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Sleep improves the cognitive and physical performance of athletes. A detailed questionnaire that detects sleep disruptions is required to identify sleep-deprived athletes. This study evaluates the translated Athlete Sleep Screening Questionnaire (ASSQ), a tool suggested by the International Olympic Committee, among Arabic-speaking athletes. The ASSQ was translated into Arabic and examined for floor or ceiling effects, internal consistency, and validity among Arabic-speaking athletes. The Arabic Pittsburgh Sleep Quality Index (PSQI) was employed to assess convergent validity. Ninety athletes (28.9% women) participated and completed this study’s questionnaires. The Cronbach’s alpha for the ASSQ-Sleep Difficulty Score (SDS) was 0.435, and that of the ASSQ-chronotype was 0.632. The SDS and chronotype subset of the ASSQ demonstrated excellent test-retest reliability, with intraclass correlation coefficients of 0.84 and 0.938, respectively. The ASSQ-SDS correlated positively with the PSQI (0.734, p = 0.001). The ASSQ-chronotype was inversely associated with the PSQI (p = 0.001). This study’s findings can assist clinicians in assessing sleep disorders in sports. The Arabic version of the ASSQ has satisfactory psychometric qualities and can identify clinically relevant sleep problems in athletes.

BackgroundLimited studies have examined the prevalence of hypertension (HTN) at the national and regional levels in Saudi Arabia. Therefore, this study aimed to examine the national and regional prevalence of HTN in the Saudi population.MethodsThis study used the data from household health survey carried out by the General Authority for Statistics in 2017. It included 24,012 households representing the Saudi population across all 13 administrative regions. The diagnosis of HTN was confirmed by a self-reported history of a physician diagnosed HTN.ResultsThe prevalence of HTN was 9.2% among Saudi population aged 15 years and older. It was relatively higher in women (10.0%) than in men (8.5%). The prevalence of HTN increased with advancing age (aged 65 years and older), accounting for 55.3% in women and 48.0% in men; its prevalence was relatively low among the younger age group, accounting for 0.1% in those aged 15–19 years. A large difference was found in the prevalence of HTN between regions, ranging from 6.0% in Najran region to 10.0% in Makkah region.ConclusionThis study reported the national and regional prevalence of HTN among Saudi adults using a representative sample with large variations in the prevalence rates according to age, sex, and regions. Older age, men, and Makkah region had higher prevalence of HTN. Our findings will help determine the etiological factors, identify the priorities for healthcare, and generate initiatives for policymakers, and develop preventive and therapeutic strategies for HTN.

Objectives The primary aim is to compare the effects of backward walking exercise to forward walking exercise on knee pain, knee functions, and thigh muscle strength in individuals with mild to moderate knee osteoarthritis using lower body positive pressure, in addition to mobility functions, balance, and self-reported health status. Methods The study is a single blind randomized clinical trial with two independent groups. This study will enroll 26 participants with mild to moderate knee osteoarthritis. The participants will be randomized into either experimental group (backward walking exercise) or control group (forward walking exercise). Both groups will use lower body positive pressure treadmill for walking exercise. Both groups will perform regular conventional exercise and worm-up exercise before walking exercise. The treatment will be three times a week for six weeks. Walking session will be up to 30 min each session. Data collection will be collected during pre- and post- intervention including primary outcomes including numeric pain rating scale (NPRS), knee injury and osteoarthritis outcome score (KOOS), and thigh muscle strength test. The secondary outcomes include five times sit to stand test (FTSTS), 3-meter backward walk test (3MBWT), timed up and go test (TUG), four square step test (FSST), functional reach test (FRT), 10-meter walk test (10-MWT), six minute walk test (6MWT), medical outcomes study short form 12 (SF-12), patient health questionnaire -9 (PHQ-9), and rapid assessment of physical activity (RAPA). An independent t-test will be used to evaluate the effect of treatment on the outcome measures. Results Not applicable. Conclusion Using lower body positive pressure may have promising results against knee osteoarthritis. Moreover, walking backward exercise using lower body positive pressure might add more benefits to individuals with knee osteoarthritis and help clinicians in decision making. Trial registration: This study was registered in ClinicalTrails.gov (ID: NCT05585099).

Urinary tract infections (UTIs) are one of the most common long-term complications of diabetes mellitus (DM). Additionally, various factors, such as socio-demographics, type of DM, fasting blood glucose, regular diabetes monitoring, comorbid chronic diseases, HbA1c, body mass index (BMI), and duration of DM, are also thought to predispose individuals to developing UTIs more frequently when they have DM. This research aims to evaluate the risk factors for UTIs and their prevalence among people with DM in Saudi Arabia (KSA). This cross-sectional study was conducted among 440 adults with type 1, type 2, and gestational DM. The participants had to be at least 18 years old, of both genders, and had been suffering from DM for any period of time. A self-administered questionnaire was utilized to collect data on demographic characteristics, such as sex, age, height, weight, material state, education level, income, and clinical profiles of DM and UTI. The crude (COR) and adjusted odds ratios (AOR) were calculated using logistic regression in the IBM SPSS software. The incidence of types 1 and 2 DM and gestational diabetes reached 34.1, 60.9, and 5%, respectively. Most of the participants had first-degree relatives with DM (65.9%). UTI was common in 39.3% of participants. A chi-squared statistical analysis revealed that the frequency of UTI varied depending (χ2 = 5.176, P = 0.023) on the type of DM. Burning urination and abdominal pain were the most common symptoms. The CORs for sex, marital status, hypertension, and BMI were significant (P < 0.05) and had values of 2.68 (95% CI = 1.78–4.02), 0.57 (95% CI = 0.36–0.92), 1.97 (95% CI = 1.14–3.43), and 2.83 (95% CI = 1.19–2.99), respectively. According to the adjusted model, only sex influenced the occurrence of UTIs. The AOR for sex was 3.45 (95% CI = 2.08–5.69). Based on this study, the authorities related to the health of DM patients can use its findings to guide awareness programs and clinical preparedness.

