Theses supervised by Prof. Dr. Feryal Subaşı
25 theses · Yeditepe University
Effects of core stabilization and proprioceptive neuromuscular facilitation exercises on motion of joint, muscle strength, posture, and functional status in patients with shoulder subacromial impingement sydrom
The shoulder is the most mobile joint in the human body, making an individual possible for performing a wide range of motion. Shoulder disorders such as Subacromial Impingement Syndrome (SIS) are the most common forms of musculoskeletal disorders and shoulder pathology with occurrence of pain and dysfunction during daily activities. The SIS injuries and rehabilitation may considerably vary, and are always important to arrange an appointment with a healthcare practitioner. Among the rehabilitation techniques, core stabilization exercises, and proprioceptive neuromuscular facilitation (PNF) improve the shoulder rehabilitation. The objective of this study was to assess the effects of core stabilization and PNF exercises on slow motion of joint, muscle power, posture, and functionality in the patients with SIS. To do this, a total of 50 persons (25 in experimental group and 25 in control group; ages ranging from 18 to 65 yr) attending in a privately owned hospital in İstanbul was involved. All the selected patients were with SIS longer than 6 months. The evaluation were made in the beginning and sixth week of the study by the same physiotherapist according to the pain, strength and endurance of the core muscles, motion of neck and shoulder joint, muscle strength for shoulder muscle, posture, and functional status criteria. The statistical analyses were performedby SPSS 19 package program. The results showed that core stabilization and PNF exercises positively affected strength of core muscle, core endurance, and posture, whereas there were there was not any significant effects on pain, joint range of motion, strength of shulder muscle, and functional values. In conclusion, this study revealed that the core stabilization and PNF exercises may partially improvethe symptoms related to the SIS as compared to the regular treatment in the clinic. Key words: Core Stabilization, Functional Status, Joint, Muscle Strength, Physiotherapy, Posture, Proprioceptive Neuromuscular Facilitation, Shoulder Subacromial Impingement Sydrom
The evaluation of running biomechanics among runners
With the increasing awareness of maintaining a healthy lifestyle in modern life, running activity is becoming popular not only by professional but also amateur athletes. Considering that running, which increases cardiovascular endurance, can cause athletes to experience acute and chronic musculoskeletal injuries if done unconsciously, understanding running biomechanics for runners of all levels can contribute to the prevention of injuries and support the development of running performance. Therefore, the purpose of this study is; to measure running biomechanics and vertical jump parameters in amateur runners and to examine the relationship between these parameters. The study included 22 amateur runners (32.23 ± 6.43 years) who received running training and had a running training period according to their annual race goals. Foot posture index and footbalance sole analysis system of each runner's foot and ankle posture in stance position; Functional dorsiflexion angle of the ankle was measured with the Weight Bearing Lunge Test. Performance-related tests are performed by optojump system, Squat Jump Test, (Height) and running biomechanical parameters are Treadmill running test (contact time, contact phase, flight time, foot flat phase, propulsion phase, stride length, step length and height). measured. Before running and jumping measurements, each runner was given a standardized warm-up program (3 minutes of running up to 12 km / h) and mobility exercise. As a result of this study, there is no statistically significant relationship was found between positional stance parameters of the foot and biomechanical running parameters (p> 0.05). However, maximal vertical jump is higher in runners with a high foot dorsiflexion angle (p <0.05). In addtion, no relationship was found between the height of the foot in running from the ground and the maximal vertical jump height. (p> 0.05). A negative correlation was found between contact time and contact phase, step length and stride length which are among the running parameters (p <0.05). There is a positive correlation between height, contact phase and step length in running. (p <0.05) In conclusion, while evaluating running biomechanics, we consider that dynamic performance measurements as well as static evaluations are valuable in evaluating running biomechanics and offering suggestions to improve running performance. For amateur runners of a certain level, reaction time drills based on the height, contact phase and duration of the foot from the ground, middle forefoot running press drills and horizontal jumps exercises, proprioception-balance exercises can be recommended to increase the step length and stride length that will affect the running performance. In addition, ankle mobility exercise and recommendations and suggestions can be given to increase the ability of the arch of the foot to adapt to movement can be made to increase vertical jumping performance in runners. Key words: Running analysis, Runners, Amateur runner, Running biyomechanics, Run perpormance
Adeziv kapsülitli olgularda konvansiyonel tedaviye ek olarak uygulanan mulligan konsepti ve PNF (proprioseptif nöromusküler fasilitasyon) tekniğinin etkilerinin karşilaştirilmasi
The aim of this study is to examine the effects of Mulligan Concept and PNF Technique applied in addition to conventional treatment on joint range of motion, pain and sleep quality in individuals diagnosed with adhesive capsulitis. The study included 42 (28F, 14E; 62.33 ± years) volunteers who were treated under the direction of a physician in Sportomed Suadiye Clinic between June 2019 and August 2020. The characteristics of the participants were evaluated with the sociodemographic questionnaire prepared by us. Shoulder range of motions were measured using a goniometer. The pectoralis muscles, teres major, latissimus dorsi and rhomboid muscles were evaluated for shortness with the help of a tape measure. Using the Shoulder Pain and Disability index, the pain intensity and disability of the patients were evaluated in a way that each question was scored between 0-10. Upper extremity pain and function were evaluated by applying the Arm, Shoulder and Hand Questionnaire. Abnormal scapular motion was evaluated with the Lateral Scapular Slip test. Sleep problems were evaluated with the Pittsburgh Sleep Quality Index. Individuals were randomly divided into two groups as Mulligan Group (n=21) and PNF Group (n=21). Individuals in both groups had the conventional treatment, which included a 20-minute hotpack and 100Hz, 0.05-0.07 MS TENS. A home exercise programme was given to the patients. The duration of treatment was 5 days a week for 3 weeks. At the end of the treatment, there were significant differences in terms of ROM, muscle shortness, pain, QoL and sleep quality in both groups compared to pre-treatment (p<0.05). However, none of the applications found to be superior to each other (p>0.05). In the line of our hypothesis, Mulligan concept and PNF technique applied in addition to conventional treatment in patients with adhesive capsulitis have a positive effect on joint range of motion, pain, quality of life and sleep quality.
