Electromyographic biofeedback training in a cerebral palsy patient undergoing pronator teres rerouting and brachioradialis to extensor carpi radialis brevis tendon transfer surgery: A case report.

Several surgical procedures are used to treat dynamic pronation position of the forearm and flexion deformity of the wrist in cerebral palsy. Postoperative results of pronator teres rerouting were explored, while specially designed postoperative physiotherapy and its outcomes were limited. Herein, we present a case in whom the outcomes of electromyographic biofeedback (EMG-BF) training were assessed after pronator teres rerouting and brachioradialis tendon to extensor carpi radialis brevis tendon transfer combined with derotation osteotomy. The peak value increased, while the resting value decreased for the muscles after the intervention. Range of motion, hand function, manual ability, functional independence, and quality of life levels were improved. In conclusion, EMG biofeedback training may have a positive effect on neuromuscular control of pronator teres and brachioradialis. Free use of the upper extremity and improved manual ability positively affect the activity and quality of life of the patients.

Dual- and Single-Task Training in Older Adults With Age-Related Hearing Loss: A Randomized Controlled Study.

We aimed to investigate the effects of dual- and single-task training in older adults with age-related hearing loss. Intervention groups included single-, dual-task training, and control groups. The dual- and single-task trainings were held 2 days a week for 40 min for a total of 10 sessions for 5 weeks. We evaluated physical, cognitive, and auditory functions, quality-of-life, balance, concerns about falling, independence in activities of daily living, and dual-task performance. A total of 42 patients fully participated in this study. Statistically significant differences were observed in chair stand, chair sit-and-reach, global cognitive function, and delayed recall between the intervention groups and control group (p < .05). There was no statistically significant difference in quality-of-life, balance, falling concerns, independence in activities of daily living, and dual-task performance between all groups (p > .05). In conclusion, single- and dual-task training had a positive effect on physical and cognitive functioning in older adults with age-related hearing loss.

Effect of electromyographic biofeedback training on functional status in zone I-III flexor tendon injuries: a randomized controlled trial.

BACKGROUND: Despite advances in hand therapy and surgery, functional deficits persist after flexor tendon repair especially in zone I-III. This suggests that methods applied may be insufficient. Electromyographic (EMG) biofeedback may provide an effective tendon gliding through visual and auditory feedback. PURPOSE: The purpose of this study was to investigate the effect of EMG biofeedback training applied in addition to early passive motion protocol on functional status in zone I-III flexor tendon injuries. METHODS: Patients were randomly assigned into two groups, each consisted of 11 patients. In addition to early passive motion method, EMG biofeedback training was applied in the first group. The second group was followed only with early passive motion protocol. Joint range of motion (ROM), Michigan Hand Outcomes Questionnaire (MHQ) and grip strength were evaluated. RESULTS: There were no significant differences between the groups in terms of the ROM, MHQ scores and grip strength (p ≥ .087). However, there were clinically important differences in the results of the 12th week ROM (effect size = 0.70), 24th week activity of daily living (ADL) score in MHQ (effect size = 0.68), 12th week gross, tip pinch and lateral grip strength (effect sizes = 0.59, 0.52, 0.81, respectively) and 24th week gross, tip pinch and lateral grip strength (effect sizes = 0.69, 0.73, 0.69, respectively) between the two groups. CONCLUSIONS: EMG biofeedback training was clinically but not statistically superior to early passive motion method in terms of the effect on functional status.

A descriptive study of knowledge, attitudes, behaviors, and precautions of physiotherapy and rehabilitation students regarding COVID-19.

