Fizyoterapi ve Rehabilitasyon Bölümü / Department of Physiotherapy and Rehabilitation
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Publication 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 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, DenizObjectives: 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.Publication Comparison of Motor Proficiency and Functional Ambulation in Duchenne Muscular Dystrophy With Healthy Peers(Taylor & Francis Ltd., 2020) Yıldız, Şulenur; Şahin, Sedef; Bulut, Numan; Tunca Yılmaz, Öznur; Karaduman, Aynur Ayşe; AKEL, BURCU SEMİNAims:The study was aimed to investigate the difference between boys with Duchenne muscular dystrophy (DMD) and healthy peers in terms of gross and fine motor proficiency, and determine the relationship between motor proficiency and ambulation. Methods:A total of 24 boys with DMD and 22 healthy peers were evaluated. Demographics and physical characteristics were recorded. The Bruininks Oseretsky Test of Motor Proficiency-Short Form (BOTMP-SF) was administered to evaluate gross and fine motor proficiency in both groups. The 6-minute walk test (6MWT) was performed to evaluate functional walking capacity and North Star Ambulatory Assessment (NSAA) was used to determine ambulatory status of boys with DMD. Results:The gross motor proficiency score was significantly lower in boys with DMD (p = 0.001). No difference was found between the groups in terms of fine motor proficiency (p = 0.962). The gross motor function of BOTMP-SF was significantly related to 6MWT distance (r = 0.696,p = 0.001) and NSAA (r = 0.738,p = 0.001). No relationship was found between BOTMP-SF fine motor proficiency and 6MWT distance (r = 0.210,p = 0.361), and NSAA (r= -0.020,p = 0.928). There were significant correlations between running speed and agility with 6MWT distance (r = 0.585,p = 0.005) and NSAA (r = 0.650,p = 0.056). Conclusions:Boys with DMD were more affected in aspects of gross motor proficiency than healthy peers, while fine motor proficiency were found same. The gross motor proficiency was found more related to the level of ambulation.Publication Cross-Cultural Adaptation, Reliability, and Validity of a Turkish Version of the Work Rehabilitation Questionnaire (WORQ-Turkish)(Springer Plenum, 2021) Aran, Orkun Tahir; Abaoğlu, Hatice; Çağlar, Gamze Ekici; AKEL, BURCU SEMİN; Aki, Esra; Karahan, Sevilay; Kayıhan, HülyaPurposeThe Work Rehabilitation Questionnaire (WORQ) is an instrument based on the International Classification of Functioning Vocational rehabilitation core set. The aim of this study was to analyze the validity, reliability and cross-cultural adaptation of the WORQ to Turkish and evaluate its psychometric properties.MethodsThe cross-cultural adaptation and translation procedures were conducted following Beaton's guidelines. The test-re-test reliability was examined by Spearman Brown Coefficient (split half analysis), internal consistency was examined by Cronbach's alpha. Criterion related validity of the WORQ was determined by Beck Depression Inventory using Pearson correlation coefficient and known group differences regarding age, gender, work and educational levels using one-way ANOVA and t test. Construct validity was examined by confirmatory factor analysis using AMOS.ResultsTwo hundred and fifty-seven participants with disabilities were included to the study from seven different provinces of Turkey. The WORQ-Turkish showed excellent internal consistency (0.906), good test-retest reliability (0.811), and good construct validity (good model fit indices). Criterion related validity analysis showed medium correlations between WORQ and Beck Depression Inventory (p < 0.001), however there were no statistical significant differences regarding known group parameters (p > 0.05).ConclusionsIn this study, the cross-cultural adaptation, and validity and reliability of WORQ-Turkish self-reported version were examined and the results indicated that WORQ-Turkish was a valid and reliable scale for analyzing vocational rehabilitation process of people with disabilities.Publication 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 Determining the Relationship Between the Impairment of Selective Voluntary Motor Control and Gait Deviations in Children With Cerebral Palsy Using Simple Video-Based Analyses(Elsevier Ireland Ltd., 2021) Sardogan, Cansu; Muammer, Rasmi; AKALAN, NAZİF EKİN; Sert, Rukiye; Bilgili, FuatBackground: The impairment of selective voluntary motor control (SVMC) in children with cerebral palsy (CP) has been shown to correlate with their gait characteristics using complex 3D gait analysis systems (3DGA); however, this relationship has not been investigated using simple video-based observational gait analysis (VBOGA). The aim of this study was to determine the relationship between VBOGA and SVMC of the lower extremities in children with CP. Methods: Forty-two