Clinical trials

This study aims to examine the associations of interoceptive awareness and interoceptive accuracy with plantar superficial sensory threshold, knee joint proprioception, pain intensity, and dynamic balance performance in cognitively intact individuals with chronic hemiplegia. Hypotheses are: * H0: There is no significant relationship between interoception and light touch, proprioception, pain, or dynamic balance performance in cognitively intact individuals with chronic hemiplegia. * H1: There is a significant relationship between interoception and light touch, proprioception, pain, or dynamic balance performance in cognitively intact individuals with chronic hemiplegia All participants will undergo a single assessment session and will not be invited for any treatment or follow-up evaluation. Participants will not take any intervention.

Lumbar disc herniation is one of the most common causes of low back pain and is associated with substantial functional limitations and reduced quality of life, particularly among working-age individuals. Displacement of disc material toward the spinal canal may result in mechanical compression and inflammation of the nerve roots, leading to pain, restricted movement, and reduced functional performance. The course of low back pain cannot be explained solely by biomechanical and anatomical factors. Psychosocial factors also play an important role in symptom persistence and functional outcomes. Within this context, the fear-avoidance model provides an important theoretical framework, suggesting that individuals may develop fear of movement and avoid physical activities because they believe these activities may increase pain or cause further injury. Over time, avoidance behaviors may contribute to physical deconditioning, reduced muscle function, and increased functional impairment. The Fear-Avoidance Beliefs Questionnaire is commonly used to assess individuals' beliefs regarding the relationship between pain, physical activity, and work-related activities. Higher levels of fear-avoidance beliefs have been associated with greater pain severity, increased disability, and poorer physical performance in individuals with low back pain. Trunk muscle endurance plays a key role in maintaining spinal stability. Adequate endurance of the paraspinal and abdominal muscles supports mechanical stability of the spine and contributes to the safe performance of functional movements. The Biering-Sørensen Test and plank test are commonly used to assess trunk muscle endurance in clinical and research settings. The Biering-Sørensen Test evaluates the endurance of the trunk extensor muscles, whereas plank-based tests assess the endurance of the anterior and lateral trunk musculature. Functional impairment in individuals with low back pain can be evaluated using the Oswestry Disability Index, a self-reported questionnaire that assesses limitations experienced during activities of daily living. Functional mobility and performance may also be evaluated using the Timed Up and Go test, which involves standing up from a chair, walking a short distance, turning, returning to the chair, and sitting down. This test reflects mobility, dynamic balance, and functional performance during daily activities. Postural control and balance may also be affected in individuals with low back pain. Reduced static balance performance can negatively influence functional activities and mobility. The Single-Leg Stance Test is a practical clinical measure used to assess postural stability and static balance. Although previous studies have examined associations between psychosocial factors and functional status in individuals with low back pain, studies evaluating the relationship between fear-avoidance beliefs, trunk muscle endurance, balance, and functional performance together remain limited. Identifying these relationships may contribute to the development of more comprehensive rehabilitation programs for individuals with lumbar disc herniation.

Background: Motion sickness (MS) is a common syndrome characterized by autonomic and behavioral symptoms, such as nausea and dizziness, resulting from exposure to motion stimuli. Its pathophysiology is closely linked to sensory conflict and postural instability theories. While previous studies suggest that postural control, proprioception, and reaction times are affected in individuals susceptible to MS, there is a lack of comprehensive, comparative research evaluating all these parameters concurrently within the same cohort using standardized methods. Objective: This study aims to systematically measure balance, proprioceptive sensitivity, coordination, and reaction time parameters, and quantitatively analyze their relationship with motion sickness severity. Methodology: In this prospective, cross-sectional study, at least 41 participants aged 18-40 with motion sickness will be recruited. Participants will undergo motion sickness susceptibility and severity grading using the Motion Sickness Susceptibility Questionnaire Short Form (MSSQ-SF) and the Graybiel Scale. Objective assessments will include static and dynamic balance testing (ProKin®), knee joint position sense (Clinometer app), manual dexterity and dynamic balance coordination (Nine-Hole Peg Test, Tandem Walk, Romberg Test), and upper/lower extremity reaction time measurements (BlazePod system).

