WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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Article Effect of Inspiratory Muscle Training on Diaphragm Function and Activity Performance in Subacute Ischemic Stroke Patients: A Single-Blind Randomized-Controlled Trial(SAGE Publications Inc., 2026) Akçay S.; Akyol D.K.; Erkut Ü.; Karagözoğlu Coşkunsu D.; Kunduracilar Z.; Bajrami A.; Dinç Yavaş A.; Kunduracilar, Zuhal; Coskunsu, Dilber Karagozoglu; Bajrami, Arsida; Akçay, Sümeyye; Akyol, Dudu Kübra; Erkut, Ümit; Karagözoğlu Coşkunsu, Dilber; Yavas, Arzu Dinc; Dinç Yavaş, ArzuBackground: Respiratory dysfunction is common after stroke and may negatively affect functional recovery. Inspiratory muscle training (IMT) has been proposed to enhance diaphragmatic function and activity performance in this population. Objective: To investigate the effects of IMT on diaphragm function and activity performance in patients with subacute ischemic stroke. Methods: In this randomized controlled, single-blind trial, 26 patients with subacute ischemic stroke (>1 month post-onset) were randomly allocated to an intervention group (IG, n = 13) or control group (CG, n = 13). Both groups received standard neurorehabilitation, aerobic training, and the Active Cycle of Breathing Technique (ACBT). The IG additionally underwent IMT, 5 days per week for 6 weeks (30 sessions). Assessments included maximal inspiratory and expiratory pressures (MIP, MEP), diaphragmatic thickness (Ti, Te) and excursion via ultrasonography, 6-minute walk test (6MWT), and Canadian Occupational Performance Measure (COPM). Results: Twenty-two participants completed the study (IG = 11; CG = 11). Significant within-group improvements were observed in both groups for MIP, MEP, Ti, TF, excursion, 6MWT, and COPM scores (P < .05). Between-group analyses showed significantly greater improvements in the IG for ΔMIP (P < .001), ΔMEP (P = .003), affected-side ΔTi (P = .007), ΔTF (P = .008), and Δexcursion (P = .005). No significant differences were found for 6MWT and COPM (P > .05). Conclusions: IMT effectively improves respiratory muscle strength, diaphragmatic thickness, and excursion in subacute ischemic stroke and may be a valuable addition to post-stroke rehabilitation programs. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT06210516. © The Author(s) 2026Article The Effect of Sportive Latin American Ballroom Dance on Foot and Ankle Posture(Amer Podiatric Med Assoc, 2025) Kayiskiran, Onurcan; Coskunsu, Dilber Karagozoglu; Isiklar, CagdasBackground: Correct use of the feet, step techniques, and positions constitute significant factors in the success of a dancer. Moreover, the type of dance has crucial effects on the posture of the foot and ankle. Therefore, the primary aim of our study was to determine whether there was a relationship between dancesport, dance experience (years), shoe-wearing time (hours), and shoe heel height (centimeters) in dance athletes performing Sportive Latin American Ballroom (SLAB) dance. Second, we aimed to compare the foot posture of SLAB dancers and nondancers with similar demographic characteristics. Methods: Twenty-six professional SLAB dancers and 26 nondancers who had similar demographic characteristics and did not use high-heeled shoes volunteered to take part in this study. Foot posture (using the Foot Posture Index [FPI]), foot pronation (using the navicular drop test [NDT]), tibiocalcaneal angle, hallux valgus angle (HVA) (using a goniometer), and ankle dorsiflexion range of motion (ROM) (using the weightbearing lunge test) were evaluated. Results: There was a positive moderate correlation between FPI score and shoe-wearing time on the dominant (P = .041; r = 0.40) and nondominant (P = .026; r = 0.43) sides. A positive very good correlation was found between shoe heel height and HVA (P < .001; r = 0.75). A negative good correlation was observed between years of dancing and nondominant ankle dorsiflexion ROM (P = .027; r =-0.43). When dancers and nondancers were compared, a statistically significant difference was found between FPI and NDT scores (P < .001). The FPI and NDT scores, tibiocalcaneal angle, HVA, and ankle dorsiflexion ROM were significantly greater in the dancer group compared with the nondancer group (P < .001) in all measurements of the dominant and nondominant sides. Conclusions: Revealing the relationship between dance experience and shoe-wearing time and the difference between the foot posture and deformities of athletes who perform SLAB dance and those of nondancers constitutes a pivotal endeavor that will increase awareness and knowledge