Comparison of trunk muscle endurance between women with and without chronic neck pain.

PURPOSE: To compare trunk flexor, extensor, and lateral flexor muscle endurance between women with moderate to severe disability due to chronic neck pain (CNP) and asymptomatic women. DESIGN: Observational case-control study. METHODS: Thirty women with CNP and Neck Disability Index scores ranging from 30% to 70% and 28 asymptomatic women were included. The visual analog scale was used to assess neck pain intensity at rest and during activity. To assess trunk muscles endurance, trunk flexor endurance test, Sorensen test, and side bridge endurance test were performed. RESULTS: Analysis of covariance indicated that neck pain group had lower body mass index-adjusted endurance times of trunk flexor, extensor, and lateral flexor muscles with large effect sizes (p < .001, η2 = 0.378-0.696). Trunk flexor endurance time showed a moderately negative correlation with neck pain intensity at rest and a weakly negative correlation with neck disability score (r = -460 and -365, p < .05). CONCLUSIONS: Women with moderate to severe disability due to CNP exhibited decreased trunk muscle endurance, which may be a predisposing factor for low back pain. Also, trunk flexor endurance was related to neck pain complaints. A holistic approach, addressing the entire spine rather than focusing solely on the cervical region, might be useful for managing CNP. CLINICAL IMPLICATIONS: The findings of reduced endurance in trunk muscles should consider incorporating interventions in the management of CNP to effectively address pain and disability.

Effects of foot exercises and customized arch support insoles on foot posture, plantar force distribution, and balance in people with flexible flatfoot: A randomized controlled trial.

BACKGROUND: Exercises strengthening foot muscles and customized arch support insoles are recommended for improving foot posture in flexible flatfoot. However, it is not known what the effects of exercises and insoles on plantar force distribution obtained during walking at different speeds. Also, randomized controlled trials comparing the effects of exercises and insoles are limited. RESEARCH QUESTION: What are the effects of foot exercises, customized arch support insoles, and exercises plus insoles on foot posture, plantar force distribution, and balance in people with flexible flatfoot? Do exercises, insoles, and exercises plus insoles affect outcome measures differently? METHODS: Forty-five people with flexible flatfoot were randomly divided into three groups and 40 of those completed the study. The exercise group performed tibialis posterior strengthening and short foot exercises three days a week for six weeks. The insole group used their customized arch support insoles for six weeks. The exercise plus insole group received both interventions for six weeks. The assessments were performed three times: before the interventions and at the 6th and 12th weeks. Outcome measures were (1) foot posture, (2) plantar force distribution in the following conditions: static standing, barefoot walking at different speeds, and walking immediately after the heel-rise test, and (3) balance. RESULTS: Foot posture improved in all groups, but insole was less effective than exercise and exercise plus insole (p<0.05). Plantar force variables obtained during standing and walking changed in all groups (p<0.05). The superiority of the interventions differed according to the plantar regions and walking speed conditions (p<0.05). Static balance improved in all groups, but limits of stability improved in the exercise plus insole and exercise groups (p<0.05). SIGNIFICANCE: The superiority of the interventions differed according to the assessed parameter. The management of flexible flatfoot should be tailored based on the assessment results of each individual.

Neurocognitive training enhances the outcomes of children with attention deficit hyperactivity disorder: A preliminary study.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by diverse clinical manifestations including inattention, hyperactivity and impulsivity. OBJECTIVE: The present study aims to investigate the effects of neurocognitive training (NT), a personalized and specialized exercise programme on symptoms, attention and dynamic balance in treatment-naïve children diagnosed with ADHD. METHODS: Fourteen treatment-naïve children aged 7-12 years diagnosed with ADHD were enrolled in the intervention group. The NT intervention was administered weekly for 10 consecutive weeks, supplemented by a structured home exercise programme for 6 days a week over the same 10-week period. ADHD-related symptoms, attention and dynamic balance were assessed in pre-treatment, post-treatment, 6 months, and 12 months. Fifteen typically developing (TD) children, matched for age, underwent evaluation only once to establish baseline normative values. RESULTS: Following the NT (post-treatment), significant improvements were observed in hyperactivity-impulsivity scores, oppositional-defiant behaviours and dynamic balance when compared to the TD children (p < 0.05). In the ADHD group, a significant difference was found in the long term (12-month follow-up) in hyperactivity-impulsivity, oppositional-defiant behaviours and dynamic balance (p < 0.05). CONCLUSION: The findings suggest that the NT yields favourable effects on hyperactivity-impulsivity, oppositional defiant behaviours and dynamic balance in children diagnosed with ADHD, with these improvements appearing to be sustained over the long term. CLINICAL TRIAL REGISTRATION NUMBER: NCT04707040.

