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.

The effect of aerobic exercises of different intensities on anxiety, cigarette addiction, sleep quality, and quality of life in former smokers.

BACKGROUND: There is a worldwide struggle to quit smoking and prevent relapsing. Aerobic exercises are frequently utilized to aid in smoking cessation and prevent relapse. AIMS: This study aimed to investigate the effects of aerobic exercises of different intensity on the level of anxiety, smoking addiction, and quality of sleep and life in former smokers. METHODS: The study included 60 people aged 18 to 45 who had quit smoking within the previous month. Individuals were randomly assigned to control (CON), mild-intensity aerobic activity (MIA), and moderate-intensity aerobic activity (MoIA) groups. The MIA group did submaximal aerobic exercises at 40% of maximum heart rate (MHR), while the MoIA group did them at 60% of MHR for 8 weeks/3 days. Participants' anxiety levels were assessed using the Beck Anxiety Scale (BAS), smoking addiction was assessed using the Fagerström Test for Nicotine Dependence and Substance Craving Scale (SCS), sleep quality was assessed using the Pittsburgh Sleep Quality Index, and quality of life was assessed using the SF-36 Short Form Scale (SF-36). RESULTS: The SCS score of the MoIA group declined more than the MIA and CON groups, and the MIA group had a lower sleep disturbance score than other groups when the influence of exercise training was assessed over time (p < 0.05). Aerobic exercise had no influence on SF-36 or BAS scores (p > 0.05). CONCLUSIONS: The benefits of mild and moderate aerobic exercise on quality of life and anxiety are similar. However, mild-intensity aerobic exercises may be suitable for sleep difficulties while moderate-intensity aerobic exercises may be preferred for reducing smoking addiction.

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.

Age Related Changes of Superior Orbicularis Oris Muscle in Terms of Tone and Viscoelastic Properties.

OBJECTIVE: To examine the age-related changes in the viscoelastic properties and tone of the superior orbicularis oris muscle by a portablehand-held myotonometer. METHODS: A total of 128 individuals (65 female, 63 male) who met the inclusion criteria were evaluated. Individuals were divided into 2 groups as under 40 years old (Group 1), and above (Group 2). The viscoelastic properties and muscle tone of orbicularis oris muscle were evaluated bilaterally in supine position with the Myoton PRO (Myoton AS, Estonia) device from the skin overlying the orbicularis oris. The reference point is accepted as the right and left paramedial philtrum dimple. The statistical analysis was performed. RESULTS: There was no statistically significant difference in the elasticity values of the right and left orbicularis oris muscles of the Group 1 and Group 2 individuals. There was a difference between the groups when the tone and stiffness values of both groups were compared. It was determined that individuals over the age of 40 had higher muscle tone and stiffness. All mechanical properties of the superior orbicularis oris muscle between the male and female individuals in Group 1 were different. The values are higher in the female gender. The elasticity values in both genders in Group 2 were similar. Tone and stiffness parameters were different between genders. CONCLUSIONS: Myoton PRO can be recommended as an alternative device in the quantitative evaluations of post-operative follow-ups, and pre/post rehabilitation in terms of viscoelastic parameters of the muscle.

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.

Evaluation of the tone and viscoelastic properties of the masseter muscle in the supine position, and its relation to age and gender.

BACKGROUND: The masseter muscle can be evaluated in various ways to examine its condition in healthy individuals or to identify pathological changes in the muscle. OBJECTIVES: This study aimed to examine the tone and viscoelastic parameters of the masseter muscle, which is the focal muscle of various pathologies, to reveal its relationship with age and gender, and to determine the reference values of this muscle in healthy individuals. MATERIAL AND METHODS: Individuals aged 18-50 years were evaluated. They were divided into 3 groups in terms of age. A total of 389 individuals participated in the study (18-28 years: 131 males, 104 females; 29-39 years: 29 males, 56 females; and 40-50 years: 30 males, 39 females). The tone and viscoelastic properties of the masseter muscle were evaluated bilaterally in the supine position. RESULTS: The mean age of all individuals was 28.64 ±9.68 years. The masseter muscle tone was found to be higher in men than in women. The elasticity of the muscle was higher in women (p < 0.05). It was determined that the masseter muscle tone and stiffness increased, whilst its elasticity decreased with aging (p < 0.05). A weak positive correlation was found between the right and left masseter muscle tone and age (r = 0.307 and r = 0.325, respectively; p = 0.001). There was a moderate positive correlation between the right and left masseter muscle stiffness and age (r = 0.507 and r = 0.511, respectively; p = 0.001). A strong positive correlation was observed between the right and left masseter muscle elasticity and age (r = 0.614 and r = 0.645, respectively; p = 0.001). CONCLUSIONS: The data obtained in this study may assist clinicians in evaluating the treatment of the pathological conditions related to the masseter muscle as well as in the planning of treatment and preand post-operation evaluations. Cite as.