The reliability and validity of the Turkish version of the self-administered neck mobility assessment tool (s-rom-neck) in patients with chronic neck pain.

BACKGROUND: The self-administered neck mobility assessment tool (S-ROM-Neck) is the subjective cervical region range of motion (S-ROM) assessment scale. The study aimed to demonstrate the reliability and validity of the Turkish version of the S-ROM-Neck in patients with chronic neck pain. METHODS: : A cross-sectional study was conducted with a total of 60 chronic neck pain patients in the Physical Therapy and Rehabilitation Clinic of Pamukkale University Hospital between January and August 2021. The mean age of the individuals was 34.1 ± 9.9 years. Patients were assessed with S-ROM-Neck twice to prove the test-retest reliability. In addition, Visual Analogue Scale (VAS), Neck Disability Index (NDI) and bubble inclinometer measurement were used to analyze the construct validity of S-ROM-Neck. RESULTS: The intraclass correlation coefficients of the S-ROM-Neck were higher than 0.80 (ICC > 80, CI: 0.90-98). The internal consistency of the S-ROM-Neck total score was within the acceptable limits (α = 0.754). Construct validity was high regarding the correlation analysis (r > 0.05, p < 0.01). DISCUSSION: Turkish S-ROM-Neck is a valid and reliable tool to assess the S-ROM of individuals with chronic neck pain.

The adaptations in muscle architecture following whole body vibration training.

OBJECTIVE: This study aims to investigate the effect of 8-week whole-body vibration (WBV) added to conventional training on muscular architecture, dynamic muscle strength and physical performance compared to controls in young basketball players. METHODS: Sixteen young basketball players between the ages of 14-16 years were randomly assigned to whole body vibration group (VG) or control group (CG). Both groups were trained with a conventional program. Pennation angle (PeA), fascicle length and muscle thickness of Rectus Femoris (RF) and Vastus lateralis were measured by ultrasonography. Isokinetic dynamic muscle testing at 180 °/s and 60°/s, squat jump (SJ) and flexibility were evaluated before and after 8 weeks of training programs. Primary outcome measure was the fascicle length. RESULTS: Fascicle length of RF, SJ height and flexibility increased significantly within VG compared to pretraining (p<0.05). SJ height increased in VG compared to CG significantly following training (p<0.05). PeA, fascicle length, muscle thicknesses, strength and flexibility did not differ between groups. CONCLUSION: Eight weeks of WBV training improved fascicle length of RF, SJ height, and flexibility compared to pre-training. Addition of WBV to conventional training did not cause improvement in muscle architecture, strength and flexibility compared to conventional training alone.

Factors affecting the results of the functional dexterity test.

STUDY DESIGN: Cross-sectional study. PURPOSE OF THE STUDY: The purpose of this study was to identify which demographic and anthropometric features affect performance (time) on the functional dexterity test (FDT). METHODS: One hundred fifty-two healthy subjects between the ages of 20 and 80 years were included in this cross-sectional study. Demographic characteristics (age, gender, height, weight, and dominant hand) and anthropometric (the girths of the first 3 fingers) variables were recorded, and the FDT (net time and total score) was performed. RESULTS: Hand dexterity (time) was slower in participants aged 60 years (35.7 ± 9.4 seconds) and older compared with those aged 40-59 (27.1 ± 7.2 seconds) years and 20-39 (23.9 ± 4.9 seconds) years (P < .001 for both) in dominant side. DISCUSSION: There was no significant difference between males (29.1 ± 9 in dominant hands and 30.9 ± 9.5 in nondominant hands) and females (27.9 ± 8.4 in dominant hands and 30.8 ± 8.1 in nondominant hands) in all groups in terms of FDT net time. The factors associated with hand dexterity were age in dominant hands (R2 = 0.321) and age and thickness of the second and third fingers in nondominant hands (R2 = 0.282). CONCLUSION: FDT scores increased with increasing age for both dominant and nondominant hands. Finger thickness, especially in nondominant hands, should be taken into account while evaluating FDT scores because of its negative effect on dexterity. LEVEL OF EVIDENCE: Level 2.

