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Öğe Age-related differences in functional capacity, physical activity, life satisfaction, well- being and quality of life in Turkish adult population during Covid-19(Dokuz Eylul Univ Inst Health Sciences, 2022) Kaya, Gözde; Zeren, MelihPurpose: During the COVID-19 pandemic, the physical and mental health of general population has been adversely affected. This study aims to investigate if there are age-related differences in functional capacity, physical activity, life satisfaction, well-being and quality of life among adults of different age groups during this era. Methods: One-hundred fifty participants aged between 18-65 years were included. Participants were divided into 5 age groups, with 30 people in each age group i.e., 18-25, 25-35, 35-45, 45-55, and 55-65 years, using a block randomization. Functional capacity was evaluated with 1-minute sit-to-stand test (1-min STST); level of physical activity with International Physical Activity Questionnaire-Short Form (IPAQ-SF); life satisfaction with The Satisfaction with Life Scale (SWLS); well-being with WHO-5 Well-Being Index (WHO-5); and the quality of life with Short Form-12 (SF-12). All assessments were applied via an online form. Results: Age negatively correlated to 1-min STST (p<0.01, r=-0.214) and IPAQ total score (p<0.01, r=-0.173), whereas positively correlated to SWLS score (p<0.05, r=0.168) and MCS-12 score (p<0.01, r=0.339). There were statistically significant age-related differences in IPAQ total scores (p=0.001; F=5.169), MCS-12 scores (p<0.001; F=8.624) and SWLS scores (p=0.046; F=2.485). Individuals aged 18-25 years had the best IPAQ-SF score, and the worst SWLS and MCS-12 scores among other age groups. Conclusion: Younger individuals seem to have worse impairment in mental aspects of their lives compared to older counterparts, despite having relatively higher functional capacity and physical activity participation during COVID-19. These age-related differences should be taken into account when tailoring rehabilitation and/or counselling programs during this era.Öğe Atrial Fibrillation Impact Questionnaire (AFImpact): Validity and reliability of the Turkish version(Aves, 2021) Zeren, Melih; Demir, Rengin; Karcı, Makbule; Yiğit, Zerrin; Uzunhasan, Işıl; Gürses, Hülya NilgünObjective: Guidelines recommend measuring and addressing health-related quality of life in the management of atrial fibrillation (AF); however, a disease-specific questionnaire is lacking for the Turkish language. Our aim was to translate and adapt the Atrial Fibrillation Impact Questionnaire (AFImpact) into Turkish and to explore its psychometric properties. Methods: This cross-sectional study was conducted in two phases, including the translation and cultural adaptation of AFImpact into Turkish language and the analysis of psychometric properties of the translated questionnaire. 98 patients diagnosed with AF were evaluated using the Turkish version of AFImpact, Short Form-36 (SF-36) and Pittsburg Sleep Quality Index (PSQI). Reliability, validity, and factor structure of the Turkish version of AFImpact was explored. Results: Cronbach's alpha coefficients for vitality, emotional distress, and sleep domains of AFImpact was 0.956, 0.955, and 0.819, respectively, indicating good-to-excellent internal consistency. No significant difference was detected between the initial and retest scores, and intraclass correlation coefficients of each domain varied between 0.991 and 0.996, indicating excellent test-retest reliability. Each domain of AFImpact highly correlated with similar domains of SF-36 and PSQI, having correlation coefficients between -0.484 and -0.699. AFImpact was able to discriminate between the patients in different functional classes, confirming know-groups validity. Factor analysis revealed AFImpact had the same factorial structure as the original questionnaire. Conclusion: The Turkish version of AFImpact is a valid and reliable questionnaire for evaluating health-related quality of life in patients with AF.