Research Article
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Investigation of the Relationship Between Functional Skills, Sensory Functions, and Anthropometric Properties of the Hand in Occupational Therapy Students Using Hierarchical Clustering Analysis

Year 2023, Volume: 11 Issue: 3, 101 - 112, 15.09.2023
https://doi.org/10.30720/ered.1238943

Abstract

Purpose: This study aims to examine the relationship between functional skills, sensorimotor, and anthropometric variables of the hand in health science students.
Material and Methods: The study was carried out on 70 students (21.51± 1.59 years; 61 women, 9 men) from Biruni University. Upper extremity anthropometric measurements were taken from the students. Hand Dynamometer and Pinchmeter were used for hand grip strength, Purdue Pegboard Test for hand dexterity, Semmes-Weinstein Monofilament for two-point discrimination, and Vibration Perception Test were used for sensory functions. Hierarchical cluster analysis was employed to find the clustering trend of the variables.
Results: At the end of the research, two main clusters were obtained, of which four sub-clusters belonging to the second one were identified. The main cluster I contains pinch, dipod, tripod, lateral grip force, Purdue pegboard dominant, non-dominant, both, and assembly. Main cluster II contains finger lengths, palmar length, hand grip, total upper extremity length, height, two-point discrimination, vibration, weight, BMI, monofilament, palmar width, segmental arm, forearm, and hand length.
Conclusion: As a result of the research, it was determined that pinch grip strength, dexterity, anthropometric and sensory characteristics were related to each other.

