Evaluating the impact of COVID-19 on vertigo and hearing impairment: A post-recovery analysis.

The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has manifested with respiratory symptoms and a spectrum of extra-pulmonary complications. Emerging evidence suggests potential impacts on the auditory and vestibular systems, but the extent and nature of these effects in recovered individuals remain unclear. This study aimed to investigate the prevalence and severity of vertigo and hearing impairment in individuals who have recovered from COVID-19 and to identify potential risk factors associated with these sensory symptoms. A cohort of 250 recovered COVID-19 patients was assessed. Standardized questionnaires, including the Dizziness Handicap Inventory and the Vertigo Symptom Scale, were used to evaluate vertigo. Hearing assessment was conducted using pure-tone audiometry, speech audiometry, tympanometry, and oto-acoustic emissions testing. Logistic regression analysis was performed to assess the association between COVID-19 severity and the occurrence of sensory symptoms, controlling for confounding variables such as age and comorbidities. Of the participants, 10% reported vertigo, varying severity. Hearing assessments revealed that most participants had normal hearing, with an average speech discrimination score of 94.6. Logistic regression analysis indicated a significant association between severe COVID-19 and an increased likelihood of vertigo (OR 2.11, 95% CI 1.02-4.35, P = .043) and hearing impairment (OR 3.29, 95% CI 1.60-6.78, P = .002). This study suggests a significant association between COVID-19 severity and vertigo and hearing impairment prevalence. The findings underscore the importance of sensory symptom assessment in the post-recovery phase of COVID-19, highlighting the need for comprehensive healthcare approaches to manage long-term sequelae.

Pediatric Acute Mastoiditis in Saudi Arabia: Demographic Insights, Clinical Profiles, and Prognostic Factors.

Acute mastoiditis, a complication of otitis media, poses significant challenges in diagnosis and treatment, particularly in pediatric populations. This study aims to comprehensively evaluate the demographic characteristics, clinical features, and prognostic factors associated with acute mastoiditis in pediatric patients in Saudi Arabia. Analysis of a multicenter dataset was conducted to assess demographic variables, symptomatology, disease course, and predictors of acute mastoiditis in pediatric patients. Significant associations were found between demographic variables (age group, gender, nationality) and acute mastoiditis risk. Symptomatology analysis revealed consistent frequencies of otalgia across age groups and genders. Disease course analysis highlighted a mean duration from symptom onset to diagnosis of 14.11 days, with frequent complications like mastoid abscess and meningitis. Predictor identification identified symptoms (otalgia, fever, otorrhea), duration of illness, and complications as significant predictors of disease severity. These findings contribute valuable insights into the epidemiology and clinical management of acute mastoiditis, informing targeted interventions to improve patient outcomes.

A Comprehensive Evaluation of AI-Assisted Diagnostic Tools in ENT Medicine: Insights and Perspectives from Healthcare Professionals.

The integration of Artificial Intelligence (AI) into healthcare has the potential to revolutionize medical diagnostics, particularly in specialized fields such as Ear, Nose, and Throat (ENT) medicine. However, the successful adoption of AI-assisted diagnostic tools in ENT practice depends on the understanding of various factors; these include influences on their effectiveness and acceptance among healthcare professionals. This cross-sectional study aimed to assess the usability and integration of AI tools in ENT practice, determine the clinical impact and accuracy of AI-assisted diagnostics in ENT, measure the trust and confidence of ENT professionals in AI tools, gauge the overall satisfaction and outlook on the future of AI in ENT diagnostics, and identify challenges, limitations, and areas for improvement in AI-assisted ENT diagnostics. A structured online questionnaire was distributed to 600 certified ENT professionals with at least one year of experience in the field. The questionnaire assessed participants' familiarity with AI tools, usability, clinical impact, trust, satisfaction, and identified challenges. A total of 458 respondents completed the questionnaire, resulting in a response rate of 91.7%. The majority of respondents reported familiarity with AI tools (60.7%) and perceived them as generally usable and clinically impactful. However, challenges such as integration with existing systems, user-friendliness, accuracy, and cost were identified. Trust and satisfaction levels varied among participants, with concerns regarding data privacy and support. Geographic and practice setting differences influenced perceptions and experiences. The study highlights the diverse perceptions and experiences of ENT professionals regarding AI-assisted diagnostics. While there is general enthusiasm for these tools, challenges related to integration, usability, trust, and cost need to be addressed for their widespread adoption. These findings provide valuable insights for developers, policymakers, and healthcare providers aiming to enhance the role of AI in ENT practice.