Öğe Breathing and relaxation exercises help improving fear of Covid-19, anxiety, and sleep quality: A randomized controlled trial(Mary Ann Liebert, Inc, 2022) Kepenek-Varol, Büşra; Zeren, Melih; Dinçer, Rukiye; Erkaya, SevalObjective: To investigate the effects of breathing and relaxation exercises performed via telerehabilitation on fear, anxiety, sleep quality, and quality of life of individuals without coronavirus disease 2019 (COVID-19) during the ongoing pandemic.Design: A prospective, randomized, controlled single-blind study.Methods: Fifty participants who had not been exposed to the COVID-19 virus earlier were randomly divided into experimental (n = 25) and control groups (n = 25). Both groups received an information session about COVID-19 once at the start of the study via a mobile phone video application. The experimental group also performed a breathing and relaxation exercise program twice daily (morning and evening), 7 days per week, for 4 weeks; one session of the program was conducted under the remote supervision of a physiotherapist as telerehabilitation, and the remaining sessions were performed as a home program. The Fear of COVID-19 Scale (FCV-19S), which was the primary outcome measure, The Hamilton Anxiety Rating Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), and EQ-5D-3L were administered to both groups.Results: The FCV-19S, HAMA, and PSQI were statistically significantly improved to compare the controls, with a large effect size (eta(2)(p) = 0.135, 0.313, and 0.200, respectively). The EQ-5D-3L index and EQ-5D-3L visual analog scale were not statistically significantly different compared with the controls; however, a small effect size was detected for the differences between the two groups (eta(2)(p) = 0.056 and 0.013, respectively).Conclusion: Breathing and relaxation exercises appear to be an effective and feasible approach to support mental health and sleep quality during the COVID-19 pandemic. Especially in highly contagious diseases such as COVID-19, telerehabilitation approaches may be useful for safely reaching individuals by eliminating human-to-human contact.Clinical Trial Registration number: NCT04910932.Öğe Cut-off values of 6-min walk test and sit-to-stand test for determining symptom burden in atrial fibrillation(Springer London Ltd, 2022) Zeren, Melih; Karcı, Makbule; Demir, Rengin; Gürses, Hülya Nilgün; Oktay, Veysel; Uzunhasan, Işıl; Yiğit, ZerrinBackground Since symptomatology is a major predictor of quality of life and an endpoint for the management of atrial fibrillation (AF), practical approaches for objectively interpreting symptom burden and functional impairment are needed. Aims We aimed to provide cut-off values for two frequently used field tests to be able to objectively interpret symptom burden in atrial fibrillation. Methods One hundred twenty-five patients with AF were evaluated with European Heart Rhythm Association (EHRA) score, 6-min walk test (6MWT), 30 s sit-to-stand test (30 s-STST), Short-Form 36 (SF-36), International Physical Activity Questionnaire-Short Form (IPAQ-SF), and spirometry. Patients with EHRA 1 were classified as asymptomatic, and those with EHRA 2-4 as symptomatic. Cut-off values of 6MWT and 30 s-STST for discriminating between these patients were calculated. Results The optimal cut-off value was 450 m for 6MWT (sensitivity: 0.71; specificity of 0.79) and 11 repetitions for 30 s-STST (sensitivity 0.77; specificity of 0.70). Area under ROC curve was 0.75 for both tests (p < 0.001). Discriminative properties of the two tests were similar, and they were significantly correlated (r = 0.58; p < 0.001). Subgroup analysis revealed patients below cut-off values also had worse outcomes in SF-36, IPAQ-SF, and spirometry. Conclusions In patients with AF, walking < 450 m in 6MWT or performing < 11 repetitions in 30 s-STST indicates increased symptom burden, as well as impaired exercise capacity, quality of life, physical activity participation, and pulmonary function. These cut-off values may help identifying patients who may require adjustments in their routine treatment or who may benefit from additional rehabilitative approaches.Öğe Do pulmonary and extrapulmonary features differ among cystic fibrosis, primary ciliary dyskinesia, and healthy children?