The effects of myofascial release in combined with task-oriented circuit training on balance in people with Parkinson's disease: a randomized pilot trial.

OBJECTIVES: Task-oriented circuit training (TOCT) has been used to improve balance in people with Parkinson's disease (pwPD). To investigate the effectiveness of TOCT on balance, quality of life, and disease symptoms when combined with myofascial release in pwPD. METHODS: Twenty-six pwPD were randomized into two groups for this randomized controlled study. The groups received TOCT three days a week for eight weeks. At the end of each session, the myofascial release was applied to the neck, trunk, and lumbar region with three sets of 60-s foam rolling body weight (Intervention group-IG) and perceived discomfort level 0/10 (Control group-CG) using a numeric rating scale. Primary outcome measures were measured by the Berg Balance Scale (BBS), Parkinson's Disease Questionnaire (PDQ-8), and Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Secondary outcome measures included posturographic assessment, timed-up and go test (TUG), Trunk Impairment Scale (TIS), and rolling time. RESULTS: Data obtained from 26 pwPDs in equal numbers in both groups were analyzed. All groups reported a significant change in MDS-UPDRS, MDS-UPDRS-III, PDQ-8, TIS, and rolling time after treatment compared to pretreatment. Post-hoc analyses showed that IG significantly improved motor symptoms, TUG, and TIS dynamics compared to CG. The mediolateral limits of stability and anterioposterior limits of stability distances of IG increased (p < 0.05). DISCUSSION: Myofascial release, when combined with TOCT, may help to reduce disease-related motor symptoms and improve dynamic balance in pwPD. These findings suggest that myofascial release can be a beneficial addition to TOCT programs for pwPD.Clinical Trial Number: NCT05900934 (ClinicalTrials.gov).

Usefulness of the Berg Balance Scale for prediction of fall risk in multiple sclerosis.

INTRODUCTION: The Berg Balance Scale, possibly the most widely used balance-related measure, has gained popularity in clinical trials. It provides information about patients' balance-related abilities and can be used to assess improvement or worsening after rehabilitation. The aim of this study is to determine the cut-off value of the Berg Balance Scale for the fall risk in patients with multiple sclerosis (MS). METHODS: This study was designed as a prospective descriptive trial, and 186 patients with MS were included. Fall history was recorded by interview; balance was assessed using the Berg Balance Scale (BBS). RESULTS: The mean ages of 96 patients with a fall history within the previous month and 90 patients without a fall history were 35.98 ± 8.58 and 35.71 ± 9.33 years, respectively. The mean value of the BBS score of the faller group was 49.44 ± 5.43 while 52.36 ± 3.53 in non-faller group. The cut-off value of the BBS for fall risk in patients with MS was determined as 50.50 points. CONCLUSIONS: For patient safety and the success of rehabilitation, it is crucial to evaluate the risk of falling in patients with MS, one of the neurological patient groups where complaints about falling are most prevalent. The results showed that BBS is a sensitive and specific measure for identifying in patients with MS at risk of falling.

How cognitive and behavioural body-functions of children with ADHD are linked to their participation and environmental supports?

BACKGROUND: Children with chronic conditions face participation restrictions and exclusions. AIMS: To investigate how cognitive and behavioural body-functions are associated with 1) participation patterns and 2) environmental factors among children with attention deficit hyperactivity disorder (ADHD). METHODS AND PROCEDURES: The study included 83 children with ADHD. Cognitive and behavioural body-functions were assessed with Conners' Parent Rating Scale-Revised Long-Version. The participation patterns of children were assessed with Participation and Environment Measure for Children and Youth (PEM-CY). Multiple regression analyses were used to examine the relationships between cognitive and behavioural body-functions and (1) participation patterns at home, school and community settings, and (2) environmental supports and barriers. OUTCOME AND RESULTS: In home setting, inattention and ADHD index which determine ADHD children from typically developing peers, were the strongest factors, explaining 24.9 % of variance in activities that mothers wanted to change. In school setting, presence/level of oppositional behaviours had the strongest effect on environmental barriers, with variation of 29.8 %. In community setting, the strongest factor explaining environmental helpfulness was anxious/shy behaviours (16.1 %). CONCLUSIONS AND IMPLICATIONS: When seeking to improve participation of children with ADHD both the cognitive and behavioural demands of chosen activities should be modified while creating environments that supports these challenges.

