Evaluation of the Viscoelastic Properties of Lower-Extremity Muscles of Pediatric Hemophilia Patients Using Myotonometric Measurements.

This study aimed to evaluate the viscoelastic properties of lower-extremity muscles in pediatric hemophilia (FVIII-IX) patients. The study included 20 severe- and moderate-type right-dominant hemophilia patients diagnosed with hemophilia A-B and 20 healthy children. Viscoelastic properties (tone, stiffness, elasticity) of the lower-extremity muscles were measured using a MyotonPRO device. The physical characteristics of the pediatric hemophilia patients (mean age: 11.9 ± 3.95 years) and the control group (mean age: 12.6 ± 3.41 years) were found to be similar. A difference was observed only in the elasticity of the right vastus lateralis (p < 0.05) by means of the viscoelastic properties of the lower-extremity muscles. The results were similar in other muscle groups (p > 0.05). The dominant-side vastus lateralis muscle elasticity (the ability of the muscle to regain its original shape after contraction or removal of an external force) of hemophilia patients was found to be lower compared to healthy children. The fact that 45% of hemarthroses occur in the knee joint and that recurrent bleeding may affect the flexibility of the vastus lateralis, which is the main muscle within the quadriceps muscle group and responsible for the stabilization of the patella, can be associated with the study results.

Investigation of glucose, serum insulin levels, and insulin resistance in patients with major burn: a retrospective cross-sectional study.

BACKGROUND: Many studies have reported that insulin resistance (IR) is present and persistent in patients with major burns; however, the evidence remains insufficient. This study was planned to investigate insulin levels and IR in the early post-traumatic period in patients with major burns and to determine the prevalence of IR after burn injury. METHODS: This study included 68 patients. These patients were followed up once a week for 4 weeks after hospitalization. In the follow-up examinations, demographic and burn injury characteristics; HbA1c, procalcitonin serum glucose, and insulin levels; and IR were evaluated. RESULTS: IR was seen in some weeks only in 25 of the 68 patients included in the study. Among all patients, IR was determined in only 11 (16.17%) patients from the 1st day of hospitalization until discharge. Patients with and without IR were evaluated as 2 groups, and their biochemical parameters were compared, and no significant difference was found between glucose and procalcitonin levels (P>0.05). Glucose levels were >100 mg/dL in the first few weeks in all patients who were followed up; however, they returned to the normal range in the following weeks. CONCLUSION: In patients with IR, there was insufficient evidence to conclude that the condition persists. We believe that the HOMA-IR value is not directly related to burn injuries and that other additional pathologies may cause it during treatment.

The effects of functional electrical stimulation cycling on gait parameters in diplegic cerebral palsy: a single-blind randomized controlled trial.

PURPOSE: To investigate the effects of functional electrical stimulation cycling (FES-C) training in addition to conventional physical therapy on gait, muscle strength, gross motor function, and energy expenditure in ambulatory children with spastic diplegic cerebral palsy. MATERIALS AND METHODS: Twenty children with diplegic cerebral palsy were randomly assigned to FES-C group (n = 10) or control group (n = 10). Subjects trained 3 days/week for 8 weeks. Control group received conventional physical therapy. The FES-C group additionally received FES-C training. The functional muscle test was used for muscle strength assessment. Vicon-3D system was used for gait analysis. Gross Motor Function Measure (GMFM-88) was used for motor function assessment and calorimeter was used for energy expenditure. Measurements were performed at the baseline, at the eight week and at the sixteenth week. RESULTS: Functional muscle strength, gross motor function, and energy expenditure improved more in the FES-C group after training and follow up (p < 0.05). There was no significant difference found between the changes in gait parameters of the two groups after treatment and follow up (p > 0.05). Pelvic tilt while walking decreased after training in the FES-C group (p < 0.05). CONCLUSIONS: FES-C applied in addition to conventional physical therapy in children with diplegic cerebral palsy is more effective than conventional physical therapy for increasing functional muscle strength, improving gross motor function functions, and reducing energy expenditure.HighlightsFES-C improves lower extremity functional muscle strength, gross motor function, and energy expenditure in ambulatory children with spastic dCP.The use of FES-C in combination with conventional physiotherapy methods may be beneficial in outpatients with spastic dCP.

