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This study aimed to evaluated the reliability and validity of the Turkish adaptation of the Questionnaire of Physiotherapeutic Specific Exercises of Scoliosis (QPSSE). Fifty-one individuals who had been performing scoliosis-specific exercises (PSSEs) for at least two months completed the QPSSE. Validity was analyzed by correlating the QPSSE with the Scoliosis Research Society-22 (SRS-22) questionnaire and the Scoliosis Japanese Questionnaire-27 (SJ-27). The intraclass correlation coefficients ( ICC ) were used to estimate test-retest reliability. The QPSSE demonstrated excellent internal consistency (Cronbach's alpha coefficients were .90 and .93) and test-retest reliability ( ICC = .92, 95% confidence interval [.86-.95]). The QPSSE also demonstrated strong construct validity with the SRS-22 ( r = -.57) and SJ-27 ( r = -.66) total scores. The Turkish QPSSE is a valid and reliable questionnaire for evaluating the physical functioning, self-image, PSSEs, psychosocial functioning, cognitive functioning, compliance, motivation, and pain-related physiotherapeutic specific exercises of scoliosis in idiopathic scoliosis., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Since scoliosis is a three-dimensional deformity, it causes some movement limitations in the spine and related joints. However, functional limitations associated with scoliosis-related hip joint involvement are the subject of research., Aims: This study aims to investigate the physical characteristics and functional limitations associated with idiopathic scoliosis (IS), focusing on hip joint., Methods: Demographic characteristics, scoliosis-specific assessments and hip joint active range of motion (RoM), lumbar mobility (Modified Schober test), lumbopelvic stability (Single leg squat test-SLS), hip joint position sense, lower extremity balance (Y-balance test) and lower extremity functionality (Lower extremity functional scale-LEFS) were evaluated., Results: The study included 120 individuals, with 86 in the scoliosis group (mean age: 15.7 ± 3.4 years) and 34 in the control group (mean age: 16.1 ± 4.8 years). The scoliosis group exhibited limited RoM of the hip joint in flexion, extension, right abduction, adduction, internal rotation, and left external rotation compared to controls (p < 0.001). Lumbar mobility was decreased (p < 0.001). In the joint position sense test, the mean difference for right flexion was and for left flexion. Bilateral decreased SLS test performances (p < 0.001) and Y-balance test performance (p < 0.05) in individuals with IS. LEFS scores were statistically different but not clinically different between groups (p < 0.05)., Conclusion: Individuals with IS show decreased hip mobility, lumbopelvic stability, hip joint position sense, and balance compared to healthy peers; however, these limitations do not have a clinical impact on daily living activities., Competing Interests: Declarations. Conflict of interest: This research is not financed, and the authors have no conflict of interest to report., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: This study investigated the effects of three different exercise protocols on functional capacity in early-stage burn patients., Methods: A total of 25 patients hospitalized in the Burn Center (wards and intensive care unit) were included in the study. The individuals were divided into three groups by covariate adaptive randomization according to burn percentage and type: 1 - standard treatment, 2 - standard treatment + aerobic exercise training, 3 - standard treatment + combined exercise (aerobic and resistance) determined by metabolic status. Individuals were evaluated weekly for six weeks from the first day of hospitalization using the 6-minute walk test, physiological cost index, and Medical Research Council muscle-strength measurements to assess functional capacity. A portable metabolism tracker device measured the metabolic status of all patients., Results: Aerobic exercises and combined exercise (aerobic and resistance), when added to standard treatment and determined by metabolic status, were more effective in enhancing functional capacity than standard treatment alone (p<0.05). Patients performing the combined exercise (aerobic and resistance) showed faster improvement in functional capacity determined according to metabolic status than those in the other two groups (p<0.05)., Conclusion: Aerobic exercises, when added to standard treatment and combined with aerobic and resistance exercises based on metabolic status, are more effective at improving functional capacity than standard treatment alone. Further controlled studies are required to explore the potential long-term benefits of this approach.

Objective: The Cognitive Exercise Therapy Approach, referred to as BETY, is a biopsychosocial model that has demonstrated effectiveness in improving the quality of life among various patient populations with chronic diseases. This study aimed to determine the efficacy of BETY combined with telerehabilitation for people living with HIV (PLWH)., Materials and Methods: Fifty PLWH who were virologically suppressed receiving follow-up and treatment at Şanlıurfa Training and Research Hospital were included in this study. Patients were divided into the telerehabilitation group (TG) and the control group (CG). In addition to routine treatments, the TG underwent group rehabilitation exercises via Zoom application for 60 minutes three times a week for 12 weeks (a total of 36 sessions) under the supervision of a physiotherapist, following the principles of BETY. The CG received no intervention and continued with routine medication treatments. Before and after the exercise therapy, the BETY Scale (BETY-BQ), Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Clinical Frailty Scale, and Frail Scale were administered to both the TG and the CG. The responses to the scales were compared between the two groups after the 12-week period., Results: The preliminary results included data from 10 patients in the TG and 15 patients in the CG who completed the 12-week treatment. In the TG, significant differences were observed in the SF-36 pain subscale and the BETY total score, while in the CG, significant differences were found in the SF-36 emotional role functioning and vitality subscales ( p <0.05). In the TG, negative values were observed in all BETY-BQ subscales, indicating improvement in all parameters. Additionally, the mean value of the SF-36 pain subscale increased from 79 before treatment to 91.5 after treatment., Conclusion: Our preliminary results indicate that the BETY method applied by telerehabilitation may be effective in reducing pain and improving biopsychosocial conditions in PLWH. Telerehabilitation with cognitive exercise therapy can provide an alternative treatment option by complementing routine therapies and offering the opportunity to participate anonymously in group therapies in PLWH., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Infectious Diseases and Clinical Microbiology.)

Objective: This study aimed to investigate the effect of a home exercise program on pain and quality of life (QoL) in TMD., Methods: Twenty patients were included in the study. The Group A received both a home exercise program and a physiotherapy program, while only a physiotherapy program was given to the Group B. Pain was measured using the Visual Analogue Scale (VAS) and QoL using the Short-Form 36 (SF-36)., Results: Pain decreased in both groups (p < 0.05). Among the SF-36 domains, bodily pain, vitality and social functioning scores improved in the Group A, while only the bodily pain parameter improved in the Group B (p < 0.05). On between-group comparison, the positive effect on pain and quality of life was greater in the Group A (p < 0.05)., Conclusion: The addition of a home exercise program to the conventional physiotherapy program provided greater improvement in pain and QoL in patients with TMD.

This study aimed to evaluate the viscoelastic properties of lower-extremity muscles in pediatric hemophilia (FVIII-IX) patients. The study included 20 severe- and moderate-type right-dominant hemophilia patients diagnosed with hemophilia A-B and 20 healthy children. Viscoelastic properties (tone, stiffness, elasticity) of the lower-extremity muscles were measured using a MyotonPRO device. The physical characteristics of the pediatric hemophilia patients (mean age: 11.9 ± 3.95 years) and the control group (mean age: 12.6 ± 3.41 years) were found to be similar. A difference was observed only in the elasticity of the right vastus lateralis ( p < 0.05) by means of the viscoelastic properties of the lower-extremity muscles. The results were similar in other muscle groups ( p > 0.05). The dominant-side vastus lateralis muscle elasticity (the ability of the muscle to regain its original shape after contraction or removal of an external force) of hemophilia patients was found to be lower compared to healthy children. The fact that 45% of hemarthroses occur in the knee joint and that recurrent bleeding may affect the flexibility of the vastus lateralis, which is the main muscle within the quadriceps muscle group and responsible for the stabilization of the patella, can be associated with the study results.

