Effects of whole body vibration on functional capacity and respiratory functions in individuals with stroke: A randomized controlled study.

BACKGROUND: Management of respiratory-related functional problems using sensory rehabilitation strategies has been poorly researched in patients with stroke. OBJECTIVE: This study aimed to investigate whether whole body vibration (WBV) training has an effect on functional capacity and respiratory functions in patients with stroke. METHODS: In the randomized-controlled study, 28 participants were randomized into two groups: one receiving Neurodevelopmental Treatment (NDT; n = 13) and one receiving both NDT and WBV (NDT + WBV; n = 15). The primary outcome measures were 6-Minute Walking Test (6MWT) and Pulmonary Function Test which evaluate functional and respiratory capacity. Secondary outcome included the chest circumference measurement to evaluate the thoracic expansion ability. RESULTS: Both groups showed positive significant changes in walking distance and maximum oxygen consumption volume (VO2max), inspiratory capacity, vital capacity and chest circumference measurement scores (p < 0.05). While the NDT +WBV group showed a significantly greater increase in walking distance and VO2max levels than the NDT group (p < 0.05), there were no significant group differences in respiratory function flow and volume parameters, and chest circumference measurement. CONCLUSION: The addition of WBV training to the treatment program has some incremental benefits on increasing functional capacity and thoracic expansion, and rehabilitating respiratory dysfunction.

ESTIMATION OF BALANCE STATUS IN PATIENTS WITH HEMIPARESIS: AN ARTIFICIAL NEURAL NETWORK IMPLEMENTATION.

ObjectiveAlthough Balance Evaluation Systems Test (BESTest) is an important balance assessment tool to differentiate balance deficits, it is time consuming and tiring for hemiparetic patients. Using artificial neural networks (ANNs) to estimate balance status can be a practical and useful tool for clinicians. The aim of this study was to compare manual BESTest results and ANNs predictive results and to determine the highest contributions of BESTest sections by using ANNs predictive results of BESTest sections. METHODS: 66 hemiparetic individuals were included in the study. Balance status was evaluated using the BESTest. 70% (n = 46), of the dataset was used for learning, 15% (n = 10) for evaluation, and 15%(n = 10) for testing purposes in order to model ANNs. Multiple linear regression models (MLRs) were used to compare with ANNs. RESULTS: The results of the study showed that ANNs(root mean square error-RMSE:4.993) were better than MLR (RMSE:7.031) model to estimate balance status of patients with hemiparesis. The BESTest sections making lowest and highest contribution to BESTest total score was found to be "Stability Limits/Verticality" and "Stability in Gait" sections, respectively. As the highest and the lowest contribution of sections items were investigated it was found that error(RMSE) values were small indicating the success of ANN modeling. DISCUSSION: The results obtained from this study showed that RMSE values of ANNs were better than the ones found in literature. It is believed that this study can lead to constitute a shorter, more sensitive and more practical mini subset of BESTest for physiotherapists to differentiate balance problems while carrying the whole philosophy of the full BESTest.

Factors affecting body awareness in older adults with chronic musculoskeletal pain.

