Researcher: Turan, Zeynep
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Turan, Zeynep
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Publication Metadata only Is poliomyelitis sequelae a disadvantage for recovery from Covid-19 ARDS: a case report(Turkish Neuropsychiatry assoc-Turk Noropsikiyatri Dernegi, 2022) N/A; N/A; N/A; N/A; Topaloğlu, Mahir; Turan, Zeynep; Tekin, Süda; Şentürk, Evren; Taşkıran, Özden Özyemişçi; Doctor; Doctor; Faculty Member; Faculty Member; Faculty Member; N/A; N/A; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 42146; 48359; 133091We present a case with acute respiratory distress syndrome due to COVID-19 who had poliomyelitis sequelae. He was hospitalized in the intensive care unit and supported by non-invasive mechanical ventilation for 7 days. IL-6 inhibitor was administered due to cytokine storm. No steroid or sedative agents were administered. Early mobilization was performed in the intensive care unit. one month after discharge, physical examination revealed COVID-19 infection did not cause significant changes in muscle strength and physical performance in this patient with poliomyelitis sequelae. It is important to promote early mobilization in the intensive care unit to prevent post-intensive care syndrome in COVID-19 acute respiratory distress syndrome.Publication Metadata only Physical rehabilitation in intensive care unit in acute respiratory distress syndrome patients with COVID-19(Edizioni Minerva Medica, 2021) N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; Taşkıran, Özden Özyemişçi; Turan, Zeynep; Tekin, Süda; Şentürk, Evren; Topaloğlu, Mahir; Yurdakul, Fatma; Ergönül, Önder; Çakar, Nahit; Faculty Member; Doctor; Faculty Member; Faculty Member; Doctor; Doctor; Faculty Member; Faculty Member; School of Medicine; N/A; School of Medicine; School of Medicine; N/A; N/A; School of Medicine; School of Medicine; KUH Hospital; 133091; N/A; 42146; 48359; N/A; N/A; 110398; 198906Background: The risk of muscle weakness is high in the survivors of acute respiratory distress syndrome with COVID-19 following discharge from intensive care unit. AIM: To evaluate the effects of early rehabilitation program in intensive care unit in patients with acute respiratory distress syndrome secondary to COVID-19. Design: The design of the study is observational. SETTING: The setting of the study is inpatient Population: Thirty-five patients with acute respiratory distress syndrome secondary to COVID-19 were enrolled. Methods: This study was performed in an intensive care unit of a university hospital. Early rehabilitation program consisting of passive or active range of motion exercises and neuromuscular electrical stimulation in addition to standard intensive care (N.=18) compared to standard intensive care (N.=17). Primary outcome was hand grip strength following discharge. RESULTS : Rehab group had higher prevalence of chronic pulmonary diseases and neurologic diseases. There was no difference in hand grip or manual muscle strength following discharge between rehab and non-rehab groups. No adverse event was noted. Conclusions: The results did not support the beneficial effects of early rehabilitation in intensive care unit on improving muscle strength. More patients with pulmonary and neurologic diseases in rehab group might impede the impact of rehabilitation on outcomes. On the other hand, these comorbidities underline the role and need of rehabilitation. It is safe both for the patients and the health care workers when necessary precautions are taken. Clinical Rehabilitation Impact: This study guide how to rehabilitate patients with acute respiratory distress syndrome with COVID-19 during intensive care unit in a safe way.Publication Metadata only Musculoskeletal complaints and associated factors in school children aged between 6 and 13 years in Istanbul during the COVID-19 pandemic: a cross-sectional study(IOS Press BV, 2023) Giray, Esra; Yilmaz Yalcinkaya, Ebru; Taşkıran, Özden Özyemişçi; Topaloğlu, Mahir; Turan, Zeynep; Sakarya, Sibel; Faculty Member; Doctor; Doctor; Faculty Member; School of Medicine; N/A; N/A; School of Medicine; Koç University Hospital; 133091; N/A; N/A; 172028Background: Following the first COVID-19 cases in Turkey, face-to-face education was ceased after March 16, 2020 until the end of the educational year (i.e. June 19, 2020) and education was substituted remotely due to confinement. Objective: This study aims to investigate the frequency of musculoskeletal complaints in school-age children and associated risk factors including reduced physical activity, increased screen time and poor ergonomics conditions in school-age children during the pandemic. Methods: This cross-sectional study included parents or guardians of 960 students aged between 6-13 years old with a non-randomized sampling. A survey was administered consisting of 65 items related with sociodemographic characteristics of the children and family, online education hours, technological device(s) used, screen time, type of physical activity, presence of musculoskeletal problems and poor ergonomics conditions such as incorrect sitting posture. Results: Logistic regression results demonstrated that age, excess weight gain, total daily screen time, smartphone use, incorrect sitting posture were associated with