Seher Özyürek

Purpose: To investigate frontal-plane shoulder and pelvic angle changes between double-leg and single-leg stance in axial spondyloarthritis (axSpA) and to examine their associations with core endurance and clinical parameters.Material and Methods: In this cross-sectional study, 55 patients with axSpA (categorized as non-radiographic axSpA, radiographic axSpA without spinal structural involvement, or radiographic axSpA with spinal structural involvement) and 19 healthy controls were evaluated. Core endurance was assessed using flexor, extensor, and bilateral side bridge tests. Angle changes were evaluated using a two-dimensional mobile posture analysis system. Results: Extensor endurance was significantly lower in patients with radiographic axSpA with spinal structural involvement group than in controls (adjusted p=0.010). Frontal-plane shoulder and pelvic angle changes did not differ between groups (p>0.05) and were not associated with core endurance or clinical parameters. Weak correlations were observed between right-stance shoulder angle change and selected spinal mobility measures.Conclusion: Endpoint frontal-plane shoulder and pelvic angle changes were not detectably altered in axSpA. These findings reflect endpoint alignment rather than continuous compensatory movement strategies.

Purpose: This study aimed to evaluate differences in diaphragm and deep abdominal muscle function between patients with ankylosing spondylitis (AS) and healthy controls and to examine their relationships with clinical parameters, including spinal mobility, quality of life, and balance performance. Materials and Methods: Patients with AS and healthy controls were included. Diaphragm and deep abdominal muscles were evaluated using two-dimensional ultrasonography. The clinical status of AS patients was assessed using ASDAS, BASDAI, BASFI, BASMI, and ASQoL. Static and dynamic balance were assessed with the NeuroCom Balance Master, including limits of stability (LOS) and sit-to-stand (STS) tests. Results: 30 AS patients (27 male, 3 female) and 33 healthy controls (27 male, 6 female) were assessed. Ultrasound measurements showed significant between-group differences in diaphragm thickness at end-expiration (p = 0.021), transversus abdominis (TrA) thickness at rest (p = 0.009), and TrA thickening fraction during the abdominal drawing-in maneuver (p = 0.010). AS patients demonstrated lower scores in several LOS and STS parameters compared with controls (p < 0.05). A significant negative correlation was found between the thickening fraction of the internal oblique muscle (TF _IO ) and ASQoL (r = −0.371, p < 0.05). TF _IO showed positive correlations with BASMI (r = 0.439, p < 0.05) and tragus-to-wall distance (r = 0.461, p < 0.05). For the internal oblique muscle, resting thickness correlated positively with cervical rotation (r = 0.464, p < 0.01), while TF _IO correlated negatively with cervical rotation (r = −0.571, p < 0.01). Conclusion: AS patients exhibit greater diaphragm end-expiratory thickness and resting TrA thickness than controls; however, reduced TrA thickening fraction indicates functional impairment despite these structural changes.

Background: Ultrasound-based diaphragm thickness assessment is increasingly used in respiratory and rehabilitation settings. However, measurements may be influenced by body position, potentially confounding clinical interpretation. Objective: To investigate whether common recumbent positions (supine, prone, side-lying) alter end-expiratory right hemidiaphragm thickness at the end of quiet expiration in healthy young men. Methods: In this randomized-order, within-subject cross-sectional study, 41 healthy male participants (18–24 years) underwent B-mode ultrasound assessment of right hemidiaphragm thickness at the zone of apposition during end-expiration. Three measurements per position were averaged. Differences across positions were analyzed using the Friedman test. Results: Diaphragm thickness differed significantly across positions ( p < 0.001), with greatest values observed in prone, followed by side-lying and supine positions. Conclusion: End-expiratory diaphragm thickness is posture-dependent in healthy young men. These findings demonstrate that diaphragm thickness measurements are strongly posture-dependent and highlight the necessity of strict positioning standardization for reliable ultrasound-based clinical assessment.

