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The aim of this study was to compare the effects of static stretching, proprioceptive neuromuscular facilitation (PNF) stretching and Mulligan technique on hip flexion range of motion (ROM) in subjects with bilateral hamstring tightness. A total of 40 students (mean age: 21.5±1.3 years, mean body height: 172.8±8.2 cm, mean body mass index: 21.9±3.0 kg · m-2) with bilateral hamstring tightness were enrolled in this randomized trial, of whom 26 completed the study. Subjects were divided into 4 groups performing (I) typical static stretching, (II) PNF stretching, (III) Mulligan traction straight leg raise (TSLR) technique, (IV) no intervention. Hip flexion ROM was measured using a digital goniometer with the passive straight leg raise test before and after 4 weeks by two physiotherapists blinded to the groups. 52 extremities of 26 subjects were analyzed. Hip flexion ROM increased in all three intervention groups (p<0.05) but not in the no-intervention group after 4 weeks. A statistically significant change in initial--final assessment differences of hip flexion ROM was found between groups (p<0.001) in favour of PNF stretching and Mulligan TSLR technique in comparison to typical static stretching (p=0.016 and p=0.02, respectively). No significant difference was found between Mulligan TSLR technique and PNF stretching (p=0.920). The initial--final assessment difference of hip flexion ROM was similar in typical static stretching and no intervention (p=0.491). A 4-week stretching intervention is beneficial for increasing hip flexion ROM in bilateral hamstring tightness. However, PNF stretching and Mulligan TSLR technique are superior to typical static stretching. These two interventions can be alternatively used for stretching in hamstring tightness. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the effects of static stretching, proprioceptive neuromuscular facilitation (PNF) stretching and Mulligan technique on hip flexion range of motion (ROM) in subjects with bilateral hamstring tightness. A total of 40 students (mean age: 21.5±1.3 years, mean body height: 172.8±8.2 cm, mean body mass index: 21.9±3.0 kg · m-2) with bilateral hamstring tightness were enrolled in this randomized trial, of whom 26 completed the study. Subjects were divided into 4 groups performing (I) typical static stretching, (II) PNF stretching, (III) Mulligan traction straight leg raise (TSLR) technique, (IV) no intervention. Hip flexion ROM was measured using a digital goniometer with the passive straight leg raise test before and after 4 weeks by two physiotherapists blinded to the groups. 52 extremities of 26 subjects were analyzed. Hip flexion ROM increased in all three intervention groups (p<0.05) but not in the no-intervention group after 4 weeks. A statistically significant change in initial-final assessment differences of hip flexion ROM was found between groups (p<0.001) in favour of PNF stretching and Mulligan TSLR technique in comparison to typical static stretching (p=0.016 and p=0.02, respectively). No significant difference was found between Mulligan TSLR technique and PNF stretching (p=0.920). The initial-final assessment difference of hip flexion ROM was similar in typical static stretching and no intervention (p=0.491). A 4-week stretching intervention is beneficial for increasing hip flexion ROM in bilateral hamstring tightness. However, PNF stretching and Mulligan TSLR technique are superior to typical static stretching. These two interventions can be alternatively used for stretching in hamstring tightness. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to determine the effects of the chronic pain severity and pain duration in patients with osteoarthritis [OA] on pressure-pain threshold [PPT] and proprioception. Methods: The study groups consisted of patients with painful joints and healthy normal controls with painless joints. The chronic pain degree was evaluated with The Chronic Pain Grade Questionnaire. The PPT was measured with a dolorimeter and proprioception was evaluated passively. Results: Sixty-three patients with OA, mean aged 55 ± 10.60 years, were included in this study. Twenty-four patients had knee arthritis, eight patients had hip arthritis, and 31 patients had shoulder arthritis. The patients with OA had experienced pain for a duration of 41.09±53.35 [12 to72] months. The PPT was decreased and joint position sense and kinesthesia were altered in the painful joint when compared with the painless joint [P < 0.05]. No correlation was found between age, body mass index, pain duration, pain intensity score and PPT, joint position sense, or kinesthesia [P > 0.05]. However, the chronic pain grade was correlated with PPT [r = -0.418], joint position sense [r = 0.445], and kinesthesia [r = 0.535]. Similarly, correlations were found between disability points and PPT [r = -0.369], joint position sense [r = 0.473], and kinesthesia [r = 0.505]. Conclusions: Chronic pain grade correlates inversely with PPT, but it correlates directly with joint position sense, and kinesthesia senses in patients with OA. However, pain duration and pain intensity do not correlate with PPT, joint position sense, or kinesthesia. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine whether there are changes in peak expiratory flow rate (PEFR) and chest expansion after a standardized physical therapy program in patients with chronic neck and back pain. In a university-based, out-patient physiotherapy department, thirty-three patients were assigned into the study (9 cervical disc herniation and 24 lumbar disc herniation, mean age respectively 45.0 +/- 12.85 (30-72 years), 41.33 +/- 11.69 (22-63 years). Data on pain intensity, PEFR and chest expansion were collected before and after physiotherapy programme. A combination of hot-pack, massage, interferential current and exercise were applied for two weeks. None of the patients were given any breathing exercises. In both groups, a significant reduction in pain intensity and increase in PEFR occurred (p<0.05) after therapy. Although considerable increases were obtained in chest expansion, only CDH group showed significant improvement at axillary level (p<0.05). No significant relation was found between changes in pain intensity and PEFR in both of the groups (CDH group r=0.045, p=0.908, LDH group r=0.014, p=0.947). This study suggests that physiotherapy programmes aimed to reduce pain and improve postural alignment of the patients have shown positive effects on respiratory functions too. [ABSTRACT FROM AUTHOR]

