Do functionality, strength, vascularization, inflammatory and biopsychosocial status improve by biopsychosocial model-based exercise in SSc?

OBJECTIVES: This study aimed to investigation of the effects of the Cognitive Exercise Therapy Approach (Bilissel Egzersiz Terapi Yaklasimi-BETY), a supervised biopsychosocial model-based exercise intervention, on functionality, muscle strength, vascularization, anti-inflammatory and biopsychosocial status in Systemic Sclerosis (SSc) patients. METHODS: Thirty-seven SSc patients were included. Twenty of them were recruited into the study group (SG) undergoing BETY group exercise sessions three times a week for three months and 17 were in the control group (CG) following a home exercise program. Assessments tools were the Modified Rodnan Skin Score (mRSS), Scleroderma Health Assessment Questionnaire (SHAQ), Modified Hand Mobility in Scleroderma (mHAMIS), Duruoz Hand Index (DHI), Six Minute Walk Test (6MWT), skeletal muscle strength measurements using an isokinetic dynamometer (Biodex System 3 Pro), Shear Wave Elastography (SWE), ELISA kits (for tumor necrosis factor-alpha, Interleukin-6, IL-10, serum irisin level), BETY-Biopsychosocial Questionnaire (BETY-BQ), Hospital Anxiety and Depression Scale (HADS), and Short Form-36 (SF-36). RESULTS: The SG demonstrated improvements in SHAQ, mHAMIS, 6MWT, BETY-BQ, HADS, and SF-36 values, excluding the DHI scores (p < 0.05). In contrast, CG showed worsening in SHAQ-general scleroderma symptoms and HADS scores compared to SG (p < 0.05). IL-10 and TNF-alpha increased in both groups, also various vascular parameters were significantly different changed in SG than CG (p < 0.05). Muscle strength values improved in the SG but decreased in the CG however this was statistically not significant (p > 0.05). CONCLUSIONS: BETY can be recommended as a nonpharmacologic approach to the disease management of SSc patients.

Health Literacy Levels of Patients With Juvenile Idiopathic Arthritis and Their Parents.

BACKGROUND: The aim of this study was to reveal the relationship between the health literacy (HL) levels of children with juvenile idiopathic arthritis (JIA) and their parents, and the general health status and physical performance of the children. METHODS: This study included 79 children aged 9-18 years with a diagnosis of JIA and one of their parents. HL levels were evaluated with the Turkish version of the Health Literacy for School-Aged Children and Turkish Health Literacy-32 (THL-32) for children and Adult Health Literacy Scale (AHLS) for their parents. The Childhood Health Assessment Questionnaire (CHAQ), 6-minute walk test (6-MWT), 10-meter walking test (10-MWT) and 10-stair climbing test (10-SCT) was used to evaluate the children. Juvenile Arthritis Biopsychosocial Questionnaire (JAB-Q) was used to assess the children's and parents' psychosocial status and perception of health. RESULTS: HL levels of patients with JIA were 16.5% low HL, %55.7 moderate HL and 27.8% high HL. According to THL-32 scale score, HL level of parents were as follows: inadequate, 3.8%; problematic, 22.8%; sufficient, 34.2%; and excellent, 39.2%. Children's HL levels increase positively as they get older, and no significant relationship was found with other parameters. The AHLS, CHAQ and JAB-Q scores were better in the group with higher education levels of the parents. No statistically significant association was found between the HL of the children and that of the parents. CONCLUSION: In our study, it was found that the high education levels of the parents positively affected the quality of life and physical condition of their children and parental HL levels. In addition, it was shown that the HL levels of children with JIA were not statistically related to other parameters. PATIENT OR PUBLIC CONTRIBUTION: Children diagnosed with JIA and one of their parents actively participated in the study. Feedback from children and families provided important information about obtaining and using HL information before and during the study. The importance of therapy programs and information focusing on the patient and their family, as well as the inter-multidisciplinary approach, in combating a chronic disease at an early age was reinforced by the feedback received from patients and their families.

