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    An approach to lipedema: a literature review of current knowledge of an underestimated health problem
    (Springer, 2019) Tuğral, Alper; Bakar, Yeşim
    Lipedema, which has been known as an adipose tissue disorder characterized by abnormal fat deposition, mostly affects women. This condition can easily be ruled out regarding its diagnosis because it is commonly misdiagnosed as obesity. True diagnosing and optimal management of lipedema show a great importance. As patients suffer from lipedema, not only experiencing physical symptoms such as tenderness or a feeling of heaviness but also psychological symptoms such as anxiety, they cause negative influences on quality of life of a person with lipedema. This paper tries to review all aspects of lipedema from diagnosis to management and assessment options.
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    Assessment of the cardiorespiratory fitness and the quality of life of patients with breast cancer undergoing chemotherapy: a prospective study
    (Springer Japan Kk, 2023) Akyol, Murat; Tuğral, Alper; Aribaş, Zeynep; Bakar, Yeşim
    BackgroundDiminished cardiorespiratory fitness is a well-known side effect of chemotherapy as well as a risk factor for potential cardiovascular diseases among cancer patients. This study aimed to assess the potential effects of systemic adjuvant (ACT) or neoadjuvant (NACT) chemotherapy on cardiorespiratory fitness and quality of life (QoL) among breast cancer (BC) patients.MethodsDemographic data, cardiorespiratory fitness, health-related QoL domains were assessed with simple data form, six-minute walk test (6MWT), European Organization for Research and Treatment of Cancer quality of life module (EORTC-C30), and Functional Assessment of Cancer Therapy (FACT-B+), respectively. Time1 (T1, prior to chemotherapy), Time2 (T2; interim assessment), and Time3 (T3, final assessment) were set as assessment points.ResultsA total of 42 patients (32 ACT vs 10 ACT) completed all assessments. There were no significant differences of main effect of time and time*group interaction on total walked distance (TWD) after controlling for age and BMI (F(2,28) = 1.309, p = 0.286; F(2,28) = 1.444, p = 0.253). EORTC symptoms subscale was found to be correlated with EORTC and FACT-B+ physical function (PF) subscales (r = - 861, p < 0.001; r = - 0.877, p < 0.001) in T3. The EORTC PF subscale was found to be correlated with the TWD in the baseline (r = 0.411, p = 0.024).ConclusionsThis study showed that the effect of chemotherapy on diminished PF and remarkably increased symptom burden among BC patients. Yet, the type of chemotherapy had no effect on TWD regarding cardiorespiratory fitness. Monitoring potential functional decline regarding cardiorespiratory fitness can be performed via simple field tests such as 6MWT.
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    Can lymphatic transport impaired by total knee arthroplasty be managed with manual lymphatic drainage?
    (Mary Ann Liebert, Inc, 2024) Cihan, Emine; Yildirim, Necmiye Un; Bakar, Yeşim; Bilge, Onur
    Objective: It is known that particles released from the prosthesis due to wear after joint replacement surgery affect the lymphatic system. This study aimed to investigate the effect of the manual lymphatic drainage (MLD) technique on pain, edema, and blood lactate dehydrogenase (LDH) levels in the early period of lymphatic transport affected by total knee arthroplasty (TKA). Method: Twenty-four patients who underwent TKA were randomly allocated (control: 12; MLD: 12). Both groups received postoperative rehabilitation. The MLD group also received MLD in the first 3 days after surgery. Clinical assessment was undertaken on the third day and at the sixth week postoperatively. The Visual Analog Scale (VAS) was used for pain during activity, algometer measurements for pain threshold levels, and the Frustum method for leg volumes. The LDH was recorded using laboratory measurements. Results: A significant difference was found in the VAS activity-related pain scores of the groups according to the assessment time (MLD: chi(2) = 47.175; p = 0.000; control; chi(2) = 30.995; p < 0.000). The pain threshold significantly increased in the MLD group from postoperative day 2 (2nd day, 3rd day, 6th week, respectively; p = 0.015; p = 0.001; p < 0.000). Leg volume significantly decreased over time in both groups after surgery (p < 0.001); however, there was no significant difference between the groups (first-third postoperative days and sixth week; p = 0.192; p = 0.343; p = 0.453; p = 0.908, respectively). While the LDH significantly decreased after drainage in the MLD group (first-third postoperative days; p = 0.002; p = 0.005; p = 0.006, respectively), it increased with exercise in the control group, first day (p = 0.004) and second day (p = 0.019). Conclusions: MLD added to exercise therapy is more effective than exercise therapy alone in reducing the LDH level, a marker of pain and muscle damage, but is not effective for edema due to surgery.
