Comparison of pain, kinesiophobia and quality of life in patients with low back and neck pain.

[Purpose] The purpose of this study was to compare patients with low back and neck pain with respect to kinesiophobia, pain, and quality of life. [Subjects and Methods] Three-hundred patients with low back (mean age 43.2±11 years) and 300 with neck pain (mean age 42.8±10.2 years) were included in this study. Pain severity was evaluated by using the Short-Form McGill Pain Questionnaire, which includes a Visual Analogue Scale, quality of life by the Nottingham Health Profile, and kinesiophobia by the Tampa Scale for Kinesiophobia. [Results] Pain severity was similar in both groups, with a Visual Analogue Scale score of 6.7±2 in the low back pain and 6.8±2 in the neck pain group. Nottingham Health Profile pain [z=-4.132] and physical activity scores [z=-5.640] in the low back pain group were significantly higher. Kinesiophobia was also more severe in the low back pain group, with a mean 42.05±5.91 versus 39.7±6.0 Tampa Scale for Kinesiophobia score [z=-4.732]. [Conclusion] Patients with low back pain developed more severe kinesiophobia, regardless of the pain severity, and had greater pain perception and lower physical activity levels. Kinesiophobia adversely affects the quality of life and requires effective management of low back pain.

Different types of upper extremity exercise training in Duchenne muscular dystrophy: effects on functional performance, strength, endurance, and ambulation.

INTRODUCTION: We investigated and compared the effects of 2 different types of upper extremity exercise training on upper extremity function, strength, endurance, and ambulation in patients with early-stage Duchenne muscular dystrophy (DMD). METHODS: The study group (n = 12) exercised with an arm ergometer under the supervision of a physiotherapist, whereas the control group (n = 12) underwent a strengthening range-of-motion (ROM) exercise program under the supervision of their families at home for 8 weeks. Upper extremity functional performance, strength, endurance, and ambulatory status were assessed before and after the training. RESULTS: Ambulation scores, endurance, and arm functions, as well as proximal muscle strength, were improved after the training in the study group (P < 0.05). CONCLUSIONS: These results demonstrate that upper extremity training with an arm ergometer is more effective in preserving and improving the functional level of early-stage DMD patients compared to ROM exercises alone.

Effect of muscle weakness distribution on balance in neuromuscular disease.

BACKGROUND: To assess balance and identify the effects of muscle weakness distribution on balance in children with different neuromuscular diseases. METHODS: Forty ambulant, pediatric patients with neuromuscular disease were enrolled in the study. Patients were separated into two groups according to muscle weakness distribution as group 1 (proximal) and group 2 (distal). Demographic data were recorded. Functional level (Brooke lower extremity functional classification), muscular strength (manual muscle testing), balance (pediatric functional reach test [PFRT], timed up-and-go test [TUGT], stabilometric platform) and functional performance (6 min walk test [6MWT]) were assessed. RESULTS: Group 1 consisted of 20 Duchenne muscular dystrophy patients, and group 2, of 20 neuropathy patients. The total lower, upper limbs and trunk muscles muscle strength (P < 0.05); forward and right side reach subsections of the sitting position, and PFRT total score (P < 0.01) were significantly different between the groups. TUGT results were 7.79 ± 1.54 s and 10.13 ± 2.63 s, respectively, in group 1 and 2 (z = -2950; P < 0.01). No statistically significant difference between groups in any performance parameters of the 6MWT was found (P ≥ 0.05). Anterior body balance was found to be dominant in group 1, while posterior body balance was dominant in group 2 (P ≤ 0.05) measured by stabilometric platform. CONCLUSIONS: The distal group was particularly affected regarding dynamic balance, and the proximal group regarding static balance. Muscle strength was important for providing dynamic stability in the distal group, and for maintaining proximal stabilization during dynamic activities in the proximal group.

Benign monomelic amyotrophy in a 7-year-old girl with proximal upper limb involvement: case report.

