Aerobic exercise and dual-task training combination is the best combination for improving cognitive status, mobility and physical performance in older adults with mild cognitive impairment.

AIM: The aim of the present study was to investigate the effects of different exercise combinations on cognitive status, muscle strength of lower extremities, mobility, physical performance, mood and quality of life in older adults with mild cognitive impairment (MCI). METHODS: A total of 48 older adults with MCI were randomly assigned to four groups: (1) aerobic plus lower extremity strengthening exercises (AG), (2) dual-task training plus lower extremity strengthening exercises (DG), (3) aerobic exercise, dual-task training and lower extremity strengthening exercises (ADG), (4) solely lower extremity strengthening exercises (CG). Patients' cognitive status, lower extremity muscle strength, balance, mobility, activities-specific balance confidence, functional exercise capacity, physical performance, mood and quality of life were evaluated. RESULTS: In all three intervention groups, there was a significant improvement in cognitive status, balance, mobility, activities-specific balance confidence, physical performance, mood and quality of life (p < 0.05). The most remarkable change was observed in the ADG on cognitive status, mobility and physical performance parameters (p < 0.05). In addition, the most significant improvement in balance parameters was recorded both in the DG and ADG (p < 0.05). Besides, the highest increase in functional exercise capacity was detected both in the AG and ADG (p < 0.05). On the other hand, both exercise combinations were superior to the control group in terms of improving mood and quality of life (p < 0.05). CONCLUSION: The trial results proved that aerobic exercise and dual-task training is the best combination for improving cognitive status, mobility and physical performance in older adults with MCI.

Validity and Reliability of the Turkish Version of LHB Score.

INTRODUCTION: Long head of biceps (LHB) pathologies are an important cause of pain and dysfunction. As LHB pathologies have specific components from other underlying or related pathologies, the LHB score is designed for an accurate assessment. The aim of this study was to adapt the LHB score into Turkish and to assess its validity and reliability. MATERIALS AND METHODS: LHB score was translated and culturally adapted from English to Turkish, and then it was applied to 62 patients with biceps long head pathology. The reliability of the scale was checked through internal consistency and test-retest methods. Internal consistency was computed with Cronbach alpha value. Test-retest reliability was assessed using an intraclass correlation coefficient. American Shoulder and Elbow Surgeons Standard Shoulder Assessment Form and modified Constant-Murley score were used to analyze concurrent validity. RESULTS: The Cronbach alpha value of the scale was found as .640. When the subsections of LHB score were computed separately, Cronbach alpha levels of pain/cramps and cosmesis sections were found as .753 and .774, respectively. The intraclass correlation coefficient value of the scale was found to be excellent (.940; P < .001). The total LHB score was determined to have a good positive correlation with the American Shoulder and Elbow Surgeons Standard Shoulder Assessment Form (.527) and Constant-Murley score (.516). But an excellent correlation was revealed between the pain/cramps section of LHB score and other pain sections in American Shoulder and Elbow Surgeons Standard Shoulder Assessment Form (.811) and Constant-Murley score (.816) (P < .001). There was an excellent correlation (.916) between cosmesis section and Popeye sign (P < .001). There was a moderate correlation (.469) between elbow-flexion strength section of LHB score and the digital handheld dynamometer outcomes (P < .001). CONCLUSION: The Turkish version of the LHB is a valid and reliable tool, especially for biceps pathologies.

Western Ontario Shoulder Instability Index: cross-cultural adaptation and validation of the Turkish version.

One way to measure the effectiveness of a specific treatment is to utilize measurements designed specifically for the disorder. Western Ontario Shoulder Instability Index (WOSI) is a subjective self-report scale indicating the latest condition of the patients with shoulder instability. The objective is to study the cultural adaptation, validity, and reliability of WOSI in Turkish population with shoulder disability. First, WOSI was translated and culturally adapted from English into Turkish. Afterward, in order to determine the level of reliability, internal consistency and test-retest analyses were conducted. Reliability (test-retest) analyses were conducted by means of retest 72 h later with a sub-group of 30 patients. Construct validity of the WOSI was checked through convergent validity with Disabilities of Arm, Shoulder and Hand Scale, Rowe Score Questionnaire, Oxford Shoulder Instability Questionnaire, and Western Ontario Rotator Cuff Index by 60 patients with shoulder instability. The Turkish version of the questionnaire displayed high internal consistency (0.77-0.91) with a Cronbach's Alpha value of 0.91. As for the test-retest reliability, the ICC value was found to be high (95% CI 0.97). Floor and ceiling effects (15%) were observed neither in sub-parameters (0-4.9%) nor in total score (0%). WOSI total score was found to have a negative good correlation with the Rowe Score (r = -0.57) and a very good-excellent correlation with other questionnaires (r = 0.67-0.89). The Turkish version of WOSI is a valid and reliable scale for use in studies to evaluate the final condition of the patients with shoulder disabilities.

