Assessment of the Saudi Population's Knowledge and Awareness Toward a Sedentary Lifestyle Risk Factors in the Post-COVID-19 Era.

Introduction: Sedentary behaviors have been on the rise, potentially exacerbated by lockdowns, remote work, and lifestyle shifts during the pandemic, emphasizing the need to assess public awareness regarding associated health risks. This study investigated the knowledge and awareness levels of the Saudi population regarding sedentary lifestyle risk factors in the post-COVID-19 era. Methodology: This cross-sectional study included 400 participants and was conducted from May 2023 to July 2023 using a questionnaire distributed randomly through social media in multiple regions of Saudi Arabia. Results: The majority of the participants were females (57.1%), aged 15-25 years (54.3%), had a higher educational degree (65.4%) and were single (62%). Most (62%) of the participants reported declined/physical activity levels in the post-COVID-19 era. Our study found that 65% of the participants had increased usage of online shopping and delivery applications after the pandemic, and a significant portion (66%) had less than 150-300 min of moderate aerobic activity weekly. Barriers, such as bad weather and insufficient time for exercise, had significant impacts. Conclusion: This study provides valuable insights into the Saudi population's demographic characteristics, knowledge, and behaviors related to physical activity and health.

Effects of diabetes mellitus complications on sleep quality among Saudi Arabian patients-A national study.

Introduction: In diabetes mellitus (DM) patients, obtaining a good night's sleep is crucial for maintaining body caloric intake, controlling insulin levels, and reducing the likelihood of engaging in unhealthy behavior. Patients with poor sleep quality may experience impaired glycemia, playing a significant role in the development of chronic complications. This study aims to explore the effects of DM complications on sleep quality among Saudi Arabian patients. Patient and Methods: This is a cross-sectional study conducted among patients with diabetes. A self-administered, validated questionnaire translated into Arabic was distributed among diabetic patients using an online survey. The questionnaire includes sociodemographic characteristics (i.e. age, gender, marital status, etc.), the medical history of the patients, and a questionnaire about sleep quality. Results: Out of 4171 patients involved, 52.7% were females and 27.7% were aged between 40 and 60 years old. The prevalence of patients with perceived poor sleep quality was 24.1%. Significant predictors of poor sleep quality were the gender female, having social stressors, comorbid sleep disorders, associated comorbidities, increasing HbA1c levels, being overweight/obese, and diabetes complications. Furthermore, sleep disturbance, taking sleep medications, daytime sleepiness, and having bad dreams during sleep were also identified as prognostic factors for poor sleep quality. Conclusion: The subjective poor sleep quality of patients with diabetes was 24.1%. Poor sleep quality was significantly demonstrated by females who were having social stressors, comorbid sleep disorders, comorbidities, uncontrolled HbA1c levels, elevated BMI levels, and complications of diabetes. However, regular physical activity and adequate sleep were estimated to be the protective factors against poor sleep quality. Further research is needed to establish the effect of sleep quality among patients with DM.

The Translation and Validation of Patient-Centered Outcomes Questionnaire Into Arabic: A Chronic Periodontitis Patient-Based Study.

Background The patient-centered outcomes questionnaire (PCOQ) is a self-report questionnaire that aims to assess four fundamental domains (pain, fatigue, distress, and interference) on an 11-point numerical rating scale from 0 to 10 in chronic diseases. The implementation of this tool will help assess chronic diseases; hence, this study aimed to translate the PCOQ to a sample of periodontitis patients. Methodology This study went through the content validity index. Arabic PCOQ used Cronbach's alpha for reliability with 300 participants. From July to August 2023, patients with periodontitis visiting an outpatient dental center in Riyadh were invited to participate in the study. The language, content, and structure of the questionnaire were appropriate, and with forward and backward translation, external entity translation was implemented. Results Regarding the participants' gender, the number of males was higher at 61%. Regarding age distribution, 50.7% of the participants were between 30 and 50 years old. A clarity score of 95.2% and a representativeness score of 97.3% were reported in the content validity analysis. The Cronbach's alpha of the Arabic PCOQ questionnaire was 0.85, and the subscales ranged between 0.68 and 0.93. Conclusions The translated version of the Arabic PCOQ is a valid tool to be used in Arab countries. Nonetheless, this instrument can provide insights for healthcare professionals, policymakers, and managers to improve patient satisfaction and healthcare system delivery.

