Clinical trials

Asthma and COPD are significant respiratory diseases that can coexist, referred to as Asthma-COPD Overlap Syndrome (ACOS). Patients with ACOS experience more severe clinical outcomes, including rapid decline in lung function, increased symptom burden, and reduced quality of life. Pulmonary rehabilitation-particularly breathing exercises-is a core non-pharmacological intervention recommended for this patient group. In recent years, video game-based applications have emerged as innovative tools that enhance motivation and participation in exercise programs. However, studies investigating the effects of video game-based breathing exercises in ACOS patients are extremely limited. Additionally, although dysfunctional breathing patterns are common in this group, few studies have addressed targeted interventions. The objective of the present study is to evaluate the effects of video game-based breathing exercises on dysfunctional breathing in ACOS patients.

This study aims to examine whether the posture of the upper back (thoracic kyphosis) is related to body awareness, core stability, and balance in people who regularly participate in weightlifting. Participants will undergo assessments of thoracic posture, proprioception, core stability, and dynamic balance. The study will also compare these measurements between different groups of weightlifting athletes.

The diaphragm contributes to both respiration and trunk stabilization. Effective diaphragmatic function may support postural control, force transfer, and upper extremity performance during dynamic activities. However, evidence regarding the immediate effects of manual diaphragmatic facilitation on upper extremity performance in athletes remains limited. This study aims to investigate the immediate effects of manual diaphragmatic facilitation on upper extremity performance and respiratory function in actively participating volleyball players. Participants will receive an approximately 15-minute session of manual diaphragmatic facilitation. Pulmonary function, respiratory muscle strength, and upper extremity strength, stability, and endurance will be assessed immediately before and after the intervention. Assessments will include spirometry, maximal inspiratory and expiratory pressures, the Medicine Ball Throw Test, the Closed Kinetic Chain Upper Extremity Stability Test, and the Scapular Endurance Test.

Eye and hand dominance may influence visuomotor coordination, motor control, and upper extremity performance in athletes. Crossed eye-hand dominance occurs when the dominant eye and dominant hand are located on opposite sides of the body. However, evidence regarding the relationship between crossed eye-hand dominance and upper extremity performance in volleyball players remains limited. This observational cross-sectional study aims to compare upper extremity muscle strength and motor performance between volleyball players with and without crossed eye-hand dominance. Participants' eye and hand dominance will be determined using standardized assessments. Upper extremity muscle strength and motor performance outcomes will then be measured and compared between the two groups.

Polyendocrine Metabolic Ovarian Syndrome (PMOS) is a common endocrine and metabolic disorder associated with insulin resistance, hyperandrogenism, and an increased risk of long-term metabolic complications. Fetuin-A and resistin are adipokines implicated in insulin resistance and chronic inflammation and may serve as potential biomarkers for metabolic dysfunction in women with PMOS. This prospective observational case-control study aims to compare serum and salivary Fetuin-A and resistin levels between women with PMOS and healthy controls. The study will evaluate the correlation between serum and salivary biomarker concentrations and investigate their associations with insulin resistance, lipid profile, and hormonal parameters. The findings may help determine whether salivary measurements can serve as reliable non-invasive biomarkers for the diagnosis and metabolic assessment of PMOS.

We will structure the study's summary to provide a clear and accessible overview for patients, families, and healthcare providers. The research will examine young adult cigarette smokers aged 18 to 24 to estimate the prevalence of a dysfunctional breathing-compatible symptom pattern using the Nijmegen Questionnaire. Furthermore, the study will assess how nicotine dependence severity-measured via the Fagerström Test for Nicotine Dependence-and physical activity levels-assessed using the International Physical Activity Questionnaire-relate to this symptom burden. We will recruit participants through social media announcements and conduct face-to-face evaluations at Istinye University. The project will employ hierarchical linear and binary logistic regression models, adjusting for age, sex, and body mass index, to determine independent predictors of dysfunctional breathing. Ultimately, the findings will provide valuable insights into the combined impacts of smoking severity and physical activity on respiratory health in young adults.

This study will investigate the effects of hyperventilation syndrome on respiratory muscle strength, respiratory muscle endurance, pulmonary functions, and functional capacity in individuals living with stroke, and in this context, stroke patients with and without hyperventilation syndrome based on Nijmegen Questionnaire scores will be compared to evaluate the relationship between symptom burden and respiratory parameters.

