Spinal posture, mobility, and position sense in adolescents with chest wall deformities: a comparison of pectus excavatum, pectus carinatum and healthy peers.

PURPOSE: The study aimed to compare spinal posture, mobility, and position sense in adolescents with pectus excavatum (PE), pectus carinatum (PC), and healthy control (HC). METHODS: 22 with PE, 22 with PC, and 21 HC were included in the study. The spinal posture (thoracic kyphosis, lumbar lordosis, pelvic tilt, thoracic, lumbar, pelvic lateral tilt angles) and mobility (thoracic, lumbar, hip/sacral, and overall, in the sagittal and frontal plane) with the spinal mouse, and spinal position sense (repositing errors) with the inclinometer were assessed. RESULTS: The thoracic kyphosis angle of PE and PC was higher than in HC (p < 0.001; p = 0.001). Hip/sacral mobility in the sagittal plane was lower in the PE and PC than control, respectively (p < 0.001; p < 0.001). Overall sagittal spinal mobility (p:0.007) and hip/sacral mobility in the frontal plane (p:0.002) were lower in the PC than in HC. Overall frontal spinal mobility was lower in the PE and PC than in HC (p:0.002; p:0.014). The PE and PC repositing errors were higher (p < 0.001; p:0.014). CONCLUSION: The study found that adolescents with PE and PC had decreased spinal mobility, spinal alignment disorders, and a decline in spinal position sense. It is important not to overlook the spine during physical examinations of adolescents with chest wall deformities. In clinical practice, we suggest that adolescents with chest deformities should undergo a spine evaluation and be referred for physical therapy to manage spinal disorders.

A comparative evaluation of the efficacy of complete decongestive therapy in the treatment of unilateral breast cancer-related lymphedema with and without metabolic syndrome.

AIM: This study aimed to investigate the effect of the presence of metabolic syndrome (MetS) on the limb volume and quality of life (QoL) of patients who underwent complex decongestive therapy (CDT) due to unilateral breast cancer-related lymphedema (BCRL). METHODS: Forty female patients with unilateral BCRL, of whom 20 had MetS (MetS group) and 20 did not have MetS (control group), were included in the study. The participants received CDT 5 days a week for 3 weeks. The participants' limb volume (percentage of excess volume (PEV) and percentage reduction of excess volume (PREV) was determined using a tape measure, and their QoL was assessed using the Lymphedema Quality of Life questionnaire (LYMQoL) before and after treatment. RESULTS: After the treatment, the PEV and PREV values and LYMQoL-symptoms scores of the patients improved (p < 0.05); however, the LYMQoL-function, appearance/body image, mood/emotions, and overall QoL scores did not change in the MetS group (p > 0.05). In the control group, the PEV and PREV values and the LYMQoL-appearance/body image, mood/emotions, and overall QoL scores improved (p < 0.05), but the LYMQoL-symptoms and LYMQoL-function scores did not change (p > 0.05). There was a greater increase in the post-treatment PEV and PREV values of the control group compared to the MetS group (p < 0.001). CONCLUSION: The study yielded that CDT was an effective treatment in BCRL with and without MetS; however, the improvement was greater in BCRL cases without MetS than in those with MetS. Therefore, the presence of MetS should be taken into account in the treatment of lymphedema in patients who develop BCRL. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT05426993. Registered 2022-06-16. https://clinicaltrials.gov/search?cond=NCT05426993.

Reliability and validity of new isokinetic strength assessment for rotator cuff muscles in a muscle architecture-based position.

