An investigation of neck pain in older adults, and its relation with shoulder position sense and upper extremity function.

PURPOSE: Neck pain is a musculoskeletal problem increasing with age. The disorders that occurs in the neck region may also affect the upper extremity due to its close anatomical relationships. The aim of this study was to determine whether neck pain affects shoulder position sense and upper extremity function in the older adults. METHODS: This cross-sectional study was carried out in nursing homes. The older adults over 65 years of age with chronic neck pain for the last 6 months were included. Pain intensity was evaluated with a Visual Analog Scale. Acumar dual digital inclinometer was used for the evaluation of shoulder position sense. 9-Hole Peg Test was used for the measure of upper extremity function. RESULTS: It was found dominant side shoulder position sense and the function of both upper extremities were different between the three groups (p < 0.05). Pain was correlated with dominant and non-dominant 60ᵒ flexion shoulder position sense and 60ᵒ abduction shoulder position sense (p < 0.05). Additionally, a relationship was found only between pain and non-dominant side upper extremity function (p < 0.05). CONCLUSION: In conclusion, we found that in older adults with neck pain, position sense and function decreased in upper extremities. The findings from this study support that detailed evaluation of anatomically related regions as well as the cervical region where pain is felt is important in creating a more effective rehabilitation program.

Investigation of non-motor symptoms, balance, muscle strength, and functional mobility in patients with parkinson's disease.

PURPOSE: Although both motor symptoms and non-motor symptoms (NMSs) occur in patients with Parkinson's disease (PD), clinical practice focuses more on motor symptoms. The aim of this study was to examine balance, muscle strength, and mobility in relation with NMSs in patients with PD. The other aim of this study was to investigate the relationship between NMSs and muscle strength, balance, and functional mobility in PD. MATERIALS AND METHODS: The study included 24 patients with PD (between Hoehn & Yahr Stage 1 and 3) and 20 healthy individuals of similar age and sex. The participants' balance was assessed with the Biodex Balance System (Biodex Medical Systems, Shirley, NY, USA), muscle strength assessments were conducted with a Biodex® System 4 Dynamometer device, and functional mobility was assessed with the Timed Up and Go test (TUG). The non-motor symptoms scale was used for NMSs. RESULTS: We found that lower extremity strength scores were lower and NMSs, balance, and mobility scores were greater in patients with PD in comparison to healthy controls (p < 0.05). The correlation analysis revealed that higher NMSs were related to reduced knee extension strength and cognitive dual task performance. CONCLUSION: Although no relationship between NMSs and balance was observed, the relationship between the TUG + cognitive task and muscle strength suggests that NMSs should be carefully evaluated along with the motor symptoms, which deteriorate beginning with the early period.

The relationship of pain, anxiety, and fatigue with knee position sense, balance, and dual task performance during menstrual cycle in females with multiple sclerosis.

PURPOSE: This study was carried out to investigate the relationship of pain, anxiety, and fatigue with position sense, balance, and dual task performance during the menstrual cycle in females with multiple sclerosis. METHODS: This study included 14 females with multiple sclerosis with regular menstrual cycles. The individuals' position sense, balance, and dual task performance were evaluated with a digital inclinometer, Biodex Balance System, and the Time Up and Go Test, respectively. Pain, anxiety, and fatigue were assessed with the Visual Analogue Scale, State-Trait Anxiety Inventory, and Fatigue Severity Scale, respectively. The study protocol was registered at http://clinicaltrials.gov (NCT04408742). RESULTS: In the early follicular phase, the pain was correlated with right knee position sense, and pain + activity was correlated with right knee position sense and dual task performance (p < .05). The correlation analysis revealed that no correlation was found between pain, pain + activity, anxiety, and fatigue, and position sense, balance, and dual task performance in the ovulation phase. In the luteal phase, the right knee position sense was correlated with pain, pain + activity, and fatigue (p < .05). Similarly, the left knee position sense was correlated with pain, pain + activity, and fatigue (p < .05). CONCLUSIONS: As a result, there may be a relationship between pain and position sense in the early follicular phase and luteal phase, and a relationship between pain and motor dual task performance in the early follicular phase. Considering these changes occurring in different phases of the menstrual cycle, we think that each phase of the menstrual cycle should be taken into consideration in the follow-up of physiotherapy evaluations in females with multiple sclerosis. Abbreviations: MS: multiple sclerosis; CNS: central nervous system; FwMS: females with multiple sclerosis; eFP: early follicular phase; OP: ovulation phase; LP: luteal phase.

An investigation of upper extremity function in patients with multiple sclerosis, and its relation with shoulder position sense and disability level.

