The effects of improvement in upper extremity function on gait and balance in children with upper extremity affected

BACKGROUND

This study aimed to investigate the effects of functional improvement in the upper extremity on gait and balance in children with upper extremity affected.

RESEARCH QUESTION

What are the effects of functional improvement in the upper extremity on gait and balance in children with upper extremity affected?

METHODS

Eighteen children with a diagnosis of rheumatologic diseases and 15 healthy children were evaluated with Shriners Hospital Upper Extremity Assessment, Jebsen-Taylor Hand Function Test, Abilhand Rheumatoid Arthritis Scale, 10-meter walk test and Childhood Health Assessment Questionnaire. For static balance assessment, the Biodex Balance was used. Ground reaction forces (peak forces (heel strike and push-off) and minimum force (loading response), single-limb support duration, Center-of-Force displacement and walking speed were evaluated with the Sensor Medica. Arm swing was evaluated with the Kinovea 2D motion analysis.

RESULTS

Before treatment, single-limb support duration and push-off force was higher and center-of-force displacement was lower on affected side compared to unaffected side in rheumatologic group. After the 6-week rehabilitation program, upper extremity function, quality of life and functional gait score improved. Single-limb support duration decreased on affected side and increased on unaffected side. On affected side, push-off force decreased. The arm swing parameters were similar before and after treatment.

SIGNIFICANCE

Improving upper extremity function can help with gait balance by decreasing the difference in walking and balance parameters between the affected and unaffected sides and providing for more symmetrical weight transfer.

Exercise programs for scoliosis in juvenile idiopathic arthritis: a randomized-controlled study

By improving core strength and stability, children with JIA can experience increased endurance, reduced pain, and improved posture. No study was found that investigated the effectiveness of 3-Dimension (3D) exercises in JIA. This study aimed to compare the effectiveness of structured 3D exercises with that of a conventional exercise program specially planned for children with JIA who have scoliosis. This was a prospective, randomized-controlled study. Structured 3D scoliosis exercises for Group 1 (n: 25) and conventional exercises for the Group 2 (n: 25) were applied for 24 weeks. The angle of trunk rotation (ATR) by scoliometer, scoliosis angle by Cobb angle, pain by a numerical rating scale (NRS), respiratory functions by spirometry, and perception of cosmetic deformity by The Walter Reed visual assessment scale (WRVAS) were evaluated. ATR, Cobb angle, and pain in Group I showed significant improvement compared to Group II. While the sub-parameters of WRVAS and increased significantly in both groups, the improvement in Group I was found to be greater between the groups. While FVC (%) and FEV1 (%) results within the group were significant in both groups. 3D exercises and conventional exercises are an effective and feasible method in the treatment of scoliosis in these children. Despite the curative effect of both methods, 3D exercises have been proven in this study to be more effective on Cobb angle, ATR, WRAS, and respiratory parameters.

The Effects of Exercise Training on Physical Activity Level, Daily Living Activities, and Participation in Children with Hemophilia

OBJECTIVE

Hemophilia is an uncommon disorder that is difficult to diagnose and manage. Effective movement and individual physiotherapy interventions can improve physical activity levels, quality of life, and participation in children with hemophilia. This study aimed to investigate the effects of individually planned exercise on joint health, functional level, pain, participation, and quality of life in children with hemophilia.

MATERIALS AND METHODS

Twenty-nine children with hemophilia (aged 8-18 years) were randomized into either an exercise group with physiotherapists (n = 14) or a counseling home-exercise group (n = 15). Pain, range of motion, and strength were measured using a visual analog scale, goniometer, and digital dynamometer, respectively. Joint health, functional capacity, participation, quality of life, and physical activity were assessed using the Hemophilia Joint Health Status, 6-Minute Walk Test, Canadian Occupation Performance Measure, Pediatrics Quality of Life, and International Physical Activity Questionnaire, respectively. The exercises were planned individually according to the needs of both groups. Additionally, the exercise group performed the exercise with a physiotherapist. Interventions were performed 3 days/week for 8 weeks.