Examination of Physical Functions, Activity and Participation in Children with Juvenile Idiopathic Arthritis.

AIMS: To examine physical functions, activity, and participation level, and associated factors with participation in children with juvenile idiopathic arthritis (JIA) across the International Classification of Functioning Disability and Health-Children and Youth. METHODS: 49 children (Girl/Boy:28/21) aged between 7 and 18 years (Mean: 13.4 ± 3.3) were included. To evaluate body structure/functioning; pain, fatigue, disease activity, and motor functions were assessed. Childhood Health Assessment Questionnaire and Juvenile Arthritis Biopsychosocial and Clinical Questionnaire were used to determine activity level. Child and Adolescent Scale of Participation was used to assess participation. RESULTS: Mild level of pain (2.0 ± 2.3), disease activity (2.0 ± 2.3), and fatigue (4.1 ± 4.0) were recorded. Decrease in motor functions was determined in 75% of children, while 61% of whom had activity-related disability. There was mild to moderate participation restrictions, and participation was significantly associated with age (r = -0.29), pain severity (r = -0.31), disease activity (r = -0.39), motor functions (r = 0.33), and activity level (r = -0.43), (p Ë‚ 0.05). CONCLUSIONS: Majority of children with JIA have deteriorations in physical functions, activity, and participation. Age, pain, disease activity, motor functions and activity level were associated with participation level. Children with JIA should be regularly evaluated multi-directional and they should be referred to rehabilitation programs to increase functionality and participation.

A biopsychosocial questionnaire for patients with primer Sjögren's syndrome: The BETY-Biopsychosocial Questionnaire.

OBJECTIVE: The BETY-Biopsychosocial Questionnaire (BETY-BQ) is a scale developed to assess the biopsychosocial domains of patients with rheumatic diseases under a single roof. The study aimed to determine the validity and reliability of the BETY-BQ in patients with primary Sjögren's Syndrome (pSS). METHODS: At enrollment and one week, 91 patients with pSS completed the BETY-BQ. Construct validity was measured by correlating the BETY-BQ total score responses with the Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), 36-Item Short-Form Health Survey (SF-36), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI), Primary Sjögren's Syndrome Quality of Life questionnaire (PSS-QoL), and Euro-QoL 5D (EQ-5D). RESULTS: The BETY-BQ correlated high to moderate with HAQ, bodily pain subscale of SF-36, Euro Qol-5D, PSS-QoL, HADS, and ESSPRI (0.776 to 0.557, p <0.05). Spearman's correlation coefficients between BETY-BQ total scores at baseline and average one week were very high (rho = 0.98, <0.001) and indicated substantial agreement between test-retest scores (ICC = 0.99, <0.001). Internal consistency reliability at baseline was 0.91 for the BETY-BQ. CONCLUSIONS: BETY-BQ is valid and reliable for assessing biopsychosocial status in patients with pSS and can be used to measure outcomes in pSS.

The dietary acid load is associated with disease severity in psoriatic arthritis (PsA).

OBJECTIVES: An acidogenic diet, by disrupting the blood pH equilibrium, can contribute to metabolic acidosis and lead to inflammation. Therefore, we hypothesized that dietary acid load (DAL) increases disease activity and inflammation in PsA patients. METHODS: This study was conducted with 58 obese/overweight patients, aged 20-65 years. Dietary intake was assessed using a 3-consecutive-day 24-hour recall. The DAL was evaluated through the PRAL (potential renal acid load) and NEAP (net endogenous acid production) and divided into the low and high groups by their median values. The disease activity assessments, anthropometric measurements, dietary data and blood parameters of patients were recorded and compared at the low and high DAL groups. RESULTS: We observed that patients in the high NEAP and PRAL groups had worse PsA pattern scores (p<0.05). Also, PRAL and NEAP scores were positively associated with DAPSA, HAQ, and PSAID-12 scores. After adjusting age, sex, smoking, and BMI, 1 mEq increase in PRAL and NEAP was associated with an elevation of DAPSA (0.506 and 0.486 points, respectively). CONCLUSIONS: These results showed a close relationship between DAL and PsA symptoms. An acidogenic diet may negatively affect PsA prognosis. Healthy eating recommendations should be part of the management of the disease.