among dancers and clinicians. (J Am Podiatr Med Assoc 115(6), 2025; doi:10.7547/24-030)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 Citation - WoS: 3Citation - Scopus: 3E-Health Literacy Status of Individuals With Multiple Sclerosis in Turkey(Mary Ann Liebert, inc, 2024) Tosun, Anil Tekeoglu; Isiklar, Cagdas; Yildirim, Merve; Coskunsu, Dilber KaragozogluBackground: This research aims to compare e-health literacy of technology users and nonusers in people with multiple sclerosis (MS) and to investigate whether there are correlations between age, duration of MS, gender, marital status, and e-health total scores.Methods: This descriptive study was carried out with a web-based questionnaire. The questionnaire was sent to 300 patients with MS who were registered at Istanbul University-Cerrahpasa Medical Faculty Neurology Department.Results: A total of 156 people (mean age: 35.33 +/- 10.47 years) participated in the survey. Smartphone 98.1% (n = 153) was the mostly used device. Rate of using Google and recommended websites about MS was 94.25% (n = 145) and 73.9% (n = 113), respectively. e-Health literacy of both the tablet and recommended websites users significantly differed from that of nonusers (p = 0.007 for both). Participants' e-health literacy total score was found to weakly, but significantly, correlate with their age, marital status, and education level (rho: -0.161, p = 0.044; rho: 0.172, p = 0.032; rho: -0.192, p = 0.016, respectively).Conclusions: With developments in digital technologies, it is important to identify the access status of people with MS to improve daily clinical management and implement further motor and cognitive rehabilitation. Therefore, determining the health literacy of individuals with MS and providing education on this subject will reduce the information pollution.Article Citation - WoS: 9Citation - Scopus: 9The Effect of Electromyography (emg)-Driven Robotic Treatment on the Recovery of the Hand Nine Years After Stroke(Hanley & Belfus-elsevier inc, 2023) Ogul, Ozden Erkan; Coskunsu, Dilber Karagozoglu; Akcay, Sumeyye; Akyol, Kubra; Hanoglu, Lutfu; Ozturk, NeclaObjective: To investigate the effect of electromyography (EMG)-driven robotic therapy on the recovery of the hand in a stroke case lasting 9 years.Case: An 18-year-old patient with hemiparesis due to the ischemic lesion was admitted to our clinic with hand impairment. Fifteen sessions (5 weeks x 3 times) of robotic rehabilitation were applied with the Hand of Hope. Average EMG (mV) of flexor digitorum superficialis (FDS) muscle, average force (N) and the rate of force development (RFD)(N/s) were also assessed before and after the treatment following the 5th and 10th sessions and at the end of treatment. Also, Fugl-Meyer Assessment of Upper Extremity Scale (FMU-UE), Motor Activity Log (MAL), Canadian Occupational Performance Score (COPM) and Visual Analog Scale (VAS) were used for assessment before and after the treatment.Results: The average EMG measured from FDS increased from 0.093-0.133 mV. The average force and average RFD increased from 45.6-97.7 and from 135.6-172.6 respectively. While affected and/or unaffected side force ratio increased dramatically from 54%-82%, the FMA-UE score increased from 56-59. The MAL quality of use score increased from 3.93-4.13. Performance and satisfaction scores of COPM changed from 5.25-7.25 and 4.5-8.25 respectively. VAS score for fatigue changed from 6 to 4.Discussion: The improvement achieved 9 years later with 15 sessions of rehabilitation suggests that im-provement may be possible for chronic stroke patients.(c) 2021 Elsevier Inc. All rights reserved.Article Does Neuromuscular Electrical Stimulation Have an Additive Effect on Disability, Pain and Abdominal and Lumbar Muscle Thickness in Chronic Low Back Pain? - a Randomized Controlled Double-Blind Study(Georg Thieme verlag Kg, 2022) Atli, Ecenur; Coskunsu, Dilber Karagozoglu; Turan, Zeynep; Taskiran, Ozden OzyemisciZusammenfassungArticle Citation - WoS: 17Citation - Scopus: 17Effects of Robotic Rehabilitation on Recovery of Hand Functions in Acute Stroke: a Preliminary Randomized Controlled Study(Wiley, 2022) Coskunsu, Dilber Karagozoglu; Akcay, Sumeyye; Ogul, Ozden Erkan; Akyol, D. Kubra; Ozturk, Necla; Zileli, Fusun; Krespi, YakupObjective The aim of this study was to investigate the effects of EMG-driven robotic rehabilitation on hand motor functions and daily living activities of patients with acute ischemic stroke. Materials & Method A preliminary randomized-controlled, single-blind trial rectuited twenty-four patients with acute ischemic stroke (<1 month