Rationale and Objectives: There is no universally accepted standard technique for measuring the scapholunate interval and no specific sources of measurement error have been identified. We aimed to establish a set of normal radiological criteria for the scapholunate interval that could be used in comparative studies of wrist pathology to determine interobserver reliability and to identify potential errors that might influence measurements., Materials and Methods: A total of 60 healthy volunteers participated in the study. Scapholunate interval was measured by three independent observers using X-ray, CT, and US in four positions, including neutral, fist, radial and ulnar deviation. Inter-observer reliability was tested using intraclass correlation coefficient. Generalizability theory was applied to evaluate specific sources of measurement error related to participant, observer, imaging modality and measurement position., Results: In neutral position, the scapholunate interval measured by X-ray, CT, and US was 3.1 mm, 3.5 mm and 3.5 mm respectively. The interval remained constant during fist and radial deviation but decreased during ulnar deviation. Correlation coefficients ranged from 0.874 to 0.907 for X-ray, 0.773-0.881 for CT and 0.964-0.979 for US. In the generalizability study, the participant x modality x position interaction accounted for the largest proportion of total variance (29%)., Conclusion: X-ray, CT, and US are reliable modalities for measuring the scapholunate interval, with US having the highest reliability. Participant and position factors may independently contribute to measurement error. Therefore, standardized measurement positions are recommended to obtain reliable measurement results., (Copyright © 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Background: Many studies have reported that insulin resistance (IR) is present and persistent in patients with major burns; however, the evidence remains insufficient. This study was planned to investigate insulin levels and IR in the early post-traumatic period in patients with major burns and to determine the prevalence of IR after burn injury., Methods: This study included 68 patients. These patients were followed up once a week for 4 weeks after hospitalization. In the follow-up examinations, demographic and burn injury characteristics; HbA1c, procalcitonin serum glucose, and insulin levels; and IR were evaluated., Results: IR was seen in some weeks only in 25 of the 68 patients included in the study. Among all patients, IR was determined in only 11 (16.17%) patients from the 1st day of hospitalization until discharge. Patients with and without IR were evaluated as 2 groups, and their biochemical parameters were compared, and no significant difference was found between glucose and procalcitonin levels (P>0.05). Glucose levels were >100 mg/dL in the first few weeks in all patients who were followed up; however, they returned to the normal range in the following weeks., Conclusion: In patients with IR, there was insufficient evidence to conclude that the condition persists. We believe that the HOMA-IR value is not directly related to burn injuries and that other additional pathologies may cause it during treatment.

Purpose: To investigate the effects of functional electrical stimulation cycling (FES-C) training in addition to conventional physical therapy on gait, muscle strength, gross motor function, and energy expenditure in ambulatory children with spastic diplegic cerebral palsy., Materials and Methods: Twenty children with diplegic cerebral palsy were randomly assigned to FES-C group ( n  = 10) or control group ( n  = 10). Subjects trained 3 days/week for 8 weeks. Control group received conventional physical therapy. The FES-C group additionally received FES-C training. The functional muscle test was used for muscle strength assessment. Vicon-3D system was used for gait analysis. Gross Motor Function Measure (GMFM-88) was used for motor function assessment and calorimeter was used for energy expenditure. Measurements were performed at the baseline, at the eight week and at the sixteenth week., Results: Functional muscle strength, gross motor function, and energy expenditure improved more in the FES-C group after training and follow up ( p  < 0.05). There was no significant difference found between the changes in gait parameters of the two groups after treatment and follow up ( p  > 0.05). Pelvic tilt while walking decreased after training in the FES-C group ( p  < 0.05)., Conclusions: FES-C applied in addition to conventional physical therapy in children with diplegic cerebral palsy is more effective than conventional physical therapy for increasing functional muscle strength, improving gross motor function functions, and reducing energy expenditure.HighlightsFES-C improves lower extremity functional muscle strength, gross motor function, and energy expenditure in ambulatory children with spastic dCP.The use of FES-C in combination with conventional physiotherapy methods may be beneficial in outpatients with spastic dCP.

Background: Preterm infants have oral feeding difficulty that often delays discharge, indicating a need for evidence-based interventions for oral-motor development., Purpose: To test the Premature Infant Oral Motor Intervention (PIOMI) on the development of oral-motor function, feeding, and anthropometric outcomes using sucking manometry., Methods: A single-blind randomized experimental design was conducted with a sample of 60 preterm infants from 2 neonatal intensive care units between May 2019 and March 2020. The experimental group received PIOMI for 5 min/d for 14 consecutive days. Sucking capacity, anthropometrics (weight and head circumference), bottle feeding, breast/chest feeding initiation, and length of hospital stay were measured. The Yakut Sucking Manometer (PCT/TR2019/050678) was developed specifically for this study and tested for the first time., Results: The experimental group had a statistically significant percent increase over controls in sucking power (69%), continuous sucking before releasing the bottle (16%), sucking time (13%), and sucking amount (12%) with partial η 2 values of interaction between the groups of 0.692, 0.164, 0.136, and 0.121, respectively. The experimental group had a higher increase in weight (89%) and head circumference (81%) over controls ( F = 485.130, P < .001; F = 254.754, P < .001, respectively). The experimental group transitioned to oral feeding 9.9 days earlier than controls ( t = -2.822; P = .007), started breast/chest feeding 10.8 days earlier ( t = 3.016; P = .004), and were discharged 3.0 days earlier., Implications for Research/practice: The PIOMI had a significant positive effect on anthropometrics, sucking capacity, readiness to initiate bottle and breast/chest feeding, and a 3-day reduction in length of hospital stay., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 by The National Association of Neonatal Nurses.)

Introduction: Knee joint proprioception is affected, and lower extremity functioning declines over time in patients with hemophilia A., Aim: To investigate the effects of a structured exercise programme consisting of the close kinetic chain (CKC) exercises on proprioception and physical activity level in pediatric patients with hemophilia., Methods: A total of 21 patients with hemophilia A who had at least one target knee joint were randomized into three groups: Study Group (SG, n = 7), Conventional Treatment Group (CTG, n = 7) and Control Group (CG, n = 7). The SG received a structured, lower limb-specific exercise protocol consisting of CKC exercises 2 days a week for 12 weeks, in addition to prophylactic treatment. The CTG received exercise training as described in the published literature. The CG continued to receive prophylactic treatment during the study period. Proprioception was measured using a digital goniometer before and after treatment in open and closed kinetic chain positions (CKCPs). The Five Times Sit to Stand (STS), Timed Up and Go (TUG) and Functional Independence Score in Hemophilia were used for the assessment of physical activity level., Results: A significant pre/post-treatment difference was found among the groups in proprioception (p = .001) and physical activity level (TUG p = .008, STS p = .001, FISH p = .006). Improvements in proprioception and physical activity level were greater in the SG compared to the other two groups (p < .05)., Conclusion: Compared to conventional exercise, the structured exercise protocol consisting of CKC exercise training produced improvements in proprioception and physical activity in patients with hemophilia A., (© 2022 John Wiley & Sons Ltd.)

Purpose: This case report investigated the effectiveness of an individualized physical therapy program in CALFAN syndrome., Case Description: A 13-year-old girl participated in physical therapy, which included trunk stabilization, balance training, and functional exercises for 12 weeks., Assessments: The International Cooperative Ataxia Rating Scale; Trunk Impairment Scale; Pediatric Quality of Life Inventory; Functional Independence Measure for Children; Quick Disability of the Arm, Shoulder, and Hand Questionnaire; 9-Hole Peg Test; and Cobb measurement were used as outcome measures., Results: Positive changes were observed in the International Cooperative Ataxia Rating Scale; Quick Disability of the Arm, Shoulder, and Hand Questionnaire; Pediatric Quality of Life Inventory; Trunk Impairment Scale; Functional Independence Measure; and the 9-Hole Peg Test. The Cobb angle was increased by 2° in the thoracic region and reduced by 11° in the lumbar region., Conclusions: Physical therapy improved quality of life, functional independence, trunk control, and upper extremity performance., What This Adds to Evidence: This case report is the first to support the effectiveness of physical therapy for a child with CALFAN syndrome., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Academy of Pediatric Physical Therapy of the American Physical Therapy Association.)

