Translation, cross cultural adaptation, and validation of Arabic version of Interview administered version of Work Rehabilitation Questionnaire (WORQ).

BACKGROUND: Accurate assessment tools for work rehabilitation are essential in healthcare settings. Adapting the Work Rehabilitation Questionnaire (WORQ) to Arabic-speaking populations ensures effective evaluation and intervention for individuals with work-related disabilities. OBJECTIVE: To execute a cross-cultural adaptation of interview-administered version Work Rehabilitation Questionnaire -Arabic (WORQ-A) and assess the psychometric properties of WORQ-A in patients with musculoskeletal problems. METHODS: WORQ is mainly intended to assess the work functioning of persons who are involved in vocational rehabilitation. Psychometric properties were scrutinized in the outpatient rehabilitation center. Test-retest reliability was examined with intraclass correlation coefficient (ICC), and internal consistency was evaluated with Cronbach's alpha. The usability of WORQ-A was established in 46 patients with musculoskeletal problems. RESULTS: WORQ-A exhibited exceptional internal consistency (0.93) and a great test-retest reliability (0.87). Regarding usability, the ability to understand the questions and answer choices was established as good. Five percent of the participants encountered minor difficulties with certain words, while the majority found it quite straightforward to choose the correct answers. CONCLUSIONS: The WORQ-A is an effective, consistent, and very easy to administer questionnaire to assess the work-related functions assumed in our study context and the individualities of the sample.

Oblique, forward, and lateral directions reach test distances in young adults, and concurrent validity of these tests with the center of pressure excursion in assessing the limits of stability.

Limits of stability is required to perform functional activities and other advanced tasks of life without losing balance, and assessment of limits of stability is essential in clinical practice. Forward, Lateral, and Oblique direction reach tests are clinical balance tests that assess limits of stability, and these reach distances in various directions may be symmetrical or asymmetrical. The aim was to establish the symmetry between various reach distances on three reach tests and to establish the concurrent validity of oblique, forward, and lateral direction reach test distances with limits of stability measured by the Iso Free machine of TecnoBody company. METHODS: The measurements of oblique, forward, and lateral reach tests and limits of stability excursions of center of pressure were taken in eight directions on Iso Free machine of Techno Body in fifty typical college-going young adults who were recruited through convenience sampling. Pearson correlation test was used to find the relationship between forward, lateral, and oblique direction reaches and limits of stability in forward, lateral, and oblique directions. Regression analysis was used to find the factors influencing the forward, lateral, and oblique reach tests. RESULTS: The reach distances were symmetrical, and out of the three tests, the lateral and oblique direction reach tests have a moderate positive correlation with limits of stability test in lateral and oblique directions with an r-value of 0.569 (p < 0.001) and 0.50 (p < 0.001) respectively. A Significant standardized beta value of 0.49 (p < 0.05) for the oblique direction reach test with total stability limits. CONCLUSIONS: The oblique and lateral direction reach tests are correlated with their respective center of pressure excursion. However, the oblique direction reach test moderately correlated with the total limits of stability scores. Forward reach distances were more in number followed by oblique and lateral reach distances among young Saudi adults.

Caregiver's Quality of Life Among Children with Cerebral Palsy in the Kingdom of Saudi Arabia, and Various Influencing Factors: A Single Cohort Study.

Purpose: Quality of life (QOL) among disabled children and their caregivers is an important concern in healthcare. We aim to evaluate the quality of life among caregivers of children with cerebral palsy and to observe the effects of various demographic factors and affected child-related factors on caregivers' quality of life. Patients and Methods: After ethical approval and written consent was obtained from the participants. One hundred six caregivers of children with cerebral palsy from the Asir region were recruited for the study. Caregivers provided details, including their demographic characteristics, social factors, and information regarding their affected children regarding age, gender, mobility levels, etc. They also completed the Arabic version of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire for assessing their QOL. Results: All the caregivers were women; their mean age was 40.38 years and SD7.09, and the overall QOL mean and standard deviations were 66.38 ± 12.88. There was a moderately significant correlation between total QOL in comparison with caregivers' educational level and mobility capacity, with R values of 0.54 (p<0.001) and 0.62 (p<0.001), respectively. Conclusion: All the subdomains of WHOQOL-BREF were found to be very closely related to the total scores for QOL. The caregivers of children with cerebral palsy had better QOL scores than the cutoff scores proposed in the WHOQOL-BREF scale. Factors such as increased mobility and education of the affected child contributed to better total QOL scores.

