How does pain localization affect physical functioning, emotional status and independency in older adults with chronic musculoskeletal pain?

[Purpose] The aim of this study was to show the impact of chronic musculoskeletal pain of the spinal column and lower extremities on physical functioning, emotional status, and independency in older adults. [Subjects] In this cross-sectional study, 258 older adults (mean age, 71.98±5.86 years, 50.8% males, 49.2% females) living in their own residences were evaluated. [Methods] Pain intensity was analyzed using a visual analogue scale. Physical functioning was evaluated with the Timed Up and Go Test (TUG) and a Six-Minute Walk Test. The Geriatric Depression Scale was used to determine emotional status. The independency in daily living of the participants was evaluated using the Lawton Brody IADL Scale. All participants were divided into two groups in accordance with the pain localization: the (1) spinal pain and (2) lower extremity pain groups. [Results] When the pain scores were compared, no significant differences between the two groups were found. The same results were found in terms of TUG scores. The spinal pain group had higher scores in terms of aerobic capacity than the lower extremity pain group. [Conclusion] The results indicate that chronic musculoskeletal pain in the lower extremities decreased aerobic capacity much more than spinal pain in older adults.

Expectations from Rehabilitation of Children with Cerebral Palsy: The Agreement between the Physiotherapists and Mothers.

[Purpose] The aim of this study was to examine the agreement between physiotherapists (PTs) and mothers (Ms) about the treatment of children with cerebral palsy (CP) who received treatment in special education and rehabilitation centers. [Subjects] Ms of 130 children with CP (75 boys, 55 girls) and 130 PTs who applied rehabilitation programs were interviewed. [Methods] Clinical types and gross motor function levels of the children were recorded. A questionnaire consisting of 6 open-ended questions was used to describe the expectations and views of the PTs and Ms about the physiotherapy and rehabilitation programs for the children. [Results] The mean age of the children was 89.80±52.05 months. The mean treatment period for the children was 73.62±42.11 months. The mean age of the mothers was 35.47±5.79 years, and the mean age of the PTs was 28.07±7.28 years. We found a statistically moderate level of agreement between the PTs and Ms regarding the appropriateness of the treatment provided to the children. There was statistically insignificant agreement regarding the applied treatment methods and the appropriateness of the applied rehabilitation programs. [Conclusion] We believe that the views and expectations of the Ms should be taken into account by the PTs when preparing a treatment program for children with CP.

Effects of pulsed electromagnetic field and swimming exercise on rats with experimental sciatic nerve injury.

[Purpose] The current study aimed to reveal the therapeutic effects of a pulsed electromagnetic field and swimming exercises on rats with experimental sciatic nerve injury, which was induced with crush-type neuropathy model damage, using electrophysiological methods. [Subjects] In the current study, the sample consisted of 28 adult male Wistar albino rats. [Methods] The rats were randomized into four groups (n=7). Swimming exercise and PEMF (2 Hz and 0.3 MT) were applied one hour a day, five days a week, for four weeks. Electroneuromyographic (ENMG) measurements were taken on day 7. [Results] When the data were evaluated, it was found that the 4 weeks of PEMF and swimming exercises led to an increase in motor conduction rates and a decrease in latency values, but the changes were not significant in comparison with the control and injury groups. The compound muscle action potential (CMAP) values of the left leg were lower in weeks 2, 3, and 4 in the swimming exercise group in comparison with the control group, although for the PEMF group, the CMAP values of the left leg reached the level observed in the control group beginning in week 3. [Conclusion] PEMF and swimming exercise made positive contributions to nerve regeneration after week 1, and regeneration was enhanced.

The impact of chronic low back pain on physical performance, fear avoidance beliefs, and depressive symptoms: A comparative study on Turkish elderly population.

OBJECTIVES: The purposes of this study were: (1) to show the impact of chronic low back pain (CLBP) on physical performance, fear avoidance behavior and depressive symptoms in older adults; (2) to describe the relationships between outcome measurements obtained in this study. METHODOLOGY: Ninety-one participants with or without chronic low back pain were included in this study. Only four tests in the Back Performance Scale were used to assess the physical performance of the participants. A Fear Avoidance Beliefs Questionnaire related to physical activity and the Geriatric Depression Scale were also used to examine each subject. RESULTS: The level of performance shown by elderly adults with low back pain was worse than elders without low back pain in the sock test and the pick-up test (p < 0.05). Little correlation between the finger-to-floor test and fear avoidance behaviour related to physical activity was found (p < 0.05). There was little/poor correlation between all performance tests and depressive symptoms (p < 0.05). CONCLUSIONS: The findings indicate that CLBP decreases physical performance, but increases fear avoidance behavior and depressive symptoms in elderly adults. At the same time, it was determined that performance level of elderly adults with back pain was related especially with depressive symptoms.