Balancing act: Unraveling the link between muscle strength, proprioception, and stability in unilateral hip osteoarthritis.

The objectives of this study are to compare hip muscle strength, hip joint proprioception, and functional balance between individuals with unilateral hip OA and asymptomatic individuals and to examine the relationships among these variables in the hip OA population. In a prospective cross-sectional study, 122 participants (unilateral Hip OA: n = 56, asymptomatic: n = 56) were assessed at the CAMS/KKU musculoskeletal Physical Therapy laboratory. Ethical standards were upheld throughout the research, with informed consent obtained. Hip muscle strength was measured using a hand-held dynamometer, hip joint proprioception with a digital inclinometer, and functional balance using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test. Hip OA individuals exhibited significantly lower muscle strength and proprioceptive accuracy, and poorer functional balance than controls (p < 0.003). Correlation analyses revealed a positive correlation between muscle strength and BBS scores (r = 0.38 to 0.42) and a negative correlation with TUG test times (r = -0.36 to -0.41). Hip joint reposition sense (JRS) in flexion showed a negative correlation with balance (r = -0.46), while JRS in abduction was positively correlated (r = 0.46). The study highlights the clinical importance of muscle strength and proprioception in functional balance among individuals with unilateral hip OA. The results support the incorporation of muscle strengthening and proprioceptive training in interventions to improve balance and mobility in this population.

Prevalence of cardiovascular events among patients with type 2 diabetes in the west region of Saudi Arabia.

Background: Diabetes mellitus (DM) remains a concern globally and particularly in Saudi Arabia, where its prevalence is continuously increasing among the Saudi population. DM is known to increase the risk of cardiovascular disease (CVD), which can progress significantly if DM is poorly controlled. Aim: Determine the prevalence of cardiovascular events among patients with type 2 diabetes (T2DM) in the west region of Saudi Arabia, and additionally the use of antidiabetic agents with cardiovascular benefits (ADc) in T2DM patients with cardiovascular events (CVEs). Method: A retrospective cohort study was conducted among all patients with T2DM who presented to the diabetic center of Prince Mansour Military Hospital (PMMH), Taif city, between the 1st of January and 30th of June 2021. Data extracted from patient medical records included demographics, home medications, medications used to treat T2DM, lab results, and ECG data. Descriptive statistics were used to analyze and compare the results. The study was approved by the Research and Ethics Committee of Medical Services General Directorate, Armed Forces Hospitals, Taif region. Result: A total of 349 patients with T2DM were recruited and included in the final analysis. Of this study population, 132 patients had experienced at least one cardiovascular event while 54 were considered to be at risk of future cardiovascular events due to having risk factors for cardiovascular diseases above and beyond the presence of diabetes. A subgroup analysis was conducted to examine HbA1c% among all groups; interestingly, all were similar, with p > 0.05. Of all diabetic patients with CVEs, only 34.8 % were on at least one anti-diabetic agent known to have cardiovascular benefits; the remainder were on other anti-diabetic agents. A similar analysis was conducted on diabetic patients with risk of CVEs, of which only 13 % were on at least one anti-diabetic agent having known cardiovascular benefits; the remainder were on other anti-diabetic agents. Conclusion: The prevalence of CVEs among T2DM patients in Saudi Arabia is very close to the global prevalence, but ADcs are underutilized in this population. Tighter glycemic control is warranted to help rein in and reduce the CVE incidence among patients with T2DM.

Combined Effects of Strengthening and Proprioceptive Training on Stability, Balance, and Proprioception Among Subjects with Chronic Ankle Instability in Different Age Groups: Evaluation of Clinical Outcome Measures.

