The effects of inspiratory muscle training on cardiorespiratory functions in juvenile idiopathic arthritis: A randomized controlled trial

INTRODUCTION

Although inspiratory muscle training (IMT) has proven effective in adult rheumatic diseases, its impact on juvenile idiopathic arthritis (JIA) remains unexplored. The present study aimed to investigate the effects of IMT in children with JIA.

METHODS

Thirty-three children (13-18 years) with JIA were divided into two groups as exercise (n = 17) and control (n = 16). The exercise group performed IMT at home daily for 8 weeks. The initial IMT load was set as 60% of maximal inspiratory pressure (PImax ) and increased by %10 of the initial load every 2 weeks. The control group received no additional intervention. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1 ), FVC/FEV1 , PImax , and maximal expiratory pressure (PEmax ) were evaluated. Peak oxygen consumption (VO2max ), metabolic equivalents (METs), and maximal heart rate were measured with cardiopulmonary exercise test. Functional capacity and quality of life were assessed with 6-min walk distance and Pediatric Quality of Life Inventory 3.0 Arthritis Module. All participants were evaluated at baseline and post-treatment.

RESULTS

FVC ( ↑ 0.20 (95% CI: 0.07/0.32) liters), FEV1 ( ↑ 0.14 (95% CI: 0.02/0.25) liters), PImax (↑19.11 (95% CI: 9.52/28.71) cmH2 O), PEmax (↑12.41 (95% CI: 3.09/21.72) cmH2 O), VO2peak (↑158.29 (95% CI: 63.85/252.73) ml/min), and METs (↑0.92 (95% CI: 0.34/1.49) [ml/kg/min]) significantly improved only in the exercise group (p < .05). The difference over time in FVC, FEV1 , PImax , VO2peak , and METs were significantly higher in exercise group compared to control group (p < .05).

CONCLUSIONS

IMT seems to be an effective option for improving respiratory functions and aerobic exercise capacity in JIA.

Effects of 16-week circuit training on physical fitness parameters, pulmonary function, and quality of life in healthy women

BACKGROUND

Circuit training (CT) is an important type of training that can combine different types of exercises in a single form of training. This study aimed to investigate the effects of 16-week CT on physical fitness parameters, pulmonary function, and quality of life in healthy women.

METHODS

Twenty-nine healthy women (median age: 37.00 [31.50/39.50] years) were included in the study. CT was applied to the participants for a total of 16 weeks. Participants' body composition with the Bioelectrical Impedance Analysis System, knee flexor and extensor muscle strength with the Biodex System-4 Pro, flexibility with the sit-and-reach test, pulmonary function with a spirometer device, and quality of life with Short Form-36 were assessed.

RESULTS

A significant difference was found between the participants' pretest and posttest median and interquartile range values of waist-hip ratio, body mass index, right/left knee flexor/extensor mean peak torque (60°/s,180°/s), right hamstring/quadriceps (H/Q) ratio (60°/s), flexibility, and SF-36 Mental Health Score (P˂0.050). There was no significant difference between the participants' pretest and posttest median and interquartile range values of total body fat, fat percentage, right H/Q ratio (180°/s), left H/Q ratio (60°/s,180°/s), pulmonary function, and Short Form-36 Physical Function Score (P˃0.050).

CONCLUSIONS

CT decreased waist-hip ratio and body mass index, increased knee flexor/extensor strength and flexibility, and improved mental health. The 16-week CT may be an alternative approach to improve physical fitness parameters and mental health without any positive effects on body fat and pulmonary functions in healthy women.

Lateral abdominal muscle thickness and contractile function in women with and without stress urinary incontinence

INTRODUCTION AND HYPOTHESIS

Stress urinary incontinence (SUI) primarily results from the weakness of pelvic floor muscles, working synergistically with the abdominal muscles. The current study aimed to compare thickness and contractile function of lateral abdominal muscles in women with and without SUI.

METHODS

Thirty-nine women with SUI (SUI group; age: 38.87 ± 8.96 years, body mass index (BMI): 24.03 (5.94) kg/m2) and 42 healthy women (control group; age: 36.21 ± 11.46 years, BMI: 23.90 (5.85) kg/m2) were included. Transverse abdominis (TrA) and internal oblique (IO) muscle thickness at rest and during abdominal drawing-in maneuver (ADIM) were measured with ultrasound imaging in B-mode using a Logiq S7/Expert device and a 9-11 MHz linear transducer. Percentage change in thickness and contractile function of these muscles were also calculated.

RESULTS

No significant differences in the thickness of TrA and IO muscles at rest and during ADIM between the groups were found (p > 0.05). The percent change in thickness and contractile function of both right and left side TrA muscles and the right side IO muscle were lower in SUI group than control group (p < 0.05). The percentage change in thickness and the contractile function of the left side IO muscle did not change (p > 0.05).

CONCLUSION

Women with SUI had a smaller percentage change in thickness and contractile function of TrA and IO muscle than women without SUI. However, there was no difference in the morphological features of these muscles between the groups. Considering the lateral abdominal muscle, training may be important for management of SUI.

