Long-term outcomes of visual motor integration and motor development children with retinopathy of prematurity.

Premature infants have a risk of neurodevelopmental deficits. Little is known, however, about how retinopathy of prematurity (ROP) affects visual motor integration (VMI), which is necessary for both fine motor skills and further school abilities. Due to the systemic escape of bevacizumab in the treatment of ROP, concerns regarding the long-term neurodevelopmental effect of the drug have arisen. The aim is to evaluate VMI and motor development long-term outcomes after intravitreal bevacizumab (IVB) injection and laser treatment for ROP. Two groups of premature children were included: Bevacizumab group - 16 premature children who received IVB treatment and laser group - 23 premature children who underwent laser photocoagulation treatment in this single center cross-sectional study. At 2-6 years of age, VMI (Beery-Buktenica Developmental Test), motor development (Peabody Developmental Motor Scales-2), visual acuity, and refractive status were assessed. The incidence of abnormal visual function was significantly higher in bevacizumab group than in laser group (p = 0.022). The incidence of abnormal VMI skill was significantly higher in bevacizumab group than in laser group (p = 0.024). Incidences of abnormal gross, fine, and total motor skills were significantly higher in bevacizumab group compared to laser group (p < 0.05). Premature children who received bevacizumab for ROP demonstrated significantly lower VMI and motor development features than those with laser treatment at preschool age. Although our results suggest the relevance of bevacizumab injection in impaired VMI and motor development outcomes, general level of sickness rather than treatment might be the cause of delayed motor development.

The Effect of Vestibular Rehabilitation on Balance and Quality of Life in Patients with Bilateral Vestibular Hypofunction.

This study aims to investigate the effectiveness of vestibular rehabilitation on balance, dynamic visual acuity, and quality of life in patients with bilateral vestibular hypofunction (BVH). 20 patients diagnosed by videonystagmography were included in the study. Balance tests, Visual Analogue Scale (VAS), testing of Dynamic Visual Acuity (DVA), Dizziness Handicap Inventory (DHI), Computer-modified Clinical Test of Sensory Interaction in Balance (m-CTSIB), and Limits of Stability Test were applied before and 3 and 6 months after the treatment. Physiotherapy sessions were given at two-week intervals. According to the development of the patients, they were asked to perform a home exercise program with 10 repetitions 3 times a day. After 6 months of vestibular rehabilitation, improvements in balance and quality of life parameters were observed in the patients. VAS, DVA, DHI, all static balance parameters except Romberg, Semi-tandem eyes open were significant (p < 0.005). In computerized M-CTSIB, while no significant results were obtained on the hard surface with the eyes open (p = 0.126), statistically significant improvement was observed on the hard surface with the eyes closed and on a foam surface with eyes open and close. LOS results showed significant improvement in velocity, reaching the endpoint, and maximal deviation in all directions except the right posterior. While significant results were found in the right, posterior, left anterior, and left posterior directions in the reaction time section, there was no statistical significance in any of the direct control sections (p < 0.005). Trial registration number: NCT05231109, Date of registration:27/01/2022 (Retrospectively registered).

Effects of structured exercise program on severity of dizziness, kinesiophobia, balance, fatigue, quality of sleep, activities of daily living, and quality of life in bilateral vestibular hypofunction.

BACKGROUND: A minimal number of studies have documented the impact of Vestibular rehabilitation (VR) on the recovery rate of patients with bilateral vestibular hypofunction (BVH). OBJECTIVE: The purpose of this study was to investigate the effectiveness of structured VR programs on severity of dizziness, kinesiophobia, balance, fatigue, quality of sleep, activities of daily living (ADL) and quality of life (QoL) in subjects with chronic BVH. METHOD: Twenty-five participants diagnosed with BVH were included in the study. A structured VR program was applied in 50-minute sessions once a week and as a home exercise program 3 times a day over 8 weeks. Participants were evaluated for severity of dizziness with the visual analog scale, for kinesiophobia with the tampa scale of kinesiophobia, for balance with the Semitandem, tandem, and standing tests, for quality of sleep with the Pittsburgh sleep quality index, for ADL with the vestibular disorders activities of daily life, for QoL with dizziness handicap inventory and for fatigue with the fatigue severity scale at the baseline (T1), at 4th week (T2), 8th week (T3), and 20th week (T4) after study started. RESULTS: Significant difference in terms of Tandem Test and 1 Leg Stand Test was found in favor of T3-T4 Period (P < .05). There were significant improvements in terms of vestibular disorders activities of daily life, tampa scale of kinesiophobia, Pittsburgh sleep quality index and dizziness handicap inventory in favor of the T3 to T4 Period (P < .05). Significant difference in terms of visual analog scale was found in favor of T2 Period (P < .05). CONCLUSIONS: A twelve-week structured VR program may enhance severity of dizziness, kinesiophobia, balance, quality of sleep, ADL and QoL in participants with chronic BVH.

