Sağlık Bilimleri Fakültesi / Faculty of Health Sciences
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Browsing Sağlık Bilimleri Fakültesi / Faculty of Health Sciences by Author "Akçay, Burçin"
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Publication Restricted 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, ADNANBackground: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.Publication 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, İlkerAim: 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.Publication Open Access Editöre Mektup: Yürekli ve Şenel, 2024, 29(3), 113-123 “Pilates Egzersizlerin Omurga Postür Bozukluklarına Etkisi: Sistematik Derleme”(Gazi Üniversitesi Rektörlüğü, 2024) Çolak, Tuğba Kuru; Akçay, Burçin; APTİ, ADNANBu mektup, Yürekli ve Şenel’in “Pilates egzersizlerinin omurga postür bozukluklarına etkisi” adlı derleme çalışmasına yönelik eleştirileri içermektedir. Yazarların Pilates egzersizlerinin omurga postür bozukluklarına etkisini incelemeyi amaçladıkları bu derleme yazısında önemli metodolojik problemler olduğu kanısındayız. Eleştiriler, çalışmada farklı yaş grupları ve tanılara sahip bireylerin aynı başlık altında ele alınmasının sonuçları genelleme açısından sorunlu hale getirdiği, skolyoza dair bazı bulguların derlemede yer almadığı ve skolyozun diğer postür bozukluklarından farklı olarak değerlendirilmesi gerektiği yönündedir. Ayrıca, Pilates’in kemiksel deformiteler ve skolyoz gibi durumlar için etkinliğine dair yeterli bilimsel kanıt bulunmadığı vurgulanmıştır. Bu nedenlerle, yazarlar derlemenin metodolojik eksiklikler içerdiğini ve yanıltıcı sonuçlar doğurabileceğini belirtmektedir.Publication 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, İlkerBackground: 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.Publication Restricted Effects of Pilates Exercises on Idiopathic Scoliosis: A Scoping Review of the Literature(Springer, 2023) Çolak, Tuğba Kuru; Akçay, Burçin; APTİ, ADNANPurpose 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.Publication 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 LasaBackground/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.Publication 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.Publication 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, BurçinObjective: 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.Publication Open Access The Reliability of the Augmented Lehnert-Schroth and Rigo Classification in Scoliosis Management(AOSIS, 2021) Akçay, Burçin; Çolak, Tuğba Kuru; APTİ, ADNAN; Çolak, İlker; Kızıltaş, ÖnderBackground: In pattern-specific scoliosis exercises and bracing, the corrective treatment plan differs according to different curve patterns. There are a limited number of studies investigating the reliability of the commonly used classifications systems. Objective: To test the reliability of the augmented Lehnert-Schroth (ALS) classification and the Rigo classification. Methods: X-rays and posterior photographs of 45 patients with scoliosis were sent by the first author to three clinicians twice at 1-week intervals. The clinicians classified images according to the ALS and Rigo classifications, and the data were analysed using SPSS V-16. Intraclass correlation coefficients (ICCs) and standard error measurement (SEM) were calculated to evaluate the inter-and intra-observer reliability. Results: The inter-observer ICC values were 0.552 (ALS), 0.452 (Rigo) for X-ray images and 0.494 (ALS), 0.518 (Rigo) for the photographs. The average intra-observer ICC value was 0.720 (ALS), 0.581 (Rigo) for the X-ray images and 0.726 (ALS) and 0.467 (Rigo) for the photographs. Conclusions: The results of our study indicate moderate inter-observer reliability for X-ray images using the ALS classification and clinical photographs using the Rigo classification. Intra-observer reliability was moderate to good for X-ray images and clinical photographs using the ALS classification and poor to moderate for X-ray and clinical photographs using the Rigo classification.Publication Open Access Skolyoz Tedavisinde Schroth Yöntemi(Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi, 2020) Çolak, Tuğba Kuru; Akçay, Burçin; APTİ, ADNANSchroth egzersizleri dünyada fizyoterapistler tarafından en yaygın olarak kullanılan skolyoza özel egzersizlerdir. Skolyoza özel üç boyutlu egzersiz yöntemi olan Schroth tedavisi 1900’lü yılların başında Almanya’da Katharina Schroth tarafından geliştirilmiştir. Günümüze kadar yöntem Schroth’un kızı Christa Lehnert-Schroth ve torunu Hans R. Weiss tarafından güncellenerek geliştirilmiştir. Tüm dünyada fizyoterapistler tarafından skolyoz tedavisinde yaygın olarak kullanılan bir tedavi yöntemidir. Güncel literatür Schroth yönteminin adolesan idiopatik skolyozda Cobb açısını azaltmada ve yaşam kalitesini geliştirmede seviye II düzeyinde bilimsel kanıt olduğunu ortaya koymuştur. Bu derleme makalesi skolyoz tedavisinde kullanılan Schroth yönteminin tarihçesini, temel egzersiz prensiplerini ve bu konudaki literatür araştırmalarına gözden geçirmek amacıyla yazılmıştır.Publication Restricted 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 ElçinPurposeDisease-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.Publication Open Access What Information Do Teenagers with Idiopathic Scoliosis and Their Families Need When First Diagnosed?(Erkan Mor, 2021) Çolak, Tuğba Kuru; Akçay, Burçin; APTİ, ADNAN; Çolak, İlker; Bettany-Saltikov, JosetteObjective: The aim of this study was to determine the information needs of individuals with adolescent idiopathic scoliosis (AIS) and theirfamilies when the disease was first diagnosed.Materials and Methods: A total of 117 patients with AIS and their parents volunteered to participate in this study. A survey developed specificallyto assess the information needs of AIS patients and their families was sent by e-mail. Of the AIS patients, 59.8% were aged >16 years andcompleted the survey alone, and 40.2% were aged <16 years and they completed the survey together with their parents.Results: The results of this study demonstrated that in the initial diagnosis, scoliosis could be observed even if the angle was <20°. Generally,scoliosis was first noticed by the child’s mother. As expected, at the time of the initial diagnosis, the children diagnosed as having scoliosis wereupset and confused and their parents also felt upset and worried. The information most needed was reported to be answers to the questions of“Will it get better, what are the causes of scoliosis?”, “What is scoliosis and what are the possible treatment options?”, and the least frequentlyasked question was “Will surgery be needed?”.Conclusion: Clear, accurate, complete, and personalized information is required by patients and their families. This information is essential inenabling patients to make major decisions and to take ownership and responsibility for the decision. Involvement in decision-making helps toimprove compliance with treatment and finally also improves satisfaction with the agreed treatment method used.