Derya Azim

Aim This study aims to investigate the relationship between the viscoelastic properties of the lower extremity muscles and balance in children with CP. Methods Conducted between May and September 2023, this descriptive study included 16 children with Spastic CP treated at a private center in İstanbul. Muscle tone, stiffness, and elasticity of the hamstring, gastrocnemius, and tibialis anterior muscles were assessed using Myoton Pro, and balance was evaluated with the Pediatric Berg Balance Scale. Spearman correlation analysis was used to examine the relationship between muscle biomechanics and balance. Results The average age of the children was 8.63±2.85 years. The mean tone, elasticity, and stiffness of the hamstring were 15.89±2.17, 244.19±51.18, and 0.85±0.12, respectively. For the Gastrocnemius, they were 14.16±3.77, 244.38±47.25, and 0.89±0.13. For the Tibialis Anterior, they were 19.05±2.28, 393.44±78.48, and 1.12±0.19. Negative correlations were found between muscle tone and stiffness of the Hamstring (r = -0.446; -0.411; P = .004; 0.04), Gastrocnemius (r = -0.307; -0.181; P = .002; 0.004), and Tibialis Anterior (r = -0.138; -0.364; P = .001; 0.003) with balance. No significant correlation was found between muscle elasticity and balance. Conclusion Our findings suggest that children with higher muscle tone and stiffness may have more pronounced balance problems. Therefore, rehabilitation programs should be tailored to individual needs and include specific strategies for managing muscle tone.

Objective : This study aimed to compare physical activity levels, pain characteristics, and quality of life among older adults living in rural and urban areas of Turkey. Methods : This cross-sectional study included 250 older adults (50 rural and 200 urban). Data were collected using the Sociodemographic Characteristics Form, the International Physical Activity Questionnaire, the Short-Form McGill Pain Questionnaire, and the World Health Organization Quality of Life Scale-Older Adults Module. Chronic pain was defined as pain lasting at least 3 months based on self-report. Group comparisons were conducted using independent samples t -tests or Mann–Whitney U tests according to data distribution, and adjusted regression analyses were performed to control for potential confounders. Results : Physical activity levels did not differ significantly between rural and urban participants ( p > .05). Urban participants reported higher pain scores ( p < .05), whereas chronic pain prevalence was higher in the rural group. Significant differences were observed in selected World Health Organization Quality of Life Scale-Older Adults Module domains, with rural participants reporting higher scores in sensory abilities, death and dying, and intimacy ( p < .05). Other domains did not show significant differences. Conclusion : The findings indicate that rural–urban differences in older adults are evident in pain and certain quality of life domains, whereas physical activity levels appear comparable. These results should be interpreted as associations rather than causal relationships. Cultural, social, and health care-related factors specific to Turkey may contribute to these differences. Future studies using longitudinal designs and more balanced samples are needed to better understand these relationships.

Background/Objectives: Structural inequalities in access to healthcare persist even within systems that have achieved near-universal coverage, reflecting the enduring influence of social determinants of health on service utilization. This study examines horizontal inequity in rehabilitation and specialist care in Türkiye and investigates whether access inequality mediates the well-documented income–depression gradient. Methods: Analyzing the nationally representative 2022 Türkiye Health Survey (adults aged ≥15; N = 22,742), we employed Latent Profile Analysis (LPA) to construct people-centered, multidimensional bodily burden profiles, and assessed need-adjusted access using survey-weighted logistic regression, Erreygers-corrected concentration-index decomposition, Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA), and restricted cubic splines, with measurement-invariance and classification-uncertainty sensitivity analyses. Statistical mediation was examined with natural-effect models and E-value sensitivity analysis. Results: Although the system demonstrated responsiveness to need—78.8% of the highest-burden profile accessed specialist services—only 13.7% of this same group reached dedicated physiotherapy or rehabilitation, revealing a profound structural bottleneck in care coordination for marginalized populations with the greatest functional impairment. A persistent pro-rich gradient was confirmed by an Erreygers-corrected concentration index of 0.058 (95% CI 0.043–0.072), driven additively by income and education. Access did not mediate the income–depression pathway (natural indirect effect OR 1.001, 95% CI 1.0003–1.002). Conclusions: The mental health burden of low income operates through pathways that equitable healthcare access alone cannot address. These findings call for macroeconomic and people-centered health system reforms—including direct physiotherapy access, transportation subsidies, and social protection interventions—to advance health equity in rehabilitation utilization.

