Kinesiophobia, physical activity levels and barriers in breast cancer patients, survivors, and healthy controls: A case-control analysis.

OBJECTIVE: To investigate kinesiophobia, physical activity levels and barriers to physical activity in women with breast cancer and breast cancer survivors. METHODS: The case-control study was conducted at the Breast Clinic of Acibadem Maslak Hospital, and the Department of Physiotherapy and Rehabilitation at Acibadem Mehmet Ali Aydinlar University, Turkey, from October 2021 to July 2022, and comprised patients with breast cancer in group A, breast cancer survivors in group B and healthy controls in group C. The primary outcome measures were physical activity levels, barriers to physical activity and kinesiophobia levels, while the secondary outcome measures were levels of anxiety, depression, fatigue and quality of life. Data was collected using standard tools. Data was analysed using SPSS 22. RESULTS: Of the 212 women, 70(33%) were in group A with mean age 50.71±11.30 years, 70(33%) in group B with mean age 47.64±9.85 years, and 72(34%) in group C with mean age 47.03±7.48 years. Group C had better physical activity levels, fatigue and quality of life scores than the other groups, but it had worse perceptions of physical activity and more individual, psychosocial and environmental barriers to physical activity compared to the other groups (p<0.05). Group A had more barriers to exercise related to fear of overall body pain, poor balance, fear of falling and fear of feeling worse post-exercise compared to the other groups (p<0.05). Group B subjects were more afraid that lymphoedema might be exacerbated if they exercised (p<0.05). CONCLUSIONS: Women with breast cancer and breast cancer survivors had worse scores for physical activity levels, fatigue and quality of life compared to the healthy controls. All three groups had a variety of barriers to physical activity.

Effects of moderate aerobic exercise, low-level laser therapy, or their combination on muscles pathology, oxidative stress and irisin levels in the mdx mouse model of Duchenne muscular dystrophy.

This study aimed to investigate how the combined use of low-level laser therapy (LLLT) and exercise, to reduce the possible side effects and/or increase the benefits of exercise, would affect oxidative stress, utrophin, irisin peptide, and skeletal, diaphragmatic, and cardiac muscle pathologies. In our study, 20 mdx mice were divided into four groups. Groups; sedentary and placebo LLLT (SC), sedentary and LLLT (SL), 30-min swimming exercise (Ex), and 30-min swimming exercise and LLLT (ExL). After 8 weeks of swimming exercise, muscle tests, biochemically; oxidative stress index (OSI), utrophin and irisin levels were measured. Skeletal, diaphragmatic and cardiac muscle histopathological scores, skeletal and cardiac muscle myocyte diameters were determined under the light and electron microscope. While only irisin levels were increased in group SL compared to SC, it was determined that OSI, heart muscle histopathological scores decreased and irisin levels increased in both exercise groups (p < 0.05). In addition, in the ExL group, an increase in rotarod and utrophin levels, and a decrease in muscle and diaphragm muscle histopathological scores were observed (p < 0.05). It was determined that the application of swimming exercise in the mdx mouse model increased the irisin level in the skeletal muscle, while reducing the OSI, degeneration in the heart muscle, inflammation and cardiopathy. When LLLT was applied in addition to exercise, muscle strength, skeletal muscle utrophin levels increased, and skeletal and diaphragmatic muscle degeneration and inflammation decreased. In addition, it was determined that only LLLT application increased the level of skeletal muscle irisin.

The psychometric properties of the Turkish version of the pectus carinatum body image quality of life questionnaire.

