Cervical proprioception in Parkinson's disease and its correlation with manual dexterity function.

OBJECTIVE: Cervical proprioception plays a crucial role in posture and movement control. This study aimed to determine the relationships of cervical proprioception, cervical muscle strength and endurance with manual dexterity and hand strength in individuals with idiopathic Parkinson's disease (PD). METHODS: Twenty individuals with PD (mean age: 63.9 years) and 20 healthy individuals as a control group (mean age: 61.9 years) were recruited. Cervical joint position error (JPE), static endurance of neck muscles, activation of deep cervical flexor muscles (Craniocervical Flexion Test, CCFT), manual dexterity (Purdue Pegboard Test, PPT), cognitive and motor tasks of the PPT, finger tapping test (FTT), pinch strength, and grip strength were assessed. RESULTS: Cervical JPE was significantly higher in individuals with PD than in controls (p < 0.05). The strength and endurance of the cervical muscles were significantly decreased in individuals with PD (p < 0.05). Cervical JPE measurements were negatively correlated with PPT, cognitive and motor tasks of the PPT in individuals with PD (all p < 0.05). The endurance of cervical flexor muscles was negatively correlated with PPT and cognitive PPT scores in the PD group (p < 0.05). In addition, a significant positive correlation was found between cervical flexor endurance and hand strength in the PD group (p < 0.05). CONCLUSION: Cervical proprioception and the strength and endurance of cervical muscles decrease in individuals with PD compared to healthy individuals. Impairment of cervical proprioception appears to be associated with poorer upper extremity performance. Detailed evaluation of the cervical region in PD may help determine the factors affecting upper extremity function.

Long-Term Characteristics of Severe COVID-19: Respiratory Function, Functional Capacity, and Quality of Life.

Recovery from pneumonia takes around 3−6 months in individuals with severe COVID-19. In order to detect the isolated damage caused by COVID-19, the 6-month period must pass after the recoveries. However, to our knowledge, no published study analyzes a comprehensive evaluation of individuals with severe COVID-19 after 6 months. We aimed to evaluate long-term consequences of severe COVID patients by comparing respiratory function, functional capacity, quality of life, fatigue, and balance 6 months after the intensive care unit (ICU) discharge with healthy individuals. Method: 26 post-COVID adult patients and 26 healthy individuals (control group) were included in this study. Physical characteristics of both groups and patients' ICU data, including APACHE II scores, were recorded. Lung function, respiratory, and peripheral muscle strength were measured. The lower limit of normal (LLN) cutoff points for forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were calculated. A 6-minute walk test (6MWT) was used to assess functional capacity. Time Up and Go test (TUG) with a stadiometer was performed for balance evaluation. Quality of life was evaluated using Nottingham Health Profile (NHP) and St George Respiratory Questionnaire (SGRQ). Results: Percent predicted FVC and FEV1, 6MWT distance, change in oxygen saturation (SpO2) during 6MWT, were lower and NHP, SGRQ, FSS scores and TUG findings were higher in the COVID group than the control group (p < 0.05). The FVC of nine individuals and the FEV1 value of seven individuals in the COVID-19 group were below the LLN values. A moderate correlation was found between ICU length of stay and APACHE II scores with FVC, FEV1, 6MWT distance, and change in SpO2 values in the COVID-19 patients (p < 0.05). Conclusion: Respiratory function, functional capacity, quality of life, and fatigue levels of the individuals with severe COVID-19 infection are impaired at 6 months after ICU discharge. Impaired lung function might be associated with severe inflammation, which starts during the acute infection process and the fibrous tissue during the healing process, impairing lung compliance and diffusion capacity. Infiltration of coronavirus and inflammatory cytokines into the cerebrum and muscle might have increased fatigue and decreased functional capacity. Overall, our study suggests that severe COVID patients need post-discharge care even after 6 months of recovery.

Breathing and Relaxation Exercises Help Improving Fear of COVID-19, Anxiety, and Sleep Quality: A Randomized Controlled Trial.

