Neck Muscle Stiffness in Participants With and Without Chronic Neck Pain: A Shear-Wave Elastography Study.

OBJECTIVES: The purpose of the present study was to investigate differences in neck muscle stiffness between patients with chronic neck pain and asymptomatic control group. METHODS: Thirty-five patients with chronic neck pain and 35 age-matched asymptomatic participants enrolled in the study. Shear wave velocity (SWV) of upper trapezius, levator scapulae, splenius capitis, and sternocleidomastoid muscles were obtained using an ACUSON S3000 Ultrasonography Device (Siemens Medical Solutions, Mountain View, California). In patients with chronic neck pain, pain intensity was measured by Numerical Rating Scale and disability level was measured by Neck Disability Index. RESULTS: The SWV of splenius capitis was similar in both groups (P = .985); however, SWV of upper trapezius (P = .001), levator scapulae (P = .038), and sternocleidomastoid (P = .001) of the patients with chronic neck pain were higher compared with the asymptomatic controls groups. Numerical Rating Scale and Neck Disability Index scores did not correlate with the SWV of the selected muscles (P > .05). CONCLUSIONS: Stiffness of upper trapezius, levator scapulae, and sternocleidomastoid muscles in patients with neck pain were higher compared to asymptomatic participants. In addition, severity of pain and disability did not correlate to stiffness of these muscles in patient with chronic neck pain.

The effects of clinical pilates exercises on bone mineral density, physical performance and quality of life of women with postmenopausal osteoporosis.

OBJECTIVE: The aim of this study was to investigate effects of Clinical Pilates Exercises on bone mineral density (BMD), physical performance and quality of life (QOL) in postmenopausal osteoporosis. METHODS: Forty-one women were recruited to the study. The subjects were divided into two groups, as the Pilates group and the control group. Subjects were evaluated for BMD at the lumbar region. Physical performance level was measured. Pain intensity level was scored with Visual Analogue Scale. QUALEFFO-41 was used for assessing QOL. RESULTS: BMD values increased in the Pilates group (p < 0.05), while BMD decreased in the control group (p< 0.05). Physical performance test results showed significant increases in the Pilates group (p< 0.05) whereas there was no changes in the control group (p> 0.05). Pain intensity level in the Pilates group was significantly decreased after the exercise (p< 0.05), while it was unchanged in the control group. There were significant increases in all parameters of QOL in the Pilates group. Conversely, some parameters of QOL showed decreases in the control group (p< 0.05). CONCLUSIONS: Pilates Exercises is effective to increase BMD; QOL and walking distance and also beneficial to relieve pain. Physiotherapist can use Pilates Exercises for the subjects with osteoporosis in the clinics.

A comparison of results of 3-dimensional gait analysis and observational gait analysis in patients with knee osteoarthritis.

OBJECTIVE: This study aimed to investigate levels of validity, and inter- and intra-observer reliability of observational gait analysis (OGA) in clinical usage, done by the physical therapists with varying clinical experience, in subjects with knee osteoarthritis. METHODS: The study included 33 subjects (22 female, 11 male; mean age: 58.24±9.14 years range: 46 to 81) clinically and radiographically diagnosed with bilateral knee osteoarthritis, and 4 physical therapists to observe the subjects' gaits. The physical therapists were separated into two groups according to their professional experience: those with 10 or more years, and those with fewer than 10 years. Video recordings were made of the subjects undergoing three-dimensional gait analysis (3DGA). These recordings were then observationally assessed twice by the participating physical therapists with at least a 6-week interval between observations. OGA was done via a form comprising 11 kinematic and 5 temporo-spatial parameters. RESULTS: Lowest levels of agreement in both validity (r=0.06, p>0.05), and inter- (ICC:-0.12-0.06) and intra-observer (ICC:0.30-0.45) reliability were found in the parameters of ankle dorsiflexion in initial contact phase and pelvic rotation in midstance phase. Highest inter- and intra-observer agreement was found in the temporo-spatial parameters of step width, double step length, cadence and velocity (ICC:0.61-0.80). Highest validity was found in pelvic tilt in stance phase (r=0.74-0.78, p<0.001). With the exception of stance phase, moderate or good agreement (r=0.52-0.69, p<0.05) was found in the temporo-spatial parameters. CONCLUSION: This study found that OGA assessment of temporo-spatial parameters had moderate or good validity and reliability. Assessment of the majority of kinematic parameters had fair or moderate validity and inter-observer reliabilty, and moderate or good intra-observer reliability.

