Clinical trials

The cervical spine is a complex structure that supports the weight of the head and protects the spinal cord and nerve roots. Cervical spinal stenosis (CSS), which develops as a result of degenerative processes, can cause narrowing of the spinal canal and compression of nerve structures, leading to symptoms such as pain, numbness, and weakness. This condition can negatively affect hand function, particularly grip strength and dexterity. However, studies in the literature examining the effect of CSS on grip strength and hand function are limited. Therefore, this study will be conducted to determine the effect of the severity of cervical spinal stenosis, identified in patients who underwent MRI following their presentation with cervical problems at the Physical Medicine and Rehabilitation outpatient clinic of Buca Seyfi Demirsoy Training and Research Hospital, İzmir Democracy University, on hand grip strength and functionality. Grip strength will be assessed using the Jamar hand dynamometer, and fine pinch strength will be evaluated using the Lafayette pinch meter. Additionally, hand functionality will be measured using the Nine-Hole Peg Test. The impact of neck pain on daily life will be assessed using the Neck Disability Index. The data obtained will be compared and analyzed using appropriate statistical methods. This study is expected to fill a significant gap in the current literature by comprehensively elucidating the effects of cervical stenosis on hand function and grip performance, thereby contributing to the individualization of rehabilitation approaches.

Degenerative cervical myelopathy (DCM) is the most common cause of non-traumatic spinal cord dysfunction in adults and may lead to progressive motor, sensory, and autonomic impairment. Accurate and standardized assessment of neurological function is essential for clinical decision-making, prognostic evaluation, and comparison of treatment outcomes. The Modified Japanese Orthopaedic Association (mJOA) score is one of the most widely used clinician-based outcome measures for evaluating neurological status in patients with DCM. Although the mJOA has been translated and validated in several languages, no validated Turkish version currently exists. This prospective, cross-sectional validation study aims to culturally adapt the mJOA score into Turkish and evaluate its validity, reliability, and clinical correlation in Turkish-speaking patients diagnosed with DCM. Adult patients (≥18 years) with clinically and radiologically confirmed DCM presenting to the outpatient clinics of Physical Medicine and Rehabilitation and Neurosurgery will be included. Previously obtained cervical magnetic resonance imaging will be reviewed retrospectively to determine myelomalacia levels, while clinical scales will be administered prospectively. Construct validity will be assessed by examining correlations between the Turkish mJOA scores and the Neck Disability Index, as well as the Nurick grading system. Inter-rater reliability will be evaluated using the Intraclass Correlation Coefficient (ICC \[2,1\]) between two independent evaluators, and test-retest reliability will be assessed in clinically stable patients after 7-14 days. Feasibility will be evaluated by recording the administration time and potential difficulties during application. This study is expected to provide a valid and reliable Turkish version of the mJOA score, facilitating standardized assessment of DCM in Turkish clinical practice and enabling comparability with international research.

This study will be one of the few to examine the effect of lipedema on knee osteoarthritis in a comparative manner with a control group within the same osteoarthritis context. Although the relationship between obesity and osteoarthritis has been extensively studied in the literature, the effect of specific adipose tissue pathologies, such as lipedema, on osteoarthritis has not been sufficiently investigated. This study aims to demonstrate the independent effect of lipedema on osteoarthritis, evaluate clinical and ultrasonographic parameters together, and contribute to early diagnosis and targeted rehabilitation strategies.

Scoliosis is a three-dimensional torsional deformity of the spine and trunk characterized by alignment abnormalities in the coronal plane, the presence of axial rotation in the horizontal plane, and abnormalities in the normal spinal curves (lordosis-kyphosis) in the sagittal plane. The most common type of scoliosis, adolescent idiopathic scoliosis (AIS), has a prevalence of approximately 3%. AIS accounts for 85% of all scoliosis types. AIS is the name given to scoliosis diagnosed between the ages of 10 and 18. Because they are actively engaged with the internet, young people have begun researching health-related topics online due to the ease of access to such information. The internet has overshadowed traditional sources of health information, such as social circles, mass media (television, radio, newspapers, magazines, etc.), and medical and non-medical health professionals; searching for medical information online has become a popular activity. Searching for medical information online appears to offer various advantages in terms of anonymity, cost-effectiveness, potential for interaction, opportunities for social support, and the amount of accessible information. However, it also carries significant drawbacks due to the risk of exposure to contradictory, confusing, unreliable, inaccurate, or outdated information. Cyberchondria is when a person's desire to research health-related symptoms online turns into excessive anxiety and repeated online searches. This can increase a person's health-related worries and fears and lead to mental health problems such as stress, anxiety, and depression. In today's information age, adolescents spend a large part of their day on the internet using smartphones and researching the symptoms of their current illnesses online before consulting a doctor or when they receive a diagnosis. This tendency can increase their anxiety levels due to misinformation. Cyberchondria is the reflection of anxiety in the digital age. Comorbidity in psychiatric disorders has generally been evaluated, but there are only a limited number of studies investigating the level of cyberchondria in a specific disease. There are no studies examining the relationship between cyberchondria and adolescent idiopathic scoliosis. This study aims to investigate the levels of cyberchondria and related factors in patients diagnosed with scoliosis and compare them with a control group.