References

  • Akseki, D., Erduran, M., Özarslan, S., & Pınar, H. (2010). Patellofemoral ağrı sendromu saptanan hastalarda, dizde vibrasyon duyusu, propriyosepsiyon duyusu ile paralel olarak algılanmaktadır: pilot çalışma. Eklem Hast Cerrahisi, 21(1), 23-30.
  • Aranha, V. P., Saxena, S., Moitra, M., Narkeesh, K., Arumugam, N., & Samuel, A. J. (2017). Reaction time norms as measured by ruler drop method in school-going South Asian children: a cross-sectional study. Homo, 68(1), 63–68. https://doi.org/10.1016/j.jchb.2016.12.001
  • Aysha, L. V., & Smitha, D. (2020). Correlation of two-point discrimination and finger dexterity with the hours of computer usage among computer users in South India. Indian Journal of Public Health Research & Development, 11(5), 67-72. https://doi.org/10.37506/ijphrd.v11i5.9292
  • Bleyenheuft, Y., Wilmotte, P., & Thonnard, J. L. (2010). Relationship between tactile spatial resolution and digital dexterity during childhood. Somatosens Mot Res, 27(1), 9–14. https://doi.org/10.3109/08990220903471831
  • Çakıt, E., Durgun, B., Cetik, O. (2016). Assessing the relationship between hand dimensions and manual dexterity performance for Turkish dental students. In: Goonetilleke, R., Karwowski, W. (Eds), Advances in Physical Ergonomics and Human Factors Advances in Intelligent Systems and Computing, (First Edition, pp. 469-479) Switzerland:Springer Cham. https://doi.org/10.1007/978-3-319-41694-6_47
  • Chahal, A., & Kumar, B. (2014). Relationship of hand anthropometry and hand grip strength in junior basketball boys. International Journal of Health Sciences and Research, 4, 166-173.
  • Conforto, I., Samir, C., Chausse, F., Goldstein, A., Pereira, B., & Coudeyre, E. (2019). Comparison of psychometric properties between the Labin, a new electronic dynamometer, and the Jamar: preliminary results in healthy subjects. Hand Surg Rehabil, 38(5), 293–297. https://doi.org/10.1016/j.hansur.2019.07.009
  • Demirel, B., & Celik, Y. (2017). Orthorexia nervosa in healthcare professionals by multivariate statistical method. International Journal of Basic and Clinical Studies (IJBCS), 10(2), 75-87.
  • Dianat, I., Molenbroek, J., & Castellucci, H. I. (2018). A review of the methodology and applications of anthropometry in ergonomics and product design. Ergonomics, 61(12), 1696–1720. https://doi.org/10.1080/00140139.2018.1502817
  • Fallahi, A., & Jadidian, A. (2011). The effect of hand dimensions, hand shape and some anthropometric characteristics on handgrip strength in male grip athletes and non-athletes. J Hum Kinet, 29, 151–159. https://doi.org/10.2478/v10078-011-0049-2
  • Gracia-Ibáñez, V., Sancho-Bru, J. L., & Vergara, M. (2018). Relevance of grasp types to assess functionality for personal autonomy. J Hand Ther, 31(1), 102–110. https://doi.org/10.1016/j.jht.2017.02.003
  • James, S., Ziviani, J., Ware, R. S., & Boyd, R. N. (2015). Relationships between activities of daily living, upper limb function, and visual perception in children and adolescents with unilateral cerebral palsy. Dev Med Child Neurol, 57(9), 852–857. https://doi.org/10.1111/dmcn.12715
  • Koley, S., Singh, J., & Kaur, S. (2010). A study of arm anthropometric profile in Indian interuniversity basketball players. Serbian Journal of Sports Sciences, 5(1), 35-40.
  • Lai, S., Ahmed, U., Bollineni, A., Lewis, R., & Ramchandren, S. (2014). Diagnostic accuracy of qualitative vs. quantitative tuning forks: outcome measure for neuropathy. Journal of Clinical Neuromuscular Disease, 15(3), 96.
  • Lawson, I. (2019). Purdue pegboard test. Occup Med-C, 69(5), 376–377. https://doi.org/10.1093/occmed/kqz044
  • Lee, S. C., Wu, L. C., Chiang, S. L., Lu, L. H., Chen, C. Y., Lin, C. H., et al. (2020). Validating the capability for measuring age-related changes in grip-force strength using a digital hand-held dynamometer in healthy young and elderly adults. Biomed Res Int, 2020, 1-9. https://doi.org/10.1155/2020/6936879
  • Lopes, J., Grams, S. T., da Silva, E. F., de Medeiros, L. A., de Brito, C. M. M., & Yamaguti, WP. (2018). Reference equations for handgrip strength: normative values in young adult and middle-aged subjects. Clin Nutr, 37(3), 914–918. https://doi.org/10.1016/j.clnu.2017.03.018
  • Martin, J. A., Ramsay, J., Hughes, C., Peters, D. M., & Edwards, M. G. (2015). Age and grip strength predict hand dexterity in adults. PloS one, 10(2), e0117598. https://doi.org/10.1371/journal.pone.0117598
  • Peters, M. J., van Nes, S. I., Vanhoutte, E. K., Bakkers, M., van Doorn, P. A., Merkies, I. S., et al. (2011). Revised normative values for grip strength with the Jamar dynamometer. J Peripher Nerv Sys, 16(1), 47-50. https://doi.org/10.1111/j.1529-8027.2011.00318.x
  • Reitz, S. M., Scaffa, M. E., & Dorsey, J. (2020). Occupational therapy in the promotion of health and well-being. Am J Occup Ther, 74(3), 7403420010p1–7403420010p14. https://doi.org/10.5014/ajot.2020.743003
  • Sala, E., Lopomo, N. F., Romagnoli, F., Tomasi, C., Fostinelli, J., & De Palma, G. (2022). Pinch grip per SE is not an occupational risk factor for the musculoskeletal system: an experimental study on field. Int J Env Res Pub He, 19(15), 8975. https://doi.org/10.3390/ijerph19158975
  • Scherder, E., Dekker, W., & Eggermont, L. (2008). Higher-level hand motor function in aging and (preclinical) dementia: its relationship with (instrumental) activities of daily life – A mini-review. Gerontology, 54(6), 333–341. https://doi.org/10.1159/000168203
  • Sheng, J. Y., Blackford, A. L., Bardia, A., Venkat, R., Rosson, G., Giles, J., et al. (2019). Prospective evaluation of finger two-point discrimination and carpal tunnel syndrome among women with breast cancer receiving adjuvant aromatase inhibitor therapy. Breast Cancer Res Tr, 176, 617-624. https://doi.org/10.1007/s10549-019-05270-4
  • Shurrab, M., Mandahawi, N., & Sarder, M. (2017). The assessment of a two-handed pinch force: quantifying different anthropometric pinch grasp patterns for males and females. Int J Ind Ergonom, 58, 38–46. https://doi.org/10.1016/j.ergon.2017.02.006
  • Sığırtmaç, I. C., & Öksüz, C. (2021). Investigation of reliability, validity, and cutoff value of the Jebsen-Taylor Hand Function Test. J Hand Ther, 34(3), 396–403. https://doi.org/10.1016/j.jht.2020.01.004
  • Suda, M., Kawakami, M., Okuyama, K., Ishii, R., Oshima, O., Hijikata, N., et al. (2021). Validity and reliability of the Semmes-Weinstein Monofilament Test and the Thumb Localizing Test in patients with stroke. Front Neurol, 11, 625917. https://doi.org/10.3389/fneur.2020.625917
  • Stijic, M., Petrovic, K., Schwingenschuh, P., Koini, M., & Schmidt, R. (2023). The Purdue Pegboard Test: normative data from 1,355 healthy people from austria. Am J Occup Ther, 77(3), 7703205030. https://doi.org/10.5014/ajot.2023.050023
  • van der Looven, R., Deschrijver, M., Hermans, L., de Muynck, M., & Vingerhoets, G. (2021). Hand size representation in healthy children and young adults. Journal of Experimental Child Psychology, 203, 105016. https://doi.org/10.1016/j.jecp.2020.105016
  • Wolny, T., Linek, P., & Michalski, P. (2017). Inter-rater reliability of two-point discrimination in acute stroke patients. NeuroRehabilitation, 41(1), 127–134. https://doi.org/10.3233/NRE-171464
  • Zaccagni, L., Toselli, S., Bramanti, B., Gualdi-Russo, E., Mongillo, J., & Rinaldo, N. (2020). Handgrip strength in young adults: association with anthropometric variables and laterality. Int J Env Res Pub He, 17(12), 4273. https://doi.org/10.3390/ijerph17124273
  • Zhang, Y., Liu, X., Jia, J., Zhang, Q., Lin, Y., Zhang, L., et al. (2021). Diabetic polyneuropathy and carpal tunnel syndrome together affect hand strength, tactile sensation and dexterity in diabetes patients. J Diabetes Invest, 12(11), 2010–2018. https://doi.org/10.1111/jdi.13580

