Clinical trials

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.

Background: Motion sickness (MS) is a common syndrome characterized by autonomic and behavioral symptoms, such as nausea and dizziness, resulting from exposure to motion stimuli. Its pathophysiology is closely linked to sensory conflict and postural instability theories. While previous studies suggest that postural control, proprioception, and reaction times are affected in individuals susceptible to MS, there is a lack of comprehensive, comparative research evaluating all these parameters concurrently within the same cohort using standardized methods. Objective: This study aims to systematically measure balance, proprioceptive sensitivity, coordination, and reaction time parameters, and quantitatively analyze their relationship with motion sickness severity. Methodology: In this prospective, cross-sectional study, at least 41 participants aged 18-40 with motion sickness will be recruited. Participants will undergo motion sickness susceptibility and severity grading using the Motion Sickness Susceptibility Questionnaire Short Form (MSSQ-SF) and the Graybiel Scale. Objective assessments will include static and dynamic balance testing (ProKin®), knee joint position sense (Clinometer app), manual dexterity and dynamic balance coordination (Nine-Hole Peg Test, Tandem Walk, Romberg Test), and upper/lower extremity reaction time measurements (BlazePod system).

The purpose of this randomized controlled trial is to investigate the effects of core training and inspiratory muscle training (IMT) on muscle oxygenation and athletic performance in youth male soccer players aged 15-18. A total of 54 healthy soccer players will be included and randomly assigned into three equal groups: the Control Group, the Core Training Group, and the Core Training + IMT Group. All interventions will be implemented for 8 weeks in addition to routine soccer training sessions. Assessments will be performed at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8). The primary outcome measures of the study are aerobic capacity assessed by the Yo-Yo Intermittent Recovery Test Level 1 and muscle oxygenation parameters monitored via near-infrared spectroscopy (NIRS) using a MOXY monitor. Secondary outcome measures include sprint performance, agility, dynamic balance, core muscle strength and endurance, inspiratory muscle strength, lower extremity explosive power, and soccer-specific technical performance tests. Overall, this study aims to reveal the combined effects of core training and inspiratory muscle training on muscle oxygenation, respiratory functions, aerobic capacity, and soccer performance, while explaining the underlying physiological mechanisms in youth athletes.

This study aims to investigate the effectiveness of a specific regional anesthesia technique, the Modified-Thoracoabdominal Nerve Block through a Perichondrial Approach (M-TAPA), on reducing pain after laparoscopic hysterectomy surgery. Hysterectomy is a common major surgical procedure, and managing postoperative pain is crucial for patient comfort and faster recovery. Participants will be randomly assigned to one of two groups: The M-TAPA Group: Patients will receive the nerve block using a local anesthetic (bupivacaine) before the surgery begins. The Control Group: Patients will receive standard postoperative pain management without the nerve block. The primary goal is to determine if the M-TAPA block reduces the total amount of opioid (morphine) used by patients in the first 24 hours after surgery. The researchers will also evaluate pain scores (NRS), the time until the first request for additional pain medication, patient satisfaction, and any side effects like nausea or vomiting

Smoking remains a significant public health problem among the young adult population. Epidemiological studies in Turkey show a steadily decreasing age of smoking initiation and a remarkably high rate of smoking among university-aged individuals. Exposure to secondhand smoke is known to have negative effects on the respiratory system, cardiovascular system, and peripheral muscle function. Impaired lung ventilation, reduced gas exchange, and insufficient oxygen transport due to smoking can lead to decreased exercise tolerance, premature fatigue, and increased perception of exertional dyspnea. These effects can manifest as a decrease in functional capacity even before the development of a clinically significant respiratory disease. Functional capacity is an important indicator reflecting an individual's ability to perform daily living activities and is frequently assessed in clinical research using submaximal exercise tests. The 6-Minute Walk Test is a widely used, valid, and reliable test for assessing cardiorespiratory endurance and overall functional status. Similarly, the 1-Minute Sit-Stand Test is recommended as a practical and applicable method for evaluating lower extremity muscle endurance and functional performance. Dyspnea is a multidimensional symptom reflecting an individual's subjective perception of respiratory discomfort and is assessed using scales such as the Modified Medical Research Council and the Borg Dyspnea Scale. The Turkish Thoracic Society's dyspnea assessment reports indicate that exertional dyspnea may increase in smokers even if respiratory function tests are within normal limits. Fatigue, on the other hand, is a significant symptom that negatively affects an individual's daily living activities and physical functionality, arising from inflammatory processes, impaired oxygenation, and decreased physical activity levels associated with smoking. The Fatigue Severity Scale is a validated and reliable scale for assessing the impact of fatigue on an individual's physical and social life. While studies in the literature examine the effects of smoking on respiratory function and exercise capacity, studies that address the relationship between functional capacity and subjective dyspnea and fatigue in young adult smokers are limited. In particular, evaluating functional test results such as the 6-Minute Walk Test and the 1-Minute Sit-Stand Test together with dyspnea and fatigue perception will contribute to the early identification of subclinical functional effects. The aim of this study is to examine the relationships between functional capacity (6-Minute Walk Test, 1-Minute Sit-Stand Test, and Timed Up and Go Test) and subjective dyspnea (Modified Medical Research Council Scale - mMRC) and fatigue level (Fatigue Severity Scale) in young adult smokers aged 18-30 years. The findings of this study are expected to draw attention to the functional effects of smoking in young adults, contribute to the development of preventive health approaches, and facilitate the planning of physiotherapy-based assessment and intervention programs.

