Associations of Upper-Extremity Exercise Capacity and Grip Strength With Cognitive Domains in Patients With COPD.

BACKGROUND: Cognitive impairment (CI), which has been reported in COPD, has been related to physical performance. However, the association between CI and upper-extremity functions is unknown. We aimed to compare upper-extremity exercise capacity and grip strength between subjects with COPD with and without CI and to determine the relationship of upper-extremity functions with specific cognitive domains. METHODS: In this cross-sectional study, 76 subjects with COPD (mean age 66.8 ± 7.5 y, FEV1% 47.12 ± 14.10) were classified as with and without CI according to the Montreal Cognitive Assessment. Clinical characteristics, upper-extremity exercise capacity (6-min pegboard ring test [6PBRT]), grip strength (hand dynamometer), dyspnea severity (modified Medical Research Council dyspnea scale), disease-specific health status (COPD Assessment Test), and disease-specific quality of life (St George Respiratory Questionnaire) were compared between groups, and the relationship of upper-extremity functions with cognitive subdomains was analyzed by multivariate regression analysis. RESULTS: The number of 6PBRT rings (P = .01) and the grip strength (P = .033) were lower in subjects with CI. Subjects with CI had lower FEV1% (P = .038), arterial oxygenation (P = .002), exercise habits (P = .033), health status (P = .01), quality of life (P = .042); and higher dyspnea (P < .001), smoking consumption (P = .032), emergency admission (P = .02), and hospitalization (P = .042). The adjusted model showed that executive functions and attention were related to upper-extremity capacity (ß = 14.4 and ß = 10.2, respectively) and hand-grip strength (ß = 1.85 and ß = 1.49, respectively). CONCLUSIONS: These findings suggest that upper-extremity functions might be decreased especially concerning executive functions and attention in subjects with COPD with CI.

Effects of a single session action observation training on hand function in healthy young adults: a randomised controlled assessor and participants-blinded trial.

PURPOSE: The aim was to investigate the effects of a single session action observation training (AOT) on hand function and evaluate whether observing self-actions would be more effective than observing someone else. MATERIALS AND METHODS: A total of 60 right-handed healthy young adults, (32 female, 28 males and the mean age was 21.32 ± 1.07 years) were included in the study. The participants were randomly divided into five groups, self-action observation (sAO), observation of a third person (AO), action practice (AP), non-action observation (nAO), and control. A single session was performed for all participants. The primary outcome was the Jebsen Taylor Hand Function Test (JTHFT) assessed by a masked assessor. RESULTS: Significant differences were observed between the sAO and control group in total left side JTHFT performance (p < 0.001). Additionally, there were significant differences between the AO and control group (p < 0.001), and AP and nAO group (p = 0.003) and AP and control group (p < 0.001) in total JTHFT performance change of the left side. Significant differences were found between the sAO and nAO (p = 0.001) and control groups (p < 0.001) in dominant side total JTHFT performance change. No difference between sAO and AP groups were observed (p > 0.05). CONCLUSION: It was observed that a single session of action observation training improved hand function in healthy adults. The better performance achieved in the group watching the self-video may suggest that watching the self-image activates more mirror neurons.

Investigation of the dual-task performance and affecting factors in female patients with fibromyalgia syndrome.

Recent studies report that dual-task (DT) performance might be affected in patients with fibromyalgia syndrome (FMS). This cross-sectional study aims to compare the DT performance in female patients with FMS and healthy controls, and to investigate the DT-related factors in these patients. This study was conducted at a university hospital between November 2021 and April 2022. Forty females aged 30-65, diagnosed with FMS, and 40 aged-matched pain-free healthy controls were included. All participants performed the Timed Up and Go Test under a single task (ST) and a cognitive DT condition, and the DT cost was calculated. The following evaluations were applied; The six-minute walk test, Baecke Habitual Physical Activity Questionnaire, Multidimensional Fatigue Inventory-20, Toronto Alexithymia Scale, Trail Making Test, and the Revised Fibromyalgia Impact Questionnaire. As a result of the study, the patient group showed lower performance than controls in both, ST and DT conditions (p < .05). Disease duration, pain and fatigue severity, functional capacity, leisure time and physical activity total scores, alexithymia scores, health status, and cognitive variables were correlated with DT performance in the patient group (p < .05). According to our results, we consider that the rehabilitation approach for females with FMS should take into account DT and related characteristics.

Psychometric Properties of the Turkish Adaptation of the Yale Physical Activity Survey.

This study aimed to examine the convergent validity and test-retest reliability of the Turkish version of the Yale Physical Activity Survey (YPAS-TR). Eighty-one volunteer older adults were included in the study. Test-retest reliability was evaluated using the intraclass correlation coefficient. Correlation coefficients between YPAS-TR and Physical Activity Scale for the Elderly (PASE), Short Form-36, and Short Physical Performance Battery were examined for convergent validity. Acceptable intraclass correlation coefficient values were reached for YPAS-TR energy expenditure, total physical activity time and summary, vigorous, leisurely walking, moving, standing, and sitting indices (intraclass correlation coefficient = .96-.99). There was a moderate correlation between energy expenditure and total physical activity time with PASE (leisure time activities), PASE (household activities), and PASE (total) (r = .478, r = .468, r = .570, r = .406, r = .490, r = .550, respectively, p < .001). Also, a weak correlation was found between summary and leisurely walking index with PASE (household activities), standing index with PASE (leisure time activities), and PASE (total) (r = .285, p = .010; r = .257, p = .021; r = .238, p = .033; r = .283, p = .010; respectively). The results of the study suggest that the YPAS-TR is a valid and reliable measurement tool that can be used to assess the physical activity patterns of Turkish older adults.