Archery is a sport that demands sport-specific motor performance, emphasizing fine motor control, postural stability, balance, and concentration skills. Athletes aim to deliver the arrow to the target by ensuring maximum stability with minimal body movement during shooting. While muscle strength, upper extremity endurance, and overall body stability are among the primary factors influencing performance, many other parameters also determine shooting success. Studies investigating muscle activity in archery have demonstrated that the primary muscle groups involved in shooting are the scapular muscles, shoulder girdle muscles, and forearm muscles. These muscles are activated at varying levels to facilitate target focus and play an active role in shooting by contributing to postural and scapular stabilization. Additionally, core muscles enhance movement capacity by centrally stabilizing the body during motion. Activation of pelvic-region muscles, in particular, contributes to improved balance skills, thereby making a meaningful impact on performance. Archers are expected to maintain stability by minimizing movement during shooting and to rapidly adapt to postural instability that may arise during aiming. Every involuntary movement decreases stability and makes it harder to hit the center of the target. In this context, executing motor actions with high precision and developing adaptive responses to postural instability are of great importance. One of the core components of the balance system-the visual system-also significantly affects performance. During postural sway, visual stabilization plays a critical role; as the distance to the target increases, displacements on the retina become larger, making visual focusing more challenging. Moreover, to make the shooting decision at the right moment, it is essential to maintain visual concentration effectively. In this project, while no intervention will be applied to the control group, archers using classical bows in the exercise group will participate in a six-week neuroscience-based exercise program. The program includes scapular and core stabilization, balance training, gaze stabilization, and NeuroTracker training. This six-week program is designed to be progressive and holistic, and its effects will be investigated. Muscle activity will be analyzed through EMG, postural sway will be assessed using the ProKin TecnoBody 252 stabilometric platform, clinical upper extremity balance will be evaluated with the Y Balance Test, eye tracking will be measured using the Pupil headset (Pupil Labs), and spinal stabilization endurance will be assessed through the Biering-Sorensen Test, Lateral Bridge Test, and the Step Test. Shooting performance will be evaluated based on target paper scores. Statistical analyses will be performed using IBM SPSS version 28. Both descriptive and inferential statistical methods will be utilized. Within the scope of descriptive statistics, participants' demographic characteristics and other key variables will be summarized using mean (X̄), standard deviation (SD), frequency (n), and percentage (%). The findings will be evaluated at a significance level of p\<0.05. The study will include a comprehensive analysis using objective measurement methods. In the literature, no previous study has approached neuroscience-based exercise interventions for archers in such a comprehensive and multidimensional manner. This project aims not only to enhance athletic performance but also to prevent shoulder, scapular, and upper extremity injuries that may result from repetitive shooting movements. This research will be one of the first comprehensive studies to address balance, muscle activity, and cognitive performance in archery holistically, offering an original and scientifically valuable contribution to the sports science literature.

This study aims to compare the effects of Dynamic Neuromuscular Stabilization (DNS) exercises delivered face-to-face (YDNS) and via tele-rehabilitation (TDNS) on respiratory function, balance, posture, core endurance, and deep stabilization system performance in healthy adults. A total of 34 participants will be randomly assigned to YDNS or TDNS groups and complete an identical 6-week DNS exercise program (3 sessions per week). Assessments will be conducted at baseline and post-intervention, including pulmonary function, Y-Balance Test, posture analysis, McGill's core stability tests, deep stabilization assessment, and patient satisfaction. All evaluations will be performed face-to-face by certified physiotherapists.

Purpose: This study aims to compare the effects of the classical pulmonary rehabilitation (PR) program and blood flow restriction (BFR) applied during low-intensity aerobic exercise within PR on systemic inflammation, hypoxemia, exercise capacity, pulmonary function, respiratory muscle strength, and quality-of-life parameters in individuals with COPD. Methods: This randomized controlled study will include 34 individuals with COPD, allocated into a BFR aerobic group and a control group. Both groups will receive core PR components, including diaphragmatic breathing, pursed-lip breathing, respiratory muscle training, and peripheral muscle strengthening. The BFR group will perform low-intensity aerobic exercise with blood flow restriction, while the control group will perform moderate-intensity aerobic exercise without BFR in accordance with standard PR protocols. All sessions will be supervised by a physiotherapist, twice per week, for eight weeks. Systemic inflammation markers, arterial blood gases, pulmonary function, exercise capacity, quality of life, and symptom scores will be assessed before PR, after the 8th session, and at the end of the program. Data will be analyzed using SPSS 26.0. Expected Contribution: This study aims to provide evidence-based insights into the physiological and clinical effects of low-intensity BFR aerobic exercise within PR and to determine its potential advantages compared with classical PR. Additionally, it seeks to clarify whether low-intensity BFR aerobic exercise may serve as a better-tolerated alternative for COPD patients who experience exercise intolerance during moderate-intensity aerobic training.

