Research Article
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Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia with Healthy Controls and within Themselves

Year 2021, Volume: 9 Issue: 3, 79 - 88, 20.12.2021
https://doi.org/10.30720/ered.931701

Abstract

Purpose: Using orthosis due to orthopedic problems are common in adults. Positive effects of orthoses are correcting existing deformities, preventing progression and immobilizing a weak/injured segment. However, the effect of orthosis on level of physical activity in pain-free individuals has not been investigated. This controlled trial investigated the level of physical activity of individuals without pain and kinesiophobia who use orthoses and compared the results with healthy individuals. Material and Methods: 244 participants (94 using orthoses, 150 healthy individuals) who were 18-65 years old participated in this study. Individuals who were painless according to the Nordic Musculoskeletal Questionnaire and without kinesiophobia according to the Tampa Kinesiophobia Scale were included in the study. Physical activity was measured with The International Physical Activity Questionnaire (IPAQ). Results: The IPAQ scores showed that healthy individuals had a statistically higher level of physical activity compared to those who used orthotic devices for any part of their body (p<0.001). When the orthosis subgroups were analyzed, there was no statistically significant difference in physical activity amongst the subgroups (p=0.906, p=0.819, p=0.537). Discussion: This study shows that in addition to the clinical benefits provided by orthoses, they can lead to complications such as significant decrease in physical activity in individuals. Raising awareness that physical activity may decrease in patients using orthoses, and therefore increasing physical activity levels, should become an important part of rehabilitation.

Supporting Institution

Destekleyen Kurum Bulunmamaktadır

Project Number

-

Thanks

The authors would like to thank Gokhan Yazici and Cagla Ozkul for their contributions to the study.