PURPOSE: The present study aimed to evaluate the psychometric properties of the Turkish version of the Pectus Carinatum Body Image Quality of Life Questionnaire (PeCBI-QOL), which was originally created in American English in patients with pectus carinatum (PC). METHODS: The study included 52 volunteer patients with PC, aged 10-18 years. Cronbach α was used to assess internal consistency. Intraclass correlation coefficient (ICC) was used to estimate the test-retest reliability. Construct validity was analyzed with the Pectus Excavatum Evaluation Questionnaire (PEEQ). RESULTS: The reliability of the Turkish version of the PeCBI-QOL was found to have acceptable to excellent internal consistency (Cronbach's α coefficient = 0.701-950). Test-retest reliability calculated for investigating the reliability of the questionnaire over time was found to be excellent (ICC = 0.817-0.983). Construct validity of the PeCBI-QOL (child and parent form) was found to be correlated with all subscales in the PEEQ questionnaire (r = - 0.425 to 897, p < 0.001) except the treatment motivation subscale (r = 0.033-0.111, p = 0.439-0.816). CONCLUSION: We determined that the Turkish version of the PeCBI-QOL questionnaire was valid and reliable for the assessment of body image and quality of life in Turkish patients with PC. PeCBI-QOL questionnaire, a self-assessment one, will assist Turkish clinicians who wish to assess body image and quality of life of patients with PC.

Acute Effects of Cold Pack for Different Periods on the Biomechanical Properties of the Rectus Femoris Muscle.

CONTEXT: Cold packs are silica gel packs that are commonly used in clinics. However, the packs are applied for various amounts of time, and the relationship between these times and temperature changes isn't fully understood. OBJECTIVES: The study intended to investigate the acute effects of cold-pack application for different periods of time on the biomechanical properties of the rectus femoris muscle. DESIGN: The study was randomized, controlled trial. SETTING: The study took place at Acibadem Mehmet Ali Aydinlar University in Istanbul, Turkey. PARTICIPANTS: Participants were 60 healthy volunteers from the community, aged 18 to 23 years. INTERVENTIONS: Participants were divided into four groups with n = 15 in each group. The cold packs were applied on the dominant rectus femoris muscle: (1) for 10 minutes in Group 1, (2) for 12 minutes in Group 2, (3) for 15 minutes in Group 3, and (4) for 20 minutes in Group 4. OUTCOME MEASURES: The outcome measures were the skin temperature, determined using a thermal camera, and biomechanical properties-tone and stiffness and muscle decrement-using a device that delivers a short mechanical impulse to the tissue. Outcomes were measured at baseline before the cold application, immediately post intervention after the cold application, and at 5, 10, 15, 20, and 30 minutes post intervention. RESULTS: The mean skin temperatures were significantly lower in all groups compared to those before cold application (P < .05), and no significant differences existed between any of the groups (P > .05). Post intervention, while Groups 1 and 2 showed an increase in muscle tone and stiffness and a decrease in elasticity (P < .05), they began to approach their baseline state by the fifth and fifteenth minutes, respectively (P > .05). In Groups 3 and 4, the muscle stiffness increased at all time points (P < .05). CONCLUSIONS: The study showed that the rectus femoris muscle of healthy people becomes stiffer and less elastic as a result of cooling with cold packs that were applied for different time periods. The amount of cold-pack time that minimized the biomechanical corruption of the muscle and provides cooling was 10 minutes. Careful warming up is recommended before and after intense athletic performance, and caution in cooling the skeletal muscle should be exercised.

Comparison of physical functions and psychosocial conditions between adolescents with pectus excavatum, pectus carinatum and healthy controls.

PURPOSE: The present study aimed to compare the physical and psychosocial conditions of adolescents with pectus excavatum (PE) and pectus carinatum (PC), who had mild-severe deformities, with those of healthy controls (HC). METHODS: This study included 180 adolescents (aged 10-18 years) with pectus deformity [PE (n = 90) and PC (n = 90)] and 90 age-matched HC. The following parameters were evaluated for each participant: clinical parameters, perceived appearance of the chest area (PAC), physical functions (grip strength, flexibility, muscle strength, endurance, physical activity), posture, psychosocial conditions, and quality of life (QOL). RESULTS: Patients with PE and PC had a lower body weight, a worse, a poorer posture, lower scores for physical functions compared to the HC group (p < 0.001, all). The PE group had lower scores (p < 0.05) for some psychosocial conditions and quality of life subscales compared to the HC and PC (except for the QOL) group (p < 0.05). The PC group had a poorer posture compared to the PE group (p < 0.05). PAC was associated with physical functions and psychosocial status (r = 0.19-0.40, p < 0.05) but pectus severity was not associated with these parameters (r = 0.02-0.12, p > 0.05). CONCLUSION: Our results indicate that all adolescents with mild, moderate, or severe pectus deformity should undergo a biopsychosocial evaluation, receive psychosocial support, and be referred for physiotherapy.