Objective: Therapeutic exercises are well documented for the treatment of osteoarthritis; there is less evidence on what the effect of closed kinetic chain exercises is for knee osteoarthritis. The aim of this study was to investigate the effects of open kinetic chain exercises and closed kinetic chain exercises on pain, muscle strength, functional status, and quality of life in patients with knee osteoarthritis., Methods: The study included a total of 60 patients with primary unilateral knee osteoarthritis grade I and II. The patients were categorized into three groups as open kinetic chain exercises (n=20), closed kinetic chain exercises (n=20), and control group (n=20). The outcome measures, including pain, isokinetic muscle strength, functional status, and quality of life, were collected at baseline and at the end of 6 and 12 weeks., Results: Closed kinetic chain exercises and open kinetic chain exercises had significant improvement in pain, muscle strength, WOMAC, and SF-36 scores after the treatment and at their 6th and 12th week follow-ups compared to their baseline values and compared to the control group (p<0.05)., Conclusion: The changes in all outcome measures were similar between closed kinetic chain exercises and open kinetic chain exercises (p>0.05). Closed kinetic chain exercises and open kinetic chain exercises were similar for knee osteoarthritis grade I and II. Closed kinetic chain exercises could be safely added to the exercise programs of patients with low-grade knee osteoarthritis.

Background: The ankle-foot complex plays a key role in maintaining balance because it collects proprioceptive data. Kinesio taping (KT) is a rehabilitative method performed by the cutaneous application of a special elastic tape. The mechanical correction technique of KT was suggested to reposition the joints and alter balance parameters. The aim was to reveal the pure effects of ankle KT on balance, range of motion (ROM), and muscle strength in healthy individuals., Methods: Forty healthy students were recruited for this randomized, sham-controlled study at a local university. Participants were divided into two groups-experimental and sham application groups. The primary outcome measures were balance parameters. Athlete Single Leg (ASL), Limits of Stability (LoS), and Clinical Test of Sensory Interaction and Balance (CTSIB) were used to measure single-leg dynamic balance, dynamic postural control, and sensory interaction of balance, respectively. Dorsiflexion ROM and dorsiflexor muscle strength were the secondary outcomes., Results: The ASL score showed significant improvement only in the experimental KT group (P=0.02); however, the LoS score increased significantly in both groups (P<0.05). CTSIB scores, dorsiflexion ROM, and dorsiflexor muscle strength for both ankles did not change in any of the groups after intervention (P>0.05). Moreover, there was no superiority of one intervention over the other in improving any of the variables (P>0.05)., Conclusion: The mechanical correction technique of KT can be useful in providing immediate improvement in single-leg dynamic balance in healthy individuals. However, it may not be effective to significantly change the sensory interaction of balance, dorsiflexion ROM, and muscle strength.

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

Background: There is no consensus about treatment of neck patients who have radicular symptoms., Objective: The purpose of the study was to investigate the effect of stabilization exercise training on pain and functional status in patients with cervical radiculopathy., Methods: The patients (n= 32) with cervical radiculopathy were randomized to two groups as follows: Stabilization exercise group (Group 1; n= 18); Home-exercise group (Group 2; n= 16). The patients were evaluated with visual analog scale, Neck Disability Index, SF-36 (Short-Form), Corbin postural assessment scale and hand grip at baseline, after treatment at 4th week and 3rd month., Results: At baseline, there were no statistically differences between groups in terms of evaluated parameters (p> 0.05). After treatment and three months later, pain and Neck Disability Index decreased; Corbin postural scores, hand grip and SF-36 scores improved statistically in both groups (p< 0.05). Changes of the measurements in both groups were similar and there were no significant differences between group 1 and group 2 at 4th week and 3rd month (p> 0.05) except postural scores., Conclusions: This study demonstrates that stabilization exercise training could be an effective intervention for decreasing pain and improving quality of life and posture in patients with cervical radiculopathy.

