Turkiye Klinikleri Journal of Sports Sciences

.: ORIGINAL RESEARCH
Basketbol ve Voleybolcularda Omuzda Tuzak Nöropati ve Kuvvet İlişkisi: Deneysel Araştırma The Relationship
Between Trap Neuropathy and Force in the Shoulder in Basketball and Volleyball Players: Experimental Research
Selma İŞLERa , Seydi Ahmet AĞAOĞLUb, Ercan TURALc , Yüksel ÖNERd , Şeyda YETİKe, Fulya CENGİZHAN ERTANf , Hacer ERDEM TİLKİg
aOndokuz Mayıs Üniversitesi Tıp Fakültesi, Sağlık Uygulama ve Araştırma Merkezi, Fiziksel Tıp ve Rehabilitasyon ABD, Samsun, Türkiye
bOndokuz Mayıs Üniversitesi Yaşar Doğu Spor Bilimleri Fakültesi, Antrenörlük Eğitimi Bölümü, Hareket ve Antrenman Bilimleri ABD, Samsun, Türkiye
cOndokuz Mayıs Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Samsun, Türkiye
dOndokuz Mayıs Üniversitesi Fen Edebiyat Fakültesi, İstatistik Bölümü, Samsun, Türkiye
eSamsun Eğitim ve Araştırma Hastanesi, Nöroloji Polikliniği, Samsun, Türkiye
fOndokuz Mayıs Üniversitesi Yaşar Doğu Spor Bilimleri Fakültesi, Antrenörlük Bölümü, Samsun, Türkiye
gOndokuz Mayıs Üniversitesi Tıp Fakültesi, Nöroloji ABD, Samsun, Türkiye
Turkiye Klinikleri J Sports Sci. 2023;15(1):1-10
doi: 10.5336/sportsci.2022-89441
Article Language: TR
Full Text
ÖZET
 Amaç: Tenis, voleybol, beyzbol, basketbol gibi farklı hareket mekaniğine sahip sporlar, omuz eklemindeki statik ve dinamik yapıları önemli ölçüde zorlar. Bu çalışmada, basketbol ve voleybolcularda tekrarlayan omuz elevasyonu sonrası aksiller sinir ve deltoid kasta oluşabilecek elektrofizyolojik değişiklikler ve bunların kuvvete yansımasının incelenmesi amaçlanmıştır. Tek bir kökten (C5) inerve olan rhomboid kası dışında tüm kaslar birbirine komşu birkaç kökten inerve olmaktadır. Kök basısını bertaraf etmek için C5 ten inerve olan rhomboid kasa da iğne elektromiyografi (EMG) yapılmıştır. Gereç ve Yöntemler: Toplam 35 sporcu [8'i (%22,9) kadın, 27'si (%77,1) erkek, 13'ü (%37,1) voleybol, 22'si (%62,9) basketbol] ve 35 sedanter [21'i (%60) kadın, 14'ü (%40) erkek] çalışmaya dâhil edildi. Tüm katılımcıların omuz abdüksiyon ve addüksiyon kuvveti izokinetik olarak ölçüldü. Deltoid ve rhomboid kasların kantitatif EMG analizi ve aksiller sinire bilateral motor sinir iletimi ölçümleri sadece sporcularda yapıldı. Bulgular: Sporcular, tüm hareketlerde kontrol grubuna göre daha yüksek pik tork değerleri gösterdi (p <0,05). Tüm deneklerde, abdüksiyon pik torku addüksiyona göre daha düşük bulundu. Basketbolcularda ve voleybolcularda aksiller sinir lezyonu ile uyumlu olabilecek elektronörografi bulgusuna rastlanmadı. 7 (%20) sporcuda (2 kadın voleybol, 5 erkek basketbol) sağ rhomboid ve deltoid kaslarda nörojenik tutulum saptandı. 2 sporcuda (1 bayan voleybol, 1 erkek basketbol) sağ dorsal skapular sinirin kronik parsiyel aksonal lezyonu rapor edildi. Nörojenik tutulumu olan ve olmayan sporcuların pik tork değerleri arasındaki fark istatistiksel olarak anlamlı değildi. Sonuç: Bu çalışmada, baş üstü aktivite yapan sporcularda aksiller sinirin yanı sıra skapula dorsal sinirin de tuzaklanabileceğini görmüş olduk. Spesifik risk faktörlerinin belirlenmesi, sporcuların ve antrenörlerin antrenman programlarını düzenlemelerine ve bu yaralanmaları azaltmalarına yardımcı olacaktır.

