Clinical trials

The effects of single dose injection of platelet rich plasma or conditioned serum in the knee joint in patients with knee osteoarthritis will be compared

The purpose of this study is to compare the effects of manual therapy and a multicomponent exercise program on suboccipital muscle thickness, joint position sense, pain, central sensitization, balance, and kinesiophobia in patients diagnosed with cervicogenic headache. Cervicogenic headache is a common secondary headache originating from dysfunction in the upper cervical spine. Dysfunction in the deep neck muscles, impaired neck joint awareness, and heightened pain sensitivity (central sensitization) are frequently observed in these patients. While both manual therapy and targeted exercise are used in physiotherapy practice, evidence regarding their direct comparative effects on suboccipital muscle morphology and somatosensory parameters remains limited. Participants will be randomly assigned to one of two treatment groups for a duration of 4 weeks (12 sessions total): 1. Manual Therapy Group: Receives joint mobilization, myofascial release, trigger point release, and suboccipital distraction targeting the cervical region. 2. Multicomponent Exercise Group: Receives deep cervical flexor strengthening, cervical proprioception training, head-eye coordination training, and progressive balance exercises. The main questions the study aims to answer are: * Do manual therapy and multicomponent exercise improve suboccipital muscle thickness and cervical joint position sense in patients with cervicogenic headache? * Is there a significant difference between manual therapy and multicomponent exercise in reducing pain intensity, central sensitization, disability, and fear of movement (kinesiophobia)? It is hypothesized that both intervention protocols will yield significant clinical improvements, with specific synergistic adaptations in muscle structure, somatosensory system processing, and pain-related fear.

This randomized crossover trial will investigate the acute effects of five passive recovery interventions following a standardized high-intensity cycling exercise protocol. Participants will complete the standardized high-intensity cycling exercise protocol during five separate study sessions. Immediately after each exercise session, participants will receive one of five recovery interventions: compression therapy, vacuum therapy, kinesiology taping, passive rest, or classical massage. The order of the interventions will be randomized according to a balanced crossover sequence. Each participant will experience all five recovery interventions during the study period. Outcomes related to post-exercise recovery will be assessed across intervention periods.

Urinary incontinence (UI) after radical prostatectomy (RP) is a common postoperative complication that significantly affects quality of life. This study aims to evaluate the efficacy of active transcutaneous tibial nerve stimulation (TTNS), added to standard pelvic floor muscle training (PFMT), compared with sham TTNS, in patients with UI after RP. The study uses a randomized, double-blind, sham-controlled design. The primary outcome is incontinence severity measured by the 24-hour pad test. Secondary outcomes include voiding diary parameters, pelvic floor muscle strength (perineometry), quality of life, sexual function, and anxiety/depression levels.

Purpose of the Study: Regular physical activity is key in managing overweight and obesity, but keeping up with a program can be challenging. The main purpose of this study is to compare how well women with overweight or obesity stick to (adhere to) a 10-week dance-based exercise program versus a clinical Pilates program. The study also aims to explore how enjoyable, acceptable, and tolerable both programs are, and how they affect participants' quality of life, physical activity levels, body measurements, and physical performance. What the Study Involves: Female volunteers aged 18 to 60 with a body mass index (BMI) between 25 and 35 kg/m² will be randomly assigned to one of two groups: 1. Dance-Based Exercise Group: Participants will join group dance sessions designed with low-impact, rhythmic movements to avoid joint strain. 2. Clinical Pilates Group: Participants will join group Pilates sessions on mats, focusing on core stability, posture, breathing, and muscle control. Both programs will run for 10 weeks, with face-to-face sessions held twice a week for about 45 to 60 minutes under the supervision of a physiotherapist. Participants will be evaluated before starting the exercise programs and immediately after completing the 10-week intervention.

