Chronic exercise effects on overall depression severity and distinct depressive symptoms in older adults: A protocol of a systematic and meta-analytic review.

INTRODUCTION: There is high evidence that chronic exercise benefits overall depression severity in older adults. However, late-life depression is characterized by considerable heterogeneity in clinical manifestation emphasizing the need for more individualized exercise intervention programs. Therefore, the objective of the proposed review is to investigate the effects of chronic exercise on overall depression severity and on different symptoms of depression in randomized controlled trials (RCTs) including older adults with a mean age of at least 60 years, and by considering the moderating effects of intervention characteristics and individual characteristics. METHODS: This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). We will use the Population-Intervention-Comparator-Outcomes-Study design (PICOS) criteria for study inclusion and will search the following database sources for relevant RCTs: Web of Science, Academic Search Complete, CINAHL, APA Psycinfo, SPORTDiscuss, Cochrane. Two independent reviewers will conduct the study selection, data extraction, and quality assessment. Disagreement will be solved by a third reviewer. Primary outcome will be changes in overall depression severity and secondary outcomes will encompass changes in symptoms of depression as defined by the DSM-5, such as sleep quality, fatigue, anxiety, mood, apathy, changes in weight, information processing speed, and executive functions, from baseline until the end of the intervention and to any available intermediary measurement or follow up. Meta-analysis will be undertaken to synthesize the effects of chronic exercise on primary and secondary outcomes. Subgroup analysis will investigate the moderating effects of intervention characteristics (frequency, intensity, duration, type of exercise, cognitive demand, social interactions, exercise supervision, behavioral change techniques, compliance, study design, dropout-rate, type of control group) and individual characteristics (age, sex, education, functional capacity, global cognition, population) on primary and secondary outcomes. Additionally, we plan to assess quality of evidence and publication bias, and to carry out sensitivity analysis. CONCLUSION: The results of the proposed review are anticipated to have a substantial impact on research and clinical practice. On the one hand, the review's conclusions could form the foundation for developing evidence-based recommendations for individualized exercise programs that alleviate depression in older adults. On the other hand, by revealing research gaps, the review results could encourage the formulation of research questions for further RCTs. PROTOCOL REGISTRATION NUMBER: This protocol has been published in the Prospero repository (PROSPERO 2022 CRD42022361418, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022361418).

Psychometric testing and the predictive validity of the Postpartum Depression Predictors Inventory-Revised (PDPI-R): A longitudinal study with Turkish women.

OBJECTIVE: The aim of this study was to investigate the validity and reliability of the prenatal and postnatal versions of the Postpartum Depression Predictors Inventory-Revised (PDPI-R) and to examine the predictive validity of PDPI-R in Turkish women, considering two gold standards to determine postpartum depression (PPD). METHODS: This prospective longitudinal study was conducted between August 2021 and September 2023. A total of 301 pregnant women participated in the study. Participants completed the PDPI-R during the third trimester of pregnancy (T1) and at 4 weeks postpartum (T2). At T2, participants also completed the Edinburgh Postnatal Depression Scale (EPDS), and women were interviewed using the Structured Clinical Interview for DSM-IV Disorders. RESULTS: The prenatal version of the PDPI-R predicted PPD with 64% (R:0.64) accuracy on the basis of the EPDS and 78% accuracy (R:0.78) according to DSM IV criteria. The postnatal version of the PDPI-R predicted PPD with 71% (R:0.71) accuracy on the basis of the EPDS and 81% accuracy (R:0.781) based on DSM IV criteria. The cut-off points exhibited the highest sensitivity and specificity values at 8.5 for the prenatal version and 10.5 for the postnatal version. CONCLUSIONS: The PDPI-R is a valid and reliable screening tool for identifying Turkish women at high risk of developing PPD and for estimating the psychosocial risk associated with PPD.

Relationship between body awareness level and musculoskeletal pain complaints, physical activity level and emotional status in healthy people.

