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Amaç: Bu çalışmanın amacı kadınlarda menstrüel ağrı şiddetinin vücut farkındalığı, fiziksel aktivite düzeyi ve duyu organizasyonu üzerine etkisini incelemekti. Yöntem: Çalışmaya 18-30 yaş arası menstrüel ağrısı olan kadınlar dahil edildi. Katılımcılar görsel analog skalasına göre hafif (n=47), orta (n=28) ve şiddetli (n=18) menstrüel ağrı grubu olmak üzere toplam üç gruba ayrıldı. Katılımcılara Vücut Farkındalığı Anketi (VFA) ve Uluslararası Fiziksel Aktivite Anketi–kısa form (UFAA) uygulandı. Katılımcıların somatosensoriyel, görsel ve vestibüler duyu organizasyonları bilgisayarlı dinamik postürografi ile incelendi. Tüm değerlendirmeler menstrüasyon sırasında uygulandı. Bulgular: VFA ve UFAA açısından; şiddetli ağrı grubu hafif ve orta şiddetli ağrı gruplarından ve orta şiddetli ağrı grubu ise hafif ağrı grubundan daha düşük puana sahipti (p

The aim of this study was to determine whether there is a difference in postural control between nulligravida women and women who have given birth by vaginal or cesarean section.Women who had only vaginal delivery in the previous 1-3 years were included in the vaginal delivery group (n = 27), those who had only cesarean delivery in the previous 1-3 years were included in the cesarean section group (n = 28), and those who had never given birth were included in the control group (n = 32). Evaluations were administered 6-8 days after the ovulation phase. Postural control of the participants was evaluated with the computerized dynamic posturography device.A total of 87 women with a mean age of 29.4 ± 4 years and a mean body mass index of 24.1 ± 3.1 kg/mIt was observed that women who birthed with vaginal or cesarean delivery had impaired somatosensory postural control. There is definitely a need for further studies with a long-term follow-up examining the effects of postural control during pregnancy and the postpartum period.

Sağlık alanında her kademede geçerliliği olan sağlık okuryazarlığı kavramının kişilerin tam iyilik haline katkısı yadsınamaz bir gerçektir. DSÖ, 1974’lü yıllarda sağlık okuryazarlığını “Bireylerin, hayatlarını sağlıklı geçirebilmeleri için sağlığın korunması ve sağlıklı halin sürdürülmesi için bir bireyin sağlık bilgisine ulaşma, anlama ve kullanma becerilerinin hepsi” olarak tanımlamıştır (1,2). Birinci basamak sağlık hizmetlerinden üçüncü basamak ve palyatif hizmetlere kadar tüm basamaklar sağlık okuryazarlığından beslenebilmektedir. Bu sebeple sağlık okuryazarlık düzeyinin düşük veya yetersiz olması sağlık sistemini olumsuz etkileyebilmektedir. Birinci basamak sağlık hizmetlerinin bileşenlerinden birisi de koruyucu sağlık hizmetleridir. Risk faktörleri yokken ve/veya varken, hastalıkları erken zamanda tespit etmek ve erken tedavi etmek gibi hizmetlerin hepsine koruyucu sağlık hizmetleri denir. Kanser taramaları da en önemli koruyucu sağlık hizmetlerinden biridir. Kanserlerin mortalite ve morbidite düzeylerinin yüksek olmasıyla beraber erkenden tanımlanabilmesi de mümkündür. Bu sebeple kanser tarama programları hem bireysel hem de toplumsal sağlık açısından önem arz eder. Yetersiz düzeyde sağlık okuryazarlığı koruyucu sağlık hizmetlerinde de aksamalara sebep olmaktadır. Sağlık okuryazarlık düzeyi yetersiz olan bireylerin daha az oranda kanser tarama programlarına başvurmaları hem bireysel sağlık hem de toplumsal sağlık hem de maliyet açısından sosyal sağlıkta olumsuz sonuçları beraberinde getirmektedir.

Purpose The aims of this study were to investigate if/how the presence of lymphedema affects the sensation of the upper limb and to assess whether complex decongestive physiotherapy (CDP) has a favorable impact on sensory testing. Methods A total of 27 patients with unilateral stage 2 breast cancer–related lymphedema (BCRL) were included in the study. Bilateral circumferential measurements were taken with a tape measure at different levels. Based on these measurements, limb volumes were determined by summing segment volumes derived from the truncated cone formula. Circumferential measurements and ultrasonographic evaluations (epidermis, dermis, and subcutaneous fat thicknesses) were performed at 10 cm distal to the elbow crease. The Semmes–Weinstein monofilament (SWM), static and moving two-point discrimination, pressure pain threshold (PPT), and tactile localization tests were also applied at the same site. After an initial evaluation, all patients underwent CDP phase 1 program. All the evaluations were repeated at the end of the treatment period. Results Before CDP, affected sides had significantly higher values than the unaffected sides in terms of SWM (p

