Adölesan idiopatik skolyozlu olgularda üç boyutlu korse uygulamasının ve üç boyutlu egzersiz tedavisinin ayak basınç dağılımına etkileri

1. Adölesan idiopatik skolyozu olan bireylerde eğriliğin neden olduğu üç boyutlu deformite alt ekstremitede sağ ve sol ayakta asimetrik yürümeye neden olmaktadır. Alt ekstremitede meydana gelen asimetrik yüklenmeye bağlı olarak plantar yüzeyde adaptif değişikliklere neden olabilmektedir. Araştırmamıza; Mayıs-Temmuz 2012 tarihleri arasında, Özel Fizik Tedavi Merkezi’nde idiopatik skolyoz tanısı konan 48 olgu alındı. Egzersiz, korse ve/veya düzenli takip talebiyle fizyoterapiye yönlendirilen 10-18 yaş aralığındaki olguların tedavi öncesi ve sonrası Cobb yöntemiyle skolyoz açıları, skolyometre ile vertebral rotasyon değerleri, pedobarografi ile peak basınç, maksimum kuvvet, temas süresi, temas alanı plantar basınç değerleri değerlendirildi. Grup I’i oluşturan 22 olguya 3 ay süreyle üç boyutlu korse ve üç boyutlu egzersiz uygulandı. Grup II’yi oluşturan 16 olguya 3 ay süreyle üç boyutlu egzersiz uygulandı. Grup III’ü oluşturan 10 olgu düzenli olarak yalnızca takip edildi. Grup I’de cobb açısı, vertebral rotasyon değerleri, peak basınç farkı, maksimum kuvvet farkı, temas süresi önemli düzeyde azalma gösterdi. Grup II’de vertebral rotasyon değerleri, peak basınç farkı değerleri azalma gösterirken, temas alanı ortalaması artış göstermiştir. Grup III’de peak basınç farkı değerleri maksimum kuvvet farkı değerleri, temas süresi farkı değerleri artış göstermiştir. Sonuç olarak; skolyozu olan bireylerde egzersiz ve korse tedavisinin skolyoz eğriliklerine, asimetrik yüklenme parametrelerine ve ayak basınç dağılımına etki gösterdiği saptandı. Anahtar Kelimeler: adölesan idiopatik skolyoz, korse, egzersiz, pedobarografi 2. SUMMARY Effects Of Three Dimensional Corset Treatment and Three Dimensional Exercise Treatment On Foot Pressure Dıstrubıtıon In The Patients With Adolescent Idiopathic Scoliosis Three dimensional deformity low extremity caused by the curvature on the individuals having adolescent idiopathic scoliosis results in an asymetry in walking over the left and right foot. In parallel to the asymetric overload which take place in sub-extremity, it may also lead up some adaptive changings on the plantar surface/level. In this/our study; 48 cases who were diagnosed with idiopathic scoliosis at the Private Physiothreapy Centre were studied betwen MAY-JULY, 2012. Scoliosis Angles is examined by using Cobb method, vertebral rotation rates with scoliometer as well as peak pressure, maximum force, contact duration and plantar pressure rate of the contact area was evaluated by using pedobarography on the stage of both pretreatment and posttreatment of the cases between 10-18 age range who are referred to physiothreapy by reason of exercise and/or regular followed-up. 22 cases who forms Group I were practiced with three dimensional corset and three dimensional exercise over the three months. 16 cases forming Group II were practised with only three dimensional exercise over the three months. 10 cases who consititutes Group III were only observed regularly. In group I, Cobb angle, vertabral rotation rates, peak pressure difference, maximum force and contact duration have showed a decrease at a significant level. In group II, vertabral rotation rates and peak pressure rates showed a decrease while average of contact area increased. In group III, peak pressure difference rates, maximum force difference rates, contact duration difference rates showed an increase. Consequently; exercise and corset treatment were ascertained that it affects scoliosis curvature, assymetric pressure parameters and foot pressure distribution of the individuals having scoliosis. Key Words: adolescent idiopathic scoliosis, corset, exercise, pedobarograph

