Comparison of motor proficiency and functional ambulation in Duchenne muscular dystrophy with healthy peers.

AIMS: The study was aimed to investigate the difference between boys with Duchenne muscular dystrophy (DMD) and healthy peers in terms of gross and fine motor proficiency, and determine the relationship between motor proficiency and ambulation. METHODS: A total of 24 boys with DMD and 22 healthy peers were evaluated. Demographics and physical characteristics were recorded. The Bruininks Oseretsky Test of Motor Proficiency-Short Form (BOTMP-SF) was administered to evaluate gross and fine motor proficiency in both groups. The 6-minute walk test (6MWT) was performed to evaluate functional walking capacity and North Star Ambulatory Assessment (NSAA) was used to determine ambulatory status of boys with DMD. RESULTS: The gross motor proficiency score was significantly lower in boys with DMD (p = 0.001). No difference was found between the groups in terms of fine motor proficiency (p = 0.962). The gross motor function of BOTMP-SF was significantly related to 6MWT distance (r = 0.696, p = 0.001) and NSAA (r = 0.738, p = 0.001). No relationship was found between BOTMP-SF fine motor proficiency and 6MWT distance (r = 0.210, p = 0.361), and NSAA (r = -0.020, p = 0.928). There were significant correlations between running speed and agility with 6MWT distance (r = 0.585, p = 0.005) and NSAA (r = 0.650, p = 0.056). CONCLUSIONS: Boys with DMD were more affected in aspects of gross motor proficiency than healthy peers, while fine motor proficiency were found same. The gross motor proficiency was found more related to the level of ambulation.

Lower Limb Flexibility in Children With Duchenne Muscular Dystrophy: Effects on Functional Performance.

OBJECTIVE: To investigate the effects of lower limb flexibility on the functional performance of children with Duchenne muscular dystrophy. METHODS: Thirty children, whose functional levels were at 1 or 2 according to the Brooke Lower Extremity Functional Classification Scale, were included in this study. The flexibilities of the hamstrings, hip flexors, tensor fascia latae, and gastrocnemius muscles were evaluated in the children's dominant lower limbs. The children's functional performance was assessed using 6-minute walk tests and timed performance tests. The correlations between the flexibilities of the lower limb muscles and the performance tests were examined. RESULTS: The flexibilities of the lower extremity muscles were found to be correlated to the 6-minute walk tests and the timed performance tests. The flexibility of the hamstrings (r = -.825), the gastrocnemius muscles (r = .545), the hip flexors (r = .481), and the tensor fascia latae (r = .445) were found to be correlated with functional performance as measured by the 6-minute walk tests (P < .05). DISCUSSION: The results of the current study indicate that the flexibility of the lower limbs has an effect on functional performance in the early stages of Duchenne muscular dystrophy. More research is needed to determine the functional effects of flexibility on performance by adding long-term flexibility exercises to the physiotherapy programs of children with Duchenne muscular dystrophy.

Comparison of Median Nerve Mechanosensitivity and Pressure Pain Threshold in Patients With Nonspecific Neck Pain and Asymptomatic Individuals.

OBJECTIVE: The purpose of this study was to investigate the presence of median nerve mechanosensitivity by comparing median nerve neurodynamic test results of patients with nonspecific neck pain (NNP) and asymptomatic individuals. METHODS: A total of 40 patients (30 women, 10 men) with NNP between the ages of 21 and 62 years (39.53 ± 10.18 years) and 38 asymptomatic individuals (23 women, 15 men) between the ages of 18 and 60 years (37.13 ± 9.64 years) participated in the study. Pressure pain threshold was assessed with digital pressure algometer, cervical joint range of motion was assessed with a universal goniometer, and median nerve mechanosensitivity was assessed with Upper Limb Neurodynamic Test 1 (ULNT1). The test step where the first sensory response was given, the location and character of the sensory response, and the final elbow extension angle were recorded during ULNT1. RESULTS: Patients with NNP had significantly decreased pressure pain threshold (P < .001), decreased range of motion of cervical flexion (P < .001), and decreased cervical lateral flexion (P = .001) compared with asymptomatic individuals, whereas no change was identified in range of motion of rotation (P = .100). In ULNT1, 45% of patients with NNP reported pain and 40% of them reported stretch. A total of 65% of asymptomatic individuals reported stretch, and 13% of them reported pain. It was identified in ULNT1 that final elbow extension angle was lower in the NNP group compared with asymptomatic individuals (P = .008). CONCLUSION: Median nerve mechanosensitivity increased, pressure pain threshold decreased, and active neck motion was limited in individuals with NNP compared with asymptomatic individuals.

Dual task effect on upper and lower extremity skills in different stages of Parkinson's disease.

BACKGROUND AND PURPOSE: Loss of automaticity and deteriorated executive function give rise to dual task deficits in Parkinson's disease (PD). This study aimed to compare single task and dual task upper and lower extremity skills in people with PD (PwPD) at different stages of PD and to examine the dual task effect (DTE) on upper and lower extremity skills in PwPD at different stages of PD. The second aim was to investigate the relationship between the DTE and the quality of life in PwPD. METHODS: 30 patients divided into 2 groups as mild PD group and moderate PD group according to the Modified Hoehn & Yahr Scale. 15 age matched healthy adults were recruited as the control group. The Unified Parkinson's Disease Rating Scale (UPDRS), the Purdue Pegboard Test (PPT), the Timed Up and Go Test (TUG), the 10 Meter Walk Test (10MWT), and the Parkinson's Disease Questionnaire (PDQ-8) were used for assessments. RESULTS: Single task and dual task scores of all assessments of all groups were significantly different. The DTE on PPT was greater in mild and moderate PD groups than control group and significantly lower in mild PD group than moderate PD group. However, DTE on the TUG and 10MWT was not different in mild PD group than control group and DTE significantly lower in both groups than moderate PD group. Significant correlations between the DTE on PPT, TUG and 10MWT and the PDQ-8 in PwPD were observed. CONCLUSION: Dual task has a worsening effect on upper and lower extremity skills in PwPD. This effect can be observed earlier in upper extremity skills than lower extremity skills. Also, the DTE and the QoL in PwPD are related.

Comparison of dual-task costs during different types of walking in people with Parkinson's disease: a controlled study.

INTRODUCTION: Many of the activities in daily living require different walking skills such as straight walking (SW), walking with turning (WwT), curved walking (CW) or backward walking (BW) in a dual-task condition. However, there is a lack of evidence regarding the dual task cost (DTC) during different types of walking. Therefore, this study was planned to compare the DTC during different types of walking in people with Parkinson's disease (PwPD) and healthy controls. METHODS: Thirty-one PwPD and 31 healthy controls were included. Different types of walking were assessed using the 10-Meter Walk Test for SW, the Timed Up and Go Test for WwT, the Figure-of-Eight Walk Test for CW, and the Three-Meter Backward Walk Test for BW. Walking assessments were performed in a single-task and a dual-task condition. RESULTS: The DTC on SW was the lowest in both groups. The DTC on WwT, BW, and CW were similar in healthy controls, whereas the order of the DTC on remaining walking types from lowest to highest was; WwT, BW, and CW in PwPD. Also, the DTC on WwT, BW, and CW were higher in PwPD than healthy controls. However, the DTC on SW was similar in PwPD and healthy controls. CONCLUSION: The DTC is different during SW, WwT, BW, and CW in PwPD. Therefore, walking type should be considered in studies investigating dual task walking in PwPD. Also, dual task exercises consisting of different types of walking should be included in rehabilitation programs of PwPD.

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.

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.