Tugba Sahbaz

Purpose: Ankylosing spondylitis (AS) is a chronic inflammatory disease frequently associated with anterior uveitis. While ocular involvement is typically considered anterior, recent evidence suggests subclinical posterior microvascular alterations. This study aimed to evaluate retinal and choroidal changes in AS patients with and without anterior uveitis using optical coherence tomography angiography (OCTA). Methods: This cross-sectional study included 77 participants: 22 AS patients with anterior uveitis (43 eyes), 22 AS patients without ocular involvement (44 eyes), and 33 healthy controls (66 eyes). All subjects underwent a comprehensive ophthalmologic examination and OCTA imaging. Quantitative OCTA parameters, including superficial and deep capillary plexus (SCP, DCP) vessel densities, foveal avascular zone (FAZ) metrics, and choriocapillaris flow area, were analyzed. Results: Both AS groups demonstrated significantly lower SCP vessel densities compared to controls (p<0.001), particularly in whole, parafoveal, and perifoveal regions. DCP vessel densities were markedly reduced in AS patients with anterior uveitis compared to both non-uveitis AS patients and controls (p<0.05). No significant differences were observed in FAZ area (p = 0.084), although FAZ perimeter was smaller in the uveitis group (p=0.045). Choriocapillaris and outer retinal flow areas also differed significantly among groups (p<0.01). Conclusion: AS patients, especially those with anterior uveitis, exhibit subclinical retinal and choroidal microvascular alterations detectable by OCTA. These findings suggest posterior segment involvement beyond clinically apparent anterior uveitis and indicate that OCTA may be a useful non-invasive tool for detecting microvascular alterations. Further longitudinal studies are warranted to assess the prognostic and therapeutic implications of these alterations.

Background: To evaluate statistical reporting quality and methodological errors in clinical research articles published in physical medicine and rehabilitation (PM&R) journals indexed in Science Citation Index Expanded (SCI-E) and Turkish National Citation Index (TR Dizin). Methods: This cross-sectional methodological study analyzed original clinical research articles published between January 2024 and January 2025 in 18 PM&R journals indexed in SCI-E and TR Dizin. Articles were evaluated using predefined criteria based on Consolidated Standards of Reporting Trials (CONSORT) statement, the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement, and the Statistical Analyses and Methods in the Published Literature (SAMPL) guidelines. Statistical reporting practices, methodological indicators, and transparency indicators were assessed. Comparisons between journal groups were performed using Pearson’s chi-square or Fisher’s exact tests. Results: A total of 433 articles were included, of which 358 (82.7%) were published in SCI-E journals and 75 (17.3%) in TR Dizin journals. Mean ± SD was reported in 93.1% of articles, whereas median-based statistics were reported in 47.3%. Normality testing was performed in 72.7% of studies. Effect size reporting was observed in 51.0% of articles. SCI-E journals reported effect sizes more frequently than TR Dizin journals (53.1% vs. 36.0%, P = .004). P reporting errors were more common in TR Dizin journals (21.3% vs. 8.9%, P = .002). Conclusion: Statistical reporting deficiencies remain common in PM&R clinical research articles. Although SCI-E indexed journals demonstrate relatively better adherence to recommended statistical practices, important methodological shortcomings persist in both indexing groups. Strengthening statistical education and improving editorial oversight may enhance the methodological quality of rehabilitation research. Cite this article as: Şahbaz T, Yorgancıgil GÖ, Dirican A. Statistical reporting quality in physical medicine and rehabilitation journals: A comparative analysis of SCI-E and TR indexed publications. Eurasian J Med. 2026, 34, 1511, doi: 10.5152/ eurasianjmed.2026.261 511.

Background: This study aims to investigate the prevalence of neuropathic pain in shoulder pain, its relationship with nociplastic pain, and the effects of both pain types on functional outcomes. Materials and Methods: Between May 2024 and December 2024, a total of 73 patients with non-traumatic shoulder pain persisting for more than three months were included in this multi-center, prospective, cross-sectional study. Participants were classified according to diagnoses of rotator cuff disorders, subacromial impingement, adhesive capsulitis, osteoarthritis, or calcific tendinitis. Assessments were performed using the Visual Analog Scale (VAS), the Short Form of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS-SF), the Central Sensitization Inventory (CSI), and the Shoulder Pain and Disability Index (SPADI). Results: Of the patients, 28 were male and 45 were female with a mean age of 54.89±10.24 (range, 32 to 70) years. Neuropathic pain was present in 26% of patients, while 28.8% exhibited central sensitization (CS), indicating nociplastic pain. Patients with both neuropathic and nociplastic pain had significantly higher SPADI scores ( p < 0.05), indicating greater functional impairment. However, nociplastic pain alone was not significantly associated with disability. Patients with CS had higher VAS scores and longer symptom duration ( p < 0.05), indicating its role in pain chronicity. Conclusion: In non-traumatic shoulder disorders, neuropathic and nociplastic pain mechanisms overlap; however, their clinical impacts differ. Nociplastic pain increases pain perception, whereas neuropathic pain is more strongly associated with functional impairment. These findings highlight the importance of multidisciplinary treatment strategies that target both pain components rather than focusing solely on CS.