BACKGROUND: Physiotherapy and rehabilitation students need to be aware of the global COVID-19 pandemic and choose the correct interventions. OBJECTIVES: To investigate the knowledge, attitudes, behaviors, and precautions of physiotherapy and rehabilitation students regarding COVID-19 during the global pandemic. METHODS: A total of 438 physiotherapy and rehabilitation students participated in the study. A web-based descriptive cross-sectional questionnaire was conducted using the "Google Forms" on physiotherapy and rehabilitation students in the months of February, March, and April 2021. The online questionnaire consisted of six main sections containing 130 items: (1) sociodemographic information, (2) knowledge sources and knowledge about COVID-19, (3) attitudes about COVID-19, (4) behaviors, (5) precautions, and (6) being a physiotherapy and rehabilitation student during the COVID-19 pandemic. The collected data were reported in terms of mean, standard deviation, number, frequency, and percentage values. RESULTS: The vast majority of the participants (n = 291, 66.5%) often/always accessed information about COVID-19 via social media, 397 (90.6%) of them often/always wear masks. Moreover, 419 (95.6%) of the physiotherapy students knew the symptoms of COVID-19, and 409 (93.4%) of the students have been responded "yes" to the question of whether pulmonary rehabilitation should be applied in intensive care units for COVID-19 infections. CONCLUSIONS: Physiotherapy and rehabilitation students have adequate awareness about COVID-19. In this regard, physiotherapy and rehabilitation students should be included in appropriate educational programs to protect themselves, their relatives, and patients against COVID-19, and their knowledge about the treatment methods should be increased.

Ulnar Styloid Fracture Accompanying Distal Radius Fracture Does Not Affect Hand Function, but What About Hand Dexterity?

Introduction Hand dexterity is not addressed in patients with distal radius fracture (DRF) accompanied with ulnar styloid fracture (USF) in literature. This study aimed to determine whether an associated USF following a DRF has any effect on hand dexterity. Materials and Methods Patients diagnosed with DRF were included in the study and were divided into two groups according to the USF presence (USF group and non-USF group). Pain, range of motion, Quick-DASH (Quick-Disabilities of the Arm, Shoulder, and Hand), handgrip and pinch strength, Purdue Pegboard test, and Jebsen Taylor Hand Function test were measured in the sixth month. Results A total of 125 patients, 68 females (54.4%) and 57 males (45.6%) were included in the study. The mean age of the patients was 47.15 ± 13.41 (18-65) years. There were 60 patients (48%) in the USF group and 65 patients (52%) in the non-USF group. No significant difference was found in pain, range of motion, Quick-DASH and handgrip and pinch strength between the groups ( p > 0.05). The hand dexterity tests showed no statistically significant difference between the groups in the sixth month ( p > 0.05). Discussion Hand function can be determined more accurately by assessing hand dexterity. In this study, it is emphasized that concomitant USF does not lead to poorer hand dexterity.

Is quality of life related to risk of falling, fear of falling, and functional status in patients with hip arthroplasty?

OBJECTIVE: The aim of the study was to investigate the relation between health-related quality of life and risk of falling, fear of falling, and functional status in patients with hip arthroplasty. METHODS: In this cross-sectional study, 48 hips of 45 patients who aged between 33 and 79 (53.56 ± 12.50) years and had cementless total hip arthroplasty between 2010 and 2014 were evaluated. Twenty-seven of the patients participated in the study were female (60.0%) and 18 were male (40.0%). Health-related quality of life with Nottingham Health Profile, function of the hip joint with Harris Hip Score, risk of falling with Performance-Oriented Motion Assessment I, and fear of falling with Falls Efficacy Scale were assessed. In addition, chair stand test, 40-m walk test, stair-climb test, and single leg stance test were carried out. In analysing the relationships between these parameters, Pearson correlation analysis was employed. The level of significance was considered as p < 0.05. RESULTS: Among the cases, who were evaluated 87.10 ± 45.22 (22.43-214.71) weeks after the operation, a significant correlation was found between health-related quality of life and risk of falling, function of hip joint, and functional tests (p < 0.05). CONCLUSION: The evaluation of the factors related to health-related quality of life in hip arthroplasty patients may help identify patient needs and guide the rehabilitation process.

Effects of musculoskeletal system problems on quality of life and depression in students preparing for university entrance exam.