Caregiver's Quality of Life Among Children with Cerebral Palsy in the Kingdom of Saudi Arabia, and Various Influencing Factors: A Single Cohort Study.

Purpose: Quality of life (QOL) among disabled children and their caregivers is an important concern in healthcare. We aim to evaluate the quality of life among caregivers of children with cerebral palsy and to observe the effects of various demographic factors and affected child-related factors on caregivers' quality of life. Patients and Methods: After ethical approval and written consent was obtained from the participants. One hundred six caregivers of children with cerebral palsy from the Asir region were recruited for the study. Caregivers provided details, including their demographic characteristics, social factors, and information regarding their affected children regarding age, gender, mobility levels, etc. They also completed the Arabic version of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire for assessing their QOL. Results: All the caregivers were women; their mean age was 40.38 years and SD7.09, and the overall QOL mean and standard deviations were 66.38 ± 12.88. There was a moderately significant correlation between total QOL in comparison with caregivers' educational level and mobility capacity, with R values of 0.54 (p<0.001) and 0.62 (p<0.001), respectively. Conclusion: All the subdomains of WHOQOL-BREF were found to be very closely related to the total scores for QOL. The caregivers of children with cerebral palsy had better QOL scores than the cutoff scores proposed in the WHOQOL-BREF scale. Factors such as increased mobility and education of the affected child contributed to better total QOL scores.

Measurement Property Evaluation of the Arabic Version of the Patient-Specific Functional Scale for Patients with Stroke.

Neurological disorders refer to disorders that occur due to disease or damage to the nervous system. Stroke is one of the most common neurological disorders in which individuals commonly present with motor and sensory deficits, leading to the limitations on the activities of daily life. Outcome measures are used to assess and monitor patients' condition change. The patient-specific functional scale (PSFS) is an outcome measure used to assess changes in performance levels in participants with a functional disability during daily activities. This study aimed to assess the reliability and validity of the Arabic version of the patient-specific functional scale (PSFS-Ar) in individuals with stroke. A longitudinal cohort study was used to examine the reliability and validity of the PSFS-Ar in patients with stroke. All participants completed the PSFS-Ar in addition to other outcome measures. Fifty-five individuals participated (fifty male, five female). The PSFS-Ar showed excellent test-retest reliability, with ICC2,1 = 0.96, p < 0.001. The SEM and MDC95 of the PSFS-Ar were 0.37 and 1.03, respectively. No floor and ceiling effect was observed in this study. Additionally, the construct validity of the PSFS-Ar showed 100% satisfaction with the pre-defined hypotheses. Since the number of female participants was very small in this study, the findings were established for male individuals with stroke. This study showed that the PSFS-Ar is a reliable and valid outcome measure for male individuals with stroke.

The Mediation Effect of Pain on the Relationship between Kinesiophobia and Lumbar Joint Position Sense in Chronic Low Back Pain Individuals: A Cross-Sectional Study.

