The effect of progressive muscle relaxation technique and myofascial release technique on premenstrual symptoms, blood circulation, and quality of life in women with premenstrual syndrome: A single-blind randomized controlled study.

BACKGROUND: Premenstrual syndrome (PMS) is a common condition in women of reproductive age. It is characterized by a range of behavioral, physical, and psychological symptoms. The aim of this study is to investigate the effects of progressive relaxation and myofascial release technique (MRT) on premenstrual symptoms, blood flow rate, pain, sleep quality and quality of life, in women with PMS. METHOD: The study will conduct as a single-blind randomized controlled trial. Study registered at the ClinicalTrial.gov Protocol ID: NCT05836454. The volunteers will be randomized using allocation software to be divided into 3 groups: the progressive muscle relaxation group, the MRT group, and the control group. Assessments will be conducted by another physical therapist who is blinded to the groups. The assessments will include the Premenstrual Syndrome Severity Score, Blood Flow Measurements, Short Form McGill Pain Questionnaire, the Pittsburgh Sleep Quality Index and Short Form-36 Health Survey. DISCUSSION: Since both methods provide relaxation, improve symptoms and quality of life, they have not been compared to each other in the literature. This prompt to us to plan this study.

Effects of perceptive rehabilitation and mobilization methods on symptoms and disability in patients with fibromyalgia: A preliminary randomized control trial.

BACKGROUND: Currently, there is no definitive cure for fibromyalgia. Instead, treatments focus of reducing symptoms and disability. AIMS: This randomized controlled study aimed to evaluate the effectiveness of perceptive rehabilitation and soft tissue and joint mobilization on the severity of symptoms and disability in fibromyalgia compared with a control group. METHODS: A total of 55 fibromyalgia patients were randomized into three groups: perceptive rehabilitation, mobilization, and control. The impact of fibromyalgia was evaluated using the Revised Fibromyalgia Impact Questionnaire (FIQR; primary outcome). Pain intensity, fatigue severity, depression, and sleep quality were secondary outcome measures. Data were collected at baseline (T0), the end of treatment (8 weeks; T1), and the end of 3 months (T2). RESULTS: Statistically significant differences were found in between-groups comparisons at T1 for primary and secondary outcome measurements (p < .05), except for sleep quality. Both the perceptive rehabilitation and mobilization groups had statistically significant differences at T1 over the control group (p < .05). Between-group pairwise comparisons showed statistically significant differences between the perceptive and control groups for all outcome measures at T1 (p < .05). Similarly, statistically significant differences existed between the mobilization and control groups for all outcome measures at T1 (p < .05), except the FIQR overall impact scores. All other variables except depression were statistically similar between groups at T2. CONCLUSION: This study shows that perceptive rehabilitation and mobilization therapy are similarly effective in improving fibromyalgia symptoms and disability, but the effects disappear within 3 months. Further research is needed to understand how the improvements could be maintained longer. TRIAL REGISTRATION: Clinical Trial Registration number, ClinicalTrials.gov Identifier: NCT03705910.

Effects of Cognitive Orientation to Daily Occupational Performance and Conductive Education Treatment Approaches on Fine Motor Skills, Activity and Participation Limitations in Children with Down Syndrome: A Randomised Controlled Trial.

This study aiming to compare the effectiveness of Cognitive Orientation to Daily Occupational Performance (CO-OP) and Conductive Education (CE) approaches on motor skills, activity limitation and participation restrictions in children with Down Syndrome (DS). Twelwe children were randomly assigned into two groups. Twelve-week CO-OP or CE intervention (period-1) followed by a 12-week washout period. Same interventions were crossed over for another 12 weeks (period-2). The Performance Quality Rating Scale (PQRS), Canadian Occupational Performance Measure (COPM) and the Bruininks Oseretsky Test of Motor Proficiency Second Edition-Brief Form (BOT2-BF) were used for outcome measurements. CO-OP was effective in the improvement of task-specific activity performance, while both approaches have similar effects on the improvement of perceived performance, satisfaction, and motor skills performance.

Effects of two different stretching techniques on proprioception and hamstring flexibility: a pilot study.

