The efficacy of taping on elbow proprioception in healthy individuals: A single-blinded randomized placebo-controlled study.

BACKGROUND: Taping stimulates the mechanoreceptors, increases sensory information to the central nervous system, and improves sensorimotor synchronization, resulting in improved motor control. However, the efficacy of taping on elbow proprioception is not clear. PURPOSE: This study aimed to evaluate the immediate effects of taping on elbow proprioception in healthy individuals. STUDY DESIGN: This study was a two-arm, parallel-group, randomized, controlled, single-blinded study with a sham application. METHODS: Fifty six healthy adults were randomized 1:1 to kinesio taping (n = 27) or sham taping (n = 29). Active joint position sense error (JPSE) was used to quantify proprioception using a universal goniometer at three-time points: baseline (BS), immediately after taping (IA), and 30 minutes after taping (30MA), with the tape still in place at 70° and 110° of elbow flexion. Participants were blinded to group assignments. The Friedman analysis assessed differences between evaluations within groups, and the Mann-Whitney U test determined differences between groups. RESULTS: The study was completed with 56 participants and there were no dropouts. No skin reaction or adverse effect was observed in the participants and no test trial was excluded. The baseline scores of the groups were similar (p > 0.05). A significant difference was detected in the study group after kinesio taping at 70° (MD = -1.22; CI = (-2.33: -0.10; p < 0.005; d = 0.653) and 110° of elbow flexion (MD = -1.34; CI = 2,47: -0,21; p < 0.005; d = 0.73). This statistically significant difference was observed even at the 30MA evaluations at 70° (p < 0.05). Also, there was a statistically insignificant tendency to decrease in JPSE of both groups at both degrees following taping. CONCLUSIONS: Elbow proprioception may be enhanced by kinesio taping, and this effect could last up to 30 minutes at 70° of elbow flexion. In contrast, sham taping did not produce such an improvement. Based on the differences in JPSE, kinesio taping proved more effective and had a longer-lasting impact than the sham application. The statistically insignificant tendency to decrease in JPSE may indicate that the 30-minute application period is inadequate to create a statistically significant effect on elbow proprioception. Longer usage periods can better reveal the effects of orthoses on proprioception.

The Intrarater and Interrater Reliability and Validity of Universal Goniometer, Digital Inclinometer, and Smartphone Application Measuring Range of Motion in Patients with Total Knee Arthroplasty.

Objectives: The aim of this study was to investigate the intrarater and interrater reliability and validity of range of motion measurements obtained with a universal goniometer, digital inclinometer, and smartphone application in patients with total knee arthroplasty. Methods: Range of motion of the knee joint was measured by two examiners with a universal goniometer, digital inclinometer, and a smartphone application. Data were obtained from 51 knees of 27 patients at postoperative 6 months. Two measurements made by the first examiner were compared to assess interrater reliability, and measurements from both examiners were compared to assess intrarater reliability. Statistical analysis was performed using intraclass correlation coefficient (ICC) and Spearman's rho values. Results: With all three methods, active and passive knee flexion range of motion measurements showed high intrarater and interrater reliability (ICC = 0.749-0.949). Concurrent validity analysis also demonstrated statistically significant, moderate to strong correlation among the three methods (r = 0.775-0.941). Conclusion: The universal goniometer, digital inclinometer, and smartphone application were all found to be reliable and valid assessment tools in clinical practice for patients with total knee arthroplasty.

Investigation of the validity and reliability of the short physical performance battery in patients undergoing total knee arthroplasty.

BACKGROUND: Practical, applicable, valid, and reliable tools are needed to assess physical performance in patients with Total Knee Arthroplasty (TKA) in a variety of settings, including routine clinical assessment, research studies, and community-based programs. OBJECTIVE: The aim of this study is to evaluate the validity and reliability of the Short Physical Performance Battery (SPPB) among patients with TKA. METHODS: We included 45 patients who underwent TKA surgery (mean age 68.89 ± 9.26). The SPPB, Timed up and go (TUG) test and, Hospital for Special Surgery (HSS) Knee Score were administered to the patients. SPPB was performed twice on the same day with 1 h rest. RESULTS: The ICC(2,1) coefficient, MDC95 and SEM values were 0.97, 1.02 and 0.37 respectively. The Pearson correlation coefficient of the SPPB with the TUG and HSS was -.78, and 0.74 respectively. CONCLUSION: SPPB has excellent reliability, and strong validity in assessing physical performance in patients with TKA. SPPB can identify even minimal detectable difference in physical performance and can be reliably used to monitor patient outcomes in the postoperative period for a comprehensive assessment of TKA in many physical performance domains, including balance, walking speed, and lower extremity strength. CLINICAL TRIAL NUMBER: NCT06201637.