Comparison of the Immediate Effect of Petrissage Massage and Manual Lymph Drainage Following Exercise on Biomechanical and Viscoelastic Properties of the Rectus Femoris Muscle in Women.

CONTEXT: Fast and adequate recovery after exercise and activity is important for increasing performance and preventing injuries. Inadequate recovery usually causes changes in the biomechanical and viscoelastic properties of the muscle. OBJECTIVE: To compare the immediate effect of petrissage massage (PM) and manual lymph drainage (MLD) following submaximal exercise on the biomechanical and viscoelastic properties of the rectus femoris muscle in healthy women. DESIGN: Cross-sectional, repeated-measures. SETTING: Marmara University. PARTICIPANTS: 18 healthy female students. INTERVENTION(S): Following the submaximal quadriceps strengthening exercise performed in 3 sets of 8 repetitions with intensity of 75% of 1 maximum repetition, participants' right leg received a 5-minute PM (PM group) and the contralateral leg received a 5-minute MLD application (MLD group). MAIN OUTCOME MEASURES: Skin temperature was measured using P45 thermographic thermal camera (Flir System; ThermaCAM, Danderyd, Sweden), and muscle tone, biomechanical, and viscoelastic features were measured with a myometer (Myoton AS, Tallinn, Estonia) at baseline, immediately postexercise, post-PM/MLD application, and 10 minutes postexercise. RESULTS: In the PM group, the tonus (P = .002) and stiffness (P < .001) values measured after the massage and at the end of the 10-minute resting period were found to be statistically different than those measured right after the exercise (P < .05). Relaxation time and creep values at all measurement times were significantly different (P < .05). In the MLD group, it was observed the tonus (P < .001), stiffness (P = .025), and relaxation time (P < .01) values decreased significantly after the MLD compared with the values measured after the exercise; however, the creep value was found to be significantly different in all measurements (P < .05). CONCLUSION: PM and MLD reduce passive tissue stiffness and improve the extent of muscle extensibility over time against the muscle tensile strength. PM and MLD are therapeutic methods that can be used to support tissue recovery after exercise and prevent injuries.

Does physiotherapy applied in conjunction with compression brace treatment in patients with pectus carinatum have efficacy? A preliminary randomized-controlled study.

PURPOSE: Non-invasive treatment of pectus carinatum (PC) deformity includes the use of a compression brace and exercises. In this study, we aimed to examine the effect of a physiotherapy protocol applied as adjunct to compression brace treatment in patients with PC. METHODS: The study included 30 male patients between 11 and 18 years of age. Patients were randomly assigned into two groups: a brace treatment only group (Group 1) and a brace and physiotherapy group (Group 2). Patient demographics and disease-related properties, protrusion measurements, postural evaluations, deformity perceptions, life quality, and treatment satisfaction were evaluated. RESULTS: Although both groups showed improvements based on external chest measurements related to PC protrusion following treatment (p < 0.001), Group 2 had more benefit from the treatment (effect size > 0.36) and displayed greater improvement in maximum protrusion degree and lateral length values (p < 0.05). Additionally, we found that patient perception of deformity, posture, psychological life quality, and treatment satisfaction scores were significantly better in Group 2 (p < 0.05). CONCLUSION: Owing to the satisfaction and additional benefits observed in the physiotherapy group, we think that a proper cardiopulmonary and musculoskeletal exercise program should be applied concurrently with brace treatment for patients with PC deformity. Nevertheless, long-term outcomes need to be clarified in future studies.