(Wiley, 2020) Denizoğlu Kulli, Hilal; Gürses, Hülya Nilgün; Zeren, Melih; Üçgün, Hikmet; Çakır, ErkanBackground Primary ciliary dyskinesia (PCD) is generally likened to cystic fibrosis (CF) due to similarities in impaired mucociliary clearance and some other symptoms. The aim of our study was to investigate pulmonary and extrapulmonary characteristics of children with CF and PCD since no studies have addressed respiratory muscle strength in children with PCD and to compare the results to those obtained from healthy age-matched controls. Methods Pulmonary and extrapulmonary characteristics were assessed by 6-min walk test, spirometry, maximum inspiratory and expiratory pressure measurements, and knee extensor strength test in the children with CF, PCD, and healthy controls. Results Children with PCD and CF had similar PFT results, except forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) which was lower in PCD (p = .04). Maximum inspiratory pressure (MIP) value was lower in the children with CF compared with the healthy controls (p = .016), MEP value of the children with PCD was worse than those with CF and healthy controls (p = .013 and p = .013), respectively. 6-min walk test (6MWT) distance of the children with CF was lower than their healthy counterparts (p = .003). Knee extensor muscle strength differed among the children with PCD, CF, and healthy control groups, but post hoc test failed to show statistical significance (p = .010). Conclusion Children with CF and PCD had some impairments in pulmonary functions, respiratory muscle strength, functional capacity, and peripheral muscle strength compared with healthy children. However, the unique characteristics of each disease should be considered during physiotherapy assessment and treatment. The clinicians may especially focus on the respiratory and peripheral muscle strength of the children with PCD.Öğe Does Duke Activity Status Index help predicting functional exercise capacity and long-term prognosis in patients with pulmonary hypertension?(W B Saunders Co Ltd, 2021) Mustafaoğlu, Rüstem; Demir, Rengin; Aslan, Gökşen Kuran; Sinan, Ümit Yaşar; Zeren, Melih; Küçükoğlu, Mehmet SerdarBackground: To investigate the association of Duke Activity Status Index (DASI) with 6-minute walk test (6MWT) and WHO-Functional Class (WHO-FC) in patients with pulmonary hypertension (PH), as well as exploring whether DASI can discriminate between the patients with better and worse long-term prognosis according to 400 m cut-off score in 6MWT. Methods: Eighty-five medically stable PH patients who met eligibility criteria were included. All patients were evaluated using 6MWT and DASI. The prognostic utility of the DASI was assessed using univariate linear regression and receiver operating characteristic (ROC) curve analysis. Results: The DASI was an independent predictor for both 6MWT and WHO-FC, explaining 50% of variance in 6MWT and 30% of variance in WHO-FC class (p < 0.001). In addition, DASI significantly correlated to 6MWT (r = 0.702) and WHO-FC class (r = 0.547). The ROC curve analysis revealed that the DASI had a discriminative value for identifying the patients with better long-term prognosis (p < 0.001), with an area under ROC curve of 0.867 [95% CI = 0.782-0.952]. The DASI >= 26 was the optimal cut-off value for better long-term prognosis, having sensitivity of 0.74 and a specificity of 0.88. Conclusions: The DASI is a valid tool reflecting functional exercise capacity in patients with PH. Considering its ability to discriminate between the patients with better or worse long-term prognosis, it may help identifying the patients at higher risk.Öğe Does the effect of comprehensive respiratory physiotherapy home-program differ in children with cystic fibrosis and non-cystic fibrosis bronchiectasis?(Springer, 2022) Gürses, Hülya Nilgün; Üçgün, Hikmet; Zeren, Melih; Denizoğlu Külli, Hilal; Çakır, ErkanBronchiectasis is a form of airway damage as a consequence of endobronchial infection and inflammation and may be present in different diseases. The underlying aetiologies include both cystic fibrosis (CF) and a group of non-cystic fibrosis diseases (NCFB) such as immunodeficiency, primary ciliary dyskinesia, or severe pulmonary infection. Although children with CF and non-cystic fibrosis bronchiectasis (NCFB) have many similar clinical features, their responses to exercise may be different. The aim of this study was to compare the efficacy of a comprehensive