INTRODUCTION: Chronic musculoskeletal pain (CMP) and cognitive impairment (CI) may reduce body awareness in older adults. The first aim of this study was to determine the impact of CMP and CI on body awareness in older adults. The second was to search for the factors most affecting body awareness using logistic regression analysis. MATERIAL AND METHODS: Two hundred and 65 older adults (males: 138 and females: 127) aged 65 and over (mean age; 72.27 ±6.42 years) living in their own homes were included. We used the following evaluation methods: CMP intensity (Visual Analog Scale - VAS), cognitive status (Hodkinson's Abbreviated Mental Test - HAMT), and body awareness (Body Awareness Questionnaire - BAQ). Logistic regression analysis was used to determine the factor most affecting the BAQ score. RESULTS: Eighty-five point two percent of participants (n = 265) reported CMP (lower extremity pain: 74.6%; spinal pain: 66.6%; upper extremities pain: 44.4%). CMP intensity was higher in lower extremities (mean VAS: 5.73 ±1.86 cm). Gender differences in terms of CMP were found in favor of males (p = 0.0001). Mean HAMT score was 8.16±1.65. Gender difference in favor of males was significant (p = 0.0001). Mean BAQ score was 77.61±20.90; there was no significant difference between the gender (p = 0.142). There was a significant moderate positive correlation between body awareness and cognitive status (r = 0.382, p = 0.0001). However, a weak negative correlation was found between body awareness and pain intensity (r = -0.234, p = 0.0001). Regression analysis showed that living environment (rural area), low education level, low cognition level and increased CMP intensity significantly predicted body awareness. CONCLUSIONS: The results obtained from this study indicate that cognitive impairment and pain should be reduced by improving body awareness among older adults. That is why health professionals should evaluate all related factors affecting body awareness before planning the most suitable rehabilitation program.

The Turkish version of the Neck Bournemouth Questionnaire in patients with chronic neck pain: a cultural adaptation, reliability, and validity study.

INTRODUCTION: The cultural adaptation of a self-report measurement in different languages is important for developing common strategies for evaluation and treatment. The Neck Bournemouth Questionnaire (NBQ), which was developed to evaluate patients with neck pain, was adapted from the Bournemouth Questionnaire in accordance with the International Classification of Functioning, Disability and Health (ICF) categories. The aim of this study was to conduct the Turkish cultural adaptation, validity and reliability study of the NBQ. MATERIAL AND METHODS: The study included 119 patients (93 females, 26 males; mean age: 37.2 ±11.8 years) with chronic nonspecific neck pain. The NBQ, Neck Disability Index (NDI) and Nottingham Health Profile (NHP) questionnaires were administered to all the subjects. Test-retest reliability (intraclass correlation coefficient) and the internal consistency (Cronbach's α) were the methods used for the reliability study. The relationship between NBQ, NDI and NHP was investigated for concurrent validity. Exploratory and confirmatory factor analysis was used for construct validity. RESULTS: The Neck Bournemouth Questionnaire showed good internal consistency (α = 0.87). The test-retest reliability coefficient was 0.913 (95% CI: 0.875-0.940). The correlations between NBQ and NDI and NHP were significant (p < 0.05). The questionnaire was found to have one factor and the explained variance was 59.084% as a result of factor analysis. CONCLUSIONS: The Neck Bournemouth Questionnaire is a valid and reliable scale for patients with chronic neck pain in the Turkish population.

Effectiveness of matrix-rhythm therapy on increased muscle tone, balance and gait parameters in stroke survivors: a single-blinded, randomized, controlled clinical trial.

This study was conducted to investigate the effectiveness of Matrix rhythm therapy (MRT) on muscle tone, balance and gait parameters in stroke survivors. Thirty stroke individuals randomly assigned to study and control group received combining BT&MRT, and BT, respectively. This study was a single-blinded (assessor-blind), randomized controlled trial. A total of 30 stroke individuals with spastic hemiparesis (n = 30) aged between 20-65 years were included. The study group received combining BT and MRT on trunk and the affected lower limb. The control group received only BT. Participants in both groups were received therapy for 4 weeks, 3 days/week. The outcome measures were Modified Ashworth Scale (MAS), goniometric measurements (ROM), Single Leg Stance Test of the BESTest Balance Evaluation System, Timed "Get Up & Go" Test of the BESTest and BTS G-Walk Gait-Analysis System. Spasticity intensity, ROM, static/dynamic balance tests' scores, gait velocity, cadence, and pelvic movement symmetries improved in study group (p < 0.05).In the control group, only dynamic balance improved after the treatment program(p < 0.05). Significant improvements were found in terms of spasticity intensity, ROM of knee and ankle joints, static/dynamic balance, gait velocity and cadence in favor of the study group (p < 0.05). This study gives preliminary evidence that adding MRT to BT may be beneficial in improving balance and gait by regulating muscle tone in the affected lower limb of stroke patients with spastic hemiparesis. The study was retrospectively registered at Clinical Trials.gov (ID: NCT04213417; URL: www.clinicaltrials.gov ).