after cerebrovascular accident) and randomly allocated to experimental group (EG) and control group (CG). Neurophysiological rehabilitation program was performed to both EG and CG for 5 days a week and totally 15 sessions. The EG also received robotic rehabilitation with the EMG-driven exoskeleton hand robot (Hand of Hope (R), Rehab-Robotics Company) 15 sessions over 3 weeks. Hand motor functions (Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT)), activities of daily living (Motor Activity Log (MAL)), force and EMG activities of extensor and flexor muscles for the cup test were evaluated before treatment (pretreatment) and after the 15th session (posttreatment). Results Eleven patients (59.91 +/- 14.20 yr) in the EG and 9 patients (70 +/- 14.06 yr) in the CG completed the study. EG did not provide a significant advantage compared with the CG in FMA-UE, ARAT and MAL scores and cup-force and EMG activities (p > .05 for all). Conclusion In this preliminary study, improvement in motor functions, daily living activities and force were found in both groups. However, addition of the EMG-driven robotic treatment to the neurophysiological rehabilitation program did not provide an additional benefit to the clinical outcomes in 3 weeks in acute stroke patients.Article Extracorporeal Shockwave Therapy Versus Graston Instrument-Assisted Soft-Tissue Mobilization in Chronic Plantar Heel Pain a Randomized Controlled Trial(Amer Podiatric Med Assoc, 2022) Pisirici, Pelin; Cil, Elif Tugce; Coskunsu, Dilber Karagozoglu; Sayli, Ugur; Subasi, FeryalBackground: Although there are studies showing that extracorporeal shockwave therapy (ESWT) and instrument-assisted soft-tissue mobilization methods are effective in chronic plantar heel pain (CPHP) treatment, there is a need for studies comparing these techniques. We com-pared the effectiveness of ESWT versus instrument-assisted soft-tissue mobilization using Graston Technique (GT) instruments in addition to stretching exercises (SEs) in CPHP. Methods: Sixty-nine patients were randomly assigned to three groups: ESWT+SEs (group 1), GT+SEs (group 2), and SEs only (control group) (ratio, 1:1:1). The SEs, twice daily for 8 weeks, were standard for all. Group 1 received low-intensity ESWT; in group 2, GT was the selected method. Visual analog scales (for initial step and activity pain), the Foot Function Index (FFI), the 12-item Short-Form Health Survey (SF-12), and the Tampa Scale for Kinesiophobia were used pretreatment, posttreatment, and at 8-week and 6-month follow-up. Results: Visual analog scale and FFI scores improved posttreatment and during follow-up in all groups (P , .001). Although effect sizes were greater in groups 1 and 2 than in the control group in initial step pain posttreatment and at 8-week follow-up, group 2 had the highest effect size at 6 months. Mean SF-12 scores in groups 1 and 2 improved on the post-treatment assessment. Furthermore, group 2 showed significant improvements in FFI scores compared with the other groups at 6-month follow-up (F = 6.33; P = .003).Conclusions: Although ESWT+SEs and GT+SEs seem to have similar effects on initial step pain posttreatment and at 8-week follow-up, GT+SEs was found most effective for improving functional status at 6 months in the management of CPHP.Article Citation - WoS: 3Citation - Scopus: 3Validity and Reliability of a New Method To Measure Cervical Proprioception(Georg Thieme verlag Kg, 2022) Koseoglu, Aygul; Coskunsu, Dilber Karagozoglu; Mutlu, Ebru KayaObjective An accurate and reliable measurement of proprioception is important in the evaluation of the cervical. The aim of this study is to investigate the validity and reliability of a new method using Horizontal Plane Target Platform (HPTP) to assess Head Repositioning Accuracy (HRA) for Cervical Proprioception (CP). Methods HRA values of 86 healthy volunteers (21.01 +/- 2.16 yrs.) were measured through AOS PropPoint laser apparatus device on HPTP, Frontal Plane Target Platform (FPTP), and also CROM device to assess test-retest reliability and validity. Results The test-retest measurements of HPTP reliability was (ICC (left) =0.69, ICC (right) =0.74; SEM (left) =0.28, SEM (right=) 0.36; MDC (left) =1.85, MDC (right) =2.02 95%CI) were moderate for both side. Correlation with the CROM device results was moderate for both side (r=0.75 for left size, r=0.83 for right side), and the absolute values demonstrate concordance between results using the Bland-Altman method. Conclusions HRA measurements performed with a laser apparatus on HPTP which we developed can be used as an alternative method in CP evaluation.