respiratory physiotherapy (CRP) home-program in children with CF and NCFB. Thirty children with CF and thirty children with NCFB were included in the study. Both groups performed the CRP home-program twice daily for 8 weeks. Pulmonary function, exercise capacity, and respiratory and peripheral muscle strength were assessed at baseline and after 8 weeks of training. Both groups experienced significant improvements in pulmonary function, exercise capacity, and respiratory and peripheral muscle strength (p < 0.001). Maximum expiratory pressure, exercise capacity, and peripheral muscle strength were further improved in NCFB group compared to CF (p < 0.05); however, there was a great variability in the improvements for each variable. Conclusion: CRP is beneficial both for children with CF and NCFB and adherence to the program was high in both groups.Öğe Effect of gender and physical activity level on sit-to-stand test performance among young adults(2020) Gürses, Hülya Nilgün; Külli, Hilal Denizoğlu; Durgut, Elif; Zeren, MelihObjective: Our study aimed to determine the sit-to-stand (STS)test performance and physical activity levels of young adults andinvestigate the relationship of STS tests with gender and physicalactivity levels.Methods: Sixty volunteers randomly performed the 5×STS,10sSTS, 30sSTS and 60sSTS tests. Fatigue was rated using theBorg category ratio scale. Physical activity level and weekly energyexpenditure of volunteers were calculated using the InternationalPhysical Activity Questionnaire.Results: The 5×STS, 10sSTS, 30sSTS and 60sSTS test scoreswere statistically different between genders (p=0.004; p=0.002;p=0.000; p=0.000, respectively). Fatigue levels after STS testsdid not show any difference between genders (p=0.636; p=0.295;p=0.888; p=0.150, respectively). Weekly energy expenditures werepositively correlated with STS tests except 5×STS test (r=?0.458,p=0.000; r=0.427, p=0.001; r=0.606, p=0.000; r=0.545, p=0.000,respectively). All STS tests had significant differences betweenparticipants with moderate or high physical activity level (p=0.016;p=0.007; p=0.000; p=0.000, respectively).Conclusion: Our study shows that STS tests scores correlate togender and physical activity levels in young adults.Öğe The effect of hypermobility on pain and quality of life in young adults Genç yetişkinlerde hipermobilitenin ağrıve yaşam kalitesi üzerine etkisi(Galenos Publ House, 2022) Arifoğlu Karaman, Ciğdem; Zeren, Elif; Maral, Fatih; Parlak, Muhammed; Kirazlı, Özlem; Boracı, Hatice; Zeren, MelihObjective: Hypermobility is the excessive range of motion of joints, and related to various musculoskeletal and extra-articular problems that may significantly impair quality of life (QoL) by causing pain. The aim of the study is to examine the prevalence of hypermobility in young adults, and its relationship with pain in various regions of body and QoL. Methods: Two hundred and twenty five volunteers, aged between 17 and 23, were classified as subjects-with-hypermobility or subjects-without-hypermobility according to the Beighton Criteria. Chronic pain was identified by using Nordic Pain Questionnaire, QoL was identified by Short Form-36 (SF-36) Questionnaire. Pain presence in 9 body regions and SF-36 scores were compared between groups using chi-square test and Independent Samples T-test, respectively. Results: Of the participants, 164 (64%) were female, 91 (36%) were male, 119 (46.7%) had hypermobility. Upper back was the body region with the highest pain prevalence where 79% of hypermobile and 74% of non-hypermobile subjects reported pain at least once in past 12 months. Pain prevalence in body regions did not differ between groups (p>0.05). In terms of QoL, physical and mental component scores of SF-36, as well as all subgroup scores except social function were significantly lower in hypermobile subjects (p<0.05). Conclusion: Pain prevalence in different body regions did not differ between subjects with and without hypermobility whereas the QoL was significantly impaired in hypermobile subjects. Hypermobility is a substantial anatomical finding in young adults that should not be disregarded. Education, emotional support and encouraging about strengthening and proprioception exercises may contribute to their quality of life.