Mid-term Effect of Lumbar Sustained Natural Apophyseal Glides in Patients with Non-specific Chronic Low Back Pain: A Randomized Clinical Trial.

OBJECTIVE: The objective of this study was to compare the standalone and combined mid-term effects of conventional physiotherapy and lumbar sustained natural apophyseal glides on pain, range of motion, fear avoidance belief, and functional status in patients with non-specific chronic low back pain. MATERIALS AND METHODS: This randomized clinical study was conducted in a state hospital. Fifty-five patients with non-specific chronic low back pain (mean age: 40.69 ± 6.27 years) were divided into 3 groups. Group I (n=18) received conventional physiotherapy (electrotherapy and heat application) 5 days a week for 3 weeks, group II (n=19) received lumbar sustained natural apophyseal glides 3 days a week for 3 weeks. Group III (n = 18) received conventional physiotherapy plus lumbar sustained natural apophyseal glides. Pain (visual analog scale), flexion range of motion (back range of motion II), functional status (Roland-Morris Disability Questionnaire), and fear avoidance belief (Fear Avoidance Belief Questionnaire) were assessed at baseline, third week, and 6-month follow-up. RESULTS: After 3 weeks of intervention, all outcome measures improved in groups II and III. These improve- ments remained significant until 6-month follow-up (P < .05), except fear avoidance belief (P=.06) and flexion range of motion (P=.764) scores of group III. Flexion range of motion (P=.001), functional status (P = .001), and fear avoidance belief (P = .03) differed significantly between the 3 groups at 6-month follow- up; post-hoc analysis revealed that flexion range of motion (P < .0001), functional status (P = .037), and fear avoidance belief (P = .002) scores were significantly improved in group II compared to group I. CONCLUSION: Compared with conventional physiotherapy, lumbar sustained natural apophyseal glides improved mid-term range of motion, functional status, and fear avoidance belief, but there was no differ- ence in pain. Conventional physiotherapy added to lumbar sustained natural apophyseal glides provided no additional benefit.

Association between Pain Intensity, Pain Belief, and Coping Strategies in Older Adults.

This study aimed to determine the relation between pain, pain belief, and coping strategies and the interaction effect of pain belief and coping stretegies on pain intensity in older adults living in Denizli. 601 older adults (68.32 ± 8.28 years) with good cognitive function participated in current study. Pain intensity, pain beliefs and coping strategies were assessed with Geriartric Pain Measure (GPM), Pain Beliefs Scale (PBS) and Pain Coping Inventory (PCI), respectively. Mean pain intensity of older adults was 53.6 ± 21 (0-99.96). There was a statistically significant difference in passive coping strategies between older adults with mild, moderate, and severe pain (p < .001). As organic pain belief and active coping strategies increase, the pain intensity decreases in older adults living in Denizli.

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.

The effect of the COVID-19 pandemic on weight gain, physical activity and mental health among Turkish university students.

BACKGROUND: The COVID-19 pandemic has brought many restrictions that affected Turkey as well as other countries around the world. Restrictions on education, sports activities and social activities affected students physically and psychologically. OBJECTIVE: The aim of this study is to investigate the impact of the COVID-19 pandemic on weight gain, physical activity, and mental health among university students. METHODS: The study included students of Pamukkale University aged between 18-25 years. Participants answered the online survey about changes in body composition and physical activity habits during the pandemic. International Physical Activity Questionnaire (IPAQ) was used to assess physical activity levels. Beck Depression Scale (BDS) was used to assess the mental health. RESULTS: 848 (546 females, 302 males) students average aged 20,72±1,63 years were included in the study. When the physical activity times before and during the pandemic were compared, a statistically significant difference was found (p < 0.05). Multivariate analyses showed that higher BDS scores (p = 0.000) were significantly associated with increased weight gain. But there was no significant association with age and changes in physical activity time. CONCLUSIONS: The results of the study showed that the COVID-19 pandemic has a negative effect on the physical activity level, weight gain and mental health of university students. Students reported an increase in weight during the pandemic. Also, the increase in depressive symptoms is related to higher levels of weight gain. Therefore, physical activity and mental health programmes should be offered to university students as an educational and health policy.

The Liverpool Elbow Score, patient-answered section: Cultural adaptation, validity and reliability of Turkish version.