Postural stability, spinal alignment, mobility, and postural competency in women with unilateral lower extremity lymphedema after radical hysterectomy following gynecologic cancer: A case-control study

PURPOSE

To compare postural stability, spinal alignment, mobility, and postural competency in women with unilateral lower extremity lymphedema after radical hysterectomy following gynecologic cancer with a matched control group.

METHODS

Twenty-seven women with unilateral lower extremity lymphedema (lymphedema group, age: 54.14 ± 5.80 years) and 30 healthy women (control group, age: 51.90 ± 6.54 years) were included. The lymphedema severity was evaluated with circumferential measurements. Postural stability with the Biodex Balance System SD and the spinal alignment, mobility, and postural competency with the Spinal Mouse device were assessed.

RESULTS

In the lymphedema group, it was found that 3.7% of the women had mild lymphedema, 7.4% had moderate lymphedema, and 88.9% had severe lymphedema. Static eyes open (EO) (overall, medio-lateral and antero-posterior) and eyes closed (EC) (antero-posterior) stability scores and dynamic EO and EC stability scores (overall and antero-posterior) were detected to be higher in the lymphedema group than in the controls (p < 0.05). Spinal mobility and postural competency scores were lower in the lymphedema group than in the control group (p < 0.05). In other parameters, there were no significant differences between the groups (p > 0.05).

CONCLUSION

Decreased postural stability, spinal mobility, and postural competency were detected in women with unilateral lower extremity lymphedema; however, no difference was seen in spinal alignment. These changes should be taken into account in the assessment and the treatment of unilateral lower extremity lymphedema.

Investigation of the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in unilateral breast cancer surgery survivors: a cross-sectional study

PURPOSE

Despite the research on structural and functional changes that may occur in breast cancer survivors, no study has investigated the relationship between spinal characteristics and the respiratory system. Therefore, we aimed to investigate the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in breast cancer patients who have completed their treatment METHODS: This cross-sectional study included 38 female breast cancer surgery survivors. Participants underwent the following evaluations: Chest wall mobility with a tapeline; postural assessments (spinal curvature, spinal mobility, and spinal inclination) with a non-invasive, computer-assisted electromechanical device; and pulmonary function test and respiratory muscle strength with a portable digital spirometer device. The relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions was analyzed by the bivariate correlation analysis.

RESULTS

Increased thoracic curvature angle was associated with decreased FEV1 (r=-0.360, p=0.026) and decreased subcostal mobility (r=-0.385, p=0.017), and the increase in thoracic frontal mobility was associated with decrease in PEF (r=-0.342, p=0.036). Increased lumbar mobility was associated with increased FVC (r=0.324, p=0.047), and increased total spinal inclination mobility was associated with decreased MIP (r=-0.396, p=0.017). Chest wall mobility was associated with postural assessments at varying rates (the r value ranged from -0.357 to 0.661, p<0.05).

CONCLUSION

The changes in spinal posture and mobility of women who have undergone unilateral breast cancer surgery were associated with respiratory parameters and thoracic cage mobility. These patients' spinal posture and mobility should be taken into account in conjunction with respiratory functions for a comprehensive assessment.

Investigation of factors associated with static and dynamic balance in early-stage lung cancer survivors

PURPOSE

Balance impairment and falls are common among patients after cancer treatment. This study aimed to compare static and dynamic balance functions in lung cancer survivors (LCS) and healthy controls and to investigate the factors related to balance in LCS.

METHODS

Cross-sectional data were collected from lung cancer patients whose treatment had been completed within the previous 3 months (n = 60) and age and gender-matched healthy controls (n = 60). Clinical characteristics and history of falls were recorded. Pulmonary function tests and measurements of respiratory muscle strength were performed. Dynamic and static balance, fear of falling, knee-extension strength, physical activity level, dyspnea, comorbidity, and quality of life (QoL) were assessed using the Time Up and Go Test, Single Leg Standing Test, the Fall Efficacy Scale-International, hand-held dynamometer, the International Physical Activity Questionnaire, the Modified Medical Research Dyspnea Scale, the Charlson Comorbidity Index, and the European Organization for Research and Treatment of Cancer QoL Scale.

RESULTS

LCS reported a higher fall rate and exhibited lower dynamic balance compared to controls (p < 0.05). The number of chemotherapy cycles, number of falls in the past year, fear of falling, perceived dyspnea, forced expiratory volume in 1 s (%), maximal inspiratory pressure (%), knee-extension strength, physical activity score, and QoL score related to physical function were correlated with balance function in LCS (p < 0.05).

CONCLUSION

LCS had a higher risk of falls and lower dynamic balance function which might be related to various clinical and physical parameters.

IMPLICATIONS FOR CANCER SURVIVORS

Identifying factors related to balance should be considered within the scope of fall prevention approaches for these patients.

Health-related physical fitness parameters in women with breast cancer-related lymphedema: a case-control study

PURPOSE

This study aimed to compare health-related physical fitness parameters of women with breast cancer-related lymphedema (BCRL) to a matched control group.