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    Comparison of a 12-week whole-body exergaming program on young adults: Differentiation in flexibility, muscle strength, reaction time, and walking speed between sexes
    (Sage Publications Inc, 2020) Bakar, Yeşim; Tuğral, Alper; Özel, Alp; Altuntaş, Yasin D.
    This study aimed to investigate the effects of exergaming on flexibility, muscle strength, reaction time, and walking speed of adults within sex differences. Fifty-four individuals participated in a 12-week exergaming program. Three 30-min sessions were conducted each week. Baseline and post-intervention assessments were done using the sit-and-reach and bend-over tests for flexibility, hand-held dynamometer for muscle strength, auditory and visual reaction time machine for reaction time, and 5-meter walk test for walking speed. There were no significant changes in the sit-and-reach, bend-over test, and auditory-visual reaction time for either gender (p> .05) with the intervention. Walking speed and muscle strength improved after exergaming in both sexes (p< .05). The study showed that the video gaming intervention led to significant and equal improvements in muscle strength and walking speed for both sexes; however, it had no impact on flexibility and auditory-visual reaction time.
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    Determination of serum trace elements (Se, Fe, Zn), macrominerals (Ca, Na, Cl), and physical activity levels in COVID-19 patients
    (Dustri-Verlag Dr Karl Feistle, 2022) Özdemir, Kadirhan; Saruhan, Ercan; Meral, Orhan; Kaya, Gözde; Benli, Tuba Kaya; Bakar, Yeşim; Kızıloğlu, İlker
    Objective: This study mainly aims to determine serum trace elements, macrominerals, and physical activity levels in COVID-19 patients compared to healthy con-trols. Materials and methods: This prospec-tive study was conducted among COVID-19 patients (group I, n = 20) and healthy con-trols (group II, n = 20). Serum trace element levels (Se, Fe, and Zn), macrominerals (Ca, Na, and Cl), vitamin D, ferritin, and physical activity levels were determined. Results: Of the participants in group I, 90% had Se defi-ciency, 65% had Fe deficiency, and 35% had Zn deficiency. In addition, 45% of the par-ticipants in group II had Se deficiency. There was Ca deficiency (60%), Na deficiency (40%), and Cl deficiency (30%) in COVID-19 patients. Healthy controls did not have any macromineral deficiencies. The trace ele-ment levels including Se, Fe, and Zn were not statistically significant (p > 0.05); how-ever, the micromineral levels including Ca, Na, and Cl were significantly lower between groups (p < 0.05). There were vitamin D de-ficiencies in 90% and 70% of the participants in group I and group II, respectively. Ferritin levels were significantly higher in group I than group II (p < 0.05). All the participants had low physical activity levels in group I, and 40% of the participants had low physi-cal activity levels in group II. Conclusion: This study showed that COVID-19 patients might have lower Ca, Na, and Cl levels than healthy adults. In addition, high rates of Se, Fe, Ca and vitamin D deficiencies, and ferritin lev-els may be seen in COVID-19 patients. More-over, COVID-19 patients may have low levels of physical activity.
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    The effect of adjuvant radiotherapy on skin biophysical properties in patients with breast cancer at risk for breast lymphedema: A prospective study
    (Wiley, 2023) Tuğral, Alper; Akyol, Murat; Bakar, Yeşim
    Breast cancer (BC) is the most common type of cancer among women. Radiotherapy (RT) is one of the main and primary treatment options for BC, especially in breast-conserving surgery (BCS). BC patients who underwent RT experience a wide range of symptoms, in which breast oedema and irritation of the skin take the lion's share. Breast oedema/lymphedema, which is also a prominent side effect after RT should be well determined in earlier settings due to the chronicity of lymphedema. Therefore, this study aimed to analyze the biophysical parameters of skin on the ipsilateral (IL) and contralateral (CL) sites via Tissue dielectric constant (TDC) and Transepidermal water loss (TEWL) methods in terms of oedema and skin barrier function (SBF). The following reference points before and after the RT were measured: (R1: Pectoralis muscle, R2: Upper breast, R3: Lower breast, R4: Lateral site of the thorax). A total of 24 BC patients (mean age and BMI: 52.78 +/- 9.85 years and 28.42 +/- 5.64 kg/m(2)) were evaluated. In the IL site, the SBF was not found significant in R1-R3, whereas significantly lower SBF was observed in R4 after RT (t = -3.361, p = 0.003). A significant increase in TDC was observed in R2 at the 5.0 mm depth (t = -2.500, p = 0.02). We suggest that a longer period of follow-up should be carefully carried out to track changes in terms of SBF and oedema in the irradiated breast. The increased need for early detection of changes associated with breast lymphedema can be achievable via noninvasive, safe, cheap, and easily repeatable devices.
