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    Comprehensive analysis of muscles wasting in disc herniation
    (Elsevier Sci Ltd, 2022) Goksen, Aysenur; Kocaman, Hikmet; Arman, Gokce Merve; Selcuk, Muhammet Lutfi
    Neuromuscular reeducation of the muscles that stabilize the spine is the basis of conservative treatment of disc herniation. Therefore, it is important to investigate how these muscles are affected by disc herniation. The aim of this study was to investigate the effect of disc herniation, herniation severity, patient age, and biomechanics on the lumbar stabilizer muscles. A total of 330 individuals, including 261 patients with disc herniations and 69 without disc herniation participated in this study. The cross-sectional areas (CSAs) of the lumbar stabilizer muscles and the lumbar lordosis angle were evaluated by magnetic resonance imaging (MRI), according to the severity of the disc herniation and the patient's age. In the patients with disc herniation, the CSAs of the quadratus lumborum (QL) and the multifidus (MF) muscles were decreased. The psoas major (PM) muscle CSA was higher in the patients with sequestered discs than in those with protruded and extruded discs. A negative relationship between the sagittal curve and the PM muscle CSA was found. In addition, MF muscle CSA was found to decrease at age 45 years and over. Although disc herniation negatively affects muscle CSAs, no linear relationship was found between the severity of the herniation and the muscle CSA. In addition, the PM muscle was found to be a strong compensatory muscle in disc herniation.
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    COVID-19 and postural sway: a comparison of individuals with a SARS-CoV-2 history and healthy sedentary women
    (Taylor & Francis Ltd, 2023) Kocaman, Hikmet; Soslu, Recep; Goksen, Aysenur; Uysal, Abdullah
    PurposeThe aim of the study was to evaluate the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postural sway in subjects who have recently recovered from infection.Materials and methodsFifty-six female individuals with a mild to moderate history of SARS-CoV-2 (n = 25, mean age; 21.13 +/- 0.64 years) and healthy sedentary controls (n = 31, mean age; 20.09 +/- 1.05 years) were included in the study. Postural sway tests were performed in double and single-leg stance on a force plate with eyes open before and after the neuromuscular fatigue test. The Wingate test was used to induce neuromuscular fatigue. To evaluate the change of the variables determined by the measurements of the groups over time and the group-time interactions, a two-way analysis of variance in repeated measures (mixed design repeated measures ANOVA) was used.ResultsIt was found that the SARS-CoV-2 group showed increased total sway path, velocity, and area than those in the healthy group on double and single-leg (right-left) stance (p < 0.05).ConclusionsEven if SARS-CoV-2 group individuals have been reported in a mild to moderate outpatient COVID-19 process, they showed deterioration in postural control compared to healthy individuals. In addition, it was found that SARS-CoV-2 accelerated neuromuscular fatigue effects. This can cause more fatigue during activities than individuals who have not had SARS-CoV-2.
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    Iliopsoas Tenotomy Does Not Negatively Affect Hip Flexion Strength in Crowe 3 and 4 Hips Undergoing Total Hip Arthroplasty
    (Elsevier B.V., 2024) Caylak, Remzi; Goksen, Aysenur; Ors, Cagrı; Togrul, Emre
    Background: In total hip arthroplasty (THA), even if there is a dislocated hip, restoring the anatomical center of rotation increases long-term survival and hip function. Even with a shortening osteotomy, the procedure is still challenging due to soft-tissue tension. Therefore, soft tissue releases such as iliopsoas tenotomy may be necessary. In our study, we aimed to examine the effects of iliopsoas tenotomy on hip flexion and abduction strength in patients who underwent THA with shortening osteotomy for Crowe 3 and 4 hip dysplasia by using a hand dynamometer for measurement. Methods: The present study examined 27 patients who underwent THA with shortening osteotomy in unilateral Crowe 3 and 4 hips. The patients' hip flexion and abduction strengths were measured with a hand dynamometer preoperatively and in the first year postoperatively. Results: The average flexion strength of the operated side was less than the nonoperated side before surgery. It also decreased further in the first six weeks. But the strength increased in the 12th week and reached the same level as the non-operated side in the sixth month. The average abduction strength was less than the nonoperated side before the surgery, and it decreased further in the 6th week after surgery. However, the strength increased during follow-ups and reached the non-operated side strengths in the twelfth week. Conclusions: In conclusion, during THA procedures for highly dislocated hips, releasing the iliopsoas tendon at the level of the minor trochanter to facilitate distalization of the hip center of rotation does not adversely affect hip flexion and abduction strengths. Level of Evidence: Level II. © 2024 Elsevier Inc.