Background/aim: Isokinetic strength assessment of the rotator cuff muscle is frequently applied in a variety of shoulder postures, but none of these consider muscular architecture, which is one of the most important aspects of improving strength development. This study aimed to examine the test and retest reliability and validity of the muscle architecture-based position (MABP), which is 25° abduction and 20° external rotation, in healthy subjects to be able to select a better isokinetic assessment position for shoulder rotator cuff muscles. Materials and methods: A total of 54 healthy males with a mean age of 21.0 ± 1.2 years and mean body mass index of 22.8 ± 1.7 kg/m2 completed an isokinetic measurement session. All of the tests were performed on an IsoMed 2000 isokinetic dynamometer concentrically and eccentrically for both upper limbs at 60°/s angular velocity. All of the participants completed 3 measurement sessions: the first represented the isokinetic testing and was performed in the scapular neutral position (SNP) (45° shoulder flexion and abduction), the second represented the MABP (25° abduction and 20° ER) for shoulder rotator cuff muscles, and the third represented the test and retest of the MABP. Results: The correlations between the 2 techniques for assessing concurrent validity ranged from 0.908 to 0.994. The values obtained from the MABP were higher than those obtained in the SNP. There was no systematic bias for any measurements between the MABP and the retest of the MABP (p > 0.05). The intraclass correlation coefficients representing the test and retest reliability results for each variable measured with the MABP was higher than 0.98 and this value was considered as excellent reliability. Conclusion: In conclusion, the MABP can be used to assess the isokinetic strength of the rotator cuff muscles safely and confidently, with increased quantities of force being released and measurement at optimal muscle tension.

The relationship between trunk control, spinal posture, and spinal mobility in patients with multiple sclerosis: a cross-sectional study.

Background/aim: Trunk control, which plays a key role in balance and mobility, decreases in patients with multiple sclerosis (PwMS) and many parameters such as sensory, motor, and musculoskeletal systems affect trunk control. The aim of this study was to compare trunk control, spinal mobility, and spinal posture in PwMS with healthy controls and investigate the relationship between trunk control with spinal posture and spinal mobility in PwMS. Materials and methods: The study was completed with 38 PwMS and 38 healthy controls with matched age and sex. Trunk control was evaluated with the Trunk Impairment Scale (TIS). Spinal posture and mobility were evaluated in sagittal and frontal planes using an IDIAG M360 Spinal Mouse. Spinal posture was evaluated in upright, maximum flexion, extension, left and right lateral flexion positions, and spinal mobility was evaluated from upright to flexion, extension, right and left flexion positions in sagittal and frontal planes. Results: TIS scores, thoracic mobility angles (from upright to flexion and left lateral flexion), lumbar mobility angles (from upright to extension and right lateral flexion) and lumbar posture angle (maximum right lateral flexion) were lower, and thoracic posture angles (upright and maximum extension) were higher in PwMS than healthy controls (p < 0.05). No significant difference was found between other spinal postures and mobility values. In addition, there was only a negative relationship between thoracic spinal mobility from upright to extension and trunk control in PwMS (r = -0.349; p = 0.032). Conclusion: These findings indicate the importance of early detection of trunk disturbances in PwMS. Thus, even in the early stages of multiple sclerosis, detailed trunk assessment will guide the implementation of comprehensive exercise programs.

Investigation of parameters related to lower extremity muscle strength and proprioception in Patients with Multiple Sclerosis: a cross-sectional study.

BACKGROUND: Patients with Multiple Sclerosis (PwMS) may experience a decline in balance, gait, and mobility as well as an increase in fear of falling (FoF) and fatigue due to weaker muscles and proprioceptive loss in their lower limbs. The study aimed to compare lower extremity muscle strength and proprioception, balance, functional mobility, gait, FoF, and fatigue between PwMS and healthy controls and to investigate the relationship between lower extremity muscle strength and proprioception and balance, functional mobility, gait, FoF, and fatigue in PwMS. METHODS: The study was completed with 35 PwMS and 35 healthy controls with matching age and gender. The 5 Repetition Sit-to Stand Test (5-STS-test), knee and ankle reposition tests (using a digital inclinometer), the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test, the Dynamic Gait Index (DGI), the Falls Efficacy-International (FES-I), and the Fatigue Severity Scale (FSS) were used for evaluations. RESULTS: The 5-STS test, knee and ankle reposition tests, TUG, FES-I, and FSS Test scores were higher and BBS and DGI scores were lower in PwMS compared to healthy controls (p < 0.05). BBS, DGI, TUG, FES-I, and FSS were associated with 5-STS test and knee and ankle reposition tests except for some nondominant reposition tests in PwMS (r between 0.342 and -0.714; p < 0.05 for all). CONCLUSION: Lower extremity muscle strength and proprioception were associated with balance, functional mobility, gait, FoF, and fatigue in PwMS. These results suggested that detailed assessment of neuromuscular parameters in lower extremity function is important in determining the appropriate rehabilitation programs.