Effects of total hip arthroplasty on spinal sagittal alignment and static balance: a prospective study on 28 patients.

PURPOSE: The aim of this study was to investigate postoperative changes in spinal sagittal alignment and postural balance in patients with hip-spine syndrome (HSS) and to verify whether any significant correlation exists between these changes and improvement of low back pain (LBP) symptoms following total hip replacement (THR) surgery. METHODS: Twenty-eight consecutive patients with HSS undergoing unilateral THR were prospectively enrolled. Whole spine X-rays were obtained before surgery and 6 months after surgery. The following parameters were measured: cervical lordosis, thoracic kyphosis, lumbar lordosis, pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and sagittal vertical axis (C7 SVA). Patients underwent pre- and postoperative postural balance assessment (950-460 BioSwayTM system; clinical test of sensory integration-CTSIB, limit of stability test-LOS) and patient reported outcome measures assessment (Short Form-36, SF-36, Oswestry Disability Index, ODI, Visual Analog Scale, VAS and Western Ontario and McMaster Universities Arthritis Index, WOMAC). RESULTS: Mean age of the patients was 61.7 ± 6.4. Median (interquartile range, IQR) pre-operative PI and PT were 50.0 (35.0, 60.0) and 11.0 (7.0, 23.0), respectively; lumbar lordosis was 49.0 (41.0, 68.0) and SVA 5.0 (-11.0, 41.0). No significant changes in sagittal alignment were observed postoperatively. Median LBP VAS decreased from 6.0 (5.0, 7.0) to 3.0 (2.0, 4.0) and ODI from 54.0 (39.0, 64.0) to 34.0 (26.0, 48.0) (p < 0.001). Median CTSIB improved from 1.22 (1.07, 1.45) to 1.01 (0.80, 1.19) and LOS from 46.0 (42.0, 58.0) to 37.0 (32.0, 39.0) postoperatively. No significant correlation was noted between postoperative changes in spinal sagittal alignment or postural balance and improvement of LBP VAS and ODI scores. CONCLUSIONS: Our study demonstrated an improvement in LBP levels (VAS and ODI) and postural balance in patients with HSS following THR surgery. No significant changes have been noted in radiographic spinal sagittal alignment postoperatively. The improvement in LBP levels does not correlate with post-operative changes in spinopelvic alignment or postural balance.

Cross-cultural adaptation, reliability and validity of the Turkish version of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire.

BACKGROUND: Low back pain is among the most common musculoskeletal system disorders. Outcome measures are needed for the measurement of function, to establish a treatment program, and for monitoring the improvement in low back pain. There exist several questionnaires enquiring about function in low back pain. One of these is Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, whose reliability and validity were previously established. Other than the original version of the questionnaire, only its Persian version exists. The present study aims to investigate the cross-cultural adaptation, reliability and validity of the Turkish version of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire. METHODS: The study included 103 patients with low back pain. For reliability assessment of the questionnaire, test-retest and internal consistency analyses were performed. The results of test-retest analysis were assessed by Intraclass Correlation Coefficient method. For internal consistency, Cronbach Alpha value was used. Validity analyses of the questionnaire were performed by construct validity. For construct validity, convergent validity was tested. Convergent validity of the questionnaire was calculated via its correlation with suitable subscales of the Short Form-36 and the total score of the Oswestry Disability Index by using Pearson's correlation coefficient. RESULTS: Intraclass Correlation Coefficient values for test-retest reliability were found to be in the range of 0.765-0.924, which indicate a sufficient level of test-retest reliability. Cronbach's Alpha value was found to be 0.804 indicating a high internal consistency. Pearson's correlation coefficient between Japanese Orthopaedic Association Back Pain Evaluation Questionnaire to Short Form-36 and Oswestry Disability Index values were ranged between 0.424 and -0.810, indicating a good correlation. CONCLUSIONS: Considering all these data, it was concluded that the Turkish version of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire is valid and reliable.

