The effect of different subtalar joint pronation amounts on postural stability, function and lower extremity alignment in healthy individuals.

INTRODUCTION: The prone foot posture has a negative effect on postural stability, function, and knee valgus, but to our knowledge, the contribution of the degree of pronation has not been examined. METHODS: 39 participants aged 18-40, with Foot Posture Index (FPI) scores between 6-12 and without any pain complaints were included. Participants with 6-9 points were included in the pronation group (PG) (n = 19), and participants with 10-12 points were included in the hyperpronation group (HPG) (n = 20). Static and dynamic postural stability, Foot and Ankle Ability Measure (FAAM), and frontal plane projection angles (FPPA) were measured for all participants. RESULTS: The initial data of the participants are distributed homogeneously. In the intergroup evaluation only FPI-1 (p = 0.001; p < 0.05), FPI-4 (p = 0.00; p < 0.05), FPI-5 (p = 0.00; p < 0.05) and FPI-T (p = 0.000; p < 0.05) scores were found significantly different. CONCLUSION: Pronation and hyperpronation of the subtalar joint did not lead to a difference in postural stability, function, and knee valgus in healthy individuals. It may be more beneficial to focus on the prone posture rather than the degree of pronation.

Physical performance tests have excellent reliability in frail and non-frail patients with prostate cancer.

PURPOSE: Our aim was to investigate the test-retest reliability of the 2-min walk test (2MWT), timed up and go test (TUG), and five times sit-to-stand test (FTSST) in prostate cancer (PC) patients. METHODS: This study was conducted with 73 patients who were classified into two groups as frail and non-frail determined by the Geriatric-8 questionnaire. Patients performed the 2MWT, TUG, and FTSST tests for two times. The test-retest reliability of the 2MWT, TUG, and FTSST was assessed by calculating the intraclass correlation coefficient (ICC). The standard error of measurement (SEM95) and minimal detectable change (MDC95) values were calculated. RESULTS: All tests showed excellent test-retest reliability for both groups (ICC(2.1) > 0.90). The SEM95 and MDC95 values of 2MWT were 3.09, 8.57, and 3.15 m, 8.73 m for frail and non-frail groups. The SEM95 and MDC95 values of TUG for the frail group were 0.6 and 1.66 and 0.43 and 1.19 for the non-frail group, respectively. The SEM95 and MDC95 values of FTST for the frail group were 0.68 and 1.88 and for the non-frail group 0.86 and 2.38. CONCLUSIONS: The 2MWT, TUG, and FTSST showed excellent reliability in frail and non-frail older adults with PC which can be used to assess physical performance.

The 2-minute walk test (2MWT), Timed up and go test (TUG) and five times sit to stand tests (FTST) are excellent reliable tests for both frail and non-frail prostate cancer patients.The Minimal Detectable Change (MDC95) value of 2MWT, TUG, and FTST provides important information to clinicians about the clinical progression of oncological patientsClinicians can use one of this evidence-based outcome measures to check change of independent mobility performance with prostate cancer patients.

Investigation of factors affecting physical activity level in patients with primary Sjögren's syndrome.

OBJECTIVES: This study aimed to determine physical activity levels and understand the factors influencing an active lifestyle among patients with primary Sjögren's syndrome (pSS). METHODS: Ninety-seven patients participated in this multicentric study. Physical activity levels were assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The Inflammatory Arthritis Facilitators and Barriers (IFAB) questionnaire was used to evaluate perceived barriers and facilitators to physical activity. RESULTS: Forty-six patients were physically inactive and the rest of them were moderately active. Commonly identified barriers included a lack of motivation, fatigue, and pain. Conversely, knowledge of the health and mood benefits for physical activity emerged as a key motivator. Patients with better scores on facilitators and lower scores on barriers exhibited higher physical activity levels (p < 0.05). Notably, a high level of perceived facilitators of physical activity (odds ratio [OR]: 1.02; 95% confidence interval [CI], 1.00 ­ 1.05) and reduced pain (OR: 0.81; 95% CI: 0.69 ­ 0.95) were linked to an active lifestyle. CONCLUSIONS: This study emphasizes the role of motivation and awareness of the benefits of physical activity for health and mood in driving physical activity for patients with primary Sjögren's syndrome. Tailored physical activity programs that address psychological aspects and disease-related pain, and fatigue should be designed to counter sedentary lifestyles in pSS patients.

