Clinical Research Directory

Functional Electrical Stimulation vs Transcutaneous Stimulation in Patients With Subacute Spinal Cord Injury

Cervical spinal cord injuries (SCI) are the most common form of spinal cord injuries within the veteran population. Losing arm function is a major concern with these injuries. Doctors often use a treatment called functional electrical stimulation (FES) during rehab sessions targeted at improving arm and hand function. For FES, clinicians places sticky pads on the skin over the muscles that need to move. A newer treatment, called transcutaneous spinal stimulation (TSS), places the pads on the skin over the spine instead. This study compares the two treatments in veterans with non-traumatic spinal cord injuries while they are in the hospital's rehab program. The main goal is to see how well each treatment improves arm and hand function, which is measured with the Capabilities of Upper Extremity Test. If TSS works well, it could help veterans regain more arm and hand function which may result in increased independence.

Assessment of Upper Extremity Proprioception in Patients With Cervical Radiculopathy

There is no study in the current literature that systematically investigates the extent of upper-extremity proprioceptive impairment in patients with radicular neuropathic symptoms secondary to cervical disc herniation, nor its association with clinical findings. Although existing reviews emphasize proprioceptive deficits in populations with neck pain or cervical spondylosis, no studies specifically address the subgroup of cervical disc-related radiculopathy. This gap in knowledge hinders the integration of proprioceptive assessments with upper-extremity functional outcome measures in diagnostic and rehabilitative processes, suggesting a need for more specific data to guide sensory-motor training approaches. The primary aim of the present study is to assess upper-extremity proprioception in patients with cervical radiculopathy by comparing them with a healthy control group. The secondary aim is to examine the relationship between upper-extremity proprioception and clinical outcomes, including parameters such as pain and functional status.

Transcutaneous Auricular Vagus Nerve Stimulation to Improve Upper Extremity Recovery After Traumatic Brain Injury

Upper extremity weakness, impaired coordination, reduced dexterity, and limited arm and hand use may continue after TBI. Repetitive, task-specific rehabilitation may improve function, but recovery can remain incomplete. taVNS is a non-invasive form of electrical stimulation delivered to part of the outer ear. The stimulation is intended to activate nerve pathways involved in learning and brain plasticity while you practice upper extremity tasks. This pilot study will evaluate safety, tolerability, feasibility, and preliminary effects on upper extremity function and cognition. Up to 40 people will take part at Craig Hospital.

Evaluation of an Adaptive Neurotechnology Based on Motor Imagery in Patients Who Suffered a Left Hemisphere Stroke

This randomized clinical trial will evaluate the feasibility and performance of a co-adaptive motor imagery brain-computer interface (BCI) for upper-limb rehabilitation in adults with subacute left-hemisphere stroke. The study will investigate whether continuous neurofeedback improves BCI control and learning compared with binary feedback based on correct or incorrect task performance. Participants will be randomly assigned to a neurofeedback group or a group receiving binary feedback. The intervention consists of BCI calibration followed by 10 real-time BCI training sessions. EEG and surface EMG signals will be recorded throughout the BCI sessions. BCI performance will be assessed using decoding accuracy and the algorithmic support provided by the Supportive Backward Adaptation (SBA) method, together with motor and neurophysiological measures.

Combined Upper Extremity Resistance and Aerobic Exercise Training in Patients With Breast Cancer

According to updated data from the International Agency for Research on Cancer (IARC) for 2022, breast cancer in women is responsible for one in four cancer cases and one in six cancer deaths worldwide and is the second leading cause of global cancer incidence, accounting for 11.6% of all cancer cases, and the fourth leading cause of cancer deaths worldwide, accounting for 6.9% of all cancer deaths. During or after breast cancer treatments, there is exposure to a variety of direct (local/regional treatment, systemic treatment and supportive care) and indirect factors (modifiable and non-modifiable risk factors) that may have adverse effects on treatment-related haematological, cardiovascular, pulmonary and musculoskeletal components. Upper limb dysfunction and lymphoedema have been reported to be two of the most common side effects affecting the quality of life of breast cancer patients after breast cancer treatments. The elastic resistance band, which is widely used in strength training, has the advantage of being applied to various classes because it provides resistance angles in various postures and has a low risk of injury. However, few studies have been conducted on elastic resistance band application in patients with breast cancer. At the same time, evidence on the effectiveness of upper extremity aerobic exercise training in patients with breast cancer is limited. Therefore, this study aimed to investigate the effects of upper extremity aerobic exercise training combined with progressive resistance training and upper extremity aerobic exercise training alone on upper extremity exercise capacity, upper extremity functionality, sarcopenia, frailty, quality of life and lymphedema in patients with breast cancer.