Scapular muscle endurance, shoulder pain, and functionality in patients with rotator-cuff-related shoulder pain: a matched, case-control study.

BACKGROUND: Deficiency in scapular muscle endurance (SME) is a risk factor for rotator-cuff-related shoulder pain (RCRSP). However, the exact relationship among SME, pain, and functionality remains unclear. This study aims to compare SME, pain, and functionality in RCRSP patients to those in age-sex-matched healthy controls. METHODS: Twenty-three patients with RCRSP and 23 age-sex matched healthy controls were included in the study. SME was measured using a 1-kg dynamometer. Self-reported pain level was assessed using a visual analog scale. The Functional Impairment Test-Hand, Neck, Shoulder, and Arm (FIT-HaNSA) was also used to assess functional impairment. RESULTS: The control group had higher SME and total FIT-HaNSA scores than the patient group (P<0.05). There was a statistically significant and positive correlation between SME and FIT-HaNSA scores in both groups (P<0.05). CONCLUSIONS: SME was affected by RCRSP. Pain and functional impairment were correlated with low SME. Level of evidence: IV.

The effect of virtual reality on pain, kinesiophobia and function in total knee arthroplasty patients: A randomized controlled trial.

BACKGROUND: Virtual reality (VR) has emerged as a promising new therapeutic approach, showing promise in the treatment of patients with a variety of diseases. This study aimed to investigate the effect of VR on pain, kinesiophobia, and function in patients undergoing total knee arthroplasty (TKA). METHODS: This randomized controlled trial was performed on patients who had TKA due to osteoarthritis at Gazi University Hospital from October 2019 to August 2021. For this study, 21 female TKA patients were divided into two groups by the blocked randomization method: VR (n = 10) and exercise (n = 11). The exercise group was given a home exercise program. The VR group received immersive VR application in addition to the exercise. Pain, kinesiophobia, pain catastrophizing, knee range of motion, functional status, and quality of life were assessed. The Wilcoxon Test and Mann-Whitney U Test were used for comparison of the results. RESULTS: The VR group had a statistically significant difference in the intensity of pain at rest, at night, and during the Timed Up and Go Test (TUG), kinesiophobia, pain catastrophizing, active knee flexion, the TUG, and the stair-climb test scores (P = 0.005 (95% confidence interval (CI) (-5.000, -1.000)), P = 0.005 (95% CI (-7.000, -2.000)), P = 0.023 (95% CI (-4.000, 0)), P = 0.006 (95% CI (-15.000, -3.000)), P = 0.012 (95% CI (-19.000, -3.000)), P = 0.010 (95% CI (4.000, 17.333)), P = 0.017 (95% CI (-14.700, -0.850)), P = 0.011 (95% CI (-23.100, -1.000)), respectively). CONCLUSION: In the early period following total knee arthroplasty, using virtual reality integrated with exercise helps to reduce pain, kinesiophobia and pain catastrophizing, and to improve functional outcomes in female patients.

Reliability and validity of the Turkish version of the patellofemoral pain and osteoarthritis subscale of the KOOS.

