The effectiveness of specific exercise types on cardiopulmonary functions in patients with ankylosing spondylitis: a systematic review.

The aim of this review was to assess the effectiveness of specific exercise types on pulmonary functions, aerobic and functional capacity in patients with ankylosing spondylitis (AS). A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID) was conducted in January 2016. The outcome measures were spirometric measurements, chest expansion, 6 minute walk distance (6MWD), pVO2, Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The search strategy was applied with limitation of date and language and this initial electronic search resulted in 143 relevant studies. After duplicates were removed, the titles and abstracts of 52 articles were screened. Of these, 14 full-text articles met initial criteria and were retrieved for review, with eight studies meeting final inclusion criteria. Both specific and conventional exercise groups showed significant improvements in BASDAI and BASFI scores (p < 0.05) in patients with AS, although there was no significant difference between two exercise groups. As for pulmonary functions, the specific exercise groups have greater improvements than conventional group in spirometric measurement, chest expansion (p < 0.05). However, there was no significant difference between specific conventional exercise types in 6MWD (p > 0.05). Specific exercises are an effective adjuvant therapy to enhance cardiopulmonary functions in patients with AS; therefore, it is assumed that in addition to the medical treatments, specific exercise therapy might reduce the cardiopulmonary complications related with AS.

Dual-task training effect on gait parameters in children with spastic diplegic cerebral palsy: Preliminary results of a self-controlled study.

BACKGROUND: Children with cerebral palsy (CP) may have difficulties under dual-task conditions. Spatiotemporal gait parameters have deteriorated with concurrent tasks in children with CP. However, how dual-task training affects gait parameters in children with spastic diplegic CP has not been clarified. RESEARCH QUESTION: How does dual-task training program effect gait, functional skills, and health-related quality of life in children with spastic diplegic CP? METHODS: Eleven children with spastic diplegic CP (median age 11 y, range 7-16 y; 4 female; 7 male) Gross Motor Function Classification System level 1-2 and obtained 27 and higher scores from Modified Mini Mental Test included in the study. The study was planned as a self-controlled clinical research design. Children were recruited to conventional physiotherapy program for 8 weeks and dual-task training program added to conventional physiotherapy program for following 8 weeks. Children were evaluated at baseline, after conventional physiotherapy program, and after dual-task training program. Children's gait was evaluated with Zebris™ FDM-2 device and Edinburgh Visual Gait Score, functional mobility skills with 1 min Walk Test (1MWT), and health-related quality of life with the Pediatric Quality of Life Inventory (PedsQL) - CP module. RESULTS: The difference in step length, step time, stride time, cadence and gait speed of spatiotemporal parameters of gait during dual-task performance were found statistically significant in children with spastic diplegic CP, after dual-task training program (p < 0,05). After dual-task training, statistically significant gains were found in 1MWT, movement and balance subtitle of PedsQL-CP module Parent Form (p < 0,05). SIGNIFICANCE: Dual-task training program added to a conventional physiotherapy program provides more gains in terms of functionality of children with spastic diplegic CP will contribute to the improvement of the motor functional level.

Physical activity patterns in children with cerebral palsy and typically developing peers.

Objective: To compare physical activity level between children with cerebral palsy and typically developing peers using accelerometer and activity diary.Method: Twenty children with spastic cerebral palsy Level I and II according to Gross Motor Function Classification System, and 20 healthy age- and sex-matched typically developing peers were included. An activity diary was logged, and each child wore an accelerometer for 4 days, 2 weekdays and 2 weekend days.Results: Total and physical activity energy expenditure assessed using either accelerometer or activity diary was markedly lower in children with spastic cerebral palsy compared to typically developing peers. Moderate and vigorous physical activities and daily total energy expenditure assessed using activity diary were significantly lower in children with cerebral palsy than those of typically developing peers (p < .05). There was a significant relationship between accelerometer and activity diary in total energy expenditure for children with cerebral palsy (r = 0.752, p < .001) and typically developing peers (r = 0.732, p < .001) and a moderate significant relationship in physical activity energy expenditure for children with cerebral palsy (r = 0.463, p = .040).Conclusion: In this study, children with cerebral palsy had lower physical activity levels than their typically developing peers. The activity diary provided detailed information about physical activities and was correlated with accelerometer data. The activity diary could be a valid measure of physical activity levels in children with cerebral palsy.

The effects of type 2 diabetes mellitus and its complications on physical and pulmonary functions: A case-control study.

AIMS: This study was planned to determine the effects of type 2 diabetes mellitus (DM) and its complications on physical and pulmonary functions. Methods: A total of 110 individuals aged 40-65 years were included in the study, 58 with type 2 DM (study group) and 52 without DM (control group). Physical activity level, functional capacity, pulmonary function, and comorbidity levels were compared between the groups. Results: The mean age of the individuals was 52.42 ± 5.88 years. Six-minute walk test distance was 507.2 ± 51.70 m in the study group and 532.23 ± 50.32 m in the control group (p < 0.05, Cohen's d = 0.49). The pulmonary function test results of the study and control groups were determined as forced vital capacity (FVC) (%): 99.17 ± 14.13 and 104.65 ± 16.01 (p > 0.05), forced expiratory volume in one second (FEV1) (%): 96.78 ± 14.43 and 99.73 ± 15.80 (p > 0.05), and FEV1/FVC ratio: 81.97 ± 4.62 and 80.16 ± 5.27 (p > 0.05), respectively. The Charlson Comorbidity Index scores of the study and control groups were 1.83 ± 0.82 and 0.12 ± 0.32 (p < 0.05). Conclusions: Type 2 DM was associated with lower functional capacity and higher rates of comorbid diseases. Therefore, potential causes of these parameters should be considered in the rehabilitation of type 2 diabetic patients.