Aim: This study aimed to compare the immediate and long-term effect of proprioceptive neuromuscular facilitation (PNF) contract-relax-antagonist-contract (CRAC) exercises versus static stretching on proprioception and flexibility in males with hamstring shortness. Patients & methods: Knee extension angle test was used to measure flexibility and isokinetic dynamometer to evaluate proprioception. Assessments were evaluated at baseline, after first exercise and eighth week. The hamstring stretching was applied 3 days a week for 8 weeks. Results: Flexibility and position sense were similar in the immediate and long term (p > 0.05). However, the motion sense increased significantly in long term within the PNF CRAC group (p = 0.02). Conclusion: Both stretching exercises are effective for improving flexibility. Moreover, PNF CRAC improved motion sense more than static stretching in the long term. Clinical trial registration number: NCT04026646.

Effects of clinical Pilates exercises on cardiovascular endurance and psychosomatic parameters on primary caregivers of special needs children: A randomized controlled trial.

OBJECTIVE: Our objective was to investigate the effects of clinical Pilates exercises (CPE), applied to the primary caregivers of special needs children, on cardiovascular endurance (CVE) and psychosomatic parameters in comparison to a control group. METHODS: Fifty-five primary caregivers of special needs children, divided into two groups as the CPE and control groups, were included in the study. The six-minute walk test, the Fatigue Severity Scale, the Coping Orientation for Problems Experienced (COPE) Inventory, the Beck Depression Inventory and the State-Trait Anxiety Inventory were used to measure CVE, fatigue severity, attitudes toward coping with problems, depression levels and anxiety levels, respectively. RESULTS: Statistically significant differences between the groups in favor of the CPE group were found concerning the denial parameter of COPE, fatigue (which was the primary outcome), depression and anxiety (all p values < 0.05). Statistically significant intragroup comparison differences were only detected in the CPE group in the fatigue, depression, anxiety and COPE (use of instrumental and emotional social support and focus on and venting of emotions) questionnaire results (all p values < 0.05). CONCLUSIONS: CPE are an applicable and effective method for the primary caregivers of special needs children in improving psychosomatic parameters, albeit not effective for CVE. It is recommended to investigate the long-term effects of clinical Pilates exercises on a similar group.

Effectiveness of clinical Pilates and home exercises in sagittal cervical disorientation: randomized controlled study.

Aim: To compare effects of clinical Pilates and home exercises on postural disorders, strength and endurance of deep cervical flexors (DCF), cervical range of motion (CROM), pain intensity and functional disability in sagittal cervical disorientation. Patients & methods: Fourty six patients were included and divided into two groups. Clinical Pilates group performed stabilization based exercise and home exercise group performed conventional exercises. Results: Craniovertebral, head tilt, cervicothoracic angles and strength and endurance of DCF muscles had improvement in favor of clinical Pilates group (p < 0.05). There was no difference between groups in terms of right-left acromial distance, pain intensity, functional disability and CROM parameters (p > 0.05). Conclusion: Clinical Pilates exercises have been found to provide clinically significant improvements in craniovertebral, head tilt, cervicothoracic angles and strength and endurance of DCF muscles. However, in the increase of CROM, decreasing pain severity and functional impairment parameters there was no superiority of both exercise training. Clinical trial registration number: NCT03352921 (Clinicaltrials.gov).

Gait oxygen consumption in adolescent idiopathic scoliosis and the effect of brace use.

BACKGROUND: Despite studies showing that gait is affected in adolescent idiopathic scoliosis (AIS), it remains unclear whether gait oxygen consumption is altered. RESEARCH QUESTION: The aims of the present study were to compare energy consumption during gait between subjects with AIS and healthy controls, and to examine the effect of brace use on gait energy expenditure. METHODS: This prospectively designed study included 15 AIS and 15 healthy girls, whose ages ranged from 10 to 16 years old and Cobb angles from 20 and 45°. At the end of the first month of brace use for the first time in individuals with AIS, oxygen consumption was measured with and without brace use on a treadmill at a gait speed of 4 km.h-1 using a metabolic analyzer. RESULTS: There was no statistically significant difference in gross and net gait oxygen consumption measurements between AIS and healthy individuals or between individuals with AIS with or without brace use (p >  0.05). SIGNIFICANCE: After one month of brace treatment, AIS is not associated with an additional metabolic load with or without the brace during gait when compared to healthy subjects.