Is Morton's neuroma in a pes planus or pes cavus foot lead to differences in pressure distribution and gait parameters?

Morton's neuroma (MN) is a compressive neuropathy of the common digital plantar nerve causing forefoot pain. Foot posture and altered plantar pressure distribution have been identified as predispoing factors, however no studies have compared individuls with different foot postures with MN. Thus, we aimed to compare the effect of MN on spatiotemporal gait parameters and foot-pressure distribution in individuals with pes planus and pes cavus. Thirty-eight patients with unilateral MN were evaluated between June and August 2021. Nineteen patients with bilateral pes planus and 19 age and gender-matched patients with pes cavus who had no prior surgery were recruited. A Zebris FDM-THM-S treadmill system (Zebris Medical GmbH, Germany) was used to evaluate step length, stride length, step width, step time, stride time, cadence, velocity, foot-pressure distribution, force and whole stance phase, loading response, mid stance, pre-swing and swing phase percentages. There were no significant differences between the groups in spatiotemporal gait parameters (p > 0.05). Patients with pes planus displayed the following results for step length (49.36 ± 8.38), step width (9.05 ± 2.12), stance phase percentage (65.92 ± 2.11), swing phase percentage (34.08 ± 2.12), gait speed (2.96 ± 0.55), and cadence (100.57 ± 8.84). In contrast, patients with pes cavus displayed the following results for step length (49.06 ± 8.37), step width (8.10 ± 2.46), stance phase percentage (64.96 ± 1.61), swing phase percentage (34.79 ± 1.60), gait speed (2.95 ± 0.65), and cadence (99.73 ± 13.81). Foot-pressure distribution values showed no differences were detected in force, forefoot, and rearfoot pressure distribution, except for midfoot force (p < 0.05). The forefoot, midfoot, and rearfoot pressure values for the pronated group were 32.14 ± 10.90, 13.80 ± 3.03, and 22.78 ± 5.10, and for the supinated group were 33.50 ± 11.49, 14.23 ± 3.11 and 24.93 ± 6.52. MN does not significantly affect spatiotemporal gait parameters or foot-pressure distribution in patients with pes cavus or pes planus.

Video-Based Information About Plantar Fasciitis Reflects Current Treatment Guidelines.

BACKGROUND: Online health-related information has become increasingly popular. Social media platforms have great potential to support and change patients' perspective. Plantar fasciitis (PF) is a common disease that is one of the most frequently researched subjects among foot problems. This study aimed to assess the content, quality, and reliability of YouTube videos related to PF and to evaluate whether they reflect current PF treatment guidelines. METHODS: The descriptive cross-sectional study analyzed the most viewed 79 YouTube videos retrieved by using the keyword "plantar fasciitis." The quality, reliability, and content of the videos were analyzed using Global Quality Scale (GQS), the modified DISCERN instrument, the Journal of the American Medical Association instrument, and a content scoring system by two independent physiotherapists. The analyzed videos were divided into three groups according to their GQS score as high, intermediate, and low quality. Also, video parameters were compared between the useful and misleading groups. RESULTS: Of the 79 analyzed videos, 26 (32.9%) were of low quality, 29 (36.7%) were of intermediate quality, and 24 were of (30.3%) high quality. Most high-quality videos were uploaded by allied health professionals (39.4%). The view ratio and video power index scores were highest in patients. There were significant differences between useful and misleading videos in terms of DISCERN, GQS, and Journal of the American Medical Association scores (P = .000, P = .000, and P = .020, respectively). Almost all of the evaluated videos contain at least one treatment approach. CONCLUSIONS: This study demonstrates that the vast of majority of YouTube videos on PF are useful and comprehensive; also, our results may lead us to propose that the vast majority of the videos reflect current treatment guidelines. Video-based information about PF may provide valuable insight to patients, especially in the absence of direct access to health care by stakeholders.

Physical literacy as a determinant of physical activity level among late adolescents.

