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• MakaleAçık Erişim2026Scopus SJRQ3/r/gumushane/13888
  Spinal 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.

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• MakaleAçık Erişim2026Scopus SJRQ2/r/gumushane/13494
  Effects of transcutaneous auricular vagus nerve stimulation added to robotic rehabilitation in patients with ischemic stroke: a randomized clinical trial

  Kızıl, Ömer Dicle; Ural, İbrahim Halil; Hatık, Sefa Haktan; Özden, Ali Veysel; Aydın, Emine Büşra

  Background: This study aimed to investigate the effects of adding transcutaneous auricular vagus nerve stimulation (taVNS) to robotic rehabilitation on functional outcomes and neuromuscular activity in patients with ischemic stroke. Methods: This randomized controlled clinical trial employed a pre–post study design and was conducted in a hospital-based physiotherapy and rehabilitation clinic. A total of 40 patients with ischemic stroke, aged 18–65 years, were randomly assigned to either a robotic rehabilitation group (RRG) or a combined vagus nerve stimulation and robotic rehabilitation group (VRRG). Spasticity, walking speed, motor function, quality of life, muscle activity, and pain were assessed at baseline and after six weeks of treatment. Results: Primary outcome measures were walking speed, motor function assessed by the Fugl–Meyer Assessment, and pain intensity. Secondary outcomes included electrophysiological measurements (H-reflex and F-wave parameters) and quality of life. Within-group analyses showed significant improvements in all outcomes in the VRRG (p < 0.05), whereas all outcomes except pain improved significantly in the RRG (p < 0.05). Between-group comparisons demonstrated greater improvements in walking speed in the VRRG compared with the RRG (mean difference − 1.84 s, 95% CI − 3.7 to − 0.7; r = 0.43; p = 0.006) and greater pain reduction in the VRRG (mean difference − 1.55, 95% CI − 2.5 to − 0.1; r = 0.30; p = 0.048). In contrast, a greater reduction in the Hmax/Mmax amplitude ratio—an electrophysiological marker of spinal excitability—was observed in the RRG. Conclusion: The findings suggest that transcutaneous auricular vagus nerve stimulation combined with robotic rehabilitation may provide additional benefits in terms of walking speed and pain reduction in patients with ischemic stroke. Trial registration: The study was registered at ClinicalTrials.gov on April 19, 2024. (Identifier: NCT06381089).

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• MakaleAçık Erişim2026Scopus SJRQ2/r/gumushane/13452
  Immediate effects of cervical spine and sacroiliac joint manipulations on the autonomic nervous system and pedobarographic analysis: Randomized controlled trial

  Turgut, Hayriye; Büyükkırlı, İlker Can; Hatık, Sefa Haktan; Aydın, Emine Büşra

  Background: This study aimed to investigate the immediate effects of cervical and sacroiliac joint manipulations on autonomic nervous system activity and baropodometric parameters. Methods: Participants were randomly assigned to three groups with equal gender distribution. The cervical manipulation group received chiropractic manipulation at the C3–C5 level, while the sacroiliac group received manipulation at the sacroiliac joint. The control group received no intervention. Pre- and post-treatment evaluations were conducted after a 30-minute interval. Plantar pressure was measured via a pedobarographic device. Autonomic nervous system activity was assessed using the Polar H10. Blood pressure and heart rate were manually recorded using a sphygmomanometer and pulse oximeter. Statistical significance was set at p < 0.05. Results: No significant differences were found among groups in terms of age, gender, height, or BMI (Kruskal-Wallis, p > 0.05). The cervical manipulation group showed significant decreases in systolic and diastolic blood pressure and heart rate post-intervention (Wilcoxon, p < 0.05). The sacroiliac group showed a significant increase in heart rate only (Wilcoxon, p < 0.05). No significant changes were observed in baropodometric parameters or autonomic activity within or between groups (Wilcoxon and Kruskal-Wallis, p > 0.05). However, post-intervention comparisons showed cervical manipulation led to a greater reduction in systolic blood pressure, while sacroiliac manipulation led to a greater increase in heart rate compared to controls (Mann-Whitney U with Bonferroni correction, p < 0.05). Conclusion: While no significant changes were observed in baropodometric or autonomic parameters, chiropractic manipulation demonstrated short-term effects on blood pressure and heart rate. The accuracy of heart rate variability assessments should be reviewed, and further studies are needed to evaluate long-term cardiovascular and autonomic outcomes.

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• MakaleAçık Erişim2026Scopus SJRQ2/r/gumushane/12216
  Yoga-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.