This study will compare two regulation-based approaches in women with overweight or obesity. The first approach is a body-based regulation program including breathing awareness, body-awareness-based yoga practices, non-invasive manual auricular stimulation, and restorative relaxation. The second approach is a mind-based regulation program including structured psychoeducation and cognitive-emotional awareness activities focused on stress, emotions, automatic thoughts, and emotional eating. Participants will be women aged 18 to 60 years with a body mass index between 27.0 and 39.9 kg/m². Eligible participants will be randomly assigned to one of the two intervention groups. Both programs will last 8 weeks. The main aim of the study is to examine and compare the preliminary effects of these two approaches on heart rate variability, especially RMSSD, which is an indicator of cardiac vagal regulation. The study will also assess emotional eating, self-compassion, mindfulness, body measurements, body composition, adherence to the program, and possible adverse events. Assessments will be performed at baseline and after the 8-week intervention by an evaluator who is blinded to group allocation.

The investigators conducted a prospective, randomized double-blind, placebo-controlled study based on a placebo technique to evaluate the efficacy of IVES vs perineal ES in women with idiopathic OAB. The main questions aimed to be answered are: Is Intravaginal Electrical Stimulation (IVES) or perineal ES more effective on clinical parameters related to incontinence and quality of life in women with idiopathic overactive bladder (OAB)? Participants (n:63) with idiopathic OAB who meet the exclusion and inclusion criteria will be divided into 3 groups using a randomization table. The first group will receive IVES and bladder training (n:21), second group will receive perineal ES and bladder training (n:21) and third group will receive bladder training (n=21) . Measurements will be performed twice in total, before and at the end of treatment (8th week).

Fibrosis due to surgical trauma is a common problem with cochlear implants. Fibrosis limits the effectiveness of implant and increases the power consumption. Our aim in this study is to benefit from the anti-inflammatory effects of autologous platelet-rich fibrin to reducing the fibrotic cascade.

Lower extremity strength, explosive power, dynamic balance, and functional range of motion are critical determinants of athletic performance and injury prevention in soccer (football). While plyometric training is widely used to improve these qualities, the comparative effects of bodyweight plyometric training versus externally loaded plyometric training, and the maintenance of these effects during detraining periods, remain unclear. This study aims to investigate the effects of two different plyometric training methods on athletic performance and subsequent detraining processes in young female soccer players. Participants will be randomly assigned to three groups: Bodyweight Plyometric Training Group (BW-PT), External Loading Plyometric Training Group (EL-PT, who will wear vests weighing 10% of their body weight), and Control Group (CG, who will only continue with routine soccer training). Training interventions will be conducted for 6 weeks, immediately followed by a 4-week detraining period. To comprehensively assess athletic performance, the following measurements will be taken at baseline (pre-test), immediately after the training period (post-test), and after the detraining period (maintenance test): Isokinetic muscle strength of knee extensors and flexors (peak torque and force development rate at 60°/s and 120°/s), Jumping performance (standing long jump, vertical jump height, and 15-second repeated jump test), Functional range of motion (via Functional Movement Screen - FMS), Dynamic balance (via Y-Balance Test). The primary objective is to determine which plyometric loading strategy, compared to traditional soccer training, provides superior and longer-lasting physiological and biomechanical adaptations in young female athletes.

Neurogenic bowel dysfunction is a common complication of spinal cord injury and may cause constipation, difficulty with defecation, prolonged bowel care, incomplete evacuation, fecal incontinence, and reduced quality of life. This randomized controlled trial aims to evaluate the effectiveness of Kinesio Taping added to a routine bowel management program in adults with spinal cord injury and upper motor neuron-type neurogenic bowel dysfunction. Thirty participants will be randomly assigned to one of two parallel groups. The control group will receive a routine bowel management program, while the intervention group will receive Kinesio Taping in addition to the routine bowel management program. Kinesio Taping will be applied to the lower abdominal and lumbosacral regions three times per week for 4 weeks. The primary outcome will be defecation frequency recorded using a 7-day bowel diary. Secondary outcomes will include stool consistency, defecation duration, perceived constipation severity, neurogenic bowel dysfunction severity, and health-related quality of life. Assessments will be performed before and after the 4-week intervention.