Determining the pain-affecting factors of university students with nonspecific low back pain.

[Purpose] This study was conducted on university students with nonspecific low back pain in order to determine the independent variables that affect their pain. [Methods] A total of 514 students were included in this study. Pain was evaluated using a Visual Analogue Scale (VAS). A special form was prepared in order to evaluate the following independent variables: gender, weight, height, Body Mass Index (BMI), working periods sitting straight (television, computer, seminar, etc.), working periods bending at a table (reading, writing, etc.), using lumbar support while sitting, the mean duration of pain within the last one year, type of pain, time of the pain, faculty, class, physical activity habits and smoking. The collected data were evaluated using the CHAID (Chi-squared Automatic Interaction Detection) analysis method. [Results] The working hours bending at a table, physical activity, height, weight, BMI and educational departments were found not to affect the severity of the pain. The pain severity was affected by the duration of pain complaints within the last one year, the duration of working staying upright, smoking, classes, usage of lumbar support and age variables. [Conclusions] The results of this study show that nonspecific low back pain of university students is affected by many factors such as smoking, class, age, using a computer and lumbar support.

Effects of whole body vibration on functional capacity and respiratory functions in individuals with stroke: A randomized controlled study.

BACKGROUND: Management of respiratory-related functional problems using sensory rehabilitation strategies has been poorly researched in patients with stroke. OBJECTIVE: This study aimed to investigate whether whole body vibration (WBV) training has an effect on functional capacity and respiratory functions in patients with stroke. METHODS: In the randomized-controlled study, 28 participants were randomized into two groups: one receiving Neurodevelopmental Treatment (NDT; n = 13) and one receiving both NDT and WBV (NDT + WBV; n = 15). The primary outcome measures were 6-Minute Walking Test (6MWT) and Pulmonary Function Test which evaluate functional and respiratory capacity. Secondary outcome included the chest circumference measurement to evaluate the thoracic expansion ability. RESULTS: Both groups showed positive significant changes in walking distance and maximum oxygen consumption volume (VO2max), inspiratory capacity, vital capacity and chest circumference measurement scores (p < 0.05). While the NDT +WBV group showed a significantly greater increase in walking distance and VO2max levels than the NDT group (p < 0.05), there were no significant group differences in respiratory function flow and volume parameters, and chest circumference measurement. CONCLUSION: The addition of WBV training to the treatment program has some incremental benefits on increasing functional capacity and thoracic expansion, and rehabilitating respiratory dysfunction.

ESTIMATION OF BALANCE STATUS IN PATIENTS WITH HEMIPARESIS: AN ARTIFICIAL NEURAL NETWORK IMPLEMENTATION.

ObjectiveAlthough Balance Evaluation Systems Test (BESTest) is an important balance assessment tool to differentiate balance deficits, it is time consuming and tiring for hemiparetic patients. Using artificial neural networks (ANNs) to estimate balance status can be a practical and useful tool for clinicians. The aim of this study was to compare manual BESTest results and ANNs predictive results and to determine the highest contributions of BESTest sections by using ANNs predictive results of BESTest sections. METHODS: 66 hemiparetic individuals were included in the study. Balance status was evaluated using the BESTest. 70% (n = 46), of the dataset was used for learning, 15% (n = 10) for evaluation, and 15%(n = 10) for testing purposes in order to model ANNs. Multiple linear regression models (MLRs) were used to compare with ANNs. RESULTS: The results of the study showed that ANNs(root mean square error-RMSE:4.993) were better than MLR (RMSE:7.031) model to estimate balance status of patients with hemiparesis. The BESTest sections making lowest and highest contribution to BESTest total score was found to be "Stability Limits/Verticality" and "Stability in Gait" sections, respectively. As the highest and the lowest contribution of sections items were investigated it was found that error(RMSE) values were small indicating the success of ANN modeling. DISCUSSION: The results obtained from this study showed that RMSE values of ANNs were better than the ones found in literature. It is believed that this study can lead to constitute a shorter, more sensitive and more practical mini subset of BESTest for physiotherapists to differentiate balance problems while carrying the whole philosophy of the full BESTest.

Determination of pain intensity risk factors among school children with nonspecific low back pain.

