Gulhan Yilmaz Gokmen

Objective: This study aimed to determine the effectiveness of telerehabilitation in managing ongoing dyspnea and associated issues following coronavirus disease 2019 (COVID-19), and observe changes over time. Design: The study included 36 participants who previously had COVID-19 but continued to experience dyspnea (mean age, 42.44 ± 15.51 years). The participants were randomly allocated into three groups: telerehabilitation (TRG), home exercise (HEG), and control (CG). Dyspnea level, exercise capacity, muscle oxygenation, respiratory function, and fatigue were evaluated at baseline, at 6th, and at 12th weeks. Telerehabilitation was performed supervised and synchronously via video-calls. Results: At the 6-week assessment, TRG showed significant improvements in dyspnea, fatigue (p < 0.001), exercise capacity (p = 0.001), and respiratory muscle strength (p < 0.001). By the 12th week, these gains were maintained, with no further changes from week 6. In HEG, dyspnea and fatigue improved at weeks 6 and 12 (p < 0.001), with no additional changes between these time points. In CG, only dyspnea improved at both assessments (p < 0.001); other parameters remained unchanged. TRG achieved greater benefits compared to CG in reducing dyspnea and fatigue at week 6 (p = 0.001 and p = 0.003, respectively), but no group differences were found at week 12 (p > 0.05). No changes in muscle oxygenation were observed in any groups or evaluation points (p > 0.05). Conclusions: Telerehabilitation effectively improved and sustained dyspnea, fatigue, respiratory muscle strength, and exercise capacity in patients with post-COVID, while home-based exercises only reduced dyspnea and fatigue. Supervised and structured telerehabilitation may be a viable approach to managing post-COVID-19 symptoms.

Hayvan destekli uygulamalar, bireylerin sağlığını iyileştirmeye yönelik etkili yöntemlerden biri olarak kabul edilmektedir. İnsan-hayvan etkileşimi, sağlığın korunması ve geliştirilmesi sürecinde önemli bir rol oynar ve bu etkileşimin faydaları yadsınamaz. Bu tür uygulamalar, bireylerin hem fiziksel hem de psikolojik durumlarını olumlu yönde etkileyerek, stres seviyelerini azaltırken sosyal ilişkileri de güçlendirme potansiyeline sahiptir. Özellikle köpek destekli terapi, hayvan destekli terapiler arasında en yaygın kullanılan ve araştırılan modellerden biridir. Köpek destekli terapi, fiziksel, duygusal veya psikolojik zorluklar yaşayan bireylerin iyileşme süreçlerini desteklemek için köpeklerin kullanıldığı bir terapi yöntemidir. Bu terapi türünde köpekler, güvenli bir ortam sağlamak, stresi azaltmak, pozitif duyguları artırmak ve hastaların rahatlamasına yardımcı olmak amacıyla uzman terapistler eşliğinde terapi sürecine dahil edilir. Özellikle çocuklar, yaşlılar ve travma geçirmiş bireylerde etkili olan bu yöntemde, köpeklerin empati ve yakınlık sağlama özellikleri tedavi sürecinde pozitif etki yaratır. Köpeklerin sahip oldukları sıcaklık, sevgi dolu tavırları ve eğitilebilir yapıları, bu terapilerin çeşitli alanlarda uygulanmasına imkan tanır. Bu derlemenin amacı, giderek daha fazla ilgi gören köpek destekli terapinin literatürde hangi alanlarda kullanıldığını incelemek ve bu alanlardaki etkilerini değerlendirmektir. Literatürde yer alan çalışmalar, bu tür terapilerin çok yönlü faydalarını ortaya koyarak, klinik uygulamalarda daha fazla kullanım alanı bulmasına katkı sağlamaktadır.

Temporomandibular eklem (TME) dislokasyonu,temporomandibular eklem bozuklukları (TME) arasında yer almaktadır. Yaş, diş yapısı, çıkığın nedeni ve süresine ek olarak çiğneme kaslarının fonksiyonu da TME dislokasyonunun mekanizmasını ve tedavisini açıklamada önemlidir. Bu disfonksiyon çiğneme, yutma ve konuşmayı bozar ve başlıca semptomları eklem sesleri, hareket açıklığının azalması ve TME fonksiyonu sırasında alt çene sapmasıdır. TME tedavisi sadece çene tedavisi olarak görülmemeli; servikal omurga ve tüm kraniomandibular sistemi kapsayan tedaviyi dikkate alarak kapsamlı bir tedavi yönetimi oluşturulmalıdır. Ayrıca TME için tek bir tedavi yönteminin etkili olmadığı ve semptomları tamamen azaltmak için multidisipliner bir yaklaşımın gerekli olduğu ileri sürülmektedir. Bu çalışmada TME dislokasyonu sonrası holistik fizyoterapi ve rehabilitasyon perspektifinden tedavi ettiğimiz 21 yaşında bir olgu sunulmaktadır.

