Evaluation of manual dexterity when using a mirror of dental students and academicians with increasing professional experience.

INTRODUCTION: To evaluate the manual dexterity of dentistry students and academicians when using a mirror according to increasing professional experience. MATERIALS AND METHODS: The study included 72 subjects, grouped according to professional experience 5th year dentistry students (DS) accepted as no experience-academicians with 1-4 years experience (A5L)-academicians with ≥5 years experience (A5M). Direct and indirect visualisation using the mirror was evaluated with the completion times of the O'Connor Finger Dexterity Test. RESULTS: The hand grip strength values of both left and right hand were found to be statistically significantly higher in all the males than in the females (p < .05). The indirect test times (ITT) using the mirror were significantly longer for males than for females (p = .001), and no significant difference was determined between the genders in the direct test times (DTT) (p > .05). For all the study participants, DTT shortened as professional experience increased (p < .05). In addition, the mean values of both DTT (p = .031) and ITT (p = .028) in the DS group were statistically significantly longer than the A5M group. CONCLUSION: With increasing professional experience, manual dexterity was determined to increase, and females were found to be more successful in the direct manual dexterity tests independently of the groups. The statistical significance between the DS and A5M groups, especially in the hand dexterity test with a mirror, shows the importance of experience. The study results demonstrated that professional manual dexterity in dentistry can be developed with increasing practical application.

The relationship between the backward walking and proprioception, trunk control, and muscle strength in children with cerebral palsy.

OBJECTIVE: This study was planned to determine the factors affecting backward walking in children with cerebral palsy (CP). METHODS: The study included 30 children with CP, with a mean age of 10.43 ± 2.76 years. Backward walking abilities were evaluated with the 3-Meter Back Walk Test (3MBWT). A digital goniometer was used to evaluate proprioception, the Trunk Control Measurement Scale (TCMS) was used for trunk control, a digital muscle dynamometer was used for muscle strength, and the Gillette Functional Assessment Questionnaire (FAQ) was used for gait evaluation. RESULTS: When the spasticity of children at levels I and II according to the Gross Motor Function Classification System (GMFCS) was compared, a significant difference was found in favor of level I in hamstring, gastro-soleus, and gastrocnemius spasticity (p < 0.05). When the results of the 3MBWT, TCMS, and FAQ were compared, a significant difference was found in favor of level I (p < 0.05). No significant relationship was revealed between the 3MBWT and lower extremity proprioception and TCMS (p > 0.05). A significant negative correlation was observed between the 3MBWT and FAQ (p < 0.05). No significant correlation was found between the 3MBWT and lower extremity muscle strengths (p > 0.05). A significant positive correlation was found only between hip extension proprioception and iliopsoas muscle strength (p = 0.023). There was no significant correlation between the FAQ and lower extremity muscle strength (p > 0.05). CONCLUSION: It was revealed that the backward walking ability increased as the forward walking function improved in children with CP, but it was not affected by proprioception, trunk control, and muscle strength. CLINICAL TRIALS: NCT05088629 (10/11/2021).

The effects of different procedures on pain levels in preterm and term infants in neonatal intensive care unit: a cross-sectional survey of pain assessment in newborns.

BACKGROUND: Newborns show a series of behavioral and physiological reactions to painful stimuli. AIMS: The current study aimed to determine the effect of different procedures on the pain levels of newborns in the Neonatal Intensive Care Unit (NICU). METHODS: One hundred ninety-six newborns with gestational age (GA) of 23-40 weeks, birth weight (BW) between 2235 ± 911 g were included. Painful procedure (PP) (vascular access (VA), heel prick (HP), umbilical catheter (UC), orogastric catheter (OC), and intubation (I)) were recorded. Pain during the PP was evaluated with Neonatal Infant Pain Scale (NIPS). Pulse and O2 saturation were recorded before (BP), during (DP) and after (AP) procedure. RESULTS: NIPS total scores were found to be significantly higher with term infants (p < 0.05). When NIPS total scores were compared according to the type of PP, significant difference was observed between groups (p = 0.000). Positive correlation was found between birth week (p = 0.000, r = 0.364), BW of infants and NIPS total score (p = 0.000, r = 0.371), pulse values of DP and NIPS total score (p = 0.000, r = 0.386). Negative correlation was found between O2 saturation values DP and the NIPS total scores (p = 0.000, r = -0.405). CONCLUSIONS: It is concluded that as GA and BW increase, so do the pain responses of the infant, which showed that the pain thresholds of term-preterm infants are different, and decrease as GA and BW increase.