Introduction: Urinary incontinence (UI) is a common pelvic floor dysfunction in pregnancy. The relationship between biomechanical changes and pregnancy-related UI has not been fully elucidated. Objective: To investigate the association of various musculoskeletal and anthropometric changes in pregnancy that affect gestational UI. Methods: The study was conducted with 275 pregnant women. Ninety-three, 110 and 72 women were in first, second and third trimesters, respectively. Incontinence Impact Questionnaire for UI, Urogenital Distress Inventory-Short Form and Incontinence Severity Index were applied. Lumbar lordosis measurement was performed by Baseline Bubble Inclinometer while diastasis recti abdominis (DRA) measurement was carried out by finger-width method. Manual muscle test for rectus abdominis and right and left external oblique abdominal muscles, and Benign joint hypermobility test with Beighton scoring method were also applied as musculoskeletal measurements. Tape measurement at the waist, umbilical and hip levels, caliper with bi-iliac and bi-trochanteric diameters were also recorded as anthropometric measurements. Results: Significant associated factors for UI were: umbilical DRA (OR = 1.57; p = .012); rectus abdominis muscle strength (values of 3 and below, OR = 1.2; p = .014); umbilical environment (OR = 1.1; p = .029); bi-iliac diameter (OR = 1.1; p = .05;) and bi-trochanteric diameter (OR = 1.3; p = .05), respectively. Conclusion: Changing musculoskeletal and anthropometric characteristics of pregnant women should be taken into consideration in UI follow-up during pregnancy.

The aim of the present study was to determine and compare the effects of connective tissue manipulation (CTM) and abdominal massage when combined with usual care on the symptoms of constipation and quality of life (QoL) immediately following a 4-week treatment in patients suffering from chronic constipation.A total of 60 patients with chronic constipation were randomly assigned to CTM, abdominal massage, or control groups. Connective tissue manipulation and abdominal massage were conducted at 5 sessions a week for 4 weeks. Each session was approximately 15 to 20 minutes. The severity of constipation by the Constipation Severity Instrument, symptoms of constipation by a bowel diary and Bristol Stool Scale, and QoL by patient assessment of QoL questionnaire were evaluated at baseline and at the end of 4 weeks.There were significant differences in the changes in constipation severity (P.001), symptoms of constipation (P ≤ .001), and QoL (P.001) among the 3 groups. However, based on pair-wise analysis, there were no significant differences in the changes of the severity and symptoms of constipation and QoL between the CTM and abdominal massage groups (P.05).The findings of the present study revealed that compared to usual care alone, the combination of usual care and CTM or abdominal massage may be more beneficial for chronic constipation. However, the superiority of CTM or abdominal massage was not observed. Further high-quality studies with long-term follow-up are needed to investigate the optimal massage therapy program in patients with chronic constipation.

Objective: The aim of the present study was to compare the differences in symptom distress, quality of life, and pelvic floor muscle function among Turkish women with mild, moderate, or severe urinary incontinence.Study design: One hundred and twenty women with a diagnosis of urinary incontinence (54.2% stress urinary incontinence and 45.8% mixed-urinary incontinence) participated in the present study. The severity of the urinary incontinence was stratified by the Incontinence Severity Index. The Turkish versions of the Urinary Distress Inventory-6 and the Incontinence Impact Questionnaire-7 were used to assess symptom distress and quality of life, respectively. Pelvic floor muscle strength and endurance were measured using a non-invasive vaginal perineometer.Results: Symptom distress and quality of life significantly differed among the mild, moderate, and severe urinary incontinence groups (p

Background: Evaluation of physical activity by condition-specific surveys provides more accurate results than generic physical activity questionnaires. The aim of this study was to investigate the reliability and validity of the Kaiser Physical Activity Survey (KPAS) in Turkish pregnant women. Methods: In the translation and cultural adaptation of the KPAS, the 6-phase guidelines recommended in the literature were followed. The study included a total of 151 pregnant women who were assessed using the Turkish version of KPAS, the Pregnancy Physical Activity Questionnaire, and the SenseWear Pro3 Armband. To determine the test–retest reliability, the KPAS was reapplied after 7 days. The psychometric properties of KPAS were analyzed with respect to internal consistency, test–retest reliability, and concurrent validity. Results: Cronbach α coefficient indicating the internal consistency of the Turkish KPAS was found to be .60 to .80, showing moderate reliability. The intraclass correlation coefficient for test–retest reliability was very strong (intraclass correlation coefficient: .96–.98). The total KPAS scores were found to be moderately correlated with the total Pregnancy Physical Activity Questionnaire score and the total energy expenditure value on the SenseWear Pro3 Armband. Conclusions: This study showed that KPAS is a valid and reliable instrument for evaluating physical activity in Turkish pregnant women in different aspects.

Amaç: Bu çalışmanın amacı, meme kanseri tedavisi ile ilişkili hafif, orta ve şiddetli lenfödemi olan hasta grupları arasında yaşam kalitesi, üst ekstremitenin fonksiyonel durumu ve fiziksel aktivite düzeyindeki karşılaştırmaktı. Gereç ve Yöntemler: Bu çalışmaya, meme kanseri tedavisi ile ilişkili lenfödem tanısı olan 83 kadın (% 24 hafif, % 41 orta, % 35 şiddetli) katıldı. Lenfödemin varlığı ve şiddeti çevre ölçümü ile belirlendi. Lenfödem Yaşam Kalite Ölçeği (LYKÖ), Kol, Omuz ve El Sorunları Anketi’nin kısa versiyonu (DASH) ve Uluslararası Fiziksel Aktivite Anketi’nin kısa formu (UFAA-KF), sırasıyla yaşam kalitesi, üst ekstremitenin fonksiyonel durumu ve fiziksel aktivite düzeyinin değerlendirilmesi için kullanıldı. Bulgular: Hafif, orta ve şiddetli lenfödemi olan hastalar arasında yaşam kalitesi ve üst ekstremitenin fonksiyonel durumu açısından istatistiksel olarak anlamlı fark vardı (p0.05). İkili analizlerin sonuçlarına göre, şiddetli lenfödemi olan hastalarda, yaşam kalitesinin fonksiyon, görünüm ve semptom alt alanlarının ve üst ekstremitenin fonksiyonel durumunun hafif derecede lenfödemi olan hastalara göre daha fazla etkilendiği bulundu (p