BACKGROUND/OBJECTIVES: This study aimed to investigate the level of physical literacy among late adolescents according to the current physical activity level and to examine the relationship between current physical activity, barriers to engaging in physical activity, and enjoyment of physical activity and physical literacy. METHODS: A total of 568 university students (405 women) aged from 18 to 20 were involved in this study. The physical literacy, physical activity level, enjoyment from activity, and barriers to physical activity were assessed with the Perceived Physical Literacy Instrument (PPLI), the International Physical Activity Questionnaire-Short Form (IPAQ-SF), Physical Activity Enjoyment Scale (PACES), and the Physical Activity Barriers Questionnaire (PABQ), respectively. Multinomial and binary logistic regression analyses were employed to explore the association between physical literacy and physical activity level. RESULTS: Highly physically active adolescents had better scores on the PPLI, PACES, and PABQ than moderately active and inactive participants. The PPLI total score was significantly moderately correlated with PACES total, positive, and negative scores and the PABQ score. There were significant poor correlations between the IPAQ-MET value and the PPLI scores. Adjusted logistic regression analysis revealed the PPLI total score and the PACES positive sub-scale scores, and gender (men) were associated with being highly active relative to moderately active. CONCLUSIONS: The findings highlight the evidence that physical literacy, gender, and enjoyment from activity can be determinants of high or moderate physical activity levels. Therefore, improving physical literacy among late adolescence may be key to achieving increased physical activity level.

Identifying frailty and its associated factors in patients with axial spondyloarthritis.

BACKGROUND AND AIM: Frailty is an elderly people phenomenon; however, younger adults with comorbidities may show a higher trajectory of frailty toward older age. The frailty status of middle-aged patients with axial spondyloarthritis (axSpA) remains little researched. We aimed to identify frailty status and to investigate the association of clinical, sociodemographic, and psychosocial factors with frailty. METHODS: This study included 114 patients aged between 40 and 65 years. The patients were classified as frail, pre-frail, and robust according to Fried's phenotype and the Kihon Checklist (KCL). Physical function, quality of life, depression, anxiety, and disease-related factors were assessed. Between-group comparisons and multinomial logistic regression analysis were performed. RESULTS: Frailty and pre-frailty prevalences were 20.2% and 49.1% for Fried's phenotype and 36.0% and 33.3% for the KCL. Frail adults had impaired physical function and increased disease activity compared to pre-frail and robust patients. Adjusted multinomial logistic regression analysis revealed that disease activity (odds ratio [OR] = 1.62, 95% CI = 1.12-2.34) and Short Physical Performance Battery (OR = 0.32, 95% CI = 0.18-0.56) were associated with Fried's phenotype-determined frailty. Disease activity (OR = 1.91, 95% CI = 1.11-3.26), Bath Ankylosing Spondylitis Functional Index (OR = 2.70, 95% CI = 1.56-4.67), and depression (OR = 1.55, 95% CI = 1.18-2.02) were associated with the KCL determined frailty. CONCLUSION: Frailty and pre-frailty are commonly detected in middle-aged individuals with axSpA. Our findings highlight a possible need for frailty screening and preventive programs targeting middle-aged axSpA patients.

Pre-sarcopenia is associated with health-related quality of life in patients with primary Sjögren's syndrome.