Effects of Cigarette Smoking on Elastographic Strain Ratio Measurements of Patellar and Achilles Tendons.

OBJECTIVES: The aim of this study was to explore the sonographic and elastographic properties of patellar and Achilles tendons in smoking and nonsmoking otherwise healthy adults. METHODS: We conducted a level 3 case-control analytical study. Smoking and nonsmoking volunteers (>18 years) without musculoskeletal system disorders were included in the study. Demographic characteristics and smoking habits (pack-years) were recorded. Proximal, middle, and distal third thicknesses of the patellar and Achilles tendons were measured by B-mode sonography. Strain ratio measurements of the same regions were measured by real-time ultrasound elastography. RESULTS: A total of 69 participants (57 male and 12 female; mean age ± SD, 35.5 ± 7.8 years) were evaluated in the study. Smoking (n = 35) and nonsmoking (n = 34) groups had no significant differences in terms of age, body mass index, sex, and activity level (all P > .05). Proximal, middle, and distal thirds of the patellar and Achilles tendons were significantly thinner in the smoking group (all P < .05). Furthermore, strain ratio measurements in the same regions were significantly lower in the smoking group (all P< .05). Patellar tendon thicknesses and strain ratios had negative correlations with the smoking amount (all P < .05). CONCLUSIONS: Thickness and strain ratio measurements of patellar and Achilles tendons were reduced (thinner and harder tendons) in smokers. Clinical implications of these morphologic and elastographic changes should be investigated in future studies.

Real-time elastography of patellar tendon in patients with auto-graft bone-tendon-bone anterior cruciate ligament reconstruction.

INTRODUCTION: Patellar tendon donor site has been previously evaluated in patients with auto-graft bone-tendon-bone (BTB) anterior cruciate ligament (ACL) reconstruction using either magnetic resonance imaging or B mode ultrasound. However, donor site patellar tendon strain ratio-reflecting structural features-has not been studied with US elastography. Here, we ascertain real-time elastography properties of patellar tendon donor site and clinical relevance of these properties in patients with auto-graft BTB ACL reconstruction in the postoperative period. METHODS: Patients who underwent ACL reconstruction using BTB autograft were evaluated. Demographic, operative and clinical data (severity of pain, Lysholm Knee score, sit to stand test, packages/year for smoking amount) were noted. Patellar tendons of the operated knees were evaluated by ultrasound (length and thickness) and sonoelastography (strain ratio). The healthy knees of the patients constituted the control group. RESULTS: Eighteen patients (17 M, 1 F; mean age 30.9 ± 7 years) were evaluated. Mean postoperative follow-up period was 22.1 ± 2.6 (range 18-26) months. Patellar tendons were shorter and thicker on the operated side when compared with the contralateral side (both p = 0.001). Patellar tendon strain ratios of the operated side were lower than the contralateral side (harder tendon on operated side). While there was no correlation between strain ratios and clinical variables (age, BMI, postoperative time, severity of pain, Lysholm score, all p values > 0.05), significant negative correlations were detected between strain ratios of proximal, middle and distal thirds of operated side and amount of smoking (p = 0.008, r = -0.607, p = 0.009, r = -0.598, p = 0.023, r = -0.533, respectively). CONCLUSION: Patellar tendons on the operated sides seemed to thicken and shorten with decreased strain ratios at the donor side compared to the healthy side at an average of 2-year follow-up in patients with ACL reconstruction using BTB autograft, and amount of smoking had negative relationship with strain ratio of donor patellar tendon.

Comparison of effects of supervised physiotherapy and a standardized home program on functional status in patients with total knee arthroplasty: a prospective study.

