Sürdürülebilir Kalkınma Amaçları
Yayınlar
- MakaleAçık Erişim2026Spinal Manipulation, Dynamic Neuromuscular Stabilization, and Their Combination in Chronic Non-Specific Low Back Pain: A Four-Group Randomized Clinical Trial
Alak, İsmail; Hatik, Sefa Haktan; Büyükkirli, İlker Can; Aydin, Emine Busra
Spinal manipulation (SM) and stabilization-focused exercise are commonly used in chronic low back pain, yet evidence on their combined effects is limited. This randomized controlled trial compared SM and dynamic neuromuscular stabilization (DNS), alone or combined, in chronic non-specific low back pain. Forty-eight participants were randomized (1:1:1:1; n=12/group) using a computer-generated sequence with opaque sealed-envelope concealment to Control, SM, DNS, or SM+DNS (SMDNS). Interventions (except Control) were delivered twice weekly for 4 weeks. Outcomes (VAS, ODI, RMDQ, DNS-HS, PostureScreen) were assessed at baseline and follow-up. Assessor blinding was not feasible (treating physiotherapist also assessed outcomes); analyses used coded group labels.Within-group analyses showed significant improvements in most outcomes (p<0.05), except for postural deviation in the SM group and frontal postural deviation in the DNS and SMDNS groups. Between-group comparisons indicated greater early pain reduction with SMDNS at the second assessment (p<0.05). By week 4, pain decreased most in DNS and SMDNS (VAS Δ=−3), while SM showed Δ=−2 and Control showed no change. Disability improved most in DNS/SMDNS (ODI Δ=−13.39/−15.38; RMDQ Δ=−5.24/−5.77). Week-4 effect sizes favored SMDNS over Control and SM for key outcomes (VAS D2 g=2.07 vs Control, 1.24 vs SM; ODI PC2 g=1.73 vs Control, 1.05 vs SM; RMDQ PC2 g=1.34 vs Control, 0.23 vs SM). Overall, adding SM to DNS may enhance early pain relief; the magnitude of between-group differences (effect sizes with 95% CIs) supports interpretation, while clinical relevance should be considered alongside established MCIDs and confirmed in larger trials with longer follow-up.
- MakaleAçık Erişim2026Yoga-based breathing exercises performed in a salt-cave environment versus a standard clinical setting in smokers: a randomized controlled trial salt-cave breathing exercises in smokers
Bağci, Uğur; Alpteki̇n, Hasan Kerem; Hatik, Sefa Haktan; Aydin, Emine Büşra
Backgorund: To investigate the effect of a speleotherapy environment on spirometric parameters in smokers and to compare the outcomes with those of the same yoga-based breathing exercise program performed in a standard clinical setting. Methods: This randomized controlled clinical trial included 60 adult smokers aged 18–65 years who were allocated to a speleotherapy group (n = 30) or a control group (n = 30). Both groups received the same physiotherapist-supervised yoga-based breathing exercise program for 6 weeks, twice weekly, in 50-minute sessions; the only difference was the intervention setting. Forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, and forced expiratory volume in 1 s/forced vital capacity were assessed at baseline, week 3, and week 6. Physical activity, functional exercise capacity, and quality of life were also evaluated. Data were analyzed using linear mixed-effects models with group, time, and group × time interaction as fixed effects and participant as a random effect. Results: Both groups showed improvements over time in spirometric and secondary outcomes. In the linear mixed-effects model analysis, the primary spirometric outcome, forced expiratory volume in 1 s, showed a significant group × time interaction in favor of the speleotherapy group. Significant group × time effects were also observed for 6-minute walk distance and selected quality-of-life domains, whereas broader spirometric superiority across forced vital capacity, peak expiratory flow, and forced expiratory volume in 1 s/forced vital capacity was limited. Conclusion: The findings suggest that the treatment environment may influence selected respiratory and functional outcomes in smokers. Yoga-based breathing exercises were associated with improvements in spirometric outcomes in both settings. The additional effect of the salt-cave environment on respiratory outcomes was limited, with a significant between-group difference observed only for forced expiratory volume in 1 s. The salt-cave setting may also be associated with greater improvements in functional capacity and selected quality-of-life outcomes, but broader pulmonary benefits or an independent speleotherapy effect cannot be concluded from the present findings. Trial registration: ClinicalTrials.gov, NCT07737587. Retrospectively registered on 30 July 2026.