METHODS

Thirty women with unilateral BCRL (lymphedema group, age = 55.00 (40.00-65.00) years) and 32 healthy women (control group, age = 49.00 (44.00-64.00) years) were included. Cardiorespiratory fitness with the UKK 2-km walk test, grip strength with a hand dynamometer, trunk muscle endurance with the McGill trunk muscle endurance tests, flexibility with the sit and reach test, body composition with a body composition analyzer, and waist-to-hip ratio were assessed.

RESULTS

In the lymphedema group, 36.7% of women had mild lymphedema, 36.7% had moderate, and 26.7% had severe lymphedema. It was found that maximal oxygen consumption, physical fitness index, grip strength, trunk extensor and lateral flexor muscle endurance, and flexibility scores were higher in the control group than in the lymphedema group (p < 0.05). In addition, body mass index, body fat percentage, and waist-to-hip ratio were found to be lower in the control group compared to the lymphedema group (p < 0.05). There was no significant difference between the trunk flexor muscle endurance scores (p > 0.05).

CONCLUSIONS

It was found that the health-related physical fitness parameters were adversely affected in women with BCRL compared to healthy women. The changes of physical fitness may be important for the assessment and the treatment of BCRL.

Western Massage Therapies in the Management of Neck Pain: A Systematic Review

OBJECTIVE

The purpose of this review was to compare types of Western massage therapy (MT) to other therapies, placebo, and no-treatment controls in neck pain (NP) in randomized and nonrandomized clinical trials.

METHODS

An electronic, systematic search was performed in 7 English and 2 Turkish databases (PubMed, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Physiotherapy Evidence-Based Database, ULAKBIM National Medical Database, and the Reference Directory of Turkey). The search terms "NP" and "massage" were used. Studies published between January 2012 and July 2021 were searched. Methodological quality was evaluated with Downs and Black Scale and version 2 of the Cochrane risk-of-bias tool.

RESULTS

A total of 932 articles were identified; 8 of them were eligible. The Downs and Black score ranged from 15 to 26 points. Two studies were rated as "fair," 3 studies as "good," and 3 studies as "excellent." According to version 2 of the Cochrane risk-of-bias tool, 3 studies had a low risk of bias, 3 studies had some concerns, and 2 studies had a high risk of bias. Fair evidence found that myofascial release therapy improved pain intensity and pain threshold compared to no intervention in the short term. Excellent evidence found that connective tissue massage with exercise improved pain intensity and pain threshold compared to exercise alone in the short term. No Western MTs were superior to other active therapies according to short-term and immediate effects.

CONCLUSION

This review suggests that Western MTs (myofascial release therapy and connective tissue massage) may improve NP, but studies are limited. This review showed that Western MTs were not superior to other active therapies for improving NP. The reviewed studies reported only immediate and short-term effects of Western MT; thus, high-quality randomized clinical trials investigating the long-term effects of Western MT are needed.

Postural stability and its relation to knee flexor/extensor strength ratio in women with mild to moderate unilateral knee osteoarthritis: a case-control study

PURPOSE/AIM

Knee muscles strength is an important factor influencing postural stability in patients with knee osteoarthritis (KOA). However, there is no evidence regarding the relationship between the knee flexor/extensor strength ratio, which is suggested to be a good indicator of knee stability, and postural stability. We aimed to investigate postural stability and its relation to knee flexor and extensor strength and strength symmetry in women with KOA.

MATERIALS AND METHODS

Thirty-five women with unilateral KOA and thirty-five asymptomatic women were assessed with the Prokin system to collect the following parameters during quiet standing with eyes-open and eyes-closed: ellipse area, perimeter, forward-backward standard deviation, mediolateral standard deviation, the average centre of pressure displacement on the x- and y-axises (COPX and COPY), and the limit of stability (LoS) score. Higher scores mean better balance for LoS and poorer balance for other parameters. Knee flexor and extensor strength were assessed bilaterally with the Lafayette hand-held dynamometer.

RESULTS

The COPX during standing with eyes-closed was higher in women with KOA than controls and the LoS score was lower (p < 0.05, Cohens'd = 0.72 and 0.65). Postural stability was correlated with knee muscles strength and the flexor/extensor strength ratios in both groups (r = between 0.395 and 0.456 for LoS, r = between -0.335 and -0.639 for the others, p < 0.05).

CONCLUSIONS

Women with KOA had poorer postural stability in the mediolateral direction during standing with eyes-closed and a worse LoS score than controls. Postural stability was related to knee flexor and extensor strength and the flexor/extensor strength ratio in women.

Comparison of Blood Pressure and Pulse Adaptations Between Younger and Older Patients During Balneotherapy With Physiotherapy

Objective

This study aimed to investigate the blood pressure and pulse adaptation characteristics between younger and older patients with musculoskeletal disorders during acute and recovery responses at the first and 10th sessions of balneotherapy added to physiotherapy.

Methods

Forty-six participants (n = 22, between 18 and 35 years of age as young adults; n = 24, more than 65 years of age as older adults) with musculoskeletal disorders admitted to physiotherapy therapy sessions with balneotherapy were enrolled. The participants' immersion time was 20 minutes each during 10 sessions occurring over the course of 2 weeks. Blood pressure and pulse were measured at the baseline and the 5th minute as acute responses, and at the baseline and the 30th minute as recovery responses during the first and 10th sessions.