Ergoterapi Bölümü Öğrencilerinde Elin Fonksiyonel Becerileri, Duyumotor ve Antropometrik Özellikleri Arasındaki İlişkilerin Hiyerarşik Küme Analizi Kullanılarak İncelenmesi

Year 2023, Volume: 11 Issue: 3, 101 - 112, 15.09.2023
https://doi.org/10.30720/ered.1238943

Abstract

Amaç: Bu çalışmanın amacı, sağlık bilimleri öğrencilerinde elin fonksiyonel becerileri ile duyu-motor ve antropometrik değişkenleri arasındaki ilişkiyi incelemektir. Gereç ve Yöntem: Araştırma Biruni Üniversitesi'nden 70 öğrenci (21.51± 1.59 yıl; 61 kadın, 9 erkek) üzerinde gerçekleştirildi. Öğrencilerden üst ekstremite antropometrik ölçümleri alındı. El kavrama kuvveti için Jamar El Dinamometresi ve Pinchmetre, el becerisi için Purdue Pegboard Testi, duyusal beceriler için Semmes-Weinstein Monofilament, iki nokta ayırt etme ve titreşim algılama testi kullanıldı. Değişkenlerin kümelenme eğilimini bulmak için Hiyerarşik Küme Analizi kullanıldı. Sonuçlar: Araştırma sonunda iki ana küme ve II. ana küme'ye ait 4 alt küme elde edilmiştir. 1. Ana küme şunları içerir: Pinch, dipod, tripod, lateral kavrama kuvveti, Purdue Pegboard dominant, dominant olmayan, her ikisi ve montaj. II. ana küme şunları içerir: Parmak uzunlukları, palmar uzunluk, el kavrama kuvveti, toplam üst ekstremite uzunluğu, boy, iki nokta ayrımı, titreşim duyusu, kilo, BMI, dokunma duyusu, palmar genişlik, segmental kol, önkol ve el uzunluğu. Tartışma: Araştırma sonucunda çimdikleyici kavrama kuvveti, el becerisi, antropometrik ve duyusal özelliklerin birbiriyle ilişkili olduğu belirlendi.