Use of Generalizability Theory Evaluating Comparative Reliability of the Scapholunate Interval Measurement With X-ray, CT, and US.

RATIONALE AND OBJECTIVES: There is no universally accepted standard technique for measuring the scapholunate interval and no specific sources of measurement error have been identified. We aimed to establish a set of normal radiological criteria for the scapholunate interval that could be used in comparative studies of wrist pathology to determine interobserver reliability and to identify potential errors that might influence measurements. MATERIALS AND METHODS: A total of 60 healthy volunteers participated in the study. Scapholunate interval was measured by three independent observers using X-ray, CT, and US in four positions, including neutral, fist, radial and ulnar deviation. Inter-observer reliability was tested using intraclass correlation coefficient. Generalizability theory was applied to evaluate specific sources of measurement error related to participant, observer, imaging modality and measurement position. RESULTS: In neutral position, the scapholunate interval measured by X-ray, CT, and US was 3.1 mm, 3.5 mm and 3.5 mm respectively. The interval remained constant during fist and radial deviation but decreased during ulnar deviation. Correlation coefficients ranged from 0.874 to 0.907 for X-ray, 0.773-0.881 for CT and 0.964-0.979 for US. In the generalizability study, the participant x modality x position interaction accounted for the largest proportion of total variance (29%). CONCLUSION: X-ray, CT, and US are reliable modalities for measuring the scapholunate interval, with US having the highest reliability. Participant and position factors may independently contribute to measurement error. Therefore, standardized measurement positions are recommended to obtain reliable measurement results.

Effect of the Premature Infant Oral Motor Intervention on Sucking Capacity in Preterm Infants in Turkey: A Randomized Controlled Trial.

BACKGROUND: Preterm infants have oral feeding difficulty that often delays discharge, indicating a need for evidence-based interventions for oral-motor development. PURPOSE: To test the Premature Infant Oral Motor Intervention (PIOMI) on the development of oral-motor function, feeding, and anthropometric outcomes using sucking manometry. METHODS: A single-blind randomized experimental design was conducted with a sample of 60 preterm infants from 2 neonatal intensive care units between May 2019 and March 2020. The experimental group received PIOMI for 5 min/d for 14 consecutive days. Sucking capacity, anthropometrics (weight and head circumference), bottle feeding, breast/chest feeding initiation, and length of hospital stay were measured. The Yakut Sucking Manometer (PCT/TR2019/050678) was developed specifically for this study and tested for the first time. RESULTS: The experimental group had a statistically significant percent increase over controls in sucking power (69%), continuous sucking before releasing the bottle (16%), sucking time (13%), and sucking amount (12%) with partial η 2 values of interaction between the groups of 0.692, 0.164, 0.136, and 0.121, respectively. The experimental group had a higher increase in weight (89%) and head circumference (81%) over controls ( F = 485.130, P < .001; F = 254.754, P < .001, respectively). The experimental group transitioned to oral feeding 9.9 days earlier than controls ( t = -2.822; P = .007), started breast/chest feeding 10.8 days earlier ( t = 3.016; P = .004), and were discharged 3.0 days earlier. IMPLICATIONS FOR RESEARCH/PRACTICE: The PIOMI had a significant positive effect on anthropometrics, sucking capacity, readiness to initiate bottle and breast/chest feeding, and a 3-day reduction in length of hospital stay.

The effects of close kinetic chain exercises on proprioception and physical activity level in pediatric patients with hemophilia.

