The effect of local vibration applied to the forearm extensor muscles on hand function and muscle activation in stroke patients: a randomized controlled study.

OBJECTIVE: This study aims to reveal the effect of low-frequency local vibration applied to the forearm extensor muscles on stroke patients' muscle activation and hand functions. METHODS: Twenty-four stroke patients were randomized to the vibration group (n = 12) or control group (n = 12). The vibration was applied at a 30 Hz frequency to the forearm extensor muscles with a local vibration device three days a week after the routine, conventional physical therapy sessions for four weeks. Six vibration sets were applied, including one vibration for one minute and a rest for 2 min. Routine, traditional physical therapy was used for the control group in 60-min sessions for 4 weeks. Patients were assessed for muscle activation with surface electromyography (MVC) and The Wolf Motor Function Test (WMFT), Functional Independent Test (FIM) was applied to all patients before and after treatment. RESULTS: As a result of our study, MVC measurement, WMFT and FIM scores of the vibration group showed more improvement than the control group. Measurement results of vibration group; While MVC measurement increased from 10.21 to 13.79, WMFT-Functional Ability score increased from 42 to 50, WMFT-Performance Time duration increased from 68.78 to 61.83, and FIM score increased from 74.5 to 83. and the measurement results of the control group; MVC measurement increased from 12.28 to 12.22, WMFT-Functional Ability score increased from 48.5 to 51, WMFT-Performance Time duration increased from 70.39 to 70.61, and FIM score increased from 72.5 to 80.5. CONCLUSION: It was concluded that low-frequency local vibration applied to the forearm extensor muscles improve forearm extensor muscle activation and hand motor function. CLINICAL TRIAL REGISTRATION: NCT04562220.

Effect of plantar vibration on static and dynamic balance in stroke patients: a randomised controlled study.

OBJECTIVE: To investigate the effects of local vibration applied to the plantar region of the foot on static and dynamic balance in stroke patients. DESIGN: Randomised, controlled trial. SETTING: Inpatient. PARTICIPANTS: Thirty patients with stroke were randomised equally to the vibration and control groups. INTERVENTION: The control group underwent conventional physical therapy (CPT) for 4 weeks. The vibration group underwent local vibration therapy at a frequency of 80Hz and CPT for 4 weeks. OUTCOME MEASURES: The primary outcome measure was the Overall Stability Index (OSI). The secondary outcome measures were: the Anteroposterior Stability Index, Mediolateral Stability Index, fall risk, Berg Balance Scale, Functional Reach Test (FRT), and Timed Up and Go Test (TUG) to assess balance; the Trunk Impairment Scale to measure trunk function; and the 10-m Walk Test (10MWT) to measure walking speed. RESULTS: Participants receiving plantar vibration experienced greater improvements in static and dynamic balance assessments compared with participants in the control group. The mean change in OSI score between baseline and 4 weeks was 0.8 [standard deviation (SD) 0.8] for the vibration group and 0.02 (SD 0.6) for the control group [mean difference 0.4, 95% confidence interval (CI) 0.1 to 0.7]. The median change in fall risk score was 0.7 [interquartile range (IQR) 0.4 to 1.4] for the vibration group and 0.1 (IQR -0.1 to 0.6) for the control group (median difference 0.5, 95% CI 0.2 to 0.7). The median change in TUG time was 4 (IQR 1 to 7) seconds for the vibration group and 4 (IQR 0 to 2) seconds for the control group (median difference 2.5, 95% CI 1.5 to 3.5). CONCLUSION: These findings suggest that plantar vibration is useful in stroke patients. Plantar vibration can be applied to support CPT. GOV REGISTRATION NUMBER: NCT03784768.

Investigation of the relationship between physical activity, kinesiophobia and fear of falling in older adults with chronic pain.