Reducing the question burden of patient reported outcome measures using Bayesian networks.

Patient Reported Outcome Measures (PROMs) are questionnaires completed by patients about aspects of their health status. They are a vital part of learning health systems as they are the primary source of information about important outcomes that are best assessed by patients such as pain, disability, anxiety and depression. The volume of questions can easily become burdensome. Previous techniques reduced this burden by dynamically selecting questions from question item banks which are specifically built for different latent constructs being measured. These techniques analyzed the information function between each question in the item bank and the measured construct based on item response theory then used this information function to dynamically select questions by computerized adaptive testing. Here we extend those ideas by using Bayesian Networks (BNs) to enable Computerized Adaptive Testing (CAT) for efficient and accurate question selection on widely-used existing PROMs. BNs offer more comprehensive probabilistic models of the connections between different PROM questions, allowing the use of information theoretic techniques to select the most informative questions. We tested our methods using five clinical PROM datasets, demonstrating that answering a small subset of questions selected with CAT has similar predictions and error to answering all questions in the PROM BN. Our results show that answering 30% - 75% questions selected with CAT had an average area under the receiver operating characteristic curve (AUC) of 0.92 (min: 0.8 - max: 0.98) for predicting the measured constructs. BNs outperformed alternative CAT approaches with a 5% (min: 0.01% - max: 9%) average increase in the accuracy of predicting the responses to unanswered question items.

The reliability, validity, and responsiveness of Cognitive Exercise Therapy Approach: Biopsychosocial Questionnaire for patients with psoriatic arthritis.

Although the importance of the biopsychosocial model that aims the optimum treatment is emphasized in the literature, there is a lack of scales that evaluate individuals with PsA in a multi-dimensional way, including all areas of influence. This study aimed to determine the validity, reliability, and responsiveness of the Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) in individuals diagnosed with Psoriatic Arthritis (PsA). Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL), Health Assessment Questionnaire, Hospital Anxiety and Depression Scale, and Short Form-36 were used for the validity of the BETY-BQ. For scale reliability, the test-retest method was performed, Intraclass Correlation Coefficient (ICC) was calculated, and Cronbach's alpha (α) coefficient was checked for internal consistency. For the responsiveness of the scale, all scales were re-applied with 3 months intervals. The correlations of BETY-BQ with the other scales were found medium to very high. ICC was analyzed to compare the reliability of the test-retest results and it was found to be excellent. Cronbach's α value was found to be 0.940 which showed an excellent internal consistency. The time-dependent change sensitivity of BETY-BQ was found to be highly correlated with the PsA-specific scale, the PsAQoL questionnaire. BETY-BQ was determined as a valid, reliable, and sensitive assessment tool that health professionals can use in individuals with PsA diagnosis. In this study, a scale that will reveal the biopsychosocial responses of individuals with PsA to pharmacological and non-pharmacological treatments was presented to the literature.

Effectiveness of a supervised group exercise therapy based on the biopsychosocial model introduced simultaneously with anti-TNF therapy in anti-TNF-naive patients with active ankylosing spondylitis.

BACKGROUND: This study aimed to investigate the effectiveness of a supervised group exercise therapy based on the biopsychosocial model introduced simultaneously with antitumor necrosis factor (TNF) therapy in anti-TNF-naive patients with active ankylosing spondylitis (AS). METHODS: Forty-eight patients were divided into two groups: the control group (CG; n = 36) received only anti-TNF therapy, and the study group (SG; n = 12) received the supervised exercise therapy based on the biopsychosocial model in addition to anti-TNF therapy. The measurements of disease activity and functionality were evaluated by The Bath AS Disease Activity Index (BASDAI) and The Bath AS Functional Index (BASFI) respectively. Other outcome measures evaluated biopsychosocial status, emotional state, spinal mobility, pain, fatigue, sleep, and quality of life. All measurements were applied to both groups at baseline and repeated 12 weeks later. RESULTS: BASDAI and BASFI analyses revealed significant differences between groups in favor of the SG (p < 0.05). At the end of the 12 weeks, the results showed that there were additional improvements in all outcome measurement parameters in the SG compared to the CG. DISCUSSION: The supervised group exercise therapy based on the biopsychosocial model introduced simultaneously with anti-TNF therapy is more effective than only anti-TNF therapy in anti-TNF-naive patients with active AS.