RESULTS

The Hemophilia Joint Health Status, 6-Minute Walk Test, Canadian Occupation Performance Measure, International Physical Activity Questionnaire, muscle strength, and range of motion (elbow, knee, and ankle) were significantly improved in both groups (P < .05). Compared with the counseling home-exercise program group, the exercise group had better results in the 6-Minute Walk Test, muscle strength, and range of motion (knee and ankle flexion) (P < .05). No significant difference was found in pain and Pediatrics Quality of Life scores in both groups.

CONCLUSION

Using individually planned exercise in children with hemophilia is an effective physiotherapy approach to improve physical activity, participation, functional level, and joint health.

Physical activity and exercise in patients with pediatric rheumatic disease: A systematic search and review

Childhood rheumatic diseases are a group of diseases that can affect many organs and systems, resulting in pain, joint stiffness, muscle atrophy and weakness. Physical inactivity has been reported in many childhood rheumatic diseases. There are many studies in the literature comparing the effectiveness of exercise programs in children with juvenile idiopathic arthritis. Exercise and physical activity are considered major parts of the treatment of children with rheumatic disease. The aim of this review is to systematically present studies on physical activity and exercise programs in children with rheumatism from the last 5 years. An internet-based search of three databases-PubMed, PEDro and Medline- was conducted to find relevant studies. Two reviewers individually identified studies on the basis of their title, abstract or full text-as necessary-to determine their eligibility. Differences of opinion between the two examiners were resolved by discussion. Scientific studies of children with different rheumatic diagnoses have shown that physical activity and exercise have a significant effect on reducing the symptoms of the disease. However, the duration, frequency, method and evaluation of the exercises are still being discussed in the literature.

Physical therapy enhances functions and quality of life in older patients with breast cancer-related lymphedema: A prospective experimental study

Background

Lymphedema of the arm is one of the most common complications following breast cancer surgery.

Aims

The primary aim of this study was to evaluate the effects of complex decongestive physical therapy (CDPt) on upper extremity functions, activities of daily living (ADL), and quality of life (QoL), and secondly the effects of the degree of lymphedema on post-treatment differences in older patients with breast cancer-related lymphedema (BCRL).

Subjects and Methods

Sixty-eight patients who had BCRL were included between 2015 and 2017. Arm function was evaluated with the Constant-Murley scale, while ADL was measured with the Lawton Instrumental Activities of Daily Living Scale, and QoL was measured with the Lymphedema Functioning, Disability and Health Questionnaire as pre- and post-treatment tests. The patients underwent a CDPt program for 6 weeks.

Results

There were statistically significant improvements for all outcome measurements in older patients with Grade 1 and 2 lymphedemas after the treatment (P < 0.001). The Grade 1 patients had a greater difference at mobility, participation in the life and social activities, and their total scores of quality of life had a significance level of P < 0.001.

Conclusion

Older patients with Grade 1 BCRL had better mobility, participation in the life, and social activities. CDPt provides enhancement of arm functions, ADL, and QoL in older patients with breast cancer-related lymphedema.

Understanding the impact of cognitive impairment and disease severity on activities of daily living in MS patients with different disability levels

OBJECTIVE

Physical impairments seen in people with multiple sclerosis (PwMS) affect the level of independence in activities of daily living (ADL). However, physical problems are insufficient to explain some debilitating conditions experienced by PwMS in daily life, especially in activities that require high cognitive ability. The aim of this study was to investigate the impact of cognitive impairment and disease severity on ADL in MS patients with different disability levels.

METHODS

Seventy PwMS were enrolled and divided into three groups according to their disability status. Cognitive functions were assessed with the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and independence level in ADL was assessed with Functional Independence Measure (FIM).

RESULTS

There were significant differences between groups in FIM and FIM motor (FIMm) scores (p < 0.001), however no significant differences were found between groups in terms of FIM cognitive (FIMc) and LOTCA scores (p = 0.195 and p = 0.348 respectively). There was a moderate positive correlation between FIM and LOTCA total scores (p < 0.001) for overall sample. While there was a low correlation between LOTCA and FIMm (p = 0.008), high correlation was found between LOTCA and FIMc (p < 0.001).