Objective: Chronic nonspecific neck pain (CNSNP) is a prevalent musculoskeletal disorder linked to disability, reduced quality of life, and high healthcare costs. Virtual reality–mediated hypnotherapy (VRH) may represent a cost-effective adjunct. This randomized controlled trial (RCT) evaluated the effectiveness of VRH combined with conventional physiotherapy. Methods: Sixty-eight patients with CNSNP were randomized (1:1) to physiotherapy alone or physiotherapy plus VRH. Physiotherapy consisted of transcutaneous electrical nerve stimulation, hot pack application, and cervical stabilization exercises, five times per week for 3 weeks. The VRH group additionally received 20 min HypnoVR ^® sessions. Outcomes included pain (Visual Analog Scale), disability (Neck Disability Index), quality of life (Nottingham Health Profile), sleep (Pittsburgh Sleep Quality Index), and healthcare costs, assessed at baseline, posttreatment, and 6 weeks. Results: Sixty-three patients completed the study (31 VRH, 32 control). Both groups improved in pain, disability, sleep, and quality of life (all p < 0.001). The VRH group showed greater pain reduction posttreatment ( p = 0.007) and at 6 weeks ( p = 0.044). Disability was lower posttreatment ( p = 0.038). VRH also provided superior short-term gains in sleep, mobility, and emotional well-being, although some effects diminished by 6 weeks. Healthcare costs were significantly reduced at 1 month ( p = 0.013) but not at 6 months. Conclusion: Adding VRH to conventional physiotherapy improved pain, disability, sleep, and emotional outcomes in CNSNP, while lowering short-term costs. Although benefits decreased over time, VRH appears safe, feasible, and associated with lower short-term costs. Larger, long-term trials are needed to establish durability.

Objective: This study aimed to compare the clinical effectiveness of 5% and 15% dextrose prolotherapy (PrT), combined with exercise therapy and bracing, versus exercise therapy alone in patients with chronic lateral epicondylitis (LE). Methods: This retrospective study included patients with LE, and participants were divided into three groups: exercise only ( n = 29), 5% PrT + exercise ( n = 30), and 15% PrT + exercise ( n = 36). PrT was performed under ultrasound guidance at weeks 0, 3, and 6 targeting the forearm extensor muscles and annular ligament entheses. All patients used an epicondylitis brace and followed a 12-week home exercise program. Pain [visual analog scale (VAS)], function [patient-rated tennis elbow evaluation (PRTEE)], and grip strength were measured at baseline, week 6, and week 12. Results: All groups showed significant within-group improvements in VAS, PRTEE, and grip strength. Both PrT groups had significantly greater improvements in pain and function than those of the exercise-only group at weeks 6 and 12. Grip strength in flexion was significantly higher in both PrT groups than that in the exercise group at week 12. No significant differences were found between the 5% and 15% PrT groups in extension and pinch grip strength across groups. Conclusion: 5% and 15% dextrose prolotherapy are both more effective than exercise alone in improving pain, function, and grip strength in chronic LE. The increased handgrip strength at week 12 suggests that prolotherapy may aid muscle strength recovery. The absence of significant differences between the prolotherapy groups indicates that higher concentrations of dextrose may not be necessary to achieve clinical improvement.

Objectives: This study aims to develop immersive virtual reality (VR) versions of the box and block test (BBT), the 360° turn test, and five times sit-to-stand (5TSTS) test to evaluate functional status within a VR-mediated gamified environment and assess their concurrent validity. Patients and methods: Thirty participants (18 males, 12 females; mean age: 59.9±11.9 years; range, 25 to 82 years) with a stroke diagnosis were included in the prospective study between February 2024 and August 2024. Each participant completed the BBT, 360° turn test, and 5TSTS test three times using both VR-based and traditional methods. Concurrent validity was examined by analyzing the correlations between VR-mediated and traditional test results. The test-retest reliability of the VR-based assessments was evaluated using intraclass correlation coefficients (ICCs). The usability of the developed software was also assessed using the System Usability Scale. Results: Strong correlations were found between VR-based and traditional assessment methods for the affected side in the BBT (r=0.562; pConclusion: The VR-based versions of the BBT, 360° turn test, and 5TSTS are valid, reliable, and user-friendly tools for assessing functional status in stroke patients. These assessments show promise for integration into clinical settings and remote rehabilitation programs.

