Has COVID-19 really affected the physical and mental health of university students? One-year follow-up results after the pandemic declaration.

BACKGROUND: The COVID-19 pandemic affected the whole world and various isolation measures were applied during this period. One of the groups that were physically and mentally affected by this period was students. OBJECTIVE: To investigate the effects of the COVID-19 pandemic on the physical activity (PA) level, attitudes and behaviors related to PA, smoking, perceived stress, and fatigue of university students one-year after the declaration of the pandemic. METHODS: A total of 102 students (79F/23M, 20.68±1.81 years) who were evaluated face to face with International Physical Activity Questionnaire-Short Form (IPAQ-SF), Cognitive Behavioral Physical Activity Questionnaire (CBPAQ), Perceived Stress Scale (PSS), and Turkish Checklist Individual Strength (CIS-T) Questionnaire before the declaration of the pandemic, were evaluated online with the same questionnaires one-year after the declaration of the pandemic. RESULTS: Although there was no difference in terms of other variables, there was a statistically significant difference in the CBPAQ outcome expectation subscale (p = 0.04). The ΔPSS and ΔCIS-T total had a statistically significant effect on the ΔCBPAQ total (p = 0.003 and p = 0.007), ΔPSS and ΔCIS-T total were independent predictors of ΔCBPAQ total (Δ: before-one year after the declaration of the pandemic). CONCLUSION: University students had positive attitudes and behaviors related to PA and they increased their PA levels, although not significantly, compared to before the declaration of the pandemic. Perceived stress and fatigue may have an effect on attitudes and behaviors related to PA and PA levels. It is thought that university students continue their routines despite the many limitations of the pandemic.

Physical and well-being effect of scapular kinesio taping combined with conventional physiotherapy in shoulder impingement syndrome: A randomized controlled study.

BACKGROUND: Kinesio taping (KT) is one of the treatment methods used on patients with shoulder impingement syndrome (SIS). There are different results regarding its effectiveness in the literature. OBJECTIVE: To investigate the effects of scapular KT combined with a conventional physiotherapy program on scapular dyskinesia, shoulder pain, upper extremity function, and well-being in patients with SIS. METHODS: The study was conducted with 60 outpatients diagnosed with SIS, aged 40-65 years. The patients were divided into two groups: KT [conventional physiotherapy program + scapular KT (targets scapular retraction and is applied along the inferior-medial edge of the scapula, starting from the processus coracoids), n= 30] and control [conventional physiotherapy program, n= 30]. In before- and after-treatment evaluations, the Lateral Scapular Slide Test (LSST) for scapular dyskinesia, a Visual Analogue Scale (VAS) for shoulder pain, and the Disabilities of the Arm, Shoulder, and Hand (DASH) for upper extremity function were used. In addition, at the end of treatment, a Kinesio taping Satisfaction Survey, created by the researchers, was filled out by the KT group for the assessment of well-being. RESULTS: The interaction effect of Group*Time was not statistically significant in all outcome measures (p> 0.05). However, the main effect of both group and time was statistically significant in the DASH-Function/Symptom, VAS-Rest, VAS-Activity, and VAS-Night (p< 0.05). Moreover, only the main effect of time was statistically significant in LSST-1 and LSST-3 (p< 0.05). In the KT group, the satisfaction level was 8.50 ± 1.69 and the recommendation level was 8.72 ± 1.81. CONCLUSION: Both conventional physiotherapy programs and additional scapular KT improved scapular dyskinesia, reduced pain, and increased the upper extremity function. Adding scapular KT to treatment did not change the results, but it had positive psychological effects and yielded a high satisfaction rate.

Cause of non-specific low back pain in women: pelvic floor muscle weakness.