Carbon monoxide (CO) is a colorless and odorless gas that can enter the human body through environmental exposure and especially tobacco use. CO binds to hemoglobin with a much higher affinity than oxygen, thereby reducing oxygen transport to tissues. This condition may lead to various physiological and psychological effects, particularly on the nervous system. In the literature, CO exposure has mainly been investigated in the context of acute poisoning cases and smoking-related effects. However, studies evaluating the effects of low-level and chronic CO exposure-more commonly encountered in the general population-on pain perception, sensory functions, and psychological status are limited. Tobacco smoke is an important source of CO, and exhaled CO levels have been shown to be significantly higher in smokers and associated with various neurocognitive changes. Evidence suggests that CO exposure may influence anxiety, depression, attention, and cognitive functions. In addition, some studies indicate that CO may affect brain regions involved in pain perception and emotional regulation. However, there is insufficient research examining the relationship between low-level carbon monoxide exposure and pain threshold, sensory functions, anxiety, depression, and subjective health complaints within the same study framework. This study aims to evaluate the relationship between exhaled carbon monoxide (CO) levels and pain threshold, sensory functions, anxiety, depression, and subjective health complaints in healthy adults. By examining the multidimensional effects of low-level CO exposure, the study seeks to fill an important gap in the literature and provide a more comprehensive understanding of this issue.

Peripheral artery disease (PAD) is a chronic and progressive condition caused by narrowing or blockage of arteries in the lower limbs due to atherosclerosis. It primarily affects adults over 50, with prevalence increasing with age, and its clinical presentation ranges from asymptomatic cases to severe ischemia that may require amputation. Intermittent claudication, characterized by exercise-induced leg pain that resolves with rest, is the most common early symptom. Impaired blood flow, poor vascularization, and muscle loss contribute to reduced lower limb strength and functional capacity, which are associated with higher morbidity and mortality. Walking exercises is a cornerstone of PAD management, particularly for patients with no or mild symptoms, making the assessment of lower limb strength and mobility essential for designing rehabilitation programs. The 30-second sit-to-stand test is a validated and practical measure of functional capacity and walking ability. Tele-assessment using video technology has been shown to be feasible and reliable in other patient populations. Although tele-rehabilitation has been widely studied and shown to improve functional outcomes, research on tele-assessment methods to accurately evaluate patient performance and the effectiveness of rehabilitation programs is still limited, particularly in PAD patients. This study aims to examine the reliability of the 30-second sit-to-stand test when performed via tele-assessment compared with face-to-face evaluation in patients with PAD.

Knee osteoarthritis is a chronic disease common in middle-aged and older adults, characterized by functional impairment and reduced quality of life due to pain. While physical examination and radiographic Kellgren-Lawrence grading are frequently used in clinical evaluation, the severity of pain does not always correlate with the degree of structural degeneration. Ultrasonography is gaining prominence in osteoarthritis research due to its advantage of simultaneously evaluating both inflammatory and structural components, such as synovial hypertrophy, effusion, power Doppler signal, and osteophytes. The Outcome Measures in Rheumatology (OMERACT) working group has developed a standardized, multidimensional ultrasound scoring system for knee osteoarthritis, and this method is frequently used in the literature. This method consists of a diagnostic ultrasound examination lasting approximately 8-10 minutes. The examination evaluates the anatomical structures of the knee and also includes soft tissue examinations such as synovial hypertrophy. With this method, a diagnostic ultrasound examination lasting approximately 8-10 minutes is performed. The examination evaluates the anatomical structures of the knee and also includes soft tissue examinations such as synovial hypertrophy. Considering the differences between societies in cultural, genetic, biomechanical, body mass index distribution, and healthcare system practices, direct validity, clinical interpretability, and inter-study comparability are of significant importance. The validity, reliability, and applicability of the OMERACT osteoarthritis ultrasound scoring system have been reported in a study conducted on the Egyptian population. However, there is no data on the validity and reliability of OMERACT ultrasound scoring in the Turkish population. This study is the first prospective validation study aimed at establishing standardization for use in clinical practice in Turkey.