Comparison of music based multitask exercise program among elderly living in nursing home
The aim of the study is to compare the results of calisthenic exercises with rhythm and music in balance education using different sensory inputs in geriatric individuals living in nursing homes. The study included 16 geriatric individuals (9K,7E) aged 65 years and over living in Ümraniye Irmak, Ataşehir Adora and Dragos Adora Nursing Home between June 2018 and August 2018. Individuals were divided into two groups. The Group 1 (G1) (n=8; 74.00±8.55 years) received exercise training using different sensory inputs, while the Group 2 (G2) (n=8; 77.62±5.15 years) received calisthenic exercise training using with rhythm and music. Exercise programs were performed once a week for eight weeks. Subjects in G1 received individual exercise training, while subjects in G2 received group training. To evaluate mobility, balance and walking parameters of the individuals, the Timed Up and Go Test (TUG) was performed. Five Times Sit to Stand Test ( FTSST) was used to evaluate functional capacity and lower extremity muscle strength, Berg Balance Test (BBT) was used to evaluate balance and fall risks. Proprioception assessment was done with an angle reproduction test in the direction of dorsiflexion and plantarflexion and deviations were recorded.Two-point discrimination with esthesiometer and vibration perception (VP) with a tuning fork (128 Hz) was evaluated. According to the results of study, Group 1 showed statistically significant improvement for pre and post-intervention results in 5TSTT, BBT, TUG, JPS, TPD (2.metatarsal head and heel pad), WHOQOL-OLD (sensory, autonomy, past, perfect, future), GDS tests (Table 4.6&4.7&4.8&4.9 p<0.05). When comparing to pre and post-intervention results, there is a significant difference in BBT and GDS results in Group 2 (p<0.05). There were significant differences in G1 in terms of 5TSTT, BBT, TUG, JPS and MMSE scores, when the difference between pre and post-intervention results in intergroup variables is considered. (Table 4.11&4.12)(p<0.05). Consistent with our hypothesis, we found that exercise training using different sensory inputs is more effective on balance and proprioception. Key Words: multi-task exercise program, balance, music-based exercise program, elderly, nursing home, calisthenic exercise
The effects of neuromuscular exercise program on adolescent male basketball players
The purpose of this study is to compare the effects of a neuromuscular exercise program on balance, vertical jump and core endurance. Sixteen basketball players in Dostlukspor Club are included in the study. Participants were assigned to either the Exercise Group (EG) or the Control Group (CG) by simple computer-based randomization. While EG participated to the neuromuscular exercise program as a warm up program, CG continued conventional warm up program twice a week for six weeks under the supervision of a physiotherapist. The neuromuscular exercise program including balance, mobility, plyometrics and core stabilization exercises lasted for 20-25 minutes. Assessments included Y-Balance Test (YBT), McGill Core Endurance Test (MCET) and Vertical Jump Test (VJT) for measuring balance, core endurance and vertical jump respectively. All the participants were evaluated before and after interventions. Study showed that there was a significant difference in all reach directions of YBT in EG before and after interventions (p<0.05). Moreover, a significant difference was found in all directions except the right anterior direction comparing EG and CG (p<0.05). A significant difference was found in the core endurance parameter including endurance of the flexor, extensor and right/left core regions in the basketvball players of EG at the end of 6 weeks (p<0.05). In the CG, a significant difference was found only in the endurance of the extensor region at the end of 6 weeks (p<0.05). In the comparison between the groups, it was found that the applied neuromuscular exercise program was influential on the core endurance parameter of the flexor, extensor and right/left core regions (p<0.05). At the end of 6 weeks, no significant difference was found in the vertical jump parameter in the both groups when compared intragroup and intergroup differences (p>0.05). In summary, the study concluded that NM warm up traning positively affected core endure and dynamic balance compared to traditional warm up program in the adolescent basketball players. Thus, NM exercise program performed during warm up period may encoureged among adolescnet basketball players to improve perfomance parametrs.
Evaluation of static and dynamic balance among subjects having crossfit training regularly
The purpose of this study is to evaluate the effects of CrossFit training on the static and dynamic balance among subjects. The study included twenty volunteer amateur athletes (10M, 10K; 25-40 years old) who have been doing CrossFit training for at least 6 months and twenty volunteer sedentary individuals (10M, 10K; 25-40 years old) who did not do sports for at least 6 months. Both groups, static balance values of individuals were evaluated by Balance Error Scoring System (BESS), and dynamic balance were evaluated by Y Balance Test (YBT). The main results of our study comparing the two groups showed that the dynamic balance of the individuals who regularly performed CrossFit training was better than the sedentary individuals in all parameters of the YBT (p <0.05). On the other hand, in some parameters of the BESS results, it was observed that the static balance of the individuals doing CrossFit training was better than the sedentary individuals. Consistent with the hypothesis, regular CrossFit training may be effective in positively improving static and dynamic balance in adults. Key Words: CrossFit, static balance, dynamic balance, Y Balance Test, Balance Error scoring System, RFT, EMOM, AMRAP
The effect of neuromuscular and vestibulo-ocular reflex training program on balance, isokinetic muscle strength and proprioception in subjects with chronic ankle instability
The aim of the study is to compare the effects of neromuscular exercise combined with vestibulo-ocular reflex training on balance,isokinetic muscle strength and proprioception in subjects who have ankle instability. This study was conducted in Sportomed Athlete Health and Orthopedic Rehabilitation clinic in February 2020, September 2022.A total of 20 participants aged 18-30 were included in the study on a voluntary basis. Participants were divided into two groups at random. Demographic information and informed consent forms were filled into all subjects who volunteered to participate in the study and in accordance with the research criteria. After the evaluation, the subjects in the first group were included in the vestibulo-ocular exercise program in addition to the neuromuscular exercise programs with the same physiotherapist. Subjects in the second group were included in neuromuscular training programs. The trainings were applied three days a week for four weeks and each training session lasted approximately 60 minutes. Functional limitations of the participants before and after the treatment were evaluated with the Foot and Ankle Ability Measure Daily Living Subscale (FAAM-ADL) and Sports Subscale (FAAM-S). Dynamic balance evaluation with star excursion balance test, proprioception evaluation by measuring joint position sense with goniometer, and ankle evertor and inverter concentric muscle strength were evaluated using isokinetic dynamometer at angular velocities of 60/s, 120/s and 180/s, and the results were recorded. According to statistical analysis,significant changes were observed in balance, muscle strength and proprioception before and after treatment in both groups (p<0.05).However, no superiority was found between the two treatment groups (p<0.05).In conclusion, it is suggested that neuromuscular training and vestibulo-ocular training have positive effects on balance, muscle strength and proprioception, and neuromuscular and vestibular training should be included in chronic ankle treatment. Key Words: ankle instability, balance, neuromuscular,vestibulo-ocular,training,strength
