Development and Validation of an Ultrasonography-Based Machine Learning Model for Predicting Outcomes of Bruxism Treatments.

BACKGROUND AND OBJECTIVES: We aimed to develop a predictive model for the outcome of bruxism treatments using ultrasonography (USG)-based machine learning (ML) techniques. This study is a quantitative research study (predictive modeling study) in which different treatment methods applied to bruxism patients are evaluated through artificial intelligence. MATERIALS AND METHODS: The study population comprised 102 participants with bruxism in three treatment groups: Manual therapy, Manual therapy and Kinesio Tape or Botulinum Toxin-A injection. USG imaging was performed on the masseter muscle to calculate muscle thickness, and pain thresholds were evaluated using an algometer. A radiomics platform was utilized to handle imaging and clinical data, as well as to perform a subsequent radiomics statistical analysis. RESULTS: The area under the curve (AUC) values of all machine learning methods ranged from 0.772 to 0.986 for the training data and from 0.394 to 0.848 for the test data. The Support Vector Machine (SVM) led to excellent discrimination between bruxism and normal patients from USG images. Radiomics characteristics in pre-treatment ultrasound scans of patients, showing coarse and nonuniform muscles, were associated with a greater chance of less effective pain reduction outcomes. CONCLUSIONS: This study has introduced a machine learning model using SVM analysis on ultrasound (USG) images for bruxism patients, which can detect masseter muscle changes on USG. Support Vector Machine regression analysis showed the combined ML models can also predict the outcome of the pain reduction.

The effects of physical activity tele-counseling intervention on physical activity, functional performance, and quality of life in post-COVID-19 conditions: a randomized controlled trial.

BACKGROUND: This study aims to investigate the effectiveness of tele-counseling to promote physical activity in COVID-19 survivors at the persistent phase. METHODS: Twenty-eight participants who suffered from COVID-19 were randomly assigned to intervention and control groups. Physical activity counseling was applied according to the transtheoretical model to the intervention group during 20 sessions. Second assessments were performed 6 weeks after the intervention. The physical activity, functional performance (4-meter gait speed; 4-MGS and 5-repetition Sit-To-Stand; STS test), exercise behavioral change and processes, quality of life, fatigue, mental health, severity of symptoms, and dyspnea were evaluated in groups. RESULTS: The baseline demographic and clinical outcomes were similar (p > 0.05) except for physical role limitations and general health perceptions in groups. Five-repetition STS, 4-MGS, activity dyspnea, step counts, sitting time, physical role limitations, Exercise Processes of Change Scale (EPCS) total, and behavioral processes scores except for self-liberation significantly improved in the counseling group. Five-repetition STS, 4-MGS improved while dramatic relief, self reevaluation, self-liberation, and EPCS total scores deteriorated in the control group. CONCLUSIONS: The tele-counseling intervention contributes to improving physical activity, functional performance, behavioral change, quality of life, and decreasing common problems related to COVID-19. The results of the tele-counseling intervention are promising in post-COVID-19 conditions. TRIAL REGISTRATION (CLINICALTRIALS.GOV): Registration ID: NCT04853966.

Does total knee arthroplasty affect pelvic movements? A prospective comparative study.

OBJECTIVE: Pathology in any segment of the spine-pelvis-lower extremity may impair the global postural balance, leading to compensatory alterations in other parts. The aim of this study was to compare the pelvic movements of patients suffering from knee osteoarthritis with patients who underwent total knee arthroplasty and healthy controls. METHODS: This study was performed at the Department of Orthopedics and Traumatology Clinic of a Cankiri State Hospital between April 2021 and February 2022. This study included 84 participants. Of them, 31 patients who underwent total knee arthroplasty between 2018 and 2020 years were selected as the total knee arthroplasty group, while 28 patients with knee osteoarthritis were selected as the knee osteoarthritis group. In the control group, there were 25 healthy individuals. Exclusion criteria from the study included any kind of neurological disease, an inability to walk a distance of 100 m unassisted, or a history of surgery to the lower limb. Pelvic movements (i.e., tilt, rotation, and obliquity) and gait parameters (i.e., "gait velocity," "cadence," and "stride length") were assessed using a wireless tri-axial accelerometer. RESULTS: Total knee arthroplasty and control groups had decreased minimum anterior tilt of the pelvis, decreased maximum anterior tilt, and decreased oblique range of the pelvis compared with the knee osteoarthritis group. In comparison with the control group, gait velocity and length of stride during gait were remarkably lower in both knee osteoarthritis and total knee arthroplasty groups. CONCLUSION: In this study, total knee arthroplasty was found to affect pelvic movements. It was thought that total knee arthroplasty changed these variables, probably owing to the frontal and sagittal plane alignment correction through surgery.

