Effects of Two Exercise Regimes on Patients with Chiari Malformation Type 1: a Randomized Controlled Trial.

This study aims to measure the effects of two different exercise programs on neck pain, proprioception, balance, coordination, posture, and quality of life in patients with Chiari malformation (CM) type 1. Sixteen patients were randomized to two different exercise programs: a tailored exercise protocol for CM (TEP-CM) and cervical spinal stabilization exercises (CSSE). Both exercise programs were implemented by a physiotherapist 3 days a week for 6 weeks. The primary outcome was Neck Disability Index. Secondary outcomes were visual analogue scale for pain, joint position sense error measurement, Berg Balance Scale, Time Up and Go Test, International Coordination Ataxia Rating Scale, PostureScreen Mobile, and Short Form-36. Assessments were done immediately before and after the intervention programs. Both groups showed significant improvement in Neck Disability Index, and some secondary outcome measures (P < 0.05). However, there were no statistical differences in post-intervention changes between the groups (P > 0.05). This is the first study to examine the effects of different exercise programs on symptoms in patients with CM type 1. Our preliminary findings indicate that exercise programs can improve pain, balance, proprioception, posture, coordination, and quality of life in CM type 1. Therefore, exercise should be considered safe, beneficial, and low-cost treatment option for CM type 1 patients without surgical indications.

Effects of Virtual Reality for Postural Control in Chronic Neck Pain: A Single-Blind, Randomized Controlled Study.

OBJECTIVE: The purpose of this study was to investigate the effects of virtual reality (VR) on postural control, posture, and kinesiophobia in patients with chronic neck pain (CNP). METHODS: Forty-one participants with CNP were randomly allocated to the VR and control groups. The VR group experienced VR with glasses for 20 minutes and then performed motor control (MC) exercises for 20 minutes. The control group received only MC exercises for 40 minutes. Both groups received 18 sessions over 6 weeks. Computerized dynamic posturography outcomes, including sensory organization test (SOT), limits of stability, and unilateral stance tests, gait speed, forward head posture (FHP), shoulder protraction (SP), cervical lordosis angle, kinesiophobia, and exercise compliance were recorded. RESULTS: The VR group had more effects regarding composite equilibrium (Cohen's d = 1.20) of SOT and kinesiophobia (Cohen's d = -0.96), P < .05). Also, the VR group was more effective in exercise compliance (P < .05). Contrary to these results, the control group was more effective in correcting FHP and SP (Cohen's d > 0.7, P < .05). CONCLUSION: Virtual reality seemed to have an effect on postural control, posture, and kinesiophobia in patients with chronic neck pain.

The ProFitMap-neck - a questionnaire for measuring symptoms and functional limitations in neck pain: reliability, validity and cross-cultural adaptation of the Turkish version

Background/aim: The Profile Fitness Mapping neck questionnaire (ProFitMap-neck) is a reliable and valid assessment instrument for measuring neck-related symptoms and functional limitations in people with neck pain, but a Turkish version of it had not been published. The purpose of this study was to investigate the adaptation, validity, and intrarater reliability of the Turkish version of the ProFitMap-neck. Materials and methods: Two hundred and thirty-five individuals with chronic neck pain were enrolled in the study. Intrarater reliability was assessed by intraclass correlation coefficient (ICC) and Cronbach's alpha was calculated for internal consistency. For concurrent validity, ProFitMap-neck scores were compared with neck disability index (NDI) and visual analoguepain scale (VAS) scores using Pearson's correlation coefficient analysis. The ProFitMap-neck, NDI, VAS, and short form health survey (SF-36) were administered to all participants. Results: For intrarater analysis, ICC ranged between 0.72 and 0.84. The total score was 0.83, indicating excellent reliability. The correlation of the ProFitMap-neck with NDI and VAS was 0.71 and 0.68, respectively, indicating good concurrent validity. Conclusion: The ProFitMap-neck is an evaluation instrument with sufficient validity and reliability to be used for evaluating Turkish patients with neck pain. Use of this scale can reveal how, how often, and how much these patients' pain affects their symptoms and functional activities.