Effects of backward walking training on balance, gait, and functional mobility in people with multiple sclerosis: A randomized controlled study.

BACKGROUND: Backward walking training (BWT) can have a positive effect on balance, gait, and functional mobility in neurological diseases; however, the effectiveness of BWT has not been examined in multiple sclerosis (MS). Therefore, the study aimed to investigate the effects of BWT on balance, gait, and functional mobility in people with MS (PwMS). METHOD: Nineteen PwMS were randomly allocated to either the experimental group (n=10) and the control group (n=9). The experimental group received BWT in addition to conventional walking training (CWT) while the control group only received CWT. Both groups performed training three times a week for 8 weeks. Participants were assessed with the Berg Balance Scale (BBS), four square step test (FSST), activities-specific balance confidence scale (ABC), timed 25-foot walk test (T25FW), dynamic gait index (DGI), 3-meter backward walk test (3MBWT), Multiple Sclerosis Walking Scale-12 (MSWS-12), and timed up and go test (TUG) before and after training. RESULTS: After training, both groups showed significant improvements on the T25FW, and TUG (p<0.05) while only the experimental group showed significant improvements on the BBS, FSST, ABC, DGI, 3MBWT, and MSWS-12 (p<0.05). The experimental group significantly improved more than the control group in all outcomes (p<0.05) except for the T25FW (p=0.202). CONCLUSION: BWT in addition to CWT is an effective way to improve balance, gait, and functional mobility for PwMS. These results suggest that BWT may be a potentially useful treatment approach when added to CWT in the rehabilitation of MS.

Validity and reliability of the Turkish version of the Ottawa Sitting Scale in patients with acute stroke.

PURPOSE: To investigate the validity and reliability of the Turkish version of the Ottawa Sitting Scale (OSS-T) in patients with acute stroke. MATERIALS AND METHODS: The Berg Balance Scale (BBS) and Trunk Impairment Scale (TIS) were used to determine the validity of the OSS-T. The OSS-T was re-applied by the same rater after an interval of 7 days to determine the reliability. To test inter-rater reliability, the evaluation was repeated by a second rater 1 day after the first evaluation. Reliability was quantified using intraclass correlation coefficients (ICC), and validity was assessed by correlating the OSS-T scores with the results of the other measures. RESULTS: The ICC of the total OSS-T score for inter-rater reliability was 0.996 and for intra-rater reliability, it was 0.951. The Cronbach's α coefficient used to determine internal consistency was 0.980, which indicates excellent reliability. A strong positive correlation was found between OSS-T and TIS (rho = 0.861, p < 0.001), and between OSS-T and BBS (rho = 0.875, p < 0.001). An evident 2-factor structure was shown by the results of the factor analysis. CONCLUSIONS: The results of this study indicated that the OSS-T has strong measurement properties, making it a valid and reliable tool for research and clinical practice in patients with acute stroke.IMPLICATIONS FOR REHABILITATIONIndependent sitting function is an important indicator of functional recovery and discharge from hospital.Unlike other sitting balance tools, the Ottawa Sitting Scale can even categorize patients with low balance reserve by applying all the items with and without foot support.The Turkish version of the Ottawa Sitting Scale is a valid and reliable tool to evaluate sitting balance in patients with acute stroke.

Effects of Different Exercise Programs on Symptoms, Sleep, and Quality of Life in Patients with Primary Restless Legs Syndrome.

