Fatigue of the intrinsic foot core muscles had a greater effect on gait than extrinsic foot core muscles: A time-series based analyze.

BACKGROUND: The Heel Rise endurance (HRE) which indicates the extrinsic foot core (ECO) muscle's performance and the paper grip endurance (PGE) which indicates the intrinsic foot core (ICO) muscle's performance are essential components of a healthy foot function. However, the foot core muscles' fatigue response on spatial and temporal gait parameters after the HRE and the PGE tests were not adequately investigated. The purpose of this study was to determine whether the fatigue of the ICO and the ECO muscles affect gait parameters. MATERIAL AND METHODS: A prospective, cross-sectional study was conducted on 22 sedentary individuals (44 feet). Gait was investigated pre and after the Heel Rise (HR) endurance test and the paper grip (PG) endurance test by inertial sensors. At least 500 consecutive steps were collected for each individual. Spatial-temporal gait parameters were used as outcome measures. RESULTS: ECO fatigue and ICO fatigue led to increases in the step length (p < 0.05) and the stride lengths (p < 0.05), the single support (p < 0.05), and the terminal stance durations (p < 0.05). It was also seen that ICO fatigue had a greater effect on gait than ECO fatigue. The ECO fatigue had a medium to large effect on the gait parameters (d=0.313-0.646). The ICO fatigue affected gait with a large effect (d=0.524-2.048). CONCLUSION: The ECO fatigue and the ICO fatigue led to clinically important changes in long-range gait parameters and the ICO fatigue had a greater effect on gait than ECO fatigue. It was suggested that clinicians add ICO muscle endurance training to improve the physical performance of individuals.

Synchronous and asynchronous telerehabilitation methods produce similar benefits in individuals with non-specific neck pain.

INTRODUCTION: Evidence exists on clinical benefits of synchronous and asynchronous telerehabilitation for patients with non-specific neck pain (NSNP); however, limited studies are comparing synchronous and asynchronous telerehabilitation (TR) programs in this population. The aim of this study was to estimate the relative effectiveness of an 8-week synchronous or asynchronous TR in improving pain, functional disability, kinesiophobia, and mobility in patients with NSNP. MATERIALS AND METHODS: This was a randomized, controlled clinical trial carried out on 60 individuals with NSNP. Participants were randomly assigned to synchronous TR group (n = 30) or asynchronous TR group (n = 30) that received the same exercise program for 8 weeks. Pain measured by Numeric Pain Rating Scale (NPRS), disability measured by Neck Disability Index (NDI), kinesiophobia measured by Tampa Scale of Kinesiophobia (TSK), and cervical range of motion were used as outcome measures. Assessments were performed at baseline, 4th week, 8th week, and 16th week. RESULTS: The analysis showed a significant effect of time and significant interaction between group and time in NPRS, NDI, TSK, and cervical mobility scores (p < 0.05), yet the group effect was not significant (p > 0.05). There were no significant differences between the groups at all time points (p > 0.05) except for cervical right lateral flexion at 8th week (p = 0.036). CONCLUSION: Telerehabilitation technologies are expanding at a rapid rate, and it is essential to understand the outcomes produced using these technologies in health conditions. This study showed that synchronous and asynchronous telerehabilitation produces similar results in patients with NSNP, supporting that either method can be used interchangeably.

Influence of Self-Reported Knee Instability on Outcomes Following Education and Exercise: A Cohort Study of 2,466 Patients With Knee Osteoarthritis.

OBJECTIVE: To study the influence of self-reported knee instability on changes in knee pain and gait speed following patient education and supervised exercise therapy in patients with knee osteoarthritis (OA). METHODS: We included patients enrolled in the Good Life With Osteoarthritis in Denmark (GLA:D) program, an 8-week education and supervised neuromuscular exercise program. Patients were classified into 4 groups according to their level of self-reported knee instability (never; rarely; sometimes; most of the time or all the time). Knee pain intensity was evaluated on a 0-100 mm scale and gait speed from the 4 × 10 meters fast-paced walk test at baseline and after the program. Using linear regression, we examined the association between knee instability and the change in pain and gait speed, respectively. Sex, age, body mass index, physical activity level, and previous knee surgery were covariates in adjusted models. RESULTS: Among 2,466 patients with knee OA, mean baseline pain and gait speed varied between 38-59 mm and 1.39-1.56 meters/second in patients experiencing no instability and patients experiencing instability most or all the time, respectively. All instability groups improved in pain and gait speed. Compared to the no instability group, patients reporting instability most or all the time experienced larger improvements in pain (4.3 mm [95% confidence interval 1.2, 7.5]), while no difference between instability groups was found for gait speed. CONCLUSION: Knee OA patients with self-reported instability seem to benefit even more from a patient education and supervised exercise therapy program than OA patients without instability.

