Clinical Research Directory

Mulligan Techniques for Gait and Pelvic Motion in Short Hamstrings

Various stretching methods have been developed to reduce hamstring tightness and improve flexibility. Static stretching is one of the safest and most common methods used to increase muscle length; however, its effect is temporary and diminishes rapidly. Additionally, such conventional methods can be uncomfortable and require longer periods to yield visible results. Unlike other mobilization procedures, the Mulligan concept is performed while patients execute a resisted muscle contraction or move actively or passively. Distinct from many other manual therapy approaches, this technique is applied within a symptom-free range of motion, which likely enhances its safety. Traction Straight Leg Raise (TSLR) and Bent Leg Raise (BLR) techniques are specific interventions defined by Mulligan. There are limited studies in the literature investigating the effects of these two techniques on hamstring flexibility. However, no study has compared these two techniques in terms of spatiotemporal gait parameters and pelvic oscillations. Therefore, the purpose of this study is to compare the effects of BLR and TSLR techniques applied to individuals with hamstring tightness on hamstring flexibility, spatiotemporal parameters of gait, and pelvic oscillations.

Effectiveness of Dance Therapy in Stroke Patients.

Hemiparesis following a stroke is associated with persistent deficits in postural control, balance, and social participation, especially in the chronic phase. Dance therapy, as a multisensory intervention based on movement, music, and body expression, could promote sensorimotor integration and improve postural stability, complementing conventional physiotherapy. The primary objective of this pilot study is to evaluate the effect of a therapeutic dance program on postural control in individuals with chronic hemiparesis. A secondary objective is to analyze changes in functional balance and gait, as well as subjective satisfaction with the therapy. A controlled study with two parallel groups will be conducted. Sixteen participants with chronic hemiparesis will be recruited (n=8 experimental group; n=8 control group). Both groups will receive standard physiotherapy, but the experimental group will also receive an 8-week therapeutic dance program, with one 30-minute session per week to complement their usual therapy. Pre- and post-intervention assessments will be performed. ThThe experimental group is expected to show a significantly greater improvement in posturographic and clinical parameters compared to the control group. The results could support the implementation of dance therapy as a complementary intervention in community neurorehabilitation programs.

Acute Effects of Oculomotor Exercises on Posturography and Gait Analysis Parameters in Regular Exercisers

This study aims to investigate the acute effects of a single-session oculomotor exercise program on static posturography and gait analysis parameters in healthy individuals who exercise regularly. Postural control and gait are complex sensorimotor functions that depend on the integration of visual, vestibular, somatosensory, and motor systems. Eye movements and gaze stabilization may contribute to postural orientation and locomotor control by influencing visual-vestibular integration, head-eye coordination, and sensorimotor adaptation. However, the immediate effects of short-duration oculomotor exercise programs on postural sway and gait-related parameters in regular exercisers have not been fully clarified. This study is designed as a single-group, within-session, pre-post interventional study. Participants will undergo baseline assessments, complete a single session of oculomotor exercises, and then be reassessed after the intervention in the same testing session. The study population will consist of healthy adults who exercise regularly and meet the predefined eligibility criteria. Individuals with musculoskeletal injury, neurological or vestibular disorders, visual conditions that may affect balance or eye movement performance, or any condition limiting participation in the testing procedures will be excluded. Static posturography will be performed using the HUR SmartBalance BTG4 system to evaluate postural sway under different sensory conditions. Measurements will be obtained during quiet standing with eyes open on a firm surface, eyes closed on a firm surface, eyes open on a foam surface, and eyes closed on a foam surface. The main posturography variables will include sway area, trace length, sway velocity, lateral sway, and anterior-posterior sway. Gait analysis will be performed before and after the intervention using the DIERS Pedogait system. Spatiotemporal, phase-related, and center-of-pressure-based gait parameters will be recorded. These parameters may include step length, stride length, step time, stride time, track width, cadence, stance phase, swing phase, double support, pre-swing, and center-of-pressure-related gait variables. The oculomotor exercise program will include three main components: extraocular eye movement exercises, vestibulo-ocular and cervico-ocular gaze stabilization exercises, and accommodation exercises. During extraocular eye movement exercises, participants will be asked to follow a visual target with eye movements while keeping the head stable. During gaze stabilization exercises, participants will maintain visual fixation on a target while performing controlled head movements and walking steps. During accommodation exercises, participants will alternate focus between a near target and a distant target. The exercises will be performed at different speeds to stimulate oculomotor control, gaze stabilization, and visual focusing mechanisms. The primary outcome of the study is the change in sway area from baseline to the post-intervention assessment. Secondary outcomes include changes in other static posturography parameters and gait analysis variables. By evaluating both postural sway and gait-related outcomes, this study aims to provide preliminary evidence on whether a short oculomotor exercise session may produce immediate changes in postural control and walking characteristics in regular exercisers.