Background Normative values for hand grip and pinch strength among children in Saudi Arabia has not been well established. Therefore, the main aim of this study is to establish normative values for hand grip and pinch strength in children aged 6 to 18 years in Saudi Arabia. Methods A cross-sectional study was conducted from different 5 regions in Saudi Arabia. Participants between the age of 6 years and 18 years old were recruited through different primary and secondary schools in Saudi Arabia. Data for age, gender, Body Mass Index, and preferred hand were collected. Hand grip strength was measured using digital hand dynamometer and the tip pinch, palmar pinch, and key pinch strength were measured using the hydraulic pinch gauge. Results A total of 616 participants included in this study (318 boys and 298 girls). Participants were stratified into 5 chronological age groups of 6–7 years, 8–9, 10–11, 12–13, 14–15, 16–17, and 18 years. The results showed an overall trend of increasing hand grip strength and pinch strength with age regardless of hand preference. Boys had significantly higher grip strength than girls in all age groups (P Conclusion This study established normative values for hand grip and pinch strength in the healthy Saudi pediatric and adolescent population, using boys and girls aged 6 to 18. The outcomes of this study also demonstrated that gender, age, and hand preference can all have an impact on how strong a handgrip develops.

Objective Previous evidence has recommended conservative interventions as the best treatment in individuals with chronic low back pain (CLBP). However, the influence of psychosocial factors on the treatment outcomes is unclear. Therefore, this systematic review aimed to address the psychosocial factors that influence changes in pain and disability in patients with CLBP after a guideline-based conservative intervention. Methods Four electronic databases were systematically searched from inception until September 2020 for prospective studies examining the relationship between psychosocial factors and the outcomes of pain and disability after conservative intervention. All included studies were selected, extracted, and critically evaluated by two independent reviewers. Results In total, 15 studies were included in this systematic review. The results support the link between the baseline fear of movement, depression, self-efficacy, and catastrophizing with future functional disability outcomes after conservative interventions. However, these factors were less likely to predict changes in pain intensity outcomes after conservative interventions. Self-efficacy seems to mediate between some of the baseline psychosocial factors (eg, fear) and future pain and disability. Conclusion Fear of movement, self-efficacy, catastrophizing and depression were consistently reported to predict disability outcomes irrespective of the type of conservative intervention. This highlights the importance of addressing these factors in conservative management of CLBP.

To investigate how plyometric exercise (PLYO-Ex) affects mechanics and morphometrics of the plantar flexor musculotendinous unit in children with unilateral cerebral palsy, 38 participants (aged 10–16 years) were allocated at random to either the PLYO-Ex group (n = 19; received 24 sessions of plyometric muscle loading, conducted 2 times a week for 3 months in succession) or the control group (n = 19; underwent traditional physical therapy for the same frequency and duration). Measurements were taken pre- and post-intervention. Standard ultrasound imaging was applied to evaluate morphometrics of the gastrocnemius muscle and Achilles tendon unit and an isokinetic dynamometer was used to evaluate maximum voluntary isometric plantar flexors contraction (IVCmax). With controlling for pre-treatment values, significant post-treatment changes favoring the PLYO-Ex group were observed for morphological (tendon (p = 0.003, η2p = 0.23) length; belly length (p = 0.001, η2p = 0.27); tendon thickness (p = 0.035, η2p = 0.35); muscle thickness (p = 0.013, η2p = 0.17); fascicle length (p = 0.009, η2p = 0.18); pennation angle (p = 0.015, η2p = 0.16)) and mechanical and material properties (IVCmax (p = 0.009, η2p = 0.18); tendon’s elongation (p = 0.012, η2p = 0.17), stiffness (p = 0.027, η2p = 0.13); stress (p = 0.006, η2p = 0.20); strain (p = 0.004, η2p = 0.21)). In conclusion, plyometric exercise induces significant adaptations within the musculotendinous unit of the plantar flexors in children with unilateral cerebral palsy. These adaptations could improve muscular efficiency and consequently optimize physical/functional performance.