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    Effects of different contraction methods on pelvic floor muscle function in asymptomatic women
    (Turkey Assoc Physiotherapists, 2021) Ünlü, İdil Esin; Özengin, Nuriye; Serindag, Sevinc; Bakar, Yeşim; Ankarali, Handan; Topcuoğlu, Ata
    Purpose: This study aimed to evaluate pelvic floor muscle function in different contractions methods at asymptomatic women with transabdominal ultrasonography. Methods: The study included 120 women who were asymptomatic according to the Global Pelvic Floor Bother Questionnaire and volunteered. After recording the physical and sociodemographic characteristics of women were given one-hour training by a physiotherapist. In this training, four different contraction methods (pelvic floor muscle contraction, Hollowing in maneuver, bracing maneuver, anal contraction) were taught theoretically and practically. Pelvic floor muscle function was evaluated under transabdominal ultrasonography. Measurements were repeated three times for each contraction, and the mean of three measurements was taken for analysis. The sequencing of the contractions was determined by random method. According to women's contraction method, pelvic floor muscle function was compared with the Analysis of Variance test in Repeated Measures. Results: According to women's contraction method, pelvic floor muscle function was significantly different (p=0.001). In light of these test results, the pelvic floor muscle function was the highest in the bracing maneuver. It was determined that this was followed by Hollowing in maneuver, pelvic floor muscle contraction and anal contraction, respectively. Conclusion: The women's pelvic floor muscle function was found to be highest in the bracing maneuver and the lowest in the anal contraction type. We consider that the exercises given with bracing maneuver during the pelvic floor muscle training is more effective in increasing the pelvic floor muscle function.
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    An important tool in lymphedema management: Validation of Turkish version of the patient benefit index-lymphedema
    (Mary Ann Liebert, Inc, 2020) Duygu, Elif; Bakar, Yeşim; Keser, İlke
    Background: The aim of this study was to investigate the Turkish adaptation, validity, and reliability of the Patient Benefit Index-Lymphedema (PBI-L) ensuring direct assessment of the benefit in patients with lymphedema (LE), lipedema, and lipolymphedema. Methods and Results: Eighty-one patients who were consulted for physiotherapy, whose diagnoses were LE, lipedema, and lipolymphedema, and who were treated or planned to be treated for these diagnoses, were included in this study. PBI-L was adapted to Turkish by considering the stages of the cultural adaptation process. Short Form-36 (SF-36) was applied for the validity of PBI-L. PBI-L was repeated after a 1-week interval for test-retest reliability. The mean age was 47.66 +/- 14.23 years. The intraclass correlation coefficient (ICC) value was determined as 0.73 (p < 0.0001) for the total score. There was a moderate correlation between first (ICC = 0.63, p < 0.0001) and second subdimensions (ICC = 0.62, p < 0.0001). Cronbach's alpha values ranged between 0.83 and 0.89. Low correlations were found between total scores of PBI-L and mental health, physical function subdimensions of SF-36 (p < 0.05). The Kaiser Meyer Olkin value was 0.6, and it was found that the PBI-L was not consistent with factor analysis. Conclusion: The Turkish version of PBI-L is a valid and reliable tool in patients with LE, lipedema, and lipolymphedema. However, the reassessment validity of PBI-L would be suggested by using an LE-specific quality of life questionnaire.