Investigating Knee Joint Proprioception and Its Impact on Limits of Stability Using Dynamic Posturography in Individuals with Bilateral Knee Osteoarthritis-A Cross-Sectional Study of Comparisons and Correlations.

(1) Background: Proprioception and limits of stability can significantly impact static and dynamic balance. Knee proprioception and limits of stability may be impaired in individuals with knee osteoarthritis (KOA). Impaired knee proprioception may impact the limits of stability, and understanding the associations between these factors is important for formulating treatment strategies in this population. The objectives of this study are to (a) compare the knee joint position error (JPE) and limits of stability between KOA and asymptomatic individuals and (b) assess the correlation between knee JPE and the limits of stability in KOA individuals. (2) Methods: This cross-sectional study included 50 individuals diagnosed with bilateral KOA and 50 asymptomatic individuals. Knee JPE was measured using a dual digital inclinometer at 25° and 45° of knee flexion (in the dominant and nondominant legs). The limits of stability variables, including reaction time (s), maximum excursion (%), and direction control (%), were evaluated using computerized dynamic posturography. (3) Results: The magnitude of the mean knee JPE is significantly larger in KOA individuals (p < 0.001) compared to asymptomatic individuals assessed at 25° and 45° of knee flexion in both the dominant and nondominant legs. The limits of stability test showed that KOA group individuals had a longer reaction time (1.64 ± 0.30 s) and reduced maximum excursion (4.37 ± 0.45) and direction control (78.42 ± 5.47) percentages compared to the asymptomatic group (reaction time = 0.89 ± 0.29, maximum excursion = 5.25 ± 1.34, direction control = 87.50 ± 4.49). Knee JPE showed moderate to strong correlations with the reaction time (r = 0.60 to 0.68, p < 0.001), maximum excursion (r = -0.28 to -0.38, p < 0.001) and direction control (r = -0.59 to -0.65, p < 0.001) parameters in the limits of stability test. (4) Conclusions: Knee proprioception and limits of stability are impaired in KOA individuals compared to asymptomatic individuals, and knee JPE showed significant relationships with the limits of stability variables. These factors and correlations may be considered when evaluating and developing treatment strategies for KOA patients.

The Mediation Effect of Pain on the Relationship between Kinesiophobia and Lumbar Joint Position Sense in Chronic Low Back Pain Individuals: A Cross-Sectional Study.

(1) Background: Fear of movement (kinesiophobia) and impaired lumbar joint position sense (LJPS) play a vital role in developing and maintaining non-specific chronic low back pain (CLBP). However, how kinesiophobia impacts LJPS is still being determined. The aims of this study are to (1) assess the correlation between kinesiophobia and LJPS in individuals with chronic low back pain; (2) compare LJPS between individuals with CLBP and those who are asymptomatic; and (3) evaluate if pain can mediate the relationship between kinesiophobia and LJPS in CLBP individuals. (2) Methods: Eighty-three individuals (mean age = 48.9 ± 7.5 years) with a diagnosis of CLBP and 95 asymptomatic individuals (mean age = 49.4 ± 7.0 years) were recruited into this cross-sectional study. Fear of movement in CLBP individuals was assessed using the Tampa Scale for Kinesiophobia (TSK). LJPS was determined using the active target repositioning technique using a dual-digital inclinometer. LJPS was evaluated in lumbar flexion, extension, and side-bending left and right directions, and the repositioning accuracy was determined in degrees using a dual digital inclinometer. (3) Results: Kinesiophobia showed a significant (p < 0.001) moderate positive correlation with LJPS (flexion: r = 0.51, extension: r = 0.41, side-bending left: r = 0.37 and side-bending right: r = 0.34). LJPS errors were larger in CLBP individuals compared to asymptomatic individuals (p < 0.05). Mediation analyses showed that pain significantly mediated the relationship between kinesiophobia and LJPS (p < 0.05) in CLBP individuals. (4) Conclusions: Kinesiophobia and LJPS were positively associated. LJPS is impaired in CLBP individuals compared to asymptomatic individuals. Pain may mediate adverse effects on LJPS. These factors must be taken into account when assessing and developing treatment plans for those with CLBP.

