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BACKGROUND: Fibromyalgia is characterized by a chronic and common musculoskeletal system pain that affects cervical mobility and inspiration. This may cause changes in thoracic mechanics. OBJECTIVE: To investigate the effectiveness of the muscle energy technique applied to cervical accessory respiratory muscles on respiratory muscle strength and endurance in patients with fibromyalgia. METHODS: The participants were 37 women diagnosed with fibromyalgia. They were assessed for their respiratory muscle strength, respiratory muscle endurance, pain and fatigue severity, flexibility and disability. The muscle energy technique was applied to the scalene, upper trapezius, and sternocleidomastoid muscles after a superficial heat application. The treatment was continued for 3 weeks with 3 sessions per week. RESULTS: After the treatment, expiratory muscle strength and respiratory muscle endurance increased significantly. Severity of pain and fatigue and disability were reduced, cervical flexibility increased significantly (p < 0.05). The effect size was r ⩾ 0.4 for all the variables. CONCLUSION: The muscle energy technique applied to cervical accessory respiratory muscles in patients with fibromyalgia who had complaints in the neck and back region positively increased respiratory muscle strength and endurance, cervical flexibility, and decrease pain intensity, fatigue and disability. It is recommended that subsequent randomized studies are carried out with a placebo control group. [ABSTRACT FROM AUTHOR]

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Purpose: The aim of this study was to assess the nutritional status, and provide information regarding anthropometric measurements of cerebral-palsied children living in the city of Ankara, Turkey. Method: A total of 447 children with cerebral palsy (CP) were participated in this cross-sectional study. Participants were assessed for functional motor impairment by the gross motor function classification system (GMFCS). Assesment of nutritional status was based on the triceps skinfold thickness (TSF), arm fat area (AFA) estimates derived from TSF and mid-upper arm circumference measurements. TSF and AFA Z-scores were computed using reference data. Results: Cerebral-palsied children had lower TSF and AFA Z-scores compared to reference data from healthy children. The prevalence of underweight and overweight among boys was 8.3 and 9.5%, respectively, whereas it was 19.0 and 0.5% for girls. Underweight was more prevalent in the low functioning children than in moderate functioning children. Conclusions: The findings of this study indicate that cerebral-palsied children face nutritional challenges. Underweight is more prevalent than overweight among cerebral-palsied children. To optimize the outcomes of rehabilitation and prevention efforts, an understanding of the heterogeneity of nutritional status among children with CP is required. [ABSTRACT FROM AUTHOR]

Objective: There are limited number of documents showing the relations between cardiovascular fitness and muscle strength. This study aimed to determine the effects of two different quadriceps strengthening exercise approaches on cardiovascular fitness in healthy female subjects. Methods: Forty female university students participated in this study on a voluntary basis. The participants were randomly assigned to do either isokinetic exercise (IE) or progressive resistive exercise (PRE) in two different groups. Both training schemes were performed three times a week for a period of two weeks. The subjects were given a maximum symptom limited exercise test on a treadmill before and after (each) training period. Results: Total exercise duration increased and Borg scale level decreased significantly after training in the two groups (p < 0.05). Maximal systolic blood pressure, recovery heart rate, and recovery diastolic blood pressure decreased significantly in the IE Group (p < 0.05). Resting and recovery systolic blood pressure decreased significantly in the PRE Group (p < 0.05). Compared to PRE group, improvement for Borg Scale level, recovery heart rate and recovery diastolic blood pressure were more obvious in IE Group (p < 0.05). Conclusions: This study demonstrated that both quadriceps strengthening methods have displayed improvements in cardiovascular fitness. Further research with larger sample groups may need to be carried out. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of low dose pulsed ultrasound for the treatment of delayed-onset muscle soreness (DOMS). Methods: Ninety female university students participated in a double-blind, placebo-controlled, randomized trial. The subjects were randomly assigned into three equal groups. DOMS was induced in the non-dominant elbow flexors of all subjects with voluntary eccentric contractions on a dynamometer. Group 1 was treated with pulsed ultrasound (spatial average-temporal peak intensity: 0.8 W/cm^{2}, spatial average-temporal average: 0.16 W/cm^{2}, pulse ratio 1:4 for 10 minutes over 5 consecutive days). Group 2 received sham pulsed ultrasound and the control group received no treatment. The results of therapy were assessed by evaluating perceived muscle soreness, elbow flexor muscle strength, range of motion, and creatine kinase activity. Results: A Friedman's repeated-measures test for muscle soreness results demonstrated a significant change in the mean of perceived muscle soreness in all groups. The first significant decrease in muscle soreness occurred 144 hours after exercise in the experimental and control groups and 120 hours after the exercise in the placebo group. At the end of treatment, there were no significant differences in muscle soreness among the 3 study groups. Conclusion: Low dose pulsed ultrasound therapy did not significantly reduce the effects of DOMS on soreness perception, active-elbow flexion angle, or muscle strength. [ABSTRACT FROM AUTHOR]