Background/Objectives: Adolescent somatic symptoms such as headache, irritability, and sleep difficulties are common and closely tied to adolescent mental health, yet they are typically studied as a single dimension and as individual complaints detached from the psychosocial adversity surrounding the adolescent. Drawing on the nationally representative 2022 Türkiye Child Survey (n = 3523, ages 13–17), we examined whether these symptoms are patterned by the psychosocial risk and support surrounding the adolescent. Methods: Measurement models, multiple correspondence analysis, survey-weighted ordinal regression, a mixed graphical model, and machine-learning algorithms were applied in sequence. Results: Somatic symptoms were organized around a dominant general factor, alongside closely correlated physical and psychological dimensions that showed differential external associations. The three relational microsystems formed a coherent psychosocial adversity gradient along which somatic burden increased. The two dimensions were linked to different factors: peer victimization, a risk factor, and parental support, a protective factor, were associated primarily with psychological burden (odds ratios per standard deviation 1.84 and 0.88), whereas female sex and chronic illness were linked more strongly to physical burden (2.35 and 1.61); body mass index, income strain, and housing problems showed no independent associations. Regression, network, and machine-learning analyses converged on this dissociation while indicating modest individual-level predictability. Conclusions: Adolescent somatic symptoms are thus systematically patterned by psychosocial risk and support at the population level, an association that may inform monitoring and psychosocially informed assessment rather than individual prediction, and that requires longitudinal work to interpret directionally.

Background/Objectives: Evidence on the role of muscle mechanical (myotonic) properties in athletic performance remains limited in young adult and sub-elite populations, particularly in American football, and sex-specific patterns of association are not well understood. This study aimed to investigate the associations between lower extremity myotonic properties and performance outcomes (strength and balance) in American football athletes, with a specific focus on sex-related differences and candidate predictors. Methods: A cross-sectional design was implemented involving 35 American football athletes (17 female, 18 male). Lower extremity muscle tone, stiffness, and elasticity were assessed using MyotonPRO. Strength parameters (lower limb, handgrip, back, and shoulder internal rotation) and balance performance (static and dynamic under eyes-open and eyes-closed conditions) were evaluated using standardized measurement protocols. Pearson correlation analysis was conducted to examine bivariate associations, followed by Least Absolute Shrinkage and Selection Operator (LASSO) regression to determine candidate predictors while addressing multicollinearity. Results: Male athletes exhibited significantly greater height, body mass, and BMI (p < 0.001), alongside elevated myotonic values compared to females. Correlation analyses indicated distinct sex-specific association patterns between myotonic properties and performance metrics. LASSO regression revealed a distinct sex-specific divergence in strength prediction: female strength was predominantly driven by proximal musculature (quadriceps and hamstring elasticity/stiffness), whereas male strength was anchored by distal musculature (gastrocnemius tone/stiffness). Furthermore, rigorous penalization shrunk nearly all balance coefficients to zero in both sexes, indicating that resting myotonic properties do not independently predict dynamic or static postural control. Conclusions: While lower extremity myotonic properties are candidate predictors of multi-regional strength via sex-specific proximal and distal strategies, they do not independently predict balance performance, suggesting postural control relies primarily on active motor recruitment rather than passive resting mechanics. Given the cross-sectional design of this study, causal inferences cannot be drawn, and these findings should be interpreted accordingly. The observed sex-specific differences may support consideration of individualized, sex-informed training strategies in American football athletes.