Impact of Forward Head Posture on Postural Stability and Gait Kinematics

1. Evaluate postural stability in subjects with forward head posture versus matching controls. 2. Evaluate gait parameters in subjects with forward head posture versus matching controls. 3. Investigate the correlation between postural stability and kinematic gait parameters in each group.

Technical Evaluation of Commercial IMUs Within Clinical Gait Analysis

A standard clinical gait analysis consists of observing walking with video (2D) or advanced equipment (VICON 3D). This 3D method provides detailed information about the gait pattern, but is time-consuming in implementation and data analysis. There are commercial 3D systems on the market that are used in healthy individuals and in sports. These so-called Inertial Measurement Units (IMUs) may also be suitable for use in the clinic. In this research protocol, the aim is to test the usability of commercial sensors and technically compare them with standard clinical 3D gait analysis in adult patients with a neurological disorder.

Effects of Treadmill-Based Gait Training in Patients With Stroke

Hemiplegia is one of the most common sequelae after stroke. Most patients develop thermal asymmetry between the affected and contralateral sides of the body, as well as an asymmetric gait pattern characterized by differences in the duration of gait cycle phases, step length, cadence, and weight distribution between limbs. These patterns result in reduced aerobic capacity, endurance, energy efficiency, and walking speed, negatively impacting the patient's functional abilities. There are different methodologies for the treatment gait impairments. Among them, treadmill training has been investigated as an effective therapeutic approach to post-stroke rehabilitation. Treadmill gait training may reduce asymmetry between hemibodies in hemiplegic patients. For this reason, our aim is to describe the effects of treadmill training on gait, focusing on its impact on thermal asymmetry, walking speed, aerobic endurance, and the biomechanical and kinematic characteristics of gait. Patients with hemiplegia will undergo treadmill-based gait training to evaluate its influence on the recovery of this sequel of stroke.

Gait Pattern Analysis After Arthroscopic Treament of Osteochondral Defects of Talus

The study will investigate alterations in post-surgical gait patterns among patients who have undergone all arthroscopic microfracture and biological scaffold implementation surgery for the osteochondral lesions of talus. The gait biomechanics of patients scheduled for surgery will be assessed preoperatively using pedobarographic analysis. Subsequent changes in walking biomechanics will be evaluated and interpreted at the 6th postoperative months. Consequently, the impact of the all arthroscopic treatment of osteochondral lesions of talus on walking will be documented.

Validity and Reliability of Gait and Jump Parameters Measured by the iSen Device in Healthy Adults

This study aims to evaluate the validity and reliability of gait and jumping parameters measured with the iSen device in healthy adults. Gait analysis is a valuable tool for assessing general health, cognitive performance, quality of life, and mortality. It is commonly used by clinicians to assess functional limitations resulting from neurological or orthopedic conditions and to guide treatment plans. Traditional gait assessments primarily focus on walking speed, but additional parameters such as step length, step time, and gait symmetry are crucial for a comprehensive analysis. The study will also assess vertical jump performance, which is a surrogate measure of explosive lower limb strength and is commonly used in sports performance and injury prediction. The iSen device, a wearable and affordable sensor, will be compared to the validated BTS G-Walk system to evaluate the accuracy and consistency of its measurements. Participants aged 18-35 with no history of musculoskeletal, neurological, or systemic conditions will be included. The study will be conducted at Gazi University and Kırıkkale University, where participants will undergo assessments of gait and jump performance using both iSen and BTS G-Walk devices. A test-retest reliability protocol will be employed with a seven-day interval between measurements. The results will provide evidence on the suitability of the iSen device for reliable and valid gait and jump measurements in clinical settings