- MakaleAçık Erişim2025COMPARISON OF INSTANT EFFECT OF LUMBAL AND SACROILAC SPINAL MANIPULATION ON FLEXIBILITY AND JUMPING PERFORMANCE IN PROFESSIONAL SOCCER PLAYERS
Dönmez, Beyza; Hatik, Sefa Haktan; Büyükkirli, Ilker Can; Aydin, Emine Busra
Recent evidence suggests that spinal manipulation can acutely improve mobility and lower-limb performance. This study compared the acute effects of lumbar and sacroiliac chiropractic manipulation on flexibility nd jump performance. Forty-five healthy male participants were randomly assigned to three groups: a Lumbar Manipulation Group (LMG; n = 15), a Sacroiliac Manipulation Group (SMG; n = 15), and a Control Group (n = 15). Flexibility was assessed using the V-Sit and Reach test, while performance was evaluated with vertical and horizontal jump tests. Lumbar manipulation was applied to the dysfunctional lumbar segment in the LMG, and sacroiliac joint manipulation was applied to the dysfunctional sacroiliac region in the SMG. No intervention was performed in the control group. Both manipulation techniques resulted in significant acute improvements in mobility and jump performance compared with the control group (p < 0.05), with the greatest improvement observed in vertical jump height (p = 0.001). No significant differences were found between the LMG and SMG. Spinal manipulation to the lumbar and sacroiliac regions appears to produce acute improvements in mobility and lower-limb power. These findings suggest that spinal manipulation may serve as a short-term performance-enhancing intervention.
- MakaleAçık Erişim2024A Comparison of the Instantaneous Effects of Spinal Manipulation and Mobilization Techniques Applied to L3 Level on Jumping, Agility and Sprint Speed in Male Volleyball Players
Aydın, Emine Büşra; Hatik, Sefa Haktan; Büyükkırlı, İlker Can
Objective: This study aims to investigate the effects of manipulation and mobilization treatments applied to the L3 segment on sportive performance to prevent performance anxiety and low performance resulting from competition stress in athletes. Material-Method: Sixty male volleyball players aged 18 to 25 were enrolled in this randomized controlled trial. Participants were randomly assigned to one of three groups: a manipulation, a mobilization, and a control group. After completing the required warm-up program, participants underwent either manipulation or mobilization based on their assigned group. Hip range of motion, lumbar range of motion, T-Test time (seconds), 10-meter sprint time (seconds), vertical jump height (cm), and horizontal jump distance (cm) were evaluated immediately before and after the interventions. Results: There were no significant differences between the groups regarding participants' age and height (p>0.05). The mobilization group had the highest mean body mass index and weight (p=0.05). In the intra-group analysis, statistically significant improvements were observed in the spinal manipulation group for hip external rotation, lumbar flexion, extension, T-test performance, and right lumbar flexion (p<0.05). In the mobilization group, significant changes were noticeable for right hip flexion, left hip abduction, hip external rotation, lumbar flexion, extension and lateral flexion, T-test performance, 10-meter sprint, and horizontal jump. Across all groups, all measures were statistically significant except for hip flexion, hip adduction, hip internal rotation, and lumbar lateral flexion (p<0.05). Conclusion: Comparing the data between the groups revealed that the spinal manipulation group demonstrated superior outcomes in right hip extension, right hip external rotation, lumbar flexion, extension, T-test performance, and 10-meter sprint times compared to the spinal mobilization and control groups. We believe that pre-competition spinal manipulation interventions may offer the greatest benefit for volleyball players.