Fizyoterapi ve Rehabilitasyon Bölümü / Department of Physiotherapy and Rehabilitation
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Publication A novel dorsal trimline approach for passive-dynamic ankle-foot orthoses(Assoc Mechanical Engineers Technicians Slovenia, Po Box 197-Iv, Ljubljana 61001, Slovenia, 2018) Sürmen, Hasan Kemal; Fetvacı, Mahmut Cüneyt; Arslan, Yunus Ziya; AKALAN, NAZİF EKİN; 123435; 176320; 19199; 110120An ankle-foot orthosis (AFO) is an externally applied assistive device that encompasses the lower leg, ankle, and foot of the human body. In the current one-piece passive-dynamic AFO design, the trimming process is performed from lateral and medial parts of the ankle to ensure desired rotational displacement (hereafter referred to as Design I). In most cases, stress concentrations occurring over the trimmed regions during walking can cause permanent damage to the AFO. In this study, to reduce the stress concentration and ensure a homogeneous stress distribution, a new trimming approach is presented, in which the trim zones were transferred from lateral and medial to dorsal (hereafter referred to as Design II). Finite element analyses of the Designs I and II models were carried out. Displacement and von Mises stress values for both models under the same loading and boundary conditions were obtained. Maximum displacement values were 8.51 mm and 9.05 mm for Design I and Design II, respectively. Maximum stress values were 15.19 MPa and 6.70 MPa for Design I and Design II, respectively. For the similar range of motion of ankle joint, the novel design produced less stress and more homogeneous stress distribution than the currently used design, thus indicating that Design II would be more resistant to plastic deformation than Design I.Publication Correlations Between Hypermobility, Muscle Strength and 3D Gait Parameters in Children With Increased Femoral Anteversion(2019-09) EVRENDILEK, HALENUR; 268497Introduction Increased femoral anteversion is a transverse plane problem that cause gait alterations in developing children and because of the moment arm changes produces muscle weakness around the hip (1). Especially, in addition with hypermobility, these children mostly have fatigue, additional muscle weakness and functional deterioration on lower extremity (2). Therefore, the aim of this study was to determine the relations between the hypermobility, muscle strength and gait parameters in children with IFA. Research Question Are there any correlation between the hypermobility, muscle strength and gait parameters in children with IFA? Methods 7 children with IFA (14 limbs, av.age: 9.14 ± 0.3, trochanteric prominens angle test (TPAT): 28 ± 6.2°) have participated in this study. As part of physical assessment; hypermobility, femoral anteversion angle, maximum isometric hip extensor and abductor, knee extensor and flexor muscles strengths were evaluated by Beighton test (3), TPAT (4) and hand-held dynamometer (HHD) (Lafayette Instruments,USA)(5) respectively. Furthermore, all participants' self-selected of walking were analyzed by 3D gait analysis (BTS Bioengineering). Kinematic gait parameters of pelvis, hip and knee were interested gait parameters. According to data distributions, Pearson's or Spearman's coefficient test were utilized for statistics (p<0.05) and interpreted by Cohen's classification (6). Results High-level correlation was found between Beighton scores and both hip extensor (r: -.70) and knee extensor (r: -.91) muscle strengths, and mean and minimum knee knee flexion angles. TPAT was highly correlated with only hip abductor HHD scores and mean hip rotation angle during walking (Table 1). Discussion In the literature, number of gait alterations were determined in children with IFA as increased mean hip internal rotation, pelvic obliquity range, peak knee extension at stance(7). The present study revealed that some of the kinematic alterations might be related to muscle strengths of the weak hip extensor and abductor, knee extensor and flexor muscles. Although, in agreement with the literature the mean hip internal rotation and hip abductors muscles strength were found significantly related to TPAT. In additionally, hypermobility, which is a commonly seen with the children with IFA, might have a role at the weakness of the hip and knee extensors and hyperextension at stance phase. In conclusion, it is important to strength hip extensor and abductor, knee extensor and flexor muscles to contribute to lower extremity function in children with IFA especially if the child is hypermobile.Publication Determination of Biomechanical İnfluences of İncreased Femoral Anteversion (twisted leg) on Running for Developing İndividua(2018-08) APTİ, ADNAN; ARAT, REFİK; 259584Publication Determination of Playing Related Postural