Objective: Sleep behaviors have not been well investigated in individuals with idiopathic scoliosis (IS). This study aimed to investigate sleep quality and daytime sleepiness in individuals with IS and investigate the relationship between sleep parameters and curve magnitude, trunk deformity severity, pain, and emotional status in adolescents with IS., Material and Methods: Ninety-one participants between the ages of 10 and 19 years with IS were included. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI), and daytime sleepiness was assessed with Epworth sleepiness scale (ESS). Pain was assessed using the short-form McGill pain questionnaire; the presence or severity of depressive feelings was evaluated using the Beck depression scale., Results: The majority of the participants (64.8%) had poor sleep quality, while daytime sleepiness was within normal limits in most participants (85.7%).The frequency of participants without pain (52.7%) was similar to participants with pain (47.3%). The prevalence of participants with depressed mood was 35.2%. Participants with poor sleep quality were more likely to have a higher sensorial index ( p <0.001), higher total pain scores ( p =0.001), and less lumbar axial rotation ( p =0.046). Higher pain (r=0.391), depression scores (r=0.234), and lower lumbar axial trunk rotation (r=-0.317) were associated with increased daytime sleepiness., Conclusion: We observed poor sleep quality and an association with pain in patients with IS. Curve magnitude had no adverse effect on sleep quality or daytime sleepiness. Therefore, the sleep profile and its association with pain should be considered during the rehabilitation process in patients with IS.

To investigate the effect of a structured exercise training program on pain, functional status, physical function and quality of life (QoL) in string and woodwind players with nonspecific cervical pain. This study had a prospective cohort design and conducted on 40 musicians (26 male, 14 female) aged between 18 and 65 years with persistent nonspecific neck pain in the previous 3 months. Forty musicians were assigned to either violin (n = 20, median age; 26.5 year, height; 1.67 m, body mass; 65 kg, BMI; 23.04 kg/m 2 ) or ney group (n = 20, median age; 27.5 year, height; 1.81 m, body mass; 75 kg, BMI; 23.35 kg/m 2 ) and followed the same structured exercise program (3 days/per week for 8 weeks). The primary outcome was neck pain intensity and assessed on a visual analog scale (VAS). Secondary outcomes; cervical range of motion (ROM) was measured using a goniometer, the jaw-to-sternum and jaw-to-wall distances were used for the assessment of cervical mobility, neck, shoulder and back muscles strength were assessed with a hand-held dynamometer, the Northwick Park Neck Pain and Short Form 36 (SF-36) questionnaires were also used. Normality of data distribution was checked using the Kolmogorov-Smirnov test. For evaluating the training effectiveness on outcome measures, Mann-Whitney U and Wilcoxon test were used compare pre-test and post-test values with/within groups, respectively. The primary outcome (pain intensity) was lowered %33 in both groups. However, the mean change was found similar (median mean changes; -2 for both groups) (p > 0.05). The secondary outcomes; cervical mobility, cervical flexion ROM, disability and muscle strength of the left middle trapezius, left hand grip, anterior and middle parts of the right deltoid, and cervical flexors also significantly improved in both groups (p < 0.05). Only the mean changes of right serratus anterior, middle trapezius and cervical flexor muscles were higher in violin group than ney group (p < 0.05). There was no significant difference in the cervical extension, right rotation, left rotation, right lateral flexion and left lateral flexion after the treatment in both groups (p > 0.05). There was no significant difference between the groups after the exercise program in terms of pain, mobility, range of motion and SF-36 subdomains (p > 0.05). Specific exercise program had similar positive effects on pain, cervical mobility, cervical fexion ROM and disability in string and woodwind players. Although several muscles showed similar improvements in strength, some muscle groups recovered differently. Physical needs specific to the instrument and performance should be taken into account when prescribing exercises to musicians having the same problem, but playing different instruments., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Ataxia is a clinical syndrome characterized by coordination problems and postural disorders., Objective: This study aimed to examine the effects of functional trunk training on trunk control and upper limb functions in autosomal recessive hereditary ataxia., Methods: Twenty patients were randomly divided into treatment and control groups. Both groups received trunk stabilization and balance exercises, and the treatment group received additional functional trunk training sessions (3 days/week for 8 weeks). The International Cooperative Ataxia Rating Scale, Trunk Impairment Scale, Modified Functional Reach Test, Nine-Hole Peg Test and Quick-Disabilities of the Arm Shoulder and Hand questionnaire were used for assessments., Results: The treatment group showed an increase in the upper limb performance bilaterally, whereas increased performance was seen only in the dominant upper limb in the control group. While the functional reach improved in the anterior-posterior (AP) and medial-lateral (ML) directions in the treatment group, it was improved only in the AP direction in the control group. Also, the mean changes in outcomes were not significantly different between the groups except for modified functional reach test., Conclusions: Functional trunk training may be a more effective method to improve upper limb performance and dynamic trunk balance in autosomal recessive hereditary ataxia.

Objectives: To investigate the influence of repeated cervical mobilization (CM) on balance and plantar loading distribution in patients with Multiple Sclerosis (MS)., Methods: A total of 12 individuals were included in the cross over study designed as a cross sectional. The study was carried out from October 2019 until July 2020. Individuals received traditional treatment (TM) and cervical mobilization treatments (CM) 2 days a week for 4 weeks in a different order by random method. It was treated with joint traction and sliding techniques. Soft tissue mobilization techniques for myofascial relaxation were applied for CM in addition to TM. Romberg test (RT), Sharpened Romberg Test (SRT), and Functional Reach Test (FRT) were used to balance the assessment. Plantar loading distribution was evaluated with Pedobarography. The maximum and mean pressure in the foot, the percentages of pressure values in the fore and rear of the foot, and percentages of the bodyweight discharge onto right feet and left feet were recorded., Results: The forefoot loading increased after treatment in the CM group ( p <0.05). The duration of RT and SRT increased, and average pressure decreased in the cervical mobilization group ( p <0.05). The body weight discharge onto right feet and left feet approached 50% after cervical mobilization ( p <0.05)., Conclusions: Cervical mobilization techniques can positively change the balance and plantar loading distribution compared to traditional treatment. Cervical mobilization applications could be used to support neurological rehabilitation., (Copyright: © Neurosciences.)

Background: Previous studies have reported increased kinesiophobia in adults with degenerative scoliosis or adolescents who have undergone spinal surgery. However, little is known about the phenomenon of kinesiophobia among adolescents with idiopathic scoliosis (IS)., Objectives: The aim of this study was to investigate levels of kinesiophobia and its association with treatment choice in IS., Methods: The study included 98 IS patients with a mean age of 14 years and 20 healthy controls. Participants with IS were divided into groups based on treatment conditions, as follows: (1) untreated (n= 33); (2) treated with exercise (n= 32); and (3) treated with a brace (n= 33). Kinesiophobia was measured using the Tampa Scale for Kinesiophobia (TSK). Comparisons were made between four groups., Results: Untreated participants with IS were found to have greater kinesiophobia than healthy controls (p< 0.001). Participants treated with a brace (p= 0.046) and exercise (p= 0.064) had similar kinesiophobia levels as the healthy control group., Conclusions: Kinesiophobia was found to be higher in adolescents with IS compared to healthy peers. Brace or exercise treatment both had a positive impact on kinesiophobia. These findings should be considered when organizing rehabilitation programs to achieve the best results for adolescents with IS.

Background: The current pandemic has affected people's health multidimensionally. This study aims to investigate musculoskeletal pain, sleep quality, depression levels, and their relationships in individuals belonging to different age groups during COVID-19 in Turkey., Methods: A web-based self-administered survey that consisted of demographic questions, The Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and scores of musculoskeletal pain was sent to participants. Pearson correlation analysis was used for determining the statistical relationship between variables., Results: The study includes 1,778 participants. The highest percentage for mild, moderate, and severe pain was in the head (49.8%), back (15.5%), and head (11.5%), respectively. The PSQI-total had shown a weak correlation with pain levels in all body parts. The highest correlation for sleep quality and pain levels was between the PSQI-5 and lower back pain. There was a weak correlation between PSQI- 2 and the BDI score, and a moderate correlation between the PSQI-1, PSQI-5, PSQI- 7, PSQI-total, and BDI score. Pain in all body parts showed a weak correlation with depression level., Conclusions: This study showed that musculoskeletal pain was varied in body parts with different intensities according to age groups in Turkey during the pandemic. The most common pain was in the head, back, and lower back. Headache was found correlated with the parameters of sleep quality. Pain of the head, neck, back, lower back, and shoulder were correlated with sleep latency. Sleep quality was associated with depression and musculoskeletal pain, while musculoskeletal pain was correlated with depression.