Öğe The effect of incentive spirometry in addition to comprehensive chest physiotherapy on length of hospital stay and hemodynamic responses in patients with COPD exacerbation(European Respiratory Soc Journals Ltd, 2023) Kulli, Hilal Denizoglu; Kaya, Meltem; Ucgun, Hikmet; Zeren, Melih; Okyaltirik, Fatmanur; Gurses, Hulya Nilgun[Abstract Not Available]Öğe Effects of inspiratory muscle training on respiratory muscle strength, respiratory function and functional capacity in adolescents with idiopathic scoliosis A randomized, controlled trial(Springer Wien, 2023) Basbug, Gozde; Gurses, Hulya Nilgun; Zeren, Melih; Elmadag, Nuh MehmetBackgroundAdolescent Idiopathic Scoliosis (AIS) may impair respiratory dynamics and affect the performance of inspiratory and expiratory muscles. The benefit of inspiratory muscle training (IMT) is not well investigated in AIS. We aimed to investigate the effects of IMT on respiratory muscle strength, respiratory function and functional capacity in adolescents with mild to moderate AIS.MethodsThirty-six adolescents were randomized into control or IMT groups. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and peak expiratory flow (PEF) were measured by spirometry; respiratory muscle strength by maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP); and functional capacity by 6-min walk test (6MWT) before and after the 8-week-long home-based exercise program. Both groups received conventional exercise program including diaphragmatic breathing exercises, resistive local expansion exercise on the collapsed areas in concave sides of scoliosis, spinal stabilization, strengthening of interscapular muscles and stretching exercises. IMT group also trained with Threshold IMT device for 15 minutes, twice a day for 8 weeks at the intensity of 30% of initial MIP value in addition to conventional exercise program.ResultsFEV1, PEF, MIP, MEP and 6MWT distance significantly improved in both groups. IMT group also showed significant improvement in FVC. The increases in FVC, MIP, MEP and 6MWT distance of IMT group were significantly higher compared to control group.ConclusionIMT is found to be beneficial for patients with AIS for achieving further improvements in respiratory function, respiratory muscle strength and functional capacity compared to conventional exercise program alone.Öğe Evaluation of primary and accessory respiratory muscles and their influence on exercise capacity and dyspnea in pulmonary arterial hypertension(Mosby-Elsevier, 2023) Durdu, Habibe; Demir, Rengin; Zeren, Melih; Basturk, Pinar; Arabaci, Hidayet Ozan; Sinan, Umit Yasar; Kucukoglu, Mehmet SerdarBackground: Skeletal and respiratory muscle disfunction has been described in pulmonary arterial hypertension (PAH), however, involvement of accessory respiratory muscles and their association with symptomatology in PAH is unclear. Objectives: To assess the primary and accessory respiratory muscles and their influence on exercise tolerance and dyspnea. Methods: 27 patients and 27 healthy controls were included. Serratus anterior (SA), pectoralis muscles (PM) and sternocleidomastoid (SCM) muscle strength were evaluated as accessory respiratory muscles, maximal inspiratory (MIP) and expiratory pressures (MEP) as primary respiratory muscles, and quadriceps as peripheral muscle. Exercise capacity was evaluated with 6-min walk test (6MWT), dyspnea with modified Medical Council Research (MMRC) and London Chest Activity of Daily Living (LCADL) scales. Results: All evaluated muscles, except SCM, and 6MWT were decreased in patient group (p < 0.01). SA was the most affected muscle among primary and accessory respiratory muscles (Cohen's-d = 1.35). All evaluated muscles significantly correlated to 6MWT (r = 0.428-0.525). A multivariate model including SA, SCM and MIP was the best model for predicting 6MWT (R = 0.606; R-2 = 0.368; p = 0.013) and SA strength had the most impact on the 6MWT (B =1.242; beta = 0.340). None of the models including respiratory muscles were able to predict dyspnea, however PM and SA strength correlated to LCADL(total) (r =-0.493) and MMRC (r =-0.523), respectively. Conclusion: SCM may be excessively used in PAH since it retains its strength. Considering the relationship of accessory respiratory muscles with exercise tolerance and dyspnea, monitoring the strength of these muscles in the clinical practice may help providing better management for PAH. (C) 2022 Elsevier Inc. All rights reserved.