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Öğe Are Fibrous Cortical Defects (FCDs) and Non-Ossifying Fibromas (NOFs) Only Radiological Findings? The Relationship between Radiological/Clinical Findings and Physical Activity in Children and Adolescents: A Cross-Sectional Study(Mdpi, 2024) Berk, Erhan; Baykara, Rabia AydoganBackground: Fibrous cortical defect (FCD) and non-ossifying fibroma (NOF) are incidentally recognised and benign developmental lesions. The objective of this study was to ascertain the clinical manifestations and symptoms of FCDs/NOFs in children and adolescent patients, to characterise the lesions radiologically using X-ray and MRI techniques, and to determine the relationship between physical activity and the condition. Methods: The study included patients under the age of 18 with radiological lesions on their extremities. The lesions were classified as FCD or NOF in accordance with the distinctive imaging features. For each lesion, the bone involved, the site involved, the size of the lesion, and the type of lesion (according to the Ritschl classification) were recorded. In the anamnesis, the patient's presenting complaint, the character of the pain, if any, and the level of activity were investigated. Pain was quantified using the visual analogue scale (VAS) and the 21-Numbered Circle VAS (21-NCVAS). The 21-Numbered Circle Activity Scale (21-NCAS) and the International Physical Activity Questionnaire (IPAQ) were employed for the assessment of physical activity. Results: The study included 34 lesions in 28 children (14 girls/14 boys). There was no difference in age between girls and boys (p = 0.45). According to Ritschl's classification, 18 (52.9%) lesions were stage A, 9 (26.5%) were stage B, and 7 (20.6%) were stage C. The lesion size increased with increasing Ritschl stage (p < 0.02). The main presenting complaint was pain (n = 13, 49.9%). In 21.4% of the children (n = 6), lesions were detected incidentally on radiographs. According to IPAQ, 39.3% of the children were physically inactive. There was a significant negative correlation between 21-NCAS and Ritschl stage (r = -0.51, p < 0.05). Activity decreased as the Ritschl stage increased. There was a significant negative correlation between 21-NCAS and VAS (r = -0.69, p < 0.05). Conclusions: Spontaneous pain was observed in 49.9% of patients diagnosed with FCD/NOF. No correlation was identified between lesion size and the presence or severity of pain. As the severity of pain and Ritschl stage increased, there was a corresponding decrease in physical activity.Öğe Çocuklar İçin Özel Gereksinim Raporu (ÇÖZGER) Almak Üzere Sağlık Kuruluna Başvuran Hastaların ÇÖZGER Yönetmeliğine Göre Hareket Gelişim Alanının İncelenmesi: Kesitsel Bir Araştırma(2022) Baykara, Rabia Aydogan; TAŞ, Nevsun Pıhtılı; Tasci, IremHastanemize çocuklar için özel gereksinim raporu (ÇÖZGER) almak\rüzere başvuran hastaların; demografik özellikleri, hareket gelişim alanı ile ilgili tanı dağılımları ve sağlıkla ilgili özel gereksinimlerinin belirlenmesi amaçlanmıştır. Gereç ve\rYöntemler: Sağlık kuruluna ÇÖZGER almak amacıyla başvuran, 472 hasta retrospektif olarak incelendi. Hastaların cinsiyet, yaş, özel gereksinim durumu, başvuru nedenleri ve hareket gelişim alanına ait veriler kaydedildi. Tüm lokomotor sistem için hareket\rgelişim alanı, romatolojik hastalıklar alanı, kalıtsal doğmalık hastalıklar alanı, metabolizma alanı ve sinir sistemi alanındaki etkilenme kaydedildi. Bulgular: Sağlık kuruluna\rbaşvuran hastaların %39’u (n=184) kız, %61’i (n=288) erkek cinsiyetteydi. Özel gereksinim alanı değerlendirmesinde hareket gelişim alanında %40,1 (n=189) oranında\rhasta vardı. Bu alanda en fazla serebral palsi tanılı hasta oranı %18,4 (n=87) idi. Bunu\rsırasıyla %5,2 (n=25) ile motor fonksiyonlarda özel gelişimsel bozukluk, %1,2 (n=6) ile\rbrakial pleksus hasarı, %1,4 (n=7) ile parapleji izlerken, konjenital diğer malformasyonlar/sendromlar; spina bifida, tethered kord sendromu, skolyoz, artrogripozis multipleks konjenita tanılarında %13,5 (n=64) oranında hastada vardı. Hastaların özel\rgereksinim düzeyi en çok özel koşul gereksinim var %39 (n=188) şeklindeydi ve\r%91,3’ünün (n=431) özel gereksinim ihtiyacı vardı. Özel gereksinim düzeyi kızlar ile\rerkekler arasında farklıydı (p<0,023). Sonuç: Çocukluk çağının işlevleri, etkinlikleri\rve sosyal yaşamdaki özel gereksinimlerinin doğru belirlenmesi çok önemlidir. Hareket\rgelişim alanı, psikiyatrik hastalıklardan sonra en çok etkilenen gelişim alanıdır (%40,1)\rve fonksiyonel kullanımının sağlanması, büyüme gelişme çağındaki çocuklarda kritik\röneme sahiptir, ayrıca erişkinlerden farklı bir disiplinle yaklaşım gerektirir. Konuyla\rilgili hekimlerin ÇÖZGER’in bu alanında bilgi sahibi olması hem rehabilitasyon hem\rde sosyal destek gereksinimi açısından önemlidir.Öğe Comparison of the effects of conventional physiotherapy and proprioception exercises on pain and ankle proprioception in patients with lumbar radiculopathy(2022) Deniz, Şenol; Erdem, Cumali; Canbolat, Mustafa; Toy, Seyma; Karatas, Turgay; Baykara, Rabia Aydogan; Ozbag, Davut; Akyurek, GokcenBACKGROUND: Lumbar radiculopathy is characterized by a significant amount of backache causing loss of workforce and is a significant health problem frequently seen in the general population. OBJECTIVE:The purpose of this study was to compare the effects of conventional physiotherapy (CT) and proprioception exercises (PE) on ankle proprioception and lumbar pain between patients with lumbar radiculopathy and a healthy control group. METHODS:In this randomized clinical trial, 89 patients referred to the Physical Medicine and Rehabilitation outpatient clinic were selected through convenience sampling. They were randomly assigned to three groups: CT (n= 27), PE (n= 31), CT&PE (n= 31). Thirty healthy volunteers were included in the study as the control group. Proprioception measurements were made with an isokinetic dynamometer at 10? dorsiflexion (DF), 11?, and 25? plantarflexion (PF) angles. Lumbar pain was assessed by using the Numerical Pain Rating Scale (NPRS). The data were analyzed by IBM SPSS Statistics version 22.0 via the Kruskal-Wallis and Mann-Whitney U tests. RESULTS: There was a statistically significant difference between the groups in terms of ankle proprioception and NPRS measurements in post-treatment evaluations (p< 0.05). Statistically significant differences were found between CT and PE groups and CT&PE and control groups. There was no statistically significant difference in comparing CT and PE groups and CT&PE and control groups within themselves (p> 0.05). CONCLUSION: The combined use of CT and PE is an effective method that can be used in the clinic to reduce angular differences in ankle proprioception which is one of the primary factors of balance and coordination and lumbar pain.