Immediate effects of elbow orthoses on elbow proprioception in asymptomatic individuals: A randomized sham-controlled single-blinded study.

BACKGROUND: Improving proprioception can reduce the risk of injuries, while its disruption may lead to injuries and recurrent or persistent symptoms. PURPOSE: This study aimed to evaluate the immediate effects of elbow orthoses on elbow proprioception in asymptomatic individuals. STUDY DESIGN: This was a randomized, controlled, single-blinded study with a sham application. METHODS: Sixty participants were equally distributed into three orthosis groups (counterforce, sleeve, and sham). Proprioception was assessed using active joint position sense error (JPSE) at 70° and 110° of elbow flexion at three time points: baseline (BS), immediately after (IA) wearing the orthosis, and 30 minutes after (30MA) wearing the orthosis. RESULTS: Between groups: No significant difference in JPSE was observed at 70° (p = 0.095); however, there was a significant difference at 110° (p = 0.005). Between time points: At 70°, JPSE did not exhibit a significant difference (p = 0.055), whereas a significant difference was observed at 110° (p = 0.020). Interaction of time points×groups: No significant interaction was observed either at 70° (p = 0.476) or at 110° (p = 0.346). At 70°, within the sleeve group, significant differences were identified between BS-30MA (p = 0.001) and IA-30MA (p = 0.009). At 110°, in the sleeve group, significant differences were observed between BS-30MA (p = 0.007) and IA-30MA (p = 0.007). In the counterforce group, significant differences were identified between BS-30MA time points (p = 0.001). At 70°, no difference was observed within the overall evaluation in the counterforce group (p > 0.05), whereas at 110°, a significant difference was noted (p = 0.026). At both 70° and 110°, no differences were identified within the overall evaluation in the sleeve and sham groups (p > 0.05). CONCLUSIONS: In asymptomatic individuals, sleeve orthosis improved elbow proprioception at 70°, whereas both counterforce and sleeve orthoses were effective at 110°.

Balance assessment under dual task conditions in patients with total knee arthroplasty: a test-retest reliability and concurrent validity study.

BACKGROUND: Under dual-task (DT), functional mobility and balance testing can detect balance and mobility problems in activities of daily living, especially in situations that cannot be identified under single-task conditions. OBJECTIVE: Determine the test-retest reliability and concurrent validity of the Four Square Step Test (FSST) under DT conditions for people with total knee arthroplasty (TKA). METHOD: A total of 30 patients with TKA participated in this research, and patients were tested with the FSST under DT conditions. In addition, concurrent validity of the dual-task FSST was calculated using Timed Up and Go (TUG) under the single-task condition and Hospital for Special Surgery (HSS) Knee Score. Patients performed two FSST trials on the same day under DT conditions. RESULTS: The intraclass correlation coefficients (ICC2,1) two-way random effects model, and minimal detectable changes with 95% confidence intervals (MDC95) values of the FSST under DT conditions were .97 and 3.43, respectively. The Pearson's correlation coefficient of the FSST with the TUG and HSS was .65 and -.40, respectively. CONCLUSION: The FSST has been found to be a reliable and valid clinical assessment tool for dynamic balance under DT conditions in patients with TKA. For identify balance disorders in daily life at early points, clinicians and researchers can use the FSST under DT conditions in TKA. CLINICAL TRIAL REGISTRATION NUMBER: NCT06108466.

Reliability, Concurrent Validity, and Minimal Detectable Change of the Hand-Held Dynamometry for the Assessment of Knee Muscle Strength in Patients With Revision Total Knee Arthroplasty.