Objective: The aim of this study was to investigate the effect of scapular muscle endurance on chronic shoulder pain in textile workers., Methods: In total, 91 textile workers were divided into two groups based on the presence (n=43) or absence (n=48) of chronic shoulder pain, as assessed using the Nordic Musculoskeletal Questionnaire (NMQ). The endurance of the serratus anterior and trapezius muscles was assessed using the Scapular Muscle Endurance (SME) test., Results: In the group with chronic shoulder pain, mean scapular muscle endurance was significantly lower than that in the pain-free group (t-test, p< 0.05). There was a significant negative correlation between rest - activity pain intensity and SME (Pearson correlation analysis, p< 0.01)., Conclusions: Scapular muscle endurance has an effect on the development of shoulder pain in textile workers.

Our aim was to determine the effects of resistance training on cardiovascular risk factors in postmenopausal women. Forty-five women were included in the study. Resistance exercises were done with an intensity of 60% of 1-Repetition Maximum, for 12 weeks. Heart rate, blood pressure, estimated peak VO(2), lipid profiles, and homocysteine levels were evaluated. There were significant time and group interactions for body mass index (p = .02), heart rate (p = .04), systolic blood pressure (p = .03), estimated mean peak VO(2) (p = .00), and total cholesterol (p = .00), but there were no interactions with other evaluated parameters. Resistance training has beneficial effects on particular cardiovascular risk factors in postmenopausal women.

Background: The Oxford Shoulder Score (OSS) is a questionnaire developed to evaluate patients with certain shoulder problems. This study aimed to translate and culturally adapt a Turkish version of the OSS and validate its use for assessing Turkish patients with shoulder pathology., Patients and Methods: OSS was translated and culturally adapted according to the guidelines in the literature. Eighty-four patients (mean age 49.26 ± 11.92 years) with shoulder problems participated. Patients completed the Turkish OSS, the Short Form 36 (SF-36), and the Shoulder Pain and Disability Index (SPADI). Internal consistency was tested using Cronbach α coefficient. Reproducibility was assessed by asking patients to complete another OSS 48 h after the first test. Correlation between the total results of both tests was determined by the Pearson correlation coefficient and ICC. Validity was assessed by calculating the Pearson correlation coefficient between the OSS and SPADI and SF-36 scores. Floor and ceiling effects were analyzed., Results: The internal consistency was high (Cronbach's α 0.92). The reproducibility tested by two different methods showed no significant difference. Correlation between the OSS and SPADI and SF-36 physical component summary score were -0.7, and 0.6, respectively (p < 0.001). There was no floor or ceiling effect in total OSS score., Conclusion: The Turkish version of the OSS proved to be valid, reliable and reproducible instrument as demonstrated by high Cronbach α and Pearson Correlation Coefficients. The application and evaluation of the instrument was feasible and minimally time consuming for use in clinical trials in Turkish-speaking patients with shoulder problems.

Objective: The study investigated the effectiveness of stretching, strengthening exercises, and the scapular stabilization exercises on the pain, shoulder range of motion (ROM), muscle strength, joint position sense (JPS), scapular dyskinesis and quality of life (OL) in the patients with subacromial impingement syndrome (SIS)., Methods: 27 women and 13 men, mean age 51 (24-71) years old, were included in this study. All the patients were separated into 2 groups according to simple random table. Stretching and strengthening exercises were given to the group I (n=20) and scapular stabilization exercises were added to the group II (n=20). The pain severity, shoulder ROM, muscle strength, JPS, lateral scapular slide test (LSST), Western Ontario Rotator Cuff (WORC) Index were evaluated before and after treatment. Patients completed a 6-week rehabilitation program, three times a week., Results: The results showed that all measurements improved statistically in both groups after treatment (p < 0.05). And the improvements in the muscle strength, JPS and scapular dyskinesia were significantly different in group II (p < 0.05)., Conclusion: It is suggested that in the treatment of SIS; scapular stabilization exercises, given with stretching and strengthening exercises, can be more effective in increasing the muscle strength, developing the JPS and decreasing the scapular dyskinesis.

