Clinical trials

The aim of this study is to examine the validity and reliability of the Turkish Validity and Reliability of The King's Brief Interstitial Lung Disease Questionnaire (K-BILD) in Individuals with Interstitial Lung Involvement Secondary to Rheumatological Diseases.

This randomized crossover trial will investigate the acute effects of five passive recovery interventions following a standardized high-intensity cycling exercise protocol. Participants will complete one supervised high-intensity cycling session per week for five consecutive weeks. Immediately after each exercise session, participants will receive one of five recovery interventions: compression therapy, vacuum therapy, kinesiology taping, passive rest, or classical massage. The order of the interventions will be randomized according to a balanced crossover sequence. Each participant will experience all five recovery interventions during the study period. Outcomes related to post-exercise recovery will be assessed across intervention periods.

This randomized controlled clinical trial aims to investigate the effects of Connective Tissue Massage (CTM) and music-based Progressive Muscle Relaxation Training (PMRT) on pain intensity, pressure pain threshold, analgesic use, and menstruation-related symptoms in women with primary dysmenorrhea. Participants will be randomly assigned to one of three groups: CTM, music-based PMRT, or control. Baseline assessment will be conducted during menstrual days 1-2 of Cycle 0. The interventions will be applied during the premenstrual intervention window of Cycle 0, from the estimated ovulation day, calculated as cycle length minus 14 days, until Cycle 1 Day 1. Post-intervention assessment will be conducted during menstrual days 1-2 of Cycle 1. No intervention will be applied after the post-intervention assessment, and follow-up assessment will be conducted during menstrual days 1-2 of Cycle 2. Outcomes including pain intensity, pressure pain threshold, analgesic use, menstrual symptoms, attitudes toward menstruation, functional and emotional impact of dysmenorrhea, and pain catastrophizing will be evaluated across menstrual cycles. Participant satisfaction and adherence to the interventions will also be assessed.

Knee osteoarthritis (OA) is one of the most common joint disorders worldwide and is a leading cause of pain, limited mobility, and functional disability, particularly in the elderly population. According to 2020 data, approximately 654 million individuals aged 40 years and older are affected by knee OA worldwide, with a global prevalence of 22.9% in this age group. In our country as well, OA is reported as the second most common rheumatologic disease. The disease not only negatively affects individuals' quality of life but also creates a significant socioeconomic burden through work loss, hospital admissions, and the need for surgical interventions. The pathogenesis of knee OA is a complex process involving articular cartilage degeneration, subchondral bone sclerosis, synovial tissue proliferation, and osteophyte formation. Once cartilage damage begins, its capacity for spontaneous healing is extremely limited; therefore, early interventions aimed at slowing or halting disease progression are of critical importance. In this context, non-pharmacological interventions, particularly exercise programs that may contribute to maintaining cartilage integrity, are strongly recommended as first-line treatment options in current clinical guidelines. The beneficial effects of exercise therapy on pain and function in patients with knee OA are well documented. However, the structural effects of exercise on femoral cartilage thickness have been relatively less investigated. Tuna et al. evaluated femoral cartilage thickness using ultrasonography in 40 patients with knee OA following a 12-week quadriceps strengthening program and reported statistically significant increases in cartilage thickness in the medial condyle, lateral condyle, and intercondylar region at 3 months. This pioneering study suggests that muscle strengthening programs may have not only symptomatic but also structural benefits. Similarly, Bozan et al. reported a strong positive correlation between quadriceps muscle thickness (rectus femoris + vastus intermedius) and femoral cartilage thickness, supporting the idea that muscle loss parallels cartilage degeneration. However, these studies focused exclusively on the quadriceps muscle, and the effects of hip musculature on femoral cartilage thickness have not been investigated. Recent biomechanical studies indicate that hip abductor and adductor muscles play a critical role in knee joint loading patterns. Hip abductor muscles provide pelvic stability during gait and directly influence knee adduction moments. Weakness of the gluteus medius leads to contralateral pelvic drop, increasing medial compartment loading on the ipsilateral knee and accelerating medial tibiofemoral cartilage wear. Indeed, Segal et al., using data from the Multicenter Osteoarthritis Study (MOST), demonstrated via MRI that greater hip abductor strength significantly reduces the risk of progression of medial patellofemoral and lateral tibiofemoral cartilage damage. On the other hand, hip adductor muscles are also thought to contribute to knee adduction moments by eccentrically controlling femoral varus motion; however, this relationship has been studied far less compared to quadriceps and abductors. Systematic reviews and meta-analyses have shown that individuals with knee OA have up to 24% lower isometric hip abductor strength compared to healthy controls. Randomized controlled trials investigating combined hip and quadriceps strengthening programs have reported significant improvements in pain and function. However, none of these studies have used femoral cartilage thickness measured by ultrasonography as a primary outcome. A review of the current literature reveals that although studies exist examining the effects of quadriceps strengthening on femoral cartilage thickness, no randomized controlled trial has compared hip abductor and adductor strengthening exercises with a quadriceps strengthening program, using ultrasonographic femoral cartilage thickness as the primary outcome measure. This study aims to address this gap. All interventions will be applied as non-invasive home exercise programs, and all measurements will be performed using ultrasonography. Baseline, 1-month, and 3-month assessments will also allow evaluation of the temporal effects of exercise on cartilage structure. The findings are expected to provide scientific evidence regarding the structural protective effects of hip exercises in knee OA rehabilitation and serve as pilot data for future large-scale multicenter studies. The aim of this study is to compare patients with knee OA receiving quadriceps strengthening exercises alone with those receiving additional hip abductor/adductor strengthening exercises in terms of changes in femoral cartilage thickness, and to evaluate whether there is a correlation between femoral cartilage thickness and the thickness of the rectus femoris, gluteus medius,