The purpose of this randomized controlled trial is to investigate the effects of core training and inspiratory muscle training (IMT) on muscle oxygenation and athletic performance in youth male soccer players aged 15-18. A total of 54 healthy soccer players will be included and randomly assigned into three equal groups: the Control Group, the Core Training Group, and the Core Training + IMT Group. All interventions will be implemented for 8 weeks in addition to routine soccer training sessions. Assessments will be performed at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8). The primary outcome measures of the study are aerobic capacity assessed by the Yo-Yo Intermittent Recovery Test Level 1 and muscle oxygenation parameters monitored via near-infrared spectroscopy (NIRS) using a MOXY monitor. Secondary outcome measures include sprint performance, agility, dynamic balance, core muscle strength and endurance, inspiratory muscle strength, lower extremity explosive power, and soccer-specific technical performance tests. Overall, this study aims to reveal the combined effects of core training and inspiratory muscle training on muscle oxygenation, respiratory functions, aerobic capacity, and soccer performance, while explaining the underlying physiological mechanisms in youth athletes.

This study aims to investigate the effectiveness of a specific regional anesthesia technique, the Modified-Thoracoabdominal Nerve Block through a Perichondrial Approach (M-TAPA), on reducing pain after laparoscopic hysterectomy surgery. Hysterectomy is a common major surgical procedure, and managing postoperative pain is crucial for patient comfort and faster recovery. Participants will be randomly assigned to one of two groups: The M-TAPA Group: Patients will receive the nerve block using a local anesthetic (bupivacaine) before the surgery begins. The Control Group: Patients will receive standard postoperative pain management without the nerve block. The primary goal is to determine if the M-TAPA block reduces the total amount of opioid (morphine) used by patients in the first 24 hours after surgery. The researchers will also evaluate pain scores (NRS), the time until the first request for additional pain medication, patient satisfaction, and any side effects like nausea or vomiting

Smoking remains a significant public health problem among the young adult population. Epidemiological studies in Turkey show a steadily decreasing age of smoking initiation and a remarkably high rate of smoking among university-aged individuals. Exposure to secondhand smoke is known to have negative effects on the respiratory system, cardiovascular system, and peripheral muscle function. Impaired lung ventilation, reduced gas exchange, and insufficient oxygen transport due to smoking can lead to decreased exercise tolerance, premature fatigue, and increased perception of exertional dyspnea. These effects can manifest as a decrease in functional capacity even before the development of a clinically significant respiratory disease. Functional capacity is an important indicator reflecting an individual's ability to perform daily living activities and is frequently assessed in clinical research using submaximal exercise tests. The 6-Minute Walk Test is a widely used, valid, and reliable test for assessing cardiorespiratory endurance and overall functional status. Similarly, the 1-Minute Sit-Stand Test is recommended as a practical and applicable method for evaluating lower extremity muscle endurance and functional performance. Dyspnea is a multidimensional symptom reflecting an individual's subjective perception of respiratory discomfort and is assessed using scales such as the Modified Medical Research Council and the Borg Dyspnea Scale. The Turkish Thoracic Society's dyspnea assessment reports indicate that exertional dyspnea may increase in smokers even if respiratory function tests are within normal limits. Fatigue, on the other hand, is a significant symptom that negatively affects an individual's daily living activities and physical functionality, arising from inflammatory processes, impaired oxygenation, and decreased physical activity levels associated with smoking. The Fatigue Severity Scale is a validated and reliable scale for assessing the impact of fatigue on an individual's physical and social life. While studies in the literature examine the effects of smoking on respiratory function and exercise capacity, studies that address the relationship between functional capacity and subjective dyspnea and fatigue in young adult smokers are limited. In particular, evaluating functional test results such as the 6-Minute Walk Test and the 1-Minute Sit-Stand Test together with dyspnea and fatigue perception will contribute to the early identification of subclinical functional effects. The aim of this study is to examine the relationships between functional capacity (6-Minute Walk Test, 1-Minute Sit-Stand Test, and Timed Up and Go Test) and subjective dyspnea (Modified Medical Research Council Scale - mMRC) and fatigue level (Fatigue Severity Scale) in young adult smokers aged 18-30 years. The findings of this study are expected to draw attention to the functional effects of smoking in young adults, contribute to the development of preventive health approaches, and facilitate the planning of physiotherapy-based assessment and intervention programs.