Tip 2 diyabetli hastalarda giyilebilir teknoloji, mobil uygulama destekli ve gözetimli egzersiz eğitiminin etkileri

Amaç: Geliştirilen online egzersiz platformunun, akıllı telefon mobil uygulaması ve giyilebilir teknoloji akıllı bileklik aracılığıyla Tip 2 Diabetes Mellitus (T2DM) olan bireylerde etkinliğinin araştırılmasıdır.Gereç ve Yöntem: Klinik araştırma aşamasında, çalışmamıza 84 T2DM’li birey dahil edildi ve randomize 3 gruba ayrıldı. Tüm gruplara haftada 3, 12 hafta boyunca dirençli, aeorobik, denge ve germe egzersizleri uygulandı. Grup 1 gözetimli egzersiz grubu fizyoterapist gözetiminde takip edilirken, Grup 2, akıllı telefon mobil uygulma ile, Grup 3, giyilebilir teknoloji akıllı bileklik aracılığıyla takip edildi. Katılımcılar demografik verilerinin alınmasının ardından, tedavi öncesi ve sonrası HbA1c değerleri, kas ve fiziksel fonksiyonu, davranış anketleri ile değerlendirildi.Bulgular: Çalışmamızda HbA1c değişimleri yüzdelik değişimler üzerinden yapılan lineer regresyon analizi sonucu gözetimli egzersiz grubu ile teknoloji grubu karşılaştırmasında fark saptanmamıştır.Sonuçlar: Tedavi sonrası tüm gruplarda glisemik kontrol, egzersiz davranışı, kas ve fiziksel fonksiyonu açısından pozitif yönde gelişme elde edildi. Grupların karşılaştırılmasında glisemik kontrol, egzersiz davranışı, kas ve fiziksel fonksiyonu açısından fark olmadığı belirlendi. Çalışmamız TÜBİTAK 2214-A Yurt Dışı Araştırma Burs Programı tarafından desteklenmiştir.--------------------Aim: The aim of this study is to investigate the effectiveness of the developed online exercise platform in individuals with Type 2 Diabetes Mellitus (T2DM) via smartphone mobile application and wearable technology smart wristband.Materials and Methods: In the clinical trial stage, 84 individuals with T2DM were included in the study and divided into three randomized groups. Resistant, aerobic, balance and stretching exercises were applied to all groups for 3-12 weeks. Group 1 supervised exercise group was followed by a physiotherapist, Group 2 was followed by smartphone mobile application, and Group 3 was followed by wearable technology smart wristband. After the demographic data of the participants, pre and post treatment HbA1c values, muscle and physical function, and behavioral questionnaires were evaluated. After treatment, all groups were positive for glycemic control, exercise behavior, muscle, and physical function. There was no difference between groups in terms of glycemic control, exercise behavior, muscle, and physical function. Findings: HbA1c changes did not differ between the supervised exercise group and technology group as a result of linear regression analysis based on percentage changes.Results: After treatment, all groups showed improvement in glycemic control, exercise behavior, muscle, and physical function. There was no difference between groups in terms of glycemic control, exercise behavior, muscle, and physical function.Our study was supported by TUBITAK 2214-A International Research Scholarship Program

First exercise reports of diabetes center in Turkey: effects of exercise on metabolic parameters in patients with type-2 diabetes mellitus

BACKGROUND: The current study aimed to show the efficacy of the exercise program performed by the type-2 diabetic patients in the exercise center related to the diabetes clinic. METHODS: This was a retrospective study, conducted on 77 (18-65 years old) diabetic patients who were attending the exercise center of the outpatient diabetes clinic. Patients who completed 3 months of supervised combined exercise program and having no chronic drug adjustment for 3 months at the beginning and during the exercise interval were recruited to the study. RESULTS: After 3 months, supervised combine exercise program, there were significant improvement of BMI (34.62 vs. 33.14 kg/m(2), P<0.001), fat mass (34.95 vs. 33.83 kg, P<0.001), fasting blood glucose (124.59 vs. 117.39 mg/dL, P=0.015), HbA1c (6.74 vs. 6.45, P<0.001), and triglyceride levels (177.78 vs. 167.50 mg/dL, P=0.038). CONCLUSIONS: In conclusion, as a real-life data the supervised combine exercise program, performed in the exercise center of the diabetes clinic, significantly improved the metabolic parameters of the patients. We believe that diabetes clinics should include exercise centers, which are controlled by experts, to provide more qualified management for diabetic patients