This prospective observational cohort study aims to investigate whether baseline central sensitization and psychological factors predict functional outcomes following rehabilitation in individuals with chronic shoulder pain. Participants with chronic shoulder pain will receive a standardized 6-week physiotherapy and rehabilitation program routinely applied in the clinic. Assessments will be performed before and after treatment, including pain severity, shoulder function, central sensitization symptoms, and psychological factors such as pain catastrophizing. The findings of this study may contribute to a better understanding of biopsychosocial factors affecting rehabilitation outcomes in chronic shoulder pain and help improve individualized rehabilitation approaches.

This study aims to investigate the effects of Kinesio Taping (KT) on hand function in patients with Zone V-VI Extensor Digitorum Communis (EDC) tendon injuries following primary repair. Extensor tendon injuries in this region often lead to complications such as adhesion formation, reduced range of motion, extensor lag, and impaired hand function, despite standard rehabilitation approaches. Therefore, additional interventions that may enhance tendon gliding and neuromuscular control are of clinical interest. In this double-blind randomized controlled trial, patients will be assigned to either a KT group or a sham taping control group. Both groups will receive a standardized postoperative rehabilitation program, while the intervention group will additionally receive KT applications between postoperative weeks 6 and 12. Outcome measures, including range of motion, grip and pinch strength, and functional hand performance, will be assessed at 12 and 24 weeks. The study seeks to determine whether KT provides additional benefits beyond conventional rehabilitation in improving functional recovery after extensor tendon injuries, addressing an important gap in the current literature.

Immobilization following median and/or ulnar nerve repairs results in strength loss in the wrist and finger extensor muscles. Given the critical importance of wrist extension for functional grip, this condition significantly restricts hand functions. Therefore, this study aims to investigate the effects of EMG-triggered electrical stimulation applied to the wrist and finger extensors, in addition to conventional physiotherapy, on functional outcomes in patients undergoing median and/or ulnar nerve repair, with the objective of restoring extensor muscle weakness induced by immobilization.

Patient-reported outcome measures, which are subjective by nature, need to be correlated with clinician-administered professional measurements as a further step toward expanding their clinical utility. Therefore, this study aimed to investigate the relationship between perceived manual dexterity and functional measurements in patients with hand-forearm injuries.

The aim of this study is to identify predictors of climate change health literacy in older adults.

The effects of single dose injection of platelet rich plasma or conditioned serum in the knee joint in patients with knee osteoarthritis will be compared

This study aimed to investigate the predictability of kinesiophobia on functional outcomes in conservatively treated patients with distal radius fractures. For this purpose, patients' level of kinesiophobia will be assessed using the Tampa Kinesiophobia Scale. To assess the functional status of patients, joint range of motion and upper extremity weight bearing measurements will be performed. Patients' functionality will be additionally assessed with the Patient Rated Wrist Evaluation Questionnaire.

The aim of this study is to examine the association between health literacy, patient-reported outcome measures, and grip strength in a cohort of patients with hand injuries.

Breast cancer is the most common cancer among women worldwide and lymphedema is one of its most significant complications. Breast cancer-related lymphedema (BCRL) may develop shortly after treatment or even years later, causing physical and psychological burden, functional impairment, and reduced quality of life. Complete decongestive therapy (CDT), which includes manual lymph drainage (MLD), compression, skin care, and exercise, is the standard approach. Intermittent pneumatic compression (IPC) has been proposed as an additional option, and current consensus reports emphasize the need for studies evaluating IPC in combination with MLD. Previous studies comparing IPC and MLD, either alone or in combination, have shown inconsistent results. Some reported no significant difference between treatment groups, while others suggested additional benefits of IPC, particularly in reducing limb heaviness and tension. However, there is still insufficient evidence to clarify the exact role of IPC within CDT. The aim of this study is to investigate the acute effects of using IPC instead of MLD, or in combination with MLD, on arm circumference, arm volume, shoulder range of motion, and quality of life in patients with BCRL.