References

  • Adams, B. D., Grosland, N. M., Murphy, D. M., & McCullough, M. (2003). Impact of impaired wrist motion on hand and upper-extremity performance. J Hand Surg Am, 28(6), 898-903. doi: 10.1016/s0363-5023(03)00424-6
  • Amer, A.O., Jarl, G.M.,& Hermansson, L.N. (2014). The effect of insoles on foot pain and daily activities. Prosthet Orthot Int, 38(6), 474-480. doi: 10.1177/0309364613512369
  • Azadinia, F., Takamjani, E. E., Kamyab, M., Parnianpour, M., Cholewicki, J., & Maroufi, N. (2017). Can lumbosacral orthoses cause trunk muscle weakness? A systematic review of literature. Spine J, 17(4), 589-602. doi: 10.1016/j.spinee.2016.12.005
  • Bauman, A. E. (2004). Updating the evidence that physical activity is good for health: An epidemiological review 2000–2003. J Sci Med Sport, 7(1), 6-19. doi: 10.1016/s1440-2440(04)80273-1
  • Choo, Y. J., & Chang, M. C. (2020). Effectiveness of orthoses for treatment in patients with spinal pain. Yeungnam Univ J Med, 37(2), 84. doi: 10.12701/yujm.2020.00150
  • Collins, N., Bisset, L., McPoil, T., & Vicenzino, B. (2007). Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis. Foot Ankle Int, 28(3), 396-412. doi: 10.3113/FAI.2007.0396
  • Craig, C. L., Marshall, A. L., Sjöström, M., Bauman, A. E., Booth, M. L., Ainsworth, B.E., et al. (2003). International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc, 35(8), 1381-1395. doi: 10.1249/01.MSS.0000078924.61453.FB
  • Dickinson, C., Campion, K., Foster, A., Newman, S., O'rourke, A., & Thomas, P. (1992). Questionnaire development: An examination of the Nordic Musculoskeletal Questionnaire. Appl Ergon, 23(3), 197-201. doi: 10.1016/0003-6870(92)90225-k
  • Dinkel, D., Hassan, M., Despiegelaere, H., Johanning, J., Pipinos, I. I., & Myers, S.A. (2020). Patients with peripheral artery disease perceptions of an ankle foot orthosis: A comparison by physical activity level. Circulation, 142(3), A13282. https://doi.org/10.1161/circ.142.suppl_3.13282
  • Dvorznak, M., Fitzpatrick, K., Karmarkar, A., Kelleher, A. & McCann, T. (2006). Orthotic devices. In R.A. Cooper, H. Ohnabe, & D.A. Hopson (Eds.), An Introduction to Rehabilitation Engineering, (First Edition, pp. 261-285). USA: Taylor & Francis.
  • Elattar, O., Smith, T., Ferguson, A., Farber, D., & Wapner, K. (2018). Uses of braces and orthotics for conservative management of foot and ankle disorders. Foot Ankle Orthopaedics, 3(3), https://doi.org/10.1177/2473011418780700
  • Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B.A., Lamonte, M.J., Lee, I. M., et al. (2011). American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc, 43(7), 1334-1359. doi: 10.1249/MSS.0b013e318213fefb
  • Hsieh, R. L., & Lee, W. C. (2014). Immediate and medium-term effects of custom-moulded insoles on pain, physical function, physical activity, and balance control in patients with knee osteoarthritis. J Rehabil Med, 46(2), 159-165. doi: 10.2340/16501977-1254
  • Kahraman, T., Genç, A. and Göz, E. (2016). The Nordic Musculoskeletal Questionnaire: Cross-cultural adaptation into Turkish assessing its psychometric properties. Disabil Rehabil, 38(21), 2153-2160. doi: 10.3109/09638288.2015.1114034
  • Kuorinka, I., Jonsson, B., Kilbom, A., Vinterberg, H., Biering-Sørensen, F., Andersson, G., et al. (1987). Standardised Nordic Questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon, 18(3), 233-237. doi: 10.1016/0003-6870(87)90010-x
  • Laufer, Y., Hausdorff, J. M., & Ring, H. (2009). Effects of a foot drop neuroprosthesis on functional abilities, social participation, and gait velocity. Am J Phys Med Rehabil, 88(1), 14-20. doi: 10.1097/PHM.0b013e3181911246
  • Lundberg, M., Styf, J., & Jansson, B. (2009). On what patients does the Tampa Scale for Kinesiophobia fit? Physiother Theory Pract, 25(7), 495-506. doi: 10.3109/09593980802662160
  • Mell, A. G., Friedman, M. A., Hughes, R. E., & Carpenter, J. E. (2006). Shoulder muscle activity increases with wrist splint use during a simulated upper-extremity work task. Am J Occup Ther, 60(3), 320-326. doi: 10.5014/ajot.60.3.320
  • Miller, R. P., Kori, S. H., & Todd, D. D. (1991). The Tampa Scale: A measure of kinesiophobia. Clin J Pain, 7(1), 51-52.
  • Mills, K., Blanch, P., Chapman, A.R., McPoil, T. G., & Vicenzino, B. (2010). Foot orthoses and gait: A systematic review and meta-analysis of literature pertaining to potential mechanisms. Br J Sports Med, 44(14), 1035-1046. doi: 10.1136/bjsm.2009.066977
  • Muzin, S., Isaac, Z., Walker, J., El Abd, O., & Baima, J. (2008). When should a cervical collar be used to treat neck pain? Curr Rew Musculoskelet Med, 1(2), 114-119. doi: 10.1007/s12178-007-9017-9
  • Negrini, S., Grivas, T.B., Kotwicki, T., Rigo, M., & Zaina, F. (2009). Guidelines on" Standards of management of idiopathic scoliosis with corrective braces in everyday clinics and in clinical research": SOSORT Consensus 2008. Scoliosis, 4(1), 1-14. doi: 10.1186/1748-7161-4-2
  • Pool, J. J., Hiralal, S., Ostelo, R. W., Van der Veer, K., Vlaeyen, J. W., Bouter, L.M., et al. (2009). The applicability of the Tampa Scale of Kinesiophobia for patients with sub-acute neck pain: a qualitative study. Qual Quant, 43(5), 773-780. doi 10.1007/s11135-008-9203-x
  • Priore, L. B., Lack, S., Garcia, C., Azevedo, F. M., & de Oliveira Silva, D. (2020). Two weeks of wearing a knee brace compared with minimal intervention on kinesiophobia at 2 and 6 weeks in people with patellofemoral pain: a randomized controlled trial. Arch of Phys Med Rehabil, 101(4), 613-623.
  • Rickert, C., Grabowski, M., Gosheger, G., Schorn, D., Schneider, K. N., Klingebiel, S., et al. (2020). How shoulder immobilization influences daily physical activity–an accelerometer based preliminary study. BMC Musculoskelet Disord, 21(1), 1-6. doi: 10.1016/j.apmr.2019.10.190
  • Saglam, M., Arikan, H., Savci, S., Inal-Ince, D., Bosnak-Guclu, M., Karabulut, E., et al. (2010). International Physical Activity Questionnaire: Reliability and validity of the Turkish version. Percept Mot Skills, 111(1), 278-284. doi: 10.2466/06.08.PMS.111.4.278-284
  • Sebastiao, E., Gobbi, S., Chodzko-Zajko, W., Schwingel, A., Papini, C., Nakamura, P., et al. (2012). The International Physical Activity Questionnaire-long form overestimates self-reported physical activity of Brazilian adults. Public Health, 126(11), 967-975. doi: 10.1016/j.puhe.2012.07.004
  • Sliepen, M., Mauricio, E., & Rosenbaum, D. (2018). Acute and mid-term (six-week) effects of an ankle-foot-orthosis on biomechanical parameters, clinical outcomes and physical activity in knee osteoarthritis patients with varus malalignment. Gait Posture, 62, 297-302. doi: 10.1016/j.gaitpost.2018.03.034
  • Telfer, S., Abbott, M., Steultjens, M., Rafferty, D., & Woodburn, J. (2013). Dose–response effects of customised foot orthoses on lower limb muscle activity and plantar pressures in pronated foot type. Gait Posture, 38(3), 443-449. doi: 10.1016/j.gaitpost.2013.01.012
  • Van Swigchem, R., Vloothuis, J., den Boer, J., Weerdesteyn, V., & Geurts, A.C. (2010). Is transcutaneous peroneal stimulation beneficial to patients with chronic stroke using an ankle-foot orthosis? A within-subjects study of patients' satisfaction, walking speed and physical activity level. J Rehabil Med, 42(2), 117-121.
  • Wang, C., Goel, R., Rahemi, H., Zhang, Q., Lepow, B., & Najafi, B. (2019). Effectiveness of daily use of bilateral custom-made ankle-foot orthoses on balance, fear of falling, and physical activity in older adults: a randomized controlled trial. Gerontology, 65(3), 299-307. doi: 10.2340/16501977-0489
  • Wanner, M., Probst-Hensch, N., Kriemler, S., Meier, F., Autenrieth, C., & Martin, B.W. (2016). Validation of the long international physical activity questionnaire: influence of age and language region. Prev Med Rep, 3, 250-256. doi:10.1016/j.pmedr.2016.03.003
  • Yilmaz, Ö.T., Yakut, Y., Uygur, F., & Uluğ, N. (2011). Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. Fiz Rehabil, 22(1), 44-49.
  • Zarghooni, K., Beyer, F., Siewe, J., & Eysel, P. (2013). The orthotic treatment of acute and chronic disease of the cervical and lumbar spine. Dtsch Arztebl Int, 110(44), 737-742. doi:10.3238/arztebl.2013.0737