Usability of Mobile Health Application for Individuals with Type 2 Diabetes Mellitus and Clinicians

Objective: Usability of technological devices is an important and relevant construct as mobile technologies are increasingly used to deliver healthcare products. Most accessible devices are smartphone and smartwatch but information on their usability is scarce. The aim of this study is to compare the usability of smartphone and smartwatch devices in delivering an exercise platform to individuals with Type 2 Diabetes Mellitus (T2DM) among two focus groups: individuals with T2DM and clinicians. Methods: A total of 40 individuals with T2DM (focus group 1) and 20 clinicians (focus group 2) were recruited to use the platforms one week. Each focus group was randomly divided into: smartphone and smartwatch groups. Each participant was provided with a practice trial for a week before data collection. Usability of both devices was measured with System Usability Scale (SUS). Student t-test was used to compare the total and subscale scores of SUS between two devices in each focus group. Results: In focus group 1 and 2, the mean total scores of SUS were slightly higher in smartphone group (88,75 +/- 9,34 and 86,75 +/- 8,68 ) than smartwatch group (87,87 +/- 7.56 and 82,35 +/- 6,59) respectively. When compared to individual items, three items were statistically significant in focus group 1 and one in focus group 2 (p 80,8) for both smartphone and smartwatch devices in individuals with T2DM and clinicians. When compared between devices for two groups, exercise platform delivered through smartphone performed better on usability than smartwatch for both individuals with T2DM and clinicians

Technology-based and supervised exercise interventions for individuals with type 2 diabetes: Randomized controlled trial

Aims: The purpose of this study was to estimate, for people with type 2 diabetes (T2D), the extent to which glycemic control was affected by a 12-week program using mobile app and wearable smartwatch in comparison to supervised exercise training. Methods: This study was a stratified, randomized, assessor-blind, controlled, pragmatic trial with three parallel groups which were supervised, mobile app and wearable smartwatch. Individually tailored exercise regimens delivered through a supervisor, mobile app and wearable smartwatch. Programs consisted of aerobic, resistance exercises, calisthenic, flexibility, balance, and coordination exercises. Primary outcome was change in glycemic control (HbA1c); secondary outcome was Six Minute Walk Test; and explanatory outcomes were exercise behaviour, muscle function, and physical capacity. The groups were contrasted for change in HbA1c and absolute reduction of ≥0.5% (Minimal Important Change). Linear and logistic regressions were used to compare the groups and generalized estimated equations were used to analyze the explanatory outcomes. Results: In total, 90 people were randomized, 6 were lost over 12 weeks, leaving 84 with outcome data. The difference in HbA1c did not differ between the supervised and the technology groups combined and between the mobile app and smartwatch group. Proportions of people achieving a clinically meaningful difference on HbA1c between the supervised and technology groups were similar (46% vs 43%) and the associated OR was 0.87 (95%CI:0.34−2.28). Within the two technology groups, proportions of people achieving a clinically meaningful difference in HbA1c were 48% in the mobile app and 38% in the smartwatch groups and the associated OR was 0.65 (95%CI:0.21−2.03). The groups did not differ on secondary and explanatory outcomes. Conclusions: The results of our trial provide evidence that all outcomes have improved in all groups regardless of the exercise delivery method. Considering the supervised programs are not available for everybody, technological options are crucial to implement to help individuals self-manage most aspects of their diabetes. © 202

Relationships between lower extremity muscle strength asymmetry, balance and ankle injury risk in professional football players