Multivariate Analysis of Risk Factors Predisposing to Kinesiophobia in Persons With Chronic Low Back and Neck Pain.

OBJECTIVE: The purpose of this study was to analyze the interaction between kinesiophobia and pain-related variables classified according to International Classification of Functioning in individuals with chronic neck and low back pain by using multivariate analysis. METHODS: The 504 persons with chronic neck and low back pain filled out questionnaires assessing impairments in body functions and structures, limitations in activities of daily living, participation, and personal factors. Univariate analyzes were performed to investigate whether there are differences between individuals with and without kinesiophobia or not. Binary logistic regression analysis was used to evaluate whether independent variables were statistically significant predictors. RESULTS: In the univariate analyses, the persons who had high-level kinesiophobia had a significantly lower level of education and had significantly higher scores for the Million Visual Analogue Scale, Neck Disability Index, Hospital Anxiety and Depression Scale, and Nottingham Health Profile (P < .001). In the final logistic regression analysis, only educational level (P = .01), Million Visual Analogue Scale (P = .002) and Hospital Anxiety and Depression Scale (P = .008, P = .012) were retained significantly as the predictors of kinesiophobia. CONCLUSION: In this group of people with chronic neck and low back pain, educational level, low back pain-associated disability, and emotional states like depression and anxiety were associated with kinesiophobia.

Comparison of the Acute Effect of Radial Shock Wave Therapy and Ultrasound Therapy in the Treatment of Plantar Fasciitis: A Randomized Controlled Study.

OBJECTIVE: This study compared the effectiveness of radial extracorporeal shock wave therapy (r-ESWT) with ultrasound (US) therapy in the treatment of plantar fasciitis (PF). STUDY DESIGN: Level II, randomized controlled study. DESIGN: A total of 54 female patients with unilateral PF were randomly assigned to two study groups and one control group. All groups performed home exercises. In addition, the first study group received three sessions of r-ESWT treatment and the second study group received seven sessions of US treatment. The Foot Function Index (FFI) and the American Orthopedic Foot and Ankle Association (AOFAS) hind foot score were determined. Static and dynamic equilibrium were evaluated with the single leg standing test and the functional reach test. Ankle proprioception sense was determined with the Biodex III isokinetic device. Patients were evaluated before and four weeks after the first treatment. RESULTS: According to the evaluation results, there was a decrease in FFI values in all groups and these decreases were more prominent in the US group than the other groups (P < 0.05). It was observed that the hind foot AOFAS scores increased in all groups, but this increase was less in the control group (P < 0.05). Static and dynamic balance increased in all groups (P < 0.05). Ankle proprioception sense increased only in the r-ESWT group (P <0.05). CONCLUSIONS: All groups and particularly the r-ESWT and US groups' symptoms were decreased after treatment. However; FFI parameters were reduced more in the US groups than the other two groups, the ankle proprioception sense increased in the r-ESWT group, and there was no change in the other groups.

Psychometric properties of Fullerton Advanced Balance Scale in patients with stroke.

BACKGROUND: Patients experience falls frequently after stroke. Preserved or acquired balance skills decrease fall risk and improve independence. Feasibility of Fullerton Advanced Balance Scale (FAB) has been shown in balance assessment in some neurological diseases except stroke. OBJECTIVES: The purpose of this study was to investigate the reliability and validity of Turkish version of FAB (FAB-T) in patients with stroke (PwS). METHODS: This cross-sectional study included 51 PwS (60.64 ± 7.66 years). Reliability analyses were conducted with Cronbach's alpha, intraclass correlation coefficient (ICC), and Spearman correlation analysis. Intra-rater and inter-rater reliability were assessed with three raters. FAB-T, Stroke Rehabilitation Assessment of Movement (STREAM), Brunnstrom Recovery Stages (BRS), Barthel Index (BI), and 36-Item Short Form Health Survey (SF-36) were used for convergent validity. Correlations of FAB-T with Berg Balance Scale (BBS) and Mini-Balance Evaluation Systems Test (Mini-BESTest) were measured for concurrent validity. Spearman correlation analysis was used for convergent and concurrent validity. For predictive validity patients' self-reports of falling were analyzed with ROC. RESULTS: Intra-rater (ICC = 0.998) and inter-rater reliability (ICCs = 0.984; 0.984; 0.990), and internal consistency (Cronbach's alpha = 0.930) were excellent. FAB-T had good correlations with STREAM (ρ = 0.677) and BI (ρ = 0.628), moderate correlations with BRS (ρ = 0.504 and ρ = 0.579) and physical function of SF-36 (ρ = 0.436). FAB-T excellently correlated with Mini-BESTest and BBS (ρ = 0.928 and ρ = 0.942). The cutoff score of FAB-T was determined to be 21.5 points, with sensitivity of 84% and specificity of 61% (AUC = 0.749). CONCLUSIONS: FAB-T is a reliable and valid balance assessment tool with an acceptable accuracy of fall prediction in PwS.

