A hand exercise mobile app for people with rheumatoid arthritis in Turkey: design, development and usability study.

To design and develop a smartphone application for a structured hand exercise programme for patients with rheumatoid arthritis (RA) in Turkey and to test its usability. We followed a two-stage process: (1) Design and Development and (2) Usability testing. In stage 1, we used a qualitative user-centered design approach. We conducted a focus group (8 therapists and people with RA) to discuss the content, features and design to produce a prototype of the application. In a second focus group session, the participants tested the prototype, provided feedback and further revisions were made. In stage 2, 17 participants with RA used the app for 4 to 6 weeks. The System Usability Scale and the adapted Usability, Satisfaction and Ease to Use Questionnaires were used to measure usability, ease of use. Semi-structured interviews were conducted to explore user experiences with the application with 17 participants. In stage 1, the following themes were identified from the focus groups (a) login techniques (b) self-monitoring (c) exercises, (d) exercise diary, (e) information, (f) behavioral change and encouragement (g) exercise adherence. In stage 2, 3 themes were determined from interviews: (a) learning and accuracy, (b) ease of use, (c) motivation and adherence. USE and SUS scores indicated that users reported a high level of usability, satisfaction and ease of use. A mobile app for hand exercise for people with RA was developed using a mixed-method and iterative design. Participants perceived the mobile app as easy to use with high levels of satisfaction.

Effects of rigid and kinesio taping on plantar pressure distribution in patients with Lisfranc fracture sequelae.

BACKGROUND: Patients with Lisfranc fractures may regain functional status after anatomical fixation, but they may experience sequelae such as flatfoot deformity and pain associated with foot pressure distribution during weight-bearing. RESEARCH QUESTION: What is the impact of Lisfranc fracture sequelae on both the injured and uninjured sides, and how does the antipronation taping affect plantar pressure distribution parameters? METHODS: Twenty-six patients who underwent anatomical fixation for Lisfranc fracture, displaying pronation on the injured side based on the Foot Posture Index-6 test, as well as 15 healthy subjects, participated in this study. Plantar pressure distribution measurements were conducted during barefoot walking for the healthy subjects. In the patient group, measurements were taken under two antipronation taping conditions (kinesio and rigid taping), as well as during barefoot walking. RESULTS: Participants who received anatomical fixation after Lisfranc fracture exhibited significant alterations in plantar pressure distribution parameters on both the injured and uninjured sides, as compared to the control group. After the application of Kinesio Taping to the injured side, there was no significant change observed in the plantar pressure distribution values (p > 0.05). The analysis of the rigid taping on the injured side revealed statistically worse values in peak pressure of the hindfoot (p = 0.027) and maximum force of the midfoot and toes (p = 0.005 and p = 0.013, respectively) compared to the injured barefoot condition. SIGNIFICANCE: Lisfranc fracture sequelae affected plantar pressure distribution on both injured and uninjured sides. Anti-pronation taping (kinesio and rigit), commonly used for foot conditions, did not lead to foot pressure distribution becoming more similar to that of the control group.

A new device for assessment and training the human balance and coordination: Marmara Balance and Education System (MarBES).

BACKGROUND: Balance and coordination are important for performing activities of daily living. Balance and coordination assessment and training are used by physiotherapists in many different rehabilitation areas. Marmara Balance and Education System (MarBES) is a device developed to evaluate and improve balance and coordination. AIMS: To examine the test-retest reliability of the MarBES device. METHODS: Double-leg and single-leg (eyes open-closed) tests were applied to healthy young adult participants for balance testing on the MarBES device. Weight data is estimated from pressure sensors located in 4 different corners and a score is calculated with computer software for the individual's center of gravity (center of pressure X, Y) and the amount of deviation from the center for each axis. Weight transfer to the target surface was measured for assessment of the participants' coordination performance. Participants rested for 10 min and all measurements were repeated by the same evaluator. The obtained data were recorded and the reliability of the measurements was evaluated with Spearman's rho correlation analysis. RESULTS: A total of 40 healthy young individuals (28 female) with a mean age of 21 years were included. The balance assessments with MarBES showed moderate to good reliability (ICC: 0.535-0.903). The coordination assessment results showed moderate to good reliability (ICC: 0.575-0.712). CONCLUSIONS: Objective evaluation of balance and coordination parameters is very important in rehabilitation. Results of the study showed that the MarBES device developed by the researchers is a reliable method for the evaluation of balance and coordination in healthy young individuals.