Amaç: Bu çalışmada profesyonel futbolcularda alt ekstremite kas kuvvet asimetrisi, dinamik denge ve ayak bileği yaralanmariski arasındaki ilişkinin incelenmesi amaçlandı.Yöntem: Çalışmaya 20 profesyonel erkek futbolcu dahil edildi. Bilateral dinamik dengeyi değerlendirmek için Y denge testikullanıldı. Alt ekstremiteye ait bilateral kalça fleksör, kalça ekstansör, kalça abduktör, kalça adduktör, diz fleksör, diz ekstansör,ayak bileği dorsifleksör, ayak bileği plantar fleksör, ayak bileği evertör ve ayak bileği invertör kas gruplarının maksimal izometrikkontraksiyonu değerlendirmek için Groinbar sistemi kullanıldı.Bulgular: Çalışmaya dahil edilen oyuncuların yaş ortalaması 27,80±5,80 yıl ve vücut kütle indeksi ortalaması 24,04 ± 1,55kg/m² olarak bulundu. Her iki ayak bileği dorsifleksör ve plantarfleksör kas grupları arasındaki oran ile denge testinde anteriorposterior bilateral fark arasında istatistiksel açıdan anlamlı sonuç elde edildi (Sol: p=0,012, rho=-0,552, Sağ: p=0, rho=-0,727). Anterior-posterior denge farkının yaralanma riski açısından değerlendirildiğinde; kalça abduktör ve adduktör kasgrupları arasındaki oran ile ayak bileği yaralanma riski açısından anlamlı korelasyon bulundu (Sol: p=0,026, rho=-0,498, Sağ:p=0,006, rho=-0,595).Sonuç: Profesyonel futbolcularda alt ekstremiteye ait plantarfleksör/dorsifleksör ve adduktör/abduktör kas gruplarınınizometrik kuvvet oranının ve bilateral plantar fleksör kuvvet asimetrisinin dinamik denge ve ayak bileği yaralanma riskiyle ilişkiliolduğu bulunduPurpose: In this study, it was aimed to determine the relationships between lower extremity muscle strength asymmetry,_x000D_ dynamic balance and ankle injury risk in professional football players._x000D_ Method: The participants of the study comprised twenty professional male soccer players. Y Balance Test was used to evaluate_x000D_ bilateral dynamic balance. Groinbar system was used to evaluate maximal isometric contraction of bilateral hip flexor, hip_x000D_ extensor, hip abductor, hip adductor, knee flexor, knee extensor, ankle dorsiflexor, ankle plantar flexor, ankle evertor and ankle_x000D_ muscle groups._x000D_ Results: The mean age of the players included in the study was 27,80±5,80 years and the mean body mass index was_x000D_ 24,04±1,55 kg/m². It was found that there was statistically meaningful result between ratio of bilateral dorsiflexors/plantar_x000D_ flexors muscle groups and anterior-posterior bilateral difference in balance test (Left: p=0,012, rho=-0,552, Right: p=0, rho=-_x000D_ 0,727). It was found that there was meaningful correlation between bilateral force asymmetry of plantar flexors and anteriorposterior bilateral difference. (p=0,038, rho=0,466). In addition, when the anterior-posterior balance difference is evaluated_x000D_ in terms of injury risk; a meaningful correlation was found between the ratio of hip abductor and adductor muscle groups, and_x000D_ the risk of ankle injury. (Left: p=0,026, rho=-0,498, Right: p=0,006, rho=-0,595). Conclusion: It was found that bilateral plantar_x000D_ flexor strength asymmetry and the isometric strength ratio of plantar flexor / dorsiflexor and adductor/abductor muscle groups_x000D_ of the lower extremity in professional football players had relationships with dynamic balance and ankle injury ris

Lumbal di̇sk herni̇li̇ bi̇reylerde hi̇bri̇t telerehabi̇li̇tasyon programinin etki̇si̇

