Clinical Research Directory

Effects of Adapted Sports on Balance, Physical Function, and Cognitive Function in Older Adults

This randomized controlled study aims to investigate the effects of adapted sports exercises on balance, physical function, and cognitive function in older adults. Participants will be randomly assigned to an intervention group and a control group. The intervention group will participate in a structured adapted sports exercise program, while the control group will maintain their usual daily activities. Balance, physical performance, and cognitive function will be assessed before and after the intervention period using standardized assessment tools. The findings of this study are expected to contribute to understanding the role of adapted physical activity in improving functional and cognitive health in older adults.

COMMUNITY-BASED POWER TRAINING IN FALLER AND NON-FALLER OLDER ADULTS: A FEASIBILITY AND FALL RISK STUDY.

Aging leads to substantial alterations in the nervous and skeletal muscle systems that ultimately lead to a reduction in "neural drive" and motor performance. While maximal strength starts declining as early as 50 years of age, aging brings even greater reductions in rate of force development and muscle power, that has been shown to be a stronger predictor of functional independence and balance impairments. Falls are a major health concern as one third of adults over 65 years loses balance and falls every year, and based on a published report, the estimated health care costs associated with falls in the European Union is €25 billion. The ability to recover balance declines with aging, where older individuals often recover balance with a greater number of balance recovery steps and non-optimal stepping strategies. In addition, older adults have more difficulty recovering balance in the medio-lateral direction. The hip abductors are fundamental in controlling the motion of the body centre of mass in this direction during weight transfers of standing, stepping, and walking. Furthermore, these muscles appear to be more susceptible to age-related composition and performance declines than other muscles of the lower limbs, especially in individuals at a higher risk for falls. Unfortunately, common balance interventions, such as, functional balance training, Tai-Chi, or dance, have a very limited capacity to reduce the risk of falls in older adults. Interestingly, resistance training is relatively better than the mentioned interventions at reducing this problem. This may come about through mitigating the agerelated neuromuscular performance deficits. However, traditional resistance training lacks the emphasis in high velocity movements required for adequate fall prevention protective stepping strategies. Muscle power training is a safe and effective alternative to traditional resistance training. By emphasizing in maximum speed of execution, its results are often better than with traditional resistance training, especially in functional outcomes, with the potential to enhance balance recovery. However, there is little and inconsistent evidence on the optimal exercise parameters (such as velocity) for prevention of falls. Community-based multi-component exercise programs are often used to promote health and functional benefits in the older adult population. These programs not only have a positive impact in a larger number of communitydwelling individuals, but can also lead to significant improvements. Nonetheless, these programs limited in reducing the risk for falls. Considering the robust effects of muscle power training in the older population, it is conceivable that a multi-component community-based exercise intervention, that focuses on developing muscle power and reduce fall risk, can improve the older individuals' ability to recover balance and consequently, bring greater benefits to the older adult community. However, there is no information on the feasibility of conducting an exercise program to develop muscle power and reduce fall risk in a community-based setting. Furthermore, it is generally unknown if such an exercise intervention can improve function, balance, and reduce the occurrence of falls in older adults especially, among those that have fallen in the past- which are the most relevant target population for both clinical studies and practice.

Virtual Reality-Based Timed Up and Go Test in Young Adults

Functional mobility encompasses the essential motor skills required for individuals to perform activities of daily living independently and safely. One of the most commonly used methods for assessing this parameter is the Timed Up and Go (TUG) test. The TUG test involves standing up from a chair, walking, turning, walking back three meters, and sitting down, and it is a measurement tool that has demonstrated high sensitivity and reliability in clinical practice for evaluating lower extremity function, mobility, and fall risk. However, tests conducted in conventional clinical settings have limitations in terms of standardization due to examiner-related variability, environmental influences, and measurement subjectivity. These factors may lead to measurement errors, particularly when detecting small performance differences. Advances in virtual reality (VR) technology offer an innovative approach to the assessment and training of motor performance by recreating real-life scenarios in a three-dimensional and interactive manner. VR-based systems allow simultaneous observation of motor and cognitive processes while enhancing user motivation and engagement, thereby making the assessment process more dynamic. Recent studies have demonstrated that VR applications are effective tools in neurological rehabilitation, particularly in conditions such as multiple sclerosis (MS), for improving balance, walking speed, and functional mobility. A review of the existing literature reveals that studies evaluating the validity and reliability of VR-based functional tests are limited. Moreover, to date, no study has specifically focused on the validity and reliability of the TUG test in an immersive VR environment for assessing lower extremity functional mobility. Therefore, this study aims to address a significant gap in the literature by being one of the first investigations to examine the validity and reliability of a VR-based version of the TUG test. This study aims to determine the feasibility, validity, and reliability of the TUG test administered in an immersive VR environment in asymptomatic young adults aged 18-30 years. Additionally, the relationships between VR-based TUG outcomes and the 4-Meter Walk Test, the Four Square Step Test, and lower extremity muscle strength measurements will be examined.

