WoS İndeksli Yayınlar Koleksiyonu

Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6

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  • Article
    Effects of Combined Triflow, Deep Breathing and Coughing Exercises on Postoperative Pulmonary Function After Mitral Valve Replacement: A Randomized Controlled Trial
    (BMC, 2026) Akinci, Naile; Eren, Esra
    Background Postoperative pulmonary complications remain a major cause of morbidity after cardiac valve surgery. Although incentive spirometry (Triflow) is routinely used in postoperative care, evidence regarding the additional benefits of combining Triflow with deep breathing and coughing exercises remains limited. This study aimed to evaluate the effects of combined Triflow, deep breathing, and coughing exercises on postoperative pulmonary function in adult patients undergoing mitral valve replacement. Methods This randomized controlled, single-blind trial was conducted between May and August 2025 in a private hospital in Istanbul. A total of 60 adult patients undergoing mitral valve replacement were randomly allocated to an experimental group (n = 30) or a control group (n = 30) using simple randomization. The experimental group performed Triflow combined with deep breathing and coughing exercises, while the control group performed Triflow alone. Results Postoperative SpO(2) levels were significantly higher in the experimental group at T1 (p = 0.009; 95% CI: 0.46-3.14), T2 (p < 0.001; 95% CI: 1.57-3.43), and T3 (p < 0.001; 95% CI: 2.72-4.54). The FEV1/FVC ratio increased significantly in the experimental group compared with the control group at discharge (p < 0.001; 95% CI: 4.46-6.41). Respiratory rate was significantly higher in the experimental group at T1 (p < 0.001; 95% CI: 1.68-4.45), T2 (p < 0.001; 95% CI: 3.34-6.26), and T3 (p < 0.001; 95% CI: 5.23-8.37). Hematocrit levels were significantly lower in the experimental group at T1 (p = 0.039; 95% CI: -8.32 to - 0.24), T2 (p = 0.007; 95% CI: -8.29 to - 1.40), and T3 (p = 0.034; 95% CI: -6.54 to - 0.28). Pain scores were significantly lower in the experimental group at T1 (p < 0.001; 95% CI: -2.82 to - 1.71) and T2 (p < 0.001; 95% CI: -1.98 to - 1.08). Time to first mobilization was significantly shorter in the experimental group (p < 0.001; 95% CI: -2.94 to - 1.26). No postoperative pulmonary complications were observed in either group. Conclusion The combined application of Triflow, deep breathing, and coughing exercises was associated with significant improvements in postoperative pulmonary function, oxygen saturation, pain reduction, and earlier mobilization compared with Triflow alone in patients undergoing mitral valve replacement. These findings suggest that a structured, combined respiratory exercise protocol may provide additional clinical benefits in the early postoperative period.
  • 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 Karagozoglu
    Background 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.