Evaluation of the relationship between the disease severity and the level of physical activity in patients followed up with COVID-19 diagnosis.

OBJECTIVES: To investigate the relationship between physical activity level and disease severity, anxiety level, sleep quality, and fatigue in patients followed up with COVID-19 diagnosis. METHODS: This was a cross-sectional study of 111 volunteer patients who were receiving treatment with COVID-19 diagnosis at the Chest Diseases Polyclinic, Sanko University, Sani Konukoglu Practice and Research Hospital, Gaziantep, Turkey between May 2021 and July 2021 were included in the study and classified clinically and radiologically. They were evaluated on the basis of demographic characteristics, International Physical Activity Questionnaire, Beck Anxiety Inventory, Pittsburgh Sleep Quality Index, and Fatigue Severity Scale. RESULTS: Approximately 63% of the patients did not have a habit of exercise, while 52.3% of our patients were clinically mild cases, and 33.3% had normal lung tomography. While clinical disease severity was not associated with exercise habits, sleep quality was impaired in clinically severe patients. CONCLUSION: The results of our study suggested that physical inactivity is common. Anxiety is a frequent symptom in COVID-19 cases and also COVID-19 negatively affects sleep quality.

Validity and reliability of the 3-meter backward walk test in patients with multiple sclerosis.

BACKGROUND: The 3-meter backward walk test (3MBWT) evaluates neuromuscular control, proprioception, protective reflexes, fall risk, and balance. This study aimed to examine the reliability, validity, and minimal detectable change (MDC) of the 3MBWT in patients with Multiple Sclerosis (pwMS). METHODS: 40 pwMS (8 male, 32 female) were included in the study. The Intraclass Correlation Coefficient (ICC) was used for the reliability of the 3MBWT. MDC estimates were calculated using baseline data. The validity of the 3MBWT was evaluated by the correlation between The Timed Up and Go test (TUG), The 12-item Multiple Sclerosis Walking Scale (MSWS-12), The 2 Min Walk Test (2MWT), The Timed 25-Foot Walk Test (T25FW), and The Four Square Step Test (FSST) RESULTS: The intra-rater (ICC 0.944-0.945) and inter-rater (ICC 0.932-0.935) reliability of the 3MBWT was determined to be excellent. MDC values for intra-rater were 1.13-1.30 sec, and MDC values for inter-rater were 1.10-1.24 sec. The correlation with 3MBWT, TUG, MSWS-12, and 2MWT was found to be statistically significant. CONCLUSION: The 3MBWT was found to be valid and reliable in pwMS. It is a short and easily applied test in outpatient and inpatient clinics without any need for equipment. According to the MDC results, small differences in pwMS can be adequately detected with 3MBWT. Therefore, it may be a clinically suitable test for detecting subtle changes in synergistic motor functions related to prorioception in relapsing or remitting periods. It, also may add some more information on to EDSS data for following the disease progression as well as treatment responses.

Muscle architecture and its relationship with lower extremity muscle strength in multiple sclerosis.

This study was planned to determine the muscle architecture (pennation angle, muscle fiber length, and muscle thickness) and its relationship to lower extremity muscle strength in patients with Multiple Sclerosis (pwMS). The muscle architecture (pennation angle, muscle fiber length, and muscle thickness) and lower extremity muscle strength were assessed in 33 pwMS [13 Relapsing-Remitting MS (RRMS), 5 Primary Progressive MS (PPMS), 5 Secondary Progressive MS (SPMS), and 11 matched healthy controls (HC)]. Muscle architecture features were assessed with ultrasonography and muscle strength were assessed with a digital hand-held dynamometer. The rectus femoris muscle thickness and pennation angle, gastrocnemius muscle thickness, and the tibialis anterior pennation angle were significantly lower in pwMS compared to HC (p < 0.05). The strength of hip flexors, hip extensors, knee extensors, foot plantar, and foot dorsi flexors were lower in pwMS. In PPMS group, muscle strength of hip flexors was lower than RRMS and SPMS groups, and muscle strength of foot dorsi flexors was lower than RRMS (p < 0.05). In pwMS, positive correlations were found, between knee flexor strength and biceps femoris pennation angle. Also knee extensor strength and rectus femoris fiber length and muscle thickness were correlated positively (p < 0.05). According to our results the muscle architecture is affected in MS. The determination of architectural changes of lower extremity muscles may guide the arrangement of optimal strength exercises in functional rehabilitation programs.ClinicalTrials: NCT03766698.

