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Objectives . This study aimed to examine the effects of a short opponens splint and hand exercise program on pain, hand functionality, daily activities, and work efficacy in computer engineers with wrist pain. Methods . Forty-five engineers were randomized into three groups: group 1 ( n  = 15) utilized both splints and exercises, group 2 ( n  = 15) engaged in exercises only and group 3 ( n  = 15) received no treatment, across 8 weeks, thrice weekly. Only exercises were applied to group 2 ( n  = 15). No treatment was applied for group 3 ( n  = 15). The progress of subjects was controlled periodically each week. Outcome measurements including the Jamar hand dynamometer, pinchmeter, nine-hole peg test (9-NHPT), visual analog scale, Boston carpal tunnel syndrome questionnaire and Michigan hand outcome questionnaire (MHQ) were evaluated pre and post treatment during the study period. Results . Comparing the outcome measurements of the three groups showed a statistically significant difference between them except for the 9-NHPT and MHQ pain and esthetics ( p  < 0.05). According to post-hoc tests, groups 1 and 2 had more significant differences than group 3. Also, there was no statistically significant difference in any parameter between group 1 and group 2 ( p  > 0.017). Conclusion. Non-restrictive minimal orthosis or exercise programs are advisable for individuals with wrist pain.

This study presents a new dataset AKTIVES for evaluating the methods for stress detection and game reaction using physiological signals. We collected data from 25 children with obstetric brachial plexus injury, dyslexia, and intellectual disabilities, and typically developed children during game therapy. A wristband was used to record physiological data (blood volume pulse (BVP), electrodermal activity (EDA), and skin temperature (ST)). Furthermore, the facial expressions of children were recorded. Three experts watched the children's videos, and physiological data is labeled "Stress/No Stress" and "Reaction/No Reaction", according to the videos. The technical validation supported high-quality signals and showed consistency between the experts., (© 2023. The Author(s).)

Functional capacity and quality of life (QoL) are reduced in children and adults with chronic kidney disease (CKD). Aerobic, strengthening exercises, and exergames are reported as effective in the treatment of symptoms associated with CKD. Unlike adult patients, there are insufficient studies investigating the effects of exercise on disease-related symptoms in pediatric CKD. This study aimed to compare the effects of Nintendo Wii-based exergaming and home-based fun video exercises on functional capacity, muscle strength, physical activity (PA), depression, fatigue, and QoL in pediatric patients with CKD. Twenty-three pediatric patients with CKD were included in the study and randomized to group I (Nintendo Wii Fit) and group II (home-based fun video exercises). Patients in both groups underwent exercise programs twice per week for 6 weeks. Functional capacity, muscle strength, PA, QoL, fatigue, and depression of the patients were evaluated before and after the treatments. Sixteen patients completed the study. After treatment, significant differences were observed in both groups on 6MWT, muscle strength, average daily steps, PedsQoL Child Self-Report PHSS, and the Visual Fatigue Scale. Left knee flexor muscle strength and average step counts were found to be superior in group I. Both exergaming and home-based fun video exercises provide positive effects on functional capacity, muscle strength, fatigue, PA, depression, and QoL in pediatric patients with CKD. We think that these exercise methods can help to protect physical and mental health of patients and should be included in treatment from the early stages of the disease., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To examine the effectiveness of video-based game exercises and structured closed kinetic chain exercises in individuals with rotator cuff rupture. Materials and Methods: Forty-five individuals with rotator cuff rupture were included in this study. Individuals were randomly divided into three groups: a conventional exercise group (CEG), a structured closed kinetic chain exercise group (CKCEG), and a video-based game exercise group (VGEG). Interventions were performed twice a week for 6 weeks. Pain severity; pain threshold; disabilities of the arm, shoulder, and hand questionnaire (DASH); rotator cuff quality of life index (RCQOL); range of motion (ROM); and joint position sense and approximation force of all individuals were evaluated pre- and post-treatment. Results: There was a statistically significant difference in all values of the pre- and post-treatment of the groups ( P  < 0.05). When the differences between the groups were compared, CKCEG and VGEG values were more significant than CEG in all parameters ( P  < 0.017). Improvements in pain threshold, ROM in shoulder flexion and abduction, DASH score, and all parameters of the RCQOL questionnaire in VGEG were statistically more significant than CKCEG ( P  < 0.017). Conclusion: Individuals with rotator cuff rupture obtained more improvements in primary and secondary outcomes after closed kinetic chain exercise and video-based game exercise, rather than conventional methods. It was considered that video-based game exercise programs would be used in rotator cuff problems.