Validity and intra- and inter-rater reliability of the Tinetti performance-oriented mobility assessment balance subscale using different tele-assessment methods in patients with chronic stroke.

INTRODUCTION: Balance assessments are an important component of rehabilitation. Considering the increasing use of telemedicine to meet rehabilitation needs, it is important to examine the feasibility of such assessments. This study aimed to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment Balance Subscale (POMA-B) when applied via synchronous and asynchronous tele-assessment. METHODS: Twenty-five patients with chronic stroke were included in the study. The first physiotherapist assessed the patients on the first day in a face-to-face clinical setting. Synchronous or asynchronous tele-assessment was applied the next day. The assessments were performed in the same time zone, with an interval of one day. The synchronous tele-assessment was done online in real time by the first and second physiotherapists. A reference assessment video was sent to the patients for asynchronous tele-assessment. They were asked to make a video recording while performing the evaluation activities according to the reference video. Then the first and second physiotherapists assessed these video recordings separately. All the tests were repeated 10 days later to determine the intra-rater reliability of the tele-assessment methods. RESULTS: The intra-class correlation coefficients ranged from 0.96 to 0.98 for inter-rater reliability and from 0.97 to 0.98 for intra-rater reliability for both tele-assessment methods. Both asynchronous and asynchronous tele-assessment methods were medium correlated with the face-to-face versions. CONCLUSIONS: We demonstrated the validity and reliability of the POMA-B in chronic stroke patients with different tele-assessment methods, typically using the internet and available devices.

Predictors of Functional Independence in Children with Spinal Cord Tumors After Surgery: From Physiotherapist Perspective.

Knowledge of the factors affecting functional outcomes has an important role in the development of the care plan in children with spinal cord tumors. Retrospective study was planned to determine predictors of functional independence in children with spinal cord tumors. Data from 80 children treated for spinal cord tumors over 2001-2020-year period was analyzed. Results showed that key predictors such as younger age, higher KPS, and better initial WeeFIM scores were strongly associated with improved functional outcomes. Further multicenter prospective studies are recommended to validate these findings and explore long-term functional outcomes to enhance rehabilitation strategies for this patient population.

Clinical Characteristics and Rehabilitation Results of Traumatic Brain Injury Patients Who Have Early Rehabilitation.

AIM: To examine the clinical characteristics and early rehabilitation results and to investigate the relationship between rehabilitation initiation time and rehabilitation-related outcome measurements in traumatic brain injury (TBI) patients who have early rehabilitation. MATERIAL AND METHODS: Forty-seven TBI patients who were referred for rehabilitation in the neurosurgery department were enrolled in the study retrospectively. Clinical characteristics and rehabilitation-related outcome measurements including consciousness, functional outcome, daily living activities, functional mobility, and ambulation of all patients were recorded. The paired samples t-test was used to compare data before and after rehabilitation. The relationship between rehabilitation initiation time and the other outcomes was analyzed with Pearson's correlation test. RESULTS: Most of the TBI patients were male (83%) and the severities of the trauma were mostly mild (42%). The causes of trauma were mostly falls (53%). Twenty-three (49%) of the patients underwent surgical intervention. The lengths of time between admission and consultation and between surgery and consultation were 19.82±17.9 and 14.24±15.4 days, respectively. The lengths of stay in intensive care and hospital were respectively 27.32±34.93 and 41.35±32.83 days. The rehabilitation time was 21.50±24.32 days. The before and after rehabilitation results showed that all rehabilitation-related outcome measurements improved significantly (p < 0.001). The relationship between rehabilitation initiation time and the other outcomes was statistically significant (p < 0.05). CONCLUSION: This was a descriptive study in terms of demonstrating the demographic and clinical characteristics of TBI patients who need rehabilitation in the neurosurgery department. Early rehabilitation can enhance the rehabilitation-related outcome including consciousness, functional outcome, daily living activities, functional mobility, and ambulation in TBI patients as soon as their medical condition is stable. Early rehabilitation initiation time is important for improving the rehabilitation-related outcomes.