Results

First, the group and session effect was examined. There was no significance in this part. Then, session main effect and group main effect were examined. The group main effect was significant, that is, a difference was found between groups independent of the session in terms of only pulse values (P < .001). There was no difference in sessions. The acute and recovery responses of the pulse at the first and 10th sessions of balneotherapy showed higher alterations in the young people compared with the older people (P < .008).

Conclusion

Greater pulse alterations at the acute and recovery phases of the first and 10th sessions were observed in young adults.

Static and Dynamic Postural Characteristics in Patients with Chronic Obstructive Pulmonary Disease: The Relationship with Dyspnea and Pulmonary Functions

BACKGROUND

There is little evidence about posture influence and its relationship with pulmonary functions in chronic obstructive pulmonary diseases(COPD) patients.

OBJECTIVES

To compare spinal curvature, mobility, and postural competency in participants with and without COPD and investigate the relationship of postural characteristics with dyspnea and pulmonary functions in COPD patients.

METHODS

We included 47 COPD patients and 47 age and gender-matched controls in our cross-sectional study. Participants underwent the following evaluations: modified Medical Research Council Dyspnea Scale, respiratory function test, and postural measurements in the sagittal plane in a standing position using a non-invasive, computer-assisted electromechanical device. Postural variables were compared between groups, and the relationship between postural variables with dyspnea and pulmonary functions was analyzed by multivariate regression analysis.

RESULTS

Thoracic and lumbar curvature were higher (p<0.05), thoracic mobility and spinal inclination were lower (p=0.011, p=0.030, respectively) in patients with COPD. Thoracic angle and spinal inclination increased in COPD patients (p=0.040, p=0.011, respectively) while only spinal tilt increased in the control group (p=0.010) under spinal loading. Thoracic angle and mobility were related with dyspnea (r2=0.25, p<0.001), forced expiratory volume in the first second (r2=0.56, p<0.001), forced vital capacity (r2=0.41, p<0.001), and RV (r2 = 0.42, p<0.001).

CONCLUSION

COPD patients had greater thoracic and lumbar angles in the static upright posture and lower thoracic mobility and spinal inclination in the sagittal plane. It was observed that patients increase their thoracic angles to maintain postural stability in dynamic conditions. Thoracic angle and mobility were related to dyspnea and pulmonary functions.

Lumbopelvic muscle endurance, morphology, alignment, and mobility in women with primary dysmenorrhea: A case-control study

BACKGROUND

In the literature, it is thought that spine or pelvic malalignment and changes in the abdominal muscle structure may affect the uterine position and cause menstrual pain. However, the overall lumbopelvic structure related to lumbopelvic muscle endurance, thickness, alignment, and mobility in women with primary dysmenorrhea has not been well investigated. This study aimed to compare women with primary dysmenorrhea and asymptomatic controls in terms of lumbopelvic structure.

METHODS

Women with primary dysmenorrhea (primary dysmenorrhea group, n: 38, age: 21 years (18-28), body mass index (BMI): 20.70 (17.31-28.73) kg/m²) and without primary dysmenorrhea (asymptomatic group, n: 39, age: 20 years (19-23), BMI: 20.83 (17.31-27.10) kg/m²) were included. The severity of menstrual pain, lumbopelvic muscle endurance, morphology, alignment, and mobility were assessed with the Visual Analogue Scale, McGill trunk muscle endurance tests, ultrasonographic imaging, and a Valedo® Shape device, respectively.

FINDINGS

The median value of the menstrual pain in the primary dysmenorrhea group was 6.5 cm (min-max: 4.0-10.0). Lumbopelvic muscle endurance (p < 0.001), muscle thickness (p < 0.001), frontal lumbar angle (p: 0.05), sagittal pelvic mobility (p < 0.001), and frontal lumbar mobility (p: 0.002) were lower in the primary dysmenorrhea group compared to the asymptomatic group.

INTERPRETATION

Muscle endurance, thickness, alignment, and mobility of the lumbopelvic structure in women with primary dysmenorrhea compared to asymptomatic women have been affected negatively. These findings should be considered in management of primary dysmenorrhea.

The comparison of regional spinal curvatures and movements in sitting posture in ambulatory children with cerebral palsy having minimal-to-moderate functional limitations

AIM

To examine the regional spinal curvatures and movements in the sagittal and frontal planes during sitting position, and the ability to act independently in patients with CP and to compare the differences between children and adolescents with minimal-to-moderate functional limitations.

METHOD

Twenty-one participants diagnosed with CP aged 5-16 years were included. The participants' Gross Motor Function Classification System (GMFCS) levels were determined and those at levels I (minimal functional limitation group: minFLG) or II-III (moderate functional limitation group: modFLG) were included. Spinal curvatures, mobilities, and inclinations in the sagittal and frontal planes were evaluated in the sitting position using a hand-held, computer-assisted non-invasive electromechanical device. Participants' functional independence levels were assessed with the Functional Independence Measure (WeeFIM).

