Tele-assessment of core performance and functional capacity: Reliability, validity, and feasibility in healthy individuals.

INTRODUCTION: Many assessment methods are used in physiotherapy to analyze the fitness level and injury risk in athletes, and to determine the general health status and the effectiveness of the treatment applied in patients. Considering the need for telehealth use, it is essential to determine the usability of tests performed as tele-assessment. This study aimed to examine the intra-rater reliability, validity, and feasibility of the tele-assessment version of core strength and endurance and functional capacity assessments in healthy individuals. METHODS: "Curl-up," "Modified Push-up," "Plank," and "Lateral Bridge" tests were used for core strength and endurance performance assessment, and "Timed Up and Go," "30 second Sit to Stand," and "Functional Reach Test" tests were used for functional capacity assessment in healthy individuals. Participants were evaluated first by tele-assessment, then one hour later on the same day, all assessments were repeated face-to-face procedures by the researchers thus the validity of the tele-assessment method was determined. All tests were applied as tele-assessment one week later to determine the intra-rater reliability of the tele-assessment method. The system usability scale was applied to evaluate the usability of our tele-assessment method. RESULTS: Eighty healthy people were enrolled. Intraclass correlation coefficients ranged between 0.91 and 0.97 for core performance tests and between 0.95 and 0.97 for functional tests. All tele-assessment versions of the core performance and functional tests were highly correlated with the face-to-face versions. DISCUSSION: Core strength-endurance and functional tests performed via tele-assessment were reliable, valid, and feasible for practically measuring the performance of healthy young adults. This study supports the tele-assessment versions of these tests. TRIAL REGISTRATION NUMBER AND TRIAL REGISTER: Clinicaltrials.gov: NCT04899804.

The outcome of total hip arthroplasty in patients with developmental dysplasia of the hip.

BACKGROUND: The optimal rehabilitation program for patients with post-total hip arthroplasty (THA) after developmental dysplasia of the hip (DDH) remains unclear. OBJECTIVE: The aim of the present study was to evaluate the clinical outcomes, to define a postoperative rehabilitation program, and to report the complication rate of THA in patients with DDH. METHODS: DDH hips (n= 89) were recruited. The transverse proximal femoral shortening osteotomy was applied to all patients. The rehabilitation program was performed on the first day immediately after operation to the 6th week. Pain was assessed via Visual Analogue Scale, and the function was evaluated by the Harris Hip Score at the end of the 3rd month and the first year. The weakness of hip abduction was assessed via the Trendelenburg test before the operation and at one year. RESULTS: Statistically significant improvements were seen for pain (p< 0.001) and function (p< 0.001) in the third month. This improvement continued for pain from three months to one year (p< 0.001). However, the function did not increase from month three to one year (p= 0.47). The Trendelenburg test was positive in all cases in the first assessment; it decreased to 24.7% at one year. The complication rate was 11.23%. CONCLUSIONS: The pain and function of patients who performed exercise following THA due to DDH might improve, especially in the first three months.

The effectiveness of trigger point treatment in rotator cuff pathology: A randomized controlled double-blind study.

BACKGROUND: Studies have emphasized the importance of the presence of myofascial trigger points (MTrPs) in patients with rotator cuff pathologies and the high frequency of MTrPs in rotator cuff muscles. OBJECTIVE: Evaluate the effectiveness of the treatment of active MTrPs in patients with rotator cuff pathologies. METHODS: Fifty-three patients with rotator cuff tear were randomized into two groups. All patients received the same standard conservative treatment twice a week for 6 weeks. Patients in Group 1 additionally received ischemic compression (IC) of MTrPs. Pain, range of motion (ROM), function, and anxiety and depression were assessed. MTrPs in rotator cuff muscles were assessed manually, and the number of MTrPs on the shoulder complex was counted. RESULTS: There were no significant differences between the groups in terms of changes in resting/activity/night pain, ROM, function, or anxiety and depression (p> 0.05). Pain scores improved only in Group 1. However, the total number of MTrPs was significantly decreased in Group 1 (p= 0.001). CONCLUSION: A six-week course of IC helps treat active MTrPs. A standard conservative treatment program reduced pain and increased function; the addition of MTrP treatment did not improve clinical outcomes in patients with rotator cuff pathologies.

Intensive supervision of rehabilitation programme improves balance and functionality in the short term after bilateral total knee arthroplasty.

PURPOSE: To evaluate the short-term results of the rehabilitation programme with two different supervision on balance and functionality after simultaneously bilateral total knee arthroplasty (SBTKA) in patients with osteoarthritis and to compare the results with those of healthy individuals. METHODS: This study was a single-blind randomized controlled study. Two exercise groups who underwent primary bilateral total knee arthroplasty (Group 1, n = 20 and Group 2, n = 20) and a control group of healthy individuals (Group 3, n = 20) included in the study. Group 1 applied exercise programme with intensive supervision of the physiotherapist for a period of 1 month (2 days/1 week). Group 2 performed exercise programme under the control of same physiotherapist twice monthly (1 day/2 weeks), and the patients were checked every week by telephone interview. Pre-operative and post-operative blind evaluations were made at first and second month. Static balance with single leg stance test, dynamic balance with timed get up & go (TGUG), functionality with walking cadence, stair climbing test (SCT) and Western Ontario McMaster Universities (WOMAC) index were assessed. RESULTS: Group 1 improved statistically significantly better in terms of SLST (p = 0.0 (right), p = 0.0 (left)) and WOMAC function (p = 0.0) at first month, and SLST (p = 0.0), TGUG (p = 0.0), SCT (p = 0.0), WOMAC pain (p = 0.0), stiffness (p = 0.0) and function (p = 0.0) at second month. In Group 1, TGUG, walking cadence, SCT, WOMAC pain, stiffness and function results reached the levels of healthy individuals at second month, and SLST was better for two legs as compared to healthy individuals. In Group 2, cadence results were similar to healthy individuals at second month. CONCLUSIONS: The osteoarthritis patients who had the applied rehabilitation programme after SBTKA with intensive supervision of the physiotherapist for 1 month have obtained more improvements in balance and functional parameters, and it was demonstrated that their performances approached the healthy control group values. As a clinical relevance of our study, intensive supervision of rehabilitation programme should be provided to the patients after SBTKA surgery to accomplish early balance and functional improvements.