Validity and reliability of the Body Awareness Questionnaire in patients with non-specific chronic low back pain.

This study was conducted to determine the validity and reliability of the Body Awareness Questionnaire (BAQ) in patients with non-specific chronic low back pain. A total of 180 participants (96 women, 84 men), aged 21-64 years, with non-specific chronic low back pain were enrolled from June to December 2019. Sociodemographic features were collected. The pain intensity using the Visual Analog Scale, the disability status due to low back pain with the Oswestry Disability Index (ODI), the body awareness level using the BAQ, and self-esteem using the Rosenberg Self-Esteem Scale (RSES) were assessed. Test-retest reliability was assessed by intraclass correlation coefficients in patients 7 days apart. The mean age of the study subjects was 42.14 ± 13.27 years. The scale was found to be reliable in patients experiencing non-specific chronic low back pain. The Cronbach's alpha reliability coefficient was 0.767. The internal consistency ranged from 0.718 to 1.00 in the items. Intraclass correlation coefficients of items ranged from 0.560 to 1.000. Intraclass correlation coefficient of BAQ total score was found to be 0.786 (p = 0.000) in test-retest results. The scores of RSES were compared in order to assess the concurrent validity of BAQ. The concurrent validity analyses showed that the BAQ and RSES were significantly correlated (r = 0.188; p = 0.012). The BAQ is a valid and reliable scale for determining body awareness status in patients with non-specific chronic low back pain.

Assessment of the musculoskeletal performance with squat tests and performance-oriented measurements in older adults.

BACKGROUND: Balance and mobility impairments, declined musculoskeletal strength and performance, limited range of motion, and poor flexibility are fairly common among older adults. OBJECTIVES: To determine the lower extremity muscle force and to verify the correlation with the gait characteristics and balance in community dwelling older adults. METHODS: Seventy-five adults with a mean age of 75.07 ± 6.28 years were included in the study. All participants were evaluated with the following tests: half squat (HS), decline squat (DS), foot print analysis (step length, step wide, stride length, walking velocity and cadence) and Tinetti Performance Oriented Mobility Assessment (POMA). RESULTS: HS and DS test scores were significantly correlated with Tinetti Balance and Gait Assessment scores and gait characteristics, except step wide (p< 0.01). The results of this study showed that the participants who have higher scores in the squat tests, showed higher scores in terms of POMA (p< 0.01). CONCLUSION: Appropriate and direct assessment of lower limb power and performance in balance and gait tests should be done to identify functioning of the older adults. Half and eccentric decline squat tests used in this study were useful, cheap and easy. The squat tests can be used to determine the relationship between balance and gait characteristics, in addition to predicting the musculoskeletal performance in older adults.

Validity and reliability of the unsupported upper-limb exercise test in individuals with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease which affects the performance of the upper extremities. There is no method to evaluate the specific upper extremity endurance of individuals with this disease. The unsupported upper-limb exercise test (UULEX) is a performance test that evaluates upper extremity performance (functionality and endurance). AIM: The aim of this study was to examine the reliability and validity of UULEX and the minimal detectable change (MDC) in individuals with RA. METHODS AND MATERIALS: The study included 71 patients (15 male, 56 female) with a mean age of 52.15 ± 10.11 years. The intraclass correlation coefficient (ICC) was used to assess the reliability of UULEX. MDC estimates were calculated using baseline data. Correlations of UULEX with the Disability of Arm, Shoulder and Hand Questionnaire (DASH), Health Assessment Questionnaire (HAQ), 30-second push-up test and 6 pegboard ring test (6PBRT) were assessed for concurrent validity. RESULTS: The level, weight and duration scores of the UULEX test were found to be excellent for intra-rater reliability (ICC = 0.922, 0.960, 0.958). Intra-rater MDC values were determined to be 0.35, 2.04, and 0.80 seconds, respectively. Moderate-excellent correlations were found between UULEX and DASH, HAQ, 30-second push-up test and 6PBRT (P < .05). CONCLUSION: The results of this study showed that UULEX test is a valid and reliable method for the assessment of upper extremity performance in individuals with RA.