musculoskeletal complaints. Conclusion: The long-term closure of schools due to the pandemic may have led to an increase in musculoskeletal complaints in 6-13 years old children, based on the factors identified in this study, which were excess weight gain, increased screen time and incorrect sitting posture. These findings might help education and health authorities to develop strategies to improve musculoskeletal health of children especially in emergencies such as the pandemic.Publication Metadata only Does hand grip strength decrease in chronic obstructive pulmonary disease exacerbation? a cross-sectional study(Tubitak Scientific & Technical Research Council Turkey, 2019) Erden, Zeynep; Köktürk, Nurdan; Kaymak Karataş, Gülçin; N/A; Turan, Zeynep; Taşkıran, Özden Özyemişçi; Doctor; Faculty Member; N/A; School of Medicine; Koç University Hospital; N/A; 133091Background/Aim: Respiratory and peripheral muscle strength are reduced in chronic obstructive pulmonary disease (COPD). There is a well-known correlation between handgrip strength (HGS) and strenght extremity muscles. Our aim in this study was to measure HGS and investigate the related factors in COPD patients with exacerbation. Materials and Methods: Subjects with COPD exacerbation (n = 101) and stable COPD (n = 22), and subjects without COPD (n = 201), were enrolled in this study. Age, sex, and body mass index were similar. HGS was measured using a Vigorimeter. Pulmonary function tests and 6-min walk tests were performed. Results: The mean HGS was significantly lower in subjects with COPD exacerbation than those with stable COPD and subjects without COPD. The mean HGS was similar between stable COPD and non-COPD subjects. The mean 6-min walk distance (6MWD) was significantly lower in subjects with COPD exacerbation than stable COPD. There was a significant correlation between HGS and 6MWD but no correlation between HGS and pulmonary function tests. Conclusion: In subjects with COPD exacerbation, the HGS was lower than that of stable COPD patients, and this difference was not explained by age, comorbidities, severity of obstruction, or smoking. Physical inactivity and steroid use during exacerbation might be possible factors affecting HGS. HGS was moderately correlated with 6MWD in cases of exacerbation. It may be used as a measure of muscle performance in COPD exacerbation, especially when the 6-min walk test cannot be performed.Publication Metadata only Does neuromuscular electrical stimulation have an additive effect on disability, pain and abdominal and lumbar muscle thickness in chronic low back pain? - a randomized controlled double-blind study(2022) Coşkunsu, Dilber Karagözoğlu; N/A; Atlı, Ecenur; Turan, Zeynep; Taşkıran, Özden Özyemişçi; Doctor; Doctor; Faculty Member; N/A; N/A; School of Medicine; Koc University Hospital; N/A; N/A; 133091N/APublication Metadata only Validity, inter-rater reliability, and feasibility of the chelsea physical assessment tool for assessing physical function in post-acute covid-19 patients: a cross-sectional study(IOS Press, 2022) Giray, Esra; Öke, Deniz; Curci, Claudio; De Sire, Alessandro; N/A; Turan, Zeynep; Topaloğlu, Mahir; Baygül, Arzu Eden; Taşkıran, Özden Özyemişçi; Doctor; Doctor; Faculty Member; Faculty Member; N/A; N/A; School of Medicine; School of Medicine; Koç University Hospital; Koç University Hospital; N/A; N/A; 272290; 133091Background: Various tools have been created to measure physical function during intensive care unit (ICU) stay and after ICU discharge, but those have not been validated in coronavirus 2019 (COVID-19) patients. There is a need for a reliable, valid and feasible tool to define the rehabilitation needs of post-ICU COVID-19 patients entering the acute wards and then rehabilitation clinics. Objective: this study aims to investigate the validity, inter-rater reliability and feasibility of Chelsea Physical Assessment Tool (CPAx) in assessing the functional status of COVID-19 patients after discharge from the ICU. Methods: Demographic and clinical characteristics of the patients were recorded. Patients were evaluated using the modified Medical Research Council (MRC) dyspnea scale, Functional Oral Intake Scale, Glasgow Coma Scale, CPAx, Barthel Index, Katz Index and MRC sum score, measurements of grip strength obtained by dynamometer, the 5 time sit-to-stand test and 30 seconds and sit-to-stand test. CPAx and the other functional assessment tools were administered to 16 patients within 48 hours following ICU discharge. For inter-rater reliability, another physiatrist independently re-assessed the patients. MRC sum score, Barthel and Katz indexes were used to assess construct validity of CPAx. The discriminative validity of CPAx was determined by its ability to differentiate between patients with and without ICU acquired muscle weakness based on MRC sum score. The intra-class correlation coefficients (ICC) were calculated to determine inter-rater reliability for total scores of the functional assessment tools. Cohen's Kappa (kappa) coefficient and weighed Kappa (kappa(w)) were calculated to determine inter-rater reliability of individual CPAx items. Ceiling and flooring effects were calculated by percentage frequency of lowest or highest possible score achieved. The number and percentages of the patients who were able to complete