Extracorporeal Shock Wave Therapy Versus Low Level Laser Therapy in The Treatment of Plantar Fasciitis: A Randomized Controlled Trial.

BACKGROUND: Plantar fasciitis (PF) is predominantly treated conservatively through some modalities such as extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT), yet the short effect of these modalities on pain and function is still ambiguous. This study aims to compare the short-term effectiveness of ESWT and LLLT on pain and function in patients with PF. METHODS: Participants (n=47) were randomly assigned into 2 groups as ESWT (n=27) and LLLT (n=20). ESWT (once a week) and LLLT (three times a week) were administered to the participants for 3 weeks. Foot function index (FFI) including pain, disability, and activity limitation subscales was administered at baseline and post-treatment. A reduction of one point in total scores was considered as a minimum clinically important difference. Repeated measures of ANOVA were used to analyze the changes in outcomes and compare the groups. RESULTS: There were significant main effects of time, and significant interaction effects between group and time on pain (P<0.001), disability (P<0.001), and activity limitation (P<0.05). The main effect of the group was not significant for all subscales (P=0.811, P=0.481, P=0.865, respectively). The LLLT group showed a significant decline in pain (P<0.001), disability (P<0.001), and activity limitation (P<0.001) while there was no change in the ESWT group over time (P=0.319, P=0.711, P=1.0 respectively). Consistently, 95% of participants in the LLLT had CID in the pain subscale whereas 48% of the ESWT group had. CONCLUSIONS: LLLT was found to be superior to ESWT as an effective approach in the short-term management of PF.

Individuals with a COVID-19 history exhibit asymmetric gait patterns despite full recovery.

COVID-19 is a multisystem infectious disease affecting the body systems. Its neurologic complications include -but are not limited to headache, loss of smell, encephalitis, and cerebrovascular accidents. Even though gait analysis is an objective measure of the neuro-motor system and may provide significant information about the pathophysiology of specific diseases, no studies have investigated the gait characteristics in adults after full recovery from COVID-19. This was a cross-sectional, controlled study that included 12 individuals (mean age, 23.0 ± 4.1 years) with mild-to-moderate COVID-19 history (COVD) and 20 sedentary controls (CONT; mean age, 24.0 ± 3.6 years). Gait was evaluated using inertial sensors on a motorized treadmill. Spatial-temporal gait parameters and gait symmetry were calculated by using at least 512 consecutive steps for each participant. The effect-size analyses were utilized to interpret the impact of the results. Spatial-temporal gait characteristics were comparable between the two groups. The COVD group showed more asymmetrical gait patterns than the CONT group in the double support duration symmetry (p = 0.042), single support duration symmetry (p = 0.006), loading response duration symmetry (p = 0.042), and pre-swing duration symmetry (p = 0.018). The effect size analyses of the differences showed large effects (d = 0.68-0.831). Individuals with a history of mild-to-moderate COVID-19 showed more asymmetrical gait patterns than individuals without a disease history. Regardless of its severity, the multifaceted long-term effects of COVID-19 need to be examined and the scope of clinical follow-up should be detailed.

Agreement Between Self-Reported Information and Administrative Data on Comorbidities, Imaging and Treatment in Denmark - A Validation Study of 38,745 Patients with Knee or Hip Osteoarthritis.