Problems in Guitar Students(2019-06) AKEL, BURCU SEMİN; 114564Objective: A significant percentage (%37) of musicians suffer musculoskeletal disorders that are sufficiently serious to affect performance. A common risk factor for musculoskeletal disorders is a poor posture.ln this study, we aimed to determine of playing-related postural problems in guitar students. Materials and Methods: Nineteen guitar bachelor students participated. Demographic data were recorded and static and dynamic posture analysis were performed via observation and video recordings; which were analyzed by a physiotherapist, an occupationaltherapist and a guitarist. Awkward postures were recorded. Posture was evaluated both globally and for individual body regions. Overall posture was divided into 3 categories: rigid, slumped, physiological. Pain was assessed with The Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians. Results: Most of the individuals (55%) experienced pain or problems that might hinder their playing skills in the last year.The most common locations of pain or problems were: shoulder, wrist, scapula and neck.The overall static posture was poor in 38% of participants when standing(33%rigid, 5% slumped). During playing, the posture was more often slumped than rigid(66%). The location of the gravity axis in the sagittal plane were forward-shifted(%55), however the physiological posture was maintained at the frontal plane.The most common problems encountered were shoulder imbalance (%61), rotation of the head(%77), rotation of body(%72), right wrist excessive ulnar deviation(%33) and thumb positioning(%72). Conclusions: According to the posture analysis, rotation and slumpy positioning was the main problem. This situation puts greater problems on the muscles of the back and abdomen and may effect proper breathing. The regions that have poor posture was neck, shou Ider, wrist and thumb. Considering this, we believe that educating music students in proper playing posture and postural awareness can be beneficial in decreasing performance-related postural problems.Publication Distinguishing the Influences of Increased Femoral Anteversion From Hypermobility During Walking For Neurologically Intact Individuals(2018-09) Akalan, Ekin; Karaca, Gülşah; Kuchimov, Shavkat Nadir; Bilgili, Fuat; Temelli, Yener; Leblebici, Gökçe; Ertürk, Gamze; Evrendirek, Halenur; ÖNERGE, KÜBRA; APTİ, ADNAN; 176320; 268498; 259584; 237820; 190878; 229941; 283338; 268636; 268497Increased femoral anteversion (IFA) is a transverse plane problem that may lead to alterations on lower body kinematics during walking (1,2). IFA and hypermobility syndrome are commonly seen together in healthy individuals (3). Therefore, describing the pure effects of IFA related gait parameters is very difficult for children with hypermobility and IFA together.Publication Does clinically measured ankle plantar flexor muscle strength or weakness correlate with walking performance in healthy individuals?(2018) Akalan, N.Ekin; Kuchimov, Shavkat Nadir; Temelli, Yener; Ören, Merve; Nene, Anand; APTİ, ADNANOBJECTIVE: Muscle strength is usually measured using isometric hand-held dynamometers (HHDs) in the clinic. However, during functional activities, the muscle acts more dynamically. The aim of this study was to investigate the relation between clinically measured plantar flexor (PF) muscle strength (PFMS) and laboratory measurements of peak ankle plantar flexion power generation (APFPG), peak ankle moment (PAM), peak plantar flexion velocity (PFV) and mean gait velocity in healthy participants. METHODS: The maximum PFMS on non-dominant sides in 18 able-bodied persons 23.88 (SD 3.55 years) was measured before (Pre-S) and after a stretching (Post-S) procedure (135 sec. x 13 rep. with 5 sec. rest) by using a HHD. The stretching procedure was used to generate temporary PF muscle weakness. Gait analysis was carried out for Pre-S and Post-S conditions. Normalized (by weight and height) and non-normalized HHD scores and differences for both conditions were correlated by Pearson correlation coefficient calculations (p < 0.05). RESULTS: Reduced PFMS (%23, p < 0.001) in Post-S, according to the HHD scores, has only a weak correlation with APFPG (r > 0.3, p < 0.5). Gait velocity was found to be strongly correlated with APFPG only in the Post-S condition (r = 0.68, p < 0.002). HHD scores and PAM were moderately correlated with the non-normalized Post-S condition (r = 0.44, p = 0.70) and strongly correlated with the non-normalized Pre-S condition (r = 0.62, p < 0.01). DISCUSSION: HHD scores of plantar flexor muscles give very limited information about the PF performance during walking in healthy individuals. Simple normalization did not improve the relations. Clinically measured isometric muscle strength and muscle weakness have only moderate strengths for establishing a treatment protocol and for predicting performance during walking in neurologically intact individuals.Publication Does hip flexor muscle weakness cause stiff-knee gait in long-term after medial open reduction surgery for children with developmental dislocation?