CONCLUSION

Although most of the limitations in ADL can be explained by the severity of the disability in MS, the ability to perform ADL including cognitive skills was found to be similar for all disability levels. Cognitive problems should be taken into consideration as well as motor problems in the process of planning treatment programs for PwMS with any levels of disability.

Musculoskeletal pain and its relation to individual and work-related factors: a cross-sectional study among Turkish office workers who work using computers

Objective. Office workers are commonly exposed to work-related musculoskeletal pain. This study investigated the individual and work-related risk factors linked to musculoskeletal pain and pain-related disability among Turkish office workers who work using computers. Methods. One-hundred and fifty office workers were included. Data were collected using an online survey with a combination of the Nordic musculoskeletal questionnaire, Oswestry disability index (ODI), neck disability index (NDI) and disabilities of the arm, shoulder, and hand questionnaire short-form (Q-DASH). The participants were divided into four subgroups: no pain (n = 26), lower back pain (n = 37), neck pain (n = 49) and upper-extremity pain (n = 38). Results. There were differences between subgroups in terms of the condition that feet touch the floor and the condition that the keyboard, mouse and wrist are in a straight line (p = 0.013 and p = 0.025, respectively). Working years was correlated with the ODI score (ρ = 0.802, p = 0.041). There was also a significant correlation between the NDI score and working hours (ρ = 0.415, p = 0.003), while Q-DASH was correlated with body mass index and working years (ρ = 0.406, p = 0.014, and ρ = 0.327, p = 0.043, respectively). Conclusions. Pain-related disability was associated with various risk factors such as physical inactivity, body mass index, working hours, working years and workplace ergonomics in the office workers.

Evaluation of balance after surgery for cerebellopontine angle tumor

BACKGROUND

The origin of about 10% of tumors located in the intracranial region is the cerebellopontine angle. Therefore Cerebellopontine Angle (CPA) tumors affect patients' balance.

OBJECTIVE

The aim of this study was to compare the balance in individuals who underwent surgery for CPA tumors with healthy individuals.

METHODS

Thirty patients who were being followed-up by the Department of Neurosurgery and had been operated on CPA tumor and 31 healthy individuals were included in the study as group 1 and group 2, respectively. The participants were evaluated using Romberg Test, Sharpened Romberg Test, One-leg Stance (OLS), Tandem Walking, Walk Across, Berg Balance Scale (BBS), Dizziness Handicap Inventory (DHI) and Short Form 36 (SF-36).

RESULTS

In comparison of the groups, OLS tests (p< 0.001), BBS (p< 0.05) and DHI (p< 0.05) were significantly different in favor of healthy group. SF-36 results revealed a significant difference between the groups, except for Bodily Pain and Vitality (p< 0.05).

CONCLUSIONS

The results of this study demonstrated a decrease in balance parameters and quality of life in individuals who underwent CPA tumor surgery in comparison to healthy individuals. Evaluation of balance in the preoperative and postoperative period should not be ignored in these patients and they are suggested to start rehabilitation in the early postoperative period.

The effects of very early mirror therapy on functional improvement of the upper extremity in acute stroke patients

[Purpose] The aim of the study was to evaluate the effects of a very early mirror therapy program on functional improvement of the upper extremity in acute stroke patients. [Subjects] Eight stroke patients who were treated in an acute neurology unit were included in the study. [Methods] The patients were assigned alternatively to either the mirror therapy group receiving mirror therapy and neurodevelopmental treatment or the neurodevelopmental treatment only group. The primary outcome measures were the upper extremity motor subscale of the Fugl-Meyer Assessment, Motricity Index upper extremity score, and the Stroke Upper Limb Capacity Scale. Somatosensory assessment with the Ayres Southern California Sensory Integration Test, and the Barthel Index were used as secondary outcome measures. [Results] No statistically significant improvements were found for any measures in either group after the treatment. In terms of minimally clinically important differences, there were improvements in Fugl-Meyer Assessment and Barthel Index in both mirror therapy and neurodevelopmental treatment groups. [Conclusion] The results of this pilot study revealed that very early mirror therapy has no additional effect on functional improvement of upper extremity function in acute stroke patients. Multicenter trials are needed to determine the results of early application of mirror therapy in stroke rehabilitation.