[Purpose] The aim of this study was to determine the functional differences between total knee arthroplasty (TKA) patients who were treated with supervised physiotherapy or a standardized home program and perform a cost analysis. [Subjects and Methods] Patients who received total knee arthroplasty between January 2009 and June 2011 were enrolled in this study; those with mean ages of 64.25±3.86 (60-68) years (n=18) and 68.08±6.25 (61-79) years (n=16) were placed in the supervised physiotherapy and standardized home program groups, respectively. All patients were evaluated by the same researcher before and after surgery, and the therapy programs were applied by another physiotherapist. All patients were evaluated for joint range of motion (ROM), pain, functional status (WOMAC), overall quality of life (SF-36), and depressive symptoms (BECK Depression Scale). [Results] A significant clinical improvement was observed in postoperative assessments. A statistically significant difference could not be found between ROM and functional levels of the patients in both groups. [Conclusion] No difference was found between the patients performing supervised or standardized home program with respect to the effects on functional status. A home exercise program can be used in the rehabilitation of patients with TKA, and implementation of home exercise programs can also reduce health-care spending.

Frequency of fibromyalgia syndrome in breast cancer patients.

BACKGROUND: We aimed to determine the frequency of fibromyalgia syndrome (FM) in operated breast cancer patients and to research the relationship between FM and the severity of fatigue and quality of life in these breast cancer patients. METHODS: The demographic data of 101 operated breast cancer patients were recorded. The patients who had pain were then classified as having regional pain (RP), widespread pain without FM (WP), and widespread pain with FM (WFM). The FM diagnosis was based on the American College of Rheumatology (ACR) criteria. The severity of fatigue was evaluated with the Brief Fatigue Inventory, the disease impact was evaluated with the Fibromyalgia Impact Questionnaire (FIQ), and the quality of life was evaluated with the European Organization for Research on Treatment of Cancer questionnaire Quality of Life-C30 (EORTC-QoL-C30). RESULTS: There was no pain in 38 (37.6%) patients, whereas there was pain in 63 (62.4%) patients (N = 42, 41.6% had RP, N = 21, 20.8% had WP). Ten (9.9%) of the entire patient cohort were diagnosed as having FM according to the ACR criteria. There were no differences among the 3 groups in respect to demographic characteristics when patients were classified as RP (N = 42), WP (N = 11), and WFM (N = 10) groups. While there were negative correlations between the FIQ and EORTC-QoL-C30-function score (r = -0.727) and EORTC-QoL-C30-global score (r = -0.488), there was a positive correlation between the FIQ and EORTC-QoL-C30-symptom score (r = 0.726). CONCLUSION: We note that the frequency of FM in the operated breast cancer patients in this study was higher than that reported in normal populations in the literature. Also, we found that the presence of FM had negative effects on the quality of life of the breast cancer patients. Accordingly, in the evaluation of widespread pain and complaints of fatigue in long-surviving breast cancer patients, after metastatic disease is excluded, the probability of FM should be kept in mind, so that appropriate treatment can be initiated to improve their functional status and quality of life.

Ultrasonographic evaluation of the femoral cartilage thickness after unilateral arthroscopic partial meniscectomy.

PURPOSE: To assess the distal femoral cartilage after unilateral arthroscopic partial meniscectomy and to explore the relationship between cartilage thickness and various disease-/surgery-related parameters. METHODS: Eighty-nine patients (42 M, 47 F) who had undergone arthroscopic partial meniscectomy surgery were evaluated. Ultrasonographic distal femoral cartilage thicknesses were measured with a 5-13-MHz linear probe (General Electric, Logiq P5) on mid-points of the lateral condyle, intercondylar notch and medial condyle of operated and non-operated knees by a physician blinded to patients' data. Demographic features, duration after surgery, type of meniscal tear and site of meniscectomy were recorded. RESULTS: Mean age of the patients was 51.8 ± 12.8 years (range 18-88). Mean body mass index was 29.4 ± 4.4 kg/m2 (range 18-38). Overall, in patients with degenerative meniscal tears, femoral cartilage thicknesses pertaining to all the three measured sites (lateral, intercondylar and medial) were found to be decreased in the operated knees when compared with those of the non-operated knees (p = 0.004, p = 0.003, p = 0.041, respectively), whereas in patients with non-degenerative tears, this decrease was significant only in the intercondylar area (p = 0.038). When patients were grouped according to the duration (months) after their surgery (≤36, 37-48 and ≥49), cartilage thickness was similar between both knees in the first group, decreased at the lateral condyle (p = 0.008) and intercondylar area (p = 0.049) in the second group and decreased at all three sites (lateral, intercondylar and medial) in the third group (p = 0.015, p = 0.005 and p = 0.008, respectively). CONCLUSION: These findings would be considered as unfavourable with respect to weight-bearing, and thus, conservative measures to support relevant joints would strongly be kept in mind during clinical practice. Lastly, ultrasonography may be a convenient alternative imaging method for the evaluation of short- and medium-term cartilage loss in patients with arthroscopic partial meniscectomy. LEVELS OF EVIDENCE: III.

