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POLAT, MİNE GÜLDEN

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Sağlık Bilimleri Fakültesi

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POLAT

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MİNE GÜLDEN

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Open Access
The effect of different body mass index levels on static and dynamic postural balance performance in adults
(2023-01-01) TİMURTAŞ, EREN; SELÇUK, HALİT; DEMİRBÜKEN, İLKŞAN; POLAT, MİNE GÜLDEN; TİMURTAŞ E., SELÇUK H., Canoz E. U., Kortelli O. S., DEMİRBÜKEN İ., POLAT M. G.
Purpose: It was aimed to estimate the static and dynamic postural balance performance in adults with different Body Mass Index (BMI) levels. Material and Methods: The study was conducted in Üsküdar Diabetes and Obesity Treatment Center between September and October 2021. Participants were divided into 5 groups according to BMI scores: normal-weight, overweight, 1st degree obese, 2nd degree obese, and 3rd degree obese. In addition, participants' static and dynamic balance performance were assessed by the Limits of Stability (LOS) and modified Clinical Test of Sensory Integration of Balance (m-CTSIB) tests. Results: For LOS parameters, there was a significant difference between groups in reaction time scores only for the backward direction (p<0.05). The endpoint and maximum excursion measurements except for the backward and directional control measurements except for the back and right were significantly different between groups, with the worst scores for 3rd degree obese group (p<0.05). For the m-CTSIB test, there was a significant difference between groups in all parameters except the eyes open condition on foam surface (p<0.05). Conclusion: The 3rd degree obese individuals are the most affected subgroup in dynamic balance. We recommended that rehabilitation and fall prevention programs primarily focus on 3rd degree obese individuals. Keywords: Limits of stability test, modified clinical test of sensory integration of balance, postural balance, body mass index
Open Access
A mobile application platform to increase physical activity in individuals with type 2 diabetes during the coronavirus (covid-19) pandemic
(2022-09-01) TİMURTAŞ, EREN; POLAT, MİNE GÜLDEN; Timurtaş E., Cinar E., Karabacak N., Sertbaş Y., Polat M. G.
Introduction: Mobile health applications for individuals with type 2 diabetes (T2DM) have the potential to improve physical activity (PA) during the coronavirus (COVID-19) pandemic; yet, there is a need to identify the content of a mobile application (app) in the light of conceptual framework and the delivery features to increase the usability of the app. The aim of this study is to improve the mobile application based on a framework that conceptually determines the needs of individuals with T2DM. At the same time, it is to determine the presentation features of the application to increase its usability for individuals and health professionals using it. Methods: The content and delivery features of a PA app were determined using the Delphi method considering the dia- betes core sets of the international classification of the functioning framework, including experts in the area of T2DM for the app\"s content and heterogeneous participants for the delivery features of the app. A mobile application was created according to the data obtained by this method after the application was created by this way. Results: Delphi experts suggested 64 ideas for the content of the app, of which 46 reached sufficient agreement (72.5–100%). In the second step, participants generated 27 ideas, yet, the consensus was reached on 12 delivery features (70–100%). The application was created by transforming these ideas into app content. Discussion and Conclusion: This study addressed the content-related limitations and usability challenges in the pre-existing studies. During the lockdown, the developed PA app can be implemented using different mobile devices.
Open Access
Covid-19 pandemisinde fizyoterapistlerin telerehabilitasyon uygulamaları bariyer ve fasilitatörlerinin incelenmesi
(2022-08-01) TİMURTAŞ, EREN; POLAT, MİNE GÜLDEN; Timurtaş E., Polat M. G.