(1) Background: Fear of movement (kinesiophobia) and impaired lumbar joint position sense (LJPS) play a vital role in developing and maintaining non-specific chronic low back pain (CLBP). However, how kinesiophobia impacts LJPS is still being determined. The aims of this study are to (1) assess the correlation between kinesiophobia and LJPS in individuals with chronic low back pain; (2) compare LJPS between individuals with CLBP and those who are asymptomatic; and (3) evaluate if pain can mediate the relationship between kinesiophobia and LJPS in CLBP individuals. (2) Methods: Eighty-three individuals (mean age = 48.9 ± 7.5 years) with a diagnosis of CLBP and 95 asymptomatic individuals (mean age = 49.4 ± 7.0 years) were recruited into this cross-sectional study. Fear of movement in CLBP individuals was assessed using the Tampa Scale for Kinesiophobia (TSK). LJPS was determined using the active target repositioning technique using a dual-digital inclinometer. LJPS was evaluated in lumbar flexion, extension, and side-bending left and right directions, and the repositioning accuracy was determined in degrees using a dual digital inclinometer. (3) Results: Kinesiophobia showed a significant (p < 0.001) moderate positive correlation with LJPS (flexion: r = 0.51, extension: r = 0.41, side-bending left: r = 0.37 and side-bending right: r = 0.34). LJPS errors were larger in CLBP individuals compared to asymptomatic individuals (p < 0.05). Mediation analyses showed that pain significantly mediated the relationship between kinesiophobia and LJPS (p < 0.05) in CLBP individuals. (4) Conclusions: Kinesiophobia and LJPS were positively associated. LJPS is impaired in CLBP individuals compared to asymptomatic individuals. Pain may mediate adverse effects on LJPS. These factors must be taken into account when assessing and developing treatment plans for those with CLBP.

Mediation Effect of Pain on the Relationship between Kinesiophobia and Postural Control: Comparison and Correlations in Individuals with Fibromyalgia Syndrome and Asymptomatic Individuals-A Cross-Sectional Study.

Background: Individuals with fibromyalgia syndrome (FM) usually present with a fear of movement (kinesiophobia), which causes their symptoms to be maintained and exacerbated. Kinesiophobia can significantly impact postural control; ascertaining their association is crucial in evaluating and managing individuals with FM. This study aims to (1) compare postural control between individuals with FM and asymptomatic individuals, (2) estimate the relationship between kinesiophobia and postural control in individuals with FM, and (3) evaluate whether pain intensity mediates the association between kinesiophobia and postural control in individuals with FM. Methods: This study enrolled 92 individuals (mean age: 51.52 ± 7.7 years) diagnosed with FM and 106 asymptomatic individuals (mean age: 50.47 ± 6.6 years). The examiners estimated the fear of movement and the intensity of pain utilizing the Tampa scale of kinesiophobia (TSK) scores and the visual analogue scale (VAS), respectively. The postural control variables included anteroposterior (A-P) sway in mm, medio-lateral (M-L) sway in mm, and ellipse area in mm2. Results: The individuals with FM had impaired postural control compared to the asymptomatic individuals (p < 0.001). Kinesiophobia exhibited mild-to-moderate correlations with the postural control variables (nondominant side: A-P sway: r = 0.48, M-L sway: r = 0.49, ellipse area: r = 0.43. Dominant side: A-P sway: r = 0.41, M-L sway: r = 0.33, ellipse area: r = 0.44). The pain intensity significantly mediated the relationship between kinesiophobia and postural control (p < 0.001). Conclusion: Kinesiophobia showed a significant positive relationship with postural control. The individuals with FM with higher TSK scores had decreased postural control. Pain intensity mediated the relationship between kinesiophobia and postural control. These factors must be considered when evaluating and formulating treatment strategies for people with FM.

Transcranial direct current stimulation (tDCS) effects on upper limb motor function in stroke: an overview review of the systematic reviews.

BACKGROUND: Stroke is the prime cause of disability in the elderly population. Transcranial direct current stimulation (tDCS) is an emerging noninvasive brain stimulation in rehabilitating upper limb function post-stroke. However, mixed evidence exists in the literature and ambiguous conclusions regarding the effect of tDCS on upper limb function. OBJECTIVE: This study aimed to assess the current evidence on the effect of (tDCS) on upper limb motor function and activities of daily living in patients after stroke by conducting an overview of systematic reviews. METHODOLOGY: We performed electronic database searches and gray literature searches for the articles. RESULTS: Two distinct literature searches gathered a total of 203 studies. Out of them, six systematic reviews and meta-analyses were included for methodological quality assessment and data extraction. All included studies were determined to be of good to high quality based on a methodological appraisal using the Assessment of Multiple Systematic Reviews checklist. CONCLUSION: Identified evidence suggests that tDCS has superior effects to control interventions in improving functions of the upper limb and activities of daily living in patients who have had a stroke. Moreover, cathodal stimulation over the non-affected brain region was more effective than anodal and dual tDCS stimulation.