(2019-09) EVRENDILEK, HALENUR; 268497Introduction Medial open reduction surgery (MOR) is performed as a treatment for children with developmental dislocation of the hip (DDH) by sectioning iliopsoas tendons [1]. A 10 years follow-up study of MOR was determined that hip flexor strength decreased in children with DDH [2] . Furthermore, the weakness of iliopsoas muscle was any one of the reasons of stiff knee gait pattern (SKG) [3], Therefore, the aim of the study was to determine whether the sagittal plane knee kinematics alters in long-term after bilateral MOR for children with DDH. Research Question What are the long-term biomechanical effects of bilateral MOR on sagittal plane knee kinematics in children with dislocation of the hip? Methods Five children (DDH group, 10 limbs, Av. age: 11.2 ± 2.8 y.o.) who had medial open reduction surgery bilaterally (10.4 years ago, Av. age: 9.6 ± 6 months o.) and six children without any orthopedic disorder (Control group, 12 limbs, Av. age: 10.8 ± 2.4 y.o) have participated in this study. All participants' selfselected speed of gait were analyzed by 3D gait analysis (BTS Bioengineering). The spatiotemporal parameters, sagittal plane hip and knee parameters and four defined SKG parameters (Pl: peak knee flexion angle, P2: range of knee flexion from toe-off to peak flexion, P3: total range of knee motion, P4: timing of peak knee flexion in swing, >3 significantly changed SKG parameters described as stiff knee ) [4] were examined. Independent t-test and Mann Whitney U test were used for comparison (p < 0.05) Results Between two groups, age, mean velocity were not significantly different (p>0.05). In DDH group, sagittal plane hip and knee range, P l, P2, P3,P4, maximum hip and knee flexion velocity were lower significantly than control group (Table 1). Discussion Normally, in late-stance, the iliopsoas is elongated depending on hip extension, then contracts at the beginning of the swing to initiate hip flexion. [5], Weakness of iliopsoas muscle, as a long-term effect of MOR surgery, reduces hip and knee flexion velocity at pre-swing and swing phases. This study showed that DDH altered all four SKG parameters significantly [4] relative to controls. This study also confirmed that hip flexion weakness may cause SKG pattern even neurologically intact individuals (3). Because of the SKG pattern increases not only the risk of reduced toe clearance and tripping but also energy expenditure [4], adding hip flexor strengthening exercises into rehabilitation programs might have a critical role for SKG treatment.Publication Does One Leg Standing Duration Have Relation With GMFM Scores and Stability in Stance Phase for Hemiplegic Children ?(2018-09) N. Ekin Akalan; Halenur, Evrendilek; Karaca, Gülşah; Bilgili, Fuat; Ertürk, Gamze; 268636; 176320; 268497; 268498; 237820This paper reports the results of a study to validate a measure of gross motor function in detecting change in the motor function of disabled children. Physiotherapists used this instrument to assess 111 patients with cerebral palsy, 25 with head injury and 34 non-disabled preschool children on two occasions, the second after an interval of four to six months. Parents and therapists independently rated the children's function within two weeks of each assessment, and a sample of paired assessments was videotaped for 'blind' evaluation by therapists. Correlations between scores for change on this measure and the judgments of change by parents, therapists and 'blind' evaluators supported the hypothesis that the instrument would be responsive to both negative and positive changes.Publication Evaluation of the effects of neural therapy in patients diagnosed with fibromyalgia(2019) Terzi, Rabia; Başaran, Aynur; Tolu, Sena; Küçüksaraç, Seher; ALTINBİLEK, TURGAYObjectives: This study aims to compare the effects of neural therapy and exercise on pain, quality of life, depression, anxiety, and functioning status in patients diagnosed with fibromyalgia syndrome (FMS). Patients and methods: This multi-center study included a total of 72 patients (60 females, 12 males; mean age: 39.2 +/- 9.5 years; range, 22 to 53 years) who were diagnosed with FMS according to the 1990 American College of Rheumatology (ACR) criteria between January 2015 and June 2015. The patients were randomly divided into two groups: the first group (n=30) received an exercise program (strengthening, stretching, relaxation, and aerobic exercises, three days a week), and the second group (n=42) received