Aysun Özlü’s research while affiliated with Kütahya Health Sciences University and other places

This research aimed to evaluate the effectiveness of acupuncture treatment in chronic low back pain using meta-analysis. Of the 743 acupuncture research studies assessed on academic databases, 11 studies with 12 samples were selected. Research participants' ages, female-to-male ratios, and initial and final Visual Analog Scale (VAS) pain scores were documented. In total, 388 patients, including 208 (53.61%) female and 180 (46.39%) male patients, were subjected to acupuncture due to low back pain. Mean age was 43.45 with 30.8-57.6 range. The initial VAS score mean was 5.79, and the final VAS score mean was 3.17. VAS difference mean was -2.62 with 0.47-5.26 range. Comparison with exercise and electrical acupuncture were insignificant (p>0.05), whereas differences between control and acupuncture groups were significant (p<0.05). Spearman’s rho correlation analysis results showed that VAS difference was only significantly correlated with VAS initial (r=-0.874; p<0.01). Female frequency, male frequency and age were not significantly correlated with VAS difference (p>0.05). Generalized Linear model (Logit) analysis results showed that age (OR=-0.055; p<0.05) and VAS initial (OR=-0.767; p<0.01) had a significant effect on VAS difference in patients having low back pain and had acupuncture treatment. Acupuncture is much more effective in the treatment of nonspecific chronic low back pain for both women and men, individuals of all age groups, but especially young people. The high level of initial pain is also one of the important factors affecting the success of low back pain treatment with acupuncture.

To investigate the awareness of the pelvic floor muscles (PFMs) and PFM exercises (PFME) knowledge, training and experience in community-dwelling women aged 60 and over and its relationship with urinary incontinence (UI). This is a questionnaire based study which was carried out in 9 Physical Medicine and Rehabilitation Centers, including a total of 500 women aged 60 and over and living in the community. The questionnaire included questions about awareness of PFMs, UI complaints and PFME knowledge, training and experience. Knowledge and awareness of PFMs and PFME knowledge, training and experience were compared in subgroups with or without urinary incontinence. The mean age of the women included in the study was 67.8 ± 6.1 (60–88). Knowledge and awareness of PFMs and PFME knowledge, training and experience were low in the study population. Knowledge and awareness of PFMs were significantly low in the subgroup with urinary incontinence (p < 0.05). Kegel exercise training and experience were significantly low in the subgroup without urinary incontinence (p = 0.01, p < 0.01). Knowledge and awareness of PFMs and PFME knowledge, training and experience are low in community-dwelling women aged 60 and over and training programs should be organized to teach the function of the PFMs and to perform PFME correctly in this population.

Purpose: To investigate the awareness of the pelvic floor muscles (PFMs) and PFM exercises (PFME) knowledge, training and experience in community-dwelling women aged 60 and over and its relationship with urinary incontinence (UI). Methods: This is a questionnaire based study which was carried out in 9 Physical Medicine and Rehabilitation Centers, including a total of 500 women aged 60 and over and living in the community. The questionnaire included questions about awareness of PFMs, UI complaints and PFME knowledge, training and experience. Knowledge and awareness of PFMs and PFME knowledge, training and experience were compared in subgroups with or without urinary incontinence. Results: Knowledge and awareness of PFMs and PFME knowledge, training and experience were low in the study population. Knowledge and awareness of PFMs were significantly low in the subgroup with urinary incontinence (p<0.05). Kegel exercise training and experience were significantly low in the subgroup without urinary incontinence (p=0.01, p<0.01). Conclusion: Knowledge and awareness of PFMs and PFME knowledge, training and experience are low in community-dwelling women aged 60 and over and training programs should be organized to teach the function of the PFMs and to perform PFME correctly in this population.

