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    An investigation of machine learning algorithms for prediction of lumbar disc herniation
    (Springer Heidelberg, 2023) Kocaman, Hikmet; Yildirim, Hasan; Goeksen, Aysenur; Arman, Gokce Merve
    The prevalence of lumbar disc herniation (LDH), which makes patients' daily activities more difficult and reduces their quality of life, has tended to increase recently. Many risk factors associated with LDH have been reported. In this study, LDH was predicted using machine learning techniques using measures of the lumbar paraspinal muscles, lumbar vessels cross-sectional area (CSA), and lumbar sagittal curve. Three hundred and forty-four individuals' MR scans were prospectively enrolled (264 with LDH and 80 healthy). Predictive factors were the lumbar sagittal curve and the cross-sectional areas of the lumbar paraspinal muscles and vessels from sagittal and axial MR images. The measurements have been analyzed via ten different and most common machine learning algorithms by considering a comprehensive parameter tuning and cross-validation process. The variable importance results have been also presented. XGBoost algorithm among all algorithms has provided the best results in terms of different classification metrics including f-score ( 0.830 ), AUC ( 0.939 ), accuracy ( 0.922 ), and kappa ( 0.779 ). The findings of this study demonstrated that cross-sectional areas of the quadratus lumborum and abdominal aorta can be utilized as a reliable indicator of LDH. Consequently, the developed model and the variables found to be important may guide to healthcare professionals to make more accurate and effective decisions in terms of prediction the LDH.
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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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    Fatigue in Post Covid Period and Strategies for Coping with Fatigue: A Pilot Study
    (Tarsus University, 2022) Gökşen, Ayşenur; Kocaman, Hikmet
    The aim of this study is to investigate the symptoms seen post-Covid period, which are fatigue and musculoskeletal system dysfunction. Another aim of the study is to proposes some suggestions to manage the fatigue symptom that occurs in the post Covid period. A total of 94 volunteers, aged 20–65 years, who had never had Covid-19 before (40 people) and who had returned from positive to negative for Covid (54 people), participated in the study. The clinical and demographic data of the individuals were recorded. Fatigue severity was measured with the Fatigue Severity Scale; musculoskeletal system symptoms were evaluated with Arthritis Research Uk Musculoskeletal Health Questionnaire (MSK-HQ). In the study, it was reported that individuals who had Covid-19 had a higher level of fatigue than those who did not (p
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    Reliability and Validity of the Back Pain and Body Posture Assessment Instrument in Adults with Disc Herniation
    (2023) Gökşen, Ayşenur; Kocaman, Hikmet; Yıldırım, Hasan
    Objective: Cervical and lumbar disc herniations are mus- culoskeletal pain disorders that affect a large part of the population as a result of exposure to certain risk factors.The aim of this study was to provide evidence for the validity and reliability of the Back Pain and Body Posture Assessment Instrument for Adults (BackPEI) among pa- tients with cervical and lumbar disc herniation.Material and Methods: Two hundred thirty-five patients with cervical and lumbar disc hernia- tion were enrolled in the study. Internal consistency, test-retest reliabil- ity, and validityof BackPEI were evaluated. Correlations with the Musculoskeletal Health Questionnaire (MHQ) were examined for va- lidity. For internal consistency and test-retest reliability were evaluated at one-week intervals. IBM SPSS and R software were used to evaluate patient data. Results: The intraclass correlation coefficient results var- ied between 0.716 and 0.800 for the total score and questions regarding pain intensity. The reproducibility data for the remaining questions an- alyzed using the k coefficient were high and satisfactory (k=0.618- 0.920). The MHQ score and the BackPEI score showed a good correlation, with a r=0.725 correlation coefficient.Conclusion: BackPEI is a reliable and valid scale in patients with cervical and lumbar disc her- niation. The BackPEI can be used in routine practice and clinical re- search to assess pain associated with disc herniation and postural habits that increase it.