Busra Ulker Eksi

Background/aim: Respiratory muscle training (RMT) and breathing exercises are crucial components in cardiopulmonary rehabilitation. RMT includes inspiratory muscle training (IMT) and expiratory muscle training (EMT); however, existing RMT devices typically support only one of these. Incentive spirometers, which also provide visual feedback for breathing exercises, are frequently used. Achieving an RMT program requires multiple devices, which increases both the cost and complexity of the training regimen. This study aimed to design, calibrate, and test a novel individualized respiratory exercise device that integrates both IMT and EMT functions into a single unit, thereby offering a cost-effective, user-friendly alternative for comprehensive cardiopulmonary rehabilitation. Materials and methods: The design process involved a comparative analysis of existing RMT devices. A concept design was developed, followed by a three-dimensional-printed prototype. Calibration was performed using a pressure meter, with tests conducted on ten healthy volunteers across a range of inspiratory and expiratory pressures. Additionally, a pilot clinical study involving six healthy adults assessed the device’s impact on maximum inspiratory and expiratory pressures (MIP, MEP) and functional exercise capacity during an eight-week RMT period. Results: The internal consistency of the lowest (0.919) and the highest (0.841) levels of inspiration pressure, and of the lowest (0.901) and the highest (0.856) levels of expiration pressure, were highly reliable. Each healthy participant who completed the eight-week RMT program showed increases in MIP, MEP, and six-minute walking distance. Conclusion: The novel respiratory exercise device successfully combines IMT and EMT functions with an incentive spirometer, enabling comprehensive respiratory exercises and RMT within a single unit. Its ease of use and adaptability make it a promising option for both clinical and home-based rehabilitation, potentially improving accessibility and adherence to cardiorespiratory rehabilitation protocols. Further clinical studies will investigate the effects of this novel device in cardiopulmonary rehabilitation.

Objective: Patient education is a key component of diabetes management and chronic disease care, facilitating behavioral changes and supporting effective self-management. Reliable instruments for assessing patients’ diabetes knowledge are essential for identifying educational needs and designing evidence-based strategies. The purpose of this study was to examine the reliability and validity of the Turkish adaptation of the Diabetes Education Questionnaire (DATE-Q) in evaluating the diabetes knowledge of individuals with diabetes. Methods: This methodological study was conducted with 200 people with type 1 (T1DM) or type 2 diabetes mellitus (T2DM). The study involved translation, back-translation, and cross cultural adaptation of the DATE-Q. The Turkish version of the Revised Diabetes Knowledge Test (DKT2) was used for validation. Criterion validity was assessed using Spearman's correlation between DATE-Q and DKT2. Cronbach’s alpha and intraclass correlation coefficient (ICC) values were used to determine the reliability. Results: Participants had a mean age of 55.9 ± 12.5 years, 63% were female, and 82.5% had T2DM. The Turkish DATE-Q demonstrated moderate criterion validity with the DKT2 (r = 0.576, P < .001). Internal consistency was excellent (Cronbach’s alpha = 0.90), and test–retest reliability was strong (ICC = 0.80-0.96). Conclusion: The Turkish version of the DATE-Q is a moderately valid and strongly reliable tool for assessing diabetes knowledge. Its use in research and clinical settings can support endocrinologists, physiotherapists, dietitians, and nurses in identifying patients’ knowledge gaps, developing tailored education programs, and promoting effective self-management strategies. Incorporating the DATE-Q into multidisciplinary diabetes care may enhance patient outcomes and help prevent diabetes related complications. Cite this article as: Yiğit S, Akıncı B, Ekşi BU, et al. Validity and reliability of the Turkish version of the diabetes education questionnaire (DATE-Q) in people with diabetes. Endocrinol Res Pract. Published online February 6, 2026. doi: 10.5152/erp.2026.25791.