Factors affecting the performance of the deep cervical flexors in young people using smartphones.

OBJECTIVE: To determine the factors affecting the performance of the deep cervical flexors (DCFs) in young people using smartphones. METHODS: Eighty-six individuals were enrolled in this study. Joint position sense errors, forward head and protracted shoulder posture, DCFs, and the superficial cervical muscles were evaluated. Smartphone Addiction Scale, State-Trait Anxiety Inventory, and International Physical Activity Questionnaire were used. RESULTS: Regression analysis indicated that smartphone addiction and superficial cervical muscle strengths affect the performance of DCFs independently (p < 0.05). SAS was correlated with JPSE-flexion (r = 0.408), DCF activity/performance score (r = -0.453/r = -0.431), forward head posture (r = -0.412), and cervical flexor/extensor muscle strengths (r = -0.313/r = -0.319). CONCLUSION: Smartphone addiction and cervical superficial muscles are related to the performance of the DCFs in young people. Using smartphones causes impaired joint position sense in flexion, decreased DCF activity, and forward head posture.

Reliability and validity of the glittre activities of daily living test in fully ambulatory multiple sclerosis patients.

BACKGROUND: Evaluation of activities of daily living (ADL) and functional exercise capacity in patients with multiple sclerosis (pwMS) is crucial in demonstrating the effectiveness of interventions. AIMS: To investigate the reliability and validity of the Glittre ADL Test in pwMS. METHODS: Twenty-five pwMS and 26 healthy adults were included in this methodological study. The Glittre ADL Test was applied. Six-Minute Walk Test (6MWT) and Nottingham Extended Activities of Daily Living Index (NEADL) were applied for concurrent validity. Expanded Disability Status Scale (EDSS), Fatigue Severity Scale (FSS), Mini Balance Evaluation Systems Test (Mini BESTest), Multiple Sclerosis Quality of Life Scale-54 (MSQoL-54), and Five Times Sit-to-Stand Test (5 STST) were applied for construct validity. The Glittre ADL Test was repeated after 3-6 days for test-retest reliability. RESULTS: The test-retest reliability of the Glittre ADL Test was excellent (ICC = 0.941). There was strong correlation of the Glittre ADL Test with 6MWT (rho = - 0.710, p < 0.001), NEADL (rho = - 0.841, p < 0.001), EDSS, (rho = 0.836, p = < 0.001), Mini BESTest (rho = 0.792, p < 0.001), and 5 STST scores (rho = 0.720, p < 0.001). There was a moderate correlation between the Glittre ADL Test and the physical health sub-item score of the MSQoL-54 (rho = - 0.591, p = 0.002). No correlation was found between the Glittre ADL Test and FSS (rho = 0.348, p = 0.096). There was a difference in the Glittre ADL Test results between the pwMS and the healthy adults (p = 0.001). CONCLUSIONS: The Glittre ADL Test has excellent reliability and strong construct and criterion validity for assessing functional exercise capacity and ADL in fully ambulatory pwMS. TRIAL REGISTRATION: TRN: NCT04182269.

Do cervical stabilization exercises change the effects of conventional exercises in patients with Parkinson's disease?