Background: The body mass index (BMI) is closely related to fat tissue, which may have direct or indirect effects on muscle function. Previous studies have evaluated BMI and muscle viscoelastic properties in vivo in older people or individual sexes; however, the relationship between BMI and muscular viscoelastic properties is still unknown. Aims: The purpose of this study was to determine the correlation of BMI with muscular viscoelastic properties, and to compare these properties in a young sedentary population with normal and overweight individuals. Methods: A total of 172 healthy sedentary individuals (mean age, 26.00 ± 5.45 years) were categorized by sex (male and female) and BMI classification (normal (BMI, 18.50-24.99 kg/m 2 ), overweight (BMI = 25.00-29.99 kg/m 2 )). Body weight was evaluated using an electronic scale, while height was measured using a standard stadiometer. BMI was calculated by dividing the weight in kilograms by the square of height in meters. The viscoelastic properties (tone, stiffness, and elasticity) of the biceps brachii (BB) and biceps femoris (BF) muscles were measured bilaterally using the MyotonPRO device at rest. Results: The bilateral BF tone and stiffness, right BB stiffness, and elasticity showed weak correlations with BMI in all participants. Furthermore, the bilateral BF tone and stiffness, right BB stiffness and elasticity, and left BB stiffness were weakly positively correlated with male sex. Only the right BB elasticity was weakly positively correlated with BMI in females ( p < 0.05). No correlation with BMI was determined for other viscoelastic properties ( p > 0.05). The overweight group showed increased bilateral BF stiffness and tone, right BB stiffness, and reduced bilateral BB elasticity compared to the normal-weight group ( p < 0.05), while other viscoelastic properties were similar ( p > 0.05). Greater bilateral BB tone, BF tone and stiffness, and lower BF elasticity were observed in males than in females ( p < 0.05), but other viscoelastic properties were not significantly different ( p < 0.05). No effect of BMI-sex interactions was found on viscoelastic properties ( p > 0.05). Conclusions: The BB and BF viscoelastic properties were weakly correlated with BMI. Males showed greater muscle tone and stiffness, and lower elasticity. The overweight individuals showed increased stiffness and tone, particularly in lower extremities, and reduced elasticity in upper extremities. The effect of BMI-sex interactions on the viscoelastic properties was not clear. Higher BMI (increased mechanical load) might cause the human body to develop different muscular viscoelastic adaptations in the extremities.

Background: While some studies of the asymmetry of lower limbs in individuals with idiopathic scoliosis exist, there is a need for multidirectional studies conducted on hip joint range of motion and its relationship to curve patterns in idiopathic scoliosis., Objectives: This study analyzes the hip joint range of multidirectional motions, hip motion asymmetry and investigates them according to curve patterns in individuals with idiopathic scoliosis., Methods: The sample included 108 females with idiopathic scoliosis. Participants were divided into three groups: double curves, single thoracic curve and single lumbar curve. The range of hip flexion and extension, abduction and adduction, and internal and external rotations were assessed actively and passively with a universal goniometer. The range of motion, left-right asymmetry and the mid-points of the ranges of motion were analyzed., Results: The passive range of the right hip abduction was higher in the thoracic curve group vs. the lumbar curve group. Active and passive ranges of hip extension were higher in the left hip vs. right hip. Active left-right asymmetry was higher than passive left-right asymmetry., Conclusion: Individuals with idiopathic scoliosis had different hip abduction motions according to curve pattern that originated from single curves. Left-right hip asymmetry was seen for the hip extension motion. Higher left-right asymmetry for active motion than passive motion in hip abduction may indicate a problem in motion perception in individuals with idiopathic scoliosis., Competing Interests: Declaration of competing interest None. The study was approved by the University of Hasan Kalyoncu Research Ethics Board. The patients were informed regarding the study and evaluation methods; and thereby, signed informed consent forms were obtained., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The aim of the study was to assess the characteristics of footwear altogether and to compare the effect of appropriate-fitting and ill-fitting footwear on functional performance, balance, and fear of falling (FoF) in older adults. Individuals who wore appropriate-fitting (n = 61) or ill-fitting footwear (n = 92) were enrolled in the study. Footwear was evaluated using the Footwear Assessment Scale (FAS). The participants were assessed using the Berg Balance Scale (BBS) for balance, the Timed Up and Go test for functional performance and the Activities-specific Balance Confidence scale for FoF. Tests were conducted twice for each individual with or without footwear. Differences between the groups were analyzed using the MANOVA for scores of balance, performance and fear of falling and Chi-squared test for homogeneity. The Paired t-test was used to compare test scores with or without footwear. It was concluded that appropriate-fitting footwear improves balance, reduces fear of falling and may affect functional performance positively. ClinicalTrials.gov No: NCT04151654., Competing Interests: Declaration of Competing Interest The Author(s) declare(s) that there is no conflict of interest., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: The instant effect of a brace on pulmonary functions of patients with adolescent idiopathic scoliosis (AIS) is known. However, the permanent effects of its regular use are still unclear., Objective: This study aimed to determine whether a brace in patients with AIS had a permanent effect on respiratory functions., Methods: Fifteen patients with a mean age of 13.2 ± 1.6 years, and a major Cobb angle of 25.8∘± 7.7∘ participated in this study. Lung volumes and respiratory muscle strength were measured with and without thoracolumbosacral brace, at the end of first month and follow-up period after the patients started using the brace for 23 hours daily., Results: When the brace was on, the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), ratio of FEV1/FVC, peak expiratory flow, and forced expiratory flow between 25% and 75% of vital capacity values were found to be lower at both first month and follow-up. After the follow-up, the measurement results did not differ from the results of the first month., Conclusions: The brace had a momentary restrictive effect on patients with AIS. However, it did not cause a permanent change in pulmonary functions after the 8-month follow-up.

Study Design: Cross-sectional and clinical measurement., Objective: To evaluate upper extremity function and its relation to the curve pattern in idiopathic scoliosis. Postural alterations and trunk distortions-caused by three-dimensional deformity itself in idiopathic scoliosis-may lead to functional changes in the upper extremity of subjects., Methods: Handgrip, pulp and lateral pinch strengths, hand dexterity, hand reaction time, coordination of upper extremity, upper extremity performance, throwing accuracy, and self-reported upper extremity disability were evaluated in 96 subjects. These subjects were divided into 3 groups: 47 with main thoracic curve pattern scoliosis (Lenke type 1), 31 with thoracolumbar/lumbar curve pattern scoliosis (Lenke type 5), and 18 unaffected (healthy control). Comparisons were performed between these three groups., Results: The thoracic scoliosis group showed a significant decrease in concave lateral pinch strength, concave hand dexterity of turning, coordination of the upper extremities, and concave hand reaction time than the thoracolumbar/lumbar scoliosis group (p < 0.05). Bilateral handgrip strengths decreased in thoracic scoliosis group when compared to healthy controls. Healthy individuals demonstrated greater throwing accuracy than individuals with scoliosis., Conclusions: Upper extremity function was found to be affected based on the curve pattern. Individuals with main thoracic curves are likely to have deteriorated upper extremity function, especially for hand-specific motor skills, on the concave side, when compared to lumbar curves and healthy controls., Level of Evidence: Level III.

Background: Postural stability (PS) problems arise as individuals grow older, and as a result, risk of falling (RoF) increases in older adults. We sought to examine the effects of insoles of various thicknesses on PS and RoF in older adults., Methods: Fifty-six study participants had PS and RoF evaluated statically and dynamically under five different conditions: barefoot, only-shoes, with 5-mm insoles, with 10-mm insoles, and with 15-mm insoles. Standard shoes with identical features were used. To avoid time-dependent problems, these assessments were performed under the same conditions in 3 consecutive weeks. The average of these three values was recorded., Results: Insoles of different thicknesses significantly affected static PS (overall: P =.003; mediolateral [ML]: P =.021; anteroposterior [AP]: P =.006), static RoF (overall, ML, and AP: P < .001), dynamic RoF (overall: P = .003; ML: P = .042; AP: P = .050), and dynamic PS (overall: P = .034; AP: P = .041) but not dynamic PS ML (P = .071). For static PS overall, dynamic PS AP, static RoF overall and ML, and dynamic RoF overall and ML, the highest PS scores and the lowest RoF were recorded when using 10-mm insoles (P < .05)., Conclusions: The use of insoles of different thicknesses has been shown to be effective on all RoF and PS measurements except dynamic PS ML. The 10-mm-thick insole was a better option for elderly individuals to increase PS and reduce RoF compared. For older adults, 10-mm-thick insoles made of medium-density Plastozote may be recommended to help improve PS and reduce RoF.