BACKGROUND: This study was planned to investigate the relationship between musculoskeletal problems, depression, and quality of life in students preparing for university entrance exams. METHODS: A total of 180 students were included in the study, 104 were female (57.77%), and 76 were male (42.22%). Students were reached through the cram schools ("dershane") in Denizli. Musculoskeletal system problems, depression status, and quality of life were determined with the Musculoskeletal-Postural Discomfort Scale (MDS), Boratav Depression Screen Scale (Bordepta), and Short Form-36 (SF-36), respectively. Demographic data, daily study, and sleep duration were also recorded. RESULTS: Students have moderate musculoskeletal discomfort. Musculoskeletal disorders and depressive symptoms are more observed in female students than male students (P = 0.000). The SF-36 results were significantly negatively correlated with the MDS and Bordepta scores. A significant positive correlation was found between musculoskeletal disorders and depression status (r = 0.351, P = 0.000). Sleep duration was negatively correlated with the MDS and Bordepta (r = -0.209, P = 0.005; r = -0.148, P = 0.047, respectively) and positively correlated with the SF-36 role limitation/emotional and social functioning subscales (r = 0.225, P = 0.002 and r = 0.191, P = 0.010 respectively). CONCLUSIONS: Musculoskeletal problems and depression status negatively affects general health status especially in female students who are preparing for university entrance examinations. Students should be informed about musculoskeletal problems by healthcare professionals and the study room, tables, and chairs should be arranged ergonomically. Further studies might be determined that why musculoskeletal disorders and depression status are more widely among female students.

The effects of radial bowing and complications in intramedullary nail fixation of adult forearm fractures.

OBJECTIVES: This study aims to evaluate the effects of radial bowing changes on fracture healing and functional results in adult forearm intramedullary nail applications and complications of forearm nails that have been discussed rarely in the literature. PATIENTS AND METHODS: Twenty-three patients -11 with isolated radius and 12 with both radius and ulna fractures- (17 males, 6 females; mean age 38.6 years; range 18 to 69 years) who were operated between September 2009 and August 2014 were included in the study. The effects of radial bowing changes on bone healing rates, time to union, and functional levels of the forearm as well as complications of forearm nails were evaluated. RESULTS: We observed fracture healing without any complication in 20 patients (86.9%) and nonunion in three patients (13.1%) although six months had passed after the operation. Statistically significant difference was detected between radial bowing change and nonunion (p=0.01). Two patients (8.6%) with AO/OTA Classification (The Arbeitsgemeinschaft für Osteosynthesefragen [AO]/Orthopaedic Trauma Association [OTA] Classification), type B3 forearm double fractures had synostosis. Extensor pollicis longus tendon rupture or impingement was detected in six patients (26.8%) for which nails were applied on radius fracture. CONCLUSION: Intramedullary nail application may be an appropriate treatment alternative in forearm fractures with their high healing rates; however, synostosis may arise with its use in wedge fractures (AO/OTA type B3) at the same level. Although radial bowing changes do not have a significant effect on ranges of motion of the forearm, it should be kept in mind that fracture healing may be affected adversely in patients with radial bowing changes of high rates. Complications regarding extensor pollicis longus tendon may develop during intra- or postoperative periods in patients for which a radius nail has been applied.

Investigation of Disability Level, Leisure Satisfaction, and Quality of Life in Disabled Employees.

The purpose of this study is to investigate the disability level, leisure satisfaction, and quality of life in employees who were disabled. Six hundred twenty-seven employees who were disabled were included in this study and classified according to age, gender and disability level. In quality of life, there was significant difference between genders and age groups (p <  .05). There was no significant difference neither in leisure satisfaction nor in disability level between groups (p > .05). In disability assessment, males were better and there was a significant difference in leisure satisfaction (p <  .05). Age, gender, and disability level were important factors affecting disability, leisure satisfaction, and quality of life among employees who were disabled.

Demographic Characteristics, Anatomical Distribution, and Clinical Presentations of Lipomatosis Tumors Arising from Hand and Wrist.

The aim of this study is to analyze demographic characteristics, anatomical distribution, and clinic presentations of the lipomatosis masses in hand and wrist. The hand and wrist magnetic resonance (MR) images of 2,453 patients were evaluated retrospectively. Nineteen cases were included in the study that is seen fat component in mass in MR images. Patients' age, sex, and clinical symptoms were noted. The size and the localization area of the mass were evaluated. Ordinary lipomas were detected in 18 (95%) patients, and fibrolipomatous hamartoma of the median nerve was detected in 1 patient (5%). Benign ordinary lipomas were most frequently observed in palmar and ventral sides. Lipomas located in palmar area tend to be bigger size comparing with other locations. Deep-seated lipoma is localized in central area frequently. In ordinary lipoma cases, patients are generally (78%) asymptomatic. The most frequent clinical symptom is limitation in movement depending on mass dimension.

