Clinical trials

Low back pain is a common musculoskeletal disorder associated with substantial disability and reduced quality of life. Although magnetic resonance imaging (MRI) is frequently used to identify structural spinal abnormalities, the relationship between MRI findings and treatment outcomes remains unclear. This retrospective study aims to evaluate whether the effectiveness of a standardized physical therapy program differs according to baseline lumbar MRI findings. Medical records of 120 patients with low back pain who underwent lumbar MRI and completed 15 sessions of physical therapy between January 2022 and February 2026 will be reviewed. Patients will be classified into three MRI-based groups: disc herniation, disc degeneration, and non-specific MRI findings. Treatment outcomes will be assessed using changes in Visual Analog Scale (VAS) pain scores and Oswestry Disability Index (ODI) scores before and after treatment. The findings may contribute to identifying patient subgroups that respond differently to conservative treatment and support more individualized rehabilitation strategies.

The Trendelenburg sign is a common clinical finding indicating hip abductor dysfunction and altered pelvic stability. The relationship between the Trendelenburg sign, spinopelvic biomechanics, hip muscle strength, and lumbar magnetic resonance imaging (MRI) abnormalities remains insufficiently understood. This study aims to investigate the association between Trendelenburg sign positivity and lumbar MRI findings, including facet arthropathy, ligamentum flavum hypertrophy, multifidus muscle morphology, and psoas muscle characteristics, as well as spinopelvic biomechanical parameters and hip abductor muscle strength.

The aim of this study is to evaluate the effects of action observation therapy and motor imagery methods, provided in addition to a conventional physiotherapy and rehabilitation program, on gross motor function, upper and lower extremity functional skills, and quality of life in children with cerebral palsy.

Objective: To evaluate the effectiveness of adding Myofascial Release Technique (MRT) to Clinical Pilates in adults with chronic non-specific low back pain (CNSLBP). Hypothesis: MRT combined with Pilates will lead to greater improvements in pain, functional disability, and soft tissue mobility compared to Pilates alone. Design \& Intervention: Randomized controlled trial. Participants (18-45 years) will be randomly assigned to: MRT + Clinical Pilates Clinical Pilates only for 6 weeks (2 sessions/week). Outcomes: Primary: Pain (VAS), ultrasonographic thickness (multifidus \& thoracolumbar fascia) Secondary: Disability (ODI), lumbar mobility, balance Eligibility: Adults with CNSLBP ≥3 months; excluding spinal surgery, rheumatic disease, and pregnancy.

The purpose of this study is to examine the effects of nomophobia levels on stress, food addiction, and body image among undergraduate students aged 18-30 at Bahçeşehir University, Faculty of Health Sciences. The primary questions it aims to answer are: * Is there a statistically significant relationship between nomophobia levels and perceived stress, food addiction, and body image among university students? * Is there a correlation between objective anthropometric data (body fat percentage, skeletal muscle mass) measured via Bioelectrical Impedance Analysis (BIA), waist/hip circumference measurements, and the individual's perceived body image?

The goal of this observational study is to learn if a combination of postural exercise programs and ergonomics education can provide protective and therapeutic effects against work-related musculoskeletal disorders (WMSDs) in academic and administrative office staff at Bahçeşehir University (aged 20-55, working at least 3 months in an office setting). The main questions it aims to answer are: Does a 6-week program of ergonomics training and regular posture exercises reduce the frequency and severity of musculoskeletal pain? Can structured ergonomics education improve the alignment of the office environment with international safety standards (OSHA)? Is there a measurable improvement in the sleep quality of office workers following these interventions? Researchers will compare the pre-intervention baseline data to post-intervention results (after 6 weeks) to see if the interventions lead to a statistically significant reduction in physical discomfort and an increase in ergonomic compliance. Participants will: Undergo a comprehensive baseline assessment, including the Cornell Musculoskeletal Discomfort Questionnaire, New York Posture Analysis, and Pittsburgh Sleep Quality Index (PSQI). Attend a one-day intensive training program covering both theoretical ergonomics and practical postural exercises. Receive an instructional brochure with a QR code providing access to exercise videos.Perform the prescribed ergonomic adjustments and exercises during workdays for a duration of 6 weeks.Complete a follow-up assessment after 6 weeks to evaluate changes in pain levels, posture, and environmental compliance.