Telerehabilitation versus virtual reality supported task-oriented circuit therapy on upper limbs and trunk functions in patients with multiple sclerosis: A randomized controlled study.

INTRODUCTION: The purpose of this study was to investigate the effects of two different technology-supported rehabilitation approaches which are mobile application based telerehabilitation (TR) and virtual reality supported task oriented circuit therapy groups (V-TOCT) on the upper limb (UL), trunk function, and functional activity kinematics in patients with Multiple Sclerosis (PwMS). METHODS: Thirty-four patients with PwMS were included in this study. The participants were evaluated at baseline and after eight weeks of treatment by an experienced physiotherapist using the Trunk Impairment Scale (TIS), kinetic function sub-parameter of the International Cooperative Ataxia Rating Scale (K-ICARS), ABILHAND, Minnesota Manual Dexterity tests (MMDT), and trunk and UL kinematics using inertial sensors. The participants were randomized into the TR and V-TOCT groups with a 1:1 allocation ratio. All participants received interventions for 1 hour per session, 3 sessions per week, for 8 weeks. RESULTS: Trunk impairment, ataxia severity, UL, and hand function showed statistically significant improvement in both groups. The functional range of motion (FRoM) of shoulder and wrist increased transversal plane and the FRoM of shoulder increased on sagittal plane in V-TOCT. Log Dimensionless Jerk (LDJ) decreased on transversal plane in V-TOCT group. The FRoM of the trunk joints increased on the coronal plane and the FRoM of the trunk joints increased on the transversal plane in TR. Dynamic balance of the trunk and K-ICARS improved better in V-TOCT than in TR (p < 0,05). CONCLUSIONS: V-TOCT and TR improved UL function, TIS, and ataxia severity in PwMS. The V-TOCT was more effective than the TR in terms of dynamic trunk control and kinetic function. The clinical results were confirmed using the kinematic metrics of motor control.

Corrigendum: Evolution of tandem repeats is mirroring post-polyploid cladogenesis in Heliophila (Brassicaceae).

[This corrects the article DOI: 10.3389/fpls.2020.607893.].

Idahoa and Subularia: Hidden polyploid origins of two enigmatic genera of crucifers.

PREMISE: The monotypic Idahoa (I. scapigera) and the bispecific Subularia (S. aquatica and S. monticola) belong to Brassicaceae with unclear phylogenetic relationships and no tribal assignment. To fill this knowledge gap, we investigated these species and their closest relatives by combining cytogenomic and phylogenomic methods. METHODS: We used whole plastome sequences in maximum likelihood and Bayesian inference analyses. We tested the phylogenetic informativeness of shared genomic repeats. We combined nuclear gene tree reconciliation and comparative chromosome painting (CCP) to examine the occurrence of past whole-genome duplications (WGDs). RESULTS: The plastid data set corroborated the sister relationship between Idahoa and Subularia within the crucifer Lineage V but failed to resolve consistent topologies using both inference methods. The shared repetitive sequences provided conflicting pwhylogenetic signals. CCP analysis unexpectedly revealed that Idahoa (2n = 16) has a diploidized mesotetraploid genome, whereas two Subularia species (2n = 28 and 30) have diploidized mesoctoploid genomes. Several ancient allopolyploidy events have also been detected in closely related taxa (Chamira circaeoides, Cremolobeae, Eudemeae, and Notothlaspideae). CONCLUSIONS: Our results suggest that the contentious phylogenetic placement of Idahoa and Subularia is best explained by two WGDs involving one or more shared parental genomes. The newly identified mesopolyploid genomes highlight the challenges of studying plant clades with complex polyploidy histories and provide a better framework for understanding genome evolution in the crucifer family.

Investigation of postural control and spatiotemporal parameters of gait during dual tasks in ataxic individuals.

