Browsing by Author "Akova, Bedrettin"
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Item Acute effects of dynamic stretching on peak and end-range functional hamstring/quadriceps strength ratios(Ortadoğu Yayınları, 2010-02) Şekir, Ufuk; Arabacı, Ramiz; Akova, Bedrettin; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.; Uludağ Üniversitesi/Spor Bilimleri Fakültesi/Beden Eğitimi ve Spor Öğretmenliği Bölümü.; 0000-0003-2735-8697; 0000-0001-8403-5742; 0000-0003-1044-8805; AAI-4550-2021; AAM-4348-2020; ABI-4831-2020; 8086677600; 24448984800; 6507563417Objective: Although recent studies have shown that dynamic stretching may improve individual muscle strength performance, its effects on the functional hamstring/quadriceps (H/Q) strength ratio and thus on injury risk characteristics has not been investigated in depth. The aim of this study was to assess the effects of dynamic stretching on functional H/Q strength ratios for iso-kinetic knee extension and flexion at peak and end range moments in elite women athletes. Material and Methods: A total of twelve healthy elite competitive female athletes (mean age 20 +/- 2 years, mean height 166 6 cm, mean weight 58 +/- 7 kg) volunteered to participate in the study. All subjects completed a non-stretching (control) or a dynamic stretching intervention protocol in a randomized fashion on separate days. The quadriceps and hamstring muscles were stretched during these protocols. Before (pre) and after (post) the intervention, the functional H/Q strength ratio was calculated at 60 degrees.s-1 and 180 degrees.s-1 angular velocities. Results: The strength ratio for knee extension displayed a significant increase and for knee flexion a significant decrease following dynamic stretching during the entire and end range of motion at both angular velocities (p<0.05). Conclusion: The effects of dynamic stretching on functional H/Q strength ratios suggest that the functional H/Q ratio do change positively following a dynamic stretching routine.Item Acute effects of static and dynamic stretching on leg flexor and extensor isokinetic strength in elite women athletes(Wiley, 2010-04) Şekir, Ufuk; Arabacı, Ramiz; Akova, Bedrettin; Kadağan, S. Murat; Uludağ Üniversitesi/Eğitim Fakültesi/Beden Eğitimi ve Spor Bölümü.; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.; 0000-0003-2735-8697; 0000-0001-8403-5742; 0000-0003-1044-8805; AAI-4550-2021; AAM-4348-2020; ABI-4831-2020; R-5044-2018; 8086677600; 24448984800; 6507563417; 35995606000The aim of this study was to explore the effects of static and dynamic stretching of the leg flexors and extensors on concentric and eccentric peak torque (PT) and electromyography (EMG) amplitude of the leg extensors and flexors in women athletes. Ten elite women athletes completed the following intervention protocol in a randomized order on separate days: (a) non-stretching (control), (b) static stretching, and (c) dynamic stretching. Stretched muscles were the quadriceps and hamstring muscles. Before and after the stretching or control intervention, concentric and eccentric isokinetic PT and EMG activity of the leg extensors and flexors were measured at 60 and 180 degrees/s. Concentric and eccentric quadriceps and hamstring muscle strength at both test speeds displayed a significant decrease following static stretching (P < 0.01-0.001). In contrast, a significant increase was observed after dynamic stretching for these strength parameters (P < 0.05-0.001). Parallel to this, normalized EMG amplitude parameters exhibited significant decreases following static (P < 0.05-0.001) and significant increases following dynamic stretching (P < 0.05-0.001) during quadriceps and hamstring muscle actions at both concentric and eccentric testing modes. Our findings suggest that dynamic stretching, as opposed to static or no stretching, may be an effective technique for enhancing muscle performance during the pre-competition warm-up routine in elite women athletes.Publication Acute effects of static stretching on peak and end-range hamstring-to-quadriceps functional ratios(Baishideng Publishing Group Inc, 2015-10-18) Şekir, Ufuk; Arabacı, Ramiz; Akova, Bedrettin; ŞEKİR, UFUK; ARABACI, RAMİZ; AKOVA, BEDRETTİN; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı; Uludağ Üniversitesi/Spor Bilimleri Fakültesi/Beden Eğitimi ve Spor Bölümü; 0000-0003-2735-8697; 0000-0003-1044-8805; R-5044-2018; ABI-4831-2020; AAI-4550-2021; AAM-4348-2020AIM: To evaluate if static stretching influences peak and end-range functional hamstring-to-quadriceps (H/Q) strength ratios in elite women athletes.METHODS: Eleven healthy female athletes in an elite competitive level participated to the study. All the participants fulfilled the static stretching or non-stretching (control) intervention protocol in a randomized design on different days. Two static unassisted stretching exercises, one in standing and one in sitting position, were used to stretch both the hamstring and quadriceps muscles during these protocols. The total time for the static stretching was 6 +/- 1 min. The isokinetic peak torque measurements for the hamstring and quadriceps muscles in eccentric and concentric modes and the calculations for the functional H/Q strength ratios at angular velocities of 60 degrees/s and 180 degrees/s were made before (pre) and after (post) the control or stretching intervention. The strength measurements and functional strength ratio calculations were based during the entire-and end-range of knee extension.RESULTS: The pre-test scores for quadriceps and hamstring peak torque and end range values were not significantly different between the groups (P > 0.05). Subsequently, although the control group did not exhibit significant changes in quadriceps and hamstring muscle strength (P > 0.05), static stretching decreased eccentric and concentric quadriceps muscle strength at both the 60 degrees/s and 180 degrees/s test speeds (P < 0.01). Similarly, static stretching also decreased eccentric and concentric hamstring muscle strength at both the 60 degrees/s and 180 degrees/s test speeds (P < 0.01). On the other hand, when the functional H/Q strength ratios were taken into consideration, the pre-intervention values