Effect of proprioceptive training on balance in patients with chronic neck pain.

OBJECTIVES: The aim of this randomized controlled study was to investigate the effect of proprioceptive training on balance in patients with chronic neck pain (CNP). METHODS: Forty patients participating in the study were randomly divided into study and control groups. Both of the groups underwent conventional physical therapy; additionally, the study group was rehabilitated with gaze direction recognition exercise (GDRE) for proprioceptive training. Exercises were performed during 3 weeks with five sessions per week. Pain intensity [visual analog scale (VAS)], neck disability [Neck Disability Index (NDI)], and balance [four step square test (FSST), single leg balance test (SLBT) with eyes opened and closed] assessments were conducted in the patients before and after the treatment and 3 weeks after the last session. RESULTS: No differences were observed between the groups in terms of pre-treatment measurements. There was a statistically significant decrease in VAS scores in both groups compared with pre-treatment conditions (p<0.05). In addition, whereas a statistically significant improvement in the study group's NDI, FSST, and SLBT with eyes opened and closed scores was observed after the treatment, pre- and post-treatment results were similar in the control group (p>0.05). CONCLUSION: Proprioceptive training should be included in physiotherapy programs to improve balance; it decreases the disability level in patients with CNP.

Comparison of musculoskeletal pain distribution, quality of life and hopelessness level in mothers with disabled children in different ambulation levels.

OBJECTIVE: The aim of this study was to compare the musculoskeletal pain distribution, quality of life, and the hopelessness level in mothers with disabled children in different ambulation levels. METHODS: This study included a total of 177 mothers (mean age: 36.1 ± 6.5 years) of children with disabilities. The mothers were divided into 3 different groups according to the ambulation level of their disabled children: Ambulatory children (Group 1), partially ambulatory children (Group 2) and non-ambulatory children (Group 3). Musculoskeletal pain distribution (body diagram) and pain intensity (The Visual Analogue Scale), four quality of life parameters (The Centers for Disease Control and Prevention Health-Related Quality of Life -4 Questionnaire) and hopelessness level (Beck Hopelessness Scale) were evaluated in all mothers. RESULTS: The results of our study showed that musculoskeletal pain was most common (79.1%) in the mothers of disabled children. The frequency and severity of back, shoulder and elbow pain in the mothers, number of activity limitation days and hopelessness level were found to increase significantly as the ambulation level in the child decreased (p< 0.05). CONCLUSIONS: The risk of musculoskeletal pain, participation in daily life and hopelessness level in the mothers increased as the ambulation level of the disabled children decreased.

Effectiveness of Neuro-Developmental Treatment (Bobath Concept) on postural control and balance in Cerebral Palsied children.

BACKGROUND AND OBJECTIVE: The aim of this study was to show the effects of an 8-week Neurodevelopmental Treatment based posture and balance training on postural control and balance in diparetic and hemiparetic Cerebral Palsied children (CPC). METHODS: Fifteen CPC (aged 5-15 yrs) were recruited from Denizli Yagmur Çocuklari Rehabilitation Centre. Gross Motor Function Classification System, Gross Motor Function Measure, 1-Min Walking Test, Modified Timed Up and Go Test, Paediatric Balance Scale, Functional Independence Measure for Children and Seated Postural Control Measure were used for assessment before and after treatment. An 8-week NDT based posture and balance training was applied to the CPC in one session (60-min) 2 days in a week. RESULTS: After the treatment program, all participants showed statistically significant improvements in terms of gross motor function (p< 0.05). They also showed statistically significant improvements about balance abilities and independence in terms of daily living activities (p< 0.05). Seated Postural Control Measure scores increased after the treatment program (p< 0.05). CONCLUSIONS: The results of this study indicate that an 8-week Neurodevelopmental Treatment based posture and balance training is an effective approach in order to improve functional motor level and functional independency by improving postural control and balance in diparetic and hemiparetic CPC.