Backgrounds: Clubfoot is a foot disorder frequently seen. Although, there are several studies about the efficiency of physiotherapy in the treatment of clubfoot, physiotherapy programs may be more efficient if the treatment apply step by step similar to the logic of the serial casting progression of the involved foot. Therefore, the aim of this study was to determine the effectiveness of three-phase physiotherapy program in children with clubfoot., Methods: Fifty-seven patients (37 males, 20 females; 7.26 ± 1.27 years) with clubfoot which had Ponseti treatment before were included. The ankle dorsiflexion (DF) and plantar flexion (PF) ranges of motion (ROM), one-leg standing time, sit-to-stand test, The Oxford Ankle Foot Questionnaire (OxAFQ) and treatment satisfaction were evaluated before and after treatment. A three-phase physiotherapy program was applied for 3 months., Results: DF, PF, one-leg standing time, sit-to-stand test, treatment satisfaction and all parameters of OxAFQ except 'Emotional' parameter of OxAFQ-Children significantly improved after treatment (p < 0.05)., Conclusions: The three-phase physiotherapy program increased the ankle range of motion, improved functional status and treatment satisfaction in children with clubfoot. The three-phase physiotherapy might be a reasonable treatment for clubfoot. Although, there is a need for long-term studies to understand its effects on preventing relapse., (Copyright © 2021 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)

The present study aimed to validate the Leap Motion Controller (LMC)-based Fizyosoft® HandROM System developed by our team to evaluate range of motion (ROM) for fingers, wrist, and forearm in a new clinical setting. Thirty-five healthy individuals participated in the study (all right-handed, 20-30 years old). The LMC-based Fizyosoft® HandROM System is a licensed software ROM-measurement developed by our team. Pronation/supination, wrist flexion/extension, ulnar/radial deviation and metacarpophalangeal (MCP) flexion/extension of all fingers were measured with both the Fizyosoft® HandROM System and a universal goniometer. No significant differences were found between the two measurement methods for almost all mean ROMs except for ulnar and radial deviation (p > 0.05). Highly significant correlations were found between all ROMs of the forearm, wrist, and thumb (p < 0.01). MCP flexion showed significant correlation only in the index finger (r = 0.516, p = 0.003) and little finger (r = 0.517, p = 0.004). Besides, for both measures, the intraclass correlations were good to excellent on all ROMs of the forearm, wrist, and fingers except for MCP of the middle and ring fingers (0.68-0.88). The present study results indicated that the LMC-based Fizyosoft® HandROM System could sensitively track changes in the active motion of the thumb, wrist, and forearm. It is a viable alternative for assessing ROMs of the forearm, wrist, and thumb in patient follow-up., (Copyright © 2021 SFCM. Published by Elsevier Masson SAS. All rights reserved.)