BACKGROUND: Concurrent cognitive and motor tasks in ataxic individuals cause functional limitations and negatively affect the independence of patients in daily life. OBJECTIVES: This study aimed to examine the effects of dual task on postural control and spatiotemporal parameters of gait in ataxic individuals. METHODS: The study included 20 individuals with ataxia. Disease severity was evaluated using the International Cooperative Ataxia Rating Scale. A force platform was used to evaluate postural sway and limits of stability and a GAITRite electronic walkway to evaluate the spatiotemporal parameters of gait. Postural control and gait were evaluated without a simultaneous task (task-1) and with dual tasks consisting of counting the names starting with "a selected letter such as A" (task-2), counting backwards aloud in threes from 100 (task-3), carrying a glass of water with a tray (task-4), and speaking on a mobile phone (task-5). The effects of dual task on postural control and gait parameters were examined with multiple comparisons. RESULTS: The tasks requiring cognitive skills (tasks 2, 3, 5) were determined to have a greater effect on the increase of body sway, and gait was seen to be affected by motor and/or cognitive tasks (tasks 2, 4, 5). CONCLUSION: From the results of the present study, it is thought that evaluations of postural control and gait performance of ataxic individuals together with the dual tasks they may encounter in daily life are important in terms of their independence in activities of daily living.

Cross-cultural adaptation, validity and reliability of Turkish version of the Waterloo Handedness and Footedness Questionnaire-Revised.

This study investigated the validity and reliability of Turkish versions of the Waterloo Handedness and Footedness Questionnaire-Revised (WHQ-R and WFQ-R). Turkish versions of the WHQ-R and the WFQ-R, and other assessments (the Handedness Questionnaire and the Footedness Preference Test) were applied to 444 healthy participants aged between 18 and 65 years. The translation and cultural adaptation process of the WHQ-R and the WFQ-R was provided by the following proposed guideline. For test-retest reliability, translated versions were re-applied to 88 participants in a 7-day interval. Cronbach's alpha of the WHQ-R was 0.984 and that of the WFQ was 0.905. The test-retest intra-class correlation coefficients (ICC) of the WHQ-R varied from 0.741 to 0.933 and those of the WFQ-R from 0.649 to 0.814. There were moderate to strong correlations between the WHQ-R and the Handedness Questionnaire (r = -853, p < 0.001) and between the WFQ-R and the Footedness Preference Test (r = -0.687, p < 0.001). Confirmatory factor analysis revealed a two-factor structure of the WHQ-R and the WFQ-R. The results of this study demonstrated that Turkish versions of the WHQ-R and the WFQ-R are reliable and valid inventories for assessing handedness and footedness in this population.

Evolution of Tandem Repeats Is Mirroring Post-polyploid Cladogenesis in Heliophila (Brassicaceae).

The unigeneric tribe Heliophileae encompassing more than 100 Heliophila species is morphologically the most diverse Brassicaceae lineage. The tribe is endemic to southern Africa, confined chiefly to the southwestern South Africa, home of two biodiversity hotspots (Cape Floristic Region and Succulent Karoo). The monospecific Chamira (C. circaeoides), the only crucifer species with persistent cotyledons, is traditionally retrieved as the closest relative of Heliophileae. Our transcriptome analysis revealed a whole-genome duplication (WGD) ∼26.15-29.20 million years ago, presumably preceding the Chamira/Heliophila split. The WGD was then followed by genome-wide diploidization, species radiations, and cladogenesis in Heliophila. The expanded phylogeny based on nuclear ribosomal DNA internal transcribed spacer (ITS) uncovered four major infrageneric clades (A-D) in Heliophila and corroborated the sister relationship between Chamira and Heliophila. Herein, we analyzed how the diploidization process impacted the evolution of repetitive sequences through low-coverage whole-genome sequencing of 15 Heliophila species, representing the four clades, and Chamira. Despite the firmly established infrageneric cladogenesis and different ecological life histories (four perennials vs. 11 annual species), repeatome analysis showed overall comparable evolution of genome sizes (288-484 Mb) and repeat content (25.04-38.90%) across Heliophila species and clades. Among Heliophila species, long terminal repeat (LTR) retrotransposons were the predominant components of the analyzed genomes (11.51-22.42%), whereas tandem repeats had lower abundances (1.03-12.10%). In Chamira, the tandem repeat content (17.92%, 16 diverse tandem repeats) equals the abundance of LTR retrotransposons (16.69%). Among the 108 tandem repeats identified in Heliophila, only 16 repeats were found to be shared among two or more species; no tandem repeats were shared by Chamira and Heliophila genomes. Six "relic" tandem repeats were shared between any two different Heliophila clades by a common descent. Four and six clade-specific repeats shared among clade A and C species, respectively, support the monophyly of these two clades. Three repeats shared by all clade A species corroborate the recent diversification of this clade revealed by plastome-based molecular dating. Phylogenetic analysis based on repeat sequence similarities separated the Heliophila species to three clades [A, C, and (B+D)], mirroring the post-polyploid cladogenesis in Heliophila inferred from rDNA ITS and plastome sequences.

