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    A Review of Physiotherapy and Rehabilitation Students' Metaphorical Perceptions of Exercise
    (Wiley, 2025) Yilmaz, Ramazan Cihad; Percin, Alper; Karaoba, Dilan Demirtas; Candiri, Busra
    Aims and Objectives: This study aimed to investigate the metaphorical perceptions of the students of the Department of Physiotherapy and Rehabilitation regarding exercise. Methods: The study was designed as a phenomenological case study, following the qualitative research method; it included 180 students from the Department of Physiotherapy and Rehabilitation. The students were asked to complete the sentence, Exercise is like...; because... to gain insight into their perception of exercise. Results: Students produced 180 metaphors, which were grouped into 13 different categories. Students most frequently compared exercise to the notions of water, reading, therapy, air, and medicine. The categories with the highest number of metaphors included happiness and soothing, psychological impact, labour, care, and continuity, and valuable. The metaphors suggested by the students of the Department of Physiotherapy and Rehabilitation toward exercise were positive; however, they defined exercise as a challenging activity that requires effort and continuity. Conclusion: Most students included in the study used positive metaphors about exercise. A few students expressed negative sentiments. Investigating the perceptions of physiotherapy students on exercise beginning from their school years can provide a reference for adopting a better quality and holistic exercise approach, including teaching about and training on exercise, thereby enhancing their future role in developing exercise prescriptions and improving exercise adherence.
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    A Comparison of the Functioning and Disability Levels of Children With Hemiplegic and Diplegic Cerebral Palsy Based on ICF-CY Components
    (Sage Publications Inc, 2024) Bingol, Hasan; Karaoba, Dilan Demirtas
    We compared children with hemiplegic and diplegic cerebral palsy (CP) using the conceptual framework of the International Classification of Functioning, Disability and Health: Child and Youth version (ICF-CY). We enrolled 42 children with CP aged 5 - 13 years old (M age = 9.57, SD = 2.8 years). We assessed their trunk control and dynamic balance with the Trunk Control Measurement Scale (TCMS) and the Timed Up and Go test (TUG), and we used ABILHAND-Kids and Assessment of Life Habits (Life-H) to assess their manual ability and participation with activities of daily living. We administered the European Child Environment Questionnaire (ECEQ) to identify relevant environmental factors. We employed structural equation modeling (SEM) to identify specific factors contributing to potential differences between these CP groups. Children with hemiplegic CP demonstrated significantly better outcomes in terms of trunk control, dynamic balance, and environmental factors compared to those with diplegic CP (p < .05). In contrast, children with diplegic CP demonstrated superior outcomes regarding manual ability, compared to those with hemiplegic CP (p < .001). In our structural equation models, trunk control strongly predicted both dynamic balance (0.75) and environmental factors (0.74). Moreover, the relationships between trunk control and participation in daily and social activities were 0.54 and 0.47, respectively. Impaired trunk control and dynamic balance were significant contributors to increased activity restrictions and environmental barriers in children with diplegic CP. This suggests that improving disability and functioning in children with diplegic CP requires a focus on trunk control training and dynamic balance exercises.
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    Effect of psoriatic arthritis on the strength, proprioception, skill, coordination, and functional condition of the hand
    (Wiley, 2022) Candiri, Busra; Talu, Burcu; Karaoba, Dilan Demirtas; Ozaltin, Gulfem Ezgi; Yolbas, Servet
    Background This study was planned to evaluate the strength, proprioception, skill, coordination, and functional condition of the hand in individuals with psoriatic arthritis and to correlate disease activity with these parameters. Methods Fifty-six individuals (psoriatic arthritis group, n = 36; control group, n = 20) were included in the study. Evaluations were performed of disease activity with Disease Activity Score 28; grip strength with a dynamometer and pinch strength with pinch gauge dynamometers; joint position sensation with a goniometer; finger skills with a mobile application; and coordination and skill of both hands with the Purdue Pegboard test. The Michigan Hand Outcomes Questionnaire (MHQ) was used for hand functional evaluation. Results There was a significant difference between the grip and pinch strength of the psoriatic arthritis group and the control group (P < 0.05). There was no significant difference between the joint position sense measurements and the mobile application scores between the groups (P > 0.05). Purdue Pegboard scores showed a significant difference only in both hands and assembly subsections (P < 0.05). With Disease Activity Score 28, significant correlations were found between grip and pinch strength, mobile application scores, Purdue Pegboard all subsections, and left-hand joint position sense average error amount, and between MHQ and grip and pinch strength. Conclusions This study is the first to show that psoriatic arthritis has a negative effect especially on hand strength; grip strength decreases as disease severity increases and, skill, coordination, and functionality of hand deteriorate.