Effect of Sensory Training on Functional Performance, Balance, Gait in Type 2 Diabetic Individuals With Neuropathy

Diabetic peripheral neuropathy (DPN) is a common complication of type 1 and type 2 diabetes. DPN is characterized by significant axonal degeneration and segmental demyelination affecting sensory and motor nerves. The effect of foot sole sensation on gait and balance parameters has been reported in various studies in the literature, however, no study has been found examining the effect of foot sensory training on plantar sensation, functional performance, balance, gait and kinesiophobia in type 2 diabetic individuals with neuropathy. In order to contribute to the literature, 40 type 2 diabetic individuals with neuropathy who applied to the Turgut Ozal Medical Center Endocrinology and Metabolic Diseases Polyclinic will be included in this randomized controlled study. After diabetic foot training is given to all participants, an experimental (20) and a control (20) group will be formed with a sequential random method. Foot sensory training will be given to the experimental group, while no intervention will be made to the control group, and sensory training will be given to the participants who wish after the study is completed. All participants will be evaluated for subscapular sense, functional performance, balance, walking and kinesiophobia at the beginning and end of the training. Subscapular sense will be evaluated with light touch, two-point discrimination and vibration tests. Functional performance evaluation will be made with timed up and go test and timed stair ascent-descend test. Kinesiophobia will be analyzed with Tampa Kinesiophobia Scale, Balance; One-Legged Stand Test and Y balance tests and walking will be analyzed with Kinect V2 camera based software. Physical activity levels will be evaluated with International Physical Activity Questionnaire-Short Form. The data taken into the research will be analyzed with SPSS (Statistical Program in Social Sciences) program. The values belonging to the data will be expressed with percentage, mean and standard deviation, and the significance level (p) will be taken as 0.05 for comparison tests.

Restorative Environments for Gait Therapy with VR

The aim of our study is to investigate the effects of landscapes during gait therapy. The investigators will evaluate the impacts of restorative landscapes as they occur in urban, rural and forest environments. Older people will experience those landscapes using virtual reality (VR) goggles during their gait training. The investigators expect the landscapes to have an effect on the following three aspects: (1) stress reduction, (2) restoration of attention and (3) change in gait parameters. For this purpose, volunteers who are currently inpatient in one of our study centers and already participating in gait therapy will be assigned to a group. The control group will receive the standard therapy. The participants of the intervention groups will receive five additional VR training sessions to the standard therapy. In these sessions, the participants will walk through urban, rural and forest landscapes and perform balance improvement exercises. The five training sessions will take place within ten days. Allocation to the control or intervention groups and their landscapes is random. At the start and end of participation, tests defining stress levels and gait parameters are carried out so that comparisons can be made between before and after treatment. The goal of the study is to find out which type of landscape supports restoration and can therefore contribute to greater gait stability. The investigators expect that improved gait stability will be promoted by stress reduction and increased attention induced by the virtual environments. The investigators are investigating the consequences of repeated application of virtual landscapes and the relationship between the effect of the landscape and the preferences and habits of the study participants.

Role of Gait Analysis in Different Type of Dementia

Aim for the work is the studying of the existence and pattern of gait impairment in pre-dementia and dementia To examine the association between dual decline in gait and cognition

Motor Function Efficacy of Pharmacological Treatments Targeting Energy Metabolism, in Parkinson's Patients

Consistent evidence suggests that mitochondrial dysfunction plays a crucial role in Parkinson¿s disease pathogenesis. Inhibition of complex I of the mitochondrial electron transport chain is sufficient to reproduce biochemical and pathological features of Parkinson¿s Disease in animal models (PD). Alterations of mitochondrial energy metabolism may intervene in PD pathogenesis by inducing inflammation, generation of reactive oxygen species (ROS), and neurodegeneration. The Nuclear factor erythroid 2-related factor 2 (Nrf2) is a regulator both of mitochondrial function and biogenesis, and of cellular resistance to oxidative stress, and may represent a novel target of PD disease-modifying therapies. The aims of the present study are to validate indicators of energy metabolism as biomarkers in PD patients and to evaluate the efficacy of drugs and natural food supplements acting on the Nrf2 pathway in improving motor impairment and Gait in PD patients.