Backgrounds: The Mini-BESTest is a clinical assessment of balance impairment; however, the translation and psychometric properties in the Arabic-speaking population have not yet been investigated. The purpose of this study was to translate into Arabic and evaluate the psychometric properties of the Mini-BESTest in Saudi community-dwelling older adults. Methods: This is a cross-sectional transcultural adaptation and validation study. A total of 144 community-dwelling older adults were enrolled (mean age = 66.2 ± 6.2 years). The translation and cross-cultural adaptation of the Mini-BESTest from English to Arabic was performed using standardized guidelines. Test–retest reliability was examined using the intraclass correlation coefficient (ICC) with one week between test and retest. The internal consistency was assessed using Cronbach’s alpha. Construct validity of the Mini-BESTest was assessed using balance such as Berg Balance Scale (BBS) and Falls Efficacy Scale International (FES-I). Results: The Arabic version of the Mini-BESTest showed good internal consistency (Cronbach’s alpha = 0.93). The scale shows excellent test–retest reliability (ICC = 0.99, 95% CI, 0.98–0.99) and excellent inter-rater reliability (ICC = 0.93, 95% CI, 0.70–0.97), which is indicative of the measure’s stability and repeatability. Mini-BESTest total scores showed an excellent inter-rater agreement. There was a significant correlation between total score of the Mini-BESTest and BBS (r = 0.72; p < 0.001). Mini-BESTest had a moderate association with FES-I. Conclusion: The Arabic version of the Mini-BESTest is a reliable and valid test for assessing balance in older adults. More research is needed to confirm the test’s reliability and validity in a specific population, such as those with neurological problems.

Background: This study examined the prevalence and risk factors of falls, by evaluating the association between risk factors and falls and number of falls, and by determining cut-off scores for fall risk measures among community-dwelling adults in Saudi Arabia.Methods A cross-sectional study was conducted in community, Riyadh city, Saudi Arabia. A sample of 276 Saudi citizens aged ³ 40 years who were able to read and write in Arabic. Fall history and number of falls in the past 12 months were determined via self-reports. Variables assessed included demographic information, self-reported chronic diseases, depressive symptoms, and back pain severity.Results: Participants were classified as either fallers (n=28, 10.14%) or non-fallers. Fallers were more likely to have arthritis (odds ratio [OR]: 7.60, p=0.001), back pain (OR: 5.22, p=0.002), and higher depressive symptom scores (OR: 1.09, p=0.013) than non-fallers. The number of reported falls was significantly associated with an elevated body mass index (incidence rate ratio [IRR]: 1.09, p=0.045), arthritis (IRR: 8.74, pConclusions: The prevalence of falls was relatively low among the individuals considered in this study. Chronic conditions, back pain severity, and depressive symptoms were determined to be associated with falls among community-dwelling individuals in Saudi Arabia.

Osteoarthritis (OA) is a common degenerative disease affecting joints with an increasing prevalence around the world and in the Middle East region. Research about the prevalence/incidence of OA in the Gulf Cooperation Council (GCC) countries was limited with inconsistent findings. Therefore, the aim of this study was to conduct a systematic review and meta-analysis for studies reporting the prevalence/incidence of OA among people living in the GCC countries. A comprehensive search was performed using MEDLINE, PubMed, CINAHL, Web of Science, and Google Scholar from inception to December 2020 to identify eligible studies examining the prevalence/incidence of OA in the GCC countries. Meta-analysis was conducted, and the Newcastle Ottawa Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was utilized to evaluate methodological quality. Thirteen studies were included (12 studies reported prevalence and one study reported incidence), with a total of 24,625 participants with an estimated overall prevalence of 16.13% and incidence of 3.5% of OA in the GCC countries. The quality of the included studies was unsatisfactory (six studies), satisfactory (six studies), and good quality (one study). Common risk factors were being older adult, female, obese, and having lower scores for quality of life. This study shows a high prevalence of OA among individuals living in the GCC countries at approximately 16.13%. Only one study reported incidence of 3.5% of OA in this population. This prevalence rate needs to be confirmed in future research with a similar population and at the site of joint OA levels. Common risk factors should be interpreted with caution since only a few studies reported risk factors. Key Points • The pooled prevalence of Osteoarthritis in the Gulf Cooperation Council countries was 16.13% based on 12 included studies.

Background: Medical students are expected to excel in their academics. Hence exposing them to a certain amount of strain may sometimes cause sleep disruptions. The purpose of this study was to determine the sleep quality among Saudi Applied Medical Sciences students and its potential connections with their academic performance and mental health. Methods: This online cross-sectional questionnaire-based study was conducted at Jazan University’s College of Applied Medical Sciences in Saudi Arabia. The Pittsburgh Sleep Quality Index (PSQI), a known indicator of sleep quality, a validated mental health measure; Depression Anxiety Stress Scales-21 (DASS-21), and Academic Performance Scale (APS) with 89 internal consistencies were included in the questionnaire. The cumulative grade point average (GPA) was also used as a covariate to evaluate students’ academic success. Results: 112 people responded (response rate = 93%), and 105 of them presented comprehensive information about their backgrounds, way of life, academic standing, sleep patterns, and mental health. Participants’ average GPA and APS scores were 4.23 ± 0.52 and 33.16 ± 5.63, respectively. The mean global PSQI score was 6.47 with 2.34 of standard deviation (SD). The majority of individuals (60%) had poor sleep quality particularly due to abnormal sleep latency and lesser sleep duration, as determined by their PSQI score. The prevalence rates for depression, anxiety, and stress were higher; 53%, 54% and 40%, respectively. Both depression and anxiety were substantially correlated with poor sleep quality (p-value = 0.008, p-value = 0.01, respectively). Sleep quality had no significant effect on GPA while global PSQI and depression were significantly negatively correlated with an APS score of participants (p-value = 0.007 and 0.015, respectively). Conclusions: Higher rates of poor sleep quality and psychologically negative emotions were prevalent. Unhealthy sleep patterns were linked to increased levels of anxiety and depression. Self-perceived academic performance was negatively impacted by inadequate sleep and negative emotions, despite the fact that the GPA results were unaffected.