Objectives: The purpose of this study was to investigate the effectiveness of structured telerehabilitation on fatigue, health status, quality of life (QoL), and activities of daily living (ADL) and compare the possible effects with structured supervised exercise programs in patients with Multiple Sclerosis., Materials and Methods: This study was a randomized, single-blind trial. Thirty patients with relapsing-remitting Multiple Sclerosis were included in the study and randomly divided into two groups; structured supervised exercise group (Group 1) and telerehabilitation group (Group 2). Group 1 (n = 15) completed a 12 week structured supervised exercise program. Group 2 (n = 15) completed a 12 week structured home-based exercise program. Patients were evaluated with functional independence measure (FIM), first section of Nottingham Health Profile (NHP-I), fatigue severity scale (FSS), and quality of life scale (QoLS) before and after the intervention., Results: Significant differences were found in all parameters in both groups after the treatment (p < .05). No significant difference was found between groups regarding FIM-total, FIM-motor, FIM-cognitive, NHP sub-parameters, and QoLS (p > .05). Between-group differences revealed a significant difference in FSS and NHP total in favor of Group 1 (p < .05)., Conclusion: A structured home-based exercise program can be an alternative to supervised exercises with no side effects in patients with multiple sclerosis. Home-based rehabilitation exercises that are checked and controlled through telerehabilitation can help patients improve their health-related QoL and ADL. However, supervised exercises can be more beneficial regarding the fatigue and health profile compared to the home-based exercises., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: The aim of the present study was to compare the effects of neurodevelopmental therapy (NDT)-based upper extremity rehabilitation and video game-based therapy (VGBT) using Nintendo ® wii and leap motion controller (LMC) games on upper extremity function in patients with cerebral palsy (CP). The 30 patients included in the present study were randomized to two groups: VGBT group (VGBT using Nintendo® Wii and LMC games) and control group (NDT-based upper extremity rehabilitation). Both groups trained 3 days a week for 8 weeks. Manual dexterity was evaluated using the "Minnesota Manual Dexterity Test (MMDT)", functional ability using the "Childhood Health Assessment Questionnaire (CHAQ)" and the "Duruoz Hand Index (DEI)" and grip and pinch strengths using a dynamometer. Following treatment, significant changes were found, MMDT, grip and pinch strength, CHAQ, and DHI scores in both groups (p < 0.05); however, VGBT group was statistically superior to group II with respect to changes in MMDT (p < 0.05). VGBT using Nintendo ® Wii and LMC games had slightly superior effects on manual dexterity in patients with CP while compared with NDT-based upper extremity rehabilitation. Futhermore, the effects of both treatment programs on grip strengths and functional ability were similar beneficial., (© 2020. Belgian Neurological Society.)

Background: The purpose of the study was to evaluate the reliability and validity of the Turkish version of the Oxford Ankle Foot Questionnaire (OxAFQ) to provide cultural adaptation., Methods: This study involved translation, back translation, and cross-cultural adaptation. Forty-nine patients with congenital talipes equinovarus were evaluated using the Turkish version of OxAFQ. Turkish version of the Childhood Health Assessment Questionnaire (CHAQ) was used as a gold standard to validate the Turkish version of the OxAFQ. The validation was assessed with Spearman correlation analysis by using CHAQ. The reliability of the questionnaire was assessed with Cronbach alpha (internal consistency) and exploratory factor analysis., Results: High validity was found between OxAFQ and CHAQ (r = -0.422-0.292) (p < 0.01). Reliability analysis showed that OxAFQ had a high level of Cronbach alpha (α = 0.88-0.96) and internal consistency (ICC = 0.90-0.96)., Conclusion: The Turkish version of OxAFQ is a valid, reliable and useful quality of life questionnaire in patients with congenital talipes equinovarus and it is proper for use by health professionals and researchers., (Copyright © 2020 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)

Objective: The purpose of this study is to investigate the effect of Leap Motion Based Exergame Therapy (LMBET) on upper limb gross grip strength (GGS), pinch forces, hand functions, gross motor function, and cognitive functions in patients with cerebral palsy (CP). Materials and Methods: Twenty patients with CP (11 hemiplegia and 9 diplegia) were included in the study. Structured Neurodevelopmental Therapy-based hand rehabilitation (SNDTBHR) (first treatment period) was applied a total of 12 sessions, 2 sessions per week (total 6 weeks), and then LMBET (second treatment period) was applied a total of 12 sessions, 2 sessions per week (total 6 weeks). GGS was evaluated by "dynamometer," pinch strengths were evaluated by "pinch meter," hand skills were evaluated by "Manual Ability Classification System (MACS)" and "Jebsen-Taylor Hand Function Test (JHFT)," the gross motor level was evaluated by "Gross Motor Function Classification System (GMFCS)," and cognitive functions were evaluated by "Wisconsin Card Sorting Test (WCST)." Results: Significant difference was found between LMBET and SNDTBHR on GGF, pinch forces, JHFT, and WCST in favor of LMBET ( P  < 0.017). There was no significant difference between both MACS and GMFCS measurements ( P  > 0.05). Conclusion: Positive effects of both SNDTBHR and LMBET have been found. However, measurements after LMBET are statistically more significant. Future research should take into account higher patient allocation. Including additional leap motion training to conventional physiotherapy is feasible and might be promising to train cognitive function in children with CP.

