Researcher:
Canbulat, Nazan

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Nazan

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Canbulat

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Canbulat, Nazan

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2014 - 201982020 - 20223

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    Effect of posterior dynamic instrumentation on high-intensity zone in lumbar degenerative disc disease
    (Turkish Neurosurgery Society, 2015) Canbay, Suat; Ataker, Yaprak; Kabaoğlu, Zeynep Ünal; Öktenoğlu, Bekir Tunç; Sasan, Mehdi; Canbulat, Nazan; Özer, Ali Fahir; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 58534; 1022
    Aim: To investigate high-intensity zone (HIZ) changes after lumbar posterior dynamic instrumentation. MaterIal and Methods: Our study included 53 patients: 27 patients in group 1, 26 patients in group 2. All patients had one or two levels of degenerative disc disease with an HIZ confirmed by magnetic resonance imaging (MRI). Group 1 underwent one- or two-level dynamic lumbar posterior instrumentation. Group 2 was treated conservatively with an exercise program. Patients were evaluated using MRI, a numerical visual analog pain scale (VAS), and the Oswestry Disability Index (ODI) at baseline, at 1 year after surgery, and at final follow-up evaluation. Results: The mean duration of follow-up was 49.3 months in group 1 and 47.19 months in group 2. The baseline VAS and ODI scores were similar for both groups. The mean VAS score of group 1 was significantly improved at 1 year after surgery and at final follow-up. The mean ODI value was lower in group 1 than in group 2 at 1 year and at final follow-up. Pfirrmann grades in group 1 significantly differed at 1 year and at final follow-up but did not change in group 2. The number of HIZs significantly decreased in from baseline to 1 year and from baseline to final follow-up in group 1 but did not differ in group 2. ConclusIon: Dynamic lumbar stabilization systems are promising. Observations such as Pfirrmann grade improvements and disappearance of HIZs are concordant with improvements in VAS and ODI scores demonstrate that dynamic stabilization systems may provide an environment for regeneration. / AMAÇ: Lomber posterior dinamik enstrümantasyonun yüksek intensite bölgesi (YİB)’ne etkisini incelemek. YÖNTEM ve GEREÇLER: Çalışmaya 53 hasta dahil edildi; grup 1: 27 hasta, grup 2: 26 hasta. Bütün hastalarda Manyetik Rezonans Görüntüleme (MRG) ile tespit edilen bir veya iki seviyede YİB içeren dejeneratif disk hastalığı vardı. Birinci gruptaki hastalara bir veya iki seviyeli posterior dinamik enstrümantasyon yapıldı. İkinci grup egzersiz tedavisi ile takip edildi. Hastalar MRG, sayısal görsel ağrı skalası (GAS), Oswestry Özürlülük İndeksi (OÖİ) ile tedavi öncesi, cerrahi sonrası 1. yıl ve geç dönemde değerlendirildi. BULGULAR: Birinci grup ortalama 49,3 ay, ikinci grup ise 47,19 ay takip edildi. Başlangıç GAS ve OÖİ ölçümleri her iki grupta benzerdi. Birinci grubun ortalama GAS skoru cerrahi sonrası 1. yıl ve geç dönemde belirgin olarak azaldı. Birinci grubun ortalama OÖİ skoru 1. yıl ve geç takipte 2. Gruba göre daha düşük bulundu. Birinci grubun Pfirrmann evreleri 1. yıl ve geç takipte belirgin olarak değişirken, ikinci grupta değişiklik görülmedi. Birinci gruptaki YİB sayısı ilk değerlendirmeye göre 1. yıl ve geç takipte azalırken, ikinci grupta değişiklik gözlenmedi. SONUÇ: Dinamik lomber stabilizasyon sistemleri ümit vericidir. Pfirrmann evrelerinde görülen gelişim, YİB’nin kaybolması ve bunların GAS ve OÖİ skorlarındaki gelişmeler ile uyumlu olması dinamik stabilizasyon sistemlerinin rejenerasyon için uygun ortam sağlayabileceğini göstermektedir.