Analysis of Community Participation Levels of Individuals Who Are Physically Disabled and Working in Industrial Environments.

The purpose of this study was to determine quality of life, leisure time satisfaction, activity performance, and community participation and analyze the relationship between these determinants and community participation in both physically disabled individuals working in industrial environments and nonworking individuals who are physically disabled. Sociodemographic data was registered into a sociodemographic form. World Health Organization Disability Assessment Schedule 2.0 was used to assess community participation. Activity performance was evaluated with Canadian Occupational Performance Measure. Leisure Satisfaction Scale was used to determine leisure time satisfaction. Short Form-36 was used for evaluating quality of life. When the participants were compared in terms of working status, a significant difference according to their WHO-DAS-II total scores were found (p < 0.05). When all participants were compared in terms of activity performance, lesisure time satisfaction, quality of life a significant differences according to their WHO-DAS-II total scores were found (p>0.05). This study shows that community participation was affected by working status, disability level, activity performance, leisure time satisfaction and quality of life. In this regard, occupational therapy and physiotherapy approaches were found necessary for developing community participation. We conclude that this study's results can be used as a guide for community participation in disabled people in community based rehabilitation politics.

Relationship of side dominance and ultrasonographic measurements of pronator quadratus muscle along with handgrip and pinch strength.

AIMS: We ascertained effects of hand dominance in both right and left-handed volunteers on the thickness and cross sectional area (CSA) of pronator quadratus (PQ) muscle as measured by the axial and sagittal views of ultrasound imaging. Secondly, we also aimed to document the extent of the relationship between the PQ measurements and handgrip. MATERIALS AND METHODS: Healthy adults from the volunteer medical staff were included in the study. Handedness was assessed via The Flinders Handedness survey. The sonographic appearance of the PQ was evaluated on sagittal and axial images for both hands. CSA of PQ muscle was digitally drawn and calculated on the axial plane. Handgrip was measured by using adjustable-handle dynamometer. RESULTS: Eighty-nine healthy volunteers were included (54 right and 35 left-handed). Significant difference was detected between dominant and non-dominant hands in CSA and muscle thickness in both right and left-handed volunteers (p<0.05). These measurements were correlated with the handgrip strength (p<0.05, r=0.55, and r=0.43 for right-handed volunteers, r=0.67 and r=0.48 for left-handed volunteers, respectively). There were also significantly high correlations between the measurements of CSA and PQ thickness of the corresponding extremity in both right-handed and left-handed volunteers (p<0.05). CONCLUSIONS: A statistically significant difference exists between dominant and non-dominant hands in CSA and muscle thickness measured by US in both right and left handed volunteers, and this is correlated with handgrip strength. Hand dominance should be considered to compare healthy and affected sites during US of PQ while investigating for occult fractures of distal forearm or PQ atrophy due to anterior interosseous nerve injury.

Investigation of the effects of connective tissue mobilisation on quality of life and emotional status in healthy subjects.

BACKGROUND: Connective Tissue Massage (CTM) or Manipulation is a bodywork technique which lies at the interface between alternative approaches. The autonomic balancing responses to CTM can be useful in the treatment of anxiety. AIM: This study was planned to investigate the effects of connective tissue mobilization (CTM) on quality of life and emotional status in healthy subjects. Design; Prospective trial, Setting; Treatment and Population. The study was conducted on 100 volunteers (students). Students in second class were in CTM group (20,49±1,37 years) and students (19,50±1,15 years) educating in class 1 were in control group. METHODS: Participants were assessed before and after CTM according to flexibility of trunk flexion, hamstring muscles, trunk hyperextension and lateral flexion. It was used The SF-36 Health-Related Quality of Life Inventory (SF-36) to assess general health status and Beck Depression Scale was used for assessing emotional status. RESULTS: It was observed a significant increase at lateral flexion to the right of trunk (p=0,03) in CTM group after application. It was found a significant difference (p=0,009) in emotional status between groups. It was found differences at general health level (p=0,001), limitations in emotional role (p=0,016) in SF-36. It was some differences in depression status and some subscales of SF-36 (general health, social status, emotional well-being, pain and energy levels) in favour of control group before application. It was no difference between groups after application. CONCLUSION: CTM could be used for minimizing depressive symptoms, improving quality of life in healthy young subjects.