Cross-cultural adaptation, validity, and reliability of Turkish version of Identification of Functional Ankle Instability (IdFAI) scale.

OBJECTIVE: This study aimed to develop the Turkish version of Identification of Functional Ankle Instability (TV_IdFAI) scale and evaluate its validity and reliability. METHODS: A total of 100 participants (54 men and 46 women; 50 volleyball players and 50 sedentary individuals) between 18 and 38 years of age were included this study. The construct validity, reference validity, sensitivity, specificity, and test-retest reliability of TV_IdFAI were evaluated. For the test-retest reliability, the scale was applied to all participants again in 10-14 days. A correlation between the scale scores and test-retest results was examined with intraclass correlation coefficient. To evaluate the construct validity, a factor analysis method was used. For reference validity, a sports physician evaluated all participants and the clinical diagnoses were compared with total score of the scale. Sensitivity and specificity were calculated to evaluate the classification success of the scale with specified cutoff. RESULTS: TV_IdFAI scale was grouped under two separate factors. It was determined that the variance for factor 1, factor 2 and for scale was 46.68%, 15.70%, and 62.38%, respectively. There was a statistically significant relationship 0.74 (95% CI 0.64-0.84; p<0.001) between the physician's diagnosis and TV_IdFAI in terms of reference validity. The sensitivity and specificity of TV_IdFAI was 0.61 and 0.80, respectively. The reliability of TV_IdFAI was 0.94 (95% CI 0.92-0.96; p<0.001). CONCLUSION: This study shows that TV_IdFAI is a simple, easy to apply, reliable, and valid scale to define functional ankle instability in Turkish population. LEVEL OF EVIDENCE: Level II, Diagnostic study.

Comparison of muscle activation levels and knee valgus between individuals with medial patellofemoral ligament reconstruction and healthy individuals during fatiguing step down task.

BACKGROUND: Medial patellofemoral ligament reconstruction becomes first-choice surgical procedure for patients with a history of lateral patellar dislocations but there is limited knowledge about neuromuscular activation patterns of individuals with a history of patellar dislocation who underwent medial patellofemoral ligament reconstruction. OBJECTIVE: The aim of this study was to compare muscle activation levels and knee valgus during step down performance test between individuals with a history of medial patellofemoral ligament reconstruction and healthy individuals. METHODS: Fifteen individuals with medial patellofemoral ligament reconstruction and 15 healthy individuals were included. Vastus medialis obliquus, vastus lateralis and gluteus medius muscle activation levels and knee valgus were measured during 60-s- step down performance test. Two-way repeated-measures of analysis of covariance was used for statistical analysis. FINDINGS: Compared to the healthy individuals, individuals with medial patellofemoral ligament reconstruction showed lower vastus medialis obliquus (p = .04) and gluteus medius (p = .005) activation levels, and higher knee valgus (p = .002) in last period of the step down performance test. INTERPRETATION: Since the significant results were only observed in the fatiguing section of the test, endurance tests may provide more information about neuromuscular control of the individuals with history of medial patellofemoral ligament reconstruction. Future studies should investigate whether endurance exercises that target to improve vastus medialis obliquus and gluteus medius activity result in better clinical outcomes than conventional programs for individuals with medial patellofemoral ligament reconstruction.

Correlation of proximal and distal muscle strength with upper limb functional ability in patients with essential tremor.

