Ozan Bahadır Türkmen

Scoliosis is a three-dimensional structural deformity of the spine characterized by lateral curvature, vertebral axial rotation, and alterations in sagittal physiological curves. Physio-logic® exercises have been reported to correct deformity in adolescent idiopathic scoliosis (AIS) patients by reducing the degree of trunk rotation. The purpose of this preliminary study was therefore to examine the acute effect of Physio-logic® exercises on muscle tone and stiffness of trunk muscles in patients with idiopathic scoliosis. Five patients diagnosed with AIS, with a mean age of 16.2 years and a mean Cobb angle of 24.8 degrees, were included in the study. Participants underwent a single session of Physio-logic® exercises targeting the improvement of sagittal physiological curvatures of the spine, applied regardless of curve type. Muscle tone and stiffness of the trapezius, erector spinae, and latissimus dorsi muscles were assessed bilaterally using the MyotonPRO device, and the angle of trunk rotation was measured with a scoliometer, both before and after the exercise session Following the exercise, decreases in muscle tone were observed in the trapezius (right: 7.23%, left: 3.75%), upper latissimus dorsi (right: 9.34%, left: 5.10%), and lower latissimus dorsi (right: 7.69%, left: 1.70%), while an increase in tone was detected in the erector spinae (right: 1.75%, left: 4.32%). Similarly, stiffness decreased in the trapezius (right: 18.38%, left: 9.20%), upper latissimus dorsi (right: 19.65%, left: 5.92%), and lower latissimus dorsi (right: 19.48%, left: 4.02%), whereas erector spinae stiffness increased bilaterally (right: 6.37%, left: 9.03%). These findings indicate that a single session of Physio-logic® exercises produces acute and differential modulation of trunk muscle tone and stiffness in AIS patients, with consistent reductions in the superficial back muscles and concurrent increases in the erector spinae. As this is a preliminary study evaluating acute efficacy, further investigations with larger samples are needed to examine the long-term changes in muscle tone and stiffness associated with Physio-logic® exercises, as well as the differential effects across distinct scoliotic curve types.

Temporomandibular disorders (TMD) involve complex interactions among behavioral and musculoskeletal factors, and machine learning (ML) has increasingly been used to model these multidimensional relationships. This study aimed to investigate the relationship between smartphone addiction and TMD symptoms by evaluating the possible contributions of clinical variables such as head posture, cervical dysfunction, and masseter muscle sensitivity to this relationship and by examining the multivariate structure using ML methods. A single-blind, cross-sectional study was conducted among university students in Turkey. Participants completed several assessments: Smartphone Addiction Scale-Short Version (SAS-SV), Fonseca Anamnestic Index for TMD severity, Neck Disability Index, Numerical Rating Scale, forward head posture, and masseter muscle pressure pain threshold using algometry. Data were analyzed using Pearson correlation, logistic regression, and various ML classification algorithms (e.g., extreme gradient boosting [XGBoost], support vector machines). Shapley additive explanations analysis was applied to determine variable importance in ML models. In this study, XGBoost demonstrated the most successful performance in determining the relationships between smartphone addiction and TMD symptoms, while the support vector machines model showed the most successful performance in classifying participants. The findings suggest that this ML based approach, taking into account postural abnormalities and masseter muscle sensitivity, could contribute to the early identification of individuals at risk for TMD and the planning of targeted intervention strategies. Research findings have revealed complex relationships between SAS-SV and TMD symptoms among university students. In analyses conducted using ML algorithms, the support vector machines model stood out with the highest classification accuracy (area under the curve [AUC] = 0.94) and performance indicators. Shapley additive explanations analyses showed that smartphone usage time, masseter muscle sensitivity, and Fonseca Anamnestic Index score were the most decisive variables on SAS-SV. In TMD prediction, the highest predictive power was explained by temporomandibular joint pain. Ensemble models such as random forest and gradient boosting yielded more successful results with lower error rates and higher R ² values compared to classical regression methods. The findings indicate that smartphone use indirectly affects TMD through postural disorders and muscle sensitivity.