Effects of a single session action observation training on hand function in healthy young adults: a randomised controlled assessor and participants-blinded trial.

PURPOSE: The aim was to investigate the effects of a single session action observation training (AOT) on hand function and evaluate whether observing self-actions would be more effective than observing someone else. MATERIALS AND METHODS: A total of 60 right-handed healthy young adults, (32 female, 28 males and the mean age was 21.32 ± 1.07 years) were included in the study. The participants were randomly divided into five groups, self-action observation (sAO), observation of a third person (AO), action practice (AP), non-action observation (nAO), and control. A single session was performed for all participants. The primary outcome was the Jebsen Taylor Hand Function Test (JTHFT) assessed by a masked assessor. RESULTS: Significant differences were observed between the sAO and control group in total left side JTHFT performance (p < 0.001). Additionally, there were significant differences between the AO and control group (p < 0.001), and AP and nAO group (p = 0.003) and AP and control group (p < 0.001) in total JTHFT performance change of the left side. Significant differences were found between the sAO and nAO (p = 0.001) and control groups (p < 0.001) in dominant side total JTHFT performance change. No difference between sAO and AP groups were observed (p > 0.05). CONCLUSION: It was observed that a single session of action observation training improved hand function in healthy adults. The better performance achieved in the group watching the self-video may suggest that watching the self-image activates more mirror neurons.

Differences of diaphragmatic muscle contraction between female patients with chronic neck pain and asymptomatic controls: A case-control study based on ultrasonography.

BACKGROUND: Recent systematic reviews and meta-analyses show that individuals with chronic neck pain (CNP) have altered respiratory muscle strength and abnormal respiratory mechanics. However, no study has investigated the diaphragmatic function in individuals with CNP compared to asymptomatic peers. OBJECTIVES: This study aimed to compare the respiratory muscle strength and diaphragmatic function between patients with CNP and asymptomatic controls. DESIGN: Observational, case-control study. METHODS: A total of 25 women with CNP and 23 asymptomatic controls participated in this case-control study. The visual analog scale and neck disability index were used to assess the pain and disability characteristics of the CNP group. Maximum inspiratory and expiratory pressures (MIP and MEP) were measured to determine respiratory muscle strengths. The diaphragmatic function (muscle thickness in deep inspiration, Tins; and at the end of calm expiration, Texp; muscle thickness change, ΔT; contraction ratio, CR) were evaluated by two-dimensional ultrasonography. RESULTS: The MIP (p = 0.001, d = 1.11), ΔT (p = 0.033, d = 0.63), and CR (p = 0.012, d = 0.75) of the diaphragm were found significantly reduced in the CNP group compared to asymptomatic controls whilst MEP, Tins, and Texp of the diaphragm were similar between study groups (p > 0.05). The intensity of neck pain was moderately correlated with MIP (r = -0.48), Tins (r = -0.46), and ΔT (r = -0.42) while NDI (r = -0.42) had a moderate correlation with Tins (p < 0.05). CONCLUSION: The present findings revealed that women with CNP have altered diaphragmatic function. Thus, screening and targeting diaphragm may improve the rehabilitation process in CNP. However, further experimental studies regarding the efficacy of breathing exercise approaches are needed.

Assessment of diaphragmatic function by ultrasonography in patients with systemic sclerosis and its relation to clinical parameters : A case-control study.