Giriş: Lumbal disk hernisi (LDH) ağrı ve duyusal kayıplara neden olan, kas kuvvetinde kayıplar ve buna bağlı olarak gelişen fonksiyon kaybı ile yaşam kalitesinin azalması ile karakterize muskuloskeletal bir problemdir. Bu çalışmanın amacı LDH tanılı bireylerde hibrit telerehabilitasyon programının etkinliğinin araştırılmasıdır. Gereç-Yöntem: Bu çalışma Ocak-Haziran 2022 tarihleri arasında Marmara Üniversitesi Fizyoterapi ve Rehabilitasyon Bölümü’nde yapıldı. Çalışmaya dahil edilme kriterlerine uyan ve çalışmaya gönüllü olarak katılan 51 LDH tanılı birey alındı. Bireylerin ağrı durumu Vizüel Analog Skala (VAS); kinezyofobi durumu Tampa Kinezyofobi Ölçeği (TKÖ), yaşam kaliteleri SF-12 Yaşam Kalitesi Ölçeği (SF-12); alt ekstremite kuvveti 30 Saniye Otur Kalk Testi (30 STS) ve fonksiyonelliği Zamanlı Kalk Yürü Testi (TUG) ve Oswestry Bel Ağrısı Engellilik Anketi (OBAEA) ile değerlendirildi. Bireyler 8 haftalık hibrit telerehabilitasyon programına dahil edildi. Değerlendirmeler dört defa (D0: program öncesi, D1: 4. haftanın sonu, D2: 8. haftanın sonu, D3: 16. haftanın sonu) yapıldı ve değişimler karşılaştırıldı. Bulgular: Programa alınan 51 hastanın 44’ü kadın 7’si erkekti (yaş ortalaması: 47,13±11,73 yıl). 22 hasta aktif olarak çalışıyordu. 25 hasta daha önce LDH nedeni ile fizik tedavi ve rehabilitasyon programına katılmıştı ve 16 hasta düzenli olarak fiziksel aktivite yaptığını bildirdi. Program öncesi sonrası değerlendirmeler karşılaştırıldığında VAS, SF-12 Fiziksel ve Mental skorları, 30 STS, TUG ve OBAEA için istatistiksel olarak anlamlı fark bulundu (p<0,01). Sonuç: Çalışmanın sonunda hibrit telerehabilitasyon programının LDH tanılı bireylerde ağrı, kas kuvveti, fonksiyonellik ve yaşam kalitesi üzerinde etkili olduğunu bulundu.Introduction: Lumbar disc herniation (LDH) is a musculoskeletal problem that causes pain and sensory loss, and is characterized by loss of muscle strength, loss of function and decreased quality of life. The aim of this study is to investigate the effectiveness of the hybrid telerehabilitation program in individuals diagnosed with LDH. Material-Method: This study was carried out between January and June 2022 at Marmara University, Department of Physiotherapy and Rehabilitation. 51 individuals diagnosed with LDH who met the inclusion criteria and voluntarily participated in the study were included. Pain status of individuals was assessed with the Visual Analogue Scale (VAS); kinesiophobia status was evaluated with Tampa Scale for Kinesiophobia (TSK), quality of life was assessed with the 12-Item Short Form Health Survey (SF-12); lower extremity strength was evaluated with the 30 Second Sit to Stand Test (30 STS) and functionality was assessed with the Timed Up and Go Test (TUG) and the Oswestry Low Back Pain Disability Questionnaire (OLBPDQ). Individuals were included in an 8-week hybrid telerehabilitation program. Evaluations were made four times (D0: pre-program, D1: end of week 4, D2: end of week 8, D3: end of week 16) and changes were compared. Results: Of the 51 patients included in the program, 44 were female and 7 were male (mean age: 47.13±11.73 years). 22 patients were actively working. 5 patients had previously participated in a physical therapy and 134 rehabilitation program due to LDH, and 16 reported regularly engaging in physical activity. When the evaluations before and after the program were compared, a statistically significant difference was found for VAS, SF-12 Physical and Mental scores, 30 STS, TUG and OLBPDQ (p<0.01). Conclusion: At the end of the study, it was found that the hybrid telerehabilitation program was effective on pain, muscle strength, functionality and quality of life in individuals with LDH

Association of Physical Fitness Indicators with Health Profile and Lifestyle of Children