It is important for postmenopausal women to acquire bone health protective behaviors to protect them from fractures. For this reason, it is necessary to evaluate bone health during menopause and to inform women. This study was conducted to examine osteoporotic fracture protection behaviors, quality of life, and self-efficacy in postmenopausal women. In the study, the data were evaluated with the socio-demographic data form, Osteoporotic Fracture Protection Scale, Osteoporosis Self-Efficacy-Efficacy Scale, European Osteoporosis Foundation Quality of Life Questionnaire-41, which includes introductory information on socio-demographic characteristics. It was determined that the postmenopausal women included in our study were between the ages of 45–92; more than half of them had chronic diseases; their average BMI was 29; and their DEXA score was − 3.00 ± 0.41. Among the people included in our study, those with a history of fractures had lower self-efficacy scores. It was determined that the fracture prevention scale scores of the participants were above the average, and the average of the osteoporosis-related quality of life score was high. In addition, it was determined that there was a strong positive correlation between self-efficacy and fracture prevention scale. It is important to determine behaviors to prevent osteoporotic fractures in postmenopausal women, to raise the necessary awareness and to inform patients about the precautions to be taken. It is thought that it will increase patients’ quality of life by increasing their disease-related self-efficacy. Therefore, there is a need for research on providing education to op patients and examining the results.

Objective: This study aimed to investigate the effect of a virtual reality (VR)-mediated gamified rehabilitation program added to a home exercise program on pain, functionality, and quality of life in shoulder impingement syndrome. Methods: Forty-eight participants with shoulder impingement syndrome were included in this prospective, randomized, single-blind study between January and July 2022. The participants were randomized into two groups: the VR group (n = 24) and the control group (n = 24). All participants were given a home exercise program for 3 weeks, with five sessions per week. The participants in the VR group received 15 sessions (45 minutes each session) of a gamified shoulder exercise program with an immersive VR headset, while those in the control group received 15 sessions (45 minutes each session) of supervised therapeutic exercises. The participants were evaluated and compared before and after treatment using the 36-item Short Form Survey (SF-36), range-of-motion (ROM) measurements, the Visual Analog Scale (VAS), and the Shoulder Pain and Disability Scale (SPADI). Results: At the baseline assessment, the two groups were homogenous regarding demographic and clinical parameters. The post-treatment shoulder extension and adduction ROM was significantly greater in the VR group and the post-treatment pain subscales for SPADI and SF-36 were significantly lower in the VR group. Conclusion: In individuals with shoulder impingement syndrome, a VR-mediated gamified exercise program added to a home exercise program increased shoulder ROM and reduced pain scores. Further clinical studies are needed to prove the long-term efficacy of the addition of VR-mediated gamified exercises to the treatment of this condition in clinical settings.

Objective: To demonstrate the effect of manual lymphatic drainage (MLD) on upper extremity functionality in patients with rheumatoid arthritis (RA). Materials and methods: Thirty-nine female patients diagnosed with RA who were in remission were included in the study. The study group included 19 participants (mean age 50.63 ± 9.83 years), the control group included 20 participants (mean age 55.05 ± 5.89 years). The patients were randomized into two groups as home exercise program plus MLD and home exercise program alone. Both groups received treatment for 4 weeks. The primary outcome measure was pressure pain threshold (PPT). The patients were evaluated using the PPT, visual analog scale (VAS), hand-wrist joint range of motion examination, hand dynamometer and pinchmeter measurements, and the Rheumatoid Arthritis Quality of Life Scale before the interventention and at the end of the 4th week. Results: The PPT evaluated at the thumbnail, wrist, and trapezius significantly increased in the study group after treatment (p < .001, p = .001, and p < .001, respectively). MLD was found to significantly increase the PPT at the thumbnail compared with home exercise program (p = .047). The VAS score significantly decreased in the study group (p = .011). The level of increase in radial deviation was statistically higher in the study group (p = .004). Conclusion: Manual lymphatic drainage had a positive effect on pain, PPT, and range of motion in RA patients in remission. MLD can be added to medical and other conservative treatments in RA patients.

Objectives: This study aims to investigate the effect of the hot pack application on the morphology of healthy median and ulnar nerves. Patients and methods: Between August 2021 and September 2022, a total of 54 healthy volunteers (17 males, 37 females; mean age: 31.9±9.4 years; range, 21 to 63 years) were included in the study. The cross-sectional area (CSA) and depth of the right median and ulnar nerve were measured using ultrasonography before and after 20-min hot pack application. The right median nerve CSA and depth from the level of the scaphoid bone (at the level of the carpal tunnel) and from the mid-forearm were also measured. The right ulnar nerve CSA and depth from the level of the hook of hamate and the mid-forearm were evaluated. The depth measurements between the skin and the outer hyperechoic border of the nerve were performed. Results: After the hot pack application, there was an increase in both the median nerve CSA at the carpal tunnel (from 0.06±0.01 to 0.09±0.02 cm2 ) and forearm (from 0.06±0.02 to 0.09±0.02 cm2 ) levels (p<0.001) and the ulnar nerve CSA at the hook of hamate (from 0.04±0.03 to 0.06±0.01 cm2 ) and forearm (0.05±0.01 to 0.08±0.02 cm2 ) levels (p<0.001). No statistically significant difference was observed between the pre- and post-application depth measurements (p>0.05). Conclusion: Our study results show that the hot pack application leads to acute swelling of the median and ulnar nerves. In future studies, the relationship between morphological changes in healthy and pathological nerves and electrodiagnostic findings should be investigated.

