Comparison of the effectiveness of late-phase clinic-based and home-based progressive resistance training in female patients with total knee arthroplasty.

BACKGROUND: Early rehabilitation after total knee arthroplasty (TKA) is crucial in functional outcomes. However, considering improvements in the first six months, there may be benefits to continuing rehabilitation beyond three months postoperatively to achieve maximum functionality and strength. OBJECTIVE: The aim was to compare: (a) effectiveness of late-phase clinic-based and home-based progressive resistance training (PRT) in female patients with TKA; and (b) crude cost of both interventions and explore feasibility. METHODS: Thirty-two patients were assigned to clinic-based PRT (n = 16) and home-based PRT (n = 16) groups. A training program was performed at the clinic or at home for eight weeks. Pain, quadriceps and hip abductor strength, patient-reported and performance-based outcomes, knee range of motion (ROM), joint awareness, quality of life (QoL) were assessed at baseline (three months postoperatively) and after 8-week intervention (five months postoperatively). Feasibility and crude cost were examined. RESULTS: Exercise adherence was 100% in clinic-based PRT and 90.6% in the home-based PRT group. Both interventions improved quadriceps and hip abductor muscle strength, performance-based and patient-reported outcomes, knee ROM, and joint awareness without side effects (p < .05). Clinic-based PRT showed better results in: activity pain (p = .004, ES = -0.888); knee flexion (p = .002, ES = 0.875) and extension ROM (p = .004, ES = -1.081); chair sit-to-stand test (p = .013, ES = 0.935); joint awareness (p = .008, ES = 0.927); and QoL than home-based PRT (p < .05). CONCLUSION: Late-phase clinical-based and home-based PRT interventions may be beneficial in improving muscle strength and functionality in patients with TKA. Late-phase PRT is feasible, cost-effective, and recommended for rehabilitation after TKA.

Effect of Superimposed Russian Current on Quadriceps Strength and Lower-Extremity Endurance in Healthy Males and Females.

CONTEXT: More studies are needed to compare the effect of voluntary contraction, electrical stimulation, and electrical stimulation superimposed onto voluntary contraction in improving trained and untrained homolog muscle strength and lower-extremity endurance. DESIGN: Seventy-six healthy young adults (age = 20.41 [3.07] y, 61 females and 15 males) were included in the study. Subjects were randomly divided into 3 groups as voluntary isometric contraction (IC) group, Russian current (RC) group, and superimposed Russian current (SRC) group. METHODS: All training regimens were performed under physiotherapist supervision for a total of 18 sessions (3 times per week for 6 wk). In each session, 10 ICs were achieved with voluntary isometric exercise only, RC only, or RC superimposed onto ICs. Main outcome measures were trained and untrained quadriceps strength (maximal voluntary isometric contraction [MVIC]) and lower-extremity endurance (sit-to-stand test). RESULTS: After 6 weeks of training, all outcome measures improved in all groups (P < .05), except the untrained quadriceps MVIC score of RC group (P = .562). The trained quadriceps MVIC score (P < .001, η2 = .478), untrained quadriceps MVIC score (P = .011, η2 = .115), and sit-to-stand test score (P < .001, η2 = .357) differed significantly among the 3 groups; post hoc analysis revealed that the trained quadriceps MVIC score was higher in SRC and RC groups than in the IC group, untrained quadriceps MVIC score was higher in SRC group than in the RC group, and sit-to-stand test score was higher in SRC group than in the RC group and IC group. CONCLUSIONS: RC and RC superimposed onto IC are superior to IC in improving quadriceps muscle strength, and RC superimposed onto IC is superior to RC and IC in improving lower-extremity endurance. RC superimposed onto IC and voluntary IC created cross-education effect on untrained quadriceps.

Effects of clinical Pilates exercises in individuals with fibromyalgia: A randomized controlled trial.

OBJECTIVE: This study aimed to investigate the effects of clinical Pilates exercises in patients with fibromyalgia (FM) and to compare the effects of one-to-one and group-based exercise methods. METHODS: A total of 42 women (mean age, 50.90±7.78 years) with FM were included. The participants were randomly divided into 2 groups (one-to-one exercise, n=16; group-based exercise, n=26). Disease impact was evaluated with the FM Impact Questionnaire, functional status with the Health Assessment Questionnaire, anxiety with the Beck Anxiety Inventory, quality of life with short form-36, and biopsychosocial status with the Bilissel Egzersiz Terapi Yaklasimi-biopsychosocial questionnaire. All the evaluations were performed pre- and post-treatment. Clinical Pilates exercises were carried out 2 days a week for 6 weeks. RESULTS: When the pre- and post-treatment data were compared, significant improvement was seen in all parameters in the group-based exercise group; in the one-to-one exercise group, improvement was noted in disease impact, quality of life, and biopsychosocial status. When post-treatment data were compared, only disease impact was significant for the one-to-one exercise group. Effect size results were found to be moderate and high for both methods. CONCLUSION: For clinical Pilates exercise in FM, one-to-one method was suggested to have high disease impact and low quality of life, whereas group-based exercise method showed high anxiety.

The effect of Tai Chi on balance and functional mobility in children with congenital sensorineural hearing loss.