INTRODUCTION: Knee joint proprioception is affected, and lower extremity functioning declines over time in patients with hemophilia A. AIM: To investigate the effects of a structured exercise programme consisting of the close kinetic chain (CKC) exercises on proprioception and physical activity level in pediatric patients with hemophilia. METHODS: A total of 21 patients with hemophilia A who had at least one target knee joint were randomized into three groups: Study Group (SG, n = 7), Conventional Treatment Group (CTG, n = 7) and Control Group (CG, n = 7). The SG received a structured, lower limb-specific exercise protocol consisting of CKC exercises 2 days a week for 12 weeks, in addition to prophylactic treatment. The CTG received exercise training as described in the published literature. The CG continued to receive prophylactic treatment during the study period. Proprioception was measured using a digital goniometer before and after treatment in open and closed kinetic chain positions (CKCPs). The Five Times Sit to Stand (STS), Timed Up and Go (TUG) and Functional Independence Score in Hemophilia were used for the assessment of physical activity level. RESULTS: A significant pre/post-treatment difference was found among the groups in proprioception (p = .001) and physical activity level (TUG p = .008, STS p = .001, FISH p = .006). Improvements in proprioception and physical activity level were greater in the SG compared to the other two groups (p < .05). CONCLUSION: Compared to conventional exercise, the structured exercise protocol consisting of CKC exercise training produced improvements in proprioception and physical activity in patients with hemophilia A.

An investigation of sleep profiles in individuals with idiopathic scoliosis.

Objective: Sleep behaviors have not been well investigated in individuals with idiopathic scoliosis (IS). This study aimed to investigate sleep quality and daytime sleepiness in individuals with IS and investigate the relationship between sleep parameters and curve magnitude, trunk deformity severity, pain, and emotional status in adolescents with IS. Material and Methods: Ninety-one participants between the ages of 10 and 19 years with IS were included. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI), and daytime sleepiness was assessed with Epworth sleepiness scale (ESS). Pain was assessed using the short-form McGill pain questionnaire; the presence or severity of depressive feelings was evaluated using the Beck depression scale. Results: The majority of the participants (64.8%) had poor sleep quality, while daytime sleepiness was within normal limits in most participants (85.7%).The frequency of participants without pain (52.7%) was similar to participants with pain (47.3%). The prevalence of participants with depressed mood was 35.2%. Participants with poor sleep quality were more likely to have a higher sensorial index (p<0.001), higher total pain scores (p=0.001), and less lumbar axial rotation (p=0.046). Higher pain (r=0.391), depression scores (r=0.234), and lower lumbar axial trunk rotation (r=-0.317) were associated with increased daytime sleepiness. Conclusion: We observed poor sleep quality and an association with pain in patients with IS. Curve magnitude had no adverse effect on sleep quality or daytime sleepiness. Therefore, the sleep profile and its association with pain should be considered during the rehabilitation process in patients with IS.

The Outcomes of an Individualized Physical Therapy Program in CALFAN Syndrome: A Case Report.

PURPOSE: This case report investigated the effectiveness of an individualized physical therapy program in CALFAN syndrome. CASE DESCRIPTION: A 13-year-old girl participated in physical therapy, which included trunk stabilization, balance training, and functional exercises for 12 weeks. ASSESSMENTS: The International Cooperative Ataxia Rating Scale; Trunk Impairment Scale; Pediatric Quality of Life Inventory; Functional Independence Measure for Children; Quick Disability of the Arm, Shoulder, and Hand Questionnaire; 9-Hole Peg Test; and Cobb measurement were used as outcome measures. RESULTS: Positive changes were observed in the International Cooperative Ataxia Rating Scale; Quick Disability of the Arm, Shoulder, and Hand Questionnaire; Pediatric Quality of Life Inventory; Trunk Impairment Scale; Functional Independence Measure; and the 9-Hole Peg Test. The Cobb angle was increased by 2° in the thoracic region and reduced by 11° in the lumbar region. CONCLUSIONS: Physical therapy improved quality of life, functional independence, trunk control, and upper extremity performance. WHAT THIS ADDS TO EVIDENCE: This case report is the first to support the effectiveness of physical therapy for a child with CALFAN syndrome.