Does total knee arthroplasty affect pelvic movements? A prospective comparative study

SUMMARY OBJECTIVE: Pathology in any segment of the spine-pelvis-lower extremity may impair the global postural balance, leading to compensatory alterations in other parts. The aim of this study was to compare the pelvic movements of patients suffering from knee osteoarthritis with patients who underwent total knee arthroplasty and healthy controls. METHODS: This study was performed at the Department of Orthopedics and Traumatology Clinic of a Cankiri State Hospital between April 2021 and February 2022. This study included 84 participants. Of them, 31 patients who underwent total knee arthroplasty between 2018 and 2020 years were selected as the total knee arthroplasty group, while 28 patients with knee osteoarthritis were selected as the knee osteoarthritis group. In the control group, there were 25 healthy individuals. Exclusion criteria from the study included any kind of neurological disease, an inability to walk a distance of 100 m unassisted, or a history of surgery to the lower limb. Pelvic movements (i.e., tilt, rotation, and obliquity) and gait parameters (i.e., "gait velocity," "cadence," and "stride length") were assessed using a wireless tri-axial accelerometer. RESULTS: Total knee arthroplasty and control groups had decreased minimum anterior tilt of the pelvis, decreased maximum anterior tilt, and decreased oblique range of the pelvis compared with the knee osteoarthritis group. In comparison with the control group, gait velocity and length of stride during gait were remarkably lower in both knee osteoarthritis and total knee arthroplasty groups. CONCLUSION: In this study, total knee arthroplasty was found to affect pelvic movements. It was thought that total knee arthroplasty changed these variables, probably owing to the frontal and sagittal plane alignment correction through surgery.

Validity and reliability of the Turkish version of the patient-specific functional scale in patients with low back pain.

BACKGROUND: The Patient-Specific Functional Scale (PSFS) is among the most used measures to evaluate physical function. The PSFS has not been translated into Turkish for patients with low back pain to date. The purpose of the present study was to translate and cross-culturally adapt the PSFS into Turkish (PSFS-T) and to assess its reliability and validity in patients with low back pain. METHODS: A total of 105 participants completed the PSFS-T, Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and Visual Analogue Scale (VAS) for pain. Sixty-nine participants completed the PSFS-T questionnaire twice in 7 days. The internal consistency of the PSFS-T was assessed using Cronbach's alpha while the Intraclass Correlation Coefficient (ICC) was used to evaluate test-retest reliability. The convergent validity of PSFS-T was determined with ODI, RMDQ, and VAS questionnaires by using Pearson's correlation coefficient analysis. RESULTS: The PSFS-T demonstrated acceptable internal consistency (Cronbach's α = 0.79) and good test-retest reliability (ICC2,1 = 0.75) with no floor or ceiling issues. The PSFS-T showed a moderate correlation with ODI (Rp =0 .49, p<0.001) and RMDQ (Rp =0 .46, p<0.001). A poor correlation was found between PSFS-T and VAS (Rp = 0.36, p< 0.001). Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) for the PSFS-T scores were 0.69 and 1.91 respectively. CONCLUSION: The Turkish version of PSFS is a valid and reliable instrument for the assessment of low back patients. It may be considered a preferable scale for clinical assessment of Turkish-speaking patients with low back pain.

Evaluation of single session physical therapy methods in bruxism patients using shear wave ultrasonography.

OBJECTIVE: To compare the immediate effects of a single session of manual therapy (MT) or Kinesio taping following MT (KTMT) in patients with bruxism using shear wave ultrasonography. METHODS: Twenty patients were included in the MT group (mean age 27.3 ± 4.8), and 19 patients were included in the KTMT group (age mean 26.2 ± 5.4), randomly. Muscle thickness and stiffness were assessed via shear wave ultrasonography, and pain pressure threshold was assessed with an algometer before and after one session of MT or KTMT. RESULTS: Significant decreases were found in muscle thickness and stiffness of the bilateral masseter (p < 0.05). Significant decrease in pain was seen in the masseter and temporalis muscle PPT measurements in the KTMT group (p < 0.05) only. CONCLUSION: Kinesio taping in addition to MT is recommended in the immediate physiotherapy treatment of bruxism for acute pain.