A new biopsychosocial and clinical questionnaire to assess juvenile idiopathic arthritis: JAB-Q.

OBJECTIVE: To create a new multidimensional questionnaire for the assessment of juvenile idiopathic arthritis (JIA) patients in standard clinical practice and study the validity and reliability of this questionnaire. METHODS: The Juvenile Arthritis Biopsychosocial and Clinical Questionnaire (JAB-Q) was created using the Delphi technique and consensus conference following an initial literature search. The questionnaire has three parts including a clinician form, child form and parent form. This is a patient/parent-centered outcome tool, which helps us to evaluate the biopsychosocial aspects of the patient, including disease activity, posture, functional and psychosocial status, fatigue, and performance in school. From January 2015 to January 2018, 6-18 years old children with JIA were enrolled in the study. The previously validated questionnaires were also applied to each participant to validate the JAB-Q: Juvenile Idiopathic Disease Arthritis Score (JADAS) and Childhood Health Assessment Questionnaire (CHAQ), and the Family Impact Questionnaire (FIS). The same questionnaire was re-administered after one week to assess the test-retest reliability in randomly selected 50 children and their parents. RESULTS: A group of experts were invited to the Delphi survey. After the Delphi tours, the final form of the questionnaire containing three parts as clinician form, child form and parent form was created. This tool was applied to 310 JIA patients and their parents. The children and parents easily handled the JAB-Q and filled the forms in around 10-15 min. The validity of the clinician, child and parents' forms were assessed by the JADAS, CHAQ, and FIS, respectively. The validity of these three scales were determined as moderate. In addition, the test-retest reliability of the clinician, child and parents' forms were considerably high. CONCLUSION: JAB-Q is a valid and reliable multidimensional biopsychosocial outcome tool that can be used routinely in clinical practice of pediatric rheumatology. The main advantage of this tool is incorporation of patients' and parents' perspectives separately while providing a practical and standard setting for the clinician's evaluation. However, further validation of this tool in an independent cohort is needed to improve its applicability.

Effects of active/passive interventions on pain, anxiety, and quality of life in women with fibromyalgia: Randomized controlled pilot trial.

The authors of this study compared the effects of pilates exercises and connective tissue massage (CTM) on pain intensity; pain-pressure threshold; and tolerance, anxiety, progress, and health-related quality of life in females with fibromyalgia. It was a pilot, assessor masked, randomized controlled trial conducted between January and August of 2013. Twenty-one women with fibromyalgia were randomly assigned to the pilates exercise program (six of whom did not complete the program), and 22 were randomly assigned to CTM (one of whom did not complete this program). Each group received the assigned intervention three times per week during a 4-week period. The Visual Analogue Scale, algometry, State-Trait Anxiety Inventory, Fibromyalgia Impact Questionnaire, and Nottingham Health Profile were used at baseline and at the end of treatments. Significant improvements were found in both groups for all parameters. However, the scores for pain-pressure threshold were significantly elevated and the symptoms of anxiety were significantly diminished in the exercise group compared to the massage group. Thus, exercise and massage might be used to provide improvements in women with fibromyalgia. The exercise group showed more advantages than the massage group and thus might be preferred for patients with fibromyalgia. However, an adequately powered trial is required to determine this with certainty.

Core stabilisation reduces compensatory movement patterns in patients with injury to the arm: a randomized controlled trial.

