Comparisons of postural control, proprioception, muscle strength, pain and disability between individuals with acute, subacute and chronic low back pain.

PURPOSE/AIM: Postural control, proprioception and lower extremity muscle strength are affected in individuals with low back pain (LBP). However, it is yet unknown whether these variables differentiate between acute, subacute and chronic stages of LBP. The aim was to investigate if there were any differences in postural control, proprioception, lower extremity muscle strength, pain intensity and disability between individuals in the different stages of LBP. MATERIALS AND METHODS: In this cross-sectional study, 124 individuals with LBP were grouped as acute LBP (ALBP) (n = 38), subacute LBP (SLBP) (n = 30) and chronic LBP (CLBP) (n = 56) groups. Postural control was assessed via computerised technology. Lumbar proprioception, lower extremity muscle strength, pain intensity and disability were assessed using Joint Repositioning Error Test, hand-held dynamometer, Numeric Rating Scale and Oswestry Disability Index (ODI), respectively. Kruskal-Wallis Tests, ANCOVA and post hoc Mann-Whitney U-Test with Bonferroni correction were performed. RESULTS: While there were no significant differences in terms of postural control, proprioception and pain intensity (p > 0.05), significant differences were found in terms of lower extremity muscle strength and ODI scores between groups when adjusted for age (p < 0.05). Individuals with CLBP demonstrated poorer lower extremity muscle strength than those with ALBP and SLBP, and higher disability than those with ALBP (p < 0.017). CONCLUSIONS: Although postural control, proprioception and pain intensity were similar between individuals with acute, subacute and chronic LBP, muscle strength and disability seem to worsen stepwise as the pain becomes chronic. Muscle strength and disability should be taken into account while evaluating and/or managing individuals with acute and subacute stages of LBP.

Constraint-induced movement therapy protocols using the number of repetitions of task practice: a systematic review of feasibility and effects.

BACKGROUND: High repetitions of task practice is required for the recovery of the motor function during constraint-induced movement therapy (CIMT). This can be achieved into ways: when the task practice is measured in hours of practice or when the number of repetitions is counted. However, it has been argued that using hours of task practice as a measure of practice does not provide a clear instruction on the dose of practice. AIM: The aim of this study is to determine the feasibility and effects of the CIMT protocol that uses the number of repetitions of task practice. MATERIALS/METHOD: The study was a systematic review registered in PROSPERO (CRD42020142140). Five databases, PubMED, CENTRAL, PEDro, OTSeeker and Web of Science, were searched. Studies of any designs in adults with stroke were included if they used the number of repetitions of task practice as a measure of dose. The methodological quality of the included studies was assessed using Modified McMaster critical review form. The results were analysed using qualitative synthesis. RESULTS: Eight studies (n = 205) were included in the study. The number of task repetitions in the studies ranges between 45 and 1280 per day. The results showed that CIMT protocol using the number of repetitions of task practice was feasible and improved outcomes such as motor function, quality of life, functional mobility and spasticity. CONCLUSION: The number of repetitions of task practice as a measure of CIMT dose can be used in place of the existing protocol that uses the number of hours of task practice.

Is Guillain-Barré Syndrome Associated With COVID-19 Infection? A Systemic Review of the Evidence.

Background: There is emerging evidence that Guillain-Barré syndrome (GBS) may be associated with coronavirus disease 2019 (COVID-19) infection. The aim of this review was to investigate the strength of the evidence. Method: The review was registered in PROSPERO (CDR42020184822). Three electronic databases, MEDLINE, PubMed, and Web of Science, and three preprint servers, MedRvix, ChemRvix, and BioRvix, were searched from December 2019 to 24th September 2020. Studies were included if they were on COVID-19 and of any design. Articles that are reviews or opinion were excluded. The selection process was carried out using EndNote and Rayyan software. The main outcomes in the study were study design, sample size, sex, age, overall GBS symptoms, other COVID-19 symptoms, comorbidity, timing between infection and the onset of neurological symptoms, CT, MRI, and EMG results. Methodological quality of the studies was assessed using the McMaster Critical Review Form. The collected data was analyzed using qualitative synthesis. Findings: Fifty-one high-quality studies (mostly) consisting of 83 patients were included in the study. All of the patients (except in a very few) in the included studies had confirmed diagnosis of COVID-19. Similarly, the diagnosis of GBS was based on standard clinical, electrophysiological, and cerebrospinal fluid (CSF) criteria. Conclusion: GBS may be associated with COVID-19, and therefore, testing for COVID-19 is recommended in patients presenting with GBS during this pandemic.