Objective: This study was designed to develop a clinical practice preparation program based on the Pediatric Nursing Excellence Model for undergraduate nursing students and to evaluate the program's effect on students' readiness, clinical comfort and anxiety, and levels of excellence. Method: This study is a pretest-posttest randomized controlled experimental study. The research is planned to be conducted with nursing students taking the Pediatric Health and Disease Nursing course. The study groups will consist of students who go out for clinical practice within the scope of this course. In the power analysis performed with the G\*Power 3.1.9.7 program, the sample size was found to be 25 for the experimental group and 25 for the control group, for a total of 50. Research data will be collected using a questionnaire. The questionnaire consists of four sections containing the following questions: "Student Descriptive Characteristics Information Form," "Nursing Students' Readiness for Clinical Practice Scale," "Pediatric Nursing Students' Clinical Comfort and Anxiety Instrument," and "Pediatric Nursing Excellence (PHM) Model Questionnaire." In the study, students in the experimental group will receive routine orientation training and a clinical practice readiness program based on the excellence model. Students in the control group will only receive routine orientation training. Data analysis will be performed using the SPSS 20.0 software package.

Considering the thumb's contribution to fine dexterity and precision grip, this study aims to evaluate fine manual dexterity alongside functional outcomes following isolated thumb tendon injuries, and to examine the relationship between postoperative functional improvement and changes in fine manual dexterity.

Chronic low back pain (CLBP) is a major public health concern worldwide, leading to reduced quality of life and significant work loss. It is defined as pain lasting more than 12 weeks between the lumbar and sacral spinal segments. The global prevalence of CLBP ranges from 13.1% to 20.3%, and the number of affected individuals has increased from 370 million in 1990 to 570 million in 2017. Core muscles, including the multifidus, erector spinae, transversus abdominis, psoas major, and quadratus lumborum, play a key role in spinal stabilization. In patients with CLBP, dysfunction and loss of synergy among these muscles can compromise spinal balance. Prolonged poor posture can reduce the strength and endurance of the lumbar erector spinae, multifidus, and transversus abdominis, leading patients to compensate by overusing the erector spinae, rectus abdominis, and oblique abdominal muscles. This compensation is considered one of the primary contributors to chronic low back pain. These deep core muscles can be objectively evaluated using ultrasonography (USG), a non-invasive, inexpensive, and accessible imaging method. Strain elastography, a quantitative ultrasonographic technique, is increasingly used to assess tissue stiffness and monitor structural changes in muscle over time. Conventional treatments for CLBP include pharmacotherapy, exercise, and physical therapy. In recent years, extracorporeal shock wave therapy (ESWT) has emerged as a non-invasive, easily applicable, and low-risk treatment method. ESWT is widely used in various musculoskeletal conditions such as lateral epicondylitis, patellar tendinopathy, and calcific tendinitis of the shoulder. Studies have shown that ESWT provides pain relief and functional improvement in patients with CLBP through its angiogenic, anti-inflammatory, analgesic, and tissue-regenerative effects. Several studies have demonstrated the positive impact of ESWT on pain reduction and functional recovery in CLBP. A recent meta-analysis reported that ESWT significantly reduces pain in CLBP patients and may be superior to other conservative treatments. Yue et al. (2021) highlighted the short-term benefits of ESWT in reducing pain and disability, while also emphasizing the need for well-designed randomized controlled trials (RCTs) to establish high-quality evidence. Similarly, Wu et al. (2023) underscored the necessity of including objective outcomes in future RCTs to better evaluate the efficacy of ESWT. Although numerous studies have assessed the effects of ESWT on pain, disability, and functional outcomes in CLBP, to date, no study has objectively evaluated its effectiveness using ultrasonographic strain elastography focusing on the elasticity and stiffness of core muscles. This study aims to be one of the first to assess the long-term effects of ESWT using objective measures. Its contribution to the literature lies in evaluating the efficacy of ESWT, when added to conventional physical therapy, through long-term monitoring with ultrasonographic strain elastography in patients with CLBP.

Considering the complex structure of hand-forearm injuries and the long rehabilitation process, it is important to investigate factors associated with recovery in geriatric individuals. Therefore, this study aimed to examine the relationship between cognitive status and functional outcomes in geriatric individuals with hand-forearm injuries.