BACKGROUND: The use of self-assessment questionnaires in addition to clinical evaluations is gradually increasing. Liverpool Elbow Scale (LES) is an elbow-specific outcome score that provides a comprehensive assessment of by both the clinicians and patients. However, it has not been adapted and validated to Turkish language. OBJECTIVE: To conduct the translation, cross-cultural adaptation and validation of Liverpool Elbow Score-patient answered outcome (LES-PAQ) into Turkish for patients with elbow fracture. DESIGN: Study of diagnostic accuracy/assessment scale. METHODS: This study was carried out in three consecutive phases: translation, cross-cultural adaptation and validation. In the third phase, we used the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH), Mayo Elbow Performance Score (MEPS) and 12-Item Short Form Survey (SF-12) physical health score. RESULTS: Sixty-one patients were included for the analysis. Neither a ceiling nor a floor effect was observed. Cronbach's α coefficient was 0.89. Intraclass correlation coefficient was 0.94 (95% CI 0.89 to 0.96; p < 0.001). SEM was 0.28 and MDC95 was 0.79. The LES-PAQ showed a high negative correlation with the Quick-DASH (r = -0.72, p < 0.001) and high positive correlation with MEPS (r = 0.77, p < 0.001), and with SF-12 physical health subscale (r = 0.73, p < 0.001). CONCLUSIONS: The Turkish version of the LES-PAQ is a reliable and valid tool for the assessment of the patients with elbow fracture.

Acute effects of distal fibular taping technique on pain, balance and forward lunge activities in Chronic Ankle Instability.

BACKGROUND: Chronic Ankle Instability (CAI) is characterized by altered muscle activation, reduced range of motion (ROM) and balance deficits. OBJECTIVE: The aim of this study was to determine whether fibular taping technique influenced the pain intensity, dorsiflexion ROM and dynamic balance in participants with CAI. METHODS: Twenty-six participants (16 males and 10 females; age 28.8 ± 5.74 y) with unilateral CAI who scored 85 points or less on the Foot and Ankle Outcome Score (FAOS) were included in our study. Mulligan distal fibular taping technique was applied. Visual Analog Scale, Star Excursion Balance Test in anterior, posteromedial and posterolateral directions and a Weight Bearing Lunge Test were taken before, after, 1 hour after and 24 hours after taping. RESULTS: Distal fibular taping technique decreases pain intensity (at rest, during range of motion and weight bearing conditions), while it increases forward lunge distance and reach distance in anterior, posteromedial and posterolateral directions (p= 0.001). CONCLUSIONS: Our study showed that distal fibular taping reduces pain intensity, postural control and dorsiflexion range of motion in individuals with CAI. Further studies are needed with participants with a lower functional level and a higher pain intensity.

Effect of proprioceptive training on balance in patients with chronic neck pain.

OBJECTIVES: The aim of this randomized controlled study was to investigate the effect of proprioceptive training on balance in patients with chronic neck pain (CNP). METHODS: Forty patients participating in the study were randomly divided into study and control groups. Both of the groups underwent conventional physical therapy; additionally, the study group was rehabilitated with gaze direction recognition exercise (GDRE) for proprioceptive training. Exercises were performed during 3 weeks with five sessions per week. Pain intensity [visual analog scale (VAS)], neck disability [Neck Disability Index (NDI)], and balance [four step square test (FSST), single leg balance test (SLBT) with eyes opened and closed] assessments were conducted in the patients before and after the treatment and 3 weeks after the last session. RESULTS: No differences were observed between the groups in terms of pre-treatment measurements. There was a statistically significant decrease in VAS scores in both groups compared with pre-treatment conditions (p<0.05). In addition, whereas a statistically significant improvement in the study group's NDI, FSST, and SLBT with eyes opened and closed scores was observed after the treatment, pre- and post-treatment results were similar in the control group (p>0.05). CONCLUSION: Proprioceptive training should be included in physiotherapy programs to improve balance; it decreases the disability level in patients with CNP.

Prevalence of and risk factors for low back pain among healthcare workers in Denizli.

