Person: ÖNERGE, KÜBRA
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ÖNERGE
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KÜBRA
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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 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 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 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 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 Azaltılmış Plantar Ön-Ayak Duyusunun Taban Basıncı Üzerine Etkisinin İncelenmesi(2018) Akalan, Ekin; Sert, Rukiye; Kuchimov, Shavkat Nadir; Leblebici, Gökçe; Ertürk, Gamze; Bilgili, Fuat; ÖNERGE, KÜBRA; 283338; 176320; 229941; 268636; 237820Publication Femoral Anteversiyon Artışı Olan Çocuklarda Hipermobilite, Kas Kuvveti ve 3 Boyutlu Yürüme Analizi Parametreleri Arasındaki İlişki(2019-10-18) EVRENDILEK, HALENUR; Karaca, Gülşah; Ertürk, Gamze; Bilgili, Fuat; AKALAN, NAZİF EKİN; ÖNERGE, KÜBRAAMAÇ Çalışmanın amacı; femoral anteversiyon artışı (FAA) olan çocuklarda hipermobilite, kas kuvveti ve 3 boyutlu yürüme analizi parametreleri arasındaki ilişkiyi araştırmaktır. YÖNTEM FAA olan 7 çocuk (14 bacak, ort.yaş:9.14 ± 0.3, trokanter prominens açı testi(TPAT):28 ± 6.2°) çalışmaya dahil edildi. Çocukların femoral anteversiyon açıları, eklem mobiliteleri ve maksimal izometrik kas kuvvetleri sırasıyla TPAT, Beighton testi ve el dinamometresiyle (Lafayette Instruments,USA) değerlendirildi. Tüm katılımcılara normal hızlarında yürürken 3 boyutlu yürüme analizleri yapılarak pelvis, kalça ve diz kinematik parametreleri incelendi. Parametreler arasındaki ilişkiler, verilerin normal dağılımlarına göre Pearson ve Spearman korelasyon testleri kullanılarak değerlendirildi. Verilerin istatistiksel olarak anlamlılık düzeyi (p<0.05) olarak kabul edildi ve sonuçlar Cohen sınıflamasına göre yorumlandı. BULGULAR Beighton testi skoru ile kalça ekstansör(r: -.70) ve diz ekstansör(r: -.91) kas kuvvetleri, minimum diz fleksiyon açısı(r: -.83) arasında yüksek korelasyon bulundu. TPAT değerleri ise kalça abduktör kas kuvveti(r: -.77) ve ortalama kalça rotasyon açısıyla yüksek korelasyon gösterdi(r: .60). TARTIŞMA Literatürde, FAA olan çocukların yürüme sırasında ortalama kalça iç rotasyon, pelvik oblikite ve duruş fazında diz ekstansiyon parametrelerinin arttığı gösterilmiştir. Bu çalışma, zayıf kalça ekstansör ve abduktür, diz fleksör ve ekstansör kaslarındaki zayıflığın kinematik değişimlerle ilişkili olabildiğini göstermiştir. Ayrıca, literatürle uyumlu olarak ortalama kalça internal rotasyon parametresiyle kalça abdüktör kas kuvvetinin TPAT açısıyla anlamlı olarak ilişkili olduğu bulumuştur. FAA olan çocuklarda sıkça görülebilen hipermobilitenin, kalça ve diz ekstansör kas zayıflığı ile duruş fazında hiperekstansiyon artışında rolü olabilir. Sonuç olarak, kalça abdüktör ve ekstansör, diz fleksör ve ekstansör kas kuvvetlerinin arttırılması, FAA olan hipermobil çocuklarda alt ekstremite fonksiyonun iyileştirilmesi için önemlidir.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 Yürüme esnasındaki gövde-baş açısı ölçümü için kablosuz çift ivmeölçerli giyilebilir sistem(IEEE, 2018) AKALAN, NAZİF EKİN; GÜRKAN, GÜRAY; ÖNERGE, KÜBRA; 113297; 283338; 176320Literatürde, yere bakarak yürümenin yürüme parametrelerini ve ayak basıncını değiştirebileceği ile ilgili bilindik bir çalışma bulunmamaktadır. Bu çalışmada, yürüme esnasında gövde-baş açı değişimini ölçebilen bir sistem sunulmaktadır. Sistemin donanım kısmı, oksipital ve sırt bölgelerine yerleştirilen iki adet 3 eksenli sayısal ivmeölçer, mikroişlemci, Bluetooth modülü ve bataryadan oluşmaktadır. Mikroişlemcinin aldığı ivme verisi Bluetooth aracılığı ile alıcı bilgisayara gönderilmektedir. Verinin alınması, açı kestiriminin yapılması ve görselleştirilmesi, sistemin yazılım kısmını oluşturan ve Python dilinde geliştirilen kullanıcı arayüzü ile yapılmaktadır. Geliştirilen sistem hem iki serbestlik dereceli bir kol üzerinde hem de yürüme sırasında bir kullanıcı üzerinde test edilmiştir.