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Article Knee Hyperextension in Chronic Stroke: Associated Biomechanical and Neuromuscular Factors(Elsevier Sci Ltd, 2025) Korkusuz, Sueleyman; Korkusuz, Busra Seckinogullari; Ozgoren, Nihat; Aritan, Serdar; Ceren, Ali Naim; Topcuoglu, Mehmet Akif; Balkan, Ayla FilBackground: This study aimed to determine the gait phase in which knee hyperextension occurs in stroke patients and to investigate the factors associated with knee hyperextension. Methods: This study included 30 stroke patients aged between 40 and 70 years with maximum knee hyperextension during the stance phase of gait. Muscle strength was evaluated with manual muscle test, and muscle tone was assessed with the Modified Ashworth Scale. Kinematic evaluation of the patients was made using the motion analysis system. Additionally, categorisation was made according to the stance phase of gait, where knee hyperextension was at its highest. Findings: A weak relationship was found between maximum knee hyperextension angle and gastrocnemius spasticity, a moderate relationship between knee flexor muscle strength, and a moderate relationship between ankle dorsiflexor muscle strength. In addition, a weak relationship was found between the maximum knee hyperextension and pelvic retraction angles. According to this clustering, it was observed that 66.67 % of the participants (20 people) showed maximum knee hyperextension in the single support phase. It was observed that the participants who had maximum knee hyperextension, especially after the mid-stance phase, had higher mean gastrocnemius spasticity. It was also observed that participants in Cluster 4, with a greater amount of maximum knee hyperextension, had the worst clinical parameters. Interpretation: Our study observed that the degree of maximum knee hyperextension was related to knee flexor and ankle dorsiflexor muscle strengths, gastrocnemius spasticity and pelvic retraction. As clinical parameters worsened, maximum knee hyperextension was thought to occur late in the stance phase. Clinical Trial code: NCT05679700Article Effect of Freezing Phenomenon on Gait Parameters and Pedobarographic Pressure Distribution in Patients with Parkinson's Disease(Springer-Verlag Italia Srl, 2025) Korkusuz, Suleyman; Korkusuz, Busra Seckinogullari; Demircan, Emine Nur; Ozcan, Aysenur; Cakmakli, Gul Yalcin; Balkan, Ayla Fil; Elibol, BulentBackground This study aimed to examine the gait parameters of individuals with Parkinson's Disease with and without freezing of gait (FoG) on the treadmill, where freezing difficulty decreases. Methods Our study included three groups of demographically similar individuals: 15 patients with Parkinson's disease without freezing of gait, 14 patients with Parkinson's disease with freezing of gait, and 14 healthy controls. Spatiotemporal parameters of gait and static-dynamic pedobarographic pressure distribution analysis were performed using a computerized gait evaluation system (on a treadmill). Results The step length, gait speed and gait phase duration of the freezing of gait group were lower than the other groups (p < 0.05). While pedobarographic pressure distribution during static stance was similar in all groups (p > 0.05), pedobarographic pressure distribution during gait was different between groups (p < 0.05). Conclusion In patients with freezing of gait, gait speed was lower, step length and single support phase were shorter, and double support phase was longer. While the amount of load on the backfoot was lower in both Parkinson's groups, the amount of load on the forefoot was lower only in patients with freezing of gait. Even if freezing of gait did not occur, it was observed that the gait characteristics of Parkinson's disease with freezing of gait were different from those of Parkinson's disease without freezing of gait.Article Citation - WoS: 3Citation - Scopus: 3Effect of Knee Hyperextension on Femoral Cartilage Thickness in Stroke Patients(Lippincott Williams & Wilkins, 2024) Korkusuz, Suleyman; Kibar, Sibel; Ozgoren, Nihat; Aritan, Serdar; Seckinogullari, Busra; Balkan, Ayla FilObjectiveKnee hyperextension is one of the most common compensatory mechanisms in stroke patients. The first aim of the study was to measure knee hyperextension and femoral cartilage thickness in stroke patients. The second aim was to compare the femoral cartilage thickness of the paretic and nonparetic limbs in stroke patients with and without knee hyperextension.DesignForty stroke patients were included in the study. The patients were divided into two groups according to the presence of knee hyperextension based on kinematic analyses performed during walking with a three-dimensional motion analysis system. The medial femoral cartilage, lateral femoral cartilage, and intercondylar cartilage thicknesses of the paretic and nonparetic sides of the patients were measured by ultrasonography.ResultsIn the study group, medial femoral cartilage, intercondylar, and lateral femoral cartilage thicknesses were less on the paretic side than on the nonparetic side, while the femoral cartilage thicknesses on the paretic and nonparetic sides were similar in the control group. Paretic side medial femoral cartilage and intercondylar thicknesses were less in the study group compared with the control group, and lateral femoral cartilage thickness was similar between the two groups.ConclusionsKnee hyperextension during walking causes femoral cartilage degeneration in stroke patients.Clinical Trial code: NCT05513157ConclusionsKnee hyperextension during walking causes femoral cartilage degeneration in stroke patients.Clinical Trial code: NCT05513157