RESULTS

In the sagittal plane, there were no differences in terms of spinal curvatures between the minFLG and modFLG (p > 0.05). Spinal mobility degrees for flexion (thoracic and lumbar regions and total spine), extension (sacral region), and total spine mobility scores were significantly greater in the minFLG (p < 0.05). In the frontal plane, lumbar spinal curvature significantly increased, and total spine mobility in the right/left lateral motions and functional independence decreased in the modFLG (p < 0.05).

INTERPRETATION

The children/adolescents with minimal functional limitations had greater spinal mobility during flexion, extension, and lateral flexions. Spinal curvatures were similar between groups in the sagittal plane. The lumbar region posture scores in the frontal plane observed as lordoscoliosis were higher, and functional independence was lower in the modFLG.

Is the international physical activity questionnaire (IPAQ) a valid assessment tool for measuring physical activity of patients with axial spondyloartritis?

BACKGROUND

Determining the level of physical activity (PA) is an essential part of patient evaluation in axial spondylarthritis (axSpA). Subjective and objective methods are both frequently used methods for evaluating PA. Although subjective methods are cost-effective and easy to use, their accuracy for measuring PA is still questionable.

OBJECTIVE

To investigate the concurrent criterion validity of a self-reported questionnaire (IPAQ-Short Form) when compared to an accelerometer (Actigraph wGT3X-BT) for measuring PA level in patients with axSpA.

DESIGN

Cross-sectional design.

METHODS

Fifty-eight patients with axSpA with a median age of 39.0 (IQR 25/75: 30.0/46.0) years were included in the study. An accelerometer (Actigraph wGT3X-BT) was attached to the waist of patients at their first visits and was removed at their second visits, seven days later. Patients were asked to complete the International Physical Activity Questionnaire Short Form (IPAQ) at their second visits.

RESULTS

No significant correlations were determined between IPAQ and accelerometer (p > 0.05), except for the moderate PA (rho: 0.367, p < 0.05), and total PA (rho: 0.330, p < 0.05). It was also observed that IPAQ was underestimating energy expenditure for all types of PA.

CONCLUSION

IPAQ might not be a valid tool for measuring PA level in patients with axSpA. Disease-specific subjective methods for determining the PA should be developed and validated for those patients.

Development of an exercise attitude scale in Turkish for pregnant women: validity and reliability

This study, conducted between October 2018 and May 2019, aimed to develop an Exercise Attitude Scale in Turkish (EAS-Turkish) for pregnant women and to determine its validity and reliability. The scale was prepared in Turkish to comprehensively measure pregnant women's exercise attitudes. Then, it administered in 253 pregnant women, who were native speakers of Turkish and older than 18 years, in the Obstetrics Polyclinic at Ataturk Training and Research Hospital, Ankara, Turkey. Validity with exploratory and confirmatory factor analysis and reliability with test-retest and internal consistency methods were tested. The 37-item scale was found to be 2-dimensional (knowledge and benefit; barrier). All indexes of the goodness of fit (χ2/df = 2.0, Comparative Fit Index = 0.90, Goodness-of-fit Index = 0.85, Root Mean Square Error of Approximation = 0.06) indicated that the fit between the model and the sample data was acceptable. The item-total score correlations varied between r = 0.22 and 0.60. The Cronbach alpha coefficients were found as 0.90 for the whole scale, 0.91 for the knowledge and benefit sub-dimension, and 0.87 for the barrier sub-dimension. In the test-retest analysis conducted with 41 pregnant women, the reliability coefficients were detected as 0.93 for the whole scale and 0.84 for each sub-dimension. The EAS-Turkish for pregnant women was found to be a valid and reliable tool.

An investigation of potential coronaphobia-related factors in adults and sleep quality relations

BACKGROUND

The study aimed to investigate potential coronaphobia-related factors in adults and to assess the relationship between coronaphobia and sleep quality.

METHODS

This cross-sectional study was conducted in 1262 participants. The Covid-19 Phobia Scale (C19P-S) and Jenkins Sleep Scale (JSS) were used to measure outcomes. Univariate and multivariate logistic regression analyses were constructed to determine risk factors for coronaphobia. Pearson correlation coefficient was used to assess the correlation between C19P-S and JSS.

RESULTS

The following risk factors were found to be associated with coronaphobia: gender, marital status, presence of chronic disease, staying home, and sleep disturbances. Female gender (OR = 2.23 and OR = 2.12), being married (OR = 1.31 and OR = 1.45), chronic disease status (OR = 1.39 and OR = 1.27), staying home (OR = 1.72 and OR = 1.35) and sleep disturbances (OR = 2.63 and OR = 2.49) were found to be associated with the likelihood of having a higher coronaphobia score (p < 0.05). Weak positive correlations were found between C19P-S and its subscales and JSS scores (p < 0.001).

CONCLUSIONS

Female gender, being married, having chronic diseases, staying home, and having sleep disturbances were found to be risk factors for having high coronaphobia scores. Moreover, the severity of coronaphobia was associated with sleep disturbances. These results should be considered in the management of coronaphobia.

The characteristics, disabilities, and spinal alignment of women with double crush syndrome: a case-control study

AIMS

Double crush syndrome is a clinical condition composed of neurological dysfunction due to compressive pathology at multiple sites along a single peripheral nerve. The aims were to investigate the characteristics and disabilities of women with double crush syndrome, to compare the spinal alignment to healthy women, and to determine the cut-offs for the spinal alignment characteristics.