Electromyographic activity and kinematics of sit-to-stand in individuals with muscle disease.

OBJECTIVE: The aim of this study was to compare activation levels of rectus femoris, biceps femoris, tibialis anterior, and soleus muscles and biomechanical properties of individuals with muscle disease and healthy individuals during sit-to-stand. METHODS: Fifteen patients (11 muscular dystrophy, 4 myopathy) and 15 healthy individuals were included in the study. A Noraxon superficial electromyography device and high-speed cameras were used to evaluate muscle activations and biomechanical properties. RESULTS: There was a difference between the activation levels of bilateral rectus femoris, tibialis anterior, soleus, and right biceps femoris of patients and healthy subjects (p < 0.05). When groups were compared in terms of biomechanical properties, there was no difference in the range of motion during sit-to-stand (p > 0.05), but there was a difference in phase 1: flexion momentum phase, phase 3: extension phase, phase 4: stabilization phase, and total time of sit-to-stand (p < 0.05). CONCLUSION: We observed that individuals with muscle disease are able to stand up in a similar sit-to-stand pattern to healthy individuals with longer duration and higher muscle activation levels. Prolonged high muscle activation during functional activities may cause fatigue and muscle destruction in patients. For this reason, planning of exercise programs for appropriate muscles and phases will enable the patients to perform the activity of sit-to-stand more easily. Thus, patients will become more functional and independent in their daily lives with less effort.

Functional range of motion in the upper extremity and trunk joints: Nine functional everyday tasks with inertial sensors.

BACKGROUND: Functional range of motion is defined as the required range of motions for individuals to maintain maximal independence, along with optimal conditions for activities of daily living. Intervention plans for rehabilitation are directed towards the acquisition of anatomical range of motion. However, this isn't always possible based on person's etiology, prognosis, or severity of disease. RESEARCH QUESTION: The aim of this study is to determine functional range of motion during different unilateral, bilateral symmetrical and bimanual asymmetrical tasks of activities of daily living. METHODS: Participants completed nine basic activities of daily living (hand to head, hanging jacket, eating, wallet placement to back pocket, washing hands and face, removing belt, water pouring, brushing teeth) linked according to International Classification of Functioning, Disability and Health, while joint kinematics of the trunk and upper extremity were recorded with inertial measurement units. Peak values of mean joint angles were determined for each activities of daily living. MVN BIOMECH Awinda MTW2-3A7G6 sensors (Xsens Technologies B.V. Enschede, Netherlands) were used for 3D kinematic analysis of activities. RESULTS: Forty-six healthy subjects (right-dominant) were included in this study. Range of motion requirements of all activities were defined 37.85° extension, 91.18° flexion, 1.25° adduction, 39.45° abduction, 63.6° internal rotation, 21.8° external rotation in the dominant shoulder, 124.17° flexion in the dominant elbow, 40.29° extension, 23.66° flexion, 18.31° supination, 12.56° pronation, 18.27 ulnar deviation and, 18.36° radial deviation in the dominant wrist. Maximum trunk range of motions were found to be 29.75° flexion in C7-T1, 10.74° flexion in T12-L1, and 24.16° flexion in L5-S1. SIGNIFICANCE: It is thought that the results of this research will contribute to the determination of normative data needed for surgical interventions, technological rehabilitation devices and task-spesific rehabilitation programs which based patient's motor skill level.

Assessment of diagnostic doses for widely used synthetic pyrethroids (Deltamethrin & Permethrin) in an endemic focus of leishmaniasis in Turkey.