Development, reliability and validity of the Closed Kinetic Chain Lower Extremity Stability Test (CKCLEST): a new clinical performance test.

This study aimed to develop and determine the test-retest, intra- and interrater reliability, and validity of the Closed Kinetic Chain Lower Extremity Stability Test (CKCLEST). Three-blinded, cross-sectional, repeated-measures clinical measurement reliability trial. Fifty young adults participated in this study. To assess the reliability of CKCLEST, intraclass correlation coefficient, standard error of measurement, minimal detectable change, and Bland-Altman plot were used. For concurrent validity of CKCLEST was applied Spearman correlation analysis with Vertical Jump Test, Isokinetic Dynamometer Test, Single-Leg Hop Test, and Prone Bridge Test. All analyses were made for both the best score and the average score. CKCLEST showed excellent reliability. ICC for test-retest reliability (0.93; 0.84), intrarater reliability (rater 1: 0.90; 0.83- rater 2: 0.93; 0.85), and interrater reliability (0.90; 0.83) was calculated for average score and best score, respectively. CKCLEST was found to be moderately correlated with each of the tests. CKCLEST is a highly reliable, valid, and new clinical assessment tool.

Respiratory muscle strength in volleyball players suffered from COVID-19.

BACKGROUND: Symptoms related to Coronavirus-19 disease (COVID-19) and quarantine measures have caused pulmonary function abnormality and impaired respiratory mechanics. However, no studies are evaluating pulmonary functions and respiratory muscle strength in female volleyball players according to COVID-19 status in the pandemic. AIMS: This study aims to compare pulmonary functions and respiratory muscle strength in female players with and without COVID-19. METHODS: Seventeen players (23.47 ± 5.89 years) who were recovered from COVID-19 and 25 female volleyball players (20.48 ± 5.05 years) who were not infected by SARS-CoV-2 were included in the study. Maximal inspiratory and expiratory pressure, pulmonary functions, body composition, symptom severity, and perceptions of performance were evaluated. RESULTS: Measured and predicted percent maximal inspiratory pressure and measured maximal expiratory pressure values of COVID-19 players were statistically significantly lower than non-COVID-19 players (p < 0.05). Dynamic lung volumes were similar in groups (p > 0.05). CONCLUSIONS: Inspiratory and expiratory muscle strength in COVID-19 players were more affected compared with non-COVID-19 players. Pulmonary functions were mostly preserved in COVID-19 players. Respiratory muscle weakening can affect the performance of female players. Therefore, respiratory muscle strength training could be suggested in female players with COVID-19 to increase respiratory muscle strength and prevent deterioration in performance. TRIAL REGISTRATION (CLINICALTRIALS.GOV): Registration ID: NCT04789512.

An online pilates exercise program is effective on proprioception and core muscle endurance in a randomized controlled trial.

BACKGROUND: Proprioception is important for stability of body segments, postural control, and functionality. However, there are no studies in literature showing effects of online Pilates exercises that create proprioceptive inputs on vertebra on trunk proprioception. AIMS: This study aims to reveal effect of online Pilates exercises conducted on trunk proprioception and core muscle endurance in healthy individuals. METHODS: We included thirty-three healthy individuals between ages of 18 and 25 in study. Individuals were randomly divided into two groups. There were 17 individuals in Pilates group (PG), and 16 individuals in control group (CG). The PG was given online Pilates exercises by the physiotherapist in groups 3 days a week for 6 weeks, 1 h a day. There was no exercise program recommended for individuals in CG. We evaluated trunk proprioception with an inclinometer, core muscle endurance with three core endurance tests created by McGill, and prone bridge tests. All evaluations completed just before start of study and 2 days after 6-week training. RESULTS: Two groups had similar demographic characteristics, and there was no difference between baseline measurements (p > 0.05). While improvement observed in PG in trunk proprioception and all of core muscle endurance tests (p < 0.05), no statistically significant difference reported in CG (p > 0.05). CONCLUSIONS: We revealed that online Pilates exercises performed at mat level for 6 weeks in healthy individuals had positive effects on trunk proprioception and core muscle endurance with this study. Contribution of Pilates exercises to development of both muscular endurance and proprioceptive senses, even if performed at a distance, is important.