Comparison of the effects of self-myofascial release and combined core stabilization exercises in physiotherapy and rehabilitation students with low back pain
The primary purpose of this study is to compare two treatment protocols, which are core stability exercises combined with the self-myofascial release and only self-myofascial release regarding the functional capacity and pain. 32 physiotherapy and rehabilitation students from Yeditepe University who had no medical problems except low back pain (18W,14M;26,78±3,66) were included. The total duration of the study was 5 weeks. Group 1 (G1) received the self-myofascial release and core exercises, while group 2 (G2) received only the self-myofascial release. An evaluation was made during the pre-intervention, mid-intervention (3rd week), and post-intervention. Functional capacity was evaluated with Oswestry Scale (ODI), while the pain was measured with the Visual Analogue Scale (VAS). According to the intragroup results, both the VAS-activity and the VAS-at rest decreased in both groups between pre-and post-measurements (p˂0.05). VAS-activity (p>0.05 ) and VAS-at rest (p˂0.05) increased in the 1st week in G1, while only the VAS-activity increased in G2 in the 1st week. (p>0.05) ODI scores decreased in both groups (<0.001). While nearly all of the sub-ODI scores decreased in G1 significantly (p˂0.05), the sub-scores of G2 decreased statistically significantly compared to pre-intervention scores (p˂0.05), except for social life and walking. Regarding the intergroup scores, the sudden VAS at rest scores were found to be statistically significant (p˂0.05). The decreases in VAS-activity and VAS-at rest were found to be statistically significant between groups in favour of G1 (p˂0.05). The decreases in the total ODI scores was statistically different between groups in favour of G1 (p=0.001). The decrease in pain severity, walking, sitting, and standing sub-scores of ODI were statistically different between the two groups (in favour of G1) (p˂ 0.05). As a result, it has been concluded that in contrast to only the SMFR protocol, the SMFR with core exercises could have more effective in physiotherapy students with low back pain regarding pain and functional capacity.
Investigation of the relationship between core stabilization, balance, and agility parameters in crossfit athletes
This study aims to evaluate the relationship between core stabilization, balance, and agility parameters in CrossFit athletes. In addition, the second aim of the study is to examine the variation of this relationship according to gender. For this purpose, 46 CrossFit athletes (F/M 22/24) between the ages of 18-57 who met the inclusion criteria of the study voluntarily participated. After the warm-up period, McGill Core Endurance Tests to assess core stabilization, Y Balance Test for Balance assessment, T Agility Test for Agility assessment, and Body Composition Analysis to assess body fat and muscle percentages were applied to the athletes, respectively. A 5-minute rest period was given between all tests. Number Cruncher Statistical System 2007 program was used for statistical analysis of the data. As a result, a negative correlation was observed between the right-side core endurance and agility levels of CrossFit athletes (r=-,620, p<0,01). Additionally, a negative correlation was observed between the left side core endurance and agility levels of CrossFit athletes (r=-,655, p<0,01). A positive correlation was observed between the right leg balance and core stabilization parameters of the athletes (r=,354, p<0.05). There was found a positive and moderately significant relationship between left leg balance and time to completion (flexor) (r=,401, p<0,01). There was found a positive and weakly significant relationship between left leg balance and flexion: extension ratio (r=,323,p<0,05). As a conclusion, core stabilization and agility parameters in CrossFit athletes affect by backward to each other. Accordingly, it means that athletes with better side core endurance finish the t-test faster and has better agility. Keywords: CrossFit, Y balance, T-agility Test, Core Stabilization
Evaluation of the relationship between foot anthropometry variables and performance in adolescent tennis players
The aim of this study is to evaluate the foot anthropometric values of adolescent tennis players and to investigate their effects on performance parameters. Adolescent age group 48(19M, 29F) volunteer tennis players with an average age of 11,02±1,792 who play active tennis in optimum tennis academy were included in the study. The sociodemographic characteristics of the participants were evaluated using a structured questionnaire. Bilateral anthropometric measurements of all participants with bare foot were measured with tape measure and digital caliper. Measured anthropometric values are medial malleolar height, lateral malleolar height, heel width, foot length, foot width, 1st metatarsophalangeal bone length. Performance tests, which are frequently used in tennis players, were applied to the participants. The hexagon agility test was used to determine the agility of the athlete, the y balance test to determine the dynamic balance, the vertical jump test to determine the lower extremity strength, and the navicular drop test to determine the foot arch height. As a result of our statistical analyzes, it was observed that there was a negative relationship (r=-0.322; p=0.026) between the length of the right foot and the hexagon agility test (clockwise). A statistically significant correlation was observed between left medial height and hexagon test (clockwise and counterclockwise) (p<0.05). A statistically significant correlation was observed between the Y balance test and the foot width and the length of the 1st metatarsophalangeal bone. Significant correlations were found between foot length (p<0.001), heel width (p<0.05), foot width (p<0.05), medial and lateral malleolus height (p<0.05) and vertical jump test. It was observed that there was a significant correlation between the height of the medial malleolus of the left foot and the navicular drop test, and between the height of the lateral malleolus and the navicular drop test (p<0.05). It has been found that the foot structure compatible with the hypothesis affects the performance of the athlete. According to the results of this study, we suggest examining the foot structure while evaluating the performance of tennis players and preparing the training program. After evaluating the player's foot, we can say that the performance can be optimized by using supported insoles according to the player's foot, myofascial relaxation techniques, strengthening the foot extensor muscles or strengthening the foot flexor muscles in order to achieve the desired increase in performance.