Association between Handgrip Strength, Skinfold Thickness, and Trunk Strength among University Students.

OBJECTIVES: The main goal was to explore the relationship between hand grip strength (HGS), the thickness of the skinfold at multiple sites, and the trunk flexor (TF) and extensor (TE) muscle strength among healthy participants. METHODS: We employed a cross-sectional design and randomly recruited 40 participants. Ultimately, only 39 participants were included. First, measurements for demographic and anthropometric variables were carried out. After that, the evaluation of hand grip strength and skinfold was performed. DATA ANALYSIS: Descriptive statistics were used to explore the amount of interaction between the smoking and nonsmoking groups, and a repeated measures analysis of variance was employed. Furthermore, associations between dependent and independent variables were discovered through a multiple linear regression model. RESULTS: The participants had a mean age of 21.59 ± 1.19 years. The results of the repeated measures analysis of variance validated an acceptable interaction between the trunk and hand grip strength at a significance level of p < 0.01, further emphasized by their moderate association (p < 0.05). Multiple regressions between TE, TF, the independent variables T score, height, and age were also significant (p < 0.05). CONCLUSIONS: The trunk muscle strength can be used as a health indicator for comprehensive evaluation. The present study also found a moderate relationship between hand grip strength, trunk strength, and T score.

Clinical Application of Rapid Upper Limb Assessment and Nordic Musculoskeletal Questionnaire in Work-Related Musculoskeletal Disorders: A Bibliometric Study.

Assessment of work-related musculoskeletal disorders (WMSDs) using the Rapid Upper Limb Assessment (RULA) and the Nordic Musculoskeletal Questionnaire (NMQ) has become widely accepted and reported in the literature. The objectives of this study are to (1) recognize and describe the topmost 50 cited scientific articles in WMSDs using the RULA and NMQ and (2) explore the factors that contribute to making an article influential. In this bibliometric study, we used the Web of Science and MEDLINE databases to identify the top 50 cited articles published from 1993 to 2022. The data collected were the title of the journal, number of citations, year of publication, type of the study, institution where the work was conducted, level of evidence, contribution of primary authors, and country of origin of the work. Our results showed that the top 50 cited articles were published between 1980 and 2010. The 2000s was the most valuable decade. Regarding journals, the Work journal had the highest number of articles concerning the use of RULA and NMQ in healthcare professionals. The maximum number of citations regarding RULA occurred in the Journal of Robotic Surgery (n = 50) and the maximum for NMQ occurred in the Journal of Safety Research (n = 106). Most articles originated from the United States, followed by England and the Netherlands. Eight authors had two publications published in the top 50 list. The majority of the topmost cited research articles were cross-sectional studies. Most of these studies were level III evidence. The bibliometric analysis from this study provides insights to researchers to choose the most appropriate and influential journal for submitting work on WMSDs.

Mediation Effect of Pain on the Relationship between Kinesiophobia and Postural Control: Comparison and Correlations in Individuals with Fibromyalgia Syndrome and Asymptomatic Individuals-A Cross-Sectional Study.