Aim: The aim of this two-stage systematic review is (1) to outline the scope of health problems commonly seen throughout the lives of individuals with Down syndrome (DS) and (2) to synthesise the effectiveness of exercise interventions implemented for these problems through multidimensional health outcomes. The review aimed to comprehensively evaluate the clinical value of exercise-based approaches for problems observed in individuals with DS in the cardiovascular, respiratory, metabolic, neuromotor, musculoskeletal, postural control, gait, and cognitive/psychosocial domains. Methods: The review was conducted in accordance with the PRISMA 2020 guidelines, and the study selection/exclusion processes were managed using the Covidence programme. Searches were conducted in the Web of Science, Scopus, PubMed, and MEDLINE databases using relevant keywords. After removing duplicate records, two independent researchers performed title-abstract and full-text screenings. Experimental or observational studies describing health problems in DS or implementing exercise/physical activity interventions for these problems were included in the review. Results: A total of 51 studies were included. In the first phase, individuals with DS demonstrated a high prevalence of congenital heart disease (CHD) (40–67%), predominantly ventricular septal defect (VSD), atrial septal defect (ASD), and atrioventricular septal defect (AVSD). CHD markedly increased mortality risk in complex cases, while early echocardiographic screening and timely surgery improved survival. Obesity and obstructive sleep apnoea were highly prevalent from early childhood, and aerobic capacity indicators (VO₂peak, HRpeak) were consistently reduced independent of adiposity. Musculoskeletal abnormalities—including pes planovalgus, impaired postural control, and altered gait patterns—were common and contributed to reduced functional performance. In the second phase, exercise interventions demonstrated clear multidomain clinical benefits in DS. Core stability and treadmill-based training improved balance, whereas structured motor programmes enhanced fundamental motor skills. Resistance and multicomponent exercise improved muscle strength, functional fitness, and oxidative stress markers. Sports-based interventions (e.g., swimming, Nordic walking, basketball) enhanced locomotor capacity and participation. Respiratory-focused approaches such as proprioceptive neuromuscular facilitation (PNF) and chest physiotherapy improved pulmonary function. Technology-assisted modalities—virtual reality (VR) and transcranial direct current stimulation (tDCS)—supported neuroplasticity and yielded clinically meaningful motor and cognitive gains. Conclusion: This systematic review demonstrates that health problems affecting multiple systems are common and determine quality of life in individuals with DS; however, appropriately planned exercise programmes provide meaningful benefits at biological, motor, cognitive and psychosocial levels. Early screening and follow-up, along with individualised, multi-component exercise approaches, are considered a fundamental intervention strategy for reducing cardiometabolic risks, maintaining functional independence, and increasing social participation in DS.

Objective: This study aims to investigate the relationship between static and dynamic core stabilization with agility and speed among female basketball players. Core stability, encompassing static and dynamic components, is fundamental for maintaining balance and enhancing athletic performance. Materials and Methods: Fifteen female athletes from the Bandırma Basketball Team participated, undergoing a series of core stability, agility, and speed assessments. These included the plank and double leg lowering test for static core stability, back extensions for dynamic core stability, the Hexagonal Obstacle Test (HOT) for agility, and a 20-meter sprint test for speed. Results: The results revealed a significant positive correlation between static core stability (plank test) and speed performance (r=0.576, p=0.025), suggesting that greater static core stability enhances sprinting capability. However, no significant correlations were observed between dynamic core stability (back extensions) and either agility or speed. Additionally, agility and speed showed a moderate correlation (r=0.569, p=0.027), indicating a mutual influence. Conclusion: These findings highlight the importance of static core stability for speed performance and suggest that training programs for basketball athletes could benefit from emphasizing static core exercises to enhance sprinting ability.