INTRODUCTION AND HYPOTHESIS: This study aimed to evaluate the relationship between pelvic floor muscle (PFM) strength and low back pain (LBP) in women with and without non-specific low back pain (NSLBP) with similar demographic and physical characteristics. METHODS: The study included 40 women (35.73±6.74 years) with NSLBP (with LBP group) and 32 women (34.59±5.93) without LBP (without LBP group). PFM strength with a perineometer, pain intensity with a Visual Analog Scale (VAS), quality of life with the Short Form-36 (SF-36), and perceptions of LBP and related disability with the Rolland Morris Disability Questionnaire (RMDQ) were evaluated. RESULTS: There was no difference between the groups in terms of age, BMI, number of births (0, 1, and 2 births) and mode of delivery (vaginal/cesarean section) (p>0.05). There was a statistical difference between the groups in all parameters except SF-36 Emotional Role Limitation subscale (p<0.05). We found PFM strength an independent predictor of the RMDQ score, and RMDQ and VAS scores as independent predictors of SF-36 physical and mental components (p<0.05). CONCLUSIONS: Decreased PFM strength in women causes non-specific mechanical low back pain and disability independent of age, BMI, and the number and type of delivery. Decreased PFM strength is a predictor of disability. Disability and pain are also independent predictors of decreased quality of life. PFM measurement should be prioritized when evaluating women with NSLBP. PFM strength may be a determinant of LBP.

Determining Post-COVID-19 Symptoms and Rehabilitation Needs in Hospitalized and Nonhospitalized COVID-19 Survivors with Tele-Assessment Methods.

Objectives: This study aimed to evaluate the post-COVID-19 symptoms, the severity of symptoms, and functional capacities seen in hospitalized and nonhospitalized COVID-19 survivors according to time periods (total 6, 1-3, and 3-6 months) by tele-assessment methods and to predict the need for periodic rehabilitation of COVID-19 survivors. Methods: Three hundred ninety-four COVID-19 survivors (50.18 ± 15.14 years) who were between 1 and 6 months after PCR(+) were included in the study, and their ongoing symptoms and the severity of these symptoms (0-10 points) were assessed with COVID-19 Yorkshire Rehabilitation Screening (C19-YRS) Tool, and the 30-s Chair Stand Test (CST) was applied by tele-assessment methods. Results: In hospitalized and nonhospitalized survivors of COVID-19, 87% experienced at least one symptom within the first 6 months. The most prevalent symptoms were anxiety (47.7%), fatigue (46.7%), and muscle pain (45.7%). The most common symptom in the nonhospitalized group was fatigue (52.6%), whereas anxiety was 46.8% in the hospitalized group. The 30-s CST score of the nonhospitalized group was significantly higher than the hospitalized group (p < 0.001). Conclusions: In the first 6 months post-COVID-19, musculoskeletal problems, anxiety, fatigue, and muscle pain were observed to be the most prevalent symptoms, regardless of time, in hospitalized and nonhospitalized survivors. There was a serious decrease in their functional capacity. Priority should be given to psychiatric, cardiopulmonary, and musculoskeletal rehabilitation in post-COVID-19. Inclusion of hospitalized/nonhospitalized COVID-19 survivors in a comprehensive rehabilitation program tailored to their needs by following a comprehensive tele-assessment by a multidisciplinary team will reduce the "long COVID-19 syndrome." ClinicalTrials.gov Registration Number: NCT04900441.

Postural stability and fall risk in patients with obstructive sleep apnea: a cross-sectional study.