Patellofemoral Pain Syndrome (PFPS), or anterior knee pain, is one of the most common disorders affecting the lower extremities. Currently, there is no established "gold standard" treatment for PFPS. However, various interventions-including strengthening of the hip and knee muscles (e.g., hip abductors, external rotators, and knee extensors), taping, bracing, foot orthoses, manual therapy, acupuncture, blood flow restriction training, and conventional physical agents (e.g., ultrasound, cryotherapy, neuromuscular electrical stimulation, laser therapy, electromyographic biofeedback, etc.)-have been reported to provide meaningful clinical benefits. Strengthening of the hip and knee muscles alone has been shown to improve both pain and function in the short, medium, and long term. In recent high-quality studies, hip and knee muscle strengthening has been recognized as an effective "classical" treatment approach for PFPS. Regarding the mechanism of pain relief, previous research suggests that strengthening these muscles may alleviate pain by stabilizing patellar motion and/or reducing pressure on the patellofemoral joint. Similar to traditional resistance training, whole-body vibration (WBV) training is an alternative method for muscle strengthening. WBV platforms can generate vertical vibrations that stimulate tonic vibration reflexes through muscle spindles, thereby activating homonymous alpha motor neurons and inducing reflex muscle contractions. As a result, increased motor unit recruitment enhances the excitability of muscle spindles, leading to improved muscle strength. Additionally, WBV training can improve muscle balance, strength, and function. Therefore, combining WBV with hip and knee strengthening exercises may represent a more effective treatment strategy for PFPS. The aim of this study is to evaluate whether the combination of WBV and hip-knee muscle strengthening is more effective in reducing pain and improving function than hip-knee strengthening alone.

The investigators conducted a prospective, randomized double-blind, placebo-controlled study based on a placebo technique to evaluate the efficacy of IVES vs perineal ES in women with idiopathic OAB. The main questions aimed to be answered are: Is Intravaginal Electrical Stimulation (IVES) or perineal ES more effective on clinical parameters related to incontinence and quality of life in women with idiopathic overactive bladder (OAB)? Participants (n:63) with idiopathic OAB who meet the exclusion and inclusion criteria will be divided into 3 groups using a randomization table. The first group will receive IVES and bladder training (n:21), second group will receive perineal ES and bladder training (n:21) and third group will receive bladder training (n=21) . Measurements will be performed twice in total, before and at the end of treatment (8th week).

The aim was to determine the minimal clinically important difference of the push-off test in distal radius fractures.

This study aims to determine the prevalence and patterns of dysfunctional breathing (DB) among music students and to investigate its relationship with music performance anxiety (MPA). Dysfunctional breathing, also known as a breathing pattern disorder, refers to maladaptive respiratory patterns not explained by medical conditions such as asthma and is associated with symptoms like hyperventilation, poor breathing control, and abnormal respiratory mechanics. Given that MPA is common among musicians and often accompanied by symptoms such as palpitations, tremor, and shortness of breath, this study explores whether DB contributes to or is influenced by performance-related anxiety in this population.

This research evaluate the effectiveness of Extracorporeal Shock Wave Therapy (ESWT) for treating spasticity in the wrist flexor muscles (flexor carpi ulnaris - FCU and flexor carpi radialis - FCR) of chronic stroke patients. Spasticity, a common complication after a stroke, causes muscle stiffness, pain, and functional limitation, leading to increased healthcare costs and a lower quality of life. Current treatments like medication and injections have significant drawbacks, such as side effects and high costs, creating a need for new, non-invasive, and effective methods. The study highlights that traditional methods for assessing spasticity, like the Modified Ashworth Scale (MAS), are subjective. It proposes using objective, non-invasive ultrasound techniques-specifically strain elastography (to measure muscle stiffness) and echogenicity (to assess muscle tissue quality)-for a more reliable evaluation. The primary goal of this research is to be the first to investigate the short- and long-term effects of ESWT on the FCR and FCU muscles using these objective ultrasound measures alongside traditional clinical scales. The findings are expected to help standardize ESWT treatment protocols and promote the use of objective ultrasound data for the management and follow-up of post-stroke spasticity.

This prospective clinical study aims to evaluate and compare the effectiveness of coronally advanced flap (CAF) and tunnel techniques, both combined with platelet-rich fibrin (PRF), in the treatment of multiple Miller Class I-II gingival recessions. Eleven participants with bilateral defects will be treated using a split-mouth design. Periodontal parameters will be assessed at baseline, 3 months, and 6 months.

In our study, investigators plan to compare the preoperative RF and genicular nerve ablation approach in patients who underwent TKA(Total Knee Arthroplasty) using the Fast-Track protocol in terms of meeting postoperative pain, function and early discharge criteria.

Alzheimer's disease is a progressive and chronic neurocognitive disorder. Individuals who assume the role of primary caregivers and are responsible for meeting the care needs of the patient often develop serious health problems over time. It is particularly important to assess the psychological resilience of those who struggle to manage the caregiving process, to identify ruminative thoughts developed in response to negative experiences, and ultimately to determine the presence of post-traumatic growth. Cognitive Behavioral Therapy (CBT)-based psychoeducational interventions are highly effective in the holistic assessment and support of primary caregivers.