Objective: High physical fitness (PF) level is a significant health determinant in children and adolescents so that it is important to identify the factors affecting PF in this population. Despite available studies highlighting the relationship between PF and characteristics of children, there is still a need to uncover how the health status and lifestyle of children impact different PF indicators. Thus, the purpose of this study is to investigate the relationship between physical fitness, and the health profile and lifestyle of children. Methods: This study was conducted with 110 (58 girls; age 11.85 +/- 0.35) adolescents between February and March 2020. The preditors of PF which were gender, body mass index, physical activity level (PAL) measured via Physical Activity Questionnaire (PAQ), motivation measured via Participation Motivation Questionnaire (PMQ), sleep time, and tablet usage time regressed against PF related outcome measured using 6 Minutes Walk test (6MWT), T-Test, vertical jump test and broad jump test (BJT). Results: There were significant associations between T-test performance, and gender, BMI (being obese), and PAL. PAL and gender were also significant predictors for 6MWT and BJT respectively. PF was not significantly associated with motivation, sleep, and table usage time. A high level of physical activity, being male, and low BMI score resulted in better PF performance. Conclusion: The health profile and lifestyle of adolescents may estimate the significant proportion of variabilities observed in physical fitness levels in adolescents

Personal, social, and environmental correlates of physical activity and sport participation in an adolescent Turkish population

Background: Benefts of physical activity has been shown for adolescents; however, there is a decline trend in number of adolescents meeting current WHO recommendations. This trend underlines the importance of identifying factors associated with adolescents’ physical activity level (PAL) with considerations of regional and cultural diferences to plan and implement efective policies. Therefore, the aim of this study was to determine personal, ecological, and social factors associated with PAL and sport participation in Turkish adolescents aged 11–14 years. A cross-sectional study was conducted by including 996 adolescents aged between 11 and 14 years from 39 secondary schools in İstanbul, Turkey. Logistic regression analyses performed to identify the signifcant personal (age, gender, sleep time, screen time, BMIz score, having siblings), ecological (presence of playground, type of school transportation), and social (family income, engaging a physical activity with family, and preferred activity at school breaks) predictors of PAL and sport participation. Results: Adolescents who were active during break time at school (p < 0.001), engaging a physical activity with family (p < 0.001), and did not have a sibling (p = 0.029) were more likely to be physically active. Adolescents behaved active during break time at school (p < 0.001), had a playground at home (p < 0.001), spending time with family for physical activity (p < 0.001), and did not have a sibling (p = 0.021) were more likely to participate in a sport activity. Conclusions: Predictors of PAL in this study indicates the need to promote active break time in school, increased physical activity time with family, and to design environmental policies to increase number of playgrounds

The Results of Physical, Radiologic, Pedabarographic, and Quality-of-Life Assessments in Patients with Surgically Treated Intraarticular Calcaneus Fractures

Calcaneal fractures are complex injuries and have historically had a poor prognosis that results in substantial disability. However, no studies have been performed that analyze both the radiographic and plantar pressure changes after treatment of intraarticular calcaneus fracture. Patients with an intrarticular calcaneus fracture treated at our institution during the study period were identified from computerized hospital records. A total of 36 patients (34 males) completed physical examination and radiographic and dynamic pedobarographic assessments. The follow-up period was from 13 to 82 months (median 38 months). The mean pain score at rest was 3.7 and during activity was 4.0 on a 10-cm visual analogue scale. The mean range of motion of the subtalar joint was restricted. The mean American Orthopaedic Foot and Ankle Society function scale score was 68.1; the mean Short Form-36 physical score was 41.8; and the mental score was 44.9. Pedabarographic results showed that the mean maximum force in the midfoot, forefoot, and toes (p = .001; p = .04; p = .002) and peak pressure in the midfoot, forefoot (p = .001; p = .007), and contact area of the midfoot and toes (p = .038; p = .004) were significantly increased in the injured foot. Radiologic findings showed hindfoot varus, forefoot adductus, and an increase in the medial arch. Even after appropriate anatomic realignment with open reduction and internal fixation of calcaneus fractures, residual differences in plantar pressures and radiographic measures are noted compared to uninjured foot. (C) 2018 by the American College of Foot and Ankle Surgeons. All rights reserved