were not significant different between the groups both during the entire and end range of knee extension (P > 0.05). Furthermore, the functional H/Q strength ratios exhibited no significant alterations during the entire and end ranges of knee extension both in the static stretching or the control intervention (P > 0.05).CONCLUSION: According to our results, static stretching routine does not influence functional H/Q ratio. Athletes can confidently perform static stretching during their warm-up routines.Item Concentric versus combined concentric-eccentric isokinetic training: Effects on functional capacity and symptoms in patients with osteoarthrosis of the knee(WB Saunders Co-Elsevier Inc, 2002-03) Hakan, Gür; Çakın, Nilgün; Akova, Bedrettin; Okay, Ertan; Küçükoğlu, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.; 0000-0003-1044-8805; AAI-4550-2021; I-9594-2017Objective: To compare the effects of concentric and coupled concentric-eccentric isokinetic resistance training on functional capacity and symptoms of patients with osteoarthrosis (OA) of both knees. Design: Repeated measures. Setting: A university exercise physiology laboratory. Participants: Twenty-three volunteers, ages 41 to 75 years. Patients were randomly assigned to 3 groups: concentric (CON, n = 9), concentric-eccentric (CON-ECC, n = 8), and nontreatment (NONTX, n = 6). Interventions: The CON group performed 12 concentric contractions of each knee extensor and flexor muscles; the CON-ECC group performed 6 concentric and 6 eccentric contractions of each knee muscle group by using a spectrum of angular velocities ranging from 30degrees/s to 180degrees/s with 30degrees/s intervals, for both sides, 3 days a week for 8 weeks. Main Outcome Measures: Functional capacity (rising from a chair, walking, stair climbing and descending,) and pain during rest and activities, peak torque, and cross-sectional area (CSA) of knee muscle groups of subjects were tested before and after training. Results: Both training groups showed marked decreases (P < .001) in pain scores and increases (P < .001) in functional capacity together with increases (P < .05-.01) in peak torque and CSA of knee muscles. However, the NONTX group did not display these marked changes after the 8-week period. The, results also indicated that concentric-eccentric training has a greater influence on functional capacity, especially stair climbing and descending, than that of concentric training when compared with NONTX group; however, the improvements in pain measurements were better in the CON group compared with the CON-ECC group after the training. Conclusions: The results suggest that with the isokinetic resistance training used in this study, it is possible to improve functional capacity and decrease pain in patients with OA of the knee. The results also showed that extensive training involving a high number of repetitions and eccentric contractions was safe, effective, and well tolerated for the patients with knee OA.Item Continuous versus separate isokinetic test protocol: The effect of estradiol on the reproducibility of concentric and eccentric isokinetic measurements in knee muscles(W B Saunders Co-Elsevier, 1999) Gür, Hakan; Akova, Bedrettin; Küçükoğlu, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.; 0000-0003-1044-8805; AAI-4550-2021; I-9594-2017Objective: To investigate the effects of estradiol on the reliability of concentric and eccentric isokinetic measurements of knee muscles and to compare the reproducibility of measurements in a continuous test protocol and a separate test protocol. Design: Repeated measurements. Setting: A university exercise physiology laboratory. Participants: Twenty healthy sedentary women volunteers, aged 19 to 37 years, who had regular menstrual cycles (ranging from 27 to 35 days). Subjects were randomly divided into two groups: continuous test group (n = 10) and separate test group (n = 10) and tested at the menstrual phase (days 1 to 3) and preovulatory phase (days 12 to 14) in both legs. Methods: Continuous reciprocal flexion-extension contractions were used in the continuous test group, and separated flexion and extension contractions were used in the separate test group. Four different test protocols were designed to determine the effects of test mode and number of contractions on the isokinetic measurements: Group A, 4 reciprocal flexion-extension repetitions at each angular velocity of 60 degrees/sec and 180 degrees/sec in one leg in the continuous test group; Group B, I and 20 reciprocal flexion-extension repetitions at 60 degrees/sec and 180 degrees/sec, respectively, in the contralateral leg-in the same group; Group C, 4 repetitions in extensors and flexors at each angular velocity of 60 degrees/sec and 180 degrees/sec with a 5-minute rest between the two muscle groups in one leg in the separate test group; and Group D, 4 repetitions at 60 degrees/sec and 20 repetitions at 180 degrees/sec for extensors and flexors with a 5-minute rest between the two muscle groups in the contralateral leg in the same group. Blood samples were analyzed for sex hormones, creatine kinase, and lactate dehydrogenase before the tests: at the menstrual phase and the preovulatory phase. In addition subjective assessment of muscle soreness was made at each blood sampling. Results: Concentric and eccentric peak torque, average power, total work, and endurance ratio at both angular velocities were not significantly different in the two phases of the cycle by paired observation t test for each of the four groups. Except for concentric and eccentric endurance ratios of quadriceps and hamstrings, and concentric peak torque and average power of hamstrings at 180 degrees/sec in Group D, intraclass correlation coefficients of tested variables showed correlations that were moderate to excellent (p < .05) between two phases. In addition, there were no significant correlations between estradiol and the tested variables. Resting serum creatine kinase and lactate dehydrogenase activities and the score of muscle soreness were at the baseline and not significantly different prior to the tests performed at preovulatory and menstrual phases. Conclusions: The results suggest that: (1) reproducibility of isokinetic tests during the menstrual cycle is not influenced by sex hormone fluctuations, particularly estradiol; (2) when compared with the separate test protocol used in this study, the continuous test protocol is more appropriate to measure peak torque, average power, total work, and endurance ratio for both muscle groups of the knee even if the number of contractions is changed. However, these conclusions are specific to sedentary individuals; to make more valid conclusions, further studies with different subject groups are needed.Publication Covid-19 pandemic and anxiety related factors in patients treated in the emergency department(Mre Press, 2020-10-01) Durak, Vahide Aslihan; DURAK, VAHİDE ASLIHAN; Günay, Seyda; GÜNAY POLATKAN, ŞEYDA; Sığırlı, Deniz; SIĞIRLI, DENİZ; Akova, Bedrettin; AKOVA, BEDRETTİN; Armağan, Erol; ARMAĞAN, EROL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi /Spor Hekimliği Anabilim Dalı; 0000-0003-0836-7862; 0000-0003-1044-8805; AAA-7472-2021; AAI-4550-2021; AAH-8846-2021; AAI-5350-2021Aims: A novel coronavirus, now known as SARS-CoV-2019, suddenly emerged in Wuhan, China and within threemonths of the initial outbreak, the virus had spread rapidly to neighboring countries causing a pandemic. After the first case was announced, emergency departments were immediately reorganized as pandemic clinics. Special areas with maximum precautions were designed to evaluate patients. The majority of studies on this pandemic have focused on the treatment of respiratory symptoms and comorbidities in intensive care units. In this study, we sought to determine those factors that contributed to the anxiety level during the COVID-19 pandemic using the 'State' subscale of State-Trait Anxiety Inventory (STAI-S). Methods: A survey was performed in the emergency department by using an online questionnaire which consisted of demographic variables, questions about the opinions and behaviors of patients during the pandemic, diagnostic test results for COVID-19, and treatment methods. Results: There was a statistically significant difference between employment status (p < 0.001), monthly income (p < 0.001), the food consumption changes during the pandemic period (p = 0.001) and the estimated end-date for the COVID-19 pandemic (p < 0.001) and total STAI-S points. Conclusions: Our study has identified factors which significantly increase anxiety during the COVID-19 pandemic and identified those individuals who may benefit from psychiatric and social support.Item Difference in the magnitude of muscle damage between elbow flexors and knee extensors eccentric exercises(Journal Sports Science & Medicine, 2009-03) Saka, Tolga; Akova, Bedrettin; Yazıcı, Zeynep; Şekir, Ufuk; Gür, Hakan; İlçöl, Yeşim Özarda; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.; Uludağ Üniversitesi/ Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0003-2735-8697; 0000-0003-2735-8697; 0000-0003-1044-8805; AAI-4550-2021; AAM-4348-2020; AAI-2303-2021; I-9594-2017; R-5044-2018; AAL-8873-2021; 6507563417; 6701668723; 8086677600; 7006025993; 35741320500The aim of this study was to investigate the difference in the magnitude of muscle damage between maximal eccentric exercises of the elbow flexors (EF) and knee extensors (KE). Twelve sedentary male volunteers participated in the study. Range of motion (ROM), isometric peak torque (IPT), delayed onset of muscle soreness (DOMS), creatine kinase activity (CK), and myoglobin concentration (Mb) were evaluated before, immediately after, and on the 1(st), 2(nd), 3(rd), and 7(th) days following exercise. Total work (TW) during exercises was recorded and corrected by muscle volume (TWc). TWc was greater (p < 0.01) for EF [24 (2) joule.cm(-3)] than for KE [7 (0.4) joule.cm(-3)]. Increases in CK on the 2(nd), 3(rd), and 7(th) days (p < 0.01) and increases in Mb on the 1(st), 2(nd), 3(rd), and 7(th) days were significantly (p<0.01) larger for EF than for KE. The decline in IPT was greater (p < 0.05- 0.01) for EF at all test occasions compared with KE. The results of this study demonstrate that the magnitude of muscle damage is greater and the recovery is slower following maximal eccentric exercise of the EF than of the KE for sedentary males.Item Diz ekstansör ve dirsek fleksör kas gruplarının eksentrik karakterli egzersiz ile oluşturulan kas hasarı yanıtları(Uludağ Üniversitesi, 2005) Saka, Tolga; Akova, Bedrettin; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.Bu çalışma ile non-dominant üst ekstremite önkol fleksör ve alt ekstremite diz ekstansör kas gruplarının maksimal tipte eksentrik egzersiz sonrası oluşan kas hasarı yanıtlarının karşılaştırılması amaçlanmıştır. Çalışmaya 22-30 yaşları arasında (ortalama 25±3) 12 sedanter erkek denek gönüllü olarak katıldı. Deneklerin her iki kas grubuna manyetik rezonans görüntüleme ile kas hacim, izometrik kuvvet, eklem hareket açıklığı ve kas çevre ölçümleri ön test olarak uygulandı. Egzersiz öncesi sübjektif ağrı skoru değerlendirildi ve kreatin kinaz (CK), aspartat transaminaz (AST), myoglobin ve lökosit kan düzeyleri için kan alındı. Egzersiz sonrası hemen, 1., 2., 3. ve 7. günlerde kan alımı, eklem hareket açıklığı, subjektif ağrı değerlendirilmesi, izometrik test ve kas çevre ölçümleri tekrarlandı. Sonuçların karşılaştırılmasında Wilcoxon eşleştirilmiş örneklem testi kullanıldı. CK, myoglobinin, AST ve lökosite ait egzersiz sonrası mutlak değerler incelendiğinde CK'ın 3. gündeki (p<0.05) ve myoglobinin egzersiz sonrası (p<0.05), 2. ve 3. günlerde ((p<0,01) diz ekstansörleri ile karşılaştırıldığında istatistiksel olarak anlamlı yüksek idi. Diz ekstansörleri ile karşılaştırıldığında ön kol fleksörlerinin CK, myoglobin ve AST'a ait egzersiz sonrası kas hacmine oranlanmış fark değerleri; CK yanıtı tüm test dönemlerinde (p<0.05-0.01), myoglobinin hemen egzersiz sonrası (p<0,05), egzersiz sonrası 3. ve 7. günlerdeki (p<0,01) değerleri ve AST' ın egzersiz sonrası 3. ve 7. değerleri (sırası ile p‹0.01,p<0.05) istatistiksel olarak anlamlı yüksek idi. Egzersiz öncesine göre egzersiz sonrası CK ve myoglobinin yüzdesel değişim farkı egzersiz sonrası 3. günde önkol fleksörlerinde istatistiksel olarak anlamlı yüksek saptandı (p<0,05). Diz ekstansörleri