Öğe Comparison of the efficacy of extracorporeal shock wave therapy and trigger point dry needling in the treatment of Calcaneal Epin- A randomized trial(Sage Publications Inc, 2025) Arpaci, Muhammed Furkan; Dogru, Feyzi; Deniz, Mine Argali; Cicek, Ipek Balikci; Baykara, Rabia Aydogan; Erdem, Cumali; Kose, EvrenBackground: Dry needling (DN) and Extracorporeal shock wave therapy (ESWT) are common in calcaneal epin treatment. Objective The aim of the study was to compare the effects of both treatments on proprioception, balance, pain, and functional status. Methods: 90 patients which consist of 45 patients as DN + self stretching and 45 patients as ESWT + self stretching. Patients in each group were treated 1 session per week for 4 weeks. Assessments of 15 degrees ankle dorsiflexion and plantar flexion proprioception, one leg standing test (OLST), foot function index (FFI), visual analog scale (VAS) (first step, resting, activity), quality of life scale (SF-36) were performed. The outcomes were recorded at pre-treatment, post-treatment, and 4 weeks after the post-treatment. Results: Statistically significant differences were determined in VAS (resting, first step, activity) and FFI values in both treatment methods (p < 0.05). In OLST, SF-36, and FFI evaluations, DN was statistically more effective than the ESWT method (p < 0.001). In the 15 degrees proprioception evaluations, a significant difference was observed in the patient's ankle in both methods, while the DN method is more effective in the indicated stages of evaluation. Conclusions: Both methods applied to epin calcanei patients were effective, but the DN method is a more effective treatment method than the ESWT method in terms of balance, proprioception, foot function, and quality of life.Öğe Could TREM-1 be a novel marker in the diagnosis of fibromyalgia?: A cross-sectional study(Lippincott Williams & Wilkins, 2024) Baykara, Rabia Aydogan; Kiran, Tugba Raika; Otlu, Onder; Erdem, Mehmet; Tas, Nevsun PihtiliTriggering receptors expressed on myeloid cells-1 (TREM-1) are transmembrane molecules expressed in cells of the immune system. Activation of TREM-1 leads to the release of pro-inflammatory mediators, which act as amplifiers of inflammation and thereby contribute to the pathogenesis of various diseases, whether inflammatory or not. This study explored the role of TREM-1 in the etiopathogenic context of fibromyalgia syndrome (FMS) and its association with disease activity. This randomized controlled and observational study included 45 patients diagnosed with FMS according to the 2016 American College of Rheumatology criteria. Serum TREM-1 levels were assessed using ELISA, and disease activity was measured using various scales such as the fibromyalgia impact questionnaire (FIQ). Patients were divided into 2 groups according to disease severity based on the FIQ score. Compared to a control group of 46 healthy individuals, patients with FMS exhibited significantly elevated concentrations of TREM-1 (mean +/- SD = 216.97 pg/mL +/- 16.04), P < .05. The FIQ, Pittsburgh sleep quality index, hospital anxiety and depression scale, fatigue severity scale, and visual analog scale, which confirm symptoms such as pain, disease severity, sleep disturbance, depression, anxiety, and fatigue seen in FMS was significantly correlated with TREM-1 level (P < .001). The optimal threshold value for TREM-1 to disease activity was determined to be 182.250, showing (area under the curve) (CI (95%)): [0.940] (0.887-0.993), a sensitivity of 97% and a specificity of 89% according to the receiver operating characteristic analysis. The positive correlation of TREM-1 with various symptom severity scales and hematological inflammatory indices may be a suitable biomarker for the diagnosis of FMS and a potential therapeutic target.