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    İnmede Telerehabilitasyon
    (Tokat Gaziosmanpasa University, 2021) Kaya, Tuba; Kaya, Gözde; Şahin, Nilay Yürekdeler; Bakar, Yeşim
    meli bireylerde, erken dönemden itibaren başlayan uzun süreli ve yoğun rehabilitasyon ihtiyacının karşılanmasında kullanılan yöntemlerden biri telerehabilitasyondur. Bilgi ve iletişim teknolojilerinin gelişmesi ile telerehabilitasyona olan ilgi her geçen yıl daha da artmaktadır. Egzersiz yaklaşımları, sanal gerçeklik ile kombine rehabilitasyon uygulamaları, robot destekli eğitim ve kognitif rehabilitasyon inmeli bireylerde telerehabilitasyon yoluyla sunulan yöntemlerinden bazılarıdır. Telerehabilitasyonun inmeli bireylerin motor, konuşma ve bilişsel fonksiyonları ile yaşam kalitelerinde gelişme sağladığı bildirilmiştir. Literatürde inmeli bireylerle yapılan çalışmalarda telerehabilitasyonun geleneksel rehabilitasyonla benzer etkileri olduğu bildirilmektedir. Telerehabilitasyon ile rehabilitasyonun önündeki coğrafi, fiziksel ve motivasyonel engeller azaltılarak tedaviye ulaşılabilirlik arttırılabilir. Bununla birlikte standart prosedür ve protokollerin olmaması, teknik imkanların yetersizliği ve teknolojik araçların kullanımına adaptasyondaki zorluklar telerehabilitasyon uygulamalarını sınırlamaktadır. COVID-19 pandemisiyle hastaların rehabilitasyon hizmetlerine erişimlerini mümkün kılmak veya olası ikincil komplikasyonları önlemek amacıyla telerehabilitasyon uygulamaları bu süreçte daha da yaygınlaşmıştır. Telerehabilitasyon yüz yüze rehabilitasyon hizmetlerine ek olarak rehabilitasyon hizmetlerinin geliştirilmesine olanak sağlayan alternatif bir yöntem olarak görülmektedir.
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    Multipl skleroz tanılı ve sağlıklı kadınların alt üriner sistem semptomlarının karşılaştırılması
    (2021) Özengin, Nuriye; Türkoğlu, Şule Aydın; Bakar, Yeşim; Tekin, Gözde; Ankaralı, Handan
    Amaç: Bu çalışmada, multipl skleroz (MS) tanılı kadınların ve sağlıklı gönüllülerin alt üriner sistem semptomlarını karşılaştırmak amaçlanmıştır. Yöntem: Çalışmaya MS’li 48 kadın (ortalama yaş 41,13±10,93 yıl) ile sağlıklı 51 kadın (38,88±10,26 yıl) dahil edildi. Sosyodemografik özellikler kaydedildikten sonra alt üriner sistem semptomları Bristol Kadın Alt Üriner Sistem Semptomları İndeksi (BKAÜSSİ) ile, pelvik taban prob¬lemleri Pelvik Taban Distres Envanteri-20 (PTDE-20) ve Global Pelvik Taban Rahatsızlık Anketi (GPTRA) ile, aşırı aktif mesane semptomları Aşırı Aktif Mesane Anketi-V8 (AAM-V8) ile, yaşam kali¬tesi Multipl Skleroz Yaşam Kalitesi Anketi-54 (MSYKA-54) ile değerlendirildi. Bulgular: İki grubun BKAÜSSİ depolama, inkontinans ve yaşam kalitesi alt boyut ve toplam puan¬ları arasında anlamlı fark saptandı (p?0,05). Üriner inkontinans şikayetleri, mikst üriner inkontinans sıklığı, pelvik taban problemleri ve aşırı aktif mesane semptomları MS’li kadınlarda sağlıklı kadınlara kıyasla daha yaygındı (p?0,05). MS’li kadınların ortalama MSYKA-54 bileşik fiziksel ve mental sağ¬lık puanları sırasıyla 58,65±19,08 ve 63,68±20,48 idi, ortalama MSYKA-54 total sağlık puanları ise 122,33±36,2 olarak tespit edildi. Sonuç: MS’li kadınlarda alt üriner sistem semptomları daha yaygındır ve yaşam kalitesi olumsuz etkilenmektedir. Klinik değerlendirmelerde üriner inkontinans problemleri göz ardı edilme¬meli, alt üriner sistem semptomları da incelenmelidir
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    Outcomes with additional manual lymphatic drainage to rehabilitation protocol in primary total knee arthroplasty patients: preliminary clinical results
    (2021) Bilge, Onur; Cihan, Emine; Doral, Mahmut Nedim; Bakar, Yeşim; Yıldırım, Necmiye Ün
    Objective: This study was carried out to evaluate the clinical outcomes such as pain, kinesiophobia and quality of life of additional manual lymph drainage (MLD) technique in theafter total knee arthroplasty (TKA) surgery.Methods: Twenty-one TKA patients were randomly allocated to a control group (n:10) and MLD group (n:11). Both groups received routine postoperative rehabilitation. MLD group also received MLD in the first three days after surgery. Clinical assessment was undertaken on postoperative 3rd day and at 6th week. This included knee pain using Visual Analog Scale (VAS), kinesiophobia using Tampa Kinesiophobia Scale (TKS) and quality of life using Nottingham Health Profile (NHP).Results: VAS and TKS values of the MLD group on the 3rd day and at the 6th week were found to be significantly lower than the control group (p<0.05). The 6th week NHP values of the MLD group were found to be significantly lower than the control group (p<0.05). For all three values, within-group, and between-group according to processes the effect size of the MLD group is greater than the control group.Conclusion: The results of the present study demonstrated that addition of MLD application to the standard rehabilitation protocol of TKA positively affected the healing process and it also improved the quality of life by reducing postoperative kinesiophobia and pain level. Adding this special technique to the rehabilitation program in TKA surgeries will provide patient satisfaction and contribute positively to the improvement in clinical outcomes.