ile karşılaştırıldığında ön kol fleksör kas grubunun egzersiz öncesine göre egzersiz sonrası izometrik kas kuvvetindeki düşüş tüm dönemlerde istatistiksel olarak anlamlı idi (p<0.05-0.01). Diz ekstansör kas grubuna oranla palpasyonla oluşturulan subjektif ağrı skorları, egzersiz sonrası 2. ve 3. günlerde önkol fleksörlerinde istatistiksel anlamlı yüksekti (p<0.05). Çevre ölçüm farkının egzersiz sonrası, 2. , 3. ve 7. günlerdeki ve ağrının başladığı eklem hareket açıklığı ile palpasyonla oluşturulan subjektif ağrı skorlarının 2. ve 3. günlerindeki yüzdesel değişimleri incelendiğinde, diz ekstansörlerine oranla önkol fleksör kas grubunda istatistiksel anlamlı yüksek değerler saptandı (p<0.05-0.01). Bu çalışma bulguları ışığında, önkol fleksör kas grubunun diz ekstansör kas grubuna oranla aynı egzersiz şiddetinde daha fazla kas hasar yanıtı sergilediği ve kas hacminin kas hasarı yanıtına ait sonuçları etkileyebileceği söylenebilir.Item Diz fleksör ile diz ekstansör ve dirsek fleksör kas gruplarının eksentrik karakterli egzersiz ile oluşturulan kas hasarı yanıtları: Kas yapısının etkisi(Uludağ Üniversitesi, 2010) Şenışık, S. Çağdaş; Akova, Bedrettin; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.Bu çalışma ile aynı kişilerde diz fleksör kasları (DF), dirsek fleksör kasları (DrF) ve diz ekstansör kaslarında (DE) eksentrik egzersiz (EE) sonrasında oluşan kas hasar yanıtını ve kas hasarı üzerinde kas yapısının etkisini incelemeyi amaçladık. Çalışmaya 20- 30 yaş arasında sağlıklı, 12 sedanter erkek denek gönüllü olarak katıldı. Deneklere ön testler olarak boy, kilo, vücut yağ yüzdesi ölçümü, test edilen her kas grubu için izometrik kuvvet testi, kas hacim ölçümü, kas pennasyon açıları ölçümü yapıldı. EE uygulamasından hemen önce, hemen sonra, 1. , 3. ve 7. günlerde subjektif ağrı düzeyi (GBKA) ve eklem hareket açıklığı (EHA) ölçüldü ve plazma kreatin kinaz (KK) ve myoglobin (Mb) düzeylerini değerlendirmek için deneklerden egzersizden hemen önce, egzersiz sonrası 1., 3., ve 7. günlerde kan alındı. EE uygulaması, deneklerin non-dominant taraf kas bölgeleri rastgele seçilerek, izokinetik dinamometrede 60°/sn’lik açısal hızda ve maksimal iş yükünde 10 kasılma içeren 6 setlik toplam 60 maksimal kasılma olacak şekilde uygulandı. EE sırasında diz ve dirsek EHA 120° olacak şekilde belirlendi. Đstastistiksel değerlendirmede non parametrik Wilcoxon signed rank testi kullanıldı. EE sonrası tüm dönemlerde KK ve Mb plazma düzeylerindeki artış DE ile karşılaştırıldığında, DrF ve DF kas grubunda benzer olarak daha fazlaydı (p<0,01). Đzometrik kas kuvvetindeki düşüş, DE ile karşılaştırıldığında, DrF (p<0,01) ve DF (p<0,05) kas grubunda benzer şekilde anlamlı olarak daha fazlaydı. EHA’da azalma ve GBKA’da artış, EE sonrası hemen, 1. ve 3. günlerde DrF kas grubunda daha fazlaydı (p<0,01). DrF ve DF ile karşılaştırıldığında, DE kas grubunda pennasyon açısı daha yüksek (p<0,01), birim iş yükü ise daha düşük (p<0,01) saptandı. Bu çalışmanın sonuçları, DE ile karşılaştırıldığında DF ve DrF kas gruplarında eksentrik egzersiz sonrası daha belirgin kas hasar yanıtları oluştuğunu göstermektedir. Bu çalışma ile, DE ve DrF kas grupları arasında daha önce gösterilmiş olan eksentrik egzersiz ile oluşan farklı kas hasar yanıtlarının daha çok kasların yapısal farklıklarından etkilenebileceği söylenebilir.Item E vitamini ve Estradiol'ün kas performansı, antioksidan savunma ve egzersize bağlı olarak gelişen kas hasarı ile lipit peroksidasyonu üzerine etkileri(Uludağ Üniversitesi, 1998) Akova, Bedrettin; Uludağ Üniversitesi/Tıp Fakültesi/Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı/Spor Hekimliği Bilim Dalı.Çalışmaya düzenli menstruel siklusa sahip olan sağlıklı ve sedanter 18 denek gönüllü olarak katıldı. Rastgele 2 gruba ayrılmış olan deneklerden E vitamini (E vit) grubuna (n=10) dahil olanlar ortalama 42 gün süreyle 300mg/gün E vit kullanırken, plasebo (P ) grubuna (n=8) dahil olan denekler aynı zaman dilimi içerisinde plasebo ilaç kullandılar. Preovulatuar (11-15 gün) ve mens (1-3 gün) test dönemlerinde gönüllüler maksimallerinin % 50'si şiddetinde bir yüke karşı bisiklet ergometresinde egzersiz yaptılar. Bisiklet egzersizini takiben izokinetik dinamometrede dominant diz ekstansörleri için 60°/saniyelik açısal hızda maksimal konsantrik piktorklannın %50'sine inene kadar maksimal konsantrik-eksentrik kombine kasılmalar içeren ve aralarda 1 dakika istirahatin verildiği 3 setlik tüketici bir egzersiz uygulandı. Egzersiz öncesi ve sonrası alınan kan örneklerinde kas hasarını belirlemek için aspartat transaminaz (AST), laktik asit dehidrogenaz (LDH), kreatin kinaz (CK), lipit peroksidasyonunu değerlendirmek için malondialdehit (MDA) ve LDL'nin oksidasyona direncini gösteren LDL gecikme zamanı (lag time), antioksidan savunmayı değerlendirmek için ise süperoksit dismutaz (SOD) ve glutatyon peroksidaz (GPx) enzim düzeyleri tespit edildi. Egzersiz öncesi alınan kan örneklerinde deneklerin E vitamini ve hormon düzeyleride belirlendi. Kassal 84performans tüketici izokinetik egzersizdeki konsantrik ve eksentrik toplam iş değerleri, yorgunluğa kadar yapılan kasılmaların sayıları ve süreler göz önüne alınarak değerlendirildi. Her iki grupta da mens dönemi ile karşılaştırıldığında preovulatuar dönemdeki estradiol düzeyleri istatistiksel anlamlı yüksekti (p<0.001). E vitamini düzeyi 42 günü takiben E vit grubunda ortalama %42'lik bir artış gösterirken (p<0.001), P grubunda preovulatuar dönemde %7'lik bir azalma (p<0.05) ve mens döneminde istatistiksel anlamlı olmayan %6'lık bir artış gösterdi. Her iki grupta preovulatuar ve mens test dönemlerinde tüketici egzersizleri takiben kas hasarını incelediğimiz parametrelerde istatistiksel anlamlı artışlar gözlemlenmesine karşın E vitamini ve estradiol tek ve kombine etkileri varyans analizi ile değerlendirildiğinde istatistiksel anlamlı farklılıklar tespit edilemedi. Benzer bir karşılaştırmada E vitamini ve estradiol'ün kassal performans üzerine anlamlı bir etkisi olmadığını tespit ettik. Lipit peroksidasyonunu değerlendirdiğimiz parametrelerden MDA düzeylerini icelediğimizde P grubunun mens döneminde egzersiz sonrasında istatistiksel anlamlı bir azalma ( p<0.05) dışında anlamlı bir değişiklik gözlemlenmedi. LDL lag