WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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Article Effects of Left and Bilateral Transcutaneous Auricular Vagus Nerve Stimulation on Pain, Mood, and Autonomic Nervous System in Female Patients With Fibromyalgia: a Randomized Controlled Trial(Taylor & Francis Inc, 2025) Akkurt, Mustafa Ferit; Ozden, Ali Veysel; Akkurt, Halil Ekrem; Akkurt, Burcu; Bildik, CelaleddinIntroduction: Fibromyalgia Syndrome (FMS) is a complex disease characterized by widespread pain, fatigue, emotional disturbances, and autonomic dysfunction. Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) has emerged as a potential noninvasive approach to modulate FMS-related symptoms. Purpose: To compare the effects of left and bilateral taVNS on pain, mood, functionality, and autonomic nervous system (ANS) activity in individuals with FMS. Methods: Forty female individuals with FMS were assigned to either a left (n = 20) or a bilateral (n = 20) taVNS group. Both received 11 sessions of taVNS targeting the tragus and concha regions (30 minutes each, 25 Hz, 300 mu s) over nonconsecutive days, excluding weekends and menstrual periods. Visual Analog Scale (VAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Fibromyalgia Impact Questionnaire (FIQ) were assessed. ANS activity was evaluated via heart rate variability (HRV). After 11 sessions of taVNS, a 2-week follow-up was performed. Results: No significant differences were observed between groups except for FIQ and BAI on day 28 (p = .002-0.008). Both groups showed significant within-group improvements in VAS (r = 0.87-0.94; p < .001), BDI (r = 0.46-0.71; p < .001), FIQ (r = 0.95-0.99; p < .001), and BAI (r = 0.69-0.94; p < .001) scores. Parasympathetic Nervous System (PNS) (p = .365-0.776) and Sympathetic Nervous System (SNS) (p = .598-0.880) indices, which are the subparameters of HRV, showed no significant between-group differences, with small effect sizes (r < 0.15). Conclusion: Both stimulation protocols effectively reduced pain and improved mood and functionality in fibromyalgia, indicating a safe, noninvasive adjunctive treatment option. Clinicaltrials.gov: (Identifier: NCT06871306).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.