METHODS

Twenty women with double crush syndrome (age: 49.50 ± 8.64 years) and 21 asymptomatic healthy controls (age: 44.76 ± 7.82 years) were included in the study. The physical characteristics, pain intensity, and symptoms were questioned. Disability with Disability of Arm and Shoulder Questionnaire and Neck Disability Index and spinal alignment with Spinal Mouse^® (Idiag, Fehraltorf, Switzerland) were assessed.

RESULTS

The pain intensity at rest, night, and during activity was 3.70 ± 3.25, 6.01 ± 2.77, and 7.15 ± 2.68 cm, respectively. The most bothersome symptom was numbness (65%). The symptoms were seen in hands and/or fingers (55%), arms (15%), shoulder blade (15%), and neck (15%). The Disability of Arm and Shoulder Questionnaire and Neck Disability Index scores were 58.64 ± 15.41 and 19.55 ± 6.37, respectively. The sagittal thoracic curvature (p: .011) and lumbar curvature (p: .049) increased, and the overall spine mobility (p<.001) decreased in the double crush syndrome patients. The cut-off points were detected as 54.5° (area under the curve: 0.680, p: .049, 40% sensitivity, 99.9% specificity) for the thoracic spinal curvature, and 113.5° (area under the curve: 0.667, p<.000, 65% sensitivity, 99.9% specificity) for the overall spine mobility.

CONCLUSIONS

The double crush syndrome patients had moderate to severe pain and disability, increased thoracic and lumbar curvature, and decreased spine mobility. The cut-off values were found as 54.5° for thoracic curvature and 113.5° for spine mobility.

Comparison of physical activity levels among different sub-types of axial spondyloarthritis patients and healthy controls

OBJECTIVES

The aim was to compare the physical activity levels among radiographic axial spondyloarthritis (axSpA) patients, non-radiographic axSpA patients, and healthy controls and investigating the possible relationships between physical activity level and clinical features.

METHODS

Thirty-four patients with radiographic axSpA (24 male), 33 patients with non-radiographic axSpA (23 male), and 35 age and sex-matched healthy controls (24 male) were included. The patients were assessed with Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, Ankylosing Spondylitis Quality of Life Questionnaire, Hospital Anxiety and Depression Scale, Tampa Scale of Kinesiophobia. Physical activity was measured by using an accelerometer (Actigraph wGT3X-BT).

RESULTS

Physical and disease-related characteristics were comparable between groups (p > .05). Radiographic axSpA patients showed lesser physical activity compared to non-radiographic axSpA patients and healthy controls (p < .05). No difference was detected between non-radiographic axSpA patients and healthy controls (p > .05). Physical activity levels were correlated with different clinical features for each sub-type of axSpA. Decreased spinal mobility is the most correlated disease characteristic with lower physical activity level for both sub-types.

CONCLUSION

It seems that disease sub-type in axSpA may alter the physical activity levels. Increasing physical activity levels might need different approaches for different sub-types of axSpA.

Acute effect of kinesiology taping on muscle strength, tissue temperature, balance, and mobility in female patients with osteoarthritis of the knee

AIM

The data on the action mechanism of the kinesiology taping (KT) used to reduce pain and inflammation, provide mechanical support, and facilitate or inhibit muscles in the treatment of osteoarthritis (OA) of the knee are contradictory. The aim of this study was to investigate the acute effects of KT treatment on muscle strength, tissue temperature, balance, and mobility in female patients diagnosed with OA of the knee.

METHODS

Thirty-four female patients (age: 60.26 ± 6.51 years) who were diagnosed with Kellgren-Lawrence Grade 2 OA according to the American Rheumatology Association (ACR-1986) criteria were included in the study. Patients who were performed KT with the superior Y, inferior Y, and U strip techniques were evaluated before and 30 min after taping. Muscle strength was assessed with a handheld dynamometer, tissue temperature with a thermal camera, balance with a monoaxial balance platform, and mobility the Timed Up and Go (TUG) test.

RESULTS

After taping, there was a significant increase in the muscle strength during both extension and flexion (p<.001, p=.005). There was no statistically significant difference in the tissue temperature and balance scores before and after taping (p=.219, p>.05). There was a significant improvement in TUG scores, which evaluated mobility, after taping (p=.033).

CONCLUSIONS

Although KT treatment seems to be ineffective on tissue temperature and balance in the short term in patients with OA of the knee, we are of the opinion that patients should be included in the treatment program due to its positive effects on muscle strength and mobility.

Comparison of Spinal Alignment and Mobility in Women With and Without Post Modified Radical Mastectomy Unilateral Lymphoedema

INTRODUCTION

Unilateral lymphoedema and breast resection after modified radical mastectomy might create impairment of spinal alignment and mobility. The aim of this study was to compare spinal alignment and mobility in women with and without post modified radical mastectomy unilateral lymphoedema.

MATERIALS AND METHODS

Twenty women with post modified radical mastectomy unilateral lymphoedema (lymphoedema group) and 18 healthy women (control group) were included in this study. The sagittal and frontal spinal alignment and mobility were assessed with a Spinal Mouse (Idiag, Fehraltorf, Switzerland). The severity of the lymphoedema was evaluated with circumferential measurements.