This randomized controlled trial will evaluate the effects of eye exercises and eye exercises plus self-cervical mobilization versus ergonomic education in office workers with mechanical neck pain. A total of 66 participants will be randomized to one of three groups and followed for 6 weeks. Outcomes assessed at baseline and week 6 include pain (VAS), cervical proprioception (joint position error), neck disability (NDI), cervical range of motion, and quality of life (Nottingham Health Profile).

Reasons such as sleep disorders, depression, decreased independence in daily living activities and decreased quality of life, which are seen in the majority of liver cirrhosis patients, can cause cognitive dysfunction, especially attention. It is known that physical dysfunctions are observed in patients with liver cirrhosis along with cognitive dysfunction. Sarcopenia is the most important of these dysfunctions. Sarcopenia is the progressive, widespread loss of muscle mass, function and strength. The aim of this study is to determine the effects of face-to-face and home-based progressive strengthening exercise program performed 3 times a week for 12 weeks on muscle strength, muscle mass, functionality and cognitive functions in individuals with liver cirrhosis. It is also aimed to test the feasibility and effectiveness of the home-based exercise method in individuals with liver cirrhosis. Another aim of our study is to determine the exercise dose required to improve muscle strength, muscle mass, functionality and cognitive functions in individuals with liver cirrhosis and the duration of treatment effectiveness through follow-up.

Stroke is a leading cause of long-term disability, and upper extremity impairments-affecting about 80% of survivors-limit functional reach, grasp, and manipulation more severely than lower limb deficits. Despite partial recovery of walking ability, meaningful functional use of the paretic arm remains limited. Conventional rehabilitation often lacks sufficient intensity, task specificity, and motor learning principles, highlighting the need for more effective approaches. The subacute phase of stroke (up to 6 months post-onset) represents a period of heightened neuroplasticity and strong rehabilitation potential. During this time, integrating cognitive and motor training-such as attentional focus strategies-has gained attention. External focus enhances movement efficiency through motor automaticity, whereas internal focus supports early motor control. Evidence suggests that combining these strategies may optimize recovery, yet their relative effectiveness in stroke rehabilitation remains unclear. Two main instructional approaches exist: combined attentional focus (internal and external cues delivered within the same session) and sequential attentional focus (internal focus first, followed by external focus as control improves). While both show therapeutic promise, comparative data in stroke populations are lacking. This study aims to compare combined versus sequential attentional focus instructions in improving upper extremity function in subacute stroke. We hypothesize that a combined approach-starting with internal focus early, then integrating external focus-will yield superior motor improvements.

This study aims to examine the psychological status and quality of life of families with children who have rare genetic disorders. The focus of the study is to understand how the child's level of functional independence relates to the well-being of the family. Functional independence will be assessed using standardized tools, and parental psychological status and quality of life will be evaluated with validated questionnaires. The information gathered from this study may help improve the understanding of how rare genetic disorders affect family dynamics and daily functioning. The results may guide health care professionals in planning family-centered physiotherapy, psychological support, and care programs.

This study investigates the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on cognitive performance in healthy adults. The study uses a sham-controlled, cross-over design in which each participant receives both active taVNS and sham stimulation in separate sessions. Each participant completes both conditions (active and sham) in a randomized order using a crossover design. Cognitive performance will be assessed before and after each session using standardized tests. The study also explores whether males and females respond differently to taVNS, in order to identify potential sex-related differences in cognitive outcomes.

Adhesive capsulitis (frozen shoulder) is a complex condition characterized by inflammation, fibrosis, and restriction of movement in the shoulder capsule, significantly limiting an individual's participation in daily living activities. It is most commonly observed in individuals aged between 40 and 60 years, and its treatment frequently involves approaches such as manual therapy, exercise, corticosteroid injections, and electrotherapy. However, these conventional methods may be limited by factors such as lack of motivation, pain-related avoidance behavior, and poor treatment adherence. Today, immersive virtual reality technologies introduce a new dimension to rehabilitation by gamifying exercise, providing sensory feedback, and enabling graded exposure through mechanisms such as distraction and engagement. They also enhance motivation and compliance with exercise programs. Studies in the literature have reported that virtual reality-based exercise is an effective method for reducing pain levels in patients diagnosed with frozen shoulder. However, only a limited number of studies have specifically examined the effects of immersive virtual reality in patients with adhesive capsulitis. To date, no study has investigated the impact of immersive virtual reality interventions on sleep and cognitive functions in these patients. Furthermore, the combined effect of patient education, home exercise programs, and immersive virtual reality therapy has not yet been explored. For these reasons, the present study aims to investigate the effects of immersive virtual reality-based exercise therapy on pain, functionality, sleep, and cognitive functions in patients with Grade 1-2 adhesive capsulitis.

