The effects of clinical pilates training on disease-specific indices, core stability, and balance in patients with ankylosing spondylitis.

OBJECTIVE: To assess the effects of clinical Pilates training on disease-specific indices, core stability, and balance in ankylosing spondylitis (AS) patients. METHODS: AS patients were randomly assigned to either the Pilates group (PG) or control group (CG). The PG participated in Pilates training 3 times a week for 8 weeks. Patients in the CG were instructed to follow a home exercise program for 8 weeks. Assessments were performed before and after the interventions. BASDAI, BASFI, BASMI, and the AS Quality of Life (ASqOL) questionnaire were used were used to evaluate disease activity, functionality spinal mobility and quality of life respectively. Static core endurance was assessed with trunk flexor, extensor endurance, and lateral bridge tests, while dynamic core endurance was assessed using modified sit-up test. Balance was evaluated with bilateral and unilateral stance static postural stability (PS), bilateral stance dynamic PS and limits of stability (LOS) tests using the Biodex Balance System. RESULTS: Twenty-one patients in the PG and 21 patients in the CG completed the study. PG showed statistically significant improvements in BASDAI, BASFI, BASMI, and ASQoL scores, all core endurance tests, and dynamic PS and LOS results. The CG demonstrated significant improvement only in flexor endurance and LOS results. Post-intervention BASDAI, BASMI, and all core endurance tests were significantly better in the PG than in the CG (p < 0.05). CONCLUSION: Pilates training has positive effects on disease activity and functional capacity, spinal mobility, core endurance, balance, and quality of life in AS patients. GOV IDENTIFIER: NCT04292028.

Do mobility exercises in different environments have different effects in ankylosing spondylitis?

AIMS: Ankylosing spondylitis (AS) reduces spinal mobility, which results in structural and functional impairments. Pulmonary problems eventually occur in most AS patients due to interstitial lung disease or as a result of chest wall abnormalities. The aim of this study was to evaluate the effects on pulmonary functions and disease related scales of aquatic and land-based multidimensional functional mobility exercises on pulmonary functions in patients with AS. METHODS: In this randomized controlled study, 57 patients with definite AS according to the modified New York criteria were randomly allocated to an aquatic (AG), land-based (LG), or home (HG) exercise group and performed multidimensional mobility exercise sessions twice a week for 8 weeks. The Bath indices were used to measure disease activity, functional limitation, and spinal mobility, and a 10-cm visual analog scale assessed pain during activity and at rest. Pulmonary function tests, maximal inspiratory mouth pressure (MIP), and maximal expiratory mouth pressure (MEP) were measured before and after the intervention. The study is registered at ClinicalTrials.gov, number NCT03667625 (27/08/2018). RESULTS: Forty-six patients (30.4% female) with a mean age of 42.0 years completed the study. Multidimensional exercises improved disease-related symptoms such as pain, spinal mobility, and functionality, but there were no significant changes in HG. Patients in AG showed significant improvements in peak expiratory flow (p=0.004), vital capacity (p=0.025), maximum voluntary ventilation (p=0.006), and MIP (p=0.001), while those in LG showed significant increases in forced expiratory volume during the first second to forced vital capacity (FEV1/FVC) ratio (p=0.049), peak expiratory flow (p=0.007), and maximum voluntary ventilation (p=0.004). There were no significant changes in HG. CONCLUSIONS: Multidimensional functional mobility exercises performed either in water or on land are important in the management of pulmonary manifestations of AS.

Determination of an Optimal Frailty Cutoff Score of Tilburg Frailty Indicator and Frailty Associated Factors in Community-Dwelling Turkish Older Adults.

BACKGROUND: Frailty is a multidimensional and dynamic state that has adverse physical, psychological, and social outcomes. The Tilburg Frailty Indicator (TFI) has the most robust evidence of reliability and validity for assessing frailty. However, the characteristics of TFI have not been investigated in detail. This study aimed to set a cutoff score for frailty and evaluate frailty-associated factors in community-dwelling older adults. METHODS: This cross-sectional study assessed frailty according to both the TFI and Fried criteria. The Geriatric Depression Scale, basic and instrumental activities of daily living, and Hospital Anxiety and Depression Scale-Anxiety subscale were also implemented. RESULTS: This study included 166 older adults. The area under the receiver operating characteristic curve was 0.735 (95% confidence interval, 0.648-0.823). A TFI cutoff point of 8, showed a sensitivity of 60% and specificity of 72.5% for the prediction of frailty (p<0.05). Frailty according to the TFI was more associated with the physical and psychological parameters, while frailty according to the Fried score was more closely related to the physical parameters (p<0.05). CONCLUSION: The results of this study suggested an optimal TFI cutoff score of 8 as a frailty instrument in community-dwelling older adults. Additionally, the TFI included physical, psychological, and social aspects, thereby providing a multidimensional evaluation of frailty.

Effects of aquatic exercises on postural control and hand function in Multiple Sclerosis: Halliwick versus Aquatic Plyometric Exercises: a randomised trial.

OBJECTIVES: Postural control and hand dexterity are significantly impaired in people with multiple sclerosis (pwMS). Aquatic interventions may have additional benefits in the treatment of pwMS. The purpose of this study is to compare the effects of two different aquatic exercises on postural control and hand function. METHODS: Thirty pwMS, relapsing-remitting type were randomly divided into a Halliwick (Hallw) and an Aquatic Plyometric Exercise (APE) group. The Limits of Stability test was used to evaluate postural control using the Biodex Balance System. The Nine-Hole Peg Test was used to evaluate hand dexterity. Both exercise interventions were performed twice a week for 8 weeks, in a pool with a depth of 120 cm and water temperature of 30-31°C. RESULTS: Limits of stability improved significantly in both groups (p<0.05) and Hallw group completed the test in a significantly shorter time (p<0.05). Hand dexterity improved significantly in both groups (p<0.01). Following intergroup analysis, Hallw group showed significantly higher improvement in hand dexterity and overall limits of stability test score (p<0.05). CONCLUSIONS: This study provides evidence that both Halliwick and APE are effective to treat balance and hand dexterity. This paper is the first evidence on APE for pwMS and showed that it is safe and improved trunk control and hand dexterity.