OBJECTIVE: To investigate the effects of adding core stabilisation exercises to traditional rehabilitation in patients with arm injuries. DESIGN: Randomized controlled trial. SETTING: Outpatient clinic. SUBJECTS: Twenty-seven patients with elbow and wrist injuries were randomized to a stabilisation or control group. INTERVENTIONS: The stabilisation group received core stabilisation training and traditional arm rehabilitation and the control group received traditional arm rehabilitation alone for three days/week for six weeks. MAIN MEASURES: Pre- and post-treatment assessments comprising an analysis of compensatory movement patterns and trunk muscle strength as well as functional measurements of the arm, including pain, range of motion, disabilities of arm, shoulder and hand questionnaire and endurance and fatigue severity were performed. RESULTS: Inter-group comparison revealed significantly greater improvements in the degree of mean change (SD) in total compensation (in degrees) of the head (-14.47 (21.65)) and trunk (-5.56 (5.71)) as well as total compensation (-50.02 (48.62)) for the stabilisation group than for the control group (p < 0.05). Increase in trunk muscle strength (2.43 (3.46)) was statistically significant in the stabilisation group compared with the control group. No significant differences were found for functional measures, including pain, range of motion, disabilities of arm, shoulder and hand or endurance and fatigue severity between the groups, although trends towards greater improvement were observed in the stabilisation group. CONCLUSIONS: Adding core stabilisation exercises to traditional arm rehabilitation for patients with traumatic arm injury reduces compensatory movement patterns. Trends towards better functional outcomes in the stabilisation group are worth testing in a large-scale trial.

The validity, reliability, and responsiveness of a new biopscyhosocial questionnaire for patients with systemic lupus erythematosus.

OBJECTIVE: In recent years, the importance of holistic care in individuals with systemic lupus erythematosus (SLE) has been emphasized, and therefore a measurement tool that evaluates biopsychosocial impact is needed. This study was conducted to determine the validity, reliability, and responsiveness of the Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) in individuals with SLE. METHODS: Lupus Quality of Life (LupusQoL), Short Form-36 (SF-36), Health Assessment Questionnaire (HAQ), and Hospital Anxiety and Depression Scale (HADS) were used for the validity. For reliability, evaluations were repeated at 1 -week intervals and for responsiveness, the same scales were re-administered at 3-month intervals to 30 patients. RESULTS: BETY-BQ showed moderate to high correlations with LupusQoL subparameters (rho = -0.522 to -0.718, p < 0.001), moderate to very high correlations with SF-36 subparameters (r = -0.826 to rho = 0.594, p < 0.001), high correlations with HAQ and HADS-D (rho = 0.735, p < 0.001; rho = 0.622, p < 0.001, respectively) and a moderate correlation with HADS-A (rho = 0.571, p < 0.001). In the test-retest method the correlation between the responses was very high (r = 0.989, p < 0.001). The intraclass correlation coefficient (r = 0.944, p < 0.001) and Cronbach's alpha value were found to be excellent (0.952). BETY-BQ showed moderate correlations with LupusQoL subparameters (the body image r = -0.443, p = 0.014; planning rho = -0.529, p = 0.003; fatigue r = -0.484, p = 0.007; intimate relationships rho = -0.421, p = 0.02), SF-36 social function subparameter (rho = -0.427, p = 0.019) and anxiety and depression subparameter of HADS (rho = 0.418, p = 0.021; r = 0.507, p = 0.004, respectively). CONCLUSION: BETY-BQ which was found as a valid, reliable, and responsive scale in individuals with SLE, was presented to healthcare professionals for use in clinical and research studies as a scale that can be preferred in the evaluation of biopsychosocial status of individuals with SLE.

The Efficacy of the Cognitive Exercise Therapy Approach by Telerehabilitation in People Living with HIV: Preliminary Results.