Comparisons and Associations between Hip-Joint Position Sense and Glycosylated Hemoglobin in Elderly Subjects with Type 2 Diabetes Mellitus-A Cross-Sectional Study.

Hip-joint position sense (JPS) accuracy may be impaired in individuals with type 2 diabetes mellitus (T2DM). An impaired hip JPS can alter postural control and bodily balance. The objectives of this study are to (1) compare the hip JPS between T2DM and asymptomatic and (2) assess the relationship between hip JPS and glycosylated hemoglobin (HbAlc). This comparative cross-sectional study included 117 elderly individuals with T2DM (mean age: 59.82 ± 6.80 y) and 142 who were asymptomatic (mean age: 57.52 ± 6.90 y). The hip JPS was measured using a digital inclinometer. The individuals were repositioned to a target position with their eyes closed, and the magnitudes of matching errors were estimated as reposition errors. The hip JPS was evaluated in the flexion and abduction directions. The magnitude of reposition errors was significantly larger in the T2DM group in the right flexion (p < 0.001), the right abduction (p < 0.001), the left flexion (p < 0.001), and the left abduction (p < 0.001) directions compared to the asymptomatic group. HbA1c values showed a significant positive correlation with JPS in the right-hip flexion (r = 0.43, p < 0.001), the right-hip abduction (r = 0.36, p < 0.001), the left-hip flexion (r = 0.44, p < 0.001), and the left-hip abduction (r = 0.49, p < 0.001) directions. Hip JPS testing may be considered when assessing and formulating treatment strategies for individuals with type 2 diabetes. Future research should focus on how hip JPS can impact balance and falls in individuals with T2DM.

Comparison of Neck Circumference, Waist Circumference, and Skinfold Thickness in Measuring the Subcutaneous Fat Distribution and Their Association with Handgrip Strength: Cross-Sectional Study.

Skinfold measurement (SKF) can accurately measure abdominal obesity and is regarded as a surrogate marker to predict non-communicable diseases. The objective of the present study was to observe the degree of association between neck circumference (NC), SKF and handgrip strength (HGS). Secondly, also to know the effects of smoking on NC, HGS and SKF. The mean and standard deviations and frequencies in percentage were analyzed, respectively. The degree of association between NC, anthropometric characters and HGS was also analyzed using the Pearson correlation. Furthermore, multiple linear regression models were used to study the degree of influence of independent variables on dependent variables. Correlation assessment for neck circumference with waist circumference and HGS revealed a weak association. While with SKF for four sites, a strong association was found. A significant regression was found among the smokers in the model (F (2, 7) = 5.2, p-value of 0.04 with an R2 of 0.598). The predictor variables, like waist and NC, can produce a variation of 59.8% in the dependent variable. Whereas, among non-smokers, an insignificant regression was seen. In conclusion, neck circumference is associated with SKF. However, a small sample size of young smokers revealed that NC and waist circumference influenced HGS.

Cervical Joint Position Sense in Individuals With Type 2 Diabetes and Its Correlations With Glycated Hemoglobin Levels: A Cross-Sectional Study.

OBJECTIVE: This study aimed to compare cervical joint position sense (JPS) between individuals with type 2 diabetes (T2D) and healthy individuals and to assess the correlation between glycated hemoglobin (HbA1c) values and cervical JPS in individuals with T2D. METHODS: Ninety-seven individuals with T2D (mean age: 59.0 ± 6.8 years; men = 63 [67.02%], women = 34 [32.98%], and 117 healthy individuals without T2D (mean age: 57.3 ± 6.9 years; men = 70 [79.80%], women = 44 [20.20%]) were recruited into this study. Cervical JPS was evaluated using a cervical range of motion device in cervical flexion, extension, and rotation in left and right directions. Participants were required to relocate their heads actively to a predefined target position with eyes closed, and their reposition accuracy was measured in degrees as joint reposition error (JRE). The HbA1c test was performed on all participants with T2D to determine their average blood sugar level over the previous 2 to 3 months. Cervical JREs were compared and correlated with HbA1c values. RESULTS: The participants with T2D showed significantly larger cervical JREs in all directions compared with the healthy group (flexion: d = 1.23, P < .001; extension: d = 1.85, P < .001; left rotation: d = 1.70, P < .001; right rotation: d = 2.60, P < .001). Pearson correlation coefficient (r) showed significant moderate positive association between HbA1c and cervical JREs in flexion (r = 0.41, P = .001), extension (r = 0.48, P < .001), left rotation (r = 0.38, P < .001), and right rotation (r = 0.37, P < .001) in participants with T2D. CONCLUSION: The magnitude of cervical JPS impairment was significant in individuals with T2D. In addition, HbA1c levels showed a significant negative correlation with cervical JPS.

