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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 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 PERCEIVED EXERCISE BELIEFS AND BARRIERS AMONG BREAST CANCER SURVIVORS: A DESCRIPTIVE CROSS-SECTIONAL STUDY(2024) Tuğral, Alper; Bakar, Yesim; Akyol, MuratSince the importance of the benefit of physical activity and exercise has been understood especially for cancer patients, efforts are taken to assess belief in exercise to adapt patients to a more physically active environment to create a sustainable health outcome. Thus, this study aimed to assess exercise beliefs and barriers by using a validated metric tool (Exercise Beliefs/Barriers Scale-EBBS) to evaluate beliefs in exercise in breast cancer survivors (BCS). In addition, it was also aimed to assess the relationships among EBBS, sociodemographic, and clinical variables of BCS. A total of 112 BCS were screened and invited to participate in this study. Clinical (type of surgery, adjuvant treatments, etc.), demographic data (age, medication use, etc.), and total sitting time were collected through a simple data form and 7th of the International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. All patients were requested to fill out EBBS.96 BCS completed this study. Weak but significant correlations were found between time spent after surgery and perceived belief (r=. -273, p=0.009), and perceived barriers (r=-.239, p=0.022), respectively. Perceived barriers were also significantly correlated with age (r=-.212, p=0.042). No significant effects of the type of breast surgery and axillary procedure as well as medications (Tamoxifen) on perceived beliefs and barriers were found. Factors should be thoroughly investigated to provide a sustainable exercise behavior among BCS. Older BCS should be thoroughly monitored to gain regular exercise behavior. This study also highlighted the emerging need for sensitive, specific, and focused tools to assess beliefs in exercise among the cancer population.Öğe Potential Role of Smartphone Addiction on Sleep Quality and Perceived Neck Pain Among Undergraduate Physiotherapy Students: A Multicentered Cross-Sectional Study(2024) Tuğral, Alper; Tuğral, YağmurPurpose: This study aimed to analyze the possible associations between smartphone addiction, perceived neck pain, and sleep quality among undergraduate physiotherapy students. Material and Methods: Students were asked to fill out the Smartphone Addiction Scale (SAS), the Neck Bournemouth Questionnaire (NBQ), and the Pittsburgh Sleep Quality Index (PSQI) on the Google Forms platform, accessed online via a QR code. Results: 355 physiotherapy students were included in this study. Considering the threshold value of 5 in PSQI which is accepted as an indicator of poor sleep, 285 out of 355 students (80.3%) showed higher scores (mean:9.73±2.68) than this threshold. A structural equation model showed that the NBQ had a significant effect on the SAS (B= .223; p=.031), and the SAS, in turn, had a significant effect on the PSQI (B=.021; p=.003). It was shown that 7% of the association between the NBQ and the PSQI was explained by the SAS acting as a mediator. Conclusion: Smartphone addiction should be considered to prevent future potential musculoskeletal complaints as well as to preserve and improve the academic performance of students from the perspectives of the associations between sleep quality and perceived neck pain.Öğe Sleep quality and sedentary behavior among cancer survivors: is there a possible link?(2024) Tuğral, Alper; Bakar, Yesim; Akyol, MuratPurpose: Disrupted sleep patterns can be frequent in cancer survivors not only during treatment but also during survival. This study aimed to analyze the possible link between sleep quality and sedentary behavior among cancer patients. Methods: Demographic and clinical information was obtained through an assessment form. Sleep quality and physical inactivity level were assessed by the Pittsburgh Sleep Quality Index (PSQI) and Sedentary Behavior Questionnaire (SBQ), respectively. This cross-sectional study was conducted between April and June 2023 in the Medical Oncology unit of Izmir Bakırçay University Faculty of Medicine. Results: This study was completed with a total of 80 patients with most of the types of cancer being breast (n=55). The mean PSQI score was 7.68±4.02. SBQ scores were 8.16±3.90, and 6.85±3.86 hours on weekdays and weekends, respectively. No significant association was observed between PSQI and SBQ total scores (p>.05). Age was correlated with sleep disturbances (r=-.24, p=0.03), daytime dysfunction (r=-.34, p=0.002), and first item of SBQ (watching TV) both on weekdays (r=.35, p=0.001) and weekends (r=.38, p=0.001), respectively. Conclusion: This study showed that there was no significant relationship between sedentary behavior and sleep quality among cancer patients, however, the remarkable rate of poor sleep quality was evident in this sample. However, it might be reasonable to suggest that the increased screen time especially for older cancer patients due to significant associations between screen time and age, should be well managed while sleep hygiene and daytime dysfunction should be considered further among younger cancer survivors.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 View of Perceived Symptoms Associated with Chemotherapyinduced Peripheral Neuropathy in Patients with Breast Cancer: A Cross-sectional Study(2024) Tuğral, Alper; Akyol, MuratObjective: This cross-sectional study aimed to assess the perceived chemotherapy-induced peripheral neuropathy (CIPN) symptoms in patients with breast cancer who received taxane-based chemotherapy. Methods: A total of 74 patients with breast cancer who underwent taxane-based chemotherapy were screened and invited to participate in this study. Perceived symptoms of CIPN were assessed via the European Organization for Research and Treatment of Cancer-Chemotherapy Induced Peripheral Neuropathy (EORTC-CIPN20) questionnaire after the completion of systemic treatment within a month and a half. Sensory, motor, and autonomic subscale scores were calculated and analyzed for each patient. Results: This study included 52 patients with breast cancer. The mean total exposure dose was 2093.92±1266.22 mg. The rates of adjuvant and neoadjuvant chemotherapy were similar (n=25 vs. n=27). Most patients underwent breast-conserving surgery (65.4%). The types of chemotherapy regimen were combined anthracycline and paclitaxel (n=28), docetaxel (n=14), and combined anthracycline, pertuzumab, trastuzumab, and docetaxel (n=10). Patients who underwent modified radical mastectomy had significantly higher scores in the perceived symptoms of CIPN motor function subscale of EORTCCIPN20 (z=-2.838, p=0.005). The autonomic subscale of EORTC-CIPN20 was significantly correlated with age (r=-0.373, p=0.006) and with the total exposure dose of chemotherapy (r=0.295, p=0.034). Conclusion: The type of surgery, specifically MRM, which has been emphasized as a contributing factor to CIPN, should be taken into consideration for further potential deterioration. By this means, it is reasonable to state that not only ongoing monitoring of the CIPN is of utmost importance, but also potential contributors to the management of the CIPN are of great importance.
