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Author: Aslan, Sema Nur

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    Article
    Role of Latissimus Dorsi-Thoracolumbar Fascia Complex Stretching on Pain and Pain-Related Parameters in Patients With Chronic Low Back Pain: A Randomised Clinical Trial
    (Wiley, 2025) Ulug, Naime; Kodak, Seyde Busra; Kodak, Muhammed Ihsan; Aslan, Sema Nur
    Background Fascial stretching is gaining interest as a potential intervention for pain management. However, evidence regarding the effect of latissimus dorsi-thoracolumbar fascia (LD-TLF) complex stretching in patients with chronic low back pain (CLBP) remains limited. Therefore, this study aimed to investigate the effects of LD-TLF complex stretching on pain-related factors and disability in patients with CLBP. Methods Thirty patients with CLBP were randomly assigned to a study group (n = 15; 7 men, 8 women) and a control group (n = 15; 7 men, 8 women). The study group received 4 weeks of LD-TLF complex stretching in combination with conventional physiotherapy, while the control group received conventional physiotherapy only. Outcomes were assessed before and after the interventions, including primary measures of pain pressure thresholds (PPT) at thoracolumbar fascia levels (L1, L3 and 12th costa), and secondary measures included the Pain Sensitivity Questionnaire (PSQ), the effects of pain on daily activities measured by the Brief Pain Inventory (BPI), and disability assessed by the Oswestry Disability Questionnaire (ODQ). Results Pre- and post-treatment PPTs, at the L1, L3 vertebrae and 12th costa levels, demonstrated significant differences between the study group and control groups. Post-treatment thresholds were significantly higher compared to pre-treatment thresholds (p < 0.001, eta p(2) = 0.67; p < 0.001, eta p(2) = 0.61; p < 0.001, eta p(2) = 0.74). Additionally, significant improvements were found in PSC, BPI and ODQ scores in the study group compared to the control group (p < 0.05). Conclusion The results of this study suggest that stretching the LD-TLF complex may be a beneficial addition to the conventional physiotherapy approach for patients with CLBP. Specifically, LD-TLF complex stretching, when used in combination with conventional physiotherapy, appears to provide improved pain thresholds, decreased pain sensitivity and pain during activity, as well as reduced disability compared to conventional physiotherapy alone in patients with CLBP.
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    Article
    Comparison of Voice Call Based and Multimodal Telerehabilitation After Total Knee Arthroplasty: A Randomized Controlled Trial
    (Taylor & Francis Inc, 2026) Aslan, Sema Nur; Bozgeyik-Bagdatli, Sibel; Demirel, Murat; Atilla, Bulent; Kinikli, Gizem Irem
    Background Telerehabilitation has emerged as a promising approach in postoperative care following total knee arthroplasty(TKA);nevertheless,the relative effectiveness of different telerehabilitation modules is still under discussion, leaving room for alternative and multimodal program approaches. Objectives This study aimed to compare the effectiveness of a multimodal telerehabilitation(MTR) and voice call based telerehabilitation(VTR) in patients undergoing TKA. Methods A two-arm randomized controlled trial was conducted with 24 patients (68.42 +/- 9.28y) in the MTR group and 21(71.19 +/- 7.26y) in the VTR group. The MTR group received weekly digital booklets containing asynchronous exercise videos, one voice call, one video call,and text messages,for a total of three contacts per week. The VTR group received weekly printed booklets and voice calls three times a week(on alternate days) over the 8-week intervention period. Outcomes were assessed face to face at discharge, and at the 4th and 8th postoperative weeks. Measures included Visual Analog Scale(VAS), active and passive range of motion(ROM), Knee Osteoarthritis Outcome Score-Physical Function(KOOS-PS), Five Repetition Sit to Stand Test(5xSST), Brief Fear of Movement(BFoM) Scale, isometric Quadriceps muscle strength, Forgotten Joint Score-12(FJS-12),Exercise Adherence Rating Scale(EARS). The primary outcome was active knee flexion ROM. Statistical significance was set at p < .05; effect sizes (r, W) were reported for the Mann - Whitney U and Wilcoxon tests. Results After 8 weeks, a statistically significant difference in pain during activity was observed between the MTR and VTR groups (p < .001, r = 0.62). Both groups showed significant gains in active and passive knee flexion ROM, 5xSST, and KOOS-PS scores (all p < .001), while the MTR group also improved in rest pain, knee extension, and BFoM (all p < .001). At week 8, statistically significant differences were observed between the MTR and VTR groups across all outcome measures (all p < .001). Conclusion Both telerehabilitation approaches were effective in improving pain, ROM, and functional outcomes after TKA.Although this study did not compare outcomes with conventional in-person rehabilitation, MTR showed greater overall improvements than VTR. Nevertheless, VTR remains a reasonable alternative when MTR cannot be implemented.