Cross-Cultural Adaptation of the Godin-Shephard Leisure-Time Physical Activity Questionnaire for Arabic Population and Testing its Psychometric Properties.

BACKGROUND Physical activity during leisure time is essential to promote health, owing to the decreased physical activity in mechanized working environments. The present study aimed to cross-culturally modify the Godin Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) into Arabic and to assess its psychometric properties. MATERIAL AND METHODS We conducted this study in various standardized stages. At each stage, the corrections were made by an expert committee. In the initial stage, the English version of the GSLTPAQ was translated into Arabic and then back-translated into English. In the second stage, we ensured the content validity by collecting the opinion of 10 professionals in the medical field. Finally, in the third stage, the Arabic version was applied to the Saudi population to check its test-retest reliability, face validity, internal consistency, and concurrent validity. RESULTS For the Arabic version of the GSLTPAQ, we evaluated the content validity by involving 10 experts, and it was found to be excellent. The scale was applied to 150 office workers in the university to assess psychometric properties. The scale showed remarkable internal consistency (0.99) and high test-retest reliability (0.88). We evaluated the concurrent validity by comparing it with the Copenhagen City Heart Study Leisure Time Physical Activity Questionnaire, and it was shown to have an excellent validity of 0.86 (<0.001). CONCLUSIONS After conducting the careful process of translations, we adapted and created the Arabic version of the GSLTPAQ. It was found to have excellent content validity, test-retest reliability, internal consistency, and concurrent validity.

Correlation and comparison of quadriceps endurance and knee joint position sense in individuals with and without unilateral knee osteoarthritis.

BACKGROUND: Knee osteoarthritis (KOA) is a painful degenerative joint disease that may limit activities of daily living. This study aimed to determine the relationship between quadriceps endurance and knee joint position sense (JPS) in KOA individuals and compare the quadriceps endurance and knee JPS with and without KOA. METHODS: This comparative cross-sectional study was conducted in medical rehabilitation clinics, King Khalid University, Saudi Arabia. This study recruited 50 individuals diagnosed with unilateral KOA (mean age = 67.10 ± 4.36 years) and 50 asymptomatic individuals (mean age = 66.50 ± 3.63 years). Quadriceps isometric endurance capacity (sec) was measured using a fatigue resistance test, and knee JPS (degrees) were assessed using a digital inclinometer and evaluated in sitting and standing positions. RESULTS: Quadriceps isometric endurance showed a significant moderate negative correlation with knee JPS in 20° of flexion (r = -0.48, p < 0.001); 40° of flexion: r = -0.62, p < 0.001; 60° of flexion: r = -0.58, p < 0.001) in sitting and 20° of flexion (r = -0.25, p = 0.084) in standing position in KOA individuals. When compared to the asymptomatic, the quadriceps endurance was lower (p < 0.001), and knee joint position errors were larger (p < 0.001) in KOA individuals. CONCLUSION: Results of this study showed that quadriceps endurance capacity is negatively associated with knee JPS. KOA individuals demonstrated lower quadriceps endurance and larger JPS compared to asymptomatic.

The Impact of Post-traumatic Stress of SARS-CoV-2 Affliction on Psychological and Mental Health of Student Survivors: Cross Sectional Study.