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• MakaleAçık Erişim2025/r/gumushane/19670
  Comparison of Physical Activity Levels, Metabolic Syndrome Risks and Sleep Quality of Athletes and Sedentary University Students: A Cross-Sectional Study

  Çebi, Mehmet; Aydın, Emine Büşra

  Objective: The aim of this study is to compare the phys- ical activity levels, metabolic syndrome risks and sleep quality of ath- letes and sedentary university students.Material and Methods: A total of 400 students, including 200 athletes and 200 sedentary students studying at Gümüşhane University, were included in this study. In col- lecting data; Pittsburgh Sleep Quality Index was used to evaluate the sleep quality of the participants, International Physical Activity Ques- tionnaire-Short Form was used to determine physical activity levels and Metabolic Syndrome Research Form was used to determine metabolic syndrome risk levels. Results: Average age of the participants was 19.94±1.48. A significant difference was detected between athletes and sedentary individuals in sleep quality and metabolic syndrome risk level. Individuals who exercise regularly and have high physical activ- ity levels were found to have higher sleep quality and lower metabolic syndrome risks. In addition, these people are less exposed to various sleep problems such as falling asleep late, daytime sleepiness, ineffi- cient sleep, etc. Conclusion: Increasing the level of physical activity improves sleep quality and reduces the risk of metabolic syndrome. Athletes have better sleep quality and lower risk of metabolic syndrome than sedantery. It is important to increase research in this area in young individuals. On the other hand, creating the right exercise program should be emphasized in studies. It is thought that our study will con- tribute to future studies in this regard.

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• MakaleAçık Erişim2025Scopus SJRQ3/r/gumushane/16096
  COMPARISON 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.

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• MakaleAçık Erişim2025Scopus SJRQ3/r/gumushane/12445
  Comparison of drop table and diversified chiropractic techniques in patients with non-specific neck pain; [Comparação das técnicas quiropráticas drop table e diversified em pacientes com dor cervical inespecífica]

  Kızıltoprak, Dünya Tajik; Hatıp, Sefa Haktan; Kızıl, Ömer Dicle; Aydın, Emine Büşra

  Introduction: Neck pain is a common musculoskeletal disorder associated with pain, reduced cervical mobility, and decreased muscle strength, often leading to functional limitations. Chiropractic manipulation is widely used as a conservative treatment, yet the comparative effects of different techniques remain unclear. ## Objective To compare the effects of the diversified and drop table chiropractic techniques on pain, cervical range of motion, and muscle strength in individuals with non-specific neck pain. ## Methods This randomized controlled clinical trial included 45 participants with non-specific neck pain, randomly assigned to three groups: diversified (DG; n = 15), drop table (DTG; n = 15), and control (CG; n = 15). Interventions were applied twice weekly for four weeks. The primary outcome measure was pain level assessed using the McGill Pain Questionnaire. Secondary outcome measures were cervical joint range of motion assessed with a goniometer and isometric neck muscle strength assessed using a microFET2 dynamometer. Outcomes were assessed pre- and post-intervention. ## Results Both DG and DTG demonstrated significant increases in cervical range of motion compared with the CG. Pain levels significantly decreased in both intervention groups. DG showed significant improvements across all isometric muscle strength measures, while DTG demonstrated selective improvements in flexion and right lateral flexion. CG showed no significant changes, except a decrease in extensor strength. ## Conclusion Chiropractic interventions effectively reduce pain and enhance cervical function in individuals with non-specific neck pain. The diversified technique provided broader muscle strength improvements, while the drop table technique showed more selective effects, emphasizing the need for individualized technique selection in clinical practice. Open access and CC-BY licensed.

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• MakaleAçık Erişim2024/r/gumushane/20006
  A 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.

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• MakaleAçık Erişim2024/r/gumushane/19827
  Sağlık Bölümlerinde Okuyan Üniversite Öğrencilerinde Sağlık Okuryazarlığı, Kardiyovasküler Hastalıklar Riski Bilgi Düzeyi ve Sağlıklı Yaşam Biçimi Davranışlarının İncelenmesi: Kesitsel Bir Çalışma