Virtual Reality-Based Five-Repetition Sit-to-Stand Test in Young Adults

Lower extremity muscle strength is a fundamental determinant of an individual's ability to maintain functional mobility, preserve balance, and perform activities of daily living independently. One of the methods used for the comprehensive evaluation of these functions is the Five-Repetition Sit-to-Stand (5STS) test, which is considered an effective tool for assessing lower extremity strength, balance, and functional mobility in both healthy individuals and various clinical populations. In this test, participants are required to consecutively stand up from and sit down on a chair five times without using their arms, and the completion time is recorded in seconds to objectively evaluate functional capacity. Due to its simplicity, low cost, and high reliability, the 5STS test is widely used in clinical and research settings. However, functional tests administered in conventional clinical environments may be insufficiently standardized due to factors such as examiner-related variability, measurement errors, and environmental influences. This limitation makes it difficult to detect small performance differences and restricts test repeatability. In recent years, rapidly advancing virtual reality (VR) technology has contributed to overcoming these limitations by offering the potential to digitally standardize measurement processes. VR systems, which recreate real-life scenarios in a three-dimensional and interactive manner, allow for a more comprehensive and objective assessment of motor performance. In addition, by increasing user interaction and reducing observer-related errors, VR enhances clinical validity. One study has reported that the most important advantage of VR in clinical balance assessments is its ability to provide a fully controllable, repeatable, and standardized environment. Similarly, a systematic review found that VR-based exercises resulted in significant improvements in motor skills, balance, and cognitive function, while increasing user engagement and motivation and thereby contributing to more effective rehabilitation outcomes. Current literature indicates that VR technology is increasingly being utilized in physiotherapy and exercise sciences. In one study, the validity and feasibility of a VR adaptation of the Wingate Anaerobic Test were investigated, and it was reported that the VR version produced performance outcomes comparable to the conventional test, while participant satisfaction was significantly higher with the VR-based method. Likewise, another study demonstrated that the VR adaptation of the Six-Minute Pegboard and Ring Test exhibited high levels of validity and reliability. Together, these studies indicate that VR-based functional tests are both feasible and clinically consistent. Despite this, no studies to date have examined the validity and reliability of the Five-Repetition Sit-to-Stand test in an immersive VR environment for assessing lower extremity function. Therefore, the present study aims to determine the validity, reliability, and feasibility of a virtual reality-based Five-Repetition Sit-to-Stand test (5STS-VR) developed on the Meta Quest 3 platform in asymptomatic young adults. Additionally, convergent validity will be evaluated by analyzing the relationships between performance data obtained from the virtual environment and outcomes of the Y-Balance Test and lower extremity muscle strength measurements.