Lung age and respiratory muscle strength in female volleyball players

SUMMARY OBJECTIVE: Lung age estimation is a useful approach to determine pulmonary pathologies. In literature, no studies have evaluated and compared lung age in athletes with healthy volunteers. This study aims to compare lung age and respiratory muscle strength in female volleyball players and age-matched healthy volunteers. METHODS: A total of 18 female volleyball players (22.39±4.97 years) and 20 female healthy volunteers (24.85±3.33 years) were included. Pulmonary functions and respiratory muscle strength were assessed using a spirometer and mouth pressure device, respectively. The lung age was calculated using reference equations associated with gender, height, and forced expiratory volume in 1 second. RESULTS: Lung age was significantly lower, and forced expiratory volume in 1 L, forced vital capacity, and maximal inspiratory and expiratory pressure (cmH2O, %) were higher in female volleyball players compared with healthy volunteers (p≤0.05). CONCLUSION: The lung age and respiratory muscle strength of female volleyball players were better than healthy volunteers. Regular training in female volleyball players may improve respiratory functions and lung age.

Comparison of Kinesio Taping and manual therapy in the treatment of patients with bruxism using shear-wave elastography-A randomised clinical trial.

BACKGROUND: Bruxism is significantly associated with craniofacial pain, feeling of stiffness or fatigue of the jaw and neck pain. Various physiotherapeutic strategies are used in the treatment of bruxism; however, it is not clear which method leads to greater decrease in pain. OBJECTIVE: The aim of this study is to compare the effects of two physiotherapy methods (manual therapy [MT] and Kinesio taping with manual therapy [KTMT]) in patients with bruxism. METHODS: Patients were randomised into MT or KTMT groups. Evaluations were performed at baseline and following 4 weeks of physiotherapy. Muscle thickness and stiffness were assessed via shear wave elastography; pain thresholds were evaluated using algometer. Sleep quality was assessed using Pittsburgh Sleep Quality Index, and quality of life was assessed with Likert scales regarding the associated symptoms. RESULTS: Significant decreases were found in muscle stiffness, pain threshold, sleep quality and quality of life (P < .05) in both MT and KTMT groups. Pain in bilateral temporalis and right occipital region of the trapezius muscle decreased more in the KTMT group compared with the MT group (P < .05). No significant differences in muscle thickness (P > .05) were found in either of the groups. CONCLUSION: Both MT and KTMT methods were effective in the treatment of bruxism. Kinesio Tape used in conjunction with MT has additionally decreased jaw pain and temporal region pain compared with MT intervention only. Therefore, if jaw pain is the primary complaint of a patient, our results recommend including Kinesio Tape application in the physiotherapeutic treatment program.

Validity and Reliability of the Turkish Version of Western Ontario Osteoarthritis of the Shoulder Index.

OBJECTIVES: This study aims to adapt the Western Ontario Osteoarthritis of the Shoulder (WOOS) index specific to shoulder osteoarthritis into Turkish and to evaluate its validity and reliability. PATIENTS AND METHODS: The WOOS index was translated and culturally adapted into Turkish, systematically. It was applied to a total of 68 patients (17 males, 51 females; mean age: 61.5±8.7 years; range, 45 to 80 years) with osteoarthritis of the shoulder treated conservatively. The reliability of the scale was checked through internal consistency and test-retest methods. Internal consistency was analyzed with Cronbach alpha value. Test-retest reliability was assessed using an intraclass correlation coefficient (ICC) with 25 patients. The Western Ontario Rotator Cuff (WORC), the Shoulder Pain and Disability Index (SPADI), and the Society of American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (ASES) scores were used to conduct concurrent validity. RESULTS: The Cronbach alpha value of the scale was found to be excellent as 0.92 (p<0.001). The ICC value was also excellent as 0.97 (p<0.001). There was an excellent positive correlation with WORC (0.847; p<0.001) and a very good positive correlation with SPADI (0.788; p<0.001). It was also negatively very good to correlate with the ASES (-0.754; p<0.001). Additionally, subsections of WOOS had a good correlation with the corresponding subsections of WORC (0.779-0.664; p<0.001). CONCLUSION: The Turkish version of the WOOS index is a valid and reliable tool and is recommended for use in the assessment of patients with osteoarthritis of the shoulder.