Comparison of the effects of pilates and scapula mobilization exercises on posture, sleep, and quality of life in persons with neck pain
The aim of the study is to examine how pilates exercises alone or in combination with scapular mobilization exercises affect pain, posture, sleep and quality of life in people with neck pain. The study included 20 volunteers(20F;34,05±8,50 years) with chronic mechanical neck pain who frequently exercised at the Simyfit pilates studio (2 or more times per week) and were advised to exercise by a doctor. Between May 2022 and October 2022, our study was conducted in the Simyfit Pilates Studio in Istanbul Ataşehir. The patients were randomly divided into the Experimental Group (EG) (n=10) and the Control Group (CG) (n=10). Individual modified pilates sessions for each participant lasted for six weeks, consisting of 12 sessions, two sessions each week. Evaluations were recorded before starting exercise sessions and after completing 12 sessions. Pain, disability, sleep quality and quality of life were assessed by respectively Visual Analogue Scale (VAS), Neck Disability Index (NDI), Pittsburgh Sleep Quality Index (PSQI) and the SF-12 Quality of Life Assessment Questionnaire. New York Posture Rating System (NYPRS) was used to determine the posture of participants. The primary results of this study comparing two groups, EG and CG, indicated similar improvement in VAS, NDI, NYPRS and PSQI (respectively p>0.05, p>0.05, p>0.05, p>0.05). There was a statistically significant difference found between EG and CG in the mental component of the quality of life assessment(MCS-12)(p<0.05). The findings of the study reported improvement in VAS, NDI NYPRS, PSQI and MCS-12 in EG (respectively p=0.00, p=0.01, p=0.00, p=0.001, p=0.023). The findings indicated improvement in VAS, NDI NYPRS, PSQI and physical component of the quality of life assessment(PCS-12) in CG (respectively p=0.00, p=0.01, p=0.00, p=0.001, p=0.047).
The prevalence of text neck syndrome among international students
This research aims to identify the frequency of text neck syndrome among international students residing in Istanbul. The study employed a cross-sectional research design. The research group was made up of international students. A total of 396 international students participated voluntarily in this online survey. Out of 396 participants, 193 were male, and 198 were female. Participants' demographic characteristics were documented using a structured questionnaire. The smartphone addiction scale, shortened version, measured smartphone addition. The neck disability index was utilized to evaluate neck discomfort. The mean value of the smartphone addiction scale was 3.74, which showed a high level of addiction, and the mean score of the neck disability index was 2.78 showing a moderate level of disability. An independent t-test was used for calculating the comparisons among groups. There was a significant difference between gender groups. Females have a high level of smartphone addiction than males. The association between the neck disability index and the smartphone addiction scale was examined using the Pearson coefficient correlation test. The significant value of .425 showed a moderate positive relationship between the smartphone addiction scale and the neck disability index. As the scores on the smartphone addiction scale increase, there is a tendency for the scores on the neck disability index to increase as well and vice versa. The p-value is 0.000, meaning the correlation is statistically significant at 5% and 1% significance levels. The results showed that the international students had neck disability, which showed a substantial relationship between text neck syndrome and smartphone addiction. Hence, it is imperative to prioritize promoting awareness regarding maintaining appropriate sitting posture and reducing mobile device usage duration.
Assessment of the immediate effect of suboccipital muscle stretching exercise on secondary type headache
The aim of this study; to evaluate pain, disability, quality of life, psychological state (anxiety and depression) and secondary type headache in patients with neck pain, as well as comparison of the effectiveness of two different home exercise programs. Forty-eight (n: 48) individuals who applied with neck pain and headache were included in the study. Our study was conducted in Fizyoaktif Wellness Center. The participants of the study were randomly divided into two groups and named as Group 1 and Group 2. Both groups were given a home exercise program, and Group 2 received a suboccipital muscle stretching exercise in addition to Group 1 exercises. Before starting the study, the sociodemographic information form was completed by the participants; Visual Analogue Scale, McGill Pain Scale Short Form, SF-36 and Neck Disability Index were evaluated. The same assessments were repeated at the end of 2 days. The obtained data were analyzed using non-parametric and parametric tests. As a result of our study, pain and neck disability questionnaire scores in both exercise groups showed significant improvement compared to the pre-treatment (p0.05). There was an increase in the quality of life in both groups. However, when the inter-group measurements in VAS, NDI, SF-MPQ and SF-36 quality of life were analyzed, more positive findings were obtained in Group 2 compared to Group 1. As a result of study, when the immediate effect of secondary headache induced by neck pain was evaluated, pain and quality of life were observed in both groups, while the suboccipital muscles were included in the exercise program and thus, more change was achieved in Group 2, and the flexibility of these muscles had more effect on pain.
Hamstring tendon otogrefti ile ön çapraz bağ rekonstrüksiyonu sonrasında modifiye ve hızlandırılmış fizyoterapi ve rehabilitasyon programının propriyosepsiyon denge ve koordinasyon üzerine etkiler
Bu çalışmanın amacı; izole ön çapraz bağ (ÖÇB) veya ön çapraz bağ ve birlikte menisküs yaralanması geçiren kişilerin, hamstring tendon otogrefti ile ön çapraz bağ rekonstrüksiyonu sonrasında modifiye ve hızlandırılmış fizyoterapi ve rehabilitasyon programının propriyosepsiyon, denge ve koordinasyon üzerine etkilerini araştırmaktır. Artroklinik Sporcu Sağlığı Biriminde Hamstring Tendon Otogreftiyle Ön Çapraz Bağ Cerrahisi Geçiren 22 kişi (n=22 K/E: 3/19) ile başladığımız çalışmada bireylerin sosyodemografik özellikleri, genel sağlık durumları ve fiziksel özellikleri sorgulandı. Dışlanma kriterlerine göre 2 kişi (n=2 K/E:1/1) çalışmadan çıkartıldı. Tüm olgulara operasyon öncesi (preop) propriyosepsiyonları gözler açık ve kapalı 15, 30, 45 ve 60 derecede Dijital Gonyometre ile ölçüldü. Operasyon sonrası (postop) tüm olgular modifiye ve hızlandırılmış fizyoterapi ve rehabilitasyon programına alındı. Tüm olgular operasyon sonrası 3. Hafta, 6. Hafta, 12. Hafta ve 6. Ay'da propriyosepsiyonları gözler açık ve kapalı 15, 30, 45 ve 60 derecede dijital gonyometre ile ölçüldü. Tüm olguların denge ve koordinasyonları Libra Dinamik Denge Cihazı ile 3. Hafta, 6. Hafta, 12. Hafta ve 6. Ay'da horizontal, sağ oblik, sol oblik ve tek ayak denge ölçümleri yapıldı. Fonksiyonel durumu değerlendirmek için Lysholm skoru ve ağrıyı değerlendirmek için VAS (Visual Ağrı Skoru) 3. Hafta, 6. Hafta, 12. Hafta ve 6. Ay'da ölçüldü. 6. Ay'da olguların fonksiyonel durumlarını değerlendirmek için tek ayak atlama, çift ayak atlama ve çapraz atlama testleri yapıldı. Anahtar Kelimeler: Ön Çapraz Bağ Rekonstrüksiyonu, modifiye ve hızlandırılmış fizyoterapi ve rehabilitasyon programı, propriyosepsiyon, denge, fonksiyonel test.