Background: Restless legs syndrome (RLS) is a sensorimotor disorder that can have a significant detrimental impact on the quality of life and sleep. Objectives: Our aim was to examine the effects of aerobic exercise and stretching exercise programs on symptom severity, sleep, and quality of life in patients with primary RLS. Methods: A total of 18 patients between the ages of 22 and 61 were randomly divided into 3 groups as aerobic exercise, stretching exercises, and control. All exercise programs were applied 3 times a week for 8 weeks. Evaluations were performed before and after treatment. Symptom severity of the patients was evaluated by the International Restless Legs Syndrome Study Group Rating Scale, sleep was evaluated with the Pittsburgh Sleep Quality Index and actigraphy, and quality of life was evaluated with the John Hopkins Restless Legs Syndrome Quality of Life Questionnaire. Recovery status of the patients was determined using the post treatment global change scale. Results: Aerobic exercise and the stretching exercise program were found to be effective in decreasing RLS symptoms (P = 0.025, P = 0.034) and improving subjective sleep quality (P = 0.034, P = 0.025), overall sleep quality (P < 0.001, P = 0.034), and quality of life (P = 0.009, P = 0016). Aerobic exercises were found to be more effective in reducing wake after sleep onset of sleep (P = 0.048), whereas stretching exercises reduced sleep disorders (P = 0.025). Conclusion: Both exercise approaches have been identified as highly effective approaches in patients with RLS. The treatment can be planned according to the choice of the available facilities, patient and clinician preference, and the advantages of the 2 exercise approaches.

The reliability and validity of the 3-m backward walk test in people with Parkinson's disease.

BACKGROUND: People with Parkinson's disease (PwPD) lose the ability in backward walking which is an important part of mobility in daily life. The 3-m backward walk test (3MBWT) evaluates backward walking; however, its reliability and validity have not been examined in PwPD yet. AIMS: To examine (1) the test-retest reliability of the 3MBWT in PwPD; (2) the minimum detectable change in the 3MBWT times; (3) the concurrent and known-groups validity of the 3MBWT; and (4) the optimum cutoff time which best discriminates fallers from non-fallers with Parkinson's disease (PD). METHODS: This cross-sectional study included 36 PwPD and 33 healthy people. The 3MBWT was conducted with the 10-m walk test, timed up and go test, Berg Balance Scale, four square step test, activity-specific balance confidence scale, Movement Disorders Society Sponsored Unified Parkinson's Disease Rating Scale, and Hoehn and Yahr Scale. RESULTS: The 3MBWT demonstrated excellent test-retest reliability (ICC = 0.965). The MDC of 2.13 s was determined. The 3MBWT had moderate to high correlations with the other outcome measures (correlation coefficient ranged from -0.592 to 0.858). On the 3MBWT times, there were significant differences between PwPD and healthy people, and between fallers and non-fallers with PD (p < 0.001 and p < 0.001, respectively). A 3MBWT time of 10.31 s was found to best discriminate fallers from non-fallers with PD. CONCLUSIONS: The 3MBWT is a reliable, valid, and easy to administer outcome measure to assess backward walking performance in PwPD, indicating it to be used in practice and research.

Altered Trunk Position Sense and Its Relationship With Spinal Posture and Spinal Mobility in Patients With Parkinson's Disease.

INTRODUCTION: Proprioception is significantly affected by dysfunction of the basal ganglia, which play an important role in sensorimotor integration. Parkinson's disease (PD), which is characterized by progressive loss of the dopaminergic neurons of the substantia nigra, leads to a variety of motor and nonmotor symptoms throughout the course of the disease. The aim of this study was to determine trunk position sense and to investigate its relationship with spinal posture and spinal mobility in patients with PD. METHODS: The study included 35 patients with PD and 35 age-matched control subjects. Trunk position sense was determined with "trunk reposition errors." A spinal mouse was used to assess spinal posture and spinal mobility. RESULTS: According to the Hoehn-Yahr rating scale, the majority of the patients were in Stage 1 (68.6%). Trunk position sense was found to be significantly decreased in patients with PD compared with the control group (p < .001) but was not correlated with spinal posture and spinal mobility in patients with PD (p > .05). CONCLUSIONS: This study revealed that trunk position sense was impaired in PD from the early stages of the disease. However, neither spinal posture nor spinal mobility was associated with decreased trunk proprioception. Further research into these relationships in the late stages of PD is needed.