Monomelic amyotrophy (MMA) is a benign motor neuron disease characterized by neurogenic amyotrophy, which usually affects one of the upper or lower extremities. Progression is slow and symptoms are clinically stable. Symptoms are seen in the second or third decades of life. In this study, we present a seven-year-old girl who was diagnosed and directed to the Physiotherapy Department at the age of 5 years and had unilateral proximal upper limb involvement. Family history of the case was recorded. Neurologic evaluation was performed. Range of joint motion, muscle shortness and strength, posture, extremity lengths, gait, timed performance, arm function, and motor and mental maturation were assessed. The physiotherapy program was designed progressively as strengthening and resistive exercises. Motor and mental developmental milestones were normal. There was no limitation in active or passive motion of all joints. She had more flexible joints, scapula alata, asymmetry between shoulder levels, and weakness on proximal muscles of the right upper extremity. In the follow-up assessment at eight months, there was no asymmetry between shoulder levels and scapular symmetry began to improve. Female gender and involvement restricted to one proximal upper limb are rare in the literature. This patient demonstrates the positive effects of physical therapy with early diagnosis of MMA. The rapid recovery of muscle weakness shows the importance of strengthening and resistive exercises applied to specific muscles in the treatment.

The effects of physical activity on sleep quality, job satisfaction, and quality of life in office workers.

BACKGROUND: A sedentary lifestyle has negative effects on many aspects of life. OBJECTIVE: The aim of this study was to determine the effects of physical activity on sleep quality, job satisfaction, and quality of life in office workers. METHODS: A convenience sample of office workers from administrative staff of a university was included. There were two groups; Group I did regular physical activity for at least eight weeks, and Group II did no regular physical activity. Sleep quality, job satisfaction, and quality of life were assessed using the Pittsburgh Sleep Quality Index, the Minnesota Job Satisfaction Scale, and the World Health Organization Quality-of-Life-Scale (WHOQOL-BREF), respectively. RESULTS: Group I included 59 individuals and Group II 50 individuals. No significant differences were found between groups in terms of age, height, weight, and the period of time worked (p > 0.05). Although no significant difference was found in terms of sleep quality (p = 0.52), the overall job satisfaction of Group I was higher than Group II (p = 0.03). All subscales of the WHOQOL-BREF for Group I was higher than Group II (p < 0.05). CONCLUSION: Regular physical activity could increase job satisfaction and quality of life for office workers. Further studies investigating the effect of physical activity in terms of its type, duration should be performed.

Effects of Arm Cycling Exercise in Spinal Muscular Atrophy Type II Patients: A Pilot Study.

Exercise studies in neuromuscular diseases like spinal muscular atrophy (SMA), a devastating disease caused by survival of motor neuron 1 ( SMN1) gene mutations, are drawing attention due to its beneficial effects. In this study, we presented a constructed arm cycling exercise protocol and evaluated the benefits on SMA patients. Five SMA type II patients performed 12 weeks of supervised arm cycling exercise. The physical functions were evaluated together with the SMN2 copy numbers, SMN protein levels, insulin-like growth factor 1(IGF1) and binding protein 3 (IGFBP3) levels. The active cycling distance and duration of patients significantly improved. Significant changes could not have detected either SMN or IGF1 and IGFBP3 levels in response to exercise. The findings demonstrated that the patients tolerated the exercise protocol and gained a benefit from arm cycling but benefits could not be associated with SMN2 copy number, SMN protein level, IGF1, or IGFBP3 levels.

Neck flexor muscle strength and its relation with functional performance in Duchenne muscular dystrophy.

AIM: The aim of this study was to investigate the relationship between neck flexor muscle strength and functional performance in children with DMD. METHODS: A total of 70 children with DMD between Level 1 and 3 according to Brooke Lower Extremity Functional Classification (BLEFC) were included in the study. Children were divided into 2 groups according to neck flexor strength measured by Medical Research Council Scale as Group 1 (3⁻ and below) and Group 2 (3 and above). Functional performance was assessed by 6 Minute Walk Distance (6MWD) and timed performance tests, and ambulatory status by North Star Ambulatory Assessment (NSAA). Correlations between neck flexor strength and performance tests were analyzed by using Spearman's correlation coefficient in non-parametric conditions. RESULTS: Thirty-six and 34 children were included in Group 1 and 2, respectively. No statistically significant difference was found in BLEFC between groups (z = -1.225, p > 0.05). 6MWD (z = -2.574, p = 0.01) was found to be longer and NSAA (z = -2.565, p = 0.01) was higher in Group 2. Positive, moderate, statistically significant correlations were determined between neck flexor muscle strength and 6MWD (p < 0.01, r = 0.374); NSAA (p < 0.01, r = 0.399) while a negative, weak correlation between neck flexor muscle strength and the duration for standing from supine position (p = 0.02, r = -0.290). CONCLUSIONS: The results indicate the relationship of neck flexor muscle strength and functional performance in DMD children. It is thought that the approaches to maintain neck flexor muscle strength from the early stages of disease process may support functional activities of daily life with less compensation and effort in DMD.

