Neural Respiratory Drive During Different Dyspnea Relief Positions and Breathing Exercises in Individuals With COPD.

BACKGROUND: When the work load of the respiratory muscles increases and/or their capacity decreases in individuals with COPD, respiratory muscle activation increases to maintain gas exchange and respiratory mechanics, and perception of dyspnea occurs. The present study aimed to compare diaphragm and accessory respiratory muscle activation during normal breathing, pursed-lip breathing, and breathing control in different dyspnea relief positions, supine and side lying. METHODS: A cross-sectional study design was used. Sixteen individuals with COPD age between 40-75 y were included. Pulmonary function was evaluated by spirometry, muscle activation by surface electromyography, and dyspnea by the modified Borg scale. Muscle activation was measured in the diaphragm, scalene, sternocleidomastoid, and parasternal muscles. The evaluation was made in the dyspnea relief positions (sitting leaning forward, sitting leaning forward at a table, leaning forward with back against a wall, standing leaning forward, and high lying), seated erect, supine, and side lying. RESULTS: There were significant differences between the 8 positions (P < .001). There was no significant difference in muscle activation between sitting leaning forward and sitting leaning forward at a table position with analyzing post hoc test results (P > .99 for each muscle). However, muscle activation was lower in these 2 positions than in the other positions (P < .001 for each muscle). Muscle activation was greater in the supine position than in the other positions (P < .001 for each muscle). No difference was observed in muscle activation between the seated erect, leaning forward with back against a wall, standing leaning forward, high-lying, or side-lying positions (P > .05 for each muscle with a minimum P value of .09). CONCLUSIONS: The use of sitting leaning forward and sitting leaning forward at a table positions together with breathing control may help people with COPD to achieve more effective dyspnea relief and greater energy efficiency.

Effects of structured training on spinal posture and selective motor control in children with unilateral spastic cerebral palsy.

BACKGROUND: Children with Unilateral Spastic Cerebral Palsy (USCP) have an asymmetrical postural pattern. Although functional limitations are less, deteriorations in spinal posture are observed. RESEARCH QUESTION: What is the effect of structured training on spinal posture and selective motor control of upper extremity? METHODS: Forty five children with USCP were included in the study. Participants were children ages 3-18 with GMFCS levels 1 and 2. Spinal posture and mobility was assessed by Spinal Mouse (SM) and the Spinal Alignment and Range of Motion Measure (SAROMM), and selective motor control of upper extremity was evaluated by the Selective Control of the Upper Extremity Scale (SCUES). Children were divided into two groups: structured training group (STG) (n = 22) and conventional physiotherapy group (CPG) (n = 23). Groups received treatment sessions lasting 45 min, 2 days a week for 8 weeks. Evaluations were made baseline and after treatment. RESULTS: In sagittal plane, there was a significant decrease in the degree of thoracic kyphosis after treatment in the STG (p = 0.004). A significant difference was found in total spine angulation (p = 0.015) and mobility from flexion to extension in the STG group. There was a difference in total spine angulation (p = 0.014) in the CPG group, but no difference in spinal mobility. Post-training differences were found in thoracic angulation (p = 0.006) and lateral flexion mobility to the affected side in the STG in thoracic (p = 0.020), lumbar (p = 0.035) and total spine (p = 0.008) in the frontal plane. When SCUES-shoulder, elbow, wrist, total scores changes was significant in CPG (p < 0.001), SCUES-forearm (p = 0.002) and fingers (p = 0.007) changes was significant in STG. SIGNIFICANCE: This study showed that although children with USCP are more mildly affected, there are adverse effects on their selective motor control and spinal posture. This study reveals the contribution of structured training in terms of selective movement, spinal smoothness and mobility in children.

The effect of modified constraint-induced movement therapy in children with hemiparetic cerebral palsy. Consecutive or intermittent days?

PURPOSE: To investigate effect of modified constraint-induced movement therapy (mCIMT) administered on consecutive or intermittent days on upper limb function in children with hemiparetic cerebral palsy (CP). MATERIALS AND METHODS: Thirty-three children (age range 5-18 y) with hemiparetic CP separated into three groups: consecutive mCIMT group (n = 11), intermittent mCIMT group (n = 11), control group (n = 11). The outcome measures consist of Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Pediatric Balance Scale (PBS), Modified Tardieu Scale (MTS), Jebsen-Taylor Hand Function Test (JTHFT), Children's Hand Use Experience Questionnaire (CHEQ), Abilhand Kids Questionnaire, surface Electromyography (sEMG). The evaluations were made baseline, 10 days after, 5 weeks after the treatment. RESULTS: Improvements were achieved in all groups. The use of upper extremities in daily life activities (p < 0.01), speed of performing the activities (p < 0.001), grasping efficiency (p < 0.001), the amount of a decrease in the children's sense of discomfort while performing activities (p < 0.001) on the affected side in both mCIMT groups were better than the control group. The gain levels in mCIMT groups were similar (p > 0.05). CONCLUSIONS: Administration of mCIMT on intermittent days facilitate the adaptation of a child, it was concluded to be a more tolerable method and could be more effective.Implications for rehabilitationmCIMT is more effective than low-dose conventional therapeutic interventions in improving paretic upper limb functions in children with hemiparetic CP.The application of mCIMT in the child's natural environment increases the motivation to participate in the treatment.The application of mCIMT on intermittent days will be more easily tolerated in paediatric individuals and will increase participation in the treatment.

Effects of working years in cold environment on the musculoskeletal system and carpal tunnel symptoms.