An individual's body awareness depends on the integration of bodily signals from both inside and outside the body. The etiology of idiopathic scoliosis includes a variety of somatosensorial and biomechanical alterations that may affect an individual's body awareness. In this study, we investigated body awareness and its relation to quality of life among individuals with idiopathic scoliosis. We studied 96 participants with scoliosis and 71 healthy control participants. We evaluated both participant groups' body awareness using the Awareness-Body-Chart, and we assessed the quality of life of those with scoliosis using the Scoliosis Research Society-22 (SRS-22) questionnaire. The overall body awareness score and the body awareness values for the face, cervical/lumbar region, back, shoulder, upper arm, lower arm/elbow, hand, genital area, thigh/hip, lower leg, and foot were all found to be significantly lower among the participants with scoliosis than among healthy participants. Among participants with scoliosis, the body awareness value for the back region was positively correlated with pain, body image, mental health, and overall quality of life scores on the SRS-22, whereas the pain score on the Awareness-Body-Chart was negatively correlated with the function/activity, pain, mental health, and overall scores for the SRS-22. This study showed that participants with idiopathic scoliosis have poorer body awareness than control participants without scoliosis, and body awareness among participants with scoliosis was correlated with their self-reports of pain, body image, function, and mental health. These findings highlight the particular importance of body awareness to quality of life for individuals with scoliosis.

Objective: The aim of this study was to investigate the short-term effects of scapular repositioning using an elastic taping technique on the three-dimensional (3-D) shoulder and thoracic kinematics during various activities of daily living (ADLs) in adolescents with idiopathic scoliosis (IS)., Methods: Shoulder and spine kinematics during five ADL movement tasks were assessed in 24 adolescents with IS (3 males and 21 females; mean age: 15.8 years; age range: 14-17 years) before and 15 min after elastic scapular taping. All the participants had a moderate curve magnitude (Cobb angle: 20°-45°), with a primary thoracic curve. A 3-D electromagnetic tracking system (Ascension Technology Corporation, Shelburne, VT, USA) was used to record 3-D shoulder and thoracic kinematics. ADL movement tasks included touching the mouth/drinking, touching the back, touching the contralateral shoulder, reaching upward, and bilateral 4-kg weight lifting. Two separate strips of elastic tape were applied using the same correction technique for each shoulder and scapular region to control scapular alterations in the resting position., Results: Elastic scapular taping significantly improved scapular external rotation and scapular upward rotation. Similarly, humeral horizontal adduction, external rotation, thoracic flexion, and lateral bending significantly increased in the taped condition depending on the specific task (p<0.05)., Conclusion: Elastic scapular taping can change scapular orientations on the convex and concave sides, thereby affecting upper extremity and trunk kinematics. Thus, the dynamic stability of the scapula increases to produce larger movements during functional activities., Level of Evidence: Level IV, Therapeutic study.

Background: This study sets out to investigate the effects of early physiotherapy on biochemical parameters in major burn patients., Methods: Ten women (50%) and 10 men (50%) aged 21-47 years old were included in this study. Participants were divided into two groups: the first group was the treatment group and the second group was the control group. In the treatment group, patients were admitted to the physiotherapy programme from the first day they have been hospitalised, in addition to their routine treatment (e.g. medical, surgery), for four days per week. The physiotherapy programme consisted of parameters, such as early mobilisation and ambulatory training, chest physiotherapy, and both active and passive normal joint movement exercises. The days of treatment were determined as of Tuesday, Wednesday, Thursday and Friday. Patients could not be treated on a Monday because that was surgery day. The control group consisted of patients who could not receive physiotherapy due to various reasons. All patients included in this study were evaluated weekly for six weeks after admission to the hospital. Parameters, such as demographic information, characteristics of burn injury, C-reactive protein, fibronectin, transferrin and prealbumin, were evaluated., Results: When the results obtained in this study were considered, there was a significant difference in favour of the treatment group for all biochemical parameters (p<0.05). From the second week, a significant increase was observed in prealbumin values in the treatment group (p<0.05). A significant increase was observed in fibronectin after the fourth week (p<0.05)., Conclusion: We believe that early physiotherapy should be included in the treatment in major burns. Early physiotherapy may reduce the effects of hypermetabolic response after major burns. There is a need for multi-centered and broader studies.

Background: Despite the common use of braces to prevent curve progression in idiopathic scoliosis, their functional effects on respiratory mechanics have not been widely studied., Objective: The objective was to determine the effects of bracing on pulmonary function in idiopathic scoliosis., Methods: A total of 27 adolescents with a mean age of 14.5 ± 1.5 years and idiopathic scoliosis were included in the study. Pulmonary function evaluation included vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, peak expiratory flow, and respiratory muscle strengths, measured with a spirometer, and patient-reported degree of dyspnea. The tests were performed once prior to bracing and at 1 month after bracing (while the patients wore the brace)., Results: Compared with the unbraced condition, vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, and peak expiratory flow values decreased and dyspnea increased in the braced condition. Respiratory muscle strength was under the norm in both unbraced and braced conditions, while no significant difference was found for these parameters between the two conditions., Conclusion: The spinal brace for idiopathic scoliosis tended to reduce pulmonary functions and increase dyspnea symptoms (when wearing a brace) in this study. Special attention should be paid in-brace effects on pulmonary functions in idiopathic scoliosis., Clinical Relevance: Bracing seems to mimic restrictive pulmonary disease, although there is no actual disease when the brace is removed. This study suggests that bracing may result in a deterioration of pulmonary function when adolescents with idiopathic scoliosis are wearing a brace.

Background: There are several kinds of scoliosis-specific and general physiotherapeutic exercise methods used in scoliosis rehabilitation. But there is need for comparable studies on the effectiveness of different exercise approaches for the treatment of adolescent idiopathic scoliosis., Objectives: Comparison of the effects of combined core stabilization exercise and bracing treatment with Scientific Exercises Approach to Scoliosis and bracing treatment in patients with moderate adolescent idiopathic scoliosis., Methods: Thirty females with adolescent idiopathic scoliosis, who have moderate curves (20°-45°), were randomly divided into two groups. In addition to brace wearing for 4 months, one group received core stabilization exercise therapy, while the other received scientific exercises approach to scoliosis exercise therapy. The outcome measures were based on Cobb angle, angle of trunk rotation, body symmetry, cosmetic trunk deformity, and quality of life., Results: Thoracic and lumbar Cobb angles and trunk rotation angles, body symmetry, and cosmetic trunk deformity improved for both groups. Quality of life did not change in either group. The pain domain of the Scoliosis Research Society-22 questionnaire improved in the core stabilization group only., Conclusion: Both treatment conditions including core stabilization with bracing and scientific exercises approach to scoliosis with bracing had similar effects in the short-term treatment of moderate adolescent idiopathic scoliosis., Clinical Relevance: This study showed that when scientific exercises approach to scoliosis (SEAS) and core stabilization (CS) exercises were administered with equal intensity, the effects of the two treatment protocols including CS and bracing and SEAS and bracing were similar in the treatment of patients with moderate adolescent idiopathic scoliosis (AIS).