BACKGROUND: Leishmania is a group of parasitic flagellated protozoons, which are transmitted by female sand flies and produces health problems in humans and also in wild and domestic animals. So far, 25 Phlebotomus and 4 Sergentomyia species were recorded in Turkey including proven or possible vectors of Leishmania spp. As no single insecticide susceptibility test was conducted targeting the sand flies in Turkey, we aimed to determine the diagnostic dose against two commonly used synthetic pyrethroids (deltamethrin and permethrin) in a hyperendemic area for leishmaniasis. METHODS: Sand flies were collected from villages of Adana in 2-4 September 2013 using Centers for Disease Control and Prevention (CDC) light traps and transferred to the laboratory. The World Health Organisation tube test method was conducted using self-prepared filter papers with different concentrations. In order to determine the diagnostic dose, lethal doses (LD) were calculated by EPA Probit Analysis. Sand flies used in the experiments were dissected, mounted and identified. RESULTS: For the lowest (0.025 %) and highest dose of permethrin (0.5 %), the mortality rate was recorded as 52.6 % and 100 % by the end of 24-h period and the diagnostic dose was recorded as 0.36 %. The mortality rate for lowest (0.0025 %) and highest (0.05 %) doses of deltamethrin was recorded as 54.8 % and 100 %. The diagnostic dose of deltamethrin was determined as 0.9 %. CONCLUSION: An insecticide susceptibility study was conducted in Turkey for the first time and effective doses were determined by calculating the LDs. According to presented results, the wild population of sand flies collected from a hyper-endemic region of Adana Province is still susceptible to deltamethrin and permethrin.

Establishment of a satellite rearing facility to support the release of sterile Aedes albopictus males. I. Optimization of mass rearing parameters.

The vector species Aedes albopictus (Skuse, 1894) was recorded in Turkey for the first time, near the Greek border, in 2011 and a high risk of expansion towards Aegean and Mediterranean coasts of Turkey was estimated. A preliminary study was planned to evaluate the possibility of creating a satellite mass rearing facility for this species and manage a larval rearing procedure by using the new mass-rearing technology proposed by the International Atomic Energy Agency (IAEA). For this purpose, the effects of different larval densities (1, 2, 3 and 4 larvae per ml) on the preimaginal development were evaluated by observing pupal, adult and male productivity using life cycle trials. Geometric morphometric analyses were also performed to define all phenotypic differences that occurred on the wing size and shape morphology of adult stage at the four different rearing conditions tested. A high pupation productivity was obtained with a larval density of 2 larvae/ml while adult emergence ratio was not affected by the densities tested. No significant difference was observed in shape of the wings among different densities in males and females. Nevertheless, a significant difference in female's centroid sizes was observed between the treatment groups 1-2 and 3-4 larvae/ml and in males centroid size reared at 1 larvae/ml versus the other densities.

Evaluation of the efficacy of Olyset® Plus in a village-based cohort study in the Cukurova Plain, Turkey, in an area of hyperendemic cutaneous leishmaniasis.

The aim of this study was to measure the protective efficacy of Olyset(®) Plus, a new long-lasting factory-treated insecticidal net (LLIN) incorporated with 2% permethrin and 1% of the synergist piperonyl butoxide (PBO), against cutaneous leishmaniasis (CL) transmission under field conditions. A village-scale trial, promoting the use of LLIN by the local inhabitants of the study area was conducted as a pilot study in a new hyperendemic focus of CL caused by a Leishmania infantum/L. donovani hybrid parasite transmitted by proven vector species Phlebotomus tobbi in Cukurova Plain, Adana, Turkey, between May, 2013 and May, 2014. The study area comprised eight villages; two of them were selected as an intervention village with Olyset(®) Plus net (Kizillar) and a control village without net application (Malihidirli). Six villages with surrounding allopatric barriers were utilized as a buffer zone cluster between intervention and control villages. Monthly entomological surveys were performed in the intervention and control villages and Damyeri, representing the other six villages, to collect adults of Phlebotomus tobbi. Results showed a significant reduction in cutaneous leishmaniasis incidence in the intervention village from 4.78% to 0.37%. The protective efficacy rate of LLIN was 92.2%. In contrast, incidence rates increased in the control village from 3.67% to 4.69%. We also evaluated residual insecticide levels of used nets after six and 12 months of usage. It was determined that the nets had retained full insecticidal strength. These results highlight the value of real-world data on bed net effectiveness and longevity to guide decisions regarding sand fly control strategies. To the best of our knowledge, this is the first field study to evaluate Olyset(®) Plus efficacy in a hyperendemic cutaneous leishmaniasis area.