Non-specific low back pain (NSLBP) is one of the most common musculoskeletal disorders all over the world and a leading cause of disability. It affects individuals across different age groups and is typically characterized by pain, stiffness, and functional limitations that reduce physical activity and overall quality of life. Among established clinical approaches, Core exercises are frequently used in the management of LBP, reducing pain and improving functionality by stabilizing the spine. However, despite their widespread use, there is limited evidence on the effectiveness of combining core exercises with cognitive interventions, such as action observation. Motor imagery (MI) and action observation (AO) offer practical, low-cost approaches that can be easily integrated into rehabilitation programs. Motor imagery involves the individual visualizing the physical movement in their mind without performing it, while action observation involves learning specific movements by observing them. These techniques can strengthen the effectiveness of physical exercises by increasing neuromuscular activation. However, it has been reported that motor imagery-based cortical processes facilitate the reorganization of sensory-motor functions during daily activities in LBP patients. Studies in this area are quite limited. The effectiveness of action observation therapy, which is primarily effective in neurological conditions, has not been investigated in non-specific low back pain. Therefore, in this study, the effects of combining action observation therapy with a core exercise program, Pain, Function, Endurance, Kinesiophobia, and Sleep Quality in patients with non-specific low back pain will be examined. The study aims to investigate the effects of combining action observation therapy with core exercises compared with core exercises alone in patients with NSLBP. Patients attending Fizyowell physiotherapy and Healthy Services clinic who meet the inclusion criteria will be included in the study. This study seeks to explore the potential benefits of integrating cognitive techniques into a conventional exercise-based rehabilitation for NSLBP. To establish participant eligibility before the study begins, a standardized demographic data form will be collected from all subjects who volunteered to participate in the study, including gender, age, height, weight, education, marital status, chronic diseases and medication use, smoking, and alcohol use. In addition, the Mini-Mental State Examination (MMSE) will be used to assess the patient's mental state, determine the ability to understand and follow instructions, and identify cognitive disorders that may make it difficult to perform mental interventions. The Movement Imagery Questionnaire-3 (MIQ-3) will be used to determine each participant's motor imagery ability. Once eligibility is confirmed, baseline assessments will be conducted, including pain intensity measured by the Visual Analog Scale (VAS), functional disability assessed using the Oswestry Low Back Pain Disability Index Questionnaire, kinesiophobia evaluated with the Tampa Scale for Kinesiophobia (TSK), core endurance tested through standardized endurance measures, and sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI). After the initial evaluation, the treatment program will be started. Advances in the treatment method specific to the groups they belong to are explained in detail below. Treatment: After the first evaluation, the core exercise program will be applied to the patients in Group 1, 3 days per week for 6 weeks. All sessions will be conducted under the supervision of a physiotherapist at the clinic. Group 2: Conservative Treatment + Action Observation Program. This group will have action observation therapy in addition to the core exercise program. The patients in this group will receive an action observation therapy for 6 minutes before each exercise therapy session. They will watch videos of 2 different activities, the duration of each video is 3 minutes, and they were recorded from 3 planes (frontal, back, and lateral).