Efficacy of electromyographic biofeedback and electrical stimulation following arthroscopic partial meniscectomy: a randomized controlled trial.

OBJECTIVE: To compare the effectiveness of electromyographic biofeedback training and electrical stimulation therapy for rehabilitation following arthroscopic partial meniscectomy. DESIGN: Randomized, prospective, controlled single-blind trial. SETTING: Department of physical medicine and rehabilitation, university hospital. SUBJECTS: Forty-five patients who had undergone surgery for arthroscopic partial meniscectomy were randomly divided into three groups with 15 patients in each group. INTERVENTIONS: The control group had home exercise, the second and third groups received electromyographic biofeedback training or electrical stimulation therapy to quadriceps muscle in addition to home exercise. MAIN MEASURES: The patients were evaluated for: visual analogue scale, gait velocity (m/s), time using a walking aid after surgery, Lysholm Knee Scoring Scale score, knee flexion-extension angle, maximum and average contraction powers of vastus medialis obliquus and vastus lateralis muscles on the day before the operation and two and six weeks after. RESULTS: The time using a walking aid was 8.3 ± 8.0, 1.5 ± 2.5 and 4.5 ± 5.5 days, respectively, for the home exercise, electromyographic biofeedback training and electrical stimulation groups, and significantly shorter in the electromyographic biofeedback training than in the home exercise group (P < 0.017). While significant progress was detected in Lysholm Knee Scoring Scale score in the second and sixth postoperative weeks compared to the preoperative within-group evaluation for each of the three groups (P < 0.017), there was significant difference in Lysholm Knee Scoring Scale in the second postoperative week in favour of electromyographic biofeedback training compared to home exercise (P < 0.017). There were significant differences in vastus medialis obliquus average and vastus lateralis maximum and average contractions in favour of electromyographic biofeedback compared to home exercise and electrical stimulation in the second postoperative week (P < 0.017). CONCLUSIONS: The addition of electromyographic biofeedback training to a conventional exercise programme following arthroscopic partial meniscectomy helps to speed up the rehabilitation process.

Effects of low-density pulsed ultrasound treatment on transforming growth factor-beta, collagen level, histology, biomechanics, and function in repaired rat tendons.

OBJECTIVES: The aim of this study is to compare the effects of low-density pulsed ultrasound (LIPUS) treatment on growth factors/collagen production, histological, biomechanical, and function of rats with Achilles tendon injury. MATERIALS AND METHODS: A total of 44 Wistar Albino rats were used in the study between April 2017 and June 2018. The rats were randomized to two treatment groups. Group 1 (n=6) received LIPUS treatment (0.3 Watt/cm2; 1 MHz, 1:5 pulse mode) and Group 2 (n=6)received sham ultrasound (US) treatment following Achilles tendon surgery. Transforming growth factor-beta 1 (TGF-ß1) and collagen gene expression levels were evaluated using polymerase chain reaction. The histological evaluation was performed with the Bonar scoring system. The tensile strength was measured by biomechanical testing and the function was evaluated with the Achilles Functional Index (AFI). RESULTS: Although TGF-ß1 expression and tensile strength evaluation showed a tendency to improve in favor of the LIPUS group, no statistically significant difference was found (p=0.065 and p=0.053, respectively). The COL3 gene expression in the LIPUS group and the COL1 expression in the sham US group were significantly higher. Bonar scores and AFI scores showed a statistically significant improvement in the LIPUS group, compared to the sham US group. CONCLUSION: Our study results show that LIPUS yields positive effects on tendon histology and functional status in repaired Achilles tendon in rats.