OBJECTIVE: To determine the concurrent validity, reliability, and minimal detectable change (MDC) of the hand-held dynamometry (HHD) for knee strength measurement in patients with revision total knee arthroplasty (r-TKA). DESIGN: A reliability and validity analysis. SETTING: Orthopedic and physical therapy services of university hospital. PARTICIPANTS: The study included 42 patients with r-TKA (N=42). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Knee muscle strength assessments were performed by 2 physiotherapists in 3 different sessions by using HHD. Participants were instructed to exert a maximal force for lasting 5 seconds against HHD. The first examiner performed the strength testing, and after 30-minutes rest, the second examiner performed the same procedure for inter-examiner reliability. One hour after the initial testing, the first examiner reperformed the strength testing for intra-examiner reliability. The correlations of the knee extensors and knee flexors strength with 50-foot walking test and 30-second chair stand test were assessed for concurrent validity. RESULTS: The inter-examiner reliabilities of knee extensors and flexors strength measurements were 0.97 and 0.95, respectively. The SEM and the minimal detectable changes at 95% confidence level (MDC95) for knee extensors were 10.39 and 28.65 Newton-meters (Nm), and SEM and MDC95 for knee flexors were 8.70 and 23.99 Nm, respectively. The intra-examiner reliabilities of knee extensors and flexors strength measurements were 0.96. SEM and MDC95 for knee extensors were 12.00 and 33.09 Nm, and SEM and MDC95 for knee flexors were 7.78 and 21.45 Nm, respectively. The knee muscle strength showed strong significant correlations with physical performance tests (all, P<.05). CONCLUSIONS: The HHD is a reliable and valid method for assessment of static knee strength after r-TKA. The HHD can be used to quantify changes in knee strength and also assists the clinicians to determine the effect of rehabilitation programs on muscle strength following r-TKA surgery.

The effectiveness of cruciate-retaining versus posterior-stabilized designs on extensor mechanism function and knee function in patients after simultaneous bilateral total knee arthroplasty: A two-year retrospective follow-up study.

INTRODUCTION: The importance of the posterior-cruciate ligament in knee functionality is known; however, the effect of preserving the posterior-cruciate ligament in total knee arthroplasty (TKA) on extensor mechanism function and knee function is not clear. We aimed to compare extensor mechanism function and knee function between patients operated with the cruciate-retaining and posterior-stabilized designs for simultaneous bilateral TKA. HYPOTHESIS: Patients operated with the cruciate-retaining design would produce better outcomes than those operated with the posterior-stabilized design. MATERIALS AND METHODS: A total of 104 patients were divided into two groups as the cruciate-retaining (n=52) and posterior-stabilized (n=52) groups. The groups were compared for extensor mechanism function (chair-rise test) and knee function (Hospital for Special Surgery [HSS] knee score). The follow-up points were six weeks, three months, six months, one year and two years. RESULTS: No statistically significant effect on chair-rise performance of the group-by-time interaction (χ2 [5, n=104]=5.32, p=.37) or of group (χ2 [1, n=104]=1.69, p=.19). In the HSS knee score, the group-by-time interaction was statistically significant (F [5.510]=6.24, p<.001). A statistically significant difference of 7.4 points in favor of the posterior-stabilized group was found at six weeks (p=.002). No statistically significant differences were found between the groups at the other follow-up points. DISCUSSION: The cruciate-retaining and posterior-stabilized designs have similar outcomes with regard to extensor mechanism function and knee function in the long-term period in patients who underwent simultaneous bilateral TKA. In the short-term period, the posterior-stabilized design shows better knee function than the cruciate-retaining design. LEVEL OF EVIDENCE: III; a retrospective study.

Immediate Effects of Mulligan Mobilization on Elbow Proprioception in Healthy Individuals: A Randomized Placebo-Controlled Single-Blind Study.

OBJECTIVE: The aim of this study was to investigate the immediate effects of Mulligan's mobilization with movement (MWM) on elbow proprioception. METHODS: The study included 26 participants in the intervention group and 30 participants in the control group. The intervention group received MWM, while the control group received a sham application. Proprioception was assessed with joint position sense error at baseline, immediately after mobilization, and 30 minutes after mobilization with 70° and 110° of elbow flexion. The hypothesis of interest was the group × time interaction. RESULTS: At 110° of elbow flexion, group × time interaction was significant (F[2, 108] = 11.48, P = .001). In the paired comparisons, there was a statistically significant difference in favor of the control group in the first measurement (P = .003). No difference was detected in other time points (P = 1.00). At 70° of elbow flexion, there was no significant difference between the time point × group interaction (F[2, 108] = 1.37, P = .10). Therefore, no pairwise comparison was made. CONCLUSION: In this study of healthy participants, no immediate difference was found between MWM and sham application on elbow proprioception.

The test-retest reliability and minimal clinically important difference of the Dubousset Functional Test and its correlation with Rolland Morris disability questionnaire in chronic non-specific low back pain.