Background: The most prominent characteristics of hemiparetic cerebral palsy (hCP) children are structural and functional asymmetries. These children have low walking speeds, endurance and poor balance. The robotic walking devices repeat and experience symmetrical stepping at the corresponding speed and angles of the lower extremities. RESEARCH QUESTION 1: Are robotic walking devices effective in the development of walking in hCP children who can walk? RESEARCH QUESTION 2: How does the aerobic exercise experience with assisted and symmetrical movement affect the walking and local muscle, peripheral oxygenation of children with hCP?, Methods: This prospective, controlled study included 24 children with hCP. All children attended to a standard physiotherapy rehabilitation (PTR) program (three days a week for 12 weeks); those in the study group (n=12) also attended to an Robotic Gait Training (RGT) program three times a week. Evaluations performed before treatment, after treatment, and at the 3rd month after treatment included assessment of balance, functionality walking and measurements for oxygenation of vastus lateralis muscle and peripheral oxygenation., Results: The evaluations were similar for both groups before treatment. After treatment, walking speed, endurance and peripheral O2 saturation were increased and balance abilities and functional performances improved in the RGT group as compared with the pre-treatment evaluations; these improvements in balance and functional performance were generally preserved after 3 months of treatment. An increase in 6-min walking distance and a partial increase in gross motor functions and functional muscle strength were observed in the control group; however, these abilities were not preserved after the treatment., Significance: RGT can provide a faster and higher effect on the development of functional muscle strength, balance, walking speed and endurance than the standard PTR program. It improves functional walking performance. RGT can be used for aerobic exercise training in children with walking hCP., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Foot orthoses are widely used in conservative treatment of painful flexible flatfoot (PFFF) however research is limited to choose the best option in orthotic treatment., Aim: We aimed to compare the effects of computer-aided design/computer-aided manufacturing (CAD-CAM) and conventional insole types in comparison with sham insole, on pain and health related quality of life in patients with PFFF., Design: Randomized controlled trial., Setting: Outpatient rehabilitation clinic., Population: Sixty-seven people with PFFF, aged between 18 and 45 years, were assigned to CAD-CAM (N.=22), conventional (N.=22) or sham (N.=23) groups., Methods: In addition to insoles, a home-based exercise program was followed by all participants for eight weeks. Foot pain intensity and quality of life were assessed at the initial evaluation and at the end of two-month follow-up., Results: Pain intensity (Mean±SD, mm on VAS) was significantly lower in CAD-CAM (27.84±18.41) and conventional (27.05±16.82) insole groups than sham group (46.39±20.18) after two months (P<0.05), but there was no difference between conventional and CAD-CAM (P>0.05). All groups had significantly higher physical health scores at the second assessment (P<0.05), but there was no intergroup difference (P>0.05)., Conclusions: CAD-CAM and conventionally designed insoles are both more effective than having sham insole in alleviating pain in PFFF., Clinical Rehabilitation Impact: CAD-CAM and conventionally designed semicustom insoles in conjunction with a home-based exercise program are both effective in controlling pain compared with sham insole and exercise in PFFF. Clinicians can prescribe both types of semicustom insoles as a part of conservative treatment instead of each other.

Purpose: Visual and proprioceptive cues are important for body orientation to maintain correct posture. This study investigated the effects of exercise training on subjective visual, postural, and haptic perception of verticality in patients with scoliosis., Subjects and Methods: Thirty-two female adolescents with moderate idiopathic scoliosis were randomly allocated to "Core Stabilization Exercise (CSE)," "Body Awareness," or "Traditional Exercise (TE)" groups. Each group completed a 1-hour supervised program, two days per week for 10 weeks while continuing to wear spinal braces. Perceptual visual, postural, and haptic estimates were assessed before and after treatment., Results: Subjective visual vertical perception only improved in the awareness group. Subjective visual horizontal perception, postural vertical perception, total postural perception scores, total haptic perception scores, and haptic perception 45° to the right were significantly improved in the stabilization and awareness groups. For the 60° right and 60° left postural perception parameters, as well as the 45° left haptic perception parameters, perception improved only in the stabilization group. No improvement was observed in the traditional group., Conclusion: Improvements in visual, postural, and haptic verticality perception within the stabilization exercise training and Basic Body Awareness group treatment suggest the addition of these exercise methods for the treatment of idiopathic scoliosis to improve internal body orientation.

Background: Evaluation of the effects of brace treatment on quality of life in adolescent idiopathic scoliosis is important., Objectives: To analyze the validity and reliability of the Turkish version of the Brace Questionnaire., Study Design: Cohort study, evaluation of reliability and validity of the Turkish version of the Brace Questionnaire., Methods: Twenty-eight patients undergoing brace treatment for adolescent idiopathic scoliosis (median age: 14.6 years) were included in the study. The Brace Questionnaire was translated into Turkish and administered to the patients twice at an interval of 5 days. Reliability was assessed using the test-retest method (Pearson's correlation coefficient); internal consistency was analyzed using Cronbach's alpha. Validity was assessed by correlating the Brace Questionnaire with the Bad Sobernheim Stress Questionnaire-Brace and Scoliosis Research Society-22 questionnaire., Results: The mean Cobb angles were 31.1° ± 8.3° and 29.7° ± 9° for thoracic and lumbar regions, respectively. Cronbach's alpha was 0.94. Intraclass correlation coefficient was 0.95 in test-retest reliability analysis. The correlations between Brace Questionnaire and Bad Sobernheim Stress Questionnaire-Brace and Scoliosis Research Society-22 were r = 0.67 and r = 0.64, respectively., Conclusion: The Turkish version of the Brace Questionnaire to measure the effects of brace treatment on quality of life in adolescent idiopathic scoliosis was found to have good validity, excellent reliability, and high internal consistency. Clinical relevance We recommend routine use of the Brace Questionnaire in scoliosis patients to evaluate brace-related quality of life and relevant factors and to support the individual when necessary during such treatment.

Background: In scoliosis, curve progresses due to muscle imbalance and poor posture. Basic body awareness therapy (BBAT) aims to improve posture, coordination, and balance by increasing body awareness, which may help decrease deformities., Objective: This study aimed to investigate effects of Basic body awareness therapy (BBAT) on curve magnitude, trunk asymmetry, cosmetic deformity, and quality of life in adolescent idiopathic scoliosis (AIS) patients., Methods: Twenty female AIS patients were randomly assigned to BBAT and traditional exercises (TEs) groups. The BBAT group received BBAT and traditional exercises (TEs), while the TEs group received only TEs. The following assessments were included: Cobb angles using X-ray, angle of trunk rotation (ATR) using scoliometer, trunk asymmetry using the Posterior Trunk Symmetry Index (POTSI), cosmetic deformity using the Walter Reed Visual Assessment Scale (WRVAS), and quality of life using the SRS-22 test. Measurements were conducted at baseline examination and ten weeks later. Patients were instructed to wear their brace 23 h daily. Results were analyzed using the Wilcoxon rank-sum test to compare repeated measurements and Mann-Whitney U test to compare the groups., Results: The BBAT group had greater improvement in the thoracic Cobb angle than the TEs group. Cosmetic deformity improved in both groups, whereas body asymmetry improved in only the BBAT group. SRS-22 scores were unchanged in both groups., Conclusions: BBAT as an additive to bracing and TEs improve curve magnitude, body symmetry and trunk deformity.

Study Design: Single-blinded randomized controlled trial., Introduction: Pain management is essential in the early stages of the rehabilitation of distal radius fractures (DRFx). Pain intensity at the acute stage is considered important for determining the individual recovery process, given that higher pain intensity and persistent pain duration negatively affect the function and cortical activity of pain response. Graded motor imagery (GMI) and its components are recent pain management strategies, established on a neuroscience basis., Purpose of the Study: To investigate the effectiveness of GMI in hand function in patients with DRFx., Methods: Thirty-six participants were randomly allocated to either GMI (n = 17; 52.59 [9.8] years) or control (n = 19; 47.16 [10.5] years) groups. The GMI group received imagery treatment in addition to traditional rehabilitation, and the control group received traditional rehabilitation for 8 weeks. The assessments included pain at rest and during activity using the visual analog scale, wrist and forearm active range of motion (ROM) with universal goniometer, grip strength with the hydraulic dynamometer (Jamar; Bolingbrook, IL), and upper extremity functional status using the Disability of the Arm, Shoulder and Hand Questionnaire, and the Michigan Hand Questionnaire. Assessments were performed twice at baseline and at the end of the eighth week., Results: The GMI group showed greater improvement in pain intensity (during rest, 2.24; activity, 6.18 points), wrist ROM (flexion, -40.59; extension, -45.59; radial deviation, -25.59; and ulnar deviation, -26.77 points) and forearm ROM (supination, -43.82 points), and functional status (Disability of the Arm, Shoulder and Hand Questionnaire, 38.00; Michigan Hand Questionnaire, -32.53 points) when compared with the control group (for all, P < .05)., Conclusion: The cortical model of pathological pain suggests new strategies established on a neuroscience basis. These strategies aim to normalize the cortical proprioceptive representation and reduce pain. One of these recent strategies, GMI appears to provide beneficial effects to control pain, improve grip strength, and increase upper extremity functions in patients with DRFx., (Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.)