Effects of severity of osteoarthritis on the temporospatial gait parameters in patients with knee osteoarthritis.

OBJECTIVE: The aim of this study was to investigate the differences in temporospatial parameters in according to severity of knee osteoarthritis (OA). METHODS: The study included a total of 110 subjects with no orthopedic or neurologic disease that might affect gait were divided into three study and one control groups. Eighty subjects (mean age: 53.13 ± 6.78 years) were diagnosed with bilateral knee OA and divided into groups according to Kellgren-Lawrence radiologic scale: the Phase 1 group included 29 subjects, Phase 2, 28 subjects, and Phase 3, 23 subjects. The control group was composed of 30 healthy subjects (25 females, 5 males; mean age: 41.50 ± 5.79 years). Temporospatial gait data were evaluated using a gait analysis system. METHODS: There were no significant differences in all temporospatial parameters between the control group and the Phase 1 and 2 OA groups (p>0.05). There was a significant decrease in cadence, gait velocity, stride length and step length (p<0.008) and a significant increase in stride time, double support time, step time, single support time and stance phase length in patients with Phase 3 knee OA compared to the other groups (p<0.008). CONCLUSION: Changes in temporospatial parameters of patients with Phase 3 knee OA may be correlated with loss of gait stabilization and increase in risk of falling. In subjects with knee OA, gait stabilization and balance loss must be examined and evaluated in terms of risk of falling and necessary precautions must be taken.

Comparison of balance and gait in visually or hearing impaired children.

The study was planned to evaluate the effect of loss of hearing and vision on balance and gait in 60 children, 20 of whom had hearing loss (M age = 9.3 yr., SD = 0.9), 20 who were visually impaired (M age = 12.2 yr., SD = 2.5), and 20 controls with no disability (M age = 9.4 yr., SD = 0.6). Standing Balance subtests of the Southern California Sensory Integration Tests were used. Gait analysis was conducted on a powdered surface. When the gait analysis results of the three groups of children were compared, statistically significant differences were noted. Scores for the hearing impaired group were more like those of the control group than those of the visually impaired group. Results show that children with visual impairment had more problems with balance and gait than controls.

[The effect of group exercise on postmenopausal osteoporosis and osteopenia]. / Menopoz sonrasi osteoporoz ve osteopenide grup egzersizlerinin etkinligi.

OBJECTIVES: We investigated the effects of group exercise on bone mineral density (BMD), pain, and quality of life in postmenopausal women with osteoporosis and osteopenia. METHODS: The study included 16 osteoporotic (mean age 55.2 years) and 17 osteopenic (mean age 55.4 years) postmenopausal women whose diagnoses were made by dual energy X-ray absorptiometry (DEXA) showing T-scores of less than -2.5 and in a range of -1 to -2.5, respectively. Subjects having orthopedic, neurological, respiratory, vascular, metabolic, or mental problems were excluded. Each group received the same group exercise program for one hour three times a week for 21 weeks, supervised by a physiotherapist, and including breathing, warm-up, stretching, strengthening, balance, stabilization, and cooling exercises. All participants were evaluated before and after the exercise program by a visual analog scale for pain severity, by DEXA for BMD, and by QUALEFFO-41 (Quality of Life Questionnaire of the European Foundation for Osteoporosis) for quality of life. RESULTS: The two groups were similar with respect to age, height, and body mass index (p>0.05), but osteopenic women had a higher body weight (p<0.05). After the exercise program, both groups exhibited significant improvements in T-score, pain score, BMD, and all parameters of the QUALEFFO-41 (p<0.05). The mean T-scores before and after exercise were -2.7 + or - 0.2 and -2.4 + or - 0.5 in osteoporotic women, and -1.8 + or - 0.5 and -1.4 + or - 0.5 in osteopenic women, respectively. Following exercise, 43.8% of osteoporotic women had a T-score showing osteopenia, and 23.5% of osteopenic women had a T-score falling within the normal range. The two groups did not differ significantly with respect to the differences between the mean improvements obtained after the exercise program (p>0.05). CONCLUSION: This pilot study demonstrates the effectiveness of physiotherapist-supervised group exercise programs in decreasing pain and increasing BMD and quality of life of both osteoporotic and osteopenic women.