Purpose: The purposes of this study were to investigate upper extremity function and shoulder position sense in patients with multiple sclerosis and its relation with disability level. Materials and methods: In this study, 20 multiple sclerosis and 20 healthy subjects participated. The disability level was determined by the Expanded Disability Status Scale. Mental state was assessed using the Mini-Mental State Examination. Upper extremity function was measured with the 9-Hole Peg Test and shoulder position sense was evaluated with a Dualer IQTM digital inclinometer. The study protocol was also registered at http://clinicaltrials.gov (NCT03846336). Results: Upper extremity function scores were lower and shoulder position sense error scores were greater in patients with multiple sclerosis in comparison to healthy controls (p < .05). While disability level was associated with dominant and non-dominant upper extremity function, no relationship was found between the disability level and shoulder position sense (p < .05). Only the dominant side shoulder position senses at 30° and 60° abduction were found to be associated with upper extremity function (p < .05). Conclusions: These results indicate that shoulder position sense and upper extremity function were affected in patients with multiple sclerosis with mild to moderate disability. Upper extremity functions were associated with shoulder abduction joint sense in patients with multiple sclerosis. In the assessment of upper extremity functions, joint position sense should be taken into account even at early stages of multiple sclerosis, so it may provide guidance in planning rehabilitation programs.

Factors affecting the recurrence in patients with venous thromboembolism: A retrospective cohort study.

BACKGROUND: The aim of the study was to evaluate the frequency of recurrence and the risk factors for recurrence in patients who were diagnosed with venous thromboembolism. METHODS: Between January 2005 and January 2015, a total of 412 venous thromboembolism patients (164 males, 248 females; mean age: 53.5±16.6 years; range: 19 to 95 years) were retrospectively analyzed. The demographics, underlying risk factors, comorbidities, imaging findings, and treatment data of the patients were recorded. RESULTS: At least one transient/permanent risk factor was found in 341 (82.7%) of the index events, and the other 71 (17.2%) were idiopathic. Recurrence developed in 76 (18.4%) of the patients. The duration of the treatment in the first event was significantly longer in recurrent cases (p=0.007). The recurrence rate in patients diagnosed with only deep vein thrombosis or patients diagnosed with pulmonary thromboembolism + deep vein thrombosis was significantly higher than the patients diagnosed with only pulmonary thromboembolism (24% vs. 14.2%, respectively; p=0.007). The rate of idiopathic venous thromboembolism was higher in recurrent cases than in non-recurrent cases (26.3% vs. 15.2%, respectively; p=0.028). At the end of the first year, the mean D-dimer levels were higher in recurrent cases (p=0.034). Hereditary risk factors were also higher in recurrent cases (39.5% vs. 19.3%, respectively; p=0.031). There was no significant correlation between recurrence and mortality. CONCLUSION: The presence of deep vein thrombosis, idiopathic events, high D-dimer levels at the end of the first year and hereditary risk factors seem to be associated with recurrence.

An investigation of knee position sense, balance, and dual task performance in different phases of menstrual cycle in females with multiple sclerosis: a pilot study.

BACKGROUND: Sex hormones have been thought to play an important role in disease progression and inflammatory activity in females with multiple sclerosis. The aim of this study was to investigate knee position sense, balance, and dual task performance in different phases of menstrual cycle in females with multiple sclerosis. METHODS: The study included 14 females diagnosed with MS and 13 healthy females with regular menstrual cycles who did not use oral contraceptives. The disability level was determined using the Expanded Disability Status Scale. The mental state was assessed using the Mini-Mental State Examination. Knee position sense was evaluated with an Acumar dual digital inclinometer (Acu360, Acumar, Lafayette, IN, USA). The balance was measured with the Biodex Balance System (Biodex Medical Systems, Shirley, NY, USA). Time taken to complete the Timed Up and Go test (TUG) under 3 conditions (TUG without task, TUG with counting backward from 100 by 3s or listing the names starting with the letter "A" [TUGcognitive], and TUG while carrying three glasses of water on a tray [TUGmotor]) was measured. Measurements were conducted in the early follicular, ovulation, and luteal phases. RESULTS: As a result, it was found that knee position sense, dynamic balance, and dual task performance decreased in the early follicular phase in both the group of females with multiple sclerosis and the control group (p<0.05). The change of dynamic balance and gait performance in the three phases of the menstrual cycle were different between the groups (p<0.05). CONCLUSION: As a result, it was found that knee position sense, dynamic balance, and dual task performance in females with multiple sclerosis changed throughout the menstrual cycle. The change in dynamic balance and gait performance differed from the control group during the menstrual cycle. Therefore, we think that each phase of the menstrual cycle should be taken into consideration in the follow-up of physiotherapy evaluations in females with multiple sclerosis.