Anahtar Kelimeler: Aksiller sinir; basketbol; izokinetik kuvvet; kantitatif elektromiyografi; voleybol
ABSTRACT
 Objective: Sports such as tennis, volleyball, baseball, and basketball with different movement mechanics force the static and dynamic structures in the shoulder joint to a substantial extent. In this study, it is aimed to examine what are the electrophysiological changes that may occur in the axillary nerve and deltoid muscle after repetitive shoulder elevation in basketball and volleyball players and how they are reflected on the strength. Except for the rhomboid muscle, which is innervated by a single root (C5), all muscles are innervated by several adjacent roots. In order to eliminate root compression, needle electromyography (EMG) was performed on the rhomboid muscle innervated from C5. Material and Methods: A total of 35 athletes [8 (22.9%) were female, 27 (77.1%) male, 13 (37.1%) volleyball, and 22 (62.9%) were basketball players], and 35 sedentary participants [21 (60%) were female, 14 (40%) male] were included in the study. Shoulder abduction and adduction of all participants was measured isokinetically. Quantitative EMG analysis of the deltoid and rhomboid muscles, and measurements of bilateral motor-sensory nerve transmission to the axillary nerve, were performed only athletes. Results: Athletes showed higher peak torque values in all movements compared to the control group (p<0.05). In all subjects, the peak torque of abduction was lower than that of adduction. There were no electroneurographic findings compatible with axillary nerve lesion in basketball and volleyball players. Neurogenic involvement was detected in the right rhomboid and deltoid muscles in 7 (20%) athletes (2 female volleyball, 5 male basketball). Chronic partial axonal lesion of the right dorsal scapular nerve was reported in 2 athletes (1 female volleyball, 1 male basketball). There was no statistically significant difference between the peak torque values of the athletes with and without neurogenic involvement. Conclusion: In this study, we have seen that the scapula dorsal nerve can also be trapped in addition to the axillary nerve in athletes doing overhead activities. Identifying specific risk factors will help athletes and coaches adjust their training programs and reduce these injuries.

Keywords: Axillary nerve; basketball; isokinetic power; quantitative electromyography; volleyball
REFERENCES:
  1. Yetim A. Sporun sosyal görünümü [Social aspects of sport]. Gazi Beden Eğitimi ve Spor Bilimleri Dergisi. 2000;1:63-72. [Link] 
  2. Aydoğ ST. Sporcularda omuz ağrısı [Shoulder pain in athletes]. Türkiye Klinikleri J PM&R-Special Topics. 2014;7(2):16-26. [Link] 
  3. Messina DF, Farney WC, DeLee JC. The incidence of injury in Texas high school basketball. A prospective study among male and female athletes. Am J Sports Med. 1999;27(3):294-9. [Crossref]  [PubMed] 
  4. Wilk KE, Meister K, Andrews JR. Current concepts in the rehabilitation of the overhead throwing athlete. Am J Sports Med. 2002;30(1):136-51. [Crossref]  [PubMed] 
  5. Aval SM, Durand P Jr, Shankwiler JA. Neurovascular injuries to the athlete's shoulder: Part I. J Am Acad Orthop Surg. 2007;15(4):249-56. [Crossref]  [PubMed] 
  6. Fleisig GS, Barrentine SW, Escamilla RF, Andrews JR. Biomechanics of overhand throwing with implications for injuries. Sports Med. 1996;21(6):421-37. [Crossref]  [PubMed] 
  7. Meister K. Injuries to the shoulder in the throwing athlete. Part one: Biomechanics/pathophysiology/classification of injury. Am J Sports Med. 2000;28(2):265-75. [Crossref]  [PubMed] 
  8. Manske RC, Sumler A, Runge J. Quadrilateral space syndrome. Human Kinetics Journals. 2009;14(2):45-7. [Crossref] 
  9. Özer Kaya D, Kalkan AC. Omuzda tuzak nöropatiler ve rehabilitasyon [Nerve entrapments in shoulder and rehabilitation]. Turkiye Klinikleri Journal of Physiotherapy and Rehabilitation-Special Topics. 2017;3(1):30-40. [Link] 
  10. Bavlı Ö, Kozanoğlu E. Adolesan basketbolcularda mevkilere göre yaralanma türleri ve nedenleri [Sports injury type and causes in adolescent basketball players according to playing position]. Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi. 2008;22(2):77-80. [Link] 
  11. Aydoğ ST, Tetik O, Demirel AH, Doral MN. Sporda periferik sinir yaralanmaları [Peripheral nerve injuries in sports]. Türk Nörosiriirji Dergisi. 2005;15(3):250-6. [Link] 
  12. Cass S. Upper extremity nerve entrapment syndromes in sports: an update. Curr Sports Med Rep. 2014;13(1):16-21. [Crossref]  [PubMed] 