BACKGROUND: Diaphragmatic function can be affected in many diseases and disorders. Although systemic sclerosis (SSc) is a serious connective tissue disease that affects not only the skin but also the pulmonary and musculoskeletal systems, there is insufficient information about diaphragm function. AIMS: To compare the diaphragmatic parameters by ultrasonography (USG) in patients with SSc and healthy individuals and examine the relationship between these parameters and clinical features in patients with SSc. METHODS: This study included 13 patients with SSc and 15 healthy individuals. Muscle thickness (in deep inspiration Tins and at the end of calm expiration Texp), changes in thickness (∆T), and thickening fraction at deep breathing were evaluated by USG. Skin thickness, pulmonary function tests, respiratory muscle strength, and the perception of dyspnea were measured as clinical features. RESULTS: The results of Texp, Tins, and ∆T were similar in both groups (p > 0.05), albeit patients in the SSc group had less thickening fraction compared to the control group (79.9 ± 36.7 cm and 103.8 ± 20.6 cm, respectively, p < 0.05). The Tins, ∆T, and thickening fraction of the diaphragm were associated with skin thickness, pulmonary function test parameters, and respiratory muscle strength (p < 0.05). Besides, there was significant correlation between muscle thickening fraction and perception of dyspnea (p < 0.05). CONCLUSION: These results confirm that diaphragm thickness and contractility can be affected in patients with SSc. Therefore, ultrasonographic evaluation of the diaphragm can play a complementary role to pulmonary function test and respiratory muscle strength measurement in the diagnosis and follow-up of patients with SSc.

Can olfactory training change the psychosocial aspects of chronic pain?

Pain and smell are the oldest senses for apperceive our environment. It is known that chronic pain and olfaction share common limbic cortical regions which are the main parts of the pain neuromatrix such as the anterior cingulate cortex, amygdala, and orbitofrontal cortex. Also, these regions point out the psychosocial aspects of chronic pain. And currently, the most challenging part of chronic pain management is the psychosocial aspect such as kinesiophobia, catastrophizing, or depression. Thus, the connection between olfaction and pain has promising clues to determining new combined therapies with odor training. According to intriguing brain imaging and genetic studies, we hypothesized that patients with chronic pain may have differentiated olfactory thresholds. Further, the additional odor training to the traditional therapeutic approach could be beneficial regarding the patients' pain perspective and psychosocial domains.

Are Static Foot Posture Measures Related to Static and Dynamic Plantar Pressure Parameters?

BACKGROUND: A few studies have investigated the relationship between foot posture measures and plantar pressure parameters, but no study has investigated the correlation of foot posture measures with all primary parameters consisting of contact area (CA), maximum force (MF), and peak pressure (PP). We aimed to determine the relationship of the Foot Posture Index-6 (FPI-6) and navicular drop (ND) with plantar pressure parameters during static standing and preferred walking. METHODS: Seventy people were included. Navicular drop and the FPI-6 were used to assess foot posture. Plantar pressure parameters including CA, MF, and PP were recorded by a pressure-sensitive mat during barefoot standing and barefoot walking at preferred speed. All assessments were repeated three times and averaged. Pearson correlation coefficients below 0.300 were accepted as negligible and higher ones were interpreted. RESULTS: Navicular drop was moderately correlated with dynamic CA under the midfoot and second metatarsal; also, the FPI-6 was moderately correlated with dynamic CA under the midfoot (0.500 < r < 0.700). The other interpreted correlations were poor (0.300 < r < 0.500). Both measures were correlated with dynamic CA under the second and third metatarsals; dynamic CA and MF under the midfoot; and static CA, MF, and PP under the first metatarsal and hallux (P < .01). Navicular drop was also correlated with dynamic MF under the first metatarsal and dynamic CA under the fourth metatarsal (P < .01). Furthermore, ND was correlated with static CA and PP under the second metatarsal and static PP under the fifth metatarsal (P < .01). The FPI-6 was also correlated with dynamic MF and PP under the hallux (P < .01). CONCLUSIONS: The correlations between foot posture measures and plantar pressure variables are poor to moderate. The measures may be useful in the clinical assessment of medial forefoot problems related to prolonged standing and midfoot complaints related to high force during walking. Furthermore, the FPI-6 may provide valuable data regarding hallux complaints related to the high loads during walking.