OBJECTIVES: Primary Sjögren's syndrome leads to pain and fatigue that may cause impaired muscle function and muscle mass. This study aimed to determine the presence of pre-sarcopenia and to clarify associated factors with pre-sarcopenia in primary Sjögren's syndrome patients. METHOD: This cross-sectional study recruited 49 patients with primary Sjögren's syndrome and 49 age- and gender-matched healthy controls. Sarcopenia was assessed according to European Working Group on Sarcopenia in Older People in 2018 (EGSWOP2) criteria by evaluating muscle mass, gait speed, and grip strength. Physical function was also assessed with five times sit-to-stand (FTSTS) test. Quality of life (QoL), psychological symptoms, and nutritional status were evaluated using Sarcopenia Quality of Life (SarQoL) questionnaire, Hospital Anxiety and Depression Scale (HADS), and Mini Nutritional Assessment Long Form (MNA-LF), respectively. RESULTS: Pre-sarcopenia was detected in 28.5% of patients with primary Sjögren's syndrome and 6.1% of healthy controls (p = 0.006). Patients with pre-sarcopenia were older and had worse scores in terms of depression, QoL, pain scores, grip strength, and gait speed compared with those without pre-sarcopenia. The SarQoL scores and grip strength were significantly correlated with gait speed, pain, FTSTS test, and depression. Logistic regression analyses identified that the independent predictive factor for pre-sarcopenia was QoL (OR: 0.79, 95% CI: 0.65-0.95; p = 0.015). CONCLUSIONS: Maintaining adequate muscle mass and muscle function in patients with primary Sjögren's syndrome may contribute toward improving health-related QoL. Also, controlling depression and malnutrition risk may help to reduce the risk of development of sarcopenia. Key Points • Pre-sarcopenia is detected in 28.4% of the patients with primary Sjögren's syndrome which is higher than healthy controls. • Pre-sarcopenia is associated with health-related quality of life in primary Sjögren's syndrome. • Psychological symptoms and low physical performance are more common in pre-sarcopenic patients.

Inflammatory Arthritis Facilitators and Barriers (IFAB) for physical activity questionnaire: cross-cultural adaptation into Turkish and evaluation of its psychometric properties.

PURPOSE: We aimed to conduct the translation and cross-cultural adaptation of the Inflammatory arthritis Facilitators and Barriers (IFAB) questionnaire into Turkish language for patients with axial spondyloarthritis (axSpA) and analyze the psychometric properties of the IFAB-Turkish version (IFAB-Tr). METHODS: Data from ninety-three patients with axSpA were analyzed who completed the IFAB-Tr, Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS) and Bath Ankylosing Spondylitis Functional Index (BASFI). Internal consistency, test-retest reliability, convergent validity, floor and ceiling effect, measurement error were examined. Exploratory factor analysis (EFA) and confirmatory factor analysis were conducted. RESULTS: Small modification was needed in the translation and cultural adaptation process. Internal consistency of the IFAB-Tr total score was 0.71 and test-retest reliability was excellent for IFAB-Tr (ICC = 0.90). A moderate negative correlation was found between IFAB-Tr total score and HAQ, HADS, BASFI scores. No floor and ceiling effect was detected. Minimal detectable change was 10.34 points. EFA revealed two factors which accounted for 55% of the variance. CONCLUSIONS: The IFAB was successfully translated into the Turkish language and seems suitable for evaluating barriers and facilitators for physical activity in rheumatic diseases and could be used in clinical settings before designing a physical activity intervention.IMPLICATIONS FOR REHABILITATIONThe Turkish version of the Inflammatory arthritis FAcilitators and Barriers (IFAB) is a valid and reliable tool to assess barriers and facilitators to physical activity for patients with axial spondyloarthritis.More work is needed to assess all psychometric properties of the IFAB questionnaire in other inflammatory rheumatic disorders.The Inflammatory arthritis FAcilitators and Barriers questionnaire in Turkish is an easy and quick way to determine potential barriers to physical activity in clinical and research settings.

Effects of custom-made insoles on foot pressure redistribution, gait parameters, and pain in calcaneal apophysitis-a pretest and posttest study.

BACKGROUND: Calcaneal apophysitis is a self-limiting disorder that often affects adolescents with a high level of activity and leads to increased pain severity, impairments in gait parameters, and poor health-related quality of life. OBJECTIVE: To investigate the combination of custom-made insoles and exercise on foot pressure distribution, spatial-temporal gait parameters, and pain intensity in patients with calcaneal apophysitis. STUDY DESIGN: A one-group pretest-posttest design. METHODS: Forty patients, aged between 8 and 15 years, diagnosed with calcaneal apophysitis, were included in this study. Patients were asked to use the custom-made insoles and to perform a home exercise program for 3 days a week. The duration of treatment was 4 weeks. The pain severity was evaluated with the Visual Analog Scale. The spatial-temporal gait parameters and foot pressure distribution were assessed with the Zebris FDM-THM-S treadmill system before and after the treatment. RESULTS: At posttreatment assessment, there were significant changes in step length, stance phase percentage, swing phase percentage, and gait speed (P < 0.05), except step width and cadence (P > 0.05). Moreover, significant differences were found in forefoot, midfoot, and rearfoot pressure distribution (P < 0.05). There was also a significant decrease in pain intensity during activity compared to the pretreatment (P < 0.05). CONCLUSION: Our study results suggest that the combination of the custom-made insoles and exercise program created improvements in spatial-temporal gait parameters and foot pressure distribution by reducing the pain severity.