Introduction: Motor Imagery (MI) and Action Observation (AO) are well-established cognitive training techniques that activate neural networks similar to those involved in actual motor execution. MI involves the mental rehearsal of a movement without physically performing it, while AO relies on observing an action performed by others to stimulate motor-related brain areas. Recent studies suggest that when these methods are combined, they may enhance motor learning, cortical plasticity, and strength gains more effectively than when applied alone. The non-dominant hand, often less trained and weaker in performance compared to the dominant hand, provides an ideal model to examine the effects of these interventions. Strengthening the non-dominant upper limb has implications not only for improving functional balance between the limbs in healthy individuals but also for potential clinical applications in rehabilitation. Aim: The primary aim of this randomized controlled study is to investigate the combined effect of MI and AO on muscular strength and functional performance of the non-dominant hand in healthy university students. Specifically, the study seeks to compare the outcomes of three groups: (1) AO combined with MI, (2) MI only, and (3) a control group with no intervention. It is hypothesized that participants in the AO+MI group will demonstrate greater improvements in grip strength and functional outcomes compared to the other groups. Evaluation: To comprehensively measure the effects of the intervention, several standardized assessment tools will be employed. Motor imagery ability will be evaluated using the Motor Imagery Questionnaire-3 (MIQ-3). Hand dominance will be determined by the Edinburgh Handedness Inventory. Grip strength will be objectively measured using a Hand Grip Dynamometer. The Recognise App will be used to assess laterality recognition and sensorimotor integration, while overall upper limb function will be measured through the Short Musculoskeletal Function Assessment (SMMT). These evaluations will be conducted both before and after the 4-week intervention period to track changes. Treatment: The intervention will span four weeks, with participants attending 2-3 sessions per week. Training protocols will include both cognitive and physical components. In the MI group, participants will engage in guided motor imagery sessions focused on visualizing non-dominant hand exercises. The AO+MI group will observe video demonstrations of the same hand movements, followed by simultaneous motor imagery practice, thereby combining visual and cognitive engagement. Physical strengthening exercises will include dumbbell wrist flexion and handball squeeze, targeting key muscles of the non-dominant hand and forearm. The control group will not undergo any intervention during this period. By integrating AO and MI with specific strengthening exercises, the study aims to determine whether this combined approach enhances neural activation and muscular strength more effectively than MI alone.

This study aims to investigate the effects of video game-based balance exercises, in addition to standard treatment, in children aged 5-12 years with lower urinary tract dysfunction (LUTD). The single-center study will include 30 children who will be randomly assigned to an experimental group (video game-based balance exercises + standard treatment) or a control group (standard treatment only). Children in the experimental group will play selected balance games using the Wii console and Wii Balance Board twice a week for 8 weeks. All participants will receive the standard program consisting of urotherapy, diaphragmatic breathing exercises, biofeedback-assisted pelvic floor muscle training, and functional exercises. Outcomes will be assessed using a Bladder Diary, uroflowmetry, ultrasonography for post-void residual urine, pelvic floor muscle activity with EMG, the Dysfunctional Voiding and Incontinence Symptoms Score Questionnaire(DVISS), quality of life with the Pediatric Incontinence Quality of Life Questionnaire (PinQ), balance tests, the McGill Core Endurance Test, and the Physical Activity Enjoyment Scale.

The basic concept of prehabilitation is to increase the functional capacity of the individual to withstand an expected injury. It embodies the idea of being proactive against the common reactive approach of rehabilitation. While the initial prehabilitation model was limited to physical training, it has now evolved into a multimodal entity that includes nutritional optimisation, psychosocial preparation and smoking cessation in addition to exercise programmes. In the last decade, there has been an increasing effort to coincide prehabilitation with surgery, as surgery is rightly perceived as a stressor for human structural and physiological functions.

This study aims to investigate the effects of dual-task exercises on balance and cognitive function in individuals with varying levels of physical performance. Dual-task training, which involves performing cognitive and motor activities simultaneously, has been shown to improve functional mobility, especially in older adults and patients with neurological conditions. However, limited data exist on how these effects differ among individuals with different physical capacities. The findings of this study will contribute to understanding the therapeutic value of dual-task exercises in promoting both physical and cognitive health.

Healthy participants will be included in this study by invitation and randomised into three groups. Participants in each group will receive bilateral transcutaneous vagus nerve stimulation with the same frequency, current transit time and current intensity. Heart rate variability will be measured over the chest in the first group, over the right arm in the second group and over the left arm in the third group. Then, the differences between the groups in heart rate variability parameters (time-dependent, frequency-dependent) will be compared. The aim of this study is to examine the differences between heart rate variability measurements measured at different sites.