Virtual Reality-Based Functional Mobility Tests in Older Adults

Objective assessment of mobility, balance, and lower extremity function in older adults is of great importance in both clinical practice and scientific research. For this purpose, performance-based tests that can be administered in a short time, are easily repeatable, and have high clinical practicality are widely preferred. These tests provide valuable information about older adults' ability to perform activities of daily living, levels of functional independence, and risk of falls, thereby contributing significantly to both diagnostic processes and treatment planning. One of these tests, the 4-Meter Walk Test (4MWT), is among the simplest and most reliable methods used to assess walking speed in older adults. Gait speed is considered a strong indicator of functional capacity and overall health status in older individuals and is also used as a critical parameter for predicting mortality, morbidity, hospitalization rates, and duration of independent living. Therefore, due to its short administration time, high repeatability, and clinical validity, the 4MWT has become one of the standard assessment tools in the field of geriatrics. Another frequently used assessment tool, the Five-Times Sit-to-Stand Test (5xSTS), is based on measuring the time required for an individual to consecutively stand up from and sit down on a chair five times. This test is closely associated with lower extremity muscle strength, functional independence, and the ability to maintain activities of daily living. In addition, the 5xSTS test is an important clinical tool for identifying muscle weakness and mobility limitations in older adults with a history of falls. Owing to its short administration time, lack of requirement for specialized equipment, and ease of understanding, it is widely used in both clinical settings and field studies. In addition, the Timed Up and Go (TUG) test is considered one of the gold standard methods for the assessment of functional mobility. The test is simple to administer: the time required for an individual to stand up from a chair, walk a specified distance, turn around, and return to sit down is measured. The TUG test not only assesses mobility but is also a reliable and valid method for predicting balance impairments and fall risk. Given that falls represent a major health concern in older adults, data obtained from the TUG test provide valuable guidance for both clinicians and researchers. In recent years, virtual reality (VR)-based assessment methods have attracted increasing attention due to their potential to provide a safe, motivating, and standardized environment, particularly for older adults. In this study, the Meta Quest 3 virtual reality headset and controllers will be used to implement VR-based functional tests. The Meta Quest 3 device features a resolution of 2064 × 2208 pixels per eye, a maximum refresh rate of 120 Hz, and a six-degrees-of-freedom (6 DoF) inside-out tracking system. The device tracks participants' head and body movements in real time and accurately reflects them within the virtual environment. This system does not require external sensors and automatically provides positional tracking in the virtual space. Previous studies have demonstrated that VR applications can produce valid and reliable outcomes when used as digital adaptations of functional tests. However, the validity and reliability of VR adaptations of the 4MWT, 5xSTS, and TUG tests in older adults have not yet been systematically investigated. The rationale of this study is to determine whether VR-based short performance tests can serve as a safer, more easily repeatable, and potentially more accessible alternative to conventional clinical assessments. The findings of this study are expected to provide important evidence supporting the use of VR technology in clinical practice for the assessment of mobility and balance in older adults.

Effects of Task Oriented Circuit Training on Functional Mobility and Activity Participation in Cerebral Palsy

cerebral palsy hemiplegia often experiences motor problems that primarily affect one side of their body. Children with hemiplegia have difficulties in functional activities. Task-Oriented Circuit Training (TOCT) is a high-intensity, progressive intervention designed to improve functional motor skills by engaging individuals in repetitive, task-specific exercis it is randomized control trail conducted with 34 patients included according to inclusion and exclusion criteria. Functional mobility assessed through 6-minute walk test and activity participation evaluated through Child Engagement in Daily Life measurement scale.

Effects of Fun-Core (Child-Friendly Core Stabilization) Exercises on Balance and Functional Mobility in Children With Spastic Cerebral Palsy

A total of 54 children, aged between 6 and 12 years, diagnosed with hemiplegic cerebral palsy and not meeting the exclusion criteria, who registered at the outpatient clinics of the Department of Physical Medicine and Rehabilitation, Istanbul University, Istanbul Faculty of Medicine, between June 1, 2025 and March 1, 2026, were planned to be included in our thesis study, which was planned to be prospective, randomized and single-blind. Children and their parents will be informed verbally and in writing about the study's purpose, duration, and method of implementation, and their informed consent will be obtained. They will be asked to sign an "Informed Consent Form." Patient assessment and follow-up forms will be completed at pre- and post-treatment follow-ups. Patients who meet the inclusion criteria will be numbered according to their order of admission and then randomly assigned to either the intervention or control groups by a computer program. In addition to a brochure showing the number of sets and repetitions to be given to the patients as a standard home exercise program, the Fun-Core video exercise program, designed as a child-friendly core stabilization exercise program to be performed 3 times a week, will be given to the intervention group (G1), and the exercises will be delivered to the participants through a website with special accounts. The control group (G2) will receive a standard home exercise program in brochure format, showing the number of sets and repetitions. The exercise program will be performed at home three times a week for 8 weeks.

LSVT Big and Dual Task Training in Cognitive Impaired Patients

The goal of this study ifs to determine the comparative effects of Lee Silverman voice treatment Big and dual task training on balance, cognition and functional mobility in older adults with cognitive impairment. Perform LSVT big four times in a week for about 4 months. Perform dual task training four times in a week for about 4 months. Complete assessments at baseline, the 4th, 8th, 12th weeks, and a follow-up at the 16th week. Outcome measures include Mini BESTest, MoCA, stroop test and time up and go test. Statistical analyses will assess within-group and between-group effects based on data distribution.