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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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    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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    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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    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.