Background: Individuals with fibromyalgia syndrome (FM) usually present with a fear of movement (kinesiophobia), which causes their symptoms to be maintained and exacerbated. Kinesiophobia can significantly impact postural control; ascertaining their association is crucial in evaluating and managing individuals with FM. This study aims to (1) compare postural control between individuals with FM and asymptomatic individuals, (2) estimate the relationship between kinesiophobia and postural control in individuals with FM, and (3) evaluate whether pain intensity mediates the association between kinesiophobia and postural control in individuals with FM. Methods: This study enrolled 92 individuals (mean age: 51.52 ± 7.7 years) diagnosed with FM and 106 asymptomatic individuals (mean age: 50.47 ± 6.6 years). The examiners estimated the fear of movement and the intensity of pain utilizing the Tampa scale of kinesiophobia (TSK) scores and the visual analogue scale (VAS), respectively. The postural control variables included anteroposterior (A-P) sway in mm, medio-lateral (M-L) sway in mm, and ellipse area in mm2. Results: The individuals with FM had impaired postural control compared to the asymptomatic individuals (p < 0.001). Kinesiophobia exhibited mild-to-moderate correlations with the postural control variables (nondominant side: A-P sway: r = 0.48, M-L sway: r = 0.49, ellipse area: r = 0.43. Dominant side: A-P sway: r = 0.41, M-L sway: r = 0.33, ellipse area: r = 0.44). The pain intensity significantly mediated the relationship between kinesiophobia and postural control (p < 0.001). Conclusion: Kinesiophobia showed a significant positive relationship with postural control. The individuals with FM with higher TSK scores had decreased postural control. Pain intensity mediated the relationship between kinesiophobia and postural control. These factors must be considered when evaluating and formulating treatment strategies for people with FM.

Transcranial direct current stimulation (tDCS) effects on upper limb motor function in stroke: an overview review of the systematic reviews.

BACKGROUND: Stroke is the prime cause of disability in the elderly population. Transcranial direct current stimulation (tDCS) is an emerging noninvasive brain stimulation in rehabilitating upper limb function post-stroke. However, mixed evidence exists in the literature and ambiguous conclusions regarding the effect of tDCS on upper limb function. OBJECTIVE: This study aimed to assess the current evidence on the effect of (tDCS) on upper limb motor function and activities of daily living in patients after stroke by conducting an overview of systematic reviews. METHODOLOGY: We performed electronic database searches and gray literature searches for the articles. RESULTS: Two distinct literature searches gathered a total of 203 studies. Out of them, six systematic reviews and meta-analyses were included for methodological quality assessment and data extraction. All included studies were determined to be of good to high quality based on a methodological appraisal using the Assessment of Multiple Systematic Reviews checklist. CONCLUSION: Identified evidence suggests that tDCS has superior effects to control interventions in improving functions of the upper limb and activities of daily living in patients who have had a stroke. Moreover, cathodal stimulation over the non-affected brain region was more effective than anodal and dual tDCS stimulation.

High-definition trans cranial direct current stimulation and its effects on cognitive function: a systematic review.

High-Definition Transcranial Direct Current Stimulation (HD-tDCS) is focal and improves higher mental functions. Due to the lack of published evidence, we conducted this review on the effect of HD-tDCS on cognitive functions in healthy and diseased individuals. We performed an electronic-data and gray-literature search to obtain the relevant studies for the review. The two distinct literature searches obtained a total of 468 studies. Out of these, a total of 12 studies were conducted on higher mental functions, and of these, two were on disordered consciousness, five were on memory, two were on speech, two were on cognition, and one was on execution. We submitted nine studies with control group to methodological quality assessment using the PEDro Scale. Remaining three studies underwent quality assessment by Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. We found that anodal HD-tDCS stimulation is significantly effective in treating disordered consciousness and improving memory, speech, cognition, and execution.

Exercise modulates the immune system in cardiorespiratory disease patients: Implications for clinical practice during the COVID-19 pandemic.