Comparison of effects of supervised physiotherapy and a standardized home program on functional status in patients with total knee arthroplasty: a prospective study.

[Purpose] The aim of this study was to determine the functional differences between total knee arthroplasty (TKA) patients who were treated with supervised physiotherapy or a standardized home program and perform a cost analysis. [Subjects and Methods] Patients who received total knee arthroplasty between January 2009 and June 2011 were enrolled in this study; those with mean ages of 64.25±3.86 (60-68) years (n=18) and 68.08±6.25 (61-79) years (n=16) were placed in the supervised physiotherapy and standardized home program groups, respectively. All patients were evaluated by the same researcher before and after surgery, and the therapy programs were applied by another physiotherapist. All patients were evaluated for joint range of motion (ROM), pain, functional status (WOMAC), overall quality of life (SF-36), and depressive symptoms (BECK Depression Scale). [Results] A significant clinical improvement was observed in postoperative assessments. A statistically significant difference could not be found between ROM and functional levels of the patients in both groups. [Conclusion] No difference was found between the patients performing supervised or standardized home program with respect to the effects on functional status. A home exercise program can be used in the rehabilitation of patients with TKA, and implementation of home exercise programs can also reduce health-care spending.

[Investigation of the relationship between severity of injury, return to work, impairment, and activity participation in hand and forearm injuries]. / El ve önkol yaralanmalarinda yaralanma ciddiyeti ile ise geri dönüs, bozukluk, aktivite ve katilim arasindaki iliskinin incelenmesi.

BACKGROUND: Forearm and hand injuries are the main cause of work-related disability. This study was planned to investigate the relationship between severity of injury, time of return to work, impairment, and activity participation of patients with hand and forearm injuries. METHODS: One hundred and thirty patients who had patients who had had forearm or hand injuries with a mean age of 31±11.13 years participated in this study. Injury severity was evaluated using Modified Hand and Forearm Injury Severity Scoring (MHISS) after surgery. Patients were evaluated using the Jebsen Hand Function Test (JHFT) and Buck-Gramko scoring eight weeks after injury. Additionally, grip strength was evaluated with a dynamometer, and disability/symptom score was evaluated using the Turkish version of the Disabilities of the Arm, Shoulder, and Hand (DASH-T) questionnaire twelve weeks after injury. RESULTS: A significant relationship between MHISS, hand strength, time of return to work, DASH-T, and Buck-Gramko scores of patients with forearm and hand injuries was identified (p≤0.05). Higher impairment was significantly related to body structure and body functions (1.86±1.47), and the most limited activity was writing (2.06±1.50) regarding ICF framework. CONCLUSION: Higher MHISS scores were associated with delays in returning to work and lower activity participation. The DASH-T score was the most strongly associated with time of return to work. Furthermore, there is a positive relation between time of return to work and activity participation of patients.

Middle-term therapeutic effect of the sacroiliac joint blockade in patients with lumbosacral fusion-related sacroiliac pain.

OBJECTIVE: The aim of this study was to compare the therapeutic effect of sacroiliac (SI) blockade in patients with and without lumbosacral fusion. METHODS: This study included 72 patients diagnosed with SI pain and who received blockade injection (methylprednisolone and lidocaine). Patients were divided into 2 groups; 22 patients in the fusion group who underwent previous lumbosacral fusion and 50 patients in the non-fusion group. Average follow-up was 17.7 (range: 6 to 30) months. All patients were evaluated before and after intervention using the Visual Analog Scale (VAS), Oswestry Disability Index, Rivermead Mobility Index and SF-36. Results were statistically analyzed. RESULTS: Activity pain (a component of VAS) was significantly better in the non-fusion group than the fusion group (p=0.042). No other statistically significant differences were observed between groups (p>0.05). CONCLUSION: Sacroiliac blockade has a similar therapeutic effect on patients who underwent lumbosacral fusion surgery as on non-operated patients in the middle-term. Therefore, alternative treatment options are not necessary in patients with fusion.