Öğe Investigation of dynamic hyperinflation and its relationship with exercise capacity in children with bronchiectasis(Wiley, 2022) Tosun, Beyza Nur Caglar; Zeren, Melih; Barlık, Meral; Demir, Esen; Gülen, FigenBackground and Aim Dynamic hyperinflation (DH) is a major contributor to exercise intolerance in patients with obstructive lung diseases. However, it has not been investigated in children with bronchiectasis (BE). We aimed to investigate dynamic ventilatory responses and their influence on functional exercise capacity in children with BE. Methods Forty children with BE (mean forced expiratory volume in 1 s [FEV1] = 78 +/- 19%pred) were included. Six-minute walk test (6MWT) was conducted using Spiropalm 6MWT (R) for evaluating dynamic ventilatory responses including inspiratory capacity (IC), minute ventilation (VE), breathing reserve (BR) and respiratory rate (RR). A decrease of >= 100 ml in IC during exertion was defined as DH. Also, spirometry was performed, and peripheral muscle strength were measured. Results Twenty patients (50%) developed DH, and four patients (10%) were ventilatory limited (BR < %30) during 6MWT. There was a 176 [100-590] ml decrease in IC after exertion in patients with DH. DH did not correlate to clinical or functional indicators of the disease, except for an increase in RR ( increment RR) during exertion. High increment RR was associated with presence of DH (r(pb)= 0.390; p < 0.05). Clinical features, peripheral muscle strength, and Spiropalm 6MWT metrics including 6MWT distance did not differ between patients with and without DH. Univariate analysis revealed FVC% (R = 0.340), VEpeak (R = 0.565), quadriceps strength (R = 0.698) and handgrip strength (R = 0.711) were the only predictors of 6MWT distance (p < 0.05). Conclusion Although DH is common in children with BE, the severity of DH is rather low and may not seem to affect functional exercise capacity. However, peripheral muscle strength was a major contributor to functional exercise capacity.Öğe Postural stability and fall risk in patients with obstructive sleep apnea: a cross-sectional study(Springer Heidelberg, 2021) Yılmaz Gökmen, Gülhan; Gürses, Hülya Nilgün; Zeren, Melih; Özyılmaz Semiramis; Kansu, Abdullah; Akkoyunlu, Muhammed EminPurpose Nocturnal hypoxia and daytime sleepiness resulting from fragmented sleep may impair the ability of postural stability in subjects with OSA. This study investigates the effect of disease severity on postural stability and whether or not it poses a fall risk in individuals with obstructive sleep apnea (OSA). Methods Forty-nine patients with OSA diagnosed by all-night polysomnography (apnea-hypopnea index (AHI) >= 5) and aged 51.4 +/- 7.2 years were included in the study. The patients were divided into two groups as severe OSA (AHI >= 30, n = 24) and non-severe OSA (5 <= AHI <= 30, n = 25). All patients were subjected to testing for postural stability (PS), limits of stability (LOST), and the stability index for fall risk (fall risk SI) with the Biodex Balance System (R). Daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). Biodex measurements and daytime sleepiness were compared between severe and non-severe OSA groups. Univariate analysis was conducted to explore if AHI, ESS score, lowest SaO(2) (%), sleep stages (%), or total arousal index predict postural stability scores. Results Overall and anterior-posterior PS indices were higher in the severe OSA group (p < 0.05). Dynamic PS and fall risk indices did not differ between groups. AHI and lowest SaO(2) (%) were found to be an independent predictor for both overall PS (r = 0.300 and r = 0.286, respectively) and fall risk SI (r = 0.296 and r = 0.374, respectively), whereas stage N1 (%) and stage N3 (%) were an independent predictor for overall LOST score (r = -0.328 and r = 0.298, respectively) (p < 0.05). Conclusion Static postural stability of individuals with severe OSA is worse than those with non-severe OSA. Static postural stability worsens, and fall risk increases as AHI increases and the lowest SaO(2) decreases in individuals with OSA. On the other hand, dynamic postural stability worsens as stage N1 (%) sleep increases and stage N3 (%) sleep decreases. While nocturnal hypoxia indicators such as AHI and lowest SaO(2) are associated with static postural stability, sleep structure-related variables are associated with dynamic stability. Including postural stability assessments in the clinical practice for OSA may help addressing workplace accidents or tendency to fall.