BACKGROUND: Low back pain (LBP) is a common disease among people under the age of 20. To the best of our knowledge few studies have been carried out on LBP among school children in Turkey, and none of them studied the correlation between pain intensity and related variables with LBP. MATERIAL/METHODS: This cross-sectional study was carried out to investigate the risk factors and their correlations with pain intensity among 222 school children (106 girls and 116 boys) aged 10-18 years in the city of Denizli. A self-reported questionnaire was used to collect the data. The regression tree method (RTM) was used to determine the risk factors by using the STATISTICA program package. Pain intensity was the outcome variable, and 8 independent variables (body mass index (BMI), sex, regular exercise habit, studying posture, transportation to/from school, duration of studying, bag handling, and type of bed) were used to detect their effect on pain intensity. RESULTS: The results showed that pain intensity is significantly affected by 4 independent variables: duration of studying, type of bed, transportation to/from school, and BMI. The overall mean and standard deviation of pain intensity was 2.58 ± 0.86 (minimum=1, maximum=5). CONCLUSIONS: Results from the literature, as well as our study, show that taking parents' and teachers' concerns seriously is of vital importance. Our results indicate that parents and teachers should be informed about duration of studying, type of bed, transportation and obesity as risk factors predicting NLBP in school children.

Effectiveness of matrix-rhythm therapy on increased muscle tone, balance and gait parameters in stroke survivors: a single-blinded, randomized, controlled clinical trial.

This study was conducted to investigate the effectiveness of Matrix rhythm therapy (MRT) on muscle tone, balance and gait parameters in stroke survivors. Thirty stroke individuals randomly assigned to study and control group received combining BT&MRT, and BT, respectively. This study was a single-blinded (assessor-blind), randomized controlled trial. A total of 30 stroke individuals with spastic hemiparesis (n = 30) aged between 20-65 years were included. The study group received combining BT and MRT on trunk and the affected lower limb. The control group received only BT. Participants in both groups were received therapy for 4 weeks, 3 days/week. The outcome measures were Modified Ashworth Scale (MAS), goniometric measurements (ROM), Single Leg Stance Test of the BESTest Balance Evaluation System, Timed "Get Up & Go" Test of the BESTest and BTS G-Walk Gait-Analysis System. Spasticity intensity, ROM, static/dynamic balance tests' scores, gait velocity, cadence, and pelvic movement symmetries improved in study group (p < 0.05).In the control group, only dynamic balance improved after the treatment program(p < 0.05). Significant improvements were found in terms of spasticity intensity, ROM of knee and ankle joints, static/dynamic balance, gait velocity and cadence in favor of the study group (p < 0.05). This study gives preliminary evidence that adding MRT to BT may be beneficial in improving balance and gait by regulating muscle tone in the affected lower limb of stroke patients with spastic hemiparesis. The study was retrospectively registered at Clinical Trials.gov (ID: NCT04213417; URL: www.clinicaltrials.gov ).

Factors affecting body awareness in older adults with chronic musculoskeletal pain.

INTRODUCTION: Chronic musculoskeletal pain (CMP) and cognitive impairment (CI) may reduce body awareness in older adults. The first aim of this study was to determine the impact of CMP and CI on body awareness in older adults. The second was to search for the factors most affecting body awareness using logistic regression analysis. MATERIAL AND METHODS: Two hundred and 65 older adults (males: 138 and females: 127) aged 65 and over (mean age; 72.27 ±6.42 years) living in their own homes were included. We used the following evaluation methods: CMP intensity (Visual Analog Scale - VAS), cognitive status (Hodkinson's Abbreviated Mental Test - HAMT), and body awareness (Body Awareness Questionnaire - BAQ). Logistic regression analysis was used to determine the factor most affecting the BAQ score. RESULTS: Eighty-five point two percent of participants (n = 265) reported CMP (lower extremity pain: 74.6%; spinal pain: 66.6%; upper extremities pain: 44.4%). CMP intensity was higher in lower extremities (mean VAS: 5.73 ±1.86 cm). Gender differences in terms of CMP were found in favor of males (p = 0.0001). Mean HAMT score was 8.16±1.65. Gender difference in favor of males was significant (p = 0.0001). Mean BAQ score was 77.61±20.90; there was no significant difference between the gender (p = 0.142). There was a significant moderate positive correlation between body awareness and cognitive status (r = 0.382, p = 0.0001). However, a weak negative correlation was found between body awareness and pain intensity (r = -0.234, p = 0.0001). Regression analysis showed that living environment (rural area), low education level, low cognition level and increased CMP intensity significantly predicted body awareness. CONCLUSIONS: The results obtained from this study indicate that cognitive impairment and pain should be reduced by improving body awareness among older adults. That is why health professionals should evaluate all related factors affecting body awareness before planning the most suitable rehabilitation program.