BACKGROUND: Patients with cardiorespiratory problems often suffer from systemic inflammation. Stress due to the disease and continuous inflammation can undermine the success of the rehabilitation program. OBJECTIVE: This review has been undertaken primarily to understand the effectiveness of exercise training on the immune system in individuals undergoing cardiorespiratory rehabilitation and its implications for further management during the COVID-19 pandemic. METHODS: Assessors analyzed related studies identified in the MEDLINE, PROQUEST, PUBMED, Cochrane Library, CINAHL, EMBASE, Google Scholar, Physiotherapy Evidence, and Science Direct databases. The studies were divided into groups focused on the effect of exercise on blood leukocytes, the anti-inflammatory effect, and the role of nutrition and exercise in resolving inflammation. RESULTS: Twenty-eight studies were included in this review. The number of studies included in each section was as follows: the effects of exercise training on leukocytes in cardiorespiratory conditions (n = 8), anti-inflammatory effect (n = 6), and the role of nutrition and exercise in resolving inflammation (n = 14). The bias risk assessment showed poor internal validity; most included studies were assigned no and unclear descriptors. CONCLUSIONS: Substantive evidence is presented that emphasizes the role of moderate-intensity exercise in boosting the immune system in patients with cardiorespiratory diseases. Exercise has anti-inflammatory effects that are vital for overall well-being and resolving longstanding inflammation. Individuals with an active lifestyle had a better pathogen immune response than more sedentary individuals. Our findings highlight the current need to investigate the long-term effects of cardiorespiratory rehabilitation programs.

The Mediating Effect of Age, Gender, and Post-Stroke Duration on the Association between Trunk and Upper Limb Recovery in Subacute Stroke Population: A Cross-Sectional Study with Mediation Analysis.

BACKGROUND: The trunk acts as proximal support with which limbs execute smooth and purposeful movement. Furthermore, as upper extremity functions are an integral component of daily living activities, exploring the association between trunk and upper extremity recovery will guide therapists in developing appropriate rehabilitation goals and interventions. The objectives of this study were to (1) assess the association between trunk and upper extremity recovery in the subacute stroke population and (2) assess the effect of trunk control on upper extremity impairment and function with age, gender, and duration of stroke as mediators using mediation analysis in subacute stroke individuals. METHODS: This cross-sectional study included 54 subacute stroke participants with a mean age of 58.37 ± 6.11 years. The trunk impairment scale (TIS) assessed the trunk's stability, mobility, and coordination. The level of upper extremity impairment was evaluated using the Fugl-Meyer Assessment scale (FMA). The quality and quantity of upper limb motor functions were measured using the Wolf motor function test (WMFT). RESULTS: The TIS exhibited moderate positive correlations with the FMA-UE, WMFT-time scale (TS), and WMFT-functional ability scale (FAS) at p < 0.001. The mediation analysis reported a profound mediation effect of post-stroke duration on the association of trunk and upper limb recovery. CONCLUSIONS: The study results substantiated that trunk control significantly correlates with upper limb impairment and the quality and quantity of its use in the subacute stroke population. Post-stroke duration proved to mediate the association between trunk and upper limb recovery. Therefore, the assessment and intervention of trunk and upper extremity motor control considering the post-stroke duration is vital and should be incorporated in stroke rehabilitation aiming at functional independence.

Comparison of Neck Circumference, Waist Circumference, and Skinfold Thickness in Measuring the Subcutaneous Fat Distribution and Their Association with Handgrip Strength: Cross-Sectional Study.

Skinfold measurement (SKF) can accurately measure abdominal obesity and is regarded as a surrogate marker to predict non-communicable diseases. The objective of the present study was to observe the degree of association between neck circumference (NC), SKF and handgrip strength (HGS). Secondly, also to know the effects of smoking on NC, HGS and SKF. The mean and standard deviations and frequencies in percentage were analyzed, respectively. The degree of association between NC, anthropometric characters and HGS was also analyzed using the Pearson correlation. Furthermore, multiple linear regression models were used to study the degree of influence of independent variables on dependent variables. Correlation assessment for neck circumference with waist circumference and HGS revealed a weak association. While with SKF for four sites, a strong association was found. A significant regression was found among the smokers in the model (F (2, 7) = 5.2, p-value of 0.04 with an R2 of 0.598). The predictor variables, like waist and NC, can produce a variation of 59.8% in the dependent variable. Whereas, among non-smokers, an insignificant regression was seen. In conclusion, neck circumference is associated with SKF. However, a small sample size of young smokers revealed that NC and waist circumference influenced HGS.

