Efficacy of hippotherapy simulator exercise program in patients with stroke: a randomized single-blind clinical trial.

OBJECTIVES: The aim of this study was to investigate the effect of hippotherapy simulator on balance, postural control, mobility, functional capacity and independence level in people with stroke. METHODS: This study involved 26 people with stroke aged 18-65, who were randomly assigned to a Hippotherapy Simulator Group (HSG; n = 13) and a Conventional Exercise Group (CEG; n = 13). Patients underwent assessments using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PAS-S), Timed Up and Go Test (TUG), Rivermead Mobility Index (RMI), 2-Minute Walking Test (2-MWT), and Barthel Daily Living Activity Index (BI) to evaluate balance, postural control, mobility, functional capacity, and independence before and after treatment. In the HSG, participants received 30 sessions of conventional exercises and hippotherapy simulator - a mechanical and robotic equipment with a dynamic saddle simulating horse movement - exercises over 6 weeks. Meanwhile, the CEG underwent 30 sessions of conventional exercises alone for 6 weeks. RESULTS: In the post-therapy evaluation between groups, BBS (p = 0.004) and 2-MWT (p < 0.001) scores were higher in HSG compared to CEG. However, no statistically significant difference was found between the two groups in terms of PAS-S, RMI, TUG and BI scores (p > 0.05). Statistically significant differences were found between BBS, PAS-S, RMI, TUG, BI and 2-MWT scores before and after treatment in both groups (p < 0.05). CONCLUSIONS: Hippotherapy simulator can be added to conventional exercises to improve balance and functional capacity in people with stroke.

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.

The effect of neck-trunk stabilization exercises in cerebral palsy: randomized controlled trial.

BACKGROUND: To investigate the effects of neck and trunk stabilization exercises on communication, speech performance, activities of daily living and quality of life in children with cerebral palsy (CP). METHODS: In this prospective, single-blinded, randomized controlled trial, forty children with CP were randomly assigned to Study and Control groups. The study group was received structured neck and trunk stabilization exercises in addition to NDT-B approach. Control group was received NDT-B approach. An oral-motor rehabilitation/therapy was trained to all children. Both groups' trainings were provided for six weeks, with a 45-minute session two times a week. Outcome measures were Communication Function Classification System and Visual Analogue Scale to evaluate communication level; Katz Scale to measure activities of daily living; Viking Speech Scale (VSS) to classify children's speech performance and Pediatric Quality of Life Inventory (PedsQL) to measure the quality of life. RESULTS: The results showed that the communication level and Physical Functioning Score of PedsQL are increased significantly in the study group. VSS is found higher than control at 18th weeks for long term follow up in the study group. CONCLUSIONS: This study highlights the positive effects of stabilization exercises on children's speech performance, Physical Functioning of PedsQL and communication level. Additionally, children' communication skills between them and their caregivers have affected positively and so that this situation provides more qualified daily lives to the children.

A Better Way to Decrease Knee Swelling in Patients with Knee Osteoarthritis: A Single-Blind Randomised Controlled Trial.

Objective: In this study, we compared the effects of intermittent pneumatic compression along with conventional treatment with cold-pack treatment along with conventional treatment on clinical outcomes in patients with knee osteoarthritis. Methods: Eighty-nine patients with knee osteoarthritis participated in this study. One group received ultrasound, transcutaneous electrical nerve stimulation, electrical stimulation, exercise, and cold packs. The second group received ultrasound, transcutaneous electrical nerve stimulation, electrical stimulation, exercise, and intermittent pneumatic compression. Range of motion, muscle strength, knee swelling, pain intensity, and functional status were measured at baseline and 4th week. Results: We found significant improvements in range of motion, muscle strength, pain intensity, and functional status after the treatment in both groups (p < 0.05). When comparing the effects of these two treatment programs, it was observed that the intermittent pneumatic compression treatment group had a better outcome in terms of knee swelling (p=0.028). Conclusions: According to the results, we could report that intermittent pneumatic compression therapy in addition to conventional treatment has significant positive effects on clinical outcomes in patients with knee osteoarthritis. We could also report that intermittent pneumatic compression therapy along with conventional treatment is superior to cold-pack therapy along with conventional treatment in terms of knee swelling in patients with knee osteoarthritis. This trial is registered with NCT03806322.