Core stability-based balance training and kinesio taping for balance, trunk control, fear of falling and walking capacity in patients with multiple sclerosis: A randomized single-blinded study.

BACKGROUND: Trunk performance-based therapies are important in the Multiple Sclerosis (MS) rehabilitation process since they have been associated with balance, trunk performance, fall prevention, and walking capacity. Kinesio taping (KT) is a popular approach that has recently been used to treat a variety of musculoskeletal and neuromuscular impairments. Therefore, the aim of this single-blind, randomized controlled study was to investigate the effects of KT combined trunk stabilization-based balance training on balance, trunk control, walking capacity, and fear of falling in patients with MS. MATERIAL AND METHODS: Thirty patients diagnosed with MS were randomly assigned to the KT group or the control group. The control group received core stability-based balance training and the KT group was treated with KT applied on global trunk muscles in addition to core stability-based balance training. Balance was measured with the Mini BESTest, trunk control with the Trunk Impairment Scale, fear of falling with the Falls Efficacy Scale and walking capacity with the 2-minute walk test. RESULTS: Balance, trunk control, fear of falling, and walking capacity of all the patients improved after treatment (p < 0.05). No superiority was found between the groups in terms of treatment efficacy (p > 0.05). CONCLUSION: In conclusion, core stability-based balance training was effective in patients with MS, and the addition of KT had no additional effect in terms of balance, trunk control, fear of falling, and walking capacity.

Determining the number of repetitions to establish isokinetic knee evaluation protocols specific to angular velocities of 60°/second and 180°/second.

INTRODUCTION: This study aims to develop a standard number of repetition at angular velocities of 60°/sec and 180°/sec and define the difference of number of repetitions between genders. METHOD: One hundred ninety-six athletes (judo, volleyball, Greco-Roman wrestling, runners, and gymnastics) were involved. Concentric-concentric isokinetic muscle strength of the knee flexor-extensor muscles of the athletes were performed with an ISOMED 2000 isokinetic dynamometer. The evaluation test protocol consisted of 10 repetition of knee flexion-extension at 60°/sec and 30 repetitions at 180°/sec. RESULTS: Athletes performed with maximal knee flexion strength at their second and third trial at 60°/sec and third-forth trial at 180°/sec. It was found that 2 repetitions and 2-3 repetitions were needed for knee extension peak torque at 60°/sec and 180°/sec respectively. The difference between the genders was significant at 60°/sec for knee flexion and extension on the dominant side; at 180°/sec for knee extension on the dominant and non-dominant side. It was determined that 3 repetitions for 60°/sec, 4 repetitions for 180°/sec were enough to determine peak torque values. DISCUSSION: Optimal number of repetitions is crucial so that athletes could have the opportunity to reach maximal strength without unnecessary workload or waste of time. CONCLUSIONS: Protocols involving 3 repetitions for 60°/sec, 4 repetitions for 180°/sec were enough to determine peak torque values. Gender of athletes should be considered when establishing isokinetic knee evaluation protocols.

The effects of a 6-Week balance training in addition to conventional physiotherapy on pain, postural control, and balance confidence in patients with cervical disc herniation: a randomized controlled trial.