Öğe Endoplasmic reticulum stress and oxidative imbalance is the missing link in fibromyalgia pathophysiology(Nature Portfolio, 2025) Otlu, Onder; Kiran, Tugba Raika; Baykara, Rabia Aydogan; Erdem, Mehmet; Inceoglu, FeyzaFibromyalgia syndrome (FMS) is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, and cognitive dysfunction. Although its exact pathophysiology remains unclear, emerging evidence suggests that endoplasmic reticulum (ER) stress and oxidative stress play significant roles in its development. This study aimed to investigate the involvement of ER stress in FMS by evaluating key ER stress markers and oxidative stress parameters in patients with FMS. A total of forty-four FMS patients and matched healthy controls were included in the study. Serum levels of ER stress markers were measured using enzyme-linked immunosorbent assay (ELISA). Additionally, oxidative stress markers were assessed to examine their relationship with ER stress in FMS. The ER stress parameters were significantly higher in the FMS group compared to controls. Furthermore, oxidative stress markers were elevated, reinforcing the interconnection between ER stress and oxidative stress in FMS pathogenesis. These findings suggest that ER stress plays a crucial role in the pathophysiology of FMS, likely contributing to disease progression through oxidative stress-related mechanisms. Targeting ER stress and oxidative stress pathways may represent a promising therapeutic strategy for FMS management. Future studies should focus on large-scale clinical investigations to further elucidate these pathways and develop effective treatment approaches.Öğe FİBROMYALJİ SENDROMUNDA KİNEZYOFOBİ: OBEZİTE, AĞRI ŞİDDETİ, YÜKSEK HASTALIK AKTİVİTESİ İLİŞKİSİ(2022) Baykara, Rabia AydoganAmaç: Fibromiyalji sendromunda hastalık şiddeti ile kinezyofobi arasındaki ilişkinin araştırılması amaçlandı.Gereç ve Yöntemler: Prospektif, kesitsel, vaka kontrol araştırması olarak planlanan bu çalışmaya Amerikan Romatoloji Koleji 2010 kriterlerine göre Fibromiyalji sendromu tanısı almış 21-67 yaş arası 149 hasta ile benzer özellikte 92 sağlıklı kontrol dâhil edildi. Hastalık şiddeti için Fibromiyalji Etki Anketi, ağrı şiddeti için vizüel analog skala, kinezyofobi için Tampa Kinezyofobi Ölçeği kullanıldı. Hastaların yaş, cinsiyet, vücut kitle indeksi gibi demografik verileri kaydedildi.Bulgular: Hasta grubu ve sağlıklı kontrol grubu arasında demografik veriler benzerdi. Tampa Kinezyofobi Ölçeği, hasta grubunda ortalama 41.51 (SS:7.31), kontrol grubunda ortalama 35.71 (SS:8.98) olarak bulunmuş olup anlamlı fark vardı (p<0.01. Hastalık şiddeti ile kinezyofobi arasında anlamlı korelasyon mevcuttu (p<0.01). Vizüel analog skala, Fibromiyalji Etki Anketi değerleri ise hasta grubunda kontrol grubuna göre anlamlı farklıydı (p<0.01). Vücut kitle indeksinin düşük (25 kg/m2 ve altı) ve yüksek grupları (25 kg/m2 üstü) ile kinezyofobi arasında anlamlı ilişki yoktu.Sonuç: Fibromiyalji sendromunda hastalık şiddeti arttıkça kinezyofobi de artmaktadır. Bu nedenle fibromiyalji sendromlu hastalarda tedavi planlarken kinezyofobi akılda tutulmalıdır.Öğe İNTERM FİZYOTERAPİ ÖĞRENCİLERİNİN ANATOMİ BİLGİ SEVİYESİNİN OMUZ PROBLEMLİ HASTALARIN TEDAVİSİ ÜZERİNDEKİ ETKİSİ(Afyonkarahisar Sağlık Bilimleri Üniversitesi, 2025) Arpacı, Muhammed Furkan; Erdem, Cumali; Çiçek, İpek Balıkçı; Baykara, Rabia Aydogan; Özdemir, Beyza; Aygül, Gökhan; Denız, Mine ArgalıAMAÇ: Çalışmanın amacı, fizyoterapi stajyer öğrencilerinin omuz kısıtlılığı hastalarının tedavisindeki başarısını ve bu yeterliliğin üst ekstremite anatomisi bilgisi ile ilişkisini belirlemektir. GEREÇ VE YÖNTEM: Üst ekstremite anatomi sınavına 48 stajyer öğrenci alındı. 