Objective: The Cognitive Exercise Therapy Approach, referred to as BETY, is a biopsychosocial model that has demonstrated effectiveness in improving the quality of life among various patient populations with chronic diseases. This study aimed to determine the efficacy of BETY combined with telerehabilitation for people living with HIV (PLWH). Materials and Methods: Fifty PLWH who were virologically suppressed receiving follow-up and treatment at Sanliurfa Training and Research Hospital were included in this study. Patients were divided into the telerehabilitation group (TG) and the control group (CG). In addition to routine treatments, the TG underwent group rehabilitation exercises via Zoom application for 60 minutes three times a week for 12 weeks (a total of 36 sessions) under the supervision of a physiotherapist, following the principles of BETY. The CG received no intervention and continued with routine medication treatments. Before and after the exercise therapy, the BETY Scale (BETY-BQ), Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Clinical Frailty Scale, and Frail Scale were administered to both the TG and the CG. The responses to the scales were compared between the two groups after the 12-week period. Results: The preliminary results included data from 10 patients in the TG and 15 patients in the CG who completed the 12-week treatment. In the TG, significant differences were observed in the SF-36 pain subscale and the BETY total score, while in the CG, significant differences were found in the SF-36 emotional role functioning and vitality subscales (p<0.05). In the TG, negative values were observed in all BETY-BQ subscales, indicating improvement in all parameters. Additionally, the mean value of the SF-36 pain subscale increased from 79 before treatment to 91.5 after treatment. Conclusion: Our preliminary results indicate that the BETY method applied by telerehabilitation may be effective in reducing pain and improving biopsychosocial conditions in PLWH. Telerehabilitation with cognitive exercise therapy can provide an alternative treatment option by complementing routine therapies and offering the opportunity to participate anonymously in group therapies in PLWH.

The Juvenile Arthritis Quality of Life Questionnaire in patients with juvenile idiopathic arthritis: Turkish version, validity, and reliability study.

INTRODUCTION: This study aimed to assess the cultural adaptation, validity, and reliability of the Turkish version of the Juvenile Arthritis Quality of Life Questionnaire (JAQQ) in patients with juvenile idiopathic arthritis (JIA). METHODS: A total of 100 JIA patients (64% female), aged 9 to 18 years, participated in the study conducted at a tertiary care university hospital. The JAQQ was culturally adapted through a rigorous translation process and administered alongside established measures, including the Childhood Health Assessment Questionnaire (CHAQ), Juvenile Arthritis Biopsychosocial Questionnaire (JABQ), and Children's Depression Inventory (CDI). Validity and reliability were evaluated using Spearman's correlation coefficients, Cronbach's alpha, intraclass correlation coefficient (ICC), standard error of the mean (SEM), and minimal detectable change (MDC). RESULTS: The Turkish version of JAQQ exhibited high convergent validity, correlating significantly with CHAQ, JABQ, and CDI. No floor or ceiling effects were observed in the total JAQQ score, indicating a balanced assessment. Internal consistency was excellent (Cronbach's α = 0.948), and test-retest reliability was satisfactory (ICC = 0.913). SEM and MDC95 values were 0.357 and 0.99, respectively. CONCLUSIONS: The Turkish adaptation of JAQQ emerges as a valid and reliable instrument for comprehensively assessing the health-related quality of life in children and adolescents diagnosed with JIA. The questionnaire's robust psychometric properties, coupled with distinctive features like individualized assessment, highlight its potential as a valuable tool for both clinical assessment and scientific research in the field of pediatric rheumatology. Key Points • The Juvenile Arthritis Quality of Life Questionnaire (JAQQ) is an important scale that evaluates the quality of life of children with Juvenile Idiopathic Arthritis (JIA). • JAQQ is known and used in the field of pediatric rheumatology in Turkey, but its Turkish adaptation has not been made before. • Our study includes 100 JIA patients aged between 9 and 18 years and shows that the Turkish version of JAQQ is valid and reliable in measuring the quality of life of these children. • This research contributes to the accurate assessment of the quality of life in Turkish children diagnosed with JIA, providing valuable insights for both clinical and scientific studies.

Comparison of the effects of aerobic training alone versus aerobic training combined with clinical Pilates exercises on the functional and psychosocial status of patients with ankylosing spondylitis: A randomized controlled trial.