time değerleri ise her iki grupta estradiol'ün düşük olduğu mens döneminde istatistiksel anlamlı olarak azaldı (E vit mens p<0.01, P mens p<0.05). Antioksidan savunmayı değerlendirmede kullandığımız enzimlerden SOD'ın egzersiz sonrası aktivitesi her iki grupta da egzersiz sonrası istatistiksel olarak anlamlı azalırken bu azalmalar estradiol'ün düşük olduğu mens dönemlerinde daha belirgindi (E vit mens p<0.001, P mens p<0.001). Benzer şekilde GPx enzim aktiviteleri her iki grupta estradiol'ün düşük olduğu 85mens dönemlerinde egzersizlerden sonra istatistiksel anlamlı olarak azaldı (E vit mens, p<0.01, P mens p<0.05). Sonuç olarak çalışmamızın bulguları ışığında; estradiol ve E vitamininin birlikte ve tek başına yorgunlukla ilgili kas performansı ve hasarı üzerine etkisi olmadığı buna karşın estradiol'ün antioksidan savunma üzerine pozitif etkisi olduğu yorumunu yapmak olasıdır. Bulgularımız ve yorumumuzun bu çalışmada kullanılan egzersiz modeli ve sedanter bireylere özgün olduğu gerçeğini göz ardı etmemek gerekir.Item Early versus late start of isokinetic hamstring-strengthening exercise after anterior cruciate ligament reconstruction with patellar tendon graft(Sage Publications, 2010-03) Şekir, Ufuk; Gür, Hakan; Akova, Bedrettin; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.; 0000-0003-2735-8697; 0000-0003-2735-8697; 0000-0003-1044-8805; AAM-4348-2020; I-9594-2017; AAI-4550-2021; 8086677600; 7006025993; 6507563417Backgound: Hamstring strengthening after anterior cruciate ligament reconstruction is a vital component of the rehabilitation program. Purpose: The objective of this trial was to investigate the effects of hamstring isokinetic training used in the early phase of the rehabilitation program on the stability, strength, symptoms, and functional outcomes of patients throughout 12 months after anterior cruciate ligament surgery. Study Design: Randomized controlled clinical trial; Level of evidence, 2. Methods: Forty-eight men underwent anterior cruciate ligament reconstruction with an ipsilateral bone-patellar tendon-bone autograft. The patients were randomly assigned to perform daily isokinetic hamstring exercises at postoperative 3 weeks (group 1) or to perform daily isokinetic hamstring exercises at postoperative 9 weeks (group 11). The patients were evaluated monthly for the first 4 months and at the 12th month for postoperative hamstring and quadriceps strength, as well as for knee function via the Cincinnati Knee Rating Scale and International Knee Documentation Committee form. Results: Hamstring isometric strength at 30 degrees of knee flexion (at the first and second months) and concentric isokinetic strength (at 2, 3, 4, and 12 months) at the angular velocity of 60 deg/s were significantly (P < .05-.01) greater in group I compared with group II. Average scores of the Cincinnati Knee Rating Scale for symptoms were significantly (P < .05-.001) higher in group I compared with group II at all evaluation periods. Walking and stair-climbing scores at 1, 2, 3, and 4 months and squatting score at all evaluation periods were also better (P < .05-.01) in group I compared with group II. In addition, group I exhibited better (P < .01-.001) Lachman test results compared with group II for all postoperative evaluation periods. The International Knee Documentation Committee final rating scores were significantly (P < .01) greater at 2, 3, and 4 months in group I compared with group II. Conclusion: The results of this study suggest that hamstring as well as quadriceps strength can be increased via early hamstring strengthening after anterior cruciate ligament reconstruction with no negative impact on knee function.Item Eccentric training improves ankle evertor and dorsiflexor strength and proprioception in functionally unstable ankles(Lippincott Williams & Wilkins, 2016-06) Hancı, Erdal; Şekir, Ufuk; Gür, Hakan; Akova, Bedrettin; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.; 0000-0003-2735-8697; 0000-0003-1044-8805; R-5044-2018; AAM-4348-2020; AAI-4550-2021; I-9594-2017; 8086677600; 7006025993; 6507563417Objective: The aim of this study was to investigate the effects of a combined eccentric-concentric exercise program of the ankle evertors and dorsiflexors on proprioception in functionally unstable ankles. Design: Thirteen male recreational athletes with unilateral functional ankle instability were admitted to this study. The unaffected opposite ankles were used as controls. The functionnaly unstable ankle of the subjects performed an isokinetic exercise program of the ankle evertors and dorsiflexors in a combined eccentric-concentric mode for 3 days per week for 6 wks. Before and after the isokinetic exercise program, active and passive joint position sense and kinesthesia and isokinetic strength of the ankle joint were evaluated. Results: Active and passive joint position sense error scores for inversion (P < 0.01-0.001) and plantarflexion (P < 0.05-0.001) direction and kinesthesia scores for inversion (P < 0.001) and plantarlexion (P < 0.01) direction showed significant reductions after 6 wks of intervention in the functionnaly unstable ankle. In addition, eccentric peak torques for the ankle evertor and dorsiflexors represented significant (P < 0.001) increases in the functionnaly unstable ankle compared with the control ankle. Conclusions: The results of this study suggest that it is possible to improve proprioceptive acuity of the ankle joint after a 6-wk eccentric-concentric isokinetic training program in functionally unstable ankles.Item Eccentric/concentric training of ankle evertor and dorsiflexors in recreational athletes: Muscle latency and strength(Wiley, 2014-02) Keleş, S. B.; Şekir, Ufuk; Gür, Hakan; Akova, Bedrettin; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.; 0000-0003-1044-8805; 0000-0003-2735-8697; I-9594-2017; AAI-4550-2021; AAM-4348-2020; 8086677600; 7006025993; 6507563417The aim of this study was to investigate the effects of a combined eccentric-concentric exercise program of the ankle evertors and dorsiflexors on the latency time of the peroneus longus and tibialis anterior muscles. Twenty-four healthy male recreational athletes were admitted to this study and were randomly assigned