Intraobserver and Interobserver Reliability of Pelvic Obliquity Measurement Methods in Patients With Idiopathic Scoliosis.

BACKGROUND: Despite the importance of the assessment of pelvic obliquity, especially in the planning of surgery, there is no consensus on the pelvic obliquity measurements. The purpose of this study is to assess the intraobserver and interobserver reliability of 4 different pelvic obliquity measuring methods in patients with idiopathic scoliosis (IS): the Osebold, O'Brien, Maloney, and Allen&Ferguson methods. METHODS: A retrospective cohort of 85 posteroanterior full-spine radiographs in the standing position of patients with IS involving the pelvic obliquity was evaluated by a team of 3 raters. The same researcher recorded the curve magnitude, apical vertebral rotation, Risser grade, curve pattern, and femoral head height difference. The pelvic obliquity angle was measured using the Osebold, O'Brien, Maloney, and Allen&Ferguson methods. The same graders were asked to regrade the same radiographs after at least 1 month. RESULTS: The Osebold method showed the highest interobserver reliability with an ICC of 0.994 and 0.983. The Allen&Ferguson method had the lowest reliability with an ICC of 0.911 and 0.934, but all of the methods were considered having excellent reliability. The Osebold method also showed the highest intraobserver reliability, ranging from 0.909 to 0.997. The Allen&Ferguson method had the lowest intraobserver reliability, with a range of 0.741 to 0.960. Also, all observers preferred the Osebold Method. The observers reported that the Allen&Ferguson method was considered the most time-consuming method, while the least time-consuming method was specified as the Osebold method. CONCLUSIONS: To the best of our knowledge, this study is the first to evaluate the intraobserver and interobserver reliability of pelvic obliquity among common measurement methods in patients with idiopathic scoliosis. All methods were evaluated as having excellent to good reliability in this study, but the Osebold method is the most reliable method of measuring pelvic obliquity on a frontal view radiograph in idiopathic scoliosis. The Osebold method is easier to use as it requires only the iliac crests to be visualized. LEVEL OF EVIDENCE: Level III-Retrospective cohort study.

The Influence of Bilateral and Unilateral Flat Foot on Coronal Spinopelvic Alignment in Asymptomatic Young Healthy Males.

BACKGROUND: This cross-sectional retrospective study aimed to present the influence of unilateral and bilateral flatfoot on coronal spinopelvic alignment in asymptomatic young healthy males. METHODS: It was carried out by examining the medical reports of individuals who apply to the National Health Board to work in positions requiring physical fitness between January 2018 and January 2019. Plain radiographies of the feet, pelvis, and spine were analyzed. Calcaneal pitch angle (CPA) for flatfoot, pelvic obliquity (PO), and Cobb angle (CA) for spinal asymmetry was measured. After all analyzes were completed, participants divided into 2 groups as unilateral (UniFF) or bilateral (BiFF) flatfoot, depending on the CPA measurements and compared. RESULTS: There was no statistically significant difference in age (p= .609). The UniFF group showed higher values in terms of BMI with a statistically significant difference (p= .01). The curve patterns identified as single thoracal, lumbal and double. Post hoc analyses suggests that males without spinal asymmetry were more likely to have unilateral flatfoot (p< .008). There were statistically significant differences between groups in PO and CA (p< .05). The effect size was found small to medium effect for PO and medium to large for CA. CONCLUSIONS: In conclusion, young males with bilaterally increased foot pronation demonstrate more increased pelvic obliquity and spinal curvature.

Short foot exercises have additional effects on knee pain, foot biomechanics, and lower extremity muscle strength in patients with patellofemoral pain.

BACKGROUND: Patellofemoral pain (PFP) is a common knee problem. The foot posture in a relaxed stance is reported as a distal factor of PFP. However, the effects of short foot exercise (SFE) on the knee and functional factors have not yet been investigated in patients with PFP. OBJECTIVE: This study aimed to investigate the additional effects of SFE on knee pain, foot biomechanics, and lower extremity muscle strength in patients with PFP following a standard exercise program. METHODS: Thirty patients with a 'weak and pronated' foot subgroup of PFP were randomized into a control group (ConG, n= 15) and a short foot exercise group (SFEG, n= 15) with concealed allocation and blinded to the group assignment. The program of ConG consisted of hip and knee strengthening and stretching exercises. SFEG program consisted of additional SFE. Both groups performed the supervised training protocol two times per week for 6 weeks. Assessment measures were pain visual analog scale (pVAS), Kujala Patellofemoral Score (KPS), navicular drop test (NDT), rearfoot angle (RA), foot posture index (FPI), and strength tests of the lower extremity muscles. RESULTS: Both groups displayed decreases in pVAS scores, but it was only significant in favor of SFEG. NDT, RA, and FPI scores decreased in SFEG whereas they increased in ConG. There was a significant group-by-time interaction effect in hip extensor strength and between-group difference was found to be significantly in favor of SFEG. CONCLUSIONS: An intervention program consisting of additional SFE had positive effects on knee pain, navicular position, and rearfoot posture. An increase in the strength of the hip extensors may also be associated with improved stabilization by SFE.

The effects of Clinical Pilates exercises on patients with shoulder pain: A randomised clinical trial.

AIM: The purpose of this study was to determine the effect of Clinical Pilates exercises on patients with shoulder pain. MATERIAL AND METHODS: Thirty-three patients, experiencing shoulder pain continuously for at least four weeks were selected as study subjects. The patients were randomly divided into two groups, namely Clinical Pilates exercise (n = 17) group and conventional exercise (n = 16) group. The patients were treated for five days a week, the total treatment being carried out for 10 days. The assessment of pain and disability amongst the patients were done at the baseline and at the end of the treatment sessions, using Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI). RESULTS: The clinical Pilates exercise group showed a significant improvement in all scores used for assessment (p < 0.05), while the conventional exercise group demonstrated a significant improvement only in the SPADI total score (p < 0.05). A comparison of scores for the VAS, SPADI-Pain and SPADI-Total between the two groups, revealed a significant improvement in the Clinical Pilates exercise group (p < 0.05). CONCLUSION: It was demonstrated by the study that Clinical Pilates exercise is an efficient technique for patients experiencing shoulder pain, as it helps reduce pain and disability among them.

Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis.

OBJECTIVE: The purpose of this study is to investigate the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis (AS). METHODS: The BATH Indexes, Dougados Functional Index (DFI), Health Assessment Questionnaire in Spondyloarthopathies (HAQ-S), Ankylosing Spondylitis Quality of Life (ASQoL) and Beck Depression Inventory (BDI) were used to evaluate twenty-four female AS patients. ESR, CRP, TNF-α and IL-6 were also analyzed. All patients were assessed at baseline and with 3 weeks intervals till 12 week. A multidimensional exercise program was applied for three times a week. RESULTS: There were significant differences in Bath Ankylosing Spondylitis Global Index (BAS-G) and Disease Activity Index (BASDAI), HAQ-S, ASQoL and BDI scores (p < 0.05). The level of the ESR, CRP and IL-6 fluctuated slightly. There was only significant difference at 3 and 12 weeks as compared to baseline levels in TNF-α values (p = 0.048, p < 0.001). CONCLUSION: We concluded that multidimensional exercise program should be taken into consideration for AS patients due to its positive effects on symptoms and antiinflammatory effects.