BACKGROUND Health-related quality of life is measured to detect the influence of lymphedema on physical, functional, and social aspects of life in patients with breast cancer-related lymphedema (BCRL). OBJECTIVE This study aimed to perform the psychometric evaluation of the Lymphedema Life Impact Scale (LLIS) in Turkish patients with BCRL. METHODS Patients with BCRL (n = 78) filled out the Turkish LLIS, Lymphedema Quality of Life, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and Quick Disability of Arm, Shoulder and Hand scales. Breast cancer survivors without BCRL (n = 35) completed only the Turkish LLIS. Psychometric properties were analyzed with the internal consistency, test-rest reliability, construct, criterion, and discriminant validity. RESULTS The internal consistency of the Turkish LLIS was strong (Cronbach's α coefficient >.70). Test-retest reliability was strong to very strong (intraclass correlation coefficients from 0.88 to 0.93; P < .001). Similar to the original structure of the scale, exploratory factor analysis identified 3 factors. Criterion validity was supported by moderate to strong correlations between the LLIS, Lymphedema Quality of Life, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and quick Disability of Arm, Shoulder and Hand. There were significant differences in the total and subscale scores of the LLIS between participants with and without BCRL (P < .05). CONCLUSIONS The present study provided the evidence to confirm reliability and clinical validity of the Turkish LLIS. IMPLICATIONS OF PRACTICE The Turkish LLIS is a reliable and valid condition-specific scale to measure the physical, functional, and psychological aspects of health-related quality of life in patients with BCRL.

Aim To evaluate the short-term effectiveness of connective tissue manipulation (CTM) for relieving menstrual pain and symptoms in primary dysmenorrhea (PD). Methods Forty-four women with PD were randomly assigned to treatment (n = 21) or control group (n = 23). While the control group was given only advising, the treatment group additionally received CTM. The primary outcome was the menstrual pain intensity by Visual Analogue Scale. Secondary outcomes included the number of pain medications, menstrual pain catastrophizing by Pain Catastrophizing Scale (PCS), menstrual symptoms by Menstrual Symptom Questionnaire (MSQ) and menstrual attitude by Menstrual Attitude Questionnaire (MAQ). Results Compared with the control group, CTM group showed statistically significant improvement in pain, medication use, PCS, MSQ (p = 0.001) and in the perception of menstruation as a natural event (p = 0.029). However, no significant differences were detected between groups for some aspects of MAQ (p > 0.05). Conclusions CTM seems to be an effective approach in the short-term in PD.

Purpose: The aim of this study was to investigate if/how the presence of lymphedema affected the sensation of the upper limb, and to assess whether complex decongestive physiotherapy (CDP) had a favorable impact on the sensory testings.Methods: A total of 27 patients with unilateral stage 2 breast cancer related lymphedema (BCRL) were included in the study. Bilateral ultrasonographic (epidermis, dermis, and subcutaneous fat thicknesses) and circumferential measurements were peformed at 10 cm distal to the elbow crease. Semmes-Weinstein monofilament (SWM), static and moving two-point discrimination, pressure pain threshold (PPT) and tactile localization tests were also applied at the same site. After their initial evaluation, all patients underwent CDP phase 1 program (five times a week, for three weeks). All the evaluations were repeated at the end of their treatment as well.Results: Before CDP, affected sides had significantly higher values than the unaffected sides in terms of SWM (pConclusion: BCRL seem to reduce light touch, static and moving two-point discrimination, PPT and tactile localization sensations whereas CDP seems to improve these sensory perceptions in women with BCRL. Of note, ultrasonographic measurements also appear to be promising for prompt and convenient follow up in the management of these patients. Clinical Trial Registration Number: NCT04296929Date of registration: March 5, 2020

The purpose of this study was to adapt the Pregnancy Sexual Response Inventory (PSRI) into Turkish and to determine the psychometric properties for pregnant women. A total of 139 pregnant women were included in the study. The psychometric features of the questionnaire were analyzed in terms of internal consistency, test–retest reliability, content and criterion validity. The Turkish version of the PSRI and the Female Sexual Function Index (FSFI) was completed by the pregnant women. Criterion validity was tested by measuring the correlations between the total and subscale scores of the PSRI and the FSFI. The test–retest reliability of the Turkish PSRI was found to be moderate to very strong (ICC = 0.57–0.96, p