The goal of this clinical trial is to learn if a structured motivational interviewing program based on the Five-Step (5A) model works to promote healthy lifestyle behaviors in individuals at high risk of obesity. It will also learn about the effects on anthropometric measurements and physical activity levels. The main questions it aims to answer are: * Does this structured program promote healthy lifestyle behaviors in individuals at high risk of obesity? * To what extent does it increase participants' intrinsic motivation and readiness for behavioral change? Participants will: * Attend structured interview sessions throughout the designated process * Visit the clinic at regular intervals for follow-up and evaluations * Record their lifestyle changes, physical activity levels, and experiences throughout the process

This prospective observational study aims to evaluate the diagnostic performance of the preoperative Diastolic Shock Index in predicting postspinal hypotension and to compare its performance with other shock indices, including the Shock Index, Modified Shock Index, and Age Shock Index. The study will include patients aged 50 years and older undergoing elective unilateral inguinal hernia surgery under spinal anesthesia. Hemodynamic parameters will be recorded before and after spinal anesthesia as part of routine clinical monitoring. The primary outcome is the development of postspinal hypotension. Secondary outcomes include vasopressor requirement, total ephedrine dose, lowest intraoperative mean arterial pressure, and the diagnostic performance of the evaluated shock indices using receiver operating characteristic curve analysis. No additional intervention beyond routine anesthetic and perioperative care will be performed for study purposes.

Lumbar disc herniation is one of the most common causes of low back pain and is associated with substantial functional limitations and reduced quality of life, particularly among working-age individuals. Displacement of disc material toward the spinal canal may result in mechanical compression and inflammation of the nerve roots, leading to pain, restricted movement, and reduced functional performance. The course of low back pain cannot be explained solely by biomechanical and anatomical factors. Psychosocial factors also play an important role in symptom persistence and functional outcomes. Within this context, the fear-avoidance model provides an important theoretical framework, suggesting that individuals may develop fear of movement and avoid physical activities because they believe these activities may increase pain or cause further injury. Over time, avoidance behaviors may contribute to physical deconditioning, reduced muscle function, and increased functional impairment. The Fear-Avoidance Beliefs Questionnaire is commonly used to assess individuals' beliefs regarding the relationship between pain, physical activity, and work-related activities. Higher levels of fear-avoidance beliefs have been associated with greater pain severity, increased disability, and poorer physical performance in individuals with low back pain. Trunk muscle endurance plays a key role in maintaining spinal stability. Adequate endurance of the paraspinal and abdominal muscles supports mechanical stability of the spine and contributes to the safe performance of functional movements. The Biering-Sørensen Test and plank test are commonly used to assess trunk muscle endurance in clinical and research settings. The Biering-Sørensen Test evaluates the endurance of the trunk extensor muscles, whereas plank-based tests assess the endurance of the anterior and lateral trunk musculature. Functional impairment in individuals with low back pain can be evaluated using the Oswestry Disability Index, a self-reported questionnaire that assesses limitations experienced during activities of daily living. Functional mobility and performance may also be evaluated using the Timed Up and Go test, which involves standing up from a chair, walking a short distance, turning, returning to the chair, and sitting down. This test reflects mobility, dynamic balance, and functional performance during daily activities. Postural control and balance may also be affected in individuals with low back pain. Reduced static balance performance can negatively influence functional activities and mobility. The Single-Leg Stance Test is a practical clinical measure used to assess postural stability and static balance. Although previous studies have examined associations between psychosocial factors and functional status in individuals with low back pain, studies evaluating the relationship between fear-avoidance beliefs, trunk muscle endurance, balance, and functional performance together remain limited. Identifying these relationships may contribute to the development of more comprehensive rehabilitation programs for individuals with lumbar disc herniation.

