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  • Küçük Resim
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    Effects of osteopathic manipulative treatment alone or in combination with respiratory training on chest wall expansion, functional mobility, and dyspnea level in patients with pulmonary arterial hypertension
    (American Thoracic Society, 2024) Naci, Baha; Demir, Rengin; Önder, Ömer Önder; Sinan, Ümit Yaşar; Küçükoğlu, Mehmet Serdar
    RATIONALE: While exercise training has been extensively investigated for nonpharmacologic treatment of pulmonary arterialhypertension (PAH), osteopathic manipulative treatment (OMT) has not been adequately examined. The purpose of this study wasto explore the efficacy of OMT alone or in association with respiratory training on chest wall expansion, functional mobility, anddyspnea level in patients with PAH. METHODS: 48 patients under PAH-targeted medical therapy for at least 3 months, betweenthe ages 20-74 (mean [SD] age: 48.4 [12.1] years) and with the World Health Organization functional class I to III were involved inthe study. Chest wall expansion was evaluated with a cloth tape measure at maximal inhalation and exhalation at 3 levels of the ribcage (axillary line, xiphoid process, lateral lower edge of the tenth costae) by subtracting the end-expiratory diameter from theend-inspiratory diameter. Functional mobility was assessed using 5-repetition sit-to-stand test. Dyspnea level was determinedwith the modified Medical Research Council scale. Patients were divided into OMT, combined intervention, and control groups,with 18 patients in each group. Rib raising, diaphragm release, suboccipital decompression, first rib mobilization, mediastinummobilization and thoracic inlet myofascial release techniques were applied to the OMT group twice weekly for 8 weeks. In additionto OMT, a yoga respiratory training session including nadishodhana, ujjayi, and bhramari pranayama was undertaken by thecombined intervention group. The breathing exercises were also performed once daily for the remaining days as home exercises.Control group received no additional intervention. All patients received an educational lecture. For between-group comparisonsand within-group differences of baseline with 8 weeks, one-way ANOVA with between-subject factor and the paired samples t testwere used, respectively. Pairwise multiple comparisons were conducted using Bonferroni post hoc tests.RESULTS: All outcomemeasures improved significantly in both intervention groups (p<0.01), whereas the control group showed no significant difference(p>0.05). Improvements for functional mobility and all the chest wall expansion data were significantly higher in combinedintervention group than other groups, and also in OMT group than control group (p<0.05) (Table 1). Improvement for dyspnea levelwas significantly higher in both intervention groups compared with the control group (p<0.05) (Table 1). CONCLUSION: This studydemonstrated that the addition of respiratory training to OMT revealed further benefit to chest wall expansion and functionalmobility compared to OMT alone and that the OMT might be an effective therapeutic method for dyspneic patients havingdifficulties in participating cardiopulmonary rehabilitation programs.
  • Kapalı Erişim
    Yayın
    The association of exhaled nitric oxide level with respiratory muscle strength, pulmonary function, exercise capacity, sleep quality, functional status, and health-related quality of life in patients with pulmonary arterial hypertension
    (Amer Thoracic So, 2025) Naci, Baha; Demir, Rengin; Önder, Ömer Önder; Sinan, Ümit Yaşar; Küçükoğlu, Mehmet Serdar
    The Association of Exhaled Nitric Oxide Level With Respiratory Muscle Strength, Pulmonary Function, Exercise Capacity, Sleep Quality, Functional Status, and Health-Related Quality of Life in Patients With Pulmonary Arterial Hypertension
  • Kapalı Erişim
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    The impact of home-based telerehabilitation pranayama on sleep quality and wellbeing in mild to moderate obstructive sleep apnea syndrome. A randomized controlled trial
    (BioMed Central, 2026) Kaçar Akkoç, Zeynep; Demir, Rengin; Mustafaoğlu, Rüstem; Önder, Ömer Önder; Naci, Baha; Atahan, Ersan
    Background Obstructive sleep apnea syndrome (OSAS) is a common disorder that causes repeated airway obstruction, disrupted breathing, and fragmented sleep. This study aimed to investigate the effects of Pranayama on sleep quality, daytime sleepiness, quality of life, fatigue, depression, and anxiety in patients with OSAS. Methods This study was designed as an open-label, prospective, randomized controlled trial. OSAS patients meeting the inclusion criteria were randomly assigned to either an Intervention group or a Control group. Pranayama training was applied to the Intervention group for 8 weeks, 7 days a week, and 3 times a day for 15 min. In addition, a single 15-minute session, 3 days a week, was conducted online under the supervision of a physiotherapist. The control group did not receive any intervention. Primary outcome was sleep quality (Pittsburgh Sleep Quality Index, PSQI). Secondary outcomes included daytime sleepiness (Epworth Sleepiness Scale, ESS), Fatigue Severity Scale (FSS), Functional Outcomes of Sleep Questionnaire (FOSQ), Nottingham Health Profile (NHP), and Hospital Anxiety and Depression Scale (HADS). All outcome measures were assessed at baseline and reassessed after the 8-week intervention period. Results Thirty-eight OSAS patients meeting the inclusion criteria were randomly assigned to either an Intervention group (n = 19) or a Control group (n = 19). Four participants (two in each group) were lost to follow-up, leaving the data of 34 participants (17 per group) available for inclusion in the final analysis. In the intervention group, PSQI scores decreased from 9.12 ± 4.71 to 6.88 ± 4.45 (p < 0.001), whereas no improvement was observed in the control group. Regarding the primary outcome, the reduction in PSQI scores was significantly greater in the intervention group than in the control group (p < 0.001). The ESS scores also decreased significantly in the intervention group, from 9.41 ± 6.15 to 7.41 ± 6.18 (p = 0.006, with a significant between-group difference (p < 0.001). Fatigue severity decreased in the intervention group (FSS change: 0.53 ± 0.70; p = 0.006), with a significant between-group difference (p = 0.037). The FOSQ score improved markedly, with significant gains in FOSQ total score (− 0.38 ± 0.25 vs. 0.14 ± 0.22 in controls; p < 0.001) and in activity level and vigilance subdomains (both p < 0.001). The HADS-anxiety scores decreased by 1.94 ± 3.94 (p = 0.059) and depression scores by 3.06 ± 2.05 (p < 0.001) in the intervention group, with significant between-group differences for both anxiety (p = 0.008) and depression (p < 0.001). Conclusion Pranayama was an effective adjunct therapy for these OSAS patients, and incorporating it into treatment strategies may enhance patient outcomes. Clinical trial registration number/date NCT04632147/22.10.2020.