Evaluation of proprioception in patients who underwent ACL reconstruction: measurement in functional position

Background/aim: Anterior cruciate ligament (ACL) injuries cause mechanoreceptor loss in the joint; therefore, proprioceptive deficits are observed after injury. In particular, proprioceptive measurements made in the functional position give more accurate results, and this is an area that requires further studies. This study aimed to evaluate proprioception in patients who had undergone ACL reconstruction (ACLR) in functional positions used in daily life (closed kinetic chain position), according to joint angles where ACL injuries occur more frequently, in comparison with healthy controls. Materials and methods: Thirty-four participants who underwent ACLR using a hamstring tendon graft (aged 29.18 ± 8.16 years; body mass index (BMI), 26.58 ± 4.02 kg/cm2) and 31 healthy participants (aged 27.35 ± 5.74 years; BMI, 24.76 ± 2.98 kg/cm2) were included. Proprioception was assessed with an active angle repetition test, using an inclinometer in the closed kinetic chain position while standing. Participants were asked to perform single-leg squats until the angle at the knee joint was 30°. After the targeted angle was defined, the participants were asked to find the targeted angle. The difference between the targeted angle and the angle reached by the participants was calculated. Results: A statistically significant difference in the active joint position sense was found among the ACLR extremity, uninvolved extremity, and control extremity (p < 0.05). The proprioceptive sense between the two extremities in the ACLR group was similar, and the proprioceptive sense was worse than that of the control group. Conclusion: To our knowledge, this is the first study to evaluate closed kinetic chain position in patients who underwent ACLR, and it showed that proprioceptive sense was still poor in patients with ACLR compared with the control group, even if an average of 24 months have elapsed since surgery.

Muscle Activation Differences During Eccentric Hamstring Exercises.

BACKGROUND: The hamstring muscles play a critical role in the prevention of lower limb injuries. However, it is still unclear which exercises are more effective in terms of muscle activation. HYPOTHESIS: In healthy individuals, there are differences between muscular activations of the biceps femoris (BF), semitendinosus (ST), and semimembranosus (SM) muscles during eccentric hamstring exercises. STUDY DESIGN: Cross-sectional. LEVEL OF EVIDENCE: Level 2. METHODS: A total of 31 healthy participants (18 male; mean age, 22.5 years; SD, 3.1) were included in this study. The maximum voluntary isometric contraction of the hamstring muscles was measured using an isokinetic dynamometer. The participants were asked to perform one of the following exercises randomly (3 repetitions each): stiff-leg deadlift (SLDL), unilateral stiff-leg deadlift (USLDL), Nordic hamstring exercise (NHE), and ball leg curl (BLC). Activation of the BF, ST, and SM muscles was measured using surface electromyography during the exercises. In the statistical analysis of this study, factorial analysis of variance was used to compare the effects of each exercise on the muscle groups and to analyze which exercise type was more effective for each muscle group. RESULTS: The NHE led to higher muscle activation than the other exercises (P < 0.001). When exercise type and muscle interaction were examined, SM activation was lower than BF (P = 0.04) and ST (P = 0.001) during NHE (P < 0.05). The highest level of muscular activation was recorded during the NHE in both male and female participants. CONCLUSION: The NHE may be the most effective exercise for the hamstring muscles as it leads to greater muscle activation. SLDL, USLDL, and BLC exercises may be preferred at the beginning of strength training programs since they lead to lower muscular activation compared with the NHE. CLINICAL RELEVANCE: To select the optimum hamstring exercise, it is important to know the activation levels of the hamstring muscles during different eccentric exercises.

Lung age and respiratory muscle strength in female volleyball players.

OBJECTIVE: Lung age estimation is a useful approach to determine pulmonary pathologies. In literature, no studies have evaluated and compared lung age in athletes with healthy volunteers. This study aims to compare lung age and respiratory muscle strength in female volleyball players and age-matched healthy volunteers. METHODS: A total of 18 female volleyball players (22.39±4.97 years) and 20 female healthy volunteers (24.85±3.33 years) were included. Pulmonary functions and respiratory muscle strength were assessed using a spirometer and mouth pressure device, respectively. The lung age was calculated using reference equations associated with gender, height, and forced expiratory volume in 1 second. RESULTS: Lung age was significantly lower, and forced expiratory volume in 1 L, forced vital capacity, and maximal inspiratory and expiratory pressure (cmH2O, %) were higher in female volleyball players compared with healthy volunteers (p≤0.05). CONCLUSION: The lung age and respiratory muscle strength of female volleyball players were better than healthy volunteers. Regular training in female volleyball players may improve respiratory functions and lung age.