AIMS: This study aims to investigate the relationship between physical activity, fear of movement and fear of falling in older adults with chronic pain. MATERIALS AND METHODS: The study includes 163 older adults aged 65 years and over, who live in a private nursing home. The cognitive functions of the individuals who participated in the study were evaluated with the mini-mental examination scale (MMES), fears of movement with the Tampa Scale of Kinesiophobia (TSK), fear-avoidance behaviour with the Fear-avoidance Beliefs Questionnaire (FABQ), physical activity levels with the Physical Activity Scale for Older (PASE), and the fears of falling were assessed with Tinetti's Falls Efficacy Scale (FES). RESULTS: In the correlation analysis, there was a weak correlation between age and fall risk (r = 0.349, p < 0.001), and PASETotal score (r = -0.020, p = 0.011). There was a weak positive correlation between Tinetti FES and FABQ scores (r = 0.349, p < 0.001), and kinesiophobia value (r = 0.259, p < 0.001), there was a weak negative correlation between Tinetti FES and PASETotal (r = -0.241, p = 0.002). A positive mid correlation was determined between kinesiophobia and the FABQ scores (r = 0.41, p < 0.001). The established regression model was found to be significant (F = 12.175; p < 0.001). Among the independent variables included in the model, FABQTotal (t = 3.589; p < 0.0001) and PASETotal (t = -3.325; p < 0.0001) significantly affected the fear of falling. CONCLUSION: The presence of chronic pain in older adults who have problems related to physical activity, fear of falling, and kinesiophobia due to advancing age may affect social participation, functional level, and quality of life significantly. Therefore, pain should be addressed in older adults and should be considered as an important issue in rehabilitation programs.

Comparison Of Short-Term Effects Of Virtual Reality and Short Foot Exercises In Pes Planus.

BACKGROUND: Virtual reality exercises (VRE) offers functional, multipurpose usage with a motivational approach. This study aimed to compare VRE and short foot exercises (SFE) in individuals with flexible pes planus. METHODS: Forty participants with pes planus were assigned to the SFE group (n = 20) or VR exercise group (n = 20). Both groups performed exercises three times a week for four weeks. The groups were assessed with a navicular drop test for the height of the medial longitudinal arch, craig Test for femoral anteversion, Star Excursion Test for balance,10 step test for performance. RESULTS: For two groups there is a statistically significant difference between before and after treatments(p < 0.05). There is no difference between VRE and SFE groups after treatments for all parameters(p > 0.05). CONCLUSIONS: Two different 4-week-exercise programs for pes planus have a similar effect on performance, balance, and navicular drop values in both groups. It was considered that the practice of VR exercises like short foot exercises could also address rehabilitation goals, which included improving balance, performance, and foot posture. CLINICALTRIALS. GOV IDENTIFIER: NCT04283357.

Immediate Effects of Plantar Vibration on Fall Risk and Postural Stability in Stroke Patients: A Randomized Controlled Trial.

BACKGROUND: Local vibration can improve balance problems of individuals with stroke when applied to the plantar region. AIMS: This study aimed to determine the immediate effect of local vibration applied to the plantar region on fall risk and postural stability in patients with stroke. STUDY DESIGN: Randomized controlled study. METHODS: 30 patients (23 male,7 female) with stroke were randomized to either vibration (n = 15; 58.47 ± 8.23 years) or control (n = 15; 58.27 ± 9.50 years) groups. Before and after the intervention, the patients were evaluated using a Biodex Balance System. Local vibration was applied to the plantar region of two feet in the supine position using a vibration device for a total of 15 min to the individuals in the vibration group. While the patients in the placebo group were in the supine position, the device was brought into contact and no vibration was applied to the plantar region of two feet for 15 min. RESULTS: While significant improvements were observed in the postural stability and fall risk of the vibration group (p < 0.05), no significant change was observed in the placebo group (p > 0.05). Furthermore, significant improvements occurred in the SD values of the postural stability expressing postural oscillation in the vibration group (p < 0.05). CONCLUSION: As a result of local vibration applied to the plantar region, immediate (within 5 min) significant improvements in postural stability and fall risk values were detected.

The reliability and validity of the Turkish version of Brunel Balance Assessment (BBA-T).