Objective This study aimed to investigate the relationship between the severity of obstructive sleep apnea (OSA) and stiffness of the genioglossus (GG) and geniohyoid (GH) muscles using shear wave elastography (SWE), a non-invasive ultrasonographic technique. Methods A total of 102 participants were enrolled, including 51 patients with OSA and 51 healthy controls. Muscle stiffness of the GG and GH was measured using SWE. OSA severity was determined according to the Apnea-Hypopnea Index (AHI) from full-night polysomnography. Comparative and correlation analyses were performed between groups and across severity levels. Results GH muscle stiffness was significantly higher in the OSA group than in controls (p = 0.017), whereas GG stiffness showed a non-significant trend (p = 0.061). Among OSA subgroups, GH stiffness was significantly greater in moderate cases than in mild cases, (p = 0.017), but no significant difference was found in GG stiffness across severity levels. Measurement reliability for both muscles was excellent (ICC > 0.95). No significant correlation was observed between stiffness values and daytime sleepiness. Conclusion This study demonstrates that GH stiffness increases with OSA and may reflect compensatory muscular adaptations, particularly at moderate disease stages. SWE appears to be a reliable and non-invasive method for assessing upper airway muscle characteristics, offering potential as a supportive tool in OSA evaluation.

Background/Objectives: We investigated whether cervical sensitive nerves (CSN) provide motor input to the trapezius muscle and how this relates to short-term functional outcomes after neck dissection. Methods: A total of 22 neck dissections were performed in 17 patients; the SAN was preserved. CSN roots (C2–C4) were stimulated intraoperatively using IONM. Shoulder and neck function were evaluated preoperatively and at 3 months in 15 operated necks using goniometry, an IMU-based motion analysis system (iSen), trapezius isometric strength, the Modified Constant–Murley Score (MCMS), and the Shoulder Pain and Disability Index (SPADI). Results: CSN-evoked trapezius responses were detected in 10/22 (45.5%) dissections (C2: 6/22, 27.2%; C3: 4/22, 18.2%; C4: 0/22). Postoperatively, neck extension/rotation and shoulder abduction/external rotation decreased significantly within groups; upper and middle trapezius strength and MCMS also declined. Shoulder flexion loss was smaller when CSN motor participation was present. Median shoulder flexion (goniometry) changed from 162°→140° in CSN(+) vs. 170°→131° in CSN(−) (between-group p = 0.024). With iSen, shoulder flexion changed 120°→116° in CSN(+) vs. 122°→97° in CSN(−) (p = 0.033). Conclusions: Approximately half of the neck dissections exhibited CSN-related motor responses. Short-term shoulder flexion was better preserved when CSN motor participation was present, suggesting that documenting CSN motor input intraoperatively may inform early rehabilitation planning.

Purpose: Proprioceptive Neuromuscular Facilitation (PNF) is a widely used rehabilitation approach. However, there are limited studies examining the effect of PNF in a critical care setting. Therefore, we aimed to investigate the acute effects of PNF-based exercises compared to active range of motion (ROM) exercises on respiratory and hemodynamic responses in critically ill patients. Material and Methods: Twenty-one spontaneously breathing non-intubated adult critically ill patients were randomly assigned to either PNF-based exercise group (n=10) or active ROM exercise group (n=11). Respiratory rate (RR; breath/min), peripheral oxygen saturation (SpO2; %), heart rate (HR; beat/min), systolic blood pressure (SBP; mmHg), diastolic blood pressure (DBP; mmHg) and mean blood pressure (MBP; mmHg) were measured using bedside monitoring system. The dyspnea severity and perceived exertion of patients were evaluated using the 0-10 numeric rating scale. Data were recorded at before, immediately after, and 5 minutes after (recovery) each exercise session. Results: Two-way repeated-measures ANOVA revealed that there were no clinically significant differences between groups in RR (breath/min), SpO2 (%), HR (beat/min), SBP (mmHg), DBP (mmHg), and MBP (mmHg) variables, the severity of dyspnea (score) and perceived exertion (score) (P>0.05). Conclusion: In the treatment of spontaneously breathing non-intubated patients, exercises based on the PNF technique can be safely performed in terms of respiratory and hemodynamic responses compared to active ROM exercises in a critical care setting.

