Combined sensory integration therapy plus neurodevelopmental therapy (NT) versus NT alone for motor and attention in children with Down syndrome: a randomized controlled trial.

In this study, we aimed to analyze the incremental effects of sensory integration therapy (SIT) plus neurodevelopmental therapy (NT) versus NT alone on the attention and motor skills in children with Down syndrome (DS). We randomly assigned into experimental (i.e. SIT + NT; n = 21) and control (i.e. NT alone; n = 21) groups. While NT was applied to both groups for six weeks, SIT was applied simultaneously to the experimental group for six weeks. Participants' motor functions (Bruininks-Oseretsky Test of Motor Proficiency-Short form (BOT-2 SF)) and attention skills (Stroop TBAG (Turkish Scientific and Technological Research Association) Form) were evaluated before and after treatment (6 weeks later). Stroop TBAG and BOT-2 SF scores of the groups were similar at the baseline (p > 0.05). Significant improvement from baseline was observed in both BOT-2 SF, and Stroop TBAG results in both groups (p < 0.05). In addition, the improvement in both BOT-2 SF and Stroop TBAG results was found to be greater in the experimental group compared to the control group (p < 0.01). There were clear advantages to adding SIT to NT alone when seeking to improve motor and attention skills in children with DS.

The Effect of Graston Technique on Pain, Proprioception, Flexibility, and Disability in Patients with Chronic Non-specific Low Back Pain.

Background: Chronic non-specific low back pain (CNLBP) causes significant dysfunction in patients. The Graston Technique (GT) is a new intervention in pain management but there is a lack of evidence in the literature regarding its effectiveness in low back pain. Study Objective: This study aims to investigate the effect of GT added to exercise on pain, proprioception, disability, flexibility, and quality of life in individuals with CNLBP. Methods: This was a randomized controlled trial with a total of 30 CNLBP patients. Setting: Karabük University Training and Research Hospital, Turkey. Participants: Thirty patients (mean age = 38.46 ± 9.03 years) with CNLBP for at least 12 weeks were included in the study. The patients were randomly divided into two groups intervention and control. Intervention: Graston was applied three times a week for four weeks in addition to the exercise program in the intervention group, while only the exercise program was applied to the control group. Outcome measures: Pain intensity, pressure pain threshold, proprioception, flexibility, disability, and quality of life were evaluated at the beginning and end of the study. Results: Significant improvements in pain, disability, and quality of life were found in both the control and intervention groups (P < .05). There was an increase in flexibility and a decrease in proprioception deviation angles of 15° and 30° in the GT group (P < .05). The improvement in pain and disability in the intervention group was significant compared to the control group (P < .05). However, there was no significant difference between the groups regarding pressure pain threshold, flexibility, proprioception, and quality of life (P > .05). Conclusion: GT added to exercise in patients with CNLBP better reduces pain and disability, improves proprioceptive sense, and increases mobility and quality of life. GT may be used as a supportive treatment during the rehabilitation of CNLBP patients.

Effects of different surgical treatments on pain, disability, anxiety and quality of life in lumbar disc herniation.

OBJECTIVE: This study aims to compare the effects of microscopic microdiscectomy and microendoscopic discectomy on pain, disability, fear of falling, kinesiophobia, anxiety, quality of life in patients with lumbar disc herniation (LDH). METHODS: A total of 90 patients who underwent microscopic microdiscectomy (n = 40) and microendoscopic discectomy (n = 50) for LDH were included in this study. The patients' pain, disability, fear of falling, kinesiophobia, anxiety, and quality of life were evaluated before the surgery, in the early postoperative period and three months after. RESULTS: In patients who underwent microendoscopic discectomy, the results of pain, disability, fear of falling, kinesiophobia and anxiety were statistically decreased compared with the microscopic microdiscectomy in the early postoperative period and three months later (p < 0.05). Also, a statistically higher increase was observed in the general health perception of patients who underwent microendoscopic discectomy three months after the operation (p < 0.01). CONCLUSION: Microendoscopic microdiscectomy, remains the most effective and widely applied method with advantages on pain, quality of life, and improved physical functions.

OBJETIVO: Este estudio tiene como objetivo comparar los efectos de la microdiscectomía microscópica y la discectomía microendoscópica sobre el dolor, la discapacidad, el miedo a caer, la kinesiofobia, la ansiedad y la calidad de vida en pacientes con hernia de disco lumbar (LDH). MÉTODOS: Se incluyeron en este estudio un total de 90 pacientes sometidos a microdiscectomía microscópica (n = 40) y discectomía microendoscópica (n = 50) por LDH. Se evaluó el dolor, la discapacidad, el miedo a caer, la kinesiofobia, la ansiedad y la calidad de vida de los pacientes antes de la cirugía, en el postoperatorio temprano y tres meses después. RESULTADOS: En los pacientes sometidos a discectomía microendoscópica, los resultados de dolor, discapacidad, miedo a caer, kinesiofobia y ansiedad disminuyeron estadísticamente en comparación con la microdiscectomía microscópica en el postoperatorio temprano y tres meses después (p < 0.05). Además, se observó un aumento estadísticamente mayor en la percepción de salud general de los pacientes sometidos a discectomía microendoscópica tres meses después de la operación (p < 0.01). CONCLUSIÓN: La microdiscectomía microendoscópica sigue siendo el método más eficaz y ampliamente aplicado con ventajas sobre el dolor, la calidad de vida y la mejora de las funciones físicas.

Acute effects of thoracolumbar fascia release techniques on range of motion, proprioception, and muscular endurance in healthy young adults.

