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    Comparison of Mini-squats and Straight Leg Raises in Patients with Knee Osteoarthritis: A Randomized Controlled Clinical Trial
    (Turkish League Against Rheumatism, 2013) Daskapan, Arzu; Anaforoglu, Bahar; Ozunlu Pekyavas, Nihan; Tuzun, Emine Handan; Nur Cosar, Sacide; Karatas, Metin
    Objectives: In this study, we aimed to compare the effects of the straight leg raise exercise (SLRE) and mini squat exercise (MSE) on pain intensity, performance, muscle strength, physical function and balance in patients with knee osteoarthritis (OA). Patients and methods: Forty female patients (mean age 59.93 +/- 10.61 years; range 30-65 years) who were admitted to Baskent University Hospital between February 2009 and February 2010 with bilateral knee OA were included in this randomized controlled double-blind clinical trial. The patients were assigned into two groups, including SLRE and MSE. Both exercise groups were scheduled for a three-week program of five sessions per week. Both groups also received an electrotherapy program in each session. Knee pain using the visual analog scale (VAS), physical performance using Timed Up and Go (TUG) Test, isokinetic quadriceps and hamstring muscle strengths using Cybex II, static balance using SportKAT 3000, physical function using Knee Injury and Osteoarhtritis Outcome Score-Physical Function Short Form (KOOS-PS) were assessed at baseline, at treatment end, and one month after treatment end. Results: No significant difference was found in static balance testing parameters after exercise program (EP) (p=0.659) and during follow-up period (p=0.327) between the groups. There was no significant difference in KOOS-PS scores after EP (p=0.398) and during follow-up (p=0.201) between SLRE and MSE groups. There was no significant difference in VAS scores after EP (p=0.149), however significant difference was found during follow-up (p=0.030) between SLRE and MSE groups. Mini squat exercise group had significantly higher TUG scores and higher right knee extensor torque at 60 degrees/sec (p=0.024), 90 degrees/sec (p=0.003), 120 degrees/sec (p=0.005) and 180 degrees/sec (p=0.017) compared to the SLRE group at the end of EP. Conclusion: Further studies are required including long-term follow-up and the evaluation criteria of the effectiveness of SLRE and MSE after this period.
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    Effect of low back pain on psychological health and quality of life in patients with lumbar spondylosis: a pilot study
    (Turkey Assoc Physiotherapists, 2013) Gurleyik, Zeliha Gamze; Daskapan, Arzu; Tuzun, Emine Handan; Akman, Nafiz
    Purpose: The aim of this pilot study was to evaluate psychosocial health and quality of life levels in patients with lumbar spondylosis and chronic low back pain and in patients with musculoskeletal pain without low back pain. Methods: Eighty patients with lumbar spondylosis, chronic low back pain and 60 patients with musculoskeletal pain (wihout low back pain) participated in the study. Pain, health-related quality of life, disability associated with back pain, depression, well-being, life satisfaction and functional back performance were evaluated in both groups. Result: Two groups were similar for pain intensity, well-being and life satisfaction (p>0.05). When compared to the other group, disability associated with back pain and depression level were higher; functional back performance and quality of life level were lower in the low back pain group (p<0.05). Conclusion: This pilot study showed that the negative effects of chronic low back pain on psychosocial health and quality of life were more significant than other musculoskeletal pain conditions. More comprehensive studies are needed on this issue.
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    Effects of two different quadriceps strengthening exercise approaches on cardiovascular fitness in healthy female subjects: A single blind randomized study
    (Ios Press, 2012) Daskapan, Arzu; Tonga, Eda; Duruturk, Neslihan; Tuzun, Emine Handan
    Objective: There are limited number of documents showing the relations between cardiovascular fitness and muscle strength. This study aimed to determine the effects of two different quadriceps strengthening exercise approaches on cardiovascular fitness in healthy female subjects. Methods: Forty female university students participated in this study on a voluntary basis. The participants were randomly assigned to do either isokinetic exercise (IE) or progressive resistive exercise (PRE) in two different groups. Both training schemes were performed three times a week for a period of two weeks. The subjects were given a maximum symptom limited exercise test on a treadmill before and after (each) training period. Results: Total exercise duration increased and Borg scale level decreased significantly after training in the two groups (p < 0.05). Maximal systolic blood pressure, recovery heart rate, and recovery diastolic blood pressure decreased significantly in the IE Group (p < 0.05). Resting and recovery systolic blood pressure decreased significantly in the PRE Group (p < 0.05). Compared to PRE group, improvement for Borg Scale level, recovery heart rate and recovery diastolic blood pressure were more obvious in IE Group (p < 0.05). Conclusions: This study demonstrated that both quadriceps strengthening methods have displayed improvements in cardiovascular fitness. Further research with larger sample groups may need to be carried out.
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    Is balance exercise training as effective as aerobic exercise training in fibromyalgia syndrome?