a total of six sessions of neural therapy as one session a week in addition to the same exercise program. Pain severity was assessed with the Visual Analog Scale (VAS), emotional state with the Beck Depression Scale (BDS) and Beck Anxiety Inventory (BAI), quality of life with Short Form-36 (SF-36), and functioning status with the Fibromyalgia Impact Questionnaire (FIQ). The patients were evaluated at the end of treatment (week 6) and one month after the end of treatment. Results: The mean disease duration was 34.3 +/- 9.3 months, the mean VAS score was 7.3 +/- 2.2, and the mean FIQ score was 58.4 +/- 13.2. There were significant improvements in the VAS, FIQ, SF-36, BDS, and BAI scores after the treatment in both groups (p<0.05). Post-treatment BDS and VAS scores were significantly lower in the neural therapy group (p=0.038; p=0.049; p<0.05). There was no significant difference in any parameter one month after the treatment between the groups (p>0.05). Conclusion: When neural therapy is combined with exercise in FMS patients, it may be advantageous in terms of pain and depression, compared to exercise alone.Publication Gait analysis of patients subjected to the atrophic mandible augmentation with Iliac bone graft(HINDAWI LTD, ADAM HOUSE, 3RD FLR, 1 FITZROY SQ, LONDON, W1T 5HF, ENGLAND, 2019) Temelli, Yener; Arslan, Yunus Ziya; Cansız, Erol; Karabulut, Derya; Doğru, Suzan Cansel; AKALAN, NAZİF EKİN; 190878; 110120; 42880; 249199; 181247; 176320In this study, we aimed to quantitatively monitor and describe the gait functions of patients, who underwent iliac crest bone grafting in atrophic jaw augmentation operation, by taking into account the alterations of gait parameters and muscle forces in the early recovery course. To do so, temporospatial and kinematic gait parameters of ten patients during pre- and postoperative periods were recorded, and forces of the gluteus medius, gluteus maximus, and iliacus muscles were calculated. Three postoperative periods were specified as one week (post-op1), two weeks (post-op2), and three weeks (post-op3) after the surgery. Restoring process of the gait patterns was comparatively evaluated by analyzing the gait parameters and muscle forces for pre- and postoperative periods. Temporospatial and kinematic parameters of post-op3 were closer to those obtained in pre-op than those in post-op1 and post-op2 (p<0.05). Muscle forces calculated in post-op3 showed the best agreement with those in pre-op among the postoperative periods in terms of both magnitude and correlation (p<0.05). In conclusion, the patients began to regain their preoperative gait characteristics from the second week after surgery, but complete recovery in gait was observed three weeks after the surgery.Publication "How Does Hypermobility Affect Lower Extremity Function for Children with Increased Femoral Anteversion? Describing Effects ofReduced Forefoot Sensation on Foot Pressure Distribution: Plot Study(2018-09) Leblebici, Gökçe; Akalan, Ekin; Kuchimov, Shavkat Nadir; Kurt, Rengin Aslıhan; ÖNERGE, KÜBRA; APTİ, ADNAN; 283338; 229941; 259584; 272694; 283338Increased femoral anteversion (IFA) and joint hypermobility are commonly seen together in pediatric clinics. Femoral anteversion and joint hypermobility may contribute falling and fatigue in activities, as well as causing abnormal gait patterns.Publication Increased femoral anteversion-related biomechanical abnormalities: lower extremity function, falling frequencies, and fatigue(2019-05) Leblebici, Gökçe; akalan, ekin; Kuchimov, Shavkat Nadir; Kurt, Aslıhan; Temelli, Yener; Miller, Freeman; ÖNERGE, KÜBRA; APTİ, ADNANBackground: Increased femoral anteversion (IFA) is defined as forwardly rotated femoral head relative to the transcondylar knee axis which may have a potential to reduce the functional quality of adolescents. Therefore, the aim of our study was to investigate the effects of IFA on lower-extremity function, falling frequency, and fatigue onset in neurologically intact children. Research question: Does increased femoral anteversion influence lower extremity function, falling frequency and fatigue on set in healthy children? Methods: Sixty-five participants with increased femoral anteversion (IFA) and thirty-two healthy peers as control were included into the study. For the function, the lower extremity function form (LEFF) which is adapted from Lower Extremity Function Test used. Falling frequency and fatigue onset time were assessed by a Likert-type scale. In addition, the activities which cause frequently fall for the participants were questioned.Results: Lower extremity function was found deteriorated (p = 0.02) and falling frequency was higher (p = 0.00) in IFA than in controls. Fatigue onset time was not different between groups, although lower extremity function was strongly