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    Sensory function and somatosensorial system changes according to visual acuity and throwing techniques in goalball players: A cross-sectional study
    (Public Library Science, 2024) Goksen, Aysenur; Ince, Gonca
    The somatosensory system is a complect sensory system that differentiates individual athletes. The aim of this study is to investigate the effect of visual acuity level on throwing technique, proprioceptive sense of the shoulder joint, light touch and two-point discrimination sense of the upper extremity, and sensory function (postural control and reaction time) in visually impaired goalball players. Goalball players who have different visual acuities B1(unable to perceive light or recognize its shape); B2 (has a visual field of less than 5 degrees and can recognize shapes); B3 (visual field greater than 5 degrees and less than 20 degrees) participated in the study. The sensorial system was evaluated with proprioceptive sense of the shoulder joint and sensory tests (light touch and two-point discrimination sense of the dominant hand.). Sensory function (postural control and reaction time) was evaluated with the flamingo balance test, functional reach test, and pro-agility test. The goalball players' throwing technique was questioned. Seventeen male players, those aged 20-30 (20.8 +/- 3.9 years) who have been professionally engaged in goalball for at least three years (58.7-37.8 months) participated. Shoulder internal rotation joint position sense and the flamingo balance test were found to be different in the group with B1 visual acuity than in the group with B3 visual acuity (p = 0.042* and 0.028 respectively). There was no difference between groups with B1-B2 visual acuity (p = 0.394 and p = 0.065) and between groups with B2-B3 visual acuity (p = 0.792 and p = 0.931). There was no difference in the groups in terms of sensory tests and reaction time (p> 0.05). In goalball, joint position sense is related to throwing techniques. Although there is a general acceptance that other sensory systems should work harder to compensate for the sense of vision, fear of falling, athlete's branch year, sports year, muscle strength, and general physical condition of the athlete may affect the measurements made, especially in the dynamic position.
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    Translation, cross-cultural adaptation, reliability, and convergent and known-group validity of the Turkish full version of the Hip Disability and Osteoarthritis Outcome Score in patients with hip osteoarthritis
    (Turkish League Against Rheumatism, 2024) Goksen, Aysenur; Caylak, Remzi; Cekok, Fatma Kuebra; Kahraman, Turhan
    Objectives: The study aimed to culturally adapt the full version of the Hip Disability and Osteoarthritis Outcome Score (HOOS) into Turkish and evaluate its reliability and validity.Patients and methods: Patients with hip osteoarthritis were included in the methodological crosscultural adaptation study between May 2022 and December 2022. We translated and adapted the HOOS into a Turkish version and validated it in a cohort of native Turkish-speaking patients with hip osteoarthritis. The HOOS includes five subscales named symptoms, pain, activities of daily living (ADL), sport and recreation (Sport/Rec), and quality of life (QoL). The psychometric properties of the Turkish HOOS were assessed. The reliability was investigated using test-retest reliability (intraclass correlation coefficient; ICC) and internal consistency methods (Cronbach's alpha). The convergent validity of the Turkish HOOS was evaluated by testing the predefined hypotheses using the correlations with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the European Quality of Life Scale (EQ-5D-3L), a generic QoL scale. Results: A total of 202 patients (131 females, 71 males; mean age: 55.2 +/- 9.7 years; range, 50 to 70 years) were recruited for the study. Cronbach's alpha values for each subscale of the HOOS were as follows: symptoms=0.76, pain=0.94, ADL=0.96, Sport/Rec=0.87, QoL=0.78, and total score=0.98, indicating it has high internal consistency. For all subscales and total score of the HOOS, the ICC values were between 0.77 and 0.86, indicating good to excellent test-retest reliability. All correlations between each subscale and total score of the Turkish HOOS, WOMAC, and EQ-5D-3L were moderate to strong. Therefore, 23 predefined hypotheses out of 24 were confirmed with a confirmation rate of 96%, indicating the Turkish version of the HOOS had adequate convergent validity.Conclusion: This study shows that the Turkish version of the HOOS has a convergent and knowngroup validity, internal consistency, and test-retest reliability. It can be used to assess the patient's perception of their hip and associated difficulties, as well as their symptoms and functional limitations.