Diabetes mellitus (DM) and osteoarthritis (OA) are chronic noncommunicable diseases that affect millions of people worldwide. OA and DM are prevalent worldwide and associated with chronic pain and disability. Evidence suggests that DM and OA coexist within the same population. The coexistence of DM in patients with OA has been linked to the development and progression of the disease. Furthermore, DM is associated with a greater degree of osteoarthritic pain. Numerous risk factors are common to both DM and OA. Age, sex, race, and metabolic diseases (e.g., obesity, hypertension, and dyslipidemia) have been identified as risk factors. These risk factors (demographics and metabolic disorder) are associated with DM or OA. Other possible factors may include sleep disorders and depression. Medications for metabolic syndromes might be related to the incidence and progression of OA, with conflicting results. Given the growing body of evidence indicating a relationship between DM and OA, it is vital to analyze, interpret, and integrate these findings. Therefore, the purpose of this review was to evaluate the evidence on the prevalence, relationship, pain, and risk factors of both DM and OA. The research was limited to knee, hip, and hand OA.

Background: To investigate how changes in sedentary behavior relate to health outcomes, it is important to establish the test–retest reliability of activity monitors in measuring habitual sedentary behavior in people with type 2 diabetes (T2D) as a prerequisite for interpreting this information. Thus, the authors’ objective was to examine the test–retest reliability of a common activity monitor (activPAL™) in measuring sedentary behavior and physical activity in people with T2D. Methods: Sedentary-time, standing-time, stepping-time, step-count, and sit-to-stand transitions were obtained from two 7-day assessment periods separated by at least 1 week. Test–retest reliability was determined with the intraclass correlation coefficient (ICC) to compare sedentary and activity measures between the 2 time points. Results: A total of 30 participants with self-reported T2D completed the study (age 65 [6] y, 63% women, body mass index 33.3 [5] kg/m2). High test–retest reliability was found for sedentary-time (ICC = .79; 95% confidence interval [CI], .61–.89) and standing-time (ICC = .74; 95% CI, .53–.87). Very high test–retest reliability was found for stepping-time (ICC = .90; 95% CI, .81–.95), step-count (ICC = .91; 95% CI, .83–.96), and sit-to-stand transitions (ICC = .90; 95% CI, .79–.95). Conclusion: The activPAL™ device showed high to very high test–retest reliability in measuring all tested activity categories in people with T2D.

The primary aim of this study was to examine the effect of Cognitive Behavioral Therapy for Insomnia (CBT-I) on the severity of insomnia in people with Type 2 diabetes (T2D) compared to a health education (HE) control group. The secondary aim was to explore the effect of CBT-I on other sleep outcomes and concomitant symptoms.Twenty-eight participants with T2D were randomly assigned to CBT-I (Validated assessments were used at baseline and post intervention to assess sleep outcomes and concomitant symptoms. In addition, actigraph and sleep diaries were used to measure sleep parameters. Independent sampleParticipants in the CBT-I group showed higher improvements in the following mean change scores compared to the HE group: insomnia symptoms (This study identified a clinically meaningful effect of CBT-I on sleep outcomes and concomitant symptoms in people with T2D and insomnia symptoms. Further work is needed to investigate the long-term effects of CBT-I in people with T2D and insomnia symptoms.

Background Previous studies have shown the negative impact of sleep disturbances, specifically insomnia symptoms, on glucose metabolism for people with type 2 diabetes (T2D). People with insomnia symptoms are at risk of poor glycemic control and suboptimal diabetes self-care behavior (DSCB). Investigating the impact of a safe and effective intervention for individuals with T2D and insomnia symptoms on diabetes’ health outcomes is needed. Therefore, the aim of this exploratory study is to examine the effects of Cognitive Behavioral Therapy for Insomnia (CBT-I) on glycemic control, DSCB, and fatigue. Methods Twenty-eight participants with T2D and insomnia symptoms, after passing an eligibility criteria at a medical research center, were randomly assigned to CBT-I (n = 14) or Health Education (HE; n = 14). The CBT-I and HE groups received 6 weekly one-hour sessions. This Randomized Controlled Trial (RCT) used a non-inferiority framework to test the effectiveness of CBT-I. Validated assessments were administered at baseline and post-intervention to assess glycemic control, DSCB, and fatigue. A Wilcoxon signed-rank test was utilized to compare within-group changes from baseline to post-intervention. A Mann-Whitney test was utilized to measure the between-group differences. Linear regression was used to assess the association between the blood glucose level and the number of days in the CBT-I group. Results The recruitment duration was from October 2018 to May 2019. A total of 13 participants completed the interventions in each group and are included in the final analysis. No adverse events, because of being a part of this RCT, were reported. CBT-I participants showed significantly greater improvement in glycemic control, DSCB, and fatigue. There was a significant association between the number of days in the CBT-I intervention with the blood glucose level before bedtime (B = -0.56, p = .009) and after awakening in the morning (B = -0.57, p = .007). Conclusions This study demonstrated a clinically meaningful effect of CBT-I on glycemic control in people with T2D and insomnia symptoms. Also, CBT-I positively impacted daytime functioning, including DSCB and fatigue. Future research is needed to investigate the long-term effects of CBT-I on laboratory tests of glycemic control and to understand the underlying mechanisms of any improvements. Trial registration Clinical Trials Registry (NCT03713996). Retrospectively registered on 22 October 2018