Sağlıklı kişilerde triseps surae kasına uygulanan kinesio tape ve rijit tape uygulamalarının dikey sıçrama ve dinamik denge üzerine anlık etkilerinin araştırılması
Bu çalışmanın amacı; sağlıklı kişilerde triseps surae kasına uygulanan kinesio tape ve rijit tape uygulamalarının dikey sıçrama ve dinamik denge üzerine anlık etkilerini karşılaştırmaktır. Yeditepe Üniversitesi Sağlık Bilimleri Fakültesi'nde eğitimine devam eden, iki yüz on beş (N:215; K/E:165/50) öğrenci ile başladığımız çalışmanın I. aşamasında bireylerin fiziksel özellikleri, sosyodemografik ve genel sağlık durumları, sağlık davranışları sorgulandı. Fiziksel aktivite durumlarını sorgulamak için 'Uluslararası Fiziksel Aktivite Anketi (UFAA)'nin kısa formu kullanıldı. Yapılan anket taramaları ve dışlanma kriterlerine göre yüz kırk altı (N:146; K/E:109/37) kişi çalışmadan çıkartıldı. Çalışmanın II. aşamasında, çalışmaya devam etmek istemeyen yirmi altı ve akut sakatlanma yaşayan üç, toplamda 29 birey çalışmadan çıkartıldı. Çalışmanın III. aşamasında; kırk (N:40; K/E:27/13) olgu randomize şekilde 'I. Grup' (n:20; K/E:13/7) ve 'II. Grup'(n:20; K/E:14/6) olarak ayrıldılar. Tüm bireylere alt ekstremiteye yönelik esneklik değerlendirmeleri ve deri altı yağ dokusu kalınlığı ölçümleri yapıldı. I.Gruptaki olgular vertikal sıçrama testi (AP: ortalama anaerobik güç; PP: maksimum anaerobik güç) 3 yönlü olarak Yıldız Dinamik Denge Testi (YDDT) ile 1. gün bantsız (U1), ikinci gün sham tape (U2) ve üçüncü gün triseps surae kasına kas fasilitasyon tekniği ile kinesio tape (U3) uygulandıktan sonra değerlendirildiler. II. Gruptaki olgulara da sırasıyla, üç bantlama yöntemi, 1.gün U1, 2. gün rijit tape (U4) uygulaması, 3. gün de U3 uygulamaları yapıldı. Tüm olgulara U1, U4 ve U3 den sonra AP, PP veYDDT testleri gerçekleştirildi. I. Grupta U2 ve U3 den sonra PP, AP, YDDT skorları arasında istatistiksel olarak farklılık görülmüştür. U2 sonrasında sonuçlar I.Grupta anlamlı derecede artmıştır (p≤0.05). Ayrıca II. Grupta da U3 ve U4 uygulamalarından sonra yapılan karşılaştırmalarda sonuçlar PP, AP, YDDT'de II. Grupta U4 (rijit tape) den sonra anlamlı derecede arttığını göstermiştir (p≤0.05). Dikey sıçrama ve dinamik dengenin anlık olarak arttırılmasında rijit tape uygulamalarının kinesio tape uygulamalarına göre daha etkin olabileceğinin görüldüğü söylenebilir.
Comparison of upper and lower extremity functions after progressive rope skip training in adolescent athletes playing basketball
The aim of this study; to compare the lower and upper extremity performance parameters of basketball players after this training program. Thirty-seven (N: 37) athletes with a mean age of 14.71 years playing basketball at the Galatasaray Sports Club were included in the study. In the first stage of the study, the demographic characteristics, training information and position of the athletes were questioned. The athletes were randomly divided into two groups as training group (n: 19; F / M: 6/13) and control group (n: 18; F / M; 6/12). All subjects underwent lower and upper extremity performance tests before progressive skipping training. Seated Medicine Ball Throw (SMBT), Seated Shot Put Test (SSPT) and Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) were used for upper extremity strength assessment and Y-Balance Test Upper Extremity (YBTUE) was used for balance assessment. Horizontal Jump (HJ) test was used to evaluate the lower extremity. In addition, agility and balance assessments Figure 8 Hop Test (Fig8) and Y-Balance Test Lower Extremity (YBTLE) test were used. All subjects continued their normal training programs in the middle of the season after the first evaluation. The athletes in the training group, unlike the control group athletes, were included in the skipping program three times a week for eight weeks. At the end of 8 weeks, all athletes were evaluated by SMBT, SSPT, CKCUEST, YBTUE, YBTLE, HJ and Fig8 tests. SSPT, CKCUE, Fig8 and HJ tests performed in the training group showed a statistically positive difference between the athletes in the training group. (P≤0,05). There was no statistically significant difference between the two groups in the Y-Balance tests performed for lower and upper extremity for balance evaluation (p> 0.05). In basketball athletes who played in infrastructure teams, we thought that rope skipping training for pliometric exercise could improve strength and stabilization of upper extremity, agility in lower extremity and jump to yacht parameters Key Words: rope Jump , basketball, Agility, strength, balance, upper extremity, lower extremity.