Aim: Aim of this study is to investigate the effects of interactive telerehabilitation exercises in office workers with chronic nonspecific neck pain. Methods: Office workers (n = 120) were randomly divided into three groups between February and July 2022, taking into account the inclusion and exclusion criteria, and office ergonomics training was given to all of the participants. Group 1 participants were given an interactive telerehabilitation program (strengthening, motor control, and posture correction exercises) for 45 min per day, 3 days a week, for a total of 6 weeks. Group 2 participants were trained to do the home exercise program on their own for 45 min per day, 3 days a week, for a total of 6 weeks. Only office ergonomics training was given to Group 3 patients. Results: Statistically significant improvement in pain (p < 0.001), range of motion (ROM) (p < 0.001), neck disability status (p < 0.001), functional status (p < 0.001), and quality of life (p < 0.001) of 6-week interactive telerehabilitation application in office workers was found. Discussion: In addition to office ergonomics training, interactive telerehabilitation program is the most effective method on pain, ROM, and neck disability compared with home exercise program and office ergonomics training alone, and studies are needed on the long-term effectiveness of telerehabilitation applications and telerehabilitation treatment diversity.

Aim: The aim of this study was to investigate the efficacy of a home-based breathing exercise program on dyspnea, quality of life, depression and sleeping disorders in patients with COVID-19 after discharge from the hospital. Methods: The study was completed with a total of 60 participants. The intervention group (n=39) received a homed-based exercise program including controlled breathing techniques and low-intensity upper and lower extremity exercises. The control group (n=21) did not receive any intervention. The patients were evaluated with the Modified Borg Scale (MBS), Nottingham Health Profile (NHP), Insomnia Severity Index (ISI) and Beck Depression Inventory (BDI) before and at the end of the intervention. Results: After treatment, the MBS scores significantly decreased in both the intervention and control groups compared with the baseline values(p

Objective To evaluate foot function and prevalence of tarsal tunnel syndrome in patients diagnosed with fibromyalgia syndrome as compared with healthy individuals. Methods This prospective study included 111 participants, including 63 female patients with fibromyalgia (mean age: 46.17±6.64 years) and 48 female healthy controls (mean age: 46.16±9.38 years) who met the selection criteria. The participants were evaluated for Tinel’s sign and asked about the presence of foot pain and paraesthesia in both groups. In addition, the participants were assessed using the Fibromyalgia Impact Questionnaire and Foot Function Index (FFI) for functionality. Bilateral electrophysiological studies of the tibial, peroneal, sural, medial and lateral plantar nerves were performed. Results Tarsal tunnel syndrome was present in 20 extremities of the patients with fibromyalgia (15.9%) and four extremities of the controls (4.2%)(p=0.005). Paraesthesia was observed in 56 extremities in the fibromyalgia group (44.4%) and 10 extremities in the control group (10.4%)(p<0.001). Tinel’s sign was positive in 69 extremities (54.8%) in the fibromyalgia group and 17 in the control group (17.7%)(p<0.001). The total number of painful feet was 123 (97.6%) in the fibromyalgia group and 22 (22.9%) in the control group (p<0.001). The mean total FFI was 66.26±60.80 for the right foot and 66.28±64.12 for the left foot in the FMS group; in the control group, it was 16.02±31.01 and 16.87±34.14, respectively. Both values exhibited a statistically significant difference between the two groups (p<0.001) Conclusion In patients with fibromyalgia syndrome, paraesthesia and foot pain may be seen more frequently. Therefore, electrophysiological evaluation of the lower extremities may be recommended in these patients.