Validity and reliability of the Body Awareness Questionnaire in patients with non-specific chronic low back pain.

This study was conducted to determine the validity and reliability of the Body Awareness Questionnaire (BAQ) in patients with non-specific chronic low back pain. A total of 180 participants (96 women, 84 men), aged 21-64 years, with non-specific chronic low back pain were enrolled from June to December 2019. Sociodemographic features were collected. The pain intensity using the Visual Analog Scale, the disability status due to low back pain with the Oswestry Disability Index (ODI), the body awareness level using the BAQ, and self-esteem using the Rosenberg Self-Esteem Scale (RSES) were assessed. Test-retest reliability was assessed by intraclass correlation coefficients in patients 7 days apart. The mean age of the study subjects was 42.14 ± 13.27 years. The scale was found to be reliable in patients experiencing non-specific chronic low back pain. The Cronbach's alpha reliability coefficient was 0.767. The internal consistency ranged from 0.718 to 1.00 in the items. Intraclass correlation coefficients of items ranged from 0.560 to 1.000. Intraclass correlation coefficient of BAQ total score was found to be 0.786 (p = 0.000) in test-retest results. The scores of RSES were compared in order to assess the concurrent validity of BAQ. The concurrent validity analyses showed that the BAQ and RSES were significantly correlated (r = 0.188; p = 0.012). The BAQ is a valid and reliable scale for determining body awareness status in patients with non-specific chronic low back pain.

The Turkish version of the Neck Bournemouth Questionnaire in patients with chronic neck pain: a cultural adaptation, reliability, and validity study.

INTRODUCTION: The cultural adaptation of a self-report measurement in different languages is important for developing common strategies for evaluation and treatment. The Neck Bournemouth Questionnaire (NBQ), which was developed to evaluate patients with neck pain, was adapted from the Bournemouth Questionnaire in accordance with the International Classification of Functioning, Disability and Health (ICF) categories. The aim of this study was to conduct the Turkish cultural adaptation, validity and reliability study of the NBQ. MATERIAL AND METHODS: The study included 119 patients (93 females, 26 males; mean age: 37.2 ±11.8 years) with chronic nonspecific neck pain. The NBQ, Neck Disability Index (NDI) and Nottingham Health Profile (NHP) questionnaires were administered to all the subjects. Test-retest reliability (intraclass correlation coefficient) and the internal consistency (Cronbach's α) were the methods used for the reliability study. The relationship between NBQ, NDI and NHP was investigated for concurrent validity. Exploratory and confirmatory factor analysis was used for construct validity. RESULTS: The Neck Bournemouth Questionnaire showed good internal consistency (α = 0.87). The test-retest reliability coefficient was 0.913 (95% CI: 0.875-0.940). The correlations between NBQ and NDI and NHP were significant (p < 0.05). The questionnaire was found to have one factor and the explained variance was 59.084% as a result of factor analysis. CONCLUSIONS: The Neck Bournemouth Questionnaire is a valid and reliable scale for patients with chronic neck pain in the Turkish population.

Assessment of the musculoskeletal performance with squat tests and performance-oriented measurements in older adults.

BACKGROUND: Balance and mobility impairments, declined musculoskeletal strength and performance, limited range of motion, and poor flexibility are fairly common among older adults. OBJECTIVES: To determine the lower extremity muscle force and to verify the correlation with the gait characteristics and balance in community dwelling older adults. METHODS: Seventy-five adults with a mean age of 75.07 ± 6.28 years were included in the study. All participants were evaluated with the following tests: half squat (HS), decline squat (DS), foot print analysis (step length, step wide, stride length, walking velocity and cadence) and Tinetti Performance Oriented Mobility Assessment (POMA). RESULTS: HS and DS test scores were significantly correlated with Tinetti Balance and Gait Assessment scores and gait characteristics, except step wide (p< 0.01). The results of this study showed that the participants who have higher scores in the squat tests, showed higher scores in terms of POMA (p< 0.01). CONCLUSION: Appropriate and direct assessment of lower limb power and performance in balance and gait tests should be done to identify functioning of the older adults. Half and eccentric decline squat tests used in this study were useful, cheap and easy. The squat tests can be used to determine the relationship between balance and gait characteristics, in addition to predicting the musculoskeletal performance in older adults.