Telerehabilitasyon, rehabilitasyon hizmetlerinin bilgi ve iletişim teknolojisi aracılığıyla uzaktan sunumu olarak tanımlanmaktadır. COVID-19 pandemisi ve artmış bulaş riski fizyoterapi kliniklerinde telerehabilitasyon kullanımını zorunlu hale getirmiştir. Çalışmamızın amacı COVID-19 pandemisi sırasında fizyoterapistlerin telerehabilitasyon uygulamalarındaki bariyer ve fasilitatörlerinin belirlenmesiydi. Yöntem: Çalışmamız Ekim-Aralık 2021 tarihleri arasında İstanbul ilinde kliniklerde telerehabilitasyon uygulayan 99 (%46,9) kadın, 112 (%53,1) erkek, yaş ortalaması 29,9±6,7 yıl, çalışma süresi ortalaması 6,9±6,7 yıl olan toplam 211 fizyoterapist ile gerçekleştirildi. Fizyoterapistlerin telerehabilitasyon uygulamaları ile ilgili tutum ve davranışları Theoretical Domains Framework (TDF) kılavuzu yönergelerine göre hazırlanan 31 madde ile sorgulandı. Veri analizinde tanımlayıcı istatistikler, açıklayıcı faktör analizi kullanıldı. Bulgular: Çalışma tanımlayıcı kesitsel tipte tasarlanmıştır. TDF kılavuzuna göre belirlenen maddelerin faktör analizi sonucunda 6 boyutta 25 madde belirlendi. TDF anketi açıklayıcı faktör analizi sonucunda KMO örneklem yeterliliği değeri 0,863 puan ile \"çok iyi\" olarak değerlendirilirken, Cronbach alfa değeri 0,91 olarak belirlendi. Fizyoterapistlerin telerehabilitasyon uygulamalarına yönelik tutumuna etki eden en güçlü fasilitatör 3,81±0,91 ortalama ile \"Telerehabilitasyon uygulamaları toplum sağlığına fayda sağlar.\" en güçlü bariyer ise 2,11±1,19 ortalama ile \"Telerehabilitasyonun nasıl uygulandığı konusunda eğitim aldım\" maddesiydi. Sonuç: TDF teorik çerçevesinde hazırlanan ölçeğin telerehabilitasyon uygulamalarının fizyoterapistler tarafından tutum ve davranışının değerlendirilmesinde önemli bir araç olacağı düşünülmektedir. TDF kılavuzu ile hazırlanan ölçeğimiz aracılığıyla belirlenen beceriler, hedefler, çevresel kaynaklar ve sosyal etkilere yönelik bariyerlerin saptanması telerehabilitasyon eğitimlerinin içeriğinin belirlenmesine katkı sunacaktır.
Open Access
The relationship between sit-to-stand task and fat tissue & lean body mass
(2020-10-01) AVCI, ENDER ERSİN; AKGÜN, İREM; DEMİRBÜKEN, İLKŞAN; TİMURTAŞ, EREN; POLAT, MİNE GÜLDEN; Timurtaş E., Demirbüken İ., Avcı E. E., Akgün İ., Polat M. G.
Open Access
Postural stability during quiet standing in obese and non-obese adults with type 2 diabetes mellitus
(2020-09-01) AVCI, ENDER ERSİN; AKGÜN, İREM; TİMURTAŞ, EREN; POLAT, MİNE GÜLDEN; DEMİRBÜKEN, İLKŞAN; TİMURTAŞ E., DEMİRBÜKEN İ., AVCI E. E., AKGÜN İ., POLAT M. G.
1. Introduction Diabetes which is a major health problem is related to impaired postural control due to peripheral neuropathy [1]. Obesity, another common health problem, is also found to be inseparably connected with postural instability. In particular, excessive body weight is demonstrated to significantly influence postural stability by altering center of mass position in the body. Impaired postural stability in T2DM and obesity has been documented separately by recent evidence [2,3]. We hypothesized that obesity would worsen the postural stability especially in adults who were diagnosed with T2DM. Therefore, the purpose of the current study was to investigate the possible impact of obesity on postural stability during quite standing in both obese and non-obese adults with T2DM. 2. Research question How does obesity influence the postural stability in adults with T2DM by means of sway velocity of center of mass during quite standing? 3. Methods The study was conducted at Fatih Sultan Mehmet Hospital Diabetes and Obesity Center in Istanbul, Turkey. Sixty-five adults (obese 37 adults with BMI ≥ 30 kg/m2 , non-obese 27 adults with BMI < 30 kg/ m2 ) who had no any musculoskeletal and neurological disorder were recruited. Modified Clinical Test of Sensory Interaction in Balance test among Balance Master System (NeuroCom, USA) was used to evaluate the postural stability. The sway velocity (degrees/second) of center of mass was measured on firm surface on firm and foam surface with eyes open (EO) and eyes closed (EC) conditions by the system. We created binary outcome according to normative scores. We performed logistic regression to estimate which groups has greater risk. 4. Results Number of people who had under normative scores in obese adults with diabetes; 14 (37,8%) in EO and 10 (27,0%) in EC on firm surface; 17 (45,9%) in EO and 34 (91,9%) in EC on foam surfaces; 26 (%70,3) in composite score. For non-obese adults with diabetes; 2 (7,4%) in EO and 8 (29,6%) in EC on firm surface; 9 (33,3%) in EO and 22 (81,5%) in EC on foam surfaces; 17 (%63,0) in composite score were determined. Obesity was higher risk eyes open scores in firm surface EO (OR:1.49 CI:1.13-1.96) but not in firm surface EC (OR:0.96 CI:0.70-1.32), firm surface with EO (OR:1.23 CI:0.82-1.84), firm surface with EC (OR:2.28 CI:0.60-8.75), composite score (OR: 1.26 CI:0.62-2.50). 5. Discussion Findings of current study revealed that obesity in T2DM is an important concern for deteriorating postural stability during quite standing. Interestingly standing with more demanding conditions as foam surface and/or eyes closed did not disturb postural sway of remarkable distinct percentages. It is noteworthy to pronounce that maintaining normal body weight in T2DM would encourage better postural stability in quite standing. An understanding of the obesity and its effect on postural stability in T2DM would provide another aspect for future intervention approaches for this population.