Ağrısı ve Kinezyofobisi Olmayan Ortez Kullanan Bireylerin Fiziksel Aktivite Düzeylerinin Sağlıklı Kontrollerle ve Kendi Içinde Karşılaştırılması

Year 2021, Volume: 9 Issue: 3, 79 - 88, 20.12.2021
https://doi.org/10.30720/ered.931701

Abstract

Amaç: Ortopedik problemler nedeniyle ortez kullanımı yetişkin popülasyonda oldukça yaygındır. Ortezlerin olumlu etkileri, mevcut deformiteleri düzeltmesi, ilerlemesini engellemesi ve zayıf/yaralı bir segmenti hareketsiz hale getirmesidir. Ancak ortez kullanan ağrısız bireylerde ortezin fiziksel aktivite düzeyine etkileri henüz araştırılmamıştır. Bu kontrollü çalışma, ortez kullanan ağrısız ve kinezyofobisi olmayan bireylerin fiziksel aktivite düzeylerini araştırmış ve sonuçları sağlıklı bireylerle karşılaştırmıştır. Gereç ve Yöntem: Bu çalışmaya 18-65 yaş arası toplam 244 birey (94 ortez kullanan, 150 sağlıklı birey) katılmıştır. Nordic Kas İskelet Sistemi Anketi’ne göre ağrısız olan ve Tampa Kinesiyofobi Ölçeği'ne göre kinezyofobisi olmayan olgular çalışmaya dâhil edildi. Fiziksel aktivite, Uluslararası Fiziksel Aktivite Anketi (IPAQ) ile ölçüldü. Sonuçlar: IPAQ skorlarına göre, sağlıklı bireylerin, vücutlarının herhangi bir yerinde ortez kullananlara kıyasla istatistiksel olarak daha yüksek fiziksel aktivite düzeyine sahip olduğunu bulundu (p<0,001). Ortez alt grupları incelendiğinde; fiziksel aktivite düzeyleri açısından alt gruplar arasında istatistiksel olarak anlamlı bir fark olmadığı görüldü (p=0,906, p=0,819, p=0,537).Tartışma: Bu çalışma, ortezlerin sağladığı klinik yararların yanında bireylerde fiziksel aktivitenin önemli ölçüde azalması gibi bir komplikasyona yol açabileceğini göstermektedir. Ortez kullanan hastalarda fiziksel aktivitenin azalabileceğinin farkındalığını yaratmak ve dolayısıyla fiziksel aktivite düzeylerini artırmak rehabilitasyonun önemli bir parçası haline gelmelidir.

