Different walk aids on gait parameters and kinematic analysis of the pelvis in patients with Adult Neuromuscular Disease.

OBJECTIVE: To investigate the effects of different walking aids (single cane, bilateral forearm crutch and walker) on gait parameters and kinematic analysis of pelvis in patients having adult neuromuscular diseases. METHODS: The study design was a self-controlled study. The study was conducted in the Department of Physiotherapy and Rehabilitation, Hacettepe University in Ankara, Turkey, between 2014-2015. The study included 18 adult patients with neuromuscular disease. The manual muscle test, the Rivermead mobility index, the motor function assessment scale, and the trunk control test were used as descriptive measurements. The 2-minute walking test, the modified Borg scale and the G-Walk gait analysis system (BTS Bioenginering S.p.A., Italy) were used as the outcome measures. The outcome measures were performed randomly during normal gait without walking aids (self control group), then during walking with single point cane, bilateral forearm crutch and walker. RESULTS: It was observed that the walking aids have decreased the walking speed, walking distance and cadence. When the pelvis kinematic was analyzed, there was only a significant difference in the extension of the pelvis between the groups (p<0.05). The most useful (61%), most comfortable (44.4%) and the most preferred (61%) walking aid was determined as single cane by patients and the safest (55%) one was determined as a walker. CONCLUSION: In the decision-making process for walking aids, the patient`s biomechanical, physiological and psychosocial needs, expectations, satisfactions and levels of independence should be considered before providing patients with aids for walking.

The effects of electrical stimulation and exercise therapy in patients with limb girdle muscular dystrophy. A controlled clinical trial.

OBJECTIVE: To evaluate and compare the effects of exercise therapy and electrical stimulation on muscle strength and functional activities in patients with limb-girdle muscular dystrophy (LGMD). METHODS: This controlled clinical trial included 24 subjects who were diagnosed with LGMD by the Neurology Department of the Hacettepe University Hospital, Ankara, Turkey and were referred to the Physical Therapy Department between May 2013 and December 2014. Subjects were enrolled into an electrical stimulation (11 patients) group, or an exercise therapy (13 patients) group. RESULTS: The mean age of patients was 31.62 years in the electrical stimulation group, and 30.14 years in the exercise therapy group. The most important results in this controlled clinical study were that the muscle strength in both groups was significantly decreased and post-treatment evaluation results indicated that muscle strength of the Deltoideus was higher in the electrical stimulation group, and the difference between the groups was maintained in the follow-up period (p<0.05). However, the muscle strength of quadriceps was similar in both groups, according to the post-treatment and follow-up evaluation results (p>0.05). Additionally, the electrical stimulation group presented more obvious overall improvements than the exercise therapy group according to muscle strength, endurance, and timed performance tests. CONCLUSION: Since no definitive treatments currently exist for patients with LGMD, these results provide important information on the role of exercise therapy and electrical stimulation for clinicians working in rehabilitation.

Assessment of health-related quality of life, depression, and anxiety in slowly and rapidly progressive neuromuscular disorders.

OBJECTIVES: To compare health-related quality of life (HRQoL) and psychosocial features in rapidly progressive neuromuscular disorders (RPNMD) and slowly progressive neuromuscular disorders (SPNMD) in adult ambulatory patients, to determine individual needs in 2 separate progression groups. METHODS: Thirty-nine SPNMD patients and 46 RPNMD patients were recruited. The functional independence measurement (FIM) was employed to evaluate the functional status. For the assessment of depression, anxiety, and HRQoL, patients were requested to fill out a Beck Depression Inventory, State-Trait Anxiety Inventory, and the Nottingham Health Profile (NHP). This study was performed at the Department of Physical Therapy and Rehabilitation, Hacettepe University Faculty of Health Science, Ankara, Turkey between August and December 2009. RESULTS: The FIM total score did not differ between the 2 groups. Only energy was significantly high (worse) among the dimensions of NHP in RPNMD patients. None of the other sub-items differed between the 2 patient groups. The SPNMD patients were more depressed than the RPNMD patients. The mean state and trait anxiety scores were significantly higher in SPNMD patients as well. CONCLUSIONS: Significant depressive or anxious symptomatology is not associated with amyotrophic lateral sclerosis (ALS). The diagnosis of SPNMD should alert physicians in an equivalent promptness to ALS and possible depression or anxiety, and concerns of patients regarding the chronic, though slowly progressive course of the disease.

Predictors of health-related quality of life in adult ambulatory independence neuromuscular disease patients.

OBJECTIVE: To evaluate the health related quality of life (HRQoL) of totally independent ambulatory neuromuscular disease (NMD) patients in comparison with age matched healthy control subjects, and to assess associations between socio demographic variables and HRQoL in totally independent NMD patients. METHODS: Ninety-nine adult patients with a diagnosis of NMD referred to the Physical Therapy Department of the Health Sciences Faculty of Hacettepe University, Ankara, Turkey between 2007 and 2009 were included in the study. The Functional Independence Measurement and the Nottingham Health Profile (NHP) were the main outcomes to assess independence level in activities of daily living and quality of life. RESULTS: The HRQoL score as measured by NHP was high (worse) in patients than healthy controls, and the difference between the 2 groups was significant for energy, physical mobility, and total score. Employed NMD patients scored significantly lower (better) than those unemployed in the majority of NHP domains. The genders and duration of illness displayed no significant difference in all dimension scores. CONCLUSION: All NMD patients had a poorer HRQoL than with healthy subjects with respect to energy, physical mobility dimensions, and total score. Furthermore, occupation was found to be a main factor that affects HRQoL in adult ambulatory NMD patients.

Rehabilitation robotics ontology on the cloud.

We introduce the first formal rehabilitation robotics ontology, called RehabRobo-Onto, to represent information about rehabilitation robots and their properties; and a software system RehabRobo-Query to facilitate access to this ontology. RehabRobo-Query is made available on the cloud, utilizing Amazon Web services, so that 1) rehabilitation robot designers around the world can add/modify information about their robots in RehabRobo-Onto, and 2) rehabilitation robot designers and physical medicine experts around the world can access the knowledge in RehabRobo-Onto by means of questions about robots, in natural language, with the guide of the intelligent userinterface of RehabRobo-Query. The ontology system consisting of RehabRobo-Onto and RehabRobo-Query is of great value to robot designers as well as physical therapists and medical doctors. On the one hand, robot designers can access various properties of the existing robots and to the related publications to further improve the state-of-the-art. On the other hand, physical therapists and medical doctors can utilize the ontology to compare rehabilitation robots and to identify the ones that serve best to cover their needs, or to evaluate the effects of various devices for targeted joint exercises on patients with specific disorders.