correlated with fatigue onset (rho = -0.537, p < 0.001). IFA children fall four times more during running (60%), three times more during fast walking (21.42%) than their healthy peers (14.28%, 7.14% respectively). Significance: IFA leads functional problems, especially in the form of high falling frequencies. According to the LEFF score, the most difficult functional parameters for these children were walking long distances, becoming tired, walking more than a mile, and standing on one spot. Also, shorter fatigue onset time may worsen the lower-extremity function secondarily. Because of the higher frequency of falling and functional problems, children with IFA may be more defenseless to injuries, especially in high-motor-skill activities such as running and soccer.Publication Intraoperative experiments combined with gait analyses indicate that active state rather than passive dominates the spastic gracilis muscle's joint movement limiting effect in cerebral palsy(2019-08) Cemre, S.Kaya; bilgili, fuat; akalan, ekin; Temelli, Yener; Ateş, Filiz; Yücesoy, Can A.In cerebral palsy, spastic muscle's passive forces are considered to be high but have not been assessed directly. Although activated spastic muscle's force-joint angle relations were studied, this was independent of gait relevant joint positions. The aim was to test the following hypotheses intraoperatively: (i) spastic gracilis passive forces are high even in flexed knee positions, (ii) its active state forces attain high amplitudes within the gait relevant knee angle range, and (iii) increase with added activations of other muscles. METHODS: Isometric forces (seven children with cerebral palsy, gross motor function classification score = II) were measured during surgery from knee flexion to full extension, at hip angles of 45° and 20° and in four conditions: (I) passive state, after gracilis was stimulated (II) alone, (III) simultaneously with its synergists, and (IV) also with an antagonist. FINDINGS: Directly measured peak passive force of spastic gracilis was only a certain fraction of the peak active state forces (maximally 26%) measured in condition II. Conditions III and IV caused gracilis forces to increase (for hip angle = 45°, by 32.8% and 71.9%, and for hip angle = 20°, by 24.5% and 45.1%, respectively). Gait analyses indicated that intraoperative data for knee angles 61-17° and 33-0° (for hip angles 45° and 20°, respectively) are particularly relevant, where active state force approximates its peak values. INTERPRETATION: Active state muscular mechanics, rather than passive, of spastic gracilis present a capacity to limit joint movement. The findings can be highly relevant for diagnosis and orthopaedic surgery in individuals with cerebral palsy.Publication Investigation of The Correlation Between Ultrasonography Based Muscle Architecture Parameters and Isometric Knee Flexor Strength(2019-09) KARACA, GÜLŞAH; 268498Publication Investigation of the Relationship Between Selective Voluntary Motor Control and Static Balance in Cerebral Palsy(2019-09) Akalan, Ekin; Ertürk, Gamze; Evrendirek, Halenur; Karaca, Gülşah; ÖNERGE, KÜBRA; 176320; 268636; 283338; 268497; 268498Introduction: Cerebral palsy is a group of disorders includes spasticity, contracture, balance disorder and selective motor control impairment [1], Although the relationship between selective voluntary motor control (SVMC) and gross motor function, ROM and spasticity had been investigated in literature [1], its relationship with static balance was not investigated in these children. Research Question: The aim of the study was to investigate the relationship between selective motor control and static balance in children with CP. Secondly, if there is a relationship, determining most static balance-related parameter in Selective Control Assessment of the Lower Extremity (SCALE) test. Method: Twelve children with CP (6 hemiplegics, 6 diplegic (18 legs); age: 9±3.49 y.o.) participated in the study. One-leg-standing test (OLST) and SCALE tests were used to determine static balance and motor control respectively. Duration of OLST was assessed by a stopwatch, while the participants placed both hands on hips, looked at the wall, and kept the other leg in 90° flexion. According to the duration of OLST, participants were scored between 0-3 points (0 point: could not initiate the OLST, 1 point: 0-5 sec, 2 points: 5-10 sec, 3 points: 10+ sec). Cohen correlation classification was used to define the strength of the correlation [2]. The twelve participants were above the minimum sample size needed to ensure a power of 95% confidence level. Results: A very high-level correlation was found between OLST and total SCALE score (p=0.001, r=0.75). In addition, there was a high-level correlation between OLST and ankle (p=0.023, r=0.56), subtalar