to either the exercise group (n=12) or the control group (n=12). Subjects in the exercise group performed an isokinetic exercise program of the ankle evertors and dorsiflexors in a combined eccentric-concentric mode for 3 days per week for 6 weeks. Before and after the exercise program, muscle reaction times of the peroneus longus and tibialis anterior muscles to sudden supinating maneuvers on a tilting platform, and isokinetic strength of the ankle joint musculature were evaluated. The peroneus longus and tibialis anterior reaction times showed significant (P<0.01-0.05) reductions following six weeks of intervention in the exercise group. Additionally, eccentric peak torques for the ankle evertor and dorsiflexors represented significant (P<0.05) increases in the exercise group compared with the control group. The results of this study suggest that it is possible to reduce peroneal and anterior tibial reaction times following a six week eccentric/concentric isokinetic training program in healthy ankles.Item Effect of upper-extremity strengthening exercises on the lumbar strength, disability and pain of patients with chronic low back pain: A randomized controlled study(Journal Sports Science & Medicine, 2017-12) Atalay, Erdem; Akova, Bedrettin; Gür, Hakan; Şekir, Ufuk; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.; 0000-0003-1044-8805; 0000-0003-2735-8697; AAI-4550-2021; AAM-4348-2020; R-5044-2018; 6507563417; 7006025993; 8086677600The present study aimed to analyze the impacts of a low back rehabilitation program accompanied with neck, shoulder and upper back exercises on pain, disability, and physical characteristics of patients with chronic low back pain. Twenty sedentary male patients with chronic low back pain participated in the study on a voluntary basis. The patients were randomly allocated into two groups: a conventional low back exercise group (CE) and a supported exercise group (SE; CE plus upper back, neck, and shoulder exercises). The Modified Oswestry Disability Questionnaire (MODQ) was used to evaluate the disability status and the Visual Analog Scale (VAS) was used to identify the pain states of the patients. In addition, neck, lumbar and shoulder isokinetic and isometric strengths of the patients were evaluated. The CE group performed lumbar stretching, mobilization and stabilization exercises in addition to low-back and abdominal isometric and concentric strengthening exercises. The SE group performed static stretching and isotonic exercises for the neck, upper-back, and shoulder muscles, in addition to the exercises performed in CE group. The exercises were implemented 3 days a week for 6 weeks in both groups. Following the 6-week exercise periods in both groups, statistically significant (p < 0.01) improvements were observed in the patients' levels of pain and the scores of MODQ reflecting an easing of disability. With respect to the levels of pain and disability, the improvements observed in the SE group was significantly (p < 0.01) greater than the improvement observed in the CE group. Based on the findings of this study, we can conclude that a low back exercise program used in combination with neck, shoulder and upper back exercises reduces the level of pain and disability in patients with chronic low back pain more prominently than conventional low back exercises.Item Effects of age on the reciprocal peak torque ratios during knee muscle contractions in elite soccer players(Munksgaard int Publ Ltd, 1999) Gür, Hakan; Akova, Bedrettin; Pündük, Zekine; Küçükoğlu, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Bölümü.; http://orcid.org/0000-0003-1044-8805; AAI-4550-2021; I-9594-2017To investigate the effects of age on the reciprocal peak torque ratios during knee muscle contractions, 25 elite male soccer players, aged 22.3 +/- 3.8 yr (18-28), volunteered for the present study. The players were grouped as adult (>21 years, n = 13) and young players (less than or equal to 21 years, n = 12). Maximal concentric (CON) and eccentric (ECC) isokinetic thigh muscle strength was measured at angular velocities of 30 degrees, 180 degrees, 240 degrees and 300 degrees/s. ECC and CON peak torques of knee flexors (hamstring, HAM) and CON peak torques of knee extensors (quadriceps, QUA) in the dominant knee were greater (P < 0.05) in adult players than in young players at 180, 240 and 300 degrees/s. ECC HAM/CON QUA peak torque ratio at 300 degrees/s was greater (P < 0.05) for adult players compared to young players in the dominant knee but not in the nondominant knee. Furthermore, conventional HAM/QUA peak torque ratios of the dominant knee at all angular velocities for ECC contraction were higher (P < 0.05) in adult players than in young players. In conclusion, the findings of the present study indicate that the reciprocal torque ratio is influenced by age in the dominant knee of elite soccer players. Because there was no effect of age for the nondominant leg, the findings of the present study are more likely to be the result of the training background of the players than their age.Publication Effects of muscle architecture on eccentric exercise induced muscle damage responses(Uludağ Üiversitesi, Spor Tıp Bölümü, 2021-12-01) Senisik, Seher Cagdas; Akova, Bedrettin; Şekir, Ufuk; Gür, Hakan; AKOVA, BEDRETTİN; ŞEKİR, UFUK; GÜR, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı; 0000-0003-1044-8805; 0000-0003-2735-8697; AAI-4550-2021; AAM-4348-2020; JQZ-4279-2023There is a need to investigate the role of muscle architecture on muscle damage responses induced by exercise. The aim of this study was to determine the effect of muscle architecture and muscle length on eccentric exercise-induced muscle damage responses. Eccentric exercise-induced muscle damage was performed randomly to the elbow flexor (EF), knee extensor (KE), and knee flexor (KF) muscle groups with two week intervals in 12 sedentary male subjects. Before and after each eccentric exercise (immediately after, on the 1st, 2nd, 3rd, and 7th days) range of motion, delayed onset muscle soreness, creatine kinase activity, myoglobin concentration and isometric peak torque in short and long muscle positions were evaluated. Furthermore, muscle volume and