This study will investigate the effects of dual-task-based high-amplitude functional exercises on balance and functional mobility in older adults with mild cognitive impairment. A total of 36 participants aged 65 years and older will be randomly assigned to either a high-amplitude functional exercise group or a traditional balance and mobility exercise group. Both groups will participate in exercise sessions four times per week for four weeks, with each session lasting 60 minutes. The effects of the exercise programs will be evaluated by assessing balance, functional mobility, dual-task performance, walking performance, fear of falling, and independence in daily activities before and after the intervention.

This study aims to investigate the short-term effects of adding core stabilization exercises to Barcelona Scoliosis Physical Therapy School (BSPTS) exercises in adolescents with idiopathic scoliosis. Participants will be randomly assigned to either a BSPTS exercise group or a BSPTS plus core stabilization exercise group. Both groups will participate in supervised exercise sessions twice a week for 6 weeks. The study will evaluate changes in trunk rotation angle and core muscle endurance as the primary outcomes, as well as dynamic balance, spinal appearance perception, postural awareness, and scoliosis-related quality of life.

This study aims to investigate the immediate effects of dual-task neuromuscular warm-up exercises on balance and proprioception in individuals with chronic nonspecific low back pain. Participants will be randomly assigned to either a dual-task neuromuscular warm-up exercise group or a neuromuscular warm-up exercise group. Both groups will also receive the same conventional physiotherapy program. Balance, proprioception, lumbar muscle properties, pressure pain threshold, and flexibility will be assessed before and after the intervention to determine whether adding cognitive tasks to neuromuscular warm-up exercises provides additional immediate benefits.

This study aims to culturally adapt the Pictorial Pain Interference Questionnaire into Turkish and evaluate its psychometric properties in individuals with chronic pain. The study will assess the validity and reliability of the Turkish version for evaluating the functional impact of chronic pain on daily life activities. Reliability will be examined through internal consistency and test-retest reliability, while validity will be assessed by examining the relationships between the questionnaire and established pain-related assessment tools. The study will determine whether the Turkish version provides a valid, reliable, and practical instrument for assessing functional interference associated with chronic pain in Turkish-speaking individuals.

The smartphone application named PhysioMaster is an easy-to-use, accessible, and freely available application. Although it has been used in several previous studies, no validity or reliability study has yet been conducted in patients with stroke. Therefore, the aim of this study is to investigate the validity and reliability of the PhysioMaster smartphone application in patients with stroke. Accordingly, our hypotheses are as follows: * H0: The PhysioMaster application is not a valid and reliable measurement tool for the assessment of posture and range of motion in patients with stroke. * H1: The PhysioMaster application is a valid and reliable measurement tool for the assessment of posture and range of motion in patients with stroke. Participants will not take any intervention. Participants will be evaluated in terms of posture and range of motion by using PhysioMaster, Universal Goniometer and PostureScreen Mobile. During the first-day assessment, physiotherapists A and B will complete both the PhysioMaster application assessments and all other evaluations on the same patient without seeing each other's assessment scores. In order to evaluate the test-retest reliability of the application, physiotherapist A will repeat the assessments on Physiomaster on the same patient after 3 days.

The aim of the study is to reduce postoperative pain by performing rectointercostal block in L/S cholecystectomy surgeries. Main goal is to provide well managed post-operative analgesia.

This study aims to evaluate the effect of the OPUCARE system, a structured mobile health application used before oocyte pick-up (OPU), on medication adherence and quality of life in infertile women. The study will also examine the possible effect of the intervention on state anxiety. Participants will be randomly assigned to either the intervention group or the control group. The intervention group will receive routine clinical care plus the OPUCARE system. The control group will receive routine clinical care and standard written and verbal information provided by the clinic, without mobile health application support. The intervention period will last approximately 2 weeks, from the start of medication treatment until oocyte pick-up. Medication adherence, quality of life, and state anxiety will be assessed before and after the intervention period.

This randomized trial aims to compare the effectiveness of two digital educational approaches for perinatal grief counseling training among midwives and nurses working in perinatal care settings in Türkiye: a social media-based education program delivered through Instagram and an online education program delivered through Zoom. Both groups will receive the same six-module perinatal grief counseling education content, but through different delivery methods. Participants will be randomly assigned to one of the two study groups. Outcomes will be assessed before the intervention, immediately after completion of the 6-week training program, and 4 weeks after the intervention. The study will evaluate changes in participants' competency and confidence in providing perinatal grief care and compare the sustainability of learning outcomes between the two digital education models.