Purpose: This study aimed to evaluate the effects of Pilates‐based tele‐exercise (PBTE) on physical and mental health in women diagnosed with primary dysmenorrhea. Methods: The study included 22 volunteers diagnosed with primary dysmenorrhea, who were randomly assigned to two groups. The intervention group (PBTE, n = 11) participated in Pilates‐based tele‐exercises for 6 weeks, twice a week, with 50‐min sessions. The control group (CG, n = 11) received no intervention. Menstrual‐related symptoms were evaluated using the Menstrual Symptom Questionnaire (MSQ), the Menstrual Attitude Questionnaire (MAQ), and the Functional and Emotional Dysmenorrhea Scale (FEDS). Results: The total MSQ score and all subdimensions in the PBTE group decreased significantly following the intervention ( p < 0.05). The MAQ subdimensions, including “menstruation as a bothersome phenomenon” and “menstruation as a natural phenomenon,” along with the total MAQ score, showed significant intra‐group improvements in the PBTE group ( p < 0.05). The FEDS total score also significantly decreased in the PBTE group ( p < 0.05). Conclusion: The findings demonstrate that Pilates‐based tele‐exercises significantly enhance the overall health and well‐being of women with primary dysmenorrhea. This is achieved through improved menstrual symptoms and positive changes in attitudes toward menstruation. These results suggest that PBTE could be an effective non‐pharmacological approach to managing primary dysmenorrhea.

Purpose : This study compared the effects of Neuro-Developmental Treatment-based trunk training, video game-based trunk training (VG-TT), and VG-TT with an orthotic garment in children with unilateral cerebral palsy. Methods : Forty-two children with unilateral cerebral palsy received usual physiotherapy (2 d/wk) for 8 weeks (control period). They were then randomized to 8 weeks of Neuro-Developmental Treatment-based trunk training, VG-TT, or VG-TT with an orthotic garment (2 d/wk) alongside usual physiotherapy (intervention period). Primary outcomes were the Trunk Control Measurement Scale and Becure Balance Assessment System. Secondary outcomes included the Pediatric Berg Balance Scale and Gillette Functional Assessment Questionnaire. Results : No significant improvements in trunk control were observed during the control period ( P > .05), and all groups showed significant gains during the intervention period ( P < .05). Functional and sitting balance improved in all groups throughout both periods ( P < .05). However, no significant differences were found between intervention groups in trunk control, sitting balance, balance, or walking function ( P > .05). Discussion : Trunk-specific training enhances trunk control and functional balance in children with unilateral cerebral palsy. As no approach proved superior, interventions can be tailored based on individual needs and clinical context.

Objective: This study aimed to investigate associations between meat attachment, food technology neophobia and physical activity levels in young adults. Materials and Methods: In this cross-sectional study, data collected from 775 young adults were analyzed. To collect the data, the Descriptive Information Form, Meat Attachment Questionnaire (MAQ), Food Technology Neophobia Scale (FTNS) and International Physical Activity Questionnaire-Short Form (IPAQ-SF) were used. In data analysis, descriptive statistics, simple and multiple linear regression analyses were performed. The significance level of statistical tests was accepted as p

Amaç: Bu çalışma, özel gereksinimli çocukların kardeşlerinde fiziksel aktivite, depresyon ve yaşam kalitesini değerlendirmek ve sağlıklı kardeşe sahip çocuklarda bu parametrelerin karşılaştırılması amacıyla gerçekleştirilmiştir. Yöntem: Kesitsel çalışma, Ocak 2024 ile Haziran 2024 arasında İstanbul’da ikamet eden özel gereksinimli kardeşe sahip 80 çocuk ve sağlıklı kardeşe sahip 80 çocuk ile gerçekleştirilmiştir. Her iki grup da demografik bilgi formu, Çocuklar İçin Yaşam Kalitesi Ölçeği, Çocuklar İçin Depresyon Envanteri (ÇDE) ve Çocuklar İçin Fiziksel Aktivite Anketi kullanılarak değerlendirilmiştir. Bulgular: Özel gereksinimli kardeşe sahip çocukların yaş ortalaması 120 ± 48 ay, sağlıklı kardeşe sahip çocukların yaş ortalaması ise 124 ± 57 ay olarak bulunmuştur. Katılımcılar arasında demografik bilgiler açısından istatistiksel olarak anlamlı bir fark yoktur. Özel gereksinimli kardeşe sahip çocukların Psikososyal Sağlık Skoru, Fiziksel Sağlık Skoru, Toplam Sağlık Skoru ve fiziksel aktivite seviyeleri daha düşük bulunmuş ve iki grup arasında anlamlı bir fark saptanmıştır (p