CP children 10.9 +/- 5.7 years old with Gross Motor Function Classification System (GMFCS) levels I-III participated in the study. Their gait characteristics were assessed using the Edinburgh Visual Gait Score (EVGS), and selective voluntary motor control was tested using the Selective Control Assessment of the Lower Extremity (SCALE). Spearman's rho correlation test with Cohen's classification were used in the statistical analyses. Results: The GMFCS levels (r = 0.604, p < 0.001), foot clearance (r = -0.584. p < 0.001), and maximum ankle dorsiflexion (r = -0.567, p < 0.001) during the swing phase had strong correlations with total SCALE scores. There was also a moderate correlation between total SCALE scores and total EVGS (r = -0.494, p < 0.001), knee extension in the terminal swing phase (r = -0.353, p < 0.001), peak sagittal trunk position (r = -0.316, p < 0.005), and maximum lateral shift (r = -0.37, p < 0.001). Conclusion: Impaired lower extremity SVMC was noticeably related to the foot and ankle movements in the swing phase and initial stance during walking as well as the total EVGS scores and sagittal and frontal trunk movements. The SCALE correlations with VBOGA were similar those observed in the complex 3DGA in the literature; therefore, we suggest that SVMC impairment of gait could be evaluated using simple VBOGA. These findings may help to tailor physical therapy programs for CP children to increase their motor control and walking quality.Publication Does Increased Femoral Anteversion Can Cause Hip Abductor Muscle Weakness?(MDPI, 2023) APTİ, ADNAN; AKALAN, NAZİF EKİNBackground: 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.Publication The Effect of Kinesiophobia on Physical Activity, Balance, and Fear of Falling in Patients with Parkinson's Disease(Taylor & Francis Inc., 2022) Oğuz, Semra; UZUNOĞLU, GAMZE ERTÜRK; Polat, Mine Gülden; Apaydın, HülyaPurpose Kinesiophobia is defined as the fear of movement and activity resulting from a feeling of vulnerability to painful injury or re-injury. This study aimed to determine the effect of kinesiophobia on physical activity, balance, and fear of falling in patients with Parkinson's disease. Methods The study, which was designed as a cross-sectional type, was conducted with 86 patients with Parkinson's disease (age 61.25 SD [9.72] years old) by face-to-face interviews with the patients. The Tampa Scale of Kinesiophobia, International Physical Activity Questionnaire-Short Form, Berg Balance Scale, Falls Efficacy Scale, Visual Analog Scale - Fear of Falling, Unified Parkinson's Disease Rating Scale - motor score, and the Hoehn and Yahr scale were used to evaluate the patients. Results Patients with Parkinson's disease who had high levels of kinesiophobia had lower levels of physical activity, worse balance, and higher disease severity and fear of falling. A correlation was found between the Tampa Scale score and physical activity, balance, fear of falling, falls efficacy, and disease motor score (p r = -0.38, -0.54, 0.67, 0.57, and 0.37, respectively). According to multiple linear regression analysis, kinesiophobia explained the dependent variables to varying degrees ranging from 13% to 44% (p < .001). Conclusions Patients with Parkinson's disease may have kinesiophobia. Rehabilitation programs to support functional capacity for these patients should be developed considering the presence of kinesiophobia.Publication The Effect of Wearing High Heels on Lower Extremity Kinematics During Walking for Female with Hypermobility(Elsevier Ireland Ltd., 2023) AYAN, BUSE; AKALAN, NAZİF EKİN; ÖNERGE, KÜBRA; KUCHIMOV, SHAVKAT; EVRENDİLEK, HALENURPublication 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 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, MeryemObjective: 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.Publication Effects of High Intensity Interval Training and Sprint Interval Training in Patients With Asthma: A Systematic Review(Taylor & Francis Ltd, 2022) UZUNOĞLU, GAMZE ERTÜRK; Günday, Çiçek; EVRENDİLEK, HALENUR; Sağır, Kübra; Aslan, Göksen KuranObjective The aim of this study is to review the effects of high-intensity interval training (HIIT)/sprint interval training (SIT) on asthma symptoms, cardiorespiratory functions, and other variables among asthmatic patients. Data sources Randomized controlled trials published between January 2000 and January 2021 were searched in PubMed/MEDLINE, Web of Science, and Cochrane Library databases. Study selections Following pre-specified inclusion criteria, this review included 7 randomized controlled studies that compare HIIT/SIT as an intervention with any other intervention and/or control group. Results Of the included studies only four reported the chronic phase effects of the HIIT/SIT protocols. HIIT and SIT protocols applied in studies differ. HIIT improved forced expiratory volume in 1 s (FEV1) in the acute