OBJECTIVE: This study examines the test-retest reliability, the minimal clinically important difference (MCID), and its correlation with the Rolland Morris Disability Questionnaire (RMDQ) of the Dubousset Functional Test (DFT) in evaluating the functional capacity and dynamic balance of patients with chronic non-specific low back pain (cnsLBP). METHODS: Seventy-five patients with cnsLBP aged 18 years and over were included. The Five-Repetition Sit-To-Stand Test (5R-STS), the subcomponents of the DFT (the Up and Walk Test, the Steps Test, the Down and Sitting Test, and the Dual-Tasking Test) were administered to the patients. Patients were rested for 1 h, and the DFT was applied again. Pain level was evaluated with the Visual Analogue Scale before the tests started and after the tests were completed. Self-report function assessment was made using the RMDQ. RESULTS: The test-retest reliability of the subcomponents of the DFT was excellent. The ICCs were: 0.91, 0.86, 0.89, and 0.89, respectively. The standard measurement errors of the subcomponents of the DFT were 0.32, 0.12, 0.14, and 0.25, respectively. The subcomponents of the DFT were highly correlated with the RMDQ and 5R-STS with the correlation coefficients of 0,83, 0,83, 0,79, 0,83 and 0,81, 0,75, 0,73, and 0,82, respectively (p < 0.01). The MCIDs of the subcomponents were 0,60, 0,23, 0,27, and 0,48, respectively. CONCLUSION: The DFT is reliable in evaluating patients' functional capacity and dynamic balance with cnsLBP without causing discomfort. It is simple, quick, and simultaneously assesses multiple areas contributing to spinal alignment, muscle integrity, and balance.

Non-drainage Offers Faster Proprioceptive and Functional Recovery, and More Clinical Benefits for Patients following Primary Total Knee Arthroplasty Compared to Drainage.

BACKGROUND: Although a non-drainage procedure following total knee arthroplasty (TKA) is becoming more acceptable in enhanced recovery after surgery, postoperative drainage is still commonly used in TKA surgeries. This study aimed to compare the non-drainage to the drainage during the early postoperative stage regarding proprioceptive and functional recovery, and postoperative outcomes of TKA patients. MATERIAL AND METHODS: A prospective, single-blind, randomized, controlled trial was carried out on 91 TKA patients, who were randomly allocated into the non-drainage group (NDG) or the drainage group (DG). Patients were evaluated regarding knee proprioception, functional outcomes, pain intensity, range of motion, knee circumference, and anesthetic consumption. Outcomes were assessed at the time of charge, at postoperative 7th day, and at postoperative 3rd month. RESULTS: There were no differences between groups at baseline (p > 0.05). During the inpatient period, the NDG experienced superior pain relief (p < 0.05), had a higher Hospital for Special Surgery knee score (p = 0.001), demanded lower assistance from a sitting position to a standing position (p = 0.001) and walking for 4.5 m (p = 0.034), and performed the Timed Up and Go test in a shorter duration (p = 0.016) compared to the DG. The NDG gained the actively straight leg raise earlier (p = 0.009), needed lower anesthetic consumption (p < 0.05), and showed improved proprioception (p < 0.05) compared to the DG during the inpatient period. CONCLUSIONS: Our findings support that a non-drainage procedure would be a better option to provide a faster proprioceptive and functional recovery, and beneficial results for patients following TKA. Therefore, the non-drainage procedure should be the first choice in TKA surgery rather than drainage.

The Reliability and Validity of the Lie-to-Sit-to-Stand-to-Walk Transfer (LSSWT) Test in Knee Osteoarthritis.

Background: Several neuromuscular impairments may be observed in older patients with knee osteoarthritis (OA), increasing the risk of falling, which is common during transfer activities. The Lie-to-Sit-to- Stand-to-Walk Transfer (LSSWT) test was developed to evaluate complex transfer abilities. The study aims to investigate the reliability and validity of LSSWT in patients with knee OA. Methods: Twenty-nine patients with knee OA were included in this study. The LSSWT, Timed up and go test (TUG), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were administered to the patients. Patients rested for at least an hour between the trials to avoid fatigue. Results: The LSSWT has excellent reliability and high validity in patients with knee OA. The relative (ICC coefficient) and absolute (SEM and SRD95) reliability values are 0.96 (95% CI: 0.91-0.98), 1.00, and 2,75, respectively. The Pearson correlation coefficient of the LSSWT with the TUG is 0.73 (p < 0.01), and the Spearmen correlation coefficient of the LSSWT with the WOMAC is 0.54 (p < 0.05). Conclusions: The LSSWT is highly reliable and valid in knee OA and is recommended for routine dynamic balance establishment. Having a low minimal clinically important difference shows the LSSWT's sensitivity. The LSSWT can easily identify dynamic balance deficits in knee OA patients and help prevent fall incidents.