Amaç: Omuz Sıkışma Sendromu’nun dominant veya non-dominant tarafta olmasının üst ekstremite fonksiyonelliğine, işteki fonksiyonelliğe ve istirahatte, aktivite sırasında ve gece oluşan ağrı şiddetine etkisini inceleyerek birbirleriyle ilişkisini araştırmak amaçlanmıştır. Gereç ve Yöntem: 18-75 yaş arasında 81 gönüllü çalışmaya dahil edildi. Dominant tarafı etkilenen 44, non-dominant tarafı etkilenen 37 kişi vardı. Katılımcıların üst ekstremite fonksiyonu Kol-Omuz-El Sorunları Anketi ile; istirahatte, aktivite ve gece oluşan omuz ağrısı Görsel Analog Skalası ile değerlendirildi. Bulgular: Gruplar arasında fonksiyonellik ve ağrı parametreleri arasında istatistiksel olarak anlamlı fark yoktu (p>0.05). Bütün hastaların verilerinin korelasyonunda Kol-Omuz-El Sorunları Anketi-Fonksiyon/Semptom ile istirahat, aktivite ve gece ağrısı arasında (sırasıyla p<0.001 p=0.001, p<0.001) ve anketin iş modeli ile de ağrı arasında korelasyon vardı (sırasıyla p=0.005, p=0.002, p<0.001). Dominant tarafı etkilenen hastaların Kol-Omuz-El Sorunları Anketi-Fonksiyon/Semptom bölümü ile istirahat, aktivite ve gece ağrısı arasında (sırasıyla p<0.001, p=0.014, p<0.001) ve iş modeli ile istirahat ve gece ağrıları arasında korelasyon vardı (p=0.016, p=0.003). Non-dominant tarafı etkilenen hastaların Kol-Omuz-El Sorunları Anketi-Fonksiyon/Semptom ile aktivite ve gece ağrısı arasında (p=0.016, p=0.020) ve iş modeli ile aktivite ve gece ağrısı arasında korelasyon vardı (p=0.003, p=0.005). Sonuç: Hastaların dominant ya da non-dominant taraflardan hangisi etkilenirse etkilensin ağrı şiddetindeki artış üst ekstremite fonksiyonunu ve işteki fonksiyonelliği azaltmaktadır.

Aim: This study aims to retrospectively evaluate the fundamental motor competence of early adolescents and to examine the affecting factors. Methods: 89 children aged 11.33±0.95 were included in the study. Minnesota Manual Dexterity Test (MMDT) for manual dexterity, 9-Hole Peg Test (9-HPT) for finger dexterity, Korebalance™ Premiere for balance, manual muscle strength measurement device for quadriceps muscle strength, hand dynamometer for hand grip strength, EMG Biofeedback for muscle activation was used. Results: Compared by gender, there was a statistically significant difference in the right and left-hand placing of MMDT and 9-HPT (p=0.004, p=0.041, p=0.004, respectively). Comparison’s of age groups, there was a statistically significant difference in the left-hand placing and turning subtests of MMDT and left grip strength (p=0.010, p=0.048, p=0.025, respectively). In a correlation analyses, age had a correlation with the left-hand placing of MMDT (r=-0.336,p=0.001); and left grip strength (r=0.219,p=0.039). Height and weight had a correlation with dynamic balance (r=-0.242,p=0.022; r=-0.244,p=0.021). Weight and BMI had a correlation with static balance (r=0.342,p=0.001; r=0.305,p=0.004) and EMG Biofeedback score (r=0.237,p=0.025; r=0.212,p=0.046). Conclusion: Manual dexterity and hand grip strength develop with age in children, and girls' manual and finger dexterities are better than boys. While the increase in BMI and weight affect static balance negatively, the increase in height and weight affect dynamic balance positively. It is thought that investigating the factors affecting motor competence will be important in evaluating the development of children and directing them to appropriate sports. Keywords: Balance, Manual dexterity, Finger dexterity, Muscle activation

Aims: The aim of this study was to investigate peripheral muscle oxygenation in patients with chronic obstructive pulmonary disease (COPD) at rest, during submaximal exercise, and during recovery, and to determine the effects of disease stage on peripheral muscle oxygenation. Methods: Of the 35 stable COPD patients (62.49±8.45 years), 18 patients in GOLD 1 and 2 were assigned to Group 1 and 17 patients in GOLD 3 and 4 were assigned to Group 2. Dyspnea perception of the patients was evaluated with the Modified Medical Research Council (mMRC) Dyspnea Scale, severity of the disease affecting daily life was evaluated with the COPD Assessment Test (CAT-COPD Assessment Test), respiratory function was evaluated with the Pulmonary Function Test, and quadriceps muscle strength was evaluated with a manual muscle testing device. Muscle oxygenation of the patients was measured with Near-infrared spectroscopy (NIRS) for 5 minutes at rest, 6 minutes during the 6-Minute Walk Test (6-MWT), and 5 minutes during recovery after the end of the test. The results of the two groups were compared. Results: Intragroup comparisons of muscle oxygenation at rest, during 6-MWT and during recovery; in Group 1, there was a statistically significant decrease between resting SmO2 mean and test SmO2 mean (p=0.001), a increase between test SmO2 mean and recovery SmO2 mean (p 0.05). In the SmO2 comparison of Group 1 and Group 2 at rest, during 6-MWT, and during recovery, it was observed that the test SmO2mean value was statistically higher in Group 2 (p=0.023). Conclusion: When the disease stage increases in individuals with COPD, muscle oxygen utilization metabolism during submaximal exercise worsens, demanding more oxygen to the muscle to produce the same movement as in individuals with a lower disease stage. This may be explained by the fact that energy metabolism and endurance are affected due to the decrease in the oxygen level of the muscle and its capacity to utilize the available oxygen with increasing disease severity.