Patellar tendinit tanısı ile başvuran kişilerde iki farklı eksentrik kuvvetlendirme protokolünün izokinetik kas kuvvet parametreleri, ağrı, fonksiyonel düzey üzerindeki etkileri
Bu çalışmanın amacı patellar tendinit tanısı ile başvuran kişilerde iki farklı eksentrik kuvvetlendirme protokolünün izokinetik kas kuvvet parametreleri, ağrı, fonksiyonel düzey üzerindeki etkilerinin karşılaştırılmasıdır. Çalışmaya ortalama yaşları 19.2 yıl olan 20 gönüllü sporcu dahil edildi.Olgular 2 gruba ayrıldı. Birinci gruba izokinetik sistem, ikinci gruba ise eğimli eğitim tahtası kullanılarak ilerleyici dirençli eksentrik egzersiz programı haftada 3 seans olmak üzere toplam 12 hafta uygulandı. Sporcular tedavi öncesi ve sonrasında eğimli ve düz zeminde squat sırasında Görsel Analog Skalası (GAS) ile ağrı şiddeti, VISA-P Anketi, tek bacak öne sıçrama ve dikey sıçrama testleri ile fonksiyonel düzey değerlendirmesi ve izokinetik dinamometre kullanılarak 600/s ve 1800/s açısal hızlarda quadriceps ve hamstring konsentrik kas kuvveti değerlendirildi ve sonuçlar kaydedildi. Grupların kendi içinde tedavi öncesi ve sonrası istatistiği "bağımlı gruplar için t testi" ile, tedavi sonrası gruplar arası farklar "bağımsız gruplar için t testi" ile incelendi. Grup içi analizlerde her iki eksentrik eğitim programının ağrının azaltılması ve fonksiyonel seviyenin artırılmasında etkili olduğu görüldü (p<0.05). Buna ek olarak izokinetik eğitim grubunda öne sıçrama testi mesafesinde (p=0.012) ve 1800/s açısal hızda quadriceps konsentrik kuvvetinde (p=0.013) ve eğimli eğitim tahtası grubunda 1800/s açısal hızda hamstring konsentrik kuvvetinde (p=0.016) artış gözlendi.Gruplar arası sonuçlara bakıldığında gruplar arasında fark gözlenmedi. Sonuç olarak; patellar tendinitin tedavisinde hem izokinetik dinamometre ile hem de 250 eğimli eğitim tahtası kullanılarak uygulanan ilerleyici eksentrik egzersiz eğitimlerinin sporcularda ağrının azaltılması ve fonksiyonun iyileştirilmesinde etkili olduğu görüldü. Ancak 12 haftalık eksentrik egzersiz eğitimi ile quadriceps, hamstring kas kuvvet gelişiminde değişimler gösterilemedi. Fonksiyonel,semptomatik sonuçlar dikkate alındığında ucuz ve pratik bir yöntem olarak decline board uygulanan protokolü,rehabilitasyon programları için önermekteyiz. Anahtar Kelimeler: patellar tendinit, eksentrik eğitim, ağrı, kas kuvveti.
Comparison the effects of powerball training on hand grip strength, pinch grip strength and proprioception among dentists
The aim of the study.is to investigate the effects of the Powerball training program with six weeks on hand grip strength, pinch grip strength and proprioception among dentists. The study included 30 dentists (14F&16M; 31.23±5.10 years) who work at Yeditepe University Dental Hospital and 30 dental students (16F&14M; 22.67±1.42 years) studying in fourth and fifth classes at Yeditepe University, Istanbul, Turkey. This study was carried out between December, 2016 and February, 2017. The sosciodemographic features of participants were recorded by using a structured questionnaire. The hand grip strength of the participants was measured by using a Jamar Hand Dynamometer (Baseline.) and pinch strength measurements were evaluated with Pinch gauge (Baseline) for followed by lateral key, tip (2-point) pinch, and palmar (C3-point pad) pinch. The participants' wrist vibration sense was measured by using 128 Hz diapason. Active Joint Position Sense (JPS) included in all axes of movement of the wrist (flexion-extension and radial-ulnar deviation) was assessed by using the goniometric platform. Pain of the participants was assessed.by Visual Analog Scale (VAS) and the disability level was assessed by Disability of Arm, Shoulder and Hand (DASH) Questionnaire. Powerball training was carried out for six weeks for both right and left hands by the participants (3times/wk. with 5 min.). The mostly important results of our study revealed that all measurements were improved through Powerball training program with six weeks in both groups (p<0.05). There were not any significantly differences in all parameters except DASH and JPS for flexion comparing two groups. Disability/symptom scores of DASH showed greater improvement in dental students (p<0.05). The other result indicated that our program led more effectiveness on JPS for flexion of left hand among dentists (Table 4.15) (p<0.05). Consistent with hypothesis, we found that Powerball training is effective on hand grip strength, pinch grip.strength.and.proprioception.among.dentists. Key Words: dentists, dental students, MSD, WMSD, proprioception, hand grip strength, pinch grip strength
Comparing the effectiveness of manual neural mobilization and conventional physiotherapy and rehabilitation among patient with carpal tunnel syndrome
The aim of this study is to compare the effectiveness of manual neural mobilization and conventional physiotherapy and rehabilitation among patient with CTS. The study was performed between January 7th and June 1st of 2019 in Kocaeli. The study included 22 volunteer women with carpal tunnel syndrome aged between 30 to 60 years. The Group 1 (n=11; 50,45 ± 5.83 years) received manual neural mobilization and home exercises 5 times a week for three weeks. The Group 2 (n=11; 49,81 ± 8,75) received conventional physiotherapy and rehabilitation and home exercises 5 times a week for three weeks. All patients were evaluated before the intervention and after three weeks of treatment. The pain status of patients was evaluated by Visual Analog Scale (VAS) and also handgrip with Jamar hand dynamometer and pinch strength with Jamar hydrolic pinch gauge was assessed by the investigator. Besides, Boston Carpal Tunnel Syndrome Questionnaire was used to assess symptom severity and functional status. Furthermore, World Health Organization Quality of Life Questionnaire was used to assess quality of life patient with CTS. The main outcome of this study is that both treatment options are effective in reducing pain, increasing hand grip strength, alleviating symptoms, improving functional activities and also quality of life. According to our results, there was no statistically meaningful difference between these two treatment options except some parameters. In terms of left hand grip strength patients who treated with conventional physiotherapy and rehabilitation had statistically shown more improvement than patients who treated with manual neural mobilization. In addition, manual neural mobilization improved functional activity compared to conventional physiotherapy and rehabilitation. In conclusion, the present study revealed that manual neural mobilization and conventional physiotherapy and rehabilitation were effective in treating mild to moderate level of patients with CTS. Key words: manual neural mobilization, conventional physiotherapy, carpal tunnel syndrome