Diabetes Mellitus (DM) is a chronic metabolic disease characterized by hyperglycemia, which occurs in insulin deficiency or when the body cannot effectively use the insulin produced. Moreover, according to the "Global Report on Diabetes" data published by the World Health Organization (WHO) in 2016, it is an important public health problem, one of the four priority non-communicable diseases (1, 2). In addition to the high mortality rates caused by complications due to DM, it is also known that it can cause low quality of life and many other additional problems in individuals. Possible complications are chronic and serious problems such as heart attack, risk of stroke, kidney failure, vision loss and nerve damage. One of the most common and most disabling complications is neuropathy. It should also be noted that approximately half of diabetic neuropathy is asymptomatic and patients diagnosed with DM may have neuropathy due to causes other than diabetes (2). These complications and damage that DM can cause can lead to decreased blood flow combined with neuropathy; As a result, foot ulcers and infections may occur; Amputation rates may increase. In addition to such additional complications that diabetic neuropathy may cause, due to all these; Loss of protective plantar sensation may also occur (3). This loss of protective sensation may lead to cutaneous deficits in the lower extremities, loss of muscle strength and reflexes, and gait and balance disorders (4). The mechanism that makes an important contribution to functional joint stability and the continuity of this stability, along with the feedback mechanisms required to ensure neuromuscular control, is proprioception, which includes joint movement (kinesthesia) and joint position sense (EPH) and is a subunit of the somatosensory system (5-7). . Rehabilitation with various injuries and other clinical conditions; Clinical studies to determine its effects on joint proprioception, neuromuscular control and balance have mostly focused on knee and ankle joints (5). The main reason for this can be attributed to the great importance of the knee and ankle joints in the lower extremities in maintaining general body kinematics and balance (8). Additionally, it has been reported in the literature that EPH and plantar sensory loss are observed in individuals diagnosed with DM, and these complications may cause additional problems (10, 12, 18-22). Additionally, many studies in the literature on this subject have been conducted in individuals with diabetic neuropathy, and changes in functional parameters such as plantar sensation, proprioception, muscle strength and balance have been examined (10, 19, 20, 22, 23). However, it has been found that not only individuals with neuropathy but also individuals diagnosed with DM without neuropathy have balance disorders (24). There are many studies in the literature about the effects of different exercise training on proprioception. In general, studies have reported that exercise training without weight bearing on the extremity has no effect on proprioception, but as a result of exercises performed with weight bearing on the extremity, a significant improvement was noted in both proprioceptive performance and muscle strength (25). In one of the most recent studies on this subject, it was stated that proprioceptive sensitivity increased in individuals with knee osteoarthritis with 8-week squat strengthening training performed by transferring weight to the extremity (26). Additionally, there are studies in the literature reporting different results regarding the effects of stretching exercises on proprioceptive performance. Some studies have reported that static stretching has no effect on proprioception, while others have reported that it has a positive effect on proprioception (27,28). The Otago Exercise Program is an evidence-based, home-based, individually tailored strength and balance retraining program. Research shows that the Otago Exercise Program is effective in reducing the risk of death and the incidence of falls in older adults over a one-year period. In one study, falls were reduced by 35% in older adults has been reported(29) This study was planned to examine the effectiveness of balance exercises given as a home program to individuals diagnosed with Type 2 DM.

The aim of this study is to examine the validity and reliability of the Turkish Validity and Reliability of The King's Brief Interstitial Lung Disease Questionnaire (K-BILD) in Individuals with Interstitial Lung Involvement Secondary to Rheumatological Diseases.