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    Radiological assessment of the shoulder region
    (Bayçınar Medical Publ-Bayçınar Tibbi Yayıncılık, 2014) Aydıngöz, Üstün; Canbulat, Nazan; Demirhan, Mehmet; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 58534; 9882
    Imaging plays a key role in the assessment of shoulder problems. Given the wide array of radiological options at the clinician's disposal, selection of proper imaging modalities at different levels or types of shoulder abnormalities may be challenging. We aim in this article to review the various imaging techniques that are available for the evaluation of shoulder problems and to highlight the key points in choosing the relevant imaging examinations. We also mention some of the radiological findings encountered in patients with shoulder problems. Cervical spinal abnormalities, which may sometimes present with shoulder problems, and their imaging assessments are beyond the scope of this review. In many cases, close collaboration with imaging experts is essential in deciding on the imaging approach to shoulder problems in a timely and cost-effective manner. Nevertheless, some imaging algorithms are available for common problems related to the shoulder region.
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    A clinical comparison of home-based and hospital-based exercise programs following arthroscopic capsulolabral repair for anterior shoulder instability
    (Human Kinetics Publ Inc, 2020) Atalar, Ata Can; Eren, Şule Meral; Uçak, Ayla; Çerezci, Önder; N/A; Eren, İlker; Canbulat, Nazan; Demirhan, Mehmet; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; Koc University Hospital; 168021; 58534; 9882
    Context: Ideal rehabilitation method following arthroscopic capsulolabral repair surgery for anterior shoulder instability has not been proven yet. Although rapid or slow protocols were compared previously, home- or hospital-based protocols were not questioned before. Objective: The aim of this prospective unrandomized controlled clinical trial is to compare the clinical outcomes of home-based and hospital-based rehabilitation programs following arthroscopic Bankart repair. Design: Non-randomized controlled trial. Setting: Orthopedics and physical therapy units of a single institution. Patients: Fifty-four patients (49 males and 5 females) with an average age of 30.5 (9.1) years, who underwent arthroscopic capsulolabral repair and met the inclusion criteria, with at least 1-year follow-up were allocated into 2 groups: home-based (n = 33) and hospital-based (n = 21) groups. Interventions: Both groups received identical rehabilitation programs. Patients in the home-based group were called for follow-up every 3 weeks. Patients in the hospital-based group admitted for therapy every other day for a total of 6 to 8 weeks. Both groups were followed identically after the eighth week and the rehabilitation program continued for 6 months. Main Outcome Measures: Clinical outcomes were assessed using Disabilities of Arm Shoulder Hand, Constant, and Rowe scores. Mann-Whitney U test was used to compare the results in both groups. Wilcoxon test was used for determining the progress in each group. Results: Groups were age and gender matched (P= .61, P = .69). Average number of treatment sessions was 13.8 (7.3) for patients in the hospital-based group. Preoperative Disabilities of Ann Shoulder Hand (27.46 [11.81] vs 32.53 [16.42], P= .22), Constant (58.23 [14.23] vs 54.17 [10.46], P = .13), and Rowe (51.72 [15.36] vs 43.81 [19.16], P= .12) scores were similar between groups. Postoperative scores at sixth month were significantly improved in each group (P = .001, P = .001, and P = .001). No significant difference was observed between 2 groups regarding clinical scores in any time point. Conclusions: We have, therefore, concluded that a controlled home-based exercise program is as effective as hospital-based rehabilitation following arthroscopic capsulolabral repair for anterior shoulder instability.
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    Does a core stabilization exercise program have a role on shoulder rehabilitation? a comparative study in young females
    (Bayçınar Medical Publ-Bayçınar Tibbi Yayıncılık, 2018) N/A; N/A; Mısırlıoğlu, Tuğçe Özekli; Eren, İlker; Canbulat, Nazan; Çobanoğlu, Erim; Günerbüyük, Caner; Demirhan, Mehmet; Doctor; Faculty Member; Faculty Member; Undergraduate Student; Teaching Faculty; Faculty Member; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 175999; 168021; 58534; N/A; N/A; 380939; 9882
    Objectives: This study aims to evaluate the effect of core stabilization exercises and to explore the immediate effect of core muscles-activated posture on shoulder maximal voluntary isometric contraction (MVIC) strength. Patients and methods: Between November 2016 and January 2015, a total of 75 healthy female volunteers (mean age 25.36 years; range, 18 to 30 years) were included. of these, 42 consecutive volunteers were assigned as the study group, while the remaining 33 volunteers were assigned as the control group. The study group completed a six-week core stabilization home-based exercise program. Two measurements were performed with six-week interval. A set of three repetitions for each shoulder side was performed by an electronic dynamometer under two conditions: core muscles relaxed and activated. Measurements were monitored real-time with a connected computer and recorded in Newton. Results: The activation of core muscles during the measurement significantly decreased the MVIC values in both groups (p<0.05). The MVIC values significantly increased after home-based exercise program in both conditions (p<0.05). Conclusion: Our study showed that six-week core stabilization exercise program had a significant positive effect on the shoulder MVIC strength. This result may support the use of core stabilization exercises in the early periods of shoulder rehabilitation when the shoulder muscle strengthening exercises are painful.
