Symptom Severity, Posture, Pain, and Physical Activity in Gastroesophageal Reflux Disease

Primary outcomes

1. Gastroesophageal Reflux Disease Questionnaire (GERD-Q)

   Time frame: 1 day

   The GERD-Q is a six-item Likert-type questionnaire that assesses the frequency of GERD-related symptoms over the past week. The first four items evaluate symptom frequency and are used for the diagnosis of the disease and monitoring treatment response. The remaining two items assess the impact of the disease on daily life, including over-the-counter medication use and sleep disturbance. Each item is scored on a four-point scale ranging from 0 to 3 according to symptom frequency. In items 1, 2, 5, and 6, scores increase from 0 to 3 with increasing symptom frequency, whereas in items 3 and 4, scoring is reversed.

2. PROMIS GERD Scale

   Time frame: 1 day

   The PROMIS GERD scale consists of 13 items. Each item is scored on a scale ranging from 0 to 4 points, and the total score is obtained by summing all item scores. According to the original scoring system, a score of 0 indicates no symptoms, scores of 1-3 indicate minimal symptoms, scores of 4-7 indicate mild symptoms, scores of 8-15 indicate moderate symptoms, and scores of 16 and above indicate severe symptoms.

3. Postural Analysis

   Time frame: 1 day

   Posture Screen Lite is a posture analysis, body composition, and movement assessment software designed for use on iOS and Android devices with built-in camera systems. In this study, posture will be assessed using the iPad-based Posture Screen Lite application. Participants will be assessed wearing appropriate clothing that leaves the upper trunk and lower legs exposed. Photographs will be taken from anterior, posterior, and right and left lateral views using a smartphone, without placing reference markers on the participant beforehand. The captured images will then be analyzed using the Posture Screen Lite software by identifying anatomical reference points on the photographs.

4. Visual Analog Scale (VAS)

   Time frame: 1 day

   The Visual Analog Scale (VAS) will be used to assess pain intensity. VAS has been shown to be a valid and reliable method that is sensitive to small changes in clinical pain and treatment-related pain intensity. Participants will be asked to indicate their pain level on a 10-cm horizontal line, ranging from "0" (no pain) to "10" (worst imaginable pain). In addition, participants will mark the location(s) of their pain on a body diagram to determine pain distribution and localization.

5. International Physical Activity Questionnaire (IPAQ)

   Time frame: 1 day

   The International Physical Activity Questionnaire (IPAQ) was developed by Craig et al. (2003) to assess physical activity levels. The short form consists of seven items and evaluates physical activity performed during the last seven days. Only activities lasting at least 10 minutes at a time are considered. Participants report the duration (in minutes) of vigorous activities (e.g., weight lifting, fast cycling, aerobic exercises, team sports), moderate activities (e.g., table tennis, folk dances, light load carrying), and walking. These values are converted into metabolic equivalent (MET) scores, and total physical activity level is calculated as MET-min/week. Based on the results, participants can be classified as inactive, minimally active, or highly active.