PURPOSE: This study investigates the acute effects of Graston and myofascial release on thoracolumbar fascia (TLF) on lumbar range of motion (ROM), lumbar and cervical proprioception, and trunk muscle endurance in healthy young adults. METHOD: Twenty-four healthy young individuals were included in the study. Individuals were randomly divided into two groups as Graston technique (GT) (n = 12) and myofascial release (MFR) (n = 12). GT group received a fascial treatment with a graston instrument and the MFR group (n = 12) received manual myofascial treatment. Both techniques were applied for 10 min and as a single session. Lumbar ROM (goniometer), lumbar proprioception (digital inclinometer), cervical proprioception (CROM device), and trunk muscle endurance (with McGill Endurance Test) were evaluated before and after treatment. RESULTS: Age, gender and body mass index of individuals in both groups were similar (p > 0.05). In both GT and MFR groups, an increase in ROM in the flexion direction (p < 0.05) and a decrease in the angle of deviation in proprioception in the flexion direction were determined (p < 0.05). Neither technique had a significant effect on cervical proprioception and trunk muscle endurance (p > 0.05). In addition, no difference was found between the effectiveness of Graston and myofascial release (p > 0.05). CONCLUSION: This study showed that Graston and myofascial release applied to TLF in healthy young adults effectively improve lumbar ROM and proprioception in the acute period. Considering these results, both Graston and myofascial release can be used to provide elasticity of TLF and improve proprioceptive return.

Physical activity levels respiratory and peripheral muscle strength and pulmonary function in young post-COVID-19 patients : A cross-sectional study.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) causes permanent problems, even mild severity. The long-term consequences of COVID-19 are still unknown. This study aimed to investigate physical activity levels, respiratory and peripheral muscle strength, and pulmonary function in the long term in young adult COVID-19 patients who recovered from mild disease. METHODS: This cross-sectional study was carried out at least 6 months after the COVID-19 diagnosis, 54 patients with COVID-19 (median age: 20 years) and 46 controls (median age: 21 years) were compared. Functional status (post-COVID-19 functional status scale), respiratory (maximum inspiratory and expiratory pressures (MIP, MEP)) and peripheral muscle strength (dynamometer), pulmonary function (Spirometry), dyspnea and fatigue (modified Borg scale), and physical activity levels (International Physical Activity Questionnaire) were evaluated. CLINICALTRIAL NUMBER: NCT05381714. RESULTS: Patients with COVID-19 measured and percent predicted MIP and MEP were statistically decreased compared with the controls (p < 0.05). Shoulder abductors muscle strength (p < 0.001) and the number of individuals with low physical activity levels were significantly higher in patients compared with controls (p = 0.048). Pulmonary function, quadriceps muscle strength, exertional dyspnea, and fatigue scores were similar in groups (p > 0.05). CONCLUSION: Respiratory and peripheral muscle strength and physical activity levels are adversely affected in patients with COVID-19, even though the patients were mildly affected in the long term. Also, symptoms such as dyspnea and fatigue may persist. Therefore, these parameters should be evaluated in the long term, even in young adults who are mildly affected by COVID-19.

Effect of core strength training on balance, vertical jump height and throwing velocity in adolescent male handball players.

BACKGROUND: The aim of this study was to examine the effects of core strength training (CST) on dynamic balance and vertical jump height, and throwing velocity in handball players. METHODS: Twenty male handball players (mean age 14.90±0.44 years) participated in this study. The players randomly divided into two groups as CST and control (CON) groups. Dynamic balance, vertical jump, and throwing velocity were measured before and after a six-week CST. RESULTS: Significant differences were found at anterior (P=0.009) and posteromedial (P=0.017) directions of the Star Excursion Balance Test (SEBT) in only CST group. There were significant improvement in vertical jump height of participants compared to pre-test scores in both CST (P=0.047) and CON group (P=0.013). No significant difference was found for throwing velocity compared with pre-test in both groups. There were no significant differences in all parameters when CST and CON groups were compared (P>0.05). CONCLUSIONS: The results of the present study indicated that a 6-week CST did not improve dynamic balance, vertical jump height and throwing velocity in adolescent male handball players. We believe that longer CST programs may provide significant benefits.

The efficacy of botulinum toxin A lower limb injections in addition to physiotherapy approaches in children with cerebral palsy: A systematic review.

BACKGROUND: To assess treatment effect of lower limb botulinum toxin type A (BTX-A) in combination with physiotherapy approaches on gross motor functions in children with cerebral palsy compared with only physiotherapy treatment. OBJECTIVE: The purpose of this review was to analyze the efficacy botulinum toxin a lower limb injections in addition to physiotherapy approaches in children with cerebral palsy. METHODS: A literature search was conducted in the following databases: Cochrane, PEDro, PubMed, MEDLINE, AMED and EMBASE. The searches were limited to the period from July 2009 to July 2015. The intervention had to contain BTX-A into the lower limb plus physiotherapy approaches and be compared with only physiotherapy. The methodological quality and clinical relevance were independently assessed by the authors. RESULTS: The database search resulted in a total of 1521 studies, of which 4 (Level II of evidence) trials were included in this review. The population represented by were age between from 11 month to 15 years. Overall there were 153 children all diagnosed with CP (87 Male, 66 Female). CONCLUSIONS: The use of BTX-A injections in addition to physiotherapy approaches seems to have positive effect on spasticity and ROM. However, the question of whether the treatment of BTX-A plus physiotherapy has a greater improvement on functional capacity, such as gross motor function or gait parameter than only physiotherapy treatments, was inconclusive. Further investigation by rigorous studies is required.