Premature ventricular complexes may be observed in individuals without underlying disease due to factors such as physical inactivity, advanced age, smoking, male sex, and psychosocial disturbances, and in some cases may result in sudden cardiac death. Therefore, the aim of this study is to investigate respiratory function, respiratory muscle strength, cough strength, handgrip strength, physical activity level, and quality of life in individuals with premature ventricular complexes.

It is aimed to reveal impairments regarding urinary incontinence, dyspnea, muscle strength, functional capacity or quality of life in children and adolescents with cystic fibrosis compared to healthy children and adolescents.

The aim of this study is to examine the relationship between injury risk and pain, fatigue, muscle strength, balance and quality of life in volleyball players. In this context, it will be investigated how the pain and fatigue levels experienced by volleyball players interact with muscle strength and balance and how these factors increase the risk of injury.

Nicotine, a major toxic component of cigarette smoke, together with carbon monoxide (CO), constitutes a significant environmental exposure with systemic effects. Beyond its addictive potential, chronic nicotine exposure may induce inflammation, oxidative stress, tissue hypoxia, and autonomic imbalance, potentially impairing respiratory muscle strength, functional capacity, and overall physical performance. Additionally, nicotine dependence has been associated with sleep disturbances, cognitive dysfunction, altered pain perception, and reduced quality of life. Although previous studies have examined individual effects of smoking on specific health outcomes, research addressing these multidimensional impacts within a comprehensive framework remains limited. Therefore, this study aims to investigate the relationship between nicotine dependence level and respiratory muscle strength, functional capacity, cognitive functions, pain, quality of life, physical activity level, and sleep quality, in order to provide a more holistic understanding of the clinical consequences of nicotine dependence.

The Urgency, Severity, and Impact Questionnaire (USIQ) assesses urinary urgency independently of incontinence, measuring both symptom severity and its impact on quality of life. While validated in English and Hebrew populations, a Turkish version has not yet been developed. This study aims to adapt USIQ for the Turkish population and evaluate its psychometric properties, providing a standardized, culturally relevant tool for clinical and research use.

Fibromyalgia (FM) is a chronic, widespread pain syndrome affecting 2-6.6% of the population and significantly impairing quality of life. In addition to pain, individuals with FM commonly experience fatigue, sleep disturbances, cognitive and psychological problems, leading to functional limitations and social difficulties. Central sensitization is considered a key mechanism, although the exact pathophysiology remains unclear, highlighting the need for multidimensional assessment. FM affects not only physical function but also psychological status, autonomic nervous system regulation, sleep quality, self-esteem, eating behaviors, and gastrointestinal function. Depression, anxiety, autonomic dysfunction, sleep disorders, altered eating behaviors, and gastrointestinal symptoms are highly prevalent and closely associated with pain severity, fatigue, and reduced quality of life. Given its complex biopsychosocial nature, FM requires a holistic evaluation and management approach. Accordingly, this study aims to compare symptoms, psychological status, autonomic function, sleep, eating behaviors, and gastrointestinal parameters between women with fibromyalgia and healthy women.

Fibromyalgia is a chronic pain syndrome often accompanied by fatigue, psychological problems, and cognitive dysfunction, leading to reduced quality of life. Telerehabilitation-based Pilates has been shown to improve symptoms and function in fibromyalgia, while kinesthetic brain exercises may enhance cognitive performance through neuroplasticity. This study aims to evaluate the effects of adding kinesthetic brain exercises to telerehabilitation-based Pilates on cognitive functions, symptom management, functional performance, and quality of life in women with fibromyalgia.

Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and functional limitations. Pain, fatigue, and fear of movement often lead individuals with FMS to adopt sedentary behaviors, which may further exacerbate symptoms and reduce physical capacity. Factors such as impaired body awareness, reduced respiratory muscle strength, kinesiophobia, central sensitization, poor functional status, and sleep disturbances play an important role in disease severity and quality of life in individuals with FMS. Although physical inactivity is common in fibromyalgia, limited evidence exists regarding the differences in these multidimensional clinical parameters between sedentary and non-sedentary individuals with FMS. Therefore, the aim of this study is to compare body awareness, respiratory muscle strength, kinesiophobia, central sensitization, functional status, and sleep quality between sedentary and non-sedentary individuals diagnosed with fibromyalgia syndrome. The findings of this study may contribute to a better understanding of the impact of sedentary behavior on clinical outcomes in fibromyalgia and help guide more comprehensive and individualized rehabilitation approaches.