Is gluteus medius injured in patients treated with a trochanter tip entry intramedullary nail? Clinical, electrophysiological and functional outcomes.

OBJECTIVES: This study aims to assess the functional outcomes, static-dynamic postural stability of patients and evaluate electromyographic activity of gluteus medius (GMed) muscle during gait and spatiotemporal parameters of gait in patients after antegrade intramedullary nailing (IMN) of femoral shaft fractures with trochanter tip entry. PATIENTS AND METHODS: Sixteen patients (15 males, 1 female; mean age 34.8±15.2 years; range, 18 to 58 years) who were treated with an antegrade trochanteric IMN between January 2009 and July 2013 and eight healthy male controls (mean age 39.3±9.8 years; range, 27 to 57 years) were included in this retrospective study. Muscle strength, static and dynamic postural stability and fall risk were evaluated. In addition, spatiotemporal parameters of gait were assessed using a validated wireless inertial sensing device and a wireless electromyography (EMG) device was used to measure electromyographic activity of GMed muscle in both groups. RESULTS: There were significant differences in muscle strength, functional and dynamic balance test scores between operated and intact sides (one-leg hop test score p=0.009, balance test scores p<0.001-0.033). There were significant differences in functional and quality of life physical function test scores between groups (one-leg hop test score p=0.014). However, no significant differences were found in EMG results, dynamics balance, and statics postural stability test scores between groups (p>0.05). CONCLUSION: After isolated femur fracture, patients treated with antegrade trochanteric IMN demonstrated good static and dynamic stability and poor functional outcomes compared to controls. In conclusion, patients with antegrade trochanteric IMN have good balance but poor functional performance; however, further studies are needed to find out the primary reason for these results.

The acute effects of two different rigid taping methods in patients with hallux valgus deformity.

BACKGROUND: Hallux valgus (HV) is one of the most common deformities of the foot, and it causes great difficulties for the patients. OBJECTIVE: We aimed to investigate the effects of different rigid taping techniques on HV angle, foot motor performance, balance and walking parameters. METHODS: Twenty-two voluntary individuals (12 males, 10 females) with flexible HV deformities between 18 and 35 years of age were included in the study. All measurements were done before and after placebo, athletic and Mulligan tapings were applied. After a three-day interval, new taping was applied on the same subject. HV angle was measured by goniometer. Foot motor performance (single leg heel rise test), balance (unilateral stance, limits of stability, sensory integration of balance) and temporospatial parameters of gait (step length, stride length, step width, foot angle and cadence) were evaluated. RESULTS: HV angles were reduced in all taping groups (p< 0.05). The Mulligan taping method was the most effective method in reducing HV angle. Foot motor performance was not affected by any type of taping (p> 0.05). Athletic taping increased step length and step width but reduced foot angle and cadence. The Mulligan taping increased cadence and reduced foot angle (p< 0.01). Both taping methods did not affect the postural stability and fall risk (p> 0.05). Stability limits were increased in Mulligan taping group (p< 0.05). CONCLUSION: It can be concluded that Mulligan taping method may be an alternative treatment method for HV rehabilitation especially as it increased the limits of stability and maintaining the balance. Mulligan method is more effective than athletic taping in terms of reducing instant HV angle.

The Validity and Reliability of Knee Proprioception Measurement Performed With Inclinometer in Different Positions.