1. Grupta 45 puanın altında puan alan 20 öğrenci, 2. Grupta ise 45 puanın üzerinde puan alan 28 öğrenci yer aldı. 48 hastaya 4 hafta boyunca, haftalık 5 seans, standart parmak merdiveni ve sopa egzersizleri uygulandı. Hastalara ayrıca kontrol ölçümlerine kadar ev egzersizleri öğretildi. VAS (dinlenme, aktivite, uyku), omuz hareket açıklığı (EHA), SF-36 (sağlık anketi anketi), kol, omuz ve el sakatlığı anketi (DASH) ve hasta memnuniyet anketi (PSQ-18) tedavi öncesi, tedavi sonrası (PostT) ve tedaviden 4 hafta sonra (C) gerçekleştirildi. BULGULAR: Grup 2'deki hastalarda kısa periyotta (PostT) VAS, ROM ve DASH'de istatistiksel olarak anlamlı iyileşme belirlendi. Uzun dönemde (C) her iki gruptaki hastalarda istatistiksel olarak anlamlı iyileşme olduğu ve gruplar arası bir üstünlük olmadığı belirlendi. Grup 2'deki hastalarda kısa periyotta (PostT ) ve uzun periyotta (C), SF-36 değerlendirmesinde istatistiksel olarak anlamlı artış gözlenirken, Grup 1'de bu artış yoktur. PSQ-18'de her iki gruptaki hastalarda istatistiksel anlamlı fark gözlenirken, gruplar arasında anlamlı farklılık yoktur. SONUÇ: Fizyoterapi stajyer öğrencilerinin üst ekstremite anatomisine ilişkin yeterli bilgi sahibi olmaları kısa periyotta etkili olmaktadır. Hastaların uzun periyotta ev egzersizlerine düzenli olarak devam etmesi, anatomi bilgisi eksikliğinden kaynaklanan tedavi kalitesinin düşüklüğünü azaltmaktadır.Öğe Proprotein convertase subtilisin/kexin type 9 and apelin in fibromyalgia syndrome(2024) TAŞ, NEVSUN PIHTILI; Baykara, Rabia Aydogan; KAMANLI, Ayhan; Gürbüz, Ali; CÜRE, Erkan; cure, medine cumhur; Erdem, MehmetObjectives: This study aimed to investigate the potential roles of proprotein convertase subtilisin/ kexin type 9 (PCSK9) and apelin in the etiology of fibromyalgia syndrome (FS). Patients and methods: The retrospective study was conducted between May 2022 and February 2023. Fifty-eight female FS patients (mean age: 45.2±9.9 years; range, 25 to 66 years) and 30 age- and body mass index-matched control subjects (mean age: 43.1±9.9 years; range, 26 to 67 years) were included in the study. Apelin and PCSK9 levels of all individuals were measured using appropriate methods. Results: The levels of PCSK9 (173.2±62.2 vs. 75.1±44.1, p<0.001) and apelin (354.6±195.5 vs. 229.0±83.2, p<0.001) were significantly higher in patients with FS compared to the control group. A positive correlation was found between PCSK9 and apelin levels and various measures, including the Fibromyalgia Impact Questionnaire (FIQ), Symptom Severity Scale (SSS), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory (BDI). Additionally, there was a positive correlation between apelin levels and FIQ, SSS, PSQI, Beck Anxiety Inventory, and BDI scores. The optimal cutoff value for PCSK9 in predicting FS was 110.0 ng/mL, with a sensitivity of 84.5% and specificity of 83.9% (area under the curve [AUC]=0.920, 95% confidence interval [CI]: 0.852-0.987, p<0.001). For apelin, the optimal cutoff value for predicting FS was 258.8 ng/L, with a sensitivity of 63.8% and specificity of 64.5% (AUC=0.732, 95% CI: 0.623–0.840, p<0.001). Conclusion: Our findings suggest that PCSK9 may play a role in FS etiology and potentially contribute to oxidative stress. Increased apelin levels may be a compensatory response to high oxidative stress, possibly leading to hyperalgesia. Both PCSK9 and apelin can be predictive markers for FS.Öğe Recommended exercises for lower back pain on YouTube videos; Are they useful or harmful?