Background: COVID-19 survivor's population is often associated with a long term impact on mental and psychological health. Recent included studies have also stated affliction of mental health due to fear of virus and preventive policies among the college students. Objectives: The research was conducted to find the psychological and mental impacts of SARS-CoV-2 affliction among the students' survivors in the university. Methods: The study design of the experiment was cross-sectional, sampling technique was non probability and sampling method being applied was convenience sampling. IBM Statistical Package for the Social Sciences version 20 was used for analyses. Descriptive data was examined and results were showed as mean and standard deviations, percentages, frequencies for continuous variables of IES-R scale (Intrusion, Avoidance, and Hyperarousal) using the total sample of n = 34. Results: Out of 34 only 24 student survivors responded to the online survey post COVID-19 recovery, with an overall participation level of 71%. Grading was given for the total IES-R score which was subdivided into a predefined range. Out of 24 participants, 9 (38%) participants showed the symptoms of mild (n = 2)-severe (n = 7) psychological impacts. On correlation of factors total IES-R score and taste and sense of smell were moderately correlated. The ordinal regression for complete loss of sense of taste and smell was also significant. Conclusion: The results from IES-R evaluation clearly outlines the presence of psychological sequels post recovery of COVID-19 episodes among the young college survivors. Complete loss of sense of smell and taste may be an indicator of psychological sequelae as compared to reduce sense of smell.

Transcranial direct current stimulation combined with trunk-targeted, proprioceptive neuromuscular facilitation in subacute stroke: a randomized controlled trial.

Background: Stroke is the foremost cause of death and disability worldwide. Improving upper extremity function and quality of life are two paramount therapeutic targets during rehabilitation. Aim of the study: To investigate the effects of transcranial direct current stimulation (tDCS) combined with trunk-targeted proprioceptive neuromuscular facilitation (PNF) on impairments, activity limitations, and participation restrictions of subjects with subacute stroke. Methodology: Fifty-four subjects with subacute stroke were divided into three groups using block randomization. All three groups received rehabilitation sessions lasting 90 min in duration, four times per week, for 6 weeks. Group 1 (n = 18) received conventional physical therapy (CPT); group 2 (n = 18) received CPT, trunk-targeted PNF, and sham tDCS; and group 3 (n = 18) received CPT, trunk-targeted PNF, and bihemispheric motor cortex stimulation with tDCS. Changes in motor impairment, motor activity, and health-related quality of life assessments were outcome measures. Results: A two-way linear mixed model analysis revealed interaction effects (group × time) for all outcome measurements (Trunk Impairment Scale, Fugl-Meyer Assessment of Motor Recovery after stroke upper extremity subsection, Wolf Motor Function Test, 10-Meter Walk Test, and the Stroke-Specific Quality of Life scale; all p < 0.01 or lower). Overall, post-pre mean differences demonstrate more substantial improvement in the active tDCS group, followed by sham stimulation associated with the PNF group and the group that received CPT alone. Conclusion: Trunk-targeted PNF combined with bihemispheric tDCS along with CPT engender larger improvements in upper extremity and trunk impairment, upper limb function, gait speed, and quality of life in the subacute stroke population.

Comparison and correlation of cervical proprioception and muscle endurance in general joint hypermobility participants with and without non-specific neck pain-a cross-sectional study.