Background: The Brunel Balance Assessment Scale (BBA) is a valid, reliable scale for evaluating functional balance and mobility in patients with stroke. It should also be fast, simple, portable and inexpensive for use in clinical practice.Objectives:The aim of this study was to evaluate the reliability and validity of the Turkish version of Brunel Balance Assessment (BBA-T) in post-stroke patients.Methods: One hundred and five stroke patients (49 female, 56 male) with a mean age of 65.45 ± 11.33 years were included. Standardize Mini-Mental Test (SMMT), BBA, Berg Balance Scale (BBS), Rivermead Mobility Index (RMI) and Postural Assessment Scale for Stroke Patients (PASS) were performed to the patients.Results: According to correlation analysis, a very strong relationship was found between first and second evaluation total BBA-T scores (r = 0.909). Cronbach's alpha coefficient was excellent. According to the Pearson correlation analysis performed to test inter-observer reliability, a very high correlation (r = 0.946) was observed among BBA total scores performed by the first and second physiotherapists. The BBA-T correlated with the BBS (r = 0.879), RMI (r = 0.862), and PASS (0.847). There was no floor observed for the BBA-T scale in this sample. However, the ceiling effect was found.Conclusions: The results of our study indicate that the Turkish version of BBA-T is a reliable and valid balance and mobility scale that can be used in the rehabilitation of stroke patients.

Validation of the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) in a sample of Turkish non-ambulatory children with cerebral palsy.

AIM: The aim of this study was to translate and transculturally adapt the Caregiver Priorities and Child Health Index of Life with Disabilities questionnaire into the Turkish language and test the reliability and validity. MATERIAL AND METHODS: Eighty-two children with cerebral palsy and their parents were included in the study. The majority of children had spastic cerebral palsy. According to the Gross Motor Function Classification System, 26 children were level III, 30 children were level IV, and 26 children were level V. International accepted guidelines were used in the transcultural adaptation and validation process. Reliability was assessed through statistical analysis of the test results for test-retest and internal consistency. To assess construct validity, Caregiver Priorities and Child Health Index of Life with Disabilities was compared with the Child Health Questionnaire Parent Form. Concurrent validity was assessed by examining how Caregiver Priorities and Child Health Index of Life with Disabilities scores changed according to Gross Motor Function Classification System levels. RESULTS: The mean total score of Caregiver Priorities and Child Health Index of Life with Disabilities was 58.34±26.39. The intraclass correlation coefficient for the total questionnaire score was 0.75, ranging from 0.43 to 0.89 for six domains. Cronbach's alpha was above 0.80 in all domains of Caregiver Priorities and Child Health Index of Life with Disabilities, except the health domain. The construct validity was good because there was a positive correlation between total Child Health Questionnaire Parent Form and Caregiver Priorities and Child Health Index of Life with Disabilities scores (r=0.58, p<0.01) according to the Pearson correlation analysis. Caregiver Priorities and Child Health Index of Life with Disabilities scores were found to be different between Gross Motor Function Classification System levels (p<0.05). CONCLUSION: This study showed that the Caregiver Priorities and Child Health Index of Life with Disabilities appears to be easy to administer, seems to have significant validity and reliability, and may be useful in the evaluation of health-related quality of life of children with cerebral palsy.

AMAÇ: Bu çalismanin amaci, Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Endeksi anketinin Türkçe'ye uyarlanmasi, geçerlilik ve güvenirliligini çalismaktir. GEREÇ VE YÖNTEMLER: Çalismaya 82 beyin felçli çocuk ve ailesi alindi. Ayrica çalismaya alinan çocuklarin büyük çogunlugu spastik tip beyin felci olup, 26'si Kaba Motor Fonksiyon Siniflama Sistemi'ne göre seviye III, 30'u seviye IV ve 26'si seviye V idi. Öncelikle, Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Endeksi'nin çeviri ve geri çeviri islemi gerçeklestirildi. Güvenirlik, test-tekrar test ve iç tutarlilik ile degerlendirildi. Yapi geçerliligi, Çocuk Sagligi Ebeveyn Formu ile degerlendirildi. Eszamanli geçerlilik ise çocuklarin Kaba Motor Fonksiyon Siniflama Sistemi seviyeleriyle, engelli çocuk yasam saglik endeksi skorlarinin nasil degistigine bakilarak degerlendirildi. BULGULAR: Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Endeksi için ortalama toplam skor 58,34±26,39 olarak belirlendi. Ölçegin iç tutarlilik degeri her 6 alt ölçüm için 0,43 ile 0,89 arasinda degisen degerlerde olup, toplam skor için 0,75 olarak saptandi. Cronbach alpha degeri saglik alt basligi hariç bütün alt ölçümlerde 0,80 degerinin üstünde bulundu. Yapi geçerliligi için yapilan Pearson korelasyon çözümlemesine göre Çocuk Sagligi Ebeveyn Formu ile Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Endeksi arasinda pozitif yönde bir iliski bulundu (r=0,58, p<0,01). Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Endeksi skorlari Kaba Motor Fonksiyon Siniflama Sistemi seviyeleri arasinda farkli bulundu (p<0,05). ÇIKARIMLAR: Bu çalisma, Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Ölçegi'nin beyin felçli çocuklarda saglikla iliskili yasam kalitesinin degerlendirilmesinde önemli derecede yararli oldugunu, ölçegin oldukça yüksek geçerlilik ve güvenirlige sahip oldugunu göstermistir.