Objective: To investigate the effects of breathing and relaxation exercises performed via telerehabilitation on fear, anxiety, sleep quality, and quality of life of individuals without coronavirus disease 2019 (COVID-19) during the ongoing pandemic. Design: A prospective, randomized, controlled single-blind study. Methods: Fifty participants who had not been exposed to the COVID-19 virus earlier were randomly divided into experimental (n = 25) and control groups (n = 25). Both groups received an information session about COVID-19 once at the start of the study via a mobile phone video application. The experimental group also performed a breathing and relaxation exercise program twice daily (morning and evening), 7 days per week, for 4 weeks; one session of the program was conducted under the remote supervision of a physiotherapist as telerehabilitation, and the remaining sessions were performed as a home program. The Fear of COVID-19 Scale (FCV-19S), which was the primary outcome measure, The Hamilton Anxiety Rating Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), and EQ-5D-3L were administered to both groups. Results: The FCV-19S, HAMA, and PSQI were statistically significantly improved to compare the controls, with a large effect size (ηp2 = 0.135, 0.313, and 0.200, respectively). The EQ-5D-3L index and EQ-5D-3L visual analog scale were not statistically significantly different compared with the controls; however, a small effect size was detected for the differences between the two groups (ηp2 = 0.056 and 0.013, respectively). Conclusion: Breathing and relaxation exercises appear to be an effective and feasible approach to support mental health and sleep quality during the COVID-19 pandemic. Especially in highly contagious diseases such as COVID-19, telerehabilitation approaches may be useful for safely reaching individuals by eliminating human-to-human contact. Clinical Trial Registration number: NCT04910932.

Effects of Inspiratory Muscle and Balance Training in Children with Hemiplegic Cerebral Palsy: A Randomized Controlled Trial.

The aim of the study was to investigate the effects of inspiratory muscle and balance training on pulmonary function, respiratory muscle strength (RMS), functional capacity, and balance in children with hemiplegic cerebral palsy (CP). Thirty children with hemiplegic CP (Gross Motor Function Classification System I-II) included in this study. The control group (n = 15) underwent conventional physiotherapy rehabilitation program (CPRP) that included balance exercises, and the training group's (n = 15) program included inspiratory muscle training (IMT) in addition to CPRP for 8 weeks. The outcome measures were pulmonary function test, RMS measurement, the six-minute walk test (6MWT), and balance tests. There were no significant differences in the score changes of pulmonary function, balance, and 6MWT distance between groups (p > .05), whereas maximum inspiratory and expiratory pressure further increased in the training group (p > .05). RMS assessment and the identification of children who need it, and adding IMT to CPRP will contribute greatly to the rehabilitative approach of children with CP.

Assessment of motor development using the Alberta Infant Motor Scale in full-term infants.

The Alberta Infant Motor Scale (AIMS) is a well-known, norm-referenced scale that evaluates the gross motor development of children from birth to 18 months. The aim of the study was to compare the Canadian norms with the AIMS scores of a Turkish sample of infants, and to investigate whether the current reference values of the AIMS are representative for Turkish full-term infants. The study was conducted with 411 Turkish infants of both sexes (195 girls and 216 boys), born with gestational age 38 weeks and older, weighing ≥2500 g at birth. Motor performance of all the cases at different ages were assessed with the AIMS which was used by a physiotherapist. The mean AIMS scores of Turkish infants were compared with the norm values of the original AIMS established in a Canadian sample of infants. The results showed no statistically significant differences between the AIMS scores of Turkish and Canadian infants during the first 18 months of life except at 0- < 1 and 2- < 3 months of age. The AIMS scores were significantly lower in Turkish infants than in Canadian infants at 0- < 1 (p=0.025) and 2- < 3 (p=0.042) months of age. In conclusion, the AIMS can be used in Turkish children to assess gross motor development, especially after 4 months of age. However, this paper was presented as a preliminary study to compare AIMS results between Turkish and Canadian infants, and further studies are needed to realize the Turkish validation of AIMS.

Is short-term hand therapy effective in a child with congenital radioulnar synostosis? A case report.