Due to the nature of competitive sports, frequent and regular training by e-sports players to increase their performance provides e-athletes with success in the field, but it also increases the time spent in front of the screen. It is known that e-athletes train for an average of 5.5 to 10 hours per day. Therefore, sedentary behavior that develops due to screens is an issue that e-athletes should be careful about. While reasons such as disrupted sleep patterns, increased stress levels and mood changes experienced in the game following increased screen time negatively affect cardiovascular and metabolic health, the fact that e-sports do not require any physical effort also negatively affects the e-sports player's muscular activation. Due to the reasons mentioned, e-sports can cause chronic diseases in the long term. The process from the presence of a stimulus to the execution of the action that will occur following the stimulus is called reaction time. Reaction time can also be described as the value taken when a stimulus exceeds the threshold value, when movement is released or at the beginning of the explosive response. Reaction time consists of stages. The process, which starts with the transmission of the sensory stimulus through the receptors, establishes a perceptual link with the motor response and decides to produce a reactive response, and ends with the process of producing a movement that requires muscular force in the perceptual process. In studies conducted on e-sports players, the most common complaints resulting from long training periods are vision problems and eye fatigue, followed by pain experienced especially in the back, neck and wrist areas. E-sports players perform with poor posture compared to traditional athletes. Games played on mobile phones, especially computer-based games, cause changes in the structure of the spine, pain complaints, movement limitations, and loss of stability and balance. It is argued that the main reason for the pain experienced by approximately half of the players is the anterior displacement of the head due to the prolonged static position spent in front of the screen after a certain number of minutes and the pains brought about by muscle strength imbalances. To our knowledge, there is no study in the literature that investigates the immediate effect of a myofascial release technique applied to university student e-sports players on hand reaction time, neck pain and cervical joint position sense parameters. The aim of this study is to investigate the instantaneous effect of a myofascial release technique, the Graston Technique, on hand reaction time, neck pain and cervical joint position sense in university student e-sports players. Our study is valuable in this respect.

The aim of this randomized controlled trial is to evaluate the effects of Structured Pelvic Floor Muscle Rehabilitation (SPFMR) in children with Primary Monosymptomatic Nocturnal Enuresis (PMNE) who are undergoing desmopressin asetat (DDAVP) treatment prescribed by a pediatric urologist. The study aims to investigate whether SPFMR can reduce the frequency and severity of enuresis episodes and whether it can also reduce relapse rates in the short- and long-term follow-up. The main questions the study seeks to answer are: * Does SPFMR reduce the frequency and severity of enuresis episodes in children with PMNE? * Does SPFMR treatment reduce relapse rates in children with PMNE in the long term? Researchers will compare the group receiving SPFMR in addition to DDAVP treatment with a control group receiving only DDAVP treatment. This comparison will help evaluate the effect of SPFMR on the severity of enuresis episodes and relapse rates. Participants will: * Receive DDAVP treatment (SPFMR group and Control group) * Participate in SPFMR sessions ( SPFMR group) * Keep a diary of enuresis frequency and severity * Assess relapse during short- and long-term follow-up The hypotheses of the study are: H0: Adding SPFMR to desmopressin treatment for children with PMNE has no short-term effect on the severity of enuresis episodes. H1: Adding SPFMR to desmopressin treatment for children with PMNE has a short-term effect on the severity of enuresis episodes. H0: Adding SPFMR to desmopressin treatment for children with PMNE has no long-term effect on the severity of enuresis episodes. H2: Adding SPFMR to desmopressin treatment for children with PMNE has a long-term effect on the severity of enuresis episodes.

Parkinson's disease is the most common progressive neurodegenerative movement disorder. Common movement impairments in Parkinson's include balance and walking difficulties. These impairments lead to falls, increased levels of functional dependency, and a decrease in quality of life. Exercise in Parkinson's patients improves their functional symptoms in daily life, enhancing both motor and non-motor skills, and consequently increases their quality of life. Recently, various additional methods have been developed to increase the effectiveness of exercise in Parkinson's rehabilitation and to contribute to motor skills. Focus of attention instructions are fundamental concepts in motor function learning. External focus of attention has been shown to facilitate motor function development, reduce postural instability, and improve dual-task walking by being easier to remember. In Parkinson's patients who experience freezing phenomena, internal focus of attention instructions enhance walking stability and movement control, thereby reducing the risk of falls. However, there are no studies on the combined focus of attention instructions in Parkinson's patients. This study is designed as a randomized controlled, single-blind, prospective trial to examine the effects of a combination of internal and external focus of attention instructions on walking, balance parameters, quality of life, and patient satisfaction levels, taking into account the presence of freezing phenomena in Parkinson's patients.