Publications by authors named "Sevgi Sevi Yeşilyaprak"

10 Publications

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INFLUENCE OF FOAM ROLLING ON ELBOW PROPRIOCEPTION, STRENGTH, AND FUNCTIONAL MOTOR PERFORMANCE.

J Athl Train 2021 Feb 24. Epub 2021 Feb 24.

School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey, +905055882829,

Context: Foam rolling has recently been used frequently to increase flexibility. However, its effects on proprioception, strength and motor performance are not well known. In addition, very few studies have examined the effects of foam rolling in the upper extremity.

Objective: To investigate the effects of foam rolling on elbow proprioception, strength, and functional motor performance in healthy individuals.

Design: Randomized controlled study.

Setting: Exercise laboratory of X Department, X University.

Patients Or Other Participants: Sixty healthy participants (mean age=22.83±4.07 years).

Intervention(s): We randomly assigned participants into two groups: the foam rolling group (FRG) (4 weeks of foam rolling for the biceps brachii muscle) and control group (CG) (no foam rolling).

Main Outcome Measure(s): We evaluated proprioception (joint position sense [JPS] and force matching), biceps brachii muscle strength, and functional motor performance (modified pull-up test [MPUT], closed kinetic chain upper extremity stability test [CKCUEST], and push-up test) at the baseline, and at the end of the 4th week and 8th week.

Results: JPS at 45° elbow flexion, muscle strength, CKCUEST, and push-up test results improved after foam rolling and improvement was maintained at the follow-up (p<0.017). While the changes in groups for the results of proprioception and CKCUEST were similar among the three time points (p>0.05), there were significant improvements for the muscle strength from baseline to the second evaluation, and from baseline to the follow-up (p<0.001) in the FRG compared to the CG (p=0.004). The FRG was superior to the CG in the improvement of push-up test results among the three time points (p=0.040, p=0.001, p<0.001). Other data did not change (p>0.05).

Conclusion: Foam rolling is effective in improving elbow JPS in small flexion angles, biceps brachii strength, and some parameters of upper extremity functional motor performance. These effects are maintained 4 weeks after application.
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http://dx.doi.org/10.4085/445-20DOI Listing
February 2021

Reliability and validity of eccentric strength measurement of the shoulder abductor muscles using a hand-held dynamometer.

Phys Ther Sport 2020 May 8;43:52-57. Epub 2020 Feb 8.

Institute of Health Sciences, Dokuz Eylul University, Mithatpasa Street, No:1606, Inciralti Health Campus, Balcova, Izmir, Turkey; Faculty of Health Sciences, Izmir University of Economics, Sakarya Street, No:156, Balcova, Izmir, Turkey. Electronic address:

Objectives: To investigate the validity and intrarater and interrater reliability of eccentric strength testing of the shoulder abductors using a hand-held dynamometer (HHD) versus an isokinetic dynamometer.

Design: Methodological.

Setting: Research laboratory and athletic training room.

Participants: Forty-seven asymptomatic shoulders of 25 participants were tested in 2 sessions by 2 physiotherapists.

Main Outcome Measures: Eccentric strength of the shoulder abductors was measured from 120° to 30° scapular plane abduction using the HHD and isokinetic dynamometer. A gyroscope was used to validate the velocity. Spearman's rank correlation coefficients, intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated.

Results: The measurement protocol showed excellent intrarater (ICC[3,3] = 0.987, SEM = 2.59 Nm and MDC = 7.18 Nm) and interrater (ICC[3,3] = 0.990, SEM = 2.28 Nm and MDC = 6.32 Nm) reliability. HHD and isokinetic dynamometer measurements were strongly correlated (rho = 0.760, p < .001). Velocities during HDD testing were similar to those of the isokinetic dynamometer (30°/s) (p > .050).