Background: Cervical proprioception and muscle endurance are essential for maintaining cervical functional joint stability. Proprioception and muscle endurance may be impaired in those with general joint hypermobility (GJH). Examining these aspects is crucial. This study's aims are to (1) compare the cervical joint position error (JPE) and muscle endurance holding capacities in GJH individuals with and without non-specific neck pain (NSNP) (2) to assess the relationship between hypermobility Beighton scores, cervical JPE's, and muscle endurance in GJH individuals with and without NSNP. Methods: In this cross-sectional comparative study, 33 GJH participants with NSNP (mean age 21.7 ± 1.8 years) and 35 asymptomatic participants GJH (mean age 22.42 ± 1.7 years) participated. Beighton's score of ≥4 of 9 tests was used as criteria to diagnose GJH. Cervical JPEs were estimated in degrees using a cervical range of motion device, and muscle endurance (flexor and extensor) were estimated in seconds using a stopwatch. Results: GJH participants with NSNP showed significantly larger cervical JPEs (p < 0.001) and decreased muscle endurance holding times (p < 0.001) compared to asymptomatic participants. Beighton hypermobility scores showed a significant moderate positive correlation with cervical JPEs (flexion: r = 0.43, p = 0.013), left rotation: r = 0.47, p = 0.005, right rotation: r = 0.57, p = 0.001) in NSNP individuals. Also, Beighton hypermobility scores showed a moderate negative correlation with muscle endurance in NSNP (flexor muscles: r = -0.40, p = 0.020, extensor muscles: r = -0.41, p = 0.020, and asymptomatic individuals (flexor muscles: -0.34, p = 0.045, extensor muscles: r = -0.45, p = 0.007). Conclusion: GJH individuals with NSNP showed increased cervical JPEs and reduced muscle endurance compared to asymptomatic. Individuals with GJH with higher Beighton scores demonstrated increased cervical JPEs and reduced neck muscle endurance holding ability. In clinical practice, therapists should be aware of these findings, incorporate proprioceptive and muscle endurance assessments, and formulate rehabilitation strategies for NSNP individuals with GJM.

Multiple lessons learned from a single case: Complications from pineal germinoma management.

BACKGROUND: Pineal tumors are uncommon tumors that affect <1% of adults, with 50% of them being germinomas. A combination of endoscopic third ventriculostomy (ETV) and tumor biopsy is usually used. Cerebral vasospasm in association with aneurysmal subarachnoid hemorrhage (aSAH) has been extensively studied. However, at least according to the research, this is not the case in intraventricular hemorrhage (IVH) cases. We present a case with two distinct findings: (1) an unexpected large IVH following the removal of an external ventricular drain (EVD) in a patient who had undergone ETV and tumor biopsy, resulting in severe clinical vasospasm and (2) incidental pineal region germinoma regression on follow-up magnetic resonance imaging (MRI) without any prior adjuvant chemoradiation to explain such regression. CASE DESCRIPTION: The authors describe an 18-year-old male patient who had a routine, uneventful combined ETV and tumor biopsy, as well as the placement of an EVD. Histopathological examination revealed germinoma. His postoperative course was complicated by IVH after EVD removal, which resulted in clinical vasospasm. Without any prior adjuvant chemoradiation, follow-up MRI of the b rain revealed a significant reduction in the size of the germinoma as well as reconstitution of the patency of the previously obstructed aqueduct of Sylvius. CONCLUSION: The take-home message from this case is that in the case of postoperative clinical deterioration in a patient with concurrent IVH and ETV, a high index of suspicion for vasospasm is required, as this may allow a significant amount of blood to pass down to the basal cisterns. Early detection and management of clinical vasospasm are critical for a better neurological outcome. Furthermore, unexpected tumor size changes can occur due to a variety of factors, so recent preoperative MRI of the brain should be obtained in the lead-up to surgery, and postoperative computed tomography should be used sparingly to avoid radiation-related tumor changes.

Knowledge, Attitude, and Practice among Physical Therapists toward COVID-19 in the Kingdom of Saudi Arabia-A Cross-Sectional Study.

To curb the COVID-19 pandemic, the knowledge, attitude, and practice (KAP) of preventive measures play an essential role, and healthcare workers have had to endure a burden to care for COVID-19 patients. Thus, this study aimed to assess the weight of the KAP of physiotherapists in Saudi Arabia during the COVID-19 pandemic. This was a cross-sectional study, where we circulated an online KAP questionnaire to 1179 physical therapists, and among those, 287 participated and completed the questionnaire. The collected responses were analyzed using descriptive statistics, t-test, ANOVA, correlation, and regression analyses, and p-value ≤ 0.05 was considered statistically significant. Both males and females participated in almost equal numbers; most of the participants were <40 years, had a bachelor's level of education, and were from the central region of Saudi Arabia. Social media and the internet were the primary sources of COVID-19-related information (74.6%). Knowledge components A (92%) and B (73.9%) were excellent among most participants. Approximately half of the participants (50.5%) had a moderate attitude toward COVID-19, and regarding the practice component, most participants (74.6%) scored moderately. Correlation analysis showed a low positive relationship between knowledge A, attitude, and practice components. Still, there was a very low positive relationship between knowledge B, attitude, and practice components, but both were statistically significant. Our study showed that physical therapists in Saudi Arabia exhibit good knowledge, attitude, and practice toward COVID-19.