The Effects of Dual-Task Training on Patient Outcomes of Institutionalized Elderly Having Chronic Stroke.

BACKGROUND/AIMS: The purpose of our study was to investigate the effects of dual-task training on balance, mobility, functional independence, and fear of falling in geriatrics with chronic stroke. METHODS: Fifty-three geriatrics diagnosed with stroke were included in our study. The elderly were divided into 2 groups, i.e., those walking with (intervention group, n = 25) and those walking without (controls, n = 28) dual-task training. RESULTS: We found statistically significant improvements in all parameters between pre- and posttreatment in both groups (p < 0.05). CONCLUSION: Based on our findings, walking with dual-task training can be used in addition to conventional stroke rehabilitation aiming to improve balance and mobility.

Clinical outcomes of kinesio taping applied in patients with knee osteoarthritis: A randomized controlled trial.

INTRODUCTION: The aim of this study was to compare kinesio taping along with conventional treatment to conventional treatment alone and to report the results of both a single and repetitive kinesio taping application applied on quadriceps femoris and hamstring muscles on pain, range of motion, muscle strength, and functional status in patients with knee osteoarthritis. METHODS: Fifty-four patients with knee osteoarthritis were randomly allocated to two groups. A total of 28 patients were included in kinesio taping group, others were included in the control group. Before and after intervention, pain was measured with visual analog scale, range of motion was measured with universal goniometer, muscle strength was measured with dynamometer, and functional status was measured with Knee Injury Osteoarthritis Outcome Score. RESULTS: There were statistically significant improvements in measures of pain, range of motion, quadriceps muscle strength and functional status between pre- and post-treatment in both groups (p< 0.05). In comparison, there were no significant differences with these parameters between groups (p> 0.05). It was also found that significant difference was observed in terms of range of motion, pain, functional status between pre-treatment and post-taping in intervention group (p< 0.017). CONCLUSION: In conclusion, we could report that kinesio taping has significant immediate effects after a single kinesio taping application on range of motion, pain and functional status in patients with knee osteoarthritis. We could also report that KT in addition to conventional treatment is not superior to conventional treatment alone in terms of clinical outcomes over 3 weeks later.

The effects of therapeutic exercises on pain, muscle strength, functional capacity, balance and hemodynamic parameters in knee osteoarthritis patients: a randomized controlled study of supervised versus home exercises.

The aim of the study was to compare the effects of low-intensity exercise programs for lower extremities, either supervised or at home, on pain, muscle strength, balance and the hemodynamic parameters of knee osteoarthritis (OA) patients. This randomized study included 78 patients with knee OA in 2 groups of supervised and home-based exercise program. Exercises were applied to the first group in the clinic as a group exercise program and were demonstrated to the second group to be performed at home. Before and after the 6-week exercise program, assessment was made of pain, quadriceps and hamstring muscle strengths, 6-min walk test (6MWT), and non-invasive hemodynamic parameters. Results of the 78 patients, 56 completed the study. Pain, muscle strength, and 6MWT scores showed significant improvements in both groups. There were also significant differences in the amount of change in pain and muscle strength (pain: p = 0.041, Rqdc: 0.009, Lqdc: 0.013, Rhms: 0.04) which indicated greater improvements in the supervised group. The balance scores of supervised group showed a significant improvement (p = 0.009). No significant change was determined in hemodynamic parameters of either group. Conclusion according to the results of this study showed that low-intensity lower extremity exercises conducted in a clinic under the supervision of a physiotherapist were more effective than home-based exercises in reducing post-activity pain levels and improving quadriceps and right hamstring muscle strength. Both the supervised and home exercise programs were seen to be effective in reducing rest pain and increasing 6 MW distance in knee osteoarthritis patients.