Conclusions: Eccentric strength testing of the shoulder abductors using an HHD is a valid and reliable method that can be used for research and clinical purposes when an isokinetic dynamometer cannot be used.
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http://dx.doi.org/10.1016/j.ptsp.2020.02.002DOI Listing
May 2020

Effects of Modified Posterior Shoulder Stretching Exercises on Shoulder Mobility, Pain, and Dysfunction in Patients With Subacromial Impingement Syndrome.

Sports Health 2020 Mar/Apr;12(2):139-148. Epub 2020 Feb 4.

School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.

Background: Posterior shoulder stretching exercises (PSSEs) aim to reduce posterior shoulder tightness (PST). Position modification of traditional PSSEs has been suggested to minimize inadequate control of scapular and glenohumeral rotation, possibly leading to increased subacromial impingement.

Hypothesis: Modified PSSEs will have positive effects on shoulder mobility, pain, and dysfunction.

Study Design: Randomized controlled trial.

Level Of Evidence: Level 1.

Methods: A total of 67 symptomatic patients with subacromial impingement syndrome (SIS) and shoulder internal rotation asymmetry were randomly assigned to 3 groups: modified cross-body stretch (MCS) (n = 22; treatment program + MCS), modified sleeper stretch (MSS) (n = 22; treatment program + MSS), and a control group (n = 23; treatment program consisting of only modalities, range of motion [ROM], and strength training but no PSSEs) for 4 weeks. Pain, PST, shoulder rotation ROM, and dysfunction were evaluated.

Results: Pain, PST, shoulder rotation ROM, function, and disability improved in all groups ( < 0.05). The MCS and MSS groups had better results compared with the control group with regard to pain with activity, internal rotation ROM, function, and disability ( < 0.05). There was no significant difference between the stretching groups ( > 0.05).

Conclusion: All treatments improved pain, shoulder mobility, function, and disability in patients with SIS. However, modified PSSEs in addition to a treatment program was superior to the treatment program alone (without PSSEs) in improving pain with activity, internal rotation ROM, and dysfunction. Moreover, stretching provided clinically significant improvements.

Clinical Relevance: Modified PSSEs, in addition to a treatment program, are beneficial for patients with SIS. Both modified cross-body and sleeper stretches are safe and efficacious for improving shoulder mobility, pain, and dysfunction.
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http://dx.doi.org/10.1177/1941738119900532DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040949PMC
March 2020

Taping to Improve Scapular Dyskinesis, Scapular Upward Rotation, and Pectoralis Minor Length in Overhead Athletes.

J Athl Train 2018 Nov 7;53(11):1063-1070. Epub 2019 Jan 7.

School of Physical Therapy and Rehabilitation, Dokuz Eylül University, İzmir, Turkey.

Context: Deviations in scapular motions and subsequent alterations in associated soft tissues are thought to contribute to overuse shoulder injuries in overhead athletes. Whereas rigid and Kinesio taping are recommended for preventing these injuries, high-level evidence from clinical trials is still needed.

Objective: To determine and compare the short-term effects of rigid and Kinesio taping on scapular dyskinesis, scapular upward rotation, and pectoralis minor length in asymptomatic overhead athletes.

Design: Randomized controlled trial.

Setting: Athletic training rooms.

Patients Or Other Participants: Seventy-two elite asymptomatic overhead athletes (age = 17.00 ± 4.09 years, height = 1.75 ± 0.11 m, mass = 67.26 ± 15.25 kg, body mass index = 21.80 ± 3.00).

Intervention(s): We randomly assigned participants to 1 of 4 groups: rigid taping, Kinesio taping, placebo, or control (no taping). For the first 3 groups, we applied tape to the shoulder and scapular region.

Main Outcome Measure(s): We evaluated all groups for observable scapular dyskinesis using the scapular dyskinesis test, scapular upward rotation using a digital inclinometer, and pectoralis minor length using the pectoralis minor index at baseline, immediately after taping, and at 60 to 72 hours after taping.