Objective: The aim of this case report was to describe the use of complete decongestive therapy (CDT) with a new approach in the management of a male patient with facial edema related to Morbus Morbihan Syndrome (MMS). Methods: An 18-year-old male patient with MMS after acne treatment was the subject of this case report. Volume assessment was performed with distance measurements of the facial area using standard reference points, the overflow method, and the measurement of the percentage of subdermal fluid. Patient-reported symptoms of lymphedema (feeling of swelling and tightness) and body image perception were evaluated with the “Visual Analogue Scale (VAS)”, and the severity of anxiety was evaluated with the “State and Trait Anxiety Inventory (STAI)”. In addition, the patient’s perception of improvement was determined using a Likert-type scale. Evaluations were performed at baseline, week-4 (during the treatment) and week-8 (immediately after treatment). CDT was applied to the patient in a total of 24 sessions, 3 days a week for 8 weeks. Results: Compared to the baseline measurement, the facial distances (tragus-mental cavity, tragus-mouth corner, mandibula-nasal canal, mandibula-internal orbita, mandibula-external orbita, mental cavity-internal orbita, mental cavity-mandibula, right–left tragus, and hairline in the forehead-mental cavity), the volume and the percentage of subdermal fluid of facial area were found to be decreased at the 4th and 8th week measurements. The anxiety score, patient reports of feelings of swelling and tightness, and body image perception improved after the 8-weeks of treatment compared to baseline. Conclusion: This case report described the use of CDT in treating edema and patient symptoms in a patient with facial lymphedema related to MMS. Body image and level of anxiety improved.

Amaç: Bu çalışmanın amacı primer dismenoreli Türk kadınlarda ağrı şiddetine göre fiziksel aktivite düzeyini, yaşam kalitesini ve menstrüel semptomlarını karşılaştırılmaktı.Gereç ve Yöntem: Primer dismenoreli kadınlar (n = 333) ağrı şiddetine göre hafif, orta ve şiddetli-ağrı gruplarına ayrıldı. Fiziksel ve demografik özellikler sorgulandı. Ağrı şiddeti, fiziksel aktivite düzeyi ve yaşam kalitesi sırasıyla Görsel Analog Skalası, Uluslararası Fiziksel Aktivite Anketi-7 (UFAA-7) ve 36-Maddelik Kısa Form Sağlık Anketi (KF-36) ile değerlendirildi. Menstrüel semptomlar kaydedildi.Bulgular: UFAA-7 skorları üç grup arasında fark göstermedi (p > 0,05). Şiddetli-ağrı grubunda KF-36’nın fiziksel fonksiyon, vücut ağrısı, emosyonel ve fiziksel problemlere bağlı rol kısıtlaması skorları hafif-ağrı grubundan daha azdı (p < 0,05). Orta-ağrı grubunda KF-36’nın fiziksel fonksiyon ve vücut ağrısı skorları hafif - ağrı grubundan daha azdı (p < 0,05). Orta-ağrı grubunda KF-36’nın emosyonel problemlere bağlı rol kısıtlaması ve vücut ağrı skorları şiddetli-ağrı grubundan daha fazlaydı (p < 0,05). Şiddetli ağrı grubunda diğer gruplardan daha fazla sayıda menstrüel semptom vardı (p < 0,05).Sonuç: Bu çalışmada primer dismenoreli Türk kadınlarda fiziksel aktivite düzeyi ve menstrüel ağrı şiddeti arasında fark olmadığı görüldü. Ek olarak daha yüksek menstrüel ağrı şiddetine sahip olan kadınlar daha düşük yaşam kalitesi ve daha yüksek menstrüel semptom sıklığına sahipti. Böylece primer dismenorenin yönetiminde bu parametreler dikkate alınmalıdır., Objective: The aim of this study was to compare physical activity, quality of life, and menstrual symptoms by pain intensity in Turkish women with primary dysmenorrhea.Method: Women with primary dysmenorrhea (n = 333) were divided into mild, moderate and severe-pain groups based on pain intensity. Physical and demographic characteristics of the participants were recorded. Pain intensity by Visual Analogue Scale, physical activity level by International Physical Activity Questionnaire-7 (IPAQ-7), quality of life by Short Form-36 (SF-36) were assessed. The presence of menstrual symptoms was recorded. Result: Physical functioning, bodily pain, vitality, role limitations due to emotional and physical problems scores of SF-36 in the severe-pain group were lower than in the mild-pain group (p < 0.05). Physical functioning and bodily pain scores of SF-36 in the moderate-pain group were lower than in the mild-pain group (p < 0.05). Role limitations due to emotional problems and bodily pain scores of SF-36 in the moderate-pain group were higher than in the severe-pain group (p < 0.05). IPAQ-7 scores did not show difference among three groups (p > 0.05). Severe-pain group had a greater number of menstrual symptoms than other groups (p < 0.05). Conclusion: In this study, there was no difference between physical activity level and menstrual pain intensities in Turkish women with primary dysmenorrhea. In addition, the higher menstrual pain intensity was associated with lower quality of life and higher frequency of menstrual symptoms. Therefore, these parameters should be taken into account for assessment and treatment of primary dysmenorrhea.