BACKGROUND: Patellofemoral pain and patellofemoral osteoarthritis are highly prevalent knee disorders associated with pain and functional limitations. The subscale of the Knee Injury and Osteoarthritis Outcome Score for patellofemoral pain and osteoarthritis (KOOS-PF) was developed to evaluate patients with patellofemoral pain and osteoarthritis. PURPOSE: This study aims to translate the KOOS-PF into Turkish and assess its measurement properties. METHODS: The Turkish version of the KOOS-PF was tested for reliability and validity in a convenience sample of 55 patients with patellofemoral pain and/or osteoarthritis. Reliability analyses were conducted through a retest 7-14 days later with a subgroup of 35 patients. The KOOS-PF was compared with Kujala's Anterior Pain Scale (AKPS) and the Short Form-36 health survey (SF-36) to assess construct validity. Additionally, responsiveness analyses were performed on 29 patients who were followed up with a home-based exercise program three months later. RESULTS: The Turkish version of KOOS-PF has high test-retest reliability (ICC2,1 = 0.96) and internal consistency (Cronbach's α = 0.91). It has a very good correlation with the AKPS (r = 0.77) and the SF-36 physical component summary (r = 0.64) with no floor or ceiling effects. Responsiveness is confirmed by a good correlation with the global rating of change score (r = 0.51). The minimal clinically important change is 16.5 points, and the minimal important difference is 10.2. CONCLUSION: The Turkish version of the KOOS-PF is valid, reliable, and responsive for evaluating patients with patellofemoral pain and/or osteoarthritis.

The Coping Strategies Questionnaire: Translation, cultural adaptation, reliability and validity in Turkish-speaking patients with chronic musculoskeletal pain.

BACKGROUND: The use of pain coping questionnaires is advantageous when selecting cognitive and behavioral targets for chronic pain management. The objective of this study was to investigate adaptation, validity, and reliability of the Coping Strategies Questionnaire (CSQ) in Turkish population with chronic musculoskeletal pain. METHODS: The Turkish version of the questionnaire (CSQ-T) was checked in terms of reliability and validity with a convenience sample of 123 patients with chronic musculoskeletal pain. Reliability (test-retest) analyses were conducted by means of a retest 48 hours later with a sub-group of 40 patients. Construct validity of the CSQ was checked through convergent validity with the Hospital Anxiety and Depression Scale (HADS) and the Short Form-36 (SF-36) health survey. RESULTS: Cronbach's alpha of the subscales ranged from 0.814 to 0.934 and the test-retest reliability ranged from 0.800 to 0.944. Neither floor nor ceiling effects (15%) were found in the subscales (13.8%) and the total score (4.1%) of the CSQ-T. Factor analysis indicated that the scale had two factors. The total CSQ-T score was correlated with both the HADS (r: -0.636/-0.549) and the SF-36 (r: 0.701/0.768). CONCLUSION: The CSQ-T is a reliable and valid measure for assessing patients with chronic musculoskeletal pain.

Proprioception following the Anterior Cruciate Ligament Reconstruction with Tibialis Anterior Tendon Allograft.

After the anterior cruciate ligament (ACL) reconstruction, a loss of proprioception is observed and it can continue years after the operation. The aim of this study is to evaluate proprioception in standing position at different knee flexion angles in patients who underwent ACL reconstruction with tibialis anterior tendon allograft. The study included 34 patients who underwent ACL reconstruction with tibialis anterior tendon allograft and 34 healthy individuals. Proprioception was evaluated in standing position at 15°, 30°, 60° flexion angles with the active joint position sense (AJPS) method using digital inclinometer. Proprioception deviation angle was found to be higher in the operated leg at 30° and 60° flexion angles in the patient group compared with the other leg (p < 0.05), the biggest proprioception difference was between the 15° and 60° flexion angles in both the patient and the control group (p < 0.05) that the difference between 15° and 30° flexion angles is lowest (p < 0.05), and that these differences are higher in the operated leg of the patient group compared with the other leg of the patient group and to the dominant leg of the control group (p < 0.05). As approximately 4 years after ACL reconstruction with tibialis anterior tendon allograft, loss of proprioception at 60° knee flexion continued, ACL injury related to loss of proprioception may occur at angles higher than 30° flexion. Thus, patients may be provided with proprioception-enhancing rehabilitation in the long term, particularly, at flexion angles above medium levels.

Adaptation of the Lawton Instrumental Activities of Daily Living Scale to Turkish: Validity and Reliability Study.