INTRODUCTiON/AIM: Defining the physical, psycho-social effects of body awareness may help to explain the functional effects. It was aimed to examine the relationship between the body awareness level and musculoskeletal pain complaints, physical activity level, and emotional state in healthy people. MATERIALS AND METHODS: A total of 289 healthy individuals between the ages of 18 and 25 were included in the study. Body awareness level was using Body Awareness Questionnaire (BAQ), musculoskeletal pain complaint using The Nordic Musculoskeletal Questionnaire (NMQ), physical activity levels using International Physical Activity Questionnaire (IPAQ-short form) and emotional status using Beck Depression Inventory (BDI) were assessed. RESULTS: The mean age of the participants was 19.50 ± 1.55 years. The mean pain intensity was 2.48 ± 1.99. The BAQ score average was 91.87 ± 15.55. Thirty percent of the participants had a mild level and 14.9% had a moderate level of depression risk. While there was a weak positive relationship between the Disease Startup sub-dimension of BAQ and the moderate-level IPAQ score (r = 0.135, p = 0.022). Also there was a weak negative relationship between Disease Startup sub-dimension and the level of depression risk. A weak positive relationship was found between the changes in the body process and attention to subjects sub-dimension and the level of depression risk (r = 0.127, p = 0.030). There was a positive correlation between level of depression risk and pain intensity (r = 0.237, p = 0.000). Body awareness levels of individuals who had back pain in the last 1 month were higher than those who did not experience pain (p = 0.029). CONCLUSION: The results of the study showed that physical activity positively affected body awareness level. The body awareness level was directly related to the pain associated with the musculoskeletal system and emotional state. There is a need more studies examining the relationship between body awareness and pain, physical activity and emotional status with subdimensions of the BAQ.

Functional and biochemical improvement following total knee arthroplasty in early postoperative period.

OBJECTIVE: There are very few studies about total knee arthroplasty biomechanical and biochemical effects in the early postoperative period. The aim of this study was to investigate the effect of total knee arthroplasty on pain intensity, knee joint valgus angle, malalignment, functional status, knee joint position sense, and cytokine levels. METHODS: A total of 29 patients (female/male: 24/5) who underwent total knee arthroplasty were included in the late-stage knee osteoarthritis group, and 22 patients (female/male: 13/9) with grade 4 osteoarthritis were included in the early-stage knee osteoarthritis group. The visual analog scale and the Western Ontario and McMaster Universities Osteoarthritis Index were used to evaluate the pain intensity and functional status. Alignment and knee position sense measurements were also calculated. Systemic venous blood samples were taken to evaluate the interleukin-6, tumor necrosis factor-alpha, and interleukin-1 beta cytokine levels. RESULTS: In the study group, there were positive improvements in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 70° knee flexion angle parameters, and interleukin-6 of patients at the postoperative 6th week compared to the preoperative period (p<0.05). The patients in the study group had similar or better results in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 35°, 55°, and 70° knee flexion angles parameters, and in interleukin-6, compared to the control group at postoperative 6th week. CONCLUSION: Total knee arthroplasty provides improvements in pain, function, valgus angle, joint position sense, and interleukin-6 in the early postoperative period.

Relationships between anthropometric measurements, muscle strength and body awareness.

Most studies on body awareness offer data on assessment and treatment in disease situations. The aim of this study is to investigate the relationship between anthropometric measurements and body awareness level of healthy people. The study was carried out with 289 volunteer students between the ages of 18-25 who studied at university. Anthropometric measurements included height, weight, circumference measurements and measurement rates, skinfold thicknesses. In addition, grip strength and lower limb muscle strength was evaluated. The level of body awareness was evaluated by the Body Awareness Questionnaire. The mean age of the participants included in the study was 19.34 ± 1.48. Sixty five percent were female and 35% were male. A negative correlation was found between body weight and body awareness level (p = 0.02). According to the results of canonical correlation analysis, the model created with circumference measurement rates and sub-dimensions of the Body Awareness Questionnaire was found significant. There was significantly correlated between the changes in the body process and attention to responses, which are sub-dimension, and total right measurement of the lower limb (r:0.124; p: 0.035). In addition, there was a significant relationship between sleep-wakefulness cycle and waist-to-thigh ratios (r:- 0.172; p: 0.003). Our study showed that body awareness is directly related to body weight, lower limb circumference measurements, and waist-to-thigh ratio. These data revealed the effect of body awareness on anatomical structures.