PURPOSE: Nocturnal hypoxia and daytime sleepiness resulting from fragmented sleep may impair the ability of postural stability in subjects with OSA. This study investigates the effect of disease severity on postural stability and whether or not it poses a fall risk in individuals with obstructive sleep apnea (OSA). METHODS: Forty-nine patients with OSA diagnosed by all-night polysomnography (apnea-hypopnea index (AHI) ≥ 5) and aged 51.4 ± 7.2 years were included in the study. The patients were divided into two groups as severe OSA (AHI ≥ 30, n = 24) and non-severe OSA (5 ≤ AHI ≤ 30, n = 25). All patients were subjected to testing for postural stability (PS), limits of stability (LOST), and the stability index for fall risk (fall risk SI) with the Biodex Balance System®. Daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). Biodex measurements and daytime sleepiness were compared between severe and non-severe OSA groups. Univariate analysis was conducted to explore if AHI, ESS score, lowest SaO2 (%), sleep stages (%), or total arousal index predict postural stability scores. RESULTS: Overall and anterior-posterior PS indices were higher in the severe OSA group (p < 0.05). Dynamic PS and fall risk indices did not differ between groups. AHI and lowest SaO2 (%) were found to be an independent predictor for both overall PS (r = 0.300 and r = 0.286, respectively) and fall risk SI (r = 0.296 and r = 0.374, respectively), whereas stage N1 (%) and stage N3 (%) were an independent predictor for overall LOST score (r = -0.328 and r = 0.298, respectively) (p < 0.05). CONCLUSION: Static postural stability of individuals with severe OSA is worse than those with non-severe OSA. Static postural stability worsens, and fall risk increases as AHI increases and the lowest SaO2 decreases in individuals with OSA. On the other hand, dynamic postural stability worsens as stage N1 (%) sleep increases and stage N3 (%) sleep decreases. While nocturnal hypoxia indicators such as AHI and lowest SaO2 are associated with static postural stability, sleep structure-related variables are associated with dynamic stability. Including postural stability assessments in the clinical practice for OSA may help addressing workplace accidents or tendency to fall. TRIAL REGISTRATION: www.ClinicalTrials.gov registration number: NCT03589417.

The Effect of T'ai Chi and Qigong Training on Patients with Obstructive Sleep Apnea: A Randomized Controlled Study.

OBJECTIVES: This study aims to investigate the effects of t'ai chi and qigong (TCQ) training on severity of obstructive sleep apnea (OSA). DESIGN: A prospective, 12-week, single-center, double-blinded, randomized controlled trial. SETTING: Sleep Disorders Center of Medical Faculty in Istanbul, Turkey. SUBJECTS: Fifty adult patients with mild and moderate OSA. INTERVENTIONS: Patients were randomly allocated into either an intervention group or a control group. The intervention group (n = 25) received TCQ training under physiotherapist supervision for 1 h, three times per week, for 12 weeks and a home exercise program was provided for another 2 days. The control group (n = 25) received only a home exercise program for 12 weeks, 5 days per week. OUTCOME MEASURES: All patients were assessed before and after the exercise program. Objective parameters of sleep were measured by polysomnography, while subjective parameters of sleep were assessed using the Epworth Sleepiness Scale (ESS) and the 3-factor Pittsburgh Sleep Quality Index (PSQI). Pulmonary functions were assessed with a pulmonary function test; health-related quality of life was evaluated through the Short Form-36. RESULTS: In the intervention group, there was a statistically significant decrease in the apnea-hypopnea index (AHI) (p = 0.001) and percentage and duration of stage N2 sleep (p = 0.041 and p = 0.037, respectively), while there was a statistically significant increase in percentage and duration of stage N3 sleep when compared with the controls (p = 0.048 and p = 0.043, respectively). There was a statistically significant decrease in the ESS, PSQI sleep efficiency, and total scores (p = 0.001, p = 0.003, and p = 0.003, respectively). CONCLUSIONS: Our study results suggest that TCQ training may reduce AHI and daytime sleepiness, while improving subjective sleep quality, in patients with mild and moderate OSA.

Evaluation report of pediatric intensive care units in Turkey.

BACKGROUND/AIM: To collect data from throughout Turkey in order to facilitate the organization of pediatric intensive care units (PICUs), and to develop short-term immediate action plans and draft long-term strategic plans. MATERIALS AND METHODS: A total of 35 specialists including 17 pediatric critical care (PCC) specialists, 9 PCC fellows in training, and 9 pediatricians working in PICUs evaluated PICUs and their infrastructures, mortality rates, appropriateness of indications for PICU admissions, PICU bed numbers, and utilization of those PICU beds. RESULTS: PICU bed numbers, PCC specialist numbers, and PICU nurse numbers are insufficient in Turkey. The high percentage of inappropriate and inefficient use of current PICU beds is also another problem. CONCLUSION: In the light of this report, it is obvious that pediatric intensive care services are successful and efficient only in the presence of PCC specialists in PICUs. Studies for improving the infrastructure of PICUs and the training of PCC specialists and other health personnel should be started immediately.