This study aimed to evaluate the factors related to the severity of menstrual pain in Turkish women with primary dysmenorrhea (PD). The study included 504 women with PD aged 18 years or older. A Visual Analogue Scale (VAS), a self-developed structured questionnaire, the International Physical Activity Questionnaire-Short Form (IPAQ-SF), State and Trait Anxiety Inventory, Beck Depression Inventory, and Nottingham Health Profile (NHP) were used to measure outcomes. Multiple multinomial logistic regression analysis was used to determine the factors related to the severity of menstrual pain. In this model, categorical menstrual pain severity levels (mild, moderate, and severe) were considered as dependent variables and the category of “severe menstrual pain” was determined as the reference category. p value less than 0.05 was considered statistically significant. The individuals were divided into 3 groups according to their VAS scores: mild-pain group (n = 132, 26.19%), moderate-pain group (n = 189, 37.50%), and severe-pain group (n = 183, 36.30%). BMI increase (OR = 1.10 and OR = 1.09), decreased chocolate consumption (OR = 1.88), menstruation duration (OR = 2.48) and menstrual pain duration (OR = 1.33 and OR = 1.61), and increased physical activity level (OR = 1.10) were found to increase the tendency to have less severe pain. The positive family history (OR = 0.35), a decrease in the age of menarche (OR = 0.47), the presence of irregular menstruation (OR = 0.36), and decreased quality of life (OR = 0.98 for NHP pain and emotional reaction) were found to be associated with a reduced likelihood of less severe pain (p

Background:. This study is aimed to determine the trimester-based changes in urogenital symptoms and their impact on the quality of life in pregnant women. Materials and methods:. Fifty-one pregnant women participated in this study. Self-reported symptom-based questionnaires, Urogenital Distress Inventory-Short Form (UDI-6), Incontinence Severity Index (ISI), and Incontinence Impact Questionnaire (IIQ-7) were administered to determine urogenital symptoms, incontinence severity, and the quality of life in all participants in the first, second, and third trimesters. The findings obtained were analyzed with the Friedman and Spearman tests. Results:. Irritative (urgency and frequency) and stress incontinence symptoms showed statistically significant changes (p 0.05) according to the scores of UDI-6 subscales over the trimesters. There were negative, weak-moderate correlations between stress incontinence symptoms and IIQ-7 in the first, second, and third trimester. There was a negative, moderate correlation between irritative symptoms and IIQ-7 only in the third trimester, but there were not any correlations between the other urogenital symptoms and IIQ-7 (p > 0.05). In the prepregnancy period, stress urinary incontinence (SUI) and urge urinary incontinence (UUI) occurred in 9.8% and 7.8% of the patients, respectively, whereas there were no women with mixed urinary incontinence (MUI) preconceptionally. The presence of SUI, UUI, and MUI were 13.7%, 7.8%, and 0% in the first, 26%, 9.8%, and 3.9% in the second, and 41.2%, 27.5%, and 13.7% in the third trimester, respectively. ISI scores showed statistically significant changes in the first, second, and third trimesters of women with SUI, UUI, and MUI (p

Introduction and hypothesisWe evaluated whether vaginal tampon training (VTT) combined with pelvic floor muscle training (PFMT) results in better outcomes than PFMT alone for treating stress urinary incontinence (SUI).MethodsThis was a randomized, controlled study. Patients were allocated to either the combined program, consisting of PFMT and VTT over 12weeks [PFMT and VTT group (n=24)] or to PFMT alone [PFMT group (n=24)]. The primary outcome measure was self-reported improvement, while secondary outcome measures were severity of incontinence, quality of life (QoL), urinary parameters, and pelvic floor muscle strength (PFMS) and endurance (PFME). Values were analyzed with Friedman, Mann-Whitney U, Wilcoxon, and chi-square tests.ResultsBetween-group analysis showed no statistically significant differences in self-reported improvement, severity of incontinence, symptom distress score, PFMS, PFME, urinary parameters, and all domains of QoL scores, except social limitations, at weeks 4, 8, and 12 (p>0.05). However, the increase in PFMS and PFME between baseline and week 12 and earlier improvement was significantly greater in the PFMT and VTT than in the PFMT group (both p

The purpose of this study was to examine the association of breast cancer-related lymphedema on shoulder girdle kinematics and upper extremity function. The study included 67 breast cancer survivors with and without unilateral lymphedema. Individuals were divided into non-lymphedema, moderate and severe lymphedema groups according to the volumetric measurement difference between the affected and unaffected upper extremities. A three-dimensional motion monitor-electromagnetic system was used to analyze scapular movements during the elevation and depression phases of the upper extremity elevation in the scapular plane. Shoulder range of motion was assessed with a digital inclinometer. Upper extremity function was assessed with the 'Disabilities of the Arm, Shoulder, and Hand Questionnaire-Short Form (Quick-DASH)'. The scapular upward rotation was lower for the severe lymphedema group than for the non-lymphedema group in the 90-60-30° depression phases of arm elevation (p .05). The scapular anterior tilt was higher for the severe lymphedema group than for the non-lymphedema group in the 30° depression phase of arm elevation (p .05). Shoulder abduction range of motion was the lowest in the severe lymphedema group (p .05). The non-lymphedema group had the lowest quick-DASH score and the severe lymphedema group had the highest score (p .05). There were statistically significant moderate associations between the quick-DASH scores and scapular movements in all groups (p .05). The development, presence and/or severity of lymphedema were associated with impaired shoulder-girdle kinematics and decreased upper extremity function. However, a need exists for longitudinal studies comparing individuals with and without lymphedema and healthy controls.