OBJECTIVES: The aim of this study was to examine whether cervical stabilization exercises (CSEs) change the effects of conventional exercises (CEs) in patients with PD. METHODS: Twenty-five patients with PD were randomized into two groups. While the experimental group (EG) received CSEs in addition to CEs, the control group (CG) received only CEs. Both programs lasted 8 weeks. Eighteen participants were able to complete the study. The outcomes were the changes in posture, cervical joint position sense (JPS), balance assessment, 10-m walking tests (10MWT), and the Timed Up & Go (TUG) test. RESULTS: At the end of the study, significant improvement was observed in both groups in terms of trunk rotation angle and pelvic asymmetry, the time parameter of TUG, and the 10MWT (p < 0.05). In the EG, greater improvement was detected in the Berg Balance Scale, static posturography, postural alignment, JPS, and the cadence parameter of TUG (p < 0.05). DISCUSSION: CEs and CSEs could improve walking speed and posture in patients with PD, but if CSEs are added to CEs, greater improvements could be achieved in JPS and postural control.(Clinical Trials ID: NCT03854747).

Virtual reality and motor control exercises to treat chronic neck pain: A randomized controlled trial.

AIM: To compare the effects of virtual reality (VR) and motor control (MC) exercises. METHODS: Forty-one participants with chronic neck pain (CNP) were randomized into the VR or MC group. Both groups performed 18 sessions over 6 weeks. The primary outcomes were pain intensity (visual analogue scale), pain pressure thresholds (PPTs), joint position sense error (JPSE), and muscle performance. The secondary outcomes were the Profile Fitness Mapping Questionnaire (ProFitMap-Neck), Hospital Anxiety-Depression Scale (HADS), and quality of life (SF-36). Data were analysed using T-Tests, and Fisher's Exact Test. Mean (standard deviation), median (interquartile range), effect size and %95 confidence interval (CI) were reported. RESULTS: The results of Independent T-Tests showed that VR was advantageous in terms of PPTs of the C1/C2 and C5/C6 articular pillar bilaterally and large effect size (Cohen's d > 0.8, p < 0.05). Moreover, VR was more effective in decreasing JPSE (Cohen's d > 0.08; mean difference changes between -2.91 and -1.24, %95 CI -4.47 to 0.80) and functional limitation (ProFitMap-Neck) (Cohen's d = 0.7, mean difference 8.27, %95 CI 0.20 to 16.35). The results of T-Tests demonstrated that neither intervention was superior in terms of pain intensity, muscle performance, symptoms (ProFitMap-Neck), HADS, or SF-36 (Cohen's d < 0.5). CONCLUSIONS: VR can be applied for improving proprioception and for decreasing cervical articular pain in CNP patients. In addition, VR may be more effective for decreasing functional limitations in patients. Clinicians can choose MC exercises with or without VR for improving pain, muscle performance, symptoms, anxiety/depression, and quality of life.

The musculoskeletal problems and psychosocial status of teachers giving online education during the COVID-19 pandemic and preventive telerehabilitation for musculoskeletal problems.

BACKGROUND: Musculoskeletal and psychosocial problems have tended to increase during the COVID-19 pandemic. OBJECTIVE: To evaluate the changes in musculoskeletal problems and psychosocial status of teachers during the COVID-19 pandemic due to online education and to investigate the effects of preventive telerehabilitation applications for musculoskeletal problems. METHODS: Forty teachers who conducted online education during the pandemic volunteered to participate in the study. All assessments were performed via online methods. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), ProFitMap-Neck questionnaire, Oswestry Disability Index (ODI), and Upper Extremity Functional Index (UEFI) were used to evaluate musculoskeletal problems; the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used to evaluate anxiety and depression, respectively; and the Work-Life Balance Scale (WLBS) was used to evaluate how well individuals achieve this balance. Information about before online education, during online education, and after training was obtained with the assessments. After the first assessment, telerehabilitation, which involved presentations and brochures, was applied to 18 participants willing to participate in the training. RESULTS: The ProFitMap, UEFI, and WLBS scores during the online education decreased significantly, while the scores of the CMDQ, ODI, BDI, and BAI during the online education increased significantly compared to the pre-online education scores (p < 0.05). In addition, the total CMDQ, ProFitMap, and ODI scores improved significantly after the training (p < 0.05). CONCLUSION: Musculoskeletal and psychosocial problems increased in teachers during online education. Preventive telerehabilitation methods will be beneficial for individuals who do not have access to face-to-face physiotherapy.