This study aims to understand how different types of fatigue affect balance and reaction time, proprioception, and fine motor in healthy young adults. Fatigue is a common experience in daily life and can arise from physical activity or prolonged mental effort. The study seeks to determine whether fatigue of the upper body, lower body, or mental fatigue from cognitively demanding tasks can negatively affect balance and reaction time, proprioception, and fine motor abilities. To examine this, participants will undergo controlled fatigue protocols designed to tire specific parts of the body or the mind. the Upper body fatigue will be induced through repeated maximal push-up sets performed until the participant can no longer maintain proper form. Lower body fatigue will be created through repeated maximal 1-minute squat jump sets, with participants touching a low box to ensure standardized depth and proper movement. Mental fatigue will be induced using a 20-minute computer-based cognitive task that alternates between the 2-back working memory task and the numerical Stroop task. These tasks are designed to require continuous attention, mental effort, and inhibitory control. Each type of fatigue will be induced independently, and participants' performance will be measured before and after each fatigue protocol. Following fatigue induction, participants will complete a series of tests designed to assess balance and reaction time, proprioception, and fine motor abilities. This includes both static and dynamic postural tasks, as well as reaction time and proprioceptive accuracy assessments. By evaluating these measures before and after fatigue, the study will determine how different forms of physical and mental fatigue impact postural stability, sensory processing, and precise motor control. The study addresses the question: "Do upper body fatigue, lower body fatigue, or mental fatigue reduce balance and reaction time, proprioception, and fine motor performance in healthy young adults?" The hypothesis is that each form of fatigue upper body, lower body, or mental-will meaningfully impair balance and reaction time, proprioception, and fine motor performance compared to non-fatigued conditions.

With the expansion of technology-based applications, daily phone use has increased significantly. According to a 2020 study, phone use habits among young adults aged 18-34 increased by 38.1%, and the time spent on the phone exceeding one hour increased by 68%. Currently, there is no clear definition of smartphone "addiction" or smartphone use, but like other types of addiction, it refers to the effort to control smartphone habits that cause problems or distress in daily life. Recent studies have reported a correlation between excessive screen use and individuals' mental and physical health. Excessive use of phones and video games causes many negative effects, including attention deficit, inability to enjoy life, hyperactivity, depression, anxiety, pain, and functional loss. Video games are a type of game played through an audiovisual device and can be story-based. While many video games improve players' critical thinking, strategic planning, and problem-solving skills, they can also cause musculoskeletal problems due to the long hours spent at the desk and the repetitive movements involved. The human spine is a kinematic chain with all joints interconnected; this means that changes in other body parts, such as the increased head tilt while texting on a smartphone, can have significant effects on the entire spine. A 2023 study showed an increase in spinal curvature, particularly in the cervical region, as smartphone use time increased. A study in Korea linked smartphone use to increased pain in the neck, wrists, hands, shoulders, and back. Another significant problem for smartphone users and video game players is "text neck," which occurs from prolonged screen time. This causes tension in the cervical spine, leading to neck pain and stiffness. Smartphone addiction leads to hand-related problems, primarily hand and wrist pain. Furthermore, excessive use of smartphones, game controllers, and joysticks can lead to repetitive strain injuries such as carpal tunnel syndrome. Prolonged phone use, repetitive movements, and uncomfortable hand positions during use cause inflammation of the muscles and tendons in the hands and wrists, leading to swelling, pain, and loss of function in these joints. Video games are played using devices such as computers, consoles, handheld computers, and smartphones. The continuous, repetitive, and uninterrupted movements performed while using these devices can lead to musculoskeletal disorders, particularly in the upper extremities. Prolonged playing of these games results in musculoskeletal problems such as carpal tunnel syndrome and tendinitis. Extensive studies have shown that individuals' pain and symptoms worsen after prolonged gaming sessions. However, to date, there has been no study comparing smartphone addicts and video game players. The aim of this research is to compare individuals with smartphone addiction, those who play video games for extended periods, and those without these habits in terms of pain, posture, and upper extremity function.