The Effect of a Muscle-mimicking, Fabric-type Shoulder Orthosis on Functional Movements of the Upper Limb in Patients With Neuromuscular Disorder

The goal of this clinical trial is to investigate the effect of a muscle-mimicking, fabric-type shoulder orthosis on functional movements of the upper limb in patients with neuromuscular disorder. The main questions it aims to answer are: * What is the impact of the muscle-mimicking, fabric-type shoulder orthosis on upper limb functional movements in patients with neuromuscular disorder? * Are there observable differences in upper limb function when the shoulder orthosis is worn versus when it is not? Participants will: * Receive education on how to wear and use the shoulder orthosis. * Undergo evaluations, including assessment of upper limb performance, shoulder muscle strength testing, active range of motion measurements, assessment of functional workspace, goal attainment scale evaluation, surface electromyography, physiological measurements such as blood pressure and heart rate, fatigue assessment, and assessment for any musculoskeletal or skin-related issues. Researchers will compare neuromuscular disorder patients before and while wearing and operating the shoulder orthosis to see if there are any significant effects on variables such as upper limb function, range of motion, functional workspace, goal attainment scale, and surface electromyography.

Anterior Suprascapular and Axillary vs. Interscalene Block for Analgesia and Diaphragmatic Function in Shoulder Surgery

Shoulder surgeries are among the most frequently performed orthopedic interventions and are often associated with moderate to severe postoperative pain. In these procedures, effective pain management is crucial for early rehabilitation and patient comfort. Peripheral nerve blockade is widely used for postoperative analgesia in shoulder surgery. While the interscalene brachial plexus block is considered the gold standard for pain control, it is frequently associated with unintended phrenic nerve blockade, leading to hemidiaphragmatic paresis. To minimize respiratory complications while maintaining effective analgesia, alternative diaphragm-sparing regional anesthesia techniques, such as the combination of suprascapular and axillary nerve blocks, have been introduced. The aim of this study is to compare the analgesic efficacy and respiratory functions preservation of the ultrasound-guided anterior approach suprascapular combined with axillary nerve block versus interscalene block in patients undergoing shoulder surgery

Effect of Kinect Based Upper Extremity Exergaming on Trunk Control and Postural Stability in Stroke Patients

This research study aims to evaluate the effectiveness of Kinect-based upper extremity exergaming in improving trunk control, postural stability, upper limb function, and quality of life among individuals recovering from stroke. A randomized controlled trial will be conducted, enrolling 40 participants between the ages of 40 and 60 years, within three months post-stroke. Participants will be randomly allocated into two groups: one group will receive Kinect-based virtual reality upper limb training, while the other will undergo conventional task-oriented upper extremity rehabilitation. Both groups will additionally receive standard physiotherapy as required. The intervention will span eight weeks, comprising three sessions per week, each lasting 30 to 45 minutes. Outcome measures will be assessed at baseline, at the fourth week, and at the conclusion of the eighth week using validated tools including the Trunk Impairment Scale, Postural Assessment Scale for Stroke Patients (PASS), Modified Functional Reach Test, Fugl-Meyer Assessment for Upper Extremity, Wolf Motor Function Test, and Stroke-Specific Quality of Life Scale. By examining the potential cross-regional benefits of upper limb virtual reality-based training on trunk control and postural stability, this study seeks to contribute to the development of evidence-based, technologically integrated rehabilitation protocols for stroke patients.

Scapula and Upper Extremity Performance in Scoliosis

Adolescent Idiopathic Scoliosis s a three-dimensional spinal deformity that may alter shoulder girdle alignment, scapular orientation, and upper extremity biomechanics. Changes in scapular position can influence arm movement, muscle activation, and overall functional performance. Understanding these relationships is clinically important for developing effective exercise and rehabilitation strategies. The aim of this study is to examine the association between scapular position and upper extremity performance in adolescents diagnosed with Adolescent Idiopathic Scoliosis. Scapular dyskinesis, scapular lateral displacement, and upper limb functional performance will be evaluated and correlated with Cobb angle severity. Findings may help clinicians better understand functional impairments linked to scoliosis and support more targeted rehabilitation programs.

Scapular Muscle Activation and Shoulder Performance in Migraine

Migraine is a significant health problem due to its high prevalence and substantial contribution to disability. Individuals with migraine have been reported to exhibit myofascial trigger points, increased pain sensitivity, and altered muscle activation patterns, particularly in the trapezius muscles. As the upper and middle trapezius muscles play critical roles in scapular stability and movement, alterations in these muscles may affect scapular orientation and upper extremity function. However, studies investigating the relationship between trapezius muscle activation, scapular orientation, and upper extremity performance in individuals with migraine are limited. Therefore, this study aimed to compare trapezius muscle activation, scapular orientation, and upper extremity performance between individuals with and without migraine. We hypothesized that individuals with migraine would exhibit altered upper and middle trapezius muscle activation, impaired scapular orientation, and reduced upper extremity performance compared with healthy controls.