RESULTS

In the lymphoedema group, the volume difference of the arms was 448.31 ± 78.14 mL, known as moderate severity lymphoedema. It was seen that the sagittal thoracic curvature (P = .017) and the frontal inclination angle (P = .048) were higher in the lymphoedema group in comparison with the control group. In the lymphoedema group, the frontal inclination angle changed towards the unaffected side (P < .001). No significant differences were found between groups in the other parameters related to spinal curvature and mobility (P > .05).

CONCLUSION

The sagittal thoracic curvature and the frontal inclination angle towards the unaffected side increased in women with post modified radical mastectomy unilateral lymphoedema. The sagittal and frontal spinal alignment changes should be taken into consideration for the assessment and the treatment of unilateral lymphoedema.

Adding connective tissue manipulation to physiotherapy for chronic low back pain improves pain, mobility, and well-being: a randomized controlled trial

This study aimed to evaluate the effectiveness of connective tissue manipulation (CTM) for improving pain, mobility, and well-being in chronic low back pain (CLBP). Sixty-six patients with CLBP were randomized to three groups: CTM, sham massage (SM) and control groups. The groups got standardized physiotherapy and the related applications 5 days/wk, 3 weeks. Pain intensity, mobility, and well-being (Hospital Anxiety and Depression Scale [HADS], Oswestry Disability Index [ODI], and Short Form-36 [SF-36]) were assessed before and after the applications. Pain, mobility, and disability improved in all groups (P<0.05). There were differences in resting pain, HADS, and SF-36 scores in CTM, resting pain in SM, and SF-36 scores in controls (P<0.05). Activity pain, HADS scores decreased, mobility and physical component of the SF-36 in-creased in CTM compared to SM (P<0.05). Pain, ODI, and HADS scores decreased, mobility and SF-36 increased in CTM, and ODI scores decreased in SM compared to controls (P<0.05). In conclusion, pain intensity during activity and at night and disability decreased, and spinal mobility increased in all groups. However, CTM showed superiority in improving pain, mobility, and well-being in patients with CLBP.

Comparison of different electrotherapy methods and exercise therapy in shoulder impingement syndrome: A prospective randomized controlled trial

OBJECTIVE

The aim of this study was to assess and compare the effects of different electrotherapy methods and exercise therapy on pain, function and quality of life in shoulder impingement syndrome.

METHODS

Eighty-three patients (66 females, 17 males; mean age: 48.2 ± 7.33 years) with shoulder impingement syndrome were selected and 79 of them were randomly allocated into four groups. Group 1 (n = 19, mean age: 47.89 ± 7.12 years) was given hot pack and exercises, Group 2 (n = 20, mean age: 47.70 ± 6.51 years) was given hot packs, exercises and interferential current, Group 3 (n = 20, mean age: 48.50 ± 8.34 years) was given hot packs, exercises and TENS and Group 4 (n = 20, mean age: 48.55 ± 7.89 years) was given hot packs, exercises and ultrasound three times a week for four weeks. Assessments were made before treatment, right after it and three months after that using the visual analog scale (VAS), Short Form-36 (SF-36) and the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measures.

RESULTS

At the fourth week and third month assessments, all groups showed significant improvements in terms of pain, DASH and SF-36 physical component scores (p < 0.05). In intragroup comparisons, a significant difference between pre- and post-treatment results was found only in SF-36 mental component scores of Group 2. No significant difference was observed between the groups in any stage of the study period (p > 0.05).

CONCLUSION

Application of ultrasound, interferential current and TENS in addition to exercise therapy in shoulder impingement syndrome treatment had similar improvements in terms of pain, function and physical component of quality of life. However, interferential current treatment showed significantly better outcomes for the mental component of quality of life.

LEVEL OF EVIDENCE

Level I, Therapeutic study.

Differences in body fat mass, muscular endurance, coordination and proprioception in woman with and without knee pain: a cross-sectional study

OBJECTIVE

The aim of this study was to compare body fat mass, muscular endurance, multi-joint coordination and proprioception between sedentary adult women with and without knee pain.

METHODS

This cross-sectional study included 149 women. All participants were evaluated using the Visual Analog Scale to determine knee pain during specific functions and divided into 2 groups accordingly. The knee pain group (n=52; mean age: 42.6±4.1 years; mean height: 1.56±5.11 m; mean weight: 75.2±14.1 kg) included patients with mild to moderate knee pain scores. The without knee pain group (n=97; mean age: 41.7±4.2 years; mean height: 1.58±5.06 m; mean weight: 73.4±10.6 kg) included cases who reported no pain. Body composition was assessed using the TANITA Body Composition Analyzer. Concentric maximal torque of the knee flexor and extensor muscles was recorded using an Isomed 2000 isokinetic dynamometer at 180 deg/s. Coordination and proprioception were assessed using the Functional Squat System.