Lower extremity proprioceptive sensation in patients with early stage knee osteoarthritis: A comparative study.

BACKGROUND: Knee OA causes pain and proprioceptive impairment. The body acts as a closed kinetic chain, and deformation on the knee cannot only affect the knee joint but also can affect the other joints. OBJECTIVE: To assess the proprioception of lower extremity in early stage knee osteoarthritis compared with without knee osteoarthritis individuals. METHODS: The study sample consisted of 26 adults with early stage knee osteoarthritis and 26 subjects without knee osteoarthritis individuals. Western Ontario and McMaster Universities Osteoarthritis Index was used for clinical disease severity. Visual Analogue Scale was used for pain severity. Proprioception (position and motion sense) was measured by isokinetic dynamometer. RESULTS: Western Ontario and McMaster Universities Osteoarthritis Index total score was 10.9 ±â€¯5. Visual Analogue Scale scores during activity were found to be significantly higher than the scores at rest and night for both sides. Hip flexion and internal rotation joint position sense were significantly different between two groups (all p's < 0.05). Hip abduction, knee flexion, ankle and subtalar position sense, as well as hip and knee motion sense were similar between groups (all p's > 0.05). Ankle dorsiflexion and eversion motion sense were significantly different between two groups (all p's < 0.05). CONCLUSIONS: This study demonstrated that the hip flexion and internal rotation position sense and ankle/subtalar joints motion sense may be affected on early stage of knee osteoarthritis. Investigation of the mechanism of proprioception for joints and also focusing on the longitudinal relationship between proprioception, knee OA disease and symptoms is recommended for future studies.

A randomized trial of trigger point dry needling versus sham needling for chronic tension-type headache.

BACKGROUND: In this randomized, double-blind, parallel-group trial, we aimed to explore the effectiveness of trigger point dry needling in patients with chronic tension-type headache in reducing headache frequency, intensity and duration, and improvement of health-related quality of life. METHODS: The 168 patients in 2 neurology clinics with chronic tension-type headache. The participants were randomly assigned to one of two treatment groups for dry needling or sham dry needling, delivered in 3 sessions a week for 2 weeks. The 160 patients fulfilled the study requirements. The dry needling was applied in active trigger points located in the musculature of the head and the neck. The patients received dry needling using sterile stainless-steel acupuncture needles of 0.25 × 40 mm and 0.25 × 25 mm dimensions. The sham dry needling procedure was applied into the adipose tissue located at any area where an active trigger point was absent. The primary outcome measurement was the headache intensity. Secondary outcomes were frequency and duration of headache, and quality of life, assessed by the Short Form-36. All outcomes were measured at baseline, at the end of 2-week, and 1-month follow-up period. RESULTS: In the dry needling group, intensity, frequency and duration of headache, and the scores of Short Form-36 subscales were significantly improved after treatment (P < .05). In the dry needling group, all the effect sizes for headache variables were large. CONCLUSIONS: The results of this clinical trial suggest that trigger point dry needling in patients with chronic tension-type headache is effective and safe in reducing headache intensity, frequency and duration, and increasing health-related quality of life. TRIAL REGISTRATION: Clinical Trials NCT03500861.

Effectiveness of the muscle energy technique on respiratory muscle strength and endurance in patients with fibromyalgia.

BACKGROUND: Fibromyalgia is characterized by a chronic and common musculoskeletal system pain that affects cervical mobility and inspiration. This may cause changes in thoracic mechanics. OBJECTIVE: To investigate the effectiveness of the muscle energy technique applied to cervical accessory respiratory muscles on respiratory muscle strength and endurance in patients with fibromyalgia. METHODS: The participants were 37 women diagnosed with fibromyalgia. They were assessed for their respiratory muscle strength, respiratory muscle endurance, pain and fatigue severity, flexibility and disability. The muscle energy technique was applied to the scalene, upper trapezius, and sternocleidomastoid muscles after a superficial heat application. The treatment was continued for 3 weeks with 3 sessions per week. RESULTS: After the treatment, expiratory muscle strength and respiratory muscle endurance increased significantly. Severity of pain and fatigue and disability were reduced, cervical flexibility increased significantly (p< 0.05). The effect size was r⩾ 0.4 for all the variables. CONCLUSION: The muscle energy technique applied to cervical accessory respiratory muscles in patients with fibromyalgia who had complaints in the neck and back region positively increased respiratory muscle strength and endurance, cervical flexibility, and decrease pain intensity, fatigue and disability. It is recommended that subsequent randomized studies are carried out with a placebo control group.