Background: The aim of the study was to examine the effect of Tai Chi on balance and functional mobility in children with congenital sensorineural hearing loss.Methods: The study included 39 children, aged 10-14 years, with congenital sensorineural hearing loss. The participants were divided into three groups as the Tai Chi group, conventional exercise group, and control group. The Tai Chi group and the conventional exercise group received a 1-h exercise program twice a week for 10 weeks. The balance function of the children was assessed using the Pediatric Balance Scale, the balance subtest of Bruininks-Oseretsky Test 2-Short Form, and the Functional Reach Test. The Timed Up and Go Test and the Timed Up and Down Stairs Test were used to assess functional mobility. The Wilcoxon rank, Kruskal-Wallis. and Mann-Whitney U-tests were used for statistical analyses.Results: When the pre-training values of the groups were compared, with the exception of the Timed Up and Go test, there was no statistically significant difference with respect to demographic data, balance, and functional mobility parameters (p > 0.05). After training, the overall balance and functional mobility tests improved compared to pre-training values in both the Tai Chi and conventional exercise groups (p < 0.05). When the post-training values were compared between the groups, with the exception of the Functional Reach Test and the Timed Up and Down Stairs Test, the results of both exercise groups were superior to those of the control group (p < 0.05).Conclusions: The results of this study indicate that Tai Chi and conventional exercise programs have positive effects on balance and functional mobility in children with congenital sensorineural hearing loss. However, no superiority of Tai Chi or the conventional exercise programs was determined over the other. Both Tai Chi and conventional exercise programs could be used to improve balance and functional mobility in children with congenital sensorineural hearing loss.Implications for rehabilitationTai Chi and conventional exercises are effective on balance in children with congenital sensorineural hearing loss.Tai Chi and conventional exercises are effective on functional mobility in children with congenital sensorineural hearing loss.Tai Chi may be added to the rehabilitation program for children with congenital sensorineural hearing loss.

The efficiency of inspiratory muscle training in patients with ankylosing spondylitis.

Ankylosing spondylitis (AS) is an inflammatory rheumatic disease affecting mainly the axial skeleton and sacroiliac joints. The aim of the current study was to investigate the effects of inspiratory muscle training (IMT) on respiratory muscles and functional exercise capacity, as well as on the specific outcomes of the disease in AS patients. A total of 32 AS patients (mean age 37.37 ± 10.41 years) were randomly assigned as the Training Group (TG) (n = 16, mean age = 35.62 ± 8.18 years) who received IMT + conventional exercise, and the Control Group (CG) (n = 16, mean age = 39.12 ± 12.26 years) who only performed the conventional exercise program. All the subjects were evaluated at baseline and at the end of the 8th week. Respiratory muscle strength was assessed by measuring the maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax). Functional exercise capacity was measured using the 6-min walk test (6MWT). The Bath AS Disease Activity Index (BASDAI), Bath AS Disease Function Index and Bath AS Metrology Index were used for activity, function and basic measurements of the disease. A statistically significant improvement was determined in the PImax (p = 0.000), PEmax (p = 0.002), 6MWT (p = 0.041) and BASDAI (p = 0.049) values in the TG after training. There was a significant difference between baseline and after conventional exercise in terms of PEmax (p = 0.017) in the CG. The PEmax (p = 0.001) and the 6MWT (p = 0.053) values were significantly better in the TG. The results of this study demonstrated that IMT in addition to conventional exercises increased inspiratory muscle strength, functional exercise capacity and positively affected the disease activity in AS.

Comparison of emotional status and physical activity between women with chronic widespread pain and fibromyalgia.

OBJECTIVES: This study was conducted to compare the emotional status and physical activity level in women with chronic widespread pain (CWP) and fibromyalgia (FM). METHODS: Thirty-three women with CWP above the waist, including the upper extremities, and 68 women with FM were evaluated. To determine physical and emotional status, the Fibromyalgia Impact Questionnaire (FIQ), the Experience of Physical Activity Instrument, the Leisure Time Physical Activity Instrument, the Physical Activity at Home and Work Instrument, and the Hospital Anxiety and Depression Scale (HADS) were used. RESULTS: The CWP group had higher physical impairment scores than the FM group (p<0.05); however, the women with FM reported that they felt worse during the previous week than the other group before the interview. They also had higher scores for pain, morning tiredness and depression (FIQ 5, 7 and 10). Emotional symptoms were significantly elevated in FM patients versus the CWP patients. Conversely, no significant differences were found between the groups concerning the health status (FIQ-total) and physical activity (p>0.05). The results indicate that increased pain intensity and spread of pain have negative effects on both physical functioning and emotional status. CONCLUSION: The women with FM reported much more severe clinical symptoms than those with CWP. Therefore, in addition to physical functioning, the emotional status of women with chronic pain should also be evaluated.

A new tool measuring health-related quality of life (HRQOL): the effects of musculoskeletal pain in a group of older Turkish people.

The aims of this study were (1) to show the effects of musculoskeletal pain on health-related quality of life (HRQOL) and (2) to look at gender differences in this field in elderly people living in Turkey. Subjects were 900 men and women (65 years of age or above), with a mean of 70.93+/-5.6 years. The centers for disease control (CDC) HRQOL-4 survey tool was used to measure HRQOL of the subjects. A visual analog scale (VAS) was used to determine pain intensity. The subjects were also asked to indicate sites where they experienced pain in their body. Of the subjects, 72.1% reported musculoskeletal pain. The prevalence of pain was higher among women (85.5%) than men (61.8%). Pain of lower extremities was the most common in both sexes. Whereas the majority of the subjects with musculoskeletal pain reported fair-poor self-rated health, those without pain reported excellent-very good-good health. Compared with subjects who did not report pain, those with pain had increased the number of physically and mentally unhealthy days in the previous 30 days (p=0.0001). The investigators concluded that musculoskeletal pain interfered negatively with HRQOL, increasing the number of unhealthy days and decreasing physical and mental performance in the elderly participants.