Öğe Prevalence of musculoskeletal pain and its impact on quality of life and functional exercise capacity in patients with pulmonary arterial hypertension(W B Saunders Co Ltd, 2022) Zeren, Melih; Demir, Rengin; Sinan, Ümit Yaşar; Mustafaoğlu, Rüstem; Yıldız, Abdurrahim; Küçükoğlu, Mehmet SerdarBackground: In pulmonary arterial hypertension (PAH), pathophysiological consequences of the disease and the drugs used to treat PAH may adversely affect musculoskeletal system. Aim of the study was to evaluate musculoskeletal pain prevalence and its impact on quality of life (QoL) and exercise capacity in PAH patients. Methods: 61 PAH patients were evaluated with Nordic Musculoskeletal Questionnaire (NMQ) for musculoskeletal pain presence, EmPHasis-10 and Minnesota Living with Heart Failure Questionnaire (MLHFQ) for QoL, 6-min walk test (6MWT) for functional exercise capacity and International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity participation. Results: 77% of PAH patients reported musculoskeletal pain. Pain prevalence was highest at low back (38%), followed by knees (36%), shoulders (36%) and neck (33%). Hemodynamic indicators of PAH severity were associated with pain presence in various parts of the body. Patients receiving any PAH-specific drug were more likely to experience pain compared to the patients whose drug therapy has not yet been initiated (RR = 1.6-2.0). Pain presence in neck, shoulder, low back and knees significantly correlated to worse QoL scores in both EmPHasis-10 and MLHFQ (p < 0.05). Pain presence in knees had the strongest influence on QoL, and it was the only significant correlate of 6MWT (r =-0.424) and IPAQ-SF (r =-0.264) (p < 0.05). Conclusions: Musculoskeletal pain is a common complaint in PAH patients, which significantly impairs QoL and physical functioning. Treatment strategies should include a more comprehensive assessment for musculoskeletal pain complaints of these patients and address pain presence accordingly, which may help providing a better management for PAH.Öğe Sit-to-stand test in children with bronchiectasis: Does it measure functional exercise capacity?(Mosby-Elsevier, 2020) Zeren, Melih; Gürses, Hülya Nilgün; Kulli, Hilal Denizoğlu; Üçgün, Hikmet; Çakır, ErkanBackground: Similar to six-minute walk test (6MWT), sit-to-stand test (STST) is a self-paced test which elicits sub-maximal effort; therefore, it is suggested as an alternative measurement for functional exercise capacity in various pulmonary conditions including COPD and cystic fibrosis. We aimed to investigate the association between 30-second STST (30s-STST) and 6MWT in both children with bronchiectasis (BE) and their healthy counterparts, as well as exploring cardiorespiratory burden and discriminative properties of both tests. Methods: Sixty children (6 to 18-year-old) diagnosed with non-cystic fibrosis BE and 20 age-matched healthy controls were included. Both groups performed 30s-STST and 6MWT. Test results, and heart rate, SpO(2) and dyspnea responses to tests were recorded. Results: Univariate analysis revealed that 30s-STST was able to explain 52% of variance in 6MWT (r = 0.718, p<0.001) in BE group, whereas 20% of variance in healthy controls (r = 0.453, p = 0.045). 6MWT elicited higher changes in heart rate and dyspnea level compared to 30s-STST, indicating it was more physically demanding. Both 30s-STST (21.65 +/- 5.28 vs 26.55 +/- 3.56 repetitions) and 6MWT (538 +/- 85 vs 596 +/- 54 m) were significantly lower in BE group compared to healthy controls (p<0.01). Receiver operating characteristic (ROC) curve analysis revealed an area under the ROC curve (UAC) of 0.765 for 30s-STST and 0.693 for 6MWT in identifying the individuals with or without BE (p<0.05). Comparison between AUCs of 30s-STST and 6MWT yielded no significant difference (p = 0.466), indicating both tests had similar discriminative properties. Conclusions: 30s-STST is found to be a valid alternative measurement for functional exercise capacity in chil-dren with BE. (c) 2020 Elsevier Inc. All rights reserved.