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    Effects of Auricular Vagus Nerve Stimulation on Cardio-Respiratory Functions After Aerobic Exercise
    (Nevzat Demirci, 2024) Gucluer, Ezgi Ovunc; Ozden, Ali Veysel; Ural, Halil Ibrahim; Alptekin, Hasan Kerem; Hatik, Sefa Haktan
    The aim of our study is to find out whether the return rate of parasympathetic activity (PA) can be accelerated with auricular transcutaneous vagus nerve stimulation (TVNS). Pulmonary function test, ANS activity, pulse and blood pressure measurements were made. Individuals ran for 15 minutes. Those in the TVNS group received 5 minutes of auricular VNS. In the control group, headphones were attached but no current was given. After the end of their procedures, they were compared with pre-exercise. In the TVNS group, the pulse parameter was higher than in the initial measurement (p=0.001). There was a significant (p=0.007) rise in the FEV1 value in the VNS group. The sympathetic nervous system (SNS) index (p<0.05) increased in both groups when compared to the initial measurement, although there was no significant difference in the index values between the groups. The TVNS group showed an increase from the first measurement (p<0.05), but there was no significant difference in the parasympathetic nervous system (PNS) Index between the groups (p>0.05). The groups' values for the first and second measures were equal (p>0.05), and the root mean square of the successive differences (RMSSD) values did not reveal a significant difference. TVNS can improve respiratory parameters in healthy individuals in the acute period after exercise, and it seems that it can also increase activation in both the sympathetic and parasympathetic system. It can be stated that TVNS may lead to variable results in different circumstances in sports © 2024 Nevzat Demirci. All rights reserved.
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    Effects of transcutaneous auricular vagus nerve stimulation added to robotic rehabilitation in patients with ischemic stroke: a randomized clinical trial
    (Bmc, 2026) Kizil, Omer Dicle; Ural, Ibrahim Halil; Hatik, Sefa Haktan; Ozden, Ali Veysel; Aydin, Emine Busra
    Background This study aimed to investigate the effects of adding transcutaneous auricular vagus nerve stimulation (taVNS) to robotic rehabilitation on functional outcomes and neuromuscular activity in patients with ischemic stroke. Methods This randomized controlled clinical trial employed a pre-post study design and was conducted in a hospital-based physiotherapy and rehabilitation clinic. A total of 40 patients with ischemic stroke, aged 18-65 years, were randomly assigned to either a robotic rehabilitation group (RRG) or a combined vagus nerve stimulation and robotic rehabilitation group (VRRG). Spasticity, walking speed, motor function, quality of life, muscle activity, and pain were assessed at baseline and after six weeks of treatment. Results Primary outcome measures were walking speed, motor function assessed by the Fugl-Meyer Assessment, and pain intensity. Secondary outcomes included electrophysiological measurements (H-reflex and F-wave parameters) and quality of life. Within-group analyses showed significant improvements in all outcomes in the VRRG (p < 0.05), whereas all outcomes except pain improved significantly in the RRG (p < 0.05). Between-group comparisons demonstrated greater improvements in walking speed in the VRRG compared with the RRG (mean difference - 1.84 s, 95% CI - 3.7 to - 0.7; r = 0.43; p = 0.006) and greater pain reduction in the VRRG (mean difference - 1.55, 95% CI - 2.5 to - 0.1; r = 0.30; p = 0.048). In contrast, a greater reduction in the Hmax/Mmax amplitude ratio-an electrophysiological marker of spinal excitability-was observed in the RRG. Conclusion The findings suggest that transcutaneous auricular vagus nerve stimulation combined with robotic rehabilitation may provide additional benefits in terms of walking speed and pain reduction in patients with ischemic stroke.
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    From Home to Health: The Effectiveness of Otago Exercise Program via Telerehabilitation on Fall-Related Outcomes in Older Adults
    (Romanian Assoc Balneology, 2025) Simsek, Kubilay; Alptekin, Hasan Kerem; Hatik, Sefa Haktan; Pehlivanoglu, Berkay Eren
    This study aimed to investigate the effects of the Otago Exercise Program (OEP), delivered via telerehabilitation, on pain, walking speed, lower extremity muscle strength, fear of falling, anxiety, quality of life, and balance in older adults with a history of falls. A total of 45 participants aged 65-78 were randomized into three groups: Face-to-Face Otago Exercise Group (FFOEG, n=15), Telerehabilitation-Based Otago Exercise Group (TBOEG, n=15), and Control Group (CG, n=15). The intervention consisted of 45-minute sessions, three times per week, for eight weeks. Evaluations were performed at baseline, 4th week, 8th week, and 4 weeks post-intervention using the Numeric Pain Scale, Timed Up and Go Test, 30-Second Sit- to-Stand Test, Falls Efficacy Scale, Beck Anxiety Inventory, WHOQOL-OLD, and Tinetti Balance and Gait Test. No significant difference was found in demographic variables between the groups (p>0.05). Intra-group analyses showed significant improvements in both intervention groups in most outcomes (p<0.05). Between-group comparisons revealed significant differences in favor of TOEG for fear of falling and balance (p<0.05). These findings support the effectiveness of OEP and suggest that telerehabilitation may be a viable alternative for delivering fall-prevention exercises to older adults in hard-to-reach areas.