Fibromiyalji sendromu (FS) ve kronik yorgunluk sendromu (KYS), yaygın kas-iskelet ağrıları, yorgunluk, uyku bozuklukları ve bilişsel zorluklarla karakterize kronik rahatsızlıklardır. Dünya Sağlık Örgütü tarafından tanımlanan FS, irritabl bağırsak sendromu, temporomandibular eklem disfonksiyonu ve ortostatik intolerans gibi çeşitli rahatsızlıklarla ilişkilendirilir. FS'nin en belirgin semptomları arasında yaygın ağrı, ruh hali değişiklikleri ve günlük aktiviteleri yerine getirememe durumu yer alır. KYS ise özellikle dinlenmeyle geçmeyen ve uzun süren yorgunlukla karakterize olup bilişsel, immünolojik ve endokrin bozukluklarla ilişkilendirilir. Her iki sendromun da etiyolojisi tam olarak aydınlatılamamış olup, genetik ve çevresel faktörlerin rol oynadığı düşünülmektedir. KYS ve FS, yorgunluk, yaygın ağrı ve uyku bozuklukları gibi birçok örtüşen semptomla kendini gösteren iki oldukça benzer bozukluk olarak bilinmektedir. Ancak, bu benzerliklere rağmen, iki durumunun da farklı olarak kavramsallaştırmak için yeterli destekleyici veriler bulunmaktadır. FS, ek koşulların varlığında veya yokluğunda tanı konulmasını mümkün kılan bir tanısal varlık olarak değerlendirilmektedir. KYS, başka bir yorgunluk oluşturan bozukluğun varlığını dışlayan, oldukça dışlayıcı bir tanım olarak öne çıkmaktadır. FS ve KYS’nin tedavisi genellikle semptomların yönetimine odaklanır. Farmakolojik tedavide ağrı kesiciler, antidepresanlar ve antikonvülsanlar kullanılırken, egzersiz, bilişsel davranışçı terapi ve fizyoterapi yaklaşımları gibi farmakolojik olmayan yöntemler de önemlidir. Her iki sendrom da yaşam kalitesini düşürmekte ve multidisipliner bir tedavi yaklaşımı gerektirmektedir. Fibromyalgia syndrome (FS) and chronic fatigue syndrome (CFS) are chronic conditions characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. FS, as defined by the World Health Organization, is associated with various conditions such as irritable bowel syndrome, temporomandibular joint dysfunction, and orthostatic intolerance. The most prominent symptoms of FS include widespread pain, mood disturbances, and an inability to perform daily activities. CFS, on the other hand, is primarily characterized by prolonged fatigue that is not relieved by rest and is associated with cognitive, immunological, and endocrine dysfunctions. The etiology of both syndromes remains unclear, although it is believed that genetic and environmental factors play a role. FS and CFS are recognized as two very similar disorders, as they both present with overlapping symptoms such as fatigue, widespread pain, and sleep disturbances. However, despite these similarities, there is sufficient evidence to conceptualize them as distinct conditions. FS is considered a diagnostic entity that can be identified with or without the presence of additional conditions, whereas CFS is defined more restrictively, excluding the presence of other fatigue-inducing disorders. The treatment of FS and CFS typically focuses on symptom management. Pharmacological treatments include pain relievers, antidepressants, and anticonvulsants, while non-pharmacological approaches such as exercise, cognitive-behavioral therapy, and physiotherapy are also important. Both syndromes significantly reduce quality of life and require a multidisciplinary treatment approach.