Despite being considered as a benign, genetic and monosymptomatic disorder, ET is a poorly understood entity with etiological and pathological heterogeneity. The aim of the present study was to examine the relation between proximal and distal muscle strength and upper limb functionality and tremor severity in patients with essential tremor (ET). The study enrolled 25 tremor patients followed at the neurology clinic of a university hospital and 19 healthy controls. Demographic data, risk factors, disease duration and dominant hand of the participants were recorded. Back and leg strength was assessed using a back and leg dynamometer and hand dynamometer and pinchmeter were used to determine hand strength. Functional ability of the participants was evaluated using the Minnesota Manual Dexterity Test (MMDT), Perdue Pegboard (PPBT) and Nine Hole Peg Test (NHPT). Tremor severity was assessed using the Fahn-Tolosa-Marin Tremor Rating Scale (FTMTRS) and the Lower Extremity Clinical Tremor Assessment Scale (LECTAS). A significant difference was found in the average back and leg muscle strength between ET patients and healthy controls (p < 0.05). The mean values for right/left hand muscle strength were not significantly different between the two groups (p > 0.05). Among the upper limb functional ability tests, significant differences were found between the two groups in the mean time to complete NHPT, Minnesota placing subtest and PPBT test (p < 0.05). While gender and risk factors were not significantly different between the two groups (p > 0.05), there was a significant difference with respect to the educational level (p < 0.01). No significant difference was found between back and leg muscle strength and FTMTRS and LECTAS (p > 0.05). A negative correlation and a significant association were found between average strength measurements obtained with the left hand dynamometer and FTMTRS in the ET group (p = 0.030, r = - 0.434). A positive correlation and a significant association were found between left hand strength and mean turning time in the MMDT in the control group (p = 0.041, r = 0.473). ET patients experience loss of proximal muscle strength and functional disability. Further studies are planned to investigate the effects of physical therapy modalities targeting increased proximal muscle strength on tremor severity and functional ability in ET patients.

Shoulder kinematics and mobility adaptations in water-polo players.

BACKGROUND: There is limited research to demonstrate how scapular kinematics and shoulder-related physical characteristics are affected in water-polo players, who undertake swimming and repetitive throwing activity. The aim of this study was to investigate possible adaptations in the three-dimensional scapular kinematics and in glenohumeral internal rotation, external rotation range of motion and shoulder posterior-capsule tightness in water-polo players. METHODS: Fourteen water-polo players and 14 asymptomatic volunteers participated in the study. The scapular kinematics were recorded using an electromagnetic tracking device during the scapular plane shoulder elevation. Additionally, shoulder range of motion and posterior-capsule tightness were evaluated. Analysis of variance models were used to make comparisons between groups. RESULTS: Although there was a trend toward increased scapular internal rotation and downward rotation in the throwing shoulders of water-polo players, comparisons revealed there was no significant differences in kinematics, shoulder internal-external range of motion and posterior-capsule tightness between the throwing shoulders of the players and dominant shoulders of the control participants. CONCLUSIONS: The throwing shoulders of water-polo players did not demonstrate alterations in shoulder kinematics and mobility parameters.

The profile of upper extremity muscular strength in female wheelchair basketball players: a pilot study.

BACKGROUND: The purpose of this study was to analyze and compare the profile of upper extremity muscle strength in female wheelchair basketball players with that of sex-matched non-disabled controls. METHODS: Nineteen female subjects were enrolled in this study. These were divided into two groups. Group 1 (N.=10) consisted of wheelchair basketball players and Group 2 (N.=9) of non-disabled individuals. Muscular strength in the shoulder was measured using an isokinetic dynamometer. Isometric and isotonic muscular endurance in the shoulder joint was evaluated in terms of the length of time subjects could hold a 5-kg dumbbell at 45° and the number of abduction repetitions to 45° with a 5-kg dumbbell in 30 seconds, respectively. Pinch strength and hand grip strength were measured using a Pinch gauge and hand dynamometer, respectively. RESULTS: Significant differences were observed between the groups in terms of all parameters of muscular strength in the shoulder joint, hand grip and pinch strength. Upper extremity muscular strength in female wheelchair basketball players was greater than in the non-disabled controls. CONCLUSIONS: We concluded that the difference in muscle strength between the groups mostly derived from using wheelchairs due to players' intense training and busy match schedules. Additionally, the profile of upper extremity muscle strength in female wheelchair basketball players in our study can be used as basic data for the introduction of exercise rehabilitation programs and as a guide for future research.

Regression of lumbar disc herniation by physiotherapy. Does non-surgical spinal decompression therapy make a difference? Double-blind randomized controlled trial.

BACKGROUND AND OBJECTIVES: The aim of the study determining whether or not Non-invasive Spinal Decompression Therapy (NSDT) was effective in resorption of herniation, increasing disc height in patients with lumbar disc herniation (LHNP). METHODS: A total of twenty patients diagnosed as LHNP and suffering from pain at least 8 weeks were enrolled to the study. Patients were allocated in study (SG) and control groups (CG) randomly. Both groups received combination of electrotherapy, deep friction massage and stabilization exercise for fifteen session. SG received additionally NSDT different from CG. Numeric Anolog Scale, Straight leg raise test, Oswestry Disability Index (ODI) were applied at baseline and after treatment. Disc height and herniation thickness were measured on Magnetic Resonance Imagination which performed at baseline and three months after therapy. RESULTS: Both treatments had positive effect for improving pain, functional restoration and reduction in thickness of herniation. Although reduction of herniation size was higher in SG than CG, no significant differences were found between groups and any superiority to each other (p> 0.05). CONCLUSIONS: This study showed that patients with LHNP received physiotherapy had improvement based on clinical and radiologic evidence. NSDT can be used as assistive agent for other physiotherapy methods in treatment of lumbar disc herniation.