Amaç: Gebelik ve doğum süreci kadın vücudunda fizyolojik, hormonal, anatomik ve biyomekaniksel değişime yol açmaktadır. Lumbar omurga başta olmak üzere, tüm omurgada meydana gelen bu adaptasyonların omurga sagital eğrileri üzerine etkilerini inceleyen çalışma sayısı sınırlıdır. Çalışmadaki amaç, doğum hikayesi olan ve olmayan kadınlarda omurganın ayakta duruştaki statik sagital eğriliklerini karşılaştırmaktı. Yöntem: Çalışmaya 18-57 yaş aralığında 201 sağlıklı kadın (doğum hikayesi olan 87 ve olmayan 114 katılımcı) dahil edildi. Torakal kifoz ve lumbal lordoz (C7-S2 vertebra aralığı) Spinal Mouse cihazı ile değerlendirildi. Oswestry Disabilite İndeksi ve İskandinav Kas İskelet Sistemi Sorgusu dahil edilme ya da dışlama kriteri olarak kullanıldı. Bulgular: Katılımcıların (n=201 ve yaş ortalaması: 35,73±11.29 yıl) ortalama torakal kifoz derecesi 48.50±9.66 ve lumbar lordoz derecesi 32,66±12,33 idi. Katılımcılar hiç doğum yapmamış (n=114 doğum hikayesi olmayan) ve en az 1 kez doğum yapmış (n=87 doğum hikayesi olan) kadınlardan oluşmaktaydı. Gruplar arasında torakal kifoz ve lumbal lordoz açısından anlamlı bir fark bulunmadı (p>0,05). Doğum sayılarına göre de torakal kifoz ve lumbal lordoz gruplar arasında benzerdi (p>0,05). Sonuç: Çalışma sonuçları, doğum hikayesi olan ve olmayan kadınların omurga sagital eğriliklerinin benzer olduğunu gösterdi. Ayrıca doğum hikayesi olan kadınlarda torasik kifoz ve lomber lordoz açılarının doğum sayısından etkilenmediği gözlendi.

Objectives This study aimed to compare the thickness and stiffness of the masseter, anterior temporalis, and sternocleidomastoid muscles of patients diagnosed with myofascial temporomandibular disorders (TMD) pain to those of a control group. Methods This was a cross-sectional study conducted at a single center. Twenty-five patients diagnosed with myofascial TMD pain and 29 asymptomatic controls (Control Group) matched by age and sex were recruited. B-mode ultrasonography and shear wave elastography were used to measure the thickness and stiffness of the bilateral masseter, temporalis, and sternocleidomastoid muscles. All measurements were performed while resting and clenching. Patients were systematically evaluated for pain intensity and maximum mouth opening. Results There were no differences between groups in the resting and clenching thickness of any muscles (p > 0.05). There were no differences in the stiffness of the measured muscles at rest and clench between the groups, except for the masseter (p > 0.05). Individuals with myofascial TMD pain showed higher median stiffness in the right (p < 0.001) and left (p = 0.003) masseter muscles during clenching (but not during resting) compared with controls. Conclusions Clenching masseter stiffness was greater in individuals with myofascial TMD pain than in asymptomatic controls. These findings might help to understand the jaw biomechanics and dysfunction of individuals with myofascial TMD pain.

Context: Proprioceptive neuromuscular facilitation stretching (PNFS) is suggested to improve the range of motion and flexibility as an active warm-up. Recently, the foam rolling (FR) methods have also emerged as a passive warm-up. However, the combined effects of PNFS and FR are still unclear, and no reports have compared their effects using thermal imaging. This study investigated the acute effects of combining nonvibration FR (NVFR) and vibration FR (VFR) prior to PNFS, in comparison with PNFS alone, on hamstring flexibility and thigh skin temperature. Design: Randomized controlled trial. Methods: Participants (n = 60) were randomly assigned to PNFS, NVFR + PNFS, VFR + PNFS, and control group (CG). Active knee-extension (AKE), sit and reach (SR) test, and thermal imaging were evaluated before (pre-int), immediately after (post-int), and 30-minutes after (post₃₀-int) intervention. Results: All intervention groups had a significant increase at all time periods (P < .001) except the CG in terms of AKE and sit and reach test (P > .05). Combined (NVFR + PNFS/VFR + PNFS) groups had also a significant increase in the post₃₀-int compared with pre-int and post-int values of thigh skin temperature (P < .001). Combined groups, over time, had the best post₃₀-int effect on increasing skin temperature. The study found a significant interaction effect between interventions and time across several measurements (P < .05). Combined groups showed more significant improvements in AKE compared to CG at post-int (P < .05). There is a similar change in AKE, SR test, and skin temperatures between combined groups and PNFS alone at both post-int and post₃₀-int (P < .05). Conclusions: These findings indicate that using FR, with or without vibration, before PNFS does not provide an additional benefit in improving hamstring flexibility and thigh skin temperatures compared with PNFS alone.