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 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: 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.