Comparison of virtual reality exergaming and home exercise programs in patients with subacromial impingement syndrome and scapular dyskinesis: Short term effect.

OBJECTIVE: The aim of this study was to compare the short term effects of home exercise program and virtual reality exergaming in patients with subacromial impingement syndrome (SAIS). METHODS: A total of 30 patients with SAIS were randomized into two groups which are Home Exercise Program (EX Group) (mean age: 40.6 ± 11.7 years) and Virtual Reality Exergaming Program (WII Group) (mean age: 40.33 ± 13.2 years). Subjects were assessed at the first session, at the end of the treatment (6 weeks) and at 1 month follow-up. The groups were assessed and compared with Visual Analogue Scale (based on rest, activity and night pain), Neer and Hawkins Tests, Scapular Retraction Test (SRT), Scapular Assistance Test (SAT), Lateral Scapular Slide Test (LSST) and shoulder disability (Shoulder Pain and Disability Index (SPADI)). RESULTS: Intensity of pain was significantly decreased in both groups with the treatment (p < 0.05). The WII Group had significantly better results for all Neer test, SRT and SAT than the EX Group (p < 0.05). CONCLUSION: Virtual reality exergaming programs with these programs were found more effective than home exercise programs at short term in subjects with SAIS. LEVEL OF EVIDENCE: Level I, Therapeutic study.

Determination of the effects of playing soccer on physical fitness in individuals with transtibial amputation.

BACKGROUND: The aim of this paper is to determine the effects of playing soccer on various components of physical performance such as body composition, muscular endurance, anaerobic power, flexibility, balance, and speed of individuals with transtibial amputation. METHODS: Twelve amputee football players aged 26.67±7.76 years and twelve sedentary individuals aged 33±6.7 years were involved in this study. Body composition, and isotonic and isometric endurance of trunk muscles were assessed. Vertical jump test, sit-and-reach test, modified Thomas test, Berg Balance Scale, L test, and figure-of-eight walk (F8W) test were used to assess other physical fitness parameters. RESULTS: The Body Mass Index, waist circumference and body fat percentages of the amputee soccer players were significantly lower than the sedentary amputees (P<0.05). The endurance of back extensors was significantly higher in the soccer group (119.33±47.15 s) than the endurance in the control group (26.25±15.96 s) (P<0.001). Subjects belonging to the soccer group had significantly higher anaerobic power than those in the control group (P<0.05). Flexibility, as assessed by the sit-and-reach test was significantly higher for the soccer group (P=0.002), whereas the modified Thomas test, which is also used to measure flexibility, indicated no significant difference among both groups (P>0.05). Balance was higher in the soccer group (P=0.023). The completion period of the F8W test was significantly lower in the soccer group (4.54±0.9 s) than in the control group (7.71±2.25 s) (P<0.001). No significant difference was observed in the numbers of steps measured during the F8W test (P=0.231). CONCLUSIONS: This is the first study which investigates the effects of sports on the physical fitness of individuals with transtibial amputation with the inclusion of a control group. Overall findings present the benefits of participating in playing soccer on physical fitness parameters of amputees, but further studies with randomized controlled trials, with larger populations, and with other sport branches should be conducted to motivate all amputees to participate in sports.

Translation and cross-cultural adaptation of the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale into Turkish.