References

  • Akseki, D., Erduran, M., Özarslan, S., & Pınar, H. (2010). Patellofemoral ağrı sendromu saptanan hastalarda, dizde vibrasyon duyusu, propriyosepsiyon duyusu ile paralel olarak algılanmaktadır: pilot çalışma. Eklem Hast Cerrahisi, 21(1), 23-30.
  • Aranha, V. P., Saxena, S., Moitra, M., Narkeesh, K., Arumugam, N., & Samuel, A. J. (2017). Reaction time norms as measured by ruler drop method in school-going South Asian children: a cross-sectional study. Homo, 68(1), 63–68. https://doi.org/10.1016/j.jchb.2016.12.001
  • Aysha, L. V., & Smitha, D. (2020). Correlation of two-point discrimination and finger dexterity with the hours of computer usage among computer users in South India. Indian Journal of Public Health Research & Development, 11(5), 67-72. https://doi.org/10.37506/ijphrd.v11i5.9292
  • Bleyenheuft, Y., Wilmotte, P., & Thonnard, J. L. (2010). Relationship between tactile spatial resolution and digital dexterity during childhood. Somatosens Mot Res, 27(1), 9–14. https://doi.org/10.3109/08990220903471831
  • Çakıt, E., Durgun, B., Cetik, O. (2016). Assessing the relationship between hand dimensions and manual dexterity performance for Turkish dental students. In: Goonetilleke, R., Karwowski, W. (Eds), Advances in Physical Ergonomics and Human Factors Advances in Intelligent Systems and Computing, (First Edition, pp. 469-479) Switzerland:Springer Cham. https://doi.org/10.1007/978-3-319-41694-6_47
  • Chahal, A., & Kumar, B. (2014). Relationship of hand anthropometry and hand grip strength in junior basketball boys. International Journal of Health Sciences and Research, 4, 166-173.
  • Conforto, I., Samir, C., Chausse, F., Goldstein, A., Pereira, B., & Coudeyre, E. (2019). Comparison of psychometric properties between the Labin, a new electronic dynamometer, and the Jamar: preliminary results in healthy subjects. Hand Surg Rehabil, 38(5), 293–297. https://doi.org/10.1016/j.hansur.2019.07.009
  • Demirel, B., & Celik, Y. (2017). Orthorexia nervosa in healthcare professionals by multivariate statistical method. International Journal of Basic and Clinical Studies (IJBCS), 10(2), 75-87.
  • Dianat, I., Molenbroek, J., & Castellucci, H. I. (2018). A review of the methodology and applications of anthropometry in ergonomics and product design. Ergonomics, 61(12), 1696–1720. https://doi.org/10.1080/00140139.2018.1502817
  • Fallahi, A., & Jadidian, A. (2011). The effect of hand dimensions, hand shape and some anthropometric characteristics on handgrip strength in male grip athletes and non-athletes. J Hum Kinet, 29, 151–159. https://doi.org/10.2478/v10078-011-0049-2
  • Gracia-Ibáñez, V., Sancho-Bru, J. L., & Vergara, M. (2018). Relevance of grasp types to assess functionality for personal autonomy. J Hand Ther, 31(1), 102–110. https://doi.org/10.1016/j.jht.2017.02.003
  • James, S., Ziviani, J., Ware, R. S., & Boyd, R. N. (2015). Relationships between activities of daily living, upper limb function, and visual perception in children and adolescents with unilateral cerebral palsy. Dev Med Child Neurol, 57(9), 852–857. https://doi.org/10.1111/dmcn.12715
  • Koley, S., Singh, J., & Kaur, S. (2010). A study of arm anthropometric profile in Indian interuniversity basketball players. Serbian Journal of Sports Sciences, 5(1), 35-40.
  • Lai, S., Ahmed, U., Bollineni, A., Lewis, R., & Ramchandren, S. (2014). Diagnostic accuracy of qualitative vs. quantitative tuning forks: outcome measure for neuropathy. Journal of Clinical Neuromuscular Disease, 15(3), 96.
  • Lawson, I. (2019). Purdue pegboard test. Occup Med-C, 69(5), 376–377. https://doi.org/10.1093/occmed/kqz044
  • Lee, S. C., Wu, L. C., Chiang, S. L., Lu, L. H., Chen, C. Y., Lin, C. H., et al. (2020). Validating the capability for measuring age-related changes in grip-force strength using a digital hand-held dynamometer in healthy young and elderly adults. Biomed Res Int, 2020, 1-9. https://doi.org/10.1155/2020/6936879