Context: There is limited information on the effects of different warm-up periods on proprioception and balance in the context of injury prevention., Objective: To determine the effects of warm-up exercises on knee proprioception and balance and to compare the effectiveness of warming up periods., Design: Pretest/posttest., Setting: Research laboratory., Participants: 30 healthy subjects (19 women, 11 men; mean age 20.70 +/- 0.99 years)., Interventions: Exercise groups performed warm-up exercises (group 1, 5 minutes; group 2, 10 minutes). Joint Position Sense (JPS) was tested at 15 degrees , 30 degrees , and 60 degrees knee flexion (KF) on a JPS device. Balance was measured using the Neurocom Balance Master System., Main Outcome Measures: JPS absolute error (AE) was measured at 15 degrees , 30 degrees , and 60 degrees KF and postural control was measured., Results: After exercise, we found significant improvements for AE of JPSs of 30 degrees right (R) KF, 15 degrees left (L) KF, and 60 degrees L KF in group 1. In group 2, AE of JPS values increased for all angles of both knees except 60 degrees R KF. AE of JPS values of 15 degrees R KF, 30 degrees R KF, 15 degrees L KF, 60 degrees L KF were significantly different in group 2 compared with group 1. In balance measurements, there were significant improvements for standing on foam with eyes closed (EC) position, velocity and R-L unilateral stance EC in group 1. There were significant improvements for velocity, end point, maximum excursion, and L unilateral stance EC in group 2., Conclusions: Both warm-up periods have positive effects on knee proprioception and balance. The 10-minute warm-up exercise improved proprioception by a greater amount than the 5 minutes warm-up exercise.

Background and Aims: Elevated plasma homocysteine (PH) levels have been identified as a risk factor for cardiovascular diseases. The aims of this study were to investigate the influences of submaximal acute aerobic exercise and aerobic training on PH levels and lipid profiles., Methods: 69 volunteer subjects (21.12 +/- 2.08 years) were randomized to three groups as acute, training and control groups. Examination and blood samples were collected before and immediately after exercise in the acute group and before and 6 weeks later in the training and control groups., Results: A significant increase in PH concentration was recorded immediately after aerobic exercise, compared with baseline values (p = 0.001). Although, in the training group, total cholesterol (p = 0.00) and LDL cholesterol (p = 0.001) decreased significantly after training, no significant changes in PH concentration, HDL cholesterol (p = 0.087) and triglyceride (p = 194) levels were found., Conclusions: It can be said that the PH level increases following submaximal acute aerobic exercise, but does not alter after submaximal aerobic training due to training duration or intensity. Therefore, submaximal aerobic training decreases lipid profiles independent of the PH level., (Copyright 2007 S. Karger AG, Basel.)

Background: Falls are one of the major health problems that effect the quality of life among older adults. The aim of this study was to explore the relationship between quality of life (Short Form-12) and the risk factors of falls (balance, functional mobility, proprioception, muscle strength, flexibility and fear of falling) in older adults., Methods: One hundred sixteen people aged 65 or older and living in the T.C. Emekli Sandigi Narlidere nursing home participated in the study. Balance (Berg Balance test), functional mobility (Timed Up and Go), proprioception (joint position sense), muscle strength (back/leg dynamometer), flexibility (sit and reach) and fear of falling (Visual Analogue Scale) were assessed as risk factors for falls. The quality of life was measured by Short Form-12 (SF-12)., Results: A strong positive correlation was observed between Physical Health Component Summary of SF-12, General Health Perception and balance, muscle strength. Proprioception and flexibility did not correlated with SF-12 (p > 0.05). There was negative correlation between Physical Health Component Summary of SF-12, General Health Perception and fear of falling, functional mobility (p < 0.05)., Conclusion: We concluded that the risk factors for falls (balance, functional mobility, muscle strength, fear of falling) in older adults are associated with quality of life while flexibility and proprioception are not.

Background: In a crowded modern world it is vital that the promotion of sport and exercise should be compatible with environmental and public health outcomes. This study aims to investigate the effects of environmental factors, lifestyle and leisure time activities on physical fitness in rural and urban children., Methods: A cross-sectional observational study of 98 rural and 74 urban healthy children (aged 9-11 years) was conducted in Turkey. A questionnaire was used in collecting information about the children's physical activity habits and their school's facilities. The physical fitness of children was evaluated with EUROFIT test battery., Results: The rural children preferred to play football and volleyball while the urban children had a tendency to prefer indoor sports. The percent of urban children not involved in any sports activity was 35%, while this rate was 30.6% for rural children. It was also found that the urban children watched TV more than the rural children (13.4 +/- 2.7 h/week, 10.9 +/- 2.7 h/week, respectively). The results showed that body mass index and skinfolds thickness were higher in the urban children (P < 0.05). There were no significant differences in the hip-waist ratio or the hip and waist circumference between the two groups. In cardiopulmonary and motor fitness, no difference was found between the two groups. In contrast, flexibility and muscle endurance were significantly higher in the rural children., Conclusion: The children living in the urban areas were more inactive and obese, which resulted in a decrease in their flexibility and muscle endurance fitness.