Attitudes of physiotherapy students toward neurology: does "neurophobia" exist among physiotherapy students?

BACKGROUND: Evidence is accumulating that medical students and practitioners have particular difficulty in neurology and have neurophobia. However, little is known about attitudes toward neurology in physiotherapy students. PURPOSE: This study aimed to assess the attitudes of physiotherapy students toward neurology and compare it with other core specialties, identify contributors to difficulties of neurology, and obtain feedback for improving the quality of neurology and neurological rehabilitation education. METHODS: A structured survey was distributed to final-year physiotherapy students in different universities across Turkey. Perceived level of knowledge, confidence, interest, difficulty, and desire to pursue a career in four main physiotherapy specialty areas (neurology, musculoskeletal, cardiopulmonary, and pediatric) were assessed. Reasons for perceived difficulty and ways to improve neurological physiotherapy education were asked by Likert-type and open-ended questions. RESULTS: Three hundred ninety-one students participated from 12 universities. Neurology was perceived as the most challenging discipline (p < .001), but a lack of knowledge, interest, and confidence were not reported. The reasons for perceived difficulties with neurology were the need-to-know basic neuroanatomy and neurophysiology, difficulty integrating information into the clinic, and the complexity of the subject. To improve learning, most students recommended increasing clinical teaching, including bedside tutorials, exposure to more patients, and case discussions. CONCLUSION: Physiotherapy students considered neurology as the most challenging discipline. Improving the integration of basic neurosciences into the clinic may improve neurology learning along with increased clinical teaching.

The acute effects of action observation training on upper extremity functions, cognitive processes and reaction times: a randomized controlled trial.

Aim: To investigate the acute effects of action observation training on upper extremity functions, cognitive functions and response time in healthy, young adults. Materials & methods: A total of 60 participants were randomly divided into five groups: the self-action observation group, action observation group, action practice group, non-action observation group and control group. The Jebsen-Taylor hand function test (JTHFT), nine-hole peg test, serial reaction time task and d2 test of attention were applied to the participants before and after the interventions. Results: JTHFT performance with both non-dominant and dominant hands improved significantly compared with baseline in all groups (p < 0.001). JTHFT performance with non-dominant and dominant hands differed between the groups (p < 0.001). Conclusion: Action observation training seems to enhance the performance of upper extremity-related functions. Observing self-actions resulted in statistically significant positive changes in more variables compared with other methods. However, its clinical effectiveness over the other methods should be investigated in future long-term studies. Clinical Trial Registration: NCT04932057 (ClinicalTrials.gov).

Pelvic floor muscle training on urinary incontinence and sexual function in people with multiple sclerosis: A systematic review.

OBJECTIVE: This systematic review evaluates and summarizes the effects of pelvic floor muscle training on urinary incontinence and sexual function in people with multiple sclerosis. DATA SOURCES: PubMed, Scopus, PEDro, CINAHL, Web of Science, and ULAKBIM databases with keywords multiple sclerosis, urinary incontinence, sexual function, and pelvic floor muscle training were screened for randomized controlled studies and clinical trials from the beginning until July 2020 (updated in August 2021). REVIEW METHODS: Two authors independently made the study selection. Turkish and English publications were taken into consideration. The risk of bias for the included studies was assessed using the Revised Cochrane risk-of-bias tool for randomized trials. The Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEXT) was used to assess the methodological quality of studies. Data extraction was performed by two researchers independently. RESULTS: Initial search identified a total of 2831 studies, after removing duplicates, 2180 records were screened and 7 studies with 248 participants [mean age (years): 50.0 ± 11.11 and range: 20-67; mean Expanded Disability Status Scale score: 4.2 ± 1.64 and range: 1.5-7.5] met the inclusion criteria. Only one study included male people with multiple sclerosis. Five studies were judged as being of some concerns and two studies were judged as being of high risk of bias. The TESTEXT scores ranged from 5 to 9 out of 15. The outcome measures were the health-related quality of life (6 studies), severity of overactive bladder (5 studies), leakage episodes (4 studies), severity of urinary incontinence (3 studies), 24-h pad test (2 studies), pad usage, sexual function, and anxiety and depression (1 study). Significant improvements were observed in all specified outcome measures in the groups that received pelvic floor muscle training in majority of the studies. CONCLUSION: Current evidence suggests that pelvic floor muscle training seems to be an effective treatment modality for improving health-related quality of life and reducing the severity of urinary incontinence and overactive bladder symptoms in people with multiple sclerosis. It also can reduce leakage episodes, pad usage, anxiety, and depression and improve sexual function. However, it should be noted that all included studies had some concerns or a high risk of bias in at least one domain of risk of bias assessment, and most of the studies did not have high quality.

