Electromyographic activity of quadriceps muscles during eccentric squat exercises: implications for exercise selection in patellar tendinopathy.

This study investigated the quadriceps muscle activity during eccentric squat exercises (ESE) with different decline angles and arcs of motion regarding the proper exercise selection for patellar tendinopathy management. Electromyographic activity of the rectus femoris, vastus lateralis, and vastus medialis obliquus (VMO) muscles was measured during ESE on 0°, 5°, 10°, 15°, and 20° decline in 20 recreationally active participants. The eccentric phase was divided into 0-30°, 30-60°, 60-90°, 0-60°, 30-90°, and 0-90° of knee flexion simultaneously via motion-analysis system. The analyses showed that there was a significant decline angle × arc interaction effect on electromyographic activity of all muscles during knee flexion movement. The main effect was found for the arc of motion of knee flexion, and the main effect for the decline angle also was present for each muscle, except for VMO. This study demonstrated that most selective quadriceps eccentric activation occurred during ESE performed on 20° decline throughout 60-90° of knee flexion.

Pain coping strategies and related factors including demographics, pain characteristics, functional mobility in postmenopausal women with chronic musculoskeletal pain.

This cross-sectional study investigated pain coping strategies and their relationship to demographic and clinical characteristics in postmenopausal women (PMWs) with chronic musculoskeletal pain (CMSP). PmW (n = 60) who presented to receive physiotherapy from a rehabilitation center participated. McGill Pain Questionnaire (MPQ) was used to assess pain intensity and characteristics, Pain Coping Inventory (PCI) was used to assess strategies of coping with pain, and Timed Up and Go-Test (TUG) was used to assess functional mobility. Data were analyzed using descriptive analyses, paired-samples t-test, independent-samples t-test, Mann Whitney U-test, one-way ANOVA, and Pearson's correlation analysis. There was no significant difference in terms of marital status, educational status, and exercise habits between the participants' statuses of using active and passive strategies of coping with pain. Younger women (50-59 years of age) preferred active strategies more than passive strategies to cope with pain (p = .047). There were significant differences among the age groups in terms of "pain transformation" subdomain of active strategies (p = .007) and "sensory" subdomain of MPQ (p = .053). Strategies of coping with pain and functional mobility of participants were not significantly related (p > .05). Results indicated that age is a significant factor in coping with pain and pain characteristics. Healthcare providers should consider PmW's preferences and experiences with pain management when recommending pain management strategies.

Bone Mineral Density Loss in Parkinson's Disease: Impact of Clinical Subtypes.

Background: This study aimed to compare the BMD status among the clinical subtypes of PD and healthy controls.Methods: Sixty patients with PD and 30 healthy age- and sex-matched controls were included in this study. The patients were divided into postural instability gait difficulty-dominant type (PIGDDT) group and tremor-dominant type (TDT) group based on the Unified Parkinson's Disease Rating Scale (UPDRS) score. BMD was measured using dual-energy X-ray absorptiometry scans in femoral and lumbar regions.Results: The T-scores in femoral and lumbar regions were similar in all groups. The prevalence of osteopenia was higher than the prevalence of osteoporosis in all three groups for femoral regions. The prevalence of osteoporosis in the intertrochanteric region and total femur in the PIGDDT group was higher than in the TDT group and controls. Our data showed a trend toward higher prevalence of osteoporosis in the PIGDDT group.Conclusion: The prevalence of osteopenia and osteoporosis may differ between clinical subtypes of PD and healthy controls. Osteopenia is more common than osteoporosis for all groups. The patients with PIGDDT of PD tended to have higher prevalence of osteoporosis, even at early stages of disease, compared to those with TDT and healthy controls.

Cross-cultural adaptation and psychometric properties of the Fear of Falling Avoidance Behavior Questionnaire in Turkish community-dwelling older adults.

PURPOSE: This study aimed to translate and adapt the Fear of Falling Avoidance Behavior Questionnaire (FFABQ) for Turkish culture and to evaluate the psychometric properties of FFABQ-Turkish in community-dwelling older adults. METHODS: Eighty community-dwelling older adults (41 females) were assessed using the FFABQ-Turkish, Activities-specific Balance Confidence Scale (ABC). Fall history and severity of fear of falling (FoF) were recorded. Forty-two participants were reassessed one week apart for test-retest reliability. Internal consistency, test-retest reliability, sensitivity to change, convergent validity, construct validity, floor and ceiling effect, and scale discrimination of FFABQ-Turkish were investigated. RESULTS: FFABQ-Turkish has high internal consistency and good test-retest reliability. Overall scores for FFABQ-Turkish were high in females, older individuals ≥ 75 years, and fallers. Minimal detectable change with 95% confidence was 4.51 points. There were strong and moderate correlations between FFABQ-Turkish and ABC, FoF, and the number of falls. Factor analysis demonstrated a two-factor structure. No floor and ceiling effect was found. FFABQ-Turkish could discriminate individuals without avoidance behavior from those with severe avoidance behavior. CONCLUSIONS: FFABQ-Turkish is a valid and reliable measure to assess the activity and participation restriction due to FoF, and could be used to quantify avoidance behavior in Turkish community-dwelling older adults. Implication for rehabilitationThe Turkish version of the Fear of Falling Avoidance Behavior Questionnaire (FFABQ) is a valid and reliable outcome measure for community-dwelling older adults.Fear of Falling Avoidance Behavior Questionnaire in Turkish is recommended for assessment of activity limitation and participation restrictions due to fear of falling in clinical and research settings.