BACKGROUND: Lateral ankle sprains are among the common injuries in the physically active population in different age groups and progress to chronic ankle instability (CAI). Accordingly, the current study assesses the effectiveness of strengthening and proprioceptive training programs on proprioception and balance in those suffering from CAI. DESIGN: Quasi-experimental design. METHODS: Thirty-six individuals with self-reported CAI were assigned into three groups based on age: group 1 (23 ± 1.84), group 2 (35.80 ± 1.68), group 3 (44.25 ± 4.86), then performed strength and balance exercises for 6 weeks. The study furthermore measured pre- and post-training of joint position sense (JPS), static balance, dynamic balance, chronic ankle instability tool (CAIT) and lower extremity functional scale (LEFS). RESULTS: Statistical analysis showed significant improvement (P < 0.01) on all outcome measures among all groups. In group 1, mainly the plantar flexion JPS improved to 3.7°, while in group 2 and group 3 the eversion JPS improved to 3.1° and 1.78° (P < 0.01). With reference to static balance with one's eyes closed and eyes open, the improvement in group 1 was 4.46, 11.05 s, group 2 was 2.23, 7.85 s and group 3 was 1.69, 4.68 s. In relation to dynamic balance, the development in group 1 was 5.85 cm, while group 2 was 4.71 cm and group 3 was 2.49 cm. Moreover, both CAIT and LEFS showed significant differences (P < 0.01) after training. CONCLUSION: This study found that combined strengthening and proprioceptive training effectively improves stability, proprioception, balance, and self-reported functional outcomes.

Foot Posture Index Reference Values among Young Adults in Saudi Arabia and Their Association with Anthropometric Determinants, Balance, Functional Mobility, and Hypermobility.

BACKGROUND: The foot posture index (FPI) is a valid, reliable, and multidimensional method for determining foot posture in a wide range of clinical settings. To date, no normative data of healthy young adults in Saudi Arabia have been available for comparison and reference. Hence, this study is aimed at establishing the FPI reference values, gender, and side differences of FPI and their association with anthropometric determinants, balance, functional mobility, and hypermobility. METHODS: FPI was assessed in 581 (291 men and 290 women) healthy young adults aged 18-25 years. The FPI range was obtained for both feet as the sum of the scores (-2, -1, 0, 1, and 2) given to each criterion: (-1 to -12) supinated foot, (0 to +5) neutral foot, and (+6 to +12) pronated foot. The study furthermore assessed the balance using a near tandem balance test, functional mobility by stair ascent and descent test, and joint hypermobility via the Beighton scale. RESULTS: The average FPI score was 2.76 ± 5.23 for all subjects, 2.98 ± 5.02 for men and 2.55 ± 5.43 for women. Neutral foot posture was most frequent in this study (52.9%). A higher proportion of women had pronated (21.0%) and supinated (11.7%) feet than men which were 16.8% and 10.3%, respectively. This study also confirmed that side differences were found to be significant (p value < 0.001), whereas gender differences were significant only in the normal, pronated, and supinated foot groups. CONCLUSION: The most common foot posture in both genders was ranged from neutral to slight pronation. We also found a correlation between balance with FPI in the supinated and hypersupinated foot groups, functional mobility with FPI of pronated and supinated foot groups, and joint hypermobility with FPI of the hyperpronated foot group.

Effect of Disability-Specific Education on Student Attitudes Toward People With Disabilities.

Attitude is a multidimensional and complex notion that considerably empowers or limits the major life activities of humans. Health professionals' attitudes toward people with disabilities are significant factors in the rehabilitation process. Soon after completing their coursework, the final-year students from health science meet the patients and rehabilitate them. This study accordingly aims to assess the attitude toward disability among final-year health science students before and after administering a disability-specific structured teaching program. A total of 243 final-year undergraduate health science students from medical, dental, physical therapy, pharmacy, laboratory sciences, radiology sciences, and nursing aged between 21 and 27 years participated in this study. This work employed the Scale of Attitudes Toward Disabled Persons (SADP) to measure attitudes among participants. The mean pre- and posttest SADP scores were 83.59 ± 15.45 and 107.83 ± 62, respectively (p < .001). Students from medical, dental, physical therapy, and nursing showed significant positive attitudes toward disability compared with other students, whereas college students in the final year of health science generally had poor attitudes toward disability. The results indicate that the disability-specific structured teaching program is effective in improving the attitude toward disability among final-year health science students. Accordingly, the authors recommend modifying the disability-related content in the health sciences curriculum.