Cervical Joint Position Sense and Its Correlations with Postural Stability in Subjects with Fibromyalgia Syndrome.

Cervical joint position sense (JPS) and postural stability are vital to maintaining balance and preventing falls in fibromyalgia syndrome (FMS). Impaired cervical JPS may influence postural stability, and understanding the relationship between them can aid in formulating treatment strategies in individuals with FMS. This study aims to (1) assess cervical JPS and postural stability between FMS and control group and (2) determine the correlation between cervical JPS and postural stability in the FMS group. This cross-sectional study recruited 92 FMS patients (mean age: 51.52 ± 7.7 yrs.) and 92 healthy controls (mean age: 49.36 ± 6.9 yrs.). A cervical range of motion (CROM) unit was utilized to assess cervical JPS. The postural stability was assessed using an IsoFree force platform, and anterior-posterior (A/P) and medial-lateral (M/L) directions of sway and ellipse area were measured. Cervical JPS and postural stability tests were assessed and compared between FMS and control groups. Cervical JPS was significantly impaired in FMS compared to the control group (p < 0.001). The JPS errors in FMS group were larger in flexion (FMS = 5.5°, control = 2.4°), extension (FMS = 6.4°, control = 3.0°), and rotation in left (FMS = 5.4°, control = 2.2°) and right directions (FMS = 5.1°, control = 2.8°). FMS individuals demonstrated statistically significant impaired postural stability compared to control in both the dominant and non-dominant legs tested (p < 0.001). The cervical JPS test showed moderate to strong positive correlations with postural stability variables. Statistically significant correlations were observed in all the JPS directions tested with all the postural stability variables (A/P and M/L sway and ellipse area). The correlation coefficients ranged between r = 0.37 (moderate) to 0.75 (strong). Cervical JPS and postural stability are impaired in FMS individuals. A moderate to strong relationship existed between JPS and postural stability. Individuals with FMS who had a greater magnitude of cervical JPS errors exhibited more severe postural control deficits. Therefore, cervical JPS and postural stability tests should be incorporated into routine clinical practice when assessing or formulating treatment strategies for patients with FMS.

Impact of Constraint-Induced Movement Therapy (CIMT) on Functional Ambulation in Stroke Patients-A Systematic Review and Meta-Analysis.

Constraint-induced movement therapy (CIMT) has been delivered in the stroke population to improve lower-extremity functions. However, its efficacy on prime components of functional ambulation, such as gait speed, balance, and cardiovascular outcomes, is ambiguous. The present review aims to delineate the effect of various lower-extremity CIMT (LECIMT) protocols on gait speed, balance, and cardiovascular outcomes. Material and methods: The databases used to collect relevant articles were EBSCO, PubMed, PEDro, Science Direct, Scopus, MEDLINE, CINAHL, and Web of Science. For this analysis, clinical trials involving stroke populations in different stages of recovery, >18 years old, and treated with LECIMT were considered. Only ten studies were included in this review, as they fulfilled the inclusion criteria. The effect of CIMT on gait speed and balance outcomes was accomplished using a random or fixed-effect model. CIMT, when compared to controlled interventions, showed superior or similar effects. The effect of LECIMT on gait speed and balance were non-significant, with mean differences (SMDs) of 0.13 and 4.94 and at 95% confidence intervals (Cis) of (-0.18-0.44) and (-2.48-12.37), respectively. In this meta-analysis, we observed that despite the fact that several trials claimed the efficacy of LECIMT in improving lower-extremity functions, gait speed and balance did not demonstrate a significant effect size favoring LECIMT. Therefore, CIMT treatment protocols should consider the patient's functional requirements, cardinal principles of CIMT, and cardiorespiratory parameters.