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    Pelvik taban kas eğitimi ve sanal gerçeklik
    (2019) Yeşilyurt, Seda Yakıt; Özengin, Nuriye; Bakar, Yeşim
    Pelvik taban kasları (PTK), simfizis pubisten koksikse doğru genişleyen, çok katlı bir kas tabakasıdır. Pelvis içindeki pozisyonu bir trambolin gibi düşünülen bu yapı, pelvik açıklıklara (üretra,vajina ve anüs) yapısal destek verir. Ayrıca işeme, dışkılama, seksüel fonksiyon ve pelvik organların desteklenmesinden de sorumludur. PTK’nin ön, orta veya arka kompartmanlarının herhangibirinde meydana gelen bir patoloji; alt üriner sistem semptomları, bağırsak semptomları, prolapsus,seksüel fonksiyon ve ağrı ile ilişkili olan pelvik taban disfonksiyonu (PTD)na neden olmaktadır.PTD özellikle kadınları etkilemekte ve zaman içerisinde kasın yeniden eğitimini gerektirmektedir.PTD tedavi seçenekleri arasında cerrahi, medikal ve fizyoterapi ve rehabilitasyon yaklaşımları yeralmaktadır. Fizyoterapi ve rehabilitasyonun amacı; semptomları azaltmak, progresyonu ve cerrahiyiönlemek ya da geciktirmek ve yaşam kalitesini artırmaktır. Bu amaçlara ulaşmak için PTD tedavisinde uygulanan fizyoterapi ve rehabilitasyon yaklaşımları pelvik taban kas eğitimini (PTKE) içermektedir. PTKE; biofeedback, vajinal kon, foley kateter, tampon, üç boyutlu real time ultrasoundve sanal gerçeklik eğitimi ile birlikte uygulanabilir. Bu derleme, PTD’de; pelvik taban kas eğitimive bu eğitimde kullanılan yöntemleri tartışmaktadır. Ayrıca, son dönemlerde oldukça popüler olansanal gerçekliğin pelvik taban kas eğitimde uygulanabilirliğini ve avantajlarını vurgulamaktadır.
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    Plantar sensation and balance in patients with type 2 diabetes mellitus with and without peripheral neuropathy
    (Sestre Milosrdnice Univ Hospital, 2021) Yumin, Eylem Tutun; Şimşek, Tulay Tarsuslu; Bakar, Yeşim
    The aim of the study was to investigate the effect of diabetes on plantar sense and balance in patients with type 2 diabetes mellitus (T2DM). The study included 300 subjects divided into three groups: 100 T2DM patients with diabetic peripheral neuropathy (group 1); 100 T2DM patients without peripheral neuropathy (group 2); and 100 subjects without DM (group 3). Berg Balance Scale (BBS), Timed Up and Go test (TUG), single leg test with eyes open and closed, and plantar sensory tests were applied in the subjects. Study results showed significant differences in plantar sensory tests, BBS, TUG and single leg test among the three groups (p<0.05). In addition, duration of DM and medication were negatively correlated with single leg test both with eyes open and closed, but showed positive correlation with plantar sense and TUG test. Furthermore, the length of insulin therapy showed positive correlation with plantar sense and TUG test and negative correlation with BBS (p<0.05). In conclusion, DM has an effect on plantar sense and balance, and there is a relation between the duration of DM and balance problems. Balance problems are observed more often in patients with neuropathy.