joint (p=0.013, r=0.6), and toes (p=0.004, r=0.67) parameters (Table 1). Since, all participant had a full score from SCALE (Hip section) test, statistical analysis could not be performed for hip parameters. Discussion: Our study showed that static balance and SVMC have a very high to a high level relationship. In practice, physical therapists may get benefit from improving selective motor to enhance the static balance for children with CP. On the other hand, because the OLST has a high level relationship with stance phase stability during gait (ESMAC 2018), improving selective motor control in lower extremity may assist in enhancing gait quality. In the future, similar studies should be done by using dynamic balance assessments and center of pressure range calculations during walking.Publication O 043 – Mechanics of spastic semitendinosus altered by intermuscular interactions elevate its contribution to pathological resistance against knee extension during gait(2018-09) Kaya, C.S.; Bilgili, Fuat; Temelli, Yener; Ateş, Filiz; Yücesoy, Can A.; AKALAN, NAZİF EKİNPublication Osteopathic manipulative treatment improves function and relieves pain in knee osteoarthritis: A single-blind, randomized-controlled trial(Bayçınar Medical Publ-Bayçınar Tıbbı Yayıncılık, Örnek Mh Dr Suphi Ezgi Sk Saray Apt No 11 D 6, Ataşehir, İstanbul 34704, Turkey, 2018) Murat, Sadiye; Yumaşakhuylu, Yasemin; İçağasıoğlu, Afitap; ALTINBİLEK, TURGAY; 182368; 269544Objectives: In this study, we aimed to compare the efficacy of osteopathic manipulative treatment (OMT) to exercise treatment in the knee osteoarthritis (OA). Patients and methods: A total of 100 patients (9 males, 76 females; mean age 54.8 +/- 8.5 years; range, 40 to 70 years) with Stage II-III bilateral knee OA enrolled to the study and randomized into two groups between January 2015 and June 2015. Group 1 performed exercise and received OMT and Group 2 performed exercise alone. We assessed the clinical parameters with Western Ontario MacMaster Questionnaire (WOMAC) pain score, WOMAC joint stiffness score, WOMAC physical function score, Visual Analog Scale (VAS) and 50-m walking time. All patients were assessed at the beginning of the study, just after the treatment, and four weeks after the treatment. Results: There was no significant difference between groups in terms of physical examination and clinical assessment parameters before treatment. Functional improvement (p<0.05) and pain relief (p<0.05) were significantly higher in the exercise + OMT group. Conclusion: Based on our study results, OMT is a particular treatment used by osteopathic physicians to complement conventional treatment of OA of the knee. In addition to the conservative treatment, OMT can be used.Publication Pain and Hand Functioning Differences between Guitar and Oud Students(2019-06-17) AKEL, BURCU SEMİN; 114564Objective: Most musicians suffer from intermittent or permanent pain which starts impairing musicians at a very early stage of music education or career. Most of the studies about instruments and musculoskeletal pain are implemented with guitar, violin or piano players. Eastern instruments are not frequently analyzed and investigated in terms of pain and discomfort. Therefore, it is aimed to investigate pain and upper extremity motor performance differences between Oud and Guitar players. Materials and Methods: Eighteen guitar players and 13 Oud players participated in the study. Pain was assessed with The Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM). Upper extremity motor performance was assessed with the Fine Finger Dexterity and Simulated Assembly tests of the VALPAR Work Samples. Results: The mean pain intensity score was 12,39± 11,28 whereas none of the oud players indicated any pain. The oud players' mean sub scores for the Fine Finger Dexterity were 71,42±24,82, 112,28+17,99 and 114,60+38,36 and the guitar players' mean sub-scores were 63,74+42,22, 82,09± 19,55 and 73,79± 10,29 respectively. The average Simulated Assembly score was 131,33±47,68 for oud players and 123,33+39,10 for the guitar players. The oud players' Fine Finger Dexterity scores were significantly higher than the guitar players (p=0,001 for the 1st subtest and p=0,029 for the 3rd subtest}. Also the pain intensity scores were significantly different between the groups (p=0,003). Conclusions: Oud players had higher hand functioning scores than the guitar players. Despite this fact, it was surprising that only two sub tests of Fine Motor Dexterity Test yielded significant differences. It was remarkable that the oud players did not indicate any pain whereas nearly all of the guitar players indicated moderate of high levels of pain. It was obvious that there is a significant difference between the instruments and there is a need for in-depth analysis of oud playing, training methods and of the instrument itself.Publication Pilot Study on Obstetric Brachial Plexus Paralysis: Docs Arm Swing Asymmetry Affect Foot Plantar Pressure Behavior?