    (Springer Heidelberg, 2015) Duruturk, Neslihan; Tuzun, Emine Handan; Culhaoglu, Belde
    The aim was to compare the effect of aerobic and balance exercises on pain severity, myalgic score, quality of life, exercise capacity and balance in fibromyalgia syndrome (FMS). A total of 33 females diagnosed with FMS by the American College of Rheumatology criteria were recruited in this randomised controlled study and allocated to aerobic exercise (AE) or balance exercise (BE) groups. Exercises were performed three times a week, for 6 weeks on a treadmill or with a Tetrax interactive balance system (TIBS). Outcome measures were characterised by myalgic score, visual analogue scale, Fibromyalgia Impact Questionnaire (FIQ), exercise testing, Timed Up-Go (TUG) and TIBS measurements. Comparisons from baseline to 6 weeks were evaluated using Wilcoxon test. Mann-Whitney U test was used to compare differences between groups. Effect sizes were also calculated. Improvements in pain, myalgic score and FIQ were found in both groups (p < 0.05). While comparing groups, myalgic score was significant (p = 0.02, d = -1.77), the value was higher in AE. Exercise duration, Borg scale, resting blood pressures (RBP) and maximal heart rate were significant in AE. In BE, Borg scale, exercise duration was significant (p < 0.05). While comparing groups, diastolic RBP (p = 0.04, d = -0.92), exercise duration (p = 0.00, d = -1.64) were significant, with higher values in AE. TUG significantly changed in groups (p < 0.05, d a parts per thousand yen -1.22). Stability scores, eyes open while standing on elastic pads (p = 0.00, d = -0.98) and head back (p = 0.03, d = -0.74), were significant, with higher values in BE. This study showed that BE provided some improvements in FMS, but AE training led to greater gains. BE training should be included in comprehensive programs.
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    Nutritional status of children with cerebral palsy in Turkey
    (Taylor & Francis Ltd, 2013) Tuzun, Emine Handan; Guven, Duygu Korkem; Eker, Levent; Elbasan, Bulent; Bulbul, Selda Fatma
    Purpose: The aim of this study was to assess the nutritional status, and provide information regarding anthropometric measurements of cerebral-palsied children living in the city of Ankara, Turkey. Method: A total of 447 children with cerebral palsy (CP) were participated in this cross-sectional study. Participants were assessed for functional motor impairment by the gross motor function classification system (GMFCS). Assesment of nutritional status was based on the triceps skinfold thickness (TSF), arm fat area (AFA) estimates derived from TSF and mid-upper arm circumference measurements. TSF and AFA Z-scores were computed using reference data. Results: Cerebral-palsied children had lower TSF and AFA Z-scores compared to reference data from healthy children. The prevalence of underweight and overweight among boys was 8.3 and 9.5%, respectively, whereas it was 19.0 and 0.5% for girls. Underweight was more prevalent in the low functioning children than in moderate functioning children. Conclusions: The findings of this study indicate that cerebral-palsied children face nutritional challenges. Underweight is more prevalent than overweight among cerebral-palsied children. To optimize the outcomes of rehabilitation and prevention efforts, an understanding of the heterogeneity of nutritional status among children with CP is required.
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    Readability levels of health education materials used in physical therapy and rehabilitation clinics
    (Turkey Assoc Physiotherapists, 2013) Eker, Levent; Tuzun, Emine Handan; Aytar, Aydan; Daskapan, Arzu
    Purpose: The aim of this study was to determine the readability levels of health education materials used in the physical therapy and rehabilitation clinics. Methods: In the study, the numbers of sentences, words and syllables were identified in the first 100-word sections of the 44 brochures used in the physical therapy and rehabilitation clinics. Atesman and cetinkayaUzun formula were used to determine the readability levels of the brochures. Correlation of the readability scores obtained using the two evaluation methods was also analyzed. Results: Readability scores calculated with Atesman and Eetinkaya-Uzun formula were 65.2 +/- 11.0 (95% BCa; 62.2-68.4), and 38.4 +/- 5.8 (95% BCa; 36.9-40.2), respectively. There was a strong and positive correlation between the readability scores obtained using the two evaluation methods, (r=96.2, 95% BCa; 93.5-98.3). Using Atesman classification approach, 30 brochures (68.2%) were leveling as hard and/or slightly hard-to-read. Thirty-four (77.3%) brochures had been prepared for the people who completed at least an 8-9 grade level of education. To be able to understand and explain the meaning of nine (20.5%) brochures, readers should have completed at least a 10-12 grade level of education. Conclusion: From the results of the study, we may speculate that the brochures used currently in the physical therapy and rehabilitation clinics cannot achieve intended benefits due to their hard-to-read nature. The readability check is necessary for any print material that is given to patients or his/her relatives.
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    The Upper Extremity Functional Index (UEFI): Cross-cultural adaptation, reliability, and validity of the Turkish version
    (Ios Press, 2015) Aytar, Aydan; Yuruk, Zeliha Ozlem; Tuzun, Emine Handan; Baltaci, Gul; Karatas, Metin; Eker, Levent
    BACKGROUND: Turkish version of the Upper Extremity Functional Index (UEFI) may help to assess shoulder function in patients with shoulder impingement syndrome (SAIS). OBJECTIVE: To translate and cross-culturally adapted UEFI into Turkish and to assess its acceptability, reliability, validity in patients with SAIS. METHODS: This study conducted with 93 SAIS participants. UEFI, the short version of the Disability of the Arm, Shoulder and Hand scale (Quick DASH), the Shoulder Pain and Disability Index, and the Short Form-36 Health Survey (SF-36) were administered. Acceptability was assessed in terms of refusal rate, rates of missing responses, and administration time. Test-retest reliability was assessed with intra class correlation coefficient (ICC), internal consistency was assessed with Cronbach's alpha coefficient. Validity was assessed by floor and ceiling effects, skew of distributions and Pearson's correlation coefficients. RESULTS: Cronbach's alpha coefficients for the UEFI at Time 1 and Time 2 were as follows: alpha = 0.89 and alpha = 0.89. Average measure ICC was 0.80. The UEFI score demonstrated strong negative correlations with SPADI total score and Quick DASH score. There was not a significant correlation between the UEFI and mental health subscale score derived from SF-36. CONCLUSIONS: The Turkish version of UEFI is acceptable, valid, and reliable.