Physical activity and health anxiety in people with and without spinal pain during the COVID-19 lockdown: A comparison study.

OBJECTIVES: In the coronavirus disease 2019 (COVID-19) pandemic, physical inactivity and health anxiety which are common risk factors for musculoskeletal pain have become widespread due to strict precautions and isolation. Thus, we aimed to com-pare physical activity, health anxiety, and spinal pain history in people experiencing and not experiencing spinal pain during the COVID-19 lockdown. METHODS: This study was designed as a case-control study. Assessments including the Nordic Musculoskeletal Questionnaire (NMQ), the International Physical Activity Questionnaire-Short Form, and the Short Health Anxiety Inventory were performed through an online questionnaire using Google forms during the COVID-19 lockdown. We reached 494 volunteers, and 348 were eliminated by the exclusion criteria. One hundred and fifty-six participants were classified as the spinal pain group (n=70) and the asymptomatic group (n=86) based on the NMQ. RESULTS: The total amount of physical activity was less in the spinal pain group than the asymptomatic group (p<0.05). The spi-nal pain group had higher levels of health anxiety than the asymptomatic group (p<0.05). Further, the percentage of people who experienced spinal pain in the past year was higher in the spinal pain group (p<0.05). CONCLUSION: People experiencing spinal pain during the COVID-19 lockdown were physically less active and more concerned about their health. These results may be useful to improve the management of spinal pain during the lockdown or possible pandemic wave scenarios.

The acute effects of action observation training on upper extremity functions, cognitive processes and reaction times: a randomized controlled trial.

Aim: To investigate the acute effects of action observation training on upper extremity functions, cognitive functions and response time in healthy, young adults. Materials & methods: A total of 60 participants were randomly divided into five groups: the self-action observation group, action observation group, action practice group, non-action observation group and control group. The Jebsen-Taylor hand function test (JTHFT), nine-hole peg test, serial reaction time task and d2 test of attention were applied to the participants before and after the interventions. Results: JTHFT performance with both non-dominant and dominant hands improved significantly compared with baseline in all groups (p < 0.001). JTHFT performance with non-dominant and dominant hands differed between the groups (p < 0.001). Conclusion: Action observation training seems to enhance the performance of upper extremity-related functions. Observing self-actions resulted in statistically significant positive changes in more variables compared with other methods. However, its clinical effectiveness over the other methods should be investigated in future long-term studies. Clinical Trial Registration: NCT04932057 (ClinicalTrials.gov).

Comparison of ultrasonographic characteristics of deep abdominal muscles in women with and without chronic neck pain: a case-control study.

OBJECTIVES: To compare ultrasonography (USG) parameters of deep abdominal muscles (transversus abdominis-TrA, internal obliques-IO) between women with and without chronic neck pain (CNP). METHODS: Women with CNP (n=18; mean-age=37.7 years; mean-BMI=22.7 kg/m2) and asymptomatic individuals (n=18; mean-age=36.1 years; mean-BMI=21.8 kg/m2) participated in the study. The activation of the deep neck flexors (ADNF) was measured using cranio-cervical flexion test. Muscle thickness, changes in thickness (ΔT), and contraction ratio (CR) of deep abdominal muscles were evaluated by ultrasonography device in two conditions: standard-protocol and during ADNF. For each condition, ultrasound image of abdominal muscles was captured at rest and during abdominal draw-in manoeuvre (ADIM). RESULTS: Comparative statistics revealed no significant difference between groups regarding ultrasonography parameters in the standard-protocol (p>0.05). Besides, there was no difference in the CR of TrA and IO between groups in the two conditions. However, women with CNP showed less muscle thickness of TrAADIM during ADNF than the asymptomatic participants (p<0.05). The CNP group also had decreased ΔT of TrA(ADIM-rest) during ADNF compared to the asymptomatic group (p<0.05). CONCLUSIONS: The ultrasonography parameters of TrA suggest that motor control in the lumbar region is altered in women with CNP. The combination of cervical stabilization exercises with ADIM can be a novel strategy in the treatment of CNP.