Effectiveness of dry needling versus a classical physiotherapy program in patients with chronic low-back pain: a single-blind, randomized, controlled trial.

[Purpose] We compared the effectiveness of dry needling with a classical physiotherapy program in patients with chronic low-back pain caused by lumbar disc hernia (LHNP). [Subjects and Methods] In total, 34 subjects were allocated randomly to the study (n=18) and control groups (n=16). In the study group, dry needling was applied using acupuncture needles. The control group performed a home exercise program in addition to hot pack, TENS, and ultrasound applications. Pain was assessed with the short form of the McGill Pain Questionnaire. The number of trigger points and their pressure sensitivity were evaluated with a physical examination (palpation). The Beck Depression Inventory was used to assess depression. The Tampa Kinesiophobia Scale was used to assess fear of movement. [Results] In the study group, the calculated Cohen's effect sizes were bigger than those in the control group in terms of pain, trigger point-related variables, and fear of movement. Effect sizes for reducing depressive symptoms were similar in both groups. [Conclusion] These results suggest that dry needling can be an effective treatment for reducing pain, number of trigger points, sensitivity, and kinesiophobia in patients with chronic low-back pain caused by lumbar disc hernia.

Is balance exercise training as effective as aerobic exercise training in fibromyalgia syndrome?

The aim was to compare the effect of aerobic and balance exercises on pain severity, myalgic score, quality of life, exercise capacity and balance in fibromyalgia syndrome (FMS). A total of 33 females diagnosed with FMS by the American College of Rheumatology criteria were recruited in this randomised controlled study and allocated to aerobic exercise (AE) or balance exercise (BE) groups. Exercises were performed three times a week, for 6 weeks on a treadmill or with a Tetrax interactive balance system (TIBS). Outcome measures were characterised by myalgic score, visual analogue scale, Fibromyalgia Impact Questionnaire (FIQ), exercise testing, Timed Up-Go (TUG) and TIBS measurements. Comparisons from baseline to 6 weeks were evaluated using Wilcoxon test. Mann-Whitney U test was used to compare differences between groups. Effect sizes were also calculated. Improvements in pain, myalgic score and FIQ were found in both groups (p < 0.05). While comparing groups, myalgic score was significant (p = 0.02, d = -1.77), the value was higher in AE. Exercise duration, Borg scale, resting blood pressures (RBP) and maximal heart rate were significant in AE. In BE, Borg scale, exercise duration was significant (p < 0.05). While comparing groups, diastolic RBP (p = 0.04, d = -0.92), exercise duration (p = 0.00, d = -1.64) were significant, with higher values in AE. TUG significantly changed in groups (p < 0.05, d ≥ -1.22). Stability scores, eyes open while standing on elastic pads (p = 0.00, d = -0.98) and head back (p = 0.03, d = -0.74), were significant, with higher values in BE. This study showed that BE provided some improvements in FMS, but AE training led to greater gains. BE training should be included in comprehensive programs.

The Upper Extremity Functional Index (UEFI): cross-cultural adaptation, reliability, and validity of the Turkish version.

BACKGROUND: Turkish version of the Upper Extremity Functional Index (UEFI) may help to assess shoulder function in patients with shoulder impingement syndrome (SAIS). OBJECTIVE: To translate and cross-culturally adapted UEFI into Turkish and to assess its acceptability, reliability, validity in patients with SAIS. METHODS: This study conducted with 93 SAIS participants. UEFI, the short version of the Disability of the Arm, Shoulder and Hand scale (Quick DASH), the Shoulder Pain and Disability Index, and the Short Form-36 Health Survey (SF-36) were administered. Acceptability was assessed in terms of refusal rate, rates of missing responses, and administration time. Test-retest reliability was assessed with intra class correlation coefficient (ICC), internal consistency was assessed with Cronbach's alpha coefficient. Validity was assessed by floor and ceiling effects, skew of distributions and Pearson's correlation coefficients. RESULTS: Cronbach's alpha coefficients for the UEFI at Time 1 and Time 2 were as follows: α = 0.89 and α = 0.89. Average measure ICC was 0.80. The UEFI score demonstrated strong negative correlations with SPADI total score and Quick DASH score. There was not a significant correlation between the UEFI and mental health subscale score derived from SF-36. CONCLUSIONS: The Turkish version of UEFI is acceptable, valid, and reliable.