İnsan vücudu dengeye yönelik tehdidi algılama ve düşmeyi önlemek için yerçekimi kuvvetine karşı koymak üzere kas aktivitesini kullanma yeteneğine “postüral kontrol” denir. Postüral kontrolün sağlanmasında değişik stratejiler bulunmaktadır. Bu stratejileri ‘reaktif’ veya ‘prediktif’ ya da her ikisinin kombinasyonu şeklinde gerçekleşebilmektedir. Postüral kontrol görsel, vestibuler ve somato- sensoriyal girdiler tarafından sağlanan duyusal bilginin etkili şekilde santral sisteme yönlendirilmesini içermektedir. Fiziksel yorgunluk, kas liflerinden gelen duyusal afferentlerin azalmasıyla sonuçlanan tekrarlayan bölgesel yorgunluk veya çok eklemli hareket görevleri içeren genel yorgunluk nedeniyle kas kuvvetinde egzersize bağlı düşüşler olarak tanımlanmaktadır. Genel yorgunluk oluşturan egzersizlerin çoğu uzayda tüm vücudun yer değiştirmesine neden olurken (koşma ve yürüme gibi) bölgesel yorgunluk (örneğin diz ekstansiyonları) tüm vücudun yer değiştirmesi yerine sadece segmental hareketlerden kaynaklanmaktadır. Fiziksel yorgunluğun, vücuttaki duyusal proprioseptif ve eksteroseptif bilgileri veya bu bilgilerin bütünleşmesini etkileyerek kas sisteminin verimliliğini azaltarak kas yorgunluğu oluşturduğu belirtilmektedir. Zihinsel yorgunluk ise uzun süreli zihinsel faaliyetler sırasında veya sonrasında ortaya çıkan psikofizyolojik bir durum olarak açıklanmaktadır. Zihinsel yorgunluk sonrası postüral kontrolde bozulmaların, periferal ve merkezi sistemlerdeki değişikliklerin yanı sıra propriosepsiyondaki bozulmalardan kaynaklandığını öne sürülmektedir. Sonuç olarak, yorgunluğun postüral kontrol üzerindeki etkisi, yorgunluğun çok boyutlu ve karmaşık doğası nedeniyle tek bir süreçle açıklanamayacak kadar geniş bir yelpazede ortaya çıkmaktadır. The ability of the human body to perceive threats to balance and use muscle activity to counteract the force of gravity to prevent falls is called “postural control”. There are different strategies to maintain postural control. These strategies can be reactive or "predictive or a combination of both. Postural control involves the effective orientation of sensory information provided by visual, vestibular and somatosensory inputs to the central system. Physical fatigue is defined as exercise-induced decreases in muscle strength due to repetitive regional fatigue resulting in decreased sensory afferents from muscle fibers or general fatigue involving multi-joint movement tasks. Most exercises that produce general fatigue involve displacement of the whole body in space (e.g. running and walking), whereas localized fatigue (e.g. knee extensions) results from segmental movements only, rather than displacement of the whole body. Physical fatigue is said to reduce the efficiency of the muscular system by affecting sensory proprioceptive and exteroceptive information in the body or the integration of this information, resulting in muscle fatigue. Mental fatigue is described as a psychophysiological state that occurs during or after prolonged mental activities. It is suggested that impairments in postural control after mental fatigue are caused by changes in peripheral and central systems as well as impairments in proprioception. In conclusion, the impact of fatigue on postural control is too extensive to be explained by a single process due to the multidimensional and complex nature of fatigue.

Background and Objectives: The aim of this study was to investigate the immediate and long-term effects of breathing exercises on simple and choice reaction time. Materials and Methods: A total of 31 participants were included in the study. The participants were randomly divided into two groups. The intervention group (IG; n:16) received 12 sessions of breathing exercises for four weeks (three days a week), while the control group (CG; n:15) received no intervention. Both groups underwent the same assessments at the same times: at baseline, after the first exercise session, and after four weeks/after 12 exercise sessions. Reaction time was assessed using three conditions: choice reaction time (CRT) of the upper limb, auditory reaction time (ART), and visual reaction time (VRT) tests. The first assessment was applied at baseline. The second assessment measured the short-term effect of the breathing exercises after the study group received their first breathing exercise session. The third assessment, to determine the long-term effect, was repeated four weeks after the baseline (A4W) assessment after completing 12 breathing exercises. Results: There was no significant difference between the groups at baseline, immediately, and A4W (p < 0.05) for the VRT, ART, and CRT results with the dominant hand (DH), whereas a group-by-time interaction was found only for the visual reaction time results with the non-dominant hand (nDH) (p > 0.05). Conclusions: The results of this study, which included the evaluation of the immediate and long-term effects of breathing exercises on reaction time, showed an improvement in visual reaction time between the groups over time. In further studies, it is recommended to evaluate the changes and responses in the central nervous system with objective methods to reveal the effect of breathing exercises on reaction time more clearly.