pennation angle of each muscle group was evaluated before initiating the eccentric exercise protocol. Pennation angle and muscle volume was significantly higher and the workload per unit muscle volume was significantly lower in the KE muscles compared with the KF and EF muscles (p < 0.01). EF muscles showed significantly higher pain levels at post-exercise days 1 and 3 compared with the KE (p < 0.01 -0.001) and KF (p < 0.01) muscles. The deficits in range of motion were higher in the EF muscles compared to the KE and KF muscles immediately after (day 0, p < 0.01), day 1 (p < 0.05 -0.01), and day 3 (p < 0.05) evaluations. The EF muscles represented significantly greater increases in CK and Mb levels at day 1, 3, and 7 than the KE muscles (p < 0.05 -0.01). The CK and Mb levels were also significantly higher in the KF muscles compared with the KE muscles (p < 0.05, p < 0.01 respectively). The KF and EF muscles represented higher isometric peak torque deficits in all the post -exercise evaluations at muscle short position (p < 0.05 -0.001) compared with the KE muscle after eccentric exercise. Isometric peak torque deficits in muscle lengthened position was significantly higher in EF in all the post-exercise evaluations compared with the KE muscle (p < 0.05 -0.01). According to the results of this study it can be concluded that muscle structural differences may be one of the responsible factors for the different muscle damage responses following eccentric exercise in various muscle groups.Item Effects of static and dynamic stretching on the isokinetic peak torques and electromyographic activities of the antagonist muscles(Spor Bilimi ve Tıp Dergisi, 2006-12-08) Şerefoğlu, Abdullah; Sekir, Ufuk; Gür, Hakan; Akova, Bedrettin; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.; 0000-0003-2735-8697; 0000-0003-1044-8805; AAM-4348-2020; I-9594-2017; AAI-4550-2021; R-5044-2018; 57193526976; 8086677600; 7006025993; 6507563417The aim of this study was to investigate if static and dynamic stretching exercises of the knee muscles (quadriceps and hamstring muscles) have any effects on concentric and eccentric isokinetic peak torques and electromyographic amplitudes (EMG) of the antagonist muscles. Twenty healthy male athletes (age between 18-30 years) voluntarily participated in this study. All of the subjects visited the laboratory to complete the following intervention in a randomized order on 5 separate days; (a) non-stretching (control), (b) static stretching of the quadriceps muscles, (c) static stretching of the hamstring muscles, (d) dynamic stretching of the quadriceps muscles, and (e) dynamic stretching of the hamstring muscles. Static stretching exercises either for the quadriceps or the hamstring muscles were carried out at the standing and sitting positions. Subjects performed four successive repetitions of each stretching exercises for 30 seconds in both stretching positions. Similar to static stretching exercises two different stretching modes were designed for dynamic stretching exercises. Concentric and eccentric isokinetic peak torque for the non-stretched antagonist quadriceps or hamstring muscles at angular velocities of 60(omicron)/sec and 240(omicron)/sec and their concurrent electromyographic (EMG) activities were measured before and immediately after the intervention. Isokinetic peak torques of the non-stretched agonist hamstring and quadriceps muscles did not represent any significant (p > 0.05) differences following static and dynamic stretching of the antagonist quadriceps and hamstring muscles, respectively. Similarly, the EMG activities of the agonist muscles exhibited no significant alterations (p > 0.05) following both stretching exercises of the antagonist muscles. According to the results of the present study it is possible to state that antagonist stretching exercises either in the static or dynamic modes do not affect the isokinetic peak torques and the EMG activities of the non-stretched agonist quadriceps or hamstring muscles.Item Exercise-induced oxidative stress and muscle performance in healthy women: Role of vitamin E supplementation and endogenous oestradiol(Springer-Verlag, 2001) Akova, Bedrettin; Gür, Esma Sürmen; Gür, Hakan; Dirican, Melahat; Sarandöl, Emre; Küçükoğlu, Sibel; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0002-2593-7196; 0000-0001-7377-9682; 0000-0003-1044-8805; I-9594-2017; ABE-1716-2020; AAI-4550-2021; AAG-6985-2021; AAG-7327-2021The purpose of this study was to investigate the individual and combined antioxidant effects of menstrual cycle phase-related alterations in blood serum oestradiol concentrations and of dietary vitamin E supplementation on exercise-induced oxidative stress and muscle performance. A group of 18 sedentary women, aged 19-35 years, were given supplements of 300 mg alpha -tocopherol (n = 10) or placebo (n = 8) daily during the course of two menstrual cycles. The subjects exercised the knee isokinetically to exhaustion after cycling submaximally at 50% maximal oxygen uptake during the menstrual and preovulatory phases of their menstrual cycles. Blood samples were taken before and after the exercise, to evaluate haematocrit, plasma lactic acid and malondialdehyde concentrations, erythrocyte antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities and apolipoprotein B containing lipoprotein (non-high density lipoprotein, HDL, fraction) oxidation. Serum vitamin E, follicle stimulating hormone, luteinizing hormone and oestradiol concentrations were measured in pre-exercise blood samples. Neither vitamin E supplementation nor oestradiol concentrations influenced SOD and GPx activities or the susceptibility of the non-HDL fraction to oxidation while at rest. Plasma malondialdehyde concentration was unaffected by exercise, however significant reductions in erythrocyte SOD and GPx activities and increased susceptibility of the non-HDL fraction to oxidation were noted after exercise. Exercise-induced changes were reduced when oestradiol concentration was high in the preovulatory phase, independent of the serum vitamin E concentrations. In addition, both pre-(r = 0.58, P < 0.05) and post-exercise (r = 0.73, P < 0.001) GPx activities in placebo administered