To compare the effects of aerobic training versus aerobic training combined with clinical Pilates exercises (CPE) on the functional and psychosocial status of patients with ankylosing spondylitis (AS). Twenty-eight patients with ankylosing spondylitis (AS) were randomized into 2 groups. Group 1 (n = 14) performed both aerobic training and CPE, whereas group 2 (n = 14) performed aerobic training alone. Functional status of the patients was assessed using the Bath Ankylosing Mobility Index (BASMI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), back scratch test (BST), single leg stance test, functional reach test, a dynamometer, chair sit and stand test, and 6-minute walk test (6MWT), and the psychosocial status of the patients was assessed using the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, the Multidimensional Assessment of Fatigue (MAF), Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety Depression Scale (HADS), and Tampa Scale of Kinesiophobia (TSK). Both training programs were conducted for 8 weeks, and then, the assessments were repeated. A statistically significant improvement was observed in the BASMI (p = .001), BASDAI (p = .001), BASFI (p = .002), BST (right, p = .05; left, p = .025), functional reach test (p = .013), back muscle strength (p = .033), 6MWT (p = .011), ASQoL (p < .001), MAF (p = .01), and PSQI (p = .013) scores in group 1. A significant difference was observed in the BASDAI (p = .028), chair sit and stand test (p = .022), 6MWT (p = .04), and ASQoL (p = .04) scores in group 2. CPE in addition to aerobic training was more effective in improving the functional and psychosocial status of the patients with AS.

Comparison of Biopsychosocial Characteristics of Children with Juvenile Idiopathic Arthritis According to Common Disease Subtypes.

OBJECTIVE: In this study, we assessed the functional and biopsychosocial characteristics of juvenile idiopathic arthritis (JIA) patients according to disease subtypes. MATERIALS AND METHODS: Child Health Assessment Questionnaire (CHAQ), Juvenile Arthritis Disease Activity Score-71 (JADAS-71), and Juvenile Arthritis Biopsychosocial Questionnaire (JAB-Q) scales were administered to 304 JIA patients, and the subscale of JAB-Q was administered to their families. RESULTS: The median age of JIA patients at diagnosis was 7.9 (5.5-13) years (female/male = 1.3). Most patients were under treatment (68.7%) and had inactive disease (69.3%). While there was no significant difference between JADAS-71 scores according to the JIA subtypes, total CHAQ scores in polyarticular JIA patients were higher than in systemic JIA patients (P = .005). Enthesitis-related arthritis (ERA) patients had higher JAB-Q fatigue total scores compared to systemic JJIA patients (P = .001). Juvenile Arthritis Biopsychosocial Questionnaire-child psychosocial status scores were higher in polyarticular JIA patients than oligoarticular and systemic JIA patients (P = .004 and P = .003, respectively), and they had higher JAB-Q child form total scores than systemic JIA patients (P = .006). In addition, systemic JIA patients' parents had higher JAB-Q family total scores compared to oligoarticular JIA patients' parents (P = .03). CONCLUSION: Our results suggest that polyarticular JIA patients had higher CHAQ, JAB-Q psychosocial status, and child form total scores, and the JAB-Q fatigue score was higher in ERA patients. Also, JAB-Q-parent scores were higher in systemic JIA patients' parents. Biopsychosocial characteristics should be evaluated in both JIA patients and their parents.

The reliability, validity, and responsiveness of Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire for patients with fibromyalgia.