Turkish translation, cross-cultural adaptation, and assessment of psychometric properties of the Ottawa sitting scale for the intensive care unit survivors.

PURPOSE: To translate and cross-culturally adapt the Ottawa Sitting Scale (OSS) developed for acute care patients into Turkish and to examine its psychometric properties in intensive care unit (ICU) survivors. METHODS: After translation process the Turkish version of the scale was adminstered to eighty-one patients aged 39-82 years after discharge from the ICU and videotape was recorded. Two physiotherapists watched the videotaped records during the evaluation and scored. Test-retest reliability was assesed by scoring the same video recordings 15 days after the initial scoring. Correlations of the OSS with Berg Balance Scale (BBS), Functional Independence Measurement (FIM), the ICU length of stay and, total mechanical ventilation duration were assessed for convergent validity. RESULTS: The intra-class correlation coefficient for inter and intra-rater reliability was 0.989-0.994 and 0.998 respectively. The internal consistency was excellent (Cronbach's α = 0.998). The OSS score was highly correlated with the BBS total score (r = 0.716), the BBS unsupported sitting item score (r = 0.863), and moderately correlated with the total score of the FIM (r = 0.602), the number of days in ICU (r= -0.545), and total mechanical ventilation duration (r = -0.518). CONCLUSION: The Turkish version of OSS has been found to be valid and reliable in assessment of sitting balance in patients discharged from intensive care unit.Implications For RehabilitationPhysiotherapeutic measurements are crucial and necessary to determine the functional status of the patients.Ottawa Sitting Scale was translated and culturally adapted to Turkish and showed good psychometric propertiesOttawa Sitting Scale is valid and reliable tool to evaluate sitting balance in intensive care unit survivors.Ottawa Sitting Scale can guide clinicians in establishing evaluation and rehabilitation programs for patients discharged from intensive care unit.

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.

Muscle Activity Ratios of Scapular Stabilizers During Closed Kinetic Chain Exercises in Healthy Shoulders: A Systematic Review.

CONTEXT: Selective strengthening of scapular stabilizers is one of the emphases of the recent literature. Closed kinetic chain (CKC) exercises are used extensively in shoulder rehabilitation. However, a limited number of studies have reported scapular muscle ratios during CKC exercises. OBJECTIVES: To determine the CKC exercises producing the optimal ratios of the scapular stabilizer muscles in healthy shoulders. EVIDENCE ACQUISITION: A systematic search within PubMed, Embase, CINAHL Plus, and SPORTDiscus with Full Text and ULAKBIM National Medical Database was performed up to January 2018. Studies were selected according to the predetermined criteria. If the pooled mean ratios (upper trapezius [UT]/middle trapezius [MT], UT/lower trapezius [LT], and UT/serratus anterior [SA]), which were calculated from the percentage of maximum voluntary contractions of muscles, were <0.60, these exercises were considered as ideal for higher activation of the MT, LT, and SA than the UT. EVIDENCE SYNTHESIS: The search identified 1284 studies, and 29 observational studies were included for review. Seventy-nine CKC exercises were determined. Four exercises for the MT, 9 for the LT, and 59 for the SA were identified from the articles as being optimal exercises to activate the specified muscle more than the UT. CONCLUSIONS: This review identified optimal CKC exercises that provide good ratios between the MT, LT, and SA with the UT. Most exercises have optimal UT/SA ratios, but some exercises performed on unstable surfaces may lead to excessive activation of the UT relative to the SA. For the UT/MT, the isometric low row, inferior glide, and half supine pull-up with slings are the ideal exercises. Isometric one-hand knee push-up variations seem to be the best choice for the UT/LT. The results suggest that many CKC exercises may be utilized to enhance scapular muscle balance when rehabilitating shoulder pathology.

Does taping in addition to physiotherapy improve the outcomes in subacromial impingement syndrome? A systematic review.

BACKGROUND: Taping is used with or without other interventions for many purposes, especially to manage pain and improve functional activity in patients with shoulder pain. OBJECTIVES: The aim of this review was to determine whether any taping technique in addition to physiotherapy care is more effective than physiotherapy care alone in patients with shoulder impingement syndrome. METHODS: A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID), The Kinesio Kinesio® Taping Method, Kinesio® Tex Tape UK and International websites ( www.kinesiotaping.co.uk ; www.kinesiotaping.com ) was conducted to June 2015. The outcome measures were pain, disability, range of motion and muscle strength. As data were not suitable for meta-analysis, narrative synthesis were applied. RESULTS: Three randomized controlled trials and one controlled trial (135 patients) were included. The results were conflicting and weak on the effectiveness of taping as an adjunct therapy for improvement of pain, disability, range of motion and muscle strength. CONCLUSION: Clinical taping in addition to physiotherapy interventions (e.g. exercise, electrotherapy, and manual therapy) might be an optional modality for managing patients with shoulder impingement syndrome, especially for the initial stage of the treatment; however, we need further robust, placebo controlled and consistent studies to prove whether it is more effective than physiotherapy interventions without taping.