Health literacy is a public health priority which refers to individual’s knowledge, motivation and competence to access, understand, appraise and apply health information to prevent disease and promote health in daily life. This study aimed to adapt European Health Literacy Survey Questionnaire (HLS-EU-Q47) into Turkish and to investigate its psychometric properties. The questionnaire was translated into Turkish by using both group translation and expert opinion methods. Forward translation–back translation method was used for language validity and the final Turkish version (HLS-TR) was formed. HLS-EU-Q47 and Health Awareness Scale (HAS) were administered to 505 respondents. The scale reliability was examined using Crohnbach’s alpha coefficient and the construct validity was assessed by principal axis factoring procedure. The convergent validity was obtained by Pearson correlation coefficients between HLS-TR and HAS scores and discriminant validity was examined comparing the scores of participants who were stratified according to ages, educational status, gender, general health status and social status. Cronbach’s alpha coefficient for the whole scale was 0.95. Principal axis factoring extracted nine factors which eigenvalues were >1 and explained 50.01% of total variance. Factor matrix displayed that all items gave greater load in factor 1, showing that health literacy measured with one factor. Positive and significant correlation was found between HLS-TR and HAS. Significant relations were found between HLS-TR scores and selected determinants of health. This study revealed that the HLS-TR was a valid and reliable measuring instrument with appropriate psychometric characteristics.

Background Diastasis recti abdominis (DRA) is a common musculoskeletal problem, which is defined as a separation of the inter-recti distance between the two bellies of the rectus abdominis muscle at the linea alba.1 Due to the hormonal, postural and musculoskeletal changes, and mechanical strain, the anterior abdominal wall becomes stretched and elongated during pregnancy. Studies have shown that DRA may occur between 27% and 100% in the second and third trimesters of pregnancy2. Although it has been reported that imbalance in the strength of the abdominal wall muscles altered with the facial tension, the role of abdominal muscle strength on DRA has not been clarified yet. Objectives The present study assessed the relation between the severity/amount of DRA and the degree of abdominal muscle (rectus abdominis (RA), external and internal oblique muscles) strength in pregnant women. Methods A total of 153 pregnant women between 14 and 35 weeks of a singleton pregnancy were included in the present study. The finger width method was used to measure the amount of DRA. The amount of separation was determined by the palpation of the medial sides of RA at three reference points: on the umbilicus, 4.5 cm above and 4.5 cm below of the umbilicus. After the subject contracts RA in hook lying position when her arms were in extended position, the size of the diastasis was measured by the number of finger.3 The strength of abdominal muscles was assessed by the manual muscle test in supine hook lying position. The correlation between the amount of DRA and the degree of abdominal muscle strength was analyzed by the Spearmans correlation. Results The mean age was 28.40±3.69 years, mean Body Mass Index was 27.01±1.26 kg/m2, and mean gestational age was 28.12±5.03 weeks. A negative correlation was found between the amount of the diastasis at 4.5 cm below of the umbilicus and the strength of the RA (r=0.219, p=0.007), right (r=0.296, p=0.015) and left external oblique muscles (r=0.293, p=0.017). Conclusion Based on the findings of the present study, the separation of RA on the lower level of umbilicus may be negatively associated with the strength of RA and oblique abdominal muscles. Therefore, to decrease the severity of DRA, abdominal strengthening programs should be provided to pregnant women. References [1] Van de Water, A. T. M., & Benjamin, D. R. (2016). Measurement methods to assess diastasis of the rectus abdominis muscle (DRAM): a systematic review of their measurement properties and meta-analytic reliability generalisation. Manual therapy, 21, 41-53. [2] B, K., Hilde, G., Tennfjord, M. K., Sperstad, J. B., & Engh, M. E. (2017). Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: prospective cohort study. Neurourology and urodynamics, 36(3), 716-721. [3] Michalska, A., Rokita, W., Wolder, D., Pogorzelska, J., & Kaczmarczyk, K. (2018). Diastasis recti abdominisa review of treatment methods. Ginekologia polska, 89(2), 97-101. Disclosure of Interests None declared

The objective of the present study was to adapt the CONTILIFE, a quality-of-life questionnaire, into Turkish and to reveal its psychometric properties in women suffering from stress urinary incontinence (SUI). Ninety-eight patients with a symptom of SUI participated in the study and filled out the Turkish CONTILIFE. Cronbach’s alpha (α) and intraclass correlation coefficients (ICCs) were evaluated for the internal consistency and test-retest reliability, respectively. Exploratory factor analysis was performed to determine the underlying structure. Criterion validity was analyzed using the correlation coefficients between the total and subscale scores of the CONTILIFE and King’s Health Questionnaire (KHQ), the Incontinence Impact Questionnaire-7 (IIQ-7), and the Urinary Distress Inventory-6 (UDI-6). Internal consistency was found to be strong to very strong (Cronbach’s α: 0.90–0.96). Test-retest reliability was very strong (ICCs = 0.91–0.98, p