Objective: The variety and use of technologies used in vestibular rehabilitation are very limited. The purpose of this study was to investigate the effects of a Web-based system on vestibular rehabilitation in patients with vestibular hypofunction., Design: A total of 20 patients with unilateral vestibular hypofunction were randomly assigned to two groups. Conventional vestibular rehabilitation was applied to the control group, whereas the study group received treatment with the Web-based system supporting the vestibulo-ocular reflex with oculomotor and optokinetic stimulus (Simulation of Vestibulo-Ocular Reflex Exercises). Vestibular and balance tests, oculomotor level, the Tampa Kinesiophobia Scale, and the Dizziness Handicap Inventory were used to evaluate the treatment's efficacy., Results: Vestibular symptoms and findings, balance tests, oculomotor functions, Tampa Kinesiophobia Scale, and Dizziness Handicap Inventory improved significantly in both groups after the interventions (P < 0.05). In the intergroup analysis, improvement was found in eyes closed Romberg, semitandem, and left one-foot position balance tests in favor of the study group (P < 0.05)., Conclusion: The new vestibular technology, Simulation of Vestibulo-Ocular Reflex Exercises, was found to be effective in vestibular rehabilitation., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Study Design: Randomized controlled trial., Introduction: Juvenile idiopathic arthritis (JIA), cerebral palsy (CP), and brachial plexus birth injury (BPBI) are the most common disorders that cause upper extremity impairments in children and adolescents. Leap Motion Controller-based training (LMCBT) is a novel therapeutic method for upper extremity rehabilitation., Purpose of the Study: The aim of the present study was to investigate the potential efficacy of an 8-week LMCBT program set as an upper extremity rehabilitation program by comparing conventional rehabilitation program in children and adolescents with physical disabilities such as JIA, CP, and BPBI., Methods: A randomized control trial which included children and adolescents of different disabilities (JIA, CP, BPBI) were grouped according to their diagnosis. All patients were randomized into 2 groups namely LMCBT (group I) and conventional treatment (group II) for the treatment (3 days/8 weeks). Duruoz Hand Index and Jebson Taylor Hand Function Test were used as primary outcomes. Secondary outcomes included the nine-hole peg test, Childhood Health Assessment Questionnaire, and assessments of grip and pinch strength using a dynamometer., Results: One hundred three patients were included in the study, and 92 of them completed the treatment. After treatment, significant differences were found in Childhood Health Assessment Questionnaire, Duruoz Hand Index, Jebson Taylor Hand Function Test, nine-hole peg test, and grip and pinch strength scores in almost all groups (effect size [ES] = 0.10 to -0.77 for group I and 0.09 to -0.70 for group II in CP; ES = 0.31 to 2.65 for the group I and 0.12 to 1.66 for group II in JIA; and ES = 0 to -0.44 for group I and 0.08 to -0.62 for group II in BPBI) (P < .05). Comparisons between LMCBT and conventional treatment groups showed similar results in all parameters in all disease groups (P > .05)., Conclusions: This study has quantitatively shown that LMCBT should be used as an effective alternative treatment option in children and adolescents with physical disabilities., (Copyright © 2019 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.)