Translation and cross-cultural adaptation of the extended version of the Nordic musculoskeletal questionnaire into Turkish.

OBJECTIVES: The purpose of this study was to translate and culturally adapt the Extended Version of the Nordic Musculoskeletal Questionnaire (NMQ-E) for use in Turkey. METHODS: The cross-cultural adaptation was achieved by translating the items from the original version, with back-translation performed by independent mother-tongue translators, followed by committee review. Reliability (internal consistency and test-retest) was examined for 132 students (97 females, 35 males; mean±SD age: 19.91±1.24 years, mean±SD body mass index: 21.77±3.31 kg/m2) who completed the NMQ-E twice (with a 1 week interval). Construct validity was analyzed with the Cornell Musculoskeletal Discomfort questionnaire. Cronbach alpha was used to assess internal consistency. Intraclass correlation coefficient (ICC) and prevalence-adjusted bias-adjusted kappa (PABAK) were used to estimate the test-retest reliability. All of the statistical analyses were performed by using SPSS (version 22.0). RESULTS: The Turkish version of the NMQ-E showed adequate internal consistency (Cronbach coefficient α=.78). The test-retest reliability was examined with PABAK and all items showed moderate to almost perfect reliability (PABAK=0.610-0.955), excellent ICC= 0.88 and good construct validity (p<0.001). CONCLUSIONS: The Turkish version of the NMQ-E has applicable psychometric properties, including good test-retest reliability, internal consistency and construct validity.

The relationships between pain beliefs and kinesiophobia and clinical parameters in Turkish patients with chronic knee osteoarthritis: a cross-sectional study.

OBJECTIVE: To investigate the relationships of pain beliefs with clinical/functional status and kinesiophobia in patients with knee osteoarthritis. METHODS: The descriptive cross-sectional study was conducted at the Department of Physical Therapy and Rehabilitation, Acibadem Hospitals Group, Istanbul, Turkey, between May 2015 and April 2016, and comprised chronic patients who were either overweight or obese. Patients were evaluated using visual analogue scale, Western Ontario and McMaster University Osteoarthritis Index, Lequesne Index (LI), Tampa Scale for Kinesiophobia and the Pain Beliefs Questionnaire. Statistical analysis was done using SPSS 15. . RESULTS: Of the 78 patients, there were 10(13%) males, 68(87%) females with an overall mean age of 56.09}11.79 years and mean body mass index of 29.3}4.91. There were moderate positive correlations among kinesiophobia, pain and functional scores, while organic pain beliefs had a moderate positive correlation with body mass index scores and positive weak correlations with clinical/functional status scores and kinesiophobia (p<0.05 each). There were no associations between the organic subscale and psychological subscale of the Pain Beliefs Questionnaire (p>0.05).. CONCLUSIONS: Possible fear of movement and pain belief should be taken into consideration in the management of patients with knee osteoarthritis.

Comparison of the long-term effectiveness of progressive neuromuscular facilitation and continuous passive motion therapies after total knee arthroplasty.

[Purpose] The aim of this longitudinal study was to examine the long term functional effectiveness of proprioceptive neuromuscular facilitation (PNF) after total knee arthroplasty. [Subjects and Methods] We included 30 patients and they were randomly assigned to two groups. In addition to the standard rehabilitation program the PNF group received proprioceptive neuromuscular facilitation therapy and the CPM group received continuous passive motion therapy. The outcome measures included range of motion using a goniometer, pain scores using a numeric pain rating scale, days to reach functional benchmarks, the Beck depression scale and isokinetic torque and isometric strength measurements. [Results] There were no significant differences between the two groups in terms of baseline demographic data, clinical findings and length of stay. Days to reach range of motion benchmarks were similar in the two groups. Pain at the 8th week was slightly higher in the PNF group. With the exception of walking with a walker, days to reach functional benchmarks were statistically significantly fewer in patients of the PNF group despite similar isokinetic measurements. Administration of PNF resulted in earlier functional gains in patients after total knee arthroplasty. These functional accomplishments were more pronounced in the PNF group despite it having isokinetic torque measurements similar to those of the CPM group. [Conclusion] PNF techniques can positively affect functional outcomes over the long term.