Dual-Task Balance Training for Motor Skill Development among Children with Intelligence Quotient Discrepancy.

The motor skills of people with mental disabilities are reportedly reduced compared with those of their peers. Therefore, any task incorporating both motor and cognitive skills was hypothesized to provide better motor recovery. The aim of this study is to find the effect of dual-task balance training (DTBT) on motor skill development in children of 6-13 years with intelligence quotient discrepancy (IQD) (score: 50-79). Overall, 30 individuals with mental disabilities aged 6-13 years having an IQ score of 50-79 were included. The participants were randomly divided into two groups that received dual-task training and standard balance training, respectively. IQ was measured with the Wechsler Intelligence Scale for Children-Revised, motor proficiency with the Bruininks-Oseretsky test, reaction time with COGNIBOARD, and balance with Functional Reach Test scores. Intervention was provided twice a week for 12 consecutive weeks. Participants in both groups showed higher test scores in all tests after the training program. Both training programs positively affected the motor performance of the participants. The DTBT was more effective in improving balance performance than the standard balance training. DTBT is a better tool than conventional balance training for improving motor skills and balance in children of 6-13 years with IQD (score: 50-79).

The Effects of Vestibular Rehabilitation on Kinesiophobia and Balance with Individuals Who has Vestibular Hypofunction.

 The study aimed to examine the effects of vestibular rehabilitation on kinesiophobia, quality of life, dynamic visual acuity, and balance. Thirty vestibular hypofunction patients aged 18-65 years who were diagnosed by videonystagmography (VNG) voluntarily participated in the study. Before and after treatment Tampa Kinesiophobia Scale, World Health Organization Quality of Life Scale-Turkish Short Form, Tandem Stance Test, Dynamic Visual Acuity, Visual Analog Scale to measure dizziness, Subjective Visual Vertical and Subjective for verticality and horizontality perception Visual Horizontal tests were applied. The exercise program was applied for 8 weeks. Patients were observed in the hospital every two weeks. The exercises given in the session were given as home exercises, 3 times a day, for 10 repetitions. As a result of the study, statistical correlations were found tandem stance test, subjective visual vertical and subjective visual horizontal tests for the perception of verticality and horizontality, visual analog scale to measure the severity of dizziness, dynamic visual acuity, quality of life and tampa kinesiophobia scales (p < 0.05). It can be said that vestibular rehabilitation improves the quality of life, balance, dynamic visual acuity, and overcomes kinesiophobia in patients. Trial registration number: NCT05070936, Date of registration:10/06/2021 (Retrospectively registered).

Changes in prefrontal cortex activation with exercise in knee osteoarthritis patients with chronic pain: An fNIRS study.

The role of exercise on pain modulatory mechanism of the prefrontal areas is not clear. We aimed to determine the effects of exercise on functional activity of the prefrontal cortex in patients with knee osteoarthritis (OA) with chronic pain and to assess the relationships between changes in clinical variables and cortical hemodynamics with exercise via functional near-infrared spectroscopy (fNIRS). Fifteen patients with knee OA with chronic pain were included. All participants attended an exercise program 3 times a week for 6 weeks. Pain during activity was assessed by visual analogue scale (VAS). Pain catastrophization, kinesiophobia and functionality were also measured. Brain hemodynamic activity was assessed with a 47-channel fNIRS system before and after the exercise. Pain, pain catastrophization, kinesiophobia and functionality scores significantly improved (p < 0.05) while functional activity of the dorsolateral prefrontal cortex (DLPFC) during painful stimuli was significantly reduced after exercise program (p < 0.05). Change in cortical hemodynamic activity within the DLPFC was significantly correlated with change in pain perception (R = 0.54, p < 0.05) and pain catastrophization scores (R = 0.44, p < 0.05). Exercise resulted in improvements in clinical assessments of pain severity and pain catastrophization which was accompanied by alterations in prefrontal cortex activation. We provided evidence about the pain modulatory effects of exercise at cortical level which is correlated with clinical improvements in patients with chronic pain. We demonstrate the feasibility and potential of fNIRS methodology for i) elucidating the neural mechanisms underlying chronic and stimulus evoked pain, and ii) exploring the effect of treatment methods on brain functionality.