Effectiveness of functional trunk training on trunk control and upper limb functions in patients with autosomal recessive hereditary ataxia.

BACKGROUND: Ataxia is a clinical syndrome characterized by coordination problems and postural disorders. OBJECTIVE: This study aimed to examine the effects of functional trunk training on trunk control and upper limb functions in autosomal recessive hereditary ataxia. METHODS: Twenty patients were randomly divided into treatment and control groups. Both groups received trunk stabilization and balance exercises, and the treatment group received additional functional trunk training sessions (3 days/week for 8 weeks). The International Cooperative Ataxia Rating Scale, Trunk Impairment Scale, Modified Functional Reach Test, Nine-Hole Peg Test and Quick-Disabilities of the Arm Shoulder and Hand questionnaire were used for assessments. RESULTS: The treatment group showed an increase in the upper limb performance bilaterally, whereas increased performance was seen only in the dominant upper limb in the control group. While the functional reach improved in the anterior-posterior (AP) and medial-lateral (ML) directions in the treatment group, it was improved only in the AP direction in the control group. Also, the mean changes in outcomes were not significantly different between the groups except for modified functional reach test. CONCLUSIONS: Functional trunk training may be a more effective method to improve upper limb performance and dynamic trunk balance in autosomal recessive hereditary ataxia.

Comparison of the effectiveness of a structured exercise program on nonspecific neck pain in string and woodwind players.

To investigate the effect of a structured exercise training program on pain, functional status, physical function and quality of life (QoL) in string and woodwind players with nonspecific cervical pain. This study had a prospective cohort design and conducted on 40 musicians (26 male, 14 female) aged between 18 and 65 years with persistent nonspecific neck pain in the previous 3 months. Forty musicians were assigned to either violin (n = 20, median age; 26.5 year, height; 1.67 m, body mass; 65 kg, BMI; 23.04 kg/m2) or ney group (n = 20, median age; 27.5 year, height; 1.81 m, body mass; 75 kg, BMI; 23.35 kg/m2) and followed the same structured exercise program (3 days/per week for 8 weeks). The primary outcome was neck pain intensity and assessed on a visual analog scale (VAS). Secondary outcomes; cervical range of motion (ROM) was measured using a goniometer, the jaw-to-sternum and jaw-to-wall distances were used for the assessment of cervical mobility, neck, shoulder and back muscles strength were assessed with a hand-held dynamometer, the Northwick Park Neck Pain and Short Form 36 (SF-36) questionnaires were also used. Normality of data distribution was checked using the Kolmogorov-Smirnov test. For evaluating the training effectiveness on outcome measures, Mann-Whitney U and Wilcoxon test were used compare pre-test and post-test values with/within groups, respectively. The primary outcome (pain intensity) was lowered %33 in both groups. However, the mean change was found similar (median mean changes; -2 for both groups) (p > 0.05). The secondary outcomes; cervical mobility, cervical flexion ROM, disability and muscle strength of the left middle trapezius, left hand grip, anterior and middle parts of the right deltoid, and cervical flexors also significantly improved in both groups (p < 0.05). Only the mean changes of right serratus anterior, middle trapezius and cervical flexor muscles were higher in violin group than ney group (p < 0.05). There was no significant difference in the cervical extension, right rotation, left rotation, right lateral flexion and left lateral flexion after the treatment in both groups (p > 0.05). There was no significant difference between the groups after the exercise program in terms of pain, mobility, range of motion and SF-36 subdomains (p > 0.05). Specific exercise program had similar positive effects on pain, cervical mobility, cervical fexion ROM and disability in string and woodwind players. Although several muscles showed similar improvements in strength, some muscle groups recovered differently. Physical needs specific to the instrument and performance should be taken into account when prescribing exercises to musicians having the same problem, but playing different instruments.

The effect of cervical mobilization on balance and static plantar loading distribution in patients with multiple sclerosis: A randomized crossover study.