The immediate effect of thoracolumbar fascia taping on biomechanical properties, low back pain and balance in individuals with transfemoral amputation.

BACKGROUND: In individuals with transfemoral amputation (TFA), adaptations caused by prosthesis use may adversely affect contractile/noncontractile structures. OBJECTIVE: To investigate the immediate effect of the thoracolumbar fascia (TLF) kinesiology taping (KT) on the tone and stiffness of the fascia, low back pain (LBP) and standing balance in individuals with TFA. METHODS: Syrian male participants with TFA were enrolled in the prospective, single-blind, randomised controlled trial. Participants were divided into two groups: Experimental (EG with KT, n= 15) and Control (CG with sham KT, n= 14). A 6-minute walk test (6MWT) was performed, after which KT was applied. Measurements were taken at baseline, immediately after the 6MWT and 30 minutes after KT. RESULTS: Although pain decreased below baseline in both groups at 30 minutes post intervention (p< 0.001), the rate of pain reduction was significantly higher in the EG (p= 0.016). Anterior-posterior sway with eyes open improved significantly 30 minutes after KT application only in the EG (p= 0.010). In the eyes closed condition, anterior-posterior and medio-lateral sway decreased significantly compared to baseline 30 minutes after taping in the EG (p= 0.010-0.032). CONCLUSION: KT can be used as an effective method to support standing balance and reduce LBP in individuals with TFA.

Occupational perceptions of physiotherapists and physiotherapy students in Turkey: A comparative study.

BACKGROUND: The social position, perceived prestige and image of a profession are often of interest to members of that profession, and physiotherapy is no exception. OBJECTIVE: The aim of this study was to examine the perceived occupational prestige and image of physiotherapists and physiotherapy students in Turkey. METHODS: 235 physiotherapy students and 465 physiotherapists were included in the study. A survey questioning occupational image, job satisfaction and prestige of the profession according to eight occupations was completed by the participants online. RESULTS: In terms of prestige, physiotherapy students ranked their profession fourth among eight undergraduate professions, while physiotherapists ranked their profession fifth. Compared to physiotherapists, physiotherapy students had more positive perceptions about their children becoming physiotherapists, the image of the profession in the eyes of the society, and job satisfaction (p < 0.05). Professional expectations of physiotherapists were higher than students. In addition, physiotherapists working for more than ten years had more positive perceptions about their children becoming physiotherapists, the public image of the profession, income level, and social standing, although perceived job satisfaction and need status were lower compared to physiotherapists with less than ten years of experience (p < 0.05). CONCLUSION: While physiotherapy students in Turkey perceived the prestige of the physiotherapist profession at a moderate level compared to other undergraduate professions, physiotherapists had a slightly lower perception of professional prestige compared to students. More comprehensive studies are needed on this subject.

Psychometric properties of the Turkish version of the Pectus Carinatum Evaluation Questionnaire used in patients with pectus carinatum treated with compression orthosis.