Fear of movement and other associated factors in older patients with total knee arthroplasty.

BACKGROUND: Kinesiophobia is an important risk factor for functional activities of patients in the early stage following total knee arthroplasty (TKA). AIMS: This study aimed to investigate the relationship between fear of movement and associated factors in older patients in the late stage after TKA. METHODS: The study included 45 older patients (mean age:70.11 ± 0.90 years) with knee osteoarthritis who underwent TKA. Kinesiophobia was assessed with the Tampa Scale of Kinesiophobia (TSK). Pain and strength in the quadriceps femoris (QF) muscle were assessed by the Visual Analog Scale and hand-held dynamometer, respectively. Functional level was determined using the 30-s sit-to-stand test (STS) and 10-m walking test. RESULTS: There were correlations between TSK and QF muscle strength (r = -0.538, p < 0.001), activity pain level (r = 0.489, p = 0.001), and 30-s STS (r = -0.306, p = 0.041). There were no correlations between TSK and age (r = 0.207, p = 0.172) and 10-m walking test (r = 0.112, p = 0.465). CONCLUSIONS: Increased pain and decreased QF muscle strength and functional level on STS were related with fear of movement in TKA patients. It was concluded that kinesiophobia of older patients with TKA must be considered during the assessment and rehabilitation program in the late stage after TKA.

Structural validity and internal consistency of the Shoulder Pain and Disability Index in Turkish patients with rotator cuff disease: A proposal of a new version.

BACKGROUND: The Shoulder Pain and Disability Index (SPADI) is a widely used patient-reported outcome questionnaire in patients with shoulder diseases; however, the structural validity and the internal consistency of the Turkish SPADI is unclear in rotator cuff disease. OBJECTIVE: To assess the internal structure of the Turkish SPADI in patients with rotator cuff disease. METHODS: A total of 109 patients with unilateral rotator cuff disease were assessed. The COnsensus-based Standards for the selection of health Measurement INstruments checklist was used for the methodological design of the study. A confirmatory factor analysis was performed, and the model fit was assessed by using the comparative fit index (CFI), the Tucker-Lewis index (TLI), the root mean square error of approximation (RMSEA), and the standardized root mean square residual (SRMR). The factor structure was examined with a principal component analysis. The internal consistency was assessed using Cronbach's alpha. RESULTS: The validity of the two subscales was not confirmed. The principal component analysis showed the Turkish SPADI consisted of one factor, and the one-factor model of the Turkish SPADI also was not confirmed. When two items were deleted, the one-factor model of the new version of the Turkish SPADI had a better fit (CFI = 0.978, TLI = 0.971, RMSEA = 0.058, SRMR = 0.043). The internal consistency of the new version of the Turkish SPADI was high (Cronbach's alpha = 0.92, 95% CI = 0.90-0.94). CONCLUSIONS: We suggest that the modified version of the Turkish SPADI should be used for patients with rotator cuff disease. The total score of the modified version should be considered.

Validity and reliability of performance tests as balance measures in patients with total knee arthroplasty.

PURPOSE: This study aimed to investigate validity and reliability of the Timed Up and Go Test (TUG), 10 Meter Walk Test (10MWT), Single Leg Stance Test (SLST), 2 Minute Walk Test (2MWT), and Five Times Sit-to-Stand Test (5xSST) for evaluating balance in patients with total knee arthroplasty (TKA). MATERIALS AND METHODS: This cross-sectional study included 41 participants who had undergone TKA 6 months before the study due to osteoarthritis. Participants performed the TUG, 10MWT, SLST, 5xSST, and 2MWT. Each of the tests was performed twice, with a 1-day interval between tests. Intraclass correlation coefficient (ICC) models were used to determine the test-retest reliability. The level of correlations between performance tests and Berg Balance Scale and Fall Efficacy Scale-International were used to establish concurrent and convergent validity of the performance tests, respectively. RESULTS: The mean age of the subjects was 64.07 ± 10.57 years. All tests showed excellent reliability (ICC > 0.94), excluding SLST that demonstrated good test-retest reliability (ICC = 0.72). All of the tests (SLST, 10MWT, 5xSST, 2MWT, TUG) were found to have good validity (rho > 0.704). CONCLUSIONS: According to these results, TUG, 10MWT, SLST, 5xSST, and 2MWT are reliable and valid outcome measures in patients with TKA, and could be used to assess balance after TKA surgery.