EURO-MUSCULUS/USPRM Global Report on Musculoskeletal Ultrasound Publications.

The developments in technology have improved access to the use of musculoskeletal ultrasound (MSUS) in different clinical settings. Accordingly, MSUS has been applied to a wide range of musculoskeletal problems including inflammatory and degenerative diseases, sport injuries, and regional pain syndromes both for clinical practice and research. In this report, the authors aimed to globally examine the publications on MSUS among different specialties, countries, and topics. Sixteen reviewers under the umbrella of the European Musculoskeletal Ultrasonography Society Group and the Ultrasound Study Group of International Society of Physical and Rehabilitation Medicine have evaluated approximately 15,000 publications on MSUS. The authors believe that the results of this comparative analysis may provide a holistic snapshot with regard to the utility of MSUS, not only for clinicians/academicians but also for the industry. Accordingly, while aiming to further increase their awareness, this article would possibly guide future investments as well.

Evaluation of balance in young adults with idiopathic scoliosis.

OBJECTIVES: This study aims to evaluate the relation of scoliosis with coronal and sagittal balance parameters and the effect of postural balancing in young adults with idiopathic scoliosis. PATIENTS AND METHODS: Between April 2017 and June 2017, a total of 24 patients (7 males, 24 females; mean age 20.3±2 years; range 17 to 24) who were diagnosed with scoliosis and 65 age- and sex-matched healthy controls (20 males, 45 females; mean age 20.3±1.6 years; range 19 to 25) were included in the study. The Cobb angle, sagittal balance, coronal balance, and truncal shift were measured with radiographs in the patient group. The Biodex Balance System (BBS) was used to assess the general stability index, anterior- posterior and medial-lateral stability index, and fall risk. RESULTS: All balance parameters were significantly worse in the patient group than in the control group (p<0.05). The static balance was mostly associated with sagittal balance, followed by coronal balance. In the patients with left scoliosis, sagittal balance was 93% negative and 67% of the patients gave their weight to the back. Coronal balance was negative in 60% of the patients and 93.3% of the patients were weighted to the right side. In 89% of the patients with right scoliosis, sagittal balance was negative and 89% of the patients gave their weight to the back. Coronal balance was 44% neutral and 78% of the patients gave their weight to the right side. CONCLUSION: In patients with scoliosis, the static balance is worse than healthy individuals. Static balance is mostly related to sagittal balance and also to coronal balance. While the coronal balance tends to be in the direction of the curve, both right and left scoliosis give more weight to the right.

Strain Ratio Measurements of Patellar and Achilles Tendons With Different Reference Regions in Healthy Volunteers.

Strain ratio measurements of tendons vary because of the reference tissue selection. The main purpose of this study is to highlight, in detail, the numeric variability attributable to the use of various reference materials on strain ratio measurements of patellar and Achilles tendons. Measurements were performed at the proximal, middle and distal thirds of the patellar and Achilles tendons on the dominant site of healthy volunteers. A total of 3 references were used: the Hoffa's fat pad for the patellar tendon, the Kager's fat pad for the Achilles tendon, subcutaneous tissue and Aquaflex gel pads (Parker Laboratories, Fairfield, NJ, USA) for both tendons. Although the same methods were used by the same physician for each tendon site on repeated measurements, strain ratio values had numeric variability with various reference materials in each measurement. Therefore, comparison of numeric strain ratio results of various studies with various reference materials could confuse the clinical interpretations of these numeric data, and, using a reference material with standard stiffness like Aquaflex ultrasound gel pads, should be considered by verifying these results with further studies.