Functional and biochemical improvement following total knee arthroplasty in early postoperative period

SUMMARY OBJECTIVE: There are very few studies about total knee arthroplasty biomechanical and biochemical effects in the early postoperative period. The aim of this study was to investigate the effect of total knee arthroplasty on pain intensity, knee joint valgus angle, malalignment, functional status, knee joint position sense, and cytokine levels. METHODS: A total of 29 patients (female/male: 24/5) who underwent total knee arthroplasty were included in the late-stage knee osteoarthritis group, and 22 patients (female/male: 13/9) with grade 4 osteoarthritis were included in the early-stage knee osteoarthritis group. The visual analog scale and the Western Ontario and McMaster Universities Osteoarthritis Index were used to evaluate the pain intensity and functional status. Alignment and knee position sense measurements were also calculated. Systemic venous blood samples were taken to evaluate the interleukin-6, tumor necrosis factor-alpha, and interleukin-1 beta cytokine levels. RESULTS: In the study group, there were positive improvements in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 70° knee flexion angle parameters, and interleukin-6 of patients at the postoperative 6th week compared to the preoperative period (p<0.05). The patients in the study group had similar or better results in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 35°, 55°, and 70° knee flexion angles parameters, and in interleukin-6, compared to the control group at postoperative 6th week. CONCLUSION: Total knee arthroplasty provides improvements in pain, function, valgus angle, joint position sense, and interleukin-6 in the early postoperative period.

Factors Affecting the Satisfaction Levels of Patients who Underwent Orthopedic Knee Surgery in the Early Postoperative Period.

The aim of this study was to investigate the effects of biopsychosocial parameters in the early postoperative period on the satisfaction of patients. Seventy-seven patients (female/male: 61/16, age: 40.28 ± 17.67 years) who underwent arthroscopic meniscectomy (n = 43), anterior cruciate ligament reconstruction (n = 25) and total knee arthroplasty (n = 9) were included in this study. The satisfaction levelwas evaluated using the Orthopedics Service Inpatient Satisfaction Survey (OTISS). In addition, the pain intensity, anxiety, depression, and independence level in daily living activities of the patients were evaluated. There was a very weak negative correlation between the anxiety and the satisfaction level with the physiotherapist and secretary (r: -0.274, p: 0.016; r:-0.265, p: 0.020). A very weak negative correlation was found between the pain intensity at activity and satisfaction with the nurse (r: -0.227, p: 0.048). There were very weak correlations between feeding and satisfaction with the physiotherapist (r: 0.292, p: 0.010), secretary (r: 0.285, p: 0.012), doctor (r: -0.269, p: 0.018), nurse (r: 0.300, p: 0.008) general satisfaction (r: 0.251, p: 0.028) and OTISS total score (r: -0.305, p: 0.007). In conclusion, the pain intensity, anxiety, and independence level in the early postoperative period were related to the satisfaction levels of patients who have undergone orthopedic knee surgery.

Validity and reliability of the Body Awareness Questionnaire in patients with non-specific chronic low back pain.

This study was conducted to determine the validity and reliability of the Body Awareness Questionnaire (BAQ) in patients with non-specific chronic low back pain. A total of 180 participants (96 women, 84 men), aged 21-64 years, with non-specific chronic low back pain were enrolled from June to December 2019. Sociodemographic features were collected. The pain intensity using the Visual Analog Scale, the disability status due to low back pain with the Oswestry Disability Index (ODI), the body awareness level using the BAQ, and self-esteem using the Rosenberg Self-Esteem Scale (RSES) were assessed. Test-retest reliability was assessed by intraclass correlation coefficients in patients 7 days apart. The mean age of the study subjects was 42.14 ± 13.27 years. The scale was found to be reliable in patients experiencing non-specific chronic low back pain. The Cronbach's alpha reliability coefficient was 0.767. The internal consistency ranged from 0.718 to 1.00 in the items. Intraclass correlation coefficients of items ranged from 0.560 to 1.000. Intraclass correlation coefficient of BAQ total score was found to be 0.786 (p = 0.000) in test-retest results. The scores of RSES were compared in order to assess the concurrent validity of BAQ. The concurrent validity analyses showed that the BAQ and RSES were significantly correlated (r = 0.188; p = 0.012). The BAQ is a valid and reliable scale for determining body awareness status in patients with non-specific chronic low back pain.