BACKGROUND: The Lawton Instrumental Activities of Daily Living (IADL) scale is the most widely used scale for the assessment of IADL in the elderly population. The aim of this study was to adapt the Lawton IADL Scale in Turkish and to investigate the validity and the reliability of the scale in older adults. METHODS: A total of 80 participants with a mean age of 71.6±5.8 years were included in the study. The independent living skills of the older adults were measured using Lawton IADL, Hodkinson Mental Test, Functional Independence Scale, Barthel Index, Katz Index, and visual analog scale. Lawton IADL was translated into Turkish, validated by professional reviewers, translated back into English, and then tested. Cronbach's alpha was used to measure reliability in a group of 34 participants and test-retest was performed 1 week after the first test. Pearson correlation analysis was used to show the relationship between Lawton IADL and other scales and indexes. RESULTS: Internal consistency (Cronbach's alpha) value was 0.843 for the whole scale. The intraclass correlation coefficient value of the scale was 0.915. CONCLUSION: These results confirm that the Turkish version of the Lawton IADL scale has excellent reliability and validity.

Cross-cultural adaptation, and validation of the Turkish version of the Nonarthritic Hip Score.

OBJECTIVE: The aim of this study was to translate and cross-culturally adapt the Nonarthritic Hip Score (NAHS) into Turkish and determine the validity and reliability of the translated version in physically active patients with hip pain. METHODS: Sixty young to middle-aged and physically active patients (34 women and 26 men; mean age=35 years; age range: 18-40 years) with hip pain were included in the study. The original version of the NAHS was first translated into Turkish and back-translated into English by two bilingual translators each. The back-translated version was compared with the initial English version by a committee of the four translators. The Turkish version was then tested with 15 patients with hip pain and 15 healthy individuals. The participants were asked whether they had difficulties in understanding the questions. Subsequently, the questionnaire was accepted for use in the study population. Test-retest reliability and internal consistency were assessed using Intraclass Correlation Coefficient (ICC) and Cronbach's alpha, respectively. The construct validity was determined via the Pearson correlation coefficient between the NAHS and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), modified Harris Hip Score (mHHS), and Short Form-12 (SF-12). Floor and ceiling effects were analyzed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to test construct validity. RESULTS: An ICC of 0.994 and Cronbach's alpha value of 0.908 were obtained; thus, the Turkish version of the NAHS was reliable. Neither floor nor ceiling effects (15%) were found in the sub-parameters (8.3-1.7%) and the total score (1.7%) of the NAHS. The EFA test showed that this questionnaire had four factors. Model fit indices in CFA were χ2/df=2.23, Tucker-Lewis index=0.90, comparative fit index=0.91, goodness of fit index=0.63, root mean square error of approximation=0.14 (90% CI: 0.12-0.16). The NAHS total score showed an excellent correlation with WOMAC (r=-0.909), mHHS (r=0.850), and SF-12 (r=0.811) scores. CONCLUSION: The Turkish version of the NAHS is a valid and reliable questionnaire for young and physically active patients with hip pain. LEVEL OF EVIDENCE: Level II, Diagnostic study.

Translation, cultural adaptation, reliability, and validity of the Turkish version of the Penn Shoulder Score.

PURPOSE: The purpose of this study is to translate the Penn Shoulder Score into Turkish and to establish its cultural adaptation, reliability, and validity in patients with shoulder dysfunctions. METHODS: The Penn Shoulder Score was translated and culturally adapted from English into Turkish. Subsequently, the Penn Shoulder Score, the Constant Score, the American Shoulder and Elbow Score, and the Western Ontario Rotator Cuff Index were completed by 97 patients with shoulder dysfunctions. To determine the test-retest reliability, 30 patients completed the Penn Shoulder Score again on day 3. Intraclass correlation coefficient and Cronbach alpha were calculated to assess reliability. The validity of the questionnaire was assessed in terms of convergent validity with Pearson Correlation Coefficient using the Constant Score, the American Shoulder and Elbow Score, and the Western Ontario Rotator Cuff Index. RESULTS: Internal consistency was good, with a Cronbach alpha of 0.81. The Intraclass correlation coefficient was 0.90 (95% confidence interval: 0.78, 0.90), demonstrating good test-retest reliability. Pearson correlation coefficients of the Penn Shoulder Score in relation with the Constant Score, the American Shoulder and Elbow Score, and the Western Ontario Rotator Cuff Index were 0.65, 0.78, and -0.77, respectively. CONCLUSION: The Turkish version of the Penn Shoulder Score is a reliable and valid measure for assessing patients with shoulder dysfunctions. Implications for Rehabilitation The Turkish version of the Penn shoulder score is valid and reliable outcome measure for assessing patients with shoulder dysfunctions. The Turkish version of the Penn shoulder score could be easily performed by patients and it is easy to score by clinicians. It is recommended to use in clinical settings and in research.