Ultrasonographic imaging of the effects of continuous, pulsed or sham ultrasound treatments on carpal tunnel syndrome: A randomized controlled study.

BACKGROUND: Clinical and electrophysiological effects of therapeutic ultrasound (US) were researched in many studies on patients with CTS with conflicting results. OBJECTIVE: To assess the effects of continuous and pulsed US treatments by ultrasonographic imaging in addition to clinical and electrophysilogical parameters in patients with carpal tunnel syndrome (CTS). METHOD: Fifty-four patients with idiopathic CTS were randomly divided into three groups. All patients used night splints for two weeks. In addition to splint therapy, continuous, pulsed or sham US treatments were applied to patients 10 min/session, 5 sessions/week for two weeks. Clinical situation (pain, hand function, strength), electrophysiological studies (motor distal latency, MDL, sensorial distal latency, SDL), and ultrasonographic area measurements of median nerve were evaluated. All evaluations were applied at pretreatment (baseline), posttreatment (2nd week) and in the 6th week. RESULTS: Whereas significant differences were detected for clinical, functional and ultrasonographic imaging findings in each group in the 2nd week and 6th week compared to baseline (p< 0.0167 for both), no electrophysiological improvements were detected in pulsed-US (p> 0.0167) and only improvement for SDL in sham US group in the 2nd week evaluation (p< 0.0167). CONCLUSION: According to the results of this study, continuous, pulsed or sham US treatments combined with splinting had similar effects on clinical, electrophysiological and ultrasonographic imaging improvements. Additionally, ultrasonographic imaging may be a preferable objective evaluation tool to prove the early posttreatment clinical improvements when electrophysiological changes could not be detected.

A case with rheumatod arthritis and atraumatic odontoid fracture: disappearence of bony landmarks.

We aim to draw attention to occult, atraumatic fractures of the odontoid process in patients with rheumatoid arthritis (RA) and to underline difficulties encountered during clinical and radiological diagnosis. A forty-seven years old man with RA for 4 years had occipital pain for 1 year without any history of trauma. Later, he developed weakness in the upper extremities, but he did not realize weakness in the lower extremities due to deformities. Contrast magnetic resonance imaging revealed a linear fracture of odontiod process and myelopathy. Cervical computed tomography scan revealed an old fracture border with separated and almost disappeared remnant of the tip of the odontoid without free particles in the cord. It was impossible to evaluate atlantoaxial and vertical subluxations with craniometric measurements due to destruction of the tip of odontoid. Following occipitocervical fusion and decompression and a rehabilitation program, his muscle strength improved; however, functional myelopathy stage did not change. Atraumatic fractures of the odontoid process may be more common than reported and may cause compression of the spinal cord or brain stem. Surgery is the treatment of choice but functional recovery is limited once neuronal damage has occurred. Erosion of the critical landmarks makes it difficult to diagnose and follow up atlantoaxial subluxation and/or vertical subluxation, therefore clinicians should consider radiographical follow-ups during the course of the disease.

The association between different molecular weights of hyaluronic acid and CHAD, HIF-1α, COL2A1 expression in chondrocyte cultures.

The aim of the present study was to investigate the effects of three different formulations of hyaluronic acid (HA): Low molecular weight (MW) Sinovial One®, medium MW Viscoplus® and high MW Durolane®, on chondrocyte proliferation and collagen type II (COL2A1), hypoxia-inducible factor 1α (HIF-1α) and chondroadherin (CHAD) expression in primary chondrocyte cultures. Standard primary chondrocyte cultures were established from osteochondral tissues surgically obtained from 6 patients with gonarthrosis. Cell morphology was evaluated using an inverted light microscope; cell proliferation was determined with a MTT assay and confirmed with acridine orange/propidium iodide staining. Levels of CHAD, COL2A1 and HIF-1α expression were assessed using specific TaqMan gene expression assays. The results demonstrated the positive effect of HA treatment on cell proliferation, which was independent from the MW. COL2A1 expression increased in the medium and high MW HA treated groups. It was observed that HIF-1α expression increased in the high MW treated group alone. CHAD expression increased only in the medium MW HA treated group. Evaluation of gene expression revealed that levels of expression increased as the duration of HA application increased, in the medium and high MW HA treated groups. In terms of increased viability and proliferation, a longer duration of HA application was more effective. Taken together, it may be concluded that the administration of medium and high MW HA may be a successful way of treating diseases affecting chondrocytes in a clinical setting.