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    PRİMER MONOSEMPTOMATİK NOKTÜRNAL ENÜREZİSLİ ÇOCUKLAR VE EBEVEYNLERİNİN YAŞAM KALİTELERİNİN İNCELENMESİ
    (Bolu Abant İzzet Baysal Üniversitesi, 2021) İnal, Büşra; Bakar, Yeşim; Amkaralı, Handan; Öztürk, Yusuf; Özengin, Nuriye
    Bu çalışma, primer monosemptomatik noktürnal enürezisli çocuklar ile sağlıklı çocukların yaşam kalitelerini ve primer monosemptomatik noktürnal enürezisli çocukların ebeveynleri ile sağlıklı çocukların ebeveynlerinin yaşam kalitelerini karşılaştırmayı amaçladı. Araştırmaya primer monosemptomatik noktürnal enürezisli 35, sağlıklı 34 çocuk ve ebeveynleri dahil edildi. Çocukların fiziksel ve sosyodemografik özellikleri kaydedildi. Çocukların yaşam kaliteleri Üriner İnkontinanslı Çocuklarda Yaşam Kalitesi Ölçeği ile değerlendirildi. Ebeveynlerin yaşam kaliteleri Kısa Form- 36 ile belirlendi. Primer monosemptomatik noktürnal enürezisli çocukların sağlıklı çocuklara göre yaşam kalitelerinin (p=0,001) daha düşük olduğu bulundu. Sağlıklı grubun ebeveynlerinin yaşam kalitelerinin primer monosemptomatik noktürnal enürezisli grubun ebeveynlerine göre genel sağlık alt parametresinde daha kötü (p=0,034), diğer parametrelerde ise benzer olduğu saptandı (p>0,05). Bu çalışmanın sonucunda primer monosemptomatik noktürnal enürezisli çocukların yaşam kalitelerinin sağlıklı çocuklara göre daha kötü olduğu saptandı. Ebeveynlerin ise yaşam kalitelerinin genel sağlık alt parametresi hariç benzer olduğu bulundu.
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    Quality of life and somatic physical function of patients with colorectal cancer who underwent oxaliplatin-based systemic chemotherapy: a prospective study
    (Springer, 2024) Tuğral, Alper; Kebabçı, Eyup; Aribas, Zeynep; Akyol, Murat; Can, Aysegul; Bakar, Yeşim
    introductionThis study aimed to study the potential effects of oxaliplatin-based chemotherapy on cardiorespiratory fitness, handgrip strength (HGS), body composition, and quality of life (QoL) of stages III-IV colorectal cancer (CRC) patients before the first cycle (T0) and after the last cycle of systemic adjuvant/neoadjuvant chemotherapy (T1).MethodsCardiorespiratory fitness, HGS, body composition, and QoL were evaluated with the six-minute walk test (6MWT), hydraulic hand dynamometer, body composition analyzer, and Functional Assessment of Cancer Therapy-Colon (FACT-C) questionnaire in both T0 and T1, respectively.ResultsTwenty-eight CRC patients were included in this study. The total walked distance (TWD) was found to be decreased from T0 to T1 (499.72 m vs. 488.56 m); however, this change was not significant (z = -.706, p = 0.48). Type of chemotherapy whether adjuvant or neoadjuvant also showed no significant effect on TWD (z = -.1.372, p = .17 vs z = -1.180, p = .238, respectively). The QoL was significantly decreased (T0 = 118.35 vs T1 = 110.77, t = 2.176,p = 0.05). The TWD was significantly correlated with the physical well-being (PWB) subscale of FACT-C (r = .64, p = 0.001) as well as with HGS (r = .46, p = .018) in T0. After controlling for age, type of chemotherapy, and type of regimen, the HGS did not show a significant difference from T0 to T1 (F(1,23) = 1.557, p = .22, eta p2 = .06). However, the effect of time x gender showed significant difference from T0 to T1 (F(1,23) = 4.906, p = .037, eta p2 = .17).ConclusionThis study showed the decreased QoL and physical well-being of CRC patients who underwent oxaliplatin-based treatment. In addition, the gender effect of decreased HGS should be considered further when planning an oncological rehabilitation program.