Relationship between scapular muscle and core endurance in healthy subjects.

BACKGROUND: Scapular muscle endurance and core endurance reportedly influence shoulder injury risk. The exact relationship between scapular muscle endurance and core endurance, and how they impact one another in the healthy subjects remain unclear. OBJECTIVE: To investigate the relationship between scapular muscle endurance and core endurance in healthy subjects. METHODS: Fifty healthy volunteers (23 males, 27 females; mean age 20.42 ± 1.04 years) were participated in this study. Endurance of the serratus anterior and trapezius muscles was assessed using the scapular muscle endurance test. Sorensen test (endurance of trunk extensor muscles), trunk flexor endurance test, and side bridge test (endurance of lateral core muscles) were conducted to assess the core endurance. Pearson's product moment correlations examined relationships between scapular muscle endurance and each of the core endurance tests scores. RESULTS: Scapular muscle endurance test scores showed a positive correlation with the side bridge test scores (r = 0.414; p = 0.003). No significant correlation was found between scapular muscle endurance test scores and the other core endurance tests scores (p > 0.05). CONCLUSIONS: There appears to be a link between the scapular muscle endurance and lateral core muscles in healthy subjects; however, more research is needed to provide a definitive answer on the nature of this relationship. Further studies involving patients with shoulder pathology are warranted.

Mild hallux valgus angle affects single-limb postural stability in asymptomatic subjects.

BACKGROUND: Single-limb postural stability is a key component of lower extremity functional status. Factors affecting postural stability should be well defined to prevent injuries. OBJECTIVE: The aim of this study was to investigate the effect of the hallux valgus angle on postural stability in asymptomatic subjects. METHODS: A total of 19 subjects were included in the study. The hallux valgus angle and postural stability were assessed. Participants were assigned to two groups according to whether the hallux valgus angle was pathological or not. A hallux valgus angle greater than 15 degrees was accepted as pathological. The relationship between the hallux valgus angle and postural stability, and the differences in postural stability scores between the two groups were analyzed. Postural stability was assessed with a stabilometer. The test was performed with the eyes open. RESULTS: We found a significant correlation between the hallux valgus angle and mediolateral and overall stability index (r= 0.484, p= 0.036; r = 0.463, p= 0.046 respectively). Subjects with a pathological mild hallux valgus angle had greater stability index scores than normal subjects (p< 0.05). CONCLUSIONS: A mild hallux valgus angle has negative effects on postural stability as a forefoot deformity. This deformity should be taken into account for injury prevention strategies in pain-free younger adults.

Does presence of anterior greater tuberosity cysts change the function in patients with chronic rotator cuff tear?

OBJECTIVES: This study aims to compare rotator cuff muscle atrophy with fatty degeneration, tear size, range of motion, shoulder muscle strength, pain and upper extremity function in patients with chronic rotator cuff tear, and with or without anterior greater tuberosity cyst. PATIENTS AND METHODS: A total of 101 patients (32 males, 69 females; mean age 51 ± 12.9 years; range 17 to 76 years) were evaluated in this study. Fifty-eight patients were excluded due to traumatic or acute rotator cuff tears and neck pain. Forty-three patients of chronic rotator cuff tear were divided into two groups as patients with (n=15) and without (n=28) an anterior greater tuberosity cyst. Patients were evaluated for range of motion, shoulder muscle strength, pain and upper extremity function, and radiologically. Statistical differences were investigated between two groups. RESULTS: The number of patients with tears larger than 1 cm and the number of patients who had muscle atrophy were higher in the group of patients with a cyst. Also, upper extremity function was reduced in the group of patients with a cyst (Western Ontario Rotator Cuff Index, p=0.03, Nine-Hole Peg Test, p=0.02). CONCLUSION: Our findings demonstrated that decreased function, larger cuff tears and muscle atrophy can be observed patients with anterior greater tuberosity cysts. Anterior greater tuberosity cysts can be detected by plain X-rays. The presence of these cysts should warn the physician regarding the possibility of decreased shoulder function, muscle atrophy and larger cuff tear before ordering a magnetic resonance imaging.