AIM: Although the importance of biopsychosocial models for chronic diseases is emphasized nowadays, the lack of assessment tools to meet this need draws attention. This study was planned to assess the validity, reliability, and responsiveness of the Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) in patients with fibromyalgia. METHOD: Hospital Anxiety and Depression Scale (HADS), Mindful Attention Awareness Scale, Health Assessment Questionnaire, the Fibromyalgia Impact Questionnaire, and Short-Form 36 (SF-36) were used for the validity of BETY-BQ. For the reliability study, evaluations were repeated at 1-week intervals and for the responsiveness, the same scales were applied to patients under medical treatment at 3-month intervals. RESULTS: The correlations of BETY-BQ with the other scales were found to be moderate to high (respectively r = .591, P < .001 and r = .441, P < .001; r = -.419, P < .001; r = .617, P < .001; r = .722, P < .001; r = -.580 and -.374, P = .001 and P < .001) and with SF-36 sub-parameters were found to be weak-moderate. The test-retest method was used for reliability, and the correlation between the responses was very high (r = .901, P < .001). The intraclass correlation coefficient (ICC) was found to be high (ICC = 0.899, P < .001). Cronbach's alpha (α) value was found to be .947. In the correlation analysis of time-dependent changes, BETY-BQ correlated weakly with other scales and moderately correlated with HADS (HADS-anxiety r = .489, P = .006, HADS-depression r = .500, P = .005). CONCLUSIONS: BETY-BQ was presented in the literature as a valid, reliable, and sensitive scale that can be used both in the biopsychosocial evaluation and as an easily understood, practical scale that can be answered in a short time in the practices of healthcare professionals.

Do obstetrical brachial plexus injuries affect proprioceptive sense?

OBJECTIVE: To evaluate the proprioceptive sensory input in the shoulder joint affected by obstetrical brachial plexus injuries (OBPI). METHODS: This controlled study included 39, 7-12-year-old children with upper and/or middle trunk OBPI, and it took place in the Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Hacettepe University, Ankara, Turkey between January 2008 and September 2009. The proprioceptive evaluation was carried at both affected and normal sides, at predetermined target angles, which were determined as 10%, 30%, and 90% of the shoulder passive abduction angle and at the rate of 2 degrees/s speed. RESULTS: A statistically significant difference was observed between affected and normal sides at 10% and 30% of the target angles. Absolute values of the affected side proprioception score were found to be higher compared to the normal side. CONCLUSION: A decrease in the proprioceptive sense in OBPI was observed. Therefore, a deteriorated proprioceptive network will eventually, over time, affect functionality in this type of injury.

The effect of the clinical pilates exercises on kinesiophobia and other symptoms related to osteoporosis: Randomised controlled trial.

OBJECTIVES: To investigate the effects of clinical pilates exercise on kinesiophobia, pain, functional status and quality of life of the osteoporosis patients. METHODS: This study involved 40 females with osteoporosis. The subjects were randomly separated into two groups. Group 1 received specific Clinical Pilates exercises provided by a qualified Physiotherapies ×3 per week for a period of 6 weeks. Group 2 acted as a control group, receiving no intervention and continuing their usual daily activities of life over the same period. All patients' kinesiophobia, pain and quality of life level and functional status were re-assessed at the end of 6 weeks. RESULTS: According to the measurements exercise group patients' kinesiophobia, pain decreased, functional status and quality of life statistically improved (p < 0,05). CONCLUSION: As clinical pilates training positively effects kinesiophobia, pain, functional status and quality of life, it can be recommended to osteoporosis patients, as a safe exercise model.

The effects of Clinical Pilates exercises on patients with shoulder pain: A randomised clinical trial.

AIM: The purpose of this study was to determine the effect of Clinical Pilates exercises on patients with shoulder pain. MATERIAL AND METHODS: Thirty-three patients, experiencing shoulder pain continuously for at least four weeks were selected as study subjects. The patients were randomly divided into two groups, namely Clinical Pilates exercise (n = 17) group and conventional exercise (n = 16) group. The patients were treated for five days a week, the total treatment being carried out for 10 days. The assessment of pain and disability amongst the patients were done at the baseline and at the end of the treatment sessions, using Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI). RESULTS: The clinical Pilates exercise group showed a significant improvement in all scores used for assessment (p < 0.05), while the conventional exercise group demonstrated a significant improvement only in the SPADI total score (p < 0.05). A comparison of scores for the VAS, SPADI-Pain and SPADI-Total between the two groups, revealed a significant improvement in the Clinical Pilates exercise group (p < 0.05). CONCLUSION: It was demonstrated by the study that Clinical Pilates exercise is an efficient technique for patients experiencing shoulder pain, as it helps reduce pain and disability among them.