Futbolcularda sakroiliak eklem provokasyon test sonuçları ve denge, sıçrama performans değerlendirmeleri arasındaki ilişki
Bu çalışmanın amacı futbolcularda ağrı provokasyon ve hareket palpasyon testleri ile sakroiliak eklemin değerlendirilmesi ve dinamik denge, zıplama parametrelerini karşılaştırmaktır. Çalışmaya İnegölspor Kulübü'nden 80 sporcu (20.04±2.77) dahil edilmiştir. Bu çalışma Haziran 2018-Mayıs 2019 tarihleri arasında yürütülmüştür. Katılımcıların sosyodemografik özellikleri yapılandırılmış bir anket kullanılarak sorgulanmıştır. Gillet Testi, Ayakta Öne Eğilme Testi, Oturarak Öne Eğilme Testi, Prone Knee Flexion Testi, Supine Long Sitting Testi, Patrick-Faber Testi, Thigh Thrust Testi, Kompresyon Testi, Distraksiyon Testi, Gaenslen's Testi uygulanarak Sakroiliak Eklem Disfonsiyonu (SIED) değerlendirilmiştir. Testlere verilen cevaplara göre katılımcılar iki gruba ayrılmıştır. Katılımcıların dinamik dengesinin değerlendirilmesinde Star Excursion Balance Test, sıçrama performansının değerlendirilmesi için de Dikey Sıçrama Testi kullanılmıştır. Çalışmamızda SIE provokasyon test sonuçları pozitif olan grubun katılımcılarının sıçrama parametreleri, medial ve posterio-medial yöndeki denge parametreleri SIE provokasyon test sonuçları negatif olan grubun katılımcılarına göre daha düşük olduğu bulundu (Tablo 4.4, Tablo 4.5, Tablo 4.8, Tablo 4.9) ( p<0.05). Hipotez ile uyumlu olarak, SIE provokasyon test sonuçları pozitif olan grubun dinamik denge ve sıçrama parametrelerinin SIE provokasyon test sonuçları negatif olan gruba göre daha düşük olduğunu tespit ettik.
The effect of six-weekly plyometric exercises on jumping, sprinting, throwing and dynamic balance capacities on women volleyball players
The aim of this study was to investigate the effect of six-week plyometri exercises on running, jumping, throwing and dynamic balance capacities in female volleyball players. Thirty female volleyball players were included in the study. The subjects were divided into two groups as the study group (n=15) with a mean age of 16.53±1.45 years and the control group (n=15) with a mean age of 16.33±1.49 years. The athletes in the first group were taken to the Plyometric exercise training program (2 days/week) in addition to the classical training programs. The second group participated the classical training program for six weeks. Both groups were evaluated with the same methods before and after a six-week pliometric exercise training program. The subjects were assesed by physical measurement, vertical jump test, 20 m sprinting test, Y balance test and ball throw test. There was a statistically significant difference in right anterior and posteromedial and left anterior, posteromedial and posterolateral values of Y balance test , vertical balance and ball throwing values before and after training in the study group in which pliometric exercise program was given (p <0.05). There was no significant difference at 20 m sprinting and right posterolateral value of Y balance test (p> 0.05). According to the evaluation results between groups; While vertical jump and ball throwing difference values increased (p <0,05), no significant difference was found in the Y balance test left anterior, posteromedial and posterolateral differences and 20 m sprinting test (p> 0.05). As a result, it is considered that plyometric training program could be especially useful to include professional athletes's in training programs since plyometric exercise training combine with training program leads the significant improvements in vertical jump, the ball throwing and balance parameters. Key Words: Plyometric exercise, Volleyball, Women Player
Sedanter ve fiziksel aktif kadınlarda denge ve postür egzersizlerinin etkilerinin karşılaştırılması
Bu çalışmanın amacı sedanter ve fiziksel aktif kadınlar arasında uygulanan denge ve postür egzersizlerinin fonksiyonel düzey üzerine olan etkilerinin karşılaştırılmasıdır. Çalışmaya Nisan 2019 – Haziran 2019 tarihleri arasında DansAlaturka Spor Kulübü'ne üye olan aktif 13 kadın (37,07 ± 9,79 yıl) ve günlük aktiviteler dışında herhangi bir egzersiz yapmayan 13 sedanter kadın (38,00 ± 7,83 yıl) gönüllü dahil edildi. Çalışmaya başlamadan önce sosyodemografik bilgi formu hastalar tarafından dolduruldu. Çalışma grubu denge, esneklik, kassal endurans, fonksiyonel mobilite, kas kuvveti ve koordinasyon açısından değerlendirildi. Denge için flamingo testi, esneklik için otur-uzan testi, kassal endurans için sit-ups testi, fonksiyonel mobilite için 50 adım yürüme testi, kas kuvveti ve koordinasyon için sandalyeden kalkma testi kullanıldı. Bireyler aktif (Grup 1) (n=13) ve sedanter (Grup 2) (n=13) olmak üzere iki gruba ayrıldı. Tüm bireyler egzersiz eğitim programına alındı ve 6 hafta boyunda haftada 3 gün yapılmak koşuluyla tüm egzersizler iki gruba da öğretildi. Aktif grubun egzersizleri 6 hafta boyunca haftada 3 gün fizyoterapist tarafından yaptırıldı. Sedanter gruba ise ilk seansta egzersizler fizyoterapist tarafından gösterilerek ilerleyen seanslarda video takibi ile devam edildi. 6 haftanın sonunda çalışma öncesi yapılan değerlendirmeler tekrarlandı ve istatistiksel analiz edildi. Gruplar karşılaştırıldığında her iki grupta da denge girişim sayılarının ölçüldüğü flamingo denge skorlarındaki düzeltme girişimi sayılarında azalma bulunmuştur. Bu azalma her iki grup için geçerli olsa da sedanter grup için istatistiksel olarak anlamlı bulunmuştur (p=0.001). Flamingo testi değerlendirmesinde gruplar arasında anlamlı fark bulunamamıştır. Her iki grupta da otur-uzan testi skoru egzersiz eğitimi sonrası ölçümlerinde istatistiksel olarak anlamlı artmıştır (sırasıyla Grup 1 ve Grup 2 için p=0.008, 0.014). Gruplar arasında başlangıçta da korunan otur-uzan testi farkı egzersiz eğitimi sonrasında da korunmuştur ve gruplar arasında anlamlı fark bulunmuştur (p<0.05). Egzersiz eğitimi sonrası sit-ups testi değerlendirmesi sonucunda her iki grupta da istatistiksel olarak anlamlı artış görülmüştür (sırasıyla Grup 1 ve Grup 2 için p=0.003, p=0.026). Sit-ups testi değerlendirmesinde gruplar arasında anlamlı bir fark bulunamamıştır (p>0.05). 50 adım yürüme ve sandalyeden kalkma testi değerlendirmelerinde gruplar arasında istatistiksel herhangi bir değişim olmamıştır (p>0.05). Çalışmamızdaki birkaç farklı hipotezde olduğu gibi denge ve postür egzersizleri bazı değerlendirme parametrelerinde bireylerin fonksiyonel düzeylerine katkı sağlamıştır. Bu sebeple sedanter kadınlarda egzersizlerin ev ortamında bile olsa düzenli olarak yapılmasıyla bireylerin fonksiyonel düzeylerine katkı sağlayabileceği düşünülmektedir. Anahtar Kelimeler: Fiziksel aktivite, sedanter yaşam, fiziksel uygunluk, denge, postür.