Open Access
Robot-assisted therapy for upper extremity rehabilitation in Erb-Duchenne palsy: A case report
(2020-10-01) AVCI, ENDER ERSİN; AKGÜN, İREM; TİMURTAŞ, EREN; DEMİRBÜKEN, İLKŞAN; POLAT, MİNE GÜLDEN; Akgün İ., Avcı E. E., Timurtaş E., Demirbüken İ., Polat M. G.
Erb-Duchenne palsy (EDP), happens during a difficult birth due to the lesion in the upper brachial plexus (involving 5thand 6th, and rarely 7th cervical nerve roots), is characterized by muscle weakness and loss of motor functions in the affected upper extremity. While some injuries are temporary with full recovery, some may be lifelong resulting in significant functional limitations in daily life [1]. Various conservative rehabilitation approaches including muscle strength and range of motion training in upper extremity have been widely used in rehabilitation clinics [2]. Robot-assisted therapy (RAT) as an intervention for upper extremity rehabilitation is an encouraging approach in order to improve upper limb function in patients with neurological impairments [3]. RAT would offer motivational and intensive rehabilitation for a pediatric patient with EDP to interact and train with task-related games in the robotic devices.
Open Access
The relationship between ankle eversion to inversion strength ratio and postural balance control in healthy individuals
(2020-10-01) AVCI, ENDER ERSİN; AKGÜN, İREM; POLAT, MİNE GÜLDEN; TİMURTAŞ, EREN; DEMİRBÜKEN, İLKŞAN; Avcı E. E., Şenocak E., Akgün İ., Timurtaş E., Demirbüken İ., Polat M. G.
The distal part of the lower extremity, foot and ankle joint, has an essential role to control postural balance through coordinated movements. The role of co-contraction between ankle dorsiflexor and plantar flexor muscles in maintaining postural balance has been mostly focused on previous researches [1,2]. However, the ankle strategy for postural control primarily occurs through eversion and inversion effort to keep the foot stable on the ground [3]. The current study aimed to investigate the relationship between isometric muscle strength ratio of eversion/ inversion (E/I) and postural balance control which is firstly corrected by ankle joint strategy.
Open Access
Exoskeleton-assisted upper limb rehabilitation after stroke: a randomized controlled trial
(2024-01-01) AKGÜN, İREM; DEMİRBÜKEN, İLKŞAN; TİMURTAŞ, EREN; POLAT, MİNE GÜLDEN; AKGÜN İ., DEMİRBÜKEN İ., TİMURTAŞ E., Pehlivan M. K., Pehlivan A. U., POLAT M. G., Francisco G. E., Yozbatiran N.
Objectives: The upper-limb exoskeleton training program which is repetetive and task-specific therapy can improve motor functions in patients with stroke. To compare the effect of an upper-limb exoskeleton training program with Bobath concept on upper limb motor functions in individuals with chronic stroke. Methods: Participants were randomly assigned to exoskeleton group (EG, n = 12) or to Bobath group (BG, n = 12). Interventions were matched in terms of session duration and total number of sessions and performed 2 times per week for 6-weeks. Primary outcome was Fugl-Meyer- Upper Extremity (FMA-UE). Secondary outcomes were Modified Ashworth Scale (elbow and wrist flexor muscles), Motor Activity Log-30 which is consist of two parts as an amount of use (AOU) and quality of movement (QOM), and The Nottingham Extended Activities of Daily Living (NEADL) index. Results: After 12-sessions of training, the mean (SD) FMA-UE score increased by 5.7 (2.9) in the EG, and 1.9 (1.5) points in the BG (p <.05). In total, 40% of participants (5/12) demonstrated a clinically meaningful improvement (≥5.25 points) in the FM-UE, while none of the participants reached MCID score in the bobath group. Changes in the AOU, QOM, and NEADL were significantly larger in the EG compared to BG (p <.05). 7/12 (58.33%) of participants for AOU and 5/12 (42%) of participants for QOM in the EG showed that clinically meaningful change. 5/12 of participants (42%) in the EG demonstrated ≥4.9-point increase in NEADL score. Discussion: High-intensity repetitive arm and hand exercises with an exoskeleton device was safe and feasible. Exoskeleton-assisted training demonstrated significant benefits in improving upper limb functions and quality of life in individuals after stroke.