Background: Balance disorders, fatigue, and walking impairments are the most common symptoms of multiple sclerosis (MS), which lead to a decrease in quality of life. To cope with these disability-increasing symptoms, it is important to select and regularly apply appropriate rehabilitation approaches. In recent years, virtual reality approaches have been suggested as a potentially useful tool in rehabilitation. Exergaming systems are used in the treatment of symptoms associated with MS, but there are few randomized controlled studies investigating the efficacy of these systems., Objective: To investigate and compare the effects of exercise training with two different exergaming systems on balance, functionality, fatigue, and quality of life in people with multiple sclerosis (PwMS)., Methods: Forty-seven volunteer PwMS were included in the study and randomized to the group I (Nintendo Wii Fit), group II (Balance Trainer), and group III (control group). The participants in the study groups underwent an exercise program under the supervision of a physiotherapist on 2 days a week for 8 weeks. Outcome measures were the Berg Balance Scale (BBS), Timed Up and Go test (TUG), Six-Minute Walk Test (6MWT), Fatigue Severity Scale (FSS), and Multiple Sclerosis International Quality of Life Questionnaire (MusiQol), which were performed before and after the treatment., Results: Forty-two participants completed the study protocol. All parameters evaluated in group I and II showed statistically significant improvement after treatment. Changes in all outcome measures were found to be superior in group I compared with group III. Similarly, all measures except the 6MWT were found to be superior in group II compared with group III. Changes in BBS and MusiQol were found to be superior in group I compared with group II., Conclusion: In comparison with no intervention, exergaming with Nintendo Wii Fit and Balance Trainer improves balance, increases functionality, reduces fatigue severity, and increases quality of life in PwMS., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The aim of the study was to compare the effect of high-intensity laser therapy (HILT) and a combination of transcutaneous nerve stimulation (TENS) and ultrasound (US) treatment on pain, range of motion (ROM) and functional activity on cervical pain associated with cervical disc herniation (CDH). A total of 40 patients (22 women and 18 men) affected by CDH were enrolled in this study. Patients were randomly divided into two groups. In group 1 (20 subjects), patients received 20 sessions of HILT plus exercise, while in group 2 (20 subjects), a combination of US, TENS and exercise were applied. The outcomes were cervical segment ROM, pain level measured by visual analogue scale (VAS), and functional activity measured by neck pain and disability scale (NPADS) before and after the therapy. The level of statistical significance was set as p < 0.05. There was no difference for cervical ROM, VAS and NPADS values between the groups at the baseline (p> 0.05). After the treatment, cervical ROM, VAS and NPADS values were significantly improved in both groups (p < 0.05). When the groups were compared in terms of post treatment VAS, NPADS and ROM values, no statistical significance was found between the two groups (p> 0.05). Both of therapeutic modalities demonstrated analgesic efficacy and improved the function in patients affected by CDH after 4 weeks of therapy (total 20 treatment sessions in 5 days a week). Both the HILT plus exercise program and the TENS / US plus exercise program were found to be effective in improving cervical range of motion and quality of life by reducing pain. These two treatment programs have similar effects in the treatment of cervical pain associated with CDH and can be used as an alternative to each other in clinical applications. However; It is clear that futher studies are needed to investigate the principles of application of HILT to painful areas or tissues (amount of area applied, dose applied, energy delivered, number of pulses, duration of session, frequency of sessions) and to exclude the effects of exercise treatment on the results of both treatment groups., Competing Interests: Declaration of Competing Interest There are no conflicts of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: To investigate the efficacy of High Intensity Laser Therapy (HILT) and Transcutaneous Electrical Nerve Stimulation (TENS) in low back pain (LBP)., Methods: Forty patients aged between 18 to 60 were included in this study. The patients were randomized into two groups as TENS (Group I) and HILT (Group II). The severity of pain was measured by Visual Analog Scale (VAS), and the range of motion (ROM) of the joint was measured by goniometer. The Oswestry Disability Questionnaire (ODQ) was used to assess the effect of LBP on daily living activities, and the Beck Depression Inventory (BDI) was used to assess depression. All patients were taken into physical therapy program for 5 days a week for a total of 20 sessions. Patients in Group I received ultrasound, hot pack and HILT, while the patients in Group II received ultrasound, hot pack and TENS., Results: In the comparison of post-treatment improvements, among all parameters only VAS score had a significant difference in favor of Group I., Conclusions: The study demonstrated that HILT is more effective than TENS in terms of pain reduction and that HILT can be used as an alternative to TENS.