The effects of calf muscles fatigue on dynamic plantar pressure distribution in normal foot posture and flexible flatfoot: A case-control study.

BACKGROUND: Flexible flatfoot is associated with altered plantar pressure distribution, but it is not clear how muscle fatigue affects plantar pressure characteristics in flexible flatfoot and normal foot. OBJECTIVE: To investigate the effects of calf muscles fatigue on plantar pressure variables in flexible flatfoot and normal foot. METHODS: Twenty-five people with flexible flatfoot and twenty-five people with normal foot were included. The unilateral heel-rise test was used to induce calf muscles fatigue. Plantar pressure variables were collected during preferred walking immediately before and after fatigue. The two-way mixed-design ANOVA was used to determine the main effect of fatigue and the interaction between foot posture and fatigue. RESULTS: Fatigue caused medialization of the contact area under the forefoot and the maximum force under the heel and forefoot (p< 0.05). When examining the differences in the effects of fatigue between groups, the contact area under the medial heel increased with fatigue in flexible flatfoot but decreased in normal foot; moreover, the contact area and maximum force under the midfoot and the maximum force under the third metatarsal decreased with fatigue in flexible flatfoot but increased in normal foot (p< 0.05). CONCLUSIONS: Calf muscles fatigue caused medialization of the maximum force and contact area. Especially the midfoot was affected differently by fatigue in flexible flatfoot and normal foot.

Effects of stabilization exercises on disability, pain, and core stability in patients with non-specific low back pain: A randomized controlled trial.

BACKGROUND: Many studies have emphasized the importance of stabilization exercises (SE) for the management of non-specific low back pain (NSLBP), yet there is no study assessing all aspects of core stability in comparing SE and other exercises. OBJECTIVE: To investigate the effects of SE on pain and core stability by using core stability tests that focus on all aspects of core stability in patients with NSLBP. METHODS: Thirty-seven individuals with chronic NSLBP were randomly divided into two groups as SE and conventional exercises (CE). Both groups underwent the progressive exercise program three days per week for six weeks. The assessments were conducted before and after the exercise programs. The outcome measures included pain, disability, trunk strength, trunk flexor, extensor and lateral flexor endurance, function, flexibility, and motor control during eyes open/closed. RESULTS: All assessment parameters except motor control during eyes open improved after SE (p < 0.05). Also, all assessment parameters except motor control during eyes open/closed and lateral trunk endurance improved after CE (p < 0.05). When comparing groups for gain scores, there were more significant improvements in pain during activity, endurance and function after SE (p < 0.05). CONCLUSIONS: SE is more effective than CE in reducing pain during activity and improving core stability regarding functionality and endurance.

Investigation of balance performance under different sensory and dual-task conditions in patients with chronic neck pain.

BACKGROUND: Most studies suggest that people with chronic neck pain (CNP) have decreased balance abilities. However, balance performance during performing concurrent tasks is not clarified. OBJECTIVES: To investigate balance performance under different sensory and dual-task conditions in people with and without CNP. METHOD: Twenty-two women with CNP and twenty-two asymptomatic women were tested using the Biodex Stability System. Overall stability index (OSI), anterior/posterior stability index (APSI), medial/lateral stability index (MLSI) were obtained in two sessions: eyes-open and eyes-closed. Both sessions consisted of four conditions: quiet standing, rotating head, counting backward, standing on foam. Higher index scores mean poorer balance. DESIGN: Case-Control study. RESULTS: A mixed factorial ANOVA (2 × 8 design) showed that there was a main effect of CNP on OSI, APSI, and MLSI (p < 0.001), which indicates that CNP causes poor balance. Further, there was an interaction between CNP and test conditions for only OSI (p < 0.05). Simple effects tests showed that patients with CNP had higher OSI in all conditions except standing on foam with eyes-open, and quiet standing and counting backward with eyes-closed (p < 0.05). The largest effect size was obtained during rotating head with eyes-open (η2:0.301), followed by counting backward with eyes-open and quiet standing with eyes-open (η2:0.267 and 0.245). Performing a concurrent task, closing eyes, or standing on foam mostly increased OSI in both groups (p < 0.05). CONCLUSIONS: Patients with CNP have poorer balance under different sensory and dual-task conditions. Addressing balance assessment while performing concurrent tasks, especially head rotations, may offer new insights into the management of CNP.