This study investigated the association of combined arthritis and diabetes, diabetes only, and arthritis only compared with neither with gait speed in the general population. This cross-sectional study included data from the second wave of Midlife in the United States-2 (MIDUS 2) project 4: Biomarker Project, 2004–2009. The MIDUS 2 biomarker project included 1255 individuals aged between 34 and 84 years. Participants were categorized into four groups: combined arthritis and diabetes, diabetes only, arthritis only, or neither. The main outcome measure was gait speed measured by the 50-ft walk test. Covariates included age, gender, body mass index (BMI), depression symptoms, and number of chronic conditions/symptoms. A total of 1255 participants were included with mean age 54.52 ± 11.71, of those 713 (56.8%) participants were females. The results showed that combined arthritis and diabetes was significantly associated with a greater decline in gait speed (B = − 0.11, 95% confidence interval (CI) [− 0.17 to − 0.6], p

Background Forward and retro locomotion on a treadmill is a common tool for lower extremity rehabilitation in the clinical setting. The purpose of this study was to evaluate effect on anthropometrical body composition adaptations and aerobic performance during forward and retro locomotion training on a treadmill at 10-degree inclinations. Methods A convenience sample of 30 healthy male subjects with mean age of 20.93±2.54 years, participated in the study. Subjects were divided into 2 groups, Forward Locomotion Group (FLG) and Retro Locomotion Group (RLG) (n=15) and performed forward and retro locomotion training on a treadmill at 10-degree inclination respectively for duration of 6 weeks. Study outcomes such as aerobic performance and anthropometrical body composition were measured at pre and post intervention phases. Results Although both FLG and RLG training improved aerobic performance significantly. However, RLG reported a significant improvement as compared to FLG in the above parameters. Whereas, anthropometrical body composition changes are not found to be significant even after 6 weeks of intervention in both groups. Conclusion Both the forward and retro locomotion training improved aerobic performance but not the body composition variables, also retro locomotion training was more effective than forward locomotion in improving aerobic performance.

Background Some studies investigated the relationship between musculoskeletal conditions and chronic diseases. However, no study examined the association between social determinants and chronic diseases among people at high risk for knee osteoarthritis. Thus, the current study was aimed to address this gap. Methods A secondary data analysis was conducted on a total of 3280 men and women aged 45 to 79 who were recruited in the Osteoarthritis Initiative. Results Multivariable logistic regression analyses show that age ≥ 65 years was associated with 1.98, 1.96, and 1.46 times odds of the presence of diabetes, heart attack, and multi-morbidity, respectively than age ≤ 64 years. Men were associated with 1.39, 1.41, 1.76, and 2.24 times odds of the presence of arthritis, cancer, diabetes, and heart attack, respectively than women. African American/Asian/ non-Caucasian was associated with 2.71, 2.56, and 1.93 times odds of the presence of arthritis, diabetes, and heart attack, respectively than Caucasian. Primary school/less education was associated with twice or more times the odds of arthritis and chronic obstructive pulmonary disease (COPD) than ≥high school education. Unemployment was associated with 1.41-, 1.73-, 1.58-, and 1.70-time odds of the presence of arthritis, cancer, COPD, and heart attack, respectively, then employed. Unmarried/widowed/separated was associated with 1.41, 1.75, 2.77, 2.76, 1.86, and 3.34 times odds of the presence of arthritis, asthma, cancer, COPD, diabetes, and heart attack, respectively than married. Annual income Conclusions Social determinants are associated with the presence of chronic diseases. Some of the social determinants are modifiable or treatable. Thus, these findings can inform public health strategies in the United States.