Nutritional status of children with cerebral palsy in Turkey.

PURPOSE: The aim of this study was to assess the nutritional status, and provide information regarding anthropometric measurements of cerebral-palsied children living in the city of Ankara, Turkey. METHOD: A total of 447 children with cerebral palsy (CP) were participated in this cross-sectional study. Participants were assessed for functional motor impairment by the gross motor function classification system (GMFCS). Assesment of nutritional status was based on the triceps skinfold thickness (TSF), arm fat area (AFA) estimates derived from TSF and mid-upper arm circumference measurements. TSF and AFA Z-scores were computed using reference data. RESULTS: Cerebral-palsied children had lower TSF and AFA Z-scores compared to reference data from healthy children. The prevalence of underweight and overweight among boys was 8.3 and 9.5%, respectively, whereas it was 19.0 and 0.5% for girls. Underweight was more prevalent in the low functioning children than in moderate functioning children. CONCLUSIONS: The findings of this study indicate that cerebral-palsied children face nutritional challenges. Underweight is more prevalent than overweight among cerebral-palsied children. To optimize the outcomes of rehabilitation and prevention efforts, an understanding of the heterogeneity of nutritional status among children with CP is required.

Effects of two different quadriceps strengthening exercise approaches on cardiovascular fitness in healthy female subjects: a single blind randomized study.

OBJECTIVE: There are limited number of documents showing the relations between cardiovascular fitness and muscle strength. This study aimed to determine the effects of two different quadriceps strengthening exercise approaches on cardiovascular fitness in healthy female subjects. METHODS: Forty female university students participated in this study on a voluntary basis. The participants were randomly assigned to do either isokinetic exercise (IE) or progressive resistive exercise (PRE) in two different groups. Both training schemes were performed three times a week for a period of two weeks. The subjects were given a maximum symptom limited exercise test on a treadmill before and after (each) training period. RESULTS: Total exercise duration increased and Borg scale level decreased significantly after training in the two groups (p < 0.05). Maximal systolic blood pressure, recovery heart rate, and recovery diastolic blood pressure decreased significantly in the IE Group (p < 0.05). Resting and recovery systolic blood pressure decreased significantly in the PRE Group (p < 0.05). Compared to PRE group, improvement for Borg Scale level, recovery heart rate and recovery diastolic blood pressure were more obvious in IE Group (p < 0.05). CONCLUSIONS: This study demonstrated that both quadriceps strengthening methods have displayed improvements in cardiovascular fitness. Further research with larger sample groups may need to be carried out.

Pain prevalence and its impact on the quality of life in a sample of Turkish children with cerebral palsy.

PURPOSE: To investigate the measurement properties of the Pain Evaluation Scale (PES), to estimate the prevalence of pain based on the PES data, and to evaluate the impact of pain on the quality of life (QoL) in a sample of Turkish children with CP. METHOD: A total of 346 children with CP participated in a cross-sectional study. The Gross Motor Function Classification System (GMFCS), PES, Wong-Baker FACES Pain Rating Scale, and the Child Health Questionnaire (CHQ-PF50) were used as the assessment tools. RESULTS: The Cronbach's alpha coefficient was 0.90 for the PES. The PES score was moderately correlated with the bodily pain subscale score, and very weekly with the mental health subscale score of the CHQ-PF50. For the threshold value of 2 on the PES, sensitivity and specificity were 91.1% and 100%, respectively. Overall, apparent prevalence and true prevalence of pain were 69.1% and 75.9%, respectively. There was a significant negative effect of pain on the QoL of subjects. The pain also negatively affected parent's personal time and caused limitations in family activities. CONCLUSIONS: The PES is valid and reliable pain assessment tool for children with CP. Pain is a frequent health problem and has severe consequences both on the cerebral palsied children's QoL and their family.