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    Kinesio taping has no immediate effect on shoulder isometric scapation strength: a study of healthy participants
    (Ios Press, 2019) N/A; N/A; N/A; N/A; N/A; N/A; N/A; Eren, İlker; Canbulat, Nazan; Çobanoğlu, Erim; Sevinç, Tolga Evrim; Mısırlıoğlu, Tuğçe Özekli; Seyahi, Aksel; Demirhan, Mehmet; Faculty Member; Faculty Member; Undergraduate Student; Undergraduate Student; Doctor; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; Koç University Hospital; 168021; 58534; N/A; N/A; 175999; 52082; 9882
    Background: Shoulder function is directly related to scapular kinematics and the scapula has always been a part of shoulder rehabilitation. Kinesio Taping (KT) is a specific taping technique where flexible tapes indirectly stabilize underlying soft tissues to modify their behavior. KT has been utilized for scapular stabilization in shoulder rehabilitation but its effect on shoulder strength was not examined before. Objectives: The aim of this self-controlled therapeutic study was to assess the effect of KT on shoulder scapation (arm elevation in scapular plane) strength in healthy individuals. Methods: This study was conducted on 160 shoulders of 80 healthy volunteers (34 males, 46 females; mean age: 23.8 [18-30]). The shoulder scaption strength was recorded, using an electronic dynamometer, as the maximal value of 3 consecutive measurements in two different forearm positions: 'palm down' and 'empty can'. Two sets of measurements, 3 days apart, were taken. The results of untaped and taped measurements were compared. Scapular taping, dominant side, forearm position, sex, and body mass index (BMI) were analyzed. Results: The test-retest findings of both forearm positions were highly correlated with ICCs ranging 0.978-0.990. There was no significant difference in strength between 'without KT' and 'with KT', 69.46 +/- 26.94 N vs 70.33 +/- 28.01 N, respectively (p = 0.126). In both experimental conditions, forearm position did not affect strength There was no significant difference between the results without and with Kinesio Taping in both forearm positions: p = 0.458 (without), p = 0.141 (with). Dominant side and male sex resulted in superior scores (p = 0.0001) while a positive correlation was calculated between BMI and shoulder strength (p = 0.0001, r = 0.4). CONCLUSIONS: Based on our comparisons, scapular KT does not appear to influence scaption strength in healthy individuals.
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    Rehabilitation after surgery of the spinal deformity
    (Turkish Neurosurgery Society, 2014) Canbulat, Nazan; Faculty Member; School of Medicine; 58534
    The main aim of the rehabilitation programs following surgical correction of spinal deformities is to restore the patient to full function as early as possible without compromising the integrity of the surgical intervention. The most important issue that need to be considered includes avoiding stress on the healing spine by avoiding strengthening exercises or range-of-motion exercises in regions that will apply significant forces to the healing spine. Early mobilization after surgery is important to prevent deconditioning and other secondary postoperative morbidities. The main points of the rehabilitation program include patient education, teaching spine protection principles and avoiding excessive stress on the healing spine. The rehabilitation plan should be based on basic sciences. Osseointegration and tissue healing timelines are important determinants of the rehabilitation program that should be taken into consideration. Core stabilization exercises strengthen the deep muscles of the spine and helps energy transfer of the body. Whole kinetic chain exercises like walking, swimming in addition to core stabilization programs are important parts of the rehabilitation programs. Close communication between surgeon and the rehabilitation team is crucially important during the return of the patient to normal daily activities. / Deformite cerrahisi sonrası