Cross-Cultural Adaptation of the Godin-Shephard Leisure-Time Physical Activity Questionnaire for Arabic Population and Testing its Psychometric Properties.

BACKGROUND Physical activity during leisure time is essential to promote health, owing to the decreased physical activity in mechanized working environments. The present study aimed to cross-culturally modify the Godin Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) into Arabic and to assess its psychometric properties. MATERIAL AND METHODS We conducted this study in various standardized stages. At each stage, the corrections were made by an expert committee. In the initial stage, the English version of the GSLTPAQ was translated into Arabic and then back-translated into English. In the second stage, we ensured the content validity by collecting the opinion of 10 professionals in the medical field. Finally, in the third stage, the Arabic version was applied to the Saudi population to check its test-retest reliability, face validity, internal consistency, and concurrent validity. RESULTS For the Arabic version of the GSLTPAQ, we evaluated the content validity by involving 10 experts, and it was found to be excellent. The scale was applied to 150 office workers in the university to assess psychometric properties. The scale showed remarkable internal consistency (0.99) and high test-retest reliability (0.88). We evaluated the concurrent validity by comparing it with the Copenhagen City Heart Study Leisure Time Physical Activity Questionnaire, and it was shown to have an excellent validity of 0.86 (<0.001). CONCLUSIONS After conducting the careful process of translations, we adapted and created the Arabic version of the GSLTPAQ. It was found to have excellent content validity, test-retest reliability, internal consistency, and concurrent validity.

Transcranial direct current stimulation combined with trunk-targeted, proprioceptive neuromuscular facilitation in subacute stroke: a randomized controlled trial.

Background: Stroke is the foremost cause of death and disability worldwide. Improving upper extremity function and quality of life are two paramount therapeutic targets during rehabilitation. Aim of the study: To investigate the effects of transcranial direct current stimulation (tDCS) combined with trunk-targeted proprioceptive neuromuscular facilitation (PNF) on impairments, activity limitations, and participation restrictions of subjects with subacute stroke. Methodology: Fifty-four subjects with subacute stroke were divided into three groups using block randomization. All three groups received rehabilitation sessions lasting 90 min in duration, four times per week, for 6 weeks. Group 1 (n = 18) received conventional physical therapy (CPT); group 2 (n = 18) received CPT, trunk-targeted PNF, and sham tDCS; and group 3 (n = 18) received CPT, trunk-targeted PNF, and bihemispheric motor cortex stimulation with tDCS. Changes in motor impairment, motor activity, and health-related quality of life assessments were outcome measures. Results: A two-way linear mixed model analysis revealed interaction effects (group × time) for all outcome measurements (Trunk Impairment Scale, Fugl-Meyer Assessment of Motor Recovery after stroke upper extremity subsection, Wolf Motor Function Test, 10-Meter Walk Test, and the Stroke-Specific Quality of Life scale; all p < 0.01 or lower). Overall, post-pre mean differences demonstrate more substantial improvement in the active tDCS group, followed by sham stimulation associated with the PNF group and the group that received CPT alone. Conclusion: Trunk-targeted PNF combined with bihemispheric tDCS along with CPT engender larger improvements in upper extremity and trunk impairment, upper limb function, gait speed, and quality of life in the subacute stroke population.

Anxiety, depression, worry, and stress-related perceptions among antenatal women during the COVID-19 pandemic: Single group repeated measures design.