This prospective observational study aims to investigate the relationship between respiratory function and multidimensional athletic performance parameters in professional soccer players. The primary hypothesis of the study is that soccer players with enhanced respiratory function and superior respiratory muscle strength will exhibit optimized motor performance outcomes and shorter (faster) reactive reaction times. Investigators will evaluate respiratory muscle strength, spirometric pulmonary functions, dynamic balance, core and abdominal endurance, and reactive visuomotor reaction times during a single testing session within the competitive season.

This study aims to investigate the relationship between cervical position sense, core stabilization, and postural balance in university students aged 18-30 years with Upper Crossed Syndrome (UCS). Upper Crossed Syndrome is a common musculoskeletal disorder characterized by muscle imbalance, including weakness of the deep cervical flexors, middle and lower trapezius, rhomboids, and serratus anterior, along with tightness of the upper trapezius, levator scapulae, sternocleidomastoid, and pectoralis major and minor. This condition frequently affects university students due to prolonged sitting, extensive computer use, and poor posture. While previous research has focused on discrete components of UCS such as posture correction or pain management, the combined effects of cervical proprioception, core stability, and postural balance remain poorly understood. A total of 48 participants will be enrolled and divided into two equal groups: 24 students diagnosed with Upper Crossed Syndrome and 24 healthy students as a control group. Assessments include cervical joint position error testing, core stabilization endurance tests (Unilateral Hip Bridge Endurance Test and Sahrmann Five-Level Core Stability Test), static balance evaluation using the Balance Error Scoring System (BESS), and dynamic balance assessment using the Y-Balance Test. Pain intensity will be measured using the Visual Analog Scale (VAS). This study will help identify neuromuscular and sensory mechanisms underlying these parameters and support evidence-based rehabilitation techniques to improve postural alignment, reduce musculoskeletal dysfunction, and enhance overall functional performance in this population.

Low back pain is one of the most prevalent musculoskeletal disorders worldwide and significantly reduces individuals' quality of life, functional capacity, and productivity. Lumbar-related leg pain (LRLP) is observed in a substantial proportion of patients with low back pain and is associated with neurodynamic dysfunctions arising from peripheral nerve sensitization. Although the effects of neural mobilization on pain and functional outcomes have been investigated in the literature, studies examining its short-term effects on balance and proprioception remain limited. Therefore, this study aims to determine the immediate effects of sciatic nerve neural mobilization on balance and proprioception in individuals with LRLP exhibiting peripheral nerve sensitivity. The study will be designed as a prospective, randomized, controlled clinical trial. Participants will be recruited from individuals presenting to the Istinye University Health Practice and Research Center Hospital who meet the inclusion criteria. Following random allocation, 52 participants will be assigned either to the intervention group (neural mobilization) or the sham group (sham mobilization). In addition to a single-session standard conventional physiotherapy program, each group will receive its respective intervention protocol. Assessments will be conducted at two time points: before treatment and immediately after treatment. Static and dynamic balance as well as proprioception will be evaluated using the ProKin balance system; muscle mechanical properties will be assessed using the MyotonPRO device; pain threshold will be measured with an algometer; and flexibility will be evaluated using the sit-and-reach test.