Turkish version of Brief Ataxia Rating Scale.

AIM: Our aim was to perform the Turkish-language adaptation of a practical ataxia rating scale for children. METHODS: The Brief Ataxia Rating Scale was subjected to cultural adaptation following receipt of the requisite permissions. Thirty-six children aged 4-18 years followed-up with a diagnosis of ataxia were included in the study. Evaluation of each child was recorded on video. The video recordings were scored independently by nine observers (four physiotherapists, one pediatric neurologist, and four pediatricians). Intra-rater reliability was tested by the same video images being scored twice, at 15-day intervals, by a pediatric neurologist. Intraclass correlation coefficients were used for inter-rater and intra-rater reliability. The Scale for the Assessment and Rating of Ataxia was used for concurrent validity. RESULTS: Good to excellent reliability was determined among the nine observers in terms of total scores with the intraclass correlation coefficient among the nine observers (intraclass correlation coefficient = 0.926; 95% CI: 0.885-0.956). Intra-rater reliability analysis results exhibited strong reliability in terms of scores elicited at two-week intervals (intraclass correlation coefficient = 0.967; 95% CI: 0.890-0.987, r = 0.97, p < 0.001). At concurrent validity analysis, a strong relation was determined between total Scale of the Assessment and Rating of Ataxia score and total Brief Ataxia Rating Scale score (r = 0.942, p < 0.001). CONCLUSION: The Turkish-language adaptation of the Brief Ataxia Rating Scale is reliable and valid for application in children.Implications for RehabilitationThis study shows the reliability and validity of the Turkish language adaptation of brief ataxia rating scale in children.The scale being both practical and easily applicable to ataxic children will contribute to broadening its use in the pediatric age group in particular.

Reliability and validity of Turkish version of pediatric balance scale.

Assessment tool is a key point to evaluate balance disturbances in children. The aim of this study was to analyze reliability and validity of Turkish version of pediatric balance scale. The present study included 34 children (13 girls; 21 boys) with balance impairments. The scale consists of 14 items. Eight observers assessed the video records of the participants for interrater agreement. One observer evaluated the records twice in 2 weeks for intrarater agreement. Intraclass correlation coefficient was used for the interobserver and intraobserver agreement. The Functional Reach Test was used to calculate concurrent validity. Mean age of the sample was 11.68 ± 3.53 years. The Turkish version of the scale was found to be reliable, perfectly (intraclass correlation coefficient for interobserver agreement = 0.915). Intraobserver agreement was also reliable, perfectly (ICC = 0.927). The strong correlation between pediatric balance scale and functional reach test was found (r = 0.692; p < 0.001). The Turkish version of the scale is a valid and reliable tool to evaluate children with balance impairments. Moreover, it is easy to use for health providers working with disabled children.

Orthopedics and Traumatology Inpatient Satisfaction Survey.