The validity and reliability of the Turkish version of the MacNew Heart Disease Questionnaire in patients with angina.

AIMS AND OBJECTIVES: Health-related quality of life (HRQL) is an important patient-reported outcome when identifying the effects of the angina and evaluating the efficacy of treatment. The aim of this study was to determine the reliability and validity of the Turkish version of the MacNew Heart Disease HRQL Questionnaire (MacNew) in patients with angina. METHOD: The Short Form SF-36, the MacNew, and the Hospital Anxiety and Depression Scale were completed by the 125 patients in first 2-3 days after admission to the coronary care unit. Internal consistency reliability (Cronbach's alpha) and reproducibility (intraclass correlation coefficients, ICC) of the MacNew were assessed, and test-retest reproducibility was evaluated over a 2-month period in 25 clinically stable patients. RESULTS: The original three-factor structure for the Turkish MacNew was confirmed, with construct validity only partially confirmed; reliability statistics show that Cronbach's alpha exceeded 0.80 and the ICC exceeded 0.60 for all MacNew scales. Discriminative validity of the MacNew was confirmed. CONCLUSION: The MacNew appears to be reliable and valid in Turkish patients with angina.

Quality of life in chronic musculoskeletal pain.

This chapter reviews the impact of chronic musculoskeletal pain on patients' health-related quality of life. In addition to the physical health consequences, chronic musculoskeletal pain can have a profound negative impact on an individual's emotional and social well-being. Although efforts in the health sector are obviously of crucial importance in the management of chronic musculoskeletal pain, a high level of patient and societal involvement is key to reducing the burden of this condition. Patients should work in partnership with health-care professionals, actively participating in their care. Family members should encourage their loved ones to be as independent as possible. The employer of a person with chronic musculoskeletal pain has a vital role in returning him or her to work as soon as possible. Removing all barriers to the use of preventive and therapeutic services will help us to reduce the burden of musculoskeletal pain conditions on both patients and society.

Perceived barriers to physical activity in university students.

Many studies which were published in other countries identified certain benefits and barriers to physical activity among young people. But there is no data about the subject pertaining to Turkish adolescents. This study tries to rectify this with a study of Turkish university students. Undergraduate university students (n = 303) were recruited to the study. Current exercise habits and perceived barriers to physical activity were assessed in the sample. Using a Likert Type scale, participants responded an instrument with 12 items representing barriers to physical activity. Mean scores were computed. External barriers were more important than internal barriers. "Lack of time due to busy lesson schedule", "My parents give academic success priority over exercise. "and "lack of time due to responsibilities related to the family and social environment "were most cited items for physical activity barriers. There is a need for future research, which will be carried out with larger sample groups to develop national standardized instrument. It will be helpful for accurately identify perceived barriers and then recommend changes to enhance physical activity among young people. Key PointsThe purpose of this study was to analyze perceived barriers to physical activity in the university students.The results showed that not having enough time was the most important barrier for not participating in physical activity among our samples.This study with relatively small sample must be considered as pilot study for related studies in the future.

Predictors of job satisfaction among physiotherapists in Turkey.

The aim of this study was to investigate the level of job satisfaction among physiotherapists, and to identify the best predictors of job satisfaction. A self-administrated questionnaire survey was conducted in September 2003. Data were collected from 198 physiotherapists in 13 health care settings (five university hospitals, seven government hospitals, and one municipality hospital) located in Ankara, Turkey. Respondents were asked to complete a 31-item job satisfaction questionnaire. The response rate was 79.8%. The percentage of satisfied physiotherapists was 45.5%. There were no significant satisfaction differences between genders or between age groups. There was a positive relationship between the global satisfaction and domain scores (all ps<0.01). Logistic regression analysis showed that the most important predictors of job satisfaction were: (1) Leadership (OR=1.03, 95% CI 1.01 to 1.06), (2) Interpersonal relationships (OR=1.03, 95% CI 1.00 to 1.05), (3) Advancement (OR=1.02, 95% CI 1.00 to 1.05), and (4) Salary (OR=1.02, 95% CI 1.00 to 1.04). Specific job satisfaction dimensions indicate that highest dissatisfaction levels occur in the area of salary and advancement. Areas of dissatisfaction are signals for change.