Background: Coronavirus disease 2019 (COVID-19) has rapidly spread across the globe, which has affected the health of all populations including antenatal women. Aims: The aim of the study was to evaluate the levels of anxiety, depression, stress, and worry in antenatal women during COVID-19 compared with the pre-COVID-19 levels and to evaluate the associations between the sociodemographic factors of antenatal women and Hospital Anxiety Depression Scale (HADS)-D, HADS-A, Generalized Anxiety Disorder (GAD)-7, Perceived Stress Scale (PSS), and Brief Measure of Worry Severity (BMWS) scores. Materials and Methods: This single group repeated measures design was conducted on 101 antenatal women who were referred to outpatient antenatal clinics from January 2020 (pre-COVID-19) to April 2020 (during the COVID-19 pandemic). Data were collected using four questionnaires including the HADS, GAD-7 scale, PSS, and BMWS. Results: Antenatal women (n = 101, Mage = 32.73 years, standard deviation = 5.67) during COVID-19 demonstrated significantly increased (P < 0.001) levels of anxiety, depression, stress, and worry compared with pre-COVID-19 levels. Multiple regression analysis indicated that panic disorder was significantly associated with HADS, PSS, and BMWS scores; pregnancy complications were significantly associated with HADS scores; associated health problems were significantly associated with PSS and BMWS scores; and current anxiety, depression, stress, and worry were significantly associated with HADS, GAD-7, and BMWS scores in antenatal women during COVID-19. Conclusion: Increased attention should be paid to the psychological health of antenatal women during this COVID-19 pandemic. Proper management of this current catastrophe is likely to result in global changes in social experiences, and interventions are necessary to address associated changes in mental health, especially among antenatal women.

Effectiveness of Constraint-Induced Movement Therapy (CIMT) on Balance and Functional Mobility in the Stroke Population: A Systematic Review and Meta-Analysis.

Constraint-induced movement therapy (CIMT) is one of the most popular treatments for enhancing upper and lower extremity motor activities and participation in patients following a stroke. However, the effect of CIMT on balance is unclear and needs further clarification. The aim of this research was to estimate the effect of CIMT on balance and functional mobility in patients after stroke. After reviewing 161 studies from search engines including Google Scholar, EBSCO, PubMed, PEDro, Science Direct, Scopus, and Web of Science, we included eight randomized controlled trials (RCT) in this study. The methodological quality of the included RCTs was verified using PEDro scoring. This systematic review showed positive effects of CIMT on balance in three studies and similar effects in five studies when compared to the control interventions such as neuro developmental treatment, modified forced-use therapy and conventional physical therapy. Furthermore, a meta-analysis indicated a statistically significant effect size by a standardized mean difference of 0.51 (P = 0.01), showing that the groups who received CIMT had improved more than the control groups. However, the meta-analysis results for functional mobility were statistically insignificant, with an effect size of -4.18 (P = 0.16), indicating that the functional mobility improvements in the investigated groups were not greater than the control group. This study's findings demonstrated the superior effects of CIMT on balance; however, the effect size analysis of functional mobility was statistically insignificant. These findings indicate that CIMT interventions can improve balance-related motor function better than neuro developmental treatment, modified forced-use therapy and conventional physical therapy in patients after a stroke.

The Aftermath of the COVID-19 Crisis in Saudi Arabia: Respiratory Rehabilitation Recommendations by Physical Therapists.

Since late 2019, the number of COVID-19 patients has gradually increased in certain regions as consecutive waves of infections hit countries. Whenever this wave hits the corresponding areas, the entire healthcare system must respond quickly to curb the diseases, morbidities, and mortalities in intensive care settings. The healthcare team involved in COVID-19 patients' care must work tirelessly without having breaks. Our understanding of COVID-19 is limited as new challenges emerge with new COVID-19 variants appearing in different world regions. Though medical therapies are finding solutions to deal with the disease, there are few recommendations for respiratory rehabilitation therapies. A group of respiratory rehabilitation care professionals in Saudi Arabia and international experts have agreed with the World Health bodies such as the World Health Organization (WHO) on the treatment and rehabilitation of patients with COVID-19. Professionals participating in COVID-19 patient treatment, rehabilitation, and recovery formulated respiratory rehabilitation guidelines based on the DELPHI Method, combining scientific research and personal practical experience. As a result, it is envisaged that the number of individuals in the region suffering from respiratory ailments due to post-COVID-19 will decrease. This narrative review and clinical expertise guidelines may give physiotherapists acceptable and standard clinical guideline protocols for treating COVID-19 patients.