Comparison of static and dynamic splinting regimens for extensor tendon repairs in zones V to VII.

The aim of this prospective, randomised, controlled trail was to compare two methods of rehabilitating extensor tendon repairs in zones V-VII. Patients who incurred simple and complete lacerations of their extensor tendons in zones V-VII enrolled into the study and underwent either static splinting (n = 25) or dynamic splinting (n = 27) after primary acute repair of tendons. Extension lag, flexion deficit, total active motion (TAM), grip strength, and functional status of upper extremities were measured. TAM was improved in the dynamic group when compared with the static group in the injured digits at 4 weeks (p = 0.001), at 12 weeks (p = 0.05), and at 6 months (p = 0.001). Grip strength outcomes demonstrated improved grip force for the dynamic group when compared with the static group at 12 weeks (p = 0.001). There were no ruptures in either group. Also, a better functional level was found in the dynamic splinting group at 6 months (p = 0.001). The findings of the current study suggest that dynamic splinting of complex lacerations of the extensor tendons in zones V-VII provides improved functional outcomes at 4 and 12 weeks and 6 months when compared with static splinting.

The effect of gender and level of vision on the physical activity level of children and adolescents with visual impairment.

This study was planned in order to determine physical activity levels of visually impaired children and adolescents and to investigate the effect of gender and level of vision on physical activity level in visually impaired children and adolescents. A total of 30 visually impaired children and adolescents (16 low vision and 14 blind) aged between 8 and 16 years participated in the study. The physical activity level of cases was evaluated with a physical activity diary (PAD) and one-mile run/walk test (OMR-WT). No difference was found between the PAD and the OMR-WT results of low vision and blind children and adolescents. The visually impaired children and adolescents were detected not to participate in vigorous physical activity. A difference was found in favor of low vision boys in terms of mild, moderate activities and OMR-WT durations. However, no difference was found between physical activity levels of blind girls and boys. The results of our study suggested that the physical activity level of visually impaired children and adolescents was low, and gender affected physical activity in low vision children and adolescents.

[Comparison of the results of supervised physiotherapy program and home-based exercise program in patients treated with arthroscopic-assisted mini-open rotator cuff repair]. / Artroskopik yardimli mini-açik yöntem ile rotator manset tamiri yapilan hastalarda gözetimli fizyoterapi programi ile ev egzersiz programinin sonuçlarinin karsilastirilmasi

OBJECTIVES: This study aims to compare the results of supervised exercise program versus standardized home based exercise program after rotator cuff repair with respect to severity of pain, functional status, quality of life, and depression. PATIENTS AND METHODS: Twenty-eight patients (5 males, 23 females; mean age 59.8±9.1 years; range 40 to 83 years) who had rotator cuff repair were evaluated. Patients were divided into two groups and the first group was treated with supervised physiotherapy (n=15) and the second group was treated with home-based exercise program (n=13). Pendulum exercises and passive exercises within pain limits were performed by all patients in the six-week immobilization period with shoulder sling with abduction pillow after rotator cuff repair. After this period, the patients in home-based exercise program were taught to perform active exercises and the patients in supervised physiotherapy group were treated with active shoulder range of motion exercises under the supervision of the physiotherapist. When patients reached to active full range of motion, strengthening exercises were added to exercise program. Patients were assessed preoperatively and at the end of the postoperative third month. Pain was evaluated with visual analog scale (VAS), functional status with Constant shoulder score, quality of life with short form-36 (SF-36), and depressive symptoms with Beck depression inventory (BDI). RESULTS: There were significant improvements in all evaluation parameters in both groups after rotator cuff repair. CONCLUSION: There were no statistical differences between the patients who received exercise program under the supervision of the physiotherapist and the patients who were treated with standardized home-based exercise program for the efficacy of treatment in the evaluation of pain, functional status, quality of life, and depression status. When the rehabilitation programs were analyzed for cost effectiveness, the supervised physiotherapy group was found to have higher costs.