Gender differences in health anxiety and musculoskeletal symptoms during the COVID-19 pandemic.

BACKGROUND: Health anxiety is often associated with musculoskeletal symptoms and gender, but there are limited studies that investigate these relationships during the COVID-19 pandemic. OBJECTIVE: We aimed to compare the genders regarding health anxiety and musculoskeletal symptoms during the COVID-19 pandemic and to investigate the relationship of musculoskeletal symptoms with physical activity and health anxiety. METHODS: Assessments were performed through an online questionnaire. Eighty-five males and eighty-five females were included by matching genders in terms of age, body mass index, education level, number of days spent at home during the pandemic, and physical activity. The Short Health Anxiety Inventory, the International Physical Activity Questionnaire-Short Form, and the Nordic Musculoskeletal Questionnaire were used to assess health anxiety, physical activity, and musculoskeletal symptoms, respectively. RESULTS: Females had a higher level of health anxiety and more musculoskeletal symptoms than males (p< 0.05). There were weak to moderate correlations in females and weak correlations in males between musculoskeletal symptoms and health anxiety (p< 0.05). Also, a weak negative correlation was found between physical activity and musculoskeletal symptoms in both genders (p< 0.05). CONCLUSIONS: Females are more anxious and have more musculoskeletal symptoms during the pandemic than males. Also, health anxiety is related to musculoskeletal symptoms in both genders.

Is the pain pressure threshold linked to the transversus abdominis in women with chronic neck pain?: a preliminary report.

PURPOSE: The present study aimed to investigate the relationship between the ultrasonography parameters of transversus abdominis and neck pain manifestations in women with chronic neck pain. MATERIALS AND METHODS: Thirty women (mean age: 38.44 ± 9.56 years, BMI: 25.57 ± 3.32 kg/m2) with chronic neck pain were included in the study. The pain severity, disability scores, and bilateral pain pressure threshold of upper trapezius were assessed. The thickness of transversus abdominis in-rest and abdominal draw-in conditions were evaluated by two-dimensional ultrasonography. Pearson's correlation coefficients and linear regression statistics were determined. RESULTS: We found a moderate correlation between the thickness of transversus abdominis in abdominal draw-in and the pain pressure threshold of right (r = 0.636, p < 0.001), and left upper trapezius (r = 0.403, p = 0.03). Moreover, there was a moderate correlation between the pain pressure threshold of the right upper trapezius and the thickness of transversus abdominis in-rest (r = 0.498, p = 0.006). No significant correlation was found between pain intensity, disability scores, and ultrasonography parameters of transversus abdominis. There was also a significant total effect of transversus abdominis' thickness on abdominal draw-in manoeuvre on predicting pain pressure threshold of right upper trapezius (B = 0.636, SE = 0.765, p < 0.001) and pain pressure threshold of left upper trapezius (B = 0.403, SE = 0.840, p = 0.03). CONCLUSIONS: Our results revealed that upper trapezius muscle tenderness may associated with decreased muscle thickness of transversus abdominis. Addressing new exercise methodologies including transversus abdominis training in the management of chronic neck pain may be helpful to improve neck pain symptoms.

Investigation of the Relationships Among Clinical Measures of Foot Posture in Individuals with and Without Pronated Foot.