phase and maximal oxygen consumption (VO2max) in the chronic phase in the asthmatic patients (p < 0.05). Conclusion To our knowledge, our systematic review is the first study evaluating the effects of HIIT/SIT protocols on asthma patients. HIIT/SIT protocols have beneficial effects on asthma patients. In order to better understand the results of these training procedures, studies that will be designed with high methodology are needed.Publication 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, ÖzgürBackground: 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.Publication 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 ESMAC 2021 Abstracts(Elsevier Ireland Ltd., 2021) AKALAN, NAZİF EKİN; GÖRGÜLÜ, M.; AYDIN, B.; Sert. R.; Bilgili F.Publication Examination of Fatigue, Well-Being and Life Habits in Children with Cancer Diagnosis(Bezmiâlem Vakıf University, 2021) Sevgili, Sümeyye; Şahin, Sedef; AKEL, BURCU SEMİNObjective: In this study, it was planned to examine fatigue, well-being and life habits in children with cancer. Methods: This cross-sectional analytical study was conducted between September 2019-January 2020. "24-Hour Child Fatigue Scale", "Child Well-being Assessment" and Child Life Habit Questionnaire (LIFE-H for Children 1.0)" were administered to 20 children with cancer aged 5-15 years. Pearson's correlation coefficient was used to determine the statistical relationship between life habits, fatigue and well-being. Statistical significance level was accepted as p<0.05. Results: There were significant relationships between fatigue and personal care, shelter and mobility parameters of life habits (r=-0.66, r=0.54, r=0.45, p<0.01, respectively) and there were significant relationships between fatigue and negative emotions (r=0.46), overall life satisfaction (r=-0.52), general happiness (r=-0.49) and positive emotions (r=-0.44 *) parameters of well-being assessment. Life habits scale was found to be related with nutrition, physical fitness and communication parameters of Child Life Habit Questionnaire were found to be most related with the meaning and purpose parameter of the well-being assessment (p<0.01). There were significant relationships between positive emotions and recreation (r=0.45, p=0.04); optimism and communication (r=-0.44, p=0.04); personal care (r=-0.49, p=0, 02), social life (r=-0.46, p=0.04) and autonomy; and mobility and negative emotions (r=-0.45, p=0.04). Conclusion: Considering the relationships determined in this study, the evaluation of the children with cancer and treatment approaches can be shaped. The fact that fatigue affects all aspects of children's life reveals the importance of dealing with fatigue. It is recommended to focus on the meaning and purpose and regain autonomy for children in order to rearrange the life habits of the children and ensure their well-being.Publication Functional Bandaging in Children with Idiopathic Toe-Walking(NLM (Medline), 2023) Tuncer, Deniz; AKALAN, NAZİF EKİN; Çalışkan, M. Mine; Temelli, Yener; Yiğit, PakizeBackground: 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.Publication Gait Characteristics and Effects of Early Treadmill Intervention in Infants and Toddlers with Down Syndrome: A Systematic Review(Taylor & Francis Ltd., 2022) Kınacı-Biber, Esra; ÖNERGE, KÜBRA; Mutlu, AkmerPurpose The aim of this study was to evaluate gait characteristics, and the effectiveness of treadmill interventions on gait in infants and toddlers with Down syndrome (DS). Materials and Methods A comprehensive search was performed on six databases for evidence published up to November 2020 for articles related to infants and toddlers with DS. The Clinical Appraisal Skills Programme Checklist assessed the methodological quality. Strength of evidence were evaluated Sackett's level. Results Nine articles analyzing instrumental gait met the inclusion criteria. Of these, 4 compared DS and typically developing (TD), and 5 included treadmill training interventions for DS. Kinematic analysis was applied in 8 studies and all articles presented evaluations at different times according to the walking experience. Analysis with EMG was used in only one of the intervention articles and in 3 of the 4 comparative articles. Conclusions Although similar improvements are seen in spatiotemporal parameters for toddlers with typical development and those with DS, the decrease in step width is not similar for DS. Early treadmill training can have a positively effect on the gait characteristics of DS infants. Further research should focus on the acquisition of gait characteristics, long-term evaluations, kinetics and EMG data, for these children.Publication 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 Increased Femoral Anteversion May Not Cause Hip Abductor Muscle Weakness During Walking(Elsevier Ireland Ltd., 2023) APTİ, ADNAN; AKALAN, NAZİF EKİN; KUCHIMOV, SHAVKAT; Temelli, Yener