The goal of this clinical trial is to learn if radial Extracorporeal Shock Wave Therapy (rESWT) is effective in reducing ankle plantar flexor spasticity and improving walking functions in stroke patients who have already received Botulinum Toxin type A (BoNT-A) injections. The main questions it aims to answer are: * Does adding rESWT to standard physical therapy significantly lower muscle spasticity in patients who have received BoNT-A, compared to receiving physical therapy alone after the injection? * Does combining rESWT with BoNT-A injection improve functional walking parameters (such as gait speed, cadence, and step length) and daily life independence more than the BoNT-A and physical therapy combination alone? * Can rESWT induce additional structural and flexibility improvements in the BoNT-A injected gastrocnemius muscle, as measured objectively by ultrasound imaging and strain elastography? Researchers will compare a group of participants receiving both rESWT and conventional physical therapy (Group 1) to a comparison group receiving only conventional physical therapy (Group 2) to see if rESWT provides additional clinical benefits. All participants in both groups will have already undergone routine BoNT-A injections one week prior to starting the study treatments. Participants will: * Undergo a 3-week conventional physical therapy and rehabilitation program, consisting of 2 to 3 hours of therapy per day, 5 days a week. * Receive 3 weekly sessions of rESWT (2000 pulses per session applied to the calf muscles) if they are randomized into the rESWT group. * Attend clinical evaluation visits and objective assessment sessions-including high-tech computerized gait analysis and specialized musculoskeletal ultrasound imaging-before the treatment, at the end of the 3rd week, and at a 12-week follow-up.

This randomized controlled clinical trial aims to investigate the effects of Connective Tissue Massage (CTM) and music-based Progressive Muscle Relaxation Training (PMRT) on pain intensity, pressure pain threshold, analgesic use, and menstruation-related symptoms in women with primary dysmenorrhea. Participants will be randomly assigned to one of three groups: CTM, music-based PMRT, or control. Baseline assessment will be conducted during menstrual days 1-2 of Cycle 0. The interventions will be applied during the premenstrual intervention window of Cycle 0, from the estimated ovulation day, calculated as cycle length minus 14 days, until Cycle 1 Day 1. Post-intervention assessment will be conducted during menstrual days 1-2 of Cycle 1. No intervention will be applied after the post-intervention assessment, and follow-up assessment will be conducted during menstrual days 1-2 of Cycle 2. Outcomes including pain intensity, pressure pain threshold, analgesic use, menstrual symptoms, attitudes toward menstruation, functional and emotional impact of dysmenorrhea, and pain catastrophizing will be evaluated across menstrual cycles. Participant satisfaction and adherence to the interventions will also be assessed.