Validity and reliability of the unsupported upper-limb exercise test in individuals with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease which affects the performance of the upper extremities. There is no method to evaluate the specific upper extremity endurance of individuals with this disease. The unsupported upper-limb exercise test (UULEX) is a performance test that evaluates upper extremity performance (functionality and endurance). AIM: The aim of this study was to examine the reliability and validity of UULEX and the minimal detectable change (MDC) in individuals with RA. METHODS AND MATERIALS: The study included 71 patients (15 male, 56 female) with a mean age of 52.15 ± 10.11 years. The intraclass correlation coefficient (ICC) was used to assess the reliability of UULEX. MDC estimates were calculated using baseline data. Correlations of UULEX with the Disability of Arm, Shoulder and Hand Questionnaire (DASH), Health Assessment Questionnaire (HAQ), 30-second push-up test and 6 pegboard ring test (6PBRT) were assessed for concurrent validity. RESULTS: The level, weight and duration scores of the UULEX test were found to be excellent for intra-rater reliability (ICC = 0.922, 0.960, 0.958). Intra-rater MDC values were determined to be 0.35, 2.04, and 0.80 seconds, respectively. Moderate-excellent correlations were found between UULEX and DASH, HAQ, 30-second push-up test and 6PBRT (P < .05). CONCLUSION: The results of this study showed that UULEX test is a valid and reliable method for the assessment of upper extremity performance in individuals with RA.

Balance performance, aging and falling: a comparative study based on a Turkish sample.

The effects of aging and gender on balance performance (BP) among ambulatory adults were investigated in the current work. If there was a relation between the BP and a history of falling, this was also detected. Two hundred and forty ambulatory subjects were divided into two groups depending on their age: (1) 125 middle-aged subjects (50-64 years); (2) 115 elderly subjects (65-75). The functional reach (FR) test, the timed up and go (TUG) test, the sit to stand (STS) test and the step test (ST) were used to evaluate the BP. The fall rate (1-2 in the last year) was 8% for the middle-aged group and was 13.9% for the elderly group. Middle-aged adults had better scores on all tests in comparison to the elderly people. There have been differences found between genders regarding the BP in both groups, except the FR scores in the middle-aged group. The FR distance of the faller subjects was rather low in comparison to non-faller elderly subjects. However, there were no significant differences between the faller and non-faller subjects in both groups regarding other tests' scores. The results of this study indicate that aging affects the BP year by year. The information in this paper can provide normative data to be used as a comparison to clinically obtained information.

Comparison of the physical and non-physical functioning between the patients with multiple sclerosis and healthy subjects.

OBJECTIVE: To investigate the relationship between physical functioning, non-physical functioning, and upper extremity functional abilities in patients with multiple sclerosis (MS) and healthy subjects. METHODS: A total of 63 patients with MS [Expanded Disability Status Scale (EDSS) score; 3-8] and 52 healthy subjects attending the Pamukkale University, School of Physical Therapy and Rehabilitation in Denizli, Turkey were studied in the period from February 2006 to June 2006. To allow further evaluation, 63 individuals with MS were divided into 2 groups according to their ambulation ability level. The physical functioning was assessed with the Functional Independence Measure (FIM), the Purdue Pegboard Test, and the Jebsen Hand Function Test, and the non-physical functioning was assessed with the Beck Depression Inventory (BDI). RESULTS: Depressive symptoms were significantly elevated in the MS group versus the control group based on the BDI (p<0.0001). In MS subjects, while there was good positive correlation between EDSS and BDI scores, there was a good negative correlation between EDSS and FIM scores (p<0.0001). CONCLUSION: Non-physical functioning, especially depression, is strongly associated with activities of daily living and decreases functional abilities in MS patients. For this reason, we recommend that non-physical functioning should also be evaluated in patients with MS to plan the most suitable physical therapy program.

Effect of proprioceptive training on balance in patients with chronic neck pain.

