acute Myofascial Pain Syndrome: A Randomized Controlled Study
(Kare Publishing, 2023) Ay, Saime; Tur, Birkan Sonel; Karakaş, Merve; Gökmen, Derya; ALTINBİLEK, TURGAY; Evcik, Deniz
Objectives: Myofascial pain syndrome (MPS) is a regional painful soft-tissue disorder, characterized by trigger points (TrPs) and taut bands in the muscles. In this study, we aimed to compare the effectiveness of kinesio taping (KT), TrPs injection, and neural therapy (NT) on pain and disability in acute MPS.Methods: 104 patients with MPS in the cervical region were allocated into three groups. Group 1 (n=35) were treated with KT, Group 2 (n=35) received local anesthetic (LA) (lidocaine of 0.5%) TrPs injection, and Group 3 (n=34) received NT with the same LA solution. Patients were assessed by means of pain, pressure pain threshold (PPT), and disability. Pain severity was measured by Visual Analog Scale. The neck pain disability scale was used for assessing disability. PPT was measured by using an algometer. Measurements were taken before and after treatment of 3(rd) and 7(th) days.Results: There were improvements on pain and disability in all groups at the end of treatments at 3(rd) day and during follow-up period (p<0.001) and no differences were found between the groups. There was significant difference in PPT values in TrPs injection and NT groups in comparisons between all time periods, however, the change, depending on time in the KT group, was not statistically significant.Conclusion: The results of this study show that all these three treatment methods found to be effective on pain relief and disability in acute MPS. In terms of PPT, injection treatments seem to be superior than KT.
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Effects of Pilates Exercises on Idiopathic Scoliosis: A Scoping Review of the Literature
(Springer, 2023) Çolak, Tuğba Kuru; Akçay, Burçin; APTİ, ADNAN
Purpose Scoliosis is a deformity involving changes in three planes. These changes include lateral curvature in the frontal plane, changes in physiological thoracic kyphosis and lumbar lordosis angles in the sagittal plane, and rotation of the vertebrae in the transverse plane. The aim of this scoping review was to review and summarize the available literature to determine whether Pilates exercises are an effective treatment for scoliosis.MethodsThe Cochrane Library (reviews, protocols, trials), PubMed, Web of Science, Ovid, Scopus, PEDro, Medline, CINAHL (EBSCO), ProQuest, and Google Scholar electronic databases were used to search for published articles from inception to February 2022. All the searches included English language studies. Keywords were determined as "scoliosis and Pilates" or "idiopathic scoliosis and Pilates", "curve and Pilates", "spinal deformity and Pilates."Results Seven studies were included; one study was a meta-analysis study, three studies compared Pilates and Schroth exercises, and three applied Pilates exercises in combined therapy. The studies included in this review used outcome measurements of Cobb angle, ATR, chest expansion, SRS-22r, posture assessment, weight distribution, and psychological factors such as depression.ConclusionsThe results of this review suggest that the level of evidence regarding the effect of Pilates exercises on scoliosis-related deformity is very limited. Pilates exercises can be applied to reduce asymmetrical posture in individuals with mild scoliosis with reduced growth potential and progression risk.
Open Access
The Effectiveness of the Schroth Best Practice Program and Cheneau-Type Brace Treatment in Adolescent Idiopathic Scoliosis: Long-Term Follow-Up Evaluation Results
(MDPI, 2023) Çolak, Tuğba Kuru; Akçay, Burçin; APTİ, ADNAN; Çolak, İlker
Background: Although the number of studies showing the efficacy of conservative treatment in adolescent idiopathic scoliosis has increased, studies with long-term follow-up are very limited. The aim of this study was to present the long-term effects of a conservative management method including exercise and brace in adolescent idiopathic scoliosis patients. Methods: This retrospective cohort study included patients with idiopathic scoliosis who presented at our department and were followed up for at least 2 years after completing the treatment. The main outcome measurements were the Cobb angle and angle of trunk rotation (ATR). Results: The cohort participants were 90.4% female, with a mean age of 11 years and the maximum Cobb angle was mean 32.1 degrees. The mean post-treatment follow-up period was 27.8 months (range 24-71 months). The improvements after treatment in mean maximum Cobb angle (p < 0.001) and ATR (p = 0.001) were statistically significant. At the end of treatment, the maximum Cobb angle was improved in 88.1% of the patients and worsened in 11.9% compared to baseline. In the long-term follow-up evaluations, 83.3% of the curvatures remained stable. Conclusions: The results of this study showed that moderate idiopathic scoliosis in growing adolescents can be successfully halted with appropriate conservative treatment and that long-term improvement is largely maintained.