RESULTS

There was no significant difference in terms of physical characteristics, body composition parameters and coordination results between groups (p>0.05). Peak torque of flexion (0.65±0.21 N/kg) and extension (0.88±0.23 N/kg) of the affected side in the knee pain group were significantly lower than the without knee pain group dominant side flexion (0.74±0.19 N/kg) and extension (0.98±0.19 N/kg) (p<0.05). A significant difference in knee extension was observed between the affected (0.88±0.23 N/kg) and non-affected sides (0.93±0.21 N/kg) of the knee pain group (p<0.05). There were no significant differences for both legs between groups in terms of coordinative concentric side-to-side deficits and eccentric deficits (p>0.05). The deviation on visible movement for proprioception was significantly higher in the knee pain group (3.23±1.01 cm) than in the without knee pain group (2.78±1.03 cm) (p=0.012).

CONCLUSION

Knee pain impairs flexor and extensor peak torques of knee endurance and multi-joint proprioceptive accuracy in sedentary woman. No differences were observed in terms of body composition and joint coordination of the groups with or without knee pain.

Effects of exercise and electrical stimulation on lumbar stabilization in asymptomatic subjects: a comparative study

BACKGROUND AND OBJECTIVES

Segmental stabilization training and electrical stimulation are used as a treatment for patients with low back pain. There is limited information on the efficacy of two interventions in the literature. In this study, the efficacy of the two interventions on the multifidus muscle activation and fatigue, segmental stabilization training and electrical stimulation, were examined and compared.

MATERIAL AND METHODS

Our sample consists of 30 asymptomatic individuals, randomly assigned to one of three groups: the group that was given segmental stabilization training, the group that was given electrical stimulation and the control group that received no treatment. The muscle activity and fatigability of the multifidus were recorded by the surface electromyography before and after the intervention.

RESULTS

No difference is detected for any of the multifidus muscle activation and fatigue characteristics either within or between groups.

CONCLUSION

Both techniques did not improve multifidus activation capacity. An effort at submaximal and maximal level affects and increases the activity of multifidus.

Long-term functional and sonographic outcomes in Osgood-Schlatter disease

PURPOSE

To evaluate the sonographic characteristics, functional aspects and life quality of a group of adolescent patients 2 years after having been diagnosed with Osgood-Schlatter disease and compare them with an age-matched healthy control group.

METHODS

The study was conducted on eighteen Osgood-Schlatter patients with unilateral involvement and 14 age-matched healthy controls. The Flaviis classification and patellar tendon characteristics were observed using a GE Logiq 9 scanner. Broad and vertical jump tests were used for jumping performance. The coordination, proprioception, strength and endurance functions were assessed with the Functional Squat System. For the quality of life, the SF-36 questionnaire was used. The Wilcoxon test for the patients' initial and second-year assessment and Mann-Whitney U test for the comparison between the patient and control groups were used.

RESULTS

By the end of second year, 38.9% of the patients had totally recovered. The patellar tendon lengthened, distal diameter and distal area of the tendon had lessened, and no significant difference was observed between patient and control groups (n.s). Improvements were detected for the bilateral broad jump test scores, the quality of life and coordination of the patients after 2 years (p < 0.05). The average power of endurance and the total work of strength were significantly higher in control group (p < 0.05).

CONCLUSIONS

According to the sonography results 2 years after diagnosis, nearly half of the patients had totally recovered. Coordination was the only parameter that improved over the 2-year period. The patient group strength and endurance function remained lower than the control group.

LEVEL OF EVIDENCE

III.

Effects of different segmental spinal stabilization exercise protocols on postural stability in asymptomatic subjects: randomized controlled trial

BACKGROUND AND OBJECTIVES

The aim was to assess and compare the postural stability effects of the "Progressive Dynamic Spine Stabilization Exercise Protocols" (PDSSEP) which were designed for different spinal segments.

MATERIAL AND METHOD

The asymptomatic, sedentary, and female volunteers (21.26 ± 1.30 years old) were allocated randomly into Cervical (n=22), Lumbar (n=21), Thoracic (n=20), Combined (n=20), and Control (n=21) Groups. All training groups participated into the related PDSSEP for six weeks, 3 days/week. The assessments were carried out at the baseline, after 6(th) week, and on the 12(th) week. "Tetrax Interactive Posturography and Balance System" (Tetrax System, Ramat Gan, Israel) was used to assess the overall postural stability (SI), weight distribution (WDI) and somatosensory reactions. "Kruskal Wallis Test" for the differences of the pre-6th weeks, pre-12(th) weeks within the groups, "Mann-Whitney U Test" for control and inter-group comparisons were used.

RESULTS

The differences were observed for eyes closed SI, and WDI in head right rotated position (p< 0.05) between the baseline and after completing the programs. Eyes closed SI in solid surface was shown statistically different in Thoracic group in comparison to controls (p< 0.02). SI on soft surface, SI head left rotated position and somatosensory reactions with head flexed position improved in Thoracic Group at the 12(th) week (p< 0.01). WDI significantly improved in Cervical Group (p< 0.01).

CONCLUSION

Thoracic spine can be considered as a hidden source for improving overall postural stability. It may be appropriate to focus on thoracic region in the kinetic chain for the treatment or training.

LEVEL OF EVIDENCE

A prospective randomized controlled trial, Level 1.