Development of Arabic Version of Vestibular Disorders Activities of Daily Living Scale: Cross-Cultural Adaptation and Assessment of Psychometric Properties.

BACKGROUND The vestibular disorders activities of daily living (VADL) scale is a valid and reliable scale created 2 decades ago to specifically test the functional problems of patients with vestibular disorders. Since its development, the VADL has been cross-culturally validated and adapted in Spanish, Portuguese, Persian, and Turkish languages. A version is not yet available in Arabic, the primary language of more than 400 million people worldwide. This study aimed to translate the patient-reported VADL into Arabic and test its psychometric properties such as content validity, internal consistency, and test-retest reliability. MATERIAL AND METHODS Our study was conducted in 2 parts. In the first part, we translated and adapted the VADL from English into Arabic with expert input. In the second part, we tested the translated scale content validity by consulting 6 experts in the field. We assessed the scale's internal consistency and test-retest reliability by administering it twice to 31 subjects with vestibular disorders with a 1-week interval between the 2 measurements. RESULTS Translation, adaptation, and pretesting were successful, and we were able to create the VADL-A, an Arabic version of the VADL. The content validity of the VADL-A was 0.96, internal consistency was 0.96, and the test-retest reliability was 0.93. CONCLUSIONS We successfully translated, adapted, and created the VADL-A. Our preliminary testing of basic psychometric properties indicated that the scale has excellent content validity, internal consistency, and test-retest reliability.

Intra-rater and inter-rater reliability of neutral and target lumbar positioning tests in subjects with and without non-specific lower back pain.

BACKGROUND: Proprioception, one's sense of movement and position, is a common term used in back rehabilitation. Kinesthetic rehabilitation may be useful in managing lower back pain; however, reliable measures are required to quantify lumbar proprioception sense. OBJECTIVE: To investigate intrarater and interrater reliability of neutral lumbar positioning (NLP) and target lumbar positioning (TLP) tests and compare the position sense errors in subjects with non-specific low back pain and healthy controls. METHODS: Intrarater (between-day) and interrater (within-day) reliability of NLP and TLP tests were assessed in 30 subjects with low back pain and 30 healthy subjects using a digital inclinometer. NLP is evaluated when the subject is repositioned to neutral from flexion, while TLP is evaluated in lumbar flexion, by bending laterally left and right. RESULTS: Intrarater reliability for NLP tests had ICC values of 0.85 and 0.89 and TLP tests had 0.78 and 0.92. Likewise, interrater reliability for NLP had ICC values of 0.75 and 0.85, and for the TLP test, the interrater reliability had 0.78 and 0.93. Subjects with back pain had significantly larger neutral and target lumbar proprioceptive errors compared to healthy controls (p< 0.001). CONCLUSIONS: Intrarater and interrater reliability showed good agreement for both NLP and TLP tests of lumbar proprioception. Subjects with nonspecific low back pain have impaired lumbar proprioceptive sense.

Effectiveness of Low-Frequency Stimulation in Proprioceptive Neuromuscular Facilitation Techniques for Post Ankle Sprain Balance and Proprioception in Adults: A Randomized Controlled Trial.

Stretching is an important part of post ankle sprain rehabilitation, as well as an effective exercise for improving general ankle-joint performance. But the combination of stretching alongside low-frequency stimulation has not yet been extensively studied. Therefore, the purpose of the present randomized controlled trial was to compare the combined effects of low-frequency transcutaneous electrical nerve stimulation (TENS) with proprioceptive neuromuscular facilitation (PNF) on strength, balance, and proprioception among individuals with post ankle sprain. Sixty male subjects with lateral ankle sprain were selected and randomly allocated to three groups: group 1, group 2, and the control group (CG). Subjects in group 1 received the PNF stretching technique combined with TENS. TENS stimulation was provided using two electrodes placed 5 cm apart directly on the triceps sural muscle of the affected leg and a biphasic current with a symmetrical waveform at 50 Hz for 15 seconds, tuned for a 3-second ramp up time and a 30-second rest time with a 250-microsecond pulse duration was given with PNF stretching. Subjects in group 2 received the PNF stretching technique alone. Both group 1 and group 2 received these treatments for 4 weeks (4 days/week); follow-up assessments were administered in the third and fifth weeks. CG received no treatment; outcome measures alone were assessed. Outcome measures comprised pain, balance, flexibility, proprioception, range of motion, muscle strength, and functional limitation. A mixed-model ANOVA showed significant interaction (time and group) and the time effect for all the outcome measures (p ≤ 0.05). Group 1 (PNF-TENS) showed significant improvement for all the outcome variables compared to the other groups. The present study showed PNF stretching combined with TENS for the triceps sural muscle to trigger muscle contraction during the muscle contraction phase of the PNF stretch, compared against PNF stretching alone, produced significant improvements in ankle function for post ankle sprain subjects.