Forward Head Posture (FHP) is a common postural dysfunction characterized by the anterior displacement of the head relative to the shoulders, leading to cervical spine misalignment, increased muscle strain, and neck pain. It is highly prevalent in university students (63-66%), largely due to prolonged sedentary behaviors and the use of smartphones, laptops, and tablets in poor ergonomic postures . This randomized controlled trial aims to evaluate the effectiveness of three intervention strategies for managing FHP in university students: Dynamic Neuromuscular Stabilization (DNS) Breathing + Conventional Exercises: DNS breathing will emphasize diaphragmatic activation and postural stabilization, combined with stretching, strengthening, and postural education. Myofascial Release (MFR) + Conventional Exercises: Suboccipital MFR to release fascial tension, combined with the same conventional exercise program. Conventional Exercises Alone (Control Group): A standard rehabilitation protocol of stretching, strengthening, and postural correction. All interventions will be delivered three times per week for six weeks, with each session lasting 45 minutes. Assessments will be conducted at baseline, week 4, and week 6: Craniovertebral Angle (CVA) and Forward Shoulder Angle (FSA) measured using smartphone photographic analysis. Wall Test to assess forward head and rounded shoulder posture. Visual Analog Scale (VAS) to measure subjective pain intensity. SF-36 Health Survey to evaluate quality of life across eight health domains. The study will compare the relative effectiveness of DNS breathing and MFR, each combined with conventional therapy, against conventional therapy alone. Findings are expected to contribute to evidence-based postural rehabilitation, particularly for young adults with sedentary lifestyles.

This study aims to investigate the relationship between cervical position sense, core stabilization, and postural balance in university students aged 18-30 years with Upper Crossed Syndrome (UCS). Upper Crossed Syndrome is a common musculoskeletal disorder characterized by muscle imbalance, including weakness of the deep cervical flexors, middle and lower trapezius, rhomboids, and serratus anterior, along with tightness of the upper trapezius, levator scapulae, sternocleidomastoid, and pectoralis major and minor. This condition frequently affects university students due to prolonged sitting, extensive computer use, and poor posture. While previous research has focused on discrete components of UCS such as posture correction or pain management, the combined effects of cervical proprioception, core stability, and postural balance remain poorly understood. A total of 48 participants will be enrolled and divided into two equal groups: 24 students diagnosed with Upper Crossed Syndrome and 24 healthy students as a control group. Assessments include cervical joint position error testing, core stabilization endurance tests (Unilateral Hip Bridge Endurance Test and Sahrmann Five-Level Core Stability Test), static balance evaluation using the Balance Error Scoring System (BESS), and dynamic balance assessment using the Y-Balance Test. Pain intensity will be measured using the Visual Analog Scale (VAS). This study will help identify neuromuscular and sensory mechanisms underlying these parameters and support evidence-based rehabilitation techniques to improve postural alignment, reduce musculoskeletal dysfunction, and enhance overall functional performance in this population.

This study is evaluating whether the timing of an interscalene nerve block affects pain control and recovery after arthroscopic rotator cuff repair surgery. An interscalene block is commonly used to reduce pain after shoulder surgery. However, it is not known whether administering the block before surgery or after surgery provides better outcomes. Participants undergoing arthroscopic rotator cuff repair are assigned to receive the interscalene block either before the surgical incision or after completion of the procedure. The study compares postoperative pain levels, opioid medication use, length of hospital stay, and ultrasound imaging quality during block administration between the two groups. Functional recovery is also assessed using patient-reported outcome measures during follow-up. The investigators hypothesize that administration of the interscalene block before surgery may provide superior early pain control and reduce postoperative opioid requirements while maintaining similar functional outcomes compared with administration after surgery.

This study aims to examine the associations of interoceptive awareness and interoceptive accuracy with plantar superficial sensory threshold, knee joint proprioception, pain intensity, and dynamic balance performance in cognitively intact individuals with chronic hemiplegia. Hypotheses are: * H0: There is no significant relationship between interoception and light touch, proprioception, pain, or dynamic balance performance in cognitively intact individuals with chronic hemiplegia. * H1: There is a significant relationship between interoception and light touch, proprioception, pain, or dynamic balance performance in cognitively intact individuals with chronic hemiplegia All participants will undergo a single assessment session and will not be invited for any treatment or follow-up evaluation. Participants will not take any intervention.