OBJECTIVES: Musculoskeletal disorders are the most common work-related health problems. The risk of musculoskeletal disorders is increased by working in a cold environment. The present study aims to investigate the effects of working years on the body. METHODS: We examined the effects of the working years on the musculoskeletal system and carpal tunnel syndrome symptoms of the individuals who were engaged in cutting, shredding, packaging, bagging and transportation operations at 9 degrees and lower ambient temperatures in a poultry factory in Turkey. Nordic Musculoskeletal Questionnaire (NMQ) was used to evaluate musculoskeletal symptoms of the individuals. Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was used to investigate the carpal tunnel symptoms. Individuals grouped according to their total working years in a cold factory setting. Groups were formed as less than two years, between two and five years, between six and nine years, and ten years or more. RESULTS: This study showed that the increase in working years in a cold factory setting might lead to a feeling of pain and discomfort in various regions of the body, disrupt ordinary works due to the pain felt (p<0.05). This study also showed that the severity of the symptoms felt because carpal tunnel syndrome worsened, especially when an individual has been working for more than ten years in cold. CONCLUSION: Working in the cold for a long time may result in long-term health effects on the human body.

Assessment of quadriceps angle in children aged between 2 and 8 years.

AIM: The quadriceps angle is the angle between the line drawn from the spina iliaca anterior superior to the midpoint of the patella, and the line drawn from the midpoint of the patella to the tuberositas tibiae. It is important for lower extremity posture. The aim of this study was to determine the normative quadriceps angle value by measurement, and to assess the probable effect of factors such as measurement position, age, sex, and presence of pes planus on these values. MATERIAL AND METHODS: A total of 599 children consisting of 296 (49.4%) girls and 303 (50.6%) boys aged between 2 and 8 years, were included in the study. The children were divided into three groups by age as 2-4 years, 4-6 years, and 6-8-years. After the children's demographic data were collected, the quadriceps angle was measured using an electronic goniometer. Pes planus was assessed by drawing the Feiss line. RESULTS: In bilateral measurement, it was found that the quadriceps angle decreased with age both in the supine and standing positions (p<0.05). It was observed that sex and presence of pes planus had no effect on the quadriceps angle independent from measurement positions (p>0.05). A low negative correlation was found between body mass index and the quadriceps angle in both measurement positions (p<0.05). CONCLUSION: It was found that positional changes and weight bearing on limbs did not cause any change in knee position in healthy children. We consider that the decrease in quadriceps angle in this age group is due to growth rate asymmetry between the femur shaft and pelvic diameter.

The Relationship Between Trunk Muscle Thickness and Static Postural Balance in Older Adults.

Trunk muscles are required for safety of movement in aging. The authors aimed to investigate the relationship between trunk muscle thickness and the static postural balance in older adults. A total of 31 females and 23 males with a mean age of 73.39 ± 6.09 completed the study. The thickness of the trunk muscles was determined with ultrasound imaging. Postural balance was assessed with force plate. There was a positive weak correlation between right and left upper rectus abdominis muscle thickness and anterior stability area (p < .05, r > .3). The negative and moderate correlation was determined between the left lower rectus abdominis and the perturbated stability sway value (p < .01, r > .5). The increase in trunk muscle thickness in older adults increases the postural stability area and decreases the postural sway especially in the mediolateral direction.

Assessment of Temporomandibular Joint Dysfunction in Patients with Stroke.

GOAL: The aim of this study was to assess temporomandibular joint dysfunction in patients with stroke. MATERIALS AND METHODS: Total of 100 participants, 50 healthy and 50 who had stroke, were recruited into this study. Digital caliper and algometer were used to assess temporomandibular joint range of motion and masticatory muscle pressure pain threshold. Labial commissure angle measurement was used for the assessment of facial paralysis severity. Fonseca questionnaire was used for temporomandibular joint dysfunction assessment and categorization. In addition, dominant mastication shift was measured by the question that asks the pre and poststroke dominant mastication side. FINDINGS: In intergroup comparison, significant decrease was found in all temporomandibular range of motion parameters in favor of stroke group (P < .05). Despite the fact that no significant difference was found between groups for the pain threshold in masticatory muscles except for middle part of the left temporalis muscle, values were higher in healthy group (P > .05). As a result of intergroup examination of labial commissure angle degree, Fonseca questionnaire score, it was found that labial commissure angle and Fonseca questionnaire scores were higher in stroke group (P < .05). Intragroup examination of patients with stroke showed that dominant mastication side shift was seen in patients with stroke (P < .05). CONCLUSION: It was concluded that, temporomandibular joint dysfunction prevalence was higher in stroke group compared with healthy group and use of modalities specific to temporomandibular joint dysfunction treatment would be beneficial.

An investigation of the relationship of drooling with nutrition and head control in individuals with quadriparetic cerebral palsy.

[Purpose] The aim of the present study was to investigate the relationship of drooling, nutrition, and head control in individuals with quadriparetic cerebral palsy. [Subjects and Methods] Fifty-six individuals between the ages 2 and 15 diagnosed with spastic quadriparetic cerebral palsy and their families/caretakers were included in the study. Drooling severity and frequency of individuals was evaluated by using the scale developed by Thomas-Stonell and Greenberg (Drooling Severity and Frequency Scale). Individuals having a drooling severity value of 1 were included in the not drooling group (group 2) (n=27). Individuals having a drooling severity of 2, 3, 4, or 5 were included in the drooling group (group 1) (n=29). The evaluations were applied to both groups. [Results] There were significant differences between the two groups in terms of gestational age, nutrition behavior, eating abilities, head control, gagging, nutritional status (inadequate nutrition, normal nutrition, over weight-obese), and low weight. It was established that as head control increased, drooling severity diminished, and as drooling severity increased, BMI index decreased. Independence of eating ability was found to be greater in the group having better drooling control. [Conclusion] In the present study, it was determined that drooling control affected nutritional functions and that drooling control was affected by head control.