Arm Exercise Capacity and Maximal Oxygen Consumption With Breast Cancer

Breast cancer is the most common type of cancer among women worldwide. The incidence rate has reached approximately 16%. According to 2016 data from the Ministry of Health, the incidence of breast cancer in Turkey is 46.8 per 100,000 people and approximately 17,000 women are diagnosed with breast cancer each year. While breast cancer survival rate is 80% in developed countries, this rate varies between 40-60% in low-middle income countries. Survival can be increased with early diagnosis and more effective treatment methods. However, a wide range of treatment-related complications are observed during and/or after breast cancer treatment. Cancer survivors are exposed to a variety of direct (local/regional therapy, systemic therapy and supportive care) and indirect factors (modifiable and non-modifiable risk factors) that can have adverse effects on pulmonary, cardiovascular, hematologic and musculoskeletal components. Oxygen consumption in cancer patients may be adversely affected by aging, deconditioning, existing comorbidities, cancer pathophysiology and cancer treatments (surgery, radiation, chemotherapy and hormone therapy). Although decreased functional capacity is common after breast cancer treatment, there are few studies evaluating maximal arm exercise capacity with oxygen consumption.

DEVELOPMENT AND PSYCHOMETRIC EVALUATION OF THE NEUROCOGNITIVE UPPER EXTREMITY TESTS: A RELIABILITY AND VALIDITY STUDY

The goal of this observational study is to develop an upper extremity neurocognitive performance test battery, determine its reliability and validity, and investigate the effect of neurocognitive load on test performance in athletes and healthy volunteers aged 18-40. The main questions it aims to answer are: Are the developed upper extremity neurocognitive tests reliable and valid tool for assessment? Does the addition of neurocognitive load significantly affect upper extremity physical performance scores? Are the neurocognitive performance test results related to shoulder rotator cuff muscle strength, rate of force development, and shoulder function? Researchers will compare the neurocognitive performance of athletes to healthy non-athlete individuals to see if the test battery can effectively differentiate between these two groups (discriminative validity). Participants will: Complete demographic forms and questionnaires regarding activity level and shoulder function. Undergo shoulder range of motion and isometric strength/rate of force development assessments. Perform a battery of 4 neurocognitive tests integrated with a light-based reaction system. Perform the same functional tests without neurocognitive load to serve as a baseline for comparison. (Athletes only) Attend additional sessions to evaluate the feasibility of the tests and to assess test-retest reliability with a one-week interval.

Functional Assessment Protocol for the Upper Limb for Pediatric Age

During data acquisition a trained therapist placed reflective markers on the skin of the participants in the selected body landmarks. The participants will be asked to perform five trial for each upper limb of a determinate functional task for each session.

Early Functional Response as a Predictor of Clinical Outcomes in Hand Rehabilitation: A Prospective Feasibility Study Using a Digital Monitoring System

This study investigates whether early changes observed during the first weeks of hand and upper extremity rehabilitation can predict patient outcomes months later. In rehabilitation practice, clinicians make numerous decisions each session regarding exercise type, frequency, duration, and treatment approach. Most of these decisions are currently made without systematic longitudinal data. This study addresses three fundamental questions using data collected during routine clinical care: (1) Can the rate of improvement in the first weeks of treatment predict functional status months later, across both session-based and milestone-based time points? (2) Are there meaningfully different recovery profiles among hand rehabilitation patients? (3) Is there measurable variation in clinical decision-making among patients with similar profiles, and does this variation relate to outcomes? A digital patient monitoring platform developed by the principal investigator, a physiotherapist and academic researcher specializing in hand rehabilitation serves as the data collection infrastructure. The platform records standard clinical assessment measures in a structured format and has been in active clinical use at Hacettepe University prior to this study. For research purposes, the system has been expanded to include structured capture of patient-reported outcomes, patient global impression of change, treatment protocol coding, home exercise adherence, and automated calculation of early response metrics. This is a 12-month prospective observational cohort study enrolling a minimum of 60 patients. Data are stored securely on the university's institutional network. Patients are anonymized using identification codes. The study is subject to Hacettepe University Ethics Committee approval and participant informed consent. Findings are expected to generate evidence supporting data-driven clinical decision-making in rehabilitation and to provide a feasibility foundation for a larger multi-center study.