Knee osteoarthritis (OA) is one of the most common joint disorders worldwide and is a leading cause of pain, limited mobility, and functional disability, particularly in the elderly population. According to 2020 data, approximately 654 million individuals aged 40 years and older are affected by knee OA worldwide, with a global prevalence of 22.9% in this age group. In our country as well, OA is reported as the second most common rheumatologic disease. The disease not only negatively affects individuals' quality of life but also creates a significant socioeconomic burden through work loss, hospital admissions, and the need for surgical interventions. The pathogenesis of knee OA is a complex process involving articular cartilage degeneration, subchondral bone sclerosis, synovial tissue proliferation, and osteophyte formation. Once cartilage damage begins, its capacity for spontaneous healing is extremely limited; therefore, early interventions aimed at slowing or halting disease progression are of critical importance. In this context, non-pharmacological interventions, particularly exercise programs that may contribute to maintaining cartilage integrity, are strongly recommended as first-line treatment options in current clinical guidelines. The beneficial effects of exercise therapy on pain and function in patients with knee OA are well documented. However, the structural effects of exercise on femoral cartilage thickness have been relatively less investigated. Tuna et al. evaluated femoral cartilage thickness using ultrasonography in 40 patients with knee OA following a 12-week quadriceps strengthening program and reported statistically significant increases in cartilage thickness in the medial condyle, lateral condyle, and intercondylar region at 3 months. This pioneering study suggests that muscle strengthening programs may have not only symptomatic but also structural benefits. Similarly, Bozan et al. reported a strong positive correlation between quadriceps muscle thickness (rectus femoris + vastus intermedius) and femoral cartilage thickness, supporting the idea that muscle loss parallels cartilage degeneration. However, these studies focused exclusively on the quadriceps muscle, and the effects of hip musculature on femoral cartilage thickness have not been investigated. Recent biomechanical studies indicate that hip abductor and adductor muscles play a critical role in knee joint loading patterns. Hip abductor muscles provide pelvic stability during gait and directly influence knee adduction moments. Weakness of the gluteus medius leads to contralateral pelvic drop, increasing medial compartment loading on the ipsilateral knee and accelerating medial tibiofemoral cartilage wear. Indeed, Segal et al., using data from the Multicenter Osteoarthritis Study (MOST), demonstrated via MRI that greater hip abductor strength significantly reduces the risk of progression of medial patellofemoral and lateral tibiofemoral cartilage damage. On the other hand, hip adductor muscles are also thought to contribute to knee adduction moments by eccentrically controlling femoral varus motion; however, this relationship has been studied far less compared to quadriceps and abductors. Systematic reviews and meta-analyses have shown that individuals with knee OA have up to 24% lower isometric hip abductor strength compared to healthy controls. Randomized controlled trials investigating combined hip and quadriceps strengthening programs have reported significant improvements in pain and function. However, none of these studies have used femoral cartilage thickness measured by ultrasonography as a primary outcome. A review of the current literature reveals that although studies exist examining the effects of quadriceps strengthening on femoral cartilage thickness, no randomized controlled trial has compared hip abductor and adductor strengthening exercises with a quadriceps strengthening program, using ultrasonographic femoral cartilage thickness as the primary outcome measure. This study aims to address this gap. All interventions will be applied as non-invasive home exercise programs, and all measurements will be performed using ultrasonography. Baseline, 1-month, and 3-month assessments will also allow evaluation of the temporal effects of exercise on cartilage structure. The findings are expected to provide scientific evidence regarding the structural protective effects of hip exercises in knee OA rehabilitation and serve as pilot data for future large-scale multicenter studies. The aim of this study is to compare patients with knee OA receiving quadriceps strengthening exercises alone with those receiving additional hip abductor/adductor strengthening exercises in terms of changes in femoral cartilage thickness, and to evaluate whether there is a correlation between femoral cartilage thickness and the thickness of the rectus femoris, gluteus medius,

This prospective observational cohort study aims to investigate whether baseline central sensitization and psychological factors predict functional outcomes following rehabilitation in individuals with chronic shoulder pain. Participants with chronic shoulder pain will receive a standardized 6-week physiotherapy and rehabilitation program routinely applied in the clinic. Assessments will be performed before and after treatment, including pain severity, shoulder function, central sensitization symptoms, and psychological factors such as pain catastrophizing. The findings of this study may contribute to a better understanding of biopsychosocial factors affecting rehabilitation outcomes in chronic shoulder pain and help improve individualized rehabilitation approaches.

This study aims to investigate the effects of Kinesio Taping (KT) on hand function in patients with Zone V-VI Extensor Digitorum Communis (EDC) tendon injuries following primary repair. Extensor tendon injuries in this region often lead to complications such as adhesion formation, reduced range of motion, extensor lag, and impaired hand function, despite standard rehabilitation approaches. Therefore, additional interventions that may enhance tendon gliding and neuromuscular control are of clinical interest. In this double-blind randomized controlled trial, patients will be assigned to either a KT group or a sham taping control group. Both groups will receive a standardized postoperative rehabilitation program, while the intervention group will additionally receive KT applications between postoperative weeks 6 and 12. Outcome measures, including range of motion, grip and pinch strength, and functional hand performance, will be assessed at 12 and 24 weeks. The study seeks to determine whether KT provides additional benefits beyond conventional rehabilitation in improving functional recovery after extensor tendon injuries, addressing an important gap in the current literature.