BACKGROUND: The Pectus Carinatum Evaluation Questionnaire (PCEQ) was developed for use in patients with pectus carinatum (PC) treated with compression orthosis. The questionnaire can be used to develop a strict program in the early follow-up period or to improve patients' compliance with the treatment after treatment initiation and to improve the quality of life. OBJECTIVE: This study aimed to evaluate the psychometric properties of the Turkish version of the PCEQ in patients with PC treated with compression orthosis. STUDY DESIGN: Validity and reliability study. METHODS: This study included 52 volunteer patients with PC, aged 10-18 years. The Cronbach α coefficient, a measure of internal consistency, was used to check questionnaire reliability, and test-retest reliability (intraclass correlation coefficient) was used to check consistency over time. Construct validity was analyzed (correlation analysis) with the days/hours of orthosis use. RESULTS: The reliability of the Turkish version of the PCEQ was found to have acceptable-to-sufficient-to-excellent internal consistency (Cronbach α coefficient = 0.701-915). Test-retest reliability calculated for investigating the reliability of the questionnaire over time was found to be excellent (intraclass correlation coefficient = 0.880-0.941). Furthermore, treatment compliance hours (r = 0.280, P = 0.044) and days (r = 0.299, P = 0.032) were found to be associated with parents' influence at a low level and with time to compliance at a moderate level (r = -0.449-457, P = 0.001). CONCLUSION: The Turkish version of the PCEQ used in patients with PC treated with compression orthosis was found to have sufficient-to-excellent validity and reliability and could be used to develop a strict program for patients with PC using the orthosis or to improve patients' treatment compliance after treatment initiation. Using this questionnaire may be important to assist the team members in the clinical decision-making process.

Acute effects of cold spray application on mechanical properties of the rectus femoris muscle in athletes.

INTRODUCTION: Cold spray is a form of cryotherapy used in acute injuries at sports medicine. In the current study, we aimed to investigate the acute effect of cold spray application as a treatment strategy for acute sports injuries on the mechanical properties of the rectus femoris muscle in athletes. METHODS: The study included 23 volunteer active male athletes between the ages of 18-23 with a subepidermal fold thickness of the rectus femoris muscle between 5 mm and 15 mm. Skin temperature (thermal camera) and mechanical property evaluations of the muscle (Myoton Pro) were measured before, immediately after, and in 2 min, 5 min, 10 min and 15 min intervals following cold spray application. RESULTS: The skin temperature value of the athletes were significantly lower even in the 15-min interval following application (p < 0.001). Muscle tone increased significantly after the application and in the second minute compared to the pre-application (p < 0.001). Muscle stiffness increased significantly only after the second and fifth minutes compared to the pre-application (p < 0.001). Muscle decrement showed an increase in all time-points compared to the pre-application (p < 0.05). CONCLUSION: In athletes, the rectus femoris muscle has been observed to become harder and less elastic following cooling with cold spray. These changes did not improve completely following the 5 min. The muscle regained its mechanical properties at the earliest approximately 10 min after the cold spray application.

Proprioceptive based training or modified constraint-induced movement therapy on upper extremity motor functions in chronic stroke patients: A randomized controlled study.

BACKGROUND: The Modified Constraint-Induced Movement Therapy (mCIMT) method is a unilateral training that respectively avoids and activates less affected and affected sides of upper extremities; however, the selected options are not typically ideal. Proprioceptive based training (PT) includes bilateral training methods and influencing proprioceptive receptors. OBJECTIVE: The primary purpose was to determine if conventional therapy and PT or conventional therapy and mCIMT therapy show similar improvement in patients with chronic stroke. The secondary purpose was to investigate the effectiveness of conventional therapy and PT or mCIMT therapy in patients with chronic stroke and to compare which of the two interventions is more effective. METHODS: Forty patients with chronic stroke were randomly allocated to only conventional therapy (PTR, n = 14), conventional therapy plus proprioception training (PTR-PT, n = 13), and mCIMT (PTR-mCIMT, n = 13) groups. Evaluations were assessed before and 6 weeks after treatment. RESULTS: Intragroup evaluations revealeda significant improvement in the all scores in the PTR-PT and PTR-mCMIT groups (p = 0.006 < 0.001). Intergroup comparisons demonstrated that the PTR-mCIMT group had a significant improvement in spasticity and motor function scores compared to the PTR (p < 0.001) and the PTR-PT groups (p = 0.006-0.015). CONCLUSIONS: PT and mCMIT applied in addition to conventional therapy in patients with chronic stroke were more effective than only conventional therapy. Additionally, mCMIT showed greater improvement in spasticity and motor function scales than PT.