The purpose of this study was to evaluate landing biomechanics in soccer players following ACLR during two landing tasks. Eighteen soccer players with an ACLR and 18 sex-matched healthy control soccer players participated in the study. Planned landing included jumping forward and landing on the force-plates, whereas unplanned landing included jumping forward to head a soccer ball and landing on the force-plates. A significant landing×group interaction was found only for knee flexion angles (p=0.002). Follow-up comparisons showed that the ACL group landed with greater knee flexion during planned landing compared with unplanned landing (p

There is increasing awareness of the high prevalence of insomnia symptoms in individuals with type 2 diabetes (T2D). Past studies have established the importance of measuring sleep parameters using measures of central tendency and variability. Additionally, subjective and objective methods involve different constructs due to the discrepancies between the two approaches. Therefore, this study is aimed at comparing the averages of sleep parameters in individuals with T2D with and without insomnia symptoms and comparing the variability of sleep parameters in these individuals. This study assessed the between-group differences in the averages and variability of sleep efficiency (SE) and total sleep time (TST) of 59 participants with T2D with and without insomnia symptoms. Actigraph measurements and sleep diaries were used to assess sleep parameter averages and variabilities calculated by the coefficient of variation across 7 nights. Mann–Whitney U tests were utilized to compare group differences in the outcomes. Validated instruments were used to assess the symptoms of depression, anxiety, and pain as covariates. Objective SE was found to be statistically lower on average (85.98±4.29) and highly variable (5.88±2.57) for patients with T2D and insomnia symptoms than in those with T2D only (90.23±6.44 and 3.82±2.05, respectively). The subjective average and variability of SE were also worse in patients with T2D and insomnia symptoms, with symptoms of depression, anxiety, and pain potentially playing a role in this difference. TST did not significantly differ between the groups on averages or in variability even after controlling for age and symptoms of depression, anxiety, and pain. Future studies are needed to investigate the underlying mechanisms of worse averages and variability of SE in individuals with T2D and insomnia symptoms. Additionally, prompting the associated risk factors of insomnia symptoms in individuals with T2D might be warranted.

Stroke is a leading cause of death and disability worldwide. However, our knowledge of the incidence of stroke for Saudi Arabian population is not known. Thus, we aimed to determine the pooled annual incidence of stroke in Saudi Arabia. We conducted a comprehensive literature search of PubMed, Web of Science, and SCOPUS, without language or publication year limits. Outcomes of interest were stroke incidence rate for both first and recurrent. A total of five studies met the inclusion criteria for this review. The pooled annual incidence of stroke in Saudi Arabia was 0.029% (95% CI: 0.015 to 0.047) equivalent of 29 strokes per 100,000 people annually (95% CI: 15 to 47). The findings indicate that there are 29 stroke cases for every 100,000 people annually for individuals residing Saudi Arabia. Our values were lower than those of other high-income countries. Establishing a nationwide stroke registry is warranted for monitoring and improving healthcare services provided to stroke survivors.

BackgroundOver recent decades, there has been a dramatic transformation in mechanization reaching all aspects of people's lives in Saudi Arabia. In the light of this, there was a significant change in physical behavior in the community. The aim of the current study was to investigate the national and regional distribution of physical activity practice among adults aged ≥15 y across Saudi Arabia.MethodsData from the Bulletin of Household Sports Practice National Survey were used to determine the physical activity practice distribution. A total of 26 000 families from 13 administrative regions across Saudi Arabia were surveyed.ResultsThe proportion of the total Saudi population who were practitioners of physical activity (i.e. ≥150 min per week) among Saudi adults aged ≥15 y was 17.40%, while the proportion of non-practitioners was 82.60%.ConclusionThis study found a low level of physical activity among Saudi adults who meet physical activity guidelines. These findings suggest that interventions and promotional programs should be developed to increase physical activity among the Saudi population.

Individuals with type 2 diabetes (T2DM) are advised to undertake diabetes self-care behavior (DSCB) in order to avoid complications of T2DM. However, comorbidities, such as insomnia symptoms which are commonly reported in people with T2DM, may limit the ability to engage in DSCB. Insomnia and the common sequelae accompanying insomnia such as pain, depression, and anxiety may negatively influence the performance of DSCB. Therefore, this study aimed to compare the DSCB of people with T2DM with and without insomnia symptoms. Sixty participants with T2DM were divided into two groups based on the presence of insomnia symptoms: T2DM-only group and T2DM+ insomnia group. Insomnia symptoms were identified using the Insomnia Severity Index (ISI). DSCB was assessed using the Diabetic Care Profile (DCP). A standardized composite score was established to account for all of the DCP domains. Chi-square and independent sample t tests were used to assess between-group differences in categorical and continuous variables, respectively. Stepwise linear regression analysis used the ISI score to predict standardized DCP composite score, while controlling for covariates. Significant between-group differences were found in age, symptoms of pain, depression, and anxiety. The total DCP composite score was significantly lower in the T2DM+ insomnia group compared to the T2DM-only group (− 0.30 ± 0.46 vs. 0.36 ± 0.48, respectively, p

Background: Access to health care (HC) in American minorities with or at high risk for knee osteoarthritis (OA) is indistinct. The current study aims to address this gap. Methods: Data of Americans (n =4,674) aged 45–79 years with or at elevated risk for knee OA were fetched from the Osteoarthritis Initiative. Participants were categorized into Caucasians and American minorities based on their racial and ethnic background. Results: American minorities had insufficient access to HC than did Caucasians (9% vs. 2% were uninsured with no health care coverage (HCC), p , while 6% vs. 9% had only HCC, p ). A multinomial regression analysis shows that less than Conclusion: American minorities had insufficient access to HC than did Caucasians. The less annual income was highly influenced by insufficient access to HC in this population.