PURPOSE: To validate self-reported information obtained from patients with knee or hip osteoarthritis (OA) in primary care against administrative data from the three national Danish registries. PATIENTS AND METHODS: We compared the baseline and 12-month follow-up data from 38,745 patients with knee or hip OA participating in the Good Life with osteoArthritis in Denmark (GLA:D®) program with registry-based data on joint surgeries, pain medication dispensing, radiographs, and hospital diagnoses. Agreement was calculated using Cohen's Kappa (k) and percentage agreement, both with 95% CI. RESULTS: There was a moderate agreement between self-report and registry-based data for previous knee surgery (k=0.58, 84.99%) and a substantial agreement for previous hip surgery (k=0.73, 97.05%). Agreement varied from 0.05 to 0.95 and 84.99% to 99.94% for different types of surgeries with lowest agreement for collateral ligament surgery (k=0.05, 99.82%) and highest agreement for joint replacement (k=0.95, 99.54% for knee; k=0.95, 99.48% for hip). There was a moderate agreement (k=0.41, 81.59%) for knee and a slight agreement (k=0.20, 64.79%) for hip radiographs. Agreement varied from 0.01 to 0.53 and 65.39% to 99.90% for pain medication with lowest agreement for topical NSAID (k=0.01, 95.00%) and highest agreement for opioids (k=0.53, 92.56%). For comorbidities, agreement varied from 0.14 to 0.90 and 78.07% to 98.91%, with lowest agreement for anemia or other blood disease (k=0.14, 97.63%) and highest agreement for diabetes (k=0.90, 98.73%). CONCLUSION: As the most common types of pain medication used by patients with OA can be bought over-the-counter and as most OA patients are treated in primary care, which is often not covered by national registries, self-report of pain medication use and comorbidities is preferred but cannot be sufficiently validated against registry-based data. Future studies collecting self-reported information on joint surgery and pain medication from patients with OA should use a less detailed categorization to improve accuracy.

Muscle activation of the upper trapezius and functional typing performance during computer typing task: A comparison of two different wrist immobilization methods.

BACKGROUND: The aim of this study was to examine the effect of two different wrist immobilization methods on the muscle activation of the upper trapezius muscle and functional typing performance during computer typing tasks in office workers. METHODS: The study was conducted on 11 healthy office workers. The study subjects were asked to type on a computer for 5 min (1) without splint or taping, (2) with a splint, (3) with rigid taping which limits the wrist flexion at the dominant side. The upper trapezius muscle activation was recorded by surface EMG during the task. The mean values obtained from EMG were normalized according to Maximum Voluntary Isometric Contraction (MVIC), comparisons were made according to %MVIC. RESULTS: The office workers' mean age was 27.45 ± 3.64 years. There was no significant difference in immobilization methods between %MVIC on dominant (p = .508) and non-dominant (p = .213) sides. The upper trapezius of the non-dominant side showed higher electromyographic activity when the subjects used a splint (p = .013). There was a significant difference between splinting and rigid taping methods in typing performance (z = -2,491, p = .013). CONCLUSION: There is no significant difference in the upper trapezius muscle activation between the splint and rigid taping methods during the computer typing task on the dominant side. The typing performance was affected more during splint use compared to rigid tape application. Considering the importance of work efficiency in employees, rigid taping might be considered as an alternative splinting for wrist immobilization in office workers.

Evaluation of vestibular functions and balance in Edirne Band musicians.

BACKGROUND: It has been found that intense noise may affect the peripheral vestibular system and consequently causes problems in balance mechanisms. OBJECTIVE: The aim of this study was to investigate the effects of exposure to chronic noise on vestibular functions and balance in Edirne Band musicians. METHODS: Twenty-two individuals working in the Edirne Band for at least 5 years and a control group of 22 individuals working at Trakya University with similar sociodemographic characteristics were included. The socio-demographic questionnaire was used to inquire about the demographic characteristics of individuals, the ABC Scale to assess how they felt about the balance, and the DHI to determine the quality of life related to dizziness. A 3D ultrasonic system was used to assess the static and dynamic balance of the individuals. RESULTS: There was a statistically significant difference between the band and the control group in terms of longitudinal deviation and self-spin parameters of the Unterberger test, dizziness handicap inventory scores, functional balance according to activity-specific balance confidence scale (p < 0.05). CONCLUSIONS: As a result of our study, it has been shown that the balance, quality of life and vestibular system functions are negatively affected in the band exposed to noise for a long time.

Temporomandibular joint disorder determined by Fonseca anamnestic index and associated factors in 18- to 27-year-old university students.

OBJECTIVE: The aim of this study was to investigate temporomandibular disorder (TMD) and associated risk factors. METHODS: This study was conducted using 212 university students. Based on the Fonseca anamnestic index, the population was divided into two groups: those with TMD and those without TMD. The two groups were compared in terms of global body posture, craniohorizontal and craniovertebral angles, neck and temporomandibular joint range of motion, stress level, and sleep quality. RESULTS: Stress level, sleep quality, and left cervical rotation were found to have statistical differences between the groups (p = 0.00, 0.00, and 0.046, respectively). Sleep quality and stress level were found to be important risk factors for the presence of TMD (p = 0.017 and 0.00, respectively). DISCUSSION: In the prevention and treatment of TMD, a holistic approach that evaluates mechanical factors and psychosocial factors should be adopted.