The Effects Of Myofascial Release Technique Combined With Core Stabilization Exercise In Elderly With Non-Specific Low Back Pain: A Randomized Controlled, Single-Blind Study.

PURPOSE: To evaluate the effects of Myofascial Release Technique (MRT) with a roller massager combined with core stabilization exercises (CSE) in elderly with non-specific low back pain (NSLBP). PATIENTS AND METHODS: A total of forty-five participants were randomly divided into two groups (CSE and CSE+MRT). A core stabilization exercise program was applied for the participants in the CSE group for 3 days per week for a total of 6 weeks. In addition to the core stabilization exercises, myofascial relaxation technique with a roller massager was performed for 3 days per week for 6 weeks for the participants in the CSE+MRT group. Participants were assessed in terms of pain, low back disability, lower body flexibility, kinesiophobia, core stability endurance, spinal mobility, gait characteristics and quality of life both pre- and post-treatment. RESULTS: It was found that the improvement in core stability endurance (p=0.031) and spinal mobility (in the sagittal plane) (p=0.022) was greater in the CSE+MRT group compared to the CSE group. There was no significant difference between the two groups in terms of pain, low back disability, lower body flexibility, kinesiophobia, gait characteristics and quality of life (p>0.05). CONCLUSION: The current study suggests that myofascial release technique with a roller massager combined with core stabilization exercises can be a better choice in the treatment of NSLBP in elderly. CLINICALTRIALSGOV IDENTIFIER: NCT03898089.

Core stability and balance in patients with ankylosing spondylitis.

The main purpose of this study was to compare core stability and balance between ankylosing spondylitis (AS) patients and healthy controls. AS patients diagnosed according to the Modified New York criteria and healthy age- and sex-matched controls were included in the study. Clinical status of AS patients was assessed using Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Spinal Mobility Index (BASMI). For evaluation of core stability, static and dynamic core endurance and hip strength were assessed. Trunk flexor and extensor endurance, lateral side bridge tests for static core endurance; modified sit-up test for dynamic core endurance were used. Hip strength was measured with a hand-held dynamometer. Biodex Balance System was used to assess static and dynamic balance. Bilateral standing static and dynamic postural stability, single leg standing postural stability and limits of stability test results were recorded. 64 AS patients (40 male, 24 female) and 64 healthy controls (39 male, 25 female) were assessed. Static and dynamic core endurance test results, hip abductor strength were significantly higher in control group than AS group (p < 0.05). Static postural stability and left leg postural stability test results were significantly better in control group than AS group (p < 0.05). Overall, forward, backward, and right, limits of stability test results were significantly higher in control group (p < 0.05). The results of our study demonstrate that AS has negative effects on core stability and balance. It would be beneficial to add core stability and balance training to AS patients' rehabilitation program.

Effects of Aqua-Lymphatic Therapy on Lower Extremity Lymphedema: A Randomized Controlled Study.

BACKGROUND: The purpose of this study is to investigate the effects of the aqua-lymphatic therapy (ALT) on unilateral lower extremity lymphedema in the maintenance phase. MATERIALS AND METHODS: This is a randomized controlled trial with a blinded assessor. The study was completed with 30 ALT and 27 control group participants. Foot volume was assessed by a water displacement device, limb volume by circumference measurements, functional capacity by a 6-minute walk test, quality of life by Short Form-36, and social appearance by Social Appearance Anxiety Scale and hopeless by Beck Hopeless Scale. The ALT and the control group had group sessions twice in a week for 6 weeks directed by a physiotherapist. RESULTS: The mean age of ALT patients was 44.50 ± 13.69 years, whereas that of the control patients was 47.66 ± 16.82 years. After the intervention, both groups' measurement of edema, functional level, quality of life, as well as social and future concerns improved significantly but this improvement was higher in the ALT group (p < 0.05, p ≤ 0.001). CONCLUSIONS: ALT was found to be a safe effective method for unilateral lower extremity lymphedema patients during the maintenance phase of Complex Decongestive Physiotherapy.

Cross-cultural adaptation and validation of the Turkish version of the pain catastrophizing scale among patients with ankylosing spondylitis.

[Purpose] This study describes the cultural adaptation, validation, and reliability of the Turkish version of the Pain Catastrophizing Scale in patients with ankylosing spondylitis. [Methods] The validity of the Turkish version of the Pain Catastrophizing Scale was assessed by evaluating data quality (missing data and floor and ceiling effects), principal components analysis, internal consistency (Cronbach's alpha), and construct validity (Spearman's rho). Reproducibility analyses included standard measurement error, minimum detectable change, limits of agreement, and intraclass correlation coefficients. [Results] Sixty-four adult patients with ankylosing spondylitis with a mean age of 42.2 years completed the study. Factor analysis revealed that all questionnaire items could be grouped into two factors. Excellent internal consistency was found, with a Chronbach's alpha value of 0.95. Reliability analyses showed an intraclass correlation coefficient (95% confidence interval) of 0.96 for the total score. There was a low correlation coefficient between the Turkish version of the Pain Catastrophizing Scale and body mass index, pain levels at rest and during activity, health-related quality of life, and fear and avoidance behaviors. [Conclusion] The results of this study indicate that the Turkish version of the Pain Catastrophizing Scale is a valid and reliable clinical and research tool for patients with ankylosing spondylitis.