OBJECTIVES: The purpose of this study was to examine personal, occupational, and psychosocial risk factors affecting prevalence of low back pain in healthcare workers. METHODS: Study included total of 1682 participants (1010 female, 672 male) working at Denizli State Hospital. Low back pain section of Standardized Nordic Musculoskeletal Questionnaire (SNMA) was used to evaluate recent occurrence, pain experienced within previous year, and over lifetime. Perceived Stress Scale and Job Satisfaction Scale were also administered. RESULTS: Prevalence of lifetime low back pain in healthcare workers was determined to be 53% based on SNMA. It was observed that low back pain was most common among medical secretaries (56.9%). Advanced age, female gender, high body mass index (p=0.002), being married (p=0.0001), lack of regular exercise (p=0.009), working for more than 4 hours while standing (p=0.012) or sitting at desk (p=0.021), using computer for more than 4 hours (p=0.0001), greater number of years of service (p=0.001), and low job satisfaction (p=0.001) were found to be factors increasing low back pain risk. CONCLUSION: Our study demonstrated that healthcare workers are among group with high risk of low back pain.

O impacto psicossocial da estética facial em crianças e adolescentes e apossibilidade de intervenções precoces: relato de dois casos clínicos / The psychosocial impact of facial aesthetics in children and adolescents and the possibility of early intervention: report of two clinical cases

Desarmonias do complexo craniofacial têm um profundo impacto na saúde psicossocial de crianças e adolescentes. Alterações de comportamento podem ser observadas em 24,7% dos indivíduos portadores dessas desarmonias. Aqui são discutidos os fatores envolvidos e relatados dois casos de duas crianças: uma portadora de severa classe II de Angle em dentição mista, e a outra portadora de severa classe III em dentição temporária. O restabelecimento da harmonia facial gerou alterações significativas no comportamento.

Disharmonies of the craniofacial complex have a profound impact on the psychosocial health of children and adolescents. Psichological changes can be observed in 24.7% of patients presenting these alterations. Here we discussed the factors involved reporting two cases of two children: One patient with severe Angle class II in mixed dentition and the other showing severe class III in temporary dentition. The reestablishment of facial harmony generated significant changes in psychosocial behavior.

An amperometric biosensor for L-glutamate determination prepared from L-glutamate oxidase immobilized in polypyrrole-polyvinylsulphonate film.

In this paper, a novel amperometric L-glutamate (Glu) biosensor with immobilization of L-glutamate oxidase (L-GlOx) on polypyrrole-polyvinylsulphonate (PPy-PVS) film has been successfully developed. L-GlOx enzyme was immobilized on PPy-PVS film by cross-linking with glutaraldehyde (GA) and bovine serum albumin (BSA). Determination of Glu was carried out by oxidation of enzymatically produced H2O2 at 0.3 V versus Ag/AgCl. The optimum pH and temperature parameters were found to be 9.0 and 55 °C, respectively. There were three linear parts in the regions between 1.0 × 10(-9) and 1.0 × 10(-8) M (R(2) = 0.847), 5.0 × 10(-8) and 5.0 × 10(-7) M (R(2) = 0.997), 5.0 × 10(-7) and 5.0 × 10(-5) M (R(2) = 0.994). Storage stability, operation stability of the enzyme electrode were also studied.

A flow cytometric analysis of the biodefensive response of deciduous tooth pulp to carious stimuli during physiological root resorption.

The present study observed biodefensive responses of deciduous tooth pulp to advancing caries lesions and analysed the role of physiological root resorption on pulpal defense potential. For this purpose, immunocompetent cell content of deciduous tooth pulp was examined using flow cytometry. A total of 49 deciduous incisor and molar teeth at various stages of physiological root resorption (carious or non-carious) to be extracted for clinical reasons were used in this study. Teeth were classified according to carious lesion depth and root resorption stage. CD3+ lymphocytes were observed to be most prevalent in the pulp and to show remarkable increase along with increase in carious lesion depth. Numbers of CD8+ lymphocytes also increased significantly as carious lesions approached the pulp. However, increase in the number of CD3+ and CD8+ cells did not significantly alter CD4+/CD8+ ratios. The study also found that while B-lymphocytes increased significantly in association with root resorption, there were no significant differences in B/CD3+ lymphocyte ratios. Thus, there was no evidence of irreversible pulpal pathosis in any groups. It can be concluded that pulp maintains its healing and defense capacity against advancing carious lesion and progressive root resorption in deciduous teeth.