  • Lopes, J., Grams, S. T., da Silva, E. F., de Medeiros, L. A., de Brito, C. M. M., & Yamaguti, WP. (2018). Reference equations for handgrip strength: normative values in young adult and middle-aged subjects. Clin Nutr, 37(3), 914–918. https://doi.org/10.1016/j.clnu.2017.03.018
  • Martin, J. A., Ramsay, J., Hughes, C., Peters, D. M., & Edwards, M. G. (2015). Age and grip strength predict hand dexterity in adults. PloS one, 10(2), e0117598. https://doi.org/10.1371/journal.pone.0117598
  • Peters, M. J., van Nes, S. I., Vanhoutte, E. K., Bakkers, M., van Doorn, P. A., Merkies, I. S., et al. (2011). Revised normative values for grip strength with the Jamar dynamometer. J Peripher Nerv Sys, 16(1), 47-50. https://doi.org/10.1111/j.1529-8027.2011.00318.x
  • Reitz, S. M., Scaffa, M. E., & Dorsey, J. (2020). Occupational therapy in the promotion of health and well-being. Am J Occup Ther, 74(3), 7403420010p1–7403420010p14. https://doi.org/10.5014/ajot.2020.743003
  • Sala, E., Lopomo, N. F., Romagnoli, F., Tomasi, C., Fostinelli, J., & De Palma, G. (2022). Pinch grip per SE is not an occupational risk factor for the musculoskeletal system: an experimental study on field. Int J Env Res Pub He, 19(15), 8975. https://doi.org/10.3390/ijerph19158975
  • Scherder, E., Dekker, W., & Eggermont, L. (2008). Higher-level hand motor function in aging and (preclinical) dementia: its relationship with (instrumental) activities of daily life – A mini-review. Gerontology, 54(6), 333–341. https://doi.org/10.1159/000168203
  • Sheng, J. Y., Blackford, A. L., Bardia, A., Venkat, R., Rosson, G., Giles, J., et al. (2019). Prospective evaluation of finger two-point discrimination and carpal tunnel syndrome among women with breast cancer receiving adjuvant aromatase inhibitor therapy. Breast Cancer Res Tr, 176, 617-624. https://doi.org/10.1007/s10549-019-05270-4
  • Shurrab, M., Mandahawi, N., & Sarder, M. (2017). The assessment of a two-handed pinch force: quantifying different anthropometric pinch grasp patterns for males and females. Int J Ind Ergonom, 58, 38–46. https://doi.org/10.1016/j.ergon.2017.02.006
  • Sığırtmaç, I. C., & Öksüz, C. (2021). Investigation of reliability, validity, and cutoff value of the Jebsen-Taylor Hand Function Test. J Hand Ther, 34(3), 396–403. https://doi.org/10.1016/j.jht.2020.01.004
  • Suda, M., Kawakami, M., Okuyama, K., Ishii, R., Oshima, O., Hijikata, N., et al. (2021). Validity and reliability of the Semmes-Weinstein Monofilament Test and the Thumb Localizing Test in patients with stroke. Front Neurol, 11, 625917. https://doi.org/10.3389/fneur.2020.625917
  • Stijic, M., Petrovic, K., Schwingenschuh, P., Koini, M., & Schmidt, R. (2023). The Purdue Pegboard Test: normative data from 1,355 healthy people from austria. Am J Occup Ther, 77(3), 7703205030. https://doi.org/10.5014/ajot.2023.050023
  • van der Looven, R., Deschrijver, M., Hermans, L., de Muynck, M., & Vingerhoets, G. (2021). Hand size representation in healthy children and young adults. Journal of Experimental Child Psychology, 203, 105016. https://doi.org/10.1016/j.jecp.2020.105016
  • Wolny, T., Linek, P., & Michalski, P. (2017). Inter-rater reliability of two-point discrimination in acute stroke patients. NeuroRehabilitation, 41(1), 127–134. https://doi.org/10.3233/NRE-171464
  • Zaccagni, L., Toselli, S., Bramanti, B., Gualdi-Russo, E., Mongillo, J., & Rinaldo, N. (2020). Handgrip strength in young adults: association with anthropometric variables and laterality. Int J Env Res Pub He, 17(12), 4273. https://doi.org/10.3390/ijerph17124273
  • Zhang, Y., Liu, X., Jia, J., Zhang, Q., Lin, Y., Zhang, L., et al. (2021). Diabetic polyneuropathy and carpal tunnel syndrome together affect hand strength, tactile sensation and dexterity in diabetes patients. J Diabetes Invest, 12(11), 2010–2018. https://doi.org/10.1111/jdi.13580
There are 31 citations in total.

