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    Muscle weakness, proprioceptive deficits, and postural stability in unilateral knee osteoarthritis: a comparative analysis of affected and unaffected limbs
    (Hacettepe University, 2025) Bozgeyik Bağdatlı, Sibel; Yavuz, Duru Ceren; Çelebi, Ezgi; Yıldız, Adalet Elçin
    Objective: This study aimed to investigate quadriceps and hamstring muscle strength, postural stability, proprioceptive sense, and weight-bearing asymmetry between the affected and unaffected lower limbs in patients with unilateral knee osteoarthritis (OA). Materials and Methods: A total of 79 patients (70 women, nine men; mean age 61.08 ± 6.28 years) diagnosed with unilateral knee OA according to the Kellgren-Lawrence classification were included. Demographic and clinical characteristics were recorded. Pain intensity was assessed using the Visual Analog Scale, and functional status was evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Muscle strength was measured with a manual muscle dynamometer, proprioception with joint position sense tests at different knee flexion angles, and postural stability using a force platform under both eyes-open and eyes-closed conditions. Weight-bearing distribution during bilateral stance was also evaluated. Results: Quadriceps and hamstring strength were significantly lower in the affected limb compared to the unaffected side (p  0.001). Weight-bearing on the affected limb was reduced under both eyes-open and eyes-closed conditions (p  0.001). However, no significant interlimb differences were observed in postural stability parameters or proprioceptive accuracy at any tested angles (p > 0.05). Additionally, patients demonstrated a significant asymmetry in load transfer during bilateral stance, favoring the non-affected limb. Conclusion: Patients with unilateral knee OA exhibit reduced muscle strength and weight-bearing capacity in the affected limb, along with asymmetrical load distribution during stance. These findings highlight the importance of addressing weight-bearing asymmetry and muscle weakness in early rehabilitation programs to prevent further functional deterioration and disease progression.
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    Segment-specific alterations in trapezius muscle viscoelasticity in chronic neck pain: a myotonometric case-control study
    (Elsevier Ltd, 2026) Bozgeyik-Bağdatlı, Sibel; Yavuz, Duru Ceren; Özçelik, Berkant Anıl; Çetin, Hatice
    Background: Chronic neck pain (CNP) is associated with altered muscle properties and pain sensitivity, especially in the trapezius muscle. However, evidence on how viscoelastic properties vary across different regions of the trapezius remains limited. Objective: This study aimed to compare the viscoelastic properties, pressure pain threshold, cervical range of motion, disability, depression, and perceived stress between individuals with CNP and asymptomatic controls. Methods: Twenty-six individuals with CNP (median age (IQR): 23 (22 – 24)) and 26 age- and sex-matched controls (median age (IQR): 23 (22 – 25)) were included. Muscle viscoelastic properties of the upper, middle, and lower trapezius were measured using the MyotonPRO. Pressure pain threshold was evaluated with a digital algometer, and cervical range of motion was assessed using a CROM device. Disability, depression, and perceived stress were measured using the Neck Disability Index, Beck Depression Inventory, and Perceived Stress Scale, respectively. Results: Individuals with CNP showed significantly increased muscle tone and stiffness in the upper trapezius bilaterally and altered viscoelastic properties in the middle trapezius (affected side). Pressure pain threshold values were significantly lower across all portions of trapezius. Despite these differences, no significant cervical range of motion limitations were found. Conclusion: Altered mechanical and sensory properties in the trapezius muscle — particularly in its upper and middle portions — may contribute to CNP, even in the absence of substantial cervical mobility limitations. This study provides the first comprehensive comparison of all three trapezius regions in individuals with CNP using handheld myotonometry, offering novel insights into the segment-specific mechanisms underlying chronic neck pain.