Non-specific neck pain (NSNP) is a common musculoskeletal condition that significantly affects quality of life, daily activities, and work productivity. Although various physical, postural, and psychosocial factors have been associated with NSNP, the role of body composition in pain and functional outcomes remains unclear. Emerging evidence suggests that muscle and fat mass may influence musculoskeletal pain and related dysfunctions; however, studies examining these relationships in individuals with NSNP using objective measurements are limited. The purpose of this study is to investigate the effects of body composition on pain threshold, posture, cervical range of motion, sensation, and cervical function in individuals with non-specific neck pain. Individuals diagnosed with NSNP will be recruited from the Physical Medicine and Rehabilitation outpatient clinic. Participants' body composition, pain threshold, posture, cervical range of motion, sensory function, and cervical disability will be assessed using validated and objective measurement tools. Understanding the relationship between body composition and cervical outcomes in individuals with non-specific neck pain may contribute to early identification of risk factors and support the development of more targeted and effective physical therapy and rehabilitation strategies.

Dysmenorrhea is a common gynecological condition that negatively affects women's physical, psychological, and social well-being. Primary dysmenorrhea (PD) has been associated with reduced pain thresholds in various body regions; however, evidence regarding its relationship with joint mobility, respiratory muscle strength, and psychosocial factors remains limited. In addition, the influence of menstrual attitudes, physical activity habits, and depressive symptoms in women with PD has not been sufficiently explored. Therefore, this study aims to compare women with and without primary dysmenorrhea in terms of pain threshold, joint mobility, physical activity level, respiratory muscle strength, menstrual attitudes, and depressive symptoms. Identifying the parameters affected by PD is essential for developing effective management strategies and may contribute to increased awareness and improved clinical approaches for primary dysmenorrhea.

The cervical spine is a structure that bears the weight of the head and has important functions, but is susceptible to mechanical stress and degenerative processes. Cervical stenosis can lead to compression of the nerve roots as a result of narrowing of the spinal canal and symptoms such as pain, numbness and weakness. Central sensitisation (CS) causes even innocuous stimuli to cause pain due to hypersensitivity of the central nervous system and negatively affects the quality of life by increasing pain intensity in individuals with chronic neck pain. Progression of cervical stenosis can lead to symptoms such as walking difficulties, loss of balance and loss of proprioception. Furthermore, CS causes patients to avoid physical activity, increasing muscle weakness and pain, which further reduces quality of life. For this reason, our study will be carried out to determine the effect of cervical stenosis on patients with neck pain whom applied to Izmir Democracy University Physical Medicine and Rehabilitation outpatient clinic and had cervical MRI. Participants' pain status, central sensitisation, sensory loss, range of motion and proprioception will be recorded. Pressure pain threshold will be measured with algometer, sensory loss will be examined with Semmes-Weinstein Monofilament (SWM) Test, joint movements and proprioception will be evaluated with Pa CROM Basic device. In addition, the effects of cervical stenosis on functional status and quality of life will be measured by questionnaires. The data obtained will be compared and analysed with appropriate statistical methods. This study is aimed to contribute to the development of treatment methods and improvement of patient care, and will provide important information in terms of pain management and improvement of quality of life.

Groin and hip injuries are common in team sports-especially soccer, rugby, and ice hockey-and frequently affect male and young athletes. About 14% of all sports injuries involve the groin and hip region, with most related to the adductor muscles. These injuries often increase during congested match periods and may result in athletes missing 1 to 6.9 weeks of training or competition, extending up to 14 weeks when surgery is required. Weakness in the adductor muscles is a key risk factor for groin injuries, and current assessments primarily measure maximal strength using tools such as squeeze tests, sphygmomanometers, or dynamometers. However, muscle endurance-critical because many injuries occur under fatigue-has not been adequately studied, and no validated endurance tests for the hip adductors exist. This study aims to evaluate the validity and reliability of a newly developed hip adductor endurance test for monitoring endurance strength in professional soccer players.