The Effect of Video-Based Games on Hand Functions and Cognitive Functions in Cerebral Palsy.

Objective: The purpose of this study is to investigate the effect of Leap Motion Based Exergame Therapy (LMBET) on upper limb gross grip strength (GGS), pinch forces, hand functions, gross motor function, and cognitive functions in patients with cerebral palsy (CP). Materials and Methods: Twenty patients with CP (11 hemiplegia and 9 diplegia) were included in the study. Structured Neurodevelopmental Therapy-based hand rehabilitation (SNDTBHR) (first treatment period) was applied a total of 12 sessions, 2 sessions per week (total 6 weeks), and then LMBET (second treatment period) was applied a total of 12 sessions, 2 sessions per week (total 6 weeks). GGS was evaluated by "dynamometer," pinch strengths were evaluated by "pinch meter," hand skills were evaluated by "Manual Ability Classification System (MACS)" and "Jebsen-Taylor Hand Function Test (JHFT)," the gross motor level was evaluated by "Gross Motor Function Classification System (GMFCS)," and cognitive functions were evaluated by "Wisconsin Card Sorting Test (WCST)." Results: Significant difference was found between LMBET and SNDTBHR on GGF, pinch forces, JHFT, and WCST in favor of LMBET (P < 0.017). There was no significant difference between both MACS and GMFCS measurements (P > 0.05). Conclusion: Positive effects of both SNDTBHR and LMBET have been found. However, measurements after LMBET are statistically more significant. Future research should take into account higher patient allocation. Including additional leap motion training to conventional physiotherapy is feasible and might be promising to train cognitive function in children with CP.

Effects of additional action observation to an exercise program in patients with chronic pain due to knee osteoarthritis: A randomized-controlled trial.

BACKGROUND: Knee osteoarthritis (OA) leads to pain, stiffness, and functional impairment and eventually decreased level of the quality of life. Although several treatment methods have been used to achieve pain relief, patients still complain of pain. OBJECTIVE: The aim of this study was to investigate the effects of the addition of action observation therapy to an exercise program on pain severity, pressure pain threshold, kinesiphobia functionality, and pain catastrophization in knee OA patients with chronic pain. METHODS: This prospective, randomized-controlled, superiority trial included a total of 36 patients with knee OA. The patients were randomly divided into two groups as the treatment group (n = 18) receiving action observation therapy in addition to exercise and control group (n = 18) receiving exercise alone. The interventions were performed three times weekly for six weeks. The primary outcomes were pain and pressure pain threshold. Secondary outcomes were kinesiphobia, functionality, and pain catastrophization. All participants were assessed at baseline (pre-intervention) and after the six-week treatment (post-intervention). RESULTS: There was no significant difference in the primary and secondary outcome measures before and after the intervention between the groups (p > 0.05). Both groups showed a significant improvement in all outcome measures after the intervention (p < 0.01). CONCLUSION: Our study results suggest that action observation therapy in addition to an exercise program does not contribute any additional benefits to pain, pressure pain threshold, kinesiophobia, pain catastrophization, and functionality in knee OA patients with chronic pain. Nonetheless, further large-scale, long-term, prospective studies are needed to gain a better understanding on this subject.

Research on the Effects of a Web-Based System With Oculomotor and Optokinetic Stimuli on Vestibular Rehabilitation.

OBJECTIVE: The variety and use of technologies used in vestibular rehabilitation are very limited. The purpose of this study was to investigate the effects of a Web-based system on vestibular rehabilitation in patients with vestibular hypofunction. DESIGN: A total of 20 patients with unilateral vestibular hypofunction were randomly assigned to two groups. Conventional vestibular rehabilitation was applied to the control group, whereas the study group received treatment with the Web-based system supporting the vestibulo-ocular reflex with oculomotor and optokinetic stimulus (Simulation of Vestibulo-Ocular Reflex Exercises). Vestibular and balance tests, oculomotor level, the Tampa Kinesiophobia Scale, and the Dizziness Handicap Inventory were used to evaluate the treatment's efficacy. RESULTS: Vestibular symptoms and findings, balance tests, oculomotor functions, Tampa Kinesiophobia Scale, and Dizziness Handicap Inventory improved significantly in both groups after the interventions (P < 0.05). In the intergroup analysis, improvement was found in eyes closed Romberg, semitandem, and left one-foot position balance tests in favor of the study group (P < 0.05). CONCLUSION: The new vestibular technology, Simulation of Vestibulo-Ocular Reflex Exercises, was found to be effective in vestibular rehabilitation.