This study sought to assess knee joint position sense(JPS) and static balance after application of cold-packs and spray. Fifteen healthy basketball players volunteered to participate. Each subject underwent testing first after cold pack application and then 1-week later cold spray application. JPS, around-the-knee pain threshold, and 1-leg static balance were assessed in all patients before and after cryotherapy. JPS was measured with an isokinetic dynamometer. Static balance was assessed using a kinesthetic ability trainer. A pressure algometer was used to measure pressure pain thresholds. Knees were tested using continuous passive motion (CPM). Flexion and extension ranged from 0 to 90 degrees; passive movement was maintained at a velocity of 5 degrees per second. Knee movement in both directions was stopped by pressing a button at the mid point (45°) as a reference point. Regarding 1-leg static balance scores, significant differences were found before and after cold pack application and between knee JPS and pain scores. Significant differences also were found for JPS before and after cold spray application and between JPS scores and pain; however, results on the 1-leg balance tests showed no significant differences. No significant differences were found for 1-leg static balance scores at 5 minutes after cryotherapy application. In this study, we showed that JPS deficits occurred, and postural control was adversely affected, with cryotherapy, and caution should be observed when athletes immediately return to their chosen sport after cryotherapy application. [ABSTRACT FROM AUTHOR]

Objectives: The Shoulder Pain And Disability Index (SPADI) is a self-report questionnaire developed to evaluate patients with shoulder problems. No validated Turkish version exists. This study sought to translate and culturally adapt a Turkish version of the SPADI and validate its use for assessing shoulder pain and disability in Turkish patients with shoulder pathology. Methods: One hundred forty patients (mean age, 60.31 ± 13.02 years) with shoulder problems participated. Patients completed the Turkish SPADI, the Short Form 36 (SF-36), and the Disability of the Arm, Shoulder, and Hand (DASH) questionnaires. Results: Internal consistency of the SPADI was good (Cronbach alpha: 0.83 for pain and 0.83 for disability subscales). There was a significant relation between SPADI pain and SF-36 bodily pain (r: -0.594; P < 0.01), SPADI disability and SF-36 physical function (r: -0.339, P < 0.01), and SPADI disability and SF-36 physical role limitation (r: -0.317, P < 0.05). There was a significant relation between SPADI pain and DASH 1 (r: 0.354, P < 0.01) and SPADI disability and DASH 1 (r: 0.591, P < 0.01). Conclusions: The Turkish version of the SPADI is a reliable and valid instrument to assess pain and disability in patients with shoulder pathology. [ABSTRACT FROM AUTHOR]