Objective: This study compared the effectiveness of radial extracorporeal shock wave therapy (r-ESWT) with ultrasound (US) therapy in the treatment of plantar fasciitis (PF)., Study Design: Level II, randomized controlled study., Design: A total of 54 female patients with unilateral PF were randomly assigned to two study groups and one control group. All groups performed home exercises. In addition, the first study group received three sessions of r-ESWT treatment and the second study group received seven sessions of US treatment. The Foot Function Index (FFI) and the American Orthopedic Foot and Ankle Association (AOFAS) hind foot score were determined. Static and dynamic equilibrium were evaluated with the single leg standing test and the functional reach test. Ankle proprioception sense was determined with the Biodex III isokinetic device. Patients were evaluated before and four weeks after the first treatment., Results: According to the evaluation results, there was a decrease in FFI values in all groups and these decreases were more prominent in the US group than the other groups (P < 0.05). It was observed that the hind foot AOFAS scores increased in all groups, but this increase was less in the control group (P < 0.05). Static and dynamic balance increased in all groups (P < 0.05). Ankle proprioception sense increased only in the r-ESWT group (P <0.05)., Conclusions: All groups and particularly the r-ESWT and US groups' symptoms were decreased after treatment. However; FFI parameters were reduced more in the US groups than the other two groups, the ankle proprioception sense increased in the r-ESWT group, and there was no change in the other groups., (© 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com)

Background/aim: Our aim was to investigate the association of kinesiophobia with pain, quality of life, clinical measures, and depression in patients with ankylosing spondylitis (AS). Materials and methods: Patients with AS (n: 163) were enrolled in the study. Kinesiophobia was evaluated with the Tampa Scale of Kinesiophobia (TSK), pain with a visual analog scale (VAS), mobility with Bath Ankylosing Spondylitis Metrology Index (BASMI), disease activity with the Bath AS Disease Activity Index (BASDAI), functional status with the Bath AS Functional Index (BASFI), depression level with Beck's Depression Inventory (BDI), and quality of life with the AS Quality of Life Questionnaire (ASQoL). Besides correlation analysis, outcome measures were compared between patients with (TSK ? 37) and without (TSK < 37) kinesiophobia. Results: Kinesiophobia was found to be common with a percentage of 66.6%. TSK scores were correlated with VAS, BASFI, ASQoL, and BDI scores (r = 0.259, r = 0.294, r = 0.392, and r = 0.398, respectively; P < 0.05 for each). There were no correlations between TSK and the BASDAI and BASMI scores (r = 0.142, r = 0.198, respectively; P > 0.05). Patients with kinesiophobia had more pain and poorer BASFI, ASQoL, and BDI scores than patients without kinesiophobia (P < 0.05).Conclusion: Our study is the first study that investigated the relationship between kinesiophobia and other clinical measures in AS patients. Pain and psychological status have an impact on fear of movement and thus functional status and quality of life.

The present study tested the reliability and validity of the Turkish version of the visual analog scale foot and ankle (VAS-FA) among healthy subjects and patients with foot problems. A total of 128 participants, 65 healthy subjects and 63 patients with foot problems, were evaluated. The VAS-FA was translated into Turkish and administered to the 128 subjects on 2 separate occasions with a 5-day interval. The test-retest reliability and internal consistency were assessed with the intraclass correlation coefficient and Cronbach's α. The validity was assessed using the correlations with Turkish versions of the Foot Function Index, the Foot and Ankle Outcome Score, and the Short-Form 36-item Health Survey. A statistically significant difference was found between the healthy group and the patient group in the overall score and subscale scores of the VAS-FA (p < .001). The internal consistency of the VAS-FA was very good, and the test-retest reliability was excellent. Adequate to good correlations were found between the overall VAS-FA score and the Foot Function Index, Foot and Ankle Outcome Score, and Short-Form 36-item Health Survey scores in the healthy and patient groups both. The Turkish version of the VAS-FA is sensitive enough to distinguish foot and ankle-specific pathologic conditions from asymptomatic conditions. The Turkish version of the VAS-FA is a reliable and valid method and can be used for foot-related problems., (Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

The scapula plays a critical role in supporting shoulder function. Considering the closed anatomical relationship between the scapula and the thoracic cage, the presence of postural disturbances could be linked to alterations in the scapular position and orientation in adolescent idiopathic scoliosis (AIS). However, currently there is a lack of descriptive research and detailed assessment of scapular kinematics in AIS. The aim of this study was to investigate the three-dimensional scapular kinematics in AIS. Nineteen AIS patients and fourteen healthy controls participated in this study. Bilateral shoulder kinematics were measured with an electromagnetic tracking device during shoulder elevation in the sagittal, scapular, and frontal planes. Data for the scapular orientation were analyzed in the resting position and at 30°, 60°, 90°, and 120° of humerothoracic elevation. Scapular behavior was different in participants with AIS, compared to healthy controls, with different patterns observed on convex and concave sides. While examining all three planes of elevation, the scapula was more internally and anteriorly tilted on the convex side, while the scapula was more externally, downwardly rotated, and posteriorly tilted on the concave side in participants with AIS. Furthermore, there was a decreased peak humerothoracic elevation and altered scapular posterior tilt in participants with AIS in the resting position. These findings increase our knowledge and understanding of scapular alterations and the reported scapular alterations can be considered as adaptive compensation strategies in AIS., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Bracing is the most common nonsurgical treatment for adolescent idiopathic scoliosis. Spinal braces affect glenohumeral and scapulothoracic motion because they restrict trunk movements. However, the potential spinal-bracing effects on scapular kinematics are unknown. The present study aimed to investigate the acute effects of spinal bracing on scapular kinematics in adolescent idiopathic scoliosis., Methods: Scapular kinematics, including scapular internal/external rotation, posterior/anterior tilting, and downward/upward rotation during scapular plane elevation, were evaluated in 27 in-brace and out-of-brace adolescent idiopathic scoliosis patients with a three-dimensional electromagnetic tracking system. Data on the position and orientation of the scapula at 30°, 60°, 90°, and 120° humerothoracic elevation were used for statistical comparisons. The paired t-test was used to assess the differences between the mean values of in-brace and out-of-brace conditions., Findings: The in-brace condition showed significantly increased (P<0.05) scapular anterior tilting and decreased internal rotation in the resting position on the convex and concave sides; increased scapular downward rotation at 120° humerothoracic elevation on the convex side and at 30°, 60°, 90°, and 120° humerothoracic elevation on the concave side; increased scapular anterior tilt at 30°, 60°, 90°, and 120° humerothoracic elevation on the convex and concave sides; and decreased (P<0.05) maximal humerothoracic elevation of the arm., Interpretation: Spinal bracing affects scapular kinematics. Observed changes in scapular kinematics with brace may also affect upper extremity function for adolescents with idiopathic scoliosis. Therefore, clinicians should include assessments of the glenohumeral and scapulothoracic joints when designing rehabilitation protocols for patients with adolescent idiopathic scoliosis., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Core stabilization training is used to improve postural balance in musculoskeletal problems., Objectives: The purpose of this study was to investigate the effectiveness of stabilization training in adolescent idiopathic scoliosis., Study Design: A randomized controlled trial, pretest-posttest design., Methods: In total, 25 subjects with adolescent idiopathic scoliosis were randomly divided into two groups: stabilization group ( n = 12) and control group ( n = 13). The stabilization group received core stabilization in addition to traditional rehabilitation, and the control group received traditional rehabilitation for 10 weeks. Assessment included Cobb's angle on radiograph, apical vertebral rotation in Adam's test, trunk asymmetry (Posterior Trunk Symmetry Index), cosmetic trunk deformity (Trunk Appearance Perception Scale), and quality of life (Scoliosis Research Society-22 questionnaire)., Results: Inter-group comparisons showed significantly greater improvements in the mean change in lumbar apical vertebral rotation degree and the pain domain of Scoliosis Research Society-22 in the stabilization group than those in the control group ( p < 0.05). No significant differences were observed for other measurements between the groups; however, trends toward greater improvement were observed in the stabilization group., Conclusion: Core stabilization training in addition to traditional exercises was more effective than traditional exercises alone in the correction of vertebral rotation and reduction of pain in adolescent idiopathic scoliosis. Clinical relevance Stabilization exercises are more effective in reducing rotation deformity and pain than traditional exercises in the conservative rehabilitation of adolescent idiopathic scoliosis. These improvements suggest that stabilization training should be added to rehabilitation programs in adolescent idiopathic scoliosis.