THE EFFECT OF BODY AWARENESS THERAPY AND AEROBIC EXERCISES ON PAIN AND QUALITY OF LIFE IN THE PATIENTS WITH TENSION TYPE HEADACHE.

BACKGROUND: This study is to investigate the effect of Body Awareness Therapy (BAT) and Aerobic Exercises on pain and quality of life in patients with Tension-Type Headache (TTH). MATERIALS AND METHOD: Sixty individuals with TTH diagnosis who referred Neurologist were incorporated into study. The individuals were randomly grouped into 3 as BAT (n=20), aerobic exercise (n=20) and control group (n=20). Pain severity of the individuals was evaluated by Visual Analog Scale (VAS) and pain diary, disability with ache; by Pain Disability Index (PDI) and Headache Impact Tests (HIT) and quality of life was evaluated by SF-36. Subsequent to first assessments, 3 sessions of 60 minutes per week throughout 6 weeks totally. RESULTS: When the groups were compared at the end of the study, a significant decrease was observed in VAS, PDI and HIT values in the individuals in the BAT and aerobic exercise groups. With the individuals in group BAT and aerobic exercise all parameters of quality of life were observed to be increased significantly. CONCLUSION: BAT and aerobic exercise programs to be applied on TTH patients were concluded to be important in decreasing the pain, in increasing the quality of life and in reducing pain-related daily constraints of the individuals.

The effect of foot plantar massage on balance and functional reach in patients with type II diabetes.

OBJECTIVE: The aim of this study was to investigate the effect of manual foot plantar massage (classic and friction massage) on functional mobility level, balance, and functional reach in patients with type II diabetes mellitus (T2 DM). METHODS: A total of 38 subjects diagnosed with T2 DM were included in the study. A healthy control group could not be formed in this study. After the subjects' socio-demographic data were obtained, Timed Up & Go (TUG) Test, functional reach test (FRT), one-leg standing test with eyes open-closed, and Visual Analogue Scale (VAS) to measure foot pain intensity were performed. The results were also divided and assessed in three groups according to the ages of the individuals (40-54, 55-64, and 65 and over). RESULTS: As a result of statistical analysis, a difference was found in the values obtained from TUG, FRT, and one-leg standing test with eyes open and closed (p < 0.05). Following the massage, TUG values significantly decreased comparison with those before the massage, whereas the values of FRT and one-leg standing test with eyes open and closed significantly increased compared with those before the massage (p > 0.05). According to age groups, there were statistical differences (p < 0.05) between the TUG, one-leg standing test with eyes open and closed test values of the individuals before and after the massage. CONCLUSIONS: The results of our study indicated that application of plantar massage to patients with T2 DM caused an improvement in balance, functional mobility, and functional reach values. An increase in body balance and functional mobility may explain the improvement in TUG. Foot massage to be added to rehabilitation exercise programs of DM patients will be important in improving balance and mobility of patients.

The effect of age and body mass index on plantar cutaneous sensation in healthy women.

[Purpose] This study was conducted to examine the effects of age and body mass index on plantar cutaneous sensation in healthy women. [Subjects and Methods] Two hundred and three healthy female volunteers over the age of 20 were included in the study. The statistical analyses were performed by considering the age and body mass index values of the individuals. The individuals were divided according to their ages and body mass index values. Foot pain was measured with a visual analogue scale and plantar cutaneous sensation using Semmes-Weinstein monofilaments. [Results] Fifty-six (27.5%) of the participants had normal weights, 67 (33%) were overweight, and 80 (39%) were obese. Statistical analysis revealed that as age and body mass index values increased, plantar sensitivity decreased and the frequency and severity of pain increased. [Conclusion] It is possible that healthy women may experience a decrease in foot plantar sensation with increasing weight and age. If women do not have any health problems, proprioception and sensory training must be focused on in order to prevent balance and falling problems.