BACKGROUND The purpose of the study was to compare the effects of core stabilization exercise (CSE) and proprioceptive neuromuscular facilitation (PNF) exercise on core muscle activation, core muscle endurance, proprioception, and balance in 80 obese children. MATERIAL AND METHODS In this single-blind, randomized controlled study, 80 obese children aged 10-13 years were randomly divided into 3 groups. The first group received CSE (n=27) and the second group received PNF exercises (n=27) 3 days a week for 8 weeks. The third group, which was the control group (n=26), received no treatment. Participants were evaluated before treatment (BT) and after treatment (AT) and at follow-up (3 months after treatment). Core muscle activation level was evaluated by Sahrmann Core Stability test (SCST), lumbar core muscle endurance was evaluated by McGill core endurance tests, and lumbar joint position sense (JPS) was evaluated by laser cursor. The single-leg standing balance test (SLSBT) and Y balance test (YBT) were used for static and dynamic balance, respectively. RESULTS AT and at follow-up, core activation, core endurance, JPS, and static balance were significantly different between the groups (P<0.05). There was no significant difference between the groups in YBT dominant and non-dominant side mixed reach distances (P>0.05). Clinical effect sizes were higher in the CSE group for all outcome measures. CONCLUSIONS CSE and PNF exercises improve the level of core muscle activation, lumbar core muscle endurance, lumbar JPS, and balance in obese children. However, the results of this study show that CSE are more clinically effective in obese children. The effects decline in the medium term.

Aim: This study aimed to compare the immediate and long-term effect of proprioceptive neuromuscular facilitation (PNF) contract-relax-antagonist-contract (CRAC) exercises versus static stretching on proprioception and flexibility in males with hamstring shortness. Patients & methods: Knee extension angle test was used to measure flexibility and isokinetic dynamometer to evaluate proprioception. Assessments were evaluated at baseline, after first exercise and eighth week. The hamstring stretching was applied 3 days a week for 8 weeks. Results: Flexibility and position sense were similar in the immediate and long term (p > 0.05). However, the motion sense increased significantly in long term within the PNF CRAC group (p = 0.02). Conclusion: Both stretching exercises are effective for improving flexibility. Moreover, PNF CRAC improved motion sense more than static stretching in the long term. Clinical trial registration number: NCT04026646.

Aim:  To compare effects of clinical Pilates and home exercises on postural disorders, strength and endurance of deep cervical flexors (DCF), cervical range of motion (CROM), pain intensity and functional disability in sagittal cervical disorientation. Patients & methods : Fourty six patients were included and divided into two groups. Clinical Pilates group performed stabilization based exercise and home exercise group performed conventional exercises. Results: Craniovertebral, head tilt, cervicothoracic angles and strength and endurance of DCF muscles had improvement in favor of clinical Pilates group (p < 0.05). There was no difference between groups in terms of right-left acromial distance, pain intensity, functional disability and CROM parameters (p > 0.05). Conclusion: Clinical Pilates exercises have been found to provide clinically significant improvements in craniovertebral, head tilt, cervicothoracic angles and strength and endurance of DCF muscles. However, in the increase of CROM, decreasing pain severity and functional impairment parameters there was no superiority of both exercise training. Clinical trial registration number: NCT03352921 (Clinicaltrials.gov).

[Purpose] We compared the effectiveness of dry needling with a classical physiotherapy program in patients with chronic low-back pain caused by lumbar disc hernia (LHNP). [Subjects and Methods] In total, 34 subjects were allocated randomly to the study (n=18) and control groups (n=16). In the study group, dry needling was applied using acupuncture needles. The control group performed a home exercise program in addition to hot pack, TENS, and ultrasound applications. Pain was assessed with the short form of the McGill Pain Questionnaire. The number of trigger points and their pressure sensitivity were evaluated with a physical examination (palpation). The Beck Depression Inventory was used to assess depression. The Tampa Kinesiophobia Scale was used to assess fear of movement. [Results] In the study group, the calculated Cohen's effect sizes were bigger than those in the control group in terms of pain, trigger point-related variables, and fear of movement. Effect sizes for reducing depressive symptoms were similar in both groups. [Conclusion] These results suggest that dry needling can be an effective treatment for reducing pain, number of trigger points, sensitivity, and kinesiophobia in patients with chronic low-back pain caused by lumbar disc hernia.