Immediate Effects of Ankle Joint Mobilization With Movement on Postural Control, Range of Motion, and Muscle Strength in Healthy Individuals: A Randomized, Sham-Controlled Trial.

CONTEXT: Ankle proprioception is one of the crucial components contributing to postural control. Although the effects of Mulligan's mobilization with movement (MWM) on postural control, ankle dorsiflexion range of motion (DFROM), and muscle strength in people with ankle disorders have previously been investigated, it is still unclear whether ankle MWM had ability to change postural control, DFROM, and muscle strength. OBJECTIVES: To reveal pure effects of MWM on postural control, ankle DFROM, and muscle strength in healthy individuals. DESIGN: A prospective, randomized, double-blinded, sham-controlled study. SETTING: Musculoskeletal laboratory, Dokuz Eylul University, Turkey. PARTICIPANTS: Forty students in good health recruited from a local university. INTERVENTIONS: Mulligan's MWM or sham application over ankle joint. MAIN OUTCOME MEASURES: The primary outcome was postural control and measured using limits of stability (LOS) test. The secondary outcomes were tibialis anterior muscle strength and ankle DFROM, which were measured using handheld dynamometer and weight-bearing lunge test, respectively. All outcomes were assessed before and immediately after intervention. RESULTS: Left and right ankle DFROM and LOS overall score showed a statistically significant improvement compared with first measurement in both groups (P < .05). However, LOS time was significantly improved only in the MWM group (P < .05). Statistical analyses of between-group mean differences showed that Mulligan's MWM provided significant improvement in the LOS in forward-right direction compared with sham application (P = .03). CONCLUSIONS: The results of this study suggest that the application of Mulligan's MWM on ankle joint might be beneficial to improve postural control in forward right direction in individuals with healthy ankles. On the other hand, both MWM and sham application were able to increase overall postural control and DFROM, and MWM had no superiority over sham application for increasing these 2 variables.

Effects of Pilates exercises on sensory interaction, postural control and fatigue in patients with multiple sclerosis.

BACKGROUND: Decreased postural control, sensory integration deficits and fatigue are important problems that cause functional impairments in patients with multiple sclerosis (pwMS). PURPOSE: To examine the effect of modified clinical Pilates exercises on sensory interaction and balance, postural control and fatigue in pwMS. METHODS: Eleven patients with multiple sclerosis and 12 healthy matched controls were recruited in this study. Limits of stability and postural stability tests were used to evaluate postural control by Biodex Balance System and sensory interaction assessed. Fatigue was assessed by Modified Fatigue Impact Scale. Pilates exercises were applied two times a week for 10 weeks and measurements were repeated to pwMS after exercise training. RESULTS: Postural control and fatigue (except psychosocial parameter) of pwMS were significantly worser than healthy controls (p<0.05). Significant improvements occurred in sensory interaction (eyes open, foam surface) and total, physical and cognitive scores of fatigue after 10-week modified clinical Pilates training (p<0.05). No significant changes were detected in postural control after the pilates exercises (p>0.05). CONCLUSIONS: Ten-week Pilates training is effective to improve sensory interaction and to decrease fatigue. Pilates exercises can be applied safely in ambulatory pwMS for enhance sensory interaction and balance and combat fatigue. More investigations are needed.

Determination of the relationship between cognitive function and hand dexterity in patients with chronic obstructive pulmonary disease (COPD): a cross-sectional study.

BACKGROUND: Hand dexterity is important for daily living activities and can be related to cognitive functions in patients with chronic obstructive pulmonary disease (COPD). OBJECTIVE: The aim of this study was to investigate the relationship between cognitive dysfunction and hand dexterity in patients with COPD. METHODS: 35 COPD patients and 36 healthy individuals were assessed. The Minnesota Hand Dexterity Test and Mini Mental State Examination (MMSE) were used for assessment of cognitive function and hand dexterity. RESULTS: Hand dexterity test scores and cognitive function of COPD patients' were significantly lower than the healthy group (p < 0.01). The MMSE scores were negatively correlated with hand dexterity scores in the COPD group (p < 0.05). CONCLUSIONS: There was a relationship between cognitive function and hand dexterity in the patients with COPD; however, hand dexterity did not alter according to hypoxemia severity. Hand dexterity which is important in daily living activities should be evaluated in greater detail with further studies in COPD patients.