Association between Kinesiophobia and Knee Pain Intensity, Joint Position Sense, and Functional Performance in Individuals with Bilateral Knee Osteoarthritis.

In current clinical practice, fear of movement has been considered a significant factor affecting patient disability and needs to be evaluated and addressed to accomplish successful rehabilitation strategies. Therefore, the study aims (1) to establish the association between kinesiophobia and knee pain intensity, joint position sense (JPS), and functional performance, and (2) to determine whether kinesiophobia predicts pain intensity, JPS, and functional performance among individuals with bilateral knee osteoarthritis (KOA). This cross-sectional study included 50 participants (mean age: 67.10 ± 4.36 years) with KOA. Outcome measures: The level of kinesiophobia was assessed using the Tampa Scale of Kinesiophobia, pain intensity using a visual analog scale (VAS), knee JPS using a digital inclinometer, and functional performance using five times sit-to-stand test. Knee JPS was assessed in target angles of 15°, 30°, and 60°. Pearson's correlation coefficients and simple linear regressions were used to analyze the data. Significant moderate positive correlations were observed between kinesiophobia and pain intensity (r = 0.55, p < 0.001), JPS (r ranged between 0.38 to 0.5, p < 0.05), and functional performance (r = 0.49, p < 0.001). Simple linear regression analysis showed kinesiophobia significantly predicted pain intensity (B = 1.05, p < 0.001), knee JPS (B ranged between 0.96 (0° of knee flexion, right side) to 1.30 (15° of knee flexion, right side)), and functional performance (B = 0.57, p < 0.001). We can conclude that kinesiophobia is significantly correlated and predicted pain intensity, JPS, and functional performance in individuals with KOA. Kinesiophobia is a significant aspect of the recovery process and may be taken into account when planning and implementing rehabilitation programs for KOA individuals.

Reliability of hip joint position sense tests using a clinically applicable measurement tool in elderly participants with unilateral hip osteoarthritis.

Hip joint proprioception is vital in maintaining posture and stability in elderly individuals. Examining hip joint position sense (JPS) using reliable tools is important in contemporary clinical practice. The objective of this study is to evaluate the intra-rater and inter-rater reliability of hip JPS tests using a clinically applicable measurement tool in elderly individuals with unilateral hip osteoarthritis (OA). Sixty-two individuals (mean age = 67.5 years) diagnosed with unilateral hip OA participated in this study. The JPS tests were evaluated using a digital inclinometer in hip flexion and abduction directions. The absolute difference between target and reproduced angle (repositioning error) in degrees was taken to measure JPS accuracy. The intraclass correlation coefficient (ICC (2.k), was used to assess the reliability. The Intra rater-reliability for hip JPS tests showed very good agreement in the lying position (hip flexion-ICC = 0.88-0.92; standard error of measurement (SEM) = 0.06-0.07, hip abduction-ICC = 0.89-0.91; SEM = 0.06-0.07) and good agreement in the standing position (hip flexion-ICC = 0.69-0.72; SEM = 0.07, hip abduction-ICC = 0.66-0.69; SEM = 0.06-0.08). Likewise, inter-rater reliability for hip JPS tests demonstrated very good agreement in the lying position (hip flexion-ICC = 0.87-0.89; SEM = 0.06-0.07, hip abduction-ICC = 0.87-0.91; SEM = 0.07) and good agreement in the standing position (hip flexion-ICC = 0.64-0.66; SEM = 0.08, hip abduction-ICC = 0.60-0.72; SEM = 0.06-0.09). The results support the use of hip JPS tests in clinical practice and should be incorporated in assessing and managing elderly participants with hip OA.