Investigation of the relationship between kinesiophobia, physical activity level and quality of life in patients with chronic low back pain1.

OBJECTIVE: The aim of our study is to examine the relationship between kinesiophobia (fear of movement), physical activity level and quality of life. METHODS: In this study, we assessed 112 patients consulting for low back pain (LBP) of ≥ 3 month's duration. We used Visual Analog Scale (VAS) for pain intensity, the International Physical Activity Questionnaire (IPAQ) for physical activity level, Tampa Kinesiophobia Scale for perception of kinesiophobia, Oswestry Disability Index for disability status of low back. RESULTS: The results of this study, there was no statistically significant correlation between International Physical Activity Questionnaire, duration of pain, intensity of pain at rest and Tampa Kinesiophobia Scale (p> 0.05). It was found a statistically significant correlation between pain intensity at activity (p= 0.009), disability level (p= 0.000) and Tampa Kinesiophobia Scale. Tampa Kinesiophobia Scale were highly negative correlated with sub-scale of SF-36 Quality of Life Index (general health, physical function, social status, bodily pain, role limitations due to physical health) (p= 0.000). CONCLUSION: The kinesiophobia adversely affect the quality of life limiting the physical activity status of patients with chronic low back pain.

Applying the International Classification of Functioning, Disability, and Health in children with low vision: differences between raters.

BACKGROUND/AIM: This study was conducted to analyze the agreement between International Classification of Functioning, Disability, and Health (ICF) raters and to show its applicability in children with low vision. MATERIALS AND METHODS: Twenty children (mean age: 11.70 ± 1.92 years) were included. To evaluate the independency of the sample, the Northwick Park Activities Daily Living questionnaire was used. The Low Vision Quality of Life Scale was used to evaluate quality of life. An ICF core set was developed to be used in this study. The core set consisted of 13 items for body functions, 3 items for body structures, 36 items for activity and participation, and 12 items for environmental factors. RESULTS: High agreement was found between two raters in terms of subparameters of the ICF core set for activity and participation (r = 0.880, P = 0.000). CONCLUSION: The findings indicate that the raters showed strong agreement in terms of the ICF core set used in this study. This shows that the core set can be used to evaluate activity and participation of children with low vision.

Comparison of pain intensity, emotional status and disability level in patients with chronic neck and low back pain.

OBJECTIVE: This study was planned to compare of pain, emotional status and disability level in patients with chronic neck pain and low back pain. METHODS: In this study, fifty patients with chronic low back pain (Group I) and fifty patients with chronic neck pain (Group II) at least 6 months were evaluated. A Visual Analog Scale was used to describe pain intensity. To determine emotional status of the subjects, the Beck Depression Scale was used The Oswestry Disability Index and the Neck Disability Index were used to evaluate disability level. RESULTS: The mean age of the patients with low back pain and neck pain were 39.70 ± 9.71 years, 45.44 ± 10.39 years, respectively. It was not found a significant difference between in low back pain (Group I) and neck pain (Group II) in results of pain intensity (p= 0.286) and pain duration (p= 0.382). It was found a significant difference between group I and group II in results of emotional status (p= 0.000) and disability level (p= 0.000). The emotional status and disability level scores were found highest in patient's with low back pain. CONCLUSION: Chronic low back pain is affect in patients than chronic neck pain as a emotional status and disability level.