Efficacy of balance training on postural control in patients with rotator cuff disease: a randomized controlled study.

We evaluated the efficacy of adding balance training to a physical therapy program on postural control and health-related quality of life in patients with rotator cuff disease. Forty-two participants were randomly allocated to the control and intervention groups. Both groups received physical therapy (education, stretching, supervised strength training, and home exercise program) 3 days/week for 6 weeks. The intervention group was instructed to perform balance exercises at home. The primary outcomes were the stability index, the Fourier transformation (F5 and F6), the weight distribution index, and the fall index, as assessed by the posturography during eight conditions with different combinations of standing (solid surface, pillows, and different head positions) and vision (eyes open/closed). The secondary outcomes included the Western Ontario Rotator Cuff Index to assess the health-related quality of life, the Shoulder Pain and Disability Index, and the Numeric Pain Rating Scale. The adherence to in-person and home-based therapy was high (>83%). The intervention group significantly improved the stability index, F5, and F6 parameters but each in only one condition (P < 0.05). No significant improvement was found in the conditions for the other primary outcomes and in the health-related quality of life. (P > 0.05). We conclude that adding the balance training protocol to the physical therapy program does not improve postural control and health-related quality of life in patients with rotator cuff disease.

Reliability, validity, and minimal detectable change of the Step Test in patients with total knee arthroplasty.

BACKGROUND: Step Test (ST) is frequently used to assess dynamic balance and locomotor function in clinical practice. AIMS: This study aimed to determine the concurrent validity, reliability, and minimal detectable change (MDC) of the ST in patients with total knee arthroplasty (TKA). METHODS: The study included 56 patients with TKA. The intraclass correlation coefficient (ICC) was used to assess the test-retest reliability of the ST. The correlations of the ST with timed up and go (TUG) and 10-m walk test (10MWT) were assessed for concurrent validity. RESULTS: Test-retest (ICC 0.90) reliability of the ST was determined to be excellent. The SEM and MDC95 values of test-retest reliability were 0.76 and 2.11, respectively. A significantly moderate correlation was found between the ST and TUG (p < 0.05, r: - 0.69), and 10MWT (p < 0.05, r: - 0.67). CONCLUSION: The ST is a valid and reliable method in the assessment of dynamic balance ability and locomotor function in patients with TKA. The ST can be used to quantify changes in dynamic balance level and locomotor function in patients with TKA.

Effect of Local Infiltration Analgesia on Functional Outcomes in Total Knee Arthroplasty: A Randomized, Placebo-Controlled, Double-Blind Clinical Trial.

Local infiltration analgesia (LIA) is a simple, surgeon-administered technique for the treatment of postoperative pain after total knee arthroplasty (TKA). The aim of the study was to investigate the efficacy of LIA and its effects on functional outcomes in TKA. A total of 135 patients with primary TKA were recruited and randomized either to receive LIA or to receive placebo injection (PI). Pain, active range of motion (ROM), knee function score, functional activities, and hospital length of stay (LOS) were assessed before surgery and from postoperative day (POD) 1 to at discharge. Lower pain scores at rest were recorded on POD1 and POD2 in the LIA group (p = 0.027 and p = 0.020, respectively). Lower pain score on walking was recorded on POD1 in the LIA group (p = 0.002). There was a statistically significant difference in active knee flexion between groups on POD1 (p = 0.038). There was a significant difference in LOS between LIA and PI groups. Shorter stay was seen in LIA group. There were no statistically significant differences between the groups in terms of knee function score and functional outcomes. LIA technique is effective for pain management in the early postoperative period. LIA added benefit for knee function in terms of active knee flexion ROM after TKA. A shorter hospital LOS was observed in LIA group. However, we did not find any differences in groups in terms of functional assessment such as ability to rise from a chair and walking capacity.The level of evidence is randomized controlled trial, level I.

Are the physical activity habits of Turkish physiotherapists associated with their physical activity promotion and counseling?