Cervical proprioception accuracy is impaired in patients with axial spondyloarthritis.

BACKGROUND: Proprioception is the awareness of body parts and includes joint position sense, kinesthesia, and sense of force. Cervical spine is one of the major affected areas in axial spondyloarthritis (axSpA), and is an essential region for proprioceptive receptors. OBJECTIVE: To investigate the cervical joint proprioceptive accuracy by using cervical joint positioning error (JPE) method in patients with axSpA and healthy controls. DESIGN: Cross-sectional study. METHODS: JPE was calculated for cervical motions in the directions of flexion, extension, rotations, and lateral flexions. Time since diagnosis, symptom duration, spinal mobility, functional status, quality of life, disease activity, and pain were evaluated in axSpA patients. Cervical JPE of axSpA patients was also compared according to radiographic status, biologic use, and existence of cervical syndesmophytes. RESULTS: Eighty-two axSpA patients (52 males) and 71 healthy subjects (53 males) were evaluated. Cervical JPE was higher in patients with axSpA compared to healthy subjects (p < 0.001), except left lateral flexion (p = 0.10). Cervical proprioceptive accuracy for extension and left rotation was better in biologics+ subgroup compared to biologic- subgroup (p < 0.05). No other differences were detected related to radiographic status nor existence of cervical syndesmophytes (p > 0.05). CONCLUSION: Cervical proprioception accuracy is impaired in patients with axSpA. It seems that controlling disease activity by using appropriate medication may have a positive effect on cervical proprioception accuracy.

Pedobarographic, Clinic, and Radiologic Evaluation after Surgically Treated Lisfranc Injury.

INTRODUCTION: Lisfranc injuries are rare, often missed, and may cause permanent structural deterioration of tarsometatarsal joint, despite optimal management. Consequently, a Lisfranc injury may lead to disruption of the biomechanics of the normal foot during walking and may alter the plantar pressure distribution, which is essential for proper gait mechanics. Therefore, the main purpose of the study was to specify the dynamic plantar pressure, radiographic and clinical features, after surgically managed Lisfranc injuries. METHODS: This study was carried out over a period of 10 years and included 62 patients who were surgically treated for Lisfranc injury, with mean 57-month follow-up. Radiological (intermetatarsal, Kite's, first metatarsophalangeal, Meary's, Hibbs' and calcaneal pitch angles, and medial cuneiform-fifth metatarsal distance), pedobarographical, and clinical results with the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score assessments for both feet were assessed. RESULTS: In the radiological assessment, the mean first intermetatarsal (p = 0.006) and Meary's angle (p = 0.000) were decreased on the injured feet compared to the uninjured feet on the anteroposterior and lateral radiographs. In the pedobarographic assessment, the injured feet midfoot contact time increased (p = 0.03), and maximum force (p = 0.001), total peak pressure (p = 0.008), and contact area (p = 0.017) decreased, compared to the uninjured feet. The mean AOFAS score was 75/100 at the final follow-up visit. There was seen to be reduced both contact surface area and time of the midfoot. CONCLUSION: Despite surgical management of Lisfranc injuries, the injured foot does not regain functional, radiological, or pedobarographical levels as compared to the uninjured foot for ≥ 57 months.

Musculoskeletal problems in academicians and related factors in Turkey.

BACKGROUND AND OBJECTIVE: Musculoskeletal problems are a common health problem with professional and ergonomic features. This study's purpose was to investigate the musculoskeletal problems distribution and related factors among academicians. METHODS: This study was performed by using a personal and professional information questionnaire, the Extended Nordic Musculoskeletal Questionnaire and International Physical Activity Questionnaire Short Form. RESULTS: The study was completed with 142 academicians (89 female, 53 male). Mean age was 39.91 ± 8.90 years, physical activity level was 1067.31 ± 1866.95 MET-minute/week, and work time was 13.73 ± 9.15 years. Neck and lower back pain were mostly seen in academicians and their incidence was equal (63.4%). The most experienced pain the previous year was neck pain (39.4%), and upper back pain is the most experienced pain today (19%). The body part that mostly caused the use of medication is neck pain (23%), and mostly caused limitation and sick-leave was low back in the past 12 months (respectively 19.7% and 9.2%). Gender, body mass index, weekly workload, physical activity level, and marital status have been determined to have an effect on musculoskeletal problems in academicians (p< 0.05). CONCLUSION: The most common musculoskeletal problems reported by academicians were in the upper back and neck regions, which have low level physical activity.