Immediate effect of stair exercise on stiffness, tone, and pressure pain threshold of thoracolumbar fascia in individuals with lower limb amputation: a preliminary report.

BACKGROUND: Adaptations to the use of prosthesis in individuals with a lower limb amputation may cause changes in lumbopelvic region structures during daily life activities. OBJECTIVE: To investigate the effect of stair exercise on the stiffness, tone, and pressure pain threshold (PPT) of the thoracolumbar fascia (TLF) in individuals with unilateral lower limb amputation. DESIGN: This is a prospective preliminary study. METHODS: The study was conducted in Prosthetic Orthotic Centers in Istanbul. Syrian individuals with unilateral transtibial (n = 17) and transfemoral (n = 15) amputation who received prosthesis and rehabilitation services at the centers between February 2020 and December 2020 were included in the study. The subjects were instructed to ascend and descend a nine-step stair one at a time at their maximum possible speed. Measurements were made before and immediately after the stair exercise. Tone and stiffness of TLF was measured using myometer. PPT was measured using algometer. Low back pain was evaluated using numerical pain rating scale. RESULTS: In the transfemoral amputation group, PPT measurements taken immediately after stair exercise were significantly decreased in both the amputated ( P = 0.001) and intact ( P = 0.021) sides, whereas significant reduction in stiffness when compared with the prestair levels was observed only at the intact side ( P = 0.019). The change in PPT values on the amputated side was significantly higher in individuals with transfemoral amputation than those in individuals with transtibial amputation ( P = 0.011). CONCLUSION: The decrease in PPT values of TLF in the transfemoral amputation group was considered as a precursor sign for low back pain development. Thus, exercises and preventive rehabilitation programs targeting TLF may be needed, especially in this group.

Effects of Dexamethasone Exposure on Neural Crest Cells and Primary and Secondary Neurulation in Chick Embryos.

AIM: To evaluate the effects of dexamethasone (Dex) treatment on neural crest cells and primary and secondary neurulation in chick embryos. MATERIAL AND METHODS: Sixty fertilized eggs with an average weight of 65 ± 2 g were incubated in 60%?70% humidity at 37.2°C ± 0.1°C. After 26 hours of incubation, the control group (n=12) received 0.1 mg/kg physiologic saline (S), group 1 (n=12) received 0.1 mg/kg Dex, group 2 (n=12) received 1 mg/kg Dex, and group 3 (n=12) received 5 mg/kg Dex into each embryonic disc. The eggs were incubated until Hamburger?Hamilton stage (HH) 15, HH18, and HH20. Then, the embryos were dissected and evaluated both macroscopically and microscopically. RESULTS: The mortality rate in the control group, group 1, and groups 2 and 3 was 27%, 48%, and 100%, respectively. The neural tube thicknesses in group 1 significantly increased in HH 15 and HH20 (p < 0.05). The mitosis number in group 1 significantly decreased in each stage (p < 0.05). Wnt-1 expression was significantly lower in group 1 in HH15 (p < 0.05) and HH18 (p < 0.05), but there was no significant difference in HH20 (p > 0.05). Fibroblast growth factor (FGF) expression was significantly lower in group 1 in HH15 (p < 0.05). The expression of N-cadherin was significantly higher in group 1 in HH20 (p < 0.05). Fibronectin expression decreased in group 1 in HH18 (p < 0.01). CONCLUSION: Although the Dex treatment did not result in neural tube closure defect, the mortality rates and neural tube thicknesses increased, whereas mitotic activation and Wnt-1 and FGF signal pathways reduced in some stages.

The impact of internet addiction on depression, physical activity level and trigger point sensitivity in Turkish university students.

