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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: NCT05513157Article 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 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: 1Citation - Scopus: 1Investigation the Effect of Rigid Taping on Knee and Hip Joint Kinematics in Chronic Stroke Patients With Knee Hyperextension Gait(Elsevier Ireland Ltd, 2025) Korkusuz, Suleyman; Fil-Balkan, Ayla; Korkusuz, Busra Seckinogullari; Ozgoren, Nihat; Aritan, Serdar; Ceren, Ali Naim; Topcuoglu, Mehmet AkifBackground: Although stroke patients gain an advantage in gait due to the knee hyperextension that occurs during the stance phase, this situation disrupts the biomechanical structure of the knee and increases the risk of injury to the capsular and ligamentous structures. The aim of this study was to examine the effects of rigid taping on hyperextension control and pelvic kinematics in stroke patients with knee hyperextension during the stance phase of gait. Research question: Does rigid taping have an effect on hyperextension control and pelvic kinematics in stroke patients with knee hyperextension? Methods: Thirty stroke patients aged between 40 and 70 were included in this pre-postintervention study. Kinematic assessment of gait was performed using a motion analysis system (Vicon Ltd, Bilston). Then, the rigid taping was applied to the patients using the hyperextension taping technique, and the kinematic analysis of the gait was repeated with the motion analysis system. Results: It was found that the rigid taping for the knee hyperextension significantly reduced the knee hyperextension (p < 0.05). Additionally, it was observed that the rigid taping significantly reduced the pelvic retraction (p < 0.05). However, no change was observed in the pelvic drop with the rigid taping application. Significance: Our results showed that the rigid taping effectively controlled the knee hyperextension. It was thought that the rigid taping application contributed to reducing knee hyperextension and pelvic retraction because it mechanically gave the knee a flexion moment and provided proprioceptive input.