CONTEXT: Proprioception is the basic element of the spontaneous control of movement, balance and joint stability. Therefore, it is necessary for the execution of walking and daily and sport activities. Loss of proprioception of the knee, which may cause a new injury, is important to evaluate the position sense of the joint during the rehabilitation period. However, the evaluation methods that are used are very expensive, complicated and non-portable, or the measuring method is difficult to implement. OBJECTIVE: We demonstrated the validity and reliability of knee proprioception measurements performed in the open kinetic chain position and closed kinetic chain position with a dual inclinometer. DESIGN: We assessed the validity and intra-tester reliability of a digital inclinometer for measuring the knee joint position sense in different positions. SETTING: Clinical laboratory. PARTICIPANTS: We enrolled 22 participants (age = 21.8 ± 0.95 years, height = 172 ± 9.1 cm, weight = 64.9 ± 14 kg) into the study. INTERVENTION: The same investigator used an inclinometer to take knee proprioception measurements in open and closed kinetic chain positions. MAIN OUTCOME MEASURES: The relative angular error was calculated by taking the arithmetic average of the difference between the target angle and reproduced angle and was the main outcome measure. RESULTS: We found that the dynamometer-inclinometer had a moderate ICC value (ICC = 0.594, SEM = 1.60, p = 0.005), whereas inclinometer t1 vs inclinometer t2 (ICC = 0.778, SEM = 0.62, p < 0.001) and closed kinetic chain position t1 and closed kinetic chain position t2 (ICC = 0.888, SEM = 0.63, p < 0.001) had high ICC values. CONCLUSION: Knee proprioception measurements performed with a dual inclinometer were reliable in the closed kinetic chain position in healthy, sedentary individuals and were valid and reliable in the open kinetic chain position.

The presence and influence of posterior capsule tightness on different shoulder problems.

BACKGROUND: In the literature it has been shown that posterior capsule flexibility is a precursor to shoulder problems. However, no study thus far has shown the influence of the flexibility of posterior capsule in different shoulder pathologies. OBJECTIVE: This study set about to compare the role of posterior capsule tightness in different shoulder problems. METHODS: One-hundred-twenty-five patients diagnosed with shoulder subacromial impingement syndrome (n= 52), partial rotator cuff tear (n= 31) or frozen shoulder (n= 42) and 30 asymptomatic peers participated in the study. Horizontal adduction was assessed in side-lying position for posterior capsule tightness. Pain was measured via the visual analogue scale and shoulder range of motion and active total elevation was assessed with goniometer. Hand behind the back (HBB) test was assessed the active internal rotation by measuring the distance between T5 and the thumb. RESULTS: It was found that the affected side of the posterior capsules of the patients with subacromial impingement syndrome (p< 0.001), partial rotator cuff tear (p< 0.001) and frozen shoulder (p< 0.001) was stiffer than their healthy side. There were significant differences among groups in the level of tightness in the posterior capsule between the affected and the healthy sides (p< 0.001). All range of motion of the shoulder including HBB test and the posterior capsule tightness of the affected side are found to be correlated (p< 0.05). CONCLUSIONS: This study emphasized that the posterior capsule's susceptibility to tightness is most evident in frozen shoulder among different shoulder problems.

Translation, cross-cultural adaptation and validation of the Turkish version of the Lower Extremity Functional Scale on patients with knee injuries.

INTRODUCTION: The Lower Extremity Functional Scale is a widely used questionnaire to evaluate the functional impairment in lower extremities. To date, the Lower Extremity Functional Scale has not been translated into Turkish. The aim of this study is to translate and culturally adapt the Lower Extremity Functional Scale into a Turkish version, and evaluate the psychometric properties of this version in patients with knee injuries. MATERIALS AND METHODS: The translation of the English version of the Lower Extremity Functional Scale into a Turkish version was performed using standard guidelines. Validity and reliability of Turkish version were tested in 134 patients with knee injuries. Association level between other outcomes measures (Kujala Patellofemoral Score, the Western Ontario and McMaster Universities Osteoarthritis Index, Lysholm Knee Scoring Scale and a Visual Analog Scale) and Turkish version of the Lower Extremity Functional Scale was analyzed to assess validation. Participants completed the questionnaire at baseline and after 2 days to test reliability. RESULTS: The Turkish version of the Lower Extremity Functional Scale was showed a high degree of internal consistency (Cronbach α = 0.93). ICCs were 0.96 and no floor or ceiling effects. The Lower Extremity Functional Scale had a high level of association with the Kujala Patellofemoral Score (r = 0.82), Lysholm Knee Scoring Scale (r = 0.80) and the Western Ontario and McMaster Universities Osteoarthritis Index scores (r = 0.69) (all, p < 0.05). CONCLUSION: The Turkish version of the Lower Extremity Functional Scale is a valid and reliable questionnaire that can be used to evaluate functional status in Turkish speaking patients with different knee disorders. LEVEL OF EVIDENCE: III.