Results: The scapular dyskinesis percentage ( P < .05) decreased and the pectoralis minor index ( P < .001) increased immediately and at 60 to 72 hours after taping in the rigid-taping and Kinesio-taping groups. We observed no differences among groups for the change in the pectoralis minor index ( P > .05). Scapular upward rotation did not change after taping in any group ( P > .05).

Conclusions: Rigid or Kinesio taping of the shoulder and scapular region improved scapular dyskinesis and pectoralis minor length but did not alter scapular upward rotation. Short-term rigid and Kinesio taping may help improve scapular dyskinesis and pectoralis minor length in overhead athletes.
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http://dx.doi.org/10.4085/1062-6050-342-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333226PMC
November 2018

The relationship between learning styles and academic performance in TURKISH physiotherapy students.

BMC Med Educ 2018 Dec 4;18(1):291. Epub 2018 Dec 4.

School of Physical Therapy and Rehabilitation, Dokuz Eylul University, 35340, Inciralti, Izmir, Turkey.

Background: Learning style refers to the unique ways an individual processes and retains new information and skills. In this study, we aimed to identify the learning styles of Turkish physiotherapy students and investigate the relationship between academic performance and learning style subscale scores in order to determine whether the learning styles of physiotherapy students could influence academic performance.

Methods: The learning styles of 184 physiotherapy students were determined using the Grasha-Riechmann Student Learning Style Scales. Cumulative grade point average was accepted as a measure of academic performance. The Kruskal-Wallis test was conducted to compare academic performance among the six learning style groups (Independent, Dependent, Competitive, Collaborative, Avoidant, and Participant).

Results: The most common learning style was Collaborative (34.8%). Academic performance was negatively correlated with Avoidant score (p < 0.001, r = - 0.317) and positively correlated with Participant score (p < 0.001, r = 0.400). The academic performance of the Participant learning style group was significantly higher than that of all the other groups (p < 0.003).

Conclusions: Although Turkish physiotherapy students most commonly exhibited a Collaborative learning style, the Participant learning style was associated with significantly higher academic performance. Teaching strategies that encourage more participant-style learning may be effective in increasing academic performance among Turkish physiotherapy students.
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http://dx.doi.org/10.1186/s12909-018-1400-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278061PMC
December 2018

The Turkish version of the MedRisk instrument for measuring patient satisfaction: measurement properties in physical therapy care among inpatients.

Disabil Rehabil 2020 01 6;42(2):247-254. Epub 2018 Sep 6.

School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey.

Our aim was to cross culturally adapt the MedRisk instrument for measuring patient satisfaction with physical therapy care for Turkish-speaking inpatients, provide information about its measurement properties, and determine the socio-demographic factors influencing satisfaction of Turkish patients. This was a cross-sectional, measurement-focused study. The MedRisk instrument for measuring patient satisfaction was translated and adapted into Turkish. Two hundred four inpatients with different health conditions from different units of a large university hospital were assessed using the Turkish version of the MedRisk instrument for measuring patient satisfaction. Forty-two patients were reassessed after 72 h. Construct validity, internal consistency, convergent validity, criterion-referenced validity, floor and ceiling effects, and test-retest reliability were evaluated. Factor analysis showed a two-factor structure. Cronbach's alpha values for the internal consistency ranged between 0.49 and 0.81. Corrected item-total correlations ranged between 0.29 and 0.72. Intraclass correlation coefficients ranged between 0.67 and 0.97, standard errors of measurement ranged between 0.34 and 2.61 points, and substantially good agreement was achieved. Eleven of twelve items were positively correlated with the global measures. No floor or ceiling effects were detected. The satisfaction level of inpatients was high. Our results suggested that the Turkish version of the MedRisk instrument for measuring patient satisfaction is a quite reliable and valid measurement to evaluate patient satisfaction with physical therapy care in Turkish-speaking inpatients. We determined that Turkish inpatients are highly satisfied with their physical therapy care, and they consider the patient-physical therapist relationship important.Implications for rehabilitationThe Turkish version of the MedRisk instrument for measuring patient satisfaction is a reliable and valid translation of the original MedRisk instrument for measuring patient satisfaction.However, it should be noted that three items from the original version were excluded.Clinicians and relevant researchers can use this instrument to evaluate satisfaction with physical therapy care among Turkish-speaking inpatients.
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http://dx.doi.org/10.1080/09638288.2018.1494216DOI Listing
January 2020