PURPOSE: To translate and culturally adapt the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale into Turkish (ACL-RSI-Tr) and examine and evaluate the psychometric properties of the Turkish version in individuals who have undergone anterior cruciate ligament (ACL) reconstruction. METHODS: The ACL-RSI was forward- and back-translated, culturally adapted and validated on ninety-three Turkish individuals who had undergone ACL reconstruction (5 females, 88 males; age 28.7 ± 8.6 years; body mass 80.1 ± 13.9 kg; height 178.8 ± 6.9 cm; body mass index 25.0 ± 3.7 kg/m2). All patients completed the translated ACL-RSI, Tampa Scale of Kinesiophobia (TSK), Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentary Committee (IKDC) and Lysholm questionnaires. We then analysed the internal consistency, reliability and validity of the newly formed ACL-RSI-Tr scale. RESULTS: The ACL-RSI-Tr showed good internal consistency (Cronbach's alpha 0.86) and test-retest reliability (ICC 0.92) and was significantly correlated with the KOOS 'quality of life' (r = 0.58, p < 0.002), 'symptoms and stiffness' (r = 0.35, p = 0.001), 'pain' (r = 0.49, p < 0.001), 'sports' (r = 0.44, p < 0.001) and 'daily life' (r = 0.42, p < 0.001) subscales. The ACL-RSI-Tr also correlated significantly with the TSK (r = - 0.45, p < 0.001), Lysholm (r = 0.45, p < 0.001) and IKDC (r = 0.44, p < 0.001) scores. CONCLUSIONS: The Turkish version of the ACL-RSI scale was valid, discriminant, consistent and reliable in patients who had undergone ACL reconstruction. This score could be useful to evaluate the effect of psychological factors on return to sport following ACL surgery. LEVEL OF EVIDENCE: Diagnostic study, Level I.

Long term test-retest reliability of Oswestry Disability Index in male office workers.

BACKGROUND: The Oswestry Disability Index (ODI) is one of the most common condition specific outcome measures used in the management of spinal disorders. But there is insufficient study on healthy populations and long term test-retest reliability. This is important because healthy populations are often used for control groups in low back pain interventions, and knowing the reliability of the controls affects the interpretation of the findings of these studies. OBJECTIVE: The purpose of this study is to determine the long term test-retest reliability of ODI in office workers. METHODS: Participants who have no chronic low back pain history were included in study. Subjects were assessed by the Turkish-ODI 2.0 (e-forms) on 1st, 2nd, 4th, 8th, 15th, 30th days to determine the stability of ODI scores over time. The study began with 58 (12 female, 46 male) participants. 36 (3 female, 33 male) participated for the full 30 days. STATISTICS: Kolmogorov-Smirnov and Friedman tests were used. Test-retest reliability was evaluated by using nonparametric statistics. All tests were done by using SPSS-11. RESULTS: There was no statistically significant difference among the median scores of each day. (χ= 6.482, p >  0.05). CONCLUSION: The difference between median score of the days with 1st day was neither statistically nor clinically significant. ODI has long term test re-test reliability in healthy subjects over a 1 month time interval.

Scapular resting position, shoulder pain and function in disabled athletes.

BACKGROUND: Despite the fact that the number of disabled individuals participating in sports is increasing, there are only sparse reports in the literature concerning overuse injuries. OBJECTIVES: The purpose of this study was to compare scapular resting position, shoulder pain, and function in wheelchair basketball, amputee soccer, and disabled table tennis players. STUDY DESIGN: Descriptive study. METHODS: A total of 63 disabled players from amputee soccer, wheelchair basketball, and disabled table tennis participated in our study. Scapular resting position was taken as primary outcome; pain and function were taken as secondary outcome measurements. Scapular resting position was evaluated with Lateral Scapular Slide Test. Visual Analog Scale was used for evaluating shoulder pain intensity. Quick disabilities of the arm, shoulder, and hand questionnaire were used to assess upper extremity function. RESULTS: There was a significant difference in shoulder pain, function, and scapular resting position in all groups (p < 0.05). Paired comparisons between amputee soccer and wheelchair basketball players and also amputee soccer and disabled table tennis showed difference for all measurement parameters (p < 0.05). CONCLUSION: When the results are evaluated, it may be stated that amputee soccer players have better scapular resting position than other sports. Crutch usage may not negatively affect scapular resting position and perceived function as much as wheelchair usage. Exercise techniques for shoulder and resting position could be included in training programs of disabled athletes. CLINICAL RELEVANCE: Wheelchair/crutch usage is a risk, and special exercise techniques for shoulder and dyskinesis could be included in training programs to prevent injury. However, it may not just be important for wheelchair athletes, it may also be important for amputee soccer players. In particular, total upper extremity evaluations and exercises could be added within exercise programs.

Effect of gender on the quadriceps-to-hamstrings coactivation ratio during different exercises.