Purpose: To investigate the measurement properties of the Pain Evaluation Scale (PES), to estimate the prevalence of pain based on the PES data, and to evaluate the impact of pain on the quality of life (QoL) in a sample of Turkish children with CP., Method: A total of 346 children with CP participated in a cross-sectional study. The Gross Motor Function Classification System (GMFCS), PES, Wong-Baker FACES Pain Rating Scale, and the Child Health Questionnaire (CHQ-PF50) were used as the assessment tools., Results: The Cronbach's alpha coefficient was 0.90 for the PES. The PES score was moderately correlated with the bodily pain subscale score, and very weekly with the mental health subscale score of the CHQ-PF50. For the threshold value of 2 on the PES, sensitivity and specificity were 91.1% and 100%, respectively. Overall, apparent prevalence and true prevalence of pain were 69.1% and 75.9%, respectively. There was a significant negative effect of pain on the QoL of subjects. The pain also negatively affected parent's personal time and caused limitations in family activities., Conclusions: The PES is valid and reliable pain assessment tool for children with CP. Pain is a frequent health problem and has severe consequences both on the cerebral palsied children's QoL and their family.

Purpose: To evaluate the quality of life of mothers with children suffering from cerebral palsy compared with those who have children with minor health problems., Method: Forty mothers with a child suffering from cerebral palsy and 44 mothers with a child suffering from minor health problems participated in a comparative study. The Turkish version of the Medical Outcomes 36-Item Short Form Health Survey (SF-36) was used to assess a mother's quality of life. The severity of a child's motor disability was assessed using the Gross Motor Function Classification System (GMFCS)., Results: With the exception of the SF-36 physical functioning subscale, the mean scores on the SF-36 subscales were significantly lower in mothers of children with CP than those of the comparison group. The quality of life scores of mothers were significantly correlated with the severity of a child's motor disability (except physical functioning subscale). Significant correlations were found between GMFCS and the role physical; vitality; role emotional; and mental health subscales of the SF-36., Conclusions: The quality of life profile of mothers of children with cerebral palsy is different from those who have a child with minor health problems. Different coping strategies and psychosocial programmes must be designed and implemented to decrease the burden of care.

The aim of this study was to investigate the level of job satisfaction among physiotherapists, and to identify the best predictors of job satisfaction. A self-administrated questionnaire survey was conducted in September 2003. Data were collected from 198 physiotherapists in 13 health care settings (five university hospitals, seven government hospitals, and one municipality hospital) located in Ankara, Turkey. Respondents were asked to complete a 31-item job satisfaction questionnaire. The response rate was 79.8%. The percentage of satisfied physiotherapists was 45.5%. There were no significant satisfaction differences between genders or between age groups. There was a positive relationship between the global satisfaction and domain scores (all ps<0.01). Logistic regression analysis showed that the most important predictors of job satisfaction were: (1) Leadership (OR=1.03, 95% CI 1.01 to 1.06), (2) Interpersonal relationships (OR=1.03, 95% CI 1.00 to 1.05), (3) Advancement (OR=1.02, 95% CI 1.00 to 1.05), and (4) Salary (OR=1.02, 95% CI 1.00 to 1.04). Specific job satisfaction dimensions indicate that highest dissatisfaction levels occur in the area of salary and advancement. Areas of dissatisfaction are signals for change.

Purpose: To compare the quality of life scores of fibromyalgia patients with myofascial pain syndrome patients., Method: Thirty-three fibromyalgia patients, 33 myofascial pain syndrome patients, and 33 age-matched controls completed Beck Depression Inventory and Short Form-36 questionnaires., Results: Compared with myofascial pain syndrome patients, fibromyalgia patients reported significantly more often fatigue, numbness, tingling, gastrointestinal discomfort, and poor sleep. The mean scores on VAS and on Beck Depression Inventory were significantly higher in fibromyalgia patients than myofascial pain syndrome patients. Patients with fibromyalgia had significantly poorer health than the patients with myofascial pain syndrome in pain, general health, vitality, and role emotional subscales., Conclusions: The quality of life profile of fibromyalgia patients is quite different from those in the myosfascial pain syndrome group. Myofascial pain syndrome impacted mostly on physical health whereas fibromyalgia impacted on both physical and mental health.