The Comparison of Individual and Group Hybrid Telerehabilitation Methods in Women with Urinary Incontinence.

INTRODUCTION AND HYPOTHESIS: The aim is to compare the effects of the progressive training program (PTP), a new protocol, with two different hybrid telerehabilitation methods, on the parameters related to urinary incontinence in women with urinary incontinence. METHODS: A total of 50 participants with stress or mixed urinary incontinence participated in this two-arm, parallel-group, randomized, non-inferiority trial. Individual hybrid training (IHT) or group hybrid training (GHT) was given to women for 8 weeks. The Power, Endurance, Repetitions, Fast contractions, and Every Contraction Timed (PERFECT) scheme and surface electromyography were used to assess pelvic floor muscle function, whereas quality of life, exercise adherence, and symptoms were assessed by questionnaires and a 3-day bladder diary. An intention-to-treat analysis was performed. Linear mixed model analysis with the factors "time" and "group" was used to determine the effects of IHT and GHT. RESULTS: The primary outcome was changes in pelvic floor muscle function as evaluated using the PERFECT scheme and surface electromyography at the 4th and 8th weeks relative to baseline. No statistical difference was found between the groups except for "power" of the PERFECT scheme and "nocturnal urination frequency" (p > 0.05). The GHT showed significant improvement in P and nocturnal urination frequency at the end of the 8th week (p < 0.05). From baseline to week 8, the effect size for the P value was found to be small (Cohen's d = 0.33). CONCLUSION: Eight weeks of PTP did not lead to different results in incontinence-related parameters in either of the training methods. It may be better to conduct GHT in terms of implementing PTP in incontinence and training programs in terms of time, staff workload, and applicability.

Effects of body awareness therapy on balance and fear of falling in patients with chronic obstructive pulmonary disease: a randomized controlled trial.

BACKGROUND: Assessment of extrapulmonary comorbidities is essential in chronic obstructive pulmonary disease (COPD). Deterioration of balance and increasing fear of falling are two of the most significant extrapulmonary manifestations. Although pulmonary rehabilitation (PR) is well-known and effective for COPD patients, there is a need for alternative treatments to enhance balance and alleviate concerns about falling. This study aimed to investigate the effect of Body Awareness Therapy (BAT), in addition to the PR program, on balance and fear of falling in patients with COPD. METHODS: Forty-three patients were randomized into two groups: the BAT + PR group (BAT: once a week, 60 min + PR: 30 min, seven days of the week) or the PR group (PR: 30 min, seven days of the week) for eight weeks. Primary (balance, fear of falling) and secondary (dyspnea, muscle strength, functional capacity) outcomes were assessed at two different times: the baseline and end of the eight weeks. RESULTS: Significant improvements were found in dynamic balance (reaction time η2 = 0.777, movement velocity η2 = 0.789, endpoint excursion η2 = 0.687, maximal excursion η2 = 0.887), static balance on firm ground (eyes opened η2 = 0.679, eyes closed η2 = 0.705), dyspnea (η2 = 0.546), muscle strength (η2 = 0.803), and functional capacity (η2 = 0.859) of the BAT + PR group (p < 0.05 for all). The improvement in fear of falling was significantly greater in the BAT + PR group than in the PR group (p < 0.001, η2 = 0.331). CONCLUSION: The BAT method added to PR was more effective than PR alone in improving balance and reducing the fear of falling in COPD patients. TRIAL REGISTRATION: This randomized controlled study was registered at clinicaltrials.gov, NCT04212676 , Registered 28 December 2019.

Effectiveness of Device-Guided Breathing in Chronic Coronary Syndrome: A Randomized Controlled Study.

Background: Chronic coronary syndrome (CCS) is one of the most life-restricting coronary artery diseases, and symptom relief is the main goal in CCS patients who suffer from angina. Objectives: To assess the potential benefits of device-guided breathing in CCS patients with angina in this randomized, controlled, single-blinded study. Methods: Fifty-one patients with CCS received device-guided breathing for 7 days/8 weeks. Exercise capacity [exercise stress test], cardiac function [transthoracic echocardiography], and angina severity [Canadian Cardiovascular Society Classification] were evaluated initially and after the training. Device-guided breathing was performed at the lowest resistance of the device (POWERbreathe® Classic LR) for the control group (n = 17). The low load training group (LLTG; n = 18) and high load training group (HLTG; n = 16) were trained at 30% and 50% of maximal inspiratory pressure. Baseline characteristics were compared using one-way ANOVA and Kruskal-Wallis test. Categorical data were compared using the chi-square test. ANCOVA was performed to compare changes between three groups. A p value < 0.05 was considered statistically significant. Results: Metabolic equivalent values were significantly improved in both HLTG and LLTG groups (p < 0.001, p = 0.003). The Duke treadmill score significantly improved and shifted to low-risk both in the HLTG (p < 0.001) and LLTG (p < 0.001) groups. Angina severity significantly alleviated after the training in both HLTG and LLTG groups (p < 0.001, p = 0.002). Conclusions: An 8-week long program of short-term respiratory muscle training provided positive gains in exercise capacity and angina severity in CCS patients with angina. The effects of long-term training programs on CCS patients should be investigated clinically because of the possibility of helping to decrease the need for invasive treatments.

Muscle activation of the upper trapezius and functional typing performance during computer typing task: A comparison of two different wrist immobilization methods.

BACKGROUND: The aim of this study was to examine the effect of two different wrist immobilization methods on the muscle activation of the upper trapezius muscle and functional typing performance during computer typing tasks in office workers. METHODS: The study was conducted on 11 healthy office workers. The study subjects were asked to type on a computer for 5 min (1) without splint or taping, (2) with a splint, (3) with rigid taping which limits the wrist flexion at the dominant side. The upper trapezius muscle activation was recorded by surface EMG during the task. The mean values obtained from EMG were normalized according to Maximum Voluntary Isometric Contraction (MVIC), comparisons were made according to %MVIC. RESULTS: The office workers' mean age was 27.45 ± 3.64 years. There was no significant difference in immobilization methods between %MVIC on dominant (p = .508) and non-dominant (p = .213) sides. The upper trapezius of the non-dominant side showed higher electromyographic activity when the subjects used a splint (p = .013). There was a significant difference between splinting and rigid taping methods in typing performance (z = -2,491, p = .013). CONCLUSION: There is no significant difference in the upper trapezius muscle activation between the splint and rigid taping methods during the computer typing task on the dominant side. The typing performance was affected more during splint use compared to rigid tape application. Considering the importance of work efficiency in employees, rigid taping might be considered as an alternative splinting for wrist immobilization in office workers.