This study aims to compare core muscle stability, postural balance, and flexibility between healthy women who regularly practice Pilates and those with a sedentary lifestyle. The researcher will evaluate if long-term Pilates practice (5 months or more) leads to significant improvements in physical performance compared to a lack of regular exercise. Assessment tools include the Pressure Biofeedback Unit (PBU) for core activation, the McGill battery for endurance, the Y-Balance test for dynamic stability, and the Sit-and-Reach test for flexibility.

This observational study aims to investigate the relationship between exercise benefits and barriers, pain beliefs, and activity patterns in individuals experiencing musculoskeletal pain. Participants will complete questionnaires about their pain, exercise habits, and daily activity patterns. The study does not involve any interventions or treatments. The purpose is to better understand how beliefs and perceived barriers influence physical activity in people with musculoskeletal pain, which may help inform future strategies to improve exercise participation and overall well-being.

This prospective observational study evaluates the association between postoperative analgesic approaches and recovery outcomes in patients undergoing elective total thyroidectomy. Patients will be followed under routine clinical care without intervention or randomization. The primary outcome is the Quality of Recovery-15 (QoR-15) score at 24 hours. Secondary outcomes include swallowing pain, resting pain, opioid consumption, postoperative nausea and vomiting, and additional analgesic requirement.

This prospective observational study aims to evaluate the relationship between ultrasound-derived rectus abdominis muscle thickness and thickening fraction and postoperative opioid consumption in geriatric patients undergoing abdominal surgery. Preoperative ultrasonographic measurements will be performed during routine clinical care, and postoperative pain scores and analgesic requirements will be recorded within the first 24 hours. The findings may help improve individualized analgesic strategies by identifying patient-specific predictors of postoperative opioid needs.

This study investigates the long-term effects of inspiratory muscle training (IMT) on pulmonary function, functional capacity, and quality of life in individuals with osteoporotic vertebral compression fractures who have undergone percutaneous vertebroplasty. Participants aged 50 and older, diagnosed with osteoporosis and having undergone thoracic vertebroplasty within the past 3 months, will be randomly assigned to either an intervention group (IMT + standard rehabilitation) or a control group (standard rehabilitation only). The primary outcome measure is spirometry-based pulmonary function. Secondary outcome measures include inspiratory muscle strength, functional walking capacity (6-minute walk test), diaphragmatic structure and elasticity, and quality of life (SGRQ, NHP). This randomized controlled trial will be conducted at the Cardiopulmonary Rehabilitation Unit of Nuh Naci Yazgan University and aims to provide scientific evidence for integrating IMT into routine post-vertebroplasty rehabilitation protocols.

This study investigates whether Kinesio Taping has immediate effects on upper extremity performance in healthy adults and whether these effects may be influenced by placebo mechanisms. Participants are randomly assigned to one of three groups: therapeutic Kinesio Taping, sham Kinesio Taping, or no intervention. All participants complete tests of hand function, including grip strength, typing performance, reaction time, and manual dexterity, before and after a short standardized waiting period. Participants also rate their perceived performance, comfort, and overall change. The purpose of this study is to determine whether improvements in performance are due to the mechanical effects of the tape or related to sensory and expectation-based (placebo) factors.

The purpose of this study is to investigate the immediate effects of a mental practice technique, called Physical, Environment, Task, Timing, Learning, Emotion, Perspective (PETTLEP)-based Action Observation and Motor Imagery (AOMI), on arm movement in stroke survivors. Stroke often causes difficulty in moving the arm smoothly, leading patients to compensate by using their back or shoulder. In this study, participants will either receive a single session of the AOMI training (watching and mentally practicing a reach-to-grasp movement) or a control relaxation task. The researchers will use a smartphone-based motion capture system (OpenCap) to measure if the mental practice immediately improves the smoothness of the arm movement and reduces compensatory body movements.