Objective: The aim of the study was to compare the effects of two different task-oriented activity training programs on activity performance and participation in children/adolescents with juvenile idiopathic arthritis., Design: Sixty-two patients were randomized into group I and group II for task-oriented activity training. In group I, activities of daily living were practiced using real materials from daily life, and in group II, activities of daily living were practiced using video-based games (Xbox 360 Kinect) for 3 d/wk for 8 wks. Pain by the Numeric Rating Scale, upper limb muscle, grip, and pinch strengths by a dynamometer, activity performance and participation by the Childhood Health Assessment Questionnaire, Canadian Occupational Performance Measure, and Duruoz Hand Index were evaluated., Results: After treatment in both groups, significant changes were found in the Numeric Rating Scale, muscle strength, grips strength, Childhood Health Assessment Questionnaire, Canadian Occupational Performance Measure, and Duruoz Hand Index (P < 0.05). Group II was statistically superior to group I in changes of almost all upper limb muscle strengths, palmar pinch strength, Canadian Occupational Performance Measure satisfaction, and Duruoz Hand Index scores (P < 0.05)., Conclusion: Video games-based task-oriented activity training is an alternative and feasible treatment for children/adolescents with juvenile idiopathic arthritis. This new method may have widespread applicability in future research, given the rapidly growing interest in virtual reality-based therapy in rehabilitation., To Claim Cme Credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Understand the rehabilitation benefits of task-oriented activity in patients with neurologic and musculoskeletal conditions; (2) Appreciate the role of video games-based task oriented activity in rehabilitation; and (3) Appropriately incorporate video games-based task oriented activity in the rehabilitation program of individuals with Juvenile Idiopathic Arthritis., Level: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Background: Mulligan mobilization techniques cause pain and affect the function in patients with Rotator cuff syndrome., Objective: The aim of the study was to investigate the effect of Mulligan mobilization on pain and quality of life in individuals with Rotator cuff syndrome., Methods: This study was conducted on 30 patients with Rotator cuff syndrome. The patients were randomized into Mulligan and control group. All the patients participating in this study were treated with conventional physiotherapy. Additionally, the Mobilization with movement (MWM) technique was used in the Mulligan group. Visual Analog Scale (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH), goniometer for the normal range of motion (ROM) and Short Form-36 (SF-36) questionnaires were used for assessment., Results: Statistically significant improvement was found in the post-treatment VAS, DASH, SF-36, and ROM values significantly improved in both groups (p< 0.05). However, the Mulligan group showed much better results when compared to the control group in ROM, VAS, DASH (p< 0.05). In the SF-36 questionnaire, significant results were obtained for both groups, except the social function parameter. For the SF-36 parameters, both groups performed equally., Conclusions: Mulligan mobilization was more effective than general treatment methods for pain as well as normal joint motion, DASH scoring and some parameters of SF-36 compared with general treatment methods.

Handball is a popular sport in many countries. There is lack of knowledge about handball athlete's functional movement capacity. The aim of this study is to investigate the Functional Movement Screen (FMS) scores, to evaluate the injury risks of handball athletes and to determine its relationship with athletic performance. A total of 51 professional handball players were included in this study. The sport-specific features and demographic data were recorded. The functional movement analysis was performed, agility and balance and force were evaluated. 37 were females and 14 were males. The mean age 21.00±4.50 years (range, 16-35 years). The mean FMS scores of handball athletes were 12.86±2.57. In addition, asymmetries were found between the left and right side FMS scores. There was a statistically significant poor correlation between the FMS and agility ( r =0.292, P =0.038) and balance (right: r =0.224, P =0.024; left: r =0.228, P =0.022). Handball is a risky sport for injuries; therefore, athletes, coaches, and medical staff should recognize about the removal of functional deficiency before performance training. The FMS is a useful and cost-effective approach to identify these deficiencies. It is necessary not only to prevent injuries, but also to improve performance. These tests must be done before every season and, then, corrective, medical, or conservative approaches may be applied to athletes before performance training. (Clinical Trial ID: NCT03468569)., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported.