Reliability and validity of the Turkish version of ABILHAND-Kids' questionnaire in a group of patients with neuromuscular disorders.

This study was performed to examine the reliability and validity of the Turkish version of ABILHAND-Kids questionnaire which assesses manual functions of children with neuromuscular diseases (NMDs). A cross sectional survey study design and Rasch analysis were used to assess the reliability and validity of the Turkish version of scale. Ninety-three children with different neuromuscular disorders and their parents were included in the study. The scale was applied to the parents with face-to-face interview twice; on their first visit and after an interval of 15 days. The test-retest reliability was assessed with intraclass correlation coefficient (ICC), and internal consistency of the multi-item subscales by calculating Cronbach alpha values. Brooke Upper Extremity Functional Classification (BUEFC) and Wee-Functional Independency Measurement (Wee-FIM) were correlated to determine the construct validity. The ICC value for the test/retest reliability was 0.94. The internal consistency was 0.81. Floor (1.1%) and ceiling (11.8%) effects were not significant. There were moderate correlations between the Turkish version of ABILHAND-Kids and Wee-FIM (0.67) and BUEFC (-0.37). Rasch analysis indicated good item fit, unidimensionality, and model fit. The Turkish version of ABILHAND-Kids questionnaire was found to be a reliable and valid scale for the assessment of the manual ability of children with NMDs.

Is there any relationship between orthotic usage and functional activities in children with neuromuscular disorders?

BACKGROUND: Contractures of Achilles tendons and gastrocnemius muscle deteriorate the performance in daily living activities of patients with neuromuscular diseases. Ankle-foot orthoses help to prevent the progression of deformities and to obtain optimal position of the joints to support standing and walking. OBJECTIVE: To investigate the relationship between orthotic usage and functional activities in pediatric patients with different neuromuscular diseases. STUDY DESIGN: Retrospective study. METHODS: A total of 127 subjects' physical assessment forms were analyzed. Functional level, type of orthoses, falling frequencies, ankle joint range of motion, and timed performance tests were examined in two consecutive dates with an interval of 3 months. RESULTS: A total of 91 patients were using orthoses while 36 patients were not within assessment dates. A total of 64 of 91 (70.3%) patients were diagnosed with Duchenne muscular dystrophy. A total of 81 (89.0%) subjects were using plastic ankle-foot orthoses for positioning at nights and 10 (11%) were using different types of the orthoses (knee-ankle-foot orthoses, dynamic ankle-foot orthoses, and so on) for gait in the study group. CONCLUSIONS: Night ankle-foot orthoses were not found to be effective directly on functional performance in children with neuromuscular diseases, although they protect ankle from contractures and may help to correct gait and balance. CLINICAL RELEVANCE: This retrospective study shows that the positive effects of using an ankle-foot orthosis at night are not reflected in the functional performance of children with neuromuscular diseases. This may be due to the progressive deteriorating nature of the disease.

Turkish version of the Egen Klassifikation scale version 2: validity and reliability in the Turkish population.

The Egen Klassifikation Scale version 2 (EK2) is an important functional ability assessment scale for nonambulant neuromuscular patients. We investigated the validity and reliability of the EK2 scale in Turkish Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA) patients. Forty-one patients were included in the study. An intra/interobserver reliability study of the EK2 scale as translated into Turkish was performed. The Brooke Functional Classification Scale (BFC) for Upper and Lower Extremities, 10-item Modified Barthel's Index for Activities of Daily Living (MBI), and Pulmonary Dysfunction Index (PDI) were used to investigate the validity of the Turkish version of the EK2 scale. Cronbach's alpha was 0.81 and ICC was 0.87 with a 95% confidence interval (r=0.92, p<0.01). There were positive, moderate correlations between the EK2 sum score and the BFC upper extremity level and between the EK2 sum score and the PDI, and a negative, moderate correlation between the EK2 sum score and the MBI (p≤0.01). The Turkish version of the EK2 scale was found to be highly reliable and valid.