Project Number

-

References

  • Adams, B. D., Grosland, N. M., Murphy, D. M., & McCullough, M. (2003). Impact of impaired wrist motion on hand and upper-extremity performance. J Hand Surg Am, 28(6), 898-903. doi: 10.1016/s0363-5023(03)00424-6
  • Amer, A.O., Jarl, G.M.,& Hermansson, L.N. (2014). The effect of insoles on foot pain and daily activities. Prosthet Orthot Int, 38(6), 474-480. doi: 10.1177/0309364613512369
  • Azadinia, F., Takamjani, E. E., Kamyab, M., Parnianpour, M., Cholewicki, J., & Maroufi, N. (2017). Can lumbosacral orthoses cause trunk muscle weakness? A systematic review of literature. Spine J, 17(4), 589-602. doi: 10.1016/j.spinee.2016.12.005
  • Bauman, A. E. (2004). Updating the evidence that physical activity is good for health: An epidemiological review 2000–2003. J Sci Med Sport, 7(1), 6-19. doi: 10.1016/s1440-2440(04)80273-1
  • Choo, Y. J., & Chang, M. C. (2020). Effectiveness of orthoses for treatment in patients with spinal pain. Yeungnam Univ J Med, 37(2), 84. doi: 10.12701/yujm.2020.00150
  • Collins, N., Bisset, L., McPoil, T., & Vicenzino, B. (2007). Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis. Foot Ankle Int, 28(3), 396-412. doi: 10.3113/FAI.2007.0396
  • Craig, C. L., Marshall, A. L., Sjöström, M., Bauman, A. E., Booth, M. L., Ainsworth, B.E., et al. (2003). International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc, 35(8), 1381-1395. doi: 10.1249/01.MSS.0000078924.61453.FB
  • Dickinson, C., Campion, K., Foster, A., Newman, S., O'rourke, A., & Thomas, P. (1992). Questionnaire development: An examination of the Nordic Musculoskeletal Questionnaire. Appl Ergon, 23(3), 197-201. doi: 10.1016/0003-6870(92)90225-k
  • Dinkel, D., Hassan, M., Despiegelaere, H., Johanning, J., Pipinos, I. I., & Myers, S.A. (2020). Patients with peripheral artery disease perceptions of an ankle foot orthosis: A comparison by physical activity level. Circulation, 142(3), A13282. https://doi.org/10.1161/circ.142.suppl_3.13282
  • Dvorznak, M., Fitzpatrick, K., Karmarkar, A., Kelleher, A. & McCann, T. (2006). Orthotic devices. In R.A. Cooper, H. Ohnabe, & D.A. Hopson (Eds.), An Introduction to Rehabilitation Engineering, (First Edition, pp. 261-285). USA: Taylor & Francis.
  • Elattar, O., Smith, T., Ferguson, A., Farber, D., & Wapner, K. (2018). Uses of braces and orthotics for conservative management of foot and ankle disorders. Foot Ankle Orthopaedics, 3(3), https://doi.org/10.1177/2473011418780700
  • Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B.A., Lamonte, M.J., Lee, I. M., et al. (2011). American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc, 43(7), 1334-1359. doi: 10.1249/MSS.0b013e318213fefb
  • Hsieh, R. L., & Lee, W. C. (2014). Immediate and medium-term effects of custom-moulded insoles on pain, physical function, physical activity, and balance control in patients with knee osteoarthritis. J Rehabil Med, 46(2), 159-165. doi: 10.2340/16501977-1254
  • Kahraman, T., Genç, A. and Göz, E. (2016). The Nordic Musculoskeletal Questionnaire: Cross-cultural adaptation into Turkish assessing its psychometric properties. Disabil Rehabil, 38(21), 2153-2160. doi: 10.3109/09638288.2015.1114034
  • Kuorinka, I., Jonsson, B., Kilbom, A., Vinterberg, H., Biering-Sørensen, F., Andersson, G., et al. (1987). Standardised Nordic Questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon, 18(3), 233-237. doi: 10.1016/0003-6870(87)90010-x
  • Laufer, Y., Hausdorff, J. M., & Ring, H. (2009). Effects of a foot drop neuroprosthesis on functional abilities, social participation, and gait velocity. Am J Phys Med Rehabil, 88(1), 14-20. doi: 10.1097/PHM.0b013e3181911246
  • Lundberg, M., Styf, J., & Jansson, B. (2009). On what patients does the Tampa Scale for Kinesiophobia fit? Physiother Theory Pract, 25(7), 495-506. doi: 10.3109/09593980802662160
  • Mell, A. G., Friedman, M. A., Hughes, R. E., & Carpenter, J. E. (2006). Shoulder muscle activity increases with wrist splint use during a simulated upper-extremity work task. Am J Occup Ther, 60(3), 320-326. doi: 10.5014/ajot.60.3.320
  • Miller, R. P., Kori, S. H., & Todd, D. D. (1991). The Tampa Scale: A measure of kinesiophobia. Clin J Pain, 7(1), 51-52.