PURPOSE: Impaired postural control and fear of falling are common symptoms in patients with neck disorders, but the effects of balance training have not yet been sufficiently investigated. The aim of this study was to determine the effects of balance training on neck pain, postural control, and balance confidence in patients with cervical disc herniation (CDH). MATERIALS AND METHODS: Thirty patients (21 females and 9 males) aged 18-55 years were randomly assigned into two groups and followed up for 6 weeks, with a 3-day weekly treatment program. Both groups received hot pack therapy, interferential current, and myofascial relaxation and cervical dynamic isometric exercises. The training group also received additional balance training on a force platform with the visual feedback technique. All patients were evaluated using the visual analogue scale for pain intensity, activity specific balance confidence scale (ABC) for balance confidence, centre of pressure with eyes closed-eyes open (CoP-EO/CoP-EC), and the limits of stability tests (LoS) for postural control with a monoaxial bipodal stabilometric force platform pre- and post-intervention. RESULTS: The pain intensity was significantly reduced in both groups (p = 0.01). CoP-EO/CoP-EC and LoS results improved in the training group (p = 0.036, p = 0.020, p = 0.23, respectively), whereas no effects were observed in the control group (p = 0.955, p = 0.307, p = 0.363, respectively). Although ABC scores increased significantly in both groups (p = 0.001, p = 0.009, respectively), the increase in the training group was significantly higher than that of the control group (p = 0.003). CONCLUSIONS: The results of our study revealed that balance training added to the treatment protocol of CDH may have positive results in the treatment of neck problems. Accordingly, balance training in the treatment of chronic neck problems should also be considered for a comprehensive management of CDH.

An investigation of upper extremity function in patients with multiple sclerosis, and its relation with shoulder position sense and disability level.

Purpose: The purposes of this study were to investigate upper extremity function and shoulder position sense in patients with multiple sclerosis and its relation with disability level. Materials and methods: In this study, 20 multiple sclerosis and 20 healthy subjects participated. The disability level was determined by the Expanded Disability Status Scale. Mental state was assessed using the Mini-Mental State Examination. Upper extremity function was measured with the 9-Hole Peg Test and shoulder position sense was evaluated with a Dualer IQTM digital inclinometer. The study protocol was also registered at http://clinicaltrials.gov (NCT03846336). Results: Upper extremity function scores were lower and shoulder position sense error scores were greater in patients with multiple sclerosis in comparison to healthy controls (p < .05). While disability level was associated with dominant and non-dominant upper extremity function, no relationship was found between the disability level and shoulder position sense (p < .05). Only the dominant side shoulder position senses at 30° and 60° abduction were found to be associated with upper extremity function (p < .05). Conclusions: These results indicate that shoulder position sense and upper extremity function were affected in patients with multiple sclerosis with mild to moderate disability. Upper extremity functions were associated with shoulder abduction joint sense in patients with multiple sclerosis. In the assessment of upper extremity functions, joint position sense should be taken into account even at early stages of multiple sclerosis, so it may provide guidance in planning rehabilitation programs.

A comparison of the effects of exercises plus connective tissue massage to exercises alone in women with fibromyalgia syndrome: a randomized controlled trial.

This study aimed to compare the effectiveness of a 6-week combined exercise program with and without connective tissue massage (CTM) on pain, fatigue, sleep problem, health status, and quality of life in patients with fibromyalgia syndrome (FMS). Patients were randomly allocated into Exercise (n = 20) and Exercise + CTM (n = 20) groups. The exercise program with and without CTM was carried out 2 days a week for 6 weeks. Pain, fatigue, sleep problem with Visual Analog Scales, health status with Fibromyalgia Impact Questionnaire (FIQ), and quality of life with Short Form-36 were evaluated. After the program, pain, fatigue and sleep problem reduced, health status (except of the scores of FIQ-1 and FIQ-10), physical functioning, role limitations due to physical health, bodily pain, role limitations due to emotional health, vitality, and general health perceptions parameters related to quality of life improved in the Exercise group, (P < 0.05). In the Exercise + CTM group, pain, fatigue and sleep problem decreased, health status and quality of life improved (P < 0.05). Pain, fatigue, sleep problem, and role limitations due to physical health improved in the Exercise + CTM group in comparison to the Exercise group (P < 0.05). The study suggested that exercises with and without CTM might be effective for decreasing pain, fatigue and sleep problem whereas increasing health status and quality of life in patients with FMS. However, exercises with CTM might be superior in improving pain, fatigue, sleep problem, and role limitations due to physical health compared to exercise alone.