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Occupational Self-Perception Level Effects on the Development of Kinesiophobia in Individuals With Total Knee Arthroplasty
(Elsevier, 2023) Yılmaz, Güleser Güney; AKEL, BURCU SEMİN; SAİTOĞLU, YELİZ SEVİMLİ; Akı, Esra
Introduction: The development of kinesiophobia after Total Knee Arthroplasty (TKA) has been one of the important issues. However, the early results and the presence of kinesiophobia before surgery have not been adequately investigated. In addition, the effects of factors such as pain perception, postoperative pain level, and demographic characteristics were mentioned. However, occupational factors such as occupational expectations and occupational self-perception level have not been adequately investigated.Methods: Each assessment tool was administered three times: once on the first day of the preoperative period and then again at the third and sixth weeks after the surgery. The assessment tools employed were the Knee Injury and Osteoarthritis Outcome Score, Tampa Scale for Kinesiophobia, Occupational Self Assessment, and Timed Up and Go test. To analyze the differences in Tampa Scale for Kinesiophobia scores, a one-way ANOVA was con-ducted. Subsequently, the patients were categorized into two groups based on their level of kinesiophobia: high and low. Independent sample t-tests were employed to compare continuous and normally distributed data be-tween the two groups, while the Mann-Whitney U test was used for non-normally distributed data. The Pearson correlation coefficient was utilized to assess the relationship between continuous data, whereas the Spearman rank-order correlation was employed for non-normally distributed data. Results: High levels of kinesiophobia were identified in individuals both prior to and following surgery. Signif-icant differences were observed between the high and low kinesiophobia groups in terms of the mean OSA Competency (p < 0.05). However, no statistically significant differences were found between the groups in relation to the other evaluation scores during the follow-up periods. Furthermore, a negative correlation was observed between TSK score and OSA Competence results (p < 0.05).Conclusion: Occupational self-perception levels effect the level of kinesiophobia in individuals with TKA and high rates of kinesiophobia observed before the surgery intensified after the surgery, especially in the early period. It may be necessary to focus more on factors such as individual factors, individuals' values, habits, and beliefs.
Open Access
Determination of Somatotypes of Children With Adolescent Idiopathic Scoliosis and Its Relationship With Scoliosis
(Bayrakol Medical Publisher, 2023) APTİ, ADNAN; Çolak, Tuğba Kuru; Akçay, Burçin; Çolak, İlker
Aim: Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine. In adolescence, body morphology can change for various reasons such as genetics, nutrition, and level of physical activity. It has been reported that there are differences in the normal physical growth pattern in children with AIS, which may be due to hormonal changes. The relationship between body morphology and scoliosis is questionable because of the differences that scoliosis creates in the spinal structure. The aim of this study was to define the somatotype characteristics of children with AIS and compare the somatotypes with healthy, age and sex-matched controls.Material and Methods: A retrospective evaluation was performed on 38 children with AIS and 27 age-matched healthy control subjects. Cobb angles and angle of trunk rotation (ATR) values were used to determine scoliosis and trunk gibbosity. Cobb angles were measured on standing anterior-posterior radiographs and the ATR using Adam's forward bending test with a scoliometer. Somatotypes were defined according to the Heath-Carter method and body morphology was categorized into three different components: endomorphy, mesomorphy, and ectomorphy.Results: Ectomorphy was the dominant type in the AIS group, and endomorphy was the dominant type in the control group. The endomorphic somatotype in individuals with scoliosis was determined at a statistically significantly lower rate than in the control group (p=0.048). There was a moderate negative correlation (p=0.001, r=-0.466) between the Cobb angle and the values of the endomorphy component, and between the ATR and the endomorphy values (p=0.010, r=-0.318).Discussion: The lower rate of endomorphic somatotype was an evident difference in children with scoliosis. These differences may cause problems in the growth and development of the spine and the skeletal structures attached to the spine during adolescence when rapid growth and development occur. Whether this difference is related to nutrition, genetic and hormonal factors, or psychosocial factors remains to be determined.
Open Access
Does Increased Femoral Anteversion Can Cause Hip Abductor Muscle Weakness?
(MDPI, 2023) APTİ, ADNAN; AKALAN, NAZİF EKİN
Background: Increased femoral anteversion (IFA) causes functional problems (i.e., tripping, frequently falling, and fatigue) by affecting the pelvis and lower extremity biomechanics. In the frontal plane, increased contralateral pelvic drop and ipsilateral hip adduction, which are mainly considered deteriorated hip abductor muscle mechanisms, are associated with hip and knee injuries. Aims: The aim of this study was to examine the effects of femoral anteversion on hip abductor weakness and frontal plane pelvis-hip biomechanics during walking. Methods: The study included nine subjects with increased femoral anteversion and a control group of eleven subjects. Maximum isometric voluntary contraction (MIVC) values of the hip abductor muscles were measured with a handheld dynamometer. Three-dimensional gait analysis was performed for kinetic, kinematic, and temporo-spatial gait parameters. Non-parametric tests were used for statistical analysis (p < 0.05). Results: There was no significant difference found between the MIVC values of the IFA and control groups (p = 0.14). Moreover, no significant difference was determined between the ipsilateral peak hip adduction (p = 0.088) and contralateral pelvic drop (p = 0.149) in the stance phase. Additionally, there was no correlation between the peak hip adduction angle in the stance phase and normalized MIVC values in the IFA group (r = -0.198, p = 0.44), or in the control group (r = -0.174, p = 0.55). The deviations of pelvic rotation (p = 0.022), hip internal rotation (p = 0.003), and internal foot progression (p = 0.022), were found to be higher in the IFA group than in the controls. Conclusions: IFA may not be associated with hip abductor muscle weakness, and it may not lead to the hip adduction and pelvic depression that can be seen in hip abductor weakness. Increased pelvic rotation and internal hip rotation during walking might be considered as a compensation for the femoral head-acetabulum alignment mechanism in the frontal plane.