CONTEXT: Coactivation ratio of quadriceps to hamstring muscles (Q:H) and medial to lateral knee muscles (M:L) contributes to the dynamic stability of the knee joint during movement patterns recommended during rehabilitation and important for daily function. OBJECTIVE: To compare the quadriceps-to-hamstring and medial-to-lateral knee muscles' coactivation ratios between men and women during the following closed kinetic chain exercises performed on a balance board: forward lunge, side lunge, single-leg stance, and single-leg squat. DESIGN: Cross-sectional. PARTICIPANTS: 20 healthy subjects (10 female and 10 male). MAIN OUTCOME MEASURES: Surface electromyography was used to measure the activation level of quadriceps (vastus lateralis and medialis) and hamstrings (biceps femoris and medial hamstrings) during forward- and side-lunge, single-leg-stance, and single-leg-squat exercises. Subjects were instructed during each exercise to move into the test position and to hold that position for 15 s. EMG was recorded during the 15-s isometric period where subjects tried to maintain a "set" position while the foot was on a balance board. Analysis of variance was used for statistical analysis. RESULTS: There was a significant exercise-by-gender interaction for Q:H ratio (F3,48 = 6.63, P = .001), but the exercise-by-gender interaction for M:L ratio was not significant (F3,48 = 1.67, P = .18). Women showed larger Q:H ratio in side-lunge exercises than men (P = .002). Both genders showed larger M:L and lower Q:H ratio in a single-leg-stance exercise than in the other exercises. CONCLUSIONS: The results indicate that the forward- and side-lunge and single-leg-squat exercises should not be recommended as exercise where a balanced coactivation between quadriceps and hamstring muscles is warranted. Single-leg-stance exercise could be used when seeking an exercise where the ratio is balanced for both women and men.

Activation of selected ankle muscles during exercises performed on rigid and compliant balance platforms.

STUDY DESIGN: Experimental laboratory study. OBJECTIVE: To compare how the design of 2 balance platforms affects ankle musculature activation for various weight-bearing exercises. BACKGROUND: Balance platforms are widely used in both training and rehabilitation, and a better understanding of how platform design and type of exercise modify the demands on the ankle musculature may be helpful in staging exercise progression. METHODS: Surface electromyography was used to measure the activation level of the fibularis longus, tibialis anterior, and medial gastrocnemius while performing 4 exercises on 2 different balance platforms (compliant and rigid). Twenty-four (12 females, 12 males) healthy, sedentary subjects participated in the study. Analysis of variance was used for statistical analysis. RESULTS: There was no significant interaction between balance platforms and exercises (P>.05), and the type of platform did not influence muscle activation for the 3 muscles monitored (P>.05). The highest activation level for the fibularis longus and medial gastrocnemius was obtained during single-leg stance, and for the tibialis anterior during the single-leg squat (P<.05). CONCLUSION: In this study, although the demands on the ankle musculature were similar for selected exercises performed on a compliant versus a rigid balance platform, muscle activation level varied based on the exercise.

Effectiveness of manual therapy and home physical therapy in patients with temporomandibular disorders: A randomized controlled trial.

The purpose of this study was to compare the short-term effectiveness of home physical therapy (HPT) alone with that of manual therapy (MT) in conjunction with home physical therapy (MT-HPT) performed for four weeks in patients with temporomandibular disorders (TMD). Forty subjects (nine males and 31 females; age, 18-72 years) with TMD were randomly divided into two groups: HPT (n = 20; five males and 15 females; mean age, 34.8 ± 12.4 years) and MT-HPT (n = 20; four males and 16 females; mean age, 37.0 ± 14.6 years). Pain intensity was evaluated at rest and with stress using a visual analogue scale (VAS). Pain-free maximum mouth opening (MMO) was also evaluated. Mean change score (MCS) in VAS and the smallest detectable difference (SDD) in pain-free MMO were measured over time. The results were analysed by MANOVA to evaluate the effects of treatment over time. At baseline, the groups did not differ from each other with respect to VAS scores and pain-free MMO (p > 0.05). Within each group, VAS with stress decreased (p < 0.001) and pain-free MMO increased (p < 0.001) over time. Between groups, both time*treatment effect and treatment effect were significant for VAS with stress (p < 0.001); however, only time*treatment effect was significant for pain-free MMO (p = 0.009). In the MT-HPT group, MCS for VAS with stress was 91.3% and SDD for pain-free MMO was 10 mm. Our results suggest that a four-week period of MT-HPT has a clinically significant effect on both pain and pain-free maximum mouth opening in patients with TMD.