With the expansion of technology-based applications, daily phone use has increased significantly. According to a 2020 study, phone use habits among young adults aged 18-34 increased by 38.1%, and the time spent on the phone exceeding one hour increased by 68%. Currently, there is no clear definition of smartphone "addiction" or smartphone use, but like other types of addiction, it refers to the effort to control smartphone habits that cause problems or distress in daily life. Recent studies have reported a correlation between excessive screen use and individuals' mental and physical health. Excessive use of phones and video games causes many negative effects, including attention deficit, inability to enjoy life, hyperactivity, depression, anxiety, pain, and functional loss. Video games are a type of game played through an audiovisual device and can be story-based. While many video games improve players' critical thinking, strategic planning, and problem-solving skills, they can also cause musculoskeletal problems due to the long hours spent at the desk and the repetitive movements involved. The human spine is a kinematic chain with all joints interconnected; this means that changes in other body parts, such as the increased head tilt while texting on a smartphone, can have significant effects on the entire spine. A 2023 study showed an increase in spinal curvature, particularly in the cervical region, as smartphone use time increased. A study in Korea linked smartphone use to increased pain in the neck, wrists, hands, shoulders, and back. Another significant problem for smartphone users and video game players is "text neck," which occurs from prolonged screen time. This causes tension in the cervical spine, leading to neck pain and stiffness. Smartphone addiction leads to hand-related problems, primarily hand and wrist pain. Furthermore, excessive use of smartphones, game controllers, and joysticks can lead to repetitive strain injuries such as carpal tunnel syndrome. Prolonged phone use, repetitive movements, and uncomfortable hand positions during use cause inflammation of the muscles and tendons in the hands and wrists, leading to swelling, pain, and loss of function in these joints. Video games are played using devices such as computers, consoles, handheld computers, and smartphones. The continuous, repetitive, and uninterrupted movements performed while using these devices can lead to musculoskeletal disorders, particularly in the upper extremities. Prolonged playing of these games results in musculoskeletal problems such as carpal tunnel syndrome and tendinitis. Extensive studies have shown that individuals' pain and symptoms worsen after prolonged gaming sessions. However, to date, there has been no study comparing smartphone addicts and video game players. The aim of this research is to compare individuals with smartphone addiction, those who play video games for extended periods, and those without these habits in terms of pain, posture, and upper extremity function.

This prospective observational study aims to investigate the relationship between respiratory function and multidimensional athletic performance parameters in professional soccer players. The primary hypothesis of the study is that soccer players with enhanced respiratory function and superior respiratory muscle strength will exhibit optimized motor performance outcomes and shorter (faster) reactive reaction times. Investigators will evaluate respiratory muscle strength, spirometric pulmonary functions, dynamic balance, core and abdominal endurance, and reactive visuomotor reaction times during a single testing session within the competitive season.

Low back pain is one of the most prevalent musculoskeletal disorders worldwide and significantly reduces individuals' quality of life, functional capacity, and productivity. Lumbar-related leg pain (LRLP) is observed in a substantial proportion of patients with low back pain and is associated with neurodynamic dysfunctions arising from peripheral nerve sensitization. Although the effects of neural mobilization on pain and functional outcomes have been investigated in the literature, studies examining its short-term effects on balance and proprioception remain limited. Therefore, this study aims to determine the immediate effects of sciatic nerve neural mobilization on balance and proprioception in individuals with LRLP exhibiting peripheral nerve sensitivity. The study will be designed as a prospective, randomized, controlled clinical trial. Participants will be recruited from individuals presenting to the Istinye University Health Practice and Research Center Hospital who meet the inclusion criteria. Following random allocation, 52 participants will be assigned either to the intervention group (neural mobilization) or the sham group (sham mobilization). In addition to a single-session standard conventional physiotherapy program, each group will receive its respective intervention protocol. Assessments will be conducted at two time points: before treatment and immediately after treatment. Static and dynamic balance as well as proprioception will be evaluated using the ProKin balance system; muscle mechanical properties will be assessed using the MyotonPRO device; pain threshold will be measured with an algometer; and flexibility will be evaluated using the sit-and-reach test.

This study aims to compare core muscle stability, postural balance, and flexibility between healthy women who regularly practice Pilates and those with a sedentary lifestyle. The researcher will evaluate if long-term Pilates practice (5 months or more) leads to significant improvements in physical performance compared to a lack of regular exercise. Assessment tools include the Pressure Biofeedback Unit (PBU) for core activation, the McGill battery for endurance, the Y-Balance test for dynamic stability, and the Sit-and-Reach test for flexibility.