The effect of Kinesio taping on cervical proprioception in athletes with mechanical neck pain-a placebo-controlled trial.

BACKGROUND: Neck proprioception is critical in maintaining neuromuscular control in and around cervical joints. Kinesio™ tape may assist in rehabilitating joint position sense. The current study compares Kinesio™ tape's effects versus a placebo on proprioception in college athletes experiencing mechanical neck pain. METHODS: This study randomized sixty-six athletes with mechanical neck pain into a Kinesio™ tape group (n = 33, mean age = 22.73 years) or placebo group (n = 33, mean age = 23.15 years). The Kinesio™ tape group received standard Kinesio™ taping applications with appropriate tension, while the placebo group received taping applications without tension. OUTCOME MEASURES: The study assessed cervical joint position errors with a cervical range-of-motion (CROM) device, pain intensity with a visual analog scale (VAS), and neck functional disability with a neck disability index (NDI). It tested joint position errors through cervical flexion, extension, rotation left, and rotation right. All the outcome measures were recorded at the baseline and twice more following 3 and 7 days of tape applications. RESULTS: Multivariate analysis of variance test demonstrated a significant reduction in joint position errors in flexion, extension and right rotation following 3 days and 7 days of tape application among the Kinesio™ tape group. There was a significant main effect of time (P < 0.05) for joint position errors in left rotation and VAS after 3 days (p > 0.05), NDI after 3 and 7 days (p > 0.05). CONCLUSIONS: The Kinesio™ tape application after 3 and 7 days effectively decreased joint position errors and neck pain intensity in mechanical neck pain participants compared to placebo, while there was no difference between both groups in the NDI. TRIAL REGISTRATION: ( CTRI/2011/07/001925 ). This study was retrospectively registered on the 27th July, 2011. LEVEL OF EVIDENCE: IIB.

The immediate and short-term effects of dynamic taping on pain, endurance, disability, mobility and kinesiophobia in individuals with chronic non-specific low back pain: A randomized controlled trial.

Evidence suggests that the application of Kinesio Tape (KT) on patients with chronic non-specific low back pain (CNLBP) is inconclusive. Dynamic tape (DT) is a relatively new treatment technique, which is increasingly being used as an adjunctive method to treat musculoskeletal problems. To our knowledge, no study has investigated the application of DT in individuals with CNLBP. To compare the immediate and short-term effects of DT versus KT and no tape among patients with CNLBP on pain, endurance, disability, mobility, and kinesiophobia. Forty-five patients with CNLBP were randomly assigned to 1 of 3 groups. Outcomes were measured at baseline, immediately, and on the third day post-application of tapes. The primary outcomes of pain, endurance, and disability were measured through the visual analog scale (VAS), Biering-Sorensen test, and Oswestry disability index (ODI), respectively. Secondary outcome measures of mobility and kinesiophobia were measured using the modified-modified Schober test and the Tampa Scale of Kinesiophobia, respectively. No significant immediate and short-term differences were found between DT and KT in pain, disability, mobility, and kinesiophobia. Improved back extensor endurance was observed for the DT group than KT (p = 0.023) and control group (p = 0.006). The application of DT may result in improvements only in back extensor endurance among individuals with CNLBP. This finding suggests that DT controls the processes that lead to back muscle fatigue.

Cardiorespiratory Fitness as a Correlate of Cardiovascular, Anthropometric, and Physical Risk Factors: Using the Ruffier Test as a Template.