Efficacy of moderate-intensity walking provided feedback by ECE PEDO on abdominal fat in overweight and obese women: A randomized, exercise study.

OBJECTIVES: The aim of this study was to investigate the effectiveness of walking with Equipment for Clever Exercise (ECE PEDO) compared to supervised, moderate-intensity, aerobic, treadmill walking exercise in overweight and obese women. PATIENTS AND METHODS: Between September 2014 and January 2015, 28 women with overweight and obesity were assigned to two groups: supervised treadmill walking (Group 1, n=14) or walking with ECE PEDO (Group 2, n=14). The target heart rate (HR) corresponding to values of 50 to 70% VO2max were determined by submaximal treadmill test. Group 1 was instructed walking at their target HR on treadmill. The number of steps in a min corresponding to the target HR was calculated by a criterion pedometer and Group 2 was instructed walking in this step range recorded to the ECE PEDO giving audible feedback. Before and after a 12-week exercise program, all participants were evaluated by Body Mass Index (BMI) and waist circumference (WC). Ultrasonographic visceral fat thickness (VFT) and ergospirometric VO2max. RESULTS: The VFT decreased in both walking groups in association with reduced WC and weight loss and also significant increases in the VO2max after exercise intervention (p<0.05). The VFT decreased only in women by walking with ECE PEDO compared to the other group (p<0.05). CONCLUSION: Our study results showed that both moderate-intensity exercise provided by a novel pedometer and supervised treadmill walking showed significant improvements in abdominal obesity and VO2max.

Effects of weighted and un-weighted pendulum exercises on ultrasonographic acromiohumeral distance in patients with subacromial impingement syndrome.

BACKGROUND: Although functional results of combined rehabilitation programs are reported, there have been no reports studying the effects of solo pendulum exercises on ultrasonographic measurements of acromiohumeral distance (AHD). OBJECTIVE: To investigate the effects of weighted and un-weighted pendulum exercises on ultrasonographic AHD and clinical symptoms in patients with subacromial impingement syndrome. METHODS: Patients with subacromial impingement syndrome were randomized to performing weighted (1.5 kilograms hand held dumbbell, N= 18) or un-weighted (free of weight, N= 16) pendulum exercises for 4 weeks, 3 sessions/day. Exercises were repeated for each direction of shoulder motion in each session (ten minutes). Clinical situation was evaluated by Constant score and Shoulder Pain Disability Index (SPADI). Ultrasonographic measurements of AHD at 0°, 30° and 60° shoulder abduction were performed. All clinical and ultrasonographic evaluations were performed at the beginning of the exercise program and at end of 4 weeks of exercise program. RESULTS: Thirty-four patients (23 females, 11 males; mean age 41.7 ± 8.9 years) were evaluated. Significant clinical improvements were detected in both exercise groups between pre and post-treatment evaluations (p < 0.05). There was no significant difference for pre and post-treatment AHD measurements at 0°, 30°, and 60° shoulder abduction between groups (p > 0.05). There was no significant difference for pre and post-treatment narrowing of AHD (narrowing of 0°-30°, and 0°-60°) between groups (p > 0.05). CONCLUSION: While significant clinical improvements were achieved with both weighted and un-weighted solo pendulum exercises, no significant difference was detected for ultrasonographic AHD measurements between exercise groups.