Effects of Rigid and Kinesio Taping on Shoulder Rotation Motions, Posterior Shoulder Tightness, and Posture in Overhead Athletes: A Randomized Controlled Trial.

J Sport Rehabil 2019 Mar 14;28(3):256-265. Epub 2018 Jul 14.

Context: Alterations in posture and motion patterns are thought to play a role in developing shoulder injuries in overhead athletes. Taping is widely used in the sporting population, but there are limited empirical data regarding its effectiveness.

Objectives: To determine and compare the effects of rigid and kinesio taping on shoulder rotation motions, posterior shoulder tightness (PST), and posture in overhead athletes.

Design: Randomized controlled trial.

Setting: Athletic training rooms.

Participants: Eighty-six asymptomatic elite overhead athletes.

Interventions: Participants were randomly divided into 4 groups: rigid taping group (RTG) that underwent therapeutic rigid taping, kinesio taping group (KTG) that underwent therapeutic kinesio taping, placebo group that underwent placebo kinesio taping (shoulder and scapular region taping for taping groups), and control group (no taping).

Main Outcome Measures: Shoulder rotation motions, PST, and head and shoulder posture were evaluated at baseline, immediately after application and 60 to 72 hours after application for all groups.

Results: Glenohumeral internal rotation increased immediately (P < .001) and at 60 to 72 hours after application in the KTG (P = .01), whereas it decreased immediately after application in the RTG (P < .001). Immediately after application, total rotation range of motion increased in the KTG (P =.02) and decreased in the RTG (P < .001), and there was a difference between groups (P = .02). Immediately after application, PST increased in the RTG (P < .001); after 60 to 72 hours, it decreased in the KTG (P = .04) and increased in the RTG (P = .01). Posture outcomes did not change significantly (P > .05).

Conclusions: Kinesio taping may improve and rigid taping may worsen glenohumeral internal rotation and PST in overhead athletes. For increasing total rotation range of motion, kinesio taping is superior to rigid taping. Taping did not affect posture. Short-term kinesio taping in overhead athletes may be useful to improve glenohumeral internal rotation, total rotation range of motion, and PST.
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http://dx.doi.org/10.1123/jsr.2017-0047DOI Listing
March 2019

Influence of pectoralis minor and upper trapezius lengths on observable scapular dyskinesis.

Phys Ther Sport 2016 May 24;19:7-13. Epub 2015 Aug 24.

School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Turkey. Electronic address:

Objectives: Although a relationship between short pectoralis minor and upper trapezius and scapular dyskinesis has been postulated, no studies have investigated this theory. Understanding the effect of these muscle lengths on observable scapular dyskinesis may aid in determining risks and therefore making treatment decisions. Being aware of the magnitude of this effect would help gauge the significance of risks involved. Our aim was to evaluate the influence of pectoralis minor and upper trapezius lengths on scapular dyskinesis.

Design: Cross-sectional study.

Setting: University research laboratory.

Participants: Asymptomatic participants (n = 148; 296 arms) were evaluated.

Main Outcome Measures: Scapular Dyskinesis Test (SDT) was used to identify scapular dyskinesis, Pectoralis Minor Index (PMI) and Upper Trapezius Length Testing were used to determine muscle length.

Results: SDT+ arms had shorter pectoralis minor resting length (PMI: 7.49 ± 0.38) (p < 0.001) and greater incidence of short upper trapezius (ISUT) (66.7%) (p < 0.001) compared to SDT- arms (PMI:8.58 ± 0.75, ISUT:22.5%). With each decrease in PMI, the likelihood of having scapular dyskinesis increased 96% (p < 0.001). Arms with short upper trapezius were 2.049 times more likely to exhibit scapular dyskinesis than those with normal length (p = 0.042).

