WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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Article The Effects of Diaphragmatic Breathing Exercises on Individuals with Premature Ejaculation: A Randomized Controlled Trial(Oxford University Press, 2025) Erkut, Umit; Karagözoğlu Coşkunsu, Dilber; Erkut, Kubra; Özden, Ali Veysel; Coskunsu, Dilber KaragozogluBackground There are no standardized, evidence-based rehabilitation protocols for premature ejaculation (PE) which hinders effective management, the development of validated patient-reported outcomes, regulatory oversight, and the potential benefits of targeted interventions. Aim To investigate the effect of diaphragmatic breathing exercises (DBE) on PE. Methods Sixty-two participants with PE were randomly assigned to Group I (n = 31) or Group II (n = 31). Both groups received behavioral therapy (BT) and pelvic floor muscle training (PFMT) twice daily, three days a week, for eight weeks. Additionally, Group I recieved DBE twice daily, every day, for eight weeks. Intravaginal ejaculation latency time (IELT) was calculated with a stopwatch, at the end of the 8th week (post-treatment), and at 1-year follow-up. Pelvic floor muscle (PFM) strength and endurance were evaluated with ultrasound, and changes in the in the autonomic nerves system (ANS) parameters (including the root mean square of successive differences [RMSSD], proportion of NN50 [PNN50], low-frequency [LF] power, and high-frequency [HF] power) were evaluated with an Elite HRV device at pre-treatment and post-treatment by a blinded assessor. Outcomes Primary outcome measurements were IELT, PFM strength and endurance, and changes in ANS paramaters. Results The study was completed by 29 participants (mean age = 31.4 ± 6.5 years) in Group I and 30 (mean age = 31.3 ± 7.6 years) in Group II. At post-treatment, all outcome measures showed significant improvements in both groups (P <.001 for all). Compared to Gropu II, Group I showed significantly greater improvements in IELT(P=0.12), RMSDD (P<.001), PNN50 (P=.003), LF Power (P<.001), HF Power (P=.003), strength(P<.001), and endurance (P<.001). The median IELT increase from baseline to post-treatment was 283 seconds (range: 84-870; 900%) in Group I and 204 seconds (range: 44- 581; 690%) in Group II. While IELT declined significantly from post-treatment to 1-year follow-up in Group II, no statistically significant change was found in Group I. Clinical Implications The effect of DBE on the ANS may help regulate the ejaculatory reflex. Strengths and Limitations This is the first study to apply breathing exercises with BT and PFMT in men with PE. Limitations include the lack of exercise adherence records beyond 8 weeks and the estimation-based IELT measurement at baseline. Conclusion Adding DBE, to BT and PFMT, yields better results in IELT (at 8 weeks and 1 year) and inreases PFM strength and endurance of PFM (at 8 weeks) in men with PE. © 2025 Elsevier B.V., All rights reserved.Article Evaluation of Immediate Effect of Sacroiliac Joint Manipulation on Balance and Muscle Strength(Edizioni Minerva Medica, 2021) Toprak, Mehmet; Karagozoglu Coskunsu, Dilber; Alptekin, Hasan K.; Inal, Habibe S.; Coşkunsu, Dilber KaragözoǧluBACKGROUND: The aim of this study was to investigate the immediate effect of chiropractic high velocity low amplitude (HVLA) sacroiliac manipulation on muscle strength and balance in healthy individuals with asymptomatic dysfunction of the sacroiliac joint. METHODS: Quadriceps and hamstring muscle strength and balance were measured before and after the application in healthy individuals, using the Biodex Balance System and MicroFet 2 Hand Dynamometer (Biodex Medical Systems, Inc., Shirley, NY, USA). Balance was measured when the patients stood on their feet eyes open, and eyes closed. In total, 60 individuals were included in the study. They were divided into two groups and the experimental group had 40 individuals in total. No application was made to the control group. One-time chiropractic HVLA sacroiliac manipulation was applied to the experimental group. RESULTS: In the control group, the quadriceps muscle strength of the right leg was 58.51 kg in the first measurement and 52.95 kg in the second measurement. The left leg yielded 57.62 kg in the first measurement and 51.06 kg in the second measurement. The Hamstring Muscle Strength of the right leg in the control group was 41.77 kg in the first measurement and 38.28 kg in the second measurement. In the left leg, it was 41.96 kg in the first measurement and 39.36 kg in the second measurement. For balance measurement, there was a significant improvement in balance in the second measurement in both eyes-closed and eyes-open positions. In the experimental group, the Quadriceps Muscle Strength of the right leg was 58.05 kg in the first measurement and 67.43 kg in the second measurement. In the left leg, it was 56.23 kg in the first measurement and 64.97 kg in the second measurement. Hamstring muscle strength increased significantly in both right and left legs after chiropractic HVLA manipulation (P<0.05). In the experimental group, the hamstring muscle strength of the right leg was 34.68 kg in the first measurement and 43.29 kg in the second measurement. In the left leg, it was 35.96 kg in the first measurement and 43.64 kg in the second measurement. CONCLUSIONS: There was no significant improvement in balance of both legs in eyes-closed and eyes-open position after chiropractic HVLA manipulation.