(2019-09) Kuchimov, Shavkat Nadir; AKALAN, NAZİF EKİN; 176320Introduction Brachial plexus palsy, as one of the most common congenital injuries affected by arm swing, is characterized by muscle weakness at different levels in the upper extremity (1). As the weakness of the upper extremity muscles can affect the trunk muscles and the postural development, these children may have some gait deviations (2,3). Previous studies have shown that walking parameters are also influenced by clinical conditions such as stroke and cerebral palsy (2-6). There is a lack of literature on determining the biomechanical influences of arm swing asymmetry on foot pressure behavior for OBBP children. Therefore, the aim of the study was determining arm-swing asymmetry related foot pressure behavioral alterations on OBBP. Research Question Does arm swing asymmetry affect foot plantar pressure behavior on OBBP patients? Methods Thirteen children with OBPP (7 females, 6 males) (mean age:9.37±2.68 years) participated in the study. For all individuals, a digital plantar-pressure analysis system (Win-track, Balma, France) was utilized to analyze the foot pressure behavior during standing and walking with self-selected velocity. The magnitude of the first and the second peak forces divided to an invidual’s weight (Fl, F2), total stance duration (Ts), time of Fl (Tl), time of min force between F1-F2 (T2), time o f F2 (T3), step length were calculated. Each stance phase was divided into five sub-phases: Loading response (Tl/Ts), mid-stance (T2-Tl/Ts), terminal stance (T3-T2/Ts) and pre-swing (Ts-T3/Ts), single limb support (T3-Tl/Ts) (7). In addition, arm swing ranges were recorded and analyzed using Kinovea software (8). Paired t-test was used for the compared between affected side and non-affected side (p < 0.05). Results Fl, pre-swing duration and step length were higher in affected side than in non-affected side(p<0.05). Single limb support duration lower in affected side than in non-affected side (p<0.05). The maximum arm flexion and extension angle and arm swing range were significantly reduced on the affected side (p<0.05). No significant difference was found in F2, loading response duration, mid-stance duration and terminal stance duration between affected side and non-affected side (Table 1). Discussion The reduced arm swing may alter the foot pressure behavior during walking on affected side as well as the non-affected side in children with OBBP. Reduced single limb support duration ((T3-Tl)/Ts) on the affected side indicate the stability problem in stance on affected side. Increase the first vertical peak force (Fl) on the affected side is probably related to the decreased arm extension range at the affected side, which absorbs the first peak of vertical force in early stance during walking. Increased step length on the affected side may due to the enhanced single limb duration on the non-affected side.Publication Raman and IR Spectroscopy Comlemented by Multivariate Alaysis as a Prospective tool to Investigate Biologically Relevant Materials(2018-08) ILDIZ, GÜLCE ÖĞRÜÇ; 107326This talk will illustrate the use of Raman and infrared (IR) spectroscopies, complemented by other techniques (in particular chemometrics, but also thermodynamics methods. X-ray analysis and quantum chemical calculations) to address different problems related with biologically relevant materials. First, a methodology based on IR spectroscopy and principal component analysis (PCA) will be introduced for the analysis of blood plasma samples, in order to identify spectral changes correlated with biomarkers of schizophrenia and bipolarity. Then. Raman spectroscopy, complemented by several chemometrics approaches (e.g., PCA. cluster analysis) will be shown to be a powerful, practical and elegant tool to investigate composition (in particular the lipid/protcin ratio contents) of soybean strains. Specifically, the lipid/protcin ratio contents of salt-tolerant soybean mutants will be compared with those of control groups, and the changes induced by the mutations evaluated. Finally, results of a multidisciplinary investigation on the structural, spectroscopic, photochemical and thermal properties of a series of hydantoins will be presented. Hydantoins are a family of molecules that derive from imadazolidine and that are used commonly as pharmaceuticals (as anticonvulsive. anti-inflammatory, antiepileptic and anticanccr drugs, among other uses). The study addresses the properties of the isolated molecules of the investigated compounds and also those of their neat condensed phases, with emphasis to polymorphism.