Effects of pulsed electromagnetic field and swimming exercise on rats with experimental sciatic nerve injury.

[Purpose] The current study aimed to reveal the therapeutic effects of a pulsed electromagnetic field and swimming exercises on rats with experimental sciatic nerve injury, which was induced with crush-type neuropathy model damage, using electrophysiological methods. [Subjects] In the current study, the sample consisted of 28 adult male Wistar albino rats. [Methods] The rats were randomized into four groups (n=7). Swimming exercise and PEMF (2 Hz and 0.3 MT) were applied one hour a day, five days a week, for four weeks. Electroneuromyographic (ENMG) measurements were taken on day 7. [Results] When the data were evaluated, it was found that the 4 weeks of PEMF and swimming exercises led to an increase in motor conduction rates and a decrease in latency values, but the changes were not significant in comparison with the control and injury groups. The compound muscle action potential (CMAP) values of the left leg were lower in weeks 2, 3, and 4 in the swimming exercise group in comparison with the control group, although for the PEMF group, the CMAP values of the left leg reached the level observed in the control group beginning in week 3. [Conclusion] PEMF and swimming exercise made positive contributions to nerve regeneration after week 1, and regeneration was enhanced.

The effects of brain stimulation of subthalamic nucleus surgery on gait and balance performance in Parkinson disease. A pilot study.

INTRODUCTION: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by tremor, rigidity and bradykinesia. Gait and postural difficulties supersede tremor, rigidity and bradykinesia as drivers of disease burden in patients with advanced PD. The aim of this study was to describe the effects of deep brain stimulation of the subthalamic nucleus on gait ability and balance performance in patients with PD. MATERIAL AND METHODS: We studied 19 consecutive patients who underwent bilateral stimulation of the subthalamic nucleus. Patients were evaluated preoperatively and at the 5(th) day and 6(th) month after surgery. Timed Up and Go Test, 12 m Walking Test, Chair Stand Test and Berg Balance Scale (BBS) were used to assess mobility and balance performance. Unified Parkinson's Disease Rating Scale (UPDRS III) and Hoehn and Yahr Scale were also used. RESULTS: All the patients' mobility ability and balance performance improved after surgery (p < 0.05). At the 6th month after surgery, the Timed Up and Go Test scores were decreased from 56.05 ±42.52 to 21.47 ±20.36, the 12 m Walking Test scores were decreased from 100.44 ±66.44 to 28.84 ±19.79, the Chair Stand Test scores were increased from 4.00 ±4.66 to 11.68 ±4.43 and the BBS score was increased from 12.84 ±6.89 to 38.89 ±8.79. UPDRS total scores were significantly improved 6 months after surgery (p < 0.001). UPDRS total scores were decreased from 98.26 ±37.69 to 39.36 ±18.85. The Hoehn and Yahr Scale score was significantly decreased after surgery (p < 0.05). CONCLUSIONS: Surgical therapy is an effective treatment to improve gait ability and balance performance in Parkinson's patients.

How does pain localization affect physical functioning, emotional status and independency in older adults with chronic musculoskeletal pain?

[Purpose] The aim of this study was to show the impact of chronic musculoskeletal pain of the spinal column and lower extremities on physical functioning, emotional status, and independency in older adults. [Subjects] In this cross-sectional study, 258 older adults (mean age, 71.98±5.86 years, 50.8% males, 49.2% females) living in their own residences were evaluated. [Methods] Pain intensity was analyzed using a visual analogue scale. Physical functioning was evaluated with the Timed Up and Go Test (TUG) and a Six-Minute Walk Test. The Geriatric Depression Scale was used to determine emotional status. The independency in daily living of the participants was evaluated using the Lawton Brody IADL Scale. All participants were divided into two groups in accordance with the pain localization: the (1) spinal pain and (2) lower extremity pain groups. [Results] When the pain scores were compared, no significant differences between the two groups were found. The same results were found in terms of TUG scores. The spinal pain group had higher scores in terms of aerobic capacity than the lower extremity pain group. [Conclusion] The results indicate that chronic musculoskeletal pain in the lower extremities decreased aerobic capacity much more than spinal pain in older adults.