rehabilitasyon programının amacı hastayı mümkün olan en kısa zamanda tam fonksiyonel duruma ulaştırmaktır. Bu noktada en önemli mesele, yapılan cerrahi girişimi riske atmadan eklem hareket açıklığı ve kuvvetlendirici egzersiz programlarının planlanmasıdır. Cerrahi sonrası kondüsyon kaybını ve diğer sekonder morbiditeleri önlemek için erken mobilizasyon önemlidir. Rehabilitasyon programı açısından özellikle üzerinde durulması gereken konular, hasta eğitiminin yapılması, omurga koruma prensiplerinin öğretilmesi ve cerrahi sonrası iyileşmekte olan omurgaya aşırı yük bindirecek egzersizlerden kaçınmaktır. Rehabilitasyon planı mutlaka bazı temel bilimlerin üzerine oturtulmadır. Osteoentegrasyon-implantın kemikle bütünleşme-süreci, cerrahi sonrasında egzersizlerin ilerleme hızının da belirleyicisidir. Osteoentegrasyon süreci göz önüne alınmalı, doku iyileşmesinin zaman aralıkları rehabilitasyon uzmanı tarafından iyi bilinmelidir. Core stabilizasyon egzersizleri, omurgayı stabilize eden derin kasları kuvvetlendirir ve vücudun enerji transferine katkıda bulunur Core stabilizasyon egzersizleri ile beraber kinetik zincirin bütününü çalıştıran yürüyüş, yüzme gibi aktiviteler deformite cerrahisi rehabilitasyon programlarının önemli parçalarıdır. Hastanın normal günlük yaşama dönüşü sürecinde cerrah ve rehabilitasyon ekibi arasındaki sürekli iletişim son derece önemlidir.
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    Nonoperative treatment of frozen shoulder: oral glucocorticoids
    (Springer, 2015) Atalar, Ata Can; Eren, Şule Meral; Uçak, Ayla; Canbulat, Nazan; Eren, İlker; Demirhan, Mehmet; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; 58534; 168021; 9882
    The aim of this study was to report our results of glucocorticoid therapy combined with pregabalin and a home exercise program in patients with frozen shoulder.
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    PublicationOpen Access
    A rehabilitation protocol for patients with lumbar degenerative disc disease treated with posterior transpedicular dynamic stabilization
    (Turkish Neurosurgical Society, 2017) Ataker, Yaprak; Çerezci, Önder; Canbulat, Nazan; Öktenoğlu, Bekir Tunç; Sasani, Mehdi; Erçelen, Ömür; Süzer, Süleyman Tuncer; Özer, Ali Fahir; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Koç University Hospital; 58534; N/A; N/A; N/A; 221691; 1022
    AIM: To evaluate the efficacy of the rehabilitation protocol on patients with lumbar degenerative disc disease after posterior transpedicular dynamic stabilization (PTDS) surgery. MATERIAL and METHODS: Patients (n=50) with single level lumbar degenerative disc disease were recruited for this study. Patients had PTDS surgery with hinged screws. A rehabilitation program was applied for all patients. Phase 1 was the preoperative evaluation phase. Phase 2 (active rest phase) was the first 6 weeks after surgery. During phase 3 (minimal movement phase, 6-12 weeks) pelvic tilt exercises initiated. In phase 4 (dynamic phase, 3-6 months) dynamic lumbar stabilization exercises were started. Phase 5 (return to sports phase) began after the 6th month. The primary outcome criteria were the Visual Analogue Pain Score (VAS) and the Oswestry Disability Index (ODI). Patients were evaluated preoperatively, postoperative 3rd, 12th and 24th months. RESULTS: The mean preoperative VAS and ODI scores were 7.52±0.97 and 60.96±8.74, respectively. During the 3rd month, VAS and ODI scores decreased to 2.62±1.05 and 26.2±7.93, respectively. VAS and ODI scores continued to decrease during the 12th month after surgery to 1.4±0.81 and 13.72±6.68, respectively. At the last follow-up (mean 34.1 months) the VAS and ODI scores were found to be 0.68±0.62 and 7.88±3.32, respectively. (p=0.0001). CONCLUSION: The protocol was designed for a postoperative rehabilitation program after PTDS surgery for patients with lumbar degenerative disc disease. The good outcomes are the result of a combination of very careful and restrictive patient selection, surgical technique, and the presented rehabilitation program.