Correlation of force sense error test measured by a pressure biofeedback unit and EMG activity of quadriceps femoris in healthy individuals.

BACKGROUND: Our study developed a force sense error test (FSET) method for use on the quadriceps muscle, which could be employed in clinical practice to correlate the results of quadriceps muscle activity levels determined by surface electromyography (sEMG). METHODS: Twenty-four healthy individuals were included in the study. A pressure biofeedback unit (PBU) placed under the knee joint, was used for force sense error test (FSET) evaluation. First, a maximum contraction value was determined with the PBU. Next, 50% and 65% of the maximum contraction value were used for the analysis. Concurrently, norm values for the quadriceps muscle activity levels were determined by sEMG. Simultaneously, quadriceps muscle activity levels were recorded while testing the FSET using the PBU. Each measurement was repeated in triplicate, and the average constant errors observed by the PBU were recorded in mmHg. RESULTS: The FSET for both 50% and 65% of the normal mmHg value determined using the PBU positively correlated with activity change levels in the quadriceps muscle determined by sEMG (p < 0.05). CONCLUSIONS: The relationship between the FSET measured using PBU and changes in the level of activity in the quadriceps muscle showed that a PBU can be used in clinical practice for proprioceptive evaluation of the knee region.

Do Stabilization Exercises Increase the Effects of Lumbar Facet Radiofrequency Denervation?

AIM: To investigate the effects of lumbar stabilization exercises on pain severity, functional disability, and physical performance after two weeks following radiofrequency denervation in patients with lumbar facet joint syndrome (LFJS). MATERIAL AND METHODS: Thirty-nine patients diagnosed with LFJS and had radiofrequency denervation were assigned to study and control groups. The study group (n=20) received a six-week stabilization exercise program and was informed about spine biomechanics, while the control group (n=19) received only informations about spine biomechanics. Pain severity with visual analogue scale, perceived disability with Oswestry disability index, physical performance with physical performance tests and gait speed test were applied before and after radiofrequency denervation, and after six weeks of intervention program. RESULTS: Despite the similar improvements were shown in terms of all outcomes in both groups following radiofrequency denervation (p > 0.05), the improvements were more in favor of study group after six week intervention program (p < 0.05). CONCLUSION: These results indicate that radiofrequency denervation is effective in improving the pain, disability, and physical performance in patients with LFJS and this effect is further enhanced by the stabilization exercises following this procedure. Adding stabilization exercises to radiofrequency denervation yielded positive outcomes and these exercise are strongly advised in physiotherapy and rehabilitation program.

A comparison of the acute effects of radial extracorporeal shockwave therapy, ultrasound therapy, and exercise therapy in plantar fasciitis.

This study was conducted to compare the acute effects of radial extracorporeal shockwave therapy (r-ESWT), ultrasound (US) therapy and home exercise therapy on pain, fatigue, performance and walking distance in women with plantar fasciitis (PF). Fifty-four female patients diagnosed with PF participated in the study. The patients were randomly divided into 3 groups as r-ESWT and home exercise groups, US and home exercise groups, and only home exercise groups. Patients' pain and fatigue levels were assessed by using a visual analog scale. Also walking distances, walking speed and plantar flexor muscles performance were assessed. Patients' pain at night before bedtime and leg fatigue after the 6-min walking test decreased in the US therapy group in comparison to the other two groups (P<0.05). The 20-m walking speed improved in the US and r-ESWT therapy groups following the treatments (P<0.05) and there was no difference between the groups. After treatment, while the 20-m walking speed was increasing in US and r-ESWT groups (P<0.05), no increase was observed in exercise group. But there was no difference between the 20-m walking speed of 3 groups after treatment (P>0.05). However, all three groups' complaints decreased after treatment. Our study results illustrated that r-ESWT, US, and home exercise therapy have acute effects on the PF treatment and when there is no possibility of practising any treatment to patients, home exercises such as r-ESWT, US treatment are effective therapies for decreasing pain and fatigue levels and improving performance and walking distance.