(Elsevier Sci Ltd, 2024) Baykara, Rabia Aydogan; Tas, Nevsun PihtiliObjective: Low back pain (LBP), a common public health problem affecting nearly 80 % of the population, causes disability and work absence, while exercise is recommended as an adjuvant treatment. YouTube is one of the most frequently used source of information, especially by patients. The aim of the study was to analyze clinically the reliability, feasibility and the content quality of exercises videos recommended for LBP on YouTube. channel. Methods: Based on the observational study of the number of views of YouTube videos, 154 videos worth evaluation were selected using the keywords low back pain and exercises,. The content quality of each video was evaluated with a) the American Medical Association Journal (JAMA), b) DISCERN, c) Global Quality Score (GQS), and d) Medical Quality Video Assessment Tool (MQ-VET) scales, while Pearson correlation analysis was performed to determine the correlation between the JAMA, GQS, DISCERN, MQ-VET scale scores. Results: According to the findings, the primary source for uploading exercise videos were physicians (32.5 %), with a high content quality. There was a statistically significant positive correlation between the total scores of all quality scales and the independent variables defined as view rates and number of comments (p < .05). The analysis of the video content showed that only 35 % (n = 54) of the videos explained the risks of the recommended exercises in detail Conclusion: It can be concluded that the relability and feasibility of exercise videos for LBP on YouTube depend highly on the upload source. Thus digital content in health should be created with a multi-disciplinary team including healthcare professionals and also standardized to inform patients with the risks and benefits to avoid the potential harm due to the complex causes of low back pain.Öğe Significant correlation between serum DOTL1 levels and pain intensity, sensitivity, and psychological distress in women with fibromyalgia(Lippincott Williams & Wilkins, 2025) Erdem, Mehmet; Kiran, Tugba Raika; Otlu, Onder; Baykara, Rabia Aydogan; Inceoglu, FeyzaDisruptor of telomeric silencing 1-like (DOT1L) is a protein involved in epigenetic regulation, as well as in the Wnt and hypoxia signaling pathways. DOT1L has been found to play a role in the pathogenesis of various diseases associated with these pathways. In this study, it was aimed to determine serum DOT1L levels in patients with fibromyalgia (FM) and its association with disease activity. Forty-eight patients diagnosed with FM according to the 2016 American College of Rheumatology criteria and 48 healthy controls were included in the study. Disease activity was measured using clinical questionnaires (Fibromyalgia Impact Questionnaire [FIQ], Visual Analog Scale [VAS], Widespread Pain Index [WPI], Symptom Severity Score [SSS], Pittsburgh Sleep Quality Index [PSQI], Fatigue Severity Scale [FSS], Hospital Anxiety Scale [HAS] and Hospital Depression Scale [HDS]) and DOT1L levels were assessed using Enzyme-Linked ImmunoSorbent Assay in all serum samples. Additionally, routine biochemical analyses were performed. Pain duration, FIQ, VAS, WPI, SSS, PSQI, FSS, HAS, and HDS were found to be statistically significant higher in FM compared to the control group (P = .001). Compared with the control group (0.53 +/- 0.12 ng/mL), DOT1L concentrations were significantly higher in patients with FM (1.47 +/- 0.13 ng/mL; P = .001). In the FM group, DOT1L levels also showed a positive correlation with the results of the all the clinical questionnaires (P = .001). It was found that the DOT1L measurement value has a statistically significant effect in predicting the difference between the FM and control groups (P = .022). When the cutoff value for DOT1L was set at 0.315 ng/mL, it was found to have 79% sensitivity and 71.7% specificity in detecting FM. This study highlights the potential of DOT1L as a valuable biomarker for FM diagnosis.