Background: Assessment of cardiorespiratory fitness (CRF) is a standard procedure in routine clinical practices. Early identification of risk factors through screening is vital in the fight against chronic diseases. Evaluation of CRF can impose cost implications in the clinical setting; thus, a simple and easy-to-use test is to be advocated. The Ruffier test is a simple test that can assess CRF, and it is necessary to find whether the test reflects the effects of compounding factors in CRF. Objective: This study aims to determine the association between CRF (estimated VO2max) with cardiovascular, anthropometric, and physical risk factors using the Ruffier test. Methods: A cross-sectional study with a sample of 52 male participants was conducted. Before the Ruffier test, each participant's body weight, height, waist circumference, skinfold thickness, thigh length, lower-limb length, thigh circumference, physical activity, blood pressure, smoking, diabetes, and pulmonary functions were recorded, and these factors correlated with CRF. Results: There was a significant inverse relationship found between the estimated VO2max and age, height, body weight, body mass index, waist circumference, a sum of skinfold, fat percentage, thigh length, lower-limb length, thigh circumference, smoking, blood pressure, heart rates, and diabetes (p < 0.05). A significant positive correlation was found between the estimated VO2max with physical activity and respiratory functions (p < 0.05). In the multivariable model, body weight and resting heart rate were significantly inversely associated with the estimated VO2max(p < 0.05). Conclusion: Using the Ruffier test, various risk factors of CRF are correlated with the estimated VO2max. This test reflects the effects of different compounding factors on CRF; therefore, it can be used in routine clinical practices to identify the risk factors early.

Reliability of Chest Wall Mobility and Its Correlation with Lung Functions in Healthy Nonsmokers, Healthy Smokers, and Patients with COPD.

Chest wall circumference measurements are common evaluation methods in clinical settings by therapists in order to obtain chest wall mobility. Previous published results have been conflicting, and there is a lot of variability in the method of testing, which needs testing in different conditions. Seventy subjects (25 healthy nonsmokers, 25 healthy smokers, and 20 COPD) aged between 18 and 70 years participated in the study. Upper and lower chest expansion (CE) measurements (2 levels) are performed with cloth inch tape. Intrarater (between day) and interrater (within-day) reliability of CE measurements was evaluated by two examiners. Lung function parameters, forced expiratory volume in first second (FEV1), forced vital capacity (FVC), FEV1/FVC, and vital capacity (VC) were measured using a computerized spirometer (Spiro lab 3). The intrarater reliability for upper and lower CE showed very good agreement with intraclass correlation (ICC) values between 0.90 and 0.93 for upper CE and 0.85 to 0.86 for lower CE. The interrater reliability for upper CE showed good to very good agreement with ICC values ranging between 0.78 and 0.83, and lower CE showed very good agreement with ICC values ranging between 0.82 and 0.84. Upper and lower CE showed a significant and positive correlation with all lung function parameters, with strong correlation with FEV1/FVC (r = 0.68). Upper and lower CE measurements with inch tape showed good intra- and interrater reliability and reproducibility in healthy nonsmokers, healthy smokers, and COPD subjects. Compared to upper, lower CE correlated well with the lung function parameters. Upper and lower CE may be more useful in clinical practice to evaluate chest mobility and to give indirect information on lung function but interpretation with caution is required when considering implementation into clinical setting.

Seroprevalence of Human Cytomegalovirus in Pregnant Women in the Asir Region, Kingdom of Saudi Arabia.

BACKGROUND: Human cytomegalovirus (HCMV) infection spreads easily by interpersonal contact. OBJECTIVE: This study determined the prevalence of seropositivity of cytomegalovirus immunoglobulin G (IgG) in the Asir Region, Kingdom of Saudi Arabia. METHODS: The study evaluated the seropositivity for cytomegalovirus-specific IgG in 460 females. Collected samples were processed and tested using enzyme-linked immunosorbent assay and specific HCMV IgG. RESULTS: The study showed that all the respondents aged 15-20 years were seropositive for the HCMV. HCMV seropositive status was recorded in 99.2% of the older patients (>40 years of age). In the remaining age groups, the rate of seropositivity ranged from 95.7 (age range 20-25 years) to 98.9% (age range 30 years). CONCLUSIONS: In all age groups of females tested, the prevalence of seropositive for HCMV was high, i.e., in the range of 95.7-100%.

Determining the reliability of craniocervical flexion test in asymptomatic individuals.