Expectations from Rehabilitation of Children with Cerebral Palsy: The Agreement between the Physiotherapists and Mothers.

[Purpose] The aim of this study was to examine the agreement between physiotherapists (PTs) and mothers (Ms) about the treatment of children with cerebral palsy (CP) who received treatment in special education and rehabilitation centers. [Subjects] Ms of 130 children with CP (75 boys, 55 girls) and 130 PTs who applied rehabilitation programs were interviewed. [Methods] Clinical types and gross motor function levels of the children were recorded. A questionnaire consisting of 6 open-ended questions was used to describe the expectations and views of the PTs and Ms about the physiotherapy and rehabilitation programs for the children. [Results] The mean age of the children was 89.80±52.05 months. The mean treatment period for the children was 73.62±42.11 months. The mean age of the mothers was 35.47±5.79 years, and the mean age of the PTs was 28.07±7.28 years. We found a statistically moderate level of agreement between the PTs and Ms regarding the appropriateness of the treatment provided to the children. There was statistically insignificant agreement regarding the applied treatment methods and the appropriateness of the applied rehabilitation programs. [Conclusion] We believe that the views and expectations of the Ms should be taken into account by the PTs when preparing a treatment program for children with CP.

Normal hip, knee and ankle range of motion in the Turkish population.

OBJECTIVE: The aim of this study was to ascertain the effect of gender and cultural habits on hip, knee and ankle range of motion (ROM) and to determine the differences between the ROM of right and left side symmetric joints of the lower extremities. METHODS: The study included 987 (513 males and 474 females) healthy volunteers. Individuals with a history of illness, prior surgery or trauma involving any joint of either lower extremity were excluded from the study. The terminology and techniques of measurements used were those suggested by the American Academy of Orthopedic Surgeons. RESULTS: Left side passive hip flexion and active internal rotation was higher than the right side. Passive flexion of the hip joint was higher in male subjects and internal and external rotation was higher in female subjects. In the knee joint, passive extension was higher in males. Plantarflexion and inversion of the ankle joint were higher in male subjects and dorsiflexion and eversion were higher in female subjects. The differences were considered insignificant in clinical terms as all were less than 3 degrees. CONCLUSION: There is no clinically significantly difference between right and left side hip, knee and ankle joints ROM. Gender and cultural habits do not appear to have clinically significantly effects on lower extremity joint ROM.

The impact of chronic low back pain on physical performance, fear avoidance beliefs, and depressive symptoms: A comparative study on Turkish elderly population.

OBJECTIVES: The purposes of this study were: (1) to show the impact of chronic low back pain (CLBP) on physical performance, fear avoidance behavior and depressive symptoms in older adults; (2) to describe the relationships between outcome measurements obtained in this study. METHODOLOGY: Ninety-one participants with or without chronic low back pain were included in this study. Only four tests in the Back Performance Scale were used to assess the physical performance of the participants. A Fear Avoidance Beliefs Questionnaire related to physical activity and the Geriatric Depression Scale were also used to examine each subject. RESULTS: The level of performance shown by elderly adults with low back pain was worse than elders without low back pain in the sock test and the pick-up test (p < 0.05). Little correlation between the finger-to-floor test and fear avoidance behaviour related to physical activity was found (p < 0.05). There was little/poor correlation between all performance tests and depressive symptoms (p < 0.05). CONCLUSIONS: The findings indicate that CLBP decreases physical performance, but increases fear avoidance behavior and depressive symptoms in elderly adults. At the same time, it was determined that performance level of elderly adults with back pain was related especially with depressive symptoms.