WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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Article Exploring E-Health Literacy Levels among Turkish Women Diagnosed with Breast Cancer: A Cross-Sectional Study(BMC, 2026) Akkurt, Burcu; Coskunsu, Dilber Karagozoglu; Reyhanioglu, Duygu Aktar; Simsek, Mine; Tosun, Anil; Yilmaz, Nergis; Koseoglu, AygulAccess to digital health information has increased for women diagnosed with breast cancer; however, searching, understanding, and interpreting this information requires adequate e-health literacy. This study aimed to determine the e-health literacy levels of women diagnosed with breast cancer and to examine the relationship between e-health literacy and selected sociodemographic and clinical characteristics. In addition, women's awareness of e-health and telerehabilitation concepts, as well as their internet use patterns, were evaluated to inform future digital health initiatives. Data were collected through face-to-face and online methods using an Information Form to assess participant characteristics and the E-health Literacy Scale to measure e-health literacy. The study included 336 voluntary Turkish-speaking women aged 18 years and older diagnosed with breast cancer.The median e-health literacy score on the E-health Literacy Scale was 25 (range: 8-40), with a mean score of 24.6 +/- 7.62. E-health literacy levels were significantly associated with age, educational level, time since diagnosis, and awareness of e-health and telerehabilitation concepts (p < .05), with lower scores observed among older women. In multivariable linear regression analysis, these sociodemographic and care-related factors jointly explained approximately 47% of the variance in e-health literacy levels. Overall, the findings indicate that women with breast cancer in Türkiye have limited awareness of e-health and telerehabilitation concepts, and that e-health literacy levels are significantly associated with age, educational level, time since diagnosis, and awareness of telerehabilitation. These results underscore the importance of developing targeted digital health education initiatives and awareness-based interventions to enhance e-health literacy and support equitable access to digital health services among breast cancer survivors.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: 5Citation - Scopus: 5The Association of Demographic, Psychological, Social and Activity Factors With Foot Health in People With Plantar Heel Pain(Wiley, 2024) Gulle, Halime; Morrissey, Dylan; Tayfur, Abdulhamit; Coskunsu, Dilber Karagozoglu; Miller, Stuart; Birn-Jeffery, Aleksandra V.; Prior, TrevorBackground: Plantar Heel Pain (PHP) can be a debilitating musculoskeletal condition from which only 50% recover within a year due to poor understanding of the mechanisms explaining severity and predicting outcomes specific to PHP. Objective: To explore associations between biopsychosocial variables and the severity of people with PHP. Secondly, to determine what combination of self-reported factors distinguishes people with PHP from other foot pain (OFP). Methods: We collected data from 235 participants, including 135 (%57) PHP (age 44 +/- 12 years, 66% female) and 99 OFP (%43) (age 38 +/- 11 years, 57% female) using 5 demographic, 13 biomedical, 8 psychological, 3 social and 8 activity-related factors. These were tested in linear and logistic regression models. Results: Quality of life (QoL) (beta = 0.35; p < 0.001), education (beta = -0.22; p = 0.003), gender (beta = -0.20; p = 0.007), morning pain duration (beta = -0.18; p = 0.01) and disease duration (beta = -0.15; p = 0.040) were significantly associated with severity of PHP. The second model, without QoL, showed that having sensitisation (beta = -0.18; p = 0.002) and a higher level of morning pain (beta = -0.20; p = 0.01) are associated with severity. The logistic regression results revealed that people with PHP tend to have a systemic disease (OR = 3.34; 1.53-7.76), express more kinesiophobia (OR = 1.02; 1.01-1.14), are less likely to have previous injuries (OR = 0.40; 0.19-0.81), worse morning pain (OR = 1.02; 1.01-1.03) and standing pain (OR = 2.60; 1.39-4.87) compared to people with OFP. Conclusions: People with PHP have higher associated levels of a range of psychological, social and activity related factors than people with OFP. The findings highlight the importance of considering psychosocial assessments alongside physical examination.