Shoulder Pain and Function in Individuals With Implantable Cardiac Electronic Devices

The primary aim of our study is to evaluate shoulder pain, range of motion, postural changes, muscle tightness, activities of daily living, upper extremity functional status, and exercise capacity in individuals with Implantable Cardiac Electronic Devices (ICED), during each follow-up visit over a two-year period, and to compare the assessment outcomes according to different types of implantable cardiac electronic devices. The secondary aim of our study is to investigate the factors determining the severity and duration of shoulder pain in these patients.

ICF-Based Effects of PNF and Kinesio Taping on Hand Function in Hemiplegic Stroke

This clinical trial aims to compare the effects of kinesio taping and PNF on hemiplegic hand functions. In addition, the effects of these applications on body structure, activity, and participation will be examined. The main questions it aims to answer are: Do kinesio taping and PNF applications have different effects on hemiplegic hand function? Are kinesio taping and PNF applications effective in body structure, activity, and participation? The researchers will compare the advantages of kinesio taping and PNF applications over each other. Participants: Kinesio taping and/or PNF applications will be applied 3 days a week for 8 weeks. Tests will be performed on the first and last day of the study to evaluate hand functions.

Comparison of Conventional and Retroclavicular Approaches for Ultrasound-guided Infraclavicular Brachial Plexus Block

Forearm and hand surgeries are among the most frequently performed surgical interventions both in trauma patients and electively.In these procedures, alternative anesthesia methods such as general anesthesia, regional intravenous anesthesia, regional peripheral nerve blocks and local anesthesia are available. Peripheral nerve blockade can be used for anesthesia and analgesia.This method allows patients to undergo surgery without general anesthesia and increases patient satisfaction by providing effective analgesia in the postoperative period. The aim of this study was to compare the conventional and retroclavicular approaches to infraclavicular block in patients undergoing forearm and hand surgery.

Scalp Acupuncture Combined With rTMS for Upper Limb Motor Dysfunction in Stroke: A Brain Network Study

This study aims to compare the improvement effects of the rTMS (repetitive transcranial magnetic stimulation) combined with conventional rehabilitation therapy group with the rTMS combined with scalp acupuncture and conventional rehabilitation therapy group. Through statistical analysis of the results obtained from functional near-infrared spectroscopy technology during task states, the investigators elucidate the neuroregulatory mechanism of scalp acupuncture combined with rTMS in improving upper limb motor function in stroke patients under MEP localization, and provide evidence for a more optimal rehabilitation program for post-stroke upper limb motor dysfunction.

Validity and Reliability of 6-minute Pegboard and Ring Test in Patients With Interstitial Lung Disease

Interstitial lung diseases (ILD) are a heterogeneous group of chronic respiratory diseases that cause significant mortality and morbidity worldwide, characterized by diffuse inflammation in the lung parenchyma and vascular structures, can progress to fibrosis, have known or unknown etiology, and can develop secondary to systemic autoimmune connective tissue diseases other than diseases where the primary pathology is in the lung. The 6-minute peg-board and ring test, which was first developed to determine the upper extremity exercise capacity of chronic obstructive pulmonary disease patients, is an exercise test used to evaluate upper extremity functional exercise capacity in different lung diseases. It has been determined that there is no study on the validity and reliability of this test in individuals with ILD.

Comparison of Upper Extremity Functional Performance in Hemophilic and Healthy Children

The goal of this observational study is to evaluate the functional performance of the upper extremity joints (scapula, shoulder, elbow, and wrist) in haemophilic children and compare muscle strength and ADL limitations with healthy children.

Upper Extremity Robot-Assisted Therapy in Stroke Patients

Upper extremity hemiparesis is one of the most common symptoms after stroke. Robot-assisted therapies have been used as an approach to rehabilitation of upper extremity hemiplegia in recent years. Robot-assisted therapy is an approach to post-stroke rehabilitation that uses robotic devices to provide motor or task-oriented training to patients. When the literature is examined, there are studies showing that robot-assisted therapies are similar or superior to conventional methods. In order to provide the most effective rehabilitation approach in upper extremity robots, it is suggested that it may be more accurate to consider the robotic device as a training platform consisting of various therapeutic techniques and principles, not as a tool alone. A robotic system will be used to overcome the disadvantages of the existing robotic systems in the literature such as not providing support to the patient at the time of need, not providing fluidity in shoulder movements by not taking into account the scapulohumeral rhythm in upper extremity movements, long installation times, and ignoring task-oriented training. The system to be used is a self-aligning exoskeleton system for robot-assisted upper extremity rehabilitation. The system provides safe and versatile rehabilitation at increasing intensity and also allows for objective assessments. The aim of this clinical study was to evaluate the efficacy of robot-assisted upper limb rehabilitation in stroke patients.