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    PublicationOpen Access
    A clinical comparison of home-based and hospital-based exercise programs following arthroscopic capsulolabral repair for anterior shoulder instability
    (Human Kinetics, 2020) Atalar, Ata Can; Eren, Şule Meral; Uçak, Ayla; Çerezci, Önder; Eren, İlker; Canbulat, Nazan; Demirhan, Mehmet; Faculty Member; Faculty Member; School of Medicine; Koç University Hospital; 168021; 58534; 9882
    Context: ideal rehabilitation method following arthroscopic capsulolabral repair surgery for anterior shoulder instability has not been proven yet. Although rapid or slow protocols were compared previously, home- or hospital-based protocols were not questioned before. Objective: the aim of this prospective unrandomized controlled clinical trial is to compare the clinical outcomes of home-based and hospital-based rehabilitation programs following arthroscopic Bankart repair. Design: non-randomized controlled trial. Setting: orthopedics and physical therapy units of a single institution. Patients: fifty-four patients (49 males and 5 females) with an average age of 30.5 (9.1) years, who underwent arthroscopic capsulolabral repair and met the inclusion criteria, with at least 1-year follow-up were allocated into 2 groups: home-based (n = 33) and hospital-based (n = 21) groups. Interventions: both groups received identical rehabilitation programs. Patients in the home-based group were called for follow-up every 3 weeks. Patients in the hospital-based group admitted for therapy every other day for a total of 6 to 8 weeks. Both groups were followed identically after the eighth week and the rehabilitation program continued for 6 months. Main Outcome Measures: Clinical outcomes were assessed using Disabilities of Arm Shoulder Hand, Constant, and Rowe scores. Mann-Whitney U test was used to compare the results in both groups. Wilcoxon test was used for determining the progress in each group. Results: groups were age and gender matched (P =.61, P =.69). Average number of treatment sessions was 13.8 (7.3) for patients in the hospital-based group. Preoperative Disabilities of Arm Shoulder Hand (27.46 [11.81] vs 32.53 [16.42], P =.22), Constant (58.23 [14.23] vs 54.17 [10.46], P =.13), and Rowe (51.72 [15.36] vs 43.81 [19.16], P =.12) scores were similar between groups. Postoperative scores at sixth month were significantly improved in each group (P =.001, P =.001, and P =.001). No significant difference was observed between 2 groups regarding clinical scores in any time point. Conclusions: we have, therefore, concluded that a controlled home-based exercise program is as effective as hospital-based rehabilitation following arthroscopic capsulolabral repair for anterior shoulder instability.
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    PublicationOpen Access
    Turkish version of the patient-based Constant-Murley Score: its cross-cultural adaptation, validity, reliability and comparison with the clinician-based version
    (Bayçınar Tıbbi Yayıncılık ve Reklam Hizmetleri, 2022) Mısırlıoğlu, Tuğçe Özekli; Eren, İlker; Taşkıran, Özden Özyemişçi; Günerbüyük, Caner; Birsel, Olgar; Canbulat, Nazan; Demirhan, Mehmet; Faculty Member; Teaching Faculty; Faculty Member; Faculty Member; School of Medicine; 168021; 133091; 380939; 202021; 58534; 9892
    Objectives: the aim of this study was to translate, cross-culturally adapt the patient-based Constant-Murley Score (p-CMS), assess its validity, reliability, and compare it with the clinician-based CMS (c-CMS). Patients and methods: this cross-sectional study included a total of 51 shoulders of 46 patients (22 males, 24 females; mean age: 49 +/- 10 years; range, 29 to 70 years) with shoulder pain between December 2015 and July 2016. After translation of p-CMS, each participant was asked to complete the final Turkish version of the p-CMS. The c-CMS was assessed by a physiatrist who was blinded to the p-CMS. Retest of the p-CMS was performed in patients (n=15) who did not receive any treatment between two visits (Days 3 to 5). Results: a total of 51 shoulders (n=5 bilateral shoulder pain) were tested. Strength, subjective, objective, and total scores were significantly different between the p-CMS and c-CMS (p<0.001). Pain scores of the c-CMS and p-CMS revealed similar results with 95% limits of agreement of -3.81 and 4.81. Weighted kappa statistics demonstrated that the levels of agreement ranged between 0.343 and 0.698 in subjective and between 0.379 and 0.515 in objective components. For test-retest reliability of the p-CMS, intraclass correlation coefficient values ranged between 0.838 and 0.995. Conclusion: the Turkish version of the p-CMS has internal consistency and test-retest reliability to evaluate shoulder function in Turkish patients with shoulder pathologies. Considering the differences in test protocols and scoring methods of c-CMS and p-CMS, their interchangeable use is not supported.