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Öğe An approach to lipedema: a literature review of current knowledge of an underestimated health problem(Springer, 2019) Tuğral, Alper; Bakar, YeşimLipedema, 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.Öğe 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.Öğe 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, İlkerObjective: 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.Öğe 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, YeşimBreast 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.Öğe 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, AtaPurpose: 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.Öğe 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, İlkeBackground: 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.Öğe Multipl skleroz tanılı ve sağlıklı kadınların alt üriner sistem semptomlarının karşılaştırılması(2021) Özengin, Nuriye; Türkoğlu, Şule Aydın; Bakar, Yeşim; Tekin, Gözde; Ankaralı, HandanAmaç: 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 incelenmelidirÖğe 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 ÜnObjective: 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.Öğe Pelvik taban kas eğitimi ve sanal gerçeklik(2019) Yeşilyurt, Seda Yakıt; Özengin, Nuriye; Bakar, YeşimPelvik 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.Öğe 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, YeşimThe 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.Öğe Tekerlekli sandalye kullanıcılarında aktivite seviyesini etkileyen demografik özelliklerin belirlenmesi: Karşılaştırmalı çalışma(2019) Saltan, Asuman; Bakar, YeşimAmaç: 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.Öğe 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, AlperThe 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.Öğe What do lymphedema patients expect from a treatment and what do they achieve? A descriptive study(Elsevier Science Inc, 2022) Yıldız, Elif Duygu; Bakar, Yeşim; Keser, İlkePurpose: Lymphedema is characterized by swelling and fibroadipose tissue deposition that is a physically, psychologically, and socially debilitating condition due to chronic and progressive nature of the disease. Treatment benefit evaluation from the patient's perspective is important for medical decision-making. The aim of this study is to investigate important treatment goals and benefits of treatment from the patients' perspective. Method: Eighty-one patients with lymphedema, lipoedema, or lipolymphoedema who are currenlty treated or who underwent previous treatment were included in the study. Socio-demographic data was recorded. Important goals and benefit from treatment were assessed with Patients Needs Questionnaire and Patient Benefit Questionnaire which are sub-questionnaires of Patient Benefit Index-Lymphedema. Results: The most important expectation and needed item was To find a clear diagnosis and therapy (n:59, 72%). The least important item for the lymphedema patients was To feel more attractive (n:9, 11%). Most beneficial effect of treatment was To have no fear that the disease will become worse (n:37, 45.7%). To have fewer out of pocket treatment expenses was rated as the least beneficial effect of treatment (n:24, 29.6%). Conclusions: It is important to identify patients' needs and expectations. Patients should be referred for treatment according to their needs. The effectiveness of the treatment should be evaluated objectively. Patient education should be considered as a part of the effective treatment to teach patients how to control their lymphedema. A clear diagnosis and access to treatment should be ensured for lymphedema patients. Regulations for health insurance benefit coverage are needed to cover cost of compression garments.(c) 2022 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.