  • Mills, K., Blanch, P., Chapman, A.R., McPoil, T. G., & Vicenzino, B. (2010). Foot orthoses and gait: A systematic review and meta-analysis of literature pertaining to potential mechanisms. Br J Sports Med, 44(14), 1035-1046. doi: 10.1136/bjsm.2009.066977
  • Muzin, S., Isaac, Z., Walker, J., El Abd, O., & Baima, J. (2008). When should a cervical collar be used to treat neck pain? Curr Rew Musculoskelet Med, 1(2), 114-119. doi: 10.1007/s12178-007-9017-9
  • Negrini, S., Grivas, T.B., Kotwicki, T., Rigo, M., & Zaina, F. (2009). Guidelines on" Standards of management of idiopathic scoliosis with corrective braces in everyday clinics and in clinical research": SOSORT Consensus 2008. Scoliosis, 4(1), 1-14. doi: 10.1186/1748-7161-4-2
  • Pool, J. J., Hiralal, S., Ostelo, R. W., Van der Veer, K., Vlaeyen, J. W., Bouter, L.M., et al. (2009). The applicability of the Tampa Scale of Kinesiophobia for patients with sub-acute neck pain: a qualitative study. Qual Quant, 43(5), 773-780. doi 10.1007/s11135-008-9203-x
  • Priore, L. B., Lack, S., Garcia, C., Azevedo, F. M., & de Oliveira Silva, D. (2020). Two weeks of wearing a knee brace compared with minimal intervention on kinesiophobia at 2 and 6 weeks in people with patellofemoral pain: a randomized controlled trial. Arch of Phys Med Rehabil, 101(4), 613-623.
  • Rickert, C., Grabowski, M., Gosheger, G., Schorn, D., Schneider, K. N., Klingebiel, S., et al. (2020). How shoulder immobilization influences daily physical activity–an accelerometer based preliminary study. BMC Musculoskelet Disord, 21(1), 1-6. doi: 10.1016/j.apmr.2019.10.190
  • Saglam, M., Arikan, H., Savci, S., Inal-Ince, D., Bosnak-Guclu, M., Karabulut, E., et al. (2010). International Physical Activity Questionnaire: Reliability and validity of the Turkish version. Percept Mot Skills, 111(1), 278-284. doi: 10.2466/06.08.PMS.111.4.278-284
  • Sebastiao, E., Gobbi, S., Chodzko-Zajko, W., Schwingel, A., Papini, C., Nakamura, P., et al. (2012). The International Physical Activity Questionnaire-long form overestimates self-reported physical activity of Brazilian adults. Public Health, 126(11), 967-975. doi: 10.1016/j.puhe.2012.07.004
  • Sliepen, M., Mauricio, E., & Rosenbaum, D. (2018). Acute and mid-term (six-week) effects of an ankle-foot-orthosis on biomechanical parameters, clinical outcomes and physical activity in knee osteoarthritis patients with varus malalignment. Gait Posture, 62, 297-302. doi: 10.1016/j.gaitpost.2018.03.034
  • Telfer, S., Abbott, M., Steultjens, M., Rafferty, D., & Woodburn, J. (2013). Dose–response effects of customised foot orthoses on lower limb muscle activity and plantar pressures in pronated foot type. Gait Posture, 38(3), 443-449. doi: 10.1016/j.gaitpost.2013.01.012
  • Van Swigchem, R., Vloothuis, J., den Boer, J., Weerdesteyn, V., & Geurts, A.C. (2010). Is transcutaneous peroneal stimulation beneficial to patients with chronic stroke using an ankle-foot orthosis? A within-subjects study of patients' satisfaction, walking speed and physical activity level. J Rehabil Med, 42(2), 117-121.
  • Wang, C., Goel, R., Rahemi, H., Zhang, Q., Lepow, B., & Najafi, B. (2019). Effectiveness of daily use of bilateral custom-made ankle-foot orthoses on balance, fear of falling, and physical activity in older adults: a randomized controlled trial. Gerontology, 65(3), 299-307. doi: 10.2340/16501977-0489
  • Wanner, M., Probst-Hensch, N., Kriemler, S., Meier, F., Autenrieth, C., & Martin, B.W. (2016). Validation of the long international physical activity questionnaire: influence of age and language region. Prev Med Rep, 3, 250-256. doi:10.1016/j.pmedr.2016.03.003
  • Yilmaz, Ö.T., Yakut, Y., Uygur, F., & Uluğ, N. (2011). Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. Fiz Rehabil, 22(1), 44-49.
  • Zarghooni, K., Beyer, F., Siewe, J., & Eysel, P. (2013). The orthotic treatment of acute and chronic disease of the cervical and lumbar spine. Dtsch Arztebl Int, 110(44), 737-742. doi:10.3238/arztebl.2013.0737
There are 34 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Melek Volkan-yazıcı 0000-0001-9686-0571