Body Mass Index, Physical Activity Habits and Physical Function Contribute to Fatigue in the Rest Home Residents.

BACKGROUNDS: Fatigue is a common complaint in older adults living in rest homes. The aim of this study was to investigate the factors associated with fatigue among older adults living in a rest home. METHODS: This cross-sectional study was carried out with a total of 92 older adults. Fatigue was evaluated by the Fatigue Severity Scale (FSS). The sociodemographic characteristics, quadriceps and handgrip strength, functional capacity and physical function were assessed using a structured questionnaire, digital dynamometers, 6-minute walking test and Short Physical Performance Battery, respectively. RESULTS: The prevalence of fatigue was 67.4%. FSS showed significant correlations with age, female gender, body mass index, physical activity habits, quadriceps strength, handgrip strength, functional exercise capacity, and physical function. However, in the regression analysis, only body mass index, physical activity habits and physical function were responsible for 51% of the variance in fatigue among rest home residents. Physical activity habits and physical function were the best predictors of fatigue explaining 47.5% of variance. CONCLUSION: This study demonstrated that body mass index, physical activity habits and physical function contributed to fatigue in rest home residents. These factors can be used to identify individuals at high risk of fatigue and to attenuate fatigue levels.

Dual-task interference during hand dexterity is a predictor for activities of daily living performance in Parkinson's disease.

INTRODUCTION: Dual-task interference (DTI) leads to impairment of hand dexterity in Parkinson's disease (PD). The performance of activities of daily living (ADL) is negatively affected by dexterity in PD. However, the contribution of DTI to dexterity-related ADL disability remains unclear. This cross-sectional study aimed to investigate the contribution of DTI to ADL performance as well as other factors affecting dexterity. METHODS: One-hundred and eight patients with PD were assessed using the ADL-related dexterity questionnaire-24 to measure dexterity-related ADL performance. Performance in single and dual task conditions was measured with the 9-hole peg test. Disease severity, cardinal symptoms and grip strength were assessed using Hoehn&Yahr, a modified version of the Unified Parkinson Disease Rating Scale, Part-III, and a hand dynamometer. The age and cognitive status were control variables. RESULTS: Multiple regression analysis revealed that disease severity explained 8.5% of the variance in dexterity-related ADL (p = 0.002). The DTI in the dominant hand was the strongest predictor of ADL performance (R2 change = 0.44, p < 0.001), but DTI in the non-dominant hand did not contribute. When cardinal symptoms were added to the model, bradykinesia contributed to ADL difficulty (R2 change = 0.072, p < 0.001), while tremor and rigidity were not significant in any model. This model accounted for 59.2% of the variance in ADL difficulties in total. CONCLUSION: The study demonstrated that disease severity, bradykinesia and DTI in the dominant hand contributed to ADL difficulties in patients with PD, and DTI in the dominant hand is the strongest predictor of ADL performance in PD.

Effects of neuromuscular electrical stimulation of quadriceps on the quadriceps strength and functional performance in nursing home residents: A comparison of short and long stimulation periods.

AIM: To determine the effect of two neuromuscular electrical stimulation (NMES) periods on quadriceps strength (QS) and functional performance in nursing home residents. METHODS: A total of 53 older adults living in a nursing home were randomized into two groups: NMES with a short stimulation period and NMES with a long stimulation period. The quadriceps muscles were bilaterally stimulated three times a week for 6 weeks in both groups. Strength was measured with a digital handheld dynamometer and 30-s chair stand test. Functional performance was evaluated with the Berg balance scale, Timed Up and Go test and 6-min walking test. RESULTS: Analysis was carried out on 44 older adults, who completed the study protocol. The isometric QS did not change within groups or between groups. Interestingly, the 30-s chair stand test score increased for both groups, but the improvements were similar among groups. The Berg balance scale score, Timed Up and Go test time and 6-min walking test distance also improved in both groups. However, no difference in any of the functional outcome measures was observed between groups. CONCLUSIONS: The present findings showed that both NMES protocols might be an alternative to achieve an improvement in functional strength of the lower extremities and functional performance in nursing home residents, whereas neither of the two protocols seems effective for improving isometric QS. Both methods might contribute to maintaining isometric QS during the aging process. Geriatr Gerontol Int 2019; 19: 409-413.

Assessment of Spinal Curvatures in Children With Upper Trunk Obstetrical Brachial Plexus Palsy.

PURPOSE: Effects of upper trunk obstetrical brachial plexus palsy (OBPP) on the spinal curvature and relationship between the curvature degrees and upper limb movements have not been reported. METHODS: Spinal Mouse was used to assess spinal curvature characteristics in the sagittal and frontal planes. Upper limb movements were assessed with using the Active Movement Scale in only study group. RESULTS: The degree of frontal plane curvatures was higher in the study group. In the OBPP group, 11 of 25 (44%) children had thoracal C-shaped scoliosis. Nine of these children had contralateral side scoliosis. Shoulder external rotation was inversely correlated with scoliosis angle. Moreover, shoulder external rotation and elbow flexion were lower in children with scoliosis in the OBPP group. CONCLUSIONS: Upper trunk OBPP may affect frontal plane alignment. Especially insufficient shoulder external rotation scores may lead to constitute thoracal scoliosis as a result of trunk compensation.