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Article The Relationship Between Concentric and Isometric Strength of Knee Flexor and Extensor Muscles and Postural Stability in Mild Stage Multiple Sclerosis Patients(Taylor & Francis Ltd, 2025) Yilmaz, Seval; Unluer, Nezehat OzgulBackground Multiple sclerosis (MS) affects muscle strength and postural stability. However, the relationship between concentric and isometric strength of knee flexors and extensors and postural stability in mild stage MS is not well known. The aim of the study was to examine the relationship between concentric and isometric strength of knee flexors and extensors and postural stability in mild stage MS patients. Materials and Methods The study included 21 mild-stage MS patients with an EDSS score of 4 or less and 21 healthy controls. The concentric and isometric strength of knee flexors and extensors was measured with the Biodex System 4 Dynamometer, and postural stability with the Biodex Balance System under eyes-open and eyes-closed conditions on a rigid surface. Results Mild-stage MS patients had reduced concentric strength of knee extensors and flexors and increased postural sway compared with healthy controls (p < 0.05). Isometric strength of knee extensors and flexors in mild stage MS patients were similar to healthy controls (p > 0.05). There was a moderate positive correlation between concentric strength of knee extensors and flexors and isometric strength of knee flexors and open-eye postural stability indexes in mild stage multiple sclerosis patients (p < 0.05). Conclusions While isometric strength of knee extensors and flexors was preserved, concentric strength of knee extensors and flexors was decreased, and postural stability was adversely affected in mild stage MS patients. The increase in the strength of the knee muscles was associated with an increase in their postural sway in mild stage MS patients.Article Citation - WoS: 5Citation - Scopus: 4Examining the Effects of Non-Immersive Virtual Reality Game-Based Training on Knee Hyperextension Control and Balance in Chronic Stroke Patients: a Single-Blind Randomized Controlled Study(Springer-verlag Italia Srl, 2024) Korkusuz, Suleyman; Taskin, Gulsen; Korkusuz, Buesra Seckinogullari; Ozen, Melike Sumeyye; Yuruk, Zeliha OzlemBackground Post-stroke hemiparesis can lead to decreased mobility, gait disturbances, impaired balance, postural instability, limitations in activities of daily living (ADL), and long-term disability. Aims The aim of this study was to examine the effect of non-immersive virtual reality game-based training (nIVRGT) in addition to conventional rehabilitation in stroke patients on dynamic balance, knee hyperextension control, and ADL. Methods Twenty-five chronic stroke patients aged between 51 and 70 were included in the study. Stroke patients were randomized to a control group (n = 12) and a study group (n = 13). Individuals in control group participated conventional physiotherapy and rehabilitation program for 60 min, 3 days a week for 6 weeks. individuals in the study group received 40 min of conventional physiotherapy and rehabilitation program plus 20 min nIVRGT. Functional Reach Test, Timed Up and Go Test, Computerized Gait Evaluation System and Barthel Index were used in the evaluation. Result The study group improved significantly in dynamic balance, knee control, and ADL (p < 0.05). In the control group, significant improvements were observed in dynamic balance and knee control (p < 0.05), except ADL (p > 0.05). The study group improved in dynamic balance compared with the control group (p < 0.05). Knee control and ADL improved similarly in both groups (p > 0.05). Conclusion Our results showed that conventional and additional nIVRGT rehabilitation improved dynamic balance and knee hyperextension control in chronic stroke. However, it was observed that the non-immersive virtual reality (nIVR) approach was more effective in improving dynamic balance in stroke patients than conventional rehabilitation alone.Article Citation - WoS: 13Citation - Scopus: 15Daily Living Activities, Exercise Capacity, Cognition, and Balance in Copd Patients With and Without Frailty(Springer London Ltd, 2022) Kagiali, Sezen; Inal-Ince, Deniz; Cakmak, Aslihan; Calik-Kutukcu, Ebru; Saglam, Melda; Vardar-Yagli, Naciye; Coplu, LutfiBackground Information on the interaction between frailty and chronic obstructive pulmonary disease (COPD) is limited. Aims This study aimed to compare activities of daily living (ADL), exercise capacity, balance, and cognition in COPD patients with and without frailty. Methods Twenty frail and 28 non-frail COPD patients aged 55 years and over were included. Frailty was determined according to Fried et al. Dyspnea was evaluated using the modified Medical Research Council (mMRC) dyspnea scale. Respiratory and peripheral muscle strength were measured. Functional capacity was assessed using a 6-min walk test (6MWT); ADL performance was evaluated using the Glittre ADL test. The balance was evaluated using the functional reach test (FRT). Cognitive function was assessed using the Montreal Cognitive Evaluation (MoCA) Test. Quality of life was measured using the COPD Assessment Test (CAT). Results The mMRC and CAT scores were higher in the frail patients as compared with the non-frail patients (p < 0.05). The maximal inspiratory pressure, handgrip strength, 6MWT distance, and FRT score were lower in the frail patients as compared with the non-frail patients (p < 0.05). The duration for the Glittre ADL test was longer in the frail patients than the non-frail patients (p < 0.05). There was no significant difference between MoCA scores between groups (p > 0.05). Conclusions Frail COPD patients have increased dyspnea perception, impaired muscle strength, and functional capacity, ADL performance, balance, and quality of life. Whether pulmonary rehabilitation programs for patients with frail COPD need to be adapted with new rehabilitation strategies, including components of frailty, needs further investigation.