  13. Falck B. Sensory nerve conduction studies with surface electrodes. Meth Clinic Neurophysiol. 1994;5:1-20.
  14. Stalberg E, Falck B. Clinical motor nerve conduction studies. Meth Clinic Neurophysiol. 1993;4:61-80. [Link] 
  15. Codine P, Bernard PL, Pocholle M, Herisson C. Evaluation et rééducation des muscles de l'épaule en isocinétisme: méthodologie, résultats et applications [Isokinetic strength measurement and training of the shoulder: methodology and results]. Ann Readapt Med Phys. 2005;48(2):80-92. French. [Crossref]  [PubMed] 
  16. Ercan MB. Servikal radikülopatide ağrı ve nörolojik belirtilerin EMG bulgularıyla korelasyonu [Uzmanlık tezi]. Ankara: Gazi Üniversitesi; 2014. [Link] 
  17. Marcondes FB, Castropil W, Schor B, Miana A, Vasconcelos R, Etchebehere M. Shoulder isokinetic performance in healthy professional judo athletes: normative data. Acta Ortop Bras. 2019;27(6):308-12. [Crossref]  [PubMed]  [PMC] 
  18. Franchini E, Brito CJ, Fukuda DH, Artioli GG. The physiology of judo-specific training modalities. J Strength Cond Res. 2014;28(5):1474-81. [Crossref]  [PubMed] 
  19. Akpınar ÇK, Çalık M, Aytaç E. Tek bir travmaya bağlı gelişen izole periferik sinir nöropatisi: iki olgu sunumu [Solated peripheral nerve neuropathy associated wiht a single travma: report of two cases]. Kocatepe Tıp Dergisi Kocatepe Medical Journal. 2018;19:145-8. [Crossref] 
  20. Bencardino JT, Rosenberg ZS. Entrapment neuropathies of the shoulder and elbow in the athlete. Clin Sports Med. 2006;25(3):465-87, vi-vii. [Crossref]  [PubMed] 
  21. Gutierrez J. Quantitative EMG. Clinical Neurophysiology. 2016;127(9):e313. [Crossref] 
  22. Paladini D, Dellantonio R, Cinti A, Angeleri F. Axillary neuropathy in volleyball players: report of two cases and literature review. J Neurol Neurosurg Psychiatry. 1996;60(3):345-7. [Crossref]  [PubMed]  [PMC] 
  23. Krivickas LS, Wilbourn AJ. Peripheral nerve injuries in athletes: a case series of over 200 injuries. Semin Neurol. 2000;20(2):225-32. [Crossref]  [PubMed] 
  24. Juhan T, Bolia IK, Kang HP, Homere A, Romano R, Tibone JE, et al. Injury epidemiology and time lost from participation in women's NCAA division I indoor versus beach volleyball players. Orthop J Sports Med. 2021;9(4):23259671211004546. [Crossref]  [PubMed]  [PMC] 
  25. Monteleone G, Gismant M, Stevanato G, Tiloca A. Silent deltoid atrophy in beach volleyball players: a report of two cases and literature review. Int J Sports Phys Ther. 2015;10(3):347-53. [PubMed]  [PMC] 
  26. Kim HJ, Nemani VM, Piyaskulkaew C, Vargas SR, Riew KD. Cervical radiculopathy: incidence and treatment of 1,420 consecutive cases. Asian Spine J. 2016;10(2):231-7. [Crossref]  [PubMed]  [PMC] 
  27. Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine (Phila Pa 1976). 2003;28(1):52-62. [Crossref]  [PubMed] 
  28. Okada E, Matsumoto M, Ichihara D, Chiba K, Toyama Y, Fujiwara H, et al. Aging of the cervical spine in healthy volunteers: a 10-year longitudinal magnetic resonance imaging study. Spine (Phila Pa 1976). 2009;34(7):706-12. [Crossref]  [PubMed] 
  29. Matsumoto M, Fujimura Y, Suzuki N, Nishi Y, Nakamura M, Yabe Y, et al. MRI of cervical intervertebral discs in asymptomatic subjects. J Bone Joint Surg Br. 1998;80(1):19-24. [Crossref]  [PubMed] 
  30. Carette S, Fehlings MG. Clinical practice. Cervical radiculopathy. N Engl J Med. 2005;353(4):392-9. [Crossref]  [PubMed] 
  31. Muir B. Dorsal scapular nerve neuropathy: a narrative review of the literature. J Can Chiropr Assoc. 2017;61(2):128-44. [PubMed]  [PMC] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com