Pain Neuroscience Education Following Arthroscopic Rotator Cuff Repair for Patients With Rotator Cuff Tears: A Double-Blind Randomized Controlled Clinical Trial.

OBJECTIVE: This trial examines the efficacy of the pain neuroscience education on clinical outcomes in patients with arthroscopic rotator cuff repair. DESIGN: A total of 36 participants undergoing arthroscopic rotator cuff repair were assigned to either the experimental group ( n = 18) or control group ( n = 18) in this randomized study. A 6-wk-long conventional physiotherapy program was administered for both groups. In addition, a pain neuroscience education protocol was administered for the experimental group for a whole period of 6 wks (1 session/week, 15-60 mins per session). The primary outcomes were to compare pretreatment and posttreatment scores of the experimental versus control groups on the pain and disability. Our secondary outcomes included the comparisons of scores on the catastrophizing, anxiety, depression, kinesiophobia, and quality of life. The participants were assessed both at baseline and posttreatment. RESULTS: The improvement in pain catastrophizing, anxiety, depression, and kinesiophobia was greater in the experimental group ( P < 0.05). The improvement was similar in both groups in terms of the rest of outcome measures. CONCLUSIONS: This study showed that the pain neuroscience education improved only psychological aspects of the chronic pain in arthroscopic rotator cuff repair. Therefore, adding pain neuroscience education to the conventional program might be useful to improve pain catastrophizing, anxiety, depression, and kinesiophobia in patients with arthroscopic rotator cuff repair.

Predictors of the 6-min walk test in patients with ovarian cancer.

PURPOSE: To identify the predictors of the 6-min walk test (6MWT) and investigate the relationship between 6MWT, performance status, functional mobility, fatigue, quality of life, neuropathy, physical activity level, and peripheral muscle strength in patients with ovarian cancer (OC). METHODS: Twenty-four patients diagnosed with stage II-III ovarian cancer were included in the study. Patients were assessed using the following measurement methods: 6MWT for walking capacity, Eastern Cooperative Oncology Group Performance Scale (ECOG-PS) for performance status, an armband physical activity monitor for physical activity level, Checklist Individual Strength (CIS) for fatigue, Functional Cancer Treatment Evaluation with Quality of Life-Extreme (FACT-O) for quality of life, Functional Evaluation of Cancer Treatment/Gynecological Oncology-Neurotoxicity (FACT/GOG-NTX) for neuropathy, a hand-held dynamometer for peripheral muscle strength, and 30-s chair-stand test for functional mobility. RESULTS: The mean 6MWT distance was 578.48 ± 115.33 meters. 6MWT distance correlated with ECOG-PS score (r = -0.438, p = 0.032), handgrip strength (r = 0.452, p= 0030), METs (r = 0.414, p = 0.044) 30s-CST (r= 0.417, p= 0.043), and neuropathy score (r = 0.417, p = 0.043) significantly. There was no relationship between 6MWT distance and other parameters (p> 0.05). Multiple linear regression analysis demonstrated that performance status was the sole predictor of 6MWT. CONCLUSION: The walking capacity seems to be associated with performance status, peripheral muscle strength, level of physical activity, functional mobility, and severity of neuropathy in patients with ovarian cancer. Evaluating these may help clinicians to understand factors behind the decreased walking capacity.

Factors influencing physical activity in patients with colorectal cancer.

BACKGROUND: Physical activity (PA) is a modifiable health behaviour in patients with colorectal cancer (CRC). Knowing the possible predictors of PA will contribute to producing physical and psychological benefits for CRC patients. OBJECTIVE: To investigate the factors that influence PA in patients with CRC. METHODS: This cross-sectional study was conducted with 47 participants with CRC. Demographic and clinical characteristics, neuropathic pain (Douleur Neuropathique 4 (DN4)), peripheral muscle strength (knee extensor and flexor, hip extensor and flexor, and ankle dorsiflexor muscle strength), balance (Balance Master System (BMS) and Berg Balance Scale (BBS)), fatigue (Brief Fatigue Inventory (BFI)), PA (International PA Questionnaire Short Form (IPAQ-SF)), and quality of life (36-item Short Form Health Survey (SF-36)) were evaluated. Multiple linear regression analysis was used to determine the variables that have the greatest influence on PA. RESULTS: IPAQ-SF score had moderate correlations with knee extensor muscle strength (r = 0.310, p = 0.034), BBS (r = 0.361, p = 0.013), and limit of stability test (movement velocity) score (r = 0.385, p = 0.008), BFI- severity of fatigue (r = - 0.488, p = 0.001), impact of fatigue on daily functioning (r = - 0.421, p = 0.003), and the SF-36 sub-parameters (role limitations due to physical health problems, physical functioning, general health perceptions and vitality) (p < 0.05). Role limitations due to physical problems, knee extensor muscle strength, and severity of fatigue had the greatest influence on PA in patients with CRC with explaining 43% of the variance in PA. CONCLUSIONS: This study suggests that quality of life, knee extensor muscle strength, and fatigue have the greatest influence on PA in patients with CRC.

Three-axis accelerometer system for comparison of gait parameters in children with cystic fibrosis and healthy peers.

BACKGROUND: Cystic Fibrosis (CF), affecting functional exercise capacity generally measured by submaximal exercise test such as 6min walk test, is a progressive, autosomal recessive and metabolic disorder. Three-axis accelerometers, which are used during gait, are an easy way to assess gait parameters in patients and healthy individuals. Gait parameters were significantly associated with clinical outcomes of COPD. However, the association between gait parameters and clinical outcomes in children with CF is unclear. RESEARCH QUESTION: Do clinical outcomes in CF have an important role in determining gait parameters?. METHODS: Twenty-one CF and 21 healthy subjects participated in this case-control study. Body composition was evaluated using Tanita-BC 418. Respiratory and knee extension muscle strengths were assessed. Functional exercise capacity was evaluated using the 6-min walk test (6MWT). Spatiotemporal gait parameters were evaluated using a validated wireless inertial sensing device (G-Sensor, BTS Bioengineering S.p.A., Italy) during the 6MWT and 7-meter gait test. RESULTS: MIP, the distance of 6MWT, and stride length were significantly lower in the CF group compare to healthy children (p<0.05). Gait speed and functional exercise capacity, cadence and functional exercise capacity, quadriceps muscle strength, FEV1, fat-free mass were found to be correlated in CF patients (p<0.05). SIGNIFICANCE: The aerobic capacity and gait parameters were affected in CF patients with mild disease severity in our study. Clinical outcomes were associated with gait parameters in CF patients. This is the first study to use the 3-axis accelerometer to evaluate functional exercise capacity and gait parameters of CF and healthy children. A three-axis accelerometer can be used to assess functional exercise capacity and gait parameters in CF patients at the clinics.