Öğe Six-minute stepper test for evaluating functional exercise capacity in patients with sarcoidosis(Mosby-Elsevier, 2023) Zeren, Melih; Demir, Rengin; Yildiz, Esma; Yigit, Zerrin; Atmaca, Sema Nur; Atahan, ErsanBackground: Researchers and clinicians may benefit from alternative tests that do not require large physical spaces or corridors for simply evaluating functional exercise capacity in the clinical practice. Objective: Aim of this study was to investigate whether six-minute stepper test (6MST) is a valid tool for measuring functional exercise capacity in patients with sarcoidosis. Methods: Thirty-six patients with sarcoidosis and 18 healthy controls were evaluated with 6MST and sixminute walk test (6MWT). Patients performed 6MST twice. Cardiovascular and symptom responses to tests including heart rate, blood pressure, SpO(2), levels of dyspnea and fatigue were recorded. Results: Receiver operating characteristic (ROC) curve analysis revealed an area under the ROC curve of 0.74 for 6MST in identifying the patients and controls, indicating acceptable discriminative ability. Patients performed significantly worse in 6MST compared to controls (277 +/- 54 vs 349 +/- 87 steps; p <0.001). 6MST was able to explain 66% of variance in 6MWT (p<0.001), and there was a strong relationship between 6MWT and 6MST (r = 0.812). SpO(2) responses to tests were similar, however, 6MST generated more severe heart rate, dyspnea and fatigue responses. Intraclass correlation coefficient calculated for initial and retest scores of 6MST was 0.990, indicating excellent test-retest reliability. However, there was a systematical improvement (similar to 4%) in retest 6MST scores. Conclusions: 6MST is a valid and reliable alternative test for measuring functional exercise capacity in sarcoidosis. 6MST may also help better testing the upper limits of cardiac system and physical endurance as it is more physically demanding than 6MWT. (C) 2022 Elsevier Inc. All rights reserved.Öğe Validity and reliability of the Turkish version of breathlessness beliefs questionnaire(Taylor & Francis Inc, 2022) Gürses, Hülya Nilgün; Saka, Seda; Zeren, Melih; Bayram, MehmetBackground Dyspnea is often the main symptom that limits exercise; however, the vicious cycle of dyspnea limiting exercise participation is also an important contributor to the reduced exercise capacity. Objective The aim of our study was to investigate the reliability and validity of Turkish Breathlessness Beliefs Questionnaire (BBQ) in patients with Chronic Obstructive Pulmonary Diseases (COPD). Methods Seventy-seven COPD patients were included in the study. Sociodemographic and physical characteristics were recorded. Turkish version of BBQ, Saint George Respiratory Questionnaire (SGRQ) and Hospital Anxiety and Depression Scale (HADS) were applied. Second evaluation of BBQ was conducted via telephone calls with no drop-outs. Reliability of the questionnaire was explored by calculating the internal consistency and test-retest analysis. Construct validity was assessed calculating correlation coefficients of BBQ with HADS and SGRQ scores. Known group validity was also explored. Results Cronbach alpha coefficients for total score of BBQ were 0.78, indicating that the questionnaire has 'good' internal consistency. Initial and test-retest BBQ total scores were 41.42 +/- 6.47 and 41.18 +/- 6.24, respectively. Intra-class correlation coefficients (ICC2,1) values of BBQ and its sub-scales varied between 0.973 and 0.983, indicating strong test-retest reliability. Correlation coefficient between BBQ total and SGRQ-Activity (0.619) was highest among the variables of interest, followed by BBQ total and SGRQ total (0.611). There was a significant correlation between BBQ total and HADS (0.390). One-way analysis of variance revealed that BBQ total and BBQ-Activity Avoidance scores were significantly differ in disease stages. Conclusion Turkish version of BBQ was found to be a valid and reliable tool for measuring dysfunctional beliefs related to the dyspnea in patients with COPD.