Inpatient satisfaction evaluation is essential for orthopedics serves. So the aim of this study was to develop a survey to evaluate the inpatients satisfaction in the orthopedics and traumatology service. The study was conducted with 102 patients (22 females and 80 males), who were hospitalized in an orthopedics and traumatology service. Data collection was performed with face to face interview. The survey development process was carried out in 4 steps: defining the problem and determining the subdimensions (1), composition an item pool (2), counselling expert (3), and reformation and implementation the survey (4). The final version of the survey have had 6 subdimensions: physiotherapist (1-3 items), inpatient administration (4,5 items), technical equipment and hygiene (6-8), doctor (9-11 items), nurse (12-14 items), and general satisfaction (15,16 items). In survey development process, internal consistency and item analysis were used for the reliability analysis. Cronbach alpha coefficient was calculated. The mean age of the participants was 41.43 ± 17.85 years, 85 of the patients underwent surgery on the knee, 13 on the hip, 3 on the leg, and 1 on the thigh. Six items were excluded from 22-itemed basic form of the survey as a result of the item analysis. The internal consistency of the final version of the survey was found good reliable (Cronbach alpha: 0.880). So health providers will be able to use it reliably on orthopedic inpatients speaking Turkish. Also it could be translate to other language to widely use.

Investigation of Body Awareness Level and Performance Emotional Status of Athletes in Different Branches of Sports.

CONTEXT: The level of body awareness, performance emotional state (PES), and demographic characteristics in different sports are subjects to be investigated. It is important to examine the concepts of PES and body awareness to better understand the body-mind relationship in different sports. OBJECTIVE: The aim of this study was to investigate the level of body awareness and PES of athletes. DESIGN: In this cross-sectional study, the independent variables are groups (4 different sports), and the dependent variables are body awareness and PES. PARTICIPANTS: The study was conducted on 188 licensed athletes (85 footballers, 36 basketball players, 34 handball players, and 33 swimmers). The mean age of the participants was 14.64 (1.89) years, mean height was 172.44 (11.03) cm, and mean body weight was 62.35 (13.12) kg. SETTINGS: Four sports clubs and 2 high schools were the intervention facilities. INTERVENTION: Body Awareness Questionnaire and Continuous Optimal Performance Emotional Status Scale-2 were used for data collection. Sociodemographic information was recorded. MAIN OUTCOME MEASURES: One-way analysis of variance was used for analysis of normal distribution data in 4 different groups, and the Kruskal-Wallis test was used for the analysis of data that did not show normal distribution. RESULTS: There was no difference in body awareness among the branches (P = .17). The PES of the footballers was better than that of other athletes (P = .01). The correlation between body awareness and PES was medium (r = .47, P < .01), and the correlations between body awareness and age, licensed year, and number of weekly training sessions were weak (r = .22, P < .01; r = .19, P < .01; r = .15, P = .03). CONCLUSIONS: The body awareness of athletes may not differ among different sports, but PES is related to many factors such as mood, age, license years, and number of training sessions. In rehabilitation and training, body awareness and PES should be evaluated together.

Turkish validity and reliability of the patient satisfaction scale in physiotherapy for patients with musculoskeletal pain.

BACKGROUND: Patient satisfaction is a key point in evaluating the quality of physiotherapy services. OBJECIVE: The aim of this study was to determine the Turkish language validity and reliability of the Patient Satisfaction Scale in Physiotherapy (PSSP). METHODS: The study included 168 participants, aged 18-74 years, with musculoskeletal pain. The PSSP, which comprises 14 items in the four sub-dimensions of treatment, admission, logistics and general satisfaction, was applied to all participants. Structural validity was assessed using the principal components method with varimax rotation. Internal consistency and the intraclass correlation coefficient (ICC) were used for the reliability analysis. The Patient Satisfaction Scale for Physical Therapy Outpatient Clinics (PCCPTO) was used to assess concurrent validity. RESULTS: The participants comprised of 71% females and 29% males with a mean age of 41.9 ± 14.9 years. The sampling competency index was 0.874. The Turkish version of the scale was found to be perfectly reliable (Cronbach's alpha reliability coefficient = 0.922). Internal consistency ranged from 0.762 to 0.904 in the subscales. Factor analysis revealed that the 14-item scale had four factors explaining 75.59% of the total variance. Floor and ceiling effects were not determined. Concurrent validity analysis showed a strong correlation between the PSSP and PCCPTO (r= 0.78; p< 0.0005). CONCLUSION: The Turkish version of the PSSP is a valid, reliable and easily applicable measure.