Age-related declines in strength and balance increase fall risk in nursing home residents. This study compared the effects of the modified Otago Exercise Program and the Large-Amplitude Functional Exercise Program (LAFEP) on fall risk, balance, functional capacity, and lower-extremity strength. In this randomized controlled trial, 70 participants (aged ≥ 65) residing in nursing homes were randomly assigned to the modified Otago Exercise Program ( n = 35) or the LAFEP ( n = 35). Both groups received supervised group exercise three times weekly for 12 weeks. Primary outcomes were the functional reach test and the timed up-and-go test. Secondary outcomes included the Performanz Balance System, the 6-min walk test, and the five times sit-to-stand test. Both interventions led to significant within-group improvements ( p < .05). However, the LAFEP group demonstrated significantly greater improvements in dynamic balance, specifically in the functional reach test ( p = .03). Improvements in functional mobility outcomes, including the timed up-and-go ( p = .67) and the five times sit-to-stand tests ( p = .17), were also more pronounced in the LAFEP group; however, these between-group differences did not reach statistical significance. Both the modified Otago Exercise Program and the LAFEP were effective in enhancing balance and functional outcomes for older adults in residential care. The LAFEP, however, yielded superior gains specifically in dynamic balance. The findings suggest that the LAFEP, adapted from neurorehabilitation principles, may be a viable and potentially more effective alternative to conventional fall prevention exercise programs for this population.

Purpose: The aim was to investigate the immediate effects of high-intensity resistance training with blood flow restriction (HIRT-BFR) on rectus femoris (RF) muscle activity, reaction time, muscular performance, and delayed onset muscle soreness (DOMS) in healthy young adults. Methods: Twenty-four healthy young adults were randomized into the HIRT-BFR group or HIRT group. Both groups performed a single session of training with 80% of 1RM, 8 repetitions, 2 sets, and 3 minutes rest to RF muscle. The activity and reaction time of the dominant extremity RF muscle were evaluated by superficial electromyography (sEMG), muscular performance by single-leg squat test, and DOMS by the Visual Analog Scale. Results: Single-leg squat performance was significantly increased in HIRT-BFR (p = .001) and HIRT group (p = .04). Additionally, in HIRT group resting average (p = .03), resting maximal voluntary contraction % (p = .04), and relaxation minimum (p = .02) values of RF were significantly increased. DOMS level decreased significantly in HIRT-BFR (p < .001) and HIRT group (p = .019). The differences were similar in the groups for sEMG parameters, muscle performance, and DOMS level. Conclusion: We observed that HIRT-BFR and HIRT were similar in terms of muscle activation, reaction time, muscular performance of the RF, and DOMS level.Trial registration number: This study is registered at www.clinicaltrails.gov (NCT05274542).

Type of funding sources: None. Backround: Vitamin D is essential for the optimal function of many bodily systems and it is associated with various types of metabolic illnesses such as obesity, diabetes mellitus, insulin resistance, and cardiovascular diseases including hypertension. Decreased absorption of vitamin D may pose a risk for sarcopenia by affecting the lipid profile responses in metabolic syndrome (MetS). Our aim is to examine the relationship between vitamin D level and selected sarkopenia parameters such as muscle and fat mass, muscle strength, body composition, and walking speed in patients with MetS. 67 patients (mean age=50.3±7.69/years, F:51, M:16) aged 35-65 years and diagnosed with MetS (according to NCEP-ATP III criteria) were included in the study. Body mass index (BMI), muscle and fat mass of the participants were assessed using bioelectrical impedance analysis (TANITA). Waist and hip circumferences were measured. Right and left quadriceps muscle strength (J-Tech CommanderTM Muscle Tester) and grip strength (Jamar dynamometer) of the dominant hand (all patients were right dominant) were measured with dynamometer. Walking speed was calculated by dividing the distance walked by minutes in the 6-minute walking test. Of the patients, 9 (13.4%) were categorized as deficiency (<12 ng/mL), 10 (14.9%) had inadequacy (≥12 and 0.05). In this study, although vitamin D level was associated with left lower extremity muscle strength in patients with MetS, it was not associated with other sarcopenia parameters such as muscle mass, upper extremity muscle strength and walking speed. The relationship between vitamin D level, fat mass and body composition seen in our study may be due to altered lipid metabolism responses. We think that the effects of vitamin D on sarcopenia in MetS should be prospectively examined in a larger sample including elderly patients and considering the vitamin D intake.