The vertebral column is an S-shaped structure that carries the body weight and transmits it to the feet. Kyphosis, a natural curvature of the spine, can increase with poor posture and muscle weakness, leading to postural kyphosis. This condition results in forward head positioning, rounded shoulders, and scapular winging, causing back pain, poor posture, balance issues, and respiratory difficulties. With technological advances, poor posture habits have become more common, especially in adolescents. Kyphosis can also affect balance, walking speed, and increase the risk of falls in older adults. Exercises like Hatha yoga and reformer Pilates are effective methods for improving posture, muscle strength, and quality of life. The aim of this study is to compare the effects of Hatha yoga and reformer Pilates exercises on posture, pain, balance, quality of life, body image, and respiratory function in individuals with hyperkyphosis.

When the literature is examined, it is seen that the extent to which cough strength, grip strength, physical activity level and quality of life levels are affected in children with chronic kidney failure compared to healthy children is not sufficiently clarified. For this reason, this study aimed to reveal impairments in grip strength, cough strength, physical activity, sleep quality or quality of life in children with chronic renal failure compared to healthy children.

Diabetes Mellitus is defined as a carbohydrate mechanism disorder in which glucose cannot be used as an adequate energy source and is produced excessively, causing hyperglycemia. For the diagnosis of diabetes, an increase in HbA1c in the blood or a high glucose concentration in venous plasma is examined. Although there are various clinical subtypes, Type 2 diabetes constitutes 90% of the approximately 537 million diabetics worldwide. In the treatment of diabetes, there are pharmacological treatments and lifestyle changes to ensure glycemic control. The most important lifestyle change interventions are balanced calorie intake, increased physical activity and regular exercise. The effect of exercise on complications associated with Type 2 diabetes, such as improving glycemic control, reducing inflammation and reducing cardiovascular risk, is clear and it is known that these also affect cognition. In this context, dual-task exercises that can target both the improvement of parameters related to postural control and balance as a physical development and the development of cognitive functions are gaining importance. The aim of dual-task exercises is to direct the person's attention to another source while the first task is being performed. When the literature is examined, there are separate studies on the effects of dual-task exercises on both balance and walking performance and cognitive functions. However, the meta-analyses conducted on these studies emphasize the need for more newly designed studies. Therefore, our study aims to examine the effects of dual-task exercise training, which includes both physical and cognitive parameters, on cognitive functions, balance and functionality in individuals with type 2 diabetes. Patients who applied to the Artvin State Hospital Internal Medicine polyclinic and were diagnosed with type 2 diabetes and who meet the inclusion and exclusion criteria will be included in our study. The patients included in the study will be divided into 3 groups: dual-task exercise group, single-task exercise group and control group. Both intervention groups will be included in an exercise program with a physiotherapist 2 days a week for 8 weeks in addition to their medical treatments. The control group will be recommended walking only in addition to their medical treatment during these 8 weeks. All 3 groups will be evaluated twice, at the beginning of the study and at the end of the 8th week.

A volleyball player with high respiratory muscle endurance can perform at a high level of efficiency during competitions without experiencing fatigue. However, no study has been found in the literature examining respiratory muscle strength, respiratory muscle endurance, cough strength and balance parameters in adolescent volleyball players which was therefore aimed to investigate the potential relationship between these parameters in this study.

This study aims to develop an Android-based 6-Minute Walk Test (6MWT) application to facilitate quick and efficient functional capacity assessment in clinical settings. The project will be carried out by a multidisciplinary team of software engineers and physiotherapists, with algorithms developed for both indoor and outdoor environments. As GPS signals may be lost indoors, the program will utilize the phone's gyroscope for distance measurement, while GPS signals will be used outdoors. The study will include healthy individuals aged 18-65, without any exercise restrictions. Participants' demographic data will be recorded, and the 6MWT will be conducted according to traditional protocols. During the test, parameters such as heart rate, oxygen saturation, and walking distance will be measured and compared with traditional methods. The Android application will provide auditory and vibration cues at the start and end of the test and will report health data in real-time. The data will be presented as mean ± standard deviation for continuous variables, and the test reliability will be assessed using the test-retest method. Results will be reported as age- and gender-adjusted z-scores for objective functional decline.

Posture is defined as the situation in which each part of the body is properly positioned in the adjacent segment and is in the most ideal position in proportion to the whole body. Posture requires the appropriateness of joint combinations and positions during movement. With the development of technology, various phone and computer-aided applications are used both in the correction and evaluation of posture. It is thought that posture disorders may cause various pathological problems in the future and may lead to functional limitations in the individual. With the developing technology, there are a limited number of studies on the validity and reliability of phone and computer-aided applications in every field of health. The aim of this study is to perform the validity and reliability study of a sensorless objective application integrated with artificial intelligence used in posture evaluation with the developing technology.