This prospective, observational study evaluates whether serum bicarbonate HCO3 levels can predict enteral nutrition intolerance (EFI) in adult ICU patients.Objective: To determine if lower HCO3 levels correlate with the development of EFI.Design: A 12-month study involving 70 participants at Sultangazi Haseki Training and Research Hospital.Methodology: Patients starting enteral nutrition within 48 hours of admission will be monitored for 72 hours. Daily HCo3 pH, and lactate levels will be recorded from routine morning blood draws.Hypothesis: Lower bicarbonate levels are an independent predictor of EFI development in critically ill patients.

The aim of this observational cross-sectional study is to compare the physical fitness characteristics of professional and amateur e-sports players and to determine whether differences exist between the two groups in terms of physical fitness parameters.

This prospective observational cohort study aims to investigate whether the weight-based equivalent (mg/kg) of a fixed 1 g dose of tranexamic acid administered during septorhinoplasty is associated with intraoperative remifentanil titration frequency and perceived anesthesiologist workload. Although tranexamic acid is routinely given as a fixed dose, its mg/kg equivalent varies according to patient weight and may influence hemodynamic management during controlled hypotension. The primary outcome is the total number of remifentanil infusion rate adjustments during surgery. Secondary outcomes include total remifentanil consumption and postoperative anesthesiologist workload assessed using the NASA Task Load Index (NASA-TLX).

Upper extremity impairment in hemiplegic patients significantly impacts daily activities and reduces quality of life. Although traditional rehabilitation methods can help, some patients experience limited progress. Recently, modern techniques such as mirror therapy and virtual reality (VR) have emerged, demonstrating promising results in motor skill improvement. This study aims to directly compare the acute effects of mirror therapy and VR therapy on upper limb motor function in hemiplegic patients. Forty-two participants aged 18-75 with hemiplegia due to stroke (6-12 months post-stroke) will be randomly assigned to either mirror therapy or VR therapy. The evaluation includes motor function (Fugl-Meyer Assessment), spasticity (Modified Ashworth Scale), activities of daily living (Barthel Index), fine motor skills (Box and Block Test), proprioception, and reaction time. The goal is to identify the effectiveness of the mirror therapy and VR therapy on motor function, spasticity control, proprioception, daily activity performance, and reaction times, contributing valuable insights to clinical rehabilitation practices.

Sedation during upper gastrointestinal endoscopy may lead to respiratory events not only during the procedure but also in the early recovery period. Although most hypoxemic episodes are considered transient, their frequency, duration, and clinical consequences during recovery remain insufficiently defined. This prospective observational study aims to evaluate the incidence, duration, and clinical impact of recovery-period hypoxemia following sedated upper gastrointestinal endoscopy. Hypoxemia is defined as SpO₂ \<90% lasting ≥10 seconds. Associated respiratory events and potential risk factors will be analyzed without altering routine clinical practice.

Pneumoperitoneum during laparoscopic bariatric surgery induces carbon dioxide absorption and may lead to perioperative alterations in acid-base balance. Serum bicarbonate (HCO₃-) plays a central role in metabolic compensation; however, the clinical relevance of perioperative bicarbonate changes remains insufficiently defined. This prospective observational study aims to evaluate the association between pneumoperitoneum duration and perioperative serum bicarbonate change (ΔHCO₃-), and to investigate whether ΔHCO₃- is associated with early discharge readiness at 48 hours (DR-48) following laparoscopic bariatric surgery. Patients undergoing laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass will be enrolled consecutively. No alteration of routine clinical care will occur.

This study aims to evaluate the effectiveness of a 4-week rhythm-based stabilization exercise protocol for professional video gamers diagnosed with scapular dyskinesis. Participants will undergo a structured exercise program consisting of 6 specific scapular stabilization exercises. These exercises will be performed on both stable surfaces (such as a treatment table or wall) and unstable surfaces (such as Swiss balls) to challenge neuromuscular control. The primary goal is to determine how this combined approach affects scapular control, upper extremity functional performance, and joint range of motion. Data will be collected through clinical assessments before and after the 4-week intervention to measure improvements in scapular stability and overall upper limb function.