Fatmagül Varol 0000-0003-2808-9732

Project Number -
Publication Date December 20, 2021
Published in Issue Year 2021 Volume: 9 Issue: 3

Cite

APA Volkan-yazıcı, M., & Varol, F. (2021). Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia with Healthy Controls and within Themselves. Ergoterapi Ve Rehabilitasyon Dergisi, 9(3), 79-88. https://doi.org/10.30720/ered.931701
AMA Volkan-yazıcı M, Varol F. Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia with Healthy Controls and within Themselves. Ergoterapi ve Rehabilitasyon Dergisi. December 2021;9(3):79-88. doi:10.30720/ered.931701
Chicago Volkan-yazıcı, Melek, and Fatmagül Varol. “Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia With Healthy Controls and Within Themselves”. Ergoterapi Ve Rehabilitasyon Dergisi 9, no. 3 (December 2021): 79-88. https://doi.org/10.30720/ered.931701.
EndNote Volkan-yazıcı M, Varol F (December 1, 2021) Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia with Healthy Controls and within Themselves. Ergoterapi ve Rehabilitasyon Dergisi 9 3 79–88.
IEEE M. Volkan-yazıcı and F. Varol, “Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia with Healthy Controls and within Themselves”, Ergoterapi ve Rehabilitasyon Dergisi, vol. 9, no. 3, pp. 79–88, 2021, doi: 10.30720/ered.931701.
ISNAD Volkan-yazıcı, Melek - Varol, Fatmagül. “Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia With Healthy Controls and Within Themselves”. Ergoterapi ve Rehabilitasyon Dergisi 9/3 (December 2021), 79-88. https://doi.org/10.30720/ered.931701.
JAMA Volkan-yazıcı M, Varol F. Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia with Healthy Controls and within Themselves. Ergoterapi ve Rehabilitasyon Dergisi. 2021;9:79–88.
MLA Volkan-yazıcı, Melek and Fatmagül Varol. “Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia With Healthy Controls and Within Themselves”. Ergoterapi Ve Rehabilitasyon Dergisi, vol. 9, no. 3, 2021, pp. 79-88, doi:10.30720/ered.931701.
Vancouver Volkan-yazıcı M, Varol F. Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia with Healthy Controls and within Themselves. Ergoterapi ve Rehabilitasyon Dergisi. 2021;9(3):79-88.

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