Mekanik boyun ağrısı olan bireylerde servikal ve skapular egzersizlerin ağrı, yaşam kalitesi ve skapular diskineziye etkisi
Bu çalışmanın amacı; mekanik boyun ağrısı olan bireylerde servikal bölge odaklı konvansiyonel fizyoterapi ve rehabilitasyon yaklaşımının yanında servikal bölgeye ilave olarak skapular bölgeyi de içeren iki farklı egzersiz programının etkinliğinin karşılaştırılmasıdır. Çalışmaya mekanik boyun ağrısıyla başvuran yirmi dört (n:24) birey dahil edildi. Çalışmamız Özel Bostancı Tıp Merkezi'nde yapıldı. Çalışmaya katılanlar rastgele 2 gruba ayrıldı ve Grup 1 ve Grup 2 şeklinde adlandırıldı. Her iki gruba konvansiyonel fizyoterapi ile birlikte servikal egzersizler uygulandı, Grup 2'ye ilave olarak skapular egzersizler verildi. Egzersizler 5hafta boyunca haftanın 3 günü fizyoterapist tarafından yaptırıldı. Çalışmaya başlamadan önce sosyodemografik bilgi formu hastalar tarafından doldurulup; Görsel Analog Skala, Boyun Disabilite İndeksi, SF-36, Skapular Diskinezi Testi, Lateral Skapular Kayma Testi ve Pektoralis Minör İndeksi'ne bakıldı. Aynı testler 5 haftanın sonunda tekrar edildi. Elde edilen veriler nonparametrik ve parametrik testler kullanılarak analiz edildi. Çalışmamızın sonucunda her iki tedavi grubun da ağrı ve Boyun Özürlülük Anketi skorlarında tedavi öncesine göre anlamlı gelişme gösterdi (p<0.05). Her iki grupta da yaşam kalitesinde artış oldu. Fakat GAS, BDİ ve SF-36 yaşam kalitesinde gruplar arası ölçümlere bakıldığında Grup 2'de Grup 1'e göre daha fazla pozitif yönde bulgular elde edildi. Skapular diskinezi ve pektoralis minör kas boyu Grup 1'de değişme göstermezken, Grup 2'de anlamlı bir değişme gösterdi (p<0.05). Sonuç olarak mekanik boyun ağrısında her iki grupta da ağrı ve yaşam kalitesinde değişimler gözlenirken tedavi programına skapular bölgenin de dahil edilmesi ve bu sayede grup 2'de skapular diskinezide kişi sayısında değişim sağlaması, boyun ağrısının tekrarlama riskinin ve vücutta diğer bölümlerin etkilenmesinin önüne geçilebileceği düşünüldü. Anahtar kelimeler; ağrı, yaşam kalitesi, skapular diskinezi, egzersiz, pektoralis minör
Multiple sklerozlu hastalarda yoga ve konvansiyonel fizyoterapi programlarının yorgunluk, denge, yürüme ve yaşam kalitesi üzerine etkileri
Bu çalışmanın amacı multipl skleroz tanısı ile başvuran kişilerde yoga ve konvensiyonel fizyoterapi programlarının yorgunluk, denge, yürüme ve yaşam kalitesi üzerine etkilerinin karşılaştırılmasıdır. Çalışmaya 20 (11K, 9E; 46,35 ± 11,89 yıl) gönüllü dahil edildi. Çalışma grubu randomize olarak iki gruba ayrıldı. Birinci gruba yin yoga (n:10) ikinci gruba ise egzersiz temelli konvansiyonel fizyoterapi programı (n:10) haftada 3 gün, günde 60 dk., toplam 8 hafta uygulandı. Olguların tedavi öncesi ve sonrasında Yorgunluk Şiddeti Ölçeği (FSS) ile yorgunluk, Berg Denge Ölçeği ile denge, MS Yürüme Ölçeği (MSWS-12 VST) ile yürüme, MS Yaşam Kalitesi Ölçeği (MSQOL-54) ile yaşam kalitesi durumları değerlendirildi. Grup içi analizlerde tedavi sonrasında yoga grubunda; yorgunluk (p= 0,041) ve MS yürüme (p=0,003) skorlarında istatiksel olarak anlamlı düzeyde azalma görülmüştür. Bu grupta yaşam kalitesi (MSQOL-54) mental ve fiziksel (p=0,013, p=0,006) değerlendirmelerinde ve denge parametrelerinde (p=0,01) istatiksel olarak anlamlı düzeyde artış olmuştur. Konvansiyonel fizyoterapi grubunda ise; yorgunluk, denge, MS yürüme ve yaşam kalitesi skorları arasında anlamlı bir farklılık yoktur. Elde ettiğimiz bulgularda yoga grubunda değerlendirmelerin daha iyi sonuç verdiğini gördük, yoganın hafif ve orta düzey MS'li hastalarda egzersiz temelli fizyoterapi ve rehabilitasyon programlarını destekleyici bir seçenek olabileceğini düşünmekteyiz.