BACKGROUND: The inter-rater reliability of the craniocervical flexion test (CCFT) has not been established. OBJECTIVE: To investigate the intra-rater and inter-rater reliabilities of the CCFT in asymptomatic subjects. METHODS: Sixty asymptomatic subjects were randomly selected for the study. The CCFT was measured on each subject by two testers for inter-rater reliability and by one of the testers after a gap of seven days for the intra-rater reliability. Before testing, the participants were trained for the movement and compensations were corrected. RESULTS: The CCFT has high inter-rater reliability (intra-class correlation coefficient = 0.907, standard error of mean = 0.735) and high intra-rater reliability (intra-class correlation coefficient = 0.986, standard error of mean = 0.287). A Bland & Altman limits of agreement analysis has confirmed the high inter- and intra-rater reliabilities of the test. CONCLUSION: The CCFT has high inter-rater and intra-rater reliabilities in asymptomatic subjects.

Influence of chronic neck pain on cervical joint position error (JPE): Comparison between young and elderly subjects.

BACKGROUND: Evaluation of cervical joint position sense in subjects with chronic neck pain has gained importance in recent times. Different authors have established increased joint position error (JPE) in subjects with acute neck pain. However, there is a paucity of studies to establish the influence of chronic neck pain on cervical JPE. OBJECTIVE: The objective of the study was to understand the influence of chronic neck pain on cervical JPE, and to examine the differences in cervical JPE between young and elderly subjects with chronic neck pain. METHODS: Forty-two chronic neck pain patients (mean age 47.4) were compared for cervical JPE with 42 age-matched healthy subjects (mean age 47.8), using a digital inclinometer. The cervical JPE were measured in flexion, extension, and rotation in right and left movement directions. RESULTS: The comparison of JPE showed significantly larger errors in subjects with chronic neck pain when compared to healthy subjects (p< 0.001). The errors were larger in all of the movement directions tested. Comparison between young and older subjects with chronic neck pain revealed no significant differences (P> 0.05) in cervical JPE. CONCLUSIONS: Cervical joint position sense is impaired in subjects with chronic neck pain.

Hand grip strength determination for healthy males in Saudi Arabia: A study of the relationship with age, body mass index, hand length and forearm circumference using a hand-held dynamometer.

Objectives To determine whether age, body mass index (BMI), hand length and forearm circumference were predictive of hand grip strength in healthy Saudi Arabian adult males. Methods This cross-sectional descriptive study recruited healthy adult male volunteers. Their anthropometric characteristics including age, BMI, hand length and forearm circumference were measured using routine techniques. Hand grip strength was assessed using a Jamar® Hydraulic Hand Dynamometer. The data were analysed using Pearson correlation coefficient ( r) as well as by a stepwise multiple linear regression analysis. Results The study included 116 healthy males who satisfied the inclusion criteria. A Pearson correlation coefficient matrix demonstrated that all the four measures, age, BMI, hand length and forearm circumference, were significantly correlated with hand grip strength. Age had an inverse correlation with hand grip strength. The anthropometric measures of hand length, age and forearm circumference accounted for 44.2% (R2 0.442) of the variation of the hand grip strength. Conclusion Hand length, age and forearm circumference significantly impacted on hand grip strength in Saudi Arabian healthy adult males.

Association of age on cervical joint position error.

This study quantitatively assesses the association between age and cervical joint position error (JPE) and compares JPE between young and older asymptomatic subjects. Subjects (n = 230) ranging in age from 17 to 70 years volunteered to participate in the study. Cervical JPE was measured for all subjects with the active movement angle reproduction test in degrees using a digital inclinometer; testing was done in all cervical movement directions (flexion, extension, side-bending right and left, rotation right and left). Subjects were divided into two groups: young (n = 169, mean age: 32.4 years; range 17-49 years) and older (n = 61, mean age: 61.9 years; range 50-70 years) and JPE was compared. Pearson's product-moment correlation coefficients were significant and positive for the association of age on cervical JPE in flexion (r = 0.71), extension (r = 0.81), side-bending right (r = 0.77), side-bending left (r = 0.84), rotation right (r = 0.84), and rotation left (r = 0.84). JPE was significantly larger (for all movement directions) in the older subject group (P < 0.001). Advancing age was significantly associated with the increasing cervical JPE and older subjects showed greater errors when compared to younger subjects.