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    Risk profiling of breast cancer-related lymphedema (BCRL) in patients with breast cancer via using body composition and tissue dielectric constant (TDC) method: A cross-sectional study
    (Cig Media Group, Lp, 2024) Tuğral, Alper; Akyol, Murat; Colakoglu, Oyku; Bakar, Yeşim
    Breast cancer-related lymphedema (BCRL) is one of the most fearsome side effects of breast cancer treatment. Higher body mass index (BMI) is a well-known risk factor for BCRL. A total of 72 patients were included. The fat mass was significantly and linearly correlated with dielectric ratios which might be indicative of preclinical Background: Breast Cancer-Related Lymphedema (BCRL) is one of the most prominent long-term side effects of breast cancer (BC) treatment. Although an increased BMI is a well-recognized risk factor for BCRL, there is a lack of knowledge regarding the potential associations between body composition and the risk of BCRL. Therefore, this study aimed to analyze the BCRL risk profiles of surgically operated BC patients via body composition and the Tissue Dielectric Constant (TDC) method, respectively. Methods: A total of 72 patients were included. Patients' risk for BCRL was assessed with Moisture MeterD (Delfin, Finland) in 4 different probes each has unique penetration depths from 0.5 (10 mm) to 5.0 (55 mm) at both upper extremities. The body composition was analyzed with Tanita-BC-420 (TANITA, Japan). Comparing the dielectric values of extremities and proportioning to one another as TDC ratio (at-risk side/unaffected side) was used to profile BCRL risk. Results: TDC values of the thorax reference point were significantly higher in all four probes on the at-risk side ( P < .05). TDC ratios in the forearm and Thorax points were significantly correlated with fat mass (r = 0.256, P = .030; r = 0.269, P = .022) as well as with visceral fat rating (VFR) (r = 0.340, P = .003; r = 0.466, P < .001). Conclusion: This study highlights the need for further care and investigation in the assessment and prediction of BCRL by considering body composition. Since the risk reduction of BCRL can be maximized by considering the individual features, we can conclude that patients with higher body fat irrespective of the BMI should be followed up regularly.
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    Tekerlekli sandalye kullanıcılarında aktivite seviyesini etkileyen demografik özelliklerin belirlenmesi: Karşılaştırmalı çalışma
    (2019) Saltan, Asuman; Bakar, Yeşim
    Amaç: Aktif yaşam tarzının faydaları bilinmesine rağmen birçok tekerlekli sandalye (TS)kullanıcısı hareketsiz yaşamı tercih etmektedir. Aktif bir yaşam TS kullanıcılarında, aynı zamanda TS ile hareket etme yeteneği anlamına gelmektedir. Engelli bireyin topluma katılımınıetkilemektedir. TS ile hareket ederken oluşan memnuniyet seviyesinin genel yaşam kalitesi ilepozitif ilişkili olduğu bulunmuştur. Bu çalışmada, günlük yaşamında hareket etmek için tekerlekli sandalye kullanan, topluma katılmış sporcu ve sedanter engelli bireylerin demografik özelliklerinin karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, yürüme fonksiyonlarıolmayan, günlük yaşamlarında hareket etmek için TS kullanan sedanter ve TS basketbol sporuyapan bireyler dâhil edildi. Bireyler sporcu (n=111) ve kontrol (n=85) olmak üzere iki gruba ayrıldı. Bireylerin cinsiyet dağılımları sporcu grubunda %9,9 (n=11) oranında kadın, %90,1 (n=100)oranında erkek; kontrol grubunda ise sırasıyla %38,8 (n=33) oranında kadın ve %61,2 (n=52)oranında erkek olarak belirlendi. Bireylerin demografik bilgileri [yaş, cinsiyet, beden kitle indeksi (BKİ), meslek, eğitim, engel tipi, engel zamanı] alındı. Bulgular: Yaş (p<0,001), cinsiyet(p<0,001), meslek (p=0,011), eğitim (p=0,0002) ve engel tipi (p=0,001), parametrelerinde gruplar arası anlamlı fark olduğu görüldü. Engel zamanı (p=0,424) ve BKİ (p=0,181) parametrelerinde ise gruplar arası anlamlı fark bulunmadı. Sonuç: Engelli bireylerde aktivite katılımınıneğitim düzeyi ve mesleki durum üzerinde etkili faktör olduğu, kadın engellilerin aktivitelerekatılımlarının teşvik edilmesi gerektiğini düşünüyoruz. Engelli bireylerin aktivite katılım seviyesinin artırılmasına yönelik çalışmalarda bireysel değerlendirmelere yer verilmesi gerektiğinidüşünüyoruz.
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    The reliability, validityand cross-cultural adaptation of Turkish version of jefferson scale of empathy for health professions students
    (Marmara Univ, Inst Health Sciences, 2024) İsmailoğlu, Elif Günay; Özdemir, Kadirhan; Tuğral, Alper; Bakar, Yeşim
    Objective: The study is aimed to study for the reliability, validity, and cross-cultural adaptation of the Turkish version of the Jefferson Scale of Empathy for undergraduate health profession students (JSE-HPS). Methods: Cultural adaptation of JSE-HPS was carried out in 5 stages according to the protocol of Beaton et al.JSE-HPS was administered to students who educated in the departments of Physiotherapy and Rehabilitation, Nursing and Health Management. The reliability of JSE-HPS was evaluated by internal consistency and test -retest analysis using Cronbach's alpha and intraclass correlation coefficient (ICC), respectively. Criterion validity assessed by comparing the scores of JSE-HPS and Emphatic Tendency Scale (ETS). An analysis of construct validity was carried out by exploratory and confirmatory factor analysis. Results: The exploratory factor analysis revealed the presence of three factors that explain 44.68% of the total variance and that correspond to the dimensions of the original scale. Following factor structures were obtained as Perspective taking, Compassionate care and Standing in patient's shoes. Turkish version of JSE-HPS total score were significantly correlated with the ETS total score (r=0.187, p=.005). The Cronbach's Alpha internal consistency coefficient was found alpha = .793. The test -retest reliability coefficient was 0.86. The confirmatory factor analysis verified a good fit of the model (chi 2/df = 1.776). Conclusion: The Turkish version of JSE-HPS is a valid and reliable scale for evaluating empathy levels of undergraduate health professions students.