Patients' preoperative perspectives concerning the decision to undergo total knee arthroplasty and comparison of their clinical assessments.

[Purpose] The aims of our study were, 1. to assess pain, limitation of movement ability, and functionality in osteoarthritis patients scheduled to undergo total knee arthroplasty, 2. to determine if pain (Group 1) or function loss (Group 2) has a greater influence on the decision of patients to have surgery, and 3. to compare results between Group 1 and Group 2. [Subject and Methods] Fifty-five osteoarthritis patients classified as grades 3 and 4 according to the Kellgren-Lawrence system of classification were evaluated for preoperative pain intensity with the Visual Analogue Scale, knee flexion/extension range of movement with a clinical goniometer, and function with the Western Ontario and McMaster Universities Osteoarthritis Index. Patients were examined to reveal their reasons regarding the decision to undergo total knee arthroplasty (pain or function loss). [Results] The Visual Analog Scale scores at rest and during activity were 5.62 and 7.42, the knee flexion range of movement and extension limitation were 93.17° and -7.04°, and the Western Ontario and McMaster Universities Osteoarthritis Index value was 82.09. Regarding the decision to undergo surgery, 47.3% (n=26) of the knees were in Group 1, and 52.7% were in Group 2; the two groups were not significantly different. There were also no significant differences between the groups in Visual Analog Scale score during activity, the Western Ontario and McMaster Universities Osteoarthritis Index value, and knee flexion range of movement and extension limitation. The only statistically significant difference was found in the Visual Analog Scale score at rest in Group 1, which was significantly higher than that in Group 2. [Conclusion] Our results showed that osteoarthritis patients decided to undergo surgery only if all of the parameters were impaired significantly. Both pain and function loss have a similar impact on a patient's decision to undergo surgery. We observed no significant difference in clinical and self-reported outcomes between patients who decided to undergo surgery due to pain or function loss.

Effect of Whole-Body Vibration on Balance Using Posturography and Balance Tests in Postmenopausal Women.

OBJECTIVE: The authors examined the impacts of whole-body vibration (WBV) applications on balance control in postmenopausal women using clinical balance tests and computerized static posturography. DESIGN: Patients were randomly divided into two groups and treated with WBV and/or home-based balance coordination exercises (BCEs). Patients in the WBV-BCE group were asked to stand on the platform in standing, squat, and deep squat positions. During each position, 30-sec vibration (30-35 Hz) and 60-sec rest periods were applied twice (20 sessions in total). The BCE program was performed by subjects twice per day. All subjects were evaluated before and after treatment using the Timed Up and Go test and the Berg Balance Scale (BBS). The fall index and the Fourier index were assessed via computerized static posturography. RESULTS: Sixty patients were recruited for the study, but only 42 patients (21 in each group) completed it. Fall index and the total values of the Fourier index 2-4 and Fourier index 5-6 frequencies indicated a significant improvement in the WBV-BCE group (P < 0.05). Both groups showed significant improvements in the Berg Balance Scale and Timed Up and Go test (P < 0.05). CONCLUSIONS: The ease of applying WBV furthermore supports its inclusion in daily treatment protocols for age-related decline in balance performance in women and improved balance and mobility measures associated with increased fall risk.

[The prevalence of pain and different pain treatments in adults]. / Eriskinlerde agri ve farkli agri tedavilerinin prevalansi

OBJECTIVES: The aim of this study was to determine prevalence of pain (p) in adults and their preference for pain treatment, by using questionnaire. METHODS: First 7 questions of "Brief Pain Inventory-Short Form" and "Cornell Musculoskeletal Discomfort Questionnaire" were applied to 250 participants in face to face interview. A hundred eighty of the individuals were women (38.3±14.0 years old) and 70 were men (36.6±13.2 years old). Data analysis were performed using SPSS, version 10. RESULTS: Eighteen individuals (7.2%) had no pain and 232 (92.8%) of them had pain in different parts of the body. A hundred fourty five individuals had lowback p, 116 neck p, 101 dorsal p, 152 shoulder p, 69 upperarm p, 66 forearm p, 75 wrist p, 59 hip p, 69 upper leg p, 98 knee p, 81 crus pain. Their mean pain score was 3.6±1.8, mean pain score at its worst in the last 24 hours was 4.4±2.6. Thirty three percent of individuals had used non-steroidal anti-inflammatory and/or analgesic drugs to relieve pain, 22.7% had physical therapy, 4.1% had other pain-relief methods, 1.2% had surgery, and 38% had nothing. CONCLUSION: Our results showed that 92.8% adults had pain. Although shoulder has highest pain prevalance, severe pain was mostly described in lowback area. Knee pain was largely interfered work ability. An important percent of persons experiencing pain has recieved no treatment and first preference for treatment was drug. Inspite of high pain prevalence in our study, slightly uncomfortable pain severity and no need for treatment can be explain a result of individual differences in pain perception.