Background: Many indirect clinical techniques have been developed to assess foot posture; however, there is relatively little research investigating the relationships among these techniques. We investigated the relationships among the most commonly used clinical measures of foot posture-Foot Posture Index-6 (FPI-6), navicular drop (NDP), navicular drift (NDT), and static and dynamic arch indices (SAI and DAI)-in individuals with normal foot posture and those with pronated foot. Methods: Sixty-three individuals with FPI-6 scores of 0 to 12 were included. A digital caliper was used to measure NDP and NDT; SAI and DAI were measured by electronic pedobarography. Assessments were applied on the dominant foot. Pearson correlation coefficients were calculated to determine the relationships among measures. Participants were classified into two groups, pronated foot (n = 33) and normal foot posture (n = 30), based on FPI-6 scores, providing a multisegmental and multiplanar assessment. The independent-samples t test was used to compare groups regarding NDP, NDT, SAI, and DAI. Results: We found a high correlation between NDP and FPI-6 (r = 0.754) and between NDP and NDT (r = 0.778) (all P < .001). A moderate correlation was found between NDT and FPI-6 (r = 0.599) and between DAI and SAI (r = 0.519) (all P < .001). A negligible correlation was found between NDP and DAI (r = 0.268; P = .033). Furthermore, NDP, NDT, and DAI values were higher in individuals with pronated foot compared with those with normal posture (P < .001 for NDP and NDT; P = .022 for DAI), whereas SAI values were not (P = .837). Conclusions: These results suggest that there are moderate-to-strong relationships among FPI-6, NDP, and NDT and between SAI and DAI. The NDP, NDT, and DAI are suitable for the classification of foot posture based on FPI-6 scores. This study can guide clinicians and researchers to associate the foot posture measures with each other.

The effects of the addition of motor imagery to home exercises on pain, disability and psychosocial parameters in patients undergoing lumbar spinal surgery: A randomized controlled trial.

CONTEXT: Patients who have suffered from persistent symptoms often undergo lumbar spinal surgery (LSS). Motor imagery should be added to postoperative home exercises to reduce patient complaints. OBJECTIVE: The aim of this study was to compare the effects of home exercise plus motor imagery and only home exercise in patients undergoing LSS. DESIGN: A randomized controlled study. SETTINGS: This study was designed by researchers at Dokuz Eylul University. PARTICIPANTS: Thirty-seven patients undergoing LSS were randomized to motor imagery group (n = 19) and control group (n = 18). MAIN OUTCOME MEASURES: Pain was measured by Visual Analogue Scale, disability related to low back pain by Oswestry Disability Index, pain-related fear by Tampa Scale of Kinesiophobia, depression by Beck Depression Inventory, quality of life by World Health Organization Quality of Life Scale-Short Form (WHOQOL-BREF). All assessments were repeated in the preoperative period, three weeks after and six weeks after the surgery. INTERVENTIONS: Motor imagery group underwent home exercise plus motor imagery program applied by voice recording. Control group underwent only home exercise program. Exercise program compliance was monitored by exercise diary and telephone calls once every week. RESULTS: There was a significant improvement in pain at rest and during activity, disability, kinesiophobia, depression, physical health and psychological sub-parameters of WHOQOL-BREF between preoperative period, and the third week and sixth week in both groups (p < 0.05). When comparing groups for gain scores, there was a more significant improvement in pain during activity in motor imagery group (p < 0.05). Motor imagery should be addressed as an effective treatment after LSS.

Physical Fitness and Dynamic Balance in Medication Naïve Turkish Children with ADHD.

This study investigated physical fitness levels and dynamic balance in medication-naïve children with Attention-Deficit/Hyperactivity Disorder (ADHD). Participants were 24 medication-naïve Turkish children with ADHD (4 girls, 20 boys) and 19 typically developing (TD) Turkish children (4 girls, 15 boys). We measured physical fitness levels with the Eurofit Test Battery, body composition with the Inbody 720 Body Composition Analyzer, cognitive attention with the Stroop Test, and dynamic balance with the Y-Balance Test. We found significantly poorer dynamic balance and both upper extremity and running fitness problems among the medication-naïve Turkish children with ADHD compared to the TD group (p = 0.002; p = 0.032; p = 0.002). It may be important to adress dynamic balance and physical fitness when treating children with ADHD.