OBJECTIVES: The aim of this randomized controlled study was to investigate the effect of proprioceptive training on balance in patients with chronic neck pain (CNP). METHODS: Forty patients participating in the study were randomly divided into study and control groups. Both of the groups underwent conventional physical therapy; additionally, the study group was rehabilitated with gaze direction recognition exercise (GDRE) for proprioceptive training. Exercises were performed during 3 weeks with five sessions per week. Pain intensity [visual analog scale (VAS)], neck disability [Neck Disability Index (NDI)], and balance [four step square test (FSST), single leg balance test (SLBT) with eyes opened and closed] assessments were conducted in the patients before and after the treatment and 3 weeks after the last session. RESULTS: No differences were observed between the groups in terms of pre-treatment measurements. There was a statistically significant decrease in VAS scores in both groups compared with pre-treatment conditions (p<0.05). In addition, whereas a statistically significant improvement in the study group's NDI, FSST, and SLBT with eyes opened and closed scores was observed after the treatment, pre- and post-treatment results were similar in the control group (p>0.05). CONCLUSION: Proprioceptive training should be included in physiotherapy programs to improve balance; it decreases the disability level in patients with CNP.

Effectiveness of Neuro-Developmental Treatment (Bobath Concept) on postural control and balance in Cerebral Palsied children.

BACKGROUND AND OBJECTIVE: The aim of this study was to show the effects of an 8-week Neurodevelopmental Treatment based posture and balance training on postural control and balance in diparetic and hemiparetic Cerebral Palsied children (CPC). METHODS: Fifteen CPC (aged 5-15 yrs) were recruited from Denizli Yagmur Çocuklari Rehabilitation Centre. Gross Motor Function Classification System, Gross Motor Function Measure, 1-Min Walking Test, Modified Timed Up and Go Test, Paediatric Balance Scale, Functional Independence Measure for Children and Seated Postural Control Measure were used for assessment before and after treatment. An 8-week NDT based posture and balance training was applied to the CPC in one session (60-min) 2 days in a week. RESULTS: After the treatment program, all participants showed statistically significant improvements in terms of gross motor function (p< 0.05). They also showed statistically significant improvements about balance abilities and independence in terms of daily living activities (p< 0.05). Seated Postural Control Measure scores increased after the treatment program (p< 0.05). CONCLUSIONS: The results of this study indicate that an 8-week Neurodevelopmental Treatment based posture and balance training is an effective approach in order to improve functional motor level and functional independency by improving postural control and balance in diparetic and hemiparetic CPC.

Comparison of musculoskeletal pain distribution, quality of life and hopelessness level in mothers with disabled children in different ambulation levels.

OBJECTIVE: The aim of this study was to compare the musculoskeletal pain distribution, quality of life, and the hopelessness level in mothers with disabled children in different ambulation levels. METHODS: This study included a total of 177 mothers (mean age: 36.1 ± 6.5 years) of children with disabilities. The mothers were divided into 3 different groups according to the ambulation level of their disabled children: Ambulatory children (Group 1), partially ambulatory children (Group 2) and non-ambulatory children (Group 3). Musculoskeletal pain distribution (body diagram) and pain intensity (The Visual Analogue Scale), four quality of life parameters (The Centers for Disease Control and Prevention Health-Related Quality of Life -4 Questionnaire) and hopelessness level (Beck Hopelessness Scale) were evaluated in all mothers. RESULTS: The results of our study showed that musculoskeletal pain was most common (79.1%) in the mothers of disabled children. The frequency and severity of back, shoulder and elbow pain in the mothers, number of activity limitation days and hopelessness level were found to increase significantly as the ambulation level in the child decreased (p< 0.05). CONCLUSIONS: The risk of musculoskeletal pain, participation in daily life and hopelessness level in the mothers increased as the ambulation level of the disabled children decreased.

Relationship between balance performance and musculoskeletal pain in lower body comparison healthy middle aged and older adults.

The purpose of this study was to determine relationship between balance performance and pain in lower body among healthy adults. Two hundred and forty volunteer subjects (125 middle aged and 115 elderly people) aged 50 years and above participated. The average age was 61.52+/-8.22 years (range 50-75 years). The functional reach test (FRT) was used to measure balance ability. The visual analog scale (VAS) was used to measure pain intensity. Subjects were also asked to indicate sites they experienced pain in their lower body (e.g., low back, hip, knee, ankle, toes). Falls history was also recorded. The elderly people had a lower FRT score as compared to the middle-aged adults (p<0.001). Knee, low back, and hip pain were most common in both groups. The elderly people reported more frequency of falls than the middle-aged adults. The score of the FRT was higher among men (20.67+/-7.16cm) than among women (18.77+/-6.59cm). In both groups; the women had a higher VAS score than those of matched the men. Although the middle-aged adults had higher and better scores than the elderly people, the data showed that the middle-aged adults are also at risk and should be prepared properly for healthy aging.