Short term effects of classic massage compared to connective tissue massage on pressure pain threshold and muscle relaxation response in women with chronic neck pain: a preliminary study.

OBJECTIVE: The purpose of this study was to evaluate the short-term effects of classic massage (CM) and connective tissue massage (CTM) on pressure pain threshold and muscle relaxation response in women with chronic neck pain. METHODS: Participants included 45 female volunteers (ages between 25 and 45 years) presenting to the Köroglu State Hospital Neurosurgery Polyclinic who had experienced neck pain for 3 to 6 months. The volunteers were randomly assigned to 2 groups (CM or CTM to the thoracic spine and the neck). Each treatment was carried out for 1 session. Outcome measures were obtained before and after treatment, which included pressure pain threshold that was measured with an algometer and muscle relaxation response that was evaluated with electromyography biofeedback (EMG-BF). RESULTS: Pressure pain threshold of the sternocleidomastoid muscle was significantly different for the CM (P < .05) group. The EMG-BF values were significantly different for the CTM group (P < .05). Comparing the results of CM and CTM, EMG-BF averages favored the CTM group (P < .05). CONCLUSION: For the group of women with chronic neck pain that were included in this study, 1 treatment of CTM demonstrated relaxation responses and 1 treatment of CM demonstrated pain reduction.

The relationship between physical, functional capacity and quality of life (QoL) among elderly people with a chronic disease.

The aim of this study was to evaluate the relationship between physical and functional capacity and quality of life (QoL) among elderly people who have a chronic disease. The study included 100 elderly individuals aged 65 years and older, who have a chronic disease. The study examined the marital and educational status, social security status, kind of chronic disease, number of chronic diseases and whether participants use assistive devices for walking. The Nottingham health profile (NHP) was used to evaluate QoL related to health; the physical mobility scale (PMS) was used to evaluate mobility in daily life and the functional independent measure (FIM) was used to evaluate functional independence in daily activities. In both female and male individuals, a statistically significant difference was found between the number of chronic diseases, kind of chronic disease, educational status, marital status, total FIM, PMS and NHP values (p<0.05). In males, there was a correlation between number of chronic illnesses and total NHP, FIM (p<0.05), but in females, there were no correlation between number of chronic illnesses and total NHP, FIM (p>0.05). There were no correlations between kind of chronic disease and PMS, NHP, FIM (p>0.05) in either of genders. It was found that there are differences among elderly female and male individuals with a chronic disease in terms of the number of chronic diseases, types of chronic disease, mobility level, functional status and QoL; and mobility level is related to functional capacity and QoL in females. It is thought that the rehabilitation programs to improve physical and functional capacity in elderly people and applications that increase participation in activities and reduce pain may improve QoL.

The effect of functional mobility and balance on health-related quality of life (HRQoL) among elderly people living at home and those living in nursing home.

The present study examined the effect of functional mobility and balance on HRQoL among elderly people living at home and those living in nursing homes. The study included 122 elderly people aged 65 and over. With regard to the individuals whose socio-demographic data were collected in the scope of the study, balance and functional mobility levels were evaluated using the timed up and go test (TUG) and Berg balance scale (BBS); HRQoL was evaluated using the Nottingham health profile (NHP); physical independence in daily activities was evaluated using the Barthel index (BI); and basic mobility in daily life was evaluated using the Rivermead mobility index (RMI). Statistically significant differences were found between the TUG, BBS and NHP values of the elderly people living in a home environment and those living in nursing homes (p<0.05). However, no statistically significant difference could be found between the BI and RMI values (p>0.05). A statistically significant relationship was found between the NHP and TUG, RMI, BI and the use of assistive devices in daily life activities (p<0.05). It is thought that the inclusion of functional mobility and balance training in elderly care and rehabilitation programs would be useful for the elderly people to develop functional independence and in increasing their HRQoL.