A comparison of occupational groups using different working postures in terms of their low back and neck health status.

OBJECTIVE: To compare how disability, fear of movement, psychosocial status and quality of life are affected in terms of low back-neck health status in three occupational groups using different work postures. METHOD: Three hundred thirty-nine individuals participated in this study from the following three different occupational groups: group A, where the individuals worked in a prolonged sitting position (secretaries), group B, where the individuals performed dynamic activities in a standing position (cleaning workers) and group C, where the individuals worked in a prolonged standing position (private security officers). The participants were evaluated by Million Visual Analog Scale, Neck Disability Index, Oswestry Disability Index, Nottingham Health Profile, Hospital Anxiety and Depression Scale and Tampa Kinesiophobia Scale. RESULTS: It was found that disability, emotional status and the quality of life were minimally affected, but kinesiophobia was increased in all of the occupational groups. In the group C, low back pain disability, quality of life and fear of movement were more affected than the other groups (p< 0.05). CONCLUSION: For the occupational groups with long working years, the presence of kinesiophobia should be considered and cognitive-behavioural treatment methods should be recommended. In cleaning workers, low back pain is an important risk factor. Therefore, its awareness should be increased, and preventive programmes should be offered.

The effect of stabilization exercises on diaphragm muscle thickness and movement in women with low back pain.

BACKGROUND: Diaphragm is an important component of spinal stability. In presence of low back pain, there may be some alterations in this muscle like other muscles that are responsible for lumbal stabilization. OBJECTIVE: This study aims to assess the effects of stabilization exercises on diaphragm muscle thickness and motion along with lumbopelvic stability. METHODS: Twenty-one women with low back pain participated in the study. Stabilization exercises including motor control training were performed on treatment group (n= 11). In control group (n= 10), strentghening exercises were peformed for back muscles, abdominal muscles and hip muscles. The patients underwent a total of 30 sessions of treatment, 3 days in a week for 10 weeks. The diaphragm muscle thickness and motion was evaluated using ultrasound (US), and lumbopelvic stability was evaluated using lumbopelvic stability tests. RESULTS: After the treatment, in the treatment group, increase in diaphragm thickness and improvement in lumbopelvic stability were statically significant (p< 0.05). However, there were no significant changes in diaphragm motion in both groups (p> 0.05). CONCLUSIONS: As a result, stabilization exercises increase diaphragm muscle thickness and improve lumbopelvic stability in women with low back pain. Therefore, stabilization exercises should be considered as a part of the treatment program in low back pain.

The efficacy of Schroth`s 3-dimensional exercise therapy in the treatment of adolescent idiopathic scoliosis in Turkey.

OBJECTIVE: To determine the effectiveness of 3-dimensional therapy in the treatment of adolescent idiopathic scoliosis. METHODS: We carried out this study with 50 patients whose average age was 14.15 +/-1.69 years at the Physical Therapy and Rehabilitation School, Hacettepe University, Ankara, Turkey, from 1999 to 2004. We treated them as outpatients, 5 days a week, in a 4-hour program for the first 6 weeks. After that, they continued with the same program at home. We evaluated the Cobb angle, vital capacity and muscle strength of the patients before treatment, and after 6 weeks, 6 months and one year, and compared all the results. RESULTS: The average Cobb angle, which was 26.10 degrees on average before treatment, was 23.45 degrees after 6 weeks, 19.25 degrees after 6 months and 17.85 degrees after one year (p<0.01). The vital capacities, which were on average 2795 ml before treatment, reached 2956 ml after 6 weeks, 3125 ml after 6 months and 3215 ml after one year (p<0.01). Similarly, according to the results of evaluations after 6 weeks, 6 months and one year, we observed an increase in muscle strength and recovery of the postural defects in all patients (p<0.01). CONCLUSION: Schroth`s technique positively influenced the Cobb angle, vital capacity, strength and postural defects in outpatient adolescents.