Details

Primary Language English
Subjects Rehabilitation
Journal Section Research Article
Authors

Başar Öztürk 0000-0001-5763-6008

Ekin Akpınar 0000-0002-5955-5647

Remziye Akarsu 0000-0002-1855-1623

Yusuf Çelik 0000-0003-2849-4033

Publication Date September 15, 2023
Published in Issue Year 2023 Volume: 11 Issue: 3

Cite

APA Öztürk, B., Akpınar, E., Akarsu, R., Çelik, Y. (2023). Investigation of the Relationship Between Functional Skills, Sensory Functions, and Anthropometric Properties of the Hand in Occupational Therapy Students Using Hierarchical Clustering Analysis. Ergoterapi Ve Rehabilitasyon Dergisi, 11(3), 101-112. https://doi.org/10.30720/ered.1238943
AMA Öztürk B, Akpınar E, Akarsu R, Çelik Y. Investigation of the Relationship Between Functional Skills, Sensory Functions, and Anthropometric Properties of the Hand in Occupational Therapy Students Using Hierarchical Clustering Analysis. Ergoterapi ve Rehabilitasyon Dergisi. September 2023;11(3):101-112. doi:10.30720/ered.1238943
Chicago Öztürk, Başar, Ekin Akpınar, Remziye Akarsu, and Yusuf Çelik. “Investigation of the Relationship Between Functional Skills, Sensory Functions, and Anthropometric Properties of the Hand in Occupational Therapy Students Using Hierarchical Clustering Analysis”. Ergoterapi Ve Rehabilitasyon Dergisi 11, no. 3 (September 2023): 101-12. https://doi.org/10.30720/ered.1238943.
EndNote Öztürk B, Akpınar E, Akarsu R, Çelik Y (September 1, 2023) Investigation of the Relationship Between Functional Skills, Sensory Functions, and Anthropometric Properties of the Hand in Occupational Therapy Students Using Hierarchical Clustering Analysis. Ergoterapi ve Rehabilitasyon Dergisi 11 3 101–112.
IEEE B. Öztürk, E. Akpınar, R. Akarsu, and Y. Çelik, “Investigation of the Relationship Between Functional Skills, Sensory Functions, and Anthropometric Properties of the Hand in Occupational Therapy Students Using Hierarchical Clustering Analysis”, Ergoterapi ve Rehabilitasyon Dergisi, vol. 11, no. 3, pp. 101–112, 2023, doi: 10.30720/ered.1238943.
ISNAD Öztürk, Başar et al. “Investigation of the Relationship Between Functional Skills, Sensory Functions, and Anthropometric Properties of the Hand in Occupational Therapy Students Using Hierarchical Clustering Analysis”. Ergoterapi ve Rehabilitasyon Dergisi 11/3 (September 2023), 101-112. https://doi.org/10.30720/ered.1238943.
JAMA Öztürk B, Akpınar E, Akarsu R, Çelik Y. Investigation of the Relationship Between Functional Skills, Sensory Functions, and Anthropometric Properties of the Hand in Occupational Therapy Students Using Hierarchical Clustering Analysis. Ergoterapi ve Rehabilitasyon Dergisi. 2023;11:101–112.
MLA Öztürk, Başar et al. “Investigation of the Relationship Between Functional Skills, Sensory Functions, and Anthropometric Properties of the Hand in Occupational Therapy Students Using Hierarchical Clustering Analysis”. Ergoterapi Ve Rehabilitasyon Dergisi, vol. 11, no. 3, 2023, pp. 101-12, doi:10.30720/ered.1238943.
Vancouver Öztürk B, Akpınar E, Akarsu R, Çelik Y. Investigation of the Relationship Between Functional Skills, Sensory Functions, and Anthropometric Properties of the Hand in Occupational Therapy Students Using Hierarchical Clustering Analysis. Ergoterapi ve Rehabilitasyon Dergisi. 2023;11(3):101-12.

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