Clinical trials

Bronchiectasis is a chronic respiratory disease clinically characterized by recurrent pulmonary exacerbations, chronic cough, and sputum production, and is associated with an increase in the airway-artery ratio and permanent airway dilatation. It is recognized as the third most common chronic respiratory disease after chronic obstructive pulmonary disease (COPD) and asthma. In the International Classification of Diseases and Related Health Problems (ICD-10), it has its own diagnostic code (J47.9). In bronchiectasis, mucociliary clearance is impaired due to bronchial dilatation, and the insufficient clearance of bacteria and mucus from the respiratory tract leads to persistent infection, inflammation, and further airway damage. Progressive airway damage results in impaired lung function, worsening of symptoms, and, ultimately, respiratory failure and death. It can represent the final pathway of various infectious, allergic, inflammatory, genetic, and degenerative disorders, making it one of the most complex and heterogeneous syndromes. Some patients present with daily symptoms, while others remain asymptomatic except during exacerbations. The most common symptom is chronic cough caused by purulent or mucopurulent sputum. Other symptoms include dyspnea, pleuritic chest pain, wheezing, fatigue, and weight loss. Fever, however, is not a common finding and differs from pneumonia. The most frequently used classification system categorizes bronchiectasis into varicose, cylindrical, and saccular (cystic) types. In the most severe form, the saccular type, the bronchi lose their structural integrity completely, forming cystic structures filled with secretions. The mildest form is cylindrical, in which the bronchi have thick, straight walls. In the varicose type, localized narrowings are observed. Diagnosis is made following history and physical examination, with high-resolution computed tomography (HRCT) being the most sensitive and specific method, along with sputum culture and chest radiography. The goals of bronchiectasis treatment are to manage symptoms, prevent complications, and improve quality of life. Both pharmacological and patient-managed interventions are commonly applied. Pharmacological treatments include antibiotics, bronchodilators, and corticosteroids, which are generally administered via inhalation. Patient-managed interventions require active participation and behavioral modification. Within published guidelines, airway clearance techniques are widely described under pulmonary rehabilitation (PR), but there is no consensus regarding PR itself. For individuals with reduced exercise tolerance, participation in PR and engagement in physical activity are recommended. However, research has shown that referral rates to PR are often low, and exercise and physical activity are not consistently prescribed. Within PR, techniques such as the active cycle of breathing techniques (ACBT), postural drainage, thoracic expansion exercises, and various airway clearance methods are applied, with inspiratory muscle training (IMT) forming an important component. Functional inspiratory muscle training (FIMT) is an IMT program developed by considering not only the ventilatory roles of the respiratory muscles but also their non-respiratory functions. FIMT integrates inspiratory muscle training with core stabilization and postural control exercises. The rhythmic co-contractions of the muscles in the core region support trunk stability and provide the basis for movement. In the first stage of the program, participants receive IMT, and subsequently, core stabilization training and dynamic trunk activation exercises are incorporated into the intervention. A review of the literature reveals that no studies have investigated the effectiveness of FIMT in adults with bronchiectasis. In our study, we aim to evaluate the effects of FIMT, applied in addition to home-based chest physiotherapy, on pulmonary function, diaphragm thickness, balance, core stability, functional capacity, physical activity, posture, and quality of life in adults with bronchiectasis. Furthermore, we aim to compare these outcomes with those of IMT applied alongside home-based chest physiotherapy. We believe that this approach will contribute to the development of treatment strategies in clinical practice and help address existing gaps in the literature.

Obesity, defined as excessive fat accumulation, is a chronic, complex, and global health issue. It is increasingly prevalent worldwide and is considered a disease that requires treatment. According to recent data, 43% of adults aged 18 and over were classified as overweight, and 16% as obese. In Turkey, a national health survey reported that among individuals aged 15 and above, 20.2% were obese, and 35.6% were in a pre-obese state based on their body mass index (BMI). The effects of excess weight on health are significant, as weight gain shortens life expectancy and reduces quality of life. Obesity has detrimental effects on many systems, including the respiratory system. It reduces the compliance of the lungs and chest wall, alters respiratory patterns and ventilation-perfusion relationships, impairs gas exchange, and decreases lung volumes. In some individuals, respiratory control is altered due to the effects of adipokines, which can lead to hypoventilation and increased levels of carbon dioxide in the blood (hypercapnia). Obesity affects the respiratory system both symptomatically (e.g., shortness of breath) and functionally. Respiratory function disorders in individuals with obesity may include decreased functional residual capacity (FRC), expiratory reserve volume (ERV), and, in some cases, reduced total lung capacity (TLC). Additionally, obesity is a health issue that affects sleep quality. There are three proposed bidirectional relationships: obesity causes poor sleep, poor sleep contributes to obesity, and both may coexist. Individuals with obesity often report poor sleep quality and sleep disorders such as sleep apnea. The primary function of the respiratory system is gas exchange, which is closely related to the mechanical properties of the respiratory pump. The functionality of this pump depends on the interaction of the lungs, abdominal wall, ribs, intercostal muscles, and the diaphragm. In diseases that impair the structure of the diaphragm, improving its function can alleviate symptoms and significantly enhance pulmonary function test results. Kinesiology taping (KT), an elastic therapeutic taping method, is commonly used for musculoskeletal disorders but has a wide range of clinical applications. Kinesiology tapes are reported to support weak muscles, increase circulation, reduce pain by stimulating the neurological system, provide proprioceptive feedback, and correct joint misalignments. The mechanism by which KT influences muscle strength depends on the application technique, which can either enhance or inhibit muscle activation. The underlying mechanism is explained by the stimulation of sensory-motor and proprioceptive systems, aiming to improve muscle function through enhanced neuromuscular feedback. Kinesiology taping has also shown potential benefits in respiratory conditions by improving diaphragm function, reducing respiratory muscle fatigue, and enhancing overall respiratory mechanics. Understanding the effects of thoracic kinesiology taping on respiratory function, vital signs, sleep, quality of life, and cognitive functions in individuals with obesity is of great importance for physiotherapists and researchers. The findings from this study may provide valuable insights for developing comprehensive rehabilitation programs and improving the health status of individuals with obesity. Therefore, the aim of this study is to investigate the effects of thoracic kinesiology taping on respiratory functions, respiratory muscle strength, vital signs, sleep, quality of life, and cognitive status in individuals with obesity.