Immobilization following median and/or ulnar nerve repairs results in strength loss in the wrist and finger extensor muscles. Given the critical importance of wrist extension for functional grip, this condition significantly restricts hand functions. Therefore, this study aims to investigate the effects of EMG-triggered electrical stimulation applied to the wrist and finger extensors, in addition to conventional physiotherapy, on functional outcomes in patients undergoing median and/or ulnar nerve repair, with the objective of restoring extensor muscle weakness induced by immobilization.

Patient-reported outcome measures, which are subjective by nature, need to be correlated with clinician-administered professional measurements as a further step toward expanding their clinical utility. Therefore, this study aimed to investigate the relationship between perceived manual dexterity and functional measurements in patients with hand-forearm injuries.

The aim of this study is to identify predictors of climate change health literacy in older adults.

This study aimed to investigate the predictability of kinesiophobia on functional outcomes in conservatively treated patients with distal radius fractures. For this purpose, patients' level of kinesiophobia will be assessed using the Tampa Kinesiophobia Scale. To assess the functional status of patients, joint range of motion and upper extremity weight bearing measurements will be performed. Patients' functionality will be additionally assessed with the Patient Rated Wrist Evaluation Questionnaire.

The aim of this study is to examine the association between health literacy, patient-reported outcome measures, and grip strength in a cohort of patients with hand injuries.

Breast cancer is the most common cancer among women worldwide and lymphedema is one of its most significant complications. Breast cancer-related lymphedema (BCRL) may develop shortly after treatment or even years later, causing physical and psychological burden, functional impairment, and reduced quality of life. Complete decongestive therapy (CDT), which includes manual lymph drainage (MLD), compression, skin care, and exercise, is the standard approach. Intermittent pneumatic compression (IPC) has been proposed as an additional option, and current consensus reports emphasize the need for studies evaluating IPC in combination with MLD. Previous studies comparing IPC and MLD, either alone or in combination, have shown inconsistent results. Some reported no significant difference between treatment groups, while others suggested additional benefits of IPC, particularly in reducing limb heaviness and tension. However, there is still insufficient evidence to clarify the exact role of IPC within CDT. The aim of this study is to investigate the acute effects of using IPC instead of MLD, or in combination with MLD, on arm circumference, arm volume, shoulder range of motion, and quality of life in patients with BCRL.

Objective: This study was designed to develop a clinical practice preparation program based on the Pediatric Nursing Excellence Model for undergraduate nursing students and to evaluate the program's effect on students' readiness, clinical comfort and anxiety, and levels of excellence. Method: This study is a pretest-posttest randomized controlled experimental study. The research is planned to be conducted with nursing students taking the Pediatric Health and Disease Nursing course. The study groups will consist of students who go out for clinical practice within the scope of this course. In the power analysis performed with the G\*Power 3.1.9.7 program, the sample size was found to be 25 for the experimental group and 25 for the control group, for a total of 50. Research data will be collected using a questionnaire. The questionnaire consists of four sections containing the following questions: "Student Descriptive Characteristics Information Form," "Nursing Students' Readiness for Clinical Practice Scale," "Pediatric Nursing Students' Clinical Comfort and Anxiety Instrument," and "Pediatric Nursing Excellence (PHM) Model Questionnaire." In the study, students in the experimental group will receive routine orientation training and a clinical practice readiness program based on the excellence model. Students in the control group will only receive routine orientation training. Data analysis will be performed using the SPSS 20.0 software package.

Considering the thumb's contribution to fine dexterity and precision grip, this study aims to evaluate fine manual dexterity alongside functional outcomes following isolated thumb tendon injuries, and to examine the relationship between postoperative functional improvement and changes in fine manual dexterity.