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    Immediate effects of cervical spine and sacroiliac joint manipulations on the autonomic nervous system and pedobarographic analysis: Randomized controlled trial
    (Elsevier, 2026) Turgut, Hayriye; Buyukkirli, Lker Lker Can; Hatik, Sefa Haktan; Aydin, Emine Busra
    Background: This study aimed to investigate the immediate effects of cervical and sacroiliac joint manipulations on autonomic nervous system activity and baropodometric parameters. Methods: Participants were randomly assigned to three groups with equal gender distribution. The cervical manipulation group received chiropractic manipulation at the C3-C5 level, while the sacroiliac group received manipulation at the sacroiliac joint. The control group received no intervention. Pre- and post-treatment evaluations were conducted after a 30-minute interval. Plantar pressure was measured via a pedobarographic device. Autonomic nervous system activity was assessed using the Polar H10. Blood pressure and heart rate were manually recorded using a sphygmomanometer and pulse oximeter. Statistical significance was set at p < 0.05. Results: No significant differences were found among groups in terms of age, gender, height, or BMI (Kruskal-Wallis, p > 0.05). The cervical manipulation group showed significant decreases in systolic and diastolic blood pressure and heart rate post-intervention (Wilcoxon, p < 0.05). The sacroiliac group showed a significant increase in heart rate only (Wilcoxon, p < 0.05). No significant changes were observed in baropodometric parameters or autonomic activity within or between groups (Wilcoxon and Kruskal-Wallis, p > 0.05). However, post-intervention comparisons showed cervical manipulation led to a greater reduction in systolic blood pressure, while sacroiliac manipulation led to a greater increase in heart rate compared to controls (Mann-Whitney U with Bonferroni correction, p < 0.05). Conclusion: While no significant changes were observed in baropodometric or autonomic parameters, chiropractic manipulation demonstrated short-term effects on blood pressure and heart rate. The accuracy of heart rate variability assessments should be reviewed, and further studies are needed to evaluate long-term cardiovascular and autonomic outcomes.
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    Investigating the relationships between headache characteristics and physical activity, autonomic function, psychological status, and quality of life in individuals with tension-type headache
    (Bmc, 2026) Arslan, Mesut; Hatik, Sefa Haktan
    Background Tension-type headache (TTH) is a highly prevalent primary headache disorder, yet its multidimensional associations remain incompletely understood. The aim of this study was to investigate the relationship between the characteristics of headaches in individuals with Tension-Type Headache (TTH) and physical activity, autonomic function, psychological state, and quality of life. Methods This observational descriptive study included 93 individuals aged 18-65 years with TTH (mean age 25.6 years, 84.9% female), diagnosed by a neurologist in accordance with the International Classification of Headache Disorders (ICHD-3) criteria. Headache characteristics were recorded; physical activity was assessed using the International Physical Activity Questionnaire (IPAQ-7), autonomic function was measured using the Polar Verity Sense device to assess heart rate variability (RMSSD, LF/HF), psychological status was evaluated using the Depression Anxiety Stress Scale (DASS-21), and quality of life was assessed using the Headache Impact Scale. Relationships were analyzed using Spearman correlation analysis. Results The vast majority of individuals were inactive (33.3%) or minimally active (57%). Moderate to weak positive correlations were found between headache frequency and severity (resting, activity, and nighttime) and depression, anxiety, and stress scores (all p < 0.05). Additionally, headache frequency and severity were significantly associated with impaired quality of life (p < 0.01). In terms of autonomic function, longer headache duration and higher resting pain intensity were negatively correlated with the RMSSD value, an indicator of lower parasympathetic activity (both rho=-0.24, p = 0.018). A weak positive relationship was observed between headache onset time and physical activity (rho = 0.26, p = 0.011)., Conclusion In this predominantly young adult and female cohort, TTH has been shown to be a multidimensional condition with weak to moderate associations to low physical activity, potentially decreased parasympathetic tone, psychological distress, and impaired quality of life. These findings map a cluster of biopsychosocial correlates in this demographic context and support the rationale for future research into integrating non-pharmacological, holistic approaches targeting physical activity, psychological support, and autonomic balance in the management of TTH. Trial registration This crosssectional study has a design that does not require a clinical research record.
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    The effect of transcutaneous auricular vagus nerve stimulation on cycling ergometry and recovery in healthy young individuals
    (Wiley, 2023) Hatik, Sefa Haktan; Asrlan, Mesut; Demirbilek, Omer; Ozden, Ali Veysel
    Background: It is aimed to examine the potential benefits and effects of the use of transcutaneous auricular vagus nerve stimulation (VNS) for sporting purposes on recovery, fatigue, and sportive performance level. Methods: In this study, 90 people between the ages of 18-23 were participated. They were randomly divided into three groups as bilateral sham, unilateral left, and bilateral VNS. A 4-day protocol was applied to the participants. Cycling exercise was performed with maximum performance for 30 min under the same watt load. Pulse, systolic and diastolic blood pressure, distance, pain, fatigue, lactic acid level, and autonomic nervous system were evaluated. Results: Within the groups, there was a statistically significant difference between the data (p < .05) except for the distance covered parameter. When we compare the groups, in addition to the distance traveled in all groups, there is no statistically significant difference in the 1st day 1st measurement and 2nd measurement data of all parameters (p > .05 When we compared the data according to days, there was a statistically significant difference between bilateral stimulation (BS) and unilateral stimulation, only pain and fatigue levels (p < .05). Conclusion: In our study, we saw that BS application gave positive results in reducing pain and fatigue due to cycling exercise compared to other applications. Similar results were obtained when we evaluated the data on a daily basis. We believe that VNS will be beneficial in reducing pain and fatigue, especially during and after the competition halftime.