OBJECTIVES: To investigate the influence of repeated cervical mobilization (CM) on balance and plantar loading distribution in patients with Multiple Sclerosis (MS). METHODS: A total of 12 individuals were included in the cross over study designed as a cross sectional. The study was carried out from October 2019 until July 2020. Individuals received traditional treatment (TM) and cervical mobilization treatments (CM) 2 days a week for 4 weeks in a different order by random method. It was treated with joint traction and sliding techniques. Soft tissue mobilization techniques for myofascial relaxation were applied for CM in addition to TM. Romberg test (RT), Sharpened Romberg Test (SRT), and Functional Reach Test (FRT) were used to balance the assessment. Plantar loading distribution was evaluated with Pedobarography. The maximum and mean pressure in the foot, the percentages of pressure values in the fore and rear of the foot, and percentages of the bodyweight discharge onto right feet and left feet were recorded. RESULTS: The forefoot loading increased after treatment in the CM group (p<0.05). The duration of RT and SRT increased, and average pressure decreased in the cervical mobilization group (p<0.05). The body weight discharge onto right feet and left feet approached 50% after cervical mobilization (p<0.05). CONCLUSIONS: Cervical mobilization techniques can positively change the balance and plantar loading distribution compared to traditional treatment. Cervical mobilization applications could be used to support neurological rehabilitation.

Kinesiophobia and its association with treatment choice in individuals with idiopathic scoliosis.

BACKGROUND: Previous studies have reported increased kinesiophobia in adults with degenerative scoliosis or adolescents who have undergone spinal surgery. However, little is known about the phenomenon of kinesiophobia among adolescents with idiopathic scoliosis (IS). OBJECTIVES: The aim of this study was to investigate levels of kinesiophobia and its association with treatment choice in IS. METHODS: The study included 98 IS patients with a mean age of 14 years and 20 healthy controls. Participants with IS were divided into groups based on treatment conditions, as follows: (1) untreated (n= 33); (2) treated with exercise (n= 32); and (3) treated with a brace (n= 33). Kinesiophobia was measured using the Tampa Scale for Kinesiophobia (TSK). Comparisons were made between four groups. RESULTS: Untreated participants with IS were found to have greater kinesiophobia than healthy controls (p< 0.001). Participants treated with a brace (p= 0.046) and exercise (p= 0.064) had similar kinesiophobia levels as the healthy control group. CONCLUSIONS: Kinesiophobia was found to be higher in adolescents with IS compared to healthy peers. Brace or exercise treatment both had a positive impact on kinesiophobia. These findings should be considered when organizing rehabilitation programs to achieve the best results for adolescents with IS.

The profile of musculoskeletal pain and its associations with sleep quality and depression during the COVID-19 in Turkey.

BACKGROUND: The current pandemic has affected people's health multidimensionally. This study aims to investigate musculoskeletal pain, sleep quality, depression levels, and their relationships in individuals belonging to different age groups during COVID-19 in Turkey. METHODS: A web-based self-administered survey that consisted of demographic questions, The Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and scores of musculoskeletal pain was sent to participants. Pearson correlation analysis was used for determining the statistical relationship between variables. RESULTS: The study includes 1,778 participants. The highest percentage for mild, moderate, and severe pain was in the head (49.8%), back (15.5%), and head (11.5%), respectively. The PSQI-total had shown a weak correlation with pain levels in all body parts. The highest correlation for sleep quality and pain levels was between the PSQI-5 and lower back pain. There was a weak correlation between PSQI- 2 and the BDI score, and a moderate correlation between the PSQI-1, PSQI-5, PSQI- 7, PSQI-total, and BDI score. Pain in all body parts showed a weak correlation with depression level. CONCLUSIONS: This study showed that musculoskeletal pain was varied in body parts with different intensities according to age groups in Turkey during the pandemic. The most common pain was in the head, back, and lower back. Headache was found correlated with the parameters of sleep quality. Pain of the head, neck, back, lower back, and shoulder were correlated with sleep latency. Sleep quality was associated with depression and musculoskeletal pain, while musculoskeletal pain was correlated with depression.