Background: Physiotherapists (PTs) must be role models and convincing promoters of physical activity (PA). Objective: This cross-sectional study aimed to determine whether Turkish PTs' PA promotion and counseling practices are associated with their own PA habits. Method: An open-access survey was distributed to 2,619 PTs via e-mail to collect information about the PTs' PA habits; their knowledge, role perception, confidence, perceived barriers and feasibility in PA promotion; and their counseling practices. During the year that the survey was online, 421 (16.1%) PTs responded. The PTs were divided into two groups: physically active PTs (engaged in at least one type of PA) and inactive PTs. Chi-square test of independence was used for data analysis. Results: Knowledge of PA did not differ between the groups (p>0.05). Physically active PTs had higher role perception (except in one item) and greater confidence in PA promotion than inactive PTs (p<0.05). Except for one barrier, engagement in PA was not associated with perceived barriers or feasibility in PA promotion (p>0.05). Significantly more physically active PTs suggested PA to 10 or more patients/month [25.2% (n=40), vs. 13.5% (n=26); p=0.005] and suggested at least one type of PA [78.7% (n=137) vs. 59.2% (n=141); p=0.000]. PTs who engaged in vigorous-intensity PA and strength training were significantly more likely to suggest these types of PA than PTs who did not [44.1% (n=15) vs. 10.4% (20); p=0.000 and 91.1% (n=113) vs. 83.2% (n=154); p=0.047, respectively]. Conclusion: This study demonstrated that physically active PTs had higher role perception and confidence, and more actively promoted PA in their counseling practice.

Reliability, concurrent validity and minimal detectable change of the L test in patients with total knee arthroplasty.

PURPOSE: The L test is a modified version of the timed up and go test (TUG), extending the walking distance from 6 to 20 meters and also requiring participants to make four turns in both (right/left) direction. It could be a useful measurement method in assessment of functional mobility for patients with Total Knee Arthroplasty (TKA). The aim of the study was to determine reliability, concurrent validity, and minimal detectable change (MDC) of L test in patients with TKA. MATERIALS AND METHODS: The study included 43 patients with TKA. The Intraclass Correlation Coefficient (ICC) was used to assess the intra-rater reliability of the L test. The correlations of the L test with TUG were assessed for concurrent validity. RESULTS: Intra-rater (ICC 0.97) reliability of the L test was determined to be excellent. The SEM and MDC95 values of intra-rater reliability were 1.03 and 2.84, respectively. A high correlation was found between the L test and TUG (r: 0.75). CONCLUSION: The L test is a valid and reliable method in the assessment of functional mobility in patients with TKA. The L test can be used to quantify changes in functional mobility level in patients with TKA.Implications for rehabilitationThe L test is a reliable and valid measurement tool that can be used to assess functional mobility in patients with TKA.Clinicians and researchers can use a greater change than 2.84 seconds for the L test as a meaningful change in patients with TKA.

The associations of emotional health with pain, disability, and health-related quality of life in patients with rotator cuff disease.

BACKGROUND: Psychosocial factors have been associated with poor outcomes in patients with rotator cuff disease. Emotional health is one of these factors, and relationships between emotional health and outcome measures evaluated before and after physical therapy have not been reported. AIM: To investigate the associations of baseline emotional health status with pre-treatment, post-treatment, and pre-to-post changes in pain, disability and health-related quality of life in patients with rotator cuff disease. METHODS: Forty-one patients with rotator cuff disease were included. Emotional health was measured with the emotions domain of the Western Ontario Rotator Cuff Index (WORC). The outcomes were the WORC-total, the Shoulder Pain and Disability Index, and the numeric pain rating scale. All outcomes were measured at baseline and 6-week follow-up. RESULTS: The baseline emotional health score and the outcomes scores were moderate to strong, and weak to moderate correlated at baseline and at follow-up, respectively. There was no correlation between the baseline emotional health score and the changes in the outcome measures from baseline to follow-up. CONCLUSIONS: Lower baseline emotional health status was associated with worse outcomes in pain, disability and health-related quality of life at baseline and follow-up in patients with rotator cuff disease. However, the changes in these outcome measures from baseline to follow-up were not correlated with the baseline emotional health status. In clinical practice, an assessment of patients' emotional health status using standardised measures may help to predict post-treatment outcomes, and a multidisciplinary cooperation (e.g., among physical therapists and psychologists) may enhance outcomes.