each tool were calculated to assess feasibility. Results: The CPAx score was strongly correlated with MRC sum score (rho: 0.83), Barthel Index (rho: 0.87) and Katz Index (rho: 0.89) (p < 0.001) showing construct validity. Area under the ROC curve demonstrated that cut off score for CPAx was <= 12 to discriminate patients with MRC sum score < 48, with a sensitivity and a specificity of 100% and 63%, respectively (AUC = 0.859, p < 0.001). ICC was high for CPAx, MRC sum score, Barthel and Katz indexes, Glasgow Coma Scale, and hand grip strength measurement, with the highest value observed for CPAx (ICC, 0.96; 95% confidence interval (CI), 0.71-0.98). kappa and kappa(w) analysis showed good to excellent inter-rater reliability for individual CPAx items. No floor or ceiling effect was observed at CPAx while floor effect was observed at Barthel Index scores (25%) and Katz Index scores (37.5%). All patients could be evaluated using CPAx while less were physically able to complete the 5 time sit-to-stand, 30 seconds sit-to-stand tests (n = 4) and MRC sum score (n = 14). Conclusion: CPAx is a valid, reliable, and feasible tool to assess the physical functional state in COVID-19 patients following discharge from the ICU.Publication Open Access Peripheral axonal excitability in hemiplegia related to subacute stroke(TÜBİTAK, 2020) Zinnuroğlu, Murat; Turan, Zeynep; Doctor; Koç University HospitalBackground/aim: this study aims to investigate peripheral nerve excitability in patients with subacute stroke. Materials and methods: the study was performed in 29 stroke patients within the subacute period and 29 healthy controls using QTRAC software and TRONDNF protocol. The threshold electrotonus, recovery cycle, stimulus-response, strength-duration, and current-threshold relationships were recorded. Results: the membrane was more hyperpolarized, and excitability was decreased in the hemiplegic side. The impairment of inward rectifying channel function, degree of hyperpolarization, and decrease of excitability were directly related to the Brunnstrom stages, which were more pronounced in lower stages. Conclusion: the lower motor neurons were affected at the level of axonal channels as a result of upper motor neuron lesions. It can be due to dying back neuropathy, homeostasis, and neurovascular regulation changes in the axonal environment, activity-dependent plastic changes, loss of drive coining from the central nervous system, or a combination of these factors.Publication Open Access Is tele-rehabilitation superior to home exercise program in COVID-19 survivors following discharge from intensive care unit? - a study protocol of a randomized controlled trial(Wiley, 2021) Turan, Zeynep; Topaloğlu, Mahir; Taşkıran, Özden Özyemişçi; Doctor; Doctor; School of Medicine; Koç University Hospital; N/A; N/A; 133091Background and purpose: evaluating the patients with COVID-19 following discharge from intensive care unit for pulmonary rehabilitation is crucial. It could be difficult to participate rehabilitation program due to transportation problems and cautions for contagiousness. Tele-rehabilitation could serve as a favorable alternative. The primary aim of this study is to investigate whether supervised tele-rehabilitation is superior to home exercise program regarding walking distance and secondarily muscle strength, muscle endurance, quality of life, physical activity level and perceived respiratory disability. Methods: this is a randomized assessor blinded control trial with two groups; tele-rehabilitation and home exercise. One hundred twenty-two COVID-19 survivors following discharge from intensive care unit will be allocated into two groups. The tele-rehabilitation group will receive breathing, aerobic, posture, stretching, strengthening exercises at their home under remote supervision via Internet for 3 days/week for 10 weeks. Home exercise group will receive the same program at their home on their own and they will be called weekly. The patients will be evaluated at the beginning, at the end of the program, 6th and 12th months following the rehabilitation. The primary outcome is the change in 6-minute walking distance; the secondary outcomes are changes in quality of life, physical function, health status, dyspnea and muscle strength. Impact statement: this detailed description of the rehabilitation protocol will guide to plan the rehabilitation program and help how to design an efficacy study comparing different models of rehabilitation in COVID-19 survivors following discharge from intensive care unit with evidence-based contribution to the literature.Publication Open Access What is the effectiveness and adverse event data of transcutaneous electrical nerve stimulation (TENS) in reducing pain in adults with chronic pain? an overview of Cochrane Reviews summary with commentary(Bayçınar Tıbbi Yayıncılık ve Reklam Hizmetleri, 2020) Turan, Zeynep; Topaloğlu, Mahir; Taşkıran, Özden Özyemişçi; Doctor; Doctor; School of Medicine; Koç University Hospital; N/A; N/A; 133091Publication Open Access Medical Research Council-sumscore: a tool for evaluating muscle weakness in patients with post-intensive care syndrome(BioMed Central, 2020) Turan, Zeynep; Topaloğlu, Mahir; Taşkıran, Özden Özyemişçi; Doctor; Doctor; School of Medicine; Koç University Hospital; N/A; N/A; 133091