Is Xbox 360 Kinect-based virtual reality training as effective as standard physiotherapy in patients undergoing breast cancer surgery?

PURPOSE: Breast cancer surgery may be associated with pain and physical symptoms in the upper limbs. Functional impairment and pain-related avoidance of movement may further increase disability level. This study aimed to investigate the potential effects of early postoperative virtual reality (VR) therapy on pain, range of motion (ROM), muscle strength, functionality, and fear of movement. METHODS: Forty women with breast cancer who had undergone unilateral mastectomy with axillary lymph node dissection and who were receiving adjuvant therapy were included in the study and randomly assigned to two groups: the Kinect-based rehabilitation group (KBRG) and the standardized physical therapy group (SPTG). The KBRG (n = 20) received VR therapy using Xbox Kinect-based games and the SPTG (n = 20) received standard physiotherapy. Study subjects were assessed at baseline and after the 6-week treatment. Outcome measures were pain (visual analogue scale), grip strength (dynamometer), functionality (disabilities of the arm shoulder and hand questionnaire), muscle strength (handheld dynamometer), ROM (digital goniometer), and fear of movement (Tampa kinesiophobia scale (TKS)). RESULTS: Both groups detected significant changes in pain, ROM, muscle strength, grip strength, functionality, and TKS scores after the treatment (p < 0.01). Fear of movement was significantly improved in the KBRG and the SPTG displayed more improvement in functionality (p < 0.05). There were no differences in ROM, muscle strength, grip strength, and pain between the groups after the treatment (p > 0.05). CONCLUSION: Kinect-based VR therapy resulted in significant outcomes that were comparable to those obtained under standard physiotherapy in the early postoperative phase in patients who had undergone breast cancer surgery. TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov ( ClinicalTrials.gov identifier: NCT03618433).

Does an Accelerated Program Give Equivalent Results in Both Elite Athletes and Nonathletes?

CONTEXT: Although many researchers have investigated the functional outcomes of different accelerated rehabilitation programs after anterior cruciate ligament reconstruction (ACLR), the functional results of the same accelerated rehabilitation program following ACLR applied for both elite athletes and nonathletes have not yet been investigated. OBJECTIVE: To examine the effects of the same accelerated anterior cruciate ligament rehabilitation program on pain and functionality of elite athletes and nonathletes. DESIGN: Prospective preintervention-postintervention design. SETTING: Physiotherapy department. PARTICIPANTS: Fifteen elite athletes and 15 nonathletes who underwent unilateral ACLR with autologous hamstring tendon graft. INTERVENTION: All participants received the same protocol for 6 weeks (5 sessions in a week). MAIN OUTCOME MEASURES: Primary measurements were pain intensity, which was measured by visual analog scale, range of motion measurement using universal goniometer, and functionality, which was detected by Lysholm score. Secondary measurements were short form-36 and Beck Depression Inventory. RESULTS: Higher Lysholm (P = .001) and Beck Depression Inventory (P = .03) scores were observed in the elite athlete group, and higher pain (P = .001) was observed in the nonathlete group at baseline assessments. Significant improvement detected for pain (P < .05), knee flexion range (P < .05), Lysholm score (P < .05), and Beck Depression Inventory (P < .05) compared with preintervention for both groups. Finally, after comparing the mean change values, the nonathlete group displayed greater decrease in pain level (P = .01) and participants in the elite athlete group further showed a greater decrease in depression level (P = .001). CONCLUSIONS: This study found that the same accelerated rehabilitation protocol provides significant improvements for pain, functionality, and depression in both elite athletes and nonathletes after ACLR. Clinicians should consider our results when applying an anterior cruciate ligament rehabilitation program for nonathlete groups.