The Relation of Body Mass Index to Muscular Viscoelastic Properties in Normal and Overweight Individuals.

Background: The body mass index (BMI) is closely related to fat tissue, which may have direct or indirect effects on muscle function. Previous studies have evaluated BMI and muscle viscoelastic properties in vivo in older people or individual sexes; however, the relationship between BMI and muscular viscoelastic properties is still unknown. Aims: The purpose of this study was to determine the correlation of BMI with muscular viscoelastic properties, and to compare these properties in a young sedentary population with normal and overweight individuals. Methods: A total of 172 healthy sedentary individuals (mean age, 26.00 ± 5.45 years) were categorized by sex (male and female) and BMI classification (normal (BMI, 18.50-24.99 kg/m2), overweight (BMI = 25.00-29.99 kg/m2)). Body weight was evaluated using an electronic scale, while height was measured using a standard stadiometer. BMI was calculated by dividing the weight in kilograms by the square of height in meters. The viscoelastic properties (tone, stiffness, and elasticity) of the biceps brachii (BB) and biceps femoris (BF) muscles were measured bilaterally using the MyotonPRO device at rest. Results: The bilateral BF tone and stiffness, right BB stiffness, and elasticity showed weak correlations with BMI in all participants. Furthermore, the bilateral BF tone and stiffness, right BB stiffness and elasticity, and left BB stiffness were weakly positively correlated with male sex. Only the right BB elasticity was weakly positively correlated with BMI in females (p < 0.05). No correlation with BMI was determined for other viscoelastic properties (p > 0.05). The overweight group showed increased bilateral BF stiffness and tone, right BB stiffness, and reduced bilateral BB elasticity compared to the normal-weight group (p < 0.05), while other viscoelastic properties were similar (p > 0.05). Greater bilateral BB tone, BF tone and stiffness, and lower BF elasticity were observed in males than in females (p < 0.05), but other viscoelastic properties were not significantly different (p < 0.05). No effect of BMI-sex interactions was found on viscoelastic properties (p > 0.05). Conclusions: The BB and BF viscoelastic properties were weakly correlated with BMI. Males showed greater muscle tone and stiffness, and lower elasticity. The overweight individuals showed increased stiffness and tone, particularly in lower extremities, and reduced elasticity in upper extremities. The effect of BMI-sex interactions on the viscoelastic properties was not clear. Higher BMI (increased mechanical load) might cause the human body to develop different muscular viscoelastic adaptations in the extremities.

Investigation of multidirectional hip range of motion and hip motion asymmetry in individuals with idiopathic scoliosis with different curve patterns.

BACKGROUND: While some studies of the asymmetry of lower limbs in individuals with idiopathic scoliosis exist, there is a need for multidirectional studies conducted on hip joint range of motion and its relationship to curve patterns in idiopathic scoliosis. OBJECTIVES: This study analyzes the hip joint range of multidirectional motions, hip motion asymmetry and investigates them according to curve patterns in individuals with idiopathic scoliosis. METHODS: The sample included 108 females with idiopathic scoliosis. Participants were divided into three groups: double curves, single thoracic curve and single lumbar curve. The range of hip flexion and extension, abduction and adduction, and internal and external rotations were assessed actively and passively with a universal goniometer. The range of motion, left-right asymmetry and the mid-points of the ranges of motion were analyzed. RESULTS: The passive range of the right hip abduction was higher in the thoracic curve group vs. the lumbar curve group. Active and passive ranges of hip extension were higher in the left hip vs. right hip. Active left-right asymmetry was higher than passive left-right asymmetry. CONCLUSION: Individuals with idiopathic scoliosis had different hip abduction motions according to curve pattern that originated from single curves. Left-right hip asymmetry was seen for the hip extension motion. Higher left-right asymmetry for active motion than passive motion in hip abduction may indicate a problem in motion perception in individuals with idiopathic scoliosis.