Conclusions: Having a shorter pectoralis minor and upper trapezius length substantially increased the likelihood of having visually observable scapular dyskinesis.
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http://dx.doi.org/10.1016/j.ptsp.2015.08.002DOI Listing
May 2016

Comparison of the effects of virtual reality-based balance exercises and conventional exercises on balance and fall risk in older adults living in nursing homes in Turkey.

Physiother Theory Pract 2016 6;32(3):191-201. Epub 2016 Apr 6.

b Department of Physical Therapy and Rehabilitation , School of Health Sciences, Istanbul Medipol University , Istanbul , Turkey.

Objectives: There is limited information on effective balance training techniques including virtual reality (VR)-based balance exercises in residential settings and no studies have been designed to compare the effects of VR-based balance exercises with conventional balance exercises in older adults living in nursing homes in Turkey. The objective of our study was to investigate the effects of VR-based balance exercises on balance and fall risk in comparison to conventional balance exercises in older adults living in nursing homes.

Methods: A total sample of 18 subjects (65-82 years of age) with fall history who were randomly assigned to either the VR group (Group 1, n = 7) or the conventional exercise group (Group 2, n = 11) completed the exercise training.

Results: In both groups, Berg balance score (BBS), timed up & go duration, and left leg stance and tandem stance duration with eyes closed significantly improved with time (p < 0.05), but changes were similar in both groups (p > 0.05) after training, indicating that neither the exercise method was superior.

Conclusion: Similar improvements were found in balance and fall risk with VR-based balance training and conventional balance training in older adults living in the nursing home. Both exercise trainings can be preferable by health care professionals considering fall prevention. Appropriate patient selection is essential.
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http://dx.doi.org/10.3109/09593985.2015.1138009DOI Listing
January 2017

Prediction of postural sway velocity by foot posture index, foot size and plantar pressure values in unilateral stance.

Eklem Hastalik Cerrahisi 2013 ;24(3):144-8

Dokuz Eylül Üniversity, School of Physical Therapy and Rehabilitation, 35340 İnciraltı, İzmir, Turkey.

Objectives: This study aims to assess whether the plantar pressure, the foot posture index (FPI) and foot size can predict the postural sway velocity in terms of postural stability in unilateral stance.

Patients And Methods: A total of 236 feet of 118 participants (62 males, 56 females; mean age 22.1±3.1 years; range 18 to 36 years) were enrolled. The feet were classified as prone, normal and supine based on the FPI. Postural sway velocity during unilateral stance with eye open (US-EO) and eye closed (US-EC) condition was measured using the Balance Master. Plantar pressure for each foot was measured from 10 different areas using EMED-M pedobarography. The force-time-area (FTA) integral was calculated based on the plantar pressure values, while standardized foot size (SFS) was calculated dividing foot width by foot length. The one-way ANOVA was used to determine differences in postural sway velocity between the groups. Multiple linear regression analysis was used to evaluate the predictability of the postural sway velocity.

Results: The postural sway velocities in US-EO condition were similar among three groups (p>0.05). In the US-EC condition, the highest postural sway velocity in the prone feet and lowest postural sway velocity in the supine feet were measured (p<0.05). There was a significant relationship between the postural sway velocity which was measured in the US-EC condition and SFS (β= 0.141, p<0.05), FTA integral under the hindfoot (β= -0.127, p<0.05) and FPI values (β= 0.246, p<0.05).

Conclusion: The predictive value of FTA integral and SFS parameters for postural sway velocity is lower in unilateral stance. The postural sway velocity is rather associated with FPI and increases by pronation of the foot.
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http://dx.doi.org/10.5606/ehc.2013.32DOI Listing
February 2016