Is Xbox 360 Kinect-based virtual reality training as effective as standard physiotherapy in patients undergoing breast cancer surgery?

PURPOSE: Breast cancer surgery may be associated with pain and physical symptoms in the upper limbs. Functional impairment and pain-related avoidance of movement may further increase disability level. This study aimed to investigate the potential effects of early postoperative virtual reality (VR) therapy on pain, range of motion (ROM), muscle strength, functionality, and fear of movement. METHODS: Forty women with breast cancer who had undergone unilateral mastectomy with axillary lymph node dissection and who were receiving adjuvant therapy were included in the study and randomly assigned to two groups: the Kinect-based rehabilitation group (KBRG) and the standardized physical therapy group (SPTG). The KBRG (n = 20) received VR therapy using Xbox Kinect-based games and the SPTG (n = 20) received standard physiotherapy. Study subjects were assessed at baseline and after the 6-week treatment. Outcome measures were pain (visual analogue scale), grip strength (dynamometer), functionality (disabilities of the arm shoulder and hand questionnaire), muscle strength (handheld dynamometer), ROM (digital goniometer), and fear of movement (Tampa kinesiophobia scale (TKS)). RESULTS: Both groups detected significant changes in pain, ROM, muscle strength, grip strength, functionality, and TKS scores after the treatment (p < 0.01). Fear of movement was significantly improved in the KBRG and the SPTG displayed more improvement in functionality (p < 0.05). There were no differences in ROM, muscle strength, grip strength, and pain between the groups after the treatment (p > 0.05). CONCLUSION: Kinect-based VR therapy resulted in significant outcomes that were comparable to those obtained under standard physiotherapy in the early postoperative phase in patients who had undergone breast cancer surgery. TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov ( ClinicalTrials.gov identifier: NCT03618433).

Comparison of two different electrotherapy methods in low back pain treatment.

OBJECTIVE: To investigate the efficacy of High Intensity Laser Therapy (HILT) and Transcutaneous Electrical Nerve Stimulation (TENS) in low back pain (LBP). METHODS: Forty patients aged between 18 to 60 were included in this study. The patients were randomized into two groups as TENS (Group I) and HILT (Group II). The severity of pain was measured by Visual Analog Scale (VAS), and the range of motion (ROM) of the joint was measured by goniometer. The Oswestry Disability Questionnaire (ODQ) was used to assess the effect of LBP on daily living activities, and the Beck Depression Inventory (BDI) was used to assess depression. All patients were taken into physical therapy program for 5 days a week for a total of 20 sessions. Patients in Group I received ultrasound, hot pack and HILT, while the patients in Group II received ultrasound, hot pack and TENS. RESULTS: In the comparison of post-treatment improvements, among all parameters only VAS score had a significant difference in favor of Group I. CONCLUSIONS: The study demonstrated that HILT is more effective than TENS in terms of pain reduction and that HILT can be used as an alternative to TENS.

Three-dimensional evaluation of pelvic posture in adolescents with and without a history of low back pain

Background/aim: This study aimed to evaluate the three-dimensional (3D) profile of pelvic posture and postural displacements of the pelvis in adolescents with and without a history of low back pain (LBP). Materials and methods: Thirty-two adolescents participated in this study. Participants were asked if they had ever suffered LBP at some point in their lives. Participants were divided into two groups: with a history of LBP (LBP group) and without a history of LBP (control group). For 3D evaluation of pelvic posture, the PosturePrint system was used. Three digital photographs were obtained in an upright stance (anteroposterior, left-right lateral) and analyzed. Postural displacements of the pelvis were calculated as rotations in degrees and translations in millimeters. The posture index, which is the total postural displacements score, was recorded. Results: Overall, 40.6% of the participants reported a history of LBP, while 59.4% of the participants did not. Although the 3D profile of pelvic posture, postural displacements of pelvis, and posture index score were similar between groups, the majority of participants in both groups had altered pelvic and total body posture. Conclusion: The findings suggest that adolescents with LBP have a profile of pelvic posture similar to those of healthy adolescents without a history of LBP.