The effect of brace treatment on pulmonary functions in adolescent idiopathic scoliosis: An 8-month follow-up study.

BACKGROUND: The instant effect of a brace on pulmonary functions of patients with adolescent idiopathic scoliosis (AIS) is known. However, the permanent effects of its regular use are still unclear. OBJECTIVE: This study aimed to determine whether a brace in patients with AIS had a permanent effect on respiratory functions. METHODS: Fifteen patients with a mean age of 13.2 ± 1.6 years, and a major Cobb angle of 25.8∘± 7.7∘ participated in this study. Lung volumes and respiratory muscle strength were measured with and without thoracolumbosacral brace, at the end of first month and follow-up period after the patients started using the brace for 23 hours daily. RESULTS: When the brace was on, the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), ratio of FEV1/FVC, peak expiratory flow, and forced expiratory flow between 25% and 75% of vital capacity values were found to be lower at both first month and follow-up. After the follow-up, the measurement results did not differ from the results of the first month. CONCLUSIONS: The brace had a momentary restrictive effect on patients with AIS. However, it did not cause a permanent change in pulmonary functions after the 8-month follow-up.

Investigating the effects of appropriate fitting footwear on functional performance level, balance and fear of falling in older adults: A comparative-observational study.

The aim of the study was to assess the characteristics of footwear altogether and to compare the effect of appropriate-fitting and ill-fitting footwear on functional performance, balance, and fear of falling (FoF) in older adults. Individuals who wore appropriate-fitting (n = 61) or ill-fitting footwear (n = 92) were enrolled in the study. Footwear was evaluated using the Footwear Assessment Scale (FAS). The participants were assessed using the Berg Balance Scale (BBS) for balance, the Timed Up and Go test for functional performance and the Activities-specific Balance Confidence scale for FoF. Tests were conducted twice for each individual with or without footwear. Differences between the groups were analyzed using the MANOVA for scores of balance, performance and fear of falling and Chi-squared test for homogeneity. The Paired t-test was used to compare test scores with or without footwear. It was concluded that appropriate-fitting footwear improves balance, reduces fear of falling and may affect functional performance positively. ClinicalTrials.gov No: NCT04151654.

Evaluation of upper extremity function and its relation to curve pattern in female adolescents with idiopathic scoliosis: a pilot study.

STUDY DESIGN: Cross-sectional and clinical measurement. OBJECTIVE: To evaluate upper extremity function and its relation to the curve pattern in idiopathic scoliosis. Postural alterations and trunk distortions-caused by three-dimensional deformity itself in idiopathic scoliosis-may lead to functional changes in the upper extremity of subjects. METHODS: Handgrip, pulp and lateral pinch strengths, hand dexterity, hand reaction time, coordination of upper extremity, upper extremity performance, throwing accuracy, and self-reported upper extremity disability were evaluated in 96 subjects. These subjects were divided into 3 groups: 47 with main thoracic curve pattern scoliosis (Lenke type 1), 31 with thoracolumbar/lumbar curve pattern scoliosis (Lenke type 5), and 18 unaffected (healthy control). Comparisons were performed between these three groups. RESULTS: The thoracic scoliosis group showed a significant decrease in concave lateral pinch strength, concave hand dexterity of turning, coordination of the upper extremities, and concave hand reaction time than the thoracolumbar/lumbar scoliosis group (p < 0.05). Bilateral handgrip strengths decreased in thoracic scoliosis group when compared to healthy controls. Healthy individuals demonstrated greater throwing accuracy than individuals with scoliosis. CONCLUSIONS: Upper extremity function was found to be affected based on the curve pattern. Individuals with main thoracic curves are likely to have deteriorated upper extremity function, especially for hand-specific motor skills, on the concave side, when compared to lumbar curves and healthy controls. LEVEL OF EVIDENCE: Level III.