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    Examination of Motor Imagery Ability in Individuals With Diplegic Cerebral Palsy: Case-Control Study
    (Imr Press, 2025) Karaoba, Dilan Demirtas; Ozaltin, Gulfem Ezgi; Candiri, Busra; Talu, Burcu
    Introduction: Given the important role of motor imagery (MI) in rehabilitation, this study aimed to compare MI abilities in individuals with spastic diplegic cerebral palsy (SDCP) and typically-developing (TD), and to determine the factors associated with MI ability in SDCP.Patients and Methods: This study was planned as a cross-sectional, case-control study. SDCP (n = 26) and TD (n = 26) individuals participated in the study. SDCP individuals were selected from Special Education and Rehabilitation Centers, while TD participants were recruited from relatives of patients receiving therapy at these centers and from volunteers responding to bulletin board announcements. All assessments were performed before or after the weekly physiotherapy sessions, to avoid interfering with routine physiotherapy and rehabilitation sessions. Visual and kinesthetic imagery abilities were assessed using the Movement imagery questionnaire for children (MIQ-C), Implicit MI capacity laterality task, and Explicit MI capacity mental chronometry.Results: The SDCP group had a mean age of 11.69 (3.78) years, consisting of 12 females and 14 males; 10 participants were classified as Gross Motor Function Classification System (GMFCS) Level I and 16 as Level II. The TD group had a mean age of 11.50 (2.30) years, including 16 females and 10 males. A significant difference was found between the groups in MIQ-C and mental chronometry performance (p < 0.05). While there was a significant difference in reaction time according to dominance in SDCP (p = 0.038), there was no difference in accuracy rate (p = 0.699). Reaction time and accuracy rate were significantly different between groups according to dominance (p < 0.05). There was no correlation between MIQ-C total score, dominant reaction time and accuracy rate and age, Body Mass Index (BMI), and GMFCS (p > 0.05). While age and BMI were not related to mental chronometry; GMFCS was found to have a significant positive effect on mental chronometry (p = 0.000).Conclusions: In children with SDCP MI ability differs from that of typically developing peers, being weaker across all assessed subparameters. Moreover, MI ability showed a moderate association with the GMFCS level.
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    Investigation of the relationship between femoral anteversion, pelvic inclination and spasticity in children with spastic diplegic cerebral palsy
    (Bayrakol Medical Publisher, 2023) Karaoba, Dilan Demirtas; Candiri, Busra; Talu, Burcu
    Aim: This research was planned to analyze the relationship between femoraloanteversion, pelvic inclination and spasticity in children with spasticodiplegic cerebral palsy. Material and Methods: The study included 33 participants with spasticldiplegic cerebrallpalsy, aged 5-18 years (mean age 13.7 years [SD 3.1 years]; 15 girls, 18 boys), with GrosslMotor Function Classification Score 1 and 2. Femoralianteversion was evaluated with the Craig test. Pelvic inclination angle was measured using a specially designed caliper-like device and a mobile application (rotating sphere clinometer) with a phone placed on the device. Spasticity was evaluated using the Modified Ashworth Scale. The average spasticity values in the lower extremity hip flexor, adductor, internal rotator, knee flexor, plantar flexor and evertor muscles were calculated. Results: A moderate positiveicorrelation was observed between the femoral anteversion angle and pelvic inclination angle (right: r=.373, p<.05; left: r=.412, p<.05) and between femoral anteversion angle and the mean value of lower extremity total spasticity (right: r= .361, p<.05, left: r= .368, p<.05). There was no significant relationship between the pelvic inclination angle and the mean value of lower extremity total spasticity (right: r=.208, p>.05; left: r=.302, p>.05). Discussion: It was observed that an increase in lower extremity spasticity value may cause an increased femoralianteversion angle, while an increase in femoral anteversion may cause an increase in pelvic inclination angle.
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    The Effect of Video-Based Action Observation Training and Live Action Observation Training on Motor Function, Activity Participation, and Secondary Outcome Measures in Children With Spastic Diparetic Cerebral Palsy: A Randomized Controlled Study
    (Sage Publications Inc, 2024) Karaoba, Dilan Demirtas; Talu, Burcu
    Background This study aimed to investigate the effects of Video-Based Action Observation Training and Live Action Observation Training on motor function, activity participation, and secondary outcome measures in children with spastic diparetic cerebral palsy (CP). Materials and Methods Thirty-nine children with spastic diparetic cerebral palsy, aged 5-14 years, with Gross Motor Function Classification System I-III, were distributed in equal numbers to any of the Video-Based Action Observation Training (conventional physiotherapy + Video-Based Action Observation Training), Live Action Observation Training (conventional physiotherapy + Live Action Observation Training), and control (conventional physiotherapy) groups through stratified randomization. For 8 weeks, action observation training groups received 20 minutes of conventional physiotherapy followed by 20 minutes of action observation training, and the control group received 40 minutes of conventional physiotherapy. Primary outcome measures were Gross Motor Function Measurement and Child and Adolescent Scale of Participation, secondary outcome measures were Pediatric Berg Balance Scale, timed-up-and-go test, five times sit-to-stand test (FTSST), Gillette Functional Assessment Questionnaire (GFAQ), and 1-minute walk test (1MWT). Results Improvements were observed in all other evaluation parameters of the groups except Gross Motor Function Measurement-lying and rolling (P = .066) in the Live Action Observation Training Group, and lying and rolling (P = .317) and crawling and kneeling (P = .063) motor subtests and Gillette Functional Assessment Questionnaire-walking scale (P = .513) in the control group. Comparisons of the increases in all other measurements between the groups, except for the dimensions of Gross Motor Function Measurement-lying and rolling (P = .172), were statistically significant (P < .05) and this difference was in favor of action observation training. Conclusion: It was found that 2 different AOTs applied in addition to conventional physiotherapy in children with spastic diparetic cerebral palsy were more effective on all outcomes than was conventional physiotherapy alone.