STUDY DESIGN: Case report. INTRODUCTION: Congenital radioulnar synostosis (CRUS) is a rare malformation that causes the restriction of the rotational movements of the forearm, and it is common in congenital elbow anomalies. PURPOSE OF THE STUDY: The aim of this case report was to present the results of physiotherapy in a patient with CRUS who did not undergo surgery. METHODS: A 7-year-old male patient with CRUS began outpatient physical therapy. The child underwent a physiotherapy program for a total of 10 weeks in the presence of a physiotherapist, 2 days per week, and with a home schedule at other times. Observational posture assessment, range of motion measurements of the upper extremities, the Jebsen-Taylor Hand Function Test, finger and hand grip strength, and Canadian Occupational Performance Measure were used to evaluate the patient before and after the physiotherapy program. RESULTS: An increase in Jebsen-Taylor Hand Function Test, Canadian Occupational Performance Measure, and grip strengths were found; however, there was no change in the range of motion values for our patient. DISCUSSION: This report contains physiotherapy results of a patient with CRUS who did not undergo surgery. Further short- and long-term follow-up studies are needed to demonstrate the effects of physiotherapy on surgical and nonsurgical patients with CRUS. CONCLUSIONS: Physiotherapy can be effective in the functional use of the upper extremities in patients with CRUS who do not undergo surgery; long-term follow-up would demonstrate whether functional changes are permanent over time.

The acute effects of physiotherapy on general movement patterns in preterm infants: A single-blind study.

BACKGROUND: The General Movement Assessment (GMA) is a video analysis method developed by Heinz Prechtl that examines the infant's spontaneous movements. In recent years, although many studies have been performed in preterm infants by applying GMA, few studies have shown the effects of early intervention on GMA. AIMS: Current study was planned to determine the acute effects of a single-session early physiotherapy approach on preterm infants' general spontaneous movements, and to reveal the change in Motor Optimality Scale (MOS) score including FMs. STUDY DESIGN: Prospective, single-blind study. SUBJECTS: Current study was carried out with 32 preterm infants at postterm 12-16 weeks. OUTCOME MEASURES: The infants included in the study were videotaped by a physiotherapist during 10-15 min before the physiotherapy session at postterm 12-16 weeks for GMA. After a single physiotherapy session, the same physiotherapist performed the same video footage second time. A blind evaluator assessed the videos taken before and after session and scored Motor Optimality Scale (MOS). RESULTS AND CONCLUSIONS: There was no statistically significant difference between MOS sub-category and total score of the infants before and after the session (p > 0.05). According to the results of present study, a single-session early physiotherapy intervention did not have an acute effect on the spontaneous movements of preterm infants at postterm 12-16 weeks. Future studies are needed to demonstrate the short and long-term effects of early physiotherapy approaches to risky infants.

The comparison of general movements assessment and neurological examination during early infancy.

This prospective single-blinded study was performed to evaluate general movements (GMs) in group of high-risk, low-birth-weight and preterm infants and to compare results with neurologic examination. All infants' neurologic examinations, Gross Motor Function Measurement (GMFM) and Bayley-III Scale were performed at the corrected age of 12 months. A total of 22 infants were included. Eight infants (group-1) (mean: 31.6±3.29 weeks, range: 25-36 weeks) had normal GMs in all recordings and were ultimately evaluated as "normal"; 12 (group-2) (mean: 31.6±3.29 weeks, range:2 5-35 weeks) had abnormal GMs during writhing movements period but had normal GMs in subsequent recordings and were evaluated as "normal"; and 2 infants (group-3) (mean:29.5±7.78 weeks, range:24-35 weeks) with consistent abnormal GMs who were evaluated as "abnormal." Complete agreement (kappa=1) was found between GMs and neurologic examination and significant agreement between GMs and cranial ultrasonography (kappa=0.76). When results of GMFM and Bayley-III were compared; statistically significant differences were found between group-1 and group-2 in "standing" parameter of GMFM (p < 0.05) and "cognitive" parameter of Bayley-III (p < 0.05). GMs assessment can help determine neurologic disorders in high-risk infant populations as an adjunct to other diagnostic techniques.