Background Low back pain (LBP) is one of the most common musculoskeletal problems during pregnancy that occurs due to a combination of mechanical, hormonal, circulatory and psychological factors. The changes in the load, body mechanics and centre of gravity, increased levels of relaxin, and decreased venous circulation in the pelvic and lumbar region may contribute to LBP in pregnant women.1,2 It has been reported that the prevalence of LBP ranges between 50% and 80%. Pregnant women suffer from LBP may experience significant physical, psychological and social problems which adversely affect their quality of life.3 Objectives The aim of the study was to compare the physical activity level of pregnant women with and without LBP. Methods A total of 151 pregnant women without obstetric and medical complications were included in this study. Sociodemographic and obstetric characteristics of the participants were assessed with a standart questionnaire. The presence of LBP was recorded as “yes” and “no”. The level of physical activity was assessed with the Pregnancy Physical Activity Questionnaire (PPAQ). The PPAQ is self-administered and asks respondents to report the time spent participating in 32 activities including household/caregiving, occupational, sports/exercise, transportation and inactivity. Independent samples t test was used to determine whether there was a difference in physical activity level between two independent groups (Group 1: Pregnant women with LBP, Group 2: Pregnant women without LBP). Results 77 pregnant women (mean age: 29.28±5.14 years, mean body mass index (BMI): 25.95±3.86 kg/m2) had no LBP. However, 74 pregnant women (mean age: 29.22±4.90 years, BMI: 26.85±2.78 kg/m2) have experienced LBP. There was no statistically significant difference in gestational week between two groups (p>0.05). Exercise-sports activity (mean: 5.69±7.29 MET–h.week-1) and vigorous activity (mean: 2.39±3.80 MET–h.week-1) scores of PPAQ were significantly lower in the pregnants with LBP than in those without LBP. Other activity scores were similar between groups (p>0.05). Conclusions The presence of LBP during pregnancy causes decreased levels of sports and exercise activities in the pregnant women while household/caregiving and occupational activities are being carried out. LBP can be a barrier to perform physical activities and exercises for pregnant women. Therefore, it should be treated with appropriate methods and pregnant women should be encouraged to regularly participate to exercise programs. References [1] Ryan, Cormac G, et al. Individuals with chronic low back pain have a lower level, and an altered pattern, of physical activity compared with matched controls: an observational study. Australian Journal of Physiotherapy2009; 55(1): 53–58. [2] Katonis P, et al. Pregnancy-related low back pain. Hippokratia2011;15(3):205. [3] Lima ACDN, Oliveira FBD, Avolio GP, Silva GDD, et al. Prevalence of low back pain and interference with quality of life of pregnant women. Revista Dor2017;18(2):119–123. Acknowledgements None. Disclosure of Interest None declared

Background Women with mastectomy are reported to have altered dynamic scapular control compared to the asymptomatic healthy individuals. However, the effects of breast cancer related lymphedema (LE) on scapular control has not been fully understood yet.1, 2 Objectives The aim of this study was to determine the impact of LE severity on scapular kinematics in breast cancer patients with moderate LE, severe LE and without LE. Methods 67 women who have undergone radical or modified radical mastectomy as part of the breast cancer treatment were included in the study. The study was approved by the local ethics committee of the university and all participants provided written informed consent. Individual’s demographic and medical characteristics were recorded. By volumetric measurement, women were divided into 3 groups. Between the affected and non-affected extremities; the non-LE group (group 1, n=22) had 0 and 200cc difference, the moderate LE group (group 2, n=18) had 250–500cc difference, and the severe LE group (group3, n=27) had a difference of 500cc or more. 3-D analysis of the scapula was performed during the bilateral upper extremity elevation in the scapular plane with the 3D Motion Monitor-Electromagnetic System. Scapular kinematics in the scapular plane were recorded at 30°, 60° and 90° (during elevation and lowering phases) of the arm elevation in the affected side. Each measurement was repeated 3 times and the mean of 3 repetitions were recorded. Patient characteristics and scapular kinematics were analysed by Kruskal Wallis test and two-way repeated measures of ANOVA test, respectively. Results There was no significant difference between groups in terms of age (mean ages; group 1: 45.54±5.88, group 2: 52.05±6.63, group 3: 56.37±8.24 years) (p=0.08). Regarding the Body Mass Index (BMI) (group 1: 25.57±2.92, group 2: 25.95±2.35, group 3: 28.93±1.02 kg/m2), it was found that group 3 had higher BMI scores than group 1 and 2 (p 0.05) and posterior tilt ((F5.05, 161.8 =1.02, p=0.4) among groups during the arm elevation in scapular plane. Conclusions The results of this study revealed that scapular upward rotation could be reduced by LE severity. LE severity might also be associated with BMI and LE duration. Further studies comparing LE patients with healthy individuals are needed to better understand the effects of LE severity on scapular kinematics. References [1] Shamley D, Srinaganathan R, Oskrochi R, Lascurain-Aguirrebena I, Sugden E. Three-dimensional scapulothoracic motion following treatment for breast cancer. Breast cancer research and treatment. 2009;118(2):315–22. [2] Crosbie J, Kilbreath SL, Dylke E, Refshauge KM, Nicholson LL, Beith JM, et al. Effects of mastectomy on shoulder and spinal kinematics during bilateral upper-limb movement. Physical therapy. 2010;90(5):679–92. Disclosure of Interest None declared