To investigate the prevalence of depressive symptoms in community-dwelling Saudi adults aged ≥50 years and the associated risk factors. Patient Health Questionnaire 9 (PHQ-9) was dichotomized as depressive symptoms when the participants scored ≥10. Risk factors included age, sex, body mass index, education, employment, marital status, number of chronic diseases and medications, fatigue severity scale (FSS), and Montreal Cognitive Assessment (MoCA). Among the 206 participants, the prevalence of depressive symptoms was 17.48%. The number of chronic diseases, medications, and fatigue symptoms were significantly higher in those with depressive symptoms, whereas cognitive functions were significantly lower. Fatigue symptoms and cognitive functions were significantly associated with depressive symptoms. The cut-off scores for risk factors were ≥42 (FSS) and ≤23 (MoCA scale). Fatigue and cognitive impairments were the only risk factors that distinguished participants with and without depressive symptoms.

Worldwide, low back pain is common and linked with many risk factors. There is a lack of studies in the Saudi Arabian community on low back pain prevalence and risk factors. Therefore, the present research will investigate the prevalence of low back pain in the middle-aged and elderly community population and examine the risk factors contributing to low back pain in Saudi Arabia. The present paper is a cross-sectional study of the community living in Riyadh and the surrounding areas in Saudi Arabia. Data were collected between October 2019 and April 2020 via trained research assistants. A total of 276 participants were included in the analysis. The prevalence of low back pain was 27.9% (n = 77) among the participants included in this study. All participants reported low back pain severity with a mean of 4.35 ± 2.19 on the pain rating scale. Older age, arthritis, hypertension, anemia, osteoporosis, and a history of fractures were all associated with having LBP. Low back pain is highly prevalent in the Saudi community adult population living in Riyadh and its surrounding areas. More than a fourth of the sample reported experiencing back pain. The study outlines several modifiable risk factors (BMI, education, employment status, marital status, and smoking status) and unmodifiable risk factors (arthritis, hypertension, anemia, osteoporosis, and a history of fractures) associated with low back pain in the study sample.

Low back pain is the most prevalent musculoskeletal condition. Studies on adolescent low back pain are scarce, with no research to determine its prevalence in Saudi Arabia. This study aimed to assess the prevalence and associated risk factors of low back pain in Saudi Arabian adolescents. This cross-sectional study was conducted among Saudi Arabian high school students, which included demographic data, medical and low back pain history. The completed survey by 2000 participants showcased 57.9% of students experiencing low back pain in the last 12 months. This included 31.2% men and 26.7% women. This study found a link between low back pain and age, clinical symptoms of diabetes, heart disease, lung disease, thyroid disease, arthritis, and back surgery, a family history of low back pain, as well as smoking. There is substantial prevalence of low back pain in Saudi Arabian adolescents. This study identified several modifiable and non-modifiable risk factors stemming from adolescent low back pain.

This study examined the feasibility and effect of sedentary behavior (SB) counseling on total sitting time (TST) and glycemic control in people with type 2 diabetes (T2D). Community-dwelling sedentary adults with T2D (n = 10; 8 women; age 65.6 ± 7.31) completed SB counseling (motivational interviewing-informed education about SB) aided by an activity monitor with a vibrotactile feature (activPAL3TM). The monitor was worn for 7 days, on weeks 1 and 13 (without the vibrotactile feature) and during weeks 5 and 9 (with the vibrotactile feature). Intervention feasibility was determined by study retention rates and activity monitor tolerability, and differences between pre- and post-intervention average daily TST. Paired t-test were performed. The effect size (ES) was calculated using Cohen d. All participants attended all study sessions with only 20% reporting moderate issues tolerating the activity monitor. TST time decreased from 11.8 hours ± 1.76 at baseline to 10.29 hours ± 1.84 at 3 months’ assessment ( P

Objective To examine the association between type 2 diabetes (T2D) and pain severity in people with localized osteoarthritis (OA) and to explore the association between glycemic control, measured by hemoglobin A1c (HbA1c) level, and pain severity in people with localized OA and T2D. Design Retrospective study. Setting A tertiary medical center. Subjects Data from 819 patients (mean age = 65.08±9.77 years, 54.3% women) were used. Methods Patients were grouped to localized OA only (N = 671) and localized OA+T2D (N = 148) based on diagnosis codes. An index date was set as the first diagnosis date of localized OA and linked to pain severity, measured by numeric rating scale from 0 to 10. HbA1c values were obtained for patients with T2D within six months of the index date. Multiple linear regression was used. Results After controlling for age, gender, body mass index (BMI); diagnoses of depression, hypertension, dyslipidemia; OA locations; and medication list (+/- 90 days of the index date), T2D was significantly associated with increased pain severity (B = 1.07, 95% confidence interval [CI] = 0.25 to 1.88, P = 0.014). For patients with T2D and localized OA with available data for HbA1c (N = 87), the results showed that an increased HbA1c value was significantly associated with higher pain severity (B = 0.36, 95% CI = 0.036 to 0.67, P = 0.029) after controlling for age, gender, BMI, medications, and OA locations. Conclusion T2D was associated with higher pain severity in people with localized OA, and poor glycemic control was associated with higher pain severity in people with localized OA+T2D. Clinicians should emphasize that better HbA1c control might help with pain management in people with T2D and OA.