Background: Taping is an effective temporary therapy for improving hallux valgus (HV) in adults. Although HV has been demonstrated to impair postural balance, there is a lack of information about how corrective taping affects balance and gait patterns in adults with HV deformity., Methods: Eighteen middle-aged female patients (average age, 53.5 years) with HV were included. Corrective tape was applied to correct HV angulation. A series of balance and gait stability tests were performed before applying tape and 1 hour after the tape was applied with a Balance Master computerized posturography device. The study involved the following tests: modified clinical test of sensory interaction and balance (mCTSIB), unilateral stance (US), limit of stability (LoS), step up/over (SUO), and walk across (WA) tests., Results: No significant difference was found between the no-tape and taped condition in the static balance mCTSIB and US tests ( P > .05). The taping intervention resulted in significant improvement in the dynamic balance measures for the LoS test's backward reaction time and left maximum excursion ( P < .05), a significantly higher impact index bilaterally in the SUO assessment ( P < .05), and an increase in step width mean and variability in the WA test ( P < .05)., Conclusions: Taping for correcting HV angulation had negative acute effects on dynamic balance in the SUO and WA tests and positive effects in the LoS test., Clinical Relevance: Corrective taping, although a form of conservative treatment for hallux valgus, has been insufficiently studied in terms of effects on balance. Our results show that taping, as an acute effect, may impair balance in middle-aged adults when walking or ascending and descending stairs.

[Purpose] The aim of this study was to investigate the effect of segmental weight of the prosthesis on hemodynamic responses and energy expenditure in lower extremity amputees. [Subjects and Methods] Thirteen patients with a mean age of 44 ± 15.84 years and with unilateral transtibial, transfemoral and Syme's amputation were included to the study. The difference between the lightest and the heaviest prosthesis, 250 g used as the weight. All the patients completed the measurements first without weight and then with 250 g weight on the ankle joint. The blood pressure and heart rate of the patients were recorded before and after Six Minute Walk Test (6MWT) and 10 stairs up & down stairs test. Physiological Cost Index was used to calculate the energy expenditure. [Results] Heart rate and energy expenditure increased significantly when without weight and with weight results compared. [Conclusion] We conclude that the segmental weight of the prosthetic limb has a significant effect on the heart rate and energy expenditure but has no effect on the systolic and diastolic blood pressure of lower limb amputees. In order to generalize our results to lower limb amputees, more patients need to be included in future studies.

The authors of this study compared the effects of pilates exercises and connective tissue massage (CTM) on pain intensity; pain-pressure threshold; and tolerance, anxiety, progress, and health-related quality of life in females with fibromyalgia. It was a pilot, assessor masked, randomized controlled trial conducted between January and August of 2013. Twenty-one women with fibromyalgia were randomly assigned to the pilates exercise program (six of whom did not complete the program), and 22 were randomly assigned to CTM (one of whom did not complete this program). Each group received the assigned intervention three times per week during a 4-week period. The Visual Analogue Scale, algometry, State-Trait Anxiety Inventory, Fibromyalgia Impact Questionnaire, and Nottingham Health Profile were used at baseline and at the end of treatments. Significant improvements were found in both groups for all parameters. However, the scores for pain-pressure threshold were significantly elevated and the symptoms of anxiety were significantly diminished in the exercise group compared to the massage group. Thus, exercise and massage might be used to provide improvements in women with fibromyalgia. The exercise group showed more advantages than the massage group and thus might be preferred for patients with fibromyalgia. However, an adequately powered trial is required to determine this with certainty.

Objective: The aim of this study was to investigate the reliability and validity of the Turkish version of the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module for 2- to 7-year-old and the PedsQL 4.0 Generic Core Scales for 5- to 7-year-old in childhood cancer., Materials and Methods: The PedsQL 3.0 Cancer Module and PedsQL 4.0 Generic Core Scales were administered to children with cancer and their parents at Hacettepe University. Internal consistency was determined by using Cronbach's alpha and test-retest reliability was determined by using the intraclass correlation coefficient (ICC). Construct validity was assessed by comparing the results of the PedsQL 3.0 Cancer Module with those of the PedsQL 4.0 Generic Core Scales., Results: Cronbach's alpha of the PedsQL 3.0 Cancer Module varied from 0.803 to 0.873 and that of the PedsQL 4.0 Generic Core Scales from 0.665 to 0.841. Test-retest ICC values of the PedsQL 3.0 Cancer Module varied from 0.877 to 0.949 and those of the PedsQL 4.0 Generic Core Scales from 0.681 to 0.824. The correlation of the PedsQL 3.0 Cancer Module with subscale scores of the PedsQL 4.0 Generic Core Scales showed that there were excellent to fair correlations between the two scales. The relationship between parent proxy-report and child self-report of the PedsQL 3.0 Cancer Module had very good correlation (r=0.694, p<0.001), as did the PedsQL 4.0 Generic Core Scales (r=0.540, p=0.002)., Conclusion: This study demonstrated the reliability, validity, and feasibility of the Turkish version of the PedsQL 3.0 Cancer Module in 2- to 4-year-old and 5- to 7-year-old and the PedsQL 4.0 Generic Core Scales in 5- to 7-year-old in childhood cancer., Competing Interests: The authors of this paper have no conflicts of interest, including specific financial interests, relationships, and/or affiliations relevant to the subject matter or materials included.

Background: Automatic and voluntary body position control is essential for postural stability; however, little is known about individual factors that impair the sensorimotor system associated with low back pain (LBP)., Objective: To evaluate automatic and voluntary motor control impairments causing postural instability in patients with LBP., Methods: Motor control impairments associated with poor movement and balance control were analyzed prospectively in 32 patients with LBP. Numeric Rating Scale (NRS) for pain assessment, Oswestry Disability Index (ODI) for disability measurement, and computerized dynamic posturography (CDP) for analysis of postural responses were used to measure outcomes of all patients. Computerized dynamic posturography tests including Sensory organization test (SOT), limits of stability test (movement velocity, directional control, endpoint, and maximum excursion), rhythmic weight shift (rhythmic movement speed and directional control), and adaptation test (toes-up and toes-down tests) were performed and the results compared with NeuroCom normative data., Results: The mean age of the patients was 40.50 ± 12.28 years. Lower equilibrium scores were observed in SOT (p < 0.05). There was a significant increase in reaction time and decrease in movement velocity, directional control, and endpoint excursion (p < 0.05). Speed of rhythmic movement along the anteroposterior direction decreased, while speed increased along the lateral direction (p < 0.05). Poor directional control was recorded in the anteroposterior direction (p < 0.05). Toes-down test showed an increased COG sway in patients compared with that in the controls (p < 0.05)., Conclusions: LBP causes poor voluntary control of body positioning, a reduction in movement control, delays in movement initiation, and a difficulty to adapt to sudden surface changes.

Background: The aim of this pilot study was to investigate the effectiveness of serial splinting in two children with bilateral knee flexion contractures due to arthrogrypotic syndrome., Case Description and Methods: We evaluated the infants' passive knee extension limitation and motor development levels. Serial orthotic treatment was applied to decrease bilateral knee flexion contractures in the knees of the subjects. The follow-up period was up to 1 year., Findings and Outcomes: At the end of serial orthotic treatment, improvement in bilateral passive extension limitation (for the first case, the increase in passive range of extension was approximately 75°, for the second case it was 45°) was achieved in both cases., Conclusion: We believe that serial orthotic intervention is effective in patients with arthrogrypotic syndrome at the preoperative period or in patients who cannot be operated on. Further studies are needed for evaluation of effectiveness of this method., Clinical Relevance: Our pilot study aimed to investigate the effectiveness of serial orthotic treatment in knee contractures due to arthrogrypotic syndrome in two infants which showed an improvement in range of extension., (© The International Society for Prosthetics and Orthotics 2014.)