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: 3Citation - Scopus: 4Effects of Manual Versus Instrumental Spinal Manipulation on Blood Flow of the Vertebral and Internal Carotid Arteries in Participants With Chronic Nonspecific Neck Pain: a Single-Blind, Randomized Study(Elsevier inc, 2023) Kocabey, Burcu; Coskunsu, Dilber Karagozoglu; Guven, Koray; Agaoglu, Mustafa H.; Yuce, Selvi; Karagözoğlu Coşkunsu, DilberObjective: The aim of this study was to compare the hemodynamic effects of manual spinal manipulation (MSM) and instrumental spinal manipulation (ISM) on the vertebral artery (VA) and internal carotid artery (ICA) in participants with chronic nonspecific neck pain (NNP). Methods: Thirty volunteers aged 20 to 40 years old with NNP over 3 months duration were included. Participants were randomly divided into the following 2 groups: (1) MSM group (n = 15) and (2) ISM group (n = 15). Ipsilateral (intervention side) and contralateral (opposite side of intervention) VAs and ICAs were evaluated using spectral color Doppler ultrasound before and immediately after manipulation. Measurements were recorded by visualizing the ICA carotid sinus (C4 level) and the VA at the V3 segment (C1-C2 level). The blood flow parameters of peak systolic velocity (PSV), end-diastolic velocity, resistive index, and volume flow (only for VA) were evaluated. The spinal segment, in which biomechanical aberrant movement was detected by palpation in the upper cervical spine, was manually manipulated in the MSM group. The same methodology was performed for the ISM group using an Activator V instrument (Activator Methods). Results: Intragroup analysis exhibited no statistically significant difference between the MSM and ISM groups in terms of PSV, end-diastolic velocity, resistive index of ipsilateral and contralateral ICA and VA, in addition to volume flow of both VAs preintervention and postintervention (P > .05). Within the intergroup analysis, there was a significant difference in ipsilateral ICA PSV (P = .031) (preintervention vs postintervention difference was -7.9 & PLUSMN; 17.2 cm/s [95% confidence interval, -17.4 to 1.6] in the ISM group and 8.7 & PLUSMN; 22.5 cm/s [95% confidence interval, -3.6 to 21.2]) in the MSM group (P < .05). Other parameters did not show any significant difference (P > .05). Conclusion: Manual and instrumental spinal manipulations applied to the upper cervical spine in participants with chronic NNP did not appear to alter blood flow parameters of the VAs and ICAs.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: 9Citation - Scopus: 7RELATIONSHIP OF DAILY TIME SPENT OUTDOORS WITH SLEEP QUALITY AND EMOTIONAL WELL-BEING AMONG COMMUNITY-DWELLING OLDER ADULTS DURING COVID-19 RESTRICTIONS(Gunes Kitabevi Ltd Sti, 2021) Sansal, Kenan Eren; Balci, Leyla Atas; Cinar, Fadime; Coskunsu, Dilber Karagozoglu; Tanriover, Sezin Hatice; Uluengin, Mehmet BenguIntroduction: Given the recent constraints imposed due to the ongoing COVID-19 pandemic and the importance of the daily light-dark cycle for entraining the human circadian system, it is possible to state that the elderly are likely to be at serious risk of experiencing sleep-related problems. Whilst reduced or limited time outdoors, and thus, exposure to diurnal bright light appear to be detrimental to sleep and emotional well-being in old age, further research is required to confirm this relationship. Materials and Method: To build on earlier work, a two-week study was conducted in a sample of 79 community-dwelling older adults recruited by using snowball sampling method. Throughout the study, the participants were allowed to be outdoors from 10.00 a.m. to 1.00 p.m. on weekdays. Whilst the participants were performing their daily habitual activities, they were asked to keep an activity diary and report on their sleep quality and emotional wellbeing using two questionnaires. Results: The results demonstrated that participants' daily time spent outdoors (49.13 minutes on average) positively correlated with their perceived sleep quality and emotional well-being at various - but significant - levels (p<0.05). Moreover, significant negative correlations were identified between participants' sleep quality and experienced emotional disturbances (p<0.001). Conclusion: Based on the research findings, it is reasonable to conclude that spending momentary periods outdoors may have adverse consequences for the elderly. To maintain a healthy sleep-wake cycle and alleviate related emotional problems in old age, increasing outdoor time and diurnal bright light exposure should be encouraged.