Background Hand grip strength (HGS) is an important function of upper extremities for older adults. Several studies have shown the importance of measuring HGS in different settings. Current established normative values of HGS are applicable for Western countries. However, there is limited information of normative values of HGS after considering demographics in Saudi population. Therefore, this study aimed to establish normative values of HGS stratified by age and gender, and to determine the association of anthropometric measurements with the HGS in Saudi population. Methods A cross-sectional study included a total of 1048 participants (mean age 73 ± 5 years). Grip strength was calculated by the average peak force of three trials for the dominant hand using a dynamometer. Sociodemographic data on age, gender, marital status, educational levels were collected. Anthropometric measurements including height, body mass index, arm circumference, and upper arm length were obtained. The sample was categorized into three age groups: 65–69 years, 70–74 years, and 75–80 years. Linear regression analysis was used to assess the association between the sociodemographic and anthropometric data and HGS. Results The mean values of HGS (kg) for men for each age group were 36.9 ± 8.3 for the younger group, 35.7 ± 7.4 for the 70–74 years group and 30.5 ± 7.1 for the older group. The mean values of HGS for women for each group were 23.2 ± 4.7 for the younger group, 21.1 ± 4.6 for the 70–74 years group and 18.8 ± 4.9 for the older group. The HGS was negatively associated with the age for men (B = -.40, 95% confidence interval (CI) [−.52, −.29], p p = .02), but negatively associated in women (B = -.42, 95% CI [− 0.75, − 0.08], p = .01). Conclusion This study is the first that established normative values of HGS for older adults in Saudi Arabia. Future research may benefit from the current normative value of HGS in Saudi population for geriatric rehabilitation programs.

Type 2 diabetes mellitus (T2DM) has been associated with osteoarthritis (OA). T2DM may be associated with generalized OA (GOA ≥ 3 joints) rather than localized OA (LOA 3 joints). The purpose of this study was to examine the prevalence of T2DM in people with GOA compared with LOA and to investigate the association between demographic risk factors and chronic diseases (i.e., T2DM, hypertension, dyslipidemia, neuropathy, and body mass index (BMI)) with GOA compared with LOA.A retrospective review of data was performed, and patients with diagnostic codes for OA were selected. Identified codes included primary GOA, primary LOA, T2DM, hypertension, dyslipidemia, neuropathy, depression, anxiety, and sleep disorders. Information about BMI and medication list was obtained. Chi-square and logistic regression were performed to examine the prevalence and risk factors, respectively.Data from 3855 patients (mean age = 66.43 ± 11.02, 60.9% women) included patients with GOA (n = 1265) and LOA (n = 2590). The prevalence of T2DM was significantly greater among patients with GOA (25.8%) compared with those with LOA (12.0%); however, the GOA group were older. Based on age groups, T2DM was prevalent in 17.8% of GOA compared with 7.2% in LOA for younger adults (aged 45-64 years) and was prevalent in 28.8% of GOA compared with 15.7% in LOA for older adults (aged 65 years or older). The odds ratio of GOA increased in people with chronic diseases compared with those without including T2DM (odds ratio (OR) 1.37, 95% confidence interval (CI) 1.05-1.78, p = 0.02), hypertension (OR 1.99, CI 1.63-2.43, p 0.001), and dyslipidemia (OR 3.46, CI 2.86-4.19, p 0.001), adjusting for covariates.Higher prevalence of T2DM was found in people with GOA when compared with LOA across both age groups. T2DM, hypertension, and dyslipidemia were associated with GOA. Future research with longitudinal designs is needed to test the causality of this association.Key Points• The prevalence of type 2 diabetes in people with generalized osteoarthritis was almost double compared with localized osteoarthritis, although generalized osteoarthritis group were older.• Among people with osteoarthritis, the risk of generalized osteoarthritis is increased by 37% when people had type 2 diabetes, by 99% when people had hypertension, and by 246% when people had dyslipidemia.

Aim: The aim of this study was to conduct a systematic review and meta -analysisforstudiesthat have examined the prevalence and risk factors of falls in older adults living in the Gulf Cooper ation Council countries(GCC). Methods: A liter ature search was performed using PubMed, Web of Science, Physiotherapy Ev idence Database; and SCOPUS up to Octo ? ber 2018 to identify studies that have examined prevalence, risk fac ? tors, or consequences of fallsin older adultsliving in the GCC. Results: A total of 6 studies met the inclusion criteria. The pooled prevalence of falls among older adults residing in GCC countries was 46.9%. Falls among included studies were associated with older age, female gender, low ed ucational level, and number of medications. Conclusions: The study shows a high prevalence of fallsin older adults living in the GCC countries. The risk factorsin the currentstudy must be interpreted with caution, since some of the included studies did not report any risk factors. Due to the limited number of ev idence eval uating risk factors and consequences of fallsin the GCC countries pop ulation, a furtherlongitudinalresearch is needed.