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Context: Asthma incidence in the older people also increases as the number of individuals over the age of 65 increases in society. The goals of asthma management include restoring expected levels of physical activity and preserving muscle mass as well as preventing symptoms and improving pulmonary function. A limited number of studies have explored the effects of superimposed neuromuscular electrical stimulation (NMES) on the quadriceps muscle for older patients with asthma. Objective: The study intended to investigate the effects of adding superimposed NMES to a conventional physiotherapy and rehabilitation (PTR) program for older patients with asthma. Design: The research team performed a blinded, randomized controlled trial. Setting: The study took place at the Kadikoy Municipality Social Life Center. Participants: Participants were 24 people with mild, persistent, stable asthma diagnosis. Interventions: The research team randomly divided participants into two groups: (1) an intervention group, the NMES + PTR group with 12 participants and a control group, the PTR group with 12 participants. All participants took part in a PTR program, which consisted of a conventional exercise program. Additionally, the NMES + PTR group received NMES applied to quadriceps muscle with a superimposed technique. Outcome Measures: At baseline, at four weeks, and postintervention, the research team assessed participants': (1) endurance of the quadriceps using the Sit to Stand Test (SST); (2) the muscle's strength using surface electromyography (sEMG) and a myometer; (3) functional exercise capacity using the Six-Minute Walking Test (6MWT), (4) quality of life (QoL) using the Asthma Quality of Life Questionnaire (AQOL); (5) dyspnea using the Modified Medical Research Council (MMRC) dyspnea scale; and (6) pulmonary functions using spirometry. Results: Postintervention, the NMES + PTR group's scores for the sit-to-stand test (P = .001), the right quadricep's sEMG active (P = .00), the right sEMG resistance (P = .00), the right myometer (P = .00), the left quadricep's sEMG active (P = .00), the left sEMG resistance (P = .00), the left myometer (P = .00), the 6MWT (P = .00), and the AQOL (P = .001) were significantly higher and on the MMRC (P = .00) were significantly lower than those of the PTR group. Conclusions: The addition of superimposed NMES to a recommended PTR program was an effective method of improving the quadricep muscle's endurance and strength, functional exercise capacity, and health-related QoL as well as decreasing dyspnea for older patients with mild persistent asthma.
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Background: Neck pain is a common problem in the general population and second only to low back pain in musculoskeletal problems. The aim of this study is to compare three different types of exercise training in patients with chronic neck pain. Methods: This study was conducted on 45 patients with neck pain. Patients were divided into 3 groups: Group 1 (conventional treatment), Group 2 (conventional treatment plus deep cervical flexor training), and Group 3 (conventional treatment plus stabilization of the neck and core region). The exercise programs were applied for four weeks, three days a week. The demographic data, pain intensity (verbal numeric pain scale), posture (Reedco's posture scale), cervical range of motion ([ROM] goniometer), and disability (Neck Disability Index [NDI]) were evaluated. Results: In all groups, a significant improvement was found in terms of pain, posture, ROM, and NDI values in all groups (P < 0.001). Between the groups, analyses showed that the pain and posture improved more in Group 3, while the ROM and NDI improved more in Group 2. Conclusions: In addition to conventional treatment, applying core stabilization exercises or deep cervical flexor muscle training to patients with neck pain may be more effective in reducing pain and disability and increasing ROM than conventional treatment alone.
RESUMO
BACKGROUND: The impairment of selective voluntary motor control (SVMC) in children with cerebral palsy (CP) has been shown to correlate with their gait characteristics using complex 3D gait analysis systems (3DGA); however, this relationship has not been investigated using simple video-based observational gait analysis (VBOGA). The aim of this study was to determine the relationship between VBOGA and SVMC of the lower extremities in children with CP. METHODS: Forty-two CP children 10.9 ± 5.7 years old with Gross Motor Function Classification System (GMFCS) levels I-III participated in the study. Their gait characteristics were assessed using the Edinburgh Visual Gait Score (EVGS), and selective voluntary motor control was tested using the Selective Control Assessment of the Lower Extremity (SCALE). Spearman's rho correlation test with Cohen's classification were used in the statistical analyses. RESULTS: The GMFCS levels (r = 0.604, p < 0.001), foot clearance (r = -0.584. p < 0.001), and maximum ankle dorsiflexion (r =-0.567, p < 0.001) during the swing phase had strong correlations with total SCALE scores. There was also a moderate correlation between total SCALE scores and total EVGS (r =-0.494, p < 0.001), knee extension in the terminal swing phase (r = -0.353, p < 0.001), peak sagittal trunk position (r = -0.316, p < 0.005), and maximum lateral shift (r = -0.37, p < 0.001). CONCLUSION: Impaired lower extremity SVMC was noticeably related to the foot and ankle movements in the swing phase and initial stance during walking as well as the total EVGS scores and sagittal and frontal trunk movements. The SCALE correlations with VBOGA were similar those observed in the complex 3DGA in the literature; therefore, we suggest that SVMC impairment of gait could be evaluated using simple VBOGA. These findings may help to tailor physical therapy programs for CP children to increase their motor control and walking quality.