BACKGROUND AND OBJECTIVES: Internet addiction (IA), defined as excessive, time consuming, uncontrollable use of the internet, has become a widespread problem. In this study, we investigated the impact of internet addiction on depression, physical activity level, and latent trigger point sensitivity in Turkish university students. METHODS: A total of 215 university students (155 females and 60 males) who were between 18-25 years of age participated in the study. Using the Addiction Profile Index Internet Addiction Form (APIINT), we identified 51 people as non-internet-addicted (non-IA) (Group 1: 10 male/41 female) and 51 as internet-addicted (IA) (Group 2: 7 male/44 female). APIINT, International Physical Activity Questionnaire-Short-Form (IPAQ), Beck Depression Inventory (BDI), and Neck Disability Index (NDI) were administered to both groups, and the pressure-pain threshold (PPT) in upper/middle trapezius latent trigger points area was measured. RESULTS: The internet addiction rate was 24.3% in our students. Compared with the non-IA group, the daily internet use time and BDI and NDI scores were higher (all p< 0.05), while the IPAQ walking (p< 0.01), IPAQ total (p< 0.05), and PPT values (p< 0.05) were lower in the IA group. CONCLUSIONS: IA is a growing problem. This addiction may lead to musculoskeletal problems and can have consequences involving the level of physical activity, depression, and musculoskeletal disorders, particularly in the neck.

Associations between the severity of disability level and fear of movement and pain beliefs in patients with chronic low back pain.

BACKGROUND AND OBJECTIVES: Low back pain (LBP) is one of the leading forms of chronic pain and is among the leading causes of pain and disability. In this study, we investigated the associations between the severity of disability and fear of movement and pain beliefs as well as the impact of the fear of movement and pain beliefs on the quality of life in patients with chronic LBP. METHODS: A total of 89 patients (42.29 ± 16.05 years) with chronic low back pain were included in the study. The instruments used in the assessments include the Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), the Tampa Kinesiophobia Scale (TKS), the Pain Belief Questionnaire (PBQ), and the SF 36-Short Form. Patients were assigned into three groups by disability severity based on ODI scores. Statistical analysis was performed using SPSS 15. RESULTS: No statistically significant intergroup differences were found in TKS and PBQ scores (p> 0.05). A positive correlation was found between TKS scores, age (r: 0.227/p< 0.05), PBQ organic (r: -0.250/p< 0.05) scores. CONCLUSIONS: Our study revealed high levels of kinesiophobia and similar pain beliefs, independent of the severity level of disability. We believe that cognitive-behavioral therapy that may reduce fear-avoidance behaviors and convert negative pain beliefs into positive ones should be added to rehabilitation procedures for LBP.

Physiotherapy in addition to vacuum bell therapy in patients with pectus excavatum.

OBJECTIVES: Vacuum bell and exercise therapy are non-invasive treatments for pectus excavatum (PE). The purpose of this study was to determine the effects of the physiotherapy programme applied in addition to vacuum bell treatment in patients with PE. METHODS: The study included 26 male patients with PE aged 11-18 years. Patients were randomly divided into 2 groups: group 1 received only vacuum bell treatment; group 2 had vacuum bell therapy and physiotherapy. Patient demographic and disease-related characteristics, type of sternal depression, perception of their deformity, postural evaluations, treatment satisfaction and quality of life were evaluated before and 12 weeks after treatment. RESULTS: From external chest circumference measurements related to PE, sternal depression and anthropometric index values showed improvement in both groups (P < 0.05), but better results were observed in group 2 than in group 1 (P < 0.05). Modified percent depth and scores from the T3 region (distance between the most prominent point of the sternum and the spinous process of the vertebra at the same level) showed improvement only in group 2 (P < 0.01), whereas severity of PE, the patient's perception of his deformity and parental physiological quality-of-life scores improved in both groups (P < 0.05). Posture, satisfaction with treatment and the patients' physiological quality-of-life scores were significantly better in group 2 (P < 0.05). CONCLUSIONS: Due to the additional improvements and greater satisfaction in the group receiving physiotherapy, we think that a proper rehabilitation programme should be applied simultaneously with the vacuum bell treatment in patients with PE. CLINICAL TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT04167865.