Differences in strength, flexibility and stability in freestyle and Greco-Roman wrestlers.

BACKGROUND AND OBJECTIVES: Wrestling includes a variety of functional properties: muscular strength, flexibility, neuromuscular coordination, and static and dynamic balance. The aim of the study was to identify differences in the strength, flexibility, postural stability and core stabilization of young national and international wrestlers in different weight groups. MATERIAL AND METHOD: Eighty-one male wrestlers (17-21 years old) were divided into 6 groups according to their body mass (light, middle and heavy) and wrestling style. The lumbosacral flexion, extension and lateral flexion range of motion, hamstring extensibility, back and leg muscle strength, postural stability, and core stabilization were assessed. RESULTS: Greco-Roman wrestlers had a higher lean body mass (6-12%) compared with freestyle wrestlers. However, the trunk lateral flexion flexibility was better in the Greco-Roman wrestlers (6-7%) than in the freestyle wrestlers, and the absolute back strength (BS) and leg strength (LS) were similar for both styles of wrestling. The BS/LBM and LS/LBM in the freestyle wrestlers were greater than in the Greco-Roman wrestlers, and the Light weight Greco-Roman wrestlers had the highest BS/LBM. The heavy weight Greco-Roman wrestlers and the light weight freestyle wrestlers had the greatest LS/LBM values. The postural control was similar for the two styles of wrestlers; however, the heavy weight Greco-Roman wrestlers had greater postural control in all directions compared with the light and middle weight Greco-Roman wrestlers. The core stabilization did not differ for the Greco-Roman and freestyle wrestlers except in the lateral bridge. CONCLUSION: The style of wrestling demonstrates different strength, flexibility and stability demands on the body. The differences between Greco-Roman and freestyle wrestlers may be due to the wrestling style differences in training and to competition-related demands. LEVEL OF EVIDENCE: Comparative study, level lV (case series).

Assessment of function in patients with rotator cuff tears: Functional test versus self-reported questionnaire.

PURPOSE: The rotator cuff tears (RCT) are a well-known cause of shoulder pain and loss of upper extremity function. The purpose of this study was to evaluate the upper extremity function using two different methods in patients with RCT and to determine the parameters that influence the upper extremity function. MATERIALS AND METHODS: A sample of 38 patients (27-76 years; 10 men and 28 women) who were diagnosed with a chronic full-thickness RCT, confirmed by magnetic resonance imaging (MRI), was studied. Upper extremity function was determined using Western Ontario Rotator Cuff Index (WORC) and 9 Hole Peg Test (9PEG). Other assessments included active range of motion (ROM), muscle strength, shoulder pain, and scapular dyskinesis. RESULTS: There was a weak association between WORC scores and 9PEG. A statistically significant, negative relationship was found between 9PEG and ROM in supination, as well as muscle strength of shoulder extensors, adductors, internal and external rotators. CONCLUSIONS: In addition to the weak association between WORC and 9PEG, the difference between the parameters related to each method suggests that they should not be used interchangeably to determine the upper extremity function. We recommend the utilization of 9PEG instead of WORC in assessing the upper extremity function in the setting of loss of muscle strength. LEVEL OF EVIDENCE: Level IV, Therapeutic study.

Malpractice leading to secondary lymphedema after radical mastectomy: case report.

BACKGROUND: With this case report we want to demonstrate the results of chemotherapy application to the mastectomized side in a patient who had undergone radical mastectomy. CASE REPORT: A patient who was accidentally given chemotherapy on the mastectomized side (PCMS) and a control patient who received chemotherapy on the non-affected side (PCNS) were included in this study. Edema, pain, muscle strength, and shoulder mobility were evaluated. The results of the 2 patients were compared. After chemotherapy, PCMS experienced edema and pain in the affected arm compared to PCNS. Increased circumference measurement, and decreased shoulder mobility and muscle strength were observed in PCMS. CONCLUSION: It was suggested that chemotherapy application on the mastectomized side triggered lymphedema. Our findings on the subject revealed that education of health care professionals and patients alike is very important.