Introduction: Physical inactivity is an important risk factor for stroke and stroke recurrence. There is insufficient knowledge about the physical activity (PA) level in stroke patients who are ambulatory in the subacute phase. Our aim was to compare the PA level between ambulatory stroke patients and a population of the same age and to investigate neuropsychological factors that could affect the PA level in the same stroke group., Methods: Eighty-five subacute stroke patients and 58 healthy subjects were included. Patients' demographic features, disease-related features, and comorbidities were recorded. The PA level was assessed by the International Physical Activity Questionnaire-Short Version and a pedometer (OMRON Walking style II). The Apathy Rating Scale was applied to determine the apathy level. Depression level was investigated by the Geriatric Depression Scale. The standardized Mini-mental State Examination was performed to assess the cognitive status., Results: The PA level was significantly higher in the healthy group than in the stroke group (p<0.001). Step count and walking distance were significantly higher in healthy group (p=0.001 and p=0.04, respectively). The PA level of men was significantly higher than that of women (p=0.03). Participants who were classified as level 4 had a lower PA level than those who were classified as level 5 according to the Functional Ambulation Category. There was no relationship between the PA level and the apathy, cognitive, and depression levels in the stroke patients (p>0.05)., Conclusion: Subacute stroke patients have a lower PA level than healthy subjects. This is not related to neuropsychological factors. The reasons for minor deficits related to ambulation should be researched further while developing strategies for increasing the PA level of subacute stroke patients., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Objective: This study aimed to evaluate postural awareness and changes in posture and flexibility of students who took Clinical Pilates class as an elective course at the undergraduate level., Methods: The study conducted from 2013-2016 included 98 students who took Clinical Pilates class at the Department of Physical Therapy and Rehabilitation, School of Health Sciences, Istanbul Medipol University, Turkey. The flexibility levels of the study participants were measured before and after the Clinical Pilates education using finger-to-floor test and modified Schober's test. Observational posture analysis and postural awareness were recorded using the scale prepared by the researchers., Results: The post-education evaluations showed that postural distortions were fixed, and a significant increase in the postural awareness of the students was observed compared with the pre-education period. The results of both modified Schober's test and finger-to-floor test, which were used to measure the flexibility levels, showed a statistically significant increase in post-education scores compared with those of the pre-education period., Conclusion: This study showed that the Clinical Pilates course increased postural awareness and flexibility of physical therapy students and fixed postural distortions. Thus, the inclusion of Clinical Pilates class in the undergraduate education is considered to be important., Competing Interests: Declaration of interest: None.

Background: This study compared the effects of Nintendo Wii-Fit ® balance-based video games and conventional balance training in children with mild cerebral palsy (CP)., Methods: This randomized controlled trial involved 30 ambulatory pediatric patients (aged 5-18 years) with CP. Participants were randomized to either conventional balance training (control group) or to Wii-Fit balance-based video games training (Wii group). Both group received neuro-developmental treatment (NDT) during 24 sessions. In addition, while the control group received conventional balance training in each session, the Wii group played Nintendo Wii Fit games such as ski slalom, tightrope walk and soccer heading on balance board. Primary outcomes were Functional Reach Test (forward and sideways), Sit-to-Stand Test and Timed Get up and Go Test. Nintendo Wii Fit balance, age and game scores, 10 m walk test, 10-step climbing test and Wee-Functional Independence Measure (Wee FIM) were secondary outcomes., Results: After the treatment, changes in balance scores and independence level in activities of daily living were significant (P < 0.05) in both groups. Statistically significant improvements were found in the Wii-based game group compared with the control group in all balance tests and total Wee FIM score (P < 0.05)., Conclusion: Wii-fit balance-based video games are better at improving both static and performance-related balance parameters when combined with NDT treatment in children with mild CP., (© 2016 Japan Pediatric Society.)

[Purpose] Cerebral palsy is a sensorimotor disorder that affects the control of posture and movement. The Nintendo(®) Wii Fit offers an inexpensive, enjoyable, suitable alternative to more complex systems for children with cerebral palsy. The aim of this study was to investigate the efficacacy of Wii-based balance therapy for children with ambulatory cerebral palsy. [Subjects] This pilot study design included fourteen ambulatory patients with cerebral palsy (11 males, 3 females; mean age 12.07 ± 3.36 years). [Methods] Balance functions before and after treatment were evaluated using one leg standing, the functional reach test, the timed up and go test, and the 6-minute walking test. The physiotherapist prescribed the Wii Fit activities,and supervised and supported the patients during the therapy sessions. Exercises were performed in a standardized program 2 times a week for 12 weeks. [Results] Balance ability of every patient improved. Statistically significant improvements were found in all outcome measures after 12 weeks. [Conclusion] The results suggest that the Nintendo(®) Wii Fit provides a safe, enjoyable, suitable and effective method that can be added to conventional treatments to improve the static balance of patients with cerebral palsy; however, further work is required.