[Is there any difference in joint position sense among different knee angles?]. / Dizin farkli açilarinda eklem pozisyon hissi farkli midir?

OBJECTIVES: The purpose of this study was to analyse the knee joint position sense in different knee angles and to compare the results. PATIENTS AND METHODS: Forty healthy volunteers (20 females, 20 males; mean age 21.1 +/- 0.7; range 19 to 23 years) participated this study. The joint position sense was analyzed at 15, 30, 60 and 90 degrees of knee flexion using the motion analysis system designed by us. RESULTS: The highest error was observed at 60 degrees of knee flexion. Statistically significant differences were found between 15-30, 15-60, 30-90 and 60-90 degrees of knee flexion. No significant difference was observed between 15-90 and 30-60 degrees of knee flexion. CONCLUSION: It has been demonstrated that the measurements of knee joint position sense differ in different positions.

Conservative treatment of scapular neck fracture: the effect of stability and glenopolar angle on clinical outcome.

The aim of this study was to determine the effect of stability and glenopolar angle on the clinical outcome of conservatively treated scapular neck fractures. Eighteen patients with scapular neck fractures were treated with conservative treatment. Twelve of the 18 patients had surgical neck fractures, whilst six of them had anatomical neck fractures. Anteroposterior radiographs and computerised tomography were performed for each patient. Glenopolar angle was measured through anteroposterior radiographs in the scapular plane. After 3-5 weeks of immobilisation, a rehabilitation programme was started, throughout which all the patients were treated in a 3-phase rehabilitation programme. The mean follow-up was 25 months, and the Constant score was 78.83+/-8.12 point (range: 68-94 points). Patient gender and the type of scapular neck fractures had no effect on functionality or clinical outcome (p>0.05), whilst associated injuries significantly affected the clinical outcome (p<0.05). There was a positive correlation between the Constant score and glenopolar angle (r=0.891, p<0.05) and between the age and glenopolar angle (r=0.472, p<0.05).

Morphological characteristics and performance variables of women soccer players.

The purpose of this study was to describe certain morphological characteristics of women soccer players and to examine aspects of training and performance. Twenty-two anthropometric sites were used in measurements of somatotype and body composition; flexibility, agility, anaerobic power, leg muscle power, and dynamic pulmonary functions were used as performance variables. Measurements were made on 17 professional athletes and 17 age-matched sedentary women who acted as controls. The women soccer players showed less fat content and less lean body mass than did the sedentary women. The mean somatotype for the soccer players was 3.07-3.55-2.43 and for the nonathletes was 3.57-3.35-2.90. Anaerobic power, leg muscle power, and agility in the athletes were higher than in the nonathletes, whereas no differences were found in flexibility and pulmonary functions (p > 0.05). The women soccer players showed more significantly mesomorphic, less endomorphic, least ectomorphic components and higher performance level than did the sedentary women.

Is visual perception of hearing-impaired children different from healthy children?

OBJECTIVE: The purpose of this study was to evaluate visual perception of hearing-impaired children, and to determine their insufficiency in rehabilitation programs. METHODS: Forty children with hearing impairment aged 8-10 years were evaluated, and were compared with age matched 40 healthy children. Children having 71 dB and over sensorineural auditory impairment in both ears were included in this study. Figure-ground perception, position in space, and design copying tests were used to evaluate the visual perception of the subjects (Ayres Southern California Sensorial Integration tests). RESULTS: The mean hearing impairment level was 95.5 +/- 13.86 dB for the right ear, and 92.25 +/- 14.3 dB for the left. There were no significant differences by mean of age, height, and body weight between the groups (P > 0.05). All of the test scores of the control group were significantly higher than those of hearing-impaired children (P < 0.05). However there was no significant difference in the completion time of the design copying test between the groups (P > 0.05). CONCLUSIONS: Motivation insufficiency and learning difficulty may be developed in hearing-impaired children depending on the communication problems. The result of this study may bring light into literature about the development of new assessment techniques, and proper rehabilitation programmes for hearing-impaired children or adults in different age groups.