Objectives: This study aims to investigate the effectiveness of the Graston method, an instrument-assisted soft tissue mobilization (IASTM) technique, on pain reduction, trigger point count (TPC), pain pressure threshold (PPT), disability, depression, and quality of life. Patients and methods: This randomized, double-blind, sham-controlled study included 84 female patients who were divided into three groups: the Graston group (GG), the sham group (SG), and the control group (CG). In addition to exercise, IASTM was applied to GG with the Graston technique, while the IASTM device was applied to SG without any technique. The CG received exercise only. Patients were assessed before and after treatment using the Numerical Rating Scale (NRS), TPC, PPT, Neck Disability Index (NDI), Beck Depression Inventory (BDI), and the World Health Organization Health-Related Quality of Life-Brief Form (WHOQOL-BREF). Results: Eight patients were lost to follow-up, and one patient failed to adhere to the exercise program. Hence, data from 75 female patients (mean age: 33.8±13.2 years) were analyzed. A statistically significant improvement was detected in NRS, TPC, PPT, and NDI in all groups. The difference in NDI and BDI scores in the GG was statistically significantly higher than in the SG. A statistically significant difference was detected in the GG compared to the CG in the changes in NRS, left-sided TPC, total TPC, NDI scores, BDI scores, and WHOQL-BREF physical health subgroup scores. Conclusion: Adding IASTM treatment to exercises for treating myofascial trigger points provided additional benefits on quality of life, depression, and disability. However, IASTM treatment applied with the Graston technique and sham treatment was similarly effective on pain and the TPC. The IASTM treatment did not affect PPT.

Background Chronic non-specific low back pain (CNSLBP) is a prevalent musculoskeletal disorder associated with pain, functional limitations, reduced quality of life, and increased healthcare costs. Virtual reality (VR)-mediated hypnotherapy combines immersive VR with hypnosis, offering a potential non-pharmacological intervention for CNSLBP. Aim To evaluate the effects of VR-mediated hypnotherapy (VRH) on pain, functional status, sleep quality, quality of life, psychological outcomes, and healthcare expenditures in individuals with CNSLBP. Methods In this prospective, parallel group, randomized controlled trial, 60 participants with CNSLBP were randomly assigned to receive either standard physiotherapy alone (control group, n = 30) or physiotherapy plus 15 sessions of VRH (VR group, n = 30). Outcomes—including pain intensity, functional disability, sleep quality, quality of life, anxiety and depression, healthcare expenditures, and software usability—were assessed at baseline, post-intervention, and six-week follow-up. Results VRH significantly reduced pain and functional disability and improved sleep quality and overall quality of life immediately post-intervention compared with control. At six weeks, only sleep improvements remained significant. Anxiety and depression scores did not differ between groups. Healthcare expenditures were significantly lower in the VR group at one month, but not at six months. The intervention was well tolerated, with transient side effects, and received a good usability rating (SUS: 72.4 ± 8.1). Conclusions VRH is a feasible and well-tolerated adjunct to physiotherapy for CNSLBP, producing short-term improvements in pain, function, sleep, and quality of life, with early reductions in healthcare expenditures. Further, larger-scale trials are needed to confirm the long-term benefits and evaluate the potential for home-based implementation. ClinicalTrials.gov registration number: NCT06698354, Date: 21.11.2024.

Fibromyalgia (FM) is a multifactorial syndrome with poorly understood pathophysiology, characterized by chronic widespread pain and fatigue affecting the central and peripheral nervous systems, as well as the endocrine and muscular systems. These characteristics create significant challenges in diagnosis and treatment. This study compared the metabolic profiles of FM patients and healthy controls using one‐dimensional (1D) 1H nuclear magnetic resonance (NMR) spectroscopy and multivariate statistical analysis to identify potential biomarkers associated with FM symptoms. Urine and serum samples from 50 FM patients and 50 healthy individuals underwent untargeted metabolic profiling. Quantitative ¹ H‐NMR spectroscopy was used to determine metabolic changes. Chemometric models and receiver operating characteristic (ROC) curves were generated using the MetaboAnalyst platform. Fold change (FC) analysis and t ‐tests were conducted to determine statistically significant differences between groups. Our findings showed significant differences at the metabolic level between FM patients and healthy controls. Increased urea, glutamate, valine, taurine, proline, glycine, and homoserine metabolites, and decreased benzoate, leucine, π‐methylhistidine, galactitol, τ‐methylhistidine, glutamine, 3‐hydroxykynurenine, and fructose levels were observed in FM serum; while increased malate, dimethylamine, trimethylamine N ‐oxide (TMAO), creatine phosphate, N ‐phenylacetylglycine, N ‐acetylglutamate (NAG), hippurate, and urea levels were observed in FM urine, and decreased guanidoacetate, creatine, malonate, serine, glucuronate, creatinine, and uracil levels were observed. Serum glutamate was positively correlated with waist/hip ratio (WHR) and negatively correlated with Fibromyalgia Impact Questionnaire (FIQ) and Visual Analog Scale (VAS); negative correlations existed between taurine and FIQ and VAS; a positive correlation existed between urea and WHR; there was a positive correlation between anserine and body mass index (BMI). Also, in urine, there were positive correlations between TMAO, N ‐phenylacetylglycine, glutamate, and xylose and WHR; negative correlations existed between glutamine and FIQ; and a positive correlation existed between glucuronate and FIQ. Our findings provide important information about potential biomarkers, associated different metabolites, and metabolic pathways of FM patients; we think that they will provide new insight into the pathogenesis of the disease and help expand our knowledge.