Objectives: This study aimed to evaluate the post-COVID-19 symptoms, the severity of symptoms, and functional capacities seen in hospitalized and nonhospitalized COVID-19 survivors according to time periods (total 6, 1–3, and 3–6 months) by tele-assessment methods and to predict the need for periodic rehabilitation of COVID-19 survivors. Methods: Three hundred ninety-four COVID-19 survivors (50.18 ± 15.14 years) who were between 1 and 6 months after PCR(+) were included in the study, and their ongoing symptoms and the severity of these symptoms (0–10 points) were assessed with COVID-19 Yorkshire Rehabilitation Screening (C19-YRS) Tool, and the 30-s Chair Stand Test (CST) was applied by tele-assessment methods. Results: In hospitalized and nonhospitalized survivors of COVID-19, 87% experienced at least one symptom within the first 6 months. The most prevalent symptoms were anxiety (47.7%), fatigue (46.7%), and muscle pain (45.7%). The most common symptom in the nonhospitalized group was fatigue (52.6%), whereas anxiety was 46.8% in the hospitalized group. The 30-s CST score of the nonhospitalized group was significantly higher than the hospitalized group (p < 0.001). Conclusions: In the first 6 months post-COVID-19, musculoskeletal problems, anxiety, fatigue, and muscle pain were observed to be the most prevalent symptoms, regardless of time, in hospitalized and nonhospitalized survivors. There was a serious decrease in their functional capacity. Priority should be given to psychiatric, cardiopulmonary, and musculoskeletal rehabilitation in post-COVID-19. Inclusion of hospitalized/nonhospitalized COVID-19 survivors in a comprehensive rehabilitation program tailored to their needs by following a comprehensive tele-assessment by a multidisciplinary team will reduce the “long COVID-19 syndrome.” ClinicalTrials.gov Registration Number: NCT04900441

Introduction and hypothesis This study aimed to evaluate the relationship between pelvic floor muscle (PFM) strength and low back pain (LBP) in women with and without non-specific low back pain (NSLBP) with similar demographic and physical characteristics. Methods The study included 40 women (35.73±6.74 years) with NSLBP (with LBP group) and 32 women (34.59±5.93) without LBP (without LBP group). PFM strength with a perineometer, pain intensity with a Visual Analog Scale (VAS), quality of life with the Short Form-36 (SF-36), and perceptions of LBP and related disability with the Rolland Morris Disability Questionnaire (RMDQ) were evaluated. Results There was no difference between the groups in terms of age, BMI, number of births (0, 1, and 2 births) and mode of delivery (vaginal/cesarean section) (p>0.05). There was a statistical difference between the groups in all parameters except SF-36 Emotional Role Limitation subscale (p<0.05). We found PFM strength an independent predictor of the RMDQ score, and RMDQ and VAS scores as independent predictors of SF-36 physical and mental components (p<0.05). Conclusions Decreased PFM strength in women causes non-specific mechanical low back pain and disability independent of age, BMI, and the number and type of delivery. Decreased PFM strength is a predictor of disability. Disability and pain are also independent predictors of decreased quality of life. PFM measurement should be prioritized when evaluating women with NSLBP. PFM strength may be a determinant of LBP.

Purpose: The aim of this study was to evaluate how surgical and medical treatments affect the quality of life, depression status and social participation of women with Stress Urinary Incontinence (SUI). Materials and Methods: The study included 32 women with diagnoses of SUI. Among these women, 16 were designated as the medical treatment group (MTG), and the other 16 were designated as the surgical treatment group (STG). Before the treatment and 8 weeks after its completion, the patients were evaluated with the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Incontinence Quality of Life Questionnaire (I-QOL), World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF), Beck Depression Inventory (BDI) and Social Participation Questionnaire (SPQ). Results: The mean age of the subjects was 54.31±11.48 years in MTG and 48.38±10.01 years in STG. The mean body mass index (BMI) values of the groups were respectively 27.56±2.79 and 26.56±2.25 kg/m2. Following the treatment, statistically significant improvements were observed in urinary incontinence, depression, social participation and overall and disease-specific quality of life in both groups (p<0.05). Comparative analysis of the post-treatment changes in both groups showed statistically significant differences in the BDI score, the total work activity and household activity scores in the Social Participation Questionnaire and the psychosocial subgroups of both WHOQOL-BREF and I-QOL (p<0.05). Conclusion: Both treatments proved to be effective and usable to reduce the severity of SUI and depression, prevent social isolation and improve the quality of life. However, extensive research is required on the effects of SUI treatment methods on larger patient groups.