Aim: The study was conducted to identify breastfeeding status and effecting factors of mothers have 0-11 month’s babies at a Health Centre Area.Materials and Method: The cross sectional study was conducted at Health Centre Area in Ankara city centre. The target population of this study has been constituted 122 mothers that their ba-bies were born 1 January 2006-31 December 2006 and have been reached 121 mothers (99.2%). Prepared questionnaire forms have been filled by nurses using face-to-face interview method with mothers.Results: Sixty percent of mothers were between 20-29 ages and 40.5 percent graduated from the primary school. Eighty four percent of babies were desired and 52.9 percent girl. All mothers bre-astfed their babies sometime and 88.5 percent of mothers continue to breastfeed their babies. Mothers started to breastfeeding within first hour after delivery have been continuing to breast-feeding more than mothers started to breastfeeding after first hour. Seventy percent of mothers initiated to supplementary food at appropriate time. Mothers graduated from the primary school and below than the secondary school and above and monthly income was less than 1000 Turkish Liras than more than 1000 Turkish Liras initiated to supplementary food at more appropriate time.Conclusion: Necessity of researching of the causes of behavior of mothers have high level of edu-cation and income that initiate to supplementary food at inappropriate time and giving educa-tion according to this and also giving more knowledge to mothers about continue to breastfeed and don’t give feeding bottle and pacifier have been thought.

This study is aimed to find out the handwashing habits and their relations to the socio-economic variables. The sampling is determined regarding the address-based population registration system of the country. The multi-staged stratified cluster sampling method was used. It is conducted by a face to face questionnaire with 6854 persons. 22 questions are asked whether they are washing their hands or not related to different situations, the results are graded and the “Handwashing Habits Score” (HHS) is obtained. The reasons for not handwashing were evaluated by categorizing as individual, environmental and combined reasons. The HHS is increasing in the older age groups (β = 0.148, p

Aim: This study aims to determine the frequency of behaviour change and related factors generated in the population through the “Fighting Obesity Campaign” of the Turkish Ministry of Health. Methods: Twelve statistical regions from NUTS-1 and 18 provinces were selected for the study sample. At least one province from each region was randomly selected, and strata were defined as urban or rural. Of the sample selected, 2,038 respondents completed a face-to-face survey. Logistic regression analysis was used to analyse the data. Changing behaviour as result of the campaign was defined as the dependent variable. Behaviour change was defined as an individual taking at least one action to increase physical activity, calculate her/his Body Mass Index (BMI) or minimise meal portions. Results: Of the sample selected, 84% of participants lived in urban areas. Of total sample selected, 49.8% were men and 50.2% were women. According to BMI categorisation, 41.4% of participants were underweight or normal weight, 34.3% were overweight and 24.3% were obese. Of the total participants, 85.2% learned about the “Fighting-Obesity Campaign” through television, 28.1% through radio, 11.0% from newspapers, 6.0% from billboards, and 19.2% from other sources. This study revealed that 28.5% of the participants adopted desired behavioural changes after exposure to the campaign. Logistic regression results demonstrated that behaviour change is greater among women, individuals living in urban settings, group of persons approving public spots, obese individuals, and among the 20-39 age group. Conclusion: Media campaigns may cause behavioural changes by increasing motivation to prevent obesity within the target population. Continuing these campaigns can lead to success at the national level. © 2014, Czech National Institute of Public Health. All rights reserved.

The aim of the present case report was to investigate the effects of a physiotherapy program combined with sirolimus in a child patient with upper extremity edema and joint limitation due to low-flow vascular malformation. This case report included an 11-year-old male patient (26 kg, 130 cm) diagnosed with congenital lymphovascular malformation on the left and right chest. The patient, who had edema on the upper left extremity and experienced joint limitations, was administered complete decongestive therapy (CDT) and manual therapy in combination with sirolimus. Physiotherapy included a total of 24 sessions, 3 sessions a week for 8 weeks. Following the physiotherapy, the patient was assigned to a home therapy program, and then the maintenance phase of the CDT was initiated. Evaluations were carried out at baseline, at the end of week 8, and after 12 months. Following the physiotherapy program combined with sirolimus, a decrease in extremity volume, an increase in joint movement range, and an improvement in disease-related complaints were observed. Physiotherapy methods combined with sirolimus may be an effective treatment method in patients with vascular malformations. However, further studies with larger sample size are warranted.

To evaluate that habitual behaviors related to genital hygiene in women living in a Health Care Center Area.In this cross-sectional study, 400 women were sampled to represent women in reproductive ages (15-49 ages) living in the Park Health Care Center Area, Ankara, Turkey between June and September 2008. Three hundred and eighty-six (96.5%) women were interviewed for evaluation of habitual behaviors related to genital hygiene. The chi-square test was used for statistical analysis.The mean age of the study group was 32.19+/-9.54 (15-49) years. Of the study group, 21.5% had daily baths, 77.2% used cotton underwear, and 71.8% wiped front to back after using the toilet. Of those who menstruated, 83.4% used hygienic pads during menstrual periods, and 42.1% of the 321 married women confirmed practicing vaginal douching. The education level p=0.001, p=0.000, income level p=0.034, p=0.005, employment p=0.022, p=0.000, and house type p=0.005, p=0.006 were found as factors affecting general frequency of bathing and type of pad used during the menstrual period. Frequency of vaginal douching was higher in housewives than employed women p=0.000.The rate of women who had appropriate behaviors related to genital hygiene among the study group was found to be low, particularly within groups with a low socioeconomic level. Thus, it will be useful for health care employers to emphasize this issue at every opportunity.