  Aydın, Emine Büşra

  Amaç: Çalışmanın amacı, üniversitede sağlık bölümünde okuyan öğrencilerin sağlık okuryazarlığı düzeyleri, sağlıklı yaşam davranışları ve kardiyovasküler hastalıkların risk faktörlerine yönelik bilgi düzeylerinin araştırılmasıdır. Gereç ve Yöntemler: Çalışma bir devlet üniversitesine ait sağlık hizmetleri meslek yüksekokulunda öğrenimine devam eden 374 öğrencinin katılımıyla gerçekleşmiştir. Araştırma verileri, demografik bilgi formu, Sağlıklı Yaşam Biçimi Davranışları Ölçeği II (SYBDÖ-II), Türkiye Sağlık Okuryazarlığı Ölçeği-32 (TSOY-32), Kardiyovasküler Hastalıklar Risk Faktörleri Bilgi Düzeyi (KARRİF-BD) Ölçeği ile toplanmıştır. Veriler, NCSS (Number Cruncher Statistical System) 2007 Statistical Software paket program ile analiz edilmiştir. Gruplar arası karşılaştırma tek yönlü varyans analizi ile yapılmış, alt grup karşılaştırması ise Tukey testi ile yapılmıştır. İki grup karşılaştırmasında bağımsız t-testi, değişkenlerin birbiri ile ilişkisinin tespit edilmesinde Pearson korelasyon analizi tercih edilmiştir. Bulgular: Katılımcıların yaş ortalamaları 20,83±1,61 yıldır. Kadınların TSOY-32 ortalamaları erkeklerden daha yüksek bulunmuştur (p<0,05). İkinci sınıf öğrencilerinin KARRİF-BD puan ortalamaları 1. sınıflardan daha yüksektir (p<0,05). Katılımcıların TSOY-32 ortalamaları ile SYBDÖ-II’nin kişilerarası ilişkiler, beslenme, sağlık sorumluluğu, stres yönetimi, manevi gelişim alt boyutları ve toplam puan arasında pozitif yönde zayıf korelasyonlar bulunmuştur (p<0,05). Öğrencilerin TSOY-32 ile KARRİF-BD ortalamaları arasında pozitif yönde zayıf korelasyon bulunduğu görülmektedir (p<0,05). Katılımcıların KARRİF-BD ortalamaları ile SYBDÖ-II kişilerarası ilişkiler, beslenme, manevi gelişim alt boyut puanları ve bu ölçeğin toplam puanı arasında istatistiksel olarak anlamlı pozitif yönde zayıf korelasyonlar bulunmaktadır (p<0,05). Sonuç: Daha yüksek sağlık okuryazarlığı, daha yüksek sağlıklı yaşam alışkanlıkları ve kardiyovasküler hastalıklara yönelik farkındalık ile ilişkilidir.

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  İncele
• MakaleAçık Erişim2023/r/gumushane/20198
  Sağlıklı Bireylerde Spinal Stabilizasyon Egzersizleri, Kayropraktik Manipülasyon ve Kombine Uygulamasının Otonom Parametreler ve Bazı İlişkili Faktörlere Etkisi

  Arslan, Mesut; Aydın, Emine Büşra

  Bu çalışmanın amacı; sağlıklı bireylerde spinal stabilizasyon egzersizleri, kayropraktik manipülasyon ve kombine uygulamasının otonom parametreler ve bazı ilişkili faktörlere etkisini araştırmaktır. Çalışmaya 18-45 yaş arası, sağlıklı 72 kişi dahil edilmiştir. Çalışmaya katılan kişiler randomize olarak 4 gruba ayrılmıştır. Grup 1’e haftada 1 kez olmak üzere 6 seans kayropraktik manipülasyon uygulanmıştır. Grup 2’ye haftada 3 kez olmak üzere 18 seans stabilizasyon egzersizleri yaptırılmıştır. Grup 3’e hem stabilizasyon egzersizleri, hem de kayropraktik manipülasyon uygulanmıştır. Tüm uygulamalar 6 hafta boyunca yapılmıştır. Grup 4 kontrol grubu olarak takip edilmiş, herhangi bir uygulama yapılmamıştır. Katılımcılar nabız, kan basıncı, solunum frekansı ve kalp hızı değişkenliği parametreleri, göğüs çevre ölçümü, Yorgunluk Şiddet Ölçeği, Algılanan Stres Ölçeği ve Pitsburg Uyku Kalitesi Ölçeği ile uygulama öncesi, uygulama sonrası ve uygulama sonrası 1. ayda değerlendirilmiştir. Tüm eğitim gruplarında uygulama sonrası ölçümde sistolik ve diyastolik kan basıncında anlamlı düşüşler elde edilmiştir. Ayrıca Grup 1’de torakal ekspansiyonda, Grup 3’te ise torakal ekspansiyon ve algılanan stres düzeyinde anlamlı iyileşmeler elde edilmiştir. Ancak değerlendirme parametrelerinin hiç birinde gruplar arası karşılaştırmada istatistiksel olarak anlamlı bir farklılık tespit edilmemiştir.

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