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    Translation, reliability, and validation of the Turkish version of the Lymphedema Quality-of-Life tool in Turkish-speaking patients with lower limb Lymphedema
    (Elsevier Science Inc, 2019) Bakar, Yeşim; Tuğral, Alper
    The aim of this study was to translate the original English version of the Lymph Quality-of-Life Questionnaire (LYMQoL) into Turkish language and test its reliability and validity in patients with lower limb lymphedema (LLL). A total of 119 patients (86 women and 33 men) with LLL were enrolled in this study. The Turkish version of the Nottingham Health Profile was used to evaluate the criterion validity of related domains in LYMQoL. The LYMQoL was performed after seven days to evaluate its test-retest reliability. Cronbach's alpha value was found to be 0.94 for internal consistency, and the intraclass correlation coefficient score for test-retest reliability was found to be 0.95. The intraclass correlation coefficient score of domains ranged between 0.83 and 0.92. For the criterion validity, functional aspects'' and symptoms'' domains moderately correlated significantly with the Nottingham Health Profile total score. Kappa values ranged from 0.356 to 0.715. According to the factor analysis, four factors that explain the 71% of the cumulative variance were found. In conclusion, this study indicates that the Turkish version of the LYMQoL is a reliable valid tool for the evaluation of disease-specific health-related quality of life in patients with LLL. It can be safely used in both clinical routine and research.
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    Understanding changes in pulmonary function and functional status in breast cancer patients after systemic chemotherapy and radiotherapy: a prospective study
    (Bmc, 2024) Tuğral, Alper; Aribas, Zeynep; Akyol, Murat; Bakar, Yeşim
    BackgroundRespiratory complications in breast cancer (BC) patients after chemotherapy (CT) and radiotherapy (RT) have been well acquainted and these complications should be investigated to prevent secondary problems and/or improve BC patients' clinical outcomes. Therefore, this study aimed to assess the potential acute effect of systemic chemotherapy and radiotherapy on respiratory function and functional status of patients with breast cancer.MethodsA total of 25 BC patients who were candidates for systemic chemotherapy and radiotherapy were recruited after oncological examination and included in this study. Respiratory function and functional status were assessed with the Pulmonary Function Test (PFT) and the Six-Minute Walk Test (6MWT), respectively. Patients were assessed before CT (c0), after CT (c1), and after RT (r1).Results25 BC patients were assessed in c0 and c1 while only 15 out of 25 patients (60%) were assessed in r1. The actual values of Forced vital capacity (FVC) (t = 2.338, p =.028), Forced expiratory volume in 1s (FEV1 (t = 2.708, p =.012), and the forced expiratory flow of between 25% and 75% of vital capacity (FEF25-75%) (t = 2.200, p =.038) were found significantly different after systemic CT. Inspiratory (MIP) and expiratory (MEP) muscle strength also did not show a significant change from c0 to c1. A significant effect of the type of surgery was found (Wilks' lambda, F [1, 19] = 6.561, p =.019, eta p2 = 0.25) between c0 and c1 in actual FVC value. The main effect of time was found significant in FVC (F [2, 28] = 4.840, p =.016, eta p2 = 0.25) from c0 to r1. Pairwise comparisons with Bonferroni correction showed that there was a significant difference between c0 and r1 (p =.037).DiscussionThe present study showed decreased FVC and FEV1 actual values and percent predicted rates from baseline to the completion of treatment. Since the interactional effect of the type of surgery was significant, we suggest that clinical and demographic factors such as age should be considered when interpreting the early changes in PFT. In addition, the significant linear trend of decreasing in some specific outcomes in respiratory function also highlighted the need for continuous monitoring of potential respiratory problems in patients with BC from baseline to the completion of chemotherapy and radiotherapy.
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