subjects were positively correlated with oestradiol concentrations. In conclusion, these findings suggest a better protective role of oestradiol against oxidative injury, compared to vitamin E. Exhausting muscle performance was, however, not influenced by vitamin E supplementation and/or cycle-phase related changes in oestradiol concentrations.Item Fonksiyonel ayak bileği instabilitesinde iki farklı elektriksel stimulasyon uygulamasının kas reaksiyon zamanı ve propriosepsiyon üzerine etkileri(Bursa Uludağ Üniversitesi, 2021) Deniz, Selim; Akova, Bedrettin; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.Bu çalışmanın amacı fonksiyonel ayak bileği instabilitesi olan hastalarda tibialis anterior ve peroneus longus kaslarına uygulanan farklı iki elektriksel stimülasyon uygulamasının kas reaksiyon zamanı ve ayak bileği propriosepsiyonu üzerine etkilerini araştırmaktır. Fonksiyonel ayak bileği intabilitesi olan 36 rekreasyonel sporcu standart elektriksel stimülasyon (SE) (n = 13), kişiye özel elektriksel stimülasyon (KE) (n = 13) ve kontrol (n = 10) gruplarına rastgele olarak dağıtılmıştır. Elektriksel stimülasyon gruplarındaki katılımcıların peroneus longus (PL) ve tibialis anterior (TA) kasları üzerine 6 hafta süresince, haftada 3 gün, günde 20 dakika elektriksel stimülasyon uygulanmıştır. Katılımcılara çalışmanın başlangıcında EMG cihazı ile inversiyon simülasyon platformunda, ayak bileği sırası ile 15° ve 30° inversiyona gidecek şekilde nötral ve plantar fleksiyon pozisyonunda olmak üzere kas reaksiyon zamanı ölçümleri yapılmıştır. Ayrıca dinamik denge, kinestezi, pasif ve aktif eklem pozisyon hissi ve izometrik kuvvet testleri uygulanmıştır. Değerlendirmeler 6 hafta süren elektriksel stimülasyon uygulaması sonrası tekrarlanmıştır. Elektriksel stimülasyon uygulaması sonrasında peroneus longus kas reaksiyon zamanları incelendiğinde; SE grubunda nötral 30°’ de (p<0.05), plantar fleksiyon pozisyonunda 15° ve 30°lerde (p<0.01), KE grubunda ise, plantar fleksiyon pozisyonunda 15°’de (p<0.01) kontrol grubuna göre istatiksel olarak anlamlı kısalma saptanmıştır. Tibialis anterior kas reaksiyon zamanlarında ise; SE grubunda plantar fleksiyon pozisyonunda 30°’de (p<0.05) kontrol grubuna göre istatiksel olarak anlamlı kısalma saptanmıştır. Dinamik dengenin değerlendirildiği yıldız denge testinde her iki grupta kontrol grubuna göre elektriksel stimülasyon sonrası istatiksel olarak anlamlı iyileşme gözlemlenmiştir (p<0.05-0.001). Elektriksel stimülasyon uygulanan grupların kas reaksiyon zamanı ve yıldız denge testi değerleri karşılaştırıldığında gruplar arası istatiksel anlamlı fark saptanmamıştır. Bununla birlikte kinestezi, eklem pozisyon hissi ve izometrik kuvvet ölçüm sonuçlarında gruplar arasında istatistiksel anlamlı fark saptanamamıştır. iii Bu bulgular ışığında, fonksiyonel ayak bileği instabilitesi olan bireylerde peronues longus ve tibialis anterior kaslarına yapılan elektriksel stimülasyon uygulamasının kas reaksiyon zamanını iyileştirdiği ve dinamik dengeye olumlu katkı sağladığı söylenebilir. Fonksiyonel ayak bileği instabilitesi olan hastalara yönelik rehabilitasyon programlarında ve sağlıklı kişilerde ayak bileği yaralanmalarının önlenmesinde elektriksel stimülasyon uygulamasının kullanılması faydalı olabilecektirItem Kronik bel ağrılı hastalarda izokinetik eksentrik bir egzersiz modelinin ağrı, fonksiyonel yetmezlik ve psikososyal durum açısından sonuçlarının karşılaştırılması(Uludağ Üniversitesi, 2013) Özhan, Gökhan; Akova, Bedrettin; Uludağ Üniversitesi/Tıp Fakültesi/Spor Hekimliği Anabilim Dalı.Bu çalışma ile kronik bel ağrılı hastalarda, eksentrik kasılma içerikli izokinetik bir lomber egzersiz modelinin, ağrı, fonksiyonel yetmezlik, psikososyal durum ve bazı fiziksel özellikler üzerine olan etkilerinin incelenmesi amaçlanmıştır. Çalışmaya en az üç aydır kronik bel ağrısı olan 20-42 yaşları arasında (ortalama yaş = 26.5 ± 5.8) toplam 30 hasta (15 erkek ve kadın) katıldı. Hastalar randomize olarak grup EE: eksentrik egzersiz grubu, grup KE: konsentrik egzersiz grubu ve grup K: kontrol grubu olacak şekilde üç ayrı gruba ayrılarak fiziksel özellikleri ölçüldü. Fonksiyonel yetmezlik, klinik depresyon ve ağrı durumlarını değerlendirmek için sırasıyla Oswestry ölçütü, Beck Depresyon Skalası ve görsel analog skala (Visual Analogue Scale, VAS) kullanıldı. Spinal mobilite değerlendirmesi lomber Schober ve el parmak-zemin mesafesi ölçülerek yapıldı. İzokinetik testlerde 300/sn?lik ve 600/sn?lik açısal hızlarda lomber fleksör ve ekstansör kasların konsentrik ve eksentrik pik kuvvet değerleri ölçüldü. Lomber ekstansörlere yönelik olarak, eksentrik grup izole eksentrik ve konsentrik grup izole konsentrik olacak şekilde haftada 3 gün 4 hafta boyunca çalıştırıldı. Tüm fiziksel ölçümler, değerlendirmeler ve kuvvet testleri 1 ay sonra tekrarlandı. Ağrı düzeylerinde ve fonksiyonel yetmezlikte eksentrik egzersiz grubundaki azalma konsentrik ve kontrol gruplarına göre anlamlıydı (p<0.05). Her iki egzersiz grubunda lomber ekstansör kuvvette istatistiksel anlamlı artış saptandı (p<0.01-p<0.001). Fleksör konsentrik/ekstansör eksentrik kuvvet oranları eksentrik egzersiz grubunda istatistiksel anlamı düştü (p<0.01). Diğer yandan Fleksör eksentrik/ekstansör konsentrik kuvvet oranları ise grup EE (p<0.01) ve grup KE (p<0.001) egzersiz gruplarının her ikisinde de grup K?e göre anlamlı düzeyde azaldı. Ekstansör kaslardaki eksentrik kuvvet artışı ile ağrı (30?/sn?lik açısal hız için r=-0.49, p<0.01; 60?/sn?lik açısal hız için r=-0.47, p<0.01) ve fonksiyonel yetmezlik (30?/sn?lik açısal hız için r=-0.60, p<0.01; 60?/sn?lik açısal hız için r=-0.48, p<0.01) arasında anlamlı korelasyon saptandı. Bel fleksör konsentrik/ekstansör eksentrik resiprokal kuvvet oranı da ağrı (30?/sn?lik açısal hız için r=0.31, p<0.05; 60?/sn?lik açısal hız için r=0.55, p<0.01) ve fonksiyonel yetmezlikle (30?/sn?lik açısal hız için r=0.35, p<0.01; 60?/sn?lik açısal hız için r=0.51, p<0.01) anlamlı korele idi. Bu çalışma bulgularına göre eksentrik egzersizlerin konsentrik egzersizler ve kontrol grubu ile karşılaştırıldığında; kronik bel ağrılı hastalarda bel ekstansör kuvvetini daha belirgin arttırdığı, ağrı ve fonksiyonel yetmezliği olumlu yönde etkilediği söylenebilir.