Kinesiophobia in relation to physical activity in chronic neck pain.

BACKGROUND: Little research is available concerning physical activity and its determinants in people with chronic neck pain. OBJECTIVE: To explore the relation between kinesiophobia and physical activity and gender effect on these relations in people with chronic neck pain. METHODS: Ninety-nine subjects (34 men and 65 women) with chronic neck pain were participated in the study. Pain intensity was assessed with Visual Analog Scale and kinesiophobia degree was determined by using Tampa Scale of Kinesiophobia. Level of physical activity was assessed with short form of the International Physical Activity Questionnaire. RESULTS: There was no statistically correlation between neck pain intensity and kinesiophobia degree (p= 0.246, r= 0.123) and physical activity level (p= 0.432, r= -0.083). It was also found that kinesiophobia degree was not correlated to physical activity level (p= 0.148, r= -0.153). There was a negative correlation between kinesiophobia degree and physical activity level only for women, not for men (p= 0.011, r= -0.318). CONCLUSIONS: Our results showed that although people with chronic neck pain reported higher pain intensity and fear of movement, pain intensity and kinesiophobia degree did not associate to their physical activity levels. It can be speculated that high kinesiophobia degrees cause low physical activity levels for women, but not for men.

The application of matrix rhythm therapy as a new clinical modality in burn physiotherapy programmes.

PURPOSE: The aim of the present study was to investigate the use of matrix rhythm therapy (MRT) as one of the electrotherapeutic modalities in clinics. METHODS: This study was carried out in the Burn and Wound Treatment Department of Dr. Lütfi Kirdar Kartal Education and Research Hospital in Istanbul between October 2010 and August 2011. A treatment protocol including whirlpool, MRT and exercise was applied to a group of patients who had burn injury of upper extremity. The evaluation of each patient included assessment of pain, range of motion, muscle strength, skin flexibility and sensory function at pre- and post-treatment. RESULTS: There was no significant difference in values of pain, muscle strength and flexibility between pre- and post-treatment assessments (p>0.05). A significant increase was found in the range of motion and sensory function at pre-treatment according to post-treatment (p<0.01). CONCLUSION: The usage of MRT in order to maintain and improve the range of motion and to minimise the development of scar tissue was investigated in this study. We suggest conducting randomised controlled studies that carry out a comparison of the MRT with other treatment modalities with more cases and investigate the long-term effects of MRT.

A comparison of three different physiotherapy modalities used in the physiotherapy of burns.

The present study compared the effectiveness of matrix rhythm therapy, ultrasound treatment (UT), laser treatment (LT) used in the physiotherapy of burns. The study was conducted at the Wound and Burn Healing Center, Dr. Lütfi Kirdar Kartal Education and Research Hospital (Turkey) from June 2009 to January 2012. The case series comprised 39 individuals with second- and third-degree upper-limb burns, whose burn traumas ended approximately 1 to 3 months previously. Participants were separated into three groups: matrix rhythm treatment (MRT), UT and LT; each group was also applied a treatment protocol including whirlpool and exercise. Pain, range of motion (ROM), muscular strength, skin elasticity, and sensory functions were evaluated before and after the treatment. Pressure sense and passive ROM were higher in the MRT group than in the LT group (P < .05). Pain was lower in the LT group than in the UT group, and passive ROM was higher in the UT group than the in LT group (P < .05). Active ROM was found to increase in all treatment groups, whereas passive ROM increased only in the MRT and UT groups; pressure sense increased only in the MRT group, and pain decreased only in the LT group (P < .05). MRT was found to be more effective in the restoration of sensory functions than LT, whereas LT was more effective in reducing pain than UT. No significant difference was observed in terms of skin elasticity according to the results of three treatment modalities. It is suggested that further research with more cases should be conducted to examine the long-term effect of treatment modalities.